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'ý 1.111.1ý1-1 1, I I, ý -,. - - I. t., - -,.4- 7 I ý - - 4 -f!, r I, ý-ý I, " -..., o, --4ý. ý4,. I ýi I., 1, -. 4 I- I 1, I,ý 4 ý A ý (,.. A i I ý-,;-, i I, - ý i, - vr ý; -, ". ý,,I,,.A j ',:ý,.eý - -,,." ý - 1., ý, 1, I I I, 'I ' f,ý,ý., ýý, - ý i I M I.......... IN $Not OW -it' OD La ul cc .1 / / Z/L//XACI LV /1 33 TREATISE ON THE PRINCIP.LES AND PRACTICE OF HOMCEOPATHY. A TREATISE ON THE PRINCIPLES AND OF PRACTICE 6*fof45L HOM(EOPATHY. BY FRANCIS BLACK, M.D. LONDON: JAMES LEATH, 5 ST PAUL'S CHURCH-YARD, (SUCCESSOR TO THOS. HURST); MACLACHLAN, STEWART, & CO., EDINBURGH; J. S. MACHIN, DOLIER STREET, DUBLIN. MDCCCXLII. PREFACE. IN an admirable history of Medicine by Dr Alison, we read a sentence which forms a fitting preface.to Homoeopathy, as it enables us to fulfil the first necessary step in the" introduction of all new systems;.that is, to prove the deficiency of the system that is wished to be supplanted, and also that the system proposed is adequate to supply the deficiency. "Our ropes (says Dr Alison,-p. 110) of the increasing efficacy and usefulness of our art must depend on the progress which may yet be expected in two lines of inquiry, in which our success has as yet been only partial; first, in the discovery of specifics which may counteract the different diseased actions of which the body is susceptible, as effectually as the cinchona counteracts the- intermit vi PREFACE. tent fever, citric acid the scurvy, or vaccination the small-pox; secondly, in the investigation of the causes of disease, whether external or internal." Nor is this a view peculiar to Dr Alison; it has been distinctly expressed by Sydenham in his preface to the Opera Omnia, and by Baglivi, that medicine can alone be perfected by the discovery of specifics, and at the same time they confess the little knowledge they possess of these remedies. The work we now present to the profession we trust may tend to fulfil this end, and put in their possession the so long wished for philosopher's stone of medicine; for since "our hopes of the increasing efficacy and usefulness of our art must depend upon the discovery of specifics," it must depend upon the study of Homoeopathy. Why? Because the doctrine of specifics is simply the doctrine of Homoeopathy. Homoeopathy discloses not only numerous specifics previously unknown, but it also beautifully shews that all medicines are specifics, if given in the appropriate case; it not only discovers specifics, but also gives a law for their universal application. Homoeopathy is, we believe, the first successful generalization of the Materia Medica, and that under one comprehen PREFACE. vii sive principle, Similia similibus curantur. A simple and universal law, founded upon pure induction, therefore not invented, but discovered. Success is the best advocacy of any new practical system. This has been the grand prop to Homoeopathy; it is by its success that it has steadily and rapidly evolved itself from its original neglect, rousing the apathy of the public, awakening the jealousy of the profession, winning adherents, and effecting deep reformations. The tide thus set in motion is sweeping with accelerating velocity over our own country, and, although a system still in its infancy, it has, in the face of the most determined opposition, gained many adherents, and daily do we hear the question asked, what is Homoeopathy? The very necessity which a rapidly advancing science establishes for a frequent and systematic narrative of its progress, and exposure of its improvements, must render the task in its nature imperfect. "Cornm menta seculorum delet dies," a truth daily experience attests, and how much more must the writings on a new system become antiquated and insufficient. Hence, while we feel very strongly how much there is to be said upon Homoeopathy, and have attempted to shape into a commodious form, CONTENTS. CHAPTER I. Allopathic practice divided into the Enantiopathic and the Heteropathic-Its disadvantages as compared with the employment of specifics, or Homceopathy-Fallacies of the present Materia Medica-Its condemnation by writers even of the allopathic school,..... Page 1 CHAPTER II. Sketch of the discovery of Homoeopathy-Life of Hahnemann, 17 CHAPTER III. Allusions to the Homoeopathic law by old authorities-Proofs of the existence of this law as shewn in the employment of many medicines by the old school, such as-Arsenic-MercuryCinchona-Tartar emetic-Iodine-Nitric acid-PlatinumCubebs-Cantharides--Apium petroselinum--ColocynthOxalic acid-Millefolium-Belladonna-Tea - SulphurVaccination-Statement of the law-Isopathy,. 22 x CONTENTS. CHAPTER IV. Explanations of the action of the homceopathic principle-That of Hahnemann-Supposition of Dr Curie and others, that it acts by assisting the vis medicatrix-That of Dr Fletcher,..... Page 48 CHAPTER V. Materia Medica-The effect of medicines should be discovered by experiments on the healthy person-Circumstances necessary to be attended to in such experiments-Various sources from which our knowledge of the pathogenetic effects of medicines are procured,..... 57 CHAPTER VI. Materia Medica-List of the Medicines-Mode of preparationMethod of prescribing,.... 66 CHAPTER VII. Materia Medica-Upon the minute doses employed in homeopathic practice-Before such doses act there must be a special susceptibility of the body-What that susceptibility consists in -Trituration and Division--Efficacy of Trituration-Views of Doppler-Of Peltier, &c.,... 81 CHAPTER VIII. What is disease-Remote and Proximate cause-Totality of the symptoms-Value of Physiology-Pathology-Nosology CONTENTS. xi When the entire symptoms have disappeared the patient is cured-Symptomatic medicine-Erroneous notions entertained as to the homceopathic system being symptomatic,. Page 91 CHAPTER IX. Chronic diseases-According to Hahnemann, attributed to three miasms-Psora, Syphilis, and Sycosis-Review of this doctrine-Medicinal diseases,.. 109 CHAPTER X. Practical application of the homoopathic law-Mode of acquiring a correct image of the disease-Selection of the remedy,-in acute-in epidemic-and in local diseases-Study of the Materia Medica-Cases illustrating the mode of selecting the remedy-Selection of the dose-Medicinal aggravation of the disease-Choice of the dilution-Repetition of the remedy-Mode of administering-Can there be an alliance between Homceopathy and Allopathy?-Use of palliatives, &c. - Diet and Regimen,.. 127 CHAPTER XI. Review of the arguments brought forward against HomoeopathyDenial of facts-Cures attributed to Diet, Nature, and Imagination-The system dangerous because poisons are givenHomoeopathy is admitted to cure chronic, but not acute diseases -Statistics shewing the fallacy of this statement-Trial of Homoeopathy in Russia-in Paris, and decision of French Academy-Why is Homoeopathy rejected by so many medical men?..... 171 ON THE PRINCIPLES AND PRACTICE OF HOMUEOPATHY. CHAPTER I. Allopathic practice divided into the Enantiopathic and Heteropathic-Its disadvantages as compared with the employment of specifics, or Homoeo-- pathy-Fallacies of the present Materia Medica-its condemnation by writers even of the allopathic school. IN commencing the study of medicine, there are three great questions which naturally present themselves to us in a logical order. 1st, By what means is the physician to arrive at the necessary information relative to a disease, in order to be able to undertake the cure? 2d, How is he to discover the powers of medicinesthat is to say, of the instruments destined to cure natural diseases? 3d, What is the best principle for guiding us in the selection of therapeutical remedies? Such a series of questions might be followed easily, were all agreed upon the principles of medicine; but in a treatise which has for its object the reformation of the present e 2- A 2 ALLOPATHIC PRACTICE. existing systems, we prefer commencing at the foundation of all practice-the laws of therapeutics. We therefore propose to reverse the natural order of these queries, and begin with the third. Before answering what is the best mode of applying medicines in the cure of diseases, we must first examine into the different modes in which medicines may be applied, viz. two, Allopathically and Homoeopathically. The term Allopathy, as a general term, is applied to the present prevailing system of medicine; but as ordinary practice owes much of its success to the homoeopsthicity of the means, such cases must be separated; and we intend now to discuss the purely allopathic practice, divided into two heads-the Enantiopathic and the Heteropathic. The Enantiopathic precept, Contraria contrariis opponenda, is the oldest and the most natural therapeutic indication. Thus instinct leads us when cold to warm ourselves; when warm, to cool ourselves; when thirsty, to moisten the mouth. This has led to the employment of purgatives in constipation, of astringents in diarrhoea, of refrigerants in fever, of sedatives in pain, of bloodletting in an excited state of the circulation, &c. But this practice, so natural in theory, is dangerous and often unsuccessful. If we follow Nature as our guide, we find no example of dissimilar diseases curing each other reciprocally, but we observe that the one only suspends the other, except in cases where they blend together, which rarely occurs in acute diseases. It is admitted that enantiopathic practice may in many cases palliate, but it never cures directly; it may relieve, but always at the expense of the patient, as the remedies are administered in large doses. Take, for example, a person labouring under some vio DANGER OF SEDATIVES. 3 lent neuralgic affection. Small doses of a sedative, say opium or its preparations, are given. The pain is relieved, but next day it returns; the dose must be repeated. Day after day it is not only repeated, but increased. What is the consequence? The sufferings may be relieved; but the drug, in addition to removing pain, acts otherwise;-it disorders the digestive organs, causes headache, constipation, &c., rendering the patient miserable, so much so that the relief is far from being equivalent to the disordered health.1 Again, in habitual constipation, a purgative is administered, the bowels are opened, but soon reaction succeeds, and is superadded to the existing constipation; the dose is repeated, increased; ere long we have hwmorrhoids, dyspepsia, and other ills produced. Bloodletting is objectionable on the ground that it is unsuccessful and dangerous, as compared with the employment of specific remedies. It is an indirect, and only palliative mode of treatment, in so far as it only relieves the urgency of the symptoms, but does not effect a radical cure. If inflammation be a name applied to a series of symptoms having for their primary cause an " abnormal condition of the vitaS A striking example of disease increasing after the use of palliatives is found in J. H. Schulze (Diss. qua Corporis Humani momentariarum Alterationum Specimina quaedam expenduntur. Halle, 1741. ~ 23.) Something similar to this is attested by Willis (Pharm. Rat., sec. 7, cap. 1, p. 298). " Opiata dolores atrocissimos plerumque sedant atque indolentiam - - - procurant, eamque - - - aliquamdiu et hoc statu quodam tempore continuant, quo spatio elapso, dolores mox recrudescunt et brevi ad solitam ferociam augentur." And p. 295-" Exactis opii viribus illico redeunt tormina, nec atrocitatem suam remittunt, nisi dam ab eodem pharmaco rursus incantantur." Hunter (in his Treatise on the Venereal Disease, p. 13) says that wine increases the energy of persons who are weak, without bestowing on them any real vigour; and that the vital powers sink afterwards in the same proportion as they have been stimulated, so that the patient gains nothing by it, but, on the contrary, loses the greater part of his strength. EVILS OF BLOODLETTING. 5 ture or the disease." In congestive or malignant fever, in mania, all must admit that its use has been too often followed by impaired health or even by death. Dr Maunsell, in talking of Dr Armstrong's treatment of scarlatina maligna, says, "For such practitionery we know no better advice than that of the judicious Huxham, at least to peruse the sixth commandment." Dr Browne of the Crichton Lunatic Asylum, in an admirable paper upon bloodletting, states, that depletion in mania seems to have "the following disadvantages.-lst, it materially retards the recovery; 2d, It gives a tendency to dementia; 3d, It is sometimes directly fatal; 4th, It debilitates at a period of depression, and in no degree facilitates the operation of other remedies. That even in such patients as have been bled, but are ultimately cured, a stage of imbecility approaching to fatuity separates the period of excitement from that of convalescence. Dementia follows directly, and obviously great evacuations and copious bloodletting where no symptoms of alienation pre-existed. There is a case under my care where incurable dementia succeeded the loss of blood in pneumonia. The fatal consequences of bleeding in delirium tremens have not suggested any warning. Depletion, while the nervous system is in a state of high excitement, proves fatal in various ways. I have seen it induce convulsions, during which the patient died. More frequently the weakness which supervenes is so great, and so little under the control of medicine or diet, that after passing through every stage of prostration and emaciation, the patient sinks from debility or from some acute disease, or, as it were, actually worn out by the irritation of the mental disease. While writing these remarks a copy of the Annual Report of the Northampton Asylum has been transmitted to me, in which a table, shewing the causes of death, contains the ANTIPATHIC TREATMENT. corroborative item. 'Exhaustion from previous depletion, two deaths.' "' Van Swieten and Amelung observe that they also have seen mental aberration rendered incurable owing to bloodletting1.2 Speranza has published some remarkable observations, which shew that among patients attacked with pneumonia, treated by Brera, the deaths were in direct proportion to the number of bleedings. In 100 cases treated without bloodletting, 14 only died; in 100 cases in which two or three bleedings were practised 19 died; in 100 who were bled from three to nine times, 22 died; and in 100 who were bled more than nine times, 68 died.3 We acknowledge that success would attend a true antipathic treatment; but this is impracticable, in as much as we know not even the material proximate cause of all the forms of disease. When the therapeutic operations are directed not against the essence of the disease, but against the isolated symptoms, the predominant functional derangements, the treatment is always incomplete, and often unfortunate, because we run the risk of arresting the reactions by which nature might save herself. Besides, the antipathic method is not always applicable, because frequently we know not the contrary of a great number of anomalies, but merely their negations, which we cannot invoke after the maxim contraria contrariis curanda, but merely in an empirical manner. In this category are placed a number of pains, disorders of sensation, and numerous dyscrasias, of the essential nature of which we are as yet entirely ignorant. SEdin. Month. Jour., vol. i., p. 72, et seq. " Blitter fiir Physchiatrie, 1 cha. Erlangen, 1837. 3 Annal. Universal. di Medecina. vol. viii. Agosto et Settemb. REVULSIVES.-PURGATION. - 7 The heteropathic or revulsive method is founded upon the observation that certain forms of disease disappear at the time when others appear. The metastasis of disease from one organ to another, has given rise to the practice of attempting to remove disease from important organs, by exciting disease in other less important parts. Thus the use of blisters, sinapisms, setons, irritating ointments, pediluvia, &c. Derivatives have been also applied, but more injuriously, to inward organs; and hence we have the frequent and often rash employment of purgatives, diuretics, and sudorifics. Setons and vesicatories are kept suppurating for years, and so recklessly are they and cauteries applied, that hospitals, whether they be places of cure or not, are truly places of torture. No one can be ignorant of the unfortunate effect arising from the abuse of derivatives, especially taken internally. If the Hamiltonian practice, so lauded by many, has been in some cases useful, it is more than counterbalanced by the irreparable injury done to the intestinal canal. The very anatomist takes up the wondrous tale of the efficacy of purgatives, and, demonstrating to his delighted audience the immense extent of the mucous membrane of the bowels, he congratulates them on the extensive field now displayed for the exercise of their purgatives. How contradictory in the allopath to despise purgatives administered by empirics! Morrison and all his followers argue in this way, that if the licensed profession administer purgatives successfully in every disease, if they consider " the bowels to be the sink, whose part's to drain all noisome filth, and keep the kitchen clean," why should he not? Since no disease is treated allopathically without purgatives, we are either to conclude that the practice is unsuc 8 ALLOPATHIC PRACTICE. cessful, or that there is nothing erroneous in the advertisement of the Hygeian College, that " their pills purify the blood, and heal all the ills that flesh is heir to." If the educated medical practitioner were successful in his practice, if his profession approached anything like to certainty, is it probable that the public would leave them and fly to quacks? It is not cheapness that supports the impudent charlatan; it is the uncertainty of the healing art as practised by the educated practitioner. The allopathic method, in addition to its being always an indirect method of cure, must often be injurious, from the large doses which must necessarily be administered, and from the violent means that are resorted to,-entailing, as an inevitable consequence, danger, great annoyance, and pain to the patient; points worthy of consideration when there is undeniably presented to us a direct, more successful, and much pleasanter method, in the specific or homoeopathic. Though the allopathic practice has been considered as embracing two separate principles, still, as these are seldom employed singly, but generally combined, it would be tedious to enter into an analysis of the treatment of each disease; and, in so far as this has been neglected, the review may be imperfect. The great objection to the allopathic method is, that no one law of therapeutics is steadily acted upon, but that all are twisted to accommodate the fancies of each particular pathological school. The materia medica, as employed by the allopathic school, is defective and injurious in many respects. Much talent and time have been deservedly employed in describing the chemical properties, the appearances and origin of the drug, but no proper experiments have been made of its physiolooical action, or its pathological effects. EXPERIMENTS ON THE SICK. Medicines have only been tried upon the lower animals, and always in poisonous doses; but such experiments are liable to error, and are only useful if they confirmed experiments upon man himself. Another field for experiment is the unfortunate patient. Dr Johnson, in reviewing the indiscriminate prescribers of kreasote, iodine, &c., says, " The patrons of the new remedies would seem in their experiments to proceed on the principle of that hospital physician who ordered his clerk to bleed the south ward and vomit the north." They appear to have heard of the observation of the late Dr Pearson. He was testing the effects of the sulphate of baryta: he gave it to almost every patient under his care. When surprise was expressed at this method of procedure, he replied naively enough, "How can I tell what its effects are, unless I give it in every disease?" To be sure, a patient or two may die, but that cannot be balanced against scientific curiosity. But the method ab usu in morbis, to be carefully followed up, should be pursued in Dr Pearson's manner; thus, each medicine should be experimented with in every disease, in order to discover the one in which its action is really salutary; and then every medicine should be givenwin a particular disease, in order to fix upon the one which cures in the most complete and certain manner. But even granting that this were merciful and proper, it still would be defective; for the class of diseases which present themselves as constantly the same is exceedingly small: it is lik4 judging the weight of bodies by putting them into a false balance. The few experiments upon man, and the more violent ones upon the lower animals, are objectionable upon this ground, that when one or two prominent effects are vaguely acquired, the medicines are arranged in certain classes; and when prescribed, the specific properties of each are not con FOLLY OF DRUG-MIXING. 1 11 butt for the' sarcasms -of Arcesilas? Do they never wish to abandon combining a crowd of substances, each of which is often onl-y partially known, or even totally unknown, to the greatest physicians? 'Althog Jones of London consumes each year 500 lb. of cinchona, what certain or complete notion have we of thie particular action of this powerful remedy V We possess very little! What do we know of the pure and special action of mercury? the enormous consumption of which would lead us to suppose that we *knew well, the manner in which it acted upon our bodies. If so singular -an obscurity envelopes each particular drug, it is as nothiing to thie phenomena which the mixtures of. these unknown substances produce in disease. I say that it is to take a handful of unequal balls, then, with closed eyes, launch them. upon a billiard table, wishing to determine beforehand what effect they will produce together, what direction each will follow, in fine, what position each will take lip. Meanwhile, the results of all mechanical powers are much more easily appreciated than the results of dynamic powers. He who frames the prescription, prescribes to each ingredient the part which it is to play in the human body. This will serve as basis, that as adjuvans; a third, as corrigens; a fourth, as excipiens! In virtue of -my power, I forbid all these ingredients to wander from the post assigned them. I wish that the corrective be not deficient in covering the faults of the base or the adjuvant, but I expressly forbid it to leave the boundaries which are traced for it, or to pretend to enact itself a part contrary to that of this base. As to thee, Adjuvant, thou shalt be the mentor of my base, thou shalt assist it in its painful task, but 1 In a certain hospital it is rumoured that large sums have been expended annually upon sarsaparilla; in thel face of the curious fact, that several physicians of the same establishment compare its effects to a dlecoction of hay. 12 FOLLY OF DRUG-MIXING. recollect well that thou art only bound to sustain it; go not, I advise thee, to perform any other duty, or act contrary to it. Have not the audacity to undertake some expedition upon thine own account, or to countermine the intentions of my base; although thou art another thing, thou must still act in concert with her, for I command thee. To all I confide the conduct of a most important affair, expel from the blood what you discover to be impure, without touching what you find to be good; alter what you find to be abnormal, modify what seem to you unhealthy. You have to diminish the irritability of the muscular fibre, to calm the excessive sensibility of the nervous, to procure sleep and repose. See you these convulsions of the arm, these spasms of the neck of the bladder, I wish that you appease them; see you that man a prey to jaundice, I command you to bleach his face and deobstruate his biliary ducts, no matter whether it is spasm or a mechanical obstacle that renders them impermeable. My long treatment and my juices of spring herbs have effected nothing with this hysterical matron; it is this which leads me to admit obstructions in the capillaries of the abdomen, my favourite resource when embarrased. Come here, dear Base, which only a few days back a pamphlet praised as an infallible deobstruent. I charge thee to resolve these indurations, though I know them not myself, as they are invisible, and ignorant of what in the sonorous language of the schools will dissolve or melt them. But thou wilt know what to do when thou art upon the spot. Soemmering correctly remarks that the vessels of enlarged glands, far from being obstructed, are on the contrary larger than natural, but what have we to do with the crude remarks of an idle dreamer? Have we physicians not deobstruated for many ages? It is sufficient then, dear Base, that I order thee to deobstruate. See thou this patient at FOLLY OF DRUG-MIXING. 13 tacked with putrid fever, dear Base, Saltpetre. I pray thee hasten to arrest the putrefaction. Excuse not thyself by saying that thou art always unfortunate in thy expeditions, for I will give thee as adjuvant, sulphuric acid, which will aid thee in all that thou wilt undertake, although these fools of chemists would make us believe that you cannot be found in company without ceasing to be what you are, without being changed into nitrate and sulphate of potash, as if that could take place without the consent of him who framed the prescription! Nevertheless, I order thee to arrest the putrid fever. You hold of me thy diploma of base, and I will add to thy service a crowd of adjuvants and correctives. Dear Base, Opium, I have an obstinate and painful cough which I reserve for thee to attack. I confide to thee this task, to thee whom the Asclepiades have granted the duty of relieving spasms and pain, however different they may be, as the seven planets have received the order in the secular calendar to rule such or such part of our body. I have, however, heard that sometimes thou bindest the belly. In short, that this phantasy may not seize thee now, I associate with thee such and such a laxative drug; it is for thee to watch that this latter does not destroy thy action. It has also been whispered thatheat of skin and perspirations are caused by thee. If it is so, I give thee camphor as corrective, to control thy conduct. Some one has lately pretended that thou lost thy properties by marching side by side. But we cannot suffer this. Each of you ought to fill the office which has been assigned you by the constitutional materia medica. But they still tell me that you hurt the stomach; but to correct this inconvenience I will order with thee several stomachics, and I command the patient to drink a cup of coffee, which, according to the writings of ourschool, aids digestion, for I have no confidence in these in 14 FOLLY OF DRUG-MIXING. novators who say, on the contrary, that it impairs it. As a last advice, thou wilt take care that the stomach be not weakened, for to this end art thou base. And thus it is that each ingredient of a prescription receives its part, as if it were a being endowed with consciousness and liberty. Three, four symptoms and more ought to be combated by as many different remedies.* Imagine, then, Arcesilas, how many drugs must be accumulated, secundunm artis leges, in order to direct the attack at once upon all points. Tendency to vomit requires one thing; diarrhoea, another; fever, and nocturnal sweats, a third. Besides, the poor patient is so feeble, that he needs much a stimulant, or even several, in order that what cannot be done with one may be effected by the other. But what should happen if all these symptoms depended upon the same cause, as is almost always the case, and if there existed a drug sufficient for all these symptoms? Ah, that would be a different thing. But it would be tedious for us to make researches of this kind; we find it more convenient to introduce into the formula something which responds with each indication, and acting thus we obey all the commands of the school. But Science, but the precious life of mani! No man can serve two masters at once. But do you conscientiously believe that your mixture goes to produce that which you attribute to each ingredient, as if the drugs which compose it ought to exercise no influence, no action, the one upon the other? Do you not see that two dynamic agents can never, when united, produce what they would do as separate? That from that arises an intermediate effect which previously we could not calculate upon. Learn, then, that three, four, &c., substances mixed together do not produce what you would expect were they given' CONFESSED IMPERFECTIONS. 15 singly,,at different times; and that they determine whether you see it or not an intermediate effect. In such cases the order of battle which you assign to each ingredient absolutely serves for nothing. Nature obeys eternal laws without asking you if she ought. She loves simplicity, and does much with a single remedy; whilst you do so little with so many. Imitate then Nature. To prescribe compound prescriptions is the height of empiricism. To give only simple remedies, and to wait before prescribing a second until the first has exhausted its action, is rational, and leads directly to the sanctuary of the art." As opinions such as have been stated, may be thought to be peculiar to those who practise homoeopathy, we quote the corroborative opinion of a no mean authority,-that of Bichat. " There is not in the Materia Medica any general system, but this science has been by turns influenced by those who have ruled in medicine; each has flowed back upon it, if I may use such an expression; hence the vagueness, the uncertainty, which now present themselves. The incoherent assemblage of opinions themselves incoherent, it is perhaps of all the sciences the best representation of the caprices of the human mind. What do I say? It is not a science for the methodic mind, it is a shapeless assemblage of inexact ideas, of observations often puerile; of deceitful means, of formulas as absurdly conceived as they are fastidiously collected. It is said the practice of medicine is disheartening; I say more, it is not in any respects that of a reasoning man, when we draw the principles in a great measure from our Materia Medica." "Loin de s'enricher dans laproportion des autres branches de la medecine, dit un homme qui en a parle en connaissance de cause, cette science (la matiere medicale) a rdellement 1 Anat. Gen. Consid. Gen., tom. i., p. 46. 16 CONFESSED IMPERFECTIONS. fait des pas rdtrogrades; une foule de substances et d'agens qui jusque-la avaient 6t6 regardd comme salutaires, sont tombes dans l'oubli, on bien out t6 proscrits; les nombreuses recherches qui avaient etf faites jusqu'a nous sur les vertus des mndicamens out cess6 d'&tre consult6es; et lPon a 6t6 jusqu' a cc point de scepticisme, et d'incertitude, qu'on a rdvoqu6 en doute l'efficacit6 des substances les plus hbroiques." Sydenham writes, " Seepe accidit ut facies morbi variet pro vario medendi processu, ac nonnulla symptomata, non tam morbo quam medico debeantur." " We can hardly refuse our assent to the observations of the late Sir Gilbert Blane, that in many cases patients get well in spite of the means employed; and sometimes when the practitioner fancies he has made a great cure, we may fairly assume the patient to have made a happy escape." 2 SBibliothrque de Therapeutique, par A. L. Bayle, tom. i., preface. 2 Pereira, Lectures on Pharmacol. Med. Gaz. Oct. 24. 1835. 3 HAHNEMANN. 17 CHAPTER II. Sketch of the discovery of Homceopathy.-Life of Hahnemann. SAMUEL HAHNEMANN, the founder of Homoeopathy, was born on the 10th of April 1755, at Meissen, a small town in Saxony. He commenced his medical studies in Leipsic, afterwards attended the hospitals of Vienna, and finally obtained the degree of Doctor in Medicine at the University of Erlangen in 1779. The commencement of his career was marked by a zeal and activity which he has nobly evinced through his whole life;. but to his reflective mind Medicine presented too many glaring inconsistencies, and accordingly he strove to reconcile the various theories of the day with the practice of the most eminent. This investigation proved a most unsatisfactory task, and induced him to abandon the practice of medicine. Quoting his own words, as when he wrote to the illustrious Hufeland,-" Eighteen years have elapsed since I quitted the beaten path in medicine. It was agony to me to walk always in darkness, with no other light than that which could be derived from books, when I had to heal the sick, and to prescribe according to such or such an hypothesis concerning disease, substances which owe their place in the Materia Medica to an arbitrary decision. I could not conscientiously treat the unknown morbid conditions of my suffering brethren by these unknown medicines, which B 18 HAHNEMANN. being very active substances, may (unless applied with the most rigorous exactness, which the physician cannot exercise, because their peculiar effects have not yet been examined) so easily occasion death, or produce new affections and chronic maladies often more difficult to remove than the original disease. That I might no longer incur the risk of doing injury, I engaged exclusively in Chemistry and in literary occupations." While translating the Materia Medica of Cullen, Hahnemann was struck with the attempted explanation of the febrifuge operations of cinchona; to him it appeared that if it was correct, bark should cure all forms of intermittent fever; but this, after patient research, he found to be belied by experience. He was then struck with the fact, that cinchona given to a healthy person, produces symptoms analogous to intermittent fever. This fortunately arrested his attention; he tried the bark upon himself when in health, and found that the statement was correct. The truth now began to dawn upon him; but proceeding upon pure induction, he repeated the experiments upon others, and also used various drugs; each new trial confirmed his opinion, and the year 1790 gave birth to the principle-Similia similibus curantur.1 Searching among the records of ancient and modern medicine he discovered that this principle was constantly shewn in the operation of medicines designated as specifics. He was also further confirmed in his views, by finding that several eminent authorities had obscurely alluded to it. Coinciding with the immortal Haller, that remedies should ' It was first published under the title:-Attempt to find a New Principle for the discovery of the Healing Power of Medicine, along with some observations on the existing methods. Hufeland's Journal, ii. Band. 3 ter., Stick. 1796. 20 HAHNEMANN. In the course of the ensuing year he returned to Leipsic, defended in public an essay " De Helleborismo veterum," and pursued the practice and teaching of Homceopathy. At the same time he commenced the publication of his " Materia Medica Pura," six volumes of which appeared in succession. But his success in Leipsic excited the jealousy of the profession, and led them to instigate the Apothecaries to carry into execution an obsolete law, forbidding the Physician to prepare and dispense his own medicines. This forced him to abandon his lucrative practice and settle at Koethen, where he was kindly received by Duke Ferdinand, freed from the immunity of the apothecaries' monopoly, and honoured with the title of Councillor of State. Here he remained several years, during which time he wrote his work on Chronic Diseases. He has now for some years resided in Paris, and, though verging upon the advanced age of 88, is full of health and mental activity. Hahnemann is the only one who has made a successful generalization of the Materia Medica, and that under one comprehensive principle,--Similia similibus curantur. He has discovered, not invented; he has founded a method of treatment, not one to be added to the methods already known,not one to be considered as only useful in certain exceptional cases when the ordinary practice fails,-but one which is the only manner of treating diseases,-TutO, cito et jucunde. But the results of his truly philosophic mind have been thee satisfied, no one could mistake for a master's hand, to the opinion of that original and extraordinary genius Richter: " Hahnemann, this rare doublehead (Doppelkoff) of learning and philosophy, whose system must drag to ruin the vulgar receipt-heads (Receptirk6pfe); although at present it is but little known and more scoffed at than welcomed." HAHNEMANN.2.21 found to strike at the vitality of the ordinary practice; he has been denounced and persecuted as a knave and charlatan. Providence has so willed it that he has risen superior to such petty opposition, and now in his old age has the satisfaction of seeing that his doctrine triumphs, that his disciples multiply, and join with him in the glorious task of supporting and perfecting that edifice he has so nobly designed. Even in the days of his bitterest persecution, he could comfort himself with the saying of Bacon, that "Truth which only doth judge itself, teacheth that the inquiry of truth, which is the love making or wooing of it; the knowledge of truth, which is the presence of it; and the belief of truth, which is the enjoying of it,-is the sovereign good of human nature. Certainly it is heaven upon earth to have a man's mind move in Charity, rest in Providence, and turn upon the poles of Truth." 22 ALLUSIONS TO LAW. CHAPTER III. Allusions to the Homceopathic law by old authorities-Proofs of the existence of this law as shewn in the employment of many medicines by the old school, such as Arsenic-MVercury-Cinchona---Tartar emetic-IodineNitric acid-Platinum-Cubebs-Cantharides-Apium PetroselinumColocynth-Oxalic acid-Millefolium-Belladonna- Tea--SulphurVaccination-Statement of the law-Isopathy. HAHNEMANN having discovered the law Similia similibus curantur, then sought among the writings of his predecessors to find corroborative evidence of a law, which, if so fundamental to success, must, he concluded, pervade more or less the present system of medicine. The following passages would seem to shew that the probable utility of homoeopathic practice had been observed by some previous to Hahnemann; but to him alone is the honour due of having experimentally proved and clearly expounded this law. As far back as in a work ascribed to Hippocrates, the following passage is found: " Similar effects must by similar creating causes be treated, and not by opposite agencies."1 Paracelsus, in talking of specifics, observes,-" It is a perverted means taught by Galen to give remedies which produce the contrary of the disease; remedies ought to be administered which act similarly to it." Stahl clearly admits the law when he says,-" The received method in medicine, of treating diseases by oppo SBasil, Froben, p. 72. 1538. ALLUSIONS TO LAW. 23 site remedies, that is to say, by medicines which are opposed to the effects they produce, is completely false and absurd. I am convinced, on the contrary, that diseases are subdued by agents which produce a similar affection; burns by the heat of a fire to which the parts are exposed; frostbites by snow, or ice-cold water, &c."' Basilius Valentinus, in his work " De Microsmo," writes: " Like is to be expelled by its like, and not by its contrary; heat by heat, cold by cold, &c." De Haen also perceived the principle, and says that dulcamara in large doses excites convulsions and delirium, and in small quantities relieves similar affections."2 Delharding thought that senna cured a peculiar kind of colic, because it possessed the power of producing a similar malady in healthy persons.3 Boulduc attributed the virtues of rhubarb in checking diarrhoea, to its purgative properties.4 Bertholon informs us, that, in diseases, electricity diminishes and finally removes a pain which is very similar to one which it also produces." Thoury affirms that positive electricity accelerates arterial pulsation; also that it renders the same slower when it is already quickened by disease.' These few quotations are sufficient to shew, that the homoeopathic law was perceived, though very vaguely, by several during the earlier periods of medicine. But if this law is true, though so long unknown, we ought still to find traces of it in the numerous reports of cases cured; and such is the fact. Hahnemann, with his usual industry and 1 Hummel, Comment. de Arthritide tam tartarea quam scorbutica, seu podagra et scorbuto, Budingae, 1773. P. 40-42. 2 Ratio Medendi, Part iv., 227. a Eph. Nat. Curt. Cent. x. obs. 76. 4 Mem. de 1'Acad. Royal, 1710. 6 Medic. Electricit., ii. pp. 15, 282. 6 Mem. lu a l'Acad. de Caen. 24 ARSENIC, care, has collected an immense number of cases, proving that prompt, perfect, durable, and manifest cures, have been made by physicians during all ages, although by chance, upon true homoeopathic principles.' At present we would wish to shew that the principal medicines, those which are given as specifics in many diseases, are in accordance with this law. For this purpose, in the left hand column is given the disease or symptoms in which the medicine has been found useful; and in the right hand column the pathogenetic effects of the medicine, as attested by well known allopathic authorities. ARSENIC. It will be admitted by all that this medicine has been often found successful in intermittent fevers (Fowler's Reports, &c., Lond. 1736); and considered by some preferable to quinine, when the disease is attended by inflammatory determinations (Cyclop. of Pract. Med., vol.ii., p. 220). Among the symptoms produced by arsenic, Boudin thus writes,-" Quelquefois augmentation de la force et de la frequence du pouls, qui diminue ensuite. M. Biott avait remarquez dans ces changemens de pouls, une sorte de periodiciti" (Boudin's own italics). " Pour mon compte j'ai vu survenir une fievre intermittente quotidienne, que je fus oblige de combattre par la quinine, chez un de mes malades, qui, pour cause d'ichthyocose, avait pris vingt-quatre centigrammes" (about 5 grains) " d'acide arsenieux en douze jours.... Sa fievre intermittente se manifesta a une epoque, ou aucune maladie semblable ne regnait eui ville." (Traites des Fievres Intermittentes, par J. C. M. Boudin. Paris, 1842.) This is confirmatory of the pathogenetic effects of arsenic, as collected by Hahnemann,2 who states that it causes ter 1 These observations will be found in Appendix, I., and should be read before proceeding further. 2 No objection can be made in this case to the authority of Hahnemann, as he is frequently quoted by Dr Christison in his article on Poisoning by Arsenic. Dr A. T. Thomson, in talking of arsenic as a tonic in intermittent fever, adds,-" It is not easy to explain the manner in which it produces its beneficial effects as it sometimes produces symptoms iat rari,,ncc with our notions of those which follow the exhibition of a tonic, and yet it cures the disease.!!" A glance at -Hahnemann's Mat. Medica will explain the difficulty,-it is homnoopathic to ague. ARSENIC. 25 - Dr Rush, in speaking of Dr Martin's specific, which was chiefly composed of arsenic, says, -" In several cancerous ulcers, the cures he performed were complete." In Cooper's Surg. Dict. (5th edit. p. 284), we find that " Justamond thought arsenic a specific for cancers. It unquestionably cures numerous ill-looking sores on the face, lips, and tongue, and is one of the best remedies for lupus." Mr Hill observes, " Experience has furnished him with some substantial reasons for considering arsenic as a medicine of considerable merit in true scirrhous tumour." (Edin. Med. and Surg. Journ. vol. vi. p. 58.) Arsenic is much vaunted in many cutaneous affections. " Much benefit will be derived (in obstinate cases of nettlerush) from small doses, gradually increased, of Fowler's arsenial solution." (Library of Prac. Med. vol. i. p. 476.) It is sometimes given with advantage in chorea and other affections of the nervous system. tian, quartan, sometimes daily fever, the symptoms of which closely resemble ague. (Mat. Med. trad., par Jourdan, tome i, p. 414 et seq.) Dr Paris states, that " the influence of the arsenical fumes is very apparent in the condition both of the animals and vegetables in the vicinity. It deserves notice, that the smelters are occasionally affected with cancerous disease of the scrotum, similar to that which affects chimney-sweeps." (Pharmacology, 7th edit., vol. ii., p. 96.) Dr Pereira says,-" The fumes from these works (where arsenic is sublimed) are most injurious to neighbouring vegetables and animals. In the human subject, eruptions, principally about the lips and nose, are produced by them." (Mat. Med, part i. p. 375.) Hargens noticed ulcers with burning pains from the internal use of arsenic; and also ulcers which bleed easily and have a thin scab. (Hufeland's Journ.Part xx. p. 1.) Heinge saw a cancerous ulcer, caused by arsenic, which progressed to such an extent, that the leg affected was obliged to be amputated. (Hufeland's Journ. Oct. No. 1813, p. 38.) Fowler observed an eruption caused by arsenic which resembled urticaria. (Fowler's Reports, &c. p. 97. Lond. 1786.) "C The sensation of tingling in various parts of the surface, which at the same time not unfrequently exhibits an erythematous or vesicular eruption, are very common effects from the internal use of arsenical preparations." (Med. Chir. Rev. Oct. 1835, p. 421.) In a case of poisoning, reported by Dr Desgranges, the body, especially the hands and feet, were covered with a considerable eruption of small pimples, with white heads like millet. (Foder6, vol. iv. p. 123.) Dr Periera mentions the following as some of the effects of long-continued small doses: " Headach, giddiness, and want of sleep are frequently observed. The limbs become painful, feeble, trembling, subject to convulsions, occasionally benumbed, MERCURY.. Mercury is considered a specific in diseases of the liver, Mercury is often given with advantage in acute and chronic rheumatism, tinal canal; such as occurs in fever, hepatitis, dysentery.1 Dr Murphy says, "mercury produces dysentery and ulceration of the intestines." (Med. Chir. Rev. Oct. 1839, p. 480.) Dr Colles observes, "c During this critical period (salivation), the patient is liable to attacks of griping, frequent desire to go to stool, and tenesmus; these efforts are attended' with only slight evacuations, which chiefly consist of mucus tinged with blood; sickness of stomach and vomiting also often supervene, the skin is hot, and the pulse quick. All of which phenomena are explained by the fact, that the specific influence of the mercury has taken effect upon the alimentary canal, instead of the salivary system. This dysenteric affection so generally appears at this period, that the patient should be forewarned and prepared for it." (Med. Chir. Rev. Jan. 1838, p. 76.) " It cannot, however, be denied, that the immoderate use of mercury has been productive of liver disease. The late Mr Hewson pointed out this to the attention of those who visited the Lock Hospital while under his care. At this period it was the custom to salivate every patient, and keep him under the full mercurial influence for a month or two, and it frequently happened, that, just as the mercurial course was finished, the patient got disease and enlargement of the liver." (Prof. Graves' Clinical Lectures, Meqd. Gazette, vol. xix. p. 452.) Dr Murphy observes," The tendency of fibrous structure to disease after a mercurial course is well exemplified by rheumatism." This effect of mercury is now so well known that it has received a distinct appellation-mercurial rheumatism. (Med. Chir. Rev. Oct. 1839, p. 483.) " Mercury given without caution often produces the same symptoms as rheumatism." Cooper's Surg. Dict. 5th Edit. p. 1204.) Hunter tells us that "1 mercury often produces pains like those of rheumatism and nodes." (On the Venereal, p. 339.) I Is this not a pretty distinct avowal that Similia similibus curantur? CINCHONA. 29 It is unnecessary to quote authorities proving the efficacy of mercury in jaundice. Dr Johnson remarks, " Dr Colles takes no notice of a tendency to jaundice after a mercurial course, yet we have seen several examples of it." (Med. Chir. Rev. Jan. 1838, p. 81.) Dr Cheyne observes: " It does not appear to be generally known, that mercurials actually produce jaundice, though it is a fact of which I have seen, within the last two years, three striking examples." (Dublin Hosp. Reports, 1818.) Dr Chapman, Professor of Medicine in Philadelphia, has observed similar cases. (Amer. Journ. of Med. Sciences, vol. i.) CINCHONA: Cinchona bark, and its preparations, are admitted by all to be specific in intermittent fever, especially when attended with congestion. We may also add, that Dr Cullen in his Materia Medica, says,-" I have met with cases, in which all the symptoms of consumption, the exacerbations of the hectic fever were marked with more or less of a cold stage, and regularly at stated periods, commonly every day, but sometimes every other day. In such cases I have given the bark with the effect of preventing the return of such symptoms for some time, and at the same time with the relief of almost all the other symptoms of the disease." He states that he again and again stopped similar paroxysms by the same 'means: It is also the case that cinchona and quinine are homoeopathic to the local lesions which accompany or supervene upon intermittent fever, such as enlargement and congestions of the liver and spleen, dropsy, &c. " Treatment of dropsy from disease of.the liver and spleen.... A nearly similar treatment will be necessary when the spleen is enlarged, to that now recom Stahl, in his Diss. Problem. de Febribus, states that it causes irregular acute fever, with very excessive perspirations. Morton states the same; Schlegel says that it causes febrile heat that is followed by debilitating perspiration. (Hufeland's Journ. vol. 7, part 4, p. 161.) Fr. Jos. Wittman, in an essay on sulphate of quinine, that obtained a prize, May 21. 1825, from the Medical and Scientific Society of Haerlem, details many experiments in which it is shewn that when administered in certain doses to a person in health, it produces a disease resembling ague.1 Prof. Luders, physician to the hospital at Kiel, states that enlargements of the spleen, dropsy of the feet, and nervous disorders, often follow the incautious use of quinine. (Med. Chirurgical Journal of Erhardt, vol. iv. p. 90.) Menard says that 30 - 40 grains given, in cases of intermittent fever, will almost certainly cause enlargements of the liver and spleen, else consumption or dropsy, and hence advises that the largest doses shall not exceed 10 - 12 grains. (Bulletin de la Soc. d'Emulation de Paris, Janvier, 1821.) SA reference to Hahnemann's experiments will confirm this point, and there also it will be found, that it is homoeopathic to the other diseases in which Dr Thomson (Mat. Med. p. 492) "speaks of its efficacy, such as " chronic pulmonary catarrh, kept up by a weakened habit; in chronic diarrhoea, in passive hmmorhages; in dyspepsia, anorexia, and every case of direct debility;" also to strumous ophthalmia, in which it has been very usefully employed by many. IODINE. 31 feet of cbntagion has been prevented; and in many instances, as in other fevers, the disease has been cut short. Both tartar emetic and ipecacuanha, particularly the latter, have been judiciously selected for this purpose by the best practitioners. (Thomson's Mat. Med., p. 725.)' hepatized. (Magendie sur l'Emetique, Paris, 1813, p. 24 et seq.) Schloepfer found that, after the injection of a solution of tartar emetic into the windpipe, death ensued in three days; the lungs and stomach were seen much inflamed, particularly the former. (De Affectibus Liquidorum, &c., p. 32.) Orfila writes, " Independently of the inflammation, more or less intense, of the parts to which the tartar emetic is in contact, this poison causes also phlogosis of the lungs and digestive canal. The deleterious effects of the tartar emetic are manifested, whether it be injected into the veins, introduced into the digestive canal (provided it has not been vomited for some time after its introduction), or into the serous cavities, or applied to the subcutaneous tissue: it acts particularly in inflaming the lungs, and mucous membrane which lines the intestinal canal, from the cardia to the inferior extremity of the gut." (Traite de Medecine Legale, 3d edit., t. 3, p. 218.) IODINE. " This renders it a most useful remedy in ascites, connected with diseased states of the liver and the mesenteric glands." " Dr Baron of Gloucester succeeded in curing that disease by its means; and I believe a case has also proved successful in the hands of Dr James Johnson.. The tincture has also succeeded in reducing enlargements of the liver, when all other means had failed." (Thomson, Mat. Med., p. 848.) ' Enlarged liver and spleen removed by iodine. Three cases of this kind have recently been reported by Dr Milligan, from the Royal Universal Infirmary for children, which appear to prove the superiority of iodine over mercury in glandular and visceral tumours." (Med.-Chir. Rev.,vol. ix., p. 168.) M. Zink found, in a case, fatalfrom iodine, which came under his notice,-enlarged abdomen from distension of the intestines with gases, enlargement of the other viscera, and serous effusion into the peritoneum, - - enlargement and pale rose-red colour of the liver; - - in the chest, serum was found in the sac of the pleura. (Journ. Complementaire, xviii., p. 126, quoted in Christison on Poisons, 1829, p. 138.) In a fatal case described in Rust's Journal, the leading symptoms were pain in the region of the liver, loss of appetite, emaciation, quartan fever, diarrhoea, excessive weakness, and, after the emaciation was far advanced, a hardened liver could be felt. (Magazin fir die gesammte Heilkunde, xvi. 3.) 1 That Ipecacuan is also homceopathic to dysentery, see Hahnemann's LMat. Med. 32 IODINE. Iodine has been recommended by several in epilepsy-and other nervous disorders. Dr Streeten, in his Retrospective Address, referring to iodine and its preparations, says,-" The diseases in which it was found most efficacious were certain chronic syphilitic affections, and especially such as are the combined results of syphilis and mercury; and various scrofulous degenerations." (Trans. of Provincial Med. and Surg. Association, vol. x., p. 87.) Its use is attended occasionally with " symptoms which resemble those of shaking palsy." (Thomson, Mat. Med., p. 258.) Diirr observed in a patient with goitre, where iodine ointment was applied, that it caused tremblings in the limbs and muscles of the face, anxiety, palpitations of the heart, vomiting, violent headache, and lastly, accessions of convulsions, attended with foaming at the mouth." (Schweizerische Zeitschrift fiir Natur und Heilkunde, vol. ii., Heilfronn, 1836.) Dr Streeten quotes from Dr Lawrie of Glasgow, who observed the following symptoms produced by the employment of iodide of potassium. (See Lond. Med. Gazette, July 1840.) " The mucousmembrane of the eyes and air-passages are said to be especially liable to become affected. In one instance the employment of the medicine was followed by urgent dyspnoea and loss of voice; in another by excruciating headache, acute pain in the eyes, profuse secretion of tears, intense pain in the nostrils, with swelling and discharge of clear serous fluid; in a third by fatal dyspnoea; in a fifth by profuse papular eruptions, which disappeared on the iodine being omitted, and reappeared on its being again resumed, followed by sore throat, acute dyspncea, and hoarseness, with fatal result; the mucous membrane of the upper part of the larynx, rima glottidis, and epiglottis being found <edematous on inspection; in a sixth by intense headache, slight salivation, and sore-throat, and in a seventh by severe headache." (Loc. cit.) 5 NITRIC ACID, &c. NITRIC ACID. 33 SNitric acid has been found to be of great use in salivation and ulcerations of the mouth, brought on by the use of mercury. (Alyon, in the M6m. de la Soc. d'Emulation. Blair, Essay on, &c., London, 1808. Beddoes, London, 1779.) Dr Scott gave it in syphilis, and applied it externally, largely diluted, as a bath, until the gums were affected, and ptyalism produced." (Med. Chir. Trans., vol. viii., p. 173, et seq.) " In some cases it has excited ptyalism, and from this circumstance, as well as from the occasional benefit derived from its use in the venereal disease, it has by some writers been compared in its operation to mercury." (Pereira, Mat. Med. part i., p. 162.) PLATINUM. Dr Ferdinand Hoefer has made, of late, experimental researches upon platinum and its preparations; he mentions that it proves useful chiefly in syphilitic and rheumatic affections. (Gaz. Med. de Paris, Nov. 28. 1840.) Dr Streeten (Trans. Provin. Med, Surg. Assoc., vol. x., p. 89.), reviewing Dr Hoefer. says the action of this metal seems to be alterative, analogous to that of gold and mercury. But at page 26 we have shewn that mercury is homoeopathic to syphilis and rheumatism. From the above statement we can also deduce that the preparations of gold, which have of late been given extensively in secondary syphilis, are also homoeopathic to this disease. CUBEBS. " Cubebs," says Sir Astley Cooper, " is a remedy of a most admirable and useful kind, and may be given with advantage even in the inflammatory stages of gonorrhoea." (Lectures, p. 506.) Sir Astley proceeds to add, " Cubebs appears to produce a specific inflammation of its own on the urethra, which has the effect of superseding the gonorrhoeal inflammation." (Lectures, p. 506.) CANTHARIDES. Cantharides has been given with great It is familiar to all that cantharides proadvantage in gonorrhoea and gleet, in dy- duces dysuria and strangury. suria and strangury.* It produces inflammation of the genitals, (Smith's Med. Communications, ii. p. which even runs on, as Ambrose Pare no505. Young, Phil. Trans., No. 280. Th. ticed, to gangrene. Bartholin, Epist. iv. p. 345.) Dr Mackintosh says: " Among other causes, inflammation of the urethra is produced by the action of cantharides upon the system." (Pract. of Physic, vol. ii., p. 249.) SDr Groenvelt, in 1693, was committed to Newgate, by a warrant from the president of the C BELLADONNA. 35 ca-Medisch. del Piemonte, Jan. 1841; spontaneous vomiting is only mentioned also, Edin. Med. & Surg. Journ, July in two instances; but in several more or 1841. less of gastric irritation remained. (Beck. Med. Jurisprudence, edit. 6, p. 705.) MILLEFOLIUM. Johann Schrcederer observes: " Mille- The same writer says,-" If the fresh folium is useful in bleeding from the nose, weed be applied to the nose it causes bleedhammoptysis, menorrhagia, abortion, pain ing. It is a very remarkable fact, when and running from haemorrhoids." applied outwardly it should stop epistaxis, Materia Medica by Koschwartz, Num- and when put into the nose should cause berg, 1693, p. 1058. it to bleed, and so produce two opposite effects." (Loc. cit.) BELLADONNA. In rendering proofs of the prophylactic virtues of Belladonna in scarlet fever, to avoid all appearance of partiality, we quote from an allopathic authority, from M. Bayle, who can have no object in testifying to facts which bear strongly in favour of homoeopathy. " At the end of last century, Hahnemann, having remarked that belladonna, taken in small doses, gave rise to a reddish eruption analogous to that of scarlatina, predicted that belladonna would be a prophylactic to this disease, according to the homoeopathic principle that diseases are cured by medicines, the effects of which, upon the organism, are similar to the symptoms of those diseases. " Notwithstanding some facts which seemed to confirm this hypothesis, it was only about 1812 that several physicians made methodic trials to establish this point. But since that period to the time I now write, more than twentyfive practitioners have been occupied in establishing the preservative properties of belladonna against scarlatina. The epidemics of this disease having been frequent in the north 36 BELLADONNA. of Europe, and often more fatal than the small-pox, the authors, who have been occupied in verifying this point in therapeutics, belong all to this part of the world.* " The following is the resum6 of the different trials:In 1812, a fatal epidemic reigned in the district of Hilschenbach, in the duchy of Berg; 8 persons died of it, 22 were ill. Schenk administered belladonna to 525 persons; 522 were preserved. The three, who were attacked, were a mother and her two children who had only taken the medicine four times. "Hufeland, and Rhodius gave perfect immunity to all the individuals to whom they had administered this substance, in several very violent epidemics. The last of these authors cites seven individuals who did not contract scarlatina, notwithstanding their continual intercourse with the sick. Murhbeck, at Demnuin (Western Pomerania), obtained the same success during seven years, in which he had frequent opportunities of having recourse to this treatment. Masius saved, by the same means, himself and four children * Perhaps the reader may not admit the testimony so readily. But why should the fact of their being northerns, in any way limit or damage the worth of their creed, or of their experiments. This is somewhat akin to the old cant cry of German mysticism,-a cry our opponents vociferously favour us with. Mysticism may arise from various sources. Every thing is mystic to a fool, or to one that either does not, or will not, understand his author. It is too bad, however, for one to complain of mysticism in an author because, forsooth, his ditch-water plummet cannot by any means find the bottom of what is not measured by inches at all. German mysticism! Alas, the poor Germans with their quite incomprehensible Luther and Melancthon, their Guttemberg and Beethoven, their Blumenbach, their Miiller, and Liebig, with a host in all regions of knowledge, whose name is legion! But as matter of course seeing our Religious Reformation turned out so very mystic a matter in the hands of the mystic Luther, it must needs be that our Medical Reformation shall prove an equally mystic business, because poor Samuel Hahnemann has the misfortune to be a countryman of Luther! BELLADONNA. 37 from the attacks of scarlatina which then made great ravages. " Gumnpert, physician at Posen, preserved his 4 children and 20 families, amounting to about 80 individuals; 2 persons were, however, attacked. In one the belladonna had only been used some days: in the other the disease declared itself in the second week. Gumpert (senior) prevented the introduction of the epidemic into several villages by administering the medicine continuously at the proper time. He remarked that in those where the epidemic had already appeared, the employment of this substance rendered the scarlatina very mild. In the district where he practises, the public have as much confidence in it as in vaccination, and the local authorities are ordered to furnish gratis this medicine. "In the very fatal epidemics of 1817, 1818, and 1819, Berndt, physician at Custrin, made use of two preparations of belladonna. With one he preserved all the subjects; with the other he obtained the following result:-out of 195, 14 were attacked, and 181 preserved. The eruption was very slight among the small number of those who contracted the disease. One of the authors whose observations are the best calculated to prove the prophylactic efficacy of belladonna is Dr Dusterberg of Warbourg. In three consecutive epidemics, this practitioner preserved from contagion all the individuals who made use of this remedy, although they were allowed to visit and keep company with the sick. He therefore regards this practice as certain a prophylactic as vaccination. To be more certain of his results, Dusterberg made a still more conclusive experiment; he chose, in each family submitted to the prophylactic treatment, a child who had not taken belladonna; all the chil 38 BELLADONNA. dren thus excepted were attacked by the contagion. Dusterberg adds, it is true that several other children, who had only used the remedy for four or five days, were also attacked, but so feebly that the only trace of the scarlatina was the subsequent desquamation. Among several of those who were preserved, there appeared a general apyretic eruption a little analogous to scarlatina, but which was only the effect of the belladonna observed by Hahnemann. "In 1820, during the course of a very fatal scarlatina, Behr, physician at Bernbourg, gave the specific to 47 individuals; among these 41 escaped the contagion, and 6 were attacked, but in an almost insensible manner. In two epidemics which reigned at Colmar in 1820 and 1821, M. \Meglin gave immunity to every one. Of 7 children inhabiting the same room, Kohler preserved 6; 1 only had the disease. 120 persons were attacked with scarlatina in a village of Silesia; W olf gave them belladonna, and after that the disease was very mild. In two other villages, 132 healthy individuals employed the same means, 6 contracted the contagion, 126 escaped it. "During an epidemic which reigned at Siegen, Schenk preserved 3 children whose mother had scarlatina; Benedik, in the island of Rugen, saved 10 who were similarly circumstanced; Wesner, at Dulmen, obtained similar success in his own children. Twenty-three children out of eighty-four were attacked with scarlet fever in the Military Foundling Hospital of Hall, in Tyrol. Zeuch, physician to the establishment, gave belladonna to the 61 remaining; all were preserved with the exception of 1; and, meanwhile, the epidemic continued to rage in the environs of the hospital. Several persons died of scarlatina in the village of Miaskowo; from the time that they had recourse to the or 40 BELLADONNA. NUMBER o AUTHORS who have given BELLADONNA. Schenk,.. Rhodius,.. Masius,.. Gumpert,.. Berndt, Behr,. Kohler, Wolf,.. Schenk, Benedik,.. Zeuch,. Kunstmann,. Genecki,.. NUMBER Of persons who took BELLADONNA. 525 7 5 84 195 47 7 132 3 10 61 70 94 170 70 300 247 NUMBER of persons preserved from SCARLATINA. 522 7 5 82 181 41 6 126 3 10 60 69 76 170 66 280 234 NUMBER of persons attacked. 3 2 14 6 1 6 1 1 8 4 20 13 Maisier, Velsen, Total, { I i 2027 1948 79 I - " All authors, however, are not partisans of belladonna. Lehmann asserts that this medicine had no preservative virtue in the epidemic of 1825 at Torgo. According to Barth, two other physicians, Raminski and Tuffel, have also pronounced against it. We cannot justly appreciate the value of the opinion of these authors, because it is supported by no facts, and the disease has not been described. Could it not be possible that the affection treated by these practitioners was not the true scarlet fever, but rather the purple military fever (fievrepourpree miliaire), to which belladonna, according to Hahnemann, affords no immunity?"7 For additional evidence as to the prophylactic virtues of belladonna, we refer to a paper read by Mr Maclure before the Harveian Society.2 Dr Feron states,3 that in an epiS Bayle, Bibliotheque Therapeutique, tome ii., p. 583, et seq. "2 Med. Gazette, vol. xiii., p. 814. "5 Journ. des Connais. Med. Chir. Aout 1839. BELLADONNA. 41. demic at Bayeux, in 1839, none of the children to whom he gave belladonna were affected by the disease. That belladonna is homoeopathic to scarlatina is proved by many observations:-Dr A. T. Thomson, in speaking of its administration as a narcotic, says: " It requires to be given in minute doses at first, and to be gradually increased until symptoms of its influence on the system become apparent. These are dryness of the throat, vertigo... an eruption closely resembling that of scarlatina." Again, when describing its beneficial effects in hooping-cough,"It produces a state of the skin closely resembling scarlatina, accompanied with fever, suffused eye, dimness of sight, and frequently, though not always, headache."' In a case by Mr Wade,2 where the external application of belladonna caused poisoning, the mucous membrane from the posterior third of the palate, as far down as could be seen, was a deep crimson colour, and the tonsils much enlarged. " Hahnemann et quelques autres auteurs ont observes dans plusieurs cas, ala suite de son usage a faible dose, une eruption rouge, assez analogue a la scarlatine."" BELLADONNA IN HYDROPHOBIA. At the commencement of the 18th cen- The following are the effects produced tury, aminer called Richter acquired great by belladonna, when it has been given in reputation as possessing a remedy against pretty large doses, as collected from two hydrophobia. This receipt, of which bel- hundred cases by Delaunay d'Hermont, ladonna was the base, was made public by Viscount Briouze, Munnicks, Gaultier, Schmidt and Maryerne, who contributed Wade, &c.:some corroborative facts of its efficacy in " Dilatation and immobility of the puhydrophobia. But the authors to whom pil, troubled, confused sight, sometimes we are indebted for the most complete and blindness; at other times optical illusions, numerous observations upon this subject,. injection of the conjunctiva, with bluish are Munch senior, a Protestant minister, blood, redness of the face, prominence of and his two sons, doctors in medicine, the eye, which is sometimes dull, at other 1 Mat. Med. p. 422. 2 Lond. Med. and Physical Journ., April 1827. 3 Bayle., Bibl. Therap., tom. ii., p. 499. 42 TEA. " Belladonna was given to 182 patients who had all been bit by mad dogs; of this number 176 had been wounded for a short time, and presented no symptom of hydrophobia; in the other 6 the disease broke out; 1 of these was a prey to horror of water, to convulsions and other violent cerebral symptoms. The following are the results of the treatment:-the 176 recently bit were preserved (Munch and his Sons); of the 6 enragys, 4 were cured, 2 died (Munch, Buchalz, Neimecke). We are permitted, no doubt, to entertain suspicions as to the exactitude of these trials; it may be objected to the observations of Munch, that he has not proved that all the dogs were mad; but it would at the least be very sceptical to reject all the results of the researches of this author, unless it were certain that he was an impostor, which nothing authorizes us to imagine. Why, therefore, it will be said, has not this treatment been adopted For a very simple reason, because practitioners who have had opportunities of treating people bit by mad dogs, have either been ignorant of the trials of Munch, or because ruled by some systematic idea, they reject beforehand all that can be contrary to their preconceived views, After this, I think it is of the utmost importance to repeat the experiments of Munch." (Bayle Therap. tom. ii. p. 502.) Here we may notice a case by Dr Allamand of" a general convulsive affection, cured by belladonna after it had resisted every other means." The writer gives several cases. (Annales Cliniques de Montpellier, tom. xiv; p. 47,) times furious; excessive thirst, dryness and burning of the lips, tongue, palate, and throat, painful deglutition, difficult and even impossible; nausea followed or not by vomiting, giddiness, drunkenness, very often slight delirium, generally gay, with smiles; in a small number of cases agitation and even transient fury, staggering gait, sometimes impossibility of sitting upright, frequent flexion of the trunk forwards, frequent movements of the hands and feet; sometimes convulsions, risus sardonicus; sometimes difficulty of speaking, or aphonia, or confused cries uttered painfully; fever, &c." (Bayle. Therap., tom. ii., p. 498.) TEA. " In the summer of 1820, I was re- It will be admitted as a familiar fact, quested," says Dr Copland, " by a practi- that the use of strong tea (especially tioner to see the daughter of a clergyman green tea), produces, above all in indiviresiding in Westminster, labouring under duals not accustomed to it, a train of most violent nervous palpitation, which nervous symptoms, such as wakefulness, SSULPHUR. 43 had resisted the means advised by several physicians who had been consulted. She was thin, delicate, and highly nervous. Finding that the usual remedies for nervous palpitation had been prescribed without any relief,; I suggested that a strong infusion of green tea should be given three or four times a day, and continued for a few days. Relief immediately followed, and perfect recovery in two or three days. (Dict. Pract. Med., part iv., p. 177.) great irritability, palpitations of the heart, anxiety, &c. SULPHUR. Sulphur has been extensively and successfully used in many cutaneous affections. The power of sulphur to excite eruptions of the skin, similar to itch and other affections in which it is given, can be doubted by no one who has visited the sulphur baths of Germany, where the " Badefriesel" (bath-rush), as it is termed, is one of the most constant effects which those who drink the waters experience. Krimer says,--" Sulphureous baths often produce the very diseases which they are employed to cure." (Hufeland's Journ. 1834, August, p. 9.) VACCINATION. The best proof of the immunity to smallpox which vaccination affords, is the universal acknowledgment of it by people of all countries. Experiments of late years have proved that, if vaccinia and variola are not identical, they are, at least, undoubtedly modifications of one miasm, and give rise to very similar symptoms. Dr Basil Thiele of Kasan (Russia) inoculated a cow with smallpox matter, and found that by so doing he could produce the true vaccinia, which was afterwards serviceable for vaccination. On the 3d day after the inoculation, a hardness is perceived in the cellular tissue of the udder; on the 5th, a vaccine-like pustule is formed; on the 7th and 9th, this contains a clear lymph; from the 9th to the 11th it begins to dry, and leaves a small superficial cicatrix. The matter so obtained can be either immediately employed, or VACCINATION. 45 de Medecine, Janv. 1841. Also Edin. Med. and Surg. Journ., July 1841, p. 290.) " A more striking resemblance between the two diseases, though a much more rare occurrence in cowpox, is what may be called a crop of secondary eruptions. I do not recollect that these have been recorded by more than three writers." (Adams' Popular View of Vaccine Inoculation, p. 160, Lond. 1807.) The three instances referred to are, those noticed by the Rev. Mr Hall (Med. Journ. vol. ii. p. 402). Another of two cases in Madeira (same Journal, vol ix., p. 309), and the third by M. Halle, to be met with in Med. and Chir. Review, vol. xv., p. 6. Miscell. In this paper the author notices several anomala which appeared during a general vaccination at Lucca; among the rest he remarks eruptions of pustules over the whole surface of the body, which took place at the time of the appearance of the areola round the inoculated part. These eruptions, which might easily be mistaken for variolous, differed, however, essentially from them in the manner of their formation, in the order in which they dried away, and especially in the nature of the fluid they contained. We have seen a well-marked instance of eruption occurring in this city, on the person of a dairy-maid, where the original pustule was visible on the inside'of the middle finger, and the greater part of the body covered with a pustular eruption. A general eruption was also observed at the H6pital Cochin (British and For. Med. Review, No. xxv.,1 Jan. 1842, p. 247.) 1 One word to Dr Alison, and those who agree with him, that " the encreasing efficacy and usefulness of our art must depend on the progress which may yet be expected... in the discovery of specifics, which may counteract the different diseased actions of which the body is susceptible, as effectually as the cinchona counteracts the intermittent fever, citric acid the scurvy, or vaccination the small pox." Would that one so deeply read and so just in observation had been led to study the Materia Medica of Hahnemann; his truthful remark would then have received a bright illumination; not only would he have found that these specifics owe their success to the homoeopathicity of their action, but he would have possessed a law explaining not only all known specifics, but also a certain path which will lead inevitably to the discovery of specifics hitherto unknown;-a law so simple, so certain, so universal,-a lawwhich now raises medicine from its low ebb of hypothesis and uncertainty to a place among the Positive Sciences. 46 STATEMENT OF LAW. The principle of the homceopathic school, Similia similibus curantur, we would state thus:-That diseases are cured most scfely and ejjectually, b~y small douses of such mnedicines as are capable in large doses of exciting, by their direct action on healthy individuals, symptoms of a very similar nature, the indirect consequences of these being the excitement of a healthy/reaction of a more or less opposite character. The existence of such a law is proved first, from the facts drawn from the practice of the old school, which we have given in this chapter, and also in appendix I.; but such proofs we only bring forward in order to meet in a measure the prejudices of our opponents. The purest proofs, those best ascertained, and those to which Hahnemann and his school appeal to, are the numerous experiments performed by himself and followers. The successful employment of medicines, whose action has been carefully proved to be homoeopathic to the diseases they cure, is the firm foundation of our principle. The experiments are published; and notwithstanding our opponents may disdain to examine them, or hastily pronounce them untruths, nevertheless the onus probandi of such an assertion lies with them. To accomplish their end, theymust prove either the error of the experiments, or the dishonesty of those who have proved the medicines; of those who have employed them in disease; and lastly the prevalent, and sadly to be lamented dishonesty of thousands who daily attest that they have been cured. With this Herculean task before them, we would ask them to pause and consider if it were not a more scientific and dignified course to test experimentally its practical application, and then arriving at a conviction of its truth or untruth, publicly acknowledge that conviction. Misapprehension of the term homoeopathic has led to much futile discussion, and error. Allusions to such sayings as ISOPATHY. 47 "Take a hair of the dog that bit you," &c., as illustrating the homoeopathic principle, arise from confounding homoopathic with homopathic, o lov with,uosov, identical with analogous. Homceopathic cures are effected by powers not identical, but only analogous. The examples given of the homopathic or isopathic system are exceedingly few, and the majority of cures effected by this method admit of a simple explanation. The undoubted efficacy of vaccinia in the treatment of smallpox is owing, not to its isopathicity, but to its homoeopathicity; for though vaccinia may be produced from varioline, it becomes modified from the channels through which it passes. The benefit derived from applying snow to a frozen limb, is not owing to isopathy, but is explained by the circumstance that it is dangerous to apply suddenly a directly opposite stimulus; this must be done gradually; the snow is less cold than the frozen part. For a similar reason the effects produced by an excessive use of intoxicating fluids are relieved by the readministration of a small quantity of spirits. Several examples of the efficacy of isopathic means have been given by zEgidi, Attomyr, Werber, and others; but the disuse into which the means recommended by them have fallen impairs our confidence in their efficacy; and it is very doubtful if the remedies employed by them, for example, cholerine, rubeoline, &c., are really the cause of such diseases, or simply the results. The subject is worthy of examination, qualified with the caution, that the pathogenetic effects should be carefully proved before their employment as therapeutic agents. ( 48 ) CHAPTER IV. Explanations of the action of the Hlomoeopathic principle-That of Hahnemann--Supposition of Dr Curie and others, that it acts by assisting the Vis Medicatrix-That of Dr Fletcher. HAHNEMANN, having clearly laid down the principle Similia similibus curantur, proceeds to add, as prefatory to his explanation of that law (~ 22), "that the curative power of medicines is founded upon the faculty which they possess of creating symptoms similar to those of the disease itself, but which are of a more intense nature. As this therapeutic law of nature clearly manifests itself in every accurate experiment and research, it consequently becomes an established fact, however unsatisfactory may be the scientific theory of the manner in which it takes place. I attach no value whatever to any explanation that could be given on this head; yet the following view of the subject appears to me the most reasonable." (~ 23.) He considers every disease, which does not belong exclusively to surgery, as being a purely dynamic and peculiar change of the vital powers in regard to the manner in which they accomplish sensation and action,-a change that expresses itself by symptoms which are perceptible to the senses ~ it therefore follows, that the homoeopathic medicinal agent, selected by a skilful physician, will convert it into another medicinal disease, which is analogous, but rather more intense. By this means the natural morbific power RATIONALE OF HAHNEMANN. 49 which had previously existed, and which was nothing more than a dynamic power without substance, terminated, while the medicinal disease, which usurps its place, being of such a nature as to be easily subdued by the vital powers, is likewise extinguished in its turn, leaving in its primitive state of integrity and health the essence or substance which animates and preserves the body. The objections to this hypothesis are, first, That it is erroneous to talk of vital powers or essences as entities, when they are merely properties of organised matter. Second, That we are unable, in very many cases, to discover any traces of the new disease which Hahnemann supposes to be set up in the system; on the contrary, we, for the most part, observe a progressive diminution of the original symptoms, and often a sudden return to health. Third, That it is far from being proved that the ordinary morbific principles have only a conditional, and often very subordinate influence, while the medicinal powers exercise one that is absolute, direct, and greatly superior to that of the former. This, which daily experience proves to be erroneous as applied to ordinary doses of medicine, must be much more so as applying to the small doses used in homoeopathic practice. It is also destroyed by the fact, that we can often cure,diseases occasioned by the abuse of medicines by means of small doses of an antidote, which again leaves no medicinal,disease behind it. Another attempted explanation has been brought forward by several writers,' and has lately been advocated by Dr Curie,2 who states it thus: " If we admit, as we must generally do, that all the phenomena resulting from organic actions constituting life, are roused by a power acting in1 Simpson, Pract. View of Horn., p. 57. "A Annals of Lond. Horn. Dispensary, p. 30, et seq D 50 RATIONALE OF DR CURIE. cessantly on the organism, it would be illogical not to admit that the rising of the same actions, and of the same phenomena constituting the disease, is ruled by the same power which directs the vital in a state of health. If, then, the morbid state be only a result of the vital or moving principle, exciting the organism to act more strongly against the morbific cause; can the physician do better than listen with attention to the vital power expressing itself by the voice of the symptoms, and send it an aid, which, acting in co-operation with it, strengthens and prevents its being exhausted by efforts which always diminish its duration." For example, inflammation of the lungs is the effort of living organization to reject externally a cause of disorganization. Rheumatism is the result of a vital effort to expel a cause of disease. But this pure assumption of the nature of disease is contradictory in itself; for if the morbid phenomena are the effects of a so-called vis medicatrix, how is it that the aids to be employed in addition to co-operating with this, also prevent it (the vital power) being exhausted by efforts (the morbid phenomena) which always diminish its duration (that is, of the vital power). But how can this be? for, to be consistent, the morbid phenomena, which tend to restore health, instead of exhausting the vital powers, ought to relieve the injured and embarrassed vitality. The allusion to exhaustion seems to lead even the advocates of this hypothesis to the truth, that if these efforts are not checked, death will ensue. It is difficult to imagine how purulent ophthalmia, which too often terminates in the destruction of the eye, is a curative reaction; so also the exudation in croup, the effusion of serum into the pericardium checking the action of the heart, the deposition of calcareous matter in the vessels of RATIONALE OF DR CURIE. 51 the brain, are all henceforth to be reckoned as tending to cure. Well may we ask,-to cure what? A nearly similar case as hanging a man to save him from imprisonment. But if it is true that morbid phenomena are not to be considered as the effects of a morbific cause, but as an action set about in order to restore health, it must also be true, that the more numerous and violent the symptoms, the speedier will the patient be out of danger (danger of worldly woes, we suppose?). One well-known fact will shew the fallacy of this doc-" trine. Those who adopt this view of disease must believe that the vomiting produced by the introduction of tartar emetic into the stomach, is not the specific effect of this drug, but is an effort of Nature to get rid of it. But unfortunately for this theory, tartar emetic will produce vomiting when introduced into a wound in the foot, or when rubbed on the skin. Of what possible use can the vomiting be in these latter cases? or why does this intelligent Nature make no efforts when opium, when prussic acid,-in short, any sedative poison,-is swallowed?' Erroneous as it is as a theory of disease, it is also deficient as explaining the action of the homceopathic law. If it were true, in every disease treated homoeopathically, we ought to have an aggravation of the symptoms produced by the remedy. Now, this is quite irreconcilable with the fact of the sudden transition to health, without any previous exacerbation, which often follows the exhibition of a well-chosen remedy, or with the gradual cessation of the symptoms more commonly observed. The late Dr Fletcher, who admits the existence and 1 This doctrine has been recently advocated by Mr Walker, in a work entitled " Pathology founded on the Natural System of Anatomy and Physiology. Lond. 1841." RATIONALE OF DR FLETCHER. beauty of the homceopathic principle, though, at the same time, he doubts of its applicability in all cases, gives the following rationale of its action.1 But in order to review clearly the opinion of Dr Fletcher, we must bear in mind his whole theory of disease. Following the school of Brown, Broussais, and others, he conceives all disease to be traceable to inflammation, and inflammation is taken as the best example of simple morbid action, without permanent structural derangement. It must be admitted, that, whether inflammation be the universal root of disease or not, it is at least a very common precursor of almost every disease, and is the entire, or nearly so, of acute diseases. And it may be presumed that, if any explanation can be shewn to be satisfactory in regard to inflammation, it may not be wholly inapplicable to other diseased conditions, since the explanation of inflammation unquestionably explains a large majority of all diseases. This, then, is his explanation of homoeopathic remedies in inflammation. According to Kaltenbrunner, Wilson Philip, Thomson, Koch, and all modern experimenters, in the first stage of inflammation, there is constriction of the capillaries, either apparent or deducible from the state of the circulation. This stage, however, is not manifest, and may be called the latent stage, although it is the most active. This state of the vessels is produced by the application of any extraordinary stimulus, such as heat, electricity, acids, irritants, &c. After this stage of constriction has subsided, in accordance to the law of the animal economy, it is followed by a state of relaxation, enlargement of vessels, increased S Elements of General Pathology, by J. Fletcher, M.D., edited by Drs Drysdale and Russell, p. 486, Edin. 1842. RATIONALE OF DR FLETCHER. 5 53 quantity of blood in them, redness, swelling, heat, and pain, in short, the usual symptoms of what is called inflammation. These symptoms, then, be it remembered, are the secondary effects of the stimulant, although to a superficial ob-~ server they appear the primary. Now, in this state of the vessels, suppose an additional stimulus applied, the effect must be constriction of the enlarged vessel;: for as certainly as a stimulus at one time, i'. e. at first, caused constriction, so certainly will a stimulus at another time, i. e. on its second application, do so likewise. The laws of the economy are ever constant; stimulation must always cause action, not collapse. Now, as certainly as this stimulus causes, or tends to cause, constriction, so certainly will it remove one,cause of disease, i. e. the enlargement of the vessel-the prominent symptom of inflammation. Therefore stimulation, to a certain amount, will be useful in inflammation,. when it can be directly applied. Examples of its utility are familiar in the treatment of ophthalmia, and gonorrhoea with local stimulants. If, then, it be admitted, and it cannot be denied without condemning all practice, that a substance which stimulates a particular set of vessels tends to produce in these vessels inflammation, and that the stimulation of these vessels, when already inflamed, tends to cure, the whole doctr -ine of homoeopathy, as applied to inflammation, is admitted. But it will be observed, that, although the stimulus is the same that produces and that cures inflammation, the state of the vessels is different. Now, all action in the living body is the resultant of two -co-efficients-the one a susceptibility to be acted on, and the other something exciting action. This resultant, or vital action, will be as much modified by any alteration III RATIONALE OF DR FLETCHER. the one co-efficient as ii the other; so that it is absurd to say that the same excitant applied at different times must produce the same action. It is true that it must always act upon the excitable part in a similar way to that in which it before acted; but the state of this part being different, the resultant is also different. Therefore it is possible for the same substance to produce and cure a disease. Nay, it is not only possible, but it is certain, that it can. Thus, we have seen that the secondary state of the vessels was the direct opposite of the primary,-we have seen that it is the secondary, not the primary, we are called on to treat; therefore the rational indication for treatment is simply to apply a remedy that produces the opposite condition of the diseased action; but the opposite condition of the present diseased state is the primary diseased state. Now, this primary diseased state was produced by a particular excitant. Admit, then, that this same cause must always produce the same effect in the thing affected, and we must have, on the application of such an excitant as is fitted to produce the primary stage of diseased action, a return to this primary stage on the reapplication of this stimulus. But it will be observed, that, in passing from the secondary to the primary stage of diseased action, it passes throug'h the state of health which occupies the middle place. Now, as the object is to settle at this point, not force on the extreme opposite of the present morbid condition, we must employ but a gentle counteracting agency,hence follows the necessityof giving small doses. Again, as it is perfectly certain that a specific stimulus will produce preternatural specific excitement, it must follow that if it be applied when that preternatural excitement is already present, it must diminish that preternatural or morbid excitement or diseased action. But, in the first place, the part, RATIONALE OF DR FLETCHER. 55 from being healthy became deranged, and in the second the part from'being deranged became healthy. Therefore, the substance that produces derangement will have a tendency to cure that derangement when already present. This explanation is applicable to all cases where there is a tendency to accession and remission, for these two states are the opposite of one another, and a substance fitted to produce the one must be adapted to the cure of the other. The reason why not the same substance which produced the disease, but a similar one, is best suited for its removal, is this:-that every stimulus, on being frequently applied, loses its power to affect; and that another stimulus, whose action is the same, operates with as much force in curing, as did the original stimulus in causing the disease. This rationale is the most plausible that has yet been brought forward; but though it clearly explains the action of homoeopathic remedies in diseases of degree, such as inflammation, it fails, many will think, in accounting for the beneficial action of homoeopathic agents in diseases of kind, such as dyscrasias. At present it would be quite out of place to discuss whether or not all diseases of kind do not depend upon changes in degree. Such are the principal expositions of the rationale of our principle, the two former erroneous, the latter perhaps imperfect; but until we arrive at a more intimate knowledge of vital laws, we can scarcely hope to explain more satisfactorily the law-Similia similibus curantur. Nor is this much to be regretted, as in practice we have not to do with hypotheses as to the rationale of the action, but with the truth and applicability of the law. The homoeopathic principle widely differs from many dogmas of the allopathic school, in that it was discovered, not invented, 56 FOUNTDATION OF LAWS. discovered in conformity to that fundamental principle,that the basis of all our knowledge is the accurate observa-~ tion of actual phenomena; and the correct generalization of these phenomena should be the sole foundation of all our reasoning. ( 57 ) CHAPTER V. MATERIA MEDIcA--The effect of medicines should be discovered by experiments on the healthy person-Circumstances necessary to be attended to in such experiments-Various sources from which our knowledge of the pathogenetic effects of medicine are procured. MEDICINES can alone cure disease in virtue of the power they possess of modifying the state of health; it follows then, as a corollary to this, that the pathogenetic effects of medicines should be carefully ascertained. This is the sure groundwork of all modes of practice; and no doubt the confused state of the allopathic Materia Medica is to be ascribed to an undue neglect of it. In chapter I. allusion has already been made to the improper plan which has been generally followed in collecting the physiological action of medicines, viz. empiricism, and deductions drawn from their employment in disease. This, though it may form a valuable adjunct when the medicine has been tried upon a healthy subject, is in itself defective and almost useless. Haller' Nempe primum in corpore sano medela tentanda est, sine peregrina ulla miscela, odoreque et sapore ejus exploratis, exigua illius dosis ingerenda et ad omnes, quae inde contingunt, affectiones, quis pulsus, quis calor, quae respiratio quanam excretiones attendendum. Inde ad ductum phenomenorum, in sano obviorum, transeas ad experimenta in corpore aegroto, &c. (Pharmacopoeia Helvet., Bale, 1771, in fol. p. 12.) JORG'S EXPERIMENTS. has pointed out the necessity of carefully observing the action of drugs upon healthy individuals; but until the time of Hahnemann, no one considered his advice as valuable. To Hahnemann alone is the honour due of having first entered upon, and faithfully carried out, this mode of procedure. The result of many years' experiment he first published, in 1805, in a small work, entitled " Fragmenta de viribus medicamentorum positivis, sine in sano corpore humano observatis.' The result of increased experiments he afterwards gave to the world in his Materia Medica Pura, and in his Chronic Diseases. In addition to these, we have now the works of Hartlaub, Trinks, Stapf, Riickert, Noack, Hering, and others. Frequently has it been stated by our opponents, that the pathogenetic effects recorded in the Materia Medica of Hahnemann, and other similar registers, are one tissue of absurdities and lies. This oft-repeated statement, unsupported by one fact, may justly be consigned to the fate it deserves,-silence. Only one series of experiments have been instituted: these were undertaken by Prof. Jorg of Leipsic, and several members of a society, with the view of disproving the doctrines of homoeopathy.1 To these individuals the praise is due of having faithfully experimented upon themselves, and the result was twofold; first, proving the accuracy of the experiments performed by the homccopathic school; second, that medicines have been supposed by the allopathic school to be invested with properties which they really do not possess. Prof. Jorg ends by warning practitioners of the danger of giving nitre in inflammations, assafcetida in hysteria and hypochondriasis, prussic acid in 1 Materialen zu einer Kiinftigen Heilmittellhre durch Versuche an ges - unden Thcnschen, von Dr Ch. G. Jirg, Iter Band. Leipzig, 1825. Materials for a fiture Materia Medica, from experiments on healthy individuals. lbv Dr Ch. G. Jirg. MATERIA MEDICA. 59 inflammatory affections of the larynx and bronchia, because, in his experiments upon healthy individuals, these substances had produced very similar diseases. He further expresses his astonishment at finding results so contrary to received opinions, and states, that as far as his experiments have yet gone, he has scarcely met with a remedy, the real properties of which are known. Though these candid experiments have not tended in converting the above society, they have proved, as far as they have gone, the accuracy of oiir experiments, and aided, in some measure, to enrich our knowledge of the effects of remedies. But, though convinced of the general accuracy of the Materia Medica, we are not so blinded as to suppose that no errors can have crept into it. We do not overlook the liability to deception from the imagination of the individual, his impaired health, and circumstances to which he may have been exposed, &c. For these reasons we consider the pathological phenomena manifested during the trial of a medicine as mere indications for its use in similar spontaneous morbid affections; and when the extinction of these thereby obtained is the result of repeated experience, these indications are raised to the rank of therapeutic tokens for further use in diseases. Nor are we ignorant of the deficiencies in the arrangement of the symptoms adopted by Hahnemann. Commingling the symptoms of the various experimenters, without noticing what doses were employed, what symptoms were primarily manifested, in what groups or order of succession they were observed by different individuals, and the slight regard paid to the objective symptoms, render it impracticable to know the organ primarily affected, the genetic -relation of many individual symptoms, or, what is most important, the character, the total operation of the medicine 60 OBJECTIONS OF OPPONENTS. so that it may be viewed as a difficult task for one who refers to these records of symptoms to select the right remedy. Less embarrassment, however, occurs in practice, because, after years of experience at the bedside, with the remedies thus represented, homoeopathists become gradually acquainted with the characters of each, its total operation, and its particular tendencies. The results thus acquired, writers upon homoeopathy have collected and published. These beginnings, though they may require revision, greatly facilitate the labours of the inexperienced in homoeopathy in acquiring a knowledge of the remedies, and spare him the circuitous way which was necessary for his predecessors. The theoretical reasonings of many of our opponents cannot therefore induce us to doubt the general utility of the trials of medicines upon the healthy, or of the valuable results hitherto attained in particular. We will not take away from homoeopathy its foundation; the reproach connected with trials which have hitherto been made, is for us only a reason hereafter to avoid, as much as possible, the present confessed deficiencies. Our experience of how much that is practically useful in what has already been attained, however imperfect it may be, and the knowledge of how much we are thereby capable of effecting, furnish the strongest motives to persevere in the path we have chosen, and to keep steadily in view the prospect, that, by means of numerous trials of remedies upon the healthy of every age and sex, under the control of experience at the bedside of the patient, we shall gradually attain a degree of knowledge, so exact and invariable, of every individual symptom, as to approach very nearly to certainty. The endeavours of homnopathlists to purify the recorded symptoms of the remedies from those that are erroneous and unessential, to ele PROVING OF MEDICINES. 61 vate the Materia Mecica to the character of a codex of pure indubitable operations of the individual remedies, we can assure our opponents has by no means been ineffectual, although we acknowledge that a beginning only has been made in the work. But our critics seem to have adopted the maxim of employing an ideal standard for all that belongs to homoeopathy, including our Materia Medica. It would be more just and impartial, however, on their part, were they to determine its value by a comparison with what is certain and what hypothetical of the old school, and to this scale we should make no possible objection.' To procure correct details of the pathogenetic effects of medicines, certain conditions are necessary to be attended to. The individual to be experimented upon must be as far as possible in a state of perfect health; those liable to hereditary diseases, to intermittent fever, or the slightest chronic disease, are objectionable. For some time before, and during the experiments, a strict regimen should be adhered to; all bodily and mental fatigue should be avoided; coffee, tea, wine, spiritous liquors, spices, and other medicinal substances, such as asparagus, celery, parsley, onions, radishes, strong cheese, acids, mineral waters, &c., must be abstained from. In other respects the diet should be what the experimenter has been ordinarily accustomed to. It is better not to fix upon individuals who have been accustomed to various powerful stimuli, even though these be abstained from, as, for some time after their withdrawal, symptoms may arise which cannot be correctly attributed to the medicine. The medicine should be given to individuals of different sexes and ages: as it is important to know the effects produced upon certain sensations and functions depending 1 Dr Paul Wolf, Thesis 13. A very good translation of the eighteen admirable theses of Dr Wolf is given in the Hom. Examiner, vol. i. p. 105. 62 PROVING OF MEDICINES. upon difference of sex, such as menstruation. Age also is an important consideration, owing to the varied susceptibilities of the same organ at different periods of life. In females the existence of menstruation and pregnancy are important circumstances. It is important to bear in mind the difference of temperament and disposition, for the same medicine produces different effects in individuals of different temperament, for ex'ample, nux vomica, and pulsatilla. Some persons are affected with headache on the slightest indisposition, others with colic, diarrhoea, coryza, &c. Such particularities have a great influence upon the effect of medicines. It is advisable that the experiments be frequently repeated, in order to detail faithfully those symptoms which are generally constant, and those which only appear at certain repetitions. The effects of medicines ought to be observed under different circumstances. Some symptoms manifesting themselves in the morning, others at noon, in the evening, or at night; others during repose or movement, sometimes in the open air, or in the house. Some relieved or aggravated by heat, others by cold. The difference of symptoms produced when thle disposition is gay, or sad; also certain negations, for example, the absence of ordinary symptoms when the experimenter may be exposed to grief, fright, &c. These and various modifications should be carefully noted down, as they form often very characteristic symptoms, and special indications for the administration of the medicine in disease. The substance to be experimented with must be pure and Sivcn singly; if from the vegetable kingdom, the expressed juice of the plant, mixed with alcohol, is preferable; but whenl this cannot be got, either in powder or tincture; when it is given in infusion, a small quantity should only be made, and this drank immediately, as, if no alcohol is 64 SOURCES OF MATERIA MEDICA. gaged in certain employments, such as in manufactories where arsenic, mercury, lead, &c., are employed. This source, when the symptoms have been accurately described, supplies many lacunee, which must necessarily arise in the ordinary experiments. Second, Particular symptoms arising in parts of the system not actually affected, during the treatment of simple forms of disease by any single remedy in large or continued doses: such as eruptions produced by copaiba and turpentine in the treatment of gonorrhea, by cod-liver oil in struma, itching of the skin produced when opium is given as a sedative, &c. Third, The results of the successful treatment of disease by simple remedies, which are generally styled specific, such as the cure of goitre by burnt sponge or iodine, which disease has been classed in the Materia Medica as one of the symptoms produced by iodine. This source is liable to lead to much error, as in the case of iodine, for it is much more probable that it cures bronchocele, not from being homoeopathic, but because it produces absorption of all the glands indiscriminately (?). A safer source is the result of homceopathic practice, in so far as the exhibition of a particular remedy for the treatment of diseases of a certain system or organ is found, upon repeated experiment, to be followed by the removal of certain organic affections, which were not previously known to be produced by them; for example, during the use of silica, rhus, antimonium, &c., warts and corns have been seen frequently to disappear; and hence, under the symptoms of these medicines we find them enumerated. This third source is very fallacious; from it no symptoms should be gathered unless attested by the best authority, and confirmed by repeated experiment; even SOURCES OF MATERIA MEDICA. 65 then they should be marked as such, and might be styled clinical./" The first and third sources will account fully for the presence of many dangerous symptoms ranked under several drugs; symptoms so formidable that they are liable to shake the faith of many who look only partially into the homceopathic Materia Medica. Fourth, Experiments carefully performed upon healthy individuals. The most satisfactory and most useful experiments are those instituted by the student upon himself. If the experience of Hahnemann and many of his followers is any encouragement, we need fear little permanent injury to the health from carefully cQnducted experiments. Our venerable founder, still full of vigour and in his 88th year, seems from such trials to have been enabled to resist the ordinary vicissitudes of common life. E ( 66 ) CHAPTER VI. MATERIA MEDICA.-List of the Medicines-Mode of Preparation--Method of Prescribing. HOMEOPATHISTS employ in general as remedies, the same substances at the allopathic school: the medicines, the pathogenitic effects of which are well known, amount to about 150; to these may be added 50 more, the actions of which are only partially proved. The following is a list of the medicines, with the contractions employed in prescribing them:-The letter a, placed after a medicine, indicates that it is prepared with alcohol; the letters tr, indicate that the three first attenuations of a medicine are made by trituration with sugar of milk. The medicines marked with tr and a, are those which may be prepared in either of these ways, but for which trituration is generally preferred. The letters aq indicate that the first attenuation is made with pure water, the second with diluted alcohol, and that it is only the third in which pure alcohol is employed. The asterisk (*) indicates the medicines of which hitherto the greatest use have been made. INORGANIC SUBSTANCES AND CHEMICAL PRODUCTS. * Alum. tr...... Alumina. * Am. c. tr......Ammonitun carbonicum. Am. mn tr......Ammonium muriaticum. LIST OF MEDICINES. 67 * Ant. tr...Antimoniurn crudum. Arg. tr...Argentum foliatum. * Ars. a. tr......Arsenicum album. * Aur. tr......Aurum foliatum. Aur. m. a......Aurum muriaticum. * Bar. c. tr......Baryta carbonica. Bar. m. tr......Baryta muriatica. Bis. tr......Bismuthi subnitras. SBor. tr......Borax veneta. Subboras sodwe. "* Calc. tr......Calcarea carb. Calcis carbonas. Caic. ph. tr......Calcarea phosphorica. " Carb. an. tr......Carbo animalis. "* Carb. v. tr...... Carbo vegetabilis. "* Caust. a..Causticum. Tinct. acris sine kali. Cinn. tr...... Cinnaberis. " Cupr. tr......Cuprum metallicum. "* Fer. tr......Ferrum. Fer. ch. tr......Ferrum chioratum, muriaticum. Fer. mg. tr......Ferrum magneticum, Deutoxide. * Graph. h'......Graphitis. Plumbago. * Hep. tr......Hepar suiphuris calcareum. Calcis sulphureturn. * a...... o. odium. Jodina. * Kal. tr....Kali carbonicum. Potassas carbonas. Kal. h. tr....... Kali hydriodicum. Potassae hydriodas. * Kreos. a.......Kreosotum. Magn. tr..... Magnesia carbonica. * Magn.m. tr.......Magnesia muriatica. Magn. s. tr.......Magnesia suiphurica. ' Mere. tr.......Mercurius solubilis Hahnemanni. o Merc. c. tr.....Mercurius subliratus corrosivus. ~ Mur. ac. aq.. Acidum muriaticui. * Natr. tr.......Natrum carbonicur. Sodwe carbonas. " Natr. mn. tr......Natrum muriaticum. Soda? murias. Natr. n. tr.. Natrum nitricurn. Soda? nitras. Natr. s. tr.... Natrum suiphuriciun. Soda? sulphas. Nic. tr.......Niccolu'm carbonicum. G Nitr. tr......Nitrum. Potassee nitras. 68. LIST OF MEDICINES. Nitr. ac. q.......qAcidum nitricum. Petr. r....... Petroleum. Oleum petrae. Phos. Ir. a.......Phosphorus. Phos. ac. aq. Acidum phosphoricum. P lat. Ir.......Platina. ~ Plumb. I)...... Plumbum. Sel. tr....... Selenium. * Sil. tr.......Silicea. Terra silicea. Stront. Wk......Strontiana carbonica. 4 Suiph. Ir. a.......Sulphur. Suiph. ac. aq.... Acidum suiphuricum. * Tart. tr......Tartarus emeticus. Tart. ac. a.... Acidum, tartaricum. " Zinc. tr.. Zincui metallicum Zinc. s. ir. Zincum suiphuricum. VEGETABLE KINGDOM. * Acon. a.... Aconitum napellus. 1Eth. a........thusa cynapium. Agar. a.......Agaricus muscarlus. Agn. a....,,Agnus castus. Anac. tr. a.......Anacardiun orientale. Ang. Ir.a......Angustura. Bouplandia trifoliata. " Arn. a.......Arnica montana. Arum. a.......Arum, maculatum. " Asa. a. Assafctida. Asar. a,.......Asarum europxeum. B Bell. a.......Atropa belladonna. Berb. a....... Berberis vulgaris. Boy. tr.......Bovista plumbea. *Bry. a. Bryonia alba. Bruc. Ir. a....... Brucea antidysenterica. Cal. a.......Caladiumn seguinum. Camph. a.......Camphora. Cann. a....... Cannabis sativa. *Caps. a.......Capsicum annuurn. 70 LIST OF MEDICINES. "Led. a.......Ledum palustre. "* Lyc. tr......Lycopodium clavatum. Men. a. - - - - - - Menyanthes trifoliata. * Mez. a.. - ---Daphne mezerium. Mill. a.....Achillea millefolium. C N. mos. tr. a... Nux moschata. "* N. vom. tr. a.... Strychnos nux-vomica. Olean. tr. a..- ---Nerium oleander. "* Op. tr. a.....Opium. Poeon. a.......Poeonia officinalis. Par. a.......Paris quadrifolia. "* Petros. a.......Apium petroselinum. Phell. tr. a......Phellandrium aquaticum. Prun. a.......Prunus spinosa. "* Puls. a......Pulsatilla nigricans. Anemone pratensis. Ran. b. a.......-Ranunculus bulbosus. Ran. sc. a.......Ranunculus sceleratus. Rat. tr. a.------Ratanhia. Krameria triandra. Rhab. Rheab. tr. a. Rhabarbarum. Rheum palmatum. Rhod. tr. a..... liRhododendrum chrysanthum. "* Rhus. a......Rhus toxicodendron. Rhus. v. a.....Rhus vernix. Rut. a......Ruta graveolens. Sabad. tr. a....... Veratrum sabadilla. "* Sabin. a.......Juniperus sabina. " Samb. a....Sambucus niger. Sang. a..- Sanguinaria canadensis. F Sars. tr. a....... Smilax sarsaparilla. "* Sec. tr. a.......Secale cornutum. Sen. tr. a.......Polygala senega. Senn. tr. a.......Senna Alexandrina. " Spig. tr. a..-....Spigelia anthelmia. Squill. a. S...quilla maritima. * Staph. tr. a....Delphinium staphysagria. C Stram. a....... Datura stramonium. Tab. a......Nicotiana tabacum. LIST OF MEDICINES. 71 Tan. a.....Tanacetum vulgare. Tar.. a....... Leontodon taraxacum. Tax. a... Taxus baccata. Tereb. a..... Terebinthine oleum. Teucr. a.....Teucrium marum verum. The. tr. a.... Thea cxsarea. Ther. a.......Theridion curassavicum. "* Thuja, a.......Thuja occidentalis. Tong. tr. a.......Baryosma tongo. Uva, a.......Uva ursi. Valer. a......Valeriana officinalis. "Verat. a..... Veratrum album. Verb. a.......Verbascum thapsus. Viol. od. a....... Viola odorata. Viol. tr. a.......Viola tricolor. ANIMAL KINGDOM. Ambr. tr. ~ Ambra grisea. Cast. a.......Castoreum. Coccion. a.......Coccionella septempunctata. Coral. tr.......Coralium rubrum. Diad. tr. a....... Diadema aranea. " Lach. tr......Lachesis. Trigonocephalus lachesis. Meph. tr......Mephitis putorius. Mosch. tr. aa.......Moschus moschiferus. 01. an. tr...-- Ol-eum animale ethereum. Oz. a.......Ozeine. * Sep. tr.......Sepia. Sepiae succus. + Spong. tr. a....... Spongia marina tosta. Vac. a....... Vaccinia. ELECTRICITAS. Mgs..............VMagnes artificialis. Mgs. are.......... Magnetis polus arcticus. Mgs. aus..........Magnetis polus australis. Some other medicines, such as Acteea spicata, Aquilegia 72 VEHICLES FOR DIVISION. vulgaris, Atriplex olida, Chenopodium glaucum, Cahinca, Nigella sativa, Osmium, Physalis alkekengi, Solanum vesicatorium, are now expelled from the Materia Medica, their pathogenises being the invention of a Dr Fiekel, alias Heyne, Hoffbauer, &c. The homaeopathic law, and the employment of small doses, are two things quite independent of each other. Hahnemann, when he commenced to practise homoeopathy, employed the ordinary doses; but, observing the frequent and often dangerous reactions, he was led gradually to diminish the dose, until he arrived at the systematic plan now adopted in the preparation of homoeopathic medicines. The principal end of the homoeopathic pharmacy is the perfect solution and division of the substances; for this end four vehicles are employed,-water, alcohol, sugar of milk, and lately sether has been recommended by some. The water must be perfectly pure and distilled; that procured from chemists is objectionable, as it may be tainted with substances formerly distilled in the same vessel. A glassretort should be used and employed solely for this purpose. The same precautions must be used in selecting the alcohol; that employed for the preparation of tinctures (mother tinctures, as they are called) should be nearly anhydrous, sp. gr. 815; for attenuations, a weaker spirit may be used, sp. gr. 835. The sugar of milk (Saccharum lactis) is generally brought from Switzerland, where it is prepared by the evaporation of the whey obtained after making cheese. The purest is crystallized, hard, colourless, slightly sweet, and inodorous; other specimens contain more or less of animal matter. That procured in the drugg'ist's must be purified by solution in boiling water, filtered, then added to an equal part of al MODE OF PREPARATION. 73 cohol, and allowed to evaporate in a dry atmosphere. As the crystals form, they are to be collected, dried, pounded in mortars, and then passed through fine sieves. The adulteration of the powdered sugar of milk with sugar is detected by its increased sweetness; that with alum by means of acetate of lead or nitrate of mercury. When it is suspected that it has been tainted by evaporation in copper vessels, it should be dissolved in water; the blue colour produced by the addition of ammonia shews the presence of this metal. Sugar of milk prepared from sour whey reddens litmus. Ether (_/Ether sulphuricus) has rarely been employed in the preparation of medicines, but has been recommended by some as a solvent for phosphorus in lieu of alcohol. These vehicles have been selected as possessing scarcely any medicinal action; the little that they do manifest produces no inconvenience, as the same vehicles are equally employed for administering the medicine during experiment as in disease.1 The vessels used must be perfectly clean; the mortars should be of porcelain, never of metal. Owing to it being feared that the trituration with sugar of milk in porcelain mortars may detach some particles of the latter, it has been ingeniously recommended by Messerschmidt that they be made of sugar of milk. Such a mortar would assuredly prevent all mixture with foreign substances, but is unnecessary, in so far as' all the experiments have been made with the substances prepared as above. The spatulas must be of bone, and well scraped every time they are used. Hahnemann recommends a new vial for each new attenuation; but this is unnecessary if they are washed frequently Dr Molin states, that he has found that triturated sugar of milk produces a sensation of constriction in the stomach, prickings between the shoulders, and oppression, especially at night (?). Journal I-Jahnemanni'rne, No. 7. 74 MODE OF PREPARATION. with great care in hot water, and thoroughly dried. Great care must be taken that the substances be perfectly genuine: plants should, if possible, be procured green, or if dried never in powder: the ordinary tinctures of drugs are never to be employed. A point not less important than the quality of the drug is the exact choice of the particular substance indicated; it is a point strictly to be insisted upon, since some have proposed improvements by substituting, in place of the substance ordered, others which appear to them more energetic, or purer in their chemical qualities. However good these changes may be in a scientific light, it is not the less certain that the least essential change may produce uncertainty in the practical application of the remedy. What regards the practitioner, is not whether the preparation be more or less scientific, but that it be similar to that with which the experiments were performed. For example, to obtain calcarea or subcarbonate of lime, such as employed in homceopathy, it must be made from oyster-shells, as prescribed by Hahnemann, although this substance is far from being a pure subcarbonate. Also tincture of cinchona, opium, nux vomica, should not be prepared from quinine, morphia, and strychnia, although these are supposed to be the active principles of the drug. Tinctures of all indigenous plants are to be procured by expressing the juice, and adding to this an equal quantity of pure alcohol. After standing for a few days, the clear fluid is to be carefully decanted, and presered for use in well-stoppered bottles. This is what is called the mother tincture. Some plants containing much mucilaginous matter are prepared by bruising the green plant, and then macerating it in alcohol.1 SA Mr Bentley has of late years been advertising tinctures prepared from 4 MODE OF PREPARATION. 7 75.Exotic vegetable substances, which cannot be procured green, are to be minutely powdered, and 20 parts of alcohol to be added; this is allowed to macerate for six or eight days, and afterwards carefully filtered. But it is preferable, in almost every instance, to prepare these dried substances by trituration with sugar of milk in the same manner as mineral substances. By this means their active properties, which are not strongly pronounced in the shape of tincture, become more fully developed; for example, lycopodium. All mineral and animal substances are prepared by trituration with sugar of milk, in the proportion of 1 to 100. Some substances, such as acids and phosphorus, are prepared by solution, some in alcohol, others in eether, in the proportion of 1 to 20. The future attenuations are prepared in such a manner that the first contains 1 grain or 1 drop of the medicine to be attenuated, mixed with 100 grains of sugar of milk, or 100 drops of alcohol, and then shaking or triturating for a due time; the second is procured by adding the 100th part of. the first to a hundred new parts of the vehicle, submitthe juice of the green plant as his discovery; but Hahnemann recommended this method more than thirty years before Mr Bentley. Bucholz (in his Manual of Analysis, 1815, i.. vi.) assures his readers that they are indebted to the Russian campaign for this excellent mode of preparing medicines, previous to which (1812) it was unknown in Germany. But in reporting this in the ver'y words of the first edition of the Organon, hie has forgotten to say that Hahnemann was the author who published it two years before the Russian campaign (1810). Some people would rather make it appear that a discovery came from the deserts of India than attribute it to the real author! It is true alcohol was formerly sometimes added to the juice of plants in order to preserve it, for a time previous to making extracts of it; but this addition was never made with the intent of administering this mixture under the title of a remedy. MODE OF PREPARATION. 76 ting it to the same process; the third in submitting to the same process the 100th part of the second, and so on to the thirtieth. The attenuations of the substances which have been prepared as tinctures, are made from the first to the last by means of alcohol. If it is desired to keep all the attenuations, it is necessary to have the required number of vials, each capable of containing about 150 drops; the name of the substance to be attenuated to be previously marked upon the label, and also on the cork. Accordin to the prescription of Hahnemann, the vials are to be;-thirds full, to one a drop of the mother tincture is to be added; this is briskly shaken for some time, and then marked by the figure 1, as indicating the first attenuation. A drop of this first is then to be added to another vial, which, after being submitted to the same operation, is marked with the figure 2, indicating the second attenuation or dilution, and so on to the thirtieth. But for ordinary purposes it is needless to employ so many bottles, as all the attenuations are never employed, those generally in use being every third; for example, 1, 3, 6, 9, &c. If then, it is not desired to preserve the second, to preserve the third it is sufficient to pour out all but the last drop of the vial containing 2; and to add to this 100 drops of alcohol, submit it to succussion, and so on with the others, preserving every third, pouring out all but one drop of the others. The proportion of 1 to 100 is that employed by Hahnemann, and is always understood when the dilution is indicated by its number. But latterly it has been recommended with advantage to substitute the proportion of 10 to 100, so that, instead of one drop or grain, ten are to be mixed with a hundred of the vehicle. By this latter proportion, it requires two attenuations to equal one dilution of the proportion of 1 to 100; 78 VARIOUS ATTENUATIONS. numerals, denoting not the number of the attenuation, but the fractional part of the contained substance. The following table shews the signs employed - Mother tincture, = First attenuation, = Second,........ = Third,.. - Fourth,......... - Fifth,.......... - Sixth,............ - Seventh,........ = Eighth,......... - Ninth,............ - &c. Twelfth,......... - Fifteenth,...... - Eighteenth,...... -= Twenty-fourth, = Thirtieth......... = 0 GERMAN. 1 = 100 = Hundredth. 2 = 10,000 = Ten thousandth. 3 = I = Millionth. 4 = 100, I = Hundred millionth. 5 = 10,000, I = One thousand millionth. 6 = II = Billionth. 7 = 100, II Hundred billionth. 8 = 10,000, II Ten thousand billionth. 9 = III Trillionth. &c. 12 = IV Quadrillionth. 15 =-- V Quintillionth. 18 = VI Sextillionth. 24 = VIII = Octilionth. 30 = X = Decillionth. The value of the Roman numeral is given by multiplying it by 3, which denotes the attenuation as employed in England. Homceopathic medicines are kept in the shape of alcoholic solution, in powder, and as globules imbibed with the alcoholic solution. The first is preferred by many, especially in the treatment of acute diseases, and is no doubt in many cases the most certain way of preserving the medicine. The first three attenuations of substances, prepared by trituration, are kept in the shape of powder. The globules are made of small grains of sugar and starch, about the size of poppy seeds. They are imbibed for some time with the alcoholic tincture, and then carefullydried npt MODIE OF PRESCRIBING. 79 paE Some have recommended that they be kept constantly wet, with the alcoholic dilution; but this, except in one or two cases, is useless, destroying the great advantage they possess, that of easy administration. The earths, salts, metals, and various vegetables, with the dilutions with which these globules are saturated, preserve their properties unchanged for years, though kept perfectly dry. But some volatile substances may undoubtedly lose their properties, such as camphor, musk, turpentine, phosphorus, &c., and should therefore be either kept in solution or the globules frequently imbibed' with the dilution. The medicines are administered, whether as liquids or globules, in sugar of milk, or in water. To powders containing 3 or 4 grains of sugar of milk, the required number of globules are added and then crushed, or a drop or two of the dilution is poured upon it. The sugar of milk is sometimes coloured with cocoa or powdered liquorice. These powders are sometimes given at once, or more generally dissolved in water, and administered in divided doses. Hahnemann and others recommend, in some cases, that the medicine be simply applied to the nostril and smelt (olfaction); but this extremely uncertain process, except in cases of highly susceptible individuals, is attended with no advantage, and is now rarely employed. In prescribing, the contractions for the medicines are employed, and the number of globules are indicated either by cyphers, or by figures following or preceding the number of the dilution. As the dilution is of more importance than thenumber of globules, it should always precede, thus-Acon. 6/3, (i. e. 3 globules of the 6th dilution of aconite), or according to the Germans, the same would be written Acon. II, 000 or 3.; when drops or grains are used, they are ex 80 MODE OF PRESCRIBING. pressed by their ordinary contraction. When it is wished to add to the powders containing the medicine some powders simply of sugar of milk (a procedure necessary in many cases where patients will not attend to dietetic rules unless daily receiving medicine), they may be prescribed thus: for example, if we wish to order 6 powders, the first three only to contain medicine (aconite) we would write, if these powders are to be taken alternatelyI. Aeon. 6/3. No. 1, 3, 5. pulv. sacch. lact. q. s., No. 2, 4, 6. Or if the three first are to contain medicine,Il5. Aeon. 6/3. No. 1, 2, 3. pulv. sacch. lact. q. s. No. 4, 5, 6. When the sugar of milk is not wished to be prescribed, a simpler plan is to write first the numbers of the powders that are to contain the medicine, and then those that are not, separating them by a sign // thus: 1. Aeon. 6/3. No. 1, 2, 3,//4, 5, 6.* SFor further information as to the history and preparation of the medicines, see Nouvelle Pharmacopee, et Posologie Homceopathique, par. G. H. G. Jahr. Paris 1841. ( 81 ) CHAPTER VII, MATERIA MEDICA.-Upon the minute doses employed in Homonopathic practice-Before such doses act there must be a special susceptibility of the body-What that susceptibility consists in-Trituration and Division -Efficacy of Trituration-Views of Doppler-Of Peltier, &c. THE employment of minute doses in homoeopathic practice has tended much to retard its progress, and has been frequently a stumbling-block to those who might otherwise have been inclined to examine the subject. It must be borne in mind that homoeopathy and the employment of minute doses are two separate things; a remedy is homoeopathic, not from the form in which it is administered, nor from the dose, but only from its relation to the disease. Every remedy is homceopathic when it stands in the relation of similarity to the disease for which it is to serve as a remedy, whether it be used in the 30th dilution or in an undiluted state, in grain or scruple doses. Large doses are opposed only to the peculiarities of Hahnemann; with them patients may be treated homoeopathically, but then we may frequently expect a positive increase of the disease, or even death. The experience of such painful and dangerous aggravations, in no case necessary to cure, led HahneF SIMILAR AND DISSIMILAR IRRITANTS. 83 moeopathic remedies. It is a well-known fact that the organism is'much more susceptible of the action of homogeneous or similar than of heterogeneous or dissimilar irritants. In typhoid fever the most enormous quantity of wine and spirits is often taken by those altogether unaccustomed to their use, and frequently without bad effects; whereas a minute quantity would act most violently if given to a person labouring under inflammatory fever or phrenitis. " A Russian peasant, under the excitement of the vapour bath, will roll himself in snow and expose himself to a shower of icecold water with impunity;" whilst a few drops on the bare neck of a chilly individual will suffice to give him a shivering fit. We may apply a degree of heat to the hand without the least inconvenience, which, were it burned, would be intolerable. From these and many analogous facts we may state as a rule, that the dose of any medicine must be so much the stronger, as its pathogenetic effects on the economy are more in opposition to the characteristic symptoms of the disease, and vice versa. Let it be borne in mind that when medicines are destined to act on that part of the organism which is already affected, as in homoeopathy, the doses must be proportionably small to what they would be were the medicines to act upon a part which is perfectly sound, as in allopathy. For example, " let a horse be unhurt, and you may rub his hide with an iron curry-comb,-touch but with your finger the shoulder which has been galled by the saddle, and the poor animal will shiver from the mane to the fetlock." The susceptibility of the animal frame of its specific irritant, is somewhat analogous to that of a chemical solution for itsspecificreagent. Aninflamed eye is disagreeably impressed and the inflammation increased by the ordinary light of day, -an inflamed ear by slight noises; but the report of artil 84 ACTION OF MINUTE DOSES. lery does not affect the inflamed eye, and dazzling light has no effect upon the inflamed ear. Now, we entertain similar views as to the operation of medicines: we believe, for example, that the 2d and 3d dilution of ipecacuanha is operative in an individual suffering from nausea with a tendency to vomit, and may even produce vomiting, but only because by reason of the existing symptoms, the susceptibility to the operation of ipecacuanha is exalted. But we do not assert that the 2d and 3d dilution is operative in every individual, and where such a morbid increase of susceptibility of the action of the medicine does not exist. For a similar reason we attach no value to the proofs of the inactivity of the homceopathic dilutions, which our opponents think they find, in the presence of medicinal particles in the atmosphere, in our food and drink; because, in order to become affected by such minimum doses, the organism must have a special susceptibility to their action. Many critics ascribe to us the folly of practising in the old method with our dilutions, and instead of an emetic, for example, they say that we administer the 3d dilution of tartar-emetic, or purge with the third dilution of jalap. This assertion is the result of inexcusable ignorance or intentional misrepresentation; for we employ the dilutions of those remedies for removing the sickness or diarrhoea adapted to them, but not to provoke these symptoms, for which purpose another form and dose would be demanded.* To the opponents of homoeopathy who endeavour to prove the inefficacy of our remedies by the argument-" That a healthy man may devour the contents of a whole pocket-case of homoeopathic medicines without feeling the least alteration "-to this Brobdignag-like feat we reply, that the peculiarity of these Dr P. Wolf, Thesis 14. TRITURATION. 85 remedies is not to operate upon the healthy, but only upon individuals whose disease bears to them a specific relation and affinity. Some individuals cannot bear a cat, and are thrown into convulsions onits approaching them. We have seen a powerful man, a professor of Natural Philosophy, faint upon smelling lavender; others swoon from the smell of a rose. Scaliger was thrown into convulsions at the sight of cresses. From the results which followed in these and many similar cases, we do not conclude that cats, roses, or cresses, produce constantly these effects, but we explain them by attributing it to the idiosyncrasy of the individual,-in other words, peculiar susceptibility of the action of certain stimuli; so also a peculiar susceptibility must exist before minute doses can act. The trituration of medicines, with another vehicle, led Hahnemann to discover that certain substances, such as gold, platinum, chalk, charcoal, lycopodium, &c., which in their natural state possess little or no action upon the human economy, become, after trituration, possessed of great power, and can be employed as very valuable medicines. These latter facts led him to suppose these medicinal dilutions to be absolute increments of power, and therefore that the 30th dilation is a sufficient dose, and the best adapted to all cases. So much did he see the efficacy of trituration, that he warns us against exalting too much the latent virtue of medicines. That the latent power of substances is developed by trituration and solution, is familiar in physics and chemistry, and has been undeniably proved by the experiments of Hahnemann and the experience of his followers as applied to medicines. Absolute increase of power can be admitted only in the case of such substances, as, in their natural state, ex DOPPLER ON TRITURATION. 87 as a partisan of homosopathy, but in a purely scientific character as a professor of physics. Before presuming to call any thing small or great-in relation to its effects, in other words, before we can set it down as powerful or powerless, we must ascertain if the property in question is one dependent on gravity or on superficies; otherwise we may be found using the balance in a case which requires the rule. Now it seems to have been tacitly assumed by pharmacologists, that the activity of a drug depends entirely on its weight; hence the ridicule bestowed on the evanescent doses employed by homceopathy. If, however, it shall appear that the activity of a medicine depends only on the parts in contact with the body, we shall perceive, a _priori, the possibility of doses insignificant in mass, but of extensive superficies, being active agents,-a result which Hahnemann and his followers have arrived at by the independent and still more satisfactory process,that of induction from facts. Before proceeding farther, it will be requisite to advert to the distinction between the physical and the mathematical superficies of a body. By the former designation we mean the sum of the superficies of all the particles composing the body, while the latter is synonymous with the surface of common parlance, and denotes that portion of the surface of the outermost particles which is external or free. It is obvious that no process of mechanical division can either increase or diminish the physical surface of a body; it can be affected only by changes which reach its ultimate molecules, those, namely, of a chemical nature. Not so with the mathematical surface, which undergoes enlargement from every fresh subdivision; particles previously in contact with other particles of the same substance now becoming external. Thus a cube of an inch reduced, we 88 DOPPLER ON TRITURATION. shall say into a million of pieces, each of which will be about the size of a grain of sand, will have increased its mathematical surface from six square inches to between six and seven square feet. By a further subdivision into particles a hundred times smaller, such as those particles of dust which float in the air, the external surface increases to a thousand square feet or more. If, then, medicinal virtue be exerted by the external surface alone, it is clear that the process of subdivision must augment it. It would be erroneous, however, to suppose, that the activity of the drug increases in the same ratio as the surface does, for we must remember that the intimate contact of the particles must prevent many of them from touching the body; in other words, from being active. To render active the whole surface gained by trituration, we must prevent this intimate contact, by the interposition of some other substance, such as sugar of milk. Proceeding on the moderate assumption, that by each trituration the particles are reduced to the hundredth part of their previous size, we shall find the surface of a medicine originally a cube of an inch, will become, at the third trituration, equal to 2 square miles; at the fifth, to the Austrian dominions; at the sixth, to the area of Asia and Africa together; and at the ninth, to the united superficies of the sun, the planets, and their moons. Doppler concludes-" We have said sufficient to shew that if medicines act in virtue of their mass, the doses used in homoeopathy must be quite inert; but if in proportion to their surface, they may be of tremendous potency.1" Others, again, attempt to explain the advantages gained by trituration, "by supposing that, during the operation, ' Journal Hahnemannienne. No. 7. Also Hygea, xi. 1. VIEWS OF PELTIER. 89 electricity, or some power analogous to it, becomes developed, and remains inseparably connected with the substance acted upon." M. Peltier declares, that, in his opinion, this was quite sufficient to account for the energy of the homoeopathic globules.1 But this explanation is erroneous, first, because oxidation only takes place in a very few instances (if ever?) where trituration is employed; second, as, according to M. Peltier, electricity is developed in proportion to the surface gained, the thirtieth dilution ought to be much more powerful than the third; which is not the case. All must feel that, as yet, the attempts made to account for the efficacy of minute doses are incomplete; but it is cheering to think that we have to do, not with how they act, but with the more important question, if they do act. That they do act has been proved by thousands of experiments, the truth of which cannot be impugned. With those who scout what they cannot explain, we confess we are unable to enter into discussion; but if they remain firm on such foundations of belief, we will grant the value of their decision, when they first prove to us satisfactorily, why five grains of tartar emetic excite vomiting. Further, these in1 )Notice d'une communication faite a l'Academie des Sciences a Paris, au mois de Janvier, 1839. " M. Peltier, un de nos meilleurs physiciens experimentateurs, a recueilli la quantit6 d'electricite qui se degage pendant l'oxidation (par l'eau) d'un milligramme de zinc. L'experience a dure 25 mois, et pendant tout ce temps il a eu un courant d'electricite d'un degre d'intensite. Ce courant d'electricite dynamique, implique l'existence d'une quantite plus considerable d'electricite statique. Or c'est celle-ci qui se recueille, s'accumule et se garde sur les corps isoles, et comme elle se fixe en raison des surfaces, plus ces surfaces sont multipliees par la trituration, ou une desagregation quelconque, plus la dose d'electricite est considerable. Cette maniere d'agir de l'6lectricitd statique rend parfaitement compte de l'energie des globules homoeopathiques. 90 ACTION OF MINUTE DOSES. dividuals, to be consistent, should deny the power of contagion, of malaria, for though thousands have experienced their baneful action, who has yet discovered their weight, measure, or composition? In mechanical philosophy and in chemistry, are we not contented with the simple observation of phenomena, and do we not leave unattempted the modes by which they operate? Like these, the efficacy of minute doses is atpresent an ultimate fact, and beyond that we cannot proceed. These are mysteries which we must leave to the Great Author who intended the whole to subserve the purposes in which we alone are interested, who has wisely secured to himself the nature and control of first causes; and who has thereby restricted our inquiries to the only useful objects of knowledge, their various phenomena. (91) CHAPTER VIII. What is Disease--Remote and Proximate Cause-Totality of the Symptoms -Value of Physiology-Pathology-Nosology-When the entire symptoms have disappeared the patient is cured-Symptomatic medicineErroneous notions entertained as to the I-Iomceopathic System being symptomatic. LIFE has erroneously been considered by some as an entity, whereas it is an abstract term denoting phenomena arising from the reaction between two factors, the one internal (organism possessing certain properties called vital), the other external, external stimuli. This reaction, when normal, constitutes health; when abnormal, disease. As Life, then, is not an entity, neither is Disease an abstract thing, possessing an existence independent of organism; both are terms simply signifying "different modes of being, or the same mode of being under different circumstances." Much discussion has arisen with regard to the dynamic nature of disease, as advocated by Hahnemann, who supposes that morbid phenomena are operations of the vital power departed from its natural condition. This substitution of vital power for vital properties is not peculiar to Hahnemann, but has been more lately laid down by Dr Copland, who supposes that morbid causes "make their first impressions upon the vital endowment of the organ, disordering the functions which it performs under the do 92 92 CAUSES OF DISEASE. minion of life; and the functional disorder either leads on to the production of further disease, or indirectly to a return to the healthy condition.",, This view and that of Hahinemann's are logical, in so far as they consider morbific causes affecting what is not a principle, a power, but a property; but we can still use the term dynamic, which, with Hahnemann, is frequently employed for vital, as it applies to disordered manifestations, not of ordinary matter, but of a peculiar organism, presenting phenomena widely different from inorganic matter. So far, then, the term vital is correct, and is in opposition to the primary effects of many chemical and mechanical agents. The causes of disease have been denominated as remote and proximate, the former have been subdivided into two, -the predisposing and exciting. One of the necessary conditions for healthy action is a natural susceptibility to natural stimuli, and in diseased action also, there must be a preternatural susceptibility to preternatural stimnuli; the former constituting the predisposing cause, the latter the exciting cause of disease. With regard to. the proximate cause, ill defined notions have existed; consequently some have overrated its value, while others have denied its existence. "11A disease is analogous to a healthy function, a proximate cause to the mechanism of that function. We may recognise the one without knowing. anything about the other. A disease bears nearly the same relation to a proximate cause which, a shadow does to the substance which produces it; and as the;shadow is the evident and immediate effect of the interposition of the substance, so as to intercept the rays of light, whether the substance be obvious or not; so a disease is the immediate effect of its proximate cause, which, in like mannemay or may not be obvious; in other words, it is merely, Diet. Pract. Med., art. Disease. HAHNEMANN'S VIEW OF DISEASE. 93 an abstract term, by which we signify certain phenomena without any reference to their immediate origin.." "It maybe easily conceived that every malady presupposes some change in the interior of the human economy, but our understandings permit us to form only a vague and dark conception of this change from a view of the morbid symptoms, Which are the sole guide we have to rely upon, except in cases purely surgical. The immediate essence of this internal and concealed change is undiscoverable, nor have we any certain means of arriving at it. As in disease, when no manifest or exciting cause presents itself for removal, we can perceive nothing but the symptoms; then must these symptoms alone guide the physician in the choice of a fit remedy to combat the disease. The totality of the symptoms, this image of the immediate essence of the malady reflected externally, ought to be the principal or sole object by which the latter could make known the medicines it stands in need of-the only agent to determine the choice of a remedy that would be most appropriate. In short, the totality of the symptoms is the principal and sole object that a physician ought to have in view in every case of disease; the power of his art is to be directed against that alone, in order to cure and transform it into health. "4 In fact the invisible change which has been produced in the interior of the body, and the mass of symptoms perceptible to the senses, are so connected by the bonds of mutual necessity, and united in so intimate a manner, in order to constitute the entire disease, that the one cannot stand or fall without the other-they must therefore appear and disappear simultaneously. From thence it follows, that whatever was capable of producing the group of perceptible 1 Fletcher's Pathology, p. 4. 94 TOTALITY OF THE SYMPTOMS. symptoms, ought also to have determined the internal morbid change which is inseparable from the external manifestation of the disease, without which the appearance of the symptoms could not possibly take place. That which destroys the totality of the symptoms of the disease ought equally to put an end to the morbid change in the interior of the organism, because the destruction of the former cannot be conceived without that of the latter, and we have no facts whatever from which we could draw an inference that one of these can take place without the other."' Great misconception has arisen from the undue consideration of the term "1totalityi of the syrnptoms:" by totality we are to consider not only the symptoms which the patient may describe, but also all those which the tact of the physician can discover. Thus, it is not to be imagined that the homoeopathist neglects the employment of the stethoscope or percussion. The indications afforded by these are surely symptoms; for example, if tubercles existed on the skin, would they not be ranked among the symptoms? Then why should they not also be so considered when existing in the lung, made appreciable to the physician not by sight but by hearingo? The invisible, the internal changes referred to by Hahnemann, and which all must agree with him in considering undiscoverable, are to be viewed, not as changes in structure or function, but purely as the essence of the disease, the causa proxima in the strictest sense. Whenever material changes exist, these are to be taken into consideration. In addition to the totality of the symptoms, the due value of the symptoms is also to be considered, which can only be arrived at by a correct acquaintance with physiology and pathology. It is an error to suppose that the homoeopathic school neglect IOrganon. 96 NOSOLOGY. veying in one word a class of symptoms; but further than this they are useless and dangerous, as leading to a routine practice which has for its guide the generic character, and not the individual species of the disease,-a practice which has led Hufeland to remark what is top true, but at first sight paradoxical, " that we treat very well the disease, but very badly the patient." All will answer negatively the question, Has the construction of nosological systems been as yet of any practical use? I " Nihil sane in artem medicam pestiferum magis unquam irrepsit malmn, quam generalia quaedam nomina morbis imponere, iisque aptare velle generaclm quamdam medicinam." (Huxham, Opp. Phys. Med.) " Dr Elliotson thinks methodical nosology useless, and advises his pupils never to plague themselves more about it; he nevertheless admits the advantage of a general arrangement. If we (Dr Forbes) were to advance an opinion on this subject, we should say, that methodical nosology, employed as it has been to reduce all known diseases within limits of a natural history arrangement, is worse than useless, and that all attempts at a universal qualification must fail, till we are perfectly acquainted with the nature, seat, and symptoms of all morbid actions. Hence the impossibility of forming a general nosology on principles either philosophically true or practically useful." (British and For. Med. Review, April 1840, p. 465.) " Delivering under their respective heads the collection of symptoms by which each is commonly known, nosologists have in general not only confined themselves, in their establishment of individual diseases, to their symptoms, but, not content with this abuse of ontology, have packed them according to all sorts of relations, real and imaginary, into shadowy fabrics of genera, orders, and classes, composed respectively of symptoms more and more general, and each distinguished by some cacophonous name,- the invention of all which, far from illustrating the distinctive value of morbid affections, has served only to substitute the interminable and incongruous fictions of a misplaced art for the comparatively few and simple realities of nature, and thus to divert the student from the contemplation of things themselves, by trammelling the mind with chimerical systems, founded on principles fleeting and intangible as the winds and clouds, and held together by relations which have freqouently no existence but in the brain of the nosologists." (Fletcher's Pathology, p. 202.) 98 SYMPTOMATIC MEDICINE. matic. To this title we do not object, were it applied on account of the great value attached to symptoms; but as standing in contradistinction to rational, it is not at all applicable. Our opponents seem to forget the great difference between treating the totality of the symptoms, and directing the treatment to one individual prominent symptom, disregarding the others. But this application of the term symptomatic in its ignoble sense, is answered by Hahnemann:" Not knowing at times what plan to adopt in disease, physicians have till now endeavoured to suppress or annihilate someone of the various symptoms which appeared. This method, which is known by the name of symptomatic medicine, has very justly excited universal contempt; not only because no advantage is derived from it, but because it gives rise to many bad consequences. A single existing symptom is no more the disease than a single leg constitutes the entire of the human body." 1 The term symptomatic, so used, is frequently applicable to the allopathic, but never to the homoeopathic school: for example, in the everyday treatment of fever, we find in a disease where such bright expositions of rational treatment are enforced, that it is, after all, purely symptomatic. The frequent constipation (supposed bythe practitioner to exist) is treated in the morning by purgatives, during the rest of the day the heat of skin and thirst must be relieved by a refrigerant, the sleeplessness at night by an opiate; occasionally the dim vision of rational treatment haunts the doctor. Here, he says, is congestion; this is the cause of the weakness; in one ward the lancet is vigorously used, or local bleeding and stimulants internally; in the other, for the same cause, the patient is invigorated with no small share of stimulants. And 1 Organon, ~ 7, note i. 100 CAUSAL CURES. removal of that cause, merely by means of a remedy suited to the aggregate of the symptoms."' Hahnemann has so often expressed himself upon this subject, that the pretence of misconception cannot for a moment be allowed.2 We again declare that the charge in question, implying, as it does, the grossest ignorance, is utterly untrue; in all cases wherein the remote cause continues to operate, if its removal be possible by the interference of art, we consider it just as much a primary indication to remove it as do. the physicians of the old school. " As the essence of a disease (taken in the strictest sense of that term) is unknown, a " causal cure," which has for its immediate object of treatment that essence, can take place just as little by the old method as by ours. The pretension to causal cures in this sense is in other respects the less availing, as proof of a general point of difference between the two schools, inasmuch as many of the adherents of the old school manifestly entertain the same views,3 and 1 See Heinroth, Antiorganon, p. 35. 2 Vide Organon, ~ 9, note i. " It is taken for granted that every intelligent physician will commence by removing this ' causa occasionalis;' then the indisposition usually yields of itself. Thus, it is necessary to remove flowers from the room where their odours occasion paroxysms of fainting or hysteria; to extract from the eye the foreign substance which occasions ophthalmia; to remove a tight bandage from a wounded limb which threatens gangrene, and apply others more suitable; lay bare and secure a wounded artery, where haemorrhage produces fainting; evacuate the berries of belladonna, &c., which have been swallowed, by vomiting; extract the foreign particles which may have been introduceed into the openings of the body (the nose, pharynx, ears, urethra, rectum); grind down a stone in the bladder; open the imperforate anus of the new-born infant," &c. 3 Professor Choulaut thus expresses himself (Neue Zeitschrift f. Natur. und Heilkunde, B. 1, H. 2; Grundziige fur die selbststaindige Bearbeitung der Medicin). " The uncertainty of practical medicine is the consequence of our attaching too high a value to our mental powers, since we not only asS...: eeo a^. ~, CAUSAL CURES. 101 mere hbypothesis and self-deception will go for nothiiig. Between the principle of homoeopathy and such a causal cure, however, there would be no incompatibility. Did we possess an intimate knowledge of the nature of diseases, and an equal acquaintance with the operation of medicines upon the healthy, itwould be in our power to cure homceopathically with still greater certainty. From the conviction that practical medicine requires an objective basis to answer its destination, and that its limits should be restricted to what we know or what may be known by investigation, we embrace the principle of suffering ourselves to. be led by the lower, but, to us, attainable data, rather than by the higher, which lies beyond the reach of human scrutiny.' sume to know the inscrutable, viz., the diseased process taking place interSnally, but even make this inscrutable itself the basis of our medical theories. We are content with images and apparent explanations of that internal cause, and build upon it our pathologo-therapeutic system; while this cutaneous eruption, that nervous disease, or that fever, must teach us that we are able to discern almost any thing sooner than that internal process which determines the course of the disease." "But that which is cognizable of the disease is only its remote cause and the totality of its symptoms; the connecting link which unites the two, the proximate cause of the disease, is to us inscrutable." " The internal cause of disease is as little cognizable to us as the cause of life itself; and as a sound physiology is satisfied with the comprehension of the laws of healthy vitality, so medicine that is truly practical needs not as its great aim a knowledge of the internal cause." 1 That the investigation of the nature or essence of disease is to be totally neglected (as IHabnemann inculcates) is no article of belief with the homceopathists. A sense of internal want, an innate desire of investigating hidden causes, urges the human mind to make even the apparently inscrutable a pro.. blem of investigation. Why should we not obey this impulse? Before we are so fortunate as to attain the desired aim, however, we are not inclined to accept images and analogies, the reality of which is very doubtful, as substitutes for facts, and still less to acknowledge them as the basis of practical -1 02 VALUE OF INTERNAL CHANGES. "We are able to investigate only the laws of phenomena, but not their internal cause, and when we think we have explored the essence, further investigation soon convinces us that we have mistaken a creature of the imagination for a reality. " But how far the knowledge of the internal changes, so far as the appreciable side of the disease is thereby to be understood, is estimated and practically regarded by the homoeopathist, we will endeavour briefly to represent: When the sub-stratum of the symptoms may be known and is of unquestionable reality; for instance, the inflammation of an internal organ, its degeneration, &c., this knowledge is no less important for the homoeopathist than for the physician of the old school, yet it is employed differently, arising from the divergence of the two methods. The old school regards the symptoms only as the means for ascertaining their cause, and the cause as the only indicans. Hence a subordinate value is attached to the symptoms which exercise no immediate influence in the treatment. To the homoeopathist the ascertained cause is also an indicans, but it does not exclude the consideration of the symptoms, which directly influence the treatment. The knowledge of the cause enables him to select remedies which, not only in appearance but in character, stand in a close relation of similarity of action with the cause of disease. If the cause, for example, be an inflammation of the brain, a homoeopathic remedy would be chosen, which has a tendency to produce this pathological condition; and if the existing cause can be medicine, and as the leading motives for our method of treatment at the bedside of the patient. Ali these investigations appertain to the natural sciences, and to them they should be restricted; but they are not a science to be applied like practical medicine, the aim of which, the cure of diseases, excludes the hyp9thetieal,' and should embrace only what is established. VALUE OF SYMPTOMS. 103 traced to an abuse of spirituous liquors, a remedy would be selected, which approaches the nearest in its action to that of alcohol. But for the further determination which particular remedy to select out of the several which have this tendency, we are governed by the aggregate of the symptoms, and we believe the treatment to be thereby more appropriate, since there are various finer shades in the symptoms not traceable to their cause, and considered by the old school non-essential, but which we regard in a different light, because we have experienced that a remedy agreeing with the principal character of the disease is remedial in some of the shades adverted to, while in others it is used ineffectually. This is a circumstance which is less regarded by our opponents, because their treatment is directed more by a method against the genus of the disease, while ours by one remedy against the variety determined by its individual character. There can be no doubt, however, that whereever the substratum of morbid condition can be known, it is a matter of essential reference to the homceopathist in his treatment, and therefore the conception of a causal cure (considered in its practical results) is just as predicable of our treatment as it is of the old method. " In many cases the substratum of the entire symptoms is, for the time being at least, inscrutable, and we are able to indicate, more or less fully, only the cause of individual, disjointed groups of symptoms. The one group shews, for example, important affections of the cerebral system, the other a great disturbance of the ganglionic system, the third the sufferings of parts of the latter expressing themselves in particular; but the actual state of our knowledge affords us just as little of a clear motive, divested of hypothesis, to refer these symptoms to a definite total substratum, as to consider the one or the other as the principal affection. Un 104 WHAT IS RATIONAL PRACTICE. der these circumstances our attention is confined to the partial substratum, and at same time to the totality of the symptoms. Hereby is implied no essential difference, in loto, with the old medical school, because many of their most notablle practitioners proceed upon the same views, which we consider superfluous any further to enlarge upon. " If to such a process the name of a causal cure is not granlted, it must be denied on the part of such practitioners only who treated the Asiatic cholera strictly under the belief of its being an inflammatory affection of the spinal marrow, a febris intermittens perniciosa, a primary decomposition of the blood, or according to any other of the innumerable views entertained concerning the nature or substratiumn of that disease. These physicians would doubtless have a right to reproach the homoeopathists, as well as those of the old school, for not treating the cause, if it is understood thereby, that to constitute a causal cure, a true knowledge of the cause need not be premised, but that it is sufficient to substitute an hypothesis, and to make it the basis of tlhe medical treatment." Let us open, for example, any monograph, and upon the information therein given, attempt to treat the disease accordiun to the varied opinions as to the nature- of the disease. Treatises upon phthisis, gout, rheumatism, cholera, fever,, c., afford ample materials; we select delirium treArmstrong regards it as a venous congestion in the brain and liver consequent upon activity of the heart and arteries increasedl by irritation; Klapp derives it from disorder of the digestive orgrans Sandwith from abdominal venous coull'tion; Staugthon from Gastritis Playfair from a Imorlbid state of the liver and intestinal secretions; Goeden titds the seat in the solar and caeliac plexus, and regards the WHAT IS RATIONAL PRACTICE. 105 affection of the brain as simply sympathetic;-Giinther admits a cerebral affection, in the one case idiopathic, caused by metastatic deposits, in the other sympathetic, provoked by gastric irritation;-Toepken believes it to be a sympathetic irritation of the cerebral system arising from the caeliac plexus; according to Perry, it consists in a febrile cerebral affection, inflammatory in a great measure; according to Sutton, in a peculiar irritation of the brain, approaching to phrensy; according to Andrea, Clutterbuck, and Bright, it is the consequence of inflammatory action in the arachnoid and pia mater; Hartes regards it as a superficial erysipelatous inflammation of the cerebrum; Blake as an indirect weakness of the nervous power consequent upon morbid activity of the brain and nerves; Hufeland believes that it is only a passive nervous delirium; Copland admits that it may sometimes be inflammatory irritation, but more generally that it is vital and nervous depression, increased by the morbid impressions produced by accumulated secretions of a vitiated kind in the biliary system, and on the digestive mucous surface; Wasserfuhr admits that the alcohol is changed into blood, from which arises drunkenness, and from this results a continued affection of the brain, when the alcohol cannot be assimilated; according to Spoeth the disease is the result of a rupture of the equilibrium between the brain and the nervous system of the abdomen; Stokes says there are two kinds; one consisting in diminished irritability, the other in increased excitement. What rational treatment can we adopt if guided by such a heap of contradictory and fanciful views? " When the phenomena of the disease are so conditioned that we are totally unable to discern the internal affection, we certainly pay exclusive and strict attention to the totality of the symptoms. When the substratum is ambiguous, 106 VALUE OF SYMPTOMS when just as many probable reasons decide for the one as for the other,-in a case, for example, wherein one practitioner believes that he has a case of plethora venosa abdominalis, another, a nervous affection, a third, an anomalous gout, &c., we also adhere pre-eminently to the totality of the symptoms; but under such circumstances we do not wholly renounce speculation; so that if the curative end should not be attained by that process, we may also employ as indicans, the more plausible opinion concerning the nature of the primitive suffering. "When the totality of the symptoms presents primary and secondary groups, it is a problem with the homoeopathic physician to find that remedy which the most completely answers to the character of the suffering expressed in the first. But among several remedies which appear to him equally suited, he unquestionably selects that one, which covers, in addition, the most important symptoms of the secondary group (for instance, painful sensations in the head, dizziness, &c., as concomitant phenomena of a gastric affection), under the conviction that a remedy, which, together with the primary condition, answers also immediately to the concomitant, is the best adapted to excite the organism to beneficial reaction. We cannot believe that the charge of not effecting a causal cure is applicable to us on account of entertaining these views. " We hope it will be clear to those of our opponents who are actuated by an unprejudiced judgment, that we regard the perceptions of the disease, which are derived through the senses no more than themselves, in the light of materials which do not require further elaboration, and the deductions of reason; that, like them, we hold the removal of the remote cause as the most needful and first indication; that we reject the light offered by the previous history, in IN HOM(EOPATHIC PRACTICE. 107 estimating the morbid condition, as little as themselves; that we regard the primary and secondary condition as well as they; that, equally with them, we avail ourselves of the present standing of medical science for a knowledge of the internal cause. It must then be evident that the distinction consists only in this,-that we do not give ourselves up to the self-delusion to suppose, that our present measure of knowledge is sufficient to enable us to trace the morbid phenomena on all occasions fully to their cause, and upon this to found the treatment; that we consider much as significant and worthy of observation of which we do not know the organic basis; that, however, we do not borrow from daily changing hypotheses a motive for the method to be pursued; that we do not, therefore, take our opinions of the internal cause, the abstractum of the symptoms as the sole indicans (in which the symptoms figure only as a caput mortuum), but the abstractum, together with the totality of the symptoms, is the ordinary indicans. There are differences which, as has been already mentioned, spring from the divergence of the two schools; the one school aims at curing with remedies selected in conformity to certain methods, the other with specific remedies strictly adapted to the concrete case. The differences, however, are not at all of a kind which would justify the adherents of the old school in making the observation of the cause a point of distinction, and to vindicate it as an advantage of theirs in opposition to the homoeopathic physicians. From the acknowledgment that in those cases in which the cause of the totality of the symptoms is not to be known, we confine our attention exclusively to the latter, if our adversaries would infer, that, at least, they practise causally in more cases than we do, we might, in reply, remind them, that between willing to treat causally and to do so in fact, there is a great 108 RATIONAL TREATMENT. difference, which is not removed by illusory explanations; that the plan of treatment may often be in strict accordance with the highest deductions of reason, and yet, in deterininirn that treatment, we perceive far more clearly the influence of the symptoms, than that of the most penetrating views regarding the nature of the disease; that the most different reasons are assigned why the same treatment has been salutary, according to the diversity of views held by different physicians; and that the desire to treat the case causally does not exempt the physician of the old school from the necessity of treating serious forms of disease by means of remedies called empirical, because the causal relations of the case cannot be traced, and yet with such remedlies good causal cures are in fact performed. Moreover, it should not be forgotten what a strictly causal relation is expressed in the principle of homoeopathy, viz. of curing local diseases, so called, solely by general remedies; morbid secretions solely by regulating the abnormal activity of the respective organ; and, finally, that, in one respect at least, a causal cure is clearly known to us, namely, the relation of the remedy to the disease.'' I Dr Walf's 9th Thesis. These valuable theses, illustrating the principles of homoeopathy according to their true sense and scientific acceptation, have been translated by Dr Matlack, and published in the Hom. Examiner, vol. i. p. 109. 109 CHAPTER IX. Chronic Diseases, according to Hahnemann, attributed to three miasmsPsoro, Syphilis, and Sycosis. - Review of this doctrine.-Medicinal Diseases. CHRONIC diseases, almost imperceptible at their commencement, and of long duration, owe their origin, according to Hahnemann, to three miasms or contagions,-Psora, Syphilis, and Sycosis. Before reviewing the Hahnemannic theory of chronic diseases, it will be necessary to shew the grounds on which he based it. After twelve years of diligent research, Hahnemann was led to believe that psora (scabies)was the source of most chronic complaints, from observing that chronic diseases, treated homoeopathically, even in the best manner, reappeared after havingbeen frequently seemingly cured; that they appeared always under a form more or less modified, and with new symptoms, and each year with a perceptible increase in their intensity; this could not be owing only to the morbid state which presented itself: it should not be considered and treated as a separate disease, since, if such were its character, homoeopathy ought in a short time not only to cure, but to cure permanently, which was contrary to his experience. From this he concluded that we have only in sight a portion of the deeply seated primitive evil, the vast extent of which is shewn by new symptoms being developed from time to time: that we ought not in such cases to pro 110 PSORA. cure a pernianent cure, until we know all the accidents and vymptoms produced by the primary unknown cause, and thus be enabled to seek the homceopathic remedy. Further confirmation was drawn from the fact that these diseases never yielded to the most healthy diet or the most regular life. He had advanced so far when he observed that the difficulty of treating certain affections which seemed to be separate diseases, and to possess an independent existence, apparently occurred in patients who had had formerly scabies, and who traced their illness from that period, or in whom, if they forgot the circumstance, slight traces of the eruption could be found. "These circumstances, joined to the fact established by numerous observations of medical writers, and sometimes also by my own experience, that the suppression of a psoric eruption, whether from bad treatment or any other cause, had been immediately followed in patients otherwise healthy by similar or analogous symptoms, left in my mind no doubt as to the internal evil which I had to combat. " By degrees I discovered means more efficacious against this primitive disease, to which I give the general name of Psora, whether existing with or without a cutaneous eruption; and in applying these medicines to the treatment of similar chronic affections, when the patient could not assign as a cause an infection of this kind, it became evident, from the success I obtained, that, even in cases where the patient did not recollect having had the itch, still his complaint was attributable to scabies, which he had forgotten, or which had been driven in while he was an infanta conjecture which was frequently confirmed by the friends of the patient. Careful observation of the curative virtues of the first antipsoric remedies only confirmed me more PSORA. 111 and more in the conviction that such was frequently the origin, not only of slight chronic diseases, but of the most severe. It persuaded me that not only the greater part of the innumerable diseases of the skin which have been distinguished and denominated so minutely by Willan, but also all the pseudo-organizations, from the wart upon the finger to the enlargement of bones, to the deviations of the vertebral column, and to many other softenings and distortions of bones in infancy and adult age; that the frequent epistaxis, the congestions of the hmemorrhoidal veins, hemoptysis, hematemesis, and hematuria, amenorrhoea, menorrhagia, habitual nocturnal sweats, dryness of the skin, habitual diarrhoea, obstinate constipation, chronic erratic pains, convulsions appearing during many consecutive years; in a word, the thousand chronic affections to which pathology assigns different names, are only, with few exceptions, the offsets of a polymorphous psora. " Continuing my observations during these later years, I remain convinced that the chronic affections of the mind and body, which vary so much as regards the accidents they determine, and the varied appearances they assume, are only (when they cannot be attributed to syphilis or sycosis) the partial manifestations of this primitive chronic miasm psora, that is to say, the ramifications of a single and immense fundamental disease, the innumerable symptoms of which form only a whole, and ought only to be considered and treated as the members of a single and unique disease. For example, in an epidemic typhus, say of 1813, one patient only presented some few of the symptoms peculiar to the epidemic; a second offered some also but different; a third and a fourth others; all meanwhile were affected with the same pestilential fever, and we were obliged to take the symptoms of. all, or in a great part, in PSORA. 113 given by him, a work has appeared by Autenrieth (an allopath), in' which he details many striking cases of the evil effects resulting from suddenly suppressing scabies: the repeated occurrence of these cases has led him to.conclude that the psoric virus frequently gives rise to epilepsy, phthisis, palsy, &c.1 Wagner also, about the same time, defended and published a thesis, entitled:-" De morbis ex scabie orientibus, magistratum attentione non indignis." Broussais considers scabies and dartres as frequently the cause of dropsies.2 Bouillaud admits that certain diseases of the heart, and more especially its hypertrophy, may succeed certain cutaneous affections. Albers says that organic disease of the heart is no unrare occurrence after scabies is repelled.3 Well marked cases, in which obstinate diseases have arisen from suddenly repelled scabies, have also been remarked by various homoeopathic writers, by Rau, Griesslich, Gastier, &c. The cases brought forward by Hahnemann, and those by other writers, prove that many chronic diseases apparently owe their origin to repelled psora; but because some spring from this contagion, it does not necessarily follow that all must. In this country, to those who have given no attention to the subject, it may appear ridiculous that any one for a moment could attach so much importance to such a doctrine; but a careful investigation would convince the most sceptical, that though there may be exaggeration in the hypothesis, still it is not devoid of truth. 1 Versuche iiber die Prakt. Heilkunst. Tubingen, 1807. 2 Comment. des propositions de pathologie, tom. ii. p. 623. 3 Beitrige zur Pathologie und Diagnostik der Herzkrankheiten; in Archiv fir Med. Erfahrung, Jan. Feb. 1833. H 114 PSORA. It is no proof that because the symptoms arising from repelled psora resemble those characterizing chronic diseases, that, therefore, the causes must be identical. We might with as great reason conclude, " that because indigo produces a blue colour, therefore all blue colours come from indigo." The statement that a large number of diseases are never perfectly cured by ordinary remedies is unfortunately too true, but is no ground for the supposition of a miasm. Hahnemann admits that many morbid states, resembling closely psoric diseases, are sometimes cured by regimen apd removal from hurtful causes; but these he considers as improper, the latter only as proper chronic diseases; but the difficulty of curing disease is no good ground for such a distinction. The remedies which Hahnemann has found useful in chronic diseases, he has styled Antipsorics, a term which, as it depends on partial hypothesis, should not now be employed. This class of medicines, however, seem peculiar in their action and duration, and from their great value in the treatment of disorders of the vegetative system, such as dyscrasias, Ran has proposed to call them Eucrastics. Erroneous as the psoric hypothesis of Hahnemann may be, it has been attended with advantages, and caused no schism whatever in the practical application of the homoeopathic law. Strictly abiding by the totality of the symptoms, he does not recommend one or two medicines to be employed against the psoric disease, but indicates a number of so-called antipsorics, the selection of which is to be determined strictly according to the peculiarity of the case, and the fundamental principle Similia similibus; so that, for example, some antipsoric remedies are more suitable for gout than for phthisis, for rheumatism than for neuralgias, &c. 116 SYPHILIS. place et ne fournissant plus la secretion specifique virulente," and can therefore only be communicated by hereditary taint. A chancre cannot be distinguished from an ordinary ulceration, either by its appearance or by the history of the case, but only by the pus which it secretes possessing the property of producing by inoculation a similar disease. " The chancre is, at its commencement, a local disease." If the chancre is (according to Hahnemann) a vicarious symptom, why should this ulceration be constantly developed upon the precise spot of inoculation, and never upon any other? The general symptoms, which cannot be manifested but after this antecedent (chancre), do not happen in all cases, and when they do take place, it is only after a certain time. To arrive at this important result, it is necessary to distinguish the real from the fictitious commencement of the chancre, that is to say, not dating from the day on which the patient observed it, but from the day on which he supposed he contracted it. " In making an extract of observations bearing upon this point, it will be seen that ulcerations completely destroyed by caustic or other means, within the three, four, or five days which follow the application of the virus, do not expose the patient to secondary infection." " It is only about the fifth day that the induration of the chancre commences; it is generally the indurated chancres that are followed by secondary symptoms, and this induration seems to be the announcement that the principle has penetrated deeper into the economy. As long as this induration does not take place, we may correctly suppose that the evil is only as yet superficial." Secondary symptoms are never communicated by conta TREATMENT OF SYPHILIS. 117 gion, but by hereditary taint. M. Ricord, after consulting many authors, and above all from his own experience, which in this disease is perhaps more extensive than that of any practitioner, says, that he knows of no single case in which the chancre being destroyed before the first five days of its real existence, the symptoms of general poisoning had ever taken place. " Destroy, then, every excoriation, every wound, every solution of continuity, which presents itself after connection. I do not say only suspected, but in every case."' Proceeding upon the nature of syphilis as given by Ricord, we should be led to recommend a modification, in some measure, of the practice inculcated by Hahnemann. In all cases of a solution of continuity after suspected connection, the part should be carefully touched with nitrate of silver, but at the same time constitutional treatment must be resorted to and persevered in for some time. The application of a cautery may appear repulsive to most of the homoeopathic school, but a similar course is followed by Hering (one of Hahnemann's most ardent followers) in the prophylaxis of hydrophobia, where he recommends heat to be applied to the wound, at the same time employing, internally, belladonna. No danger whatever can arise from the administration of the small doses of mercury2 used] in homoeopathic practice, so that the slightest danger of injuring the constitution, the great bugbear in allopathic practice, need not be dreaded. SRicord, Trait6 Pratique des Maladies Veneriennes. Paris, 1838. P. 80, et seq. The experiments of Dr Mairion in the Hospital of Louvain are also very satisfactory. "2 It must not be supposed that mercury is the only specific; there are several other remedies also homoeopathic to syphilis. 118 SYCOSIS. Cauterisation is contra-indicated when the chancre has existed three or four days, and it may likewise be injurious as inducing the practitioner to suspend the constitutional treatment. By this procedure, the danger of overlooking and increasing the general disease is avoided, and in many cases the cautery will succeed completely in preventing the constitution being tainted with the virus,-an end much more desirable than an opportunity of manifesting the beneficial results of specific treatment. Where the solution is a simple abrasion of the surface, and not arising from suspected connection, a weak solution of the tincture of arnica will speedily heal it. Sycosis (Maladie des fics, from ficus) is a disease which has been only partially noticed abroad, and in this country has scarcely been written upon. It was very much spread during the last war from 1809 to 1814, but from the latter date it has been much rarer. As it was only considered as a symptom of syphilis, and mercury consequently employed, the treatment has been generally very unsuccessful, and attended with injury to the patient. The excrescences appear generally upon the genital organs a few days, or even weeks, after impure connection, and are frequently attended with a gonorrhceal discharge. "They are seldom dry, resembling warts, more generally soft, spongy, imbibed with a fetid liquid, bleeding easily, and similar to cocks' combs or cauliflowers; they appear in. the male upon the glans penis, at the margin and inside of the prepuce, also on the scrotum, perineum, and nates; in the female, on the vulva and neighbouring parts. These excrescences have usually been treated by the most violent external applications, cautery, excision, ligatures, &c. The immediate and natural result of this method was, that, SYCOSIS. 119 generally, they reappeared at the end of some time, and these were again subjected to the same treatment; or if the practice succeeded in destroying them, the sycosis, deprived of its local symptom, which was vicarious to the internal disease, manifested itself in a more frightful manner by secondary symptoms; the external applications and the mercury (to which it is unappropriate) given internally being unable to destroy, in any degree, the sycosic miasm with which the body was as if in a measure impregnated. Not only the mercury, always hurtful in this disease, especially given in large doses, and in the shape of acrid preparations, destroyed the general health, but, in addition, analogous excrescences appeared upon other parts of the body; in some cases spongy elevations, whitish, sensible, and flat; at other times large, projecting, brownish looking tubercles, in the armpits, on the neck, and scalp; or, again, other symptoms were manifested, among which I will only mention here, retraction of the flexor tendons, especially those of the fingers. The gonorrhoea depending upon the sycosic miasm, and the excrescences, of which it is the source, are cured iU the most certain and radical manner by the internal administration of the juice of the Thuja occidentalis."' A few drops of a low dilution of thuja, in some cases alternated with nitric acid, will succeed in a short time in effecting a cure; in obstinate cases, in addition to internal administration, the condylomata may be touched daily with' diluted tincture of thuja.2 Traite des Maladies Chron. Vol. i. p. 132. et seq. 2 The virus of ordinary gonorrhoeas does not appear to affect the entire organism, but to be simply local. Such discharges yield readily to petroselinum, cannabis, or cdpaiba; I-Iahnemann recommends a drop of the mother tincture, which is to be repeated according to circumstances. In obstinate 120 JOHNSTON ON SYCOSIS. The only writer in this country who, as far as we have been able to find, has attended to sycosis, is Mr H. Johnston, who has given an excellent description of this disease, and its attendant secondary symptoms.1 In the first part of the paper, the various appearances of the condylomata are well described; the author agrees that " they are usually attended with profuse vaginal or urethral discharge." The secondary symptoms, he says, " are buboes, ulceration of the tonsils, a peculiar affection of the lip and of the tongue, and stains, or scaly eruptions, on the skin... The tonsils are commonly enlarged, sometimes very much so. Their surface displays a peculiar whitish ulceration. For the most part this is superficial; I have never seen it deep. Sometimes the ulceration is of a yellowish tint, with little enlargement of the tonsils; but the former state is by far the most frequent. Indeed, the experienced surgeon may in numerous instances predict this state of tonsils from observing the condition of the condyloma. I would wish to draw particular attention to these circumstances, as the combination of white ulceration of the tonsils with condyloma has never, so far as I know, been pointed out. Indeed, I am not aware that any of the secondary symptoms from condyloma have been noticed;"-except by Hahnemann. " Sometimes the soft cases of gleet, Hahnemann supposes that a dormant psora has been called into action; this, which we may view as a state occurring in certain diatheses, especially the strumous, must be treated by the so-called antipsoric or eucrastic remedies, especially sulphur. Hahnemann was the first to recommend and employ the Thuja occidentalis. 1 Remarks on the Venereal Condyloma, &c., Med. Chir. Rev. for 1834, p. 241. The author of this very descriptive paper, we hope, may be induced (although the Med. Chir. Rev. is very hostile to homoeopathy) to test the truth of this doctrine in the employment of the Thuja. HAHNEMANN'S THEORY. 123 this virus have distinctly traced it as the cause of many symptoms; and no doubt future observers will add their testimony to the fact, that acquired or hereditary psora is the origin of many diseases which at present are attributed to that so common cause, depraved secretions, which expresses nothing farther than that diseases are caused by diseases. It throws great light also upon another very generally given cause of chronic diseases, namely, hereditary predisposition. But we may well ask, what is this predisposition? The existence of a strumous, a rheumatic, an arthritic diathesis, are admitted as conditions which tend, upon very partial causes, to develope disease. But observers, and observers that can be depended upon, have gone further; they have shewn, by numerous cases, that repelled psora may give rise to these diseases, and also that the individual transmits to his progeny the same disease, which may be latent and only burst forth when excited by some very trifling cause. This doctrine of latent psora, whether it be true or not, as explaining the hitherto unknown signification of hereditary predisposition, has thrown great light upon the practice of homoeopathy as regards prophylaxis. Dismissing for the present the theory, it is pleasing to think how much has been done, and will still be done, by the employment of the class of remedies designated by Hahnemann, antipsorics. Until their employment chronic diseases were frequently palliated, but the disease only slumbered to break out ere long afresh; but by their means the deep seated evil is removed, and the individual is not only cured of his disease, for example, rheumatism, but in future is in a great measure freed from its attack. This is the great improvement which this doctrine of Hahnemann has introduced, not only relieving the patient, but also destroying his predisposition to the disease. MEDICINAL DISEASES. 125 ing the injurious effects of mercury, especially in some diseases and constitutions; works upon domestic medicine teem with most valuable warnings as to its employment. So deeply rooted is the dread of this drug that the very quack has to conceal its presence in his vegetable nostrum. But with all these salutary advices, its excessive use is still very general, and the injurious consequences become too frequently the subject of homoeopathic practice. In another chapter we have spoken of the injurious effects of purgatives, and in addition to this common cause of disease, we may allude to the general employment of stimulants. The administration of wine, bitters, ether, tea, coffee, &c. may appear a harmless practice; but were the profession less prejudiced, less partial to the only means they resort to in relieving debility, nervousness, &c. they would soon be convinced of the evils, physical and moral, they entail upon their unfortunate patient. The excitement, or what is as often described by the patient as comfortable feelings, arising from these means, is soon followed by depression; the dose is increased, repeated, and continued, until headaches, dyspepsia, &c. arise, and a more careful investigation would discover that these latter symptoms are the pathogenetic effects of the means employed. But the evil does not finish here; the little stimulant commenced for the stomach's sake, increases to a large quantity for the body's sake; and the sad sequel is too often seen. The employment of large doses of cinchona and quinine is also a frequent cause of disease, shewn chiefly in enlargement of the spleen,-a result admitted by allopathic authorities; and which Plaff, strangely enough, attributes to the azote which it contains.' 1 System der Materiellen Medicin. Leipsic, 1824. P1. viii. p. 117. The injurious effects of cinchona we have given at p. 29. 126 MEDICINAL DISEASES. Another medicine, the excessive employment of which is attended with many bad results, is chamomilla,-a plant which, though little employed in this country, is very extensively used in Germany. In the lying-in hospitals, where it is given as a diet-drink, its evil effects are not immediately seen, but as soon as the patient has left, the symptoms begin to manifest themselves. In the treatment of chronic diseases, it is important, in gathering the previous history of the patient, to observe especially the course of treatment which he may have undergone; for example, when mercury and quinine have been largely administered, we may conclude that they have ag.gravated, and probably changed the disease, and accordingly, in the selection of the remedy, be guided to some one of the various antidotes to these drugs. These antidotes are homoeopathic to the pathogenetic effects of the drug, and are to be selected in strict accordance with the law Similia similibus curantur. Our opponents may deny the existence of medicinal disease; nothing is more natural: it is rare to find men who will plead guilty to injurious practice; but a short glance at the records of homceopathic practice, or, if this will not be conceded, an impartial view of their own will, we hope, convince them that many a train of injurious symptoms stand to the means employed inthe relation of cause and effect.I ( 127 ) CHAPTER X. Practical application of the Homoeopathic law-Mode of acquiring a correct image of the disease-Selection of the remedy,-in acute,-in epidemic, -and in local diseases-Study of the Materia Medica-Cases illustrating the mode of selecting the remedy-Selection of the dose-Medicinal aggravation of the disease-Choice of the dilution-Repetition, of the remedy-Mode of administering-Can there be an alliance between Homceopathy and Allopathy?-Use of palliatives-Diet and Regimen. I THE groundwork of all practice is a knowledge of the object to be treated, and also of the remedy: these presuppose an accurate acquaintance with physiology, pathology, etiology, and semeiology. The physician, in addition to scientific and professional attainments, must be possessed of circumspection and tact, a knowledge of the human heart, prudence and patience to be enabled to form to himself a true and complete image of the disease. For the practical application of the homoeopathic law, the first necessary step to be observed is forming to ourselves a correct inmage of the disease. To attain this object we are to listen, write, interrogate, and lastly arrange. The examination is first to bear upon the history of the case; secondly upon the patient himself; and, thirdly, upon the disease. Hahnemann has recommended that every detail of 128 EXAMINATION OF PATIENT. the case should be committed to writing,-a practice which, in proportion as it is carefully performed, will facilitate the treatment. The totality of the symptoms which characterise a given case,-or, in other terms, the image of the disease, being once committed to writing, the most difficult part is accomplished. The physician ought ever after to have this image before his eyes, to serve as a basis to the treatment, especially when the disease is chronic. He can then study it in all its parts, and draw from it the characteristic marks, in order to oppose to these symptoms,-that is to say, to the disease itself, -a remedy that is perfectly homoeopathic, whose choice has been decided on according to the nature of the morbid symptoms which it produces, from its simple action on the body. And if, during the course of the treatment, he inquires after the effects of the remedy, and the changes that have taken place in the state of the patient, it only remains to obliterate from the group of primitive symptoms those which have entirely disappeared, to note down those of which there are still some remains, and add the new ones which have supervened.1 But before commencing to write, it is necessary to request the patient to detail the history and nature of his affection; having by these means acquired a general notion of the discase, we are enabled to proceed more specially in the examination. The questions should first bear upon the history of the case, the previous health of the patient, hereditary dispositions, supposed cause of the disease, if brought on by cold, heat, by excesses of various sorts, by contagion, &c. Especial regard must be paid, above all in chronic diseases, to SOrganon, 104. 6 EXAMINATION OF PATIENT. 129 the previous treatment. The questions must then bear upon the patient himself, his age, appearance, and temperament, idiosyncrasy, occupation, manner of living, disposition if gay or sad, passionate or mild, and if disease has in any measure altered his natural dispositions. Lastly, the questions are to bear upon the disease itself. We cannot err in being too minute in the examination of symptoms, both objective and subjective; and in doing so, all preconceived notions as to what is thought sufficient by the Allopathic School of Medicine must be laid aside; the object being to ascertain, not only the existence of a few prominent symptoms, but to acquire a complete and accurate picture of the disease. The answers of the patient, unless minutely interrogated, are often far from being sufficient, especially in chronic diseases; they pay little or no attention to the lesser symptoms, which are often very characteristic of the disease, and decisive in regard to the choice of the remedy. The examination, as a general rule, may be commenced at the head, proceeding to the organs of sight, hearing, and smell, thence to the mouth, throat, and the digestive organs, from thence to the genito-urinary, and then to the thoracic organs, including the pulse, &c. Afterwards to the skin, organs of motion, nature of the sleep, mental symptoms, &c. By understanding the nature of the case, we are led at once to examine more minutely in certain parts than others. The symptoms which indicate the organs or part of the body most affected, should be underlined, as distinguishing them from others, which, however, are also characteristic in the selection of the remedy. In addition to acquiring a knowledge of the seat of the symptoms, great attention must be paid to their character, which will propose such questions as, 'What is the particuI 130 EXAMINATION OF PATIENT. lar character of the pains? Are they burning, lancinating, gnawing, throbbing, pressive, dragging, &c.?1 Are they increased by rest or motion, or in bed? At what time of the day or night are these symptoms most prominent? Are they intermittent or periodical? What influence has the room'or the open air, walking or lying, heat or cold, dryness or dampness, food, or drink, or abstinence? Are they worse after particular food? Are they increased by mental exercise, by emotions, &c.? In the examination of the female, it is extremely necessary to pay attention to pregnancy, sterility, accouchement, miscarriage, lactation, and the state of the catamenia. A prudish modesty and over affected delicacy induce many, especially in allopathic practice, to slur over these symptoms; and, as it rarely happens that the patient refers to them, the consequence is, that many females present themselves for homoeopathic treatment, who were led by the former physician to believe they had dyspepsia, spine disease, nervousness, &c., while the true evil consisted in disordered menstruation, or in disease of the uterus. With regard to the catamenia, it is necessary to ask, if they return at too short intervals, or at others that are too distant; how long they continue; if they flow uninterrupted or only at intervals; if the flow is copious; its colour, if attended with pain; if leucorrhoea appears before or after; what is the state of the body and mind previous to, during, and subsequent I Such minuteness has afforded great fund of amusement and pseudo-wit for our opponents, but we have no objection that they humorously crack our nuts while we enjoy the kernels. Who gave laughers a patent to be always just and always omniscient? " If the philosophers of Nootka Sound were pleased to laugh at the manoeuvres of Cook's seamen, did that render these manoeuvres useless? and were the seamen to stand idle, or to take to leather canoes till the laughter abated?" Let our laughter-loving opponents judge. SELECTION OF REMEDY. 131 to the menses; if the female is attacked with leucorrhoea, of what nature it is, in what quantity it appears, under what circumstances, and on what occasion, it manifests itself. In many acute diseases of short duration, it will be apparent, that committing the case to writing is not so necessary as in more chronic affections. The second necessary step in the application of the homoeopathic law, is the careful selection of the remedy. The selection of a homoeopathic remedy is not a mere mechanical process, requiring only an effort of memory, or a recourse to repertoriums, but demands the most comprehensive examination, and presupposes an extensive acquaintance with medical science. The similarity of the remedy to the image of the disease must not only be in appearance, but similar, if possible, in cause; for example, if the cause of the disease be an inflammation of the brain, a remedy is to be chosen which has a tendency to produce this pathological condition, and if the exciting cause can be traced to an abuse of spirituous liquors, a remedy would be selected which approaches the nearest in its action to that of alcohol. Again, if in fever the patient complained of headach, we would be guided by the other symptoms in judging if this was idiopathic, or if it was sympathetic; keeping the other symptoms in view, we might probably, in the first case, give belladonna; in the latter, nux vomica. As in forming an image of the disease we at first seek to discover the occasional cause, so in selecting the remedy, we seek for a corresponding similarity. Experience now enables us to choose medicines which are peculiarly adapted to a train of sy-nptoms arising from certain causes; for example, in neuralgia arising from cold or a chill, the medicines which are indicated would be dulc., nux v., or perhaps aconite; if it appeared after intermittent fever, arsenicum, or china; if an abuse of mercury was suspected SELECTION OF REMEDY. 133"0.and attended with perspiration, which gave no relief, then mercurius would be homoeopathic. Such is a slight sketch of the manner of viewing this subject, the importance of which will be much increased after a study of the Materia Medica. Similarity in the mental symptoms forms frequently an important characteristic in the selection of the remedy. In some diseases not strictly mental, the abnormal-mental manifestations assume so great a preponderance, that they become the most important of all. In such cases it is necessary that, among the number of symptoms peculiar to the remedy, there should be some which resemble as closely as possible, not only the bodily symptoms of the disease, but also its moral ones in particular. In acute specific diseases, which in almost all individuals present similar symptoms, such as pneumonia, scarlet fever, measles, smallpox, &c., the selection is generally confined to two or three substances; but, at the same time, the error of prescribing on account of the name, and not the totality, of the symptoms must be guarded against. "With regard to a search after the totality of the symptoms in epidemic and sporadic diseases, it is wholly indifferent whether anything similar ever existed before in the world or not, under any name whatever. Neither the novelty nor the specific character of an affection of this kind will make any difference in the mode of studying it, or in that of the treatment. In fact, we ought to regard the pure image of each prevailing disease as a disease that is new and unknown, and study the same from its foundation, if we would really exercise the art of healing,-that is to say, we ought never to substitute the hypothesis in the room of the observation. Never regard any given case of disease as already known, either in part or wholly, without having first 134 SELECTION IN EPIDEMIC DISEASES. carefully examined all its appearances. This prudent mode of proceeding is so much the more requisite here, as every reigning epidemic is, in many respects, a particular species of phenomenon, and which, upon attentive examination, will be found to differ greatly from all former epidemics to which the same name has been wrongfully applied. We must, however, except those epidemics which are caused by miasms, that always retain their identity; such, for example, as measles, smallpox, &c." "It may happen that a physician, who, for the first time, treats a person attacked with an epidemic disease, will not immediately discover the perfect image of the affection, because a knowledge of the totality of the signs and symptoms in these collective maladies is not acquired till after having observed several cases. However, a practised physician will, after having treated one or two patients, see so far into the real state of things as to be often able to form to himself a characteristic image of the same, and know what homceopathic remedy he is to have recourse to in order to combat the disease." "By carefully noting down all the symptoms observed in several cases of this description, the image that has once been formed of the malady will be always rendered still more comprehensive. It neither becomes extended in a greater degree nor lengthened in the detail, but it is much more graphic and characteristic of the peculiarities of the collective malady. On the one side, the general symptoms (such, for example, as loss of appetite, insomnolency, &c.) acquire a still greater degree of precision; on the other, the special and more marked symptoms, which are even rare in epidemics, and belong elsewhere to a small number of diseases only, develope themselves, and form the character of the disease. It is true that persons attacked with an epi SELECTION IN CHRONIC DISEASES. 135 demic have all a disease arising from the same source, and consequently equal; but the entire extent of an affection of this nature, together with the totality of the symptoms,a knowledge of which is necessary to form a complete image of the morbid state, and to choose according to that the homoeopathic remedy most in harmony with the ensemble of the symptoms,-cannot be observed in the case of a single patient. In order to arrive at these, it will be requisite to abstract them from a view of the symptoms of several patients of different constitutions."' In the treatment of chronic diseases, which have been long the subject of allopathic practice, it must be borne in mind, that many of the symptoms may arise from an abuse of the medicines previously administered. In cases where this is evident, a remedy is to be selected which is an antidote to the medicine previously abused; and this, although there may be other remedies apparently more closely homoeopathic to the case, but which experience has not found to be antidotes to the drug. For example, it will sometimes happen that an affection in which mercury was long prescribed, though treated by homoeopathic remedies, is attended with very partial success, until an antidote to the mercury is for some time given; after this the other medicines will act with greater efficacy. As there are various antidotes, they are to be selected in conformity to the homoeopathic law. Muller2 remarks, that frequently in chronic diseases, treated long allopathically, especially by mineral waters, it is difficult to select an antipsonic (eucrastic) remedy which has not previously been taken in excess, as calc., natr. carb., and muriat., sulpb., magnes. carb., silicia, &c. In these cases he recommends that such medicines should be chosen, provided they be homoeopathic, as lycopod., sepia., petrol., 'Organon, ~ 100. 2 Arch. Homoeop. tom. i. p. 289. 136 TREATMENT OF means which the allopathist has not yet, fortunately, had the opportunity of administering. Diseases of a local nature, being generally characterised by few symptoms, are by far the most difficult to treat. The treatment of these affections we extract from the Organon, and though reference is frequently made to the psoric doctrine, still this, though denied by many, as we have previously explained, does not invalidate the excellent practice IHahnemann inculcates. Among partial diseases, those which are called local, hold a most important rank. By these are meant the changes and affections experienced by the external part of the body. Until the present time it has been the theory of the former schools of medicine that the external parts only were affected in such a case, and that the rest of the body did not participate in the disease,-an absurd theoretical proposition that has led to the most pernicious therapeutic system. The local diseases of recent origin, arising chiefly from external causes, are alone entitled to this name. But the injury must then be very trifling; for if the evils which attack the body externally are of importance, the entire system sympathises, and fever declares itself. The treatment of these maladies belongs to surgery, so far as it is necessary to bring mechanical aid to the suffering parts, in order to remove and annihilate mechanical obstacles to the cure, which can only be expected from the powers of the organism itself. Among these may be ranked, for example, the reduction of dislocations, uniting wounds by bandages, extracting foreign substances that have penetrated the living parts, opening the cavity of the abdomen, either to remove a substance that is burdensome to the system, or to give vent to effusions and collections of liquids; placing in 138 TREATMENT OF the body did not participate. Its production would be impossible if it did not result from some modification of the entire principle of life, so closely are the parts of the body connected with each other, and form so inseparable a whole in regard to feeling and action. No eruption of the lips nor whitlow can take place, without some internal derangement having been previously and simultaneously. effected. All medical treatment of external diseases, that have arisen without any violence having been exercised on the exterior of the body, ought, consequently, to have for its object the annihilation and cure of the general malady, under which the organism suffers by internal remedies. There is no other safe mode of curing them radically. This is confirmed by experience, which shews us that every energetic internal remedy produces, immediately after it has been administered, important changes in the general state of the patient, and particularly in that of the external parts that are affected (which the ordinary schools of medicine look upon as isolated), even when they are situated at the extremities of the body. And these changes are of the most salutary nature; they consist of the cure of the entire body, and remove, at the same time, the local evil without the necessity of applying any external remedy, provided the internal one that is directed against the whole malady had been well selected and is perfectly homoeopathic. The best method of effecting this object is, on examining the actual case of disease, to take into consideration, not only the exact character of the local affection, but, in addition to that, every other change that is perceptible in the state of the patient. All these symptoms ought to be re-united in one perfect image, to be able to select a suitable homosopathic remedy, from among the medicines whose morbid symptoms are already known. LOCAL DISEASES.13 139 This remedy administered alone internally, and of which a Single dose will suffice when the disease is of recent origin, cures simultaneously the general bodily disease and the local affection. Such an effect, ou the part of the remedy, ought to prove to us, that the local evil depends solely upon a malady of the entire body, and that it ought to be considered as an inseparable part of the whole, and one of the most considerable and prominent symptoms of the general disease. It is not proper, either in acute local affections of recent origin, or in those which have already existed a long time, to make any topical application whatever to the diseased part, not even a substance which would be homoeopathic or specific, if taken internally, or to administer it simultaneously with an internal medicinal agent. Acute local affections, such as inflammation, erysipelas, &c., which have not been produced by external injuries, violent in proportion to their intensity, but by internal causes, generally yield in a very short time to remedies capable of exciting an internal and external state similar to the one that actually exists.' If the disease is not wholly removed-if, notwithstanding the regularity of the mode of life of the patient, there still remains some local or general trace of it, which the vital power is not able to restore to the normal state-then the actual local affection was (what happens very frequently) the product of psora, which had till then been latent in the interior of the organism, and which is now on the point of manifesting itself in the form of a chronic disease. To perform a radical cnre in these cases, which are by no means rare, it is.necessary to direct an appropriate anti-psoric treatment against the symptoms which continue to exist, I For example, aconite, rhus, belladonna, moercury, &e. 140 140 TREATMENT OF LOCAL DISEASES. and against those which the patient had been subject to previously. For the rest, an internal anti-psoric treatment is only requisite in local chronic affections that are manifestly not venereal. It might be supposed that these diseases would be cured more promptly if the remedy known to be homoeopathic to the totality of the symptoms was employed, not. only internally but likewise externally, and that a medicine applied to the spot itself that is diseased ought then to produce a more rapid change. But this method should be rejected, not only in local affections which depend upon the mniasm of psora, but also in those which result from the miasms of syphilis or sycosis. For the simultaneous application of a remedy internally and externally, in a disease whose principal symptom is a permanent local evil, brings one serious disadvantage with itthe external affection usually disappears faster than the in-~ ternal malady, which gives rise to an erroneous impression' that the cure 'is complete, or at least it becomes difficult, and sometimes impossible, to judge whether the entire disease has been destroyed or not by the internal remedy. The same motive ought to make us reject the mere local application of remedies to the external symptoms of miasmatic diseases. For if we confine ourselves to the suppression of the local symptoms, an impenetrable obscurity is then spread over the treatment which is necessary, to the perfect re-establishment of health.; the principal symptom of the local affection is removed, and there only remain the others which are much less important and certain, and which are often not sufficiently characterised to furnish a clear and perfect image of the disease. On the subject of the employment of certain local remedies, we would differ from Hahnemann. Great advantage LOCAL APPLICATIONS. 1 141 frequiently arises from the application of topical remedies, especially when they exercise no medicinal effect upon the system; as, for example, hot poultices to an abscess about to suppurate, and the application of hot vapour in inflammation of the ear: such means give great relief, and do not interfere in the least with the action of the specific remedy. When the local application exercises a general action, or when it is at variance with the specific remedy, it is contraindicated. Hahnemann contradicts himself when he forbids the local application of a substance which would be homoeopathic or specific if taken internally, but not if applied externally, for, as we have quoted at page 119, he recommends the application of the tincture of Thuja in sycosis. Again, we consider it erroneous to state that a remedy is homoeopathic if taken internally, but not if applied externally. This, in addition to being contrary to experience, is also Qpposed to Hahnemann's own view of local disease. No predilection must be made for any particular remedies which chance may sometimes have led us to administer with success. This preference may cause us to reject others which would be still more homoeopathic, and consequently of greater efficacy. We must likewise be careful not to entertain a prejudice against those remedies, which, on previous occasions, from want of due selection, may have been unattended with success; and we should never lose sight of this great truth, that of all known remedies there is but one that merits a preference before all others, namely, that whose symptoms bear the closest resemblance to the totality of those which characterise the disease. The best works to study in order to acquire a knowledge of the pathogenetic effects of medicines, are the Materia Medicas of Hahnemann, Hartlaub, and Trinks, that of Ruckert, and one now publishing by Noack. To facilitate 142 STUDY OF MATERIA MEDICA. the study, it is best to commence with some of the wellproved remedies, and which, from their value, have been styled 'polychrists.' To impress the effects of the remedy, it is very useful to select a well-marked case in which it has been administered with benefit, and to compare the symptoms of the disease with those of the remedy. This is the most advantageous method of acquiring a knowledge of what to all beginners is a most laborious, and often uninteresting task, but which is the groundwork of practice. As it is frequently difficult, from the size and want of arrangement in the Materia Medica of Hahnemann, and others, to discover readily the remedy, smaller manuals have been published which afford great facilities, but are always to be considered as subservient to the larger. The best of these is that of Jahr.' In the first volume is given a summary of the pathogenetic effects of the remedies, headed with a list of the diseases in which they have been found useful. The second part is a repertorium, the diseases being given with the principal indications for the medicines which may be administered, and also a dictionary of symptoms occurring in various parts of the body, with the medicines which give rise to them. In this work will be found many useful hints as to the manner and order of studying the Materia Medica, and from its brevity great facility is afforded for remarking the characteristic analogies and distinctive differences of the various remedies. 1 Nouveau Manuel de Medecine Homoeopathique. Par G. H. G. Jahr, tomes ii. Paris, 1840. There is an English translation by Dr Laurie, in which it is to be regretted that Jahr's introduction has been omitted. Another translation has lately appeared in America. A work which promises to be useful is now publishing, entitled Symptomatologie Homoeopathique ou Tableau Synoptique de toute la Matibre Medicale Pure. Par P. Lafitte. ILLUSTRATIVE CASES. 143 To illustrate the manner of selecting the remedy, we give two simple cases treated by Hahnemann. S-, a washerwoman, aged about forty, of a healthy constitution, had already been three weeks unable to work when she applied for medical assistance. The symptoms were as follows: 1st, Lancinating pains in the pit of the stomach, proceeding from the left side after moving, or when she rose, especially when she made a false step. 2d, When lying she experienced no pain, neither in the side nor in the pit of the stomach. 3d, She could not sleep until three o'clock in the morning. 4th, She ate with pleasure, but after partaking of food suffered from sickness. 5th, Rising of clear water, which seemed to flow into the mouth. 6th, After eating, efforts to vomit, but without result. 7th, Disposition violent, choleric; copious perspiration covered the body during the violent pains. Fifteen days before, she had menstruated naturally. Otherwise healthy. As regards symptom 1, belladonna and china occasion lancinating pain in the pit of the stomach, but neither excite them when the individual is only in motion, as in this case. Pulsatilla also produces them on making a false step, but rarely; and it causes neither the same gastric derangement indicated by the symptoms 4, 5, and 6, nor the same moral dispositions. Bryonia alone occasions pains during movement, especially lancinating. It also produces prickings under the sternum when the arm is raised; and also the other sensations on making a false step. 144 ILLUSTRATIVE CASES. Symptom 3 is furnished by several medicines and also by bryonia. Symptom 4, sickness after eating belongs to several remedies, ignatia, nux v., mercurius, ferrum, belladonna, pulsatilla, cantharides, but not constantly, and rarely accompanied with relish for food, as is the case from bryonia. With regard to symptom 5, several medicines produce rising of clear water, also bryonia; but they do not occasion the other symptoms constituting the disease. Bryonia is preferable to all in this respect. Efforts to vomit after eating (symptom 6) are produced by few remedies; none occasions them more frequently, or so well marked, as bryonia. Moral symptoms are one of the principal indications in disease, and as under this head bryonia produces phenomena analogous to that presented by the patient, together with the preceding symptoms, it was preferred to any other homoeopathic remedy. A drop of the mother tincture of bryonia was given; in forty-eight hours the woman was cured, and returned to her work. A pale sickly man, aged forty-two, who had long been engaged in sedentary occupations, after being five days ill applied for medical assistance. 1st, On the first evening, without any assignable cause, he had sickness, vertigo, swimming of the head, and frequent efforts to vomit. 2d, The following night, towards two o'clock, vomiting of sour matter. 3d, The following nights, violent efforts to vomit. 4th, The day of the visit, risings of a foetid, disagreeable taste. 5th, Sensation as if some indigestible substance lay on the stomach. 6th, Feeling of uneasiness in the head, attended with sensation of emptiness. 7th, The least noise annoyed him. 8th, Disposition mild and patient. 5 146 SELECTION OF THE DOSE. unseemly discussion, the acrimony of which would lead us to suppose that it was a vital point in homoeopathy, and that the selection of the dose, instead of being subordinate, was paramount in importance to that of the remedy. One party have maintained that the high dilutions, for example, 30, are the best in all cases; another party have considered the lowest as only serviceable, and that the practice of the former was nothing better than a " m6decine expectante." The discrepancy of two such opposite opinions may be partly explained by the circumstance, that the former class have had generally chronic diseases to treat, the latter acute; and also, that, in a number of cases, where the medicine is well chosen, the difference of dilution is really very imperceptible, and the 30th succeeds as well as the 3d. The first view is supported by Hahnemann and many of his followers, and seems to be founded, first, upon the belief that the higher the dilution the greater is its power: this has previously been shewn to be erroneous, and is in contradiction to the second, their dread of aggravation from the employment of low dilutions. Before proceeding further, the subject of aggravations must be alluded to. Exacerbation of the existing symptoms, after the administration of a homoeopathic remedy, sometimes occurs, but it is far from being necessary to cure; and in some cases, when most violent, is attended with no benefit. Aggravations have been observed after the administration of both high and low dilutions. It is worthy of notice, that the occurrence of exacerbations of the disease is more frequently referred to in the practice of those who employ the high dilutions, than in those who give the low; the latter, however, have recorded many instances, in which the employment of a low dilution was attended with manifest dan \ AGGRAVATIONS. 147 ger, and in many cases where the low increased the evil, the administration of a higher was attended with advantage. Dr Miiller, referring to the practice of the Leipsic Hospital as bearing upon exacerbations, says,-" It appears not a little extraordinary, that they now see nothing of these aggravations, of which only two years previously they were able daily to adduce several examples."' The explanation of this change he properly seeks in the preconceived notions of the practitioners. It sometimes happens that the administration of a remedy is followed, not by an increase of the disease, but by the appearance of symptoms unconnected with the affection under treatment. We have seen, in a phthisical patient, hemoptysis occur on three occasions after the administration of phosphorus 18, and which never followed the employment of the other remedies. Hursch has observed the same.2 Griessilich has known sensation of pressure on the stomach, flatulent distension, sickness, heaviness of the head, and vertigo, follow nux v. given in a case of toothache;3 and other symptoms manifested after the use of arsenic and sulphur.4 Hering observed bilious vomiting occur after the administration of arsenic in a case of skin disease.5 We have seen, in a case of chronic rheumatism, pulsatilla 30, when given on two occasions, produce violent diarrhoea. Also in a case of head affection, a scarlet eruption appeared all over the chest and abdomen, after three doses of belladonna 6. Rau states that numerous such examples have occurred in his practice.' I Jahrbiicher der homceop. Heil-und-Lehranstalt, 3 v. p. 31. Leipsic, 1833. 2 Allg. horn. Zeitung, 7 vol. No. 8. 3 Hygea, 4 vol. p. 132. 4 Hygea, 4 vol. p. 28. SArchiv. fiir die horn. Heilk., 15 vol. 1 pt. p. 53. 6 Nouvel Organe, p. 257. QUESTION OF THE DILUTION. 149 organs sympathetically connected with the diseased ones; such phenomena resemble a crisis, and in many cases probably are so. They ought always to be desired in diseases considered incomplete, for if not followed by amelioration, they furnish an indication in a doubtful case, and render the treatment easier. Experience only enables us in such cases to decide whether we should remain inactive spectators, and observe if nature is sufficient to restore the discord; or if it is necessary to repeat the medicine, or select another. To return to the question of the dose: as a general rule it may be stated, that diseases may be cured by all the dilutions, when the suitable remedy is administered; but that the cure may be much accelerated by selecting the dose appropriate to the individual case. This selection should be determined by the susceptibility of the patient, the seat, nature, duration, and intensity of the disease. The positive rule laid down by Jahr and others, with the hypothetical explanation given by Dr Curie, is much too general, and is contrary to the experience of the majority of the homoeopathic school.* This explanation is founded upon a pure assumption, and is in direct violation of all known physical, physiological, and pathological laws. That the highest dilutions are preferable, and most successful in all diseases, is quite contrary to the experience of the most eminent homoeopathists. Rau,1 Kramer,2 Werber,3 Griessilich,4 Schroeun, Elwert,6 zEgidi,7 Miiller, Trinks, Simpson, and many others, have successfully proved by ex* See in ann. Lond. horn. disp., No 2. SNouvel Organe, p. 241. 2 Hygea, vol. i. p. 29. 3 Archiv. gen. Aug. 1835. 4 Hygea, vol. vi., p. 316, et seq. "5 Hygea, vol. iii., p. 318. 6 Allgem. hom. Zeitung, vol. ix.,p. 186, 7 Hygea, vol. ii., p. 200.--Most of the above papers, and several others 150 SELECTION OF THE DILUTION. periment, that the employment of low dilutions is not attended with the so-much dreaded aggravation, and that, by the low dilutions, they cured diseases which had suffered no change by the employment of high ones. They consider, that to keep invariably to the high dilutions leads to a very prejudicial hesitation, and to frequent change of the remedy. This hesitation hinders the physician from thoroughly observing and knowing the medicine.; he administers them one after another, and sees them all produce little or no effect; he thinks he has made a wrong choice, and it never occurs to him that one might have been efficacious if he had employed it in a suitable dose; he loses time without gaining anything in experience. At a late meeting of the Parisian Homceopathic Society, the relative efficacy of different attenuations in acute and also in chronic diseases formed the subject of discussion. The result of this discussion was, that at present it is impossible to give a fixed and invariable rule,-that if it was true that in acute diseases the low dilutions should be preferred to the high, still this course admitted of such numerous exceptions that it was impossible to make a general law,-that even in chronic diseases there are many affections, such as cutaneous diseases, which have yielded completely to the employment of the low dilutions of a medicine which, when given in high dilutions, had completely failed in curing them. The conclusion of this debate was, that the safest rule to follow was-to individualize the dose and the dilutions with the same care with which we individualize the medicine.' bearing upon the same subject, have been reprinted in the Arch. et Journ. Horn., tome i. ii. Uii. IAnnales de la Med. Horn. tome L No. 5. p. 399. SELECTION OF THE DILUTION. 151 The rhost complete evidence in favour of the lower dilutions, is the comparative inefficiency of the higher dilutions in all public trials which have been made of the method, but particularly in the Clinical Hospital at Leipsic. If, with a complete knowledge of the effects of certain medicines in adequate doses derived from other sources, we consult the published reports of that institution, the frequent insufficiency of the high dilutions is too remarkable to admit of any doubt on the subject.1 The experience afforded by the hospital at Vienna is also very confirmatory of the same point. Upon these grounds we may learn, that, in certain cases, the low dilutions are applicable, in others high,-and state generally, that, in the majority of cases, the dilutions under 15 will be found more useful than those above thai number. Rau2 recommends, as the surest indication for the selection of the dose, the susceptibility of the patient. In this he has been followed by many. Bethman3 (a partizan of weak doses) says, the susceptibility of the organism for the medicines is very variable, and it alone furnishes a rule for the dose and its repetition. Fielitz4 recommends that doses be administered according to the susceptibility of the organism. Backhausen,6 in other words, says we must pay attention to the irritability of the patient. Werber6 expresses himself very decidedly upon this point. Every disease, says he, requires a proportional quantity of medicine, in order that the body may not either be S Simpson's Prac. View of Homceopathy, p. 209. S Nouvel Organe, p. 242. 3 Allgem. homoeop. Zeitung, vol. x., n. 11. 4 Allg. Horn. Zeitung, vol. ii., p. 22. 6 Hygea, vol. ii., pt. 1., p. 103. 6 Hygea, vol. i., pt. 1., p. 173. SELECTION OF THlE DILUTION.13 153 According to so me physicians, stronger doses are necessary in Russia than *in more southern countries. Rau has often observed, that the French, Italians, and Spaniards, are strongly' affected by doses which have no action upon the English. Wolf corroborates this statement. The sensibility is increased by intellectual occupations, by excitement of the imagination, by sedentary occupations, by long sleep, and especially an effeminate life. Persons accustomed, to long and severe out-door employments, who sleep little, and whose diet is coarse, are less susceptible. Rau observes, that people who are in the habit of chewing or smoking tobacco, or who work in a tobacco manufactory, possess very little susceptibility to the action of the medicines. It is the same with perfumers, grocers, spirit-merchants, distillers of yinegar. Individuals who have long taken medicines, especially metallic, require low dilutions in order to effect a cure. Women are in general more irritable than men, but with the former the power of reaction is greater. Mansfield has observed, that the deaf and dumb require larger doses, which accords with the experience of Majon..3d, Character of the disease.-This does not refer to the rapidity of its course, for this may depend either upon increase of vital action, or upon diminution, as, for example, in the most malignant forms of cholera; in the first case it is only the high dilutions, and in the second the low, which, should be administered. The high dilutions are suitable in erythism, the low in torpor, and if this is great, drops of the mother tincture may be beneficially administered. It was for this reason that Werber succeeded in curing, with drops of the tincture of digitalis, an aged patient with hydro-thorax.; and Reubel the, cholera with drops of the tincture of phosphorus. It is for this reason, says Rau, that he has 1 Gaz. Med. de Paris. Jan. 1834. 154 SELECTION OF THE DILUTION. seen belladonna 24 attended with the most beneficial results in children labouring under menengitis with convulsions. In the febris nervosa versatilis we can employ with success the 20th or even 30th dilution of bryon., bell., rhus, and phosphorus, &c.; while in the nervous, tepid, and putrid fevers, much lower dilutions should be administered of hyosciamus, cocculus, phosphoric acid, copper, mercury, arsenic, &c. The high dilutions are most suitable in inflammatory affections, with increased arterial action; the low in inflammations of a torpid character. It is the same in hbemorrhages. Thus the crocus which corresponds to venous hemorrhage, ought always to be administered in lower dilution than the sabina which cures arterial hremorrhage. 4th, Seat of the disease.-The more the affected organ is susceptible, so in proportion ought the dilution to be high, and vice versa. Rau considers it dangerous in erysipelas of the head, attended with delirium and affection of the meninges, to give belladonna 3, a dilution which is necessary in a similar affection of the extremities. He says in carditis he never ventures to give arsenic under 30, while much lower dilutions are necessary in hydrothorax and oedema of the lungs. As regards the danger of a lower dilution in carditis, it is opposed to the experience of many. Croup is much more successfully treated by the employment of the 6th of aconite and spongia, of the first and second trituration, and of hep. sulph., than by higher dilutions. In local diseases, in which the rest of the organism takes comparatively very little share, as, for example, old callous ulcers, tenia, ottorhoea, leucorrhoea, induration of glands, abnormal growths, the lowest dilutions are decidedly preferable. No doubt such affections have been cured by the higher, but might not this have been more speedily effected by more powerful doses? SELECTION OF THE DILUTION. 155 In proportion as the medicines are powerful, so it is necessary to give high dilutions, and vice versa. It cannot be doubted that medicines such as bell., puls., nux v., lach., phos., or arsenic, may be frequently used with advantage at the 20th or 30th; but there are others again, such as taraxacum, euphrasia, clematis, lycopodium, &c., which, at these dilutions, are not so generally attended with success. 5th, Affinities of Medicines for certain Organs.-The greater this affinity is, the more energetic is the action of the medicines, and the more efficacious is the employment of high dilutions. Kopp and Ludbeck have remarked, that ulcers of the palate are cured with mercury 30, whilst those of the genital organs require much lower. Rau has frequently corroborated similar observations. Clematis ought to be given in much lower dilutions in cutaneous affections than in chronic orchitis; rheumatic palsy, in which belladonna is suitable, requires much lower dilutions than what is necessary in meningitis or angina. Aconite has a great affinity for the throat and respiratory organs, but none for the liver: however, it is sometimes necessary to administer it in hepatitis, on account of the violent inflammatory fever, but then it must be given in larger doses than in angina, pneumonia, or pleurisy. 6th, Idiosyncrasy.-It will be found that some individuals are extremely susceptible to certain medicines; this, of course, cannot be known a priori, but, when ascertained, should be borne in mind as guiding the future selection of the dilution.' It sometimes happens that the economy is not at all susceptible of a well chosen homceopathicremedy. In such cases, 1 These directions, as to the selection of the dilution, are given in Rau'a Nouvel Organe, p. 244, et seq. See also a paper by Trinks, and also one by Gross, in the Arch. Horn. tom. i. p. 183, et seq. 156 SELECTION OF THE DILUTION. when convinced that the remedy is appropriate, it is advisable to employ lower dilutions, and when reaction is manifested, return to the higher. Wolf states, that, in cases of syphilitic ulcerations of the throat, when he found the ordinary dilutions of mercury fail, he had recourse for two or three days to the employment of mercury in larger doses, repeated daily; he then waited a few days, and afterwards administered higher dilutions. This procedure, in the very few cases in which he had to employ it, he found so successful that he recommends a similar repetition of the homoeopathic remedy in other chronic cases manifesting the same inactivity.' Hahnemann recommends, when the organism is insensible to the impression of medicines, the administration of one of the lowest dilutions of opium every eight or twelve hours; frequently after this, he says, the susceptibility is not only increased, but new symptoms of the disease are also manifested. Carbo v. has likewise been recommended for the same purpose. In some cases the temporary insensibility to remedies may be traced to exciting regimen or previous abuse of medicines given allopathically; in such cases it is best for some time to abstain from the administration of any remedies, and subject the patient to strict dietetic rules. After some time the treatment may be resumed with low dilutions; and even then, though no benefit immediately ensue, by perseverance for some months, the success will be apparent. A remarkable fact is the great difference which exists between some medicines as to the manner in which they affect the susceptibility of the organism. Wolf remarks, that the long continued use of prussic acid destroys very much the 1 Arch. Horn. tom. i. p. 291. 158 REPETITION OF THE REMEDY. but only the long perseverance of the economy to obey the impulse which it has received to manifest healthy phenomena. There is too much importance placed upon the dread of interrupting the action of a medicine by repetition: it is not corroborated by experience, nor can we in theory believe that a new impulse in the same direction should cause a former one to cease. The fundamental rule is to administer only one medicine at a time, and to examine attentively the effect before administering another. 1st, The repetition of the medicine is useful and necessary when the violence of the disease has evidently diminished, without having changed essentially its character, and when the amelioration ceases.' 2d, "If in such cases the repetition of the dose produces no effect, it is a proof that the organism has become insensible to the dose employed. We must then, besides repeating, augment the dose, and repeat several times if necessary. I refer to the excellent remarks of Werber, Tietze, and others, that the first dose occasions an exacerbation of the disease, and that the others produce none. Schindler recommends the repetition of the indicated medicine until it produces evident reaction, and then to allow it to develope its curative effects. I am entirely of his opinion, for the repetition ought to have an end, and be confined to certain limits; only it is impossible in this respect to prescribe rules to those who want the talent of observation and practice; they ought to depend, in some measure, upon the nature of each individual case. I The following rules are given by Rau, as founded upon his own experience and that of others. Nouvel Organe, p. 251. REPETITION OF THE REMEDY.15 159 3d, "1In acute disease, either where there is increased action, as in violent inflammations, or prostration and dimi-. nution of action, as in adynamic and putrid fevers, the short duration of action of the medicines renders the repetition more frequent than in chronic diseases. In cholera the dloses were repeated every quarter of an hour, or even five minutes, and with success. In very violent inflammatory affections, I have administered aconite every hour, and in meningitis every half hour, a treatment which I feel convinced has saved many. According to ~~gidi, we may repeat in acute diseases the dose every hour, and in chronic affections every day.1 This, however, I would not admit as a general rule; it depends much upon the system, or the organ which is the seat of the disease. In cases of great sensibility and great activity, the effect of the medicine is more transient, and the repetition, therefore, more necessary. Effects must be observed and acted upon accordingly. They are generally manifested more quickly in acute than in chronic affections. "11If in fever, with considerable erethism, the medicine administered produces no change in an hour, we may, according to my observations, admit as certain, either that the dose is too feeble, or that the medicine has been ill chosen, and take measures accordingly. I believe also, that I am not deceived when I remark, that even in chronic diseases we ought to expect little from a medicine which, at the end of twenty-four, or at the most fortya-eight hours, produces no effect or change in the condition.2 I do not speak of cure, but of those sensations of different kinds, which I will indicate in the following paragraph. 4th, " The same medicine ought not to be repeated when - 1Hygea, vol. ii. p. 34. 2Experience leads us to dissent from this rem-ark of Rau 160 REPETITION OF THE REMEDY. it acts with energy, and produces an essential change in the form of the disease. Hering remarks, that, in such cases, the vital power seems exhausted to a certain point in reacting against the medicine, the repetition of which would consequently be injurious.1 " I do not believe this, but I feel convinced that, if not injurious, the repetition at least would be useless, and Helbig agrees with me."2 The repetition is less suitable when the disease has passed from one stage to another, as in smallpox, when the pustules maturate, when in bronchitis expectoration commences, &c.; we must, then, of necessity select medicines corresponding to the existing state. We ought not to repeat long the same medicine even in chronic diseases, because the organism becomes habituated to its action, even when the dose is increased. It is proper in such cases to administer for some time, as an intercurrent remedy, a medicine which is as closely homoeopathic as possible, and afterwards return to the first; we are thus more certain of producing an effect. It will often happen, that, after the administration of an appropriate remedy, the disease will be changed not so much in its symptoms, as in its intensity. In such cases, we might at first be led to repeat the same medicine; but a more careful examination will discover slight shades of symptoms indicative of another closely similar in its pathogenetic effects. For example, Hahnemann has indicated calcarea, or nitric acid, as suitable after sulphur, lycopodium, &c. Hering, Boenninghausen, and others, have pointed out a number of analogous medicines. Jahr, in his Manual, has ' Archiv. fiir die horn. Heilkunst. Vol. xiii., 3 pt., p. 73. 2 Hygca, vol. viii., 3 pt. MODE OF ADMINISTRATION. 161 given a list of such medicines as are found to follow beneficially the administration of others. He correctly adds, " The principal advantage which the physician should draw from these indications, is to make a comparative study of these analogous medicines, in order the better to establish their points of difference, and thus guard himself against numerous errors which are certain to happen if he confound or administer the one for the other; for example, lachesis in place of mercury, veratrum or china instead of arsenic, &c. On the contrary, it would be an abuse of these indications to take them as an absolute guide in the selection, and to give a series of analogous medicines on no other grounds than this analogy."' As we formerly stated, the administration of remedies by olfaction is a mode never to be resorted to; it is extremely uncertain, and possesses no advantage. It is urged by a few, that it is useful in some cases, as not interfering with the action of a remedy administered at the same time by the mouth; but this is in direct opposition to all sound physiology, and a violation of the law laid down by Hahnemann, that only one medicine be administered at a time. Administration of the remedy to a child at the breast by means of the mother is still more uncertain. In allopathic practice, when large doses of nauseating and powerful remedies are given, this is a convenient mode, but not in homoeopathic, in which facility of administration is one of its many advantages. It must also be borne in mind, that rarely will the mother be so healthy as not to destroy the action of the m'edicine. The medicines may either be given dry, or in solution and repeated frequently; the latter is the best method in 1 Introduction, p. xxii. L 162 CAN ALLOPATHY AND all instances; but is contra-indicated in cases when it is feared that attention will not be paid to cleanliness, and due precautions in preserving the solution. Hahnemann has pointed out that the period of the day at which the remedy is to be given is often very important; in acute diseases this, of course, cannot be attended to. For example, nux v., calc. ant. cr., &c., act principally in the morning; on the other hand, bell., bry., ignat., cham., puls., &c., in the evening. It is recommended not to give the medicines at the period in which their action is most manifested. Several writers have testified to the advantage of Hahnemann's advice.' Rau observes, that he has frequently seen belladonna, chamomilla, and pulsatilla, when taken in the evening, disturb the sleep; and, again, that nux vomica is most efficacious when taken upon going to bed. As a general rule, the evening is to be preferred for the administration of the remedy, during the day there are so many influences coming constantly into play and disturbing the action of the medicine. It is an opinion of some that medicines should not be administered during the menstrual period; and as at this time females are generally more susceptible, a higher dilution may be given than would otherwise have been chosen. The question will suggest itself to many, Can there be an alliance between Allopathy and Homoeopathy?2 To this query we would answer generally, that a combi1 Boenninghausen has given some useful information upon this subject, in a treatise which has been translated into French, and appended to Jourdan's translation of Hahnemann's Mat. Medica. 2 For a fuller discussion of this question, see Archiv. de la Med. Horn. tom. ii. p. 177. In this paper are given the opinions of Hahnemann, Rummel, Miiller, Trinks, Riickcrt, Tietze, and Hartlaub. REGIMEN. 167 The homoeopathic school pay great attention to diet, and so imnportant a feature of the system does it appear to many, that they attribute all cures to its agency. But, unfortunately for mankind, Hahnemann and his followers have not yet been so fortunate as to frame a system of dietetics that will cure all diseases. That attention to regimen is of great importance in the treatment of disease, is a point not to be questioned; but, though advantageous, it is not in all cases essentially necessary. Too great attachment to the strict dietetic rules enforced by Hahnemann, is frequently attended with disadvantages. First, by forbidding articles to which the patient, from daily use, has become habituated, so great a disturbance is caused in the economy, that not only is the action of the medicine destroyed, but new symptoms are manifested. Second, stimuli to which the patient is habituated being forbidden, he becomes frequently so susceptible as to be disagreeably impressed by causes that can scarcely be avoided. For example, so acute does the sense of smell become, that the least perfume, the smell of a rose, of a dusty old book, the smoke of tobacco, is to such a one overpowering. Frequently the patient is disheartened, and many are deterred from trying homoeopathic treatment solely from the dread of its severe regimen. We may safely say, that a majority of the homoeopathic school do not now constantly enforce the ordinary strict regimen, but allow the moderate use of many articles which formerly were forbidden. If the action of our remedies are so transient and so weak that the least infringement of diet destroys their efficacy, how could so many cures be performed? Many writers have reported cases bearing upon this point, where marked deviation from dietetic rules had not the slightest effect in retarding the cure, nay, even where, 168 DIET AND REGIMEN. until the ordinary diet was restored, the medicines failed to act. Hahnemann himself does not forbid the moderate use of tobacco. When one day consulted by a peasant at Coethen, he gave him medicine, with directions to follow strictly the homoeopathic regimen; in eight days the man returned, feeling worse, and stating that he would rather die than lose his " schnapps." How much do you drink daily? asked Hahnemann. A bottle, answered the patient. Hahnemann allowed him half a bottle; with this indulgence he continued the treatment, and was soon cured. Such cases are familiar to every homoeopathist. But at the same time that a certain freedom in diet may be allowed, we would beware of running into the opposite extreme of neglecting it entirely. That diet is a secondary consideration, is a point that may usefully be borne in mind by many who, when they fail in effecting a cure, are too apt to attach to errors in diet, what with greater justice is attributable to the improper choice of remedies. Diet and regimen are employed to fulfil two ends; first, to increase the susceptibility of the patient to the action of the medicine, by removing all stimulating agents which may, directly or indirectly, affect its action; directly, inasmuch as they are antidotes to the remedy; indirectly, inasmuch as they excite such action in the body as prevents the medicine exercising its effects: second, to guard against the use of certain articles of food, drink, &c., which may have caused or increased the disease. In acute diseases the feelings of the patient may be much 1 Werber, in Hygea, vol. i. p. 192, et seq. Kscemann, loc. cit. vol. iii. p. 355, et seq. Molin, Bibl. Horn. de GenBve, Oct. 1835. JEgidi, Arch. de la Med. Horn., tome ii. p. 462. Croserio, Annales de la Med. Horn., tome i. p. 26. Rau, Nouvel Organe, p. 265. .DIET AND REGIMEN. 169 consulted. Food is generally loathed, and the drink most wished for is cold water, which may generally be given ad libitum. Acid fruits, drinks, and soda or seltzer water, being antidotes to the'medicine, must be abstained from. Rice -or barley water, eau sucr6e, or other such simple liquids, may occasionally be substituted for the water. In convalescence from acute diseases, nourishment should be given moderately; but the conmnon error of administering stimulants, such as wine, porter, &c., must not be committed, unless in cases where the patient was previously much accustomed to their use. The best stimulant is good nourishing food. Prudent ventilation is to be made, but all fumigations are forbidden. In chronic diseases the best general rule is,--use aliment the most nutritious,. and drink the most simple. The ordinary habits of patients should be changed as little as possible;. forbidding whatever may have caused or increased the disease, or what may act as an antidote to the medicine. The following rules are what are applicable in most cases* Avoid pork, veal, goose, duck, and all young meats; these are forbidden as being less nutritious than other meats, and as being generally cookedwith spice and sauces. Avoid celery, sorrel, onions, and garlic; acid or unripe fruits, as currants, &c.; spices, mustard, pepper, vinegar, wine, spirits, malt liquor, coffee, strong tea. A little wine or spirits with water may be allowed to those who have daily taken them, except in cases where they seem injurious. Malt-liquor is. rarely adn-issible, being generally adulterated with medicinal substances. Homebrewed beer is the best; ale is preferable to porter. Coffee, even weak, can seldom be allowed, being an antidote to most medicines. Weak tea may be generally allowed in 170 170 DIET AND REGIMEN. this country, except with dyspeptic or nervous patients, where it seems to have produced or increased the disorder; cocoa is preferrable at all times to tea. Avoid aromatics, perfumes, and tooth-p6wder containing camphor. Those who snuff or smoke should be recommended to do so in moderation, or if possible give up the habit. When children at the breast are treated, the nurse should follow the dietetic rules. For Breakfast.-Take cocoa, weak tea, milk, arrowroot, eggs, or mutton chops. For Dinnier.-Beef, mutton, and poultry, plain roasted or boiled fish, and game; vegetables in moderation, and well boiled; plain puddings of bread, rice, sago, and tapi-. oca. Eat moderately; and select, with the above restrictions, such food as may be found to agree best. In all chronic cases, take as much exercise as possible in the. open -air, without fatigue. When the strength does not admit of walking, exercise in a carriage may be substituted. Avoid late hours and crowded rooms. As regards cleanliness, neither warm nor cold baths must be used, unless when ordered; si mple ablution with a sponge and cold or tepid water being all that is requisite. CURES ATTRIBUTED TO NATURE, &c. 173 Why the patient's imagination should be more excited while under the treatment of the homceopathist, a class of men whom he has been led to look upon with suspicion as quacks and knaves, rather than when trusting to his allopathic attendant, in whom he has implicitly confided for years, we know not. Why the imagination should be more active when the patient's health has been ruined by former treatment, than previously, when comparatively he was healthy;-why it should be excited to such lively faith, when a few tasteless globules are given, than when stimulated by a blister or a black potion, are to us inexplicable. The diseases the homoeopathist is most confident of curing, are those of children at the breast; in them no diet is employed, and surely there can be no imagination exercised by the helpless infant: it must, then, be nature; but if nature is sufficient to effect a cure, why do our opponents torture them with physic? Let such of our opponents as attribute our cures to diet, nature, and imagination, honestly examine the recorded homoeopathic cures of the diseases of children, of that of the lower animals, of cholera, inflammation of the lungs, of scrofulous diseases, of gout and rheumatism, and if they can still conscientiously attribute them to diet, nature, and imagination, let them mark the dilemma into which they fall. Such avowals are simply this, that diseases, incurable by allopathy, or against which the most violent and dangerous measures are used, are cured by homoeopathy, which, agreeable to their views, is simply diet, nature, and imagination. Let them give forth to the public this much to be desired information; let them continue to preach, as virtually they do, that medicine is a humbug; but let them mark in their blindness, that the wea-,,o 174 ARGUMENTS AGAINST pon they wield against homoeopathy, deals the coup de grace to allopathy. When it is found that the expedient to call homoeopathic medicines mere nonentities, and that the cures are attributable to diet, nature, and imagination, fails, another tack is taken, and the patient is assured that these same medicines are violent poisons, and that his life is in jeopardy! Such a statement must be seen to be absurd and contradictory by all who for a moment consider it, and we would willingly have passed it over as an idle rumour, but that it has beenasserted in our own experience bymedical men, of whom we might have expectedmore candid statements. The simple answer to this is,-with a very few exceptions the homoeopathic medicines and the allopathic are the same, and only differ in quantity. Now if, for example, arsenic, prussic acid, mercury, opium, &c., are poisonous in homoeopathic doses, how much more deadly must they be in allopathic doses, where, at a moderate average, the poison is a thousand times greater in the latter than in the former? How beatifully does Hahnemann remark, that God has given us iron wherewith to make the assassin's dagger or the peaceful ploughshare. Who uses the dagger, or who the ploughshare? he who gives grain doses, or he who gives the millionth of a grain? What inconsistency to blow hot and cold with the same breath; at one time to call the medicines trash, mere water; at another deadly poisons. As the statement of giving poisons generally hinges upon our occasional administration of arsenic, of which substance the 3d dilution (the millionth of a grain) is the strongest used, we refer such remarkers to a passage written in 1786 by one of their own school. " Had it been announced to the world a century or two ago, that by the simple contrivance of a minute division of its parts, the most violent mi HOM(EOPATHY. 175 neral poison then known, had been found experimentally to be a 'medicine of most surprising activity and efficacy, yet safe in its administration; the accounts would hardly have been believed. Nevertheless this is really the case at present with respect to arsenic."' Another mode attempted, of refuting homoeopathy, is by attributing to it imperfection and failures. First, Cases are quoted in which homosopathy has failed, and therefore, conclude our opponents, it must always fail. But they who condemn a system from one or fifty failures, forget that they are condemning themselves. For who that has had many patients has not lost some? and if all such are to be condemned, the judge himself must be included in his own sentence. Second, It is stated that homceopathy may be successful in chronic diseases, but fails in acute affections; in this argument the enemyseems to retreat, and leave to homoeopathy the wide field of chronic diseases. This is a valuable admission, and we now proceed to prove that homoeopathy can and has cured acute diseases to the satisfaction of the most sanguine believer in medicine. In proof of this we give extracts from works which, being either allopathic or official, cannot be suspected of favouring homoeopathy. The first extract then we give, is one attested by ilufeland, which is a sufficient guarantee for its impartiality and authenticity. The success of a homoeopathist, Dr Stap in curing Egyptian ophthalmia among the soldiers in the garrisons of the Rhine, attracted the attention of the Prussian Minister of War, who solicited him to visit Berlin, to take charge of its I Fowler's Report on Arsenic, &c., p. 109, Lond. 1786. 176 HOMiEOPATHY SUCCESSFUL. military hospitals, Lazareth and La CharitY. He accepted the invitation, and officiated to the entire satisfaction of the minister. HUFELAND, who introduced Staff to the assembled company of La Charit6, then paid him a deserved personal compliment, and at the same time expressed these impartial views respecting the homoeopathic system:" Homoeopathia seems to me to be particularly valuable in two points of view; first, because it promises to lead the art of healing back to the only true path of quiet observation and experience, and gives new life to the too much neglected worth of symptomatology; and, secondly, because it furnishes simplicity in the treatment of disease. The man whom I have the honour to present to you is not a blind worshipper of his system. He is, I have learned with joy, as well acquainted with the entire science of medicine, and as classically educated as he is well informed in the new science."' Le Moniteur (the official organ of the French government), for Feb. 1, 1836, thus refers to the distinction conferred on Dr Mabit, in consequence of his successful homceopathic treatment of cholera at Bordeaux, and also for having founded a homoeopathic hospital, the results of which were sufficiently striking to command the attention of the King of the French:"Dr Mabit has been created knight of the legion of honour, a recompense rendered to his devotion and exertions on the appearance of the Asiatic cholera, as well as to his stedfast zeal and continued researches for the interests of humanity and progress of medicine." Dr Mabit has collected from authentic sources the results of the allopathic and homoeopathic systems in the treatment of cholera. In his table he gives the comparative trial each 1 Hufeland, die Lehre von den Heilungs-Objecten und ihrer Erkentniss, oder die Jatragnomik. Berlin, 1829. DECISION OF FRENCH ACADEMY. 183 eyes," and, therefore, issued an ukase or order for the establishment of homoeopathic apothecaries in the various governments of that vast empire. The ukase was published in November 1833. Homoeopathy is steadily extending through Russia. Much importance has been attached to the decision of the French Academy of Medicine; and were the statements contained in their letter to the Minister of Public Instruction true, we would at once admit that Homoeopathy is a system of absurdities and falsehood, a convenient shelter for charlatans, unworthy of the confidence of the public or the attention of the physician. But we would beg those, and there are many, who have been turned aside from studying Homoeopathy, simply because it is under the ban of the French Academy, we beg of them an attentive examination of the grounds upon which that body pronounced their judgment. Even viewing the subject apart from the. grounds of judgment, why are we induced to believe in the infallibility of the Academy? does the experience of former decisions raise them in. our estimation as judges? or do they not remind us that these academicians are men, as men, liable to error, and from their very situation prone. to view with prejudice discoveries which, if true, condemn themselves? The very tone of their letter to. the minister, the acrimony and levity of their discussion, the illiberal style in which that discussion has been reported, should of themselves lead the honest observer to doubt much the capability and candour of the judges. From the Medical Gazette (vol. xv. p. 922.), we extract the statements made by M. Andral jun. and M. Bally, who alone of all the academicians could speak from experience (?).the value of their experience and the truth of their statements will afterwards be seen. ON THE DECISION OF THE ACADEMY. 189.had referred the question of homceopathy to them. It will be well for us to state the motives of our conduct. " We wished to obtain permission to organize ourselves into a scientific society, and to found a dispensary with a view of collecting materials, both of a theoretical and practical nature, on which the Academy (to which it was intended to appeal in the course of time) might ground their decision. For it has never been our wish that homceopathy should insinuate itself, as if by stealth, into medical science and medical practice, and the obloquy which has been cast on the doctrine as on every other innovation, could not be but annoying to us its professed adherents. But we had watched too narrowly the progress of ideas in the world not to know that the most well-grounded discoveries, and truths the most evident, are always contemned at the outset, even by those who are considered as the only competent judges. Such has been the history of truth in all ages and countries, and such has it been in our own times. But, whenever it was known that the Academy had been called upon to pronounce on the value of homeeopathy, we endeavoured to right ourselves in our new position,-a position which we are content to retain for the future, though it was none of our choosing. We therefore addressed the following letter to the Committee: "GENTLEMEN, "We have learned through the medium of the public papers, that you had been appointed by the Academy of Medicine to examine into the question addressed to it by the Minister of Public Instruction relative to the homceopathic system of medicine. You have not, in his opinion, to examine into the scientific points involved in this doctrine, but merely to decide on the propriety or non-propriety to grant the sanction required by law to the Dispensary we have founded. " We are not aware what steps you intend taking in the prosecution of your inquiry, but shall be happy to place at your disposal all the documents of an official and authentic character, which may serve to shew how the practice of homceopathy has been sanc 190 LETTER TO M. GUIZOT tioned in the various states of Germany and Russia in which it prevails. " If, again, the Committee thinks it cannot venture to pronounce on a question of medical police without entering into the heart of the subject, and is desirous with this view of engaging in regular and methodical experimental researches, the7H-omceopathic Society begs you will consider its members entirely at your service. " The Society seizes this opportunity of expressing its regret at seeing the homceopathic doctrine brought before the Academy thus indirectly. It was intended to bring the subject before that body in a direct form, requesting it to examine the doctrine in all its bearings. With this object it was collecting materials capable of throwing light on the subject; and in applying to the Government to obtain leave to establish a Dispensary, it had no other intention than that of conforming to the laws, and, amongst others, to the new act against associations. " And, in truth, nothing would be more gratifying to the Homceopathic Society than that the Academy should institute a scrutiny into the question in its whole extent and under all its aspects. "We have the honour to remain, &c. &c. "CROSERIO, Pres. "LEON SIMON, Gen. Sec." "The following reply was received from the Perpetual Secretary in the name of his colleagues. " GENTLEMEN, "IThe Academy has received the letter you were so good as address to it, and immediately transmitted it to the Committee intrusted with the preparation of an answer to the questions put by Government. Your letter contains offers of services which the Committee will not hesitate to avail itself of if it thinks them requisite. " I have the honour to convey to you the thanks of the Committee and of the Academy. I am, &c. &c. ",E. PARISET, Perp. Sec." 194 LETTER TO M. GUIZOT " The same inconvenience seems to present itself in all the chronic affections intrusted to our care. Thus, the patient in bed No. 44 of the ward St Landry, affected with chronic hepatitis and haemorrhoidal flux, threatens to leave the hospital, not that he doubts the action of the 'infiniments petits', but because, on the contrary, he experienced for some time an aggravation of his symptoms, which is occasionally the primary action of the homoeopathic medicines. However, under their influence, the haemorrhoidal discharge has much diminished. But the patient is not cured.' " It is the same with the old soldier labouring under pulmonary emphysema of fifteen years' standing. For the treatment of this patient we would require a long time, at least many months; but we doubt much the man's patience, and fear that as soon as he felt a little relieved, he would then, like the others, leave the hospital. " We will encounter the same obstacles every time that we have to treat chronic affections of old standing, and you have no more power than we have of retaining a patient contrary to his wish. Are we not justified then in concluding that no decisive results can be arrived at as regards chronic diseases, unless we can act on a greater scale, and thus hope that among the number, some perfect cases can be produced, the only ones that are conclusive? It is not with six male and two female patients that we can hope so desirable a result. " Upon these grounds, we beg of you, if possible, to concentrate our efforts upon acute diseases. " A.t this period, your wards are divided among four persons. M. Piorry possess the half; the 'interne' has equally a share, the remaining portion is divided between you and us. You should then make a general application of the homoeopathic treatment to all the patients reserved to you; it is this favour we ask. Then we will hope to meet with some conclusive observations, such as will admit of no reply, and which will authorize us to continue the trials, and that within a limited time. * Mark the minuteness of those details compared with the general statements of M. Bally. 196 LETTER TO M. GUIZOT it was specially requested; bread was given to him contrary to our orders; for several days the starch enemata were not given. These inconveniences, which will be constantly occurring, depend upon the arrangement of the wards. At the hour we pay our visit, internes', pupils in medicine and pharmacy, dressers, and nurses, are occupied with M. Piorry's visit. It is only by running from one ward to another, that we are enabled to give the prescriptions for our patients. Is it then astonishing that frequently they are neglected? " In addition it is difficult for us to avoid these inconveniences, since we have no authority over the persons attached to your wards, and you yourself are unable to visit the hospital along with us. We act, then, completely isolated. You know well, Sir, that to judge of a disease and a therapeutical method, it is not sufficient to have before one the commencement and the result. It is the general mode of judging, but not sufficient for the scientific observer. The wide difference of the two points in which we are placed, requires that we all meet at the patient's bedside, in order that the results obtained by us be duly appreciated. " Visits made and clinical reports taken by ourselves alone lead to nothing. Sometimes, we admit, you have added your own observations. But as we were then absent it was impossible for us to make any remarks upon their contents, and thus it has happened that you have marked increase of the symptoms in cases where we would have attributed it to medicinal aggravations. ",( In conclusion, we repeat, that homeeopathic trials made in hospitals require two necessary conditions; first, that the trials be observed by all those interested in them; second, that the experimenters be placed in the most favourable circumstances to conduct these experiments. "A But adhering only to the second of these conditions, we ask of you to place a sufficient number of patients at our disposal, in order that within the six weeks or two months that we can devote to these trials, we may be enabled to produce some conclusive facts. We also ask of you, that the management of the wards be so arranged that those who are attached to them be under our orders, in order that the errors and omissions of which we have ON THE DECISION OF THE ACADEMY. 197 complained do not again occur. Otherwise we lose precious time without convincing you personally of the truth of the homoeopathic doctrine, without profit to ourselves or advantage to science. " We have considered ourselves bound to transmit to you these remarks, in order to put a termination to a position which we cannot longer occupy, and beg of you to come to a determination, &c. " LEON-SIMON CURIE." " After this recital of the occurrences which took place at the H6tel-Dieu, statements so correct that M. Bally has made no other reply than that he would accede to our request as soon as he had terminated his experiments upon kreosote, is it matter of astonishment that our colleagues have not obtained cures in the space of a month? To their care are entrusted phthisical patients, an encysted dropsy which had been already tapped twelve times, a pulmonary emphysema of fifteen years' standing, two cases of chronic bronchitis, that had been under M. Bally's care for several months, and who in three weeks were so much better as to demand their discharge,-more than allopathy could effect in several months. Notwithstanding it is admitted that two patients were dismissed reporting themselves cured. The one was a female labouring under cancer of the womb, who again returned to the hospital in fifteen days, and then died. She had been under treatment for months, and it must be granted that if this treatment did not cure, it at least produced so much improvement, that the patient left the hospital under the idea that she was cured. If anything astonishes us it is, that in a case so dangerous and so well marked, M. Bally did not verify the pretended cure of this woman. M Bally thus remarks with regard to the young man labouring under typhus fever,-' Two men of the same age and of equal strength, labouring under typhus, being admitted into the H6tel-Dieu were put under treatment; the one treated by myself was cured at the end of ten days; the second, treated by M. Curie was also cured, but only at the end of three or four months.' 1 See la Lancette, and la Gazette Medicale, from which these extracts are 198 198 LETTER TO M. GUIZOT " M. Curie disputes the duration of treatment, and the letter given previously asserts, that at the end of three weeks the typhoid symptoms had ceased, and that there only remained the a-ffection of the chest, which had commenced prior to the typhous fever. This latter circumstance, which it would have been honest in M. Bally to mention to the Academy, explains the difference in the duration of the treatment. Besides, is it not universally admitted, that acute diseases are more difficult* to cure when they occur in patients labour'ing under chronic affections? " We state boldly, that M. Ballyhas followed in this case an unfortunate course, and little in harmony with his character. He demands a full and entire verification of the homoeopathic system, and when our colleagues accede to his request, he hands over to them, almost disdainfully, a few incurables. Among the number occurs an acute disease, but it is complicated with a chronic affection, of which no mention is made. "11M. Bally offers to produce the proofs of what he has advanced. He affirms that a register of the cases had been kept. Our colleagues agree with him in this; but this register, according to one of them (M. Curie), depones in favour of the trials that had been made. The Academy does not consider it necessary that that register be produced. M. Curie is more exacting; he writes to M. Bally letter upon letter to obtain the representation of this irresistible argument. But M. Bally has removed his library, and the register is lost. He o~ffers them a proof which it was impossible for him to produce; and this document, which no one had seen or attested, was one of the reasons which actuated the judgment of the Academy. But the Academy had previously formed its opinion; after that, every pretext was a motive, every assertion became a proof. "ccHowever that may be, after the 16th January M. Simon, judging that the proposed trials were mere pretexts, withdrew himtaken. See also Le Reformateur, Le Temps, and Le Messager. Let the reader observe closely the looseness of M. Bally's statement; to him it is little matter whether the duration of the treatment was three or four months. Who ever heard of typhus lasting four months? 200 ANDRAL'S EXPERIMENTS. posed; the number of medicines indicated amounts to nearly 60, Although chinchona is specific in some, it is not in other species of intermittents. Why, then, be surprised, that while successful in one case, it failed in others? But it is added, that the augmentation of the dose was all that was required to effect a cure. This suggests, Sir, a point of doctrine which we shall allude to without entering into it. "Homoeopathy teaches that there are two ways of arriving at the cure of a disease -the one the direct, the other the indirect. The specific method, that which accords to the precept Similia similibus curantur, is the direct one; the contrary is the indirect one. The first cures the disease speedily and permanently, without disturbance of the system, and leaves no artificial malady after its employment; the second always disturbs the system;,and leaves, after the extinction of the original disease, effects more or less permanent. In the cases now referred to, there are torpor of the digestive functions, more or less obstinate constipation, and various nervous affections. The patient is declared cured, because the intermittent fever has disappeared: but the symptoms produced by chinchona are not taken into account. It might as well be maintained that the wretched patients whose pains are stifled by opium is therefore well. And the allopathic physicians themselves know that the benefit derived from opium is doubtful; they know that their too vaunted remedy arrests not the progress of organization in the affected tissues-silencing only the pain which was the outward manifestation, and, so to speak, the measure of the disease. "In addition, how do they effect these so-called cures? By enormous doses of medicines, which always disorder the economy, in a transient manner in those whose power of vital reaction is strong, in a more permanent and too often irremediable manner in those unfortunate patients whose power of reaction is feeble. In the case in which M. Andral speaks, the chinchona was not indicated; on that account, therefore, the fever resisted the homceopathic doses." OPPOSITION TO NEW TRUTHS. 20 203 probably more than in any other science, have been too often displayed the obstinacy with which errors have been clung to and improvements resisted. If the innovations which various schools have effected for a longer or shorter period in medicine have been bitterly opposed, although received by, the majority, can it be matter of astonishment that Homoeopathy has been opposed? nay, more, that it has been Scouted at, and condemned without judgment. The various pathological schools have differed more in name than in reality, their arguments were founded upon matters which none understood fully, not upon facts but upon empty distinctions. Each incorporated itself or gave way to the other, each was comparatively well received, as it effected little reform in practical medicine; the same therapeutical precept was acted upon, the same medicines were administered. But how different with- Homoeopathy! Based upon pure induction, it starts with an established law; steadily guid-.ed by this law, it adopts whatever is consonant with it and dismisses whatever is opposed, no matter ho w great a favourite it may be with the schools; it rises superior to the thought that scholastic opinions are to be venerated for their antiquity; it avoids the error of deriving truth from rules, and not rules from truth; it makes no compromise with the present system of therapeutics. Is it to he wondered at, then, that Homoeohis return to Edinburgh, being in company with some very intelligent gentlemen, members of the legal and other learned professions, he told them of the novelty of pretending to light London with coal smoke. He and the intelligent company, broke out into a hearty laugh at this piece of novelty. "Gentlemen," Scott observed, 11I must confess such fools as this man with his coal-smoke light, are worse than other fools-they are the most stubborn fools, and cannot be dissuaded in any manner from their monomania." Some twenty years thereafter, Sir Walter Scott was appointed a Director of the Edinburgh Gas Light Company! NOT STUDY HOM(EOPATHY?20 205 such obscure persons, that it is excluded from universities, and condemned wholesale by Royal Colleges. This reasoning, if such it can be called, is characteristic of the age in which we live; we have now singing for the million, teaching for the million, cheap publications for the million; and, alas, Truth, unless supported by the million, can be no truth at all! How truly has that master-spirit Carlisle pourtrayed this feature as a'sign of the times. "1We fig~ure society," says he, " as a machine, and that mind is opposed to mind as body is to body; whereby two or at most ten little minds must be stronger than one great mind. Notable absurdity! For the plain truth, very plain we think, is, that minds are opposed to minds in quite a different way; and one man that has a higher direction, a hitherto unknown spiritual truth in him, is stronger, not than ten men that have it not, or than ten thousand, but than all men that have it not; and stands among them with a quite ethereal, angelic power, as with a sword out of Heaven's own armoury, sky tempered, which no buckler and no tower of brass will -finally withstand." -Because Homoeopathy is not believed in (it should al-, ways be added, because not studied) by the majority of the great ones in medicine, therefore it is unworthy of attention. Such is the argument of very weak minds, unable to observe and reason for themselves; like blind men they must be led by others, such slaves to opinion that they never can break through the magic circle of prejudice, which a favourite master may have woven around them. If we wait until a new system finds its way into universities, which have been so aptly called by the greatest ornament of our own, " those dormitories, not nurseries of learning;" if we wait until it be invested in the gown of state, we may 5 OF TESTING HOM(EOPATHY. 207 i quickly, gently, and permanently, relate the whole number of cases, and cover Homoeopathy with disgrace, by proclaiming the want of success of treatment adopted rigorously after its principles. APPENDIX. No. I. PROOFS TO A CERTAIN EXTENT OF THE EXISTENCE OF THE HOMOEOPATHIC LAW, COLLECTED BY HAHNEMANN. I shall here relate some examples of these homceopathic cures, which find a clear and precise interpretation in the homoeopathic doctrine now discovered and acknowledged, but which we are by no means to regard as arguments in favour of the latter, because it stands firm without the aid of any such support.' The author of the treatise on epidemic diseases (attributed to Hippocrates2), mentions a case of cholera morbus that resisted every remedy, and which he cured by means of white hellebore alone, which, however, excites cholera of itself, as witnessed by Forestus, Ledelius, Reimann, and many others.3 1 If, in the cases which will be cited here, the doses of medicine exceeded those which the safe homoeopathic doctrine prescribes, they were, of course, very naturally attended with the same degree of danger which usually results from all homoeopathic agents when administered in large doses. However, it oftens happens from various causes which cannot at all times be discovered, that even very large doses of homoeopathic medicines effect a cure, without causing any notable injury; either from the vegetable substance having lost a part of its strength, or because abundant evacuations ensued which destroyed the greater part of the effects of the remedy; or, finally, because the stomach had received at the same time other substances, which, acting as an antidote, lessened the strength of the dose. 2 At the commencement of lib. 5. 3 P. Forestus, xviii. obs. 44.-Ledelius, Misc. nat. cur. dec. iii., ann. i., obs. 65.-Reimann, Bresl. Samml. 1724, p. 535. In this, and in all the examples that follow, I have purposely abstained from reporting either my own observations or those of my pupils upon the special effects of each individual medicine, but merely those of the physicians of times past. My object for acting in this manner, is to shew that the art of curing homoeopathically might have been discovered before my time. 0 HOM(EOPATHIC LAW. 211 the stomach produced by this liquid, and P. Forestus1 violent colic likewise caused by its administration. If F. Hoffman praises the efficacy of millefoil in various cases of hemorrhage; if G. E. Stahl, Buchwald and Loseke, have found this plant useful in excessive hemorrhoidal flux; if Quarin and the editors of the Breslauer Sammlungen speak of the cure it has effected of hemoptysis; and finally, if Thomasius (according to Haller) has used it successfully in uterine hemorrhage; these cures are evidently owing to the power possessed by the plant, of exciting of itself intestinal hemorrhage and hematuria, as observed by G. Hoffman,2 and more especially of producing epistaxis, as confirmed by Boecler.3 Scovolo,4 among many others, cured a case where the urinary discharge was puriform, by arbutus uva ursi; which never could have been performed if this plant had not the property of exciting heat in the urinary passage, with a mucous discharge after passing water, as seen by Sauvages.5 And though the frequent experience of Stoerck, Marges, Planchon, du Monceau, F. C. Junker, Schinz, Ehrmann, and others, had not already established the fact, that colchicum autumnale cures a species of dropsy, still this faculty was to have been expected from it, by reason of the particular power which it possesses of diminishing the urinary secretion, and of exciting at the same time a continual desire to pass water. It likwise causes the flow of a small quantity of urine of a fiery red colour, as witnessed by Stoerck6 and de Berge. The cure of an asthma attended with hypochondriasis7 effected by Goritzs by means of colchicum, and that of an asthma complicated with hydrothorax, performed by Stoerck9 with the same substance, were evidently grounded upon the homceopathic property which it possesses, of exciting by itself asthma and dyspnoea, as witnessed by de Berge.o1 Observat. et Curationes, lib. 21. 2 De Medicam. Officin. Leyden, 1738. 3 Cynosura Mat Med. Cont. p. 552. 4 In Girardi, de uva ursi. Padua, 1764. "5 Nosolog., iii. p. 200. 6 Libellus de Colchico. Vienna, 1763, p. 12. 7 Journal de Medicine, 22. 8 A.E. Biichner, Miscell. Phys. Med. Mathem. Ann. 1728, jul. pp. 1212, 1213. Erfurt, 1732. 9 Ibid. cas. 11, 13. Cont. cas. 4, 9. 10 Ibid. loc. cit. N 212 EXAMPLES- OF THE Muraltol has seen what we may witness every day, viz., that jalap, besides creating gripes of the stomach, also causes great uneasiness and agitation. Every physician acquainted with the facts upon which homoeopathy rests, will find it perfectly natural, that the power so justly ascribed to this medicine by G. W. Wedel," of allaying the gripes which are so frequent in young children, and of restoring them to tranquil repose, arises from homoeopathic influence. It is also known and has been attested by Murray, Hillary, and Spielmann, that senna occasions colic, and produces, according to C. Hoffmann3 and F. Hoffmann,4 flatulency and general excitement,5 ordinary causes of insomnolency. It was this innate homceopathic virtue of senna, which enabled Detharding6 to cure with its aid, patients afflicted with violent colic and insomnolency. Stoerck, who had so intimate a knowledge of medicines, was on the point of discovering that the bad effects of the dictamnus, which sometimes provokes a mucous discharge from the vagina,7 arose from the very same properties in this root by virtue of which he cured a leucorrhoea of long standing.8 Stoerck might, in like manner, have been struck with the idea of curing a general chronic eruption (humid phagedenic and psoric) with the clematis,9 having himself ascertained10 that this plant has the power of producing a psoric eruption over the whole body. If, according to Murray,' the euphrasia cures a certain form of ophthalmy, how could it otherwise have produced this effect, but by the faculty it possesses of exciting a kind of inflammation in the eyes, as has been remarked by Lobel.12 According to J. I-. Lange,13 the nutmeg has been found efficacious in hysterical fainting fits. The sole natural cause of this phenomenon is homoeopathic, and can be attributed to no other i Misc. Nat. Cur. dec. ii. anm. 7, obs. 112. " Opiolog, lib. 1, p. 1. cap. 2. p. 38. 3 De Medicin. Officin. lib. 1, cap. 36. S Diss de Manna, p. 16. 5 Murray, loc. cit. ii. p. 507. 6 Ephem. nat. cur. cent. 10, obs. 76. 7 Lib. de. Flamm. Jovis. Vienna, 1769, cap. 2. s Ibid. cap. 9. " Ibid. cap. 13. 10 Ibid. p. 33. "1 Appar. Medic. 11, p. 221. 12 Strip, Adversar. p. 219. 13 Domest. Brunsvic. p. 136. 214 EXAMPLES OF THE quently produces similar affections to those which arise from colds, as Carrere himself has observed,' and likewise Starcke.2 Fritze3 saw the dulcamara produce convulsions, and de Haen4 witnessed the very same effects, attended with delirium. On the other hand, convulsions attended with delirium, have yielded to small doses of the dulcamara administered by the latter physician. It were vain to seek, amid the vast empire of hypotheses, the cause that renders the dulcamara so efficacious in a species of dartre, as witnessed by Carrere,5 Fouquet,6 and Poupart.7 Nature, which requires the aid of homoeopathy to perform a safe cure, sufficiently explains the cause, in the faculty possessed by the dulcamara of producing a certain species of dartre. Carrere saw the use of this plant excite dartrous eruptions which covered the entire body during a fortnight; and on another occasion where it produced the same on the hands,9 and a third time where it fixed itself on the labia pudendi.10 Rucker"l saw the scrophularia produce swelling of the entire body. This is the reason that Gatackerl2 and Crillo13 succeeded in curing with its aid (homoeopathically) a species of dropsy. Boerhaave,"4 Sydenham,'5 and Radcliffe,16 cured another species of dropsy with the aid of the sambucus nigra, because, as Haller17 informs us, this plant causes an cedematous swelling when applied externally. 1 Carrere and Starcke, Abhandl. ueber die Eigenschaften Nachtschattens oder Bitter suesses. Jena, 1786, pp. 20-23. 2 In Carrere, Ibid. 3 Annalen des Klinischen Instituts, iii. p. 45. 4 Ratio Medendi, tom. iv. p. 228. 5 Ratio Medendi, tom. iv. p. 92. 6 In Raouz, Tables Nosologiques. 7 Traites des Dartres. Paris, 1782, pp. 184, 192. S Ibid. p. 96. 9 Ibid. p. 149. 10 Ibid. p. 164. " Commerc. Liter. Naric. 1731, p. 372. "12 Versuche und Bemerk. der Edinb. Gesellschaft, Altenburg, 1762, vii. pp. 95, 98. 13 Consult. Medichi, tom. iii. Naples, 1738. 4to. "4 Historia Plantarum, p. I. p. 207. 15 Opera, p. 496. "1 In Haller, Arzneimittellehre, p. 349. 17 In Vicat, Plantes veneneuses, p. 125. HOM(EOPATHIC LAW.. 221 was cured in a single night by wine which Rademacher1 administered to the patient. Can any one deny the power of a medicinal irritation analogous to the disease itself (similia similibus) in either of these cases? A strong infusion of tea produces anxiety and palpitation of the heart in persons who are not in the habit of drinking it; on the other hand, if taken in small doses, it is an excellent remedy against such symptoms when produced by other causes, as testified by G. L. Rau.2 A case resembling the agonies of death, in which the patient was convulsed to such a degree as to deprive him of his senses, alternating with attacks of spasmodic breathing, sometimes also sobbing and stertorous respiration, with icy coldness of the face and body, lividity of the feet and hands, and feebleness of the pulse (a state perfectly analogous to the whole of the symptoms which Schweikert and others saw produced by the use of opium), was at first treated unsuccessfully by Stulz3 with ammonia, but afterwards cured in a speedy and permanent manner with opium. In this instance, could any one fail to discover the homoeopathic method brought into action without the knowledge of the person who employed it? According to Vicat, J. C. Grimm, and others, opium also produces a powerful and almost irresistible tendency to sleep, accompanied by profuse perspiration and delirium. This was the reason why Osthoff4 was afraid to administer it in a case of epidemic fever which exhibited similar symptoms, for the principles of the system which he pursued prohibited the use of it under such circumstances. However, after having exhausted in vain all the known remedies, and seeing his patient at the point of death, he resolved, at all hazards, to administer a small quantity of opium, whose effects proved salutary, as they always must, according to the unerring law of homceopathy. x In Hufeland's Journal, xvi. i. p. 92. 2 Uber den Werth des Homceopatischen Heilf. Heidelberg, 1824, p. 72. 3 In Hufeland's Journal, x. iv. 4 In the Salzburgh MecL Chirurg. Journal, 1805, iii. p. 110. HOM(EOPATHIC LAW. 223 ed in curing lethargic fevers with opium. A case of lethargy of which De Meza1 effected a cure, would yield only to this substance, which, in such cases, acts homceopathically, since it produces lethargy of itself. C. C. Matthai,2 in an obstinate case of nervous disease, where the principal symptoms were insensibility and numbness of the arms, legs, and belly, after having for a long time treated it with inappropriate, that is to say, non-homoeopathic remedies, at length effected a cure by opium, which, according to Stiitz, J. Young, and others, excites similar symptoms of a more intense nature, and which, as every one must perceive, only succeeded on this occasion by homoeopathic means. The cure of a case of lethargy which had already existed several days, and which Hufeland performed by the use of opium,3 by what other law could this have been effected, if not by that of homoeopathy which has remained unknown till the present time? In that peculiar species of epilepsy which never manifests itself but during sleep, De Hean discovered that it was not at all a sleep, but a lethargic stupor, with stertorous respiration, perfectly similar to that which opium produces in persons who are in health; it was by the means of opium alone that he transformed it into a natural and healthy sleep, while at the same time he delivered the patient of his epilepsy.4 How is it possible that opium, which of all vegetable substances is the one whose administration in small doses produces the most powerful and obstinate constipation, should notwithstanding be a remedy the most to be relied upon in cases of constipation which endanger life, if it was not in virtue of the homoeopathic law so little known-that is to say, if nature had not decreed that medicines should subdue natural diseases by a special action on their part, which consists in producing an analogous affection? Opium, whose first effects are so powerful in constipating the bowels, was discovered by Tralles5 to be the only cure in a case which he had till then treated ineffectually with evacuants ' Act. reg. soc. med. Hafn. III. p. 202. 2 In Struve's Triumph der Heilk. III. 3 In Hufeland's Journal, XII. I. 4 Ratio Medendi, V. p. 126. - Opii usus et abusus. Sect. II. p. 260. 224 EXAMPLES OF THE and other remedies. Lentilius1 and G. W. Wedel,2 Wirthenson, Bell, Heister, and Richter,3 have likewise confirmed the efficacy of opium, even when administered alone in this disease. Bohn was likewise convinced by experience that nothing but opiates would act as purgatives in the cholic called miserere4; and the celebrated Hoffman, in the most dangerous cases of this nature, placed his sole reliance on opium combined with the anodyne liquor called after his name.5 All the theories contained in the two hundred thousand volumes that have been written on medicine, and which are entirely ignorant of the therapeutic law of homoeopathy, would they be able to furnish us with a rational explanation of this and so many other similar facts? Have their doctrines conducted us to the discovery of this law of nature so clearly manifested in every perfect, speedy, and permanent cure-,4hat is to say, have they taught us that when we use medicines in the treatment of diseases, it is necessary to take for a guide the resemblance of their effects upon a person in health, to the symptoms of those very diseases? Rave6 and Wedekind7 have suppressed uterine hemorrhage with the aid of sabine, which, as every one knows, causes uterine hemorrhage, and consequently abortion with women who are in health. Could any one, in this case, fail to perceive the homceopathic law which ordains that we should cure similia similibus? In that species of spasmodic asthma designated by the name of Millar's, how could musk act almost specifically, if it did not of itself produce spasmodic suffocation without cough, as observed by F. Hoffman?8 Could vaccination protect us from the small-pox otherwise than homceopathically? Without mentioning any other traits of close resemblance which often exist between these two maladies, they 1 Eph. nat. cur. dec. III. ann. I. app. p. 131. 2 Opiologia, p. 120. 3 Anfangsgriinde der Wundarzneikunde, V. ~ 328.-Chronische Krankheiten. Berlin, 1816, II. p. 220. (Rudiments of Surgery, V. ~ 328.Chronic Diseases, Berlin, 1816, II. p. 220.) 4 De Officio Medici. 5 Medicin. rat. system. T. IV. P. II. p. 297. "B Bcobachtungen und Schliisse (Observations and Conclusions), II. p. 7. 7 In Hufeland's Journal, X. I. p. 77. 8 Med. ration, system. III. p. 92. HOM(EOPATHIC LAW. 225 have this in common-they generally appear but once during the course of a person's life; they leave behind cicatrices equally deep; they both occasion tumefaction of the axillary glands; a fever that is analogous; an inflamed areola round each pock; and finally, ophthalmia and convulsions. The cow-pock would even destroy the small-pox on its first appearance, that is to say, it would cure this already existing malady, if the intensity of the small-pox did not predominate over it. To produce this effect, then, it only wants that excess of power which, according to the law of nature, ought to correspond with the homeeopathic resemblance, in order to effect a cure (~152). Vaccination, considered as a homoeopathic remedy, cannot, therefore, prove efficacious except when employed previous to the appearance of the small-pox, which is the stronger of the two. In this manner it excites a disease very analogous (and consequently, homoeopathic) to the small-pox, after whose course, the human body, which, according to custom, can only be attacked once with a disease of this nature, is henceforward protected against a similar contagion.1 It is well known that retention of urine is one of the most common and painful evils which the use of cantharides produces, This. point has been sufficiently established by J. Camerarius, Baccius, de Hilden, Forest, J. Lanzoni, van der Wiel, and Werlhoff.2 Cantharides administered internally and with precaution, ought consequently to be a very salutary homoeopathic remedy in similar cases of painful dysury. And this is in reality the case. For, without enumerating all the Greek physicians, who instead of our cantharides, made use of meloe cichorii, Fabricius de Aquapendente, Capo di Vacca, Reidlin, Th. Bartholin,,Young,4 Smith,5 1 This mode of homoeopathic cure in antecessum (which is called preservation or prophylaxy) also appears possible in many other cases. For example, by carrying on our persons sulphur, we think we are preserved from the itch which is so common among wool-workers; and by: taking as feeble a dose as possible of belladonna, that we are protected from scarlet fever. 2 See my Fragmenta deviribus medicamentorum positivis. Leipsic, 1805, i. p. 83. 3 Epist. 4, p. 345. 4 Phil; Trans. No. 280. 5 Medic. Communications, ii. p. 505. P HOM(EOPATHIC LAW. 227 able1 to cure with its aid, dysentery and hemorrhoidal diseases attended with tenesmus, as observed by Werlhoff,2 and according to Rave,3 colic caused by hemorrhoids. It is well known that the waters at Toeplitz, like all other warm sulphureous mineral waters, excite the appearance of an exanthema which strongly resembles the itch so prevalent among persons employed in wool-working. It is precisely this homoeopathic virtue which they possess that removes various kinds of psoric eruptions. Can there be any thing more suffocating than sulphureous fumes? Yet it is the vapour arising from the combustion of sulphur that Bucquet4 discovered to be the best means of reanimating persons in a state of asphyxia produced by another cause. From the writings of Beddoes and others, we learn that the English physicians found nitric acid of great utility in salivation and ulceration of the mouth occasioned by the use of mercury. This acid could never have proved useful in such cases if it did not of itself excite salivation and ulceration of the mouth. To produce these effects, it is only necessary to bathe the surface of the body with it, as Scott5 and BlairG observe, and the same will occur if administered internally, according to the testimony of Aloyn,7 Luke,8 I. Ferriar,9 and G. Kelly.10 Fritze"1 saw a species of tetanus produced by a bath impregnated with carbonate of potash, and A. de Humboldt". by the application of a solution of salt of tartar increased the irritability of the muscles to such a degree as to excite tetanic spasm. The curative power which caustic potash exercises in all kinds of tetanus, in which Stiitz and others have found it so useful, could it be acSMedic. National-Zeitung (National Med. Gazette), 1798, p. 153. 2 Observat. de Febribus, p. 3, ~ 6. 3 In Hufeland's Journal, vii. ii. p. 168. 4 Edinb. Med. Comment. ix. 5 In Hufeland's Journal, iv. p. 353. 6 Neueste Erfahrungen (Most recent Discoveries), Glogau, 1801. 7 In the M6moirs de la Soc. Med. d' emulation. i. p. 195. 8 In Beddoes. 9 In the Sammlung auserles. Abhandl. fiir pract. Aertze (Select Treatises for Practical Surgeons), xix. ii. 10 Ibid. xix. i. p. 116. 11 In Hufeland's Journal, xii. i. p. 116. 12 Versuch iiber die gereizte Muskel-and Nervenfaser (Treatise on the Irritability of the Muscles and Nerves), Posen and Berlin, 1797. HOMOEOPATHIC LAW. 229 proceed from its faculty of exciting fever, as almost every observer of the evils resulting from this substance has remarked, particularly Amatus Lusitanus, Degner, Buchholz, Heun, and Knape? "We may confidently believe E. Alexander,1 when he tells us that arsenic is a sovereign remedy in cases of angina pectoris, since Tachenius, Guilbert, Preussius, Thilenius, and Pyl, have seen it give rise to very strong oppression of the breast, Griselius,2 to a dyspnoea approaching even to suffocation; and Majault, 3 in particular, saw it produce sudden attacks of asthma excited by walking, attended with great depression of the vital powers. The convulsions which are caused by the administration of copper, and those observed by Tondi, Ramsay, Fabas, Pyl, and Cosmier, as proceeding from the use of aliments impregnated with copper; the reiterated attacks of epilepsy which J. Lazerne4 saw result from the accidental introduction of a copper coin into the stomach, and which Pfiindel saw produced by the ingestion of a compound of sal ammoniac and copper into the digestive canal, sufficiently explain, to those physicians who will take the trouble to reflect upon it, how copper has been able to cure a case of chorea, as reported by R. Willan,6 Walcker,7 Theussink,8 and Delarive,9 and why preparations of copper have so frequently effected the cure of epilepsy, as attested by Batty, Baumes, Bierling, Boerhaave, Causland, Cullen, Duncan, Feuerstein, Hevelius, Lieb, Magennis, C. F. Michaelis, Reil, Russel, Stisser, Thilenius, Weissmann, Weizenbreyer, Whithers, and others. If Poterius, Wepfer, F. Hoffmann, R. A. Vogel, Thierry, and Albrecht, have cured a species of phthisis, hectic fever, chronic catarrh, and mucous asthma, with tin, it is because this metal pos1 Med. comm. of Edinb. dec. ii. t. i. p. 85. 2 Misc. nat. cur. dec. i. ann. 2, p. 149. 3 In the Sammlung Auserles. Abhandl. fir Aerzte, vii. 1. 4 De morbis internis capitis. Amsterdam, 1748, p. 253. 5 In Hufeland's Journal, ii. p. 264; and according to the testimony of Burdach, in his System of Medicine, i. Leip. 1807, p. 284. 6 Sammlung Ausarles. Abhandl. xii. p. 62. 7 Ibid. xi. iii. p. 672. 8 Waarnemingen, No. 18. 9 In Kiibn's phys. med. Journal, January, 1800, p. 58. ALLOPATHIC AND HOM(EOPATHIC TREATMENT. 235 Numerical and Comparative Statement of Patients admitted into the Hospitals, since I1 have been Surgeon of the Regiment, during the years 1835, 1836, and 1837. Number Number Total Total Years. Diseases. of of number of number Patients. Days. Patients. of Days. Fevers.,.. 86 1220 1835 Wounded,. 32 2800i 123 4138 Venereal,. 3 92( Cutaneous, 2 291 Fevers,.. 38 1660 1836 Wounded,. 35 1400 73 3160 Cutaneous,..... Fevers,.. 1 27 187 Wounded,. 5 243! 7 187 Venereal, 6 270.. Cutaneous,...J Observations.-From the 17th November 1834 to 15th June 1837, 194 patients were admitted into the hospitals, the duration of their illness amounts to 70560 days, the expense of which, at lid., to L-321: 18: 2. Patients treated at the Infirmary since December 1834 to 15th June 1837. 1835. 1836. 1837. Fevers.,.. 105 Fevers, - 86 Fevers,. 34 Wounded, - 78 Wounded,. 67 Wounded,. 24 Venereal,. 74 Venereal,. 40 Venereal,. 15 Total, 217 Total, 19 Total, 73 Observations.-From the 7th December 1834 to 15th June 1837,.1 treated at the regimental infirmary 483 patients, at the cost to Government of L.37, 13s. The majority of the patients were treated in their own quarters, and laboured under slight affections. Among these, several threat UNIVERSITY OF MICHIGAN 3 9015 05850 2918 B I Pew 7ýV I - I -A- "67 r. ý7 ob.ýý............................. -7