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Boston
MEDICAL LIBRARY
8 THE FENWAY
i
THE MONTHLY
HOMEOPATHIC REVIEW.
.^^''
EDITED BT
ALFRED C. POPE, M.D., D. DICE BROWN, M.A^ M.D.J
AMD
A. & KENNEDY, LRC.P. EDIN.
VOL. XXVI.
90nb;on:
£. 60X7LD & SON, 69, MOOBGATE STREET,
1882.
,-:<ON MEo^
rinv 5 r
^/QRAB^,.
LOHDON :
STBAKRft BIOS, 'ft <X>^ PBDrTBBS,
36) CBUIOIIILB BnUEBTy B.C.
NCV 51918
BvvwWf 1J6S. If 18b*
INDEX.
m
INDEX.
Beviews of Books will be foxmd only andar tha mud "Bmiffm ; *' sobjecks from ExtzBctsfrom Medical LitetatuxeTuidBr themnd " EztnGBts ; * ' and AssoeiationB under the word '' Hbm<Bqpatliic»''
A.
AconiU mTtaatA AMeetioDB.,, 289
Addreu deliyered before the BntiahHomoBopathioSociefy, by Alfred C. Pope, MJ>. ... 456
AdTantages of HomcBopathy in tiie Treatment of the Insane, by Belden H. Taloott, MJ). 402
Advertising ..••••••••••^.•••..«.*. 662
Allopathic vemst HomoBO- ^thic Theories, by Dr. John Wilde 226
Amateur Dramatic Perfor- mance 242, 804
Amflrican Ophthalmological
and Otological Society 421
480
B.
Bcptwta in Typhoid FeF«r, bf Dr. Dyoe Brown, M.D. ••^.. 206
Bathis, Donald, M.D,, on Elaotzicity 115, 178, 228, 822» 548
B^Uodonna Poisoning 426
BI.4KX, 8» H., Esq., dinical Caaeip with Bemaziks, by
92, 890, 670
., 0. H., M.D.^ On the Influence d[ Infinitesi- mal Quantities in tTiiin<p«g Pbysiological Aotien, by ..» Blacxukt, J. G., M.B., Clinical X«ctore on EzysipelaSy h|y.«.
604 188
BAac
Blindnsn, A Price Esny an tiie Causes and Prevention of 52
Blindness, Hints for the Pre- Tentian of the mcst oonxmon Accidents caosing , 568
Bluubeeg, H., M.D., J.P., The Medicine of the Fatnre, hr 881
Bnght*s Disease, hj T. E. Pnidom, M.D. •••«• .•• 785
British Medical AssodatifStr The 510
Bbown, D. Dtcb, MJ)., Can BapHsia cut short tnxe l^yphoid Perer ? by —• 208
BuTOHXB, W. D., Esq., Perio- dicity of Disease and of Drug Action, by J 654
.^
0.
Cardiac Tfaanpeniiea, Iqr 'SL Wkxid PoEBtBT, Esq... .^.^^^ 846
Case of dasftBO-lniBBtinal Hrnnmrhaga, by Dr. ProelL 40
Case ol MyooaioditiB In Bhaa- matic Fever, with Bphygmo- gnqphio Tracings, by Edward M. Madden, MJB., Bixmint-
Case of ObnmB Disane of Stomach, by ^ JJayd TuKikBy, MJ3., OJL ^...... 582
Gases of Pericaiditai, with Effmion, by J. Hamiltnir jA^v;<ift}tniA^ ifn ^,,^^,^ 619
IV
INDEX.
Monthly HomoBopaflde Baview, Deo. l, 1883«
Case of Pouoning by Sulphur, byEobortT. Cooper,MJ)... 89
Caseii, Glixdcal, with Bemarks, I7 S. H. Blake, Esq. ...92,
809, 890, 670
Oastor-Ofl Plant as a Ply- KiUer 426
Caetor-Oil, Poisoning by 427
Chronio Deafness, Bemedies for, by T. Cooper, M.D.... 729
Clabkb, JoBir H., M J)., Notes on the Antagonistio Action of Medicines, with some Be- marks on Ohzonio Poison- ings, by ^..., 688
Clabxz, Johx H., M.D., Two Spirits in Medicine, by 164
Ci*iUDB, Dr 662
Clinical Cases, with Bemarks, by S. H. Blake, Esq. ... 92,
209, 890, 670
Clinical Leoinre on Erysipelas, by J. Galley Blackly, M.B.. 188
Clinical Proofs of the Efficacy of Infiniiesiinal Doses, by Dr. P. Jonsset 409
Colds, «* A Mere Noth^*' ... 240
Congenital Deformity, A Case of, Beported by Dr. Morxis- Bon 288
Congress, The Approaching... 609
Convalescent Home, Slon^... 761
COOPSB, BOBXBT T., MJ)., A Case of Poisoning by Sulphur, by 89
D.
<* Death of HomoBopathy " ... 248 Diploma of the London School of HomcBopathy, Bemarks on the Proposedy by Alfred
C. Pope, M.D 274
Dispensaries, Onr 197
Drug Selection, On the Prin- ciples of, by Alfred C. Pope,
M.D 9
Dmgs, On the Study of the Effects and Mode of Aetien of. by Alfred 0. Pope, M.D. 77
«< Drank or Dying'* 668
DauiT, WxLLUK v., MJ)., The Search after Troth, by 677
E.
PACK
Ebxtbt, Lord, Testimonial to... 286
Electricity, Its Physiological Actions and Therapeutic Uses, by Donald Baynes, M.D 116. 178, 223, 322, 648
Eiysipelas, Clinical Lecture on by J. GaU^ Blackly, M3. 188
ETil, The King's 668
F.
FoBSTEB, E. Wood, Esq., Cardiac Therapeutics, by ... 846
FsiNKLiN, E. C, M.D., Lupus audits Treatment with Hy- droeotyle AiioHea, by 81
G.
Gastro-Intestinal Hemorr- hage. A Case of, Inr Dr. ProeU
40'
H.
HahuemanTi CouYalesoent Home, Boumemoutii 867
Hahnemann Publishing So- ciety 669, 690
*< Hahnemannians," 671, 696
Hair, The Trade in False 669
Harper, Testimonial to Dr. 606, 660
Hemorrhage, Gastro-Intes- tinal, A Case of, by Dr. ProeU 40
Hering's latest Works, Con- stantino 442
HomoBopathio Congress, The British 601, 620
Homoeopathic Convention, International, Transactions of the 876, 421
Homoeopathic Diplonm, llie London 818, 879
Homoeopathic Dispensary, Bournemouth, Beport of the Hahnemann Convalescent Home and 867
MonlUy HmnflBopiitliio BfliioWt D60. 1) 1689«
INDEX.
PAoa HonuBopatliio Dispenaaxy,
DeYon and OoxnwaU S67
HomiBopsihio Dispensaiy,
HastingB and St. Leon-
arda 198, 234
HomoBopathio Diepensaxy,
liiretpool 233
HoouBopalhio J>i8pen8az7, Neweaatle-on-Tyxia, 1881 ... 867
Homoeopaihio DispenBaiy, Oxford 884
Homodopathio DispenBariefl, Bed urn and Beigate 192
HomoBopathio Engineering,
Wicked 486. 507
HomoBopathie Hospital, Bath 288 HomcBopathio Hospital, Bir- min^m 128
HomcBopathio Hospital, Lon- don (Notes on), 58, 155, 245, 304, 817, 857, 867, 421,
505, 558, 685, 750 HanuBopathio Hospital, Mel-- boome 867
Homoeqpathio Institution, Not- tinghamshire 130
flomoBopathio Medioo-Ohimr- gioal Society, Liyerpool, Meeting of the 235
HomoBopathic Patients, One Way of Treating (r) 699
HomoBpathio Physicians and German Watering Places ... 568
HomoBopatiiic Ftaotice, by Dr. B. Hughes 480
HomoBopathio Pnbliidiing So- eiety, Amerioan 448
BomoBopathic Society, British, 55, 180, 191, 245, 806, 867,
456, 505
HomflBopathy and Medical Ethioa in the State of New York 414
HomoBopaihy and the New Medical BiU 188
HomoBopathy and "HomoBO- pathy" 877, 439
«'HomoBopathy, Death of" ... 248
Homceopathy, Experiences with, by Ide Stettin, M.D. 264
fiomiOBopathy, ** HomoBopathy " and Sisientific Pbysicians ... 307
HonuBopathy in Cleveland ... 421
Homoeopathy in India 687
HomcBopathy in Spain, lay Ghailfis Lloyd Tnckey, M3. 826
PAOB
HomoBopathy in the State of New York 253
Homceopathy in the UniteHd States 867, 421
HomcBopaihy, Eer, Dr., On the Propagation of 505
HomoBopathy, London School
of (Notes on), 50,56, 129, 242,
274, 298, 806, 367, 421,
575, 655, 698
HomoBopathy, Posology in Eo- lation to, by Alfred G. Pope, M.D 139
HomoBopatby, Progress of 53
HomoBopathy, the American Institute of 502
Homceopathy, TA« Lancet on 555
HomcBopathy, Tbe Licentiate in ...194, 246, 247, 248, 249, 250
Homoeopathy, the Boyal College of Physicians on 65
HomoeopaUiy vemu Allopathy in the Denver Almshouse ... 241
Horses, The Treatment of Splints in, by W. B. B. Scriven, M.D 87
How Infectious Disease is Spread 248
Eydrocotyle Asiatiea, Lupus and its Treatment with, by E. C. Franklin, M.D 31
Hygiene, An Address on, by M. Both, MJ) 66
Hyoieiamia in Mental De- rangement 288
HUGHBS, Dr. BiCHARD, ou
HomoBOpathlc Practice 480
HnsHDAUi, J. S., Esq., M.B.C.Y.S., Veterinary Sdence 712
L
lodoforMt Oaution in the Use of 429
Infinitesimal Doses, Proofs of the EfELcaqy of, by Dr. P. Jousset 409
Infinitesimal Quantities. On the Influence of, in inducing Physiological Action, by C. H. Blackley, M.D 604
Insane, The Advantages of - Homoeopathy in the Treat- ment of the, by Selden H. Tatoott,M.D 402
71
Un^EX.
Monthly HoBKBopi^thie Bflviow, Deo. 1« IfiOL
PAOB
InteBtinsl Obstrnoticm, An Aooonnt of a Bare Case of, with BenuurkB, by £. IL Madden, M.B. 494
Iri$ V&nioolor, Bpurioxu ....^ 608
J.
JmaEB,*B, Professor, Neural
Ajxalysifl, by Percy B. Wilde,.
M3 841
JonsasT, Dr. P., Clinical Ihroofti
of the £f&cacy of Infiniteai.
mallkaaB, by .^....^ 409
Eeb, Dr., On the Propagation:
of Homceopathy 505
Eing'B Evil, The ., 568
L.
Lancet on EomoDopathy, The 555
Lead Poisoning 421
LeaTee, Poisonous 567
Iilgaoy to the London Homoo*
pathic Hospital 505
Lnpns and its Treatment with Hydrocotyle Anatica, by E. C. Franklin, M.D SI
MagKxcbrib, J. H., M.D., Gases of Pericarditis with Eflusion, by 519
Maddbn, E. M., M.B., Case of Intestinal Obstruction, by... 494
Maddxv, E. M., M.B., Myo- carditis in Bheumatic Feyer, by 173
FAGS
Medical Acts Commission 445
Medical Ethics and HomcBO- pathy in the State of New York ^ 414
Medicine as a Civilising Agent 481
Medicine of the Future, The, by H. Blumberg, M.D., J.P. Sftl
Medicine, Two Spirits in, A Beview by John H. Cladce, M.D 164
Medicines, Notes on tiie Anta- gonistic Action of, by John H. Clarke, M.D 588
Mental Derangement, Hyotci- amtain 238
Mind and Matter, A Case of Congenital Deformity, Be- portedby Dr. Morrisson ... 288
Mineral Waters, Falsification of 486
Modern Scaentifio Therapeor tics 695
MoBBiflBON, Dr., Mind and Matter, A Case of Congeni- tal Deformity, Beported by 288
Movement Cups, The 128
Myocarditis in Bheumatio Fever, by E. M. Madden, M3., Binningham «».*.* 178
N.
Nephritis, Acute Suppurative, by Walter T. P. Wolston, M.D ^
Neural- Analysis, Professor JaBger's, by Percy B. Wilde, M.B
New Preparations
.••«•...••»••. a
642
841 807
0.
Ophthalmologieal and Otolo- gioal Society, The American 421
Opiates and Peristalsis 480
Otological and Ophthalmc^ogi- cal Society, The American... 421
Obituabt : — Cronin, Edward, MJ>.... 193, 245 Gray, John Franklin. MJX 486
- - 1, -
INDBX.
TO
P.
PAOK.
IPiKrifl, Some Kotes of a Becent Yimt to, by M. Both, M.D. 406
••PamileB" 236
^•Pathies" ^ 430
Pathology 482
Pericarditis, with 'Effusion, Gases of, by J. Hamilton
MacKeehnie, M.D 519
PeriodioBisordeiB, by L.Salzer,
M.D., Calcutta 664
Periodicity of Disease and of Dnig Action, byW. Deane
Batcher, Esq 654
Peristalsis and Opiates 480
Thofphonu in Ether, Solu- bility of, by J. M. Wybom. . . 44 Physicians, The Besolution of
the College of 128
FodaphyUin, Effects of an
Oyerdoseof 428
PolBonons LeaYos * 567
PopB, A. C, M.D.,An Address deliTered before the British HomcBopathio Society, by... 456 PopB, A. C, M.D., On the Prineii^esof Drug Selection, 9
by
Pops, a. 0., M.D., On the Study of the Effects and Mode of Action of Drugs, by 77
Pops, A. 0., M.D., Posology in Belation to Homoeopathy, by 139
Pqfb, a. C.« M.D., Bemarks on tiie Proposed Diploma of the Iiondon School of Homos- opatfay, by 274
Poflology in jEtelation to Homoe- opathy, \fj A. C. Pq>e, M J). 189
Practitianers, Unqualt&ed 432
Prise Essay 686
^BOBLL, Dr., A Case of Gastro- Litestinsl Hwmorr hage, by 40
PuBDOx, T. B., Esq., Bright^i Disease 785
Pbitfaig sway the Pattues 867
PAGE
Both, M., M.D., Some Notes
of a Becent Visit to Paris, by 406 BsTixws : —
A Letter to the Medical Acts Commission, by Di. William Bayes 121
American Medicinal Plants, by Charles F. Millspan^ M.D 619
A Treatise on Diseases of the Bye, by Henry C. Angell, MJO ^ fiOD
A Treatise on the MedioBl and Surgical Diseases of Women, by Morton Monro Eaton, M.D ^ 351
Comparative Therapeutics, By Samuel 0. Potter, M J). 558
Faulkner's Yisiting List ••• 738
Hahnemann as a Medical Philosopher; TheOr^afwrn. Being the Second Hahne- mannian Lecture, 1881, 1^ Biohard Hughes, L.B.C.P. Bdin 289
Insanity and its Treatment, by Samuel Worcester,M.D. 386
Ophthalmic Therapeutics, by G. S. Norton, M.D. ^ 290
Bheumatism,byT. Maclagan, M.D 46
SpedalPathology and Thoa- peutic Hints, Baue 190
Sopersalinity of the Blood, by J. Compton Buznett, M.D 419
The Delegates from the United States of America to the InternationflJ Homoeopathic Convention held in London, July, 1881 191
The Human Ear ' and its Diseases, by W. H. Win- slow, MJ)., Ph.D. 849
The new Handbook of Doso- metric Therapeutics, by Dr. Ad. Burggrave 420
Bepoct of fhe Medical Acts Commission 445
fioiB, M., M.D., An Address on Hyi^ene, by 105
S.
Salzsb, L., M.D., Calcutta, Periodic Disorders, by 664
SoBivEN, W. B. B., M.D., The Treatment of Splints in Horses, by 87
"VUl
INDEX.
Monthly HonMBopstlito
PA OK
Slough, ConTalesoent Home at 761
Small Pox in Chicago 55
Smith, J. Edwabds, M.D.,
Gleyeland, Ohio, Bemarks
and Suggestions Conoeming
Certain Homceopathio Tritn-
rations, by ..•■ 682
Solnbility of Photphanti in
Bthir, by J. M. Wyborn ... 44 Spain, Homoeopathy in, by
0. L. Tuckey, M.B., CM.... 826 Splints in Hones, Treatment
of, by W. B. B. Scriyen, M J). 87 Snlphnr, A Case of Poisoning,
by Bobert T. Cooper, M.D. 39
Snzgery versus Medicine 484
Stomach, Case of Obsooie
Disease of the, by 0. L.
Tnekey, M.B., CM 532
T.
Talcott, Sbldbk H., M.D., The Advantages of Homoeo- pathy in the Treatment of the Lisane, by 402
Testimonial to Dr. Harper, 505, 560
Testimonial to Lord Ebnry ... 235
Thein, The Headache of, by Bobert T. Cooper, M.D. ... 689
Therapeutics, Modem Scien- tific 695
Therapeutics, The Importance of 54
Throat Affections, Aennite in 239
Treatment of Splints in Horses, by W. B. B. Scriven, M.D 37
Tritmrations, Bemarks and Suggestions Concerning certain Homoeopathic, by J. Edwards Smith, M.D., Cleveland, Ohio 682, 721
Truth, The Search after, by W.V.Drury,M.D.,M.B.IJL 577
PAoa
Two Corrections — Degrees, PalliativeB 570
Two Spirits in Medicine, A Beview, by John H. Clarke, MJ) 164
TucxsT, C. L., M.B., Case of Obscure Disease of Stomach, by 632
TncKBT, C L., M.B., Homoeo- pathy in Spain 326
T;^hoid Fever? Can BapHsia Cut Short True, by D. Dyce Brown, M.A., M.D 203
U.
UrethritiBr Is there a Specific 696
V.
Vaccination, Protecting In-;
fluence of 857
Veterinary Science, by J. S., Humdall,EBq.,M.B.CV.S., 712
W.
Weather 245
Wilds, Pebot B., M.B., Ptof. J»ger*8 Neural Analysis, by 341
WzLDX, Dr. John, Allopathic versus Homoeopathic Theo- ries, by 226
WoLBTON, Waltbb,T. P., M.D., A Case of Suppurative Nephritis, with Bemarks, by 642
Wtbobn, J. M., Note on the Solubility of Phosphorus in Sther, by 44
2!SSiS'STS»*' A twelve-month's teachihos.
I ,-- '^N ^iEC-
J
1^ 1 r/^^gfii LI r "IT
HOMOEOPATHIC REVIEW^
A TWELVE-MONTH'S TEACHINGS.
The year 1881, with its niunerons eventfal episodes, has passed into history, and has been franght more than most of its predecessors with lessons well worthy of the carefal thought of all true-hearted, honest homoeopaths.
Great military commanders have commended to their subordinates the frequent and careful study of bygone campaigns, knowing well that it is only by a thorough insight into the fiedlings of others, that we can attain to snoeess in the future. While no man can command success, it is in the power of many to prevent failure by forethought*
Let us, then, lay on our oars for awhile, and scan the way by which we have come these past twelve months.
The most noteworthy event of the year, without doubt, has been the Intbbnational HoMoaoPATHio Cokventiok, which assembled in London in July last. We can easily conceive that the presence of so many homoeopathic prac* titioners in the metropolis, representing such a large number of brethren in all lands, must have been a rude blow to those ostriches of the profession who would fain have their little world believe with than that homoeopathy is like that extinct bird, the Dodo. All we can say is, tiiat the extinct system showed itself pretty lively at the Con- vention.
Yol. 36, No. h B
^
4 A TWSLTE-HOirrH's TEACHINGS. '%^'^S|!'?i8aL
A more BeriooB, because a more direct attack on homiBO- pathy, was an anonymous letter thereon which appeared in the Times of Good Friday last. Evidently written by a medical man, it contained certain charges against the character of homcBopaths, as such^ which, had they been written regarding a private individual by one who had had sufficient honesty to sign his name, would to a certainty have insured his appearance in a court of law at no very distant date. Several homcsopathio practitioners replied to- these letters, but a collective protest passed by the Bbhish HoM<BOPATHia SodETTy'at a special meeting, was refused admission, and the high-souled author of the original letter remains hidden under the wing of the editor of '^ the leading journal."
It is a pleasure to turn from this picture of bigotry and ignorance to take a glance at a more liberal phase of pro- fessional opinion as expressed at the meeting of the British Medical Association at Byde. What a stride has been made by this body since 1861 ! Surely some of the departed worthies must have shuddered in their graves to hear such a liberal speech as the following from the Presi* dent, Mr. Bahbow : —
" I fail to see how a homcBopath can be called a quack, or why he should be tabooed by the profession, as it were, cut off from a position amongst medical men, forbidden to gather with them, and prevented from discussing publicly his system and hearing the contrary from those practising legitimate medicine. The benefit would be mutual, and these discussions would be of benefit to the public, and an additional proof to them that their weal was uppermost in our minds."
Similar opinions were expressed by Mr. Jonathan Hutch- INSOK and Dr. Bbistow ; a sufficient rebuke, we fanoyi
BfJBWt JflB. % IflBS.
A twxlve-honth'b teaohinob.
to flie anogance and insolence so noently displayed by Dr. QuAiN and Sir WnuAU Jbnnib.
This policy of toleration seems to have ill accorded with ihe feelings of some of the members of the Association, for we find that» on September 21sty a specially convened meeting of the Lancashire and Cheshire Branch was held at Liverpool for the pnrpose of once more condemning honuBopathy and homoBopaths to perpetnal ostracism. Alas for poor homc9opathy, always either extinct, or aboub to be extingoished ! Fancy the Prime Minister's pertarbation on being informed that his policy had been severely eensnred by the vestrymen of Slocnm Podger ! ! Or to use a simile which we borrow firom an allopathic con/r^e, fancy the Archbishop of Canterbury being excommunicated by an African fetish.
The result of the meeting must have been a rude shock to the exclusives; an amendment according freedom of consultation — aye, and more than that, freedom of opinion to all practitioners, was only lost by a vote of 26 to 28, and on the previous question being moved, the fossilized reso- Intion was withdrawn, wheezing and gasping after its encounter with the unexpected shock of toleration. To its introducer we commend a little speech made by Mr. Hawabd, of St. Oeorge's Hospital. ''Intolerance,*' said he, ''has always been associated with ignorance." Dr. Lowkdes, of Liverpool, who proposed the amendment, deserves much credit for giving practical utterance to a feeling which we are sure is to be found in a large portion of the profession. The day has long gone by when trades unionism can force a man to hold any one particular set of opinions. Dr. .LowHBBS, in a letter to the BritUh Medical Joumaly very clearly enunciates this sentiment. He says, "that an association founded for scientific and social purposes degraded itself into a trades union, or a Boycotting
6 A twelve-month's TBACHINOB. ""^^^injiaBf
machine^ when it hampered and haraased its members by telling them what line of practice they were not to adopts and what kind of practitioners they were not to meet."
It is to men like this that the profession will look for leaders in the future, and not to those who by luck or favour are pitchforked into the van of the profession, with- but scant scientific claims to the position.
From the events of the year, it must be evident to a careful onlooker that a more liberal spirit of enquiry is gradually diffusing itself through the profession generally, and we have every reason to hope that at the commence- ment of next year we shall have to congratulate ourselves on still further advances on the road to recognition.
The word '' recognition" brings us by an easy transition to the London School of Hom<eopathy. This institution seems to be emerging from its trials and promises to be of signal usefulness. There have been more students during this than in any previous year, and the interest felt by the profession, even by some of the allopaths, is increasing, while it constitutes what we have long wanted, a centre at which enquiry may be made regarding homoeopathy.
The Hahnemann Lecture was delivered by Dr. Bichaei> Hughes, who took for his subject, ''Hahnemann as a Medical Philosopher,** as shown in the Organon, The Board-room of the Hospital was crowded with an attentive audience, amongst whom were some who probably had never trod on homoeopathic ground before. Dr. Hughes' lecture was. a masterly exposition and vindication of the therapeutic method of Hahnemann.
The School, as originally constituted, was intended as a five years' experiment. This term ended at the close of the past year. By some it was advised to allow the School, to lapse, on the ground that it had not proved as successful
ItSS^^T^^^ A twblvb-month's teachings.
JUificw, Jan. S, 1S8I.
$B it was hoped that it would do, bat it has been wisely decided to carry it on as. heretofore. The number of students is considerably greater than it ever has been, and we yentnre to prognosticate a steady increase in numbers as the spirit of enquiry makes itself more and more felt amongst students and practitioners. We feel sure that there are many who would willingly attend the lectures if they only knew of their existence.
The hospital, too, has been literally undergoing re-con- struction. It was found by the surveyor that one of the outer walls was in an unsafe condition. To remedy this the wall has been almost entirely rebuilt from the founda- tion, and structural improvements introduced by which two wards have been thrown into one, both on the first and second floors. By this means increased accommodation has been obtained, besides improved ventilation, and a greater facility in the nursing arrangements of the wards ; while the large amount of care and thought which is bestowed upon its management, as a letter from the treasurer in our present number fully shows, gives to it additional claims upon the support of all who are interested in propagating a knowledge of homoeopathy, and of extend- ing its advantages to the sick poor.
A testimonial has been arranged to that staunch supporter of the hospital and school. Lord Ebury. A full length portrait of the noble lord is to be presented to Lady Ebuby at an early date. This testimonial is but a feeble expression of the gratitude which we feel to Lord Ebury for his life-long service in the cause of homoeopathy. It was he who, on the only occasion when the system had a fiance of being brought before Parliament, successfully defeated the determined effort which was made to prevent the voice of truth being heard, and obtained the publication of the cholera returns presented to the Board of Health by
8 A TWBLYE-MOKTHS' TEACHINGS. ^'bSw^SZ^^wSl
the medical officera of the hospital, but whieh were by that board endeayonred to be stifled.
Whilst on the subject of testimonials^ we mnst not omit mention of the complimentary dinner which was given to Dr. Bayes at the Orosrenor GhiUery on the 27th of April, on the occasion of his leaving London for Brighton. Dr. Bayes* long professional career, and his ardnons labours on behalf of the good cause, have entitled him to the best wishes of all who know him. A handsome album, with an illuminated inscription, was presented as a token of regard from about fiffcy of his brethren. The dinner was most successful, and cannot fail to have done something towards establishing a healthy esprit de corps^ a feeling by the way in which we fear many homoeopaths are lamentably deficient.
The appointment of Mr. Ejyox Shaw as Medical Officer of Health for Hastings, proves that there is nothing but medical trades unionism to prevent homoBopaths from obtaining any post which a legally qualified medical man can fill, and we trust that others will be encouraged to try in their respective districts to secure some such position. There is no reason why in England, as in America, homoeo- paths should not, in the eye of the law, be regarded as in every way the legal equals of allopaths.
After every campaign comes the sad duty of calling the roll of the missing ; since last New Year several gaps have been made in our ranks.
The names of Dalzell, Laubie, and Leadam will be looked back upon with regret by all who came within their circle. Each was well known as an earnest worker, and although of late years through various causes, not so often heard of, yet their efforts, each in his own way, to promote the advancement of scientific medicine will prove their lasting memorial.
Xafiev, Jan. % Ifltt.
DBUa BXLECTION. 9
Not BO widely known^ yet not the less missed, were Dr. Hale Txtdoe, Mr. G. Williams and Mr. H. Bobebtson.
In condnsiony we would nrge upon all the duty of giving not only a passiye, bat an active support to our literature. It is not sufficient merely to subscribe to one of the journals, and to read and enjoy the fruits of other men's labours; far better would the result be, if each would look out for eases of interest and instruction, with a ▼iew to. their being recorded for the future benefit of homoeopathy. There is a sad lack of that element which Abounds in the earlier volumes of the Review, — clinical cases, and drug indications.
The laity, too, are quite capable of reading with enjoy- ment much which medical men are apt to think is too scientific for them, and a word from the physician would ofttimes induce an extended circulation in this direction.
We look forward to 1882 with hopeful confidence, sure that if we only use a little personal exertion, homoeopathy at its close will stand in even a better position than at the dose of 1881. Much has been done, and well done ; but more may be done without much difficulty. Public opinion must be formed, prejudice gently combated, enquiry encouraged, and in good time we shall see the full daylight of which we are even now experiencing the dawn.
ON THE PRINCIPLES OP DRUG SELECTION.*
By AiiFimD C. Pope, M.D.,
Lecturer on Materia Madioa at tMe LoDdon School of HomoBopathy, Aq.
In commencing a course of lectures on the medicinal properties of drugs, I think it may be both appropriate and convenient to devote some little time to the consideration of those principles which are calculated to guide the physician in the selection of the drug remedies he employs
* A Lecture delivered at the London Sohool of Homoaopathy, October 6th, 1681.
10 DBUO SBLBCTION. *'S!J£lSS??TSr
B«vieir, Jan. 9, IStt.
in his endeayonrs to cure or relieve disease. This appears to me to be specially desirable at the present time, in view of the yarious letters and essays bearing upon homoeopathy which haye appeared, during the last few months, in the general as well as in the medical press.
The Lancet^ for example, told its readers in an '' anno- tation " on the 11th of Jane, that it was " a matter of perfect indifference to a sick man or his friends how the physician selects his dmgs." A statement like this is too absurd to require refutation. The real secret of success in prescribing drugs consists in making a correct selection of them. Whatever views we may hold as to the modus- operandi of a drug, certain definite principles are operative when medicinal agents are chosen and prescribed.
These I propose to consider briefly to day.
The principles of drug selection will be found to be six in number — ^the analeptic, the anti-parasitic, the empirical^ the antipathic, the allopathic and the homoeopathic.
On one or other of these principles drugs are prescribed by all physicians.
A certain number of remedies are given as analeptics —
substances with supply material, the lack of which the
physician presumes is the causa morbi. For example, in
ansemia iron is known to be in diminished amount in the
blood — hence, iron is prescribed medicinally. Again, in
other states, certain salts of lime, such as phosphates, are
defective in amount, and hypo-phosphites are accordingly
introduced into the body. At the first blush this basi9 of
drug selection appears thoroughly rational in the class of
cases in which it is adopted. We know, for example, that
in rickets and mollitus ossium certain of the constituents
of bone are wanting ; these being so, what proceeding can,
apparently, be more in harmony witib common sense than
to give such salts to the patient. But when we come to
ask ourselves why these salts are not present in the bones,
why the food which is adequate to provide them in one
child is incapable of doing so in another, we are compelled
to trace their absence, not merely to a defective supply, but
to an inadequate power on the part of the patient to
assimilate or appropriate them when supplied. Hence it
is not simply a lack of the salts that we have to make good,
but it is a defective power of assimilating such salts that-
we have to cure. As Dr. Henry Madden puts it : " The
same viands may form the daily food of the healthful rosy
jfiSSfST'^^i^ DBUG SBLECnON. 11
JUmew, Jan. % 18B8.
maiden and the pale chlorotio girl, and the same breast may noarish the strong child and its pnny rachitic brother ; the pabolom supplied to both may be precisely similar, but tiie appropriating power being diYerse, the results prove widely different.''*
On the other hand, experience has shown (or perhaps I should say has appeared to show) that good results may be obtained by prescribing materials the want of which is the most palpable manifestation of the morbid state. This is explicable on the hypothesis that the best stimulus to any oi^an is the presence of the material on which it is intended to act. This being so, the dose of the medicine is not necessarily a large or physiological dose, but one just suffi- cient, and no more than sufficient, to rouse the tissues tO' increased action.
Of the possibility of acting efficiently upon the human organism by supplying material in which it is evidently wanting, we have had of late years some interesting evi- dence in papers by Dr. Tuckey, of Cork, in the Procrittoner, 1878, and by Dr. Burnett in the Monthly HonuBopathie Review for 1880. The mod/as operandi of such remedies is probably that of a specific stimulus. But after all, when we have said all that can be said in favour of remedies of this class in certain forms of disease, there still remains the objection to our rehance upon it, save perhaps in iso- lated cases, that the defect lies in an imperfect power of assimilating certain salts provided by the food, rather than in an insufficiency of the salts themselves. Hence, rational medicine would direct us to consider, in our selection of suitable drug-remedies, such as are competent to deal with the imperfect power of nutrition.
Secondly, In a limited class of cases the maxim cavsd iuUatd toUitur effecius is capable of being acted upon. The cause of disease, in such instances, is mainly, if not entirely, the presence of some form of parasite. Herein are com- monly, and so far appropriately, used substances which destroy directly the parasitic growths of ringworm, lice,^ acarus scabei and other epizoa, which obtain a habitat on the surface of the body, and worms, whose host is the intestinal canal. Of the value of these there can be no difference of opinion. They enable us to apply the maxim toUe causam, and that in a very efficient manner in many
* Britith Jowmal of Homaopathift yoL yiIL, p. 194.
12 DRUG SBLBOnOF. ^£S^?jST«S
eafles. Neverihelesfly there is here one point whidi, in the treatment of sach eases, is Tery generally overlooked, one that suggests the necessity of some additional means of core being applied in these cases. It is this — that for a parasite to thrive in a given person — a certain undefined and not easily described state of iU-health is necessary. In some natnrally healthy children, for example, a parasiticide such as carbolic acid will extinguish a ringworm in a very brief period — ^in others, the most efficient of such prepara^ tions will prove useless for months. The difference is to be found by a careful study of the indications of ill-health other than those presented by the appearance on the scalp. 80, too, in itch. Some cases cannot be cured for a consider- able length of time by the usual methods of destroying the insect. On the other hand, persons there are who may be exposed to infection in the most direct manner that is possible, and that for a long period of time, and will remain proof against it. The difference is one of health. It is a difference which the parasiticide will not meet, which purely hygienic conditions will not counteract, but one that must be remedied by medicinal agents appropriately selected. It is this state of ill-health that Hahnemann termed psora.
Thirdly. Medicines are selected empiricaUy. That is to say, in a given condition, a medicine which has in the past appeared to have assisted in promoting its cure, is prescribed whenever a similar condition of disordered health presents itself. This is a plan which finds more favour, perhaps, in the present day than is commonly admitted. '' The practice of medicine " wrote the editor of the Medical Times and Gazette some fifteen years ago ''had its origin in empiricism, and by empiricism it is nourished still. Empirical were its foundations in the days of old and empirical it is now." In a letter published in the Lancet a few weeks ago, Dr. DonMn stated that our best remedies are and ever have been empirical.
Think for one moment of the differences, the many differences, which are met with in practice in a series of 4)ases of a disease so well defined as pneumonia — differences juising from constitutional causes, modifications produced by the localiiy, degree and extent of the inflammatory processes, differences attributable to age, to the epidemic -constitution and pre-existing states of health — and who shall say that one medicine, however valuable tradition may assert that it has been found, shall be useful in all
r
cases ? Qainine is good in Bgae, True ; but not by any means in all cases of ague — ^in not a few cases it is nseless*
Dr. Bristowe, in his recently delivered address before the British Medicid Association, disputed this. He* denies that quinine produces a condition similar to ague. He denies that it is prejudicial in ague, and he denies that Ague ever yields to infinitesimal doses of quinine. That quinine does produce a febrile condition similar to ague is ibe testimony of many authors of good repufce,t — of physicians who have witnessed this property exhibited in the qvinine factories in the south of France and Germany. That quinine is answerable for many cases of enlarged ^leen is the opinion of not a few American physicians who- lutve used it extensively. That ague does yield to small doses — such doses as Dr. Bristowe and Indian physicians would regard as infinitesimal — ^has been testified to by Dr. BayeSyl from his experience in Cambridgeshire, and by numerous American physicians residing in malariouft- districts. While that some cases of ague will not yield to qmnine when they will to arsenic is a thoroughly well* known and admitted feust— just as is the reverse.
Ague, from a pathological point of view, may be one and the same disease in all instances, but for therapeutic purposes each case must be studied by itself.
Ipecacuanha is by some given empirically — given, that is, because someone has said ^t he has found it to be useful- in some cases of vomiting — but true though it is that it is a prompt and efiicient curative agent in many such cases, it is hopelessly disappointing in its action in others. To select a medicine, then, on empirical grounds, to pre- scribe traditionally, to see a case of disease which is well marked, and label it with the name of some medicine, is,. at the best, a very uncertain method of selecting a remedy. To being a scientific method it has, and, indeed, makes no- pretension. Empiricism has, and empirical remedies have, however, their uses — ^but then their uses are educational rather than anything else. It is by a carefid examination of the results and teadiings of empiricism that we may hope to learn something better — that we may reasonably look
for hints from which we may derive a knowledge of how to
I 11 I I ■ I I ■ - I 111 ■ ^i^-^^»^
• BritUh Medical JowmaX^ August 13th, 1881. t Dr. Weitenweber, (EsterreiehUehe Wocheruehrift^ March, 1844; Br. O^liB, Med. Zeit. Bu8$€, 1861; Dr. GhevaUer, Arm. dPHyg., July, 1881. t AnmOe of th» BrUUh H<nttaqpaihic Society. Vol. L, p. 469,
14 BBUO SELEGTION. ^^^t^H^STVlS^
BtfvinFf Jm. St loBL
-select medicines on a more tmstiwoiihy, a more precise, and more accurate basis than that of tradition.
But of this I shall speak more at length presently, and I will now proceed to consider the fourth basis of drug selection, Tiz. : —
The antipathic method. — On this principle medicines are fielected on the gronnd that they will produce symptoms directly opposite to those which reflect the morbid condition to be cured. The chief classifications of drugs have their origin in the general application of this principle. Thus we find the larger proportion of medicines divided by authors of works on Materia Medica into purgatives, diu- retics, sedatives, diaphoretics, expectorants, stimulants, •emmenagogues, and tonics. Where, for example, constipa- tion is a prominent, troublesome, or may be anxious symptom, a drug such as sulphate of magnesia or croton oil is ordered, to produce an evacuation of the contents of the bowel. Is a patient sleepless ? opiums or its chief alkaloid, morphia, is given ; is the skin abnormally dry, as in febrile states ? James's powder is prescribed.
The objections which may be raised to this plan of selecting a medicine are various.
In the first place, it necessitates the prescribing of a dose which approaches the pdsonous, and being so, introduces a new element into the morbid state. The purgation, for example, irritates the mucous membrane of the intestine, and exhausts the tone of its muscular fibre. The bowel is unloaded, truly — ^but, save in persons otherwise healthy, the reaction of exhaustion necessarily tends to confirm the tendency to the constipation, and to require the repetition of the medicine. How often do we meet with persons who, having at one time suffered from inactivity of the bowel, have sought relief in the aperient with the result of being obliged to continue its more or less frequent use during the remainder of life ! The sleep, too, which opium gives to the otherwise sleepless, is grateful only because obUvion is preferable to wakefol tossing to and fro. It is not the sleep which is restorative, but narcotic, a condition of stupor, of cerebral congestion for the time being — a partial poisoning, in point of fact.
Hence the antipathic remedy is a palliative merely — ^it is not directly curative, not specific. Again, the antipathic principle is capable of being employed to meet only in- dividual symptoms— not the entire condition constituting
ifiSS'ST'SS^ l>EUa SELECTION. 15
B«fiew, Jan. 2, 1888.
disease, not one which is expressed by the whole of thcL symptoms present in any given case. Constipation is but A symptom, sleeplessness is bat a symptom. This ^LifiBcolty is supposed to be overcome by what Dr. Fother^ll calls ''building ap a prescription'' — a process which he illustrates very fully in his Practitioner's Hand- took of Treatment (pp. 15-18.) Thus he supposes a case of anaemia with constipation. For the former he gives iron, for the latter sulphate of magnesia; to this he adds some Uneture of eapsieum, to induce the stomach to tolerate the two former ingredients. Possibly, however, he suggests, the patient may be one who is too easily purged, and, being .ansdmic, may be supposed to require a tonic,, so that the sulphate of magnesia is omitted, and quinine with hydrochloric (icid substituted for it, while the bowels are looked after by a pill of aioes and myrrh at bed-time. Perhaps the patient may also have piles, then gaU cintment is applied. Maybe she has leucorrhcea in jKldition, and then an injection of stUphaie of alum must be used. It is not unlikely, he suggests, that such a patient may have some palpitation at ti^e same time, and then belladonna plaster is to be applied. Are the pUes painful .and preventive of sleep, then add a quarter-of«a-graia of morphia to the gall ointment.
Dr. Fothergill describes this as a *' fairly exhaustive treatment," and such it undoubtedly is, possibly, however, it may be so in more senses than one. At any rate it is pure symptom treatment, and therefore not scientific. It 4Sonsists in the introduction into the body in tolerably full doses of no less than ten drugs, not counting the infusion •of quassia which is the vehide, in the course of the day ! •Of ten substances which have a more or less irritating action upon some portion or other of the body.
But yet again, we may know what is the action of any <me of these substances per se, but how can we predicate what, this wUl be of all mixed up together, or of all intro- duced into the body in the course of the same day ?
It is supposed that each drug will perform the part the. prescriber luus . designed for it, provided that he has been •careful to avoid introducing into his prescription substances i^hich are known to be incompatible. But who shall say a priori what drugs are, and what are not incompatibles ? Some are known to be so, but have all their combinations been tested, have all been experimented with ? Verily no —
16 DBUG SELECTION. ^"S^l^rTSJ!
and yet, wiihoat experiment, positiye knowledge is impos- sible— ^without experiment notibing remains bnt hypothesis*
Once more, is this method of symptom prescribing, fascinating and ** exhanstive " as it may appear — ^is this piling of palliative upon paUiative satisfiEtctory in its results? Does it tend to promote the cure of disease ? It has been the basis of drug therapeutics for long enough to enable us to reply to these questions without any resort to statistics. We may estimate its value by the effect its results have had upon the minds of physicians who have carefuUy reflected upon their experience in therapeutics. From Sir John Forbes five and thirty years ago down to Dr. Andrew Clark* in our day its effect has been to discredit the action of medicinal agents as being directly curative of disease. Eighty years ago Hahnemann denounced it together with the then common practice of venesection and mercurialisa- tion, which happily require no denunciation now, in terms scarcely stronger than those used by Forbes, Mathews, Duncant and Andrew Clark. It has been by reliance upon palliatives that the art of prescribing drugs has become so discredited by physicians of large and ripe experience in these latter days. It is irom this cause that it has come to be believed that not only the specific fevers, but more or less all acute diseases have a definite course to run, a course which can neither be checked or abbreviated by the physician.
It is from this cause that chronic disease is looked upon as a state which we can scarcely expect to cure, one the sufferings from which can only be relieved from time to time.
Nevertheless, merely palliative treatment cannot be wholly ignored. There are cases of severely painful and entirely incurable disease where relief can only be obtained by palliatives of this kind — cases where suffering depends upon mechanical obstructions which are irremediable. Here the opiate or the aperient find their uses* It is not for the cure of disease that the antipathioally selected drug is useful, but to obtain a diminution of suffering, the cause of which is irremovable.
A Jifth principle of drug selection directs the pre^ seription of a medicine calcidated to excite irritation in tf part of the body presumably or, at any rate, comparatively
* BriHih Medical Journal, Angost 9ih, 1879.
t Edinburgh Monthly Journal of Medical Science, 1877.
tS^^%vSb^ mug selection. 17
healthy, on the hypothesis that the existmg morbid con- dition will be redueed by exciting determinatioD of blood elsewhere — '^deriving/' as it is termed, the blood from a part where it is doing obvioos mischief towards one where its excess will be less hnrtfol. This is the aUopathie prindpley and is seen in action when an active pnrgative is given in cerebral congestion — ^when in pelvic congestion tile feet are soaked in hot water or mnstaid and water.
Formerly this principle of drug selection was largely used by the physician. At the present day it is regarded with little favonr, and is comparatively rarely resorted to, and, save in snch methods as hot applications to the ex- tremities, it is one that is of littie or no value. Purging for cerebral congestion, for example, irritates the bowels, complicates existing disease, and exhausts the strength of a patient when on tiie conservation of that his chances of recovery are so generally contingent, and it does so without any adequate advantage being gained. Though so seldom
2 plied in practice, it is not a littie singular that it is by is term that the basis of therapeutics generally employed is known ! I apprehend that tiiis arises from the much greater frequency with which it was relied upon in the earlier part of the present century than it is now.
The gixtii and last principle upon which drugs can be selected, is the hornoeopatMc — that which directs us to prescribe medicines capable of producing symptoms similar to those which characterise or egress tiie morbid state we desire to remedy.
It is not, mark you, the prescribing a medicine which produces one symptom like one more or less prominent in a disease we desire to cure, but the entire group present in a given case, what Hahnemann called ''the totality." Hence, if constipaticm is especially remarked on by the patient, it is not a matter of indifference what drug capable of producing constipation in a healthy person is prescribed, (mly that one can be regarded as homoaopathically indicated which gives rise not o^y to the constipation but also to the other symptoms arising from the condition which has excited the inactivity of the bowel«
In estimating the value of this principle of drug selection, we have first to consider its po$mbility. Is it, we ask our- selves, possible that a substance which, in a larger dose, wiU excite a certain state of ill-health, will core a similar condition when arising from other causes.
YoL 26, No. 1. 0
18 DBUa SELECTION. ^"SS^^fl^^^^
Beview,Jaji. 2,1883.
I referred jast now to empiricism as having an educa- tional value — as affording us material out of which we Bright frame a more or less exact method of drug selection. A little research will Bhow you that in very many instances in the past history of medicine a drug which had obtained a reputation — ^not as a purgative, sudorific, or emetic, but as having a curative power over a given form of disease, was also known to have caused a similar condition in healthy persons. Indeed one of Hahnemann's earliest essays, setting forth the therapeutic value of the principle similia similibtLs curantur, was entitled The Aledicine of Experience* This was published in Hufeland's Joumsd in 1805. While in an essay published in 1796, entitled Suggestions for Ascertaining the Curative Powers of Drugs^ and, fourteen years later, in the introduction to the Organon der HeUkunst, Hahnemann gives a very considerable collec- tion of illustrations of drugs curing diseases similar to the conditions they themselves will produce derived from the literature of medicine. Again, to come to more recent times, the works of all authors on Materia Medica of the present day are full of the applications of drugs derived from the works of homcBopathic physicians — of applications which were discovered through this principle of similars. Furtheir, in somewhat older authors, you will find that the only instances in which drugs are described as competent to cure certain conditions are examples of conditions like those they are stated to produce. In Christison's Dis- pensatory, published in 1846, you will find many such.
Thus arsenic is referred to as causing and curing epilepsy ; colehieum as producing suppression of urine and acting therapeutically as a diuretic ; creosote as producing nausea and vomiting, and on the other hand as allaying vomiting from frmctional disturbance of the stomach ; digitalis is said to produce suppression of urine and also to act as a diuretic ; turpentine is described as frequently giving rise to violent strangury, bloody urine, and other symptoms of irritation of the kidneys or bladder, and on the next page is said to be especially useful in chronic inflammation of the bladder. Now, I feel sure that Piofessor Ghristison did not perceive that connection between these fiiets which appeared so clear to the mind of
* Tk€ Leu€r WHting$ ftf Sammel Hakmmum. ts^iuJmI^ I7 B. S. Dudgeon, If J). Headland.
IS^SrS"?!^' DBUO SELBCTION. 19
fieriev, Jan. S, 1888.
Hahnemann. That it is equally obscure to more modem writers is more than I should like to vouch for.
Then, Bgam^ my colleague. Dr. Dyce Brown, in an appendix to an essay, entitled Homosopathy : Its Nature and Relative Valuer published in 1869, gives a similar collection, culled from the works of Trousseau and Pidoux, Pereira, Wood, Waring, Christison, Taylor, aud Graves. Dr. Brown's illustrations are derived from forty drugs; Hahnemann's from forty-three. Dr. Brown refers to thirteen of the latter, so that we have in all seventy substances, which have been noticed as having cured 4>onditions more or less similar to such as they have been observed to produce.
Surely if the observation of natural phenomena can be utilised by comparison and analysis for the formulation of an expression of mutual relation, those recorded of seventy drugs may be safely employed to ascertain that which subsists between the disease-exciting and disease-curing powers of a drug in general. Throughout the entire series of observations there runs one fact common to all — one phenomenon characteristic of all, viz., that the drug, which had been observed to cure a given disease, had, in every instance, been observed to produce a similar morbid con- ilition in a healthy person.
To Hahnemann's observations herein referred to Dr. Bristowe, in the address alluded to, makes exceptions. He says ** that while a large number of them are merely loose And untrustworthy statements of supposed flEtcts, nearly all of them prove notiiing whatever, to any unbiassed mind, in reference to those homoeopathic principles which they are assumed to support."
In the first place, all of Hahnemann's illustrations are far from being of equal value. The very one — that of the sweating sickness cured by tydorifiea — selected as the example by Dr. Bristowe, is one as Little exact, of as little value, save as being suggestive, as any. It is, as Dr. Hayle, of Bochdale, had stated at the International Homoeopathic Convention a few days before Dr. Bristowe delivered his address — ^it is one of the '' rough and ready ^lass/'* To reply adequately to Dr. Bristowe's general criticism, one would need to go through each of Hahne- mann's illustrations. This is, of course, impossible here,
* TraniOcHonM of the IntemaHonal HomotopatJUe CongresSt 1881.— P. 5, pftrtiv. London: Adlard.
0 — 2
20 BBUO BSLBCnOH. ^'^SSL
.J«m.4»
ftnd I must content m jself with saying thst a lepernsal of these illnstrations does not seem to me to justify in any way the description Dr. Bristowe has giyen of them. Those collected by Dr. Brown and by Dr. Drommond, of Manchester,* are, however, mnch more exact, maoh more eondnsiYe. JPnrther, in some instances, they cany ns into Dr. Bristowe's Cayonrite place of study, the po$t^mortem room, and show how similar, for example, are the po$t» mortem appearances of arsenical poisoning, and gastritis, and cholera ; how mnch alike are the appearances in the Inngs presented after death from tartar emetic and those which result from congestion of those organs. These, at any rate, are not ** merely euperficud rdation$hip8y easily obserred, between the effects of certain mori>id conditions and the efiiBcts of certain drugs." t
I do not, however, wish to attach any higher degree of importance to observations of this class than they deserve ; but, I do contend that they prove the poseibiUiy of the principle of similars being a trustworthy principle of drug selection.
In the methods of drug selection I briefly reviewed a few minutes ago, the empirical and the antipathic were those which alone appeared to be capable of general appli* cation. The latter I showed to you was palliative of certain symptoms, of pronounced features of disease, rather than of morbid conditions in their entirety, or, when disease as a whole was encountered by drugs so selected, the process of doing so involved the prescription of a number <a different drugs taken simultaneously, and for the most part in mixture, of the combined action of which it was impossible to foresee the result. Further, it was necessary tiiat the dose should be large, that in point of fact it should approxi- mate the poisonous with as much regard to safety as was compatible with its producing the effect desired.
Now in putting into practice the homoeopathic method of drug selection, it is not an individual symptom, however important it may be, that is regsided, but the morbid con- dition as reflected in the whole series of symptoms.
Homodopathy has been most erroneously described as mere symptom treatment. It is indeed the antipathic method which alone is exposed to such criticism. It is true that the homoeopathic physician is guided by the
* Honutopathy among the Allopaths. Tomer A Co., ManohftHter. t BrUtowe, op. Ht.
bSSS'jETmS* ^>»^<» MLBCrnON. 21
symptoms in seleeting his drag-remedy, jast as he is so directed in making his diagnosis or forming a prognosis-— bat in so doing he is in the sorest possible manner treating, thai iSy applying his remedy to the condition — ^to the morbid state expressed by or reflected in the symptoms, objectiye and sabjective.
Certain forms of disease are well defined in their mani- festations or at any rate in those of a more obyions kind. Meeting with one of these we feel assored from oar knowledge of the action of drags, and from that we have of the diseased process we desire to check, that the most appropriate medicine will be foand among a comparatively small groap of drags. Take, for example, pneamonia. Phosphorus, bryoma and tartar emetic aU excite inflam- mation of the air cells of the Ixmgs. Oar inyestigation of oar patient's case has told as that he has pneamonia, and we tiierefore feel assared that one of these three remedies will be asefal in promoting its resolution. Bat which are we to give? All are more or less homoeopathic, each prodaces in the healthy sabject a morbid condition like that to be cared — ^the qaestion we have to sohe is, which of the three prodaces a morbid condition most like that indiyidaal specimen before as. This is determined, can only be determined by a carefol comparison, not merely of the coarser, the more obvioas, the pathognomonic symptoms of the disease with those of the drug, for each drag has probably prodaced all of these, bat by a carefal comparison of the finer, the less marked, bat yet, for all that, the most •characteristic symptoms of the indiyidaal case, with sach as the drag has been foand to give rise to.
Thas, in well-defined disease, the pathological process of which is well and clearly anderstood, it is perfectly possible to niime a series of medicines, one of whi^ wiU bi found to be the remedy, while the nltimate appeal in ascertaining which mast be directed to the indicationes morbi — ^the symptoms alone.
Bat all diseases are not well defined ; some are obscare, many are complex. In sach the difficulty of finding the exact remedy is often considerable, while generalising from pathological data is in sach too freqaently hardly available. Still, in most instances, disease has its centre in some one organ or another, while each drag has a special affinity for some one or more organs in preference to others. Here a groap of medicines, more or less considerable in namber,
22 DBIXG 8SLECTIOR. iSeS^Jm^^xtS
will attract attention, and from this group that which is hest adapted to core wiU be foond in the same manner, Tiz., by a eaiefdl comparison of all the symptomsof disease presented by the patient with those the drog has prodnced in a healthy person.
By selecting onr medicine on the principle of similars, it is clear then that we obtain one which has a direct in- fluence over the very tissues which form the seat of disease, and not only so, but an influence so similar that it is expressed in a manner more or less exactly like that which constitutes the disorder.
Thus the homoeopathic method of drug selection has the great adTantage of pointing us to a medicine whose action is direct or specific — ^not to one that is merely palliatiTe.
Further, in prescribing a medicine, selected on the ground that it has a direct influence over the part diseased, it is obviously nccessaiy that the dose given should be com- paratively small. Thus, Professor Jorg of Leipsic, in discussing the relation of disease and its remedy, s<iys :
'' On the other hand, medicines operate most powerfully upon the sick when the symptoms correspond wiUi those of the disease. A very small quantity of medicinal camica will produce a violent effect upon persons who have an irritable state of the oesophagus and stomach. Mercurial prepara- tions have, in very small doses, given rise to pains and loose stools, when administered in inflammatory states of the intestines . . . yet why," he exclaims, '^ why should I occupy time by adducing more examples of a similar operation of medicines, since it is the very nature of the thing that a medicine must produce a much greater effiect when it is applied to a body already sufiiering under an aflection similar to that which the medicine itself is capa- ble of producing ? "*
It is, then, not only unnecessary, but impossible to pre- scribe medicines selected on the homoeopathic principle in a dose which approaches the poisonous — the very object of prescribing at all would be defeated by so doing.
I am not going at present into an argument in support of infinitesimal doses, but I refer here to the necessity of the small dose simply as one of the advantages derived from
* Contributions to a Future Materia Medica from Experiments witJi Medicinea on Persom in Health. Obtained and ooUeoted by Dr. John 0^ G. Jorg, LeipBio, 1825.— P. 16.
^S^^TS'^S^ DBUO SELECTION. 28
Beffiew, Jaa. i» ISBSt.
the application of the homodopathic principle of drug selec- tion in the treatment of disease.
We have seen, then, that homoopathy enables ns to treat disease with directness and accuracy, we know that onr remedy acts npon the part that is diseased, and we have also seen that it enables ns, nay compels us to pre- scribe oar medicines in doses that cannot be injurious.
Another adyantage possessed by the homoeopathic prin- ciple of drug-selection is, that by it we are enabled to predicate the remedy in any new form of disease that may appear. Thus in 1829 cholera was entirely new to the European physician, and Hahnemann, without having ever seen a case, and simply from a written description of the phenomena cholera presented, was able to indicate the medicines that would be of greatest service.* He then pointed to camiphor, to copper, and to white hellebore as the chief medicines in such cases — and these have ever since proved themselves to be especially worthy of reliance in this formidable disease.
Again, some thirty years ago, an epidemic of purulent meningitis broke out among the soldiers in the barracks at Avignon. The mortality was considerable, the resources of medicine powerless in the contest. Two physicians, practising homoeopathy in the town, prepared themselves to meet it, should it appear among the civil population, by a careful study of the symptoms of the disease with those produced by drugs. They came to the conclusion that hyosq^amus and ipecacuanlia were those, the action of which presented the closest analogy to that of the epidemic. Presently three cases occurred in the practice of one of them (Dr. Denis), and all three recovered. Subsequently more than 150 cases were treated successfully by them with these two drugs. By and by the medical officer of the regiment which had been so seriously attacked, discovered and announced as the result of his own researches that ipeccLcwanha was capable of controlling the scourge by which he was surrounded. From the moment, he said, that he began to prescribe ipecacuanha, the mortality among his patients diminished in the most extraordinary manner, f
No stronger evidence of the value of a principle of drug selection could be given than that it will enable a physician
* Leuer Writingif p. 841.
f De la Mtningite purvlente Epidimique qui a Regne h Avignon dant^ VEiver 1846-7. Par le Dr. J. J. B^chet. Paris : BaiUidre, 1852.
24 DBUG SEIfCnON.
1,188^
to predict what medioine will be luefiil in rafieving a diBesLBe previoosly unknown.
This power tbuB principle of sinulan does confer, as the illnstrationB I hsTO recited pro^e.
Bnty after all, gentlemen, the great advantage of homoso- pathy — of being guided in prescribing by the homcdopathio law of drag selection is seen in, is i^oided by the cUnical test Unless it can be shown that prescribing on this basis is more snecessfiil in abbreviating illness, in con- tending with chronic disease, and in diminishing mortality, any other advantage it may apparently present is dearly purchased. As Dr. Bordon Sanderson has somewhere said, '' In jndging of the value of a therapentical method, the one and only criterion is success." The great end of our lives, as physicians, is the cure and prevention of disease. It is a good thing and a useful to be an accom- plished physiologist; equally so is it to be a profound pathologist, to have an intimate knowledge of all the phases of disease ; but it is far better, for more useful that we should be good therapeutists; that our knowledge should bear good fruit at the bedside of the sick. What- ever tends to cure disease, cUo, tuto et jucunde, it should ever be the aim of the physician to know.
The homoeopathic method of drug selection has now been put into practice carefully and carelessly, with medi- cines prescribed in doses of a very wide range, in every part of the world, in every form of disease, and in every class of society, for more than eighty years ; and homoeo- pathy has a greater, a more numerous body of adherents to-day than at any former period of its history. Had the success attending its practice not been greater than that of rival, and far more influentially supported methods, this would not have been its position now. But further, the records of eighty years provide us with an abundance of material for making a survey of the relative success of homoeopathy, and the ordinary therapeutics of the schools; an abundance so great as by the very magnitude of the numbers to preclude erroneous inferences being drawn from them. Touching lightly upon this method of demon- strating the value of homoeopathy. Dr. Bristowe asks, '* What evidence is there that any internal inflammation, any internal growth, any specific fever, has ever been cured or ameliorated by homoeopathic remedies?" And then adds, ^* Of course, affirmative assertions will be made ; of
iKSS^STSS** mug selection. 25
course, statistical evidenee will be forthcoming. But mere assertions, and statistics which are merely tabulated asser- tions, are not evidence which a man possessing scientific cantion would accept in snch a case."
Now, I can scarcely suppose that even Dr: Bristowe would summarily reject aU statistical eyidence bearing upon therapeutics. I admit willingly, and at once, that there is no kmd of evidence which requires to be received with greater caution than does statistical. Further, there is no form of statistical evidence which demands more carefnl exiMnination than such as relates to therapeutics. Allowing aU this, I at the same time assert that statistics may be usefully applied in ascertaining therapeutic truth. Given observers competent for their task, and honest in its per- formance— cases in large numbers occurring at the same time, in the same locality, drawn from persons in a similar social position, the treatment of whose disease or diseases differed in nothing save in the medicines prescribed, and you have conditions from which you may derive statistics having a value in the determination of tiierapeutic questions.
And here let me refer for a minute to the question of Dr. Bristowe suggesting that there is no evidence that any *^ internal inflammation has been cured or ameliorated by homoeopathic remedies.'' Time prevents my entering upon this point with anything like the fulness which the material at my disposal would allow. But I must, in reply, refer to a singularly able paper by the late Professor Henderson, of Edinburgh, in the British Journal of Homoeopathy for 1862, entitled Pneumonia under HomoeO' pathic, Allopathic, and Dietetic Treatment. Herein, Pro- fessor Henderson, with ail the caution the most scrupulous critic could desire, and with that fulness of pathological learning for which he was so justiy distinguished, examines a series of carefully observed cases of pneumonia occurring in his own practice and in that of M. Tessier, of Paris, and compares them with a large series, the results of which were published by M. I>ietl of Vienna. The entire cases on both sides were unselected. So far as Dr. Henderson and M. Tessier were concerned, they were aU that had occurred to them during the time they had practised homoBopathy. M. Dietl's were also complete series.
Henderson's and Tessier's cases were 50 in number, of these 8, or 6 per cent, died, and the duration of illness, reckoning until complete restoration had occurred was
26 DRUa SELECTION. ''SSL^^^T^
Beriew, Jan. 2, 1868.
11 2-8rd days. M. Dieti treated 85 eases by venesection, of these 17, or 20.4 per cent, died, the average duration of illness in the recovered cases being 35 days.. He treated 106 cases by tartar emetic, the mortsJity was 20.7 per cent., and the doration of illness 28.9 days. He left to natore — ^gave no medicine and drew no blood — 129 cases, of these 14, or 7.4 per cent, died, the duration of illness being an average of 28 days for each case.
Now here, in an acute internal inflammation, while homoe- opathic treatment is infinitely more successful in saving life than the old-fashioned method of blood-letting and heavily dosing with tartar emetic, and while it is but slightly, only 1.4 per cent., better in this regard than pure expectancy, the average duration of the disease under homoeopathic treatment is seventeen days less, a result which, as Professor Hender- son states, '' places beyond all rational doubt the claim of homoeopathy to a very high degree of active curative power in pneumonia." I can do no more here than commend thi? very able paper of Dr. Henderson's to the careful study of every sceptic as to the power of homoeopathy over an acute internal inflammation.
A few statistics of the kind I just now referred to I will proceed to notice. First of all let me direct your attention to the results obtained by the late M. Tessier, at THopital Beaujon,* in Paris. (M. Tessier has been dead so many years that I may be excused for remarking that he was a physician whose high capacity and sense of honour no one ever called in question.) Here he investigated homoeo- pathic treatment clinically — ^the only way in which it can be inquired into with any degree of satisfaction.
In the year 1849-50-51, there were admitted into the two wards under his care 4,663 cases. The number of deaths during this time was 893, or 8.55 per cent., or 85 per 1,000. In the same hospital and during the sam^ period of time there were in the other wards 8,724 admissions, with a mortality of 411, or 11.08 per cent., or 110 per 1000.
M. Tessier had 100 beds under his charge, his allo- pathic colleagues 99. With only one additional bed he was able to receive during the three years 989 more cases than they were. There could be no reason for this other than the greater rapidity with which M. Tessier was able to fit his patients for leaving the hospital. Again, any
*Dela MMcatian, dtc. : Ballidre, Paris, 1852.
^A^j^HISf^ DBUa BBLEOTION. 27
Benew, Jan. S, 1882.
selection of oases was impossible. In this, as in all the public hospitals of Paris, the admissions were entirely independent of the physicians, save in a very small number of cases. The patients were sent in regular rotation to such wards as had vacant beds, and this by the officials, not by the physicians.
In this instance we have a large number of cases, occur- ring during the same period of time, in the same hospital, under sinular circumstances, the only difference in the condition bearing upon recovery from illness is, that one set is treated with medicines selected on the homoeopathic principle and given in small doses, while the other received medicines either of the palliative or expectant class, and this, it is to be presumed, in considerable doses. The practical result to the patients was, that the mortality among the former was 2*48 less than it was among the latter, and the duration of illness was so much shorter among the former that, during three years, each bed under M. Tessier's care received 46 patients, while those under the direction of his colleagues could only receive 87.
Another and very interesting illustration of the results of homoBopathic treatment occurred some years ago in another part of France. At Boubaix, M. Liagre was the physician to the general hospital of the town.* From 1856- to 1862 the patients under his care were treated in the manner ordinarily taught in the schools, viz., as a rule, by large doses of antipathically selected drugs. The mortality was during this period at the rate of 19'26. In 1868 M. Liagre changed his therapeutics, and now selected his remedies on the homoeopathic principle ; during this year the hospital mortality fell to 18'70, while during the following year it was reduced to 12*97. In his report to the administrators of the hospital, M. Liagre noticed that the greater rapidity with which his patients recovered after he adopted homoeopathy enabled him to admit a much larger number of patients into his 40 beds than he had previously been able to do. In 1862 he had only 848 admissions ; in 1868, 416 ; and in 1864, 479. It must also be observed that his beds were always full during each year. So that, as he himself remarks, '' in 1868, 68 patients, and in 1864, 130 patients could be received into
* Official Beport of the BeealtB obtained by the Homoeopathic Treatment at the Hoflpital of Boubaix (Nord.). Bull, de la Soe, M4d. Rom, de France^ October, 1865.
28 PBUQ jgBLEOTioH. '^BSSSrSSTat!
the hospital in consequence of homoeopathic treatment, who wonld ha^e been excluded for want of room had the old system been continued."
Here, then, you will see is a long series of cases treated by the same physician in the same hospital, in which by a change in the method of drug selection, and by this only, a saying of life to the extent of seven per cent, was effected, while the rate at which the sick recovered was so greatly increased in rapidity, that he was able to receive into the same number of beds more than one third more cases of disease than he had been able to do before he altered his manner of choosing drugs.
Take now a somewhat different class of observations and compare the results of the different methods of drug selection in two similar public institutions. The subjects of the experiment are derived from the same class of the population, and frt>m the same city, and occurred during the same period of time.*
In the city of New York there were during the twelve years ending in 1854 five Orphan Asylums. In four the medical treatment was non-homoeopathic, and during these twelve years the average number of orphans received into each asylum was 8568*5— the mortality in these was at the rate of 1 in 41 or 2.10 per cent. In the Protestant Half- Orphan Asylum, where the treatment was homoeopathic, the number received in the twelve years ending with 1854 was 8,075, the mortality 1 in 146 or .68 per cent. Showing the rates of mortality under the different modes of drug selection to be more than 8 to 1.
In another class of cases the evidence is unquestionably less exact, and therefore more open to criticism ; but the numbers dealt with are so considerable, the authorities to whom we are indebted for them are so thoroughly reliable, and they afford such striking evidence of the therapeutic value of the homoeopathic law of drug selection, that I must not omit them from our consideration. I refer to the results which have followed homoeopathic treatment in cholera and yellow fever.
The practice of homoeopathy was, some fifty years ago, forbidden in Austria, but the imperial edict failing to suppress it, a commission of twelve physicians was
* From the Beport of the Minority of a Coxnmittee ftppointed to enqttize into the propriety of introdnoing Homoeopathy into BelleTue Hospital, Kew York. North American Journal of Homaopatky, May, 1858.
2SS^Sr?S^ MUa SELECTION. 29
appointed to enquire into it at the Josephinam Military Hospital. AH the members of this court of enquiry were strenaooflly opposed to' homceopathy. Dr. Marenzeller^ a Teteran homoBopathist and contemporary of Hahnemann's, was appointed the physician, and two members of the commission attended with him daily, reporting the pro- gress of the cases at the expiration of every ten days. The only part of the report published was that by Dr. Jaeger and Dr. Zang. It contained a very brief outline of Uie eases and their treatment, and expressed the surprise of these eminent physicians at the happy issue of some of them. The commission, however, as a body, came to the oonoluaion that, from the results of their investigation, it was impossible to declare either for or against homoeo- pathy. One of them, however, subsequently stated his conviction of the efficacy of the system from these trials, and subsequently became an open adherent of the system.
When cholera prevailed in Vienna in 1836, the Leo- poldstadt hospital, under the care of Dr. Fleischmann, was ordered to be fitted up for the reception of cholera patients. On comparing the report of the results obtained in this hospital with those of otiier hospitals in Vienna, it was found that whereas in the former, two thirds recovered, in the latter, two thirds died. These results led to the repeal of the edict prohibiting the practice of homcdopathy in the empire. These facts I give on the authority of the late Sir Wm. Wilde, the eminent ophthalmic surgeon, who records them in his book entitled Austria and its Insti' iutions, published about 80 years ago. There must have been an irresistible degree of reality in these results of Dr. Ileischmann to have elicited so signal an expression of opinion from so autocratic a government as that of Austria.
So, too, in Edinburgh in 1848-49, out of 236 cases of well marked cholera, attended by the physician of the homodo- pathio dispensary, 67 or 24.6 died, while of 876 cases, occurring at the same time, treated in the ordinary way, 646 or 62 per cent, died.* In Liverpool in 1849, out of 179 eases, 45 or 25.7 per cent, died; the cholera mortality throughout the town, being stated by the medical officer of health, to have been 46 per cent.t At the London Homceo*^ pathic Hospital in 1864, 88 cases — ^28 being in a state of eoUi^Mie — ^were admitted, 7 died, one discontinued the
^ Ruuell on Cholera. Londoii: HMuUftnd. t BrUUk JmHmal of BomoNgMlAy, 1860.
•80 DRUG SELECTION. "S^^ST^lSi"
Beyiev, Jan. 2, 1882.
treatment, leaying the mortality at 21 per cent. These cases, though too few in number ^o be of much value, if taken alone, have an additional importance attaching them from their having been watched by a Medical Inspector of the Board of Health, the late Dr. Macloughlin, who, in a report he made upon his visits, said that all the cases were true cholera in various stages of the disease, and that he saw several which did well, that he had no hesitation in say- ing would have died under any other treatment.
Similar results have been obtained in other towns in England and in the Barbadoes.
In the chief cities of the Southern States of America the success of homoeopathy in various epidemics of yellow fever during the last thirty years has been simply remarkable — the mortality in a large series of cases being generally about 6 or 7, and never exceeding 10 per cent.
Those on whose authority these results are given are physicians of large experience in several epidemics, physi- cians living in localities where they have occurred — men whose honour and veracity are as indisputable as are those of any physicians in the world.
Dr. Bristowe, I just now remarked, has stated that the statistics which would be adduced to rebut his estimate of the practical worthlessness of homoeopathy were such as no cautious scientific observer could accept. The scientific observer is not, however, the only cautious student of statistics or of statistics bearing upon the chances of life. The commercial man is a singularly cautious student of such statistics, and perhaps no commercial man is more cautious in drawing inferences having a money value than is the New Yorker. In New York we find a Life Assurance company doing a good and profitable business, the chief feature of which is that persons who, when ill, pledge them- selves to be treated homoeopathically are assured at 10 per cent, lower rates than are those who will not do so. During the first ten years of its existence 8,882 policies were issued to homoeopathists, of which 112, or 1 in 74, terminated by death ; and 2,860 were non-homoeopathic — of these 75, or 1 in 81, terminated by death. ' In all American insurance offices the books and securities are liable to examination at any moment, and if found unsafe the office is compulsorily closed. Repeated examinations of this kind have resulted in showing that the New York Homoeopathic Mutual Insurance Company
^^j^sra^ i-^^s. 31
is doing a good and safe business. Statistics which are reliable enough for a New York merchant, after thirteen years' experience of placing confidence in them, may surely be regarded as worthy the attention of a scientific observer.
These statistics of the results of homoeopathic drug selection in the treatment of formidable disease might be Teiy widely extended, but I think I have adduced sufficient to assure you that comparative success in the treatment of -disease warrants us in relying upon homoBopathy in 4shoosing our drug remedies.
Further, these statistics appear to me to do far more ihan this. They are so striking, so incontestable, that they ought to make it a matter of duty with every medical man, to test for himself the plan of drug selection to which the results they record are due. Sir William Gull said the other day, in opening the section of Practical Medicine at the International Medical Congress, that while we call ourselves physicians, and should be jealous of the title, we must remember that we are medici, or curers of disease. Yes, to cure disease is the mission of us all, and he best fulfils that mission who most thoroughly investigates all methods of relieving suffering which are presented to him, with well-sustained evidence of their value.
The thorough clinical study of the homoeopathic method of drug selection is, then, I contend, the duty of every prac- titioner and student of medicine.
To this study, we invite you in this lecture room, and in the wards of this hospital.
21, Henrietta Street, Cavendish Square, W.
LUPUS AND ITS TREATMENT WITH HYDROCO-
TYLE ASIATICA.*
By E. C. Fbaneun, M.D., University of Michigan.
I HAVB had in my surgical clinic five well marked cases of lupus non exedens in patients who exceeded the fortieth year. I propose to give the treatment that has been eminently successful in all but one case, which, from the general impairment of constitution and extreme old age of the patient, does not promise such good results as I had hoped
• Beprmted horn the New York Medical Timet.
82 LUPUB. "i^fsryga!
for, in considering the beaatifol cures in the other cases. This latter case is still under treatment, and is the last of the series. The others are cured and have left the clinic for a period of time varying from three to sixteen months.
D^nition. Under the term lupus — a heterogeneous neoplasm of the skin, which consists of a deposit in the corium of '' granulation tissue/' the elements of which resemble the cells of the Malpighian layer — ^I shall include all the varieties of this disease, viz. : lupus non exedens, the exedens^ and the erythematodes. This term has been vaguely applied to other forms of cutaneous ulceration, which has tended very materially not only to embarrass the nosology of diseases, but to confuse their curative treatment.
Lupus exedenSf says Helmuth, ''first appears in the form of a tubercle on the ala of the nose ; it is hard and dusky red ; quite sore, the soreness sometimes extending into the nostril." A thick scab first covers the ulcerated spot ; this in time fiedls off and shows the ulcer extending inwards and rapidly destroying the alae, tip, and columna. At this period &ere seems a respite to its advance inwards, and the spreading is rather on tne surfieice than among the deep lying tissues. This deceptive pause soon yields, however, to a greater erosion than before, and all the struc- tures that lie in its path inwards, whether of bone, muscle, connective, cartilaginous, fibrous, or mucous tissues, melt away before it, presenting a deep, clean-cut excavation, without fetor, swelling, or redness, but enveloped in a dark-brown or blackish crust, the surrounding skin being unimplicated to the very margin of the ulcer*
When it attacks a patient of scrofulous habit, the exten- sion of the ulcer is more superficial than deep, and more rapid in its progress, destroying the whole nose in two or three weeks. In the non-sorofulous patient the disease moves on with scarcely any perceptible advance, occupying years in completing its devastation.
Occasionally it is associated with a syphilitic taint, and presents all the evidence of venereal infection.
A very interesting case of the first variety of this disease came under my observation while in joint attendance with Dr. Helmuth* in the Good Samaritan Hospital, St. Louis, Mo., to which the reader is referred for interesting details
* Sm Hdmath'f Qyftan of Sngery, p. 8S8.
of description and treatment. It is rare in old age, and frequently is seen between the 10th and 80th year.
Lnpns non exedens is a milder type of the disease, and appears in the shape of a red patch, or a small, soft nodnle occupying the nose, face, or chin, which is covered by a fine, brawny, superficial desquamation, or white scales of detached epidermis. It often remains stationary for years, producing a contracted appearance of the skin, with a feeling of stiffiiess or drawing in of the features, resembling the cicatrix following a bum. It is covered with a slight scaly covering, which, dropping off, shows a reddened, brawny appearance of the integument beneath. In time these patches increase in size and depth, which sometimes undergo fatty degeneration and become absorbed, leaving a superficial or depressed scar, according to the degree of deposit. At other times the ulceration extends superficially, involving the entire thickness of the skin, which is covered with a continuous crust.
iMjms erythematodes. This is a peculiar variety of tho disease, and unlike the two preceding, in its characteristics. It begins as a small reddish macule in the walls of the sebaceous follicles, and extends to the adjacent structures, and spreads superficially at the periphery while it is healing in the central point. The patches are studded with pearl- coloured or grayish points of sebum, which shoot up from the implicated follicles, without producing deep ulceration. Upon the subsidence of the disease there appears a thin, shining, depressed, cicatrix, showing the atrophic changes going on in the skin.
An acute form of the disease, more common in Germany than elsewhere, according to Hebra and Kaposi, has a large number of these macules scattered over the face, in some cases being confluent, and occasionally involving the trunk and extremities. They are painfrd and increase with con- siderable rapidity, and give to the disease the appearance of acuteness. Its leading characteristics are, the primitive macule, the colour, the slight brawny scales, tiie chronic and slow course, and the tendency to scarring. No pain or pruritue, but a sUght itching, marks the course of lupus in all its varieties.
Histological dementi. '' The lupus tubercle consists of an aggregation of small cells, among which larger poly- nucleated ones, known as 'giant cells,' are sometimes found." In the lupus exedens, ** the ohuracteristic micro-
YoL S6, No. 1. 9
Oil T-rmTTa Montlily HoaiOMpatiilO
O^ ItUPUB. Bavicnr. Jan. «. isn.
Boopic feature is the ocenrrence of sharply defined aggrega- tions of small non-stratified cells, withont much or any diffuse cellular infiltration." (Piffard.)
Etiology, The proposition is almost universally held in England, France, and Italy, that lupus may properly he considered an expression of the scroAilous diathesis. On the contrary, the Vienna school and its adherents oppose the scrofulous participation. Thompson, who is excellent authority on this point, maintains that it is ** hut the local manifestation of a general disease," a view indorsed hy Dr. Piffard, a late writer on the therapeutics of the skin, as well as other dermatologists whose opinions are entitled to great weight.
Prognosis. Before any special lesion is concerned, the prognosis of this disease is good, and I helieve better results have followed homoeopathic treatment than any other known therapeutics. In the early stages of the disease it yields readily to internal and local medication. If it has progressed 80 far as to produce a lesion of considerable size, the cure will be correspondingly protracted. If it has been neglected and has gone on to involve the deep structures, thereby placing the disease beyond the hope of surgical means, with ^constitutional impairment which is the rule in these cases, then the prognosis is proportionately doubtful, more from the cachectic condition developed than the extent of the lesion. In two cases I am sure that I have seen epithelioma developed upon the site of an old lupoid ulceration, when all the characters of the disease were changed.
Treatment. The treatment of lupus must be considered, first, with reference to the genius of the disease, viz., a constitutional dyscrasia ; secondly, to the cure of the local disorder by externally applied medicinal agents. It cannot be doubted that, if the constitutional diathesis presents well pronounced symptoms, our chief reliance must be placed upon those remedies that expend their curative action over those internal and physiological processes most deeply involved in the disease. If, on the other hand, no systemic impairment can be detected, and the lupus shows no evidence of acuteness, the local manifestations being the most prominent indications for treatment, attention to the external lesion will be ordinarily sufficient. It is just here where the higher potencies effect so much good and so firequently bring about a happy issue in these cases, where the best
directed efix)rtfl of the dlopathio physician have most signally fttiled in effecting a cure.
The remedies which I have employed the most success* folly in the non exedens and the erythematodes, as well as in the earty stages of the exedens, are Ars, iod., Calc. iod., Ferr. iod., Kali, iod., Merc, iod., KalL bich., HydrocotyU Anat.y Silica.
I have tried most faithfully the remedies proposed by Gilchrist in his Surgical Therapeutics in various potencies, and regret to say the patients were not benefited in the least by either one of the following : Caust., Staph., Lyc.^ C&niwn.j Baryt,, Graph., Phot., and Sulph. My experi- ence has led me to remark that the iodides and their bases have effected better results with me than either of the preceding remedies, yet I have sometimes been disappointed in their use. Of all the remedies which have given me the most successful results is the Hydrocotyle Agiatica, and I can testify my commendation of this remedy which Helmuth has called the attention of the profession to in his recent work on Surgery, and which acquired such " great reputa- tion in the hands of Dr. Boileau, resident in the Mauritius." " Of 57 persons suffering from lupus who were treated by the remedy, in aU trithout exception, the disease was arrested and in a veiy short time."
I have heard the statement made, I think by Dr. Qilchrist, tbat Hydrocotyle was not curative of lupus ; that the rela- tions of the drug pointed to elephantiasis arabum alone. My opinion differs widely from this, and I have the record of three cases to prove its efficacy in lupus, and I am sure the profession can rely upon it with certainty in all cases where constitotional dia&iesis does not develop a marked mdication for treatment.
ABSTKACT OF CASES TREATED IN CUNIG AND HOSPITAL THE
PAST TWO YBABS.
Case 1. Sarah C, st. 86. May 6, 1880. Had ulcer on rig^t side of cheek covered with scab size of half-dollar. Qui been suffering with the disease more or less for three years. Removal of scab shows the characters of lupus. Sharp stitching pain in part. For the past year growth has ceased till three months ago, when it began to increase sensibly. Diagnosis, lupus non exedens. Prescription, Hydrocotyle As. 6z, three times a day internally and ten dxops in one ounce of water locally. May 12. Feels a little
86 LviroB. "g^^Srg^
better; parts do not feel so stiff; no pain; O.T. May 12. Beports herself decidedly improved ; G.T. Jane 10. Scab shows no tendency to return ; skin feels a trifle indurated, but shows marked improvement ; G. T. ; medicine to be given twice a day. Jnne 22. Beports herself perfectly cured. Discharged.
Case 2. Mrs. T. Webster. Entered clinic May 18. History. Seven years ago had small pimple on right side of nos6y red and elevated, which ulcerated and spread, and for nearly two years it stopped growing. The size of a silver dollar now, and extending over the skin surface. It began to grow from being overheated, attended with itching. The scabs would grow and fall off, leaving a reddish base. Diagnosis, lupus non exedens. Prescription, Hydrocotyle As. 6x, three times a day and first cUlution of remedy applied locally. June 1. Patient improving; G. T. June 28. Improvement continues; G. T. This case con- tinued the remedy till all was taken, and in consequence of my absence from the city did not see her till my return in October, when she reported herself cured.
Gase 8. Mrs. P. Entered hospital November 27, 1880. History like the preeeding. Gave her Are. iod. 6th, three times a day, and ten drops of iodine in one oxmce of water applied externally* In three weeks she returned very little benefited if any. Gave ferrum iod, 8d, twice a day, and the same application locally. Returned in two weeks not improved. Ordered no medicine for one week, and Hydro- cotyle As. 6th, three times a day for two weeks, and the Hyd. externally as in the preceding cases. She reported in the three weeks that she felt *^ a hundred per cent, better;*' C. T. To report in three weeks more. Beported cured.
Gase 4. J. W. H., sBt. 70, male. March 22, 1881. Had growth under left eye. Began as a red, elevated pimple in the skin. The physician treated it with es- charotics, which resulted in complete ectropion, which was subsequently operated upon and cured. Now has a similar growth on nose. Diagnosis, Lupus non exedens, Gave- Hydrocotyle As. 6th, three times a day, and the external lotion. April 7. Beturned with slight improvement. Ordered medicine continued. Have not seen him since and do not know positively the result of treatment.
I shall look at this case with a considerable interest, for I was a little in doubt about the diagnosis, although the previous surgeon expressed himself with great positivenesS'
aS^jS!fSS^ BPLINTS IN H0B8BS. 87
as to the disease, and pronounced it unhesitatingly the non exedeng variety of Inpns.
It seemed to me that the disease was implicating the skin too deeply ; the scab was a little too hard for Inpns, and the adjacent skin too mnch infiltrated for a po9itiv$ diagnosis of Inpns. We shall see soon and report the result.
THE TKEATMENT OF SPLINTS IN HORSES.
By W. B. B. ScBiVEN, M.D.
Etebt bondjide example of the genuine action of the law of similars is valuable and worth recording. This is more especially the case when the subject is an unimaginative pachyderm, who is ignorant of the object of the treatment of which he or she may be the victim. I may here observe that the lower animals have in several instances been instrumental in convincing some of the most powerful intellects of the truth and superiority of our system of cure. Archbishop Whately was converted in this wise. My late friend, Dr. Charles Luther, had attended with success, one of the Misses Whately. Her father, then a candid unbeliever, could not refuse his assent to the fact that the health of his daughter had been quite re-estab- lished under Dr. Luther's treatment, after a long period of delicacy and active medication secundem artem. His Grace, still sceptical as to the efficacy of infinitesimals, remarked that Dr. Luther's success might, in a great measure, be due to the action of "mind on matter,'' but said, that if he (Dr. Luther) would cure his favourite dog, a brown Irish water- spaniel, who was almost depilated by mange, and had been under the care of the most distinguished vets, in London and Dublin, he would believe. Luther accepted the challenge : the dog recovered his hair and his health in six or eight weeks; the great logician became a firm homoeopath, ajid continued so till death.
We have now to do with a larger, if not nobler animal. About three years ago, I bought a well-bred mare, five years old, with a very prominent splint, the size of a walnut, on the inside of the near fore leg, about three inches below the knee. From its position and its having, become thoroughly ossified, it did not cause lameness or
68 SPLINTS IN HOKSBS. ''^SSSiSS!??^
Beview, Jml. S, 188t,
coDBtitate '' nnsQUQdness/' but was a blemish wliich I hoped to remove. Dr. Garth Wilkinson has drawn atten- tion to the action of the lava of Mount Heela on the cattle find ponies which grasse on the slopes of the monntain, giving rise in them to various bony deformities.
It occurred to me that if the lava could produce exos- tosis it ought to cure splint. I got our friend, Mr. Gould, to prepare an ointment of one drachm of 1st trit. <^ lava to an ounce of lard. This was rubbed on the splint night and morning, and five grains of the Srd dec. trit. was put on the mare's tongue twice a day. In three weeks the splint began to soften, and in three or four more had quite dis- appeared. The next case was that of a valuable high- stepping harness mare^ twelve years old, who, when young, had thrown out a large splint, which, after hard work, used to inflame, and lame her, but latterly had given us little [trouble. As an experiment, I ordered the same treatment to be resorted to with her, and in a few days the splint became so tender that we desisted, and when the aggravation passed off, the splint had become smaller, and now causes no inconvenience. Last summer, a military friend told me he had a very valuable hunter which had become lame from ossification of the cartilages of both fore feet. I mentioned my success with the lava, and advised him to try it. He afterwards went abroad, and when in London en route for Cannes, wrote to me as follows from the Army and Navy Club, Pall Mall: "My horse was afiected in both fore feet with a considerable enlargement and hardness of the cartilages from ossification. I applied your remedy both internally and externally for three weeks, before I perceived any improvement, but after that time the benefit was very marked, both in removing the enlarge- ment, and also taking away the hardness at the heels and restoring their springy feel. Whether the cure will be perfect, time alone will tell, but so far nothing can be more satisfactory. I am still going on with the treatment* Again thanking you much for your kindness, &c., &c."
I called some days ago at the stables of my friend, and saw the horse, who has now no trace of hardness, and goes perfectly sound.
Dublin, 28rd Nov., 1881.
ISrtSl^jSTaSL* PoisoNma bt solphdr. 89
A CASE OF POISONING BY SULPHUR. By Robert T. Coopeb, M.D.,
Physician, Difieases of Ear, London HomGdopatbio Hospital.
The diffuaion of JuZj?At4r-con8titaents thronghont nature is so extensive that it probably happens there are more cases of poisoning by sulphur and its deriratives than by any of the other chemical elementary bodies, phosphorus and arsenic even, not being excepted.
And yet scattered through medical literature there would probably be found a hundred cases of arsenic poisoning for one of sulphur, the reason being that arsenical effects thrust themselves upon us, and in a way compel us to notice them. Considerations such as this show the need there is for following, in this respect at all events, the instructions of the illustrious Hahnemann, and noting down all the circumstances connected with our patients' cases, whether these appear at the time to be calculated to help us to a better understanding of the case or not.
A collection of such cases, carefolly studied, would, I feel sure, lead to the inference that many of i^em must have been under the influence of ^_p/if^r-bearing substances.
Ehzabeth D — , a housemaid, aged 26, consulted me 15th November, 1881, for weakness, with inter-scapular pains ; she assures me she never has been strong, though much worse the last two months. She has suffered a good deal from irregular action of the heart, and complains of an unpleasant taste and confined bowels, her appetite, notwithstanding, being good. Observing the peculiar atra* bilious complexion and roughness of skin that I have for long been in the habit of considering an indication for sulphur, I prescribed our sulphur mother-tincture, and was just handing her the prescription, when she gave me the following interesting particulars : —
A year and a half ago, not feeUng well, was induced to take a teaspoonful of sulphur in a little treacle, and has never felt well since. This quantity was taken during the catamenia, and inmiediately afterwards a change took place in the colour of the discharge. From being natural, it changed to a pale yellow discharge, exactly Uxe colour of the sulphur itself, and so it continued for at least three months. Ever since then, for a week before each monthly illness, she is troubled with this nasty yellow discharge, which smells and looks exactly like sulphur.
40 GASTR0-INTE8TINAL HiEMOBRHAGE. ^^S^^SSSIifi^.
Moreover, she says that soon after taking the sulphur f abscesses formed about the teeth, which until they dis- charged, would occasion a great deal of pain.
Still further, any purgative medicine, instead of acting upon her bowels, will, since taking the sulphur, be suc- ceeded not by purgation, but by an increase of this horrid discharge, and the urine, too, will at the same time smell strongly of sulphur. The discharge leaves a yellow stain, with sulphur-VkQ odour upon her linen. Her teeth, especially the back teeth, upper and lower, are much decayed, in fact they are perfectly useless, while before taking the sulphur they were very good indeed.
Hearing all this, I naturally altered my prescription, and gave ten grains of mercurius soluhUis, Srd dec. to go over the week.
November 22nd. — ^Feels stronger, and is clearer in her complexion. Has had an increase of discharge since taking the medicine, and it smells even more sulphury than before. Inter-scapular pain gone, bowels still confined.
November 29. — Very much better in all respects, bowels act all right, monthly illness on — natural.
Briefly, the case shows — ^(ij the antidotal power of mer- curius over sulphur (''in such cases (i.e., where much sulphur had been used) a dose of m^curius x ought to be given first, before the sulphur is exhibited. — Chronic Diseases, Hahnemann, vol. i., p. 162) ; ('bj that sulphur acting injuriously leads to decay of the teeth, thereby con- firming both Hahnemann and the Vienna provings ; and lastly, re J it seems to prove that under some circumstances there may grow up in the system a manufactory of sulphur, just as we know occurs with carbon. — {Vide Mackellar, Edinhwrgh Monthly Journal of Medical Science, 1846).
A CASE OF GASTEO-INTESTINAL HAEMORRHAGE.
By Dr. Proell, Nice and Gastein.
Last March, whilst the Sirocco wind was blowing, I was called to go as quickly as possible to a gentleman suffering severely from violent vomiting and colic. I found him in bed, complaining of continual sickness and great anxiety, and trying to alleviate his sufferings by compressing his bowels with both hands ; great giddiness when raising his head.
Xeview, Jan. s, 18tt. OABTBO-INTESTINAL HJEMOBBHAGB. 41
Present State. — ^A tall man, 70 jesetB of ag6> light eyes, fiice extremely pale, tongue white, boot odour from the breath. He Tomited with great effort a vessel full of a ihick poultice-like substance, resembling chocolate or •coffee-dregs, of a very offensive odour ; no thirst ; burning -and pricMng pain in the abdomen, which was much swoUen ; great difBculty in speaking ; pulse 80, and hard ; breathing accelerated ; urine normid ; skin cool.
Prescription. — 2'rit. earbo. veget. 5- A pinch every half-hour.
Diet. — ^Nothing but cold milk, and a little water in case thirst should return.
Legs and feet to be enveloped in flannel.
After an absence of two hours I returned, and found the 'Colic and vomiting much lessened, the temperature higher.
The following morning I was told that he had passed a better night. He had vomited several times, but only towards morning, when the vessel was again filled with the same kind of bluish-black poultice-looking material. Colic much lessened, but still the same painful moaning.
Prescription. — Trit. earbo. veget. Ix: A pinch every two hours. Gold milk every hour, but only a teaspoonfid in order not to fatigue the exhausted stomach.
Evening Visit. — ^During the day appetite returned, but only momentarily. Great weakness, with sticking burning pains, and increased violent vomiting towards evening. Much thirst, but satisfied with small draughts of water. Vomiting of the same quantity and quaJity as before. Urine normal.
Prescription. — Arsen. 6 dilut. : 2 drops on the tongue every half-hour until a change occurs, then less frequently.
March 12. — The next morning I learned that soon after the second dose of arsen^ the burning pain was lessened. After the third dose the vomiting and tlurst decreased, and the patient slept from 1 a.m. till 7 a.m. In the morning he awoke with a bitter taste in the mouth and offensive smeU from the breath ; no appetite ; tongue covered with a thick yellow coating ; no thnrst ; nausea and hiccup ; sen- sation of fulness in the stomach ; vomiting and burning pain entirely passed away ; no evacuation for four days.
Prescription, — ^It was now desirable to empty the bowels, and I first ordered an injection of lukewarm water. To this the patient made great objection, and as there was no instrument in the house, and no one capable of managing
42 GASTBO-nrrEBTINAL H£MOBRHAOB. ^'t^
Bvfww, Jan. S, ISBS.
one, I was obliged ta give up thai way of helping him, and prescribed instead tisiciure qfnvx, vani. 6^ 2 drops every 3 hoars. I chose nux, rom.^ not only on account of the new symptoms^ bat also because he had been accastomed all his fife to good living {bon vivant de ftemiere cUuge), In the evening I was sent for harriedly, as the invalid had been found stretched senseless upon the floor of his room, by the bedside, in the midst of involuntary evacuations^ His friend, who lived in the same pension, had come by chance into his room, and after washing him, whilst lying on the floor, put him back into bed, with the help of others. Whilst lying on the floor, the patient was quite cold, and of a deatibly hue, but when returned to bed, be became of a burning heat, and quite red with fever. He had again much thirst, with anxiety, and a fieiy sensation in the bowels. Symptoms. — tongue blackiah, mouth very dry, breathing short, thirst inextinguishable, but satisfied with small quantities of water. Pulse, 84, and very weak. No vomiting.
Prescription. — Tinct. arsen.y Ix. dilut., 2 drops on the tongue every hour ; to be stopped when the diarrhoea ceased.
Diet. — Bice and rice water alternately, with tea, to be given often, but in very small quantities.
March 18th. — ^Morning visit. Found the patient had slept better. No vomiting. Two evacuations of the same kind as before. All the above-mentioned symptoms lessened. Less apathetic. Breathing still short. Pulse^ 80. Swelling of the abdomen. No longer thirsty.
Prescription. — Carbo. veget., Ix, trit., a pinch on the tongue every three hours.
Evening. — Still better in every respect,
Diet.^ No longer milk alone, but mixed with a tea- spoonful of Cognac.
March 14th. — Morning. — Had slept tolerably during the night. Five evacuations, but these, for the first time, were more brown than black. Abdomen swelled, but less- painful. Breathing easier.
Prescription. — Carbo. veget., Ix.
Evening visit. Only one -evacuation. All symptoms better. Carbo. to be given once only, just before going to- sleep.
March 15, morning. Passed a good night. No evacua* tion. Same prescription and diet.
lt!SS^SrS!wS^ OASTB0-INTB8TINAL H2B1I0EEHAGB. 4S
March 16, morning. Had no sleep dariBg night. Ten attacks of diarrhoea, hnt colour browner, and of a firmer consistence. Prescription. — Carbo 30. No longer milk, but tea and biscuit^ also a little weak brandy and water to be given when thirsty.
March 17. Passed a good night. No evacuation. Patient fresher, but pulse still 80, and very weak. Pre^ 9cripiian. No more medicine. Beef tea with toasted bread, and instead of brandy, Bordeaux in small quantities.
March 2S. The first normal evacuation after three days costiveness. Patient now allowed to get up, take a drive in the carriage, and eat regular dinners. I now ordered him to take Gastein water, in order to strengthen the bowels. At the end of April he left Nice, completely cured, and his face had then lost its pallid hue.
This case is interesting on account of the uncertainty surrounding its pathology. It was only during the last few days of his convalescence that I was made acquainted with the full history of the disease, which is somewhat as follows : —
When an officer in a cavalry regiment in his 17th year, he suffered greatly from piles and gout, and, during the bombardment of Venice, from malaria. Some months after- wards he had a dangerous attack of inflammation of the bowels, and at Vienna dropsy of the abdomen. In his 48rd year he married, and remained three years longer in the eavaliy. He then had an attack of gastralgia and gout, and went to Carlsbad. The death of two children threw him into a state of nervous debility and chronic gastric disorder. It was not until he attained the age of 60 that he had the first internal bleeding, when he lost 7 lbs. of blood. This attack, which threatened his life, was, he thinks, brought on by too hard and excessive riding on horseback. The enormous loss of blood was checked, and he went to Naples for recovery. There he lost his wife> and suffered greatly from continual colic, but the summer brought relief. The next spring he went to Marienbad, but soon afterwards he had again internal bleeding, with faint- ing. Weak during two months. He came to Nice in February, 1861, and the 11th of March following began the disease just related.
Nice, Nov. 15, 1881.
44 SOLUBILITT OF PHOSPHOBUS. M-^^JJ^wpj^
Bafiev, Jan. t» ifln.
NOTE ON THE SOLUBILITY OF PHOSPHORUS
m ETHEB.
By J. M. W-iBOBN.
The gravimetric estimation otphogphorus in ethereal soln- tions being a matter of great difficulty, the following experiments were made with a view to ascertain somewhat exactly the extent to which the substance is soluble in this medium at the ordinary laboratory temperature, viz., 60^ Fahr.
The precautions described in a note on alcohoUc solutions of this medicine (this Journal, vol. xxi, p. 748) were observed —
1. Solutions in absolute ether were first prepared to determine approximately the proportion of vitreous phog- phorus soluble, and this was found to be, while the solutions remained clear, about one grain in between 200 and 250 minims, but the Uquid quickly became opalescent and began to deposit a half liquid, half pulverulent mass, varying in colour from that of straw to red, and which finally became solid and adhered to the glass firmly.
2. Common ether having a specific gravity of 0.7S5 at 60^ (ascertained by the balance immediately before and 4kfter the experiment) was used in this case. 2,000 grain measures were measured by the specific gravity bottle, and placed in an ether capped, white glass bottie, holding little more than this quantity, and kept during the operation in a boxwood case to guard it from the light. 8.10 grains of phosphorus chips were placed in this and completely dis- solved in a few days, the solution remaining clear. 1.10 grain was then added and in due course dissolved. 1.80 grain was afterwards added, but only a little more than half this quantity was taken up, and tiie solution ultimately .became turbid, so that the operation could not be carried further. It was, however, calculated that 10 grains in all had dissolved, the proportion being equal to a grain in about 219 minims. The temperature remained at about
'60^ during this experiment.
8. A block oi phosphorus from the same sample, weigh- ing 16.8 grains, was placed in 2,000 grain measures of the same ether, and after maceration and occasional shaking for five days, was re-weighed, and the net weight found to be 6.4 grains, 10.4 grains being left in the solution, corres-
SSSTjiST^m^ solubility of phosphorus: 4&
ponding to the proportion of one grain in 211 minims. Temperatnre was maintained at 60^.
4. A block of phosphorus weighing 84.16 grains from a different sample to that preyionsly used, was placed in 2,000 grain measures of ether haying a speciJSc gravity of 0.788, and macerated with occasional shaking for six days. Between the third and fifth day it remained onshaken, the temperature in the meantime falling to 55? ; in consequence of tliis, a quantity of crystals formed from the solution, which were only partially re-dissolred, after thorough shaking and further maceration at 60^ for five hours, and the ex^ periment was abandoned. The block when re-weighed contained 22.56 grains, having therefore lost 11.60 grains in weight, and the residuary crystals were roughly estimated, by the quantity of ether required to dissolve them, at about a grain, leaving about 10.6 graina dissolved, and proving that the maximum amount in solution was less than 11.60' grains.
5. A block o{ phosphorus weighing 20.02 grains, from the same sample as that used in tiie last experiment, was placed in 2,000 grain measures of the same ether, and macerated as before for five days. The lowest temperature reached was 56^, and the solution showed a tendency tO' crystallise on the fifth day, some vety minute crystals form- ing, which were nearly all re-dissolved by shaking and further maceration for some hours at 60^. The block re- maining weighed 8.69 grains, having lost 11.88 grains, and the solution remained clear.
The mean results of experiments 2, 8 and 5, would probably represent the average degree of solubility of different samples oi phosphorus in common ether, varying, as it usually does in the pharmaceutical laboratory, between. n>ecific gravity 0.788 and 0.785. The proportions would tnen be as under : —
No. 2. No. 8. No.5. Mean.
Ptoportioii in mmimfl lin219... 1 in 211 ... 1 in 194 ... 1 in 208 „ gr. meainxeB lin200... 1 in 192 ... 1 in 177 ... 1 in 189 ,, gn. weight linl47... lln 141 ... 1 in 129 ...1 in 139
For medicinal purposes the saturated solution of phos- phorus in common ether might be considered as containing a grain in about 200 minims.
It also appears that absolute ether is an unsuitable solvent of this drug.
46 BS¥IBW8.
Bvfww. J«L % IBBB.
REVIEWS.
Bkenmaium. Bj T. J. MiciAOAir, M.I>. Pickering & Co.
IjOndoii.
Undes this titie we reeeive an exhanstive monograph on this most fonnidable disease. From Dr. Ifachigan's standpoint the snbjeet is treated with a masterly hand, ahnost the whole Utera- tore of rheumatism being laid under oontribation to fomish TnaiariiJ in fJRYoiir of his YiewB.
The first three chapters are devoted to the biology of the disease and the symptoms of the different Yarieties ; also to the special characteristics of rheumatic inflammation, from whioh the anthor draws the condosion that " this inflammation is the result of the action of a special poison circulating in the blood." From this the transition is easy to the consideration of the nature of this poison. Starting with the generally receiyed idea, that iheumatism is due to excesd of lactic acid. Dr. Maclagan points out that this idea, although it possesses a definite foundation for a rational line of treatment^ has of late years been somewhat dis- credited. The failure of the routine treatment by alkalies having tended more than any other cause to bring about this result. The presence of lactic acid in excess cannot be denied, but the author cannot see that it necessarily is the cause of the rheu- matism. He says, ** It is quite possible that the morbid action which constitutes the rheumatism may give rise to an excess of acid," pointing to a similar relationship between urea and the specific fevers. One of the chief arguments against the lactic acid theory of causation is the fact that the administration of alkalies, however early, exercises littie or no power over the disease; but for want of a better treatment they have till recently continued to be the chief remedies. We pause here to wonder at the professional morality which will continue to administer drugs confessedly inert, and would contemptuously refuse to make any trial of such well-tried remedial measures as aeanitef bryonia or rhus. The author's chain of reasoning is as follows : '* The excess of lactic acid which occurs in acute rheumatism results directly from increased metamorphosis of muscular tissue : this in its turn is a result of the disturbance of the vasomotor system of the locomotor apparatus of the affected joints ; the cause of this is inflammation of the white fibrous textures of these joints ; and the cause of this inflammation is, as ahready explained, the action of the rheumatic poison." And the nature of this poison the author proceeds to show in the •chapter on << The Miasmatic Theory of Bheumatism." Taking up the law that the poisons entering the system from without are •of two kinds, the contagia axid the miasmata , he points oat the
SrtggfjSTil^ M8VIEW8. 47
wemt of resemblance between iSie rhenmatie poison and the general features of the eontagia, namelj, their power of repro- dnotion, and commnnicability from the sick to Qxe healthy, and their fixed and definite period of duration. ** The rheomatic -poison, therefore, does not possess the properties of a contagium. There remain only the miasmata,"
Dr. Maclagan admits that all that is known on this point is extremely vagae, their existence being only known to us by their ^ects.
'* The poison has never been separated ; and examination of the soil, water, and air supposed to contain it, has given only negative restilts.''
We have some difficnlfy in reconciling these statements with those on page 74.
** The researches of Lanzi and Terrigi, and the more recent ones of Professor Elebs and Signer Tommasi-Oradeli, made in the malarial district of the Agro Romano, near Rome, point to the conclusion that the malarial poison is an organism which may be obtained from the soil and may be cultivated in the bodies of animals. Tbjs organism, say the last two observers, belongs to the genus haeiUua, and exists in the soil of malarial districts in the form of shining ovoid spores ; .... By inoculating rabbits with liquids taken directly from malarial soil, and con- taining this bacillus, there was produced fever, often of an inter- mittent type."
After pointing out the similarity in the course of symptoms between rheumatism and the malarial type of diseases, the author goes on to a very careful and difiuse description of the symptoms and pathology of rheumatism with the complications of endocar- ditis, pericarditiB, and myocarditis. This portion of the book bears witness to long and careful study of disease, and is stamped as the work of a master hand in pathology. We next come to a retrospect of the various treatments for rheumatism even as far back as Sydenham, in 1666, and, written as it is by an allopath, with all tiie angularities toned down, we can only say that it is a pitiful history of barbarous leechdom. Sydenham at first adyooated profuse bleedings, but ten years later seems to have seen the error of his ways, and advised instead light and nutritious diet, and that the patient should be kept cool, showing that the gospel of expeetancy as preached by its apostle, Dr. Andrew Clark, is none of the newest, and if age be any criterion of wori^, should be even more successful than it is.
Pttrgatives, Diaphoreties^ opiums cinchona, qmrdne, cohhtcum^ and nitrate of potass have all had their admirers, and in their day have been lauded to the skies, only to be deposed when Bome other drug was brought into notice.
Omaeum^ too, has long enjoyed favour as a remedy for
48 BEViBWB. »2^=5SrS^*
Beyjew, JaiL i, 1889^
rheumatism, " Any good effects which it produces are probably due to its stimulant action on the skin.** So much for ignorance> of drug proving. Listen to what Phillips says (and strangely enough, possibly a coincidence, TTftlw^^ir^ftnTi also) of large doses^
** Sti&ess of a rheumatic character is felt in the nape of the> neck and small of the back, with pains in the bones of the legs- . . . . darting pains, apparently of a rheumatic neuralgic character, extend also from the feet to the knees." To this^ then, and not to its action on the skin, is any good result probably attributable.
We now come to the first attempt at rationality in the course of two centuries of medical practice, and after wading through P00I3 of blood, and violent antiphlogistic treatment, it is really refreshing to find something approaching to scientific thera- peutics ; we would commend a careful perusal of the literature of rheumatic fever to those venerable medical practitioners who cHng tenaciously to the antiquated allopathy of Iheir great grand fathers, pleading for its efficacy on account of its age.
How delicious it is to read of sage physicians carefully treating rheumatic fever with mint water in default of a better remedy, and carefully recording their results in the medical press.. Dr. Maclagui significantly adds that **this treatment has as satisfactory results as more active measures.'*
Dr. Maclagan*s views of the history of the therapeutics of rheu- matism deserve quotation, coming as they do from an eminent- allopath, and covering as they do with ignominy and contempt the treatment which has been till lately the sheet anchor of that portion of the profession who delight to term themselves scientific prac- titioners. ** Antiphlogistic treatment was practised, not because of the proved excellence of its results — for two hundred years ago, these were regarded as unsatisfactory by Sydenham, and have frequently since then been called in question by others — but because such treatment was the legitimate outcome of the view& held regarding the nature and mode of production of rheumatism.. The expectant treatment was the practical expression of the opinion which had graduaUy been gaioing ground, that the results of the alkaline treatment were not satii^actory. It suc- ceeded the failure of the alkaline treatment in the nineteenth century, just as in the hands of Sydenham, it succeeded the fjEolure of the antiphlogistic in the seventeenth,** and will, with all due deference to sctUcin and its admirers, again in the nine- teenth century, succeed to this latest fashion in medicine.
Having now disposed of the lactic acid theory of causation^ and the chemico-therapeutic method of treatment, Dr. Maclagan proceeds to the unfolding of the remedy which he has proposed for the cure of rheumatism, on the ground that it is of miasmatic origin. The author maintains that saUcin cures rheumatism in
Si^JSrae?* beviews, 4»
Bensur, Jan. fl, 188i«
the same xnanDer that cinchona cures agae. And with regard to this same therapeutic action of cinchona^ we are treated to some curious remarks. '* That the cinchona alkaloids arrest the course
of intermittent fever, is an established fact How they do-
80 has never been explained. The cinchona compounds ar» possessed of no physiological action by which their power ta arrest the course of intermittent fever may be explained." Ever seeking for a physiological explanation, the modem therapeutist ignores the wonderful chain of thought which flashed through the brain of one, Samuel Hahnemann, with regard to this very drug^ cinchona •
Dr. Maclagan gives a long series of cases bearing out his proposition th&t saiicyl compounds cure rheumatic fever ; but da they really do so as a general practical rule? Let us look at the sul]gect now from another and still allopathic standpoint.
Dr. Greenhow, in May, 1880, read a paper on the treatment of rheumatic fever before the Clinical Society. His remarks induce us to think that saUcin and saUcyUUe of soda might justly be added to Dr. Madagan's long list of therapeutic failures. The conclusion he comes to from a series of sixty cases, is that these drugs ** cannot be regarded as, in any respect, specifics in the treatment of rheumatic fever. The temperature is brought down and the pains relieved pretty quickly, at first, at least, but neither of these results is uniform. In some cases the temper- ature went up in spite of the medicines, and the pains were not relieved, while one or several relapses were unusually frequent. Complications of pericarditis and pleurisy occurred during the use of the drugs, and more frequently than the average under other treatment. Deafness, vertigo, headache, vomiting and diarrhoea were often produced. The heart's action was rendered so weak in many cases, as to require the administration of stimulants. Convalescence was unusually long, the average stay in hospital being 55 to 57 days, while even tiien the patients were sent out in a state in which they were unfit for work.
As homoeopaths we have no opportunity of judging of the results of sctHcin in actual practice, but Dr. Gxeenhow does not stand in an isolated position. The one or two cases which we have seen treated by this method, fully bear out his statements SaUcin has nearly shot its bolt, and we shall soon have an inter- regnum until the next discovery is heralded into the medical worid. With medicine as with courts, it is ** Le Boi est mortf twe le EoiJ^ For Boi read " the specific"
The last two chapters of Dr. Maclagan's book are of great interest, launching ihe reader into a subject of which but little is known, but of which we would like to know more. *' The Belation between Bheumatism and Chorea" is at present shrouded in some mystery, and offers a wide field for inquiry.
YoL 36, No. 1. a
yj.S V, £: . .
MoBtUy HaahaBopfttliio
OV \^ FQTABILI^y Beriew, Jan. 8. 1882.
The ablest theory is thai of Kirkes, Hngfalings Jackson and Bioadbent, attributing choreic symptoms to embolic plugging of the minute vessels of the motor ganglia. It is however but a theory, and not nmeh satisfactory evidence has been advanced in its favour. The volume closes with an interesting chapter on Hyperpyrexia.
In conclusion, we may remark that however we may diner from the writer on therapeutic grounds we have derived much satisfac- tion from perusal of this work, and can commend it as being, from Dr. Maclagan's loctts standi at any rate, a most acceptable addition to the literature of rheumatic fever.
NOTABILIA.
LONDON SCHOOL OF HOMOEOPATHY.
At the special meeting of the Subscribers and Donors to this Institution, held in the Lecture-room, Great Ormond Street, on Thursday, the 15th December, Major Wm. Yaughan Morgan in the chair (in the unavoidable absence of the President, Lobd Ebubt).
We are unable, in the present number, to insert the full report, which, however, we hope to be able to print in our next issue.
The chief business of the meeting was to receive the report of the Sub-Committee which was appointed to revise the Bules and Xiaws, and to determine several points connected with the sim- plification of the Executive of tiie School, and to decide the future courses of instruction, &c.
The first point which came before the meeting was the resolu- tion that the London School of Homoeopathy should be con- tinued : this was carried unanimously.
The new Bules and Laws, as revised by the Committee, were then considered, and, with some slight modifications, adopted.
The most important business was a new Bule proposed by Dr. Hughes: —
'' That any student who has diligently attended the lectures during one winter and one summer session of the School, and who has passed satisfactorily an examination in the Principles, Materia Medica, and Practice of Homoeopathy, and who has passed a Clinical examination in the Wards of the Hospital, shall be awarded the diploma of * Licentiate in Homoeopathy,* and shall be entitled to add < L.H.* to such titles qualifying him to practice as he may possess or hereafter obtain/*
This resolution was seconded, and passed unanimously, on the understanding that it only applied to such students as were
SSSS'jSTHS?*' notabilia. 51
BerkrWf Jan. 2, 1882.
already possessed of a qualification to practise medicine, either in Great Britain or in the country to which they belong.
The names of the following gentlemen were proposed and imanimonsly appointed the examiners : —
Dr. William Bayes, of 88, Lansdowne Place, Brighton.
Dr. J. Galley Blackley, of 2, Gordon Street, London.
Dr. D. Dyce Brown, of 29, Seymour Street, Portman
Square, London. Dr. J. Compton Burnett, of 5, Holies Street, Cavendish
Square, London. Dr. Richard Hughes, of 86, Sillwood Road, Brighton. Dr. A. G. Pope, of 21, Henrietta Street, Cavendish Square,
London.
The following addition was then passed : —
" For the diploma, so obtained, a fee shall be paid ; the amount of such fee to be determined hereafter by the Committee and Council from time to time.
Dr. Bayes then proposed that : —
*' Physicians and Surgeons who are of good repute, and who have practised homoeopathy for five consecutive years preceding the 25th of December, 1881, may be elected, without examina- tion, to the title of L.H., provided they apply to the Medical Council of the London School of Homoeopathy before the end of December, 1888, and are elected by the vote of the majority of the members of ihe Medical Council."
The following resolutions relating to the general business of the School were also passed.
1. That a sum not exceeding Jg200 shall remain in the bank as a current balance for the present ; that after paying all debts, if a balance of over £200 shall remain on the 81st of December, it shall be invested in the names of the Trustees.''
We understand that the moneys at present invested, and standing in the names of the Trustees, amount to about or above d£l,800. It is not intended to draw upon this fund, but should any emergency arise it will be within the power of the executive of the School to apply any portion of it that may be required, provided the governors and subscribers give their consent at a special general or annual meeting.
It was further resolved : —
2. '* That the present Subscribers to the School be requested to continue to subscribe, and that their attention be directed to the necessity which exists for their efforts to obtain increased subBcriptions from those interested in sustaming and developing the educational effort which has been inaugurated by the London fichool of Homoeopathy ; this effort comprises two great divisions of medical scholastic procedure, both of equal importance.
l2
52 HOTABUJA. ^^SSSL^S!''?^^!'
BflfiBv, Jn.^ Ifltt.
The firai is the inerease of the effideney of the Hospital as a dinieal school ; for this purpose, a great effort should he made towards endowing the Hospital with, at least, £70»000 more than it at present possesses. The seeond is the fBrther enlargement of the London School of Homoeopathy, until it shall heoome a complete medical school, with the full eomplement of lecturers and of aU the necessary adjuncts, such as a complete hbraiy, museum, and aU that appertains to the construction of a first- class medical school ; to do this efficiently it is computed that not less than £30,000 will be required.'*
Lastly, the following was proposed and earned : —
" That it is recommended that evezy medical praetiiioner of homceopathy within Great Britain and L'eland, be once more urged to exert a great effort, to establish in the metropolis a central Homoeopi^hie School as aboye indicated, and to bring before his patients and friends the claims of the central Insti- tutions above-named. We cannot but believe that if this were done earnestly the aims which we have in view would be speedily reached." W. B.
A PRIZE ESSAY ON THE CAUSES AKD PREVENTION
OF BLINDNESS.
OuB energetic colleague, Dr. Roth, has been for a long while engaged in making enquiries throughout Europe as to the causes which have led to 800,000 persons being hopelessly blind. The results of his investigations have proved to him that two-thirds of these cases need not have occurred had proper hygienic pre- cautions been taken. He now proposes to stimulate enquiry by the offer of a prize of 2,000 francs for an essay on the " Study of the Causes of Blindness." The better to carry out his purpose he has laid his prqject before various European Societies, soliciting their advice in drawing up a basis for the guidance of the com- petitors. Among other societies consulted has been the Societe Fran^aise d*Hygiene. This association appointed a committee to consider the questions to be enquired into. After two meetings the following programme was agreed upon to be submitted to Dr. Roth :—
Programme of the Societe Frangaise d'Hygiene,
Past I.
Study of the Causes of Blindness.
A. — Hereditary causes, consanguineous marriages, syphilis, and
other constitutional diseases. B. — ^Diseases in infancy and childhood, the various inflammations
of the eye.
bS^jSmSS^ hotabilia. 63
C — ^Inflaences of eraptive fevers.
JD. — Period of life from the 8th to the 18th year. The school, college, the workshop, woonds and accidents, sympathetic ophthalmia, &e.
E, — ^Adnlt and old age.
JP. — ^Neglected, had, and misuitable treatment of eye diseases by quacks and ignorant or inexperienced medical men. Pro- gressiye myopia, diathetic, professional, climatic and other influences, as for instance of various injurious trades, and of poisoning, &c.
Pabt n.
An outline of the most practical means for preventing blindness with reference to the various groups of causes mentioned in Part I. — a, legislative, 6, educational, c, hygienic, d, medical means.
LONDON HOMCEOPATmC HOSPITAL.
An opportuniiy presents itself for doing a really charitable and kind action on the part of those of our readers who possess votes for the Boyal Hospital for Licurables, Putney. Miss Tarr, for many years housekeeper of the hospital, a position which, we understand, she filled with great zeal and efficiency, and to the entire satisfaction of the hospital authorities, has become almost entirely incapacitated owing to contraction of the tendons of the ankle joints, with ulceration.
The helpless state she has arrived at is, to a great extent, traceable to the severe work which a proper performance of the duties of housekeeper at the hospital entails, owing to the great number of steps from the basement to the upper story, and which must be surmounted frequently in the course of every day in carrying out a close supervision over the servants of the establishment. We are pleased to draw attention to this deserving case, and recommend it to our homoBopathic brethren. Miss Tarr is seeking to obtain one of the out-pensions of £20 a year, granted in such cases.
PROGRESS OF HOMOEOPATHY.
'* You are all aware that homoeopathy has been a very great puzzle to a large class of deeply interested persons for about a hundred years. Its funeral has been cheerfully anticipated daily during all that period ; but notwithstanding the amount of ' regular ' surgery to which it has been subjected, there are still no positive signs of its early demise. Poets have sung its requiem. Prophets have foretold its destruction. Savants have criticised its philosophy adversely. And medical scientists have
KA vnTAmTTA Monthly HomoBopa^
0*t XHOTAHiljiA. Sa-vipw. Jan. 2. 1881.
Review, Jan. 2, 1881.
pronounced it a delusion. At first, as a matter of course, homoeopathy was purely a doctrine. Wait, said its opponents, until it is hrought to the test of practice. That will end it. But that was the thing which precisely did not end it. It grew stronger. Introduced into famihes it soon made for itself there a domestic stronghold. Wait longer, said its opponents. It may flourish in private and grow fat upon domestic ignorance, hut let it be brought to the pubhc test in hospital and other pubhc service ; then it will assuredly collapse. But now for many years homoeopathy has been increasingly represented in armies, and public hospitals, and everywhere its history has been the same. Not one word drawn from its practical results in these departments has ever been uttered against it. Further- more, the death records of great cities are open to the inspection of all men. If homoeopathy were a failure in practice, those records would show it, and we and our patients alike would desert it in terror. Now, if the theory of any system of thera- peutics were to be proved absurd in a hundred different ways, it would not avail, so long as the practical results all point the other way. Neither wSl any amount of demonstration of the scientific superiority of a medical system avail anything, so long as practical results fail to attest such superiority. Of course, this proves nothing for or against the theory of our school. It simply declares its practical success." — Dr. Foster , Chicago,
THE BIPORTANCE OF THERAPEUTICS.
** The International Convention (old-school), which followed our own in London, was notable for the poverty of papers and dis^ cussions upon the subject of therapeutics; indeed, in this particular it may be said to have been almost a blank. Pathology and kindred sciences were splendidly represented, but on the subject of therapeutics these learned men from all parts of the globe were silent. One would imagine that the medical treat- ment of disease was no part of a physician^s duty. This was in marked contrast with our own. General medical science was for the time waived aside, and attention strictly devoted to the subject of internal therapeutics. I refer to' this to illustrate marked characteristics of the two schools. The unsatisfiictory results obtained from drugs as administered bv the ordinary praclice has had the cftoct of creating widespread scepticism in their nmks as to the value of medication at all (giving rise to the common remark that * such a doctor gives little or no medicine,') the profession devoting themselves to the study of pathology, Burgery, hygiene, and other practical branches, and pursuing vhat is called the * expectant method.* On the other hand, the practitioners of homoeopathy, with the clear light of a guiding
^^rJ^^%!^ NOTABILIA. 55
principle of drag action to direct them, have become more and more convinced of the efficacy of drags in the core of disease, and since the days of Hahnemann have devoted themselves to the reconstraction of the Materia Medica upon a physiological basis, in order to make every known medicine available for the core of disease." — Br. MeCUlland^ of Pittsburgh.
SMALL POX IN CHICAGO.
The New York Medical Becord says that of 1,859 cases of small- pox in Chicago since January 1st, 40 per cent, have proved fatal. Most of the cases have occarred in those districts where the more degraded portion of the foreign element lives, and where attempts at vaccination have at times been met by open violence. In that part of the city there are 40,000 persons who have not been vaccinated, and of the 108 deaths in September, 81 occurred amongst these.
OUR REVIEW.
Drs. Pope and Dtce Bbown have much pleasure in stating that Dr. Abthxjb Kennedy, of Blackheath, has, at their request, joined them in the editorial management of this journal.
Dr. Kennedy^s intimate knowledge of the practice and litera- ture of his profession, his thorough comiction and open avowal of the truth of homoeopathy, as well as his proved literary ability^ assure them that his accession to the staff of the Eeview will be to the advantage, both of homoeopathy and of the periodical which has endeavoured to represent its interests during the last twenty- five years.
BRITISH HOM(EOPATHIC SOCIETY.
The next meeting of this Society will be held on Thursday next, the 5th instant, at 7 o'clock, when a paper will be read by Dr. Meyhoffer, of Nice, on An Unusual Case of Acute Pulmonary Disease, with Remarks.
Dr. Roth has kindly invited the Members of the Society to witness a demonstration of the Movement- Cure, and a meeting for the purpose wiU be held at his house, 48, Wimpole Street, on Thursday, January 19th, at 7.80 p.m. Dr. Roth will be glad to have a card of intimation beforehand from such Members as purpose to be present.
66 OOREKBPONDBNOE. ""^^J^SSfT?^
Beyi6w, Jan. 2, 1882.
CORRESPONDENCE,
THE MANAGEMENT OF THE LONDON HOMOEOPATHIC
HOSPITAL. To the Editors of the Monthly Homeeopathic Review.
Gbntlbmem, — I have always endeayonred to stimnlate the medical profession into taking a more active interest in the wel- fare of onr hospital. The members of the medical profession, and they only, are able to influence effectually the homoeopathic section of the public, and it must be principally through their exertions that we can look forward to seeing the 72 beds which the hospital now accommodates occupied by patients. The notice of a recent meeting of some of the medical subscribers to the hospital, which reached me through the courtesy of our much esteemed senior medical officers, induces me to ask you to find space for this letter in your next issue. It is written with the simple view of affording all the information in my power, for it appears that the position and modus operandi of those who are responsible for the working of the hospital are not sufficiently well-known to the profession generally.
In order that good may result from any discussions re the hospital it is absolutely necessary that our friends should not be led astray on a false issue ; but that they should know the exact facts which have to be dealt with.
It is a collateral advantage accruing to the hospitals from the existence of the ** Saturday " and " Sunday " Funds that they impose the necessity of a close supervision of the expenditure of the institutions to which they make awards. Extravagantly conducted hospitals do not reap the full benefit of these funds, and the returns published furnish an excellent basis for a general comparison of the working of similar institutions. How, then, does the working expenditure of our hospital compare with that of its contemporaries 9 The following table, which speaks for itself, and the figures in which are those furnished in the 1880 Beport of the Hospital Saturday Fund, answers the question in a favourable way : while under the heading ** Observations " will be found my own calculation, based upon the average annual ordinary expenditure, and the average annual cost of manage- ment, with the proportion the latter bears to the former.f Even
Obbkbvations. t Average axmual ordinary expenditure — calculated on the last six years, 1875 to 1880-81 inclusive. (including salaries
and costs of management) ' £3,692
Average annual cost of management —
A. — Salaries £444
B. — Advertising, printing, postage, petty ex- penses, and stationery 181
•626
* Equal to 17 per cent, of the total expenditure. Note. — Under the heading A are included salaries of the official
K^SrSaf^ 00BBB8P0NDBN0B.
57
ihe percentage thas shown will be considerably reduced during the •current year, as will be seen by another paragraph of this letter : —
TABULAB STATEMENT— L CoKPAaAiiva Tablb of ths Cost of MAKA0BIIENT of sbybral
HoaPITAIf WIIH AM ApPBOXIIUTSLT CORBBBFONDINa KUMBSB OF
In-Patuntb. (Taken fsok ths Hospital Satubdat Fund Bktubn fob 1880.) ___^_^
Kajb.
Cancer
Great Northern ^
Hospital for Women... London Homoeopathic
Metropolitan Fr^
Poplar
Boyal, for Diseases )
of the Chest j
Samaritan, Free
West London.. m»>*
Adduss.
Brompton
Caledonian Boad . . .
Soho Square
Great Ormond St. . Commercial St., E. EastLidiaDookBd.
City Boad, E.O. ...
Lower Seymour St. Hammersmith Bd. .
No. of
In- Patienta^
306 350 440 494 279 463
249
446 569
Cortof Management.
No. of
Ont-
PatientB
£ 8. d.
1,413 14 4
508 15 7
878 13 9
468 18 11
851 13 5
407 8 11
574 18 0
1,145 11 653 13
0 8
721 8,152 3,565 6,903 48,122 4,564
6,872
5,197 21,532
Committees have heen from time to time appointed — one in 1878, to consider the dietary and other expenses of the hospital. A chief resolt of the lahonrs of this committee was a con- fiiderable reduction in the cost of ** Ward washing," which had attained a very high figure. Economies effected under the head of "Provisions," *' Coals and wood," and ** Gas," caused a total reduction in the expenditure of the year 1878, as compared with 1877, of £S61 ; although 21 more in-patients were treated in 1878 than in the previous year.
Another committee, in the month of February last, went fuUy into the question of the expenditure generally, and some reduc- tion has been effected in tiie staff of servants, and by the em- ployment of a boy in the dispensary at lower wages than the youth previously engaged.
For making a comparison of the present cost of maintaining the London Homoeopathic Hospital — (including in that term the cost of management) — with that of the previous years, it must be noted that, although the cost of several important items under the heading '< Expenditure" has been reduced by entering into favourable contracts and dealing at the Civil Service Stores, the increase in the number of nurses for the more efficient working of the hospital wards, and the supply to the nurses of uniforms (the total cost of which for the whole staff, since the measure was first sanctioned in October, 1877, has been £126 15s. lid.) ogether with an unavoidable enlargement of the domestic staff
manager and secretary, and pomidage to the collector. And under B are included expenses for each item chargeable to the medical staff and nursing institute.
68 COBBESPONDBNCB. '^^SJL^SfTtSJf
Beview, Jan. 2, 1888;
(chiefly in consequence of additions to the hospital hnildings) have prevented a greater reduction being made in the gross expenditure.
Besides, it is notorious that the general cost of living, of servants, taxes, &c., has materially increased within the last ten years or so, and consequently it is fallacious to suppose that an increase of, say, one-third to the annual income of the hospital enables the Board of Management to maintain a correspondingly increased number of patients. The nurses now employed in the wards of the hospital also cost more in maintenance, and the ex- penditure on account of the Internal Staff of the hospital is much higher than formerly.
On the other hand, the income, which remained almost stationary for some years prior to 1875, has been steadily increased by efforts made to that end ; but the benefit of such increase has not hitherto been folly felt on account of the arrears due upon the accounts of former years, which have had to be gradually extinguished, and the large and, until now, increasing expenditure under the heading of " Repairs," which, from the nature and character of the bmldings forming the hospital,^ and the fact that repairs of all kinds had been, as much as possible, deferred from year to year until they could no longer be avoided^ has formed a large item in the yearly balance sheet, wholly independent, it must be borne in mind, of the special expenses incurred for drainage and other works paid for out of the '' Reser\'e Fund."
In considering the cost of management^ it is, of course, neces- sary to distinguish between gi'oss expenditure and that incurred for management.
The expenditure incurred for mamtmance is comprised under the following headings : — Repairs, rates, taxes, provisions, clean- ing, washing, fuel and light, dispensary, surgical appliances^ salaries of chaplain, resident medical officer, lady superintendent of nursing, dispenser, housekeeper, wages of nurses and of servants and porters. And that of management is composed of salaries of the official manager and the secretary, poundage on collections to the collector, and advertising, printing, postage, petty expenses,, and stationery.
The ordinary income of the hospital consists of dividends on stocks ; donations ; subscriptions ; Dr. Quin's annuity (since 1879 inclusive) ; registration fees ; Hospital Sunday and Saturday Funds ; rents ; and nursing fund.
The ordinary expenditure is included under two headings : (A) maintenance, and (B) management. The following tabular statement (11.) shows, in detail, the amount expended under each heading since 1875, inclusive ; that is, for the last six years, for which, as usual, the official annual reports have been published with balance sheets audited by public accountants : —
Mkmthljr HamoBopathio Beviev, Jan. 2, 1882.
OOBBESPONDENCE.
69
TABULAB STATEMENT H.
|
1876 |
1876 |
1877 |
1878 |
1879^ |
1880-81 |
|
|
Patiekts. |
■ |
|||||
|
Total Number of Patients id xear «•• ••« •*■ ••• |
|395 |
461 |
631 |
662 |
494 |
484 |
|
Daily Average for the Tear ... |
a |
60 |
46 |
46 |
39 |
89 |
|
Number of Days each Patient wasBesident |
a i |
89 |
87 |
36 |
27 |
27 |
|
NUBSING StAPF. |
||||||
|
Average Number of Nurses on |
\ |
|||||
|
the Staff doring the Tear |
. 6 |
h |
h |
18 |
22 |
18 |
|
(including the Lady Super- |
A^ |
|||||
|
intendent of Nursing) |
i |
|||||
|
Average Number employed |
6 |
h |
h |
7 |
10 |
7 |
|
constantly in Out-Nursing... |
V |
|||||
|
Average Number otherwise maintained ••• |
6 |
h |
b |
11 |
12 |
11 |
|
DoMEBTio Staff. |
||||||
|
Average Number of Servants, |
) |
|||||
|
Porters, &c. (including the, |
s |
9 |
10 |
10 |
12 |
12 |
|
Housekeeper) |
) |
|||||
|
EXPENDITUKE |
||||||
|
Provisions. |
£ |
£ |
£ |
£ |
£ |
£ |
|
Meat ... ... ... ... |
616 |
662 |
727 |
606 |
652 |
646 |
|
Bread ... |
103 |
103 |
134 |
116 |
126 |
115 |
|
Butter, Eggs, and Cheese |
111 |
119 |
162 |
137 |
166 |
149 |
|
209 |
238 |
314 |
257 |
189 |
204 |
|
|
Grocery... |
104 |
112 |
126 |
120 |
137 |
111 |
|
J> XoU ••« ■•• •■• ■». |
60 |
66 |
74 |
63 |
69 |
66 |
|
Greengrocery |
64 |
68 |
77 |
64 |
61 |
46 |
|
■Docr ... ■•• ... ... |
64 |
41 |
62 |
31 |
36 |
38 |
|
Wines, Spirits, <fec |
89 |
62 |
63 |
24 |
34 |
36 |
|
Housekeeper's Sundries |
28 |
26 |
26 |
16 |
14 |
19 |
|
Cleaning |
8 |
20 |
13 |
11 |
12 |
18 |
|
66 |
66 |
69 |
77 |
79 |
75 |
|
|
61 |
74 |
148 |
125 |
98 |
96 |
|
|
£ |
1,498 |
1,636 |
1,964 |
^1,646 |
1,651 |
1,606 |
Obsbbvations.
a For the year 1876 no statistics or records are in existence, from 'which the required information can with certainty be given.
h In 1876 and 1877 the Lady Superintendent of Nursing did not furnish a weekly return of nurses (as is now done), and consequently there are no- flgnrea or documents available for calculating the required averages.
60
OOBBEBPONDENOE.
Be?iew, Jan. S, 188i.
|
1875 |
1876 |
1877 |
1878 |
1879^ |
1880-1 |
|
|
Bzotight forward £ FUML AXD LlOBT. Coals and Wood UbB ••■ ■•• ••• •«■ |
1.498 |
1,636 |
1,964 |
£ 1,646 |
1,651 |
£ 1,506 |
|
134 91 |
167 108 |
154 119 |
115 114 |
170 183 |
129 111 |
|
|
Mbsical. |
£225 |
275 |
273 58 22 |
229 |
353 |
240 |
|
Dispenaaiy ••• ••• ••« Siu^;ical AppUanoes |
58 |
53 54 |
60 60 |
69 90 |
81 32 |
|
|
OmciAi.. |
£58 |
107 |
80 |
120 |
89 111c 34 60 |
113 |
|
Printiiig and Stationaiy Advertising Postage and Petty Expenses... |
57 23 27 |
82 54 40 |
99 48 64 |
67 19 48 |
148e 44 75 |
|
|
HOUSB. |
£107 |
176 |
211 |
124 |
205 |
267 |
|
Famitnre ... ••> Aepaifa ... ••• •*. ... Bates, Taxes, and Insurance |
181 170 86 |
69 79 87 |
137 203 79 |
247 221 105 |
289 191 78 |
203 143 122 |
|
Batj^rtkr and Wagks. Medical Salaries— Resident Medical Officer d Lady Dispenser Dispensaiy Boy |
£437 |
235 |
419 |
573 99 70 17 |
558 118 71 19 |
468 |
|
100 50 14 |
96 50 10 |
106 61 16 |
116 76 25« |
|||
|
Nursing Salanes— |
£164 [ 50 171 |
156 |
183 |
186 |
208 75 377 |
216 |
|
Lady Superintendent of Nursing ••■ .*• ... JDI uxBCS ■•• ••• .*• |
66 157 |
75 261 |
75 306 |
75 360 |
||
|
T^OTiiefftic ^Iftrif^fl — |
£221 |
223 |
326 |
381 |
452 |
436 |
|
Housekeeper oervants ... .*• •»• Porters ^ |
36 64 62 |
35 77 62 |
39 97 62 |
42 104 62 |
42 117 69 |
89/ 121 69^ |
|
£162 |
174 |
198 |
208 |
228 |
229 |
|
|
Chaplain ... ... |
25 |
25 |
25 |
25 |
25 |
25A |
|
Gross Totals £ |
2,897 |
3,007 |
3,679 |
3,492 |
3,669 |
3,499 |
Obsebtationb. e The increase in these two years is due to : —
1. Sums overdue from the year 1878.
2. A new set of account books, and reprint of other books.
3. Fuller annual reports, and greater publicity given to the Institution. d The cost of the Assistant Besident Medical Officer is distributed
over the provisions.
e Bednced in the year 1881-2.
/ The present salary of the Housekeeper is £36.
g The wages of the Porters at the present time are at the rate of £40 a year.
h A Special Fund is annually raised towards meeting the salary of tha Chaplain.
MdBtUf HomoBopathie Bevi0ir, Jan. % 188S.
COBBESPONDEHGE*
61
OmciAL Staif.
1875
Official ICanager Socrotuy
Golleetor
£800
100
84
Grofls Income from all sooroes £
INCOlfE m DETAIL—
Donations Sabscriptions ... BegiBiration Fees Nnrsing Fnnd ... DnrningBeds ...
.•• •■•
• •r
• ••
• *.
Total...
••♦^ ••.
Bazaar ... Special ParpoBes Fund B'hie Art Distribution.. • Dramatio Ferformanoea
Total...
.. . *.
£884
2,699
1876
300
182
76
1877
♦166
169
86
3,727
487
1,019
807
180
1,998 91
... ... ...
... ...
Dividends •••
XbBDCB ... ...
Dr. Qoin Annuity Fund Hospital Sunday Fund Hondtal Saturday Fund Faymg Patients
• a.
•••
.*• ••*
Gross Totals £
498
1,218
287
190
2,188
3.084 272
247
96n
3,699
2,188 289
1878
820
160
88
407 899 668 462
1879-80
227
160
86
3,441
617
1,674
264
202
4,749
804
1,661
286
899
2,657 266
••• ...
... ...
260
2,727
2,822
290 26
... 216 88nl
2,660
1,377 102
4,681
888
1,703
310
612
1880-1
276 150 88i
60S
4,380
4,129
223 180
• • •
210 67
8,441 1 4,749
8,008
577TO 88
8,678
243 180 240 216 68 76
495 1,482X; 272 6261 420
3,294
110
222 180 260 245
47 82
4,681 4,880
The Legacies reoeiyed in these years were : —
1877 A700
xOfV'OU ... •«• ••• •.• ^Uv
IcSoV-pX ... ••• ... ••• vU
£960
Obsxbyixioks.
* Tear of Mr. Tmeman's retirement* i Appearing in balance-sheet •••
Buanoe due from previous year •••
Actual Amount
•••
£74 8 10 9 12 5
£88 16 8
k In 1880-81 the subscription of the London School of Homooopathyr £867 10a, was not paid.
Z Gross total of Iffursinff Fund Beoeipts, without deducting Nurses' wages.
SI Including £448, which appeared in the separate balanoe-sheet published for the first three months of 1879.
II Two years' Awards paid in one sum.
€2
corkbspondbnce;
Monthly Eomoaoitathie BeTiew, Jan. 2, 1882.
The following tabular statement shows the " ordinary" income and *' ordinary" expenditure during the same six years. It will be observed that, for the first four years, there was a deficU ; for ihe last two years a surplus : —
TABULAB STATEMENT— m.
|
YSAB. |
1876 |
1876 |
1877 |
1878 |
1879-80 |
1880-1 |
|
Ordinary Income Ordinary Expenditure |
£ 2,602 3,108 |
£ 2,729 3,394 |
3,180 4,029 |
3,272 3,843 |
£ 3,971 3,897 |
£ 3,767* 3,367t |
|
Deficit |
506 |
665 |
849 |
671 |
— |
|
|
Surplus |
» ••• |
£74 |
£390 |
The income from special efforts during the past four years has amounted, in the aggregate, to d62,620, and it has been applied towards extinguishmg the deficits just mentioned and oth^ expenses.
The expenditure for the current year will, it is estimated, show further reductions, and in future years under the heading of " Management y'' a saving of about JSIOO will be effected, owing to the Official Manager having, at the commencement of the present financial year, spontaneously and for the good of the hospital, waived his claim to future commission upon new income traceable to his exertions. This commission was accorded to him at the date of his appointment.
The cost of management will then be at the rate of £50 a year more than in 1875, and previous years, owing to the pay of the Secretary being higher than that of the clerk then employed ; but such increase of pay is fuUy justified both by the very great amount of additional work performed now, and the fact that the present Secretary has largely and successfully exerted himself to increase the income of the hospital by means of donations and subscriptions. When he was &rst appointed his salary was fixed at the old rate (£100 a year), with a commission of 10 per cent, upon new income traceable to his exertions, and within the first half-year after his appointment he received commission upon
* In this amount is included only the profit derived from the Nursing Fund. If the whole receipts are included — m in the case of the former ■^ye years— the total ordinary income becomes £4,192.
f The salary of the Lady Superintendent of Nursing, and the wages of the nurses, amounting, in idi, to £435, are not included. If that sum be added to £3,367, the total rdmary expenditure becomes £8,802.
S^JSnS^ COBRESPONDENOB. 63
£65, chiefly new subscriptions. In the next eight months, until the appointment of the present Official Manager, he received com- mission upon £486 odd. It was then thought better to increase the fixed salary of the Secretary from £100 to £150 a year, and to cease to pay any commission, and this has been found to work yery satis&ctorily, while the Secretary has still continued to exert himself to obtain additional support for the hospital. It should also be stated that, within the first year after his appointment, Mr. Cross recovered annual subscriptions in arrear to tiie amount of £56 2s., which would otherwise have been lost to the hospital.
It is true that there is an increase due to the higher amount paid to the collector ; but that is entirely owing to the fact that his remuneration is dependent upon the amount collected.
Permit me, in conclusion, to point out that the medical pro* fession can best assist in the progress and efficiency of the hospital, first, by inducing their patients and Mends to subscribe to the funds ; secondly, by helping to fill the beds with interest- ing eases ; and, finally, by proposing new members of the Board of Management. The Board is always ready to welcome a new and useful member, and if medical governors could recommend any of their body for appointment to ^e Board, I am perfectly sure that the present members of the Board would be sensible of the value of such additions. What is there, for example, that should prevent the utilisation on the Board of the experience of such well-known members of the medical profession as Dr. Black and Dr. Dunn, who are no longer in active practice ?
I am, Gentlemen,
Yours teuly,
Wm. Vaughan Morgan, Treasurer of the London Homoeopathic Hospital.
Ghreat Ormond Street, W.C, December 12th, 1881.
To the Editors of the Monthly HomcBopathic Review,
GsNTLEMSN, — ^Dr. Berridge has kindly directed my attention to page 786 of your last number of the Beview. The symptom " singing noises " is the one which first directed my notice to sanffuinaria, and this symptom occurred in my case-book, together with the symptom ''voice seems to come from a distance ; " the former being the one noted in the Cypher Repertory, The two symptoms should have been written in full, and conjoined and placed before the reference to the Repertory in the case reported.
18, St. James' Boad, I am, yours, &o.,
Liverpool. S. H. Blake.
December 6th, 1881.
64 GOBBBSPONBENTS. ""ffiL^JS!*?^
Bcnrieir, Jan. f , 18B2.
NOTICES TO CORRESPONDENTS.
^\ We eanncA tmdertaie to retmn r^jtcUd montciertjptc.
Dr. MooBB (of Liverpool), TrMumrer of the Wright fond— writes to say that he feels greatly obliged to those friends who haye responded so promptly to "the Gircnlar." He is still Teiy far short of the smn required, and hopes the arrival of the New Year will excite ImieTolent emotions in the hearts of many others towards the widow and the father- less.
Commmucations, Ao., have been reeeived from Dr. Both; Bilajor Yauohah-Mobgar ; Captain 1£atoocx; Mr. Cboss, and Mr. Wxborx (London) ; Dr. Batxs (Brighton) ; Dr. Batnbb (Ganterbmy) ; Mr. 8. H. Blaex (Liyezpool) ; Dr. Scbivxh (Dnhlin) ; &c.
BOOKS RECEIVED.
IwumHy and iu TreatmanL By 8. Wocoester, MJ). Boerioke di Tafel New York.
Special Patholoffy and DiagnotU. By C. G. Bane, M.D. 2nd edition. PKdkdelphia : Boerioke A Tatfel. London': Trittmer Ss Go.
TrantacHom of the American IneUtute of Homaopathy. 1881.
Address before tJie PermsyUMmian State Homaopathie Society. By Dr. M*Glelland, of Pittsburgh.
The HonuBopathic World.
The Student's Journal,
The Medical News and Collegiate Herald,
The Chemist and Druggist.
Burgoyne's Magcuine of Pharmacy and Chemistry.
The New England Medical GoMette.
Vaccination Inquirer.
The Hahnemannian Monthly.
The New York Medical Times.
The Medical Advance.
The Clinique.
The Therapeutic Gazette.
The Medical Counsellor.
The Homesopathic Physician.
Boericke and TafeVs Quarterly BuUeHn.
Bibliothtque Homoeopathique.
Progr^ MedxctUe.
AUgemeine Hom. Zeitung.
Horn. Rundschau.
Boletino Clinico.
La Reforma Medica.
Papers, Dispensary Beports, and Books for Beview to be sent to Dr. Pope, 21, Henrietta Street, Gavendish Square, W.; Dr. D. Dtob Bbowh, 29, Seymour Street, Portman Square, W. ; or to Dr. Ebriiidt, 16, Montpelier Bow, Blaokheath, S.E. Advertisements and Businees oommmiioatians to be sent to Messrs. B. Gouza dt Soa. 59. MoorgSite Street, E.C. i . •^
S^^^VT^i^ COLLEGE OF PHYSICIANS. * ' 65
THE MONTHLY
HOMOEOPATHIC REVIEW-
THE ROYAL COLLEGE OF PHYSICIANS ON
HOMOEOPATHY.
On the 27th of December, 1881, an " Extraordinary '* meeting of the Fellows of the College of Physicians was held for the purpose of placing a sort of collegiate ban upon homceopathy. The promoter of this proposal was Dr. WiLKs, of Guy's Hospital. In bringing forward his reso- lution, he admitted that any attempt upon the part of the College to prohibit its Fellows from meeting homoeopathists in consultation would be inoperative ; and urged, that '' it would be ridiculous for the College to pass a strong reso- lution one day, and find that some of its leading Fellows disregarded it the next day. And," he added, " it might also be said, that there are some members and licentiates of the College who are homoeopaths, and a penal clause <;ould not be enforced against them. Moreover," he con- tinued, " there would be a legal difficulty in such enforce- ment. It was imperative on any College like that to grant its licence to every one who passed its examination, irre- spective of his opinions. The College could not hand a candidate his diploma one day, and the next take it from him ; and if the College could not deal with those who hold its diploma and practise homoeopathy, how could it deal with others who err less grossly ? "
VoL 26, No. 2. p
66 COLLEGE OF PHTSICUHS. ^^B^^I^Mffi*
It being thus perfectly dear that the College conld not deal with a Fellow who practises homcBopathj as it could some two hundred years ago, when it committed Dr. Gb(EN- VELT to Newgate for prescribing cantharides in inflamma- tion of bladder, jost as hcmMBopathists have done for the last eighty years, and as Dr. Rixgeb, in imitation of them, does to-day, it became necessary to find oat some other method of proscribing members of the profession, who openly acknowledge that they practise homoeopathically.
The objection to homoeopathy, was not, Dr. Wiles urged, one of doctrine. He added that for his part he repudiated the notion that there was any medical doctrine in reference to therapentics. " It was a device of the enemy to say that there was a doctrine." Dr. Wilks, ten years ago, announced the &ct that he had no therapeutic principles. Indeed, like Mr. Hosea Biglow's friend, he gloried
•* In hran' nothin' o* the sort."
Dr. Wiles not only has no therapeutic principles him- self, but he thinks it impossible that anyone should have any such principles — nay more, that the existence of such principles is impossible ! This is, however, the opinion only of Dr. Wiles and a few of his friends. Another of his coUeagues, Dr. Moxon, has openly sneered at the use of drugs as curative agents, describing them as merely *' stepping stones to &ith in the weaiy time/' Dr. Akdbem' Glabe, who also took part in the discussion at the Col- lege, has recorded in his address at the British Medical Association, 1879, his most emphatic contempt for medi- cines as aids to recovery in illness. Dr. Matthews DnvcAN has poured ridicule upon their prescription* Whence comes all this scepticism ? We believe that it is entirely due to the want of recognition of the fact, unblushingly repudiated by Dr. Wiles, that there is a
iT^TSffi!*** COLLEGE OF PHYSICIANS. 67
medical doctrine in therapeutics. That there is such a dodaJne, the experience of many thousands of physicians practising in different parts of the world during the last ei^ty years, testifies. Dr. Wilks refuses to examine the efidence on which it is based. He wilfully closes his eyes against it. Therefore, for him, it has no existence.
Having then, to his own satisfaction, at least, protested agUBst the idea that the dispute between homoeopaths and noQ-faomcaopaths was not one of doctrine, he proceeded to slate that the question at issue was one of mordU, The immcmdity of the homoeopathist consists, according to our ceouBor, in openly declaring that he believes in the existence of a therapeutic doctrine, and endeavours to the best of his ability to practise in harmony with it. According to the ethical views of Dr. Wilks, it may be eminently proper for a physician to practise homoaopathy, but extremely im- moral for him to admit that he does so. For Dr. Wiles to proclaim to the world that he has no therapeutic principle is perfectly right, but for any other physician to assert that he does believe in one, and that he acts accordingly, is, afortiari, immoral.
Sir THOHiB Watsom once described therapeutics, or treatment, as being ''the supreme end of our profession." Dr. Wilks regards looking upon treatment only, as a *' tradesman-like view of medicine." ''What," asks Dr. Wilks, "is a quack? A quack," he said, "is one who has to do with treatment only." For what, we would ask, do the sick public consult physicians, if not for treatment ? Treatment is the sole object with which a patient goes to his doctor. " Homceopathy," he added, " says that medi- cixie is simply a question of treatment." Homoeopathy says nothing of the sort. What homcBopathists do say is that treatment is the sole end of medicine. It is for the purposes of treatment that the various branches of learning
68 COLLEGE OF PHYSICIANS. ^S^'wfpSl^riS^
which go to make up medical science are studied. . Then, bursting with indignation, he insolently describes homoBo- pathy as *' nothing more than a glorified quackery, to suit the superior intellects of lord chancellors and archbishops." A physician who can thus describe a therapeutic method, to which he and many others are indebted for the most successful therapeutic hints they have ever obtained, can excite no other feelings than those of pity and contempt.
The next few sentences of his speech explain somewhat the cause of this ignorant exhibition of wrath. From these it appears that Dr. Wiles was about to be consulted by a gentleman sufifering from heart disease and dropsy, when a homoeopath was preferred before him. The patient got better. Learning afterwards that he had received digitalis and iron as medicines. Dr. Wiles said that he would have given the same medicines had he been consulted. The patient replied that he preferred the homoeopath because he was guided by a principle. This was doubtless very annoying to Dr. Wiles, but that a sick man should prefer a physician who was directed by a definite thera- peutic principle to one who boasted that he had none, that he was in fact a pure empiricist, is after all not very surprising.
Dr. Wiles has the insolence and audacity to rank physicians who practise homoeopathically, with advertising pill-mongers ! He ignores the fact that the wares of such persons correspond closely with the prescriptions which he, for want of a therapeutic principle, orders daily for those who consult him. The advertising pill-monger is much more nearly allied to the non-homoeopathic physician than he is to the homoeopathist. The recipes from which his ventures are compounded are mostly those of physicians of the Wiles type ! Then, again, he fails to recognise that the essence of quackery consists in its secrecy. " Buy my
B^r^bTiaK^''' COLLEGE OF PHYSICIANS. 69
pills/' says the quack, and you will be cured of whatsoeyer ails yon." The customer asks what the pill is made of, and no answer is vouchsafed. The homodopathist has never advocated the use of a drug, but of a principle of drug selection. This, so far from keeping secret, he has announced with every form of publicity ; and this publicity it is which constitutes Dr. Wiles' ground of complaint against him!
In the version of Dr. Wilks' speech, given in the British Medical Journal of the 81st December, he is said to have renoarked : '' The homoeopaths abused everybody else, and brought forward wonderful cases which no one else, could cure.'' After the amount of abuse which has been showered upon homoeopaths during the last half-century, it sounds rather strange to find one of their systematic abusers com- plaining that the very feeble retaliation, '' You're another," has been at times employed. In this controversy, we have nothing whatever to do with individuals ; all that we con- tend for is principle. We oppose nothing save methods of treatment that experience and observation have convinced us are ineffective, imperfect, or injurious, and, in proportion as they are either the one or the other, do we strive to enforce our views with clearness. For persons who practise homceopathicaUy every day of their lives, and yet never leave an opportunity of traducing homoeopathy unutilised, we confess thai we have no respect whatever. Nay, more, we believe that they are, to a large extent, impeding the development of scientific therapeutics. Then it is alleged that we bring forward '' wonderful cases which no one else can cure." That "wonderful cases" which have refused to yield to any but homceopathicaUy selected medicines are frequently reported in our journals is true enough ; but that they are such as " no one else can cure " is not true. Any physician could cure such cases, if he would but use the
70 COLLEGE OF PHTSICIAl^S. ^tS&^SS^UiSaL
same means. It is to imdace the use of snck rneus thsi they are published. They form not only the praeticai eTidenee of the tmth of our mMhod, but illustrations of how it may be put into practice. Did we withhold the knowledge of the remediea emfdoyed, did we keep silent as to how they were discoTered, the charge of secrecy woold be all^[ed against ns, and we might well then be looked upon as qnacks. But oar offence in the eyes of Dr. Wilkb is that with ns everything is done openly. HomcBopathistfl do not blow individnal tnunpets, or proclaim indindnal snperiority. The saperiority of their clinical results over those which Dr. Wilkb and similarly practising ^ysicians can show, is entirely due to the therapeutic method they adopt. This therapeutic method is open to all, may be known by all, studied by all, and practised by alL Whea it is so, the superiority of one physician to another will be a matter of individual ability, or of popularily.
The Lancety when announcing the meeting we are commenting upon, wrote as follows : — '* No one has a right to dictate how a man shall practise his art. That rests with himself, both in the mode and in the le^onsi- bility. But, whilst each has full liberty to act in hia practice as he pleases, it is an abuse of liberty to eooe tenance his assumption of a title in order to c<mvey to the laity the impression that his art differs irom the art of medicine as practised by his fellows ; that he is possessed of special virtues of which they are ignorant; that by coming to him people will be dealt with in a more en- lightlied way than if they went to others." Here, again, personality is confounded with a therapeutic method. That homcQopathy does differ firom medicine as commonly practised is true. It is because the difference consists in the greater control oyer disease which it enables the physician to have, that we have adopted it. A physietan
SSSn^JSTaff^ COLLEGE OP PHYBICUNS. 71
idio knows that homoBopatby is trae, and who feels that it is a truth of very great importance, one with which all physicians shonld be familiar^ and who recognises the fact that a large proportion of hi^ medical brethren are ignorant of it, is bonnd to testify to its tmth* That homoeopathy does present a more enlightened way of dealing with disease is the testimony of aU who have tried it, and compared the resolts they have obtained with those they were wont to meet with when practising after the manner taught in the schools*
We assume no special designation. Those who practise homcBopathically rarely announce the fact either on door- plate or Tisiting card. The doing so has been at all times diBconntenanoed by the British Homoeopathic and other societies. But, on the other hand, if a physician answers affirmatiyely to the question, ''Do you practise homoeo- pathy ?" he is at once told that he is a homoBopathist, and so in point of fact he is ; but this does not constitute the ''assumption of a title." It merely indicates the phyfflcian's belief in a medical doctrine which is not generally accepted as yet, just as in years gone by ihe disciple of Bboussais was called a Bboussaisist, and this, whether he " accepted '' the " title " or not.
We have given the College no excuse whatever for asserting that we have assxmied a title for trade purposes. We indignantly spurn the charge as one utterly and entirely fsdee and incapable of justification.
Indeed, laying so much stress upon this, so-eaUed^ assumption of a distinctive title appears to us to have for its object the encouragement of that crypto-homoeopathy which is so rapidly on the increase. Addressing in this resolution their members and licentiates, the Fellows seem to say, — "Practise howsoever you like, but say nothing about homoeopathy. We know nothing about it, except
72 COLLEGE OP PHYSICIANS. ^'S^^^rS^S©!
that we hate it, and if it gets known that yon practise homoeopathy we ahall be injured professionaUy. Great iff Diana of the Ephesians ! " This is, in reality, the inter- pretation of Dr. WiLKs' resolution.
Dr. WiLKS objeets very much to what he calls the assumption of titles, but he appears to have none to the assumption, at any rate, by himself, of impure motives on the part of those who practise homcBopathy. He said that the College, by agreeing to his resolution, " would help to remove difficulties from the way of hesitating students, some of whom, more worldly minded than others, were induced to start as homoeopathists from motives of trade- rather than anything else." How does he know that any do so ? What evidence has he to adduce in support of his base charge ? None whatever.
The resolution itself is as feeble as was the effort to justify it. It runs as follows : —
*' While the College has no desire"^' to fetter the opinions of its members in reference to any theories they may see fit to adopt in the practice of medicine, it nevertheless thinks it desirable to express its opinion that the assmnption or acceptance by members of the profession of designations im- plying the adoption of special modes of treatment is opposed to those principles of the freedom and dignity of the profession, which should govern the relations of its members to each other and to the public. The College therefore expects that all its Fellows, Members, and liceniaates will uphold these principles by discountenancing those who trade upon such designations."
It was seconded by Dr. Beale.
The resolution was objected to by Dr. Alexandeb, of Halifax, who moved the previous question, but both the
• Would not the word " power *' have expressed the true position and feeUng of the GoUege more accurately than " desire " ?
S^f^T^^ COLLEGE OP PHYSICUNS. 73
Lancet and BritUh Medical Journal carefully and signifi- cantly abstain from reporting his remarks.
Dr. Andrew Clabe did not regard Dr. Wilkb' moral groond as the right one. *' The trne ground was that when two men meet in consultation holding radically different opinions as to principles of treatment, it was impossible for them to hold any true consultation. No harmony and no good result could accrue from such a consultation. It must be a false one, and anyone sharing in it was guilty of an immoral act, and if the College permitted this it was par- ticipating in an immoral act." Considering that Dr. Clare has little or no faith in the power of drugs to cure disease, we do not see that he need have any scruples about sanddoning such as a homoeopathist would select. The only question that occurs to us here is, how anyone so sceptical as to ihe curative virtues of drugs, as Dr. Clare is reported to be, and, indeed, has avowed himself to be, can ever prescribe any at all !
Dr. BucENiLL — a lunacy expert'—said that his ground of refusal to meet a homoeopath was that '^ he could not believe that a well educated medical man, fully instructed in physiology and pathology, could, if honest, be a homoBO- path;" and thereupon he moved an amendment to the effect that ** the College, considering that no competent medical man can honestly practise the so-called homoBO- pathie system, is of opinion that no Fellow, Member or Licentiate of the CoUege should consult with any who adopt that system." This is rather a roundabout way of saying, as has oftentimes been said before, that all homoeo- paths are either knaves or fools ! Of one thing we are sure, that no person competent by study and experience to pronounce an opinion on homoeopathy could honestly make such an assertion. Dr. Bucenill is, we have no doubt, perfectly ignorant of the subject of his criticism. At any
74 COLLEGE OF PHTSICIAHS. '^^'i
1.
rate, this is the only exense irtiieh can be offered for his making a statement which reflects open no one but himself. To the credit of the Collie, be it said. Dr. Bucknill was persnaded to withdraw his atrocionsly shmderons amend- ment. It is not a little singolar that Dr. Wilson Fox's remarks on this amendment, as reported by the Lancet on the one hand and the BrUUk Medical Journal on the other, are directly opposite ! The Lancet makes him say that " He did not think any man coold honestly practise homoeopathy." According to the BrUi$h Medical Journal, he said, '* The College certainly coold not accept Dr. Bucenill's amend- ment. What conld not a man honestly believe ? "
The British Medical JoumoTs report was pnUished on the 81st December ; that in the Lancet on the 7th olt. It wonld appear as though the speeches had undergone a certain amount of '* cooking " during the interval !
Sir WiujAM Jenner posed, as usual, as the narrow- minded bigot he is well known to be. He objected to consultations with homoeopaths because they were not for the good of the patient. That, after all, is a question to be decided by the patient and the medical attendant*. If they think that such a consultation would be for the good of the patient, the physician may fairly assume that it will be so, until experience has proved that it is not. Then it will be time for him to withdraw. ** It had been said/' Sir William remarked, ** that we should meet them for purposes of diagnosis. Am I," he added, ^'a mere puzzle- Holver ? Am I to be paid so much for solving a pnaszle ? I go to do good to the patient, to ease or prolong his life." We never heard of a pathologist of the reputation of Sir William Jenner speak so contemptuously of the diagnostic art before. We will venture to say that Sir William Jenner*s opinion on diagnosis is much better ^\ orth paying for than is his therapeutic advice.
•SrtSlJrSrrM^ college op physicians. 75
Dr. Andbxw Clabk asked Dr. Wilis at the dose of the meeting to state in his reply what the Fellows were to do in regard to consultations with those who neither assume nor accept a distinctive title, bnt practise one system one 4ay and another the next.
We are not, however, permitted to learn in what way Dr. WiLKs proposed to solve this pnzzle !
Sir William Oull, we mnst not omit to notice^ seems to have been a little ashamed of the whole affair, or, perhaps, afraid of its effect upon the public, for he said, ** The question should be discussed only intra muros ; no vesolution should be published." There are, as is well known, some deeds that don't bear daylight. This, we quite agree with Sir Willum, is one of them. Neverthe- less, we hope that full publicity will be given to it, that the public may know on what sort of men it is that it is accustomed to rely in sickness. Men who boast that they have no therapeutic principles ; men who in medical societies talk of the utter worthlessness of medicines and write prescriptions for medicine all day long ; men who are utterly ignorant of the most scientific therapeutic method of the day, and denounce as dishonest those who have studied and now practise it: such are the leaders in medicine at the commencement of 1882 !
It is not a little singular that Dr. Wilson Fox casually ^ve the very best possible reason tor the use of the word homcBopathy — " to testify for the truth." Herein lies the sole necessity for the retentimi of a distinctive name for •a distinctive therapeutic method.
The doctrine, to the truth of which we testify, of which w« are witnesses, fw the defence and propagation of which we are responsible, is one, it must be remembered, which is not merely denied by a large portion of the profession, 4»ut.it8 very discussion is prohibited. It is not permissible
76 COLLEGE OP PHYSICIANS. ^^:^,^STJ^^
to allude to it in a medical society save in terms of con- tempt. No medical journal which is not devoted especially to the interests of homoeopathy, will allow the appearance in its columns of any paper based upon or clinically illus- trating it. While the editorial articles regarding it have^ with one or two exceptions, ever been devoted to studied misrepresentations of the doctrine and vilification of its. supporters. The very last article we have read — ^that in the Lancet of the 7th ult. — is a fair specimen of the lengths^ to which our opponents will go in deliberate misrepresen- tation. ** Nothing," says the Lancet, " now remains but the name. The infinitesimal dose has been repudiated and the doctrine of similars given up." To suppose that any medical man capable of writing an article in a medical journal did not know that, in making such st-atements as. these, he was publishing what was false and misleading, would be carrying charity into the region of credulity. Dr. Wtld's letters, published in 1877, which are referred to, give no support to these assertions. And if they did, they could but refer to Dr. Wtld. For though his mode of expressing his ideas of the limitation of homoeopathy was very far from amounting to repudiation, either of the infinitesimal dose or of the law of similars, still, even the extent of limi- tation to which he was prepared to go met with no- sympathy at all from any but a very small minority — an infinitesimal minority of his homoeopathic Mends.
Such, then, being the position in which homoeopathy stands as a therapeutic doctrine, and homoeopathists as the witnesses of that doctrine, it is our duty while pro- testing against the unfounded, unproven, and disgraceful charge of the College of Physicians, that we are actuated by trade motives in using the words homoeopathy, homoeo- pathic, and homoeopathist, when referring to the doctrine itself, to the institutions established to support or illustrate
JS^fF^nrSg"! ACTION OF DBUQS. 77
it, and to the persons who defend and practise it — it is our lK)imden daty to defend and propagate this doctrine by every means in our power ; to leave no stone unturned to draw the attention of the profession and of the public to it — to make homoeopathy known and appreciated is as much our duty as it is to practise it. The use of the words, which are so highly objectionable to Dr. Wilks, is one means by which we may keep the doctrine constantly in sight ; and it is almost the only means left to us. Excluded from the ordinary channels of communicating our views, we have created channels of our own, and the names they bear indicate their raison d'etre. The case of our School, Hospitals, Dispensaries, and Societies is in all respects similar. Until Dr. Wilks and those, who, in medicine, regard homoeopathy much in the same light as he does, are prepared to withdraw all impediments to the discussion, teaching, and practice of homoeopathy, we should be the most contemptible of cowards were we to do otherwise than maintain our position without the slightest regard to the feelings of the College of Physicians or the professional interests of its Fellows.
ON THE STUDY OF THE EFFECTS AND MODE
OF ACTION OF DRUGS.*
By Alfred C. Pope, M.D.,
President of the British Homceopathic Society ; Lecturer on Materia Medica at the London School of Homoeopathy.
In my lecture on Thursday last, I endeavoured to set before you the chief principles which guide the physician in the selection of his drug remedies. To-day I must ask you to follow me while I endeayour to examine the methods of studying the effects and the action of drugs upon the body in health.
Prior to the time of Hahnemann, the properties and uses of drugs as medicines had been guessed at rather than in-
* Deliyered at the London School of Homoeopathy, October 10, 1881.
78 ACTION OF DRUGS. "gS^^^ST?^'
Beriew, Feb. 1, 1662.
vestigated — imagined rather than enquired into. Trne^ Stahl and Yon Stoerck had noted the great want of exact knowledge respecting them, and had, in no ohsciure or doubtful language, hinted at the track along which those must travel who desired such information. To Hahnemann, however, accurate knowledge of the effects of drugs upon the health of man was a matter of importance of the first order. Without it the method of drug selection he had drawn attention to was practically useless — was indeed impossible. Hence the earnestness and zeal with which he pursued, and endeavoured to persuade others to pursue,, experiments with drugs.
"In studying the properties of a medicine," wrote the editor of the Lancet, on the 21st of last May, "it is always tried upon the healthy." If this is true, and I hope that it is so, it is to Hahnemann that medicine is indebted for the development of the method. Before his researches: were made, the only observers by whom this plan bad been adopted were some three or four — Haller,* Von Stocrck,t Alexander,! a Scotch physician, and another, who made some experiments on opium, were the only persons who had resorted to this plan of studying the effects of drugs with a view to using them as remedies in disease. Their experiments were few in number, and their example had no result. Neither is there anything remarkable in this,, for, as Dr. Bristowe recently said, " We must admit the truth of the homoeopathic view of the relations between medicines and diseases, before we can admit the special value of investigations conducted only on the healthy body." § How, I would ask, can we know what a drug will effect in disease without a previous knowledge of the distmbances it will work in the healthy body ? Manifold experiments have been made with drugs since the days of Magendie upon the bodies of cats, dogs, rabbits, and other animals ; the results have not been without their value, it is true, but this has not been seen in improved methods of treating disease. It is upon man that such experiments must be performed if they are to be of any service to man. Poisoning the lower animals with divers drugs, watching their effects, and comparing them with the alterations in
♦ Preface to the Swiss Pharmacqpaia,
t LiUUut d€ Stramonio, dsc, \ Experimental Essays,
§ British Medical Journal, AT3giist, 1881.
iKSSf^nX*!^ ACTION OF DRUGS. 79
tissue observed after death, are useful in supplementing investigations made upon the human subject by showing the parts that ultimately become affected, how they lead on to death, but they are in many ways misleading when relied on solely. They are so by reason of the different degrees in which different species of animals are affected by the same substance, as well as by the various ways in which the functions of life are performed by different animals. What we require to know in order to use a drug rationally in the treatment of disease in the human subject are the effects it will produce on the human subject when in health-
To obtain this knowledge Hahnemann instituted a largo number of experiments upon men and women. For the conduct of such experiments he laid down a series of rules ^liiich are fully set forth in the Organon. That you may possess a clear understanding of his method I will here summarise his rules.*
In the first place, he insisted on the importance of the drug being absolutely pure and genuine ; that it should be taken in the simplest possible form ; that, during all the time the experiment lasted, the diet should be strictly regulated, and that, not only should the observer abstain entirely during the experiments from all medicinal stimu- lants, such as wine, brandy, coffee or tea, but that he must have done so previously for some considerable time. Ho especially insisted on an absolute state of good health at the time the experiments commence. Describing the qualifications for a prover, he writes : " His body must be in what is, for him, a good state of health, and ho must possess a sufficient amoxmt of intelligence to be able to express and describe his sensations in accurate terms." Then, again, he directs that the medicine shall be tested upon both men and women, in order to reveal the alterations in health they produce upon the sexual systems.
The doses used by Hahnemann in proving or experi- menting with medicines, varied at different periods of his career. One of his earliest instructions in this matter was thus worded : *' In order to ascertain the effects of medicinal agents, we must give only one pretty strong dose to the
* Organon of the Healing Art, Fifth edition. Translated by B. E. Dudgeon, M.P. Ss. cxxi.— cxl.
80 ACTION OF DRUGS, ""S^^fSSTif;^
temperate, healthy person who is the snhject of the experi- ment, and it is best to give it in solution, if we wish to ascertain the remaining symptoms which were not revealed by the first trial, we may give to another person, or to the same individual, bat to the latter only after the lapse of several days, when the action of the first dose is folly over, a similar or even stronger portion, and note the symptoms of irritation, thence resulting, in the same careful and sceptical manner. For medicines that are weaker we require, in addition to a considerable dose, individuals that are healthy, it is true, but of a very irritable delicate con- stitution.*
Such, then, are the leading features of the rules laid down by Hahnemann for the use of those who assisted bim in the work of investigating the effects of drugs upon the human body. That they evince the greatest caution in ob- serving, no one, I think, will deny. That they were carried out to the letter every one, who is at all acquainted with the exacting character of their author, will readily admit. The son of one of his provers, now a physician practising in Boston, in the United States, ]ias assured me that his father was most precise in observing the minutest of the rules enjoined by Hahnemann. Hahnemann's character was of itself a guarantee that what he directed was carried out to the letter. He was, before all things, a man having authority, and how sternly he exercised this authority, how severely he rebuked and resented the slightest divergence from his instructions on the part of any of his disciples, the history of homoeopathy, during the first half of this century, presents many instances. That he had exercised the greatest care in collecting his observations, that he had studied them in a sceptical spirit, is shown by the late Dr. Constantino Hering, of Philadelphia, who thus describes Hahnemann's way of conducting provings : "After," he says, "he had lectured to his fellow-workers on the rules of proving, he handed them the bottles with the tincture, and when they afterwards brought him their day-books" — that is to say, the record of the symptoms of disordered health that day by day were observed and attributed to the medicine they were taking, " when they afterwards brought him their day-books, he examined every prover carefully about evei^ particular symptom, continually calling attention to the necessary
* The Medicine of Experience, Lesser Writings of Samuel Hahnemann.
^^^rrS^ ACTION OF DRUGS. 81
BcfTiew, Feb. 1, 1882.
accuracy in expressing the kind of feeling, the point or locality of the observation; and the mentioning of everything that influenced their feelings, the time of day, &c. When handing him their papers after they had been cress- examined, they had to afi&rm that it was the truth and nothing but the truth, to the best of their knowledge, by offering their hands to him — ^the customary pledge of the German Universities instead of an oath. This," adds Hering, ''was the way in which our master built up his Materia Medica." *
So Csir, then, we have good reason for believing that Hahnemann's experiments on the effects of drugs were made with as much caution as could be desired, and as thoroughly as the opportunities of the time allowed.
Voluntary experiments are not, however, the only sources whence we may derive our knowledge of the effects of drugs. Cases of poisoning are, in many points, of equal, and in some cases, of greater value ; while instances of overdosing in illness are to a certain extent, and when carefully and cautiously examined, also of use.
Hence, Hahnemann, in addition to his systematic ex- periments, made an extensive series of researches into the literature of medicine, and drew therefrom a number of cases of poisoning and of overdosing, which have materially aided us in our means of applying remedies. They are, in the earlier editions of the Materia Medica Pura, published separately from the details of experiments, under the title. Observations of others. These have of late years undergone both revision and addition. Dr. Hughes has examined, with much care, all the original details of these excerpts by Hahnemann, and he has both corrected, and in some instances explained the nature of the cases whence the recorded symptoms were drawn. These corrections, with numerous additional cases derived from modern medical literature, are all presented in that magnum opus, Allen's Encyclopedia of Materia Medica.
It was, be it remembered, almost exclusively from the facts given in this Materia Medica of Hahnemann that the adherents of his method during the first half of this century were enabled to obtain those results, which have led to the sound and wide basis upon which the reputation of homoe- opathy as a method of drug selection has been reared.
* A McM/aal of Pharmacodynamics. By Richard Hughes, M.D. Fourth edition, p. 28.
Vol. 2G, No. 2. o
82 ACTION OF DRUGS. ^"^^JF^SSST^
Dr. Bristowe regards the method pursued by Hahne- raann as one espeeiidly calculated to promote self-deceptioii. '' Think," he says, '* of the innumerable phenomena whidi a hypochondriacal old man, a youthful enthusiast in experi- mental research, or a credulous believer would find un4«r such circumstances arising from inconceivable doses of the most inert substances ; the itching at this point, the aching at that, the variations in the pulse, the watering of the eyes, the noises in the ears, the muscular startings, the eructations, the rumbling in the bowels, and many otiier matters of the same kind/'*
This is not the first time we have heard of criticism &t this kind. M. Trousseau, when on one occasion he was lecturing upon arsenic, said, '' We will not here speak of the singular reveries of hypochondriac homoeopaths, nmd the innnmerable symptoms they have discovered in ar^eme: we leave them in the ideas which they cherish and which they force themselves to believe."
To him replied another professor of Materia Medica, M. Imbcrt-Gourbeyre, of Clermont-Ferrand, who at the time when M. Trousseau's lecture was pubhshed wa'< investigating homoeopathy. He thought, and rightly, that as M. Trousseau had announced arsenic as a inxgy the Hahnemannic symptomatology of which was full of ^^ singular reveries " that he would compare the reoofd given by Hahnemann with the observations regarding arsenical poisoning in medical literature. To this end, a» he says, he " consulted all the books, monographs, essays, and ^eses on arsenic. There does not," he adds, '' exist the smallest observation of arsenical poisoning in aN degrees which I have not verified. I have given a place ia my library to all that has been published on this subject in Europe, as well as in America ; in France, as well aH in Germany ; in England, in Sweden, Eussia, in Italy, and everywhere. Not only did I wish to read everything, hot I desired to see and repeat for myself the experiments with arsenic in doses varying from that commonly used, up to the highest infinitesimal degree; and after this arduous work, which has lasted now nearly fifteen years, and which goes on yet, what was my astonishment when £ saw that Hahnemann in describing these numerous symptoms of arsenic, was in agreement with all tradition, with m
*■ British Medical Journal^ August 15th, 1881.
rS^'^^^T^SS^ action of drugs. 83
Banem, Feb. 1, 1888.
thoQsand observations of poisoning published by toxicolo- gists, with a thousand physiological facts^ published by the allopaths themselyes ; while, at the same time, I saw tiie same hcts perpetually repeated in my personal experiments.
My labours even show that the number of
symptoms caused by arsenic is still greater than that given by Hahnemann."^
While^ then, the researches of M. Lnbert-Gourbeyre famish us with, so far, a suf&cient reply to the objections of Dr. Bristowe, we may add here, that however plausible such criticism might have been fifty or sixty years ago, it is all too late now. During this time clinical observation has repeatedly and abundantly verified the general and, for ail practical purposes, the sufficient accuracy of Hahne- mann's observations, and has fully justified the correctness of his method.
I alluded just now to experiments on living animals as affording us means of tracing the effects of drugs until these are seen post mortem in alterations of structure. At the same time such observations constitute but supple- mentary, confirmatory evidence ; they arc not at all essen- tial— and when useful in any degree are only imperfoctly so — ^in selecting medicinal remedies.
Take, for example, the illustration Dr. Lauder Bnmton gives of the value of pharmacological research by experi- ments on living animals. In the fifth chapter of his work on Pharmacology and Therapeutics, he gives a full account of Magendie's researches into the action of upas poison. These involved the slaughter of a large number of frogs, and the experiments were, it must be allowed, both in- genious and exhaustive. He proved the absorption of the poison, that it reached its ultimate destination through the circulation, and lastly, that it acted directly on the spinal cord ; while that to its action on this structure its most marked effects were due. Dr. Brunton then quotes a pas- sage in which Magendie suggests what Dr. Brunton terms 'Hhe therapeutical employment of the first-fruits of phar- maoological research." '* Medicine would perhaps," writes the physiologist, '^ derive advantages iroxfi the knowledge of a substance whose property is to act especially on the
* Lectures PnbliqneB stir 1* Homoeopathie faites au Palais des Faealt^i de Clermonk-Fernuid, par A. Imbert-Gonrbeyre, Profesaeor de Mati^ra MWoide & rSooIe de Medioine de Clermont-Ferrand. Paris : Baillidre.
84 ACTION OF DRUGS. ^^^^L^SfbT^'
B«Tiew, Feb. 1, 1882.
spinal cordy for we know that many very seTere diBeases have their seat in this part of the neryons system ; but upas does not occur in commerce, and even though experi- ence should show it to be a precious medicine, how is it to be procured ? " Such being the case, Magendie proceeded to repeat his experiments with nux vomica, which he found to have an action almost exactly like that of upas. " While seeking " writes Dr. Brunton *' an opportunity to apply this in practice, his intention was forestalled by M. Fouquier, who was induced, probably by the publication of Magendie's research, to use nux vomica in cases of paralysis. His success was great, and the results he obtained were shortly afterwards confirmed by Magendie himself, who had used the drug as he originally intended before becoming aware of Fouquier's experiments. To pharmacological research, therefore," adds Dr. Brunton, " we owe one of the most valuable remedies we possess." In the first place, Magendie's pharmacological researches were published by him in 1809 — ^Hahnemann's in 1805. Secondly, Magendie suggested ntu; vomica in paralysis because it had a well marked action on the spinal cord, in which, as he says, many severe diseases have their seat. Fouquier's idea was that it would create an artificial tetanus, which would be advantageous to the patient; and when describing the efiect of a full dose upon a paralytic, he says it produces a state having all the features of an irritable tetanus. In short he endeavoured to stimulate the paralysed muscles to unwonted action, he spurred the tired horse, but he did not cure the disease upon which the paralysis depended. It was, in point of fact, an endeavour to develop muscle by motion. The tetanic movements excited by the strychnia were apparently regarded in the same light as those pro- duced by galvanism or Ling's movement cure. The action of nu^ vomica in paralysis is therefore anti-pathic, and as such is surrounded by all the dangers incident to the induction of the kind of action arising &om the anti-pathic selection of a powerful drug. It is now generally admitted that any value which mix vomica or strychnia may have in paralysis is limited to cases of a chronic character, cases which are insusceptible of cure, cases which admit only of relief. This they obtain — when they do obtain it — ^through the undue exercise of the stimulant properties of the drug upon healthy tissue in the neighbourhood of that which is diseased — not in any sense by the remedying of diseased tissue.
l£S5friSTSf^" ACTION OF DRUGS. 85
But suppose it were otherwise, suppose that these experi- ments of Magendie had led to the discovery of a remedy in paralysis — ^paralysis is a condition depending upon several morbid processes, all differing one from another, all requiring different remedial measures. To which of these did Magendie's experiments point, as that in which niLx vomica would prove curative ? To neither. The conclusion that it was useful in chronic paralysis was arrived at through clinical experiment. And it was only after it bad been given in cases of recent disease, and had resulted in increasing its intensity, as Trousseau and Pidoux* show, that it was reserved for chronic cases. It is, then, only in the roughest and crudest manner that Magendie's experi- ments can be credited with having given us a novel appli- cation of a drug.
By the observation of the effects of a drug upon healthy men and women, and by taking them as a basis of selection under the guidance of the principle of similars, Hahne- mann was able to predicate the exact case of a given form of disease in which a drug would prove curative. This such experiments as Magendie' s never have done and never could do.
They are undoubtedly of great interest and utility in demonstrating the locaUty on which a drug acts, and the precise tissues, disorder in which gives rise to the symptoms we observe, but they are far too inadequate to enable us to prescribe on homoeopathic indications. They explain very many of the symptoms produced by ntux; vomica^ and especially that irregular muscular action — ^that spasm — which is seen so frequently in the course of studying its effects upon health.
Dr. Brunton is then, I hold, in error — and Professor Fraser, at the recent International Congress, followed him here — in attributing to Magendie the credit of originating pharmacological research. Hahnemann was more than ten years before him in this work. He errs also in attach- ing an undue value to the work he did accomplish.
By looking to the effects of drugs upon the human body as the sources of our knowledge regarding their action we are able to put to a useful purpose the many accidents which occur from time to time in cases of poisoning and of
* Traits de TMrapeutiqxu^ et de Mati^e M^dicale, Ninth edition, p. 21.
86 ACTION OF DRUGS. "'SSSL^SKT?^"
, Pob. 1, 1882.
over-dosmg. Previously to this method of studying drug action and of selecting drugs as remedies, such cases had simply a passing interest, teaching us what to avoid rath^ than what to use. Many a useful remedy, like veratrum album, for example, has in the course of the history of medicine dropped out of use because too dangerous to be handled. When, however, its effects have been thoroughly examined, after the manner of Hahnemann, and the homodo- pathic principle of drug selection is applied, they become, as veratrtim albvm has become, valuable remedies.
That the method of Hahnemann — ^the studying of the effects of drugs upon healthy men and women, for the purpose of knowing how to prescribe them in the diseases of men and women, was a correct one, seems to me unquestionable ; it is simply a common sense proceeding ; one presenting the only way in which the requisite know- ledge can be obtained ; while, at the same time, the results which have followed the utilisation of the information thus secured have, as I showed to you in my last lecture, given ample evidence of its value.
We must however recollect that the means for enquiring into the nature and character of disturbances in health, whether such disturbances proceed from the ordinary causes of disease or from the use of drugs were, in Hahne- mann's time, very limited indeed. Physical diagnosis had scarcely any existence fifty years ago. The stethoscope, even, was unknown when these enquiries of Hahnemann were made. Now, however, we have ample resources for additional investigations. Hence, in the more recettt provings of drugs, chemistry, the microscope, and oiher measures for ascertaining objective phenomena have been brought into use. The studies which Dr. Sidney Ringer, Dr. Murrell, and others have made of gelsemium and some other drugs have added much to our knowledge of the effects they produce. The symptoms which should guide us in choosing our remedies are not merely subjective, but also objective; and one aim which the student of drug action should keep constantly in view is the careful investi- gation of the latter kind of phenomena as an especially important class of drug effects* Our aim in all such enquiries should be greater and yet greater precision, greater exactitude, greater completeness.
The example set by Hahnemann has been extensively followed, so extensively, indeed, that the number of sub-
ItS^^rr!^ ACTION OF DRUGS. 87
Aeview, Feb. 1, 18B2.
flttfices which have been made the subject of experiment is BOW very couBiderable.
Of these, some were made by Profcsser Jorg, of Leipsic, in 1881, and very &ir provings they are. " The several drugn were," says Dr. Hughes in describing Jorg's enquiries, ''taken in moderate doses, repeated (and if necessary jacreased) until a decided impression was made. The expefiments of each prover are related in full, just as they wore made, and aa the symptoms occurred. In the preface a description is given of the age, temperament, and consti- tution of those engaged in the work, and the assurance aSHded that all were in good health.''
Largely, too, have the resources of Materia Medica been added to by the researches of American physicians from whom we have received many valuable collections of experiments.
By British physicians, little has so far been accomplished. The investigation into the effects of the bichromate of p0fashy by Dr. Drysdale, is £he most important of any, and this is perhaps the best proved drug in the entire Materia Medica.
farther contributions to our knowledge of Materia Medica were made in 1842 by a society of Viennese physi- cians. These were for the most part re-provinga of drugs jpreviously experimented with by Hahnemann. In these experiments full details are given of the alterations in fa«ttlth occurring in each person while taking the medicine. While confirming the results recorded by Hahnemann, they enable us to obtain a clearer insight into the action of each drag than his method of arranging the symptoms permits OS to do.
This notice brin^ me to say a word about Hahnemann's anrangement. Hahnemann^ in my opinion, and I believe in that of most physicians who practise homceopathy, com- mitted a great error when he contented himself with pub- lishing mere Usts of symptoms, separating them from their coBiuction one with another. For as complete a knowledge uf a drag as is attainable, we require the details of each espeiimant^ the relation of the phenomena as they occurred ID each individual. The placing of all the symptoms of 4iffdieat piovers relating to one organ under the heading of &Kt orgaUy had done more than anything else, perhaps, to ntfd. an enquirer, to confuse a student, and to embarrass
88 ACTION OP DRUGS. ^'^I^^^r?^^
Beyiew, Feb. 1, 188S.
a practitioner. It is much to be regretted also that others should have presented the results of their experiments in the same manner. All disjointed as they are, however, these catalogues of symptoms have done admirable service ; while the difiGiculties they present in the way of studying the general action, and getting to know the chief points of attack of each medicine, are rapidly disappearing before the publication of such works as Dr. Hughes' Pliarmacody- namics, and monographs on different drugs which appear from time to time in our serial literature.
Again, another difficulty which presents itself to the student of the Materia Medica consists in the vast number of symptoms recorded as the effect of some drugs. This, however, admits of easy explanation. A little study and reflection will soon show that the number appears much greater than it really is. Thus, Hahnemann, it must be remembered, carefully noted every apparent disturbance of health in every one of his provers. He published every symptom that he could find attributed, with apparent jus- tice, to every case of poisoning he could meet with in medical literature. Hence we are perpetually finding the same symptom repeated in slightly different words, each being numbered as though it were a different symptom, or in- dicative of another form of ill-health.
Further, we often hear objections raised to the trivial and apparently fanciful symptoms which are set down as the effects of certain drugs. These, too, it may be remarked, contribute somewhat to the apparently considerable number of symptoms in the several records. Nothing perhaps impresses a physician who has been accustomed to pay attention only to the grosser and more obvious indications of drug action more unfavourably than the record of such symp- toms as these. Of this, the passage which I read to you from Dr. Bristowe's recent address just now is evidence. But that they are often important, that they are indeed real manifestations of morbid action, experience has proven, and that abundantly. I, for one, attach much more im- portance to them now than I did some years ago. I remember very well a poor, withered, nervous looking army tailor coming one evening to see me in York many years ago. He complained simply and solely that after a short sleep he was suddenly awoke by a noise in one ear like the crack of a pistol. After that he could get no sleep. Beyond feeling weak and nervous from the loss of
SSSS^Srr/S?^' ACTION OP DRUGS. 89
Beyitfw, Heb. 1, 1882.
his night's rest, I could get no indication of ill-health from him. I thought, here is a case to test the value of some of these qneer looking, trivial symptoms ; is there snch an one as this attributed to any drug ? I turned to the Reper- tory— the index of all the symptoms — and found that a precisely similar symptom had been remarked as the pro- duct of rhu8 toxicodendron. I gave the man a few pilules which had been soaked in the third decimal tincture of this drug, and after taking a couple he never had a return of the symptom, secured his night's rest, and rapidly re- covered his strength. This case had, I remember, much to do with curing me of neglecting symptoms that were apparently trivial. That such symptoms are often impor- ant, that they are indeed real manifestations of morbid action, and that they have proved of value in deciding the relative claims of two otherwise similarly acting remedies, is the testimony of every physician who has surmounted those prejudices of education which run counter to taking notice of phenomena of this kind, and has been ultimately guided in his drug selection by them.
We are indebted to Hahnemann for the development, as fully as was possible in his day, of the method of learning the effects of drugs by experiments on healthy persons. His enquiries have been fruitful in good results. They are, with the additional means of research within our reach, doubtless capable of being made still more useful.
In conclusion, let me offer you a few observations on the nature of drug action.
Homoeopathy, strictly speaking, has no concern with the modus operandi of drugs. It relates simply to a principle or method of selection in prescribing. Whatever views we may hold as to the action of drugs, when once introduced into the body, if we select as our medicines such as are similar in their effects upon the healthy body to those of the disease we desire to cure, we practise homoeopathy.
The explanations which have been given from time to time of Uie mode in which a homoeopathically selected medicine operates in promoting a restoration of healthy tone in a disordered condition, have been both many and various. I do not propose to detain you by discussing them. This has been well done already by Dr. Dudgeon, in his Lectures on Homoeopathy ^ published nearly thirty jears ago, and of which I, for one^ and I know that many
90 ACTION OF DRUGS. ^*SiSiL°iSS*?^'
Eeviev, Feb. 1,1882.
are like-minded, heartily desire that he would give ii& a revised edition.
The view taken by Hahnemann was that a medi/eiBal disease was exeited by the remedy similar to, but stronger than, that which was natural, and that the stronger over- came the weaker. This, of course, is pure hypothesis, and ' that, too, of a highly speculative order. It is, moreover,., one which no experiment has ever endorsed ; there ia, in. short, no evidence either of its truth or of its probability.
Dr. John Fletcher,* of Edinburgh, a very learned and' much-esteemed teacher of medicine of forty years ago, came much nearer to the probable solution of the question, how a homoBppafchically selected medicine operates, when he said that it consisted in exciting in the diseased tissues a condition exactly opposite to that which constituted them morbid.
Inflammation may, as has often been said, be regarded as the initial type of disease. The primary phenomenon of inflammation is a paralysis of the vaso-motor nerves of a. part, leading to dilatation of its vessels. They have lost their normal stimulus, and, until this is restored, health cannot be recovered.
The action of a drug is now pretty generally recognised as two-fold. Hahnemann, years ago, wrote of the primary and secondary action of drugs ; the latter being the opposite of the former. The primary eflect is usually to stimulate, . while the secondary is to depress. If, then, we give a, medicine in a small dose, the effect of which, taken in health in considerable quantity, is to produce a condition like that we have to cure, w^e are, in so doing, bringing into play the stimulating — ^ihe specifically stimulating pro- perty of the substance. In such a dose it will stimulate the dilated vessels to contract — will restore their lost tone r — will enable absorption of morbid matters to take place.
It is, then, as a stimulant — a specific stimulant to healthy action — ^that I am inclined to view the mode in which a homcBopathically selected medicine operates, when given in* an appropriate dose.
I say a specific stimulant. By experiments on healthy persons, and by cases of poisoning, we know, as I have-
* ElemenU of Pathology. By John Fletcher, M.D. Edinbnigh Maclachlftn & Stewart.
iii^SS^^TS^ MOTION OF DEUGS. 91
jmt pointed out, the parts the drug will affect, we know the tissues it will disorder, or, perhaps, I shoald say, if we folly understood the meaning of all symptoms, if we had it in our power to trace all back to the exact tissue affected, we should do so. But herein we are able so to do quite as much, when studying the symptoms of disease, as we are when investigating those produced by drags. At the same time we know full well that groups of symptoms, which are similar in kind and locality, are alike in their source. We therefore feel assured, whether we can demonstrate as fully as we would, both the seat and kind of action which is going on in a diseased body, or whether we cannot, that if we give a medicine producing a series of symptoms precisely similar to that expressing the disease, we are in very deed influencing the discnrdercd tissues, whatever they may be. Further, when we do so with a smaller dose, wc are directly stimulating these tissues to renewed vigour.
Homoeopathy, as I have already stated, is a method of drug selection, and does not define a mode of drug action.
A few weeks ago, the editor of the Lancet* in a very interesting and suggestive article on homoeopathy, seemed to plume himself on informing homcBopathists that drugs selected because of the similarity of their effects to those of disease cured by reason of their contrary effects. This I have shown you has been recognised for ftdly forty years ! Throughout nearly the whole of homoeopathic literature, during this period, whenever the modus operandi of a homceopathically selected drug has been discussed, it has been very firequently argued that the action of such a selected remedy was precisely opposite to that of the diseased process !
The mode in which a drug acts is very much a matter of speculation, doubtless yerj interesting, and very useful so £ur as it goes. Bui, a method of drug selection is 9k fact ; one eapabk of demonstration, without any theorising, withooi any speculation. Hahnemann's idea of the mode in which a homoeopathic remedy acted was doubtless enoneous, certainly, it was unsubstantial — ^but when he prescribed homceopathically, selecting his medicine on the ground of the similarity of its effects to those of the disease,
• May 21, 1881.
92 CLINICAL CASES. ^S2^.=igr??lS'
Beview, Feb. 1, 1882.
the results were as froitftd as though his theory of its mode of operating had been true to the letter.
Whether then^ as is probable enough, the homoeopath- ically selected medicine act on the principle of contraries or noty if it is chosen on that of similars, the whole idea of homoeopathy is fulfilled.
21, Henrietta Street,
Cavendish Square, W.
CLINICAL CASES, WITH EEMAEKS.* By S. H. Blake, M.R.C.S., LiverpooU
Case IV. Neuralgia cured by arseniciim.
Feb. 26. Sarah C, set. 28, of fair complexion and sanguine temperament. Temper irritable of late years since haying a family (five children). No ansemia. Colour of lips and face has been even better and more sanguine since her marriage. She complains of pain beginning at the top of the left frontal eminence near the temple, descending quickly thence to the left eye, '' making the eye jump and dart," and at the same time rendering "the head sore." She describes the pain as " shooting," and when it comes on it will last for hours. She also describes the pain as a '' shooting and burning pain like needles,'* also like " a cutting of the bones with hot knives," and at the time of the prevalence of the pain she cannot see with the left eye, but only sees as it were '^ fire coming out of it." At the same time the eye seems to go back into the head. The left eye also becomes bloodshot and ** runs water ; " but the right eye remains intact. With the pain she is very restless, and " buries her h«ad " in pillows and clothes, &c., pressing and covering it in the endeavour to get relief, and thinks she is going mad when sufiering in this way.
Concomitants are loss of appetite and white coated, tremulous tongue, all more marked during the pain. The attack begins at 6.80 a.m., and lasts to 8.80 p.m., or it
* Being part of a series of cases, the record of which gained for Mr. Blake the "Bpps*' prize of £10.
SSSS^STT!^ clinical cases. 93
B«Tiew, Feb. 1, 1882.
may begin at 10.80 and go on to 4 p.m. It never occurs at nighty at which time she feels quite well.
She is feverish during the attacks, and is then rather thirsty, but only then. The tongue is still tremulous in the absence of the attack. Arsen. cM. 8.c. pil. 8.h*
Mnstard and linseed poultice is the only thing she has tried which has given reHef.
She is suckling a baby, now four months old*
Feb. 28th. She reports that she has been a great deal better after the medicine, for the ** shooting " and ''burning" pains have been stopped 'since the 26th, and did not occur after the first dose ; whereas before coining for advice they had recurred daily, and always lasted for hours.
Although the symptoms had been thus bad for a week, they had also existed, though in a less severe degree, for some considerable time prior to the time referred to. All the symptoms having subsided, she has nothing further to complain of; but I considered it best to continue the medicine for a few days more. Repeat are. 8 t.d.
Both terms, "shooting" and "burning," were used voluntarily by the patient when asked to name the kind of pain. When questioning very partially educated persons it does not seem very wise to rely solely on their statements and lay too much emphasis upon the terms they use when describing them. It is, I think, quite common for persons subject to any rapidly passing pain to describe this as shooting. Our great difficulty is to know what each person actually means by a term of this kind when so used by them. Not unfrequently patients will absolutely refuse to describe the character of the pain at all, or repeatedly declare their inability to do so. One would suppose that education is the only remedy for this difficulty.
The ^' burning " characteristic of arsenicum is so well known as a generalisation that it hardly needs refereoce. But it does not appear to have been so well worked out and noted in provings in reference to neuralgia of the head, as in some other parts — the rectum and anus for example. There was a time when the provings had a beginning. Then progression came, and it is still going on. Com- pletion has not arrived yet. When will it arrive ? It may approach that much to be desired consummation soon, but in the meantime, generalisations are of no little aid, and
94 CLINICAL CASES. ^S^L^SS.'TSS'
Reriew, Feb. 1, 1682.
come in at times to the assistance of the " not to he done without '' localisation and its specification in quality.
Hence it is that wherever we find the characteristic nerve pain of arsenic, together with its concomitants, we oon- jecture that that medicine may effect a cnre. How can we always localise the pain in a patient in the very identical nerve in which it may have occurred only once in a prover ? If the drug have not been thoroughly proved or be a new medicine, it is a fact of most valuable import that it should have caused a pain of some special characteristic in any one nerve. This one link may be the key to its action with which it is consistent everywhere else. This diagnostic prescience is like that of the decision into which class or group an extinct animal should be placed when only ono of its extremities, or its jaw and teeth have been discovered. Though open to some doubt, this plan of decision i^pears to become sometimes useful, and therefore necessary. Yet even if we generalise the local head symptoms of arsenic, they are like enough to those of the woman cured to show the homcBopathic relationship. In what consists the necessity of this intimate relationship in order that a drug should be in the first rank and cure as homoeopathic ? The law ^' similia s. curantur," even *' similia similibus curen- tur,'* does not prescribe this application, yet both include it. "Like cures like," but in what respect must they be like in order that they shall cure it, other opposing laws not rendering this event impossible ? What conditions or what concomitants must be fulfilled in order that we may render our account to this law and anticipate its payment in full ? And again, in what manner or conditions must the weight be placed in the scale in order to prevent the opposite weight from obeying the law of gravitation ? If we knew the replies to these questions we could apply the law of similia with the greatest precision in cases where without method we shall fail in its correct application. Are we able to say that, setting aside other opposing laws and co-existing causes of disease, if we obtain the seat and character of a pain, together with its conditional symptoms, if any, and its concomitants, if any (belonging directly to it), that with the temperament corresponding in " contingent homoeopathy," and in any person with " abso- lute homoeopathy," irrespective of temperament, we are able for certain to cure, so far as that is compatible with fhe intactness of physiological persistency? An important
^^^ir^^' CLINICAL CASES. 96
-element comes in here as to the anticipated result, namely, the proportional quantity of disease present in respect of the size of the body and organs diseased, and the vitality and age of the patients, for the same amount of disease curable in one patient would appear to be sufficient to .produce a fatal result in another, in spite of any medication.
Taken from the provings, the sufferings from argenic are thus described : *' Anguish and despair, driving from one place to another for relief. The anxiety and restlessness are indescribable. * Kill me,' he cried, * or relieve my pains.' Violent headache. Severe headache, getting worse all day, ^ith constricted feeling at the temples. Headache on rising in the morning, worse on the left side. (But arsenicum does also cause right cephalalgia as well as left). Increase of headache at 11 p.m., with C(dd hands and face. Headache increased by light and noise (are we to ascribe the onset of the diurnal headache of ar$en. to this relation- ship to sun, light, and noises, for these are absent at night ?) Burning pain in the head. Pain as if bruised in external head, worse when touched, pain as if sore. Ago- nising pains about forehead and temples. Headache over left eye, violent at evening and night. Constrictive (drawing together) pain above eyes and in temples. (In my patient the left eye was, as it were, drawn backwards). Tearing stitches in the left temple. Dull beating pain in one half of the head, as far as above the eye. Violent neuralgia on left side of head, followed by lame feeling. Tearing pains. Violent pain in left eye. Burning pain. Distorted or sunken eye. Suborbital pains, with prickings as vnth needles, sometimes quite severe ; stitching pains. Sensa- tion round eyes and temples as if pricked with innumerable red-hot needles. At 1 p.m. sudden severe pain in lids, with painful prickings and lachrymation, lasting ten minutes ; burning in margin of upper eyelids. Eyes red, watery lachrymation. Inflammation of conjunctiva, mth snffusion and intolerance of light. Inflammation, violent and frequently recurring."
Here again is the periodicity of the arsenical action : ^*Eyes very red; bloodshot." *'Eyes retracted," the symptom cured in the case recorded.
There is a neuralgia beginning in the jaw and extending thence up the temple and over the whold head, which closely resembles arsenical neuralgia, but which is relieved «Jways on going into the open air, for which nwx vomica is
96 CLINICAL OASES. ^'^IFSSl^?^'
Beview, Feb. 1» 1862.
more snited than arsenic, and if mental grieyance be the cause I think ignatia might be preferred. Phosphorus, which also has relief in the open air^ has pulsating pain in the left temple, with burning, stinging pains commencing in the occiput.
The medicines causing pain from the forehead to the left eye are badiaga, and agntis casius.
From forehead or temple to eyes, berheris.
From forehead to eye, apis.
Case V. Cure of hemicrania by zinciim.
May Slst. A. C, a woman of 25, has suffered for months from what she calls " neuralgia," a yery severe pain, of which she cannot well describe the character, affecting the right side of the head, and the pain extends through the temple on the same side. It comes on in violent paroxysms, and the attacks are attended by vomiting and by a watering of the right eye. She suffers likewise from monorrhagia. If she take milk, it is soon expelled from the stomach in curds. Also during the attacks other kinds of food are vomited. She has had frequent attacks during the past fortnight, and she is not only affected during the menstrual periods but during the intervals also. The menses are both too early and too profuse.
Zincum S x gr. i. ter die.
June 3rd. Beports herself much better. " The neu- ralgia '* has now entirely gone. Since taking the medicine the attacks of pain duninished in frequency, and soon disappeared altogether. She has had no pain to complain of during the past three days. Bepeat medicine.
June 10th. No return of pain. Bepeat.
After this the patient did not require any further treat- ment.
The Materia Medica (and provings) supply us with the indications for zinctMn : —
** Hemicrania worse after dinner, tearing and stinging (note the association with food and the vomiting in the case cured by it). Cramp-like tearing pain in right temple. Pressure on vertex worse after dinner ; frequent vertigo, then nausea and vomiting of bile; face pale; costive; cerebral depression. Bight hemicrania — ^internal head-
^^'5rfi^^^ CLINICAL CASES. 97
Beview, Feb. 1, 1682.
-aches, mostly semi-lateral ; worse from wine, warm room, and after eating.
'' Eyes dim and watery ; fiEtce pale ; alternating with redness. After milk sonr eructations.
''Nausea in stomach, with retching and vomiting of bitter mucus.
'* Menses early and profuse ; lumps of coagulum pass •away when walking ; flow profuse at night. Ulceration of cervix ; acrid discharges and irritation of vulva."
*' Hemicrania is a disease which requires to be closely individualised." — ^Dr. Hughes.
The eye symptoms referable to zincum are apt to bs ■associated with cerebral or central nervous lesions; thus the eye sympathises with neuralgic pain or the hemicrania occurring &om the nervous centres on the same side of the brain. In this case, cured by zinc., we observe that the eye watered on the side of the head affected by pain during the paroxysm. The attacks of pain also were described as very severe. One of the maladies to which zincum is thus appropriate would appear to be a neurosis ; not necessarily confined, however, to the right side of the head.
Bight-sided and semi-lateral headaches have been pro- 'duced by a great number of medicines. The number of drugs also which have caused nausea, vomiting, or both, with the headache are also very numerous. Bovista .and conium are noted as having produced headache with lachrymation. For right hemicrania, with nausea, vomiting, we may refer to alm.^ bov,, ch-s.y con., coc, phyto., tab,, mez.y nux. vom. {sepia, san., noted as left-sided), also kali bic, asr. (bursting pain, with watering of the eyes), ghn., cavst., graph,, K. carb. (frontal), lack, and athusa.
Alumina, stitches in brain, with nausea, or throbbing frontal pain.
Bovista, deep headache, as if enlarged.
Cincliona, tearing, throbbing, bursting, or as if bruised.
Conium, bursting, stitching, tearing; sensation in right half of brain, as of a large foreign body. Pain moving on awaking.
CoccuLus, pain as if eyes were being torn out ; head as if screwed together, or pressed from within outwards; worse by eating, drinking, sleeping, and riding; better •during rest indoors.
Phyto., soreness deep in brain, or as if brain were
VoL 26, No. 2. a
98 CLIKICAL CASES. '^gS^^Sni^
braised ; megrim^ with backache and bearing down onoe a week.
Tab., early morning sick headache and worse by noon ; nausea and vomiting, aggravated by noise and light ; better in the open air.
Mez.y after exertion and talking much ; sensitiveness to slight contact, relieved by stooping ; sensation as if upper part of head were pithy.
Nux vom., pressive, boring pain, with sour vomiting and palpitation, worse from mental exertion, noise, coffee, and eating. Pressing down into head from vertex as if skull were pressed asunder. Bruised, sore pain; brain seems to shake when walking ; pain better in the open air.
K. bich.y semi-lateral headache in small spots ; sharp stitches in the bones.
Glonoin, throbbing ; relief only when quiet, the head and upper part of the body being elevated.
Causticum^ stitches, worse sitting or reading; also pressive pain; sensation as of an empty space between forehead and brain.
Graph.y tearing or throbbing, or as if constricted with a cord ; violent pain, with nausea during menses.
Kali carb., congestive; worse by riding, coughing, sneezing, on awaking from sleep, and from coryza.
Lach.f pressing or bursting; better lying down; pale face, yet throbbing temples.
jEthuM cyn., violent pain, as if the braia were dashed to pieces ; headache ceases with discharge of flatus from the bowel ; stitches and pulsations.
Sepia^ stinging pain from within outwards (left side especially), with contraction of pupils; worse indoors and when walking feist ; better in the open air and when lying on the painful side of the head {nux, vomica the reverse, right-sided pain better when lying on the painless fiide) ; sweat of feet and axilla) ; uterine relationship.
With these medicines the pain is closely associated with nausea and vomiting. There are other medicines, however, in which at present I am not able to assume that this Implies, but which may apply to hemicrania. Thus, there is heU, with throbbing and pain as if the bones were lifted up.
Calc. c, with coldness in the head and much acid in the eructations and vomiting ; also calc. acet.
SSi^Srr5S4"' clinical cases. 99
Seview, Feb. 1, 18H2
Tgnatia, clavus, ** clonic spasms and tho paroxysms ealminating in diuresis" — Hughes. Pain, as of a nail driven oat through the side of the head, better when lying on it (nux vam,) Pain like a hard pressure on upper BurfiEice of brain. In other respects symptoms very much like those under niij: vomica.
Stannumy every morning headache over one or the other eye, mostly left side, increasing and decreasing gradually ; or painful jerks leaving a dull pressure, worse during rest, better from motion ; or throbbing in the temples.
Case VI. Heart Disease,
On March 10th, James E., aged 14 years, first came under my treatment in a very serious condition indeed. That he would live many days was, at this time, very xmcertain.
Previovs history. — Has been for the past three months in the infirmary, in which institution he has formed an excellent example for clinical study. His condition, how- ever, has not been improving during his residence there, and therefore he has been removed, says his mother, to see if anything could be done for him at home. On a former occasion he had an attack of *' heart disease/' and was visited by one of our colleagues for that complaint, and got better, to the satisfaction of his parents ; but subsequently, at a future time, another illness came on, and on this occasion, by the advice of her friends, she thought it best to get him into the infirmary if possible. When taken to him for treatment, the physician in attendance did not omit to seriously caution the mother on the danger and injury likely to accrue from having on a former occasion relied on homceopathy for his treatment. How wise or unwise this statement may seem to be is best learned by observing the results of two days treatment by homoeopathy, and this may be learned without disparaging in any way the care, attention, and skill bestowed upon such a case minus bomoBopathic treatment. He is the subject of hip-joint disease.
Present Condition. — March. He is kept sitting, propped up in a chair with pillows, for he cannot lie down night or day for the dyspnoea.
n— 2
100 oLiNioAL CASKS. "CSJ^STT,^':
Beview, Feb. 1, 18B2.
He is pale and pasty-looking, with an expression as of long-coniinned pain, and has been losing flesh rapidly of late, for he has lost appetite, and the tongue, which is dry, is covered with a <firty brownish white fur. There is marked thirst for water and cooling drinks, and he drinks plentifully if permitted to do so {arsenic, bryonia).
His suffering is and has been very great, the anxiety and pain in the cardiac region are continuous, and sometimes extreme. If anything be said which makes him inclined to laugh, the attempt at the commencement of laughing causes intolerable pain at the heart. Bowels relaxed, from one to two loose fetid evacuations daily. Frequently vomits food taken.
The cardiac area of dulness is enlarged ; action of heart heaving, forcible ; and there is a visible, very broad, and palpable apex beat perceptible at a position two inches below and two inches to the left side of the left nipple. Hyper- trophy, with displacement of apex beat downwards, and to the left of the normal position. Loud mitral regurgitant murmur displacing the flrst sound, distinguished most plainly over the ventricular region, and second sound, purer than the first, but still somewhat obscured and deficient in distinction and accentuation as heard at the second and third intercostal spaces near the sternum. I diagnosed endocarditis, and possibly fresh deposition or inflammatory exudation going on in the endocardial lining and on the valves. That this cardiac disease may have been originally connected with and at the present attack promoted by the long-continued hip-joint disease, wherein the femur had been displaced, and pus or detritus locked up, is a possible conjecture. In addi- tion to the heart symptoms, the right side of the chest is affected, and has been so for some time during his hospital residence. The entire right chest is bulged out, especially so in the posterior region and towards the spine. The intercostal spaces are pressed outwards. The signs of hydrothorax of extensive amount, bulging out and deforming the entire right chest, are present. The liver also is enlarged, owing, doubtless, to the degeneration so often found in association with chronic bone disease.
The urine is scanty, very high-coloured, but forms no coagulum — with heat and nitric acid (non-albuminous).
^t^Srr^^' CLINICAL OASES. 101
Review, Feb. 1,1882
The feet and legs, which he is obliged, in order to get relief at all, to support on a chair, pit deeply on pressure. The oedema extends up to the knees, or even higher on both sides. The lower eyelids are very (edematous. There is retraction of the muscles of the abdomen under and to the left of the apex beat, as if the diaphragmatic attachments of the ribs, and abdominal structures, are drawn inwards and upwards towards the heart, because of the abnormal action of this organ. Pulse small, quick, thready, irregular, 180 per minute. Respiration difficult, shallow, and short, as if afraid to breathe for pain and difficulty. A long breath is painful and seems impossible.
He does not sleep at night, or very little; or, if he doses off, starts and screams out.
Arsen. aZb.^ 3 x, gtt. x., to water f tumblerful. A dessert-spoonful every two hours.
March — . Forty-eight hours after the first prescription I find the patient greatly relieyed. Not nearly so much distress in the expression of the face. Appearance stronger and healthier. (Edema almost entirely gone from the legs and feet. Bight side of chest reduced to almost its usual dimensions. Intercostal spaces now very little distended. He is able, without inconvenience, to place the feet to the groond without their swelling, and to move more freely in the chair without cardiac distress. (Edema of eyelids gone altogether. Heart sotmds decidedly purer, action less violent and less heaving, murmur with first sound has become more modified and not so continued.
Urine, instead of being concentrated, and almost " blood colour," is now pale straw colour, copiously passed, and still non-albuminous. Diarrhoea and vomiting cured. Bep. ar$. as before.
March 14th. — Does not improve so rapidly as during the first two days of the a/rsenicum treatment. The dyspnoea has become extreme at times, and has become the most prominent symptom. Had hardly any sleep in the night for it* He passed a very restless night, and was in so much pain and difficulty of breathing, with palpitation, which is at times fluttering, at others violent, that they thought he would have died during the night. Never- theless, I find the heart sounds improved; action more regular, less forcible and heaving. Murmur less prolonged, and better distinction can be drawn between the first and
102 CLINICAL CASES. ^'SSS
Review, Keb. 1, IflOL
second Boands. The cardiac symptoms have been more distressing, bat on the whole he look& much better.
Tongae much cleaner. Pulse 120.
Considering now that arsenicum, whose sphere of aotton is endocardial, had been doing material good there, besides removing the dropsical effusions, but ceased to correspond to some of the more urgent symptoms, particularly to the now very marked cardinc dyspnoea and palpitation, I altered and gave verat. viride A gtt. ii. 0.2. h, ex. aqua.
This was prescribed especially for the paroxysms of nocturnal excitement, with dyspnoea and palpitation of fluttering character as the more prominent symptoms. It has appeared to me to regulate vnth great certainty ihe nervo-motor loss of balance between the cardiac and respiratory nerve centres, when occurring with the above- named symptoms.
March 15th. Has passed a better night. Dyspnoaa much relieved : less restlessness during the night ; and in other respects better. Continue medicine.
March 16th. No screaming out at night since taking the medicine, able to get good sleep now, still in the sitting-up posture ; the hands being rested on the palms, and the head and neck dropped downwards, as it were for rest, between the shoulders. He cannot lie down to sleep yet, for if he does so there occurs a throbbing sensation upwards in the laiyngeal region, causing great distress. Feels much relieved ; appetite much improved ; no trouble- some dyspnoea now, and no visible cardiac movements, nor any palpitation with dyspnoea. The urgency of the latter symptoms has entirely disappeared. In other respects continues to improve.
To omit medicine for twenty-four hours.
March 17th. Has passed another very good night, sleeping soundly, though for sleep he has still to sopport his thorax by making straightening the arms downwards, with the palms placed flat on the chair. Is greatly relieved in every respect. Urine still copious, but somewhat more concentrated than it was after the arseyiictim treatment.
Pulse now only &om 96 to 100 (sitting posture), regolar ; but yet is even weaker and smaller than before^ being counted with great difficulty on account of. its smallness ; although its rate per minute has become much reduced, as above noted. He is now able to rest the tieet on the grouiid. There is no sign of any return of the oedema, and tiie fiuaa
SSSSr^hTSS?** CLINICAL CASES. 103
has lost all appearance of pain. The retracted state of the abdomen below the heart gone, and the contoor of the ehest in front has assumed a natnral aspect. Area of impulse diminished, less forcible, and without the agitation which was so very marked when first seen, and which was still visible tluree days ago. Heart's action regular, though stiU characteristic of hypertrophy. Seat of apex beat is now two inches below and about an inch to the leffc of the nipple. Right posterior part of chest presents only the deformity present formerly, on account of spinal curva- ture from disease of right hip joint, which has not at present any fistulous opening, though the head of the femur, or the end of the bone which represents it, is dislocated far upwards on the ilium.
He is eating very heartily; the tongue is cleaning rapidly — only two patches of whitish coat are visible towards its dorsum ; bowels acting well. There is now no reasonable doubt of his making an excellent recovery. Murmur still plain, but the sounds are more natural.
Verat. viride A. gtt. v. ; water twelve dessert-spoonfuls ; a spoonful every third hour.
The effects of these medicines is beyond dispute, and further explanation is superfluous. However, we note these two much-to-be desired results: — The arsenicum removed the oedema, diarrhoea, and vomiting. The verat. vir. removed the palpitation, dyspnoea, and irregular action of the heart, with the excitement and sleeplessness. In consequence of the great improvement thus effected, all diflBculty in the case, and doubt as to its issue has now passed away.
That digitaUs was not the most suitable medicine is easily seen by a glance at the symptoms proven by that drug on the mind, disposition, and circulation, as well as by the prominence of gastro-enteric symptoms of the case. In vain we look to the general teaching of the majority of the schools of medicine for those indications for this and other drugs which can be found only in the provings on the healthy.
The action of arsenic on the endocardium is well known.
'* The heart beats more quickly when lying on the back,** hence the patient sits up for relief, and should this con- dition be a prominent one, is an indication for a/rsenic. Subsequently to the previous notes the patient was treated for symptoms resembling those of aconite. Great restless-
104 CUHICAL CASES. "'iSSflS^TS^
11688 and agitation at night, with strong palpitation and dyspnoM, '^ jumping and kicking" sensation referred to> the trachial region, with pnlse qnick, fiill, and strong. Aconite A gave him erery relief, especially at night, pro- curing sleep, and stopping the '* screaming out " at night« On March 23rd I again saw him after the aconite treatment, and fonnd him still improving, and the heart sounds very mnch better. Both sounds fiairly perceptible at apex, and the murmur with first sound at this time so far lessened.as to cause very little obscuration, or rather, displacement of the first sound.
It would appear from the alternating action and different effects in different doses of some drugs, that the same medicine may come to be indicated in the actually different conditions of undue hypertrophy on the one hand, with strong action, and of degeneration, and dilatation on the other, with weak action,' provided always that the symptoms • characteristic of the medicine be present. Hence the difficulty of fEurly classifying in all the various abnor- malities of cardiac action becomes very great. Again,, each drug may correspond to alternating, opposite, and different phases of the same disease, and yet be the curative remedy. Thus phosphorus may become indicated in states occurring with hypertrophy, or with degeneration ; and belladonna in states with a full and quick, or full and slow, or a weak, small and soft pulse, according to the associations in the provings. My first recollections of the application of arsenic to endo-cardial symptoms are asso- ciated with an excellent account of the symptoms in a thick volume by Dr. Laurie. Therein he goes on to describe, under the heading of '^ Pathological anatomy," indications- for arsenic, but we are not told whether the pathological appearances referred to are truly post niorteni effects observed after arsenical poisoning. On first reading them, I took them for such, and so believed them to be ; but have been rather disappointed at not finding them in Allen's work. I quote from Laurie : '' Very much relaxed, or violently contracted heart ; thick fluid, tar-like blood in the right ventricle; opalescent spots upon the inner surface of ihe left ventricle, from the presence of false membranes ; violet red spots wifli softening of the endocar- dium ; red-marbled spots in the left auricle and ventricle ;. smaller carmine red spots, especially on the papillary muscles, and penetrating into the substance of the heart ;
gggrraf° hyqiese. 105
mncb darker rednesB, almost blackness of the right cavities of the heart, and some spots on bho papillary muscles ; red or black broad spots in the left Tentricle, inflammation of the semilunar vahes of the aorta."
If these symptoms be really pathogenetic, they speak for themselveSy and throw a considerable and convincing light on the power of arsenic in endocarditis with the appropriate symptoms, which I will now quote from Allen : '' Inflam- mation of the heart and its results, dilatation, and cedema of the feet. Great irregularity of heart and breathing. Irritable heart. Action feeble and hurried. Violent^ tumultuous and painful palpitation, especially at night. Strong, visible, audible pulsations, chiefly at night, worse when lying on the back, when it beats stronger and faster. Violent blowing sound, with full pulse, 110 beats per minute. Or, violent palpitation, with small irregular pulse. Palpitation and anxiety. Nocturnal anguish, with palpi- tation. Pulse quick, hard and full ; or again, weak, small and quick, or scarcely perceptible. PiUse restless and smaU, yet increased after repeated vomiting."
On comparing these conditions with those of the boy treated by arsenic^ we observe that it is just this array of phenomena as caused by the drug, which were so much ameliorated by the treatment.
AN ADDRESS ON HYGIENE.*
By M. Roth, M.D.
In all parts of the world, both among the most civilised nations as well as among the most ignorant tribes, man is surrounded by many injurious influences, exposing him to a number of preventible acute and chronic diseases, as well as to premature death.
In order to remove these injurious influences, or rather,, when this is impossible, to counteract their bad effects, we must have recourse to hygiene, a science dating so far back as 4000 years ago, as proved by the Egyptian and Mosaic sanitary laws. Although the science itself has made considerable progress in the present century, its practical application has taken but slight root among the people at large as well as among the medical profession,.
* Bepristed from The Transactions of the International Homosopathic Convention, 1881.
106 HTQIENB. "S^^SfffSU
Benev, FM>. 1, Iflfit.
the majority of whom are tanght to cure diseases hnt not to preyent them. E^en our friends who have prepared the programme of the first and present International Homoao- pathic Convention have either forgotten or neglected to name hygiene as a subject of an essay or discnssion.
Being convinced that the highest aim of medicine is the prevention of disease and increase of the average duration of life, by permission of yonr Committee I have taken the liberty of addressing you on the oft-neglected subject of hygiene, in order to elicit your opinions concerning the most practical means of preventing disease and prolonging life. Those who might object that this Convention has nothing to do with prophylactics^ I will remind that the knowledge of the physiological effects of medicines has enabled us to use belladonna as a prophylactic against scarlatina, aconite against measles, and quinine against the various forms of intermittent and remittent malignant fevers. Dr. Hutchinson, a naval surgeon, whom I met last year at the International Congress of Hygiene at Turin, told me that, being at the head of an expedition up the Niger, he gave every man on board a dwly dose of quinine for at least three weeks before reaching the coast of Africa; he continued this medicine throughout the whole period of the expedition, and even for some weeks after, and did not lose a single man out of more than a hundred that he had with him. Drunkards take consider- able doses of strychnine as soon as they feel the first symptoms of delirium tremens; our American friends probably know Dr. Morey's report, published in the Pacific Medical Journal, upon the case of a man who, being in the habit of taking large quantities of strychnine, after drinking whisky in immoderate quantities for a fortnight, was able to prevent the attacks of delirium tremens. Wine and brandy tasters and merchants, bottlers and other persons obliged, on account of their business, to live in an atmosphere impregnated with alcoholic vapours, counteract the bad effect of these vapours by means of strong and unadulterated coffee. Pasteur has shown that the diluted poison of the poultry cholera, and of the anthrax in sheep, -either diminishes the intensity of or actually prevents the disease, probably in the same manner as vaccine modifies or prevents smallpox.
These few instances are sufficient proof that the study •of the physiological effects of medicines may lead to tlw
BiiviAw. F^ Lima. UitrlJJjJNJK. ±\Jt
Beview, F^. 1, IflBI.
prevention of diBease, which mast he preceded by the study of the causes of the various diseases, as well as of the ^conditions most favourable for preserving health.
The most important conditions for preserving health are pure air, good soil, pure water, and unadulterated food. It is the duty of the authorities, to whom public hygiene is entrusted, to provide these conditions for the public in general, and especially for all public establishments, such as churches, schools, workhouses, prisons, reformatories, barracks, courts of justice, theatres, and other places of amusement, and where a large number of people resort. It is the duty of the legislative assemblies to bring forward such laws as would enable the authorities to prevent and remove all injurious influences affecting the purity of the air, soil, water, and food, both in town as well as in the country. Unfortunately, we have only amateur hygienic legislators in the House of Lords ; this august body has hitherto not admitted any learned physician who could advise practical measures for the public health, although no objection has been made to the admission of members of the other learned professions, as well as to bankers, manufacturers, soldiers, and landed proprietors. In the House of Commons the number of medical members is yet too small to give sufficient weight to the introduction of such measures as affect the health of the public at large. It is owing to this legislative neglect of hygienic measures that nxany diseases must and will still continue to spread and to cause premature death. Architects, surveyors, builders, and engineers, who plan and build our houses, have not as yet been sufficiently trained in hygiene as to be enabled to build houses and homos which in every respect answer to the conditions of health. There is, then, only the medical man left, and it is* he who has the most respofnsible duty to fulfil, namely to enquire into the causes of disease and premature death, and to discover the means of counteracting them. Hitherto the great aim pursued in the training of a medical man has been to enable him to cure diseases while the study of hygiene or the preservation of health has been almost everywhere more or less neglected. This is an additional reason why the public are so ignorant of a practical and popular knowledge of hygiene, with which every human being should be acquainted.
It is not enough that the best sanitary laws or special regulations regarding public health should be inscribed on
108 HYGIENE. "?£S1J:%TSS^
Beriew.Feb. 1,1882.
paper, they mast also be carried out into practice; for example I may mention how badly the duties of the inspectors of health are performed* and how little attention) is paid to the reports and suggestions of the medical officers of health.
Everybody knows how the regulation for having closed Davy lamps for the prevention of explosions in mines is neglected, and how many lives are yearly sacrificed through this neglect. Mr. Ouido Komer in Freiburg last year invented a h'groin lamp (ligroin is one of the liquid carburetted hydrogens similar to benzine and petroleum ether) in which capsules of asbestos, previously covered with a layer of palladium, are placed over the wick ; this lamp consumes per minute from one to one and half cubic metres of the noxious vapours, and is at present considered to be the most successftd apparatus for preventing explosions in mines.
Again, in the fen districts the basement and cellars of numerous houses are almost always filled with stagnant water ; the inhabitants are weakened, while the children suffer from general debility, swollen glands, fever, head- aches, as well as rheumatic and other complaints, caused by constant exposure to the damp. Now, although it is well known that covering the ground with asphalte and other impermeable materials would prevent the percolation of the water, this precautionary matter is almost entirely neglected except in the subterranean and subaqueous bomb and shell-proof compartments of our fortresses. The inser- tion of layers of asphalte cement in the humid walls of older buildings is an easy and not expensive process, but how rarely is it used to improve the unhealthy conditions of habitations built on clay, or on land exposed to inundation I
It has been found that the malaria fever is due to the Bacillus malarise, a microscopic organism which Corvelli has found to be propagated by spores, and which Marchia- fava found in the blood of three patients who died during the cold stage of the fever. We know at present that draining the malaria countries and the planting of the eucalyptus counteract the effects of the fever ; the appli- cation of these two measures belongs to the authorities presiding over public hygiene.
* In a pamphlet entitled The Fever Dens in the North Weetem and Wett Central Districtt of Lond^m^ I have published some more notes on. this subject.
iSSSS^^rf^S^ HYGIENE. 109
Beriew, Feb. 1, isas.
Among the objects of public hygiene^ cremation is now attracting much attention. While other ooontries, especially Italy, are progressing in diminishing the noxious and most injurious influences arising from tihe decompo- sition and putrefSoM^ion of bodies buried according to the present anti-hygienic system, we are prevented in England by legal difficulties from making use of the crematorium At Woking. The fear of poisoned bodies being destroyed and thus of preventing the detection of crime, is the principal obstacle in England to one of the most important sanitary measures ; an obstacle which, in Italy, has been removed without any difficulty by means of a preliminary post-mortem examination. Happening to be present last year at two cremations in Milan, I had several opportunities of studying publications on the subject. I also saw a coffin opened in which a body had been buried for six months ; the millions oi insects and the putrid body com- pared with the calcined bones of the cremated body are quite sufficient to convince the most incredulous of the hygienic advantages of cremation and the anti-hygienic conditions of interment. Again, the researches of Pro- fessor Selmi on ptomaines, the fixed alkaloids developed in the human body after putrefaction, show still more how desirable and necessary cremation is from a hygienic point of view. The symptoms of animals poisoned by these ptomaines are, dilatation of the pupils with subsequent contraction, instantaneous retarding and irregularity of the pulse, together with some convulsive movements which leave the heart after death absolutely empty and in systole. Some of these poisons are as venomous as the most toxic vegetable alkaloids ; some have been found analogous to veratrine^ while in a person who bad died from asphyxia similar poisons were found only eight days afber death. It appears that many of the cases of poisoning by diseased meat and fish are due to the presence of ptomaines, which in certain fish are produced a few hours after death. In the torrid zone certain species of mackerel, perch, and herring produce poisonous effects at certain seasons; in Japan, the eating of the fish fugu (petrodon) is forbidden at different times of the year by a special law. The know- ledge of the development of these poisonous alkaloids in the human body so soon after death will, I hope, consider- ably accelerate the general introduction of cremation,and thus remove a very fertile cause of disease and premature death*
110 HYGIENE. "s2!SL=srr?2^
Beriew, Feb. 1, 1882.
Another of the problems to be solved by the sanitary authorities, is the disinfection and utilisation of the f&ecal matters accumulating in the severs of large and small towns ; the latest experiments, by passing smoke through the substances to be disinfected, have succeeded on a small scale, but whether it can or will be successfully carried out on a large scale has not yet been proved.
Again, one of the objects of public hygiene is to prevent accidents and diseases arising from various trades and occupations; for instance, the law does not permit any children to be employed as chimney-sweeps, an occupation which would constantly expose them to various accidents. Last year I read a paper at the International Congress of Hygiene on the anti-hygienic conditions under which the engineers work in the Scotch shipbuilding yards ; however, there is no hope for any improvement until legislative measures are brought forward.
During the last thirty years the use of compressed air for industrial purposes while constructing bridges has become more general, the men working at a depth of from thirty to seventy feet under water, in a caisson, with compressed air When the bridge near St. Louis, over the Mississippi, was built, the men had to descend to a depth of a hundred and twenty-three feet, which is the greatest depth hitherto known in which men have worked under water. After the air in the caisson has been com- pressed to three, four, and even more atmospheres, the men enter a kind of ante-room which communicates with the open air. When the door is hermetically closed, the atmospheric pressure in this ante-room is by degrees iiicrcased till it has the same pressure as the caisson ; then the door communicating with the caisson is opened for the entrance of the working men, — ^behind them it is imme- diately closed. When the men leave the caisson after their work, in the ante-room the atmospheric pressure is vciy slowly diminished ; this diminution lasts half an hour, when the previous pressure did not exceed two atmo- spheres, but it should last an hour if the previous pressure was of four atmospheres.
The effects of the compressed air are sometimes very serious, for example, the workman may feel, during the slightly increasing pressure, a general painful sensation, noises in the ear, accompanied with intense pain ; hearing is very much diminished, and the power of whistling gone ;
J£siS»F^rr5af^ HToiENE. Ill
Beriew, Feb. 1, 1882.
breathing is first of all much quicker, afterwards slower ; inspiration diminishes, the capacity of the thorax as well as of the lungs is increased; at the same time cough begins, with oppression of the chest, the circulation languishes, the pulse can scarcely be felt, and the com- bination of the oxygen with the blood increases. Beyond a pressure of four atmospheres very dangerous, and eTen fatal, accidents take place, while a pressure of more than six atmospheres causes asphyxia, through congestion, as well as convulsions and that special tetanus which is due to oxygen-poisoning. In the mines of Douchy, with a pressure of four atmospheres, the pathological and physio- logical effects have been very marked, causing the death of two men through congestion, destroying the eyesight and hearing of several others, while one man suffered from diplopia, and two remained deaf and amblyopic. Out of 643 men working at Toulon, under a pressure of three atmospheres, according to Dr. Michels, 2 died, 48 were sent to hospital, and 123 to the infirmary ; while out of 115 men who worked regularly under the same pressure, from the 22nd of August to the 13th September, 43 of them, or 88 per cent., had some ailment or other, such as paralysis, paraplegia, convulsions, pains in the ears and head, as well as painful sweUings in the joints and muscles. The pressure amounts to more than 400 lbs. on every square decimetre when a man works at a depth of fifty feet, and two effects are produced, one due to the pressure and the other to the increase of the oxygen ; changes in the rhythm and amplitudes of the respirations occur, while, according to Dr. Grand, the body is in a state of hyperox- ffimia, and as the quantity of gas dissolved in the serum of the blood is much greater than under the normal atmos-* pheric pressure, the oxidation of the haemoglobin is more active, changes take place in the tissues, the quantity of urea and carbonic acid is increased, the temperature raised, and the movements of the heart accelerated. Compressed air also causes pulmonary ansmia, less blood flows to the left ventricle, so that the arterial work and tension are diminished, while the blood accumulates in the right ventricle, the work and venous tension of which is increased. The dangers of the too sudden or too violent diminution in the previously increased pressure are greater than those caused by protracted increased pressure ; thus the shock causes active congestion of several organs, cerebral, pul-
1 1 Q T7vr<TT?'Kri? Monthly Homoaopathio
•''^^ HYGIENE. fieview. Feb. 1, 1862.
monary, and spinal apopleiy, violent itching of the skin, deafness and blindness, as well as paralysis of the limbs, bladder, and rectum, which may be of short or long duration or it may cause death by asphyxia within a few hours. These accidents can be prevented by a minute examination of the working men, who must be young, in good health, very temperate, with regular and good habits ; the heart, large vessels, and lungs must be subjected to a minute auscultation, and must be proved to be in a perfect condition ; the men must be cautioned not to expose themselves to the intense cold and humidity caused by the c{<?compre8sion ; they should be dressed in woollen garments and take small quantities of wine or punch, and not expose themselves too quickly to the external air.
Having given instances how public hygiene can con- tribute to the prevention of disease and accidents, I shall give some instances how private hygiene can prevent diseases.
A large number of infantile diseases, of abnormal derange- ments, of the very dangerous infantile diarrhoea, and the concomitant fits, convulsions, and paralytic affections are mostly caused by improper management, unsuitable food, want of cleanliness and fresh air. It is an absolute necessity that every child should be brought up by the mother's milk, and only in cases of disease should the mother's milk be substituted by cows* or asses' milk ; the supervision of all dairies, the daily medical inspection of the cows, of the stables, of the vessels for transporting the milk, of the place of the sale, and of the distribution of the milk, is of the greatest importance ; frequent analysis •of the milk, and the constant use of the lactometer, and the most scrupulous cleanliness of feeding jbottleSi and regulations for feeding, are indispensable conditions for diminishing the still prevailing infant mortality ; the acidity of tiie milk, and the development of vegetable and animal micro-organisms caused by want of cleanhness of feeding bottles and the elastic tubes, which should be entirely abolished, are quite sufficient to account for the -so-called infantile diarrhoea. To these may be added the mixing of milk-food with beer, brandy, wine, buns and cakes, sugar, oranges — as it can be observed daily in the streets of London. As long as mothers are left in their present ignorance, the excessive infant mortality must ^continue. Adulterated milk acts not only on the present
UbQthJjr HonuBopoUiic irvn.TVWV* lift
Beriew, f^b. 1, 1882
generation but also on the future. Infants and children consume a great quantity of milk. The brain, nerves and muscles do not obtain the necessary material, and the chUdren's power of resisting iUness is considerably diminished.
Half of the blindness of the children found in all European blind institutions is caused by a similar ignorance of mothers regarding the necessity of babies' eyes being kept scrupulously clean, and of seelang medical advice as soon as the first traces of the inflammation of the eyes of new bom babies manifest themselves. The ignorance of school- masters and schoolmistresses with regard to the infectious character of the various purulent eye diseases ; the igno- rance and neglect of the working people in protecting their eyes while engaged in trades where mineral, vegetable and animal dust is floating constantly in the air ; the ignorance of the majority of professional men in the treatment of eye complaints ; the objection of patients to the extirpation of an eye lost by accident or by some disease which endangers the loss of the other eye, are additional and preventible causes of the blindness from which 800,000 persons in Europe sufiiBr.
Children as well as adults are suffering frequently from the irritation caused by worms. Hygiene can do much for the prevention of these parasites, which are often caused by eating raw minced meat, recommended in some wasting diseases; by insufficiently cooked meat, sausages, and ham — the two last only smoked, by salads and cresses which are not well washed ; eggs of parasites and snails adhere to these vegetables, which are mostly consumed raw (these snails cause the distoma hepaticum) ; impure water-courses and dirty bathing tanks; accumulations of dirt — ^raw vegetables and animal food — in dark kitchens and dark store rooms ; by dogs and cats admitted to kitchens and dining rooms. Dogs and cats should be fed on cooked meat, and not eat the falling off of butchers' shops and of abattoirs. Bats infest pigs with trichinae, therefore pigsties must be kept clean and no rats admitted. All these contribute to the development of worms which, in various ways, find their way into the human organism.
We establish homes for cripples instead of preventing the
development of rickets and the consequent deformities,
although the hygienic laws are sufficiently known which
would prevent the artificial development of cripples. The
Vol. 26. Ko. 2. I
114 HYomiii;. 'xa.^rna
Italian eohool for rickety children in Turin, and a similar institute in Milan, have already practically proved that even nnder unfavonrablo conditions, half of the rickety children are cured, and the development of cripplcu pre- vented. Many deformitiea and complaints caused in schools can bo prevented.
Although tho number of instancoB in which private hygiene can prevent disease can be considerably increased, those I have named will be sufficient for admitting the desirability of popularising hygiene amongst all classes of society, whilo professional men must pursue this science in all its bearings on the public and private health ; to be able to advance with their hygienic knowledge, and to teach tho public how to obtain, in a healthy state, the longest period of homan life.
Besides public hygiene, the knowledge of private and individual hygiene is of the ^eatcst importance ; no medical student should therefore be permitted to obtain a degree withoat having passed an examination in theoretical and practical hygiene, which at present is only required by the very smallest number of examining bodies. How can we expect the introduction of the obligatory study of the elements of hygiene into training colleges for teachers as long as yonng medical men are permitted to practise with- out having given proofs of their hygienic knowledge? Every school-teacher should be taught how to impart to tho pupils popular practical knowledge conccruiug air, water, food, drink, dress, &c. ; how to develop their mind and body harmoniously ; bow to prevent them from acquiring the normal school complaints, such as headache, short- sight, bleeding from the nose, all kinds of cold, crooked spines, high, round, and projecting shoulders, flat chests, and contracted necks. The teacher should also know the preliminary symptoms of smallpox, measles, scarlatina, Durolent iuflammatiou of the eyes, whooping-cough, ring- I, and of the other common infectious diiiUHses, as well lilepsy, catalepsy, and St. Vitus' dance (which are d by imitation), and have a slight knowledge con- ig rickets, scrofula, and chronic catarrh of the respi- f organs, which are still curable in the early stages ; ^t also to know the sanitary conditions of the school, ot-boildings, and furniture; the diETerent modes of ng, warming, and ventilating it ; the cleanliness both I school as well as of the bodies and clothing of the
a^SS^^SSmS^ BLECTBIOITT. 116
fisTiew, ftt>. If 1881.
papils, together with the most fayonrable means of preserving health, the suitable length of time for exercise and study, and, in fact, all other sanitary requirements.
Besides the hygienic knowledge just mentioned the training colleges for schoolmistresses should have model nurseries attached to them, where a few motherless babes and infants could be brought up according to the best hitherto known methods. These model nurseries would serre as schools to medical students, to young mothers, nursery governesses, nurses, and all tibose who have to do with the management of infants and children. The elements of popular hygiene in their practical application to ventilation, warming, clothing, food and drink, should form an obhgatory branch of pqpular education ; the more advanced parts of hygiene a necessary branch of education in all higher schools, colleges, academies and universites.^
While thanking you for having listened with much patience to this long address, I beg you to assist by your experience and advice the introduction into this and other countries of the great science of hygiene, which is usefhl to everybody, and contributes to the well-being of our fellow-creatures by diminishing disease and misery.
ON ELECTRICITY : ITS PHYSIOLOGICAL ACTION
AND THERAPEUTIC USES.
By DoNAiiD Batnes, M.A., M.D., F.R.G.S.
Having found from experience what valuable and powerful therapeutic agents we possess in the various forms of elec- tricity, I purpose in a few short papers drawing the attention of my professional brethren to their nature, and shall endearvour to point out the indications for their practical application iii the treatment of disease.
" Electricity is now regarded as a force, correlated to the other great forces of nature — ^heat, light, &c. — and, like
* For the ptirpoee of popnlarising hygienic knowledge Dr. Both originated about twenty-five years ago the Ladies* Sanitary Association, which has distiihated abont 1,500,000 sanitary tracts. Lady Mount- Temple (at that time the Hon. Birs. W. Cowper), Lady Shnry ^at that time Lady Bobert Grosvenor), and Mdmo. la Gomtcsse do Noaiiles {m!e Trevelyan), are the first ladies who assisted Dr. Koth. For farther nformation apply to the office of the Ladies' Sanitary Aisaociation, 22, Bemera Street, Oxford Street, W.
1—9
116 ELECTRICITY, ^"SS^Iy^vSt^^^
them, is simply a mode of motion, a form of vibration." — (Beard and Rockwell.)
The name is derived from the word *E\eK7pov, signifying amber; this sabstance being the first observed by the anoients to exhibit electrical properties or phenomena. The general divisions, or forms, in which electricity is mani- fested, are : —
1st. Magnetism.
2nd. Static, Frictional, or Franklinic.
8rd. Dynamic, Voltaic, or Galvanic.
By combination and induction we get other forms or SHb-divisiotis, as —
(a). Electro-magnetic, usually called Faradic.
(b). Magneto-electricity.
(c). Thermo-electricity.
Of these, the galvanic is the form I shall chiefly dweD upon.
Magnetism, so called from the city Magnesia, in Asia Minor, near which certain iron ores were found which had the property of attracting iron. These pieces q{ iron ore were called magnets. Eventually it was discovered that other pieces of iron could be endowed with the same power ; these were called artificial magnets, in contradistinction to the former, which were called natural magnets, or lode, more properly load-stones. Artificial magnets are usually made of steel bars that have been magnetised by a galvanic current or by other magnets. These bars may be either straight or bent. We usually see them in the form of a horse-shoe. Each end of a magnet is a pole, and each pole manifests an opposite kind of magnetism ; this property is called the polarity of a magnet. If a magnetic needle be suspended, so that its movements are quite free, one pole will point to the north, and is called the north pole ; the other will point to the south, and is called the south pole. The greatest attractive power of a magnet is situated at the ends or poles; this attractive power gradually becomes less as we approach the middle, and is lost altogether at the median line, which is called the neutral point, or magnetic equator.
Experience has shown that like poles repel each other, while unlike poles attract. This may be proved by sus- pending a magnetic bar, so that it may move freely in the air ; now, if another magnet be brought near it, it will be seen that the north pole of the one is attracted to the
SSS^^STJC ELECTRICITY. 117
soath pole of the other, and vice versd^ Some substances are attracted, and others repeUed, when in the neighbour- hood of a magnet; the former are caUed magnetic, and the latter diamagnetic. The magnetic are — Iron, nickel, cobalt, manganese, platinam, &c. ; the diamagnetic — ^Bismath, antimony, zinc, tin, mercury, lead, silver, gold, &c. If a magnet be broken in two, each half will be a perfect magnet, having two poles and a neutral line; this property is retained, if each half be again broken, and will be manifested, so long as the division can be carried out. If a bar of soft iron is brought near or in contact with one of the poles of a magnet, it becomes itself magnetic for the time being, and presents the usual properties of a magnet. This power it obtains by induction. If it now be removed from the magnet, it loses all its magnetic power, and is for this reason called a temporary magnet. If, however, a bar of steel be treated in the same way, it also becomes magnetic, but to a less degree, and taldng a longer time to become so. It differs, however, from the bar of soft iron, in not losing its power, but permanently retaining it, hence it is called a permanent magnet.
Static Electricity, also called Frictional or Franklinic. — This, in its simplest form may be exhibited by rubbing briskly a glass rod with silk, when it acquires the property of attracting light substances. If a pith ball be suspended by a silk thread, and the excited glass rod be brought near, it will attract it; after, however, being in contact for a short time, the pith ball also becomes charged with the electricity, and will then be repelled, instead of being attracted by it. This electricity is called vitreous, positive or + electricity.
A piece of sealing-wax rubbed with flannel also acquires the property of attracting light substances. If, now, we bring the excited sealing-wax near the pith-ball charged by the glass rod, it will immediately attract it ; however, as soon as it has been in contact long enough to acquire electricity from the wax, repulsion will again occur. This form is called resinous, negative, or — electricity. If we, however, reverse the experiment, and charge the pith-ball with resinous electricity, we find the ball will be repelled by the wax, and attracted by the glass. From these experiments we deduce the law that ''unlike electricities attract, like electricities repel." Frictional electricity may Also be developed by cleavage or by pressure. An example of this may be noticed on cleaving a piece of mica in the
118 ELECTRICITY. "^SSL^SKT?^
Beyiew, Feb. 1, 1888.
dark, when a light is observed at the moment of separation. Each plate may be proved to contain an electricity of an opposite kind. The light seen on breaking a piece of loaf sugar is dtie to the development of electricity by cleavage. Again, if a thin piece of cork be pressed against a slice of orange, by means of insulating hemdles, one will exhibit positive and the other negative electricity ; these, however, are not the only substances which develop electricity by cleavage or pressure.
These phenomena led to further enquiries, and apparatus more or less perfect was, from time to time, invented to conduct these experiments. The first electric machine was that invented by Otto Von Guericke, of Magdeburg, in 1672, and consisted simply of a globe of sulphur turned on its axis by one hand, and pressed against the other. Sub- sequently a glass cylinder was substituted for the sulphur ball. In 1740, Winckles made a great improvement, using cushions of horsehair as rubbers. In 1760, Bamsden 80 far improved on the former machines, as to substitute a circular glass plate for the glass cylhider. He so far perfected the electric machine that those used at the present day are simply modifications of it. The best and latest electric machine is that introduced by Holtz, of Berlin, and invented by him in 1865. This has lately been greatly improved by what is called " The Toepler Modification."
Bodies may be charged with electricity in two ways, viz., by condu<;tion — actual contact — and by induction — at a distance. In conduction, the body giving the electricity loses a portion of its electricity, whereas in induction it loses none. In conduction, the electricity given to the body is of the same kind as that which gives it, but in induction it is of an opposite kind.
Bodies are divided, as regards their electrical action, into two great groups, viz., condactors and insulatara. Conductors are metals, charcoal, graphite, acids, water,. &c., &c. InsnlatorSy caoutchouc, silk, glass, wax, sulphur, resins, &c., &c.
Certain substances, although they do not conduct electricity, yet allow it to pass through them ; they are transparent to electricity, as glass is to light ; for instance, if electricity be excited on one side of a plate of glass, the other side will exhibit electrical phenomena. These substances are called dialectric.
SS^fF^g-nT" ELECTMCm. 119
Electricity spreads itself over the surface of a body, but does not penetrate to its interior.
Electric density, or thickness, is the quantity of elec- tricity on a given surface at a given time.
Electricity tends to accumulate at points, hence light- ning rods are made to terminate in sharp points. If a body in the shape of an egg be charged with electricity, the density will be greater at the ends, and greatest at tho small end. In circular discs, the density is greatest at the edges.
The electrical machine chiefly used for medical purposes, is very simple, its essential parts being three, viz. : the rubber, the rubber body, and the prime conductor — tho rubber being usually a pair of leather cushions, amalga- mated with a paste, made of zinc and tin turnings, rubbed down with mercury and lard ; the rubbed body, a large circular plate of glass, mounted on a glass axle, and turned by a handle between the cushions ; and the prime conductor, usually an insulated metal cylinder, intended to receive the kind of electricity required. This form of electricity is used for medical purposes in three ways, viz. — The electric bath, electrization by sparks, and the Leyden jar. The electric bath is of two kinds, electro-positive and electro-negative. The former increases tho vital forces, the latter decreases them. In the electro-positive bath the electricity is gathered from the glass plate, on to the prime conductor, while the negative electricity is carried away by a chain from the cushions to the floor. The patient being placed on an insulated stool or chair> is connected with the prime conductor. The whole surface of the patient's body is thus charged with positive electricity, while the surrounding air is rendered negative. If the electric bath be given in a dark room, a luminous appearance is produced by the escape of electricity into the air. The electro-negative bath is given in the same way, but with this difierence, that the negative electricity from the cushions is coUected, while the positive is liberated and carried to the ground by a chain. The electro-negative is said to have a debilitating effect, by reducing the natural electricity of the patient, thus acting like blood-letting — the pulse being retarded.
These baths have been found very useful in old standing neuralgias, sciaticas, and unpleasant flutterings about the heart, depending on weak innervation ; tremors of the limbs
120 ELECTRICITY. "^&?Sr?»:^
Review, Feb. 1, 188S.
have been removed by simply charging a patient, as it is called, even when other forms of electricity have failed.
Electrization by sparks. — The patient is charged in the manner jast described as an electric bath. The operator bringing his hand near the patient, the same becomes negatively electric. The negative electricity of the hand combines with the positive electricity of the patient ; this produces a flash of light, accompanied by a snap, and this is called the electric spark. These sparks may be drawn from the body by metallic conductors, and produce a sharp pricking at the part; if continued, the skin becomes reddened, and white wheals are produced. At some hospitals and in the consulting rooms of electric specialists, a chain or moveable wire is suspended from the ceiling and connected with the ground, to which is attached a brass ball which slides up and down the chain or wire : this is brought close to the patient, about an inch from the spine ; l^e patient is now charged, and the ball passed up and down in a line with the spine ; sparks now pass to the ball, and thence to the ground by the wire. In this way a rapid succession of sparks can be obtained. Cavallo has recommended the drawing of the sparks through flannel. If the sparks follow each other rapidly, they may cause slight vibration of the muscles which are close under the skin. This form has been used with success in urticaria, paralysis, choreai impotence, some kinds of amenorrhoea, and in some spasmodic affections. Static electricity is also very useful in spinal irritation, and in phthisis, &c.
The Leyden jar consists of a glass jar, coated inside and outside with zinc foil to within a quarter of the top; it has a varnished wooden cover, through which passes a wire connected to the foil inside ; outside, this wire terminates in a knob. The inside of the jar is charged with electricity by means of the wire : as the glass is dialectric, the out- side of the jar also becomes charged with electricity, but of an opposite kind. The jar is now said to be charged. It is discharged when communication takes place between the knob and the outside coating. This takes place with a bright flash of light and a loud report. The discharge is usually effected by means of a discharging rod. This is generally a curved brass rod, terminating in knobs, and provided with insulating handles. For medical purposes it may be used as follows : — ^A conductor communicates with the
^S^^f^r^^ BEVIEW8. 121
Bariew, Feb. 1, 188S.
inner surface of the jar, by means of the wire knob, to the part to be electrified ; the outer surface is then connected to the opposite side of the part to be electrified ; a spark is produced, and the neutralisation of the opposite electricities takes place through the part of the body between the two ^conductors. A battery of Leyden jars is made by con- necting a number of these jars together. By this means a very large quantity of electricity may be stored up. This form is rarely used for medical purposes.
{To be continued^) Canterbury,
December 24th, 1881.
REVIEWS.
A Letter to the Medical Acts Commission on the Claims of the Hmnaopathic Public and Homcsopathic Physicians to comidera- lion under any new Medical Act. By Dr. William Bayes. London : Hamilton, Adams & Co.
We have had abundant eiddence during the last few years of the zeal of oar colleague, Dr. Bayes, in the work of propagating homoeopathy. In the letter before us additional illustration of his energy in this direction is supplied. The Medical Acts Commission was appointed some time back to collect evidence regarding the amendments and additions which may be required in any new Medical Act, and to report them to the House of Commons. Dr. Bayes has endeavoured to take advantage of the opportunity thus presented to press upon the attention of the Commissioners the claims of all who are interested in homoeo- pathy to some sort of recognition. He has done so simply in his individual capacity, and in this way has been able to bring forward his own views without in the very least compromising any society or association.
There can be no doubt about two things. First, that a much larger prc^ortion of persons desire skilled homoeopalhic treatment than are able to obtain it. And secondly, that those who do desire homoeopathic treatment are entitled to some better guarantee of the competency of those who are supposed to practise homoeo- patbically than they have at present. That both of these points ought to be considered by any Commission enquiring into medical legislation is incontrovertible.
In his letter to the Commission, Dr. Bayes draws attention to these points, offers certain suggestions as to the best means of -satis^^g the legitimate claims of homoeopathists, and concludes
122 REVIEWS. "T^jfjsnnSr
bj enforcing them by a brief account of the state of homoeopathy in England, the organisation of the London School of Homoeo- pathy, and the condition of homoeopathy in the United States^ Canada, Spain and France.
The plans which Dr. Bayes submits to the Commission, as those one or other of which would, in his opinion, meet the requirements of homoeopathists, are either —
First. The institution of a complete medical school, within which the professors and teachers of medicine and surgery should bo men who practise homoeopathy. This plan would, we apprehend, involve also a new licensing board.
Second. The appointment of homoeopathic lecturers and teachers in certain medical schools or colleges, in addition to those of the ordinary allopathic school. This will, doubtless, be adopted in the future. But its adoption will also require ex- amination in homoeopathic therapeutics by the licensing boards. Dr. Wilks, in his speech at the College of Physicians the other day, made the following remark : ** There were difficulties in the way of the recognition of homoeopathy of a practical kind. A general practitioner, a licentiate of the College, who had been much exercised by the homoeopaths, had said to him, that if Fellows of the College consulted with such, ho could sec no reason why he should not ; and what would he do then, supposing he had a homoeopathic prescription before him, which he would not know how to read ? He would have to ask the College to- widen its curriculum, to insist that homooopfithy should be taught in the medical schools, and that candidates for the license should be examined in it ; so that they might understand such things, and not be placed in a dilemma when they became practitioners." There is really no ** practical " difficulty about the carrying out of such a scheme as this. All that is necessary is that the College should exercise a little common sense, show a little higher degree of intelligence than they ordinarily display^ and the very excellent plan shadowed forth by Dr. Wilks could easily become un fait accompli. So long as medical educatior does not comprise the study of homoeopathy, it is imperfect ; and so long as an examination for a medical diploma does not involve an inquiry into the candidate's knowledge of homoeopathy » it is inadequate.
Dr. Bayes' third plan is a proposal that the lectures of private lecturers should be recognised as qualifying students to present themselves for examination before the central board.
Dr. Bayes has so completely omitted to define what he means by a private lecturer, that it is not surprising that he should have been generally supposed to have meant that any one should, from tiie mere fact of his undertaking to lecture, have a claim on the central board for recognition of his lectures. This we
^^^SSrr^' NOTABILIA. 12S
B43viefW, Feb. 1. 1882.
believe is not the case ; but rather that some snch plan as thai recently proposed by the University of Edinburgh for ascer- taining the qnalifications of a man for the duties of a private lectnrer should be enforced by a suitable authority. These new r^nlations of the University of Edinburgh were published in extenso in the Medical Press and Circular of the 21st of Decem- ber. They are very comprehensive and would ensure the fitness of a man for the duties of private lectnrer as completely as any- thing can do. Such lecturers would be similar to the ^* Privat- Doeents'* of a German University town, from whom professors are generally selected. To lecturers so appointed no reasonable objection could be made. By ^his means some movement might be effected towards what Dr. Drysdale terms ** recognition."
The whole question involved in Dr. Bayes' Letter needs dis- cussion ; and we doubt not but that, in bringing tho subject forward as he has done, the first step has been taken towards securing what must eventually be granted, viz., that the subject of homoeopathy shall form a part of all medical education, and a knowledge of homoeopathy be one of the conditions on which a diploma is granted.
NOTABILIA.
THE RESOLUTION OF THE COLLEGE OF
PHYSICIANS.
The following clever letter from Dr. Dudgeon, regarding the resolution we have discussed at some length in our leading article, appears in the Medical Times and Gazette of the 14th inst. : —
" Tho acknowledged aim and object of this resolution was to pass a censure upon those members of the profession who consider the homoeopathic therapeutic rule the best guide for tho selection of remedies in their treatment of the sick. This we learn without any doubt whatever from the discussion or con- versation that ensued among those present at the meeting. But the resolution has no application to the practitioners aimed at» though it may perhaps hit some practitioners it was never intended for. Practitioners who have studied and who practise homoeopathy in preference to any other method, when they meet with cases for which it is adapted, neither assume nor accept the nickname of * homoeopath ' that has been bestowed on them, and which is commonly applied to them for tho sake of brevity and to avoid circumlocution ; just as we speak of antiseptic Burgeons, meaning those who commonly adopt the antiseptic treatment, or as we call one who makes a speciality of electricity;
124 NOTABILIA. "S^=SfWSf
Beriew, Feb. 1, tSBS.
a ''medical eleeiaician." But that is quite a different thing from trading upon a particular designation. We cannot conceal from our colleagues or the world that we have a faith in the homoeopathic method, for every prescription we write hetrays our therapeutic faith. Nor do we affect any conceahnent ; on the contrary, we endeavour in every legitimate way to convince our colleagues of the excellence of the homoeopathic method, and we would justly incur their censure did we keep that method a secret to ourselves. And is not this precisely what the hest men of the profession do when they know of a good method or a good remedy ? Did Mr. Lister, or his predecessor Dr. D^lat, keep the antiseptic method to himself? On the contrary, he has put it so persistently before the profession and the public, that the method is now very commonly called 'Listerism.* Do those surgeons who practise this * listerism ' trade on the designation ? Certainly they do so, quite as much as those who practise homoeopathy. Dr. Wilkes is disgusted Uiat a patient left him for another doctor because the latter ' had a principle guiding his practice.* In like manner a surgeon who did not believe in antiseptic surgery might feel disgusted at being abandoned by a patient who preferred an antiseptic surgeon.
** The resolution passed by the College of Physicians has thus completely missed its aim. If I were a Fellow, Member, or Licentiate of the College, I could subscribe to ihis resolution with perfect good faith, Uiough I am one of those against whom it is aimed. I neither assume nor accept any other designation than that of ' physician,' and as a physician I yield to no one in upholding * those principles of the freedom and dignity of the profession which should govern the relations of its members to each other and the public*
The resolution of the College applies far more to the tribe of specialists in the profession than to those who endeavour to give their patients the benefit of the discovery of Hahnemann. The oculists, aurists, gynaecologists, electricians, et hoc genus omnef trade upon their designations much more than we do. They, of all members of the profession, have a right to complain of the milk-and-water resolution of the College. ' Our withers are unwmng ; ' the resolution does not affect us.
'' Why did not the College adopt Dr. Buckniirs amendment ? That at least went to the root of the matter. In declaring that ' no competent medical man can honestly practise the homoeo- pathic system,* it spoke out the sentiments of the great majority of the profession. But there were some objections to passing such an amendment. It so happens that a goodly number of the members or licentiates of the College consider ^e homoeo- pathic to be the best therapeutic rule out, and practise accordingly. To doubt the competency of those the College had
SSS^^STS^ NOTABILU. 125
B6fl9W* SW>. If 188S.
admitted into its bosom after testing them by examination^ would have been to condemn themselves ; and to accuse them of dishonesty might have been to bring themselves within measure- able distance of an action for libel. The condemnation to a heavy fine of several German doctors who lately indulged in similar imputations on their colleagues who practised ' tiie so- called homoeopathic system * was not very encouraging to those who wished to impugn the honesty of certain of their colleagues. So Dr. Bucknill's amendment was dropped hastily like a hot potato.
** As for consultations between those who know and use the homoeopathic method and those who do not, I quite agree with Sir W. Jenner that they are to be deprecated. Like hun, * I go to do the patient good, to ease or prolong his life,' and I ehoidd be very unwilling to relinquish what I hold to be the better treatment in order to adopt what I consider the worse. I do not admit that Sir W. Jenner has any monopoly of the wish to do the patient good, but if his good wishes are never disappointed, if the patient about whom he is consulted is never rather the worse- than the better for his advice, then he is a much more successful consultant than any I have yet heard of.*'
To the Lancet of the same date, Dr. Dudgeon sent the following communication, which appears in the correspondence columns of that journal.
** The resolution passed unanimously by the members of the Royal College of Physicians at their meeting on the 27th ult. is one that will meet ihe approbation of almost all practitioners who think with me that the therapeutic law discovered by HftlinATKiftTin is the best that has yet been revealed for our guidance in practice. We — that is, those who think as I do on therapeutic matters — ^as a rule neither assume nor accept any designation implying the adoption of a special mode of treat- ment, and indeed most of us have protested in our published writings against the habit that prevails among our colleagues and the public of giving us designations of this character. Still we do not hesitate to express our belief on any opportunity that the homoeopathic therapeutic rule is the best, some say the only real therapeutic rule that medicine can offer, and we do our best to impress our views on the medical profession. We have cer- tainly our homoeopathic societies, for it is a necessity with us to meet and discuss subjects connected with homoeopathy, and such subjects are not allowed to be discussed in the ordinary medical societies. We have our special periodicals, for the same reason. But we assume no such designation as that the College of Physicians objects to, and, like the College, we scorn those who trade on such designations. For the sake of brevity, we allow
126 NOTABIUA. "'S!!^=S5fT?S'
Review, Feb. 1, 1888.
onr adversaries in discussing therapentic subjects to speak of us who practise homoeopathy, when the case seems to admit of it, as * homoeopaths ; ' but we do not put this name on our cards, our door-plates, or the books we write.
*' As regards consultations with those who think differentlj from us on therapeutic matters, we hold them to ba absurd, and quite agree with Sir W. Jenner, that as they can be of no use to ike patient, they should not be held. It may be different with respect to consultations for purposes of diagnosis, and as such consultations may be of use to the patient, and there is no reason to suppose there would be any insuperable differences of opinion between the consultants, we do not see why they should not take place if wished by patients.
*' It was well the college did not adopt Dr. Bucknill's amend- ment, impeaching the honesty of those who practise homoeo- pathy, for that would have been to calumniate all those members and Ucentiates of the College who have adopted the homoeopathic method firom conviction.
'* I rejoice to think that the meeting of the College, which was expected to pass a severe censure on those who take the liberty to think for themselves and to practise the system they tliink best for their patients, has resulted in the passing of a resolution to which we can all cordially subscribe.''
Dr. Bayes, who is an extra-licentiate of the College, has addressed the following letter to Dr. Wilks, the Senior Censor, who moved the resolution in question :— •
Utk January, 1882.
88, Lansdowne Place, Brighton.
Deab Sir — Thanks for your note. I have carefully read the report of your speech, to which I feel it will be needfdl to reply more fully hereafter. It seems to me altogether an anachronism that a body of educated men should bind themselves together in an endeavour to fetter thought and to impose penalties on men equally educated, whose only difference from themselves lies in a question of therapeutics.
It is of no use to attempt to avoid this point on the pretence that your resolution is aimed at a^ *' special treatment,*' or at the '* avowal '* of any *' special treatment."
It is useless to gloss over the real question at issue. It is an attempt to justify the refusal by Sir William Jenner to meet Dr. I^dd in the case of the late £arl of Beaconsfield.
The true point is, whether the Medical Profession is to be governed by laws made by Parliament or by bye-laws enforced by an arbitrary body of Fellows, which laws are made in private con-
l^™',grnS2?^ NOTABILIA. 127
Beview, Feb. 1, 1H82.
«lavey to over-ride by organised attempts the Jree will and judg- ment of the individual members of the medical profession, and to impose restrictions upon them which are contrary to the whole spirit of the XXIQ and other clauses of the Medical Act.
I thmk you will soe, upon reflection, the inconsbtency in a Boyal (Chartered) College, in thus attempting to deprive its members of the liberty given to them by Parliamentary Law ; which liberty is essential to the true progress of medical science.
All other issues arc futile, and, I may say, short-sighted.
Your resolution of December the 27th may show the necessity of surrounding medical freedom, in science, with further guaran- tees under the proposed New Medical Act, and so far may do real service ; but that is all.
I forward you a letter I have written to the Medical Commis- sioners, and i you give fair and full consideration to the subject, you will, I hope, admit that a system of medicine numbering among its adherents in England and in other countries, especially in America, so many medical supporters, cannot be put aside as a quackery ; nor can the term ** dishonest '' be applied by '* tjen- Uemen '* to professional brethren who only differ from themselves in a point of therapeutic belief.
I practised the first thirteen years of my professional Hfe (after becoming legally qualified) on the ordinary lines ; circum- stances drew my attention to the greater curative power of Hahnemann's method, and after careM experiment I adopted it. This is now twenty-five years since, and in spite of all the obstacles and unpleasantnesses thrown in my way by the kind of opposition I have met with, both socially and medically, I have never once seen cause to regret my adoption of tiie Homoiopathic system of therapeutics.
I fully beheve in thus acting I was carrying out the highest duty of my profession, as embodied in the words contained in the first proposition in Hahnemann's Organon of Medicine.
'' The physician's high and only mission is to restore the sick to health ; to cure, as it is termed."
In following out this direction I believe I have fulfilled the promise which I gave both to the College of Physicians, and to the British Homoeopathic Society, to do my uttermost to uphold the honour and dignity of the profession.
Whether I am mistaken or not in my readings of foists, and in my deductions, I claim at least as great a love and reverence for the duties of a physician as any man, and I protest earnestly against any attempt to coerce the liberty of the scientific physician, whether by the silken thread of resolutions such as yours, or by the vxdgar cart-rope which so long bound the members of the enslaved British Medical Association.
In establishing a School of Homoeopathy and a Homoeopathic
128 NOTABILIA. "S^=Sr?'?Sl5?
Beview, Feb. 1, 1882.
Hospital I believe we are doing our best to winnow out any errors which may have existed or may exist. Those institutions are open to the whole profession, and they both shall have my warmest support till they have completed the estabhshment of Truth and the exposure of Error. In either result you and other earnest physicians ought to help us forward. For myself and my colleagues I claim that we are acting as scientific physicians should do, and using the liberty granted us by the law of England, which you and some others are attempting to deprive us of.
Yours faithfully,
(Signed) William Bates.
BIRMINGHAM HOMCEOPATHIC HOSPITAL.
We have heard with much pleasure that at a meeting of ike- trustees of the WiUiam Dudley charity, held at Birmingham, on December 28rd, for the purpose of distributing their surplus income in Christmas gifts to charitable institutions— out of the J6500 thus awarded, a sum of JS200 was devoted to the Homoeo- pathic Hospital.
From a notice of the hospital given in the Birmingham Daily Post, we learn that during 1880, 24,000 patients were received^ being an increase of 4,000 over 1879. This newspaper adds that '* in giving £200 to the Homoeopathic Hospital, the trustees have only looked to the simple fact tiiat that hospital is engaged in a good work, and one — apparently from the number of patients applying for relief — of considerable importance to the town, and that it is, therefore, entitled in its turn to share in the benefits of the charity.'*
THE MOVEMENT CURE.
On Thursday, the 19th ult., Dr. Both gave a demonstration of the method of treatment known as the Movement Cure, or Ling's System, to the members of the British Homoeopathic Society and some other medical friends.
Dr. Both commenced the proceedings by a short sketch of the career of Ling, who developed the method. He then described the various gymnastics of Ling as divisible into Educational, Military, Esthetic and Medical, The various kinds of move- ments and of nuusags were detailed, and the limited amount of machinery used was shown. In exhibiting the kinds of move- ments Dr. Both had the aid of two assistants. He concluded a
NOTABUiU.
129
most interantifig leeiore by poiiilbg oat the physiological effects of the yarioas movemente, including those of the mauage,
A hearty vote of thanks, proposed by the President of the British Honueopathic Society, seconded by Br. Dudgeon (V. P.) terminated the proceedings, after which Dr. Both hospitably entertained his Mends at a sapper.
LONDON SCHOOL OF HOMCEOPATHY.
Lest of Sabsciiptions HonuBopaihy, reeeiyed 1882:—
in sapport of the London School of or promised, to date, 14th January,
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SOGI£t£ FEANOAISE D'HYGIENE.
CompOiJtMnifor 1882.
I. — ^Hygiene akdPhtsical Education of Childben fbom 6 to 12
YEABS OLD.
Home life, school life, country life, and life in the workshop to be discnesed separately.
n. — ^PiBaoNAii AMD Domestic GuBAiajNBas. A stady of personal and domestic cleanliness of rich and poor of both sexes and all ages, in town and country.
O&neral BuIsb applying to both CampetUums. 1. — The essays not to exceed 80 to 40 pages of printed matter
in 12mo. 2. — ^The essays to be sent, distingoished only by a motto, to the. office of the Society, ** 80, Bue du Dragon,'' before Sep- tember 1st, 1882. (Candidates who make tbemselves' Imo^fn in any way will be excluded from the c<mipetitions}»
TeL 26, No. 2.
180 HOTABOLU iSlRfSSTiS
8* — The sofieessiiil eaMys beeome liw pioparty (tf tte Soeiety,
and inll be pnbtighed either m «rtfiuo, or in a& abridged Ibnn,
the names of alisnecesflfiileoiiipetilontobeinthetEyepage
of the published pamphlet, ndueh wili be Ingelj eiiviilated.
The aboTe are two dirtinet oompetitkms, in each of idiieh a
gold, silver, and two bronze medate are offend.
Puis, 15th December, 1881.
NOTTINGHAMSHmE HOMCEOPATHIC INSTTrUTION.
Wb have reodyed a report of the above nseliil institotion from Dr. Stanust Wiij>b. Considering the small nnmber of sob- seiibeni. Dr. Bbadsha.w and his coUeagae are to be congratulated on the large nnmber of patients who have availed themselves of the dispensaxy during the past year, no less than 1,084 having presented themselves for treatment ; the nnmber of attendances being 9,245. These figures are no mean total for an institution irfaose honoraiy snbsoriptions only amonnted to abont £30 for the year.
Dr. Bradshaw having retired from practice, the work of the dispensary has now devolved on his successor, Dr. Stanley Wilde, to whom we wish as suecessfiil a career as his honoured predecessor.
It must be gratifying, indeed, to Dr. Bradshaw to know that ** he has carried away with him in his retirement the regrets and hearty good wishes of all who were in any way associated with him in his long career of practice in Nottingham ; and none have been more earnest in their expressions of gratitude and regard than the poor attending tins institution, between whom and Dr. Bradshaw a sincere and mutual attachment existed."
The report draws the attention of local scoffers to the number of patients attending the dispensary, asking whether " patients would attend in such numbers i they derived no benefit tiierefrom ? "
We trust that this institution will continue to flourish in the future, and that the next report may show a still frirther increase in its already very creditable number of patients.
BEmSH HOMCEOPATHIO SOdfiTY.
Thb Fifth Ordinazy Meeting of the present session will be held on Thursday, February 2nd, 1882, at Seven o'doek.
A paper will be read by Dr. Hayward, of Liverpool, entitled, «The Dose of Crotdlui Venom, ^ — ^Toxieologioal, Pathogenetic and Therapeutic."
Of this contribution the following abstract has been printed, in order to facilitate discussion : —
" That some of the pathogenetic effeets are €Am>luU and can be produoed at will ; otiiera are only conUnffmt^ and can be pro- dueed only in eome persons. That the different kinds (tf absolute
^SSS^^HnSS^ COEKBSPOHDENOB. 181
IBeflsWf iFsb. It IflBS.
symptoms ean be produced by different doses, but caainot be produced by iufimtesinial doses. The same facts as to some other drugs. That contingent effects may be developed by any dose, eren infinitesimal : thai they bear no relationship to the size of the dose, but depend upon the presence of < special susceptibility.' Illustrations from other drags. Special suscep- tibility. Distinction of symptoms into absolute and contingent, vide Dr. Drysdale, in B. J. H. zxvi., p. 76.
** That the above facts in pathogenesy may be used as keys to
* the dose ' in therapeutics That contingent symptoms are the sphere of infinitesimal doses ; that they can be cured by any and every dose; there being no quantitative relationship here between dose and cure. Contingent symptoms are the most important of all symptoms in a therapeutic point of view, furnishing the
* characteristics ' in diseases and in pathogenetics. That special susceptibility is furnished by the natural state of the organism in pa&ogenetics, but is induced by the disease in therapeutics.
** That there is danger of breaking up the particles of the irenom by continued dilution, and that the extent of attenuation should be limited by the twelfth centesimal. That there is quantitative relationship between dose and cure in absolute symptoms. That the sixth centesimal should be used for the contingent symptoms, and the lower for the absolute. lUustra- tions with other drugs."
CORRESPONDENCE.
DR. FRANKLIN ON HYDROCOTYLE. To the Editors of the ** Monthly Homaopathie Beview.** OsHTiiXicEM, — ^In the paper of Dr. Franklin's, which you have reprinted in your last issue, there is a grave error, which I ask jour permission to correct. It is the statement that Dr. Boileau's cases, reported as cured by hydrocotyle^ were of lupus, whereas they were really of elephantiasis, as a reference to Dr. Audouit's monograph on the drug will show. The mistake originated with Dr. Hehnuth,* and was pointed out in a note to the article on hydroeotyle in the fourth edition of my Pharmaeo- dynamics. I also called Dr. Franklin's attention to it, on the appearance of his article in the New York Medical Times^ in a inivaie letter. It should not go any farther.
I fear, however, that the con^Bction will not do much to advance our knowledge of the treatment of elephantiasis itself, as Dr. Bofleau could not, in spite of his hydroeotyle^ avert his own death firom this very disease.
I am, Gtontiemen,
Faithfully yours,
Brighton, Jan. 18, 1882. Riohabd Huobbs.
— - ^— ^^^^^^— ^^— ^— ^.
* System of Surgery^ 4th Ed., p. 1861.
s-8
182 COBEEBPOHDENTS. "SrtSir^^ifwSu
NOTICES TO CORRESPONDENTS.
«% We cannot und&rtake to return r^eeted mannuenptt.
GoBBSOTXON. — ^We have been Teqaested by Dr. Both to state that the pxiie offered for the best essay on the Stady of the Causes of Blindness is to be given not as our paxagraph might lead people to suppose, by Dr. Both himself, bnt by the Society far the Prevention of Blin^iess, of whioh he is (pro tern,) Secretary and Treasurer.
Commnnioations have been received from Dr. Both, Dr. Goopsb, Dr. BulCXlst, Dr. Clabk, Captain Mazoocx, Mr. Chakbb6 (London) ^ Dr. Bates, Dr. Hughes (Brighton); Dr. Hakhaii Smith (Bamsgate); Dr. Batnbs (Canterbury), &c.
BOOKS RECEIVED.
Chronic Sore Throat, Second edition. By E. B. Sholdham, MJ), London. Gould Sb Son.
Ophthalmic Therapeutict, By Dr. Norton. NewTork. Boericke <fi; TaleL
The Ophthalmoicope, lU Theory and JPractUal XJeea. ByC.H. Yilas, M.A., M J). Chicago. Duncan Bros.
Visiting Li$t and Prescribing Record. Otis Clapp k, Son. Boston.
British Journal of Hofnotopathy,
Dublin Journal of Medical Science,
The Honusopaihic World.
The StudenVi Journal and Hospital 0€U$tte.
The Midland Medical MisceUany.
The Medical News and Collegiate Herald.
Burgoyne*e Mag<uine of Pharmacy and Chemistry,
The New York Medical Times.
The Medical Advance.
Medical Press and Cireular. Jan. 18.
The United States Medical Investigator.
The American Observer.
The Medical Counsellor.
The HomcBopathie Physician.
The Hahnemannian Monthly.
Martin's Chemist and Druggisi's BulUtim, New Totk.
Bulletin de la Soc. Med, Homaopathique de France.
BihUothi^ue Homcsopathique.
Bevue HommopaMque Beige.
AUgemeine Horn.
El Criteria Medica.
Bolletino Clinico.
Papers, Dispensary Beports, and Books for Bevisw to be sent to Dr. Pope, 81, Heniietto Street, Cavendish Square, W. ; Dr. D. Dtcs BmowK, S9, Seymour Street, Portman Square, W. ; or to Dr. Ebkkbdt, 16, Montpelier Bow, BlacUieath, S.B. Advertisements and Business oommunicatioiui to be sent to Messn. E. Gould & Boh, 69, Moorgata 6trset>£.a
ISlSa^^ul^ KBW MEDICAL BILL. 183
THE MONTHLY
HOMGEOPATHIC REYIEW-
HOMOEOPATHY AND THE NEW MEDICAL BHiL.
It is expected that, dnring the present session of Parlia- menty after the more argent business has been disposed of, a new Medical Bill will be introduced. The Medical Acts Commission, which was appointed to take evidence on various points on which there was difference of opinion, has concluded its sittings, and sent in its report to Parlia- ment.
Keeping in recollection how vitally important were the provisions for the protection of homoeopaths in the Act which is at present in force, and that they were only intro- duced by members of both Houses in the interests of homoeo- pathy, and after this Bill had been drawn out by men acting in the interests of the old school, it behoves practitioners of homoeopathy, and the public who so largely avail them- selves of this enlightened and scientific mode of treat- ment, to consider, at the present juncture, what ought to be the course adopted in regard to the new Bill.
The general opinion, we apprehend, will be that we
ought to stand on the defensive. One mode of so doing
will be, we &ncy, advocated by some of our body, namely,
to sit still, and let those of the old school who manage
Vol. 26. No. 8. L
134 NEW MEDICAL BILL. ^^^^gXlflSSr
the Bill and pull the wires do as they like, and only inter- fere when anything subversive of the interests of homoeo- pathy is proposed, when, perhaps, it may be too late to- prevent mischievous legislation. This is not what we, however, understand by remaining on the defensive. It is simply putting off our uniform, and going to sleep. What every one means in war by acting on the defensive is standing in a strong position, fully armed, and fortifying the camp ready to meet any attack. We have to make sure that we take every means in our power to hold and keep .the position we now have, and strengthen it in every possible way. We are so assailed on eveiy side that unless our defensive position is a fully armed one, we must be crushed out. One wing of the opposing army attacks us by telling the public and ourselves that our chief cusiu hdli is an ethical one, that while our principle is not ob- jectionable in itself, we hold to the name *' homoeopathy " and use it for '' trade purposes." A second battalion assails us by asserting that our principle is no principle at all,. but unscientific, and, in fact, nonsense. On a third side we are told that our doses are absurd and useless, and that our system is, therefore, only quackery; while a fourth wing, the most dangerous of all, make use of our principles and our medicines, while they ignore us altor gether, and, still worse, ignore the great founder of homoe- opathy and his diBcoveries. These sharpshooters infomn the public that there is now no difference between allopathy and homoeopathy, and, in fact, that homoeopathy does not now exist.
Between these cross fires we have difficulty in holding our own. Spies in the camp hold out the bribe of the loaves and fishes of the old school as an inducement to lower the flag and drop the name of homoeopathy* To act on the defensive in suoh circumstances means the assump*
aUS^SSHi^. »BW MEBICAE BILL. 186
I
tioB of a folly armed and fortified pogition^ maintained ocoasionally by sorties into the enemy's camp. To drop metflfphor we must, in the first plaoe, resoWe to maintain the honoured name of homoBopatby. We all agree to fight for the principle and the liberty to practise homceopathy, bnt we cannot too dearly make it understood that the pmctiee of the homodopath is essentially different from that of the old school, and that while this differatoe exists, as it most do nntil our prindples and practice become not only generally adopted, bnt adopted openly and with foil recognition of the correctness of both, there mast be a name to distinguish the one practice from the other. No better word than the time-honoured one of " homoeopathy*' has ever been suggested. We, therefore, must retain it, and call ourselves homoeopaths, glorying in the name, as indicating our belief that we have found the most im- portant guide in the labyrinth of disease ever discovered, and that, till it is universally recognised, it is an honour to be the custodians of a great truth, and not even to seem to be ashamed of the word descriptive of it.
Next, we must strengthen our defensive position by letting it be as widely known as possible what homoeopathy really consists of, and how different it is to that which our opponents choose to describe as such. Besides maintain- ing our journals, hospitals, and dispensaries, we must keep up the School as a place where those who wish to inquire into the subject can have information given to them, not only as to what homoeopathy means, but how to practise it.
Such, we apprehend, is the general feeling as to how we should conduct ourselves at the present juncture ; and to give as clear a notion as possible of this, our defensive position, to the Legislature, it was proposed by Dr. Bates, who is always in the front in energy and activity when an ofvportxBitty offers of aiding the cause of homoeopathy, to
L-2
186 HBW MEDICAL BIJJ,. SS^SS^^^
send ft petttion to Parliament, to be signed hy the membra of the profession praotiaing homceopathically, &nd hy those of the laify interested in the spread of this benign system. The form he drew out was sabmitted to a meeting of medical men, and, with some modifications, adopted as expressing the views and wishes of the new Bobool. This petition will be sent to all practitioners of homueopatby for their approval and signature. The points taken ap in the petition are the logical sequence of a determination to maintain the armed defensive position we have described.
The preamble states that onr claims deserve serions consideration in the new Bill.
The first clause of the petition prays that the clanses of the Act of 1868, which protected the student holding homoeopathic beliefs from being rejected in his examination on that account, be continued : and that, in addition, the right to teach such views be permitted without fear of refusal of recognition by the Medical Council on that score.
2. That it be made illegal to exclude any man from the stafi* of a hospital or dispensary, or a professorial chair, on account of his holding homceopathic beliefs.
3. That it be made illegal for any medical corporation to pass laws, or bye-laws, advising its members to refuse to consult with homceopaths, aa such, or to attempt to enforce any penalties on their members for so doing. In other words, to prevent medical " boycotting."
That fnU liberty of thought and action shall be litted in the practice of the profesmon, and that binations to prevent this be rendered illegal.
That in the Medical Council faomteopathy -be full; i^ented.
That in order to strengthen the hands of the London
i£SS?'&Tm1! new medical bill. 187
School of HomcBopathy, a charter of incorporation be graniecL
7* That this School should be empowered to grant to those stadents who satisfactorily pass an examination in homoeopathy a diploma or certificate of such knowledge, to be called the '' L.H." or Licentiate in HomoBopathy.
Lastly, that provision be made for the establishment of new schools of medicine, which are not to be refused recog- nition on account of theories of practice being there taught other than those at present taught in the schools.
Such claims of the petition seem to us to be only the logical and practical outcome of our determination to hold our ground, and not to be snuffed out or absorbed in any new Medical Bill. The only point in which there may be a difference of opinion, will, we fiemcy, be the appli- cation to empower the School to grant the ^'L.H." diploma. We may be told that this tends to the keeping up of the sectarian position of homoeopathy, or putting it into this position. Now, a litUe consideration will show that such is not the case. It is not proposed to give this as a license to practise. On the contrary, it is not to be granted to any one who is not legally qualified to practice. It is simply a tangible assurance of the knowledge of homcBopathy on the part of any one who professes to prac- tise on this method — ^merely the official stamp of study and necessary training, while it protects the public from being taken in by a man who, from any motive, professes to prac- tise a system of which he knows nothing. Those who already practise homoeopathy are well aware of the amount of study required to do so satisfactorily, and that it can not be taken up by any novice without careful study and train* ing. It behoves them, therefore, to do all in their power to prevent their benign and scientific system being brought into disrepute by men who know nothing of it. It is there-
188 NEW MEDICAL BILL. fiS^M^IfttS!
fore simply a defensive measaie — defensive for the already existing practitioners, defensive for the public, and defen- sive also for the commencing practitioner. The possessor of the ''L.H." is received into the fireemasonry of homceo- pathy as a brother, instead of being regarded with suspicion by the public or the profession. In order to given an immediate value of this nature to the ^' L.H./' it is pro- posed to ask those already in homoeopathic practice to apply for the honorary diploma, not to enhance their already existing position, but to serve as an example to the young men, and to render the possession of it by a man commen- cing practice absolutely necessary, and the non-possession of it a ground of suspicion of his knowledge of this mode of treatment. Unless the main body of the practitioneirs of homoeopathy accept this honorary diploma, any one com- mencing to practise homceopathically may snap his fingers at it, as being a certificate which very few have or care to have. It is, then, not an aggressive or sectarian move, but simply a measure of defence.
Whether this view of the ** L.H." carry practical convic- tion to the minds of our confreres or not, we trust that, at all events, they will to a man sign the petition. A peti- tion largely signed will carry great weight, whUe the reverse will always look like a flag of distress, and seem to show how little we care for the principles we live to promulgate and practise. We are satisfied that the true way to gain the position in the profession at large which we are entitled to, and which we shall have one day, is to maintain an armed resistance, resolved not to yield an iota of what we deem vital in the honourable struggle we have so long maintained, while weak knees and indifierence to our claims will only end in annihilation, and consequent retrogression of medical science.
^t^SSSu^ P080LOOY, <180
P080L0GY IN RELATION TO HOMCEOPATHY .♦
By AiiFred C. Popx^ M.D.
Pierident of the Britiflh Homoeopathio Sodeiy. Leetarer on ICMoria Medioa at the London School of Homoeopathy.
On Monday last I discussed the method of ascertaining the effects of drags with the Tiew of ntilising them in the treatment of disease, and also endeavoured to explain the action — ^the modus operandi — of ahomoeopathically selected medicine. To-day, I propose to consider the question' of the dose in which snch a medicine should' be prescribed.
The size of dose in which medicines are given is, catlsrU paribus and within certain Hmits, contingent npon the principle on which they are selected. Thus an analeptic remedy is given in a dose capable of being easily digested, or in one adequate to produce that degree of stimulatiom which is required. An anti-parasitic must be applied in 'a quantity such as experiment has shown will render germ Sfe impossible, and a vermicide should be administered with reference to the species of worm it is desired to get rid of ; an empirical medicine should be prescribed in that dose in which it first acquired its reputation ; one that is antipathic or allopathic requires to be given in as large' a quantity as is sufficient to excite the abnormal action it fjs designed to promote ; wiiile, of a homoeopathically selected remedy, a quantity must be given smaller than that which will suffice to excite tiie pathogenetic action of the drug.
Such, then, are the principles of posology. It now becomes our business to enquire more particularly into the -dosage which is desirable — ^that which has been found most advisable in practice, when a homceopathicaUy selected medicine is prescribed.
The general principle which I have just laid down is midoubtodly sound, out we have to leom how much smaller than that necessary to excite pathogenetic effects may the dose be, and how much Bmsller shotUd it be.
The infinitesimally small doses in which, from compava- tively early in the history of honuBopathy, medicines have been prescribed, has led many to suppose that they -were necessary, were essential to the carrying out of the prin- eiple. That this is contrary to fact has now been abim-
txtWAi
Delivered at the London School of HomcBopathy, October 134k, ISlL
140 posoLOGY. ?£^J£r?St
Bemw,]f]urahl.iaaL
dantly proven. Between the requisite smaliness and the possible smaUness is a very wide range indeed; while between this, and that degree of minateness it has been sought to obtain, the range is Teiy much more considerable stiU.
Hahnemann/ during the first four or five years in which he treated disease homoeopathicaUy, used 8-4 grain doses of such medicines as nux vomica and veratrum album: arnica in a few grains ; of ignaiia, 8 to 7 grains; of opium, from l-6th to 1^ a grain ; camphor, in from 80 to 40 grains ; ledum palustri, in from 6 to 7 grains ; cinchona^ in half drachm and drachm doses. After this time we find him giving heUadmna in the 432,000th of a grain, and some other medicines in similarly small proportions.! In 1806, he writes of hundredths, thousandths, and millionths of an ordinaiy dose.t From this time forwards he gradually diminished his dose, until in 1829 he arrived at the con- clusion that the 80th dilution or the decillionth part of a grain was the best possible dose in all cases. § Albeit, this is dogmatically stated in the Organon as applying to aU medicines, it is, at the same time, perfectly clear that he recognised exceptions, for in 1881, when writing his direc- tions for the treatment of cholera |1 he directed camphor to be given in two or three drop doses of a solution of one part of camphor to six of alcohol, and repeated every few minutes. Indeed, throughout the whole thirty-'five years, during which he had been gradually giving less and less medicine, whenever camphor is referred to, it is always directed to be given in such a dose.
Hahnemann rests his claim to pronounce thus dog- matically on the size of the dose upon his *' experience.'* On no better basis could a conclusion of this kind rest. By no other means than by experiment can we learn the proper dose of any medicine. At the same time, in order that we may accept a conclusion so broadly and unreservedly expressed, one which must inevitably be influenced by so
* Lesser WriHngs.—^UB.yB published from 1797-1800. London: Headland, t On the Cure and Prerention of Scarlet Feveac,— Lesser WriHngs,
iThe Medicine of Experience. — Lesser Writings. The Orgaium of Medicine. Fifth Edition. Note to § ocxItI, page S89. Dodman's Tranalatiop.
I On the Cure and Prevention of Asiatic Cholera. 1881.— LeiMr WriHngs.
ggygaySg POSOLOQY, 141
many and Buoh varioos eircamstanoes, we ought to be in a position to examine this experience. We shonld like to lead the notes of some of those cases which convinced Hahnemann that his early doses were excessiye. Un- fortunately, we are not in a position to do this. Two cases, and two only, were left by him.* The ojie is a case cored by drop doses of the pure tincture of bryoniay the other, one where the 12ih dilution of pidsatiUa was used. Not having the eyidence before us that satisfied him, we are unable t5 form an estimate of its value. Hahnemann's experience is one we cannot criticise, and therefore cannot appreciate the force of. However justifiably we may appeal to it in support of general propositions, it is not available to demonstrate such as are particular. It points to the general adequacy of homoeopatiiy to meet the necessities of disease, so &r as the administration of medicine is concerned, and it affords abundant reason for putting homcBopatiiy to the test of clinical investigation. But it does not supply us with evidence that the 80th dilution is the proper dose under every circumstance. On the con- trary, it is impossible to study cM his directions about the dose without being struck witib the frequent contradictions in which he involves himself; the hasty conclusions, so emphatically pronounced, at which he occasionally arrives, and the marked influence which theoretical speculations of doubtfol validity exercised on all his practical work.
Hence, I conclude that, not only are we not, as homoeo- pathically practising physicians, bound by the conclusions arrived at by Hahnemann, but we ought not, in justice to ourselves or to medical science, to rest satisfied with his teaching on the question of the dose. On the contrary, it is our duty to bring to beur upon its solution, the observa* tions of sdl who have carefully examined and recorded the results of their experience in the use of homoeopathically selected medicines.
Taking it then as proved that the curative dose of a homoeopathically selected remedy is smaller than one that is pathogenetic, I will proceed to consider the circum- stances which general experience has served to show may in some measure regulate the degree of smallness.
* Materia MedUa Pwra, vol. i., page 20-23. Hahnenuuin PabHshiBg Bodefy's Ttuulation.
142 POSOLOGT. iS^'^SSffSS
Bevi0ir,]fWBbl,1
The size of the dose will be influMieed by ciienmstaiMfe hsTing referenoe to the pttaent, to the dMease, and to'4he medicine*
1. The Patient. Bxperienoe has ftiUy pnyfed Imw Tarionsly different individiials are afiected by certain medi- cines ; and not only so, but in some instances a person will be markedly afiected by a given drag in a certain dose at one time, while on another occasion he will be qnite insus- ceptible to its action in such a qoantity. In disease, agaan, special susceptibility exists in certain organs to drags for which they possefit an deotive affinity. Thus a medicine which in a healthy person will excite congestion of the kidney, will, in one saffeiing from this condition, act upon the ladney in a mncfa smaller dose than it woald do in health. The kidney has, throagh being congested, become especially sendtire to the inflaence of tiiat <fa*ag.
Temperament, too, modifies indiyidnal sasceptibility to the action of drags. Thns Trinks says that the melan- cholic, sanguine, and choleric temperaments display the greatest susceptibility, the lymphatic the least; and all writers agree in recognising the fact of the existence of special sensibility to medicinal action in persons of a nervous temperament.
Sex and age both modify the degree of susceptibility to the action of medicine. Cateris paribus the female and the two extremes of life are more easUy acted upon than the male and the middle-aged.
Climate, again, has been found to be a &ctor in deter- mining medicinal power. A very dry climate increases sus- ceptibility to medicinal influence, while in one that is damp it is diminished.
Occupation, diet, indulgence in the use of stimulants and narcotics, the long continued or habitual use of drugs, such as opium or tobacco, all tend to modify the power of resistance to the action of drugs.
These reflections will serve to show how impossible it is that one dose should be suitable to all persons, and how certain it becomes, that in determining a dose of medicine, we must take into account the constitutional disposition and social habits of a patient, as well as the locality in which he lives. In short, in considering the dose of the medicine we propose to give, we must endeavour to farm an estimate of the effect the circumstances amid which a
XSSil'SrTflS? P080L0OT. 148
Beriew, Manfa 1, 1802.
patient liyee is likely to have upon his power of resistanoe to dmgs in general, as well as to certain drags in porticmkr.
2. The nature of disease has its influence in determining the dose. No role has met with more general acceptance than that which enjoins the use of low cUIntions, and eren small doses of the erode drag, inacnte, and of infinitesimals^ properly so called, in chronic disease.
The late Dr. Phillips, of Manchester, read a paper at the Congress, held at Edinburgh, in 1862, in which he argued the general propriety of this rule. He based his ^yooacj of it on his haying, in the course of a somewhat extensiye experience, compared the effects of different •dilutions of the same mechciae in persons liable to occa- sional attacks of the same form of disease, such as ulcerated sore throat, acute dyspeptic headadie, &c. In chronic disease, he adduced clinical eyidenoe to show that the same medicines which had fiedled to giye any relief in the Srd and 'Gth dilution, had proyed ouratiye in the 80th.*
The late Dr. Trinks,t a highly practical physician, thought that, with a few exceptions, this rale was a correct one. iBg^ and Glotar Muller, of Leipsic, on the other hand, doubted its yalue; while the late Dr. Carroll Dunham, t of New York, contended that the highest dilutions were preferable to — ^more rapidly curatiye than the low, both in acute and in chronic disease. And only a few days ago, I met at a consultation in the country, a phy- sician, who I know to be a singularly careful practitioner, and he assured me that his most marked success in acute disease had been obtained with medicine in comparatiyely high dilutions, such as 6th and 12th. ' Going from generals to particulars, we find Dr.Neidhard,§ of Philadelphia, saying that his experience pointed to the special adaptability of the higher and highest dilutions to all diseases of the brain, spine, and neryous system, and as a general rule, to diseases of the skin ; while the lower dilutions and material preparations he had found more useful in diseases of mucous membrane, particularly that of the bronchi and lungs ; that all chronic diseases of
* British Journal of HomoBopathyt vol. x., p. 660. t (Est. ZeiUch., pp. 1, 3, 286.
t On the use of High and Low PoienoieB in the Treatment of Diieftse. American Honueopathie Review, Tol. iv. } British J<mrfuU of HomoBopathyt Tol. xxvii., p. 58S.
144 POSOLOGT. ^^^tSSr?^
BoTiew, lianh 1, ises:
the liyer require the largest doses, and that syphilitic disease he had never been able to cure without the emploj- ment of the lower preparations.
Dr. Trinksy* who always manifested a preference for the lower dilutions, regarded the nature and character of disease, rather than its situation, as a determining circum- stance. Diseases that display in all their phenomena great energy, and intensity and rapidity of eyolutioui attack the most important organs, betray much malignancy, and threaten the integrity of the whole organism or of certain parts of it, demand, he says, an energetic and rapid medi- cinal influence. Higher dilutions he seems only to regard as useful in some cases of hysteria and neuralgia, in some spasmodic affections, and chronic gout.
Dr. Sharp thinks that '* different doses of the same drug are sometimes characterised ... by acting upon diffe- rent organs.^'t This seems to me to be likely, with carefid study, to prove a somewhat fruitful idea, and certainly it is one that is deserving of much more examination than it has yet received. It is perfectly possible to examine the provings of the Austrian Provers' Society, for example, and note the organs which, with different doses ol^ the same medicine, give rise to symptoms. So, too, with drugs like arsenic and mercury, for instance, of which examples of their action upon the body may be met with from doses of very wide degrees of magnitude. Well worked out, on a somewhat considerable scale, I think this view of Dr. Sharp's would do much towards enabling us to regulate our posology, with far greater accuracy than we can do at present.
Then Dr. Henry Madden has endeavoured to show " that different doses of the same drug will be found suitable i» different phases of the action of that drug."t That is to say that a medicine, the pathogenesy of which may bear a likeness to several forms of disease, will meet each in a different dilution, far better than it will in one that is uniform. What Dr. Sharp's suggestion is from the physio- logical side, Dr. Madden's is from the pathological. The latter has also a hopeful look about it ; and perhaps, if a veiy extensive series of observations of the necessary kind
* Dr. Dadgeon'fl Ijeeturet on Homceopathy, p. 424. t Homaopathie Review, vol. xi., p. 741. } BritUh Journal of Hotnceopathy, vol. xxvi.
Beview, ICareh 1, 1882. POSOLOGY, i.40
conld be made, it might have a practical Talue. At present the evidence respecting it is contradictory; for example. Dr. Bayes* and Dr. Madden have both asserted that the 12th dilation of chamomiUa is that best adapted to meet those eases of reflex irritability of the gastric and intestinal mncoas membranes in childhood for which it is indicated. On the other hand, Dr. Hirsch strongly recommends a weak infusion of the flowers in snch cases.! Again, Dr. Bayes regards the 18th dilution of bryonia as that which is most useful in acute rheumatism ; I while Dr. Yeldbam thinks that one, two, or three drop doses of the pure tincture none too much ; and Dr. Black and others tell us that the 1st, 2nd, and 8rd dec. are far more useful than a higher dilution. In Dr. Bayes' very excellent work on Applied Homceopathy, he has endeavoured to work out tids line of thought, and has, in referring to each form of disease influenced by a given medicine, stated the dose or dilution in which he has found it to be most serviceable.
From what I have now laid before you, you will see how much thought has been brought to bear upon the deter- mination of the very diflicult question. What is the best dose of a homoeopathically indicated medicine? How various are the views held regarding it I And yet, if you read books such as Simpson's Homoeopathy ^ its Tenets and Tendencies, you will be led to believe that a globule of the 80th dilution is the one dose used by all homoeopaths. And until quite recently such was the teaching of the medical Press. Some years ago the Lancet, in order to put the misrepresentation concisely, invented the term '' globulists," to designate physicians practising homoBO- pathy. And yet, notwithstanding all the discussion and all our experience, all we learn from the evidence is, in the first place, that such or such a medicine has been found useful in a very wide variety of dose ; and secondly, that there has during the last five-and-twenty years been a growing conviction that the lower dilutions — ^preparations containing the 10th, the 100th, and the 1,000th part of a grain or drop of the original substance are more generally applicable to meet the necessities of disease — especially of such as are acute — than are more infinitesimal quantities.
— - ■ - ■ — ~ — I — — ■ ■ — — — - — -
* Applied Homoeopathy. London : Tomer & Co. t British Journal of Homceopathy ^ voL zzv., p. 892. X Op, eit.
140 POSOLOGY. isssjfSrjSf
Thirdly^ we haye to enqmre how far the dose is inflaeneed by the medicine itself.
That certain medicines are more serviceable in a low dilation, or even in the crude state, while others are so in high dilutions, is a proposition which has met with a large amount of consent from practical writers. Hahnemann himself, before he had committed himself to the statement that the 80th dilution was the best in all cases, recognised this as may be seen in his Materia Medica Pura. Thus, gmacum is ordered in drop doses of the pure tincture,, camphor in the eighth of a grain, sarsapariUa in the pure tincture, svlphur^ hepar sniphuris, and argentum in grain doses of the 2nd trituration, euphratia^ menyanthes, and Bamhwcm in the pure tincture, so too taraxacum^ ipecacuanha in the 8rd dilution, stramonium in ihe 9th, digitdUa in the 16th, arsenic in the 80th, beUadanna in the 80th ; and so on. There was, until 1829, a great yariety in the dilutions advised by Hahnemann. Dr. Goullon, in an essay on the dose, published in the British Jowmal of Hom4Xopathy five-and-thirty years ago, says that certain medicines act equally weU in the undiluted state and in the 80th dilution. Others, again, require dilutions before they will evince medicinal properties; while a third class must be given in the 1st or 2nd dilution or in the pure tincture to produce any effect at all. Dr. Hirsch * also says that his experience assures him that certain medicines manifest their healing virtues better in an undi* luted state, while others act more promptly in dilution. So also with Trinks.f He divides the Materia Medica into three classes : one comprising medicines that ought to be given in the high dilutions, one in which the medium dilutions should be used, and a third composed of those which are best prescribed in the lowest dilutions, or in the pure substance.
Of medicines which require trituration before evincing medicinal properties at all, are such as Ume, silica^ lyco- podiumy and common salt. With regard to lycopodium^ the explanation of the necessity for this trituration is easily found. An examination of the lycopodivm powder shows that it is made up of a number of littie particles about the eight*hundredth of an inch in diameter, having all the
t Dudgeon's Ltctwru on Homoeopathy.
abape and firmness of a nut. After prolonged trituration is an agate mortar^ these dense particles are fractured, and their contents— -oil globules — dispersed. It is in this oleaginous matter that the medicinal power of lyeopodium is believed to reside. Mr. Isaac Thompson, of Liverpool,^ who drew attention to this fact some years ago, found that, for complete fracture of all the particles, trituration with sugar of milk required to be prolonged for two hours. In pr^aring a tincture ether is essential.
With regard to the otiier substances named, an explana- tion of their having medicinal influence after prolonged trituratiou, and either none or at all, or very little in their crude state, and of the further £&ct, that they manifest their mftdioinal properties, even when very highly diluted, the interpretation is not so ectsy. Hahnemann, in his desire to account for the facts, advanced l:he doctrine known as dynamisation, or development of properties. He held that prolonged trituration and succession increased and developed lat^it medicinal properties.
Unfortunately, he associated with this, in itself, not improbable theory the idea that the development of properties produced by trituration, proceeded at so great a rate that diminution of matter became essential to prevent oyer-action of the drag, and this to a very extreme degree of infinitesimality. While there is, as I shall show presently, sk. prima fade probability of prolonged trituration developing latent force, that it renders actual that which previously was potential, there is no evidence whatever that any advantage accrues, any additional development of properties obtains, by any extensive diminution of dose, or any very lengthy trituration.
Of the fact that, in. a well triturated and diluted state, such substances as those I have named do possess medicinal power, I have not the shadow of a doubt. My own clinical expisrieQce, and that of all homoBopathic physicians, assure me that they have. While it only remains for those who doubt their having such properties, to try these medicines in cases to which they are homoeopathic to have the same assurance.
The effect of prolonged rubbing upon some substances, whioh, in their ordinary state* are for all practical purposes inert, is, as I have said, to develop latent force, and by so
* Britiih Journal of Hommpathy^ vol. xxziv., p. 188.
148 P080L0OY. ^£-2i'22Sf?Sli?
Renew, Mndi 1, 18tt.
doing to admit of the display of medioinal action enabling the drug to influence tissue. This view is well set forth by Mr. Sonstadt, in a paper published in the Homasopathie Review (yoI. xiy.), in which he discussed the effects of trituration upon matter. Every molecule of all simple or chemically combined substances, he writes, when '' in its entire state contains most of its energy in a closed circuit (somewhat as does a magnet with its keeper on), and while in this state, so much of its energy is potential, not actual. Every such molecule may be torn asunder, and, when divided, the energy before latent becomes apparent as force, and able to do work." After some comment on this, he goes on to say, " In the homoeopathic triturations, at a certain stage of the process, the molecules are torn asunder by mechanical force (or by forces engendered by mechanical force), and retained asunder, thereby keeping an active virtue which appears only momentarily in chem- ical processes." The whole advantage then of trituration, according to this theory, consists in the setting free of latent force by mechanical molecular rupture. If this be so, trituration beyond the 6th decimal would not seem to be necessary ; while trituration on the decimal scale would be more effective than it is on the centesimal scale. Both these conclusions are, I think, justified by clinical experience.
Again, the class of symptoms has been thought to give a clue to the right dose. Thus Dr. Drysdale divides the symptoms producible by a drug into such as are absolute and those which are contingent. The former include such as are produced at will, those that will occur in almost everyone who takes the drug in a full dose; while the latter are symptoms which will occur only in persons specially susceptible to the action of that drug. In pre- scribing to meet symptoms of the former class. Dr. Drysdale is of opinion that -we should keep as little below the physiological dose as will allow of our avoiding any aggravation ; while, when the symptoms are of the contin- gent order, the dilution should be high; but he, at the same time, says that the sixth is high enough. While there is much probability in the truth of this suggestion, it is, after all, only a more exact way of stating the empi- rical rule of low dilution in acute, and high dilution in chronic disease.
From this part of our subject we may infer, then, that
JSSl^SSf?^*" POSOLOGY. • 149
Bfiview, Much I, laft*.
experience has shown that, within certain limits, differeut medicines act better in different doses. This, from what we know of the varying degree of activity in different medicines taken in health, is what might be anticipated.
Our examination of this qaestion so far has shown as that, beyond the very rough role that our dose in each instance should be one smaller than the physiological or pathogenetic, there is, in the meantime, no sure guide to the selection of the exact or precise dose.
Practically, our business as physicians is to prescribe medicine in sufficient and not excessiye quantities. How, then, are we to determine what is sufficient and what is excessiye ?
The only justification that can be urged for using medi- cine in a highly diluted form is the rucessity for doing so. If a high dilution is unnecessary, if as good results can be obtained, I will not say uniformly, but generally, with small doses of the crude substance, or with the lower dilutions, as with such as are high, there are, I think, good soxmd reasons to be urged why we should prefer the former. It is perfectly true that medicines, in what may be termed the higher dilutions, are capable, when homoeo- paihically selected, of curing disease, and that rapidly. All the earlier triumphs of homoeopathy were won wiUi medicine given in this form. But that is not sufficient to justify our persisting in confining ourselves to their use, if it can be shown that more mat^ial quantities act equally well.
Preference, I think, should be given to the lower dilutions where these are of equal therapeutic value with the higher, because the delicacy of the latter renders them especially exposed to sources of injury from physical causes, such as light, exposure to the air, and so on. These, of course, can be guarded against by care, but such sensitive agents are ever of doubtful integrity, and it it undesirable to add to possible causes of disappointment already existing in using a medicine.
Again, it is a matter of great interest and satisfaction that the dose of medicine we prescribe should be capable of physical demonstration. The researches which have been made of later years by Dr. Conrad Wesselhoft, of Boston, Dr. Edward Smith, of Cleveland, and others, have shown that beyond the twelfth dilution it is impossible to
Yo). 36, No. 8.
160 PosoLOCFY. ^^S'SSSr?^'
Review, March 1, 188S.
demonstrate the presence of matter.* That it exists in some form or other in higher dilations than this, clinical evidence of the power to control disease of tsr higher dilations than the twelfth assares me. Bat, below the twelfth, we have it in oar power to demonstrate the presence of drag matter. And this, I maintain, is a very important position for as to hold ; while the nearer we get to the orade sabstance the greater the control we have over the parity of the preparations we employ. That we shoald be able to examine and test oar pharmaceatical preparations is, I apprehend, a matter of serioas importance. In asing the lower dilations we have this power ; when em- ploying the higher we are entirely destitate of it.
Farther, every medical man who knows and feels that homoeopathy is trae is, before all things, anxioaa that bis medical brethren who are ignorant of its method shoold test it — test it clinically. The existence of this School is evidence that fltich is oar desire. Oar fiteratore is sas- tained to this end. If, then, we create a stambling-^blook in the way of the professional examination of homoeopathy by maintaining the importance of a dose so infinitesimal as to render its existence almost incredible — when so smaU a dose, however sufficient, is vfwnecessary — we are, I think, impeding the progress of therapeatics, and diminishing the valae of our special work.
I would be the last man to advocate any denial, or apparent denial, of that which is essential to the de- velopment of trath in order to increase the rate at which an appreciation of homoeopathy is advancing in the profession. At the same time» so firmly con- vinoed am I of the sapreme importance of homoeo- pathy as a method of drag selection; so sore am I that, after a certain point has been reached, and thence within certain moderate and very tangible limits, the aise 4>f the dose is of comparatively small importance in any but exceptional instances, that I think we are perfectly jastified in laying stress upon, and attaching importance to, ofidy that d^rte of drag 4ittenuatum which has been ffooed to be necessary in order to avoid aggravation, and to ansore that the amoont of tissue stimolfiiion we desire to evoke will not be exceeded.
• TrtmmcH<mM of th$ Awmican InsHhOe of Eomeeopath^, 1879 and 1880.
iSS^£5MSf POBOLQgY. 161
In considering what is neoeBSftry in the matter of doeage, .we oan bat appeal to the experience of men who have practised homoeopathy, nsing daring a long series of years srell nigh every variety of dilation and of dose. Of pre- fwations odled '' potencies/' and described as the 1,000th, the 10,000th, and the 100,000th, and so on, I hav^ nothing whatever to say. This simply beeanse I have yet in be convinced that sach dilations were ever made in the flense in which we have the third, the sixth, or the twelfth. To make the millionth dilation of one medicine, after Hahnemann's manner — and no other is reliable — ^wottld -ocoapy more than a year of time, devoting twelve hoars a ^y and six days a week to the occapation. Farther, Dr. Bardick, of New York, has oonclasively shown, by daborate ealealations and microseopieal investigations, that meh is the mode of preparation adopted in making these ''^ potencies," that the so-called millionth potency ef Dr. Swan *' cannot exceed ihe tenth centesimal of Hahnemann, and is liable to be mach lower."
The observers to whom I propose to refer in assisting as in determining the necessary dose are physicians who have nsed the crade drag, and dilations ap to the thirtieth.
In the first place let me lay before yoa the conclasions arrived at by Dr. Wilhelm Arnold, of Heidelberg, who, writing thirty years ago, gave the following as the results of his twenty years' practice of homoeopathy : —
"After," he says, "I was convinced of the truth of Hafandmann's law of cure, I deemed it my duty to listen to tlierepeatedly expressed desire of the Beformer, and repeat his experiments exactly. Asfar as the doses were concerned, I did this with great unwillingness, and with great scepticism as to the iwmlts. Nevertibekss I saw not a few cases recover jAer the administoition of medicineiS in the tenth, twentieth, aad even tiiirtietii centesimal dilation. I observed not only speedy «are of acute disease, but also frequently a wmmiaiAe diaa^e in many chronic cases. I grant readily tliat many of the cures wbach encouraged me in the com- meneenMnt of my homcsopathic experiments were not due to the sn^iall doses of medicine ; but that all tiie results aire to be ascribed to the healing power of nature alone, I -can by no means convince myself, even with all the forees of scepticism. I saw in not a ifew eases which had resisted
152 P080L0OY. "t^SSSmf^
BoTioWf Mudi If 188i«
the most different modes of treatment, cure take place after a small dose of a carefully-chosen homoeopathic medicine. In not a few cases, however, I waited in vain for any cnrative result from the small doses; but neverthelesSy distrusting myself rather than the precepts of Hahnemann, I at first sought the cause of fidlure, not in the insufficiency of the dese, but in error in the choice of the medicine. This brought on me many cares and troubles, until I saw myself obliged to descend to lower dilutions. I was soon convinced that these yielded much more certain results, without the so-much-dreaded disadvantages. In this manner, guided by experience, I arrived step by step at the position that it is never neeessaiy to administer medicine in any dilution or trituration higher than the sixth dec. (third cent.), and I have never had to complain of any hurtful collateral action, or any primary action, that disturbed the cure. But I must add that it is only very seldom, and with very powerful medicines, and in very susceptible patients, thiat I ever go as high as the fifth or sixth dec. dilution, that in geneial I confine myself to the first or second dilution or trituration, though not unfre- quently I find it necessary to go up to the l^ird or fourth dec. dilution for these purposes. In the six lowest decimal dilutions and triturations I consider that we possess a scale suitable to afford the corresponding doses for all the present known diseases.
In a period of ten years I have never found it necessary to go above the sixth dec. dilution, but I have often been obliged to give the specific remedy in stronger doses, such as several drops of the pure tincture, or one-fourth, one, or even sevenJ grains of the original preparation."*
Then, again. Dr. Black writes, after thirty years' expe- rience, and says : " I began the practice of homoeopathy by using the higher dilutions, encouraged by the personal exhortations of Hahnemann ; but the exigencies of practice soon led me to reduce the scale. I now think the suitable therapeutic dose so near that dose which can excite physio- logical action in the healthy body, that a range from the crude substance to the third centesimal dilution is amply sufficient to meet all the requirements of practice."! So,
• Dm RaHmUa SpetiJUeke o4er Uiepaiki$eke HHherfakren, <le., bj Br. Wilhelm Arnold, fleidfllbaq|» ISfiL. t Britiih Jcmnal of Homoeopathy^ TdL zxtz., p. 581.
SSSS^SSSJW^ POBOLOGT. 168
StvisWt llinrah It 18ttt
also, Dr. DiyBdale, who has frequently described the sixth dilation as that beyond which it is never necessary to go.
Dr. Yeldham, who has for many years evinced a great interest in the discussion of suitable doses, rarely, I believe, thinks it necessary to give a smaller dose than a few drops of the third decimal.
Then, again, among medical men who do not recognise the homoeopathic principle as a basis of drag selection, bat who, nevertheless, prescribe homoBopathically with increas- ing frequency from year to year, we find that their homoBO- pathio prescriptions answer admirably well, when they restrict themsialves to small doses of the crade drug. Thus drop doses of ipeccLcwmha answer perfectly in the cases of vomiting, to which that medicine is homoBopathic ; so, too, does cantharides, in drop doses, in cystitis ; simi- lar quantities of aconite in inflammatory fever are equally serviceable. The results thus achieved are at least as good as those we secure with dilutions of the same drugs. Are we to decline to profit by experience of this sort because it eomes from men who, while anathematising us when they preach, imitate us so considerably when they practise? Certainly not — Fas est ah hosts doceri f
When, however, gentlemen make use of a homoBopathi- eally indicated memcine in a dose suited to fulfil anti- pathic indications, they generally come to grief as signally as did a friend of mine who gave a drachm of the tincture of gelsemium to a lady si&ering from a headache very similar to that gelsemium will produce.
It is possible enough that now and again in especially susceptible people there is a risk of produciug aggravation 0^ or increase in the symptoms present from tiie use of doses of the strength I just now referred to ; but after all the risk is not great, and the result of no real consequence when it does occur. The remark of Hahnemann in one of his earliest papers, that *' scarlet fever is a much more serious evU tiian a few troublesome symptoms produced by somewhat too large a dose of beUadonnay'' may be applied to all diseases and all medicines.
Then, gentlemen, I conclude that experience does not endorse the necessity, in order to cany out the homoeo- pathic principle of ^rug selection, of infinitesimal doses. It does, indeed, assure us that very small doses are neces- sary; that doses much smaller than those which are
164 P08Ck£A«T. M^JbSTiTSi!!
leqnired "whem a drag is anlipflihieally or allopathicaMy chosen, are really esseittial. Bat in prescribing there ia no absolute need to go beyond the range in which physical tests will determine tiie presence of matter.
It would, however, appear that it is impossible to speak absolutely on this matter of the dose. For I tiunk it is ^ experience of moat homosopathio physicians, who have not committed themselyes to any distinct line on thin qpestion, that now and again cases do occur which will nofe respond to any but a high dilution. How to recognise them I caimot instruct you ; that they doooeur I £9el sure, and that they are very rare I am equally certain. Hence, I think that it is good practice, when prescribing a carep fully selected medicine, to give it in a small, but nofc necessarily infinitesimal, dose ; and should no good resuU follow, and a re-examination of the case convince you thab the medicine chosen is thoroughly h<»ncBopathic — change the dilution rather than the medicine, giving it higher or lower as the circumstances may seen to indicate* Because, however, the lower dilutions are more generally useful, and because those which are higher are not necessary to the carrying out of the homoBopathio principle of selection when prescribing, do not lose sight of the higher dilutions. They will occasionally help you when you may least expect help from such a source.
In conclusion, then, I think that when prescribing homoeopathically you will generally find the most suitable dose to be one or two itope of the second or third decimal -^that is to sagr, about the lOOtib or 1,000th of a grain ; ^diile a few medicines require to be given in the crude state. In certain cases of disease, when susceptibility te specific medication is considerable, you will find it to your advauM^ to give much less medicine and to prescribe tiba sixth diecimal, or eien the sixth centesimal. Similar variations in dosage will also be necessitated by the droum- stances and habits of a patient^ and also by tiie nature o£ the drug itself. Baxely, too, you will find it necessary ta resort to one of those highsr dilutions, whose power ta influence disease Hahnemann was the first to recognise.
Finally, I would commend to those who are anxioua to* do good service in endeavouring to determine the questioitti involved in the consideration of the best dose of a homceo* pathioally selected medicine, the study of the eflects of
r
£2li^S3?7?SS? CLINICAL NOTES. 155
1>
dmg& on tbe healthy from different doses. The materialB abound for saeh enquiries in nnmfflrons recorded oases of poooning and OYer-dosing.
From SQoh a stndy as this we might derive some principle directing the selection of an accnrately soitable dose. At present we have none.
21, Hionrietta Street,
GaYGndish Square, W.
CLINICAL NOTES FROM THE LONDON HOMCEOPATHIC HOSPITAL.
Reported by G. Scrivbn, B.A., M.B., B.Ch., Trinity College, Dublin, Resident Medical Officer.
The following three cases are of interest individaally, but their interost is much enhanced when they are considered in relation to each other, and to the common origin of the different forms of disease in all. Before relating each case in detail, it may therefore bo well to consider l£e circum- stances under which they all occurred, as illustrating how from the same unhealthy conditions of life different diseases arise in different individuals.
The three patients referred to live in the same house, whioh is let in iSats, or single rooms, the unsanitaiy state of which is unpleasantly obvious to the most casual olfactory obsenrstion. On the basement resides a woman whose con- tempt for sanitaiy science is shown by keeping a large bofiket for the reception of various household filth in aeon* venient comer of her apartment ; this bucket is not emptied tfll it is incapable of containing another ounce of ** slops *' or another scrap of refuse.
The ground floor is occupied by a family consisting of fiAer, mother, and eight children, of whom the mother and one child furnish two of the cases above referred to.
The mother, thirty-fire years of age, after suffering for some time from symptoms of on indefinite character, was admiiaked to the hospital, and went through a well-marked attack of diphtheria.
The child, seven years old, admitted to hospital a few days after the mother, suffered from tjrphoid fever.
The third case was that of a woman twenty-seven years of age, who, with her husband and two young children,
156 CLINICAL NOTES. ^t^.^SS^^TSt.
Seview, UuA 1, Utt.
lived in one room on the first floor of the same house ; she was admitted to hospital a week after the last patient. In her the disease took the form of hronchitisy of an acate type, characterised by much greater febrile excitement than is nsoal in ordinary forms of this disease, by veiy marked depression and adynamia, and by the appearance for a few days of a petechial purpuric eruption most marked on the limbs, but scattered also over the abdomen and chest.
Such being a general outline of these cases in their rela- tion to each other and their common origin, we will now proceed to a detailed account of each.
Case I.
L. P., aged thirty-five, married, eight children, was admitted to the London Homoeopathic Hospital, under Dr. Blackley, on Nov. 28th, 1881, with the following history and symptoms : —
About three weeks ago, just before the catamenial period, she felt pains in her shoulders and sides of an aching character, and sudden sharp pains from time to time in her limbs. During this '' period " she thinks that she caught cold, as, on the cessation of the menstrual discharge, she suffered from attacks of shivering, followed by flushes of heat, and from severe frontal headache. On Nov. 26th she became so much worse that she was obliged to go to bed, sufiering from shivering and '' pains all over." Next day she was worse, and sent for the house-surgeon of the London Homoeopathic Hospital, who found her complaining of the foregoing symptoms ; temperature 102 ; pulse 92 ; tongue smooth, and inclined to be dry. There was great tenderness on pressure over the abdomen, especially in the middle line. Ordered Aeon. 1 x, Bryon. 1 x, mj. alty. 2 hrs.
On the 28th she was no better, and was admitted to the hospital under care of Dr. Blackley, when the following notes were taken : — ^Patient complains of severe pain all over the abdomen, which is very tender, especially in the middle line ; pain in the back ; severe frontal headache. The tongue is coated, except at the tip, which is bright red. There are no spots on the abdomen, and no gurgling or special tenderness on pressure in the iliac fossa ; the spleen is normal in size. She states that there has been no action of the bowels for three days. Examination per vaginam showed that the uteniB was nonaal in position, but
bSSS!SSS^^I^. cunical notbs. 157
.somewhat fixed^ and yeiy tender on pressnre ; there was no OYarian tenderness or enlargement. Temp. 102; pnlse, 92y weak. Ordered milk and beef tea, and to continue Bry, and Aeon. For the next two days there was little 'Change in her condition, except that the abdominal tender- ness diminished considerably, though the temperature con- idnued 102 night and morning, and she slept httle.
Nov. 30th. — Bell. 1 x, gttj. alty. every 2 hrs., with Aeon. 1 X, was substituted for Bryan. 1 x.
Dec. Ist. — M. T. 102 ; p. 92 ; very weak ; slept very little, owing to pain in the back ; her bowels were moved yesterday stfter two enemas, the stool being loose and dark, with hard masses ; abdominal tenderness much less, but continues in the uterine region. E. T. 108.6.
Dec. 2nd.— M. T. 102.2 ; p. 92 ; did not sleep at all ; complains of headache, and is very dull and stupid. E. T. 108.2,
Dec. Srd. — ^M. T. 102 ; p. 92, and very weak ; pain in back less, but she did not sleep ; tongue red and dry in the centre. E. T. 102.6.
Dec. 4th. — ^M. T. 101 ; p. 96 ; slept 4 hrs. ; pain in back returned yesterday afternoon; tongue more moist; bowels moved by enema ; stool constipated and natural in colour. Sphygmographic tracing of radial pulse shows ^eat feebleness of heart's impulse, and some irregularity, but no intermission or dicrotism. £. T. 108.6.
Dec. 6th.— M. T. 101.2; p. 88; very weak; slept 6 hrs. ; throat sore and dry ; fauces much congested, sticky with mucus clinging to them ; much pain on swallowing ; tongue dry and glazed at tip and in the centre ; coated posteriorly; some muttering delirium at intervals; expression anxious ; clammy sweat. Ordered Rhus 1 x, mj. every 2 hrs. ; to get brandy and champagne. E. T. 102.8.
Dec. 6th.— M.T. 102 ; p. 92 ; extremely feeble. Was very restless during the night and slept little, but no delirium ; fauces much inflamed, and coated with sticky tnucos. There is a dark patch of fidse membrane on the {Aiarynx; swaUowing less painful. Ordered Mercuriui eyanatus 8 x, grj. every two hours. Poultices to be applied round the throat, and the pharynx to be sponged with a week solution of Argent, niir. E. T. 102.2.
Dec. 7th.— M. T. 101.6; p. 100; somewhat stronger ; psin on swallowing less ; has slept 8 hrs. ; coughed up a
158 cauraoAL notes. ^SS^SSS^?^
Beview, Ifazch 1, 18B».
great deal of sticky mnfiUBj and some shreda of greyish membrane. E. T. 103.4*
Dec. eth.— M. T. 108.6 ; p, 116 ; ozdy slept about half an hour; perspired reiy freely in the night; membrane not so thick on the pharynx, but has spr^ over the fances ; tongue moist ; can swallow more easily. Ordered port wine, chicken jelly^ and eggs beaten up, and Rkvs 1 x, mj., alternately with Soda. saliq^L grs. 5, every 2 hrs. E. T. 102.6.
Deo. 9th.— M. T. 101.6 ; p. 120 ; weak ; slept little ; mouth very dry ; membrane hanging to fauees in shreds; passed one stool this morning, consisting of a large quantity of dark blood; no pain with the motion. Ordered Hamamelis 1 x, mj. every 2 hrs.
She passed another stool of dark blood at 12.30, and again at 7.46 ; no pain. E. T. 108.
Dec. 10th.— M. T. 108.4 ; p. 120 ; very feeble ; slept 8 hrs. ; bowels moved twice in the night, the stools each time being loose and light in colour ; membrane still adhering to fauces and pharynx. Bhu% and Soda 9aL repeated. E. T. 103.8.
Dec. 11th.— M. T. 108.8 ; p. 120 ; slept 4 hrs. ; bowels have not been moved since 6 a.m. yesterday ; mouth very dry and tongue sore. E.T. 108.8.
Dec. 12th.— M. T. 102.4 ; p. 120 ; slept better. E. T. 103.2.
Dec. 13th.— M. T. 102.4 ; p. 112 ; slept little owing to the bowels being moved twice in the night with consider- able pain, and after two oil enamata, stools extremely hard and dry; no blood; bowels acted again this morning; motion not so hard ; deposit thick on the pharynx ; tongue more moist. E. T. 101.8.
Dec. 14th.— M. T. 101.4 ; p. 108 ; slept 8 hrs. ; per- spired very freely in the night ; deposit of thin white mem- brane on &uces ; tongue much more moist ; swallows veiy comfortably. E. T. lOliJ.
Dec. 16th.— M. T. 101.2; p. 100; slept well; mem- brane thick on the jdiaiynx ; tongue quite moist ; bowels moved naturally this morning ; stool dark and loose. E. T. 101.8.
Dec. 16th.— M. T. 102.4; p. 120; slept very well; deposit on pharynx continues. One loose and dark stool last night. E. T. 101.4.
Dec. 17th.— M.T. 101.8 ; p. 124 ; slept well tiU 8 a.m.,
nSSS^SSST^ (OtlNICAL HOTBB. 159
BsvisWt BEudi 1) 18ffi.
btrfc was restless afterwsTds. One stool in night, formed and dark ; pharynx freer of deposit. To return to Mere, egtm. 8 x, gij., erery three brs., and the pharynx to be sprayed with a saturated sointion of boracic acid in gfyoerine onee a day^ and the sponging with Argent, nitr. oontinQed. To have arrowroot. E. T. 101.
•Dec. 18th.— M. T. 100.2 ; p. 124 ; slept vdry well ; less membrane on pharynx. E. T. 100.4.
Dec. 19th.— M. T. 99.8 ; p. 108 ; slept well ; bowels moved natnrally yesterday. Ordered two eggs and chicken. E. T. 99.6.
Dec. 20th.— M. T. 99.8 ; p. 112 ; slept well ; bowels moTed naturally; pharynx much clearer; tongue moist. From this time she progressed steadily to recovery.
On the 22ndy she was ordered a chop and bitter ale, and to have China (p mjjj* every 4 hrs., and her temperature was normal night and morning. She remained, however, very weak for some days, and was not discharged tiU Jan. 7th. She had only been at home a few days when she was obliged to take to bed again owing to great prostration and vomiting, while her temperature rose to 102.
She was re-admitted to the hospital on Jan. 13th, and suffered for some days from vomiting and a return of some of tba old symptoms ; her temperature rising again to 108.6 ; her throat was extremely sore, the pharynx being injected and covered with viscid mucus* She was treated with Nux vom, 1 x, and, after the vomiting was checked, with Merc, biniod 8 x. The temperature was normal night aod morning, on Jan. 28rd| ten days after re-admission ; and on Feb. 4th, she was sent to the country for change of air.
Gasb II.
Florrie P., danghter of preceding patient, aged seven, was admitted into the London Homoeopathic Hospital on Decfith^ 1881, under Dr. Blackley, with the following his- tory and symptoms : —
Ha0 been atrtended at home for three days by the house- surgeon: She complained of slight t^iderness over the Adatoeakf and was very low and prostrate; the bowels mtiier eonfined; temp. 102 at night. She was treated wih Baptis. <f> mj. every 8 hrs. As she did not improve, she was admitted to the hospital on Dec. 5th.
160 CUHIGAL H0TE8.
On admiuian* — Patient oompbdns of pain on swallow- ing; dull headache; is drowsy, and the face flushed. The tongue is coated, with red papillsB protruding through the fur; there is some distension of the abdomen, but no tenderness on pressure, and no spots. Heart and lungs normal. Ordered milk and beef tea, and continue JBop^.f. E. T. 101.4. .
Dec. 6th.— M. T. 102 ; p. 128 ; slept in the night, but rather restlessly ; tongue foul ; the &uce8 are swollen and congested. Ordered Merc. cor. 8 x, gij. eveiy 2 hrs., alternately with BaptU. f. E. T. 102.4
Dec. 7th.— M. T. 108 ; p. 124 ; slept very well, but talks in her sleep ; &uces less inflame^ no ulceration. E. T. 104.
Dec. 8th.— M. T. 102 ; p. 124 ; slept very well, and did not talk in her sleep. Tongue clean at the tip, white- coated posteriorly. There is a greyish patch on the pharynx. She swallows well. The bowels have not acted for three days. The urine is acid, sp. gr. 1088. ; contains no albumen. Ordered Merc, biniod. 8 x, grj. every 2 hrs., and to get white wine whey. E. T. 102,4.
Dec. 9th,— M. T. 102 ; p. 120 ; slept very weU, Patch on pharynx unchanged. Bowels moYed four times since yesterday morning ; stools loose. E. T. 102.6.
Dec. 10th,— M. T. 102; p. 116; slept very well. There is no exudation on the pharynx. Bowels have been moved six times in the last 24 hrs. ; stools loose, light, and of a typhoid character. There is no tenderness over the abdo- men, and no increase of splenic dulness. One pink spot is visible on the abdomen. Ordered Soda saUcyL, grs. 2j^ every 2 hrs. E. T. 102.6.
Dec. 11th.— M. T. 97.8; p. 112; bowels moved eight times in 24 hrs. ; stools of same character. Soda saUcyl. was discontinued, and Arsen. 8 x, mj. every 8 hrs. substi- tuted. She was given arrowroot and (EtUi's milk food. m. T. 101.8.
Dec. 12th. — ^M. T. 101 ; p. 112 ; bowels moved fourtimes in 24 hrs. £. T. 100.
Dec. 18th.— M. T. 100.6 ; p. 112 ; bowels moved four times. E. T. 101.
From this time she progressed to recovery, although on the 14th and 16th the evening temperature rose again to 108^, and five loose stools were passed in 24 hrs. She perspired freely every night.
5S£^S;ST:2? clinical notes. 161
1.
On the 18ih the bowels were moved once, and the stool formed. On the 20th her temperature was normal night and morning, 16 days after admission ; she had no return of diarrhoea ; was ordered Chin, 0 mj. ter. die. She was discharged on Jan. 7th, 1882, and has had no relapse, although she retomed to the same house from whence she came.
Case III.
Eliza J.y aged 27) married, two children, was admitted into the London Homcsopathic Hospital, under Dr. Blackley, on Dec. 12th, 1881, with the following history and symptoms : —
Patient lives on the drawing-room floor of the same house as the preceding patients. Has been attended at home by the house-surgeon since Dec. 2nd, since which date she has complained of lassitude, inability for exertion, and, within the last week, of a severe cough. She has been getting steadily worse, and for the last few days has been confined to bed; the temperature has gradually risen to 102.
On admis$ion, — ^Patient is extremely weak, the face is much flushed, and the expression anxious; cough very troublesome, and expectoration difficult.
Ex0minatian. — There is no dulness on either side of the chest, anteriorly or posteriorly. Bronchitic rales are heard all over both sides. The abdomen is somewhat distended, and there is general tenderness on pressure over the surface. The bowels have not acted for some days ; tongue coated. Ordered beef tea, milk, veal jelly, and brandy S ii. in 24 hrs. and Antim. tart* 8 x, grj. every 8 hrs. M. T. 108.2 ; p. 186, with a tendency to dicrotism, as shown by the sphygmograph ; respirations 86. E. T. 108.4.
Dec. 18th.— M. T. 108.2 ; p. 112 ; r. 82 ; slept very well; cough extremely troublesome, and expectoration difficult this morning. Physical signs unchanged. There is an eruption of small bright red petechisB scattered thickly over the limbs, and more sparsely over the abdomen and chest ; a few spots about the size of a pea, and of a dark purple colour, are mixed with these; none of the spots disappear on pressure. The fauces and pharynx are darkly congested, and there is a whitish patch on the right anterior pillar of the fiauces. No difficulty in swallowing. The bowels were moved yesterday by enema ; stool natund
162 CLINICAL NOTES. 2b^!
Eevtow, Mtfdi !»
in colour aiid conidstenoe. PatiaDt haa beoome Yary deaf* E. T. 102.4.
Dec. 14Ui.— M. T. 100.2 ; p. 116 ; r. 36 ; did not deep well. Physical signs in chest continue. Peteohi» not quite so bright ; tongue thickly coated posterioiiy. The patch on the fiwaoes is more di0linot« Ordered Cupr. tvoeL 3 X, grj. every 8 hrs. E. T. 102.
Dec. 15th.— M. T. 103 ; p. 120 ; r. 36 ; has slept very well. The petechia are fading ; patch on fauces continues. Bowels moved by enema yest^day. The deafness is less. Cvipmm stopped and Aniitn. tart, repeated. E. T. 104^6*
Dec. 16th.— M. T. 98 ; p. 116 ; r. 86 ; slept about an hour ; the patch on the fauces is less distinct ; squeaking rales are heard all over the chest. E. T. 102.6.
Dec. 17th.— M. T. 101.2 ; p. 180; r. 82 ; slept all night ; cough very troublesome at times ; expectoration pro* fuse, muco*pujulent and frothy; the petechias have diB** appeared. E. T. 102.
Dec. 18th.— M. T. 100.2 ; p. 120 ; r. 86 ; slept very well ; cough easier. E. T. 99.8.
Dec. 19th. — ^M. T. 99; p. 112; r. 36; improving; there is nothing to be seen on the fauoes or pharynx. E. T. 101.8.
From this date she progsessed steadily to recovery; notwithstanding that her temperature rose on the morning of the 22nd to 102.4 ; p. 136 ; r. 40; Phm. 8 x, mj. was then ordered alternately with Antim. This, however, was a merely temporary exacerbation^ as on the same ermm^ the temperature fell again to 99^, and on the 28rd was normal night and morning. The bronchitic ncmoAa gradually disappeaied firom the chest, whidi was quite five from abnormal sounds on the SSth, when she was ordered Hepar 9ulph. 3 x, grj. every 4 hns* She was, however, very weak, and was not disdhaiged from the hospitd till Jan. 7th, 1882.
Cask 17.
AaUe Glosiitis.
Eliia G., age 47, a lady's maid, was a<knitled into die London HomoBopathic Hoq>ital Jan. 28rd, 1888, uadar oare of Dr. Dyoe Brown, with the following hintory aal symptoms : —
Patient has genesally eqoyed good health. Six yeast ago aha had an attack of faoiaJ erysipelas afiter taking
SSJrS5??i8S! CLINICAL HOTBS. 168
eold. Last Christmas was hid np for fourteen days mih ''jaundice.''
On Saturday night, Jan. 2l8t, she thinks she oaught «old, as she suffered from shiYering and aching in the limbsy and slept Uttle. Next morning her tongue, espe- isially the right half, was much swollen, and she had pain •on swallowing on the right side of the tiiroat. The tongue Gontinned to become more swollen and painful during the day. She slept badly on Sunday night, and on Monday morning had an attack of painless diarrhoBa, and suffered from severe frontal headache, with pain of a pricking 43haracter in the right half of the tongue and down the throat. She was admitted to hospital on Monday evening.
On admission. — Patient complains of aching pain in the frontal region. She is unable to speak plainly owing to the swellmg of the tongue, and the effort to speak or swallow is attended with much pain in this organ. Pain and tenderness in the right sub-maxillary region, extend- ing to the angle of the jaw, where there is some amount of brawny swelling. The forehead and right side of the face and neck are suffused with a pink blush, disappearing on pressure. There is no oedema of the &ce.
The tongue is enlarged in its right half and of a hard brawny consistence ; it is very tender ; the patient cannot protrude it farther than just to the edge of the teeth. It is thickly coated all over except along the edge, which is pink in colour, with dark red papillas standing out. The breath is extremely foul, and speech difficult and indistinct. There is pain on swallowing, even liquids ; referred to the ** back of the tongue," and right side of throat. Ordered milk and beef tea, and Aeon, 1 mj., Apis 1 mj. alternately every 2 hours. E. T. 100.4.
Jan. 24th.— M. T. 98.4 ; p. 124 ; did not sleep, but was not restless ; tongue still very painfnf and swollen ; less pain in throat on swallowing ; no difficulty in breathing. E. T. 98.4.
Jan. 26th.— M.T. 98.4; p. 104; slept weU; tongue less swollen and not so tender ; no pain in throat. The Aeon, was now stopped, and Apis continued every 8 hrs. E. T. 98.4.
Jan. 20th.— M.T. 98.4 ; p. 92. ; did not sleep so well, but is much better tiiis morning. The 'tongue is less swollen, still red rooad the edge and ftirred over £he .surfiBu^e; is marked by the teeth along the right side.
164 TWO SPIBITS IN MEDICINE. iSd^SSSofiML
Patient can speak maoh more distinctly; breath still very fonl ; bowels moved in the morning naturally. E. T. OS.'^ Jan. 27th. — The temperature did not rise again above 98.4. The tongne gradually diminished in size and the pain and tenderness disappeared, the white furred coat cleaned off from the tip, and on Feb. 8rd all trace of the disease was gone, except a slight stiffness along the right side of the tongue. On this day she was ordered a fdU diet, and Chin. 1 X, No. Y. ter die. She was discharged perfectly well on Feb. 9th.
TWO SPIRITS IN MEDICINE.*
A Review.
By John H. Clabee^ M.D.
From many points of view besides the strictly professional one, the history of medicine presents a study of surpassing interest. In it the lover of history finds the leading traits of our conmiou human nature prominently brought out ; the philanthropist views the beginnings and course of the long struggle of men to overcome the Uls that oppress their fellows — ^a struggle in which he at the present day is bearing his part; the humorist sees displayed in abundance those touches of nature — ^half absurd* half pathetic — ^which make the whole world kin ; the satirist finds a glorious quany of baseless assumptions, overweening pretensions, flat contradictions, and hopeless inconsistencies, to hew in pieces with his keen and pitiless blade. Dr. Mellen Gate, of Washington, has given us a new and original view. He has studied the history of medicine in its length and breadth, and in his book has traced the rise, development, and fatal operation of the class-spirit that has dominated the medical world from the remotest times. This is the spirit of dogmatism. He also shows how from time to time men have arisen to protest against the slavery of submission to dogma, and how they have Cured ; and lastly, in the rise of the homoBopathic school, the first successful protest against the tyranny, and the rise of a truer, gentler spirit in medicine, the spirit of the medicine of pure experience.
* Tht CkiU of PrmUe, ^y WmiMa Hdton Oile^ MJ>. WMhington, D.G. H. B. Bnzobam d^ Co.
Sii^riES?^! TWO SPIBITS IN MEDICINE. 165
It will thus be seen that the book is not so maeh a sketch of the history of the whole of medicine, as it is of the pro- fession and the professional spirit* And a yery able sketch it is, as interesting and instractive as the treatment is novel. Dr. Gate introduces the allegorical into his work. The fall title is as follows : The Child of Promise ; or, the Isaac of Medicine, and Ishmasl, the Half-Brother, being a covi- prehensive Glance at tlie Inetincts and Pr&iilections of the Bival Schools of Medicine.
This title is more f ally explained by the following quota- ticm which appears on a page to itself, between the title- page and the preface.
'* Aad he shall dwell with wild men." '' His hand shall be against every man, and every man's hand against him."
'* For Isbmael *' ''I have blessed him, and will make him firoitfnl, and will mnltiply him exceedingly ; " " Bat my covenant will I establish with Isaac," ** for an everlasting covenant, and with his seed after him."
** And Sarah saw the son of Hagar, which she had borne unto Abraham, mockino t ! "
''Wherefore she said onto Abraham, 'cast out this bond- woman and her son.' "
For " He (Isaac) was a man of oemtlb natube ... of devoat and blameless life."
After this the allegorical is chiefly confined to the headings of the chapters, bat the fittingness of it becomes very marked as the work progresses, and the story he has to tell fally jastifies the author's boldness in the selection of the title and form of his book. It is to be hoped that its oddness will attract many readers, who will not be disappointed with their fare, though it is to be feared some may be repelled, and leave the contents of the volume nntasted because they cannot digest the outside.
Dr. Gate tells us that his reasons for publishing this treatise are three.
First. He has observed that lay homoeopathists know only the practical claims of the system they believe in, and he desires to provide them with some knowledge of its historical claims as well, that they may be able to rebut the thousand calumnies that are always being heaped upon it.
Second. A work, Medical Heresies, has lately been published by a Professor Smyth, which contains " perhaps the most able of the many constantly appearing attacks upon this school,'' and deserves attention.
YoL 26, No. 8. n
166 TWO SPIRITS IN MBDICINE. ^SSJ^SSTiIuS
Third. Recent standard works on medical history maioe no allasion to Hahnemann or homoDopathy.
Dr. Cate has laid the homoeopathic world under obliga- tion by the pleasing and effectiye way in which he has met each of these wants. He does not appear to be acquainted with The History and Heroes of Medicine, by the late Dr. Rutherford Russell — a book deserving a place on eveiy medical man's shelf — ^in which Hahnemann and homoeo- pathy find their proper place, and due consideration. But even this can hardly be described as among the " more recent standard works " on the history of medicine, and Dr. Gate's book, which has no pretensions to the calibre of that of Dr. Russell, and which runs on somewhat different lines, will doubtless penetrate much further, and in many more directions than the other has, or could have done.
I will now endeavour to indicate the author's line of thought.
The art of medicine, he says, is as old as man himself — at least as old as his pains and aches. The first doctors by profession appear to have been the Brahmins. The first medical book appeared in China B.C. 2700. This is still the standard medical authority in that conservative country. It gives elaborate instructions for feeling the pulse with several fingers at a time, used as a performer on the piano- forte uses his, now on one arm and now on the other, by which procedure diseases were to be discovered. This may seem astonishing, but there is a story told of a pro- fessor of medicine in recent years who, in a case where there was a doubt as to whether the disease was peri- or ^mZo-carditis, with his fingers on the patient's pulse, after a few moments' profound consideration, exclaimed with confidence to his admiring class, ''Pm-carditis !" and this was final. This occurred, as the story goes, in a British University.
After the Chinese the Egyptians next claim consideration
for their doings in medicine. Their great authority is one
Thoth, but whether he wrote all that goes by his name is
not certain. The principal thing to note is that the lore
and practice of medicine feU to the hereditary possession of
the inferior priests. " He who was bom a physician was
prohibited equally by heaven and the laws from abandoning
_ibe occupation of his ancestors." " Furthermore," says our
or, and this is important to note, ''the pastophori
it-physicians) were confined to the doctrines of Thoth
^SSSS^SSS"?^? TWO SPIBITS IN MEDICINE. 167
tor hints as to the management of the sick ; for, if disease -were met after a method not expressly prescribed in the .works of Thothy should the patient die, the priest respon- 4sible for this departure from the authorised practices was jjpuniflhed with death." What a glorious text-book !
From the Egyptians the Greeks derived, among other things, medical ideas and practices. The Asclepiadse, the oldest doctors amongst the Greeks, were an exclusive caste, handing down their secrets from one generation to another, jmd having recourse, like the Egyptian pastophori, to mys- terious incantations.
About 570 B.C., Pythagoras, the first Philosopher, appeared on the scene. Not only was he endowed with an intense thirst for knowledge, and ''love of wisdom,'* but he was also possessed with the passion for divulging all the knowledge he gained, as being the conmion property of all. Among other things he studied medicine, and made no secret of what he learned. This was too much for the professional spirit of that day, and probably cost him his life. But he had done his worL He had broken the ice, and made way for all who would to draw of the waters of knowledge* Thus by the time Hippocrates appeared, 460 B.C., it was not a mortal offence to tell tales out of school.
Hippocrates fully deserves his title of Father of Medicine. "With his fiuthful descriptions of disease, his accurate observations of the operations of nature and the workings of her laws, medicine proper may be said to begin. He is the father of the two leading spirits in medicine. His theories of the four elements, and the four humours, his enuBciation of the therapeutic law ''contraria contrariis corantur," formed on these theories, and his therapeutic indications inferred from them, prove him to be the father of the Ishmael of medicine — ^the dogmatic spirit embodied in the allopathic school. On the other hand, his own injunction " that the nature of man cannot be well knovm mthout the aid of medical observation^ and that nothing should be affirmed concerning that nature until after having acquired a certainty of it by the aid of the senses,^* together wi£b his observation that most diseases get well of them- selves, and that many diseases are cured by drugs that have icansed the like, prove him to be the father of the ^' Child of Promise," the Isaac of Medicine, the spirit of pure eiferienoe and honest open-minded observation, from which
N— 3
168 TWO SPIRITS IN MEDICINE. ^g^^SSfifMST
alone we hope for perfection in oar art, and to which we confidently look for advance. With the departnre of Hippocrates came an era of confusion. Ont of this oon-^ fusion arose the do^^matic school. All ori^nality was quenched, and the reign of another Thoth began. Ishmad entered on his career. Medicine now was not the possession of a priestly caste. It was part of the education of all the learned. Hence the part Aristotle has played in medical history, though he never practised medicine. He could theorise and assume with the best and boldest, and all the weight of his great authority went to support dogmatism^ He assumed a communication between the heart and trachea for the passage of a current of inhaled air into the cavity of the heart ! He reasoned on the expulsion of the fcBtus, that, as it was oval shaped, it could only come out head foremost, reasoning on the analogy of an olive in a narrow-necked bottle. The inference was that in all breech and cross-births the attempt should be made to bring down the head. He did not notice that as the olive could get out of the bottle whichever end might happen to come first, though it could not if it fell across, so the fcBtus might get out whichever end of the oval presented. Consequently, relying on this great but unpractised authority, the learned for centuries did their best to prevent the natural deliveiy of infants which they discovered to be coming by the breech, and the simple operation of turning in cross-births never entered their thoughts.
The Empirics of Alexandria and the Methodists made a stand for a short time against the power of dogmatism, but with the overthrow of Alexandria their resistance came to an end, though the labours of the Empirics, especially in the field of anatomy, were not without good effect on the subsequent course of medical history.
In the second century of the Christian era appeared Celsus and Galen, both dogmatists, the latter a man of surpassing talents, whose word was law in the medical world for centuries after his death. He accepted the theory of four elements, he endorsed Aristotle's division of the human soul into three parts — ^vegetative, irascible, rational — and from these data explained all phenomena of the economy, declaring his colleagues to be "ignorant or punctilious dialecticians whose discussions are frequently repugnant to the most common sense." He uplifted the insignia of dogmatism, contraria conirariig curantur, as the distinctive-
ShSS^SSk"?*^ two bpibits in medicine. 169
Bmkm, Mmh 1, 1S6S
symbol of the school, and by him " dogmatism, amplified, explained, was pushed to its last consequences."
In that wonderful movement amongst the descendants of the veritable Ishmael, the Arabs, which followed the ap- pearance and mission of Mahomet, among all the arts and sciences that grew to great perfection, the art of medicine and its cognate science, chemistry, and, as it then was so thought to be, astrology, received their share of advance- ment. But the blight of dogmatism was over it even there ; the authority of Aristotle barred the progress that should have been made, and threw the weight of the Arabian savants into the scale of dogmatism.
This state of things continued till the twelfth century, during which time medicine had again become the property of priests, and when at length Yesalius arose and dared to state anatomical truths in opposition to the theories of the ancients, he came imder the ma of the Inquisition, for holding the heretical notion that there could possibly be error in the writings of Aristotle or Galen. It mattered not that there was no bone in any of the hearts Yesalius examined, Galen said there was a bone in the anatomy of the heart, and it was heresy to contradict that.
After him, Paracelsus dared to think for himself and use his own eyes, scorning the authority of the ancients, and iie was branded as '* Uie quack." How our own Harvey's discoveries were received is well known, and Sydenham, the English Hippocrates, was looked on with disfavour in London, the College of Physicians refusing him their fellowship, and granting him the licentiate only.
Oar autiior thus brings us down to more modem days. He then tells us the story of Hahnemann's early life, studies, and labours, of his great discovery, and how he worked it out. He compares the labours of Hahnemann with those of Yesalius and Harvey, and shows how much more difficult the former were than the latter, as being so much more complicated, and so much less easy of demonstration.
He then traces the rise of the homoeopathic school, and the fierce antagonism it aroused on the part of the dogma- tists. He compares the spirit of the two schools, and the two systems of medicine, and the force of the allegory needs no pointing out. He gives an account of the '' heresy-hunt " undertaken by the allopathic body in this country, and an instance of the same in America. It appears in that land of the free, there is an American
170 TWO SPmiTS IN MBDIOINB. ^nS^.wSS^SHSSt
Medical Association whicli exercises absolute despotism oyer all provincial affiliated associations, and forces on them its definitions and codes of ethics. The example given of how it exercises this prerogative is too delicious to curtail, and I must refer readers to the book itself. Our author has condensed the spirit of the transaction into verse, which is quite worthy of the sentiment it embodies, and expresses so perfectly.
'* Believe as we believe, no more, no less, That we are right, and nothing less confess ; By the code of ethics and its mandates we abide, And concede such other things as with it coincide. Think ye as we think, and do as we do, And then, and only then, well fellowship with yon.
" That we are right, and always right, we know, For the ' assembled wisdom of the ages * tells us so, And to be right is simply this, to be Entirely and in all respects as we ; To deviate a hair's breadth, or begin To question, or to doubt, is sin.
*< 'Twere better that the sick should die than live. Unless they take the medicine we give ; Let sink the drowning, if he will not swim Upon the plank that we throw out to him ; 'Twere better that the world stand still than move In any other way than that which we approve."
The author then proceeds to expose in masterly fashion the falseness of the arguments brought against the new system and its adherents by the dominant school, and to cftiow how, with true Ishmaelitic spirit, it has recourse to mockery when reasoning fails, and at the same time is not above ** feeding on the meat it mocks," adopting homoeo- pathic remedies and procedures wholesale.
One of the charges made against homoeopathists by that august body, the American Medical Association, is that they have spoken contemptuously of medicine as regularly practised. How is it that they still tolerate Oliver WendeU Holmes, and allow him an honoured place in their midst? Surely, they should have expelled him with every mark of ignominy, after saying, as our author [reports : — " With the exception of Tnorphine and stdphtmc ether, I firmly believe that if the whole Materia Medica could be sunk to the bottom of the sea it would be all the better for man- kind, and all the worse for the fishes." Hufeland said^
SS^SSS^uSS^ TWO BPmiTS IN MEDIOIKE* 171
46
HomcBopathy is the grave of soience." He might have said with much more truth, "Medicine is the grave of science." Science, we have been lately told by one of its greatest exponents, has taught ns (in medicine) what not to do, and he hopes now that it will soon tell us something on the positive side* As yet it has told us nothing. Physics, chemistry, botany, the life-sciences, and the new science of disordered life, pathology, pave tiie way for us to a right understanding of the condition of our patients, but medidne, in its accurate sense, how to heal — which should be the end and fruition of all these sciences — is for them a dark and pathless waste. Whenever science attempts to enter this region she falls into a bottomless pit. There is a narrow track through the darkness — ^the path of pure experience ; and there is a clue to keep us in the path — ^the discovery of Hahnemann. Keeping to these we are on solid ground. But this ground has not been won by physics, by chemistry, by botany, or the sciences of life in health and disease. Science cannot claim it as her own. Science does much for us at the bedside of our patient, but when we ask her how to cure him she has no answer to give. Experience can tell us something, and with Hahnemann to interpret can tell us much, Homoeo- pathists may have spoken contemptuously of the old way of practice, but not more so than have its own followers ; and the facts of its history speak more contemptuously still. And then, — dwellers in glass houses should not throw stones. How much contempt has homoeopathy had to endure — ^blind, unreasoning contempt — ^from the other side?
In his closing chapters Dr. Gate deals more particularly with Professor Smyth and his arguments. It does not appear that he has anything fresh to urge against the homoeopathic heresy, but he adopts a more reasonable tone tiian most of his fellows. Like the Boyal College of Physicians in the days of their conflict with Dr. Quin, like 0. W. Holmes five-and-twenty years ago, Professor Smyth assumes the role of the prophet, and asserts, as they did, that homoeopathy ** in a few short years '* will be non est. Doubtless he will turn out to be as true a prophet as his predecessors ! Dr. Gate tells a delightful little story of the Michigan University, and how the bomcBopathic chair was founded and occupied after a struggle with the Ishmaelites of medicinCi as we may now call them, which readers will
172 TWO 8P1BIT8 IN MEDICINE. aSS^SSSIf^
find Tory diverting. His oonoluding words shall be giyen
entire : —
"This medieal faith (allopathy) which is grounded in the ever shifting sands of popular prejadice, this Ishmael of mediciney for a reason as competont as that relating to the joonger half-brother in medicine, will not ' cross the Stygian ferry ; ' on the contrary, ' I • . . will make frcdtfal, and multiply him exceedingly.' However, at this epoch, he has been and still poses before us as a mocker. Therefore firom the pale of civilisation will he be ea$t out, to dwell and exercise his peculiar offices with the paganic and barbarous races; for the hand of every educated mind mH be against this Ishmael, while this outcast will, as his instincts and predilections have ever influenced him to act in the past, con- tinue to raise his band against everything that opposes his assumption of power and of rule.
'* The civilised world will thereupon assert its preference for employing the good offices of the Isaac in medicine in overcoming disease, that man of gentie nature, a clear definition of whose exponent was so many years ago concisely set forth by one of the most prominent and eloquent authors — William H. Holoombe, M.D. — in the ranks of tbe homoeopathic profession.
*' Dr. Holcombe tells us that a homoeopathic physician is one who uses all the surgical, obstetrical, mechanical, and chemical measures where indicated, and who in the vital or dynamic sphere is guided by the homoeopathic law —
^* iimUia HmiWm$ airantur.'*
In taking leave of Dr. Cate and his book, I cannot con- clude without thanking him for the pleasure it has given me to read it. I trust he will find a wide circle of readers, both in and out of the profession. I shall be glad if this very meagre sketch should make the work known, and send readers of it, eager for more> to the book itself. The get- np of the book is excellent, as we are accustomed to expect in books from across the Atlantic, and reflects credit on printer and publisher alike. In a future edition, which I hope will soon be called for. Dr. Cate must not let con- traribus do duty for contrariia, whatever the printers may think. It would be well also if he gave his authority for the statement that Hippocrates was the first to use obste- trical forceps. The honour is usually ascribed to the Arabian physicians.
16, St. George's Terrace,
Gloucester Road, London, S.W.
i^^SSSlIf^. MYOOABDITIS. ITS
CASE OF MYOCARDITIS IN RHEUMATIC FEVER.
With Sphygtnographic Tracings*
By Edwabd M. Maddbn, M.B.y Birmingham.
The following case is of interest, as showing the diagnostic ^ralne of the sphygmograph, and the benefit following the nse of digitalis in material doses.
Miss Edith , tet. 16, one of a large family, all
healthy children, and living in a yery healthy, though exposed, country house, about nine miles from Birmingham, •caught a chill on the eyening of December 7th, 1881, but went to school as usual the next day. On the 9th she stayed at home, and complained of pains all oyer her, and <<on the 10th, as she was feyerish, her father asked me to go and see her. I then found that she had an undoubted iittack of acute rheumatism, with a pulse of 105, and temperature 101^.8, pain in all the joints, and a slight blush oyer both ankles and wrists. The tongue was white and furred, but there was no thirst nor sweat. The bowels were confined, and the urine scanty, dark and lithic.
She went on yery satisfactorily for the first ten days, ttaking aconite and bryonia, chiefly the latter, in the mother tincture fiye drops for a dose. Under this treatment the pains left the joints, there was no swelling, the feyer neyer rose above 102^, and auscultation showed no implication of the heart, though on the 21st she was breathing rather faster than nsual, and the pulse was 120.
I did not see her after this till the 24th, and I then found the following state of affairs. There was no pain or swelling in any of the joints, but rather a severe pain over ihe region of the liver (? diaphragm), but only on move- ment or deep breathing. The breathing was very short and gasping, 60 per minute, the face very flushed. Tempera- ture 101*^.5. Pulse 180 and unsteady. The respiration 'was harsh at both bases, and the left base was dull on percussion. I could, however, still discover no abnormal sounds with the stethoscope, and there was certainly no j)ericarditis. I now began to get very anxious for my patient, and gave her phosphorus 5 x every two hours, believing that the condition of the lungs was the cause of her being so much worse ; however, I determined to take Dr. Dudgeon's sphygmograph with me the next day, to determine the condition of the heart.
174 MTOflAEDina. SSS?£S*?^
The next day, GhriBbuaB dsj, I fmmd ber do better ; tbe respiration 64. Pnlae very nneteady, and nearly 200; temperature 100P.5; and I obtained the following tracing —
which enabled me to dia^^ose myocarditis, without any doabt, and of considerable severity too. It will be sees that the different parts of the normal pnlse trace ore at most entirely wanting, only occasionally do we get a fJoint suspicion of the tidal ware or the dicrotic notch, bnt in their place we get a single weak unsteady wave, with a very unequal elevation and mieven base line, showing unmistakably that the heart muscle wag acting in a tumultuous, weak and irregular manner, and probably that the different fibres of the ventricles contracted vrith a different rhythm. The breath sounds in the right lung were now normal, but there was evidence of pleural effnsion at the left base, though not extensive. I now gave her cactus 2x and digitalis Sx (trit.} in alternation.
The next day, December 26th, the respiration varied &om 48 to 60; the temperature was lOO^'S, and the following was the pulse t
ahowing the same features as the first, if poasibie, in an aggravated degree, especially the upper one.
The condition of the cheat remained the same. I may as well say there was no cough, or any evidence of true pneumonia all through. Bepeat the medicines.
December 27th. Bespiration 60, temperature 99.9, and. the following tracing, which shows no essential improve- ment—
Strrlew, MwA 1, ISM.
UTOOABDITIB.
I now gave her dt^talu 0, m. xt. every two hours.
December 28tb. Bespiration 86, temperature 99*7, and feele better in herself; there is a little pais in the left lower ribs, where there is still dnlness oo percassioa, and distant breathing to be found.
The following is the tracing for this day^
December 29th. BeHpiration £2 ; temperature 100 ; pulse 1S2, thoagh still tety irregolar, as the folloving bracings ahow. Hoverez, it will be observed how verj mncb more clearly the traoiiig is shown ; the dicrotic wan showing at each beat, thongh frequently cnt short hj the- next np-Btroke —
December 30th. Respiration 38 ; temperature 99 ; poise 102, with the foUowing tracing, which shows for the first time complete regularity of beats as to time, thoagh not qnite as to strength—
She was feeling much better in herself, and the urine v for the first time, clear.
176 UTOCABDITIS.
I DOW reduced the dose of tUgitalis, whicli hmd bean given regalarly since the 27th, to m. x, every three boon.
December Slst. Respiration 86; temperature 99.3; pulse 108 ; with the following tracing —
which shows a still further improvement, in so &r as the tidal wave ia quite perceptible and the dicrotic wave is not nearly so high. I now reduced the dose of digUaUt to m. V. every 3 hours.
January 2nd, 1882. Respiration 40; temperature 99.6; pulse 120 ; with the following tracing. —
She is evidently not quite so well, possibly due to some extra excitement yeBterday. Also for the first time there has become evident a soft mitral sj'stolic bruit. How- ever, the urine has become clear and pale, and the effusion at the left base is nearly absorbed.
I now ceased the digitalia altogether, and gave her bry. 0 and cactus 2x in aJteraation.
January 4th. The fever has now quite gone, the chest is clear, and she feels much better in herself; the respira' tion is 26, and the pulse 120, with the following tracing. —
From this time she bae got steadily better without any drawbacks, though the mitral bruit still remains. She sat out of bed on the 12th, and began to walk on the 14th.
MT0CABDITI8. 177
Tbo lasi tracing I took waa od Janaarj 14ib, wban the reBpintioD was 16, and the pulse 100.
It will be Been that siace the Slet, the tidal wave has agUD been lost in the ap-atroke, and tbat the pulse is atill highly dicrotic, evideocing great relaxation of the arteries, a condition which is iavariably fonnd doting fevers, and dnring convalescence for some time after. Mitral Btenosis does not give any distinctive poise trace, bo the present tracing is simply that of an exhansted arterial system, and somewhat enfeebled heart moscle.
Of course my patient is by no means well yet, bnt, con- sidering the very serioos nature of the complication, I am very wedl satisfied at the fever having leil her, and her being able to sit ap fire weeks after she first took to her bed. The mitral broit is by no means a loud one, and I have good hopes that it may disappear onder treatment, or at all events, not be the caose of any appreciable ill-healtli in later years.
The Msistance I reoeived from the spbygmograph in estiioating the amoont of heart mischief, and its progress from day to day was most gratifying, and cannot &U to be evident, even to those only slightly acquainted with its traoingB, and not less so was the improvement onder the nee of digitalis, for the cachu 2x and diffiuUii 3z were given <Hi December 25th and 26th, and then the tincture of digi- UUit alone in pretty foil doses with the result ttiat by December 80th the pulse was reduced from nearly 200, and a most irregolar and almost oninteUii^ble tracing, to a little over 100 utd perfectly regolar, whioE it has remained ever siooe.
NovB. — Thetiaoiiiga bb printed ue not ftltogetfaM MttsfMtorf, thoagli tbej nu7 pooalb]; be m good m nnytliing but a photograph oan be. Tbn, howevBT, give a vety lair general tepreBenttttion of the originals, ■Bfflcimt to indicate the alterations tiom daj to day, bnt in the flnt two tradngB th« dtveraitiei both ai to time and Tolnme are made leM obvious thm they IMII7 were, while in the last one the itrokei ahoold have beam more ersn and regular, and vithoQt the wavineei there ahown in a few of Ihelinef.
I
178 ON BLECTWCITT. ^^'S2:??»Sar
Bttview, Harch 1, 188RI.
ON ELECTKICITY : ITS PHYSIOLOGICAL ACTION
AND THEKAPEUTIC USES.
By Donald Batnes, M.A., M.D.y F.R.G.S.
(Contifmed.)
QaJxanic or Voltaic Electricity : So-called from its dis- -ooverer and earliest chief investigator. Also called dynamic electricity, the battery current, &c.
In 1790 Galvani, Professor of Anatomy at Bologna, dis- covered this form of electricity while investigating the influence of electricity on the nervous excitability of animals. He noticed that when the lumbar nerves of a dead frog were connected, by means of a metallic conductor, with the crural muscles, these latter were contracted. He also noticed that the energy of the contractions greatly depended on the conductor being composed of two different metals.
He explained this phenomenon by assuming that the electricity was inherent in the animal (calling it the vital fluid), and simply passed from the lumbar nerves to the muscles by means of the metallic conductor, thus causing the contractions. This theory, though supported by many eminent men of his day, was denied by others, notably Volta, of Pavia, who attributed the contractions in the frog's leg to ihe influence of the metallic conductor, strengthening his theory by Galvani's own statement, that the contractions depended, to a great extent, on . the conductor being com* posed of two metals, and that the electricity was evolved from the contact of tiie two metals ; that the frog's body was only a conductor, and at the same time a very sensitive electroscope. Yolta, by a series of experiments with an electroscope invented by himself, proved that electricity was developed by the contact of different metals under favourable circumstances, the famous Yoltaic pile being the result of his experiments. A long controversy was carried on between Galvani and Yolta, each having a numerous party of supporters, and each conducting elaborate experiments to prove his respective theories. Volta finally propounded the following principle, viz., " That when two heterogeneous substances are placed in contact, one of them always assumes the positive and the other tiie negative electrical condition." Other invest!-
ItS^^^^^ ON ELECTBIOITY. 179
B«view, March 1, 18BS.
gators followed; who in turn challenged Yolta's theories, advancing their own, or modifying his. Among the most notable may be mentioned Fabroni, WoUaston, Davy, De la Rive, and the immortal Faraday. In the present day earnest investigations are being diligently carried on in this interesting field, with the magnificent results that are now being daily seen at the various electrical exhibi- tions or conferences.
The galvanic, or battery current as it is called, may be produced in its simplest form by the contact of two metals in one exciting fiuid, which acts chemically on the one, but has no action, or at any rate a lesser action, on the other. Take an earthenware or glass jar containing a solution of sulphuric acid and water (one part of the former to eight or ten of the latter). Now, partially immerse in the solu* tion a plate of copper and a plate of zinc, a piece of copper wire being attached to the free, or unimmersed end of each plate. No electrical or chemical action can be noticed beyond a few bubbles of hydrogen disengaged from the zinc plate; if, however, the ends of the wires are brought together, violent chemical action is immediately set up. A ^sonsiderable quantity of hydrogen is disengaged, which is not now noticed at the zinc, but at the copper plate. The connecting wires present many magnetic, thermal, and other properties. If a galvanometer be interposed in the wires or circuit, the needle will immediately be deflected, thus proving the existence of an electric current. The zinc plate, being the one chemically acted on, is called the gene- rating plate, while the copper plate, which sustains little if any chemical action, is called the collecting plate. The electricity produced at the zinc passes through the liquid to the copper plate; and, as it always takes a definite •course, it follows on in the same direction outside the cell, passing over the copper along the wires to the zinc plate, thus completing its circuit. The current flowing within the cell through the liquid from the zinc or positive to the oopper or negative plate, is positive. At the same time, a current of negative electricity is supposed to start from the copper, travelling in an opposite direction through the liquid to the zinc plate, and continues over the zinc and out of the cell back to the copper plate, thus completing its circuit. Thus the positive current generated within the cell at the zinc is obtained outside the cell from a conductor attached to the copper plate, and vice versa.
180 ON ELBOTMOITr. S^^52S?^
Bcview, Uandi 1, 186K.
A battery is formed by uniting sevend such ceUs together, the copper pkte of the first cell being connected with the zinc plate of the second cell, and so on throughout the series. Iliis form of battery is called a single fluid battery, and is what is called inconstant, i.e., subject to a rapid decrease of power during use, and for this reason is but little adapted for medical purposes. This decrease of power is due chiefly to the formation of sulphate of zinc, from the chemical action of the dilute sulphuric acid on the zinc, which renders the exciting fluid less acid, and there- fore less able to produce the original active chemical action ; and to what is called polarisation of the copper plate, which is due to the deposition of part of the hydrogen on the copper, evolyed during the action of the dilute sulphuric acid on the zinc. This deposit of hydrogen ofiiers consider- able resistance to the passage of the electric current, and, in addition, causes a deposit of metallic zinc on the copper, by reducing the sulphate of zinc in solution, which prac- tically gives us two zinc plates instead of one, and of necessity destroys the conditions necessary to tbe produc- tion of the electric current. This trouble hiui been overcome by the introduction of elements which will give a steady and constant supply of electricity for a very long time. These elements are ** double fluid."
The following batteries are those chiefly used for medical purposes: — The Smee combination. — ^Here the elements consist of zinc and platinum, the exciting fluid being dilute sulphuric acid. This combination, as is the case with all single-fluid batteries, soon loses its power.
The Grenet combination, which is perhaps the best of all single-fluid batteries, consists of zinc and carbon elements, an acid solution of bichromate of potash being the exciting fluid. This battery is much more constant than Smee's. In Stohrer's batteries the same elements and exciting fluid are used. In the constant, or two-fluid batteries, polarisation is prevented by chemical reaction and mechanical means.
Grove's battery consists of an outer and an inner cup, the inner being porous. In the outer cup is a zinc plate, immersed in dilute sulphuric acid; the inner contains nitric acid, in which a platinum plate is suspended. In this case polarisation of the hydrogen is prevented by its combining with some of the oxygen of the nitric acid passing off in fumes, which are easily noticed when the
?£S^SiSJr^ ON BLECTBICITY. 181
Befkfw, March 1, 1882
1)atter7 is working ; the porous cup acts as a diaphragm, preyenting the deposit of zinc on the platinum.
Bunsen^B battery is very similar to Grove's, the only difference being that the negatiye element is carbon instead of platinum. One of the best of the two fluid batteries is the Daniell, the elements being zinc and copper, separated bj a diaphragm of porous earthenware. The zinc is im- mersed in dilute sulphuric acid, and the copper in a satu- rated solution of sulphate of copper. The hydrogen evolved in the zinc compartment traverses the porous diaphragm, reduces the sulphate of copper, thus causing a dei>osit of metallic copper on the copper plate ; the sul- phuric acid, set free from the copper solution, also traverses the porous diaphragm, and helps to keep up the strength of the dilute sulphuric acid in tiie zinc chamber.
Two modifications of the Daniell, the Siemens-Eblske and the Becker-Muirhead, are used to a great extent. Another constant battery is the Leclanch6, which consists of zinc and gas carbon. The carbon is packed in a porous cell with powdered carbon and peroxide of manganese ; this cell is placed in another, containing a saturated solution of sal-ammoniac, in which is immersed a zinc rod. In this element chloride of zinc is formed, and hydrogen and ammonia set free.
The elements I usually employ for stationary batteries are " Hill's Gravity Cells." They are very inexpensive, and work well for a long time, with little, if any, attention. The element consists of a glass or earthenware cell, circular in shape ; at the bottom is placed a roll of copper, covered with crystals of sulphate of copper; water is added till the cell is one-third full, a saturated solution of sul- phate of zinc is carefully poured over this till the cell is about two-thirds full ; suspended from the top of the cell and just touching the upper solution is a zinc disc, usually made with a large aperture in the centre. The only atten- tion necessary is occasionally to add a little water, to replace any loss by evaporation ; a layer of paraffin covering the zinc solution will almost entirely prevent any loss from this cause. The solutions of sulphate of zinc and copper are kept apart by the difference in their specific gravities. Care must be taken not to shake the cells, or the solutions will become mixed.
The smallest element in use is Gaiffe's, which consists ^f a plate of zinc and a plate of chloride of silver, separated
YoL 26, No. 8. o
182 ON ELECTBICITY. f2S^52»??nSir
Bevibw, MATch 1, VBBL.
by some bibulous paper, moistened with salt and water. As we have seen, a galvanic battery consists of a number of elements joined together in a series by metallic connections ; the collecting plate of the first element is connected to the generating plate of the next, and so on, the last collecting being joined to the first generating plate. These con- nections consist of good conductors, that is, of bodies that ofier but little resistance to the passage of the electrio current. Most metals, charcoal, and acidulated liquids, are good conductors. The best metallic conductors are gold^ silver, and copper, the last being chiefly employed owing to its cheapness. Even the best conductors resist the passage of the electric current more or less. Non-conductors, or insulators, are substances which ofier very great resistance, or almost entirely prevent the passage of the electric current, as gutta-percha, porcelain, wood, resin, &c. This brings us to the subject of electrical resistance, which may be defined as being that quality of a body which tends to retard, or obstruct, the flow of the electric current, and it is found to be directly proportional to its length ; that is, the resistance ofiered by a wire, for example, a mile long, would be double that ofiered by the same wire half a mile long.
Different substances have each a resistance peculiar to itself, which, by comparison with fixed standards, has been measured, and is called the '^ specific resistsmce'* of the body. The resistance of a body also depends on its cross section, and is inversely proportional to it. A copper wire, for instance, of large calibre, offers less resistance to an electric current than a similar one of smaller calibre. In a galvanic battery the resistance to the electric current consists — In the first place, of that offered within the cell, which depends on the exciting fluid, the distance between the plates, the size of the plates, and any polarisation that may be going on. This is called the essential, internal, or intrabatterial resistance. In the second place to tiiat occurring outside the cell, due to the connections, conducting wires, or other media that may be introduced in the circuit ; this is called external, extrabatterial, interpolar, or non* essential resistance.
To sum up : The resistance within the battery is directly as the distance between the plates, and inversely as the surface acted on. In the connecting wires the resistance is directly as its length, and inversely as its cross-section*
S^aSTf^' EBTBIEELAa, 18ft
These principles are brought out in the different arrange- . nients of the elements in a battery. They may be arranged in two ways ; first, when the collecting plate of the first element is joined to the generating plate of the second, and so on throughout the series, as already described; this arrangement is calculated to overcome great external resistance, and it is said to be 'Sn series,*' or an " intensity arrangement^ If^ however, we connect all the collecting plates together, and all the generating plates together, we practically get one large element of each kind, instead of aeveral small ones ; that is to say, we increase the area of the plates, and the quantity of galvanism obtained is very great. This is technically described as ^* quantity arrangement.** Electro-motive force may be described as the power a battery possesses of generating and propelling an electric current. This is found to be proportional to the chemical action taking place in the battery ; the greater the amount of chemical action, the greater the electro-motive force. Thus a Bunsen element has a far greater electro-motive force than a Smee.
By the intensity^ or strength of a current, we mean the qiiantity of electricity which flows through a section of the circuit in a unit of time. It is proved to be proportional to the electro-motive force. This is Ohm's law, and may be stated as follows : — " The intensity, or strength of the current, is equal to tlie electro-motive force, divided by the resistance"
Or expressing it as a formula —
R (2V> be continued.)
I^OTB. — In the ifarst paper, thenno-eleotrieity has b«en printed as snb- diTision (c), whereas it was intended to be division 4th.
CLINICAL LECTURE ON ERYSIPELAS.
Delivered at the London HomoBopathic Hospital, Jan. 28rd, 1882, by J. Galley Blaoklby, M.B., Physician in charge of the Skin Department.
Gentlemen, — ^Those of you who have accompanied me round the wards during the last few weeks will have seen the man A. B., an occupant of Hahnemann ward, the subject of phlegmonous erysipelas. As the case possesses
0 — 8
fQ4 T?T>vaTT)T?T AQ Monthly HamoBopAffcic
Beview, March 1, 18fc2.
more than ordinary interest, I would invite yonr attention for a few moments to the notes^ as famished by our resident medical officer, Dr. Scriven.
"The patient, a cab-driver, aged 54, was admitted December 9th, 1881, stating that, except for winter coagh, he had always enjoyed good health, until four days ago, when he noticed a stiffness in the calf of the right leg, which became the same night very painful, the pain being of a burning character. On the following day the leg began to swell, and the pain became worse. On the day but one previous to his admission he noticed blisters appearing along the tibia ; these gradually coalesced, and on the following day fresh ones appeared on the outer side of the leg, the earlier ones meanwhile beginning to burst.
At the time of his admission to the hospital the whole tibial aspect of the leg was covered with large bullsB of the size of a half-crown, two or three being apparently on the point of coalescing, the contents being large pustular, whilst the outer side of the leg was occupied by a single large bulla, containing pure serum. There were several smaller buUse about the ankle. All these were surrounded by an erythematous blush, which disappeared, however, on pressure, and the whole leg was very tender to the touch.
Pulse is 120 full and throbbing, temperature 99.6. Tongue beefy, but inclined to be coated in the centre. To have tr. rhus tox., 1 x, a drop every four hours, the bulla to be pricked, and poulticed with bread and water, and the patient placed on a full meat diet.
Dec. 11th. — Pulse 124 ; temp. 100 morning and evening. Tongue now thickly coated in centre. Leg and foot both slightly oedematous. Has not slept since his admission, owing to pain in the leg. To have canth. 1 x, gttj., 4tay quaque hora.
Dec. 12th. — Temp. 100 morning and evening. Leg and foot more oedematous. There is a hard brawny swelling in the popliteal space, and some tenderness along the course of the int. saphenous vein. Tongue very thickly coated in centre, fiery red round the edges. Has had several sharp rigors, and cannot sleep owing to gnawing pain in the leg. Linseed poultices were ordered to the leg and knee, and chin, 0 gttj. every four hours was substituted for the last medicine. A generous diet was ordered, with the addition of a pint of bitter ale daily.
Dej. 13th. — Temp, last night 101.6; this morning
SsSS'iSsr?^*' EBYsnPBLAS. 185
BtvriflVy SfAvdi 1* 1683
98.6 ; pain less ; has slept a little. For some days the temp, kept up, yarying from 100.2 to 101.2, the leg con- tiiming meanwhile very painful, though the swelling and hardness were less. The tongue was red and fiery at the tip.
Dec. 19th. — Temp. last night 102 ; had a smart rigor in the eyening. As the swelling was now '* boggy " and showed signs of pointing, free incisions were made on the inner and outer aspect of the calf, and a couple of drainage tubes inserted. The poulticing to be continued.
Dec. 20th. — Temp. 102.2 last night, 99.6 this morning ; discharge of pus very free, especially from the internal incision. Has slept better.
Dec. 22nd. — ^Evening temperature still high ; discharge free; tongue more moist. The dose of china was increased to gtt. t. ter die. Four ounces of port wine were substituted for one half-pint of ale."
During the following week the eyeniug temperature fell to 100. The discharge diminished and the wounds ap- peared to be granulating in a healthy manner. Long sinuses could, howeyer, still be felt amongst the muscles inside the leg. A small phlegmon formed oyer the outer condyle of the femur; this was opened, and a quantity of ^sanious pus was eyacuated. The patient is meanwhile gaining eyery day in flesh and strength. The tongue is clean, and the patient eats yoraciously. The poultices haye now been left off and the wounds dressed with carbolic acid lotion.
Jan. 6th. — Temp, normal night and morning ; small sinus outside the knee still discharging thin ichorous matter. The other openings are looloug healthy, thoagh a probe still passes 1^ inches between the muscles. 9 silic. 8 grj. t. d., the wounds to be packed with pledgets of lint dipped in carbolic acid lotion.
The second case is that of Caroline F., st. 27, senrant, whom some of you may remember as being admitted an inmate of Cambridge ward on Noy. 22nd : '* Says she had an attack of erysipelas in the face three years ago but has otherwise enjoyed yery good health. Has been working in a hot kitchen and exposed to draughts." On admission the face and anterior part of the hairy scalp were occupied by the characteristic smooth, shiny, fiery red swelling, known popularly as St. Anthony's fire. The temperature on admission was 103.4, and the same eyening rose to
186 UBYSIPELAS: ^SS^.S^?^,
104. Was seen by the house surgeon, who prescribed aeon, and beUad., in drop doses of the first decimal dilution every two hours alternately, and a lotion consisting of a drachm of tr, veraL vir. to six ounces of water, to be applied to the face on a mask of lint ; the diet to consist of milk, beef tea, arrowroot, and cocoa ad libitum*
"Nov. 23rd. — ^Temp. 104.2; tongue dry and cracked; has been delirious all night, and required closely watching to keep her in bed. Continue the remedies.
Nov. 24th. — Temp, last night 105 ; this mormng 108 ; delirium not so violent. Takes nourishment well.
Nov. 25th.— Temp. 103.6 last night ; 102 this morning; swelling in the feuse has increased very much, and has spread to the neck and scalp ; is now hard and brawny, and is showing signs of vesiculating on the surface. BEas now been steadily unconscious for two days. Tongue diy and brown; sordes round teeth. Was ordered i iv. of port wine, and a couple of eggs beaten up with brandy in addition to the above diet, which she continues to take wen. The lotion was replaced by a mixture of olive oil and tincture of veratum viride, and the aconite was omitted.
102 4- Nov. 27th. — ^Temp. Tq2^ ^* '^^^ ' ^^ wandered all
night, but is semi-conscious again this morning. The
lower part of the face is much swollen ; tongue dry, brown
and slimy ; passes urine involuntarily ; takes nourishment
welL The beUad. was replaced by rhus 1 x,^tj, 2da
quaque hora.
102.8 ' Nov. 28th. — Temp, qq/ ' pulse 96 ; slept for a few
hours during the night, but is unconscious this morning,
and is muttering constantly. One stool passed in bed ;
swelling has now spread down left side of neck.
102.6 • Nov. 29th, — ^Temp. qq/ * pulse 96 ; in other respects
the aaxne. To have five drops of mother tincture of china every three hours and a pint of champagne per diem in place of the port wine.
Nov. 30th. — Temp. 99.6 night and morning ; pulse J2 ; is quite conscious this morning. Face not so much BwoUen. Passed a stool unconsciously during the night.
Dec. 1st. — Temp. 99.4 at night, 99.2 this morning; pulse 78 ; slept very quietly during tibe night, and is quite
^tSSS^^tSP?^^ BBYSIPELAB. 187
i.
eoiiBcioiis this morning. Swelling maoh less in the faoe, and has not spread below the neck. Bowels acting iiatorally, and does not pass nrine in bed. Bedsore on right buttock. To discontinue china and have apis 8 x., gjttj. evGTj two honrs.
Dec. 2nd. — ^Temp. iqqq\ pnlse 78, feeble; was very
•drowsy all yesterday and during the night; breathing stertorous at times. Was ordered 15 minims of tp. ammon* 'Orom, every four hours. Seems much brighter this morning ; tongue moist and cleaner. Is taking nourish- ment well. Face desquamating.
Dec. 8rd. — Ten:^. 100.6 last night, normal this morning; idapt well all night without wandering. Tongue moist, and much cleaner. Pnlse 72, much stronger. Passed one stool during sleep."
It is needless to give you the subsequent details from day to day. She made a straight progress towards recovery ; was out of bed for the first time on Dec. 19th, and was discharged cured on the 22nd, exactly a month from the •day of her admission.
The third case — one that several of you have seen in my out-patient room — ^is that of Mary S., aged 21, teacher, who came on April 21st, stating that she had for years had periodical attacks of erysipelas, commencing in the nose, 4uid invading subsequently the &ce and head. The case is interesting, from tiie fact that she suffers in the intervals with neuralgia of the head and face, and that she is the subject of complete alopecia, extending to eyebrows and eyelashes, dating from the first attack of erysipelas. She wears a wig, and has had the head shaved at times. For the slight erysipelatous redness present at the time of her visit she received bdL 1 x., a pilule three times a day ; and -when this had subsided at the end of a fortnight, although but very few traces of hair follicles could be made out with a lens, she was given ac. jluor. S gttj. t. d., which Ae took steadily for two months, with instructions to keep the head shaved once a week. At the end of June she came 43omplaining of a small patch of indurated skin on the left ala nasi, which she said had always been the foous from which the erysipelas commenced. On examination it was seen to be slightly raised above the surrounding skm, smooth and soft, slightly scaly round the edges, resembliag^ in fact, a small patch of lupus folliculans. For thk I gave
188 EBTSIPELAS. «2S*lf52°??T2Sr
Review, Harch 1, ISOL
her Hydrocotyle Asiatica 1 x., gttj. t. d. This she took steadily for three monthsi but without any manifest improvement other than that nnmerons downy hairs haye begun to appear on the scalp. She is now taking kal. bich., and the growth of hair continues slowly, but steadily, the downy hairs being interspersed here and there with vigorous, dark-coloured shafts.
These three cases will perhaps serve to give you a fair general idea of the symptoms and treatment of the more severe forms of erysipelas. The milder forms do not pre- sent themselves very frequently in hospital practice, owing^^ to the fact that they generally improve spontaneously*. When they do, however, there is usually little difficulty in nipping the malady in the bud. The patch of rosy red sUn, tense and shining, slightly elevated above the sur*- rounding skin, hot to the touch, and tender on pressure, is easily recognised, and as easily met by belladonna (drop doses of the first dec.) every two hours. I have quite given up the use of aconite in &is as in all specific fevers, for there can be little doubt that erysipelas belongs to the specific infectious diseases. Should the attack not subside within 48 hours, vesiculation of the surface commences, and the patch may spread at the same time. Here rkm tax. 1 z, gttj. 2 dis hor. is the remedy, with perhaps bellad, at night, if delirium or great restlessness are present, as is frequently the case. The skin should be rigorousty- excluded from the air, either by oil or collodion.
In the more severe forms many authorities recommend compression as a means of preventing or aborting the* phlegmonous form. Yelpeau, in his lessons on clinical' surgery, says " That when the phlegmonous erysipelas is^ only of three days' duration, compression wUl almost always produce resolution, and that it is still useful eveui when pus has formed, and the cellular tissue has become mortified."* Subsequent experience has, however, failed tO' ratify Yelpeau's suggestions, and there can be no doubt that where simple means have fedled, and we are conscious of the presence of pus, it should be speedily evacuated.
In the graver varieties of erysipelas, of which my first two cases are examples, no time should be lost in subject* ing the patient to tike remedy more distinctly adapted to
* Le^om Ora/«f d4 Clinique OMrurffieaU, vol. iii., p. 271.
SS^^JjSr:^ RBTSIPBLAS. 189
B0Tiew, ICarofa 1, 1862
the indiyidual case. For this reason, as a rule, the use of beUadanna is rather a waste of time. Where yesiculatioa or bollsB are present, rhvs is the drug to be exhibited ; and the same may bo said of all cases which lapse into a low typhoid condition, evidenced by the condition of the tongae, the low muttering delirium, and the persistent high tern* perature. Where the indications are rather those of toxsBmia, especially with very extensive oedema, and gene- rally dusky colour of skin, and temperature not very high, apia is the drug to be tried. If, however, we have rigors from time to time, and very high temperature, with con- siderable difference between the morning and evening, we have in cinchona bark a most valuable adjuvant, whether the case go on to suppuration or not/ The drug must, however, not be given in infinitesimal doses. You will have noticed the very satisfactory fall in temperature in the case of Caroline F. after the administration of a few five-drop doses of the strong tincture. On the subject of diet, wnat I have said as to the dietary of the two patients, should suffice. It should, in all cases of erysipelas, be generous and easily digested. Stimulants should also be exhibited freely, and in some conditions, where there is profound adynamia, and alcohol fails to give the necessary fillip, the spirits of saUvolatile, as given in our second ease, is a very useful and reliable stimulant.
* China, as a remedy in eryBipelas, has hardly received the attention it deserves at the hands of recent writers on homoeopathic therapeutics. The anatomical changes in the skin and sabcntaneons connective tissne, atthoQgh few in number, are yet sufficiently characteristic to lead one to «zpeet good results from the exhibition of the drug where the febrile and other symptoms present are in accord with' the pathogeuesis of eJdna (vide AllerCi Encyelopadia, voL iii., pp. 204 and 206). Hahnemann Mmears to have been fully cognisant of the beneficial eifects of china in pmegmonoos erysipelas, for in the introduction to his account of the dmg (Materia Mediea Fwra^ Dudgeon's translation, voL i., p. 416) he says: —
«» So also in those cases where we have to do with io-ealled moist gangrene in the external parts, we shaU generally notice in the remainder of the patient*s ailments, morbid symptoms similar to the symptoms peenUar to cinchona bark; hence it is so useful in such cases."
Jousset (" Du Quinquina et du Sulfate de Quinine dans le Traitement de l^Erysipele/' L*Art Medical, Jan. 1880, p. 11) cites two cases of severe eiysipdias cured by eMna, In one, substantial doses of the viman cinchona were administered.
190 BBViBws. B2^'22Sfi?i2?
BeYiew, 2Citch 1, IttS.
REVIEWS.
Special Pathology and Therapeutic Hints, IUtte. Boericke and Tafel, New Tork.
The second edition of this work is a decided improvement on the first. The author tells ns that the first had become old* Views on pathalogy which were almost startling when it first saw the light, have become musty and antiquated since then, many of them have even been proved to be fallacious ; hence the need of a new edition, which appears in the form of a very handsome volume of nearly 1,100 pages.
To those who have not the time to put on their literary sea- boots and wade chin deep througli Allen, this book will profve a storehouse of information.
Without having to wander wearily through pages of symptoitts, many of which may be of questionable value, we are enabled to turn at once to the disease we want to study, and find all the principal remedies alphabetically arranged, with their patho- genetic indications concisely described.
The pathology of the work is carefully brought up to modem standard. Some few errors in nomenclature have slipped in, which, but for their recurrence, we should have attributed to the much maligned printers. For instance " metastic meningitis " from the context is evidently meant for '' metastatic," and again the word '* insulatio " is applied to sunstroke ; were the patient to be exposed to the electric current we could understand tb.e use of this word, but not when used in reference to Father " Sol."
These, however, are but of minor importance, and detract but little firom the value of the work to the homoeopathic practitioner. The section on kidney diseases is well written, and abounds with useful information. Brain and spinal diseases, too, have been carefdlly studied. Whilst old physic is almost helpless in this class of diseases, homoeopathy is fertile in resource.
The homoeopathic physician, by means of the laws of similars, can avail himself of the lai^ge class of drugs acting on the brain and cord, which the allopath dare not tamper with for fear of producing aggravation.
Dr. Bane deserves our best wishes for the catholicity of his opinions. We quote from the preface : —
''This book does not give any prescription in regard to the dose, because that is still an open question, and must be left entirely to the free judgment of the practitioner." "I, myselfi prefer the highest potencies ; others may think differently. So much is certain, that there are undoubted facts which seem to favour both sides of the question • . . Judge then for
thyself."
iSSS'JKS??^^ NOTABILIA. 191
fienew, 3Caieh 1, 1883.
Such liberal views an a weighty qnestioii do much to cBsarm criticism, and with the exception of a £bw experiments in nomen- «latiure, to whioh oar English eaocs have not yet become aecnstooied, this book will jnnk high as a reliable referee in doubtful
The Delegates from the United States of America to the Interna- tional HomcBopathiti Oonvention, held in London, July, 1881 • Barrand, 96, Gloucester Place, Portman Bqoare. "Wb have in ^s very well arranged group the photographio portraits of twenty-five of our transatlantic colleagues who took 80 active and useM a part in the business of our Convention last summer. The portraits are on the whole excellent. The majority are admirable likenesses, while two or three only are lees striking. This was of course inevitable. Among the best are Dr. Talbot, Dr. Dake, Dr. Breyfogle, Mrs. Dr. Baker, Dr. Ordway, Dr. Higbee, Dr. Eaton, Dr. Cooper, Dr. Benjamin, Dr. MitcheU, Dr. de Gexisdoff and Dr. Foster. Mr. Barraud may fairly be congratulated on having produced a very interesting and successful group. It is one^^di we are sure our colleagues would wnh to possess ; and when we add that three half crowns will enable them to have it, we oaonet doubt that a large sale will be secured for it.
NOTABILIA.
BRITISH HOMCBOPATHIC SOCIETY.
The Sixth Ordinary Meeting of the present Session will be held on Thursday, March 2nd, 1882, at seven o'dook, when the following motions win be discussed : —
Proposed by Dr. Huohbs, seconded by Dr. Yrldham —
** 1. That, in view of the considerations as to the state of our Materia Medica, lately adduced by Drs. Yeldham and Black in this country, and Dr. J. P. Dake in America, the British Homoeo- pathic Society feels that the time has come for its reconstruction, and is prepared to undertake the task.
" 2. ThsA, for this purpose, a Committee of seven of its members, including the President and Secretary, be appointed.
*' 8. That this Committee be instructed to take for the basis of its work the Encychpadia of Dr. Allen, in the light of the criticisms made upon it by its e£tor in the NbriJi American, and by Dr. Hughes in the British Journal of Homoeopathy ,
*' 4. That the translation of Hahnemann*s Materia Medica JPura, recently issued by the Society, be regarded as the first
192 KOTABiuA. S5«'5^!?l£^
ICanli 1, 18H8»
instalment of its work ; and that the symptoms furnished thereto* by Hahnemann and his fellow-provers be not again presented nnder the medicines to which they belong.
" 5. That the aim of the Committee shall be to exponge tSl nntmstworthy and irrelevant matter, and to present what remedns in the most accurate, concise, and intelligible form, — ^all repe- titions being avoided, and All provings being given, where possible^ in consecutive order as related by the experimenters."
Proposed by Dr. Dudgeon, seconded by Dr. Hale —
'< That the proposed diploma and title of Licentiate of Homoeo- pathy, resolved on by the London School of Homceopathy, is^ contrary to the spirit of the laws of this Society, and calculated to damage our position as members of the medical profession.*'
At eight o'clock, a paper will be read by Dr. Roth, of London, on <* The Treatment of Various Uterine Complaints by Move- ments."
ANNUAL REPORT OP THE RED HILL AND REIGATE
DISPENSARIES.
We have received from Dr. Woodgates the First Annual Report of the Red Hill and Reigate Public Homoeopathic Dispensaries. Seldom have we seen sueh good results attending a first year's operations. The subscriptions and tickets amounted to £Gi lis. ; and after all disbursements there remains a balance in hand of £1 ds. 7d. There are few public institutions of this nature which,, after twelve months' existence, can show such financial sound- ness. We would draw particular attention to the fact, that the Dispensary Committee voted a donation of two guineas to the London Homoeopathic Hospital, and a similar sum to the Hahne- mann Convalescent Home, Bournemouth ; thus securing to their honorary medical officer the power of sending serious cases ta either the hospital or the home, and thereby increasing the benefits derivable from the local institution. The medical officer'^ report shows that three cases were thus dealt with in the course of the year, and derived great benefit from their treatment while in hospital.
Dispensaries, properly conducted and efficiently managed, are the very siege train of the armament of homoeopathy. Work* ing, as they do, amongst a class of people who judge more than most from results, the cures wrought by homoeopathy act aa most convincing arguments, far outdoing in their effect any amount of literary proselytism or verbal controversy.
We are glad to see that Dr. Woodgates is as active in spread- ing homoeopathy in Reigate as he proved himself to be in Exeter, and we cordially wish every success to this young and flourish- ing institution.
K^Si^SSn^lSJ" OBITUABT. 198
B«Tiew, Mareh 1, IBSS
HASTINGS AND ST. LEONARDS HOMCEOPATfflO
DISPENSARY.
Thb following extract from the recently issued annual report of this tnstitation is both gratifying and interesting : —
** Daring the year, 552 patients have presented themselves at the dispensary for teeatment, and the total number of attend- jmces recorded is 4,200, making an average weekly attendance •of 80 patients. One hundred and eleven patients suffering from diseases of the eye presented themselves for treatment during ^e year.
'* These figures, compared with those published in the last report, show an increase in the number of attendances of 1,579. This fiaot emphatically bears testimony to the appreciation of the iastitution by the poor/
fi
OBITUARY.
EDWARD CRONIN, M.D.
The late Dr. Cronin, of Brixton, whose death occurred on the 1st February, was born in Cork in 1801. He studied for the profession of medicine at the Meath Hospital, Dublin. During the earlier portion of his career Dr. Cronin devoted himself to missionary work. In 1828, in coDJunction with his friends, Mr. John Pumell (now Lord Congleton), Professor F. Newman, and Dr. Eitto, he took an active part in constituting the religious body now known as the Plymouth Brethren. His first wife having died in 1829 — ^a year after marriage — Dr. Cronin, in company with the friends we have named, went to the East as a missionary. When in Bagdad an epidemic of the plague broke out, and Dr. Cronin exerted himself strenuously to relieve the physical wants of those by whom he was surrounded. In 1885 he left Syria for the Madias Presidency of India, when he again devoted himself to religious and medical work. In 1887 he returned to England, and now his acquaintance with homoeo- pathy commenced. In 1888 he married a daughter of Sir John Kennaway, Bart., of Escot, Devon, and after practising for a short time in Islington and in Stafford, he finally settled in Brixton, where he has since resided, and been engaged in a very extensive practice, ei^'oying not only the confidence but the warm affiaction of a large circle of friends.
Dr. Cronin's eldest son. Dr. Eugene Cronin, is the well-known homoeopathic physician at Clapham, while another is the honorary dentist to the London Homoeopathic Hospital.
194 COaBESPONDBNCE, ^^Kte^f^
CORRESPONDENCE.
THE UCENTIATESHIP IN HOMOEOPATHY.
To the Editors of ike ** Montfily Homaopathic Review"
Gentlemen, — As I find that the action of the School in offering^ a diploma to its students has dissatisfied a few (I hope a very few) of our colleagues, I would ask you to allow me — as ita initiator — to say a few words in explanation and Tindicatiaa of it.
Its primary object is to increase the School's opportunities of usefulness by holding out an additional inducement to students, to attend its instruction. We have been crippled hitherto in this respect £rom being unable to give a qualification for practice,, or to have our lectures counted as part of the required curricu- lum. The institution of the '< L.H. " will do something to* supply this deficiency. In it the student will have an addition to those significant letters which other institutions enable him to append to his name, and which are his passport to the practice at which he aims.
But, secondly, we hereby supply that great desideratum — a means whereby the laity may know a man's qualification to treat them homoeopathically. They have it for medicine, surgery, veterinary, and dental surgery, pharmacy, &c., in the L.R.C.P., M.R.C.S., and such like designations, bestowed by various examining bodies. It is confessed to be a duty on our part to provide them with practitioners instructed in homoeopathy : it is a logical inference that we should certify them of that instruc* tion having been gained, and should do so in the usual manner.
These are the objects of the step just taken by the School^ and I hold them to be such as to warrant it well. But were there anything unprofessional in the mode of proceeding adopted to promote them, I, for one, would have had no part in it. I maintain it to be quite otherwise. It is said that if we accept this titie we forfeit our power to disclaim the censure pro- nounced by the College of Physicians on those who *' trade upon a name.'* But to assume a distinctive appellation — as by putting '* HomoBopathist " on card or door-plate — is one thing : to receive and use a diploma of competency in the practice of a special method is quite another* No one deprecates the former more than I do. I joined my colleagues in this town some years ago in requesting that the word '' Homoeopathic " might not be (as heretofore) affixed to our names in the local directory. But a man must have — if he be a beginner or a settier in a new place — some mode of making it known that he is prepared to treat patients homoeopathically. At present he is tempted to do- this by illegitimate means. In the '' L.H. " we give him one which is just the reverse, which stands on the same footing as
S^5^S??'1^ CJOBBBSPOHDENCE. 196
BerioWy March ij 1882.
his "M.E.C.S.," luB^ "L.B.C.P.," or— more particularly— his *^ L.M.,'* of which it is in almost every respect an analogae.
Again, it is urged that to designate ourselves in this way is to brand ourselves as sectarian, and hind ourselves to an exclusive practice. I must answer that it does nothing of the kind. It is aimply an evidence of proficiency. A licentiate in homoeopathy must know something ahout the method ; hut how far he shaU use it in the treatment of his patients is still a matter entirely in his own judgment. That a man shall put '* L.H." to his name does indeed avow his belief in homoeopathy, as far as it goes ; and this will be no small collateral advantage of the diploma. The Lancety unable to convict us of assuming distinctive appella- tions, now charges us with dishonesty because we refrain from so doing. The accusation is ridiculous ; but it is not the less a gain to be able to meet it point blank. To take and use the *' L.H." will be avowal plain enough, though within strictly pro- fessional limits. For this purpose even established practitioners, who do not need it as a passport to practice, may well apply for it, as it will give them a means of showing that they are not Mhamed of tiie method to which they owe allegiance. I have sought it myself accordingly.
The new diploma has &us much in its favour even at the pre- sent time, but still more marked may be its advantage in the fiitnre. I am one of those who hope to see ere long a complete absorption of the homoeopathic body in that of the profession at large. It can only come when the method of Hahnemann is recognised as legitimate ; but such recognition cannot much longer be delayed. When this re-union, so devoutly to be wished for, comes about, there are two dangers to be avoided. One is that our method itself shall suffer absorption — shall lose its distmctive outlines, and survive only as a sort of Ringerism. The other is that the homoeopathic laity shall lose the few means they now have of knowing those from whom they can have the treatment they desire, ^e ** L.H." will obviously preclude the latter danger ; and a Httle thought will show that it operates no less actively against the former. As long as there is a licentiate- ship in homoeopathy, so long there must be a teaching of the system, and it will run no risk of bemg swallowed up.
We are thus exercising a wise foresight, as well as providing for present necessities, in instituting this diploma ; and I hope that in good time there will not be a single believer in the value of homoeopathy who will not be willing and proud to wear it.
I am. Gentleman,
Faithfully yours,
BiCHABD HUOHXS.
Brighton, Feb. 8, 1882.
196 C0BRB8P0NDBNT8. ShSJ^SSK^Jw!
NOTICES TO CORRESPONDENTS.
«*« We cannot undertake to return rejected manuteripte.
Dr. Pr5xll (Gaatein).— Yonr pnckage has arrived. Many thanks for it.
Br. Gramk (Philadelphia).— We shall he happy to oomply with the nqnest of your Association, and have given instmotions to our publishers accordingly.
Commtmications, &c., have been leoeived f rom Dr. Both, Dr. BiiACKLST (London); Dr. Bayes, Dr. Hughes (Brighton); Dr. Batnbs (Canferboiy); Dr. Madden (Birmingham) ; Dr. Maffret (Bradford).
BOOKS RECEIVED.
Materia Medica Pura, By Samnel Hahnemann. T^»nslated from the latest (German Edition by B. E. Dudgeon, M.D., with Annotations 1^ Biehard Hughes, L.B.G.P., Edin. YoL ii. Hahnemann Publishing Society.
Hahnemann as a Medical Philosopher. By Biehard Hughes, L.B.G.P. Edin. London : Gk>uld Ss Son.
Companion to the Britith Homteopathic PJiarmacopcda, Eeene and Ashwell, Bond Street, London. AnnaXe of the British Homaopathic Society, The Homaopathic World.
Report of the BucJutnan Ophthalmic and Cottage Hospital, Hastings^ Report of the Liverpool Homotopathic Dispensaries. The Student's Journal and Hospital Gasette. Burgoyne*s Magazine of Pharmacy and Chemistry. Tlve New York Medical Times. The New England Medical Gazette. Tlie United States Medical Investigator. Tlie American Observer. The America/a Homanpath. TJie Medical Counsellor. Bulletin de la Soc. Med, de France, Revue Homaeopathique Beige, AUgemeine Horn. Zeitung.
Papers, Dispensary Beports, and Books for Beview to be sent to Dr. Pope, 21, Henrietta Street, GaTondish Square, W.; Dr. D. Dtcob Bbown, 29, Seymour Street, Portman Square, W. ; or to Dr. Ebnnsdt, 16, Montpelier Bow, BlaoUieath, S.E. Advertisements and Business communications to be sent to Messrs. E. Gould & Son, 69, Moorgata Street, E.G.
l£S^fS3lT?Sr . OUB 0ISPBN8ABIBS. 197
THE MONTHLY
HOMCEOPATHIC REYIEAV-
OUR DISPENSARIES.
Much attention has recently been drawn to oar School, oar Society, oar MagazineB, and oar Literatore, bat Dispen- saries have, as a rale, been allowed to drag along withoat mnch organised assistance. That some of them are able to give sach a good accoant of themselves is more dae to the energy of their medical officers, and the inherent saccess of homcBopathy, than to any extraneoas aid or encoarage- ment they have received. This is not as it shoald be. A Pispensary forms the most efficient and onfailing method of spreading a knowledge of homcBopathy; the rich are reached throagh the poor, and the poor are benefited by the process. It will be a good day for the pablio when every town has its Homoeopathic Pablic Dispensary, where the necessitons poor can be treated in the trae therapeatic method, their time saved, and their health preserved to them. The poor man loses mach more by ill-health than his richer neighboar ; a week withoat work oftimes brings the wolf very near the door, and the prolonged illness of the bread-winner causes pale sunken cheeks in the little ones, and a wan careworn look in the poor mother,
Yo]. 26. No. 4. p
198 oroPMBBreAMEe. "ff^j^.^ff^
All praise, then, to any institntiony whatever be its therapeutic method, which mitigates the severity of disease among tJie poor. Allopathic dispensaries have long done a good work amongst the fever dens and slams of our great cities, and for their hard- worked medical officers we have nothing but praise. Knowing, as we all do, the superior curative power of homoeopathy, is it not incum- bent on us to fulfil the high moral duty imposed on us of endeavouring to hold out a helping hand to tiie poor of our land ? As homcBopaths, are we not bound to extend the knowledge of the benefits of our system to those who, from ignorance or inability^ are unable to seek them for themselves? The well-to-do oan pick and choose for themselves amongst the various medical men of the district in which they reside, and select whichever form of treatment they prefer ; the very poor, on the other hand, are, in many cases, restricted to what the Frenchman once termed, '' Le choix de M. Hobson." UnaUe to pay tiro ordinary medical fees, they nrast have cither the union doctor or the dispensary medical officer of their district. Now, how ever kind and talented these gentlemen may be — ^and many of them are true friends to the poor — ibe fauetB for our consideration remain, that their method of treatment is not that which many of the rich prefer, and tiiat from that mode of treatment the poor may nxit dtBsent.
In most towns, with few exceptionB, the poor must either hove allopotiiy, or do without treatment. Now this order of things is opposed to the spirit of freedom and lAeraiity which we, in the nineteenth century, are apt to fride ourBelves on exhibiting. In no othw £reetion are fte poor forced to adopt a partieular fixed opinion. They mKf efaoose thdr own ministers now, altfaough ibmierly ihey could not ; they may dioose tiieir own lawyer^ soch of
SSSSfJ^rSS!" OUE M8PBNSABIES. 19©
tkem as ha?e slomaeh for law ; and ihey may patronke any particular pablid-hoaBe that may be a favimrite in; the BflighboarlMMd. Tke only person whose war^s av« Jiterally, in isany poor chiMrens' cases, stuffed down tikeir ihxoats, is tke Atebn.
The proper remedt^ for this state <tf affairs k, withoot doabi, the establishneiit» in e^ery town which can boast of •a homoBopathic praetilioner, of a well orgamsod, propwJ^ conducted, Homoeopathic Dispensary.
If our brethren like to take a little trouble at the outeet, a dispensary may soon be set a*going T^ich will beneftt 4dike the poor, homeopathy, and the practitioner.
The methods of working Dispensaries have been Yari^NUS-; the first, and most effeacious, in our opinion, is the Publie Free Dispensary system. This, unfortunately, is seen tM seldom ; the best eaamples being found in Birmingham^ Liverpool, and London. The report of the Liverpwi Dispensaries, which is noticed in another part of thus Review^ shows bow much can be done by patient wophia^ in the right direction. Where the medical men of a town have a sufficient number of the upper classes in their -clientele who are willing to give a little time and moaef to aid the good work, there should be no difficulty itt forming a strong committee to organise a Free Dispensary. If a cottage can be secured, to be devoted entirely to tine use of the Dispensary, so much the better. Should this, however, from any cause, be unattainable, suitable loome should be secured in a populous neighbourhood. The position of the Dispensary is of the greatest importance. It hes been found that the poor will not go any great dis- tance to a new institution ; therefore the more eeiKtral the situation the better for the futmre of the Dispensary. The composition of the committee, too> should be earefuUjr studied. It is generally found that one or two of the
p-2
200 OUR MBPBHBAWBS. ISS^.^S^SiJfM^
clergy in most towns are favourable to homcBopatby^ Their co-operation should be at once secured, as, through their influence, the most influential and charitable per8on» in the neighbourhood may generally be reached. Once let it be understood that the Dispensary is to be really a free and charitable institution, and that the medical men are going to devote themselves to the good work as honorary- medical officers, and many friends will step forward to assist who otherwise might not do so.
The committee once formed, and a suitable habitat obtained, the young Dispensary will soon acquire reputa- tion. Patients will not be lacking, and if cures are wrought, the recipients of the benefit will not be backward in spreading the good news amongst fellow sufferers* In the course of time the sphere of the Dispensary will be bo enlarged that a visiting medical officer will be required* Where actual good work is being done, its supporters are seldom slow in providing funds, and any special appeal will rarely faH to meet with generous support.
Such a Dispensary may be seen in Liverpool, in Birmingham, and at the out-patient department of the London Homoeopathic Hospital ; at each large numbers of patients are constantly in attendance.
In the report of the Liverpool Dispensaries, a notice ol which appears in the pages of this number, we see the veiy satisfactory number of 66,126 separate attendances regis- tered for the past year, the funds for defraying the expenses being entirely of a charitable nature. Consider what an incalculable benefit this means to the poor ! Homoeopathy brought to their doors, their illnesses shortened, their means of living in many cases saved to them. Who shall say in the face of these figures that homoeopathy is not acceptable to the poor ?
The second form of Dispensary is that of the semi-publia
iSSS^AffySa!" OPR DISPENSARIES, 201
institution. In most towns, which possess a homoeopathic chemist, one of these Dispensaries may be foond. There is generally a committee, and a varying number of sub- scribers, who get for their subscriptions tickets to distribute. There is, however, this difference between it and the Public Free Dispensary — ^that many patients, who are either unable to obtain a ticket, or who are scarcely objects for charitable relief, go directly to the chemists and purchase for themselves a ticket entitling them to attendance and advice as Dispensary patients. There can be no doubt that this leads in many cases to abuses similar to those seen in out- patient practice at most of the large hospitals. Patients, who can well afford a moderate fee to a medical man, take advantage of the Dispensaiy and use it as a means of obtaining the doctor's advice and their medicine at a con- siderably cheaper rate than they otherwise could. Still, in .ihe majority of cases these Dispensaries do an immense : amount of good in their various neighbourhoods, and have materially advanced the spread of homodopathy.
The third form of Dispensary is the proprietary or self* supporting one. By this we mean Dispensaries, opened in new neighbourhoods or at the chemists' shops by medical men, at which the patients pay for their treatment a certain •fixed sum, low enough no doubt in most cases. These are . to the homoeopath what his surgery is to the allopath ; and apart from the financial success of the undertaking, they . open up a great field of clinical work, which, to the young practitioner, at any rate, is most valuable. Shut out from the hospital work which he has just left behind him, the beginner in homoeopathy finds at his Dispensary the school for thought and careful trial, which are so essential to true successful practice. At the same time the public benefit largely by the Dispensary, as they obtain at a small cost medical treatment of the most advanced type, which most
am OUR DI8PIIK8ABBBS. ^S^gS^.W^MlS
oC4hQSft GMiid not poflsiblj have obtained otherwise. One ef these Diijpensaries commenced in a d^isely populated difitriot of the poor, where, from yanoiie circumstances, the otiier forma of Dispensaries are impracticable, acts as a oeatre of lights leavening the district to such an extent, thait in a sorprisuigly short time a considerable homoBO- paihic practioe will often spring up around it.
We think it is a duty of paramount importance that every homodopathic practitioner should be connected with a Dispensary of some form or other. Let binn recollect that in most cases the poor are, from their position, very imUkely ever to become acquainted with homceopathy as private patients, while homoBopathy ou^t, if possible, to ii^ and do as much for her poor as allopathy does. We* have not, of course, so many opportonities^ but if each of us were to avail himself of those opportunities, which ever and aaon present themselves, there is no doubt that homcBo. pathy, the poor, and the practitioner would be greatly and mutually benefited. The popularisation of homoeopathy should be oui* great aim ; we are unfortunately too apt to- espend our energies on controversial .proselytising. Wero wo to devote ourselves more systematically to the spread of the knowledge of homcdopathy ammogst the masses, we should greatly expedite the time when public opinion will iMrce the medical profession as a body to pay attention to the claims of homoeopathy. Wlien we can point to Dispen- saries in every city, such as those of Liverpool, Manchester,
Bath and London, each with its hundreds and thousands of patients; when we can show a widespread clientele throughout the length and breadth of the land, there is little doubt that our claims to notice and public recognition will no longer be disregarded.
Let us, then, for the sake of the future of homoeopathy dsarpen our weapons of aggression, the chief amongst wiiioh are, without doubt, our Dispensaries.
S!£!T^T5S?° typhoid fevbk. 208
BsriMft April ly 1889
CAir BAPTI8IA CUT EHHEORT TRUE
FEVER?
By IX Dyob BBovm, M^, M.D.
This question is an extremely important one, and one not easily decided. For when a case presenting symptoms liie the early ones of typhoid get well in a comparatiTely short time, it is difficult to prove that they were csfles of genuine typhoid. Dr. Hughes {Manual of Pharmacodynaimcs) comes to the conclusion that the fever which is aborted by baptUia is not true typhoid, but *' simple continued fever '* — something different from '' febricula/' and yet not the other, or typhus. Into the argumente pro and con,. and the sifting of the evidence on either side of the question, I do not here propose to enter, as this would involve a long paper. I simply relate three caseg in which the evidence was, in my opinion, indubitable, that they were cases of true typhoid, and in each of which the disease was cut short by baptisia. The rasultfi of these cases lead me to form the opinion that while baptisia is not to be reckoned a specific in the sense that it will abort every case of typhoid — for many cases run their regular course in spite of baptisia — ^yet that, when indicated, it does sometimes cut short the genuine disease. As to the homoeopathic or symptomatic similarity between the eady stages of the disease and the pathogenesis of the medicine there are not two opinions.
Case L
liMit summer, during the dry, hot weather, the wvter- pipessQiqslyiBg a part of Bayawater hnist, leaving many honses in a state of absolute wKot of water. In one of theao hDuaeB Misa Y., and ibe other memdbera of idbo faaily, noticed oflfenirive dxaan fimells at diis time. She f<dt ill for some days, faftd a rigWy.and when I saw her ttie tempevatitre was 1(K1.4^, and all the symptmnB of ocpm- w|Afifting typhoid wexe present. By the end of the 'fint week one or two spots ware peioeptible, there wae slight diacrhiCBa, dec. ; in fact Aeve was no donbt as to tbensfciire of the case. I had her removed to aii<)ther house the- day after I first saw her. I preBeiibad 'baftma, 1 x., 2 .drqps evevy 2 homs* The case progmised. admirably. Tij tbo end of the first weak the fidl in tempesatnre was vei^ noticeable, and on the tfaicteeniih day it was normal,. tm
204 TYPHOID PBVEB. *S!SS%?WS?
BerieWyApril 1. IBOL
pnlse aleo normal, and she expressed herself as feeling so well that she wanted to get up. After my visit on that day she was allowed hy her friends, most injudiciously, to read some Australian letters, which so excited her that the temperature at once rose to above lOS^. Baptisia nov failed to check this relapse, and she went on to the twenty- eighth day, when the temperature came down again to normal, and convalescence proceeded as after an ordinary case of typhoid.
Now, in this case, had there been the least doubt of the genuine nature of the disease, this would be dissipated by the occurrence of the relapse, going on to the twenty-eighth day from the commencement of the fever. The relapse was, of course, disappointing to myself as well as to the patient and her friends, but I think that the normal temperature and pulse, with freedom from all symptoms of illness on the thirteenth day, is, in this case, ample proof of the powers of the medicine to cut short the disease, as there can be no doubt, I think, that had not the indiscretion above alluded to been made, Miss Y. would have convalesced from that date.
The failure of the baptisia to check the relapse is also noteworthy.
Case II.
Quite recently, two young ladies — sisters — ^were taken ill about the same time with symptoms of typhoid fever, the temperature in both rising to 108^, and presenting the well-known symptoms, including diarrhoea, &c. The eruption in both was very scanty, but one or two spots could be detected. Baptisia 1 x. every two hours was prescribed for both. The elder one progressed most &vourably, but fever ran the usual course of twenty-one days. The younger sister however fibred better, and by the eleventh day the temperature was nomud, as was also the pulse. The appetite returned, and she was so little pulled down by her comparatively short illness, that I allowed her to be out of bed in two days. She went on thus perfectly well for three days more, when her mother injudiciously, after having given her a warm bath, took her at once into another room. The result of this was a rigor, and a complete relapse. The temperature went up as high as ever, and in spite of baptisia, the case went on to the twenty-first day firom the commencement of the illness, the temperature falling on the same day as her sister's.
S^SSr?!2^ TTPHOH) FBVBE. 205
^EeTiew, April 1, 1888.
This relapse, though short coini>aratiYel7, was very un- fortunate, as a second time occurring in a case of undoubted •tjphoid which had been cut short by baptiaia. It, how- eyer, in my opinion, in no way invalidates the fact of the patient being perfectly well in all symptoms, including 4;emperature and pulse, till the rigor after the bath, and the subsequent exposure. The baptiiia did not clieck the relapse, though it was a comparatively short one. Had there been any doubt as to the genuineness of the case, the {act of her sister's fever going on to the twenty-first •day, with all the prominent features of typhoid, would dissipate such doubt.
CaseIII.
This presented some features of much interest, and I therefore give the notes in full as reported by the Junior House Surgeon at the Homoeopathic Hospital (Mr. Frank Shaw).
Alfred Nicholson, set. 18, printer, was admitted at the hospital on February 18th, 1882, under the care of Dr. Dyce Brown.
Patient has always been strong and healthy.
Last Friday evening (Feb. 10th) first complained of feeling unwell; felt languid, had a headache, and went to bed early; but was able to go to his work as usual on Saturday morning. He was, however, obliged to give it vp on account of headache and feeling generally ill. He had no appetite, and his bowels were not open. He took four opening pills, and the bowels were moved three times. Motions loose but light in colour. He got worse towards morning, and wandered a good deal during the night. On Sunday he was no better, and kept his bed ; anorexia and .great thirst. Pain across the lower part of his chest. felt cold, and had some rigors.
Was first seen at home on Monday (18th). Tongue coated with thick, whitish fur. Abdomen distended ; soft 4md tender. No spots. Rigors. Complained of intense headache, and feeling cold. Temp. 105 ; resp. 40. Some rhonchi to be heard all over chest. Wanders when he sleeps. He is not deaf. He says that three of the lads working in the same workshop with him have lately ftcithin 4he last six weeks J had typhoid fever. One has died.
Patient was sent into the London Homoeopathic Hospital 'the same day. To be kept on milk. Ordered arsen, 8x., mj. bapt. 9, mj. every two hours in alternation. A tea-
2©6 TYPHOID FBVEB. 'iSSi.^SlfSS!
speooful of bntudj eveij two hours ; wet linea compress bo abdomoD.
Fab. 14tb.— Xfimp. .q.' ; p. 112, wry soft and
compressible ; res. 40 ; slept fire hours dnting 'tiie n but wandered & good deal. Is very heavy this moming, bnt caD be ronsed when spoken to. Tongne vety coated, except at edges, with browny-white for. AbdomMi fall, resonant, tender on preasnre. One donbtfol, rosy lenticu- lar spot on lower part of chest. Bowels open ooce : motion of a typical peasonp character. Urine thick. Dr. Dyce Brown saw him to-day for the first time. He considered it unnecessary to alternate the arsenic and baptiaia, and prescribed baptisia alone in half-drop doses of the mother tinctnre ereij two hours. To eontinne the brandy every three hours.
Feb. 15th.— Tamp. f^^. p. 108, rtaj soft, fflfipt three boars during the night. "Wandered a great deal, and tried to get ont of bed. Bowels moved five times ; stools very loose, light and typhoid in character ; tongue thickly coated, drj- in the centre ; urine sp. gr. 1028 ; acid. Large quantity of lithates. Ordered haptU. ^ m^ every hour. Continne the brandy.
Feb. 16th. — Temp. fnTV! P- l**: pa««d s very- reatless night ; delirious ; cough troublesome ; azpectora- tioo tenacious, and slightly tinged wiMl blood. Tongue cleaning posteriorly, very red and drj- at tip; bowels open twice. Ordered beU Is., miij. at night if delirious. Con- tinue hapt. every hour.
Feb. 17th.— Temp. ^Y- P' *' ^- '*'* ' ^*^''
towards yestoiday afternoon, becanu leas wandering, and
took notice of what was going on in the ward. Qelirians
— -■- '~wardB night and tried to get oat of b»d. Paaood
1 under him ; two actions otherwise. This auvn-
I sleeping quietly. Tongue deanw but very dry.
is uourifihment well. Cou^ atill troahlesome.
incbi to be heard. Two spots on abdomen. Looks
id doll, but poise ia mach stronger. Bi^tu.
for (U-Mi). 3a.., mj. S hrs. ; omit brandy ; P^ ^-
SSS'SaT?S£** TYPHOID pimB. 207
r,4«rill»18tt
96 ' Feb. 18th. — Temp, sygr p- 56; rather irn^gukr;
req^.^C* Hashal aweii better «i{[ht ; slept >vell ; i^btly
delffieoB at tinea. This BKmiiiig tongae cleaner, in(»flt.
Bowdfi open tiuree timefly ^617 loose. One or two feeah
spots; cough better. Ordered arsen. 8 x., mij. three
hours, pt. beU. ait night.
98.6 * Feb. 19th. — Temp. 900! P- 56; regular; res. 82.
^ept well for seven hours ; not delirious. Bowels open twice, very loose, light. Tongue cleaner, rather dry. Hardly any tendMness of abdomen. Omit bell. pt. arsen.
F«b. 20th.— l^MKp. ^gy: p. 48 ; regular, soft. Much
better. Bowels twice moved. Ordered arsenic 8 x., mij.
digital. 9, mij. three hours in alternation.
98' Feb. 2l8t. — Temp. HifV: ?• 48; soft, compressible.
Ordered beef tea thickened wUh arro\^TOot.
98.2 * Fob. 92nd.— Temp. qoV; p. 48; and stronger;
heart's action good. Has been kept awake at night by a few
painful boils in.gluteal region. To&gue moist.
99.2 * Feb. 28rd. — Temp. qoV! p- 48; slept better; boils
easier; tongue Boore ooated* but moist. Bowels not moved. Pt. gg g ,
Feb. 2Ath.— TeiBp. Ag'^ ' p. 52; did not sleep se«weftl;
boils larger and more painful. Bowels not moved. Omit
digitalis, and continue arsen. Tea and bread.
99.2 • Feb. 25tti. — Temf. q^a', p. 56 ; better this morning.
Bowels Jiot moTcd.
99' Feb. 1l6th. — Temp, qcs'a. P« ^8 ; slept well. Had an
enema this meraiiig, which acted weU.
98.8 * Feb. 27th. — Temp. af-Q~, going on well.
98 * Feb. 28th. — Temp. qoT" complains this morning of
slight tenderness on left side of abdomwi. Tongue slightly coated. No action of bowels. Niuc. torn. 8 gttj. ter die.
208 TYPHOID PEVEB, ^BSS5;ISi?tw?
March Ist. — Temperature normal night and morning. Ordered fish. Bowels open naturally. Tongue clean.
From this date temperature nonual night and morning, and boy has gone on uninterruptedly well, gaining strengtti daily, and he may now be considered (March ITth) as quite well.
China 1 x., gtt. v. ter die, was substituted for the ntix. vom. on the 4th of March.
This case is interesting in several ways. 1. The ill- ness was so severe on admission as to require the ad- ministration of brandy, an unusual necessity so early, but the soft compressible pulse, and his general condition called for it. 2. The case was unmistakably one of true typhoid. 8. The temperature was normal on the morning of the eighth day, and both night and morning on the ninth day. 4. The diarrhoea continued some days after the temperature became normal. 6. The pulse fell down to 48, and continued about that number of beats till he was able to be out of bed, with the exception of a rise to 66, when the boils on the buttock caused a slight rise of tem- perature. It was on this account that digitalis was given in alternation with arsenic. It seemed, however, to have very Kttle effect, except that the pulse became stronger. The heart's action was not weak. As it produced so little result in quickening the pulse, and as the heart's action was so good, the dig. was omitted after a few days. I had come to the conclusion that in all probability the boy's pulse was naturally a slow one, since at first it was only 112, with a temperature of 106^. At the date of the conclusion of the report, however (March 17th), his pulse had risen to 80. The slow pulse then must have been a result of the depressing action of the fever poison. ^ In conclusion, I claim that these three cases are suffi- cient positive evidence, outweighing any amount of negative evidence, to prove that baptisia can and does cut short certain cases of true typhoid, while, in other cases, for "^bat reason one is ignorant, it only goes the length of mitigating the symptoms, and so rendering the whole ill- ness nailder than would otherwise occur. The speciai indications for baptisia are well known, so I forbear enter- ing on this point.
29, Seymour Street,
Portman Square, W. March 20th.
bS^a^ouS^ clinical case8> 209
CLINICAL CASES, WITH REMARKS.* By S. H. Blakb, M.R.C.S., Liverpool.
Cabb vn.
Chronic Inflammation of the Lachrymal Sac.
Maboh 8th. — Mary M., aged 60. Has swelling with some tenderness over the region of the lachrymal sac and duct. The entire stmctures, from the upper part of the superior maxillary bone towards the inner oanthus, are elevated and swollen, with hardne'^s, as if the bone and its coverings are thickened. The swelling also extends upwards, invading both the upper and lower eyelids, and over the whole is a diffused didl red erysipelatous blush, reminding one of that erysipelatous redness of the face for which rhtis tox, is so often beneficial. There is no overflow of tears, hence the lachrymal passages do not appear to be materially obstructed. The right eye is the one thus affected. This condition has been in continuance now for six months, daring which time the complaint has been getting no better, and of late has become decidedly worse. There is some pain, but not severe. The bone over the sac feels as if elevated and thickened. It is worse when the wind is cold and she is exposed to it. Formerly when it first commenced there was a sharp pain in the sac, '' as if some- thing were round " therein, together with pains shooting in both ears. In other respects she is in good health. I gave a trial to acid fluoric 3 c pil. om. 6a hor.
March 15th. — She reports herself " a great deal better." '' The effect of the medicine is wonderful." On examina- tion I found the tumidity and erysipelatous blush over the eyelids gone and the redness and swelling of the skin over the lachrymal sac very much diminished. There is still, however, some of the bony hardness remaining by the side of the nose which could not be expected to diminish much in so short a time. Altogether uiere is very great relief, and there is little or no tenderness now. Repeat medicine.
Gonsiderinp the action of rhus t. on the Uds with " ery- sipelatous OBoema," and its action on conjunctivitis, with '^ lachrymation in the open air," one might have expected
* Being part of a aeries of cases, the record of which gained for Mr. Blake &e ** Epps '' prize of £10.
210 CLINICAL CASES. 'gf^I^ST?^'
it to have stiited also this case, and to have remoyed the swelling and erysipelas — although there appeared to be a deficiency in the Materia Medica as regards its action on the lachrymal sac particolarlyy yet should this condition come on after exposure to cold and wet, one might expect good from rhus tox for the erysipelatous* swelling of the sac. However, as above seen, the^umc a.eid effected great benefit.
csAgB vni.
Chronic DiseoM of ike Lachrymal Apparatus,
Ann A., aged 43, has been under homoBopathic treat- ment for a considerable time. During a period of eight years she has been treated (and by various doctors) homceo- pathically for disease and obstruction of the lachrymal sac or its duct. At intervals, of course, she has required from time to time intercurrent treatment for other more tem- porary ailments, but has not during this period received any material benefit for the lachrymal symptoms. I am not able to supply the details of her treatment during this number of years, but the first details in my possession are those occurring from July 10th, 1880, to August 14th, 1880, during which time she was under cimicifugaf 3 t.d. This patient first came under my own observation and treatment on August 14th, 1880, and a note was made that ''the lachrymal sac of the right eye swells and dis- charges pus at intervals. The eye constantly overflows with water ; the lachrymation at times only is scalding, but in general it is bland. The eye becomes worse when she goes into the open air. There is no perceptible amelioration from the cimidfiiga.^ The sac is tumid, rather reddened, and tender.
August 14th. — AcidfiuoHCf 3 ter. die.
{Materia Medica. — ^Increased lachrymation, itching in eanthi, fistula lachrymalis.)
There is nothing special about this woman^s appearance, be3Fond that she looks worn and weakly, considering her age. The face is much wrinkled ; she is thin, and of mervous^ bilious temperament. I am not able to trace the chronic inflammation of the lachrymal passage to any distinct causes except that it is worse in cold air and by taking cold.
Septanber 4th.**^She proclaims the ej^ caatM^sMj better. Repeat.
ISSS^SST^" CLIHICAL CASES. m
The medidne was continued until September llth, wken, daring my abtenoe, a colleague saw her for me, and for Bome reason, perhaps for the discharge of pus, kindly changed the medicine for me, and ordered hepar 3, t.d. s«
September Sfitk. — ^Reports her eye as ''worse.*' To repeat ac. Jliwric, 8, t. d.
October 9th. Eye feels easier, but there is hot and aedding watery dhnharge. Bcpeat.
Octol^ 90th. — improvement. Repeat.
November IStfa. — &nprovement. ** The substanee," she says, '' still continues to come at intervals as before," (the inflammatoiy tumeAietion ?) and it fills up, too, but this event takes place 'Mess often than it formerly did." It also, '' oomes and goes »way sooner." Repeat.
December 4th. — Ixnprovement continues. Repeat.
December llth. — Has been suffering from epigastric pain and vomiting of food and "phlegm " from stomach. Has sour and bi^r eructations. I find she drinks too much strong tea* Ordered her to discontinue tea. Never- tiieless, ^tioric acid produces these symptoms : — "bilious vomiting afler dtght eirors, with increased alvine dis- d&rges, pieoeded by tomtna." Repeat.
January Ist, 1881. — ^Vomiting or regurgitation baek again after eating still continues. " It comes up into the tbroat in lumps" (pathogenetic). Fluoric acid produoes a peculiar Tariety of dyi^hagia, of which I will shortly deaaiibe a cure, the pain occurring in the act of swallowing from impUoation of tiie throat and gullet. These symptoms are increased after ^cposure and slight colds. To continue, she further adds, ** Lumps of food return up the throat, and vritii tiiem phlegm, and this occurs with pain in the upper epigastric or lower cdsophageal region " (pathogenetio, see Allen). ** The pain is like a knife or pins running in Hiere, and is eased by the vomiting and belohing." She is'oidy '^easy^vriien lying down in bed" {bry.)y and there axe bronddaJ mucous rake. She ''vomits every kind of food, even so much as a teaspoonful returns." As an antidote, I ordered bry. alb., S x., pil. t. d.
These inrmptoms, supposing them pathogenetic from pKoric acid should be relieved by bryonia. It iscalonlated to relieve the stomach aood chest symptoms. The latter mi^ be, perhaps, partly owing to her having taken fresh cold.
Jan. 7th. — Much better as to stomach and ffiefhagoal
212 CLINICAL CASKS, ^S^^^S^
symptoms. Bronchitis relieved. The upper respiratoiy passages and the gnllet are in intimate relationship. They are supplied contignonsly by branches of the same nerres. Bep. bry, 8x.
Jan. 15th. — The chest and epigastric pain are now veiy much less. *' The medicine has done her a great deal of good/' and the '' congh is less." She says she has receiyed ^' great benefit from the treatment dnring the past three weeks," but is, of course, not aware that bryonia has been given only for two weeks, and that possibly the symptoms increasing during the previous week were owing to the increasing action from the flworic add, I now changed again to acidfluor. 8 c. t.d.
Jan. 22nd. — Continuing in improvement. Bepeat.
March 6th. — Has been absent from my notice since the last prescription, for she felt herself so &r well as not Uy require treatment. Nothing of the lachrymal disease has been since noticed. The only symptom she has noticed during the past few weeks has been this, that after the least cold air, the sac has been apt to fill up with tears occasionally, and on a little pressure they return and ran over the lid, but otherwise there is no inconvenience. The general lachrymation has disappeared, the sac has ceased to become hard, inflamed, and to discharge pas as it did formerly at intervals, and tiie general health is good. Thus this disease, which had continued unabated for eight years,, has ceased to be a trouble during the past few montha dnring the treatment hjjiuorie cuAd, and the tears are now able to take their proper course through the nasal duct.
I need not omit to mention that during the last week of treatment the patient also noted a new symptom to her in the left eye, previously healthy, and which is also found under ^uorio acid, namely, she felt a sensation in the left eye as if some sand had been blown into it, and since has had some small pimples on the left eye lids, and a sensation as of *' dust moving about " between the lids and the eye- ball, symptoms which I believe to be pathogenetic ;* but none of Uiese were present when I last saw her on March 6th. The left was then well.
Inflammation of the sac has been cured by tilicia 6, and fistula by the same medicine, also by caicarea c, rkU* mur,,
* A symptom is given in Allen's work in quite a similar form to tfaii one, as pathogenetic.
'^S^^Sn^ CLINIOAL CABEB, 213
-and cauttieum, as well as hj fluoric acid. It is interesting to observe the connection of the disease of the lachrymfd apparatus with inflammation of the eyelids, and to note that the medicines for the cure of lachrymal disease are all •noted and powerful eyelid medicines. The fistula in many .instances appears to be but a further extension of the inflammatory and obstructiye process, and if this can be subdued with reopening of the duct, or a passage along the proper course of the duct, then the fistula also may eventually close, and so restoration be thus complete. That the mechanical law should sometimes present itself to be applied here is not unlikely, but if so it can be but a useful auxiliary at times, just as the boogie and the catheter are in stricture of the urethra, and in no way can its use dishonour the homoeopathic law, nor can it compromise the ability and * credit of the homosopathic practitioner, as some would have as suppose, any more than it can deprive him of the right to term himself a homoBopath should he feel so disposed. Mere. cor. and stdpkur have also played a prominent part in the cures of this disease. That the nature of the affec- tion should vary in different cases is not surprising when we see how various are diseases of the eyelids, and how •different the constitutional state is in d^erent persons, . pointing the way, as in all diseases, not to one, but to several medicines.
Considering the Cypher Repertory, we have : — Abscess of the sac., natrum, pule. Inflammation, petro- leum. Swelling, nat. mwr.y stlica. Ditto of the size of pigeon's egg, petroleum. On blowing the nose, nat. mw. With dryness of the face, peU s. Pain undefined, not. mwr. And under lachrymal bone for inflammation, mer.; for •4melling, mer. $.
Besides some of the medicines already referred to, Angell recommends, under certain conditions, aconite and -belladonna, hepar, kali hyd., macrotin, etiUingia, hyd/raatis, sanguinaria, org, nit., cup. sulph., and astringent applica- tions, besides other surgical measures suitable for the relief of mechanical obstruction and distention of the sac. He states, moreover, that some of these drugs, prescribed for symptoms quite remote from the eye, have proved beneficial for the lachrymal disease. This latter plan of removing a group of symptoms, often as we notice it to be successful in certain instances, and often unexpectedly, as when the groups referred to are actually not yet found
YoL 26, No. 4. q
214 CLINICAL 0A8K8. 'g^,^gggSr
registored in the If ateria Medica, but yet disappear when fljjfmptoDas other than these are the indications taken for the medieine. If this plan be aceordmg to definable law, BB illustrated, let us suppose, by altering the prediq>osii^ eauee or some other group of symptoms upon which the gfoup to be remoTed are dependent^ there is nevertheless a great diflBcuttyin cairying out the homoBopathic principle dn a systematic manner for each case. This is so, because it is easier to refer at once to the q)eoial locality of the symptoms to be remored and find what drugs have heea ^eadyproyed to be in definite relation thereto ; whereas if me c(m8ider these as of no importance, and throw oTer all iAxe drugs which produce them as usdess unless they /happen also to possess the more remote symptoms in addition, or not finding all requisites under one drag, we discard all these drugs and employ o4hftrs referable only to the comrtitutional state, tempeirameiit» or to more remote qrmptoms than those we hope to rsmove. We have thus laid open to us a yery wide field, with a small basis of evidence to prascribe upon and periuq)s very few or indefinite symptoms. Yet it may be said that the latter -method does sometimes produce results quite uneapected, or if expected, haj?dly with great certainty in the present afeate of our information. To the perfection of the latter method it is possible that a thorough acquaintance with the pathological sequence of disease, and a reading and enlightment of the provings in relation thereto, may 'be of great service, if not a 9me qud non clinical appli- cation. If the action of fvha/tiUa in disease of the sac and ducts should bear any resemblance to its action in Ot)hthahnia, otitis and deafiiess, we should noturaUy sup- pose that simple inflammation of catarrhal origin having the kind of inflammation characteristic of pulMMUa^ with bland secretion, if any, and that it will be adopted under those conditions of temperament and mental state so weU known since the time of Hahnemann to be appropriate to puUaUUa. It is easy to beliere that a blenorrhoea of the «ac, or even a chronic inflammation of its lining mucous membrane, leading to distension, or, it may be, oomplete obstruction ending in fistula, might under these conditioins be effectually met by pulaatiUa. The same might perhaps be said of merevrittSf kali Iqfd. in syphilitic subjects or in -scrofulous persons. Fbnoric acid has in its. provings this i{^ptom — '^ A marked tendency to take cold on the least
exposure " — ^a symptom often Tery notiiwable in blenocrbfiea of the sac. It is quite possible that ooaditxons leadixig to bl^iorrbcea in one person would in another person gar on to obstruction and bursting of the sac^ JKoording to smaU VBryiBg dteantttonoea-differences iriiich may require more yariation in the surgical ingenuity than in medidnal application where the medicinal indications remain the same. When, as often, fortunately it happens that we can find a drug to cover both local syasptoms and constitutkmal condition, the method is of course clear wnd is sometimes easy. In other oases it is open to prescribe precisely for the symptems of the local disease. Finally^ to use only, the general symptoms of a patient might necessitate a course of action which if extended in descrip- tion might lead us through an examination and description of the entire Matenia Medica.
With reference to the methods of application of homoao- pathy it may be questioned whether or not we are not actually compelled to generalise the use. of certain medi- cines, even provided the exactly localised symptoms for which we so prescribe them are not as yet found registeved as such in tiie provings. Thus when we find an acut^B* inflammation of the lachrymal apparatus having the charac- teristies of aconite or belladonna (as adrised, for instance,, by Angell), we use these medicines, taking our indicatMms tram their characteristic inflammatory symptoms of the eyelids, face, or other parts of the body ; together with the special symptoms dependent on the febrile state simul- taneously set in progress. Hence we use aconite for an acute inflammation where the general indications ave adapted to that medicine, and where the local inflammation is of a type ccmaistent with that produced elsewhere by the drug ; and the same method should, if feasible at all, be applicable also to other medicines. When we confer that the lachrymal mc is, as it were, an appendage to the eyelids, lined by mucous membrane continuous with that of the lids, to which it acts as a water conduit, it is not snrpriaing that there should be a paucity of symptoms, produced specially on the sac and ducts, as compared with those produced on the eye and lids. It is not unlikely that only in a certain fewer number of persons, we should get symptoms produced at first, and specially on this small and comparatively insignificant strncture. On the oidier hand,, nearly all, if not all, those drugs which affect the sac,,
Q-2
216 CLINICAL CASES. "S^^'S??:^.
HerioWy April If 18B8*
act early and markedly on the eyelids themselTes, and the symptoms may be reg^urded as rather extending to the sae than as affecting it singly and solely. It is in certain pecoliarly susceptible persons or special contingencies that inflammation of the sac wonld arise without affection of the eyelids, and we might fsdrly expect that many drugs capable of affecting the mucous membrane of the eyelids will have also an alUed effect upon the sac and ducts consistent with such action, although but few such cases in the provings may have been actually on record. In the curative sphere of observation this action of drugs has been well observed, several medicines having been noted as beneficial for lachry- mal fistula, ^tcoric add being one of such, among which there is an extreme paucity of symptoms proven on this small organ, whether absolute or contingent. Among the symptoms which give us a clue to the use ot fluoric actd on the lachrymal apparatus, we have not much to rely upon as matter for absolute certainty, yet one may gaUier firom Allen these symptoms : —
" Quivering in the right eye, and soon after a burning shooting pain at the bottom of the orbital cavity."
Again, *^ sensation as if the eyelids were opened by force, and a fresh wind were blowing on them ; after that, a sen- sation like sand in the eyeball, resembling the feeling as if the eyes were inflamed. Pricking and burning in the internal canthus, also itching in it." This is a symptom which brings us at once close up to the lachiymal ducts, and many drugs produce this.
Again, '^ Deep pain in the posterior part of the right eye, extending very fur into the upper jaw."
** Painful itching in the left eye as if from a grain of sand." This and the symptom consistent with it above named, as of ''wind blowing" on the eye, it may be remembered, are quite in accordance with the left eye symptom which is noted as probably pathogenetic during the treatment of the case of Aim A. hj fluoric acid.
There are one or two more symptoms also worthy of of note, i.e., ** In the morning beneath the eyes are super- ficial whitish pu% folds extending towards the nose.'* '' The upper jaw-bones are much affected by the medicine." Hering gives these indications : —
PuLb., fistxda 1., discharging pus when pressed. PetrO" leum, fistula Is. (of recent origin). Nat. mur., fistula, stricture of duct, blenorrhoea of sac. Silica, fistula, bone
l£SS?5rirnSS!' CLINICAL CABB8. 217
- — ■ ■ ■■ ■ ^— ■ I
aflTectedf swelling of right sac, skin oyer it inflamed, glis- tening, throbbing pain, tears hot, worse evening. Calc. c, fistula suppurating.
Cass IX.
Fluoric Acid produces a kind of dysphagia for which, if appropriately used, this medicine is abundantly curative, as the following case will serve to demonstrate. Affections of the OBSophagus and stomach of this description are not nearly so frequent as many other ailments, so that an unusual interest attaches itself to instances of cure, when the symptoms are referable specially to the oesophagus.
Mr. J. S., aged 50, consulted me for the first time on March 1st, 1881.
Previous history: — Has been suffering from his com- plaint [which will shortly be described] for five months. At the outset of the disease he was under homceopathic treatment, but only for a brief period, too short to get any amendment, and he thinks he received at that time arsenicum ; but as he very soon removed from the south of England to London, he then gave up homoeopathy, and placed himself under a London physician from whom he received some benefit; but, as he subsequently ''took cold in the chest," the malady returned, or rather, became worse again, for it had never been fairly removed. The first physician referred to diagnosed his case as one of ulceration of the oesophagus, at or near the cardiac orifice of the stomach, and the physician under whose treatment he was before coming to me acquiesced in this verdict. In my view also the symptoms were consistent with this opinion of the nature of the disease. His symptoms, as presented to me, were as follows, which I will recite under the heading of present condition : —
He suffers from a severe pain referred to the mid-chest, that is behind the sternal region, about half way or a little below this point, between the top of the sternum and the xiphoid cartilage. This pain is only felt when swallowing, and it comes on '' immediately on swallowing," during the very act as it were. This pain attends especially the swallowing of solid food, so that he dares only to take small quantities of liquid nourishment. During these months he has been gradually wasting until he has become very much reduced in bulk and weight. His appetite is very good ; he feels hungry but cannot eat for the pain, though he longs
218 CLINICAL CASES. "pS^i^^Sn^*'
Benew, Aptfl l. IStt.
for azid likes the food. He can swallow fluids, like sotip, withoat paiOy so this kind of food hfts const^uted his only means of sustenance. However, hot imlk and bread eyen disagrees with him, whereas cold milk suits. He cannot manage the bread with the milk. The pain appears also to extend down so far as he is able to localise it, to near the region of the xiphoid cartilage, and when swallowing he describes it as a ** severe cutting," as if the food were paming over a woimd there. He is very liable to take Goids, and after every cold the oesophageal pain is worse again. Has no flutulence ; No bitter or sour eructations, or very little; bowels regular; no thirst; no chills; no pyrexia. Tongue, slightly whitish coat at back, otherwise quite healthy-looking. Expectorates a small quantity of froAy sputum from chest. There appears to him to be a difficulty in the passage of the food at the spot where the pain is experienced. He has only once vomited some blood, which was six months ago. It was black and clotted blood. There is especial difficulty in swallowing bread4 No pain in the epigastrium, nor in the other parts of the stomach and abdomen at any time.
The pain is most distinct during the act of swallowing, or rather after it has just passed through the throat, but con- tinues somewhat after the act of swallowing has just been attempted. His own description is the best — "immediately on swiilowing." "When he tried to eat oatmeal it made him vomit.'* Of late only he has had hiccough when eat- ing, and an eructation of phlegm with the cutting pain. There is no pain after the food " is once fairly down."
Referring these symptoms to the Cypher Repertory^ we have: — ^ . / Pain immediately after eating — ha. a., hry., coc, cap.y
^ i 1 9^P'9 thuja.
g'C \ Pain after the smallest meal — china, c. ph., lob., ^ S i mere, nnx v., ear.
2[.&\ Pain after all food — iod.
S"« Pain after solid food — ba. m., aim.
« ^ 7 Pain when eating — ana., aitg., bell., hry., chi,, grp., ^ ''^ \ led., man., mer., ni. x., rho., san., sug. thuja, ver. pTwill refer to oesophageal pains fiirther on.] The medicines first chosen for the patient^s treatment were -not successful. It is to be hoped that no one else ever chooses a medicine which fails to immediately cure a patient. If there be such a fortunate physician in
^2£?i[Sr?S^" CLINICAL CASES. 219
fi0n0w» Apol 1, law.
existence, I should be gratified to have the pleasore of hhi aequaintaaoe, not having as yet met with such a divine person in the flesh. Saffice it to say that hr^onia 1 x wae first given, and the patient had a eough at the time, whioh it did some good for, but not the least benefit had followed, as far as the stomach was concerned, by March 3rd, when he reports that on attenopting to take solid food, it returns again as if vomited en mame. After eating, also, there is the '^ copions moeoas frothy " flnid retamed afterwards.
'* Sonp even now does not digest well." '' Has digested his breakfast of flnid natriment, but has taken nothing since (now 7 p.m.). Port wine or hot ooffee seem now to be the only things that will stop down. The food sticks " at one point as before described. Here we see disease as merciless as it can well be. It is a case of slow starvation. He ^'does not know what the taste of a dinner is/* and "he bids fair to rival the famous Dr. Tanner." VeraU alb. 1 gtt. i. 0 8rd hour.
March 5th. — Pain as before ; symptoms no better what- ever. Merc. cor. b. was then given, likewise withont avail.
He again comes four days afterwards. His patience is exhausted. Finding himself no better and slowly startvingy he feels himself no longer able to attend properly to his occupation. He will go to London on business shortly, and will think of consulting a physician there. I give him a note of introduction to see a Liverpool consulting physi* eian in case he does not go to London. He decides to do 80, but to try one more prescription before leaving me, as a last shot. Considering the susceptibility to take cold^ noted as characteristic of Jluoric acid, and the peculiar <B8ophageal symptoms of this drug, I decided to give this a tnal and ordered ac. ^ohc, gtt. ii. 6 hours. SeeAlleOi '* Sore throat, with difficult deglutition, as far as below the larynx ; felt so sore that the bread, although masticated very thoroughly, could not be swallowed without the greatest- pain, after smelling the acid 5 p.m. until the next morning after breakfast : the same morning, hawking up of much phlegm mixed with some blood ; during the ^y, abatement of the in^ptoms." — Provings.
The patient did not appear again until the 22nd of March, by which time I supposed he had gone to London^ when I met him accidentally in the street, and on enquiry learned that he had been so much better directly after •taking the last medicine that he did not feel in any ur§eiib*
220 CLINICAL CASES. ^feS^^SI*;^
; Aptfl 1, 188S.
need of calling on me. This medicine, said he, '^ has jast done the thing for me." It has ''acted on the pamfal spot/' and I can now *' swallow solids without discomfort." This effect was not immediate, but the symptoms had become gradually and increasingly ameliorated eyer since commencing the fluoric add. I took, he said, ** my first good dinner last Sunday (20th March), and I have been able to eat well since and digest food properly " so that " I think this medicine has just done what was required at the painful spot." Such were his words, and so I left him ; promising to call and see me again in a few days. He was quite satisfied with the result, and so am I. This medicine was prescribed from the Materia Medica without the aid of an index ; and if we refer to the symptoms in Allen's work for the peculiar sort of dysphagia oi fluoric acid we note the following symptoms in addition to the one already quoted in full. Thus we find '' soreness in the pharynx, extending down below the larynx; swallowing bread is painful," (the very symptoms my patient ex- perienced). In the back of the throat, low down, at the entrance of the OBSophagus, more to the left side, a s^osa- tion as if it were somewhat raw, or as though an ulcer would form ; it was indefinite and slightly painful, yet it seemed very troublesome, and twice while hawking he thought that blood would come from it, in the morning and forenoon." If this be compared with the history of the case recorded, the symptom of blood coming up is yeiy significant, although this occurred only once in the early commencement of the disease. Again, Allen gives, ** the greatest difficulty was experienced in getting him to swallow anything." If the experimental proof of homoeopathy rested only upon this one symptom cured, it would be for me sufficiently condusiye. Then, as regards the appetite, there is the ''longing for coffee," also "hunger," and. again, "he eats little though his appetite is good;" all probably dependent symptoms. On die throat itself, and apparently low down in it, there is the constriction, . hawking of bloody mucus from low down, and one yery peculiar condition is noted by one prover, " a singular sensation as though the passage from the mouth to the nose was wide open during his walk in the open air," which is not unlike the peculiar eye symptom, when it feels as if the lids were drawn wide open, and cold air were blowing, upon the eye.
SSS^^STuS!* CLINICAL CASES. 221
With this drug there is a noticeable absence of pains seated actually in the stomach, although burning, pinching- and pressure are noted, whereas the throat and gullet are^ distinctly the seat of pain, connected with swallowing food. When we haye to do with oesophageal pain, even where it comes at or close to the cardiac orifice, the epigastric pains- are of minor importance for reference, yet it may be of some use to turn to some symptoms connected with these^ and more especially the symptoms ** pain when eating," or ''pain immediately after eating," eyen if referred down- wards towards the epigastrium. It is possible that a group of medicines thus pointed out for us might contain some one or more haying a bearing on the cardiac orifice of the gullet, where it actually unites with the stomach itself.
The actual seat of the pain becomes of great importance in selecting for specially oesophageal disease on the one hand, and gastric disease on the other hand. Neyertheless, in some diseases we are placed in some difficulty if we- attempt to draw the line here in selecting from a repertory,, because many sensations are reflex and not referred always directly to the seat of the lesion. For instance, in the knee pain of hip joint disease it would be wrong for us to- exclude hip joint symptoms as of secondary importance to- the knee pain. The safer plan, no doubt, is to look oyer both groups in search for an applicable medicine.
If we refer the selection for dysphagia to the Cypher Bepertortfy we find a yast number of medicines under '' Throat." Among these lachesis acts as if '' food were opposed at the cardiac orifice," and '' drinks return through the nose." With stramonium *' the yelum hangs low, food passes it with difficulty, and causes scraping pain. Inability to swallow bread and milk." These symptoms appear to be actually associated with an affection as paralysis of the yelum palati rather than the gullet proper.
Again, under oesophagus fluoric cLcid is not recorded possibly because the word '' oesophagus " is not giyen as such in the proyings, although Allen notes the word dys* phagia. Howeyer, so many drugs haye symptoms actually noted as pertaining to the gullet that it would be impossible to notice them all here, but notably there are for dysphagia in the oesophagus c. ch., k. carb.y oar. add,
Colchicum. — '* Pain in throat and larynx and muscles of neck. Pain down oesophagus and impeded deglutition," symptoms in themselyes distinctiye enough.
222 CLIOTCAL CASES. *^^.^SST^
Bevikir, April 1, IBBL
Kali earb. — Dysphagia. " The food passes slowly down. Sensibility of (Bsophagas, warm food bums him ; he can only take tepid things*"
Oxalic acid, — *' Dysphagia and burning in (BSophagns and' throat." '* Morning dysphagia." To these we might add, to judge from its provings —
Fluoric a4:id^ — " Dysphagia, bread causes great pain, with sensation as if a raw place, scHre or ulcer were in the throat lowdown, with hawking up of phlegm."
Merc, has burning pain, but otiberwise resembles the case cured hjfltvoric acid. cole, carb.^ ba.'carh. kali hie, natu mur., nit. ax:., sulphur, tar., tri., verat, on the gullet, but the symptoms are peculiar in each case, and different from the case recorded.
None of these drugs are noted as having the cutting pain described by my patient, and I regard his description of the pain as badly chosen, and that '' smarting like a sore/' or as if ''food were passing over a sore," are the more applicable terms for the fbrmer, of which flturric acid is specified, together with a legion of other medicines. Pains on swallowing also are common to many drugs, including Jiuoric acid. Auru^iiWBS "only when swallowing." But most of these symptoms are truly upper throat symptoms, and not lower oesophageal, although aurum claims the extreme sensitiveness to cold air, like unto ^uoric acid. Indications according to the Symptoms of tlie Loealitif of
the Sac*
Nat. mur. — *' CataiThal susceptibility to wind. Burning in the inner canthus. Acrid lachrymation in open air makes canthi red and sore." This character of the tears may perhaps induce inflammation of tho lining of the sac.
SiUda. — Swelling of gland and sac. Burning and stinging pain of lids. Hard mucous agglutination. Lachrymation and dimness of the eyes.
Sulphur. — Lids red and swollen in the morning. Lachrymation and coryza morning and in the open air. Burning, acrid and profase lachrymation* Itching.
Merc. sol. — ^Lachrymation in open air.
Kali tod.— Lids bluish, red swelling. Swollen, red and uloearatad.
PttlsatiUa. — Stye on the lid near the inner canthus. Lower lid inflamed with morning lachrymation. Laohry-
** From AUen.
SS^SSTTS^*" ON ELECTRICITY. 223
fiffNmr, April 1, 188S.
imtiMi in cold open air or of one eye, iivdth drawing head- adw ; blear-eyed ; morning agglutination. Bnming, itcfamg, biting and pressive ocular pain are also symptoms of pwtsatiUa.
Petroleum, — Much water presses out of both canthi. Lachiymatita though in open air ; not necessarily in cold air^ ajid it continues even indoors. Inflanunation and BweOing of the size of pigeon's egg at the inner canthus, like an incipient lachrymal fistula^ with dryness of the right ride of the nose, lasting several days. Burnings biting of the lids, and lachrymation in the open air.
Cak. carb. — Profuse lachrymation of right eye, with buniiiig. Morning and evening lachrymation, and when writing.
Hepar, cede, c, mere, cor., kali iod.^ are found to be very deficient at present in symptoms referable directly to ^ sac, hence, if prescribed, they have to be employed recording to indications other than those more immediately connected with this seat of this disorder.
ON ELECTRICITY : ITS PHYSIOLOGICAL ACTION AND THERAPEUTIC USES.
B7 Donald Batkes, M.A., M.D., F.R.G.S.
(Continued.)
Dynaaaie^ Induction or Faradism is of two kinds.
(a) Eleotro^magnetic.
(i) Magnetotelectrie.
The principle of these forms of electricity is as follows : If two coBdnetoxB be placed near each other, but not in contact, and a current of electricity be passed through one of them, a momentary current of the same kind, though ptmng in an oppoeite direction, will instantly be produced in the other. If the current be now stopped, another momentary current will again be produced, but now in the same direction as the current passing in the first conductor. The enrvent passing through the first conductor is called the prinuucy ox inducing current, while the momentary cunreBt set updn the second conductor is called the induced or secondaarj cuneikt* These are in aU cases momentary, oceunring oidy at the msomfint of opening and closing of the inducing cor primary current. In like mannei* induced or
224 ON ELBCTBIOITY. ^SS^Jj^Sl^'
secondary currents may be used to set up other indaced. currents in other adjacent conductors ; these are called ternary currents and may again be used to set up other induced currents in adjacent conductors, called quaternary currents, and so on.
We have already seen that a piece of soft iron be- comes magnetic while in connection with a galvanic or other electrical current, and that this magnetic condition disappears on the cessation of the electric current* These facts have been taken advantage of, and are well exemplified in the construction of induction machines or batteries.
In taking a galvauo-faradic or electro-magnetic machine to pieces, it is found to consist of the following parts : —
1st. The galvanic battery of one or two cells.
2nd. The primary coil, which is made of a short thick insulated wire wound round a bobbin. One extremity of the wire is attached to the battery, and the other to the contact breaker.
8rd. A bundle of soft iron wires, called the core. This is placed inside the primary coil, and is well insulated from it.
4th. A metallic tube, which passes over the core of iron wires, and can be drawn out or pushed in at will. This modifies the strength of the current very considerably, according as it covers or uncovers the core of wires.
5th. The secondary coil, made of a much longer and finer insulated wire than that forming the primary ooiL It is wound round the primary coil, but is insulated from it, and is quite independent of the rest of the apparatus. The two extremities are attached by means of binding screws to convenient parts of the frame-work of the machine, where the electrodes intended to carry away the secondary current can be connected. Branch wires from the extremities of the primary coil are attached in a similar way, for connection with electrodes intended to convey the primary or " extra current."
6th. The contact breaker or interrupter. This is a steel spring terminating in a hammer-like head, which is placed close to the front end of the core, and vibrates in front of it. It is connected, as before mentioned, to one extremity of the insulated wire forming the primary coil. About the middle of this spring, on ^e opposite side to^ the hammer-head facing the core, is a smaU disc or plate-
^t^^lSTS^ ON BLECTKICITY. 225
S0ffav, April 1, isn.
•of platinum, and rdstiog against this is a fixed screw tipped with platinum^ and so arranged that it can regulate the yibrations of the spring.
The induced current in the secondary coil depending, as it does, on the opening and closing of the galvanic or primary current, it is necessary to have the means of doing this regularly and automatically. This is perfectly carried out by the contact breaker, above described, as follows : —
The core of wires becoming magnetic, as the galvanic current passes through the primary coil, attracts the hammer. This, as soon as it touches the core, demagnetises it (owing to the current being broken by the separation of the hammer from the screw), and being set free, flies back to the screw by virtue of its own resiliency ; the core again becomes magnetic, again attracts the hammer, which again demagnetises it;, and flies back to its place as before, and so on, thus causing a regular series of interruptions.
At the moment the core becomes or ceases to become magnetic, it increases the strength of the current in the primary coil by induction. The turns in the primary coil also act on each other by induction increasing the strength of the current. These currents were called by Faraday " extra currents," and in the Faradic medical machines are collected and used under the name of the '' primary current." The current induced in the secondary coil is also strengthened by induction between its coils.
Magneto-electricity is an electricity induced in insulated wire coils surrounding the soft iron cylinders, of peculiarly ^M>n8tructed armatures, during the time they rotate in the immediate vicinity of the poles of a magnet.
The medical electro-magnetic machine consists of two coils of insulated wire, having cores of soft iron. These coils are made to rotate rapidly, by means of a crank and handle, in such a way that the cores are brought alternately in contact with the poles of a horse-shoe magnet. The cores coming in momentary contact with the poles of the magnet, momentarily become magnetic, and induce electric currents in the coils surrounding them at the moments they gain and lose their magnetic properties. Magneto- electricity is chiefly used for light-houses, electric lights, &c. Here the machine is worked by steam or water power.
Thermo-electricity is the electricity derived from the 4u$tion of heat applied at the point of contact of two dis-
226 THK0BIB8. ''S^XST!^
similar metals. The metals chiefly ased are antimony and bismuth. A thermo-electric pair consists of a bar of each metal soldered together; they are nsually made in the shape of a V or U. A series of such pairs form the thermo-electric pile. This form of electricity has been greatly used in experiments on heat. It also plays «n important part in physiological research and medical diagnosis. By its use it has been proved that the normal temperature of the left side of the brain is higher than that of the right side. By its means the natural deviations in the temperature of the human body under varying circumstances, mental as well as physical, have been investigated.
ALLOPATHIC VERSUS HOM(EOPATHIC
THEORIES.
By Dr. John Wilde.
It is natural that our allopathic opponents should select the weakest spots, as they think them, in our armour, when they point their ridicule at us. At one time it is the dynamisation theory, at another the *^ peoric miAsm." One of their favourite attacks is that directed against the nastiness or the disgusting nature of some of our remedies.
Now, I must say I have felt consideraUe sympathy with this objection. The '' cimex lectularius " looks very- well in its Latin dress, and the laity may, in a trituration, partake of the blood of this delightful creature in utter ignorance that they are taking sweet revenge on the blood- sucker; but to t^e initiated there is truly something repulsive in the idea of '' smashed bugs," as I onoe heard the medicament vulgarly called by an <^ponent.
I have always had my doubts whether the trituration of *' Norfolk Howards " was a reliable, if legitimate, remedy in our Materia Medica. Any doubts I might have had, and any misgivings which my readers may still entertain, I am happy to say are now rendered nugatory. We may now throw up our hats and cry " Yivat cimex."
Our allopathic contemporary. The FraetitioneTf by introducing the following extract fjxMn an American jounial, may be considered to endorse the remarkable theories therein set forth ; at least, there is no editorial disclaimer attached to the paragraph.
S^rgSygS!' THE0BIB8, 247
We poor homcBopaths have had to suffer for permitting the use of *^ bed bugB '' in medicine, on the principle that the same symptoms induced on the prover by bed bags wore curable, if met with in disease, by giving the tritaration:of the animals. This, of course, was homtoeo- paihy, and therefore was absurd. But it seems you really can cure disease by ''bed bugs/' only you must adopt another theory to explain the cure. Bed bugs, howeyer repulsive in our hands, are most delightful remedies if an allopath takes them up, and the theory- which explains their use is simple beyond everything ; and, moreover, it opens up sooh a field of speculation, that one marvels how any human brain could have developed the idea. But not to keep our readers in suspense, here is the article in the Pra^etUioner for January. It is headed '' A New Source of Quinine," and goes on to say —
'* A recent writer, under the name of * Medicus,' in the Dallas Herald of Beptember 6th, says : — * In my last paper I asserted that mosquitoes contained a large quantity of animal quiniay and, therefore, when they bit a person, they injected into his system an antidote to malaria and' febrile causes generally. Since you published my com- munication, I have captured quite a number of these insects, and macerating tiiem with a mortar in alcohol, have, by chemical experiment, actually precipitated the mdphate of quinia to the amount of 70 per cent, of the mass. The '' chinch " or bed bug, in sucking blood from the human body, draws nourishment and strength, and, above all, the material which, in the retorts of his body, is distilled into a rich fluid, which, in biting one, he ejects into the body, and this, entering into the body, furnishes an antidote against rheumatism! ! ' ''
Then the writer goes on to say —
'' All mercurial preparations cause articular rheumatism. The ealomel taken into the system, by decomposition forms corrosive finbUmate, not in qusmtity to produce death, save the slaw torture of rheumatism. Corrosive sublimate, as every housewife knows, is the only riddance for bed bugs. The juices of the bugs and the sublimate are the antidotes of each other.' "
The writer having evolved his theory in the above most beautiful and convincing manner, proceeds to say that bed bugs tfre an arrangement of Providence for curing rheuma- tism produced by the corrosive sublimate, which was.
-228 REVIEWS. "SS^^SSR^
Banew, April 1, 1881.
produced by the calomel, &c. It is a regular '' House that Jack Built " theory, and the whole consists of a series of links, making a chain of evidence not easily broken.
What will allopathic objectors have to say to triturated cimices now ? Why, here they have furnished us with, not only proof of curative agency, but have likewise given us a clear and elaborate account of how the cure is brought about, and there is no objectionable homoeopathy about it. You may be as nasty as you like, if you keep on the allopathic side of the hedge. Pounded mosquitoes are merely '^ animal quinia,^* even to 70 per cent, of their delightful organism. In future it will be a positive luzurj to be bitten by these anti*malarious creatures. We must look out now for a reduction in the price of quimne. Mosquitoes are worth catching.' I only hope they will make ''animal quinia** in the tropical regions, where these excellent blood-suckers abound, as we would rather have them after they have passed ''the mortar" than imported " alive, oh ! "
Talk about '' specifics," and these being few in number! Why, here are two more — ^the anti-rheumatic bug and the anti-malarious mosquito. Probably every objectionable entomological blood-sucker is an antidote to something or other. We must cherish our lice and gad-flies, which will doubtless turn out specifics ; but we must look to America for the ingenuity which shall furnish the theory of thrir action.
Park House, Weston-super-Mare. March 5, 1882.
REVIEWS.
Brandt's Treatment of Uterine Disease and Prolapsus by the Movement Cure, Edited and translated, with an hitroduction by Dr. Both. London : Bailliere, Tyndali & Cox. 1882.
Wb are much indebted to our indefatigable colleague. Dr. Both, for giving us an English translation of Brandt's work, which is one of much interest, and occupies an entirely new field. The benefits of the movement cure are being more and more recog- nised in the treatment of various chronic ailments, especially spinal deformities, and their consequences, paralysis, defective muscular power, &c., but it is new to us to hear of all uterine diseases, acute and chronic, treated and cured by manipulations.
:5StSS^ BEVIBWB. 229
As Dr. Both has been so sacoessfnl in illnfitrating in hispraetioe, and in making more widely known the valne of oiis treatment in rsj^nsl and otiber diseases of this class, it was natural that he sbooid wish to make known the results obtained by similar means in the treatment of uterine diseases, and displacements. In his introduction, Dr. Both says : —
* * The following is the way in which this treatment originated : —
*' ' Mr. Brandt, some years after having, withgreat credit, passed his examination at the Central Gymnastic Institation at Stock- hohn (in 1849) — ^whilst on active service with his regiment — was suddenly called upon to replace a prolapsus ami which had occurred in a soldier ; the regimental surgeon being at the time absent from the camp, he was obliged to act at once, and not being acquainted with the ordinary manipulations used in order to replace the protuding gut, he, availing himself of his knowkdge of the anatomy of the parts, and calling into practice the princi- ples he had l^med at the Gymnastic Institution, at once placed the soldier en his hack with the knees bentf and eommensed to operate through the abdominal parietes in making a deep pressure^ combined with a traction upward and to the left ; by r^etition of this movement the gut was actually pulled in. Afterwards, in order to act on the sacral nerves, ^pugnal percussion* was applied on the sacrum, and by these two movements the soldier was enabled to turn out for drill the same afternoon, and was not troubled with his prolapsus afterwards/
*' ' In Sweden, prolapsus uteri is a common complaint among the peasant women, who are obliged to go about, and to do heavy work immediately after confinement.
** * Mr. Brandt was then living in the coimtry, and the thought of applying a process somewhat similar to that which had succeeded so well with the soldier, in order to procure relief for the poor woman was not so very fiar-fetched.
** * Be, therefore, employed for the purpose three movements of which in the first, by a Uftiag vibratory action the womb was, as it were, drawn upwards ,or lifted ; in the second a vibratory point pressure was directed to act on the nerves, and ligaments of the organ, and in the third a pugnal percussion was applied on the lumbo-sacral region from wUch Uie pelvic o^ans obtain nerve supply.
'^ < The result proves the correctness of the suggestion, and by and by, through the reports of Mr. Brandt's success, and under the advice and patronage of some medical friends, "Dx* Liedbeck, Dr. Lewin, Dr. Skoldbeig, &c., who soon saw the rationale of the treatment, his. practice increased. He has gradually en- larged the sphere of his treatment, and at present (1880^, having treated upwards of 8,000 cases, he has, with the aid or interior manipulations, resembling, in a measure, those used by Dr.
Yol. 26, No. 4. B
280 BBviBws. ^S2II.%Sm^2S!'
B«Ti0w, April 1, int.
OasaaaXy aaccfissfaily treated cases of ohronio metritis, para- inetritis, mtemal tomonrs, and, besides, the Tarious d^ectiaii» of the womb. Mr. Brandt has had several pttpils* amongst Uie gj^MOoloigists of SoandinaTia, and is certainly the first gymnast ^0 has been engaged in a large and saeeessfdl gynecological practice/ "
''That manipulations, through the hypogastric region hare been used by Becamier, I find in Dr. Phillipeaax, Etude Pratiqtu sur Ua Frictions et le Managsy page 182 : — ' In certain circnm- stanoes Recamier introduced a finger into the anus, if the patioii vna a virgin or a man, or in the yagina if the patient was a married woman, and placed the tip of the finger on the neck oT the bladder^ and, if possible, nndemeath ; he tried by pressmi^ with the other hand on the hypogastrimn to make soffioieni movements, succuMnanj vibration, and oscillations on the neck of the bladder.
(( < Although several of the manipulations applied by Brandt have been made use of by Ling, Branting, and Georgii in the treatment of diseases of the pelvic organs, such as flooding^ amenorrhcea, dysmenorriioea, seminal losses, &c., Brandt has the great merit of having more specially developed the treatmen* of uterine complaints and prolapsus by the movement-cure, tiie principal features of which he has made known in the following fifty.three notes, which he has collected since 1861. Dr. Oscar Nissen, of Christiania (who has kindly sent me his Norwegian pami^et, Thvre BnmdU Uterm GymnasHkf Christiania, 1875, while I wae translating these notes), caUs special attention (pi^ 4) to Brandt's examination of the uterus, to the pressure on the ptinc nerves, to the manual replacement of the uterus, to the lifting movements and the manipulations inside the pelvis ; all cf these were originated by Brandt. Prof. Dr. Hartelius, of Stock- holm, the well-known director of the medical department of the Bofal Swedish Central Oymnastic Institute, writes to me in a letter dated 19 Decembe^, 1881,' concerning Thure Brandt's method. ' I can say, according to my experience, t^ deserves to he taken notice of by the pkysiei^m.*
*' With the exception of a few medical men, Brandt's original treatment has scarcely yet been sufficiently appreciated by the profession — which is usually very slow in aclmowledging the merits of new modes of treatment, espedaQy when opposed to pveoonoeived orthodox notions.*'
This sul^ect bemg so entirely new to us, we are unable to express any opinion on it firmn experience. But the enormous practice ^riuch Brandt obtained, and the success he records, make it an important matter of study for aU who are engaged in ^meoological practice. All forms of disease, infiammatoiy or of displacement, are treated by this method of regulated man^ula-
'^OOB. Tb» detail of Iheab, even asm illtniritfon of the tn^Chod, would oeeapj too maeh ipsoe io quote. We shaU do tlie oathoir and tbo niader nuieh more jnstioe by tiinpl j drawing a^tenlioii to tha wock, and nrfetring him to it fo detail of treatment. The .bode ifl SBwU, and eaaily read, and is enridied by rareral pktes illustrating the position of the patient and operator daring some of the manipnlations« We ahonld be glad to hear deiails of cases treated in this novel manner, and meantime thank Dr. Both for his energy in translating Bnmdt's book, and for his interest- ing introduction.
The Ophthalmo8eop4j its Theory and Practical Uses. C. H. YiLiS, MJL, M.I>. Chieago : Duncan Brothers.
»
7hib book has been published, the author tells us, to occupy ia place hitherto vacant in medical literature, and to supply a want -vAddk he, as a teacher, has long felt. Books written on the use of Ihe ophthalmoscope generally begin by assuming too much as to flie pupfls* knowledge. The first chapters of tms work, how- ever, are devoted to abstruse disquisitions on optics and the ttteoiy of tiie ophthalmoscope. But after all, the earlier study of IUb instrument is rarely much assisted by theoretical book lore. dinieal instruction alone is of any use in teaching the beginner. Kever&eless the author does real good work in the chapters ireaisng of the various kinds of instruments used in ophthabno- scopie examination. Judging from the list given uSi we should imagine tiiat every ophthalmic surgeon of any note had £alt it his bonnden duty to attach his name to some new form or modifica- tion of ophtludmoscope. The author has done his best, by niieaos «f diagrams and dear description, to point out the principal forms and indicate their claims to favour.
•
The best portion of this work is in the chapters devoted to simple directions how to conduct both the indirect and direct metliods of examination.' There is here much useful information condensed into a smafi space, and every phenomenon is explained in an easy way.
Having glanced at the various modes of using the ophthalmo- scope, we come by a natural transition to the various* abnormal conditions of the organ of vision which the practitioner meets with. Here we are disposed to be sorry that the author has been to brief, although he forewarned us tb^t the volume is intended to be only for beginners ; cataract of varioua kinds is discussed in two pages and a half, and similar short measure is shown in dealing with other important diseases. The book is evidentiy written with a careful regard io modern pathology, and 10. certainly worthy the notice of the young practitioner.
282 NOTABIUA. tS^^jSSiTSS
Dr. Yilas has strietly adhered throu^oat to his pka of maUng the book simply a text-book of instmctions for the stodent, as from first to last not one word of therapeutics has been allowed to ereeip in, hence we have no doubt that in America the wotk will be received as well by allopaths as it will be by our own brethren.
NOTABIUA.
BEPOBT OF THE UYERPOOL HOMCEOPATHIO
DISPENSARIES.
We have received the annual repcHrt of this magnificent charity, and after perusing the statistics afforded, can heartily ooneiir with the gratification felt by the committee, who announce thai never before during the forty years of their history have the dis- pensaries been in more efficient working order tlum at present. The sphere of operations is becoming very extended, as will be seen from the following paragraph : —
*< During the past year it was deemed desirable to increase the medical staff by ihe appointment of a fifth paid medical officer, as without such addition it was found impossible to satiafiEu^torily keep pace with the increasing demands from the poor to be visited at their own homes, ^e city is now carefully divided into five districts, and one district apportioned to each medical officer, and in this manner the homes of all, within the Parlia- mentary boundary, are visited when necessaiy."
The attendances of patients at the two dispensaries have been very large during the past year, amounting to a total of 65,12S. We append the tabular statement : —
AT HABDMAN STBBXT.
Indoor attendances 25,682
'nsited at their own homes 6,026
AT BOSCOMMOM STBEBT.
Indoor attendances 25,087
Visited at their own homes 7,480
Or a weekly average of 1,252. 65,125
These figures are most satisfactory, testifying as they do to the widespread belief in homoeopathy amongst the poor of Liverpool, precisely amongst the class of people who, we are so often assured, never will believe in it.
At the annual meeting of the subscribers on January 26th, the Mayor of Liverpool in the chair, Mr. Eccles pointed oat several interesting &cts in the report. He particularly drew
nS^SSTSm NOTABIUA. 288
tttontion to the fact th*t they had done a mazimma of good with a minimiim of cost, having relieved 65,000 people at the small coat of something less than £1,000. He was not awaxe of any other institation of the kind which ooold boast of a sinular sue- eeea. Speaking of the fatnze of the dispensaries, he said that although not 8i:&ciently sanguine to expect that a hospital would soon be boilt, he thought that, having regard to the immense number of the poor reUeved by this institution, they might fairly elaim to have homoeopathio wards allotted in the various hospitals in the city.
The Mayor, in responding to a vote of thanks, said in the oonrse of his remarks: ** There is no doubt that the leading feature of your report is the large amount of work, and work amongst the poorer classes of the city, which has been done at such a trifling expense. I do not think there is any institution in the city which can compare so &vourab]y with you in this respect. Diuing the time that I have had the honour of filling the oflce I now hold, it has always been a source of great gratification to me to take part in any movement, not only in aid of such an institu- tion as this, but any movement which has for its object the amelioration of the sufferings of the labouring dasses of our dty."
ANNUAL REPORT OF THE BATH HOMOSOPATHIG
HOSPITAL.
Thb thirty-second annual report of this hospital shows a steady increase in the number of patients, and an amount of progress which must be vexy satisfactory to the committee and sub- scribers.
There have been 54 in-patients, as compared with 46 in 1880 ; and the out-patient attendances have been 8,591, with 754 new eases, as compared with 8,800, and 600 new cases, in 1880.
The report is made specially valuable by a rStume of the various diseases treated in the hospital. Anyone reading the list will see at a glance the absurdity of the idea put forward by some, that only trifiing ailments ever go into a homceopathic hospital. For example, amongst others, we notice, anaBmia, carbuncle, erysipelas, enteric fever, (Uphthetia, bronchitis, pneumonia, pneumonic phthisis, tubercular phthisis, mesenteric disease, atrophy of the liver, phlebitis, aneurism, hip-j<Mnt disease, ooncussion of spine, erythema nodosum, and muscular atrophy. The migority of the patients received permanent ben^t, but one died in the hospital from consumption ot the bowels.
284 KOTABILIA. "g^.^ggg?;^'
There irefe U paying in-patients, 8 ha^mg private ^mrds at a guinea a vroek, the others paying Ss. a week.
The total benefit to the hospital from the Bazaar aad Une Art Exhibition laet Norember amounted to about ^75. This, we are glad to learn, has materially improved the financial posi- tion of the hospital.
HASTINGS AND ST. LEONARDS HOMCEOPATHIC
INSTITUTION.
At tJbje annnal meeting of the friends and subscribers of this important inatitation a very satisfactory report was presented. Daring 1881 the number of patients was 552, with a total of 4,200 attendances. This shows an increase of 1,579 attendancea on the previous year, a fact which emphatioally bears testimoiij to the appreciation of the institution by the poor.
The funds of the institution are in a very satisfactory con- dition, the income for the year being £158 10s. Id,, leaving that most comfortable remainder, a balance in hand, ci £68 2s. 5d.
Dr. Pope, who had been specially invited down from London for the occasion, addressed Ihe meeting at some length on the benefits of homoeopathy to the public. He pointed out the necessity of adhering to the principle of homoeopathy, and of maintaining their institution aa a true homoBopathic dispensary. He quoted important statisti/Bs showing the bearing of homoe- opathy on life assurance, there being one insurance company in New York which actually allowed homoeopaths 10 per cenU discount off their premiums. Looked at from a rigidly com- mercial point of view, this was a very important evidence of the lower rdative mortality in disease treated purely by homoeopathy. Dr. Pope also referred to the results of M. Tessier's practice, which are well known to most of us, showing that about the only occasion on which homoeopathy was ever fairly tried in an allopathic hospital it completely triumphed.
We are glad to see that the conmiittee of the dispensary are going to put in a claim for a share in the Hospital Sunday Fund, and trust that the next report of this flourishing insti- tution will be able to chronicle a satisfactory addition to its finances from this source.
QXFOKD HOMCEOPATHIC DISPENSABZ.
Wa are pleased to observe firom the annual report — the
of this institution, that it is rapidly increasing in usefuhiess. Hie
ioOowiiig facts revealed by the books of the dispettssry ■staroDgly to the valae of the institatioii :-^
New patients admitted in 1681 221
Attendances 2,442
Yaccmations ... ... «.. ... ... 80
x^e&tuD ••• ••• ... •*. •*. ... o
Total number of attendances since 1872 ... 15,251
The Oxford Homceopatbio Dispensary is nnder the medical .superintendence of Dr. Guinness, who is now one of the oldest of homcBopathic practitioners. Induced to examine intD the merits of homoeopathy by a relative, in 1844, Dr. Guinness pursued the only real method of doing so — ^that <^ clinical enqiiiiy. He was especially urged to this course, on the gromid •that if he found it to be '* humbug " he. would have an oppor- tunity of exposing it to the whole world. Like every one else, however, who has tested homoeopathy at the bedside of l^e sick, Dr. Guinness found that cases which had resisted the usual methods of treatment yielded readily to homoeopathy. He has since been instrumental in founding dispensaries in Exeter, Beading, and Oxford, and we congratulate him on the success which has followed his endeavours to serve the poor in this manner, and to . extend the advantage of homoeopathy.
^^tm.ammmm0*^-^mm*ma^,-mmmmtmmm.tm»mm»*aammt^
MEETING OF ** THE LTVEBPOOL HOMCEOPATHIO
MEDICO-CHIRURGICAL SOCIETY."
At the last meeting of this society, held on March 2nd, the time was principally devoted to a diiscussion on *' The new title " ** Ii.H. '* (Licentiate of Homoeopathy.) The society came to the following resolution : — '* That it is desirable to petition in favour of a homoeopathic title that shall have a legal recognition 1^ appearing on the Medical Register."
M«MMM<ta^aM.«M««M«Mki«|«aa«irtMi
TESTIMONIAL TO LORD EBURY.
Ix win be remembered that some months ago it was determined to acknowledge the eminent services which Lord Ebury has, throughout the last 40 or 50 years, rendered to homoeopathy, by making a presentation to him. After much discussion it was determined that his lordship should be requested to sit for his .portrait, and that this should be presented to I^dy Ebory. The portrait has been executed by Mr. Cyrus Johnson, of Devonshire Street, and is stated by those who have seen it to be a faithful likeness. We hope shortly to see it on the walls of Burlington ^House.
286 NOTABUJA. "S^^rypffi?
Bflvitv, Aftnl U Itti-
On Saturday, the 25th nit., the Committee, which eonsiflts of Lord Denbigh, Lord DnBmore, Major Yanghan Moi^aD, Dr. Hamilton, Dr. Yeldham, Dr. Dudgeon, Dr. Dyce Brown, Mr. Cameron, Mr. Pete, and Mr. Chambre, presented the portrait to Lady Ebnry. The presentation took place privately, in con- seqaence of the recent &mily bereayement of the noble lord.
ThiB presentation occmted so near the time of oar going to press that we are obliged to defer the full acconnt till next month.
"PARVULES."
'^Pabvulbs. To the medical profession only." — A Chicago friend sends ns a little pamphlet, which, if it is widely distri* bnted, has not before chajiced to light in onr sanctum. It is not only a pamphlet, bat it is a " straw " as well, and shows qoite condasively which way the *' trade wind " is blowing. The well- known house of Wm. B. Warner & Co., of Philadelphia, whole- sale draggists, &o., &c., have something new to offer in the way of pharmaceutical preparations. They have inyented an improved method of preparing drags. We quote from their circular r *' The term Parnile from Parvum (small) is applied to a new class of remedies in the form of minute pills, containing TniniTnnm doses for frequent repetition in cases of children and adulta- [patients, neither children nor adults hare to take 0. S. most likely]. It is claimed by some [over 6,000 homcBopathic] prac- ..titioners that small doses given at short intervals exert a more salutary effect. Sidney &nger [who has wnmg his information out of his homoeopathic neighbours] , in his recent work on therapeutics, sustains this theory in a great variety of cases without catering to homoeopathy. [To cater is to provide food for. The idea of Sidney Binger providing homoeopathy with anything but half sucked egg-sh^, tiie remains of honest meat he^ stole from it, is absurd.] As medicine advances from the domain of empiricism and becomes more of an exact science, all of its lateral branches must assume new forms. The modem teachings of phy Biological therapeutics inculcate a change in the manner and mattor of dosage that shall meet the varying indications of disease and the peculiar susceptibility of different individuals. The large,, and oftentimes nauseating compoxmds of our ancestry, haye liyed their day, and died, let us hope without regret. [How near dead they are, please consult the latest book on * Formularies*]. The elegant preparations of the pharmacy of the present day have met a well recognised need, and have added lustre to the physi- cian who could disguise frx>m his patient the unpalatable or unsavoury nature of his medicaments. But there was still some* thing lacking. There was a growing demand for accurate, graduated, tasteless preparations, which might be easy of admin.- istration to children and adults, and which should subserve a
sats^^arss*' hotabima. 237
nsefiil purpose in the treatment of many diseases. [In other words, the homoBopathic doctors have taught the people better things, and allopatiiiy is obliged to come to time.] It is a weD veoeiyed fact in medicine that a smaQ dose, frequently repeated, win Teiy often be crowned with more brilliant saccess than a sin^ large dose. This is pecoliaily well iUostrated in the treat- ment of certain fonns of dianrhoBa. [It would be difficult to find this fact so much as hinted at in the ordinaiy allopathic text- book.] Ringer, in his treatise, lays great stress upon the efficacy of minimum doses of corrome tubUmaU in the treatment of this. disease, whether the stools contain blood or not. [Par?ules of corronve tubUmatey 1-100 gr., are made by Wm. B. Warner & Co.] A large experience of professional men endorses the certain action of the Parvules of podophylUn in constipation due to a kurpid action of the liyer, with d€^oient biliary secretion, and in persons in whom there is manifest want of tonicity in the mus- eular fibres of the intestines. This is due, unquestionably, to the permanency of the stimulation induced by frequent repetition* A ain^ large dose produces an ephemeral impression, more or less profound, and ceases to exercise any effect whatever after the impression so induced has been lost in the increased peristalsis. The intelligent use of the P^urvule first creates the desuned condi- tion, which may be continued for as long a time as the practitioner may deem expedient. [An allopathic journal on our table, says of Binger's writings, that they contain not a litUe clandestine homcBopathy. It would be a mistake to suppose the above ideas in any respect represented homoeopathy. No sensible homoeo- path ever £e^ught or believed such absurd therapeutic notions.. And yet they are something far better than the ideas foUowed by the ordinary allopath, lliey show progress especially in the direction of smaller doses.] Drs. Peters, of Paris, Einger, Bartholow, Dessau and others, equally well known in the literary arena, have cited numerous cases of almost every variety of disease, wherein they brought about a desired result by the adop- tion of minimum doses when all other plans of trea^nent have Med.''
It would be hard to find anything more suggestive than this* little circular ; and it will do more to revolutionise the allopathic practice than all the medical colleges and journals and text-books put together. Here, for almost the first time, medicines are pre- pared by an allopathic wholesale pharmaceutist in an. uncombined lorm and in — for that school — ^remaikably small doses. Here are^ more than fifty of the leading drags used by that school prepared in doses of one-twentieth, one-fortieth, one-fifiieth| one one-hun* dredth and one two-hundredth of a grain.
Can saoh things be And oveioome us like a sammer's olood Without our special wonder?
288 NOTABiOA. ^'SSS^^SSSn^
B«VJcw, April 1, 1881.
It 18 amnaing to find in this pamphlet a vigorous protest agaiitft the supposition that this new departure in phaimaceutios and therapeutios has anything to do with homoeopathy. More than a score of ttmes the wzitec declares that these snudl doses ** are iit no sense homoeopathic/' Well, no intelligent person wouM suppose they were. Such amdel^ is needless. But we can see in it an open door out of which the intelligent allopath may stop into the l^t and liberty of homoeopathy. When he finds these small doses doing improved work, he will try some homoeopatlae attenuations. Warner and Oo« are doing good work. We heartily applaud their endeavours to improve the crude and often barbsEouB methods of the allopathic school. In closing, we cannot resist a quotation from the Sotttham Medical (AUopathie) Record : '* The efficiency of these Parvules we attri- bute not to homoeopathy, but to the thoroughness of prepanlioa and the purity of the articles used. In so &r as homoe<^athy advocates thorough trituration as enhancing solubility and neat^ ness of preparation as more likely to agree with defeats stomachs we make no issue, and we think tiuit often much good results from the avoidance of those disagreeable antipi^ues which not unfrequently prevent the administration of medicines to delicate persons by reason of the nauseous form in whidi medicines are ordinarily administered." — Cinckmad Medical Advance.
HYOSCIAMTA IN MENTAL DEEANGEMENT.
Dn. Whitman, of Illinois, calls attention in the yew YcrkMedictd Times to the great success attending the substitution of hyos- cianda {hyoeciamine) for the ordinary form of the drug in some obscure mental cases. In one case the patient, a lady of 85, suffered from attacks of mania coming on at each period, and lasting two or three days. Various remedies were tried, including puls.f heL, gen., aletrin, mac, and cauloph. None of these proving useldl, bell, dx and kyos, 8x were ^ven. Of these kycs. proved of some benefit, but the effects were not permanent. After a long and varied course of treatment, she was persuaded to consult Dr. Hale, of Chicago, who, on hearing that hyoseiamus was the only drug which had at all influenced the disease, advised the substitution of hyosciaima.
She was put upon this remedy, 2z trit. four doses a day, and passed the- next period without any return of the headache and mania, and although nearly two years have now elapsed, she has never h€kl a ret%tm of either. Time enough has now passed to entitle this to rank as a cure and not as a mere palHation.
The second case was that of a lady, set. 88, suffering from hereditary insanity. She had had two previous attacks of mania.
ItS^^SSTSS^ KOTABiLu. 289
&!•
and W9S dedttred inenrable by the medieal oAoers of the State
After six montiis allopatiiio treitment she was placed under 4be eare of Dr. Whkman, who, profiting by the lesson of the previous case, at once placed her on hyosciamia^ and in less than two we^e had the satisfaction of seeing marked improvement both in the mania and constipation ; the latter complaint being relieved by hydrastis. She continued to improve under these r«mediee (no others being given) for two months, when her treat- ment wa» suspended, and she has remained well ever since, which is about fourteen months. The preparation used by Dr. Hale is ihe amorphous hyoBciamia, Although hyosdamm is almost otir sheet anchor in mania, the use of hyoseiamim is, we think, not generally adopted in this country. We trust that some of our btetliren will bear this in mind, and give it a trial, and let us know the results at some future date. The substitution of an alkaloid for the drug itself is often of marked benefit, witness the use of Mrapia in cerebral and spinal congestion, where beUadonna seems indicated but fiuls.
ACONITE m THEOAT AFFECTIONS.
Anotbeb disciple of St. Ringer, having succeeded in subduing an inflammatory case by the use of aeoftUe, hastens to inform the world at hurge, through the medium of ITie Lancet^ of the importance of this marvellous truth in therapeutics. " Aconite has been recommended by Binger to allay local inflammation^ especially of throat affections. In the spring of 1881 1 attended a case of laryngitis, brought on partly by exposure to the weather, and excited hj swaDowing a capsicum lozenge, which at first threatened suflbcation. I had tried several remedies without any improvement, but on the second day of the attack I gave the patient half a drop dose of tincture of oeomfo every half hour for twenty-four hours, when a marked im]^:ovement in the breathix^ took pkee» but ddirium set in ; but after application of ice to the Jiead it passed ofl in a few days, and the patient rapidly jrecov^ed."
We do not knew whether either Dr. Binger or his disciple make a practice of reading homoeopathic literature, but should they do so they cannot fail to find in Dr. Hughes' therapeutics, xmder^tbe bead of larynffitisy the following words: ^* Aconite seems indispensable at the commencement, and is sometimes .sufficient fer the cure.'* One can scsroely help smiling at the matter of faet way in which this gentleman states that *' a marked improvement in the breathing took place, but deUrium set in ; " we wonder whether it haa ever occurred to him that if he had given the tenOi or hundredth of a drop for a dose, it is just
240 KOTABiLu. "a^fsgrgar
possible the deliriniD and snffermg entailed might have been ayoided. Having brought himself to the half-drop dose, let ns hope, for the safety of his patients, that he will manage to get a lit^e farther on the road before the next case of aente laryngitis presents itselll
AN HONEST MAN.
The Southern Clinic (allopathic) for January last contains aa article on ** The Curative power of small doses of Drugs," by E. A. de Cailhol, M.D., of St. Louis, as a leader in its '' original "" department. Dr. de Cailhol practises homoBopathically, and makes no secret of it.
His paper elucidates many of the points upon which honMBO- pathic practice depends, and asserts that **this great truth commences to be understood by the members of the profession now, as indicated everywhere in allopathic medical journals, by advertisements of medicines prepared by chemists in parvules and granules of one tenth of a grain, and even one hundredth of a grain ; but they will soon find, if they try both well — as I have honestly done myself — ^that the same medicines, prepared in triturations with sugar of milk, will give them a great deal more satisfiBLction.'' In conclusion, he says *' that the initial fact of all medical doctrine or system is not to imagine the truth, but to prove the truth by experimentation.''
Such honesty in an allopath is very refreshing, the more so a» it is quite a novelty, a novelty of which many of our leading English therapeutists might do well to import a supply. At present anyone seeking for an honest assimilator of homoeopathic facts must be much in the position of Diogenes of old with his lantern.
"A MERE NOTHING."
How many people are there whose life-work has been abruptly cut short by the progress of disease originating in the most trivial manner, and unregarded until it has become, perhaps, incurable ? A trifling cold, a little pain, a slight indigestion, *' a mere nothing," as it is popularly termed, is permitted to exist unheeded for a time, and at length it develops the beginnings of chronic affections, that terminate only with the life of the sufferer. The briefest review of any ordinary practitioner's case-book wiM- supply numberless examples of this kind ; the experience of every physician will yield innumerable instances of fatalities brought about by neglect of minor ailments at the outset. Among professional men, and hard- workers in every calling, it is regarded as involving too considerable a loss of time to give any heed to sick- ness that does not entirely incapacitate for discharge of businefls-;.
4HDd thus to ** lie ap " for a eold, or for a pain wfaieh can be borne irith under any possibility, is considered as uncalled for indnlgence. It may be, perhaps, that medicine itself is to blame for tins indifference to risk. Too little has yet been made clear jespeeting the early progress of even dangerous diseases ; we are, in spite ci all adyances, all but absolutely ignorant of the sub- JeetiTe and objective symptoms indicative of the initial lesions which give rise to most dangerous consequences; the '^mere aothings '* of every-day life may have a significance, and doubt* l&BB do possess an importance which, could we but trace the whole e^nls to which they give rise, would obtain for them an itttention they have never yet received. In the absence of this knowledge, it is our duty to impress, at all times, and in all places, the gravity of '* trifles/' and to stimulate a universal desire to ke rid of the **mere nothings** which go far to create the eommon diseases of mankind. — Medical Prest and Circular,
HOMCEOPATHY vertus ALLOPATHY IN THE DENVER
ALMSHOUSE.
The annual report of Dr. Ambrose 8. Everett, County Physician of Arapahoe County, Colorado, presents quite a number of in- teresting and instnictive fieicts and figures. The following xecapitulation compares the nine months of 1881, when the hospital was under homoBopathic management, with the corre- sponding months of 1880, when the hospital was under allopathic
control:
1880. 1881.
Number on hand, January 1st • . 40 82
Number admitted 562 649
Number discharged 468 586
Number bom 5 8
Number died 76 58
l^umber remaining 77 100
Average daily attendance ... 60 72
Number of jail and outside patients • 161 285
Total number treated .... 777 974 liortality rate at hospital, with the
number discharged as a basis • • .14 .08 Cost of drugs and surgical supplies in
hospital tl888 16 S780 71
Hospital druggist's salary • . . 450 00 0 00 Cost of prescriptions for jail and outside
patients 241 27 0 00
Total cost of drugs and surgical supplies,
and druggist's salaay • . • • 2074 48* 780 71
Cost per patient from the above figures • 2 66 80 '^Hahnmnanman Monthly.
242
J^OTABIIiU:
Beview. Afcfl 1, 1882.
LONDON SCHOOL OP HOMOEOPATHY.
StJBscBiPTioNS and donations received since 1st Janoaij,.
1882 :—
£ 0. d. £ 8. a.
Dr. J. W. Haywftrd ... 5 6 0
Miss Hodgsldns X I 0 tion) J.. ...3 3 0
W. Baynes, Esq.jMJ).... 110
8 8 0
110 2 2 0
1 1 5 1 1 1 1 1 1 1 1 1 5 2 1
1 1
0 1 1 1
W. Besan, Esq.
Bev. J. Hildyftid
^sbG. MiUetl
MiflB H. A. PeanoB Mrs. Walbanke Ghildsrs W. Bryce, Esq., M.D. ... J, Dixon, Esq., M.D. ...
Mrs. A. E. Baksr
Bbt. E.E.Emotl.., ... Boy. B. H. Cobbold ... F. H. Bodman, Ssq.,M.D.
!Mr. J. Harper
Mrs. H. Bosher
IObs Bofiher ... .«. ... Alfred Bosher, Esq. . . . George Bosher, Esq. ...
F. Bosher, Esq.
E.M. Madden, Esq., M.D. G.D.Wingfield-Digb7,£8q. 2 10 Sfiss J. Barton ... ... 1 1
Major Yanghan Morgan 8
Dr. B. Hughes 5
A. J. ElUs, Esq., F JUS. 1
0 0 0 0 0 0
0 0
1 1 1 1 I 5 2 1
3 0 1 0 0 2 5
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
B. S. Holford, Esq. ... 10 Miss Macniool ..« ... 1 G. F. Francis, Esq. ... 2 Dr. Eubulus Willtams ... 6 E. H. Ganrie, Esq. (Dona- tion) 110
Dr. J. S. Marsden 110
Dr. W. Bayes 8 3 0
Miss Eyre 10 0
8. Elliott, Esq 110
Dr. W. F. Edgelow ... I 1. 0
A&s. T. G. Archer. 110
H.Epp6, Esq 110
Additional subscriptions and March, 1882 :—
Miss Bobertson 10 0
Dr. Y. Moore 2 2 0
J. P. StUweU, Beq. ...110
James Epps, Esq. (Deaa-
tion) «•• ...
James Epps, Esq., Junz.
(Donation) 1
Dr. E. H. MiUln 1
Dr. H. BATtis 2
BeT. G. Newnham 1
Bev. O. P. Greenstieet
(Donation) 0
Miss M. Fox (Donation) 15
E. Gonld & Sons Mrs. Dallas (Ikmation)... Miss Flitt (Donation) ... T. B. Dale, Esq
F. J. Pfeil, Esq. (Dona- bion I ... ... ... ...
Miss B. N« Price
Dr. A. C. Clifton
Bt. Hon. Lord Eb^ ...
Miss Jackson
Miss Goldsmid (Dona-
cion) ... ... ... ...
Miss A. Moore
Mrs. Moore
Dr. C. Macintosh
Dr. G. Shepherd
Dr. C. P. Collins
Miss Weston (Donation) S. C. Coleman, Esq. ...
Dr. T. Hayle
Mrs» Bnshton
H. B. Willianu, Esq.
(Donation) ...
Dr.Matheson
Dr. Lloyd Tuckey...
••• ■••
2 2
1 2
5 1 2
10 2
20 1 3 1 1 1 1 1 1 2
10 2 1
1 0
1 0
2 0-
1 0
10 0
0 0
2 0
0 a
0 2
0 1
0 0 3 1 1 1 1 1 1 2
0 0
0 0
2 0
10 0
2 0
0 0 0 0 0 0 0 0 0 0
0 0 2 0
1 0
£177 18 0
donations from 12Ui to 2l8t
S. Pinsent, Esq. Dr. Matheson... Dr. C. L. Tuckey
2 2 0 2 2 0 110
AMATEUB DBAMATTO PERFOBMANCE.
A performance of '* The Lancers" (commonly known as ti&e '<<;^en*8 Shilling''), preceded by </ Turn Him Oat,'* will be given at St. George's Hall, Langham Place, on Apiil Idth. The ladies and gentlemen who have organised this pex-
fonnanee desire that the proceeds shall be given to the London Homoeopathic Hospital.
The notice is rather short, but we trust that, notwithstanding tiuB, onr brethren will aid the caase as maeh as possible by poshing ihe sale of tickets amongst friends and patients.
CSronlars have been sent with this object to the various' medical men in the London district.
Ihr. Kennedj is the seeretaiy, and A. Chambre, Esq., has
loudly consented to act as principal steward on the occasion.
II ■ ■ - I I
HOW INFECTIOUS DISEASE IS SPREAD. Mr. Atkinbon, in his last annual report on the health of the Graven combined district, mentions some cturioos instances of the ignorance existing among the population under his charge. In one case, when pointing oat the necessity for disinfection, he was told by an old woaaii thai, '*Te msik' a deal o' fuss i* sich \]km eans, but it's na' good ; for if they'll have it, they'll have it^ and if they'll dee, they'll dee." In another, when examining some premises to find a cause for typhoid fever, he was told that he cooldlook if he chose, but it was of no use, for '' t' feaver'a it' fjBanily, 'is father 'ed it, and 'is grand&ther 'ed it, and na' t' lad's gotten it." Mr. Atkinson adds that, in this last case, tiie cttose was not far distant, since an open rabble sewer was* constantly emitting its odours at the back of the premises, and a fool gutter was just below the windows. — Another typical instance of the carelessness of parents in cases of infectious disease recently came before the Exeter School Board. At the last meeting of that body, it was stated that, while one girl was lying at home ill with fever, five other members of the family were being sent to one of the Board schools without the sUghtest intimation being given to the aathorities. The existence of fbver only came to the knowledge of the Board on their summon- ing the parent for the non-attendance of the sofierer. It is not eneooraging to reflect that, after so mnch time, money, and energy have been expended in erecting and maintaining a public health service, such instances of cnuss ignorance as these should have still to be reported. — BrUith MstUeal Journal.
"DEATH OF HOM(EOPATHY." It is now jast forty years since that delightful poet and quasi physician, Oliver Wendell Holmes, gave to the Boston public two leotores on '' Homosopathy and its Eindred Delusions." In these lectures homoeopathy was denounced as the most absurd of all medical delusions ; and the prophecy was then made that it vMold be short-lived, and that ** not many years can pass away before t^ same curiosity excited by one of Perkins's Tractors will be awakened at the sight of the Infinitesimal 0-lobules. If
244 NOTABILU. "SSS.^SSM
it shonld elaim a longer existenee, it can only be by &lling into the hands of the sordid wretches who wring their bread fitmi the cold grasp of disease and death in the hovels of ignorant poTer^." Thirty years passed away, and in 1872 the ** lifeless delusion," as Holmes called it in 1842, had become a power in the land. Its practitioners were numbered by thousands, and its believers by hundreds of thousands. In Boston it had a dis- pensary for the sick poor, at which nearly 1,000 were treated yearly. An effort had been made to establish a hospital to which the poor could resort and have homoeopathic treatment. In fact, its institutions, its societies, and its practitioners were prosperous, and exhibited as yet no sign of the much-wished-for decay. There being no prospect of its dying a natural death, the councillors of the great Massachusetts Meddcal Society in seciet conclave determined to kill it: First, by declaring it arrant quackery ; second, by expelling, as unprincipled men, any who practised it ; and third, by forbidding members to hold any pro- fessional relations with these *^ charli^ans.*' The result of this action is best seen in the growth of homceopathy in New England since that performance. In Boston the number of homoeopathic physicians has increased from sixty to upwards of one hundred ; in New England from five hundred to ei^ hundred* A medical school in connection with Boston Univer* sity has been established, which, with thorough instruction in every department, has already graduated two hundred and fifty physicians ; a hospital has been founded, which has cared for upwards of 1,600 patients, and has secured of fimds for running expenses, for land, buildings, and permanent funds, upwards (tf $250,000 ; and the dispensary has enlarged its work from 978 patients in 1871 to 11,862 m 1881. But this growth is not confined to New England. Twenty-six State medical societies and one hundred and nine local societies exist in the United States, with a membership exceeding 2,000. Forty-two hos- pitals, with 1,600 beds, employ whoUy homoeopathic treatment, while more than 100,000 poor patients are annually treated at homoeopathic dispensaries. Moreover, seventeen medical jour- nals are sustained, and eleven medical colleges are educating at the present moment upwards of 1,800 students in homoeopa^iio opinions and preparing them for homoeopathic practice. The success of these practitioners, the quality of their patrons, and the amount of charitable work performed would indicate that the '< sordid wretches " and the scarcity of " infinitesimal globules " prophesied belong not to this generation. May the " death of homoeopathy " continue, in the future as in the past, to be con- fined to the realms of prophecy, until, at least, science shall have given to humanity a better method of healing.^-iMw England Medical QmeUe.
gSgg^^an^r NOTABILU. 245
THE LATE DB. CBONIN.
Wb hftTe received from Mr. Barrand, the eminent photographic ftrtist of Gloucester Place, a copy of a very striking likeness of the venerable physician whose long, active and osefdl life we briefly referred to in onr last number. We notice it because we aie snre that many who esteem and respect the late Dr. Cronin will be pleased to learn that they have an opportunity of obtaining a really characteristic memorial of their departed friend. It is both a pleasing and accurate representation of the deceased.
WmLST this winter has been remarkably mild In Western Europe, it has been of quite unusual severity in South-Eastem Bussia. The main chain of the Caucasus is covered from the top to the bweet valleys with snow. The great depression of the Eura and Arako rivers looks like a Siberian plain covered with snow. The bright sun of the south seems unable to warm the cold soil, and in the night the small streams and irrigating channels freeze. Even the Mikhael Qulf of the Caspian, south of Erasnovodsk, was frozen from December 19 to January 7, and the thickness of the ice was 4^ inches. — Nature,
LONDON HOMCEOPATfflC HOSPITAL.
Ibe Betum of Patients admitted during the month ending Uareh 16th, 1882, gives the following statistics : —
Bemaining in Hospital February 16th, 1882 ... 40 Admitted between that date and March 16tii ... 85
76 Discharged between Feb. 16th and March 16th. . • 80
Bemaining in Hospital, March 16th, 1882 ... 45
The number of new Out-Patients during the above period has been 644.
The total number of Out-Patients* attendances for the same period has been 2,154.
BBITISH HOMCBOPATHIC SOCIETY.
Ire Seventh Ordinary Meeting of the present Session will be held on Thursday, April 18th (instead of the 6th), 1882, at seven o'clock, llie paper by Dr. Meyhoffer, of Nice (Corres- ponding Member), which was deferred from the January meeting, will now be read. It id entitled *' On an unusual Case of Pul monazy Disease.'* YoL 86, No. 4. s
246 COBRESPONMNCE. ^SS&^^SS'S^.
CORfiESPONDENOE.
THE UCENTIATESHIS IN HOM(EOPATHY.
To the Editors of tlie Monthly Homceopathic Eeview,
Gektijbmem, — 8iBoe writiiig to yoa on this subjeet last buobIIi, some further objectioDe — ^not then anticipated by me — ^bave been made by eoQeagues to the step takeii by the school ; and, at these seem to me readily met, I woTild ajk yoa to allow xfte to say a few forther words in reply to them.
(1.) Objection is taken to the term *' Licentiate *' as implying a '^ license," and this meaning a permission, without which some given proceeding is unlawful. It is alleged that no one needs such permission to practise homoeopathy^ and hence' that *' L.H." is a misnomer and an absurdity. Now, I do not deny that this is tbe etymological and lexicographical meaning of a << license,** but I do deny that the usage of the word in the profession fixes such significance upon it. Take the '' L.M." already cited as an analogue, and which is bestowed, not only by the English College of Suxgeons, but by several universities and by the great obstetrical establishments of Dublin (which last are not even chartered institutions}. Can no one practise as an accoucheur who has not obtained this license from one of the examining bodies which give it ? Everyone knows that it is not so. The L.M. is simply a special evidence of capacity — a warrant on the part of the bestowers that its recipients are com- petent to work at the art to which it refers. Such will be the licentiateship in Homoeopathy of the London School.
(2.) But it is further objected that the proposed action is «' illegal" — that the school has no authority from the State to bestow a diploma, which therefore must be '< a sham/' I confess that this argument has very little weight with me. I have yet to learn that no title can be a reality without legal imprimatur. I have all an Englishman's respect for law, when made, but I cannot admit that nothing exists without it — ^that everything extra-legal or pre-legal is therefore valueless. A diploma granted, after study and examination (or their eqoi- vsJents), by a duly organised body of five years' standing (itself composed of duly qualified practitioners), must have its own intrinsic worth. State sanction may recognise and (as it were) patent it, but that is all it can do,
I cannot allow, therefore, that the school would be going beyond its rights were it at once to accord to the eighty or ninety men among us who have asked for it, the diploma of Licentiate in Homoeopathy. At the same time^ nothing would be lost by so far deferring to the difficulty felt^ by some as to atispend further proceedings till incorporation has been sought
S^S^^!^^ COREBSPONDBNCE. 247
for. I believe that the xnaDagers of the sohool are about to take this step forthwith. Both the friends and the foes of the new diploma maj wdl await the result.
I am, Gentlemen,
Faithfally yours, Brighton, March 11, 1882. RioOABn Qua^BS.
'm^m^m^-^^^^^^'^'^^— ■ in« |..i.., ,>i
THE LICBNTIATE IN HOMOEOPATHY.
To the Editors of the ** Monthly Honucopathic Review,*'
GsNTLEaiBN, — Hie institation of a diploma by the Xiondon Sehool of Homoeopathy has given rise to so much oritioism sacl excitement amangst the members of our body, and so much difference of opinion exists as to its value, that I should like to mrite a few lines on the subject.
It would on many grounds be a good thing if we oould ha?« the knowledge of homoeopathy possessed by young man tested before they commenee practice. Having passed such an ezami* nation would give thAm confidenee, and would inspire confidenee in those of ua who may wish to inbro^uce patients to them.
But I woold ask, is a new diploma necessary for this purpose ? I ftm not aware that any autlK>rity or power has been conferred upon the school entitling .them to grapt a license, and without SQch authority, which can only be conferred by a charter, I do not see what right the school possesses to give such a license.
On the other hand, were tiie school to appoint a board of examiners to test the knowledge of candidates, and to give to snob as succeeded a certificate of competency, the only purpose for which the license is to be granted would be fulfilled, w}ule the possessor of such a certificate might, by virtue of it, be fleeted a member of the London School of Hoxomopathy.
It would, of courSiB, be understood, or rath«r diatinclly stfited, that after a certain date no certifieate entitling to membiNPphip would be granted except after examination.
Those who have been engaged in pwetising liowiOBopatliy ket two jsars might be allowed, on a petition si^o^ed by three w^ IpuQwn ptaetitioners of ten years' standing, to r^o^ve the ^rti6c«(e or be admitted to memhisrship, if the af>p)ioiitiop were sent in b^fiofe the end of the year. In eadi and oveiy oas^ the 0Ax»didf^t« 9JtM>idd be a doiy registered praetitioBar.
I think such a plan weold remove maoiy objeetions to th* ivopoaed L.H., and would answer every purpose whi^ that ^loma is proposed to fulfil. It would entitle the member tn w four letters instead of two— Member of th^ LooiIoa GkJiMi o H<wioK)pathy. I am.
Your obedient servant, Umh l(Hh« M,B.H^
s— 2
248 COBBBSPONDBNCB. 'S^.^pJoiftSt
THE L.H. QUALIFIOATION.
To the EdUan of the** Monthly HonuBopathic Eeview.'*
Gbntlembm, — Abseneefrom England having prevented me* giving my vote in the British HomoBopathic Society in favour of the resolution that the proposed tiUe of L.H. is damaging to onr position as members of the medical profession, I ts^e this* opportnnity to express my cordial appro^.
I see no analogy between certain diplomas, signified by certain letters denoting the great divisions of professional work, Modi- cine, Surgery, and Midwifery, and the letters L.H., Licentiate in Homoeopathy.
It is illegal, and the idea of issuing it is most inconsistent with the clause in the Medical Act which declares that the holding of any peculiar medical theory shall not be a bar to legal qualifications. With this as our Magna Charta of protection, some of us attempt, by the creation of an L.H., to limit the power to practise unless subordinate to a medical theory, and yet these men petition fer liberty I It is the use intended to be made of this L.H. which constitutes the offence against profes* sional ethics. One object, as stated by its supporters, is to point out to " patients desiring homoeopathic treatment the men they should seek.** • • " It is to one going to a new field of practice, giving him a daim to the support of the homoeopaihi& public.'*
These seem to me purposes which, in our peculiar position, invite the charge of " trading on a name.**
If the L.H. is to be useful as a mode of publishing his prac- tice, the holder must bring it prominently forward, and then he professionally errs. To avoid misapprehension, I wish to draw a very clear distinction between certain faults in professional ethics and moral delinquency ; the two are totally separate^.^.} a solicitor may rightly seek for business in a maimer which, if pursued by a barnster, involves a marked breach in professional ethics ; the Medical Act empowers a medical man to recover in court amounts due for advice, the London College of Physiciana considers such procedure a grave offence ; the tradesman may rightly and honestly advertise his goods, but old and wholesome custom holds such course reprehensible in the professional man. Let these instances suffice to show that when I make a charge of breach of professional ethics, I disclaim the very thou^t of impugning the honour and morality of those who, from my etlucfd standpoint, are transgressors. Isolated as we are, we cannot pitdi onr ethics too h^h.
What encouragement does this L.H. afibrd to any man estab- lished in practice, joining our ranks ? Hitherto this step has only brought <m him obloquy, but were this course of the sehod
jS*i?5Sn^ OORBESPOHDKNOB. 249
4uiopted, he must make np his mind to the still further ordeal of qualifying as an L.H., in order that he may '* claim the support -of the homoBopathic public." If he does not possess this L.H., then *' the non-possession of it will be a ground of suspicion of his knowledge of this mode of treatment."
Instead of this step exercising '* a wise foresight," it is, in my o{nnion, most ruinous, instead of being *' a measure of d^ence," it is the most destructiTe course which can possibly be taken. We are urged to take this step '* topreyentour benign and scien- lific system being brought into disrepute by men who know nothing of it." . • • '* to protect the pubUc from being taken in by a man who from any motive proposes to practise a system •of which he knows nothing.*'
How the whole history of the struggles and course of the homoBopathic system in this country utterly refute such state- ments.
How have we hitherto existed for nearly half a century ? If such 'dangers are now ahead, they never can be met by such futile ^measures as the granting of L.H.
A title illegal, sectarian, a lieeme which may be assumed by any jnany or given by any body.
With equal legality HoUoway's clerks, " two being a quorum," might meet in council, and in order to protect the public, estab- lish an L.H., none genuine but the licensed HoUowayist.
If a scheme were desired to foster the growth of crypto- homoeopaths, here it is amply furnished in this L.H.
I trust the school will wisely reconsider its policy, and reserve its energy for its true function of teaching. Let the value of this be the student's reward, and not the emptmess and mischief of the title L.H.
I am, Gentlemen, yours, &c.,
Francis Black, M.D. Edin.
THE L.H. DIPLOMA.
To the Editors of the " Monthly Honusopathic Review.*'
Qemtlbhkn, — ^Nothing has occurred in the whole history of iiomoBopathy in this countary that has excited such a deep and wide-spread feeling of disapprobation as the proposal of the school authorities to issue a license to practise homoeopathy. The cause of this feeling is not'£ur to seek. Such a step, if persisted in, will, beyond a doubt, seriously compromise our whole body of practitioners. There is one thing on which, above all others, we have * always been able to plume ourselves, and which our bitterest enemies have admitted, vis.: that in our /professional conduct generally — ^putting aside the question of our
250 CORRESPONDENCE. *S^,^SSTfSBr.
mddkal docbriiifis-^we kave borne ooraelyee like high-piineipbd and faonoiitable men. One of the leading objects of tiie BritiBh Homcsopatiiie Society has alwayfi been to maintain amongst vs- tiie highest stand of professional ethics. Institute a spoxionft diploma, and we instantly forfeit our claim to this position ; and what do we get in etchajige ? An empty and deceptiye title ; for a Ueenee implies an authority to do, under its powers, a Bomethiag thiyt we haiv no right to do without it. The proposed L.H. confers no privilege we do not afaready possess. The oaly way to check this mischievous absurdity is by a univezsal rejection of the proffered boon. It is difficult to believe that any one amongst us can be so devoid of self-respect, or so blind to the obligations he owes to the noble profession to which he belongs, as to accept a self-made and unauthorised diploma. If a etndent wisbes for a certificate of having attended lectures, by all means let him have it. It is a right and proper thing to give- It says honestly what it means and no more. It mideads nobody, and nobody would object to it. But an unreal and meaningless degree is a delusion and a snare, which no man wiUi a spark of professional pride would for a moment think of assuming.
Is it too much to hope that the promoters of this scheme will bow to the votes of disapproval that were adopted at two recent meetings, and iet the matter drop ? Such a result would, I am sure, be hailed with the liveliest satisfacti<»i by a vaet majority of our body.
i am, yours, &c.,
B. YELDHaiC
THE L.H. QUALIFICATION.
To ike Editors of the ^^ Monthly Homeopathic Review,'^
Gentlemen, — ^It is my only hope that the circular I have just received from the Secretary of the British Homoeopathic Society will once and for all settle the question of the diploma of Licentiate in Homoeopathy meditated by the London School of Homoeopathy, lliat circular is to this effect : — ^At a meeting of the tfooiety lately held a resokition was carried by a two to one majority^*-'* That the pn^sed diploma and title of lieeatiale in Homoeopathy, resolved on by the London School of Homcso- patho, as contrary to the spirit of the kws of this society, aad cakmlated to damage our position as members of the medieal profession." I heaitily endorse that resolution, and cannot help believing that, on reconsidering the matter, the school will, do 4K) too.
To grant a iieentiatedk^ is a serious thing lor the school to* do. It is estaUishiaK a new precedent in medicine. I know
£!!iSi?i£Sn» "^ OOBBBSPONDBUCE. 251
nothing in its past history analogous to it. A small fraction of the medical bodj of this coontry, a small minoHty of that fraction eyen, have constituted themselves into a school, and a resolution has heen come to, not a unanimous one, by that school, that it is right and expedient to give to such of its aluwmi as have Buooessfiilly passed aa eroniiiMttioa a diploma of fitness to practise homceopathy. Bown to Uus date a diploma in medieiBe has been a legally recognised doanmant. But the school proposes to confer a distinction -which -will have no legal vabe, which will probably in many eases not be made use of > if it is not refused, by those to whom it is given^ which will he disapproved of and condemned by most of fiie existing homoeo- pathic practitioners, and which will have the effect of widening the already large breach betwixt ourselves and the old school, to say nothing of that between parties in our own ranks.
And cut Ixmo ? If it could be shown that our own interests, those of homoeopathy and medicine, those of the public, could he advBDced by this innovation, this leap in the dark, there would be some justification of it. It jnight in such case a{>p«ar to he ahaost a neoessitj. £ v«n then, however, it would be unwise to make it in the face of the resolution of the British Homceopaiiuc Society. Such an innovation would re^[uire ios its jnstifieation the unanimous, or almost unanimous, approval of the whole homoeopathic body : and that approval it wiU not obtua.
To say that the step is not a seetarian one is oontraxy to the fitct. Whatever has tiie effect <^f rounding us off into a distmct body, and of throwing us more out of the pale of recognised medicine, must be sectarian, and tiiat this liceotiateship will have that effect there can be littie dofubt. B is said, also, ttiat the diploma will not constitute a license ta practise. But if the non-possessor of it is looked upon with suspicion, as it is said he ynSL be, then he will feel himself compelled to qualify hnnself for it before he settles down in practice. To him, therefore, it will be a license to practise — ^that is to say, the diploma will be.
But though some beginning practice will append the letters L.H. to their names, a large proportion of the medical men already in practice will not do so. Our body will then be divided into two classes, the licensed and the non-licensed. Is this desirable ? It is not sufficient to say that all can possess them- selves of the diploma. All will not; and the result wiU be division and dissension amongst ours^es — a pazded public, and a profiossion stiU more alienated from us than before, and mih a good jnstiftnatfcm oC theiar alieotttioB.
Brfore this apple of £scord is thrown into our mMbt I hope the school will seriously reconsider the matter.
Your obedient servant,
C. B. Eeb.
252 OOBBBSPOKDBNTB. ^S^^aSTTISS?
Btriew, April, 1 UNI.
NOTICES TO CORRESPONDENTS.
0% We cannot undertake to return rejected manuecrijgU.
"Dt, TuTHiLL Masbt wishes us to state that he has zetnzaed to Brighton, where his address wOl be 18, Powis Boad.
Ck)mmTinioations, ^., have been leoeiyed from Mr. OaiMBBft (London); Dr. MoBBissoN (Gamberwell) ; Dr. Bates and Dr. Hughes (Brightan); Dr. GuFTOM (Northampton) ; Dr. Batmbs (Canterbniy) ; Dr. Woodoahs (Beigato) ; Dr. Masst (Bednill) ; Dr. Mjlddbm (Birmingham) ; ICr. Kxox Smaw (HastingB).
BOOKS RECEIVED.
The Human Ear and lU Dieeaeee, By W. H. Winslow, HJD., HlD. New Toik: Boerieke & Tafel.
TrwMoctione of the State Homaqpathie Medical SoeUiiff of Pem^ tyUHaUa, 1881.
The Homaopathie World.
The StudenVe Journal.
The Chemitt and Druggiet,
Burgoyne^e Magaeine of Pharmacy.
The New England Medical Qaeette.
The Hahnemanaian Monthly,
The New Tork Medical Timet.
The North Amertcan Journal of Homceopathy.
The Medical Advance.
The Clinique.
The Therapeutic Gazette,
The Medical Couneellor.
Boerieke and TdfeVe Bulletin.
BihliotK^ue Homceopathique.
AUgemeine Horn. Zeitung,
El Criterio Medico*
BoUetino Clinieo.
Papers, Dispoisaxy Beports, and Books for Beyiew to be sent to Dr. Pope, 21, Henrietta Street, CaTendish Square, W. ; Dr. D. Droi Bbowv, 29, Seymonr Straet, Portman Sqnaxe, W. ; or to Dr. Ebhkidt, 16, MontpeUer Bow, Blaokheath, B.E. AdTertiaements and BosineBa eommnnioations to be cent to Messrs. E. Gouu) dt Sov» 69, Mooigat« Street, £.0.
MSS^SSTvm!^ HOir<BOPATftY IN NBW YOBK. 263
THE MONTHLY
HOMCEOPATHIC REVIEW
HOMCEOPATHY IN THE STATE OF NEW YORK.
In no part of the world has homoBopathy had to encounter A greater degree of bitterness of feeling from the allopathic sect than it has in the United States of America. In spite, however, of diatribes against it, in spite of the expulsion from States Medical Societies of those members who have openly avowed their faith in homoeopathy, in spite of regu- lations by the American Medical Association of the most stringent and arbitrary character to prevent professional interconrse between homoeopaths and their opponents — ^in spite of all this and many other devices to assist in the fulfilment of Dr. Oliveb Wendell Holmes' 1842 j)rophecy — ^ihat in a few years from that date a globule would be as rare and great a curiosity as a Perkins tractor was then — notwithstanding these many and ingeniously devised efforts, homoeopathy has progressed in public and in professional favour more rapidly in the U.S.A. than in any other country the world over.
The effect of this progress is now making itself apparent in the altered attitude which leading men in medicine are flflsuming towards homoeopathic practitioners, in the altered tone in which they speak of them in medical societies, and write regarding homoeopathy in their journals. Yo]. 26. No. 5. T
i$4> HOMCEOPATHy » NEW YORK, ^^^S^^SyTtttt
Of this we have very fall evidence in the New York Medical Times for March — a journal devoted to the interests of medicme in general and of homoeopathy in particular.
First of all we notice that the Medical Socieiy of the State of New York, having recently adopted a new code of ethical rules, unanimously agreed to the fbUowingi as that which should govern consultations : —
« Members of the Medical Society of the State of New York, and of the medical societies in alBliation therewith, may meet in consultation legally qnahfied practitioners of medicine. Emer- gencies may occur in which all restrictions should, in the judg- ment of the practitioner, yield to the demands of humanity."
The adoption of this resolution has created a good deal of remark, not only in medical circles, but in the public press. The Albany Argus, for example, regards the new "code" as "a great step in advance.'* " The eflfect," it says, '^ of the action of the State Medical Society on the matter of professional ethics is significant. • • •
*' The amendments adopted enlarge the limits and freedom of consultation to a degree that practically removes all restrictions, by giving the practitioner full liberty to construe or waive restric- tions in the iaterests of humanity or commanding exigency. • .
" The persistence of the profession in a policy which pro- claimed its sense or theory of inability to trust to the honour and conserving power, of which its educative processes are the factors and its personnel the guardians and exponents, has not dazed laymen, for they knew the precautions and traditions on which it was based. They also knew that it had survived the necessity for it and would soon go to meet the effete causes which called it into being. It may be said that medicine cannot insure eveiy one entering it being a gentleman. Neither can any profession; but medicine and any profession can insure a great mugorityof every collection of its members, in every community, being gentlemen, and the associated principle of action among doctors.
IS^SS^rSSi!^ OMKEOPATBT IN NEW TORE. MB
I ~ Ilia- ■■ . ■ I «.
•eenres majority nile, and tiM Befofiiit suprtmaey and gorern*^ ment of genUeman, The argameiitof doabt and dislniat anawem iftaelf , wlaen pioparlj ezte&ded. • • .
^'Thefomial oblitaraikm of the ban of separation in feUovship and aeti<Ki bettireein what are misoalled allopathy and homcao* poihj, ifl the zecognition of the indiriaibiliiy of the eeienee of mfadieine, whieh the inteUigenoe of the age Icmg ago realised, whieh the action of progressive dootors, of both classes, long agb* taeitly effeeted, and whieh the enlightenment of patients long aga praetieallj insisted an apid seoased.. The age has oanse to con* gratolate itself on the results aeooied and the &ot that foil liberty no longer knocks at the door^bot is across the threshold and wiE 0ocm set up housekeeping as a foil owner and not as a mere gnesi or tenant by eonrtesy. . • •
" The Society has broken the back of the ancient medical code. Consaltation with legally recognised physicians is now permitted* Oansnltation with anybody, under such circnmstanoes as sound a paramount call to humanity, is pennitted. The physicians are to be the jodges of the circumstances. The progressiYeness of the society is one of the sensatums of the times."
Then, again, the discnssion of the questions inyolyed ia consultation has led to the examination of homoBopathjr itself at the meetings of medical societies. Thus at a meeting of the Wayne County Medical Society (Michigan) —
" Dr. Devedorf read a paper on * Consultation and Affiliation with Homoeopaths.' He took the ground that as regular physi- cians, we are bound down by no dogma, but that with the whole fidd of nature before us it is our privilege, with perfect con- sistency, to choose whatsoever is of value -in the treatment of disease. We acknowledge no universal law of cure any niore than we recognise the existence of any universal panacea, but profiting by the labours of our professional brethren, in the laboratory or in the sick room, accepting nothing on any one's ipse dixity it is our duty to submit all to the test of our own experience, and then to accept or reject according to the result of auch test. Let us in tins process avoid bigotry and not wrap
T— 2
266 HOM(EOPATHY IN NEW YORK. ^'^SSSL
onnelYes in a garment of ezoliisi^«iieiS and oiy out to ihoBo lAo differ from ns, * stand afar off; thou art miclean.'
** Homoeopathy was the outgrowth of a reaetion in medidne. When it came to ns, a few years ago, its supposed noveltf attraeied a certain class of peoj^y who afkerwards became its allies and champions in consequence of the fierce and bitter warfiue waged against it by the so-called old school physiciaBi. The ranks of its practitioners were filled, firstly by those who, though few in number, were honest m their opinions and edn- eated in their profession. Secondly, by those who, devoid of honesty, were shrewd enough to recognise a partial drift of puUie opinion and a^ail themselYes of the current to achieve snceoai. Thirdly, and most largely, by the ignorant, who discovered here new fields of labour. But the years which have passed have wrought a change iu all this. There is in the universe of mind A law analogous to the grand law of gravitation, which rules and controls the physical world. In obedience to this law eocentrie movements are corrected, and the pendulum which maiks the oscillation of public opinion, firom one extreme to the other, tends at last to fiiU and rest at the centre of gravity — ^which is truth.
** And so with homoeopathy, after the first few years in iviiich ignorance and irregularity in its practitioners were overlooM and condoned on account of the attractiveness of a new doetriue, there came a change ; its followers, the charm of novelty having worn away, discerned the fiiolts of their leaders, and demanded physicians of a better dass, men of more honesty, better edu- eation and higher cultnre. In response to this demand, better men have come to the fixmt, and ignorance and dishonesty are being crowded back.
" The educated homoeopathist differs in no material respect firom the educated regular physician. He recognises the &ct that there is a truth in the dictom simUia dndUbut eura$Uur, but scouts the universal i^fdicability of the dogma as a law of cureu The thoughtful and observant physician of any consideraUe experience cannot but have recognised a truth in the dogma, and in so far as it is true it is his duty and privilege to accept it
ISfSSH^y^TS^ HOUOBOPATHT IK H8W TOBK. 267
Zkb troth aiioidd form % oftmmoti ground an whieh honMBopfttli and regolar ahonld meet. As educated men there can be no diftranoe betvreein them except on the qaeetum of therapeatics, and this is not the only qnestion inTofared in a consultation.
''Dr. DeirendoKf 'wovdd adTocate the meeting of homoaopalhs in eonnseland go with them as&r as pofnible, reserving the rif^ in SQish oonanltationj as in eonaoltation with a ' regolar/ to differ and to give his reasons for so doing when his yiews are at laiianee with those of the consultant, and thns throw the case into the hands of the patient fat decision as to who should take ohaxge of the case. In this way, he thonghti homoBopathy would Booaoet be brooght to its proper level. This coarse would deprive the system of the pahnlnm, on which it thrives, viz., persecntion. * Let ns,' he said in condnding his interesting paper, ' hold firmly those things whose tmth has been established ; let us be ready to give up and cast aside all theories, however dear they may be to US, if they are proven false. We are yet groping in the dark ; bets whieh long years of experience have placed in our pos« seseion, dnes that we have laid hold upon, seem oftentimes to lead us in diffinrent and even contrary directions ; but I am t(mr fidant that in the iatore they will all be reconciled, for I believe that back and beyond them all, there b one grand iherapeutio law, which will be revealed to us when Jifo and its processes are no langac a mystery.' "
In the discnssioit which followed Dr. Mtjlhbron said :— ^ «« Homceopathy is too often condamned at sight, and without a previous enquiry into its nature. He had taken some pains to look into it and was convinced that it contained a very unportaat law of cure— one of the laws of cure, for there are severaL There is not a physician who does not daify unwittingly treat diseann aeoordiug to this law. He instanced the protective infiuenee cl vaccinia against vanola, the local application of the mitigatml stick to granular lids, the iigestian of a solntion of nitrate of silver in dysentery, and the appUcstion of a blister to m old, ill-eonditioiied ulder as indispntaUe iltestrations of thO' ^Mttking. of the kw of simiiiB 9imUibu$ turuntur. There is a
$68 QOMOiOPATHY IK NAW TOBK* ''t^^SclSTim
imth in hoznQBOpaiUiy and it is tlM 4aiy of the laagniar pfajmbm to ntUifle it."
. Ajid ihirdly, passing from the societies to th« joiinialB» we find Dr. BEODiB-^the PresideQt of the Wayne Connfy Society — ^writing as follows in the I^erapmtic OazMe^ ol wliieh he is the editor : —
*' Hie qfuestion of the propriety as well as the possilrility of regnisr praetitionen of medieine, so-eaHed, holding eonstdtaiictt with faomoBopathie physieians ht the bedside of the patient is om wfaieh has reee&tly come prominently to the front in England, partioulariy dnring the past year. And although drenmstanoes have favoured this prominence in that coimtry, the qnestiea is one in which the profesAon of this oonntty are not less interested, notwithstanding the fact that it has received comparativeiy litfle attention on this side the Atlaulio. Our British brethren are anything but liable to be easily distiubed by trivial causes, and the fact that there has been a very general discussion on (his subject, pro and am^ in their medical societies and medioal journals, indicates a deep undereurrent of interest in the matter. This discussion indicates a veiy marked change in sentiment from that which obtained even a decade ago, when to have entertained the proposition of consultation and affliation with the homcBO- patbs would have cost the physician most exalted in his profession, his rank and even recognition as a respectable prac- titioner. But the world moves, and to-day we find those hi^ in authority in England-^msn who for a fnU generation have been bri^t particular -stars in the medieal firmament — not only enter* taining such a proposilion, but actually meeting at the bednie those who pin their frith to the law of similars in iherapeutieSy and their standing is not pereeptibly affected by the act.
** We, in this eountry, notwithstandii^ our daims to inde* pendeaoe, are stiU largely doaiDated byBnrqpean aathority, and fte fret that the movement indicated is on foot across the seas makes it adviaahle for ns» mndi as we nugr ditfke te do so, ia oast about for an. easy place en which to drop from the high poaition wa hare assumed on the ^pestion of fte lecogoBtione^
wSSSS^'SStu^Sl^ boikbopatht in kbw tobk. 35d
Moi ftftlitttion wiftkt liomcMpailiy. individually, the pill woqU !>• as yet a.Utto one&r os to awaUow, but the yeet lew yeen iiane veetedit inth eeveial layen of e^gu eoetmg, and we eannol ^eloee oar ejeB to the poattUUty of the additkA of eneh layers ift Ae eottparatirejy near foiiire as wiU render it fiur from die- iaetefiiL Xhe laet o£ the loatter ia, there is a ehange going on, aad the eonditiooa irtneh render the pvopoeitum to conenH with A hamoBepath, a few yean age nflwve to eveiy eense of ethieal and Mientiie propriefy, have been vexy largely eliminated from ihe foeetf^tt^ -We can remember , when the term ' homodopath^ "wae ptaeiieal^ qmanymooa with ignonmoe of the fandamentale ^md eHfwmfa'ali of medieine in him who sailed nnder that eolonr. We can resMmber, too, wlien among * regolars ' methods whieh sxe now regarded as erode were held in hig^ fsToar, and when the saee^as of the dose was apparently largely eonditioned in its aaaseoiUBiesai The paet qnarter of a centnry, however, has wroni^ a very material ehange in these regards. Thehonueo- jath haa foand that something mete than a mere paktabiiity of iue medioinee is neoessaiy to souessfol therapeosis, and the -* regular ' that palatabiliiy is in ihrnlf not only an onobjeeticmable psoperfy of a dose, hoi thai it is one which shonld be positively 4HLltivated« Xhe hoUHSopath has &i»d (hat a little more than a tineture Jot moonshine {s neoeoBaiy to therapeutios, and the -'regolar' thait a little less tha^i forked lightning will, in a m^oriij of instances, anvwer aIl.praefioal paosposes* Xhns the two have been gradnally appnoaching each other from c^posite di^reetions, and it is not b^^nd the bpnnds of the poesible-^t is, indeed, within those of the probable, that they may, in the not distant future, get near enongh to clasp hands and laa|^ together 4yver the eoasnnunate idiocy of their graoddaddies.
** The fast that there is a troth m l^omcBopathy will scarcely he •denied by a^y one who has taken palps to investigate its claims* Booh willalso scarcely deny the fiiet that. its former daim of the muyersalajpplicabiUty of the law fit dmiim dmiUbu$ curcur^r is nmtenable. It is, lorthermore, we believe, an indisputable fiuft ihat nine-tfnths of those who to-day style tMiq^vef ' hcHPacaa*
260 BOiKfiOPATHY IN KBW TOBK. TSS!SJ!uS^hwS[
^attm ' aure soeh only m muooe — fbmi is, that iksy da not pnoiiae what the BBme Qnder ndiieh ihey Mil imiilies, fii., thai thej prescKibe, under ell dieoBftuiMe, on the theoiy that the in^ given prodneee in the patient a modified iona of the eijeluig dieeaee whkhy running ite eonne* ezhaoste the saeeeptibility of the eyetem to the oiiginal diitafeing cenae. Ineofiur aaihejdia not do this they are ineoniintant, if not aetnally dJehoaaat, and herein lies the chief ol;9eetMn to oar affiliation irith thenu Aaeoimng the dietbotive nama^of homcaopatti, honeefy demanda ihat they ehoold fellow eneh praetiee aa the name imphea, to ita legitinaie conelnsionB, It ia oar priYilegey not being boond doimt hj any tradition or name^ to preicribe honuaopatfaicaUy ahoold we eooehide that» in a given cMe» aaeh pzaeeiiption be piopar, bnt the homiaopath aa such, moat traTel in the nairow rot of hia dogma. Let him who now ohana ia be a honuBopath, b«t vHia ia only partially mohi stiike from hia sign the distinetm iqipeUar tion, andif he be an edoeated man» that is in sach essentiala of medicine as constitute common gioond between all * schools ' of tbarapeatic8» the day of the affiliation with those now yelepi honuBopaths will be broo^t qoite near."
Then, again» Dr. Sfbbb pabKahea the fbllowfaig reioaik- ably ontspoken article in a reoent nomber of the Me^Ucal Becard — ^the leading medical jonmal in the United States : —
** Although homoeopathy has bean received with derision by a vast migority of the medical worid, it has steadily progressed in favour, overcoming obstacle after obstacle, untQ to-day the ^stem of mediobe founded upon it numbers among its patrona and steadfast friends a large proportion of the more inteUigeni and cultored people of each community. It is recognised in some of our universities. Our State Boards of Health are in part composed of homoBopaUsts. Some of our State instita- •tloBs are controlled by themt and in a late number of the Medical Bscard it is announced that the Bh^hamton Aaiylam for the Insane has been placed under flie medical charge of a homceopathist. This is the second asylum for the insane in the "State of New Yoih under homoeopathic control Oonsultatkni
tS^,SSTSmf^ HOMOSaPATHT IN KBW 70BK. 981
irittt bomiBapttttysti has bMn adtOMied by tueli mm a» Joiu41iftii HniahjnBoa and Jahn Sjer Bxistow. With Mich £»t» rtaring US in tha &(0e, it b^ooiftMi otir dnty, as honaat pneti* tioBfln of tho faeatiiig art» ta iavestigftti, ealmly and ihoroDghly, the dainaB of homoM^thj, and if we find thai it teaohes the ase of any mnediee whieh, used aocofldiiig to this syatam* are more iUDcesafiEd in the eare id diseaae than those lemediea we have Jbeea tao^t to piesetibey we are boUad by ho&oor» duty, to say aothiiig of self-interest, to ase them* The sobgeet is too Tast to be eonsidered in a single paper. I shaU, therefore, seket two medicinal snbstances, viz., acomU and mercuryt and shall try to psoTe, by onr own standard aathorities, that when we are aneeessfol in treating diseases with them, it is in accordance with the homoBopathio doctrine, and althongh all sorts of explanations are advanced as to their modus operandi^ the plain simple iiMt is, that Hahnemann gave the symptoms and treatment years ago that PtofiB. Bartholow and Eingor now emphasise.
^' Are we better qualified to-day, so fiu: as having a definito knowledge why we nse certain drugs, in coring disease than we were fifty years ago ?
" Will any gentleman present es^lain to me why he uses. mtreury in any disease ? Have we really made any progress in the practice of medicine except what has been forced upon ns by those whom we regard as icregidsr practitioners ? "
These are serions questions, and should command omr .earnest attention.
After going over the curative action of ocontt^ and mercury^ Dr. Spseb shows that the special indications for the drags are alone found in homoeopathic authorities. In reference to mercwry he says : —
** Kowy gentlemen, after the statement of Prof. Binger, that in one form of dianhflsa UMaride of menmiy acts more satis* fceloriiy, and in another form gray powder, where shall we go to* obtain some explanationor reason for this? Have we an author
fl02 JicanE^iiTET tk hew tobx. *lS^fO!'iI'St
,wlio will point it oat to m ? If «» hwra, I hftve &iled to toA lum. Oa the contrary, the mere I fltwKed Ifce maHer ths -gr««(er wu m; coofodoB, oatfl I Mof^t m hDmoMpKUu« wgritt Jin- ft Kdaiioo, &□! then I fband it dear ntd Blnpls ; and I -aa/j flftf that the indio«tioiu for the ose of Um diffarent HMrotaid pMpanticBBs as poiotad ont by fte eailier homeeopathie writenf, AM thoM by wfaioh they are now -gorenied is praaBoe. Wt adopt the treatment em^ieidy, koA aie in a measoi* tracMW- fbl ; bat not neogniang the taw \^ wbiiA it is admiiiiatared, in me the lemedy at a great disadnaitage.
" lliere are tvo things in homisopathy that at once antago- nise the regular physidan. The similia principle, and the size of the doBB adminigtered ; and the feeling is so bitter, that Bcorcely a phynctan can be found who will make the least InTestagafaon of it. The principle of eimilia, &a., no matter how much ve may deny it, is stiQ the only one by which we can «xplain the action of many of bar most potent remedies. Second, in administering drags, we aim to give jost enoa((h to prove cnratiTe in the disease we are treating. No school of medicine, I bdieve, attempts to do more. Homceopathiats elium tliat ihdr method of preparing drags is saperior to onrs, and that they can obtun the same lesnHs irith mncfa smaHer doses. Dr. iSaiej (Homaopalhte Thmtn/ tmd Praettet of VeHeitu, page 119| 18S0), writfa^ on this snbjeet, says : ' Tlte advantagee irtdcfa w -obtain from a miimte sabdivifMHi of cnida anbstancefl ar« ai iaiOwB : —
" ' Fint. — ^We develop every part of the aetJTe principle per- taining lo the snbsbwce by breaking np all natural organiaation or arraogemeot betw«en its molecnleH, and thos exposing » large 1 of octet'* Bor&ce, which would otherwise have renwaed
'ieemd. — By diatnbatiiig. tiieee molerake intimately boat an inert vebiole (sogac or mter), thay ace iu duxp absorbed by the deliaate laeteals and abearbenta Ihaa and irritating partiolei of matter.
Uajh
jscmasoPATHT m new toik. 388
** * ThMU^^Whrn tbtat niniiis slonB htan been oouYeyed hf •ilie blood to thoee putB witti which 4hey htt?B mi affinity, thoj iponetcmte tfaa nudlcst TesMb, iapnss the minQtett sentient nerves, and become productive of resntti entiveljr anattBinable hj JxngB in a orade fi>na»
'' 'F(iNiri4.~Ihiriag the aeiof «iibdimioii it is not improbaU^ 4luit the atoms of dragB sonoMiunes beeeme oxidised, and thw acquire new and inoreaaed powesSb
" ' FinaUy, — ^We. in&r that no new pnopeitaas are developed l>y the homoBopathic method of preparing drags, except such as arise from the mere anbdivision of their particles, and that all ideas respecting gpintuaUBoUonf dynamisation^ and magnetism in the preparation of medicines are erroneous and mitenable. In regard to the repetition of doses, we are to be guided by the -acute or ehronie nature of the mah4y, the orgenoy and danger of the symptoms, and the effects produced by the medidae.*
" Dr. H. G. Piffard, Professor of Dermatology, University of ITew York, in his McUeria Medica and Therapeutice of tlie Skin ' (article ' Mercury '), says : * Since we have used the tritorationi^ iiowever, in praferenoe to the ordiaaiy pilb, patients more lare^ eomplain of disagreeable sensations. We have further been -enabled to materially reduce the size of the dose in order to obtain the desired effect. In other words, a larger proportion of -the drug is utilised for specific purposes, while but a smaU jonoimt remains to give rise to local irritaiian, I have nothing to add to this, he says, except that I continue to use triturations <of mercury and other substances with increasing satisfaction.'
** Dr. Piffard began with the first and second decimal tritura- iiocB; how much higher he goes he does not say.
" These are aU the drugs to wtnch I shall allude in this paper. Of my own personal experience in the use of them I shall say notliing. My only wish is that we may investigate the subject ^careMly and wisely, and if we find that the principle of eirniUa mmHilnm (Maroa^tm^ even to a- limited exteni, is eosreet, it is our duty at once to admit it. And if the administration of drugs in jninute. doses, in the fpnn of dilntipus.'and triturations, is more
364 EXPEBISHCS WITH HOMIBOPATHT. ^^S^SVjliST
benefioial ttuun irheii giy«ii is the waul fimn and waj, we shoold i^t onoe admtfwladgtt it ; and not only tiiai» wa akould maka good use of them, so far aa they ma.7 go, in troatiiig those who JBAJ be placed in onr eare.
** To alleviate the pain and distress of the siek in the easiest and pleasantest manner posaMe ought to be the eomtant stady of the phyaieiiai, and the simple eizease far not infestigating this sabjeet, that so much prejudice has been aroused by it, is mi- worthy the dignity <tf the medical profession."
EXPERIENCE WITH HOMCEOPATHY. By Idb Stettin, M.D.*
<« I am neither allopath nor homcBopath; I am Batisfied to call mjadf a physioian."— lurBBT GbmtBEna.
I IK) not attempt to engage in the present hot discusion as to the merits of homoeopathy — a discnssion which can aever be decided a priori. Sach a procedure verifies the old adage, Invidia medicorum pessima, I wish only to let fiedr and precise experience speak. This alone is conclusiye on the subject. I wish to show from the daily practice of a non-homcBopathio physician that the Habnemamiian aphorism, HnHlia simiMbus curafUar, is really of hi|^ therapeutic worth, and if indeed, not a therapeutic law, is at least a valuable guide. I wish also to show that small and very small doses work cures'. Such candour on my part may appear at this time critical and dangeroas, but I hold it to be my duty to acknowledge openly what I know to be the troth.
It was no culpable inquisitiveness that led me to stretch out my hand for the forbidden fruit. It was necessity, it was tlie desire to aid my patients in cases which the methods and expmences of the school had left in the lurch; oases, too, which have not been exceptional, but which other physicians also fiedl to cure. I believe thai such a situation excuses the practical physician for solus (egroti suprema lex.
Has it not happened to me — and I know that many oolleagues have had the same experience— that patients
t*-
« Translated from the Berliner JUgemeine Medieinieehe Centrai Zeitung, for the Sahnemannian Monthly, by 8. Lflienthid, M.D.
ts«ated by m for a longer or flliMter period wtthont benefit, have been restored to healthy and aometimes regy rapidly, by homoBopatbio treatment? It is, indeed, nonsenae to attempt a jasiification by claiming the core to be effected by proper diet, natnre, &c* The pnblio do not believe it and simply ask, why we did not nse the same effective means ? I consider it dishonest, and the public look upon it as an evidence of bitter envy, when we meer at homcBo* pathic cnres.
** There are more things in heaven and earth, Horatio, ihan are dreamt of in yonr pbolosophy," and what appears to us incomprehensihle and amazing need not, therefore, be false.
It would be more honourable to admit onr ignorance of this therapeutic method, and to study not alone the doc- trine of homoBopathy, but also with all fiuthfolness and earnestness its Materia Sledica, and to prove its value and truth as asserted by so large a number of physicians.
This was my motive in writing this article and in giving the following Hst of cases, and I can promise any non« prejudiced colleague that he may be in a position to aid his patients more than heretofore, as well as to confer on him* self much peace and satisfaction :
1. Arsenic and DioarrhcB€u — ^That arsenin in small doses causes Tomiting and diarrhoBa, which are not seldom bloody end watery, also great prostration, can be read in any book on Materia Medica.
Kurt BL, St. fiye months was brought to me, suffering with entero-coUtis. He vomited occasionally ; his passages were frequent, watery, with streaks of blood, and discharged as if shot out of a pistol ; moaning, tenesmus, and gieat prostration. My first prescription failed to relieve. I then prescribed aolut. an. Fawleri guttas duos ad 75 grammes (18 teaspoonfhls) aqua, a teaspoonful every two to three hours. The next day the number of passages diminished, and were less watery, with no signs of blood. Instead of this, however, there was oedema of the face, par- ticularly of the lower eyelids, which the mother correctly ascribed to the effects of the medicine. I therefore admin- istered the remedy at longer intervals and in smaller quantities. In three or four days the intestinal secretion was entirely arrested, but the cedema of the &ce still renudned, and to this was added reddening of the ^ges of the lids.
266 EXPBBIBlffOB WITH HOMiBOFliTHY. ^"b^. liiiy i; im^
< These symptoms aie fonad'so frequently to be oMifeMd If anenicy tiaiat I can safely claim that orgenie aeted. And this was due to two drops of Fowler's solution divided over a period of five days.
2. Arsenio and Abi^e$$eB.'^ThBt ar$€mc from long^oon^ tinned application acts injxixioasly npon the akin, producing even deep ulcesatimiBy thair the pains are mostly of a homing diaract«r with nightly aggravations, may be found not only in the so-called Materia Medica PurOf but also in the text-books of the schodl. The frequent exhibition of m^enic in chrosiie exanthemata is thereibre homoBopathic (homoeopathia involuntazia)» Still move striking is its action in peculiar obstinate ulcers of the feet, with great destruction, puffed callouls edges, with hard infiltration of the surrounding parts and accompanied by severe l>uming pains, robbing the patients of sleep and driving tibiem from bed.
I succeeded in curing an nicer of the lower limb in an old decrepit woman who had been troubled with itfor years* I prescribed sobd. Fowleri gvitag tree ad 100- grammei (25 teaspoomfnls) aqua, a. teaspoonful three times a day, in connection with the external use of (d carbolicum.
The pains subsided at once, and the woman was able to sleep the first night after the medicine was taken.
3. It is well known that the antinumial preparations, and especially tart, atibiaius, promote secretion from the respiratory mucous membrane and also from the skin.
This fact enabled me to cure one of my patients homo^- pathically, who was suffering with emphysema and chronie bronchial catanfa, and who every foil and spring had feverish exacerbations of his catarrh, accompanied by pro* fuse expectorations and drenching sweat. Tart, atib, cured the exacerbations in four or five days, though the chronio disease remained. I prescribed tart. stib. 0.01 ad 200 grammes (50 teaapoonfuls) aqtue, one teaspoonfol eveiy three hours. Formerly it took me weeks to accomplish the same resuH.
4. Calcium eulfuratum^ hepar ealeisiy is but httle used lyy our school, and Bematidk (Eulenburg's Real Encgdapadief vol. ii) does not even menti(»i it. And still I should not like to do without this remedy, which is prixed so highly and so freqnently used by the homoeopath. It is therefore no httle satisfaction to me to find that Sidney Binger, in his handbook of Therapevtics, warmly recommends it :
!• In ulcaraiioiis with uDbfioltliy ftm; 2« loflantmfitioiiai which thrertea to exki in Bapptiiati/pn, m its ^xhibiticn j^ventfl its andTing at that sta^e; 8. Id ahready formed^ abscesses, as blood boils and carbonolesi as it hastens the fonnation of pus, the opening of the abscess, an4 lessens tbe inflammation ; 4. In indolent ceUakur tissbe abscesses of scrofoloos children; 6. In scrofnlous disease of the' bones and in scrofnla generally. Now, all these indications' and many others no less yalnable, homoeopathy— Sidney Binger is no hom(Bop%th-^had given us long before Binger.
The similarity between Sidney Ringer and honueopathy becomes still greater when we read that the former employs extremely simdl doses, in reality honxoaopathic doses, namely, 0.003—0.006 with 0.12 sngar of miU;« which ia eqniyalent to the Bd— ^th trituration of the homcaopaths, and the one most frequently used by them. I can confijnm tiie experiences of Sidney Bmger, and as such an authority gives evidenee, although involuntary,* for homcdopathy, it will not be necessary for me to detail specdal oases from practice.
. 5. Arnica is a well-known drug, but is used less by physicians than by the laity; still for all that, it fully deserves its names oifaUkrauty bkublume, wohlverleih.
Among other things, I wish to call alitention to its bene* ficial action in contusions from £bJ1s, and in haemorrhages of all kinds. It makes the use of ice superfluous, being superior to it in its working, aside from its easier and pleasanter application.
Particularly striking for me was a case of contusion of the thigh. The accident had happened eighteen days pre- vious, and cups, cold effusion, and inunctions had been used without any benefit.
The external thigh was considerably swollen, fluctuated. on palpitation, and several loose coagula could be recognised. The extravasated blood-mass was considerable, and the skin showed the usual discolouration. Most physicians would have considered an incision nuide with all antiseptic rules absolutely necessary. I, however, prescribed tinct, arnica rad. guttaa sex ad 100 grammes (26 teaspoonfals) aquuBj 1 teaspoonful four times a day and had the satis* &ction to achieve the desired effect in a JCew days.
For, when the patient called upon me again ten days later, it was not on account of his contusion but for a cat on his finger. He had been working for several days.
EXP EBIENOB WITH HOHtBOP&THT. '
SBTinr. Hit l, UBt
The thigh ritowed oaly a aK^t Bwelling, which did not floettute anj more, utd betweeo the i]pp«r and middle thiid of the Tasta» ext. moBcle one eoold dlathigiuBh % hardnesB, in all probability the site where he had been straek.
I aehierad a no less happy and rapid resolt by the int«nal and external exhibition of arnica in a severe snb- hcaUaoD of the knee, with oonaiderable swelling and effosion in the joint.
6. In thia esse I diBcovered the working of a remedy, tba eflleaoy of which is denied by some. I mean eilicea.
nte patient, who had believ^ himself enred, need his limb too soon and too aererely, produced agun pain and htmeneaa, uid the examining hand conld feel a widespread a«pitalaoD in the fibroas portions of the knee-joint. A three-days' use of nUcea 8d. trit, 0.06 gram, 8 times a day alUyed all the symptoms.
That the working of nUcea here was not accidental is proved by another case.
Two years ago a student brmeed his right elbow-joint. A year ago be fell upon the same, and since then has snffered from pain, stiffiaeaB, and lameness, with slight swelling of the snrronnding parts. Still later the joint was over-exerted in fencing, and when I saw it, fonrteen days afterwards, it was greatly swollen ; the arm conld neither be fnlly flexed or extended, and I conld feel considerable crepitation at the inner edge of the condyle. I prescribed Bilicea M trit, 3 times daily. Several days later, the patient presented himself feeling greatly improved, and fonr days afterwards the joint was perfectly normal.
7. Cantharidts prodnoes inflammation of the bladder, dysnria, and bloody nrine. One will therefore never go ftmiss in prescribing it in small doses for snoh ailments.
On the 6th of Jnne, a patient came to me who was troabled with cystitis, hematuria, and the other well- known symptoms as seqtielte of a gonorrhcea. I prescribed
tharidea guttas tres ad 200 grammta (50 tea-
I agva, 1 teaspoonful, evety 8 boors. The ind pains ceased the s&me day ; on the 8th of urine was still clondy, bnt on the 12th every ladder troable had vanished.
B^fiS^Tien^ '^^^ ^^^ ^^^ ^B^ LAMB* 209
THE LION AND THE LAMB.*
Whatevbb donbt may have existed respecting the desire 4ji the allopathic lion to secure peace and harmony by flwaUowing the homoeopathic lamb, must surely have been dispelled by the events of the past few months. A mighty rerolution is shaking the defences of professional intolerance to their foundations, and the whole superstructure, which only one brief year ago seemed well-nigh impregnable, is to-day tottering to its fall. The apparent beginning of this revolution, beside the death-bed of the late Lord Beaconsfield ; the stimulus it received in the addresses of Drs. Bristbwe and Hutchinson ; the conquests it has received in the Boyal College of Physicians of England and in the State Medical Society of New York ; the marked change in the ione of aUopathic journals ; all these had their real origin in a gradual change of professional sentiment, which only Awaited an opportunity to give itself open and peremptory expression. Looking at the history of medical ethics from the standpoint of the present, we can see how little cause for surprise there is at the sudden change in the attitude 4>t allopathy. It would have been a monstrous injustice to suppose that allopathic physicians were unanimous in the support of their infamous code of ethics. That phenomena! stupidity was the creation of a political majority only ; it no more represented the sentiment of the majority of the more honest and progressive portion of the allopathic school than do the wiles of the machine politician represent* the intelligence and honesty of the great party he professes to serve ; and this being the case, there was really no reason why the overturning should not be sudden and com- plete, when once the integrity and the wisdom of the profession should be able to assert their divine, kingly pre- rogative. And thus it is. The processes whose com- pletion was expected to require years and decades, are being crowded into months, and compressed into days, and momentous events are treading upon each other's heels in eager haste to repair the misdeeds of the past, and to wipe outy if that were possible, the foulest stain upon the page of medical history — the professional bigotry of the nine* teenth century.
Yet it would be a profound mistake to imagine that the
men who place themselves in the forefront of the revolu«
■■ I ■ ^ ■ ' ■■ ■ ' ■ ■ ... — ■■ ■■"
* Beprinted from Hahneynatmian Monthly, Maxch, 1882. YoL 26, No. 5. U
270 TttB HON AND THE LAMB. "aSSi^SSa^
tion are neceflBarily more ^se, more liberal, or more honest than their fellows who are scaroely seen in the movement. The shrewd bat nnscrapuloas politieian always tries to be on the winning side. If we judge these would-be leaders by their actions — and we have no other method — it mast be apparent that their jealousy of honue- opathy is as venomous as ever. The system of Hahne-^ mann was hated in its birth, hated in its weakness, hated in its growth, and it is hated now in its vigorous maturity — and hated all the more because, after all the predictions of its failure, it has dared to succeed. But now that its strength renders it indifferent to the opini<ms and the treatment of its adversaries, a different method is neoes* sary in dealing with the young giant. The homcBopathy of 1826, knocking timidly at the Eastern Portal of the Bepublic, poor, weak, friendless, helpless, was an object to be contemned. The homoeopathy of to-day, reaching out its resistless arms to the Golden Gate of the Pacific, strong, confident of the divinity of its mission, flashed with an undreamed-of success, and hurrying forward to new victories and more magnificent achievements, is a power which cannot with safety be despised, and must therefore be conciliated.
It is not very likely that the homcBopathic profession can be misled by Uie new tactics of its adversaries, or rather of those who are placing themselves at the head of the move- ment. The opinions of these men respecting homoBopathy are precisely what they were nine months ago, when they issued their impotent anathema against their professors who dared to lecture in the presence of homosopathic students. Besides, it is not a question of opinion, it is a matter of sentiment and of feeling. MMty of these men know that homoeopathy is a therapeutic truth ; but they hate it none the less. Indeed, some of them appear to become more bitter against it in proportion as its troth and efficacy become more apparent. Will any of us be foolish enough to imagine that these people are becoming friendly to homoeopathy, simply because they are yielding to the force of a public sentiment which they cannot and dare not longer resist ? Is the Boyal College of Physiciana favourable to homoeopathy when it votes to allow its members to practise that system, but forbids them to acknowledge their opinions openly? Is the New York State Allopathic Society becoming favourable to homoK>pathy
^S!^&i!lSm^ THE LION AND THE LAMB* 271
when it Yotodto allow oouBiiliation with ns, and bases its action on the statement of its president, that we have abandoned onr principles? Considering the persistence and the energy with which a few indastrioos members of our own school have misrepresented wb, we can scarcely be surprised to hear their fidsehoods echoed from the other side ; but how far may we trust a body of men who thus agree to consult with us, not because they hold our opinions, but because we profess one thing and practise another? The allopath who bases his friendship for a homcsopath on the latter's want of good faith is himself a knaye. And the homoBopath who knowingly accepts such a friendship is both a ImaTe and a fool. He not only acknowledges his rascalityi he advertises it.
It is the old invitation of the spider to the fly — ** Will 70U walk into my parlour?'* The new system, which always wonted its ancient rival in an argumentative appeal to reason, always substantiated its principles by the test of experiment, always scored a victory in a competitive trial of success, always throve under ridicule and grew vigorous under persecution, is now to be overcome, if possible, by diplomacy and chicanery* According to the English plan, the homoBopathist is to drop his title and tiiUB lose his identity. Then the allopath is to feel per- fectly free to practise aU the homoBopathy he chooses, and thus to acquire the reputation for therapeutic skUl and auecess, which properly belongs to his quondam rival. The American plan is much like it, but with this addition, that the homcBopatii is to be branded, and, if possible, induced to brand himself, as a cheat and a scoundrel ; that he is thus to be prevented fix>m wresting any more hospitals and asylums, and any more public offices from his insatiate opponent ; while on the other hand the allo- path is to take possession of that small portion of the Homceopathic Materia Medica which he has not yet stolen, and thus place himself upon a therapeutic equality with his hated competitor. It is a pretty little scheme, and if only the homoeopath can be wheedled into it, will doubt- less accomplish what the bolder and more honest methods 'have utterly failed to effect — the overthrow of homoBO* pathy as a special therapeutic system, the upbuilding of an incongruous system of mixed practice upon its ruins, and the setting back of medical science at least half a century*
272 THE LION AND THE LAMB. ^'bS^SSi^vSl
The motiye which actuates the reyolation is not dii&ciilt to discoyer. The ayerage allopath is not so densely ignorant bat that he can learn the relation between caose and effect like other people. 'Bjb knowledge of drug effects and of disease effects, crude though it may be, is not so exceedingly shallow but that he £iows the law of similars to be true, just as well as we know it. He applies it eyeiy day in his practice, he sees its almost maryellouB operation in the cure of disease, he reads the comparatiye statistics of the two schools, he beholds the system making inroads upon the old-school domain, he detects in his own textbooks multitudes of plagiarisms from homoeopathic works, and, last of all, he subjects the principle of similars to the test of rational examination uid finds it to be not only reasonable, but the mo$t reasonable method of apply- ing drugs to the treatment of disease which his mind is •capable of conceiying. He belieyes in homcBopathy because his common sense compels belief. But will he publicly ayow his fedth ?
V Aye ; there's the rub ! " The question of belief may be easily settled, but the jealousy and the hate are not so easily put aside. Harder yet is it for the morally weak to confess fully and freely the faults uid follies of a whole career. The prejudice against Hahnemann's teachinga» intense as it has been, is scarcely so strong as Uie almost unutterable dislike of Hahnemann's name and person. Moreoyer» the allopathic profession has always denied the right of original research and discoyery to oyeiybody outside of its own charmed circle. Gould they, at this moment, obliterate the world's remembrance of Hahne- mann and his disooyeiy, thousands upon thoosands of them would hasten to redisooyer homoeopathy, uid the second medical crusade would be preached almost before the ink is dry upon this jHrinted page. To them the honour of dis- ooyery is glorious ; the humdrum acceptance of another's disooyery is tame ; the reception of a discoyery made by one ridiculed and hated is so repugnant as to be well-nigh impossible ; and the thought of establishing general medical practioe upon the basis of homoeopathy, eyen upon a physical demonstration of its truth and superior efficaq^, is so utterly abhonent to the allopathie profession that they are ready to adopt ^mnct ^ny pl^n laiher t^^^xi "^^^^^^^^
IraUio conoessionB to Hahnemann or to his present fol- owwk Tkmt is a pill which, although it must be swal-
M^^UiSu^ THB LION AND THE LAMB. 273
lowed sooiier or later, will require sereral layers of sugar boating to disguise its intense bitterness. The proposed abandonment of our homoBopathic title is oTie coating, designed to render the dose more palatable ; the false assertion that we now reject most of Hahnemann's teach- ings is another ; the statement that our colleges now teach anatomy, chemistry, and pathology, implying that they finrmerly did not, is a third layer of sugar ; the falsehood that our practice has changed in its essential character, and that it is no longer "based upon an exclusive dogma," — as though a change in the practice constituted a change in the dogma too — ^is a fourth stratum of sweeten- ing ; and the poor allopath finds that the bitterness per- meates the coatings one after another, that the pill has grown to be a bolus, and bids fair to choke the patient in bis Tain endeavour to get it down without making grimaces over it.
The proper attitude for the homoeopathic profession to assume, under the changed and still changing ciroum- stances, is a matter of vast and vital concern. The only safe course for us is that which will best subserve the interests of humanity, best promote the advancement of therapeutic science and art, best commend itself to posterity when the asperities of professional controversy shall have been forgotten. If we believe, as we profess to believe, that homoeopathy famishes the surest, the safest, and the quickest method of curing disease, we are morally, as well as professionally, bound to give our whole energies to its development and its promulgation, and this without the slightest regard to any position which allopathy has taken or may hereafter take. Arrogant as it may seem, we must consider ourselves " the profession," not in any pharisaical sense, but as the Heaven-appointed custodians of the highest and foremost truths of therapeutic science, whose sacred interests we dare not even neglect, much less sacri- fice to the behests of a maudlin sentimentality. There never was a time in homoeopathic history when watchful- ness, and energy, and unity on our part were so imperatively demanded as now. We must be on the alert lest our wily opponents wrest from us our present high vantage-ground, or betray us into inconsistencies which shall render us unworthy of further victories. We must extend and increase the number, the membership, and the efficiency of our organisations ; we must secure more and better
274 THE PBOPOSED DIPLOMA. ^'"isS&^lSSTSi,
hospital experienee ; we mast strengthen our cc^eges ; im mnst encourage our literainre, develop oar fields of origiasl research, and strengthen oar individaal influence in dailf practice. Above all, we must stand together as one fium, hold fast the trust committed to us by the Almighty Healer, and let no man take either Hahnemann's crown or ours. When all physicians recognise the fitct that a scientific system of therapeutics is not possible, except upon the unchanging basis of a knowledge of dmg-actioii upon the healthy body, and that there must be some definite and uniform relation between drug effects and the phenomena of disease, then we shall see the adherents of ail schools working together in harmony to advance the grand interests of science and of humanity. So let the middle wall of partition be broken down ; let the schools take counsel together ; let medical research be ontrammelled and medical opinion free. Let unreasoning prejudice gi^ way, and the foul spirit of medical intolerance hide its monstrous deformity in a grave whose depths no resunee* tion trumpet-blast shall ever sound. Then we shall soon know whether the central doctrine of homoBopathy is to live or to die ; whether our struggle has been for nought, and our sacrifices offered in vain ; and of the results of that day we have no doubt and no fear.
REMARKS ON THE PROPOSED DIPLOMA OF THE LONDON SCHOOL OF HOMCEOPATHY.
By Alfbbd G. Pops, M.D.,
Leotarer on Materia Medioa at the London School of HomoBopathy.
I HAVB hitherto, for reasons on which it is needless for me to enteri abstained from taking any active part in the dis- cussion which has recently been provoked by the resoluiioii of a small and irregularly sunuuoned meeting of the Governors of the London School of Homoeopathy to create a diploma having the style of Licentiate in Homoeopathy. I feel, however, that I can no longer refrain from an ex* pression of opinion on the step which has been taken ; tha more especially, as I see that it has been publicly stated by the chief advocate of this movement that it had, at one time, my " full approval." So far is this from being the case — ^that it is a step which I had never contemplated a«^
B^£n^&^ THB PBOPOBBD BIPLOIU. 275
■ I III ^^i»^^— ^T— ^^— ^p^
leiag wiihui tha nmge of praotioal politicg; one of whioh I W18 not made aware until it was un fait aeeompU ; one to whidbi beings as I nipposed, beyond recall, though I did not offer any prononneed opposition, I certainly gave no •eoontenance ; while the sole nioti?e I had for not protesting against it, was my personal regard for those who were 6nthasia9tioally bent upon carrying it into effect. But the more I haye contemplated this proposal, the mode of ittf initiation, its bearings and its consequences, the more con* Tineed I am of its mischieTous character. While, then, I yield to no one in my admiration of the enthusiasm and seal for the fortherance of a knowledge of homcsopathy^ which have induced its proposers to bring it forward, I cannot but lament the want of tact and discretion which hate marked the exhibition of their enthusiasm.
I can recall no event in the history of homodopathy which has occurred in this country during the last thirty years whidi has given rise to so considerable a series ot painful and ever to be regretted incidents as the institution of this diploma has done.
In consequence thereof, we have had angry and perfectly useless debates regarding it, involving the loss of much valnable time, at our chief medical society. We have, been shocked by the issue of a periodical, the tone» style and temper of which have been imiversally deplored, and cannot he too strongly deprecated. The regret which such a production has excited has, moreover, been rendered deeper by the knowledge, that the gentleman, who is solely responsible for it, is one who has rendered services to homoeopathy of the highest value, whose zeal for doing good in the same direction is not exceeded, if indeed it is equalled, by that of any member of our body, and whose power and influence are likewise considerable. Then, again, threats have been held out, on the one hand, to make the granting of this diploma the basis of a distinct schism; while in another quarter, a desire has apparently been manifested to render it a means for breaking up what little miity at present exists among homoeopathists here in England. And, lastly, we have seen Dr. Drysdale take advantage of this hasty and ill-considered proceeding to make a violent and ungenerous attack upon the Londoi^ School of Homoeopathy, and inferentially to express his desire to see it rooted out, unless it is conducted in a way'
276 tHK PBOPOSSD DIPLOVA. "fc^^SSft*«
Bi&wknr, Ifay 1, Iflflt.
in which eveiy one who knows anything about the matter ia^ folly assured that it cannot be oondncted.
Such are a few of the deplorable restdts of the injudicious action of the adioumed meeting of the Goyemors of the School held on the 16th of December last.
First of ally I will notice the proceedings.
The meeting of the 15th of Deeember, 1881, was called for the purpose of revising the laws of the London School of Homoeopathy — the proposed revision having already been published in the November number of the Monthly Homceth paihie Review. Not one word was said in the circular convening this meeting of any intention to propose the institution of a diploma. And yet it has since been stated in the weekly periodical to which I have alluded that " thia step was by no means a surprise to those present ! " I have every reason to believe that before entering the room not one of those present, save the proposer and the hoaioraiy ■ecretaryy had any idea of the move that they were to be asked to sanction! No medical governor had* the least reason to suppose that anything of the kind would be- brought forward. Nothing approaching diploma-giving is mentioned, either directly or indirectly, in the statement of " The Objects " of the school published in 1876, nor in *'The Preamble" to the laws as revised at this veiy December meeting ! It being presumed that the business would, as it always is at public meetings of societies, asso- ciations, companies, &c., be confined to the points stated in the circular convening the meeting, and the proposed revision as published containing nothing objectionable, medical governors naturally did not feel tibeir presence to be essential. The meeting, it was anticipated^ would be a purely formal one.
It turned out very differently, however. A resolution was, as arranged with the honoraiy secretary, brought forward by Dr. Hughes, instituting this ''Licentiate in Homoeopathy " diploma ! Seven medical governors were present, one of whom was obliged to leave before ihe con- elusion of the business, and this momentous issue, this parent of so much evil, was resolved on bv six !
It has been urged, in eiq^lanation of tnis extraordinaiy course, that a diploma is llie normal sequel of education, and that therefore there was no necessity for the insertion of any intention to confer one among the objects of the BohooL But education in a special therapeutic method
wSXi^SSTSSl!^ TBS PBOfooD u»]jOmi« 877
does not nftlnriJly ienniiMite in a diploma. No preoddeht for myihing of tiie kind ean be ahown. The L.M; of the College of Sox^geonSy or of the Dublin hospitals, testifies to proficiency in one of the three great divisions of the pro* iession of medkine — ^not to a mathod of treatment wbieh is more or less common to alL
Further, it is well known that hsA the intention to confer such a diploma been stated to be among the objects of the Sehool at the oatset, it would not have received the large amount of support that it did ; while the opposition, which it encountered somewhat later, would have been intensified tenfold.
Again, it is urged that the proposal to institute, this diploma was only made known to the honorary seeretaiy by Dr. Hi^hes two days after the dradar convening the meetiftg had been ieeued I This may be sufficient to acquit Dr. Hughes and Dr. Bayes of any intention to '' spring " this proposal upon their colleagues unawares, but it is no excuse for their having done so. The very least that might have been expected under such circumstances would have been the issuing of a fresh circular announcing Dr. Hughes' intention. Properly, however, the proposal should have been adjourned until a future occasion, on the ground, that it was sent in too late.
But the apologists for this move further say, that,, according to one of the laws, any motion may be brought forward at an *' annual meeting." The meeting, however,. on the 16th of December was not an ** annual meeting." This took place in September. The December meeting was an adjournment of the annual meetmg for a special purpose — viz., to revise the laws on the basis of a report of a committee appointed at the September meeting.
Supposing, however, that the apologists are as right in fheir apology as they are in reaUty wrong, what must the effect of su<^ a law, so carried out, be upon an institution? Anyone might come forward, without any notice, and, in a suitably packed annual meeting, propose its closure and the diversion of its funds into any channel rather than the one into which the subscribers destined those funds ta flow!
No. The law gives permission to any governor ta bring forward any motion at an annual meeting, but it Aoes so on the tinwritten, but universally received, under- Standing that full notice shall be given to all inlexested of
278 TBJB BBOPOSBD PIPLOIIA* ^'^^
BOTiev,Miy 1, IM
the terms of the prDpoaed motion. Withoi^ saoh an imderstaQding, fiilly and honomrably carried out| we ehonli liAYe no guarantee for.the etability of any of our soeietioi or asfloeiations.
I object, then, to this diploma, in the first plaee, lecanse the schoq^ can show no title to confer snek distinction npon anyone; and secondly, becanse, even supposing that it conld do no, the manner in which it wai done was irregular and in defiance of all those well nnder^ etood and accepted rales which goTern the bnainesa of meetings of such institutions; thirdly, because, if con- firmed, it establishes a precedent which may be quoted in the future with most disastrous results to the well-being of the school.
If anything of the kind proposed by Dr. Hughes is done by the school, a special meeting of the goyemors must be held— ^r«f, to enlarge the scope of the school's objects, and then to carry out such addition to these objects as may hare been agreed upon.
By no other means can any diploma issued by the school be other than illegal and spurious.
I will now consider the details of the proposal of the school, supposing that it had been brought forward as regularly, as it has, undoubtedly, been irregularly introduced.
Dr* Dudgeon states (Britiih Jowmal of HomcgopcOkif^ April, 1882, p. 157) that ^'the guiding spirits of the London School of Homoeopathy wish to establish a body And have it entitled under the Medical Act to grant qualir fications, which shall impose upon a candidate, ofiering himself for examination, an obligation to adopt the practice of a particular theory of medicine." Nothing of this kind has, BO far as I am aware, been suggested. The achotA proposes to ascertain the knowledge which a candidate, already qualified to practise, possesses regarding a metho4 of treatment respecting his familiarity with which, the diplomas he holds give no evidence. They do not seek to give a qualification to practise* In the face of tha refusal of Parliament to grant such a privilege to the Yiot toria University, any endeavoar of the kind would be use- jess. Neither do they deaire. to impose any obligation to practise, or refrain from practising, either homoeopathy or any other theory of medicipe. Their sole object is aa
juMerUinmeni of kiio^fiMlg#, and the diploma is the oertift* 4Mit6 thai this knowledge is possessed.
The diploma proposed to be giTen irith this mtent is styled a *' lioentiate in Homooopathy ; " or rather th^ holder of it is so stgrled, the document itself is necessarily a license to practise homceopathy. The very word '' license '' conveys a meaning which is insompatible with the intention of the school not to grant a qualification to practise, but simply to afford to the holder evidence of his Imowledge of hoxncBopathy, or» in the phraseology of Dr* Hughes, *' i^ warrant of his competency *' to practise it.
That the word liceme does not convey the meaning which the diploma of the school would alone bear. Dr. Hughes " bru^s aside " as a " triviality.*' But, if words have meanings, we are bound to respect such meuiings when we use them ; and this more especially in documents of a public character, documents which will have to be inter- preted by persons who attach the ''lexicographical" meanings to the words employed.
A license* then, conveys the idea of permission, it does not testify to anything. The Licentiate in Homceopathy would go before the public aimed with a document giving him permiBsion to do that which no one can give him a title to do ! It would lead all to suppose that he was a specially privileged person, while, in point of fact, he has no special privilege whatever. If^ as Dr. .Hughes says, *' it simply warrants its possessor as compet^t in the judgment of a duly organised body of his colleagues to practise the particular method whose name it bears ^ — ^then let the diploma be of the nature of such a warrant, and not one calculated to convey a totally different meaning. Any title or document couched in terms or language Kable to give a false impression is to be deprecated, and such would be the effect of a diploma styled a '' license in homcaopathy.*'
The proposed license is to be designated by the letters ** L. H." The chief value of a diploma is the degree of public credit enjoyed by the body which issues it. These letters convey no idea of the source whence the individual using them derived his authority to do so. At present they are generally understood to denote a '' Licensed Hawker ! " As they stand, unconnected as they are with any publiq institution, they are really valoeless, if not indeed meaning- less. . I think, alsoi that there is much foroe in Dr. Black's
280 tin PBOPOSBD diploma. ^''tSS^lS^TSlL
objection, that this diploma would tend ''to foster the growth of orypto-homoeopathy." If it were generally anpposed that a diploma was necessary to the reputable and sncoessfdl practice of homcBopatfay, and that snch a diploma coald only be obtained by spending nine months in attendance at the London School of Homoeopathy, a distinct discouragement would be offered to the inrestigation and study of homoeopathy by medical men in general practice. They could not afford to spend the requisite time in attend- ance upon lectures, but they could, with the aid of books, and the adyice of an already established homoeopathic prac- titioner, make a very fair study of the subject.
This many hare done, aQd many others I trust will do so, but learning that to all who practised homoeopathically this diploma was a rine qud non of doing so respectably, that without it an avowed homoeopath was Uable to be r^;ard6d with suspicion; and to be looked upon as a charlatan, such practitioners would never avow the method they had adopted; they would be of no service in propagating a knowledge of homoeopathy, or in working it out from a scientific point of view ; they would become crypto-homoeopaths, and rarely rise above the rank of empirical homoeopathists.
Among the various objections brought forward to this diploma by some of the writers in the BriHah Journal </ Homoeopathy (loc. cit.) are two with which I can hold no sympathy. They apply equally to a '' license" and to a " certificate."
Ist. To hold such a testimonial of fitness is, we are told, '' trading on a name." For my part, I should like to see a clear definition of this process in the first place, and of its professional iniquity in the second.
Because a professional man possesses qualifications superior to his neighbour, the public resort to him in preference. For example — ^Mr. Smith is a Fellow of the College of Surgeons, Mr. Jones is only a Member. Mr. Bobinson, having broken his arm, goes to Mr. Smith rather than to Mr. Jones, because he knows that the cBploma of " Fellow " indicates the possession of superior surgical skill to that of *' Member." Is Mr. Smith, then^ to he charged with trading en the name " Fellow? "
Again, where is the difference between, on the one hand^ telling all your friends and patients that homoeopathy is a great truth, tiiat you beliete in it and practise homoeo-
jSSSS^SSu^S^ THB PB0P08XD DI9LQ1U* 281
ptthically ; and, on the otber^ informing them that yon haye passed an examination in homodopathy and hare reeeiTed a diploma of competency to praotiae it ? Where» again, ia the di£Eerenee between adding the lettera M JB.H.S. to yonr name and letters signifying the possession of a diploma testifying to your knowledge of homoBopathy? Howy likewise, is it pe^ctly correct to hold an appoint- ment as physician or snrgeon to a homoMqiathic dispensary and, contra bonoM morei, to have obtained a document showing that you haye taken some pains to qualify your<^ self for the post ?
For my part, I can see no difference between these soYeral acts* If one is trading on a name, so is the other in each instance. Each and all indicate and make publicly known a faith in homoeopathy, or, at any rate, the practice of it.
2nd. A diploma would stamp us as sectarian, it is said. Nothing stamps a man as sectarian except a refusal on his part to associate or professionally to co-operate with his professional brethren. The simple possession of eridence that he haa studied a branch of therapeutics which, in the meantime, has not reoeived the imprimatur of the College of Physicians cannot make a man a sectary. It shows that he has added to, not narrowed, the area of his professional knowledge.
But, after all, the phrase '' trading on a name " and the cry of ''sectarianism*' are mere pieces of cant. They have been invented and uttered with the view of preventing men, who desire above all things to be eminently correct, from studying homoeopathy. Whether a physician prac- tiaes homoeopathically after having had his knowledge of the subject tested, or without having dooe so, these false and fraudulent epithets will be cast in his teeth. They may well be '' brushed aside " as ** trivialities " too con- temptible to engage attention.
While, then, I regard the act the six medical governors of the school have performed as vitra vires, and, therefore, nnjustifiable ; and while the diploma they propose to issue ia one which under no existing circumstances they have any right to issue — one which is calculated to convey a &lse impression, one which in its very terms is unreal ; I am far from thinking that the school may not, after due deliberation, provide a means of testing the degree of knowledge of the subject taught attained by those who
382 T0B PBOP08B3D DIPLOMA. ^'a^^S^Tun!
lutTe attended its leetnrefl, and at the same time give them a certificate setliiig forth the nature and reenlt of the examination they have passed. What is reqnired is an 4vidence of proficiency* This, and this idone, is all that a
Eipil of the school can ask for ; this, and this alone, is all at is required for the pnblic good. This evidence of proficiency might quite wett take the form of a certificate, or, if the hankering after loudly sounding phrases, wfaidi is so apparent in some quarters just now, must needs bs gratified, the document might be called '^ Letters-testi- monial." This, as Dr. Diysdale says, ^^ could without impropriety be shown to those whom it might concern. . • • . It would serve all legitimate purposes, and offend no professional proprieties*" The only answer I have yet heard to the statement that a certificate would answer all legitimate purposes is the very simple, but, to my mind, inconclusive one — ''it wouldn't." I notice, also, that though this proposal has been freely talked about during the last month or six weeks, neither of the defenders of the L. H. diploma, as it stands, in the British Journal of Homceopatky (loo. cit.) refers to it. If a certificate obtained after examination is not as good evidence of a man's competency to practise homcdopathy — is not as well calcu- lated to satisfy the requirements of the public — as an L. H. diploma, I should like much to know why it is not so.
I further think, that advantage might be taken by the school to strengthen its position by affiliating to itself all who hold its certificate, creating such gentlemen members of the school, and giving them a voice in its management. By so doing, we ^ould have the earnest support of a number of men whose attachment to the institution has been gained in a manner better calculated to render it enduring and cordial than any other. Supported by a yearly increasing number of members, who would firom time to time attend its meetings, the institution would ran but little risk of being injured by captious opposition, personal animosities, or individual indiscretion.
I have been told, that no one ever heard of such a desig- nation as ** Member of a School ; " and that the title shoolo^ in order to carry out this plan, be changed to ** College.*' For my part, I see no need for such a dbiange. The word ** College " is needlessly pretentious. The institution is, in every particular, a '' School." Under this name it has
M^l^iTiSoL^* ^BB PROPOSBD DIPLOMA. 388
eined tiie position it oeeapiea^ by it, it is evevywhere own*
Bat to erery proposal whioh does away irith the title li. H. it is replied, 91 medical men liave applied for it ; and their wishes mast be respected. These gentiemen hare, I spprehendy by their applications signified their approral of fhe idea conveyed by the L. H., rather than a deaire for* this particular title. By creating them honorary members' of the school, their aspirations would, I doubt *not, be folftlled, especially if they ftilly understood that, by thiS' change, a great deal of ill-feeling would be quieted, and much opposition be disposed of.
Their applications were made without the knowledge on their part ot the illegal and unconstitutional way in which the movement had been initiated, and without the objee* tionable features of the diploma itself being laid heiore them.
With these facts brought under their notice, I feel tolerably sure that all, save perchance a small minority, would gladly exchange the equivocal title of Licentiate in HomoBopathy, for the more legitimate and really more influential designation of Member of the London Sehool of Homoeopathy.
And, finaUy, though many who have strongly opposed &e present proposal would take no part in that which I suggest, their opposition would be- withdrawn, simply because the objections which they have raised to the L. H* would have no force at all if urged against a certificate obtained alAer examination.
Before concluding these remarks on the proposed diploma, I must make some comments on the roflections ]>r. Brysdale makes on the school itself in his contribu- tion to the British Jornnal symposium.
He takes advantage of the opportunity presented by the indiscreet act of the school, which I have discussed, to make a violent attack upon the institution, chiefly, as it appears, because the members of the committee have not been sufficiently credulous to waste their time or energies in applying to the various medical boards for a recognition of the lectures, as Dr. Drysdale desired should be done. Some time back, I believe, he was infonned by the honorary secretary, that if he would make the requisite enquiries, and lay a practicable scheme before the council.
284 THE PBOPOWD DIPLOMA. *^e^J,?5S?i!«8Jl
it would receive their most oerions consideration. The answer waa very characteristic, — ^' I can't do it, it is yoa men in London that most do it, I can't.*' We all know that Dr. Drysdale could not do it, and are equally well assured that the men in London could not do it either !
Among other thingSi Dr. Drysdale aflfects to be Teiy much dusgusted because the L. H. diploma is only to be giyen to men already qualified ; albeit Dr. Dudgeon, a few pages back, is equally disgusted because it is to be ''a qualification to practise ! " Now, I have not the slightest doubt, that had the school proposed to issue a qualification such as Dr. Drysdale pretends to think that they ought to have done, and as Dr. Dudgeon says they have done, then is no one who would haye poured out such copious yials of wrath upon the school for having done so as would Dr. Drjrsdale, of Liverpool !
This is quite sufficient to show that the feeling against the school, on the paart of Dr. Drysdale and of tiiose who are associated with him in opposing it, is quite independent of anything that may be done by its committee, its officers or its lecturers. Whatever they do will entail upon them their maledictions.
The following extraordinary sentence I must quote in full : '^ Unfortunately, this act of the school managers does not stand alone, and may be looked on as the climax of a series of acts, which might be construed, and which our enemies will be certain to construe as deliberate acts of set purpose to put the stamp of sectarianism on our whole doctrine and practice, and thus widen, as fieur as possible, the breach between us and the profession in general, with the efiect of deterring them from studying, and finally absorbing our practice into general medicine, thereby giving prolonged opportunity for any of the baser sort who may lurk in our body of ' trading on a name.' "
What those '' acts " are which constitute his '^ series " Dr. Drysdale does not say, but wanders off" to complain once more of the school authorities not having set oat in pursuit of the will o' the wisp he had endeavoured to dis- tract their attention by pointing to ! This want of appro* ciation of Dr. Drysdale's interest in the wel&re of the school forms, I doubt not, the chief item of the '' series of acts ! " He positively says, that he believes that, at one time, the claim for recognition of the lectures as part of the medical curriculum had "a very fair chance of
ISSS^SS^uIm^ ^HB PR0P0SU> BIPLOHiL. 285
maooBBB " ! ! Ifi is needlesB to add, that there does not •exist the slightest ground for any sneh utterly misplaced ■oonfidenee I Continuing to harp upon the neglect by the rflchool officers of his proposal to obtain recognition for the lectnres» Dr. Drysdale writes: ''One reason given for the leeistanoe of the managers to making onr claim for recog- nition^ was» that there was no chance of its being granted/* *' One reason " indeed — the fSEict that there was not the remotest chance of such recognition bdng accorded was the reason! Nothing wonld gratify the oonunittee and lec- turers more than that the lectores should be recognised as part of the corricnlnm of medical stndy — ^bnt they know fiill well that not even a hearing wonld be accorded to any such pro^Kwaly on ihe part of those in whose hands the power to grant or withhold recognition lies* Then he goes on to say* — ** Whatever chance there was ** [bnt there was none] *' it was onr dnty to make the application, and to neglect ^r refuse to do so, argues either distrust in the trntifi of homoBopathy, or the desire to keep it as a sectarian practice apart from general medicine." I reply that the rejfusal of rthe school authorities to enter upon the Quixotic mission proposed by Dr. Drysdale argues neither a distrust of -homcBopathy nor a desire for seotarianism, but simply shows ^lat they had a much clearer and juster appreciation of the situation than I^« Drysdale appears to have had. They knew perfectly well that to apply for recognition was useless. They offered, as I have already said, to entertain any proposal for the purpose that Dr. Drysdale might obtain authority to submit to them from those in whose hands the power to recognise lies, but Dr. Drysdale declined the mission !
We all know that, as Dr. Drysdale says, '' one medical eonvert does more for the spread of a medical truth than a thousand laymen," and, for this very reason, we have established the London School of Homoeopathy to instruct these medical converts, whether they are in statu pupiliari or in practice; and yet Dr. Drysdale would have us restrict our attention to the former and shut the doors upon the ktterl
The managers of the school are next stated by Dr. Drysdale to *' have been led away by a &lBe analogy with the homosopathic schools of America." Had they been so, they would have established a complete medical school and have instituted a diploma qualifying for practice, after Tol. S6, Ko. 5. z
286 THE PHOFOHBD DIPLOMA* ^'^SSSi^SSfTSt.
having obtained the anthoiity of a eharterfrom Fiarliameiil. This they have neither done, nor attempted to do. Thqr have sought to teaoh homceopathy beoanse this is the only branch of medical science which tiie ordinary sdioolfl of the country refase to teach.' The title of the school indi- cates their object, and nothing more. Dr. Drysdale thinks that there is no harm in the American schools ealliBg themselves homoBopathio ; bnt, that they woold have been wiser to have adopted the plan of the University of Boston, and have refrained from taking the title homosopathie. Here, again, as he has often done before. Dr. Dxysdab compares conditions, which, by reason of their essential difference do not admit of c<miparison. Hie medical school at Boston is an integral part of the University, and not an independent college like the Homodopathio Medical Golleg& of New York, for example. The University of Boston comprises several faculties, — ^law, literatnre, theology, music, as well as medicine. The New York College is exclusiTcly medical, and has no connection with the University.
In concluding, Dr. Drysdale once more goes back upon his old line. '' Obtain recognition," he says, ''by applying in the ordinary way, and complying with the same reguk- tions which bind e^ery medical i^her in this con^." We are sure that if Dr. Drysdale will do this, and lay before the committee of the school a definite plan by wfaicb our lectures can be recognised as a part of the ordinary curriculum of medical education, that it will meet with the fullest possible attention. But as the committee know perfectly well that no such application would be enter- tained, he can hardly expect them to devote their time to making it.
He believes that ''the small coterie in London, who have hitherto had the whole power, do not really rquresent the feelings and wishes of the respectable members of our body.'* Who these " respectable ** gentlem^oi are I do not know, but presume that they are those whose viewa coincide with the opinions of Dr. Drysdale ! Is it possible to be " respectable," and at the same time differ from him ? He next proposes that a clean sweep shall be made of the committee, the o£9cers, and, I presume, the lecturers, and urges the provincial governors to attend a ' special meeting a^ ^VV^7 ^^® broom !
Here and there throughout this paper Dr. Dxyadale
mH^SSTHSu!^ ™K PBoroiHED DIPI.OMA. 287
brings inlo pjromiiMnee his coatempt for the opinion of sU persons ontsida the profession of medicine. He forgets, or appears to forget, tl]Mt the profession exists for the pnblio — ^not the pnblio for the profession. He also fails to lecolleot that homoeopathy is Tastlj more ^^redated by the public than it is by the profession. He describes those who have supported our medical institutions — ^those without whose aid we should neyer haye had either hospital, dispensary, or school — as ** ignorant non-medical enthusiasts.'' Besides being an untrue and therefore un* just descripticm of those who hare so gratefully assisted us in our efforts to diffuse a knowledge of homoBopathy, such an account of oar lay friends is ungenerous in the extreme, llie public know ^e value of homcDopathy because they have felt it. They haye had illnesses which haye been treated allopathically without ayail — ^they haye resorted to homoeopathy and haye recoyered ; and their well grounded and grateful enthusiasm has urged them to do all in their power to extend like advantages to others.
How comes it to pass that homoBopathy has extended so rapidly and widely in the United States of America ? It has been through the efforts of the more intelligent portion ot the public, in no small degree. Dr. Diysdale may describe the profession of medicine as one ''always unfavourably disposed to movements attempted to be forced upon them from without." That may be true ; but per- petual '' kicking against the pricks " is impossible. There cannot, I think, be a doubt but that the remarkable change which is taking place among the allopaths in the State of New York, as shadowed forth in some papers which appear in the present number of the Review ^ is due to the influence of public opinion. In short, our American colleagues have *' gone for " the public ; here in England we have care- HEdly eschewed the public, and have endeavoured to secure the profession. The result is seen in the fact that in the United States there are 6,000 homosopathic physicians, and here at home there are scarcely 800 1
We may have done our duty to the profession, and have received nothing but contumely and scorn for our pains ; but it is an open question whether we have fulfilled it to the public.
Whatever may be the fate of the diploma, the bearings of whieh I have endeavoured to set forth, that our Londok School of Hom<bopatht should have, and is entitled to
288 MIND AND MATTEB. "S^^S^^Mf
have, onr wannest support is anquestionable. It teaches the most important of the rarioas bratiches of medical science in a manner which is not taaght elsewhere. It is not in any sense sectarian, but is an establishment — and the only one of its kind — ^for giving instruction in a medical doctrine which we all know to be of supreme valae to eveiy physician. The name it bears indicates its mission in a clear and onmistakable manner. It has had a fair amount of success, in spite of much relentless opposition from many who, had tiiey done their duty to homcsopathy, would have exerted themselves to promote its interests. It is not what Dr. Drysdale says it is — the wish, it may well be feared, being father to the thought — ^it is not *' a virti^il failure." The attendance last session was considerably in excess of that of any former session, and the interest dis* played by the students was as well marked as it was gratifying.
21, Henrietta Street,
Cavendish Square, W. April 12th, 1882.
4iii . — ■■■■■■, ,. .1
MIND AND MATTER.— A CASE OF CONGENITAL
DEFORMITY,
Bjspobted by Dr. Mormsson.
Mrs. C, a lady of highly impressionable temperament, the mother of four children, was confined of her fifth child on the 30th January last. When three months and a half advanced in pregnancy she consulted a dentist, who bore the impress of double hare lip and cleft palate. To this individual she took an instinctive dislike, which was intensified by the way in which the dentist elevated her upper lip and pressed upon the jaw with.his thumb while extracting two stumps, preparatory to fitting some artificial teeth. But the incident did not appear to have made anj permanent impression. Parturition was preceded by an illness of three weeks duration, due to angina pectoris, complicated with mental symptoms, and a severe attack of lifismorrhoids. The child was born, in the second cranial position, after a labour of eight hours duration. On inspection the infant was found to be frightfully deformed, through double bare lip and a palate completely severed. The mother was too much enfeebled to take immediate
2»2j?rSr* BEVIBW8. 288
interest, but a few hoars later she insisted upon knowing whether the infant was perfect. Upon being told that he had hare lip and cleft palate, she at once exclaimed^ ''Gordon J." (the name of the dentist), and she soon pointed ont two spots on the infant's gum, which corresponded to the position of her two extracted fangs, as well as the thnmb-like appearance of the intervening piece of lip, and the resemblance of the infant's nose to that of the dentist. Knowing the latter, I could not but confirm the striking similarity.
Now mark the sequel. The child was cyanotic. Add to an enfeebled circulation a difficulty of deglutition, and the chance of surviving becomes small. I was anxious to. have an operation performed early, as the lesser risk. For this purpose the infant was .taken to a hospital, but the house-surgeon postponed, referring to the senior officer. Meanwhile the vital power steadily declined, from imper- fect assimilation of food; the edges of the cleft palate became aphthous ; and after a troubled existence of six weeks, the little sufferer finally closed his eyes upon this outer world.
St. Saviour's Boad,
Brixton Bise.
March, 1882.
REVIEWS.
Hahrumofnn as a Medical Philosopher : — The Orpanon. Being the Second Hahnemannian Lecture, 1881. By Biohard Hughes, L.B.C.P. Edin. London ; E. Gould and Son, 1882. In this brilliant pieee of oratory, Dr. Hughes sets forth the daims of Hahnemann to be regarded as a medical philosopher of the highest rank. He finds the basis of the position he seeks to establish in the Organan, This great, and as yet much mis- understood and cQnseqnently much misrepresented work. Dr. Hughes examines with scrupulous care. Not' content with the last edition, he begins with the first, and by noticing the altera- tions and additions presented in each succeeding edition, he brings before us, in a way we do not recollect having seen done previously, the gradual growth in Hahtiemann*s mmd of the several doctrines inculcated in his Organon, It is, as he says, '^ quite impossible to form an adequate estimate either of the Organon or of its author without some knowledge of the changes it has undergone in successive stages." He illustrates
890 Mvmws. ^"S^^S??^
Beriew, May 1. Ifltt.
this point as follows : — *^ Hie hypothesis ct the origin of much 6broDic disease in psora^ which, not long ago, was i^iiihoritatiTely stated to be one of the fundamental principles of homcBopathy, first appeared in the fourth edition in 1829. The theory of the dynamisation of medicines, t.^., the actaal increase of power attained by attenuation, when accompanied by tritura- tion or succnssion, is hardly propounded until the fifth edition." While the earliest mention of the doctrine of rital force, as the source of all the phenomena of life, as the sphere in which disease begins and medicines act, occurs in the fourth. 80 that all that is essential to homosopathy was published twenty years before either of these doctrines, which many of our would-be critics declare to be homoeopathy, had been broached at all.
Dr. Hughes avails himself of the opportunity to criticise several of the passages in Dr. Bristowe's address at Eyde, and he does so most effectively.
It forms an admirable essay to put into the hands of a medical man who is honestly inquiring into the merits of homoeopathy. It will serve to wipe out from his mind many of those erroneous notions derived from a cursory reading of the Organon, which allopathic writers have from time to time foisted upon their readers.
Ophthalmic Therapeutics. By G. 8. Norton, M.D., Professor of
Ophthalmology in the College of the New York Ophthahnic
Hospital, &c., with an Introduction by Professor T. F. Allen,
M.D. Second Edition. Be-written and revised, with copious
additions. New York and Philadelphia : Boericke & Tafel, 1882.
This is a second edition of a work of considerable importance.
Ophthalmic diseases are supposed, far too generally, to be
amenable only to the surgeon's knife, while tiiie skilful operator
is frequently but too much satisfied with his manual dexterity
to take the trouble to enquire whether remedial measures, in the
form of drugs, may not answer all the purposes required for
enre. As a physician said to us not long ago-^!' It is the men
who cannot cut out a cataract who will endeavour to cure it
with medicine ; those who can, will not take the trouble to
do so."
The volume before us does not ignore surgical procedures where these are, in the present state of our knowledge, absolutely essential ; but it lays before us, as the result of many years of large and carefully-studied experience, indications for the use of remedies which may,- very often, supersede the knife. And it oannot too frequently be stated that a recovery after a surgical Iteration is very different to, and a very much more imperfect flJEfdr than reeovcrv from the use of medicines.
mSS^SSTS!^ mmtihqs. 291
In pnUbhing the fini edition of this work, Dr. Norton was aasoeiaied with Dr. AUsa* tha editor of the Encyt^prndia €f Materia Medica; on the present oeoaoion Dr. Allen rehnqnishee all the reeponeibilitj of anthonhip, on the ground that Dr« Norton has himaelf perfonned aU the lahoor of revision.
It is divided into two parts. The first detailing the indioa> tions of 188 medieines for use in diseases of the eye, as drawn from the proving8» and— what is of infinite importance — as con- firmed bj dinical results obtained at the New York Ophthalmic Hospital ; xesnlts^ too, niiich are firequently used to illustrate ihetext.
The second partnotioes briefly each disease to which the eye IB Hable, points out the various medicines which are useful in «aoh, and the indications guiding their selection.
We would earnestly advise all our eoUeagnes, and more espe- cially those vHio are interested in ophthafanic surgery, to procure this book, and, having done so, carefully to study it ; and, above all things, never to resort to, or to recommend an operation withont having, first of all, tested the Talue of its iigunctions.
There is something so fascinating about operative surgery, «nd the skill displayed by the surgeon is so attractive, that the temptatiim to perform an operation, and at the same time to avo>ni the trouble of a carefiil selection of a medicinal remedy, is often too strong lor some, and especially for young men. But it must ever be remembered that surgery does but make good, in a more or less imper^Bct manner, Uie defects of medicine, and that, after all, he is the most skilAil and the most useful, if not the most popular suigeon, who avoids the use of the knife, as fiur as the resources St medicine will allow him to do.
Here, then, is a work, based upon a long and carefully recorded experience, which will matenaUy enable the ophthalmie surgeon to cure disease of the most important and delicate of organs with a imntmimi employment of the kmfe. As such we commend it to the careful study of our coUeagues.
— - — - *
MEETINGS.
PRESENTATION OF A TESTIMONIAL TO THE RIGHT
HONOURABLE LORD EBUBY,
Wb are indebted to Mr. Alan E. Chambre for the following fiill report of this very interesting meeting, to which we briefly referred in our last number : —
On Saturday, the SM^tb March, the Committee, at the invitation of Major Wm. Taughan Morgan, met at the Junior Athenwnm C^ub, and proceeded thence to the iomn residence of Lord Ebury to present the testimonial. Mq'or Wm. Yaughan Morgan, who
2&2 MBETmOB.
1.
made tho presentation, was aoeompanied by Br. fiamiltoii, Dr. Dudgeon, Dr. Yeldham, Mr. Hugh Cameron, Dr. Dyce Brown, Mr. Alan E. Chambre, and Mr. Alfred B. Pite. Thej wera.reoeiTed by Lord and Lady Ebory, with whom were the Hon. MisB GroBvenor, the Hon. Albertina Grosvenor, the Hon. Mr* and Mrs, Norman Grosvenor, and tiie Hon. Bichard Qro6Teiior«
After the neeessary introdnotionB, the portrait of Lord Ebory was uncovered. The likeness is in every respeot adminaUe, while the artist — ^Mr. Gyms Johnson— is nnqoestionably to be oongratalated on the qualities of the picture as a work of art.
Si^jor Yanghan Morgan, in fonnally presenting the portrait, and addressing Lady Ebury, said he did so on behalf of a Iszge number of subscribers, of the nobility, the medical profession, and the laity, who desired to present that portrait of the noble lord, which he hoped would be considered excellent, as a maik of their appreciation of the signal services rendered by his lordship to tiie cause oi medical science. He could have wished that some other person had been selected to perform that grateful duty, but the Earl of Denbigh was not able to be present, and the Earl of Dunmore was away from London, both noblemen being members of the Committee which had been formed to organise this general teatimony to the honour in which Lord Ebury was held, but there were present Dr* Hamilton, and Mr. Cameron, and Dr. Dudgeon and others^ especially Dr. Yeldham, to whose happy inspiration the move- ment was originally due, and these gentlemen could have more worthily folfiUed the pleasant duty before them than himselL But they had delegateid it to him, and while he must yield to them in point of ability, he would yield to no one in his zeal for homosopathy, and his appreciation of the services rendered to that cause by the noble lord. (Hear, hear.) He need hardly remind her ladyship that his lordship had done great services to homoeopathy, as Lord Grosvenor, in obtaining a special r^nm to Parliament of the marked success of the homoeopathic treat- ment of cholera during the prevalence of that malady in 1854. So soon as it was discovered that, although such a return had been made by the authorities of the London Homoeopathic Hospital, in accordance with the request of the 3oard of Health, that important document had been suppressed by the Medical Council specially appointed, and kept out of the other returns duly made to Parliament, his lordship took immediate steps to have the omission rectified. The result of his lordship's ener- getic action was an order by the House of Commons for a special pfkper, embodying that return, together with the correspondence which had ti^n place between the authorities of the hospital and the Medical Council ia consequence of the suppression.
Bat aa even greater sertioe than ihat was Tendered by Loid fibnxyt not cuoly to komcBopathjy bat to medical progresa generalljy irfaen tbe Aet of 185B '* to Begnlaie the Qoalificatioiia of Ptaetitionera in Medicine and Sui^eiy " was in prooess of becoming law* it was an Act to ensure a most desirable thing, the regniar qualification of everf person practisiDg medicine or snzgerj. Now, it had happened that instances were w^ known in which medical students had been refused certificates and diplomas in consequence of their known belief in the doctrines of Hafanemaim, in one case the student being commanded even to return a diploma granted after his suceessfiiUj passing th» prescribed examination. Against this persecution the new Act afforded no protection, which indeed it might be construed to &TOur rather than otherwise. This was brought to the knowledge of Lord Eburj, and on the third reading in the House of Lords, his lordship succeeded in securing the insertion of a clause prohibiting the examining bodies from prescribing tests as to medical theories, and from refusing diplomas in consequence of medical beliefe. Without this signal service to the cause of medical freedom, candidates for degrees who believed in the doctrines of Hahnemann might have found it quite impossible to become legally qualified practitioners. This clause had been aptly described as '* the charter of the lights of homieopathy." (Hear, hear.) The speaker said he wonld not take up time much further, but as treasurer of the London Homosopathic Hospital he must render a tribute to the devotion and energy of his kNrdship in the interests of that Institation. The English Homcsopathio Association, the Hahne- mann Hospital, the London Homceopathic Hospital, and the London Bchool of Homoeopathy were all of them institutions which had derived the greatest advantage from the countenance and support of Lord Ebury. (Applaiue.) And in the service of these — especially of the existing hospital, too much could not be said for his lordship's urbanity, 9a»oirfaiTe and loyalty. He said loyalty, because that, in his opinion, was one of his lord* ships greatest characteristics (hear, hear), and because there had been some little unpleasantnesses, wMch, on accoimt of old friendships, had placed his lordship in a difficult situation, but in which his loyiJty to his colleagues on the Board of Manage- ment was never fiyr a moment shaken^ Mf^or Morgan said thai he would not detain the attention of her ladyship on other matters, but Lord Ebury had rendered marked services in other eaoses than hmnosopathy. They were Englishmen as well as homcBopaths. He might say they were Englishmen first and homcBopaths afterwards. Lord Ebupf had done good work for his countiy, and was indeed one of those men who not only would leave the world better than they found it, but could
294 MSETiNcn* bSS^
iairlj olaim to have takan an aotiTe pari in maldng it so. Ha would only say in tonoloMon that the idea of preeenting thii teetimonial had first originated on the oceasion o£ the ei^tietii hirthday of his lordship, but they all hoped he woold be spared to them fix many years yet. (Hear, hear.) At all events their hope was that whan many years had past, this portzait would remain, so that their children and their children^i children, who would know what he was in dianuster and spirit, might also learn what he was like in the fiesh, and how he had influenced those who only knew him in his public capadfy, and had learned to admire his great qualities. Mmjos Morgan than handed to her ladyship a book containing a list of the names of the ladies and gentlemen who had subecnbed to the testimanial, remarking that it would be found rather long, because it had been felt that it would be more pleasing to her ladyship and Lord Ebury that the presentation should be the result of a general expression, ra^er than limiting it to a few friands, indeed, if he might be allowed to use the expression, rather a large collection of HomoBopathio sums, than a smiill one of Allopathic amounts. It only remained for him to ask her ladyship's acceptance of the portrait, and the aooompanying list
The book containing the list of subscribers to the testimonial was adorned by a medallion in gilt, bearing the head of Hahne- mann encircled by the inscription of the homoDopathie formula, SmiUa SimiUimi Guurantwr.
Lord Ebuiy in acknowledging the presentation on behalf of Lady Ebury said : — ^I am quite conscious of my own unworthiness of so valuable an expression of regard as Lady Ebury hss xeceived, and I feel almost at a loss for words in view of such a catalogue of virtues as that which my honouxable and gallant £iend has ascribed to me. I wiah I could adequately describe to you Ihe gratification I experience from your presence hers to-day, or the sense which I entertain of the kindness which has prompted yon, and all those whom you represent to adopt this most flattering mode of showing your estimation of the humble services which I have endeavoured to render to the cause of freedom in the pursuit of medical science. (I may, I think, without being accused of exaggeraticm, say that it is the most important of all sciences, because it deals with the comfort and happiness of the entire human race.) I labour, however, under « dMculty, which besets all those who are situated as I am at this moment, because I am compelled to talk about myself-'^ very tempting but dangerous subject ; . but gentlemen, it is en- tirely your own fault, and if, as is very likely, I should in whal I have to say become tedious, all that is left ma is to advise you to have that which you aire so fond of recommending to jour clients who don't get well as quickly as you desire — I mean
SSlS'SrfS?^ MBBTIKOS. 295
Wbtfkm,UaifU
^tienee. I mij^t, indeed, irar« I to dupoied, oontant mjvdf with aSeaing yon, as I do, mj most Bineere aiid oordial acknow*- ledgmentB for the honour that yoa aie eokiteriDg apon mO) and saying no more, hat I eannot help thinking tiiat, considering tiiat I am the oldest person now living who recoUeetH the advent 4»f the doctrinee of the great Qerman philosopher to onr shoreSi and all the cirenmstanoes oonnected with it, you may feel mter- ested in knowing how it was that I became so early acquainted with them, and as it were to take an active interest in the move- ment. I owe it to two individnals-^-one my brother, the Earl of Wilton, the president of onr hospital, who has recently passed Away from amongst ns. He was a man of an inquiring turn of mind, of a calm and impartial temperament, and as he was, as probably you gentlemen know already, acquainted with one branch of the healing art, was well qualified to form a correct and unbiassed judgment in regard to a question of tiiis sort. I think it was Dr. Cane who first brought it to his notice. The •other was a medical man whose name will never be pronounced by any of us without a feeling of regard and attachment — I made his acquaintance so long ago as 1822, when he was inivelling, in the suite of King Leopold, with Dr. Beloumini. I B<^n learned to appreciate his excellent qualities, and a friendship was the result which lasted through the whole of his long and distinguished career. He was the apostle, my brother one of the earliest converts ; and when we came to talk over the subject and study it in all its bearings, I felt convinced of its superiority over any of the so-called systems of the day. The best proof that I could give of my gratitude to the inventor of this new mode of succouring human nature was to devote my energies to spread the knowledge of it as far and wide as possible, and above all to get a hospital erected where the poorer classes might share tile blessmgs I considered it capable of conferring, and also to be the means of improving, and as fsr as might be, perfecting a system so auspiciously inaugurated. I had every reason to be grateful for the knowledge I had obtained ; for whilst under the influence of the pink dbraught, the blue, the grey, the unmentionable black, and the prescription composed of articles almost as numerous, though not quite so tempting as the bill ci fare of a Lord Mayor's feast, I was, at the age of tiiirty-seven led to consider myself about to become a confirmed invalid. Forty- four years have since passed, and here I am, gentlemen, address- ing JOTiy and enjoying as good health as most persons who have arrived at so mature an age. Now, I do not wish it to be taken for more than it is worth, and I am not so foolish as to suppose that rimiUa simUibus is always right and contraria eontrariU idways wrongs or that there is peHection anywhere, but I think tlie faid may be noteworthy, that having a large fftmity, and of
398 HEBTores. ^'^SS&^St^TS^
Bevtov, May h 1M>
ooiane having had to daai mlh a eonaiderable amotnit of thow ills to which human flesh ia heir, ire have never, during the period of more than forty years, heen compelled to go ebewhere for assistance. I will now cease to talk ahont myself, hut I cazmot, on such an occasion as this, avoid adverting for a ipoment to the very remarkahle founder of this veiy remarkable ff^stem. Will it be believed — ^I fear it mast be — ^that the medical practitioners of his own comitry, npon whom Hahnemann's system dawned, instead of welcoming any apparent discovery which came from so very distinguished and learned a source, and trying to understand and prove it, at once combined to malign its author, to misrepresent its theory and practice, and to try to strangle it in its birth, and he was persdnally' treated with great indignity. Now. just think of what the state of medical sk^ at that period was, as described in their own publications, it was one continued complaint, almost of despair, at its destructive divisions and want of success. I cannot, perhaps, better illustrate it than by telling you what happened to the £arl of Lauderdale of that day, somewhere about iSie time of the French Revolution^ January, 1790. He was travelling in the Low Countiies, and was taken ill — ^I think, at Antwerp— and sent for the doctor, who came, shook his head, and requested to be allowed to call in an assistant ; this was done, and his symptoms having been duly ascertained, his lordship overheard the result of the consultation expressed in Latin, in the following words :-*-*' Saniamu9 ilium vsqvs ad deliquiumviUB quia juvenis ac/oftu tie peregrinus «st, er^ sa^Mnmmtum/acientus. Fortunately, his lordship knew Latin aa well as his doctors, and so instead of the promising experiment they so kindly proposed, they were shown the door with all con* venient speed, and recommended not to be found again near tho house. That may appear to some of our present generation a. somewhat exaggerated view of the practice of those days, but it has always been considered as a true story, and many equallj strange could be adduced from contemporary memoirs. Well would it indeed have been for the honour of professional human nature had this discreditable treatment of the illustrioua Hahnemann been confined to its first appearance, but it .has gone on ever since, and sad to relate, it assumed its most unpro- fessional form in our own country. I will not dwell upon thia painful subject, which is patent to all the world, except to notice the extraordinary virulence which it assumed. Bayle*s dictionaiy must be searched by any one who desires to acquaint himself with the contumelious epithets which were hurled at the heads of the unfortunate individuals who presumed to favour or practisa the new doctrines ; and even some of us laymen did not alto* gether escape unscathed in the pitiless storm. That haa apparently spent itself, and fortunately hard words brake na
&^J£;T185g* . Mwwjwe. 807
boxiM, and iia last matteringt conaisied flbnpljia an apparentlj aomewlmt eontempiiions asieriion iliatwo.took a tradesman's Tiew of medioine. I am noA, bowerer, oertam that it may not have been meant for a eompUment; a tradesman to snooeed mast be a good man of bnsinees^ and why not a physician ? Bat we aU zeooUeet a desoription of the genuine orthodox prae- iitionear by one of oar own poets, at a time too» when there were Tko groTeUing Habnemanns, whidi shows that some people did think they took something resembling a •tradesman's view of medicine, for he says : —
" Is there no hope ? " the sick man said, The silent doetor idiook his head. And left the house in deepest sorrow,
^of eonrse on accdnnt of the snfierings of his patient, but also^)
Despairing of his fee to-mozrow." I have, however, a much graver charge to make against these gentlemen of tradesmanism in its bad sense. What do trades imions do f Why, they endeayonr by intimidation to gain that which they are unable to obtain by fair argument, •and I fear it will have to be sud that these learned •persons had reoonrse to social and professional ostracism; to stifle, and that they did succeed effectually in impeding, 4he study and practice of a medical system which, what- ever may be said of it, has been acknowledged as a blessing •by hundreds of thousands of persona in every part of the •eivilised world, I have now, gentlemen, nearly finished ; but before I sit down I should like to remark that in selecting this mode of doing honour to my xmworthy self, you have conferred •an honour much better deserved upon another person, and that is the lady who sits beside me, Lady Ebury. The portrait that ia looking at us there is not for me, but for her, and well has «he deserved it. Compliments between husband and wife are not always credited, but it is well that you should know how large a meed of praise is due to her in this matter. She has inherited from her illustrious uncle much of that tenacity of purpose in eveiy enterprise worthy of the effort ; accordingly, no sooner had she been convinced that Hahnemann's doctrines were worthy of examination than she set to work to study every document that could throw light upon the subject wiUi such Vigour and success, that she has been able, personally, to extend the advantages of this treatment to hun(£reds of poor people who could not have obtained access to professional treatment ; and it was lucky for you medieal gentlemen that she did not come to London, take out a diploma, and set up in practice (mucb biughter). Gentlemen, yon eould not have selected a day more appropriate for this ceremony, for it is the 26th of March, in other words, Lady Day. It now only remains for me again
208 unrwoB. "gSJXTtt
to offer to jovip gentlemen, and aU thoee irhom jwi raproBont, my most gratefal admofwledgments for tlie honour jon have ocmferred upon me. This is probably the last pnblie occasion in which I shall appear odmonH vmpw ; and the possession of this work of art will be a constant sooroe of gratifieation to me, as proTingthat, small as my services have been in the canse of freedom in the pnrsnit and practice of medical science, they were still thought by those most able to jndge, not nnwortfay <^ so valued a recognition.
We regret that the pressure upon our space does not allow of our publishing this month the names of those who contributed to the testimonial fund.
The portrait of his lordship will be on exhibition at the Boyal Academy.
THE LONDON SCHOOL OF HOMCEOPATHY.
A Special General Meeting of the Goyemors of the London School of Homooopathy was held on Thursday, 20th Apnl, 1882, at the lecture room of the London Honueopathic Hospital. Migor Yaughan-Morgan presided , and was supported by Dr.^ Hughes, Dr. Pope, Dr. Mathescm, Ih-. H, Wheeler, Dr. Tuckey* Mr. Bosher, Mr. Pite, Dr. Clifton, Dr. Blackley, Dr. Smait^ J>x. Croucher, Mr. Francis* Dr. Morgan, Dr. Dyce Brown, Mr. Butcher, Dr. Buck, Dr. B. Moir, Dr. Anderson, Dr. Clarkcr Dr. Epps, Mr. H. Harris, ^* Goldsboro, Dr. Morrisson, Dr. Shuldham, Mr. Wybum, and others.
After the usual notices had been read, the chairman directed the secretary, Capt. Mayoock» to read the minutes of the last meeting.
Dr. Hughes asked whether, as this was an exizaordinaiy meet-^ ii^, it was competent to it to confirm the minutes of last meeting.
Dr. PoFB had thought that it would not be necessary to read those minutes, but, as he understood the matter, the laws passed at the meeting of 16th December last, would be inoperatife until they were confirmed.
Dr. Hughes thought the minutes of a general meeting did not require confirmation.
The CHAiBiiAK ruling thai this view was correct, no minutss were read.
The Chajbman: The first business then is to receiye the resignation of the honorary secretary, Dr. Bayes. The foUowisg letter from Dr. Bayes was read ; —
«< 88, Lansdowne Place,
" Bri^t<ui, 19th April, 1882.
«« To ths Prmdmt of th$ London Si^ool of Homaopatky. " My Lord, — It is with great regret that I feel compelled, ^om the state of my healHi and my consequent absence from
w^u^Sf^ MSSTmes* 299
laoadon^ to adc your lordBhip, and the oommitiee and eooneil of Hm Sohoolt to aoaapt my iwignation of the poat of honoraxy aaerataiy to the School.
" I have to tender my ainoere ihanka to yoor lordship, and to tha eommitiee^ oooncil, and officers of the Sohool, for many oonrteaies, and for most valnahle and cordial support, ever granted to me in the performance of my duties, during the past fiye or six years, hy which my duties have heen greatly lightened.
''Beliere me, my lord and gentlemen^ most sincerely and grateliilly»
Your erer faithful
«< William Batm.
" To the Lord Ehury, &e., ke.*'
Br. Mathsson said that he thought he should only be ex- pressing the general feeling of the meeting by proposing the foUowing resolution : —
'* That in accepting Dr. Bayes' resignation of the office of honorary secretary of the London School of Homoeopathy, the governors desire to express their deep sense of the obligations under which the retiring secretaxy has laid all who are interested in the development of homoeopathy during the course of his distinguished Hterary and professional career ; that the cordial tiianks of the meeting be accorded to him for his invaluable services in founding and sustaining this institution, and for the mivarying and self-sacrificing devotion with which he has watched over its interests during the six years of its existence, to which is mainly due the state of efficiency in which he leaves it on retiring.'*
Br. Btce Bbown : I beg to second that.
The resolution was then put by the Chaibmak, and carried with applause.
Br. Pops said that he had great pleasure in proposing fliat Br. Bayes be appointed vice-president. It was entirely due to the exertions of Br. Bayes, and the support that he had given to the School, that the work they had done, and the pro- gress they had made, had been accomplished^ Br. Bayes had been untiring in his endeavours to sustain the public interest in homoeopathy, and to develop the School, and he (Br. Pope) thought that they could in no more fitting manner acknowledge "flteir obligations, and express the sentiments of esteem which they entertained for him, than by asking him to become ^ce-president of the institution of which he was practically the parent.
Ih*. HuoHKS seconded the proposition, which was put from the chair, and carried unanimously.
The Chaibican: The office of honorary secretary being vacant, it is for you now to propose somebody to fill it.
900 M£ETIN€I8. ^%S&^S^7iS£
Br. Bmabt said he roee to propose Dr. Pope as saeeessor to Dr. Bajes, aod he felt that no reconuneadation from him was needed in support of the proposition, as Dr. Pope wm irall known as a warm supporter of hommopathy.
Dr. Gboughbb said that he had great pleasure in seconding that, as he was sure they would all agree that no one eoold he found better qualified than Dr. Pope for the office in question.
Dr. HuoHBs said that as his name had been mentioned in connection with this office, he desired to explain that be had offered his services solely beoamse he had understood from Dr. Bayes that he could find no one who was in a position to take it. When, however, he heard that Dr. Pope was willing to take it, he at once withdrew his candidature, and he hi^Md Dr. Pope would understand that he was in no way a rival in having any pretensions to the office, and he thought that no one could fulfil the duties of the office better than Dr. Pope could.
The Chaibmav, after the very handsome manner in ^diich Dr. Hughes had expressed himself, had great pleasure in supporting the candidature of Dr. Pope. He then pat Dr. Smart's proposition that Dr. Pope be appointed seerataiy vice Dr. Bayes, resigned, and it was carried unanimpusly.
Dr. PoFB said that he was very much obliged to the governors and subscribers for the compliment they had paid him in appointing him their honorary secretary in succession to Dr. Bayes. It was no easy task to follow such a man as Dr. Bayes, but there was one satisfaction about the matter, which was that Dr. Bayes left the business of the School in such a complete state, that there was little more to do than to keep the existing machinery in operation, and he should endeavour, to the best of his ability to do that, to the end that the School might not only flourish, but increasingly flourish. The last session was by very far the best that they had had, and he trusted that in the next they would do better still. AU that was wanted was the support of their medical colleagues throughout the country : if they were well supported in that way he had no doubt that they would have a very considerable class at the School.
Dr. C. L. TucKST stated that as Dr. Bayes had been very much pressed with the work that he had had to do, he (Dr. Tuckey) had for some time past assisted him in the duties of his office as honorary secretary, and that when he heard that Dr. Bayes was about to resign he had found it incumbent upon him to tender his resignation also. He had since enquired whether an assistant secretary was needed, and that finding that he coold be useful he should have much pleasure in withdrawing his resignation.
Bwiev, Mmy l, JffiS. MBBTIHM. 801
The Cbasmmam aaid that he was sure that the govemorg 'woaid be very pleased still to have the services of Dr. Tnckey IB the capacity of assistaiit secretary, and Br. Tackey's appoint- ment to that office was agreed to.
Dr. Dtob Bbown said that he thought that they should now take that other step that was contemplated in the notice for this meeting, and he therefore proposed thiat the new secretary should be called the Dean. All medical schools had their Dean; it would give more importance to their School to have one. It might appear a small point to some people, but he did not think it was a small point in reality, and he therefore proposed that Dr. Pope should have the title of Dean.
The CHimiUN : Will anybody second that f
Dr. PoFE said he thought that it would be well to defer the ^xmsideration of this matter for a time. They had recently had an accession of a good many new governors, who, however,' would not be entitled to vote untU a period of six months from their admission had been completed ; there had been consider- Able discussion about this new title, which was one of some pretentiousness ; and he thought that it would be well if the new governors ' were allowed an opportunity of voting upon the question. There was to be a meeting in October, and if this and other small matters could stand over until then he thought it 'would be as well.
The smendment was seconded by Dr. Whbblbb, and on being put to the meeting, was carried.
Dr. HuoHXS said that he had undertaken, as the original proposer of the motion, to propose an adjournment of action in the matter of the L. H. diploma. He needed not to remind them of what had taken place in reference to it. There had been a good deal written about it, and the result was that two objections to further action stood out rather prominently. It was deedrable that if such a diploma were instituted it should be the action of the School as a body. At the meeting at which it was put fmrward there were only seven present, but as a matter of fact there were many friends of the School, who were not governors, who would soon be govemors, and as these gentlemen who had come forward so recently had no vote for six months, the pro- moters of the motion had wished that the matter ediould be pos^ned for six months. That was the first reason. The second was, perhaps, more important. A strong feeling that had been expressed against the diploma, was that it wss illegal, or rather that it was extra legal. He (the speaker) did not value that objection himself, but he respected the feeling in the minds of others. The members of the Liverpool society did not approve of its being instituted until legal sanction had been obtained. They say that it is necessary to get a charter to make it legaL
Y<4. 96. Ko. 5. T
He thonght, therefore, that it would be best for them to wait until that difficulty iddch had been raised had been swept out of the way ; then the thing conld be disciused upon its own meritt. The resolution he proposed was-^*' That the London Sehool of Homoeopathy think it deairabLe to suspend fbrttier actuni in the matter of the licentiateship m Homoeopathy lor six months ; during wliich time inquiry ^all be made as to the possibilily of obtaining a Royal Charter for the School, and legal sanction for its diploma. That a coamiittee of five governors be i^pointed to mike such inquiries, and to report to a genend meeting, to be called after the 20th October.'- Dr. Hughes added that he had purposely drawn this motion in an altogether colourless manner; it did not commit them to wish for anything, but only that during the six months inquiry should be made, and that the committee- should report to the meeting in October. He hoped thai this would meet the approval of those present, and thai they woidd leave it for future consideration.
Dr. Blagklst said, that as the original seconder of the motion, he had much pleasure in seconding tiie proposed postponement of ccmsideration of this matter. That wcidd give them time to mature their opinions on the subject, There had been a good many expressions of opinion about it in the journals and else- where. He did not think that the questi(m of legality was a very serious objection, because even if they did not get a Royal Charter, there were a very large number of homoeopatiiists in favour of giving a certificate---a licentiateship,' if tiiey liked. There was one objection which he had no doubt he woidd have an opportunity of bringing forward in October, which to his mind, was the greatest of all. He had taken the trouble to- obtain an expression of opinion ftom the younger men, who were the men for whom the licentiateship was especially designed. He did not take it for one moment that the licentiateship was meant to be oonferred as an honorary diploma upon men who had been in practice for twenty years ; if it was to be of any use at all, it must be used by the younger men. On making his enquiries, he was surprised to find thai many of those men who had gone through the curricuhim of the School did not desire it ; there were only two who would have anything to say to the diploma at any price ; and he did not think that any of the pro- moters of the licentiateship would think of carrying it on in the^ fiuse of such an objection as that. If such an objecticm obtained among the whole of these younger men, he supposed no one would propose to go on with iL None of them objected to undergo a thorough examination at the end of a term, but none of them would accept a titie of L.H. This, however, was all by the way, and would, no doubt, oome before the meeting which was to
ke phce in October, and in the interval these gentlemen might
flESTSa?^ MHBTINGg. 906
MB reaaon to jAax^e thfiir opinion^ and also there would, no donbt, be a large acceBsion to those atteoding the School of HoDUBopathj, and from them they would, no doabt, got an expression of opinion. He had, therefore, to seeond the pro- posal to postpone the consideration of this matter till October — till alter the 20th October.
Dr. MoBGAK suggested that in order the better to obtain an exporession of opinion from members, one*third of whom probably were in the provinces, a means shoold be adopted by which they fdionld be epMed to express their opinions by means of proxies.
Dr. 8mab9 said that it seemed to him that titles of any kind were altogether prematnre. He did not think that they were sofficiently advanced for such a step as that proposed, but that they should first obtain a more general recognition in the eyes of the world. He wonld rather &at the matter were altogether deferred.
The CHAiurAN : May I take it, instead of being postponed, that the proposal should be annulled for the time being f
Dr. Bmabt : I would propose that it should be altogether deferred.
Dr. Wheeleb : I have great sympathy with what Dr. Smart says, but we have had several accessions lately, and I think it would be improper to interfere with Dr. Hughes' proposal. I do not think myself that it can militate against Dr. Snuurt's views to carry Dr. Hughes* motion now.
After some further remarks, the Chairman put Dr. Hughes' motion, which was carried.
Dr. HuoHBs then proposed that Dr. Bayes, Dr. Pope, Mr. Pite, Dr. Blaokley, and himself should be constituted the committee of enquiry.
Mr. Pttb said he thought he might make one or two sugges- tions, as he had had some experience in the matter of charters. He was sure that any committee would have to appoint a solidtor's firm to act for them in the matter. There was the Board of Trade had to be applied to, and numerous particulars had to be frumished as to rights and property and the privileges sought to be obtainedr^a kind of work ^at only a solicitor could manage. He was quite sure that any committee would only be a committee of observation.
Dr. Pops : Perhaps Mr. Pite can tell us something about the expense.
Mr. Pttb said that the least expense was about fifty guineas. In the matter in which he had been interested, it had been put at twenty-five guineas at first, but they had been drawn on to fifty. After they had reached that amount, circumstances made them desire to withdraw from it. There was a great deal of
Y-2
' 804 NOTABILU. ^ B^^SSSfifS?
pofiitive work and a great deal of respoiuibiKtj and inqniiy, and statistics had to be framed in a very careM manner.
After some forther discussion, the resolation was agreed to, with the addition that the committee do not spend more flum ten guineas in making their enqniries.
It was next proposed by Dr. Moboan, seconded by Dr. Whbelbb, and carried, ** That the committee send their report to the goTemors before the meeting, and that governors unable to attend the meeting may vote by proxy."
The hon. secretary, Dr. Pope, tiben read a letter which had been received from Dr. Drysdale in reply to one asking him to accept the office of Hahnemann Lecturer, in which Dr. Drysdale declined the offer on the ground that hia engagements entire!^ precluded his undertaking it.
Dr. Pope suggested that a committee should be appointed to select a lecturer for the coming year.
The Chatrmaw suggested that the committee already appointed for another purpose should act in this matter also.
This was proposed by Dr. Pope, seconded by Dr. Tucket, and <3arried.
The Chahuian. — We have now to propose for election ss Medical Governors, the following gentlemen : —
Dr. Ussher, Dr. Clarke, Dr. Anderson, Dr. Byres Moir, Dr. 0. C. Tuckey, Dr. Goldsbrough, Dr. E. T. Blake, and Dr. Jagielski, and Mr. Thorold Wood.
The proposal having been seconded, was put to the meetmg, and carried unanimously.
A vote of thanks to l^e Chairman terminated the proceedings.
NOTABILIA.
AMATEUR THEATRICAL PERFORMANCE IN AID OP THE FUNDS OF THE LONDON HOMCEOPATHIC
HOSPITAL. ( CammumcaUdJ.
It is our pleasing duty to record a highly successful dramalie entertainment on behalf of the funds of the hospital, which took place at St. George's Hall on the 18th April. This was not the usual annual performance by our old fnends the "Thalians," as, from a variety of reasons, it had been decided not to organise theatricals this year; but it was the outcome of a generous resolve of some friends of Dr. Kennedy to hand over to the London Homoeopathic Hospital the net proceeds of a theatrical performance, which those friends had made arrangements should come off on the date above named.
^SSSS&^'SS^' SOTABimu 806:
, Having said so nmcb by way of explanation, let us at onoe repeat that the efforts of the ladies and gentlemen, who thus so geoeroaaly gave their services on behalf of the hospital, were crowned with complete success, as testified by the frequent and hearty applause of a bnUiant and numerous audience. The pieces sdected were the well-known farce by Mr. Williams, *' Turn Him Out,*' and that charming comedy by Mr. Gilbert, "On Quard," so fnU of sparkling repartee and excellent " situations." The latter was, late in the day, substituted for . '' The I^uicers," in consequence of the author and part* proprietor of the latter play having positively declined to grant permission, on any terms, to Mr« Whitehurst (stage manager, and director for the ncoxce) to produce it. It is due to the actors that this should be known, as they are entitled to so much the more credit for their readiness to take up another piece at short notice, with but few opportunities left for rdiearsaL Indeed, an apology on this score was made from the stage ; but seeing how excellently well the actors se wnt tiris d'affair$^ no i^kigy was needed.
Space fiails us to describe the plot of the pieces performed, but probably, to the minority of our readers, that would be un- necessary. Suffice it that the farce was performed with plenty of spirit and '* go," and the *' make up " and acting of the chief character, Nioodemus Nobbs, by Mr. Whitehurst, was perfect*. The next best acted character was, to our thinking, Susan (the maid-of-all-work), by Mrs. C. A. Becker, who identified herself well with the character, and this must have been difficult lor the fair performer. Those who had laughed at Mr. White- burst in tiie farce, were so little prepared to see that gentleman in the part of Denis Grant in " On Guard," that we heard strong doubts expressed as to the correctness of the programme. (By the way, how tasteftil the programmes were, printed, as usual at the performances f<« the hoi^tal, in Old English style). In' effect the change was wonderful, and we must at once heartily congratulate ]k&. Whitehurst on the excellence of his assumption of tiEie character— a very noble one to have to fill, and which secured the unanimous and enthusiastic suffrages of the ladies ! Thai last word reminds us that we should have spoken first of the ladies. Two charming ladies filled the characters of Jessie Biake and Mrs. FitsOsbome, and — ^must we be hyper-critical — the only fault we have to find is, that incidental to so many amateurs, a tendency not to raise the voice sufficiently, and occasionally, to turn too modi away from the audience. They qpoke their parts with a due appreciation of the sparkling -things- ihey had to say, and their dresses — ah 1 now we are treading on ipound beyond our legitimate province — ^but, in a word, the messes were worthy of those who wore them. We feel that we
30e mfkntuk: ^""^^tSST^
may give a mead of almost unqualified prake to the gentfemen who filled the other charaeten, and, if yre mnst distrngnish one above another, peihaps Mr. Waller Lewis as Guy Warrington^ and Mr. W. H. Ohandler as Gmnse, most took our fimcy ; bnt Dr. Kennedy — ^who had an migratefol, beeause nnpoptikr, part to iyi — did excellently well, and is entitled to the praise of knowing his part Hioronghly.
The chief characters were called before the curtain at the eon- ckision of the second aet.
A very excellent amnteur orchestra, consisting of twenty-five peiformers, led by Mr. Norfolk Megone, discoursed sweet mnsie at frequent intervals during the evening.
We are not yet informed what are the pecmiiary results of t^e perfonnance ; but certain we are that, whiEitever falling off there may be in this respect over previous entertainments of the kind for the hospital, will be due to no want of exertions on the part ci all concerned, but to causes beyond their control, such as the absence from town for the Easter recess of a number of kind friends and supporters who usually attend, and the modesty of the promoters, who fixed the prices of the tickets at a decidedly low rate, and, moreover, the somewhat short notice of the per- formance, which, under the circumstances, was unavoidable.
We feel sure that we express the feelings of the hospital authorities in heartily thanking the ladies and gentlemen who so generously exerted themsdves on this occasion to onsmre a successful entertainment, and in hoping that we may again meet with them under similar circumstances on a future occasion.
■ ■■■ I ..■— I «■■■. ■ iiiM m>
LONDON SCHOOL OP HOMOEOPATHY.
SuMMEB Session, 1882.
Du. HuoHEs will give a Course of Lectures on '* The PniMiples of Homceopathy,'* oomsieQciiig Thursday, May ith, at 4 p.m., and continuing every subsequent Thursday at the same hour during the months of May, June, and July.
Db. Dycs Bbown wUl oommeoQce the Ssmmer Course of Lectures on *' The Principles and Practice of Medicine," ob Tuesday, May 2, at 5 o'clock, p.m. Subject: — *' Diseases of the Digestive Organs and of the Spinal Cord."
Dr. J. Galley Blackubt will commence his course of " Clini- cs Jjectaxea " on Monday, M^y 8th, at 10 i^m.
BRITISH HOMCEOPATHIC SOCIETY.
Thb eighth Ordinaiy Meeting of the present Session wffl be held on Thursday, May 4th, 1862, at seven o'clock. A paper ynH be read by Dr. KotH, of London, on " The Treatment of Varioos Uterine Complaints by Movements."
fsss^arratf* koxabima* sot
NEW PBEPAAiLXIONS. (Ettu'b Swiss Miuc Food fob Infants. Ws haYO miifllL plessore m notioiiig this new infiiats* fbodi irhioh contrasts adjnirably with many of the starohy £oods wbioh Are so mneh in use. It is, from its eompoBition» well suited for ihe proper nourishment of infants who eannot be nnrsed by ihehr mothers*
The following is the analysis of it: — Moistore ••• .*• 5.40 per eent.
J. a* ••• ••• ••• ••• ••• 4c«OM 91
Soluble Carbohydrates (eontaining
Dextrine and Sugar) 48.70 ,t
Inselnble CarbohydlBtes (containing iarinaceons matter perfectly soluble
in pancreatine solution) • 26.80 ,»
Albomenoids ••• ... ••. .>• 12.52 ,» Ash (containing Phosphoric Acid) ... 1.78 ,» We have thns all the elements necessary for the formation df iKme end mnscle» end presented in a state which is most easily •digested.
We httfe used it with success in oases of infants who were jredaced to semi-stanration with improper food, and it is much i^ed by babies. We have also used it with much benefit for adnlts whose digestkm is extremely delicate. Thus, not only theoretically, but from experience, we can highly recommend this food.
It is imported by Messrs. B. licbmann and Co., 106, Fenchureh ^eet.
The same firm haye introduced an un$w€0tened Swiss milk. This was a great desideratum, the ordinary Swiss milk being too sweet for many palates. Lehmann*s unsweetened milk is an excellent pniparaticm, and forms an admirable substitute for cow's milk.
CORRESPONDENCE.
HOM(EOPATHT, " HOMCEOPATHY " AND SCIBNTIFIC
PHYSICIANS. To the BdUon of Ihe ^^ Monthly Homceopathie BevtewJ'* DxAB SzRS, — It has frequently been urged in this journal that iKMnoeopathists and homodopathie institutions mast hold a ** dis- tincttre position *' so long as the principles of ** homoeopathy '* remain untaught in the schools, and their discussion dimllowed in the medical societies and journals. This is a perfectiy reasonaUe proposition. Contineed of certain truUis, ana believing that an extended knowledge of these truths is for the common good, you take the only means left open hj which yott may make known your conrifStirnkS.
'i808 C0IUkMtK>NDBi7CE. "SfiL^iSSfPSf
Jlmkm, Bfor 1, Ml.
Those who sappoit a new traih, one that is opposed to a traditional belief, are of necessitj '* unorthodox/' and as a body they form << a sect." It ib useless to qnarrd ^nth *tiie term, the relation cannot be aRered. Yon may leave the party nndis* tingtdshed by a name, yon may neglect to give it prominence by special jonmals and institntions, yon may break down every link which connects the members of that sect together, but still the sect remains. To say to tiie members of that party *< hold yoor views if you wHl, bat givo up year seetaiun position,'* i» ridicnlons, because the views -create ihe sect, and tlM>se who hold them could not be unsectariatt if they would. Sedarianism i» an unpreventable product of mental activity, only to be eliminated by an universal orthodoxy. But it is perfectiy possible for a sect to exist without representing any distinctive principles ; it may be merely a party in opposition, having my programme of its own. Such a body may claim to^ hold an honourable position in many departments of thought, but in the science of medicine, it would, by disturbing public confidence in those who, of all men, undertake the gravest responsibilities, do so much injury tiiat censure would very properly fall upon it.
I have no intention of implying that "homoeopathy " holds such a position, but I would call the attention of tiiose who dispute the medical system of the day to the necessify of taking a course which shall clearly distinguish their efforts from mere opposition, so that by no possibility they can be construed into a desire to weaken public confidence in the medical profession, in order that personal advuitages may be secured. It is necessaiy that they should not only distinctiy point out- where they differ from that system, and the methods they would have adopted instead, but it is also of the highest importance that they should State the extent to which their views accord. It is held by tiie medical profession that the principles of homoeopathy are set forth in the 294 propositions to be found in the Orrfftnon of Homoeopathic Medicine, by Samuel Hahnenann. If this be true, you hold a very '* distinctive '' position, and one not wholly enviable. In these days of more exact knowledge, many ot Hahnemann's speculations appear in a very foolish light, and it is only necessaiy for an opponent to recall some of these when he wishes to prove that '' homceopathy " is unworthy of scientific consideration. Homoeopathists are inclined to c<»nplain of the injustice of this, but I think unreasonably, for do the laws of chivalry forbid the combatant to seek the weak point in his adversary's armour ? It is obviously the homoeopathist's duty to close the opening, but the nu^ority are content to parry the attack by sti^g that individittUy they do not believa these things. Then follows the very natural answer from their opponents^ ** You have no light to the tiUe of homoeopathy" and
f^TvSSk C0BBS8F0NUKII08. 89d
■ ■ ■ ■
iUfl 1ft loadJty eehoed by a miticiriiy who Mm to b6> and with fl0aie troihi the *'oDly homcBopaihs." But while you are engaged in defasding yoor pocdiion in this external and intestine wwrfiue, you lead the mttaek in another direction. You find a praetitioner treating hie oaaee in a manner almost identieai with your own* You charge this man with " homoeopathy/' and hold him in seom and contempt becinise he refuses to connect himself with the homoBopathio body* Your argument is, that he belieyea in one of the principles promulgated by the founder of homoao* pftthy, and put into practice by homoBopaths^ and that he is tben^ore morally obliged to call himself a homosopath. If this mtgamoDi stated a general truth it should be transferrabley and have an equal yalue when af^lied in parallel circumstances. We will anppose then, that this man ia of opinion that frequent iblntiMas are essential to the religious and moral welfare of the eommnnity, and that he put this opinion into practice in his own case* We can show him that Mahommed was the first to pro* mnlgate this doctrine, and to insist upon its practice, and we aigne, therefore, that he is morally obliged to call himself a Maboanmedan and identify himself with ihat body. With the same argument we might seek to show him that he is morally bound to attach to lumself a number of names, which would have the common result of totally misrepresenting his actual beliefis. It is stated that the refusal to call himself a *' homodo- paih *' arises from *' moral cowardice." If this be so I fieal to see the distinctioa between such cowardice, and that proper self* respect which leads eveiy scientifie man to express no opuiion upon a doaen things in which he half believes, rather than identify himself with one that may be proved false. But let us sqnpose that this man is prevailed upon by your argument, and in evder to express his belief in (we will say) the law of similars^ ealta himself a **homceopath.'* A stranger afterwards remarks to him, **You are a homcaopath, I believe?" *'Yes," he replies, and then, anxious not to leave the impression that he is a blind disdjide of Hahnemann, he adds, *'l don't believe, however, in all the theories of homcoopathy." The stranger goes on his way reflecting, *' I have always been told that there IS mneh nonsense in homoeopathy, and the remark of this pro- fessed homoeopath proves it to be true. I may as well cease my enquiies into this matter*" His reflections would have taken a different turn if the answer had he^a *' No, I am not a homoBopaihist, but I agree with the more importimt principlca advanced by that body." Harm, rather than good, reralts when^ those who should zefose to call themselves homoeopathists, on gronnds of logical disability, consent to do so from a mistaken notion of moral necessity* The whole question narrows itself to fhift : — On the one hand, stem togical principles demand that wa
810 COBBBSMirMSKOB. jm&jS?
think only of the Mom; on the other hand is a-kinjlyijuipalliy, originatuig in benefits receired, luring ns to a tempomy oipe diency. The etndent BeMag eomething bettor than the medieal method of the day ifl earpriMd and d^ghted at the resalte ob* tained from a system whieh on the face (^ it appeared ridieyhwi. As his enqoiry proceeds, he finds himself ginng np> one by one, the modes oftreatment he formerly adopted. Now cornea the qfaesiionf Bhall I annoonce myself *' a homoBopath ? " He aeqpDuiats himself with the theories and principles of homoeopaHiyy and finds the facts in which he beBeyee, so entangled witii qneetionahle doetrines that it is difficnlt to separate the one from the other. He knows that his scientific training forbids him to eoppoii these last centnry gnessee, and yet he fe^ a sense of indelite^ ness to homoeopathy at a ttkole ; he knows it has been con* demned a$ a whole by the profession, and he feeto a sort of moral oUigatikm to assome the title of homcsopath so aa to fjlve it snch si^pport as lays within him. <* I can believe the tratfa that is witlun it, and not trouble myself abont its hSkam. I shall thus accomplish my chief oliject, Tie., to aid what I know to be tnie." But, hete is the fallacy; he does not aid the tralh, he hinders it. What he does, is to help retain eertaaa valuable scientific principles in the entanglements in whieh they wen placed by Hafanemanfi, to help keep them in a condition whieh aUowB earnest workers and thinkers to pass them by and never know them. Btiled by sympathy and drifting into «cpedien^t he izgmres the truth he "s^uld support. As a scientific man, he is bound to take a move difilcult task, to state boldly what h« finds to be true, and to point out with equal boldness what he finds to be false.
Thus he would at first occupy an isolated position, condemned by those who would keep every sheep to its fold. But in pr»- 3K)rtion to the truth ^of his principles would he find himaelf in :a short time one of a large body, iHio, keeping steadily before them the truth, pursuing their enquiries imtranimelled l^ tia« ditional methods, would place those frets which it is the preaumed desire of modem homoeopathists to propagate on a firm scient^ basis, and aid their progress in a manner wliich 10 impossible to a body who, united under one common nazne, have no oommm belief, and no common object*
Stated vaguely, the common ol^eot of homceopathiata ia to ssa system of prescribing adopted by the profocsion as a body. It may be said that this will only be aecomplished when tha fuiionaU of the law of similarB veeeives scientific demenstraticn* Let us suppose that this ia accomplished in this manner. Thai physiologists pursuing their inveetigationa into the fonctiona of the nervous system as well as the laws against viviseetioii viB aUow, make olear the action of the minute aenvma ganglia, and
2hm"iB?* fiCfMflwP(Mii>aMcaB» SU
.Ifiqri
:fiad ike etfwit of WMk aad alioiig •lhnnkntii» appHad to ihAiii» jmd that it is thus proved ihat ia. order to pvodiice a certain assies of effeeta it ia neoesasxy ta ap^y an infiaitesimal qnantitj of a eeriaia toade agent, while ezaotly the opposito effaots are prodnoed on applyi^ an insBsaaad quantity of it. That ih» madieal profession, tsking adiwitage of these new physiologieal ^piinfiiples, find themselTea adopting the same dose and the same drag as honuBopathists. Ia ii to be sapposed that they woald^ tiisarafore, adopt' the terminokifiy of Hahnemann, and say with ihe HomaopoMe World fi>r last month — ^* We belieTe that drogii have a spiritaal and dynamio actioa, and disease a spiritual and dynamie origin.'* Or would they use jmy of those terms in •common use among hommopatha,^ not £or reason's sake, bat for Hahnemann's? And iKmld not the bonoar which shoald properly iall to hoBUBopaths lor holding on to the tmth in spito of pro* ibssioBal and social obloquy, Im somewhat shadowed by the ladt •on their part of any effort to obtain for those traths a proper aeieatific position.
This is a hypothetical casoi bni there most be some sneh end to this thevapentic heresy, and it is to tUs end we loolu .HomcBopathisIs have a doty to theaaselTes, a duty to the truth tkey hold, and a duty to those wim are as amdous as them* MtimB to sapport the troth. There is no room tor expediency, it ia not a matter of '^hanliag down the cdoars,'* or thinking ''< What the Lancet will say." Those who admit Uiat ih^fm 4»$ fallacies embraced under the name of homoeopathy most distiaetly separato it from them or tbemselTes from homoBopathy. Thiacamiot be dona in& few lines of definition. It will require a •carafiil analysis, eliminating every doabtfol thing, patting :nottiing forward as fact which is not capable of demonstration. .Siqperieoce teaches in this matter how easy it is to add new iacts and how difl&calt to get rid of old fAllacies,
I am, Dear Sirs,
Yours respectfblly,
Pjebct R. Wilde, M.B.
[The foregoing lettor appears to us to demand a few obMrvations, in order to remove some misapprehensions wbi<dt appear to have obtained a hold apon the writer, and are probably entertained by others.
Dr. WMe says that *« it is held by the medical profession that the principles of homodopa^ are set ibrth in the 894 propositions •of the Organmx^^ It has been urged, time and again, during the last fifty years, that iHliile the principles of homoeopathy are set lorth in some of those pn)f>ositions, others deal with mattors, 'ttw truth or Msify of which do not in the least affect tho prineiplee of hemosoptttfay. How thoreughiy coirect this is, ia
S12 GOBRHBPONIHDIOE. ^''SSSJ^lS^,
shown by Dr. Hogfaes' waaAjma of tha several editioiui of tbe Organon. HbmoBopathy was as deariy taught in the first as ii was in the fifth, bat, ii was net xaJ^ the fourth and fifth that Hahnemann advanoed theories, whieh axe generally regarded sa nnsubstantiated by fiusts, HomcBopaihy has r^eatedly been shown to consist in selecting drnga on the frineiple of similara, and its practioe to involve the stady of the pathogenetie properties of drugs, the small dose, and the single medicine.
In the case of Dr. Wilde's supposed practitioner, who treaia his patients in a manner almost identical with that which ia h(Hn(Bopathic, and yet refuses to be called a homodopatht we do not hold him i^> to soom and contempt because he refiises to join the homoaopathic body, or to call himself a homoeopath ; but because, believing in, not one of the principles of homoeope^hy, but the principle, and patting it into practice daily, he refiises public aeknowledgment of &e troth of thai in which he gives constant evidence that he believes.
Then, again, he makes one of his supposed practitioDeKa of homoeopathy disclaim belief in some of *'the theories of homoeopathy." Here, again, homoeopathy is supposed to mean all that Hahnemann taught. It is nothing of the Hahnemann taught homoeopathy phu various pathological, and physical theories, which are quite iadependeni of it, and can only be regarded as a part of it by those whose study of it has been imperfect.
Dr. Wilde urges the avowed homoeopath ** to state boldly what he finds to be true, and to point out with equal boldness -what he finds to be false." This piece oi vary ezcell«it advice seems to us, fdien viewed in the %ht of homoB(^athic literature, to be somewhat needless* When we look into the writings of such exponents of homoeopathy as Arnold, IMnks, HHSchel^ Georg Schmid, Watzke, Wurmb, Fleischmann, Caspar, Tesaier, Jousset, Cretin, Drysdale, Dudgeon, Russell, Henderson, Black, Hughes, Bdce, Holcombe, Ludkm, Wesselhoeft, Talbot, — we see that these and many others have lacked no candour in their criticisms, have left the opponents of homoeopathy without excuse for declaring it to be bui*an expression signifying all tbe opinions of Hahnemanix. Let Dr. Wilde rdad Dr. Dudgeon*& Lecturet on Homceapathy^ and he will there see the very con- siderable amount of criticism to which Hahnemann's views have been subjected throughout the entire histoiy 'of the thecapeatie method which he formed and daborated.
The simple fi^st is, that any physician, who admita that homoeopathy, as we have defined it, is true, is ss much expos^ to the contempt, ridicule, uid insolenee o£ ihe dominant section of the prpfesaion as one who aeoeptB. without a doubt every i^inion eipresaed by Hahnemann^ If
•
he believes that it ifl trae» in the foregoing dense; he is boond by his dnty to his profession to say so openly, regs^ess of con* sequences, and indifferent to ndsrepresentation. Only in this way can he contribute his quota to the development of scientific medicine, an'd to hastening on the time when the knowledge of homoeopathy shall become general, and its appreciation too indely felt to form any bamer to the existence of friendly ieelings and cordial mntoal co-operation thronghont th^ pro- fession.— ^Eds. M. H, R.]
THE L. H. UIPLOMA.
To the Editors of tJis ** Monthly Hovfuxopaihic Review J^
Gbmtusmxn — ^The mysterious letters " L.H/* wonld puzzle ihe world at large. They are regarded with aversion and dis- may by many of oar fnramost eoOeagues. On the other hand, the diploma which they represent is supported by most of the leaders of British homoeopathic journalism.* I unsh, however, to say that the more the license is considered the less likely is it to be generally approved. It is true that Dr. Bayes obtained About 100 ayes, and only dO noes, in response to hu appeal by letter to honueopathie practitioners* But this was the result of a statement of one side of the argument. When the vote was laken at the British Homosopatiiie Society, after full discussion, ft large majority decided against the diploma, and some ool« leagues who intended to say " Yes '* to Dr. Bayes, voted *< No,** after they had asked and received my reasons on ihe other side. Moreover, one gentteman who assented wrote to Dr. Bayes that he ''had not considered the question much," but that he *^ yi^ded to so large a minority." It may also be concluded that the 140 practitioners who sent no reply were not very warm admirers of the license.
The zeal of Dr. Bayes in the cause of homoeopathy is worthy of admiration. But it is to be hoped that further reflection will «liow him the wisdom of abandoning, the projected license.
Dr. Bayes was indignant at my suggestion that the Spiri- toalists would be seeking a diploma of L. S., and Table-turners ihatof L.T.T. He fancied that I was ridiculing homoeopathy. On the contrary, the obvious intention was to apply the &mous logical fonnula of redadio ad aimardum to the license. It seems that a similar view of the case occurred to Dr. Black, who sa3rs, in the April number of the Emnew (p. 249), that Holloway's elerks might, '' in order to protect the public, estaUish an L.H., none genuine but the Licensed HoUowayist."
* Since ihe above web written, Dr. bnrnett has seceded from the Hoensing scheme. Not that he objeeis to the L.H., bat only to the aiamMr in which it is advocated by Dr. Bi^es.
814 coBftsapoHPXircB. ^'IS^L^M^f?^
Bafi«v,lls3rl,lffit.
It was a notable idea to hint that those vho did not poeseM the licenBe would be left in the eold as meertified honKeopatiue practitionen* It may be eonfidentlj predieted, howeyer, that the threat wiU be as nnsnceessfid as the bait. Anyone may be ]nroad to possess the degree of M*D. of a British or £ctfeig& miiyersity of high repute, or the diploma of a College oi Phy- ricians or Borgeons. These ere recognised titles granted after examination by chartered iQ8titation8, and the names of those who hold them are published in the Medical Begifter. Bot^ happily, no man can be c<»(ipelled to aesame the proposed diploma, as a license to practise the glorions system Imown as homoeopathy. It is difficult to imagine even a newly-fledged practitioner parading himself as '* Mr. Overall, L.H."
Yonrs fiEuthfally, Nbvillb Wood, M.D., F.B.G.P.E., {hut not L. H.) 10, Onslow Square,
April 8rd, 1882.
■ I ■ I ■ - -.111 «■ — — » 1.1 .1. I II ■■>■ 111 r I i.» ■ ■■ I I
To the Editors of the *' Monthly Homaopathie Review.**
Gentlembn, — ^I had no idea when I gare in my adhesion to the use of the L.H. diploma in oor ranks that such an amount of opposition would be made to the proposal, and from men of esteem among us. A degree of bittemesi also has been exhibited in the controversy which is not creditable to our position as mem of culture. Let us review our position. The 28rd elanse of the Medical Act merely binds the examining bodies, it does not make it illegal for the candidates to add to their legid quahfiefr* tions any fresh knowledge, or to accept an attestation of that addition. The legal qus£fication ignores any addition that may be made to our knowledge, whether in theory or practice. It ignores it, but it permits it. The candidates are at liberty to believe or practise anything they like, from the acupuncture of the Japanese to the incantations of the medicine man in America. Now, if within the wide limits, geographical as well as actual^ of this charlatanry we should stumble upon a God-given law ai eure, recognised largely by humanity and only ignored by the chartered bodies, there is nothing to prevent our availing our* selves of it, nor, as far as I know, of an attestation that w» thoroughly understand it and are qualified to practise it. Tbm is due from us to the public, and they have a right to expect it of us. We do not parade it on our door-plates, just as we do not parade the L.M., or any other titie of special meaning. We have an apparatus for teaching both tiie tbeoiy and practice of
tSSSS^U^UM^ OOBBBgroifBBHOB. 815
lids goUime disooveiy. Batter men eannot be found than these teaelien. Why stioQld we not nee their atteetatioDs of our eompetencj — in a professional way, but so as to let the pnUie know that we imderstand the subject? It has been objected that it is prapoaed to endow ^very practitioner of homceopathy with the eer^ficate if he be only of old standing. I do not see &e foiwe of this objection. Every reform must be of this nature. No reform can be retrospectiye. The law, when it became stringent for legal qualification, excepted all those in practice before 1815, for it was felt to be uigust to disqualify men already established, however unworthy. I think we are doing the rational thing. We cannot wait till men eome to their senses before we guarantee the public against incompetent practitioners. If there be any in our ranks unwoirthy the name of Hahnemann ttiey will die out ; the rising generation, at least, will be stamped with the seal of genuineness, and the crypto-homoeopaths, who are hiding in the ranks of those who profess disbelief in medicine, win be known as not of us, and as not quite genuine, but pre- tenders. Something more is due to a great truth than clandes- tine admission into such company, to have it smuggled into respectability as contraband. We cannot wait for a charter or to be made legal. The advent of homoeopathy to public accept- ance must be with shouting ; it must be placed in the edifice of medicine ; it must be hailed as the ^'Head of the Comer."
I am, Gentlemen,
Yours respectfully,
Thokas HayiiB. Bochdale, April 11th, 1892.
P.S. I have no unconquerable desire for the use of L.H. Any other designation wiU do.
To the Editors of the *^ Monthly Homceopathic Bevietc,**
Gentxjucen, — ^I am directed to forward you the Besolution passed at the meeting of ''Liverpool Homoeopathic Medico- Chirurgical Society,*' held on April 6th, viz. : —
** That as the resolution passed by this Society at its last meeting seems to have been misunderstood, it is hereby resolved that we are opposed to any title being conferred by the London School of Homoeopathy, unless they obtain legal power to grant one." I am, yours truly,
S. H. Blake, Hon. Sec.
We have also received the following note from Dr. Drysdale ; —
** The fdlowing resolution was agreed to by the undersigned
homoeopathic medical men in Liverpool and neighbourhood, who
816 COBBBBFONBBNTB. ^'tSS^lS^UTmi
were not present at the meeting of the Liverpool HicRniBopathio Medieo-C^iirorgiioal Sooiatj, on 2nd March, 1882, or diaaaitfld from the resolution then pasaed.
'' * It is not expedient, in the true intereeta of homceopaihy, to seek for a sectarian title, each as Ldoentiate in Homooopathy, to be made registrable.' — J. Dryadale, J. W. Hayward, J. liooret E. Hawkes, T. Simpson, T. Carson, J. D. Hajward, E. L. Hod- son, J. Finlay, Samuel Brown." .
NOTICES TO CORRESPONDENTS.
^% We cannot undertake to return r^eeted mamueripti.
We much regret that we have, m eonfleqtienoe of the presoore on oar space, been eompelled to postpone the pnblieatloii of 9e;pen lij Bn. l&CKBBBo, Bathes, and C. L. Tuokbt, and zevieira of Db. WnsLow^ work on The Human Ear, and of Dr. £atoxi*s on The Diuaeu of Women. All, we tmst, will appear in June.
CommunicationB, AchavebeenreoeiyedfromDr. Both, Dr. G. L.TuasiT, Dr. MoEBiBSON, Captain Matcock, Mr. Chambb^ (London) ; Dr. Dbybdals ^verpool) ; Dr. BaowN (Chester) ; Dr. Batioss (Canterboiy) ; Dr. Bitbb (Brighton) ; Dr. Gummss (Oiford) ; Dr. K M. Maddkh (Biimini^iam).
EBIUTUM.
The number of new patients admitted during last year to the Ozfoid HomcBOjpathio Dispensaiy was 921 and not 221 as stated on page 235 of our April number.
BOOKS RECEIVED.
Brituh Journal of Honueopathy,
The Homaopatkie World.
Student*$ Journal of Med&eine.
The Chemist and Druggist,
Burgoyne'e Magazine of Pharmaeg.
The New England Medical Gazette.
The Hahnemannian Monthly.
The New York Medical Times.
The Medical Advance.
AmeHean HomaopaXK
The Therapeutic Gazette.
The Medical Counsellor.
BihHothtque HomeMpatkique.
BuUet^de laSoeiiti Homesopatkitue Midieeie de Fremee.
AUgemeine Horn. Zeitung.
El Criterio Medico*
BdlUHno CUnieo.
Rivista Omiopatiea.
Papers, Dispensaiy Beports, and Boolu for Beyiew to be sent to Dr. Pops, 21, llenrietU Street, Cavondish Square, W. ; Dr. D. Dtcb BaowN, 99, Seymour Street, Poiiman Square, W. ; or to Dr. KaNXiDT, 16, Montpetier Bow, BlaeUieath, BJB. AdrcctisenMnts sad Buflineis eommunioations to be sent to llessrs. S. Qoulp dt Soi, 69, Ifooigite Street, £.a
, Jvns 1. 1812.
LOKBOX HOKOBOPATHIO HOSFITAIt. 817
THE MONTHLY
HOMOEOPATHIC REVIEW-
"THE LONDON HOMOEOPATHIC HOSPITAL."
In our April nninber it was oar pleasing duty to lay before
onr readers the results obtained at several of our leading
dispensaries, and to direct attention to the various points of
practical utility in their working. We survcgredy as it were,
the outworks of homoeopathy, the advanced posts, where the
hardest work is done, and where, perhaps, there is the least
notice bestowed on the workers. We will now take our
readers with us into the fortress, the citadel of homoBopathy
in our great metropolis. The thirty-second annual report
of the hospital furnishes us with an interesting theme.
It is doubtless well-known to most of us that the hospital
building has tmdergone considerable alteration during the
past year, part of it having been to a great extent
re-modelled. This was necessitated by a defect in the
masonry of the east wall of the building, which after careful
survey it was decided to pull down and rebuild. Whilst
the repairs were in progress, ** a committee of medical men
and some members of the Board decided that it was
desirable to take advantage of this opportunity to abolish
some cumbersome and very inconvenient party walls,
dividing the wards on the two floors chiefly affected, and
thus to throw into one two wards on each floor. The
advantages gained by this measure are greatly improved
ventilation and light ; much greater facility in carrying out
the nursing duties, and at a less cost ; and a very marked Yol. 26. No. 6. z
318 LONDON HQM<EOPATHIC HOSPITAIi. ^'''SSS^SSSTSS^
improvement in the appearance and general character of the wards."
The sweeping alterations indicated in the above extract from the report deserve more than a passing remark. The committee have devised and carried ont a great stractoial improvement^ which has gone a long way towards raising the efficiency of onr hospital to the high standard all its friends desire for it.
Viewed according to our modem ideas, there is mnch to be desired in the arrangement and accommodation of the hospital. But it has long been known that without entire rebuilding, the present structure can never be sufficiently modernised to answer to all the hospital demands of the present day. This, in the present state of affairs, is out of the question, but the committee deserve all praise for the great and successful efforts they have put forth to make the best of the building as they find it.
We hope the time is not far distant when the friends of homoeopathy will be asked to put their *' shoulder to the wheel," and that a new edifice, having at least 150 beds, and replete with every requirement of modem sanitation and medical science, shall arise to extend the blessings of homoeopathy to the poor of our great metropolis.
As it is, the benefit of our present hospital is felt far and wide ; the out-patient department draws on every suburb round London for its clientele, and a curious enquirer would be surprised at the distances some patients come in order to obtain homoeopathic treatment.
The alterations in the east wing have added greatly to the efficiency as well as the appearance of the wards. Only one thing more is needed, and that is, " Patients — more Patients." That it should be so, arises largely from the fact that it is not generally known that there is good accommodation for 71 in-patients ; but in the absence of
mS^J^TTSS^ LONDON ROM(EOPATHIC HOOPITAI.. 819
fit snbjectB for treatmenty there ^rore, at the time the return was made out, only 63 in the hospital. We desire to draw the special attention of onr medical brethren to this matter, for, after all is said and done, it is to them that ^e hoqpital authorities must chiefly look for eligifale ^ases for treatmoit in the wards.
Another noteworthy event in the year 1881-1882 was tho presentattoii to Lady Ebuby of a life-size portrait of the highly-valued and esteemed Chairman of the Board of Management — ^the Lord Ebury. This interesting pre* sentation was noticed at some length in our last number. The Board take the opportunity afforded by the report of ** recording an earnest hope that his lordship may yet be spared for many years to hold the position of Chairman^ which for so long a pmod — twenty-eight years — he has filled, to the great benefit of the institution." A wish which every true homoaopath will devoutly re-echo.
During the year the noble President of the Hospital — the Eabl of Wilton — has been removed by death. His place has been filled by the appointment of Eabl Caibns, who has signified his pleasure to accept of the position. We regret very much the loss which the hospital has sustained, but share with the Board the gratification which they feel at the acceptance of the office of President by so thorough a homoaopath as Eabl CAmNs.
Turning to the paragraph of the report which refers to the expenditure of the hospital we find much matter for congratulation. This paragraph forms, as it were, a testimonial of efficienqr for the Board and their Official Manager. Owing to the economy in administration, and the fact that the number of in-patients has been but slightly increased^ the board have been enabled to pay not only the expenditure proper to the year, but also to repay out of income the sum of £400 due to the Treasurer, and
820 liONDON HOMCBOPATHIG HOBPITAL. ^^SSSi^^HSumt
jtt to show on the ennent aeeoant at tbebanken a balanoe of £4A 68, 2d. -with which to eommenoe the new year.
There is a point which we wish to hring prominentij before our medical readeis, and that la, that although there are seventy-one beda in the hospital, yet.the present income will only suffice to maintain a daily average of between fifty and sixty in-patients.
Snxely with the widespread knowledge of homoeopathy now prevailing, there should be no lack of response to an appeal for help. We fear this state of affairs arises mote from the want of an appeal than from unwillingness to respond to it. If our colleagues would each take the trouUe to lay before influential patients the claima of the hospital, and to press the. necessities of the case on their attention, there can be no doubt that the remaining beds would be filled and the whole organisation placed on a satisfactory footing. The management deserve all praiae for what they have done with the means at their command, but much remains to be done, which could easily be done if our brethren would cease from polemics, and instead of seeking for an extinguisher for our light would do some- thing to help the good of the cause.
Then again, there is another paragraph in the r^Kurt, which calls for the careful consideration of those of oar colleagues resident in and aroimd the metropolis — we allude to the changes which have taken place in the external staff and the difficulty found in replacing those gentlemen who have resigned. We trust that some of our younger colleagues will be found willing to give up a small portion of their time to this work. The out-patient department of hospital work bas always, and justly so, been regarded as the training ground of the physician, the variety snd number of the cases affording him a varied and wide field for developing those percq>tive faculties so useful in daily
1»
LONDON HOUCBWATHIO HOSPITAL. 821
praetioe. The out-patient department of our hospital has always been nomeroaslj attended, and patients from all parts of London testify to the benefits received there.
The amateor dramatic perfonnanee given last year by ''the Thalians" was, to use a stage phrase, ''a regular bumper," the net profits having amounted to one hundred and eight pounds.
We are glad to see that some friends have recognised the necessity of providing amusement for the patients. It is wonderful how a little fun and diversion dieers up the ward* and seems to lend new life to the sufferers. *^ A cheerful mind helps the doctor,'' and there can be no doubt that occasional entertainments and concerts would do much to brighten the weary hours of suffering. Such a concert was organised by Lady Ida Low, in March, 1882, assisted by watne mmhen oi the Kyrle Society, and most thoroughly it was appreciated. We only hope that the success it met with may encourage a repetition at some future date.
Homoeopaths in general are apt to .overlook the claims of the hospital. With a few notable and praiseworthy excep- tionsy the old adage, ** out of sight out of mind," holds good of this as of many other kmdied institutions. This should not be 80, and perhaps in the future, when a new generation of homoBopaths shall arise, who are not ashamed of the name of the hospital where they received instruction, we shall find medical men pressing the claims of our insti- tution upon the rich, and encouraging the poor to add their mite. How soon, if all were unanimous in their efforts, mif^t the Board of Mani^ment feel themselves encouraged to enlarge their borders, how soon might all the beds be constantly occupied. Oases there are in plenty, if medical men would only show a sufficient amount of interest to send them in for treatment. The organisation and machinery are in thorough working order, all that is wanted is more patients, more subscribers — that we may have the former we must ha^ tibe latter. And it is to our medical readers that we look to supply both deficiencies.
ELBCTKIOITT.
ONELECTMCITY: ITS PHYSIOLOGICAL ACTION
AND THERAPEUTIC USES.
By DoM&LD Baykeb, M.A.. MJ)., F.B.a.S.
fContinued.j
The galTuiic curreot prodnoes no shock, onlaBS it be broken or intemtpted. This is nnually done by means of ft rheotome or intermpting handle ; if weak, liie cnrrent prodaces little or no pain ; if strong, it prodnoes a tingling, homing sensation, at the point of contact with the elec- trode ; if Tory strong, it qoickly beoomeB nnbearable, and produces nlceration. The charscteristics of this fonn of electricity are comparatively low " intensity " in its action on nerves and muscles, bat a large amount of " quantity." It produces chemical and thermic results far beyond those of atatio or Faradic electricities.
Faradic electricity is of high tension, having almost no
chamical action, or any direct effect on the temperatore.
It prodaoes none of the senBations so oharacteristic of the
tfaiVanie current. In the application of electricity it most
be borne in mind that the positive pole is the less irritating,
therefore, in general electrization, the negative pole shon^
be placed at the feet, coccyx or epigastrinm, while the
gmsitiTe should be applied to the head, neck, spine, and
other sensitive parts. In cases where the sedative effects
of electricity are reqnired, the positive pole is preferable,
being less irritating ; but if stimnlating effects are desired.
the negative pole shonld be ased. The strength of the
current used must depend on the snaceptibility of the
patient to electricity. Some cannot bear even the mildest
application. A mild current, either long continued or
fH^uently repeated, is far more beneficial as a therapentic
■gent than a strong one ; strong currents ore more apt to
M hortfol than beneficial, and usually canse aggravatioD of
,e disease. The results of electricity, when carefally
iplied, and in properly indicated cases, are relief of pain ;
iprovement in the pulse, digestion and nutrition ; increase
appetite ; and a soothing effect, with tendency to produoe
sep. When improperly applied, if oontinned for too IsDg
time, or used too strongly, profose pei^intioB, dizzinesB,
"BpncBft, headache, soreness, nervoDsoeas, exhanstion,
id certain aggravation of the complaint.
Ekciricity may be adminiBtered in two ways — '/ locally " for purely local affeciionSy where it ia desired as maoh as possible to confine the action of the current to some par* ticular part ; and *' generally/' where a constitutional effect is wished for. In tiiis latter instance the greater part of the body is brought under the influence of the current. Electric currents may be '' direct or '' indirect." Direct currents are those which are applied over the surface of the muscle or part to be acted upon ; indirect where they are applied to the nenre supplying tiie muscle or part to be influenced. The points where the nerves enter the muscles are called "motor points." These are well shown in Zeimssen's charts of motor points. Large electrodes are used for direct, and small for indirect electrisation. Currents are either " stable," where both electrodes are kept in the same position ; or " labile," where one or both are moved oyer tixe surface.
Local Electrization is, as before mentioned, the method of employing electricity, where the purely local action of the electric current is required. In this method the elec- trodes are so placed, that the part to be influenced lies between them, and as the current passes from one electrode to the other, it must necessarily affect the part that lies between them. In electrization of the head, one pole may be placed on the forehead and the other on the occiput — or one pole on either mastoid process, or immediately behind the mastoid processes, according to the effect desired to be produced. To galvanise the cervical sympathetic, one electrode is placed over the auriculo-maxillary fossa, and the other over the last cervical vertebra.
General Faradization. — ^By this method the whole of the body is brought, as far as possible, under the influence of the Faradic current. In employing this method, one pole is placed at the feet, or coccyx, by means of a broad elec- trode, the other being passed over the entire surface of the body. This latter electrode should consist of a metal or carbon cylinder, covered with qpoii^ge or flannel, to which a Y shaped handle is attached, the whole somewhat resembling a miniature garden roller. This form of elec- trode is easily applied, and is more suitable for this purpose than the ordinary flat sponge electrodes.
Central Gaivanization. By this method, the entire central nervous system is brought under the influence of the galvanic current. To accomplish this, the negative
324 ELBCTMCITT. "SS&5S??»SJ'
Betkrw, Jime 1, 18B1
pole, or electrode, is placed a little below the ensifona cartilage ; while the positive is passed over the forehead, to the top of the head, down the side and nape of the neck, and along the whole length of the spme. GPreat care mast be taken in applying electricity to the head and neck, otherwise alarming syncc^, and even death, may resnlt.
Another method of administering electricity (either galranic or faradic), is by means of the electric bath. This method combines all the advantages derivable from all the various ways of applying electricity, and, in addition, gives the patient the extra benefit of the warm bath. In treating disease by means of the electric bath, everything depends on its proper constmction and mode of administration. The electric bath nsed, and I believe introduced by Dr. Schweig, of New York, has always given me the greatest satisfaction, and I consider it the best in use.
The bath is made in the form of the ordinary plnnge baths found in most houses. It is made of wood, slate, or marble ; wood is the cheapest and less liable to be acted on by acids or other chemicals introduced into the bath. At the head and foot of the bath carbon plates are let into the wood ; these plates are connected by means of a copper wire, which runs along a groove let into the head and foot pieces of the bath to the coping, where it communicates with two binding screws, one at the head and the other at the foot of the bath. When a bath is given, a wire is connected from either pole of the battery to the binding screws. If the conductor from the positive pole is con- nected with the binding screw at the head board, and the negative with that at the foot, we get a descending current. Where an ascending current is required, the reverse of this must be carried out. If we desire to localise the current in special parts of the body from one of the poles, what is termed a surface board is used ; this is a piece of board about 14 inches long, 5 broad, and | thick, having a bed cut in it large enough to receive a carbon plate, 5 inches long, 2 wide, and ^ thick; through the centre of this board a metallic binding screw is introduced and brought into connection with the carbon, and to this binding screw is attached a piece of insulated wire, which may, as required, be attached to either conducting wire from the battery. The current is said to be centripetal when the surfiice board is connected with the negative, and centri* fugal when connected with the positive pole. The average
bS!Sw!^STSS^ blbotmoity. 9iS
diiittlion of the btth is about twenty mimites, though the time may range from ten minutes to an hour and a-half. The temperature of the bath may range from 85^ to 100^ or 105^ Fabr. Certain chemicals may be introduced, which will, under certain conditions, enhance its effect. Iron (tart, of iron and ammonia) is useful in amsmia, ehlorosify etc. lodiney either as tincture, or in the form of iodide of potassium, is Tcry useful in the absorption of plastic exiublionsy articuhff deposits foUowing rheumaitism and gout, also in the elimination of lead, in cases of lead poisoning: in these cases about an ounce of iodide of poiaseium is added to each bath. Extract df nudt alone, or in conjunction with iron, has been found very useful in cases of mal-nutrition and debility* If we wish to obtain counter-irritant effects, mustard or common salt maybe added. To render the bath alkaline in some cases of skin diseases, add bi-carbonate of potash, or soda; starch is sometinies a useful adjuTant to the potash or soda.
The general therapeutic effects and uses of the electric bath may be summarised as follows : —
1st. Its value as a diagnostic. — The current makes itself more decidedly, and often, even, painfully felt, in any part where a morbid condition exists, whether this be of an inflammatory, neuralgic, rheumatic, traumatic, congestive, or other nature. It may be compared to tenderness on pressure. In anesthesia the current makes itself con* spicuous by the absence of its normal effects.
2nd. It is an excellent counter-irritant* — The amount of counter-irritation can be regulated to a nicety by the intensity pf the current. After a bath the back and legs are seen to be quite red. Concentrated local counter- irritation can be obtained by the use of the surface board.
8rd« As a general invigorant and tonic it can have few, if any, superiors. In cases of debility, mal-nutrition, want of energy, etc., the tonic effects are striking and brilliant.
4th. It has great powers as a hypnotie and general sedative. The greater the degree of restlessness, irrita^ bility, or wakefulness, the more strikingly does the soothing sod hypnotie inflnence become apparent.
6tb« Improved nutrition, as manifested by rapid increase of weight, is a reliable and constant effect.
Among the diseases that seem to be specially amenable to this fevm of treatment may be mentioned : —
826 HOM(EOPATHY IN SPAIN. ^SSiSL^SWS?
nvfivw, wWW 1« UK«
Ist. BihenmstiBiDy sab-acate and chronio, with their seqnelffi.
2nd. Ohorea, or St. Vitus' dance.
8rd. Hysterical afFections.
4tb. Nenroas exhaustion.
5th. Insomnia (sleeplessness).
6th. AntBmia (the cause of nnmeroas morbid con- ditions).
7th. Paralysis (here yery specially the beneficial effects have been amply jHroved) •
8th« Many forms of nenralgia.
9th. Articolar efEnsions.
10th. Impotency.
11th. Dyspepsia^ constipation^ and chronic diarrhoda.
12th. Some forms of metallic poisonings, as lead, mer- curial, etc.
18th. Very usefal in convalescence from acute diseases, chronic headaches, hay fever, uterine and special 'female complaints.
HOMOEOPATHY IN SPAIN. By Charles Lloyd Tucket, M.B., CM.
Physioiaii to the London Homoeopathio Hospital.
In the volume containing the reports of the business done at the International Homoeopathic Convention, held in London last year, I contributed a short article detailing the principal events that had happened in Spain con- nected with the progress of homceopathy during the preceding five years.
This was written at the last moment, as no Spanish medical man came forward, and was compiled from the homoBopathic medical journals published in Madrid.
Since that paper was written many events bearing upon the progress of our cause in Spain have occurred, and a short sketch of these will no doubt prove interesting to some of the readers of the Review.
It would perhaps be impossible to discover two countries more dissimilar in nearly every way than are Spain and Great Britain, and one might eiqvect the modes of thought of the inhabitants to be equally diverse. How strange is it, therefore, to find, at least in the history of homodopathy.
S^^SiTwbS** HOMCEOPATHT IN SPAIN. 827
ihftt our politios have bomo a fair analogy to thoie ot the
In the report referred to I briefly noticed the foundation and inangoration of the Madrid HomoBopathic Hoapital and School, under the patronage, and chiefly through the exertionB» of Dr. Nnnea, Marquis and Grandee of Spain ; the death of this great man ; and also the unfortunate diviaion which occurred between his friends and the Hahnemannian Society of Madrid, in consequence of hia wiU.
I shall now proceed to notice at greatar length the course the society has adopted to obtain possession of the hospital and school ; the present state of parties ; and the constitution and laws of the school, or institute.
There appears to have been no opposition to the scheme of founding an hospital for the treatment of the sick, and a school in connection with it for the instruction of students according to homcBopathic principals, and the dual institu- tion Iras inaugurated in February, 1878, with great eeremony, and it was entitled, *' The Hospital and Institute of St. Joseph," after Dr. Nunez's patron saint; and Dr. Nunez was unanimously appointed the first dhrector. Four members of the society were appointed physicians in charge of the wards, with three assistant physicians under them to attend to the out-patient department. These physicians were also named professors, and they were to give lectures and clinical instruction to the students attending the school.
All went well as long as Dr. Nunez lived ; but when he died, at the close of 1879, he lefb a will in which he dis- posed of the hospital as though it were his private property, and he left minute instractions as to its management, which were to be carried out by a board of *' patrons," appointed by him for the purpose.
The Cardinal Bishop of Toledo was to be the chief of these, and was to succeed theMarqnis as director, and this body was to have absolute control over the management and appointments. The society was entirely left out in the cold, not being even mentioned in the document. Hence have arisen the straggles for supremacy which have not yet terminated.
The official organ of the society, and the oldest homoao- nathic journal in Spain, El Criteria Medico, immediately began to publish a series of violent articles against
328 HOM<EOFATHY IK SPAIN. ^bSS^^^STTmil
Dr« Nunez and his biendsy denonnemg their eondiiai> and giving a history of the hospital. According to this aeeonnt Dr. Nnnaa certainly originated the scheme and did more than any other man to cany it out ; but he acted as presi- dent of the soeiety» and agent merely for the society. Dr. Nnnez had saggested that* to simpHfy matters and to prevent legal complications* it woold be better for him alone to sign all the contracts and docoments connected with the poiohase of building land, and the erection and famishing of the institution, and to this apparently con- siderate action the society had agreed, but without the least idea that thereby they were makhig him the legal owner of the estate.
The physicians and lecturers at the hospital, and the Mends of the late president, left the society shortly after the publication of this statement, and started an opposi- tion journal* devoted to the interests of the institution — BcUtin CUmio dd Instituto Homoeopadeo de Madrid — and in this they published a counter statement. Accord- ing to this the society ought to have understood* and, in fact, did understand, perfectly well* that Dr. Nones founded the institution as an individual e£brt to promote honuBopothy, and not in any way as the president or agent of the society ; that though he had been very glad to avail himself of the assistance of other medical men* yet he would have carried out the project whether they had hdped him or not ; that, as a matter of fact, he had found two- thirds of the whole amount required to complete the work* and had endowed it with his private fortune on his decease ; and that the society had acknowledged this, when the building was pubKcly opened, in the laudatoiy address it presented to him, in whidi it proposed to call it the Nunez Hospital, and attributed the undertaking entirely to him.
This quarrel has not been confined to the columns of the rival journals, but it has even found its way into the Spanish Cortes. Dr. Pas Alvarez, principal editor of El Criterio Medico, president of the Hahnemannian Society* and member of Parliament* made a long speech on the Aibject, and ended by asking the Minister for Home Afiaiia to interfere in the matter, and to restore the hospital to its rightful owners (the society). The Minister thus appealed to replied that he was quite unable to interfere in the matter, and that the affidr was one not for Buii**
2SSwfS?rSS*" HOHCBOPATHY IK BFUH. 829
ment^ bat for the law-courts. At the same time a ooimter petition was presented to him by the Bishop of Toledo^ on behalf of the board of patronage^ giting another version of the case. In answer to this his Excellency wrote that the xepresentatiYes of the late Dr. Nunez were the legal and solely responsible owners of the institution, as long as their claims were not set aside by the tribunals.
So iar^ then, the society has been delaated upon all points, and whatever its moral claims may be, the legal position of the present patrons appears unassailable.
The monthly reports of the hospital were at first pub- lished in both journals, but as the estrangement became greater the Criteria Medico ceased to mention the institu- tion except to sneer at its management and comment upon the high mortality among the patients in its wards. The Boletin ClinicOf however, g^ves very full and glowing accounts of its progress, and from these it aj^pears that the mortality is about six per cent, of the in-patients treated. This is about one-half that of the other general hospitals in Madrid, though the cases are of quite equal severity.
UntU last year, out of the fifty beds the hospital con- tained, fifteen were always kept empty for want of funds. But last November the Minister who superintends the public charities of Madrid proposed that an annual grant of 12,000 pesetas (about Jb'500) should be made to the Hospital of St. Joseph, on account of the useful and charitable work it was doing. This proposal, was met by the counter one that the money should be given instead to the Madrid Hygienic Society, but this was afterwards with- drawn, and the grant was voted. Now, therefore, there are sufficient funds to permit of every bed being filled.
El Boletin CUnico, in an article on the subject, says : *' We understand Dr. Paz Alvarez wa^ prepared to vote against the grant being made if there had been any active opposition to it." To this El Criterio MeMoo rejoined : ** We hurl back in the face of its scandalous author the ridiculous and mendacious report published in El Boletin against our most illustrious president," &c.
in the January number of El Criterio Medico are given the results of two legal suits. The first, brought against oxie of its editors for libel by the Bishop of Toledo, was dismissed with costs. The second, brought against the son-in-law of Dr. Nuness by the society, ended in this
880 HOMOSaPATHY IN SPAIN. *p2K£%??^
Re?i«ir, JtUM 1, 188L
f^ntleman being publicly oensored and condemned to pay flJl costs.
One wonld naturally fear that the school would suffer in efficiency, owing to the jealousies of those who should support it, but fortunately this does not appear to be the case. In the annual meeting of its supporters, held in the institution in January, the Dean spoke of the progress made during the preceding twelve months, and stated that there were forty-six students attending the lectures for the winter session 1881-82, against twenty-six during 1880-81. He spoke highly of the standard of education reached, and said their school might be compared without fear to those of England and America. In strongly urging all students and young medical men desiring to understand homoeopathy to attend the lectures and clinical instruction given by the school, he said he was sure that two years of study within its precincts would enable a man to learn more homoeopathy than twenty years spent in ordinary country practice.
The following are some of the rules of the institution, mostly laid down by Dr. Nunez in 1879, and which are carried out by the patrons : —
1. There are two professorial chairs — of Homoeopathic Materia Medica and Therapeutics, and of the History and Practice of Medicine — ^these chairs being held by physicians to the hospital.
2* The physicians in charge of the wards give two clinical lectures weekly, by the bedside of the patient.
8. One of the professors is Dean of the faculty.
4. The professors are paid by the fees of students — these being very small, according to our ideas.
6. The student after attending lectures at the liospital for two years goes up for examination on the subjects studied, and if he passes he is given the diploma of *' homoeopathic doctor,'* for which he pays a small fee.
6. This title is also conferred upon physicians who have practised homoeopathically for six years before the founda- tion of the school.
Only qualified medical men receive the diploma, others are given a certificate of having studied and passed an examination in stated subjects. •
In cases of great merit the diploma is given to students free of charge, and in honour of the Centenary of Gal- deron, six such.distinctions were bestowed upon Alumni.
£!£^j£?vS^ MBDIcniK OF THE FUTUBE. 331
The practice tangbt by the profesflors, and carried out in the wards, is to gi?e one medicine of a high potency — ^200 being apparently the favourite dilation. Think of thia in the country of Sangrado ! A synopBia of the lectures to be deliveredy a folly reported clinical lecture, and details of 0ome interesting case in the wards iq»pear in the numbers of El Boletin ClinicOy together with much personal and polemical matter.
Learning from its adversary. El Criteria Medico has increased its size, and has vastly improved its contents. Whereas formerly it was filled almost entirely with trans- lations from German, American, and English medical papers, it now publishes capital articles on drugs and diseases of home manufiftcture. It also continues to pub- lish, in full, reports of the meetings of the society, and it devotes a certain portion of its space very often to com- ments on, and contradictions of, articles published in El Boletin CUnieo.
From the two journals which have been referred to the above history has been, as impartially as possible, com- piled, and therefrom will be seen that the spirit of discord present with us here in England is also rampant among our eonfriree in Spain, and the ** Courteous Spaniard " seems, indeed, to be our master in the language of con- tumely. Yet homoeopathy is flourishing throughout Spain. Many of the most influential members of the Court and aristocracy are active propagandists of its truths, and, in spite of all opposition, the school is sending out yearly increasing numbers of educated physicians, to carry its principles into every village throughout the land.
21, Henrietta Street, Cavendish Square. April, 1882.
THE MEDICINE OF THE FUTURE.*
By H. Blumbebo M.D., J.P.
First of all I must correct the title of my lecture. It is not the medicine of the future upon which I crave your attention. I have no particular drug or remedy to bring to your notice, but it is Medicine of the Future, in analogy with Richard Wagner's Music of the Future. Allow me
* Bead before the Sonthport Ltterarr andFhiloiophical Bodeir, Maieh 17th, 1883. r ^ r /.
882 IfJBDXOINE OF THE FUTUBB. "^SSL^JftSt
Bsrieir, Jime 1, WtL
to eiqdain the purport of my paper in a few words* I intend to upecnlate upon the future of the art o£ ^M^lmgp or, in other words, I will aak, and try to answer, tiie question, ''What will be the position of phyaiciana in regard to their patients ; and what will their method of treatment be, say, in fifty years hence ? " Every treatise which has to deal with the future rests, as you are wdl aware, more or less upon hypothetical foundations, bat such foundations need not be an airy fabric, which leaTes no trace behind ; on the contrary, a hypothesis deducted from analogy in Nature, or from historical premises, is often the precursor of truth* The historian is like a prophet turned backward and looking analytically down, and a prophet is an historian looking forwards and synthe- tically upwards. The first condition, therefore, in order to be enabled to speculate on the future career of medical art and its professors is to take a clear and correct survey of the history of medicine — ^what medicine has been. The next is to understand what medicine is at present, and not till then we shall be at liberty to inquire what medicine will be. But before I begin the sketch q( the past or retrospect of the history of medicine, let me assure you Mr. President, Liidies, and Gentlemen, that I have not undertaken to deliver this lecture in any sectarian spirit or with the hope of gaining proselytes. I have been asked by our. worthy secretary to read a paper, and I have naturally selected a subject which I understuid and which is daily in my mind. This is the explanation of my paper. I need not tell yon that I will avoid as much as I can to give offence to my medical brethren who think differently. Our motto is m certiM unitas, m dubiiB lihertM^ in omnibui eharitaa. The history of medicine is of course intimately connected wifch the general history of mankind, and has exactly, as the latter, three great phases. The first epoch from the dawn of the art under the Asklepiads until Galenus, who brought the medicine of the ancients to comparative per* fection. Then a gradual decline of medical art and science, synchronous with the decline in civilisation sub- sequent on the downfall of the Boman Emjure, a decline which lasted nearly to the time of Sydenham and Harvey; and lastly, beginning with these eminent physicians, an era of slow, very slow progress, which only became accelerated by the teachings of one great medical reformer in the first quarter of our century. Allow me, Ladies and Gentlemen,
S^fj^Tl^'' MEDICINE OF THE FUTURE. 333
to go somewhat more into detail as regards these three great Epochs. The first traces of medical art are found in the records of ancient Egypt, that mother of all civilisation. Isis and Osiris the mysterious deities were considered to have revealed to mortals the secrets of the healing art. The caste of priests was the only one allowed to practise, and any one of another caste who dared' treat the sick was pmiished with death. Disease was always considered hy the Egyptians, as later on hy the Hehrews, to be the effect of divine anger, and sacrifice offered to the priests was enjoined as the best means of cure. The ancient Hindus had already many centuries before our Christian era a book on pathology and therapeutics in Sanscrit, the Agar- Veda, whose author was San*atas. But the principal physicians of the ancient world were the Greeks. There was one large family, the supposed descendants of iEsculapius, who were in the possession of the secrets of medicine. Their way of cure was simple but peculiar. The patient had to pass one or more nights in their temples, and to tell his dream to the priest-doctor, who ascertained by that dream the nature of the complaint, and then ordered the necessary remedies. The great master of the healing art, a man who really deserves the proud title of Father of Medicine, rose among the Greeks about the fifth century before Christ. I mean Hippocrates. Hippocrates was a scion of the Askle- piad fanuly, and was bom in the Greek Island of Cos, 460 years before Christ. He is said to have learnt the medical art from his father, and after being fully trained he practised as a sort of wandering physician in Athens and other parts of Greece, Asia Minor and Lybia. In his old age he settled in his native place of Cos, where he died 874 years before Christ. He had a wonderful intellect, and in those books which have escaped the ravages of time, and have been preserved for us — ^books on diet, on epi- demics, on prognostics, and the wonderful collection of aphorisms — ^he laid down rules of treatment which can be studied with great advantage even now. He laid justly great stress upon air, diet, climate, and even the circum- stances of the patients. His remedies were simple and mostly taken from the vegetable world. He hated un- pleasant drugs, and one of the passages in his writings is, " If there are two remedies whereby you can cure an illness, choose always that which is most agreeable to the patient." After Hippocrates came his two sons, Hippilas and Dracon,
Vol. 26, No. 6. 2 a
334 MEDICINE OP THE FUTURE. ^^i.^'SJ^fMa
1881.
and after them the school of Alexandria, who cultiyated the medical art according to the principles of Hippocrates. The Romans who had taken their political system, their art, their literature, their theatre, their architecture, and their theogony and religious rites from the Greeks — ^took from them also their system of medicine. In repuhliciui Borne Greek slaves or libertines were the only medical men. Themison, a Greek, practising in Rome about the time of the Emperor Titus, lays, like the father of medicine, great stress upon diet, air, exercise, and intro- duced also the cold water treatment, by which later on the Emperor Augustus was cured. After him Gelsus was the fashionable physician, or as our witty neighbours, the French, would call it, Vassasin a la mode, in Rome. He departed already from the simple and sensible teachings of Hippocrates and treated patients in a crude, empirical way. Galenus, at the end of the Roman period, collected all the theories and practical precepts of his predecessors,' and was the great medical authority for more than a thousand years. But his successors, though they quoted his words, did not understand their meaning; and medicine sank from year to year — ^from century to century — deeper in a senseless, superstitious, cruel and dangerous routine. An attempt at a reformation was made by the Arabs, particu- larly in the tenth and eleventh centuries after Christ, chiefly by the celebrated Aviceuna, but it had no great success; and with the downfall of the Arab power in Europe it came altogether to an end. It is really painful to trace the state of medicine in the Middle Ages. All sorts of magical formulas, talismans, the most disgusting remedies from all kinds of animals, the absolute ignorance of the human constitution, of physiological laws — form a most objectionable picture. I regret to say that traces of that time have continued within the present memory of man, and I am not sure whether living persons who put their faith in nasty smelling liver pads of advertising quacks, or in some cure-all of some old witch, are any more advanced than the poor ignorant serfs of the Middle Ages. With the return of learning, which began in Italy, and gradually spread to the nortih and west of Europe* some opposition was attempted by the more clear-headed among the laity. But the power of the doctors was too absolute, and langs and universities upheld their ortho- doxy. Still the scepticism in the wisdom of the faculty
iSfe^J^STwM?^ MEDICINE OP THE FDTCTRE. 335
began to spread among the lettered and edacated classes, and as they could not defy the doctors openly, they took refage in satire. Rabelais (himself a doctor of medicine) poured out the inexhaustible yials of his wit on the ignorance, the pride and the covetousness of his colleagues, and from his time the doctor became a standing figure in comedy. Who has not read and laughed at the consulta- tion of doctors in Moliere, or at Lesage's most entertaining sketch of the blood-letting Dr. Sangrado ? It is marvellous that the faculty surviyed all these attacks, for many cen- turies, modifying but little their silly practice, and continuing up to the last few years, we may say, to swear by the obsolete doctrines of their ancestors —
To follow foolisli precedent, and wink With both oar eyes is easier than to think.
The lancet remained the chief remedy, and it was well said by the eminent physician, the late Sir John Forbes, that it had killed more than the sword. Not that there did not arise from time to time clear-seeing and correctly-thinking men among the profession — for instance, Paracelsus, whose mind was most original, and whose influence upon the development of medicine has hardly as yet been properly acknowledged ; Van Helmont, Wilham Harvey, who not only by his great discovery of the circulation of the blood, but by his most important maxim, Omne vivum ex ovo, laid the firm foundation of modem physiology, nay, in some sense even of modern philosophy — Stahl, Hofimann, Haller, Cullen, Brown, Frank, Hufeland — ^but though all these men had immortal merits on certain branches of the science of medicine, none of them had sufficient influence to leaven the whole mass of prac- titioners with a new cardinal principle reforming the whole domain of the healing art. The man who tried to accom- plish this grand task, and who, in my opinion, has accom- plished it, is Samuel Hahnemann. I know, Mr. President, Ladies, and Gentlemen, I am treading somewhat on for- bidden ground by trying to trace the revolution accom- plished by this great man. His life, his character, his doctrines have been (particularly at the time of the lament- able demise of Lord Beaconsfield) publicly and violently assailed and as warmly defended. One writer in the Times called him, who was certainly the most learned physician of his age, an ignorant man ! Many of his followers are, on the other side, but too much inclined to make of him a
2 A -2
836 MEDICINE OF THE FUTUBE. ""l^f^SI?^!
demigod, and to pretend that after him there is no more progress necessary. I will try to give yon a fair and objective picture of the reformer and his theory. Samuel Christian Frederick Hahnemann was born on the 10th of April, 1755, at Meissen, in Germany, and received his classical education at the grammar school of that town, studying afterwards medicine at the celebrated universities of Leipsig, Vienna, and Erlangen, at which latter univer- sity took his degree with honours as a doctor of medicine. He practised in different* smaller places, and studying continuously, besides medicine, chemistry and mineralogy, he settled at last in the year 1789 in Leipsig. Here he published, besides a great Pharmaceutical Lexicon^ a number of smaller essays on a great many medical subjects. He translated also the great work of Cullen on Materia Medica, All that time he had been studying the effects of medicaments, not only clinically on patients, but also physiologically on himself and a select few of his friends who volunteered for the experiments. In this manner he discovered his cardinal doctrine, that medicines in large doses, are apt to produce somewhat similar symptoms to those which in smaller doses they cure- The first medi- cine which led him to this discovery was chinin, and it is well known now that chinin taken by the healthy in large doses, produces first chilliness, followed soon by heat and headache. He embodied his theory — first in his funda- mental work, Organon of Rational Medicine , now translated in all the principal living languages, and develoj^ed his doctrines more fully in his Pure Materia Medica, in six volumes, and Chronic Diseases, in five, besides a number of smaller treatises in Latin and German. Violently persecuted on account of his supposed heresy from orthodox medicine, in his native country, he left it, and settled in Paris, where, having married again at an advanced age, he died on the 2nd of July, 1848, not fiur from the 90th year of his life. After his death, the very people who reviled him when living, erected him statues — one on the market-place at Dessau, and another at Leipzig. Now, Mr. President, and Ladies and Gentlemten, I will carefully abstain from the vexed question, which is the best medical system ? I do not think it right to debate it in an assembly composed greatly of laics, but you will allow me simply to enumerate Hahnemann's merits as a Reformer — merits which have been and will be acknow-
Sd^Jfj^lT^'' MEDICINE OP THE FUTURE. 837
ledged by all candid minds to whatever school they belong. 1. Hahnemann was the first physician who broke loose from the fallacious doctrine that disease is an entity, which can be classified and ticketed as it were, which exists independently and in antagonism to the physiological functions, and which can only be combated by violent antagonistic proceedings. His theory, on the contrary, was that disease was only a modification of physiological action, which was impaired, bat not annihilated ; and that far from being able to put every disease as it were in a separate box and label it, the modifications are innumerable and vary in every individual. That we, in fact, can know disease only by the means of totality of the symptoms, and that we have to study all symptoms carefully in every indi- vidual case. 2. Hahnemann was the first physician who took pains to prove the physiological action of medicines before he used them therapeutically. Since his time, and particularly in the last twenty years, both schools have given great atten- tion to this point. You have only to compare the excellent hand-book9 of Materia Medica of Dr. Sydney Einger or Dr. Phillips (both belonging to the orthodox school, but both adopting a great many ideas of the other school) with their predecessors to be struck by the enormous diflFerence. 3. Hsdmemann was the first who set his face against the polypharmacy prevalent at his time, and he thus incurred, of course, the hatred of all chemists and druggists. He insisted upon the absolute purity of the medicine. He insisted, also, upon the necessity of avoiding mixing sundry medicines together. It is clear that this doctrine is sound. How is it possible that a physician can control the action of medicines when from half a dozen to twenty and more drugs are mixed together ? Is the correct effect of medicines ascertainable in such a '* leap in the dark ? " Hahnemann's ideas on this point have now also been generally adopted by the profession, at least by the more prominent members of it, though occasionally in some remote country places we still meet with polypharmacists. An American tells a story how, travelling in the Far West, he was laid up with a bad cold, and after having been seen by the local surgeon, the latter returned in about half an hour, bringing a very large bottle of physic with him. **Here," he said, "that will cure you; it contains fourteen different drugs. You must take half the bottleful at once." The Yankee eyed the bottle with
888 MEDICINE OF THE FUTURE. "^S^^SJifMa
Baspicion, and then said to the astonished surgeon, ^'I calculate, doctor, you'd better drink half this botUe, and if it does not kill you in a quarter of an hour, I'll take the other half ! " 4. Hahnemann was the first physician who tried to reduce the dose to the quantity absolutely necessary to produce curative effects. He did not try to kill flies with cannon balls, and be followed the precepts of the Persian poet, Mirza-Schaffy, which I beg to tnmslate : —
The true wise man does not search far
Near things to handle ; Nor does his hand catch at a star
To light his candle.
Hahnemann's medicines were simple, sure and small. It is true that he carried his doctrine of dynamisation farther than his modern disciples ; but who is bold enough to deny the curative action of small doses when he reads of substances like the one in a late trial, of wliich l-20th part of a grain can kill a strong man in an hour or two ; or if he takes into account the invisible and imponderable nature of miasmas which carry death in their essence* Can small substances do only mischief, and will you deny that they can do good ? It is truly said that the greatest power in nature is the power of the small. 6. Hahnemann was the first physician who supplied medical men vrith a principle to guide them in the selection of medicines. Before his time medicines were selected empirically or on the authority of some medical writer of ages ago. A story is told of a young doctor in Germany who had to treat as his first patient a shoemaker who suffered from an attack of ague : he prescribed duly, and on his second visit found the patient, to his delight, much better ; but his delight was modified when the patient told him that he had not taken the medicine, but that he had been eating sausages and sauerkraut, and that that had cured him. The young doctor sighed, but inscribed on his tablet, ** Sausage and sauerkraut, capital for ague." As fate would have it, his second patient, a tailor, suffered also from ague. The doctor ordered him to eat plentifully of sausages and sauerkraut, but the poor tailor, what with the ague and what with the diet, soon breathed his last. The young doctor sighed again, but added in his notebook, " very good for shoemakers, but bad for tailors ! " In reading some of the collections of prescriptions of the last century, one is reminded of the young doctor's notes —
S5Sl?rjS?rS»^ medicine of the future. 389
ikey are quite as absurd. Hahnemann tried to furnish an nnerring guide of selection. How far he succeeded, how far his nmUia gimiUbus cwrantur has proved a true principle of selection I will not enter upon, as that is still a delMited point, the opponents of Hahnemann saying that though his principle may be applicable in some cases, it is not applicable in all. This is the only difference which diTides in the year 1882 the two schools of medicine. Liastly, I must mention that Hahnemann — ^though in that respect he only followed Hippocrates — ^laid great weight upon suitable diet. I need not tell you that modem physicians of all systems follow him in that direction too. It is told that a lady who went lately to London to consult a celebrated medical baronet, after detailing to him her Bufferings, got the following short and pitiiy advice: — ''Drink milk; drink milk, madam. My fee is two guineas.'* And if she followed his advice I am sure the money was well-spent. Such is a very short outline of medicine in the past. After the death of Hahnemann, many of the scientific branches of modem physiology, pathology, organic chemistry, &c., made immense pro- gross, having improved greatly. Medicine also in its stricter sense made progress, though not quite so fast. Still the lancet got discarded and a good many mischievous theories were silently abandoned. At the present moment we are in a transition state. The old intolerance of new ideas has greatly died away. We have ceased to call each other fools or rogues, for no other reason but that the one gives a hundred^, the other a thousandth part of a grain of arsenic or phosphorus. The different success in treatment depends now less upon the theories which the physician holds, but more upon the qualification of the individual physician. Healing is not a science, but an art. The doctor, though he must learn a great many sciences connected wi& medicine, is not a scientist, but an artist. The ideal doctor must have all senses in perfection ; ought to haye the scent of a foxhound, the taste of Brillat-Savarin, the sight of Baphaelle, the touch of Rubinstein, and the ear of Sims Beeves. He must read character like Lavater, have the memory of Macaulay, the quick perception of Dickens, and the cool judgment of the present Lord Derby. He must be conciliating, yet firm ; stiavis in modo, yet fortis in re; eloquent and silent in turns, shaipsighted and blind, cheerful and grave ; but above all,
840 MEDKIINE OF THE FUTURE, "^i:^ ^S!??!^
Bmrlew, June U iSA.
he must be patient and fall of sympathy with the snffering; he must be both chary and procUgal of his time, both mth rich and poor. If, with all that, he is open to conviction ; if he examines eyerything, and chooses the best ; and if he is not troubled with the wind of vainglory, nor with the itchy palm of ayarice, you are very safe to choose him, to whatever school he apparently belongs. But now, Mr. President, Ladies and Gentlemen, I have been historian long enough ; let me try my hand at prophecy. Tou want to know what will be medicine and its professors in fif^ years hence. I'll tell you, and I hope that all of you will be able to verify my statements. First — There will not be so many doctors in proportion to the population, because the health of the people, owing to the continued progress in sanitary science, will be better; because also the knowledge of simple remedies will be widely spread, and because the sanatoria — ^be it air, diet, or hydropathic establishments — will be greatly increased. 2. Patent medicines will cease to exist, as the State will at last be ashamed to derive income from, a source which is worse than the opium trade. 8. Most fathers and mothers of families will study short manuals of the laws of health and of the physical education of children, which will be pub- lished cheaply by the then existing — I cannot tell you whether it will be Liberal or Conservative — Government. 4. Young ladies will also have to read such manuals, and those who object will be punished by having tor wear stays. 6. The adulteration of food will be punished not by fines, as hitherto, but by imprisonment and hard labour. 6. No hospital will exist which wiU not have sufficient bathing accommodation, including vapour and Turkish bath. The bills for stimulants in hospitals will be reduced to a minimum. The ordering of the diet and treatment of the patient will be left to the doctor, and any aunt or oousin who recommends particularly some diah which she has heard from Mrs. A., who was told by Mrs. B., that it has done good to a distant relative of Miss C, will be banished from the bedside of the patient. 7. The State will acknow- ledge the services of doctors for saving life by giving them a pension when old or infirm in the same ratio as it pen- sions military men for taking life. 8. In the treatment of disease four great physicians will always be called to aid — Dr. Water, Dr. Diet, Dr. Air and Dr. Exercise. 9. Medicines will be given pure and only one at a time, or at
S^fSrrSS** NBDBAL AHAMBIS. 841
the utmost two in alternation. They will as a rule not be unpleasant. 10. The nature of every new remedy will be well studied before experiments on the sick are allowed.
11. The doctor of the future will be such a man as I sketched before, and not call his fellow-doctors names.
12. He will, in the . words of the Reformers, clearly perceiye what is to be cured in eyery indiyidual ease of disease. He will also clearly perceive what is curative in each individual medicine. He will know, according to clearly defined principle, to apply what is curative in medicine to what is morbid in the patient, so that recovery must ensue. He will know how to apply it, both in respect to the suitableness of medicine to each individual case, as also the easiest mode of preparation, and the quantity (neither less nor more) and the proper period of repeating the dose. He ^11 also be careful to remove all obstacles which prevent a perfect recovery. The doctor of the future will study and note every in- dividual case of illness and the symptoms of the corre- sponding medicines, so that the Materia Mediea of the future will be a receptacle, not of time-hallowed fancies of a creed outworn, but of truth ! Magna est Veritas et
pravaiebit^
The truth an all-wise Providence intended
To be a bleasiiur to mankind ; He did not bury deep, but slightly fended,
That any earnest search might nnd.
PROFESSOE JiEGER'S NEURAL ANALYSIS.*
By Percy R. Wilde, M.B.
(Author of An Analyni of the Involtmiary Motiofu of the Hand,)
If Professor Jseger's experiments are to be relied upon, the potency of the highest dilutions is demonstrated, physiological effects are to be produced by amelling the 2,000th dilution of natrum muriatieum, and these effects can be graphically recorded.
It is but little wonder that those who have placed faith in such dilutions should be elated. The Homoeopathic Phpsidan notices that a doctor has been speaking dis- paragingly of high dilutions, and it heads the article,
* Beviewed from Professor Manuel Gnater's Paper in Populate ZeiUchrift fur Homceopatkie. Translated into the Homaopathie PJ^aicUm (Riiladeli^ia).
842 mniBAL analysis. *%£t%::??!^
Bflvieir, Jvae 1, 18Bi.
€(
Has not heard of J»ger." The Homoeopathie Pkytieian is fully conyinced that if this scoffer liad heard of Jfl^er, he would haye mended his ways.
The conception which led Professor Jseger to institute these experiments was good. It is known tiiat an interval of time elapses between any sensory impression and the motor act put forth immediately following it. This interval was shown by Helmholtz to vary in different people, and in the same individual at different times, dependent upon the condition of the nervous system. By means of the chronoscope this interval, which Professor Jeeger calls *^ nerve time," can be measured, and it occurred to him that if the time were taken before and then after some drug had been inhaled, the effect of the drug might be exhibited by an alteration of the nerve time. We know that^ Professor JsBger is fond of observing the effects of odours, but it is difficult to understand why in these -experiments he only allowed the drugs to be smelled, and not administered in the ordinary way.
The mode of experimenting was as follows : — The subject presses his finger upon a key, which sets an indicator in rapid rotation. He is intenUy watching this indicator, and at the moment he sees it commence moving he withdraws the pressure, and so stops it. The distauce travelled by the indicator represents the ** nerve time."
The extreme delicacy of this experiment is apparent. It is one in which a number of conditions may operate to cause error. In the first place, we must consider the functional condition of the sensorium at the time of experi- ment in relation to internal causes. This Professor Jaeger met by taking the record of the person immediately before the use of the toxic agent. As his dilutions were all mixed with alcohol, he was careful also to try the effect of the alcohol alone before trying it in admixture with the drug. The second factor to be considered is the condition of the sensorium in relation to synchronous impressions in point of number and intensity. It will be understood that if the whole attention is fixed and ready to receive an expected impression, one kind of result may be produced; while, if the sensorium or intellectual centres are already occupied by impressions or sensations, another result may be expected, and this result will vary in proportion to the intensity of the synchronous impressions and the active or passive attention yielded to them at the exact moment
£5S5^jS?rSw!^ NBUBAL ANALYSIS. 848
when the impresgion under observation is received. When the person is carefully regarding the dial, and his whole attention concentrated npon the indicator, his sensorium, as far as can be judged, is unoccupied and free to receive the single impression. But when this act of observation is united with the smelling of a substance, the sensorium is no longer unoccupied, and a different result may be expected. The operation of this fiEustor appears to have been wholly overlooked by Professor JsBger*
When the substance was alcohol, the results were as follows: *'With some persons they (the ''nerve times ") are considerably lengthened, with others they are shortened, or they move in a confused zig-zag up and down." This is precisely the result which we should mark in our laboratory book '' nil." We want to know whether certain conditions produce a result, and then to ascertain the cha- racter of that result. If the same resxQt persistently follows whenever we set up the same condition, we have some right to assume that the condition produced, and the result which follows, have the relation of cause and effect. But if there is no such persistency between the two factors, we learn that there is either some error in our experiment or that the supposed relation is non-existent. But Professor JsBger does not bind himself by the laws of enquiry, he simply asserts that the effects are the result of alcohol. If we grant this, it is difiScult to conceive how we can continue experimenting with dilutions made with alcohol, for whether we find the nerve time retarded or accelerated, or it goes zig-zag fashiou, it might equally be produced by the alcohol and not by tiie drug.
But this does not trouble Professor JsBger. Belying on mere assertion to prove that the first results were the effects of alcohol, he wants no other evidence to prove that the next results are the effect of the drug. He chooses aconite in the 15th dilution, and having produced a certain series of effects (?) on one person, he tries it upon another, and finds his result exactly reversed. But Professor Jaeger is made of stuff that bears reverses calmly. This, he says, ** proves that medicines act differently upon each organism." The variation is in nature^ not in Professor Jagei's expert- ments. All the incessant vexations of experimental work are over, we have only to follow ProfiBSSor Jseger's method, and we shall prove everything to our own satisfaction, and that, perhaps, of some intelligent American journals, who
344 NEURAL ANALYSIS. "S^SS^^^SS?^
Review, June !« 18St.
appear to think that any proof is good proof which proves tneir own belief.
The third factor we should have attended to is the infiuence of unc&nsciotts reflection in affecting motor retfdta. As Professor Gneter says in his prdiminary remarks, that '' the central organ of the wUl is the brain,*^ he wiU hardly accept the correction when we say that ike volitional centre occupies one portion of the brain. Prom the mode in which Professor JsBger's experiments were conducted, it is evident that he is either ignorant of the fact, or does not believe that there are intellectual centres which act automatically, and that these can produce or alter motor results without affecting the sphere of con* sciousness. Professor Jfieger may have the most perfect confidence in his three pupils, but they are only reliable as far as their volition permits. In experiments where con* elusions depend upon delicate motor results, the factor of unconscious reflection is always present, and can be only set aside by keeping the subjects experimented upon in entire ignorance of tibe nature of the experiment. When a person places his hand upon the Kyrograph, and pro- mises not to use any muscular control over it, be he ever so honest in intention, providing that he knows the object of the experiment, we find on examining the tracing that he has, although unconsciously, tried to help or hinder the mechanical movements, and this we can demonstrate to him. In this manner we can read ideas passing in his mind of which he is completely unconscious.
Some thirty years ago. Dr. H. Madden, of Brighton, tested a number of drugs by means of an instrument called a magnetometer. This is a gallows-shaped arrangement, from the arm of which a ball is suspended by a fine thread ; the operator places his finger on the upright support, and holds the substance to be tested in his hand. The ball then commences to swing in one direction or another, according to the nature of the drug. At least, so Dr. Madden thought, until it occurred to him to try the experi- ment without previous knowledge of the jbug he was ** testing." He now found that the ball did not swing in the same definite order as before, and he then discovered that the movements of the ball merely represented the results of reflections of which he was unconscious. He thereupon admitted the error of his first conclusion, and by pointing out this error he rendered an important service to
X:^5SSr8^ NBUBAL AHAIYSIB. 345
Beview, Jane 1» 1882
physiology — ft sarrice which after writers upon the subject hftYe forgotten to mention. Dr. Madden was one of the first, if not the fbrsti to point oat that onoonscioaa cerebral processes can set up motor results ; since then the whole physiology of this subject has been extensively studied. But after all this. Professor JsBger proceeds to a series of experiments, very similar to those undertaken by Dr. Madden, and falls into Dr. Madden's first error; and although the results had nothing of the persistency which followed Dr. Madden's efforts, &eir variability constantly pointing out that something was wrongs Professor J»ger has failed to detect it.
He and his pupils knew the drugs they were experi- menting upon, nor did they attempt to find whether the same results would follow from a repetition of the experi- ments without previous knowledge of the drug they were testing. Only in one case is there any pretence of such an experiment, and as in the very next experiment an exactly opposite result was produced, even Professor JsBger could hardly attach much importance to it.
It is because we know Professor JfiBger to be a scientist of some reputation, that we cannot think that he seriously believes in his own experiments. He has taken a mountain of labour to very little purpose. K he really thought that the smell of high dilutions affected the nervous system, and this could be demonstrated by the chronoscope, nothing could have been simpler than for him to have selected four different drugs, and to have experimented with each of these. upon twenty different persons entirely ignorant of their nature. If he had found a similar series of results follow each drug in even 60 per cent, of his cases, he might have concluded that there was some relation between the smelling of the drug and the *' nerve time." So far as we can gather from Professor Graeter's paper, there is nothing to indicate that these are to be considered as cause and effect, save the bare assertion founded on Professor Jffiger's pre-conceived idea. If Professor Jaeger seriously believed that his pupil Gohrum had -such a highly developed sense of smell, 'Hhat he is able to distinguish this medicament {natruin muriaticum) in the 10th, 20th, and higher potencies, from alcohol without having recourse to the apparatus," Why did he not put it to the test ?
We candidly confess that we don't believe in Herr
846 CABDIAC THBRAPBUTIOS. ^S^^S?JJtS»*
Oohrnm's acute power of detecting odoars which never existed, but we do believe that with snch a man as Herr Gohrmn to perform the experiments the apparatas was not needed ; if he had been allowed to smell around and describe his sensations we believe the results would have been equal in value to those put forward by Professor Jasger. There is hardly a law of experimental enquiry which Professor JaBger has not broken, and homoaopathy is unfortunate enough to have the results put forward as a " new discovery in its service." Professor GraBter, in concluding his paper, says : ** But to the adversaries of our cause who probably will endeavour to dispose of this discovery with theoretiod reasoning, or with defamations of Professor Jaeger's person, we will now exclaim, in Hahnemann's words, ** imUaU it, biU imitate it exactly,*' I think homoeopathists will answer politely, but firmly, '*jVb thank you"
OAEDTAC THEBAPEUTICS.* By E. Wood Fobsteb, M.B.C.S.Eng., L.S.A., Darlington.
Case 1.
In June, 1880, 1 was called to attend a young gentleman about fifteen years of age. I found that he had suffered for some time from intermittent pains of the left mammaiy region.; that he complained of being soon tired — soon pumped out ; that his breathing, too, would be incon- veniently rapid after running or undertaking an ascent. There was also a history of nervousness, of being easily startled, of considerable timidity, and of calling out in sleep. His family is subject to •hereditary renal disease; and upwards of two years before this time there had been, to my knowledge, albuminuria without organic disease. Now, the urine was clear and non-albuminous.
The functions of the liver and stomach were healthy. Examination of the heart showed absence of valvular lesion, but slight hypertrophy with energetic impulse, and pulsa- tions about 100 per minute : an intense condition of cardiac irritability. There was not an actual intermission of pulse- waves; but it was very noticeable that a succession of stronger beats was followed by a succession of feebler ones.
♦ Reprinted from the BritUh Medical Journal, April 16th, 1882.
^t^JiSSTSm!^ CARDIAC THERAPEUTICS- 847
la connection with hygienic influences, digitalis was administered on the 18th, five drops three times a day in half an ounce of simple water, and continued until the 80th June. To this time it had not ** quieted the system " ; but the neuralgic stitches of the mammary region were well, and the pulse-waves flowed more regularly. The cardiac irritability, with high pulse-beat and disagreeable nerre-consequences, still remained. On the 80th, throe drops of veratrum viride were repeated three times a day in half an ounce of simple water. This treatment was most efficacious, so that in twd or three days the medicine was ordered to be taken only once a day, or every other day, and was discontinucfd at the end of the fortnight.
I believe it would have been more therapeutically correct to begin at once with the veratrum. The general system of arterioles was healthy, and did not require to be inter- fered with. The indications were that the heart-muscle was the organ to which a remedy ought to be applied. It was not the regulating apparatus that was at fault, but rather the musculo^motor to which attention was to be directed. DigitaU$ therefore failed, because it is a mus- culo-motor stimulant. This was not required in such a case as I have just described.
VercOrum '^ diminishes the force of the heart-beat by a direct influence on the cardiac muscle " CWood) — ^I presume through the musculo-motor ganglia. And the advantage of the small dose is that, firstly, we so use our remedy that its influence does not extend to other organs, but is expended on that organ which, being diseased, most sensitively feels its therapeutic power ; and, secondly, we keep clear of inducing any disagreeable effect on the patient : and thus, by keeping well within the therapeutic dose, we can eflect a '' safe, speedy, and permanent cure, whenever a cure is possible."
Case 2*
On May 18th of last year, I was consulted by a lady of about seventy years. She came panting into my room, with livid lips, dilated nostrils, and a bumping heart. There was evidence of an obstruction of the liver, with some stomach-derangement, and scanty urine, containing urates, but non-albuminous. There had been for a month oedema of the right leg. There was mitral disease (said to be hereditary), rapid cardiac action, pulse 90, palpitation.
348 OABDIAC THBRAPBDTICS. ^'^S^fjSSSum.
iutermission, and a short dry ooagh. Undoubtedly the heart was primarily at faalt ; bat its oondition was aggra- vated by the obstructed state of the hepatio systeniy the consequence of its own incompetency. By the third day» these obstacles were removed : the colour and odour of the evacuations became natural; and the urine increased in quantity under small doses of mercury.
Attention was now entirely given to the hearty and tincture of spigelia (Savory and Moore's) was administered. This is a powerful remedy in suitable cases; to this I can testify. (See Phillips ; cdso Sharpe in Practitionery May, 1878, p, 831.) It was given because of its special action on the heart. The kidneys, acting well, did not require the subordinate action of digitalis. Likewise, the rapid irritable state of the cardiac muscle seemed to imply nervous excitement ; therefore the exoluskm of digitalis. However, spigelia failed to relieve, in five-drop doses thrice daily, the cardiac oppression and its concomitants. Why did it fedl ? Therapeutically, it was a wrong remedy. The small dose kept up the force and frequency of the heart's action. It probably acted as a stimulant to the accelerator nerves, and tended to increase the venous congestion. If I had given large doses, I might have conmderaUy lowered the pulse ; but then spigelia at the some time physiologi- cally produces palpitation, with strong beating.
On the 25th, the cardiac agitation, dyspnosa, and hot dry skin pointed, with no uncertain indication, to aconite. One minim of Fleming's tincture was given in half an ounce of simple water thrice a day. Its efficiency was quickly apparent. In the course of a week, there was amelioration of all the symptoms ; and when I saw the old lady on July 4th, she was well and jocose.
^' The method by which the aconite influences the heart is not certainly settled" (Wood). Therapeutically, in small doses, its beneficial influence is exercised through the cardiac ganglia. The hot dry skin was an important indication of treatment. Aconite being known to dilate the arterioles, and to '* increase the capacity of the vascular system" (Ringer), [promotes perspiration and relieves congestion. Thus we obtain, in addition to the direct action on the cai'diac ganglia, a powerful drain to the surface.
In weighing the probabilities between veratruvh and aconite in a case of cardiac disease, we should deliberately
SSSi^SSrS^ BBVIEWB. 84»
Bsview, June i, 18tt.
consider the totality of symptoms present in the particnlar case. In the former case, veratrum was chosen, becanse of its direct effect on the heart only. The kidneys were acting normally ; the skin also was normal ; and tempera- ture was normal ; therefore, to hare given aconite in such a case wonld have been a needless waste of aconite inflnence, and might possibly have prodaced a feeling of increased lassitude. In the latter case, veratrum would not have touched either the kidneys or the skin. As aconite embraced these within its beneficial range, it was emphatically the remedy, and did not require the clumsy expedient of combining with it spirits of nitre, or potash acetate, to effect that which it was qnite capable of doing alone.
The advantage of the single medicine is its simplicity, and its accuracy in operating only upon the diseased organ in proper therapeutic dose, which must be far removed from the physiological one.
If a medicine have a special action upon a special organ or part in health, so it would seem very desirable and judicious to administer that particular remedy in disease of that same part which appropriates the remedy in health. But we must bear in mind, as a clinical fact, that the tissues in disease are much more sensitive and responsive to the action of a drug, so that the dose to be then thera- peutic must be small.
REVIEWS.
The Human Ear and its Diseases. A Practical Treatise upon the Examination, Becognition and Treatment of Affections of the Ear and Associate Parts, prepared for the instruction of students and the guidance of physicians. By W. H. Wims- LOW,M.D., Ph.D., Oculist and Aurist to the Pittsburgh Homoe- opa^ic Hospital, &c. New York and Philadelphia : Boericke and Tafel, 1882 ; pp. 626.
The first thought suggested by the perusal of this handsome volume is the immense amount of research which has been brought to bear upon the study of diseases of the ear within quite a limited period. But little more than forty years ago the ear was the happy hunting-ground of the quack. Little was known of the physiology of this valuable and delicate organ, scarcely anything of the pathological changes to which it was subject, and absolutely nothing as to the means best adapted to
YoL36,Ko. 6. S 9
850 RBViBws. "S^.^Sr?^
Bartew, Juns 1, im.
modify these ehanges. At this time the ** anriet " of the dmy was one Curtis. By the free use of all the arts idiich the quack knows so well how to ezeroise in bringing the hopelessly infirm within his grasp, this man, perfectly ignorant of the dis- eases he pretended to core, amassed an enormous fortune in London. On one occasion — as related by Mr. dark in the Medical Times and Gazette some years ago-— he went out of his ordinary beat, and undertook to read a paper on aural surgery before the London Medical Society. Amons his hearers was a young surgeon, who was seeking a field for practice. Well instructed in anatomy and physiology, Gurtis's utter ignorance of his subject made a deep impression upon young Toynbee's mind. The conclusion expressed by him to a friend was to the effeet that if this fellow, knowing nothing whatever about the ear, eaa make such an income as he is doing, what cannot I do if I devote myself to the study of its anatomy, physiology, and pathology? From that moment he set to work, and at St. Mary's Hospital commenced the series of researehes into aural pathology which formed the basis of most of our present know- ledge.
During the forty years which have since elapsed the proTxnee of aural surgery has so expanded as to require, for its full eluci- dation, a work so ample as that which lies before us. Had we no other illustration to offer, this alone would suffice to demon- strate, not only the progress of surgery during the last few years, but also the immense amount of industry and skill which have been devoted to its study.
Dr. Winslow brings to bear upon his snbjeet a large «xperi- ence, gained both in hospital and private practice. We ara, therefore, prepared to expect a very full account of the Tarions diseases to which the ear is liable, as well as the resources pro- vided by art for encountering them. Neither are we, so hi, disappointed.
Beginning at the beginning, Dr. Winslow gives us a dear description of the anatomy and physiology of the ear, and then proceeds to lay before his readers a very full account of the methods of examining its physical condition. He next passes to the consideration of the morbid processes which constitute the diseases of the external, middle, and internal ear. Li these chapters, which constitute the especially practical portion of the work, Dr. Winslow displays an intimate knowledge of his subject, and not only so, but he communicates it in a manner which shows him to have considerable power as an instructor.
The operative, or surgical part of his work, is much better done than that which relates to the use of drugs. The former is full and complete, while in the latter he is too much given to naming half-a-dozen or more medicines, and directing the reader
to compare them. In 8ota6 instancds he points out the differentia which should guide the surgeon in his selection, bat this could have been done much more freely with advantage. It is quite true that the ear symptoms of many medicines are few, and, in some instances, not very reliable. But much may be accomplished to M up the void thus left by studying the actions of drugs on analogous structureB, and noting their operations upon ^am. Further, very many of the diseases of the ear, which are particularly amenable to medicinal treatment, are dominated by some special constitutional diathesis to which medicines have, £rom their general action, shown themselves to be homoeopathic.
Dr. Winslow, it may be added, looks forward to much therapeutic help in the future from electricity; and mentions several conditions in which it may be expected to be serviceable* We doubt not but that in a future edition he will be able to enlarge much on the adaptation of this potent force to remedial purposes.
Ab a whole the work is one which may be studied with great advantage by all, be they specialists or general practitioners. It is full of information, and abounds in useful, common-sense suggestions for practice ; and we trust that when Dr. Winslow comes to revise <his first edition, he will be able to render his indications for the use of medicines both fuUer and more precise. Ko one, we are sure, is more competent for this work, and few have better opportunities for performing it.
A Treatise on the Medical and Surgical Diseasea of Women, with their Homceopathic Treatment, By Mobton Monbos Eaton, M.D. Boericke & Tafel.
We owe our apologies to the author of this work for not having* noted it sooner, and it deserves more than a few passing words of approval.
In the first place we must note that this book bears the evident- impress of the author's individuality, that it is the legitimate product of his own brain, the result of his own experience and tiiought, and that where he does quote from others he honestly prints it in inverted commas. This in itself is no praise, but unfortunately we have had several systematic works published by homoeopathic practitioners in America in which the only work of the author seems to be the jumbling together at the end of each chapter, or section, of the names of a number of medicines, and a request to refer to the Materia Medica to find their indications* 8uch works are a standing reproach to homoeopathy. We are ^ad to notice Dr. Eaton's work as an exception. But it deserves- much more than mere negative praise, it is a sohd practical work^
2 B— a
S62 BEyiB^. "Ssa^^fSTftS?
Beviev, June 1, 1891.
lind is Tory evidently written by a man who works hard at his profession, is an enthusiast at lus own speciality, and has a pro- foond belief in himself and his practice --a belief, we fancy, in which all good practical men share.
The subjects treated of embrace fairly exhanstively aU the diseases of women which are likely to be met with in general practice, and include some which are usually left to obstetric works, such as the vomiting of pregnancy, puerperal fever and mania, phlegmasia, &c. ; but this we think a decided advantage, for all gynoecologists include abortion, extra-uterine pregnancy, and premature labour as legitimate subjects for their treatment and treatises, and as the same accidents are liable to follow or precede these as the delivery at full terfii, it seems unnecessary to separate them.
' Dr. Eaton appears to have been so anxious to treat exhaustively of each subject which he announces at the head of a chapter or section that we constantiy find him repeating himself, and the book is in this way considerably lengthened. This makes it all the more valuable as a book of reference, but is a decided objec- tion to it as a systematic work to be studied as a whole.
For example, we have chapters on ''Inflammation .of the Female Genitalia,'* and " Metritis " on pages 60-87. Then we get chapters on ** Cervicitis and Endo-cervicitis," " Endo- metritis," and *^ Leucorrhoea,'* on pages 211-249. And again, " Catarrh of the Uterus and Vagina," on pages 880-885. While, still further on, he gives us a chapter on " Sympathetic effects of Diseases of the Uterus and its appendages " on pages 472- 490 ; all of which subjects necessarily go over much of Uie same ground, and by a re-arrangement of chapters and bringing together the different parts of the same subject they might be not only very much condensed, but improved, although each of these chapters is good in itself, and when used for reference would be found most useful. The surgery of the book is very complete, and well described ; Dr. Eaton having evidently per- formed most of the operations he recommends, though he, somewhat unnecessarily, quotes from others accounts of opera- tions which he has neither done nor seen, and which he dis- approves of.
We notice, with much pleasure, that he entirely discoun- tenances the use of caustic applications to the uterus, and, except in rare cases, of all forms of vaginal pessaries ; when he does recommend one it is usually the inflated air bag. The inter-uterine stem he sternly condemns, and in this we cordiaUy agree with him.
BLis descriptions of the various diseases are very good and often forcibly written, and will give much help to students and young practitioners who refer to the book for diagnostic aid.
SSSS'JSsr^KS^ BJBVMWB. 368
BflTlew, June 1, 18S2.
Bis etiology is in some eases peculiar, as for example, that moles are often the result of imperfect impregnation, through the use of a syringe after copulation, whereby only one or twa spermatozoa were left to find their way into the womb. But his strongest idiosyncrasy of opinion (if one may use such a term), is in connection with the pressure of the intestines upon the pelvic organs ; and as he bases a special treatment upon this, it is only fair to give his own words on the subject as fully as we can to do him justice. This is what he says : —
'* It is easy to see how women, by compressing the upper portion of the abdomen with corsets and drsigging it down with the weight of clothing worn by many fastened about the waist, have pressed the intestines down upon the uterus, and thereby displaced it. Now, if the physician forcibly replaces the organ and presses it upwards with pessaries in the vagina, the uterus is placed between two pressures, one from above, another from below. This double pressure would likely produce a flexion or cause inflammation. Now, it has for many years appeared to me to be a rational and philosophical practice to lift up the abdominal viscera by some means, and give the uterus room to occupy its normal position."
" Dr. Emmet seems nearly to have grasped the idea, which I bad already published in 1878 in the Cinemnati Medical Advance, viz., The influence of atmospheric pressure in main- taining the uterus in situ. He says : *■ I often give my patients instructions to assume the position on the knees and elbows at night, and to open with the fingers the outlet of the vagina while in this position, so that the uterus may be carried well up into the pelvis by atmospheric pressure.* Well, why not open the vagina while the patient is erect ? Does not the atmosphere press with as much force upwards as downwards ? Now, it is clearly the result of taking off the weight of the abdominal viscera by the knee-elbow position that enables the atmosphere to act so forcibly upon the uterus in its replacement ; but he gives no hint of this, nor does he or anyone else mention that lifting off the abdominal viscera by position, causing them to draw away from the pelvis, thereby creating a partial vacuum in the lower abdomen, is the main cause of such favourable results from atmospheric pressure. I therefore claim this idea of the production of a partial vacuum by lifting up the abdominal viscera, in connection with atmospheric pressure as a support to the uterus, as original in the treatment of displacements.'' '* How to accomplish this is the next question. An improvement of the * London Abdominal Supporter,' which I have had made by Max Wocher and Son, of Cincinnati, I find the most desirable, except in cases of extremely pendulous abdomens, when the silk elastic band is preferable.''
864 KEvnawB. "S^fC??^
He gives us a plate of this belt, and ailer describing how it is put on, and laying special stress on the necessity for making it fit tightly at the lowest part of the abdomen and loosely at the npper, so that it shall be an abdominal supporter and not a compressor and saying that at the same time all corsets most be discarded and the clothes hmig from the shoulders instead of from the waist, he goes on, '* Conjoin with this, the insertion into the yagma during the day, for an hour or two, of a round specnlnm, having the knees widely separated, with the patient reclining. This makes np the plan of treatment which I have snccessfally followed for abont twenty years, using means to replace versions, flexions, and prolapse.'*
Such then are Dr. Eaton's views on this subject, and we accordingly find the use of such a '' supporter " recommended, combined with other treatment, in all displacements, and in nearly every chronic disease within the pelvis.
We think it must be admitted that the theory is in itself sound, the question being whether it is possible to carry it out by the means suggested. In the first place, it must be remem- bered, that all abdominal belts, whether we call themr^^ sup- porters " or not, have only one fixed point of resistance, viz., the lumbar and sacral spine, so that ill pressure, whether made higher or lower, must be from before backwards, and, except in unusually pendulous abdomens, which overhang the pubis, can hardly be converted into an upward pressure.
Secondly, it is difficult to see how, in a normally made woman, except when in the sitting posture, the abdominal viscera can make any direct pressure within the pelvis ; still, as most women are in the sitting posture a great part of the day, this may be allowed to pass. It remains, however, that Dr. Eaton, with a large and extended experience, places more confidence in this than in any other part of his treatment of chronic pelvic de- rangements, and as such we commend it to our readers' con- sideration or criticism.
The application of atmospheric pressure by the daily use of a speculum for an hour or two at a time is quite new to us, and certainly does not recommend itself at first sight from a practical point of view.
In discussing Amenorrhoea, Dr. Eaton calls attention to the fact that sufierers from this disease are frequently attacked mit congestion of the lungs, to such an extent as to be mistaken for phthisis and treated accordingly, and later on he says that he has always met with a condition of deficient or absent catamenia in true phthisis. It is to be regretted that he does not elaborate his remarks on this subject and tell us how to diagnose bettreen these two classes of cases we may meet with ; we presume th^ chief factor in coming to a conclusion would be whether the
Qtenne or lung symptoms appeared first, bat a earefiil examination of the Inngs ought to tell as whether there was trae taberele or a simile congestion to deal with. This seems to be a very impor« tant soggestiony bat we oannot recall any eases bearing apon ii in our own experienee.
The absolute necessity of determining the oaose of monorr- hagia and the distinction between it and metrorrhagia are forcibly laid down ; but we are sorprised that among the means for arresting it, while he mentions the use of cold vaginal in- jections, which are very apt to be followed by unpleasant reaction, he omits altogether hot-water injections, which have been well proved now to be, not only very efficacious, but less harmful than most local means.
He also recommends giving three or four doses of secaU 0,- ni zx for a dose, to be taken in warm water, but omits the much more powerful subcutaneous injection of ergotine. He, however, adds another to our list of medicines for this condition in the viburnum pruntfoUum^ which he declares to be an efficient remedy for true menorrhagia in the Ix dilution ** given in tea- spoonfol doses." Surely ^ere is something omitted here. We are not in the habit of giving our dilutions, even the Ix, in drachm doses I We presume he means two or three drops in a teaspoonfol of water.
The chapter on dysmenorrhosa is somewhat disappointing, both from a pathological and therapeutic view.
Dr. Eaton conmiences by limiting the term to true uterine pains of an intermittent character, and^iirther gives it as his opinion that they almost always depend upon flexions or stenosis.
Yet he admits further on that there is generally an unhealthy condition of the endometrium, to which, besides the mechanical straightening and dilating of the canal, he mainly devotes his treatment ; and this we regret to say he does chiefly by local applications of solution of iodms. Hence we are not altogether surprised that he omits all mention of the use of geisemiumf 4!autopkyUumt tfanthoaeylum and other medicines which might probabty save him and his patients the necessity of so much surgical treatment.
He deliberately excludes, on what grounds we cannot under- stand, cases of ovarian neuralgia occurring at the menstrual periods, and makes no mention of uterine neuralgia, while he believes uterine congestion or inflammation to be practically unknown except as a consequence of mechanical obstruction.
He, however, makes passing allusion to the pain caused by dironic ovaritis at the menstrual period, and gives us a rheumatio variety of dysmenorrhoea with eimicifuga as its most probable remedy.
Dr. Eaton would seem to find the local application of iodine %
o66 HEYJEWS* SAviflw^Snl 1 Tm^
Beviflw, June 1, 1881.
most efficient stunnlant, as be recommends its use in varying strengths in all the chronic inflammations of the mucous lining of the uterus and cervix, and also for injection, after eyacuation, in all cystic tumours, whether ovarian or labial, and in all abscesses which have definite walls. He also describes two eases of what he considered hypertrophy and induration of the ovary, the result of ovaritis, in which he was able completely to disperse the tumours, though of considerable size, by the use of iodine and its compounds with mere, and ars, internally, combined with frequent painting of the whole of the abdomen wiib tr, iodine. If the success of this treatment is confirmed on further trial, it will be a most valuable addition to our therapeutic resources. The local application of iodine to the uterus certainly is a great improvement upon the caustic applications of the old school, inasmuch as it produces absolutely no pain, and being at the same time a stimulant to healthy granulation, it may often prove of great service ; for though we must always keep the ideal before UB of being able to cure all diseases, outside pure surgery, by drugs alone, yet there are few, if any, of us who yet feel able to discard all local treatment in chronic uterine disease.
We could have wished that Dr. Eaton had been able to give us more help in the homceopathic treatment of the diseases of women ; but, though he undoubtedly practises homoeopathy in nearly all cases where he gives medicine, he is evidently more of a surgeon than a physician, and there is a marked, though rather unaccountable, absence of reference to the American indigenous plants, on which we in this country have learned to rely with great confidence. In spite, however, of its deficiency in this respect, it is much the best book which has yet been published on the subject in which homoeopathic treatment is recommended at all, and it will rarely be consulted withoai some useful suggestion being found, though it leaves a wide field for future workers to till in the special department of therapeutics.
We cannot conclude without giving a well-deserved word of praise on the get-up of the book. It is well printed in bold type, on good paper, and is profusely illustrated with very well executed wood-cuts, >^hich add considerably to its value.
Itisanity and iu Treatment, Lectures on ihe Treatment of Insanity and kindred Nervous Diseases, By Samtjkl WoBGESTEBp M.D., LecturoT on Insanity, Nervous Diseases and Dermatology, at Boston University and School of Medicine, &c. New York and Philadelphia : Boericke and Tafel.
This volume presents us with the course of lectures delivered bj the author, at the Boston University. Without making any
£5£?S!!Ti»* MEETINGS. 367
preiensions to originality, and while drawing largely on bis pre- decessors in anthorship on this sabject — ** several hundred Tdnmes/' we are informed in the prefacet '^bave been con- solted,*' — ^Dr. Worcester has provided as with a very nsefol work of reference in the diseases concerning which he has dis- oonrses. His description of the yarions forms of mental disease are accurate and clear, and the yarions indications for homoeo- pathic treatment are reliable ; while the clinical illustrations he has gathered from the MidcUetown Asylum and elsewhere are interesting and instructiTe.
There is no form of disease in which medicinal treatment is more discredited than it is in such as is mental. Save for pallia- tiye purposes, drugs are but rarely used in our large asylums. The Homoeopathic Asylum, at Middletown, has, under the able superintendence of Dr. Talcott, done much to show that medi- cines prescribed in direct specific relation to the form which the mental disease presents are useful in promoting recovery. We cannot too strongly urge upon those who have tibe care of insane patients, the duty, and as we believe, the advantage of supple- menting the ordinary routine of nursing, dieting, and watch- fulness, by appropriately, that is to say, homoeopathically selected medicines. In so doing, Dr. Worcester's lectures will be found of much service.
MEETINGS.
THE LONDON HOMCEOPATHIG HOSPITAL.
The thirty-second annual general meeting of the Governors and Subscribers of the hospital was held in the board room of the hospital, on Thursday afternoon, 27th April, 1882, at three o'clock. In the absence of the Lord Ebury, the chair was taken by Major Wm. Yaughan-Morgan, who was supported by Sir James Alexander, E.C.B., Mr. F. Bosher, Mr. Sclater, Mr. Boodle, and Mr. Alan £. Chambre. Among those present were — ^Mr. Cameron, Dr. Hughes, Dr. Teldham, Dr. Dyce Brown, Dr. Pope, Dr. Matheson, Mr. Higgs, Mr. Tate, Dr. Burnett, the Rev. Dacre Craven, Dr. Blackloy, Dr. Carfrae, Dr. Moir, Dr. Clarke, Dr. Cooper and Mr. Wybom. Several ladies were also present.
The Bev. Dagbb Csavsn (the Chaplain) opened the meeting with prayer.
The minutes of the previous meeting having been read and confirmed, the annual report was presented by Mr. CHAHsni:.
The Board of Management commence by noticing as —
** The principal event marking the hospital year just closed has been ite reconstruction of about two-thirds of the east wall
368 MEETINGS. *%S&^^2r?^S?
Beview, Juw 1, 1881,
of the hospital — that abutting on Powib Place — and the con* sequent alterations of the mrds on that side of the building. In June last, i^ portion of the east wall was suddenly discovered to be bulging outward, and a yery careful inspection, carried out under the directions of the honorary architect of the hospitaly disclosed the fact that the state of the wall generally was so serious that it was absolutely necessary to re-build a very large portion of it.
** A committee, consisting of scnne members of the Board and seyeral medical men called together to consider the matter, decided that it was desirable to take advantage of this opportunity to abolish some cumbersome and very inoonyenient party walls dividing the wards on the two floors chiefly affe<jted, and thus to throw into one two wards on each floor. The advantages gained by this measure are greatly improved ventilation and light ; much greater facility in carrying out the nursing duties, and at a less cost ; and a very marked improvement in the appearance and general character of the wards."
Notwithstanding the necessity for closing the wards during the six months occupied by their alteration, the total numb^ of patients received during the year was three in excess of the previous year.
The presentation to Lady Ebury of the portrait of the Chair- man of the Board — ^Lord Ebury — (which may now be seen on the walls of the Royal Academy) — is next noticed. The regret of the Board at the death of the noble President of the hospital — ^the Earl of Wilton — ^is then expressed. The Governors are also congratulated that Earl Cairns has signified his pleasure at accepting the office thus rendered vacant.
We now come to the important subject of expenditure, on which the following remarks are made : —
'' The question of the expenditure of the hospital has continued to occupy the very careful consideration of the Board throughout the year, and economies have been effected wherever found practicable. It is partly due to this circumstance, and partly to the fact that the total number of in-patients has been less, that the Board have been enabled to pay, not only the expenditure proper to the year, but also to repay out of income the sum of £400 due to the Treasurer, and yet to show on the current account at the bankers a balance of J644 6s. 2d. with which to commence the new year.
" If there should be no falling off in the annual subscriptions and donations for the ensuing year, the ordinary income will, it is estimated, suffice to maintain a daily average of between £ity and sixty in-patients ; but to keep filled the seventy-one beds now accommodated by the hospital, would necessitate a very largo increase of income.
SS^JSJTKg^ MBBTiHas. 369
Btfwimwt JniM 1, 18n
•< The permanent income of the hospital has been benefited in the course of the year by a legacy of iS500 from the late Mr. Lnz- more, and a legacy of ilOO from the late Dr. Bnddock ; but, on the other hand, the sum of oyer £900 is required to defiuy the special expenditure referred to in the opening paragraphs of this report. The deficit so created in the reserre frmd will, however, be more \haxk made up by three legacies, of which due notice has been received, but wluoh have not yet been paid to the hospital : one of £1,800, another £1,000, and the third £50,"
The changes which death, and the resignation of Mr. Williams — ^who has occupied a seat at the board for 27 years — are next noticed^ as are also the retirement of the honorary solicitor, Mr. Boaher, and the appointment of Messrs. Qedge, Kirby, MiUett and Morse — ^the solicitors to the Qoin bequest trust— in his stead.
The abandonment of the scheme for receiving 'Spaying patients," the introduction of vaccination with calf-lymph, the setting aside of a ward on the top floor of the house for the reception of cases whose infectious character has developed after their entrance into the hospital, and new arrangements to eontendwith the possible accident of fire, are then severally reCBrred to.
The dramatic performances last year produced £108 to the funds. Mr. Pite, the honorary architect, has presented a set of plans of the hospital, including the new drainage.
After presenting their thanks to donors, the medical staff and the lady visitors, the concert given in the board room to the patients by Lady Ida Low and the members of the Eyrie Society last March, and the annual Ohristmas Tree entertainment, the following statistical particulars are fronished :—
a. The Ordinary Receipts for the year 1861-62 (see
Appendix) as compared with the previous year were as follows : —
1880-81 £8,767 18 8
1881-82 8,628 10 11
b. The Extraordinary Receipts were : —
<'Thalian" Dramatic Performance £108 0 0 Legacy 618 12 10
£726 12 10 e* The Expenditure on account of
Ordinary Income has been £8,840 7 9
The Expenditure on account of Extraordinary Expenses (as stated in paragraph 16) 986 14 4
360 MBBTIHOS. "feS£^SS??'a?
Bevieur, June 1, 1881.
d. The Ammal Sabscriptioiia amoonied
in the twelve months to £1,453 0 1
showing a falUng off on the pre- vious year of £29,
e. The Donations dming the year to*.* ig248 17 4
or £247 Uu than in 1880-81.
/• The Registration Fees amotmted to £827 7 0 or £55 more than in the previons year.
g. The Nursing Fond Beeeipis to £629 10 0
and, after deducting the Cost of the Nurses, a net profit of £197 has been ayailahle for the General Expenditure of the Hospital.
A. The working Expenditure ci the
Hospital for the year 1881-82 was £8,840 7 9 or £27 Us8 than for the preceding twelve months*
t. The Invested Funds df the Hospital at the 8lst March, 1882 (See Appendix C.)» exelosive of the Hospital Premises and Fnmitnre, and the Free- hold Honse, No. 1, Powis Place, consisted of : —
Consols £1,578 4 9
New Three per Cents.... 4,757 17 10
Total £6,886 2 7
k. The total nnmber of In-Patients treated in the Hospital from Ist of April, 1881, to the 8l8t of March, 1882, has been ... 487 while in the year immediately preceding the nnmber was 484
/• The total nnmber of Out-Patients during the year ended 8l8t of March, 1882, has
been 7,467
while that for the year 1880-1 was 6,217
showing a markid increase of 1,250
The report was, at various points, warmly applauded.
Mf^or Yauohilk-Moboan in moving the adoption of the report, said : Ladies and Gentlemen, I am sure that aU present to-day regret veiy much the absence of our noble Chairman, and none more so than myself, who, very unworthily« has to take his place. I am happy to inform you, however, that his Lorddiip's absence IB not caxaBed by aoy aerioua bodily ailment, but simply from
gggSTj^yrSff" MEETiwes, 861
'Weakness of sight. We have receiyed from his Lordship a letter, 'which it will gratify you if I read : —
" Dear Mr. Chambre,
'* There is, I regret to say, no chance of my being able to be present at onr anniversary. The report which yon have sent me reads pleasantly and encouragingly, and I hope all will go off well. I am sorry we have lost Mr. Bosher; it was quite a familiar name amongst ns. Equally I regret also what I suppose is the compulsory retirement of Mr. Williams. Earl Cairns is a considerable reinforcement. Mr. Pite does us great service.
" Yours faithfully,
" Ebuey."
After noticing the presentation of Lord Ebuiy's portrait, M%jor MoBGAN referred with regret to the fiulure of the plan of receiving paying patients, and proceeded to speak as follows : — Well, now, as to the alterations on which we have spent so much money, and for spending which we shall ask your sanction to-day, the most cursory observation will show you that they are manifest and very decided improvements — (hear, hear) — and the Board only wish that the Governors and Subscribers who have not abready done so would come and see these alterations. Dr. Yeldham, who has recently been urging the necessity of a new hospital, is now nearly of opinion &at a new hospital is not requisite. (Laughter.) In former years the Board used to look to public dinners as a means of inereasing the income of the hospital; and the Board had decided to organise a festival dinner this year, in Heu of the annual dramatic performance ; but in consequence of the very great difBiculty of organising the matter, and from other circumstuices, it was found that for this year, at all events, a dinner could not take place. Meanwhile, the usual dramatic performance had been put off. Just then Dr. Kennedy wrote to our official manager to say that some friends of his were preparing an amateur dramatic performance in St. George's Hall, and had resolved to devote the proceeds to the hospital. (Cheers.) Well, that took place at the beginning of the present month, and it is expected that when the expenses are paid, the sum of £20 or £80 will be at the disposal of the hospital. (Cheers.) I was recently present at a fancy costume ball at the Albert Hall, in aid of a self-supporting hospital with which I am connected, and this morning I have received a statement of the fmancial results, which amount to £150. I do not know whether it would be possible for us to have such a ball. Perhaps some of the younger medical men may see their way to assist in such an en- deavour, as these public dSbrts not only give material assistance
862 MSKTiNOB. •teSJ^fS^SSf
Boriew, JTim* 1, 1881
to the hospital fonds, bat they go far to bring the institaiioB prominently before the public, and therefore benefit it in thai way. Yon have already learned from the report and from the public papers of the death of our President, tiie Earl of Wilton, an announcement which everybody received with profound regret. You can easily understand how difficult it is to find a suitable successor to such a noble man as the late Earl, but we have been very fortunate in inducing the Earl Cairns — (cheers) — ^to accept the vacant post. Earl Cairns is a very firm and consistent friend to homoeopathy ; he stands very high in public opinion, and is likely to stand even higher. Therefore the friends of the hospital are to be congratulated on his Lordship's acceptance of that appointment. Turning to the income of the hospital, we find that, as compared witib the income of last year, tiiere are certain losses, but that on the whole the current income has increased. rCSieers.) We have lost, principally through deaths, something like J680 in subscriptions alone, including the generous subscription of the late Earl of Crawford and Balcaires, which amounted to £86 a year. We have, however, no reason to complain of want of munificent support, and that amount has been practically made up ; thanks to the zeal and activity of our staff.
One generous nobleman now gives us not less than jS250 every year. (Applause.) Then there is Miss Duming South, whose name is quite a household word with us — (applause) — and in recognition of whose munificence we have named a ward ** Duming.*' That lady, as you well know, gives us £210 every year — (applause), — and has written two letters to the Official Manager, which I am sure you will be glad to hear. In the first letter she says : ** Will you kindly convey to the Board of Management of your hospital, on my behalf, my acknowledg- ment of the great complunent they have paid me in naming one of the wards * Duming,' in commemoration of the gift of the ' Duming Beds.' I thmk it must be a proof that the beds have been of service to the hospital. I intend to send you a cheque regularly in January until the beds are endowed — (applause) — and should be obliged if, at the beginning of next year, you will send me a report of the eases that have occupied the beds during the past twelve months." Well, at the beginning of this year a report was sent, and gave Miss Smith so much satisfaction that she wrote the following : *' I was much pleased to receive the report of the cases treated in the Duming Beds during 1881. The result seems to me hi^y satisfactory. The case of * Tabes Mesenterica ' is most remark- able, and shows what a valuable help in the treatment of disease homoeopathy is. The cases of ' varicose ulcers ' in leg and of ^ paralysis ' are also most interesting and satisfiictory. Will
jou idndlj tell Dr. Scriven how much interested I haTe been in liis report." (Applaase.) So that this generous lady is quite satisfied with the nse which has been made of the beds she has placed at the disposal of the Board.
This does not end the list of generous benefactions. We hare recently receiyad a subscription of £25 firom Mr. and Mrs. Gibb, of Canada, friends of Dr. Matheson, who desire to establish a Cot in the Children's Ward, to be called the '* James Torrance Gibb" Cot, in memory of their recently deceased child.
Turning to our reserve fund, we are about to increase that by several very acceptable legacies. There is one of £1,800; another of £1,000; and a donation from Mr. Cohen of 50 guineas. (Cheers.) The result of this will be, that while we shall have spent £2,028 in structural alterations to the hospital, we shall receive £2,868, so that we shall be something like £800 better off than when we began these improvements, which really almost amount to a re-building. It is also interesting to know that at the present time we have 72 beds in the hospital. Of these 40 are at this moment occupied, and consequently we have room for more patients, and every prospect of fonds to •m«TitftiTi them.
The question of the Nursing Institute continues to be regarded by the Board with great interest. We have established a school for nurses, so that medical men may send for them and may rely upon receiving efficient and careful nurses. We have now twenty-one nurses on our staff; the establishment at present requires ten, and therefore we have eleven we can send out to nurse invalids at their own homes. The Nursing Institute is intended to aid the annual income of the hospitid, and would be a source of great profit if the nurses were constantly employed. Those who are sent for always give the very utmost satisfaction. A few days ago I saw at St. Leonards a nurse who was trained in this hospital, and who has taken charge of a small hospital there, and I never heard a person more highly spoken of. This is the general testimony as to our nurses — (hear, hear) — and I can only say that we are prepared to keep an even larger number if the demand can only be increased. I will not detain you longer with any remarks of mine, but will simply move that the report which we have heard read be adopted. (Cheers.)
Dr. Dtos Brown said he had much pleasure in rising to second the adoption of the report, which, he thought, they must agree in thinking satisfactory in every way, especially in reference to the increased and improved accommodation for sixty patients in the wards. As to the nurses, his own experience of them was that they are most admirable nurses, and gave the greatest satisfaction to the patients and the patients' friends, and
864 MEETINGS. ^'S^^^SJyP^
R«Tiew, June 1, 1881.
their efficiency and other qualifieations reflected the highest degree of credit upon the power of choosing the right women which was displayed in their selection. With regard to the paying patients, one reason that the experiment was not so successfol at this hospital as it appears to be at St. Thomases was that the cases obtained were mostly of a chronic character. When acute cases came in the results were always more satia&c- tory. They do well, and do credit to the hospital In chronie cases the patients inyariably had been a great deal coddled at home. It was impossible that they should have the same amocmt of coddling at the hospital, and it was not desirable either. Yeiy often the patient would expect to find a nurse set apart to be always at his or her beck and call. A majority were such cases as do no credit to the hospital, and it often ended by their finding a great deal of fault. On the other hand, the acute cases did the hospital much credit, and the patients spoke in the highest terms of the treatment they received. Regarding the alterations made in the wards, all who had seen them Inust agree that they were great improvements ; the wards were now more light, airy, and well ventilated than ever. One very great improvement was the ward set apart for infectious cases. Do what they might cases would occur in which the patients, not received as infectious, would develop into infectious oases. That was a very serious matter — (hear, hear), — and he was glad that the Board had made provision for these casual cases. ]>. Dyce Brown concluded by seconding the adoption of the report, which, he said, was excel- lent and satisfactory.
The report was then adopted.
Dr. Hughes proposed a vote of thanks to the Chairman, the Board of Management, the House CJommittee, the Treasurer, and the Sub-Treasurer, which was seconded by Dr.. Bcbnbtt, and responded to by M%jor YAUGBAN-MoBaAn.
Earl Cairns was next proposed as President of the Hospital by Mr. Chambrk, on behalf of Lord Ebury, and seconded by Major Morgan. The resolution was carried with enthusiasm.
The re-election of those members of the Board of Management who retire by rotation was proposed by General Albxandeb, seconded by Dr. Ysldham, and carried.
Dr. Blagkley next proposed the confirmation of the appoint- ment to the Board of I^. J. Pakenham Stillwell and General Alexander. In doing so. Dr. Blagkley advocated the direct representation of the medical profession on the Board. He
said : —
A few years ago our own Board of Management had among their number three medical gentlemen, and it wiU be remembered that those appointments evoked considerable opposition. Bat he believed a change had occurred since then, and if the step
iS^^SmSr MBBTINOS. 865
Seyiew, Jnne 1, Iffid
were taken over again, and some of the medieal men competent to pionoonee judgment on medical questions were appointed to the Board, great opposition would not now arise. He had eyeiy reason to suppose that the Board were themseWes fiaTourable to the suggestion, and would be the first to welcome the medical element. Of course the matter was open to question (hear, hear) ; but what would please those medical subscribers whom he had consulted was that some members of the medical staff should be ex officio Members of the Board. Thirty jears ago saoh a proposition would have been regarded as the extreme of radicalism, but tempora mutantur — and he felt sure that the concensus of lay opinion would now be in favour of the repre- sentation of the medical staff of a hospital on its board of management. He felt equally sure that the learned founder of the' hospital — ^Dr. Quin— (cheers), much as he was originally opposed to the idea would, if he were still living, agree to it now. He (Dr. Blackley) hoped that the step would in due time be taken, and the medical element again make its appearance at the Board of Management, although he did not now move it as an amendment.
Dr. Ci«ABxs had much pleasure in seconding the motion brought forward by Dr. Blackley for the confirmation of the appointment of Mr. J. Pakenham Stillwell and General Sir James Alexander, and in doing so must express his concurrence in the remarks which had been made as to members of the medical staff having a voice in the management.
M%jor Yauohan-Moboan said that before inviting discussion on the question, he would put the motion which stood proposed and seoonded. This being unanimously carried.
Dr. Pope said : Sir, the proposal to place medical men on the Board is one which, considered in the abstract, is most desirable ; but, when we come to details, the first question we have to solve is, where are we to get the medical men from ? From the staff, or from outside the staff ? If we take two from off the staff — the jealousies of the remainder of the staff are aroused ; if we select two firom outside the staff — ^the jealousies of the entire staff are excited. Such, sir, has been my experience.
Dr. Yeldhah : This is an important question (hear, hear), and I think it is one upon which great deUberation should be exer- •cised. If the suggestion could be carried out no doubt it is good enough, but it is open to the very serious objections which Dr. Pope has pointed out. (Laughter.) The question is quite deserving of discussion, however, but it is one which requires very much time for consideration. (Hear, hear.) There are a good many sides to it. Some years ago three medical gentiemen were elected to seats at the Board of Management, and ob- jections were urged by members of the medical staff with so
Vol. 26, No. 6. 2 c
866 MEETINGS. "^£L"SJf!^
Beview, June 1. VjBL
much persistencj that those gentlemen felt it their duty, in the intereets of the hospital, to accept the Chiitem Hondreds. (Much laughter.) It was not so long ago, and we may take it as a sufficient indication that the time has not yet come when medical men can sit at the Board of Management without- exciting dissension. (Cheers.)
Mr. Thomas Higos said that as an old suhscriber of the hos- pital he was old enough to remember the Hahnemann hospital, of which he was also a supporter. At that hospital, which wa& so short lived, one of the principles was that medical men should have a seat at the board of management. Every one who remembers that hospital will remember that it was discontinued solely in consequence of the dissension of the medical men on the board. He was afraid similar difficulties might ensue if medical men were appointed to the Board of this hospital (hear, hear), and as, he supposed, the opinion of the medical men could be obtained without their sitting on the Board, it was hard to see what more could be wanted. (Hear, hear.)
Dr. BuBNETT compared the administration of a hospital to the control of a large business, in which it was impossible that those who ought to devote their energies to the practical details of the work could claim to have the powers of direction. Whether the medical staff were paid or not they were the subordinates of the Board — ^not in any obnoxious sense, and it should be thdr pleasure to carry out the wishes of the Board, without claiming any administrative powers.
Mr. SiiATEB would say to those who moved in this matter that the medical officers have the most ready aeoess to the Board, and his own suggestion would be that they would have no cause of complaint of being unable to get a hearing if they addressed the House Committee or the Official Manager (hear, hear), and he was sure that no reasonable proposition would be overlooked. Suppose any discussion had to be raised at the Board on the internal working of the hospital, how could it be discussed fairly with those interested present 9 (Hear, hear.)
Major Wm. Yaughan-Moboan, having said he was glad the subject had been raised and discussed, suggested that it might profitably be made the subject of discussion by the British Homoeopathic Society, which was wholly composed of medical men, and for the opinions of which Society the Board felt very great deference.
The subject was then allowed to drop.
Mr. Boodle proposed and Mr. Wybom seconded the confir- mation of the election of Dr. Anderson to the exteinal medical staff, which was carried.
Mr. Slates proposed a vote of thanks to the medical stafi of the hospital.
SSS^j^S^^SS?* NOTABIUA. 8«7
B0VWW, June 1, 1888.
Mr. BosHEB seconded the iBSolniion, which was carried nnani- moQslj, and acknowledged by Dr. Coofkb.
The BeT. Dacbe Cbavzn moved a vote of thanks for the vain- able services of the band of Lidy visitors who did so mnch to alleviate the sufferings of the sick ; also to the Honorary Solicitor and Honorary Architect, both of whom had rendered great services.
The motion was seconded by Dr. Mathbson, and carried.
Dr. PoPB then proposed a vote of thanks to the Chairman (loud applause) for presiding at that meeting, and alluded to the long unbroken series of years dnxing which Lord Ebory, who, nnfor- tnnately, was not present, had filled that position, and to the great public services his brdship had rendered to the cause of homoeopathy.
Dr. YxLDHAH seconded the motion.
M^or Yauohan-Moboan in acknowledging the vote expressed his obligation for the kind terms in which the speakers had spoken of any humble services he had rendered to homoeopathy.
NOTABILIA.
HOMOEOPATHY IN THE UNITED STATES.
In our April number, we referred to Dr. Oliver Wendell Holmes^ and the prophecy on which he ventured forty years ago, to the effect that not many years would pass away before the same curiosity excited by one of Perkins* tractors, would be awakened by the sight of one of the infinitesimal globules, and so on. ** The lifeless delusion/' as the poet then termed it, still lives, and the latest evidence not only of its vitality, but of its robust vitality, appear in the following report of what occurred at a meeting of the Massachusetts State Committee on Public Charit- able Institutions, when Dr. J. T. Talbot appeared before them on behalf of the Massachusetts State Homoeopathic Medical Society. He addressed the committee as follows : —
** Gentlemen : As chairman of the committee appointed by the Massachusetts Homoeopathic State Medical Society, it is perhaps proper that I should present to you the subject of this petition. This petition asks in general terms that the State may provide homoeopathic medical treatment for the insane who are under its care and who desire it or for whom it may be desired.. It is not necessary nor is it desirable to enter upon a discussion of the merits of homoeopathy before your committee. Suffice it to say that this system of medicine, once so novel and strange, is now well known and has been steadily increasing in the num- ber of its believers and advocates for the past forty years. In
2 c— 2
868 NOTABiMA. "^S^^^STrSS:
Berview, June 1, IBHL
1840 there were bnt 6 honueopailuc practitioners mMassachnsetts. In 1850 there were in round numbers 50 ; in 1860, 150 ; in 1870, 250 ; and in 1880, 400.
^'The bdievers in homoeopathic medication haye in the last ten years, at a coat of $200,000, built and sustained a hospital in Boston which has taken care of upwards of 1,500 patients who otherwise could not in this State have had in any hospital the medical treatment they believed in and desired. They have sustained a dispensary which in the last 25 years has in this city of Boston given gratuitous treatment to 100,000 poor sick people who have preferred this kind of treatment, of whom about 12,(NX) have been treated the past year. They also sustain a medieal achool in connection with Boston University, with a cuiriculum of study unsurpassed in thoroughness, in which more than 100 students are enrolled, and from which in eight years 2S0 physicians have been graduated in medicine. It is tins body of physicians and these believers in homoeopathy, who, from their own experience, feel assured that this method is the best for the treatment of disease, and who now come forward and ask yon to provide for them and for their friends, if they should be obliged to go to an insane asylum, the kind of medical treatment in which they have so much confidence. Moreover, they deem it an injustice and a hardship that they, loyal citizens and tax- payers of Massachusetts, should be compelled to submit to treatment in which they have no faith and against which they often hold a deep seated prejudice. So firm is this conviction that many wiU not go or allow their friends to go to the hospital until actually compelled to do so. Then if they die they feel that it was from lack of proper medication ; if they recover, they think the recovery would have been sooner under homoeopathic medication.
" Whether this be true or not, such is their belief, and where- «ver numbers render it practicable we doubt not your committee will consider that the State should accede to the personal rights and opinions of its citizens in a matter like this.
'* The petitions which you already have, together with those in the hands qi the committee not yet presented to the House, contain the names of more than 5,000 citizens of the Common- wealth and residents of 45 different towns and cities. Among these are to be found some of the heaviest taxpayers, merchants, manufacturers, bankers, and members of almost every trade and profession. . In fact, there is hardly a person to be found, what- -ever may be his own wishes as regards medical treatment for himself, who would not desire the State to extend liberty of opinion and choice in this matter to all the citizens. When a thing to be done is clearly right and is sustained by the people .almost unanimously, it cannot be difficult to provide for it We
JKsSJ'^frraS^'' hotabilu. 869"
Barhew, June 1, 1882.
therefore ask your committee to prepare a Bill wbioli shall secure in the hest and quickest maimer the object of these petitions.
'< There are yarious ways by which homoeopathic treatment could be provided.
'^ 1. By the appointment of a homoeopathic physician in each of the present existing hospitals, who diould have the medical care and control of all patients for whom homoeopathic treatment is desired.
"2. To set apart a portion of each hospital for the exclusive treatment of patients homoeopathieally.
'* (Both of these methods would require friendly relations, not only with the superintendent, but also with the medical staff, to ensure the greatest success.)
*' 8. The devoting of one of the existing hospitals entirely to homoeopathic treatment.
'^ 4. The establishment in some favourable location and in an economical manner, of a small hospital capable of providing for 100 patients, with opportunities for enlargement as needed.
« This latter plan would require no immediate outlay of money by the State, but would need careful consideration by those most interested and in connection with the State officials luiving charge of the insane.
<< Dr. J. Heber Smith, of Melrose, Dr. Worcester, of Salem, and Dr. West, of Neponset, also argued that the subject matter of the petitions should be given, in some form, definite legal shape, aiter which Dr. Talbot closed the case. No one appeared to object to the action sought."
LONDON SCHOOL OF HOMCEOPATHY.
Db. Hughes* lectures on the Principles of Homoeopathy during the past month have embraced the following topics : — May 4th. The Relation of Homoeopathy to Hahnemann. ,, 11th. The Knowledge of Disease. „ 18th. The Knowledge of Medicines. „ 26th. Similia simiha curentur. The programme for June will be as follows : — June 1st. The Selection of the Similar Remedy. 8th. The same (continued). 15th. The Administration of the Similar Remedy. 22nd. The same (continued). 29th. Homoeopathic Practice. July 6th. The same (continued).
If
870
NOTABILIA.
ICopthly HonuBop^Chie r, June 1, tttl.
LONDON SCHOOL OF HOMCEOPATHY.
BuBsoBiPTioiiB and vdcmatibnB 22nd April, 1882 :—
reoeiTed from 21st March to
£ 8. d.
••• •• <
1 1
Dr. C. C. Tuckey ...
Dr. A. J. Powell
*' E. J./' per Dr. Bayes (Donation) 10
MiMsn. LeaUi and Wool- cott, per Dr. Bayes (Donation)
**A Thankoffering," per Dr. Bayes (Donation)
Dr. J. G. Blaokley
Dr. A. C. Pope
Dr. H.Wheder
Dr. J. H. Clarke
Dr. A. P. T. Anderson...
Dr. Byres Moir
Dr. Washington Epps ...
Dr. B. Hughes
Dr. E. T. Bh&ke
H. T.Wood, Esq
Dr. Dyoe Brown
I>r. Midgely Cash
W. Davy A Son
Dr. S. H. Woodyatee ...
I>r. Samu^ Morgan ...
Wm. Melhnifih, Esq. (Do- nation)
1 1
0 0
0 0
110
1
1 1 1 1 1 1 1 1 1 1 2 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 2 1 1 1 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
•a. ... ...
110
Miss Colekin, per Dr.
Bayes (Donation) ... "A Friend," do. do. Dr. Donald Baynes Dr. G. F. Ooldsbroagh...
Dr. G. Clifton
Miss Simpson
Dr. A. B. Croneher
Dr. Wm. Boohe
Dr. Victor Jagielski ...
Dr. B. T. Cooper
A. B. Pite, Esq
Dr. A. H. Bnck
Dr. S. Morrisson
W. D. Batcher, Esq. ... Messrs. Woodman St Tul-
xoon ... ... ... ...
Dr. J. Harmar Smith ...
Dr. Black
Dr. Gibbs Blake
Dr. Burnett ..
P. Wilwin, Esq.
£ 8. d.
2 2
0 10
1 1
1 1 1 1
1 1
1 1
3 2 2 2
... ...
1 3
1
1 1
1
1 1 I 1 5
1 2 1 1 1
1 1 1 1 1 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0
£60 18 0
LONDON HOMEOPATHIC HOSPITAL.
The Betorn of Patients admitted to May 9th affords the following statistics : —
Remaining in Hospital at date of last return (March 16th) 45
Admitted between that date and May 9th ... 89
Discharged during the same period Remaining in Hospital on May 9th
184
81
58
The number of new Out-Patients during the period firom March 16th to May 9th, has been 1,058.
The total number of Out-Patients* attendances during the same period has been 8,506.
REPORT OF THE HAHNEMANN CONVALESCENT HOME AND HOMCEOPATHIC DISPENSARY, BOURNEMOUTH.
We have received the third annual report of this eminently useful institution, which does a great and good work with veiy
ISSl^J^friSS* NOTABILU. 371
■
limited resources. Daring the year 44 patios bad been reeeivedy but owing to lack of room and funds, the committee bad to refiise large numbers of applicants.
in regard to the finances, the year opened with a deficiency of £86 18s. 7d. on the bousdceeping, whilst every proper economy has been studied, the committee regret to state that this deficiency has increased to £161 18s. 8d,
This state of affairs calls urgently for assistance. We find our only homoDopathic convalescent home crippled, so to speak, for funds.
Patients received, are in most instances drawn from distant parts of the country, and it is scarcely right that they should depend so largely, as at present, on local support.
Bournemouth is a place to which invalid visitors from all parts fiock. How easy it would be for a medical man, in sending patients there for health, to interest them in in the home, and get them to visit it. One visit, we are sure would suffice to enlist their sympathies and ensure a donation. Such a good cause surely deserves all the help we can give it.
THIRTEENTH ANNUAL REPORT OP THE MELBOURNE
HOMiEOPATHIG HOSPITAL.
It is indeed a pleasure to read the report which we have just received from the Empire City of the South. Homoeopathy flourishes like a cedar and spreads its branches far and wide in that enlightened land. Supported by Qovemment grants, a site for tiie new buildings voted by Parliament, and reckoning many of the most prominent colonists amongst its staunch supporters, our cause progresses in a way to suit the most go-a- h^Ld views. Perhaps it is the Americanism, so to speak, with which our southern colonies are tinctured ; perhaps it is the freedom with which new and progressive views on all subjects are taken up, but at any rate, bigotry and the College of Physi- ^nans would find themselves considerably '* out of it" if Ibey went crusading against homoBopathy in Melbourne,
It is proposed to begin the new hospital very soon, a site baving been promised by the (Government and a grant of J62,00O made towards the building fund. Altogether J64,000 have been promised for this object.
The total number of patients for the year was 1,766, 146 being in-patients, 1,610 out-patients.
A bazaar was held in April, 1881, which realised the very handsome sum of £544 towards the building fond.
The system of receiving small amounts from such of the patients as are in a position to pay still continues to act well, and ^hile adding to the income of ^e institution, tends to dieck
872 KOTABILU. '^SSS&'^SSf?^
, June 1, 18BL
pauperism, and condaces to mdividnal reliance and self-respect. The receipts last year from this source were from in-patients, Jgll4 ; out-patients, £225 18s. 6d. ; total, Jg889 IBs. 6d.
This idea of paying patients has been gradually making way with us in England, and though not extended to out-patients as yet, certainly deserves a trial in that direction, the abuse of that decent of our charities being a notorioua ^vfl.
The tone of the whole report is very satisfactory, giving evi- dence of the healthy activity of homoeopathy in the Colony of Victoria.
DEVON AND CORNWALL HOMCEOPATHIC DISPENSARY.
We are gratified to learn from the recently received annual report of this institution that the evidences which exist of its increasing prosperity are decided. More commodious premises have been secured ; the patients have considerably increased in numbers ; the services of a regularly trained nurse have been secured to attend serious cases among those visited by the stipendiary medical ofSicer ; and the committee are able to look forward to the establishment of a cottage hospital as a by no means distant prospect.
The medical report is as follows : —
Number of patients remaining on the books,
December 81st, 1880 ,.. 59
Admitted and re-admitted from January 1st, 1881, to December 81st, 1881 1,196
1,255
|
Of these |
were cured or relieved |
... 1,048 |
|
|
19 |
no report ... |
• • a |
61 |
|
ft |
notreheved |
• . • |
42 |
|
») |
died •.. |
• •• |
19 |
|
it |
under care, December 81,1881 |
90 |
1,265
Of the above 1,255, 268 who were too ill to attend personally, were attended at their own homes, and 1,450 visits were paid them.
REPORT OP THE NEWCASTLE-ON-TYNE HOMCEO- PATHIC DISPENSARY FOR 1881.
Thb medical ^wrk of the Dispensary has gone on satisfactorily during the past year. Since' May it has been open every week- day instead of thi-ce days in the week. It has been attended by
^SS^^SSufm!" NOTABILIA. 878
Bnr. Pordom, Kennedy, and Gkdlo^j. Over 880 patients have been under treatment during the year, representing nearly 2,500 attendances. Many Tisits have been paid to patients unable to attend at the dispensary. A large number have reported them- selves as relieved or cured. Several new subscribers have been added to the list.
HAHNEMANN CONVALESCENT HOME, BOURNEMOUTH.
Thb following piece of information, extracted from the Bourne- month Visitors* Directory, will, we are sure, excite at once the sympathy and interest of our readers : —
Through the kind exertions of three ladies, the Countess Cairns, Mrs. Hull (Ecclesbum), and Mrs. Snell (Windlesham), the sum of iS607 9s'. has been collected to endow permanently a bed in this home in memory of the late Mrs. Nankivell, who had always shown herself deeply interested in the temporal and spiritual welfare of its inmates. The money will be invested in the names of three or more of the trustees of the home, and the income derived will form part of its revenue in perpetuity. The power of nominating to this endowed bed will be vested for his life with Dr. Nankivell, who has signified to the kind donors his most grateful acceptance of their proposals, and his deep appre- ciation of the' suitability of the memorial.
PROTECTING INFLUENCE OF VACCINATION,
Dr. J. H. Raymond, Health Commissioner of Brooklyn, fainiflhes the following interesting statement regarding the first hundred eased of sm^-pox that have come under the observation of the Health Department since the Ist of January last, which, he considers &ould set at rest all questions as to the utility of vaccination : — ** From January Ist to February 26th, there were reported to the department 112 cases as small-pox cases. Of this number, 98 .were found on examination to have the disease, and 14 not to have it ; and two cases reported to be chicken-pox proved to be small-pox. Of the 14 cases that were examined and found not to have small pox, one was scarlet fever, four chicken-pox, three measles, one German measles, and five were cases of skin disease. Of 100 who had small-pox, 45 had never been vaccinated^ 27 of whom died. Eight others had pale, indis- tinct, and impiorfect marks of vaccination, and were probably never vaccination — using the term as it should properly be used. Of these four died, so tlmt we may say 58 had never been vacci- nated, or that 81, or 58 per cent., died. Of the 47 who had been successfolly vaccinated, 6, or 12 per cent., died. Twenty -four of this number were adults, who had not been vaccinated since infancy ; three of them died. Of the 28 who were supposed to
874 NOTABiLiA. "s*ffi:^'sr?'?S
Baview, Jme !• tBSL
be protected by vaccixiation, 20 had a mild attack of Taiidoid ; one aged three years, who had been well vaccinated in infiEuicy and again later, died ; two children, aged respectiyely five and eight yean, members of the same family, and having good markv of vaccination, died. The youngest person attacked was three months and the oldest sixty years old.'* — British Medical JoumaL
" PUTTING AWAY THE TATHIES."
At the last meeting of the New York Medical Sodefy, a most important change was effected in the ethics of medical practice. This consisted in the adoption of a new code for the guidance of the faculty, virtually permitting a physician of the ** old school '* to consult with any physicians of the other schools in good standing he may choose.
This is a wise and timely measure, and must result in a great improvement in the tone of the profession, raising it in the respect of everyone, and divesting it of much that is discredit- able. In the eyes of the law, both schools have the same privileges and striding ; there are well conducted state homoeo- pathic, as well as allopathic asylums and hospitals ; there are regularly chartered colleges of both schools ; and it is high time that arbitrary distinctions should be at an end.
The action of the State Society at Albany has naturally drawn forth the adverse criticisms of men whose ideas are as narrow and illiberal as those of the most bigoted theologians. It has even been insinuated by one Philadelphia medical journal that the new code was suggested by the " specialists " of the regular school in New York City, who, knowing that a large number of rich and influential people in that city employed homcoopatfaistB, wished for a change that would permit tiiem to meet flieir « irregular '* brethren in consultation.
Equally silly and hastily formed opinions have been expressed by otiier non-progressive critics, who seem to cling as fondly to the traditional blue laws of their school as the venerable puritan climg to his iron-bound bible with one hand, while with the other he piled feggots upon the fire built to consume the nnfbrta- nate witch.
After all, the duty of the physician is to relieve hnman sufforing, and whether he does so by the use of the heroic measures of Bishop Berkeley's tar water, or the infinitesimal doses of the LiUiputs, it matters not. The clever and succeesfol practitioner seizes the best remedy that presents itself, and does not stop to enquire whether he violates any code in so doing. The ** old school" are making daily use of the remedies of the '* homoeo- paths," while the latter do not hesitate to administer remedies not included in their pharmacopoeia. In America, Dr. Henij G. Piffard, of New York, and in England, Dr. Sidney Banger,
l£!SSSfj?!Staf' NOTABILIA. 876
were among the first of ** allopaths '* to call attention to the yalae of the homoeopathic use of certain drugs.
What is really needed in medicine is the putting away of the ** pathies " which belong to the quacks, to the creatures who thrive on printing ink and '* testimonials," and who prey upon the superstition and credulity of the general public. If such an amalgamation as will probably follow the passage of the new code does occur, it will mark an era in medical progress that must <earry with it a more scientific exactness. The weaker men in both schools must be crowded to the wall, and at the bedside of the patient there will be a fair and practical application of what is good in each system.
Under the new regime, the public ought to be able to judge more clearly of the character and ability of their physicians. The question wOl not be so much of the school, as of the honourable standing of the individual among his comrades of both schools.
When he is called hard names by his fellows, it ought hereafter to mean something more than a difference of opinion on matters of theory.
Let tiie public now be on its guard against supposedly ''regular *' physicians, who are known among their brethren as '' commercial " doctors. These men, with the endorsement of titles, or a membership in some respectable medical socieiy, prostitute their learning by indulgence in ** claptrap,'* by the recommendation of ** cures," and by useless and unnecessary operations, performed on ev;>r7 occasion, and n^n every patient, no matter what may be his disease. One will cQscover that some particular part of the body is the seat of a morbid process, and will proceed to remove it by a mysterious operation ; while another will prescribe a remedy which can be procured only at a certain place, and can be taken only in a certain position. A more matter-of-fact practitioner will suggest the extent and value of his practice by means of a pile of bank notes of large denomi- nalionB exposed upon his desk.
With these men no code of ethics is of the slightest use, and their more honest and plodding fellow-physicians must bear the disgrace thus brought upon their calling. But if the profession itself finds it difficult to deal technically with such men, the public, as we have said, ought to be better able to discern them now that the allopaths are disposed, in their public attitude and private conversation, to reserve their harsh criticisms for real offenders.
BRITISH HOMCEOPATHIC SOCIETY.
Tax Ninth Ordinary Meeting of the present Session will be held on Thursday, June 1st, 1882; and, by a resolution of the Society, will be taken as the first evening of the Annual Assembly.
376 OOBBBSPONDBNCB. "S^f^SJ^^^
At seven o'clock the following motion will be discussed, pro> posed by Mr. Harris, seconded by Br, Bnrwood : —
'* In Law Y, to omit the words ' shall have treated their patients homoBopathically for at least three years/ and to substitute in place thereof the words ' shall have passed a satisfactory examination in the principles and practice of homoeopathy.'
** In Law XIV, to omit all up to the words * at least two years ' indusive, and to substitute the following : — < Inceptiye members shall consist of, (1) medical students, and (2) regis- tered medical practitioners who believe in the truth of the law of homoeopathy, but have not qualified as ordinary members of the society.' "
At eight o'clock, the specimen medicine, aloe, prepared by the Committee appointed in March for the revision of the Materia Medica, and which will shortly be in the hands of the members, will be discussed.
It is much desired that those unable to be present will com- municate their views on the matter by letter, to be read at the meeting.
The honorary secretary requests us to announce that as it is important that the society's accounts be balanced up to the date of the annual assembly, he will be much obliged by receiving any arrears that may be due, and that the library of tlie society being in course of re-arrangement, prior to cataloguing, it would be a great convenience if members who have books from it would return them before the end of the present month.
The Annual Assembly will be held on Thursday, the 29th inst, when an address will be delivered by the President.
CORRESPONDENCE.
TRANSACTIONS OF THE INTERNATIONAL HOMOEO-
PATmC CONVENTION.
To the Editors of iks Monthly HotruxopaMc Review.
GENTiiEMSN, — Will you allow me to make it known through your pages that a considerable stock of the Transactions of our late International Convention remains on hand, and that the sub- scriptions as yet received for them are insufficient to reimburse the cost of their publication. It will be remembered that their expenses were to be thus defrayed ; but it was not thought well to hold back their issue until a complete subscription list was obtained. They were published in confidence that the body of English-speaking homoeopathists would not allow those respon- sible for their cost to suffer loss. In this confidence I now appeal to as many as have not already possessed themselves of
XSSS'^SSTJ^^ C0RBE8P0NDBNCB. 877
B0Tiew, June 1, 188i.
the volume to apply to Mr. Adiard (Bartholomew Close, London, £.C.,) for a copy of it.
The subscription price is lOs., and a few extra pence have to be paid for carriage, according to distance.
I am. Gentlemen, fiaithfnllj yours,
i^CHABD HUOHBS,
Brighton, May 19th, 1882. Editor.
HOMCflOPATHY AND " HOM(EOPATB[Y.''
To the Editors of the ^^ Monthly Homoeopathic Review.'' Deab Sirs, — From yonr comments npon my letter I think that I have failed to make my meaning suffidenUy clear. I wish to point oat briefly that there is a great difference between the action of an individual practitioner calling himself a homoeopath and that of homoaopaths acting as a body. Hahnemann did not propose to merely add a new therapeutical law to the existing science of medicine, but he undertook to establish an entirely new system, having a pathology, a physiology, a pharmacology, and a therapeutics of its own. To the system he gave the name of Homoeopathy, and, to farther separate it from tibe old school, he christened that Allopathy.
Now, it is perfectiy intelligible that certain individuals examining the doctrines of this new system should discard all but one, which they regarded as very valuable, and that being ordinary physicians, or allopaths (to use Hahnemann's objection- able term), in every other sense of the word, they dismissed the empirical method of drug selection and replaced by the law of similars. Whether these persons were right in calling themselves homoeopaths it is unnecessary to consider. They could not be charged with dbhonesty or with sailing under false colours, because in their writings they gave a detailed statement of their views.
But, Sirs, what proof have we that modem homoeopaths as a body use the term homoeopathy in the same sense as these individuals ? How are we to prove that modem homoeopaths do not cherish the theories of ** homoeopathy " as well as its facta ? How are we to know that the term homoeopathy is not synonymous with a contempt for pathology 9 The expression of opinion uttered by single individuals speaks only of their own belief — ^it explains the position they take up, and not that of homoeopaths as a body. I have before me a number of quotations from homoeopathic writers, each insisting on one or other of Hahnemann's doctrines as an essential of homoeopathic practice, and they give as their authority for making these statements Hahnemann's Organon. Suppose, then, that I con- tradict their assertions, or the statements that are made in the ordinary medical press respecting homoeopathy, where shall I
878 COBBESPONBENOE. ''SSlL^SJT^
', June 1> ISOL
find my authority ? The opinion of a single individual would stand for nothing. It would require a statement made by some represeniAtive body of homceopatiis. It is the neeessity of such a statement that I would urge upon the attention of those who profess to practise homoeopathy.
I am, dear Sirs,
Yours respectfully,
Pebct E. Wilde, MJ>.
P.S. — Dr. Berridge writes me that he intends to challenge me to point out '* what Hahnemann's foolish speculations were ? " This is not the point I have before me. I am not discussing whether my opinions on this matter are right or whether they are wrong, but whether the holding of such opinions is compatible with the profession of homoeopathy.
[The word homoeopathy, we contend, must be regarded as meaning what it expresses, viz., a similarity in the effects of drug and disease. The clinical application of this doctrine may and does vary according to the views or experience of those who adopt it as a basis of drug selection. Hiahnemannism, on the other hand, is a word used to express, not only homoeopathy, but Hahnemann's views on pathology, physiology, and so on. Many of these, all, save a few, know and admit, are not tenable in the light of subsequent discoveries. To get at a consensus on these points is, we fear, Utopian to expect. — ^Eds. M. H. R.]
To the Editors qfthe** Monthly HomceopaUiio Beview.'^
Gentlembn, — I was much pleased at certain remarks in the letter of Dr. Percy Wilde, in your May number, especially those to the effect that the Hahnemannians claim, ''with some truth," to be the only homoeopaths, and that those who assume the title of homoeopaths without accepting all Hahnemann's practical doctrines, do harm to the cause of scientific truth. May I be permitted, however, to ask him exactly where he himself stands? From some of his remarks, I should judge him not to be a Hahnemannian, but yet the appearance of his name in the Homoeopathic Directory is, after the statements which I have quoted, quite inconsistent with such a hypothesis. But what I wish especially to refer to is this : Dr. Wilde says — ** In these days of more exact knowledge, many of Hahnemann's specu- lations appear in a very foolii^ light, and it is only necessary for an opponent to recall some of tbese when he wishes to prove that homoeopathy is unworthy of scientific consideration. Homoeopathists are inclined to complain of the injustice of this, but I think unreasonably, for do the laws of chivalry forbid the combatant to seek the weak points in his adversary's annour ? It is obviously the homoeopathist's duty to close the opening." With this latter sentence I fully agree, and if Dr. Wilde will
iE5SSfjS??f?iS^ CORBBSPONDBNOB. 879
point out what Hahnemann's ** foolish speculations " are, and why he objects to them, I shall be happy to break a knightly lance with him. Mailed in the whole armour of Hahnemann, I have no fear for the result. Hahnemann states in the preface to the Organon: "Thus homoeopathy is a perfectly simple system of medicine, remaining always fixed in its principles as in its practice." On this I take my stand. If homceopathy is a *' system of medicine,'* it is something more than a mere rule or even law for the selection of the remedy. Hahnemann gave the name of homoeopathy to his system, and surely he knew best what he meant by it. Yours, &o.,
E. W. Bebbidoe, M.D.
THE PROPOSED L. H. DIPLOMA.
To the Editors of the *•*" Monthly HomcBopathic Review.**
Gbntlbhbn, — ^I am extremely sorry to peruse the recent con- troversy in the English homoeopathic periodicals, the cause of this dispute being the creation of the L. H. title by the authori- ties of tiie London School of Homoeopathy. There is no reason for the complaints made against it. It is alleged that by this procedure we are assuming a sectarian position. What does it mean ? If we assume that by this action we are forsaken by onr brother practitioners of the old school, we are not sorry for it, inasmuch as they have already forced us to assume that position. It is said that this title is damaging to the progress of homoeopathy. I believe, on the contrary, that our progress will be enhanced. There is recently a tendency to the growth and multiplication of the so-called crypto-homoeopaths, and this tendency, unless checked, will lead to a very disastrous conse- quence, Le.f it wiU tend to reduce the estimation of homoeopathy in the public eyes, I regret to find such names as Drs. Dudgeon, Drysdale, Black, Burnett, &c., among the opposition party. If they ponder over the matter calmly and dispas- sionately, they will find this action of the School is not injurious to homoeopaihy. The arguments for its favour have already been given to the world by Drs. Hughes and Bayes. The opposite party should bear this in mind, that however con- cUiating we may be towards our old-school friends, they will never accept us pubUcly on friendly terms. So, without trying to satisfy l^em, we should direct our energy for the improve- ment of our own system. In India, the same attempt at con- ciliation has been made by one of our colleagues, without any effect. So we shotdd do away with disputes among our own body, but direct our joint exertions to the great cause which our illustrious master imposed upon us.
Calcutta, India. P. C. Majumdab, L.M.S.
2nd May, 1882.
880 C0RBE8P0NDENT8. "jS^^^Tuub!
NOTICES TO CORRESPONDENTS.
«% We cannot vniertake to return rejected mamueripte.
EREiLTUM.
In onr report of Lord Ebnry'B speech at page 295, line 17, inateul of — *< I think it was Dr. Cane who first brought it to his notice. The other was a medical man whose name/* <feo., read --<' I think it was Dr. Qoin who first brought it to his notice — a medical man whose name," Ac
Commmiications, ^., have been received from Dr. B. Blikb, Dr. Snss- Hahneicanm, Dr. Bebbidoi (London) ; Dr. H. Nankiyell (Bonmemoath) ; Dr. Hughes (Brighton) ; Dr. Batnbs (Canterbnr^) ; Dr. Pubdom (New- castle) ; Dr. Hastings (Byde) ; Dr. Fischeb (Sioney) ; Dr. Majuximlb (Calcutta), <&c.
BOOKS RECEIVED.
Supersalinity of the Blood; an Accelerator of Senility ^ and a caiae of Cataract. By J. 0. Burnett, M.D. Homceopathie Publidiing Company. 1882.
A Treatise on Diseases of the Eye. By H. C. Angell, MJ). New Tork: Boericke & Tafel. 1882.
An Index of Comparative Therapeutics, By S. 0. L. Potter, MJ). Chicago : Gross & Delbridge, 1882.
Electricity in Surgery. By John Bath, M.D. Boericke and TaU: New Tork.
LeucorrhoMLt its Concomitant Symptoms and HomoBopatkic Treatment By A. M. Cushing, M.D. Boston : Mudge & Co. 1882.
The New Handbook of Dosemetric Thempeutics, By Dr. A. Bm^graeve. Translated by H. A. Allbutt, M.B.C.P. Edin. London : David Bayne. 1882.
The Oout, and iU Various Manifestations. By G. A. Pettit, MJD. Paris: E. Plon et Cie.
The Homoeopathic World.
The Students* Jimmal.
The Chemist and Druggist.
The New York Medical Times,
The New England Medical Gazette.
The Medical Counsellor.
Tfic Therapeutic Gazette.
VArt Medical.
Bibliothique Homaopathique.
AUgemeine Horn. Zeitung.
Homceop. Rundschau.
El Criterio Medico.
Omiqpatica Rivista.
Papers, Dispensary Beports, and Books for Beview to be sent to Dr. Pope, 21, Henrietta Street, Cavendish Square, W.; Dr. D. Dtcb Bbown, 29, Seymour Street, Portman Sqxiare, W. ; or to Dr. Ken-ksdt, 16, Montpelier Bow, Blaokheath, S.E. Advertisements and Bosiness communications to be cent to Messrs. B. Gk>ULD & Son, 69, Moorgate Street, E.C.
tSS^^^Trnt" OUR SCIENTIFIC POSITION. 381
THE MONTHLY
HOMCEOPATHIC EEYIEW
OUE SCIENTIFIC POSITION.
XhjBma the last few months, much has been said and written about the professional aspects of homcBopathy and the position taken np by honuBopathic practitioners. We have been told that we have assumed a sectarian designa* tion for trade pxtrposes, that we are not what we represent onrselTes to be, that we are purposely keeping ourselves outside the pale of professional inierooursei and last, but not least, that there are no homcBopaths left ! So many have harped upon the sectarian string, in so many different, and generally minor keys, that the noise of their wailing has almost persuaded some, who formerly thought other- wise, to belicTe that a sectarian designation is a very wrong thing indeed, something much worse than deception or ignorance.
Now there is an aspect in which homoeopathy is not much looked at in all this interchange of courtesies, and an influence at work which must be kept prominently before the minds of our readers. We refer to the distinctiye scientific position which homoeopaths hold, and the in- fluence which homoeopathy has in moulding the development of modem scientific medicine.
Vol. 26, No. 7. 2d
382 OUR SCIENTIFIC POSITION. '^SSSwfjS^ifm
Old-fashioned physic, down from the remotest ages of antiquity, till within quite recent years, was nothing more than a farrago of empiric remedies applied after more or less reliable rules handed down by tradition. During the last hundred years or so, the progress of physiology and pathology has done much to clear away misty views of disease, and to throw light on the path of the careful prac- titioner. The invention of the stethoscope, the application of the thermometer, and of many other instruments of research in disease, have done wonders in assisting diag- nosis. But the knowledge of drugs and drug action has, till quite recently, say within the last twenty years, remained in the same fossil condition. '^ Empiricism rampant " might have been, or even now might be, the motto of the College of Physicians. The man who gives chalk mixture simply because he is treating a case of diarrhoea, and has been told that chalk mixture is good for diarrhoea, without attempting to find a remedy exaeOj suited to the particular kind of diarrhoea, is, for all practical purposes, as much a quack as the unqualified herbalist who goes about with '^ universal panaceas " or " magic mixture," which, to the sound of a brass band, he sells to the gaping and credulous rustics. The alchemist, or magician of old times, who mixed nasty and nauseous simples in his mys- terious alembic, finds a parallel in the enlightened and qualified modern practitioner who^ his superior in scientific knowledge and diagnostic skill, yet proceeds to mix together from half a dozen to a dozen different drugs, some of them possessing widely different actions, in the vain hope that one may do good, and that the rest may prove harmless. The history of medicine shows us a long succession of authors who gravely record their fiailures in endeavouring to elucidate a single theory of therapeutic action capable of general application. Take the literature of any one disease
S^l^h^'' ^^^ SODBNTIPIC POSITION. 383
.at random, say of rheumatic or typhoid fever, and we find ihat only within the knowledge of the present generation haye their pathology and etiology been clearly defined, and that, even at the present day, their best treatment is 'Summed up in the words '^ non-meddlesome expectancy."
Some authors, perhaps more honest than their fellows, tell us that, if we depend too much on drug action, we shall be apt to disappoint ourselves, and that much more jhttention should be devoted to hygiene and diet.
Enlightenment amongst allopaths (with some exceptions, of whom more anon) means progress in the direction of expectancy.
Until the advent of homodopathy there has never yet been any fixed law relating to the selection of the medicinal remedial agent. Traditional and magistral formuke there have been in plenty, but of the rudest and most empirical nature, only calculated to disappoint those who trust in them. The theory embodied in the words .simiUa simiUbus curentur is the only one for which any scientific basis can be claimed. Hahnemann stands out pre-eminent amongst historic healers as the first man who jidduced any definite law for the selection of drugs. Homoeopathy, puce the Hahnemannians, may not be a perfect law, and it is possible, though not perhaps probable, that at a fature period some further development may put the human race in possession of powers which may place even the doctrine of similars in a secondary -position. But whatever be the future which awaits homoeopathy, we can at least honestly affirm that its faith- ful disciples, having once accepted the theory, are votaries of a science of unsurpassed exactitude in medicine. Given ;a sdund knowledge of the symptoms of the case, and a careful study of the action of drugs, the application of this science to the selection of the remedy places the practi-
2d— 2
884 ouB sciENTiPic POSITION. "'S^^SJfTtSr
B«view, July 1, last.
tioner in a position infinitely more likely to ensnre aoooeBB than the empiric who has to rely merely on what he has seen or heard to be good for a similar case.
The scientific homoeopath recognises niceties of dis- tinction in the treatment of disease, which are apt to be oyerlooked by, or when noticed to be r^arded as of no import to, the average allopath. Fever, as a rnle^ to the allopath means heightened temperature and quickened pulse. The homoBopath, on the contrary, distinguishes between the febrile conditions calling for a4:onite, gd- semium, rhtts, baptina, and arsenic.
Diarrhoea, by the ordinary rule of thumb aUopath, is to be treated either with astringents or purgatives. The homoeopath, on the other hand, takes cognizance of the totality of the symptoms, and prescribes as indicated— perhaps mercurius, chamomiUa, arsenic^ cotocynth, amnphofi veratrum, cuprum, his choice in each case being grcdded by the scientific law of similars. We might multiply instances endlessly, and through all the long list of ills that flesh is heir to, we should find the allopath guided merely by broad traditional principles, if principles they can be called, whilst the honest homoeopath, to whom alone we refer, has the means of treating his cases with scientific exactitude.
We do not wish to be misunderstood in speaking of the average allopathic practitioner as being without a guiding law. There are exceptions, and their number is in- creasing, but they have only become prominent of late years, and of them and the reason for their existence we shall speak presently.
That homoeopathy is a theory established on a scientific basis is self-evident in several ways. The chief of these is the enormous influence which the practice of homoeopathy in England during forty years has had on the practice of
ISSl^j^SyrS^ 0^» SOIBNTIFIC POSITION. 386
old-fashioned physio. We constantly meet^ both amongst those of the profession who are opposed to us and the laity, thinlring men who are willing to admit freely that, whether homoBopathy be true or not, it certainly has modified the practice of medicine to a degree which would not have been credited even ten years ago. The older generation of practitioners cannot be expected to change mueh, but the younger men are beginning to find that rough polypharmacy is not satisfactory. Therapeutists of the first rank are now openly advocating the use of a single active principle at a time, and not only the single remedy, but the reduced dose has been propounded to and swallowed by men who scoff at homoeopathy. This leads us to speak of the exceptions we have mentioned. The first dawn of enlightenment may be said to have originated with RiNGEB and his contemporaries in the movement, Wood, Babtholow, and Phillips. Of the last we have but little to say, as the influence of homoeopathy on his therapeutics is notorious and easily accounted for.
A perusal of Rinoeb's Handbook of Therapetntica will go &r to convince any unprejudiced mind of the wonderM influence which homoBopathy is exerting in the way of modifying traditional treatment. We have no doubt Dr. BiNOBB would be indignant if he were called a homoeopath, but it is only since this gentle influence has prepared the way, that he would have dared to propound the advanced views he holds without fear of professional ostracism and obloquy. The most careful study of all works on thera- peutics antecedent to Dr. Bingeb would fail to find any indication of the use of corrosive sublimate in dysentery. And we do not remember to have heard in any previous allopathic text book of the use of sulphide of lime in glandular enlargements and sluggish abscesses.
The discovery of the use of minute doses of ipecaeuanJia
386 OUR SCIENTIPIO POSITION. "^^^fjS^Sfl^
in certain forms of emesis, would redound much to Dr. Bikger's credit if such a doctrine as homoeopathy w6re unknown. The use of pulsatiUa, too, in menstrual irregn- larities [has been unfolded to an admiring profession by these pioneers of physic, these adapters of the ideas of others. "Homoeopathy Re-discovered" would be an appropriate title for any forthcoming work on this subject. Whilst we should be glad, for the sake of suffering humanity, that such a change is passing over the face of the field of physic, still we cannot but despise the unblushing audacity of men who calmly cull information from the pages of a Hiring author, and present it to an appreciative profession as the offspring of their own giant intellects. Some recent adaptations show a pretty extensive acquaintance with homoeopathic literature ; and we know several instances of men, who, but for pressing reasons of medical or social polity, would be prepared to admit the truth and openly adopt the practice of homoeopathy. Crypto-homoeopathy is a thing to be deplored by all right-minded men, eqnaUy with hermaphrodite medicine, if we may so term the practice of those who, for trade purposes, make a show of using a little homoeopathy now and then. This latter form however, is homage to the scientific influence of homoeo- pathy in the present day. Such has been the spread of the knowledge of homoeopathy amongst the laity, thftt practitioners, wise in their generation, are beginning to find that a certain reputation for a leaning towards its prin- ciples is rather beneficial in certain circles. It is amusing to note the nice gradations of feeling assumed, from the free and open opinion that " in many cases homoeopathy i^ of the greatest assistance," to the guarded and hesitating admission, " that after all, there may be some good in the system." This, of course, only relates to intercourse with the outside public, as it is rarely that a practitioner can
SS^JulTr^^ ^^» SCIENTIFIC POSITION. 387
sacceed in concealing his farthing rushlight under such a humiliating bushel from his professional colleagues. All this, however, but points to the widespread influence of homoeopathy in our time.
Not content with filching new remedies, and new uses of old ones, from hom<8opathy, modem aUopathy is proceeding to '^ adapt " our pharmaceutical methods. A new genera- tion having sprung up, who have learnt some of the benefits of homoeopathy, a more elegant style of dispensing is required to keep pace with the newly acquired knowledge of drug action. And modem pharmacy, not being troubled with any scruples as to the source of the idea, supplies the needful improvement.
Minimum doses are called for, and minimum doses appear straightway, under the guise of "parvules" (for parv. read pxl.) We recollect the time when one of the chief railing accusations against homoeopaths was that we carried small cases in our pockets filled witii various little bottles of sweets. If we mistake not, one learned gentle- man proved to his own satisfaction, if not exactly to the whole world, the utter fallacy of homoeopathy, from the impunity with which his children indulged in a diet of pilules obtained from a homoeopathic source. Yet such has been the influence of this derided science on pharmacy, that we find the Britiih Medical JiywmoX advocating the nse of the obnoxious pocket case : '' A well assorted selec- tion of sugar parvules or granules (or pilules ?) impregnated vdth all the various alkaloids and active principles or their salts could then be carried in the coat pocket or lie on the study table."
The Lancetf too, after having wasted gallons of ink in vituperation of the much abused pilule in times past, actually confesses to the use of this form of prescribing. Fancy the editor of the Lancet with a pocket pilule case !
388 OUR SCIENTIFIC POBITION. ^'SJ&f JSTJfiSS! '
We only regret that the range of medicines was limited to
twenty.
'^ Qui s^excme s^accme ** is a good old adage ; and reading throogh the pamphlet which sets forth the virtues of par- vnles^ we were much stmck by the frequent and reassuring assertions^ that this mode of dispensing is not in the least like, and must not be confounded with, the obnoxious homoeopathy.
A few extracts may be edifying and instructive : —
** It is claimed by some practitionera that small doses given at short intervals exert a most salutary effect. Sn>- NEY Ringer, in his recent work on therapeutics, sustains this theory in a great variety of cases, without catering to homoeopathy."
The difficulty of explaining the action of minimum doses, save on homoeopathic principles, is elegantly evaded.
** A logical explanation of the exact action of minimum doses is an impossibility in the present state of physio- logical investigation."
*' Parvules must not be regarded as homoeopathic in any sense."
Dr. Dessau says : '' If I am asked to explain on what principle these small doses act in certain diseases, I reply on the principle so far as known of actual experience (I) This is all we know about it" (or aU we care to admU about it. — ^Eds.).
The same apologetic and indignant repudiation of homoeopathic leanings pervades all the testimonials to this wonderful discovery. One writer says: "In indorsing them I must disclaim any favouritism or sympathy with homoeopathy. A parvule given every hour, it will be seen, is not homoeopathy in theory or practice." If it were not
bS^J^^IT^^ our scientific position. 389
for this gentleman's assurance, we might ahnost have fallen into the error that it was so.
'^ The efiGiciency of these pamdes we attribute, not to homoeopathy, but to the thoroughness of preparation and the purity of the articles used." So that we may infer that the opposite holds good of homoeopathic pharmacy.
'' The distinction between such a praxis (parvules) and homoeopathy is so evident that it need not be alluded to." This is a graceful and elegant way of dealing with awkward facts which commends itself to the honest philosopher.
Now, all this but adds force to the assertion which we have made, that homoeopathy is a scientific method, which eyen its bitterest enemies cannot overlook, and have even attempted to compromise; and in the face of such attempts, it ill becomes any section of our body to try to belittle our position. The more insidious and plausible the efforts of our enemies, for such they are, the more decided and firm should be our stand by the tenets and principles which are at issue.
Our adversaries, and not we ourselves, have built up the sectarian hedge, and now that they wish to sink it, finding that after all we are on the right side of it, it is our duty as conscientious and self-respecting practitioners to insist on the admission, that if the profession wish to absorb our methods and therapeutics, they must first acknowledge the correctness of the system which produced them. When homoeopathy is publicly taught and recognised as on an equality with all other forms of therapy, then and then only will it be time to say, we are no longer homoeopaths, but simply physicians.
890 CLINICAL CASES. ^"^^^Zf^^
Review, July 1,18B!.
CLINICAL CASES, WITH REMARKS.*
By S. Blake, M.R.C.S., Liverpool.
Case X.
Variety of MoUuscum cured by Thuja,
Thebe is less donbt engendered by describing the exact symptoms present, with their source, progress, conditions and concomitants than by naming the disease. In this way the cases may afterwards come to be placed nnder another heading of nomenclature, or be differently named, but the importance of the therapeutic result still riemains. This case was diagnosed by my colleague. Dr. E. Williams, as moUuscum, and, agreeing with this verdict, I will so name it.
E. H., a woman of 85, presented herself for treatment for an eruption about the face, forehead and neck. Each of the elevations were separate, and at a distance from the others, there being from ten to twenty of them out at one time about the face and forehead. ^' They come out in successive crops ; after the old ones disappear a new crop follows. They are like a pock in appearance, but more tuberculated, of longer continuance during their progress, and more hard and warty-looking and elevated than the pock of true variola. They are, however, umbilicated at the apex. They grow gradually from small smooth hard papules, and after lasting for several weeks, gradually maturate, discharge their contents, and then die away, only to give place to a fresh crop. At the end of their career tiiey suppurate slowly with a red areola. In their commence- ment, or young stage, they are attended by a very slight itching. If pressed with the nail when getting ripe, their contents of white sebaceous matter can readily be pressed out, leaving the tubercle to wither. After some weeks only, when broken down, do the contents become purulent, thus differing both from varicella and variola. Although in certain stages the pock looks at first sight very like that of variola at a certain period of its later development, there is none of the eruption on other parts of the body. These crops have now been appearing for a period extending upwards of six months, and are in no way diminishing/' She was treated for four weeks by thuja 12th decimal
* Being part of the series of cases, the record of which gained for Hr. Blake the '< Epps " prize.
iE5S?j5?r?^ CLINICAL CASES. 391
Seriew, July 1, 1088.
attenuation — a dose three times a day, aided by emptying the riper tubercles with the nail as they maturated.
For a week thuja 6 x was ordered her^ and after this it was noted that '^ the nodules look red, but disappear sooner or die away faster than they ever did before." This was on May 1st. Medicine continued.
On May 16th it is noted there are no fresh spots coming out nowy and the old ones are dying off ; but a new symp- tom has appeared, viz., headache in the vertex. Was this pathogenetic ? In the provings of thuja there occurs : *^ Pressing in the vertex as from a nail, worse afternoon and 8 to 4 a.m. ; better in motion and after sweat."
No fresh spots followed, and the disease did not after- wards return.
There are several varieties, and it may be there are different diseases under the name moUuscum. Thus some of the projections are described as pedunculated warts, others stand on a broad basis, as occurred in the case referred to.
Thuja, as is well known, is often the medicine for pedun- eulated warts. In one instance I knew a wart, one among a cluster of white, smooth, and thinly pedunculated warts- behind the ear of a young child, drop off during the first few days of treatment by thuja 12 c. It became at first purple, as if strangled internally at its neck, and then dropped off spontaneously, but its companions refused to co-operate in the same design after a few weeks persistent treatment with the same medicine. The patient getting tired of it, I then tied the remainder, and soon made away with them. The 12 c. and 6th dec. of thvja failed to remove the remainder of the warts referred to in this instance.
The symptoms of thuja which bring us near to mollus- cum are : —
A. The condylomatous, warty, and nodular or tubercle- like projections of its provings.
B. [From Allen] . Round blackish brown elevated spots, mostly on the face, nape of neck and chest ; on the hands, wart-shaped excrescences of the size of a poppy seed, gradually increasing during the proving to sixteen in number. Their shape a truncated cone; their surface smooth and apparently seated in the epidermis. Their size varies according to their age, the largest as large as a small pea. They remained in that condition for about six weeks, when the larger ones became depressed in the centre, and
392 CLINICAL CASES. ^SSL!^SJ?«!
Rtfview, JvHf 1, iffii-
resembled a small pit (ambilication) suTroiinded by an elevated ridge. This ridge disappeared gradually, together with the wart. The smaller warts disappeared without going through this process. Eight stiU remained (after three months ; aU warts gone except one on little finger after five monliiB.)
They ceased to grow individually a fortnight after ceasing the proving (takmg the medicine ?) The new warts are smooth and truncated, and, unlike the old ones, are not homy, and do not split. Four sets of warts are at one time noticed of different ages belonging to different crops. The older ones have red areolae.
They are less painful and the red areola is less on the appearance of the menses.
Similar warts occurred on the neck, chin and other places.
Pimples on the face. Pock-like eruption over the whole body, with febrile chill in the evening, sweat at night and other symptoms in a person of gonorrhoeal cachexy. In one case the pocks broke out first on the face and scalp and became confluent like variola ; suppurated and scabbed, but without leaving any mark with a cure to the gonorrhceal cachexy.
Pock-like eruption behind ears on the chin and foreheadi also on neck^ partly becoming small brown warts. Erup- tions also are noted which more resemble varicella* than the former kinds described.
But few medicines are recorded as curing moUuscum. These are, "Mica and lycopodium (Dr. Dudgeon), and kcdi sodatum (Dr. Belcher)." — ^Dr. Hughes.
Silica. Large fleshy warts suppurating (Hering). Variola-like pustules en^g in suppurating ulcers (Allen).
It is interesting that all these three drugs have a symp- tomatic and clinical relationship very much in common as regards three conditions of skm, apart from molluscom, i.e., to blotches here and there, to nsBvus, and to blood boils. With silica and lycopodium suppurating eruptions are common. This is not noticed so much under thuja, where the diseases seem less inclined to form suppurations or ulcers.
Kali hydriodicvm, ** pustular eruption, often umbilicated, leaving scars. Papul® on face, shoulders, and back, and small boils in the same parts, leaving scars." — Bering's Materia Medico.
iSSS^jrfTrSS?*" CLINICAL CASES. 398
Bmimf, Julr 1, I8tt.
Allen giyes under kali iod.y ^'a congestion of the cellular tissue, beneath the skin, is added to the other symptoms, giving rise to excrescences like tubercles. Eruption resembles pustules of acne ; also like condylomata."
Lycopodium. Pimples contract to a scurf. Warts. Pimples bedome pustular and scab over : copper-coloured scar.
The umbilicated nature of the elevations brings us a character of considerable importance in selecting a medi- cine. But few medicines possess this feature. Thus rktts tox.f though having this character of umbilication, produces a more evanescent vesicular eruption, which, as is well known, approximates more closely to chicken pock than an eruption of the nature of moUuscum. HydrctstiSy again, presents characters closely resembling small pox, with its umbilicated pustule. There is sometimes, but rarely seen, an eruption of pustules scattered over the body during the first and early stage of syphilis ; the pustules being slightly depressed at the apex. This erup- tion was quickly resolved by mere. soL 1, in a case under my care the eruption being cured in two days.
To the constitutional infection in this man ''local sup- purating contagious chancres *' were superadded, as well as balanitis. (Double infection from chancres having '' Hun- terian " characters plus suppuration and lymphatic contagion ?) The depressed eruption of kali iod. is interesting when considered in relation to the kind of case of syphilis just described. It is not common to find what appears like double infection corresponding to two, as a rule, distinct diseases and worthy of note that the entire disease disappeared so speedily under mere. sol. The pocks in this case were rather hard at the base, with a slightly red areola and well formed, almost resembling variola when advanced towards maturation.
Hydrastis is another medicine related to variola and the umbilicated symptoms ; thus we note '* pimples resem- bling the early stage of variola or varioloid, vesicating, becoming pustular, umbilicated, and turning black and scaling off on the 9th day " (Allen). It would be a medicine worthy of trial in such an eruption as that occurring in the instance I have recorded under the title moUuscum.
894 CLINICAL CASES. "SS£,=iS??T£?
Beriew, Joly 1, IStt.
Case XI. Amenorrhoea.
Miss E. L., aged 16, commences treatment on November 12th for imperfect menstmation. Her general health has been very fair until recently, although she is by no means a vigorous girl. The complexion is pale, and the appearance of the face puffy, and she is of the fat and soft character of flesh. She is of a merry and genial disposition, and although inclined to be genUe and timid, is not at all given to &et, or cry at trifles, but even when feeling poorly keeps up her good spirits. The only appearance of the menses, however, have been on two occasions, occurring in the preceding April and May, and then only as a mere trace. She feels often a sickly sensa- tion associated with the stomach, with nausea at food; has, however, little or no flatulence rising from the stomach, and feels relieved of these symptoms when walking in the open air ; she also feels better generally when there is plenty of fresh air. There is no thirst. The tongue is large and flabby, but without any marked coating, and the bowels are costive. The feet are cold and clammy. She complains of a dull pain in the occipital region, and also pain at certain times in the loins. Has no leuchorr- hoBa. There has been an eruption of pimples and scabs on the face. This group of symptoms inclines one to con- sider such medicines as puUatiUa, cakarea^ baryta, stdphuff gelsem.y conium, pluvibtcm, natrum muriaticum.
However much the symptom — "relieved by fresh air" — inclined me to commence with pulsatiUa, I did not feel satisfied that this medicine would be quite certain to meet the case, especially as the disposition of the patient did not correspond to that typical of the class generally adapted to this medicine. On referring to the symptoms of the other medicines, I considered that graphites, also covered several of the symptoms, and as regards the rest that baryta, cal- carea and conium and nat» mur. also met the group closely in several points.
Oraphites 6 cent. trit. spoonful ter die.
Now graphites corresponds to a case of this description in the timidity and the slowness of disposition, inclination to be fearful or dejected at times ; for the mood is changeable as seen in the provings. Again. The pressive pain in the occiput ; headache with nausea during the menses, althoagh
ISl^^TnS^ CLINICAL CASES. 895
Bflfview^ Jnly 1, 188S.
the pain may be also in the vertex, as well as occiput, the pale and bloated face (or even going on to chlorosis), the aversion to food in some persons, the nausea with vertigo or dulness of head, or with headache, with inclination to vomit, added to a cold clammy state of the skin, and again the chronic constipation with large knotty foeces, with a marked absence of early sexual development, with menses too scanty and too pale (the os uteri directed backwards and reached with difBculty. — Hering), the delayed menses, tendency to obesity, the facial eruptions, the lassitude, the clammy sweat and cold extremities (pointing more to gra- phites than calcarea ; see Allen), with tendency to oedema, the skin for the most part often dry with tendency to form dry scaly or scabby eruptions. These symptoms form a group taken from the provings which show how suitable graphites is to such a corresponding picture as that of the case cited. In this girl there was no typical ansemia, there was pallor well marked, but the lips were red, if anything the pallor sinks into a kind of chlorosis rather than the proper aneemia which is so often met with in non- menstruating girls. The typical ansBmia is generally well cnred by ptdsatiUa, and the ferruginous preparations, and assisted, perhaps, in certain persons, by nux vomicay and these cases form a contrast to that of the girl whose case I have described. The Pulsatilla indications are much more frequently met with in practice as a more complete group, but the result of the treatment of this case testifies to the inunense power of graphites for rectifying these derangements where the symptom and constitutional con- dition correspond to the latter medicine.
Nothing more is heard of her until December 8th, when the report is that the medicine has done her a great deal of good, without any other having been given, that the menses liave appeared more copiously, that her good health has returned, that of late there has been no pain in the back of ihe head, the face looks less pu% and pale, and has resumed its healthy look, and she is more spirited, and feels altogether better. The sickly feelings haver also gone. There is a better appetite, and the feet are less cold ; but the bowels are still somewhat confined. Bepeat graphites € ter die.
This completely cured this case, established the menses snd the general health, and I have had no occasion to prescribe for the patient again. She continues in good
896 CUNICAL CASES. ^^^g^^SS^tftg?
health and spirits, aod I hai^ freqaently seen her since, and there is now nothing to complain of (Jan., 1881). What medicine bat homoeopathic medicine could have effected snch a manrellons transformation in so reaaonable a time ?
Comparison of Medicines and Remarks.
In dealing clinically with amenorrhcea, we have to take into consideration the cansation of the disease, which both helps us to remove, if possible, those conditions of life which tend to keep up that state of health of which the amenia is but one of the products, and also for the yaluable aid which this consideration gives us in the classification of certain medicines which become suitable for symptoms resulting from and produced under these very conditions of life. This helps us to bind together the causations of disease with our information as to the power of medicmes to produce the symptoms under such contingencies, and also renders us able to more readily classify those cases coming under our notice, placing them in such a category that from the outset we shall get a corresponding group of medicines, from which, taken together with the special indicating symptom, we shall be able to select a veiy suitable medicine.
Thus many persons present themselves who, we find on enquiry. havV been originaUy of good health, perhaps even plethoric, but in consequence of long and sedentary occupation, perhaps also working by gaslight, with a mini- mum of free oxygen, or an absence of fresh currents of air and good sunlight, have become the subjects of anaemia.
These present us with the commonest forms of ansmia, and chlorosis with symptoms often requiring ptdsatUla and nux vomica, according to their special indications. Herein we have at one view brought into a focus the causation, pathology, and the appropriate remedies at the very outset of our clinical investigation. Fresh air, daily excur- sions, horse exercise, carefully regulated and appropriate ablutions, appropriate diet, as suited to each case in- dividually, become here, as everyone knows, the best of prescriptions. These are valuable auxiliaries. Will the pidsatilla, ferrum, &c., enable us to reverse the diverted processes of the organs without these helps ? From a frequent observation in the instances of persons who are, it may be, unable to fulfil all these demands of nature, I think we are compelled to acknowledge that the rightly
^KSS'JSfr?^^ CLINICAL CASES. 397
£«view, Jnlr l, 1882.
selected homoBopathic medicine will do a very great deal in spite of the continuance of these causes — exciting the ^^rganisnoi to struggle as it were, with the deranged func- tions, and eyen gradually in many instances the body plods its way on to a comparative state of health. I think such cases are yery prone to relapses, and tend to exhibit alterations of the morbid phenomena rather than to rapid and complete cure. The causes continuing, posh forward the same disease again as before when the effects of the medicine wear off, or else push out symptoms in some other direction, much to the annoyance of the physician. No one can doubt that such diseases take longer to get better under medicine, and more constant repetition of it, other things being equal, and perhaps also larger doses eyeutually than would be the case where hygienic indications have been properly carried out. Between this class of amenorrhoea and that class where there is obtainable an abundance of good food, air, and sunlight, there is a great difference. In the latter we must naturally refer much to the previously existing un- healthy state of the individual ; not necessarily so to the former class. Nevertheless it is probable that there are in the first-named class persons belonging to either of these groups, namely — (a) those of originally good health, and (b) tiiose who are ab initio unhealthy, and to whom also the surrounding conditions are most inappropriate. This «las8 must be the worst of all states of this disease. There is here a doubly bad causation — a very compound etiology. I think this is one reason why such persons often require more than one medicine and perhaps more than two medicines to cure them. It is not easy always to find any one drug corresponding to a complex condition of the diseased state in all its multiplied causes, and also in its special symptoms. How often do we notice that diseases present the pictures of phenomena traceable to distinctly separable causes ! For instance, a man has been suffering for a long time with hepatic symptoms — rheuma- tism, or say gout — and he takes cold and gets bronchitis or pneumonia. We set about curing the latter complaint first, hy medicines applicable to its symptoms, the state referable to the last cause of the catarrh and the hepatic disease which is chronic, remains with the rheumatism or gout, for ns to take our time about and cure afterwards, if we can. So, similarly, it may be with amenorrhoea and anaemia. How
Vol. 26, No. 7. 2 s
398 CLINICAL CASES. ^**?SiL^i?7^
Bevieir, July 1, 1882.
speedily Bome persons are restored by a few days' residence nnder change of air and exercise. How different are others, where the state of the original bodily conditions needs to be gradually altered by medicinal stimulation.
In the instance of the girl to whom I have referred, the only auxiliaiy employed in addition to the medicine was & hip bath before breakfast every other morning, hot, and containing a handful of sea-salt, preceded by a cup of milk containing a teaspoonful of rum, and the bath followed by a tepid sponging of the loins and pelvis.
It need not be wondered at that Uie sedentary patient feels better in the open air, considering that oxygen is really both food and medicine to her ; and that another patient, suffering from deficient oxygenation, should also feel relief from the same fresh air, notwithstanding that the degraded state of tissue metamorphosis has not arisen from a sedentary em- ployment, but from causes to be sought further than this one.
A few medicines may be compared with one another, and some of their indications given, although it would be impossible here to describe all the minute differ- ences of each to each. Thus of iron it may be said that it cures essential chloro-ansemia. It also acts well where deficient oxygenation has been the cause, assisted by Pulsatilla and other drugs for special symptoms, in many cases especially where there has been close confinement; and improves the health also in those cases where young girls or youths are employed in large tobacco manufactories (effects of tabani7n)y although it does sometimes fail in these where the health has fallen very low, and where tha person cannot or will not give up the employment. And in reference to these cases, a similar remark applies to nnx vomica. As regards other medicines, we learn that in persons where there is a naturally low state of health we may refer to : — Amenorrhcea.
^ ( Face earthy, yellowish, pale bloated,
Conium. (herpetic diathesis. White milky leucorrhoea land pelvic pains. Depressed sexual activity- Face pde, puffed, moping disposition, scurfs, nose-bleed, toothache and leucorrhcoa before the menses. Menses last only one day. Weight over pubi3s. Backache. Pallor of face, bloated face, oedema, subject
^ , . ; to eczematous, or dry, scaly, or scabby erup-
Crrai^/iift's.'^^^g Dislike to sexual relationships on
Ipart of patient.
p m
2
r3
Baryta CJ
^^^^U^S^ CLINICAL CASES. 899
Nat. mur. <
Skin dry, harsh, vindictive disposition or, melancholic. Sallow, pale yellow, or lividity, with swelling, thirst, eructa lactea. Acrid secretions and headache during menses. ,Skin of face shines.
(Face* yellowish, corpse-like. Bloated, shiny. Painless peeling off of the lips. iMenses cease with colicky pain.
Unhealthy appearance of skin, pale, sickly,. Q 7 7 J eyes sunken or circumscribed redness,
iMap/mr. freckles. General an»mia. Heat flushes.
.Papular eruptions.
And again there are : — Ferrum, ansemia with a chlorotic appearance.
Arsenicum, ghastly pallor, even corpse-like, sometimes xnenorrhagic but necessarily so, oedema in addition or not, frequently gastro-enteric catarrhal symptoms with great debility of digestion (not generally so marked in ferrum cases), evidenced by loss of appetite, thirst, red tongue and great weakness. Litensely white appearance of face, with loss of flesh (differs bam ferrum). The appearance comes^ to resemble that of a pernicious and very progressive deep- ening of true ansdmia, rather than chlorosis, of which there is little in arsenic cases ; whereas, with iron, the progress is towards distinct chlorosis, even if blended with aneemia. It may be a question whether, after arsenicum has done its work in certain cases, ferrum may be called into play with advantage. Further — ^in persons where there is mal- determination of blood to certain organs — ^we have iodiwm^ In girls with dark hair and eyes, complexion pale, as in the scrofulo-phthisical appearance, or dirty and muddy looking, skin rough and dry, or in persons in great debility with clammy moisture. Mind sensitive during digestion, melancholy or low-spirited, or with irritability and sen- sitiveness. GonjunctivsB dirty yellow, cedematous lids, lioss of appetite, or else eats freely, yet loses flesh, tendency to glandular affections, constipation alternating with diarrhoea, acrid leucorrhoea, oedema of feet, cold feet at night, or flushes of heat. The face pale, yellowish, or changing to a brownish hue, with distressed weary appear- ance, or alternating with a dirty redness and coldness of the face.
2 s -2
400
CLINICAL CASES.
Xoathly HomoeopftthSe Reriew, Jnly 1, l&BL
Pulsatilla.
Sepia,
Pallor of face and skiiiy yet a determination of blood to pelvic organs, terminating in leu- icorrhoea instead of menses, and sometimes [determination of blood to chest. f Congestive determination of blood to pelvic organs well marked, bearing down, tender- ness, constipation, sometimes oppression of respiration, leucorrhoea, yellow or greenish water, badly smelling, itching and irritation of vulva; conjnnctivse, and face pale and yellowish, pimples, and styes, ** green-sick- ness," fits of involuntary weeping and laughter. Temper sad, irritable, or with indifference and subject to variations ; more suited to delayed and dark menses than to suppressed menses. Hence, more often useful for those disturbances which are mostly found in women who have already menstruated, but have become again un- ^healthy: Where there is no ansBmia properly speaking, but a per- verted plethoric state, with nose-bleed,deter- mination or rush of blood to the head, face, &c.
The symptoms of sulphur so much resemble those of sepia in many respects, and even in the kind of its leucor- rhcBa and the perspirations that it is difiScult to discriminate between them as to its effect on the pelvic organs them- selves. It corresponds rather to the suppressed forms of anaemia. The facial appearance of sulphur is very notable, being more pale and sickly, the eyes sunken, with bine margins, or circumscribed redness of the cheeks ; freckled complexion, and the altogether very depressed state of vitality and general unhealthy, debilitated look, in addition to the abnormal local determinations of blood and their results, enable us to form one of the sources of discrimina- tion between it and sepia on the one hand, and hryotua and calcarea on the other.
"With reference to the large groups of cases of amenor- rhoea which depend entirely, or in part, upon defined
:
1. Bryonia.
2. Calcarea.
Menses copious at one time, but have become suppressed.
iSS^J^TT^*!^ CLINICAL CASES. 401
mechanical or pathological deviations of the pelvic Btructures^ even in young girls, such as closure of the cervis or os uteri, flexions or other malpositions of the uterus, there is not opportunity to say anything here. Whether these occur alone or in complication with anaamia in addition, thoy would require descriptions of special methods of treatment, involving also the sphere of the Buigeon, which it might not be possible to enter upon in this paper, which is chiefly devoted to anaemic amenorrhoea.
A differentiation has been made between suppression or cessation of menses in women during the years of menstrual activity generally and those cases where there is suppression or an absence of their appearance at the age of' puberty ; but practically at whatever time the deficient menstruation takes place, the medicines have to be applied in each case according to the indications by the special symptoms of each medicine, and so it comes to pass that much the same group of medicines comes into force for both these forms of amenia. One reason for this, no doubt, is because many of the determining causes of this deranged function which apply to puberty come into play also under similar conditions during the ensuing years, whilst the menstrual function has already been established ; and whereas, in the first instance, such cause may have prevented the normal onset of the menses, in the second place and later on these same causes may give rise to a diminution or actual suppression of the once regular menstrual discharge.
Hence, it is not inconvenient in practice to classify the treatment of these two forms of amenia, grouping the symptoms of the medicines together, arranging them under the general title amenorrhoea, or amenia.
Thus we may, with benefit, compare a case, for instance, where a young girl of sixteen or seventeen has never menstruated regularly and has deficient menses, with another of a simUar age where the flow has commenced with due regularity, but has become deficient or obsolete from similar or different causes to those influencing the former.
It may be safely asserted, that the general tone of health is below par, and the constitutional state really at fault in almost every case where there is amenia, and that medicine is required to mend this, and artificial terms might be made to include all such cases, such as psoric, &c., but this would be but for a mere convenience, and after all,
402 ADVANTAGES OP HOMOEOPATHY. ^rS^^I^^I^
would not rightly inclnde all cases, for although the entire system is at fault in every case, nevertheless, this derange- ment is not necessarily always congenital as is implied when we use a term by common acceptation, to mean hereditary dyscrasia. Many forms of amenorrhoea are induced long afterbirth. Not unfrequently, the menstrua! flow is restored under gelsemium ; more especially I ha^e noted this when this medicine has been prescribed specially for symptoms quite remote from the utems, the menses being at the time scanty or suppressed.
THE ADVANTAGES OF HOMCEOPATHY IN THE TREATMENT OF THE INSANE.*
By Selden H. Talcott, M.D., Middletown, N.Y.
We propose in this paper to briefly pourtray, in as plain and practical a manner as possible, the advantages to be gained by homceopathic medication of those who suffer ^rith mental aberration.
To begin with> we will illustrate by presenting a con- densed synopsis of results already attained at the only homoeopathic asylum under State patronage in this country — ^we mean the one located at Middletown, N.Y. This institution was opened for the admission of patients in June, 1874. It is, therefore, in the eighth year of its existence and active usefulness. There have been treated at this asylum about eleven hundred patients ; nearly nine hundred of these have been discharged, and the remainder — somewhat over two hundred — are now under treatment. Of those discharged, over forty-Jive per cent, were faUy restored to mental health. The death rate at this asylum has varied from seven to four per cent. During the past four years the death rate has averaged a little more than four and one half per cent.
Now, in considering these very favourable results, it is well to remember that the asylum is located but sixty-six miles from New York, in one of the oldest and most populous sections of the United States. The material, therefore, which it necessarily receives is not the best or most favourable for the purpose of effecting recoveries. In more recently settled States, where the population is yet
* Beprinted from the New England Medical Gazette,
gg^fJS?yaff^ ADVANTAGES OP HOMCEOPATHT. 403
vigorous, and where the inmates of as;lnms share, to a considerable extent, the general vigour of the masses, there Are larger opportunities for successful treatment of the insane than in those commonwealths which are burdened with a certain amount of aged, effete, and decaying humanity*
Again, the managers of the homoBopathic asylum at Middletown haye often been requested (and these requests have been complied with) to admit to its wards, for treat- ment, patients who have for years been inmates of other asylums. This has been done (to the evident detriment of the asylum's curative records) for the purpose of accom- modating those anxious friends of the insane who were clutching eagerly at the last straw of uncertain hope. It is but justice, therefore, to the homoeopathic asylum, while 'Considering its already notable achievements, to state also some of the disadvantages against which it has worked. But in spite of the fact that nomerous cases, hopeless from the very outset, have been admitted to its wards, the triumphs achieved by the homoeopathic asylum at Middle- town have been such as to warrant the establishment and 'equipment of a similar asylum for the insane in every State of the Union. Not only would the cures wrought in such Asylums compensate for their erection, but the competition thus excited would stimulate the managers of other asylums to better work and more scrupulous care ; and thus the general effects upon all institutions for the insane would be beneficial in the extreme.
But let us proceed to an enumeration of the particular advantages that may be derived from the homoeopathic treatment of the insane.
First. We believe that this method of treatment is safer, as well as more curative, than any other. Every physician knows the possible dangers which may arise from the administration of drugs in overpowering doses. This danger is peculiarly apt to occur in the treatment of the insane ; and especially where the effort is made to subdue a disturbed patient by the use of large quantities of sleep- <$ompelling medicines. To overcome the mental excitement of a case of acute mania by such means is a procedure that invites most unwelcome risks. Powerful medication may Bot only *' quiet the patient," but it may likewise arrest or pervert the functions of the brain to an extent far exceeding the disastrous influences of the disease which the physician
404 ADVANTAGES OF HOM(EOPATHT. *^S^^fjS?^!f^
is endeaYouriDg to combat ; and thus the new pathological changes induced by the drug may prove greater obstacles to recovery than the original malady. From a careful study of their histories, .we are forced to the opinion that many patients have been hurried into dementia by the unwise use' of subduing sedatives, who might, under milder medica- tion, have been permanently and safely restored to physical and mental health.
Moreover, when a patient is placed under the benumbing influences of such remedies as hydrate of chloral, or the bromides, it is impossible after that to detect with accuracy the actual condition, progress, and severity of the disease which one is attempting to treat. The work of curing the sick in such cases has degenerated to a game of blind- man's-buff. The physician's eyes are bandaged, as it were, by his own hands, and, thus equipped for battle with disease, he blindly and vainly attempts to catch a care. But too often, alas ! for the patient, the Fates do not favour him.
Secondly. Patients who recover under homoeopathic treatment are less liable to relapse than those who are supposed to recover under massive dosage. Nor do they suffer from the after-effects of extensive medication. We have no such camp followers or disabled veterans as *' chloral drunkards," or " victims of the opium habit;'' nor are our patients, once freed from the thraldom of disease, henceforth pursued by that Kakus band of brain- robbers, — ^the bromides.
Those who recover from their insanity by the use of homoeopathic medicines regain their normal mental status gradually, but steadily and surely; and they leave the asylum with their systems unvitiated by huge potions of destructive poisons. Drug danger to the human system can hardly be over-estimated. For evidence of this fact witness the vast, weary army of those who will suffer to the end of life from mercury and opium, from chloral and bromide of potash. These drugs are like fire and water, useful and obedient servants when carefully ,and economi- cally applied, but most dangerous elements when turned loose en viasse to wreak their destroying powers within the temples of helpless unfortunates.
Thirdly. Upon the score of economy, we may urge the establishment of homoeopathic asylums and hospitals for the treatment of the insane and sick. During the yeinr
S^J^iTiSf*" ADVANTAGES OF HOM(EOPATHY. 405
1876 there were treated at the Homoeopathic Hospital on Ward's Island, N.Y., 8,077 cases, at an average yearly cost, for drugs and Uquors, of fifty-three cents for each patient. At Charity Hospital, on Blackwell's Island — an institution under old-school management — there were treated 8,621 cases, at an average cost, for drugs and liquors, of $1.58 for each patient. The saving to the city of New York, in this instance, had homoeopathic treatment of these patients been substituted for the '' regular " methods, would have been $8,621, — a sum large enough to purchase over one thousand barrels offlowr /
The death rate during that year at the Homoeopathic Hospital was six and one-tenth per cent. The mortality at Charity Hospital during the same year was eight and one-eighth per cent. So it seems that in this instance, at least, the greater the amount of drugs used the larger the death rate became.
Fourthly. We claim that under homoeopathic treatment the beneficial effects of good diet, of employment, of amuse- ment, and of all measures essential to speedy and sure restoration of the insane are more favourably manifested than under a system of practice where the. forces of nature are disturbed and overpowered by the use of unnecessary quantities of deleterious drugs. The stomach that is superfreighted with medicine cannot receive and digest with its customary readiness and power the food which is necessary to recuperate a body that is worn and enfeebled by disease. A brain stupefied with narcotics cannot perform even simple tasks or engage in light amusements with that zest, enjoyment, and benefit characteristic of a brain uninfluenced by such abhorent forces.
Fifthly. The administration of the laws of kindness is most readily accomplished in an institution where benign medication prevails. The patient whose faculties are uncancelled by the obliterating juice of the poppy, or xmburdened by the effects of strange compounds from the pharmacy, is one who most readily appreciates the efforts made for his restoration by those around him. Though suffering from the cankering curse of disease, be is yet free from the more aggravating stupor of drugs ; and in many instances he enjoys most heartily his freedom from obfus- cating medicine, as well^s his privileges in other directions.
Sixthly. In an at^yJ^m where homoeopathic treatment prevails, the patients aii3 >but little inclined to delusions of
406 MEDICAL NOTES. "1S2S:"55??m».
Bariew.Jnlrl. tsa.
1
poisoning ; and if snch delusions do arise in the minds of the insane they are more quickly dispelled under mild than under heroic medication. To allay, by gentle measures, the fears of the insane that they are being killed or tor- tured by poison, is one of the happiest achieyements of the earnest and philanthropic alienist.
Seventhly. Where mild medicines, in palataUe and attractive form, are given the insane, there is usually no disgust excited in their minds ; nor is hatred engendered in their hearts against their attendants. Hence, little or no force is required in their administration. And to avoid a necessity for restraint, in the treatment of the insane, is to keep pace with the requirements of our times.
We have presented a few of the reasons why we beliefe homoeopathic treatment for the insane to be the best that is known ; and we trust that these reasons will receive the thoughtful consideration of those who read them.
SOME NOTES OF A KECENT YISIT TO PARIS.
By M. Roth, M.D.
DuKiNa a short stay in Paris this spring, I had opportunities for making some observations on matters of medical interest, a few of which I send for publication in the Review,
Depot Central de la Prefecture,
In this depot the daily average of arrested persons is about 250. Among them are many who have not committed any offence, but have been arrested as. vagabonds. Not a few try to be arrested for the purpose of obtaining a sleeping place for one night, and of getting some soup for breaHast. The place is divided into departments, for males and for females, besides which there are special rooms set apart for old people, and seven for children who are detained for vagabondage, for theft, or from having been deserted by their parents.
With the permission, and by order of the director of the depot, the brigadier took me through the various rooms. The majority of them are insufficiently lighted, the single ^ells are provided with good beds, a table, chair, and notwithstanding a kind of w.c. being in the cell, no bad smell could be observed. Besides the cells for the boys^ there were a few small rooms fitted up for insane persons.
S^J^rnS^ MEDICAL NOTES. 407
snch as had a sadden attack of mental disease. Within twenty-four hoars a namber are liberated, if not accased of any special offence, the sick and insane are sent to the hospitals, the others sent to the varioas prisons and institutions. The principal object of the depot is to serve as a transitory place for the 260 persons arrested daring the preyious day.
Dr. Tripier's Treatment of Uterine Fibrous Tumours.
5th April, 1882. — ^My old firiend, Dr. Tripier, invited me to see his treatment of these complaints ; during the last few years, he has tried, partly through electrolysis, partly by local application of absorbent medicines, to relieve and to cure the uterine fibroma — which is very frequently developed without the patient knowing that she has any tumour. Dr. Tripier has made experiments with many medicines, and at present he uses mostly the '' jodure de potassium," which is mixed with various articles tagive it a cylindrical form, which is injected through a small tube into the cavity of the uterus — ^this injection is repeated every other day except during the catamenia. Amongst the ten patients whom I have questioned about their symptoms, all told me that they feel much better ; one who could neither walk nor stand, and who was obliged always to be in a lying position, mentioned as a proof of her improvement, her power of walking a certain distance, and going up stairs to the doctor, who lives on the second floor ; another, who suffered much from pain, constant nausea, and actual vomiting, had lost these symptoms. At any rate my friends who are more specially engaged in the treatment of female disease and uterine ttunours, will find it very useful to be more fully acquainted with Dr. Tripier's treatment.
Assistance aux MutiUs Pauvres. The Society for Assisting the Mutilated Poor by living them gratis artificial feet, legs, arms, and hands, &c.
6th April, 1882.— On the day before I left Paris, Count de Beaufort, the philanthropic and indefatigable honorary secretary of this society, which he originated in 1868, was so kind as to call on me at the hotel for the purpose of giving me all the information regarding the society, which enables the poor amputated, especially in the country, to do some work by providing them with
408 MEDICAL ROTBS. "SSSL^^?^
Beview, July 1, vtt.
artificial limbs ; it thus prevents mendicity, and improyes the moral condition of the mutilated through occupation and work. The society supplies not only French bat foreign poor with artificial limbs, which are manufactored by Mr. Werber, the orthopaedic instrument maker, of .20, Bue de Bichelieu, Paris, at cost price, and in manj cases, even at less than his own expense, as he is very kind to the poor. Every applicant for an artificial limb has —
1. First to show a certificate of poverty.
2. To give his name, place of abode, circumstances of his family, the cause of the amputation, his previous and present occupation.
8. He must promise to inform the general secretaiy within one month how the artificial limb works.
The annual subscription is 1 franc, or ten pence ; twenty francs (16 shillings) paid at once gives the title of a perpetual subscriber.
Count do Beaufort accompanied me to Mr. Werber, who showed me the various apparatus, which have been in the first instance planned by Mr. De Beaufort, who had the idea of taking pincers as his model for a useful hand. Thus working men are able to grasp firmly any object they have to work. In other apparatus the hand and fingers are placed in a curve, while the thumb only is moveable. The feet and legs are also constructed on a very simple plan, and the expense for the various con- trivances varies from 16 to 25 shillings. Those who are more interested in the subject will find an interesting paper in Macvdllan's Magazine, written by Miss Wyse, of Frant Court, Tunbridge Wells. I may also call attention to a pamphlet, Recherclies sur la Prothese des Membres, par le Comte de Beaufort, published in 1867 by Asselin, which the author was so kind as to give me a few years ago. It contains many interesting facts, amongst others the first attempts of the mutilated after obtaining an artificial limb. Thus a woman made the first use of ber artificial hand to write the word merci (thanks). A gentleman sends a specimen of his writing with his left hand, and finishes with the right artificial hand ; a copy of the writings is reproduced, and finishes with the remark that the wTiter prefers to write with the artificial right
M«jtt|THom«op^ CLINICAL PROOFS. 409
JUrriew, July 1, 1882.
liand. While thanking Count de Beanfort for his kind attention in making me acquainted with these and many other details, I hope that there might be amongst the readers of this note some who will endeavour to establish a similar society in Great Britain, and thus benefit many mutilated poor by enabling them to do some work and to prevent them from begging in the streets.
CLINICAL PROOFS OF THE EFFICACY OF INFINITESIMAL DOSES.*
By Dr, p. Jousset.
On the 15th of February I was called to attend M. H. The patient is a man of sixty-four years of age, very stout and florid, and leading a very active and busy life. He lias a chronic gouty inflammation of the right knee.
For the last three days the patient has been attacked -each morning with supra-orbital neuralgia of the left side. The pain begins quite slightly with a well-marked sensation of coldness. It increases progressively, and attains its climax at the end of three hours. It is then accompanied with great heat. It persists to the same extent during an hour, then decreases gradually, and disappears entirely in the afternoon.
This neuralgia, then, presents three hours of increasing pain, one hour of intense pain, and three hours of diminish- ing pain. The first morning it commenced at nine o'clock^ the second at eleven, and the third again at nine. It was, then, a very characteristic neuralgia of a doubly intermit- tent type, indicating the use of quinine in large doses ; and if, as is probable, cure had followed sufficiently frequently repeated doses of this medicine, no medical man would have denied the curative virtue of sulpliate of quinine in the treatment of this case of malarial fever.
Nux vomica in the 6th, 12th, and then the 80th dilution was administered. The disease was modified from the first day of its use, and it was completely cured in four days. From what blindness, then, can one refuse to infinitesimal doses of nux vomica the credit which one .accords to strong doses of quinine ?
The third day of the illness I prescribed nux vomica 6, two drops in a hundred grammes of water (=3 iij), three
* Translated from UArt Medical by Dr. C. L. Tackej.
410 CLINICAL PKOOFS. ^Sj^fjS^Jf!^
spoonfuls to be taken in the intervals of the attack — the first just before dinner, the second on going to bed, the third on waking in the morning.
4th day. — This was the day on which the attack used not to begin until eleven o'clock. It was almost completely absent ; there were only some slight twinges of pain between eleven and four o'clock. The same medicine was continued.
5th day. — The attack appeared at nine o'clock as usual, and lasted very severely until four o'clock. The same pre- scription was continued ; only instead of two drops of 6 I prescribed four globules of 12 in a hundred grammes of water.
6th day. — ^No attack. The neuralgia was evidently becoming tertian. Nnx vomica 12 continued.
7th day. — The attack did not come on until two o'clock; it was much less violent^ and indeed the patient suffered but little from it.
I prescribed then four globules of 80 in the same quantity of water as before, to be used in the same way. For three days this medicine was continued in the same strength as a measure of precaution, but there has been no return of the malady.
What can you reply to this, you who contemn small doses ? You who do not believe in the homoeopathic law, and who are well satisfied with your incredulity, because if you believed you would practise it, and that would be repugnant to you ; this is always the reasoning of men who are blinded by prejudice and scientific dislike ; there always is this stupid obstinacy in denying what you think is not in accordance with ordinary science. However, some physicians of better spirit and of less obstinacy do not reply to these facts by absolutely denying them, but attribute them to a cmncidence. A cure has taken place at the same time as an insignificant dose of 7iux vomica was being given, but of course the medicine had nothing to do with it. It was just a case of intermittent neuralgia cured by nature. But if j^ou had given sulphate of quinine in the dose of a gramme after the first attack, and the disease had not returned, you would not have doubted but that the medicine had cured your patient.
Coincidence, spontaneous cure, you say. Very well ; but M. H. has twice before suffered from similar attacks of supra-orbital neuralgia. The first was five or six years ago, and it resisted for eight months enormous doses of
lt^^;TS^' CLINICAL PB00F8. 411
Sertew, July 1, ltM8.
quinine^ injections of morphia constantly repeated, sea Yoyages, and baths. The treatment was carried out by Dr. Hillairety and by Dr. Delpech, my former colleague, and after eight months of this terrible treatment — and useless as terrible — ^M. H. consulted me, and was cured by ntix vomica 12 and SO in a few days !
But M. H., who seems fated to prove the efScacy of infinitesimals, had again another attack of the neuralgia in September, 1880, and I once more cured him with nvj: vomica 12 and SO. And you call these facts coincidences !
Confess, then, that there is still one side of medicine of which you know nothing and which you ought to study. Ah, you say, very likely — but this M. H., tlus big gouty man is a sensitive subject, and infinitesimal doses of nux vomica would not succeed with another patient. But this argument, again, has not a leg to stand upon. Open the VArt Medical and you will find a number of similar cases. At page S38, vol. iii., you will read of several cases of sub- orbital and supra-orbital neuralgia occurring every morning, and of intermittent fevers cured by nux vomica in the thir- tieth dilution. Volume xi. contains on page 448 an account of a morning, intermittent, facial neuralgia cured by mix vomica 12. And, finally, in volume xv., page 195, you will find a case of intermittent morning supra-orbital neuralgia cured by nux vomica 12, after resisting three * doses of quinine, two of a gramme and a quarter and another of a gramme and a half.
However, physicians familiar with the method of Hahne- mann know that the curability of supra-orbital neuralgia of an intermittent type, with morning exacerbation, is an acknowledged fact in homoeopathy.
A Case of Intermittent Fever of Panama cured by Nux
Vomica 80.
M., aged 22, is affected with intermittent fever, con- tracted at Panama, and with considerable engorgement of the spleen. It is unnecessary to say that sulpliate of quinine has been administered with a lavish hand, but though it has to a certain extent checked the paroxysms of fever it has not cured the patient.
28th May, 1881, Adrien B. arrived at the Isthmus of Panama to work as a porter on the canal scheme.
28th July, 1881. On this day, he says, there was a heavy fall of rain, followed by sufibcating heat. On the
412 CLINICAL PROOFS. "'S^^SSn^
*
same eTening he was seized with a yiolent shiyering, and on the 1st of Angnst he entered the hospital, where he remained until the 14th of September.
The feyerish fits were quotidian, and always came on about 5 o'clock in the evening and lasted until 1 o'clock the next afternoon. During the fits he was very sleepy, had singing in the ears, felt in a state of nervous tension, followed by nervous exhaustion.
At the same time he had attacks of colic, without diarr- hoea ; and his liver was much increased in size, at least, 80 said the doctor in attendance.
Treatment. — ^He was given sulphate of quinine^ and sulphate of qvinidine in doses of from 45 to 60 centigrams, with sulphate of iron and cinchonine.
On September 24th he left the Isthmus on his return to France.
On November 8th, 1881, he entered the hospital of La Oharite, and became a patient under Dr. Desnos, and he was there treated, as he says, for pain in the region of the spleen of a very violent character and for general anaemia. He was treated with quinine ivine.
On the 22nd November he left La Charite, and on the 7th December he became an inmate of La Piti6, under Dr. Audorey, and there he remained until January 22nd, 1882. Here he was treated for anaemia, for hepatic coUc, with severe pain on a level with the right breast, and pains in the right thigh. Treatment — ^Injections of morphia^ iron, digitaline, blisters to the thigh.
From the 1st to the 16th of February there were daily attacks of fever, with painful shootings in the kidneys and shoulders. The fit used to begin in the morning about half-past seven, and last until three in the afternoon. The two last fits before he entered St. Jacques' were of the tertian type.
From the 1st to the 16th of February the patient took no medicine.
February 16th he entered St. Jacques'. Beport. — The patient is a large-sized man, with a yellow tawny com- plexion. The spleen is very enlarged (16 centimetres). On the inner side of the right thigh, a little above the internal condyle, there is a point very painful to pressure. Treatment — China 80.
17th. — No fever. Continue china.
18th. — ^About two o'clock in the afternoon he felt a rigor.
I
SM'SjrSSS!*" CLINICAL PROOFS. 418
and went to bed. The thermometer was nsed towards the end of the fit, and marked 38.6 (centigrade). Continue china.
19ih. — No fever.
20th. — At half-past eleven in the morning another fit was ushered in by a rigor, and continued until 6 o'clock in the afternoon. About the middle of the fit the tempera- ture was 40.2 (centigrade). Continue medicine.
21st. — ^No fever. Continue china 80.
22nd. — A fit commenced with a rigor about half-past eleven in the morning, and lasted until four o'clock in the afternoon. Temperature 40.8 (centigrade). After the fit was over, nux vomica 80 was prescribed.
28rd. — No fever. Continue mix vomica.
24th. — A fit began at one and lasted until five o'clock in the afternoon. Temperature 88.8 (centigrade). Continue.
The fits of fever now ceased for five days, but the medi- cine being discontinued, on the 2nd of March there was a relapse. Nux vomica 80 was again prescribed and con- tinued, and there were no further attacks. On the 1st of April the patient was dismissed cured and fit for work. The spleen had then diminished to nearly its normal size, but the painful spot in the thigh was in the same condition as when he entered the hospital. His general condition had greatly improved.
In conclusion, a young man is stricken with intermittent fever at Panama : he returns to France, and his feverish fits are checked. But the malarial cachexia and the hyper- trophy of the spleen reaiBt stdphate of quinine and ch^ge of climate. The fever reappears on February 1st, in the tertian form, and so exists, when the patient is admitted into St. Jacques', on February 16th. China 80 is pre- scribed and continued for several days, but in vain. The fits of fever became daily worse, their onset being now in the morning.
Niix vomica 80 is prescribed, and it checks the fits. It is left off too soon, and the fits reappear. It is given a second time, and the fever altogether ceases, and the general condition of the patient rapidly improves. The action of the medicine is again, then, in this case, incon- testable.
But, now, do not suppose from these cases that all medicines attain their greatest power of cure in all diseases in the 80th dilution. Beware of this seductive theory, or
Vol. 26, No. 7. 2 F
414 HOMCEOPATHY IN NEW YORK. ^'^^^^^^
yon will leave the path of experience, fall into ways of routine, and rapidly drift into iJie absnrdest exaggerations of the pure high dilutionists. Do not forget that oar therapeutics rest on the basis of the Materia Medica of experience and upon positive indications ; that the spirits of hypothesis and sectarian feeling are our greatest enemies ; and that it is less permissible for us to neglect clinical facts than it is for others.
I can only add this, that for seven years I practised medicine in a country subjected to intermittent fevers, and never during that time succeeded in checking an attack with globules of sulphate of quinine 80. What conclusions are we, then, to draw from these facts ?
First. — That the curative dose varies with the disease, and with the medicine we prescribe.
Secondly. — That we cannot deny the curative action of infinitesimal doses in certain cases, unless we give prejudice the place of experience, and this would be absurd.
HOMCEOPATHY AND MEDICAL ETHICS IN THE
STATE OP NEW YORK.
The determination of the Medical Society of the State of New York to break down the barriers which were erected Bome years ago to separate homoeopathic and non-homoeo- pathic practitioners, is creating no small degree of excite- ment throughout the American Union. It is, we believe, generally supposed that at the next annual meeting of the American Medical Association some effort will be made to counteract the efforts of the New York Society. That any attempt of this kind will meet with success is improbable enough. Meanwhile, in various directions, efforts are being made to sustain the measure which has been adopted in New York.
In the New York Medical Times we find the following important extract bearing on this question from the Medical liecord, published in the same city : —
In the Medical Record of May ISth we find the opinion of Prof. Theo. W. Dwight, LL.D., the eminent jurist, in response to a request of Dr. Agnew (one of the committee which reported the new code) for a study of this subject, upon data furnished by the "old code," the "new code," and the editorials, excerpta, etc., of certain medical journals. It seems to have been the aim of Dr. Agnew to
^S2Sf MrnS©"'' HOMCEOPATHY IN NEW YORK. 415
obtain an intelligent and unprejudiced criticism of the questions involved, in the light of pure ethics, and he could not have selected one more able from every point of view, to make an impartial study, as evidenced by his report, 41 synopsis of which we reproduce here : —
*' The rule, as I understand it, is as follows : < Rules governing ^antuUoHons. Members of the Medical Society of the State of New York, and of the medical societies in affiliation therewith, may meet in consultation legally qualified practitioners of medicine. Emergencies may occur in which all restrictions should, in the Judgment of the practitioner, ' yield to the demands of humanity.* I find this section in a ' Code of Medical Ethics ' laid down by the society for the guidance of the action of its members in matters of morality and conscience. One of the leading divisions of this concerns the relations of physicians to the public, another the rules concerning consultations, while the third division applies to the relations of physicians to each other. All of the points, as far as I can observe, concern moral relations, including the general observance of the rules of kindness, good feeling, and humanity toward all men suffering pain and disease who can be relieved by medical skill and attention, as well as the duties of courtesy and mutual aid toward professional brethren.
«« In the outset, it must be fiurly presumed that medical ethics are but a branch of universal ethics of morality. They are but the application of the general rules of morality to special cases. All intelligent men who have a cultivated moral sense are capable of judging of them. They ought, then, to square with the rules of general morality. Any special medical rule professing to be * ethical,' which is based on a violation or restriction of the great rules of morality, is in itself 'unethical,' opposed to public policy, and fraught with evil and disaster to the non-medical public as well as to physicians themselves.
'< From this point of view, the rule that I have quoted above must be interpreted. There is another cardinal rule of interpre- tation to be stated. This is, that the whole of the rule of the society must be taken into account. It must be considered with its qualification. Fairly interpreted, the rule has the following prominent points : — (1). The members of the State Medical Society may meet in special cases in consultation * legally quali- fied ' practitioners of medicine, not members of the society, in fact any and all of that class, notwithstanding general restrictions on this subject. (2). The special case referred to is an ' emer- gency.' An emergency is a matter of pressing necessity — an unforeseen casualty — a sudden occasion (' Worcester's definition of Emergency '). (4). The object of giving way to the • emer- gency ' is * to yield to the demands of humanity.' (See the
2 F-2
416 HOMCEOPATHY IN NEW YOBK. ^'^^^^^^^
rule.) Still more, the roles, as I observe, apply equally to physicians and surgeons. All through the code, medical and surgical practice is referred to. Under this rule, the qnestion might arise whether a ' legally qualified practitioner of medicine' might call in consultation an eminent surgical practitioner of another school. The question might be as to the direction of a gun shot wound, whether it extends from below upward, or from above downward. This may be vital to the treatment, and bis opinion maybe to the last degree important, and so in a thousand other cases where all schools of medicine act in common. The object of the consultation, I repeat, is the demands of hmnanity. It is the suffering patient who requires it, and who may have no other succour. (4). The regulation is permissiye. No one is required to follow it. If you ask how shall abuse be avoided, the answer is, the physician who is called in consultation must exercise hh own judgment. To that in the end all questions of ethics must come. Ethical rules are established only to guide the judgment. The great value of the new role, if it bave a value, as I akn sure it has, is that it substitutes an elastic for an iron-clad rule. The Medical Society says in sobstance to tbe practitioner, we will not place you under a stem rule witiioni any exceptions. We retain the general rule by impEeation. Humanity may demand its relaxation. Whether it does so or not in the special case, we, as a society, have no means of determining ; of that we must leave you, the practitioner, in possession of the particular facts in the case, to be the judge.
« Having thus considered the true scope and purport d &b rule, the remaining question is. Is it right ? Is it ethical ? The question answers itself : Shall a true physician hesitate bdbre any lawful acts when driven to it by the * demands of humanity?* The patient does not exist for the rule of the profession, but the medical profession always and ever3rwhere for the good of tiie patient. It is par excellence the profession which deals with man in a * matter of humanity.' Take away from it that element, and you shear from it its royal prerogative. If this rule is not right, then it should be put in this form : ' Members of this society shall not consult with legally qualified practitioners of any other society than our own, not even if an emergency arises in which the demands of humanity require it.' Can any nghi- minded physician vote for such a resolution ? And yet is not that the position that the opponents of this regulation must take? I should say unhesitatingly tiiat any such ground taken expressly or by implication is contrary to public pohcy and worthy of pubhc reprobation.
'< There is another suggestion which may not be ont of place. The State Medical Society exercises a right conferred on it by the statutes of the State. It is not a mere voluntary society^
B^^J^THm*^ HOMOEOPATHY IN NEW YORK. 417
-*■
bnt has certain compulsory powers conferred npon it by law. It profits by the exclusion of unqualified persons from practice. When the State authorises practitioners of other schools to practise medicine, does not courtesy to State authority dictate recognition of their fitness for association ? How can ^e State Medical Society consistently demand public recognition by reason of State legislation, and yet deny it to others who have pre- •dsely the same authority.
<« I cannot but think that the rule that you have brought to my attention is sound and salutary, and worthy of the advancing stage of medical thought and ethicfd refinement. Let us never sacrifice the demands of humanity to professional etiquette, nor imitate the poor King of Spain, who is reported to have lost his life because, by the laws of a rigorous Spanish ceremonial, no one was at hand who was professionally competent to move his •chair from the fire that was slowly gnawing at his vitals."
Our contemporary then makes the following comments on this opinion : —
" In view of the foregoing, how narrow and -insignificant appear the sentiments of some of our contemporaries in this discussion, who talk of licensing the quack for affiliation with the educated physician.
*' We have no defence for quacks, for lack of education, or for that laxity in ethics which begets either of these ; neither are we unmindful of the fact that the public needs protection from the hoard of pretenders which prey upon it, and it is just as important that there should be legal restrictions guarding the portals of the medical profession as of any other. Experience, the world over, has shown the necessity of safeguards, both in behalf of the professional body and also in protection of the public from imposition.
** The legal profession has found it necessary to protect itself and the public, by means of statutes in their behalf, and the Bar Association is ever on the alert for offenders against the ethics of morality, honesty and justice, and upon the same grounds the medical profession not only has a right but is bound to proceed. For this purpose the precepts of the ' GK)lden Rule * are sufficient I Our friends in this controversy should not lose sight ^f the fact that the quacks, the uneducated and the pretenders, jure not confined to any particular school or sect, for they are to be found in all, and it should be our purpose to ferret them out, no matter what the consequences, and to so guard the future that ^the possibility of their getting in be reduced to the minimum.
** It is a well-known principle of consultation, in case of dis- ;agreement of the consultants, that the points of difference shall be stated to the patient or to his representative, and the decision
to who shall have the further conduct of the case is left with
418 HOMOEOPATHY IN NEW YORK. ^ E^Jf jS^^!'
the party most iBterested, thereby granting to the patient all the lights and advantages that could accrue from such deliberation. In case an emergency should bring together consultants whose Tiews could not be reconciled, the course to be adopted is obvious, the patient would not be edlowed to suffer on account of it, and there would be no humiliation of either consultant. This state of things sometimes occurs, and it would doubtless be better for the patient if it were more frequent, for it too often happens that consultation is a mere JarcBy consequent upon a forced agreement, or quasi indorsement of the treatment being employed. In view of this state of affairs and of the fact thai the various so-called schools differ only in a single point and that of therapeutics, we do not see wherein lies the objection to con- sultation of practitioners of differing views. On the contraiy, it might result in a greater good to Uie patient to say nothing of the possibility of its being of service to either or both of the consultants.
'' It has often been our lot to consult with colleagues of different therapeutical beliefs, and a compromise of principles has never thus resulted, although wo can imagine cases in which agreement would be impossible on account of lack of knowledge of that mode of procedure known only to our school.
*' The old school practitioner must become familiar with all therapeutic means before he can expect to be of service in a case in which that principle may enter as a factor. It is astonishing how self- satisfied some of these * regulars ' are with their know- ledge of therapeutics, notwithstanc^g their ignorance of the indlvidualisation of drug effects and of the application of small doses.
'* They argue as if they knew it all, and there could be nothing outside their narrow limits worth knowing.
'< Our local society ' declares that it regards with disfavoar any steps taken to lessen or obliterate the distinction and safe- guards between an honourable practice of medicine founded upon science and that founded upon any of the current delusions and exclusive medical systems of the day,* and it arrogates to itself the ability and right to decide these points with a knowledge of only one side of tiie controversy.
*' They dare not study our indications for the use of medicines, and when they do snatch a bit of experience from us, they herald it as originating in their own brains.
*' It is evident that honesty and justice requires different treat- ment, and this must be insisted upon before consultation can become general and of universal service to the public.
'' At a time, as at present, when our school is in a most flourishing condition, its number of adherents rapidly increasing* its number of practitioners receiving recruits daily from the
iSSSSfj^mi^'!^ REVIEWS. 419
ranks of the old school, its institatioBS heing built up so that now nearly every city of any size has a hospital and other organisations distinctively its own, it would be useless to suggest a dishonourable or unfair capitulation.
'* All we ask is that we receive that treatment which is becoming to all gentlemen. Our position is one which entitles ns to demand such terms, and we are going to insist upon this, or the * flag of truce ' will have been in vain.
'* It is quite amusing to observe how the rank aud file, includ- ing some medical journals, are whipped into line and silence, after giving expression to sentiments of a liberal character regarding this matter.
''What a glorious spectacle will be presented when the American Medical Association, through its three hundred or so delegates, attempts to discipline its thousands of members by means of punishment to be applied to a portion within the Empire State ! If we are not mistaken these members will not quietly submit to the castigation, but will be found fully equal to their own defence unless they see flt to ignore the meeting altogether !
<< Much has been written about the insigniflcance in point of numbers of the body which adopted the ' new code,' but as far as we can see, the gathering was much larger proportionately than such meetings generally are, and the sentiments adopted were as fair exponents of the universal feeling as representa- tive bodies usrudly express. That there was no attempt to spring a trap is shown by the fact that the subject-matter had been under consideration for a year or more in the hands of a committee. It is £Edr to presume [that the profession in general throughout the State could have held no very serious objections to iixe proposed code, or it would have been defeated. The principal point at issue seems to have been between no code at all and the one which was adopted. It is now asserted upon good authority that the code will be abolished entirely at the next meeting of the State Society, leaving the question of consultation in the hands of the individual practitioner to decide for himself in each particular case."
REVIEWS.
Supersalinity of the Blood ; an Accelerator of Senility and a . Cause of Cataract. By J. Compton Bdbnett, M.D. London : Homoeopathic Publishing Company. 1882.
In the pathogenesy of Natrum MuriaOcum and in efforts to cure cataract by medicines. Dr. Burnett has already shown an active interest. In the little book before us he examines the
420 RPVIFWa Monthly Hoinasopa|Wfl
^^^ UBi VJEWB. Beriew, July 1, 1881.
experiments made in Grennany by Ennde and Eohnhorn, and in England by W. B. Biohardson, which go to proye that a per- sistent dosing of cats and frogs with common salt, cnhninates in the production of a form of cataract. <* The physiological effect of salt," writes Dr. Bnmett, **is to dry up; and when any portion of the living tissue gets too dry, then, if the exsiccation persists, the vital state of the tissues is altered, and morbid metamorphosis may ensue."
Such, Dr. Burnett believes to be the action of salt upon the tissues of the lens. The tissues of the lens being thus capable of modification in a morbid direction by a substance acting specifically upon them, he argues that the disease ought to be cured in a like manner. It having been proved by the authori- ties already mentioned that salt produces cataract in cats, frogs, pigs, and fish, Dr. Burnett has enquired whether there is any connection between the development of cataract in the human subject and an unusual penchant for table salt. In support of the opinion that free indulgence in salt will cause the lens tissue to degenerate, he adduces twelve exsmples of cataract occurring in persons accustomed for many years to take salt in unusual quantities. No one knows better than Dr. Burnett that a dozen observations prove nothing, but at the same time they do suggest the possibility, and more than the possibility of such a connec- tion. The enquiry is a very simple one, and were the salt-eating habits of every cataractous patient consulting the same practi- tioner during a certain period of time enquired into, the in- teresting and really important question raised by Dr. Burnett might be in a fair way of being answered.
As we have now an ophthalmic department at the London Homoeopathic Hospital, an enquiiy of this kind might very veil be set a-going there.
We commend Dr. Burnett's book, and the careful considera- tion of the enquiry it suggests, to our medical brethren.
The New Handbook of Dosimetric Therapeutics, or the Treatment of Disease by Simple Remedies, By Dr. Ad. Bubograsvb. Translated from the French and Edited by Henbt Abthub Allbutt, M.R.C.P.E. and L.S.A., &c. London : David Bogue, 1882.
In 1868 Dr. Burggraeve, the senior surgeon of the hospital at Ghent, published a little book entitled Mlthode Atomistique^ ou Nouveau Mode de Prescrire Us Medicaments, of which we gave some account in the September number of our Review in that year. M. Burggraeve 's new method consisted then '*in triturating a medicine with sugar of milk for two hours or les8» in order to reduce it to an atomistic condition." '' Of a medicine
^^^J^^HS^ NOTABILU. 421
SO prepared,'* he said, '* the dose to be given is a millegTamme " (l-65th of a grain). The prolonged trituration was clearly stated to have been adopted for the purpose of increasing the aeti-vity of the substance by affecting molecular division.
The administration of substances so prepared and dispensed as '* granules *' M. Burggraeve dignifies with the name of a ** system of medicine." To us it appears as simply a pharma- ceutical process. In the book before us we are told what ** granules *' ought to be prescribed in every form of disease ; but on what principle one medicine is preferred to another we have no information whatever. In many instances it would appear that the medicines ordinarily prescribed in certain condi- tions by homceopathists are those which are most esteemed by M. Burggraeve, while in others there would seem to be no obvious reason why they are recommended. Thus (p. 188) we are told that in pleurisy ''the first symptoms, such as initial shivering and pungent pain, are sufficient to indicate the necessity of giving strychnine or qumine (arsemate), digUdUns^ and cicutine,'' though why we should do so does not appear.
Beally, the only fact that appears clearly stated in Dr. Allbutt*s translation is that '' no granules are genuine or reliable bat those which are manufactured by M. Chauteaud, the eminent Parisian pharmacist. To them only has Dr. Burggraeve attached his signature as proof of their reliability.'' As i^e mode of preparation of such alkaloids as acomUne^ digitaUne, quinine^ strychnine^ and the like is well known to pharmaceutical chemists, there is, we presume, somewhat of mystery attaching to the manufacture of M. Burggraeve's granules. Such being the case, we can only regard &s book as a long drawn out advertisement of the pharmaceutical preparations of a French chemist. It certainly sets forth no *' system " of therapeutics whatever.
NOTABILIA.
LONDON HOMCEOPATHIO HOSPITAL.
We gladly draw the attention of our readers to the alterations in the out-patient department of the Hospital, which have been in operation since the Ist June.
A special section for Diseases of the Eye has been opened lately under the charge of Dr. Byres Moir, and there is already a satisfactory number of cases under treatment. The daily ave;rage of in-patients for the last few weeks has been 50.
The managers have just received a present of a cot for the *^ Barton " (Children's) Ward, from an old Mend of the Hospital.
422 NOTABILIA. "^"^^^TSr^
BeTiew, Jnly 1, 1S8S.
The return of patients admitted to Jane Tth, affords the following statistics : —
Bemaining in Hospital at date of last return
(May 9th) ... ... ... 58
Admitted between that date and June 7th ... 45
98 Discharged during the same period ... ... 46
Bemaining in Hospital on June 7th ... ... 52
The number of new out-patients during the period from May 9th to June 7th has been 526.
The total number of out-patients' attendouces during the same period has been 2,008.
Out-Patient Department. — On and after the Ist June, 1882| medical officers will be in attendance in the out-patient depart- ment of this Hospital daily (Sundays excepted) at 8 p-m., for the treatment of General Diseases of Men, Women and Children. Medical officers also attend at 8 p.m. : for Dis- eases of the Eye, every Monday and Thursday ; for Diseases peculiar to Women, every Tuesday ; for Surgical Cases, every Tuesday ; for Diseases of ^e Skin, every Thursday ; for Diseases of the Ear, every Saturday.
The doors for the admission of out-patients are opened at 2.80 p.m., and closed precisely at 8.80 p.m.
Out-patients will not be admitted after the doors are closed.
The dentist attends every Monday at 9 a.m.
HOMGEOPATHY IN THE UNITED STATES.
The tone in which homoeopathic practitioners have received the alterations in the code of so-called ^' ethics,'' recently resolved on by the Medical Society of the State of New York, indicates the strength of the position held by our colleagues across the Atlantic. In reference to this subject, one which appears to be very generally discussed at the present time throughout the medical journals of the States, The Hdknemannian MonUily (June) writes as follows : —
'' If it should ever come to pass that allopathic physicians, in their relation to homoeopathic physicians, should govern their conduct by those principles and precepts which characterise the acts of gentlemen, it would, of course, be a glad day for homa?o- pathists — ^glad simply because the profession, of which they form a part, would thus be cleansed of its deepest disgrace, and all physicians could then look the members of other learned pro- fessions right in the face, and not feel themselves the butt and laughing stock of Christendom.
£!*i^J^"Ml^ NOTABILIA. 423
''Bnt what other benefit would it be to us? The time was when homoeopathic physicians were in sore need of the privileges of consultation with aUopathic surgeons and specialists, because they had none in their own school. Now, however, we are well supplied with both, as well in quality and almost in quantity as is the other school. Our pathologists and diagnosticians are also rapidly taking rank with theirs. As to questions of treatment, all progressive homoeopathic physicians are to be regarded as therapeutic apedalists, and if one of them should call an allopath to aid him in the selection of remedies, he would be regarded as far advanced in cerebral degeneration. As well might a well- skilled ophthalmologist take counsel with a general practitioner respecting the treatment of a catai'act or a glaucoma. We have no possible interest, then, in the solution of the consultation question, save only as it may affect the honour of the profession of medicine.''
HOMCEOPATHY IN CLEVELAND.
It affords us pleasure to present the following authentic reports of the results of practice in two. of the pubUc institutions of Cleveland, and the ratio of deaths of the Allopathic and Homoeo- pathic Schools of Medicine for the year 1881.
The Cleveland Orphan Asylum, which was for two years under the medical direction of Dr. F. H. Barr, had three epidemics : scarlet fever, measles and diphtheria. Though maUgnant in character, all recovered.
For the eleven years Dr. Biggar was surgeon-in-charge of the Cleveland Workhouse, 11,789 patients were treated, 25,068 prescriptions dispensed. There were 85 deaths. A comparison with the best mortality reports of other workhouses gives this institution a ratio of mortality 86 per cent, better than the Detroit Workhouse and 57 per cent, better than the Allegheny, and 450 per cent, better than the Ohio Penitentiary.
For the year 1881 the ratio of deaths in Cleveland to each aUopathic docter is 16.54, and for each homoeopathic doctor 7.48 — a percentage of 121.12 better than the allopathic school.
Of all reported cities, the homoeopathic doctors of Cleveland have the smallest ratio of deaths and the largest percentage over the allopaths.
THE AMERICAN OPHTHALMOLOGICAL AND OTOLOGICAL SOCIETY.
At the meeting of this Society held at Indianapolis on the 14th ult., during the sessions of the American Institute of Homoeo- pathy, Dr. Dudgeon, Dr. Burnett, and Dr. Cooper were elected honorary members.
424
KOTABILIA.
Moaflily HomoBOpittlc Review, July 1, 18tt.
THE LONDON SCHOOL OF HOMOSOPATHY.
We have mnch pleasure in stating that Dr. Dudgeon has, at the request of the committee of Ihis Institation, consented to deliver the Hahnemann lectnre at the opening of the ensuing session.
The lectures for the month of July, on " The Principles of EbmoBopathy/* will he delivered hy Dr. Hughes, as follows: — July 6th. " The Philosophy of Homoeopathy." Idth. \^ Hahnemann's Theories.*' 20th. " The History of Homoeopathy." 27th. " The Claims of Homoeopathy."
>>
>>
HOMOEOPATHIC INTERNATIONAL CONVENTION, 1881. The following is the balance sheet presented by the treasurer : —
Income.
& s. d. By Subscriptions 188 18 6
£188 18 6
Expenditure.
£ 8. d.
Postage 10 6
Printing 12 18 2
Beporting 40 0 0
Hire of Boom ... 24 14 0 Conversazione at the
Dilettante Club 22 0 0
Sundries 3 10 9
Paid Dr. Hughes to- wards Transactions 79 10 0
£183 18 5
Francis Black, Treasurer, Examined and found correct,
AtiFbrt) C. Pope,
Pro Committee.
LEAD POISONING.
Two deaths having lately taken place in the North of England from lead poisoning, notwithstanding the fact that the best known safeguards for securing the health of the workpeople had been taken by the owners of the works, leads to the question whether there are any antidotes for preventing lead seriously affecting the health of those engaged in its manipulation. At Hebbum, on the Tjrne, there are extensive works where the de-silvering of lead is carried on by Pattison*s beautiful process, and where white lead is made on an extensive scale. In the latter branch in par- ticular a good many females are employed, some of them in putting the lead through the rolls ; but with respect to all of
SSSt^J^^ST" NOTABILIA. 425
them most stringent regulations are laid doim, so as to preTent the lead affecting them in any way. There are baths and lava- tories which the females are obliged to avail themselves of at certain times* for it is considered that the hands should be frequently and thoroughly cleansed several times a day, and that all should bathe at least once a week. In addition to these necessary appliances, provision is made for a daily supply to all hands of nulk, beer, and acidulated drinks to be used for the purpose of washing out the month, and counteracting the dele- terious effects of the lead ; whilst recnpirators were also provided. But the rules made in the interests of the women were frequently evaded by many of them, especially as to the bathings, although persons were specially appointed to see that the rules were fully carried out. Yet it is stated, on high medical authority, that were these rules fully adopted, there would be very few of what are termed ** lead cases." In almost every branch connected with the working of lead, those engaged are subject to certain diseases, which turn out to be more or less fatal to those who are attacked. StiU it has been shown that, even by dietary, the ordinary effect of lead can be counteracted, although there are some persons who are more susceptible of the effects of lead than others are, and who, under ahnost any circumstances, will in the long run succumb to its poisoning powers, more especially if they are attacked after they have been but a comparatively short time at the work. Where, however, persons have been constantiy at work for some years, and have not suffered from the lead, it may be fairly assumed that they have become somewhat impervious to its deadly effects. As to the antidotes, we are told that at large workis, where both Englishmen and Scotchmen were employed, the former, who lived a good deal on fat meat and fatty matters, were much less susceptible to the effects of lead than those whose dietary was largely composed of oatmeal. At some of the works on the Continent where the lead workers were at one time subject to palsy, colic, pains in the bones, and ending with convulsions, the usual attributes of lead poisoning, these soon gave way when the employes began to feed largely on fai meats, especially before going to work in the morning. At one place where a great deal of lead work was done, and where at one time there were the usual attacks, a change was made in the dietary, and cheese, butter, bacon, pork, lard, and other fatty materials having been the principal articles of food, no person, it is said, was attacked with lead colic for a period of upwards of 15 years. There is here a most important problem for our medical men to work out for the benefit of a large class of persons engaged in an employment that has hitherto been attended with a very high annual death-rate. There is a strong belief that lead poisoning can be effectually prevented, and what is therefore
426 NOTABILIA. ''g^fi^ygg
required is the laying down of certain simple rules as to dietary, sanitary, and other requirements, that will have the effect of making lead workers as little liable to diseases most frequently ending in death as persons who have to deal with other minerals that are equally as deadly, but in which there is a much less annual death-rate. — Mining JoumaL
BELLADONNA POISONING.
Case Noted by Chables A. Sewall, M.D., Assistant- Subgeon
U. S. Abmt.
In the hospital under my charge, a solution of atropia (four grains to the ounce) was prepared for instillation into the eye. When the solution was made, the water being a little cloudy, about a drachm, representing one-half a grain of atropia^ was left in the bottom of a graduated measure, One of the atten- dants, an intelligent man, needing a glass of water, picked up the measure, and, filling it up, drank it off. I saw the patient fifteen minutes afterwards, at twelve o'clock mid-day. He was lying down, being unable to stand. The face was flushed, and there was intense vertigo ; but he was able to talk, and said distinctly that he knew he must have taken atropia by mistake, even mentioning how much he thought he had taken. The pulse was 140; respiration correspondingly increased. The countenance wore a peculiarly anxious expression, which I think one might recognise again in a like condition, suggesting the idea that it might be a distinctive expression. Although photo- phobia was marked, the eyes were wide open, and he shaded them with his hand. The pupils were largely dilated. There was a sense of formication all over the body, and tingling in the ends of the fingers and toes ; the tongue was moist to the sight and touch, but the man said it felt ** as dry as a chip," and the throat seemed almost as if its sides were stuck together. HaIIu- cinations of sight and hearing were present, but, as I have noticed before in a similar case of narcotic poisoning, the patient was unable to remember anything he had seen or heard except for a short time. — The American Homoeopath.
THE CASTOK-OIL PLANT AS A FLY-KILLER.
Obsebvations made by M. Bafford, a member of the Sociite d'Horticulture at Limoges, show that, a castor-oil plant having being placed in a room infested with flies, they disappeared, as by enchantment. Wishing to find the cause, he soon found imder the castor-oil plant a number of dead flies, and a large
IK^'ATn^' NOTABILIA. 427
Beriew, July 1, 1882.
number of bodies bad remained clinging to ibe nnder-surface of tbe leaves. It would, tberefore, appear tbat tbe leaves of tbe <3astor-oil plant give out an essential oil, or some toxic principle wbicb possesses very strong insecticide qualities. Castor-oil plants are in France very mucb nsed as ornamental plants in rooms, and tbej resist very well variations of atmosphere and temperature. As tbe castor-oil plant is very mncb grown and •cnltivated in all gardens, tbe Journal d^ Agriculture points out tbat it would be wortb while to try decoctions of tbe leaves to destroy tbe green flies and other insects which in summer are so destructive to plants and fruit trees. Anyhow, M. Rafford*s observations merit that trial should be made of tbe properties of tbe castor-oil plant both for the destruction of flies in dwellings And of other troublesome insects. — British Medical Journal,
POISONING BY CASTOR-OIL.
An inquest was recently held by the Coroner for Central Middle- sex which serves forcibly to illustrate tbe necessity for care in the administration of purgatives to children. From the evidence it would appear tbat a woman purchased some castor- oil, and gave her child— only a month or two old — *< a dose," thinking tbat its '* stomach was out of order," and tbat it might do it good. A severe convulsion followed, in which tbe child died ; and tbe doctor who was called in expressed a decided opinion that death bad resulted from tbe treatment. Tbe <eoroner said tbat the practice of giving young children aperients whenever they seemed unwell was one of the most dangerous And pernicious with which he was acquainted. It could not be too generally known tbat, when a child vomited, the stomach and intestines became absolutely empty, and collapse might ensue. Parents should be careful to get cold-drawn oil, for many of tbe preparations sold were only fit for horses, and, if administered to a child, might set up intense irritation, and 'Cause convulsions and deatib. Whilst coinciding with the coroner in his remarks on tbe necessity for caution in the Administration of aperients, we think there is one other point to which it may be as well to call attention. It appears not to be generally known that castor-oil is very commonly adulterated with croton-oil to increase its activity. Cases of death from <castor-oil alone are very tare ; and we entertain no doubt tbat, in tbe case now under consideration, the fatal termination was due to a more powerful irritant. — British Medical Journal,
428 NOTABILIA. ^S^f53?2TS
EFFECT OF AN OYERDOSE OF PODOPHYLLIN. Amount taken abont Sixty Centigranxs (Ten Grains).
Professor D. W. Prentiss. — Philadelphia Medical Tkrm.
Mbs. H., aged abont 45 years, a strong, healthy person, had been constipated for a week, and was feeling badly in conse- quence. Her husband was in the habit of ts^ing podophyUin for constipation, and had a bottle of it in the house. JSi&s. H., knowing this circumstance, got the bottle, and took out as mneh of the medicine as could be held on the handle of a teaspoon, mixed it with a little water, and swallowed it. The dose was taken April 9, at 6 p.m.
At 7 p.m. had cutting pains on both sides of the abdomen, with desire for stool.
At 8 p.m., feeling very badly, went to bed. The pain had ceased ; there was great exhaustion, with relaxed muscles and a feeling as though the body was bathed in sweat, which it was not ; then came a fearful pain in the occiput, as '^ though the head was being split open. This pain lasted about two minutes, and was followed by a dull throbbing ache and feeling of heavi- ness, so that the head could not be raised from the pillow. At 8.80 o'clock vomiting began, — ^first the contents of the stonoach, then thin, bitter, dark-green fluid,— from half a pint to a pint at each attack. There were six or seven spells of vomiting between 8.80 o'clock and 4 o'clock the next morning. A^th each spell of vomiting the bowels moved, — ^first constipated, then thin, watery stools, but no blood. There was no pain with the stools. Frequent sensations of heat passing over face and head were noticed. With each occasion of vomiting the exhaustion was so great that she felt as though dying. Could not raise the head or assist in the act of emesis.
I was called to the case at one o'clock in the night, — eight hours after the podophyUin had been taken, — when I found the patient in a state bordering on collapse ; Teatures pinched, extremities cold, pulse very feeble.
It is remarkable in this case that there should have been so little pain in the stomach and bowels. This was almost entirely absent, with the exception of occasional cutting pains at the first. On the contrary, there was a disposition to drowsiness. The greatest distress was from the exhaustion and the pain in the head. The intellect was unimpaired; the eye-sight and pupils were unaffected ; no involuntary discharges.
Mrs. H. kept her bed on the 10th, but got up on the 11th, feeling well, but with tingling in the extremities and weak as from a severe illness. — The American Homaopath,
^t^j^rrSS^ NOTABILIA. 429
Beiiew, July 1, 1882.
CAUTION m THE USE OF IODOFORM.
In a commanication to the New York Medical Becord, No. 12, Dr. Sands, after taking a general review of the results of the employment of iodoform, and describing two cases of mania that had resulted from its use in his own practice, goes on to say that it has not as yet been ascertained what amomit of it is necessary to induce poisoning. Susceptibility to its action varies greatly, for while in many cases two or three ounces have been applied to extensive open wounds immediately after operations, in others half an ounce and upwards may induce attacks of mania, and even a gramme give rise to sUght nervous disturbance. In many of the German cases excessive quantities have been applied, sometimes amounting to five or six ounces. The effects depend much upon the extent of absorbing surface and the recency of the wound. Old persons are especially Uable to suffer, while children seem to be much less so. "It is already apparent that the sanguine expectations at first entertained regarding the value 6f this antiseptic cannot be fully realised, and that in the present state of our knowledge iodoform should be employed with great caution, and in such a manner that it can be readily removed from the wound in case symptoms of poisoning should supervene. It is certainly hazardous to fill a large fresh wound with the powder, which may penetrate the meshes of the connective tissue so that it cannot be washed out. By employing it in the mini- mum quantity it will produce the desired effect, and by learning, perhaps, to recognise beforehand the class of cases that are peculiarly susceptible to its deleterious influence, we may yet be enabled to use with safety this antiseptic, which, in many respects, is the most valuable that has ever been introduced into surgical practice.*' — Medical Times and Gazette,
OPIATES AND PERISTALSIS.
Pbofessob Nothnaobl of Vienna recently communicated to a German society the results of experiments on the action of opium and morphia on the intestine. The constipating power of these drugs appears due to their being irritants of the splanchic, the inhibitory nerve of the intestine. That nerve is specifically influenced by morphia, just as the vagus, the inhibitory nerve of the heart, is acted upon by digitalis ; in fact, in both cases, small doses excite, large doses paralyse. It was observed, in a discussion on this question, that tiie peristaltic action of tho intestines is not necessarily the same in man as in animals. Antiperistalsis does not appear to occur in the latter ; in our species it is known to exist ; though, when obstruction exists, peristalsis in the ordinary direction is quite sufficient to account for fiecal vomiting. Dr. Rosenstein, however, had seen chronic
Vol. 26, No. 7. 2 o
480 NOTABIMA. *"?^L=?S?7^
Beriew, July 1, 1B8L
fsBcal Tomiting in a patient of his where no mechanical obstraction conld be found. Professor Prejer stated that he had seen anti- peristaltic movements of the small intestine in animals, and pointed oat that the filling and emptying of the csBcom, especially of the very long caecum of some animals, could only be effected by alternate peristalsis and antiperistalsifi. — Britiih Medical Journal.
ANJ5STHETICS.
Pbofessor Billroth, the celebrated surgeon of Vienna, thns states his conclusions on ancesthetics. '< At the end of the year 1878 I had had a quarter of a century's experience in operations — more than six years as od assistant, and the rest of the time in the charge of my own cUnique. During this period I had seen cklorofarm administered some 6,000 times, with two cases of death. Up to the end of 1870 I always employed chloroform alone as an ansesthetic. Since then I have used a mixture con- sisting of three parts of chloroform^ one of sulphuric ether, and one of alcohoL With this anesthetic I am perfectly well satisfied, and have not seen any asphjrxia or syncope result from its use. The mixture seems to me to be merely of service in diluting the chloroform. My two assistant-surgeons and my eight assistants undertake the post of chloroformist for a month at a time in regular rotation. On this account, again, I think it more prudent to use diluted chloroform. No doubt the pue ehlorofonn produces anaesthesia more rapidly than this mixture, but, on the other hand, the latter is less apt to excite vomiting.*' —Clinical Surgery, by Dr. Th. Billroth. Translated by C. T. Dent, F.R.O.S. The New Sydenham Society, 1881.
The anaesthetic mixture approved of some years ago by a committee of the Royal Medico-Chimrgical Society, consisted of one part of alcohol, two of chloroform^ and throe of ether,
«* PATHBES."
BiCBASD Grakt Whitb, in his Words and their Uses, thus writes eonoeming '* hydropathy " and similar expressions : " This word and * electropathy,* and aQ of the same sort, should be scouted oat of sight and hearing. Hahnemann called the system of medi- cine v^ch he advocated, homceopathy, because its method was to cure disease by drags which would cause a Hke (omoios) disease or suffering {pathos). The older system was naturally called by him allopathy, becMse it worked by medidnes which set up an aetion counter to, different firom (aUos) the disease. These are good technical Greek derivatives. And by just as much as they are good and reasonable are hydropathy and electropathy bad and foolish. Why should water^tirv be odled water-<2iMaM / " —
Momthiy.
^"^Jj^^aS^" NOTABILIA. 431
MEDICINE AS A CIVILISING AGENT.
Neysb does our profession appear to greater advantage than in its dealings with savage or semi-savage nations. We are far from including the people of India in either of the above categories, but it mnst be admitted that the great mass of the natives of our Indian Empire are grossly ignorant. The part played by the medical profession in reconciling the people of India to the role of a race alien in blood and religion, from the earliest days of our connection with that conntry, has been most important, although the Government has never been forward in acknowledging it. When the missionary and educator adds a •competent knowledge of medicine and surgery to his other quali- fications for his work, he is doubly armed. The present Bishop of Rangoon is a Doctor of Medicine ; for many years before he was consecrated bishop of his diocese, he laboured as a missionary in the district of Tinivelly, in Southern India, a district containing the largest community of native Christians in that country. It is A well known fact that the medical and surgical skill of our now right reverend brother gave him an influence far surpassing that of any labourer in the civilising work to which his life has been devoted. We have been led to make the above remarks by the receipt of a copy of the report of the Grey Native Hospi^ in King William's Town. It does not appear that Dr. Fitzgerald, the superintendent, is engaged in missionary work ; but it is impossible to read the record of his labours for a single year with- out seeing that, as in India, so in South Africa, the healer is after all the most powerful civiliser ; 600 cases of disease were treated in the hospital, and 1,700 as out-door patients. It appears that natives continue to travel very long distances to this hospital for medical aid, coming from beyond the Kei, from Fingoland, Fort Beaufort, Eriskama Hoek, and other distant places. Dr. Fitzgerald relates the following as an instance of the impression made on the minds of natives by the successful application of aound surgical knowledge.
''Only yesterday, a native woman was brought in a waggon irom the Bashee, sufifering from complete inversion of the entire •eyelashes of both upper eyehds ; the eyelashes lay on the balls of the eyes, brushing up and down at every motion of the lids, causing intense irritation, which would soon end in the total loss •of sight. One can easily understand the sufifering which this poor woman endured, if we consider the pain and irritation caused by only one eyelash in the eye. The eyes were very much inflamed. On questioning this woman, I found that she had been suffering from this diseased state of the eyes for some jears, and that she had consulted several distinguished members of the native factdty without any relief of her sufifering.
2 a-2
432 NOTABiLiA. "le^fsa?^
She was informed by her medical attendants that the spirits were angry with her because they never had any food given to them at her expense. In consequence of this opinion, a cow and a young ox were slaughtered, and plentifully partaken of by the doctors aud their attendants, and the bones were burnt and offered up as a sacrifice to appease the spirits. The patient's eyes were then covered with cow-dung, and pieces of sticks and leaves sucked out of her eyes and exhibited to her friends, leaving, of course, her eyes as bad as they were before the operation. Not getting any relief from the profession in its uncivilised state, she was advised by a native woman, who had been operated on at this hospital for a similar disease, to come here, and this day all her pain and sufferings were put an end to by an operation ; her eyelids and eyelashes restored to their natural state, and she will soon be able to leave here for her distant home, with good sight and free from pain. Cases of this sort make a great impression amongst the natives, and afford an interesting subject for conversation and wonder at their kraals."
Dr. Fitzgerald urges the Government he serves so well to favourably consider his suggestion to extend the system of medical relief amongst the native tribes, not only on grounds of humanity, but as a powerful means in helping on the civilisatiiw of the native races ; in this wise recommendation we entirely concur. — British Medical Journal.
PATHOLOGY.
<* What place is this ? This is the Pathological Society. How does one know it is the Pathological Society ? You know it bj the specimens and the smells. What does that gentleman say ? He says he has made a post-mortem. All the gentlemen make post-mortems. They would rather make a post-mortem than go to a party. What is that on a plate ? That is a tumour. It is a very large tumour. It weighs 112 lbs. The patient weighed 88 lbs. Was the tumour removed from the patient ? No, the patient was removed from the tumour. Did they save the patient ? No, but they saved the tumour. What is this in the bottle ? It is a tape-worm. It is a long tape-worm ; it is three- quarters of a mile long. Is that much for a tapeworm ? It is, indeed, much for a tape- worm, but not much for the Pathological Society." — New York Medical Becord,
UNQUALIFIED PRACTITIONERS.
The Medical Times and Gazette, of the 17th ult., has the following remarks, suggested by some disclosures recently made at the East End of London.
S^jITHI^' notabilia. 43S
— -
**An inquest was recently held at Poplar by Sir John Humphreys, Coroner for East Middlesex, on the bodies of a male and a female child, whose deaths, it was alleged were caused through improper treatment on the part of an unqualified medical practitioner, commonly known throughout the East End of London as the * Black Doctor/ The inquiry afforded fresh evidence of the extent and great evil of the * dispensary * system as carried on in many parts of the metropolich-— an evil which will never be lessened by mere censure, however severe, by coroners* juries. The evidence showed that a medical man, stated to be duly qualified and registered, was the proprietor of a number of dispensaries in difierent localities in the East End of London, at one of which a 'half-caste,' calling himself ' Colonel Griffen,* acted as assistant and prescribed for patients. In the course of the enquiry this person admitted that he was not a qualified surgeon, and had no diploma in England nor in any other place ; he had, however, * studied medicine,' and in the country to which he belonged he was a barrister. This colonel, barrister, and amateur doctor was, moreover, in the habit of signing death-certificates in the name of the practitioner with whom or for whom he worked, and he declared that until the present case occurred he had no idea that he was acting illegally. After considering their verdict in private, the jury found that the deceased died from natural causes, but they severely cen- sured the qualified practitioner for allowing * Colonel Griffon ' and other unqualified persons to practise in his dispensaries. This appears to be one of the cases in which the Registrar- General might effectively intervene, and prosecute for the illegal filling up of death certificates. The chief offenders in these cases, are not, however, the unqualified assistants, but the qualified practitioners, who make a profit out of medical * business ' carried on in their names by wholly unqualified servants of theirs. Dispensaries carried on in this way are a scandal and disgrace to the profession, and a mockery and a danger to the public."
While fuUy agreeing with the remarks of our contemporary, we take the opportunity of expressing our regret that of late years homoeopathy has been subject to an abuse of precisely the same character. Two or more medical men have been known to have dispensaries in different parts of London, which are served by men without any pretensions to qualification. In one instance, the name of the principal was assumed by each assistant ! In another, a more or less qualified man has been occasionally obtained, but more generally, persons have prescribed who have had no medical education whatever.
The ii^ury thus done to persons suffering from disease must often be considerable, while that which is infiicted upon homoeo-
434 NOTABiLiA. *'*S2^=Sr7:^
Beviev. Jolj 1, 1881.
pathy by the discredit sach persons reflect upon it is also serious. So long as this mode of obtaining money succeeds, so long we presume will unscrupulous persons persevere in adopting it. We, therefore, urge those who have the opportunity for doing so to expose proceedings of this kind ; and if those who are res- ponsible for them are deaf to the voice of conscience, let them have an opportunity of hearing that of the law.
SURGERY V. MEDICINE.*
FBIOBITY IN AOB AND BEVELOPHENT CLADCED FOB THE PLAINTIFF*
I am a surgeon, and in making this assertion
*Tis my apology for doing what I can To set aside the undeserved aspersion
That says, while medicine is quite as old as man, Holding within its vast consideration
All wisdom, learning, ethics, and decorum That surgery is claimed, as is a poor relation,
Being at best *' the opprobrium m£dicorum.'' 'Tis certainly a subject for humility,
And one *tis hard /or doctors to endure, That they must own their utter inability
In many cases to effect a cure ; And then, with shrugs and sighs, their patients urge on
To give themselves their only chance of life By caUing on the poor forgotten surgeon,
Who cuts and cures them with the dreaded knife. But as for age, I'll prove *tis all a libel
(The statement's bold, but I could make it bolder), For on no less authority than the Bible
I'll prove that surgery is surely older Than any form of med'cine whatsoever ;
And having finished, will appeal to the majority And have the point adjusted here forever,
That " surgery in age can claim priority."
'Tis true the snake aroused the curiosity.
And gave to Eve the apple fair and bright ; She ate, and with a fatal generosity
Inveigled Adam to a luscious bite. That from that time disease and suffering came,
Doctors were called upon to cure the evil ; The art of healing^ then, with all its fame.
Was at the first developed by the Devil.
*At the banquet to the TisitoTS to the International Homoeopathic ConvBntion Prof. Wm. Tod Hehnath, M J)., recited his poem Soigery v. Hedioine, a few verset only of which we were able to print. They are bo- lioh in pore homour, we reprint them entire from the author's boolc SimUkm ^ ft Swfeotu
^t^SS^?"^^ NOTABILIA. 435
Beriew, JulyJ, I8tt.
Med'cine thns stands coeval with the sinning
Of mother Eve, fair creature, though quite human, While nohle surgery had its beginning
hi Paradise before there was a woman. The facts are patent, aad we all agree
*Twas Satan laid on man the direful rod ; That Doctors are the Devil's progeny ,
While surgeons come directly down from God ! For thus we read (although the analgesia
Of Richardson was entirely unknown) Adam profoundly slept with anaesthesia,
And from his thorax was removed a bone. This was the first recorded operation,
(No doctor here dare tell me that I fib !) And surgery, thus early in creation,
Can claim complete excision of a rib !
But this is nothing to the obligation
The world to surgery must ever own When woman, loveliest of the creation.
Grew and developed from that very bone. Then lovesick swains began inditing sounets.
And Fashion talked with Folly by the way. Then came bulimia for becoming bonnets —
Hereditary epidemic of to-day.
Then, too, began those endless loves and frolics That poets sing in soft and sweet refrains,
Doctors grew frantic o'er infantile colics. Announced at midnight with angehc strains.
From this the world was peopled. So Doctors own, While you lay c^^im to such superiority,
That surgery, in the development of bone As weU as age, can clearly claim priority.
My task is done, and with my best endeavour
I have essayed to vindicate my art ; So list my friends, ere friendly ties we sever.
While waning moments bring the hour to part, Whatever land, whatever clime may hold you.
Some time give honour to the bright scalpel. And when you recoUect what I have told you,
Bemember me — 'tis all I ask. Farewell.
436 OBITUARY. "^iL^?S??^
Bcview, Jul7 1, 1882.
THE FALSIFICATION OF MINERAL WATERS.
The water-supply abroad is so often of a donbtfnl character that many travellers have resorted to the pradent expedient of drinking only some well-known mineral water. Thereupon a large trade has been done in the purchase from rag and bottle merchants of such mineral water bottles as still bore the labels in fairly good condition. It was then easy to fill them with ordinary and possibly contaminated water, adding a salt to give the taste and appearance of the desired mineral spring. By this frand the consumer was not merely robbed, but made to dnnk the veiy water he was doing his best to avoid. We are therefore pleased to note that in France, at least, the Prefect of Police has adopted energetic measures to check this abuse. Orders have been given to visit all depots of mineral waters, to seize hap-hazard a speci- men and analyse it on the spot. The tradesmen will also be called upon to exhibit their invoices to prove whence their stock is derived. Not only are the stores of wholesale agents or dealers to be thus inspected, but the retailers, the cafe, restaurant, and pqjblic-house keepers will be subjected to an equally rigoroos supervision, and all vendors of such falsifications will be liable to prosecution. There is great need of similar measures in England. The public have no guarantee that the waters ofifered for sale have really come from springs specified on the label. — Lancet*
MURDEROUS ATTACK ON A HOMCEOPATHIC CHEMIST.
On May 24 a lad, between 17 and 16, made a murderous attack on Mr. Joseph dc Trosier, homoeopathic chemist, Bouthgate, Wakefield. The lad came to Mr. de Trosier (who is 67 years of age) for some ointment, and when he turned to get it, struck him on the head with a hammer. A struggle ensued, in which the chemist received two other blows with the hammer, and the lad did his best to throttle him and to cut his throat, inflicting five wounds on the throat, neck, and side of the head. The lad does not deny the charge. He is intelligent, but small of stature, and his father is in a lunatic asylum. It is said he lost all his money betting on the last Derby races, and that he hoped to ston Mr. de Trosier and get possession of the till. — Chemist and Druggist,
OBITUARY,
JOHN FRANKLIN GRAY, M.D. We have learned with much regret through the Daily New of the 21st ult. of the death of Dr. Gray, of New York, the senior homoeopathic physician in the United States of America. Dr. Gray was bom in 1804 at Sherburne, Chenango Co., N.Y. He commenced the study of medicine under the direction of a
i£Sgi^J^?ngg"' OBITUARY. 437
medical man when a mere boy. When twenty years of age he went to New York, and became a pupil of Dr. Hosach and Dr. Francis. A year later and he entered the navy as an assistant surgeon, having received a license from the County Medical Society. Soon afterwards he was appointed resident assistant surgeon to the New York Hospital. After passing an examination and receiving the degree of M.D. he commenced practice in New York, and succeeded thoroughly.
In the year 1828 he was persuaded to make the acquaintance of Dr. Gram, who three years earlier had arrived from Copen- hagen, and commenced the practice of homoeopathy in New York. By way of testing the value of homoeopathy, Dr. Gray sabmitted reports of some difficult cases to Dr. Gram, and their rapid recovery convinced him that there was more in the system than appeared probable or possible at first sights His patients, however, could not believe that so little medicine cotdd have any good influence, and his practice dwindled. In 1829 or 1880 Dr. Vanderburgh, who was Gram's first convert, and was in large practice, advised Dr. Gray to remove to a more prominent part of the city, and guaranteed him enough to pay his rent. Here he succeeded so £eu: as to make ^^850 during his first year.
At this time, there was no translation of any of Hahnemann's works into English, and a knowledge of German was as essential to the practice of medicine homoeopathically as was an acquaintance with physiology or pathology. Gray was ignorant of the language, and set to work to study it under the tuition of Dr. Gram. From that time his practice rapidly increased, and continued to be very extensive until his practical retirement
a few years ago.
He edited, with Dr. Hull, the Atnerican Journal of Homao- pathia and the first series of the Homceopathic Examiner. He also assisted Dr. Hempel in the preparation of the Symptomen Codex, and was the author of various communications to the New York homoeopathic journals, and of several
pamphlets.
Dr. Gray was, with Dr. Constantine Hering, Dr. Flagg of Boston, Dr. William Channing, and Dr. Dunnel, one of the founders of the American Institute of Homoeopathy, and was the first general secretary of that body.
For some years he has lived in comparative retirement at the Fifth Avenue Hotel, seeing patients only in consultation, and
that but rarely.
He was a thoroughly well-informed physician, an earnest homceopathist, and much esteemed by his professional brethren. Dr. Gray was a corresponding member of the British Homoeo- pathic Society.
488^ CORRESPONDENCE. ^^'^^I^SSf?^
.Jnljl, UBL
CORRESPONDENCE.
WICKED HOMCEOPATHIC ENGINEERING.
To the Editors of the '* MonMy HanuBopathic Beview"
Gentlemen , — ^AIlow me to draw yonr attention to a short sermon in No. 5 of a eorioas serial s^led HomcBopathie Medical Progress (Incus a non lucendo).
In this discourse, duly commenced and finished with scriptore texts, the preacher points the finger of condemnation thus : —
« Their wish ia to do away with the disUnetive title d homoeopathy altogether. With a degree of caution commendable in purely partisan politics only, their policy has heen to approach the suhject cautiously, by a series of ' zigzags,* thus hoping to conceal their approach from the garrison of the homoeopathic fortress till they have approached it so near as to make it possible to carry its defences, to lower the flag for which we have so long fought manfully. One of the first ' approaches ' was made, many years gone by (by Dr. Francis Black) in a paper read by him (if we remember rightly) at the British Homoeopathic Society, called "Am I a Physician or a Homoeopath?' Steadily and persbtentlj Dr. Black and Dr. Dudgeon, and a few others, have been undermining the defences by which homoeopathy has been made a distinctive and special branch of medicine,**
Why single me out as a warning to his flock ? If I have erred, is not the man more worthy of the stocks, who, posing as Governor of the homoeopathic fortress, not only sanctions, but claims priority in the construction of the naughty, naughty ** zigzag " approaches.
In order that the preacher may smite this treacheroos engineer on the hip, I recommend to his notice the paper referred to — he will find it in The Transactions of the Briiisk Homaopathic Society, 1866, and at the end of it a note worthy of his perusal ; the italics in it are not mine. '' Since reading this paper. Dr. Bayes, who was present, but unable to wait for the discussion, has drawn my ^attention to a pamphlet {Two Sides to a Question^ 1860), in which he thus alludes to my question, ' For my own part, I have investigated the subject, and the result of my investigation has been tiiat I have adopted homoeopathy into my practice. Observe I object to H^e titU ff homcBopath. Its assumption savours of sectarianism. I object to any other title than that of physician, or at the most, physician practising homoeopathy.'"
aSSS^^^riry' cqbbespondence. 439
After reading this passage, I can imagine the preacher in his next discourse, on the text, ** Hoist hy his own petard/' waxing wrathful, and exclaiming, ** Oh I Doctor ! I how yery naughty of you to have drawn wicked ' zigzags ' so long ago as 1860 1 You, the chief elder of my flock, — alas, treacherous engineer 1 alas, seducing writer of * voyages en zigzag!^ how you have deceived me I
''How can I ever again rouse my flock' with the wonted high-falutin strains, when they hear that you, the Goody-Goody, the Governor of the homoBopathic fortress, object to the title of hamceopathf because its assumption savours of sectarianism, Alas ! and alack I the heavy day ! What terms strong enough can I And for treacherous * zigzaggers ? ' they are — ^they are — alas 1 in my sorrowful astonishment I can only groan, they are ' quite too utterly utter r "
Fbanois Bulck.
HOMCEOPATHY AND " HOMCEOPATHY.'*
To the Editors of the Monthly HomoBopathic Review,
Deab Sibs, — ^Dr. Berridge puts to me a very pertinent question. I have admitted that the same name cannot represent the views of both of us, and I have further admitted that in the present undefined state of *' homoeopathy, " the party to which Dr. Berridge belongs have the best claim to the title of homoeopath — he now asks why I do not withdraw my name from the Homceopathic Directory /
It may please Dr. Berridge to know that I so fully appreciate the logic of his reasoning, that at the end of last year I sent a letter to the editors of the Directory requesting them to withdraw my name from the present issue. It was after I had done this, that I came to the conclusion that I had not adopted the best course by doing so. While I felt that the presence of my name in the Directory was likely to give the medical profession and public an erroneous view of my therapeutical beliefs (that is if any one troubled themselves at all about the matter), I saw that by withdrawing my name, I should give rise to an equally erroneous view, viz., that I dissented from the therapeutical views, of those whose names are recorded there. Now this is not BO. So f)Eur as I am enabled to judge, I am perfectly at one with the majority of those whose names appear in the Homceopathic Directory, It is my great desire to add my humble efforts to theirs in the work of establishing a great natural truth. I am thus placed on the horns of a dilemma, and have therefore asked
440 CORRESPONDENCE. ^S^^fj3?J?8fflf
the editors to repeat my name for the present year, in the hope that before they next issue their Directory some course will be taken by the London School of Homoeopathy or other repre- sentative body, which wiU relieve me of the necessity of dis- associating myself from homoeopaths as a body.
Since opening this discussion, I have read Dr. Sharpens review of Hahnemann's system, and am interested to find that he found the same difficulty in adopting homoeopathy as myself. He says (p. 844) : *' Having adopted the practice of homosopathy, I may foe supposed to be a disciple of Hahnemann, and be held respon- sible for his follies.'*
In his article on the " Common Sense of Homoeopathy," Br. Sharpe reaches the very gist of the present question. He says : Hahnemann in his Organon keeps in the background the practical fact, and labours to establish a speculative explanation of it. His followers do not agree in adopting his explanation, but so far as I am acquainted with their writings, they all have some hypothesis of their own. I have been condemned for not accepting any of these. I respectfully decline them all, and offer no explanation. By this course homoeopathy is placed upon a foundation which it has not yet fairly occupied. Henceforward it will be in vain for its opponents to attack it as they have hitherto done. It is presented as a fact, supported by sufficient evidence, and to assail it as such will be found a task much more difficult than to criticise speculations however ingenious."
I am asking homoeopaths to take up the position suggested by Dr. Sharpe nearly thirty years ago. Dr. Sharpe makes, however, an unintentional error when he says, '* By this course (t.^., the course taken by Dr. Sharpe) ** honuxopatky is placed upon a foundation which it has not yet fairly occupied,'' The error here made runs through the whole argument of those who assert that homoeopathy has assumed this position, that it is distinctly separated from Hahnemannism and speculative theories. Dr. Sharpe is a very great authority, and his views have pro- bably had a great effect in directing thought upon this subject, but the action of Dr. Sharpe, as an individually cannot alter the foundation or the signification of the word homoeopathy ; all he can do is to alter the relation of the word in reference to himself.
My contention is, and I think Dr. Sharpe will agree with me, that no individual can alter the position of homceopathy or the meaning of the word; that homoDopathists €u a body are alone capable of accomplishing this. The original meaning of the word is of little value so soon as we shall know on good authoriiy what is at the present time meant by those who profess it.
Of coarse I have been told that it is perfectly impracticable to obtain a precise statement of the view held by the modem homoeopathic body. It is not necessary for me to point out that,
It^^^S^T^S^"" CORRESPONDENCE. 441
.Jal7 1.1882.
if this be true, homoeopaibj stands confessed a very poor thing indeed. Bat I do not believe it to be the indefinable shadow that its professors wonld make it. It is a baby science dealing with phenomena, freely reproducible but not altogether explainable. It has shared the fate of every other set of unexplainable facts ; the dreamy metaphysicians have surrounded it with clouds of mysticism, and used it to prove their fancies, and then, of course, the **impombiliii/'' gentlemen, the Thugs of progress, have tried to strangle it, and have succeeded in distorting it. The result is that the only people who can recognise it as the simple, natural truth are those who have the ability, and the leisure, and the desire to examine the whole thing for themselves, or to read the analytical descriptions of those who have. We cannot all be Dudgeons, Bharpes, Hughes, or Drysdales, we cannot all write bool^, and so we have at present no way in which we can make it manifest that we have left the region of speculation and have arrived at the scientific '* don't know." The great majority of homoeopaths are unanimous in the assertion of certain simple truths; they are imanimous in the rejection of particular theories which have been associated with these truths. I know this, because I have had the wish and the opportunity to find it out, but how is the ordinary physician to discover it ? how is he to know how many of you tid^e the position of Dr. Sharpo or Dr. Hughes ?
He is logically hound to believe that every homoeopath follows in its entirety the system of medicine to which the name was originally given, until he receives information to the contrary. And if you give a definition which says nothing about the various theories which have been from the first associated with homoeo- pathy, then he is still entitled to believe that you still hold those theories. There are, I know, differences of opinion about those theories, there are differences of opinion about the dose, but does this prove the statement impossible ?
On the other hand, it is another indication for its necessity, not to affirm the behef of any particular party, but to affirm, where such is the case, that homoeopathists oj a body have accepted no particular theory, and (beyond certain limits, within which all are agreed), have no fixed view as to the question of the dose. To exchange the positive statements of Hahnemann for the negative views of true science is the first great step towards progress.
Modem homoeopaths owe it to the profession, the public them- selves to give a full and lucid account of in what they differ and in what tibey agree with the system of medicine taught in the schools.
At a small cost a copy of this statement could be furnished to every medical practitioner in the kingdom. After this there would be some excuse for censuring the physician who misundiar-
442 CORKESPONDENCE. ''SS5L^?S??^
Befview, July 1, 18BS.
stood the views of homoeopaths, at present there is none. U there are any homoeopaths who prefer the present nnintelligihie condition of affairs, who love the darkness, rather than the light, we have Seriptnral authority for drawing conclusions respecting them.
I am. Dear Sirs,
Yours respectfully,
Peboy K. Wiij>e, M.6.
P.S. — ^I must not forget that *' knightly lance " which Dr. Berridge wishes to hreak with me. It would be a waste of time and space for me to write a disquisition on Hahnemann's false theories and speculations, which have done so much harm to homoeo- pathy, or to bring forward proofs that he did not rightly under- stand the law which he cmfortunately expressed by the words sinUlia rimilibus cwrantur. This has been very often done before. Dr. Berridge may, if he wishes, consider that I have advanoed the arguments expressed in Dr. Sharpens review of Hahnemann's system (Essays on Medicine, xiii., p. 881). By taking a tilt at these, he will have made a very good beginning.
CONSTANTINE HERING*8 LATEST WORKS. To the Editors of the ^^ Monthly Homoeopathic Review,*'
Gentlemen, — ^Will you oblige me by publishing the enclosed circular. Henng's Guiding Symptoms and Analytical Repertory will, when completed, be the greatest homoeopathic works of the day. But, to complete them speedily^ more funds are required. By taking a fully paid-up share of the value of ten dollars (£2 Is. 8d.), anyone can procure these works, and all others published by the Society, at cost price. Thus, the Analytical Repertory, Vol. i., which is sold here for 18s., will cost a share^ holder only 8s. 4d., carriage paid; while each volume of the Guiding Symptoms, which here costs 25s., costs the same only lis. 6d. Every physician ought to subscribe for these works, and every layman, too, who has benefited by homoeopathy, should do something for the cause. By bringing out these works speedily, they will do more good than even by subscribing to homoeopathic hospitals ; for tiie latter are of use only in tiieir immediate vicinity, whereas these books will bear fruit wherever the English language is spoken.
Subscriptions for shares and books should be sent to C. B. Enexr, M.D., 112, North Twelfth Street, Philadelphia, Pa., U.S.A.
Yours &c.,
E. W. Bebbidob, MJ).
SSSJfj^Tir?^'"* CORRESPONDENCE. 443
AMERICAN HOMCEOPATHIC PUBLISHING SOCIETY.
' The attention of physicians and the friends and patrons of homoeopathy generally is invited to the natore, scope, and pur- poses of the American Homoeopathic Pablishing Society.
It is a regularly organised corporation, chartered under the Seal of the Commonwealth of Pennsylvania. It possesses the right to publish and sell books, and is authorised to issue stock certificates to the subscribers to its capital to the extent of 1,000 shares of glO.OO each. Under the provisions of the act, stock- holders are liable to the extent of the par value of the stock held. The certificates are issued only upon paid-up subscriptions, therefore there can be no assessments made by the Society, and there can be no liability beyond the sum actually paid in by each stockholder.
The Society is limited only by the bounds of homoeopathic medical science. The doors are open to all who have manu- scripts to offer for publication, on any phase or branch of medi- cine, or medical science treated homceopathieally. Authors are invited to offer their works or contemplated works to this Society for publication.
The Society aims first of all to give to the profession and the public thoroughly sound and reliable works ; and secondly, to give to its members the material advantage of obtaining medical books at the actual cost of production.
The working capital of the Society is contributed by the stock- holders who receive their profits in the purchase of books at cost, which is at about 50 per cent, of the ordinary trade retail prices. A holder of one share of stock costing glO.OO, may purchase one copy of every volume published by the Society at cost. It is therefore clearly to the advantage of every purchaser of homoeepathic books to become a stockholder in this Corpora- tion to the extent of at least one share of stock.
Books At.r»ai>y Pubushbd.
Hering's Symptoms of the Hind, Complete in one volume. Price to Stockholders, $2.00 Price to others, S8.50 Hering's Quidmg Symptoms, Volume I, 11, and m.
SOAUB OF PbICBS.
To Stoekholden. To Non-Stodkholden.
Bound in Cloth $2.75 per vol. $5.00 per vol.
,y Library Leather 8.25 „ 6.00
HalfMorocco... 8.75 „ 7.00
»
„ .unuMB.v>vvvv... V. rv „ f.W ,,
444 COBBE8PONDEMTS. "S^fjSJ??!^
NOTICES TO CORRESPONDENTS.
9
«% We cannot undertake to return rejected mamueripts.
A Caution. — ^We have been requested by Dr. Pkbct Wilds, of Ipswich, to warn oar coUeagnes against a person describing himself as Dr. Fbaks- UN, from New Zealand, who is apparently on a begging expedition amonR(t homoBopathic practitioners. He states that he is vouched for by Dr. David Wilson, Dr. Skinnbb, and Dr. Besbidob. We have been informed by each of these gentlemen that he knows nothing of sach a person. The man is an impostor, and should be treated as such.
Dr. Bradbhaw, late of Nottingham, having recovered his health, bfts commenced practice at Worthing. Mr. Butcher, of Beading, has gone to Windsor to succeed Dr. Haepbr, who comes to London. Dr. lliNa is opening a Dispensary at Maidenhead, where he resides.
Communications, Ac, have been received from Dr. Both, Dr. Wiuov, Dr. Skinneb, Dr. Bebbidob, Dr. C. L. Tucket, and Mr. Chakbb^ (Lon- don) ; Dr. Hughes (Brighton) ; Dr. Mia>DEN (Biimingham) ; Dr. Bbadseaw (Worthing) ; Dr. Majuxbab (Calcutta).
BOOKS RECEIVED.
Tfie Opium Habit : its tuceessful treatment hy the Avena Saliva, By E. H. M. Sells, A.M., M.D. New York.
Bemarka on Certain Medical Principles and Puhlicatums. By Dr. J. Hamernik, of Piague. London : £. W. Allen.
The Homaopathic World,
The Students* JaumaL
The Chemist and Druggist.
The Calcutta Journal of M^.dieine. Calcutta, 1882.
The Indian Homoeopathic Revitic, Calcutta, 1882.
Tfie North American Journal of Homceopathy. New Tork, 1882.
The Hahnemannian Monthly, Philadelphia, 1882.
The St. Louis Clinical Review. St. Louis, 1882.
The Therapeutic Gazette. Detroit.
The New York Medical Tiw£s,
The New England Medical Gazette,
The Medical Counsellor.
Homaopathic Obstetric Journal, New York.
VArt Medical, Paris.
Bull, de la Soe. Horn. Med, de France, Paris.
Biblioth^que Homaopathique, Paris.
AUgemeine Horn. Zeitung.
PJiarmaceutische Zeitschrift fiir Russland, St. Petersburg.
El Criterio Medico, Madrid.
Bolletino Clinico, Madrid.
Papers, Dispensary Beports, and Books for Beview to be sent to Dr. Pope, 21, Henrietta ^treet, Cavendish Square, W.; Dr. D. Drci Bbown, 29, Seymour Street, Portman Square, W. ; or to Dr. Kennkdt, 16, Montpelier Bow, Blackheath, S.E. Advertisements and BusineBS oonminnicationB to be Eent to MoBsn. E. Gouu> St Sox, 59, Moorgate Street, E.C.
£l!Si^'A5?1?la^^ MEDICAL ACTS COMMISSION. 445
THE MONTHLY
HOMOEOPATHIC REVIEW.
THE REPORT OF THE MEDICAL ACTS
COMMISSION.
A TEAR ago eleven gentlemen were appointed to enquire into the details of admission to the profession of medicine, and, on the eyidenoe laid before them, to base such suggestions for securing that all admitted should have received a complete and thorough education as might seem fit to them. The result of forty meetings by the Commis- sion is presented to us in a Report issued a few weeks ago. The relations of our profession to the laws of the country have for years proved a fruitful source of dis- cussion. The Medical Act of 1858, the result of nearly thirty years of agitation, was scarcely enforced ere amend- ments to it were proposed and amended acts passed. Two or three entirely new bills have been introduced into one or other house of Parliament, and more than one Com- mission has sat to enquire into the needs of the public and the profession during the twenty-four years that have elapsed since the Medical Act was passed. To lay the ghost of medical ** reform " seems impossible.
"What, we would ask, before we pass to the consideration of the proposals of the Commission, what measures are necessary to give the public such security as they are entitled to demand that those persons who represent themselves as medical men are really competent to practise
Yd. 26, No. 8. 2 H
446 MEDICAL ACTS COMMISSION. ^^SS^SS^fS?
medicine ? This seems to us to be all that ought to concern the Legislature in dealing with the profession of medicine.
To this question we would reply that every candidate for admission to the profession ought to give evidence before a board of examiners, composed of men who liave not been his teachers, that he has had a liberal education before commencmg to study medicine ; that he has been engaged in this study during four years^ his time having been suitably divided between the different branches of medical art and science ; and that he possesses such a knowledge of medicine, surgery, and midwifery as shall render him a fit and proper person to consult in emergencies of a medical, surgical, or obstetrical character.
As things are conducted at present, nineteen bodies compete for the privilege of initiating the medical student into the '^ mystery of physic." That full confidence may be reposed in these bodies, it is necessary that the examinations at each should be watched — a process that becomes very expensive and very liable to be imperfectly carried out when there are nineteen to be attended to- Then, again, though the Medical Council may recommend alterations in the curriculum of study and the subjects of examination at each, it has no power to enforce its recommendations. Hence it happens that in some instances a given diploma testifies only to the candidate's knowledge of medicine, another is limited to assuring the public of his competency as a surgeon, while a third is restricted to certifying to his capacity as a ''man-midwile.^ With the exception of the University degrees, no one diploma gives evidence of its holder possessing an avenge aeqnamtanee with each of the three departments oi tha pmfesBion.
That the interests of the public demand tbat tbose
SSSUfA^M?* MEDICAL ACTS COMMISSION. 447
offer their services as medical practitioners should give eTidence of haying demonstrated their acquaintance with the details of each department of the profession, needs no argument in its support. While, that, inasmuch as the State confers certain exclusive rights and privileges upon members of the medical profession, it has also a just claim to be satisfied that those upon whom such rights and privileges are conferred are fully qualified to enjoy them, is equally clear.
Hence, the conclusion arrived at by the Commission, ** That the holding of a license ought to be conclusive evidence of sufficient proficiency in medicine, surgery, and midwifery," will be generally acquiesced in. In order to earry this principle into practice the Commissioners appear to regard as hopeless any arrangement by which existing examining bodies may retain their present licensing powers. Surely, it would have been possible to have rendered it compulsory on every examining body to have ascertained the qualification of candidates in each department of medicine. Were this done, there would be no necessity for that general deprivation of licensing powers which have been enjoyed during the last twenty-four years ; a period during which medical education has improved more con- siderably, and examinations have become more searching than during any similar period since the century opened. Further, it is the Colleges and not the Universities that are open to the charge of conferring diplomas after an imperfect examination. Why should both sets of institu- ticms be treated as though both were equally at fault ?
The practical result of the proposals of the Commis- sioneis would seem to be, that while easting medicitl authorities shall take part in the examinations, they are to dd 00 as agents of the State, and to confer a State Ktense which alone cdiall admit men to the Register* ''Our
2
448 ICBDICAL ACTS COMMISSION. ^BSSS^XS^iJm
proposal/' we read in the Report, '^ stated in general temup is : — ^that there shall be one Medical Conncil, and that in each of the three divisions of the United Kingdom theie shall be a Divisional Board, representing all the medical anthorities of the division ; that the right of admitting to the Medical Register, and a general control over the pro- ceedings of the Divisional Boards, shall vest in the Medical Council; and that, subject to such control, each Divisional Board shall, in its own division, conduct the examinations for license."
Thus, at one stroke, the licensing power at present possessed by nineteen corporations is swept away and transferred to a State Board of Euminers. As a legal qualification to practise, no University degree or College diploma will be of any value. *' If our reconmiendations/' say the Commissioners, '' be adopted, the statutory privi- lege of conferring a medical license will no longer attach to the diplomas and degrees of the medical authorities, and in a certain sense their importance will be diminished." And again, '^ in order to obtain admission to the Medical Register, it has hitherto been necessary to possess the diploma or degree of one of the medical authorities ; bat if our recommendations be adopted, the certificate of a Divisional Board will in future of itself confer a right to registration on payment of the fees. Affiliation to a medical authority will thus no longer be necessary ; but we hope and believe that medical men will not be contented with a bare license to practise, and that they will continue to seek to belong to one or more of the Universities or Medical Corporations."
Pleasant reading this for Senates and Councils ! In the future the importance of a degree or a diploma will be solely dependent on the prestige attaching to connection with the University or College issuing a degree or diploma.
SSSSS^aCTSm?* medical acts commission. 449
The degree of a BritiBh Uniyersity will, so far as the law is concerned, be placed on a level with that of an American or Continental Uniyersity.
We fail to see why, on the ground either of justice or ^expediency, the Uniyersities are to be depriyed of their existing powers. Their examinations are admitted to be ikdequate both in the interests of the State and of the pablic. Why, then, are their degrees to be merely honorary, to carry with them no qualifying professional advantage ?
Mr. Huxley and Professor Tubneb differ from the recommendations of their colleagues on this point, and have expressed their differences in very clearly stated memo- randa. Mr. Huxley says : " The plan which I venture to suggest is of extreme simplicity ; and while I cannot but think that it would prove thoroughly efficient, it interferes .with no fair vested interest in such a manner as to give a claim for compensation, and it inflicts no burden either in ^the way of taxation or of extra examination, on the medical profession.
*' This proposal is, that if any examining body satisfies the Medical Council (or other State authority) that it requires full and efficient instruction and examination in the three branches of medicine, surgery, and midwifery; 4aid, if it admits a certain number of coadjutor examiners appointed by the State authority, the certificate of that •examining body shall give admission to the Medical Register.
"I submit that while the adoption of this proposal would secure a practically uniform minimuTU standard of ^examination, it would leave free play to the individuality of the various existing or future Universities and Medical Corporations ; that the revenues of such bodies, in so far as they are derived from medical examinations, would thence- forth increase or diminish in the ratio of their deserts ; .that a really efficient inspection of the examinations would
460 MEDICAL A0T8 OQMMISSION. ^'S^^SSS^U^
be seenred; and that no one i¥onld oome upon the ReffUUr without a complete qualifieation."
Mnch after the same plan. Professor Tubmeb makes iihe following proposal : —
** (a) No person shall receive a license to practise and be admitted to the Medical Register who does not possess a complete qualification in both medicine and sm^ry, including therein midwifery.
" (b) The diplomas granted by those authorities, viz., the TJniyersities which conduct complete examinations and confer degrees in medicine and surgeiy, shall also be licenses to practise and admit to the Register.
*' (c) Those authorities, viz., the corporations wfaidi grant diplomas in medicine alone, or in surgery alone, shall combine in each division of the kingdom, conduct a com- plete examination, and confer a quatification both in surgery and medicine which shall admit to the Register.
*' {d) The Medical CSouncil shall appoint assessors to attend the several examinations conducted with the view of conferring the license to practise, both by the Universities and by the conjoined corporations. These assessors shall report after each examination if it be satisfactory or not, and the Medical Council shall have power to suspend all examinations which are net of a sufficient standard of proficiency. Under this system the visitation of examina- tions, now made periodically by the Medical Council, would be no longer required, and the money at present expended on visitation could be employed to pay assessors.*'
Now, we contend that if these proposals would ensure that no person would enter the medical profession without having given fall and sufficient evidraice of his capacity alike in medicine, surgery, and midwifery, there is no reason whatever for the sweeping alterations which have received Ae sanction of the majority of the GommissionerB ;
m^l^S^u'^'' MEDICAL ACTS COMMISSION. 451
while, if no reason exists for them, patting them into foree wonld be an act of gross injustice.
While, howerer, simple registration of the licensie of a Ditisional Board is to constitute the sole title to be regarded as a legally qualified practitioner of medicine, it is recommended that University and College titles should also be r^stered, and that separate lists should be set apart in the Medical Register for the registration of persons holding recognised Foreign or Colonial diplomas.
If, howeyer, the Register is to be a record of State licenses, while the State ignores the licensing poiHer of the Universities and Colleges, we think that the piiblication of these latter should be left to private enterprise, and that the official Register should be simply a record o1^ the names of officially recognised persons.
We notice among other paragraphs in the Bepprt, that '* The London School of Homodopathy has laid before us a petition, praying for the establishment of a Homoeopathic School or the appointment of some Homoopathic Lecturer in each Medical School or College. Their request does not appear to fall within the terms of your Majesty's c<aai-
mission.'*
This refers, we believe, to a letter addressed to the Commission by Dr. Bayxs, and not to anything emanating from the London School of Homoeopathy. The School, as such, made no representation to the Commission.
One portion of the Report is occupied with a discussion on the constitution of the Medical Council. It proposes that the number of members be reduced from twenty^two to eighteen. This is so far an advantage, as it will tend to diminish the amount of talk which occupies the time of the meetings of Council. It also proposes that four members should be elected by the registered practitioners. Wherein ihe advantages of this mode of election will be found we do
462 MEDICAL ACTS COMMISSION. ^b^^aSmJm^
not see. The best men for a position in the Cooncil will have neither time nor inclination to enter into a contested election at a heavy cost, and carrying with it no actual advantage. Any candidate for a position on the Medical Council through the suffrages of his medical brethren will have to go through a great deal to arrive at very little, as Mr. Welleb observed the charity boy said that he had done^ when he got to the end of the alphabet ! This direct representation has, however, been clamoured for for some years past by the Lancet and the British Medical Journal^ and as noise is often more effective than argument, the din these journals have raised on this subject will, doubtless, some day have its reward. For our part, we think it probable that the most undesirable and narrow-minded members of the future Medical Council wUl be those introduced through the arts of the skilled electioneerer. The Senate of a University or the Council of a College are much better able to judge of the qualifications of a candi- date for a seat at the Medical Council Board than the country practitioner whose time is too fully occupied in the pursuit of his calling to enable him to devote any attention to the politics of the profession.
The objections to this mode of election are well and clearly set forth by Professor Turner, of Edinburgh, and Mr. SmoN. The Lancet (July 8th), instead of replying to these objections, simply sneers at the gentlemen making them as mere '^ scientists," and as persons who are there- fore unacquainted with the wants of the medical profession. Mr. Simon and Mr. Turner know perfectly well, we will venture to say, what is for the advantage of the profession, while the Lancet is, we do not doubt, equally alive to the advantages the proprietor of a journal may expect to derive from a contested election i
Although the Report bears the signature of each Com-
bSSSST^mTSb?" medical acts commission. 453
missioner, there is so real anaoimity on its essential features. Thus Mr. Simon, Professor Turner, and Mr. Sglater-Booth object to the principle of direct represen- tation of the profession on the Medical Council; Mr. HuxiiET, Professor Turner, and Mr. Brtce object to the diyisional examinations proposed as the sole portal of Amission to the Register ; while the Bishop of Peter- BOROUOH advocates a Stoats Examen — ^an examination, con- <dncted on behalf of the State, of those who have previouslj obtained a complete qualification by license, or a degree from some chartered medical authority or authorities.
In a leading article in the Times of the 28th Jane, the ^editor, remarking on these differences of opinion, says : —
Two things will at once become manifest — ^first, that their dissent is not likely to rest upon any bat weighty and safficient pounds ; secondly, that it can scarcely depend apon the operation of any professional prejadice or any common point of view. It onfortonately happens, moreover, that the qaestions raised by the separate memoranda are precisely those which were previoasly in dispate, and for which it was hoped that the Commission might discover some aniyersally acceptable sola- iion. The points on which the eleven members are agreed seem to be chiefly, if not entirely, matters of detail; and the recommendations which they have pat forth concerning them are essentially sach as were already felt to be inevitable. It is chiefly with reference to the mode of condacting the examina- tion of candidates for the lowest medical license, or bare qualification to practise, and with reference to the mode of appointing the Coancil by which medical edacation is to be ^controlled, that the majority of the Commissioners are more or less dissentient from the report ; and these are almost the sole •questions apon which the Bills broaght into Parhament by the Duke of Richhomd and by Lord Bipon were wrecked.
Farther, we think the report does not disclose any very {prave necessity for legislation at all. It is quite true that
454
MKDIOAL ACTS COMMISSION. ^bS^^STTm^T
some examinations are imperfeot; lliat one body osdy examines in medicine, and another only in snrgery ; but as a matter of faet, how few are there who enter on practice without a qnalification in both branches of the profession 1^ What is more important, how few appointments are open to any who do so ? The absence of any immediate necessity^ for a new Medical Beform Bill, the serioas differences of opinion which exist amongst those who hare devoted most attention to the subject, the large amount of arrears or legislative work occasioned by the position of Ireland, and the only too great probability that for a long while yet to come the energies of our legislators will be devoted to- devising and carrying out measures for the prevention or robbery and murder in that unhappy country, render it pro- bable that the question will be shelved for some time to oome^
As, however, it has been brought before us, and as it is- just possible that it may be discussed in Parliament during next Session, we may enquire how far the proposals of the Commission are likely to influence homceopathists, and what precautions we need to take in order to protect our interests^
In approaching the subject from this point of view, we must remember that the Commission had no power to enquire into the details of medical education, and that con- sequently no Act of Parliament that may be based upon their report will deal with such details. All that the Com- mission had to consider, and all that an Act of Parliament wiU embrace> will be the broad professional divisions — ^medi- cine, surgery and midwifery. How these several subjects may be treated, either by teachers or examiners, is entirely beyond the scope of an Act of Parliament. And inas- much as knowledge regarding either is progressive, it is necessarily so.
All, therefore, that can legitimately concern us in an Act of Parliament regulating admission to the rights and.
uS^SSTtm!^ MBDIOAL ACTS COMMISSION. 455
privilegeB of the profiBssion of loedicixie is that no obstacle be placed in the way of any one entering the profession on the gronnd of his believing in homoeopathy.
The Medical Act of 1858 contains in its 28rd clause a distinct protection of this kind, and any alteration that maybe made in the laws regalating onr profession must be jealously watched, lest by some side wind or manoeuvre this protection be lost. It is indeed highly improbable that a eandidate's futh in homodopathy would nowadays prevent him enjoying the fruits of passing a good examination, but nevertheless it is well not to place temptation in the way of an examiner. Hence we must insist on the retention of this 28rd clause in full force.
It would be very desirable were we able to insist on every candidate being ei^amined as to his knowledge of — not of his faith in — ^homoBopathy, and of the pathogenetic action of drugs. Until examinations do comprise these subjects, they will be, pro tanto, imperfect. But these are matters with which we can hardly expect an Act of Parliament to deal. They are for the consideration of the Medical Council, and it is this adamantine body that we must impress before we can hope to see a knowledge of homosopaihy necessary to admission to the Medical Register. Such an impression we can only make ^i^^en Vbt principles and practice of homoeopathy are much more largely appreciated by the profession than they are now. Three hundred members of the profession cannot hope to force their views of what is right and necessary upon twenty-three thousand. The time will come, if we are faithful in practising homcBopathy, and earnest in spreading a knowledge of it by every means within our reach, when it will be taught, and when it will form one of the subjects of examination of all candidates for a diploma in medicine. It is to this end that we must labour and strive, and work of this kind is best and most Barely performed through the press, the lecture room, and at the bedside. It cannot be done by Acts of Parliament.
456 BBITI8H HOM<EOPATHIO BOGIETT. ^£^,^55°?Ssl
AN ADDBESS DELIVERED BEFORE THE FEL-
LOWS AND MEMBERS OF THE BRITISH
HOMOEOPATHIC SOCIETY, AT THE
CLOSE OF SESSION, 1881-1882.*
By Alfbed C. Pope, M.D., President of the Society.
Gentlemen, — We, this evening, bring to a close the proceedings of the thirty-eighth session of our Society. We cannot, I think, do so more appropriately than by inquiring, in the first place, what we have done, during the last nine months, towards the accomplishment of tiiose objects for the promotion of which our Society exists. And secondlyy we may, with advantage, endeavour to ascertain the position which the therapeutic doctrine we are here to cherish and to nourish holds at the present time in the realm of medicine.
The chief object of our Society is the cultivation of therapeutics — of special and general therapeutics.
The study of Materia Medica from the pathogenetic standpoint, and the practical application of the lessons derived from this study, are, of all subjects of medical inquiry, those which are most befitting our attention.
On the degree of perfection to which wc can bring our knowledge of the action of individual drugs upon the healthy body, and the amount of accuracy with which, guided by the principle similia, simtZifruf cwrantur^ we can apply this knowledge clinically, depend in a large measure not only our success as healers of disease, but also the influence we have in extending a knowledge of homoeopathy, the power we possess of compelling professional inquiry into our therapeutic method.
Let us then occupy ourselves for a few minutes with a rapid sketchof the work of the Society during the past session.
At our first meeting, last October, a paper was read by Dr. Washington Epps based upon the details of two cases of Chrome Eczema.
The practical lesson which this essay seemed to me to teach us, was the supreme importance of paying due regard to the diathesis underlying an eruption on the skin. To this end it is essential that the mind of the physician should not be too exclusively occupied either with the locality or the character of the eruption, but that in select- ing his medicine he should take into account every other
* Reprinted from ^k^AnfiaUofth€BrUuhH(matopathU8ocuty,kQ%.Ad^l^
iS^S^TS^ BRITISH HOM(EOPATHIO 800IETT. 45T
» 11. ■
symptom of disordered health whieh is associated with its derelopment. An emption is but the outward and visible sign of a mnch more generally diffused and obscurely situated disorder. And it is with this that in order to cure the more obvious indication of ill-health, that we have to do battle; while it is only by a due recognition of the totality of the symptoms that' we can accomplish our purpose. To this end we must endeavour to keep as clear as we can of the phrase '^ skin-disease." It is, I believe, a term which has no really inteUigible nosological signifi- cance, or, if it have any, it is one that is misleading. The eruption to which it gives such undue prominence is but a symptom or, at the most, a phase of constitutional dis- turbance. In no class of disease is Hahnemann's injunc- tion to be guided, in drug selection, by the totality of the symptoms, more deserving of our thoughtful attention, than it is in those disorders, one feature of which is an eruption. While at no period in the history of medicine (one in which a scientifically demoralising tendency to- specialism has obtained so strong a hold on the mind of the profession), never, I say, was it more necessary than it is now that we should remind one another of the importance of this fact. ** If one member of the body suffers all the members suffer with it," and the only way, especially in obscure constitutional forms of disease, in which we can hope, or have any right to expect to be able, by means of medicines, to modify the health of all the members of the body, is by paying due heed to the totality of the symptoms eyinced by all, by listening attentively to the language of living pathology.
At tibe following meeting Mr. Butcher read a paper having foritBiitleHomceopathic Therapeutics in Surgery. Thought- ful and interesting as this essay was, it was limited rather to showing that the progress of modem thought lay in the direction of homoeopathy than to pointing out the influence of homoeopathic medication upon such diseases and injuries as are regarded as being within the province of the surgeon.
This is a subject of considerable importance, and, I trust, that on some future occasion Mr. Butcher will return to its consideration, and handle it with that eare and fulness which it deserves, and which he is so capable of giving to it.
Operative surgery is eminently attractive. It affords so wide a scope for the display of coolness, courage^ and"
458 BBITISH HOMCSOPATHIO SOCIBTY. ^^^J.^SuHf^
manipulatiye skilly its results are so palpable, and in many instances afford so mnch immediate relief to the sofferer, that the temptation to cut the Gordian knot of disease with the scalpel, instead of endeavouring to untie it with homoBopathically selected medicines, is oftentimes too strong for the surgeon.
NeyerthelesB the facts remain that many limbs have been saved by such remedial measures, when disease of the joints has seemed to call for their removal by the ampu- tating knife ; not a few cases of ophthalmic disorder are still interfered with by those beautiful and delicate instruments which are the pride and boast of ophthalmic surgeons, that ought to yield to medicinal influences; while in a few instances some kinds of tumours have been found to disperse under the action of appropriate remedies. And, further, it has long since been placed beyond dispute that, where surgical procedures have become inevitable, the after treatment has been rendered much more effective by homoeopathic medication.
Far be it from me to make light of the value of operative surgery as a means of saving life. Important, necessary, and highly developed as it is, the aim of the surgeon should still be to restrict rather than extend the sphere of •operations, to substitute medicine for the knife wherever it may be possible to do so. Much, I think, remains to be done in this direction, and much I feel persuaded may be done by the careful study of individual cases, by giving more unremitting attention to constitutional conditions, and by carefully considering all the symptoms attending the rise, progress, and status prasens of a disease.
In December Dr. Burnett criticised with much acuteness and fulness a portion of the article on the pathogenetic properties of Silver contained in Dr. Allen's Encyclopisdia of Materia Medica. The eondusioiis arrived at by our learned colleague's examination of this article must, I feaer, be regarded as calculated to diminish our confidence in the uniform accuracy of the translations from foreign autiiors which form so considerable a portion of that gigantic work. Its thorough re-examination by competent critics has been shown by Dr. Burnett to be essential. It must,* however, be admitted that Dr. Allen has liberally supplied the means necessary for such re-examination by the fulness with w^hich be has given the references to the soureea whence
IS^SST^ BMTISH HOMCBOPATHIO SOCIETY. 469
1i0 deriyed the material he has so industriously collected for us.
No more desirable work can, I belieYe, be undertaken than the carefdl re^examination of about one hundred of the most generally useful medicines, the pathogenetic effects of which, being recorded in this Encyclopcedia^ are not contained in Hahnemann's Materia Medica Pura. These published as a supplement to that great work — of which we have now, thanks to two distinguished Fellows of our Society, so admirable a rendering — ^would place within the reach of the physician an ample source of power in his drug-dealings with disease. The necessity for sacb ^ work is, I am sure, becoming increasingly felt ; and, as in commerce, a demand creates sapply, so here I trust that the same influence may ensure a like result.
In January Dr. Clark introduced the subject of the Antagonistic Action of Medicines, By a series of apposite «nd interesting cases of chronic poisoning from brass, opium, and arsenic, he showed that small doses of medicines acting on the same tissues as do these several drugs, relieved, with more or less permanence, the symptoms they had eroked, albeit, in each instance, the influence of the poison was continued.
The practical lesson illustrated by Dr. Clark's cases is alike interesting and important, teaching, as it does, how wide is the sphere and how active is the power of a homoeopathically selected medicine.
At our February meeting Dr. Hayward brought before us a study of the Afferent Imid of efiects produced by large «nd small doses of the poison of the Crotalus horridus. The object of the paper was to direct attention to the rela* tion subsisting between the dose requisite to give rise to a given class of symptoms and that which is necessary in order to cure similar symptoms. A further study of the dose question in the direction pointed out by Dr. Hayward is one that appears likely to prove fruitful.
The time devoted to our meeting in March was wholly absorbed by discussion of a polemical character. While it Ib much to be regretted that we should be occupied with a debate of this kind to the exclusion of questions having a snentific interest, and of matters of practical value, it was important, and indeed necessary, that the members of this fkwiafy shoald expreu their opinions regarding a at^ so aarious aa tiut before us on this oecaaion, even though it
460 BRITISH HOMCBOPATHIO BOCIBTY. ^bSSJ.^SJ?^
was one for taking which we were in no way responsible. While much earnestly expressed feeling animated both the opponents and supporters of the proposals of the London School of Homoeopathy to institute a diploma testifying to a knowledge of homoeopathy, it is gratifying to be able to remember here that the discussion was entirely devoid of any of those unpleasant and ungenerous personalities which are so frequently conspicuous on occasions where strong feelings are aroused.
In April Dr. Meyhoffer, of Nice, presented to the Society a very full and elaborate clinical record of a some- what unusual form of ActUe Pneumonia. It showed, in a striking manner, the necessity which exists not only in the treatment of chronic disease, but also in that of such as is acute, of being guided in selecting our medicines by the constitutional condition of the patient at the time when the local lesion manifested itself. The presence of any special diathesis in acute disease must not only affect our prog- nosis, but should also influence our therapeutics.
At our May meeting Dr. Both described to us the method of treating Prolap$us and some other diseases of the uterus by means of exciting active movements in the abdominal and pelvic muscles, devised by Major Brandt, of the Swedish army. The great success which had followed Major Brandt's efforts in Uiis direction, attested as it was, to a large extent at any rate, by distinguished Swedish physicians, as well as the purely palliative character of much of Uie therapeutics of uterine disease, abundantly justified our energetic and enthusiastic colleague in bringing it before this Society for discussion. At the same time, the mere &ct that the treatment proposed involves a some- what frequent vaginal examination renders it improbable that, unless this part of the process can be modified, itisa method likely to commend itself either to English physicians or English patients.
A few months back the Society appointed a committee to prepare a plan upon whieh our records of the patho- genetio effects of drugs mig^t be revised. In taking thia step the Society had especially in view the critical exami- nation of all the symptoms of ill-health ascribed to the use of those drags which eonstttute our Materia Medica, the eiq>anging firam tlie provings all untrusiworthy and irrele- vant matter, and the preseatatioD of the remainder in a
uS^Ja^T^"" BRITISH HOMCEOPATHIC BOCIETY. 461
form at once more accurate, concise, and intelligible than that in which they exist at present.
At our meeting on the first day of this month Dr. Hughes laid before the Society a specimen of the plan which the committee recommended the Society to adopt in this revision of the Materia Medica. The medicine chosen to exhibit it was Aloes, The manner in which the recorded effects of this drug had been dealt with gave rise to con- siderable and, I trust, useful discussion. The work of the committee was subjected to that rigid and uncompromising form of criticism by which alone our Materia Medica can be rendered more and more reliable.
We have, as the direct effects of drags upon compara- tiyely healthy human beings — I say comparatively healthy, because I doubt the existence of an absolutely healthy person just as much as I question the existence of an absolutely sound horse — we have, as such effects, symptoms which are divisible into two classes.
First y those which are always, or^almost always, evoked by large doses in nearly all persons — symptoms such as Dr. Drysdale has termed '' absolute." These are easily recognised, and in the case of aloes are well described by many writers on Materia Medica.
Secondb/y we have such as have been observed to follow only comparatively small doses. These are, for the most part, symptoms which have been, as it were, overshadowed by the weightier consequences of large doses, and are only observable in persons who are especially susceptible to medicinal action. These Dr. Drysdale has termed con- tingent. Now, in any revision of our Materia Medica that we may make, we must be careful to pay due regard to each of these classes of symptoms. We cannot afford to dispense with either. In regard to the first class, there is little difficulty in forming an opinion as to their trust- worthiness. But when we have to make an estimate of the degree of genuineness to be attached to symptoms ascribed to small doses, the difficulty of being sure that they are real drug effects is greatly increased.
The work to which I have referred is thus one not only of considerable magnitude but one imposing a large amount of responsibility upon those who have undertaken it. It has, therefore, strong claims upon the support and sympathy of the Society, and is one in the prosecution of
Yol. 26, No. 8. 2 i
462 BRITISH HOMOEOPATHIC SOCIETY. "^BSSS^.^nfMaL
which I tmst that every member will feel it to be his duty to render all the assistance in his power.
The revision of onr Pliarmacoposia has also occapied onr attention dnring the past few months. The new edition, which it was resolved should be prepared, is now, I believe, in the press, and will be in the hands of membeis early next session.
Finally, the Society has tiiis session manifested that interest in the preservation of the public health by the prevention of canses of disease which every medical society IB bound to exhibit. In fdrtherance of this part of oar duty we have presented a petition to both Honaes of Parliament, drawing attention to the dangers which arise from the sale of colours containing arsenic, especially from the presence of this poison in wall-papers, and while doing so we have pointed out the necessity for legislative enaet- ments rendering the sale and use of materials so detrimental to health illegal.
With a brief reference to some points of detaU, I wiU conclude this portion of the observations I have to lay before you this evening.
During the session we have admitted three new members, two being inceptive and one an ordinary member. Two inceptives have become ordinary members, and three ordi- nary members have been raised to the rank of ^* Fellow." Since our last annual assembly we have had to regret the loss of two Fellows, one. Dr. Bayes, by resignation, and the other, Dr. Leadam, by death. Our deceased colleague was elected a member of our Society in 1848. No one was more respected, none more esteemed amongst us, than was Dr. Leadam. His earnest zeal for the promotion of homoeopathy was well known to all who had the advantage of his personal acquaintance, while his desire to assist in its scientific development was attested by his long service in the wards of the hospital in which we are here assem- bled, as well as by his frequent contributions to the pro- ceedings of our Society.
Within the last few days the intelligence has reached us of the death of a distinguished corresponding member of our Society, the venerable Dr. John Franklin Gray, of New York. Dr. Gray was one of the earUest converts to homoeopathy in the United States of America, where he has practised homoeopathy since 1828, and was also one of the founders of the American Institute of Homoeopathy.
ISHS^jSn^vm^ BBITI8H HOMCBOPATHIC 800IETT. 463
Of him one of his eontemporaries has said^ ''Dr. Qray may truly be reckoned the very first scientific homcdopathic physician after Dr. Gram [who introduced the practice of homcaopaihy into New York] , and he has been an unflinching and constant champion of it up to the present hour."
I should be most imperfectly fulfilling my duties here this evening were I to omit the mention of another loss which the Society has sustained this session in the resig- nation by Dr. Sbmilton of the office of Treasurer* Elected a member in 1847 he was within a few years — thiee or four, I believe — ^chosen to fill that office to which he has been unanimously re-elected at each succeeding annual assembly, and &om which he has, after more than thirty years of valuable service, only definitely retired this even- ing. By the care and attention he has devoted to the financial interests of the Society and the uniform kindness and courtesy he has displayed to its Fellows and Members, Dr. Hamilton has abundantly earned the thanks we have very cordially presented to him this evening. We all trust that, though he has ceased to be an officer, he will long remain associated with us as a Fellow, and by his presence at our meetings add to the advantages we attend here to obtain.
Leaving now the consideration of our work here during the paid; session, I must ask you to bear with me for a short time longer while I endeavour to reply to the questions — Is a knowledge of homoBopathy increasing ? Is it, as a method of drug selection, more appreciated now than once it was 9 Is its influence upon general thera- peutics extending.
How variously are such enquiries met by diflerent classes of people !
Thus, we are told by writers in the allopathic medical press that homoBopathy exists but as a '' trade mark," save as something to attract patients to particular practitioners.
Again, a few there are amongst ourselves who never weary of uttering the cry that homoBopathy is " going to the dogs," that the practice of homoeopathy nowadays is not that perfection of therapeutics it was when they were young, ardent, and industrious, that medicines are not selected with that degree of accuracy that they were wont to be thirty years ago, and that at the present time they
2 1— 2
1
464 BRITISH HOM(EOPATHIC SOCIETY. ^^!,fSS!i!m.
are too generally prescribed in doses which, from tim size, preclude their having a coratiye and render them liable to excite a pathogenetic action.
Lastly, we find a small but somewhat noisy band, wkoae mission it would seem to be to proclaim on eyery possiUe occasion, and through every available medium, not exc^cmg an allopathic medical journal — a kind of periodical only too glad to give them the use of its columns — ^that the piesent generation of physicians who openly acknowledge thdtroA of homcBopathy know nothing ihereof, but rarely pnctise homcBopathically, and that Uiey and they alone, &w in number and contentious in character as they are, are the only representatives of this therapeutic method.
The questions I have proposed to discuss may, I ttuok, be best replied to by a brief notice of each of these tluee classes.
The allopathic journalist has greedily snatched al the suggestion made, for the first time some eight or ten yem ago, by Mr. Oliver Pemberton, of Birmingham, that tk offence of homoeopathy lies in the name attached to it. li was a clever and ingenious hit of Mr. Pemberton's was this inveighing against the name ; and it has been a wa^ Buccessfal one, for not only has it had the influence it yn& desired that it should have upon the minds of allopadtic practitioners, but it has succeeded in somewhat obscoring the vision of a few of our own members. It has impressed their sensitiveness to the charge it implies of nooK adventitious means for securing patients. Further, it htf furnished some who know that homoeopathy is true, and know, still more decidedly, that the isolated position of tf avowed homoeopathist is a bed of thorns rather than (^ of roses, with a plausible excuse for practising homoeopithj without acknowledging that they do so, for shirking 9d evading those responsibilities which their knowledge imposes upon them. As an excuse for such a conise d action I have heard it urged that one does not know witft homoeopathy is; that by one author it is regarded is meaning one thing, by another as something else, and bj a third as that which is quite different still. Such a mo^ of evading a difficulty will not bear examination. Let asj member of the profession endeavour to procure admissioB to a medical society where homoeopathic practitioners tfc excluded by stating that he is not a homoeopathist, h^ that, at the same time, he has no doubt that medicines
SS^^Tm^ BRITISH HOMOSOPATHIC SOCIETY. 465
which in health prodace condiiioiis like those they are desired to cure are those which are most nsefnl in such caseSy and he will be very promptly informed that he is not eligible for election, that he is endeavonring to sail under false colours, and that a mere repudiation of the name is insufficient to entitle him to receive professional fellow- ship.
The Lancet^ which has to a large extent educated the profession in its opposition to homoeopaihy, and now represents the feeling regarding it of a ye^ considerable proportion of its members, has told us, with ample dis- tinctness, that ''nothing less than the most unreserved renunciation of all the dogmas of homoeopathy, both in name and in deed, will be accepted " (June 2nd, 1877).
Gentlemen, the word '' homoeopathy *' is no trade mark. It is the concise definition of a therapeutic doctrine, of a doctrine having a wider scope and greater practical value than any other in the whole range of medical science. Neither are '' Hahnemannism *' and '' Homoeopathy " equivalent terms. The former may be fairly held to denote the entire teaching of the illustrious physician from whose name it has been coined. Comparatively few of those who believe in homoeopathy are prepared to pin their faith to every precept taught by him to whom we are indebted for our familiarity with the therapeutic doctrine of the transcendent value of which we are one and all convinced.
In reality, however, the use of the word homoeopathy by those who believe in it is protested against, because it involves an open confession that the doctrine it expresses is true. This doctrine, according to some, may without offence be taught piecemeal, it may be illustrated by individual cases after an empirical fashion, and it is permissible to comment upon such cases in detail, and without any distinct allusion to the doctrine itself you are at liberty to bring out every feature of it ; but once define this doctrine by a comprehensive word, and you are perpetrating an outrage upon medical propriety! A therapeutic doctrine may be perfectly sound — at least, that known as homoeopathy may be so — ^but that doctrine must not have a verbal definition !
Such is the practical outcome of the objection raised to the name. To me it appears to be, in the first place, childish ; and, in the second, as obstructive to therapeutic
466 BRITISH HOMCEOPATHIO 80CIETT. ^S^
Beview, Aag. i, UBL
progress. To admit the truth of a doctrine, and yet to declare that the definition of that doctrine by a particular word is an offence, would seem to be a proposition that could not be defended. Neither is it; it is simply asserted. Why is it so ? Why has it been raised ? Why has it been 80 repeatedly pressed upon the attention of the profession by the chief organs of medical opinion ? The answer to these questions will, I think, be found in the consideration of the position which those who object to the use of the word homoeopathy have occupied towards the doctrine it denotes in the past, and that which they now fill towards it.
For half a century the medical press of this country has uniformly denounc^ homceopathy as a ''fiirrago of absurdity '* and a '* form of quackery ; " it has represented this doctrine as ** a folly," and its practice as a " firaud.'*
So much for the past. What is the state of therapeutics to-day ? What are the books on Materia Medica so cor- dially recommended to the study of their readers by the medical journals now ?
The very periodicals which have in the past derided, misrepresented, and attacked homoeopathy and its advo- cates with such uncompromising virulence, have, during the last few years, with ever increasing frequency, pree^ited their readers with hints for using various medicines first made known through the study and practice of homoeopathy. While, as to the text-books on Materia Medica which have the ear of the profession, they abound in practical lessons filched firom the teachings of homoeopathy. Thus to a veiy large extent is homoeopathy taught — ^taught empirically it is true, taught without any reference to a therapeutic doc- trine— ^but none the less taught, and therefore practically endorsed.
How is it possible to reconcile the contumely with which homoeopathy has been treated — aye, and is still treated — with the adoption, not only of uses of old remedies first made known through its practice, but of drugs — such as p^dsatillaf lor example — ^which prior to the study of homoeo- pathy wore but little known in medicine ? Such positions as these cannot be reconciled. If the therapeutic facts, now 80 widely admitted to be not only true, but valuable truths^ are accept^, the disparagement with which homoeopathy has hitherto been and still is regarded was and *is unde- served, unjust, unworthy of the intelligence of those who are responsible for it.
SSSiffiSnjMtt^ BBITISH HOMCEOPATHIO SOCIETY- 467
The Lancet and its contemporaries must, however, main- tain their consistency. The coarage to admit an error they have not ; the amoont of honesty necessary to enable them to confess that their misrepresentations were doe to a want of knowledge of the questions at issue is lacking.
Many facts derived from the therapeutic work that homcBopathists have accomplished have, in these latter days, been appropriated and disseminated by authorities too influential to admit of their utterances, whencesoever obtained, being burked. It is impossible to prevent these facts being utUised. Hence it comes that while the newly gained light is freely exhibited, every effort is made to obscure the source whence it was obtained. Hence comes the desire to prevent, and if possible to prohibit, all reference to the doctrine so long protested against. That doctrine, very many of the practical results of which are now so commonly adopted and taught, is, nevertheless, the same doctrine as that to the falsity of which the medical press has through long years committed itself, and which for consistency's sake it must still denounce, even while circulating among its readers some of the fruit which has been derived from it. Hence it comes that the medical profession is, as it were, enjoined to accept, in an empirical manner, the facts which homceopathists have brought to light, but is at the same time adjured to repudiate, or, at the least, to obscure the doctrine through the practice of which these facts were brought to light.
It is then, I verily believe, in order that the virulent opposition with which homoaopathy has been encountered may be justified, while the results which have flowed from its study are silently utilisedythat it is now sought to sever the word homoeopathy from the practice and teaching thereof.
2ndly. To abandon — were such a thing possible — the use of the word homoBopathy would, I submit, be to offer an obstruction to therapeutic progress.
Lose sight of the word homceopathy, and ere long you will lose sight of the doctrine signified by that word* Having lost sight of the doctrine of homceopathy what will remain ? A large collection of unstrung empirical fiftets ; facts of untold value when interpreted by the light of the homoeopathic law, but when viewed without that connecting link, incapable of being understood or appreciated, iBJodf save imperfectly, and ever uncertainly made use of in
468 BRITISH HOMGBOPATHIO SOCIETY. *]SSS.^S^TiML
Again, the doctrine of homoeopathy being lost sight of, how are we to discover or apply new remedies ? How are we to meet hitherto unknown forms of disease ? How can we devote our energies to improving the treatment of such disorders as must even now be ranked as incurable ?
Homoeopathy is the only therapeutic doctrine which ever has taught, and, so far as we can see at present, the only doctrine which can teach us the specific or directly curative uses of a given drug. The knowledge of every direct drug- remedy, of every medicine, that is, which is admitted to be curative of a given condition — ^which has not been dis- covered through homoeopathy — ^has been made known only through accident or tradition.
To modem pharmacological investigations we frequently hear ascribed the discovery of the remedial virtues of such drugs as the bromide of potassivmy chloral, morphia, and salicylic acid! What disease, in the treatment of which they are most fashionable, does either cure ? The bromide will, it is true, suspend at times the development of an epileptic paroxysm, but you have only to omit the daily dose to discover that your epileptic patient is not cured, and worse still you have, in many instances, but to watch him, to note how his originally smaU modicum of intellectaal power is gradually lessening. Chloral will send your worried and sleepless invalid into a state of unconsciousness for a time, but it will not cure the nerve disturbance which has previously prevented sleep. Morphia will numb the sensation of pain, but it will not cure the condition which has provoked it. Salicylic add will, perchance, reduce the temperature of a rheumatic fever, but a large amount of clinical experience has shown that there is but scant reason to believe that it has any influence on the course of the disease.
And so I might go on throughout the whole series of those new me£cines, which are, by some therapeutists^ regai'ded as the glory of the pharmacological researches of our time. They are palliative not curative of disease.
On the other hand, to homoeopathy we owe the know- ledge that aconita cures sthenic fever, that phospliortu cures pneumonia, that bryonia cures rheumatism, that corrowoe- eublirnate cures dysentery, that camphor, copper^ and' areenic cure cholera and so on.
In short, the study of the effects of drugs upon healthy men and women, and the clinical application, by the^
B^tm^h^!^ BRITISH HOMCEOPATHIC SOCIETY. 469'
gaidance of the law of similars, of the knowledge thus obtained, is the only method by which the specific, the directly therapeutic power of drugs can be ascertained, and this method is known far and wide thronghout the wholo civilised world as homoeopathy.
Are we then, I would ask you, are we prepared to lose sight of such a doctrine, of such a method as this ? Are we prepared, in obedience to the mandate of the Boyal College of Physicians, or of any other body, to cease from proclaiming its truth, to desist from its public teaching, to draw a veil of silence over our knowledge of it ? May God forbid !
To what end, I would have you consider, are we asked to abjure the word homoeopathy ?
The College of Physicians, did we consent to do so, would, we are led to infer, cease from raising objections to their Fellows and Members meeting us in consultation, to our admission into medical societies, to our holding public medical appointments. The Lancet, however, speaking on behalf of the general practitioner, very distinctly informed the College that a mere renunciation of the name homoeo- pathy would not satisfy its clientele. It is the doctrine and practice of homoeopathy that we are, by this oracle of medical opinion, urged to abandon ; it is the justice of the course the Lancet has pursued towards homoeopathy in the past that we must bear witness to, if we would gain such results as these !
But, supposing it were otherwise, is there, I would ask, any one who, for privileges so comparatively paltry as these, would renounce his freedom of speech, would abstain from declaring his faith in so important a doctrine as that of homoeopathy, who would barter away the honoiu* of taking part in the development of the therapeutics of a day not far distant now ? If such an one there be I pity him. In place of the countenance of those whose favour he desires he will but receive their contempt, and in so doing he will but get his deserts. And what he will feel more still, aye and as long as he possesses an unseared conscience, is an ever-abiding sense of humiliation. He will stand self- convicted of having allowed his tongue to be tied when he knew that it ought to be actively employed ; he will be conscious of possessing a knowledge he has sacrificed his right to communicate.
*' Practise homoeopathy by all means, but say nothing
470 BBITISH HOM(EOPATHIG SOCrETY. ^^^S^ifSi
aboat it/' is the advice which is now and again Tonchsafed to medical men, who are Mly aliye to the imperfectioDB and risks of tiie practice of medicine as taught in the schools, who have a firm faith in the yalae of homoM^thy, bnt who are, at the same time, repelled from an open avowal of its trath by the disabilities snch an acknow- ledgment entails.
Well, gentlemen, I do not mind confessing that now, nearly thirty years ago, such an idea floated b^re my own mind. It required, howeyer^ bat little reflection to assure me that, were I to practise medicine after a method so little understood, so generally denounced, so constantly misrepresented, and yet withal of such surpassing value to the sick as I knew homoeopathy to be, and were I at the same time, from motives of self-interest or from fear of consequences, to refrain from admitting how I gained my therapeutic Imowledge, there would be no person in the whole world who I should so thoroughly despise as myself. With such a consciousness ever preying upon one life would not be worth possessing.
No, gentlemen, take into consideration these two facts — first y homoeopathy has been proved by a large mass of well- attested evidence to be a great life-saving, illness-shortening truth ; to be the basis of all specific drug-therapeutic progress; and then, secondly , homoeopathy is a truth, against the spread of which there is a widely organised conspiracy, resistance to which involves much that is impleasant. Put these two facts together and then, remembering Nelson's address to his sailors, let each ask himself " What is my duty ?"
Let us then, each and all, rest assured that it is impos- sible to contribute to the advance of therapeutics, in a direction likely to be permanently fruitful, without bearing testimony, not only to the doctrine which constitutes the foundation of specific medicine, but also, without adhering to the name which that doctrine has hitherto borne, bears still, and ever will bear.
While, however, I insist thus earnestly upon the reten- tion in our medical literature of the word homoeopathy, as one that is not only legitimate, but full of meaning, and essential to real therapeutic progress, — it is its scientific employment, and not its professional use, that I desire to impress upon you to-night.
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The appearance of this word upon the door-plate of a practitioner is, to say the least of it, an exhihition of had taste. All that a medical man requires here is the .-annonneement of his profession. The word homoBopathisty in such a position, suggests the existence of a distinct profession. This homoeopathy is not. It is the highest development the therapeutic art has attained at the present moment. It is, therefore, not only an integral part of medi- -cine, but it is the most scientific phase on which that depart- ment of medicine known as therapeutics has, so far, entered*
Our aim is, and ever ought to he, to ensure the cultiva- tion of the doctrine we cherish within the profession, and by every member of it. By describing ourselves, in public places, as Homoeopathists, we give some excuse for the charge that we desire to remain separate and apart from the great body of the profession. We have no such desire ; but, on the contrary, would readily join the general medical societies, and in them discuss, illustrate, and endeavour to propagate, the doctrine of homoeopathy.
And, further, such a designation, so used, does to some extent justify the imputation that, in the treatment of disease, we profess to place our sole reliance upon homoeo- pathically selected medicines. This we do not profess to do. On the contrary, we have ever acknowledged that we avail ourselves in practice of as large a variety of resources, in endeavouring to counteract disease, as any members of the profession are accustomed to do. Homoeopathy relates to the giving of medicines alone, while the art of thera- peutics comprehends much besides pure medication. Again, vrith regard to medicines, we know, and gladly avail our- selves of the knowledge, that in the vast proportion of the diseased conditions with which we are called upon to deal, the homoBopathicaUy selected medicine is that which is productive of the greatest amount of benefit to be derived £:om medicine. But at the same time we admit, and ever liave admitted, that there are some cases where antipathic 3>alliative8 can alone give such relief as medicine is calculated to afford. These are few in number it is true, and the more intimate becomes our acquaintance with the Materia Medica will be yet fewer still — but we must, in the mean- time, recognise their existence, recognise the imperfection of our knowledge. Hence it is more in harmony with our real position that we should describe ourselves as physicians
472 BRITISH HOMCEOPATHIC SOCIETY. "^^S^.^SJTSfSt
or sargeonBi than that we should put thus pFominenily forward the designation Homoeopathist.
Believing in the therapeutic superiority of the law of similars, and acting upon that belief in the treatment of disease, as far as lies in our power, we are homoeopathists truly, but we are so in a scientific sense, not in one that may be regarded as professional.
No one ever described the position we occupy, as members of the profession of medicine, towards the word homoeopathy better or more clearly than did Dr. Bayes^ when, after hearing a paper by Dr. Francis Black (read at a meeting of this Society), entitled " Am I a Physician or am I a Homosopathist ? " he wrote the note to Dr. Black, an extract from which appears appended to that paper, as published in the 4th Tolume of our Annals (p. 404). In this note Dr. Bayes drew Dr. Black's attention to a pamphlet, published by him a few years preyiously, in which he had written : " For my own part, I have investi- gated the subject, and the result of my investigation haa been, that I have adopted homoeopathy into my practice. Observe, / object to the title of ' Homceopath.' Its assumption savours of sectarianism. I object to any other title than that of * Physician ' or, at the most, ^ Physician practising Homoeopathy.'
» >>
Our societies, our journals, our schools, our public hospitals and dispensaries present this question under another aspect. The raison d'etre of these institutions is- the public setting forth, teaching, and illustrating of homoeopathy. But for the obligation imposed upon us to fulfil such purposes as these they would have no existence. They have been established and are carried on solely because in no medical society, journal, school, hospital, or dispensary connected with general medicine, can homoeo- pathy be set forth, taught or practised at the present time. And further, they receive the distinctive appellation ^' Homoeopathic " because it is of the first importance that all who are desirous of knowing what homoeopathy is should have an opportunity of Imowing also where they may learn somewhat of it.
Secondly. The Lancet and its contemporaries having described homoeopathy as extinct, save^as^ trade-mark, we
bS^A^TSw!** BRITISH HOMOEOPATHIC SOCIETY. 473
meet also, ever and anon, with some latidator temporis dcti amongst onrselves deploring the impei-fections of the practice of homoeopathy in oar day. How far is the depression such an one displays justifiable ?
The chief differences obserrable between the homoeopa- thists of to-day and those of thirty or forty years ago are, I think, that at that time there was a disposition to accept the statements and conclusions of Hahnemann with more or less of unquestioning confidence, while to-day such state- ments and conclusions are met by and subjected to a rigid criticism. Then the personal influence that had been exerted by Hahnemann was still felt, now this is no longer perceptible.
Then almost any assertion regarding the effects of a drug ascribed to however infinitesimal a dose, and occurring at a period, no matter how long, after it had been taken, was accepted without a doubt being raised as to its reality; to-day our provings are examined in almost every direction. The very translations we have of experiments recorded in a foreign tongue are held as being open to question until they have been overhauled by competent philological critics.
Then, again, the dosage commonly employed by homoeo- pathic physicians thirty or forty years ago was much more uniformly infinitesimal than it is to-day. The various questions involved in the consideration of the necessity and advantages of relatively small and large doses have received a very ample measure of discussion during this period, and the practice of homoeopathy in this direction is now based upon exact personal observation rather than upon the tra- ditions handed down by Hahnemann.
In short, the chief difference between the practice of homoeopathy now and that of the good old days when some of us were younger is, that the former is much more criti- cal, much more exacting as to matters of fact, than was the latter. In such a change there is seen nothing of retro- gression ; on the contrary, all criticism, all inquiry, is healthy, and tends but to sound enduring progress.
Nevertheless, there are some points upon the importance of which, while we are all agreed in the abstract, we still jrequire to be frequently reminded if we would continue in the paths of progress.
First and foremost among such is the study of the Materia Medica. Here I refer, not so much to the study of the action and uses of individual drugs, as to that of the
474 BRITISH HOM(EOPATHIO S0C5IBTY. *bSS^.^^!7m^
relation of indiTidaal drags to indiYidnal eases. In the early history of homceopathy, as we may see by Hahne- mann's well-known recital of two cases, the method of finding a medicine by covering the symptoms was much more precise than any commonly employed to-day. It was indeed one mnch more easily employed then than it is now. Then the number of medicines available for examination was bnt small, now it extends to several hondreds. Further, there is something repugnant to our intellectuality in the idea of being shut up to so purely mechanical a process as this. Hence, at the present time, the general pathol<^cat state of a patient is first of all compared with the patho- genetic action of several drugs, and then that one of tliia group, the symptoms produced by which most closely resemble those of the individual patient, is chosen.
This is a perfectly sound and reliable method wh^ completely carried out. But, it must be confessed that, the temptation to guess at rather than by reference to the Materia Medica to ascertain which of the group selected for more minute comparison is most completely homcBO* pathic to the condition of the patient, is oftentimes too strong to enable us, by making such reference, to select our medicine as carefully and therefore as successfully as we might do.
If we would avoid the unscientific and often unsatis&e- tory method of alternating medicines, if we would rei^ the full advantages of small doses, and if we would be indq)e]i- dent of the use of palliatives, it is only by the study of the Materia Medica in connection with individual cases that we can gratify our desires.
There is, I believe, little if any doubt but that many of the failures to relieve disease that fall to the lot of each of us now and again, the occasions we ever and anon give to the enemy to blaspheme, and the only approach to a justification for despairing of the future of homceopathy which any pessimists amongst ourselves can make, lies in a neglect or an imperfect study of the Materia Medica,
Whatever excuse for such neglect comparatively im- perfect renderings of drug pa^ogenesies may have furnished in the past is now rapidly disappearing. So &r as the best proved medicines in our possession are con- cerned—those provings through the unremittiBg study of which the early triumphs of homoeopathy wue won— we can now oflPer no such excuse at all.
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Hie Materia Medica Pura of Hahnemann, as translated by Dr. Dudgeon and annotated by Dr. Hughes, is, I believe, as reliable a translation and as accurate in qbser- yation as any work in the literature of medicine.
As further silencing this excuse, let me remind you that with all its shortcomings, with all its errors of observation, with all its oversights and translators' blunders, the English version •of our Materia Medica has enabled the large majority of British and American homcBopathic practitioners to encounter disease with a degree of success far, very far in advance of any that either is or can be secured by the most eminent of allopathic physicians.
Such a work as this, one that has produced results so brilliant, iB, I maintain, well worthy of oar confidence, and quite available for affording us the information we require.
Permit me, then, to ask you to reflect, once again, upon the importance and indeed the necessity of our studying individual cases with the records of the pathogenetic effects of drugs before us.
Thirdly. We are told by a few — so far as this country is concerned, numbering some half-dozen I believe — that they, and they alone, are true practitioners of homoeo- pathy, that they, and they alone, understand what homoeopathy really is, and that all beside who profess to believe therein and to practise homoeopathically are but deluding themselves and those who, in the hope of obtain- ing the advantages which homoeopathy is well known to present, are in the habit of consulting them.
The arrogance and presumption which characterise these pretensions are apparent on the surface; but I desire nevertheless to examine very briefly the basis on which they rest.
The first principle of the Hahnemannians is, I under- stand, that the entire body of precepts, doctrinal and practical, contained in the latest edition of the Organon ot Hahnemann is represented by the word homoeopathy. Any departure from these precepts is, they tell us, a departure from homoeopathy, and, as they would have us believe, a departure from truth. All criticism of Hahnemann's assertions is but little, if at all, short of treason. In prescribing, the dose must be restricted to the highest imaginable dilution. The method of attaining such a dilution, or rather, as it is termed, '^potency," must not be
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too closely examined. It is sufficient for all to know that the instrnments devised for this parpose are ingeniously designed and declared by their inventors to be adequate to the purpose for which they are used. We are therefore bound, I presume, to conclude that they do actually effect, within the space of a few hours, the millionth dilution of any substance. Further, the Hahnemannian would have us believe that anything beyond a single dose of such a dilution of the most accurately corresponding medicine is not only entirely unnecessary for the cure of ^sease, but is distinctly prejudicial to the recovery of the sick.
An abscess, however painful and obvious, must not be opened. All external applications, whether homoeopathic or simply warm and soothing, must be regarded as obnoxious.
Now, gentlemen, I maintain that the Orgation, while containing homoeopathy, contains also a great deal that has no necessary connection with it. Hahnemann was just as much a homoeopathist when he published the first edition of his Organon as he was when, five-and-twenty years later, he issued the fifth. And yet it is only in this last and in one that appeared a few years earlier that he gave expres- sion to those views on which his servile imitators of to-day lay so much stress, views which thoughtful and intelligent critics have for the most part regarded as untenable and as inconsistent with the developments of modem science.
Nothing, to my thinking, does greater injury to Hahne- mann's memory than perpetually insisting upon the truth of that which the state of science in his day did not render impossible, but which modem researches have shown to be so.
The greatest men who have adorned the profession of medicine have been necessarily tied by the science of the day in whicli they Uved. Their views and opinions were in advance of those of their predecessors just as the light which we are privileged to possess, is greater than tiijoi which our fathers enjoyed.
The marvel is, not that Hahnemann erred occasionally, but that he erred so little as he did. That he should have recognised facts which few beside himself could see, but of the truth of which all are now convinced; that well nigh a hundred years ago he should have lifted up his voice in the denunciation of the bloodletting, mercuriEdism, and purgation, that constituted nine-tenths of the therapeutics of the time, displayed not only
iSS^AiSrrSffl?*' BRITISH HOMCEOPATHIC SOCIETY. 477
coinage but on insight into the nature and requirements of disease, which was fully fifty years in adyance of the age in which he lived. That single-handed, and despite a powerful opposition, he should, ere this century opened, liave proclaimed a therapeutic doctrine and have set forth the means for carrying it into practice, and that this doctrine should prove to be oue which to-day is largely recognised everywhere, and that these means should have formed a method of practically applying it, the details of which are gradually but surely asserting their pre-eminence, evinces a mental power, a scientific foresight, an acuteness of perception, which must, in the near future, excite the admiration of all students of the history of medicine.
Achievements such as these ought not to have their lustre dimmed, their true greatness overshadowed by placing in the front of them the mysticism which clouded the latter years of their author. The theoretical notions of the veteran of eighty should not be allowed to obscure the work of one whose vigorous manhood gave to the world a doctrine so fiir-reaching as homoeopathy, and a method so exact as the physiological study of drugs, the small dose, And the single medicine.
Homoeopathy, then, I contend, does not, as the self-styled Hahnemannian would have us believe, consist in the entire body of Hahnemann's teachings, but in the practical appli- cation of the doctrine of similars in the selection of medi- cines to cure the sick. The practice of homoeopathy does not enable us to dispense with fomentations, poultices, the evacuation of abscesses, and so on, any more than through its adoption we can disregard attention to the food, sanitary surroundings, and habits of those who consult us. So far as the prescribing of medicines is concerned, in all, save a few cases, it directs us to the use of such as are amply sufficient to fulfil all the purposes to which medicines can be applied with the mazimmn of advantage. But we cannot therefore in any case a£ford to neglect the use of means for supplying relief derived from other than medicinal sources.
While then a Hahnemannian is a homoeopathist, a homoBopathist is not necessarily a Hahnemannian ; and the exclusive position to which the latter pretends is one to which he has no title : and further, by pertinaciously pressing his claims thereto, he is, in reality, impeding the progress of the very therapeutic method the name of which iie declares to be so peculiarly his own.
Vol. 26, No. 8. 2 k
478 BBITIBH HOM(EOPATHIO SOCIETT. ^bIS&^K'WS'
B«view,Aqr. l,lfltt.
In oonclasion, gentlemen, the reflections which I have snbmitted to yon seem to me to snggest that we ha^e arrived at a period in the history of our therapeutic method which we are justified in regarding as critical.
The antagonism of that section of the profesedon, whence has proceeded the most pronounced opposition to every item in our therapeutic creed, has, in a large degree, dwindled down to a mistaken and, as it appears to me, a acmiewhat puerile objection to the name it bears.
Some few months since I had an opportunity of referring to this point at a meeting of non-homcBopathic practitioners ; and, when addressing them, I said — '^ Yoa have to a very considerable extent, in practice though not in theory, accepted the principle of similars as one of drag selection ; you haye adopted Hahnemann's plan of study- ing the e£fects of drugs by the light sh^ upon them through the effects they produce upon healthy men and women ; you prescribe medicines selected on ttus principle in doses of, amongst yourselves, previously unheard of smallness, and you exhibit such medicines singly and on- combined. All that you protest against now is the name which this method bears. Having gone so fiEu:, it will not be long ere you admit the propriety of the name likewise.*'
Now, gentlemen, what I do most earnestly desire to impress upon your minds to-night is, that the length of time which must elapse ere this consummation is reached depends entirely upon ourselves — depends entirely upon those who now openly recognise the truth of homoeopathy*
When we reflect upon ti^e importance of homooopathy, when we consider that we know lliat through it disease is cuied or relieved more quickly, more oertainly, and more safely than by any other method, the responsibility resting upon us to do all in our power to hasten this time is no light one.
No one understanding what homoeopathy is can read sudi works as those of Binger, Hiillips, and Bartholow— no one can peruse such papers as those which, leprintad from the New York journals, were published in the May number of the Htmuropathic lUview — no one can reflect upon such a contrilmtton as that on cardiac therapeutieB made by Mr. Wood Forster, of Darlington, to the Britkh Medical J<Himal of the 15th of April last— without being assured of the immense advance which homoeopathy has made during the last few years towards attaining that
I,
BBITISH HOIC(EOPATHIC SOCIETT. 479
pOEdtion of prominenee it is deatiiied to hold in the world of medicine.
HoWy I would mek, in it that it has adiieved its present status ? Has it been by hesitating to nae the word hoouBo- pathy on all fitting occasions ? Yeaify, no ! On the con- trary, it has been by steadily and peraev«dngly jmxdaiming Triiat homoBopathy is. It has been by repeatedly illustiaAing the practice of homoBopathy. It has been by consistent efforts to treat disease homceopathioall j. It haa heea bj the snceess which has followed these efforts, made as they haTe been by a small band of resolute and devoted practi- tioners pnrsning their calling under difficulties of no small magnitude.
And, gentlemen, if we would see the arrival of the day when homoeopathy shall be taught in all our medical schools/ when it shall form the basis of therapeutics in all our hospitals, it is only by pursuing the same course as that which we, and those who have preceded us, have pur- sued hitherto, that we can hope to witness it.
In order that we may do all that lies in our power towards speeding tbe time when the therapeutic doctrine we hold in so much esteem shall receive that full and com- plete recognition to which it is entiUed, we must adhere tenaciously to the scientific use of that word which expresses it. We must insist on the correct interpretation of this word, an interpretation involving simply and solely the principle of similars, and the necessity, in putting this principle into practice, of the study of the physiological action of drugs, of employing medicines in comparatively small doses, and uncombined.
We must support, and improve, every means we possess for teaching and disseminating the doctrine we desire to make known. Our hospitals and dispensaries, our journals, our societies and our schools.
Finally, but before all and above all, it behoves us to be especially careful how we put this doctrine into practice. We must do so in a manner that will enable us to cure disease most certainly and most promptiy. That we may accomplish this, the supreme end of our mission as physi- cians, we must study, with the greatest care, the records of drug action contained in our Materia Medica. We must feel that no time is lost, no labour is too great, which is spent in endeavouring to avoid falling back upon palliativee
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480 HOM(EOPATHIC PRACTICE. ^'S^^jSSTS^.
on the one hand, or snrgieal procedures on the other, in order that we may remedy disease by medicine.
Snch is onr duty, and never since the day when the first Tolnme of Hahnemann's Materia Medica Pura was pub- lished have our opportunities for performing tiiis duty been 80 great as they are now.
So far then from being extinct I verily believe that never before was homcBopattiy either scientifically or empi- rically so generally practised as it is at this hour. So bx from *^ going to the dogs/' never before was homoBopathy the subject of so much careful, cautious, and exact criticiJ study as it is at the present time. So far from the small sect of the Hahnemannians being the exclusive possessors of the brilliant inheritance bequeathed to us by Hahnemann, never ere now was the work he performed so largely appre- ciated, so generally availed of, as it is to-day.
HOMCEOPATHIC PRACTICE.*
By Dr. Hughes.
Gentlemen. — ^We have now surveyed the method of Hahnemann, in all that is essential to it. It is a rule — ^let likes be treated by likes. The "likes" are — on the one side the clinical features of disease, with such knowledge of its aetiology and pathology as can be had ; on the other, the physiological action of drugs. This similarity is to be, as far as possible, generic, specific, and individual ; and the remedy thus selected is to be given (as a rule) singly, rarely, constitutionally, and minutely. If you have followed with concurrence the reasonings I have set before you, I trust you are satisfied that this method has every claim — scientific and practical — upon our acceptance ; that our wisdom as medical men is to carry it out wherever it is applicable.
I have yet to speak to you of some subsidiary matters — of the philosophy of homoeopathy, the rationale of its curative process ; of its history in the world of medicine ; and of its claims on the profession. I shall also say some- thing of the theories of its founder, which, though logically unconnected with his method, have actually had a good deal to do with both its controversial and its practical
* A Lecture delivered in the London School of Homoeopathy, June ^th, 1882.
nS!Si!^i!'^'' HOMOEOPATHIC PRACTICE. 481
,_ IT I ~ n ^*
aspects. But before passing on to these, I feel bound to dwell on another series of considerations. I am assuming that you accept the method of Hahnemann, that you intend to adopt " homoeopathic practice." What does this involye ? What alteration does it make in your relation to the pro- fession and the public? What duties does it lay upon you ? What provision must you make, and what course of action must you follow, to carry it out aright ? You may well ask such questions ; and I am bound to answer them* Let us pass to-day, then, from the principles of homoeo- pathy to its practice.
I. When Hahnemann first propounded his method, he did so in the ordinary medical journals, addressing himself to his colleagues. He wrote, as he acted, in the liberty which every qualified physician is supposed to have, of doing what he thinks best for his patients, and of expressing his views among his peers. But this liberty, which had been granted to every systematiser who had preceded him, and has never since been refused, was denied to him. The reform in therapeutics he proposed was so great, so sweep- ing ; the mode of treatment he would substitute for that then current so put to shame its complexity, its violence^ its absence of solid base, that the practitioners of his day could not bear it. They silenced him in their journals ; they stirred up the druggists to hinder his dispensing his medicines ; they invoked the arm of the State to forbid the new practice. If any man would carry it on, he must do so secretly. It was outlawed alike professionally and politi- cally.
Nevertheless, it was believed in : it was adopted. Those who dared to adhere to it found themselves excluded from all the associations whereby the practitioners of medicine seek to advance themselves in the knowledge of their art. Membership of medical societies, practice in established hospitals, freedom of utterance in professional journals, was denied them : the recognition of truth to which their reason led them, and the application of it for the good of their patients to which their conscience constrained them» were treated as crimes. Their only wish was to practise freely, in their natural position, what their judgment dictated to be best ; but this was sternly disallowed them. What was the result? As they multiplied, they set up societies, hospitals, journals for themselves, calling these
482 HOMOEOPATHIC PRACTIOE. ^S^I^SmmI
by tlie name of the method to which they were devoted. As tune went on, schools and colleges had to he established to teach the new method, whose very mention was tabooed in the existing educational institutions ; and homoeopathic pharmacies became necessary, where onr medicines conld be obtained, and homoBopathic directories, from which the public could learn who were practitioners of the system.
The consequence is, that homoeopathy has ac(inired an organisation. From a creed it has become a church- The new adherent to it at the present day finds it in this posi- tion, and the first question he has to decide is whether he shall join this church or not. Shall he simply embrace the creed, practising it as far as his patients and colleagues permit, and professing it no more than occasion demands? Or shall he avow his faith, affiliate himself to homoeo- pathic institutions, and allow his name to appear in the Homoeopathic Directo7*y ? Now, I am well aw6ure of how much there is to be said for the former altematiye. Li the abstract, it is the legitimate course to follow. It was the mode of proceeding adopted in every country at the first, until the intolerance of the profession compelled its abandonment ; and each new convert must feel strongly induced to attempt it afresh. But, much as I sympathise with the sentiment which actuates him, I can have no hesitation in advising him to prefer the other course. The organisation of homoeopathy was, indeed, forced upon it ; but, however acquired, it now belongs to it as a body to its soul. The position it has taken up was not of its seeking; but, having been occupied, it cannot be abandoned without fatal misunderstanding. We, who have held the fort for many a day, must continue to hold it until our claims are yielded, and our method receives its legitimate recognition, our mode of practice its due liberty and honour. We cannot do so unless from time to time we receive reinforce- ments to supply the gaps left by age, sickness, and death. The greater our numbers, the better our institutions arc manned and our journals filled, the more respect we shall win for our system, the nearer we shall bring the day when the profession shall be forced to recognise it and to invite us back to free fellowship* Till then, do not weaken the cause by standing aloof from its embodiments. Allow your names to be pl&ced in the Homoeopathic Directory, or ridher, be proud of it as of an enrolment in a Legion of Honour. Seek service in any homoeopathic hospital or
SSSfS'irSSr" HOMCBOPATHIC PBACTIOB. 488
dispenaaiy which may be in your neighbourhood; send caaea to the homoeopathic journals ; ap^dy for membership in the British or other Homoeopathic Society. Every man who acts thus lends fresh strength to the witness we bear to truth in medicine, and hastens the day of its victory.
I know that in the meantime the course of conduct to which I invite you involves heavy sacrifices. Things are not indeed as bad as they were, when to avow one's belief in homoeopathy meant professional and even social out* lawry. But the price is still a heavy one to pay. Such memberships and appointments as you may have you will find it hard to retain, and you will get no more. Con- sultations and assistance will be generally grudged, aften refused. By many of your fellows you will be treated as a black sheep, spoken of behind your back as a fool, if not knave, met face to face with significant coldness. Even .the more liberal-minded, though they tolerate you, will do it with a pity which is often contemptuous. There are, of •eouxse, exceptions to this rule, in individuals, and even in «circlef( — among which Birmingham deserves honourable mention ; but as a rule it holds good. You must run the jrisk of being so treated. But what of that ? Axe you the £rst who has had to suffer for truth — ^to go, if need be, without the camp, bearing its reproach ? Count the cost, indeed, before you make your avowal; but do not let it •deter you from making it. To some extent you will find compensation. Another fellowship will welcome you, other places* of honour and usefulness will be open to you. Still, you will be a heavy loser, and can only incur the loss in the firm conviction that you are thereby serving the cause of truth. This conviction is mine ; I trust it may also be yours.
n. This, then, is the first thing I have to advise — that you avow your new faith in the most practical way, iiantify yourself with its body and not merely its sou!, join its church as weU as profess its creed. And now arises the next question, — ^What are the duties of the new position you have taken up ? In what way do they differ from those of every practitioner of medicine ?
Do you, in acknowledging the truth of homoeopathy, bind yoEurselves to its exclusive practice ? No ; by no means. In becoming (as men will call you) " homoeopaths," you imfre not ceased to be physicians. '^ Physicianus nomen, jMWUVopathicus cognomen," we may say after St. Angus-
484 HOM(EOPATHIO PRACTICE. ^'S^^^'i^,
tine's manner. It is the supreme daty of ns all to do what we judge best for our patients, irrespective of any creed or system. We have protested against the tyranny which has ostracised us because we believe this ''best" ordinarily to be homoeopathy ; and it is not for us to be entangled again with any other yoke of bondage. We must let no one impugn our right of unfettered thera- peutic choice. In allying ourselves to homceopatiue institutions we manfully recognise a truth which has laid hold of us, but which is at present denied and cast out : we in no way determine how far its practical consequences shall reach. Take up this position from the first. Claim to be (as I have said in another place) priests of the one Catholic Church of Medicine, however much the prevailing majority deny your orders and invalidate your sacraments. They force you into a sectarian position ; but let them not inspire you with a sectarian spirit. Assert your inheri- tance in all the past of medicine, and your share in all its present : maintain your liberty to avail yourselves of eveiy resource which the wit of man has devised or shall devise for the averting of death and the relief of suffering. This is the only legitimate ground to occupy, and you should make it plain that on this you stand.
But while desirous of impressing this primary truth upon you, I would remind you that you have duties as ** homoeo- pathicus," and not only as ''physicianus." Duties to your patients, for they will seek your aid as such ; duties to the method itself, under whose name you enlist, and whose advantages you enjoy. The con'elative of liberty here, as everywhere else, is loyalty ; and without such counterpoise it degenerates into mere hap-hazard and empiricism. Our special vantage-ground is our practice according to law, instead of in the ^* unchartered freedom " of which our old- school colleagues boast, but of which the best of them must often tire. Do not readily forsake it. At the outset think even of liberty as little as possible. Children are not the better for being free ; and the same may be said of novices in the method of Hahnemann. Your wisdom at the first is to practise it as exclusively as you can. Let experience, rather than a priori assumption, teach you where it needs supplementing by other means. You will actually do more good to your patients on the whole, than if you began as eclectics ; and you will be acquiring habits of order and precision which will stand you in good stead as you go on*
fiSSSff^TiTS^ HOMCBOPATHIC PRACTICE. 485
I am speaking thus, as regarding men who are about to commence practice in a new locality as avowed homoBO- pathists. There are others, of coarse, who — already in harness — ^must erect their new bnilding within the walls and under the cover of the old. They will begin by treating selected cases with their novel remedies, leaving unchanged the great bulk of their practice. As they leam confidence and experience, they will push their homoeopathy farther on, and let their former expedients drop more and more into the background. At last the latter will have become the exception, and the former the rule of their practice, and the term " homoeopathic ** becomes justly applicable to their position and mode of treatment. They will then have reached the ground already occupied by those who have practised homoeopathically from the beginning. But there will be this difference. They will have learnt what are the exceptions to the rule similia similibus airentur, and what are the auxiliaries with which it must be carried out. No man can know these so well as he who has worked out the subject for himself. Nevertheless, homoeopathic practice as a whole is, regarded scientifically, a vast experiment towards the decision of the question how far likes cure all diseases without the aid of other means ; and the results of that experiment, so far as it has gone, are available for the beginner. Let me briefly indicate them here.
1. First of all, you will remember that drug-giving, however important, is not the beginning and end of the physician's duty. He has to adapt to his patient all natural forces and circumstances within his control — ^heat and cold, light and air and water, rest and exercise, food and stimulus. He has to remove mechanical obstacles, and neutralise chemical or organic infections. You must not call the measures — surgical, regiminal, hydropathic — by which you effect these ends, " auxiliaries ; " you must not imply that they lie outside the ordinary path of medicine. Do not enter upon homoeopathic practice with the thought that all your knowledge and command of natural influences may henceforth be laid aside. You must be — as Hahnemann ever was — ^hygienists, that you may also be healers.
2. This applies to the fundamental duty of the physi- cian, whatever be his medical creed. He must obey the rule " tolle catisam,*' when practicable, before any other ;
486 HOMCEOPATHIC PRACTICE. ^b^,^?^mS
he mast remoye the Icgdentia and supply the juvantia of nature at large. But when, now, the physician praetising homcBopathically comes to his own rule, '' sivdUa ginuHbm curentur,'* he must bear in mind the limitations of it inherent in its own nature. Likes can only be treated by likes, where likes are to be found. Where your patient's trouble is one which drugs cannot simulate on the healthy body, you cannot apply your law. You will remember the instances of this which were suggested when we were on the subject. How can drugs produce anything like the disorder of sensation and function attending the passage of a calculus ? How can they supply analogues to neoplas- mata ? Homoeopathic medicines may do something for such conditions, as every now and then they have done ; but there is no homoeopathy, strictly spesJdng, in their administration. The homoeopathic practitioner is not passing by his law, if in the one case he hushes pain or relaxes spasm, if in the other he melts down the morbid growth by a liquedekcient.
3. But, over and aboye such qualifications and limita- tions, the rule similia similibus may have practical excep- tions— exceptions found to be Jsuch from experience, not necessary, nor such as could be foreseen a priori ; in all probability provisional only, but actual, and to be duly regarded. Are there many, or any, such ? Well, my Manual of llierapeutics expressly contemplates such cases. It is '' according to the method of Hahnemann ;" and of that method it says — '' There may be diseases which lie beyond its possible range ; and still more likely is it that there are diseases which have not yet come within its practical range. Accordingly, our first step must be to enquire what homoeopathy can do — ^as compared with the capabilities of old physic — in each malady that comes before us. What is the answer to such enquiry ? I find only the following instances in which a candid survey of actual practice gives the preference to non-homoeopathiis measures : —
^a. J The use of cold baths in typhoid fever seems to give better statistics as regards recoveries than even oar -own treatment can boast.*
* See Dr. Bakody's report of the Pesth Hoapitftl (BriL Jourm. of HatL, zxxiv. 149.)
b!^a^uvS^'' homceopathic practice. 487
Cb,J The recurrence in relapsing fever cannot be prevented by homoeopatbic remedies ; but can be by anti- septics like the hypomdphite of soda A
ft.) We have nothing to take the place of fall doses of iodide ofpotasgium in tertiary syphilis.
rdj In peritonitis from perforation we must give full doses of opium, as in ordinary practice, if we are to have a chance of saving our patients.
(^e.J In cardiac dropsy we can rarely get the good effects of digitalis without the induction of its primary physiological effect, so raising the arterial tension.
f"fj. Nitrite of amyl is a better palliative in the parox- ysms of angina pectoris than any homoeopathically-acting remedy.
CgJ. The use ot iodide of potassium in aneurism seems outside the range of our method, and is yet a most valuable piece of practice, on which we cannot improve.
rhj. In urtemic coma, measures for relieving the brain of the *' perilous stuff" which is oppressing it — if needful, venesection itself — are of more avail than the best drug- treatment.
These eight, I say, are the only instances I can find in which, homcBopathic treatment being applicable in the nature of things, it is at present so excelled as to be dis- placed by measures of another kind. You will see at once how few they are in proportion to the mass of ills where the balance is just the other way. You will thus be encouraged to commit yourselves freely, with such reser- vations, to the guidance of the homoBopathic law. Let none impugn your liberty, but let all respect your loyalty : so you will witness to the method you profess, and will have the approval of your own best judgment.
m. Such is the counsel I would give you as to the general ordering of your practice. Let us now go more into detail, and see what should be your actual work at the bedside and in the consulting room.
I have spoken of the selection of the homoBopathic remedy. I have shown you that its similarity should be, as far as possible, generic, specific, and individual : I have indicated the parts which generalisation and individualisa- tion respectively should play in the process. Descending
t So Dr. Dyce Brown in Brit. Jcum. of JBom., zxjd. 868.
488 HOMOEOPATHIC PBACTICE. *bSSS!^.^JSp??m!
now from principles to practice, let me advise you to let generalisation predominate in your prescriptions for acute disease. That is, do not let your tlioughts range down the whole Materia Medica, from aconite to zincum (as we used to say ; now it must be from aiies to zizia)^ in search of your simillimnm. Fix them rather upon the group of medicines which general consent has associated with the malady before you. They were first arrived at by the rule similia similibus ; or, if obtained ex usu in morbisy they have seemed warranted a posteriori by it. They have stood the test of long and wide experience, so that you may be sure of their answering to the species — the essence of the disease. Suit them, as among themselves, to the form and stage of the malady ; but do not, without very grave cause, go beyond them in search of a closer similarity, which is too often illusory. Of course no finality is contemplated: new remedies must from time to time be introduced, and old ones extend their known range of action. Leave this, however, to men of krger experience ; as beginners, you had better keep to the ground already surveyed. In the presence of pleurisy, the best thing you can do for your patient is to appropriate aconite and bryonin^ cantharis and apis, arsenicum, sulphur, and hepar sulphurls to the inflam- mation and effusion. If pneumonia is before you, aconite, bryonia and sulphur again, with phosphorus and tartar emetic, comprise the whole ordinary therapeutics of the disease. Some five or six medicines in variola, seven or eight in scarlatina, ten in continued fever, twelve in chronic intermittents (in recent ones four will suffice), are as many as are ordinarily required for your choice ; and our best comparative results have been obtained where — as with yellow fever and cholera — our remedies have been few in number and everywhere the same.
The same rule holds good even in chronic disease, where the disorder conforms to a recognised type. You will get little good, in diabetes, by deserting phosphoric acid and vraniuni, in rickets, by going beyond calcarea^ phosphoric acid again, and silica. But when your patient's narrative has gone so far as to satisfy you that you have to deal with an anomalous case of no definite character, you wilt do well to let your mind work freely among the medicines which the symptoms suggest. Qo upon the plan of exclusion. Test the remedy which first occurs to you by the next symptom mentioned. If you have chosen aright, it
S^^rSei^*'' HOMCEOPATHIC PRACTICE. 489
^11 harmonise therewith : if not it will suggest another, -and the symptom next following will decide between these, or supply a third candidate for your acceptance. So, step "by step, you will proceed ; and when the whole case is before you, you will have obtained as the result of your elimination one, two, or three medicines, which seem well to cover the case. These you will then prescribe, in succession or alternation, as you may determine ; and, if yon have proceeded carefully, you will find them the fundamental remedies for the disorder. They may be with advantage suspended for a time, or even replaced by others ; but you will be driven again and again to them, and ultimately it will be with them — if ever — that you gain the day.
In thus choosing, do not neglect to supplement your memory by reference to the Materia Medica, and to its indices — the repertories. Do not, indeed, be ashamed of -doing so in the presence of your patients, if need so requires : they will not complain of you for taking too much pains. But ospecially when the day's work is over : when a new case has come before you, or an old one hangs fire, — review its symptoms. Look them up one by one in your repertory ; follow the drugs indicated to the Materia Medica, and weigh well what you find. Do not be hasty, or too fondly credulous : examine into the source of symptoms ere you trust them : but if you can safely do so, essay the medicines to which they point. You will thus frequently gain unexpected successes, and will be ever enriching your armamentarium. In acute and typical diseases, the fewer your remedies the better : but beyond this range, you can hardly have too many. It is here, that the mere specificker^ the mere organopathist fails ; while the full method of Hahnemann wins victories which are a continual source of delight.
rV. And now a few words about the choice of dose. I have spoken with sufScient fulness of the general facts and principles of homoeopathic posology. Short of actual ex- perience, you are in a position to judge for yourselves what you will do in the matter. I do not wish unduly to bias you on so moot a question. It would, however, be carrying reserve too far — it would be neglecting your obvious interests, if I failed to give you some practical advice — from an experience of over twenty years — as to the doses jou should commonly employ.
4Q0 HOMOEOPATHIC PRACTICE. ^SSSrf^lflM:
And here, as in the choice of the remedy, I would distingnish two categories into which yoor cases will fall. We have seen that the object of attenuation is two-fold-— to avoid aggravation and collateral disturbances, and to develope the pecoliar properties of drags. Now in the acute, typical disorders — the fevers, inflammations, catarrhs, neuralgias, spasms — ^which constitute the bulk of daily practice, the first-named object < need alone be sought. The medicines with which you combat them are such as are already active in their crude state : your only care need be to protect your patients from their over- activity, to see that their physiological be wholly absorbed in their therapeutical action. For this purpose but moderate attenuation suffices. If you cany in your pocket- case the first decimal of aconite^ baptisia, beUadonna, bryonia, gehemivmt, ipecacuan, iris, nux vomica^ rhus, and gpongia ; the first centesimal of apis and tartar emetic ; the second of arsenicum ; the third of mcrcurius carrosivui, phoaphoruSj and veratrum album; if you reinforce these with a few medicines of like sti*ength to meet special contingencies — ^as hamainelis for haBmorrhage, and camphor for shock and collapse, — you will have a quiverful of shafts which will rarely need augmenting. By further dilution, if need be, at your patient's house you can exactly pro- portion the dose to age, sex, and susceptibility ; and yoa will rarely do anything but pure good.
It is otherwise when you have to deal with chronic dis- order in its almost infinite variety. Your range of medi- cines here is a wide one, and so also must be that of your dose. Of the drugs aunong which you will have to choose many are such as only devclopo active properties after a certain degree of attenuation : such are sulphur^ calcaren, MicUy lycopodium^ iiatnini muriaticum, sepia. Certain actions, moreover, of the more potent, and even of the feebler drugs, belong to them peculiarly in infinitesinial form. I may cite arsetucy pIiosphoruB, and nux vomica in the former category, cliamomilla and coffea in the latter. In my Pltarmacodynamksy when speaking of the dosage of each drug, I have noted these points ; and they may well lead you, as they have led mc, to associate certain potencies with certain medicines, making the two almost as insepa- rable as the words and tune of a song. Sulphur 30 is a definite remedy to mc, dose and all. I know what I can do with it as I know the powers of aconite Ix. So I can say
£^f A^TS» "" HOM(EOPATHIC PBACTICE. 491
of l^copodium 12 and Mica 6, and of many other drugs. I roqoire here, therefore, a wide range of dosage as regards my remedies ; and still more as regards my patients. Their ▼ariations in susceptibility are great ; they require change of potency from time to time as well as of medicines ; the protean transformations of their maladies have to be followed up with corresponding shiftings of means. I do not know that you need go higher than Hahnemann's SOths ; but, as you have thus already got beyond the estimated divisibility of matter, you will himlly be taking a fresh step if you dip occasionally into Dunham's 200ths.
In such affections, then, while not neglecting the lowest preparations, I advise you to rely largely upon the medium and higher — to use attenuation for developing the finer actions of drugs which you desire to bring into play. In prescribing for other than acute disorders, you should always — if possible — do so from a homoeopathic chemist* There are plenty such in this country — intelligent, well- informed men : they have an excellent PharmacopoBia for iheir guidance: you may rely upon them, and should rapport them. The best way of prescribing is to order a drachm or two of the tincture or trituration, directing the proper number (three is a good average one) of drops or grains to be taken at a dose. The tinctures can be thus measured by being dropped into water from the phial ; for the triturations small scoops are provided, holdmg about three grains by weight, which will best be taken dry on the tongue. Sometimes, when quantity is no consideration, and when the convenience of busy men or the tastes of children are to be consulted, you may give the medicines in the form of pilules, or even of globules ; but I confess that I am not fond of these preparations, and do not advise their preferential choice.
Y. A practitioner's medicines form his chief apparatus for practice ; but next come his books. What works, you may fairly ask me, should you add to your library, and what use should you make of them, to enable you to super- add a literary knowledge of homoeopathy to that of medicine in general ?
Well : first of all yon should be well grounded in the j^noiples of our system. You should study Hahnemann's Organon, — ^in which task I venture to think that yon will be helped by reading the lecture on ''Hahnemann as a Medicid Philosopher," in which I havo endeavoured to
492
HOMCEOPATHIC PRACTICE. ^Re^^xS^ulm.
expound the great work of the master ; and yon should follow it np by a thoughtful perusal of the posthumous volume of essays by the late Carroll Dunham, entided Homoeopathy the Science of Tlierapeutics. For an inde- pendent study and presentation of the subject, I may com- mend to you the Essays on Medicine of the yenerable Dr. Sharp. If you will also read at your leisure the Lesser Writings of Hahnemann which Dr. Dudgeon has collected and translated for us, you will have attained a thorough and ficholarly knowledge of the basis of the new method yon intend to practise.
Next, you must possess, in some form or other, the Materia Medica of Homoeopathy — the collection of the pathogenetic effects of drugs with which it works the role, ** let likes be treated by likes." If your means allow, the best way in which you can do this is the purchase of the ten Tolumes of Allen's Encyclopedia. You will have there every symptom which the most untiring industry could collect as resulting from the action of medicines on the healthy, though with the wheat you must take a multitude of tares growing side by side with it till the time of harvest. If a work of such cost is beyond your reach, do not take any form of Jahr*s Manual instead, still less the Condensed Materia Medica of Hering. These compilations arc quite untrustworthy : they give you pathogenetic symptoms with- out enabling you to judge of the nature of their source, and the latter blends with them ^'clinical" symptoms — t.^., such as have disappeared while the drug was being taken — without note of distinction. I have reason to hope that ere long a revised Materia Medica, sound in material, intelli- gible in presentation, and within the reach of all, will be given to the homoeopathic world. Until this is done, I would advise you to content yourself with such expositions of the Materia Medica as have been delivered by lecturers •on the subject, and have found their way into print. Among these I may name HempeFs, Dunham's, and my own ; and I hope that ere long I shall be able to add those which Dr. Pope has been delivering in this school, several of which I have heard with great satisfaction. If possible, -however, procure also Hahnemann's own Materia Medica Puray which we now have in excellent rendering and shape. Its preface and notes alone make it worth possessing ; and though you may not learn much a priori from reading its iists of detached symptoms, yet, when a repertory refers
B^fA^TS^ HOMEOPATHIC PRACTICE. 498
yon to them, yon will have them in their original and only ayailable form.
Of repertories themselves I have already spoken to yon : it only remains that I indicate the best treatises on the homoeopathic practice of physic. By some these are dis- conntenanced altogether, on the ground of the pure indiyidualisation which is conceiyed as governing our therapeutics. To this I need not tell yon that I cannot assent : I hold it on the other hand a great gain that the accredited homoeopathic treatment of the definite types of disease should be set down for the guidance of the beginner. I have worked myself in this field also ; but far more elaborate treatises have been given us by Drs. Bahr and Kafka in Germany, and Dr. Jousset in France. The Science of Therapeutics of the first, and the Clinical Lectures of the last, are available for us in an English dress ; and we shdl all welcome Dr. Dyce Brown's addition to our store, when he gives to the world the teachings on the subject which have so long been valued here. Bead such books through; consult their appro- priate sections when you have to treat each form of disease ; and you will gain strength and light incalculable for your daily work.
In addition to these, take in as many homoeopathic journals as you can afford, from England, from America, and from other countries with whose language you may be acquainted. Take them in, and read tliem — a consequence which does not always follow. Oive those who edit and supply them the support of feeling that their work is appre- ciated ; and reap the utmost benefit of it for yourselves. Dwell in no isolation ; indulge in no self-suiBBciency. You can only live in the life of the body to which you belong : in its growth alone can you grow. You are cut ofi" at present from the wider fellowship of the profession at large ; but you can cultivate the corporate virtues in your narrower circle. The great hindrance to the spread of homoeopathy in the old world has been the lack of esprit de corps among homoBopathists : had it not, indeed, possessed the vitality which bruth alone can give, it had perished long ago in the midst of our dissensions and divisions. I trust that you will not contribute to these, but will rather bring strength to the heart of the body — its centre of life and unity. You will do this as you think more of the essentials of the
Vol. 20, Ko. 8. 2 L
494 INTESTINAL OBSTBUCTION. ^"^^rfSSTttW.
"
method thao of its accidents ; as you caltiTate it for the good of your patients rather than for the filling of your own pockets ; as you count all difference of opinion as to means a small thing in comparison with our common end — ^the promotion of the good cause we have at heart Practise homoeopathy in this spirit ; and you will do your part, small or great as it may be, for the reform in medi- cine which one day will be seen to mark with white the nineteenth century of our era.
ACCOUNT OF A RAEE CASE OF INTESTINAL OBSTEUCTION, WITH EEMAEKS.
By Edwabd M, Maddek, M.B.
Surgeon for the Difieases of Women to the Birmingham HomoBopathie
HospitaL
The following case, in spite of its unfortunate terminatioii» is of so unusual a nature and of such interest, that I feel it to be my duty to write an account of it for the benefit of my colleagues.
Ellen H., age 17, was admitted into the Birmingham Homoaopathic Hospital, under my care, on 7th June, 1882, with the following history : — On Whit Monday (29th May) she was holiday making with friends at Burton and wgs pushed down a small embankment in such a way that she fell upon her face, and struck the ground with the right side of her abdomen. She did not feel hurt at the time, and continued her games, returning home late at night. For the next two days she felt nothing amiss with her, but from the 81st she became constipated, though not in any way alarmed at it. On the Saturday (June 8rd) she went to a fair and ate largely of gingerbread, and the same night she was seized with veiy severe pain in the abdomen, chiefly in the epigastric region though extending right across. The next day, June 4th, she passed with much straining a small amount of dry scybalous motion, but with no relief to the pain in the belly. During the next few days she was treated by a surgeon in her neighboxu> hood who gave her large doses of cathartics, with the only result of increasing her pain and producing vomiting, and on her admission into the hospital she was said to vomit back all she swallowed.
Her condition on admission was that she was in nearly constant pain over the stomach and the transverse colon.
SSSJ^^TMaM?*" INTESTINAL OBSTBUCTiON. 495
and was frequently troubled with empty retching. There was no tumour or mass of any kind to be discoTered in the abdomen, or by rectal examination^ her temperature was nonnal, pulse 76^ and tongue covered with a white slimy for, but quite moist. The abdomen was slightly swollen «nd tympanitic over the transverse colon, but she could bear pressure fairly well.
The treatment adopted was to apply hot poultices or^r the painful part of the belly, to give absolutely no food by the mouth, except now and then a tea-spoonfiil of iced imlk and soda-water, to give nutrient enemas every three hours, consisting of about three ounces of warm gruel with maltme prepared so that the starchy portion woi^d be con- Terted into glucose before injection, as in this way it is more readily absorbed. She was also given opium Ix mj O.2. hs.
June 8th. There has been no vomiting since her admission, and the enemas were retained, but tbe symptom of pain and obstruction remains the same. In the afternoon she vomited about half a pint of thick greenish fluid, but with not the faintest foecal odour. The treatment was continued exactly the same, only that she was now given mux; vomica 2 x mj in alternation with the opivm, one to be taken every hour.
June 9tb. Was in a little less pain during the early port of the morning, but at 9 a.m. vomited a pint and a half of the same green fluid with a very sour smell. At mid-day a tube was carefully passed into the rectum, so as to reach, if not to pass through, the sigmoid flexure, and between two and three pints of olive oil was carefully injected. In about an hour this returned, bringing with it a small amount of clay coloured fences quite softened by the oil. EEhe was in great pain immediately after the injection, and the pain remained more than before, even after the return 'Of it. In the afternoon she was again sick, and brought up about three-quarters of a pint of the same green fluid. To-day the nubdent enemata were returned as soon as iiijected, so she was allowed to take iced milk and soda- water in dessert spoonfuls as often as every half hour, which was very grateful to her, as she was excessively thirsty. The coating on the tongue was to-day brownish yeDow, but the tongue was quite moist. The temperature from the first had not risen above the normal, nor did it do
2 L-2
496 INTESTINAL OBSTRUCTION. ■b^^S^mm.
80 daring the whole course of her ilhiess ; the pulse was this evening 102.
June 10th* She has had scarcely any sleep on accomit of the pain. At 9 a.m. she had an injection of soap and water^ as much as could be got in, though this was not more than two or three pints : this returned within half an-hour, bringing with it a little more of the putty-like forces and a considerable . quantity of the oil which had remained in since yesterday. Between 12 and 1 she again vomited a small quantity of the same kind of fluid as before, and felt constant nausea. The tongue is much cleaner to-day, especially at the tip and edges. The abdomen is still painful all over, and is tympanitic except at the flanks, where it is dull. The iced inilk and soda- water and the medicines were continued the same.
June 11th. Has had a very bad night, no sleep at all. Vomited at 2 a.m. about a pint of the same fluid as before, and with hardly so ofiiensive a smell as that of yesterday. At 10 a.m. she had another injection, though still no more than three pints could be got to enter the bowel ; this returned presently, with no sign of fceces. She was again sick between 11 and 12 a.m.
The abdomen to-day is very hard and distended, and is dull all over except the transverse colon, which is tym- panitic. On careful watching, peristaltic motion can be seen in the distended coils of intestine, the outlines of which are plainly visible through the tense skin. The pain, which still continues very severe at times, is not now referred specially to the epigastrium, but is more in the umbilical region. The tongue continues moist, though thickly furred. The temperature is 98, and the pulse 110. The question of an operation was mooted to-day, but was decided against because the vomit was not stercoraceons, and she was still able to retain a little fluid nourishment, so there seemed room to hope for a favourable termination without one. The medicine, however, was changed to ipecac, Ix., trit. gr. v., every hour.
June 12th. She has passed a very bad night, vomiting incessantly, and has brought up some three pints of a yellowish grumous fluid, with (for the first time) a dis- tinctly fcBcal smell. The pain continues very severe ; she has an anxious haggard look in the face, with sunken eyes and hanging cheeks, and is, in fact, evidently on the verge of collapse. The tongue, however, is cleaner, though very
SSSS^^TTSm"'' intestinal obstbuotion. 497
dry, and the temperature is still normal, bnt the pnlse is Tery feeble and soft, abont 180.
The medicine was discontinned, and ^ gr. of acetate of morphia was injected at 10.80 a.m., and again at 12.30 a.m.
At 8 p:m. I held an anxioas consnltation with my col- I^aes as to an operation, and it was eventually decided to give her the chance which such a procedure might offer, as it was very evident that she could not live long if left alone.
Accordingly, shortly before 4 p.m., assisted by Dr. Wynne Thomas, Dr. Chas. Huxley, Mr. A. J. Aowbotham, and the house surgeon (Mr. F. W. Clifton) I opened the abdomen to search for, and if possible remove, the cause of obstruc- tion. On opening the peritonoeum, the small intestine protruded at once through the wound, and was evidently much distended and congested, but there was no sign of impaction anywhere. On introducing the finger and making a carefiil search among the deeper parts of the cavity, it was not long before I found, immediately under the umbili- cal region and close to the spine, what was evidently a thick cord tightly stretched across the mesentery : to expose and examine this, it was necessary to extend the external opening above the umbilicus, and when this was done the cord was easily foimd, and appeared to be a piece of small intestine, quite empty and collapsed, and very much on the stretch ; on following it up, however, it was foxmd to be a diverticulum from the small intestine, and to be (when stretched) about 4^ or 5 inches long, the distal end of it being bound down by a firm broad fibrous adhesion to the front of the mesocoecum, and it was firmly com- pressing the ileum just above the ilio-coecal valve so as completely to obstruct it. I tied two ligatures round this, one on the fibrous band, and, as there was not room for a second ligature on this band, a second about half an inch from the extremity of the diverticulum, and divided it between the two. Then, as quickly as possible, the intes- tines were replaced, the cavity of the abdomen sponged out, and the external wound sewn up with strong cat-gut ligature. Carbolic-acid spray, 1 in 60, was being played over the abdomen during the whole of the operation. The patient was then quickly taken to bed, and external heat applied all round her, and a little brandy poured down her throat. On recovering consciousness she was able to fiwallow and retain a little liquid food, and did not again
498 IHTE8TINAL obstbuction: ''S^
.1,
vomit after the operation, though at times a little of the same fluid as she had vomited before '^ worked out " of the month without any effort at vomiting. In spite of all we could do, she never rallied^ and died the same evening at 10 p.m.
At the post mortem, whieh we made the following day, nothing beak was discovered, except conclusive proof thai there was no other cause of obstruction than the one which had been removed. The small intestines were fdO of the same yellow fluid which she had vomited, and some had found its way into the colon. The diverticulum /was found to arise from the ileum, about two feet from the ilio-ccBcal valve, and now that it was no longer stretched it proved to be about three inches in length.
I removed that portion of the ileum to which it ifl attached and the codcum with the remains of its fllwons adhesion and hope to preserve it as a dry specimen.
On looking back over the history of this case one cannol help being forcibly struck with one or two things. In the first place it is evident that no kind of treatment, other than operation, however carefully planned and skilfalty carried out, could have had any chance of success ; also that this, the only useful treatment, was postponed till it was too late, for the patient never rallied from the state of collapse into which she had fallen on the morning of the operation, though I do not think that the operation in any way increased this or hastened her death.
Had the operation been performed 48 or even 24 houts sooner, there is every probabiUty that it might have saied her life, but the symptoms were altogether so obscure, and there was no evidence of the extreme urgency which would alone, with most of us, warrant such a serious operation.
It will be noticed that the vomit did not beoome stercoraceous until the last morning, and that so lately as 48 hours before the operation a smidl quantity of retained foBces was brought away by an enema. How then is it possible in such a case to decide when to operate ? It does not appear to be possible to give a satisfactory answer to this, but were I myself the patient, I should mosl certainly desire to be operated upon as soon as the evidence of obstruction was conclusive, and that the cause of it was not proved to be such as to predetermine that an operation was useless. But here again we are met with the difficulty that the cause is so difficult to- find out,, so that I think
SSilfSTS^ INTESTINAL OBSTRUCTION. 499
the role should be to operate in cases of doabtfnl by which I mean, of coarse, diagnosis as to the cause, not the fact of obstraction. True intns-snsceptiony enteritis and the presence of malignant tnmoors are the chief conditions in which an operation would be naeless, and these shoold in most cases be. diacoyerable. Since the time of Dr. Brinton's standard work on Intestinal ObttrtiC' tion, abdominal surgery has taken very rapid strides, so that we now know that, with reasonable care, there is no more danger to be apprehended from an abdominal secti<»i than from an excision of the breast, indeed gynsecological specialists not un&equently open the peritonoeimi for diagnostic purposes, and apparently with complete immunity from harm; so that it is not necessary to observe iJie extreme caution and aversion to an operation which he there inculcates.
As to the treatment which was pursued previous to the operation, I think it will not require apology or explana- tion to those who practise homoeopathy. Opifum was of course ?dthheld in bulk as it was being given in dilution, and when both this and nux vomica fedled to relieve y^cac. was given chiefly on the strength of some remark- able cases reported as having been cured by it, in the same doses as were given here, in vol. 27 of the British Journal of Homoeopathy by Dr. Imbert Gourbeyre.
Concerning the cause of obstruction, it is I believe one of the rarest of the many possible causes of this terrible calamity. A diverticulum from the small intestine is not particularly rare, and appears to be a persistence of an embryonic structure in the form of the vitello-intestinal duct, and is always foimd in connection with the ileum, not &r from its termination; but it appears to be the exception for its distal end to be attached.
Dr. John Struthers, now Professor of Anatomy in Aberdeen, published in 1864 a paper upon this abnormal condition, and gives an account and illustrations of twenty cases in which such a diverticulum had been found, in two of these the distal end was fixed, and in both cases was the cause of death from obstruction ; he also relates a third similar case from the practice of Dr. Pirrie, of Aberdeen, but in all these cases the attachment was to the mesentery opposite that part of the intestine from which it arose ; but in this case the attachment, evidently an old one, was at a considerable distance from its origin, and hence the
500 BEYIEWS. "g^far?^
strangnlation was produced in a different way : for in the cases related by Dr. Struthers^ a loop of intestine had got nnder the diverticnlam and become strangulated, whereas in this case that part of the ileum between the origin of the diverticulum and the coecum would appear to hayo ^ skipped/ so to speak, under the diverticulum and its attachment, so that it was obstructed by being pressed upon close to its entrance into the coecum, between the diverticulum and the psoas muscle, and was not truly strangulated at all.
I have not been able to find an account of any case in which this condition was discovered during life, and cured by an operation, and the question how best to deal with such a condition is not even suggested in any of the books I have been able to consult. There would appear to be three ways in which it might be dealt with : first, to snip through the fibrous attachment, either with or without ligatures, and leave the diverticulum free ; or, as in this case, where the fibrous attachment is very short, to apply two ligatures and divide the diverticulum between them ; or, thirdly, to ligature close to the ileum, and take the diveiiiculum away altogether ; and further consideration convinces me that the third plan, where practicable, would probably the best thing to do, as it not only would relieve the obstruction, but would remove the risk of future trouble, either by a second adhesion forming or the production of an obstruction, or inflammation, from a fruit-stone or any other impaction getting into the diverticulum itself, such as sometimes happens in the vermiform appendix.
REVIEWS.
A Treatise on Disetisss of the Eye, for the use of Students and General Practitioners, By Henby C. Angbll, M.B., Professor of Ophthalmology at the Boston University. Sixth edition. New York and Philadelphia: Boericke & Tafel. London: Triibner & Co. 1882.
The volume before us first appeared in 1870. It has now reached its sixth edition, a fact which alone testifies to its valne. The present edition has, we are told, been remodelled, and, to a large extent, re-written. The rapid advance made in ophthal- mology would alone render this necessary, and Dr. Angell has carefully availed himself of the many researches which have been made of late years in this department of surgery. His descrip* tions of disease are clear, the methods of diagnosis are well given
SSSJ'iSJTB^ NOTABILIA. 601
, Aug. 1, ISn.
and easily tmderstood. The various operations, too, are carefoUy pointed out. But so far as drag-selection is concerned, this treatise is less full and less valuable than we should have expected from a practitioner so familiar vith homoeopathy as is its author. It is a surgical rather than a medical work. So far as it goes it is excellent, and we can only regret that it has not gone much further. At the same time, read and studied side by side with Dr. Norton's Ophthalmic Therapeutics — noticed in our May number — it will be of the greatest assistance to the practitioner, and thoroughly deserves our commendation.
NOTABILIA.
THE BRTTISH HOMCEOPATHIC CONGRESS.
We beg to remind our readers that the Annual Meeting of the British Homoeopathic Congress will be held on Thursday, September 7th, at the Windsor Hotel, Edinburgh, at 10 a.m. The Congress will be opened by an Address by the President, Ih*. Drury, which we are sure will be able, interesting and instructive. There will be three papers read — 1. By Dr. Blackley, on *' the action of diastase as exhibiting the influence of infinitesimal quantities." — 2. By Dr. Walter Wolston, on **a ease of acute nephritis, presenting peculiar features of interest,** •and — 8. By Mr. Deane Butcher, on '' the periodicity of certain diseases, and their homoeopathic treatment." The names of the authors of these papers will be reckoned a sufficient guarantee of their excellence, while the subjects present a happy combination of the scientific and the practical. Dr. Blackley's able and most elaborate researches on the subject of hay-fever ensure us a paper of no ordinary interest and importance. Should time permit after the reading of these papers Dr. Bayes wiU make a few jremarks on the proposed L.H. diploma.
The members will dine together at six o'clock.
The selection of Edinburgh as a place of meeting ought to {guarantee a large meeting. The beauty of the northern metropolis, the *' modem Athens,*' is so familiar to all that it would be out of place to enlarge upon it. Should there be a rara avis in our ranks who has never been in Edinburgh, we advise him to embrace this opportunity of seeing one of &e most beautiful cities in the world, one, moreover, which is full of the richest historical associations. The Windsor Hotel, in which the Congress is to be held, is in the most central position in Edinburgh, and we hope that the members will not be lured away from the business in hand by the great attractions of this charming city.
We trust that all who are not unavoidably prevented by calls .of practice, will make a point of being present, and render the meeting a success worthy of the city in which it is held.
602 NOTABILIA. '^SSSl.^yg^
THE AMERICAN INSTITUTE OP HOMGBOPATHY.
T&£ Annual Meetings of this body were held at Indianapolis, June 18th to 16th inclnsiTe. Every State in the Union was wdL represented.
The Rev. E. A. Bradley having invoked the Divine blessing on the proceedings, the members were welcomed to the city in which they were assembled by the Mayor, the Hon. D. W. Grobb, and by Dr. Corliss, representing the Medical Society of the State. These courtesies having been acknowledged, the President, Dr. Breyfogle, proceeded to deliver the Annual Address.
He commenced by referring to the interest taken by the public in the progress of medicine, as seen especially in the attention paid to sanitary science. On the influence exercised by public opinion he said —
'' Public opinion may seem at times to deal unjustly, but in the main it is nearly correct, and medical science to-day owes more of its advancement to this cause than to all the accumulated. wisdom of the medical priesthood.
'* It is to a great extent due to this fiust thai homoeopathy occupies its present high position. An intelligent public^ impressed with the fietct that it was at times compelled to take medicine, determined to take as little as possible, and seemed ready and anxious to adopt a treatment which Hahnemann had proclaimed to be successful in curing disease without the neces- sity of hazardous measures. The people cared less for the philosophy of Hahnemann's particular method than for practical results, and believing success to be the test of merit they have continued to encourage it with liberal support and patronage, until its influence has been felt throughout the entire civilized world. Its practitioners have not been idle, but gratefdl for such generous encouragement, they have made every effort to perfect the new system of medicine and to prove themselves worthy.'*
Having noticed the influence public opinion has had upon the old system of medicine, he said —
" It is indeed, a golden opportunity for medical truth. If we stand flrmly by our principles ; if we tune our instruments alike, discard mysterious platitudes, and throw wide open the door to investigation, the best of them will, one by one, be forced to enter our ranks, accepting the law of similars, and assisting ub in placing the honoured name of Hahnemann where it propeify belongs in the history of medicine. This is inevitable. Public opinion will not tolerate a base and transparent imitation. But. if, on the other hand, we do not stretch forth the hand of liberality while challenging the most searching investigation, if we make no kindly effort to bring them within our fold, they may one day dispute with us the rich inheritance left by E^hne- mann, and perchance leave us with nothing but the name homcBO- pathy, while they retain the substance."
l^^TS^ NOTABIUA. 608
Br. Breyfogle then showed how great would be the adrantages of harmony among medical men holding different views in therapenties in advancing surgery and sanitary science.
Passing next to the consideration of the progress of homoeo- pathy, he referred to the International Homoeopathic Convention, held in London last year, noticing the speedy production of the tranaactians as an illustration of the energy and ability of the I^reaident, Dr. Hn^^ies. In concluding this portion of his retrospect, Dr. Breyfogle said —
*' The hospitality extended the visiting brethren was most eordial and lavish. Societies and individuals alike seemed vying with each other to render attentions that actually made 00 forget that we were in a foreign country and among strangers. There were pleasures that will live and keep fresh in our hearts while all else grows old and fieided.
" In many respects the International Homoeopathic Congress was a model medical meeting. Through the wonderful executive ability of its presiding officer, a brid synopsis of each paper was presented, and the discussions thereupon were led by regularly appointed debaters who had previously read the fall text of the pikers under consideration, thus avoiding confusion while insuring full criticism. The American Institute would do well to imitate the example— and, indeed, any medical society would find it greatly to its interest to adopt this plan — thereby saving the time usually consumed in reading lengthy papers and affor&ig greater opportnnity for thorough discussion."
New works on homoeopathy, published in America during the past year, the state of the hospitals and the colleges were reported on, and the improvement which has taken place in the standard of medical education and examination described.
The affiurs of the Institute were next considered, and the institution of a bureau of education and one of pharmacy was advo- cated. The President also suggested that the bureau of Materia Medica should undertake the publication of a condensed Materia ICedica, and concluded an Address, which was received with well- marked satisfaction, by noticing the gaps which death had made in the ranks during the year.
To give a foil detail of the business done by the Institute during the four days of the session is out of our power. One <Kr two points only can we notice.
Dr. Talbot, the Chairman of the Bureau of Organisation, Begistration, and Statistics, made a most interesting report, of which the following is a trammary. There are 7,000 homoeo- pathic physicians in the United States, and 278 institutions connected with the development of homoeopathy ; four national societies report 1,069 members; twenty-six State societies report 1,788 membars ; of one hundred and three local societies edxty-six report 2,856; of thirteen olubs, seven report 97
504 NOTABIUA. ^'SSSL^jSST^
BtmiBWt Aug. 1, IflBS.
members ; of twenty-three general hospitals, eighteen report 1,268 beds ; fifteen of these last year treated 6,676 patients ; and the estimated value of eleven of these hospitals is (770,500 (i^l54,100). Of thirty special hospitals, fifteen report 859 beds ; and nine of these treated, last year, 10,617 patients, of whom about one-half were confined to tiieir beds ; and the cost of ten of these institutions was $1,006,000 (Jg201,200). Of thirty-nine dispensaries, twenty-seven report, last year, 111,469 patients, and to these have been furnished 256,589 prescriptions. Twelve medical colleges have had 1,267 students, and graduated 421 physicians this year, and 5,680 since they were founded; sixteen journals have published, this year, 9,748 pages.
A very important and interesting discussion on vaecination culminated in the adoption of a resolution proposed by Dr. Talbot, urging the intervention of the Government to protect the profession and community agidnst the propagation or sale of impure virus.
From the report of the committee on legislation, it appears that the Surgeon- General of the Navy has consented to the admission of homoeopathic practitioners as surgeons in the navy ; while the corresponding army official has refused to engage the services of homoeopathists.
The report of the delegation to the International Homoeopathic Convention was presented by Dr. B. W. James, who among other pleasant things said, ''that an American homoeopathist could never imagine the hearty hospitality of his English brethren until he had actually experienced it.'* [We hope that many will, after this, endeavour to make ** a proving *' of it. — J^:d. M. H. R.]
The subject of triturations was discussed at much length, and the impurities noted were, we regret to say, both frequent and startling.
At the banquet we are gratified to find among the toasts " Our Friends in Old England,*' proposed by Dr. J. P. Dake.
Niagara was selected as the place of the next meeting. We do not observe, however, that any date was fixed. Is it not possible that, were the meeting to take place about the 15th of August, some of our colleagues might be induced to make a trip to Niagara, their autumn hoUday? Eleven days, and probably less, would suffice to accomplish the voyage firom Liverpool. What could be more refreshing, what more delightful, than after a sail to New York, to go up the Hudson river to Albany, md then by rail to Niagara, returning through Lake Ontario and down the St. Lawrence, through the thousand islands to Montreal, and then through Lake Champlain and Lake George to New York.
Dr. B. W. James of Philadelphia, was elected President, and Dr. 0. S. Runnels of Indianapcdis, Vice-President.
nS^A^u'SS:^ COKRESPONDBNCB. 506
TESTIMONIAL TO DR. HARPER. Oh the 80th Jnne a most gratifying presentation was made to Dr. Harper, late of Windsor fwho has recently succeeded Mr. Cameron in his practice at Hertford Street) by those who have been his patients during the last twenty-five years. A report of the proceedings is in type, and will be pnbhshed next month. We regret that the nnezpected length of some articles pr^lnde its appearance in onr present number.
LEGACY TO THE LONDON HOMCEOPATHIO HOSPITAL. It gives us much pleasure to state that by the will of Miss Mar- garet Trotter, late of 9a, Upper Brook Street, Grosvenor Square, and of the Ch&teau la Rocheville, Pecq, near Versailles, which was proved on the 9th of June, this institution becomes entitled to £8,500 Midland Railway Stock, which, at the price of the day, is equal to about £4,700.
BRITISH HOMOEOPATHIC SOCIETY. At the annual assembly of this Society, held on the 29th June, Dr. Dbttbt was elected President, and Drs. Blacklet (Man- chester) and Cabfbae, Vice-Presidents. Dr. Black was unani- mously appointed Treasurer, vice Dr. Hamilton resigned, and Dr. HnoHEs was re-elected Secretary.
CORRESPONDENCE.
DR. KER ON THE PROPAGATION OF HOMOEOPATHY. To tJie Editors of the ^^ MoniMy HomcBopathie Beview,*'
Gentlemen, — ^Dr. Eer's letter in the last number of the British Journal of Homceopathy seems to require earlier notice than it could have in the next number of the journal in which it appeared, so I trust you wiU allow me space for a few words thereanent in your August number.
Of Dr. Ker*s sincere desire to promote a knowledge of homoeopathy, no one can entertain a doubt; that he is thoroughly convinced that this will be most rapidly brought about by the means he suggests, and that these means are feasible, I am sure that he is equally confident. At the same time I am fully as certain that he is in error, and that if it were possible to exclude the word homoeopathy and its derivatives from medical parlance, the probability is that homoeopathy itself would suffer extinction.
Dr. Drysdale may be right in supposing that the ultimate adoption of homoeopathic truths by the profession will be coincident with the extinction of the name, and that this will constitute its final triumph, and yet Dr. Eer's proposals be quite mistimed, to say the least of them. I do not myself believe that the word homoeopathy will ever die out. That some of its derivatives will is possible enough, when the time of its
506 GOEBESPONDENCE. ^'SS^^f^J^
ultimate adoption arrives. Poeeibly the word Chrifitiaii will die out when the millemdnm arrivee, when, that is, all men aai OhristianB, bnt not before.
Oar business at present is to achieve the ultimate adoption of homoBopathic truths. To imagine that we have arrived at that point in medical history is very unwise. We have not done anything of the kind. We have made considerable advances towards it of late years, it is true, and it has been by keeping homoeopathy as such constantly to the fore that these advances have been made.
Dr. Ear seems to think that a reconciliation between the dominant section of the profession and ourselves could be brought about by '' a surrender of the word homceopaihy and a& its derivatives — a surrender of the name and not of the thing." But who has made such a proposal, and who has authority to make such an one ? The nearest approach to anything of the kind was Dr. Wilks' resolution at the College of Physicians some six or seven months ago.
Now, the wording of this resolution gave no promise '' that all the rights and privil^es, the honours and distinctions at its [the general body of medicine] disposal will be open to the deserving amongst us,'* or that <' dubs, societies, journals, hospitals, and professional offices, libraries, &c., from which we are at present effectually excluded, will be thrown open to us," if we ceased to designate our method of selecting drugs as homoeopathy ! Nothing of the kind I
But supposing that it did so, the discussion it elicited proved conclusively that no result of this sort would follow our sub- mission. And, again, in its comments upon the meeting the Lancet repudiated such a concession entirely, as it has done over and over again.
The *' consummation " pictured by Dr. Eer in the extcaots I have made from his letter is certainly one " devoutly to be wished," and, moreover, it is one certain to be arrived at, but not yet. We have a great deal of hard work of the propaganda, the missionary, order to do before that time arrives. We muatv in short, convince the whole body of the profession that hooKBO* pathy is true. Can we do this by never alluding to such a thing as homoeopathy ? By so doing, we shall but strengthen tho0e who differ from us in their differences ; we shall but make than doubt our sincerity ; we shall but lead them to feel that there can be nothing in homoeopathy after all that is worth contending fpr.
'* What we desire and pray for is/' writes Dr. Eer, <* ttie conversion of medicine to belief in the homooopathic law. Half a century's endeavours to this end have signally failed to efEeet this." If they have so failed, it haa been because they have not been pressed forward as earnestly and enthusiastically as ifaey lid have been; because they have been hampered by too
JSSSJf^iTS?** COBBB8PONDBN0B. 607
:great a regard for the feeliiigs and mterests of opponents, who baye shown none for ottr feelings and interests, because they have been too mooh sacrificed to the dictates of professional etiquette.
In the United States, where homosopathj has been pressed forward regardless of all interests, except the interests of homceo- pathy, more than one-third of the practitioners of medicine are honuBopathists. This is a pretty good stride to have made towards the conversion of medicine in half a centory.
Dr. Eer's new method of proselytism is, then, I regret to be obliged to conclude, impracticable, and, indeed, impossible. Not a journal, not a club, not a society, not a hospital will give us a chance of trying it. We must stQl, for a time, be content to be as missionaries in a heathen land, and must redouble our energies and diminish oar scruples in making homoeopathy more widely known, and its influence more generally felt.
I am, Gentlemen. Yours fluthfolly, London, July 6, 1882. J. Smith, M.D.
" WICKED HOMOEOPATHIC ENGINEERING."
To the Editors of the ** Monthly Honutopathic Review,*^
GfiNTLBMZN, — ^Permit me to reply to a note on page 488, of your issue of July, 1882, from the pen of Dr. F. Black.
Dr. Black is quite right in the fact that, in a pamphlet of mine called Ttco Sides to a Question, published in the year 1860^ I wrote, " Observe, I object to the title of homoeopath. Its assumption savours of sectarianism. I object to any other title than that of physician, or at most, of physician practising homoeopathy."
I need scarcely remind Dr. F. Black, that in 1860 I had been a homoeopath for a little over Viree years^ and had scarcely fairly «ome out of the Egyptian darkness of the old school Twenty-two years^ further erperience, have made me ding more firmly to the revered teaching of Hahnemaim, and I now glory in the name of homoeopath, as it is our right and a duty to do.
Like all young converts, I was then but half a homoeopath, now that I have added txcefUy-two years' further experience in the course of my practice of the blessings of homoeopathy, wideh are indeed inestimable, I should esteem myself beneath contempt did I not uphold my testimony to the grand beneficence of the homoeopathic law, and did I not glory in proclaiming what I beheve to be the greatest discovery in medioed therapeutics. I would that all who have benefited by homoeopathy would equally acknowledge this great law of drug healing, instead of openly despising tiie name and thus lowering the flag.
Yours very truly,
WiLLiAu Bates, M.D.
Brighton, 17th July, 1882.
608 CORRESPONDENTS. *b^J,^SS!Twb!
To the Editors of the ''Monthly Homceopathic Beview.'* GkENTLEMEN, — As jOQ hav6 kindly Bhown me Dr. Bayes' letter in M.S., I wish to remind him that the sentence he qnotes, though originally published in 1860, was brought by him specially to my knowledge in 1866, that is ten years after he had been practising homoeopathically. The moral of my tale was, Dr. Bayes having held snch views for ten years opght, in charity, not to have made the " zigzag '* eharges. Francis Black.
SPURIOUS IMS VERSICOLOR. To the Editors of ike *' Monthly Homaopathic Review"
Deab Sirs, — ^We are accustomed to meet with snch snbstitn- tions of species of medicinal plants as those of Spigelia maryUmdica for S. ArUhelmiaf and (EnarUhe crocata^ and other umbeUates, for dcuta virosa, but recently a serious mistake has been made by some of our pharmacists with regard to Iris versicolor.
Doubtless from a want of knowledge of the various species, and encouraged by the demand for cheap medicines, instead of import- ing the tincture from North America, the root of some cultivated species (probably Iris germanica) has been employed in making it, and the results of its action are likely to be very disappointing, if not dangerous.
The spurious tincture has a deep brown instead of a straw-yellow colour ; a violaceous odour resembling orris root (Irisflorejttina), and is not disagreeable to the taste. It is very di£ferent in these qualities from the genuine tincture, which has a nauseous odour and taste.
Yours faithfully, E. Gould & Son.
69, Moorgate St., E.G., July 19th, 1882.
NOTICES TO CORRESPONDENTS.
«% We cannot undertake to return rejected manuteripte*
Invalids going to Austbaua. — One of onr coUeagaes,. who is sailing in a first-daBS ship to Sydney and Melbonme in September, will be happy to take charge of invalids, without any fee. We shall be happy to reoeive any applica lions.
Dr. C. T. Neatby requests ns to state that he has settled at Ventnor.
Commimications, Ac, have been reoeived from Dr. Black (London) ; Dr. Hughes and Dr. Bates (Brighton) ; Dr. Gibbs Blaxx and Dr. S. M« BfADDEN (Birmingham) ; Dr. Matvey (Bradford).
BOOKS RECEIVED.
T?ie British Journal of Homaopathy ; The Hcmaopathie World ; The Chemist and Druggist ; The Students^ Journal; The Indian Hcmaopaikic Review ; The Calcutta Medical Journal ; The New York Medical Times ; The New England Gazette ; The Hahnemannian Monthly; The CUnieal Beview. St. Louis; The Medical Counsellor; BibUotKbque Homaopathique; AUgemeine Horn, Zeitung ; Rivista Omiopatica, ^^____^„
FapeiB, DispeoBaiy Beports, and Books for Review to be sent to Dr. Bops, 21, Hennetta Street, OaTendiBh Square, W.; Dr. D. Dygk Bbowk, S9, SeTmoor Street* Fortman Square, W.; or to Dr. KsmrsoT, 16, MJontpelier Bow, Buokfaeatfa, B.B. Advertiaements and BnaiiieBB communications to be tent to Mmhs. E. Ogdld St Sovy 69, Moorgate Street, E.C.
^riS^^^JfcT?^ THE APPBOACHINd CONGRESS. SOQ*
THE MONTHLY
HOMCEOPATHIC REYIEW,
^
THE APPROACHING CONGRESS.
Thirty years have passed away since the last Congress of medical men practising homoeopathy was held in Edinburgh* Of those who were present on that occasion, more than half have departed from amongst us. Of these the most conspicuous is the distinguished physician who occupied the chair — the late Professor Hendebson — a man of pro- foxmd learning, skilful in the exercise of his art beyond the large majority of his contemporaries, thoroughly convinced of the truth of homoeopathy, unswerving in his defence of the therapeutic doctrine he had tested with care and dili- gence and practised with success — one who has left behind, him an example of constancy and fidelity to truth which can never be too frequently reflected upon. The paper he read before the Congress on that occasion on pneumonia i& a model of therapeutic research. The extreme caution it displays in dealing with that most difficult subject of medi- cal enquiry — ^therapeutic statistics — ^the obvious justice of the inferences he drew from the results of his many-sided examinations of the questions before him, this essay had an influence on the subsequent progress of homoeopathy which few other essays have had.
On taking the chair and opening the business of the meeting, Professor Hendebson addressed the members.
yoL26,No.9. 3 K
610 THE APPROACHING CONGRESS. "^^^S^tTwaL
present in a few well-chosen words, words which express so folly and so thoroughly the advantages which sach a meeting o£fers to all who are willing to take the trouble of attending it, that we cannot do better than recall them here.
After welcoming his professional brethren to Edinburgh, Dr. Henderson went on to say : —
''The institntion of scientific associations for the pnrpose of meeting periodically at different places ma^ be regarded as peculiar to this busy, enterprising age, and the purposes they serve are both important and manifold. If they do not actually plant the lamp of science where its light had been previously Tinknown, they at least refresh it with oil and make it bum brighter in the places they visit. They awaken a public interest — a popular interest — ^in the progress of useful knowledge more than local, stationary, and more familiar societies usually do, and by bringing together labourers from different parts of the field of science and from different countries, they quicken the interchange of new truths, and enliven their devotion to iheir favourite studies ^y affording them opportunities of intercourse with persons of kindred tastes. These advantages are conmnm to all such associations, but our advantage is peculiar to our- fielves in the existing circumstances of our profession, and, indeed, of medical science itself. I have no intention either to deprecate the hostility of those who treat us with bitterness and misrepresentation, or of entering into any detail on the subject. I advert merely to that speciality in our own condition which makes meetings like this peculiarly pleasant and profitable. Scattered as we are, each in our own place, singly or in small companies, over the three kingdoms, exposed everywhere to the treatment I have referred to, it is exceedingly encouraging and delightful to behold, as on this occasion, so many who maiTit«n the same just principles — so many whose names are funiliar to us as the defenders of those great truths which we all knov from experience to be by for the most important in the vhob range of medicine. 'As iron sharpeneth iron, so does the
lt^^S^!T^ THE APPBOAOHING CONGRESS. 511
eonntenance of a man that of his friend/ is a proTorb the tnith of which mnst be felt by all of us on an occasion like this. I feel satisfied that, when this Congress is dispersed, each will retnm to the sphere of his arduous and responsible ayocations with a zeal and a resolution strengthened by the opportunity he has had of personal intercourse with so many that hold the same great principles in medicine and have the same experience as himself."
We trnst that any who may have entertained doubts as to whether they will go to Edinburgh next Thursday, and fiome of those who have already decided that they cannot «)nveniently do so, will, on reading Dr. Henderson's brief address, feel that it will be so good for them to be present that they will at once prepare to go, and determine that nothing shall prevent their doing so.
The opening address was delivered by Dr. Dbtsdale — then as now one of the foremost amongst the scientific workers in the field of homoeopathic medicine. The so- called *' high-potencies " of Jenichen were then a novelty, and Dr. Drysdale explained the fact of their having been succesfifully used, by showing that these '^ dilutions were really not higher than those originally in use, or were even, in many cases, quite low." Since that time, the ^' high- potency " mania has been carried into far loftier regions ; and, curiously enough, with somewhat similar results ; for Dr. Bubdioe, of New York, has shown that the " high- potencies" of Dr. Swan — ^which run into millionths — rarely reach, in fEict, beyond the tenth, and are liable to be much lower.
Dr. Dbtsdale also noticed another novelty which had recently been interesting and agitating the minds of homoeopathic practitioners for a brief space^ — the magneto- scope of Mr. Butter, of Brighton — an instrument designed to afford a physical demonstration of the presence of infini-
2
512 THE APPBOAOHING CONGBBBS. 'b^.^SlTmb!'
tesimal particIeR of matter. To-day, we have the parallel of the magnetoBOope in the nenranalysis of Professor jAEaEB ! This, as has been shown recently in oar Review by Dr. Peboy Wilde, has as little claim to oar confidence in proving the presence of matter in infinitesimal propor- tions as had Mr. Butter's magnetoscope. The very natural desire which must ever be present amongst us to be able to demonstrate physically the presence of that of which we have, in the meantime, only physiological and clinical evidence, will probably ever and anon lead to the supposed discovery of some means for gratifying it. The history of these two efforts should, however, render us both sceptical and cautious in approaching the investigation of any proposal having a similar end in view.
For nearly the first time, we believe, in any public assembly of homcBopathic practitioners, the question of so- called ''auxiliaries" was broached in Dr. Dbysdals's paper, and well discussed afterwards. This is a subject which has been thoroughly sifted since, and the praeticat advantages of palliatives in a few conditions are now con- tested by none save those who are prepared to sacrifice everything to the maintenance, whether in season or out of season, of a theory.
The dose was, of course, a subject of debate, and was introduced by Dr. Dbtsdale, and again, in a special paper upon it, read by the late Dr. Pftt.TiTps. Much as has been the light since thrown by experience on this important* question, we doubt if we are any nearer to a real principle of what we may term '' dose-selection " than we were then. And when we consider the many and varied circumstances which must infiuence the choice of the most suitable dose, this is not to be wondered at. We certainly know much more, surely, than we did then, that, when we keep outside the physiological dose, we are in a path of safety. That
IK^^PtTSM?* THE APPBOAOHING OONQRESS. 513
the amount prescribed is then sufficient for cnratiye pur* posesy and one not likely to excite aggravations.
Referring to the character of the opposition to homoeo- pathy which was prevalent at that time^ Dr. Dbysdalb described it in terms which would equally well apply to the bulk of that which is written agaiust our therapeutic method to-day. Speaking of our opponents, he said: ^'From a few passages gleaned &om the Organon, they dress up a phantom which they style homcBopathy, and when they find that our practice is something very different indeed from that, they charge us with fraud, and with practising under fEtlse pretences." So it has ever been, so is it still ! *^ HomoBopathy is extinct.*' ** Nothing remains but the name." ** Those who profess to practise homoBo- pathy do so merely in appearance." With these and simila]^ false platitudes, the medical Press of to-day hugs the delusion that they have ousted homoeopathy altogether; and that no investigation of the subject is incumbent upon them!
Such were the chief questions of interest thirty years ago. Briefly will we now refer to those which will be raised on Thursday next.
Of the subject of the President's address, we can, of course, say nothing, but that it will be interesting and suggestive we have no doubt. A President's address does not, however, afford matter for discussion during the meeting, and therefore our ignorance regarding the subject with which it will deal is a matter of less importance.
Dr. BiiAOiOiBY, of Manchester, will, in his paper on ** The action of diastase, as exhibiting the influence of infinitesimal quantities," illustrate a subject which has of late attracted a large amount of attention, viz., the physical demonstration of infinitesimal particles of matter. Clinical evidence of the power of infinitesimal doses of medicine to
614 THE APPROAOHINa CONGRBBS. "^S^j^Tim!
modify the health of the body, we have in abundance ; and to the practitioner such evidence is all-sufficient; bntat the same time we must not nnderrate the fact that physical evidence of the presence of matter is very welcome to the cantious observer, and greatly strengthens oar position as therapentists. We therefore anticipate in Dr. Blackley's essay, not only an interesting and usefol subject for dis- cussion, but a contribution of considerable importance to the advancement of homoeopathy.
Dr. WoLSTON, of Edinburgh, will, in his clinical illus- tration of acute nephritis, provide a text for a discussion of a thoroughly practical and very important character. We cannot refer to this subject without recalling to memoiy . the very striking and thoroughly recorded cases of the same disease by the President of the last Homoeopathic Congress held in Edinburgh. They appear in the British Journal of Homoeopathy, and are models of what clinical observation and research should be.
On re-assembling after luncheon, the Hahnekakn Society's report will be presented. This, we are glad to know, will show a greater degree of life and activity, and a nearer approach to the accomplishment of a substantial instalment of useful work, than any report that has been issued for some time has done. After this has been read, Dr. Hughes will introduce the subject of the revision of the Materia Medica, in order to elicit the opinions of the members as to the most efficient method of carrying it out.
This report having been discussed, the officers for the next year will be elected, and the place of the next meeting be decided on. We hope that in making the next fixture, historical associations will be less considered than the convenience of the majority, and that beauty of situation may yield to the more prosaic but practical claim of accessi- bility by rail ! Edinburgh is, we fear, sufficiently distant
SSSJfs^rSsa!^' THE APPKOAOHINQ CONGRESS. 515
&om the majority of homoeopathic practitioners to render a large meeting dnbions, and we tmst that next year those, whose time and opportunities for moving about are limited, — ^that is to say the majority — ^may have an opportunity of taking part in the deliberations of Congress.
Executive business being concluded, Mr. Deane Butcheb, of Windsor, will read a paper on " The Periodicity of Certain Diseases, and their Homoeopathic Treatment." In bringing this subject before the Congress, Mr. Butcheb is performing a very useful service. The periodicity of disease is a more or less generally acknowledged fact, and has indeed been made the basis of a system of medicine. We allude to Dr. Dickson's chrono-thermal system. It is also a fact, with which we have to reckon in forming a prognosis, and likewise in prescribing, and that not medicine only, but such general rules as it maybe necessary to direct a patient to follow. The subject is one, therefore, which is full of interest and of much practical importance, and one which Mr. Butcheb is well qualified to handle with advantage.
Should the time have allowed. Dr. Bayes had intended to make a few remarks on the diploma, which last winter the London School of Homoeopathy proposed to confer upon such of its students as passed an examination in homoeopathy, but we understand that he has since deter- mined not to do 80.
Additional interest will, we are happy to be able to state, be given to this Congress by the presence of several American colleagues, who are now in England or on the Continent. Among them are Dr. LudiiAm, and Dr. Vilas, of Chicago, and Dr. Bbanstbup, of Vincennes, Indiana. We are sure that they will receive a warm welcome, and add greatly to the pleasure all may expect to derive from a trip to modem Athens on the 7th of this month.
516 BBITI8H MEDICAL ASSOCIATION. "SSl^SfTlM
BerieWy Sept, 1| 1981.
While the distance most will have to travel in order to attend the meeting renders some misgiyings as to the strength of the force that will he present inevitable, we nevertheless have reason to believe that homoeopathy will be well represented, and that all who will make the small sacrifices necessary to be at the Congress, will be well rewarded for having done so.
THE BEITISH MEDICAL ASSOCIATION.
Tms Association has, dnring the past month, been engaged in celebrating its Jnbilee at Worcester.
The opening address of the President, Dr. Stbange, of Worcester, formed a very interesting review of medicine daring the lifetime of the Association. That of Dr. Wads, who delivered '^ The Address in Medicine," bore on some- what similar topics, bnt was perhaps more exclusively therapeutic in its character. Most striking was the picture drawn of the position of blood-letting, as a remedy in 1832, and the slight regard in which it is held now. To the late Dr. Mabshall Hall is attributed the credit of having been the first to endeavour to dethrone the lancet from the high
place it had during many years held in the repertory of the physician. Mabshall TTat.t. wrote on the subject for the first time in 1820. Many years, however, before that date HAHNEMAinf had denounced blood-letting, as not only useless, but injurious, and he in his turn had been denounced as a quack and an impostor for so doing. But he had done more than point out the &llacy of the popular remedy of the time — he had supplied its place. In describing Aconite as all efficient in inflammatoiy fever, he had performed a service to medicine which is being felt all the world over at this hour. In his criticism of the therapeutics of fifty years ago, Dr. Wade abundantly justified all the hard words in which it was described at the time by Hahnemann.
During the last few weeks we have repeatedly heard that the Jubilee of the Association would be celebrated by the
B^SJTsStTwB?* BRITISH MEDICAL ABSOOIATION. 517
display of a determined front to homcBopathy, and that the views announced at Byde by Dr. Biustowe and Mr. Hutoh- ZNSON woold be met with a very practical repudiation at the hands of the members ! What happened ? The report of the Ciouncil stated that the question of homoeopathy had occupied much of the time and thought of its Committee. They have, as far as possible, rendered it impossible for a professing homoeopath to enter the Association. ^* Against perversion to homoeopathy/' the Committee of Council add, '*' they are powerless at present except by expulsion of the offender, and this under present circumstances they con- consider unadvisable," as being beneath the dignity of a liberal profession, and secondly, as giving needless notoriety to the offender. Common sense of this kind was most repulsive to Mr. Nelson Hardy, of London, and a perfervid Irishman from Liverpool, one Dr. Fitz Patriok. These gentlemen moved an amendment urging the expulsion of every one who acknowledged that homoeopathy was true. Mr. Husband, of Bournemouth, who described himself as strongly opposed to homoeopathy, both theoretically and prac- tically— and who might truthfully have added that he was both theoretically and practically ignorant of it — opposed the amendment, and in doing so he was supported by the whole of a large meeting save some fourteen members !
Not a word was mooted against consultation or any sort of professional association with homoeopathists. All that the Association could in 1882 bring itself to enact was that they would not admit a homoeopath if they knew it ! The difference between the course pursued on this question in 1852 and 1882 is indeed great! The progress the Association has made in thirty years is not inconsiderable, and such as it is we congratulate its members upon their having made it, and trust that in another thirty years they will have gone a good deal further in the same enlightened direction.
The following comments on the address of the President, which we reprint from a Glasgow newspaper — The Evening Citizen p{ the 11th ult. — are both interesting and a propos*
Dr. Strange explained the very wide basis on which the British Medical Association was founded. The liberality of its consti- tution may be said to have been the leading theme on which he descanted. To quote his own words — " The first and noblest of its characteristics at the present time was liberty — freedom of thought, speech, writing, and teaching." There was here neither
618 BRITISH MEDICAL ASSOCIATION. "^S^f^ifSS!
dnbiety of language nor limitation of scope. It may be, however, that Dr. Strange was giving forth his own views rather than the views of the Association. At aU events, the proceedings which immediatelj followed supplied rather an awkward commentaiy on the declarations of its President. The report of the Goonefl for the past year was read. It was a satisfactory document; bat Mr. Nelson Hardy, of Dnlwich, in moving its adoption, added a " rider " to the effect that the practice of homoeopathy should render a member no longer eligible. Over this proposition an exciting wrangle took place. In its final form Mr. Hardts amendment asked that the adoption, by any member of the Association, of the practice of homoeopathy, or of any other designation implying a special form of practice, should ipso facta exclude him from membership. The Council, however, had obtained a legal opinion that although they might prevent any person from becoming a member, they had no power to expel him after he had been regularly admitted. Ultimately the report vras adopted simpUciter by a large migority, only fourteen hands being held up for the amendment. Neyertheless, the feeling against homoeopathy was strongly demonstrated, though the amendment was rejected on technical grounds, and against tlua display of hostility we have, of course, nothing to say. Some eminent physicians have, it is true, become converts to homoeo- pathy, and it is also true that many a shrewd man has, like the late Lord BsAcoNSFiEiiD, selected a homoeopathist for his physician. But the merits or demerits of the system of Hahms- ifANN we are not qualified to discuss ; nor are these now in contro* versy. We know that the professional world is, as a rule, dead against the system, and that it condemns both its theories and its statistics of cure as fallacious. Yet from the British Medical Association, if the fundamental principle of that body was rightly interpreted by its President, we should have expected for homceo- pathy, with its respectable antecedents, a somewhat larger tolerance. The stormy movement for excluding the homoeo- pathists from its membership, instead of meeting their contentions with such fair argument as might have induced their return to the allopathic method, can hardly, at all events, be considered as justifying the claim put forward on its behalf by Dr. Stramor as having '^ freedom of thought, speech, writing, and teaching" as ''the first and noblest of its characteristics." Nay, tiie Doctor went still further in his vindication of the catholicity of the British Medical Association, for he added, with enthusiasm — << They had no thirty-nine articles to subscribe. There was no theory they nught not promulgate, and there was no practice, short of manslaughter, which i^ey might not adopt." These were brave words, but straightway started up Mr. Hardt with his *' rider," condemnatory of the practice of homoeopathy, and
iuSSSJf ^l/iSw?*^ OASES OP PEMCABDITIS. 61&
proposing to oetracise its professors ! Here, then, was. a large pretension of liberty, followed by a sudden attempt to forge the meanest of fetters. Well, doctors differ, and each is entitled to his opinion ; but in this case either Mr. Hardy was wrong in the character and intensity of his anti-homoeopathic attitude, or Dr. Stbanoe's exposition of the free and comprehensive principles of the Association over which he is presiding was a concoction of error and bounce calculated only to mislead. At the same time, we are disposed to think that those who would resort to expulsion as a punishment of difference in theory or practice may not, after all, be the true representatives of the spirit of the Association, for an admirable address by Dr W. F. Wadb, of Birmingham, and other addresses which followed, were little else than records of changes in medical practice, such as the almost total disuse of blood-letting as a curative process, and of the enlightened readi- ness of the profession generally to discuss, without either bitter- ness or ** boycotting," new ideas and discoveries in therapeutics, whether they adopt them or not.
CASES OF PEMCAKDITIS, WITH EFFUSION. By J. Hamilton Mackechnie, M.D.,
Phydoian to the London Homceopathio Hospital.
In manuals treating of this disease by similars, certain drags are very generally recognised as available. My object is to suggest the trial of a new one, or rather of a modifica- tion of an old one. As I base my remarks upon certain cases of greater or less importance, I think it well to record my cases first, and di*aw any inferences from them after- wards.
On the 17th February, I found on my return home from my afternoon round a telegram and a message from a patient, urging me to go to a suburb to see the daughter of a friend of his who was at school there and exceedingly ill.
I went as early as might be, and found my patient at a boarding school, where she had been placed in hospital, that is to say, in the upper part of the stabling belonging to the establishment, which was used for such cases as might turn out to be infectious.
The child, set. 9, had been attacked five days before with pain in the chest and difficulty of breathing. I could not make out whether there had been any premonitory febrile ohills — certainly there had been no symptoms of acute rheumatism, there was no swelling of the joints ; there had
620 0A8EB OF PEBIOABDITIS. *b!^. fcJtlfttfflL
been some slight aching of the shoolders, but no tenderness or swelling, and no excessive perspirations.
Unfortunately I had left my thermometer behind in town, but there could be no doubt that the temperature was yeiy high.
I found the child in a state of profound anxiety, prin- cipally from the dyspnoea, and she did not remain in one position two minutes consecutively, but lifted herself and flung herself down with a gesture of the intensest distress.
I was told the medical man who had been attending had diagnosed pericarditis, and that he had given the case up its hopeless at mid-day.
Upon turning down the bed-clothes, I found the cardiac region enveloped in a large linseed poultice, underneath which were the marks of vigorous countet-irritation in the shape of a weeping red patch of about two inches diameter, instituted, I afterwards heard, by the repeated use of liquor epispastica.
There was undulatory impulse of the heart ; I believe there was bulging of the intercostal spaces, but I have not recorded it. The cardiac dulness extended to the right of the sternum, to the left beyond the angle of the rib, and to the second interspace above.
The heart sounds were feeble, and sounded distant, but I could detect no roughening nor any friction, and the apex-beat could not be felt — only heard.
There were large moist crepitant rales over the upper part of the chest, both sides, and a good deal of cough with scanty, difficult, and tenacious sputa. The dulness did not extend to the lower part of the chest except in the cardiac region.
I could but confirm the diagnosis of the medical man who had been in charge, but said I should not give the case up as hopeless, though unquestionably I thought it a very grave one.
In addition to these symptoms, I found there was very frequent diarrhoea, of watery dark-coloured stools, which had been occurring for two days, and which the patient had much difficulty in controlling — in fact, could not always control. I found that she never micturated without stool passing at the same time, and as there was no bed-pan, not even of the most antiquated cruelty of form, the patient had either to be raised from the bed, or
SS^SSTSS?^ C^SBS OP PEBIOARDITIS. 521
what had happened must occur. I was urgent^ therefore, that a good Blipper-pan should be immediately obtained.
Pulse was 110, respirations 48. Skin was neither dry nor very wet- Taking the copious effusion, the consequent anxiety and restlessness, the difficult, hurried breathing, the diarrhoea, and the great prostration evident, I had no doubt about the appropriateness of arsenicum in the case, and I ordered her 1 -200th of a grain of the iodide dissolved in water, every two hours, while some spigelia was to be obtained and' given, when it came, alternately.
Feeling decidedly anxious about the case, I visited it the next forenoon, and received a report that the child was ** much the same,*' which I found was literally true, and. yet that there were indications rather favourable than otherwise. The night, though restless, had been quieter towards morning; the breathing, though difficult, had been more level than previously; the diarrhcBa, though continuing, had been less; the food had been taken as^ well as before. I noticed that the coimtenance was more placid in expression, and the tossing about was less hope- less in gesture, but the respirations were 60, which might have been caused by the entrance of a stranger.
The temperature was 104.2. I could not detect any change in the state of the heart or bronchia on auscul- tation.
I could only say that I thought there might be some improvement, that the temperature was certainly alarming, but still, if there were any change it did not appear to be for the worse. I left a thermometer to be applied at 7 p.m., and kept in the axilla for ten minutes.
The next day (19th) I found very smiling £Eices all around, and I was welcomed with the news that the child was much better. She had passed a very good night, having slept nearly throughout. The child's expression bore this out. On asking for the thermometer, I found the index at 97.2^ ! Of course, I thought the instrument had been ill applied, or allowed to slip, and introduced it very carefully myseU ; it registered 97^ ! To make sure, I re-introduced it for another three minutes, but found it unaltered. The desired fall of temperature had come. There was manifest difference in the area of dulness, and. the sounds were plainer. Bespirations 82.^
522 CASES OP PERICARDITIS. "e^.^SlTSi?
Bowels much quieter, but not yet right. Cough still troublesome. Moist rhonchi, principally about the upper part of left lung. No special perspirations had occurred ; no pains in joints.
I may say here that I heard that the medical man of whom I spoke before had met the nurse and enquired after this case, and on nurse's expressing some hopes of the child's recovery, had replied emphatically, "Never, never!**
On Sunday 20th, had passed a less quiet night, and was eross and fretful, a very different moral state, however, to that of two days ago. Temperature 97. Bespirations 86. Effdsion diminishing.
The mother was very anxious to get home, as they were very uncomfortable in their present domicile, and wanted my permission to return with the child to-morrow.
I prescribed some arum macul, for a troublesome, irrita- tive, tickling cough, which shakes and bothers the child very much. Continue the arsen. iod.
20th. Improving still. Passed a formed stool. Taking food well — solid and liquid. Wants to sit up, though manifestly very weak. The area of dulness diminishing. Cough better. Has not had a very good night. Tempera- ture normal.
On the 2l8t I again went down, but found the child flitting up in bed nearly well. Could not say that the heart was at all displaced. No bruit.' Sleeps well. Bowels regular.
Under these circumstances, I thought it quite permissi- ble to allow her to be brought home the following day, which was done.
I visited her in town the following evening, to make sure that nothing wrong had occurred. She went on perfectly well. I have not seen her lately, though I heard the other day that she was losing her hair very much.
Case II.
Is one of endo and peri-carditis, which occurred in the wards of the London Homoeopathic Hospital under my care. J. P., a maid servant, aged 24, was admitted No- vember 11th, 1880, having been sent up from among the out-patients by Dr. Buck, complaixiing of fever pains in joints, perspirations, &c.
About seven years ago was laid up for a fortnight with what she believes was rheumatic fever. Has noticed since
SSS^flStT^SS*' OASES OF PEBICABDITIS. 623
that time that her breath has been short under very little exertion. Present attack began five days ago, with shiyering and pain in the limbs and chest. On admission, temperature 102, pulse 110, respirations frequent, lips rather livid, and face flabby. Complains of pains in legs, knees, ankles, shoulders ; knees and ankles being swollen and tender. Has had a good deal of pain in the preecordia, but it is now easier. The apex-beat is diffuse. Distinct murmur at the apex, with both sounds. A murmur heard at both aortic and at pulmonary areas, with systole.
Tongue coated ; appetite bad ; bowels act; about every other day ; urine scanty, loaded with lithates ; perspiring rather profusely. An urticarious rash about the body, which changes its locality very frequently.
Bryonia 1 x was given every two hours, to be alternated with aconite during the night, if needful. In the evening, the temperature went up to 108.
November 12th. Temperature, morning, 101*2. Pulse 108. No pain except in the right shoulder. No swelling of any of the joints. Perspired copiously during the night. Urticaria much fednter. Coughing a little. Bespiration laboured. Continue medicine.
Evening temperature, 108*8.
November 18th. Morning temperature, 101*2. Pulse 96. Bight shoulder and elbow painful. Tongue cleaner. Heart's action seems rather stronger: murmurs very distinct. Still perspiring very much. Evening tempera- ture, 102*4. Continue.
November 14th. Morning temperature, 100*4; de- cidedly better. Evening temperature, 102*8*
November 15th. Morning temperature, 100*4. Pulse 96. Left hand and wrist swollen and painful; not much cough. Area of cardiac dulness increased. Evening temperature, 108*6.
November 16th. Morning temperature, 101*4. Pulse 96. Bespirations 86. Slept at intervals through the night. Ciomplaining much of the pain in the left side, and in the light hand and wrist. Sweating profusely; feels very weak ; cough more troublesome and frequent ; no expec- toration. Bronchial rales heard over most of the chest. Dulness of cardiac area increasing. Bowels acted naturally. Pho9phor%c add 1 x, 4ta horis.
Later on in the day — ^prostration and dyspnoea both increasing. BigUalis was substituted for the phosphoric
524 OASES OP PEBICABDITIS- "^JjaS^Ma^
acid, while brandy was given every two hoars in teaspoonfdl doses, and beef-tea as liberally as the patient conld take it. Linseed poultices over cardiac region. Evening tempera- ture, 102.
November 17th. Morning temperature, 101. Pulse 96. Bespirations, 24. The area of heart's dulness extending^ upwards as high as the second rib on the left side. Apex- beat below and to the left of the breast. Dulness extends also to right edge of sternum, and measures six inches diagonally.
Was very fiednt last night ; lips livid ; face waxy. Is better this morning. Pulse regular. Passed 24 ozs. of urine in the 24 hours. Not much cough. Temperature (evening), 102*2. The poultices continued. Digitalis continued in alternation with bryonia 1 x every two hours.
November 18th. Morning temperature, 99.8. Pulse 96. Bespirations 86. Appears much easier. Slept well. Pulse regalar and fuller. Double bruit distinct at apes, though sounding very distant.
Tongue raw-beef colour, but clean. Evening tempera- ture, 101.6. Continue bryon. and digitoMs. Food and stimulants continued.
November 19th. Morning temperature, 99.6. Pulse 90. Bespirations 26, rather jerking or sobbing in character. Seems stronger this morning. Occasionally sharp pain about left side of chest. Dulness keeps much the same.
Still perspires freely. Evening temperature, 101.6.
Arsenicum 8, alternately with the digitalis every two hours.
Some fish was ordered, to be followed, if taken without marked embarrassment, by a chop. The stimulants con- tinued.
November 20th. Morning temperature, 100.4. PhIbs 90, jerky but stronger. Bespirations 82. Several timesr yesterday and during the night became faint, with veiy distressing dyspnoea. Sharp pain about three inches beloTr the breast. Just under the breast, a rubbing sound maybe heard with the impulse. Murmurs sound most distant at apex-beat, which is outside of breast. Bight hand a little swollen. Evening temperature, 101.8.
November 21st. Morning temperature, 100.4. Pulse 86»^ Bespirations 80.
Much stronger. Food taken well. Evening temperatuie^ 101.8.
r
bSK^8^???Sb^ oases of pebioabditis. 525
November 22nd. Morning temperature, 99.6. Poise 96. Bespirations, 27. Passed a better night. No pain. Breath- ing easier. Seems decidedly stronger. Area of cardiac didness diminishing. Heart's sounds heard more distinctly. Evening temperature, 101.8.
Continue ar^en. without the cUgitalis.
November 28rd. Morning temperature, 99. Pulse 84. Bespirations, 80. Evening temperature, 101.4.
November 24th. Morning temperature, 98.8. Pulse 96. Bespirations 30. Passed a good night. Complaining of pain in top of left shoulder. Sweating freely still. Evening temperature, 101.2.
November 25th. Morning temperature, 98.8. Pulse 96. Bespirations, 24, jerky and uneven. Dulness does not extend so high. Perspiring much. Pain this morning in right shoulder. Cardiac dulness continues to diminish. Evening temperature, 100.2. Digitalis alternately with araen,
November 26th. Morning temperature, 99. Pulse, 96. Bespirations 84. Evening temperature, 100.8.
November 29th. Temperature, ^ Pulse 92. Bespi- rations, 26. Pulse stronger. Breathing better. No pain, and patient altogether improving rapidly.
December 1st. Temperature, ^ Pulse 72. Bespira- tions 86, easier, and not so jerking. No pains in joints. Not much perspiration. Pulse exceedingly compressible.
From this date the reports continue much the same till December 10th, when temperature, -^ Pulse 96. Less dulness over prsBcordia. Heart's action is stronger. Com- plaining of pain (neuralgic) on right side of face.
December 20th. Is gaining strength gradually. At the apex there is distinct double bruit ; at the base the 1st sound is wholly replaced by a murmur, loudest at the pulmonary area.
From this time she continued to improve, regaining strength slowly, progress being checked by a rather profuse attack of epistaxis following a headache on the 12th of January.
She had china after this, and was discharged " much . improved " on January 22nd, 1881.
Case No. 8.— rPeri-carditis with some endo-carditis.
The next case is one that occurred in private practice at the seaside. Miss B., sat 20, was attacked September
Vol. 26, Ko. 9. 2 m
626 CASES OF PBKIOABDITIS. ^ESS^J.^^ITtttt
17thy 1881> with febrile symptomBy alFter having felt some chills the day before, accompanied by headache and de- pression of spirits.
There were pains in the limbs and in the abdomen; tongue slightly coated; temperature (evening), 100.2; bowels inactive. There was slight tenderness in the right iliac region, to which my attention was particularly directed by the fact that there had been ^eventl cases of typhoid in the neighbourhood.
I was not able to make any decided diagnosis, and I gave baptisia.
September 18th. Temperature 101.2 mane. Pulse 98, soft. Has passed a rather restless night, but feels herself better in spite of the increase of the true feverish symp- toms. Skin is slightly moist. Temperature sera, 102*3.
' September lyth. There was no longer any doubt as to the nature of the affection this morning. The temperatme was 101, pulse 98. The skin moist, perspiring freely, and the secretion of characteristic odour. Pain, tenderness, and swelling in the left shoulder, right knee, and slightly in right ankle. Bestless, and inclined to move about in spite of the trouble and pain the movement causes. Bowels inactive; urine acid re-action, moderate in quantity, no deposit.
No pain in chest, but a little irritative cough. Some rhonchi to be heard in different parts of the chest ; no cardiac sounds.
Aconite and bryonia 1 x were given alternately. The parents were warned about the danger of chill, and the patient was ordered flannel next the skin — ^the risk of heart affection being stated. It was not until near the end of the treatment that I found that my warning had been disregarded, and that the patient had been permitted to get up for some reason, while the fever was at its height, and the skin moist with the peculiar secretion.
The cardiac region was watched very carefully. Tem- perature (p.m.) 101*4.
September 20th. Morning temperature 101*2. Pulse 102. Ko special dij£culty of breathing. The right ankle now affected most severely. Has passed again a very restless night. Heart sounds natural; still, neither friction nor alteration of position of dulness being to be found* Mr. Shaw, who had been the family attendant
BS^BStTSaS*' CASES OF PBBICABD1TI8. 527
previously, saw her with me this afternoon, and confirmed my diagnosis and treatment. Temperature, evening, 102*6.
September 21st. Temperature, morning, 101. Pulse 102. Bespirations 24. Complains of some uneasiness of breathing, and sense of pressure in cardiac region. Gould find no firiction sound, but the apex-beat was outside of and below the mamma; dulness extending to second inter- space above, and nearly to right edge of sternum ; effusion having taken place rather suddenly, as I had examined the heart the evening before, and found no friction sound, nor any marked extension of dulness.
There was no murmur now perceptible, but the sounds at the apex seemed distant. The night had been a very restless one, and the pains were mainly in the right lower extremity, where the knee was the joint principally affected, thus showing the specially wandering character of the affection, whidbi most practitioners will have ob- Berved varies in this respect extremely in different cases. For my part, I consider these cases of specially wandering character as the worst to deal with. One never is able to
*
feel sure that one's enemy is beaten, or, at least, until one's patient is quite convalescent, and it is notorious that Buch cases are those in which the heart is most certain to be affected endo and peri-cardially.
I ordered large bran poultices to be applied to the 4>ardiac region, and frequently renewed, but did not change the medicine from the bryonia, though I considered the xieonite had better be suspended. Temperature (p.m.), 102.4.
September 22nd. Morning temperature, 101*2. Pulse 102, regular, but jerky and compressible. Bespirations 80. The friends had been alarmed in the night at an attack of -difficulty of breathing, but by the time I arrived I could find no special dyspno)a, nothing more than the oppression to be expected in such a state.
The night had been restless and sleepless. The princi- -pal site of the rheumatism had again changed to the left fihoulder, though all the large joints were more or less swollen and tender.
The dulness had now extended quite to the right edge of the sternum, an inch outside the line of the left nipple and below the mamma, and a decided roughening of the first sound was heard. The spirits were very much depressed, and the patient had given herself up. Milk
2n— 2
628 GA8E8 OF PEBI0ABDITI8. '^^^Sl?^
i>
and beef-tea were ordered, and a little brandy and water. Tbe potQtices were continued nntQ in the afternoon, when Mr. Shaw again saw her with me. He then suggested the substitution of spigelia for the bryonia, and of cotton wool for the moist warmth ; confirmed the use of stimulants and nourishment. His suggestions were followed out. The eyening temperature was 108.
September 28rd. The morning temperature, 101*2. Pulse 102, jerky, compressible. Bespirations 86. Has passed a bad night, with much dyspnoea, and yeiy restless, unable to turn, but cannot keep quiet. The pains in tbe limbs continue much the same; perspirations profiue^ especially at night.
Urine scanty and depositing urates^ aeid re-action.
Bowels only relieved by enemata.
Dyspnoea rather better after daylight. No sign of im- provement as to effusion. Area of dulness not diminished, and there was some roughening of the systole at the apex, the apex-beat being the same in position as yesterday, bat not to be felt.
Food and stimulants continued. Evening temperature, 102.8.
September 24th. Dyspnoea very distressing, and she has passed a very restless night. Effusion continues much the same, patient tossing about even in the day. Bheumatic pains still changing about, scarcely any visit finding the condition of the joints relatively the same. Moming temperature, 101.2. Pulse 100, occasionally intermitting. Sespirations 40. The dulness continues much the same, perhaps a little higher up in the second interspace. Perspira- tions continue, but are rather less copious^ Urine very loaded and deep coloured. No albumen. As there could not be said to be any decided improvement, I ordered the poultices to be re-imposed, and gave arsenicutn iod, 8x in alternation with the spigelia. Evening temperature, 108.
September 25th. Temperature, moming, 100*8. Has passed a very restless night. Obtained an hour and a half s sleep last evening, but not a quarter hour through night.
Pain at cardiac region very sharp at times. Bou^bness of murmur more marked, and sounding nearer. Pulse 100, intermitting and very compressible. Pains in joints much the same. Urine rather more copious, and less dark coloured. Slight cough.
On the whole the impression is that there is a little less
SiSi^StTSS^ OASES OF PEEICAKDITIS. 529
distress and restlessness this morning. Contintie the treatment. Temperature, evening, 102.4.
September 26th. Morning temperature, 100. Pulse 96, still intermitting, but stronger. Bespirations 26, and less imxious. Has passed a mueh better night, having slept two hours at a time more than once. The breathing more regular and less laboured. Countenance manifestly less anxious, though her spirits have not much improved. Tongue fdrred. Takes her food — ^beef tea, &c. — with much less reluctance.
Bowels inactive.
Dulness shows decided signs of lessening, not extending «o far out-side of the nipple line. Bruit much the same, except that all sounds seem clearer.
The improvement is manifest to every one about the patient.
Treatment continued. Evening temperature, 101'2.
September 27th. Greatly improved, having slept much better. Morning temperature, 99'8. Pulse 96. Slight thrill perceptible, intermissions occasionally. Bespira- tions, 24.
The pains still wandering from joint to joint, affecting the left shoulder with the greatest constancy. Manifest reduction in area of dulness. Apex-beat again to be felt, though indistinctly.
T^es food better. Bowels sluggish, urine freer. Morale improving.
Continue spigelia and arsen. iod,
September 28th. Improvement still more manifest in all ways.
September 80th. I found her sitting up in bed, propped up by her pillows. Pulse 96, very feeble stroke. Bespira- iions 20. Sleeping nearly all the night. Taking nourish- ment eagerly. Tongue forred, but cleaning at the edges, where it is very red. Bowels still inactive.
Urine clearer, still acid in reaction, and at times depositing some urates.
Dulness at cardiac region greatly reduced, its border being within the sternum at the right edge, and about half an inch outside the nipple line at left — ^not reaching the second space above.
SystoUc mitral bruit very audible. Ordered a little fish, if possible, continued the Uquid foods and some stimulant* •Continue the ar$en iod. alone, every four hours.
630 OASES OF PEBIOABDITIS. ^BSSS^fS^^MS!:
October 2nd. Improving in all respects.
The case was not under my charge for many days after this, and I am not, therefore, able to give so satisfactoiy a report of it as might be, but so fax as the remoyal of the serous effusion is concerned, I think the iod, of arsenic may fairly be set down as having been the principal agent.
Case 4.
November 1st, 1881. A friend of mine called on me to tell me that his daughter, set. 11 years, had been suffering for a week from severe pain in the left side, interfering with the breathing and describing her state as very serious. My impression was that it was a case of pleurisy. I sent some aconite, and went the next day, when I found the following case of endo and pericarditis.
Miss E. S., tall and delicate looking, had been exposed to cold and wetting a week ago, and since has been troubled with severe pain in left side, increased by movement of the arms and by deep inspiration.
I found there had been pains in some of the joints, which had subsided as the pain at the chest developed itself. Temperature, 101*2. Pulse 98. Respirations 24. Tender- ness over cardiac region. Cardiac dulness extending to outside of nipple line half an inch, and to middle of ster- num. Loud but not sharp systolic murmur over mitral region. Apex-beat diffuse outside of nipple.
Child pale, emaciated. Dyspnoea with the least move- ment, yet the child was dressed and about the house. I, of course, ordered her to be put to bed. The cardiac region to be fomented well with hot water, followed by poultices. I ordered aconite and bryonia 1 x alternately every four hours.
November 7th. Pain less severe. Breathing even more difficult. Respirations 30. Pulse 100. Temperature lOlr
Has passed a restless night. Pain at heart. No rheu- matic pains in limbs. Dulness much the same. No perspirations. Skin rather dry than otherwise. Appetite very bad. Tongue furred in middle. Bowels regular or relaxed. Urine depositing on the vessel a pink sediment.
Dulness continues the same as at last report. Pain less sharp. The apex-beat scarcely to be distinguished by toucLr I ordered arsen. iod. 8 x every four hours.
November 12th. I found the child greatly improved. ' Pulse 102, weak and irregular. Respirations 24, but laboured. Countenance very blue. Still sleeps a good
■S^sSrSrStt* CASES OF PEBICAEDITIS. 681
deal at night. No rheumatic pains. Perspirations scarcely perceptible. Urine still depositing. Tongue farred, not mnch liking for food. Bowels acting eveiy other day with some difficulty.
The dolness nearly reduced to natural limits, and the apex-beat felt quite forcibly about an inch below and to left of nipple line.
Loud systolic bruit at apex.
A good deal of cough of dry and irritative character.
Some general rales over greater part of the chest, espe* cially on right side.
To continue medicine. Some meat allowed, in addition to the liquids she has had.
November 14th. Improvement progressing. Gounte* naqce much improved in colour, and breathing easier* No very marked pain at cardiac region, complains of a dull aching there.
Apex-beat forcible. Bruit very loud. Dulness in same. Has taken her food well, and the tongue has cleaned con* siderably under it.
Urine improving in quantity and with less deposit.
Cough better. Continue arsen. iod.
From this time the patient continued to improve, though she has had another attack since, which was easily con- trolled by aconUe and bryania.
I saw her a few days ago, and found the heart's action forcible, and feeling as though it drew in the fifth and sixth interspace. The bruit at apex was veiy loud and rough.
These cases so far carry their moral with them that there is not much for me to add. I think they all indicate that arsenieum is a most valuable, if not an indispensable medi- cine in the treatment of pericarditis with copious effusion ; this, however, is hardly new. Most of our manuals tell us this, but I think the cases taken altogether, and especially the first case, suggest that the iodide is a form which, so far as clinical experience goes, is worthy of a &ir trial.
Case No. 1 was most striking from its manifest severity^ the amount of effusion, and the rapidity and completeness of the cure, especially as it had been progressing steadily the wrong way until the moment of the introduction of the new medicine*
But some one may say, ^' There is no evidence that the iodide of arsenic will produce pericarditis with serous effusion." Not absolutely, but we do know that both the
582 DISEASE OP THE STOMACH. *Sffi!ll2?7TS
BorieWf Sept. IflfiBL
radicals of which the salt is composed do ; at least the negative element is known to prodace efihsion in the closed sacs, while of the basic radicad there is no doubt.
I am far from thinking that we must necessarily repudiate every drug until it has been thoroughly proved. Practically we are bound to make use of all means that come to hand hy which we can conquer the pain and suffering it is our mission to do battle with, and while we look steadily forward to the farther development and improvement of oar arms of precision, we may sometimes destroy our enemy by an old-school flint-pistol.
When we have arrived at the happy day when all metals and metaloids, all ethers and alcohols, carbon and nitrogen compounds, all salts, all vegetable, animal and mineral poisons shall have been equally well proved; when the ** Allen " of that day — ^in how many volumes ? — shall only need for us, by aid of the repertory, to seek out a gimiUmum for any case that may offer, we may perhaps give a millionth dilution and cure our patient straight off — but, meanwhile, are we to eschew the use of all such drugs as have not been fully proved ? I trow not. If we have a fisdr pre- sumption that the agent will do the work we want done better than those we already employ, let us make essay of it.
Every case should be considered wholly on its own merits, and the greatest enemy to progress is routine.
60, Wimpole Street, Cavendish Square, W. July 26, 1882.
CASE OF OBSCUEE DISEASE OF THE STOMACH. By Chables Lloyd Tuckey, M.B., CM.
Assistant Physician to the London HomoBopathic Hospital.
On the 28th of March, 1881, I was called upon to visil Mrs. H., wife of a highly placed official. I found the patient lying in bed and complaining of great pain in the region of the stomach, and of exhaustion consequent upon it. Examination of the abdomen was attended with con- siderable pain, as the parts were tender to pressure and felt sore and bruised, but neither upon this nor upon sub- sequent occasions did it furnish any obvious explanation of ihe symptoms complained of. The parietes were distesided
r
S^StTSS** BISBABB OF THE STOMACH. 588
and mnch relaxed ; the liver dxilness was slightly increased ; there was considerable moyement of flatus on deep pressure ; and aboYe and to the right of the nmbilicns there was drcnmscribed soreness and great tenderness, with, at the same time, a strong arterial pulsation, visible and audible by the stethoscope. The heart and lungs were found to be healthy, though the pulse was somewhat quick and weak. The bowels were perfectly regular, and the kidneys acted normally. The tongue was uniformly covered with a thin white coat, but not more so than one often finds in perfectly healthy old age. There was a slight lateral curvature of the spine, and her face was of a waxen hue, and bore an expression of great suffering.
The patient was fair, and of a sanguine temperament, of medium height, and sixty-five years of age. Her family history was excellent, and her own health, until the. last few years, had been unusually good. Married at twenty- five, she had had two children, one of whom had died in infEmcy. The uterine functions had been well performed, and she had been subjected to no malarial or other morbid influence.
Her ill health had its beginning, then, when she was about fifty-three years of age, and at that time she was residing at Pembroke with her husband.
It began with slight symptoms of indigestion — such as pain after eating, flatulence, loss of appetite, and general malaise. Medicine was prescribed without effect, but a change to the Continent at once and completely removed the symptoms and restored the patient to health. A few months, however, after her return to Pembroke, dyspeptic troubles recommenced, and recourse was again had to physic. After a little beating about the bush, bisrimth was prescribed in large doses, and this drug in a few weeks effected an apparent cure.
During the rest of Mrs. H.'s residence at Pembroke she 4iK>ntinued pretty well, but caution in diet became more and more necessary, for pains in the stomach were sure to follow any indiscretion.
In 1871 Mrs. H. came to reside in London, and gradually the symptoms of acute indigestion became more distressing and constant. The patient soon availed herself of the unrivaUed advantages enjoyed by Londoners in the way of diverse medical opinions, and she soon became learned in the differential diagnosis between cancer and ulcer of the
684 DIBBASfi OF THE STOMACH. ^jS^.^SSlI^mml
— ■%
Btomach, and between neuralgia of the solar plexus and gastritis. Her illness was attributable to all these causes, as well as to the curvature of the spine, cirrhosis of the liver, and hysteria. The treatment adopted was as varied as the diagnosis. Those physicians who discovered obvions cancerous tumours contenting themselves with ordering opium and other anodynes, whilst others, to get to the root of matters, gave iron, strychnia^ quinine, and all kinds of gastric sedatives. Of course brandy was not without its advocates, and in sufficiently large and crude doses it reUeved the patient's sufferings more than any other agent.
The symptoms all this time were much the same as in the early stages of the illness, but they constantly tended to become more severe.
They were, especially, intense radiating pain, coming on within an hour after eating, and lasting for two or three hours, according to the nature of the food taken. This pain always began to the right of and above the umbilicus, and spread gradually over the whole abdomen. If the article of food taken was indigestible, or if she had been subjected to fatigue, emotion, or any other disturbing influences, violent retching and sickness supervened; when the stomach was emptied, the pain instantly disappeared, leaving only a feeling of soreness. If, for fear of pain, Mrs H. abstained from food altogether, the pain would still come on in a modified form, and be accompanied with great Binking and empty retching.
From experience she found that by keeping the stomach a little occupied by drinking at frequent intervals small quantities of milk, this latter form of pain was kept off, and consequently at her worst times she almost subsisted in this way, at other times taking soups and farinaceous puddings.
Going abroad, especially to Paris, entirely removed her sufferings, and when on the Continent she was able to eat and live like other people. Also, when attacked by other illnesses, such as bronchitis, the gastralgia disappeared for a time.
Her bowels at all times were perfectly natural, and her tongue was characterised by the slight white fur I have mentioned.
In the autumn of 1880, Mrs. H. had as usual gone abroad for some weeks, and, for the first time, the change failed to remove the pain and other symptoms, though it
JB^^tT^^ DISEASE OP THE STOMACH. 585
relieved iheniy and on her return to London her sufferings became more acnte than ever, and small quantities of milk no longer had their old effect of keeping off pain.
The winter of 1880-81 was thus miserably passed by the patienty and in March, 1881, as above-mentioned, the aid of homoeopathy was invoked in the person of the writer* Mrs. H.'s state being as described, it wa^ time that some^ thing should be done, as the exhaustion alone consequent upon many days and nights of pain, was threatening a speedy termination of the case. There were so many symp- toms pointing to cancer, probably of the pyloric end of the stomach, that hydrastis was the first medicine thought of, from its well proved efficacy in that disease. Five drop doses were given every three hours of the 1st decimal dilution, a water compress was ordered to be worn con- stantly over the chief seat of pain, and the diet was confined to miUs, beef tea, and weak brandy and water. For three days this treatment was religiously carried out, but without the smallest effect upon the disease. On the third day I witnessed one of the most violent attacks which had occurred. It came on &om no apparent cause, and was accompanied by such severe pain that the unfortunate lady was completely '' doubled up " by it, and groaned in anguish. It continued for about haK an hour, and violent vomiting of the contents of the stomach — a little milk and mucus only then ensued, and the sleep of exhaustion followed. Diligent search of the Materia Medica was then undertaken, with the result that arsenic^ cupi'um, conivm, dioscorea, nux vomica and argentum were all found to correspond more or less closely with the symptoms. Cuprum mitaiicum 6 wa» first given alone, and then in alternation with conium 8 for a period of ten days, but no effect was observable, and the inability to bear pain was increasing. Chloroform by inha- lation was had recourse to, but it only momentarily relieved the pain, which returned in its full intensity after each administration. Nitrite of amyl given in the same way produced only intense sickness and no cessation of pain, and moschus was equally ineffectual. In the middle of April argentum 8 was prescribed, and its administration continued for four days. Then, as from the patient's history bismuth had formerly been so successful, this drug was given, at first in five grain doses of the 1st decimal, and then of the crude subnitrate. A week of this treatment showed its utter inefficiency under the circumstances. The beginning o£
586 DISEASE OF THE STOMACH. ^^S^^SSh^
May found doctors, patient, and friends almost rednced to despair. The last sacraments of the Boman Catholic Church were administered, and death seemed close at hand, when at length snccess crowned the treatment. To relieye pain and produce sleep, I wrote a prescription for twelye extract of opium pills, each pill to contain half a grain, and with directions that one was to be taken when an acute attack of pain was deyeloped. At that time there were four or five such daily. At the same time perfect rest to the stomach was enjoined, and directions given for feeding the patient entirely by nutrient enemata. The medicine was changed to argentum nitricum 1 c, one drop to be taken with sugar of milk every four hours.
The effect of this compound treatment was immediate; the first day three pills were taken, and they checked the spasms of pain and allowed of comfortable sleep. The second day two pills were taken, and there were but faint warnings of pain, the same on the third and fourth day, and on the fifth only one pill was taken, and that at bed time.
On the sixth day the altar flowers and incense were removed from the room, and the patient was quite cheerfiil, no opium being taken. For fourteen days she was fed entirely by enemata, one being given every four hours, and during that time the nourishment of the body improved and strength increased. On the fourteenth day the bowels began to be troublesome, and there appeared various colicky and unpleasant sensations in the abdomen. So, with fear and trembling, the stomach was again set to work. A diet entirely of koumiss had been tried and had failed, during the earlier stages of the illness, but it was now again ordered, with chicken broth, milk and lime water, and ice. To our intense gratification no discomfort followed on the first meal, and from that time there was an end of all severe pain. The nitrate of silver was continued, with less frequency, for many weeks ; the opivm was less and less used, and she had entirely given it up by the beginning of July, when, by the advice of a specialist, I sent her to dnnk the waters of Neuenahr. A month's residence there com- pletely restored her to health, and on her return to London in the autumn she was able to eat and digest well cooked venison or mutton, to walk a fair distance and to enjoy life generally. She still, however, feels that imprudence in diet would bring on the old pain; the laxity of the abdominal walls and pulsation in the right hypochondriac
JSSS^SrrSS?* wsease of the btomaoh. 587
region oontinne in a diminished degree ; and she still has recourse at intervals to the nitrate of silyer, and on very rare occasions to the extract of opium pills. Until recently there was much discomfort when the stomach was empty, but now (Jnly, 1882) this is no longer felt, and Mrs. H. is able to go about without taking occasional sips of milk or other light refreshment. In fact she is in a normal state of heall^y apparently.
In reporting this case, I am fully conscious that many &ults may be found with the treatment of it. The medi- cines were not, perhaps, given for a sufficient length of time to fully prove their action before they were discarded for others. The weak falling back upon larger doses of bismuth was an offence which brought its own punishment, as it failed to give the least relief. The recourse to opium was a confession of helplessness, which every homoeopath abhors. And the final use of silver in such comparatively large doses will be repugnant to the feelings of some of us* To these objections I can only answer that the patient was flesh and blood, and so was her doctor, and the case appeared so desperate at one time, that euthanasia seemed the chief thing to strive for.
It also shows the immense difficulties in the way of a correct diagnosis of some diseases of the stomach, and the consequent necessity of caution and reserve.
The complete faUure of argentum met, 8 to give the slightest relief, when shortly afterwards argentum nit. 1 acted like a charm is also of interest as bearing upon the vexed question of dose; and the successful maintenance of nutrition entirely by the use of enemata for so long a time has greatly increased my confidence in this mode of feeding.
From the light thrown upon it by its subsequent history, I have formed my diagnosis of the case. This lay at first between cancer and gastric ulcer. Its successfid issue, I think, shuts out the former hypothesis. We know how prone women are to ulceration of the mucous mem- branes at the change of life, and it seems to me that the ulcerative diathesis — if I may so term it — began at that time, and was never completely changed until the appro- priate homodopathic remedy was given and went to the root of the disease.
Changes of climate so modified the constitution that, for a time, perhaps, the active progress of ulceration was
1
538 ACTION OP MEDICINES. "^^.^SSTim!
stopped and healing even commenced, bat the return of the aisease when the patient's un&yourable mode of life was resumed, shows how near the sm&ce was the amend- ment. The large doses of hismuthy at first so BaccessM, also produced the same temporary improvement, bat the action of this remedy was evidently that of a local sedative, and superficial, for its good effect was soon exhausted.
The cure now appears permanent, but it would be interesting to know if, without proper treatment, maJignant disease might not have been set up in the affected tissue.
The non-appearance of blood in the vomited matters would appear to contradict the hypothesis of either cancer or ulcer, but there are many cases on record of both these diseases where hsematemesis was absent to the last.
I may add that in my limited experience I have found argentvm nitricum most useful in painful affections of the stomach simulating ulceration, especially in the old and debilitated. In two or three cases No. 8 has been suc- cessful, but in the majority I have found it necessary to descend to the 8rd decimal or the Ist centesimal, whereas, with other mineral medicines I have never required to go below the 6th or 12th centesimal.
21, Henrietta Street,
Cavendish Square.
NOTES ON THE ANTAGONISTIC ACTION OF
MEDICINES; WITH SOME KEMABKS ON
CHRONIC POISONINGS.*
By John H. Clabee, MJ>.
Of late years a distinction has been drawn between antidotism and antagonism. Formerly an antidote meant any substance which would annul the effects of a poison acting in an animal organism. Such is still the meaning of the term in conmion speech. But, in scientific language, the late researches on the action of drugs have rendered more precision necessary. There are two ways in which the]| effects of a poison may be counteracted — by a drag
* Beprinted from the AnndU of the BritUh Homaopathic Sacktyt 1^0.54.
aSSSfsS^t^Sw^ ACTION OP MEDICINES. 539
flcting on fhe same part as the poison, or by a drug acting on a different part. For example, strychnia acts on the spinal cord, exalting its sensibility. Chloral also acts on the spinal cord, depressing its sensibility. Chloral is said, therefore, to antagonise strychnia. On the other hand, cwrara will stop the convulsions of strychnia as effectually as chloraly not by acting on the cord, but by paralysing the endings of the spinal nerves in the muscles. Curara ifiy therefore, in the new terminology, called an antidote to strychnia — ^it annuls the symptoms, but does not act on the same part. From this it will be seen that the antidotism to which Hahnemann is constantly drawing Attention would in these days be called antagonism.
This distinction is purely arbitrary, and though useful for certain purposes, is not without its drawbacks. It introduces a confusion between the uses of the same term in former and present times ; and, ponsidering how little is definitely known of the true seat of the action of drugs, it is apt to give rise to the drawing of distinctions between tilings quite indistinguishable.
In a paper on the '^ Nature and Limits of Physiological Antagonism," by Dr. H. C. Wood, of Philadelphia, read before the Materia Medica Section of the International Congress, the author called especial attention to this dis- tinction, as containing in it a demonstration of the mixed truth and falsity of homoeopathy. I quote from the abstract of his paper.
** Take," he says, '' the action of veratroidia upon the heart. In large doses it paralyses, in small ones it stimu- lates the pneumogastrics. Supposing the pneumogastrics to be depressed, and the heart's action consequently too rapid, veratroidia in minute doses might be useful. Sup- posing, on the other hand, that the heart has been para- lysed by an excessive dose of veratroidia, or some similarly stimulant drug, could it be expected that minute doses of veratroidia would restore the action of the heart ? " We are not concerned with what could or could not be ex- pected, we have to do with what is. Dr. Wood assumes that all that is true in homoBopathy depends on the fact that some drugs act oppositely in large and small doses. With this I do not trouble myself to-night. But he makes another assumption. He says that a minute dose of a medicine will not antagonise tiie effect of a large dose of
540 ACTION OF MEDICINES. ^ESSSr^SfciJm
the same, or of a svmilmly acting drag. In support of this, he adduces not one particle of proof. In the discnssion which followed the reading of this paper, I ventnred to point this out, and adduced a case which controverted the latter part of it, a case which I shall bring before your notice later on. I shall, I think, show to demonstration that homoBopathic medicines do antagonise each other and that quite independently of dose.
We are all familiar with Hahnemann's notes on the medicines which antidote, or antagonise one another, and we have no difficulty in conceiving of such antagcmiam when the quantities of the two drugs are not excessive in either case. When, however, we are confronted with a patient thoroughly saturated with some medicinal substance, which is producing in him its characteristic poisonous effects, it seems a hopeless undertaking to attempt to remove those effects by homoeopathic medicines so long as the poison is still in his system, or so long as he continues to be exposed to its operation. We fear that unless we can get the poison out of him, or him out of the way of the poison, there is little or nothing to be done. Who, in the words of Dr. Wood, could expect anything from a medi- cine having the same action as the poison ? Certainly I for one did not, but none the less I made a trial, and as a reward got more than I looked for. Do not let it be understood that I do not advocate getting rid of the poison where that is possible, but there are cases where that is impossible, and it is well to know that in them homoeopathy can do some good. I wUl now proceed to relate to you some of the facts which have brought me to this conclusion.
On the 12th of March of last year, a young man, set. 28, brass-finisher, tall, muscular, though not broad, very dark, black hair and eyes, sallow, with distinctly greenish hue of skin, came to my clinic at the hospital complaining of a pain in the chest, doubling him up at times, confined state of the bowels — ^large, dry, hard, difficult motions — sight becoming defective, general Hmguor and miserable feeling, and a short dry cough.
He told me that this came on two years previously, and that the first thing he noticed was a bad taste in the mouth, headache and costiveness.
He had never been very strong, but had enjoyed fairly good health up to that time. Family history excellent.
t^S^B^T^ ACTION OF MEDICINES. 541
He was married and had two children both in Tery good health.
He had always been steady, had worked at his trade several years. The last two and three quarter years had worked in a '^general " shop, where ** turning " as well as ** finishing " was carried on, and that, he said, was more injnrions than the latter. Besides this, the shop was very draughty.
His tongue was coated and dirty, teeth black with tartar, gums receding. His sleep was heavy, and his head heavy on waking. He had no cramp.
One had only to look at him to see he was saturated with brass. To that I attributed his sufferings, and had not mueh hope of benefiting him. I prescribed nux vomica 1, drop doses three times a day, for a fortnight.
The following week a fellow- worker of his, whose case I will relate next, came to me, and it was interesting to compare the two.
The patient received some slight benefit from niuc ; he was less languid and miserable, and his bowels were a little less costive. I repeated the medicine. The next fortnight he was much in the same condition, cough troublesome in the day, pains sharp on motion, nostrils stopped. I gave hryonia 1 in the same way.
The next report was that the pain in the chest was a little better, but he had had an attack of diarrhoea and sickness, which has left him veiy weak. Arsen, 9-
May 14th. — Throat and cough the same. The inside is sore when he coughs. Sickness is less.
Beconsidering the whole case it seemed to me that kali bichrom. was more accurately homoBopathic to his conditions than any of the medicines I had given him before. I gave it in the 8rd dilution, drop doses three times a day.
The change when be presented himself three weeks later agreeably astonished me. He declared himself well except a sensation of sinking at the epigastrium. I gave him the same medicine with a dose of actaa 1 to take occasionally. This removed the sickness, and he remained much im- proved. Even his complexion improved to a certain extent.
Since then he has been from time to time under my care with one or other of the old symptoms, chiefly the cough, causing a pain at the chest, doubling him up, and pain in the shoulder. Kali bichrom. has dmost entirely^
YoL 26, No. 9. 3 o
542 ACTION OF MEDICINES. "^SrMSS
relieyed the former, and fhe latter disappeared under bryonia 8. The stopped state of his nostnls has neTer altogether got well, bat has improved. Both nostrils aie Bot stopped at a time, but first one and then the other, changing in a few hours' time. His general healiiii improved immensely, and all the time the conditions of his work and living were unchanged. He had, preTiondj to consulting me, been under allopathic treatment ^thont benefit.
On March the 19th of the same year, B. H., ffii 44, also a brass-finisher, small, dark hair, blue eyes, consnhed me. He complained of a cough with much expeetorafioQ and retching in the morning, at times great difficnltjin getting his breath, much wind at the stomach— vhich \i usually has — spasms at the epigastrium, restless nights- he awoke half an hour after falling asleep and tsssd get to sleep after — loss of appetite, cold in head, thii nasal discharge. He was subject to attacks of this bni Three or four years ago had one. This had kst«d t fortnight. Tongue cracked, thin white coat, bowels regnb* I examined his chest and found no bronchial rales. ^ heart sounds were normal. I prescribed ars. 8, one diof three times a day.
He reported himself in a week no better, cough ahno^ incessant from 2.80 to 8 a.m., much cramp7pains,espec3iltj in the lower abdomen. Botching in the morning, m^^ expectoration during the day, the spitting relieving ^ cough. No night sweat. Wind not quite so bad. Teeft very dirty but all sound, green deposit all round ^ margin. Lower Jeft canine and bicuspid numb: Kali eori. 6, one drop every four hours.
The next week he reported that for the first part of ^ week he had been much better, had slept better, then be had taken cold and become worse, phlegm difficult to raise, pain in the right side of chest when he coaghei> hoarseness, pharynx congested. Bryonia 8.
In a fortnight the only change was that the congh vtf a little better, but he was still hoarse. Hepar 6.
April 80. — Cough better, still hoarse, nose stopped* phlegm hard to raise. Kali bichrom. 8, one drop thicA -times a day.
May 14tii, a fortnight later> he reported himaelf as m^ better generally; the phlegm was very much easier, tte
SSSSf^T^w!**' ACTION OF MEDICINES. 543
nose was still stopped. I repeated the medicine and he did not return.
The success of kali Uchrom. in this case suggested it to me in the case previonsly reported, though the symptoms, when once thought of, were evidently homoeopathic enough.
Though different in many minor points, these cases were very similar to each other. Both men were evidently full of the minute particles of brass, and to this I have no hesitation in ascribing much of their sufferings. They were not common colds that they suffered from, though cold may have had a share in producing the symptoms. But the character of the symptoms suggested a common cause in the two cases, which was not far to seek. In both instances, kali hichrom. was eminently homceopathic, and in both it, in infinitesimal doses, antagonised the action of the metal as completely as it is possible for one drug to antagonise imother.
According to the logical inferences for Dr. Wood's assertion, kali bichrom. ought to have done nothing but aggravate the evil;
The next case is more striking and conclusive.
A single lady, set. about 67, very small, and of delicate make, of considerable intellectual gifts, contracted the opium habit in early life, opium having ' been prescribed her for some painful affection by a medical man. This habit she has continued with little interruption for fifty years. She now takes eighty drops of the liquor moiyhi^e hydrochloratis in the twenty-four hours. Some time ago she consulted me about a distressing pain in the sacral region and con- stipation. The latter she had had for years — indeed, she could not recollect the last time she had a natural motion — always having recourse to artificial means, chiefly enemata. I said the cause was only too plain, and I did not expect homoeopathic medicines would do anything so long as the habit remained. Still I gave ascvlris hippocasL 1, drop doses every three or four hours. To her great astonishment, and mine no less, she had soon after a per- fectly natural and easy motion, and the pain in the sacrum vanished. This continued as long as she took the ascidua. At times the motions were natural and came without Assistance, and when the enema was had recourse to there was far less difficulty than formerly.
In this case there could be no doubt of the cause of the constipation, and there could be no doubt that ascvlus was
2 0—2
544 ACTION OP MEDICINES. "b^.^^Him-
in that partictilar a like-acting drag to the marjMu. Between the massive doses of morphia and the hnndredtb of a drop of the tinctnre of ascvlus there conld be no comparison. And yet the latter completely antagonised the former in its sphere.
The same effect followed in the same patient when she was taking add nitric 1 for a different affection, an inflamed toe consequent on a badly cut corn, not only did the toe improve, bnt the difficulty with the bowels vas completely relieved.
A^ain, this same patient, in spite of her narcotic, ifi ft very bad sleeper. She nsnally wakes many times in the night, and latterly she got so that she conld hardly sleep at all. Half a drop of coffea crvda 1, taken two or three times during the day and once at bedtime, obtained for her such sleep as she had not had for months, and this good effect has now lasted some time after leaving it off. It will be understood that during the whole of this time the daily dose of morphia has been taken.
The sleeplessness of opium is weU known as an alterna- ting effect with its drowsiness, and it thus becomes in infinitesimal doses one of our best remedies against sleep- lessness. In this case coffea was perfectly homoeopathic, and completely antagonised the effect of the other drag.
I shall now merely mention two cases of arsenical poisoning. I have often been puzzled in watching cases I have known to be caused by arsenic to see them improve under remedies when their conditions remained unchanged. It is true the contrary has much more often been my experience, and the good effects of treatment have seldom been permanent until the conditions have been altered. At the same time, I have seen enough to convince me that even arsenic can be antagonised by homoeopathic remedies sometimes, even when the poison is present in quantity and the antagonist given in infinitesimal doses.
The cases have already appeared in the Monthly Hamcso^ pathic Review of June, 1881, so I need do no more than refer to them briefly.
March 19th, 1881. — ^Mrs. H. K — , set. 56, housewife, dark, florid, spare, complained of pain at the epigastrium, of scraping character, fulness after food, flatulence, passing both upwards and downwards, great weakness and faintness. She waked with burning pain in bregmatic region of head, much pain across the eyes and burning in them, sight dim*
SSSSfflSrrS^' ACTION OP MEDICINES. 546
Tongae dirty at back, bowels confined, appetite fair ; con- janctiy» darkly congested in lower half; pharynx dark; gams healthy, bnt she has had much neuralgia and has lost many teeth. She has been ailing many years.
Annie K — , let. 26, daughter of above, thin, pale, dark, imhealthy looking, suffering much as her mother, scraping pain at epigastrium before and after food, much flatulence 4Somes upwards, lassitude and fainting. Tongue thinly Qoated white, bowels regular, appetite yeiy good. Cata- menia regular ; pulse small and quick ; ieetix and gums healthy ; phaiynz dark ; oonjunotiYaB congested ; sight good.
In addition to this I was told that the whole family had had feverish attacks coming on every six weeks since they had Uved in their house. The mother described such an attack to me as it affected her. A triangular patch of her forehead, the apex at the root of the nose, burned, became red, the burning spread all over the head, and was accom- panied with smarting. Eyes became bad, and she got into a state of burning fever all over.
I need not say I had little difSculty in finding the cause of all this. I need not repeat here the details of the dis- covery, suffice it to say the house was papered with hang- ings of the worst description, five or six deep in the different rooms.
I could not promise them much unless they got away firom such unhealthy surroundings, but I gave them each carbo veg. 6, one drop three times a day. In a fortnight they both returned very much better, especially in regard to the gastric trouble. The improvement continued for a month, when they were both worse again, having had their usual feverish attack. The flatulence, however, remained better in the mother's case in spite of the fever. As I did not see either of them again I conclude that they took my advice and got out of the house.
In a case of similar gastric disorder from the same cause, I gave carbo veg., but with no effect on the flatulence until the patient got away from the influence of the arsenic.
My case is now as complete as I have time to make it, though not by any means as complete as it might be made. I submit, however, that I have made out that, whatever conclusions our expectations might lead us to adopt, it is a £Bu$tthat a medicine will sometimes antagonise the action of another medicine acting like itself> and on the same part
646 ACTION OP MEDICINES, "ffl,^^?^
as itself, even when this has been taken in massive doses for long periods of time. In cases of acute poisoning vnSx massive doses I have had no experience, but, judging from what I have seen in chronic cases, there seems to me no reason why the homoBopathically-indicated medicine should not be of service there also when the poison has got beyond the reach of stomach-pump and emetics.
In conclusion, I have a few observations to offer on chronic poisonings generally. The more I know of medicine the more does my respect grow for the powers of endurance and accommodation possessed by the human body. In studying chronic poisonings this is most striking. Again and again I have watched cases, thinking the end coold not be far off, and yet it has not come. One such especiallj recurs to me now. It was the case of a woman, aged forty- five, who had lived in a house papered throughout with arsenical papers for eleven years, and who presented in her unfortunate person a perfect repertory of arsenical symptoms. Never free from pain, never enjoying a particle of food, and vomiting almost all she took, fainting several times in the day, she was reduced to the last stage of weak- ness, as I thought. She was so situated that she cooll not get away from the house, and those who ought wonll not trouble themselves to get it put into better condition. I had fully made up my mind to bring the case before the coroner when the end should come. One day I received a hurried message to go and see her, as she had been assaulted in her garden and had her purse stolen. This I thought would certainly prove too much for her, and as I went along I debated with myself how much blame should be apportioned to the poison and how much to the assailant. I found her suffering from severe shock and badly bruised. Contrary to my expectations she got over these, and gradu- ally regained her usual ill health, and for aught I know is living still. Whether such a life as her's is worth living is another question.
We are all familiar with the accounts of the Styrian mountaineers, and the common habit grooms have of dosing their horses with arsenic. In the case of the horses, when an unfortunate purchaser buys one that has been so dosed, unless he continues the practice he finds the animal ''go all to pieces " on his hands, and has to turn him off for six months before he is of any use. Still, during the time of the dosing no ill effects are apparent, and the same is said
B^^fs^rS^ ACTION OF MEDICINES. 547
of the StyrianB. Why this should be so, when in such cases as that I haye just mentioned the sufferings are so seYere, I cannot say. Perhaps the constant open-air Ufe and exercise of the Styrians and the horses may partly account for their exemption. But why one suffering so extremely as my patient, and being constantly exposed to the poison, should still linger on is more difficult to explain. I am inclined to think that the state of invalidism induced has something to do with it. This renders the bodily wear and tear so small that the little food that is assimilated suffices to repair the waste.
Brass -workers say that there are among them many old men who have worked all their working days at their trade, and have become perfectly green in hue, even their hair being green, and who still enjoy excellent health.
We are all acquainted with stories of venerable topers who have attained great ages in spite of their indulgence.
Are we to conclude from these considerations that chronic poisoning, though it may derange health, does not shorten life ? I think not.
Sir Robert Christison, in his lectures, when on the sub* ject of opium^ mentioned a once celebrated ]aw-suit respect- ing the liability of an insurance company in the case of the death of an opium-eater. As usual in such cases, there was great diversity of opinion among the medical witnesses as to whether the habit did or did not shorten life. The case was eventually decided for the company, and Sir Robert was strongly of opinion that the decision was right. He said that the habit greatly predisposed to certain diseases, notably apoplexy, and distinctly tended to shorten life. This I think is the case in most chronic poisonings. The poisons do not as a rule destroy life by their own dynamic power, but create a strong predisposition to certain natural diseases, to which their victims in the end fall an easy prey. We see this in the case of drinkers. For one who dies of cirrhosis, how many are there who die of diseases less directly produced by alcohol ? In exceptional cases this predisposition may never find a proximate cause to draw it out, and the sufferer may drag bis life out to its proper span, as if he had taken no poison. But these cases are quite the exception.
648 ACTION OF ELEOTBICITY. "b^.^TmSl
THE THEEAPEUTIC ACTION OP ELEOTRICTTY.
By Donald Baynes, M.D.
f Continued from page 826.^
I PUBPOSE, in this paper, mentioning some of the diseases in which I have employed electricity with benefit ; the kind used and its mode of application. For a full description of electro-therapeutics I must refer the reader to one of the many well-known text-books written on this subject.
Anosmiu (Loss of smell). — In this very troublesome affection electricity sometimes acts like a charm, and some- times is very disappointing in its results. In such cases the galyanic and faradic currents should be used on alter- nate days. The galvanic current to be applied — ^the positive pole to the bridge of the nose, close to the forehead, and the negative to the nape of the neck — a mild current to be allowed to flow for the space of ten to fifteen minutes. The faradic — a moderately strong current of about ten minutes duration, the electrodes being placed one on either side of the nose.
Aphonia. — Faradise the vocal cords, one electrode being placed over the pomum adami, and the other applied directly to the paralysed vocal cord, by means of Mackenzie's laryngeal electrode. Unless the aphonia is the result of thickening or ulceration consequent on laryngeal phthisis or syphilis^ one or two applications are usually sufficient to restore the voice.
Asthma is usually relieved and frequently cured by galvanisation of the vagus. Some cases require an ascending, others a descending current. This point is to be determined in each case by actual experiment.
Chorea, — ^Excellent results are obtained in this disease, either by galvanisation of the spinis, or by charging the patient with static electricity and drawing sparks from the spine.
Constipation, especially in elderly people, who have been in the habit of taking purgatives, or using enemata, may be permanently cured by faradism — one electrode being either applied over the sacrum or else inserted into the rectum, the other being passed over the entire abdomen. A fairly strong current should be employed.
Oout arid Rheumatic Gout, — In these affections the action of electricity is very uncertain. Some cases are
T^!iSi!SS^U^ ACTION OP ELBOTRIOITY. 649
quickly oared, while others benefit bat little by its applica- tioB. The galvanio oarrent gives the best results.
Hay Fever is very amenable to galvanisation of the spine and pneumogastric, followed by general faradisation*
Lumbago yields quickly to local galvanisation of the ftfiected muscles. A fairly strong current should be employed twice daily. In other forms of myalgia, gal- vanism gives excellent results. In stiff-neck it acts like a charm.
Neuralgia. — The relief of pam is one of the most promi- nent characteristics of galvanism, even though it may not remove the cause of the pain. In facial neuralgia, the results are striking and brilliant. The applications should at first be made daily. In each seance, begin with central galvanisation, then follow up with local adminis- tration. In cervico-brachial neuralgia, the anode is placed over the brachial plexus, while the cathode is passed slowly up and down the arm. The tedious neuralgia following herpes-zoster in old people is much benefited by galvani- sation.
Miikf absence or deficient secretion of. — A few applica- tions of the faradic current to the breast generally produces a full supply of milk.
Odontalgia is often quite cured by a few applications of galvanism. The negative pole is to be inserted into the carious tooth by means of a proper electrode, and the positive to be applied to the face over the nerve supplying the tooth.
Paralysis. — ^In no disease has electricity been more largely used than in the various forms of paralysis ; and in none has it given more brilliant results when employed in properly indicated cases. Many cases of paralysis, firom tiieir cause and nature, preclude all hope of success being obtained by electrical treatment. In others, espe- cially if recent, a happy result may be confidently expected from its proper administration. Hysterical and rheumatic paralysis are chiefly treated by faradisation, and yield most excellent results. Diphtheritic paralysis is most frequently treated by the faradic current. In infantile paralysis, also in lead paralysis, and in all forms of this disease where there is a tendency to wasting of the muscles, the galvanic current should be first employed and then followed by the faradic. A general rule is that where the paralysed muscles do not respond to the faradic
C60 ACTION OP ELECTBICITY. ^'^^^b^I^'^^.
current the treatment mast be commenced with a course of galvanism. Cases illustrating this mode of treatment are given.
Pruritus ani and pruritus vulva. — These most trouble- some disorders are greatly benefited by electricity. Gal- vanism and faradism of the patient on alternate days should be resorted to.
Sciatica, — This most painful and obstinate disease is^ in the great majority of cases, completely under the control of the galvanic current. In its application, the positive pole is placed over the spot where the nerve escapes from the pelvis ; the negative pole is passed over the limb, along the course of the nerve. Sometimes, one pole is placed in the rectum. A large number of cells should be used, and frequent applications must be made.
Spinal Irritation. — This tedious complaint is best treated by alternate applications of central galvanisation, and general faradisation. The cure will be greatly facilitated by massage and rest, with suitable di^t.
The following cases, taken from my note-book, will serve as examples of the therapeutic value of electricity in disease.
I. Aphonia. — ^Miss B. came to me in April. Had been in a weak state for some time; periods irregular, and bowels very constipated. About three months previously to her visit to me she had caught a severe cold, which resulted in complete loss of voice — so much so that she carried a slate and pencil as a means of communication. A laryngoscopic examination revealed paralysis of the vocal cords. On attempting to phonate, the right remained com- pletely motionless, whilst the left did not quite reach the median line. One pole of a faradic battery was appUed externally to the larynx, and the other, by means of a lai^ngeal electrode, directly to the vocal cords themselves.^ The effect was instantaneous : her voice being completely restored. Her general condition was then attended to, and she shortly regained good health.
II. Lumbago. — Colonel B. had been suffering for nearly a week when he consulted me. His pain was so great that he could scarcely cross the room. The galvanic current was applied, for about fifteen minutes, over the lower part of the spine, the hips and the thighs. This application gave great relief. The galvanism was repeated next day ; he was now so far restored that he cocdd walk a short
bS^JS^TIb^ action op electricity. 651
distance withont much inconvenience. Three more appli- cations completed the cure, and he was able to take his daily ride and walk without suffering discomfort.
Judge — had been troubled for some time with pains in the back. He had tried all -sorts of remedies, without experiencing much, if any benefit. He was treated with electric baths, of which he took four. Marked improvement followed the first bath, and he declared himself perfectly free from pain after the third. He has had no return of the pain up to the present time.
III. Dejidency of Milk, — Mrs. H. consulted me in reference to the entire absence of milk in the right breast.^ This was the third time she had lost the secretion in this breast, and was probably the result of previous abcesses. Three applications of the faradic current resulted in a full supply of milk,
IV. Paralysis — (1st.) James L. fell from a window, about 20 feet from the ground, striking the left side of his head (the fall was more or less broken by the branches of a tree, which grew close to the house). The child was taken up insensible, and remained so for four or five days.^ When sensation returned, it was noticed that he was unable to speak, and that one leg was paralysed. On exam- ination there was found to be a good deal of anaBsthesia in the paralysed limb, and no response to the faradic current. Treatment : Daily applioations of both galvanic and faradic currents. In from eight to ten days, speech returned, and the child was able to stand. Three days afterwards, he could walk alone, and after three weeks* further treatment was dismissed cured. During the latter part of the treat- ment the electricity was applied less frequently — only twice or three times in the week.
(2nd). Frank M., 14 months old; a strong, well- nourished child ; sent me by Dr. Kennedy ; first seen Sep- tember 24. On examination, the left leg was found to be paralysed, muscles flabby and wasted ; the limb was cold and much smaller than the right. Aiitecedent history. — About three weeks previously ttie child woke up crying after its morning nap, and vomited several times ; it was very feverish. The mother gave it a dose of castor-oil, and towards evening it seemed better. The next day the mother noticed that the patient had lost power in one leg^ and was unable to use it when creeping. The supposed cause of the paralysis was chill, as the child was sitting
652 ACTION OF BIiBCTBICITY. "^gSS^jaSt^^ttS!
for some time on damp grass the da^ before its illness. Treatment : As the mnscles did not rei^ond to faradism, the galvanic current was employed. The positive pole was applW to the lower part of tiie spine, and the negative passed over the entire length of the limb. Early in October the mnedes began to respond to the faradic current — there was a fair retnm of sensation, and the temperature of the limb was higher. The faradic current was now used on alternate days with the galvanic. At the end of October the limb had increased in ^ze, and was easily kept warm ; treatment continued. In November the child was able, not only to move the leg, but to begin to creep and stand. In December it was dismissed, cured.
(8rd.) Miss M., aged 24. She had been in the habit •of taking Epsom salts daily for more than a year. Caught a severe cold towards the end of December, 1877, whidi resulted in spinal congestion, for which she was attended by Dr. Boddick, who sent her to me, January 18, 1877, for electrical treatment. She was then complaining of numbness of both legs, (the numbness extending as higji as the lumbar vertebrsB) weariness on the slightest exertion, and considerable difficulty in locomotion, loss of appetite, constipation, feverishness and restlessness at night. Treatment : Electric baths, 15 to 20 minutes with the galvanic current, followed by 10 minutes with the faradic. She took, in all, six ba^s, one every other day, when she returned, cured^ to her occupation as saleswoman in a shop.
V. Post Partum Hamorrhage. — ^A friend has furnished me with the following cases. (1st.) Was called to see Mrs. D., a thin delicate woman who had been in labour for some 19 hours. On examination found the os utep fully dilated, head presenting, the anterior diameter some- what shorter than normal. Her pains were very feeble and tea between. She appeared very low. I gave her two or three doses of fluid extract of ergot, but these produced little or no effect. I then applied the forceps and delivered her. The placenta came away spontaneously. Shortly afterwards severe hsemorrhage set in, the uterus refusing to contract under the application of cold, ice, etc. Mrs. D. fainted. I had already sent for my battery, which now arrived. I gave the nurse one pole to apply over the abdomen, and, tiding the other in my hand, passed it into the uterus, whioh immediately answered to the stimulus and contracted
SaS^SSPTl!^ REVIBW8. 55a
BsTJeWf Sept. 1, 18BI.
Ibmly. I withdrew my hand and applied both poles for a few minntes to the abdomen dyer the ntems. There was no recnrrence of the hsBmorrhage, and the ntems remained firmly contracted.
(2nd.) Was called to see Mrs. S. The labour had been an ordinary one ; howeyer, soon after the remoyal of the placenta, flooding set in. Ergot had Ibeen giyen and ice had been introdnoed into the ntems, bnt inthont the effect of producing permanent contraction. On my arriyal I fonnd the patient much ezhansted; ex-sangnine, and with the ntems relaxed. I immediately applied the faradic current to the abdomen oyer the ntems. This was followed by a temporary contraction. The tttems, howeyer^ again relaxed. I now introduced one pole into the ntems itself and applied Che other to the abdomen. This resulted in the organ becoming firmly and permanently contracted. The woman made a good recoyery.
VI. Debility, — Mrs. F. L. came to me in a yery low, neryons, and depressed state. She told me she felt thoroughly unfit, mentally and physically, either to read, write, or attend to her ordinary household duties. Her bowels were obstinately constipated, and she was greatly troubled with leucorrbcea. I began the treatment with electric baths in April. After the third bath she began to improye, and at the end of June had quite regained her usual health and mental yigour. She was able to walk two or three miles without excessiye fatigue.
REVIEWS.
Comparative Therapeutics, By Samuel 0. Potter, M.D. Gross
& Delbridge : Chicago. Tms work, which first appeared in 1880, has met with such a rapid and appreciatiye ssde as to haye necessitated the issue of a second edition, exactly twelye months after the first. This fact alone should incUne us to examine carefully into its merits. It is written on an entirely new plan, the only approach to which, as £Eur as our memory seryes, is to be found in the small clinicid index of Buddock. Dr. Potter*s book is, howeyer, far more elaborate and comprehensiye, embracing, as it does, what we may presume is the cream of the therapeutics of both schools.
The author, in explaining the intention of his yolume, says : ''The object aimed at in this book is to present the therapeutics of the two great medical schools in the manner best adapted to comparatiye study and quick reference. In parallel columns are
^54 BEYMWS. "S^Xt^^
placed the remedies recommended by the most eminent and liberal teachers in the regular and homoeopathic branches of the profession.**
It is rather to be regretted that the author should have used the word '* regular ** in this connection ; surely in so catholic and impartial a book this little pandering to the enemy should have been omitted.
Glancing through the list of authorities, we notice the names of the most modem and advanced thinkers, as well as standard and old established references on both sides. When we mention among the allopaths the names of Bartholow, Phillips, Binger, Trousseau and Wood, we have said sufficient to account in many instances for the identity of drugs in both columns. And on the other hand, when we find references given to such writers as Angell, Allen, Hughes, Hale, Hahnemann, Helmuth, Hering and Jahr, we may rest assured that the very soundest views on the homoeopathic side of the question will be met with here.
The further we read, the more we are struck by the colourless impartiality with which the author has discharged his task. He has confined himself strictly to the enumeration of the principal drugs used in both schools for any given disease with the veiy briefest indications for their choice.
This book does not pretend to take the place of the reference library, but only to put the remedies in a tabular and handy form, and give the reference to the authority where more copious indications may be found. And after a carefol perusal we can confidently say that Dr. Potter fulfils his promises.
The arrangement is alphabetical, and the contents range over the whole field of medical science, including, rather to our amusement, a table of the fees copied from the fee bill of the New York State Medical Society, and the Detroit Schedule.
The article under the headmg '' Homoeopathy ** is veiy well written, and presents in a concise review the history of homoeo- pathy and its present position throughout the world.
The two formulae of homoeopathy, the one, of the moderates, the other, of the Hahnemannians, we quote verbatim : —
'* Although firmly believing the principle ' similia simibl>us curantur * to constitute the best general guide for the selection of remedies, this belief does not debar us from recognising and making use of the results of any experience, and we shall exercise and defend the inviolable right of every educated physician to make practical use of any established principle in medical science, or of any therapeutical facts founded on experiments and verified by experience, so far as in his individual judgment they shall tend to promote the welfare of those under his professional care.**
Catholic enough, and comprehensive enough, in all conscience.
iSsa^Bgrnss!' kotabiua. 555
is this creed. The Hahnemannian formTila has more of the trne Athanasian flavonr about it.
<< We believe the Organon of Samuel Hahnemami to be the only reliable guide in therapeutics. This clearly teaches that homoeopathy consists in the law of similars, the totality of the symptoms, the single remedy, the minimum dose of the dyna- mised drug, and Uiese not singly, but collectively." And we £anoy we hear them add, '' except a man believe all this he cannot be a homoeopathJ*
Very useful to the practitioner will be found the complete dose list of all drugs used in both schools, and the chapters on Dif- ferential Diagnosis and Thermometry. The section on Urinary Examination, too, is methodical and simple.
We have been much struck with the clearness of arrange- ment and the completeness of the information contained in this book. At the same time it must be remembered that it does not attempt or profess to supersede larger works of reference, but merely to present in a handy form hints on thera- peutics culled from larger books^ with the indications where they are to be found.
Yiewed in this light, we wish every success to the work, and have no doubt that &e sale of the second edition wiU be as rapid as was that of the first.
NOTABILIA.
THE LANCET ON HOMCEOPATHY.
•Cbyino aloud to keep one's courage up, is a very old arrange- ment. None better understand the art of shouting loudly and with a reckless contempt for truth, in order to force on their readers a conviction of the reality of that in which they wish them to believe, than do those who are responsible for the con- tents of the Lancet, For example, in a paragraph we are about to quote, it is stated that the allusions to homosopathy made last year at Byde, by Dr. Bristowe and Mr. Hutchinson, were so made *' by mutual understanding and with the concurrence of the Council.'' That this is absolutely false is well known to every reader of periodical medical literature. This statement was made last year by the Lancet within a week or fortnight of the delivery of those addresses, and it was categorically denied at once by Dr. Bristowe, Mr. Hutchinson, and the President of the Council 1 *
* See letters from Dr. Bristowe and Mr. Hutohmson in the Lancetf Sept. 17th, 1881, p. 508 ; and from the President of the Council ia the JBrtUsh Medical JowmaZj Sept. drd, 1881, p. 418.
556 50TABILIA. 'S^.lggar
A year later, and the Lancet repeats the statement, neeessarily knowing its trathlessness 1 With regard to homoeopathy, its tacties are precisely similar. Bold, nncompromising, and irnth- defying assertion is the weapon which the Lancet has ever wielded against homoeopathy. Can it, we would ask, he possible that any person qualified to be on the staff of a medical journal, can be so ignorant of homoeopathy and all relating to it, as to publish in good faith, believing them to be true, ti^e statements contained in the following paragraph extracted from the Lancet of the 19th nit?
*' The authorities of the Bri&h Medical Association may con- gratulate themselres on escaping so easily from an embarrassmg position in reference to the question of homoeopathy. The inju- dicious allusions to it last year by Dr. Bristowe and Mr. Hutch- inson respectively, by mutual understanding and with the con- currence of the Council, placed the Association in a very paminl position. It was not to be supposed for a moment that a great medical Association, having the same opinion and the same laws, in regard to homoeopathy, held and practised by scientific medical men all over the world, could quietiy let pass such advice as was administered to it by gentiemen who only looked on the subject from an academic and benevolent point of view. It is not now — when homoeopathy is extinct; when the real disciples of Hahnemann in England can be counted on one's fingers ; when these say that homoeopathy is no longer taught, even in the School of Homoeopathy ; when the contempt and denunciation of homoeopathy have received their triumphant vindication — that a great medical Association should have been asked to show any quarter to medical men who still either believe in the exploded nonsense or trade on the belief of non-medical persons who do so. But this was the suggestion of the authors of the address is Surgery and the address in Medicine last year. And when the members of the Association would naturally have risen to protest, they were given to understand it would not be courteous to express their dissent then and there. Many significant indi- cations have been given to the Council that the members of the Association would not allow themselves twice to be found in such a childish and false position. It is not one of the notes of a liberal profession to tolerate either false principles or those who trade on them. Accordingly, the Council, in its report at the recent meeting, dealt boldly and candidly with the members on the subject, and announced rules which wiU make it impossible for a homoeopath henceforth to become a member of the Asso- ciation. Mr. Nelson Hardy wished to go ftirther. He wished to so alter the resolution adopting the report as to secure that the avowal of a belief in homoeopathy, or of any other designation implying a special mode of treatment, should ipso facto disqualii^
fSSi^iS!TS^ HOTABitiA. 557
Baview, Sept. 1, 1888.
tar membership of tiie Association. The Association was content iobe assured that the new roles would henceforth exclnde all homoeopaths. If any homoeopath now chooses to remain a member, he may ; but his sense of dignity will be a subject for the study of his fellow members. Here this question will end liar the present. There is only one way in whidi gentlemen now using the title and the shibboleths of Hahnemann can be admitted to Medical Societies, and that is by ceasing to use them. It is they who raise the sect and import narrowness into Medicine. It is they who exclude themselyes. They would not be owned OTon by TTahTiATnaTin- They haye abandoned the fundamental points of his faith and practice. Let them act candidly with the public and abandon a name which misleads it, and they will find no want of magnanimity in the profession to which they return.*'
So homoeopathy is once more declared to be ''extinct!" ^* The contempt and denunciation of homoeopathy have received their triumphant vindication ! 1 " By many a village surgeon these fines will be read with dehght. And the conclusive remark, ** I always said it would be so, only give it time and rope enough/** will complacently follow. In small country towns, where the rector has '* a book and a chest,** and silently and un- obtmnvely does a great deal of good with them to the poor ; and where the wife of ihe squire at the Hall contrives by the same means to keep the principal doctor of the neighbourhood at arm's length, these words of the Lancet will be a source of comfort and joy, and give rise to dreams of the visits that will be required during the coming winter, and of the mixtures and jnBlB ttiat will have to be prepared t In places where homoeo- pathic practitioners are settled and doing well, some ray of hope win spring up in the minds of the neglected practitioners, and a degree of confidence be inspired in looking forward to the long- expeeted collapse of their too successful ri^. These and similar anticipations are, however, all doomed to disappointment. Out of his inner consciousness the editor of the Lancet has, for the fiftieth time, declared that homoeopathy is not. The wish is father to the thought.
That homoeopa^c practitioners " have abandoned the fonda- mental points of the fiilth and practice of Hahnemann " is notoriously false. On the other hand, that no small proportion of the minority of the profession have adopted these fundamental points is undeniable — ^it is apparent on the face of all modem medical literature. In a paper on Cardiac Therapeutics^ pub- lished in the British Medical Journal last April, every one of these fimdamental points was practically illustrated by the author! Just in proportion as homoeopathy gains a greater foothold, as the basis of scieniific therapeutics, does the Lancet pfoekim its extinotion. This sort ai thing has, however,.
Vol. 20, No. 9. 2 p
668 NOTABUJA. *^SS&"^S?SS
BerieWt Sept. It IflSl.
become nearly <* played ont." The cry has been raised so freqaently dnring tiie last thirty years, that people are becoming accustomed to it, and naturally take no heed of it.
In the last nnmber of the HonuBopathic Worlds Mr. Boss, of the firm of Leath and Boss, the well-known homcBopa^c chemists of Yere Street, illustrates the mode in which the *' extinction " of homcBopathy is going on, and it is one in which we trust that it will continue to go on.
He has had nearly thirty years' experience in preparing and selling homoeopathic medicines. When he became a convert the resident homoeopathic practitioners in London might almost he counted on the fingers, while there were but two or three chemisks who manufactured and sold homoeopathic medicines. Now there «re more than 100 practitioners and some 80 chemists in London alone ; many of the former with large and increasing practices, some of the latter with extensive and steadily increasing businesses. When Messrs. Leath & Boss first sent out a traveller, some fifteen years ago, his reception by the allopathic chemists was anything but courteous, and it was no uncommon thing for him to be threatened with a pedal application if he ventured within the sacred precincts of their pharmacies again with his obnoxious and senseless wares ; now there is hardly a respectable chemist within the three kingdoms who does not keep and seU homoeo- pathic medicines. Twenty years ago they hardly sold a hundred- weight of pilules in a year, now their output of this form of meddcine alone is upwards of 1 ton annually ; twenty years ago their consumption of spirit in the preparation of medicines scarcely amounted to 5 gallons a month ; now they require 500 gallons per annum. Twenty years ago 100 gross of bottles would have sufficed to meet the requirements for twelve monlhs ; last year 2,163 gross were barely sufficient.
Many another homoeopathic chemist could make a similar report. The statement of the Lancet and the fiicts adduced by Mr. Boss cannot both be true. The latter have the advantage (2 being susceptible of proof by reference to day-books and ledgers. The former is the product of a vain and sorely vexed imaginatioiu
The ultimate tnumph of homoeopathy cannot be far distant when its adversaries are reduced to resort to such transparent misrepresentation in order to discredit it.
NOTES OF THE LONDON HOMOEOPATHIC HOSPITAL.
We understand that the staff of nurses available for attending private patients is to be increased — a circumstance which we are sure will be gratifying to many homoeopathic practitioners.
A marked increase, we are pleased to note, has taken place in the daily average of patients in the wards as compared with last
£^£ST^^ NOTABILIA. 659
Seriew, Sept. 1, 188S.
jear. Daring July, 1881, it was 26 ; daring last Joly, it was 45. From 1st April to the 81st Joly, the total admissions were 195 ; daring the same period this year, 281.
Yarioas soms of money have recently been received. £50 from a generous friend in Brighton ; £200 from the estate of the late Edward Byron Noden, of Angel Boad, Brixton ; being a portion of a sam left to be divided amongst charitable institutions at the discretion of the administrators. £50 has been received from the estate of the late Admiral Coffin, and a similar sum has been left by the late Mr. Elkin. A legacy of £1,000 from the estate of the late Mr. Osgood Torkington — already annoonced — ^has also been lately received. The estate of the late Dr. Qoin has now been faUy realised, and a farther balance in favour of the hospital is shown, which will be invested in Consols. The award of the Hospital Sunday Fund for 1882 has been £191 5s. Od., as against £2d6s. 5s. Od., in 1881, a decrease of £45 — due probably to the fsLCi that the number of patients admitted during several months was— owing to structural alterations in progress— but small.
The Betum of Patients admitted to August 10th affords the following statistics : —
Bemaining in Hospital at date of last return (June 7th) ... ... ... ... ... 52
Admitted between that date and August 10th ... 90
142
Discharged during the same period 98
Bemaining in Hospital on August 10th 44
The number of new Out-Patients during the period from Jane 7th to August 10th, has been 1,088.
The total number of Out-Patients* attendances during the same period has been 8,924.
Arrangements have been proposed for keeping at the hospital a list of gentlemen willing to act as locum tenens, and also of homoeopa&c practices for sale, as well as of gentlemen requiring practices. Applications are to be made to the Secretary.
HAHNEMANN PUBLISHING SOCIETY.
The annual meeting of this Society will be held at the Windsor Hotel, 100, Princes Street, Edinburgh, on the evening of Wednesday, September 6, at 8.80 p.m. ; and if necessary, by a4Joumment at 9 a.m. on Thursday, the 7th.
It is very desirable that as many members as possible should he present on Wednesday evening, because very important busi-
2 p-2
560 NOTABiLiA. ••SSa=2?'??!Hr
ness as to the past and future work of the Society will be brought forward.
Gentlemen who may have any reports or suggestions to make should communieate at once with the Hon. Secretary, Dr. Hay- ward, 117, Grove Street, Liverpool.
TESTIMONIAL TO DB. HABPEB.
On the 80th of June, a most gratifying mark of esteem was shown to Dr. J. P. Harper, who has recently left Windsor to commence practice in London. A handsome ormolu and oxy- dised embossed casket containing two hundred and fifty guineas,, together with a beautifully illuminated list of the subscribers oo vdium, framed and glazed, was presented to Dr. Harper at Clydesdale Villa, by a deputation from a committee formed for carrying out the wishes* of the numerous subscribers. The heading to the list reads as follows : —
'* The accompanying casket, containing two hundred and fifty guineas, was presented to James Peddie Harper, Esq., MJ>., L.B.C.S. Edin., by the undermentioned among his patients and friends of all classes, in token of their gratitude for his un- remitting sympathetic professional attention; their recognition of his great medical skill ; their admiration of his high Christian character ; their appreciation of his constant and gratuitous aid to the needy; their deeply felt regret at his removal from Windsor (after twenty-four years of most successful practice), and their fervent hope that he may enjoy much happiness^ enlarged usefulness, and continuous prosperity, in his new sphere of life and labour. — ^Windsor, June 80, 1882."
In presenting the above to Dr. Harper, the Hon. and Bev. Canon Courtenay said : Dr. Harper, — ^I have been requested to- act as spokesman on behalf of a committee of your numerous patients and friends, which has been formed in order to present you with some testimonial of their gratitude and affectionate regard. It is an especial pleasure to me to fill this place, as I trust that I may be reckoned as not amongst the most recent of your friends, or ihe least grateful of your patients. We have known each other more than twenty-three years. The committee is a small one for convenience sake ; you must not take its size as a measure of the feeling of which it is the expression. The testimonial takes a three-fold shape — a casket, that which i& enclosed in it, and an illuminated list of subscribers. It has taken this particular form partly because some of the subscribas amongst (lie most influential judged it the best, and partly because amongst so many subscribers it would have been impossible to come to a unanimous decision as to any one object to be presented. I know you well enough. Dr. Harper, to be sure that the less I say about yourself the better pleased you
ISSSS^^Sgnff^ NOTABim. 661
Tvill be ; all thiB, therefore, I pass by ; I only wish to assure yoa that this offering is no mere formal or complimentary offering, snch as has become almost of necessity after a man in any ca- pacity has been in one place for a certaon nmnber of years, but that it is the real and spontaneoos expression, of the very tme and affectionate esteem, and gratitude, which your numerous patients and Mends feel towards you. And I should also like to state to you that this offering is the result not of any canvass for donations, but of gifts freely given, simply on the announce- ment of the proposal of such a memorial. And I am sure that •one little fact wUl please you more than perhaps all else, namely, that this offering is joined in by a large number of your poor patients at the Dispensary. I now in the name of the committee put the key of the casket into your hands with our best wishes tiiat God may prosper you in the work which you have undertaken.
Dr. Harper replied to the following effect : Canon Courtenay and Gentlemen, — ^I cannot adequately express to you and the kind friends and patients who have contributed to this most hand- some gift my feeling of gratitude and satisfaction. Until the day before I left Windsor I had no idea that such a thing was contemplated, and when it became known to me I never imagined that anything so splendid as this was thought of. On looking back I feel inclined to say, what have I done to deserve such a gifl as this ? I have taken no part in public movements, and have perhaps too carefully avoided identifying myself with questions of general interest ; but have rather endeavoured to conffne myself to the work of a medical practitioner, whose calling is to heal the sick and relieve the suffering, and if in the good providence of God I have in some measure been able to do this, I am deeply grate- ful. But all this is duty, and duty neither seeks, nor expects, nor desires a reward. Tlds valuable testimonial therefore must be regarded as an expression of personal confidence, affection and esteem, and in this light it is to me very precious. In severing a connection which has existed unbroken for twenty-four years, I have suffered more pain than I care to say, and have met with deeper expressions of sorrow and regret than I at all anticipated, and which I could scarcely have h^ed had I foreseen. It is no small satisfaction to me, however, to leave as my successor one vho is second to none in professional qualification, and whose kindness of heart and real sympathy have only to be known to be appreciated. I have again only to thank you and all the kind friends from the highest to the lowest, from the poor who have 80 touehingly come forward, to the Peer whose name I found at the head of the committee list. To the gentlemen who consti- iated the committee I offer my special and heartfelt thanks.
Dr. Harper succeeds to the practice of Mr. Cameron in Hertford Street, Mayfair, and is succeeded in Windsor by Ur. Deane Butcher, from Beading.
662 NOTAsaiA. "SSS-^fWS?
Beriefw, Sept. 1, IflBI.
ADVERTISING.
Under the somewhat carious title of ''Homoeopathic AdTer- tising," the Students' Journal and Hospital Gazette^ of the 5th nit., has a paragraph referring to a yery nnprofessional adyertise' ment issued by a homoeopathic practitioner, iu the form of a handbill, and asking whether the Homceopathic Review consideis " this mode of practice thoroughly orthodox from a homoeopathic point of yiew." We, for our part, are surprised at such a question being asked, and to find that the StudeTUs* Journal ^ould suppose that there can be other than one answer. The rul^s of the British Homoeopathic Society are most stringent in reference to anything approaching to adyertising, and it is yeiy rarely that our attention has to be drawn to any breach of su^ rules. We regret that such breaches haye been committed. We haye been in communication with the gentleman referred to, and find that the objectionable notices are not, as The Students* Jauiyial seems to imply, indiscriminately circulated, but are giyen to indiyidual patients who come to the surgery or dispensary for adyice.
But how can this proceeding be called '' homoeopathic ? " Is giying a yulgar and pretentious handbill to a patient coming into your consulting room '* homoeopathic *' adyertising ? and putting an adyertisement of your professional arrangements in the local papers, as it appears does a medical man hailing from Clifton^ who comes in for a mild amount of censure in another part of the same paper, ** allopathic'* adyertising? Perhaps the brilliant literary. genius of some distant day, who is trying, and creditably trying, his 'prentice hand at editorial work on the Students* Journal, will describe how an adyertisement can become "homoe- opathic." We can understand how ipecacuanha or arsenic can become homoeopathic, but how a public announcement of pro- fessional arrangements can become so we do not understand.
DR. CLAUDE.
We haye heard lately with deep regret that our actiye and energetic colleague, Dr. Claude, of Pans, who has ahready done BO much useful work for French homoeopathic medical journalism, and has giyen ample eridence of his power and willingness to do much more, has become the yictim of glaucoma of bo^ eyes. It appears that for some considerable time he has suffered from a sense of great fatigue and sharp pain in both eyes, and that recently, on an examination being made by an ophthalmic Burgeon, glaucomta was discoyered. The diagnosis baring been confimed by two other ophthahnio surgeons. Dr. Claude withdrew to the country, where we are happy to learn that under
HbiiflUy HonuBopAtfaio Befivw, Sept. 1, ifitt.
NOTABILIA.
568
suitable treatment he is improving, and he is able to anticipate a complete recovery. This we are sore all who know him per- sonally, and appreciate his ability, industry, and many good qualities, will join us in hoping may not be long delayed.
HOMCEOPATHIC PHYSICIANS AT GERMAN WATERING
PLACES.
Wb quote from the Allgemeine Homdopathische ZeUung the names of well-known German homoeopathic physicians who are in practice at some of the most frequented watering places in Germany, thinking that some of our colleagues, who may be sending patients thither, may find the knowledge of them convenient : —
|
Catlsbad |
Dr. Th. Kafka. |
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»> •« |
Dr. London. |
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Teplitz |
Dr. Stein |
|
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Eissingen |
Dr. Hermann Welsch, Junr. |
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Kainzenbad . |
Dr. H. Sauer. |
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Lippspringe .. |
Dr. Rorig. |
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Aachen |
Dr. Notldichs. |
|
|
Wiesbaden .. |
Dr. Thilenius. |
|
|
>> •« |
Dr. Liebmann. |
|
|
>> •• |
Dr. Johannsen. |
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» |
Dr. Jirau2. |
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Gastein |
Dr. Proele. |
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Wildbad |
Dr. Fischer. |
HINTS FOR THE PREVENTION OF THE MOST COM- MON ACCIDENTS CAUSING BLINDNESS, AND IN- STRUCTION HOW TO ACT TILL MEDICAL AID CAN BE OBTAINED.
The Society for the Prevention of Blindness have issued the following instructions in cases of accidents. Their being re- printed here will, we trust, add to their usefulness.
There are many preventable accidents abd injuries which cause the destruction of important parts of ihe eye, and consequently blindness.
1. Infants are carelessly left without supervision; and it happens that flies which have just left some dirty place, some diseased person or animal, some putrifying or poisonous sub- stance may alight upon and affect the external parts of the eye, causing most dangerous suppurating inflammations of the eyes.
2« Infants are often left, in the country, in the poultry yard.
664 NOTABILIA. ^feSr^STSS?
. h
where the fowls, seeing a "fly near or on the chfld's eye, pedc the eye in their attempt to catch the fly, and thus caoae a dangerous wound in the cornea (which is the name of the trails- parent part in front of the eye^, followed hy blindness.
8. Cats and dogs sometimes scratch babies* eyes while playing with them, causing dangerons wounds and blindness.
4. Children while playing or fighting cause serious accidents to one another, by polong their fingers in the eyes, or they may accidentally ihrust quill pins, pencils, hair-pins, knitting-needles or pen-knives into one another's eyes ; sometimes they throw small stones, sand and dust into the eyes.
5. In trying to undo a knot, either with the aid of a pin, A hair-pin, a fork, or the point of a pair of scissors ; the string gives suddenly way, when the point of the instrument strikes the eye with great force, causing a dangerous wound, which is followed by the loss of the sight of the wounded eye'; — some- times by sympathetic inflammation, the second eye is also lost.
6. The breaking of elastic chest expanders — ^the use of which is not at all to be recommended — causes also accidents to the eyes. The elastic, while too much stretched, breaks, tiien it contracts suddenly, and in its recoil it gives the eye a very strong blow.
7. In playing with gunpowder children firequently inflict serious damage on their eyes by the explosion of the powder while their faces are near it, or by foreign bodies being pro- pelled into the eyes by the explosion. They should on no account be allowed to play with explosive substances. Careless shooting frequently causes blindness.
8. Writing or reading for a long time in school or offices in bad positions, opposite a strong artificial or natural light, or when and where llie light is not sufficient ; copying and drawing very small print, so-caUed etching, in fistct whenever the eye is too long strained in paying attention to very small objects — a predisposition is developed to painful eye-diseases — ^to short sight and other complaints weakening the eye.
9. There are certain qualities of coal which, like old, dry fir- wood, explode while burnt in the grate, and cause accidents similar to those produced by gunpowder to persons sitting or standing opposite the grate.
10. Accidents to the eyes by scalding with boiling water, by pla3ring with melted lead, arc not very rare.
11. Painters, masons, plasterers, labourers, and other persons engaged in the use and application of lime, chalk, mortar, cement, and similar substances, are liable to get these materials thrown into their eyes; quick-lime, or lime before it has been slaked by the addition of water, is one of the most destructive agents which can come in contact with the
gSSi^SfTSS* KOTABOIA. 666
Befivw, Sept. 1, IflU.
siu&ce of the eje. If a snfficiettt quantity is allowed to remain long enough in contact with the eye, abaolnte destraotion of the part and a sloogh follows, which folly completes the loss of the eye. Plaster, mortar, lime, and other combinations of lime nsed for building purposes, di£fer only in degree from qnick-lime in the way they affect the eye.
12. All persons whose occupations oblige them to live in an atmosphere impregnated with animal, yegetable or mineral dust, are liable to inflammation of the eyes — ^aJl should use spectacles of plain glass surrounded by a soft substance, which, by adhering to the skm of the forehead, the temples, the upper part of the nose, and the upper part of the cheek-bones, would prevent the dust from affecting the eyes ; the greatest cleanliness by washing of the eyes after leaving work is extremely useful.
18. Coal-miners, stone-breakers, sculptors, metal-workers, blacksmiths, are also exposed to injuries of the eyes, caused by small particles of the various materials entering with much force the external covering of the eyes, — ^perforating wounds and blindness may be then caused ; — ^they are recommended to wear spectacles similar to those mentioned in the previous paragraph*
14. People should be very careftd to avoid using any towels, rags, sponges, which are used by any patient suffering from a discharge from the eyes ; almost all such discharges are dan- gerously infectious ; there is the greatest difficulty of arresting and curing epidemics of contagious eye-diseases, when they occur in schools, workhouses, workshops, barracks, hospitals, in fact wherever a large number of people congregate. Whenever pos- sible the patients should be separated, individually treated, and whatever has been once used for cleansing the eye from the dis- charge, should be disinfected before the same towel, rag, sponge, or other material is used a second time ; — ^in fact it is best to bum immediately everything which has been used once for such cleansing purposes.
The accidents which occur through infection by purulent eye- inflammation of various kinds are very numerous ; they can and should be always prevented by timely rational medical aid.
15. In all cases of injury of the external or internal parts of the eye, apply immediately for medical aid ; it is desirable, till medical advice can be had, that the iigured person should at once remain in a reclining or horizontal position ; on the closed eyelids apply liquid or cold water compresses (that is — little pieces of old Hnen rags are steeped in tepid or cold water, and placed over the closed eyelids). The patient soon finds out what tempera- ture suits him and best relieves the pain.
If there is any foreign body visible in the eye, and it is easily removable, it should be done at once, otherwise all should be left to the medical man.
666 NOTABILIA. ^S^^ISH'^.
BeTiew, Sept. 1, 188S.
If the iig'nry is caused by lime, mortar, and its Tarions com- binations, it is of first importance to remove firom the eye eyery particle of lime as qnickly as possible, and thus to arrest any farther destmctiye action of any fragment which may still stick to the external membranes of the eye.
Special attention is reqnired that in these cases no water should under any condition be used for cleaning the eye ; — as the water dissolves still more the quick-lime, the heat of the dis- solved lime increases, which thus would destroy the eye still quicker. Sweet oil should be dropped immediately into the eye — which is done either by a little paint-brush dipped in oil, or if there is not such a brush at hand, a rag, a fearer, a piece of rolled paper are dipped in the oil. The way to apply the oil is to draw up the upper lid and draw down the lower lid at the outer angle, and insert the oil while the patient turns the eye- ball towards his nose. Both eyelids may be everted ; in tiiis position the smallest particle of lime can be seen and easily removed, either with a small paint-brush or with the rolled up comer of fine rag or paper, or any small soft and round object ; before the eyelids are replaced in their normal position and closed, a few more drops of oil should be dropped on the eye and between the lids. A slight stream of tepid water on the front of the eye and on the outward-turned eyelids, will wash away the smallest particle of dust or any other substance.
16. It happens frequently that when one eye is lost by an external injury, that the eyesight of the other is in danger of being lost ; this is caused by what is usually called sympathetic inflammation of the eye. In these cases there is only one means of saving the second eye : this is by the extirpation or enHcleation of the first eye, of which the sight has been lost. As many people object to this operation, it is necessary to remind them that they must ascribe to themselves the loss of the second eye by their refusal of the operation just named.
17. Blindness is also frequently caused by the use of so-called wonderful eye-salves, ophthalmic ointments, eye-lotions, and similar medicines, which are used without medical advice, and often change a curable eye-disease into an incurable one followed by blindness.
18. Persons interested in the Society for the Prevention of Blindness, are requested to communicate with Dr. Both, pro t^m. Hon. Treasurer and Secretary, 48, Wimpole Street, London, W. Dr. Both would like to be informed of other causes of blindness that may have fallen under the notice of medical men. Cheques to be sent to the National Bank, Oxford Street Branch, Old Cavendish Street, London, W.
iS^S^TS^ NOTABILIA, 567
POISONOUS LEAVES.
Some of our most admired flowers, which we should least willingly banish from coltiTation, are associated with green leaves of a Teiy poisonous character. The narrow long leayes of the daffodil act as an irritant poison ; the delicate compound leaves of laburnum have a narcotic and acrid juice which causes purging, vomiting, and has not unfrequently led to death. The narrow leaves of the meadow saffiron or autumn crocus give rise to the utmost irritation of the throat, thirst, dilated pupils, with vomiting and purging. The dangerous character of aconite, or monkshood leaves, is doubtless well known, but each generation of children requires instruction to avoid above all things those large palm- shaped leaves, dark green on the upper surface. Leaves of coarse weeds provide an abundant quota of danger, but frequently their strong scent and bitter or nauseous taste give timely warning against their being consumed. Of all our British orders of plants perhaps the umbelliferous order contributes the rankest and most widespread elements of danger. The tall hemlock is everywhere known to be poisonous, and it is one of the most abundant occupants of the hedge, A peculiar ** mousey*' odour can generally be recognised on squeezing the leaves, which are deep green in colour and trebly compound, the small lobes being lanceolate and deeply cut. It is said that the mousey smell can be detected in water containing not more than a fifty-thousandth part of the juice. Hemlock is both an irritant to any sore place and a general narcotic poison, producing headache, imperfect vision, loss of power to swallow, and extreme drowsiness, with complete paralysis of voluntary muscles and muscles of respiration^ The water dropwort, too, a flourishing ditch plant ; the water hemlock, fool's parsley, must be ranked among our most dangerous poisonous plants belonging to the umbelliferous order. The fool's parsley leaves are sometimes mistaken for genuine parsley, but their nauseous odour and darker leaves should prevent this. The nightshade order is another with dangerous and often extremely poisonous leaves. Indeed, no nightshade can be regarded as safe, while the deadly nightshade, with its oval uncut leaves, soil, smooth, and stalked, are in the highest degree to be avoided. Henbane and thorn-apple again, with their large and much-indented leaves, are conspicuous members of the '' dangerous classes." Holly leaves contain a juice which is both narcotic and acrid, causing vomiting, pain, and purging. Even elder leaves and privet leaves may produce active and injurious irritation when eaten. With regard to the treatment in cases of poisoning by leaves if no doctor is at hand, produce vomiting till all offending matter is expelled, and when consider-
668 woTABiLiA. 'S:^.X£?«i!
able sleepiness or drowsiness has come on give strong tea or «offee, and again bring on vomiting ; then stimulate and ronse the brain in every possible mode, as formerly recommended. — Land and Water,
"DRUNK OR DYING."
Fbom the report of a recent inquest on a case in which the police had failed to discriminate between apoplexy and drunkenness, it appears that a medical witness remarked, " It was a mistake poHce officers often made; but the local police had been attending the ambulance lectures, and, he thought, would have been able to distinguish the two." This would seem to imply that at least one member of the profession expects more than is reasonable to expect from the modicum of information it is possible to acquire in the course of a system of instruction which is rather well- intended than well-advised. If the teaching given by the ambulance authorities were more modest, it would be incompar- ably more useful. It is not mere surplusage to talk to policemen ■about the special symptoms of drunkenness as distinguished from apoplexy. Even trained medical men have often great difficulty in recognising the difference between the two states, and, as we know, mistakes sometimes occur even in hospitals. The police should be instructed to treat aU insensible or drowsy persons as though they were suffering from illness, and to send at once for medical aid. If the case prove to be one of simple drunkenness, the fee for attendance could be added to 4he fme imposed ; if not, it would be only too gladly paid by the friends of the patient. It is inevitable that mistakes should occur if the poHce axe permitted to attempt a diagnosb. We should be glad to hear that the whole system of instruction by " lectures '* and ^'examinations" given under the auspices of the Ambulance Association had been revised, and that instead of the bewildering, because quasi-technical knowledge, it is now desired to inculcate* A few simple principles were laid down with sole reference to the prevention of accidents, until proper aid can be obtained. It is in no spirit of jealousy that we make these remarks. The Ambulance Association might do excellent work, but it has over> stepped its province and is ill-advised. This is manifest from the questions set in the '' examination papers." — Lancet.
THE KING'S EYCL.
Mb. W. Penoellt, of Torquay, furnishes to Notes and Querisg the following story of a cure far the King's Evil : — " I was ferried across the Dart on Jan. 17th last by a man about 60 years of age, who had always lived in the same village, on the right bank of the river. He told me that in his childhood he had the
iSSSS^SlTKS^ notaboia. SG9
B0View,S6pl.l, 18tt
* king's evil ;' and his pajrents, having tried all the doctors in the district, hnt without the least advantt^e, were at length prevailed on to place a dead toad in a silk catse, and to cover that with broad tape. ' This ' said my informant, ' I pnt on when I was nine, and I wore it on the pit of my stomach, roimd my neck, for ten years ; and it made a perfect core. I've to bless the day when I first wore that toad.' "
THE TBADE IN FALSE FTATR,
Haib has been so ill-treated by fashion that its vitality is now serionaly impaired. What with the strain and over-heating duo to the blending of the fiEdse with the real, the binding, the crimping, the curling, and the dyeing, a vast nmnber of ladiea have prematurely lost all or a great part of this graceful appendage of the human form divine. Hence the unwelcome &&on, adopted per force, of wearing short hair, as preferable to no hair, hias gained ground, and we hope the refreshing effect of the scissors may repair some of the mischief done. At the same time, the demand for fialse hair has greatly increased, while the supply has diminished to an extent qualified as perfectly alarming by the West-end coiffeurs. Europeans either will not sell their hair or have no longer any hair to sell ; and the trade has been compelled to travel farther afield. The actual supply of false hair for the European markets is now for the most part imported, via Marseilles, from Asia Minor, India, China, and Japan. But the hair imported from these countries is almost invariably black, and fails utterly to harmonise with the auburn and golden tints that so well befit a northern complexion. It has tiierefore been found necessary to boil the hair in diluted nitric acid to deprive it of its original colour, and it can then be dyed to the tint most in vogue. This operation has, however, been attended with considerable danger to the workmen engaged in this new handicraft. Severe coughs, bronchitis, and olher accidents were the natural results of the nitrous vapour escaping from the cauldrons used for boiling the hair. This new danger appears to have been first discovered by Dr. Felix, of Bucharest, and the Roumanian Council of Hygiene has issued a circular to all members of the trade warning them of the danger, and suggesting the necessary precautions. These facts fail to har- monise with the poet's conception that beauty can draw love with a single hair. The demand is for hair by the ton, and it is time to see that in adapting the colour of Eastern hair to Western usages the work should be carried out under proper supervision. We should strongly object to hairdressers indulging in amateur dabbling with dangerous chemicals, especially nitric acid. — Lancet*
570 COBBESPONBBHCE. ""^^.^SST^
CORRESPONDENCE.
TWO CORRECTIONS— DEGREES, PALLIATIVES. To the Editors of the *' Monthly Homeopathic Review.**
Gentlemen, — On page 446 of the Review for the present month, this statement occnrs : —
<* With the exception of the University Degrees, no one diploma gives evidence of its holder possessing an average acquaintance with each of the three departments of the profession."
This statement is incorrect, as applied to that of the Royal College of Physicians, of London. The diploma of that College is thus worded : —
" I., A. B., President of the Royal College of Physicians of London, with the consent of the Fellows of the same CoUege, have, under the authority given to us by Royal Charter and Act of Parliament, granted to C. D., who has satisfied the College of his proficiency, our license under the said Charter to practise Physic, including therein the Practice of Medicine, Surgery, and Midwifery;" to which is added, ''that such License is a legal authority to him to practise Medicine, Surgery, and Midwifery, and to Dispense Medicines, but only to those who are his own patients.*' And it certainly cannot be said of this College that it is ''open to the charge of conferring diplomas alter an imperfect examination " (p. 447).
2nd. On page 487 of the same number of the Revieic may be found this paragraph : —
" (/,) Nitrite of ainyl is a better palliative in the paroxysms of angina pectoris than any homoeopathically-acting remedy."
Surely this is a broad assertion. I have, in one patient, repeatedly relieved these paroxysms with the 200th potency, the attacks steadily decreasing in frequency and severity, indeed there has not been a recurrence since a slight return about November last. Was not the medicine homoBopathio to the disease ?
A gentleman consulted me on the 81st January last for incipient diabetes. The urine was acid, albuminous, sp. gr. 1080, with some renal casts, and an abundance of sugar. There was considerable palpitation, with general nervous debilily, which were greatly relieved by amyl mtr<xte 12 and 200. Chi the 81st July the urine was free from albumen (but contained phosphates), sp. gr. 1025, no casts, and much less sugar. The only other me(£cine used has been lycopodium 12 and 80. The patient now says he feels " quite weU.*'
Faithfully yours, London, Aug., 1882. S. Mobbisson.
^^rsStlTSr CORBBSPONDENCB. 671
" HAHNEMANNIANS/' To the Editors of the Monthly Homaopathic Beview.
Gentlemen, — In your August number, p. 476, Dr. Pope asserts ihat '* the Hahnemannians would have us believe that anything beyond a single dose of such a dilution of the most accurately corresponding medicine is not only entirely unnecessary for the cure of disease, but is distinctly prejudicial to the recovery of the sick.'' Perhaps he will favour me with the names of the Hahnemannians referred to. I never yet met with one who claimed that in every case a single dose was sufficient ; and a repetition of the dose in many cases is exyoined by Hahnemann as necessary.
Dr. Pope further says, quoting the supposed doctrines of the Hahnemannians, ''An abscess j however painful and obvious, must not be opened. All external applications, whether homoeopathic or simply warm and soothing, must be regarded as obnoxious." Where does Hahnemann forbid the opening of an abscess? Where does he forbid the uses of " simply warm and soothing " applications, so long as they are non-medicinal ?
Yours, &c.,
4, Highbury New Park, N. £. W. Bebbtoge, M.D.
August 12th, 1882.
[One of the chief authorities of the so-called Hahnemanninus is Dr. lippe, of Philadelphia. This gentleman, in a series of amusing papers entitled '' Fatal Errors,*' has repeatedly inveighed against the common practice of repeating a medicine at intervals of time, the duration of which bears a close relationship to the acuteness of disease. The dose is to be given and the medicine is, as it is termed, '' to be allowed to act,'* and this, for any- thing that is stated to the contrary, for an indefinite period.
With regard to the opening of abscesses, another Hahne- mannian authority — to wit, Dr. Berridge himself — has asserted, in the defunct Anglo-American journal called The Organon^ '* that in whitlow (and by analogy in other cases of suppuration) it is not necessary to evacuate the pus." — ^Yol. I., p. 187. Further, I have had brought before me, on evidence which is indisputable, a case of perineal abscess occurring in the person of a medical friend, in which a Hahnemannian was consulted with a view to his opening it at once. This he declined to do, es being unnecessary and injurious ; but, on the other hand, in consultation with another Hahnemannian, he seated himself, Repertory in hand, at a respectful distance from the bulging pus, and '' inspected the premises." Having done so, and obtained an account of what few subjective symptoms were present, with the aid of his Repertory, he gave the patient one globule of croton e.m. ! A night of suffering, such as a rapidly maturing perineal
672 OOBBEBPONDENTS. ^SSj^fiKT?^
1.
abscess is well capable of producing, followed ; and when the Hahnemannians appeared in the morning to see how the medicine had '' acted,** the patient insisted so strongly on being relieved by cold steel that, under protest, they yielded and gave him that relief which, as everyone but a Hahnemannian ad- mits, the bistonry alone can give in perineal abscess. I never said that Hahnemann forbiide the opening of an abscess. It is those who style themselves Hahnemannians who I stated were guilty of this folly. Neither does he forbid simple soothing applications. It is the Hahnemannian who objects to aU exteznal apphcations. It was Dr. Berridge, who, in the Honueopadtie Review for December, 1880, in disclaiming the use of any auxiliary, declared that his practice was *' distinctively homoeo- pathic and nothing else.** ff so he can never use a poultice as a part of his treatment. This must consist in the administration of a homoeopathically acting drug and ** nothing else."
Alfbed C. Pofb.
NOTICES TO CORRESPONDENTS.
«% We cannot tmdertake to return r^eeted manmcripts.
Db. M'Gonkel Beed. — ^We soaroely think that yoa have so far made oat a claim on the assistanoe of perBons at a distanoe in providing a homoeopathio hospital for the people of Southampton. "When the looil effort has assured success, provided a small addiiiooal sum is raised— then you may rightly appeal to homoBopathists elsewhere— hut not before.
Gommumoations, fto., have been received from I>r. Dudosoh, Dr. Suss Hahnemann, Dr. BEBan>OB and Mr. Cboss Hjondon); Dr. Gibbs Blasb (Birmingham) ; Dr. Bates (Brighton) ; Dr. Hatwabd (liveipool), fto.
BOOKS RECEIVED.
Afnerican Medicinal Plante; an lUuetrative and DeseripHve OtUde to the American Plantt wed as Homoeopathic Bemediei, By Gharles F. Millspaugh, M.D. No. 1. Boericke & Tafel. New Yark.^Phihui$ Pulmonalii, or Tubercular Phthieit. By G. N. Brigham, MJ). New York: Boeribke A Tafel.— TAe HomeBopathic World —The Students Journal and Hotpital Gazette. — Hie Chendtt and Druggist. — Burgoffne^e Journal of Pharmacy. — The North American Journal of HomoBopathff, — The New York Medical Times.— The New England Medical GatetU. — The Hahnemannian Monthly. — The Medical Counsellor. — The St. Lame CUnieal Revtew.-^The Calcutta Journal of Medicine.— The Indiem Homoeopathic Beview. — VArt MidicaL — BibUotKtque Homaopatkique. — AUgemeine Horn. Zeitung. — Homdop. Rundschau, Leipsie. — El CriteHo Medico. — BoleHn Clinico de Madrid. — Ondopatiea Bivista,
Papers, Dispensaiy Reports, and Books for Beview to be sent to Dr. Pope, 21, Henrietta Street, Gavendish Square, W.; Dr. D. Dtob Bbown, 29, Seymour Street, Portman Square, W. ; or to Dr. Ejoosmdy^ 16, Montpialier Bow, Blaokheath, S.£. Advertisements and Busineas oommunications to be sent to Messrs. E. Gouu> dt Sol, 59, MoorgMo- Street, E.G.
SS^foSfjjS^ SCHOOL OF HOMCEOPATHY. 578
THE MONTHLY
HOMCEOPATHIC REVIEW-
THE LONDON SCHOOL OF HOMCEOPATHY.
FoiiLowiKG closely on the meeting of Congress, which took place at Edinburgh on the 7th of September, comes the opening of the seventh winter session of the London School of HomoBopathj. We maj congratulate ourselves on the fact that, aftier this lapse of time, the School is as. vigorous as ever, and that excellent work has been done in the way of enabling a very considerable number of practitioners to become acquainted with the principles and practice of homoaopathio medicine. Some of these students were already aware of the meaning of homoao* pathy, and appreciated its value over the old system; but it was at the School that they obtained that instruction which put them in a position to practise on the principle of similars ; while others who came, utterly ignorant of the meaning of homoeopathy, and only from curiosity, had their eyes opened, and eagerly drank in the teaching offered to them. These were most regular in their attendance at the lectures, and are now practising according to the new system, with enthusiasm and a success they never previously had. Such a result is well worth working for, and we are convinced that every additional year of the existence of the School will find it stronger and more vigorous. In all probability, before the^
Vol 26, Ko. 10. 3 q
674 SCHOOL OP HOHCEOPATHT. ^b^JJoS^JSSI
present session is oyer, a Charter of Incorporation will have been obtained^ and so remove the fears expressed by not a few pessimists, that the School wonld collapse in no long time. Had it been going to pass to an untimely end, that event wonld have taken place long ere this. The comparatively small classes — small, that is, as com- pared with those of folly equipped schools — ^mnst not discourage those who take an active interest in the well- being and progress of the institution. We must not deEfpise '^the day of small things." We must not look for impossibilities, and be disappointed when they are not obtained. We have before now pointed out that in Ae present state of feeling in the old school towards homoeo- pathy, our classes must be small. The reasons for this are obvious on a little consideration. The students can only consist of three classes. 1. — ^Thoee attending the other Schools — m statu pupiUairi. 2. — ^Those who haye been recently qualified, and are firesh from their studies. 8. — Those in actual practice. The first class — students at other Schools have, or think they have, enough to learn and work at without taking up an extra subject Very few will care to thus add to their necessary work, while of those who would wish to come to our lectures, many are afraid, and not unnaturally^ — albeit we belicYe ^uite needlessly — of compromising themselves with their oxaminers, by having it known that they were attending lectures on the tabooed subject. It is dear then that we can only expect the few who are students in real oamest, anxious to perfect themselves in the knowledge of overy means of cure, and determined to do so regardless of consequences. We need not say that such men forma fimall minority. Of the second class — ^those who hafD lately left the Schools and are qualified — the migority, after A four years' course, are anxious to eam their living, and
B^rSlviS^ SCHOOL OP HOMEOPATHY. 575
cannot afford to devote another year to study. Hence, we cannot expect many of this class. There remains only the third class — those actually in practice. The majority of such are afraid to risk the loss of practice involved in changing the system of treatment they are supposed to pursue. That such a fear always turns out groundless we know fall well, but still it exists, and deters men from coming forward to study homcBopathy ; while those who do not thus fear the result of the search afl^er truth, often find it difficult to leave their work to attend lectures.
We thus see that until the trades-union ban is so far removed, our numbers at the School must be limited, and, therefore, we should look at the matter in a common-sense light, and not be discouraged that our work does not appear more imposing. A class of six or seven attending regularly, with others on the roll who cannot come so constantly, is not to be despised, and is a sufficient stimulus to those who have their heart in their work, and who deem it a privilege to be able to propagate the greatest truth in medicine ever discovered, to persevere in teaching it.
The merits of the School are becoming widely known, and we now have students coming from the Continent and from America, and we ought to have the sympathy and co- operation of all who are really interested in the spread of homoeopathy. As nothing in this world is perfect, as no two agree as to what perfection consists in, there will always be cavillers at the work done, and at the way in which it is done. Friendly criticism is always salutary and acceptable, but we would deprecate unfriendly cavilling, as not only accomplishing no good, but as doing a great deal of harm to the cause, and discouraging the efforts of those who are doing their best to teach the students. The teachers can only put their students in what they consider to be the right path, along which they must work their own
2 Q— a
676 SCHOOL OF HOMCEOPATHT. ""al^^^tsuML
way, and if by pra;ctice and experience they can improve on what they hare been taught, no one will be more pleased than the lecturers themselres. But there can be no doabt that courses of systematic lectures on Materia Medica and on Practice of Medicine do materially help the enquirer in commencing the study of homoaopatby. Without them, the labour of mastering the subject is a very difficult and slow operation, and it is a very important thing to be able to lighten the task of the beginner, putting him in a high road, instead of leaving him to dig out a path for himself. Many who have had to do the latter have expressed the wish that in their time there had been a School, while nearly all — ^whether student or practitioner — ^who have gone through the courses of lectures, have expressed their sense of the benefit they have derived from having their labours much simplified, and time thus saved. Many that we know of have been deteiTcd from doing more than glance into the Materia Medica, owing to the magnitude of the work of study required. This now need never occur. We would then entreat all those friends of homoeopathy to support the School in as active a manner as is in their power, and if this be done, there need never be the slightest fear of its prosperity and increasing usefulness. We are happy to have to announce that, this year, Dr. Prateb, whose liberality in promoting the good cause is well known, has offered two prizes of df 10 each to students attending the coming session at the School, who pass the best examina- tion in Materia Medica and in Practice of Medicine respec- tively.
In the case of the latter, a new feature is to be added, in the shape of a clinical examination in the wards of the hospital, each candidate being examined orally at the bed- side, and having to write out one case fully, with the diagnosis and treatment he would suggest, giving at the
iKSS^^cSTia^ SBABCH APTBB TRUTH. 577
•same time hia reasons for the selection of the medicines. We shall thus ensure that the winner of the prize shall be no mere book learner.
There can be no donbt of the value of prizes as stimuli to work, and we trust that Dr. Pbatsb's noble example will be followed in subsequent years by others who are able in this very practical manner to encourage the study of homoeopathy.
The session is this year to be opened on the 8rd of October by the deUyery, by Dr. Dubobon, of the " Hahne- mann Lecture." Dr. Dudgeon's position in the pro- fession, with his well-known deep acquaintance with his subject, renders his suitability for the post apparent to every- one, and we look forward to his lecture as one of the events of the year. On Thursday, the 6th inst., Dr. Popb will .open the course of lectures on Materia Medica, with an introductory address on the Definition of Homoeopathy; and on Friday, the 6th, Dr. Dtoe Bbowk will commence ;the course of lectures on Practical Medicine, with an introductory lecture on Homoeopathy.
THE SEAECH AFTER TRUTH.* By William V. Dbuby, M.D., M.R.I.A.,
Plnesiddnt of the British Homoeopathio Society.
Gentlemen. — It is my pleasant duty, on taking the chair at this Congress, to return my warm thanks for tiie honour you conferred upon me last year in electing me your President during my absence in Orkney, an absence that deprived me of the pleasure of being present at the great International Congress, held last year in London under the able Presidency of Dr. Richard Hughes.
My election during my absence, as well as the &ct that Edinburgh has been selected as our place of meeting, makes ;the honour doubly gratifying.
« Being the Presidential Address delivered at the British Homcsopathio XToDgress held in Edinburgh, September 7fth, 1882.
678 SBABCH AFTBB TRUTH. ^rSS^^oSu^
' There are, howeyer^ few pleasures in this life without some alloy^ and if from former assooiatioiis it is pleasant to meet in Edinburgh, yet the remembrance that many old friends, whose memory we cherish, have passed from amongst us, causes pain.
Some of you gentlemen may be visiting this grand old city for the first time, if so it will require much allegiance to the cause that brings us togetiber to secure your attendance here, for you are on classic ground, every spot marked by some event in history, the very houses made famous by the names of their former occupants.
The papers, however, that are to be read, and the names of those gentlemen that are to read them, will serve as a counter attraction, and let me hope that after to-day's business is ended you will not grudge yourselves a fair amount of time to see something of Edinburgh, and whether your taste lies in the direction of historical events or of natural beauty, they will be equally gratified. I know no city to compare with it.
I am not a stranger. I have lived in Edinburgh, and some of my forebears (to use a Scottish word) have played their part here. But I must not talk of ancestors, or you will remind me of a well known saying — ** When a man talks much of his ancestors, he reminds me of a potato, or some such root, the best part of him is underground."
Coming down to days that some of us can recollect, I can remember that here I made the acquaintance of Dr. Fearon, Dr. Butherford Bussell, and Dr. Black, the two first, alas, long since passed away, the last happily still amongst us, labouring as steadily and usefully as he did forty years ago, to spread abroad the truths of homoeopathy which he had learned. You know what he is as a veteran ; the same fire burned as brightly in the young graduate, when I heard him expounding ihe principles of Hahnemann's teaching in one of our medical societies to a sceptical, though not inattentive audience.
I can well remember the generous ardour with which those early friends pressed home their opinions, en- deavouring to awaken in their fellow students a belief in those doctrines that they themselves had accepted. It was the integrity, honesty of purpose, and thorough reliance in their system, that led me to treat their opinions with respect, though it was not till some years later that, like
iM^MT^Sf^ BBABCH AFTBB TBUTH. 679
Aikin Henderaon, Bansford and others, I oame to share their convictions.
There is no donbt that at this period a reyolntion was QomxneDcing in the practice of medicine, dne to homoBo- psthy, hardly recognised then, and not fully admitted now. Men learned to give smaller doses, and that the lancet might be dispens^ with.
After a time it was said that the hnman constitution had undergone a change. Sydenham had taught the possibility of this, or something akin to it, but there is no doubt that it was seeing cures effected by homoeopathy that led men to modify their own doses. Like others, I learned to do with smaller doses than I had been taught to give, and the last patients I remember bleeding were two of Professor Henderson's that one of his clinical clerks asked me to bleed for him. Marshall Hall helped to put bleeding out of fashion by his teaching.
The only positive homoeopathic practice that I then adopted was the giving belladonna as a prophylactic ; the mode of administering this I learned from an allopathic practice of medicine. Lecturing on Materia Medica in one of the Dublin schools of medicine, I am unaware that my teaching was further influenced by what I had seen, but I had a very strong suspicion that homceopathy was the law that ruled the action of specifics. At a discussion in one of the Edinburgh Medical Societies, I had said that if those gentlemen who were advocating this new system merely claimed for it that specific medicines (medicines reputed as cures for special diseases, as bark for ague) acted in this way, they would have less difficulty in propagating their opinions. Had I myself followed up this opinion to its legitimate conclusion, or had I been fortunate enough to luive seen some acute cases treated at the Edinburgh Homoeopathic Dispensary, I might have adopted the teaching of Hahnemann earlier. In later years I learned more of the true action of a. specific, and that the medicine that cured a disease having a name by which it was recognised, might signally fieui at another time in the same complaint, simply because it did not fiurly meet the existing symptoms; thus, in this disease, ague or intermittent fever, we may have to deal with chill, heat, perspiration, thirst and other symptoms. The order in which tibiese symptoms come, the predominance of one, and indeed the whole group as it presents itself to our
580 SBABCH APTBB TBUTH. ""l^w^fSSL^MSf
notice^ must regulate our choice of a medicine, and not tiie name of a disease.
I need not tell this to yon, gentlemen, bnt on an occasion of this kind, as others may wish to hiow what we do believe, it is necessary to state some familiar feu^ plainly. This mast be my apology now, and throughout this address, when I thus briefly touch on elementary truths. The want of a hospital was a great hindrance to the early teachers of homoeopathy in Edinburgh. The same want was felt later in London, and led to the establishment of the London Homoeopathic Hospital. Nearly two hundred years ago a somewhat similar want led to what may be considered as the real foundation of the famous school of medicine that has now so long flourished in Edinburgh.
Padua, Pisa, Leyden, Bome, had each attracted students from other countries, as, owing to imperfect teaching at home, men desirous of studying medicine had to go long distances to enable them to do so. If inconvenient, this had its advantages, as ideas became enlarged and learned men met each other and were enabled to make known their ideas in a way they cotild not otherwise do, as thought could not be interchanged in those days as it is now.
In 1694, the celebrated Dr. Pitcaim sought to obtain from the Town Council of Edinburgh permission to open the bodies of those who died in Paul's Work, and had none to bury them. He complained of the difficulties he had to encounter, and says, *^ there is great opposition by the chief surgeons^who neither eat hay nor suffer the oxen to eat it. I do propose, if this be granted, to make better improvements in anatomy than have been made in Leyden these thirty years, for I think most or all anatomists have neglected or not known what was most useful for a physician." Pitcairn may have found some difficulty in carrying out this work himself, for we find him connecting himself with Mr. Alexander Menteith, a member of the Corporation .of Surgeons, for, as a physician, there may have been some professional obstacles that he could not overcome. Mr. Menteith received permission to carry on his dissections for thirteen years, one of the conditions being that he was to attend the whole' town's poor gratis y and to supply them with medicines at cost price. The liberality of boards, in the matter of paying their medical officers, seems to have been made much on the same scale as in the present day.
wS^^r^^ 8BAB0H AFTBB TiRUTH. 681
The following advertisement from the Edinburgh Gazette ef May 8, 1699, is of interest : — *' Upon Monday, the firc(t of June next, at the laboratory in the Chirorgeon Apothe- caries Hall, tiiere will begin a coorse of Chymie in which all the useful operations and preparations will be performed. The .course will continue six weeks, and will be concluded with a short description of the whole Materia Medica by Alexander Menteith, GhirurgeonApothecary inEdinburgh.'* Fancy our friends Dr. Hughes, Dr. Pope, or Dr. Dyce Brown, in their lectures, compressing Allen's ten volumes into a six weeks' course.
Some of the surgeons of the town were stimulated into action, and they applied for the bodies of still-born children. Suicides, and criminals for the purpose of dissection. Their request was granted on the condition that before Michaelmas, 1697, they should have ready an anatomical theatre, where they shall once a year (a subject offering) have a public anatomical dissection, as much as can be shown upon one body. ** And if they fail, then these pre- sents to be null and void."
Steps were taken to secure the community from infec- tion. The gross intestines were to be buried within forty- eight hours, and the whole body in ten days.
Mr. Menteith's original plan not succeeding, owing probably to the advantages gained by the corporation, he was given four hundred pounds Scots, about dBS8 6s. 8d. (a pound Scots being equal to one shilling and eight-pence)» as a remuneration.
It was not till 1706 that the want of one recognised teacher was sufficiently felt as to lead to the induction of Mr. Robert Elliot as the first Professor of Anatomy in the University of Edinburgh. On his death, in 1714, he was succeeded by Mr. Adam Drummond, who had associated with him Mr. John Macgill. This Mr. Macgill operated successfully for aneurism in the arm. The operation was witnessed and commended by a young surgeon who had had the best medical training available in those days, and who later on succeeded to the Professorship. This was the first Munro. Interesting as it may be, I cannot follow in detail the growth of the Edinburgh School, but briefly lead up to what has a bearing on the subject in which this Congress is most interested.
The first name in this University that concerns us is that of William GuUen. Not that this great medical luminiury
682 BEABCH AFTEB TRUTH. ^"'^SL
BflvtoWf O0fc> S( UBS*
knew anything of the law of homcBopaihy^ bat that standing at the head of his profession as a teacher, his worhi attracted the attention of Samuel Hahnemann. Gnllen collected facts, reduced them to order, and elaborated a system of classification that has greatly advanced the study of medicine, though increased knowledge of disease has called for changes in it. Hahnemann went a step further. He tried to find out the cause of some of the things that GuUen ntu-rated, and so was led to the discoreiy of a great truth of which I shall have to speak again.
Black succeeded his master CuUen in the ebair of chemistry in Edinburgh, and by his researches on heat added to the fame of the University. Others followed, the first men of the day being attracted to the celebrated School, but Scotland needed no foreign aid, her own sons were sufScient to sustain the reputation of this great seat of learning. I must not speak of the classical, theo- logical and other teachers who were not behind their medical colleagues, but amongst these last, the names of Gregory, and his famous nephew and son-in-law, Alison, Bell, Syme, Henderson, Simpson, and Ghristison, are not forgotten. The last, who as a young man made a European reputation by his great work on poisons, and in his dispensatory left a model tibat it would be well for all writers on Materia Medica to copy, has but departed from amongst us, as it were, yesterday. Having been his clinical clerk and laboratory assistant, I was gratified a few years ago, at seeing my old master enter the graduatioii hall, round after round of applause showed how dear the old man was to his former pupils, and that the younger ones were well aware of how great a man they had still among them.
Time warns me that I must pass on at once to the subject I have selected for my address, '* The Search after Truth.''
Eighteen hundred years ago, Pilate, the Boma» governor of Judaea, asked of One who could have answered him as none other could, ''What is truth?" The not waiting for an answer showed what an unreal thing he thought truth was. And yet it is what the wisest and best have craved for. Theologians and men of scieno^ in their various departments have striven to detect ii» Thousands have perished in pursuit of it, and thousands hme perished for it. The man of science has often in
2SS^5t?rS^ SBABOH AFTBB TBUTH. 683
penury and Bolitnde spent long years in searching for it. It has cheered the death-bed of many a dying Christian, who with the eagle eye of fiedth looked upwards to catch a glimpse of that inheritance of which he knew he was the heir. It is the craving of every earnest-hearted man. And ''The land of the leal" has become a household word throughout our land since it has been familiarised to us in the words of one of Scotland's sweet songstresses, — ^the Baroness Nairn.
** There's nae sonnow there, John, There's neither oanld nor care, John,
The day is aye fair In the land o* the leal.**
More is needed than desire to grasp, and earnest labour to acquire truth. Many in the search have Mien into the greatest erjror. It is well ever to bear this in mind, and to remember how easily we may be diverted out of the right path. A truth may be misapplied^ and I think it can be easily shown that there are few great errors that are not based on some truth. It may happen that but a modicum of truth serves as a basis on which a huge superstructure of error may be erected ; the very presence of a little truth serving as iixe bait to lure some from th^ right road.
The very zeal with which a truth is sought becomes a danger, as what is longed for, or expected, is often accepted as a reality on the most slender evidence. Medical men are very apt to go astray, and I believe those who seek to learn the action of medicines by noticiug the symptoms they produce when taken by persons in health are no exception. I was much struck by hearing Mr. John Wood say to the students at King's College Hospital, when speaking of an apparent surgical success, ^' but, gentleman, one or two cases prove nothing." Caution of this kind goes a long way in preventing error. Some years ago Sarracenea pufrpurea was spoken of as a wonderfoi remedy for small- pox. Mr. Marson, of the Small-pox Hospital, submitted the medicine to a rigid test. He selected cases, as they pre- sented themselves, that seemed likely in the ordinary course of events to die, some thirty-six in all ; in no single case did the medicine appear to check the fatal result. He con- dnded, and I think fairly, tibat if the medicine had any of ihe virtues ascribed to it, it ought to have been of use in some one of these cases.
To look in another direction, what shipwreck some have
Ii84 SBABOH AFTER TBUTH. '■^irjoST^St
made of the study of prophecy by arriving at unwarranted •conclusions on a very small amount of what looked like evidence.
Madame de Stael said she did not believe in ghosts, but that she was very much afraid of them. I should think a very trifling circimistance would have given her the belief she said she had not got, and would have very considerably augmented her fears.
Without in any way encouraging scepticism in its ordinary meaning, as wise men, and for the sake of the truth that, as medical men, we accept, we cannot be too careful in requiring the fullest amount of evidence as to facts connected with it.
When a truth that we had not before noticed is opening up to us, there is a great danger of accepting what appears to be a corroboration of it on too slight evidence. My younger brethren will excuse me giving a word of caution on this head.
»
A gentleman, now many years dead, became a convert to homoeopathy. He had occupied a prominent position as an opponent, consequently his change of belief caused some stir. He issued a pamphlet giving an account of what had helped to confirm his opinion. While there may have been more than enough to justify him in the step he had taken, I could not avoid thinking, on reading bis pamphlet, that as he grew older he would become less sanguine and would learn that the success he had met with might not always be due to the action of his drags but to oUier causes. I do not now say this to censure one who cannot defend himself, but who, had he lived, would no doubt have taken a prominent place amongst us, and probably would have joined with me in warning you against the rock upon which he had run, and on whidi I have no doubt I myself have done the same.
I can but very cursorily glance at the search for truth in its scientific aspect, and, indeed, only briefly at it in its medical bearings.
By the word truth, as I seek to apply it, I mean the recognition of all known scientific laws, and of all estab- lished scientific facts.
Thus, I would say, that when the Atlantic Cable was broken, and lay many hundred feet deep at the bottom of iihe Atlantic, it was true science that enabled those in •charge of the expedition to return to the exact spot to find
Ifa^yHonwBoprthio gB^HOH APTBB TBUTH. 686
Beview, Oot. 3, 1861.
it, and theiiy by the perfection of their appliances, raise it on board the ship, make a splice, and open commnnica- tions with the shore.
The completion of Telford's suspension bridge over the Menai Strait was in its day a great engineering trinmph, as was also the still greater feat of the laying the tubnlar bridge across the same Strait; the last needing all the skill of Eaton Hodgkinson to make those true calculations as to the strength of the iron, that enabled Robert Stephen- son to accomplish the great undertaking that has since then conveyed thousands of trains across in safety.
It was the failure of making true calculations, as well as- faulty material, that led to the disaster at the Tay Bridge, and tiie making of which correctly has saved the light but elegant bridge made by Brunei over the river at Saltash,. near Plymouth.
Science has not been equally felicitous in all her branches, though great truths have been developed, and in our day the unrolling of them has advanced at express speed.
Going back to the early history of the world we find the Babylonians laying the foundation of the study of astronomy, mapping out the heavens, naming the constel- lations, and discovering that there were true and unerring laws guiding all the movements of the heavenly bodies. And yet with all this knowledge that should have led them to recognise a divine head overruling all, how rapidly they sunk into the grossest error, and forgot God, the great Creator.
Again, in those early ages, we find the Egyptians re- nowned for their learning, yet, like the rivsd kingdom, accepting the most revolting form of worship, and in the end degenerating from all their ancient grandeur.
Piazzi Smith, the Astronomer Boyal of Scotland, has, in his deeply interesting book. Our Inheritance in the Great Pyramidy shown how this wondrous structure difiers from all other Egyptian buildings ; how measurements and calculations may be made from it, that, if his conjectures are right, show, as he says, that either its builder was divinely inspired, or that in those days an amount of knowledge was possessed greater than we now enjoy. It is interesting to know that the calculations of the sun's dis- tance from the earth, based on the information obtained from the pyramid measurements, comes nearer what we now
686 SEABOH APTBB TBUTH. "1SSSL?S2??^
Beriew, Oct. 2, Ifltt.
think approximates to the truth 'than the measnrementa formerly given.
Spectrum analysis has opened up a new field of truth. Thus, gases, especially hydrogen, and metals, such as sodium, iron, calcium, magnesium and others have be^i demonstrated as existing in the vapouiy atmosphere sur- rounding the sun.
By this newly discovered agency, a portion as small as the one five-millionth part of a grain may be detected. To us this is of interest, as supporting what we have so long contended for, that matter was capable of division to an extent of which we could form no comprehension. Ordinary means give us some idea of this. The 6th decimal dilution of musk, or the 100,000th part of a grain, is readily recog- nised. And when we know that musk will scent a drawer for years, and unpleasantly influence a susceptible person long after the original particle has been removed, we may ask what is the quantity that effects this. Again, what is the quantity of scarlet fever poison that will produce disease? These questions are more easily asked than answered, but it is well they should be thought about. In an interesting paper by Dr. Bamsbotham of Leeds, in reply to a letter in the Leeds Mercurj/y he mentions that '^ Dr. Burden Sanderson has discovered ^in vaccine lymph small particles of less than the 20,000th of an inch in size, and for vaccination to be successful, one at least of these particles must be introduced under the skin." While speaking of the action of small quantities, I may refer to a statement of Darwin's, quoted by Dr. Galley Blacklej. '' It is," says he, ''an astonishing fact, on which I will not here again enlarge, that so inconceivably minute a quanti^ as one 20,000,000th of a grain of phosphate of amTtumia should induce some changes in a gliuid of drosera suiBici^it to cause a motor impulse to be sent down the whole length of the tentacle; this impulse exciting movement often through an angle of above 180 degrees. I know not whether to be most astonished at this fact, or that the presence of a minute bit of hair, supported by a dense secretion, should quickly cause comprdiensive movement." (Insectivorous Plcmts, by C. Darwin, M.A., F.R.S.)
Just now electrici^ bids fair to cause as wondrous a change as the locomotive did in its day. Other agencies, such as compressed air, or compressed gases, may yet com- pete with steam and electricity in the purposes to whidx
SlSS^^"j?iSf^ SBABOH AFTBB TBTJTH. 587
ihey are applied. Upwards of forty years ago the late Mr. Kemp showed what enormous power existed in com- pressed gases. All we then needed, as we still do, was to know how to ntilise it.
Geology is accnmnlating fresh facts, and paleontology is opening np new snhjects of interest, the tmths connected with which we have yet to search for. Bemains of animal life are now found in rocks where they were not known to exist. The traces of Eozoon Ganadense, found in rocks helow the Cambrian, described by Dawson, shows how fiEU* we have gone in this direction. The smallness of the brains of mammals of the tertiary period, and of birds of the cre- taceous period, has attracted notice. The Titanosaurus found in the Jurassic beds of Colorado is another creature of a bygone age to which modem exploration has introduced us. We may be glad not to have this beastie, one hundred feet long and thirty high, wandering at large, unless we oould turn his gigantic force to account and make him work. Had he been in existence we could better appreciate the fMe of the cock standing in the dark in a stable with horses, who thus addressed them : ** My friends, I think we had better stand still for fear of treading on each others feet."
The recent discovery of salt in Cleveland, will be the means of opening up a new industry in that district, thus turning scientific exploration to good practical account.
The recent adoption of a method of storing fodder, practised in parts of France and America, bids fair to be a source of wealth to the farmer in enabling him to supply a greatly increased number of cattle with food. It is called ensilage. Trenches several feet deep are dug, and lined with brickwork, oement or concrete. The fodder containing all its moisture is chopped, and buried in these pits or Mas. The whole is then covered up with boards, felt and earth. When opened the fodder is found to retain its freshness and purity.
It is to be lamented that the discovery of another truth that would largely benefit the farmer is so long delayed. I refer to the best mode of utilising our sewage, as there can he no question as to the fatal mistake of our present system, whereby our rivers are polluted, our healtii injured, and enormous quantities of fertilising material wasted. Surely it would be better to retain the sewage for the use of the laad, even at a present loss, than go on as we are doing.
688 SBABOH AFTEB TBUTH. ^El^?oS'?Mtt!
There are many difficulties that have to be oyeroome in other directions. Thus, how to restore some beauty to the fields of Lancashire and Yorkshire by getting rid of the tall factory chimneys, while the fiEu^tories themselves are made .more healthy and pleasant-looking to the eye, is well worthy of attention. Hitherto the beautiful has had to give way to the utilitarian. Our efforts should be to secure all the advantages we can from each.
Modem research is everywhere opening up new fields of investigation, in which much truth may be learned. But has the time come for founding systems as if they were undeniably true, on the facts and suppositions that are brought before us from day to day ? Embryology is a new study, but already men are jumping to conclusions that they may have soon again to give up. Is this likely ta advance truth ? I would recall the admonition, " ^tove all things, hold fast that which is good."
Let us see how some of these discoveries affect us.
The changes that occur in certain forms of animal life, and these influencing disease, become of importance. Thus the fluke causing rot in sheep, and existing at one part of its career in snsols and slugs, is a truth that it is well to know, and may yet be turned to practical account.
Again, the discovery of new forms of microscopic life, capable of inducing disease, leads to greater care. The discovery made some years ago that fermentation was due to vegetable life, has been followed by the recognition of the fact that the germs of animal life floating in our atmosphere may give rise to unhealthy action when they come in contact with open wounds. This knowledge led Mr. Lister, then of Edinburgh, to seek for some means of destroying these germs, and on this his famous antiseptic treatment is founded.
The Bacillus Anthracis it is now known produces splenic fever, communicable to man (the wool-sorter's disease). Cattle inoculated with matter containing the Bacillus are found to be protected from the disease.
Koch, of Berlin, has shown that tubercle owes its origin to a form of Bacilli, and that he can produce tubercle in animals. All this is leading towards inoculation as a pre- ventive remedy, but as it is a dangerous one to experiment with, we can hardly see as yet what practical truth may be developed from it. I would guard myself from being supposed for one
SSS^<S??Sb?^ sbaboh afteb truth. 589
moment in this to say a word against vaccination. I do not like compnlsory vaccination as at present carried out, but of the blessing that inoculation first, and latterly vaccina- tion, has been to mankind, I have not a shadow of doubt. It is hard to say in what direction knowledge is not advanc- ing, and curious facts coming under our observation. Thus it has been for a long time recognised that trees may be attacked with diseases akin to those affecting animals, such, lor example, as ulcer and dropsy.
In searching for truth many pitfalls lie around us, one that I would especially say a woi^ of warning about is the being led astray by a great man. Few men are great ^^ all round/' but the more we admire the brilliant genius of any man, the greater the risk of adopting his errors* It is very noticeable in politics, it is equally so in religion, and if a great man goes wrong what a number are apt to follow in his wake ; hence narrow views, and sectarianism. Medical men are no exception. One man sees something of the same disease in every case he meets. Another wages war against some particular food; another always orders it. But let some leader order patients to a particular locality, and then up springs a host of imitators; yesterday it was a warm dry climate, to-day it is up in the mountains — ^the wonder is we have not got a limited liability company for an hotel on the summit of Mont Blanc. It is in medicines that fashion is so much followed. A drug that every one is taking at one time will after a run be neglected and then almost forgotten, simply because instead of being given in selected cases it is administered indiscriminately.
This does not advance truth, and is a great evil in allopathic practice, happily it is one but little felt where medicines are selected in accordance with the homoeopathic law.
It is interesting to notice how error in one direction will retard the growth of truth in another.
I have alluded to the Babylonians as learned in astronomy. In many ways they were a great nation. Under great dif&culties they formed libraries. To convey their ideas they used the cuneiform or wedge-shaped characters. These were stamped upon clay tablets that were afterwards hardened by fire. Learned men of the present day are getting to know much more about this people by deciphering their writing. Notwithstanding their greatness in some things, they had a degraded form
VoL 26, Ko. 10. 2 b
690 SEARCH AFTEB TBUTH. ^''bS&JJoSuSml
* ' '
of religion which was an effectual barrier to anything that would emancipate the mind. Their knowledge of medicine suffered as a natural consequence. Sorceiy, witchcraft^ with all their abominable superstitions took the place of what was true and good, and portents and omens were their guide in difficulties. Thus we read in the prophet Ezekiel xxi.> 21 ** For the king of Babylon stood at the parting of the way, at the head of the two ways to use divination : he made his arrows bright, he consulted with images, he looked in the liver."
To some minds charms and occult ways hsve an attrac- tion, but where truth runs counter to these as it must do, it can make no growth till they are oast aside. In the history of Greece and Rome we find there were some men who strove to free themselves from the superstitious belief of the multitude. What happened in religion most pro- bably happened in medicine, for we find some progress made. Xhe names of Hippocrates, Dioscorides, Ceisus, Galen, AretsBus, and others, stand out as luminaries lighting up a dark sky, but they lacked that collateral knowledge, and appliances that we have in modem days, which retarded their advance.
The discovery of the circulation of the blood gave a great help to surgery, but it is not till we come close on our own time that many of those aids that we are now perfectly &mi* liar with were discovered. Laennec, wishing to hear the sounds of the heart in a case where he could not conveniently apply his ear, rolled up a sheet of paper into a tubular shape and used it to hear through, this led to his intro- ducing the stethoscope in 1816. It rapidly came into use, but perhaps by none was it turned to better account than by Louis and Stokes. Mistakes have been made with this instrument, but that is the fault of the individual in not understanding better what the stethoscope conveys to him.
Akin to the stethoscope is the thermometer, which tells us some most important truths about disease. Indeed ita value cannot be over-rated. It was long suspected that the thermometer might tell us much, but it was not till an instrument was constructed that could be taken away from the patient and read at leisure that what iti was able to teach could be turned to good account.
The sphygmograph is one of the latest inventions, and is on its trial. Our colleague, Dr. Dudgeon, has con^
iSrtSl^S'nBS?^ SBAROH AFTEB TBUTH. 691
stracted one of these instraments that haB, I belieye, met with a considerable amoont of approval.
Other instnunents for aiding diagnosis have been intro- dacedy some that haye been of much use, and some that are capable of being Very misohieyonsly applied.
The microscope has been considerably improved, and has taught ns some truths relating to minute anatomy and diseased structore. It was in this city that the first lectures connected with this instrument were given by Dr. Hughes Bennett, a course I attended, and where I had the advantage of making the necessary demonstrations for the lectures.
The discovery of the use of ether as an anasthetic by Mr. Horace Wells has been the means of relieving an enormous amount of human Bufferings and has been of immense help to surgery. The extended application of chloroform by the late Sir James Simpson has also been a^ great boon to suffering humanity.
Some great surgicaJ truths have been brought to light,, and operations are now daily successfully performed that but a very short time ago would not have been undertaken without the greatest trepidation. I allude to ovariotomy. Another class of operations, where the peritoneal cavity may also require to be opened, may be found less formid- able than is thought, if they be performed sufficiently early.
Still, with all the advances of modem days, a want has been felt of some system that would at once place the practice of medicine on a scientific basis.
No ordinary practice of medicine supplies this want. The symptoms of a disease, and the course it is likely to- run, may be given accurately, but as to any fixed rule to guide the treatment there is none. The only approach to unanimity is where specific remedies are used, such as quinine for ague, opium for delirium tremens, &c., but a satisfactory explanation of how these act is wanted, and their usefulness in the cases in which they are given is no help as to how they should be used in other forms of disease.
The late Dr. George Gregory's practice of medicine was the standard authority till it was superseded by Sir Thomas Watson's some thirty-five or forty years ago. I once asked Dr. Gregory to allow me to issue a new edition of his book, bringing it up to the requirements of some thirty-two years ago. He very wisely said no, that his book would show what the practice of medicine was in his day, and he would rather leave it so. Sir Thomas Watson's book, followed.
8
692 SEARCH AFTER TRUTH. "^aJS^f^oSL^MfflL
by Aitken's, were great improyements on Qr^ory; tbej marked a great step forward in improved knowledge <^ disease, but made no approach to a sound therapeutic law.
Dr. Hodgkin's book on the mucous and serous mem- branes was an attempt to improve our knowledge of disease, and was followed by Billing's Principles of Medicine and Alison's Pathology and Medicine. But sJl these, thoi^h clearly pointing to the great want that was felt» and though much appreciated by thoughtful students, fsdled, as Watson's and Aitken's that came out after them did.
Dr. Hughes Bennett's book was a good attempt in a new direction, but like all the others, it merely helped in making us better acquainted with disease, but the same want of a true law to guide in the administration of medicine showed that it was no real advance, and already the book is dropping out of memory.
The want I speak of must have been often sorely felt by searchers after truths and by none more keenly than by Samuel Hahnemann, a native of Meissen in Saxony, who, practising towards the close of last century in the neigh- bourhood of Leipsic, felt so dissatisfied with the unscientific condition of the practice of medicine that he thought of abandoning his profession. Having, however, to provide for the wants of his family in " the battle of life," he had to use his brains to obtain his daily bread. At this time he was asked to translate Cullen's Materia Medica from English into German, and reading there an account of the action of Jesuit's bark, or cinchona, in ague, he asked himself the question, why does this medicine cure ague ? Not knowing how to answer his own question, he resolved to try and find an answer. Happily he sought in the direction of noticing the e£fect of cinchona when taken in health. To his surprise, he found it produced symptoms similar to those it was said to cure. Further investigation showed him that many remedies reputed as cures for different diseases were apt to produce symptoms similar to those they cured. He had found the key that fitted the lock, and the discovery of homoBopathy, or like curing like, in the treatment of disease was the result.
It must not be expected that every healthy person taking
'bark will suffer from symptoms of ague ; some may suffer
instead from severe congestive headache or other symptoms;
medicines do not affect everyone in exactly the same way«
'o, likewise, a number of persons may drink impure milk
mS^oSkS£^ sbabch aftbb tbuth. 698
or water, only a certain nnmber may in consequence suffer from typhoid or a choleraic attack.
When Hahnemann made his great discovery known it was receiyed with coldness, and is to this day rejected by the larger portion of the medical profession, who still experience the want, the remedy for which is within their reach. It reminds me of what was told at a reviyal meeting. A ship arriyed off the coast of South America in great distress from want of water. Meeting another ship, they mentioned their want ; the reply was, ^' lower your buckets into the sea.'' They did so, and found they had abundance of what they wanted around them : they were in the track of the mighty Amazon, whose waters are carried out a long distance before they mingle with those of the ocean. Had Hahnemann rested content with the discoyeiy of ''like curing like," '' wmiiia rimUibvs curantur,'* his doctrine might gradually have made its way, as there was nothing in it to shock the prejudices of medical men. But he laid down a rule that only one medicine should be given at a time. This was not imreasonable, but finding tiiat medicines given in ordinary doses were very apt to produce a group of fresh symptoms while they cured o^ers, he tried the effect of giving smaller doses, and found he lost nothing by so doing. Those who have felt uncom- fortable effects from taking iron for some time, or who have taken much iodine, or been salivated by mercury^ or had their skin permanently discoloured . by the action of nitrate of silvery can bear testimony to the fact that medi- cines can do harm as well as good, and if, unhappily, the harm follows and not the good, as sometimes happens, the giving the smaller dose would be an undoubted advantage.
Once Hahnemann found a small dose answer, he was led on to make a further reduction, and see how small a dose would cure. An allopath may at once exclaim, I cannot believe in this, because I know a certain quantity is needed to produce a certain effect. I cannot induce vomiting with less than a given quantity of ipecacuanha. That, I may say, is perfectly true, but you forget our medicines are given on a totally different principle. I do not want to induce vomiting, but I want to allay the sensation of sick* ness, therefore I give a medicine that I know would pro* duce vomiting in larger doses, and by so doing I hope to remove the feeling of nausea. And it is simply because
094 8EABCH AVTEB TBUTH. '^^^Sl^^a^s^
iUness eziBts that my fimall dose acts, it has something to deal withy to which it is hostile ; did this not exist, my dose is so small that it wonld not be likely to produce any deleterious action.
Hahnemann did reduce his doses so much that I think the greatest allowance ought to be made for those who opposed him. In our day it is different. Things are now accepted as truths, that, if believed in formerly, would have made those who let their belief be known candidates for lunatic asylums.
I need not repeat what I have already said about speo- trum analysis and other discoveries of our day, but in the face of these what Hahnemann taught about the small dose ceases to be so strange. The simple question at issue is, do the small doses act curatively, or do they not? Thousands of witnesses assert that they do, but thousands of witnesses may believe an untruth ; it has been so, and may be so again. We, however, do not rest on mere assertion, we ask our professional brethren to come and judge of these things for themselves. They can witness our treatment in hospitals and dispensaries, and where it can be done I am sure my professional brethren wonld gladly let an enquirer see something of his private practice. Where those who oppose us hear of cholera, pneumonia, and other serious diseases being treated successfally they lose a golden opportunity of not seeing for themselves whether this is so or not.
Still, I think every allowance should be made for our opponents ; we know how hard it was for ourselves to acc^t what Hahnemann taught, we know that he was not in&llible, and that some of his utterances may have been too hasty, though of his general principles we may have no question. We know that in our own body there are divi- sions; that the very small dose is looked upon with disfavour by some, while those who give the larger doses are very strongly condenmed by the small dose men. I may be pardoned for giving my own experience in this matter. I have seen extraordinary results from the small dose, I have seen moQt gratifying results from larger ones.
At one period of my career my leanings were in fsivour of the small dose. I tested it fairly, and was satisfied with the results. When suffering severely from illness con- tracted from a child that died of diphtheria, I was treated ^vith the most minute doses, so that in this I gave hostages
iKS^iSlT?^ SEABOH APTBB TRUTH. 595
for my conyictionB. As time rolled on I saw the diffionltj that existed in connection with the small dose. A long time was often needed in the selection of a remedy. Some of those who nsed the small doses went to great extrava- gances, and things were done that unnecessarily tried the faith of some. Then again there was the danger of not haying the confidence that was needed in the way the medi- cine was prepared, for however upright and careful the head of a pharmaceutic firm may be — and I am proud to say that amongst our chemists there are men of probity and worth in whom we can place the fullest confidence — ^yet, as any dere- liction on the part of a subordinate, either in a homosopathic -or allopathic pharmacy (and we know that others may suffer as well as ourselves), may be followed by serious con- sequences, it is better to avoid the risk of such as much as possible. Preparing our own medicines, or having a guarantee that they are prepared by the heads of firms, ensures safety. But if the same results can be obtained from less highly diluted medicines, the patient, the chemist, and we ourselves are gainers. Anxious to settle this question for myself, I tested different strengths of medicines over a long period of time, and was so far satisfied with results, that though I might in the case of some medicines use them more highly diluted than others, yet on the whole I was quite satisfied with the results obtained from medi- cines approaching tangible quantities, ranging chiefly from 12 X or 6 to 1 X. I speak of 12 x, but according to the rule in the pharmacopoeia, this should be 6. I should have been glad to have made it 12 x in our new edition, but the rule having been adopted it was thought better not to change again. Let me say here that adopting such doses did not lead me to run down the higher dilutions, or say that in the Lands of a man like mv friend Dr. David Wilson they may not produce great results. But to follow those who carried high dilutionism to the lengths some in this country and some in America had done, I was not prepared to go at any time.
Unhappily for the success of homoeopathy, the globule was introduced, and became an abomination to medical men of the old school, and a strain on the belief of the public. It was a mistake. Not, let me at once say, that the globule may not do all that the pilule may do, and I would rather take it than some of the allopathic parvules that are being introduced, but as it was a barrier to the advance of homoeo*
696 SEARCH APTEB TRUTH. ^"^^^^oSl^^
pathy it would have been feur better to have used powders saturated with tincture ae the globules are. It is well, however, to remember that in spite of the objections to the^ globule, the greatest advance that homoeopathy has seen was made while it was in use.
Some of our body made a mistake in crying down tinc- tures, forgetting, I think, the great secret of what must* ever lead to a successful practice, the selection of the right medicine. Admirable cures have been effected by tinctures, pilules, and globules. And as the globules all contaiii> tincture, no man should have been blamed for using which he pleased.
I must now come to a question of the day, the antago^ nism between practitioners of allopathy and believers in homoeopathy.
The size, and form, in which our medicines are given is open for every man to deal with as his judgment may lead him to decide upon doing. The real question at issue is one of simple belief. I claim the right to believe that medicines given on the principle of like curing like is a grand truth, and the safest rule to guide us in their administration. I do not deny that- medicines given to effect a certain object, as opium to procure sleep, a sudorific to induce perspiration, an expectorant to relieve cough, and such like, may affect a cure by directly counteracting some symptom that ia giving trouble — in short, that by an alterative action of some kind, good may result, but that acting on these lines there is much of guess work, that the great part of a man's- knowledge must be acquired by personal experience, and that in difiBcult cases he has nothing to steer by. For holding this belief and exercising the right of private judgment, which every medical man should contend for, I am shut out from societies, I am refused to be met in consultation, and if it were possible I would be shut out from the practice of my profession. Well, gentlemen, we have survived, notwithstanding this treatment, and will, I trust, continue to do so. I quite admit that we may at times be inconvenienced by the opposition we meet with, but rest assured so long as we practise our profession honourably and fairly, we are on Uie winning side. Our* numbers are augmenting, our practice is adopted without acknowledgment, and tiie bitterness of former days is greatly lessened. Many men refuse now to be parties to^
bS^m^%iS^ sbaboh aftbb tbuth. 697
that illiberal feeling that was once so common. A few opponents have still, it is true, much power. One or two men in a town can exercise a considerable influence over others who do not share that nngenerons spirit thai animates some men of small minds. A threat from one of these little men to write to the Lancet to complain of some coUeagne who has shown some sympathy with ns has not yet lost its power, though it is gradually decaying, and the day has assuredly gone by when any large measure of Uliberality could either be carried or desired by the majority of the profession. It is gratifying to know that at Worcester and elsewhere men have been found to rise superior to any unworthy effort, to dictate to them as to the action they should adopt towards us.
Now let me say a word as to our' position. If any man adopts a name to enable him to work his way into practice^ he is doing what is wrong. The British HomoBopathic Society and the heads of our branch of the profession, that hold ihe belief in the law of homcBopathy, have objected most strongly to anyone putting the word homoeopath on. his door-plate. We claim to be physicians, and to be at liberty to adopt any treatment we think best for our patient. So long, then, as we pursue this line of conduct, we are practising our profession fairly, and if, doing this, others choose to act unfairly towards us, they are the greatest losers, for they expose themselves to the charge of acting from unworthy motives.
Errors have been committed, and rash words uttered by some of us. I have preferred giving up a patient to allowing, him to have his own way about taking some auxiliary medicine. I should do so still if there was any attempt to- dictate to me, but I would not seek to avoid running counter to the wish of my patient in a matter concerning his comfort unless I felt I was doing him a positive injury by letting him have his own way. Again, if I believed I could benefit my patient by the administration of a drug, homcBopathic or not, I shorJd hold myself free to use it.
Some may go much further than others in this, and I should be sorry to restrict any man's freedom, but I feel assured that anyone who fairly understands and believes in the homoeopathic law, will think twice before he departs from it. Even in such a case as giving opiates to relieve pain, he will weigh the question whether he may not be^
598 SEABOH AFTSB TBUTH. ^""^iiJIoSnS^
■ — - »
purchasing temporary relief at too high a price. A man must act in such a case in such a way that he has a dear conscience.
Some years ago I treated a case of rannla of soma standing with mercuHnSf under which treatment it dis- appeared. Recently I saw a case where it was not large or of long duration. I had not lost faith in mercttriu^, but I thought that by applying nitrate of siher I wonld -obtain the result I desired more expeditiously. I therefore used the caustic. The following day the size was lessened, and in a short time it disappeared. In former years I should have hesitated about departing from homoeopathic treatment, but, expecting a result, I fdt justified in acting as I did.
Our body is somewhat agitated at this time as to the retention of the name by wMch we are known. Some are charged with wanting to give it up. I know no one who wants to give up the word homoeopathy. I do not know one that does not boast that he is a believer in it. It is the very ground on which we stand, it is identified with our hospitals, our dispensaries, our literature, and our school ; therefore, as describing our system, it must be retained, but this expression of my belief does not compel me to give up my title as a physician, and adopt a name that makes me a sectarian. I write M.D. after my name, not homoeopath. I think if this question is separated from party feeling, there need be no real difficulty amongst us about it. Il I am called a homoeopath, I will not quarrel with the man who, for convenience to himself, so describes me. If I am asked about my medical belief, I do not designate myself a homoeopathy but I say I am a believer in homoeopathy.
I may be asked how are consultations to be carried on between ourselves and those who do not believe with us. I answer, precisely as they are at present. Two allopaths may be diametrically opposed to one another. If they cannot arrange as to treatment, the difficulty is stated to the patient or his friends, who usually decide in &vour of the man in whom they have most confidence. Medical men generally have some voice in the matter when a con- sultation is proposed, and naturally suggest the name of a man with whom they can agree. If the consultation is merely for diagnosis or to settle some question of surgical
tB^STi^ sbabch after tbuth. 699
interferenoey it does not matter so long as a good man is ^caUed in,
I &el satisfied that by acting coorteoasly and fairly iowards onr professional brethren, many difiSculties will be :smoothed over. Above all things I would urge my younger brethren, when called in fd!ter another man has been in attendance, be he of our own way of thinking or the reverse, to avoid finding fault with past treatment, or insinuating that, if called in earlier, so much more might have been done. There is a temptation to do this. I regret to say it is often yielded to. It is ungenerous and unwise. Ungenerous because the efibrt is made to elevate self at the expense of another's discomfiture, and that where the man is no longer in a position to give any explanation ; it is unwise because his position to-day may be ours to-morrow.
Even where conscious that a man has made a positive mistake, let us correct it as far as we can, but say as little to his disparagement as possible ; we should remember the injury we may do him, and that we are not infallible, and that some of the greatest men in our profession have made some very serious mistakes. In all these matters let us do to others as we would be done by.
The treatment adopted by the rival schools is not so great as it was formerly, there has been a drawing together. I would rather, however, see our opponents drawn to us, than we to them. We are guardians of a great truth ; we cannot afford to return into error.
Dr. Sidney Binger, Dr. Charles Phillips, and others, have wisely introduced many homoeopathic remedies to the notice of the profession; it would, perhaps, have been fairer if they had said where they got their inspiration from, but they might not have done so much good< And while believing much that we do, they may not believe enough to justify them in casting in their lot with us ; indeed, Dr. Charles Phillips is a deserter from our ranks ; but where a man has doubts and misgivings it is better for him to withdraw altogether as he did than hold an uncertain position. As an illustration of how our weapons are borrowed, I may quote from the Lancet of August 12tb, under the heading, '' Hydrophobia treated successfully with AconiUy' (of the case having been hydrophobia I liave more than doubts, but that is not to the point). The writer claims Dr. Binger's support in the following words :
600 SEARCH AFTER TRUTH. ''rSSwTS??^
** To substantiate what I haye jnst said/' as to how aconite actSi '' I cannot do better than qnote a few examples from Dr. Singer's text book. He says that one drop of tincture of aconite given at bedtime qniets the distressing fidgets of men and women, and causes calm and refreshing deep." If the author of the paper will go back to the writings of Hahnemann, he will lliere learn from the original authority this same fact about the action of aconite.
If these men to whom I allude see some of our defects, it may also be urged as an excuse for their not belonging to us.
As lovers of truth you will not blame me for the ad- mission, that there are defects that ought to be remedied. As in religion, so in medicine — ^we should seek to go on to perfection. This may not be attainable in this life, but it is a grand thing to strive for; it keeps alive hope, and elevates and ennobles our thoughts.
One cause of our failure is that there are a class of eases that are not amenable to any treatment, except palliative, these are cases of organic disease. Whether the discovery of bacilli as a cause of phthisis, is to lead to some great therapeutic discovery that may enable us to remove the cause and so prevent or check diseases that have hitherto baffled us, has yet to be seen.
We are blamed at times from the failure of an individual. A wrong diagnosis, a failure to select the right remedy, are not faults of our system, and are such as we share in common with our opponents. But let us look at what may be improved.
We depend upon our Materia Medica and our Repertories for information about our medicines; the pathogenetic action of drugs when taken by persons in health, and clinical observation being the sources from whence these are supplied.
In making our provings, or ascertaining the pathogenetic action, great care is needed that only genuine medicinal symptoms be noted down, and not those arising from some accidental circumstance. To guard against this danger a symptom should be repeated in different provers, or be diifferent times removed by the medicine Uiat has been believed to produce it, before it can be accepted as reliable.
Where symptoms appear to yield to treatment, and in so doing acquire a position as clinical symptoms, to be recorded to the credit of the medicine given, a thorou^
bSHS^oS^iI^ 8BABCH AFTER TBUTH. 601
knowledge of what may be called the natural history of disease is necessary, to prevent what may be an improve- ment to be looked for at a certain stage of the illness, being attributed to medicine instead of the real cause.
When our symptoms are fairly recorded, and we look to <uu' repertories to enable us to pick out the medicine suitable for some case of illness, we usually try to select some prominent, or key symptom, to guide us aright ; thus, for example, a patient may be sufifering severe pain from peri- tonitis, which he describes as pain like cutting with knives. I then find that sabadiUa has this as a prominent symptom. Led by this I shall most probably find that the rest of the symptoms fit in well with this medicine. Not that it is necessarily the best in peritonitis, for you are all too well acquainted with the action of aconite^ belladonna, bryonia^ and other drugs not to know that our choice is by no means a limited one.
In Hahnemann's time, and for long after it, the means that we now have of investigating disease were unknown. The stethoscope, the thermometer, the laryngoscope, and the proper use of chemical agents, as well as the micro- scope, were either unknown or comparatively useless as applied to the study of disease, therefore our early provings are entirely deficient in the knowledge to be derived from these helps. Hence arises the necessity for new provings. I am happy to say that the British Homoeopathic Society and the Hahnemann Publishing Society are quite alive to this want, as well as to the necessity of excluding all untrustworthy matter from our early provings. As both societies are actively engaged in this direction, let me hope that before another Congress meets each society shall have some substantial work .to show. It is to be hoped they will not forget a point that troubles our friend Dr. Allen — the proper pronunciation of the names of our medicines. Is it geUeminum or gel se- minum 9 podophyllum or podoo-phyllum ? — reminding one of the famous trial in Edinburgh of ^' Syme versus Lizars or Sym versus Lizars,'* as one of the counsel put it.
I have alluded to our societies, let me say a word about them. When I had the honour of being secretary to the British Homoeopathic Society, I had great difficulty in persuading some of our country friends of the advantage of belonging to such a society. If they did not get what they thought was a penny's^worth for every penny of their sub-
602 SEABCH AFTBB TRUTH. *t5!^L??S??^
, Oot. f , 1881.
Boription, they thought the fmbscription ought to be redaoed. Well, what has the Society done« besides serving as a great central, rallying point for our branch of the profession? It has published several volumes of its annals. It has publisheid two editions of its Pharmacopona, which have succeeded so well that a third has been called for, the editing of which has been entrusted to my care, and which edition is now, I am happy to say, on the verge of comple- tion, the body of the work being finished and the appendix far advanced. I have to express my grateful thanks to Mr. Wybom, who has done the lion's share of the work, also to my colleagues. Dr. Hughes and Dr. Burnett for their valuable aid, thanks that I am sure the Society and the Profession will gratefcilly accord to these gentlemen.
Then again, owing to the sound financial position in which the Society is, it has been enabled to help the sister society, the Hahnemann Publishing Society, largely, so that they have been able to issue tibe magnificent edition of Hahnemann's Materia Mediea Pura, ^hich, I may say, serves also as one of the many monuments of the untiring industry of our friends, Drs. Dudgeon and Richard Hughes. I have alluded to the other work that is before these Societies. I can only hope that every member of our profession will see that his name is enrolled as a member of one or both of these Societies.
I have endeavoured, very imperfectly I fear, to touch on some of the great truths of our day, including the one that has brought us together. Like most great truths ii has been met with opposition by those who should have hailed it with gladness ; in spite of this it has spread ot^ the whole civilised world. In America, where it has had but few difficulties to encounter, it has grown rapidly, as its colleges, professors, and extended literature testify. In this country its growth has been somewhat retarded, as its prejudiced adversaries have had powerfal auxiliaries in the red tapeism and fossilised regulations that so often stop progress in our land. Still it has grown, and nearly all our large towns are to some extent provided with medical men who practise in accordance with the homcBO- pathic law. Unhappily there are not enough men to supply the need of the smaller ones. It is the maxim in political economy that a demand creates a supply, and in this case the rule would no doubt hdd good, but the
Mo^Homajg^ SEABOH AFTEB TEUTH. 603
training of onr stadents being in the hands of those that are nnfriendly to our system, they can indoctrinate the young beginner in snch a way that he finds it very hard to mn coonter to the teaching of a man he has learned to look np to.
Among all classes of the laity homoBopathy has spread to snch a degree that there are few fanulies that have not ffot some of its adherents amongst them ; men of the highest intellect placing themselyes and their families in the hands of its practitioners.
It is more than fifty years ago since Dr. Quin, who had been physician to the King of the Belgians, and had become a convert to homoeopathy, proceeded to Hungary to test the merits of Hahnemann's doctrines in the treat- ment of cholera. Many of his cases he treated with camphor alone. So great was his success that his statistics ought at once to have convinced those men who were groping in the musty learning of centuries for a remedy that they could not find, that a true mode of treating the disease had been found. Strengthened in his convictions he returned to London and resumed practice, meeting with an amoimt of patronage that might have satisfied the most ambitious. Belluonimi, Dunsford, Currie, and others followed, and soon homoeopathy took a position that its enemies in vain assailed.
The Organon of Hahnemann was translated into English, by Dr. Streeton, and published in Dublin. This edition has been superseded by Dr. Dudgeon's translation, which, leaves nothing to be desired.
In Dublin and Bel&st the Luthers acquired large practices. My old friend Woldemar XiUther is, I regret to say, the only representative of the family left. I am glad, to see that he is present with us to day.
In Edinburgh, as I have shown, Dr. Fearon, Dr. Black, and Dr. Butherford Bussell, introduced homceopathy U> iheir medical brethren, and opening a dispensary, I think to them belongs the honour of being its first teachers in this country, though they wore no professor's gown, nor mounted the rostrum in any established school. They, however, found at least one distinguished pupil, than whom no man in his day bid fair to rise to a higher position. I allude to the late Professor Henderson. His great talents secured him the respect of his colleagues, his success as a clinical teacher endeared him to his students, so that
604 INFINITESIMAL QUANTITIES. **^SS^S?S!mml
when he announced his intention of investigating homoBO- pathy, the late Dr. Abercromhie, then at the head of his profession, said, ** Well, now we shall see if there is any- thing in this." Unfortunately, Abercrombie's death prevented our knowiug how he would have acted when Henderson was led by his investigations to proclaim his belief in the truth of Hahnemann's teaching. An expression of belief, however, for which he had to pay dear. It is no pleasure to tell the story of persecution, when many that joined in it may have regretted the part they took, and when we have heard that one of the leaders in it expressed his regret on his death bed for what he had done.
Those who wish to know more of the histoiy of what I have so briefly touched on, will find, in Dr. Dudgeon's lectures, Dr. Hamilton's admirable memoir of Dr. Quin, Dr. Luther's Concise View of Homoeopathy, published without his name, Dr. Sharp's tract. Dr. Burnett's excel- lent sketch of Hahnemann, and many other books of the same kind, all they may wish to know.
It only remains for me to express my grateful thanks for your patience in listening to this rather long address, to bid you all a hearty welcome to Edinburgh, and to hope that any visitors who may wish to hear the papers tluit are to be read will come in and out as they please, and to express the further hope that our Congress may be an instructive one, and one that we may be able to look back on with pleasure.
ON THE INFLUENCE OF INFINITESIMAL QUANTITIES IN INDUCING PHYSIOLOGICAL
ACTION.
By Chables Habrison Blacelet, M.D.
Mr. President and Gentlemen, — The possibility of exceed- ingly minute quantities of matter being able to play any important part in the ordinary functions of nutrition in the animal and vegetable organism, has often been denied by those of our medical brethren who have never taken the trouble to put the matter to the test of experimental inves- tigation. In the case of agents that do not possess the power of growth and reproduction, they have also contended that infinitesimal quantities cannot generate disease on the
SSJ^oSTSSS^ infinitesimal quantities. 605
one hand, or cnre or modify it on the other ; and they say, moreover, that we have never heen able to prove, by extra- elinical e]q)erimentB, that extremely minnte doses can alter the activity of any morbific agent.
In the case of the zymotic diseases, they are ready to grant that the dose of the exciting canse may be exceedingly minnte, hot as we have no means of determining the exact amount of the deleterioas agent that the zymotic action may prodace, we have, they also contend, no right to assume that it is infinitesimal in quantity in any given ease.
In order to show Ihat some of these statements are not in strict accordance with facts, I propose, first, to bring under your notice a portion of the experiments that have been made by one of my fellow-townsmen on the action of ihe digestive ferments ; secondly, to draw your attention to some of the investigations of the lamented Darwin on the insectivorous plants ; and finally, to notice some of my own observations in another department, and to consider the effect these various researches have in giving support to our belief in the power of infinitesimal quantities. And here it will, perhaps, be well for me to say that I have con- fined my attention simply to the action of these quantities, without attempting in any way to deal with the principle upon which our section of the profession believe drugs to act in the cure of disease. It is not, however, that I undervalue the importance of the principle of aiynUia that- I take this course, but simply because i^e question I have attempted to discuss is quite large enough to occupy our attention in the time we have at our disposal on the present occasion.
It will be remembered by most here, that, in the year- 1880, Professor William Boberts, of Manchester, delivered. a course of lectures on the digestive ferments, before the Boyal College of Physicians of London.* In the admirable and deeply interesting researches detailed in the course of these lectures, Dr. Boberts shows that two main types of digestion go on in the animal and also, to some extent, in the vegetable organism. He also shows that various kinds of ferments are the chief agents in the different processes of digestion. For the immediate object I have in view it
^ On the DigeiHve FermerOi and ihe preparation of ArtifieiaUy Digested Food. By Wm. Boberta, M.D., FJELS., Ak}. London: 1880.
YoL 26, Ko. 10. S 8
606 INFINITESIMAL QUANTITIEB. ^''^^S^^^oSuSmt
18 only necessary to consider the action of the fermant termed diastase or ptyaUne, and which is found in the secretions of the salivary glands and the pancreas. The function of this diastase is to act upon the starch which forms so large and important a part of our food. The changes which the latter ondergoes. when brought into contact with diastase are somewhat complicated, and result eventnally in the conversion of the former into sugar and dextrine — ^two bodies which, in their properties imd mode of behaviour with re-agents, are totally different to the starch &om which they are derived. It would serve no good purpose for me to attempt on the present occasion to trace out the various changes that starch undei^oes in being converted into the two substances named above, but it wiU be well to notice some of the properties of the class of bodies to which diastase belongs before I go on to con- sider the quantity of the agent that is needed to produce the changes alluded to.
The known digestive ferments are termed unorganised fer- ments. " They are," Dr. Boberts teUs us, " sharply distin- guished from the insoluble or organised ferments, of which yeast is the type, in not having the power of self-multiplica- tion and self-nutrition. Soluble ferments cannot therefore be said to be alive, but they are all the direct products of living cells, and may be regarded as detached repositories of cell force. They are quite unknown in the domain of ordinary chemistry. Their mode of action bears no re- semblance to that of ordinary chemical affinity, and has a distinctly physiological character. They do not derive their marvellous endowments from their material substance. They give nothing material to, and take nothing material from, the substance acted upon. The albumenoid matter which constitutes their mass is evidently nothing more than the material substratum of a special kind of energy — just as the steel of a magnet is the material substratum of the mag- netic energy — ^but is not that energy. This albumenoid matter of the ferment may be said to become charged at the moment of elaboration by the gland cells with potential energy of a special kind, in the same way that a piece of steel becomes charged with magnetism by contact with a pre-existing magnet. The potential energy of the ferment is changed into the active form (i.e., becomes kinetic) when it is brought into contact with the alimentary substance on which it is designed to ^t."
ISSi^OdT^iS^ IKPINITBBIMAL QUANTITIES. 607
The proportion of diastase that is found to he capable of eonverting a given quantity of starch into sugar and dex- trine is, relatiyely, exceedingly. small. Payen and Persoz had previously estimated that malt diastase was ahle to change ttco thousand times its weight of starch into sugar. This estimate, however, greatly exceeds the quantity that is really needed. In a very carefiiUy conducted set of experi- ments Dr. Roberts found that instead of converting only two thousand times its weight of starch, it was able to convert forty thousand times its weight into sugar and dextrine. Dr. Roberts describes this as an '' astounding result," but marvellous as this is, other experimenters,* he tells us, have arrived at results still more wonderful in estimating the transforming power of malt diastase.
In connection with this part of the subject. Dr. Roberts makes some observations which it is important for me to notice before passing on, because they bear somewhat on a question which has been, and I fear must still be, a vexed question with us, namely, the amount and repetition of the dose. It had been imagined by some observers that the energy of diastase was not consumed in action, but experiment demonstrated that this was not the case. It was found that for every grain of starch converted, the energy of one 40,000th of a grain of diastase was ex- hausted once and for all. An excess of diastase, up to a certain point, merely quickened the action but did not alter the final result ; but an excess of starch always left dome of the starch unaltered. If the quantity of diastase was suflScient but not in excess, the change would be slow, and would continue for about forty-eight hours. If, however, the diastase was largely in excess the change would be very rapid. But this mode of action differs entirely from wiiat is seen in the operations of ordinary chemical affinity. If an acid is mingled with an excess of alkali, or an alkali with an excess of acid, the change is instantaneous, and comes to an end at once ; '' the affinity of the two bodies for each other is a mutual affinity. But this is not the case with the action of diastase on starch. The starch appears entirely passive in the process; all the energy is on the side of diastase, and this energy can only be liberated gradually." Dr. Roberts illustrates his
«*■ ■ 11.11 ■ ■
* HCr. Horace Bioyfn and Mr. Heron.
2 8—2
608 INFINITESIMAL QUANTITIES. ^
meaniDg b; comparing the particles of the ferment to s band of Uving workmen whose function it is to soattei little heaps of atones. If the heaps are few and the workmen many, all the heaps will be scattered at once and the eaetgs of the woikmen will still remain, not seosibly impured. Bat, if the heaps are miUionB and the workmen hundreds, and if the workmen are doomed to labonr on ontil they fall eshansted at their task, the scattering of the heaps will go on for a long period, and the process of exhaustion will be a gradnal one.
The number of distinct ferments met with in the dirrcstive organs of man is supposed to be at least seven or eight, and it is important to obserre that eadi ferment acts only upon one kind of food. Diastase, as we have sees, acts only upon starch, and the potential energy with which it is endowed becomes active only when this kind of food is present ; with all others it is perfectly inert.
If the facts I have cited above stood alone, they would, as proofs that small quantities are capable of inducing physiological action, be of mnch less Talne than they really are. They do not, however, stand alone; scientific research is continually revealing to us phenomena that point unmis- takably in the same direction. As an example of this, I must refer to some of the researches of the deeply-lamented Darwin, as given in his learned and elaborate work on Insectivorous PlanU. In his experimentB on the di- gestive action of the secretion of the glands of the Drosera rotundifolia he used solutions of various saJts, and amongst them pJiogphatc of ammonia- Sunirised at the smallness of the quantity that sufficed to induce phy- siological action in the glands of this leaf, he repeated Mb experiments with every possible care against chances of error. The quantity of pliospkate was lessened gradually, until he found that one 20,000,000th of a grain was su£S- cient to produce distinct physiological action in each gland.
In speaking of this, Mr. Darwin says ; " The reader will *-"t realise this degree of dilution by remembering that
00 ounces would more than fill a thirty-one gallon cask ;
1 that to this large body of water one grain of the salt i added ; only hsJf a drachm, or thirty minims, of the ition being poured over a leafi Yet this amount sufficed •ause the inflection of almost every tentacle, and often of
blade of the leaf." . . . . " I am well aware," . Darwin goes on to say, "that this statement will
5£3SJ!r<^SwS?^ INFINITESIMAL QUANTITIES. 609
appear incredible to almost every one. Drosera is far from riTalling the power of the spectroscope, bnt it can detect, as shown by the moTements of its leaves, a much smaller -quantity of the phosphate of ammonia than the most skilful chemist can of any substance. My resnlts were for a long time incredible, evei^ to myself, and I anxiously sought for every source of error. , . • • The observations were repeated during several years. Two of my sons, who were .as incredulous as myself, compared several lots of leaves simultaneously immersed in the weaker solutions and in water, and declared that there could be no doubt about the
difference in their appearance Astonishing as
this result is, there is no sound reasoB why we should
reject it as incredible In fact every time that
we perceive an odour, we have evidence that infinitely BmX particles act on our nerves. When a dog stands i quarter of a mile to the leeward of a deer or other animal, and perceives its presence, the 6dorous particles produce some change in the olfactory nerves ; yet these particles must be infinitely smaller than those of tjie phosphate jof ammoma weighing the one 20,000,000th of a grain. These nerves then transmit some influence to the brain of the dog, which leads to action on its part. With drosera the rcNsdly marvellous fact is, that a plant without any specialised nervous system should be affected by such minute particles ; but we have no grounds for assuming that other tissues could not be rendered as exquisitely sus- ^ceptible to impressions from without if this were beneficial to the or^nism as is the nervous system to the higher animals."*
If I could have done so I should have been glad to notice in detail some of the experiments that Mr. Darwin tried on the effect that a comparatively small dose of the salt had upon the vitality of the leaf — ^in some cases damaging it rseriously and in others killing it outright. As time will not permit, however, I must, with your permission, pass on to notice some of my own investigations on \}ie cause of hay-fever. Those of you that have done me the honour of reading my work on the subject will remember that pollen was shown to be the cause of the malady. In the last edition of my work a chapter was devoted to the determi- — - - ' - ■
* Imeetivorout Plants. By Charles Darwin, M.A., F.B.S., Ac., i>p. 170-78.
610 INFINITESIMAL QUANTITIES. """toS^SifSwaL
nation of the qaantity of pollen necessary to produce hay- fever, in those who are sensitiye to its action. By a series of experiments, pursued with as much care and precision as circamstances would permit, it was found that the quantity was exceedingly small. In the case of a young patient, kindly sent to me by my friend Dr. Drysdale, symptoms were produced by so smsJl a quantity as the 120,000th ci a grain, and in my own case symptoms could be distinctly perceived if one 100,000th of a grain was inhaled in eadi twenty-four hours. When the malady began to be really troublesome one 40,000th of a grain was found to be suffi- cient to make it so ; and when the disorder had attained its maximum degree of intensity, in the height of the flowering period of the grasses, the quantity inhaled in each twenty- four hours was rather less than one 8,400th of a grain in weight.
But the quantities above-named are considerably in excess of the weight of that which constitutes the active portion of the pollen. A pollen grain is, as you are all aware, a simple cell with granular contents. The cell .wall consists of two, and in some cases of three, layers of cellulose, which is, so far as we know at present, perfectly inert. The granular matter is the active agent in the production of the most important of the symptoms, and as this weighs only about half the weight of the whole pollen grain, it follows that the numbers I have given will have to be reduced to one-half. But I go even further than this. You will have seen that the weights given represented what had been inhaled in the whole day of twenty-four hours in each case. Now, in actual practice, it was found that the great bulk of this was inhaled during the ten or twelve hours of active work. It was also found that a single hour's inhalation in ahnost aU cases soflSoed to bring on very decided sjrmptoms, often to an unpleasant degree of severity. Consequently, if we make a calculation of the hourly dose that would be taken by a hay-fever patient, we find that for the earliest symptoms of the dis- order it would be about the two TniUionA of a grain ; for the middle period of the disease there would be about one 800,000th; and for the period of greatest intensity one 60,800th of a grain would be taken hourly.
In the experiments cited above we haye various phases of the subject included. In those of Dr. Roberts we have an important function shown to be performed by a rela*
^SSfoS^^SS!*** nrWNITKSIMAL QUANTITIES. 611
ti^ly minute dose of a nonnal animal secretion, and it is one of those remarkable examples we sometimes see of the way in which nature economises space or balk by the inerease of power in any given secretion. If the glands had secreted a fluid only capable of acting upon its own weight of starchy we can easily imagine the enormous bulk of gland straotnre that would have been needed to perform the work of digestion. In Darwin's experiments we find that an infinitesimal dose of a salt of ammonia is able to set up physiological action in the glandular leaf of a plant deyoid of nervous tissue. We have thus digestion per- formed and some of the first steps taken towards the production of a digestive fluid by iufinitesimal quantities of the appropriate material. In the results of my own investigations, we have quite another phase of the subject presented. Here we find that infinitesimal doses of veget- able matter, having no zymotic properties, are capable of giving rise to a troublesome form of disease.
In some of their properties the phosphate of ammonia and the granular matter of pollen resemble the soluble ferments described by Dr. Roberts. With some verbal alterations, the same desoriptioh will answer for one or the other. The granular matter of the pollen is the direct product of living cells, and may be regarded as the detached repository of cdl force. Its mode of action bears no re- semblance to that of ordinary chemical affinity, and is distinctly physiological in character. It does not derive its marvellous endowments from its material substance. The granular matter is evidently nothing more than the material substratum of a special form of energy, but is not that energy. The potential energy with which this matter becomes charged at the moment of its elaboration by the vegetable cells, is changed into the active form when brought into contact with the tissue upon which it is^ capable of acting.
Whilst remembering that the drugs used in Darwin's experiments are not derived from living bodies, the same description would largely apply to them, and I hardly need point out to you that it would agree very closely wiUi that which could be given of the great majority of the sub- stances we use in the cure of disease. It is also one of the most hopeful signs of the times, in relation to the medical science of the future, fhat a complete knowledge of the ^leoific energy of the drugs used in medicine, as well as of
612 INFINITESIMAL QUANTITIES. ""^^^S^^mS
the specific irritability of the healthy and diseased organism, are beginning to be recognised as absolutely essential to the successfol practice of tixe art of healing.
I pass on now to notice what, to me, appears an interesting phase of the subject. We have seen that infinitesimal doses of the granular matter of the pollen cell can give rise to a distinct form of disease, and it should be borne in mind that this is set up by a body that has no zymotic properties, and that rapidly exhausts the energy it possesses when brought into contact with the mucous membranes of a sensitive patient. Now, this granular matter closely resembles the starch upon which diastase acts in so wonderful a manner, and although the pollens of the various orders contain different accidental ingredients in minute proportions, the great bulk of the granular matter in all of them consists of an amyloid body that gives the same reaction as starch does with iadiTie. The largest granules seem to have an investing membrane similar to that of the smallest starch granules of rice. The smallest seem to be mere specks of protoplasm apparently without investing membrane, and it is, I believe, these that may in some cases penetrate the walls of the capillary vessels, and set up disturbance in the temperature of the body.
It is said that raw starch passes through the digestive organs of the human subject unchanged, and that in order to permit the diastase to act upon it it requires to be boiled. With the starch granules of the pollen it does not appear to be so ; at any rate, some change of an important character seems to be effected early on in the process of digestion. I cannot now attempt to give the details of the experiments tried in this direction, and it must sufilce to say that I have frequently taken comparatively large doses of pollen without any inconvenience; and the natural inference is that the diastase of the digestive fluids acts upon the granular matter in such a manner as to rob it of its irritating properties. Outside the body the diastase of the salivary glands acts very slowly upon the granular matter. From this it would seem that contact with the living organism ensured a more vigorous action. Now, if it is a fact that diastase can change the constitution of 40,000 times its weight of starch, the quantity that will be needed to operate upon the dose of granular matter that sets up hay-fever will be exceedingly small. It will be
2SSS^(SETiS!^ infinitesimal quantitibs. 613
remembered that at the commencement of the troublesome form of the symptoms, one 80,000th of a grain of the granular matter taken in each twenty-four hours was sufficient ; and that in the later and most acute stage, one 6,80(Hh of a grain sufficed. If we divide these numbers by 40,000 (the proportion of diastase needed to neutralise the starch) we find that for the commencement of the troublesome form of the disease one 8,200,000,000th of a grain of diastase would be sufficient to neutralise the daily dose of pollen, and that for the most acute stage one 272,000,000th of a grain would be sufficient.
We haye thus seen that physiological action in the animal and vegetable organism can be set up by infinitesimal quantities of the appropriate material when endowed with its own specific energy. Infinitesimal quantities when endowed in a similar manner can also set up pathological conditions in the human organism, whilst a still smaller quantity can neutralise the power of that which gives rise to these conditions.
It may naturally be asked if any use can be made of this last named £act. Into this part of the question I cannot enter now, further than to say that the possibility of the discovery of agents that possess that form of specific energy that would enable them, when given in minute doses, to neutralise the action of some of the most deadly of the exciting causes of disease, opens up a great future for the art of medicine. I have, however, purposely refrained from entering upon the therapeutic phase of the question, and have strictly confined my attention to phenomena that are entirely independent of theory. In doing so I have en- deavoured to build upon the solid ground of experimental investigation, and in this way I have endeavoured to give a reason for the faith that we have in the power of infini- tesimal doses.
Discussion.
The President described Dr. Blackley's contribution as one of a class of papers of great value, in two directions. Looking at the paper from a scientific point of view, it showed that Dr. Blackley was following up a line of investigation which was tending to advance their cause. The more they could demon- strate the effect of minute particles of matter, ihe more readily could they justify, before medical men, the course they had taken up. They might also take a practical view of the paper ; and he hoped it would be the commencement of a series on the subject
614 IKFINITEBIMAL QUANTITIES. ^'^BS^ToSf^MM.
of hay-feyer, which would lead to mnch good. (Applause). The discnssion would now be proceeded with, and he trusted that the distinguished Americans who were present would take part in it. (Applause.)
Dr. Dyce Bbown said they must all thank Dr. Blackley for his extremely interesting and important paper. He quite agreed with the President that the class of papers to which it belonged was very valuable indeed. The more that these intwestmg feusts, that at first seemed incredible, became known to those who did not give small doses, the more would the public mind become famiharised with the fact of minute doses being success- ful. He thought that the carrying on of such a series of experi- ments as those in which Dr. Blackley was engaged, was calculated to lead to great results. (Applause.)
Dr. Gabfkae said that he was not prepared to make any remarks at all, but he could not refrain from thanking Dr. Blackley for his very excellent paper. He agreed with the previous speakers that it was a very valuable one. It was of the greatest importance to get at the fiEtcts to which Dr. Blackley had referred. They had already a considerable body of facts bearing on the subject. For example, Dr. Hughes, in his book, showed the extremely small dose of belladonna that was required to produce its characteristic action on the pupil of the eye ; and they had .other facts bearing on the importance of infinitesimal doses that added to their store. He had no doubt that ulti- mately these investigations would have an important influence in settling the very much vexed question of the dose. He con- fessed that he had been working in the other direction. It would be interesting to discuss the question as to the neutralising, by iodide potassium, of the poison of hay-fever. He was confident that it was one of the most valuable remedies for that disease.
Dr. LuDLAM said that he had only a very few remarks to make. First of all, he had to thank them for their kindness in allowing biTn to participate in the discussion, and also to thank Dr. Black- ley personally for his paper, because it had interested him veiy much. He Uked such confirmations as had been given of whii tkey knew in a clinical way. The observations of Claude Bernard went to show that anaeslhesia would stop germination and fer- mentation so long as the ansBsthesia lasted ; and that when the anesthesia was disposed of the processes went on, provided the conditions were what they ought to be. He had thought that other influences besides an»sti^esia might be brought to bear on the physiology of plants and vegetables, so as to give us a con- firmation indirectly of the possibility of the infinitesimal doses working in a salutary way.
Mr. BuTGHEB said it was very interestiDg to him to hear the idea confirmed that a very small dose — ^a vezy small quantity of
SSiS^(STS?^ INFINITB8IMAL QUANTITIES. 615'
an organiBm — should retain mihin itself a virtae so great, and also a mechanical energy of snch enormons power, as wag supposed from the fact that an infinitesimal dose of diastaso was able to tear apart the chemical atoms of so large a quantity of starch. In a small amount of diastase there was stored a mechamcal energy that might yet be counted as able to lift so many pounds or ounces. It reminded him also of a phenomenon of nature well known, and which had always been of great interest — ^that was the phenomenon of impregnation — ^how a single mole- cule should cause such an enormous change in the ovum in the female body. It seemed to be a case on dl fours with the action of the spermatozoa. It was not so much a conglomeration of a certain number of atoms of matter as a reservoir of an enormous amount of potential force. Many particles of that force were wasted in several points, but some one would come in contact with external circumstances which directed that force ; and therein ihey had a wonderfdl example of a microscopic amount of matter causing an enormous discharge of force. He thought that these experiments, more especially on diastase, might lead them to very wide and useful results, allying homoeopathy to natural science, which he hoped would be the effect of investigations in the future.
Dr. PuLiIiB, Edinburgh, said he had to thank Dr. Blackley for his excellent paper. He thought with the other speakers that nothing could be more importimt than placing the doctrine of infinitesimals on scientific ground in the way that this paper tended to do, because it seemed that the whole tendency of modem inquiries was in their favour, showing the extreme divisibility of matter, and that we had to look on matter not as we were accustomed to do, but on its potential influence. They were dealing with a certain kind of matter which the •hemist could not now gauge according to the old acceptation of his work. It used to be put, as one of the shallow objections of the critics of the infinitesimal doctrine, that you could not see any particles beyond a certain point with the microscope. He wished to ask Dr. Blackley whether he had heard of some observations, of the reliability of which he knew nothing; but if there was anything in them it was, he thought, a subject worthy of investigation. It was stated that Dr. Jager, in Germany, had been making some observations with a modifica- tion of an instrument used by astronomers, with which they noted the difference between the time they made a particular observation and the time they noted it on the index. That, he believed, was called " nerve time."
Dr. Nanxiveij. asked whether they were right in maintaining that there was that tremendous amount of lat^t force in minute particles, or in spermatozoa, or in those infinitesimal exciters, that was supposed. Was it not rather the case that the power lay in
616 INFINITESIMAL QUANTITIES. ^^'iSS^IoSLi^l^
the substance under action ? Was it not diiefly in the OTum ? Was it not a power in the starch akeady ? And was not the •eSOfect of the diastase or of the spermatozoa merely to remoYe a slight hindrance to this molecular change ? Here was an illus- tration. They would be leaving Edinburgh that night. The engine-driver would lift a handle, and the locomotive would go into action ; but the power was there already. All the imm^mnA latent force that was to take them south or north, as the case might be, lay not in the driver, but in the engine ; and his action merely permitted it to come into action under the guidance of certain laws. The action of the diastase enabled the starch granules to pass into the condition of sugar. The development in the ovum could only take place under certain conditions, the principal being the presence of spermatozoa. He thought that if they had such enormous latenl power in these stimuli them- selves, they should expect that latent power to show itself some way or other besides on the different bodies on which they acted already. He would not speak of it as a power, without the necessary stimulus which enabled the substance acted upon to pass through certain changes. In looking on the action of medi- cines in the same way, they ought to consider it not as the action of medicine, but the action of the living system in the presence of certain drugs.
Mr. Potts said he apprehended that no one in that room required to be convinced of the truth of the doctrine of infini- tesimal doses. He himself became convinced of that doctrine the first week that he commenced to work with homoeopathic -doses.
Dr. Haywabd said that his only reason for rising to make a few observations was this, that he heartily approved of the remarks made by Dr. Nankivell. He thought tlu^t in his idea of the matter they had a very philosophical aid to the operation of medicines in general, and especially of infinitesimal doses. He believed that the power did not rest in the infinitesimal dose itself; but that it was merely like the engine-driver — the liberator of the power. As to infinit^imal doses, he thought they ou^t to consider whether their doses were of animal, vegetable, or mineral matters ; for he believed that infinitesimal doses varied with these. He believed that an animal substance mi§^t be a very much larger infinitesimal dose than some others. For instance, the ^ennaiozoon-a complete animal stractaie-ina composed of a great deal of material, which, broken up, earned the dilution farther ; but break up the cell, and it was no longer able to produce any operation. The vegetable cell was a complete substance. Take beiladonna. So long as they had one cell, it would produce its operation, but break up that cell, and it was no jnore able to do it. But it was different with mineral
S^r^?Sm*** INFINITESIMAL QUANTITIES. 617
Take a partide of gold or anemic ; they might divide and divide it more than they oonld do with an animal or vegetable substance, and they might still get the infinitesimal dose. He thought thai with the vegetable and the animal preparations they most stop a little nearer than with the mineral.
Dr. Blagkusy, in reply, said he would like to pass rapidly over the various points that had been referred to by the several speakers. With regard to the dose referred to by Dr. Carfrae, he was glad of the opportmiity of saying that the question of dose had troubled boUi his mind and practice a little. His fear in writing the paper was lest it might be inferred that it bore him individually in the direction of the transcendental dose. It did nothing of the kind. It only furnished him with a hcus ttandif or scientific ground, for assuming that infinitesimal doses do act ; but, in his own case, he was now what he had been for fifteen or twenty years; he used all doses, but one rule he adopted, and it was that in the dose he gave he kept below the- power of disturbing the organism. In doing so, he thought he did all that he required to do. What he cliumed for himself — freedom of action — he claimed for every other brother in the profession. (Applause.) But his experience was that they found patients were susceptible in various degrees, and that they would have to use various doses for different patients. He thought it became a matter of the highest importance that they should get to know their patients as well as to know their drugs. Dr. Carfrae spoke of iodide of potassium. He had made some- experiments with infinitesimal doses of drugs on the living poUen. It was a very difficult matter to get the pollen thoroughly alive, and till they could work it, especially in the case of a busy medical man. With regard to the iodide of potassium, it was a very valuable, but he did not think the most valuable of medicines. The iodide of arsenic carried the palm so far as his experience went. But the saying was, '*Art is long and life is short,'* and it took a long time to come to safe con-^ elusions. The next point that he fdt necessary to mention was that touched upon by Mr. Butcher, as to mechanical energy. He did not know whether it would be strictly correct for them to consider it mechanical energy, and it was a point on which he would not pronounce himself. Still it was an important question for them to bear in mind. Speaking of impregnation, Mr. Butcher referred to the quality of action in impregnating. That appeared to be purely physiological. He had made some pre- parations showing the pollen dipping into the structure of the plant, and the calculations he had given them would be carried immensely further if he were to nuuce any statement as to the quantity that produced impregnation. It was one of the most difficult problems. Wiih regard to matters being out of the
618 INFINITESIMAL QUANTITIES. "'^^wTSl'^mS
range of the microseope, he thonght that the mierofloope had more than kept pace and beaten Uie test tabe and balance long ago. He had weighed the one-500»000,000th of a grain, divided by the homoeopathic method of preparing the dilations, but that did not represent anything like the distance that they should go some day. Others had carried on observations tiiat would put that completely into the shade. He had read something about the chronoscope, but he did not know how it could be brought to bear on the subject they had in hand. It was an exceedingly interesting subject— the measuring of time that occurred between the perception of a phenom6Don and the registration of it. There must be some time occur in tbe passage of the sensation of the eye and nostril and the transmission of that into motion by the hand. With regard to Dr. Nankivell*s remarks, there was one thing he would mention in regard to the question: Were they right in 4i8suniing the whole of the power to rest in the diastase ? He thought they were ; but they had to take another thing into account, and that was the irritability of the substances on which it acted, especially as to the Uving action. Some were sus- ceptible of one drug and some not. They could not poison a rabbit with heUadonnay but how di£ferent was it with a human being ; and they must take that irritability into account. Dr. Hayward touched upon a very important point, to the effect tiiat what made up a vegetable ceU was much lai^er than what might act in the case of other substances. Well, it so happened that some of our vegetables — ^at all events, some of our animal or vegetable productions — ^were infinitely smaller than any partide that they could produce by any preparation in the metals. In order to show that he needed only to refer to the investigations of Dr. Drysdale, and they would find that some of the monads in the earliest germ form were so infinitely small that, working with the highest powers of the microscope in this country or in any other, tiiey could scarcely be distinguished. He had heard that in Dr. Ludlam's country they had succeeded in bringing out a glass of higher power than was to be found here, but he had heard of no results with it. But even with the highest powers, some of these monads made only a mere nebula under the microscope. Whether they could yet be followed up it was impossible to tell, but they could not go farther in the mean* time. He had to thank the meeting for the extremely kind manner in which they had received the paper.
2»(S"nSr BBVDBWS. 619
REVIEWS.
American Medicmal Plants: an lUuatratwe and DetcripHve Guide to the American Plants used as Homaopaihic Remedies ; their History, Preparation, Chemistry and Physiologieal Effects. By Chasles F. Millspaugh, M.D. New York and Philadelphia : Boericke & TafeL No. 1.
Tbis is the first instalment of a work, which promises to be one of much interest. Its principal feature is a coloured drawing of each plant, and minor sketches of those parts which are most characteristie of it. The drawing is excellent, and the colouring very life-like and natural. The text, which accompanies each illustration, gives a botanical description of the plant, its history and habitat, the part used in medicine, the mode — i.e., the anther's mode — of preparing the tincture, which is invariably by maceration, the chemical constituents, where these have been ascertained, and finally the physiological effects. These are given very briefly and concisely. For example, the account of iris versicolor in this respect is as follows : —
" Iris acts powerfully upon the gastro-intestinal tract, the liver, and especially the pancreas ; causing burning sensations and a high state of congestion, as proven by post mortem examinations of f^nimftk after tiie exhibition of the drug.
''It is an excitant of the saUvary and biliary secretions, being therefore an excellent remedy to be thought of in ptyalism and obstinate constipation.
** The gastro-intestinal effects are profuse acid vomitings and frequent watery evacuations, the latter accompanied by severe oolic and burning. Upon the* nervous system its action is marked, as shown by the severe toxic neuralgias of the head, face and limbs.*'
Scarcely accurate in all points, such a description of physio- logical effects, were it perfectly correct, would he of Uttie if any service in enabling us to prescribe iris homoeopathically. The botanical account of the several plants is very clear, and will greatiy assist the student in his study of each ; while the drawings are such as will enable him to recognise a specimen without any difficulty.
What Dr. Hamilton accomplished thirty years ago for the Materia Medica Pura of Hahnemann, Dr. Millspaugh is en- deavouring— and that most creditably — ^to do for the indigenous medicinal plants of the United States.
620 MBBTINOS. "S2Sl=?[2??S!^
B0vi0W« Octk S| IflBL
MEETINGS.
THE BRITISH HOMOEOPATHIC CONGRESS.
The Anntud Congress of British HomcBopathic Practitioners took place in the Windsor Hotel, Edinbnigh, on Thursday, the 7th September.
The chair was occupied by Dr. Drnry, Bonmemonth, the pre- sident. There were abo present — ^Dr. Bryce, Edinbnigh, Tice- president; Dr. Biggar, Cleveland, U.S.A. ; Dr. Dyce Bro^m, London ; Mr. Batcher, Windsor; Dr. Blackley, Mani^ester ; Dr. Carfrae, London ; Dr. Washington Epps, London ; Dr. Gibson, Stirling; Dr. Hayward, Liyeipool ; Dr. Kennedy, Newcastle- on-Tyne ; Dr. Lather, Belfast ; Dr. Ladlam, Chicago, U.S.A. ; Dr. Moore, Liverpool; Dr. Madden, Birmingham; Dr. H. Nankivell, Boomemouth; Dr. Pordom, Newcastle-on-Tyne ; Dr. Alfd. Pallar, Edinburgh ; Mr. Potts, Sunderland ; Dr. T. Simpson, Liverpool; Mr. Stephens, Cannes; Dr. Sutiierland» Edinburgh; Dr. Williams, Clifton; Dr. Walter Wolston,. Edinburgh; Dr. Wielobycki, Edinburgh; Dr. Hardy, Glasgow; Dr. T. P. Simpson, Glasgow.
The proceedings of the Congress were opened by an Address from the President, which appears at page 577 of our present number.
At the close of the Address,
The President said that he had received a letter from Dr. Yeldham, London, expressing regret that he was not able to be present with them. Dr. Roth and others also expressed Ihfr same regret. Dr. Hughes, of Brighton, telegraphed as follows : '' Best wishes for success- of Congress, from one who grieves he cannot bo there.'* He was sure that all would regret the absence of Dr. Hughes, as well as that of many others. (Applause). He was quite distressed that some of their old friends were noi with them, but he supposed that the meeting of the Oongreaa being held so far north had prevented them attending. Dr. Blake had telegraphed — '' Sorry I cannot be at the Congress. Obliged to return from Aberdeen Monday. Hope to welcome next year the Congress to Birmingham.** Dr. Burnett, London, tele* graphed — *' Serious illness in my own family compels my absence from the Congress, and my regret is all the greater because I regard Edinburgh as the cradle of our reform in these Isles." He was sure that they all regretted the absence of these gentlemen.
Dr. Walteb Wolbton, Edinburgh, said that he had recently met Dr. Guernsey, of Philadelphia, who expressed his regret thi& he could not be present at the Congress, and desired his very kind remembrances to be mentioned to his assembled brethren. (Applause).
SSS^^ST'SE!?* MBBT1N08. 621
BtfntWf Oflv. St loSSa
The PBBsmENT then deliyered the Address, uddoh win be found at page 677. At its oondnsion.
Dr. MooEB, lirerpool, said that before the business of the meeting was proceeded with, he thought that their first duty was to retnm their yerj hearty and cordial, he might say, miited thanks to the President for his very able Address. (Applause). After expressing his high appreciation of the Address, Dr. Moore moved — '* That the cordial thanks of the meeting be given to Dr. Dmry for his valuable Address." (Applause).
Dr. Bbtoe, Edinburgh, said he had very much pleasure in seconding the motion that a vote of thaidcs be given to the President.
The motion, which was supported by Mr. Potts, of Sunder- land, was cordially agreed to.
The Pbesidsmt said he was deeply indebted to the meeting for the kind expression of their thanks. He was a&aid that he had trespassed too much on their time. He came there with a feeling somewhat of terror, but he had the consolation that he was l^Le the [clergyman who had the great advantage over hia hearers in that they had no power of reply. (Laughter and applause).
iMFDirrBSDCAIi QUAHTITISS.
Dr. Blacklsy then read a paper On the Influence of InfinU tesimal Quantities in Inducing Physiological Action, This paper, followed by the discussion to which it gave rise, will be found at page 604 of our present number.
At the conclusion of the discussion the members were very handsomely entertained at luncheon by Drs. Bryce and Wolston*.
On re-assembling, the report of the Hahnemann Publishing Society was first taken.
Dr. Hatwabd (Secretary) said that a meeting of that Society bad been held the previous evening, and by adjournment that- morning ; and it was stated that since last meeting the Society had published two very important works, the two volumes of the Materia Medica Pura of Hahnemann, translated by Dr. Dudgeon and annotated by Dr. Hughes, and that it had in hand a revision of the Materia Medica. It was agreed that an appeal should be made to the Congress for fonds to meet the cost of bringing out this revision. Dr. Black and the British Homoeopathic Society had each promised £25 towards this olgect, and it was hoped that their colleagues would assist in the prosecution of the work. It would be a handy volume,, containing about twelve of their best medicines, and would be published at about 10s. He said that at the last annual meeting it was unanimously agreed that the comprehensive diaracter of Allen's Materia M^ica involved the collection of
Yd. 20, Ko. 10. T
622 MBBTINOS. "S^^oSMl
donbtfol symptoms and numeroos repetitions. It was, therefore, no substitute for the Materia Medica of the Hahnemaim Publishing Society, in which only reliably symptoms were giyen, and that in natural groups. It was, therefore, unanimously resohed that it was most important to proceed with and pu^ forward the work of the Society, and to publish their material in a more convenient form than they had done hitherto ; it wu also resolved that it should be brought out in a neutral form, one not objectionable to so-called orthodox practitioners, in order that they might be induced to purchase and use it. It was mentioned at the meeting that during the year there had been much correspondence and discussion between Drs. Black, Dudgeon, Hughes, Hayward, and others, as to the form the work should assume ; and it was agreed that it should provide A pathogenesis, a Schema, and clmical information — ^that was, that there should be a collection of all provings, poisonings, &c«
After some discussion, the following resolutions had been adopted for presentation to the Congress for discussion, namely. " That the Materia Medica to be published by the HomoBopathie body shall be such as to meet the requirements of both students and practitioners, by supplying the following essentials : —
** (a.) It shall provide a collection of patibogeneses in the way of provings, poisonings, &c., and these shall be corroborated by post-mortem results wherever possible.
** (b.) It shall provide an interpretation of these pathogeneses, by way of commentary on the general and topical action.
'' (c.) It shall provide a Schema of these pathogeneses on the different organs, with indices and concordances.
" (d.) It shall furnish clinical confirmations of the general And local operation of each medicine by means of clinical cases or cures.
'< (e.) It shall have a neutral title, such as A Physiological and Therapeutic Materia Medica,'*
In conclusion. Dr. Hatwabd said he had received the above statement fix)m Dr. Hughes as the proposal of the "British Homceopathic Society.
Dr. Madden said he thought they should let the British Homoeopathic Society do as much as they thought proper, and they should supplement their work if necessary.
Dr. Gabfrae said he thought they should have the most com- plete work, viz., that suggested by the Hahnemann Publishipg Society ; and he did not see the necessity for any other. The larger would include the lesser.
Dr. Nankivell said that the British Homoeopathic Socieiy seemed to press the most important point of all, and that was a collection under each medicine of all the original provings, poisonings and post-mortem examinations. 3?hat must be the
S5SI*£rS^^ MBBTWos. 628:
BsfieWy OoL S| tSBSL
basis of any Materia Medieay and that was what they ought to have had all along. He took it that the British Homoeopathic Society wished to add a Schema of the whole. He believed that if the pathogeneses were thoronghly well indexed and brought together at the dose of the pathogeneses, they should be able to get on without printing the Schema at all. He thought that the index would take the place of the Schema, and refer the reader back to the symptom that he needed ; and not only so, but to the symptoms that grouped themselves round a particular case. He felt that to get at idl forward in their scientific treatment of disease by applying the law of similars thoroughly and philo- sophically, they had to treat the symptom as it appeared, as well as the surroundings of the case of poisoning and proving in which it occurred. He thought that if the work were well indexed, it would serve the purpose required ; and he was quite sure that their interest in the Materia Medica, with such an arrangement, would be increased a hundredfold. ' It was impossible to get up an interest in a Scliema ; it was a sort of Chinese puzzle. If they had the symptoms in the pathogeneses, they would be part of the story, and the interest in the whole would be much greater, while the treatment would be more successful. He would say, let them have no Schema, but a tho- roughly good index. If they had that, he thought they might find the British Homoeopa^ic Society and the Hahnemann Publishing Society at one in the matter.
Dr. Bbyce said be wished to know what kind of index would be proposed. It appeared to him that, if they had an index, the whole of the pathogeneses must be repeated. The advantage of the Schema form was that they had it arranged according to the different localities and organs of the body ; but in an index they had it in a scattered and indefinite form, and not so ready at hand.
Dr. Nankivell said that the index would be in the Schema form. The anatomical portions of the body would form the basis of the index instead of giving the whole, symptoms in the Schemxi. He knew that Dr. Drysdale approved of groups of symptoms, all that appeared together being grouped together in one single paragraph.
Dr. Blacklev said that, like all of them, he had no doubt foxmd the necessity of having the provings given in much the same way that they would get up a picture — that is, having the symptoms grouped in the regular order of their occurrence. It had been idways a difficulty to go to the Schema to seek out and to determine, without knowledge gained in other ways, the way in which the symptoms had occurred ; but the selection of a medicine depended on the order in which the symptoms occurred. The Schema as they had it at the present day
2 T-2
«24 MBKTINQB. ^''SSS^'oSTmi
DMembldd portraits of the different races, reDdered by eattiiig off the ears and noses and patting them all in a group together. Now, if they could only secure the proTings as they occiured in various individuals, instead of cutting them up into a Schtma^ they would accomplish a great thing. Xhey could afterwaids go to the Schema if they wished.
The Pbesidbnt said that as he understood it, the Britidi HbnuBopathic Society would supply the provings, and the other would supplement it, giving the whole history of the drug and everything about it.
I^. Hatwabd said that the proposal was that their Materia Medtca should be a complete Materia Medica.
Dr. Madden asked if there had been any estimate of the number of volumes it would make, and the number of book- shelves that would be required to hold them. (Laughter.)
I>r. Hatwabd said that of course the Materia Medica would include all the medicines. He maintained that it need not be one half the size of that Allen had given them. He had given them ten volumes, and only in Schema form ; it was now proposed to pro- duce a more usefdl and reliable work in half that numb^ of volumes.
Dr. Hatwabd having again read the proposals.
Dr. MooBE moved that the Schema be left out. The symptoms were very often misleading, but here they were going to tay to do somethiz^ intelligent, and something that would be understand- able by the ordinary professional mind. He would move — *' That a, bf and c be adopted, that the Schema be omitted, and that its place be supplied by a full index."
Dr. Najnkivell seconded the motion.
Dr. Dtob Bbown moved as an amendment — '^ That the Sdkema be added.'*
Dr. Hatwabd seconded the amendment. He said that in many cases the circumstances were to be found by the Schem^^ and by the Schema only. Take a series of provings and a series of pathogeneses, such as they might have in a vohnne. A person would come in complaining A a peculiar headache, and you wonder whether belladonna produces it. You turn over the Schema, and under the *' head ** you will find a peculiar headache that belladonna produces, but you don't find the one you want. Must you read all the provings while your patient is waiting ?
Dr. MooBB : But the index would show that.
Dr. Hatwabd : Then it is a Schema ?
Dr. Nankivxll : It is a Schema, but refers to the patho- geneses, and is not a Schema only.
Dr. Moobb said that Dr. Hayward forgot that the Sdisma
nSSS^StTS^ MSBTiNqs, 625
would doable the flize of the book. Their great object was to keep the thing within readable compase.
Dr. Bbygb said he thonghi that the great objection to the Schema was that they had the provings by one man, then by iwo, three, eight, or ten men. The proposal of the H^fanenuum Society was to take what was right, and not to take the provings of six or eight men, and that would not be a long mattelr. It did not appear to him that the British HomoBopathic Society would midce such a large number of Tolumes after all. Wii^ regard to the Sehema, a patient might come in with no complaint except in the hea^ or abdomen, and the practitioner wished to refer to the Schema at once. He did not see that they could make an index to overtake that.
Dr. Dyob Bbowm said he thought that if the thing was to be made complete it should be so, even although there might be A few volumes extra. That would be much better than having things half done. (Hear, hear.)
Dr. Cabfras said that the first question was whether they would have a Materia Mediiea of the British Homoeopathic Society or the one of this Congress. If they decided first as .to that, tiien they could decide the other question.
The Chaibman said that the proposal of the British Homooo- pathic Society merely refiaired to ttie proving of the drugs, if that was done it would be a very important thing. He understood that the Publishing Society would give again whai was given by the British Homoeopathic Society. He bought it would be better to let the British Homoeopathic Society give the provings, and the Hahnemann PnbHshmg Society to do the remainder. As regarded the Schema he must say that he should be soriy to see the work without it. It would be a different thing from what they had had hitherto. Where a certain effect was observed once it might be noted, and where it had beeA observed six or seven times it might be noted as such. He would now put to the vote the amendment proposed by Dr. Brown, ** That the Schema be given as proposed.*'
On the vote being taken, eight voted for tiie amendment and eight for the contrsury opinion.
The OHATBlfAN having been asked to give his casting-vote, he flaid he would give it for Dr. Brown's amendment in flavour of the Schema. He said that he did not like giving a casting-vote ; but he knew that Dr. Bryce, who was temporanly absent, would have given it in fiivour of the amendment.
Dr. Hatwabo said that the only other question that now arose was as to the title of the book. The object was to bring out a eomplete Materia Mediea, one that would fill the place of sll the Materia Medicos that had been published. That might appear taither ambitious, but it could be done. They knew that much
626 MEETINGS. ^'"^^
£«nev. OeL S, I8BL
of their material — ^the material of the homceopatfaic hod j — mna taken and made good use of hj those who said that there wn nothing in homceopathj. Of their Materia Medieea that were pnhliahed, Dr. Hnghes* Pharmacodynamics had gone throng three or four editions, and a great many more had been sold than there were homoeopaths to bny. Of eonrse they were pur- chased by the allopaths. Hnghes*, Phillips*, and Ringer's Materia Medicas showed the rising taste for these works, and their own Materia Mediea on^t to take the place of the three. If they ticketed it as homoeopathic it would not do. The pro' fession would say, " We don't want that, we want Binger's." But let them drop the name, and give it a title that would not be objectionable, and then it would be bought. They would real it, and by-;and-by become homoeopaths. He would suggest thst they should entitle it, A Pkyeioloifical and Therapeutic Materia Mediea,
Dr. Williams asked if the work would be published by the Hahnemann Publishing Society.
Dr. Hatwabd said that it might be published by a neutnd firm.
The PjEtESiDBNT asked who the work would be stated as by ?
Dr. Hatwabd said it would not be necessary to state that it was by any one in particular. The author's name would be on each paper that he wrote, and it might be published by Lewis, of London. It would go into his lists , and would then pass throng the world as The Physiological and Hierapeutic Materia Medico^ He had read a letter that morning from Dr. Dtysdale, in which he said that, after aJl, Materia Mediea meant " matter medically,** so that the '* Therapeutic '* would be supeifluous, and ** Physuh logical Materia Mediea " would be quite sufficient. He did not know that it was necessary to settle the title at present, further than that the Congress approve of a neutral title.
Dr. Dtge Bbown said there was a great deal to be said for a neutral title ; but he thought that to do justice to themsehres and to Hahnemann, they must introduce lus name in a proper way — such as. The Materia Mediea compiled under the auspices, or compiled by the Homoeopathic Congress ; and then distinctly state in the preface that they owed to Hahnemann this method of investigating medicines, and of bringing before the publie the pure action of medicines. He thought this would sati^ alL
Dr. Nankivell said that he was going to say very much what Dr. Brown had said just now. It appeared that publishing a Tolume was a sort of venture ; they were going to try to put salt on the allopaths* tail (laughter) ; and it was a quesiioD whether they would succeed. If they did not succeed, and if they did not put the name on the title, they knew who would Jhave the laughing side. If they were to have a Schema let
them acknowledge the principles of the man to whom they owed the work.
Dr. Cabfbax said that his feelings were very mnch the same as those that had just been expressed. If they took up any book on any subject at all that tiiey wished to make their guide, the first thing they did was to look at the title page to see who was the author, and whether he was a reliable guide. But if it was simply a Materia Medica, there were so many calls on one's time, that his first impression would probably be to put it aside ; and, besides, he would like to know whose Materia Medica it was. He thought it would be rather shirking their principles if they were not to say, *' Published by the Hidmemann Publishing Society." He thought that they ought to give prominence to the source of this Materia Mediea. They need not call it a Homceopathic Materia Medica^ but they might say *< Published by the Hahnemann Publishing Society,*' and let the preface give honour to whom honour was due. He thought they could not too prominently bring forward the truths which they maintained, and if this proposid was a success it would put the matter on a proper basis.
Dr. Walter Wolston asked who would be the responsible editor?
Dr. Garfbab said that there would be a publishing committee.
Dr. BiooAB said he thought, as the last speaker had said, that it was well to have some person who would be responsible with regard to the work ; and while they, as homoeopathic physicians did not wish to say in every instance that they were homoeo- pathic physicians, still they believed the doctrines of homoeo- pathy ; and if they were making such inroads, let the work be pubhshed by the Hahnemann Publishing Society. With regard to the title, it should be as concise as possible, and it might be called The Materia Medica of the British Homceopathic Congress,
Dr. Walter Wolston said that it might be published by Lewis under the auspices of the Hahnemann Publishing Society.
Dr. Dyce Brown said that probably he would not do that.
The Chatrman said that Dr. Hayward wished a vote taken as to whether they should have the Hahnemann Publishing Society appearing on the title-page.
On a i^ow of hands being taken, fourteen voted for the namo appearing on the title page, and four against it.
The Chairuan declared the proposal agreed to.
Dr. Dtcb Brown said he supposed it was understood that there would be a special preface.
Dr. Hayward said that there would be a general preface. He ■did not know, however, that they could mBke a better prefietoe than that they had.
C28 KSPtaaB. ''B^,oet«;i«.
Dr. Dtcb Bbown moved *' That a hiitorieal prafaee shofiild be added, in which it is distinctly stated that we owe to Hahae- mann this method of diacoveries in the action of medidnee, and the mode of htying them before the pnbHo.**
Br. WiLUAM B seconded the motion.
Dr. Oabfbas said he thought that the proposal was snpet- flaons. There mnst be a preface^ and, if they had eonfidenee enough in the men who published the book to allow them to work oat all the rest of it, they might tnist that they would not omit to give proper hononr in the preface. While he agreed with the principle, he thought the proposal was quite superfluous. -
Dr. Dtob Bbown said that what they wiahed specially was that the kind of prefftce to which he refenred should go in.
Dr. MooBB said he would give notice at the next meeting that the Hahnemann Publishing Society be called the Homoeopathie Society*
Dr. Cabfbae moved, " That the prefiEuse be left to the Hahne- mann Publishing Society.**
Dr. Blacklet seconded this motion.
On a show of hands thirteen voted for the motion, and six against it, and it was agreed to leave the preface to the Hahne- mann Publishing Society.
PLAOE OF NEXT MEBTIMO.
Dr. Nankivbll moved that the next place of meeting be Bournemouth.
This was seconded by Dr. Moobb.
Dr. Maddbn proposed Binmngham, which was seconded by Dr. Blackley.
Dr. Hayward, seconded by Dr. Bbtce, proposed Matlock, and it was eventually agreed that Matlock should be the next place of meeting ; and that the Congress should be held on the second Thursday of September, 1688.
SLSGTION OF PBESmSMT.
The election of President for next year was then proceeded with.
On the voting papers being collected,
The P&B8IDBNT said he had the pleasure of Announcing that their choice had fallen on their friend, Dr. Blackley. (Applansa.)
Dr. Blaoklbt said he was exceedingly obliged for the honour they intended to do him, but felt obliged to decline it, on the ground that his time was so completely occupied with a series of researches on which he had been long engaged, that he would be unable to do that justice to the office which he would wish to do.
Another vote was then taken, when the Pbbsidkmt announoed
mS^SlTSuH^ MBirrnws. 091
the eleetioQ of Br. Moore, of Liverpool, by an orenvfaefamng minority.
Dr. MooBB rekurned ihanke in iq[ipropiiate terms for the honour that had been done to him, and said that he would endeavonr to the best of his ability to perform the duties of the office.
Br. Waltbb Wolston moyed that Br. Hayward be appointed to the office of Vice-President.
Br. Btoe Bbowk seconded the motion, which was carried vnanimonsly.
The General Secretary (Br. B. Brown), and Treasarw (Br. £. Madden), were re*appointed.
Br. Wolston then proceeded to read a paper on a case of Nephritis, which, together with the discnssion, we hope to publish next month. This was followed by a paper on the Periodicity of Certain Biseases by Mr. Batcher, of Windsor, which we purpose pnblishing in onr next number.
A ccwdial vote of thanks to the President brou§dit the proceedings to a conclusion.
THE DINMEB.
At six o'clock the members and their friends dined together in the Windsor Hotel. The President (Br. Bmry) occupied the chair, and Br. Bryce (Edinburgh) the vice-chair. In addition to the members of the Congress, several friends were present, among whom were Mr. Futvoye, of Bourne- mouth, the Bey. Mr. Gordon (Edinburgh), Councillor Boyd, Mr. Henderson, &c.
The Pbbsidsnt gave the usual loyal and patriotic toasts, ^nrhich were cordially responded to.
Br. Gibson (Stirling) returned thanks on behalf of '^ The Navy, Army, and Reserve Forces.'*
The Peesidbnt then said that on an occasion of this kind the name of one whom they all revered, and who was instrumental in calling them together, was always remembered — Samuel Hahmbkann. (Applause.) He was sorry to say he had never seen Hahnemann. He (Dr. Bbu&y) first saw a little of homoBO- pathy at a dispensary, and after having been some time in Bublin, where he lectured on Materia Medica, he went into partnership in London with a gentlemiMC^ who gave extraordinary doses. He it was who brought him to homoeopathy. He was attending a little child, which grew worse and worse, and the medidne given appeared to do it more harm than good. One day he called at tiie house, but was not asked to go up stairs. He called next day, and was not asked to go up stairs. The fither afterwards said to him, '* Yon will ^tunk it strange not to iiave been asked to see the child again. Well, the &et is, a
^80 MESTINQa. ^'"SSSL
Befiew. Oet 1| Iffilr
drowning man will catch at a straw, I took the child to a homoeopath, and it got better." (Laughter and applaose.) That made an impression on him. Another case oocnxred in a coach- man who was ill with pleoxisy. The patient told him there was a gentleman he was with who gave him some of '' those ronnd things," and he was greatly the better of them. By-and-by he said to himself, *' I wHl try homoeopathy," and he set himself for six months to the stady of it with the most satisfB^tory resnlis. His partner died, and he was left in this position, that he was a homoeopath and all his patients were allopaths. One patient came and another left. Fresh ones came in, however, and at the end of the year he fomid that he had kept his ground. (Applanse.) He then went on to say that but for Hahnemann they would not have been assembled there on that occasion. Hahnemann's was one of the great master minds of the centuiy ; and, seeing the truth, he was able to carry it on a great way towards perfection. He- would not say to perfection altogether ; because there were a great many thmgs in which many might think he was wrong; but he discovered a grand truth, and put it on such a footing thai from his day to the present it had not gone back. It was not to be expected that he should perfect the truth, but he had placed it on a safe footing ; and it was for them to perfect it as much as possible. It was for them to follow in his steps, and he trusted that as years rolled on Hahnemann's principles would become more and more established in the land, and that thoee who had hitherto been their opponents would join their ranks. (Applause.) Those who joined them now were chiefly from among the older members of the profession. Comparatively few of the students came to them owing to the teaching of the schools, but the older men came with firmer and stronger convictions. He hoped, how- ever, that the time would soon arrive when the students would see in the schools and hospitals of homoeopathy what was going on, and be led to investigate it. He now asked the Company to- drink to the memory of Samuel Hahnemann.
The toast was drunk in silence.
Dr. LuDLAM then proposed, ''The President and Vice-President of the Congress." (Applause.) He said that in giving this toast he wished to refer to what he had observed and heard that day. Beginning with the address, he felt that he would be well repaid for crossing the Atlantic if he had only heard that addresSr (Applause.) One liked to hear his own views echoed by a speaker, and his views were certainly expressed in that addxess. They were exceedingly well set forth in all that pertained to the character and the deportment of homoeopathic physicians towards iheir professional brethren in the latitude from which he came. He was sure that in the address there was a common chord struck that morning. (Applause.) These views, carried into practice
SSS^Sfra^ MBBTiHas. 681
9f&titiw% Ooi. St 18Bk
had already done a 'great deal for homoBopathy. He believed they had seoD evidence that day that they were getting out of tiie oontroversial period of homoeopathy, and passing into the practical field — away from talking of tweedledum and tweedledee; and if they continaed to show a good spirit in their literature, in their sdiools, and otherwise, the consequences could not fail to be highly beneficial. (Applause.) He now wished to say something with reference to the vice-president. He had not seen half so much of him as he should have wished. It waa something to say of those gentlemen who went out of office — as he understood that their late departed fnends did — ^that a proper diagnosis had been made. (Laughter and applause.) Old Dr. Chapman, in Philadelphia, had the reputation of being the greatest wag, in a medical way, in America.. One of his stories was as follows : — ^He said one day to bis students, ''It is very important in the practice of medi- cine, that you should mAke a proper diagnosis ; you cannot prescribe intelligently if yon do not know the case. It will never do to take the say-so of a patient as to what his ailment really is. Catechise your patients, make up your mind from the evidence, and then prescribe on that. I was called the other day in great haste to see a young woman. I went in and. asked what was the matter with her. * I have,* she said, ' the aurora borealis.* (Laughter.) * What ? * I said, * the aurora^ borealis ! that is impossible.' (Laughter^) * Oh, yes,' she said, * you told me once before that I had the aurora borealis, and I have it again.' (Laughter.) Well, there was no use quarrelling with the woman, so I examined her carefully, and I found she- was suffenng from cholera morbus. (Laughter.) I prescribed fcNT her and told her the difference of the disease. I said, ' Don't- forget that cholera morbus may arise, and often does arise, from. a disorder of the liver, but the aurora borealis is always an affection of the lights." ' (Loud lau^ter.)
The PsKsmsMT, in acknowledging the toast, said they were always greatly pleased to meet their brethren — ^he could not call them strangers — from America. (Applause.) He hoped they would often have the pleasure of seeing Dr. Lndlam and Dr. Big- gar amongst them. (Applause.)
The YicE-PBBsmENT said he had also to return thanks for the kind way in which he had been coupled with his worthy friend. Dr. Drury in this toast. He referred to the last Congress held in Edinburgh, and to the excitement regarding homoBopathy which preva^ed in Edinburgh in 1861, which he said was largely owing to the shock which the conversion of the late Professor Hflsidbrson to homoBopathy had given his colleagues at the University. Again, last year the Professor of Medicine in the Umvendiy and one of the surgical professors, set upon them very
682 iiBWiKoe- *2SS?o!f?Mt
Beirtew, Oct 9; un.
severely, but he Jbeiieved that no harm came from it. The speeches that these gentlemen made were not wortti thinlring about. He conolnded bj again retoming thanks for his name having been oonpled in the toast with that of the President.
Dr. Bl^cklbt then proposed ** Saccess to the HomoBopathie Hospitals, Dispensaries, and School.*' He said that each of these had in its time, and in its own way, a very important influence for good on the spread of homoBopathy. The graai want of the day was that they were not suffieiently nnmeroiis. The difficulty in establishing these institutions he Imd found to lie in obtaining sufficient professional help, in getting new -blood introduced. He had found that young men who were discovered by their teachers to be imbued with homoeopathic proclivities were diligentiy pHed with tiie idea that the adoption of homoeo- pathy was derogatory to their position and diminished their influence. This he believed was the cause of their not seenxiBg a larger number of young men to represent homoeopathy. Hence they required a complete school, such as existed in America iHiere a diploma giving a licence to practise could be obtained. If a charter could be had giving such power, it would be of grest importance, and homoeopathy would then grow as rapidly in this country as it did in America. He believed the day would come when it would do so. At the dinner they had last year after their Convention, it pained him considerably to hear some of their older men pointing to America as the great source from which homoeopathy would have to grow, and they seemed to think that we had arrived at about the maximum of what we could do. He thought then, and still thought, that some of their older friends had mistaken the work they had been doing. They had been in the fore-front of the battie some twenty, thirty, and forty years, and he did not wonder at their feding the com* paratively small amount of success they had achieved ; but they forgot that they had not only been fighting, but they had been sowing seed, and that some of the seeds had b^ne fruit. .(Applause.) He had no doubt that many in America and eke* where had derived advantage from some of the seeds that were jown here. He was not going to derogate from the woik in \merica, but he merely referred to it as having grown partty from what had been done in this country. He tiiou^t that tf they could only take a much more courageous view of mattera, and put their shoulders to the wheel, they would accompKsh a good deal more. When they could manage to place tfa^selvea •on one solid foundation, and be determined to pursue one palli in the way of teaching their principles, they would get into the practical period. What he designated the practical period wav the period of teachmg and giving a complete professional •education to their younger men, and so getting new blood
S2*S^r2?yffi*^ MEBTINOS. 683
BNiew,Oot»,18eB.
amongBt them. Wheneyer they could do that, he thought they would make greater progresa in thia covntiy than they had hitherto done. It muat be by hospitalay where the students eonld see the work done ; by the dispensaries, where the people oonld feel the work that was done; and the schools, where they conid teach the principles of their glorious and noble pirofession. He had great pleasure in askuig them to drink '^ Success to the Homoeopathic Hospitals, Dispensaries, and School.*' (Applause.)
Dr. Maadbn said it was with much diffidence that he rose to reply to the toast. He felt that he himself owed so much to these hospitals and dispensaries that had been started, that he eonsidered it was only his duty to do what he could to speak in their favour and support their extension. (Applause.) It was about ten years since he left Edinburgh, baring been recently capped ; and being the son of a homoeopath, £9 was naturally anxious to leam homoeopathy btfore starting in practice, and he did not know Teiy well where to get the knowledge that he wished. He was fortunately enabled to spend some time with Dr. Hughes, and one of the best teachings he gave him was to take him to the Brighton Dispensary. Shortly after that a vacancy occurred in the house surgeoncy in Birmingham, and it was there that he got the experience that enabled him to practise in private^ It was there, also, that he got that knowledge of Birmingham that induced him to settle there. He believed that if hospitals and dispensaries were increased they would get many young men to leam homoeopathy, and to remain in Uie towns where they had learnt it. (Applause).
Dr. MooBB proposed, *' Success to Homoeopathic literature." fie said that first of all they had the British Journal of Honuta- pathy^ conducted by Dr. Dudgeon and Dr. Hughes, both men of great talent. Dr. Hughes was known to everybody who knew what homoeopathy was, and his name was a great power through- out the vast continents of Europe and America. They had the HovuBopathic Reinew and the HomowpaMc World, which were conducted with great ability. He would have liked to have seen more of the editors present. He alluded to the able senices that had been rendered by Dr. Pope, Dr. Dyce Brown, Dr. Kennedy, Dr. Burnett and Dr. Nankivell. Dr. Pope, he much regretted, was not present, for, as every one knew, he fsgoke like a book. He was a personified, living essay. (Applause.) If they read one of his lectures they would see that he was a man who went on like a river. But he was not like the Pope of Bome, for he allowed people to think for themselves. (Laughter and applause.) He was the Pope of the McmMy Uomao' pathic Beview^ (Applause.) They must keep up tiie title of hflmoeopathy. 13iey ought not to have slavish obedience to a
684 MEETINGS. '''ga^^^STS!!
man, bat cordial obedience to a great law. That was what he wanted people to come to. He would say to those opposed to them, '' Admit the tmth of oar great law, and we will join yoQ, bat anlesB yoa do that, we most retain onr present position." He had much pleasore in coapling the toast with the name of Dr. Dyce Brown. (Applanse.)
Dr. Dtge Brown said it gave him very great pleasure to rise to return thanks for the toast, and he only regretted that his colleague, Dr. Pope, had not been able to do so. His health had not been satisfactory of late, and a long and necessarily hurried journey, and the excitement of a meeting in which he felt a deep interest, were more than his strength allowed him to undertake. He could assure them, speaking for himself and all the others engaged in homoeopathic literature, that they had a great satisfiEustion in feeling that they could be of any service in promoting the interests of homoeopathy. Sometimes, perhaps, things might be written that wdre not altogether to the mind of everyone ; but he assured them that everything was written with the very best intentions, and with the idea that the view they had taken was the best and most likely to further homoeopathy. (Applause.)
The Vicb-President proposed " The health of the Secretaries."
Dr. Dtgb Bbown, in the absence of Dr. Wolston, briefly responded.
The Yioe-Pbesidsnt proposed *' The health of Dr. Ludlam and Dr. Biggar " — whom they welcomed very cordially. (Applause.)
Dr. BiooAB, in acknowledging the toast, said that for himself, and on behalf of the physicians of the United States, he had to thank the meeting for tiie opportunity of being present at their proceedings that day. He had spent some time on the Continent and in Great Britain, but he had not spent a single day that had given him so much satisfaction as he had experienced that day in listening to and seeing all that had been said and done.
Dr. Dtge Bbown proposed '*The health of the Treasurer, Dr. Madden.*' (Applause).
Dr. Madden replied.
Dr. WiLUAicB gave the next toast " The City of Edinburgh, coupled with the name of Councillor Boyd."
Councillor Botd in replying to the toaist, thanked the company for their good wishes for the city.
Dr. Hatward had great pleasure in proposing '' The health of the Visitors, coupled with the name of Mr. Henderson." (Applause).
Mr. Henderson acknowledged the toast. He said he conld assure them that he had very great pride and satisfEu^on in representing the patients of homoeopathic physicians. He had
S5*?SnS?* KOTABIUA. 686
BsffeWf Oct. % t66i«
often thought that the patients did far too little considering what ihe physicians did and suffered for them. A remark had heen made as to there being no hdmoBopathic dispensary in Edin- burgh. He thought that it should spring from the patients, and not from the doctors, who supplied the sloll. He thought that the least that the patients could do would be to extend tibe benefits of the homoeopathic system to their poorer brethren. (Applause). The proceedings, which were throughout of a most agreeable character, were ^ortiy afterwards brought to a dose.
NOTABILIA.
IIOTES OF THE LONDON HOMCEOPATHIC HOSPITAL.
In our last month's issue we announced that it was in contempla- tion to increase the staff of nurses for attending private patients. It appears now that a scheme to that effect is nearly matured, and as the house. No. 1, Powis Place, ac^oining, and the property of the hospital, is now vacant, there will be no difficulty in carrying the measure into effect at an early date — so soon, in fact, as the necessary alterations, which wUl not be extensive, oan be carried out. The space at the disposal of the authorities will, however, be greater than actually needed for the acconunoda- tion of the additional nurses, and it is, therefore, proposed to appropriate rooms on the ground floor for the reception of a private patient, fitted in a superior manner, and the charge for which would be proportionately higher than when the experiment was first tried within the walls of the hospital. This is a move in the right direction.
PRIZES FOR STUDENTS AT THE LONDON SCHOOL
OF HOMCEOPATHY.
Db. Prater offers two prizes of JglO each, for students attend- ing the ensuing winter session at the school, to be awarded at the end of March, 1888. One prize of £10, for the best examination in Materia Medica. The other prize of £10 for the best examination in the Principles and Practice of Medicine. Candidates for the latter prize, besides having a written examina- tion, will be examined clinically in the wards of the hospital, and write out one case in full, stating at the end of the case, the diagnosis and treatment, with their reasons for the selection of the remedies.
The adjudicators of the prizes to be Dr. Bayes, Dr. Hughes, Dr. Pope, and Dr. Dyce Brown.
686 OOBBBSPOKDBHTB. ^'msv, Oot. >; lan.
PEIZE E88AT.
Db. Prateb, with his nBoal generous liberality, offers a prize of £80 for the best essay *^ On Hydrophobia.*' (a.) Its history, pathology, and symptoms, (b.) The yarions measures, surgical and medical, for the prevention of the disease after inoculaiion of the virus, (c) Curative measures after its development, stating the pathogenesis of the medicines recommended, as £» as they relate to the disorder, and the more or less close simHaritj of each to the disease in its different stages, (d.) Gases on record or unrecorded, illustrating the value of ^e treatment adopted before and after the development of the hydrophobia.
Essays to be sent to Dr. Dyce Brown, 29, Seymour Street, Portman Square, W., on or before November 1st, 1888.
All essays to bear a motto, and without a name. The name and address of the author to be placed in a sealed envelope, bearing the motto attached to the essay. Any essay to which a name u othermse appended will be disqualified. Dr. Bayes, Dr. Hughes, Dr. Pope, and Dr. Dyoe Brown are the adjudicators of the prize. N.B. — If no essay comes up to the required standard of excellence, the prize will not be awarded.
NOTICES TO CORRESPONDENTS.
«% We cannot undertake to return r^eeted manuscr^rte,
Mb. HtTBNDALL, M Jt.O.Y.S., Liverpool. — ^Tonr paper has been reoeiTed, and shall appear on the first opportunity.
GommiinicationB, Ao., have been reoeived from Dr. Coovem, Dr. Bub- NBTT, Mr. GHAiCBBft (Loudon) ; Dr. Huohbb (Brighton); Dr. Pdllab rESdinbnigh) ; Dr. Dbubt (Boumemonth) ; Meesrs. Thoxfsom Ss Caffbb (Liverpool).
BOOKS RECEIVED.
8ur U Bythme de Quelqttee MedieamentSt pa le Dr. A. Glande. Paris, 1081,— The Eomaopathic World —The Chemitt and Druggiet.^The Students* Journal and HoapUdl Gaxette, — Burgoyne*» Journal of Phmr- macy.—The New York Medical Times^-^The New England Medici Oazette. — The Hahnemannian Monthly. — The Medical Adoance, — The Medical Counsellor, — The American Observer. — The St. Louis CUnieal Review. — The Calcutta Journal of Medicine. — The Indian HonueopatMe Seview.—BuU, de la Soc. Med. Horn, de Franec-^BibUothtque Hcmaso- patMque. — Bevue Horn. Beige. — El Criterio Medico*
Papers, DiBpentazy Beports, and Books for BevieW to be sent lo Dr. Pora, 21, Henzietta Street, Cavendish Sqnars, W.; Dr. D. Dvcb Bbowb, 29, Seymour Street, Portman Square, W. ; or to Dr. EbzoibdXs 16, Montpelier Bow, BlaoUieath, SJS. Advertisements and BnsinaBa eommmiioationB to be sent to Messrs. E. Gouu> A Sox, 69, Moocgate Street, £.0.
IBSSfN^^tSS** HOMOBOPATHY IN INDIA. 687
THE MONTHLY
HOMCEOPATHIC REYIEAV-
HOMCEOPATHT IN INDIA.
The practice of medicine in India, as in other Oriental countries, has altered very little in the course of centuries. Semi-supernatural power, natural magic, necromancy, witchcraft, devil-worship, and a yery slight knowledge of medicine, were the powers brought to bear on disease by the Hindoo physician. In a country, whose early histoiy is lost in the mist of ages, whose creeds date back 2,000 years or more, the practice of physic has been handed down from generation to generation, like a pocket borough before the Reform Bill. With the advent of the Feringhee came some little change, perforce, amongst those who were brought directly in contact with European civilisation. It was found that the English doctors could oftentimes cure diseases which the native ^sculapius had failed to exorcise or charm away. The (Government enforced, as best they might, laws of sanitation to preserve the nation from the scourges of pestilence and famine, which, like twin demons, stalked through the land at varying intervals.
The establishment of English rule in India e&cted,
without doubt, a great stride in the heaUng art, but still
the native mind was prone to turn to the Kabirajes, or
country physicians, with their old world-charms and
Yd. S6, No. U. H u
638 HOMOEOPATHY IN INDIA. ^^JSJ^mS^i^!
potions. In fact, as far as regards actual therapeutic agents, we do not know that the new r^gimi was a very great improyement on the old.
But it must be admitted, in all fairness, that the general condition of public health, especially with regard to epidemic disease, was much ameliorated by the improyed knowledge brought to bear upon the community by the European physicians.
The next step in the spread of what we must, for the nonce, call modern physic, was the education of numbers of intelligent young natives to act as apothecaries, dis- pensers, and surgical assistants throughout the countiy. Many of these, as might be expected, developed consider- able skill in the practice of their profession, and aided considerably in spreading the knowledge of European medicine and hygiene throughout our great Indian Empire. The work of humanity, begun in the days of the East India Company, and continued under the beneficent, if not very economical, rule of the Imperial Government, has now penetrated through the whole Peninsula, so that the poorest ryoty nay, even the meanest outcast pariahy can carry his ailments to the doctor sahib at the nearest station, and obtain the best relief which allopathy can afford him.
But it has been reserved for the latter half of the nineteenth century to see the introduction of scientific therapeutics into India. Many of the English residents, having learned the benefits of homoeopathy at home, carried with them the system which they preferred, and continued its practice in their new homes. Gradually the knowledge of the system spread, until each of the great cities could boast of its homoeopathic chemist and dispen- sary. Now homoeopathy is an admitted power in the land. One of its leading Professors, Dr. Sircar, was for a long time on tbc Council of the University of Calcutta, of which
iSS^riSr^aM"" HOMCEOPATHY IN INPIA. 639
he is a distingaished gradnate. More practitioners are urgently demanded, and only recently we were informed that an English homoeopathic physician could be sure of a good reception and profitable practice in Galcatta.
The outward and visible sign of the spread of homoeopathy is the success and increase of its literature The Presidency of Bengal has for the last eight years had A first-class homoBopathic journal, ably edited by Dr. Siboab, the Calcutta Journal of Medicine. Conducted by a homoe- .opathic physician, it is catholic to a degree in its scope, never, however, yielding any of the cardinal points of the homoeopathic law or method. Its pages are well furnished with clinical cases of great interest, an example which we wish our more numerous readers would enable us to emulate. The prevalent diseases of the country, such as diarrhoea, dysentery, cholera, ophthalmia, are frequently and fully discussed. Some able papers in repertory form have appeared this year, in which all the medicines likely to be of use in these diseases, have been carefully studied, many of the symptoms being new and original. Written entirely in EngUsh, this journal occupies a position in the first rank of homoeopathic journalism, and we are glad to see it so flourishing in the tenth year of its existence.
The Calcutta Journal of Medicine has a younger sister which gives equal promise of future success. We refer to the new journal entitled the Indian Homoeopathic Revieii\ the first number of which appeared in January of the present year. Apparently the demand has arisen for some homoeopathic periodical suitable for circulation amongst the laity as well as the profession of the Presidency. This demand the new magazine is well calculated to meet, as half of it is printed in the Bengali vernacular and in the native character. We regret that Bengali has not been
2 U--
640 HOMCEOPATHY IN IHDU. "SSSL^SST?^
B0fi0W« KoT. 1* IBBtL
part of onr cnmcalniny so we are obliged to confine onr- Belves to the bare statement of fact, without giving any extracts from this portion. If, howeyer, [it is eqnal to that part of the periodical devoted to the edification of readers of the Anglo-Saxon language, we are confident that the cause of Homodopathy has received a great *' lift '*' from the publication of the Indian Homceopaihic Review.
The first number commences with an *' Apologia pm vita 8iui,^* which is so good and forcible that we would like to give it to our readers in extenso, but must be &in to content ourselves with a small extract : —
*^ As journalists we are respoDsible for our own existence, and it is necessary that we should iazplain why we have thought fit to- call ourselves into being. Without much preface, therefore, we proceed to state the reasons of our existence, and the objects it is intended to attain. It is not to be disputed that homoeopathy is gaining gronnd in India. More and more people are bear- ing of it every day. More and more homceopathic dis^ pensaried are coming into existence. Instances of cores by means of homoBopathic medicines are multiplying. And the number of converts to the new fidth is also unquestionably on the increase. Yet the cause does not advance. The popularity of the method seems to be owing not to an intelligent appreciation of it as a method, but to a confused idea that some homoeopathic drags are sometimes very useful. Men are proud to show their can- dour and their acumen by admitting that homoeopaths have got good medicines for this disease and that disease. We set no value upon such admissions, and if every single man in India were to make such admissions, we should not be justified in thinking that the cause of homoeopathy had adyanced. That we may not raise false hopes, or inculcate false ideas of our catholicity, we think it our duty to state that we entirely repudiate the motto, * He is the best physician who rescues men from diseases.' The bare fact of removal of a disease or of some particular diseases is of little consequence when the in*
aSSS^^rS^ HOMCEOPATHY IN INDU. 641
qmry is to disooTer a law of eare. Observation of particular inBtances is no doubt necessary to discover a general law. Bat when the observed instances have no sort of resemblance, of what nse are they ? There will be fonnd men, and very well located men they are, who generalize their experience in some such way as the following : — ' The homoeopaths have got good medicines for cholera and some other diseases. The allopaths liave got good medicines for acnte fever, for surgical diseases, ^nd some other diseases. The kabirajea have got good medi- 4sines for chronic diarrhoea, chronic fever, and some other ^LLseases. Some sanayasU, mokunts, and old women also know some very good medicines for some diseases.' All that we can «ay in answer is that we should find it difficult to be happy in «uoh a frame of mind. If we axe to choose medicines empiri- ■cally, what progress have we made since the time of Qslen ? "What is the method we are to foUow, or must we renounce the possibility of a method ? Are cures to be regarded as so many isolated phenomena not amenable to any law 7 We hold and we shall attempt to teach in this journal that all the above inquiries liave been satis&ctorily answered by Hahnemann. The method has been found. The law is known. Without mincing matters find using periphrastic expressions, we distinctly and unreservedly commit ourselves to the method of Hahnemann. By that method we are prepared to stand or fioll ; and it will be our duty io expound it, to illustrate it, to develop it, and to propagate it to the best of our ability.*'
This is downright stalwart homoeopathy, and a very out- spoken confession of faith in the law of Hahnemann. No eclecticism, under the guise of homoeopathy, is fonnd here — no sneaking apology for the sectarian name which we liave been forced to assume, and which we trust will never be laid aside until the circumstances which necessitate it liave vanished into the past. Dr. Bhadubi merits the thanks of all honest homoeopaths for this article.
The present state of homoeopathy in India appears very much to resemble the state of homoeopathy generally.
642 SUPPtJRATIVB NBPHBITIS. ^^^^STF^
BericWf 17ot. 1« 18BL
The snccess of the system is not to be jndged by the nnmber of its qualified practitioners, either in this country or in the far East; for owing to powerftil opposing inflnences, all trying to choke the new system, its qualified practitioners are not numerically commensurate with its successful spread. Far different is the state of affairs when we turn to the West, as we trust to do in some future article. Dr. Bhadxjbi's description of homoeopathy in India would do admirably for England, if for '' India " we read ''England." And yet we know that the system is spreading rapidly, although, from well-known reasons, not in an open manner amongst the profession. Here, as in India, dispensaries are increasing, cures are made, and the number of converts is unquestionably on the increase* Our chemists can assure us that the demand for homcBO- pathic medicines has multiplied greatly during the last few years, and is still increasing. With this state of affairs we are satisfied for the present, knowing that the irresistible force of public opinion is being gradually formed, which will eventually sweep away every obstacle to the honest inquiry into the truth of homoeopathy, both at home and abroad.
A CASE OF ACUTE SUPPURATIVE NEPHBITIS,
WITH REMAEKS.*
By Walteb T. P. Wolston, M.D.
Mr. President akd Gentlemen, — If excuse be needed for venturing to read a paper at this Congress, based on the record of a single case, it must stand in this, that I have only met with one such in my practice during seventeen years. Nor is this strange, when we bear in mind that nephritiSf of the kind I speak of to-day, is a very rare malady — ^rare, whether we consider its absolute frequency or view it in relation to other renal disorders.
* Read before the British Homoeopathio Congress at Edinburgh.
ISSS?fy°riTa^ SUPPURATIVE NEPHRITIS, 648
Secondary affections of the kidney, arising from diseases of the lower urinary tract, though not unfamiliar to hospital surgeons, have received less attention from physicians than their importance demands, and it is with a view of adding a mite of information, which may help towards more exact diagnosis and effectual treatment, that I relate my experience.
Mary H., aged 6^, the child of a gentleman, who for many years has suffered from haematuria, and probably renal calculus, was £rst seen in her present illness on Monday, May 8th, 1882. She had been a very healthy child till November, 1881, when she had a smart attack of peritonitis lasting three weeks, and from which she com- pletely recovered. Her present ailment is a vaginal dis- charge of viscid muco-purulent matter in considerable quantity. This condition has obtained for ten days.
It appears that on Wednesday, April 19th, the child went with her three brothers and an elder sister to Pit- lochrie for change of au*. While there the nurse noticed that during two nights she was rather hot and restless, but seemed otherwise quite well, and took her food normally. She had no sore throat, nor was any redness of skin noticed.
Present state* — She seems quite well in every way, excepting only the vaginal discharge. This is glairy, muco-purulent, and stains her linen yellowish green. On examining the surface of her body, I found the remains of some small boils on ' the thighs, and, regarding the case as one of transient blood disorder, I gave heparsulph. trit. 8x., gr. i. t.d.s. Nothing of note occurred, and I did not see her till Thursday, 11th May, when I was sent for in the afternoon. She had been dressed and taken down stairs, and seemed well enough unless moved, or trying to walk, when she complained of pain in the loins and hips — ^upecially the right side, extending down both thighs. I found the vaginal discharge was still continuing, and, if anything, more profuse than on the 8th. The inguinal glands, specially on the left side, were much enlarged, forming a knotted chain. The skin was hot and dry. P. 110 ; T. 102.
I immediately ordered her to bed, and prescribed warm fomentations to the hips and loins, and aeon. 8x. and rhu$ tox. Sx, in alternation, in two drop doses, every two hours.
644 SUPPURATIVB NEPHBITI8. ^^^^^^SSTJfSlf
Friday, 12th (11.) — ^A restless night had been passed* The right hip was now tender to the touch, and appeared swollen. P. 110 ; T. 102. The urine was noticed to be smoky-colonred, and on examination found to contain one-sixth albumen and a large deposit of urates, but no tube casts. In quantity it was normal.
A purely milk diet was ordered, with poultices to the hip, and continue accm, and rhu8.
Saturday, 13th (in.) — ^A very restless night, with much pain in both hip joints and thighs, of a lancinating character, and the child lay in bed on her back, with her legs drawn up. Tongue fairly clean, and not at all straw- berry-like. The water was very profuse in quantity, but very dark, and contained one-hfidf albumen, much blood, a good many oxalates, and abundance of fibrinous cylinders, inflammatory and granular tube casts. Sp. gr. 1026. P. 120, good ; T. 108. There was no redness of the skin. Vaginal discharge less.
The child's parents getting anxious, and thinking there must be some disease of the hips, as the pain was all confined to that part, Mr. Joseph Bell, senior surgeon to the Boyal Infirmary, saw the case with me in the afternoon. He reported no hip mischief, but thought the case was one of post-scarlatinal nephritis, with anomalous symptoms in the region of the hips.
The milk diet was continued, and a large linseed meal poultice applied that enveloped the lower part of trunk and thighs. Aeon. 8 and hry, 8x were now given.
Vespere, — P. 125 ; T. 102 ; and she was much easier as to pain.
Sunday, 14th (lY.) — Had a good night, and appears much better to-day. Urine plentiful, amd contains only one-fourth albumen. P. 100 ; T. 101. Has little pain anywhere.
Monday 16th (V.)— Is wishing to get up. P. 90 ; T. 99.6. Water much lighter colour, copious, and contains one-sixth albumen. A careful microscopical examination of the vaginal discharge was to-day made, but no special organisms were found.
Tuesday, 1 6th (TI.)— P- 80 ; T. 98.6. Water nearly normal in colour, one-sixth albumen. To-day she was to be allowed a little weak chicken tea, in addition to her milk.
Wednesday, 17th (VII.)— Not so good a night. P. 110 ;
a^fN^^TSffl!^ SUPPURATIVE HBPHMTIS. 645
T. 102. Albumen one-sixth ; nrine still free. Complains •of pain in left Inmbar region.
Thursday, 18th (VHI.)— A bad night. P. 120 ; T. 108. Urine very dark coloured, and becoming scanty ; albumen one-half. I^ Canth. 2x gtt. ii. qq. 8 h.
Vespere, — T. 105 ; p. 185. At five p.m. a sudden attack of vomiting occurred, and she ejected a quantity of grass- ^reen fluid, while the bowels simultaneously were moved, snd constant diarrhcea set in. Omit canth. Ars. alb. Sx, and verat. alb. 8x were given in alternation every two hours, in two drop doses. At this time there was great, general iendemess over the abdomen, and it was evident that Acute peritonitis was supervening.
Friday, 19th (IX.) — ^A rather restless night, caused by frequent motions, which, however, ceased towards morn- ing. P. 130 ; T. 104. Urine becoming very scanty. Albumen three-fourths. Her skin is very dry and burn- ing. She was now put into a cold pack, in which she lay for two hours. Tongue a little loaded in centre. I^ aeon. Sx.y and canth. 2x.
Vespere. P. 100; T. 102.6. The pack relieved her much, soothing her generally, and producing some pers- |)iration.
Saturday, May 20th (X.) — She wandered a good deal, imd cried during the night, as if in pain, which she indicated as being in the abdomen. P. 120 ; weak ; T. 101.6. Urine still very scanty; half albumen. The tongue, for the first time, is furred from apex to base, white, with protruding papilla, and getting red and clean at tip and edges. Bowels not moved. She was ordered to be again packed at 7 p.m.
Four p.m. — She has vomited some more grass green fluid.
Veapere. — She has been in the pack for two hours, and perspired, but not freely. The tongue is assuming more the strawberry-red hue in the anterior half. P. 90 ; T. 101.5. The face is very flushed and pupils somewhat dilated, and she is slightly delirious. ^ bell. 8x., and 4ir8. alb. 8x.
Sunday, May 21st (XI.) — She had a very restless night, sleeping only three hours in all. The tongue is now clean from tip to base, and presents the typical ** strawberry ^ngue,'' being very red, and papilla much elevated*
646 SUPPURATIVB NEPHRITIS. ^^J^fSSJ^MaOL
?• 120, weak ; T. 100.8. Water very scanty and half albumen. Bowels not moved.
Five p.m. — Some bloody discharge has come from nose and throat, but there is no membrane nor any special throat congestion. P. 135; T. 102.8. The urinary secre- tion is now almost suppressed. She is quite conscious, but every now and then cries as if from head pain.
Vespere, — ^My colleague, Dr. Bryce, kindly saw her, in consultation, at the evening visit. She was then much weaker. P. 130 ; T. 102.2. Abdomen very tympanitic. Tongue red and dry; fauces clean. Pupils are widely dilated, and do not fully contract to light, and she is con- stantly on the toss and burrowing her occiput in the pillows. There are no swelled glands in neck or cervical region. The amount of urine passed during the day is 8 oz., of which half is albumen. Dr. Bryce recommended a warm bath, and thereafter wrapping her in warm, dry blankets, and aeon, 2x, and terebinth Sx, 1 drop doses, alternately every hour.
Monday, 22nd (XII.) — She had the bath, in which she cried a great deal, and was ever urgent to be released from the blankets. She cried wildly most of the night in delirium, and had little sleep. To-day, P. 145 ; T. 108. No water at all has passed. As she seemed to constantly urge, as if wishing to urinate, I passed a small catheter, but found the bladder quite empty. The abdomen is not more distended, and the bowels have moved twice, each time a healthy yellow stool. Tongue red and dry. Eyes injected, pupils dilated. She sweat a little after the bath, so I gave her another now, and continued the aeon, and tereb.
Four p.m. — P. 180; T. 105.5. No water. The extremi- ties are getting cold.
Five p.m. — She quietly breathed her last, the tempera- ture rising to 106 degs.
Sectio CadaveriB* 40 hours, p.m.
This was kindly made by my friend Dr. Sheridan Delepine, assistant to the Pathologist of the Boyal Infirmary.
The upper part of right thigh and the pudenda showed some small vesicles and pustules, also some excoriations.
On opening the abdomen the omentum and intestines were found covered with a layer of fibrinous lymph, and
JSSS^KfS^ SUPPUaATIVE NEPHRITIS. 64T
slightly adherent to the parietal peritoneum, as well as matted together.
There were about 40 oz. of sero-pnralent fluid, of a yellowish grey colour, in the peritoneal cavity. In drawing the coils of the intestines from the pelvis a cavity, bounded by fresh adhesions, was laid open, and thick yellow pus was found to fill the pouch of Douglas.
The intestines were slightly congested here and there, but no trace of inflammation of the mucous coat could be found in the parts of the large and small intestine which were examined.
The liver and spleen wpre apparently normal.
The bladder was empty, its walls perfectly anaemic, very smooth, and coated with a thin layer of tenacious mucus. The trigone, however, was congested, particularly at opening of the right ureter, the congestion extending for two or three inches up along the ureter.
The vagina, uterus, Fallopian tubes, ovaries, and adjacent fibrous structures were deeply congested ; the ovaries specially so ; the vessels being highly distended with dark blood. All these organs presented a continuous dark purple colour. The vaginal canal was almost dry, the mucous membrane showing nothing particular beyond the reticular injection. The cavity of the uterus contained a little purulent matter, and the mucous membrane was congested, as also the rest of the organ, which was extremely flabby.
Kidneys. — The right kidney was enlarged, slightly lobulated, dark bluish purple in colour, and flabby in consistence. After section the capsule was found to strip ofif easily. A part of the surface of the organ was covered with a sofb coagulum of dark blood, forming a thin layer.. Under the capsule, the part of the cortex corresponding to it was pulpy and disorganised. The cortex was enlarged and deeply congested, presenting here and there small interstitial haBmorrhages. The tubules were distended with yellowish matter (fatty epithelium), having a slight pinkish tinge, due, apparently, to extravasated blood.
The malpighian bodies were not more visible than normally.
The medvUa showed deep congestion of the pyramids, and the straight tubules were also distended with yellowish, matter, just as the convoluted tubules.
648 SUPPUBATIVB NEPHBITIS. "bS^^nS??!^
The calices and pelvis were not much congested, and contained a little purnlent matter.
The LEFT KIDNEY was in the same state as the right as regards the capsvle, ttiimles, calices, and pebns^ but there were fewer interstitial haemorrhages. The organ was firmer, and not so friable; it was evidently not so •deeply affected as the other.
The thorax and head were not opened.
After hearing this record the query will at once arise in your minds — ^What were the sanitary conditions of the abode of this child, and to what influences was she exposed to lead to these fatal consequences ?
She liyed in one of our best West End houses, of which the w.c.'s were in good order, the soil pipes properly Tentilatedy and wash basins and baths discharged to open surface gratings. There was on the basement floor this •defect, that the scullery and washhouse waste pipes con* nected directly with the drain, and the servants' w.c. had no ventilating shaft. Thus it is manifest that sewer gas could enter the house, and doubtless did, and I think here was the starting point of the mischief, as two of those who lived much on this lower floor were taken ill at or about the same time.
My patient was in perfect health when she went north on Wednesday, 19th April. The following day I was requested to see the cook of the family. She was feeling very ill, and suffering from a bad sore throat. Quite weU the day before, she was now in high fever, and her throat had a very diphtheritic look about it. Circumstances rendered it impossible for her to be treated there, and she was accordingly removed to the Old Boyal Infirmary, where she was for many days very ill with high fever. The attending physician afterwards informed me that no tme evidence of scarlet fever could be detected, nor could it be called diphtheria. It was, any way, a very malignant sore throat, from which she recovered.
But this was not all. The table maid had gone to Pitlochrie with the children, and was to return next day. She, however, was taken ill with a very severe sore throat, which detained her till Saturday. When I saw her on Sunday (28rd) the throat was quite clean, but very sore, and congested. Other members of the family, while at Pitlochrie, had sore throats, but Mary, be it noted, had not. Her first indication of real illness was the vaginal
JKS^i^mS^'' SUPPUBATIVB KEPHRITI8. 649
diseharge. Now this, in a child, is not uncommon, and, therefore, I did not attack it with the vigour which I think now I should have done.
While she lay so iU, her elder sister, a girl of 12, commenced to have a similar leucorrhoeal discharge. Becognising then its gravity, I immediately had carbolic acid douches — of a strength 1 to 100 — ^given thrice daily,, with the happiest and most immediate result.*
Mary's case then, you will see, I do not at aU regard aa one of post-scarlatinal nephritis. There seems to me no- evidence in favour of that theory of her illness. There was no sore throat, no rash — at least noticed — and no des- quamation, and although the *^ strawberry tongue'* was visible on the eleventh day of her illness, tiiat is the only feature that points to previously existing scarlatina. And had it been so, the tongue would have showed thia- character before the eleventih day — at least, so has been my observation.
I regard, on the other hand, the vaginal discharge as the- f ecus whence the fatal poison entered the system, by continuity of surface. What the peculiar poison-germ was I will not say. Our microscopic examination of the discharge on Monday, the fifth day of her illness, failed to detect the peculiar organisms of diphtheria.
In some way, which I do not see clearly, the vaginal mucous membrane became irritated, and a nidus was found for the floating enemies of life. There germinating, the first efiect was a leucorrhoea, which seemed bland and. innocuous, but which passed, by direct continuity of mucous surface, on the one hand, through the urethra, bladder, ureter, and pelvis of the kidney, to the secreting^ structures of that organ, and, on the other, found its way to the lately inflamed peritoneum, by way of the cavity of the womb, and Fallopian tubes, setting up a deadly inflammation in these highly sensitive spheres.
The free quantity of water which was passed from the first to the seventh day of illness — although there waa much blood therewith — Pleads me to think that only one kidney was at first affected, the other really doing all the work. From the effect of the first infection of the system.
* Since reading this paper, another similar case of profuse leucorrhoea in a girl of 7 has come under my oaie, in which the carbolic acid iiijeetioi) prodnoed a rapid cure.
•660 SUPPURATIVE NEPHRITIS. ^'SSSrfN^TiSaL
-and destractive change in the kidney —the right one I infer — there was evidently sufficient vital power to rally, and the clearing of the water, diminution of albumen to one* sixth, and fall of pulse and temperature to the normal standard on the sixth day of the illness, all pointed to resolution about to be established, and, I must confess, at that time expected.
Whetber the addition of a little weak chicken tea to the diet could have caused the subsequent fresh outbreak is a matter for consideration, but certainly the next day saw a fresh lighting up of kidney mischief. At that date I think the left kidney became involved. The day following (the . 8th) the acute peritonitis supervened, and from that hoar I regarded the case as hopeless.
The treatment of acute symptoms, as they arose, demanded the use of remedies which are not usually exhibited in renal cases, and perhaps the earlier use of terebinth might have been better, but in nephritis, with bloody urine, cajitharis has been an unfailing Iriend till now, when it certainly failed.
The bibliography of suppurative nephritis is not very extensive, and scattered chiefly in journals. The subject is not overlooked by Ziemssen and Beynolds, in their respective systems, but the best account of it with which I am acquainted is found in the Traite de Pathologie Interne, of M. Jaccoud, Professor of Pathology to the Faculty of Paris, vol ii., p. 444, cf. seq.
As this work is not translated into English, and will be found on few book shelves, I venture to give a short resume of his views of the malady.
He says the causes are sufficiently well defined. 1st. TRAUifATisMS of the lumbar region ; blows, falls, contusions^ and wounds.
2nd. Inflammation of the lower urinaby passages; urethra, bladder, ureters.
8rd. Retention of urine, whatever be the cause : e.g., cerebro-spinal diseases, vesical or urethral lesions. 4th. Perinephritis.
6th. Purulent infection (under which class, coupled with the second, my case comes.) Here the purulent centres in the kidney are caused by emboli. They are the metastatic infarctiy but this mode of production, viz., by infarcti, is not constant. In a good number of cases the suppurative nephritis is produced directly by the altered blood, as are.
SIfei^'^STM^ SUPPURATIVE NEPHBITI8. 651
frequently, at the same time, inflammations of the plenrsB and peritoneum (as in my case.) The nephritis is often double, but, contrary to the diiOfuse form of renal inflom* mation, it may be unilateral. All depends on the cause which gave rise to it.
MoBBiD ANATOMY. — ^At the Commencement the kidney, ■or kidneys, are increased in size, their consistence is diminished, and the congestion shows itself by a dark red colouration, which may be general or circumscribed. The injection of the vessels may be seen through the capsule, which is thickened, but can be peeled off easily, without tearing the subjacent tissue.
On making a section into the kidney the distinction between the cortex and medtdla is almost obliterated, but the cortex is particularly swollen, and tumefied, by the injected blood vessels and the exudation into its substance. It frequently shows small punctiform or striate haemor- rhages.
The pyramids are of a dark colour, and as if dis associated at their bases by the interstitial infiltration.
The mucous lining of the pelvis and calyces is decidedly hypenemic. At a later stage colourless points appear. (This was a stage at which my case did not arrive, the first one of congestion and exudation being particularly well marked, and the hsBmorrhages into the substance and under the capsule being excessive.) Soon these decolorised points become purulent, either by the new formation of <sells or by extravasation of white corpuscles. At the level of these parts the normal tissue is destroyed or pushed away by the purulent collection, and there are formed small abscesses, which are of a round or cylindrical shape, according as to whether they exist between the pyramids or in the cortex.
In septic nephritis these abscesses remain often isolated, but in the common forms they unite, and form a large purulent collection, occupying one-third or one-half the organ; When even a large portion of the kidney has been involved, the abscess may become encysted, and undergo the calcareous cheesy transformation.
Under other circumstances the pus may be evacuated by the pelvis of the kidney into the peritoneum, the bronchi, the bowel, or by a long fistula externally. When one kidney is attacked it is rare for the other to be lefb nntonched.
662 SUPPUBATIVE NEPHRITIS. ^^^SSI^tSSHT^
Symptoms. — ^The acute sappnratiye nephritis has a yeiy deceptive commeDcement, which simulates that of small- pox. Kgor and intense feyer, lumbar pains of an extremely acute nature, more intense even than those of small-pox. Vomiting is more or less frequent. The pain is increased by pressure or moyement, and often it radiates along the ureter towards the bladder and testicle (and, according to Reynolds, and as seen in my little patient, down the thighs). The pain has often the character of a^ nephritic colic, the absence of feyer distinguishing them. These phenomena are present on both sides if the nephritis be double, on one side if single.
To these symptoms are added alterations in the urine. The secretion is diminished, as a consequence of the compression which the exudation exercises upon the glomeruli and tubules.
The patient often suffers from tenesmus, passing, with great efforts, yery smaU quantities of urine — ^tbere i» ischuria. Sometimes the secretion is momentarily sus- pended, and, in spite of the patient's complaint of needing to pass water, tiie catheter reyeals an empty bladder — there is anuresis.
The density of the urine may be increased (my patient's was 1025), or it may be normal, or even there may be a diminution of urea and uric acid. The colour is dark, ordinarily no albumen, unless there be blood present. In the sediment are foimd blood corpuscles and fibrinous cylinders, showing that the hsBmonrhage is really intra- tubular. If the fibrinous coagula do not take the form of cylinders, it shows that the hsemorrhage is not from the kidneys, but bora the pelvis, ureters, bladder, or urethra.
Thus constituted, the acute suppurative nephritis has a variable evolution, and it may end in a solution. In other cases (as in mine) it may kill, before it reaches the suppurative stage, by urinary insufficiency. The fever takes on a typhoid character, and the phenomena of ursBmia may appear. Ordinarily it ends in suppuration, which is announced by the persistence of the symptoms— notably by repeated rigors, fever, and an aggravated general condition. The urine is still scanty, but not high-coloured, and it does not contain pus, unless the abscess open into the pelvis of the kidney, or the mucous membranes of the lower urinary passages share in the inflammation.
This case, and outline of acute suppurative nephiitia
SJriSSf l^rr^**' SUPPURATIVE NEPHRITIS. 668
will, I trusty have the effect of inculcating the necessity of watchful and prompt dealing with leucorrhoeal discharges in children, and afford you a hasis for a good discussion, after the patient hearing you have givez\ me, and for which I must tender you my tiianks.
Discussion.
The PREsmsNT said he was sure they were very much indebted to Dr. Wolston for his excellent paper. Diseases were sometimes very much mistaken. It recently happened that a number of Esquimaux were brought from Labrador for exhibition in Germany. Three of them died, and the cause of death was not known. Shortly afterwards the remainder of them died in Paris of small-pox. The first probably died of small-pox also. He had seen scarlet fever so slight that its diagnosis was no easy matter. He had known a child very dangerously ill, and the nature of the illness absolutely obscure. Further examination found the slightest taint of sore throat, and it presently became evident that suppressed scarlet fever was the real condition.
Dr. Bryce said that he had seen the case to which Dr. Wolston bad referred, but he could add nothing to what he had told them, as he had placed it very folly before them in all its details. He saw the case within twenty-four hours before death. It was evident that there was peritonitis, but what else it was difficult to say. When he saw the child he thought it was a case of blood poisoning in some aspect or other. He rather leant to the idea that it was one of those cases of apparently mild scarlatiiui, which had not been discovered till late in the illness. That waa the opinion he had at the time, although it might not have been a correct one ; but he had seen many complicated cases, due to a similar canse.
Dr. LuDLAM said he had been greatly interested in the very excellent report of this case. Concerning its nature, he would exclude diphther^ on account of the absence of any observable deposit, and because of the free formation of pus within the peritoneal cavity. If the patient had had scarlatina in a severe degree, the temperature must have been higher, with the dry skin and urinary trouble. He thought the evidence was in fjftvour of its haying been a form of peritonitis, probably a metro- peritonitis, with suppuration and purulent infection therefrom. The frequent pulse, the local pain, and the transformation of the serum into pus, showed that, in all probability, the renal lesion was secondary, as a py»mic nephritis. The case was the counterpart of pysemic puerperal peritonitis, with a resulting kidney complication.
Dr. MooRB asked how Dr. Ludlam accounted for a child six and a half years having peritonitis, and a sister also.
Vol. 26, Ko. 21. 2 z
654 PEBIODICITY OF DISEASE. ''SSSrfN^*?!*^
Dr. LtiDLAM sad he tbongbt that the case was pysmic when it started.
Dr. Hayward said that he was extremely interested in this case, in its managen^ent, treatment, and end. All the time that the essayist was giving it to them, there was in his mind a picture of the effects of crotalus. The course of the disease, the end of the disease, and its post-mortem examination, showed eroialus It seemed to him as if they had had the effect of rattlesnake l)ites before them. He thought it was a blood poisoning, and the resnlt of the treatment-^-the known beneficial effects of their great remedies — ^would support the idea. His feeling was that in all such cases they had a grand Temedym crotalus. The whole "Sjinptoms pointed in that direction.
Dr. Carfrae said there were two points that occurred to bim with reference to the case. It was admirably detailed from beginning to end, and he thought they were very much indebted to Dr. Wolston. One of the points that occurred to him was the persistent sticking to aconite so long. It was only in the preliminary stage that aconite was of use. He thought there might have been some help got from carbolic acid in such a case, especially when the state of the kidneys was taken into consideration.
Dr. Naneivell said that in chronic nephritis he had found sulphate, carbonate of soda, and lime, very effectual. He there- fore agreed with Dr. Carfrae, that in a case of this kind, even where the symptoms were very acute, and the illness terminated so rapidly in a fatal way, carbolic acid, given in a salt, might liave had a beneficial effect in restraining the extension of the mischief, and given time to the constitution to make a rally
Dr. BiGGAR said he thought that veratrum should have been resorted to in this case.
Dr. Wolston said he had to thank them for the kind wav in
mf
which they had received his paper. He might state that at first he was inclined to look on the case as a post-scarlatinal poison- ing, but the inquiries he made caused him to give up that theory. He was satisfied it was a blood-poisoning, but whether it was the kidneys or the uterus that was the first attacked it was hard to say,
PEEIODIOITY OF DISEASE AND OF DRUG
ACTION.*
By W. Deane Butcher, Esq., Windsor.
The study of periodic diseases, and of periodic remedies, which has been prepared for this Congress, must be
regarded merely as introductory ; as Memoirs pour Servir
-
* Bead at the Britiih HonuBopathio Congress, Edinboiigh, September,
I
fiSto^rN^T^ST' PERIODICITY OP mSEABB. 655
for a fatare more complete history of periodicity in its Tarious phases.
The study of periodicity is not a new one. It is one of the oldest problems which have exercised the ingenuity of medical theorists, dating from the time when our ancestors looked on drugs and disease as specially under the influence of the planets, and regarded the times and seasons from an astrological standpoint.
Habit and periodicity is woven into the very warp and woof of our life ; and not only life, but almost all natural phenomena are periodic. The movements of the heavenly bodies, the alternation of day and night, the return of the seasons, the diurnal, lunar and yearly cycles, all seemed to have stamped their impress on the nervous nature as well as on the imagination of mankind. Disease cycles, too, are equally noticeable. We need only allude to the tertian, quartan, and other types of intermittents — ^the daily and weekly exacerbations of many nervous diseases, and the mensual period, which is not wholly confined to one sex. The rise and fcdl of temperature, in strict diurnal rhythm, corresponds to a rhythmical activity and depression of the whole vital economy, and the life of man, with its seven Shakesperian periods, from the puling infant to the slippered pantaloon, is but an extended rhythm.
There are according to some even longer cycles. A seven-year rhythm was recognised by our ancestors, and the eleven-year cycles of sun-spots have their counterpart in the activity of vital phenomena. All action of nerve tissue would seem to be periodic, the periodicity being more marked in those nerve centres, which are more or less removed from the influence of the will.
And first, as to the phenomena of periodicity in health. In the heart, for instance, the presence of blood acts as the appropriate stimulus to the cardiac ganglia, and the systole . is due to periodic nerve discharge. In the lungs the carbonic Bcid is the appropriate stimuhmt of the respiratory nerve centres ; respiratory movements ensuing only when the ganglia have accumulated a sufficient electrical charge. The discharge of nerve force is in this case also strictly intermittent and periodic. The nerve ganglia, indeed, are storehouses of energy, and all nerve action is always periodic discharge of accumulated force.
The following seems to be the natural sequence. An impression on a Ecnsory nerve is carried to the spine. It
2 z—a
656 PERIODICITY OP DISEASE. ^SSS&^kKT?^
, Not. 1, l&es.
travels thence to the brain. There it may be either noticed as a sensation, giving rise at once to appropriate action ; or it may be registered as a memory, the corre- sponding action being suppressed, or perhaps deferred for months or years. Certain molecules of the brain are re- arranged in a form which absorbs a certain quantity of mechanical energy, which energy is stored for fiiture use. But if the spinal cord is diseased, as, for instance, in tetanus, this energy, instead of being stored, may be immediately translated into motion. In that case it is not registered in the brain as a sensitive impression.
This latter fact, I believe, has not been duly noticed ; but in several cases which I observed with that view I made out clearly that the tetanic spasm, although so painful to witness, was not painful to the patient in anything like the same degree.
A nerve centre, then, is not merely an apparatus designed to translate sensory into motor iipressions. bat it is a storehouse of force, an apparatus for the accumulation of nerve energy, which can be liberated under appropriate and often slight stimuli. Nature appears to have a mechanism of its own, whereby the accumulated charge may be dis- charged at regular intervals ; just as the escapement of a clock regulates the striking, an intermittent discharge of force stored in the spring or weight.
Perhaps a more appropriate symbol would be that of the accumulation and storage of an electrical charge in a Leyden jar. It would be easy to make a mechanical toy which should occupy a definite time in being charged, and should be discharged at regular intervals, which might vaiy according to the strength of the source of electricity, and the distance apart of the discharging points.
There are, as we know, in the body, thousands of these nerve centres, perfectly independent of one another, which, like the soldiers in an army, have each its private habits, preferences, idiosyncrasies, though they all may be united by a superior authority for a single object, and are all subject to the conmion contagion of panic or warlike ardour.
If this then, be the theory of periodicity in health, let ns turn our attention for a moment to the periodicity of disease. The researches of Tommasi, Crudeli, and Kleba have left it almost without doubt that the original cause of intermittents is the development in the system of the
R^?:Srn^ PERIODICITY OF DISEASE. 667
germs of a microscopic organism, the baeiUm malaruB But it is more difficult to determine what is the true cause of the periodicity of the disease phenomena.
There are only three possible theories which can at all account for intermittency.
One, that the crisis is caused by the deyelopment of successive batches of bacillar sporules, each crop of which produces a fresh dose of ferment, and thus produces a fresh impress on the nerve tissue.
The poison secreted by the sporigerous bacilli is in itself fatal to the continued life of tixe fuU-grown bacillus, just as the alcohol, if too concentrated, is fatal to the yeast plant which produces it. It does not, however, destroy the germs which are ready to develop and produce, in their turn, new symptoms.
The second theory of periodicity is, that it is due to a recurring periodic interference, like the phenomena of interference causing the beats in acoustics — an inter- ference, that is, between the vibratile motion of nerve atoms and that of the nervine poison ; the waves of interference Teaching a maximum only every twenty-four hours, or at a longer interval. We need not have any difficulty in imagining such an effect from the slightness of the sup- posed cause, but I am not mathematician enough to investigate this theory further.
The third theory, which I am inclined to regard as the true one, is that the phenomena are due to a compound intermittent cause, partly the natural intermittent excita- l>ility of nerve tissue, and partly the intermittency due to the successive development and death of succeeding generations of bacilli. It would seem that the bacteria germs may lie perdu in the blood for months or years without any, or but little harm ; but when once stimu- lated into development they cause a septic ferment, which acts as a nerve poison. Nature will eliminate this poison by the ordinary methods, but a paludal intoxication is meantime set up.
Thus there may be distinguished several distinct periods.
I. The period of infection, when the germs of the bacilli find entrance into the blood.
II. A period of latency, during which, perhaps, for years the germs may lie harmless in the body for lack of the necessary conditions of development.
658 PEBIODICITY OF DISEASE. ^b^^SHuSSl
m. The period of growth, doriog which the spomles develop into a germ-bearing bacillas. This growth is determined, either by the presence of external conditions of heaty moisture, &c., or by the resistance of the living tissues being for the time diminished.
lY. It is at some time daring this growth that there is a production of the malarial poison, just as alcohol is pro- duced during the growth and development of the.torula cervisisB.
Y. Then follows the period of pure neurosis, of inter- mittent febrile symptoms, caused by depression of the nerve centres, or of irregular and abnormal stimuhition, accompanied by discharge of their stored charge of force.
YI. When the nerve centres have been accustomed to discharge their stores of force after the lapse of a certain interval, a morbid habit seems to be formed, and except under the stimulus of the will, or of excitement, or medicinal action, this morbid habit remains long after the poison has been eliminated.
YII. The last period is that of organic complication, when the faulty nerve action has given rise to congestions and inflammations, resulting in disease of internal organs*
You will remember the principal types of intermittent — quotidian, tertian, quartan, &c. Of these the simplest is quotidian, in which the attacks recur every day, conunencing morning, or towards midday. Is there any significance in these varieties of interval ?
I cannot doubt that there is, when we reflect that the fever of paludal origin is almost always in the morning, while that of syphilitic pain is worse at night, and the fevers of phthisis and other cachexia is almost always in the evening* It would seem, however, as if the length of interval between the recurrences were of far more importance than the precise time of day at which symptoms occur.
We notice in ague then, the accumulation of force for twenty-four or forty-eight, or any other number of hours, and a sudden irregular discharge of that force at the end of that period. But that is not all. Periodicity of nerve tissue wHl not fully account for the whole phenomena.
That intermittency is not due to the nature of the nerve tissue alone is, I think, proved by the fact that the type of ague prevalent in one district shall be tertian, while every ague in an adjacent district shall be quartan.
Trousseau relates that fourteen soldiers came from
l&^J^^^^h'S^ PBRIODIOITY OP DISBABB. 65»
Saumur to Tonrs, and that after a residence of ten days in the latter city, nine of them were admitted into hospital soffenng with quartan fever, the germ of which they had eyidently contracted in Saamar, since the Toumian intermittent was of the tertian type, and a quartan fever was unknown there. Similarly in India each locality has its special type of fever.
If, then, the paludal poison may differ in different localities, so that one variety shall cause nerve discharge in twenty-four hours, and another in forty-eight houra, we cannot consider the rhythm as due entirely to peculiarities of nerve tissue.
In the treatment of intermittents, the scientific methods of cure are threefold : —
I. In the primary stage we may destroy the bacillus, provided it be fully developed. In this we imitate the action of nature, who poisons the bacillus by the very pro- duct itself has made. The most powerful, and at the same time most useful bacteria* cidal agent is, as you know, quinine, but even Trousseau allows that while the next approaching paroxysm of ague may be cut short by a single massive dose of quinine, the disease is not cured. Quinine seems to have no power over undeveloped germs, and must be again exhibited after an interval during which the germs may be supposed to have arrived at maturity. Hence, a large dose of quinine needs to be repeated after an interval of five days, and again and again with longer and longer intervals after each dose, so as to allow time For the alter- nate development and destruction of successive batches of bacteria.
This intermittent quinine treatment reminds one irre- sistibly of the process which Tyndall adopts for the per- fect sterilisation of his hay infusions. The liquid is boiled, thus at once destroying the bacteria which are fully deve- loped, but leaving a multitude of germs untouched* Neither heat in the one case, nor quinine in the other, is germicidal, though they are both bacteriacidal. Inter- mittency in boiling or quinine administration is necessary in order to allow time for the germs to grow into easily destructible organisms. Just so the housewife finds it impossible to destroy the eggs and larvsB of moths, but finds it easy to poison by fumigation the full-grown insect.
n. In the second stage, when a distinct nervine poison has been brewed, the quinine treatment by massive doses
660 PEBIOWCITY OP DIBBASB. ^m^^^SHu^
is not sufficient. It is, we believe, positively hurtful in the third stage, when a faulty habit of periodic irritabiliiy has been set up. It is in these latter stages that homoeo- pathy finds more specially its sphere.
It is, however, by no means easy to choose a true simil* limum in these cases. It is not sufficient to attack roughly the nerve tissue by a spinal or a sympathetic irritant, but we must, if possible, pick out the very nerve centre or centres which are affected. Nor is even this sufficient, for a simillimum should set up in healthy tissue an action simi- lar to the disease in time, phase, rhythm, and character of pain or sensation. For instance, let us take a case in point : —
A patient, suffering from obscure intermittent symptoms, observes a sensation of warmth, like blushing, on one of the nates. This is not accidental, for it recurs continually, and always in the same spot. It is so trivial one almost hesitates to record it, but, however unimportant, it speaks with absolute certainty of its origin. We can be sure that at some spot in the ante-vertebral chain of sympathetic ganglia there is one ganglion which we will call X, which is the seat of intermittent irritation. It is impossible for us to tell which is the ganglion, or how it is affected. If, however, omong our drugs we have one which has been observed to cause a similar sensation in the same spot, we may predicate with absolute certainty that this drug has an elective affinity for the particuliar ganglion in question.
If, moreover, we know a remedy wliich will cause the same sensation in the same place, at the same hour, with the same regularity of occurrence, at the same interval, we may be well assured that the drug is in true harmony with the disease, and will most certainly cure it iif exhibited in the appropriate dose.
It would be easy, by general sympathetic nervine excitants, to irritate, and thereby cause a continuous instead of an intermittent discharge of nerve force from the ganglion X, in common with its neighbours V, W, Y, and Z, but a true specific is in unison only with the particular centre, or centres, which are affected. As these are quite out of our ken, we are obliged to trust too often to those apparently trivial subjective symptoms which excite the derision of those who know nothing of our method.
Thus, in a regiment, music, like a sympathetic irritant,
iSSSSfN^Tl^^SS^ PBRIODIOITT OF DISEASE. 661
netB as an excitant to eyery soldier in common. But the aimillimnm is like the appropriate tune which acts on personal idiosyncrasies. The Scotchman will thrill in sympathy with " The Camphells are coming," while the Welshman's martial ardonr is stimulated hy ** The Men of Harlech."
Homoeopathy, then, is a kind of transcendental organ* opathy, and its modus operafidi may he explained by the theory of irritation of specialised nerve ganglia. Each ganglion has its special drug sympathy. At diis we need not be surprised when we reflect that many thousands of generations of nerve centres have been differentiated in the process of development by selection and inheritance, till at last only one responds to the vibrations of light, one to ihose of sound, and one to scent.
Homoeopathy is a more refined mode of counter irrita- tion. Just as one violent emotion seems to destroy or •prevent another — as anger is incompatible with pity and hatred with love — so it would seem that the vibration of one nerve, ganglia, or collection of cells, is incompatible with a similar vibration in an adjacent part of the nervous system. It is a question of the transmutation of force, for if we represent the ganglia, or nerve centres in the cerebro- spinal system by the letters of the alphabet A, B, G, &c., arranged vertictdly, then if E be excited by some morbid iustion, its neighbours, D and F, are not necessarily involved. Homoeopathy alone teaches us how to dis- tinguish between the disease in the adjacent ganglia, D, K, F, and G. Sensory nerve fibres conduct ordinary sense impression from the right knee, let us say, to D ; from the left knee to E. Therefore, a drug, X, shall be the appropriate stimulus of £, while another drug, Y, shall have no action whatever on E, but shall cause in a healthy person a painful stimulation of D.
In a previous paper on '' Pharmacodynamics " I have shown how it is conceivable that the cause of this tissue selection or election is to be found in the correspondence, or non-correspondence, in the number and phase of its vibrations between a centre and its appropriate stimulus* We should not forget that disease symptoms are but phases of tissue motion — and drug action is but the addition or transformation of motion in the body — that medicine is the •science of morbid forces, not morbid matter.
To return to our subject, the symptoms of ague are not
662 PERIODICITY OF DISEASE. ^^l^fN^^Jf^a!
fc— ^^^^^^^^— ^^— — ■ - -_ _ — - ■■ I I "
due to irritation of a single nerve centre. It is a single neurosis, it is true ; but it is a compound neurosis, involving difi*erent varieties of nerve tissue. The chill and heat are not mere alternative effects, but different symptoms, caused by irritation of two different nerve centres. Thus there are frequently sensations of coldness on special parts, accom- panying heat of the whole system. The malarial poison may cause in one subject a neuralgia ; in another an intes- tinal catarrh. It will cause in a rheumatic subject an endo-carditis, or gastralgia, or it may set up convulsions, or hysteria, thus proving that the brain, or the cord, the anterior or posterior columns, or the sympathetic system,. or isolated ganglia, may be the seat of malarial irritation.
The paroxysm of pure ague begins, however, with a distinct chill, followed by a distinct heat, and that followed by sweat.
Now, Claude Beruard has pointed out that the sensation of heat should be referred to the sympathetic system, while chilliness is due to irritation of the spinal ganglia. Hence the primaiy chill must be due to spinal, the secondaiy heat to sympathetic action, while the sweat is due to the nervous apparatus controlling the glandular system.
Hence, as Lord has pointed out, ague medicines may be divided into two great classes — sympathetic and spinal irritants.
The number of usual ague remedies are few. Ruckert reports them as useful in the following order : — Arsenicum^ pulsatiUu, niLx vomica^ cliina^ ignatia, and natrum muriaiicumy as most useful ; whereas bryoniay eina, rhus^ veratria, carbo vegetabilisy and ipecacuanha are of secondary importance.
The spinal irritants, which are more particularly nur vom., ignatia, rhus, eupatoriay veratria, piilsatiHa, saba- dilla, may be, in Lord's opinion, further subdivided into anterior spinal and posterior spinal.
The sympathetic irritants are arsenicum, ipecacwanha^ natrum mtir,, cina, chamomilla, cohcynth, cimex.
These generalisations, though useful in practice, are by no means sufficient. Homoeopathy needs a more accurate specialisation of the exact locality of nerve action, and of the character of its phase or rhythm.
Whatever may be the ultimate nature and cause of periodicity in disease, we come to the question whether
l£rtS?fN^?nS^ PEBIOWCITY OF DISEASE. 665-
there is a correEfponding periodicity in the action of our remedies. This is not easy to answer.
Hitherto the theory of organopathy has more or less influenced our classification. If a drug is classed, it is indexed under the organ it affects. It is a purgative, acting on the howels, or a soporific, acting on the brain. It is a nerve stimulant, or a heart depressor, as the case may he. All our repertories have heen influenced by the fi&ct that symptoms are classed as to the position of the aJSected organs.
But there is another point of view under which drugs may he classed, according to their similarity of periodicity of phase or rhythm. With this view I am anxious to intro- duce to your attention this time repertory of the Materia Medica, the work of my friend Dr* Salzer, of Calcutta. It was undertaken with a view to test whether the periodicity in our records of drug action was. real or apparent only. Hence the work which I have here, and which I present to the Congress, and which I hope will, at some future time, be published. Samples of this time repertory will, through the kindness of the editors, be published from time to time in the Homcsopathic Review. Its basis is Allen's Materia Medica.
We have had no time for verification of symptoms, and, therefore, the dele-niator — if I may coin a word — ^will have ahundant opportunity of excision here ; but I will not be so unfriendly as to anticipate the critics in pointing out all the disadvantages and imperfections of our plan. At all events I think we may claim that no symptoms recorded in Allen that have in the slightest degree a periodic or rhythmic value have been omitted.
At the outset difficulties were met with which were* almost fatal to the success of the scheme. The original study of the day-books of the different provers can alone determine whether the time recorded was accidental or not. The labour of revision remains, and is a serious one.
Too often we cannot help an uneasy suspicion that we are not studying the periodic action of a drug at all, but only the purposeless vagaries of the ohserver.
For instance, '' burning, biting pain in the eye in the morning " ought to mean, at all events, that the pain was absent in the night and afternoon, or at least that it was aggravated in the morning. It too prohably means that the note was written or tiie observation made some time*
664 PERIODIC DISORDERS. "'gSSrfNS^fifiS
before the naiTator's luncheon » or perchance some time before a late dinner. The prover in mere gaiete de coewr chronicles the great event, and Allen stereotypes it to the plague and confusion of all future generations of students. Again, hiccough between 12 or 12.80 should mean, if it mean an3rthing, that the prover had frequent attacks of hiccough coming on at mid-day. If not it is redundant Jind misleading.
Dr. Lord, in his work on intermittent fevers, says: *^ The pathogenesis of every drug is full of accidental, incidental, fanciful, idiosyncratic, and imaginary ^ymptons, modified by circumstance, condition, and habit, which -symptoms have no relation to the nature of the drug. These exotic symptoms appear like echoes on every page.** None but those who have tried can tell how difficult it is to root out these tares without destroying also the wheat.
The use of " the time repertory,*' at all events, will enable the student to get an idea of the time symptoms at one view, and will give a new idea of a portion of our Materia Medica from a novel point of view.
In conclusion I will read a paper on the same subject of periodicity, communicated by Dr. Salzer, which may be a fit introduction to the study of his time repertory.
PERIODIC DISORDERS.
By L. Salzeb, M.D., Calcutta.
There are so many ailments whose especial peculiarity it is to appear, disappear, and reappear, all, as it were, of their own accord, that we might almost be tempted to divide diseases into two large classes, viz., periodic and non-periodic.
Granting, for a moment, such a division, we should include in the first class all disorders characterised either by regular or irregular recurrence, so that periodical and paroxysmal disorders might be gathered together into one class. The range could yet be ma3e wider if we included in it all those diseases which manifest, during their course, regular or irregular aggravations or ameliorations. And in order to make the category complete, we might further add to it all diseases marked by some intercurrent symp- toms of a periodical or paroxysmal nature.
From a strictly pathological point of view such a division -could hardly meet with our approval. Intermittent fevers
^^JkS^TSU^ periodic disordebs. 666-
and syphilis would be classified in the same rank because of the syphilitic bone pains which are regularly aggrayated at night.
Yet it cannot be denied that periodic disorders, whereyer met with, and in whateyer way they may manifest them- selyes, haye something in common. If they are not to be classified under one pathological head, they deserye at least to be considered in dieir ensemble.
It might be said periodicity is, after all, only a symptom accompanying a certain diseased state; it is merely the rhythmicfid expression of the manner in which a certain disorder manifests itself, but it by no means constitutes a disorder in itself. This is true enough. But then it is not less true that periodicity characterises often most emphatically certain diseases, and seems to be interwoyen with their yery root. If it be only a symptom, it certainly is, in many cases, a most characteristic one, and as such should, especially from the standpoint of our school, not be slighted.
We may almost say that all disorders characterised by periodicity of any kind are more or less of a chronic tendency ; for there' is no saying how often the cycle of appearance and disappearance might be repeated, ^besides which eyery such repetition tends to weaken the constitution^ and consequently to engraye the eyil so much the deeper.
On the other hand, we find many chronic diseases subject to all sorts of periodical and paroxysmal fluctua- tions if left to themselyes. We need only hear the history of such sufferers who, in despair of all medical aid, haye, once for all, made up their minds to leaye eyil alone.
And here a remark may not be out of place which might throw some light on our eyentual failures in dealing with this class of diseases. It sometimes happens that we are- called upon to prescribe in such cases, and the eyil, to all appearance, yields to our treatment. After a time there is a relapse. We are called again; we examine the case afresh ; we find the patient well-nigh in the same condition as he was at the time of our first treatment, and we con- sequently repeat our former prescription. To our great surprise we find, howeyer, this time the disease to be stronger than our remedies, and we wonder how it is that a remedy which had been of so great seirice at first should show itself quite inert in its action on a second similar occasion. Delusion ! The remedy had neyer been of any
^666 PERIOMC DISORDERS. ^Sl^^SST?^
Beriew, Nov. 1, 168S.
service; the man got better the first time because he happened jnst to enter into the periodic stage of amelioration.
It is true, most of our remedies lose in some cases, and to some extent, their curative effect on repetition. Yet there are cases where periodicity is a potent agent in the apparent improvement of chronic diseases, and it is worth while, before accusing our remedy, to inquire where the fault lies.
If we look to our Materia Medica we find that those drugs which Hahnemann considered particularly suitable in chronic diseases are, as far as their pathogenesis is con- cerned, the richest in periodic symptoms ; and arsenic which -stands at the head of all the toxic agents at our command is richer than any of them in pathogenetic symptoms charactised by periodicity.
Little as we know about the pathology of periodic diseases, it would appear that they take their starting point, in common with all other diseases, from certain physiological laws governing our organism. The tem- perature of our body is subject to a rhythmical oscillation every twenty -four hours ; and a similar oscillation has been observed, corresponding to the season of the year. But a rise and fall of temperature means a rise and fall of the stream of life. The first conditions of periodicity are thus physiologically engrafted upon our economy.
Seeing the importance of periodic disorders, it behoves us to ask ourselves in how far our school is prepared to meet them. That most of our drugs have produced some periodic symptoms in some of the provers has already been stated. That incidental symptoms, as they have now and then occurred in some provers, may have their therapeutic value, we all know. But can we point to any drugs which, in their pathogenesis, are more or less characteristically -stamped by periodicity ? Or are there others which pro- 'duce in the healthy a certain disorder of a more or less pronounced periodical type ?
There is no drug in our Materia Medica which could 'Compete with arsenic as regard the periodicity by which its large pathogenesis is marked. In fact, there is hardly another drug which comes near arsenic in this respect. If we were asked — Could you produce in the healthy a disorder of a periodic type ? We should say — Try arsenic. The bark of cinchona, and its alkaloid, quinine, stand in this
iSJfaSJrNjrriS^ periodic disobdbbs. 667
respect far below arsenic. The pathogenesis of cinchona is not particularly marked by periodicity ; certainly not more than the pathogenesis of such drags as nux vomica, pulsaUUa, &g. And quinine has still less to show in this respect.
On the other hand cinchona produces in a most marked manner a certain disorder of a periodic type — the workers in the mills of cinchona bark are known to be affected for the first few days by attacks strikingly resembling inter* mittent fevers. In this particnlar branch of pathogenesis arsenic yields the palm to cinchona, A thorough proving of chininum arsenicosum is needed in order to enrich, perhaps even to complete, our knowledge in this respect.
Of the workers in zinc it has been said that they, too. Ate affected by regular febrile attacks in the evening, and Allen, in his Materia Medica, has given us a collection of facts which go to show that it is a characteristic of morphium to produce, in those who abuse the drug, attacks which can hardly be distinguished from intermittent fever.
That neither of these two drugs has been tried as yet in Hie treatment of intermittent fevers is hard to explain. As to zinc J Bering tells us that it acts better (therapeutically) when given in the evening — ^a clinical hint which has its -significance in connection with our subject. Whatever may be the pathological nature of intermittent disorders, it is generally admitted that the nervous system plays a part in all these ailments, and we know, on the other hand, that zinc is one of our most potent neurotic agents.
Of Tnorphia, as a therapeutic agent in intermittents, we ^ow as yet very little, or next to nothing. Opium bad, however, in former times a great reputation in the treat- ment of malarial disorders. It had been prescribed under the impression that it deadens the nervous system against the influence of malaria. Most of the quack medicines in India against intermittent fevers contain, up to this day, .amongst many other ingredients, opium. And it would be worth while to inquire how opium eaters of that country fare with regard to immunity, or otherwise to intermittent fevers.
Coming now to the large number of drugs which have, each of them in their own way, produced some periodical iittacks in some of the provers, we find, to our great surprise, that there is yet a great deal to learn for us, and, virhat is more, a great deal to unlearn, with respect to the
668 PEBIODIC DI80RDSBS. *^S5rjSS!?!!M£
periodic symptoms they have yielded, and the therapeutic nse we make of them.
Hahnemann has from the very beginning of his proTings insisted that the time at which a certain symptom had repeatedly occorred, should not be lost sight of by the prover. He has thus shown as the way, how to meet periodic disorders. In oar provings made since, we haye followed his example, and have thus far acted according to the strict method of scientific experimentation. Bat when we come to gather the fraits of the large stock of know- ledge we thereby gained, it would appear as if we had left the path of sound and practical reason altogether. It is in our repertories that the treasures of our Materia Medica are stored up for therapeutic use ; and it is just in these very repertories where the stumbling-block lies, touching our varied information about periodicity.
Suppose a prover while taking chamoTniUa had felt a toothache between four and five o'clock in the evening. He had never experienced a toothache before. What do we reasonably learn from that fact? That chainomiUa is capable of producing toothache in the healthy. Do we learn at the same time from that single fact, that the chainomiUa-iooihsLche isproduced, or is liable to be produced, between four and five o'clock in the evening ? Decidedly not. After all, any event must occur at some time or other. Was it, then, quite useless on the part of the prover to have recorded the time at which his symptom occurred? By no means. Let him only go on recording exactly the time ; the same symptom may repeat itself the next day, or any following day, just between four and five in the evening, and then his first record will be in so far useful to us, as it would be apt to show some periodic tendency of the symptom. Or there may be no repetition in his own case, but a fellow prover might have experienced the same symptom at the same time, and such a coincidence in two provers would no less go to show a tendency of the symp- tom to occur at a certain particular time. But whenever neither the one nor the other is the case, then the symptom has its therapeutical value as a symptom, but none what- ever as to the time at which it had been recorded to have occurred.
If we look, however, to our repertories, we find that this consideration, so simple and evident, has been entirely dis- regarded. All the rabrics concerning time in those reper*
iKSg^K^TSa^ PEBIODIO DIS0BDEB6. 669
tones are fanlty from beginning to end, because they hare been slayishly transferred from the Materia Medica, with- ont any discrimination. Most of the drags ennmerated onder those headings of time have not the slightest pre- tension to periodicity. They stand there on the strength of one single occnrrence in one single prover, at a certain stated time. And snch being the case, they do more mis- chief than good ; they mislead the inquiring practitioner. While a careful sifting in this respect is urgently needed, let us, however, not forget that pathogenesis is not the only guide in the selection of our remedies. Clinical experience is a great factor in the treatment of diseases, and many a drug which pathogenetically does not stand out as particularly periodic in its action, has proved itself to be of remarkable therapeutic service in some periodic varieties. To mention only one example. On reading the provings of ignatia, one could hardly detect that this drug had produced in any prominent manner disorders of an anticipating type. Yet clinical experience has here outrun the revelations of pathogenesis, and ignatia fully deserves its place amongst the remedies to be thought of in perio- dical disorders of an anticipating type.
There remains yet something to be said in connection with our subject, about alternating symptoms. We meet now and then with such cases. A man appears to suffer from two different diseases, as far as organopathy and pathology in general is concerned. He severs for some time from some illness, which we will call A. Hardly has he got rid of it, then another disturbance, of quite another pathological character, makes its appearance in another organ ; a disturbance which we will call B. A. and B. change in this way hands, to the despair of both the patient and the attending physician.
We are liable in such cases to recur to a double set of remedies, one of them corresponding to the disorder A, the other to the disorder B, alternating the respective remedies in the measure as the symptoms alter. It is thus a sort of therapeutic patchwork, the only merit of which consists in this, that it sometimes does succeed in benefit- ing the patient. A more precise study of the case may lead us to a remedy, which ** covers " both groups of the symptoms A and B, and such a remedy would no doubt have more chance of success than the above combination.
Yet even then we shall often miss the case. For what
Vol. 36, No. 11. 9 X
670 CLINICAL CASES, "'S^^^SftfSS:
Beriew, Nor. 1. tOB.
does it, after all, mean, when we say a certain drug covers both groups of symptoms ? It means that onr drug hss produced in some prover or provers the symptoms A, and in others the symptoms B. But to bring to bear a compilation of symptoms, as derived from different provers, upon a given pathological case, in order to establish the wanted similarity between drug action and disease, is simply another attempt towards therapeutic patchwork. Again we may, for all that, meet with success, but we must not wonder if we fail. Nearer we should be to the mark if we could lay hold upon a drug which had produced in one and the same prover both the disorders A and B, and the drag which stands nearer yet to our case would be that whi<^ had produced in one and the same prover the symptoms A and B in alternation. The rubric of alternation is, how- ever, as yet, very sparingly cultivated, even in our best repertories.
CLINICAL CASES, WITH KEMAEKS. By S. H. Blake, M.R.C.S.
('Continued from page 4l02.J
Case XII.
January 20th. Florence H., aged four and a-half, of Tery fair complexion and light-coloured hair, is brought for a troublesome cough and loss of appetite. The child is sickly-looking and pale, is very sleepy as a rule during the daytime, does not sweat during the day nor feel chilly, but at night tosses the bedclothes off and sweats much, especially if covered with too many clothes. At night there is heat of the skin, with sweat, and the perspiration is most marked on the bead itself (not on the forehead or •occiput, calc, carb). The breath from the mouth is fetid. The general weakness and anorexia have continued for several months, and the child does not improve, notwith- standing much medical treatment. Moreover, her mother, by medical advice, after it was found that physic did not succeed, took her for change of air into the open country of Dorsetshire. This was unavaiUng ; the child got no better, and only fretted there. Here we see the change of air not accomplishing that end for which it is so often jbund adapted, and as we shall find, the cliild's system only waited for that therapeutic change which it may be could not be found in this country residence, but was
^^J^oTu^ CLINICAI. CASES. 671
easily supplied by a ^mall ^[uantity of a suitable medicine in a very brief period of time. This change in the body haying been accomplished, no doubt a change of air would prove much more beneficial than it had done before ; and io this end, I advised the niother. How often patients are sent for change of air in the hope^ that this may perchance ^u^complish something for which an appropriate medicine has not been forthcoming, and how often hydropathy has to finish what therapeutics has not even begun. It is not possible to conceive, nor would it be a pleasant reflection ; not that one would wish to deny the immense advantages from both these sources of renewed health, nor limit in the least the justifiable application of these measures to -suitable instandas of disease. The natural reflection is that many such cases require in addition an appropriate medicine to induce recovery, and this medicine it is often the privilege of the homoeopath to supply. To continue this child's history. — She had never had measles. Had liad pertussis when only five months old, and was very ill with it. Had no other exanthem. Both parents living. Two other children, however, died in " measles and bron- chitis.'' Her temperament is nervous ; she is quick and excitable.
She was ordered silica 6c., trit. gr. 1 ter die.
February 1st. In the short space of ten days after her {irst visit, I find her general appearance altogether changed for the better ; a healthier complexion ; the weakly, debili- tated look almost gone ; and the mother reports her as ^* very much better. The sweatings on the head and the fetor of breath are cured." Her mother stated that "the third dose altered her, and after that she seemed quite a diflferent child." The medicine was renewed for another week, at the end of which time she was cured. I then recommended her for change of air, to complete the luilding up of health.
Selection of Medicines. It is correctly asserted, as I believe, that on an examination of Dr. Allen's Encyclopcedia it cannot be shown that calcarea has such a symptom as sweating of the head, implying that the hairy scalp is the part affected. At the same time, I cannot deny that cases where sweat does iippear to come on this part, sometimes do well under calcarea, and especially so, where calcarea covers some of the other sjrmptoms. Nevertheless, in the presence of so
3 T— 8
672 CLIOTCAL CASES. "SSS&^Sr??^
Bevisir, Nor. 1, 180.
many proviiigs, giving as nnmbers of other symptoms for calcareUy this symptom being omitted, whilst iUica has notably sweat on head, running down even on to the forehead, it would appear that the application of caicarea' to this head-sweat is hardly exact enongh to fulfil, in a proper way, the full demands of *' The Law."
In the symptoms of the case cited, we note that range of symptoms which has long been considered the special feature of the dyscrasia called rickets, and although the general appearance was agreeable thereto, I could not assert that the joints were in any decided degree widened or expanded. To this state, silica has long been known and shown to be one of the applicable medicines as covering the symptoms. For us to state that calc. carb would have cured as well or better, or to state that a pase having such syniptoms, has been cured by it, is not to establish nor to- fulfil the Haw, but is only to overstep the grounds of the law as hitherto known, and to wait for proof. In the meantime, if we cannot absolutely prove calcarea strictly homoeopathic thereto, and we do not, in such statement,, clearly set forth that our observation is empirical, and not yet proven, would be to mislead and misinform those ignorant of its origin, as I have known to occiir, a part which should never be willingly adopted by those desirous of being rich in medical wisdom. A similar statement would apply to cold, clammy extremities (legs and feet), no such symptoms being found among the myriads of symptoms recorded in Allen. On the contrary, nearly all the symptoms point quite another way. Heat and irritability of the skin of the extremities are well marked symptoms, and from many cases, so £eu: as my obser- vations extend, calcarea c. cures these symptoms, and I cannot say the same where it has been used for the cold sweaty condition. It is a matter of doubt whether the last named state is a truly homoeopathic indication for calc. carb,, or, if so, whether it be not a very rare and exceptional kind of symptom for the use of this medicine.
Between this and silica the head symptoms clearly define the grounds of our choice. It becomes necessary to enquire of the patients if the sweat be actually on the hairy scalp, falling down, it may be, on to the forehead {silica), or whether only on the forehead, occiput, or nape {cole, c), as also if there be bad smell of the sweat {silica) ; and to beware of not taking for granted the first answer or state^
SSSSr^ri!ag^ CLiyiOAL OASES. 678
ment of patients that perspiration is of the head generally, whereas on enquiry we may often find that it is on the forehead and face that they have actually seen it, and these persons on close enquiry often will not affirm that they have actually seen it over the haiiy scalp.
It is scarcely necessary to refer to the provings for the symptoms of sUica showing its homceopathicity to such a ^oup of symptoms as that referred to, hut they may he noted hriefly as : —
Mental State and Head, — "Despondency, indifference^ Apathy, restlessness, fidgetty (fretting ?), vertigo, with sleepiness (day time), congestion to head, with burning, pulsation, and sweat of head (worse at night), profuse head fiweat.
Conditions.— O^n fontanelles, head too large, rest of body emaciated, face pale. Anorexia, aversion to hot food and meat. Tremor and debility. Sleep disturbed at night by startings, ebullitions (heats ?) and night sweats, and is unrefreshed in the morning. Dry cough with hoarseness, soreness of chest and tickling in throat pit.'* '^ Night cough'' (throwing off the bed-clothes when sweating may cause this cough).
To compare this with other medicines, we might con- veniently conmience by directing our attention to one of the prominent symptoms, the head perspiration at night, and from this point of view, we have brought under our notice, that these symptoms occur but rarely when taken together AS one symptom in provings, and hence it is not easy to find them in repertories in such a form that we can 43lasBify from them. We ofben look in vain elsewhere for that which can be found only from the internal evidence of the veritable provings themselves. On reference to the Cypher Repertory ^ to Jahr and Lilienthal's works, a number of medicines are pointed out for head-sweats. With some of them it is to be inferred or presumed that they may be Applied to nocturnal head perspiration. There is one characteristic, however, of some value, namely, the desire to uncover, as with Ud^im and spigelia for instance, in contrast with others where there is sweat and heat, yet aversion to uncover. Whether this really depends upon the presence of increased heat, or the chill at the time such a symptom is recognised by the patient, is a further question. Of some of the medicines and their symptoms, referred to heat and sweat of the head, is here given in a list.
674
CLINICAL CASES.
Vontlilj HonuBopaflufr r. Not. li IflBt*
/ Silica.
Cham. Bryony.
Bell.
China.
06 fl
M
IS
s
'a
o CO
o
I Keeps the child awake, with heat of ^head and sour or fetid sweat. f During sleep, sour, with smarting of \8kin. Sweat generally profuse and sour.
I Heat predominating and burning heat [compare calc. c], sweat during sleep,, quickly disappearing. During sleep,
C In V ih^ Sweat smells like urine, causing itching ^ *\of skin.
} Night sweat, putrid or sour, chiefly on (forehead ; tendency to uncover. Heat and l^sweat in alternation with itching. Sour and ofTensiye. Stains yellow.
Clammy sweat {nux. rom.), but ayersion \to uncoYer.
r Day and night without relief (compare \merc.) and clammy sweat.
Ledum.
Graph. Merc.
Hepar.
Ipecacuan. Very offensive sweat.
PuU.
53 s Sepia. Opium.
08
w
'3
e 3.
Phoe.
\
f Sour, musty, at times cold, at night with
^stupid slumber ; sweetish acid odour.
j Every third ni^ht sour, offensive, like
"^elder blossoms.
( Snoring, twitching, and cold limbs, head
\hot, heat with sweat.
j Sweat, worse during sleep, with increased
\urine.
XT 4. ^..^ / Sweat on awaking at night and on rising JSat. mur.\. ,^ . / i 77* j r \
\m the mommg (see also kali and raph.).
Tfh T / Sour, musty, or putrid sweat, with violent anus. X . ^^ii-cting of the erupfion. Staphisy' ( Sweat smells like rotten eggs ; cold on nia. [forehead and feet.
f Heat interrupted by shivering, and re- Sahadilla. (turning at the same hour. Sweat during (morning hours.
( Offensive sweat; eruptions on scalps \ringworm. Mag. mur. Averse to uncover ; thirst, o • 7< / Offensive sweat ; dull in the back ; heat ^ ^^ • \of face and hands, with desire to uncover. Q t^ ) Heat and sweats, mixed ; profuse and ^'\exhausting; sour; putrid.
Dulc.
gS^^rn^ CLINICAL CASES. 675
Others might be compared as : — Sarsoe, raph,, rhab., graph., calc. caust, caust, naumtlph., camphor, and sulphur.
That cole. c. should he used for any peculiar instances of disease where there occurs other than heat of skin, or heat of the skin of the extremities with perspiration, with notable chill or without it, it must, for the present, remain for those so employing it, to show in what kind of particular case it is so adapted. Lest any one should doubt that this drug can cure these symptoms of heat referred to, I will record one case, although many more might be easily given, to show how useful it is in these symptoms, which it is found so often to produce, in the provings. There is something worthy of note in Hahnemann's statement, that it would take an unnecessary amount of time and labour to recount all such cases, and to enter into all the reasons passing through the mind for and against this or that drug at the time of its selection. If, nevertheless, it may prove of any practical benefit to enter upon the record of cases cured, it is wise to do so, more especially as regards cases of a kind from which instruction may be gathered, or by which the memory may be refreshed.
Case XIII.
On Feb. 4th. Robert D., a fair-haired, blue-eyed child, thin, and a little ansemic, aged two years, has been ailing for about four weeks, with depressed spirits, and disinclination for his play. He is restless, and the sleep is disturbed at night. There is, in this case, no sweating of the head or forehead noticed at night, but the head and the whole body are hot at night, and he is very restless with it. He suffered severely from this nocturnal feverishness two weeks ago, and required to be kept in bed for a few days.
There are enlarged glands in the neck and anorexia. On enquiry, there is no thirst notable either diurnal or nocturnal. Calc. carh. 3 trit. gr. 1 ter. die.
February 11th. Report. A good deal better after this medicine. He is more lively, says the mother, in dis- position since taking it, and sleeps much better. *' The lumps " in the neck are now gone. Appetite improved. He is now cured, she says, of *' the heat of head and body, and the nocturnal restlessness, which for the past few weeks have been so troublesome. He has now taken to his play again.'*
In this instance the flesh had become soft, but there was
676 CLINICAL CASES. "SSSl^SSf?^
Bcriew, Nor. 1» I8e>.
no marked wasting. However, I considered it better to use cole, for a week more, and repeated the medicine.
The differential degree between the suitability of this or that medicine is often to be decided by tiiie tem- perament and general appearance of the patient. The colour of the face, the quality of the hair, the state of the mental disposition — ^all contribute to our differential power. There is an unhealthy appearance which corresponds well to sulphur, another to iodine, another to ferrunif and soon. As to heat of the head, again, how often belladonna is found beneficial in the plethoric face with red cheek, excitable temperament, with burning heat and redness to a marked degree in the evening, and nocturnal restlessness of a degree amounting in some cases to actual delirium. BeUa- donna picts better here at any rate, to begin with, than calcarea.
Again, sulphur gives us dulness, or irritability. The Cace sickly, eyes sunken with blue margins, or spotted redness of the cheek. The sweat at night on the nape and occiput, and a general sour sweat profuse at night. Heats in flushes.
Calc. carb. More restlessness and irritability, although mental depression as well.
Burning on the top of the head. Flushes of heat. Heat followed by chill and cold hands.
Face pale, and bloated [or very exceptionally yellowish] or pale and thin, with blue margins round eyes, or in a farther advanced degree of illness, old and wrinkled looking.
Calc. pho8. Peevish and fretful. Involuntary sighing. Face pale, sallow, yellowish, earthy, full of pimples. Diy evening heat, copious night s Treats on single parts towards morning.
lodium. Depression or excessive excitability. Face pale, yellow, or changing to brownish tint (children with dark eyes often present these signs), sullen, distressed expression; or paleness alternating with red. At night, flushes of heat all over, profuse sour night sweats, debili- tating, and towards morning hours with much thirst.
These medicines and belladonna before referred to, being all so well known for their power over lymph glands, which were cured by col. o. in the case cited, may be usefally compared with the latter medicine in reference to the anorexia, nocturnal heats, mental and physical depression.
The prevalence of these high temperatures implying, it is beUeyed, a certain amount of waste in the heart and
ISS^SSirSS^ QLIOTCAI. OASBB. 677
mnscnlar straotares generally is saggestiye of the value of tepid ablutions or of cold water if the child be sufficiently strong. This, apart from the medical treatment which it will support, becomes a valuable ally and auxiliary, to say nothing of the benefits of cleanliness and removal of old epidemic sheddings or of sweat products.
Last, but not least, the symptom thirst (not present in this case cured) occurs with the chill of calc. c. and diurnally, and is not a symptom of the nocturnal heat of calcarea c, occurring then rarely, if ever, whereas it is distinctly produced by iodium in association with its night sweats.
Case XIV.
S. J. W., girl aged 18; began treatment under my col- league, on July 29th, for a dry eruption of the occiput, with lice in the hair. This was the condition when first seen by myself. Graphites 12c. had been employed, and on first seeing her on August 8th this medicine was re- peated.
August 28rd. No improvement in eruption. Has a new symptom now, — " itching and smarting all over the body and limbs."
Nat. mur., 6c. t.d.
If this itching be pathogenetic from graphites — ^for the symptom is consistent with the action of graphites (itching) — and the other symptoms of disease remaining unbenefited, it warrants a change of prescription. Nat, mur. also causes marked itching, and hence, taken with the skin eruption, I considered that it might be suitable. The eruption consists of dry crusts, in separate portions, between the roots of the hair. The smaller portions of the crusts get detached by scratching, and some of them remain adhering io the hairs.
September 6th. Itching symptom gone; the occipital condition better.
September 18th. Decidedly better, both as regards local and general symptoms. Eruption of head beginning to disappear. Patient stronger.
September 27th. Continues to improve. Repeat.
October 5th. The scabby eruption around and on lower •occipital region has entirely disappeared. The enlarge- ment of the glands (sub-occipital and posterior cervical lymphatics), which had been previously enlarged to the size of beans, and very hard, has now subsided. Appear-
678 OEJUIOAL OASES. "S^^S!??^
Beyiew, Nor. 1, 1881.
ance of hair greatly improved. Scalp healthy-looking and lice gone. The general health, too, is now good. Aa» regards the symptoms for which she first came, the case was entered as cared ; bat on the same date another new symptom is noted, i.e., '' a ranning sometimes from the eyes and nose.*' (Pathogenetic, very likely.) It occurs in (he provings. To discontinue treatment.
Nothing more is heard of her until November 1st, when she comes again with a fresh crop of eruption at the occiput and back of the neck. Nat. mur., 6 t.d.
November 8th. Much better of eruption. Nape of the neck cured. Bepeat.
November 15th. Stil^ better. Bepeat.
December 6th. Neck completely cured. Bepeat.
December 13. Case quite cured, no eruption, hair and general appearance of skin healthy. The patient's appear- ance and complexion have much improved since she came uuder treatment.
Case XV.
M. P., girl set 19. Commenced treatment on August 16th for a scabby eruption about the occiput, with lice in the hair. Numerous eggs of pediculus capitis, and a soft scabby eruption between and adhering to the roots of the hair. Nat mur,, 6 c. t.d.
August 23rd. '^ Oreat deal better." Bepeat. Lice in hair perfectly removed, so far as examination can demonstrate it.
August 31st. Head eruption much less. Bepeat med.
The patient did not come again until September 27tb, when the general health was found still better. The head disease gone. She came on this occasion for pain in the knees, of rheumatic character, and this was prescribed for, and then the patient was lost sight of, but the case had been previously concluded, so far as the head eruption and. not. muriaticum were concerned, and was, no doubt, completely cured after the last prescription on September 27th, by bry. alb. for the knee pain, which corresponded to the indications of that medicine.
Most of the cases successfully treated by natram vmr. for the kind of eruption just referred to, have been in pale^ debilitated children, with fair hair. I have also known it followed by good results in a similar weak state of health, but where the hair is also of a darker hue, though having
SS^^Tf^^ CLINICAL CASES. 679^
Beriew, Nov. 1, 1882.
the same discrepancy in quality and polish. I have the notes of another case of which I cannot, for want of room, give the full details here.
In this patient, a child of sanguine temperament, and naturally having a good deal of colour, had become pale, sickly-looking, and weak ; with anorexia, pain in chest on breathing, soreness of the nose. After a fortnight's treat- ment with nat. mur. 6c., these symptoms gave way with a most satisfactory recovery of general health ; but at this juncture I found that the head had broken out with a sore and scabby eruption, and the soft, moist, newly-formed scabs or crusts at the centre of the occiput, I found to be the central point of habitat of numerous fat, healthy- looking lice. Scabs, pale yellowish grey. Several lice around one of the largest scabs, and very busy moving about amongst the hair. Crusts easily detached. There is also a freshly formed scab, with soreness, at the edge of ihe right nostril. (Pathogenetic, perhaps.) It is in- teresting to observe that a crop of lice and eruption of this sort had not ever before appeared in this patient. They came out during the use of nat^ mur. for other symptoms. If the outbreak were not induced by the nat. mur., the due condition being understood to be actually present, it is not a little remarkable that this medicine should have been given at so opportune a moment, that the outbreak should be just imminent from the previously diseased state only, and also to have so occurred in just such a state of disease for which nat. mur. had been employed to cure the erup- tion and lice in other instances where the patients were in a very similar condition of ill-health before they received ' this medicine. This head trouble was not present when she first came to me. I cannot help regarding this as very likely to have been brought out by the medicine, and it is remarkable that the lice should have appeared quite suddenly and apparently contemporaneously with the erup- tion. And a similar remark applies to the eruption of the nostril. In the cases cured by nat. mur. I have observed that the hair is dull-looking, deficient in glossiness, and of a dry and inferior quality. Hering's Materia Medica gives '' scabs on the head and axillaa, raw eczema, oozing a corroding fluid, destroying the hair. Impetigo worse on the boundaries of the hairy scalp, especially about the nape of the neck. Sore nose, interior of wings of nose swollen ; scabs in the nose. Left sided inflammation and.
•680 CLINICAL OASES. "S^^SS?!"^
S/BTWWf XOT. If IflSL
swelling of nose; painfal to toncb. Nose on one fdde feels numb."
I bave in my band several more eases wberein tbe effect of tbis medicine (not, mur.) bas been no less effectual than in the foregoing instances; but I must defer giving tbe details of tbese to some future opportunity. In one, a patient forty years of age, rbeumatic pains of tbe neck and sboulders, occipital pain, witb eruptions and sore eyes, -disappeared under tbe 6tb attenuation of not. mur. ; and in tbe otber, a girl of twelve, tbe occipital eruption and dyspepsia, witb debility, were greatly benefited under the 6tb, and finally removed under tbe 80tb attenuation. I bave used tbis medicine for a great number of similar cases — ^bow many I am unable to say precisely — ^but it bas been a matter of astonisbment to me bow rarely it bas bappened tbat sucb a group of symptoms bas foiled to give way veiy speedily to tbe medicine. "Whereas, formerly, I was in the babit of using cleansing lotions or ointments and powders capable of killing tbe lice and cleansing the hair of tbe ova, a plan I do not doubt still followed by many, I bave not found tbis necessary in a single instance during tbe past twelve months or more, since employing the not. mur, internally. Tbe lice appear to have an intense abhorrence of this drug or of tbe changes it produces in tbe scalp and hair, for they (in my experience) seenpi to disappear of themselves as soon as the system is brought under its influence. Tbe improvement in the health either renders their presence no longer necessary or possible, and when the conditions essential to their vitality -cease to be fulfilled, they also cease to exist. While I write, anotber instance comes to my mind, where a little girl of ten was for several years subject to lice in the hair and eruptions of the scalp — a pale, weak, and sickly child. The mother of this child shortly before her death informed those left in charge of her that they would find that want of cleanliness had not been the cause of this trouble. The view of tbe case taken by tbe dying mother proved after- wards to be correct, for this child continued to suffer from the same trouble for a year or more afterwards, in spite of close attention to cleanliness. After a fortnight's treat- ment by nat, mur. 6, I received a letter to say that the head had recovered the healthy condition. It must not be supposed that nat mur. should remove lice in every case, nor tmless the state of ill-health were suitable for this medidne.
S^fy^rSS^^ CLINICAL OASES. 681
In some instances I have used, with saccess, other medicines for the ernption, with hard enlarged glands beneath the occiput. Hepar and rhus, in succession, I have known effectual, but not so speedily for the entire group of symptoms, as when nat. mur. has been employed^
Diagnosis. — There are some other occipital eruptions with which this class may be confounded, unless the hair and scalp be examined. Thus itch is n^t nearly bo unfrequent in this locality among the poorer classes as some persons might suppose. I have frequently known cases of eruption, with the characteristic symptoms of the itch, affect this part, together with other parts of the body, and in rarer instances about the head and neck almost exclusively. These cases give way rapidly to sulphur applications. Many eruptions of the scalp, how- ever, which caonot be easily proved to be actually itch, nor perhaps the insects actually found, disappear quickly under a little sulphur ointment, and especii^lyis this so with eruptions, itching at night like the typical itch. Hence, there is much more difficulty in drawing the line where the psora principle (itch of Hahnemann's chronic diseases) should end, and when it should begin. It cannot be doubted that true itch assumes many phases and forms, and brings out a variety of eruptions, and underlying this, there is, as- we conclude, a basis of ill-health, of which the eruption and other local manifestations are but as the leafy expansion spreading from the deeply lying root. So far as I can observe, the diathesis, to which the lice and their eruption belong, forms a basis quite distinct from that of the itch proper.
Finally, as regards the various forms of ringworm, in- spection, as a rule, discloses the nature of this easily, and we are assisted by the fact that if it occur under the occi- put, which it does but rarely, it generally is by extension from patches further up on tiie scalp.
That there are several other kinds of eruptions than those here referred to, and differing from them, I am well aware ; notably those hard, firmly caked crusts, which are commonly devoid of pediculi, and which form a distinct kind of complaint from those which I have described as being successfully met by nat. muriaiicum, and that these are suitable cases often for calcarea has been frequently observed.
"682 HOMCEOPATHIC TRITURATIONS. ^^S^f^S^l'^wS!
The Materia Medica enlightens ns as to the scalp . ernptions for natrum mur. in the following manner : —
''The scalp smells badly, musty; the hairs stick to- gether ; falling out of the hair. Sore when touched as if the hair were sore. Itching over the whole head ; also violent itching on the head and nape of the neck. Scurf. Stiffness of the nape and by the occiput. Tension in the nape, with swelling of the cervical glands (symptom cured). Eruptions on skin : — Itching eruption on the margin of the hair at the nape of the neck (cured), temples, and also -eyebrows. Itching, gritty rash behind the ear for several days." The nasal eruptions of tMt. mur, are well known — especially the inflammation producing vesicles, and ending by the formation of scab.
EEMARKS AND SUGGESTIONS CONCERirtNG CERTAIN HOMCEOPATHIC TRITURATIONS.—
FIRST PAPER.
By J. Edwards Smith, M.D., Cleveland, Ohio**
Lycopodixjm-Spores.
'Some time during the month of January last a homodo- pathic practitioner of the city called my attention to excellent results in his hands, obtained from the tincture of lycopodium, and at his request I made a trial of the same preparation (made by himself), which, in turn, rendered me excellent service.
I then resolved to test the virtues of the first decimal trituration, which trituration I at once obtained from the pharmacy of Mr. L, H. Witte, of this city. In less than thirty days from this date I had occasion to prescribe this first dec. trit. in two difficult cases, and was in each instance rewarded by brilliant cures.
Three of the cases above referred to will hereafter be presented in this journal ; one of these was a remarkably interesting case (which came to me from the allopaths), and demonstrates what can be accomplished at times by " rational medicine."
Having thus applied the clinical test to the lowest decimal trituration of lye. getting nice effects, the question
* Beprinted from the New York Medical Ttmet, BeptemW, 1882.
RS^^TT^^^'noviCEOPArmc triturations. 688
yery often snggested itself : Have I now the best possible trituration of lycopodium ?
Shortly after my retnm from the late session of the American Institute this interrogatory became so often present in my mind that I determined to learn more con- cerning lycopodium triturations without delay. The first X trituration of Mr. Witte's was at once subjected to a five-hour microscopic examination, during which many mounts were prepared and diligently examined. During ihe whole of this examination I succeeded in finding but two whole spores. This, while the debris of thousands, if not millions, of spores must have passed under my eye.
The next day I called on Mr. Witte, asking for informa- tion regarding his method of preparing the first x tritura- tion of lycopodium, Mr. Witte replied that he did not j>r«-triturate the spores dry, and that he had found it preferable in making the first x trituration to introduce the entire quantity of sugar of milk at once, ue., one part •of lye. spores to nine parts of aacck. lac., and then -triturate the whole for ten hours.
Mr. Witte kindly offering me all the conveniences in his -power, use of his machine triturators, &c., the following series of experiments were at once instituted. These -studies have beeb conducted throughout entirely under my .direction and supervision.
It is proper here to say that the observations which I am iibout to record are a simple recital of results arrived at from my personal examinations of certain triturations of .lycopodium spores. This record is not offered to the preju- dice of triturations (by whomsoever made) which have not been subjected to examination. Nor shall I attempt (assuming the judical) to assert what may be, or not be, possible to arrive at by triturations of the spores of lycopodium clavatum.
For want of space very many of the details of the microscopic work are omitted. One-half inch, one-quarter inch, and one-tenth inch modem objectives were employed, ;and also the modified vertical illuminator.
With these preliminary remarks I now proceed (as briefly as possible) with the recital of the experiments thus far completed. An exhaustive report is reserved for future presentation.
My first effort was to prepare a first x trituration
684 JBOMCBOPATHIO TBITUKATIONB. "^g^.^CTw^
— * ' 1
precisely according to Mr. Witte's previoug MsUmUj Thus :— V
(0.) = ]&« Lyc<y>oJ{ium spores, one part, = ^ onnce.
Sacch. lac. ... nine parts, = 2 J onnce.
The whole of the above material was at once ipixad •together and then triturated continnonsly for ten honrs, after which the trituration was carefolly examined, nndar the microscope, using. powers from 500 to 2,000 diameters and upward. I entirely failed to find a single whole spore, or eyen parts of spores large enough to be identified with any certainty. It is true that perforce of patient hunting, using very high powers, I did disooTer what I supposed to be very minute portions of the spore capsule wall, having a small portion of the zninute markings attached. These minute fragments were ''few and far between/'
Sometime during the next day Dr. Allen Y. Moore called at my office. Dr. Moore is the present incumbent of the Chair of Microscopy in the college here. I handed him a specimen of this '' 0 " trituration, asking him to give it a careful examination. Dr. Moore's experience with the specimen was almost identical with my own, as the following letter (published by permission) mtt attest. It reads thus : —
''Dear Doctob, — I have carefully examined th^ iiitaia- tion of lycopodivm (first x), as you desired, ana tlkisk it without exception the finest ground I have yet seen^
''At my first glance, using a new Spencer one-inch objective, I was impressed with the idea that you' had made a mistake, and given me the thirtieth in the place of the first X. But in a subsequent examination with a wide- angled four-tenths, I could see that there was enough of something besides milk sugar to justify its claim to being the first X of something, but not a spore could I see. I used a one one-tenth immersion, and at last fell back upon my oil immersion one-eighteenth. With the one-tbnth and one-eighteenth I could occasionally see the Burface reticulations spoken of.
'' I have examined a number of first x triturations of various drags, but do not remember ever having seen one which was finer ground than this.
" Very respectfully,
"A. Y. MooBB, M J).'*
b5^i^?m«?** homeopathic tbitubation. 685
Next in order came the desire to asoertain more pre- cisely as to the amount of trituration required to break up the spores. The initial experiment was repeated with the following variations : —
(U.) — IJ. . lye. spores one part, = J onnce. ) -^ Sacch, lac. - nine parts, =2^ ounce. ) ^*
(U* )=" U " was triturated for two hours, and then ex- amined ; but very few unbroken spores were found — say one per cent*
(TJ^ )=" U " triturated four hours. No unbroken spores seen.
(U*" )=" U " triturated six hours. No unbroken spores. Fractured portions are getting smaller.
(U**)=**U** triturated eight hours. No unbroken spores. Fractured portions not much, if any, smaller.
Thus it seems that a four-hour trituration was sufficient to break down the spores. Desiring still more definite results, the next step was : —
(V)=I{».iyc. spores one part. = J ounce, \^. Sacch.Lac. - - nine parts. =2^ ounces.) ^'
(V* )=" V " triturated one hour. Twenty-five per cent, of the spores unbroken.
(Y*»)=="V" triturated two hours. Now and then an unbroken spore was found — say one per cent.
(V*") ="V" triturated three hours. Spores. oZmost all broken up — say one-tenth of one per cent, unbroken.
Comparing now " U " with " V " I gather that four hours' time is required to fairly break up the spores.
I now present a second series of experiments quite dif- ferent from the foregoing : —
(L) = Jjyc. spores not triturated.
(P) = One-fourth ounce of lye. Spores triturated three hours. On examination ninety-five per cent, of the spores were found to be unbroken.
Comparing ''L " with '' P " it is to be remarked that, notwithstanding there are but few spores fractured in '* P," nevertheless the character of the ^' P " spores have changed materially. They aire slightly darker in colour, and may, if not closely cross-questioned under the objective, deceive the observer. They become oily on their surfEuse, and hence appear smooth and devoid of their charaoteristio markings (i.€., the polyhedric surface markings). It was easy, however, to demonstrate that these stufaoe mark-
Vol. 26, Ko. IL 3 %
686 HOMCEOPATHIG TBITUBATION. "e^j§S?7uml
ing8 Btill existed. A few experiments with ''P" now follow : —
(P* ) = One-fourth ounce of " P."
+ One-fourth ounce sacch. lac. and triturate one hour. Spores aggregated together (perforce of the oil ?) ninety per cent, of spores unbroken.
(pb ) = One-fourth ounce of " P."
+ One-half ounce sacch. lac. and triturated three and one-half hours. Eighty percent, of spores unbroken. (P<= ) = One-fourth ounce of " P."
+ Three-fourths ounce sacch. lac., triturate 6J hours. Ten per cent, of spores unbroken. (p») = One-fourth ounce of "P."
+ One ounce of sacch. lac., triturate 8^ hours. Only now and then can an unbroken spore be seen — say one per cent, unbroken. (P«) = One-fourth ounce of "P." •
+ One one-fourfch ounce sacch. lac., triturated 11^ hours.
A tolerably prolonged examination failed to exhibit any whole spores. By comparing " P " with " 0 " I foil to see anything but disadyantage resulting from the prelimi- nary trituration of the dry spores. Besides this preliminaiy triturating is attended with considerable trouble. The mass of the trituration soon becomes oily, and forms a slippery, pasty mess, over which the pestle glides with but little effective force. The mass requires almost constant scraping from the sides of the mortar.
This " P " experiment was next modified by adding the proper quantity of sacch. la<f. at once. Thus : —
(Q) = One-fourth ounce of lye, spores triturated alone for three hours, and then mixed with two and one-fourth ounce sacch. lac.
(Q* ) = « Q " triturated one hour. Result : Fifty per cent, of spores unbroken. Characteristic sur&ce mailings to be seen.
(Q»» ) = " Q " triturated two hours. Result : Thirty-fiye per cent, of spores unbroken. Characteristic markings to be seen.
(Q* ) = " Q " triturated three hours. Result : Twenty
aSri^H^Ta^ H0M(E0PATH10 TEITUBATION. 687
per cent, of spores unbroken. No characterisiio markings noticed.
(QO) = «Q" triturated four hours. Result: Ten per cent, of spores unbroken. No markings seen.
(Q* ) = " Q " triturated five hours. Result : After a tedious e:^mination of this trituration, I succeeded in finding but one whole spore, and also about three-fourths of a second spore.
Experiments were now instituted in order to discover efiects due to using different qualities of the sugar of milk. The '^ Q '' trituration is next modified as follows : —
(R* ) = ^ ounce of lyc^ spores triturated by themselves for three hours. Then adding 2|- ounces of a sample of sugar of milk known to be of inferior quality.
Mr. Witte informs me, in reference to this sample of saceh lac. that it differs from that used in trituration '' Q/' in that, by greater exposure to heat used in its manufac- ture and refining of it, it forms softer crystals, having less efficiency to cut and to break down drug particles in the process of trituration.
(R* ) = « B »» triturated 1 J hours. Result : Eighty per cent, of spores unbroken. The spores have become aggre- gated into " colonies/*
(R^) = *' R " triturated two hours. Result : Sixty per cent, of the spores unbroken. The aggregations or colonies are somewhat more broken up.
(R ) = " R *' triturated four hours. Result : Fifty per cent, of spores unbroken. There are plenty of colonies still visible.
(B« ) ^ " R " triturated five hours. Result : Thirty per cent, of spores unbroken. The aggregations become much smaller, yet they are still to be seen.
(R' ) = " R " triturated six hours. Result : Twenty per cent, of spores unbroken. The colonies are tolerably well dispersed, yet the tendency in this direction is still to be noticed.
Resume. — ^By comparing the triturations of " P " with those of '^ Q," it seems evident that time is lost by adding sacch. lac. in fractional portions.
Comparing triturations **Q" with those of "R," it appears that the quality of the milk sugar affects the results obtained by the process of trituration.
2 z-2
688 HOMCEOPATHIO TBITUBATION. "^SS^?S!??!Sf
Befkm, Nor U UBL
Comparing trituration "Q** with those of "U" and " Y " the inference obtained that the time used in preparing^ the lycopodium by first triturating the spores by themselyes is not only lost altogether, but that it required a longw time to triturate lycopodium thus prepared. This may be due to the fact that the preliminary trituration liberates (aa I judge) about 20 per cent, of the oil contained in iJie spores, which seems to haye the effect of massing the remaining 80 per cent, together, thus interfering with the proper action of the sugar of milk, as also with the proper action of the pestle upon the triturating mass. These suggestions occurred to me with much force while watching the '' P " trituration during the introduction of the earlier portions of the saech. lac. The triturating mass becomes an oily paste, which, under the action of the pestle, spreads out into a thinnish layer, lining the interior of the mortar, oyer which the pestle seems to glides and in order to secure a better action of the pestle, the thin layer must be almost constantly scraped from the sides of the mortar.
The foregoing includes all that I have tiow to report concerning trituraiions of lycopodium. Further observa- tion yet remain to be made. These will be reported at a future date. Experiments relating to the tincture of lycopodium have been some days in progress. Of these I here make but the bare mention, leaving results hereafter to be obtained for a future paper.
(S) = One-fourth ounce of lycopodium spores, plus two fluid ounces of ninety-four per cent, alcohol. Digested from July Slst to August 7th.
Note. — ^The above will be used as a comparison tinc- ture.
(T) = One-fourth ounce of lycopodium spores, plus one- half ounce of emery. Triturated six hours. Then added two fluid ounces ninety-four per cent, alcohol, and digested from July Slst to August 7th.
Lycopodium spores have also been placed in the hands of Prof. Wood, for special analysis. His determinationa will be reported at a future date.
August lOthi 1882.
It^^ar^SS^ HEADACHE OF THEIN, 689
THE HEADACHE OF' THEIN. By BoBEBT T. GooPEB, M.D.y
Phjiidaii, DImmm of Ear, Londoa HomoBOi»alhio HospitaL
iltBB* B.y a hard-working needlewoman^ dark haired, and of a neryons temperament^ aged 62, consulted me in Febmary, 1880, with a seTere headache, which generally jaffects the entire head, and sometimes is localised in particular parts of the head, not preferring any one region. It comes on if worried, and is accompanied by much sink- ing of the chest and restless sleep. The digestion is feeble, Jbut otherwise natural. On this occasion the headache ceased aft;er taking drop doses of ignatia ^. She next con- sulted me in November, 1881, and then the symptoms were : Headache all over the head with sickness, keeps her .awake all night, so that she remains walking about till 4 o'clock a.m. ; it is accompanied by a sense of great depres- fdon, the pain in the head being that of opening and shutting ; there is a sense of weight in the stomach after eating, though the bowels are regular ; appetite good, and pulse pretty fair. Partakes but moderately of tea. Up till the end of the year she took chin.^ sulph., strych.f suVphur and ignatia^ without marked effect ; and in January and February of 1882^^ ignatia, sahina, strych., phos., camphor bromide, and then strych. nitr. were given ; the last alone brought relief, and by the middle of March she considered herself sufficiently well to leave off treatment.
But the moment she returned to work the headache came back, and then I put her upon thein Ix, 6 gr., to be taken three times a day. During the first week of the tiiein the headache gave place to neuralgia of the left side •of the fiice, which she never had had before. During the second and third week she remained all but completely free from headache, and then ceased taking medicine, remaining until the present quite free from pain.
We have not reported this case in full, but judging from the symptoms present from time to time while under treat- ment, would put down the headache curable by thein as a headache with great exhaustion of the system, restlessness at night, feebleness of digestion, and (not mentioned in the above report) a tendency to back-ache, with a weak, tiresome cough.
21, Henrietta Street, Cavendish Square, October 17th, 1882.
690 MEETINGS. ^'SSS^f^SITSS?
MEETINGS.
REPORT OF HAHNEMANN PUBLISHING SOCIETY.
The annual meeting of thiB society was held at 100, Princes Street, Edinburgh, in the evening of September 6th, 1882 ; and, by adjournment, in the morning of the 7th.
There were present : — ^Dr. H. Nankivell, vice-president, in the chair ; also Drs. Blackley, Dyce Brown, Bryce, Carfrae, Drory, Gibson, Hajward, Kennedy, Madden, Moore, Pollar, Stephens, and Walter Wolston ; with Dr. Lndlam, of Chicago, as visitor.
After reading the notice calling the meeting, the Hon. Secretary read the minutes of the previous meeting ; tibiese were confirmed and signed. He then read the report of the proceedings since the previous annual meeting. In this it was stated that six new members had joined the society, and, as to tcorh done, chapter Back and Neck of the Repertory, prepared by Dr. Stokes, was published in October, 1881, and 500 copies printed ; and volume n. of the ** Re- translation of Hahnemann's Materia Medica Pura,'' prepared by Drs. Dudgeon and Richard Hughes, was published in January, 1882, and 1,000 copies printed. A» to work in Jiand, there had been, during the year, several meet- ings and considerable correspondence between Drs. Black, Dudgeon, Drysdale, Hayward, Hughes, and others engaged on the revision of the Materia Medica ; and Dr. Black, having com^ pleted his. arrangement of digitalis, plumbum, and mto! vomica^ had submitted that of ntuv vomica, as a sample, to the Materia Medica Committee for approval, and to the Publishing Committee for sanction of printing ; but after some discussion of the plan he had adopted, he had undertaken to make some modifications and additions. This had prevented him presenting these medicines to the meeting as ready for the privter, as he had hoped to be able to do. Dr. Clarke's arrangement of argeivLum nitricum was reported as almost ready. Drs. Dudgeon, Bumebt, Ker, and Edward Blake, were making progress w-th ihe arrange^ ments of mercurius corr,, phosphorus, conium, aiid secaiSf respectively. Dr. Jessen, of Chicago, had neaily completed that of thuja, and Dr. Hayward had neai'ly finished Uiat of crotaltts* It was, iherefore, hoped that very shortly some twelve medic?nea would be published in a good sized handy volume. Dr. Black and the British Homoeopathic Society had each promised £25 towards the expenses.
It was here mentioned that the Bureau of Materia Medica of ihe American Inslitute was now also engaged in a revision of the Materia Medica, and that the secretary of the H. P. S., be?ng a member of that Bureau^ was in correspondence with the chair
gSSy^nnS^ MEETnroa. . 691
man, and it was probable, therefore, that the two committees might work together.
It was farther reported that Dr. Stokes had nndertaken to pre- pare chapter *' Generalities '* of the Repertory, and had made snch progress with it as to be able to promise its completion by next annual meeting. That Dr. Simpson, of Liverpool, was fairly well on with chapters Urinary and Male Genital Organs ; and Dr. Simpson, of Glasgow, with chapter Sleep and Dreams. Dr. J. G. Blackley and Dr. Hawkes had in hand the chapters Skin, and Larynx and Chest, respectively.
And it was reported that, of chapter XY. of the Repertory, viz., Stools and Anus, there were only ten copies remaining; of chapter IV. (Eyes), V. (Ears), VI. (Nose), VII. (Face and Neck), and Vm. (Teeth and Gums), there were only three copies ; whilst of chapter XI. (Appetite, Taste and Digestion), XII. (Acidity, Eructation, Nausea, andVomitmg), and XUI. (Stomach), there was not a single copy.
The financial state of the society for the year was the following : —
Payments £857 17 6
Receipts 852 18 8
Balance due to treasurer £4 19 8
In reference to this society we have the following communica*
tion from Dr. Hayward : —
•
'* Gentlemen, — ^In the account of the discussion on the revision of the Materia Medical on page 622 of the October Review, I am represented as having said I * had received the above state- ment from Dr. Hughes as the proposal of the British Homoeopathic Society.'
'' This is scarcely correct ; because it makes it appear that the resolution was the proposal of the B. H. S.
''The mistake has evidently arisen from my reading Dr. Hughes's statement without handing it to the reporter, and the reporter having omitted to mention my handing in the specimen, aconitinum ; both of which Dr. Hughes, as representative of British Homoeopathic Society, had forwarded to me for presenta- tion to Congress, he himself being unable to be present.
*' My reference to the specimen, and Dr. Hughes's remarks, should have followed the resolution (e) on page 622, and then your report would have been complete.
692 . MBBTDroB. "SSL'^sryssr
Bflfviev, KoT. 1, IflBt.
"Will yoa pleaae supply the omissioiiB in the November Beview by publishing this explanation, and Dr. Hog^ies's remadn, which follo¥^.
" Yonrs truly,
" John W. KiYWABD."
The following are the remarks by Dr. Hu^es, referred to by Dr. Hayward : —
'* That the Materia Medica^ needed for the practice of homoeo- pathy, is a collection of the pathogenetic effects of drugs, needs no demonstration. From Hahnemann downwards, it has been universaUy recognised. But the form such collection should assume is another question. It would be answered differently, according as it is the practiticmer's or the student's need which is contemplated. The former makes mainly an a posteriori use of the Materia Medica ; in presence of a case of disease he consults it to find what drug has produced the nearest simHUmvm of the symptoms. For him the scheme form, with indices and concordances, as elaborated in the Hahnemann Materia Medica, is the best thing we can have ; and such arrangements of medicines cannot be multiplied too far.
'^ It is otherwise, however, for the student, who has to learn d priori the actions of the medicines which form his armoury for warfEure. For him it is essential that he should be able to read the provings and poisonings with drugs which we possess in detail, recorded as the symptoms were experienced. This, too, is now generally admitted, and few provings are given to the "world primarily, in scheme form, as were those of Hahnemann and his immediate successors. But the detailed records, though in existence, are scattered through such a wide range of literature that they are not available for ordinary purposes. It seems to me that one of our undertakings in the sphere of Materia Medica should be the supplying of this need. 8. Allen, in his Encyclopedia, has gone to the sources, but what he has drawn from them he has given as separate symptoms in a scheme. My proposal is that, from the same and other sources, we should obtain a series of pathogeneses like that of aconitine, which is now submitted to your notice. This has been drawn up by a committee of the British Homoeopathic Society, and printed, for the sake of publicity, as an appendix to the October numb^ of the British Journal of Homaopathy. If it is approved by the society, this body will probably undertake the work of preparing and publishing an entire Materia Medica so constituted. It would be much aided towards its decision by the opinion of the present Congress."
fiSS^STfa?^ HOTABILU. 698
.Ssfiew, Nor. l.
NOTABILIA.
THE LONDON SCHOOL OF HOMCEOPATHY.
On Tuesday, the 8rd ult., Dr. Dndgeon dellTered the axmnal Hahnemann lecture, with which the work of the session is in- 4»ig(irated. The andience was considerahle— the Board Boom of the hospital heing well filled — and included many non-homoeo- pathic practitioners. Dr. Dudgeon took for his suhject, Hi^nsmann, ike Fotmder of Scientific Therapeutics, Oommenc- ^g hy ohserving that Hahnemann had heen dead nearly 40 years, and that we could estimate him in comparison with the great medical personages of the past, and fix accurately his place in the history of medicine. Dr. Dudgeon said he should in this lecture endeaTour to show what tihat place was. As a pre- liminary, he would ask what was the aim and ohject of medicine ? It was the cure of disease. As Hahnemann expressed it in the first aphorism of his Organon^ '* the high and only mission of the physician is to restore the sick to health.*' It was necessary to rememher this, for it had often heen forgotten hy some of the most illustrious names in the history of medicine. Anatomy, physiology, hotany, chemistry, and all the other so-called collatenJ branches of medical science were but the means to the end — that end being the cure of disease. But the means had often been cultivated as though they were the end ; and their cultivators were wont to look down on the therapeutist as though the cure of disease were but a poor thing in comparison with the study of disease as a branch of natural history, or with physiological or ■anatomical research. It was impossible to say when or to whom the idea first occurred that diseases could be cured by drugs. In the first edition of the Organon, par. 7» Hahnemann said, *' There must be in medicines a healing principle ; common fiense tells us this." But to the common sense of many there ^as no "must *' about the matter. Unless we had been told that medicines had a liealing principle we should scarcely have suspected it. On the contrary, seeing their uncomfortable effects when we swallowed them, we might easily come to consider them and class them among disease-producers rather than disease- removers. Having then traced briefly the history of early attempts to construct an art of healing, he gave, with some amusing detail, an account of the therapeutics of the latter half of the 17th and the first half of the 18th century. While the grosser elements of prescriptions of which he had been speaking were discarded by the contemporaries of Hannemann, the thera- peutics of his time, and for many years afterwards, remained as mational as ever. When, in 1796, he first tentatively put for-
694 KOTABIMA. "SSiSl^S^TSSL
ward the idea that in the treatment of chronic diseases medicines might be given on the shnUia nmiUbus principle, and when he launched his system, propwly excogitated in his Organon in 1810, no signs had been given by the chiefs of the medical schools that they thought that complex prescriptions were irrational, that inflammations were not best treated by blood- letting, that frequent purgation was not eminently conducive to health, or that alteratives, meaning thereby, generally, mercury, pushed to salivation were not scientific remedies. EDomoeopathy was not ** in the air " when Hahnemann wrote about it, nor for many years after the Organon appeared. Describing th^ the circumstances under which Hahnemann was by observation and experiments, first on himself and family, and afterwards witii the aid of his class of students in tiie University of Leipsic, enabled to complete the six volumes of his colossal work, containing the positive effects of 64 medicines, the lecturer said it constituted a real treasury of Materia Medica, displaying the accurately observed effects of medicines on the hmnan body without any alloy of hypothesis or conjecture. He proved his medicines in substantial doses, and he reduced the dose of the medicine he administered for the treatment of disease expressly in order to avoid the too violent effects of large doseSr He varied his doses according to the nature of the medicine and of the disease. The great central truths of Hahnemann's teach* ing up to the time when he was driven firom Leipsic by the hostility of his colleagues were — the demonstration by reasoning and proof of the truth of the therapeutic rule, *' let likes be treated by likes ; " the necessity for ascertaining the effects of medicines on the healthy human body ; the administration of medicines in disease simply and alone, and iu the precise form in which they had been proved ; and the diminution of the dose for the purpose of avoiding its too violent action. So utterly opposed was he up to the time of his leaving Leipsic, to hypothesis, thai he ridiculed the idea of our ever obtaining a knowledge a£ the proximate causes of disease. But after he had been driven from Leipsic, in his enforced solitude and isolation, as he grew old, he took to the dangerous course of spinning hypothesis, which being xmcorrected by discussion with other minds, and incapable of being tested by experience at the sick-bed, he came to consider as truths of equal value ^ith the great fundamental truth he had slowly and painfully elaborated by experiment and observation. It was dming this period that he inti'oduced all those surprising doctrines that have rendered his system so repugnant to the intelligence of educated physicians. He adopted the hypothesis of disease being a derangement of the vital force ; of Uie spirit of a medicine b^ing liberated from the matter ; of the increase of power of a medicine by trituration and succussion ; of the
^SSS^^!rS^ KOTABIMA. 696
origin of chroxiio diseases from three fixed miasms ; of the anti- psoric power of certain substances ; and of a certain dilation being the appropriate dose for all medicines in all diseases. Had he remained at Leipsic the dogmatism and intolerance that are so conspicuous in the writings of the septuagenarian hermit would never have been developed in the society of sharp-witted and independent companions. Homoeopathy would have re- mained what Hahnemann originally declared it to be — *^ rational medicine '* joar excellence — and its practitioners would not, as now, be handicapped in medical controversy by having to defend, explain away, or repudiate a number of crude speculations which were not of ihe essence of homoeopathy, but which were clustered like parasites round that great therapeutic discovery, and which served only to hide its fair proportions by their unwelcome ob- trusiveness. Having next glanced at what the greatest physicians of the past had done for practical medicine, the lecturer, observ- ing that Hahnemann's was the one name in the whole history of medicine connected with a rational, simple, and efficacious system of therapeutics based on the solid foundation of irrefragable facts, concluded by speaking of the change he had wrought in the modem practice of medicine.
MODERN SCIENTIFIC THERAPEUTICS.
The following extract from the Midland Medical Miscellany is an excellent example of the way in which the public are nowadays treated by highly educated scientific therapeutists of the '* regular" school. Defend us from such '* regularity '* as this, which seems strangely akin to quackery : —
*' You are called to see a sick child. You find that there is much pyrexia. The belly is as hard as a football and as hot as a new loaf, the bowels costive and the knees drawn up. The whole chest rattles during both respiratory movements. There is vomiting, coughing, shrieking and a decided tendency to convulsions. You move some of the joints and occasion evident pain. You ransack the patient for a sound and healthy organ, but fail to discover one. Now you are not asked for the diagnosis. That, of course, is ymmggteritis — or congestion of the entire kid. The question is — What medicinal treatment is to be adopted ? Answer : — Your surgery should contain a number of 1^ oz. phials, ready labelled and wrapped up, containing a mixture of aromaUe confection^ chloric ceiJier^ bromide of potassium^ bicarbonate of potass, diU water and syrup, A bird-shot prescription is what is wanted to cover the needs of aU doubtful and undeveloped ailments ; to be useful in every instance and harmful in none.
696 COBBESPONDENGE. "'Sl^^feC???^?
BevicWt Nov. 1, ISBt*
IS THERE A SPECIFIC URETHRITIS ?/
In a <^ special article " in the September number of the New York Medical Journal and Obstetrical Review^ Dr. P. Albert Morrow handles the question of the specific or non-specific nature of gonorrhoaa. After a fair statement and a close analysis of the arguments for and against specificity, he concludes that the position of the viruUsts rests altogether upon pure hypothesis, and is wholly untenable, while all the £Etcts^-experimental, . clinical, and pathological — are overwhelmingly in favour of the non-specific character of the gonorrhoeal indlammation. When we apply the gaufi^e of specificity to gonorrhoea it corresponds to none of the conditions of an undoubtedly specific infiammation. No artificial production of any disease belonging to this group is possible ; a specific disease is the product alone of a specific poison. Gonorrhoea, on the contrary, may be due to a variety ^f causes — contagious, irritant (mechanical or chemical), diathetic, &c. Again, in all specific diseases, there is between the time of infection and the first expression of the (disease a period of incubation. No incubation, properly so called, characterises gonorrhoea. A drop of this same gonorrhoeal pus, which may require two or three days to excite suppuration of the xirethra, will develop such effect in a few hours when applied to the conjunctiva, showing that the so-called incubation, depends not upon the quality of the exciting cause, but upon the susceptibility of the mucous membrane. Another distincttve peculiarity of this group is that a single attack of the disease confers almost complete security from another attack— a peculiarity precisely the opposite of what is observed of gonorrhoea, The morbid poison of a specific inflammation, once in action, continues until the textural predisposition to its special stimulus is exhausted. The patient is incapable of regenerating the poison or of being affected by it when exposed anew. Both of Uiese conditions are negatived in the clinical history of gonorrhoea. Finally, specific inflammation determines special pathological changes and demands special treatment. Identical pathological processes are met with in urethritis firom various causes, and the most radical of virulists treat all urethral inflammations alike.
CORRESPONDENCE.
HAHNEMANNIANS.
Gentleuen, — Dr. Pope admits that Hahnemann does not absolutely forbid the opening of an abscess or ^e use of 4ioothing (non-medicinal) applications; but he accuses the Hahnemannians of being *' guilty of this folly." Query: How can a physician be a H^nemannian if he does not practise in
U-
SS^rH^oTSSr' OOBRBSPONDBKOB. 69T
accordance with Hahnemann's teachings ? Dr. Pope's logic is nd generis.
As snpposed proofs of his assertions, Dr. Pope quotes the following instances : —
(1). He declares that Dr. Lippe ''has repeatedly inveighed against the common practice of repeating a medicine at inte^als* of time, &c." Dr. Idppe is doubtless as well able to hold his ground against Dr. Pope now as of old, so I will only say here that if the latter had carefully read Dr. lippe's articles, he would have found that in many cases he repeated the dose, as do all Hahnemannians when they consider the case requires it. But Dr. lippe cures even when he does give a single dose, and what more does Dr. Pope ask for ?
(2). Dr. Pope quotes me as saying *^ that in whitlow (and by analogy in other cases of suppuration) it is not necessary to evacuate the pus.*' In this quotation he has not observed *< the totality of the symptoms." He has quoted my words shorn of their *< conditions and concomitants." If he will read the subsequent sentences, he will find that I refeired to cases where «< the truly homodopathic remedy is given," and not to cases- treated allopathicaUy or pseudo-homoeopathically. This makes all the difference. The views I here expressed were subse- quently confirmed by me in another case of whitlow, where under ttie action of a few doses (not a single dose this time 1 1) of a very high potency of hepar, which corresponded accurately to the symptoms of that particular case, the pain was removed and the pus absorbed without any discharge. Dr. Bushmore, of Plainfield, New Jersey, U.S.A., has published a case verifying my statement, and Dr. Fincke has repeatedly verified it also. I recently treated a mammary abscess occurring after weaning. The swuUimum^ in a high potency, first relieved the pain and constitutional symptoms, and afterwards the abscess discharged without the use of the knife, and she made an excellent recovery*- But if I find that the best selected medicine does not speedily relieve, then I know that, either firom the imperfections of our Materia Medica or my own asinine stupidity, I have failed to solve the homoeopathic equation, and Uien I evacuate the pus artificially as soon as possible ; htit tliese latter cases do not heaZ up so well as when the simiUimum is found and no knife required, (8). Dr. Pope's quoted case of perineal abscess I decline to receive as evidence, until I know the names of the two ** Hahne- mannians " referred to, aiid hear their version of it. At present I will only say that I was not one of them. Furthermore I can find no perineal symptoms under eroton; and as the prescribers of cm. potencies are very accurate in their selection of the remedy, this discrepancy stamps the case as one about which there is a mysteiy to be solved, even if it is not altogether apo-
698 COBBBSPONDBNOB. "^SStJiiSJrTS!
cryphal. I am also nnder the impiessioii that Dr. Lippe onee pablished a similar case in Dr. Pope's own journal, cured willi plumbum, without any operation. Dr. Pope had better look vg this case and see.
(4). l)r. Pope accnaes me of " disclaiming the nse of any anzitiary." If he will insert the word " medicanal/' he will be a little nearer the mark ; and had he read my letter in conjunction with the statement which it was intended to refdte, he woold have seen that when I said my practice was '* distinctivdy homoeo- pathic, and nothing else/* I meant that I never gave medidms in any case of disease whatever, except in accordance with Hahnemann's roles. If I find that an abscess is soothed by a non-medicinal poultice or by bathing with hot water, I prescribe Boch treatment ; bat if I find that heat aggravates, I do not pre- scribe it. This is very different firom prescribing a poultice in all cases '^ to draw it to a head,'* just as some routinists pre- scribe iiepar in all such cases for a similar purpose. Some abscesses are made much more painful by poulticing.
While I am in the sphere of controversy, let me reply to the statement on page 511 of the Review, Dr. Drysdale could not in 1852 have '* shown ** that Jenichen's high potencies were really low, because he did not know how they were made. No one knew except Hering, and he communicated Jenichen's method to me both orally and by copies of Jenichen's letters. Dr. Drysdale's sole source of information was Bentsch's '< con- jectures,'* which are valueless.
Again, you state that Dr. Burdick has *' shown '* that Swan's millionths " are really the tenth or lower. Dr. Burdick has not shown " this ; he has simply made an assertion. This asser- tion, with the promise to publish his experiments, was made just five years ago. As the promised experiments have never yet seen the light, I can only conclude that Dr. Burdick himself is not satisfied wiiii them.
But the argument cuts both ways ; for if Dr. Burdick's physical test is to be held conclusive against the altitude of Dr. Swan's potencies, Dr. Skinner's physical test must equally be held con- clusive in favour of the enormously high degree of attenuation of the potencies made on his own plan, and that of Fincke.
Yours, Scc.f
E. W. Bebbidge, M.D.
48, Sussex Gardens, Hyde Park, W.
[The petitio prmeipii is so obvious throughout the foregoing curious effusion that scarcely any reply is needed. I quoted Dr. Berridge precisely as he wrote, and oould not be supposed
CI
^t^^mSS^ OOBBBSPOHDEHOB. 699
Benew, No?. 1, 1882.
to sapply what it now appears that he had omitted. I know nothing of Dr. Boshmore, bat eannot attach any importance to the eyidenoe of Dr. Fincke, who, I belieye, asserted some years ago that by prescribing by post for a patient, with irreducible hernia, residing in Germany, he had completely cored him with some ''potency " or other deriyed from his patented apparatus. The evidence of such a witness is worthless. As to the case of perineal abscess not being evidence, all I need say is that I had the account of it from the lips of the patient, and that before sending my rejoinder to Dr. Berridge's last letter to press I read it over to him, and he assured me that it .was perfectly accurate. I cannot mention the names of the " Hahne- mannians " without my friend's permission, and he is at present abroad. Dr. Berridge knows both very well — one especially well! — ^Alfred C. Pope.]
OKE WAY OP TREATING PATIENTS HOMCEO-
PATHICALLY(?).
To the Editors of the Monthly HomceopcUMe Eeview,
Gentlemen, — ^I recently heard a narrative of the experiences of a lady who went to consult a soi-disant homoeopath, which is so startHngly original that I am tempted to hope you may insert it for the benefit of some of your colleagues. I give the story in the lady's own words : —
" I was ushered into the room afi»r waiting for five hours. On Temarking that the time had seemed rather long, the great man loftily exclaimed, ' What does it matter if you had to wait seven, Madam (! !) ; and what may be the matter with you ? '
" ' That, sir, is exactly what I have come to you to find out.'
« ' Hum 1 Ah ! want of tone, I see ;' and without feeling my pulse, looking at my tongue, examining my heart, or asking one single question further, the physician took up a packet of powders from a lot of others, ready prepared, and handed them to me, saying, ' I think these will exactly suit your case.' I asked what the fee was, and was informed graciously that it was ' only a guinea.' Here my indignation got the better of me, and I said, ' And that guinea, sir, I decline to pay, or to take your medicine either ; you have neither examined my tongue, or felt my pulse, which an ordinary chemist would have done, and then you give me some medicine which you say will exactly suit
my case. No, sir, I will neither pay your fee, nor take your
medicine.' — Eait. (Curtain).
700
On reaching home the lad^ vrote sajing that after the veiy onrsory examination he had made, he oonld know nothing of her onBO, bnt she wonld be glad if he wonld answer her queries, as to place of abode, climate, diet, &o., &e„ and enclosed his toe. Strange to relate, tiie letter airived, all her qneiies were answered, and a sheet of inatmctiona giTen.
And this is what Tast nnmbers of the pablic believe to be homceopathy, The above case I can vouch for. Plenty more if required.
I enclose my card, and am, Gentlemen,
Tonrs, &e.,
VniDEX.
London, October 16th.
NOTICES TO CORRESPONDENTS.
,% JFe earatot midtrtakt (o return r^ected mamueripU.
BOOKS RECEIVED.
The ffomaopalhie World.
The StiuUnU' Journal.
The Chemiit and Druggul.
The Indian Homaapathie IUv{e«. OalontU.
The Calcutta Jmimal of Medieirte.
The New York MtdittU Tumi. September.
The Ntv England Medical Oaulte. Soaton.
The American Obierver.
Eotnbopatitche RttnAtehoH. Liipzig.
BoUtin Clinico. Madrid.
Vielettnett of VivUection. Lamon Tail.
The Seamh after Truth. Dr. Drory,
BomaopalhU Joantal qf OUtetria. Ifew Totk.
mi Lou pQttneie*. Dr. B. U. Faine, Albany.
I, Dupeniaiy Beporta, and Books for Beview to be aent to >TaB Bhowh, as, Beynmiu; Street, Foitman Sqaars, W., <x to KKDi, le, Montpelier Bow, Blaokheath, BM. AdTcetiaamanta ineas ocmmnnioations to be cent to Ueaars. B. Oodlb & Sov, 8ate8t)Mt,E.a
jSri^D^^'riSffli^ BOHOOL OP HOM(B0PATHY. 701
THE MONTHLY
HOMOEOPATHIC REVIEW.
THE LONDON SCHOOL OF HOM(EOPA.THY.
A moHLY important meeting of the Goyemors and Sab- scribers of this institution was held at the London Homoeopathic Hospital on the 26th of October. Its object was to receiye the report of a snb-committee, appointed, at a meeting held in April last, to make enquiries regarding the incorporation of the School. As a result of their enquiries, the sub-committee presented a fully elaborated scheme of incorporation, the adoption of which was dis- cussed and finally accepted on the occasion referred to. A full report of the proceedings will be found in another part of our present number.
The proposal of the committee is that the School should take advantage of the arrangements made in the Companies' Acts, 1862-67, which proyide for the incorporation of scien- tific and other Societies by the permission of the Secretary of the Board of Trade. Under these provisions, various similar bodies are incorporated — such, for example, as The Uniyersity of Durham College of Medicine, The Physical Society of London, The Philological Society, The Anthro* pological Society, Uniyersity College, Bristol, The Institute of Chemistry of Great Britain and Ireland, The Institute of Mechanical Engineers, The College of Organists, The
Vol. 26, Ko. 12. 8 4
702 SCHOOL OF HOM<EOPATHY. ^^S^J^^S^'TtStt
London Society for the Extension of University Teaching, The Association for Home Hospitals, and fourteen other institutions of a like character.
The chief objection raised to the School taking this step was that the Charter it was proposed to apply for gave no advantages to the institution, and was consequently need- less. One speaker went so far as to describe it as '* a sham ; " a piece of criticism which, had we not the John- sonian dislike to punning, we should be inclined to regard as '' a shame." At the same time, we have no doubt that the objection urged was entirely due to a quite excusable want of knowledge of the effects of a charter of the kind.
In the first place, it is perfectly clear that did not certain advantages, well worth having, pertain to the possession of such a charter, the bodies we have named would not have gone to the expense of procuring them.
We will, therefore, endeavour to point out what the chief of these advantages are. In their report, the sub-committee summarise them as consisting in rendering the management of the School more exact and precise ; in strengthening public confidence in the stability of the institution ; and in rendering its permanence more thoroughly assured.
One of the effects of incorporation, in the manner pro* posed, will be that the School can hold property in its own registered name ; while dealing with such property is &Gilitated, and the expenses of trustees are avoided. It alao becomes incumbent upon it to keep a registered office, a register of members and of councillors, and also of all securities, whether mortgage, bond, or otherwise. And under the deed of incorporation it is rendered imperative that the entire income and proper^, bowsoev^ derived, shall be invested and applied solely to the maintenance of tha credit of the institution, and the carrying out of die objects set forth in the memoiandum.
BSriSJfnSnrS^ school of HOMCBOPATiBT. 708
The School thus at once beeomes a public body, ia the fullest sense of the term ; and any infringeoaeoit of iJ^ obligations imposed npon it on the part of those entini$rii^ with its management can be reported to the Begistrar, .aoid by him to the Secretary of State, and if proved, he viiited with penalties on those who are respoBsible for its manage- ment.
Such provisions as these, do, we maintain, conduce in a vQiy thorough manner to the precise and orderly direotion of the institution; and, m proportion as they do so, do they contribute to create confidence id the application of the funds provided by the public for its purposes*
The name of School becomes inviolable. It will be impossible for any other body to assume the same or any similar name. This is provided for by the 18th aecti<m qf the Act, which states, as the first result of the granting of a certificate of incorporation, the creation of an ii2stiti^tLO|i as a body corporate "by the name contaix^ in tbe memorandum of association ; " and again, by section 90, the Registrar is prohibited from placing upod the jregifiter any company having a name identical with tbM ^ea^ registered, or one having a name so nearly rea^p^bling that of the previously registered company as to be calcu/* lated to deceive. Hence, the registwed oame bepon^ a right, and renders any attempt, through the use of a similar name, to divert money from the iiistiitatiQQi whether bequeathed or subscribed, impossible tii^o^t incurring a liability to pemal Gonseqnencesu '^M^ ffiw, if any, would feel inclined to mour.
A great deal was made of the ipomet .ot anjope to ;use the initial letters denoting nuuacibershipfof the SphopL .To this it may be replied that rthe initial iletters of axQT institution, howsoever inooijpQraited, may be flraiidnlep% wed. The magic letters M.D^ whenoesoevor ottained^
3 k'-2
704 SCHOOL OP H0M<E0PATH7. "fel^^?2??^
Beview, Dee. 1, VBOt,
may be thus employed. For example : A quack doctor, who described himself as M.D., was on one occasion summoned for so doing before a bench of magistrates. When asked on what grounds he called himself a doctor of medicine, he replied that he had done nothing of the kind. To the further question, what then did he mean by appending the letters M.D. to his name, he answered that he meant that he required " Money Down." It was im- possible to proTe that he did not intend this interpretation, and law was powerless. Any cobbler may style himself an F.B.S., provided that he can produce evidence to show that he only desired that people should understand that he was a First-Bate Shoemaker !
There is, and can be, no copyright in initial letters, which may be made to do duty for any words commencing with them. But at the same time, there is a copyright in words; and no one, we apprehend, could use the name Incorporated London School of Homoeopathy, without rendering himself liable to prosecution. This we regard as an important security in obtaining funds in suppcrt of the institution.
Further, by becoming a ''body corporate," the institution acquires all the advantages of perpetual succession, and of having a common seal, under which any business in any part of the world may be transacted. So long as the members of the institution number seven, so long it exists. Its permanence, as an institution, becomes thereby assured, and an additional reason for public confidence is obtained. This idea of permanence was, singularly enough, regarded by some as an objection. It was argued, that we are in this way stereotyping homoBopathy, that we compel the retention of the word homoeopathy for all time, and so prevent the adoption of any improvement that may be made in therapeutics. Now we all know, and so thorough-going
aSSSSTDSfiTSS** SCHOOL OP H0MG50PATHT. 705
a hoDKBopathiBt as was the late Dr. Gabboll Dunham has admitted, that there is no finality in homcBopathy. Medicine is a progressive soience, and while we recognise in homoeo- pathy the most advanced stage at which therapeutics has arrived, it is impossible to assert that there is not one still more advanced to be reached in the future. A reference to the memorandum of association shows at once that this has been fully recognis^ in two ways. First, in Article 8, sub-section g, which describes as one of the objects of the corporation : —
" The advancement, encouragement and dissemination of pro- fessional knowledge, study and research, and the results thereof respectively by all or any of the following methods, viz. : — ^by the establishment and mamtenance of physiological, pathological, pharmaceutical, chemical, botanical, surgical, and other labora- tories, museums and institutions ; by the delivery of lectures and instructions in all or any branches of a complete medical and surgical education ; by giving prizes and rewards ; and by giving to such persons as — ^being already legally qualified practitioners of medicine or surgery in the state or country of which they are citizens — shall have attended such courses of instruction given by the Corporation during such a period or periods of time, and shall have passed such examinations as may from time to time be 'prescribed by the Governing Body of the Corporation (such examinations to be conducted by teachers, professors or prac- iitioners of medicine or surgery duly qualified by law and 'appointed from time to time by the Council), a Certificate of Fellowship certifying the recipient's knowledge and proficiency in and fitness to practise 'homoeopathy,' or any modification ihereof."
How, we would ask, could a fuller scope of study and enquiry be well drawn than is here set forth ?
Then again, secondly, when the time arrives when liomoeopathy as a therapeutic method shall be superseded .by something infinitely better, and when, in consequencOi
706 SCirOOl* OF HOMCEOPATHY, "S^^Sl^St
ft Sdiool of HotiMdopathy will be needless, it will be in the power of the corporationi by the 65fch article, to be ^ wottnd tip Yoltmtarily, whenever a special or extraordinary resolntion, as defined by the Companies Act, 1862, is passed, requiring the corporation to be wound np Tolnn- tarily."
A remark of Dr. DudOeon's in support of this form of objection must be noticed. Asking what would be the efiect of the memorandum on the School, he replied: *^ They would be crystallised in their present form, and they would never be able to stir from the terms of that x&emorandum. Medicine was a progressive science, and homcBopaths were not going to stand still any mere than Were their medical confreres. Even now, homoeopathy is modified from what it was in the time of BEahkemann. Why should the School be crystallised in this way ? " What is exactly meant here it is not easy to state with any degree of certainty. But how an institution, which obtains a special right to give *^ instruction in all or any branches of a complete medical and surgical education," can be said to be less progressive than any other Medical School, we do not understand. Dr. Black regretted the proposed step because it would prevent our being able to get away from the word homcBopathy. Some, we hope, still survive amongst us who are prepared to sustain the use of this woid in all suitable places, and under all appropriate eueumstances ; some there are yet who do not desire its abandonment, in deference to the prejudices and passions of an ignorant, intolerant, and domineering majority of the profession ; and not only some but all, save a veiy few, who have realised the truth and value of homoe(q>athy.
The simple answer to Dr. Blaok here is, that so long as tke existence of this Sohod is necessary, so long will the tiite of tbe word honueopathy be necessary. When it
SSd^riSnTSS?^ school of homoeopathy. ' 707
l>ecoiQ6ft unnecessary to teach homoBopathy, then the institution can be wound np and the word homooopatby be decentiy interred.
Br. Dudgeon, as we have said, referred to the improve- ments which had taken place in homosopathy since the time of Hahnemann as affording positive evidence that forther improvements would occur, which, from the objection he has to the use of the word homoBopathy, we may suppose will involve its death and burial. While various alterations have been made in the method of putting homoeopathy into practice since the days of Eahnejkunn — alterations which some regard as improve- ments, and which others do not look at in the same light — ^homoeopathy itself is unchanged. The principle is still the same ; the properties of medicines are still ascertained by provings ; medicines are still given uncombined ; the dose is still small. This was the homoeopathy of the time of Hahnemann ; it is also the homoeopathy of our own time. No therapeutic doctrine has ever had so lengthy an existence. Before the day arrives to which Dr. Black and Dr. Dudgeon look with longing eyes, when homoeopathy shall be rendered needless by some larger and more successful therapeutic method, homoeopathy must be understood and practised by the entire profession of medicine. All improvements take place by a process of evolution. In all instances of scientific progress it is from the best plan that existed previously that the better, which is presently triun^hant, was derived ; and it is from this thai the still better of the future will be drawn. It is 80 with therapeutics. If a better method than homoeo- pathy is capable of being devised and put into practice, it is from homoeopathy that it must be worked out. Such being the case, it is all important that homoeopathy be systematically taught. It is the best therapeusis d the
708 SCHOOL OF HOM(BOPATHY. ^'bSSi^S?!^
day, and consequently contains the germ of the best of the fatnre. Where can this germ be better noorished and cared for than in a School especially devoted to give *^ instmction in oU or any branches of a complete medical and snrgical education?" Or in one, the very raison cCitre of which is the investigation of homoeopathy ?
So far, then, from regarding the incorporation of the School as undesirable, because it will prevent our getting away from the word homoeopathy, we look upon the en- shrinement of that word in the memorandum of association as a distinct advantage, as tending to its conservation, so long as the vitality and development of homoeopathy may be necessary for the advance of medical science.
This naming of the name of homoeopathy with bated breath is, to us, one of the most deplorable signs of the times, BO far as our therapeutic method is concerned. The desire, which is so frequently expressed or hinted at by a few, to see the word homoeopathy blotted out of the vocabu- lary, is doing more than anything to check enquiry into what homoeopathy is. Among those who entertain views of this kind are some who, we know, are as anxious to see therapeutics universally based upon homoeopathy as we are ourselves. But what is the effect of their giving expression to such desires upon those who do not know these our colleagues? Its effect, unquestionably, is to cast a doubt, and a good deal more than a doubt, upon their sincerity, upon the reality of the convictions they have professed. ** See,'' it is said, " here are men who have professed to believe in homoeopathy, who are supposed to have practised homoeopathically, who have appeared tb work earnestly and unselfishly in defending the doctrine they have espoused through many long years, and now they are striving to extinguish the name of this very doctrine they have seemed to believe in and to practise ;
t^jD^^^w^"" SCHOOL OF HOMOEOPATHY. 709
can Bnch a doctrine as this be worth the tronble of an enquiry?" This is no mere hypothesis. An argument of this kind has within our experience had the very natural result of stopping an enquirer into homoeopathy from pur- suing his investigations. It becomes, then, particularly incumbent upon those who feel that the teaching of homoBopathy is a public duty, and that this method cannot be effectually taught without the use of the word, which for nearly a century has defined it, to take every precaution that this word is not lost sight of before its time — and most assuredly that time is not yet. One such pre- caution is taken when it forms part of the title of our School.
Another objection brought forward was that the School, in this memorandum, sought power to grant a certificate of knowledge of the special subject taught at the School to those who had been found to possess such a degree of that knowledge as to entitle them to evidence of their having acquired it. This, we confess, rather surprised us. The objection to the proposal made last winter by a meeting of the governors and subscribers to confer a diploma of Licentiate in Homoeopathy, differs in toto from that now made. The *' L. H." was a license in name, at least, and the use of this word gave the impression that the School * intended to confer a power which they had no inherent right to confer, to issue a commission to an individual to do something which any medical man is at liberty to do. By the memorandum of association, it is provided that duly qualified medical men shall, after having had their know- ledge of homoeopathy adequately tested, have ** a certificate of fellowship certifying the recipient's knowledge, and proficiency in, and fitness to practise homoeopathy," given to him. We always understood that those who opposed the license were quite content that a certificate of this
710 SCHOOL OP HOMCBOPATHT. ^''SS^
kind should be awai-ded to fit and proper persons by the authorities of the School. The holder of the ceriifieata beocHnes^ by irirtue of having it, a feUow of the c(»poratioii ; bat unless a subscriber and guarantor of one pound — a sum which cannot be required unless, oa the winding up of the corporation, the funds in hand are inadequate to- meet outstanding debts — he can take no part in the business of the corporation. The object here is to have a line distinctly drawn between the professional and lay members of the corporation, the former being styled *' Fellows " the latter " Members."
In endeayouring to ascertain, and after haying satta- factorily ascertained, the sufficiency of the knowledge of homoBopathy possessed by a gentleman who proposea to practise homoeopathically ; in giving him the right te describe himself as a Fellow of the School, we are doing nothing which is beyond our power whilst unincorpenAed. But while it is only just that so legitimate an end of teaching a special branch of knowledge should be indaded in a memorandum of this kind, it is also necessary that every intention of the School should be laid before the Secretary of State, that he may have the power to place his veto upon any that it may seem to bin) unadvisable to grant. Whether there is any precedent for empowering a corporation to grant a certificate of this kind> in the manner set forth in the memorandum, we know not; bat the privilege sought is one which can only result in good, can have no other ^id than the public benefit, oonfeis no special power or right on any one. It is merely a testamur, on the part of an educational body, of tbe possession by an individual of an amount of knowledge adequate to enable him to turn jko useful acoount the in* atructions he has received from tbe educational body in question. It is farther fully set forth in the memorandum^
BSSSSfSTlTSSf** SCHOOL OF HOMCEOPATHY. 711
becanse the corporation xniiBt restrict its operaticms to the lines laid down in that doctunent ; and it is donbtfol whether, if the Begistrar's certificate were granted withont snch a provision being contained in the deed, the corpora- tion would not be debarred in the fature from doing that which, in the meantime, the School is perfectly free to do.
If the British Homoeopathic Society is entitled to grant dqplomas of fellowship and membership to persons who are merely proposed and seconded as such, and if the initial letters of such diplomas not only can be, but constantly are, used to signify that a knowledge of homoeopathy is possessed by the fellow or member, surely a body which grants its fellowship only to those who haye given evidence by examination of their knowledge of the subject, is, to say the least, equally entitled to grant certificates of fellowship! Any qualified medical man of good pro- fessional character, who is prepared to sign a declaration to the effect that he will do all in his power to advance the interests of homoeopathy, is sure of admission to the Society, and can go forth, and, by describing himself as M.B.H.S., obtain the reputation of being familiar with the practice of homoeopathy. With the Incorporated London School of Homoeopathy something more will be required ere its fellowship is obtained, and that will be a something which it is to the public advantage should be demanded before a medical man is in a position to use his connection with the School in such a manner as to sustain his pre- tensions to a knowledge of homoeopathy.
We conclude, then, that a deed of incorporation, such as it has been decided to apply for, gives a security to the property of the School, and ensures the expenditure of its funds in a clearly defined manner, far more fully and com- pletely than is the case with a purely voluntary association. There is in the former instance a direct State control
712 VETEBINABT SCIENCE, ^SSSr^*?^
1.
which does not exist in the latter. As the School funds amount now to nearly two thonsand pounds, and as there is every probability that this sum will be largely increased, especially if this additional security is obtained, it is eminently desirable that every effort should be made to acquire it.
The certificate of fellowship it is proposed to confer upon those who have by examination shown that they possess a knowledge of homcBopathy sufficient to enable them to practise homcBopathically, is entirely free from any of the objections which were alleged against the Licentiate in Homoeopathy diploma. It is a document which the School would be perfectly justified in giving without any deed of incorporation.
The deed has been described as '' coiumercial ; " but inasmuch as it emphatically prohibits the members from deriving profit from the operations of the School, or from its invested funds, such a description is simply misleading.
As we have pointed out, this deed of incorporation, if obtained, will give to the property of the School and its ^stribution increased security ; and, by doing so, will add io the public confidence in the orderly and efficient manage- ment of the institution.
Were there no other advantage to be obtained from incorporation, it, and it alone, would form an ample justi- 'fication for making the effort necessary to secure it.
VETERINARY SCIENCE, PAST AND PRESENT.
Wht Homceopatht has exeboised little influekce on IT ; WITH SuaoESTioNS, AaoBESSivE AND Engoubaqing, fob
THE FUTUBE.
By J. SuTGLiFFE HuBNDAiiL, M.R.G.y.S., Liverpool.
When we take into consideration the very large proportion X)f persons who in one way or another are interested in the welfare of the lower animals, it is surprising how marvel- lously little is known about those whose aim in life is to mitigate the various ills to which animal flesh is heir.
ltato^^!Ti§ffl!^ VETBBINABY SCIENCE. 713
It is not surprising that laymen should sometimes — indeed, as a role — ^be unable to account for the indisposition of their only too willing servants and pets, as it is impos- sible to learn anything from them subjectively; but one would consider that this very inability on their part would encourage a disposition to become better acquainted with those whose whole life is devoted to the alleviation of animal suffering, crude and imperfect though the knowledge of the practitioner may have been.
The vast amount of wealth which in Great Britain is^ represented by the value of horses, cattle, sheep, swine,, and the various kinds of sporting dogs kept by gentlemen, either for pleasure, utility, or profit, should ensure to the veterinary surgeon a position of respect second to no othev profession. It is, however, a fact, that until within recent years practitioners of veterinary medicine do not appear to have commanded, as a body, so high an estimate of their worth, nor to have occupied such an exalted position in public opinion as the members of the sister profession- There is no doubt that the high standard of opinion which is very properly taken of the value of human, as compared with lower animal life, in a great measure accounts for this; but the disparity in social and professional status^ between the two branches of medicine, so apparent in bygone times, requires a deeper explanation. It is not proposed to discuss here the why and wherefore ; different, persons will be able to offer each their own particular reason ; it is merely stated as a fact, in order the better to compare the past with the present, and as a point to start from. In the opinion of many, to make such a comparison may appear invidious, but why should it? Those who understand the value to the human pathologist of the study of comparative pathology, will know that the intelligent student of disease among the lower animals has informa- tion at his disposal that may be of infinite value to the physician, and they will readily recognise the place that should be assigned to those who, in the practice of the veterinary art, have brought intelligence and education of a high order to bear upon their work.
It nevertheless remains a matter of surprise that there are still so many persons, for whom the well trained, veterinary sorgeon could save so mach in actual pecnniaiy value if only offered the same opportunities of treating patients as practitioners of human medicine enjoy, who
714 VETEBINABY SCIENCE. ^'^^rfD^^fSS?
neglect to call in professional assistance altogether, or leaye it until it is too late for the professional adviser to have anything like a chance of effecting a cure. This is one of the difficulties against which the better educated veterinary surgeon has in the past had to contend, by reason, it is presumed, of the failures of illiterate empirics, who merely prescribe by rule of thumb, quite regardless of scientific reasoning. It is a difficulty, however, which is capable of being surmounted by a steady and consistent earnestness in the prosecution of duty, and by fostering a continuous and ever-increasing thirst for Imowledge, a course which in the long run must tell its own tale.
For the past ten years or so the veterinary profession has recognised the importance of developing a higher standard of general and professional education, and led by several enthusiastic worshippers of the art, well qualified to undertake the arduous responsibility, much has been and is still being done in this direction. It is to this feM^ that thoughtful attention is invited, for it is of the first importance it should be understood that, as a profession, we are by no means at a standstill. Thei-e are those in our ranks who are keenly alive to the rapid strides that are being made in scientific discovery, especially in the sciences of physiology and pathology, and it may be confidently stated that the number, among our younger practitioners, who take a deep and growing interest in pathological research is steadily increasing. It requires only a corresponding stimulus to that enjoyed by students of the sister profession to ensure a proportionate amount of energy in this direction among the students and practi- tioners of veterinary medicine.
Important responsibilities, arising out of an ever increas- ing property in cattle, sheep, and valuable horses, are, an4 will more than ever in the fdtur© be, undertaken by men whose zeal for the honour of their calling is only equaHed by the inaportance of the work they are called upon to perform. Reference is made to the future with a confidence that only one who is personally acquainted with the gentle- men on the teaching staff of the Royal Veterinary GoUegey would undertake to anticipate ; Irat it may venly be pre- dicted that if the mantle of EKjat is allowed to faH upon Elisha, the present and future generations in the veterinary profession will be men of thou^t and mark, who will leave behind them proofis of useful lives, spent not merely "for the
SS^dSTmS*^ vbtbbinary science. 715
benefit of the lower animalB, but the human race also, by reason of their contribntions to the higher branches of scientific research. Without being invidious, we may be permitted to state that there are few men among the teachers of the special sciences who bring higher qualities io bear upon their work than the present Principal of the Boyal Veterinary College ; he is a man of culture ; an •enthusiastic and untiring worker ; he possesses great aUility to communicate knowledge ; he has had the advantage of wide and extended experience ; and he takes a deep and sincere interest, professionally and morally, in those who ^come under his influence.
Probably few persons among the laity are aware that quite recently the veterinary profession has obtained from the legislature an Act of Parliament which ensures to qualified members of the Royal College of Veterinary Surgeons that legal protection in the practice of their art, which, in the opinion of many, they should have enjoyed for some time past.
Henceforward, only those who have gone through the prescribed course of study at the Boyal Veterinary College or one of the Scotch Veterinary Colleges, and thereafter passed successfully the examination before the examining body, from time to time appointed by tbe council of the Boyal College of Veterinary Surgeons, can legally practise as and entitle himself a veterinary surgeon ; those who were earning a living as practitioners prior to the passing of the Act of 1881, for five years before that date, may^ by application to the council of the Boyal College of Veterinary Surgeons, be enrolled as '^ Existing Prae^ titioners," provided they satisfy the council that they are of good morals, respectable members of society^ and sufficiently acquainted with the rudiments of treating disease to enable them to practise their calling with fair prospect of success; their place on the register mD be distinctly defined under the heading of " Existing Practitioners," in order that no mistake may arise as to the poaition they occupy. Anyone who attempts to establish himself as a veterinary surgeon hereafter wbo does not hold the diploma of the Boyal College of Veterinary Surgeons, renders himself liable to severe penalties under the Act ; and it behaves the public in its own interest) as well aa members of the profession, to see to a, that no one attempts to put Idiis '^ Act " at defiaooe.
716 VBTBRINABY BCDSNCB. ^'"rSS^^^D^T^.
It may be interesting and nsefdl that we shonld indicate what sabjects the yeterinary student has to read np and submit to be examined upon before he can obtain the diploma; they are as foUows, viz.: — Botany, Chemistry, Materia Medica, Physiology, General and Comparative Anatomy, Morbid Anatomy, Horse and Cattle Pathology, and Helminthology ; he has abundant opportunify of obtaining practical experience and making clinical obserya* tions, if so disposed, among the numerous patients admitted to the infirmary of the College; on this last point we refer, so far as personal experience goes, to the Boyal Yeterinary College, but doubt not that similar opportuni- ties are afforded at the Scotch Colleges. There is also very superficial teaching in the practical work of shoeing ; but of the superficiality we do not complain, as in our opinion the man who is well up in the anatomy and pathology of the foot is quite as well qualified, and probably far better, to give instruction what particular sort of shoe a horse may require, as he who is an adept at removing and putting on shoes, and who has swung the blacksmith's hammer until he has an arm like Hercules. For our own part, we haye heard about " practical men " until we are nauseated by it ; our motto is, let practice and theory go hand in hand, for the one cannot do without the other. *
Whatever may have been the general public opinion in the past in favour of the so-called ''practical men," it should be understood that there has always been a broad line of distinction between this highly favoured individual, who as a rule never had passed an examination in his li& — and could not have done so to save it, had needs be — and the man who had qualified himself to practise by hard study and a stringent examination.
Such a statement seems at first sight to be not only unnecessary, but absolutely ridiculous ; nevertheless there is good reason for making it, and no one is more responsible for its necessity than that portion of the pubUc who from time to time require the services of the veterinaiy surgeon. The explanation is not feur to seek. These gentlemen have not troubled themselves to find out who are really qualified and who are not ; as a rule that man who is most addicted to surgical operations, wields the scalpel with the greatest boldness, or applies the cauterising iron with the least regard to the patient's sufferings, is he who is thought
It^SHTvSS^ TEIHMHABY SOIENOE. 717
most of ; or the aelection of the praotitioner is kit to the dLBcretion of the ooachman or groom, neither of whom uoe as a role oompetant by education to form an opinion on the matter ; they may be goided by hearsay, or, if nnscrapiiloiifl» will try to find the practitioner who will lend an ear to propositions about ''commission on the account; " and it is useless to pretend that no qualified members e^ex lent themselyee to such dishonest practices ; doubtless there are black sheep among our number as in every other profeasioii and rank in life ; but it is hoped and belieyed they are few^ axid will continue to become fewer* Certainly this will be the case, if gentlemep will take this matter more into thedr own hands* Let it be understood, therefore, that the veterinary surgeons of to-day are no longer to be ranknd with coachmen and grooms ; it is necessary to state this in the plainest language, because custom has so ord^ed it in the past.
Thanks to the unwearying and persistent efforts of such gentlemcoi as Mr. George Fleming, F.B.C.y.S., the pres^it President of the Royal College of Veterinary Suzgeons, Professor Sabertson, Principal ol the Boyal Yeterinaij College, Professors Brown» Axe, Williams, and Whalley, the yeterinary profession will take rank with the Bister psrofession, and ere long draw forth full recognition by its own inherent aetiyity, foroa, and power, from all men ot science.
Headers of the Review will naturally look for aoone referenoe to the bearing and influence of Hahn^nann'a ^eat prineiple upon yetecinary medicine: surprise has been expressed that so &w yetarinary surgeons practise on hoDMBopathie porineiflai^ but an intimate acquaintance with all the ciresmstaneea fiBOUBhes an easy explanation to aeeoimt for ihis« It is only dnciBg the last decade that Teterinary medicine has lifted its iMod aboye a mediscn position, and it does not appear that the pfdbssion aa n whole has oyineed a snfickntly enqpniing turn o£ mind to sosrch for tntth beyond the stsraofyped rules they Isaznod in their youth. Indeed, so customacy has it always beon to administer yiery laxge doses to yetfirinary patients, thai the question of the dose itself was quite enough to oonyince the majority that Hahnemann's system of tneat- meni wsa in their pinion nothing but an inqpestoae* Unfortonataly, few hayo bean the men whoso thint lor knowledge bAs indofltd thoBito undoiMdfie the labenDoa
ToL 26| No. 12. 8 B
I
718 VETBRINABT SOIBNOB. ^B^Jw^SSTttMU
task of investigation; enide empiricism has satisfied almost the whole body; homoeopathy has been and still remains to the majority of veterinaiy practitioners a daric letter, and with a few exceptions, inclading Haycock, Lord^ and Moore, to whom hononr enough cannot be accorded, the science of similars has been recognised only in terms of reproach and scorn. This, however, need not be in the fntnre. It is probably too mnch to expect that the lead^s of veterinary medicine should condescend to the carefol investigation of the Hahnemannian principle any more than do the so-called leaders in human medicine. Possibly they would consider it derogatory to their position ; and maybe the spicy, though often bitter and venomous articles which now and then appear in the Lancet are much more satisfying to their literary appetite than would be the mental £gestion by careful study of Hahnemann's, Bahr*s, Jahr's, Dudgeon's, Hughes', Dunham's, and Hale's writings, with a view to the discovery of the real truth concerning this important subject. It does not follow, however, &at this should be a hindrance to the develop- ment of homoeopathic practice among the lower animals ; if older members of the profession are satisfied to wander on in the darkness of therapeutic chaos, it must devolve upon younger men, whose minds are less biassed, to profit by the painstaking investigations of Hahnemann and his successors.
Here there is an opening for some young fellows who are in difficulty as to what shsdl be their future occupation in life — always provided that they enjoy the following qualifi- cations, viz. : a good general education ; some knowledge of the habits, management and peculiarities of various domestic animals ; a respect for and love of animal creation ; a taste for scientific research ; a persevering and earnest determination to overcome difficulties. Thev should of course have satisfied themselves, so fiu* as minds untrained in professional study can be, of the truth, value and im- portance of the law of similars ; wisely keeping their own counsel as to their particular faith until they can afibrd to divulge it, lest unnecessary difficulties should be put in the way. of their qualifying ; for although we live in a free country, we are not allowed to be quite free to think for ourselves yet, specially in matters medical. At one time it was considered infra dig. to become a '' Yet.," as members of this profession are, sometimes sneeringly, sometimes
eSSS^^TSm?^ vbterinaby science. 719
patronisingly called ; but now every man who chooses to hold np his head with dignity and re8er7ed ooortesy, whether he have to do with peer or peasant, will be met and Teceiyed as a gentleman ; this is one of the results of higher education, and inasmach as the present President of the Boyal College of Veterinary Surgeons has been in a high degree instrumental in bringing about such a condition of iihings, the privilege of pardonable pride may with pleasure tmd satisfaction be conceded to him. There is abundant scope in this profession for well educated gentlemen, and especially so if of sufficiently studious a turn of mind to lead to the steady investigation of pathogenetic effects among the different orders of animals ; this is a study of profound interest when viewed from the homoeopathist's standpoint, and productive of immense advantage clinically. Those who have been struck with admiration at the almost miraculous effects of homodopathioally applied remedies in the human subject, may, if they will, see equally startling results effected thereby in veterinary practice ; and the fact that so few have embraced the faith in this branch of 'medicine, while in the sister branch the numbers are yearly increasing, is evidence that a fair field of operations is open to those who may have the courage to enter it.
Attention has already been drawn to some of the diffi- culties that are experienced by the veterinary practitioner, arising out of the JmpUcit, one might almost say blind, confidence placed in coachmen and grooms, and when it comes to the administration of homoeopathic remedies the difficulties are by no means lessened. It has been the custom from time immemorial to give such massive doses to horses and other animals, and to resort to measures sufficiently heroic to produce the maximum of results in the shortest space of time possible, that these men are not imnaturally very sceptical about any good being realised by such minute doses as five or ten grains of a harmless looking substance, more like sugar than ough£ else, or by a tablespoonful of a draught which is all but colourless in a wine glass of water ; moreover, to repeat these miniature doses of medicine three, or perhaps four times a day, involves, in their opinion, an amount of trouble which probable results do not, they consider, justify them in taking. The question arises, how is this to be obviated ? One answer among others would be this ! Let the master •or mistress take upon themselves to explain that it is a
T20 vETiaaHABX acuKCE. ""^^rfSSfSiSfc
syalem which relies t^mmi mneh ansballer doses of mediciao; tfaai the remedies ace speeiflUy j^epared ; that the 6aoiij has experienced great benefit firom this particular treait- aftent; that inasotneh as the doses are smaller and leas «SDpalatable» the animal is less likely to resist the adminis* tration ; that the system is moeh more humane, and that the remedies effect real and permanent cures without inter* fering with the animal's general health or exercising any lowering effects upon its c(MiStitution ; lastly, that it is the owner's wish that these remedies should have a fair trial, and that the man is expected to administer them stricUy in accordance with instruDtionB.
Acute diseases, soeh as ccdio, enteritis, bronchitis, pneumonia, pneumonic congestion, nephritis, and others dfa like description, yield very readily to homoeopathic treatment when taken in time, indeed, so rapid is the effect of the remedies sometimeiB, iJiat attendants, and even, at times, educated gentlemen, appear doubtful that aaything so serious after ail was the matter. It is in cases of seyere lameness, arising £r(»n longstanding chronic inflammaticHis of the osteal, periosteal, and white fibrous tissues, that the ingenuity and patience of the homoeopathic veterinaiy surgeon is put to the test ; not that he cannot fall bad: upon abundant and efficacious remedies, nor that he is unable to effect a cure In less time than his allopathic Qonfrei-e, but because a far greater amount of steady, per- seyeriug work on the part of the attendant is called for ; it is not so much the administration of internal remedies, as the constant application of external ones that involyea trouble. It is yery much easier to haye the horse blistered or fired, or to make the e&ct surer, haye both done under one operation^ than to systematieally rub in a lotion of arnica or rhus tox.j night and morning, for a quarter of an hour at a time, and tluii; often after spending a quarter of m hour preyiously in fomca^tiog the part.
In the face of this,, we can oaly urge all those who are genuine homoeopathUits to do what they can in proovulr gating intelligent ideaa among their subordinates of the great advantages deriyed £eom homoaopathic treatment ; m this way great results may aocrueu and the good of the aawa be loaterially einhaaeed^
It is a very good thing for homcsopathy that it doea not require yery much '' champiioiBing,'' if we may yenture i9 coin a word ; give the system but half a chance, and it will
2SSS5f^Ti^^ HOM(EOPATmc TMTtmATIONS, 721
■- — - - -- .—^ « — . — ^ — ^_.^^^ .^_^ ■ ^ . r ■ -
soon make itself felt and appreekted. Had this ]»>t been the case, it would have been stamped out of existence long enough ago; haying truth, howerrer, on its side, it has withstood all the onslaughts of the enemy, and will (xmtinue to withstand them. Were we to recapitulitte but a few of the modes of treatment resorted to in th« old school of veterinary medicine, it would make our readers' blood 4»irdle in their veins ; but we refrain, and satisfy ourselves by urging in conclusion aU who have the prosperity of the rational and humane system of homcaopathy at heart to do what they can to encourage its practice more and mote among the lower animals.
248, Upper Parliament Stroet, Liverpool. 8th September, 1882.
REMARKS AND SUGGESTIONS CONGERNtSTG HOMCEOPATHIC TBITURATIONS.
FIRST PAPER feandadedj.
By J. Edwaeds Smith, M.D„ Cleveland, Ohio.*
Ltcopodium-Spobbs.
A SAUPLS of the same alcohol used in the pr^araticm of '' S " and '' T " being at hand, my next step was to ascer- tain the specific gravity of the three s^cimens, viz* : " S," '' T," and the alcohol.
All of these having first been brought to the exaet temperature of the suiroanding air> the specific gra^rify of «ach was determined by means of a 100 grain (60^ f^.) glass capsulo, having a long capillary ueck. This instrti- ment was made expressly for me by Prof. Wood> of thia e^y. The weighings were determined on my delicate balance (by the same maker), which is oensible to the l-10,000th of a grain.
Capsule volume ai diitiUod watar
at 78^ F ..=^99.8149 graiM.
Capsule volume alcohol <^8LS280 „
Capsule volume tine *^ S " .,.=81*6010 y. Capsule volume tine "T" .v*:=81.6670
I
* Bepriuted from the Utiw TorJb MemetA Tiiim, Oetobttr, 188ft.
722 HOMOSOPATHIC TBITUBATIONB,
Beriew, Dec 1, tOBL.
By oompatation^ resting on the
above data, we haye specific
gravity of the alcohol =0.81479 „
(Corresponding to 98, 1-2 per
cent, nearly.) Specific gravity of tinct. " S " ...=0.81657 „ Specific gravity of tinct. ** T " ...=0.81819 „
Arranging these three specific gravity determinations for easy reference, we have as follows : —
(1). Spec. grav. of" S ''=0.81667 grs.p'S" greater by Spec. grav. of alcol. =0.81479 „ J 0.00178 grs.
(2). Spec. grav. of " T "=0.81819 grs.) "T" the greater Spec. grav. of "S "=0.81657 „ i by 0.00162 grs.
A simple inspection of the above figures seems to suggest : —
First. That the effect of lye. spores is to increcue the specific gravity of the vehicle.
Second. That of the two tinctures, " S " and " T," the latter is much the strongest, and
Third. That positive advantage arises from the pre- liminary triturating with the emery.
While in the act of cleansing the glass capsule, through an inadvertence, I used distilled water, vice alcohol. A precipitation of lye, immediately occurred which was at once put to a practical purpose, to wit :
Selecting two, 2-fluid drachm flat sample vials, I intro« duced into each respectively, 1-2-flaid drachms of samples ** S " and " T," adding immediately to each, 1-2 drachms of distilled water. The lyeopodium matter was at once, to a greater or less extent, thrown out of solution in both vials, the contents of each vial became cloudy. The particles thus thrown out of solution do not sink after standing quietly fifteen days. A result which might have been inferred from the specific gravity of the samples '^ S " and " T " as compared with distilled water.
The slightest glance, however, at these two vials demon- strates instantly that the tincture in *'T** is very much stronger than that of " S."
The two samples of lyeopodium tincture, after having been digested in alcohol for the period of time above mentioned, appear to the naked eye almost identical ; thej are each of a clear lemon or canary colour. On shaking
u-
JS^^nrS^" HOM<BOPATHIO TMTURATIOHS. 728
slightly both vials, the ** T " sample seemed to be more oily and heavier than the '* S."
(Note : The qaestion here suggested itself, wonld it not be a good plan to determine accurately the specific gravity of all oar homoeopathic tinctures ?)
If it be admitted that ** T " is a much stronger tincture than '' S/' the question arises, may not '' S " gain strength by longer digestion in the alcohol? To determine this point a second specimen of '^ S "='' S^ " has been prepared precisely like the first, excepting that the latter has been allowed to digest in the alcohol double the time given to '* S," viz. : fourteen days, after which the specific gravity was determined as follows :
Capsule vol. of distilled water at
74? F 99.8631 grains.
Capsule vol. of Unct. " S* '' 74^ F. 81.5988 „
Specific gravity of tinct. " S* " . . . 0.81706 Comparing "S' *' with " S " and " T " we have:—
(1). Spec. g. of "S*" = 0.81705\ " S* " greater by Spec. g. of "8" = 0.81667] 0.00048.
(2). Spec. g. of " T " = 0.81819) "T " greater by Spec. g. of "S*" = 0.81705 J 0.00114.
Thus it becomes evident that '' S^ '' gained but little strength from the prolonged digestion in alcohol. Fur- thermore it is improbable that any amount of time would suffice to bring " S " to the standard of " T."
Bepeating the ** flat-vial*' test with sample ^^S"" and comparing with ** S " and ^* T," the specific gravity test becomes at once confirmed by the eye alone.
Obviously, the spec. grav. of lye. tinctures only becomes an index of strength when the spec. grav. of the alcohol is known. Ergo, fluting the alcohol with water would serve to increase the spec, gravity, and also to reduce its solvent properties.
It may be observed, on the other hand, that the ^' flat* vial " test is nothing more or less than a rough analysis by the volumetric method, and yet sufficiently determinate for the general purposes of the practitioner. In the case of lye, Sie '' standard solution " is simply pure water, which will always serve the purpose with all tincts. prepared with strong alcohol as a solvent. It would not, I opine, require
724 HOMCEOPATHIO TBITT7BATION8. ^'S^^S^^um!,
macb Btndj to adapt this yial metliod to the ezaomnatiim of nearly all onr homoeopathic tmctmeEr.
My next experiment was to tritozate the spores first with aleokol before adding the sugar of milk. In order to giuurd against tixe effects of evaporation the aloohol was added in fractional portions, thus : —
(W)=One-foarth ounce of lye. spcfren tritunU»d wiili two and one-fourth fluid ounces of 98, 1-2 per cent, alcohol, the alcohol was added in divided lots for three and on^ half hours, finally adding two and one-fourth ounces of sacch. lac. Mix and again triturate.
(W* ) — " W " triturated one and one-half hours. Besult : spoi^es but little broken, and aggregated together in large ** colonies."
(W** ) -- " W ' triturated two and one-half hours. Result : the aggregations or " colonies " become more numerous and smaller, yet the contained spores still appear to be but little injured.
(W')="W" triturated three and one-half hours. Besult: the spores are now observed to be getting decidedly the worse for wear under the pestle. Nevertheless^ iheie are but few spores actually broken up, the ^* colonies " are getting smaller, but are plainly recognised.
(W^)=.'*W" triturated four and one-half hours. Besult : spores about the same as in *' W* " — a plenty of whole spores to be seen^ say 30 per cent.
Thus far it will be noticed that all the triturations dealt with were prepared according to the decimal scale. I therefore deemed it advisable to introduce a centesimal trituration, as follows : —
(B) - 10 grains lye. spores \= 1st cent. trit. +990 grains sacch- lac, /Mix and triturate.
(B*) = "B" triturated one hour. Besult: no un- doubtedly wholly unbroken spores seen. The fracture- spores congregate in masses.
(B^)==«B" triturated two hours. Besult: Five unbroken spores discovered.
(B* ) = ** B " triturated three hours. Result : Four nnbroken spores seen. Also several large pieces in a ehimp together.
ISlSSiH^S^im^ HOM(EOPATRIC TBSTlIB&TIONS% 725
(B^) = "B" triturated Sowc hours. Besult: TliMe eutire spores discovered. Also several pieces easily reeog* nised.
(B* ) = " B " triturated five koois. Heffult : No whole spores seen. One large piece, as large as four-fifths of a spore, was discovered. Also several tolerably large pieces.
(B' ) = " B " triturated six hoars. Result : No whole spores. Several tolerably large pieces, noticed.
(B"f) = " B" triturated seven hours. Result: Several places are still to be seen, but no whole spores.
(B"" ) r= <' B '' triturated eight hours. Result : No whole spores* There were a few pieces still to be seen.
Bbmabks.— Comparing "B*" with "B^,'* *'B*" and '"B"^," it will be noticed that, although no whok spores wwe tfscovered in '^B*",'' the contraafy was the case with the subsequent Mturations; this apparent anomaly may possibly be reconciled when it is remembered that we are BOW dealing with a centesimal trituration, requiring a longer time to secure the equai dififusion of the c&ug throughout Ihe mass of the trituration.
It is a rule among pharmacists, I believe, to triturate 100 grains ten times as long as they do 10 grains. Recog- nising this law, the whole amount of material triturated in *' B " was arranged to approximately correspond to that of the (1st dec.) ^* 0 " trituration previously mentioned.
HANB-KABE TBITUBJLZIONS.
By the courtesy of Dr. M. J. Rhees, of Wheeling, West Virginia, I am enabled to include in this paper the examination of the following hand-made triturations of lycopodium (prepared by the Doctor personally) lately sent to me for study under the microscope. Believing the details of the method pursued by Dr. Rhees to be of interest, I present them entire, to wit : —
His first decimal trituration is obtained as follows (I quote from his letter by permission) : ** I first rubbed one grain of lye, spores in a Wedgwood mortar alone three minutes; scraped it together five minutes; rubbed five minutes; scraped five minutes; rubbed two minutes; = 20 minutes. Added one grain sacch. lac, and rubbed three minutes ; scraped five minutes ; rubbed two minutes; seraped five minutes ; rubbed five minutes ; scraped five minutes; =s 25 minutes (total 46 minutes). Added eight
726 HOMCEOPATHIO TBITUEATIONS. '"aSSr^ET^
Beview, Dm. 1, UBt.
grains sacch. lac.f and triturated three xninntes; scraped six minutes ; triturated six minutes ; scraped fiye minutes r = 20 minutes. This is iixe 1st x trituration. Time = 65 minutes. Took out one grain, which I sent to you."
Microscopic examination. — ^The lycopodium appears in masses. My first observations over this specimen failed to show eyen one whole spore, which fact was at once reported to Dr. Bhees. A protracted subsequent examina- tion, howeyer, displayed one whole spore.
Dr. Bhees' second decimal = 1st centesimal trituration was prepared as follows (I quote again from his letter), to wit : '^ I now added 81 grains of sacch. Uic. to the remaining nine in the mortar. Triturated eight minutes ; scraped seven minutes ; triturated eight minutes ; scraped seven minutes ; =: 80 minutes. Total time, 1 hour and 86 minutes. This completed the 1st centesimal tritura- tion, of which I sent you a powdar."
Microscopic examination : — Two tolerably large masses- of the drug seen; otherwise, it seems well distributed* My experience with this trituration was quite similar to that of the preceding, i.e., on the first examination I found not one whole spore, but on re-examination I did discover but one solitary whole spore. In this connection I beg to refer the reader to my previous experience with my own 1st centesimal trituration. I can have no reason- able doubt that if the opportunity could have been had of a thorough re-examination of '' B%" the finding of a whole spore or two would only have been a matter of time.
PUBITY OF THE SUGAR OF MILK.
A sample of the sugar used in all my machine tritura- tions, and also a sample of that used by Dr. Bhees in hia hand-made triturations, has been subjected to incineration for the detection of inorganic matter, to wit :
200 grs. of sugar used by Dr. Bhees
gave residue « =0.020 grs.
200 grs. of sugar used by J. Ed. S.
gave residue =^0.016 grs.
Consisting of silicaf alumina, lime, iron and phos. acid,
CHEMICAL ANALYSIS.
The following letter from Prof. Wood, accompanying hia analysis of lycopodium spores, will, I believe, interest the
tS!^SSTiSS^ HOMCBOPATHIO TBITUBATIONS. 727
profession. I therefore, with his permission, present it verbatim : —
<< August 27th, 1882. "Deab Doctob:
« I haye just finished examining the lyeopodium spores, with results as follows : —
'' Total amount of spores experimented on, == 25 grains ; ash,. 0.5 grains.
PercerUagei. ConsHtuinU.
20.2 Silica 0.101 grains.
44.8 Almmna 0.224
9.8 Iron (ferric) ... 0.049
5.6 • ... Lime 0.028
7*1 Pbos. acid 0.0855
1.0 Potash & soda ... 0.005
Magnesia, a trace — ^not weighed. 11.5 Loss, &e 0.0575
100.0 0.5000
''The combination of the elements is not quite clear, but probably the silica is a very fine sand, washed by the rains on to the lyeopodium plants. I tbink I can detect Uie small grains even with my microscope. You can settle that point more satis- factorily by a thorough examination of the untouched spores. The alumina may come in the same way.
« The lime and magnesia are undoubtedly phosphates , and the potash and soda should be carbonates, though I did not disooTer any carbonic acid ; the quantity was so small that it probably escaped notice. The whole work might be revised, using larger quantities.
" As ever, yours truly,
«' (Signed) N. B. Wood."
It is interesting to note that of the eight constituents mentioned in Prof. Wood's analysis, four of them, viz., silica, lime, phos. acid, and soda, were already recognised as anidognes of lyeopodium. See Hall's Jahr., p. 88.
It so happened that I was present in Prof. Wood's laboratory while the reactions for phoa, acid were under consideration ; and on returning to my office, I at once compared the symptoms of lycopodivm with those of phos^ a^Ad, as given in Dr. Lippe's text-book. For the conve- nience of thiO reader, I have transcribed the identical or similar symptoms in parallel columns, thus : —
728 HOIfCEOPATHIO TBITtUUTXOKB* ^'sS^^^^^Tmt
Ltgo»oi»com,
Mind and Disposition. — ^Ex- tremely indiffierent; low spirited and doubts abont his salvation; desponding, grieving mood.
Head. — Stupefying head- ache ; pressing headache ; sensation of scraping on ex- ternal head ; hair becomes grey early ; baldness ; hair falls out.
Eyes. — Cold feeiing in eyes; inflammation of eyeB,
Ears. — Over-sensitiveness of hearing ; music and sounds affect ears painfully.
Face. — Swelling of nose ; earthy, yellow complexion, with deep furrows; blue circles around eyes ; a large ulcer on vermilion border of lip ; erup- tions around month.
Mouth and Throat. — ^Yellow c<^our of teeth ; toothache ; gums bleed violently on being touched ; gumboils ; dryness di mouth and tongue without thirst ; posterior part of mouth covered by tough mucus.
Stomach and Abdomen. — Nauseainpharynx and stomach ; aceumolation of flatolenca.
Urinary Orgami.^-FreqaGDi desire to urinate, with dis*- charge of large quantities of pale urine ; greasy pellicle on urine.
Sexual Organs.— Sexual de- sire suppressed ; excessive and exhausting pollutions ; bloated- ness of abdomen.
IteararoBiG Acm.
Mind and Disposition. — ^Per- fect indifference ; low-spiiited ; anxiety about the future ; sad- siknoe.
Head. — ^Stupefaction in far^ head ; pressing, tensive head- ache ; feeling as if swollen and tender periosteum was scraped with kmfe ; hair beccMnes gray early ; falling off of hair.
Eyes. — Coldness in internal rarface of eyes ; inflammation of eyelids.
Ears. — ^Every sound re- echoes loudly in ears ; intole- rance of all sounds, especially music.
Face. — Swelling of dorsum of nose; pale, sickly complexion; lustreless, sunken eyes, sur- rounded by blue margins ; pim- ples and scurfs on vernuhon border of lip ; lips dry, scurfy, and suppnratmg.
Month and Throat. — Teeth become yellow; toothache; gums are swollen; stand off from teelih and bleed easily; painM tubercle on gums ; dry- ness of throat (palate) without thirst ; hawking of tough mucus.
Stomach and Abdomtn. — Continuous nausea in throat; rumbling in intestines.
Urinmry Orgams. — ^FVeqnettt piKsfose emission of watorf urine ; eloud forms on top of urine.
Seamal Organs. — Sexual de- sire suppressed ; frequent in- voluntary, very debihtatiag emissions; meteoristic disian-
r
iS^Sn^S^ OHBOMO PBAFNS8S.
729
LYGOFODimMU
BespirtUory Organs, — Sbcttt- iMBs and opprefiinon of break- ing ; ooagh with eopions pom- lent ezpectoratiaii ; con^ irith expectoration of blood.
Extremities, — Arms and fin^ gers go to sleep easily ; skin of band is dry ; old ulcers on lower legs, with tearing, itching, and bnming at nigbt ; sweUing of feet aroand ankles ; profuse sweat of feet.
Oeneralities. — Tbe whole body feels braised.
Sleep, — Sopor.
Fever, — Chills and heat attemating; violent perapira- tim ; clammy.
8km, — Bloodboils (periodi- eally) ; inflammation of bones* with pains at night ; caries and softening of bones ; chilblains.
Conditions, — Whilst at rest the debility is mostly felt, but there is also great aversion to I exercise. '
P&0£P8QiaC A(2Pk
Rstpiratary Organs, — Short- of breath ; cough with pvulient, ¥erj offensive ozpeo- tozatton; oo«gh with expeeto- ration of dark blood.
EatrmUties*SkajqpLy marked deadness of one-half of fingers ; shrivelled, dry akin of hands and fingers ; ulcers on lower extremities with itching; feet swollen^ sweaty.
Oeneraitties, — Sensation as if bedy and Hmbs were bruised.
Sleep, — Great drowsiness.
Fever, — Chili and heat fre- qventiy alternating ; profaie perflpieation ; clammy.
iS/etn. — Bloodboils ; inflam- mation of bones, witlx burning at night ; caries with smarting; swelling of bones ; chilblains.
Conditio7is, — ^Most of pains are only felt during rest, and are ameliorated by motion*
Prof. Wood's soggestioa a& to tbe silica will be acted upon, and with the advent of cooler weather a supplenaent to tbe preceding obsermfcions will be probably given to the readers of tbe Times*
Cleipeland, Okio^
September, 1882*
INDICATIONS FOR REMEDIES FOB CHRONIC
DEAFNESS.
By RcBonr T. Coofsb, MJ>.
Fbysician, Diseases of the Esr, London Homodopathic Hospital. Hono- rary Member, Amerieaa Ophtiialm^ogieid and Oiologieal Society.
After bjaviug* had nutny yeajrg' experienee in the treatment of ear diseaaae with lioiBUAopathio riemedies, upon looking back and considering the caaeg tbftt have £aUen to my caca,
780 CHRONIC DEAFNESS. ^^IS^^dSJ^JwS
I feel inclined to divide all ear cases into two great classes — the very easily cured, and those that are very difficult to cure. To the first class belong some of the simple and most of the complex deaCaesses {vide my paper in Annals of the British Homoeopathic Sodetyy read before the Society February, 1879), and to the second belong all three, but especially the complicated deafnesses.
The division into curable and obstinate, is in practice very obvious when we are called upon to express an opinion upon the probability of being able to- effect any marked improvement.
In some cases of obstinate deafness it is really impossible to foretell what amount, if any, of improvement is likely to take place, and as to the period of time required to effect improvement, we are altogether in the dark.
For example, some time ago two ladies came to me tmffering from deafuess of a very obstinate description. The one was a lady of about fifty years of age, but young looking for this age, and with plenty of reaction in her system, who dated her deafness back some fourteen years ; the other was an old lady of seventy, who had been deaf all her life, having had scarlatina at two years old, and had used a trumpet in public meetings ^' within the memory of man."
In the former case one might reasonably have expected to do some good, in the other it would have appeared to those not experienced in such matters, impossible, and even as it was, the highest authorities of the day among the allopaths had declared the case beyond help.
It was not so, however, for under homoeopathic treatment, I am proud to say, this lady is hearing well, and no longer uses a trumpet ; and as the case is known far and wide, the impression made upon her friends is veiy considerable, many of them having consulted me in consequence.
But my reason for bringing forward these cases is to illustrate the difficulty that attends the expression of an opinion in deaf cases. In both these cases I had reason- able grounds for hoping that improvement would take place. In neither was there present any feature leading me to suppose the case incurable. In both cases it would have been, I feel convinced, inconsistent with my duty not to have undertaken the case, and yet in the one instance marked and immediate recovery resulted ; in the other, I grieve to say, and that the apparently most curable, no improvement whatever was effected.
SS^rSTiTSSS^ OHBONIO DSAFNEBS* 731
I refer to these oases simply '' to point a moral.*' At some fdtare time we may take advantage of one of them ** to adorn a tale."
Comparatively few oases of dea&iess present any features justifying as in pronouncing them incurable. Instances of the curability of the most chronic forms of dea&ess are continually cropping up. In this fact rests our hope, and I must repeat what I have often insisted upon, that with fiur play, if we only search out in a painstaking manner the indications for our remedies, we are, with homoeo- pathy, in a position to do a great deal for the treatment of chronic deafness.
For myself I have tried all means that have been suggested for the relief of this obstinate affection, and from none have I derived any benefit worth speaking of, except from pure homoeopathy.
The low dilutions, which I honestly confess I have a partiality for, act very well in recent and comparatively curable cases; while in obstinate chronic cases, however useful the low dilutions may be as inter-current remedies, it is upon the high dilutions we must depend for the com- pletion of anything like a satisfactory cure.
In such cases as the following a low dilution will act very well : —
H. M. T., a gentleman, of 28 years of age, fairly healthy looking, of lightish complexion, and nervo-sanguine dis- position, consulted me in the end of August for deafness, with recurrent abscesses, which settle in different parts, but generally upon the walls of the meatus of the right, but sometimes also of the left ear ; has been getting much worse of late, the '' gatherings " being attended with con- siderable earache. The ear discharged up till three or four days ago, and now feels hot, and full, and uncomfort- able. The head sympathises with the condition of the ear, feeUng heavy and uncomfortable also. Appetite is poor; sleep good; bowels regular; pulse fair. Has not had trouble with the wisdom teeth, and the family history is not unfavourable.
The right membrane is not perforated, but it is bulged outwards to a slight degree ; is purplish looking, and the malleus handle is of a pinkish suffusion; the left membrane partakes of the same characters, though not bulged.
I lay stress upon this appearance of the membranes, as being a marked indication for hydrastis, 12 drops of the
732 43HBOinC DSAFHES8. ^'nS^
.Dm.1.
^ tincture of wfaieh was giTen to go orar a fortniglity and 15 drops of the same to half an onnee of glycerine and water, to be used as a lotion to the right ear.
On 16th Octdber he i^etaimed, sajing he was qnito well ; the kevvj feeling had quite gone from the ear, and his head felt much clearer. He eoiild also hear every soond qnito naturally (which was not the ease before, ihongh on oemiBg to me the watch hearing was nenial). The left ear beeanie swollen soon after seeing me, but it came to nothing ; and altogether, except for a sligfat hoarseness, for wiiicfa I prescribed tnangcmum, he feels infinitely better than he did.
This was an example of easily curable deafeess ; eaaily carable, that is to say, with the indicated remedy^ bi^ oertadnly not eamHy corabie after the haphazard manner of the allopaths. The following is an example of yeiy obsti- nate deafDees :•*«-
M. K., aged 24, liying- in the Sonth of England, eamt to me with deafness, whieh had been coming on gradnaliy for many years, the supposed cause being a succession ot ulcerated sore throats. She has been to two of the leadii^ specialists in London, both of whom declared her case to be beyond their power to reliere, and besides this* every now and then her family doctcH: has drawn a bow at a yenture, but all to no purpose.
Up tUl three years ago her dea&ess got gradually worse, but now it appears staitionaryy upon whicb. &ct rests her (mly hope '* that something may be done.'*
Miss W. has been a great suSerer from headaehei^ which generally end in hysterical attacks, bat this has been rather lem the case of recent years than formerly. With the monthly iUaees alsa much headache and pain ]» suffered, and on the tldrd day die becomes hygterioaL Hysterical attacks^ however, nerer occur without good and tangible reason.
Complains mu^ of noises in the head, but only whsB tired, and is subject to much sinking in the pit of tbs chest, but this also is present only when tired* Bowels are regular ; appetite is feucr ; sleep fairly good.
hearing. — None wikatever on tike ri^t side ; caB just discern the tick of a watch when pressed agaittst the kA ear.
Ttnting fork heard fairly, best with the right ear.
Membranes pale, psssesting the appearance I ksf»
ih^o£n?u£^ OHBONIO DBAniliBB. 783
described as accompanying nervotis deafness (vide my DUecues of Ear y Second EcUtion, p. 178).
The indications for picric acia were very marked, the Aoises in the head and sinking in the chest being worse when tired {vide Transactions of the International HomosO' pathic Convention, the Minntes of the Meetings, p. 186, where I make some reference to this), and the alteration of ihe symptoms during a condition of exhaustion point very clearly to it.
I wish particular attention to be paid to each report of tiie case, as it illustrates how, eyen if we choose the right remedy, we may often go astray from not disposing the dose in accordance with the varying requirements of the i^se.
On the 28rd January, 1882, 1 first prescribed a grain of picric acid to 6 ounces of water for this case, and on the 6th February again saw my patient, who gave this report : Wakes every morning with very much headache, and the headaches last longer than they did ; constant twitching of ihe left eyelid; noises stiU, which are a great deal worse on getting up in the morning and when tired; monthly period has been on, but with much less headache.
Hearing rather better.
The italicised symptoms I looked upon as aggravation, and therefore gave instead the sixth decimal of picric acidf 7 drops for the fortnight.
20th February. — ^Has felt better, but hearing the same. The twitching of the left eyelid and the headaches are much better ; noises are worse.
To have ac. pic. 6 ce., 7 drops for the ^r«£ fortnight, and terebinth second decimal, 12 drops for the second fort- Bight.
7th March. Hears better ; appetite not good ; feels weak and easily upset. Had a very bad headache with the last monthly illness. Noises are much better. At times the hearing is markedly improved. Membranes of both ears look certainly more natural than they did.
Considering the improvement to be due to the picric acidy I gave it again in the 6th ce.
4th April. Is much better ; slight but decided improve- ment ; feels stronger, but still has head and backache after a short walk. To continue.
SrdMay. Decidedly better and stronger; general health much better. To continue for another month.
Vol. 36, No. 18. 8 0
T84 GHBOmO DEAFNESS. "ffiw^SHfuS^
28th Jane, 1882. Betnrns, saying that it is two weeks since she took the medicine, and misses it greatly. On leaTing it off her general health suffered, and her hearing heoame yery painfully confused ; then took cod liyer oil, and felt hotter, but not so well as when taking the medicine. likiiseB (the noises are, I should mention, of a throbbing oharacter) still continue, but are less.
To haye two pilules of the same dilution of picric add three times a day.
I heard nothing farther of this -patient till, on the 12th of this month, a friend of hers came to consult me in con- sequence of the astonishing improyement that had taken
place in Miss K 's case, so great, that it was regarded
as perfectly remarkable by all her friends, and though her hearing had not entirely recoyered, she yet was hearing aomids it would haye been impossible for her to haye done befixre, and was continuing to get better. A recent letter from this patient entirely oonfinns this report.
This interesting subject of the UnnitiLB of picric add deseryes farther illustration*
In July, 1881, a brother practitioner brought his wife to me for adyice for deafiiess which had come on from sore throats six years before ; the right ear alone is affected, and ijr aches and becomes tender when lying upon it. Is mudi distressed with noises like booming in the ear. The right membrane is white and polished.
For these symptoms I prescribed a trituration of ignoHa, and heard nothing further till the following year, when (June, 1882) her husband wrote to say his wife had been nmch better of the tinnitus after taking tibie ignatia, "though neiver quite reeoyered the faring of tixe ear."
Now reports, that for the last two weeks she has had a return of the noises worse than before, with yertigo brought on by the slightest moyement.
Tympanic membrane he describes as y^ry tense and shiny, the malleus. hancUa standing out prominently • These symptoms, are ascribed., to her haying been, oyei^ worked, seeing visitors,. Ac
I ordered in reply to the aboye report^ ac. pie. a graiB» tabe^diBsolyed in 4 ozs^ o£ water and a teaspoonful to be taJDon fiourtimes a day..
On 18th June, 1882, he wrote in great distress to say Mk wife was yery^mndi worse for the picric acid ; daring all Sunday and^ yesterday wa& worse than she has been yet,.
^jjttlyHaiMeogfflito bbIGHT'S DISEASE. 785
B«vi0w, Deo. U 1889.
the noises being veiy distressing, and for about an bonr yesterday, when the noises were at the worst, the vertigo was yery distressing, being accompanied by naasea, bat no actual Yomiting.
Fatigue, he describes', always produces marked aggrava- tion of the noise, and vertigo has also a constant dull pressive headache, which is present even on waking, worse before rising than during the day.
Taking food relieves the vertigo, but not the noises, temporanly. The headache seems to extend all the way up from the root of the neck, and is worse in a line straight through, just above, and in front of the ears.
The above is a full, and» I think, verbatim report, as given me by her husband; it is well worthy of careful perusal.
Becognising aggravation, I ordered a drop of the twelfth of the ac. pic. instead of the solution of the crude substance, and soon after had a letter thanking me most heartily for the benefit my prescription had given ; it was marked and satisfactory, and has proved a permanent relief.
Dr. Macnutt mentioned to me a case of a lady in whom picric acid had removed a zone of yellowish discoloration that surrounded the mouth, causing great disfigurement.
Possibly this may be amongst its indications.
21,. Henrietta Street, Cavendisli Square, W. October, 1882-
— — ■ — — — ■ — .^— — »— ^.^^
BKEEF NOTES FROM CASE BOOK.
By T.. E. PuxDoit, M.D.y Newcastle-on-Tyne.
Brighfs Disease — Bronchitis.
Mr. J., $bL about 6S, tailor. Present condition, November 17th, 1876 : — Bronchitis, with morning sickness. The latter, bfr» thinks, is brought on by^ violent coughing. Heart hyper- trophied and sounds muffled* Pulse &st and full, but feeble. Dull aching pain across the lumbar region. Urine somewhat scanty, with some sediment. Dull frontal headache and feeling of intoxication. Face pufiy and pale*. Bowels very protuberant, but from adipose tissue.- Urine ocntains l-12th of dbumen, with some debziSr <dso granulflx and fatty oasts in small fragments.
8 0-2
736 BRiaHT's DISEASE. "'S^fSSTSS
Diagnosis. — Chronio tabular nephritis.
Prognosis. — ^Unfavoarable oltimately, but fiAYonrable at present.
Treatment. — Ars. 8 x — 2 x, and ant. tart. 8 x — 2 x. Soon removed the bronchitis and reduced the quantity of albumen considerably.
He then took ars. alb. 8 x and infusion of digitaUs (concentrated), 6 drop doseSi being equal to forty drops of the ordinary inftision.
November SOth, 1875. — The last prescription has done him much good. '
In 1882 he is in fairly good health.
Bronchitis — Rachitis — Whooping Cough.
Wilson, J.y 83t 19 months.
Bronchitis from exposure at open window. Aeon. Bry. Previous to this he had been strong and well developed. Acute symptoms relieved. Restlessness; Chamom. and china for debility.
February 14th, 1875. Is teething. Languid ; cannot stand ; spine seems curving backward at root of neck as if from debility; chest is projecting in pigeon-breast fashion. Bachitis had evidently set in as a result of the bronchitis, and consequent debility during dentition.
March, 1875. He had chamom.^ calc. phos., cod Uver oil, syrup, lact. phos., phos. calcis, with as nourishing diet as possible. Regulated pressure on sternum to help the expansion of the ribs. Salt baths.
May, 1875. Difficult breathing ; cough, with no power to expectorate; respiration almost normal; tonsils en- larged; feverish and fretful; great cephalic perspiration. BeU. 1, Phos., 8, friction with cod liver oil.
May 6th, 1875. Cough much better, scarcely any perspiration on head. Ac. phos. 8 and sUicea 6, were prescribed for this. The child kept improving a little till the autumn, when he began to lose ground again. A change to the seaside then picked him up wonderfrilly.
April 19th, 1876. For several days has been coughing, (brother has whooping cough) and though looking better I felt that if this developed into whooping cough, in his rickety condition, he would have very Uttle chance of recovery.
He improved a little till April 80th, when his respiration suddenly became much worse. Cough parosysmid but
SiSS^SnrS^ bmoht's disbabb. 737
very little power with it. No whoop developed; no expectoration; great distress; conynlsions; death; the last severe symptoms lasting only fourteen hours. For the last attack he had beli,, ipecac, , ant tarL; cuprum with brandy as a stimulant.
In this case the bellad., phos.^ ac. phos. and dlicea were useful. Sea air had a very good effect ; but there was no stamina to resist any fresh disease, and specially whooping cough.
MeoBles, Scarlet Fever, Acute BheumatUm.
M. W.» SBt« 7. Measles well developed, and treated in the usual way. As the measles rash was fading, he was evidently still far from being well ; this was explained by the distinct rash of scarlet fever developing with sore throat, and swollen glands. Soon after these symptoms developed he complained of pains in various joyits. Ere the scarlet fever rash was well away, he was evidently suffering from acute rheumatism with high fever. Two weeks saw him through what may be called three fevers ; the finale being a profuse perspiration and a copious eruption of sudamina. The heart was slightly injured, and its action was quick and excited for some time after. I record this as an interesting instance of one fever merging into another ; the one poison being in abeyance while the other was at its height. Some of his brothers had measles at the same time, but nothing more. There was nothing special in the treatment, save that I noted that verat. viride seemed to reduce the fever in its third rise very quickly.
Acute Chorea masking (for a time) Rheumatic Fever.
Cardiac complication.
L — ., aet. 17. Works in Ship-yard. Two or three weeks ago his movements were noticed to be slightly irregular. Able to remain at work till a few days ago* Has grown very fast, but has had no illnesses to speak of. Generally very healthy. He is exposed to changes of temperature at work. Has been under treatment for some days, and has had a draught to moderate movements and promote sleep.
November 6th, 1881. Saw him for the first time, and found him suffering from excessive irregular muscular movements. These affected both sides, but specially the right arm and leg. Great mental agitation. Shouts out occasionally. Tongue swollen, protruded with jerks, and
788 Bxmsw. ^■"S^^STffSS
furred. Speech thick and staimnermg. No sleep saiB from draught, which soon loses its effect. Bowels costive. No history nor complaint of rhenmatism. Heart acticm excited. Systolic brait; temperature 104S. Perspiring freely ; the perspiration being sour. Urine high coloured.
Aeon, (p and actaa (p were prescribed in fractional doses every alternate hour. These were taken for three days, with considerable abatement of the movements.
10th November. Movements less ; looks very exhausted ; mind wandering; heart is quicker. Bheumatism now developed in two or three joints. Aeon, 1 x, bry. alh. 1 x.
11th November. Movements worse again* Fever still present. Aeon. ^, acUea (p.
14th November. Violent movements, almost throwing himself out of bed. Delirious; shouting. Actaa 9, jitra- mon. (p in fractional doses.
16th November. Slept several hours, which he had alao done under aeon* and dctaa at first. The stramonium con- trolled the movements and mental state wonderfully. Continue acUea alone, giving the stramonium if necessaiy.
16th November. Beported much better.
18th November. Improving. Sleeping well ; still slight movements, with partial paralysis of right arm and leg. Actaa 9, sidph. (p,
November 26th. Has been up. CSardiac sounds normal; pulse regular ; all chorea gone. Still some want of power in right arm. Tongue raw (this was severely bitten at the first, when he had to be held in bed). Liq. araenicalisy mj. ter in die. Pil. svlph. Nocte.
The action of acUea and stramonium in this severe case was well marked. I only saw the patient occasionally, as he lived at some distance.
REVIEW.
T?ie Vmtmg lAst and Pocket Bepertory. By Bobebv Taulsmzb,
M.D. Boericke & Tafel. New York. We have received a copy of this convenient visiting list for 1888. It is a veniable muUum in parvo^ for in addition to ample spaoe for visiting list, it has also columns for daily record of medicines prescribed which are often apt to slip oat of the memory. The Bepertory at the commencement is of necessity brief, and with- out pretending to be more than a mere sign-post to a remedy, yet will serve well enough when larger volumes of reference ace out of reach. The book is well got up, and much superior to many visiting lists we have seen, and has an additional chum to notice in being purely homodopathic throughout.
^^^S!u^ MBBTIKOS. 789
MEETINGS.
LONDON SCHOOL OF HOMiEOPATHY.
A Special General Meeting of the Governors and Sabscribers of this Institution was held in the board room at the London Homoeopathic Hospital, on Thursday, October 26th, at three o'clock. The meeting was an a4}oanmient from the 20th April, and was called to receive the report of the sub-committee, which had been appointed at the April meeting, to make enquiries as to the possibility of obtaining a Boyal Charter for the Schocd, and legal sanction for its Diploma. Among the governors and subscribers present were Dr. Matheson, Mr. Harris, Dr. Hughes, Dr. Dudgeon, Dr. Bayes, Mr. Bosher, Major W. Vaughan- Morgan, Dr. Marsden, Dr. Blackley, Dr. Epps, Dr. Black, Dr. Jagielski, Dr. Goldsbrough, Dr. Noble, Dr. Anderson, Dr. Moir, Dr. Clarke, Dr. Dyce Brown, Dr. Pope (the honorary secretary).
In the absence of Lord Ebuty, Dr. Bayes, as vice-president, occupied the chair.
Dr. Bates said that the principal business of the meeting was to receive, and if approved, to adopt the report of the sub-oom- mittee appointed on the 20th April, and he would, therefore, call upon the honorary secretary to read that report.
Dr. Pope then read the report as follows : —
'* The committee appointed, consisting of Dr. Bayes (V*P.)) Dr. Hughes, Dr. Galley Blackley, Mr. Pite, and Dr. Pope (Hon. Bee.), have to report that in considering, the question submitted to them, they have met on five occasions.
'' They found that there were three methods of incorporation •^one by Boyal Charter ; one by a Special Act of Parliament ; and one by general Acts relating to the incorporation of learned and other societies, passed between the years 1862 and 1867.
** Incorporation by Boyal Charter presented numerous dffi- culties— -difficulties which have be^a materially increased of Mo years, owing to Parliament having passed measures enablixig bodies, desirous of incorporation, to obtain all the advantages of a Boyal Charter, without adding to the business of the Pxfvy Council Office.
'*A Special Act of Parliament might possibly have been secured, but the expenses attendant on doing so were so great as to place attempting it beyond the power of the London S&ool of Homoeopathy.
<* The tlurd plan, they found, was one that would enable them to acquire the rights and privileges of an incorporated society, and that the expenses of securing it would not exceed £Q0 or £70.
740 MEETINGfl; '^^g^^SySL
** They have, therefore, to propose to the goyemors of the London School of HomoBopathj, that an application shall be made to the authority appointed by Act of Parliament — ^in this instance the Secretary of the Board of Trade — to grant the School letters of incorporation and a common seal. In taking this step it is necessary to comply with special instmctions from the Board of Trade. These inyolve &e presentation to the Secretary of the Board, and by him to the Comisel of the Board, a memorandum setting forth the proposed name of the institu- tion, its locality, its objects and management, together with th» articles of association under which the members of the proposed Incorporation intend to act together, and the rules by which they will be governed.
'* The consideration of these various points has been attended with much anxious discussion by the members of your com* mittee, in which they have had the assistance of the solicitors consulted by them — ^Messrs. Eimber & Co., of Lombard Street. The result of these deliberations is contained in the memorandum and articles sent herewith.
** The memorandum, it will be observed, is much more com- prehensive in its scope than may at first sight appear necessary to attain the objects of the institution. But your committee were advised that it was necessary to insert in this document, not only everything that was desirable now, but also everything that there was the least probabihty might ever be required in the interests of the School. The reason urged by the solicitors for this course being that no addition or alteration could at any future time be made in the memorandum. To the lines laid down in this document the members must adhere for all time. Hence, eveiy object that the members of the School might now or at any futiure period be likely to desire to carry out, must be inserted.
'< By incorporation the School acquires legal power to act in all the circumstances set forth in the memorandum ; its manage- ment becomes more exact and precise ; it will be more likely to secure public confidence ; its permanence, as an institution, is more thoroughly assured.
'' For these reasons your committee submit that incorporation is desirable, and that the scheme now proposed is that whichia most likely to ensiure its being obtained.
'* Signed on behalf of the committee,
« A1.FBED C. Pope, Hon. Sec"
The CHAmifAN then said that as presumably aD present had received the printed memorandum of association, which had been sent to all the subscribers, it would perhaps not be desirable or necessary that it should be* read. It was a long document, and he would, if that were the general wish, take it as
SS^STfS^ MBBTINQS. 741
BovlsWy Doo. If 1868*
read, as the portions they wonld hare to disenss were no donbt pretty generally understood.
This coarse being approved,
Dr. Bates then said he would also propose that they should proceed immediately to the discussion of Uie report, which had been read in their heaiing, so that full opportunity might be given for any remarks which it might be desired to make. He proposed that the report they had heard be adopted.
Dr. Mathxbon seconded the proposition.
Dr. Dttdgeon said that it was not apparent to him, on the face of the report, what advantages could be gained by the proposed incorporation. Let them ask what is incorporation ? It is not a cliarter. It gives no privileges. A deed of incorporation is merely a commercial document forming us into an association, and incurring certain liabilities and responsibilities. Coming to the memorandum of association, what would be the effect of that on the School ? They would be crystallised in their present form, and they would never be able to stir from the terms of that memorandum. Medicine was a progressive science, and homceo- paths were not going to stand still, any more than their other medical confreres. Even now, homoeopathy is modified from what it was in the times of Hahnemann. Why should the School be crystallised in this way ? It might be said that though they might crystallise the School, they would not necessarily crystallise homoeopathy, or stay the progress of science. But what advantages were to follow from their binding themsdves by terms like the laws of the Modes and Persians ? It was only right that, when invited to place themselves under conditions and regulations of association, in which no alteration could ever be made, they should ask themselves what they were doing this for ? Is it to gain any advantages ? For his own part he had not seen any advantage pointed out as the consequence of this memorandum of association, and he would be very pleased to hear what advantages they were to gain from it. In the British Homoeopathic Society they had no such memorandum of associa* tion, yet that society was perfectiy competent to create fellows and members. The School had, without any incorporation, pre- cisely the same powers as the society, and the proposed incorpo- ration could confer no others. They had heard that the expense of incorporation would be about £60 or £70, and he would ask, is it worth while to make that outiay for the purpose of fixing themselves in a stereotyped form, witiiout any possibility of ever altering it. As an amendment, he proposed that the report of the sub-committee be not adopted, presuming that if that amendment were carried, it would have the effect of allowing the School to remain as it was.
742 joxtaaB. '^^
Dee.lt
Dr. BiACK rose to second the aznendment, and said that before speaking on it, be would much prefer that someone would point oat what were snpposed to be the adTantages of incorporation. This course would allow him the opportunity of testing the reality of those adyantages.
Dr. Dtoe Bbown said he had been under the impression fin now that the advantages of incorporation were admitted by afl their body. (Hear, hear). The School of Homoeopathy had existed for a number of years, and it had recently been proposed that it should grant a diploma of '* Licentiate in Homoeopathy.*' That had been met by a number of objections, the most impor- tant of which was that to such a diploma so granted there could attach no legal standing. Now, under a deed of incorporation the position would be somewhat different.
Dr. Black : What legal standing can incorporation giro ?
Dr. Dudgeon : It gives no legal value whatever.
Dr. Dyce Bbown : [Those genUemen who objected said that having a School of Homoeopathy, merely, the diploma had no value ; but if the School were on an incorporated basis, then the diploma might have some legal weight virtually* As to the incorporation stopping progress, every means had been taken, in drawing up the deed, to obviate any danger of that. Of course if a Boyal Charter could be obtained, that would be the most desirable thing ; but it was generally understood that the next best was to secure a charter of incorporation, as calculated io give any diploma issued by the School more weight. And to prevent any danger of the crystallisation which had been suggested, every possible means of enlarging the sphere of the School, and taking in a wider curriculum, had been adopted. While they had endeavoured to give a firm legal standing to the School and its diploma, they had secured every possible chance of deviating, if necessary, from a stereotyped form.
Dr. Black said he thought he would now be able to under- stand the position. It was clearly understood that this incorporation by the JBoard of Trade was not in any sense a charter. The Board of Trade had no power to give a charter, and their deed of incorporation gave no more legal value to the proposed diploma of *' Licentiate in Homoeopathy *' than it possessed before. The fact was that any man could call himself F.L.S.H., and would, by so doing, incur no legal penalty. He knew perfectly well, from experience, the difficulty of obtain- ing a charter, and between a charter granted by the Privy Council, or by Parliament, and an incorporation by the Board of Trade, there was the widest difference. It did not follow either that they would get what they were asking for. Incor- poration itself was not an easy matter. And if a dozen men were to write to the Board of Trade, and say that they regarded
the proposed incorporation as not for the advantage of tibe School, the probability was that it would not be granted. There was, in his opinion, another serions objection to the memorandmn of association. K the School became incorporated nnder that memorandmn, they would never be able to get away from the name homoeopathy. He regarded it altogether as most nnfortn- jiate, that jnst as there was a prospect of peace and agreement between the supporters of the School, there was set up this •question of a diploma, which would be a fresh cause of lack of sympathy. Men who were quite as zealously attached to homoeo- pathy as the promoters of this measure, were anxious that the ^School should strictly limit itself to its proper function of teaching. It comes to this — ^if you wish to give a certificate, well and good, but if you wish to give a diploma, then the moacse men become qualified the more superior they will becomBix) £uch diplomas as have no legal value. By diis measure yon resuscitate that lack of sympathy, which has before been so much regretted, you stereotype your sectarian position, and yon merely place yourselves on a commercial basis, such as a gas company or other association, and you throw dust in the eyes of the public, by your diploma, seeiQg that you cannot say yon have a charter.
Dr. Pope said that with regard to the objection which was made by Dr. Dudgeon as to stereotyping the form of homoeo- pathy, if Dr. Dudgeon would read clause c of paragraph 8 of the memorandum of association, he would see that by that clause stereotyping will be impossible. That clause provides for ** the consideration, discussion, and determination of questions relating to general and special therapeutics, practical medicine, .and surgery, physiology, pathology, chemistry, botany, pharmacy and other branches of the science and art of medicine and sur- gery, and the dissemination of the results of such deliberations, or any of them." Clause g of the same paragraph also sets forth that the School was established for ''the advancement, encouragement and dissemination of professional knowledge, study and research, and the results thereof respectively by all or Any of the following methods, viz : — by the establiahment and maintenance of physiological, pathological, pharmaceutical, .chemical, botanical, surgical, and other laboratories, museums and institutions ; by the delivery of lectures and instructions in all or any branches of a complete medical and surgical education ; /by giving prizes and rewardB ; and by giving to such persons as -—being already legally qualified practitioners of medicine or surgery iu the state or country of which they are citizens — shall liave attended such courses of instruction given by the corpora- tion during such a period or periods of time, and shall have passed such examinations as may from time to time be prescribed
744 MBBTiHaB. **2S2L^ffST^
1.
1
i
by the governing body of the corporation (such examinations to be conducted by teachers, professors or practitioners of medicine or surgery duly qualified by law and appointed from time to time by the council), a certificate of fdlowship certifying the recipient's knowledge and proficiency in and fitness to practise ' homoaopathy,' or any modification thereof.'* The fiict was the whole deed had been drawn up with the greatest care to pre- vent the possibility of any stereotyping. (Hear, hear). It was also a mistake to suppose that anything less than a Boyal Charter could confer no advantages in point of position. Several societies of known position were incorporated, but had no Boyal Charter. The British Medical Association, the Anthropological Sociely, the Philological Society were incorporated, but had no* Boyal Charter. If the point were of no more importance than Dr. Black had represented, those bodies would not have attached the weight that they do in securing it. It would be a very great advantage if we could obtain a Boyal Charter, we admit ; and that a deed of incorporation is not all we desire is quite true p but it is all we can get. It will certainly increase public con* fidence, in the stability and proper management of tiie Schoolv and just in proportion as it does this, it will be valuable to ns^ and fulfil the desired purpose. Dr. Black has objected to tba^ permanence which the deed of incorporation will give to the School and homoeopathy in the present form. He says that the name homoeopathy may die out. Well, I am sure that we shall all die out before it does (laughter), at least, I hope so. (Cheers). It had been stated that &e proposed incorporation would place the School on a commercial basis, but paragraph 4 of the articles of association would show that there was no danger of that. This paragraph set forth that — << The income and property of the corporation whencesoever derived shall be applied solely to the promotion of the objects of the corporation as set forth in this memorandum, and no portion thereof shall be paid or transferred directly or indirectly by way of dividend, bonus, or otherwise howsoever by way of profit to the members of the corporation. Provided that nothing herein shall prevent the payment in good faith of remuneration to any officers or servants (whether mem- bers, governors, life-governors or otherwise) of the corporation, or other person in return for any services actually rendered to the corporation." There was nothing commercial in that. (Hear» hear). It was not to be in any sense an association for profit. Dr. Pope then read an extract firom the laws affecting corporate bodies, and proceeded to show that they were quite prohibited from receiving profit. As to those gentlemen who do not think that the incorporation of the School will improve the position of the School with the public, he entirely differed ^ 'sm them. Undoubtedly it secures permanency (applause^
^S^SST^SS^ MEExraqa, 745
and is oalcnlated to promote a more general stady of homoeo- pathy. (Cheers).
Br. Mabsden said he had always agreed with Drs. Black and Dadgeon on previons questions on wlueh differences existed, and when some time ago it was stated to him that the School desired «to grant a diploma, he coold only make the simple hat conclnsive :«nswer — ^they have no right to do so. Bat when the School, if it could not secure a Boyal Charter, might become incor- porated, thoagh he could still see the disadvantages as to legal standing, yet that seemed to him to alter the case. It seemed to him that nothing in the memorandum was calculated to pre- vent progress. There were in the articles of association clauses which amply allowed for progress in the principles of medicine. On the other hand it was very hard that students of the School should be launched into the world without such certificates as were in contemplation, and it seemed to him that the quahfica- tion in question, though not what mi^t be termed a legal quali- fication, yet carried practical advantages with it. At present homoeopaths were isolated, and the probabilities of recognition, in the allopathic sense of the word, seemed to him to be still distant. For that reason he came to vote for the measure as calculated to improve the status of homoeopathic practitioners. He maintained that the London School of Homoeopathy had done as much as could reasonably be expected from it in the short time that its lectures had been in progress. The lecturers had, in his opinion, shown great determination, and perseverance and learning, in their endeavours to promulgate the great dis- covery which he thought had done as much to revolutionise medical science as the discoveries of Harvey and Jenner. As Dr. Pope had said, the proposed incorporation was not what they wanted, but it was aU they could get, and was calculated to induce a greater number of young supporters of homoeopathy. (Applause).
Ihr. Jaodblski asked whether Dr. Pope, who had visited the United States, could tell them whether any precedent existed in that country for the incorporation of homoeopathic medical bo^es, and whether any great advantages had been found to result from such incorporation. The United States had pro- gressed so greatly in advance of English homoeopaths that it might be well if they could follow so good an example.
Dr. Pops, in reply, said that all the homoeopathic medical colleges of the United States had received charters of incorpora- •tion from their Legislatures. But then it must be remembered that obtaining a charter from a State Legislature, and procuring a Boyal Charter in England, were two totally different things. The one was a very simple and easy process ; the other, one of the most difficult, and at the preseiit tune almost impossible.
746 lavTiKos. "SSSL^TEf^SSr
BcnrioWy Dec* It tttt*
Dr. Mont said that as reference had been made to young' members, be would take the opportonitj of saying that he knew the feeling of several yom^ members of the profession, and they were against the diploma. The eertifieate ^ich the School might give would derive no additional^valne from the incorporation of liie School. Dr. Pope had admitted, that while he considered the incorporation good, it wonld also be very expensive, and he* {Dr^ Moir) was of opinion that the position taken np wonld drive students from ^e SchooL
Dr. GoiJ>sBBOU6H saidthati acra former student of the Schod^ he was sorry to disagree with Dr. Moir. He also thought thai the diploma of the School, while it might not have much weight with those gentiemen who were settled in London, it would have- a real value in the case of practitioners going to a new place in the country. In addition to their legal certificates, it would riiow that tiiey had studied homceopathy. (Hear, hear). It was true, as Dr. Black had pointed out, that the letters " F.L.S.H."^ or *' L.H." could have no legal value, yet he thought that they must have some weight as given by an incorporated body. (Hear). Dr. Black also had rather put it as possible that homoBopathy might become so triumphant that it would he- desirable to drop the distinctive titie of '* homoeopathy.*' Well, there was a clause in the memorandum of association which, when homoeopathy is triumphant,would provide for the winding up ^ The Incorporated London School of Homoeopathy.'* (Cheers). But there was one question which he would like to ask, and it was, whether the provings of medicine by the School would be legal under the articles of association ? He regarded the provings of medicine on the healthy human body as entirely distinctive of homoeopathy, and as a valuable means of discovery. He would like to know whether the proposed incorporation would admit of the provings of drugs under the auspices of the School ?
Dr. Pope said that, in reply to that question, there wezB; several clauses in the articles (tf association, under which they would have the right to conduct experiments of the kind referred to.
Dr* GoLDSBRoiTGFH mod that, with all due respect, the artides: only provided for ''the consideration, and discuscnon, and determination of questions."
Dr. HuoHES said ho should think such ezpaiments would oome under the head of '' determination of questions." But there was present a gentleman from the firm of Messn; Kimber & Co., of Lombard Street, who had been the legal advisers in this matter, and perhaps he would be able to answer that questiout^and settle sevconl points of a legal character, which had been asked. He (Dr. Hu^es) would, however, tkke tiw opportunity of saying tiiilthenrwB¬hing in the memorandunr
S^gnnsr MgrriNqs. 747
of asBOciatioii wldoh wonld neeessitate' stereotyping or crystallisa- tiozL; and as to the supposed continnation of the School after the word *' homoaopathy " had ceased to exist, if ever that happened, the necessity for the School itself would cease to exist. (Hear, hear). He, however, regretted very mncb to hear that the endeavours to secnre the incorp(»iition wotdd he likely to canse any renewal of the differences of opinion hetween some memhers of the School and those who acted officially for the School.
Dr. Black explained that there could not hut he a want of sympathy hetween the memhers referred to and those who were xesponsihle for such measures as were now proposed.
Dr. Hughes, continuing, said that the question, which seemed to him the real question, was whether the game was worth the candle. He had signed the memorandum, although personally not well acquainted with legal details, hut relying mainly on the advice of their legal advisers and the judgment of his colleagues. He hoped that 1V&. Watts, who was present to represent Messrs. Eimher & Co., would he received as a memher of that meeting pro tem,f and permitted to speak, as ho (Dr. Hughes), for one, would he guided by what he said..
Mr. Watts, being called upon by the Chairman, said : I feel rather under a difficulty, because I did not expect to be called upon. But I may say generally, i^iat when we were con- sulted upon the proposition to apply fat a Royal Charter, we said that that was the only thing which would give a right to grant diplomas possessing any legal value. But we said you can incorporate under the Act of 1867, and that course will give you several advantages, such as having the regulations of the society sanctioned by the State ; and as regarded the right to grant certificates, we thought that there could be no harm in making application for it. If the Board of Trade grant the power sought the document awarded by the School would not be a diploma, but simply a certificate ; it would, however, have this value — ^that you, an incorporated body, have examined the person holding the certificate, and certify' that he possesses certain qualifications. All along we have placed this view before your flub-conmiittee. If the proposal now meet with your approval, we shall send it in to the Board of Trade.; and although some may consider the valua of the certificate doubtful, I think I am expressing the general opinion of the sub-committee when I say liiat the certificate will certainly ha\(e a value to all who value you.
Dr. Black said he knew quite well what the fate of the pro- posal would be. The Board of Trade would naturally refer it to ttieir legal advisers, who in their turn will refer it to their iiwdical advisers, and the School would soon get its answer;
748 MBBTIKGS. "^S;r?DS?i!SSf
He bad had a great deal to do with seenring a charter^ and ha cotdd well forecast the coarse which would be taken. Then, suppose that any man, not being a member of this body, were to call himself *< F.L.S.H/' what conld yon do ?
Mr. Watts : Well, it would be open to the School to remon- strate with him. (Lan^ter).
Dr. Black : We conld take no action whatever.
Mr. Watts : It should be remembered that the same objection obtains in the case of the initials of any learned society or any degree whatever. He might clear the ground by stating distinctly that no law prevents the use of initials, which may mean any- thing. The same remark applies to tities. Any person oouLd put F.L.S.H. after his name ; but no one, supposing the School be incorporated, could add the words Fell. Lond. Sch. Hom., because they would have a signification as the title of this , incorporated Society. The plan would be not to use initials but syllables.
Dr. Hughes thought that was of very great impcnrtanee, because their solicitor now said that in that form their title would have a legal value.
Mr. Watts : No two companies can be incorporated in precisely similar names. When a proposal is first made to the Secretary of the Board of Trade, the first thing he does is to see if there is any other Society bearing the same titie on the books. If not, and the Society is incorporated, no other society or individual can adopt that name.
Dr. Pope said that Dr. Black a few minutes previously had referred to him as having said that the School would in tiie future restrict itself to teaching and make no pretensions to qualifying. It was just because this proposed deed of iocorpora- tion would so restrict them, and limit them to issuing certificates, and render all further disturbance and dispute impossible, that he supported it and advocated its adoption.
Dr. Clarke said that they would aU agree upon one point — that to secure a Boyal Charter, and legal sanction for tibe pro- posed diploma, was practically impossible. But their sub- committee was appointed to make enquiries as to the possibility of obtaining such a Boyal Charter and legal sanction for their diploma. That being so, all this memorandum of association was apart from the object for which the committee was appointed ; and although it is said that we can get certain advantages from this proposed incorporation, he did not quite see, from a business point of view, what those advantages were. They could do as much without incorporation as they could do with it. It was as stated — ^a mere question of trying it on ; and as that prooesi eonfessedly involved considerable expense, he thought that it would perhaps be better to let some other society try it on first.
JfiSS'STfa^ MEBTINOS. 749
Biffew, Deo. 1, lfi88.
and bear the expense. It seemed to him that they were doing a great deal to gain nothing.
Dr. DuDOBON said he would now be obliged to leave the meeting, bat before going he wotdd like to say that the whola thing appeared to him to be a sham. At the best, they had been told, they were only going to try it on. It had never been done before, and the object was to take advantage, if possible, of some^ want of observation on the part of the Board of Trade. (Cries of " No, no.")
Mr. Watts : We did not say we intended to slip it in unob- served, but simply to make the experiment.
Dr. Dudgeon said that in the case of the British Homoeopathic Society, the letters '* MJB.H.S.*' were assumed when chosen. That society is not an incorporated body, but it has the power to confer those initials, which have their meaning, and can be used if thought proper, but the present proposition, while it can confer no real advantages, will have the effect of raising a great deal of opposition. (Cries of ** Divide ").
The Chaibman: By being an incorporated society we can secure permanence. I understood Dr. Black to thmk that a disadvantage.
Dr. Black said he agreed entirely with permanency. What he objected to was perpetuating distinctions and differences.
The Chaibmam, to "Mx. Watts : Does not incorporation give us some real advantages in dealing with the money.
ILr. Watts : Yes — greater legality.
The Chaibman : When the new Medical Act comes into force it will give greater facilities to incorporated bodies, and it would, give us a greater chance of getting examining power. Mean- while I apprehend that no one fears our being driven to legal proceediiqgs to prevent anyone adopting our title, which I take it no one could legally do.
Mr. Watts : In doing so, presuming that he used the words- ** Fellow of the London School of Homoeopathy," he would be using words which would constitute an infringement of your right, for which you could proceed against him.
The Chaibman said that the great value of the diploma would be its evidence that the person holding it was competent to practise homoeopathy. (Hear, hear). He had again carefully looked through the memorandum of association, and he did not see that there was much in the objections which had been raised. They could still take care to make every enquiry on all matters of importance, but as to the document in general, he was per- fectly satisfied. (Cheers).
Dr. Mabsdbn said that the School at present was an individual body, but when it was a corporate body its teachers would be much more generally recognised. He agreed with the chairman
Vol. 26, No. 12. 8 n
750 NOTABILIA. ^'^gS;
B0Vi6Vt Dwi. 1«
in the desirability of earafoDy obTiatmg any distant dangen, bol he eonld see many advantages id the proposed inoorparation.
The Chaibmam then, in response to invitations £rom the meeting, put the motion and the amendment to the vote, calling attention to the fact that at that meeting proxies were admissible^ and suggested that scmtineers be appointed to examine those tendered.
Br. Pope and Dr. Clarke were appointed scratineera.
The Ghaibbcan said that the moUon was, " That the report d snb-committee be adopted." The amendment was, *' Thai the report of the snb-committee be not adopted."
The amendment, '* That the report of the sab-eommittee be not adopted/' was then put, when the voting was as follows : —
For the amendment 5
Against ... ... ... ... 11
Majority in favour of the motion 6
The motion, '* That the report of the sub-committee be adopted," was then pat to the vote, which was as follows : —
For the motion 12
Proxies... ... ... ••• 15
— 27 Against... ... ... «•• 5
Majority in favour of the motion 22
Dr. Bayes then proposed the following resolution : — ** That an application to incorporate the London School of Homoeopathy in the terms of the printed memorandum and articles of asso* eiation, be made to ihe Board of Trade, by the chairman of the present meeting, on behalf of the Sobiety."
The resolution, having been seconded by Dr. Matbxsok, was carried.
The proceedings terminated with a vote of thanks to the chairman.
NOTABILIA.
KOTES ON THE LONDON HOlCiEOPATHIC HOSPITAL.
Thb supporters of the hospital will learn with satisfaction that the amount of subscriptions received in the first half of the corrent year is slightly in excess of the sum received last yeaf , although, owing to the death of some subscribers, some valuable sabscriptions — ^including one of £86 per annum, some of ten guineas, and others — ^have been lost. Should this increase be maintained, the present financial year (1882-8) will compan
SS^5ri?3^ NOTABIUA. 761
favourably with the year 1881-2. The same may be said in xegard to donations.
There has, however, been a decrease in the amount of the Hospital Snnday grant of £4S. This is, however, entirely owing to the complicated system of assessment, and the charges made on the reserve fund for repairs. These sums are deducted by the authorities of the Hospital Sunday Fund from the amount of the grant, so that the hospital does not benefit proportionately.
The nursing fund receipts also continue to increase.
The proposed extension of the nursing institute seems to be generally considered a very. desirable thing, and it is proposed to pull down and reconstruct No. 1, Powis Place (purchased some years ago by the hospital), and to adapt for the present reception of additional nurses ; but later on — when sufficient income shall have been secured — ^to utilise it for new wards con- taining a large number of additional beds.
We sincerely hope that this praiseworthy effort of the hospital authorities will receive the fullest support of our medical brethren, and that the demand for traiued nurses will increase in ratio to the supply, and so insure great pecuniary results.
The estimated expense of preparing the house will be £1,000, and the treasurer — Major W. Yaugluin-Morgan — has opened a special subscription list by a donation of JSIOO.
Apart altogether from this fund, the indefatigable official manager, Mr. Chambre, has arranged for a dramatic performance in January next, and we doubt not that the afiair will prove as successfol as former efforts in the same direction. Our old friends, *' The Thalians," under the management of Captain and Mrs. Conyers d'Arcy, wiH be the performers, and so we think we may predict a thoroughly good entertainment.
HOMCEOPATHIO CONVALESCENT HOME FOR
CHILDREN, SLOUGH.
We are pleased to notice that some kind friends are anxious to provide a convalescent home for the little ones. The hospital can do, and does much for them, but the requisite change of f^ to complete the good work is often hard to come by, owing to poverty or other circumstances.
A suitable house has been selected at Slough, where six patients can be received. Mr. Deane Butcher has kindly promised to become honorary medical officer, and a lady residing near (Miss Forsyth) will become honorary superintendent. £800 a year will defray all expenses. Will all who are well-wishers to this kind effort on behalf of the little ones, send help. Mr. Craske, London and County Bank, Slough, has kindly promised to receive remittances.
8 D— 2
762 NOTABILIA. "S^^SfifwS
BeTi0«, Dec 1, 1881.
»t
A MEDICAL CATECHISM.
Patient : Now, doctor, how would you define << medical science ?
Doctor : Well, medical science sometimes consists in making a person think he's very sick when he isn't, and at other times it teUs people there isn't much the matter with them when they •are half dead. Sometimes all this depends on the size of the patient's pocket-hook. That in medicine is a very important and vital organ. The great aim, however, in my experience, is to have as many folks sick as possible, and to keep them sick.
Patient : What is your idea as to the naming of diseases?
Doctor : To change the name at least once in ten years.
Patient: Why?
Doctor : Because old names, such as " croup," " lung fever," i^c, get too common. People are too apt to find out how to treat such diseases themselves. But when we clap a Latin Jiame on the old complaint, it mystifies the public, scares them, and sets them all adrift again. There'd be millions of doUars lost to the medical profession if we didn't change the names of our complaints occasionally.
Patient : Suppose a well-to-do person is a little out of sorts and comes to you with an idea that something very serious is the matter him, what will you do ?
Doctor : This affords me some of my best-paying practice. In such cases I ''break up the disease." I tell him that he is seriously threatened with something awful in Greek or Latin, •composed of two words, seven or eight syllables, and one hyphen. Then I put him on a course of hannless drugs, to be taken at regular intervals of two hours. I put him also on a strict system of diet, and keep him in bed. It requires about a week to ''break up the disease." Such prevention is better than immediate cure. It pays better too.
Patient: When you are called in and are yourself uncertain as to the nature of the patient's sickness, what do you say to his enquiring friends or family ?
Doctor : The proper course in aU such cases is to look wise and grave, and to say as little as possible. We leave some medicine, of course. How can one be a doctor unless he always gives medicine ? The medicine quiets the patient's mind and those of his friends. Patients, to tell the truth, are as bad as the doctors iu this respect. They will insist on having some medicine when they do not need it. But it never pays for a doctor to talk much.
Patient : If you are called in after the sick person has been for several days previous in the care of another physician, and the patient dies, what is your course ?
Doctor : Invariably to regret, to particular friends, in a sab- odued manner, at the proper times and places, that I had not been called in before ^e disease had made such headway.
]S5i^5nrSC^ KOTABILU. 758
Patient : Do yon not think, in many cases of sickness, that natore, aided by plenty of rest and good nursing, would effect •« core ?
Doctor : We do not encourage nature in such practices. It •would ruin the profession.
Patient : Now, if you treat a patient for you don't exactly know what, and he reoorers, don't you take all the credit for such recovery ?
Doctor : Sir, that is a professional secret.
Patient : Can you tell me. Doctor, why it is that an expensive office, a horse and carriage, and a residence in the fashionable <qaarter are practically considered as of as much, if not more, importance to a doctor than his skill or experience in his art, and that a doctor without the capital to set himself up in this manner, be his skill ever so great, can never hope to obtain a fashionable practice ?
Doctor : Certainly I can. It's custom and stupidity. But stupidity makes money for us. Are we going to try and cure stupidity — ^kill the goose that lays for us golden eggs ? Never I
Patient : What other means have you for stimulating and developing practice ?
Doctor ! A good doctor will always have a reputable standing in some respectable church. He will at least hire a pew — ^front pew if possible — and send his family regularly. Of course lie must have a family. A doctor without a family is unsafe — hasn't given any hostages to society. He needn't attend church regularly himself. If he has much practice, it isn't supposed he can. The sick must be visited, Sunday or no Sunday. And when he does come to church, it is well to have him called out occasionally — case of sudden illness — doctor sent for ; so hard on the poor man, too, when he has so little opportunity to worship. Yet no rose without its thorns. No-— I mean no cloud without its silver lining. When the doctor is called out of church all the con- gregation will see he's in demand. It's splendid advertisement.
Patient: Who are the most permanent and lucrative patients ?
Doctor: Women.
Patient: Why?
Doctor : Well, I think sometimes they had rather be sick and under a doctor's supervision than not. Another reason is they are more perverse than men iu clinging to the causes of their ailments. A man better realises that without health he •cannot carry on his business. So when he finds out the cause •of disease he'll set to work to stop it. Tell a man he needs more fresh air and he'll try and get it. Tell him he needs more out- door exercise and he'U try and take it. But most women won't. They squeeze themselves into corsets, and insist on being cured of ills caused by corsets with pOls. They'll go out in cold, damp ireather in costumes which show off their figures and without
764 OOBBESPONDBNCE. ""^JL^S*?^
Beviev, Bee. 1, 1888.
cloaks, wben the cold drives sJl the blood from their skin, for biogrs. They'll insist on being cured by doctors and pills. They'll wear tight shoes, which deform and pain their feet, and this plan drawing indirectly from their strength — ^they'll insist on being cured with more pills. Nor is this ^. But I shall tell no mors. It is giving the '* profession " away. These things involve our most lucrative secrets. I shan't be thanked now by thousands of brother medical nurses of disease for what I have told. Go to, young man ! Go tol You've got enough, and how in the world you've managed to worm out of me what you have is a mystery. Get thee to a nuimeiy I I'll never more have one such as thou pumping from me tiiat information which is to me my professional life-Uood. Thou art an interviewer disguised in the likeness of a sick man. Go to ! — New York Daily G-raphk,
CORRESPONDENCE.
THE REVISION OP THE MATERIA MEDICA.
To the Editors of the ^^ Monthly Honueopathic Review, ^^
Gentlemen, — ^As this subject is being actively discussed, will you permit me to make a few remaiks upon it ? As I had not the opportunity of being present at the Edinburgh Congress, I will take this opportunity of expressing my general agreement with the views of Dr. Nankivell and those on his side, as reported. But my criticism must take a wider scope. I include the general relationship of the work of the Hahnemann Publishing Society to the wants of the profession. This Society has enlisted in its service, it is presumed, most of the active spirits of our small body, and it is on this side of the water the only working organisation we have, and for the painstaking, self-denying, and Si^If-imposed labour exhibited by it, nothing but the wannest a^Qloiowledgment is due. With the method and scope of its worky however, some difference of opinion may exist. It started with the praiseworthy object of supplying us with a reliable Materia Medica, a Repertory, and a Therapeutic Companioiit These constitute, in my opinion, the desidera^ for practice.
It is now thirty years since the first instalment of the Materia Medica was issued ; during that time the work has dragged its^ slow length along, and five medicines in all have been presented to us, Uie Repertory chapters and the tentative essays in the therapeutic part not being here referred to. After thirty yean of effort in itxe Materia Medica section, a dispute springs up as to whether future medicines are to be worked in a Schema form or uot. At this rate the blocks that are being quarried and shaped for the homoeopathic pyramid will have crumbled away before the last are finished, and we shall never build the structure intended. For it is in the nature of physiological science that it i3 progressive and cumulative, and books upon it become rapidly l^:|ti4uated^ Fortunately for us, we have had the materials f^r
Mjn^^aoBjgWo COBBBSPONDBNCE. 756
practice more or less accnrately supplied by a host of other e^tii' pilations, and we have now the excellent Materia Medica of Alien along with the couple of volnmes of Hahnemann's, recently trakm* lated by Dr. Dudgeon, giving us our working material. But aitixbi stage a cry is heard for a revision of the whole, and not wi^ool cause. It has been felt all along that to present us with thto provings chopped up in the Schema is feeding us with thefa- peutic mincemeat, and we require the whole joint in itslftir proportions, or even the entire animal, to enable us to foim a true judgment of what will suit us.
Besides this, we wish to get rid of redundancies in the way of vain repetition, and to see wherein we are deficient. It is evident that to go on with the superstructure when the fonudta^ tioHs are impeifect is to waste tune and labour. We reqrwte a Council of the Church to determine vrhioh of our books are to be considered canonical, and to have them collected in a systematic form, for it is undoubted that we have a large amount of what is spurious and what is apochryphal mixed up with what is genuine. The lawyer has his Acts of Parliament and the tbeo^ logian his canonical writings to refer to, but ours we have not. It seems to me the most pressing necessity of our time to pass under review our provings, and publish them in full in narrative form without gloss or comment, except by way of explanation* The ■attempt in this direction in the aconiti/imm diapter, lately issued, has given a life-like picture of the drug, and teaches us more than the best- arranged Schema' possibly could. A Materia Medica sifted and supplied in full, excluding redundancies, after this fiEtshion would not be likely to grow antiquated, for it coidd be added to by way of supplement from time to time as new provings appeared. It appears to me to be wasting the time of the Hahnemann Society to even undertake the arrangmg of a medicine. The Council of Trent did not spend its time in making a Concordance to the Scriptures ; a Cruden could do that. So I hold the Hahnemann Society might more profitably occupy itself with giving us an authentic Materia Medica to tilie best of its ability, and leave the depicting and tabulating of the symptoms to a future time or to other hands, for repertories are and must be variously constructed to meet the various tastes and Wttjs of working out our cases. The Cypher Eepertory does not com- mand universal approval, and it is a pity to employ such good working-power in a direction that is of only partial ace^tance.
I would propose, therefore, that the volunteers ready Ibr the purpose, form themselves into a purely revising committee and get the work already to their hands, passed under scrutiny and stamped with their approval, and published in order from A to Z. The provings have not to be made, they exist in our literature, and this being the case we see what can be done in the Hahnemann Materia Medica lately traushted.
766 GORBEBPONDENTS. ''^2L^Sf?*?2J'
Beriew, Dw. 1, 1882.
The Hahnemann Society has attempied too mnoh, in my opinion, and if it will disencnmber ite^ of the mere work of a dictionary maker, it may serre a high purpose in gathering together and assaying the precious metal that constitutes onr real wealth, and when this is done, the work of minting it into current coin may be left to whoever will undertake it, as it is of minor importance, and as before said, will doubtless be yariously done. In the meantime we wiU make shift with our present repertories.
As regards the Schema, it appears to me to be quite unne- cessary. It is only a collection of symptoms dissected out and grouped artificially, and if the provings were indexed in some such manner as the verses of the Bevised Version of the New Testament, they could be noted in any fonn of repertory and ao allow of ready reference to them. The Schema is only a middle- man coming between the provings and the repertory, and as he is only a thing of shreds and patches he may be dispensed with.
Let us but have a reliable record of provings, and indexes, con- cordances, and repertories, cypher and others, general and special, will spring up, and with monographs on all subjects we duil not have to find fault with the materials for homcsopathic practice, excepting of course the inadequacy of every human means for meeting all the contmgencies of disease. P. Pboctob, L.R.C.P.
NOTICES TO CORRESPONDENTS.
«% We cannot undertake to return rejected manuacripte, GommonioatioDS, Ao., have been received from Dr. Coofbb (London) ; Dr. BsMJAFiBLD (Tasmania) ; Dr. Pubdom (Newcastle) ; Dr. Sioth (Cleve- land, U.S.) ; Dr. Pboell (Gastein); Dr. Blacklet (Manchester) ; AziAK £. CHAMBRfe, Bsq. (London) ; Miss Fobsitb (Slough) ; Dr. Hawm^^ Siotr /Bamsgate) ; Dr. Pboctob (Liverpool^ ; Dr. BLatiiB (Boohdale). Several important commnnications are anavoidably crnshed out.
BOOKS RECEIVED.
The Homeeopathie World, — Homeeopathic Medical Progress, — The New York Medical Timei,^The Calcutta Journal of Medicine—The New England Medical Gazette, Boston. — The Clinique. C^cago. — Bibluh tf^ue Homasopathique. Paris. — Bulletin de la Soci€tS MediaUe Homaso- oathique, Paris. — The Melbourne Argue, — The Hobart Mercury, — AUgemeine Homdopat, Zeitung. lieipng.Soletin Clinico, Madrid. — Homeeopathie Pharmacopeia. U.S.A. Boerieke & Tafel. — Faiulkner''e Viiiting List for 1883, Boerieke Ss Tafel.— Pr«ndmetaZ Addrett, Homa- opathie Society of Pennsylvania, — North American Journal of HomoNh pathy. — The Therapeutic Oazette, Detroit. — A Momentous Education Question. By P. A. Siljestrom. Translated by Dr. Garth Wilkinsen. Young: London. — Spinal Curvature. By Heather Bigg. GhurdbilL Indian Homaopathie Beview, Calcutta.^^tiultfnts* JoumaL — El Criteria Medico, — The American Observer, — The Medical Advance, — The Hahne* marmian Monthly, — Burgoyne's Monthly Magatine of Pharmacy,
Papen, Dispensary Beporto, and Bo^n lor Reriew to be sent to Dr. D. Droc Bbowji, 89. Seymour Street. Fortman Square, W.; or to Dr. KsmraDT, 16, MontpeUer Bow, Blaekheatfa, S.E. AaTertiaementa ana Buainesa oommanioatlons to be aent ta Meaan. E. Gould & Sov, 80, Mooigate Stnet, B.C.
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