Homopathy ; the science of therapeutics : a collection of papers elucidating and illustrating the principles of homopathy

Presented by
Loren A. Button, D. 0.

COLLEGE OF OSTEOPATHIC PHYSICIANS
AND SURGEONS • LOS ANGELES, CALIFORNIA

FROM THE LIBRARY

PASADENA

(JIOMCEOPATHY

THE SCIENCE OF THERAPEUTICS

of

ELUCIDATING AND ILLUSTRATING

THE PRINCIPLES OF HOMCEOPATHY.

VBY •'

DUN

CARROLL DUNHAM, A.M., M.D.

GRADUATE OF THE NEW- YORK COLLEGE OF PHYSICIANS AND SURGEONS; DEAN OF NEW-YORK
HOMCEOPATHIC COLLEGE; PROFESSOR OF MATERIA MEDICA; PRESIDENT OF THE
AMERICAN INSTITUTE OF HOMCEOPATHY, AND OF THE WORLD'S HOMCEO-
PATHIC CONVENTION HELD AT PHILADELPHIA, 1876; AND MEMBER
OF VARIOUS AMERICAN AND FOREIGN SOCIETIES.

FOR SALE AT ALL HOMCEOPATHIC PHARMACIES.

PRINTED FOR THE PROPRIETOR, BY

FRANCIS HART & COMPANY, No. 63 MURRAY STREET, NEW- YORK.

1877.

Entered, according to Act of Congress, in the year 1877,

By HARRIET E. K. DUNHAM,
In the Office of the Librarian of Congress at Washington.

P. P. WELLS, M. D.

THE HONORED COLLEAGUE AND BELOVED FRIEND OF
CARROLL DUNHAM,

THIS VOLUME
IS RESPECTFULLY DEDICATED.

CONTENTS.

ig62
PEUTICS

I...

Date. Page.

I. HOMOEOPATHY THE SCIENCE OF THERA-

I 1864 99

II. ANTAGONISM BETWEEN HOMOEOPATHY ) 0, ,

£ 1863 67

AND ALLOPATHY )

III. RELATION OF PATHOLOGY TO THERA-

PEUTICS

IV. PRIMARY AND SECONDARY SYMPTOMS OF }

DRUGS AS GUIDES IN DETERMINING > 1875 115

THE DOSE )

V. THE DOSE IN DRUG- PROVING 1860 136

VI. ALTERNATION OF REMEDIES. No. i 1863 156

VII. ALTERNATION OF REMEDIES. No. 2 1865 166

VIII. EDITORIAL REMARKS ON ALTERNATION. I... 1865 215

IX. EDITORIAL REMARKS ON ALTERNATION. II... 1865 223

X. THE USE OF HIGH POTENCIES IN THE )

TREATMENT OF THE SICK ) x ^ 22'

XL REPLY TO A LETTER ON HIGH POTENCIES.. .1864 257
XII. THE QUESTION OF THE DOSE 1864 267

XIII. THE BASIS OF TREATMENT 1864 272

XIV. DIAGNOSIS IN HOMCEOPATHIC PRACTICE, )

WITH COMPILATIONS FROM DR. KAS- > 1852 277

PAR'S LECTURES )

XV. BELLADONNA— REPORTED FROM THE GERMAN. 185 2 343
XVI. A WEAK SPOT IN OUR MATERIA MEDICA .... 1870 347

CONTENTS.

Date. Page.

XVII. DIRECTIONS FOR DRUG-PROVERS 1869 350

XVIII. PROVINGS OF LILIUM TIGRINUM 1870 353

XIX. MUREX PURPUREA 1864 367

XX. PLATINA — ADAPTED FROM THE GERMAN 1853 387

XXI. REMARKS ON RUMEX CRISPUS 1860 417

XXII. REMARKS ON GUAO 1863 423

XXIII. REMARKS ON SPIGELIA 1864 427

XXIV. DR. HARLEY ON CONIUM MACULATUM 1869 433

XXV. REMARKS ON CONIUM MACULATUM 1870 443

XXVI. REMARKS ON MEZEREUM 1860 458

XXVII. DEAFNESS CURED BY MEZEREUM 1858 462

XXVIII. CROUP CURED BY BGENNINGHAUSEN'S POWDERS. 1 860 467

XXIX. CHRONIC DIARRHOEA CURED BY A SIN-
GLE DOSE OF A HIGH POTENCY

XXX. PTERYGIUM CRASSUM CURED BY A SIN-
GLE DOSE IN A HIGH POTENCY

SIN- > Q,

v 1860 470

SIN- )

j 1864 474

XXXI. PANAMA FEVER CURED BY ARSENICUM 1860 479

XXXII. CASE CURED BY MAGNESIA CARBONICA 1870 482

XXXIII. OVARIAN TUMOR CURED BY COLOCYNTH 1869 485

XXXIV. BAPTISIA AS A HAIR- WASH 1868 488

XXXV. CHLORINE IN SPASMUS GLOTTIDIS. No. i ...1859 490

XXXVI. CHLORINE IN SPASMUS GLOTTIDIS. No. 2 ...1863 497

XXXVII. CHLORINE IN SPASMUS GLOTTIDIS. No. 3 ...1869 499

XXXVIII. ON THE ELIMINATION THEORY 1866 502

XXXIX. CHOLERA 1865 504

PREFACE.

Since the death of Dr. Carroll Dunham, a desire
has been expressed by many of his colleagues that
his writings should be collected in book form.

The present volume contains such as most directly
express his views on the cure of disease by drugs. In
their arrangement no attention has been paid to the
order of time in which they were written, but those
on the principles of cure have been placed together,
while clinical cases illustrating these principles have
been put side by side; and so great is the unity of
thought running through all, that it has not been
deemed inappropriate to give to the collection the
title of the main Essay.

If, forgetting that experience and reflection will,
as years go by, modify the opinions of every thinker,
any reader should fancy he sees contradictions in
these papers, he is referred to the dates at which they
were written1 and he will discover a mind ever
progressive and hospitable to truth. In 1864 the
Author writes: "The object of our professional life
is to find out the truth, and shape our practice accord-
ingly. Consistency to this object is true consistency,

1 See Table of Contents.

PREFACE.

while consistency to any form of opinion or doctrine
which may at one time have been supposed to be the
truth and proclaimed by us as such, consistency to
such opinion merely because we may have once
publicly uttered it, this is the basest and most ignoble
bigotry and cowardice."

These papers were occasional, unconnected contri-
butions to periodicals, addresses delivered at the
request of societies, studies of remedies or some
topic connected with them, and clinical cases. Could
they have been revised for publication as a book by
the hand that wrote them they might be more
uniform in style though scarcely more connected in
thought. To the Essay, "Homoeopathy the Science
of Therapeutics," the Author devoted more than usual
time, and after its publication in the A merican Homoe-
opathic Review it was issued in pamphlet form.
The Dedicatory Letter which then accompanied it
is here given:

To M. J. CHAPMAN, A. M., Cantab., M. D., Edin., London.

Dear Friend and Colleague :

If I show presumption in honoring these pages by the prefix of your
name, I may plead in extenuation that they were in some sort written at your
instigation.

When I had the pleasure of personal intercourse with you (now ten
years ago), you frequently gave me the following advice : " Make a study of
Hygiene in its relations to Medicine! "

One could not proceed far in such a study, involving as it does the
entire philosophy of the art of medicine, without being compelled to meet the

PREFACE.

following questions, which have perplexed, and still perplex and divide our
school :

Is the Homoeopathic law of cure sufficient for all the procedures required
in the treatment of the sick ?

Or is it, on the contrary, only a part of a still broader generalization ?

Or, again, are there other laws which are sometimes to be our guides in
Therapeutics? and if so, -when are they to be used ?

Are so-called " auxiliary " means ever requisite ? and if so, how does
this fact affect the jurisdiction of the law of cure ?

Those who give only a limited jurisdiction to the Therapeutic law deduce
their faith from their practice; but they have never given a satisfactory defini-
tion of the boundaries of this limited jurisdiction.

Those, on the other hand, who claim exclusive dominion for the Thera-
peutic law, belie their faith by their practice, for in treating the sick they do, as
a matter of fact, avail themselves of means and methods which are not author-
ized by this law.

Yet neither party should be called dishonest. The truth is, their clin-
ical instinct, their practical sagacity, has outrun their philosophical acuteness.
Each party felt its way nearly to the true ground, but neither has succeeded
in vindicating its claim to consistency in occupying that ground.

The result has been, on the part of Homoeopathic practitioners, an uncer-
tainty of their true position in relation to Old-school medicine, and, consequently,
a degree of distrust on the part of the community.

It has seemed to me that these difficulties might be removed, and the
perplexing questions fairly answered, by an elaboration of the nature and rela-
tions of the sciences of Therapeutics and Hygiene, which should show :

That Therapeutics concerns herself only with the discovery and selection
of an individually specific remedy for each individual case of disease ; which is
done in accordance with a Therapeutic law. This law may be the Homoeopathic
formula, or it may be some broader generalization ; but there can be but one
law of this kind ;

That the province of Hygiene is to discover whatever causes may have
contributed to induce or perpetuate the diseased condition, and, if possible, to
remove them ;

That Hygiene alone is sufficient to restore many sick persons to health,
and that it is in most cases an indispensable aid to Therapeutics; that,
therefore, the practicing physician is at one and the same time Hygienist and
Therapeutist, employing often, therefore, for the same case both specific reme-
dies and various " auxiliaries ; "

That in so far as Hygiene is concerned, Homoeopaths and Allopaths
occupy common ground, — the philosophy of the science being the same for
both, however modified and shaded in practical application by the different
Therapeutics of the two schools ;

That in Therapeutics alone — that is, in the discovery and selection of
the individually specific remedy for each individual case of disease — do we
differ radically from the old school of medicine, — the Allopaths having, in fact,
no science of Therapeutics whatever, their philosophy of cure being an applica-
tion of the principles of Hygiene to all diseased conditions.

PREFACE.

The natural sequence of a study of the philosophy of the science of
Therapeutics is the question how to make a practical application of it in the
treatment of the sick. I have therefore written of the study of the Materia
Medica.

Should the views I present throw any light upon these subjects, I shall
have to thank you for the direction given to my studies. Should they prove
worthless, you will join me in hoping for a sounder fruit from the labors of the
next decade.

CARROLL DUNHAM.
New- York, January, 1863.

Should the reader miss in the present volume
some Paper he had expected to find here, it is prob-
ably among the " Lectures," reserved for future pub-
lication, or among the Miscellanies not strictly
belonging to the present book.

Irvington-on-Hudson,
June 25, 1877.

HOMCEOPATHY THE SCIENCE OF
THERAPEUTICS.

Homoeopathy claims to be " The Science of Therapeutics."
This claim involves the assumption that prior to the estab-
lishment of Homoeopathy on a scientific basis, Therapeutics,
as a science, had no existence. It is incumbent on Homoeop-
athists to show the justice of this assumption. To accom-
plish this, it will be necessary to prove that such a science is
possible, to demonstrate what its nature and conditions must
be, and to show that medicine hitherto has not furnished the
means for the construction of a science which fulfills these
conditions.

It is the object of this paper, first, to discuss the nature
and conditions of the only possible science of Therapeutics,
to show that these conditions are not fulfilled by what is
called rational medicine, and to inquire in what degree they
are fulfilled by Homoeopathy. And, second, to examine the
methods by which this science may be most successfully stud-
ied and made subservient to the practical art of medicine.

But on the threshold of the discussion we are met by the
necessity of defining the term Therapeutics. It will be
found that, though still sufficiently comprehensive, it is used
by us in a much more restricted sense than that which, in
popular thought, is attached to it.

Therapeutics being etymologically the science of curing
diseases, it would seem to comprise the entire function of
the physician. It is evident, however, on slight considera-
tion, that the medical man in general practice brings into
requisition too great a variety of scientific knowledge to
admit of comprehension under a single term. To show
2

2 HOMOEOPATHY

how great this variety is and at the same time to give an
indirect definition and limitation to the term Therapeutics,
let us analyze a series of cases which shall not be ideal
cases, but drawn from records of actual practice.

The physician is called in haste to an elderly person whose
only intelligible complaint is of great anguish in the prae-
cordia, and which appears by its violence to endanger his
life. If he be in immediate danger of death, the state of his
affairs renders it desirable that his family should be informed
of the fact and how long he will probably live. The prog-
nosis is demanded, and its correctness is a matter of great
importance. The medical man must rely on his knowledge
of Pathology1 for a conclusion respecting the nature, cause,
and probable termination of the disease. With this, if it be
a fatal case, the function of the physician ends. Yet how
important may this function be to the survivors ! Here is as
yet no question of Therapeutics. It is merely a problem in
the natural history of disease, which the physician regards
just as a Naturalist would a problem in Physics, and just as
if the idea of curing disease had never entered the head
of man.

Again, he is called to a man who lies in an epileptiform
convulsion. It is well known that convulsions may arise
from the most various proximate causes. They may result
from physical irritation of the nervous centers or of the
extremities of the nerve-filaments, and in this case they
will cease to recur so soon as the cause of irritation is
removed ; or, on the other hand, from modifications of the
vital functions, such as are beyond our observation and
which we can rectify only indirectly by the action of specific

1 Throughout this paper, as always sues, and is concrete. A corresponding

by its author, Pathology is used with a distinction obtains between Physiol-

meaning totally distinct from that of ogy, which is the science of healthy

Pathological Anatomy. The former processes and functions, and Physiolog-

is the science of morbid processes and ical Anatomy, which is the science of

functions, and is abstract ; the latter is healthy organs and tissues.
the science of morbid organs and tis-

THE SCIENCE OF THERAPEUTICS. 3

agents. The first problem before the physician is to deter-
mine by a study of the phenomena which the patient
presents, to which of these great classes the case before
him belongs. It is indispensable to determine this question,
because the treatment of the case must depend directly
upon it, — in the former case it may be mechanical or hygi-
enic, in the latter it must be therapeutic. He determines,
we will suppose, in the case before us, that the convulsion
is eccentric in its origin and reflex in its nature, and he sees
reason for suspecting that it depends on some cause of irri-
tation in a nerve-filament of the lower extremity. He seeks,
in the history of the case, and by a physical examination,
for this irritating cause, and discovers that the patient had,
years ago, received a gunshot wound in the thigh. There
is no evidence that the ball was ever extracted. A close
examination seems to confirm the conjecture that it still lies
imbedded in the muscles of the thigh. An exploratory
operation is performed and the ball is actually found lying
upon a branch of the sciatic nerve. It is removed and the
patient has no more convulsions. l

In this case the physician's knowledge of pathology ena-
bled him to discriminate between the varieties of convulsion
as to their proximate causes; his acquaintance with physiol-
ogy familiarized him with the phenomena of reflex-nervous
action and enabled him to detect the seat of the irritation,
and finally his dexterity in practical surgery placed it in his
power to cure the patient of a dreadful malady. But, in this
case from beginning to end, Therapeutics was not called into
play.

Again, the patient, a child of two and a half years, is
subject to epileptiform convulsions, which occur daily, often
twice a day. They first appeared when the child was four-
teen months old and soon after it was weaned. They are
now producing a very sad effect upon the child's intelligence.

1 This occurred in the practice of a distinguished Surgeon of Massachusetts.

4 HOMOEOPATHY

The same question of proximate cause, which the last case
gave rise to, suggests itself, first of all, to the mind of the
physician. Careful investigation satisfies him that there is
probably a constant or a frequently repeated source of irri-
tation in the digestive apparatus. What so probable cause
of irritation in these organs as improper food ? The question
is put at once, "What food does your child take?" "Nothing
whatever, except molasses-cake and milk." " How do you
make molasses- cake ?" "Three cups of flour, one of butter,
one of milk, one of molasses, one egg and a tea-spoonful of
pearlash ! " " Very bad for your child ! Give it good wheat
bread and milk and nothing else, except this powder" (of
sugar of milk as a placebo). The diet of the child is thus
reformed, but no medicine is administered and the case is
carefully watched. For one week the spasms steadily de-
crease in frequency and in violence, at the end of that period
they cease and they never recur.1 Thus an abnormal state
of things, which would certainly have had a fatal issue, is
rectified by the application of a knowledge of Physiology,
Pathology and Hygiene ; but Therapeutics has no part in it.

Errors in diet being perhaps the most numerous of all of
which the community are guilty, instances like this might be
accumulated to an indefinite extent. It is clear that a large
part of a medical man's practice is made up of similar cases,
and consequently that a great many serious cases may be
successfully treated without recourse to medicine — without
the aid of Therapeutics.

Again, a patient presents herself with the following history:
Within three months she has rapidly emaciated ; her sleep is
disturbed, her appetite gone; she has night-sweats; is prone
to diarrhoea ; takes frequent deep inspirations which fatigue
her; has a dry, hacking cough; complains of extreme weak-
ness and despondency. A careful physical examination fails
to discover organic disease of thoracic or abdominal organs,

1 This case occurred in 1857. There The child on good diet is healthy,
h'as been no recurrence of spasms.

THE SCIENCE OF THERAPEUTICS. 5

nor does an investigation of her domestic or social relations
disclose any source of mental or affectional anxiety. The
case is perplexing as to its inducing cause, and the physician
inclines to ascribe it to dynamic causes and to have recourse
primarily to specific remedies for its cure, — in other words,
to call Therapeutics to his aid, — when he discovers that the
patient is nursing an infant of twelve months. Her milk is
very abundant, but a microscopic examination shows that it
is extremely deficient in oily matter. It is now clear that
the patient is unequal to the drain to which nursing subjects
her ; she is suffering from consequent anaemia. It is ordered
that she wean her babe at once. As soon as she does so,
appetite returns, the cough and night-sweats disappear, and
strength and flesh are restored. Now, it is true that, in such
a case, the decline of vigor may be retarded, and after wean-
ing, the restoration may be accelerated by a judicious appli-
cation of Therapeutics ; but it is unquestionably true that
Therapeutics would play a very subordinate part, since no
administration of medicines could be an offset to the drain
which is exhausting the patient.

In cases of similar exhaustion, facial Neuralgia of a reg-
ularly intermitting character sometimes occurs and bids
defiance to Therapeutics, the patient meanwhile declining
rapidly in strength and health until, medicine being perhaps
altogether discarded, but the patient induced to wean her
infant and thereby enabled to take hearty food, strength
and flesh return, and the Neuralgic pains cease. In this
case, also, the restoration may be accelerated by a judicious
recourse to Therapeutics, but here too Therapeutics must be
subordinate to Hygiene.

Once more, a patient, who exhibits signs of depraved
nutrition, complains of a burning pain under the angle of the
right scapula, with a tight aching across ,the back between
the scapulas. I fear that repeated prescriptions will fail to
relieve this burning pain unless the physician's knowledge of
pathology shall have suggested to him that the symptoms

6 HOMOEOPATHY

result ultimately from a too steady use of the needle with
too rapid a motion, and unless his skill in Hygiene shall have
enabled him so to order her mode of life as to combine due
recreation and exercise in the open air with her necessary
labor. Here, as in other cases, Therapeutics may of course
come in and play a subordinate part.

Finally, a patient has severe darting and aching in the
shin, especially at evening, with coldness of the extremity,
and, after the pain has lasted an hour, great sensibility to
touch, relieved by warmth and by continued motion. This
case has been treated by a variety of Therapeutic agents
in the hands of several learned practitioners, but with no
success. It is noticed that the patient, in the course of his
business, incurs great exposure to dampness and cold. A
woolen stocking is advised, and he enjoys ever after adopting
it almost complete freedom from suffering, and which is
rendered absolutely complete by a few doses of Rhus tox-
icodendron. It must be remarked that this remedy had been
previously administered in every variety of potency and dose.

Instances of a similar character to these might be indefi-
nitely multiplied. They go to show, not that medicines are
vain or unnecessary, but that very many cases of severe
suffering and even of what threatens to become fatal disease
occur in general practice, which call for and are successfully
met by the application of scientific knowledge apart from
Therapeutics. They show that an extensive and thorough
knowledge of Physiology, Pathology and Hygiene are indis-
pensable to the physician to enable him to make that prelim-
inary analysis of a case by which he will determine under
what category the case belongs, and whether or not it calls
for treatment by medicines in part or entirely — whether it
comes under the domain of Therapeutics or not. They show,
moreover, that, inasmuch as Homoeopathy directly involves
the science of Therapeutics alone, there is a large field which
is occupied and cultivated in common by Homceopathists
and practitioners of the Old School. They serve in part, also,

THE SCIENCE OF THERAPEUTICS. /

to mark the boundaries of that field in which " Rational
Medicine " may legitimately claim dominion, in which her
chief honors have been won, and in which the great advances
which she boasts of having made in the treatment of diseases
within the last thirty years have almost exclusively been
achieved — the field of Hygiene. It is fitting that we study
for a few moments this territory of Hygiene, which is com-
mon to practitioners of all the varieties of Therapeutic faith
and practice, — this science on which, together with the sci-
ence of Therapeutics, the whole art of medicine is based —
its subjects, limits, conditions, and mode of growth.

THE NATURE AND LIMITS OF THE SCIENCES OF
HYGIENE AND THERAPEUTICS. — The living organism
possesses a susceptibility to the action of certain general
stimuli, such as light, heat, electricity, aliment, atmospheric
air, etc. The action and reaction of these stimuli and this
susceptibility are the conditions of life. So long as they act
upon it in a due relative proportion, as regards intensity and
quantity, the equilibrium of the functions is preserved and
the organism continues in healthy action. The absolute
withdrawal of one of the stimuli for any considerable length
of time results in death. A disturbance of their due propor-
tion, in respect of intensity or quantity, produces an abnor-
mal performance of function in the organism — a deviation
from health — disease. But these stimuli are continually
varying in proportion, or, in other words, the relative suscep-
tibility of the organism is continually changing. Why does
not disease constantly exist ? Because the organism is
endowed with either a faculty of provisionally supplementing
to a limited extent one stimulus by another, or with a kind
of elasticity, — a power of enduring for a certain time a
disturbance of the equilibrium of these stimuli, and of
rebounding to a normal performance of functions again so
soon as the natural proportion of the stimuli is restored or
the deficiency made up. In this respect, the living organism

8 HOMCEOPATHY

differs from an inorganic machine, which cannot, in the
nature of things, possess any power to endure a disturbance
of that equilibrium of forces which is the condition of its
normal working without a disorganization from which it has
no inherent power to recover.

But, in the organism this elasticity has its limits. This
"vis medicatrix natura" is not inexhaustible. If the due
proportion of the stimuli remain too long disturbed, the
functions of the organism become permanently deranged —
at least, to such an extent, that no restoration of the balance
of the stimuli will cause a return to their normal perform-
ance. The functions are and remain deranged — disease
has occurred ; or, if we choose to call every deviation from a
state of equilibrium disease, then we may say that now
disease ensues which has no tendency to revert to health
without the intervention of some extraneous influence foreign
to the organism and different from the general stimuli
aforesaid. Since, then, the general stimuli will not bring
back the organism to a healthy action, a new element
must be sought for and introduced, the action of which
upon the susceptibilities of the organism may cause a restora-
tion to health. This new element will be a special stimu-
lus. Being foreign to the organism and different from the
general stimuli, not only must it act upon susceptibilities
in the organism which the latter do not awaken, but the
formula which shall express its relations to those suscepti-
bilities, and which shall furnish the rule for its employment,
can never be discovered by a study of Physiology, for Physi-
ology concerns herself with the relations of the general
stimuli aforesaid and the general susceptibilities of the
organism. This formula of the relations of special stimuli
and special susceptibilities can be discovered only by the
application of induction to a multitude of instances of the
action and reaction of such stimuli and susceptibilities, and
confirmed by subsequent deductive verifications. This for-
mula will constitute an empirical law, which will be the law

THE SCIENCE OF THERAPEUTICS. Cj

or fundamental principle of Therapeutics. For the applica-
tion of special stimuli to the diseased organism is the domain
of the science of Therapeutics, while all that concerns the
restoration and maintenance of a proper equilibrium of the
general stimuli appertains to the science of Hygiene.

These propositions may be more intelligible if illustrated
by a reference to daily experience. A healthy man is ex-
posed to an unusual degree of cold ; in other words, there
exists for him a deficit of heat — one of the general stimuli
which are necessary to maintain life. Nature has anticipated
variations in the supply of this stimulus from external
sources by her liberal provisions of calorific apparatus within
the organism. Despite the operation of this provision, he
is chilled and suffers from rigors, etc. After a time he seeks
shelter, sits by a fire, takes a warm drink ; in other words,
receives from external sources an excess of that general
stimulus from deficiency of which he has been suffering. His
functions resume their normal play. He is in perfect health.
Here the equilibrium of the functions has been disturbed and
(if we use terms with extreme rigor) disease has been pro-
duced, but not to a degree beyond the provisions of the vis-
medicatrix natures — the natural tendency to a restoration of
the balance of the functions. The case was treated upon
" general principles " in accordance with the maxim causa sub-
lata tollittir effectus. And this maxim represents, in fact,
the great law of Hygiene, viz. : that it be ascertained what
stimulus has been deficient or excessive in quantity or
abnormal in quality, and that the equilibrium of the stimuli
be restored.

But let us suppose that the same man has again been
exposed to cold, perhaps to a greater degree. He seeks
shelter and essays to restore the lost heat, but without avail.
Despite the fire and warm drinks, the rigors continue and
are succeeded by fever and quickened respiration, cough,
etc., or by rheumatic pains, redness and swelling, etc. Why
this difference between the cases ? This case too has been

IO HOMCEOPATHY

treated on " general principles." The cause has been re-
moved, why has not the effect ceased ? The equilibrium of
the general stimuli has been restored and the loss made
good; why is not the normal equilibrium of the functions
re-established ?

The normal proportion of the general stimuli, it is true,
has been restored, but during the disturbance a new element
had been introduced into the problem. The organism had
suffered a dynamic and then an organic change. The func-
tions are permanently modified. The general stimuli may
henceforth be balanced never so carefully, and in strictest
accordance with the rules of Hygiene ; the organism will not
respond.

Its functions are performed after a new fashion. The
organs are not susceptible to the wonted stimuli applied
according to the laws of Hygiene. The organism has passed
from a state of health into one of permanent disease. The
general stimuli which, modified and balanced under the laws
of Hygiene, sufficed to steady it as it rocked and swayed in
its rapid course along the rough and crooked railway of life,
will no longer answer the purpose, for in its rocking it has
run off the track, and is now bumping along over the cross-
ties, making headway, it is true, but toward its own destruc-
tion. It needs now the intervention of some new agent
acting under a new law — of a jack-screw and levers operated
by forces from without — to re-instate it on the road of
healthy action. The wonted general stimuli under the laws
of Hygiene being insufficient, new stimuli of a special charac-
ter must be applied according to a neiv law. This new law,
whatever it be, is the Therapeutic law, and these new stimuli
are Therapeutic agents, and the study of the law and of the
agents constitutes the science of Therapeutics.

Having thus marked out its limits, we have next to
inquire what the nature of any possible science of Thera-
peutics must be. Its subject is the modified functions and
organs of the body. Its agents are special stimuli drawn

THE SCIENCE OF THERAPEUTICS. II

from whatever region of the external world. By what sort
of a formula can these agents be applied to that subject ?
Can the Therapeutist act on " general principles " as the
Hygienist does ? Can he act on the maxim causa sublata
tollitur effectus? Obviously he cannot. In so far as the
cause of disease can be discovered in external influences, the
treatment falls within the limits of the science of Hygiene as
already discussed. In so far, however, as the cause of
disease is identical with the essential cause of the modifica-
tion of function or organ which we recognize as the disease,
it can never be discovered, for it is the same, in its nature, as
the cause of healthy functional or organic action ; in other
words, it is life itself, the nature of which, as of every first
cause, is inscrutable. It being impossible then to ascertain
the essential cause of disease, and to apply a remedy accord-
ing to the rational method — as the Hygienist does — the
Therapeutist is necessarily thrown back from an attempt to
investigate first causes, to the study of phenomena and to the
adoption of the empirical method. In accordance with this
method, the subject of his researches will be respectively the
phenomena manifested by the patient, and the phenomena
produced by the special stimulus, and his endeavor must be
to discover a general formula which shall express a constant
relation between these two series of phenomena and shall
serve as the Therapeutic law. In thus acting, and upon this
method, he will do precisely what the student of every
branch of Natural Science does and has done. For in his
inability to find out the essential cause of the phenomena
that form the subject of his study, the physician finds himself
in the very same predicament as the Naturalist who likewise
has vainly sought to discover the essential causes of the phe-
nomena of gravitation, of light, of chemical action, and of elec-
tricity. As the physician is unable to discover the essential
nature of life and organism, whether normal or modified, to
ascertain the cause of health or of disease, and is therefore
unable to treat disease upon the principle " tolle causam "

12 HOMCEOPATHY

(except in matters of Hygiene, as before stated), or " on
general principles;" so the Naturalist has been compelled to
abandon the rational method, such as Aristotle proposed and
philosophers elaborated up to the time of Bacon and New-
ton, and to adopt an empirical method in which the funda-
mental principle is an empirical law or generalization
expressing the relation between two series of phenomena.
The science of Physics, for example, consists of the phenom-
ena respectively of two bodies, or series of bodies, so far
as density and volume are concerned, and of the law of
gravitation which expresses the relation between these
respective phenomena.

The Therapeutist, then, abandoning all idea of construct-
ing a science of Therapeutics on the rational method, must
have recourse to the empirical, as the elaborators of other
natural sciences have done. The elements of his science will
be as follows : He has to deal with a subject known by its
phenomena — the sick body, with an agent known also by
its phenomena — the drug; and with a law which shall tell
how to apply the agent to the subject for the accomplish-
ment of a cure, — a law which shall express the general
relation between the drug and the morbid organism.

The following tabular statement will show more clearly
the nature of Therapeutics as a science, and its harmony
with other Natural Sciences; for every Inductive Natural
Science (except those of classification) consists elementarily
of two series of independent phenomena, connected by the
formula of their general relation :

THERAPEUTICS.

Morbid Functions & Organs, \ ( Toxic Functions & Organs,
Or, Pathology and Patho- ( Therapeutic ^ Or, Pathogenesis and Patho-
logical Anatomy, f Law. y genetic Anatomy,
Or, Sick-Phenomena, J \ Or, Drug- Phenomena.

PHYSICS.

Phenomena of the Sun, i T of ^ Phenomena of the Earth,

as regards Volume and > Attraction 1 as regar(*s Volume and

Density, ) ( Density.

THE SCIENCE OF THERAPEUTICS. 13

CHEMISTRY.

) Law of Chemical (

Properties of Potassa, > Affinity and Defi- < Properties of Sulphuric acid.

) nite Proportion. (

OPTICS.

Properties of the Luminous f -^.^ °. ^ ] Properties of the light-re-

Body, ^ L}ght ^ ceivingbody.

Though thus simple in theory, Therapeutics is in reality
the most complex of all the natural sciences. Each of the
classes of phenomena requires for its study the aid of several
auxiliary sciences. Thus, in order to know thoroughly the
phenomena of disease, we must call to our aid Anatomy and
Physiology, Chemistry, Physics and Psychology. To know
and understand thoroughly the phenomena of artificial dis-
ease or pathogenesy, we must avail ourselves of the same
auxiliary sciences. The more imperfect our knowledge of
these sciences, the less complete will be our acquaintance
respectively with the phenomena of Pathology and Patho-
genesy, and the converse. But, however complete or partial
may be our knowledge of these two classes of phenomena,
the relation between them, as known, remains the same, and
is always expressed by the therapeutic law. The same is
true of Physics and of all the natural sciences. Our knowl-
edge of the physical properties of matter is continually
increasing. The more complete it is, the more exact will be
our application of the law of attraction. But complete or
incomplete, the law is equally applicable, and pro tanto
available.

THE CONDITIONS OF A SCIENCE OF THERAPEUTICS. —
We come now to consider two conditions to which every
natural science must be subject, and which may therefore
serve as tests of its fitness to be regarded as a " Science."
The first of these is a capability of infinite progress in each
of its elements without detriment to its integrity as a whole.

14 HOMCEOPATHY

We have already seen that the science of Physics is capa-
ble of such progress in the phenomena with which it deals.
Our knowledge of these phenomena is continually growing
more comprehensive and more minute, and new elements of
knowledge are continually coming into our possession with
regard to them ; yet their relation to each other through
the law of attraction remains the same, and the science, in
its nature and structure, receives no modification. But not
only are its subjects, the phenomena, capable of progress ;
the law itself may advance from a minor to a grander gener-
alization, as it was advanced, step by step, by Newton, and
still without destruction of the previous steps. The same is
true of Chemistry. As our means of investigation become
more exact and extensive, our knowledge of the properties
of bodies increases ; yet the law of Chemical Affinity in
definite proportions remains undisturbed. Furthermore, this
law itself becomes the subject of more extended generaliza-
tions. The law as established by Black and Cavendish was
suspended, yet not overthrown (nor the science disturbed)
by the wider generalization of Dalton's Atomic Theory ;
and this again forms but a part of Faraday's Theory of the
Identity of Chemical Affinity and Electrical Attraction, and
amid all these revolutions in abstract theory, the science of
practical Chemistry has held an even way.

In the science of Optics, again, the phenomena of the
luminous body and those of the light-receiving body are
connected by the law of the transmission and diffusion of
light. This structure of the science and all that is based
upon it rests undisturbed through all the mighty changes
which recent discoveries have wrought in our knowledge of
Optics — enriched but not revolutionized by them. But
while the progress of the science has been thus rapid and
uninterrupted, philosophers have been and remain at vari-
ance respecting the very nature of light and its mode of
propagation. One school holds to the theory of emission,
another to the undulatory theory. Now, let us suppose

THE SCIENCE OF THERAPEUTICS. 15

that the science of Optics, instead of being based upon an
empirical law, the result of induction, and which expresses
the relation between two series of observed phenomena, had
been based upon a theory of the essential nature of light and
its mode of transmission. It is very evident that the whole
structure that might be built upon the theory of emission
would be toppled over so soon as the theory of undulation
should be established. And should subsequent observation
again lend . countenance to the theory of emission, down
would go, of necessity, the whole science as built upon the
undulatory theory. And thus, inasmuch as experience and
sound philosophy render it tolerably certain that we shall
never attain absolute knowledge on this subject, we should
have, through all time, an endless succession of half-com-
pleted fabrics and hopeless ruins, but no infinitely progres-
sive science of Optics.

This furnishes an exact illustration of what would be the
history of any science of Therapeutics not constructed upon
the empirical plan already elaborated. Let us suppose that
instead of taking as the subject of action, the phenomena of
disease as derived from observation with all the aid which
auxiliary sciences can afford, we should take a theory of
disease, — its essential nature and mode of development, — and
upon ttiis theory should construct a science. All would
go well, until facts should show that our theory was insuf-
ficient and untenable (and facts would show this, since, as
we have already seen, the essential nature of disease is
inscrutable). Now our whole structure would be over-
thrown, nor would the fragments even be available for the
construction of another science or another theory, for they
would consist of observations made, not independently, but
on the basis of a theory and with reference to it. There
could thus be no possibility of steady, uninterrupted, infinite
progress in the science. There would be a succession of
dynasties of theory, each based on the overthrow of a
former, and each in turn demolished by its successor. That

1 6 HOMOEOPATHY

this is the history of the Therapeutics of the Old School
of medicine up to the present day is admitted by common
consent. It will continue until attempts to erect a rational
science of Therapeutics upon a theory of disease, confound-
ing the law with the phenomena, shall give place to the
construction of an empirical inductive science.

"What then ! " it may be asked, "shall we not investigate
and theorize upon the nature of disease in general, or of
diseases in particular ? " By all means investigate and
theorize, just as physicists do upon the nature, properties
and transmission of light — but do it as studying the science
of Pathology, not that of Therapeutics — and avoid most
carefully, making these theories which can be at best no
more than temporary aids to the observation and grouping
of phenomena, the basis of a practical science. If, however,
they throw light on the study of phenomena, render our
observations of them more keen and more exact, or afford
us connecting links between isolated groups of phenomena, —
and they will do all this, — they will render valuable indirect
aid to the science of Therapeutics, just as similar investiga-
tions of light have advanced our knowledge of Optics.

A second condition or test of a natural science, and
therefore of any proposed science of Therapeutics, is that it
shall provide for the prediction of future events within its
own domain. It must furnish means of prevision. The
problem must be as follows : Given the law and one series
of phenomena, to state the corresponding series of phenom-
ena on the other side. This condition is admirably stated
by Whewell : " Men cannot help believing that the laws laid
down by discoverers must be in a great measure identical
with the real laws of nature, when the discoverers thus
determine effects beforehand, in the same manner in which
nature herself determines them when the occasion occurs.
Those who can do this must to a great extent have detected
nature's secret — must have fixed upon the conditions to
which she attends and must have seized the rules by which

THE SCIENCE OF THERAPEUTICS. \J

she applies them. Such a coincidence of untried facts with
speculative assertions cannot be the work of chance, but
implies some large portion of truth in the principles on
which the reasoning is founded. To trace order and law in
that which has been observed, may be considered as inter-
preting what nature has written down for us and will
commonly prove that we understand her alphabet. But to
predict what has not been observed is to attempt ourselves to
use the legislative phrases of nature ; and when she responds
plainly and precisely to that which we thus utter, we cannot
but suppose that we have in a great measure made ourselves
masters of the meaning and structure of her language. The
prediction of results even of the same kind as those which
have been observed, in new cases, is a proof of real success
in our inductive processes." 1

The discovery of the planet Neptune by Leverrier and
Adams affords an instance of this prevision, in Astronomy,
the details of which are familiar to all. The problem was :
Given the law of attraction and a series of phenomena, con-
sisting of certain unexplained perturbations of Jupiter — to
find the other and corresponding series of phenomena. The
calculations were made ; the resulting phenomena were
stated to be those of an undiscovered planet of a given size
and orbit and a definite location, the existence of which was
accordingly affirmed and its discovery predicted. Physical
investigation confirmed the induction.

This condition applies to all natural sciences, and of course
to Therapeutics. The problem would be : Given the Thera-
peutic law and a certain series of phenomena of natural or
drug disease, to find the corresponding series of phenomena
of drug or natural disease.

DOES " RATIONAL MEDICINE " FULFILL THESE CONDI-
TIONS?— This being the nature and these the conditions and

1 Whewell, Philosophy of the Inductive Sciences, vol. ii., pp. 64, 65.

3

1 8 HOMCEOPATHY

tests of the only possible science of Therapeutics, we come
now to inquire whether the Old- School Therapeutics are of
this nature or will sustain these tests. The works of the
foremost men of the Old School abound in admissions of their
lack of a therapeutic law and of the chaotic state of their
practice.1 But the efforts of these men to remedy this sad
state of things show a constant misapprehension of the philos-
ophy of the science they are striving to construct.

We may divide Old-School Therapeutics into two methods.
The one bases the plan of cure upon a theory of the nature
of the disease,2 endeavors so to study the pathology of the
disease as to form a sound hypothesis of its modus operandi
and then essays the cure upon " general principles." It
undertakes, in fact, to act in Therapeutics upon what we have
seen to be the true method in Hygiene. There are three
objections to this method, any of which would be conclusive
were there not a prior difficulty in the simple impossibility of
arriving at a knowledge of the nature of the disease, which
is modified life, A simple example will show this impos-
sibility. In Pneumonia the blood contains an excess of
fibrine. How happens this ? Why, either the elimination
of fibrine has been retarded or its fabrication has been accel-
erated. What are the agents of these respective processes ?
Cells — which are essentially similar in all parts of the body
— and yet whose structureless walls possess the power of
separating from the circumambient fluids the most diverse
substances in different organs — nay, even of manufacturing
new substances. Now, until we can learn the secret of this
mysterious power of the cell wall, which begins and ends
with life, which we can neither comprehend nor imitate nor
simulate, we shall not arrive at an understanding of the
nature of any disease.

1 See Forbes, Bennett, Tod, Holmes says : " In these wards, by those bed-
and others. sides, have you seen the patient ap-

2 Thus Prof. Geo. T. Elliott in his plication of the searching analytical
recent Valedictory to the Graduating laws by which we seek to discover the
class at Bellevue College Hospital essentiality of disease."

THE SCIENCE OF THERAPEUTICS. 19

Of the other objections to this method the first two are
somewhat paradoxical. The method constitutes rather a
congeries of sciences of Therapeutics, based on theories of
isolated groups or types of disease, than a single, all-embrac-
ing science founded on one comprehensive theory of disease.
Hence, a new science must be formed for every new type.
It is too special. On the other hand, it is too general to
embrace all the phenomena of each individual case. For
observation shows incontestably that so great are the vari-
eties of temperament and relative organization and condition
among men, that no two cases of the same disease, so to
speak, are exactly alike.

Such a Therapeutics must be necessarily based on a
theory which is a generalization, and which therefore over-
looks those phenomena of a given case which are peculiar to
the individual patient and takes cognizance only of those
phenomena which are common to a great number of cases.
Now, a method which requires such generalization and makes
no provision for the strictest individualization is radically
vicious.

The eye of science regards natural phenomena with the
most absolute impartiality. In her view there are no trifles,
no events, subjective or objective, which are "irrelevant"
and " of no moment." A method of Therapeutics, however,
which selects a few symptoms, calls them pathognomonic of
Pneumonia, constructs upon them a theory of the disease,
and from this deduces a mode of cure, must disregard many
phenomena of every individual case. It arbitrarily pro-
nounces them " accidental " — but Nature knows no accidents.

So far is this method from meeting the requirements of
inductive science, that it is not too much to say that this
process of generalization actually leads to the treatment of
cases which have no real existence and never had any, — in
fact, to the treatment of abstractions. For who ever saw a
case in which none but the pathognomonic symptoms of
Pneumonia were present — or of Rheumatism or Dysentery ?

2O HOMOEOPATHY

Who ever saw ideal cases of these diseases ? We all see
cases which present the pathognomonic symptoms plus
certain others peculiar to the individual, but these vary
with the individual, and thus make each case different from
every other. We see and treat the Pneumonia or Rheuma-
tism of John Doe or Richard Roe, each of which presents,
in addition to the pathognomonic signs of the disease, certain
peculiar modifications impressed upon these signs by the
temperament and idiosyncrasies of these persons, along
with other symptoms peculiar to each. For such an indi-
vidualization of disease as would give equal (or, as they
deserve, higher) rank to these peculiarities of the individual
patient, the method under consideration makes no provision.
This fallacy was perceived and well exposed by the Leipsic
Professor who recently exclaimed to his class: "Gentlemen,
we have to do with patients and not with diseases."

The next objection to this method is that it does not fulfill
the first condition of a physical science. It is not capable of
infinite progress. This point needs no elaboration. It was
fully considered when the condition was stated. In confir-
mation of what was then said, I need not refer to the
successive rise and decline of Brunonism, Broussaisism, the
humoral and solid pathology, the theory of the dyscrasias
and the reign and decade-nee of Iron, Iodine, Cod Liver
Oil, etc.

The second method of Old-School Therapeutics is the
methodical, which discards theory and founds its rules for
treating disease upon numerical data, obtained from observa-
tion or by experience upon the sick.

Given records of three series of cases, 1,000 in each, and
under three modes of treatment : Under treatment A, 500
recovered ; under B, 300 ; under C, 200. A is adopted as
the established mode of treatment for the disease — " Risum
teneatis, Amid?" An elaborate criticism of this method is.
unnecessary. It is enough to say that it does not fulfill
either condition of a physical science. It is incapable of

THE SCIENCE OF THERAPEUTICS. 21

infinite progress. The addition of 500 cases to the 3000
above named might modify all conclusions and place treat-
ment C in advance of A or B. There would result a
complete revolution in practice and in the direction of
investigation.

But it utterly fails to enable us to foresee and provide
against new forms of disease. If a thousand or two of
cases must be seen and experimented upon, in all conceivable
ways, before definite and trustworthy conclusions as to the
best treatment can be arrived at, who would not pray that
his turn might come among the third or fourth thousand ?
Who would not pity the victims among the first thousands ?

Notwithstanding these obvious objections, this method of
constructing a science of Therapeutics upon observation,
whether at random or based on experimentation upon the
sick, has the sanction of some of the highest names in the
profession — among which it is sufficient to name Louis and
Forbes. It demands, therefore, a more extended considera-
tion. As it involves the application of both Mathematics
and Logic, the opinion of the highest authorities in these
respective sciences should be conclusive as to the soundness
of the method, and we content ourselves with quoting two
of them :

M. Auguste Comte, one of the first living mathematicians,
and who would therefore be disposed to apply mathematical
methods to the natural sciences wherever this were possible,
expresses himself in the following manner concerning the
numerical method in medicine :

" Indeed, the spirit of calculation tends in our day to intro-
duce itself into this study (Physiology), especially into that
part of it which relates to medical questions, by a far less
direct method, under a far more deceptive form, and with
infinitely more humble pretensions. I wish to speak of that
assumed application of it which is called the Statistics of
Medicine, from which so many savants expect great things
and which, from its very nature, can lead only to profound

22 HOMCEOPATHY

and direct degradation of the medical art (which would be
reduced by it to a method of blind enumeration). Such a
method, if we may be allowed to call it by the name of
method at all, cannot in reality be anything else than absolute
empiricism, disguised under the frivolous garb of mathe-
matics. Pushed to its extreme logical consequences, it will
tend to make all rational medication radically disappear from
medicine, by conducting the practitioner to make random
trials of certain therapeutic measures with the object of
noting down, with minute precision, the numerical results of
their application. It is evident, on principle, that the con-
tinued variations to which all organism is subject, are neces-
sarily more pronounced in a pathological than in a normal
state, and as a consequence of this fact, the cases must be
even less exactly similar, whence results the manifest impos-
sibility of making a judicious comparison between two cura-
tive methods derived from data, furnished by statistical tables
alone, independent of some sound medical theory. No doubt,
some direct experimentation, restrained under proper limits,
might be of great importance to medicine as well as to
Physiology, but it is precisely under the strict condition that
it shall never be merely empirical, but shall always attach
itself either in institution or in its interpretation to an entire
system of corresponding positive doctrines. Notwithstanding
the imposing aspect of the forms of exactness, it would be
difficult to conceive of an opinion in Therapeutics more super-
ficial and more uncertain than that which rests solely on the
easy computation of fatal and favorable cases, to say nothing
of the pernicious practical consequences of such a manner of
proceeding, when one could not beforehand exclude any kind
of attempt.

" It is really deplorable that geometricians have sometimes
honored with some kind of encouragement, such a profoundly
irrational aberration by making vain and puerile efforts to
determine by their illusory theories of chances, the number of
cases sufficient to make these statistical results legitimate."1

1 Cours de Philosophic Positive,pa.r M. Auguste Comte, torn, iii., pp. 418-420.

THE SCIENCE OF THERAPEUTICS. 23

And with a direct reference to the method of obtaining a
correct system of Therapeutics by experimenting with indi-
vidual medicines and individual cases of diseases, and form-
ing of the results statistical tables from which deductions are
to be drawn by the numerical method, the highest modern
authority in philosophy, John Stuart Mill, speaks in his Sys-
tem of Logic: l "Let the subject of inquiry be the conditions
of health and disease in the human body ; or (for greater
simplicity) the conditions of recovery from a given disease ;
and in order to narrow the question still more, let it be
limited, in the first instance, to this one inquiry: Is or is not
a particular medicament (Mercury, for instance) a remedy for
that disease ?

" The experimental method would simply administer Mer-
cury in as many cases as possible, noting the age, sex, tem-
perament and other peculiarities of bodily constitution, the
particular form and variety of the disease, the particular
stage of its progress, etc., remarking in which of these cases
it produced a salutary effect, and with what circumstances it
was on those occasions combined. * * * *

" When we devise an experiment to ascertain the effect of a
given agent, there are certain precautions which we never, if
we can help it, omit. In the first place, we introduce the
agent into the midst of a set of circumstances, which we have
exactly ascertained. It need hardly be remarked how far
this condition is from being realized in any case connected
with the phenomena of life ; how far we are from knowing
what are all the circumstances which pre-exist in any
instance in which Mercury is administered to a living being.
This difficulty, however, though insuperable in most cases,
may not be so in all ; there are sometimes (though I should
think never in Physiology) concurrences of many causes
in which we yet know accurately what the causes are. But
when we have got rid of this obstacle, we encounter another
still more serious. In other cases, when we intend to try an
experiment, we do not reckon it enough that there be no cir-
1 Harper's edition, 1848, p. 260.

24 HOMOEOPATHY

cumstances in the case, the presence of which is unknown to
us. We require also that none of the circumstances which
we do know of shall have effects susceptible of being con-
founded with those of the agent whose properties we wish to
study. We take the utmost pains to exclude all causes
capable of composition with the given cause ; or if forced to
let in any such causes we take care to make them such that
we can compute and allow for their influence, so that the
effect of the given cause may, after the subduction of those
other effects, be apparent as a residual phenomenon.

" These precautions are inapplicable to such cases as we
are now considering. The Mercury of our experiment
being tried with an unknown multitude (or let it be a known
multitude) of other influencing circumstances, the mere fact
of their being influencing circumstances implies that they
disguise the effect of the Mercury, and preclude us from
knowing whether it has any effect or no. * * *

" In phenomena so complicated it is questionable if two
cases similar in all respects but one ever occurred ; and were
they to occur we could not possibly know that they were so
exactly similar.

" Anything like a scientific use of the method of experi-
ment in these complicated cases is therefore out of the
question. We can in the most favorable cases, only discover,
by a succession of trials, that a certain cause is very often
followed by a certain effect."

HAS "RATIONAL MEDICINE" ACCOMPLISHED NOTH-
ING?— But it may reasonably be asked, can it be possible
that a large number of men of every generation since
Hippocrates, and among them some of the brightest intel-
lects the world has known, should have been engaged in the
study and practice of medicine, with no better result than
this — a simple vacuity? I admit the rare intelligence and
devotion of the laborers. But, in the first place, the task is
mightier than any other essayed by man ; may it not

THE SCIENCE OF THERAPEUTICS. 25

reasonably require ages to complete its plan ? Again, labor,
however intelligent and devoted, if misdirected, must fail of
its end. If one generation of intellectual giants erect a
towering fabric and their equally lusty successors demolish
it, what does the third inherit save a heap of rubbish which
it may require the- best years of its life to clear away. Gen-
eration after generation of wise men labored to construct
the physical theory of the universe, yet not until the recent
day of Newton did we learn how to begin aright. True,
Newton's predecessors from the earliest ages observed and
stored away a mass of isolated facts of the greatest value,
but they knew not the magic word wherewith to charm
them into order. In like manner, it is not denied that we
are indebted to our predecessors for a vast number of
isolated facts of incontestable value as materials to be used
in the construction of a science of Therapeutics. We are
indebted to them also for the elaboration of those subsidiary
sciences — Anatomy, Physiology, Pathology, Chemistry and
the like — in which, indeed, the great glories of the medicine
of to-day have been won, and without which, we cheerfully
admit, Therapeutics as a science could not exist.

But it is said that Therapeutics must have advanced inas-
much as the rates of mortality have steadily diminished.
One sort of improvement we gladly acknowledge. Simul-
taneously with the spread of Homoeopathy, Old-School
physicians began to learn to abstain from mischievous modes
of treatment formerly pursued, and which terribly enhanced
the natural fatality of diseases. Professor Bennett, in the
introduction to his work on Clinical Medicine, specifies
Apoplexy, Pneumonia and Pleurisy, Syphilis, Small-pox,
Phthisis, Bright's disease, and Favus, as diseases in treating
which, he says, "great improvements have been made;"
and he adduces this as a proof of the advancement of
medicine. A reference to the chapters in which he treats
of these diseases shows that he conceives the " improvement
in their treatment" to consist in abstinence from methods

26 HOMOEOPATHY

which were formerly employed and which he clearly proves
were very mischievous. For example, Blood-letting in
Apoplexy, Pneumonia, Pleurisy, Phthisis and Bright's dis-
ease— the immoderate use of Mercury in Syphilis — heroic
medication and external warmth in Small-pox, and avoid-
ance of all internal medication forFavus, which he conceives
to be a vegetable parasite. This improvement, then, is purely
negative, a very poor ground on which to claim positive
advancement in the construction of a science, however
deserving of the gratitude of suffering humanity. The
formula for improvement of all kinds is, " Cease to do evil ;
learn to do well." We admit that the Old School are learning
to obey the former, the negative clause. We invite them to
advance and join us in the latter, the positive.

Again, an extended knowledge of the remote causes of
disease and of the principles of Hygiene has enabled med-
ical men to prevent the occurrence or the spread of many
forms of disease. And far be it from us to undervalue,
through any love of a newly constructed science of Thera-
peutics, this branch of a physician's function, the forestalling
or arrest of maladies by Hygienic means. As increased
knowledge in this department of science has enabled us to
dispense with therapeutic agents in many cases in which
they were formerly resorted to, so we firmly believe that,
with the advancement of learning, Hygiene will more and
more curtail the boundaries of Therapeutics, until the day
shall come when the physician shall be prized as the preserver
rather than solely the restorer of health, and shall be con-
sulted respecting the means of preventing rather than solely
of curing disease, and the "family doctor" shall be regarded
as the confidential adviser, valuable in proportion as he
keeps his client out of bed, just as the family lawyer is con-
fided in, for the purpose of keeping his clients out of court !
In that day there will be fewer apothecaries.

DOES HOMCEOPATHY FULFILL THE CONDITIONS OF A

SCIENCE OF THERAPEUTICS ? — Returning now to our argu-

THE SCIENCE OF THERAPEUTICS. 2/

ment, we find that the field is open for a science of Thera-
peutics. In the light of what has been said we proceed to
examine the claims of Homoeopathy to the honor of being
that science.

In its structure as a science, Homoeopathy conforms to
the model we have delineated. It consists of a law or
formula which expresses the relation between two series of
phenomena, those of a given case of disease on the one
hand and those of a given drug-proving on the other. The
elaboration of each of these series is the province of various
subsidiary sciences, and they are analogous in their mode of
elaboration. Each series, however, is entirely independent
of the other. Each may be pursued independently, as a
branch of Natural Science and under the heads of Pathology
and Pathogenesy respectively, researches may be made in
each without any view to a practical application in the cure
of the sick. It is only when connected by the law of their
relation (the formula of similarities) that they constitute the
science of Therapeutics.

Their application, moreover, in obedience to this law is
based upon no hypothesis respecting the essential nature of
either variety of phenomena or of their modus operandi
where brought into operation. This may surprise some who
know how earnestly Hahnemann argued on these very
points in his Organon. But these arguments were no essen-
tial parts of his system. They were the results of an
endeavor to commend his discovery to the prevalent way
of thinking. They constitute the only controvertible part
of his writings, and are the only positions of his which have
not triumphantly withstood the assaults of his critics.

Coming now to apply to Homreopathy, as tests, the condi-
tions to which we have shown that every inductive science
must conform, we find in the first place that it is capable of
infinite progress in each of its elements, without such prog-
ress involving the destruction or denial of what has been
previously constructed or received. The study of the

28 HOMOEOPATHY

phenomena (whether of disease or of drug-action) was limited
at first to the observation of external manifestations and
subjective sensations as these might present themselves to
our senses unassisted by any of the aids by which modern
science has sharpened them, or to our minds unaided by
that knowledge of the connection and mutual relations and
dependences of symptoms for which we are indebted to
modern discoveries in Chemistry and Pathology. But these
advances in Pathology, great as they have been, have not
altered the relation which the phenomena of natural disease
bear to those of drug-disease. These phenomena respect-
ively, whether rudely apprehended, or clearly and fully
understood in all their relations and inter-dependences, still
bear the same relation to each other — expressed by the law
Similia Similibus Curantur. And we can imagine no
possible development of the sciences of Pathology and
Pathogenesy which could alter this relation.

And then the law itself may be but a stepping-stone to a
still wider generalization which shall one day embrace both
it and something besides, and which shall make clear some
things which we now see darkly. But should this occur, as
the like has occurred in other Natural Sciences, there will
be, there can be, no revolutionary action in it. It may be
that the edifice, as we now occupy it, is still unfinished, — it
may be that other stories are one day to be added, — but
assuredly, as the tower is to the spire, as the buttress to the
pinnacle, so will this generalization be to that which may be
constructed upon it, — a basis, — an indispensable first step in
the construction of the science.

The complete manner in which the second condition—
that of prevision — is fulfilled by Homoeopathy is a source of
inexpressible benefit to the race. It follows, from the very
terms of the science, that if the phenomena of a given case
of disease be known, the law of relation will at once point
to the appropriate remedy (if this be contained in the Ma-
teria Medica) ; and this indication may be relied upon with

THE SCIENCE OF THERAPEUTICS. 29

implicit confidence, even though no such case of disease has
ever heretofore been subjected to treatment. Conversely,
when the properties of a given drug have been investigated
and its toxic phenomena well ascertained, the physician is
able to pronounce with certainty what form of disease it will
cure, even though no such disease has ever been witnessed
or treated by himself, or by anybody. An illustrious exam-
ple of this prevision was afforded by Hahnemann. The
terrible fatality of Asiatic Cholera, on its first invasion of
Europe, is well known. In extenuation of their lack of
success, physicians of the Old School pleaded that the disease
was new to them, — they had had no opportunities to study
it, and to ascertain by experiment the effects of remedies
upon it. The plea was plausible, but fatal to the pretensions
of their science. In fact, it was good for nothing. For
surely the first thousand cases should have afforded means
enough for learning the Pathology of the disease and how
to cure it, if this were to be learned from Pathology. But
hundreds of thousands perished, and yet the percentage of
mortality remained the same.

While the disease was still on the confines of Europe, —
before it had invaded Germany, — long before either he or
any of his disciples had ever seen a case of it, " Hahnemann,
guided by the unerring therapeutic rule he had discovered,
at once fixed upon the remedies which should prove spe-
cific for it, and caused directions to be printed and distributed
over the country by thousands ; so that on its actual inva-
sion the Homceopathists and those who had received Hahne-
mann's directions were fully prepared for its treatment and
prophylaxis; and thus there is no doubt many lives were
saved and many victims rescued from the pestilence. On all
sides statements were published testifying to the immense
comparative success that had attended the employment of
the means recommended by Hahnemann before he had seen
or treated a single case. This one fact speaks more for
Homoeopathy, and the truth of the law of nature on which

3O HOMCEOPATHY

the system is founded, than almost any other I could offer,
viz. : that Hahnemann, from merely reading a description of
one of the most appallingly rapid and fatal diseases, could
confidently and dogmatically say, such and such a medicine
will do good in this stage of the disease, such and such other
medicines in that ; and that the united testimony of hundreds
of practitioners in all parts of Europe should bear practical
testimony to the accuracy of Hahnemann's conclusions."1

We may add that in the second Epidemic of Cholera in
1849, the Old School, despite their experience in 1831-34,
had but little better success, while again the justice of Hah-
nemann's conclusions and the claim of Homoeopathy to that
prevision which characterizes a true science were vindicated
by the splendid success of the Homoeopathic treatment.

John Stuart Mill, in the portion of his work on Logic
from which we have already quoted, in speaking of the three
methods of investigation, — that of observation, that of exper-
imentation, and that of deduction, — after showing conclu-
sively that the former two are inapplicable to medicine,
speaks of the deductive method in terms which are (unin-
tentionally of course, and for this very reason they are the
more conclusive) a description of the philosophy of Homoeop-
athy. " If, for instance, we try the experiments with Mer-
cury on a person in health, in order to ascertain the general
laws of its action upon the human body, and then reason
from these laws to determine how it will act upon persons
affected with a particular disease, this may be a really effect-
ual method, but this is deduction.'"

How TO STUDY THE SCIENCE OF THERAPEUTICS.—
The method of studying the two series of phenomena
which, together with the law of relation, constitute the
science of Therapeutics, follows from what has been said.

When first brought into the presence of a concrete case of
disease, the business of the physician is to ascertain what

1 Dudgeon's Lectures on Homoeopathy, p. 37.

THE SCIENCE OF THERAPEUTICS. 31

branch of medical science he is called upon to exercise. Is
the case one which requires hygienic management or thera-
peutic, or both, or is the patient beyond the reach of art ?
To answer these questions a diagnosis and prognosis must
be made, and to make these, a knowledge of the remote and
proximate causes and of the course and determination of
diseases is required. In a word, a knowledge of Physiology
and Pathology is indispensable on the very threshold of med-
ical practice and before any question of Therapeutics has
arisen.

When these preliminary questions have been settled and
the case has been found to come within the domain of Ther-
apeutics, its phenomena are to be studied in such a way that
all deviations from a normal state may be perceived, as well
those which are common to a number of similar cases, as
more particularly those which seem to be peculiar to the
individual case in hand, and which therefore serve to give it
individuality and to distinguish it from all other and similar
cases. The case is to be then individualized as sharply as
possible, and a complete picture of the morbid phenomena
obtained in their natural groups and connections.

Now, morbid phenomena are deviations from healthy
phenomena. How can we recognize the deviations unless
we are familiar with the standard? How can we appreciate
morbid phenomena save through a knowledge of Physiology,
which is the science of healthy phenomena ?

In like manner we are able to get a complete picture of
the morbid symptoms only by an orderly and methodical
investigation ; and such an investigation is possible to those
alone who are familiar with the relations and sequences of
morbid phenomena, — that is to say, with Pathology. A
simple reference to practical experience will prove this. A
patient complains of pain in her left hypochondrium, distress
and faintness in the epigastrium, vertigo and various symp-
toms of dyspepsia, but never thinks of mentioning — perhaps
is unconscious of — certain evidences of uterine disease to

32 HOMCEOPATHY

which the attention of the physician is instantly directed
through his knowledge of the connection and sequence
of symptoms. So of the connection of certain forms of
vomiting with disease of the brain or of the kidneys, etc., etc.

Clearly, then, Physiology and Pathology are quite indis-
pensable to the physician, and they speak with little thought
who affirm that these sciences are of no value to the Homoe-
opathist and are disregarded by him. They are the sciences
respectively of healthy and morbid phenomena. He cannot
take the first step in the study of disease or of Materia
Medica save by their aid. But he restricts them to their
legitimate function. Pathology is for him not a guide in
Therapeutics, but an instrument which he uses in studying
those phenomena which are to be respectively the subject and
the agents of his therapeutic operations.

Having, by the aid of Pathology, arrived at a complete
and comprehensive knowledge of the morbid phenomena, he
passes on beyond the confines of that science to a higher and
more complex science, whose domain is the relation of the
phenomena of which he has thus acquired a knowledge, with
other phenomena. Through Pathology he learns to know
disease, but it is through Therapeutics alone that he can cure
it. And it is quite time that it were well understood not
only by the profession but also by the public, that to know
the nature and course of a disease is not of necessity to know
how to cure it. It may be a necessary preliminary step —
but it is nothing more. Nor is this true of medicine alone.
My carriage breaks down ; I well know where it has broken
and why and how ; yet this knowledge does not involve the
knowledge how to forge and weld the iron that has broken
and so to mend it. For that I require knowledge of another
sort. The nature of Pneumonia, of Cholera, or Rheumatism
is as well known as those of any disease can be; "their
Pathology," as doctors say, "is well understood," yet this
gives no clue to their therapeutic treatment, — it is no guide
to the special stimulus which must be brought to bear on the

THE SCIENCE OF THERAPEUTICS. 33

diseased organs to lead them back to healthy action. This
stimulus must be discovered by quite another method ; its
discovery is the object of a distinct process.

Thus Pathology, restricted to its proper sphere, is an indis-
pensable auxiliary to the study of the subject of Therapeutics.
It may be further subservient in enabling the physician to
group the symptoms of a case in such a way as more readily
to marshal and retain them in memory. Nor is generaliza-
tion of this kind at all repugnant to the letter or spirit of
Hahnemann's method or of homoeopathic science.

The generalization to which Hahnemann objected was to
that of disease in general upon nosological hypotheses made
on theoretical grounds, and then applied a priori \.o individual
cases. That to which we refer is a generalization made spe-
cially in each case, consisting of a grouping of connected
symptoms under one general term and extending only to
such pathological states as are well defined and constant, such,
for example, as Anaemia, Plethora, the proportion between
the affections of different parts of the nervous system, etc.,
under which we may group a number of generic symp-
toms to the great relief of our memory, while at the same
time the individual or characteristic symptoms are not only
not obscured by the process but are even brought more
sharply into view, as will be evident when we consider this
matter more at length under the head of the Study of the
Materia Medica.

THE STUDY OF THE MATERIA MEDICA. — The method
by which any subject may be most successfully studied must
depend on the use which is to be made of the knowledge
thus gained. It is proper, then, to inquire at the outset in
what way the knowledge of Materia Medica is to be made
subservient to the treatment of disease.

In accordance with the homoeopathic law, we select for the
cure of each individual case of disease that remedy of which
the pathogenetic effects are most similar to the symptoms of
4

34 HOMCEOPATHY

the case. In the process of making this selection we must
pass in mental review the various drugs which compose the
Materia Medica, take a comprehensive view of the pure
effects of each, and institute a comparison between each in
turn, and the case for which we are prescribing. This is the
theory of the process.

Now, it is evident that, in order to select from a number of
candidates one which most nearly resembles a given standard,
we must be familiar, not merely with the general properties
of all the candidates or of certain classes into which they may
be divided, but also with certain properties more or less pecu-
liar to each one of the candidates, and which shall serve to
distinguish each of them from all the others. In fact our
method requires the strictest individualization of both disease
and remedy. We are so to study Materia Medica as, above
all, to bring into strong relief and fix firmly in memory those
peculiarities of each drug which are not met with in any
other, and which therefore serve to individualize and give
character to the drug that produces them and which are
called its " characteristic symptoms." This term having been
much and loosely used of late, it may not be unprofitable to
devote a few words to the subject of characteristic symp-
toms.

By some writers the leading and most obvious and most
frequently recurring symptoms are called characteristic.
Thus Bennett calls fever a characteristic of the Exanthemata.
By others the pathognomonic symptoms of a class of diseases
are called characteristic, — by others the pathologico-anatom-
ical.

Now, the signification of such a word as characteristic is
not absolute. It depends on the connection in which you
please to use it, and which is determined by the question,
" Characteristic of what?" In the instances just adduced,
the varieties of symptoms cited may indeed be called char-
acteristic, but — characteristic of what? Of classes (the
Exanthemata), of groups (nosological) — but not of indi-

THE SCIENCE OF THERAPEUTICS. 35 \

vidttals. But the only sense in which Homoeopathists can
use the term is in its application to individuals. Hence a
characteristic symptom must mean one which is possessed
by none other than the individual drug of which it is predi-
cated, and to which therefore it gives character as an indi-
vidual. In this sense it corresponds precisely to those
features of a man by which his friends are enabled to distin-
guish him from other persons and to recognize him at a glance.

It is obvious that these characteristic symptoms so pre-
cious to the Therapeutist may seem to be of little or no
pathological value, — may even seem accidental to those who
forget that there are no accidents in Nature. They would
be valueless if we did not need to individualize, but could be
content with grouping our diseases and remedies.

To the Naturalist whose object it is to group his speci-
mens, it is sufficient to know that John Doe has a vertebral
column, is a mammal, has two hands, and is a Caucasian —
because this enables him at once to place John Doe in the
variety Caucasian of the species man, and his analysis goes
no farther. From this his whole physiological status follows.
But these items of general knowledge would hardly enable
the sheriff to recognize John Doe in Broadway. It is of no
importance to the Naturalist that he has such " accidental "
peculiarities as an aquiline nose, black eyes and hair, and a
brown mole on the left ala nasi ; but these very peculiarities
are all important to the sheriff, for they give him the means
of detecting the object of his search upon the crowded street.
It must not be forgotten, however, that the points on which
the Naturalist laid stress are equally important to the sheriff;
for if the latter should bear in mind only the individual
peculiarities of the object of his quest and should forget that
he is a Caucasian, he might find the former in the person of
an Indian, or, if he should forget that he is a bimanous
creature, he might arrest a monkey.

To drop the figure, then, it is evident that we must seek
to discover among the symptoms of every drug certain ones

36 HOMOEOPATHY

that are produced by no other drug, and which shall serve
to distinguish it from all other drugs similar in other re-
spects ; that these symptoms will often be unimportant and
trivial in a physiological point of view ; furthermore, that we
must, for convenience sake, when the number of drugs in
our Materia Medica has become considerable, endeavor so
to group them, on the basis of certain clearly defined symp-
toms or collections of symptoms, that for the purpose of
preliminary examination and comparison, these groups may
be regarded and compared as though they were individual
drugs.

Let us suppose a case of uterine haemorrhage. As many
as forty drugs probably produce uterine haemorrhage. On
the basis of this symptom, they form a group isolated from
the three hundred and forty remaining drugs of the Materia
Medica. We select this group from the Materia Medica, and
now we must select a remedy from the group. It were a
tedious task to consider and compare them one by one. But
we group them again ; ten of them produce dark-colored
and ten florid haemorrhage ; ten a limpid and ten a clotted
discharge. Our case has a dark-colored discharge. Our
choice is now restricted to ten drugs. But of the ten which
produce a dark discharge, only five produce simultaneously
a congestive headache. Thus we are limited to five drugs.
Thus far, the distinctions on which our grouping has been
based (or which have been characteristic of the groups)
have had a pathological significance and importance. We
can find no such basis for any further subdivision into
groups. But we observe in the case a peculiar subjective
symptom. The patient complains " as though a living body
were moving through the abdomen." This may seem trivial.
It is equally, however, a symptom produced by Crocus, which
is one of the five remedies to which our choice had been
restricted, and it is produced by no other drug in the Materia
Medica. It is, then, a characteristic symptom of Crocus,
enabling us to individualize Crocus, and to distinguish it

THE SCIENCE OF THERAPEUTICS. 37

from all the other drugs which in many other respects agree
with it.

It will be observed that dark-colored uterine haemorrhage,
though produced by Crocus, cannot be said to be character-
istic of it. It is a characteristic symptom of a group to
which Crocus belongs, but not of Crocus, for it is produced
by the other members of this group as well as by Crocus.

Characteristic symptoms must of necessity be for the most
part subjective and seemingly trivial phenomena. A list of
them alone, if presented as the pathogenesis of a drug,
would be as meaningless, and at first sight as ridiculous, as a
list of the colors and marks and angles and curves by which
friends recognize each other would be, if presented alone as
the sum total of the properties of certain genera and species
of the animate creation. As a background to the latter,
there must be a series of phenomena capable of morpholog-
ical and organic arrangement, and as the basis of the former
we must have a series of objective and organic symptoms
capable of physiological and pathological arrangement and
of approximate explanation. But it must never be forgotten
that without the characteristics, as we have described them^
there can be no individualization, and without this there can
be no accurate homoeopathic prescription,

The truth of this is made apparent by a glance at the
history of Homoeopathy. Certain of Hahnemann's followers
discarded the apparently trivial subjective phenomena from
the provings of drugs, retaining only the objective, organic
symptoms. They thus lost the means of distinguishing
between the individual members of the groups of remedies.
It was thenceforward useless for them to discriminate closely
between individual cases of any one type of disease. Hence,
inevitably, arose the. fashion of prescribing a specific remedy
for a disease, — as the phrase went, — putting the leading
members of respective groups of drugs and diseases to rep-
resent the whole groups. These were the so-called " specif-
ikers," — who had one or two remedies for dysentery, one

38 HOMCEOPATHY

for hooping-cough, one or two for scarlatina, etc., " of whom
the world is weary."

But the characteristic is not always a definite symptom.
Sometimes it is so, — as in the case of Crocus, and as in the
peculiar diplopia of Stramonium. But sometimes it resides
in a peculiar condition which attaches to some symptom
common to two or more drugs. This condition may be of
time, or circumstance, or concomitance. Thus, if two drugs
have the symptom " dry cough from tickling in the supra-
sternal fossa," — but to one is added the condition "occurring
only in the evening," — this condition of time is the charac-
teristic of that drug in so far as the dry cough is concerned; or
if one have this condition of circumstance, that " the cough
is aggravated by inspiring cold air," — this condition is the
characteristic ; or if one have the concomitant that the cough
is attended by retching, — this condition of concomitance is
the characteristic.

Sometimes the characteristic resides in the conditions
collectively. We borrow examples from Dr. Drysdale's
admirable Introduction to The British Repertory :

" Pain in the stomach with nausea occurs under twenty-
eight medicines.

" Pain in the stomach in the morning under thirty-
seven.

" Pain in the stomach with nausea in the morning under
four only."

Or it may reside in a concomitant.

" Dry retching occurs under forty- five drugs.

" Dry retching in the morning under five.

" Dry retching with eructation under one only — Ledunv"

Every drug-proving, then, is to be studied in a two-fold
way : On the one hand, so as to enable us to attach it in
our memory to certain groups of drugs to which it shows
marked general resemblances ; and, on the other hand, so as
to bring out clearly into view those characteristics which
distinguish it from all the other drugs of these groups in

THE SCIENCE OF THERAPEUTICS. 39

particular and of the Materia Medica in general. Our study
will be at once synthetic and analytic.

Such a study is of necessity comparative in its nature.
Each positive step in the study of a drug involves a question
of the correspondence or difference of other drugs in respect
of that step. An isolated study of all the remedies would
not give us an available knowledge of the Materia Medica.
It is not enough to know that Pulsatilla, Nux vomica and
Chamomilla each produce diarrhoea of a certain kind. We
must also know and fix in our minds the similarities and dif-
ferences of each of these diarrhoeas to those of the two
other and of all other drugs. The study of one drug is, in
fact, then, the study of the whole Materia Medica. One is
never so competent to thoroughly master a proving as when
he has already mastered all other provings. The first effort
must necessarily be the least satisfactory, the most im-
perfect.

This is the task to which the student of Materia Medica is
invited and at which his predecessors have been laboring for
fifty years. Why, he may ask, has not this been wrought
out and systematized by those who have gone before? Why
is the Materia Medica left in the same state in which Hahne-
mann placed it fifty years ago?

Our Materia Medica consists of the provings of drugs
upon the healthy, made by Hahnemann and his disciples.
These provings, as we have them, are, for the most part, a
formal arrangement of the symptoms subjective and object-
ive observed by the prover or his friends. No attempt is
made, with but few exceptions, to trace any pathological
connection between symptoms, or to give any physiological
explanations, or to distinguish between characteristic and
generic symptoms. The symptoms alone are given, just as
the symptoms of a case of disease would be given by an
intelligent but uninstructed patient who unfolds his case to
us in as plain untechnical words as he can, leaving to us the
task of tracing connections and contriving explanations.

40 HOMOEOPATHY

There they stand, records of facts made in the plain vernac-
ular, intelligible so long as the language shall endure.

But Hahnemann had a much higher idea of the kind of
knowledge of Materia Medica which a physician requires
than this statement would imply. In an essay on " The
Power of Small Doses," in Hufeland's Journal, he describes
this knowledge as follows : " What organs it (the drug)
deranges functionally, what it modifies in other ways, what
nerves it principally benumbs or excites, what alterations it
effects in the circulation and digestive operations, how it
affects the mind, how the disposition, what influence it exerts
over some secretions, what modification the muscula/ fiber
receives from it, how long its action lasts, and by what
means it is rendered powerless, etc., etc." Why, then, did
he not construct his Materia Medica on this model ? Un-
questionably because, with a wonderful sagacity which
together with his brilliant genius and his prodigious learning
made him the " double-headed prodigy," which Jean Paul
Richter called him, Hahnemann clearly perceived the follow-
ing truths: that the positi 've facts with which a physician has
to deal in constructing a Materia Medica are the observations
of the prover recorded in plain, unfigurative, non-hypotheti-
cal language. That the construction which he saw to
be so desirable must be the result of the application of the
sciences of Physiology and Pathology to these facts. That
the facts of the proving being of the nature of positive
observation are enduring and unchangeable. But that the
sciences of Physiology and Pathology, being incomplete and
progressive, are continually undergoing change, and that their
terms must therefore be ever varying in significance as the
theories on which the sciences are based vary. That, con-
sequently, a Materia Medica constructed by him out of these
two elements, one constant and the other variable, would of
necessity be transient, — could not be enduring, — would
soon grow obsolete and in its decline would carry out of
sight the constant element also, and thus the labor of the

THE SCIENCE OF THERAPEUTICS. 4!

provers would soon be lost to the world. Such a structure
would have involved an intermingling of the current physio-
logical theories with the facts derived from observation.
The precise point and extent of the intermingling would
soon become undistinguishable and thus a vitiated record
would be transmitted to posterity such as the advance of
science would soon render useless. A comparison of the
present state of Physiology with that of 1800, of which the
very terms are almost obsolete, makes the great wisdom of
this view apparent. On the other hand, the pure records of
observed facts, untainted by theoretical speculations, come
to us from the Master's hand as pure, as intelligible, as
available as when first recorded.

We have the same material for the construction of a phys-
iological theory of the drug-action that Hahnemann had,
and we can construct it with the advantage in our favor of the
great advances which Physiology and Pathology have made
since Hahnemann's day. This is the work which each of us
must do for himself. No other can do it for him. The result
of his labor may and will differ somewhat from that of every
other student, for with the light of the auxiliary sciences he
forms a judgment concerning observed facts, and the sig-
nificance of a fact is measured by the capacity of the observer}-

The student should seek his knowledge of Materia Medica
at the fountain head, in the original publications of Hahne-
mann's Materia Medica Pura and Chronic Diseases in the
provings in Stapf's Archiv. and in the Austrian and other
journals.

The Manuals, however convenient for reference in the
hurry of practice, are not suitable for systematic study. In
some of them, the phraseology of the prover has been altered.

1 Lest by an omission I expose my- it is incumbent on each generation to

self to misconstruction, I may say re- prove to a certain extent the rem-

that inasmuch as advances in collat- edies of the Materia Medica so as to

eral medical sciences are affording bring these aids to bear on the study

continually new aids to observation, of Pathogenesy.

42 HOMOEOPATHY

In others, the symptoms, as reported by the prover, have
been arbitrarily sundered into fragments and these fragments
are scattered throughout the record. Or symptoms ex usu
in morbis have been introduced and the names of diseases sup-
posed to have been cured by the drug are incorporated with
the pure symptoms. In all of them the arrangement is some-
what altered. In many, attempts at abbreviation have been
made, and with no better success than if one should squeeze
one's lemons to lessen the bulk of one's luggage and yet
hope to have good lemonade at the end of one's journey ;
for it always happens, and must from the nature of the case,
that the skins are the part retained while the juice is thrown
away.

If a Manual must be employed, that of Noack and Trinks
seems preferable ; for it preserves the phraseology of the
prover and does not to any great extent sunder groups of
symptoms, while it places under distinct headings the pure
symptoms, and the clinical effects of the drugs and the
theoretical speculations of the compilers, so that the student
is in no danger of mistaking the one for the other, a danger
to which Jahr's Manual does certainly expose him, and for
which reason Jahr's work is less desirable than that of Noack
and Trinks.

We have dwelt at some length on the sources from which
the student should seek his knowledge of Materia Medica —
and with good reason ! " For, can a bitter fountain send
forth sweet waters ? " " Do grapes grow on thorns, or figs
on thistles ? " If the student should fall among false or
incompetent teachers, could the doctrine and practice he
learns be true and successful ? Now, it will be observed that
the records and provings and the manuals of Materia Medica
to which we have commended the student are all German
works, while nine-tenths of our American and English prac-
titioners and students are unacquainted with the German
language.1 It is humiliating to us to be compelled to say

1 The Author considered a knowl- to a student of Homoeopathy. — ED.
edge of German almost indispensable

THE SCIENCE OF THERAPEUTICS. 43

that there are no trustworthy manuals in the English lan-
guage and no translations of the German works which we
have named on which reliance can be placed. We have
translations of Hahnemann's Materia Medica and Chronic
Diseases and of Stapf s Contributions to the Materia Medica,
by Dr. Hempel. But, either (perhaps we should say both]
from lack of moral capacity, or of intellectual and profes-
sional acquirements, or from haste and carelessness, the
translator has so marred these works by errors of omission
and of translation, that they are to the student and prac-
titioner what false lights on a difficult coast are to the unsus-
pecting mariner.

Dr. Hempel translated also Jahr's New Manual or Symp-
tomen Codex, and claims to have incorporated with it nearly
all that is valuable in the Manual of Noack and Trinks, thus
making it the most complete and perfect work of the kind in
existence, and the best possible in the present state of our
science. This translation was published with a preface by
Dr. C. Hering and under the high sanction of his name and
that of Dr. Gray, of New- York. It is almost universally
used in this country and in England, and the knowledge of
the Materia Medica and of the true practice of Homoeop-
athy possessed by the rising generation of practitioners is,
in the main, what this manual is capable of affording.

If now, I should say that this translation and compilation
contains all the errors, omissions and perversions which ren-
dered Dr. Hempel's former translations untrustworthy, along
with many others peculiar to this work, I should surely hear
in reply that Dr. Hering has expressly in his preface com-
mended the diligence and accuracy and zeal of the trans-
lator, and I should be referred to page six of the preface,1
where Dr. Hering is made to say, " The Editor has, with
extraordinary minuteness and labor, compared the two man-
uals and has transferred to the manual of Jahr all additional
drugs and pathogenetic effects contained in Noack and
Trinks' work." What could I say in offset to this indorse -

1 Jahr's New Manual or Symptomen Codex, pref. vi.

44 HOMCEOPATHY

ment of Dr. Hering ? There is a word to say on the subject
of this preface. It was unquestionably written originally by
Dr. Hering in German. The English translation, by whom-
soever made, seems not to. have been altogether satisfactory
to Dr. Hering (as well it might not be), for the German
original was published by him (a " verbatim copy," as he
says) in the Allg. Horn. Zeitung. The English preface to
Jahr's New Manual differs from this German original far
more widely than the license of scholarship will at all justify.
In a foot-note to the original of the passage we have quoted
above in commendation of the Editor and translator of
Jahr's New Manual, Dr. Hering says : * " After comparison
of the translation with the original, the above indorsement
is hereby altogether and completely withdrawn."2 Thus,
in an obscure foot-note in a German periodical, seen by not
more than one in a hundred of those American and English
students who are induced by Dr. Hering's commendatory
preface to place confidence in Dr. Hempel's translations
and compilations, Dr. Hering vindicates his fame as a good
scholar and a faithful champion of our science by withdraw-
ing his commendation of Dr. Hempel.

If those whose confidence has been misplaced by reason
of this indorsement in English, canceled in German only,
should, with a measure of just indignation, demand of me
why the retraction was not made in the language and in the
country in which the commendation was suffered to be pub-
lished,— why Drs. Hering and Gray, acknowledged leaders
of our school in America, did not suppress this so-called
translation or expose its false pretensions, in words as intel-
ligible and as widely read as those in which their support
of it was permitted, — alas! I have nothing to say. (See
Appendix.)

To plead that, in a matter which involves the education
or perversion of a whole generation and the healthy progress

1 Vol. XL, Nos. 23 and 24, Feb- z Dies wird hiermit nach Vergleich-
ruary and March, 1851. ung der Uebersetzung mit dem Orig-

inal ganz und gar zuruckgenommen.

THE SCIENCE OF THERAPEUTICS. 45

and soundness of Homoeopathy wherever the English
language is spoken, — in such a matter the engrossments of
business or tenderness toward a delinquent individual kept
them silent, would be to cast a doubt upon the estimate in
which they hold scientific truth, a doubt inadmissible in
gentlemen of their position.

It avails not to say : Why find fault with these translations
and this manual, inasmuch as we have no others ? Had the
unworthiness of these been made known, had they not, on
the contrary, been indorsed by high authority, we had long
since had others and trustworthy. An exposure of the
imperfections we have spoken of would have created a
demand for other works, and it is not less true in science
than in trade that "demand creates a supply."

Having selected a remedy on which to commence his
studies, the student should gather together all the reports of
provers, whether in the form of their daily records (in which
form our dear and lamented colleague Dr. Joslin published
his admirable proving of Rumex crispus, as did also the
Austrian provers), or in the Hahnemannian anatomical
scheme, and should carefully peruse them. We will assume
that he has selected Pulsatilla, and will use this remedy to
illustrate what we have further to say. We have no other
proving of this drug than the very perfect one of Hahnemann
in vol. i. of Materia Medico, Pura.

During the first perusal, — and several may be necessary
for the purpose, — the student should endeavor to make a
general analysis of the proving. This analysis would enable
him to place the drug along with several others in one or
other of certain groups into which he will find, as he
advances in his studies, the Materia Medica arranges itself.
Among the chief points of this general analysis will be the
following :

I. Sphere of action in the drug. It will be seen that every
drug affects some organs or systems of organs or tissues

46 HOMCEOPATHY

more decidedly than others. Pulsatilla, for example, acts
pre-eminently upon the vegetative system, upon the organs
of reproduction and their appendages, and upon the com-
position of the blood, depressing the action of the former
systems and producing in the latter a condition similar to
that of one form of chlorosis. We learn these facts by
bringing a knowledge of Physiology to bear upon and
interpret the symptoms of the intestinal tract and of the
urino-genital organs, those of the vascular system and the
symptoms of the head and disposition. For in these we
have retarded digestion, vertigo, audible pulsation of the
carotids, momentary loss of sight and hearing on sudden
exertion, palpitation, paleness, retarded and scanty menstru-
ation with syncope and exhaustion ; depressed melancholic
disposition. On the other hand, the student will notice that
Pulsatilla exerts but little action upon the bones, skin and
glands, and this will be another important step toward
grouping.

II. The extent to whicJi the organic substance is affected.
From some provings it must be gathered — Spigelia, for
example — that the organic substance is but slightly affected
or only in isolated localities, while in other provings the
effect is profound and general, — Carbo vegetabilis and
Lachesis. In others, again, the affection of the organic
substance and the irritation of the nervous system are equal
in degree and both are great, — Arsenicum. Conclusions on
this head are drawn from the following symptoms : those of
the complexion and of the skin generally, as regards color
and temperature, which enlighten us respecting congestions,
if there be any, and the color and character of the congesting
fluid ; those of the evacuations from the bowels, bladder,
uterus and all secreting glands and surfaces; those of the
cutaneous eruptions and ulcers ; finally, those which denote
the existence of dyscrasias of whatever variety, e.g., dropsies,
phthisis, cancer, gout, rheumatism, etc. Under this head
we find in the proving of Pulsatilla no evidence of any

THE SCIENCE OF THERAPEUTICS. 47

further action than that above mentioned — a hydrsemic
dyscrasia and which is further corroborated by the abundant
serous or thin mucous discharges from secreting glands and
surfaces.

III. The action of the drug on the vital power, correlative
of the above, and shown in the symptoms of the nervous
system as they are given conjointly with the symptoms of the
various organs to which the different parts of the nervous
system are distributed. He may consider the nervous system
under five heads, a. The sensorium, of which the symptoms
are found chiefly under the rubrics Head and Disposition.
b. The general sensibility, c. The general mobility. Data
respecting these heads are found in the symptoms of the
tissues to which the nerves of sense and motion are distrib-
uted, d. The special sensibility, as exhibited in the symp-
toms of the organs of special sense — the eye, ear, nose and
tongue, e. The sympathetic system — as exhibited in the
symptoms of organs containing involuntary muscles — in the
intestinal tract and in all the sphincters.

In forming conclusions on any one of these points, regard
must be had to the entire remaining action of the drug. We
should otherwise reach a very false judgment. Pulsatilla,
for example, produces blindness and deafness. We might
regard these as very important affections of the special
senses, did we not learn also that these phenomena occur
simultaneously with scanty and difficult menstruation, and
with palpitation and throbbing of the carotids, and conjointly
with great pallor and frequent syncope. These concurrences
compel us to regard the blindness and deafness as sympa-
thetic symptoms occurring in a chlorotic patient, and con-
nected perhaps with a hydraemia produced by Pulsatilla.

These three sections of a general analysis having been
elaborated during a first perusal, the student will already be
in a position to arrange many drugs in groups by their simi-
larities and differences in these respects. He will note, for
example, that in their sphere of action Pulsatilla and Nux

48 HOMCEOPATHY

vomica are closely allied, while again they differ widely in
their mode of action both on the organic substance and on
the vital power, etc.

The practical use of such an analysis is this : that when
such fundamental facts are known of two or more drugs, it is
enough to have clearly in mind, in any case of disease, what
are the effects of the disease in these three fundamental
respects. If, then, the action, for example, on the organic
substance be similar to what we have seen to be the effect
of Pulsatilla, there can be no possibility of Nux vomica being
applicable in the case and no need, therefore, of studying that
drug further for the case. This process of elimination by
means of a general analysis may be relied on wherever we
have good and complete provings of drugs, and where the
case of disease presents clear and definite symptoms.
When we are dealing with fragmentary provings and obscure
cases it is of course not practicable.

As further examples, we may adduce the following : Spi-
gelia and Silicea both affect the special senses remarkably and
similarly ; yet they are extremely different in their action on
the organic substance. Hyoscyamus and Carbo vegetabilis
affect the sphincters similarly, though in other respects so
unlike.

After thus generalizing in a comprehensive way, the
student will observe certain phenomena of a more special
character ; for example, that among the variety of sensations
recorded as having been produced by the drug, there is a
certain uniformity in general character throughout most of
the organs affected. But here he meets difficulties arising
from inaccuracy of provers, or rather from the fact that, all
descriptions of sensations being clothed in figurative lan-
guage, the imaginations of different provers suggest to them
different modes of expression. The wealth of the German
language in synonyms has not diminished this difficulty. An
approximate analysis of sensations such as has been made
by Dr. Dudgeon would be of service in this regard. The

THE SCIENCE OF THERAPEUTICS. 49

Individuality of some drugs is much more strongly marked
than that of others by this feature of their effects, and pro
tanto, it serves as their characteristic. Thus Bryonia and
Squilla are distinguished by sticking, and Arsenicum by
burning, pains.

Another point to be noted, and which may serve still
further to individualize the drug, is periodicity, which in
many drugs is well marked and of a definite type; e.g.,
Arsenium, Ipecacuanha, Natrum muriaticum, Nux vomica.
In Pulsatilla it is very marked, but the type is not constant.

But, perhaps, the most important of all the considerations
in which resides the individuality of a drug are the condi-
tions and concomitants of the symptoms. The conditions
are the phenomena of time, place, and circumstance on
which the symptoms depend. For example, Pulsatilla pro-
duces tearing pain in the hip. So do several drugs, but
that of Pulsatilla occurs in the afternoon, — condition of
time; it occurs and is aggravated in a warm room, — con-
dition of place ; occurs during and is aggravated by repose,
— condition of circumstance. A concurrence of this phe-
nomenon and these conditions is found only under Pulsatilla.
Here these conditions are the characteristic. The concomi-
tants are those phenomena, whether we call them sympa-
thetic or secondary, which always accompany any symptom
or group of symptoms. Absence of thirst is a concomitant
of many groups of symptoms under Pulsatilla. So likewise
are chilliness, cold feet, wakefulness in the evening and
sleepiness in the morning, etc. Nux vomica has the
reverse. So is cold sweat of the forehead under Veratrum.

Having thus made a general analysis of the proving,
obtaining, first, a general view of the action of the drug on
the great divisions of the organism and of the pathological
conditions which it produces ; and, second, a general view of
the characteristics of its action, the student may proceed to
a special analysis, which will involve a similar study of the
action of the drug on each organ and anatomical region of
5

50 HOMOEOPATHY

the body. In this he cannot do better than follow the
Hahnemannian scheme.

The points to be considered in each region and under each
rubric are the following : The organic changes ; the sensa-
tions,— their nature, locality and direction ; the conditions
of time, place and circumstance, and the concomitants. Thus,
for example, in studying the Head, he may consider :

a. The SENSORIUM, under which the subdivisions may
be:

1. Vertigo, its nature, conditions of time, place and cir-
cumstance, and its concomitants. Thus, the vertigo of Pul-
satilla is a staggering ; it occurs after eating, in a warm room,
and during repose (there is a rare alternate effect) ; the
concomitants are heaviness in head on stooping, paleness-
and internal heat in the head.

2. Intelligence, with conditions and concomitants as above,
j. Memory,

4.. Illusions of the imagination,

b. HEADACHE, under which the points to be noted are :
/. Character of the pain.

2. Locality.

j. Its course if it move.

^. Conditions and concomitants as above.

c. THE ORGANIC CHANGES, which are to be studied in
the same way. These comprise all objective and material
phenomena.

In this manner, the student will examine the effect of the
drug upon each organ and tissue of the body, as will be more
clearly shown by a scheme for the study of the Materia
Medica which will be appended to this essay.

The result will be an accurate knowledge of the action of

THE SCIENCE OF THERAPEUTICS. 51

the drug, in so far as the proving is complete, upon the
whole organism in general and in detail. The special
analysis will serve to correct certain errors into which the
general analysis might lead the practitioner. Conditions are
not always uniform for all the organs. Thus, although the
general conditions of Pulsatilla are occurrence and aggrava-
tion in the afternoon and evening, during repose and by
heat, with relief by motion and cold, and must be so stated
in a general analysis, yet there are a few special symptoms
to which the opposite conditions attach, and this fact is
brought out by the special analysis.

The study of a proving to be practically available must be
comparative. After ascertaining the properties of each drug
by positive investigation and analysis, in the manner detailed,
the next step is to ascertain what drugs resemble it, and in
what features they are like and how they differ. To make
such a comparison as this in studying the Materia Medica, a
repertory is indispensable, and this need alone, if a repertory
were not equally indispensable in daily practice, would be a
sufficient reply to those who idly talk about such a work
being superfluous or mischievous.

Such is a method of studying the Materia Medica which,
after much reflection and trial of various plans, I venture with
unfeigned diffidence to unfold. It is elaborate and requires
a wearying application which those alone can appreciate who
have engaged in similar tasks. To complete such a sys-
tematic study, even in comparative leisure, might require
seven years of unremitting labor — just the period for which
a lad is apprenticed to learn his trade. Should we shrink
from devoting so long a time to the mastery of the most
complex and difficult, and the noblest science and art which
are possible to man on earth ?

I desire to add a few words of a practical nature. Pre-
scribers are liable to two errors of an opposite kind; the
possibility of which will be apparent from what has been
written.

52 HOMOEOPATHY

The one consists in prescribing from a general analysis of
drugs without regard to the characteristics which individual-
ize them. This is equivalent to prescribing any member
indifferently of a whole group of drugs, and necessitates a
corresponding generalizing view of disease. It is the method
of the Old School which seeks to arrange drugs and diseases
in groups and which ignores characteristics and individuals.
The other error consists in prescribing on the strength of one
or two characteristics which maybe detected, without however
examining whether the general effects of the drug correspond
to the general features of the disease. Now, characteristics,
for the most part, as we have seen, derive their value from
their association as concomitants or conditions with some
symptom which is not in itself a characteristic. Discon-
nected from this, they are as void of significance as a man's
nose would be if cut off from his face, though while on his
face it might have been the chief feature by which his friends
recognize him. I will not deny that by this method, great
successes, "lucky hits" I would call them, are sometimes
made. But I do stoutly affirm that atrocious and inexcus-
able blunders are much more frequently the result.

I admit, too, that in certain cases of disease there is no
possibility of making such an analysis as we have advised,
and that certain drugs are so incompletely proved that we
know of them only one or two characteristic symptoms and
Cannot study them as recommended. All that can be said
of such cases is that they are incomplete and come under no
rule. We must do the best we can and adopt a defective
method, which is nevertheless sometimes successful rather
than make no attempt to cure. Better cure by a " lucky
hit" than not at all. But let not this lead us astray where
we might do better.

If one had to traverse a wilderness he would desire first of
all a compass. If this were not to be had he might " steer
by the stars." If these were obscured he might judge from
the direction of vegetation and of hills and rivers. Failing

THE SCIENCE OF THERAPEUTICS. 53

these, he might even " guess" and his guess might lead him
right. Nevertheless, few travelers of sound mind would be
led by such a success to prefer a "guess " to a "compass."

A SCHEME FOR THE STUDY OF MATERIA MEDICA. — In
the hope that what has been written may serve not only to
explain the method in which I have thought the study of
Materia Medica may be best pursued, but also to assist those
who are entering upon that arduous study, I publish here-
with a schedule drawn up originally for my own guidance,
and which, I think, was a great assistance to me.

A.-^GENERAL ANALYSIS.

1. ACTION ON THE VITAL POWER — as exhibited in the
action of the remedy upon — a. The sensorium ; b. The
special senses ; c. The sphincters ; d. The other involuntary
muscles ; e. The power of locomotion.

2. ACTION ON THE ORGANIC SUBSTANCE ; as exhibited
in a. The complexion (showing, viz. : the state of vessels
and the nature of their contents) ; b. The evacuations ; c.
Ulcers, if any which previously existed are modified by the
remedy or if any are produced by the remedy ; d. Erup-
tions; e. General affections of a dyscrasic nature, such as
dropsy, tuberculosis, etc., etc.

3. THE SPHERE OF ACTION OF THE REMEDY. What
organs or systems of the body are affected in a general way
and in what order they are affected.

4. SENSATIONS. What kind of sensations predominate
among those ascribed to the remedy in the proving, and
what relation, if any, appears to exist between certain
varieties of sensation and certain classes of organs or
tissues.

5. PERIODICITY. If there be any periodicity in the symp-
toms it is to be particularly noted and its character denned.

54 HOMOEOPATHY

•

6. PECULIARITIES. There are few good provings which
do not ascribe to the remedy certain peculiarities of action
which are incapable of classification, which run through the
whole action of the remedy and which are peculiar to one
remedy and are therefore important characteristics.

These peculiarities constitute the conditions of time, cir-
cumstance, aggravation and concomitance, which are attached
to the symptoms and often give individual character to them
as belonging to one remedy in particular, and as incapable
of being ascribed in mass to any other drug. A symptom
being recorded as produced, for example, by Pulsatilla, the
questions "When did it occur?" "When was it aggra-
vated?" "When was it ameliorated?"' "When did it
cease?" give the condition of time which attach to that
symptom. In like manner the questions " Under what cir-
cumstances (viz., of rest or motion, of heat or cold, etc.,
etc.) did it occur, was it aggravated, was it ameliorated,"
give the conditions of circumstance and aggravation which
attach to the symptom.

It will be observed of almost every remedy that certain
symptoms or series of symptoms are accompanied by one
or several other symptoms. This fact is the condition of
concomitance to which we refer. For example, many symp-
toms of Pulsatilla are accompanied by a disposition to
weep, of Nux vomica by fugitive chills, of Arsenicum by
inordinate weakness, of Veratrum by cold sweat of the
forehead, etc.

It is further noticeable that in the provings of some drugs
this concomitance of symptoms by other symptoms is
strongly marked, and almost universal as in the case of
Arsenicum.

7. RESUM^ OF THE CHARACTERISTICS OF THE REMEDY.
This will include everything in the above analysis which is
shown by a comparative study of other drugs to be peculiar
to it. It will comprise in particular the conditions of time,
circumstance, aggravation and concomitance, and the periods
of the day at which the action of the drugs is most marked.

THE SCIENCE OF THERAPEUTICS. 55

B.— SPECIAL ANALYSIS.

1. HEAD.

a. Sensorium, comprising the subdivisions : I . Vertigo ;
•2. Intelligence ; 3. Memory ; 4. Illusions. Each of these
subdivisions is to be studied in respect of sensations in so
far as they can be predicated of it ; of periodicity ; of con-
ditions of time, circumstance, aggravation and amelioration ;
and of concomitance. And under the latter rubric it is to be
especially inquired what symptoms affecting other organs, or
systems, occur simultaneously in evident physiological con-
nection with the symptom under consideration.

b. Headache. The points to be investigated are : I . The
location of the pain if it be stationary — its course if it move;
2. The sensation ; 3. The conditions of time, circumstance,
aggravation and amelioration, as above explained in detail >
4. Concomitance.

c. Organic changes. These affect the material substances
and tissues of the head, and comprise all deviations from a
normal material condition of which we can in any way
become cognizant — affections, for example, of the skin,
glands, vessels, organs of special sense, etc.

2. EYES.

a. The Orbit. I. Location; 2. Sensations; 3. Condi-
tions; 4. Concomitance; 5. Organic changes. These sub-
divisions here and throughout the scheme, wherever used,
are to be understood and studied as already explained in the
general analysis and under the title " Head."

b. Lids. I. Location; 2. Sensation; 3. Conditions; 4.
Concomitance; 5. Organic changes.

c. Conjunctiva, i. Location; 2. Sensations; 3. Condi-
tions; 4. Concomitance; 5. Organic changes.

d. Globe. I. Location; 2. Sensations; 3. Conditions;
4. Concomitance; 5. Organic changes.

56 HOMCEOPATHY

e. Secretions, i. Character, as regards color, acridity,
quantity, etc. ; 2. Conditions ; 3. Concomitance.

f. Special sense. i. Vision, altered, intensified, dimin-
ished, or perverted. 2. Conditions attached to such altera-
tion ; 3. Concomitance.

N. B. After each such study of a single organ, a physio-
logical estimate should be made of the significance of the
symptoms. For this purpose a faithful study of the con-
comitance is of inestimable value. For example, the proving
of Pulsatilla gives sudden loss of vision. Is this Amaurosis ?
The concomitance shows that the loss of vision is accom-
panied by loss of hearing, by syncope, and occurs at a
period of menstrual irregularities. The symptom is at once
explained. This is only a very obvious instance of what is
not always an easy though always a most necessary task.

j. EARS.

a. External Ear. i. Location; 2. Sensations, 3. Con-
ditions; 4. Concomitance; 5. Organic changes.

b. Internal Ear. I. Location; 2. Sensations; 3. Con-
ditions; 4. Concomitance; 5. Organic changes (as secre-
tions, etc.) and their conditions.

c. Special sense. I. Deviations, whether intensified,
diminished or perverted ; 2. Conditions ; 3. Concomi-
tance.

4. NOSE. i. Location; 2. Sensations; 3. Organic changes,
including secretions. With reference to each of the above,
observe, a. The conditions ; b. The concomitance.

Special sense of smell, i. Deviations from a normal con-
dition; 2. Conditions; 3. Concomitance.

5. FACE. I. Location; 2. Complexion; 3. Sensations;
4. Temperature; 5. Organic changes. As regards each
of these subdivisions, study, a. The conditions ; b. The
concomitance.

THE SCIENCE OF THERAPEUTICS. 57

6. LIPS. I. Location; 2. Aspect; 3. Sensations; 4.
Temperature; 5. Organic changes. Respecting each sub-
division, note, a. The conditions ; b. The concomitance.

7. GUMS AND TEETH, i. Location; 2. Sensations; 3.
Organic changes. In reference to each subdivision, note, a.
The conditions ; b. The concomitance.

8. MOUTH, i. Location; 2. Sensations; 3. Organic
changes. Of these, a. The conditions ; b. Concomitance.

p. TASTE, i. Deviation from normal state, a. Condi-
tions ; b. Concomitance.

10. TONGUE, i. Location; 2. Sensations; 3. Aspect;
4. Organic changes. Of these, a. The conditions ; b. The
concomitance.

11. THROAT AND FAUCES, i. Location; 2. Sensations;
3. Aspect; 4. Organic changes (including tumefaction, secre-
tion, deposits, etc.). Respecting these divisions, a. The
conditions ; b. The concomitance.

12. OESOPHAGUS, i. Location; 2. Sensations ; 3. Organic
changes ; 4. Special function. Of these, a. The conditions ;
b. The concomitance.

zj. STOMACH, i. Location; 2. Sensations; 3. Organic
changes ; 4. Special function modified, as respects, a. Appe-
tite ; b. Thirst ; and these modifications may be exaltation,
diminution or perversion ; c. Nausea ; d. Vomiting. Re-
specting these divisions and subdivisions, observe, a. The
conditions ; b. The concomitance.

14. HYPOCHONDRIA, i. Right, 2. Left. As regards each,
study, I. Location; 2. Sensations; 3. Organic changes. As
regards each subdivision, observe, a. The conditions; b.
The concomitance.

(Here and wherever the rubric comprises a region which
contains a number of organs, endeavor to make by the aid
of the sciences of Physiology and Pathology a rational

58 HOMOEOPATHY

appreciation of the organs involved, and in this study, pay
especial regard to the concomitance, in order to gain the
full physiological significance of the symptoms. For exam-
ple, in affections of the right hypochondrium where the liver
may be supposed to be implicated, the concomitance will
justify the supposition if it show simultaneous and corre-
sponding symptoms of the tongue, stomach, head, stool,
skin, back, etc., etc. So of the left hypochondrium and the
uterine system.)

75. ABDOMEN. I. Location with appreciation of the
organs involved; 2. Sensations; 3. Organic changes.
Respecting these divisions, note, a. The conditions ; b. The
concomitance.

16. STOOL. I. Sensations, their character, location and
course, a. Before stool ; b. During stool ; c. After stool.
As regards these three subdivisions, note, a. The conditions ;
b. The concomitance. 2. Organic phenomena, viz., color,
odor, consistence, composition, e. g. — digested or not —
consisting of faeces alone or combined, etc.

77. ANUS AND RECTUM. I. Location; 2. Sensations;
3. Organic changes (including secretions, tumors, condylo-
mata, etc., etc.). Respecting all of these divisions, note, a.
The conditions ; b. The concomitance.

18. URINARY ORGANS.

a. Bladder. i. Location; 2. Sensations; 3. Organic
changes.

b. Urethra. I. Location; 2. Sensations; 3. Organic
changes.

c. Kidneys. i. Location; 2. Sensations; 3. Organic
changes.

d. Ureters. I. Location; 2. Sensations; 3. Organic
changes.

With regard to all of these divisions, under each of these
organs, study, a. The conditions ; b. The concomitance.

THE SCIENCE OF THERAPEUTICS. 59

e. Urine, i. Quantity; 2. Color — physical properties;
3. Odor; 4. Deposits.

f. Micturition. I. Frequency; 2. Sensations. Note, a.
Conditions; b. Concomitance.

19. GENITAL ORGANS — Male.

a. Penis. I. Location; 2. Sensations; 3. Organic
changes.

b. Testes. I. Location; 2. Sensations; 3. Organic
changes.

c. Special function. I. Modifications, as regards exalta-
tions, diminution, or perversion ; 2. Sensations.

Respecting these divisions and subdivisions, study under
each, a. The conditions ; b. The concomitance.

d. Secretion. I. Quantity; 2. Quality, admixture, etc.;
3. Mode of evacuations, a. Conditions ; b. Concomitance.

20. GENITAL ORGANS — Female.

a. Vulva. I. Location; 2. Sensations; 3. Organic
changes.

b. Vagina. I. Location; 2. Sensations; 3. Organic
changes ; 4. Secretion, considered as regards, a. Character ;
b. Quantity; c. Color.

c. Uterus. I. Location; 2. Sensations; 3. Organic
changes ; 4. Secretions considered as above.

d. Ovaries, i. Sensations; 2. Organic changes. Under
these divisions and subdivisions, note, a. The conditions;
b. The concomitance, attaching to each.

e. Menstruation, i. Sensation; 2. Periodicity; 3. Quan-
tity; 4. Color; 5. Consistence; 6. Duration. Under these,
a. The conditions ; b. The concomitance.

21. RESPIRATORY ORGANS.

a. Nasal Mucous Membrane, i. Location; 2. Sensations ;
3. Organic changes ; 4. Secretions, as regards quantity and
quality. Respecting all these, a. The conditions; b. The
concomitance.

60 HOMOEOPATHY

b. Larynx and Trachea. I. Location; 2. Sensations; 3.
Organic changes; 4. Secretions as above. Respecting all
these, a. The conditions; b. The concomitance.

/. Cough, a. Its sound; b. Its character, as paroxysmal
or otherwise, dry or loose; c. Location of the sensation which
provokes it ; d. Conditions ; e. Concomitance.

2. Sputa, i. Character; 2. Consistence; 3. Color; 4.
Smell ; 5. Taste ; 6. Locality from which it appears to come ;
7. Mode of evacuation; 8. Sensations which precede and
follow its evacuation ; 9. Conditions; 10. Concomitance.

c. Thorax — Internal. I. Location; 2. Sensation; 3. Or-
ganic changes, a. Conditions ; b. Concomitance.

— External. I. Location; 2. Sensation; 3. Organic
changes (including mammae and nipples); 4. Secretions.
Respecting the above, a. Conditions; b. Concomitance.

d. Respiration. I. Sensations; 2. Organic action; 3^
Breath, its odor, temperature, volume. Regarding these, a.
The conditions; b. Concomitance.

22. HEART.

a. Subjective. I. Location; 2. Sensations.

b. Objective. I. Location; 2. Organic changes as shown
by position, sounds, magnitude and by rational signs ; 3.
Pulsation. Respecting these divisions, a. The conditions;
b. The concomitance.

23. BACK. I. Location, dividing the back into regions
from below upward and appreciating the organs and tissues
involved, as well as the concomitance will admit; 2. Sensa-
tions ; 3. Organic changes. Under these, a. Conditions ;
b. Concomitance.

24. UPPER EXTREMITIES — RIGHT AND LEFT. Re-
specting each, study

i. Articulations. I. Location ; 2. Sensations; 3. Organic
changes.

THE SCIENCE OF THERAPEUTICS. 6 1

2. Interarticular Region, i. Locations; 2. Sensations;

3. Organic changes. Respecting all of these, a. Conditions ;
b. Concomitance.

25. LOWER EXTREMITIES — RIGHT AND LEFT. Studied
in all respects as the Upper Extremities.

As regards the Extremities generally, note Sensations with
their course (and Duration) if they be wandering; e. g., from
a right upper, to a left lower extremity, etc.

26. SLEEP. I. Character; 2. Periods; 3. Preceded by;

4. Succeeded by ; 6. Concomitance.

a. Dreams. I. Conditions; 2. Concomitance.

2j. FEVER, as a paroxysm made up of stages.

1. Incomplete Paroxysm, consisting of only one or of two
stages, i. Their order; 2. Relative severity and duration ;
3. Antecedents ; 4. Sequelae ; 5. Conditions; and, 6. Con-
comitance.

2. Complete Paroxysm. I. Order of the stages; 2. Their
relation to each other. Then consider the separate stages ; e.g. :

a. Chill, i. Character; 2. Precursor; 3. Succeeded by;
a. Conditions ; b. Concomitance.

b. Fever, as a single stage, or Heat. i. Character; 2.
Precursors ; 3. Sequelae, a. Condition ; b. Concomitance.

c. Sweat, i. Character; 2. Precursors; 3. Sequelae, a.
Conditions; b. Concomitance.

Between chill and heat and heat and sweat, study the

Interval, i. Character; 2. Sensations; 3. Conditions; 4.
Concomitance. Also the time

After the paroxysm, i. Sensations; 2. Conditions; 3.
Concomitance.

Pulse, i. Quality; 2. Frequency; 3. Conditions.

28. SKIN.

i. General, i. Sensations; 2. Organic changes ; 3. Con-
ditions ; 4. Concomitance.

62 HOMOEOPATHY THE SCIENCE OF THERAPEUTICS.

2. Special. I. Localities affected; 2. Sensations; 3.
Organic changes ; 4. Conditions; 5. Concomitance.

3. Organic Changes. Under this head are comprised :

1. Eruptions. I. Aspect; 2. Color; 3. Sensations; 4.
Secretions, a. Their color ; b. Consistence ; c. Odor ; d.
Quality — e.g., acrid or bland, etc.; 5. Scabs, a. Quality;
b. Tenacity; c. Color; d. Odor; e. Conditions of subjacent
tissues or secretions.

2. Ulcers. To be studied as Eruptions.

3. Warts.

4. Tumors. I. Physical properties; 2. Sensations; 3.
Conditions; 4. Concomitance.

29. MIND.

1. Faculties Modified, i. Exalted ; 2. Depressed ; 3.
Perverted. Under these, a. Conditions ; b. Concomitance.

2. Memory. As under Faculties.

jo. DISPOSITION, i. Quality; 2. Conditions; 3. Con-
comitance.

APPENDIX.

ANNOTATIONS on the History of Homoeopathic Literature in the English
Language. Letter from Dr. Lippe.

Dr. Carroll Dunham in his excellent article " Homoeopathy the Science of
Therapeutics," published in the AMERICAN HOMCEOPATHIC REVIEW, after
complaining that it is humiliating to be compelled to say that there are no-
trustworthy manuals of our Materia Medica in the English language, alludes to-
the Preface of Jahr's New Manual and Symptomen Codex, by Dr. Constantine
Hering, and refers to the subsequent publication of that Preface in the original
German manuscript, in the Allg. Horn. Zeitung, and which contains also the
following foot-note by Dr. Hering : " After comparison of the translation with
the original, the above indorsement is hereby altogether and completely with-
drawn.'? Dr. Dunham further says that if he were asked why this retraction
was not made in the language and in the country in which the commendation
was suffered to be published, he would have nothing to say. Dr. Dunham
further continues : " It avails not to say, why find fault with these translations
and this manual, inasmuch as we have no others ? Had the unworthiness of
these been made known, had they not, on the contrary, been indorsed by high
authority, we had long since had others and trustworthy. An exposure of the
imperfections we have spoken of would have created a demand for other works,
and it is not less true in science than in trade that ' demand creates a supply.' "

Dr. D. Wilson, who is now publishing an article in the Monthly Homoeopathic
Review, beginning in No. 7, vol. vi., headed " How far is Dr. Hempel to be
trusted as a translator of Hahnemann's works," says, in that number : " Yet,
strange to say, no one, as far as I am aware, has hitherto publicly pointed out
the blunders that have been perpetrated by Dr. Hempel in his voluminous
translations of Hahnemann's works." To correct the above erroneous state-
ments allow me then to publish the following facts :

JaAr's New Manual and Symptomen Codex, by Dr. C. J. Hempel, vol. iii.,
was reviewed by me for the Philadelphia Journal of Homoeopathy, in 1852, in
vol. i., page 427 to 432, my name not appearing. Dr. Hempel puts in a
demurrer in vol. i., page 467 to 476 of the same Journal, dated December I5th,
1852. In vol. i., page 518 to 521 of that Journal, I felt compelled as the
Author of the Review to answer, and there say : " I write (this criticism) for the
American HomoaopathistSy to vindicate ourselves before the world," etc. Dr.
Hempel answers again, February 24th, 1853, vol. i., page 549, and remarks
that the interest of the publisher must be protected ; he then appeals to the
recommendations of Dr. C. Hering in the preface to the first volume of the

64 APPENDIX.

work, to which I replied, March 24th, 1853, vol. ii., page 59 to 6l, vindicating
Dr. Hering by stating that he could not then publish his original German
preface or its correct translation, nor could he withdraw his recommendation
in the country in which that commendation was published, as the Homoeopathic
Journal then published was in the hands of the publisher of the New Manual,
who would not receive and circulate communications adverse to his interests.
I further then gave there the foot-note of Dr. Hering in the Allg. Horn. Zeitung,
above referred to. "After comparing the translation with the original, I
solemnly withdraw this my above communication and indorsement."

Dr. Hempel again replied, in vol. ii., pages 318 and 319, declaring me to
stand convicted of libel, threatening legal proceedings or demanding an arbitra-
tion by committee. The committee report of the 24th of September and the
8th of October, 1853, is published in vol. ii., page 430, and this committee,
having examined Dr. C. Hering's original German manuscript of the preface
to the New Manual and its publication in the Allg. Horn. Zeitung, with the
translation by Dr. Hempel as published, find, that the point assumed by me,
viz., that the translation of Dr. C. Hering's preface to the New Manual and
Symptomen Codex contained willful perversions and omissions, has been estab-
lished. A reply to this report by Dr. C. Hempel is published in vol. ii., page
573, in which he boldly denies that he is guilty of any essential alterations.
Later the publisher succeeded in obtaining by some means the names of a few
physicians as a recommendation to the Complete Repertory.

The Review was published ten years ago. It had only the effect to procure
for Dr. C. J. Hempel a professorship in the Pennsylvania College of Homoeop-
athy. What effect his teachings and publications had while Professor in that
Institute are well known.

That ten years later Dr. Wilson, in England, and Dr. Dunham, in the
United States, should indorse my review of 1852 is exceedingly gratifying to
me, but unfortunately does not remedy the evil done to Homoeopathy and its
progress during that length of time.

I sincerely hope that Drs. Wilson and Dunham will be more successful in
1862 in arousing the English-reading members of the profession to the necessity
of accurate translations and correct versions of Hahnemann's writings and our
standard works.

AD. LIPPE, M. D.

Philadelphia, December 7th, 1862.

NOTE. — The facts respecting the publications in the Philadelphia Journal, in
1852-53, are essentially as above stated by Dr. Lippe. The reasons why they
did not attract general attention and were not accepted by the profession as a
withdrawal by Dr. Hering of his strong indorsement of Dr. Hempel's transla-
tion of the Symptomen Codex, I suppose to be the following :

1. The first paper by Dr. Lippe was anonymous, and therefore was not
authoritative in any personal sense.

2. The foot-note attached by Dr. Hering to the German publication of his
preface was not quoted by Dr. Lippe until after a succession of demurrers by
Dr. Hempel and replications by himself had given the matter the aspect of
a somewhat personal controversy ; and even then it was introduced as a kind

APPENDIX. 65

of obiter dictum, because the foot-note referred to the " Symptomen Codex or
New Manual," in two volumes, whereas Dr. Lippe's review had treated almost
exclusively of the Repertory, or vol. iii.

Now, this repertory was really to all intents and purposes not so much a
translation as a new work by Dr. Hempel, and he is entitled to commendation
or adverse criticism according to the merits or demerits of the work, as an
Author rather than as a Translator. In such a capacity Dr. Hering's foot-note
and preface could hardly refer to him, and hence the foot-note, introduced " by
the way," in Dr. Lippe's letters concerning his review of the Repertory failed
to attract general attention and to vindicate Dr. Hering.

But the above " annotations " are entirely satisfactory. Coming, as they do,
from a confidential friend of Dr. Hering, and with his express sanction and
approval, they are a complete withdrawal of his indorsement of the English
version of Jahr's New Manual. They give, moreover, a satisfactory reason
why this withdrawal could not have been published at an earlier date in this
country, viz. : the fact that the publishing interest controlled all of our Journals
from the year 1850 to 1858, to such an extent that nothing in the shape of an
adverse criticism of any important publication was allowed to appear in any
Journal. This statement the writer can corroborate from personal experience.

While accepting Dr. Lippe's annotations as full and satisfactory on these
points, I am not disposed to adopt unreservedly his criticisms of Dr. Hempel.
I have no evidence that the errors and omissions which render it impossible
to receive his works, as trustworthy translations of the books they profess to
represent, are willful or malicious. I think they may be all accounted for by
the fact that the translations were made in haste and therefore carelessly, and
that to some of the tasks which he undertook Dr. Hempel may have been, at
the time, hardly competent. And when we consider the immense amount of
labor required by these numerous translations, we can hardly wonder that
errors have been committed and omissions made. Unhappily, this does not
make the books any less undeserving of confidence. Of course an error or an
omission is just as fatal to the trustworthiness of a translation, whether it be
the result of haste, of carelessness, or of willful perversion — but the interests of
science do not require the critic to go beyond a statement of the fact that the
work is not trustworthy, and of the particulars in which it fails.

In my remarks on Manuals to which Dr. Lippe alludes, I refer only to that
part of the New Manual which relates to the Materia Medica. The faults of
the English version of the preface, however provoking to the Author of the
preface, have not the same kind of relation to the general interests of the
science. They do, however, concern the personal and professional reputation
of Dr. Hering, and at his request we publish a letter addressed by him to Dr.
Gardiner, Editor of the Philadelphia Journal of Homoeopathy at the time of the
publication of Dr. Lippe's Review of the Repertory before alluded to.

DUNHAM.

[ COPY. ]

PHILADELPHIA, August i8th, 1853.
Dr. WM. GARDINER,

Sir: You say, in your Journal, the last number, page 318, you " wish to deal
justly "—" nothing further to be published on that subject." On the same

6

66 APPENDIX.

page you allow your own name to be put at the head of a committee to
examine the original manuscript of Dr. Hering's preface, or as an alternative
the mean threat of setting New- York pettifoggers upon the first one who has
had ability and courage to awake the attention of American Homoeopaths to
the danger to which monopolizing and book manufacturing leads our cause. I
am willing to lay in the hands of any respectable committee meeting in Phila-
delphia, at any time,

1. My original manuscript.

2. The verbatim printed copy in the Allg. Horn, Zeitung.

3. The English translation of it as a preface to the Symptomen Codex.

4. A comparison of the translation with the original, pointing out the willful
perversions and omissions.

Said committee, according to common sense and custom, cannot have any
interested parties members of it, but ought to be appointed by them, and of
course only of such physicians as understand the German language. You
ought to be the umpire. Is not your Journal the proper organ in which such a
report of such a committee ought to be published ?
(Signed)

Yours,

CONSTANTINE HERING.

ANTAGONISM BETWEEN HOMOEOPATHY AND
ALLOPATHY.

Address, delivered at the semi-annual meeting of the Homoeopathic Medical
Society of the State of New- York, Albany, February 10, 1863.

Gentlemen of the Society :

By the request of your president and other officers, I
appear before you to perform that duty which, on such an
occasion as this, devolves upon the president of the Society,
but which the special engagements of that officer, at this
season of the year, in New- York, have prevented his ful-
filling.

The session of this evening brings to a close the first
regular meeting of the Homoeopathic Medical Society of the
State of New- York.

The object of this Society is declared to be " the advance-
ment of the science of medicine."

In these days, when the value of associated labor is so
well understood, one might certainly ask, with surprise,
" Can it be that, prior to this year, there has existed in the
State of New- York no central organization for the advance-
ment of the science of medicine ? "

The fact is, there has been a State Medical Society in
active operation since 1806. Its object is the same as that
of our Society ; its organization and its mode of operation
are identical with ours.

What, then, is the necessity for a second Society ? Why
should men of the same profession, engaged in similar
labors, for a common object, divide their forces, and thereby
diminish their efficiency? What is the nature of the
antagonism which this division implies, and what is the

68 ANTAGONISM BETWEEN

necessity for its perpetuation ? Candid and exhaustive
replies to these questions will explain and justify our posi-
tion of separation from the Old School of medicine. They
will, at the same time, sharply define the outlines of that
branch of medical science to which we have especially
devoted ourselves, and will give us a clear view of the labors
which devolve upon us for its advancement and develop-
ment.

I propose, therefore, to discuss this antagonism, — first
from a historic and then from a philosophical point of view.

Samuel Hahnemann, the great reformer of medicine, was
a regularly educated physician, of great learning and very
uncommon general culture and literary attainments. In the
words of Sir John Forbes, who surely cannot be accused of
any partiality for the founder of Homoeopathy : " No candid
observer of his actions, or candid reader of his writings, can
hesitate for a moment to admit that he was a very extraor-
dinary man, — one whose name will descend to posterity as
the exclusive excogitator and founder of an original system
of medicine, as ingenious as many that preceded it, and
destined, probably, to be the remote, if not the immediate,
cause of more important fundamental changes in the prac-
tice of the healing art than have resulted from any promul-
gated since the days of Galen himself; * * *
he was undoubtedly a man of genius, and a scholar ; a
man of indefatigable industry and of dauntless energy."1

Hufeland, the Nestor of orthodox medicine in Germany,
in calling attention to an essay published by Hahnemann, in
his Journal, in 1801, speaks of him as "one of the most dis-
tinguished physicians in Germany."

This being the estimate in which Hahnemann was held by
his most distinguished contemporary (Hufeland) and by his
most learned critic (Forbes), both of whom, be it observed,
were opposed to the medical reform which he had instituted,
let us glance at his professional career.

1 British and Foreign Medical Review, xli., 1846.

HOMOEOPATHY AND ALLOPATHY. 69

After practicing in various localities and positions, with
such success and acceptance as to acquire the reputation
which Hufeland records of being " one of the most distin-
guished physicians in Germany," Hahnemann tells the pro-
fession, in several essays on medical subjects, that he has
become so deeply convinced of the uncertainty of medical
practice, and of the positive injurious effects of many meth-
ods in common use among physicians at that day, that at
length he really "doubts whether his patients would not, in
many cases, have thriven as well, or better, without his aid as
with it."

This conviction of the uncertainty of medicine, this sus-
picion of the injury which it sometimes inflicts on the
patients, were not peculiar to Hahnemann. Girtanner and
several others, before his day, expressed them. Sir John
Forbes, from whom we have already quoted, says, in 1846,
of the medical methods of our own time, " In a considerable
proportion of diseases it would fare as well, or better, with
patients, in the actual condition of the medical art, as more
generally practiced, if all remedies, at least all active reme-
dies, especially drugs, were abandoned." "Things [in medi-
cine] have arrived at such a pitch, that they cannot be worse;
they must mend or end."1 Such views have been repeatedly
expressed by members of the medical profession in this
country.

Hahnemann has said nothing more severe nor more
sweeping than this condemnation of practical medicine,
by the late head of the profession in England.

But what did Hahnemann do when he had become con-
vinced of the inutility and mischievousness of the current
medical methods ? Did he continue a routine practice for
the sake of "making a living?" No! like a noble, honest
man, he refused to make a pretense of curing where he
believed he did not cure. He relinquished the practice of
medicine and devoted himself to the collateral science of

1 British and Foreign Medical Review, xli., 1846.

70 ANTAGONISM BETWEEN

chemistry and to literary labors. But his mind was ever at
work on the great question of the improvement of the prac-
tice of medicine, for he was " sure that the Creator had not
left His creatures without a means of succor from the pangs
and ravages of disease."

Thus intent on this subject, he could not fail to remark
that although the prevailing treatment of diseases was, in
general, blind and at least ineffectual to cure, yet there were
certain remedies which were used in the case of certain dis-
eases with almost uniformly happy results — or at least with
such results as left no room for doubting that in these cases,
at least, real cures were effected. This he had observed to
be the result of the use of mercury in certain cases, not
unfrequently encountered by medical men ; but his attention
was especially called to the fact in connection with Peruvian
bark, the febrifuge properties of which had, during the latter
part of the preceding century, become well established and
highly prized on the continent.

" If," he thought to himself, " if the number of these
specific remedies could be vastly increased, and if some sys-
tem could be discovered in accordance with which we could
ascertain their exact properties and could know beforehand
in what cases of disease they would be applicable, then in-
deed would the uncertainties of medical practice be removed,
then might we anticipate as great success in the treatment
of all diseases as we now attain in the treatment of a few for
which we have specifics."

This desire for specifics was not original with Hahnemann.
It had been expressed before his day by Bacon and by Boyle.
Sydenham had longed for them in expressions almost
pathetic in their hopelessness. But Hahnemann, with his
"dauntless energy and indefatigable industry," went to work
to discover this system.

A casual observation in Cullen's Materia Medica gave him
the clue to his discovery, as the falling apple did to Newton,
and the swinging chandelier in the church at Pisa, to Galileo.

HOMOEOPATHY AND ALLOPATHY. 71

From this observation it occurred to him that provings of
drugs upon healthy persons might furnish a knowledge of
their specific properties, and that the administration of drugs
in cases presenting symptoms similar to those which the drug
produces in the healthy subject, might be the law of the ap-
plication of specifics.

He sought throughout the whole medical literature of
ancient and modern times for instances bearing upon this
subject, and he collected a large mass of evidence corrobo-
rating his speculations.

He then proceeded to verHy his theory by actual experi-
ment. First upon himself and then upon all healthy
persons who would join him in these self-sacrificing labors,
he proved the effects of a number of drugs. Then, cautiously,
first in his own family, and then, little by little, in his
general practice, which he had now resumed, he gave, as
occasion offered, the drugs which he had proved, in cases
of disease that presented symptoms similar to those pro-
duced by the drugs.

From 1790 to 1805, fifteen years of the prime of his life
were devoted to constant, exhausting labors of this nature,
during which time he proved on his own person more than
sixty drugs ; " for," said he, " when we have to do with an
art whose end is the saving of human life, any neglect to
make ourselves masters of it becomes a crime ! " At the
end of this period, sure of the truth of the great principle he
had discovered, — with all the incidental testimony of history
to support it — with the positive results of a long experience
to confirm it, — he presented his views and the results of his
labors to the profession in an essay of wonderful logical
power, of the utmost moderation in expression, full of almost
tender persuasion and of the noblest enthusiasm;2 and he
published at the same time the first part of his Materia
Medica.3 Five years later appeared the more elaborate
exposition, the " Organon."

1 Dudgeon, Hahnemann's Lesser 2 Medicine of Experience.
Writings. 3 Frag, de Vir. Med. pos.

72 ANTAGONISM BETWEEN

This was the turning-point of Hahnemann's career. Let
us see what was his relation to the profession at this time.

He had, by universal consent, attained a position in the
profession which justified him in assuming to criticise pre-
vailing methods and to suggest improvements. He had
shown the need of improvements, and he had borne testi-
mony to his honesty in this exposition, by retiring from a
lucrative practice. He now came before the profession say-
ing, " I believe I have discovered a system which will render
the practice of medicine certain, and its success brilliant. I
have labored fifteen years to test my discovery. My own
experiments and the testimony furnished by the records of
medicine convince me of its truth. I lay it and them before
you, my colleagues, and I conjure you in the name of truth,
by the interests of humanity, to investigate it candidly and
without prejudice." " If," he says in his letter to Hufeland
on this occasion, " if experience should show you that my
method is the best, then make use of it for the benefit of
mankind, and give God the glory !"

How were this exposition and appeal received by the
medical men of the day ?

In 1811, appeared the Anti-Organon of Prof. Hecker — a
work full of the most bitter aspersions upon Hahnemann's
personal character, whereas, in fact, the question had rela-
tion to principles and not to persons ; abounding in the most
concentrated contempt and scorn of the system which Hahne-
mann had unfolded ; and without a single suggestion to
investigate, by practical experiment, the practical method

which Hahnemann had stated to have been attended, in his

•

hands, with such brilliant practical success !

And from that day to the present, all the utterances of
the Old School, whether from the press, the council, the
professor's chair, or in the forum of the academy, have been
bitter personal denunciations and aspersions of the character
and motives of Hahnemann, and of all who have adopted or
have even shown a disposition to investigate his method.

HOMCEOPATHY AND ALLOPATHY. 73

But many a scientific discoverer has met with opposition
and calumny at the hands of his colleagues. Not to go
beyond the ranks of medicine, Harvey was denounced as a
quack, because he demonstrated the circulation of the blood !
Jenner was scandalized with most persistent violence because
he introduced vaccination.

To Hahnemann, however, persecution came nearer home.
After he had satisfied himself of the value of his discovery
of the true method of medical practice, he resumed the
exercise of his profession. His success was more brilliant
than it had ever been. His fame as a practitioner grew
rapidly, and patients began to come to him from consider-
able distances. This good fortune excited the envy of his
colleagues in Konigslutter, where he then resided. At their
instigation, the apothecaries of the place brought a prosecu-
tion against him for infringement of the law which forbids to
practitioners of medicine the compounding and sale of the
remedies they prescribe. For, it must be observed, that, as
an inevitable corollary to his new sys'tem of practice, Hahne-
mann had come to prescribe only a single drug at a time,
and that he used simple preparations such as could not be
obtained in the requisite purity at the apothecaries'. In
vain it was urged that the spirit of the law was not infringed,
since Hahnemann himself was an expert apothecary and
chemist, and since his remedies were not " compounded," but
simples, and not "sold," but dispensed gratuitously. The
opposition was too strong. He was forbidden to practice,
save in accordance with the law alluded to.

Rather than yield in a matter which he considered essen-
tial to the freedom of the physician and to the purity and
certainty of his practice, Hahnemann determined to leave
Konigslutter; and accordingly, to the delight of his col-
leagues and of the apothecaries, and to the regret of the
citizens, who were loath to lose their benefactor, and a cortege
of whom attended his carriage far beyond the gates of the
town, he removed to Hamburg.

74 ANTAGONISM BETWEEN

Here, as he became known and appreciated, the same
persecution was revived, and with the same result. He
removed to Altona.

In this way, during a period of twenty-two years, from
1799 to 1821, Hahnemann was constrained, by the persecu-
tion of his colleagues, under cover of the law, to change
his abode at least eleven times. The last place from which
he was driven in this manner was Leipsic — a city for which
he had a peculiar affection. Here he had pursued his
earliest medical studies and met with his first successes.
Here he had, in later years, established a college of
Homoeopathy, and had lectured to large audiences. In
the shady walks and groves that surround the city, he
had been wont to spend the evening of each day in social
converse with his family and with the students whom he
had gathered about him and who took part in his labors of
proving drugs.

From this city of his love, the scientific capital of his
fatherland, he was now, in the sixty-sixth year of his
laborious life, driven away to an asylum offered him in
the tiny capital of the tiny Duchy of Anhalt-Coethen !

No wonder that he who for so many years had followed
the injunction, " When they persecute you in one city,
flee ye to another," — that he who, like the Divine Healer,
had gone " about from place to place doing good and
healing all manner of sickness and disease among the
people" — no wonder that he forgot, under the pressure
of this last indignity, that other injunction of the Divine
Teacher, to " love them that hate you, and pray for them
that despitefully use you and persecute you," and that, like
Luther, he now bared his hitherto sheathed weapons of
satire and invective against those who had striven to hinder
his usefulness — who had so cruelly marred his peace and
happiness — all save that peace which can never be taken
from the man who has within himself the " mens sibi conscia
recti ! " If in this he erred and came short of the Divine

HOMCEOPATHY AND ALLOPATHY. 75

example, let him among men who is " pure," cast the first
stone at him !

Time brings its sweet revenges. After a career of honor
and usefulness at Coethen, where his ever-increasing fame
brought him throngs of patients from all parts of Europe,
and a subsequent residence in Paris, where his reputation
extorted from the government a license to practice as he
pleased, Hahnemann died at Paris in 1843, full of years
and honors. Eight years afterward, in 1851, the town
council of Leipsic appropriated a beautiful plot of ground
as a site for his monument, and the council celebrated
officially the uncovering of a costly and beautiful bronze
statue of that man, as one of Saxony's most illustrious
sons, whom thirty years before the same council had igno-
miniously chased from their borders as an unauthorized
and illegal prescriber !

Before we leave this branch of our subject, let us draw
one lesson from the story of Hahnemann's persecutions.
All his sufferings might have been avoided, he might have
lived in peace and affluence, enjoying consideration among
his colleagues and making plenty of money, had he been
willing to "yield a little," to waive the right of dispensing
his own medicines, to accommodate his system in various
points to suit the notions of his time. The temptation to
do this might, by some, be supposed to have been great,
for Hahnemann's family was large, he suffered during his
wanderings from the pinchings of cruel poverty, and this
took from him the leisure so necessary for his studies.

But Hahnemann was not made of the stuff that could
compromise, for personal ease and prosperity, the charter
that God had given him for the benefit of the race. He
refused to give up one particle of anything which he
deemed essential to the purity and perfectness of his system,
and so he has left it to us, pure and perfect !

Let us remember his example when prospects of ease and
consideration, and of the cessation of strife for the truth,

76 ANTAGONISM BETWEEN

tempt us to compromise unworthily with any portion of
the Old School of medicine.

For there are those among us, as there are men in other
walks of life, who, for the sake of what they call peace
and union, would join hands with what they know to be
false ! aye, even though to do it, they should have to " cut
off the fanatics," who adhere strictly to Hahnemann, — to
leave the " brains" of their system " out in the cold."

This is the origin and the personal history of the antag-
onism between Homoeopathy and the dominant school of
medicine. Hahnemann showed the imperfections of the
current methods. Nobody disproved what he said. Every-
body agreed with him and everybody sighed for something
better. He discovered something better and offered it to
his colleagues, with demonstrations of its value ; he begged
them to investigate it; and in case they should find it
better than the old method, to use it for the good of man-
kind, and give God the glory ! Then, with one accord,
they denounced him as a vile impostor, and chased him
from their midst, nor have they yet ceased to heap ignominy
on his name !

It may be objected that I have not stated the whole
grounds of the opposition of the Old School to Homoeop-
athy, inasmuch as I have said nothing about the " little
doses."

If this were true, it would not alter the bearings of the
case, because the doctrine of the " little doses," like all the
rest of Hahnemann's method, was offered to the profession,
to be by them submitted to the test of experience, by which,
like all the rest, it should stand or fall. But, in point of
fact, Hahnemann came very slowly to see the necessity of
giving small doses when he prescribed according to the law
of Homoeopathy ; and he did not express himself authorita-
tively upon this subject until long after the opposition to
him and the prosecutions in the name of the apothecaries

HOMCEOPATHY AND ALLOPATHY. 77

were in full blast ! Therefore, this opposition could not
have originated in the doctrine of the dose.

Nor is the question of the dose at all essential to the
experiments which Hahnemann invited his professional
brethren to make for the purpose of testing his system.
Intelligent experiments with doses of ordinary size would
convince any physician of the truth of the Homoeopathic
law; and if he continued the experiments, the inconven-
iences that he would find to result from the use of such
doses would inevitably lead the experimenter, as they led
Hahnemann, to continually diminish the dose, until he
should become convinced of the truth of Hahnemann's
dogma on this subject also.

This has been the uniform experience of all physicians
who have become convinced, through experiment, of the
truth of Homoeopathy, and have adopted the method in
practice. And the more strictly they conform to Hahne-
mann's method in prescribing, the more exactly do they
agree with him respecting the dose. The number of these
witnesses amounts to-day to many thousands, and their
concurrent testimony does not admit of dispute.

Let us now consider this antagonism from a philosophical
point of view.

As I have already said, Hahnemann perceived that the
prevailing method of treating disease comprised two
processes.

One of these processes was what was then, and is still,
called the "Rational." It involves a theory of the cause
and essential nature of the disease, and the resort to some
expedient which would be likely to remove this supposed
cause of the disease, and to bring about a contrary state,
and so conduce to health. Of this kind was Galen's
method, which divided diseases into hot, cold, moist and
dry; made a similar classification of remedies, and applied
to each disease a remedy from a class of the contrary

78 ANTAGONISM BETWEEN

nature. Less glaringly absurd, but in no way different in
nature, are the theories which hold that certain diseases,
for example, are caused by accumulation of the blood in
certain organs, and are to be cured by abstraction of blood ;
that others depend upon what is imagined to be want of
tone, and are to be cured by remedies which are assumed
to be tonics ; that others are due to a languid state of the
" animal spirits," and are to be encountered by the admin-
istration of "stimulants" etc.

That these were the grounds upon which the prevalent
methods, in the generation preceding Hahnemann, were
based, is shown by Cullen's theory of the action of bark,
and also by the following passage from " Sydenham on
Pleurisy : "

" After attentively considering the various phenomena of
this disease, I think it is a fever originating in a proper and
peculiar inflammation of the blood, — an inflammation by
means of which nature deposits the peccant matter in the
pleurae. In my treatment, I have the following aim in
view : to repress the inflammation of the blood, and to
divert those inflamed particles which have made an onset
on the lining membrane of the ribs (and which have lit
up so much mischief) into their proper outlets. For this
reason, my sheet-anchor is blood-letting"

A modification of this process is that which is known as
the Hippocratic method of observing and following the
indications of nature; in the words of Sydenham, "watch-
ing what method Nature might take, with the intention of
subduing symptoms by following in her footsteps." Accord-
ing to this method, if, in any disease, recovery was preceded
by a critical evacuation, — such as a copious sweat, — this
was assumed to be nature's method, and sudorifics were
accordingly resorted to in similar cases.

Now, independently of the fatal objection, that this
method would confine our curative power to such diseases
as Nature herself \s wont to cure by critical discharges, etc., —

HOMCEOPATHY AND ALLOPATHY. 79

the very diseases, therefore, in which medical aid could be
best dispensed with, — while it makes no provision at all for
such diseases as rarely or never get well of themselves, —
such as nature never cures by critical discharges, — the
very cases, therefore, in which there is most need of the
intervention of art, — Sydenham tells us that he "found that
spontaneous sweats often did good." " But these," he says,
"were very different things irom forced ones." And Hahne-
mann showed that " in such cases the critical discharges
and the recovery were simultaneous; that the discharge was
the consequence and announcement rather than the cause of
the recovery ; and that to infer from such a state of things
that we could bring about a cure by inducing an artificial
sweat, would be like ringing bells and lighting bonfires to
secure a victory instead of to announce one."1

The other process, which Hahnemann perceived to be
comprised in the prevailing methods of treatment, was —
administering, in the case of a very few diseases, of which
fever from marsh miasma may be taken as the most illustri-
ous example, certain remedies which had been discovered to
possess, in some unexplained way, a power to cure these dis-
eases. Such remedies had been discovered by the merest
accident. No method was known by which others could be
discovered: no method had been suggested by which it
could be more clearly ascertained and defined for what par-
ticular varieties of the diseases in question these " specifics,"
as they were called, were especially appropriate.

Hahnemann showed the fallacy of the philosophy on
which the " Rational" method was based. He showed that,
even admitting that accumulations of blood do exist as the
" proximate cause" in certain diseased conditions, yet these
accumulations cannot be regarded as the essential cause of
the disease. On the contrary, that cause must be sought in
that force which regulates the circulation and preserves its
equilibrium. This force must have been set into abnormal
i Russell, History and Heroes of the Art of Medicine.— " Sydenham."

8O ANTAGONISM BETWEEN

action, in order that an accumulation could take place in any
particular organs; and, therefore, in the accumulations we see,
not the essential cause of the disease, but only one of the results
of that cause. To undertake, then, by abstraction of blood to
remove a result of the cause, is not to cure the disease by
removing the cause, but only to seek to palliate it by carry-
ing away some of its products. He showed, further, that this
abnormal condition of one of the dynamic forces, the action
of which constitutes the life of the body, is beyond the
sphere of our observation. Like the healthy action of these
same forces — in a word, like life — it is an ultimate fact,
behind which we cannot penetrate, and which, therefore, we
cannot study as a cause of disease and seek to remove by
direct rational means.

But Hahnemann went farther, and showed that, although
we cannot investigate the ultimate nature and causes of those
modifications of the dynamic forces of the organism, which
are the essential causes of diseased action, and then remove
them, as a " rational" method would propose to do, yet that
if, while a disease is in full vigor, we administer a remedy
which causes a sudden cessation of the morbid action with-
out any abstraction of the fluids or any derivative action
whatever, we are then justified in concluding that the remedy
we have given has, in some way or other peculiar to itself
reached that force which was in a state of abnormal action,
and has so modified it as to bring it back to a condition of
normal action ; that this remedy has a " specific " effect upon
that force under certain conditions ; and we draw this con-
clusion upon the general principle that when an effect ceases
we may conclude that the cause has ceased to act.

And Hahnemann showed, farther, that if we could discover
substances having such a specific action, and a law by which
we should know just when to apply them, we should have
accomplished the much needed reform in medical science.

He appreciated so highly the value of the specifics of which
medicine was already in possession, that he consecrated his

HOMCEOPATHY AND ALLOPATHY. 8 1

life to the task of discovering a method of increasing their
number and of reducing their use to a system.

In this appreciation of the direction in which alone im-
provement in the curing of diseases was to be looked for,
Hahnemann was anticipated, as I have said, by Bacon, Boyle
and Sydenham.

Thus Bacon, in the " Advancement of Learning," after a
sweeping condemnation of the unphilosophical method of
Galen, says : " A work is wanting upon the cures of reput-
edly incurable diseases, that physicians of eminence and res-
olution may be excited and encouraged to pursue the matter
as far as the nature of things will permit ; since to pronounce
diseases to be incurable is to exhibit ignorance and careless-
ness, as it were, and to screen ignorance from reproach."
And again, " I find a deficiency in the receipts of propriety
respecting the cure of particular diseases." Again, " They
have no particular medicines which, by a specific property,
are adapted to particular diseases. I remember a learned
Jew physician who used to say, ' Your European physi-
cians are like bishops; they have the keys of binding
and loosing — nothing more !' It would be of great conse-
quence if physicians eminent for learning and practical skill
would compile a work of approved and experienced medi-
cines in particular diseases."

The learned Boyle, the father of chemistry, who had
devoted much time to the study of medicine, says : " I can-
not forbear to wish that divers learned physicians were more
concerned than they seem to be to advance the curative part
of their profession, without which, three at least, of four
other parts, may prove indeed delightful and beneficial to the
physician, but will be of very little use to the patient, whose
relief is yet the principal end of physic. I had much rather
that the physician of any friend of mine should keep his
patient, by powerful medicines, from dying, than tell me
punctually when he shall die, or show me in the opened car-
cass why, it is supposed, he lived no longer.
7

82 ANTAGONISM BETWEEN

Again he says, when speaking of the need of specifics r
" Finding at every turn that the main thing which does pre-
vail with learned physicians to reject specifics is, that they
cannot conceive the distinct manner of the specifics' working,
and think it utterly improbable that such a medicine, which
must pass through digestions in the body and be whirled
about by the mass of the blood to all the parts, should,
respecting the rest, show itself friendly to the brain, for
instance, or the kidneys, or fall upon this or that juice or
humor rather than any other.

" First, I would demand of these objectors a clear and
satisfactory, or at least an intelligible explication, of the man-
ner of working of divers other medicaments that do not pass
for specifics. For I confess that to me, even many of the vulgar
operations of common drugs seem not to have been hitherto
intelligibly explained by physicians, who have yet, for aught
I have observed, to seek for an account of the manner of how
diuretics, sudorifics, etc., perform their operations, etc.

" The same objection that is urged to prove that a specific
cannot befriend the kidneys, for example, or the throat rather
than any other parts of the body, lies against the obnoxious-
ness of poisons to this or that determinate part ; yet experi-
ence manifests that some poisons do respect particular parts
of the body without equally or at all sensibly offending the
rest; and we see that cantharides, in a certain dose, are
noxious to the kidneys and bladder, and quicksilver to the
throat and glandules thereabout, stramonium to the brain
and opium to the animal spirits and genus nervosum"1

Sydenham expresses himself on this subject with his accus-
tomed brevity and directness. Speaking of intermittent fever,
he says : " We must do one of two things ; we must, by
careful and anxious observation of the process by which nature
relieves herself of this disease, draw indications as to the man-
ner by which the incipient fermentation may be promoted

1 Russell, History and Heroes of the Art of Medicine, vol. ii., p. IOI ;
art. "Robert Boyle."

HOMCEOPATHY AND ALLOPATHY. 83

and the patient restored to health, or else we must discover
a specific. By the latter method, we shall attack the malady
directly."

It may be observed that Sydenham did not hesitate to
choose the latter method so soon as the specific virtues of
Peruvian bark in intermittent fever were recognized, and that
he was the chief means of making the value of this great
specific known in England; nor have the profession gener-
ally, since his day, been disposed to hesitate in their choice
between the Hippocratic and the specific methods of treat-
ing this disease, — the two alternatives which Sydenham so
clearly lays down.

He continues : " By no means do I wish to express myself
as if wise and learned physicians were to despair ; as if they
were to think out no better modes of treatment, and as if
they were to throw away the hope of discovering nobler and
more potent medicines for accelerating the cure of diseases.
So far am I from tjiis that I do not despair of finding out,
even myself, some such medicines and some such method of
curing."

These things which Bacon, Boyle and Sydenham point
out so forcibly as the desiderata of Medicine, which Syden-
ham did not despair of finding out, yet died without dis-
covering,— these " specific medicines," and this " methodus
medendi" were offered to the profession one hundred years
later by Hahnemann.

Dr. Lettsom tells us, "the great Sydenham, for all his
labors, only gained the sad and unjust recompense of cal-
umny and ignominy, and that from emulation of some of his
collegiate brethren and others, whose indignation at length
arose to that height that they endeavored to banish him from
that illustrious society (the Royal College of Physicians), as
guilty of medicinal heresy."

And yet Sydenham only longed for, and looked forward
to, the discovery of specifics and of the law of their employ-
ment. He was the Moses of the specific method. It was,

84 ANTAGONISM BETWEEN

therefore, in the regular course of historic sequence that
Hahnemann, the Joshua of that method, who led the hosts
of jEsculapius into the promised land of which the Moses
had had a glorious vision, should be unsparingly denounced
as a heretic and actually banished from every well-regulated
society !

This, then, is the antagonism. Hahnemann shows that
specifics are to be discovered by ascertaining the effects of
drugs upon healthy persons ; that they are to be applied by
giving to a sick person such a drug as would produce, in the
healthy subject, symptoms similar to those of the sick per-
son. He presents this discovery to the profession as some-
thing in advance of present knowledge. They refuse to
accept or even to test it, and they denounce him for offering
it. On which side lies the onus of the antagonism ?

But it may be said, however true these statements are as
regards the age for which Hahnemann w/ote, the scientific
progress of the last fifty years has changed all that. It has
changed the names of things and little besides in therapeutics.
We hear no more, it is true, of "temperaments" and
"humors," of the "animal spirits," of the " Arc&Jius" but
instead, the talk is now of " the dyscrasias," of " diatheses,"
of the "cellular pathology," of "analogies" and " heterol-
ogies."

There is the same endeavor to draw from a theory of the
essential nature of the disease a rational indication of cure,
of which Hahnemann exposed the fallacy and impossibility.
Indeed, Sir John Forbes affirms, in 1846, "The progress of
therapeutics (the cure of diseases) during all the centuries
that have elapsed since the days of Hippocrates, has been
less than that achieved by the elementary sciences of medi-
cine during the last fifty years. This department of medi-
cine must indeed be regarded as yet in its merest infancy."

It should be clearly understood, and I state it most
emphatically, that all expositions of the insufficiency and

HOMCEOPATHY AND ALLOPATHY. 8$

the chaotic state of the prevalent system of medicine —
whether by the outspoken leaders of the Old School, like
Forbes, or by Hahnemann and his followers — refer ex-
clusively to the department of therapeutics, the science and
art of curing diseases by medicines. In the development of
the natural history of the healthy and of the diseased body,
that is to say, in the sciences of physiology and physio-
logical anatomy, and of pathology and pathological anatomy,
as well as in the departments of hygiene, surgery, obstetrics
and medical chemistry, medicine has fully kept pace with
the wonderful progress of scientific knowledge in our day.
We profit by the labors of our colleagues in these branches,
and accord them full recognition and admiration. But the
great end and object of all these things is to cure diseases.
If they afford no facilities for this, they are profitless to man-
kind. Now, if the same men who have brought these
collateral sciences to such perfection have been unable to
bring therapeutics- out of what Forbes calls its present chaos
of " merest infancy," is not the conclusion irresistible that
they have not yet got hold of the right clue — of the true
philosophy of the science ?

There is even a greater indisposition in our day, than in
the time of Boyle, to admit the value and to stimulate the
discovery of specifics. Nor is this wonderful ; for specifics
obstinately refuse to range themselves under any rational
hypothesis. They exert a peculiar, inscrutable action upon
certain organs when in certain conditions, and more than
this nobody can say of them. And yet, notwithstanding
their philosophical aversion to them, the practical sagacity
of our colleagues, with which they keep their philosophy
strangely at variance, leads them to seize eagerly upon
specifics whenever these are presented to their notice.
Witness the avidity with which they have availed themselves
of Iodine, Ergot, Cod Liver Oil, the Hypophosphites, Iron,
Veratrum viride, as well as of Nickel and Oxalate of Cerium
which the Houdin of orthodox medicine has lately intro-

86 ANTAGONISM BETWEEN

duced to them. Nay, people do say that our learned friends
of the Old School make frequent use, " upon the sly," of
Aconite as a specific in fever, and of Nux vomica and of
Pulsatilla as specifics in gastrodynia and dysmenorrhoea,
etc., etc., — remedies of the specific properties of which their
only knowledge is derived from the labors of Hahnemann.

It is true, they undertake to give a "rational" theory of
the action of these specific remedies, but with as little suc-
cess as Cullen met with when he attempted to explain the
febrifuge action of Peruvian bark. It is all comprised in
the doggerel explication that Moliere gives of the hypnotic
effects of opium :

" Domandatur causam et rationem quare
Opium facit dormire.
A quoi respondeo,
Quia est in eo
Virtus dormitiva,
Cujus est natura
Sensus assoupire."

Now, as in the days of Hahnemann, there is an antagonism
between the Homoeopathists and the Old School. The
former hold out to the latter what they believe to be that
method which has ever been a desideratum in medicine.
The latter refuse even to examine it, and expel the Homoe-
opathists from all associations over which they hold control.
We cannot unite with them in any associated labors without
ignoring and disavowing what we believe to be the true
theory and practice of the all- important part of medical
science — the science of therapeutics. They will not unite
with us in associated labors for the development of this
science.

Had Hahnemann done nothing more than devise a method
of discovering and using specifics in the gross and whole-
sale sense in which the term was and is understood and used
by the Old School of medicine, he would still have been
entitled to the gratitude of mankind. He did far more.

HOMOEOPATHY AND ALLOPATHY. 8/

He perceived that, in the dominant school, a specific was
set apart as adapted to any individual member, indiscrimi-
nately, of a large nosological group [of diseases]; that bark,
for example, was held to be the specific for malarious fevers
in general, and that no account was taken of individual
deviations within the limits of this group. Whereas, in
point of fact, he perceived what is well known within the
profession and without it, that although bark is really the
specific for many, indeed for the majority of malarious
fevers, it is not so for all ; since many cases cannot be cured
or even improved by its use.

Now, this wholesale way of regarding diseases, in groups,
was the logical and inevitable consequence of the Old School
theories of disease and of the method of cure. When Galen
propounded the doctrine that all diseases depend upon one
of four conditions, heat, cold, dryness, moisture, it was an
inevitable consequence that he should disregard every phe-
nomenon presented by his patients, except such as served
to indicate that the case belonged to one of the above cate-
gories, and that he should have but four classes of remedial
agents appropriate to these categories.

And when, in our day, physicians assume to ascribe dis-
eases to certain pathologico-anatomical states as their essen-
tial causes, it is manifest that whatever varieties the case of
each one of a dozen patients may present, must be disre-
garded, provided the pathologico-anatomical condition be
the same in all, for they are grouped on the basis of this
condition, and the indication for the cure is drawn from the
existence of this condition, and must necessarily be the same
for all.

Now, just as any spot upon the surface of the globe may
be approached by an almost infinite number of roads, and
yet, when the traveler has reached the spot, there shall be
nothing in the mere fact of his presence there to indicate
with certainty the road by which he has come thither, so the
same pathologico-anatomical result may issue from the most

88 ANTAGONISM BETWEEN

multifarious pathological processes, which processes, however,
leave no sign in the result. If, then, the mode of treatment
be based on the result, it can take no account of this variety
in \h& processes.

A wholesale generalization, then, of diseases and of reme-
dies is inevitable from the philosophy of the "Rational"
method.

The common experience of the community teaches men
that diseases to which the same name is given may present
in different persons an entirely different aspect. John Doe
and Richard Roe both have rheumatism, but their symptoms
and whole condition are so entirely different that no one
would have imagined them to have the same disease, if the
doctor had not said so. The pathologico-anatomical condi-
tion, however, is the same in both (viz., the altered condition
of the blood), and consequently the rational indications for
the cure are identical in the two cases. If the doctor be
true to the philosophy of his method, he treats them alike,
notwithstanding the difference in their symptoms and ap-
parent condition. But I call your attention to the fact which
is familiar to every one, that every sagacious and long-
headed physician of the Old School pays the less regard to
the rules of his art the more experience he acquires at the
bedside.

In treating disease he " feels his way," as the saying is;
he relies on his " practical tact and experience," and often
deviates widely from the rules of practice as they are deduced
in the books from the theory of the art ; he trusts less and
less implicitly to a pathologico-anatomical basis of treatment,
and more and more to " general indications," by which he
means the sum of the symptoms of each individual case.
In truth, experience has taught him the fallacy of the science
of therapeutics, as founded on the " Rational " basis.

Now, if this were a true science, would not experience
rather confirm the practitioner's faith in it, and add to his
skill in applying it ?

HOMCEOPATHY AND ALLOPATHY. 89

When on the other hand we cast aside all endeavors to
base a method of treatment upon a theory of disease; when
we give over all attempts to discover the inscrutable, essen-
tial nature and cause of diseases, and confine our observa-
tions to the phenomena of morbid action, whether these be
material or functional, then we can take into account the
pathological processes as well as the pathologico-anatomical
results. We are then in condition to give due weight to the
peculiarities of each individual case of disease, to study it,
as under other circumstances groups are studied, and to give
due attention to the modifying idiosyncrasies of the indi-
vidual.

Hence, under our method alone is an absolute individual-
ization of disease possible. Such a method of studying dis-
ease, however, would be barren under the Old School method
of treatment, even with specifics. For the properties of spe-
cifics were known to the Old School only with reference to
large and ill-defined groups of diseases. By us, on the other
hand, specifics are studied in the effects which they produce
upon the healthy subject, precisely as diseases are studied in
the effects which morbific causes produce upon the sick.
The same strict individualization, then, is practicable with
regard to specifics that we have seen to be necessary in the
study of diseases. It is not only practicable — it is fruitful
of the richest returns.

The case, therefore, is not half stated when we say that
Hahnemann discovered the method of specifics. He taught
us how to discover and apply, and showed us the necessity of
applying, an individual specific to each individual case of dis-
ease, as studied in the totality of its phenomena and without
regard to the nosological group to which, for purposes of
classification, the case might be assignable.

As a necessary consequence of this individualization, Hah-
nemann taught the value of subjective symptoms. By these,
we mean those symptoms of which the physician becomes
cognizant through the sensibilities of the patient. Among

90 ANTAGONISM BETWEEN

them are all the varieties of pains and abnormal sensations
which accompany disease. These symptoms were previously
disregarded and are still considered as of no value by the
"rational" or "physiological" school of medicine. Thus, Pro-
fessor Bock, of Leipsic, in his work on Diagnosis (1853),
says : " Only the objective symptoms — of which the prac-
titioner derives a knowledge by the use of his own five
senses, by sight, touch, hearing, mensuration, percussion, and
by microscopic and chemical examinations — are of any
value to the physician. The subjective symptoms are in the
highest degree uncertain and treacherous." In other words,
the disease is to be studied in all cases just as the phenomena
of an inanimate plant or mineral are studied ; the case of an
intelligent and self-possessed patient, just as that of a patient
whose intelligence is dormant under the cloud of a typhoid
fever !

Now, everybody knows that pains and various sensations
different from those of health, make up a large and impor-
tant part in every case of illness. And what are these
sensations ? Unquestionably they are the results of abnor-
mal action of the sentient nerves, or else they are evidences
conveyed by the sentient nerves of abnormal action in some
of the organs of the body.

It is in the highest degree unphilosophical to arbitrarily
disregard and cast aside any of the phenomena of disease.
If they find no place in our system of medicine, why, so
much the worse for our system ! If they cannot be made
available under our method of treating disease, this fact is
prima facie evidence that our method is defective ! Fur-
thermore, every physician and every intelligent person
knows, by observation and experience, that pains and abnor-
mal sensations almost always precede any material or
organic evidence of disease. Common sense teaches every
man the value, in medical treatment, of the maxim, " Obsta
principiis ! " Diseases should come under treatment at
the earliest possible moment. Some that are curable at an

HOMOEOPATHY AND ALLOPATHY. 91

early period are well known to be incurable by our present
resources, if allowed to establish themselves firmly. But
the first evidences of nearly all diseases consist of subjective
symptoms. A method, therefore, which does not provide
for the employment of these symptoms in the determination
of the treatment, cannot furnish means for encountering dis-
ease at the very outset.

And, appealing again to the experience of the community
to bear me out, I say that honest and candid practitioners
of the Old School often say to their patients, " Wait a little
until your disease shall have become developed, — at present
I know not what to do." Why does he not know what to
do ? This question touches the weak point in the philoso-
phy of the physiological school. It is because the patient,
as yet, presents only "subjective symptoms," which are
evidence of " dynamic changes " only, — because he cannot
form a theory of the cause of the disease until the disease
has progressed far enough to furnish him with some material
results of these dynamic changes, — in a word, with objective
symptoms. This instance is another evidence of the insuf-
ficiency of the Old School philosophy of medicine, while at
the same time it shows that, so long as they accept this
philosophy, the physiological school are consistent and
logical in excluding subjective symptoms from consideration.

Not a few diseases — the neuroses, for example — consist
almost entirely of subjective symptoms. In these, the phys-
iological physician admits his inability to institute a rational
treatment, and he resorts at once to specifics. But if the
specific method of treatment is available against diseases for
which the physiological method fails, as well as for all other
cases, is it not confessedly the universal method ?

Hahnemann's method, which avails itself of all the phe-
nomena which the patient presents,— holding that all,
together, make up the disease,— sets a true value upon sub-
jective symptoms. Not requiring a theory of the nature
and cause of the disease as a preliminary to the treatment,

92 ANTAGONISM BETWEEN

but basing the treatment directly upon the phenomena which
the patient presents, it can proceed to cure a patient who
presents only subjective symptoms as readily and as surely
as one in whom these have given place to objective symp-
toms.

More than this, Hahnemann showed the value of sub-
jective symptoms in the aid which they afford us in indi-
vidualizing cases of disease, and thereby enabling us to
select a specific for each individual case with more absolute
precision. Indeed, he showed that it is only by means of
subjective symptoms that the application of individual spe-
cifics is possible. It has already been remarked that the
material or organic changes in the tissues of the body,
which furnish the objective symptoms, may have resulted
from any one of a number of pathological processes or
abnormal alterations of function, and that they give us in
themselves no means of knowing from what particular abnor-
mal process they resulted. Now, unless we know this, we
cannot apply specifics with exactness. The physiological
school have no means of knowing it, and therefore they,
very logically, do not undertake to apply specifics with
exactness to individualize cases of disease. But the subjective
symptoms enable us to take cognizance of these patho-
logical processes, these abnormal changes of function, and
hence the value of these symptoms. To Hahnemann
belongs the honor of having demonstrated this value, and
of having shown us how to avail ourselves of it.

To Hahnemann, again, belongs the credit of having
insisted upon the propriety of using only one remedy at a
time. As this, however, was clearly expressed by Boyle,
and is admitted by Sir John Forbes, I shall content myself
with quoting their words. Boyle says (1654): " It seems
a great impediment to the further discovery of the virtues of
simples, to confound so many of them in compositions ; for
in a mixture of a great number of ingredients, it is hard to
know what is the operation of each or any of them, so that

HOMOEOPATHY AND ALLOPATHY. 93

I fear there will scarce, in a long time, be any progress made
in the discovery of the virtues of simple drugs, till they either
be oftener employed singly or be but few of them
employed in a single remedy." And Forbes says, in
1846: "Our system here is greatly and radically wrong.
Our officinal formulae are already most absurdly complex,
and our fashion is to double and redouble the existing com-
plexities. This system is a most serious impediment in the
way of ascertaining the precise and peculiar powers (if any)
of the individual drugs, and thus interferes in the most
important manner with the progress of therapeutics."

And, finally, Hahnemann demonstrated these facts :

1st. That the curative power of a specific remedy is not in
the direct ratio of its material quantity. This had been sus-
pected by his predecessor Sydenham, with respect to bark.

2d. That a drug exerts a more powerful effect on those
organs for which it has a specific affinity when these organs
are sick than when they are healthy ; whence it follows that
smaller doses of the same drug are required to cure diseases
for which it is the specific remedy, than would be needed to
produce their symptoms in the healthy person.

3d. That not only are smaller doses of specifics required
to cure diseases than to produce their symptoms in the
healthy, but that, when the symptoms of the diseased organ-
ism are similar to those produced in the healthy subject by
a given drug, then this drug will act curatively on that
organism in doses so small that they would hardly produce
any effect whatever on the healthy organism.

But how small ? This is the practical question. A priori,
Hahnemann said, "The smaller the better, provided they
only cure the disease in the quickest and surest manner."
He experimented for the purpose of reaching definite con-
clusions, and out of these facts and experiments came the
doctrine and practice of the little doses. And I repeat that
those who follow Hahnemann most closely, individualize
their cases most strictly, and select the individual specific

94 ANTAGONISM BETWEEN

with most exactness, will surely arrive, as all such have
done, at the conclusion, on this subject, to which Hahne-
mann came.

It is remarkable that the first and second facts I mentioned
respecting the dose of specifics did not escape the acute mind
of Robert Boyle. He says : "To show you that a distem-
pered body is an engine disposed to receive alterations
under such impressions as will make none upon a sound
body, let me put you in mind that those subtle streams
that wander through the air before considerable changes of
weather disclose themselves, are wont to be painfully felt by
many sickly persons, and more constantly by men that have
had great bruises or wounds, in the parts that have been so
hurt, — though neither are healthy men at all incommoded
thereby, nor do those themselves that have been hurt feel
anything in their sound parts whose tone or texture has not
been altered or enfeebled by outward violence."

If quantity be accepted as the measure of power, then the
question of the dose must be resolved by the well-known
laws of physics.

But so soon as it is admitted that the power of a drug is
not determined by its quantity alone, but also by its form,
and still more by the condition of the patient and by the rela-
tion of the specific properties of the drug to the diseased
condition against which it is administered, then the whole
question is withdrawn from the domain of physics and is left
open to be settled by experiment.

Now, it is admitted by all medical men, that some drugs
at least, exert their specific influence more speedily and more
powerfully when given in small doses than when given in large
doses, as, for example, Mercury, and according to Dr. Chris-
tison, Oxalic acid, which shows that there is not always a
direct ratio between power and quantity.

Moreover, all medical men agree that in certain morbid
states, the body is much more sensitive to the specific action
of certain remedies than it is, in certain other morbid states,

HOMOEOPATHY AND ALLOPATHY. 95

to the same remedies. The phrase that "such or such a
disease does not bear Mercury well," is familiar to the pro-
fessional ear. This shows that the condition of the patient
has something to do in determining the power with which a
certain dose of a specific shall manifest its action, and con-
versely that this condition should be taken into consideration
in determining the dose.

These two facts show that the whole question of the dose
was, at the time of Hahnemann's writing, an open one, to
be settled by experiment alone.

And, as Hahnemann showed that those morbid conditions
of the system in which a specific exerts the most power in
small doses, — in which, in other words, the susceptibility of
the system to the specific is the greatest, — are precisely those
in which the symptoms are similar to those which the same
drug would produce in a healthy person, it follows that no
experiment can be valid on the subject of the dose which
does not take into consideration the condition of the patient
at the time, and which does not require, as preliminary con-
ditions, first, that the subject of the experiment shall be sick,
and second, that the symptoms of the sickness shall be simi-
lar to those which the drug with which the experiment is
made would produce on the healthy subject.

In none of the experiments on which our opponents base
their objections to the dose of Homoeopathy have these con-
ditions been observed.

In no case in which they have been observed has the
result been adverse to that at which Hahnemann arrived.

But, in truth, these objections depend in general not so
much on the result of experiments as on what is -called the
a priori improbability, and upon the seeming simplicity and
triviality of the means employed in proportion to the end
sought to be attained.

The improbability exists only in the minds of those who
reckon respecting the living organism as they reckon respect-
ing an inanimate machine, employing the rules of physics.

96 ANTAGONISM BETWEEN

Let me quote again from Boyle: "Whereas," he says, "it
is objected that so small a quantity of the matter of a specific
as is able to retain its nature, when it arrives at the part it
should work on, must have little or no power to relieve it ;
this difficulty will not stagger those who know how unsafe
it is to measure the power that natural agents may have to
work upon such an engine as the human body by their
bulk, rather than by their subtlety and activity."

And as concerns the relative simplicity and triviality of
the dose, listen to the practical Sydenham.

Speaking of the success of his new plan of treating rheuma-
tism with whey, instead of by blood-letting, he says :
41 Should any one despise this method for its simplicity, I
would have him to know that weak minds only, scorn things
for being clear and plain. * * * The usual pomp of
medicine exhibited over dying patients is like the garlands
of a beast at the sacrifice." x

Gentlemen of the Society : In the torch- races of ancient
Greece the participants ran with lighted torches, each striv-
ing to preserve the flame alive, and to hand his torch unex-
tinguished to his successor. If the light went out in his
hands he was dishonored. This was done in memory of
Prometheus, who first brought fire from heaven for the
benefit of men.

We have received from the generation of the pupils and
successors of Hahnemann the blazing torch which the
Prometheus of our system lighted at the altar of Eternal
Truth. Our honor depends on the care with which we
cherish it, and the state in which we, in turn, transmit it to
those who shall follow us.

The especial direction which our labors should take is
determined by the peculiarities of our method.

We are to increase the number of specific remedies. We
are to labor diligently, as our predecessors have done, to
increase our materia medica, until we shall have ascertained

1 Russell, History and Heroes of the Art of Medicine.

HOMOEOPATHY ANP ALLOPATHY. 97

the specific remedial properties of all substances capable of
being used in treating diseases.

But more especially are we to labor to make the knowl-
edge we thus acquire of new specifics, and the knowledge
we already possess of such as we now use, more exact and
definite ; until we shall possess an exhaustive knowledge
of each remedy, and also such a differential knowledge as
shall put us in possession of all the points of resemblance
and difference between each of our remedies and all the
rest.

And it is in this particular province that there is the
greatest present need of labor. Our materia medica is being
filled with the names of drugs of which a few general proper-
ties are loosely recorded, but respecting which no exact or
exhaustive knowledge has been attempted to be gained.
All this must be changed if we would establish and maintain
a reputation at all commensurate with the demands of
modern science.

Finally, we must bring to bear upon our study of materia
medica and of symptomatology all that is useful in the
labors of the physiological school of medicine, in the depart-
ment of the collateral medical sciences of physiology, pathol-
ogy, chemistry and physical diagnosis.

For, chaotic as are the therapeutics of this school, and
based on a false philosophy, we must not suffer this fact to
blind us to the wonderful progress made by it in these
collateral sciences, and which are as valuable to us as to it.

They supply the means of exact observation. We need,
then, in part, to reprove our materia medica, availing our-
selves of these improved means of observation; and we
must employ the same in our examination of the sick.

We are called also to give ourselves to the study of sub-
jective symptoms. This is our especial province, because
the physiological school discards these symptoms. Prof.
Bock says they are "difficult to understand and apt to
deceive."

98 ANTAGONISM BET. HOMCEOPATHY AND ALLOPATHY.

I have yet to learn that a study is to be avoided because
it is difficult ! or that a precious tool should be cast aside
because it requires a skillful hand to use it. •

The import of subjective symptoms, their connection with
each other, their physiological and pathological significance,
are all matters which it is indispensably necessary for us to
elaborate and master.

And, last of all, the still open question of the dose
demands our earnest study.

Conscientious, untiring labor in these departments will
enable us to hold with honor our place in the great race,
and to hand our torch, still blazing, to our successors.

We shall thus do our part toward making good the confi-
dent expectation of our master respecting his system.

" Our art," says he, " needs no political lever, no worldly
badges of honor, in order to become something. Amid all
the rank and unsightly weeds that flourish round about it,
it grows gradually from a small acorn to a slender tree ;
already its lofty summit overtops the rank vegetation around
it. Only have patience ! It strikes its roots deep under
ground, gains strength imperceptibly, but all the more cer-
tainly, and in due time it will grow up to a lofty God's oak,
stretching its great arms, that no longer bend to the storm,
far away into all the regions of the earth ; and mankind,
who have hitherto been tormented, will be refreshed under
its beneficent shadows."

RELATION OF PATHOLOGY TO
THERAPEUTICS.1

THE question of the Relation of Pathology to Therapeutics
is one of exceeding importance, if for no other reason than
this : that, by a very large portion of the medical profession,
it is commonly held that the whole science of Therapeutics
is based, in its general principles and in its special applica-
tions, upon the science and the facts of Pathology.

Before beginning the discussion of this subject, it is neces-
sary to define the terms used in stating the question, as well
as certain kindred terms.

The study of the tissues and organs of which the healthy
human body is composed constitutes the science of Physi-
ological Anatomy. It may be pursued upon the living or
the dead body, provided the death resulted from violence and
not from disease.

The tissues and organs of the healthy body are so fashioned
as to perform, each, a special work. This act of performing
its special work is called the function of an organ. An
organ can act only during the life of the individual. Func-
tions, therefore, can be predicated only of living organs. The
study of the performance of their special work by the aggre-
gation of organs which make up the body constitutes the
science of Physiology.

Physiological Anatomy, then, is the science of the tissues
and organs of the healthy body ; Physiology is the science of
the functions of the healthy, living organism.

When any or all of the tissues or organs of the body have
suffered modifications of substance or of structure in conse-

1 Read before the Homoeopathic Medical Society of the State of New-York,
May, 1863.

100 RELATION OF PATHOLOGY

quence of disease, the study of these material changes, which
are the results of disease, constitutes the science of Patho-
logical Anatomy. This maybe studied upon the living or
the dead diseased organism.

When, in consequence of the action of a morbific agent,
any or all of the organs of the body perform their special
work in an abnormal manner ; in other words, when the
function of any of the organs of the body is perverted, the
study of these changes and perversions of function constitutes
the science of Pathology, which, like Physiology, can be
studied only in the living organism.

Pathological Anatomy, then, is the science of the morbid
tissues and organs of the diseased body. Pathology is the
science of the abnormal functions of the diseased living body.

Diseased tissues and organs being modifications of healthy
tissues and organs, it is clearly necessary to understand
Physiological Anatomy before we can understand Patho-
logical Anatomy. Just as necessary is it, for the same reason,
to understand Physiology before we can master Pathology.
Indeed the latter might be said to exist only by comparison
with the former.

If this be true of the details of these sciences, it is no less
true of their essential nature and philosophy. If one would
gain a correct notion of the subject, scope, limits and rela-
tions of the science of Pathology, he must first have a just
and exact idea of those of Physiology. To the latter, there-
fore, I propose to devote a few words.

Dr. Carpenter defines the object of Physiology to be the
study of "the phenomena which normally present them-
selves during the existence of living beings," or, in another
place, "the phenomena of health or normal life."

Its object, then, is not, as it has been sometimes loosely
stated, life itself, but the phenomena which depend upon and
result from normal life. The science of Physiology brings
these phenomena into systematic form, classifies and com-
pares them, analyzes secondary and complex phenomena into

TO THERAPEUTICS. IOI

their simple elements, and seeks the ultimate phenomenon
in which the real elementary manifestation of simple life is
made, uncomplicated by secondary or related chemical or
mech'anical phenomena.

Virchow says, " The chief point is to obtain a recognition
of the fact that the cell is really the ultimate morphological
element in which there is any manifestation of life, and that
we must not transfer the seat of real vital action to any point
beyond the cell."1

Dr. Carpenter says, "The cell lives for itself and by itself,
and is dependent upon nothing but a due supply of nutri-
ment and a proper temperature for the continuance of its
growth, and for the due performance of its functions until its
term of life expires. Its chief endowment seems to be that
of attracting or drawing to itself some of the various sub-
stances which are contained in the nutritive fluid in relation
with it. This fluid is a mixture of a great number of com-
ponents ; and different sets of cells appear destined severally
to appropriate these. As far as is yet known, however, the
composition of the cell-wall is everywhere the same, being
that of Proteine."

Dr. J. H. Bennett says, " Nutrition is now considered to
depend upon an inherent vital property peculiar to the tissues
themselves, which exercise a force at the same time attract-
ive and selective. By its agency each tissue and gland
attracts from the blood that amount of matter which is
necessary to maintain it in bulk, and at the same time selects
from it the peculiar substance necessary for itself and for the
secretion it is destined to produce."

According, then, to the most advanced writers on this sub-
ject, we are to regard the organism as a complex which is
capable of being analyzed into an aggregation of cells, of
homogeneous structure, but each of which is endowed with a
peculiar inherent vital power of " attraction and selection,"
which we recognize only in its results and which constitutes
the only " real action of life" that we are capable of observing.

Cell. Path., Eng. ed., 3.

CQLL'EG

102 RELATION OF PATHOLOGY

In the words of Virchow, " Every animal presents itself as a
sum of vital unities, every one of which manifests all the
characteristics of life."

Life, then, really consists in the exercise by each cell of
its inherent peculiar attractive and selective power. Physi-
ology concerns herself with the results of this exercise. A
cell by virtue of its inherent power abstracts from the nutri-
ent fluid a substance which is to serve to nourish the organ
to which the cell belongs, or to furnish the secretion of that
organ. If the former, then the future history of that organ,
its development, its functions and its interstitial decline and
dissolution and the fate of its debris belong to the secondary
and complex phenomena to which Physiology devotes her-
self. With these phenomena, life has no exclusive connec-
tion save in the primary exertion by the cell-wall of its
" inherent attractive and selective power."

Physiologists with great propriety attempt to explain by
mechanical, chemical and electrical laws the secondary phe-
nomena of the organism, the relations of different tissues and
secretions to each other and their mutual reactions. But
they make no attempt to explain the action of the cell-wall
which is the ultimate and essential phenomenon of life. They
accept this as an ultimate fact, they recognize a power pecu-
liar to the wall of each variety of cell and different from
that of any other cell, and they deal with the results of the
exercise of this power.

Physiology having been defined as the science of the phe-
nomena of normal life, Pathology has been declared by the
same writer (Dr. Carpenter), to be the science of the phe-
nomena of " disease or abnormal life"

If the mutual reaction of two secretions be different in any
individual case from that which is observed in the healthy
organism, one or other of the secretions must be of an abnor-
mal character. This must have resulted from an abnormal
exercise by the cell- wall of that inherent selective power, by

TO THERAPEUTICS. 1 03

virtue of which the secretion was made. The essential and
ultimate act of disease is found, like that of life, to consist
in some abnormal exercise by the cell-wall of its inherent
vital power. As we recognize the existence of this power
in the healthy cell only through its action and its result,
viz., the function of secretion and the substance secreted, so
we recognize disease, which is an abnormal exercise of this
power, only through its action, viz., the perverted function,
and through its result, viz., an abnormal secretion.

"Not unfrequently," says Dr. Bennett, "this attractive
and selective power in the tissues is deranged, producing
increase or diminution in growth or secretion, general or
partial. Not unfrequently the selective power appears to be
lost, and the attractive power much increased," etc., etc.
From this alteration of these forces, diseased conditions
of these fluids and tissues result. The secondary and com-
plex phenomena resulting from the reaction of abnormal
tissues are analyzed by Pathology and referred to this
elementary deviation in the selective and attractive forces
of the cell- wall. But the nature and intimate cause of this
alteration, which is, however, the essence of disease, Pathol-
ogy does not attempt to explain or apprehend, knowing it
only by its effects.

As, therefore, Physiology concerns herself with the results
of life, so does Pathology take cognizance of the results
of disease. For it must be repeated that as the functions of
healthy organs and the tissues of the healthy body which
are respectively the subjects of Anatomy and Physiology
are not life, but only results of life, so the abnormal func-
tions and the altered tissues of the diseased body, which are
respectively the subjects of the science of Pathology and
Pathological Anatomy are not disease itself, but only the
results of disease.

These distinctions, it will be perceived, have a direct and
most important bearing upon the science of Therapeutics,
which has for its object the cure of disease.

104 RELATION OF PATHOLOGY

The process by which the secretion of any fluid of the
body is accomplished cannot be explained. It is an exer-
tion of that peculiar vital power of which we have spoken
as inherent in the cell- wall. The secretion of the gastric
juice and of the bile, for example, is wholly inexplicable.
But when, after being secreted, these or similar fluids are
brought into contact with each other or with any foreign
substance, whether within or without the body, the actions
and reactions which ensue are explicable by chemical,
mechanical or electrical laws, and these explanations con-
stitute the object of Physiology. It is obvious that these
phenomena may be of great complexity and that the
explanations may require to state the conditions of several
successive series of reactions, which intervene between the
external fact or symptom as viewed by the observer, and
that ultimate action of the cell-wall which Virchow declares
to be "the only real vital action of the living organism" —
or, on the other hand, the phenomena may be simple and
the explanation may be complete by a simple and direct
reference to the selective action of the cell- wall. Thus, for
example, the fact of salivation, as noticed by an external
observer, is made up of the discharge of the salivary secre-
tion into the mouth. The explanation refers us at once
to that selective power of the cell-wall of the salivary glands
which extracts from the nutritive fluids the constituents of
this peculiar secretion which, as such, is not found any-
where in the body except in the salivary ducts as the result
of the process we have just described.

On the other hand, the fact of urination is made up, so
far as the external observer is concerned, of the discharge of
urine from the urethra and the emptying of the urinary
bladder. The physiological investigation, however, shows
the process to be quite complicated, and the explanation
carries us through several series of phenomena, before we
arrive at the ultimate fact. Thus, we trace the urine through
its reservoir, the bladder, up the ureters to the tubuli of the

TO THERAPEUTICS.

105

kidneys, where it has probably received, if not the whole, at
least a great portion of its watery constituents; and this
contribution may require a further explanation by the
mechanical laws of endosmosis and exosmosis whereby this
constituent was separated from the blood. Not tracing this
constituent further, for the present, by asking; as we should
logically be required to do, how this substance came to be
contained in definite quantity in the blood, we seek the
other constituents of the urine and find the urea and possi-
bly some other of them eliminated by the Malpighian
bodies from the blood through the agency of the cell-wall.
And yet even this can hardly be called the ultimate vital
act, which will require to be sought by a still deeper analysis.
For although the cells of the Malpighian bodies do separate
the urea from the blood, yet they do not manufacture it
from the constituents of that fluid. They find it there
already formed, and an exhaustive analysis of the physio-
logical fact of urination would require us to seek the origin
of the urea in the blood. This would lead us jto the study
of the nutrition and decay of the nitrogenized tissues, and
in the cell-walls of these we should first meet with that
ultimate vital act, in which alone, of all the processes which
urination involves, life, pure, simple and inexplicable, is
concerned.

Physiology goes somewhat further than this analysis of
the actual normal functions of the living organism. Under
the name of Experimental Physiology she not only seeks to
apply the test of synthesis to her analysis, but she endeavors
to solve her problems by the substitution of analogous sub-
stances for some elements of the nutrient fluid, or for some
of the secretions of the organism, and thus light is thrown
not merely on the processes of the living organism, but also
contributions are made to the derived science of Patltology.
•

Let us now take a similar view of the science of Pathology,
which deals with abnormal functions as Physiology does with

IO6 RELATION OF PATHOLOGY

normal functions, and which might almost, by a license of
speech, be called the science of Morbid Physiology.

The fact of morbid salivation is, to the observer of object-
ive occurrences, only a discharge of abnormal salivary fluid.
The pathological explanation, like the physiological, leads us
to the selection from the blood by the cell- wall of the glands
of the substances out of which it fabricates the salivary
fluid. If the blood be normal and yet the saliva be, as we
have supposed, abnormal, then the mysterious power of the
cell-wall must have been perverted, altered or impaired.
This manifestation of life must have become a manifestation
of abnormal life — which is disease. Here, then, is the seat
of disease — just where we found the seat of life — in the
inherent attractive and selective power of the cell-wall.
This, then, is the nature of disease, a modification of that
unknown and inscrutable power, life.

"Health," says Carpenter, " or normal life;" "disease or
abnormal life."

"Not unfrequently," says Dr. Bennett, "this attractive
and selective power in the tissues is deranged. Not unfre-
quently the selective power appears to be lost and the
attractive power greatly increased, and thus," after a few
intermediate steps described, " the phenomena which we
call inflammation ensue."

To take, now, an example of a more complex series of
phenomena, the fact of the evacuation of morbid urine,
simple as it may appear to the observer of external phe-
nomena only, yet leads us, in our search after the original
act of " abnormal life " in which the morbid excretion had
its origin, to examine first, whether the change was purely a
chemical change, originated and effected while the urine was
retained in its reservoir, the bladder — for if so, it differs
little from a corresponding change which occurs daily in
the " vase de nuit" — secondly, whether- the urine derived its
morbid character from the admixture of morbid secretion,
or effusion from the surface of the bladder, of the ureters,

TO THERAPEUTICS.

107

of the pelvis of the kidney, or from the tubuli ; from each of
which it might receive blood, or mucus, or pus, or, perhaps,
liquor sanguinis alone holding fibrine in solution, or finally
solid fibrinous casts; or, thirdly, whether the morbid change
in the urine came from a loss, on the part of the cell-
walls in the Malpighian bodies, of their inherent vital
selective power, whereby they are enabled to separate from
the blood those substances which it is their province in
the healthy body to separate ; or, finally, whether the blood
no longer contains, as in a normal state it should do, those
elements which it is the function of the kidney cells to
eliminate from it, — in other words, whether the whole train of
processes which eventuates at last in the evacuation of
abnormal urine, may be traceable to an abnormal interstitial
nutrition and destruction of the nitrogenized tissues ; all
these are questions which it is the legitimate and very
useful business of Pathology to solve.

Now, be it observed, whether the cause be traced to
abnormal action in the cell of bladder, ureter, kidney, or
in that of the muscular or cerebral tissue, we arrive always
at the fact that as the action of the cell-wall in the healthy
body constitutes the only real vital action of the organism,
the only unmixed manifestation of life ; so the modified and
abnormal action of the*cell-wall in the diseased body consti-
tutes the only real action 'of abnormal vitality in the
organism — the only unmixed manifestation of disease.

It may be objected that no account has been taken in
what we have said, of the action of the nervous system,
to which, nevertheless, both in the case of morbid saliva-
tion and in that of morbid urine, the alteration in the sali-
vary gland and in the kidney respectively may have been
attributable. But this objection simply adds another step to
the analysis. For every action of any part of the nervous
system involves an expenditure of a portion of nervous
substance, that is, a process of interstitial destruction and
reconstruction, and this process is effected only through the

108 RELATION OF PATHOLOGY

attractive and selective power of the cell-wall of the nervous
tissue. Thus are we brought again face to face with this
inevitable mysterious power, the abnormal action of which
constitutes Disease.

We are now in a position to discuss the relations of this
science of Pathology, which treats of the phenomena of the
diseased organism, to the science of Therapeutics, which pro-
poses to cure disease.

It has been stated that a large portion of the medical pro-
fession hold that the science and practice of Therapeutics
are based upon the science and facts of Pathology. It is
held that the explanation of the phenomena of the morbid
organism, which Pathology furnishes, gives the key to the
procedures which should be adopted for the restoration of
the morbid organism to a healthy condition. If, for example,
it be ascertained through the investigations which Pathol-
ogy makes for us, that a certain series of morbid symptoms
may be traced to an abnormal condition of the gastric fluid, —
a too great acidity, for example, — " it is," says Dr. Bennett,
"the discovery and removal of such causes as this that
constitute the chief indications of the scientific practitioner."
Let us see in what way Dr. Bennett proposes that this
" removal " shall be accomplished. He says, supposing
another case : " The capillary vessels become over-distended
with blood, and the exudation t)f the liquor sanguinis to an
unusual extent takes place, constituting inflammation. How
is this to be treated ? In the early stage, topical bleeding,
if directly applied to the part, may diminish the congestion,
and the application of cold will check the amount of exuda-
tion. But the exudation, having once coagulated outside of
the vessels, acts as a foreign body, and the treatment must
be directed to furthering the transformations which take
place in it, and facilitating the absorption and excretion of
effete matter. This is accomplished by the local application
of heat and moisture, the internal use of neutral salts to
dissolve the increase of fibrine in the blood, and the employ-

TO THERAPEUTICS. 109

ment of diuretics and purgatives to assist its excretion by
urine or stool."

In this plan of treatment, we have a proposition to adopt
mechanical measures — blood-letting — for the diminution of
a congestion ; chemical means — neutral salts — for the solu-
tion of the exudation; and mechanical means again —
diuretics — for the removal of the dissolved exudation from
the blood.

But it cannot fail to attract the attention of every reader
that this plan proposes to deal only with the results of
disease — not with the disease itself — for the congestion is a
primary result of the abnormal action of cell- wall, and the
exudation which results from the congestion is a secondary
result of the same abnormal action of the cell-wall. This is
clearly shown by Dr. Bennett's words already quoted, but
which we again cite : " Not unfrequently the selective power
of the cell appears to be lost, and the attractive power so
much increased, that the liquor sanguinis is drawn out
through the vessels, so that its fibrine coagulates in a mass
outside of them. This result, preceded or accompanied by
certain changes in the vessels themselves, and more or less
stagnation of the current of the blood, constitutes the
phenomenon hitherto described as inflammation."

It is here most distinctly stated, and most conclusively
shown, that the cause of the phenomena of inflammation lies
behind these phenomena of congestion and exudation, and
is to be found in a modification of that mysterious vital
power of the cell- wall. It follows from this that a treatment
which is addressed to these resultant phenomena, and not to
their cause, must be but a palliative treatment. It can in no
sense be called a radical or a rational treatment. To remove
or assist in removing from the body or any part of it the
results of morbid causes may alleviate suffering, may enable
the patient to hold out longer under disease, just as pumping
out a leaking ship may postpone the time when she will
sink, may increase her chances of getting into port before

IIO RELATION OF PATHOLOGY

she sinks, — may thus in fact be the means of saving her. But
as, certainly, pumping is only a palliative mode of treating a
leaking ship — as the stoppage of the leak is the only radical
treatment imaginable — so in the case of inflammation the
only radical treatment would be one which addressed itself
directly to the cell- wall, and in such a way as to restore to
it the just amount and proportion of its now perverted
" inherent attractive and selective power."

It is evident that when this had been accomplished, con-
gestion would cease to be produced, and in consequence of
this cessation there would be no further exudation. It
might now be within the province of Pathology to indicate
some mechanical or chemical way of aiding or hastening the
removal of the results of disease — the congestion and exuda-
tion—but this would be only a sequel of the curative treat-
ment.

A curative treatment, then, must address itself directly to
the cell- wall, which is the ultimate seat of disease. And
every method which is directed to the results of disease,
which are the proper subjects of Pathology and Pathological
Anatomy, must, of necessity, be a palliative method.

But, it may be objected, we are unable to plan any such
curative treatment, for the reason that we do not understand
the nature of this cell force, nor the nature of its perversion,
in any case. To recur to our simile of the ship : it is some-
times impossible to find the leak, or, if its location be known,
to stop it. Nothing remains but palliation. This statement,
as applied to disease, is correct in only a few instances, the
number of which is becoming continually diminished by the
progress of science. It is true that we do not understand
the nature of the cell force, whether normal or perverted.
Neither do we understand the nature of chemical affinity,
nor the modus operandi of chemical reaction. Yet we have
an experimental knowledge of each, and we know the
peculiar chemical affinities and reactions of a vast number of
bodies.

TO THERAPEUTICS. HI

In like manner we may learn the reaction of foreign
bodies introduced into the circulation upon the inherent
forces of the cell- wall. Reasoning upon the general physical
law that " like effects are produced by similar causes," we
conclude that, if in any case, having introduced into the
circulation of the healthy subject a foreign body, we observe
the phenomena of congestion and exudation, with stagnation
of the current of the blood, identical with those known to us
as the phenomena of inflammation, then the peculiar inherent
powers of the cell-wall must have been affected by this
foreign body in precisely the same way (whatever it be) as
that in which any accidental exciting cause of inflammation
affects these forces. We thus discover re-agents which act
directly upon the inherent power of the cell-wall, and we
thus, by experiments upon the healthy, determine precisely
the limits and direction of their action. This knowledge is
rendered possible and exact by the science of Pathology,
which enables us to trace out and analyze the results of
intentionally induced abnormal cell-action, just as it does
those of accidental disease.

This is not a matter of mere speculation. It is well known
to every physician that almost every drug, every substance
in fact which is not a simple aliment, has, besides any
chemical affinities it may possess for some of the secretions
of the living organs, a certain peculiar power of modifying
the functions of some of the organs of the body, a power
which is inexplicable and is recognized only by its results.
Examples of this power of drugs are found in that of Tartar
emetic to produce changes which result in congestion and
exudation, of Opium to produce changes which result in
narcotism, etc. These, which are known as the specific
properties of drugs, are evidently the properties by which
they modify the forces of the cell-wall, and from which all
observed Pathological (or Pathogenetic) and Pathologico-
anatomical phenomena result.

And it is manifest that the specific modifying power of

112 RELATION OF PATHOLOGY

each drug can be surely ascertained, as an absolute property,
by testing it upon the healthy living organism. And it
follows as clearly, from all that has been said, that the appli-
cation of specific drugs which have a direct action upon the
cell-wall whose inherent forces are acting abnormally under
the influence of disease, is the only direct and radical method
of curing disease.

The task of finding out by what formula the specific
action of drugs upon the cell-forces of different tissues
should be brought to bear upon the perverted cell-forces
in any given case of disease, comes under the science of
Therapeutics and lies beyond our present province. It is
the problem of the Therapeutic Law.

From all that has been said, the Relations of Pathology
and Therapeutics may be deduced in a few words.

Physiology and Pathology themselves teach us that the
science of Pathology can in no sense serve as a basis or
foundation of the science of Therapeutics. They show us
that whereas Pathology is the science of disease based on
a theory of observed morbid processes, Therapeutics, when
truly regarded, is a science of cure, based on a theory of
cure and resting on a foundation of experiment. Although
not the basis of Therapeutics, Pathology must yet be a
most important instrument in the practical application of the
science of Therapeutics.

The problem in the art of medicine being to apply to the
abnormally acting cell-wall that remedial agent which is
capable of acting directly upon it, and in such way as to
restore its normal action, it is clearly indispensable that the
physician be able to trace the morbific agent through all its
complex resultant phenomena up to the original perversion
of cell-force, from which the whole disorder springs; that
he be able to analyze secondary and tertiary series of
phenomena into their simple elements. And in this work
Pathology is the instrument of which he avails himself.

I cannot refrain, in conclusion, from rendering homage to

TO THERAPEUTICS. H*

that wonderful prevision of genius by which, in an age when
Pathology, as we understand it, was unknown, Samuel Hah-
nemann anticipated all that we have said, and all that the
most advanced writers of our day have taught, respecting
the scope and influence of Pathology in relation to Thera-
peutics.

The symptoms of the urinary organs in connection with
the discharge of morbid urine would at one time have been
regarded as the proper subject of treatment. But Pathology
has now taught us to trace these symptoms back to the
kidney, and beyond the kidney to the blood, and beyond the
blood to the nutrition and the destruction of all the nitro-
genized tissues. As Dr. Carpenter remarks, "When, for
example, the urine presents a particular sediment, our
inquiries are directed not so much to the kidney itself, as
to the constitutional state which causes an undue amount of
the substance in question to be carried off by the urinary
excretion, or which prevents it from being (as usual)
dissolved in the fluid." To confine the attention, therefore,
in prescribing for a given case, to the immediate organ the
perversion of whose functions is most obviously pointed out
by the prominent symptoms, is to disregard the clearest
indications of Pathology. We must analyze these obvious
symptoms and must include their remotest elements in our
indications. Nay, these remotest elements — the constitutional
disturbances, for instance, of which Carpenter speaks — are
even more important indications for treatment than the more
obvious and objective symptoms. But how can we analyze
these more obvious symptoms, and ascertain those " consti-
tutional disturbances " in which they have their origin ? In
no other way than by a study of the functions of the entire
organism — in what way and to what extent they are per-
formed in an abnormal manner. But this brings us at once
to that rule on which Hahnemann so strongly insisted, that
the entire organism of the patient should be examined in
every possible way, and that the "totality of the symp-
9

114 RELATION OF PATHOLOGY TO THERAPEUTICS.'

toms" should be made the basis of the prescription f nay,
that the constitutional, general symptoms are often more
conclusive as to the proper treatment than the more obvious
local symptom. The grand old master reached at a single
bound the same conclusions to which the labors of a half
century of able Pathologists have at length, with infinite
research, brought the medical profession.

And those of our school who insist upon Pathology as a
basis of Therapeutics, who look upon the single objective
symptom and its nearest organic origin as the subject for
treatment, and who deride the notion of prescribing upon
the totality of the symptoms, and claim to be more than
mere symptom-coverers, in that they discover and aim to
remove the cause of the disease — these colleagues are as
false in their Pathology, according to the highest Old- School
authority, as they are faithless to the doctrines and impotent
as to the successes of the founder of the Homoeopathic
School.

PRIMARY AND SECONDARY SYMPTOMS OF
DRUGS AS GUIDES IN DETERMINING THE
DOSE.

As preliminary to an intelligible discussion of this question,
we must briefly define primary and secondary symptoms
respectively, and state how, in our judgment, the discrimina-
tion between them bears upon the selection of the remedy.
And this, notwithstanding these questions have been elabo-
rately and lucidly discussed by other members of this bureau.
For it will not have escaped the reader's observation that
these terms are used with different significations by different
writers.

Symptoms may be called primary as being first in order
of occurrence, in comparison with others which, occurring at
a later period, are, with reference to time, secondary to them.

Or, symptoms may be called primary as being, in a sense,
the exciting cause of other and opposing symptoms, which
are then secondary to, as being contingent upon, the former.

Or, symptoms may be styled primary as being of greater
importance or significance than others called, therefore,
secondary.

The distinction, then, may be based on considerations of
time, of opposition in nature, or of rank. And it is impor-
tant not to confound or combine these ideas in our discussions.

Since most of our traditional notions on this subject
originated in Hahnemann's utterances upon it throughout
his writings, I will briefly repeat his views before stating my
practical conclusions.

In an essay entitled Suggestions for Ascertaining the
Curative Powers of Drugs, published 1796 (S. W., 312),

Il6 PRIMARY AND SECONDARY SYMPTOMS OF DRUGS

Hahnemann says : " Most medicines have more than one
action ; the first a direct action, which gradually changes
into the second (which I call the indirect secondary action).
The latter is generally a state exactly the opposite of the
former. In this way most vegetables act. But few medi-
cines are exceptions to this rule, e.g., metals and minerals."
He illustrates what he means by the secondary action in the
following note : " Under Opium, for example, a fearless
elevation of spirit, a sensation of strength and high courage,
an imaginative gayety, etc., are part of the direct primary
action of a moderate dose ; but after eight or twelve hours
an opposite state sets in — the indirect secondary action;
there ensue relaxation, dejection, diffidence, fear, loss of
memory, etc."

In the preface of the Fragmenta de Vir. Med. Pos., etc.,
1805, Hahnemann says: "Simple drugs produce in the
healthy body symptoms peculiar to themselves, but not all
at once, nor in one and the same series, nor all in each
experimenter; but to-day perhaps these, to-morrow those;
this first one in Caius, the third in Titus, but so that on
some other occasion Titus may experience what Caius felt
yesterday.

" A certain drug evokes some symptoms earlier and
others later, which are somewhat opposed and dissimilar to
each other ; indeed may be diametrically opposed. I call
the former primary, or of the first order, and the latter
secondary, or of the second order.

"For each individual drug has a peculiar and definite
period of action in the human body, longer or shorter, and
when this has passed, all the symptoms produced by the
drug cease together.

" Of the drugs, therefore, the effects of which pass over in
a brief space of time, the primary symptoms appear and
disappear within a few hours. After these the secondary
appear and as quickly disappear. But the exact hour in
which any symptom may be wont to show itself cannot be

AS GUIDES IN DETERMINING THE DOSE. 117

positively determined, partly because of the diverse nature
of men, partly because of different doses. * * *

" I have observed some drugs the course of whose effects
consisted in two, three or more paroxysms, comprising both
kinds of symptoms, both the primary and the secondary ;
the former, indeed, as I have stated in general terms,
appeared first and the latter second. And, sometimes, it
seems to me I have seen symptoms of a kind of third order.
******

" Under the action of moderate or small doses, the symp-
toms of the first order come chiefly to view ; less frequently
those of the second order. I have chiefly preserved the
former, as most suitable to the Medical Art and most worthy
to be known."

Finally he speaks of a class of symptoms which he de-
nominates " reliquias," generally the effects of very large
doses, and which seem to indicate or depend upon more or
less permanent alterations of tissue, including the symptoms
of the " agony" in fatal cases.

As illustrating these views, I quote remarks prefixed or
appended to the symptomatology of several of the drugs
mentioned in the Fragmenta.

In a note to Aconite, Hahnemann says : " Through the
whole course of action of this plant, its effects of the first
and second order were repeated in short paroxysms, two,
three, or four times before the whole effect ceased (eight to
sixteen hours)." And he describes these effects as follows :

" Coldness of the whole body and dry internal heat Chilli-
ness. Sense of heat first in the hands, then in the whole body,
especially in the thorax, without sensible external heat.

" Alternating paroxysms (during the third, fourth, and
fifth hours); general sense of heat, with red cheeks and
headache, worse on moving the eyeballs upward and later-
rally, then shivering of the whole body with red cheeks and
hot head ; then shivering and lachrymation with pressing
headache and red cheeks."

Il8 PRIMARY AND SECONDARY SYMPTOMS OF DRUGS

In a note to Chamomilla, Hahnemann says : " The course
of its action is run in paroxysms of several hours' duration,
comprising symptoms of each order, free spaces or remis-
sions being interjected, so, nevertheless, that in the earlier
paroxysms, the symptoms of the first order, in the later,
those of the second order predominate."

In a note to Ignatia, he says : " Ignatia is wont to display
the curriculum of its operation in several paroxysms com-
prising both orders of symptoms, and repeated at intervals
of several hours ;" and concerning the mental symptoms :
" Inconstancy, impatience, vacillation, quarrelsomeness, won-
derful mutability of disposition, now prone to laughter, now
to tears," he says : "These mental symptoms are wont to be
repeated at intervals of three or four hours."

Hahnemann's teachings on this subject in the Organon
(in which all the editions substantially agree) have been so
fully given by Dr. C. Wesselhceft in the preceding section of
the report of this bureau, that I am spared the necessity of
quoting them.

It appears that Hahnemann, in the Fragmenta and the
Organon, teaches that among the symptoms of a drug,
there appear series which are opposed to each other in
different degrees of diversity, from being " somewhat
opposed" to " diametrically opposite ;" and that, of these
series, that which occurs first in order of time, is to rank
among the primary, and that occurring subsequently among
the secondary symptoms. But he calls attention to the fact
that there are some kinds of symptoms in every proving, to
which there can be no series of an opposite nature, i. e., to
which an opposite cannot be predicated ; for, he says, " Our
organism always bestirs itself to set up in opposition to this
effect [first drug action], the OPPOSITE condition, WHERE
SUCH A CONDITION CAN EXIST."1

In his definition of primary and secondary symptoms,
therefore, Hahnemann blended the elements of time and of

1 Organon, 2d and 3d ed., § 74; 4th ed., $63.

AS GUIDES IN DETERMINING THE DOSE. 119

causation or nature (viz., that these classes were opposed in
their nature). The secondary symptoms were not an inde-
pendent series, but were secondary by virtue of their relation
of opposition in nature to a series of preceding symptoms.
And such symptoms as did not in their nature admit of an
opposite condition (as, for example, pain, cutaneous eruption,
etc.) could not be called primary, because, in the nature of
things, they could not be followed by an opposite class of
symptoms. Nor could they be called secondary, because, in
the nature of things, they could not have been preceded by
an opposite series, which could stand to them in the relation
of primary symptoms. Hahnemann, then, appears to have
recognized in the pathogeneses of drugs, symptoms which
being opposed ig nature could be arranged into series of
primary and secondary, and other symptoms not susceptible
of such arrangement.

He distinctly tell us1 that the primary or positive symp-
toms of drugs are those on which we are to base our
prescriptions.

These statements in the Organon, as quoted by Dr. Wes-
selhceft, embrace not only a description of various classes of
symptoms as observed by Hahnemann in drug-proving, but
also a theory of the nature and genesis of these various
classes. A man's observations of natural phenomena, if he
be a keen and accurate observer, as Hahnemann unquestion-
ably was, are generally correct. His theoretical explanation
of them is pretty sure to be tinctured with the philosophy of
the period in which he wrote, and is not likely to be accepted
without qualification by men of a subsequent period. And,
at the present day, few would accept Hahnemann's explana-
tion of the genesis of primary and secondary symptoms as
representing respectively a state of passivity followed by a
state of intensified activity on the part of the vital force ;
this conception of a vital force, in the sense in which Hahne-
mann used the term, being one which, itself, has been

1 Organon, 2d and 3d ed., $ 59 ; 4th ed., $ 152.

120 PRIMARY AND SECONDARY SYMPTOMS OF DRUGS

discarded by most physiologists. But the rejection of the
explanation offered by Hahnemann does not involve the
rejection of the observations to which he attached it.

Among the symptoms which he called primary (Erst
wirkungen), Hahnemann recognized the occasional occur-
rence of what he called alternate (Wechselwirkungen),
opposed, sometimes contradictory symptoms, which, never-
theless, were not secondary. He does not tell us how to
recognize these, nor how to distinguish them from the
secondary symptoms. But he does give us instances of
what he regards as secondary symptoms, as follows :l " The
gayety which follows the use of coffee is a primary symp-
tom ; the subsequent drowsiness and lassitude are secondary
symptoms. The sleep which follows Opium is a primary
and the subsequent insomnia a secondary symptom; the
purging of cathartics is a primary and the subsequent con-
stipation a secondary symptom. The constipation of Opium
is a primary and the subsequent diarrhoea a secondary symp-
tom." And consistently with Hahnemann's instructions, we
should not expect to base our prescriptions on these second-
ary symptoms.

But when we examine Hahnemann's remarks on the indi-
vidual drugs of the Materia Medica Pura, we find devia-
tions from his definitions and illustrations as given in the
Organon. In the preface to Belladonna we read:2 "There
is no known drug of long action which expresses itself in so
manifold (two and three fold) alternate conditions as Bella-
donna. Only compare symptom 15 with 16 and this with
17, 56 with 58, and this with 60, 61 and 114, and these with
113 and 152; again, 62 with 63, 64, and these with 70,
and 62 with 72, 158 with 159, and this with 160 and 165,
and this with 163 ; and 172 with 174 and 175, and these
with 176. Of none of these alternate conditions (Wechsel-
wirkungen) can it be said that they are beyond the primary
action."

1 Organon, 2d and 3d eds., $ 76; * Materia Medica Pura, 1st ed.
4th ed., $ 65.

AS GUIDES IN DETERMINING THE DOSE. 121

The symptoms thus referred to describe opposite condi-
tions as follows :

Contracted pupils and dilated pupils.

Abdominal pains compelling to bend backward and to sit
still, — to move forward and not admitting of motion.

Suppressed stool and urine and involuntary stool and
micturition, and constant tenesmus.

Sleeplessness and deep slumber.

Raging delirium and wild fear, and foolish madness, etc.

It is evidently Hahnemann's meaning, and surely experi-
ence justifies him, that Belladonna may be given (other
symptoms corresponding) when either the one or the other
(the opposite) of these conditions is present. And these
opposites belong to the class described in the Organon as
secondary, and on which we are told, we are not to base our
prescriptions.

In the introduction to Nux vomica (Materia Medica Pura,
1st ed.) Hahnemann says : " The symptoms of a single dose
of Nux vomica are wont to recur several days in succession,
at the same time of day, even at the same hour, or every
other day. Hence the usefulness of this drug in some typical
diseases when the symptoms otherwise correspond. Besides
this periodicity of the symptoms, and besides the alternation
of heat and cold, there follow also upon one another, here
and there (as is the case also with other drugs), symptoms
which differ very much from one another, and appear to be
opposed to each other, although they all belong to the primary
action of the drug. We may call these alternate actions
(Wechselwirkungen)." And among the symptoms of Nux
vomica, Hahnemann calls attention to 232 and 233 "ano-
rexia" as contrasted with 236-238, " great appetite," and
says these are alternate actions, and belong to the primary
symptoms, and are, therefore, to be used as bases of pre-
scriptions. He refers also to 369-374, " Constipation with
tenesmus," etc.; and to 357-359, "Diarrhoea with desire
and tenesmus," etc.; and says, in a note, "Diarrhoea,

122 PRIMARY AND SECONDARY SYMPTOMS OF DRUGS

constant, abundant, strictly so called, is not, according to
my observation, to be expected in the primary action
of Nux vomica; and that which here appears among the
symptoms as diarrhoea is partly very small, mostly mucous
discharges with tenesmus and pain," etc. Again, in a
note to 456, he says : " Discharge of mucus from the nose is
an alternate action with dry obstructions of the nose." There
is, clearly, a discrepancy between Hahnemann's general prop-
ositions in the Organon and his practical instructions in the
Materia Medica Pura. For we find from the latter that Bel-
ladonna, for instance, may be given for the primary symptom,
"sopor," as well as for what in the Organon is called the
secondary, but in the Materia Medica Pura the alternate symp-
tom " sleeplessness," and that Nux vomica may be given for
the primary symptom " constipation," and likewise for what
is called in the Organon the secondary, but in the Materia
Medica Pura the alternate symptom " diarrhoea."

The very terms primary and secondary, as thus illustrated,
seem to imply a succession of symptoms, more or less opposed
in character, and all of them differing from the equilibri-
um of function which we recognize as health. The instances
given, and, indeed, the only possible instances, relate to func-
tions of which a "more" or "less," or an "opposite," may
be predicated ; as, for example, temperature, sleep, certain
mental conditions, and the secretions and excretions gener-
ally. Thus we may have" an unnaturally prolonged sleep or
wakefulness, gayety, or despondency, and a plus or minus of
sweat, alvine discharge, urine, etc., etc. But how could we
have an opposite condition to any specified pain or sub-
jective sensation, to parenchymatous deposit, to cutaneous
eruption, etc., etc. ? The absence of these phenomena would
be pro tanto a state of health ; it would not be an opposed
morbid condition or sensation.

The possibility, then, of classifying symptoms into primary
and secondary on the basis of the relative nature of the symp-
toms, is not co- extensive with symptomatology ; it is partial,

AS GUIDES IN DETERMINING THE DOSE. 123

confined to a moderate number of conceivable morbid phe-
nomena.

Shall we, then, in the second place, base the distinction on
the element of time, and call the symptoms which first occur
primary, and those which come later, secondary? Where
then shall we draw the line ? how many hours or days shall
we allow for the development of primary symptoms? In
view of the immense differences in the rapidity with which
the curriculum of action of different drugs is run, it is obvious
that a special rule must be established for each drug. Nor is
this the only difficulty. The results of different doses on the
same provers, and of different doses or even of the same dose
on different provers, are so various that, ist, as Hahnemann
intimates in the preface to the Fragmenta, the symptom
which appears in one prover to-day will not appear for several
days in another prover ; and, 2d, a very small dose may pro-
duce only one series of symptoms ; a larger dose two series
of opposed symptoms ; a still larger dose two series differ-
ently opposed ; and a very large dose again only one series.
This point has been so well illustrated by Prof. Allen, with
whose views I am glad to express my entire concurrence,
that I need not dwell upon it, but may content myself with
two illustrations from our Materia Medica.

On looking over the register of symptoms of Argentum
nitricum,1 we find reported as occurring early in the prov-
ing, irritation of the bladder and urethra and increased fre-
quency and quantity of urine, and as occurring later in the
proving, diminution in frequency of micturition and in the
quantity of urine. Surely one might pronounce the former
to be primary and the latter secondary symptoms. But on
examining the provers' day-books we find that the majority of
the provers (being those who took large doses) report the
former and not the latter symptoms. It was the prover who
took the 30th who reported diminished urine, and he did not
report any increase at any time.

1 Oest. Zeit. I.

124 PRIMARY AND SECONDARY SYMPTOMS OF DRUGS

These symptoms, therefore, which appear in the register
to be opposed, and properly distinguishable as primary and
secondary, did not bear to each other any relation of appo-
sition or correlation, as they might have done had they oc-
curred in the same individual. They are different, unrelated,
independent effects of different doses in different individuals.
And let me suggest, in passing, that the beautiful pictures
of primary and secondary effects of drugs which we find in
works of Old -School writers, and which have been made the
basis of " laws of the dose " by writers of our own school,
are composite pictures made up from a variety of observa-
tions on patients and from cases of poisoning, and bear no
more resemblance to a pathogenesis on a single individual,
than the composition of an artist which has the mountains of
Ecuador covered with the forests of Oregon and decked with
the flowers of Java presents to a faithful landscape from nature.

Most of the provers of Tellurium taking the 3d trit. had,
on the first and subsequent days, symptoms of the general
sensibility, of sweat, of the skin, of the bladder, etc., etc.
But one prover who took the 4th trit. had no symptoms at
all until the fourteenth or fifteenth day, when cutaneous
symptoms affecting the ear appeared and were very persist-
ent and troublesome. Were these symptoms secondary
because they came later than other symptoms in other prov-
ers ? And secondary to what ? How can John's lumbago
be secondary to James's toothache ? But during the second
month this same prover, his ear symptoms having vanished,
had symptoms referred to the dorsal spine. Were these
secondary to the ear symptoms because they came later?
Certainly as regards time they were secondary, because later.
But being in nature wholly unrelated, neither opposite nor
similar, they cannot be called secondary as regards nature
nor as regards rank or value. Both have been repeatedly
verified in practice.

Again, we are told l that coldness, a condition correspond-
1 "The Dose," by E. M. Hale, M.D., N. A. J., ix. 265.

AS GUIDES IN DETERMINING THE DOSE. 125

ing to the chilly stage of fevers, is the primary effect of
Aconite, and that a state corresponding to the hot stage of
fevers is the secondary effect of that drug. Let us hear
Hahnemann. In the introduction to Aconite1 he says:
"Aconite is one of a few drugs whose primary action
consists in several alternating conditions of chill or coldness
and heat." And now let us study the day-books of the
Austrian provers of Aconite.

Rothausl took tincture of Aconite in doses regularly
increasing from six drops daily to fifteen drops daily for
nine days, when, feeling powerful effects, he ceased taking it
and noted his symptoms.

From the second to the eighth day inclusive, he had the
following constantly recurring symptoms: restlessness at
night ; bad dreams ; unnatural heat of body ; rawness and
increased secretion in the larynx; cough; vertigo; head-
ache. On the ninth day, after midnight, severe chill in
paroxysms of shivering, starting from the praecordia,
lasting two hours, followed by burning, dry heat, with
frequent, feverish pulse ; and this followed by moderate
sweat.

For the next six days he had various troublesome symp-
toms affecting the chest and limbs, and on the sixteenth day
of the proving he had again, at night, a febrile paroxysm
consisting of chill, heat and sweat, the first less severe, the
last more abundant than on the ninth day.

On the seventeenth day, at night, a similar febrile par-
oxysm. Then for seven days symptoms of increasing
severity in the head and chest, ending with haemoptysis on
the nineteenth day, and finally, on the twenty-fourth day, a
very severe and well marked and defined neuralgic head and
face ache.

How can the ingenuity of the most ambitious lawgiver
find a pretext for dividing the symptoms (especially the
febrile symptoms) of this excellent proving into primary and

1 Mat. Med. Pura, 1st ed.

126 PRIMARY AND SECONDARY SYMPTOMS OF DRUGS

secondary ? A febrile paroxysm occurred on the ninth, the
sixteenth and the seventeenth days ; before it and after it
were well-marked symptoms of the chest and extremities.
Which shall be primary and which secondary if date of
occurrence determine the question ? Which, if nature or if
rank determine it ?

Certainly, if lateness of occurrence stamp a symptom as
secondary, then the neuralgic head and face ache, the very
last symptom reported by Rothausl, must be classed as
secondary. Not so fast, however ! In the proving of
Aconite by Zlatarovich with the second decimal, which he
took in increasing and very large doses for seven days with-
out effect, the very first symptom was a violent neuralgic
head and face ache, almost identical with that described by
Rothausl on his twenty-fourth day.

It appears, then, that Rothausl's last symptom was Zla-
tarovich's first. If the time of occurrence determines the
class, we must rank Rothausl's headache among the second-
ary, and Zlatarovich's identical headache among the primary,
and thus we have the same symptom in each class, which is
a reductio ad absurdum.

It will be noticed that these identical symptoms, produced
at different times in different provers of Aconite, were pro-
duced by different doses. The opposite symptoms of Argen-
tum nitricum in different provers resulted from different doses.

Prof. T. F. Allen has shown how greatly the results of
different doses vary. Dr. Sharp shows that, in the same
prover, Aconite has four different kinds of action on the
heart, as shown by the radial pulse, depending 'on the dose,
and that in only two of these is one series of symptoms
followed by an opposite series.

Hahnemann, who, it must be remembered, had an
immense experience as a drug-prover, and who brought to
the work a devotion and powers of observation and analysis
rarely equaled, was well aware of the fact that the appear-
ance of apparently contradictory symptoms in a proving is

AS GUIDES IN DETERMINING THE DOSE. 127

greatly dependent on the dose, as appears from § 66 of the
Organon (4th ed.), in which, for this reason, he recommends
the use of small doses in proving.

Passing for a moment to the second division of the subject,
the value of primary and secondary symptoms as guides in
selecting the remedy, there are many drugs which, having
certain constant characteristic symptoms, have also series
of alternating symptoms relating chiefly to the secretions.
Among them we may mention Veratrum album, which has
(122-124) "Thin stool passing unnoticed with flatus. Fre-
quent liquid stools. Liquid stools unnoticed with flatus.
Diarrhoea of acrid faeces, etc." And also (127-139), " Con-
stipation from thickness and hardness of faeces. A desire
and compulsion to stool in the upper abdomen, and yet no
stool, or a very difficult one, as if from inactivity of the rectum,
and as if the rectum took no part in the peristaltic motion
of the upper intestines." Also Hahnemann quotes from
Greding, " Diarrhoea with copious sweat" and "long-con-
tinued constipation."

The efficacy of Veratrum in the treatment of diarrhoea of
an appropriate character is universally conceded in our
school. And in my own practice, Veratrum has for many
years been a frequently used and highly valued remedy for
constipation in persons of all ages, but especially in infants
and young children, in whom digestion appearing to be well
performed, the evacuation of faeces appears nevertheless to
be impossible because of the inertia of the rectum — a fact
demonstrated by the circumstance that a healthy stool can
be procured almost at will by irritation of the rectum, as by
the common practice of introducing into the anus a piece of
soap or an oiled paper, or a rubber bougie. We have here
the apparent anomaly of the same remedy equally efficacious
in diarrhoea and constipation.

Nux vomica furnishes a similar example. Its efficacy in
certain forms of constipation as well as of dysenteric diar-
rhoea is well known.

128 PRIMARY AND SECONDARY SYMPTOMS OF DRUGS

Let us now, for a moment, examine a little more closely
the nature of the functions affecting which the alternate
series of opposed conditions, which have been called primary
and secondary, are mostly observed in drug-proving, ist.
They are such as in the nature of things are periodic, and
not continuous ; characterized by periods of repose and
activity, and susceptible of quantitative and qualitative
correlative interchange among themselves. Thus sleep is
periodic, and capable of being supplemented to a degree by
other forms of repose to the nervous system. The intestinal
canal, the genito- urinary apparatus, the skin, in so far as
secretion and excretion are concerned, have periods of
activity and repose ; and the inactivity of one may be
made up by increased activity of another. And thus
the function of any one of these apparatus may vary
widely at different times without a condition of opposition
being established. For this reason, then, the mere quantity
of one of the excretions, or the degree in which any one of
these periodic and convertible functions is performed, does
not rank first among the indications on which the selection
of a drug is to be based. If we now analyze the prescrip-
tions of Veratrum and Nux vomica referred to, we shall
find certain constant phenomena characterizing both the
constipation and the diarrhoea, and which would determine
the prescription almost without reference to the excretion.

The Veratrum diarrhoea is uncontrolled and almost unno-
ticed by the patient, liquid faeces escaping with the flatus.
Here we have a paretic and anaesthetic state of the rectum
and sphincter. The Veratrum constipation exists solely
because the rectum does not perform its expulsive function,
and is not, as normally it should be, irritated thereto by the
presence of faeces. Here likewise is a paretic and anaesthetic
condition. But Veratrum is not fully indicated in either case
without the characteristic general symptoms : general depres-
sion of vitality ; predominant coldness of the body ; pallor
and cold sweat of the forehead, or of the whole body, on

AS GUIDES IN DETERMINING THE DOSE. 129

slight emotion or exertion, as, for example, on having a
diarrhceic stool, or making the ineffectual effort to have a
stool, if constipated.

Both the constipation and the diarrhoea of Nux vomica
are characterized by increased but uncoordinated activity
of the intestine, evinced by tormina and tenesmus, and fre-
quent insufficient stools ; so that the condition of intestinal
action is the same, whether there be, as in one case a minus,
and as in the other, a plus of excretion ; and, indeed, in the
Nux vomica patient these conditions often alternate. These
remarks and instances will sufficiently illustrate my conclu-
sions, viz. :

That the appearance or non-appearance of opposed series
among the symptoms of a drug depends chiefly, if not alto-
gether, upon the dose in which the drug was proved ; and
that the question of the constant and necessary appearance
of such series cannot be determined until experiments with a
uniform and the least possible dose shall have been made by
many provers with the same drug, and in the case of many
drugs, and therefore that, ist, Although in our Materia
Medica, as it now exists, pathogeneses do present certain
series of symptoms more or less opposed, nevertheless
(excluding the symptoms of the agony which are not available
in practice), inasmuch as these series of symptoms occur in
different orders in different provers according to dose or
idiosyncrasy, no sound practical distinction can be drawn
between them, based on assumed difference of nature, by
virtue of which they can be designated respectively as
primary and secondary.

2d: That symptoms, apparently opposed (not including
those of the agony), occurring in a drug-proving are equally
available as guides in the selection of remedies.

Coming now to the special subject of this paper, I justify
the length at which the preliminary subjects have been dis-
cussed by the suggestion that, if I have shown that there is
no basis for a division of drug-symptoms into primary and
10

130 PRIMARY AND SECONDARY SYMPTOMS OF DRUGS

secondary, I have thereby shown the impossibility of a law
of dose based on such a division. Or, if admitting that in
pathogeneses there do appear groups of symptoms appar-
ently opposed, I have shown that these refer only to certain
functions, and by no means embrace, or could be made to
include, the symptoms of the entire organism. I have
thereby shown that an alleged law of dose based on the
existence of these groups, must necessarily be partial, and
therefore devoid of that generality of application to the entire
pathogenesis which alone would justify the appellation
"LAW;" and I claim to have shown these things.

In 1844, Dr. C. Hering in a letter to the German Central
Verein in session at Magdeburgh (N. Archiv., 21, 3, 166)
rejects Hahnemann's explanation of primary and secondary
symptoms. He admits that there are in every proving
primary and secondary symptoms, in the sense that some
symptoms appear earlier and others later in the course of the
proving, but affirms that although these may appear to be
opposed to each other, they are all to be regarded as drug-
symptoms, and as such are to be made the basis of prescrip-
tions. He gives instances of such prescriptions in the cases
of Conium, Opium, and Mercury. Indeed, he says that the
longer-lasting, more permanent and more opposed to the
earlier these later symptoms are, the more useful are they in
practice. He says further, that "the course of the drug-
disease (in proving) must correspond with that of the disease
to be treated." Hering further states that "all symptoms
which arise in provings of the higher potencies are similar to
the later effects of the lower or so-called stronger doses, and
are not like ti\e first effects of strong doses." He adds that
the great characteristics of remedies [as we have seen in the
cases of Nux vomica, Veratrum, etc.] accompany both the
earlier and later symptoms, e. g.y the burning of Arsenic.

From these considerations, Hering deduces the following
law of dose :

" Having chosen the remedy according to the symptoms
of a case from the complete correspondence of the charac-

AS GUIDES IN DETERMINING THE DOSE. 131

teristics in disease and drug, we have only to consider
whether the symptoms of the case generally have more
resemblance to the earlier (primary) symptoms of the drug,
and then we give the lower potencies ; or more resemblance
to the later (secondary) effects, that is, to the symptoms
produced by the higher-potency provings, and then we give
the higher."

It may be said that this is simply saying : Prescribe doses
analogous to those which produced, in the proving, the
symptoms presented by the case under treatment. But it
amounts to a great deal more, for by showing that the
symptoms produced in provings by small doses correspond
with the later effects of large doses, it enables us to infer the
effects of small doses in cases where provings have been
conducted with large doses only.

In 1860, Dr. E. M. Hale published an elaborate article in
the N. A. y. of H., vol. ix., on "The Dose," in which he
expresses the belief that he has discovered the long-desired
law by which "the proper dose for each case may be
selected with as much certainty as the proper remedy," as
follows :

" In any case of disease we must select a remedy whose
primary and secondary symptoms correspond with those of
the malady to be treated," and

" If the primary symptoms of a disease are present, and
we are combating them with a remedy whose primary
symptoms correspond, we must make the dose the smallest
compatible with reason; and if we are treating the
secondary symptoms of a malady with a remedy whose
secondary symptoms correspond, we must use as large a
dose as we can with safety."

These propositions rest on the assumption that all drugs
produce, and all diseases present, two series of symptoms,
primary and secondary, and that in one or other of these
classes is embraced every symptom of drug or disease. I
have expressed my dissent from this view, and given reasons
for thinking that a distinction between primary and second-

132 PRIMARY AND SECONDARY SYMPTOMS OF DRUGS

ary symptoms, if ever justifiable, is, at most, applicable to
but a portion of the symptoms of each drug. It cannot, if I
am correct, be made the basis of a general law.

Dr. Hale illustrates his meaning by referring to Aconite,
the primary symptoms of which, he says, " correspond
perfectly with the chilly stage of all fevers" while the
secondary symptoms of Aconite " correspond with the hot
stage of fever." He therefore recommends a small dose of a
dilution of Aconite during the chilly stage, and large doses
of the tincture or ist decimal during the hot stage, and
relates results of such treatment, which seem to have
satisfied him, but would hardly have satisfied me.

Again, he tells us that the primary symptoms of a group
of remedies, of which Cinchona, Ferrum, Conium, Nux
vomica, and Ignatia are members, are such as to denote
that these drugs first " increase the tone and strength of the
muscular or nervous system, impart vitality and vigor to the
functions of the vital organs ; " and that their secondary effects
are to cause "a peculiar atony, a condition of deficient vitality,
and a cachexia of a more or less obstinate character." And,
stating further, that an outbreak of intermittent fever is
always preceded by " an era of good feeling," a condition
of exalted muscular and nervous tone and vigor, he regards
this as the primary stage of that disease, to be treated, when
recognized, therefore, by small doses of Cinchona. The
outbreak of paroxysmal fever is regarded by Hale as
belonging to the secondary series of symptoms, and therefore
to be treated by as large doses of Cinchona as may safely
be given.

In a paper presented to this Institute in 1874, Dr. Hale
reiterates these views in substance and re-affirms this alleged
" law of dose." He illustrates the two alleged series of
symptoms in disease, called primary and secondary, by the
instance of inflammation of the urinary passages, in which
congestion and arrested secretion with fever and pain appear
first, and are succeeded by profuse secretion or suppuration,

AS GUIDES IN DETERMINING THE DOSE. 133

prostration and cessation of pain, etc. And he affirms that
the group of cognate drugs, of which Cantharis may be the
representative, presents similar series of primary and
secondary symptoms.

Considering, first of all, the last illustration, it is true that
the process of inflammation consists of several successive
steps, "accelerated and increased circulation, followed *by
retarded and diminished circulation, exudation of liquor
sanguinis, emigration of leucocytes and stasis," and it is true
that the earlier steps are prior to the later, but they are
equally successive and necessary steps in a uniform and
definite process, and nothing justifies the drawing a line
anywhere in the process, and affirming that all that lies
behind the line belongs to a different and opposite series to
that which lies in front of it. Nor can I recognize in drug-
provings any such opposed series. Neither Hahnemann's
provings of Cinchona and Ferrum, nor Hahnemann's
and Harley's proving of Conium, nor Hahnemann's provings
of Nux vomica and Ignatia seem to me to support the alle-
gations of Dr. Hale.

Alluding now to Hale's remarks upon Aconite, I refer to
my quotations of Hahnemann, Rothausl, Zlatarovich and
Sharp, which show that Aconite does not produce a distinct
chilly stage first, followed by continued heat, but, as Hahne-
mann says, " alternating conditions made up of shiver-
ing or cold and heat, and recurring frequently or at longer
intervals." So that while I will not deny that Dr. Hale pre-
scribed as he says he did, and with the results which he
describes, I do affirm that the pathogenesis of Aconite affords
no ground for the theory on which he says he acted, or
which he deduced from his action.

And, if I may deviate for an instant from the subject
strictly under discussion, these statements about Aconite and
its application suggest the fact that many prescriptions pro-
fessedly homoeopathic are really made ex usu in morbis, and
are not based on a strict individualization of the case, and a

134 PRIMARY AND SECONDARY SYMPTOMS OF DRUGS

selection of the drug whose symptoms correspond to it.
Aconite, having early acquired a reputation as a remedy in
febrile conditions, is too often given in routine fashion, " in
all fevers " (to use Dr Rale's phrase), and therefore in many
cases in which the symptoms do not at all indicate it. For,
as even Hahnemann warned us, " it is not in every case
presenting febrile symptoms that Aconite is homceopathically
indicated ; " and therefore it cannot truly be said to corre-
spond to the "chilly" or any other "stage of all fevers."
Given when the patient is quiet, lies still, is tranquil in mind
and hopeful or patient, it will not remove the symptoms as a
homceopathically selected remedy would do. Nor is it
indicated by a similarity of symptoms in any save a small
minority, if in any, of the intermittent, remittent or con-
tinued fevers which so often prevail in different parts of our
country, nor in the febrile condition which persists when
parenchymatous inflammation is established in any important
organ.

It was my purpose to follow and analyze the statements
and arguments of this writer on this important subject, but
I find that I cannot do so. His premises consist of citations
from allopathic writers, which seem to me to be statements
based on observations of the action of drugs in large doses
on the sick, and on theoretical deductions from these obser-
vations, and which certainly bear little or no resemblance to
the pathogeneses of the Materia Medica Pura, on which I
have been wont to rely for a knowledge of drug-effects, but
to which my colleague rarely refers. His allusions to treat-
ment seem to me to be of a very generic character, based
on assumptions of the pathological nature of the disease in
question, and consisting of an application of drugs according
to a vague and general resemblance of assumed pathological
conditions. In all of this I fail to see any allusion to, or any
place for, the strict individualization of cases, which is the
very essence of sound homoeopathic treatment. In studying
these papers, in fact, I hardly realize that I am perusing the

AS GUIDES IN DETERMINING THE DOSE. 135

works of a practical homoeopathist, according to my concep-
tion of Hahnemann's idea of homoeopathic practice, and I
perceive, to my dismay, that I do not stand on common
ground with the author to the extent necessary to make
possible a further discussion of his treatment of the question
at issue.

I must content myself, therefore, with the simple state-
ment that my own observation and experience do not enable
me to corroborate Dr. Rale's statement of the " Law of the
Dose," based on the distinction of primary and secondary
symptoms. Where Aconite has been truly indicated by the
symptoms of the case, I have seen prompt relief follow the
administration of a high potency, given when the patient
was in the hot stage, and likewise when in the chilly stage ;
and in both the effect has appeared in a much shorter time
than Dr. Hale's remarks would lead one to anticipate.

In the treatment both of constipation and of dysenteric
diarrhoea by Nux vomica in cases in which the characteristics
of Nux vomica were present, the higher potencies have been
equally efficient, leaving nothing to be desired, and the same
may be said of Veratrum album in diarrhoea and in consti-
pation, when the characteristics of that drug were present.

It may be, and I am inclined to believe, that the law pro-
posed by Dr. Hering may be found to represent the facts ;
but for its demonstration and its general application in
practice, we need a much more complete Materia Medica
than has yet been furnished us.

In conclusion of this branch of the subject, I think that no
law for the determination of the dose can be deduced from
the relation of opposition or contrariety on the basis of
which symptoms have been divided into series of primary
and secondary.

THE DOSE IN DRUG-PROVING.

The symptoms which drugs produce upon the healthy
organism vary according to the dose. They may be :

1. CHEMICAL — depending on the chemical affinity which
exists between the drug and the tissues of the body, and
independent of vitality ; or,

2. MECHANICAL (or revolutionary), consisting chiefly in
violent efforts on the part of the organism to eject from its
cavities the offending substance ; or,

3. DYNAMIC, contingent upon vitality and resulting from
the relations of the peculiar properties of the drug to the
susceptibilities of the living, healthy organism. These
dynamic effects may be :

A. Generic — such as are common to all the members of
a certain class of drugs and which serve to distinguish this
class from others, but do not furnish means of distinguishing
between different individuals of the same class. For
example, Arsenic in certain doses produces vomiting and
diarrhoea, with cold sweat and cramps of the extremities.
These are dynamic effects of Arsenic but they are generic,
since other members of the class to which Arsenic belongs,
viz. : Cuprum, Veratrum, Tartar emetic, etc., in certain
doses, produce identical symptoms ; and were these reme-
dies proved in such doses alone, it would be impossible to
distinguish the pathogenesis of one of them from that of any
of the others.

B. Specific — such as results from the dynamic action of
the drug and are peculiar to it. They serve to distinguish
a given drug from all others. For example, Arsenic, taken

THE DOSE IN DRUG-PROVING. 137

in different doses from those which produce the generic
dynamic effects, produces vomiting and diarrhoea or ten-
dencies thereto ; but these phenomena are accompanied and
characterized by conditions quite different from those which
accompany the similar symptoms of Cuprum, Veratrum, etc.,
and are thus distinguishable from the effects of these drugs.

The Specific-dynamic symptoms may be again sub-divided
into Central and Peripheral.

The Central symptoms appear speedily after the drug is
taken, are generally the result of comparatively large doses
and, in the case of many drugs, are confined to the aliment-
ary canal and to the organs immediately connected with it

The Peripheral symptoms appear more tardily, are gen-
erally the result of comparatively small doses, taken repeat-
edly or allowed to act without interruption for a long period,
and appear in the bones, skin, glands, etc., and in the
coordinated phenomena of life. They are often the mani-
festations of a dyscrasia or cachexy. Doses which produce
central symptoms do not generally produce the peripheral
(or at least not until after a long period has elapsed) and
vice versa. For example, Mercury, in certain doses, pro-
duces well-marked and characteristic action upon the aliment-
ary canal and its appendages. In smaller doses it produces,
instead of these effects, a series of symptoms in the skin,
bones, glands, etc. — the Mercurial cachexy. The former
are what we mean by central specific dynamic symptoms.
The latter are the peripheral symptoms. Arsenic, again,
furnishes, according to the dose, examples of all of the above
varieties of symptoms. In certain doses it develops
chemical and revolutionary effects. In smaller doses, as we
have seen, generic dynamic ; in still smaller doses, specific
dynamic symptoms of the central variety. In yet smaller
doses, it produces peripheral specific symptoms, which are
those of the so-called "gradual poisoning;" as for instance
in poisoning by exhalations of Arsenic from green wall-
paper, in which the phenomena of vomiting and diarrhoea

138 THE DOSE IN DRUG-PROVING.

or the central specific symptoms do not appear, but instead
of these we have evidence of a distinct cachexy, in the skin
and glandular symptoms, marasmus, etc.

Such are the varieties of symptoms produced by corre-
sponding varieties in the dose. It is hardly necessary to say
that they are not always to be distinguished with precision ;
but the facility with which we are able to recognize them is
in proportion to the completeness of our proving.

It unquestionably behooves the homoeopathic physician to
have an exhaustive knowledge of the whole sphere of action
of his drugs ; but, as a prescriber, he 'must be familiar with
the varieties and subvarieties of dynamic effects which we
have specified. This knowledge is to be attained in the first
place only by drug-proving. The proving of drugs must
then be so conducted as to produce in the greatest possible
completeness and clearness, each of these varieties and sub-
varieties. This, as has been shown, is to be accomplished by
a skillful selection and succession of doses. It is not so simple
and easy a matter as it might at first view appear to be : for,

First : The doses by which the corresponding varieties of
symptoms are produced, differ widely in different drugs. For
example, a half grain of crude Nitrate of silver or of Sul-
phuric acid produces chemical symptoms, while a half grain
of Lycopodium or of Silicea produces probably no symptom
at all. A grain of Arsenic produces generic dynamic symp-
toms, while ten grains of Natrum muriaticum may be inert.
Forty drops of Bryonia tincture may excite a fair show of
specific dynamic symptoms, while forty drops of tincture of
Opium will produce generic dynamic symptoms or full
narcotism.

Secondly : The susceptibility of different provers to the
same drug is very different, and the degree of susceptibility
which each prover possesses is to be learned only by exper-
iment. For example, one prover will take five hundred drops
of Thuja without any effect ; another, taking twenty drops,
experiences violent specific symptoms.

THE DOSE IN DRUG-PROVING. 139

Thirdly : The susceptibility of provers to different prepa-
rations of the same drug is very various and apparently capri-
cious. One records characteristic specific symptoms from
large doses of the crude drug, and is not affected by smaller
doses ; another is acted on by dilutions and not by any quan-
tity of the crude substance.

The relative power of a drug and susceptibility of the
prover being altogether unknown until ascertained by direct
experiment, the proving of a new drug is therefore a matter
of pure experiment in every particular, and it might at first
view be supposed to be a matter of indifference in what man-
ner or with what doses the experiment is begun ; which vari-
ety or subvariety of symptoms is first developed, whether
we take heroic doses and develop chemical symptoms or
small doses and produce peripheral dynamic symptoms ; since
in either case we should be able by subsequent experiments
based on the first, to develop the complementary symptoms
and thus complete our proving. Experience teaches, however,
that this supposition is not sound, and for the following rea*
sons : Drugs vary not more in the intensity than in the per-
manence of their action upon the organism. Some drugs
appear speedily to exhaust, sometimes by a single large dose,
the susceptibility of the prover, so that no subsequent doses,
whether large or small, produce any effect. Of others again,
a single large dose develops some one generic or central spe-
cific symptom, and along with it induces such an exalted and
distorted susceptibility that every subsequent dose, whether
large or small, evokes straightway that one symptom or
series of symptoms and none other. Thus the proving is in
either case partial and incomplete— we fail to get those symp-
toms which are the most valuable of all to us, as being those
which clearly characterize the drug and enable us to distin-
guish it from all other drugs, viz. :— the/m>//Wand central
specific dynamic symptoms. To illustrate this point,— it is
well known that Mercury given in such doses as to produce cen-
tral specific symptoms, induces often so great a susceptibility

140 THE DOSE IN DRUG-PROVING.

of the organism to the action of this drug that subsequent
doses, even of tolerably high dilutions, provoke straight-
way a series of central symptoms. The same is true of Ar-
senic. We have seen a case in which, generic and specific
symptoms having once been produced by massive doses of
Tartar emetic, the organism remained so sensitive to the
action of this substance, that a few globules of the thirtieth
dilution would at any time produce vomiting and diarrhoea,
with cold sweat and prostration. It may be said that these
are cases of very unusually great susceptibility to the action
of the respective drugs. This is true, but it is precisely such
cases of great susceptibility that are of exceeding value to
us, for in them, by judicious experimentation, we could get
most valuable peripheral symptoms, unalloyed by generic or
by revolutionary effects.

There is no reason to believe, on the other hand, that
small doses, so administered as to produce the peripheral
specific symptoms, modify the susceptibility of the prover
in any such way as to prevent his obtaining by subsequent
larger doses the central specific, the generic dynamic, or
even the chemical and mechanical effects. It follows from
what has been said, that to obtain an exhaustive proving of
a drug, we should begin with small doses, gradually increas-
ing the quantity until unequivocal symptoms appear. We
shall thus, if we continue our experiments a suitable length
of time^ obtain peripheral symptoms ; and these small doses
will not have so influenced the system as to prevent our
obtaining by subsequent larger doses the other varieties of
effects. Inasmuch as, in the nature of things, the peripheral
symptoms, representing, as they do, a cachexy, cannot be
speedily produced, a considerable space of time should be
devoted to our first experiments with small doses. Finally,
after an interval of non-medication, larger doses should be
taken until we have exhausted the whole dynamic action of
the drug, and even obtained a fair picture of its chemical
and revolutionary action, although this may in a measure be
gained from records of poisonings.

THE DOSE IN DRUG-PROVING. 141

But, in this relation, what are the "small doses" with
which we are to begin our proving ? The term is compara-
tive. Are they drop doses of the tinctures, or are they
high dilutions ? They are such doses as have, in the proving
of some previous drug, shown themselves capable of produc-
ing unequivocal symptoms. We must search the records of
provings, therefore, for our standard initial dose. What
this is at present we shall soon see: as our experience
increases, this standard may from time to time be altered.

It is evident that the method of conducting a proving is a
matter of great importance, and should not be left to caprice
or accident. The completeness of our Materia Medica, and
consequently our ability to cure disease, depend upon our
selection of a happy method. This important subject has
received the attention of the American Institute of Homoeop-
athy, to which the Central Bureau of Materia Medica
has presented a report on Drug- Provings. The majority of
the Bureau repeat Hahnemann's directions for proving as
contained in the Organon ; and as regards the dose, they
recommend " the prover who makes use of potencies " to
make a trial of the high potencies first, and afterward, if
necessary, to take the lower dilutions and triturations, or
the crude substance or tincture, if satisfactory results are
not obtained with the attenuations.

This recommendation accords with our deductions and
corresponds with the spirit of Hahnemann's directions.
Hahnemann's instructions differed at different periods of his
life. One essential idea, however, pervades them all — a
small dose is to be taken at first, and the dose is to be
increased until unequivocal symptoms manifest themselves.
In the last edition of the Organon he adds, as the result of
his extensive observation, that "The most recent experience
has taught that medicinal substances, when taken in the crude
state, do not for a long time display the full extent of their
virtues, as they do when taken in higher developments.
Thus any one, even of those medicines whose virtues are

142 THE DOSE IN DRUG-PROVING.

considered weakest, is now found to be most advantageously
studied if four to six globules of the thirtieth dilution be
taken every morning for several days." In this statement,
Hahnemann does not contradict the spirit of his former
directions, for he adds, "Should the effects of such a dose be
weak, it may be daily increased." He further ado's, "The
more moderate the dose, the more are the primitive effects
developed, which are the most important to be known."
We see nothing in Hahnemann's writings which shows that
he ever thought of restricting the dose in proving to the
thirtieth dilution, as some have stated; he simply assures
us that unless provings with so high a dilution were made,
the prover would fail to get all of the symptoms which the
drug is capable of evolving.

In the Minority report of the Central Bureau,1 Dr.
Hempel differs from the majority in so far as the proving
with dilutions is concerned. He would propose that " all
such provings should be rejected rather than encouraged ;"
and he " is convinced in his deepest soul, that it is owing to
the incorporation of such provings in our Materia Medica
that all the confusion and uncertainties with which it is now
tainted, are presenting immense and almost insufferable
difficulties to the inexperienced student of our science."
We trust that it is unnecessary to say that in commenting
freely, as we shall do, on Dr. Hempel's report, we are
actuated by no unworthy feeling toward our colleague,
whose unceasing and very arduous labors in the cause of
Homoeopathy command our highest respect, and deserve
the grateful recognition of every English and American
Homoeopath. We speak of him only because, by his report,
lie stands forth as the representative of certain opinions,
which seem to us unsound and unsupported by the evidence
on which they are supposed to rest.

His report may be reduced to the following propositions :
i. Drugs should not be proved with attenuated sub-
stances.

1 Am. Horn, Re-view, vol. i., p. 575.

THE DOSE IN DRUG-PROVING.

143

2. The middle and higher potencies do not produce
reliable symptoms, unless the system has been previously
saturated with massive doses of the original drug. Corol-
lary : the saturation of the system by massive doses of a
drug renders it susceptible to the action of the middle and
higher potencies.

3. In exceptional cases a peculiar idiosyncrasy may
enable the organism to develop symptoms from the higher
potencies ; but " it is unreliable to commence the proving
with these potencies." The sequence of this conclusion is
not very clear. We suppose Dr. Hempel to mean that
symptoms developed, where an idiosyncratic susceptibility
to drug-action exists, are not so reliable as those developed
where there is no idiosyncrasy.

It is much to Dr. Hempel's credit that he has not left
these propositions to stand in his report as bare unsupported
assertions. Recognizing the experimental nature of the
question, he has referred for corroboration of his views to
the experience of those who have made our provings, and
has called to the witness-stand the great body of our drug-
provers in the following terms : "All the splendid provings
of the original provers of the Materia Medica, and of the
Austrian Provers' Union, of the Provers' Society of Prague,
and of any other Provers' Society, whose provings are
accepted with universal acclaim and confidence, have been
instituted with massive doses of the strongest preparations of
the drug ; the higher and middle potencies were invariably
tried after the former." If this statement were literally
correct, if, indeed, none of these provers ever began their
provings with potencies, then they are incompetent witnesses
for Dr. Hempel's purpose — they are incapable of testifying
as to the action of dilutions when not preceded by massive
doses, since, Dr. Hempel says, they never tried them. If
this were so, then the second proposition of Dr. Hempel's
report would rest unsupported save by the one witness
whom, we neglected to say, Dr. Hempel cites, first of all, in

144 THE DOSE IN DRUG-PROVING.

these words : " Dr. Hempel has never been able to elicit
any reliable symptoms by means of the middle or higher
potencies, unless the organism had been previously saturated
with massive doses of the original drug." On this one
point of negative evidence, then, this important proposition
stands — "Dr. Hempel has never been able." But perhaps
others have been able. Perhaps the very witnesses whom
Dr. Hempel has called have been more successful than he.
We will cross-examine them.

First, then, we call upon the " Original Provers of the
Materia Medico," by which we suppose Dr. Hempel means
Hahnemann's " Materia Medica Pura" and " Chronische
Krankheiten." Of these provers, the " Great Original" was
Hahnemann himself. His pupils and friends adhered
strictly to his directions and method. What Hahnemann's
opinion was as to the propriety of commencing a proving
with small doses we have already seen. After thirty-five
years' experience in drug-proving, he sums up his observa-
tions in the advice to begin with the thirtieth dilution.
But what was his practice ? What doses did he actually
take ? It has been generally supposed that he did not as a
rule record the doses with which his provings were made.
Dr. Hempel, however, seems to have had access to some
sources of knowledge on the subject that are not open to the
general reader, for he tells us without qualification, that "all
the splendid provings of the original provers of the Materia
Medica were made with massive doses of the strongest prepa-
rations, etc." Those who have not enjoyed these unusual
means of information, gather from a few observations, scat-
tered through Hahnemann's writings, the following facts :

Silver was proved by Hahnemann in the first trituration.
The Nitrate of Silver, of which he gives a few symptoms, in
the fifteenth dilution. Carbo vegetabilis was proved in the
third trituration. In a letter in the Neues Archiv. (1813),
he directs Stapf to prove Helleborus thus: "Add a drop of
the tincture to eight ounces of water and one drachm of

THE D€)SE IN DRUG-PROVING. 145

alcohol ; shake well, and take an ounce every hour and a
half or two hours until some decided effects are produced."
And camphor, thus : " Dissolve two grains in a drachm of
alcohol ; shake this well with eight ounces of water, and take
in from four to six doses during the day."

In the first publication of the proving of Natrum muriat-
icum (1830), Hahnemann tells us that a great part at least
of this proving was made with the thirtieth dilution, and he
adds, that "it is only in such a highly potenized form that
this and all other drugs display the whole of their power to
alter the condition of the organism." This was Hahnemann's
conclusion after thirty years of active experience in drug-
proving. As a voucher he gives us the proving of Natrum
muriaticum, the value of which is attested by the clinical
experience of the last thirty years, and confirmed as we
shall see by the Austrian re-proving. In the same volume of
the Chronische Krankheiten, Hahnemann published the
proving of Kali carbonicum, and large additions to the
previously published provings of Carbo vegetabilis, Causti-
cum, Conium and Sulphur. It is but reasonable to con-
clude that the symptoms of Kali carbonicum, and many
at least of those of the other drugs above named, were
produced by the thirtieth dilution as well as those of
Natrum muriaticum.

In view of these facts, it is hardly correct to say, as Dr.
Hempel does, that " all the provings of the original provers
of our Materia Medica were made with massive doses of the
strongest preparations, etc."

Second, we call upon the Austrian Provers' Union. This
society conducted in the years 1842 to 1848, a series of
re-provings of certain of the drugs proved by Hahnemann,
in the hope of discovering the pathological connection of the
symptoms which in Hahnemann's scheme are disconnected.
Conceiving also that some of Hahnemann's symptoms were
vague, because produced, as they supposed, by small doses,
they pushed their provings with massive doses, in many
11

146 THE DOSE IN DRUG-PROVING.

cases to extreme poisoning. With these views we could
hardly expect from them much testimony, either positive or
negative, on the subject of proving with potencies ; but, in
that which they do furnish, we should expect them to be
unfavorable witnesses for our views, since their proclivities
are almost uniformly against the use of potencies in proving
or in therapeutics. Dr. Hempel says, " All these splendid
provings, etc., were instituted with massive doses ; the
middle and higher potencies were invariably tried after the
former." Let us examine the records.

In the proving of Aconite, sixteen provers made in all
thirty-seven experiments. Six of these were made with
dilutions from the first to the twelfth centesimal, and
symptoms were observed in all but one. In five of these
cases, large doses of the tincture had been taken before the
dilution. In one case the prover began with the first cen-
tesimal dilution and got symptoms.

In the proving of Bryonia, fourteen provers made twenty-
nine experiments, of which ten were with dilutions from the
first decimal to the 203 d. In two of these, the provers
began with the dilutions, viz. : with the tenth and the thirti-
eth, and got in one case very graphic symptoms ; in the
other, symptoms unequivocal though less numerous. In the
cases in which dilutions were used after massive doses of
the tincture had been taken, considerable intervals were
allowed to elapse after the last symptoms from the tincture-
proving disappeared before the dilutions were taken, e. g.,
forty-one days before the 203 d dilution was taken, and yet
this dilution appears to have produced decided symptoms.
It is true that the propriety of ascribing these symptoms to
the Bryonia is called in question by the Editor of the
Austrian Journal, but with scarcely sufficient grounds, since a
subsequent proving with the 203 d dilution evoked them
again. Here, then, in the only two cases in which dilutions
were taken before the tincture, symptoms were obtained
(while in one case in which they were taken after the

THE DOSE IN DRUG-PROVING. 147

tincture, no symptoms were observed, shows that the corollary
to proposition No. 2 is at least not universally true).

In the proving of Silver we find that the drug was taken
by one prover each in the first, second, and third triturations,
and in the fourth, fifth, and sixth dilutions, and valuable
symptoms were obtained by each. The Editor calls atten-
tion to the great correspondence between these symptoms
and those of Hahnemann, obtained, as we know, from the
first trituration.

In the proving of Nitrate of Silver, the Editor remarks :
"Between the experiments a sufficient time elapsed to
insure against the effects of one experiment being compli-
cated by those of a preceding one, two years being con-
sumed in the proving." The proving was begun with the
first decimal trituration, and subsequently in succession the
second, sixth, and thirtieth dilutions were used. The effect
of each dose was allowed to expend itself before a new
experiment was instituted ; symptoms clear and character-
istic, and covering a period of six to nine days, were obtained
from a single dose of the thirtieth dilution. Here, it is true,
the dilutions were preceded by low triturations, yet the
Austrian provers were of opinion that in these cases the
lower preparations did not influence the susceptibility of
the system to the higher potencies.

In proving Kali bichromicum, in only two cases was a
dilution higher than the third employed. In both of these the
twelfth was used and symptoms were obtained. In one, that
of Dr. Wachtl, the symptoms from a single dose give a com-
plete picture of the subjective and objective effects of this drug
in the pharynx and neighboring organs. In neither of these
cases had the drug been previously taken in massive doses.

In the proving of Colocynth, fifteen provers made twenty-
five experiments. Ten were made with dilutions, and in
nine, symptoms were obtained. In three of these, the third
dilution was used and no other preparation of Colocynth had
previously been taken.

I48 THE DOSE IN DRUG-PROVING.

In proving Thuja, twenty-three provers made fifty-nine
experiments. Seventeen were made with dilutions, and, in
thirteen, unequivocal symptoms followed. Nine began their
provings with dilutions and got symptoms. Four began
their provings with dilutions and got no symptoms. But, on
the other hand, seven conducted their provings with massive
doses of the tincture without obtaining any unequivocal
symptoms. It is evident, then, that negative testimony on
this subject is of little value.

In proving Cochineal, four provers began their experi-
ments with the hundredth dilution, one with the sixtieth
and one with the thirtieth dilution, and all got valuable
symptoms. One prover, on the other hand, began with the
2OOth dilution and gradually descended, getting no symptoms
until he took massive doses.

In the proving of Natrum muriaticum, thirty-nine provers
took part. Fourteen began with dilutions varying from the
sixth to thirtieth, — the majority beginning with the thirtieth,
— twelve obtained symptoms of which some are of great
value, lasting and recurring for many days after the last dose.
Thus, in twelve cases out of thirty- nine, dilutions were taken
before " the system was saturated with massive doses of the
strongest preparations, etc.," instead of dilutions being " in-
variably tried after" such massive doses.

We may remark that in every case in which we ascribed
symptoms to the dilutions, except the case of the 2O3d of
Bryonia, they have been so admitted by the Austrian prov-
ers themselves.

In conclusion, we may observe that with Natrum muriati-
cum the record of the Austrian provings closes. In his con-
cluding remarks on that drug, Dr. Watzke uses the following
language: "lam — alas! — I say, alas ! for I would much
rather have upheld the larger doses which accord with current
views — I am compelled to declare myself for the higher
dilutions. The physiological experiments made with Natrum
muriaticum, as well as the great majority of the clinical

THE DOSE IN DRUG-PROVING. 149

results attained therewith, speak decisively and distinctly for
these preparations. Several of our most cautious provers
have obtained unquestionable characteristic Natrum muriati-
cum symptoms from them." It is remarkable that as Hah-
nemann was evidently led by experience to recommend that
in drug-provings dilutions should be used as well as crude
preparations, in like manner, the Austrian prover should, as
the result of his experience, express himself as above.
Watzke further remarks r1 " I am very far from regarding a
stormy method of proving as the only proper and useful one,
and I recognize the conditions of an all-sided knowledge of
the remedy, in the free, unrestrained method we have
adopted ; experiments being made with large, small, and
smallest doses according to the disposition, judgment and
good pleasure of the prover." And again, in reply to a
critic, " My friend says, '/have proved all my remedies in
strong and some in the strongest doses ; with many I have
also made provings with the higher, even with the thirtieth
dilution' — Have /then done otherwise ?"

In a recent number of the Allg. Zeitung, it is stated that
a member of the Old Austrian Provers' Union has begun to
prove Quassia amara with the thirtieth dilution, and has
obtained valuable symptoms. Experto crede.

In view of these facts, we think Dr. Hempel is hardly cor-
rect in stating that " all the provings of the Austrian Provers'
Union were made with massive doses, etc. — the middle and
higher potencies being invariably tried after the massive
doses."

The records of the Austrian Union not only prove that
dilutions may evoke trustworthy symptoms in a majority of
the cases in which they are employed, but they also give us
the means of forming a judgment on the propositions which
form the substance of Dr. Hempel's report.

I. "Drugs should not be proved with attenuations." —
Mow, since it has been shown that attenuations produce

Out. Zeitschrift, voL hi., p. 64, note.

150 THE DOSE IN DRUG-PROVING.

reliable and valuable symptoms, we submit that they should
be used and for these reasons :

(a.) Because attenuations have produced symptoms which
have not also been produced by massive doses, and which
have been confirmed by clinical experience. In the proving
of Natrum muriaticum, the only distinct picture of periodic
fever was induced in Dr. Wurmb while proving the thirtieth
and twenty-fifth dilutions. Dr. Schreter, proving the thirti-
eth, got symptoms which no prover with massive doses pre-
sents. In the proving of Thuja, certain symptoms affecting
the vision were produced in Dr. Huber by the sixtieth dilu-
tion, and in Prof. Zlatarovich by the twelfth, which no other
provers have recorded. In the proving of Colocynth, the
third dilution produced symptoms not recorded by any
prover who took massive doses, and yet corroborated by a
second prover with the third.

(b.) Because some provers are susceptible to the action of
dilutions or small doses, and not to that of massive doses of
the crude substance. For instance, Dr. Wurmb got decided
and persistent symptoms from dilutions (thirtieth to sixth)
of Natrum muriaticum. From lower dilutions and from
the crude substance, even in half-ounce doses and repeated
frequently, he got no symptoms. Was this because his
system was saturated ? We think not ; for on recurring to
the dilutions, he again got symptoms as at first. Now, had
the provings been confined to the crude substance, we
should not have Dr. Wurmb's proving of Natrum muriati-
cum, the most complete and reliable single experiment that
we possess, and which we could hardly consent to give up,
notwithstanding Dr. Hempel's opinion that " potency-prov-
ings should rather be rejected than encouraged." The same
thing is observed in the provings of Aconite, Thuja and
Colocynth.

2. " Potencies do not produce reliable symptoms unless
the system has been previously saturated with massive
doses of the crude substance ; and, Corollary, massive doses

THE DOSE IN DRUG-PROVING. 15 1

render the system susceptible to the action of smaller quan-
tities."

We have shown that in repeated instances, symptoms
which Hahnemann and the Austrian provers regarded as
"reliable" have resulted from potencies not preceded by
massive doses — symptoms confirmed by other provings and
by clinical experience. On what grounds does Dr. Hempel
question their reliability ?

Again, we have no conclusive evidence that massive doses,
as a rule, render the system more sensitive to small doses.
In some cases they appear to do so. In others they have
the opposite effect. In the records, we find the utmost
variety as regards the susceptibility of provers to various
doses. Some, like Dr. Wurmb, are susceptible to dilutions
alone of a given drug, others to massive doses alone. Many
obtain symptoms at first from comparatively small doses of
the crude substance, but find it necessary to steadily increase
the dose, until finally, after taking in some cases several
hundred drops or grains, they get no symptoms at all from
any preparation. This looks like a blunting of the suscepti-
bility rather than an exaltation. We are not always justi-
fied in assuming that, where dilutions were taken after
massive doses, the symptoms were due to the massive doses
and not to the dilutions. In the majority of these cases a
sufficient period elapsed between the experiments to prevent
all possibility of the one complicating the other. In a few
cases no such period elapsed, and in these it may be that the
symptoms ascribed to the dilutions were really due to the
previous massive doses, yet even in these cases we cannot
be certain of this ; for in one of them, that of Prof. Zlataro-
vich, who, after taking in the aggregate several thousand
drops of the Thuja-tincture, changed without delay to the
twelfth dilution, a symptom was observed which had not
occurred to him or to any one else while proving the tincture,
but only to Huber while taking the sixtieth.

In conclusion, we see in the Austrian records more reason

152 THE DOSE IN DRUG-PROVING.

to suppose that massive doses, as a rule, blunt than that
they exalt the susceptibility, although in some cases they
unquestionably have the latter effect As these cases
cannot be recognized in advance, it is clear that in the case
of an individual drug or prover, nothing positive on this
head can be assumed as a basis on which to plan a proving.

3. It is said that "idiosyncrasy'' determines the action of
potencies, and that provings having this origin are not
reliable.

The word " idiosyncrasy " is used in two senses. Properly,
it signifies an abnormal sensibility to drug-action ; or such a
relation to a special drug as that the drug produces in the
prover symptoms that occur to no other prover, and which
bear no analogy at all to the symptoms which others experi-
ence. Such symptoms as these must always be regarded as
suspicious until verified by clinical experience. Such an
idiosyncrasy is exemplified by persons who have " hay
asthma," " rose catarrh," etc.

But, as most frequently employed, the word " idiosyn-
crasy" is synonymous with "susceptibility," implying an
unusually acute, but not abnormal, sensibility to the action of
the drug, and a prover who shows a marked susceptibility to
the action of a drug is said to have an idiosyncrasy which
favors its action. This susceptibility is similar to that which
individuals exhibit for natural diseases — some being prone
to one kind of disease, others to another, just as one prover
is especially susceptible to Thuja, another to Aconite. Now,
what pathologist would think of objecting to a case of
pneumonia that it was not a reliable picture of the disease,
because it could be shown that the patient had a great
susceptibility to the disease, and took it on the slightest
provocation ? A certain susceptibility to the action of a
drug is absolutely necessary to a good proving. Hahne-
mann speaks of it in his Organon as a necessary condition.
What the Austrian provers think on the subject may be
gathered from the following remarks of Watzke (Dr.

THE DOSE IN DRUG-PROVING. 153

Wurmb proved Thuja five times, — four times in massive
doses and once in dilutions ; result very meager) : " We
may observe that the proving of a drug is not so easy an
affair as it seems to be. The individuality of the prover as
well as of the drug plays here so important a part, that a
successful proving is often an entirely accidental piece of
good fortune of the susceptible prover, while the boldest,
but unsusceptible prover, with the best good-will and the
greatest devotion may obtain only a scanty and one-sided
result."

This susceptibility may be to the drug in general or to
particular preparations of it. Wurmb was acted on only by
dilutions of Natrfum muriaticum. Watzke only by immense
doses of the crude substance. Watzke was sensitive to very
small doses of Thuja, while Wurmb and Reisinger were
almost insensible to every preparation of it. Obviously, then,
a prover's susceptibility varies with the drug and with the
preparations, and can be learned only by experiment with
all preparations.

From the general tenor of Dr. Hempel's report, one
might infer that while the middle and higher potencies
produce symptoms only in very exceptional cases, massive
doses of the strongest preparations act always. The records
of the Austrian provings hardly warrant such an assumption.
Of the thirty-one experiments made with tincture of Aconite,
six were not followed by any trustworthy symptoms. Of
the thirty-six made with large doses of tincture of Thuja,
seven were without result. Of fourteen made with large
doses of crude Colocynth, one was without result. Of the
fifteen provers of Byronia, one at least took very large
doses of the tincture without observing any symptoms.
Several who took large doses of crude Natrum muriaticum
were insensible to its action. It is obvious, then, that the
development of symptoms is not of necessity copious and
satisfactory in the ratio of the dose. The Austrian records
abound in editorial remarks, intimating that provers have

154 THE DOSE IN DRUG-PROVING.

defeated their object by taking too large doses, and by
repeating the dose too frequently.

We have seen, then, that potency-provings may be trust-
worthy and that they are indispensable to a complete and
exhaustive proving. It is to be observed that even the few
Austrian potency-provings which we have, were not, gener-
ally, conducted in such a way as to demonstrate the full
value of such experiments. In very many cases, only a
few days were allowed for the development of symptoms
before a larger dose was taken. In the few cases in which
a different course was pursued, as in Wurmb's proving of
Natrum muriaticum, clear and persistent and most valuable
series of symptoms were obtained.

In order to obtain a perfect proving, the prover should
ever bear in mind certain fallacies to which he is liable.
These fallacies differ according to the dose which he is
employing; they are equal for either extreme of dose. If
he use the higher dilutions, he is in great danger of
confounding "imaginary" symptoms with real subjective
drug symptoms. If he employ massive doses, he is in equal
danger of including in his record chemical and mechanical
symptoms. Either error is a source of confusion and
uncertainty, but he is greatly mistaken who thinks to avoid
introducing confusion and uncertainty into the Materia
Medica by simply rejecting potency-provings. They can be
avoided only by the constant analysis of the symptoms
(whether produced with potencies or with large doses),
by frequent repetitions of the provings on one's self and
others, and by clinical verifications of the symptoms. The
Austrian records give an example of the latter fallacy. The
symptoms are so intermingled with chemical and revolu-
tionary effects, that one cannot use too great caution in
basing a prescription upon them,

In conclusion, we may assume the following points to be
established by induction and by direct experience :

THE DOSE IN DRUG-PROVING. 155

In order to obtain an exhaustive proving :

1. We must prove the drug both in dilutions and in
massive doses.

2. The proving should be commenced with dilutions;
and high dilutions should be employed until satisfactory
evidence is obtained that the prover is not susceptible to
their action. We thus obtain one of the unknown quantities
of our problem, viz., the measure of the susceptibility of
the prover.

3. Where a keen susceptibility is found to exist, the
greatest care must be exercised to avoid blunting or pervert-
ing it. With this view, repeated experiments should be
made at long intervals, with high potencies, until no new
varieties of symptoms are evoked. Then, after a long
period of non-medication, the prover should take lower
potencies and then small doses of the crude substance
repeated at intervals, and finally after another long period of
repose, large doses of crude substance. A thorough proving
after this fashion may require years for its completion — but
it will have an advantage over most of our recent provings,
in the fact that it will be thorough, and that it will be of
permanent and certain use to the practitioner.

4. In proving with dilutions, as well as with massive doses,
a long period of time should be occupied in testing each
preparation, in order that the full effect may be seen in the
production of dyscrasias, etc.

5. The greatest care should be exercised in verifying
symptoms by repeated experiments, in order that " imagi-
nary " symptoms on the one hand and chemical and
mechanical symptoms on the other may be excluded. The
fashion, which has become very prevalent of late, of including
in the pathogenesis every sensation which occurs during
the proving, without distinction or verification — and which
may be called the Pre-Raphaelite method of proving —
cannot be too strongly rebuked.

ALTERNATION OF REMEDIES. No. i.

The following remarks upon the interesting, but, in our
judgment, unsound paper on this subject by Dr. J. R. Coxe,
jr., published in the February number of the current volume
of the American Homoeopathic Review,1 may serve at least,
it is hoped, to call attention to this very important approach
to Polypharmacy in the customary method of prescribing,
and, perhaps, to stimulate a discussion of its necessity and
propriety.

In admitting that the alternation of remedies is incompat-
ible with the theory of a true homoeopathic prescription, our
colleague has granted all that the opponents of alternation
could reasonably ask. That our practice has not yet come
up to our theory, and that we are not yet fully possessed of
the means and knowledge to bring it up to that degree of
perfection, and that therefore some prescribers may feel con-
strained sometimes to alternate remedies, as it were zmder
protest, may not be denied. But to urge that because our
practice lags thus behind our theory, we are to rest satisfied
with it, nay, to defend it and to conform our theory to it, is a
position that would be fatal to all progress, and which we
cannot think of conceding. . Nor is the appeal to experience
in the sense in which our colleague uses it valid. He " has
alternated remedies in a practice of twenty-five years, and
his practice has been generally successful." We do not
doubt this. But we believe his respected father practiced
allopathy for a much longer period, and was a successful
practitioner ; would this fact be a valid argument in favor
of allopathy ?

1 Vol. iiL, 1863.

ALTERNATION OF REMEDIES. NO. I. 157

Alternation and succession of remedies are not generally
understood to be identical processes. By alternation, we
think, practitioners generally understand the prescription, at
one and the same time, of two or more remedies to follow
each other at short intervals, the symptoms of these remedies
taken altogether being thought to cover the symptoms of
the case more completely than those of either remedy alone
would do. The prescription is the result of one single
examination of the patient and of one single comparison of
the symptoms with the Materia Medica.

But when a succession of remedies is given, in either an
acute or a chronic disease, the understanding is, that the
first remedy, having been carefully selected, is allowed to
exhaust its action alone, and then a collection of the
symptoms the patient then presents is made, and the case is
prescribed for afresh, almost as if it were a new case ; and
this process is repeated, each new prescription being the
subject of a special study, until the case is cured. Such a
process is equivalent to prescribing for a number of new and
independent cases, and it is evidently not incompatible with
the theory of a true homoeopathic prescription.

The very thoughtful article by Dr. Payne, to which refer-
ence is made by Dr. Coxe, contains nothing incompatible
with these views. He instances cases in which a remedy
which had covered all the symptoms acts well for a time,
then ceases to act, and leaves the case still uncured. He
advises then a fresh study of the case, and especially a study
of the previous history of the patient, and the prescription
of a suitable antipsoric or antisyphilitic — in fact, a strictly
homoeopathic prescription de novo. Now, in many such
cases, acute though they appeared at the outset, if the pre-
scriber had studied thus carefully at the very beginning, not
only the present symptoms, but also the previous history of
the patient, a single antipsoric prescribed at first might have
sufficed for the case. For although chronic diseases may be
incurable except by an antipsoric, antisyphilitic or anti-

158 ALTERNATION OF REMEDIES. NO. I.

sycotic, yet these remedies may also be required in the very
beginning of diseases that appear to be most acute. I can
certainly testify, from repeated observation, to the efficacy
of Sulphur30 in most violent puerperal peritonitis, that
remedy being all that was required to bring the cases to a
speedy and favorable issue. This calls to mind Hahne-
mann's admonition — Organon, § 257. *
The physician " should never lose sight of this great truth,
that of all known remedies there is but one that merits a
preference before all others, viz. : that whose symptoms
bear the closest resemblance to the totality of those which
characterize the malady."

Be this as it may, Dr. Payne's advice clearly contemplates
a new study of the case for every new prescription, and, if
this plan be pursued, the treatment will be strictly homoe-
opathic, even though a dozen remedies were required in
succession before the case is cured.

Alternation, however, as generally understood and prac-
ticed, does not contemplate this new study of the case before
a second remedy is administered, or before every change of
remedies ; and herein it fails to come up to the requirements
of a true homoeopathic prescription. And this is the kernel
of the whole controversy.

Suppose a case of pleurisy. Bryonia covers all the symp-
toms. The patient improves for a time and then ceases to
improve. The case is studied anew. Some symptoms are
found to have vanished ; some new ones have appeared.
The physician studies the previous history of the patient
more closely ; he may or may not conclude that there is a
psoric taint. At all evejits he perceives that Sulphur
corresponds to the symptoms better than any other remedy.
He prescribes Sulphur, therefore, just as though this were a
new case that had just come under his treatment. This is an
instance of succession of remedies. But each prescription is a
strictly homoeopathic one, and in every respect commendable.

Suppose another case. A patient has acute tonsilitis.

ALTERNATION OF REMEDIES. NO. I.

159

The physician collects his symptoms and prescribes " Bella-
donna, to be followed in four hours by Mercurius, and that
again in four hours by Belladonna, and so on." These two
steady nags, so familiar to all, in this relation, are sometimes
enlivened by the company of Aconite and Coffea (pro re
nata) where the prescriber has no scruples about driving
"four in hand."

This is an example of alternation of remedies, and is
objectionable on the following grounds: Suppose the first
dose of Belladonna to have been a judicious prescription,
and to have had an effect How can the prescriber know
beforehand that this effect will be just such as to cause the
totality of the symptoms at the end of four hours to corre-
spond exactly to Mercurius, and, what would be still more
wonderful, how can he foresee that the effect of the Mer-
curius will be just such as to cause Belladonna to be better
indicated than any other remedy at the end of another
period of four hours ? .The second remedy (a fortiori a
third or fourth ! ) in such cases must always be prescribed
without a preliminary study of the actual condition of
the patient as modified by the action of the first remedy.
It cannot, therefore, be an exact homoeopathic prescrip-
tion.

Hahnemann has expressed himself fully on this subject in
the Organon 1 as follows :

Sec. 272. " In no instance is it requisite to employ more
than one simple medicine at a time." :

Sec. 169. " It may easily occur, on examining a disease
for the first time, and also on selecting for the first time the
remedy that is to combat it, that the totality of the symp-

1 Fourth edition, British translation. given both remedies at the same time,

2 Experiments have been made by or nearly so ; but I earnestly caution
some Homceopathists in cases where, all my adherents against such a
imagining that one part of the symp- hazardous practice, which never will
toms of a disease required one remedy, be necessary, though, in some in-
and that another remedy was more stances, it may appear serviceable."
suitable to the other part, they hare

160 ALTERNATION OF REMEDIES. NO. I.

toms of the disease is found not to be sufficiently covered by
the morbific symptoms of a single medicine, and that two
remedies dispute the preference as to eligibility in the
present instance, the one being homoeopathic to one part of
the disease, and the other still more so to another. It is,
then, by no means advisable after using the preferable of the
two remedies, to take the other without examination,
because the medicine given as the inferior of the two, under
the change of circumstances, may not be proper for the
remaining symptoms ; in which case, it follows, that a suit-
able homoeopathic remedy for the new set of symptoms
should be selected in its stead."

Sec. 167. "In short, if the application of an imperfect
homoeopathic remedy used, in the first instance, cause any
accessory symptoms of some importance, the action of the
first dose is not allowed to exhaust itself in acute diseases;
the altered state of the patient is then to be examined and
the remainder of the primitive symptoms to be joined to
those which have been recently discovered, to form of the
whole a new image of the disease."

Sec. 1 68. "A new remedy that is analogous may then be
easily discovered among the medicines that are known, a
single application of which will suffice, if not to destroy the
disease entirely, at least to facilitate the cure in a great
degree. If this new remedy is not sufficient to restore the
health completely, then examine what yet remains of the
diseased state and select the homoeopathic remedy that is
most suitable to the new image that results from it. In this
manner, the physician must continue until he attains his
object — that is to say, until he has fully restored the health
of the patient."

The name and practice of Hahnemann, Boenninghausen
and Hering have been adduced in support of alternation.
Hahnemann's views on the subject we have already quoted
from the Organon. The case to which Dr. Coxe refers, as
cured by Hahnemann by " the alternate use of Bryonia tinct-

ALTERNATION OF REMEDIES. NO. I. l6l

ure and Pulsatilla," has escaped our notice, and we should
esteem it a favor if Dr. Coxe would inform us whereabouts
in homoeopathic literature it is recorded.

Hahnemann published very few cases. In vol. ii. of the
Materia Medico, Pura, third edition, 1838, he relates two
cases, one of which was cured by a single dose of Bryonia
tincture, and the other by a single dose of Pulsatilla. May
Dr. Coxe have, possibly, referred inaccurately to these cases
and, by a fault of memory, blended them ?

It is often stated, however, that Hahnemann used Bryonia
and Rhus toxicodendron alternately in his very successful
treatment of the typhus or hospital fever which prevailed
so extensively in northern Germany, in 1813-14, after the
French invasion. A reference to his article on the " Treat-
ment of the Typhus or Hospital Fever at present prevailing,"
originally published in the Allgem. Anzeig. der Deutschen,
number six, 1814, and translated by Dr. Dudgeon among
" Hahnemann's Lesser Writings," 1 will show how erroneous
this statement is.

He says, " This fever has two principal stages," of which
he gives the distinguishing symptoms ; the first stage being
characterized by "pains and consciousness" the second
stage by "delirium and mania."

" In the first stage," he continues, " two vegetable sub-
stances are of use and generally quite remove the disease at
the commencement — the Bryonia alba and the Rhus tox-
icodendron."

He proceeds to give the special indications for each of
these remedies. "If the patient complains of dizziness,
shooting (or jerking-tearing) pains in the head, throat, chest,
or abdomen, etc. „ which are felt particularly on moving the
part — in addition to the other symptoms, the haemorrhages,
the vomiting, the heat, the thirst, the nocturnal restlessness,
etc., we give a single drop of Bryonia12. Improvement takes
place in the course of four and twenty hours, and as long as

1 P. 631 et seq., American edition.

12

1 62 ALTERNATION OF REMEDIES. NO. I.

the improvement goes on, we give him no other medicine, nor
even repeat the same dose.

" If now the amendment produced by the single dose of
Bryonia goes off in the course of two, three or four days, that
is to say, if the patient then complains of shooting pains in
one or other parts of the body whilst the part is at rest; if the
prostration and anorexia are greater, if there is harassing
cough or such a debility of certain parts as to threaten
paralysis, we give a single drop of Rhus toxicodendron12 and
no more nor any other medicine so long as the improve-
ment is manifest and continued. * * Or, if the symptoms
I have just described occur at the very commencement of
the attack, we give at its very commencement a drop of
Rhus toxicodendron12." * * * *

" The whole disease will generally be removed by a single
dose of the first or of the second medicine (according as the one
or the other is indicated, without the addition of any other).

" If, notwithstanding, the disease should pass into the
'second stage' of delirium and mania, then Hyoscyamus
niger meets all the indications of the case."

These detailed directions for the treatment of an. epidemic
disease give a perfect picture of a true homoeopathic treat-
ment They state, in substance, that the generic symptoms
of the disease are always accompanied in the commencement
by one or the other of two groups of characteristic symp-
toms. Accordingly, as one or the other of these groups is
present, Bryonia or Rhus is to be given. When the conse-
quent amelioration ceases, then the case is to be examined
anew, and. according to the characteristics then found to
present themselves, a new remedy is to be selected, and thus
the practitioner is to go on until the case is cured. But
alternation is nowhere advised or allowed.

Hahnemann's brief and very general hints relating to the
treatment of croup are of the same general character. In
the introduction to Spongia,1 he says: " Homoeopathy has

1 Materia Medica Pura, vol. vi., second edition, Dresden, p. 199.

ALTERNATION OF REMEDIES. NO. I. 163

found, in symptom 145 and in other symptoms, the most
remarkable applicability of Spongia to that terrible acute
disease — membranous croup — provided, however, the local
inflammation has first been diminished or subdued by a very
small dose of Aconite. The additional use of a small dose
of Hepar sulphuris will rarely be found necessary." Nothing
is here said or in any way intimated concerning alternation.

In giving general directions beforehand for the treatment
of this disease, which usually presents a very uniform group
of symptoms, he shows that the symptoms, while the local
inflammation is still raging, call for a very small dose of
Aconite ; that when this has acted, it will generally be found
that the local inflammation is subdued, leaving a group of
symptoms which correspond best to the symptoms of
Spongia ; that sometimes there may be such a modification
as to call instead or subsequently for Hepar sulphuris.

When a physician has it in his power to visit his cases
frequently, and to watch their course, he has no excuse for
deviating from the methods of a true homoeopathic prescrip-
tion. If it prove necessary to give a succession of remedies,
he is bound to make each successive prescription the subject
of a special study, both of the symptoms of the patient and
of the provings in the Materia Medica, and to select on each
occasion the remedy which corresponds best to the symp-
toms of the case.

But where, as sometimes happens, the physician is unable
to see the case at all, or where he is giving general direc-
tions for the treatment of a case which it is supposed may,
at some future time, occur, this accuracy is impossible. His
duty is then to describe to his client the symptoms which
will probably be present in each stage of the disease, if it
appear in the ordinary form and follow the ordinary course ;
to point out the indications for the appropriate remedy in
each stage ; and to instruct his client to give only one medi-
cine at a time at each stage, and never to repeat the dose,
or to give any other remedy so long as amelioration is

1 64 ALTERNATION OF REMEDIES. NO. I.

manifest. This is the best the physician can do when
treating disease under the disadvantage of never seeing the
patient. This is the method adopted by Hahnemann with
reference to hospital typhus. It is the method of Dr.
Boenninghausen in treating croup.

It is well known that Dr. Bcenninghausen does not visit
his cases, but prescribes chiefly in his offices. He knows
that the first symptoms of croup are almost uniformly com-
bined with a local inflammation which, along with all the
other symptoms, forms a group to which Aconite corresponds
better than any other remedy. His first powder, therefore,
is Aconite. And his instructions are explicit. The second
powder is never to be given until the amelioration, conse-
quent on the first, shall have ceased, and so with the remain-
ing powders. The recipients of " croup powders " are
especially and carefully instructed under what circumstances
alone it is proper to give any or all of the subsequent
powders. This is as near an approach to a new study for
each change of remedy as is possible when the physician
does not see the patient.

It does not really amount in most cases even to a succes-
sion, much less an alternation of remedies, for in a large
majority of cases the Aconite alone cures the patient.

That Dr. Bcenninghausen does not regard this method as
an "alternation of remedies" is shown in vol. ii., p. £61, of
the American Homoeopathic Review.

Indeed, in theory and in practice Dr. Bcenninghausen is as
decidedly opposed to alternation as we have shown that
Hahnemann was.

We believe we could say that Dr. Hering's views are
similar to those we have expressed, but we prefer to await a
statement from his own vigorous pen of those arguments,
both theoretical and practical, which none could give so
well as he.

In conclusion, we hope it is hardly necessary to add, that
inasmuch as offensive language and odious epithets lend no

ALTERNATION OF REMEDIES. NO. I. l6§

strength to argument nor sweetness to persuasion, we
entirely agree with our colleague in his closing paragraph.
Nay ! for that very reason, he will allow us to say, we could
almost wish his own expressions had been a very little less
emphatic.

ALTERNATION OF REMEDIES. No. 2.

When, in the February and April numbers of this Review,2
vol. iii., 1863, we published Dr. J. R. Coxe's article on
Alternation, and our own modest objections to what we
regarded as unsound argument and inaccurate statement on
the part of Dr. Coxe, we had no idea that we were enter-
ing upon the discussion of a question, about the terms of
which there could be any chance for a misunderstanding.
Subsequent publications, from various quarters, have shown
that all practitioners do not understand the same thing by
the word alternation, as applied to the mode of prescribing
homoeopathic remedies. We think we shall be able to show
that the practice which some writers defend, under the name
of alternation, is not properly called by that name. But,
before entering upon the subject itself, we desire to make,
once for all, two statements of general principles by which
we are governed not only in the treatment of this question
but of all questions that concern the practice of medicine ;
premising that we utterly disclaim any disposition to dogma-
tize or to speak as with authority on any question of medical
practice. If the earnestness of conviction should betray us
into too positive warmth of language, this is our misfort-
une ; and none can disapprove it more decidedly than we
regret it.

i. The business of the physician is to cure his patient;
this is the great practical object of his labor. We believe
that nature is not always restricted to a single path — and
that while some cases are so severe that there is but one

^American Homoeopathic Review, 1865. *Ibid, 1863.

ALTERNATION OF REMEDIES. NO. 2. 167

way in which it is possible to cure them, there are often
several ways in which it may be possible to effect the cure
of some other case ; each way having more or less of incon-
venience attaching to it and of detriment resulting from it, in
proportion as it differs, more or less widely, from the best
way. Thus, we believe that Allopathy, with her heroic
antiphlogistic*, her revulsives (borrowed from the " circum-
locution office "), and, still more frequently, with her blind
and blundering misuse of specifics, does sometimes "cure"
her cases ; but this is not the kind of cure that should satisfy
the physician's desires. It is neither safe (inasmuch as it
is debilitating in itself and is likely to involve damaging
sequelae), nor rapid, nor pleasant. Thus, likewise, we
know that Homceopathists who mix medicines, whether in
the tumbler or in the patient's stomach (conglomerators or
alternators), do often " cure " their patients. These cures,
if our observations be correct, are neither so rapid nor so
pleasant (free from sequelae) as cures might be ; and we are
confident that by these methods not nearly so large a pro-
portion of the sick may be cured as by adherence to the
simple, single remedy. Still, we admit that when a
physician has cured a patient, by whatever method, he has,
in so far as that patient is concerned, done the chief part of
his duty. Though his method were not the best of known
methods, he is not to be blamed without qualification.

2. But, although, from the ethical stand-point, we may
concede that:

" ' T is better to have " erred and cured
" Than never to have " cured " at all,"

we think there is abundant reason for cautioning the prac-
titioner to beware of confounding the misfortune of the error,
with the good -luck of the cure.

As one to whom have been confided the interests of that
individual patient, he may justly rejoice in the cure ; but do
his functions cease here ? By no means. He is a man of
science, to whose care are to be intrusted, every day of his

1 68 ALTERNATION OF REMEDIES. NO. 2.

active professional life, case after case of disease which he is
to bend his energies to cure. What is it to be a man of
science ? It is to be one whose mind is stored with an array
of facts carefully observed by others as well as by himself,
and methodically arranged, in such wise that principles have
been and may be correctly inferred from them — principles
by virtue of which new observations may be arranged along
with these facts — principles by the aid of which the facts
which will result from operations observed to be in progress,
or intentionally put into activity, may be accurately predicted,
and, conversely, may be produced at pleasure.

Such is the scientific physician. Let us note the difference
between the action of his mind and that of the patient, after
a cure of the latter has been accomplished by the former.
The patient says to himself, " I was sick and now I am well.
I will pay my doctor and then, to my work again ! " This is
all his sickness is to the patient

The soliloquy of the doctor will depend very much upon
the nature of the mental process by which he arrived at the
mode of treatment that cured the patient. It may be :

1. " How can I ever be thankful enough for the lucky
accident that made me give him Ledum ! May I be as
fortunate when I guess again ! " or,

2. " When I gave Bryonia alone and Sepia alone, though
each seemed to correspond pretty well, still the patient did
not get much better. But when the happy thought of
alternating them occurred to me, and I did it, she recovered.
From this I shall learn that two remedies, each of which
corresponds to part of a case, may cure the case if given
in alternation, when neither, if given singly, would cure
it;" or,

3. " A year ago I should have given, for such an angina
as this, Belladonna and Mercurius in alternation, as Rummel
recommends, and the patient would probably have gotten
well in two or three days and I should have been satisfied ;
but since I have studied Lachesis, I find that remedy covers

ALTERNATION OF REMEDIES. NO. 2. 169

the whole case much better than Belladonna and Mercurius
would do ; and lo ! he is well in twelve hours. From this, I
learn to shun, more earnestly than ever, those expedients
which, like alternation, are borrowed from the polypharmacy
of the Old School and which, being opposed to sound prin-
ciple, must be inferior in their results to some better way
which accords with sound principles and which way I shall
be most likely to find out if I make my practice follow prin-
ciple. This case, then, gives me fresh zeal in my study of
Materia Medica ;" or,

4. "This case cost me much study. I saw that the symp-
toms of the abdomen and digestive canal as well as those of
the lumbar region and of the hip and thigh and the general
conditions of aggravation and amelioration corresponded
admirably to Colocynth, but then, the patient had, in addi-
tion, an enlarged ovary (from which, possibly in some way,
the other symptoms sprang), and I have never heard of
Colocynth in connection with enlarged ovary. I might,
therefore, have been tempted to alternate Colocynth with
some remedy which is known to have cured and perhaps
produced enlarged ovary, such as Lachesis, Apis, Graphites,
Lycopodium, Staphysagria, etc., but for my aversion to
disregard what seems to me the well-established principle :
that maladies are not local affections, but general, pervading
the entire organism — that the individual man is not an
aggregation of independent monads, each of which may be
ill or get well ' on its own hook,' without its neighbor being
thereby jostled, and against which may be discharged a cor-
responding load of medicinal monads each of which will find
its own particular target without hitting any other — not this,
but an individual being, whose functions and tissues are so
intimately connected, that, ' if one member suffers, all the
members suffer;' and conversely, if we get the key to the
malady by finding the characteristic symptoms which will
point us to the true remedy, we shall cure the entire suffer-
ing, to whatever member we may address ourselves. In this

I/O ALTERNATION OF REMEDIES. NO. 2.

faith, regarding the characteristic symptoms as calling
unmistakably for Colocynth (there was nothing character-
istic of any remedy in the ovarian symptoms — the ovary was
enlarged, that was all), I give that remedy. And now, while
in a few days the other symptoms which plainly called for
Colocynth disappeared (permanently, as the event proved),
in the space of two months the ovarian tumor had likewise
disappeared, and the patient, who had been confined for six
years to her room and couch, could now walk, drive, and go
about the house as well as ever.1 From this I learn the
unity of disease, and by this I am strengthened in my belief
that adherence to well-settled principles will, in the end,
carry one farther and faster, even over dark and uncertain
ways, than any make-shift and irrational expedient would be
likely to do ; " or,

5. "In this case of dysmenorrhoea the symptoms of the
head and eyes are very characteristic of Cyclamen. But,
surely, the menstrual symptoms are too important to be
overlooked in this case, and the remedy must correspond to
these symptoms in order to cover the case. I looked for
the symptoms of Cyclamen on the female sexual organs,
and lo ! none are recorded in the Materia Medica Pura. It
seems that there was not a woman among the early provers
of Cyclamen. What was to be done ? The menstrual
symptoms corresponded pretty well with those of Pulsatilla,
though the head and eye symptoms did not correspond.
Should I alternate Cyclamen and Pulsatilla, which jointly
cover the case? I should have high authority for such
a course ! But, I reflect, that the same kind of a human
organism which, under some disease-producing influence,
experiences, at one and the same time, the amenorrhcea and
the head and eye symptoms of my patients — the same kind
of human organism, I say, experienced also, when proving
Cyclamen, head and eye symptoms exactly like those of
my patient. Is it not fair to presume that, if this disease-

lSee "Observations on Colocyntk."

ALTERNATION OF REMEDIES. NO. 2. 171

producing cause and the specific properties of Cyclamen are
so nearly alike as to produce identical symptoms in the head
and eyes, they would have produced identical symptoms
likewise in the female sexual organs, had the prover of
Cyclamen been a woman? So strongly did probabilities
seem to me to favor this presumption, that regarding alter-
nation as an unsound and irrational expedient, I was about
to take the risk of giving Cyclamen alone on the strength
of this anticipated result of some future proving by a
woman, when, chancing to meet with the new Austrian
proving of Cyclamen, I found that provings by women are
there recorded which confirmed my presumption in every
particular. The case recovering speedily under Cyclamen,
I learn from it that in many cases we are tempted to alter-
nate because we cannot cover every feature of the case with
either of the remedies which we think of alternating. But,
in some of these cases, the symptoms which are really
characteristic are fully met by one of these remedies, and
there is ground for assuming, as clinical records show, that
subsequent and more extended provings will demonstrate to
us that this remedy, if fully proved, would really cover the
entire case, characteristics and all. This experience fortifies
me against a temptation to alternate, and leads me to rely
more confidently on the indications furnished by character-
istic symptoms."

If we review these cases and analyze the operations of the
physician's mind, we shall see that, in number one, he con-
fesses that he has been the '* accident of an accident," and
he invokes his " good luck " to stand him in stead again.
He does not exercise his reasoning faculties at all. Let
him pass.

In the other cases, there is, besides a thanksgiving for
success, an effort of the mind to arrange the facts which the
case presents in order, along with some other facts already
stored there, and to infer from the aggregate store of facts
some principle or plan of action which may be profitably

1/2 ALTERNATION OF REMEDIES. NO. 2.

brought to bear on some future case. It is thus and only
thus that "experience teaches" For, since no two cases are
ever met with that are in every respect precisely alike, the
experience acquired in treating one case can never be avail-
.able in treating another, except through the intermediate
application of the reasoning powers. We hear and observe
facts, collect and arrange them, analyze and reflect upon
them, induce principles from them, and prepare ourselves to
make practical application of these principles when a new
case shall call for it.

Now, what is this but theorizing ? When we analyze a
case in such a way as to suggest to our minds its proper
mode or course of action, or to infer from it any principle
that might help us in a future case, we form a " theory."
We cannot think, indeed, about collecting facts without
theorizing.

Yet the defenders of alternation invite us simply " to look
and see," to " establish facts. These once fixed, any theory
which will perfectly account for them is good." These
are Dr. Hawley's words. * And the London Homoeopathic
Review, vol. ix., p. 432, quotes Dr. Hawley's words approv-
ingly: " The homoeopathic system of medicine," * * *
says Dr. Hawley, " bases itself, not on theories but on facts
as they are observed in the world of man. It frees its dis-
ciples from all dogmas and simply asks them to look and
see." Well, being thus invited, we "look and see." What
do we see ? Why we see Dr. Hawley giving Bryonia and
Sepia in alternation in one chronic case and Arsenic and
China in another case, and curing both in a way which
satisfies him well. This is what we see. But what does Dr.
Hawley see when he looks at these same facts ? Why he
sees something which proves to him that " for him, the use
of remedies in alternation is better than the use of a single
remedy." And the London Review sees in the same facts
something "which proved to him (Dr. Hawley) that the

1 American Homoeopathic Review, vol. v., p. 338.

ALTERNATION OF REMEDIES. NO. 2. 173

alternation of medicines is not only admissible, but that
cases now and then occur which CAN ONLY BE CURED BY
SUCH ALTERNATION."

Is not this "theorizing" pretty strongly and on a rather
slender basis ? Our friends warn us against " theory " and
yet, from two facts, Dr. Hawley concludes that, " for him,
the use of remedies in alternation is better than the use of
a single remedy." From the same two facts the London
Review makes Dr. Hawley conclude that " cases now and
then occur, which CAN ONLY BE CURED BY SUCH ALTER-
NATION." This is a broad generalization on a very narrow
foundation. But Dr. Hawley admonishes us that " we have
not yet any such collection of facts as will warrant any
generalization"

For ourselves, we should not feel justified in drawing any
such conclusions as these from Dr. Hawley's cases or from
any of the cases already narrated, cured by alternation.
When adduced in evidence, we accept them as facts and
give them what we consider to be their full value. They
prove to us that cases may be cured by alternated remedies,
but they prove no more than that. They prove that two
remedies in alternation cured a case which neither of those
two remedies singly had cured. Beyond this they prove
nothing. Assuredly they do not prove that a physician
could not have cured each case more quickly with some
other remedy, given singly. How could such evidence be
held by us to justify such conclusions as Dr. Hawley and
his reviewer draw from it, when our daily experience fur-
nishes case after case which had been treated ineffectually by
physicians who always alternate and which yields promptly
to the single remedy. Evidence of this kind whether FOR
or AGAINST alternation, will not settle this question.

These remarks, extended as they are, have been made for
the purpose of showing that clinical experience is available
as a means of improvement in medical practice only in so
far as it is analyzed, thought about, and, in fact, "theorized"

174 ALTERNATION OF REMEDIES. NO. 2.

about; that those who deprecate dogmatism and would put
off the formation of generalizations, do, themselves, dogmatize
and theorize, and from the nature of the case they -must do so
in the act of reasoning about the evidence they bring forward.

If this be inevitable, then, it must be allowed us likewise
to theorize and in what we have to say about alternation
we shall hold ourselves justified in basing our argument on
generalizations from a multitude of collated facts. We hold
that the argument from theory is in order. And regarding
a SCIENCE as being a connected and independent series of
generalizations based on an analysis of methodically arranged
and collated facts, we require the advocates of alternation to
rest their cause, as we do our opposition to alternation, on
such a generalization. Failing to do this, they have no claim
for their method as a part of the SCIENCE of Therapeutics.
Failing this, the facts which seem to justify alternation can
be used in no other way than in the blind, empirical way of
literal imitation, in which accuracy and certainty are quite
out of the question. But our whole object in study and
labor, beyond the direct need of our patients, is to complete
the structure of our science, such as we have defined a
Science to be, a means of attaining accuracy and certainty.

Some of the advocates of alternation have failed to per-
ceive the necessity of raising their procedures to the level of
a scientific method. They still rest on the rude empirical
ground of unmethodized experience. Their argument is :
" I have alternated remedies which, singly, had failed, and I
cured. Henceforth I shall alternate." Or, as the London
Review varies the argument (9, 432), " The practice of alter-
nation of remedies is one so widely adopted that it would
appear to have the sanction of very extended practical
experience. Experience has proved

abundantly that the alternation of remedies increases the
rapidity of the cure," etc. The same argument was used by
Dr. Coxe,1 who claims to have alternated for twenty-five

1 American Homoeopathic Review, iii., 59.

ALTERNATION OF REMEDIES. NO. 2. 175

years, and to have been successful. As we have before
remarked, the same argument may be used by Allopathists,
and by the advocates of every form of practice, whether
pure, mixed, or wholly vicious. The same argument may
be, and is, advanced by those who oppose alternation.

Others, however, have seen the necessity of basing their
advocacy of alternation on some general principles, among
them particularly Dr. Drysdale 1 and Dr. Coe,2 and to these
statements of principles we wish to devote some attention.

But, first, let us have a clear understanding of what is
properly meant by alternation of remedies.

As we have stated, the term is used in different senses.

i. Dr. J. R. Coxe (loc. cit.) seemed to think that the
opponents of alternation contend that each case of sickness
should be treated with one single remedy, and that, if during
an illness a change in the symptoms should compel a change
in the remedy, this, by whatever name it be called, is, in
fact, alternation. He scouts the idea of any real distinction
between alternation and succession of remedies. Well, if
this be all that alternation means, we have no reason to
oppose it. But, what is a case of disease in this sense ? Does
it comprise all that may ail a man from the time that he
takes to his bed to the time that he goes to his work again ?
Suppose a patient sick of dysentery, and recovering finely
under the single remedy Mercurius corrosivus. When just
convalescent he is seized with rheumatism, and requires
Rhus toxicodendron. Is it "alternating" to give it to him?
And then, suppose him safely over rheumatism ; but just
before he goes to work again, he has a return of dysentery,
requiring Mercurius corrosivus. Is it " alternating " to give
it, if the symptoms require it ? And if, when cured of this
relapse, he gets the measles and requires Euphrasia, is it
"alternating" again to give him this remedy? Why,
according to this definition, if you call this all one sickness,

1 Annals of British Homoeopathic 2 The American Homoeopathic Rt~

Society. view, vol. v., April, 1865.

ALTERNATION OF REMEDIES. NO. 2.

it has been a case of alternation. If you call it four sick-
nesses, perhaps not. To the patient, certainly, it is "all
one," whatever you call it ! Now, suppose the symptoms
in a case to have changed just as decidedly as in the case
supposed above, but yet not so definitely as to induce you
to give to the changes these nosological names of dysentery,
rheumatism and measles. The medicines, Mercurius, Rhus
and Euphrasia will have been just as clearly indicated by
these successive changes, and just as imperatively required
as though the patient were regarded as having had four
successive diseases. Is it " alternation " to give these
remedies successively just as they become clearly indicated ?
We think it is not, but some say it is. We are sure it is
sound practice.

2. Dr. Quin, of London,1 calls the method of prescribing
successive remedies in a case as the changes of symptoms
may require them, "alternation a posteriori" and sanctions
and defends it. But he reprobates, under the name of
"alternation a priori" the practice which, it seems to us, is
the only one which can properly be called " alternation,"
viz. :

" Prescribing at the very outset of the treatment — at the very first visit and
also, not unfrequently, almost at every subsequent visit, two or more medicines,
to be alternated every quarter, half hour, or every two, three, or four hours.
It is difficult to believe," he continues, " that such practitioners are in the habit
of carefully considering the cases under treatment, or have well studied their
Materia Medica, or to divest one's self of the idea that they resort to such slip-
shod practice in the hope that if one of the medicines does not hit off the
complaint, some one of the others may. One meets with instructions for
similar alternation laid down in popular books on Homoeopathy, showing that
this a priori style of alternating remedies is, with certain practitioners, more a
rule than an exception."

3. Dr. Drysdale defines alternation to be "the giving a
second medicine while the sphere of action of the first is still
unexhausted." But Dr. Drysdale, while advocating alter-
nation, in this sense, in certain specified cases, does not
propose to give his second medicine except after a careful

1 Annual Address, Annals of British Homoeopathic Sodety.

ALTERNATION OF REMEDIES. NO. 2. 177

re-examination of the symptoms of the patient, and a com-
parison of them with the Materia Medica. It is clear, then,
that alternation as he defines and defends it, is not the same
thing as the alternation a priori which Dr. Quin reprobates,
and to which we would restrict the term. Dr. Drysdale's
definition seems to us very vague and impracticable. How
are we to know when the sphere of action of the medicine
is exhausted ? By inferences from the proving ? But
we have reason to believe that the speed at which vital
processes go on in sickness may be very different from that
during a physiological proving. Reduced to a practical
rule, Dr. Drysdale's reasoning would amount to this : If, on
our second visit, symptoms shall be found to have arisen
which seem to call for the second medicine, we should
suspend the first and give the second, and then, if, at the
third visit, the symptoms be found to have changed again,
so as to call again for the first medicine, we should give it.
But this, he says, is "alternation." With certain qualifica-
tions we agree to his rule of practice, but we object to the
name he gives it. And here names are important. It is of
great consequence to avoid giving to two radically different
procedures one and the same name.

Now, what do we mean by "alternation?" Let us give
a practical answer. . We have before us a prescription label
filled up by Dr. John Doe. It reads thus :

"No. i, Aeon.3; No. 2, Bellad.6; of each, twelve pow-
ders. Take the powders alternately as numbered, every
four hours."

We have another paper containing directions prepared by
Dr. Busy, for a chronic patient :

"Take as follows: Mercurius hydriod., first decimal tritu-
ration, every night for seven nights;

"Then Sulphur3, every night for seven nights;

"Then Collinsonia1, every night for seven nights;
13

178 ALTERNATION OF REMEDIES. NO. 2.

" Then Podophyllum pelt.2, every night for seven nights ;
"Then Ignatia3 and China1, alternately every night and
morning, for seven days ;

"Then Aurum met.1, every night for seven nights;
"Then Pulsatilla1, every night for seven nights;
"Then Phytolacca dec.1, every night for seven nights."

We object to these, and to all kindred procedures, that
they rest on hypotheses which are not warranted by the
present possibilities of science. Dr. John Doe's first pre-
scription of Aconite may be all right; the symptoms
probably call for it. But the physician cannot know in
advance that, in four hours, the symptoms will have so
changed that, if he were present, he would perceive Bella-
donna to be indicated ; and that, in four hours later, Aconite
will be indicated again ; and that the symptoms will go on,
oscillating between these two series of indications, each
oscillation consuming just four hours.

And " Dr. Busy," by what wonderful gift could he foresee
that seven days of Mercurius hydrargyrum would bring his
patient to a state requiring Sulphur, and seven days of
Sulphur to a state requiring Collinsonia (whatever that state
may be), and seven days of Collinsonia to a state calling for
Podophyllum (and for just seven days of it too), and seven
days of Podophyllum to a state of complex misery that calls
for China and Ignatia in alternation (for just seven days
likewise) and so on to the end of this long chapter !

" Oh, wad some power that giftie gie us! "

These instances, and the comments upon them, comprise
our definition of "alternation," and our objection to it. It
is a practice very prevalent in the United States and in
England. It is exceptional in Germany, France, Spain and
Italy.

The principles which govern the selection and administra-
tion of homoeopathic remedies are very simple.

ALTERNATION OF REMEDIES. NO. 2. 179

The great law, SIMILIA SIMILIBUS CURANTUR, teaches
us to select a remedy the characteristic pathogenetic symp-
toms of which are very similar to those of the patient.
This is a grand generalization, supported by a multitude of
facts. We accept it. It takes no heed of names of diseases,
nor of pathological theories of the seat and origin of diseases.
Giving a broad and liberal signification to the word " symp-
tom," so as to include everything abnormal about the
patient, whether it be historical or actual, this law pays
regard to the symptoms alone. It requires that the symp-
toms shall be collected and compared with the Materia
Medica every time a prescription is made, and that the drug
that has produced symptoms most similar to those of the
patient shall be chosen and given. This is a true homoeo-
pathic prescription. No matter how often during the sick-
ness of a patient this process be repeated ; no matter how
many remedies be given in succession ; no matter if the
first remedy be recurred to after the second and the second
after the first — if each prescription have been the fruit of a
special collection of symptoms and comparison of them with
the Materia Medica — call it "alternation" or by whatever
other wrong name you please, it is a sound and defensible
homoeopathic prescription, such as Hahnemann taught and
practiced, and his followers adopted.

But the physician sometimes leaves a second remedy to
be substituted for the first under certain specified contingen-
cies. Is this alternation ? By no means. In so doing, he
makes the attendant his deputy, and describes the series of
symptoms which, in his judgment, will be an indication that
another remedy is required. He is merely instructing and
empowering another person to make, in his stead, the study
and selection of a remedy which should precede and be the
basis of every new prescription.

And wherever, in his writings, Hahnemann has seemed
to authorize or sanction alternation, his directions have been
of this character. He has mentioned that a certain group

180 ALTERNATION OF REMEDIES. NO. 2.

of remedies is likely to be indicated in a certain disease, and
although he has sometimes used the word " alternate "
(abwechseln), yet, in every case, he has specified the
particular symptoms, or groups of symptoms, which would
specially indicate and authorize the preference to be given
to one or another remedy of these groups.

In a previous paper1 we showed this to be true of
Hahnemann's directions for the use of Spongia, Hepar and
Aconite in croup, and also for Bryonia and Rhus in typhoid
fever. The same is true of his directions touching cholera.

The London Homoeopathic Review ~ says : " Those who
combat ' Alternation ' on the ground that it is opposed to
the practice of Hahnemann, fall into a grave error. In the
introduction to Belladonna in his Materia Medica Pura, he
advises the alternation of Aconite and Coffea cruda in purple
rash, in these words : ' Aconite and Coffea should be alter-
nately given every twelve, sixteen or twenty-four hours, in
proportion as one or other remedy is indicated.' '

It is true that the above words are contained in the intro-
duction to Belladonna, but they are not all the words con-
tained in the sentence from which they are quoted. This
sentence, complete, is as follows: "There (in the purple rash)
Belladonna, naturally, does no good, and the other, common,
charlatan treatment must also allow the most of the patients
to die of it, whereas they might all be cured by the alternate
use of Aconite and of the tincture of Coffea cruda, the
former for the heat and the increasing restlessness and
agonizing anxiety, the latter for over-excessive pains with a
lachrymose humor ; the Aconite in the 3Oth dilution of the
juice and the tincture of Coffea cruda in the 3d dilution,
both in the dose of the smallest part of a drop, the one or
the other every twelve, sixteen or twenty-four hours, accord-
ing as the one or the other is indicated." The two groups of
symptoms which Hahnemann gives as indications, respect-

1 American Homoeopathic Revinv, * Vol. ix., p. 432.

April, 1863.

ALTERNATION OF REMEDIES. NO. 2. igl

ively, for the one or the other of these remedies, are omitted
by the London Review. They are the essence of the whole
matter. Following this advice of Hahnemann, it would not
be possible for the practitioner, on meeting a case of purple
rash, to begin with a blind a priori alternation of Aconite
and Coffea. On the contrary, as we understand Hahne-
mann's direction, he should examine his case to see whether
it presented the groups of symptoms " heat, increasing rest-
lessness and agonizing anxiety," in which case he would
give Aconite; or whether the characteristics of the case
were " over-excessive pains with a lachrymose humor," in
which case he would give Coffea. Suppose at his next visit,
twelve, sixteen or twenty-four hours after, he should find, as
might well happen, that the group of symptoms first
observed had disappeared and had given place to the other
group, he would, for this reason, change his remedy. Or, if
he lived at a distance from the patient, he might make the
nurse his deputy, and, instructing this deputy as to the
distinction between the groups of symptoms, might direct
her (as Hahnemann has directed us) to make changes in the
remedies when corresponding changes in the symptoms
should call for them. In this way there would be no
assumption and no a priori "alternation." The practice
would be sound, fulfilling the conditions of a sound prescrip-
tion, viz. : that each prescription be preceded by a fresh
collection of the symptoms of the case, and comparison of
them with the Materia Medica.

Is it suggested that Hahnemann meant to intimate that
these groups of symptoms might co-exist in the patient at
the same time and might make a "totality of symptoms"
that would require these two remedies to cover it ? But
these groups are pathologically incompatible. No one con-
versant with the phenomena of sickness could conceive of a
patient presenting, at one and the same time, " heat, increas-
ing restlessness and agonizing anxiety," and likewise over-
sensibility to pain and a disposition to weep and despond. No !

1 82 ALTERNATION OF REMEDIES. NO. 2.

patients in a waxing fever often swear ; but they seldom pine
and weep ; they feel general anguish but make light of specific
pains. But when the fever has waned, there often succeeds
it a stage of over-sensibility and of proneness to weep ; and
this succession may be repeated again and again, and we sup-
pose Hahnemann recommended these remedies to corre-
pond to this succession. We cannot comprehend his words
in the sense attached to them by the London Review. In
the signification in which we have understood them, they
correspond precisely to all of his other directions, which
have been quoted as favoring "alternation."

But, now, suppose it conceded that, while Hahnemann's
practical deductions from scientific principles were opposed to
" alternation," his practice sanctioned it. Is the argument
from his practice all powerful against his principles? This
reminds us of what the Chairman of the British Society calls
Dr. Drysdale's Socratic irony " — you all object to alternation,
and, yet, you all alternate." We have seen that Dr. Drys-
dale's definition of alternation is such as to cover almost
every actual case of treatment and is different from that of
every other writer. But, the argument from the universality
of a practice, in favor of its propriety, is a dangerous one to
play with. Place it in the mouth of a theologian and see
how it reads : You all condemn sin, and yet, you are all
sinners!"

Does the weight of this argument lie on the side of sin
or on the side of the condemnation of sin ! Does propriety
necessarily follow from universality ? Are the majority
always right, just because they are the majority ? If so, all
hail, Allopathy !

The conditions of a true and defensible homoeopathic pre-
scription require, in our opinion, that the symptoms of the
patient, at the time of prescribing, shall be collected and
compared with the provings in the Materia Medica, and that
the drug whose symptoms correspond most closely with
those of the patient shall be selected. Perhaps no Homceo-

ALTERNATION OF REMEDIES. NO. 2. 183

pathician would object to this statement. But let us see
what it requires.

First. It requires that before every prescription, the
symptoms of the patient shall be studied anew. In some
way or other, whether it be done by the physician or by a
provisional deputy specially instructed for the case (as we
have explained that the nurse may be), more or less perfectly,
this must be done. We have seen that in the ordinary
method of alternation (a priori) this is not attempted to be
done and cannot be done ; it is not proposed to do it.

Second. It requires that the aggregate of the symptoms
presented by the patient be regarded as one malady, for
which an analogue is to be found in the Materia Medica.
We have no authority in science for arbitrarily dividing this
aggregate °f symptoms into groups, for each of which we
are to find an analogue in the Materia Medica, and then
giving these analogues, in combination, or in alternation.
This requirement is perhaps the most difficult of all to fulfill.
In collecting the symptoms, our utmost sharpness of insight
and our deepest and most extensive learning in every de-
partment of physiological, psychological and pathological
science will be tasked to construct, from the patient's history
and from his present condition, a complete picture of the
morbid phenomena which he presents, from which the
physiological idiosyncrasies of his peculiar temperament and
personality shall all have been eliminated, and in which his
symptoms shall be duly arranged with regard to their mutual
relations and dependencies. Then, furthermore, inasmuch
as we cannot hope to find, in the proving of any drug, a
duplicate symptom for every symptom of the patient, the
rarest judgment and most extensive knowledge of semeiology
are required to analyze the patient's symptoms and to detect
those which are truly characteristic of that individual case,
and for which an analogue must be found in the proving ;
and to set these characteristics apart from the other
symptoms, the analogue of which it may be less impera-

1 84 ALTERNATION OF REMEDIES. NO. 2.

tively necessary to discover. It is here, undoubtedly, that
the greatest knowledge and ability are required of the
physician and here that failures are most frequently made.
It is, probably, from failures in this analysis of symptoms,
that the supposed necessity of alternation most frequently
arises.

Third. It requires that a drug shall be selected which
has produced on the healthy subject, symptoms very similar
to those of the patient. The substance given must have
been proved in the same form (not necessarily the same dose)
as that in which it is proposed to be given. If Hepar sul-
phuris calcareum correspond to the case, this requirement is,
by no means, fulfilled if we give Sulphur and Calcareacarbonica
combined or alternated, on the ground that these substances
are the constituents of Hepar sulphuris calcareum. For,
this involves the assumption that the Sulphur and the
Calcarea carbonica have undergone no changes during the
process which made, out of them, that third substance —
Hepar sulphuris. No ! Hepar sulphuris was proved as such.
If we select it, for the reason that the symptoms which it
produced correspond to those of the patient, then we must
give Hepar sulphuris, the very substance that was proved.
Otherwise we plunge into a sea of speculation and hy-
pothesis and forfeit that certainty which it was the sole
object of our science (as of every science) to attain. In like
manner, if the Iodide of Mercury had been proved on the
healthy subject and its symptoms were most similar to those
of our patient, it would not be a compliance with the
demands of our science should we give, instead of Iodide of
Mercury the very substance that produced these symptoms,
the Mercurius vivus and the tincture of Iodine, assuming
that, because Iodide of Mercury is a compound of these two
substances, therefore the conjoined or alternate action of the
elements from whose union it sprang must be identical with
its own. From instances like these, it is clearly to be seen
that we may not, consistently with the principles of our

ALTERNATION OF REMEDIES. NO. 2. 185

science, prescribe drugs in any other form or combination
than that in which they were proved. If drugs had been
proved in alternation, we might then with propriety, perhaps,
prescribe them in alternation. Until this is done, the method
is a hap-hazard, chance operation — successful, no doubt, at
times, but in such a way that success could never be fore-
seen or insured, nor could the experience of the practitioner
in any way serve to establish or confirm any principle of
medical science.

A homoeopathic prescription, as we have denned it, is a
deduction from a generalization, which has been established
by induction from a multitude of instances. This is the law
SIMILIA SIMILIBUS CURANTUR, in accordance with which
the remedy is selected, under the three requirements that
we have specified. So well established is this law of
nature, that if we are so fortunate as to be able, in any given
case of disease, to comply closely with those requirements,
and particularly with the second, we may with certainty
predict, and in confidence await, the favorable result of our
prescriptions. Such certainty of foresight and such confi-
dence it is our great object to attain, and nothing but a
scientific method can afford them.

But we have shown that alternation, as we use the term,
and as we have described the process, is incompatible with
this scientific method. It does not meet the requirements
of the law. It does not 'take the aggregate of the symptoms
as the single basis of prescription. It does not give the
remedy, single and simple, such as it was used in the proving.
But it permits itself to act on two 'assumptions — that the
aggregate of the symptoms may be arbitrarily divided and
separately prescribed for ; and that two or more drugs which
have been proved independently of each other may be used
conjointly as a sort of composite analogue to the aggregate
of the symptoms ; and all this with equally good and sure
results. These two assumptions are not even alleged to be
based on any collection of facts. Their introduction

1 86 ALTERNATION OF REMEDIES. NO. 2.

deprives the proceeding of all claim to a strictly scientific
process

The advocates and defenders of alternation are naturally
divided into two classes. The one frankly disavow any
pretension that alternation is a scientific deduction from a
general principle, and defend it on the simple ground of
experience. They have alternated successfully in a case or
cases like the present, and therefore they do it again.

Now, obviously, with this class we cannot discuss the
question on scientific grounds. There is no reason in their
method, because there is in it no reference to general princi-
ple, to natural laws : it gives no means of foreseeing and
providing for future results ; it is the simplest form of literal
empiricism. We can do nothing more than show, as has
been done, its unreasonableness and the precarious and con-
tradictory and disappointing character of its results. We
can only point out how far it falls below the standard of
action to which practitioners of medicine should hold them-
selves, and how unworthy, in our judgment, such methods
are of reasoning and conscientious men.

The second class accept our definition of the requirements
of a sound prescription, and our statement 'of the obligation
of scientific men to abide by natural laws. But they claim
that alternation does not necessarily, as we have maintained,
contravene the requirements of such a prescription ; and
they claim that there are certain established principles in
accordance with which we may, with scientific accuracy,
determine when and how to alternate. This class defend
alternation "on principle." As the former class comprises
some of our most conscientious and estimable colleagues, so
does the latter embrace many of the most gifted and learned
of our school. Their opinions are worthy of the most
earnest and respectful consideration.

We have previously stated that some who defend alter-
nation on principle designate by that name methods which,
we think, ought not to be so called, and which we do not

ALTERNATION OF REMEDIES. NO. 2. 187

find fault with ; as, for example, Dr. Coxe ; likewise Dr.
Drysdale, in so far as his definition is concerned. Their
methods do not always, of necessity, conflict with the require-
ments of a sound prescription. There are still other pro-
cedures, called " alternation," but which are not always
necessarily liable to the objections urged against " alter-
nation," properly so called, as we have defined it (a priori).

The occurrence of complications, and especially of trau-
matic complications, such as a burn of the hand, during the
course of a pneumonia — a contused vulva simultaneously
with a milk fever, are mentioned by Dr. Drysdale, as
instances which may require alternation ; as, for example,
Urtica urens to the burned hand, while Phosphorus is being
given internally for the pneumonia, and Arnica to the
vulva, while Aconite is given for the milk fever.

Now, of such cases as these it might perhaps be properly
said, that they do not come under the scope of our inquiry,
inasmuch as the burn and the contusion might be regarded
as purely local, and not at all constitutional affections, and
the respective applications might be viewed in the same
light, and as not capable, when thus used, of affecting the
general system, and of thus being, in fact, alternated with
the remedy which the patient is taking internally. But,
waiving this reply, we may say that the teaching of our
own experience is, that, in such cases as these, the best way
is to follow the one great rule which governs homeopathic
prescription ; after the occurrence of the complication, collect
and scrutinize the patient's symptoms anew. If the burn
shall have been so slight as to make no impression on t
general system, to produce no modification in the symptc
of the previously existing pneumonia, then there
reason for doubting that simple protection from the atn
pheric air will be all that is needed in the way of
for the burn.

If, on the other hand, the burn have been of a ser
character, so as to produce constitutional disturbance, it will

1 88 ALTERNATION OF REMEDIES. NO. 2.

assuredly have modified the symptoms of the pneumonia,
and we shall perhaps find, on taking the aggregate of
the symptoms again, that some other remedy than phos-
phorus is now indicated to meet the new state of things
resulting from the pneumonia and the shock of the burn
combined, and that this new remedy will meet both troubles.
For it must not be hastily assumed, as Dr. Drysdale seems
inclined to intimate, that Urtica urens locally applied is
always the best (or a good) remedy for burns. They are
often (at least) best treated, as Boenninghausen has shown,
by an internal remedy. Singularly enough, it once chanced
to myself to meet the complication which Dr. Drysdale here
supposes. The burn was severe, and the effect of the shock
so modified the symptoms of the pneumonia that the result-
ing aggregate of symptoms called unmistakably for Arseni-
cum, which was given with most gratifying results, as
regards both pneumonia and burn. The same may be said
of the application of Arnica to contused vulva. Indeed,
there is too great haste among us to recur to topical
applications.

The second " principle " upon which, according to Dr.
Drysdale, "the practice of alternation rests," is "the main-
taining the susceptibility." Dr. Drysdale says : " In disease
we generally find that the susceptibility to the homoeopathic
remedy is present from the nature of the case, and our great
object should be to manage the doses and repetitions so
that it shall not be exhausted before the natural period
essential for a cure. This unfortunately, however, not un-
frequently happens, in spite of varying the dilutions or
originally having chosen the best. In this case the plan has
been adopted of interposing doses of another remedy as
nearly as possible homoeopathic to the case. This must, of
course, be an antidote, but, as in the case of natural disease,
it may tend to revive the susceptibility to the first remedy.
* * * Without the use of occasional alternation and
intermediate remedies, we should be almost deprived of the

ALTERNATION OF REMEDIES. NO. 2. 189

use of a large class of serviceable remedies in chronic disease,
such as Opium in constipation, Lobelia, Lactuca, etc., in
asthma, Coffea and Aconite in neuralgia, etc."

This question of the propriety of alternating for the pur-
pose of reviving the exhausted susceptibility may be treated
in much the same way as the question of alternating to meet
complications. When we have a case under treatment, we
shall not be led to suspect an exhaustion of susceptibility,
except by a change in the symptoms. Now, if the
symptoms have changed, this very change furnishes us the
basis for a new prescription. Why shall we not at once
proceed, in accordance with the great rule of our art, to
select a new remedy corresponding with these changed
symptoms ? Why should we prefer, to this certain method,
the pathological hypothesis that the susceptibility to a rem-
edy which we have assumed to be suited to the disease has
become exhausted and needs a stimulant ? This hypothesis
may be correct, but can never be a certain basis for practice.

But let us take an example : Cases of dysentery not unfre-
quently occur in which Nux vomica or Mercurius seemed in
the beginning to be very clearly indicated. The patient im-
proves for a few days under the use of one of these remedies,
and then ceases to improve. On a careful scrutiny of the
case it appears that the prominent characteristic symptoms
(most of them subjective, of course) have disappeared or be-
come obscure. Even the evacuations have ceased to be
characteristic of any remedy. The entire system is dull,
languid, unimpressible. In such a case as this, we are told
that the susceptibility of the patient has become exhausted;
that a few doses of Opium will arouse it so that it will again
respond to the appropriate remedy, and will be cured.

As a matter of fact we know this treatment does succeed
in many cases, but the rationale of the process is by no
means satisfactory to us. And this is not a solitary instance
of a successful practice following, through good luck, from a
very faulty theory. If we analyze the case described we

190 ALTERNATION OF REMEDIES. NO. 2.

shall find, that when the patient ceases to improve under the
Nux or the Mercurius which was first given, his symptoms
changed in such a way that their totality furnished a satisfac-
tory indication for Opium, and a capable prescriber would
accordingly have selected Opium and cured his case, even
though the notion of " exhausted susceptibility " had never
entered his head. Simple adherence to the great principle
of homoeopathic prescribing, viz., that each prescription is to
be founded on a new collection of the symptoms and a new
comparison of them with the Materia Medica, leads to suc-
cess in all such cases, without the intervention of any patho-
logical hypothesis whatever ; at the same time it excludes all
danger of appearing to sanction the bad habit of alternation.
As regards the use of Opium for constipation in chronic
diseases, and Coffea in neuralgia, these being used as inter-
mediate or alternated remedies, they, like topical applica-
tions in traumatic complications, are much abused, and often
altogether needless if not hurtful. A single example will
illustrate this point : A patient, not long ago, while under a
friend's treatment came under my observation. Her symp-
toms corresponded exceedingly well with those of Conium
maculatum. It was a chronic disease of long standing.
She had troublesome constipation, which was sometimes so
bad that it seemed to completely neutralize the good effect
which Conium was evidently producing. A dose or two of
Opium1"50 would relieve the constipation, and the patient
would seem for a while to improve again under the Conium.
This might be called an illustration of what Dr. Drysdale
refers to as the necessity for alternated or intermediate
remedies in either "complications of chronic diseases," or
"exhausted susceptibility." It was not, however, satisfac-
tory to my friend, nor to myself. He could not regard the
regularly recurring constipation as a foreign complication.
Believing in the unity of disease, he looked upon it as an
integral portion of that patient's sickness and did not rest
contented until he had found a single remedy which covered

ALTERNATION OF REMEDIES. NO. 2. 191

both the symptoms to which Conium corresponded and the
constipation besides. This remedy was Alumina, under
which the bowels became, and they have remained, perfectly
regular. The patient's improvement, in other respects, was
all that could be desired. In this case, as in most cases
narrated of cures by alternation, the Opium and Conium, in
alternation, seemed to work very well, and promised to
effect a cure in the fullness of time. I doubt not that if,
to all the other histories of cures by alternation, a sequel
could be written, it would be found that each of these cases
has, in the Materia Medica (actual or future), its own par-
ticular Alumina, which would effect a cure in as few days,
as the most sanguine alternate would expect to accomplish
it in months.

Having thus shown our belief that the alternation which
Dr. Drysdale defends, for the purposes of " meeting compli-
cations," and of "awakening susceptibility," is not alter-
nation a priori, not alternation properly so called, but is
compatible with sound doctrine, although explained by the
use of unsound pathological hypotheses, we shall pass, next,
to the two general principles on which alternation, properly
so called, is really based and defended.

Before proceeding further in the discussion of the subject
of Alternation, let us briefly recapitulate the positions
already taken.

I. We have assumed that the propriety of Alternation can
be argued about only by those who regard the practice of
medicine as an art based upon scientific principles, by refer-
ence to which it is to be regulated and exercised. We have
not considered it possible to discuss the question with those
who make their practice a series of repetitions of individual
experiences, without the intervention of general principles
based on and inferred from a large number of individual

instances.

No discussion can be sustained with this class of practi-
tioners, for the reason that argument involves, in its very

192 ALTERNATION OF REMEDIES. NO. 2.

nature, an appeal to principle and the exercise of reason.
When, consequently, an advocate of Alternation objects to
our condemnation of his method, that he regards the subject
from a practical point of view, while we persist in ignoring
the practical, and in looking only at the question as one of
science, we feel driven to the conclusion that, if excluded
from the ground of scientific principle, we have no ground
left on which to stand for the discussion of this or of any
question of medical practice ; and further than this we have
nothing to say.

2. We have stated our belief that many writers have
defended, under the name of ALTERNATION, modes of
practice which are, in our opinion, not properly called
Alternation, and which certainly are not open to the objec-
tions that we entertain to what we have defined as ALTER-
NATION, properly so called.

3. Defining Alternation, as we understand it, we have
taken occasion to state the requirements of a sound homoeo-
pathic prescription, requirements which cannot be met by
the process of Alternation.

We come now, in conclusion, to consider certain state-
ments of principles by which Alternation, as we define it,
has been sought to be justified and defended.

Dr. Coe ! states : " It is an established principle in Homoe-
opathy, demonstrated by drug-proving and clinical experi-
ence, that each drug has its own specific sphere and manner
of action, hence that each remedy acts in a particular
manner upon a particular organ or tissue, or upon a particu-
lar set of organs or tissues. Another recognized principle
in Homoeopathy is, that attenuated remedies act on the
system only by virtue of their homceopathicity to the disease
by which the system is at the time affected ; hence they are
inert when taken by persons in health." [One of our best
provings of Natrum muriaticum on the healthy was made
by Dr. Wurmb with the jot/i decimal dilution /] * *

1 American Homoeopathic Revieiu, vol. v., p. 447.

ALTERNATION OF REMEDIES. NO. 2. 193

" But, supposing I find no single remedy that will complete
the picture [corresponding to the picture of the disease] ;
some part is still defective — it either wants a head, a body,
or a limb, what am I to do ? What I do is this : I finish
out the picture with something that will complete it. If the
head symptoms are unmistakably Aconite symptoms, and
nothing else, the chest symptoms unmistakably Bryonia symp-
toms, and nothing else, and the symptoms of the lower limbs
unmistakably Rhus symptoms, and nothing else,1 1 can finish
my picture in no other way, nor can any one else. * *
But the single remedy objector says, one of my medicines
will modify the action of the other in such a manner that I
cannot rely upon their doing what their pathogenesis would
indicate. I think he is mistaken. If attenuated medicines
only act homceopathically, as we all hold, only act ^lpon
those organs and tissues which are affected by disease in a
manner similar to the drug affection, then my Aconite,
Bryonia and Rhus each goes to its own place, and performs
its own office, without interfering or being interfered with
by the others."

Dr. Drysdale appears to agree with Dr. Coe, for he says :2
" There are, therefore, no a priori physiological grounds for
doubting that two medicines, whose physiological spheres
are sufficiently dissimilar, can display their effects without
interference, when given at intervals. Let us apply this to
the treatment of complications in disease, and by this we may
chiefly understand those symptoms or morbid states that are
not necessarily dependent on one common proximate cause,
but are connected merely by their happening to co-exist
in the same individual." [We protest against this cool

1 Humane capiti cervicem pictor equinam
Jungere si velit, et varias inducere plumas
Undique collatis membris, ut turpiter atrum
Desinat in piscem mulier formosa superne,
Spectatum admissi risum teneatis, amici ?

Horat. Epiit. ad Pisones.

* Annals of British Horn. Society, xvii., 375-
14

194 ALTERNATION OF REMEDIES. NO. 2.

assumption that two or more " morbid states may co-exist
in the same individual," connected merely by their acci-
dental co-existence ! ] " After exposure to cold we may be
attacked with inflammation of the nasal, tracheal or bronchial
mucous membrane, or parenchyma of the lungs or the pleura
or the parietes of the chest or the liver or peritoneum, etc.,
according to the specific susceptibility of the tissues attacked ;
and each of these diseases may exist separately, and be
attended with the appropriate essential and sympathetic
symptoms of the case. In such cases we ought properly to
rely on one medicine, which may be reasonably expected to
meet the specific susceptibility of the part primarily affected.
But, on the other hand, from exposure to the same cause,
inflammation may be set up in several of those tissues at the
same time, and thus several trains of morbid symptoms set
up that have no necessary [ would the author have better
expressed his real meaning if he had said, 'pathologico-ana-
tomical ? ' ] connection, except that of occurring in the same
individual. In that case, how can any one medicine be
homoeopathic to the case which does not show its specific
relation to all those different tissues in health ? *

" Dr. Gate also brings forward inflammation of the mucous
coat of the colon. When it extends to the peritoneal coat
of the gut, he gives Mercurius corrosivus in alternation with
Sulphur, corresponding to their specific action on their
(these) different tissues. Also in inflammation of the mem-
branes of the brain, threatening effusion, he finds Bryonia,
alternated with Hellebore, more efficacious than either
singly. But this is already recognized in Homoeopathy,
without stepping into the doubtful regions of pathology."

In discussing these statements we desire to use great mod-
eration of expression, conceding freely that they involve
questions of pathology and pathogenesy, of which our
knowledge is only, and perhaps can be only, proximative,
and concerning which, instead of absolute facts, we have
only probabilities.

ALTERNATION OF REMEDIES. NO. 2. 195

Among those who discuss questions of medical philoso-
phy may be distinguished two characters of mind, corre-
sponding to similar classes among intellectual philosophers —
the analytic and the synthetic.

The tendency of the one class is to divide an independent
group of phenomena, such as a sick man or a drug-proving
presents, into elements each one of which it inclines to
regard as independent of the others. To the researches of
this character of mind we owe our knowledge of Histology,
both physiological and pathological, and much else that is of
inestimable value in medical science. The same disposition
being carried into clinical investigation, the symptoms of the
sick man have been analyzed into the perversions of function
of the various organs, and the alterations of the different tis-
sues of the body, as well as the formation of tissues not
found in the healthy body. As a result, we have the precious
sciences of Pathology and Pathological Anatomy.

Based, as these analyses are, upon material changes of
structure and of product, the danger to which those who
engage in them are liable is this : that having their attention
exclusively directed to material changes, or to visible and
tangible results of material changes, they overlook two
points to which it is equally important that observations
should be directed.

ist. That inasmuch as healthy tissues exist, and healthy
functions are performed, by virtue of an imponderable force
called for lack of a better name, " vital force," and which
is inherent in each tissue, and gives to it its specific proper-
ties, there must have been a change in this force preceding
every material change.

2d. That this force, though it seem to impart to each tissue
and organ a susceptibility to stimulus peculiar to that tissue,
yet so pervades and vivifies the entire organism, as to give
rise to what is known as sympathy — a property of living
organisms, by virtue of which there results, from the serious
modification of any function or alteration of any tissue, a

196 ALTERNATION OF REMEDIES. NO. 2.

corresponding and definite modification of most if not all of
the functions of the body, and an alteration of at least many
of the tissues. It is by virtue of this property that each
individual man is a living unit, and not a collection of
independent monads, which merely chance to co-exist in
one human form.

No physical research can detect this vital force, nor reveal
the nature or modus operandi of this function of sympathy,
and hence it happens that those whose minds incline to rest
upon the data of physical analysis are prone to overlook
them, or, even though they admit them in their philosophy,
yet to practically ignore or underestimate them. From this
tendency results a disposition to regard the proximate cause
of disease — that is to say, the material change of tissue and
product — as the essence of the disease, forgetting the modifi-
cation of vital force, which must have preceded and been the
occasion of this proximate cause, — and a further disposition
to look upon the alteration of function and tissue of each
organ or system of the body as a separate disease, thus
easily admitting the idea of the co-existence of several
independent diseases and of complicating diseases without
number.

From the stand-point of this class of mind it is not easy to
perceive the mutual relations and interdependencies of appar-
ently remote groups of symptoms — such, for example, as
ulceration of the cervix uteri and chronic conjunctivitis,
which, if they co-exist in any patient, would be likely to be
regarded as independent diseases, and to be treated by
independent courses of medication ; whereas, in fact, they
are so intimately connected that they are best treated by a
single remedy.

Nothing is farther from our purpose than to make light of
Pathology, which, as an aid in the investigation of disease,
is of inestimable value. It is evident, however, that Hahne-
mann was right in warning his disciples against making it
the basis of medical practice. Its investigations cannot, in

ALTERNATION OF REMEDIES. NO. 2. 197

the nature of things, go beyond material changes. Yet dis-
ease begins in dynamic changes ; and the connections of
different groups of symptoms are dynamic, and beyond the
reach of physical research.

And then, even where the subject is material and amen-
able to physical research, to base the prescription upon a
determination of the organ or tissue affected by the drug
and by the disease, is to go backward from the certainty
afforded by a comparison of the symptoms to the uncertainty
of a double hypothesis. For, as in the cases supposed by Dr.
Drysdale, we have first to assume that the symptoms pro-
duced on the healthy subject by Mercurius corrosivus and
by Sulphur respectively, show that the one of these drugs
acts especially on the mucous membrane of the colon, and
the other on the serous covering of it ; and, secondly, we
must assume that, in the patient before us, the inflammation
which began in the mucous membrane has extended to the
serous membrane ; and on this double assumption our
alternation is to be based and defended. Suppose, that in
its progress from within outward, the disease also affected
the muscular coat — should we give Nux vomica also ? Or
the glands likewise — shall we give a fourth remedy, say,
Rhus ? Then the vascular system of the gut is probably
simultaneously affected — would this call for Hamamelis, or for
Aconite for the arteries and Hamamelis for the veins ? Here
we should have six remedies to be alternated, the selection
of each being based upon its "specific relation to the tissue"
affected, etc., etc. Now, what is all this but a revival of the
old method, against which Hahnemann so earnestly pro-
tested, of prescribing upon the basis of an hypothesis of the
nature' and seat of the disease— an utter throwing overboard
of the whole system of Inductive Philosophy, as so logically
and so successfully applied to medical practice by Hahne-
mann ?

It may be worth our while to dwell for a few moments
longer on this very important branch of the subject, for it is

198 ALTERNATION OF REMEDIES. NO. 2.

a point on which very many practitioners have gone astray.
Indeed, we have seen an attempt to reconstruct our entire
Materia Medica Pura, on the basis of the specific action of
the drugs respectively upon certain organs and tissues of
the body — almost all symptoms not anatomically expli-
cable being excluded (the so-called " American Materia
Medica").

The statement of a " general principle," which we quoted,
viz., " It is an established principle in Homoeopathy, demon-
strated by drug-proving and clinical experience, that each
drug has its own specific sphere and manner of action,
hence (\] that each remedy acts in a particular manner upon
a particular organ or tissue, or upon a particular set of organs
or tissues," contains, it seems to us, a fallacy. While we
admit, of course, that each drug has its own specific sphere
and manner of action, it does not seem to us that this is
equivalent to saying that each drug acts in its peculiar way
on "a particular organ or tissue, or a particular set of organs
and tissues," leaving — (for this is implied in the statement,
as the rest of the article from which we quote shows) — leav-
ing the other organs and tissues of the body wholly
tinaffected by the action of the drug or disease, as the case
may be. Yet it is necessary to assume this fallacy, in order
to justify the practice of alternation.

On the contrary, we have never met with, and we do not
believe in the possible existence of, a case of sickness in
which, as adduced by Dr. Coe, the head could be affected in
one way, so as to unmistakably call for Aconite, and yet no
organ of the body show Aconite symptoms ; while at the
same time the chest presented exclusively Bryonia symp-
toms, and the extremities Rhus symptoms. The uniform
tendency of our own practical experience goes to satisfy us
that, if any concrete case should present clear characteristic
Aconite symptoms in any portion of the body, then not only
would symptoms of disease be found in most of the other
important organs or systems, but that these systems would

ALTERNATION OF REMEDIES. NO. 2. 199

present more or less well defined characteristics of Aconite :
or even should they not present characteristics which we
recognize as those of Aconite, the symptoms would never-
theless speedily disappear under the use of Aconite, if that
drug were clearly indicated by characteristic symptoms in
the other organs. So abundantly has our experience con-
firmed this view, that if we find clear characteristics of any
drug in the symptoms of any organ of the body, no matter
what symptoms may be presented by other parts of the
body, and no matter how little these latter symptoms may
seem to indicate this same drug, we never dream of alterna-
ting remedies. We are confident that a remedy which is
clearly indicated by characteristic symptoms, though they be
but few in number, will cover the whole case, and will
remove the entire disease. Nor do we, as is assumed by the
alternators, expect to accomplish by "succession" what they
aim to effect by Alternation. We so thoroughly believe in
the unity of disease as to be confident, that, in however
many organs and tissues morbid symptoms may present
themselves, they still spring from and depend upon one and
the same unknown and inscrutable cause, just as the multifari-
ous symptoms of a drug-proving depend upon the one cause,
viz., the drug; and that though the characteristic symptoms
which furnish the indication for the remedy may be observed
only in the symptoms of one organ or system, yet the symp-
toms of all the rest of the body will be equally controlled by
the action of this remedy. It is remarkable, however, to
how great an extent, if we observe carefully and intelligently,
we may recognize, in the various groups of symptoms affect-
ing the various organs of the patient, the characteristic mode
of action, and the conditions of that remedy, the characteris-
tic indications for which we find in some one organ alone of
the patient !

The tendency of the second of the classes of minds into
which we divided medical philosophy is to synthesis. They
are, perhaps, in danger of underestimating those material

200 ALTERNATION OF REMEDIES. NO. 2.

changes of tissue which are the proximate cause of disease,
because they are intent upon observing and tracing out that
perversion of the vital force which must have preceded and
induced all the organic and material changes which the case
presents, and which perversion they regard as essentially the
disease itself. They study this perversion in its various
manifestations, viz., the symptoms. They do not seek to
analyze these groups of symptoms, for the purpose of form-
ing a theory respecting the tissues affected, so as to select a
remedy which affects, as they suppose, identical tissues, and
in the same way. They do not thus admit hypothesis into
their method. They study the groups of symptoms to get
at their peculiarities and conditions. Profoundly impressed
with the intimate connection of all parts of the body, through
the all-pervading Vital Force (whatever it may be), and with
the fact, observed every day, that change of function in one
part of the body speedily brings about corresponding changes
in almost every other part, they seek, by the light of one
group of symptoms, to find in the patient other and corre-
sponding groups. In these investigations Physiology and
Pathology, which teach the relations and mutual dependen-
cies of different organs, are of inestimable value, enabling the
student to find in remote organs parallel groups of symp-
toms; the characteristic which determines his choice of a
remedy being often in an organ very remote from that to
which his attention was first called as being the seat of
disease. Having thus been led, by his philosophy, to collect
the various groups of symptoms presented by the entire
body, as constituting one single disease, the practitioner
surveys this collection in search of the characteristic symp-
tom, or group of symptoms which shall point to his remedy.
Ninety of the symptoms might be found among many reme-
dies, ten perhaps may be peculiar to, and characteristic of, a
single drug. This he selects, without hesitation, as his
remedy for the entire malady of that patient.

Suppose the patient to have taken cold, and to present,

ALTERNATION OF REMEDIES. NO. 2. 2OI

in consequence, a malady which, anatomically, is made up
of a pneumonia and hepatitis. It is all well enough, and
doubtless important for the purposes of diagnosis and prog-
nosis, to make this pathologico-anatomical analysis of the
case. But when we come to regard the case from the
stand-point of Therapeutics, we are not surely to follow the
plan which Dr. Drysdale seems to sanction, viz., to look
among the drugs which are shown by provings to act on the
tissues of the lung, and select the best from among them,
and then to look among remedies which act on the tissues
of the liver, and select the best from among these remedies,
and to alternate the two thus selected. What if, as would
be likely in such a case, the pleura, likewise, were inflamed ?
Should we have a third remedy? Or the kidneys also?
Should we have a fourth ? "Quousque tandem - "

On the contrary, we should collect the various groups of
symptoms, as well those from which the Pathologist infers
that the tissue of the lung is affected, as those from which he
infers that the tissue of the liver is affected. All other
symptoms likewise would be gathered. We should examine
these symptoms, in the manner so often described, for the
purpose of finding in them the peculiar characteristics of
some particular drug. In thus dealing with the case, we
should have this advantage over the Pathologist, that whereas
his inferences may lead him astray, since the lung tissue
may not be affected as he thinks it is— and likewise the
tissue of the liver — we, on the other hand, taking into
account only the obvious symptoms, avoid at least one very
patent source of fallacy. Our own experience has alto-
gether misled us if we do not find, in the case supposed,
that if the lung symptoms give us characteristic indications
for a remedy, the liver symptoms not only will not contradict
this indication by affording one for some other remedy, but
they will corroborate the indication, so as to give us no pre-
text for alternating.

But another case is supposed, viz., that a pneumonia i

lr K '

202 ALTERNATION OF REMEDIES. NO. 2.

present, and a remedy has been well selected for it, and now
a hepatitis supervenes to complicate the case. Here, we
are told, is a new disease, which can have nothing to do
with the previously existing pneumonia, and which must
require a distinct treatment, in the way of alternation. This
is in no way different from the complication of a burn, of
which we have already spoken. If the complication is
serious enough to produce constitutional symptoms (as a
hepatitis would surely be), it would always (or our observa-
tion has uniformly deceived us) modify all existing symp-
toms. For example, a severe burn would give a typhoid
character to an existing pneumonia. We must then make a
new collection of the symptoms, and proceed as before to
select a remedy.

Under any other plan — if we are to select our remedy
according to correspondence of known drug-action and
disease-action upon the tissues of the body — not only are
we liable to errors already pointed out, but our scope is
wonderfully restricted. How could we find remedies for
changes of structure, such as we can never expect to see in
drug-provings, such as cancer and heterologous growths of
all kinds ? How, for affections which do not depend on or
involve any definite known change of tissue, as intermittent
fever, epilepsy, hysteria, and the host of chronic ailments ?

The two principles on which alternation has been sought
to be defended have been stated as follows :

ist. "Each drug has its own specific sphere and manner
of action ; hence that remedy acts in a particular manner
upon a particular organ or tissue, or upon a particular set
of organs or tissues."

2d. " Attenuated remedies act upon the system only by
virtue of their homceopathicity to the disease by which the
system is at the time affected."

The artificial disease intentionally produced by a drug,
and the natural disease which results from the usual morbific
predisposing and exciting causes may, for all purposes of

ALTERNATION OF REMEDIES. NO. 2. 203

argument, be regarded as identical. Principle No. I might,
therefore, with equal propriety, be expressed thus: "A
disease has its own specific sphere and manner of action;
hence that disease acts in a particular manner upon a
particular organ or tissue, or upon a particular set of organs
or tissues."

A corollary of this proposition is, that, inasmuch as the
drug and the disease respectively act in a particular manner
and upon particular organs or tissues, they leave other
organs and tissues of the body altogether unaffected, in their
normal state and performing their healthy functions, and
liable to be themselves attacked by some other disease,
which may affect them in its own particular manner, and
may run a simultaneous and independent course.

This is the argument for alternation which is constructed
upon these principles : a certain disease affects in a peculiar
way certain organs or tissues of the body, leaving the other
organs and tissues in the fulfillment of their normal functions.
Attenuated medicines may be administered to cure this
disease. Attenuated medicines " act only by their homoeo-
pathicity to the disease." "They are inert" so far as action
on the healthy organs or tissues is concerned. Homoeo-
pathic medicines act only where, says Dr. Drysdale, they
find that preternatural susceptibility to their action, which
inheres in organs or tissues diseased in a manner similar to
the morbid state which those drugs can produce on the
healthy.

These attenuated medicines then may be given for the
case we have supposed. They will act upon the diseased
organs and tissues, but will not affect the healthy ones at all.
Now, then, during the existence of this disease, which, as
stated, affects in a particular manner certain organs and
tissues, and leaves all the rest undisturbed, a second disease
may attack the individual (may we call one who may be
thus divided up an individual?) acting in some other par-
ticular manner, upon some other particular organ or tissue.

204 ALTERNATION OF REMEDIES. NO. 2.

To meet this new disease, co-existent with the original, it
is affirmed that a second remedy homoeopathic to it may be
administered simultaneously with the former remedy. Or
rather, since to administer it simultaneously might involve
the risk of the chemical reaction of the drugs, the remedies
may be alternated. It will not interfere with the former
remedy, because attenuated medicines act only by virtue of
their homceopathicity to the disease (to which they are
respectively homoeopathic). Thus each drug " will go to its
own place," like the respective members of a well- trained
coach team when the winding horn announces that the coach
is ready for the new relay !

Such is the argument for alternation succinctly, and, we
think it will be conceded, fairly, stated. In a former discus-
sion of this subject we showed that, assuming natural disease
and drug disease to be, for the purposes of this argument,
substantially the same thing, it was proving too imich to
demonstrate that two or more diseases co-existing in the
body could not and do not affect each other. This would
render a cure of a disease impossible ; for in the act of
curing we propose to cure a natural disease by creating in
the body a drug disease which shall annihilate the natural
disease, and shall, in that very act, be itself annihilated.
When a certain form of rheumatism exists in the body, we
give Bryonia, and our intention is that Bryonia shall so act
upon the body (producing, therefore, virtually, a Bryonia
disease) as to cause the disappearance of the rheumatism and
at the same time not to leave in its stead a Bryonia disease
nor any other disease. But if two diseases co-existing cannot
react upon and modify each other, how could a cure take
place ? The proposition is evidently too broad ; the argu-
ment proves too much.

Dr. Drysdale provides against this objection by limiting
the alleged possible independent co-existence of diseases, to
diseases which act in a dissimilar manner upon remote or
unrelated organs and tissues.

ALTERNATION OF REMEDIES. NO. 2. 2O5

According to this view, two diseases might co-exist and
not modify each other, if seated in organs distant from each
other or, which is equivalent, a natural disease may exist,
and a drug may be given which acts only upon organs
remote from those which are the seat of the disease, and (if
the doses be strong enough) may produce its peculiar drug
disease without at all affecting the natural disease which is
already present.

In other words, it is only diseases (whether natural or
drug diseases) which are homoeopathically related to each
other, that are incompatible and may not co-exist without
modifying each other.

Dr. Drysdale and several other physicians hold these
views, and appeal to their own observation and experience.
If we may be allowed to draw an inference from Dr. Drys-
dale's remarks,1 he believes that a hepatitis may supervene
upon an already active pneumonia, and that each may run an
independent course, and be treated independently by alter-
nated remedies, without modifying each other or blending
into one morbid state.

Our own experience has led us to very different conclu-
sions, and we have on our side the names of colleagues who,
not having deviated from the modes of practice observed by
Hahnemann's early disciples, do not feel compelled to
acknowledge and lament, as Dr. Drysdale does, that their
practice is "not proportionally so successful as was that of
Hahnemann's early followers.2

How can this direct contrariety of inferences from observa-
tion be explained ? We have altogether too profound a
respect for the observing and reasoning powers of our dis-
sentient friends, to set them a particle below our own ! There
must be an opposition in some of our methods of observa-
tion, or principles of inference. It will be found, we think,
in the fact that to the word "disease" we respectively attach

^Annals of British Horn. Sot., No. *New Repertory, Introduction.
17. P- 375-

206 ALTERNATION OF REMEDIES. NO. 2.

very different ideas. We mean by disease the aggregate of
those symptoms presented by the sick man, which are char-
acteristic of his particular deviation from a healthy state.
The colleagues from whom we differ speak of disease as
denoting a definite pathological and pathologico-anatomical
change of the functions and tissues of some definite organ
or system of organs.

In this latter view the patient might present evidence of
those pathological changes in the organs and functions of
respiration, to which the name pneumonia has been attached.
Here then is one disease, pneumonia.

He may also present evidences of those pathological
changes of function and tissue in the liver which give rise to
the name hepatitis. And here would be another, co-existent
disease, hepatitis ; and these two pathological and pathologi-
co-anatomical conditions might, we freely admit, from the
pathological and nosological stand-point, run their course to
resolution or to destruction without so modifying each other
as to coalesce or in any way blend or be confounded ; for the
lungs and the liver can never collide.

But, let it be borne in mind, we are discussing a question
of practical medicine and not one of pathology or of nosol-
ogy-
How would this case look from our stand-point? The
patient has, we suppose, dyspnoea, stitching pain in the
thorax, hard, dry cough from tickling behind the sternum,
scanty and occasionally bloody sputa — headache on the
vertex, and sharp fever. He is worse at night ; his pains are
much aggravated by motion, and are relieved by repose and
by warmth.

We have selected Bryonia for him — had previously diag-
nosticated pneumonia (physical signs aiding or confirming
our diagnosis). Now he gets, in the hepatic region, stick-
ing pains, fullness and tenderness ; he has bilious vomiting
and bitter taste. Aided again by physical signs, we diag-
nosticate hepatitis, complicating the pneumonia; but the

ALTERNATION OF REMEDIES. NO. 2. 2O/

symptoms still indicate Bryonia, and so we continue that
remedy.

But, we shall be asked, suppose the new symptoms do not
indicate Bryonia, but, on the contrary, some other drug, will
you not give that other drug for the liver and continue the
Bryonia for the pneumonia ?

To this we reply that in so far as our observation has
taught us, in such a case the supervening of these new
symptoms (of the liver, namely) will have so modified the
whole organism, including the diseased respiratory organs,
that Bryonia will no longer be indicated by any symptoms ;
but the aggregate of characteristic symptoms of the entire
sickness will now indicate some other remedy which will
apply to and will cover the whole morbid state of that
individual.

Here we are again at issue. Dr. Drysdale and his friends
appeal to certain observations which we will now briefly
discuss.

In the discussion which followed the reading of Dr. Drys-
dale's paper in the British Homoeopathic Society, Dr. Rus-
sell took the same ground as Dr. Drysdale. He said : " That
two morbid specific actions could occur simultaneously in
the human body, and each pursue its course without arrest-
ing or modifying the other, is a proposition entirely at
variance with the opinions of the old pathologists who
flourished before the time of Hahnemann. * * It is of
great importance to us to know whether this pathological
doctrine be in accordance with the larger experience and
observation to which we now have access."

We could hardly have two diseases more specifically
distinct than typhus and small-pox, yet, in the following
narrative, we have a description of the two running their
course, side by side, without either interfering with the
other." The case occurred in the London Fever Hospital,
and is quoted by Dr. Murchison.

Dr. Russell proceeded to say : " There are many instances

208 ALTERNATION OF REMEDIES. NO. 2.

of a similar kind on record, and we must frame our theories
so that they shall embrace this new category of cases.
Suppose we encounter a case, and there are such on record,
of a combination of scarlet fever and of typhus, how are we
to deal with it ? Are we to engage only one of the two
destroying agents, and let the other alone until the first be
entirely subdued ? If we believe it is impossible for two
medicinal actions to proceed part passu in the animal
economy, this is the rational course to pursue, and the one
recommended by Hahnemann ! " (This is an inexcusably
lax statement. Hahnemann nowhere ever recommended
that we should make only a part of the patient's ailment
the basis of our choice of a remedy ; he always strongly
insisted on our considering the " totality of the symptoms,"
and this would include both scarlet fever and typhus.)

But, if two entirely different natural morbid processes
can co-exist in the human body without the one affecting
the development of the other, what reason is there why there
may not be two artificial simultaneous series of morbid
phenomena, each equally independent of the other ? If
scarlet fever, or if small-pox, can each run its course, while
at the same time typhus is doing so likewise, why may not
Belladonna and Arsenicum each run their course when given
in alternation."1

In reference to this last question, we may ask, would Dr.
Russell expect to get pure symptoms of any drug if it were
proved simultaneously with another drug ; would he believe
that the two drug-diseases would run an independent, simul-
taneous course in a prover ? Would he practically believe
it by consenting to rely upon a materia medica pura made
up in this way ? Or, which is the same thing, would he
trust to a materia medica composed of the results of an
artificial (drug) disease running " an independent course
simultaneously" with "a natural disease?" In other
words, would he trust provings made on sick persons ?

1 Annals British Homoeopathic Society, xvii.,p. 399 et seq.

ALTERNATION OF REMEDIES. NO. 2. 209

We know he would not; for he is one of those who
reject or suspect the provings of many of our most val-
uable drugs, because symptoms observed on the sick are
included in the list, or because the provers were not
careful enough to exclude other morbific or toxic agents
while proving.

But this inconsistency aside, let us take notice that in
these remarks, and in this citation of a case of the co-exist-
ence of two diseases, Dr. Russell speaks altogether from the
stand-point of the pathologist and nosologist, and not at all
from that of the practical physician — the stand-point of
therapeutics. He thinks he has proved his case if he has
established, what nobody is disposed to deny, viz., that two
nosological abstractions, called by distinct names (to wit,
scarlet fever and typhus), may co -exist.

' Does he forget that nothing is more firmly established in
homoeopathic practice than that the " name " which we may
feel authorized to give to a sickness in no wise determines
our treatment of the sickness ? Because we call the sickness
typhus, we do not therefore, of necessity, give Arsenicum, or
scarlet fever Belladonna ! We may as often have to give
Arsenic in a case that we should call scarlet fever, and Bella-
donna in a typhus.

What, then, guides us in selecting a remedy? Nothing
save the aggregate of the characteristic symptoms. We
might divide and subdivide the symptoms and signs that the
sick man presents (including under the designation " symp-
toms and signs " everything that distinguishes that sick man
from himself when not sick) into a dozen nosological groups,
each having a distinct name, and yet the aggregate of these
symptoms might (and we think it always would) point to
one single remedy as corresponding to, and indicated by, the
entire morbid state of that sick man.

To prove his case by the argument and instances quoted,
Dr. Russell must show that the symptoms of the scarlet
fever and of the typhus, respectively, were incompatible in
15

210 ALTERNATION OF REMEDIES. NO. 2.

the case cited by him, and that they did not combine to
present the characteristics of one common remedy.

For this is the point of the whole discussion. No matter
how many of the pathological groups which are dignified by
the names of distinct diseases may co- exist in a patient, if
they be so blended and mutually modified as to indicate, in
the aggregate, one single remedy, there can be no call for
alternation,

Inasmuch as Dr. Russell rests his argument for alternation
on the possible and frequent co-existence of distinct, specific
forms of disease, it is incumbent on him to show that these
co- existent, distinct forms of disease do not, by their co-ex-
istence, modify each other and blend into one harmonious
aggregate of symptoms, the characteristic ones of which
may be covered by a single remedy. In our experience
this has always seemed to be the case, and we shall adduce.
other evidence to the same effect.

But before citing authorities, let us point out how far Dr.
Russell's argument, even allowing it full force, comes short
of being a defense of alternation, as it is actually practiced
here and in England ! Dr. Russell allows it where " two
distinct, specific forms of disease " co-exist, such as scarlet
fever or small-pox and typhus — a phenomenon that no
physician in ordinary family practice is likely to observe
more than once a week ! Yet how many times a day do a
majority of our colleagues alternate? It is safe to say that,
with very many, the giving a single remedy is the infrequent
exception! Their case is exactly met by the following
remarks of Dr. Russell, one of the champions of alternation:

"The objection usually urged against alternation is that
it leads to laxity of practice. True, if we give two medi-
cines instead of one and let the system take its choice, as
it were, to which it shall submit — if, in a given case, for
example, we find two medicines pretty nearly indicated, and,
instead of ourselves selecting the one and rejecting the other,
we toss them both in, trusting that the right one will act,

ALTERNATION OF REMEDIES. NO. 2. 211

and the other be a nonentity or negative quantity. No
ONE WHO DEALS CONSCIENTIOUSLY WITH HIMSELF WILL
DELIBERATELY APPROVE OF SO SIMPLE A METHOD OF
EVADING THE DIFFICULTY OF CHOICE."

A few instances and citations may serve to recall to the
minds of practitioners of medicine, the frequent instances
in which two varieties of disease, co-existing, modify each
other. A young person whose parents died of consumption,
and who has himself had abscesses of the cervical glands
and eruptions of the face and who takes cold readily — is
feeble and pale — who, in short, has scrofulosis and is a pre-
destined victim of consumption, gets an attack of enteritis
or of pneumonia. Is it not notorious that the joint action
and reaction upon each other, of this chronic scrofulosis and
the acute enteritis or pneumonia, will be such that instead
of the acute affections running the short and sharp course
which they would follow in a robust subject, they will almost
surely degenerate into tuberculosis of the mesenteric glands
with colliquative diarrhoea, and of the lungs, respectively?
And would any one dream of treating these acute affections
in such a subject just as they would treat them in a subject
otherwise and previously healthy?

But why not ? Because the previously existing disease
modified and (so far as symptoms are concerned) blended
with the acute attacks. No doubt one single remedy will
cover this blended case.

When a patient has suffered from paroxysms of intermit-
tent fever, and on the cessation of their regular recurrence
he is still sallow, feeble, dyspeptic and full of malaise, there
can be no question that he still suffers from the disease — the
result of marsh miasm. If now this patient get a pneumonia
or a neuralgia, here will be a second and a distinct and
dissimilar disease co-existing with the former. So different,
however, will be its course from what it would have been in
a patient not laboring under miasmatic disease, — so blended
will it be, from the beginning, with the latter, — that, though

212 ALTERNATION OF REMEDIES. NO. 2.

a wholly distinct " pathological form " of disease, it will
require the identical treatment of miasmatic disease and will
yield to nothing else. The same thing is eminently true of
syphilis in the system.

Bonchut says : J " Syphilis, herpetism, scrofula, the marsh-
miasmatic disease, etc., often appear under forms not
habitual. * * * We imagine that we are deal-
ing with acute or chronic inflammations, and we treat them
as such until, some day, changing our method, we see them
recover, one under Mercury, another under Sulphur, another
under Sulphate of quinine, another under Iodine, etc. Is
there anything stranger than those observations in marshy
countries, where pneumonia, fever, encephalo-meningitis,
are cured by Quinine rather than by blood-lettings and by
antiphlogistics ? "

Another instance of the modifying power of two morbid
influences co-operating on the same individual is furnished
by the fact that when an epidemic prevails not only are
almost all healthy persons, to some extent, affected by the
epidemic influence, but the maladies of all sick persons,
whatever their nature may be, are modified and- changed
into a greater or less conformity with the epidemic, what-
ever it may be.

Dr. David Hosack uses these words:2 "The fact stated
by Sydenham and other writers on epidemics, that the
prevailing disease swallows up all other disorders ; that is,
that during the prevalence of an epidemic plague, typhus,
dysentery or other diseases of this class, every indisposition
of a febrile sort readily assumes the character of the prevail-
ing disorder. We know this to be experienced in the
diseases of other countries, and we see it daily exemplified
in our own."

Homoeopathicians especially, since their observations are
finer and are less exposed to fallacy from drug-poisonings,

1 Pathologie Generale, p. 269. * Copland's Diet. Pratt. Med., 2,

404, note.

ALTERNATION OF REMEDIES. NO. 2. 213

have opportunity to make observations of this kind, and
they have often noticed how, at one season and under one
epidemic, a single drug or group of drugs corresponds to
the most diverse pathological forms of disease, while at other
seasons and under other epidemic influences, very different
groups of remedies are indicated by the same pathological
forms of disease.

And we believe that most Homceopathicians who have
dealt much with chronic cases, must have fallen in with
patients who labor under such a constitutional affection as
herpes or cancer, and which, under favorable circumstances,
is kept in a latent condition by the occasional use of some
clearly indicated remedy. If these patients get an acute
disease of whatever kind, this disease is almost sure to
present, at an early period, symptoms which indicate this
same remedy that suits their chronic malady. Does not
this argument a posteriori show that these two independent,
co-existent maladies blend and modify each other, at least in
the view of the therapeutist ?

The entire homoeopathic doctrine of chronic diseases, and
the use and necessity of so-called antipsoric remedies, are
based upon this same idea of the mutually modifying influ-
ence of two co-existent maladies.

Hahnemann says he found that in some persons acute
disorders did not yield promptly to remedies which seemed
indicated and which quickly cured them in others. On
examining closely he found these patients presented, in the
present or in the past, symptoms indicating their infection
by certain miasms which he reduced (whether rightly or not
is immaterial) to three miasms — psora, syphilis and sycosis.
He sought for remedies which would meet the indications of
these chronic miasms and the acute affections combined, and
this led him to prove and use the remedies known as the
antipsorics. Our success with those remedies might be taken
as another a posteriori proof of the blending of two co-exist-
ing diseases.

214 ALTERNATION OF REMEDIES. NO. 2.

Dr. Drysdale, apologizing for the practice of alternation,
says:

"We have not a few examples where the patient has,
through ignorance or design, unknown to us, taken large
doses of heterogeneous drugs, such as Quinine or Opium or
purgatives, and yet our higher dilutions have taken effect
notwithstanding. On this subject Trinks confirms Kampfer's
remark, that, in chronic diseases which have been long
treated with excessive doses of allopathic medicines, we often
find a great susceptibility to the action of homoeopathic
medicine."

Are these writers to be understood as maintaining that
chronic drug-poisonings, such as the mercurial, the sulphur,
the iodine, the quinine, the iron or the opium cachexy, do
not cause acute disease to be most difficult of cure ? The
contrary is notoriously the case, as the literature of phy-
sicians of every school abundantly shows. How can this be,
unless the artificial chronic disease, viz., the cachexy, blend
with, and modify, the supervening acute, natural disease !

These remarks might be extended to great length by mul-
tiplied instances. They suffice, however, to show distinctly
the practical conclusions to which, what we conceive to be
sound principles, as well as accurate observation, have led
us. With them we conclude what we have to say concerning
the alternation of remedies, taking our leave of the subject
in the spirit of Bishop Chillingworth's declaration :

" I will take no man's liberty of judgment from him ; nei-
ther shall any man take mine from me. I will think no man
the worse man, * * I will love no man the less for differ-
ing in opinion from me. And what measure I mete to others
I expect from them again."

EDITORIAL REMARKS ON ALTERNATION.1

I.

We publish with great pleasure articles which, like the
above, though they seem to favor a practice which we depre-
cate, are, nevertheless, honest expressions of the earnest
convictions of men of close observation and faithful study.

Nothing could be farther from our intention than to
undertake to dogmatize on this question, which we admit to
be an open question, and on which men of eminence enter-
tain opinions at variance with our own. It may be allowed
us, nevertheless, in all courtesy to our contributor, to
signify the points on which we take issue with him.

i. We assuredly do entertain the belief that "two or more
medicinal forces (or, we prefer to say "morbific forces")
cannot together act upon the economy without so modifying
each other that neither shall produce the effect it would if
only one were acting." This belief has prevailed among
medical men from the earliest ages. It is the foundation of
the practice of polypharmacy in all its varieties, from the
complex prescriptions of the seventeenth century to the
alternations of our own colleagues. For we hold, with Dr.
Sorge (by no means a Hahnemannian, let us add), that
" the practice of alternation, as it exists among homceopa-
thicians, is only another form of mixing remedies with the
intention of getting an effect compounded of the action
of the two or more drugs that are alternated."

We say, this belief is the foundation of polypharmacy.
The rationale of a compound prescription we take to be the
following: the drug which is regarded as the one chiefly

1 Suggested by a contribution by Dr. H. to the American Homoeopathic
Review, vol. v., February, 1865.

2l6 EDITORIAL REMARKS ON ALTERNATION.

indicated possesses, let us suppose, certain properties which
would be hurtful to the patient. Another drug is conjoined
with it for the purpose of antidoting those hurtful proper-
ties. Again, it lacks the power to produce certain effects
which are deemed desirable. Another drug is added to
supplement this deficiency, and so on; ad infinitum. This
entire procedure rests on the belief that these medicinal
forces will so modify each other in the economy that neither
shall produce the effect it would if only one were acting.

As an example, we mention calomel and opium, a very
familiar combination. Certainly the object of giving the
opium is that it may modify the action of the calomel, and
in a way which conforms to the known action of opium when
given alone.

If there were no reason to believe that " two or more
morbific forces (a drug is a morbific agent exciting a
morbific force) could not together act upon the economy,
without so modifying each other that neither shall produce
the effect it would if only one were acting," how could we
ever cure disease ? The morbific force which constitutes the
disease is acting upon the economy, and we bring to bear
upon the economy another morbific force, viz., a drug. Now,
if the latter be properly selected with reference to the former,
we know that these forces will so modify each other that, on
the one hand, the manifestations of disease will cease, and
on the other hand, the drug will not produce pathogenetic
symptoms as it would on the healthy subject. This state-
ment rests on the basis of such "facts" as our friend invokes.
On what other theory than the mutual modification of mor-
bific forces acting together upon the economy could it be
explained ?

On what other theory could we explain the action of
antidotes as homceopathicians understand and employ them ?
How else could we explain the action of Belladonna, in
large doses, in antidoting poisonous doses of morphine1 as

1 American Journal Medical Science, January, 1862.

EDITORIAL REMARKS ON ALTERNATION. 217

well as the mutual antidoting powers which allopaths have
recently discovered, many of the cerebro stimulants and
spinant alkaloids to possess ? How else, finally, could we
explain the efficacy claimed for the practice of alternation
in general and for certain instances of it in particular, such
as the cases related by Dr. H., and which we fully credit,
where Belladonna and Bryonia in alternation accomplished
what neither could do singly, and where Arsenic and China
in alternation cured a case which neither alone had cured ?
How else but by conceding that two or more medicinal
forces cannot act together upon the economy without so
• modifying each other, that neither shall produce the effect it
would if only one were acting ?

The fact that medicinal or morbific influences must be
avoided when we are engaged in proving drugs is universally
admitted ; even Dr. H. assented to it. But on what other
grounds than the belief already stated ?

That persons long accustomed to use tobacco or coffee are
not easily affected by drugs is accounted for, probably, by the
fact that long habit has, in so far as those persons are con-
cerned, caused tobacco or coffee to cease to be " medicinal
forces." Use has become "second nature." That in per-
sons not accustomed to the use of coffee, a dose of it will
modify the action of another morbific, or medicinal, force is
demonstrated by the effect of coffee antidoting opium, Nux
vomica, alcohol, as well as in neutralizing the beneficial
curative action of many drugs, as our clinical observations
often satisfy us that it does. The same statements apply to
tobacco.

2. We think we may then assume, as conceded, the fact
that " two or more medicinal forces cannot at the same time
act upon the human system, without mutual modification."
It is now asked, whether granting this modification, we may
not avail ourselves of it to derive, from the alternate use of
drugs which modify each other, good effects that we have
attained in no other way ? There can be no doubt of the

2l8 EDITORIAL REMARKS ON ALTERNATION.

possibility of this being done, no doubt that it has been
done with advantage; as, indeed, Dr. H. shows by two
instances.

But, in the present state of our science, it would be impos-
sible for any one to lay down rules for the selection of reme-
dies to be given in alternation, with the view of gaining any
desired modification of the action of each. Nor can we con-
ceive of the possibility of arriving at any such law. The
rule of the ancient polypharmacy, viz., to select remedies
according to the effects which they produce singly, and to
combine them with reference to the effect desired, does not
always work well in practice. For example, calomel and
opium produce a combined effect, which is clearly a modifi-
cation of the known action of each drug. But on the other
hand, the combined action of opium, ipecacuanha and the
sulphate of potash in Dover's powder is quite distinct and
different from that of either constituent alone, and is such
as could hardly be anticipated from what we know of these
constituents.

Arsenic and China produced a combined effect which
cured an ague that neither singly would cure. Now, if this
fact were to be taken as a guide in selecting a combination
for a case of uterine disease, for example, in which we were
at a loss to decide between Sepia and Pulsatilla, it might
lead us to alternate those two remedies. But it is not three
months since one of us took charge of a case in which this
alternation, on this very ground, had been employed, but the
patient had not recovered. We were led to the conclusion
that the Sepia was really the remedy indicated — that it did
good, but that its effects were constantly antidoted by the
Pulsatilla. We omitted the Pulsatilla, gave Sepia judiciously,
and the patient promptly recovered.

When, in addition to this difficulty arising from the fact
that alternated drugs do not always produce a morbific action
which can be predicated in advance from their known single
action, we consider that the various degrees of suscepti-

EDITORIAL REMARKS ON ALTERNATION. 2 19

bility of the organism to drugs indicated with different
degrees of accuracy, will cause the modification by drugs of
each other's action to be different in each individual case, we
clearly see that we can never be in a position to predicate,
in advance, the effect of the joint administration of several
drugs. We can never, therefore, have a scientific indication
for such a combination or alternation. If we make it, it
must always be the result of "guess-work" — of "feeling our
way along," just as Dr. H. did in the cases he relates.

But we claim superiority for Homoeopathy in that it gives
us the means of selecting our remedies with a reasonable
certainty of their effects, and we rightly claim that medicine
should not rest content with anything short of a method
which, given the symptoms of a disease, points us to a cer-
tain remedy if our materia medica contain it ; or, given the
pathogenesis of a drug, indicates to us, a priori, the complex
of symptoms which the drug will remove.

But the method of alternation throws us back from all
such certainty — back to the field of unmethodized clinical
experience — back to the trackless wilderness of polyphar-
macy and allopathy.

For these reasons, briefly and imperfectly stated, from the
stand-point of science we hold that homoeopathic medicine
cannot countenance nor tolerate alternation. And we have
such a faith in the unity of nature as to believe that what
sound reasoning shows to be erroneous, accumulated facts
will prove to be mischievous and unnecessary.

3. But there is another view of this matter from the
practical stand-point. Dr. H. says : " Grant that in a given
case of the use of two remedies, some one remedy might
have been found that would as well, or better, have answered
the purpose * * * the question is not, Could some
other person have done better than I, but Have / done the
best I could ? Undoubtedly, yes ! And, so far as the
prescriber's own conscience is concerned, this answer
exonerates him, even though his prescription were a faulty

22O EDITORIAL REMARKS ON ALTERNATION.

one. And in so far, from the practical point of view, alter-
nation may be justifiable. But will this question, ' Have I
done the best I could ? ' if affirmatively answered, always
justify the prescriber? The practitioner of one year's
experience may commit a sad blunder and yet be fully
justified, because being inexperienced and young, bad
though his error was, he did 'the best he could.' Would
this plea justify the same blunder ten years later ?
Obviously it would not. Yet is it not the tendency of this
plea to satisfy a man with the knowledge he has and with
the methods he pursues, and thus to blunt his zeal for
greater knowledge and better methods ? Remonstrate with
the allopathist for murdering patients with lancet and purge;
he replies, ' I act according to my light ; I do the best I
can.' And so through all degrees of error and imperfect
knowledge. It is a dangerous plea, unless its complement
be always added, ' I have done the best I can, but, please
God, I will do better next time ! "'

And here we see the advantage of a sound "theory"
which our friend holds in so light esteem.

Suppose a practitioner driven, as Dr. H. was driven, to
alternate. The patient recovers. He has, nevertheless,
a conviction that drugs modify each other's action in a way
that we cannot foretell, and that the action of the entire
organism is so harmonious that " two morbid states cannot
co-exist independently," and that, therefore, the morbid
state being essentially one, there must be a possibility of one
similar drug-disease to oppose it. A sound theory compels
him to the belief that alternation is not justifiable nor
defensible on scientific grounds, and that it can do nothing
to advance our knowledge of Therapeutics, but rather con-
fuses it. He enters in his mind a protest against the practice
to which the necessities of practical duty and his limited
knowledge of the materia medica have constrained him, and
turns with redoubled vigor to the study of materia medica,
smarting a little with shame that the exigencies of practice

EDITORIAL REMARKS ON ALTERNATION. 221

have found him unprepared, and have compelled him to a
resort which, though successful, his reason condemns, and
determined that the next time he will, if possible, be equally
if not more successful, and by a method which shall commend
itself to his reason, and shall add to his stock of knowledge
for future use.

And if, while "doing the best they can," as each case
presents itself, practitioners will earnestly and systematically
study the materia medica, determined to do better and
better the next time, we shall have no word of reproach to
utter against their temporary expedient of alternating drugs.
With broader knowledge they will alternate less and less,
and we are very sure that they will see, as we have done,
how, in case after case in which they had alternated, the
recovery was in truth retarded by the mutual reaction of
the drugs ; and how the careful individualization of the case,
and the painstaking selection of the single drug in the
manner that Hahnemann advised, will be in their hands the
means to a success far beyond any ever reached through
alternation. For, though we have admitted and do admit
that success is often attained through alternation, and that
" success is the object of all our labors," we are nevertheless
convinced, through our own experience, — for we have alter-
nated in our day, — that a much larger measure of success is
obtained by adherence to the rule of administering single
remedies, and that closer study of the materia medica and
sharper investigation of cases will preserve us from those
dilemmas in which we are tempted or compelled to resort
to alternation.

4. And if we appeal to the experience of Hahnemann,
let it be understood that we appeal to the man who both
knew materia medica better than any other man ever
knew it, and who had more practical experience than any of
us has had. Let us not indulge in the fallacy of supposing
that, because we are now practicing in the fifty-ninth year
since the Organon was published, we have had fifty- nine

222 EDITORIAL REMARKS ON ALTERNATION.

years' experience in homoeopathic practice, and have been
studying materia medica fifty-nine years. On the contrary,
our own experience is measured only by the actual number
of years we have practiced ; since in this matter of assimila-
ting to one's own mind the facts of the materia medica, and
of seeing the correspondence between these and the facts of
the disease, we can borrow but little from the experience of
others.

If then we, from our little experience of fifteen, or ten,
or five years, appeal to Hahnemann with his venerable
experience of more than fifty years of active practice, with
his unapproachable knowledge of the materia medica, of
which he might justly say like JEneas, " magnet, pars fui"
with his unrivaled powers of observation and discrimination ;
if we appeal to him as "authority" on this question, at once
practical and scientific, can it justly be said, that we are
seeking some "authority outside of and beyond our own
reason?" Our colleague appeals to collections of "facts."
Is not Hahnemann's statement of his practical conclusions a
most stupendous "collection of facts?" Who ever observed
so many of them ? Who ever observed so well as he ?
Facts must be received on testimony ; who ever reported
more graphically and more faithfully than Hahnemann ? If
we doubt his ability, his capacity, his candor, what are we
doing with his materia medica, on the truth of which we
risk our patients' lives ?

This outcry against "swearing in the words of the master"
has come to have a very different meaning from that of the
ancient original protest It was never meant to intimate
that the opinion and testimony of him whose abilities had
crowned him " king of men" should not have a royal weight
of influence.

EDITORIAL REMARKS ON ALTERNATION.1

II.

This article very justly affirms that the question of alter-
nation, being a practical one, " must be decided by experi-
ence ; " that no dogmatism will satisfy those differing in
opinion. The writer then straightway proceeds to dogma-
tize on the basis of two assumptions, which he claims to be
" established principles in Homoeopathy," but which very few
will concede in the terms in which he has expressed them.

Having referred the question to experience, he makes no
appeal to experience, whether his own or his neighbor's- If
he have experience which can throw light on this question,
it ought to be comparative experience. He ought to be
able to say: " For a certain period of times I avoided alterna-
tion, selecting my remedies as Hahnemann directs ; then, for
a period I alternated. My success under the latter method
was the greater." Such a statement as this would carry
weight. But we gather from this article that the author has
always practiced alternation, deriving his ideas of its pro-
priety and necessity from the assumed "established prin-
ciples " upon which he bases his arguments, and upon the
assumed imperfections of the materia medica.

If our conjecture be correct, then his experience, being
confined to the practice of alternation and not bearing upon
the opposite method, can have only a negative value. It
merely shows that a measure of success does attend this
faulty form of practice, a point which was freely conceded to
Dr. H.2 But inasmuch as no advocate of alternation claims
invariable success, the question remains, " Might not the

1 Suggested by a contribution by Dr. C. to the American Homeopathic
Review, vol. v., April, 1865. * See previous paper.

224 EDITORIAL REMARKS ON ALTERNATION.

success have been greater if alternation had been avoided? "
Not having any comparative experience by the light of
which to answer this question, the alternator ab initio, could
not reply.

Our editorial note to Dr. H.'s paper expressly referred to
Hahnemann's experience, and to the experience of the
writer, as being of this comparative character, and as, there-
fore, bearing on this question, and as showing, so far as they
go, that the results of adherence to the single remedy are
more satisfactory than those of alternation.

Some of the points touched by Dr. C. are too important
to be treated in this annotation. They will be discussed in
a future number of the Review?-

Suffice it now to say that, when he states that " the only
reason why he practices alternation is the want of perfection
of the materia medica," he concedes (if he will allow us to
add one other analogous reason, viz., "want of perfection in
the knowledge possessed by practitioners of the materia
medica which we already have") all that the opponents
of alternation contend for. For this position admits that
alternation is wrong in principle, and is only necessitated by
a temporary emergency. We contend that the emergency,
instead of being common, is rare, if not altogether imaginary,
and we appeal to our practice.

How dangerous it is to discuss a question of science with
rhetorical figures !

Dr. C. makes merry over his imagined double-headed
monster, for each head of which he provides a club, and he
grows happy at the thought that by his two-handed energy-
he will have destroyed this figurative disease much more
quickly than the luckless editor could do it, whom he
restricts to the use of a single club to be applied to but one
head at a time.

Now, we have always supposed that the efficacy of an
armament depended not so much upon the number of
1 See "Alternation of Remedies," Nos. i and 2.

EDITORIAL REMARKS ON ALTERNATION. 225

efficient weapons as upon the skill with which the weapons
existing were used, and one club in a vigorous right hand
might do more execution even on a double-headed monster
than two clubs even in the hands of our ambidextrous cor-
respondent. But why restrict the monster to the " two-
headed " form ? If we are to admit the dual or multiple
independent co-existence of disease, why not liken it to a
centipede, each foot "possessing independent vitality?"
With what armament now will our friend cope with his
antagonist ? Shall he call Briareus in consultation, and arm
him with one hundred clubs ? We do not believe in the
multiple co-existence of disease. Leaving out of view
traumatic affections which may supervene during idiopathic
sickness, as Drysdale shows, we believe in the unity of
disease, and we expect to find one remedy of which the
characteristic symptoms cover the whole case.

The figure of the two-headed monster is, therefore, in our
view, defective, but, admitting the figure, why must we use
clubs at all ? In the days when brute force reigned
supreme they were well enough. But surely in this day of
enlightenment " clubs are not trumps."

Hercules was the embodiment of brute strength as dis-
tinguished from intellectual acuteness and skill. Surely his
subjugation of the Lernean Hydra should not serve us as an
example in treating disease. We cannot afford to spend so
much time as the club treatment requires ; for both the
experience of Hercules, and that of our Irish friends at Don-
nybrook Fair, prove that the breaking of heads by clubs is
a tedious and uncertain affair. We decline to enter into
competition with our friend in the use of his favorite thera-
peutic agent, the club, whether he use it single, double, or a
hundred fold. But, if he insist on a mechanical figure, we
will suggest that, while he is counting the heads of the
monster and is casting about in his club-room for a bludgeon
adapted to each head, and is fitting his hand, for the arduous
effort, and is so getting his balance as to make sure that the
16

226 EDITORIAL REMARKS ON ALTERNATION.

complex wielding of his numerous weapons shall not trip
him up, we shall humbly survey the monstrous form with
the intent to study the controlling characteristics of his
anatomical structure, and when we shall have learned to
what type he belongs and what are his characteristics as an
individual, then with one single weapon (a slender sword,
it may be, or a bodkin, or a drop of prussic acid), we shall
touch the vital part (the heart, or the medulla, or a delicate
mucous membrane) on whose integrity depends the life of
all the heads and all the rest — and presto — before the
ponderous clubs have time to fall on those devoted heads
"belaboring them simultaneously" — the work is done !

Multiplicity in armament is generally inconsistent with
simplicity and efficiency, and is characteristic of a barbaric
age or race.

Thus the double-club array is known as the " Indian
Clubs."

The Japanese wear two swords, and yet cannot stand a
moment before the single rapier of the Frenchman.

The savage of the Southern States glories in his belt full
of six-shooters) and his boot-legs bristling with bowie-knives.
Before : the single purpose of the Northern Farmer he is
rapidly passing into the realm of history.

THE USE OF HIGH POTENCIES IN THE
TREATMENT OF THE SICK.

Having been honored by the President of the Society1
with an appointment to report on the use of High Potencies
in Chronic Diseases, I trust it may not be considered an
unwarrantable presumption if, for the following reasons,
I venture to modify, to a slight extent, the theme assigned
to me.

First. The subject contemplates a report of a practical
nature. But from the stand-point of practice, I think that a
clear and well-defined distinction between acute and chronic
diseases is not possible. If we attempt to base such a
distinction upon the element of time alone, paying regard
only to the duration of the disease, it cannot be made at the
beginning of the treatment, and cannot therefore be of any
practical value in determining the potency to be used.

If we base the distinction upon a pathological conception
— that is, upon the presumed existence in the patient of some
dyscrasia, diathesis or miasm — it is equally impossible, at
least in very many instances, to make it at the commence-
ment of an illness.

It is a matter of common remark that cases which begin
without any sign of miasmatic or dyscratic complication
often develop in their course unequivocal evidence of such
complication, so that a case which would, in the outset, have
been regarded as, in this sense, unquestionably acute, proves
in its course to be unmistakably chronic.

Second. Furthermore, the subject as stated, involves a
kind of petitio principii. To require a report on the " Use
1 The Homoeopathic Medical Society of the State of New- York,, Oct., 1863.

228 THE USE OF HIGH POTENCIES

of the High Potencies in Chronic Diseases" is in some
sort to imply that these potencies are especially useful and
appropriate, if at all, in the treatment of chronic diseases
as distinguished from acute diseases — an implication which
it is true corresponds to a very widely received opinion
among those physicians who have but little practical
acquaintance with the action of the high potencies, but
which, as we shall see, is not supported by the results of
experiment

By the kind indulgence of the Society, then, I shall beg
leave to report on the " Use of High Potencies in the Treat-
ment of the Sick."

No question connected with Homoeopathy has given rise
to more vigorous controversy or to more earnest partisan
feeling than that concerning the infinitesimal dose. The
most bitter opposition of the Old School to Hahnemann was
based on this question. It has been also the chief ground
of division and contention among homceopathists them-
selves.

After an animated disputation covering a period of more
than fifty years, there seems now, however, to be a cessation
of hostilities between the advocates and opponents of the
higher potencies. There seems to be a mutual disposition
to suspend the discussion hitherto maintained chiefly on
hypothetical grounds, and to appeal in good faith to the
" ultima ratio" — experiment. The times are favorable,
therefore, for a quiet survey of the field and for a dis-
passionate estimate of the experimental knowledge of which
the practical labors of our colleagues have put us in pos-
session.

It is probable that Hahnemann was never what could be
called an "heroic prescriber." In his work on The Venereal
Disease, published 1789, before he had discovered the hom-
oeopathic law of cure, he portrays the evil effects of exces-
sive doses of mercurial preparations, and speaks of radically
curing some cases of syphilis by the use of a single grain of

IN THE TREATMENT OF THE SICK. 229

Mercurius solubilis in divided doses; and says that eight
grains thus administered will often be sufficient to cure "very
severe cases of syphilis." Compared with the practice of his
contemporaries, these are almost infinitesimal prescriptions.

In his first essays upon the homoeopathic law, Hahnemann
advises the administration of doses but little, if any, smaller
than those he had previously used. We first meet with the
recommendation to use infinitesimal doses in the essays on
"Scarlet Fever," published in 1801, but referring to cases
treated in 1799. He here advises Belladonna and Chamo-
milla to be given in preparations which correspond pretty
nearly to the third centesimal dilution.

It pleases Dr. Dudgeon to suppose that "this sudden
change," as he calls it, from material to infinitesimal doses,
was a matter of expediency and policy rather than of con-
viction on the part of Hahnemann, inasmuch as it coincided
in point of time with the prosecutions of Hahnemann by the
apothecaries.

But there is no evidence that the change was so very
sudden as to require such an explanation. Even so short a
period as one year spent in constant practice might be suffi-
cient to satisfy so acute an observer as Hahnemann, that
remedies given according to the homoeopathic law must be
given in very small doses.

The whole career of Hahnemann is a consistent protest
against the adoption or renunciation of any procedure con-
nected with the practice of medicine, on grounds of mere
policy or expediency. Hahnemann's long life was a con-
tinual sacrifice of ease and prosperity and highly prized
friendships to his convictions of truth. While therefore,
during a period of twenty years he submitted to be driven
from city to city rather than renounce the right of dispensing
his own medicines, is it at all probable that he devised the
method of diluting or potentizing remedies and insisted on
the superiority of potentized remedies, simply, or in any
degree from motives of expediency ?

230 THE USE OF HIGH POTENCIES

In subsequent essays Hahnemann advises still more dis-
tinctly the administration of potentized remedies, and in the
first edition of the Organon, published in 1810, he says:
"Scarcely any dose of the homceopathically selected remedy
can be so small as not to be stronger than the natural disease
and not capable of overcoming it." About the same period
he advises the use of the ninth dilution of Nux vomica and
the eighteenth of Arsenic.

In the earlier volumes and editions of the Materia Medica
Pura, Hahnemann recommends a particular dose for each
remedy. Some remedies are to be given in the first dilution,
some in the third, some in the ninth, some in the fifteenth,
some in the twenty-fourth, some in the thirtieth.

In subsequent editions of the Materia Medica and in the
work on Chronic Diseases, Hahnemann, as is well known,
advises that all remedies be given in a uniform dose — the
thirtieth dilution.

In the latter years of his life he speaks of using with great
success the sixtieth, one hundred and fiftieth and three hun-
dredth dilutions, and it is well known that during these years
he did not confine himself to a uniform dose, but used in some
cases the lower potencies, and in some the very highest

It is not unworthy of remark that as Hahnemann's prac-
tical experience in the treatment of disease increased, so did
his estimate of the advantage and necessity of using higher
dilutions, in at least many cases, likewise increase.

The promulgation of the dynamization theory by Hahne-
mann, and his adoption of the practice of giving infinitesimal
doses, were the occasion of the most violent denunciation of
Homoeopathy by his professional opponents. Indeed, to
this day, this really subordinate department of the method
is regarded by allopaths as the essential feature of Homoe-
opathy ; and to a superficial observer it would seem as if the
infinitesimal dose were almost the only obstacle to a blend-
ing of Homoeopathy and the so-called Physiological School
of Medicine.

IN THE TREATMENT OF THE SICK. 231

The progressive advocacy by Hahnemann of the higher
dilutions, and especially the introduction by Korsakoff of
what are technically known as the " high potencies " (the
one hundred to fifteen hundredth) gave rise, as has been
said, to a lively and bitter and decidedly personal contro-
versy among homceopathists.

In every party or school which is still a minority, there
are always Conservatives, who regret the necessity which
compelled a separation from the party or school of the
majority; who strive to make that separation as little
decisive and marked as may be ; who stoutly oppose any
measure which would tend to increase the division or to
make it irremediable ; and who hail with delight almost any
project of compromise or reunion. There are also Radicals,
whose turbulent nature revels in the sensation of opposition;
whose tendency it is to lay more stress on points of differ-
ence than on points of coincidence ; who, having once
separated from the majority, will not only entertain no
thought of a reunion with them, but consider that fidelity to
the principle on which their separation was based, requires
that the separating chasm should be made continually wider.
They seem to glory, not so much in the truth for the sake
of which they separated, as in the mere fact of separation.

These two classes are necessary in every progressive
school. The Radicals furnish the propelling force — the
steam. The Conservatives supply the restraining and
moderating influence — the fly-wheel.

Among the followers of Hahnemann, the Radicals and
the Conservatives were the respective parties to the contest
about the potentization theory ; and in weighing the argu-
ments which each side brought forward, we must not lose
sight of the respective tendencies of these two parties.

The law, Similia similibus curantur, which is the essence
of Homoeopathy, was not an absolute novelty in medicine.
Indeed, Hahnemann's first argument in favor of it was
drawn from the records of medicine. He showed that, in all

THE USE OF HIGH POTENCIES

ages, many cures had been made in accordance with it. He
proved that his contemporaries, often unwittingly and some-
times consciously, applied it in treating the sick. To urge
its admission as the universal law of cure was, therefore,
simply to advocate the recognition, as a universal truth, of
that which was already received by medical men as, at least,
a truth of partial and limited application.

Accordingly, the opposition to Hahnemann was, at the
very first, moderate. It was somewhat of the nature of a
demand for more conclusive testimony.

Men of conservative tendencies might very consistently,
at this time, have become homoeopath ists ; for it was not
unreasonable to anticipate, at some period in the not dis-
tant future, a universal recognition of the homoeopathic law
of cure and a consequent reunion with the dominant power.

But the dynamization theory was in irreconcilable opposi-
tion to all the notions of Hahnemann's opponents. It taught
that doses inconceivably small were sufficient to effect radi-
cal cures in acute and dangerous diseases — that such doses
were even more efficacious than larger ones. It taught that
instead of the curative power of the drug being directly in
proportion to its material quantity, there was reason for
believing that, to some extent, at least, the converse was
true.

There could be no such thing as a compromise on this
question. Truth lay either with Hahnemann or with his
opponents. It could not lie between them. To maintain
this dynamization theory would be to make the separation
between homceopathists and the dominant school of medi-
cine perpetual and irremediable

It is easy to perceive what sort of a reception was likely
to be accorded to the dynamization theory by the Conserva-
tive homceopathists. They could not regard it without
unfavorable prepossessions. If compelled at last to admit its
soundness, this would not be until irresistible testimony in
its favor had been amassed — nor even then without regret

IN THE TREATMENT OF THE SICK. 233

for the fact and deprecation of the obstacles which it
created in the way of a reunion with the Old School. All
their a priori assumptions would be unfavorable to its
validity.

The Radicals, on the other hand, would receive with joy
this additional element of difference from the Old School of
medicine. They would advocate it with enthusiasm. Their
a priori arguments would lend it a vigorous support.

Thus in relation to a question that can be settled by
experiment alone, and by a course of experiment requiring
careful unprejudiced observation through many successive
years, we have all the conditions requisite for an ardent con-
troversy at the very outset, before any valid evidence could
possibly have been gathered by either party.

We shall be less surprised at the vigorous opposition to
the dynamization theory, if we recollect the condition of
medicine and pharmacy at the beginning of the present
century. The posology of that period was decidedly heroic.
Drugs were given in the crudest forms. Pharmaceutical
chemistry had not yet discovered the essential principles of
drugs, the use of which at the present day has made doses
of the one-fourth, one-eighth, or one-twentieth of a grain
familiar even to practitioners of the Old School. The
microscope was still a rude and primitive instrument;
quantitative chemical analysis had not attained any great
development ; much less was there any thought of applying,
as is now done, the reactive susceptibility of the living
organism to detect, through its specific affinities, particles of
matter so small as to elude the microscopist and the chemist.
In fact the doctrine of the extreme divisibility of matter
rested, at that time, rather on the speculations of the meta-
physician than on the demonstration of the naturalist.

For this very reason, on the other hand, the speculations
of the metaphysician had at that period the wider scope
and the greater authority. And thus it was very easy for
some of Hahhemann's more radical followers to erect on a

234 THE USE OF HIGH POTENCIES

figurative illustration used by him in the Organon a " cloud-
capped " theory of the transplantation of the medicinal force
from the substance of the drug to the substance of the
vehicle used for dilution, and upon the basis of this airy
hypothesis to explain all manner of supposed action and
reaction of drug-spirit upon diseased force, etc., etc.

These considerations will, I think, justify us in passing
over with scarcely a word of comment all that was so copi-
ously written on the subject of the dose, from the date of
Korsakoff s first publication to the date of Dr. Trinks' public
letter to Dr. Stens in 1859.

The principles involved in the question of the efficacy and
advantages of high potencies are these :

1. The curative power of a properly selected drug is not
in the direct ratio of the quantity of the drug.

2. The process of potentization which Hahnemann in- (
vented, develops a curative power in substances, which in
the crude form, manifest no such power ; and it increases
the curative power of drugs which in the crude form do
manifest a curative power.

Now, although these principles had been satisfactorily
established, one would think, by the successful use of the
third or sixth potencies, long before the controversy about
the " high potencies " began, yet it will be perceived that
almost all the objectors who began to write after Korsa-
koff's publication and Hahnemann's cautious and conditional
approval of it, derive their arguments from considerations
of the probable quantity of the drugs which these high
potencies might contain. Thus we are cautioned, even by
those who admit that higher potencies have curative powers,
that they are not to be trusted in acute diseases which have
a rapid course, because, as Dr. Scott expresses it, " in these
diseases the vital forces act with exaggerated energy and to
act upon them, we require a greater amount of medicinal
power, that is, a lower dilution." This statement, it will be
perceived, regards the curative power as directly proper-

IN THE TREATMENT OF THE SICK. 235

tioned to the quantity of the drug, and begs the whole
question at issue.

But when Hahnemann had shown that a more efficient
curative power was exerted by the first dilution or tritura-
tion, or even by drop doses of the mother tincture of drugs
than by massive doses, as he had done to the satisfaction of
all homceopathists, long before the higher dilutions were
ever made, he had demonstrated that the curative power of
drugs is not in the proportion of their material quantity, and
had thus established the first principle of the dynamization
theory.

When, furthermore, he showed to the satisfaction of all
homceopathists, that substances which in their crude state
exert no medicinal power, such as gold, charcoal, tin, com-
mon salt, etc., etc., do, after dilution, trituration or potenti-
zation, come to possess a medicinal power, he demonstrated,
in part, the second principle of the dynamization theory.

These demonstrations removing the question of dose
entirely from the domain of mechanics, in which power is
directly proportioned to quantity y left the whole question
open for experiment.

The points to be determined were these :

1. The curative power of a drug not being directly pro-
portioned to the quantity of the drug, what relation does
exist between this power and quantity ? What effect does a
continued diminution of quantity exert upon the curative
power of the drug ?

2. It being admitted that the potentization process does
develop the curative power, what are the limits of this
development ? What varieties in the nature and extent of
this developed power are produced by various degrees of
potentization ?

Obviously these questions were to be solved only by a
long course of methodical experiment.

While the controversy on hypothetical grounds was
being carried on by the Conservative and Radical homce-

236 THE USE OF HIGH POTENCIES

opathists, reports of cases were accumulating in the homoe-
opathic journals, which furnished indisputable testimony to
the action of the higher potencies. Among those who pub-
lished these records, the names of Gross, Stapf, Hering, von
Boenninghausen, ^Egidi and Nunez are conspicuous.

Their testimony was disputed on various grounds. Against
some cases it was urged that they were inconclusive, since it
was not clearly shown that the cure resulted from the
remedy given and not rather from some hygienic prescrip-
tion or restriction resorted to at the same time. Such
criticism is legitimate, and cases to which it is fairly applica-
ble must be excluded.

Against other cases it was urged that the data were not so
fully recorded as to enable the reader to make sure of the
diagnosis. I do not think such criticism as this is admis-
sible, unless in a very few cases.

The value and authority of clinical records always depend
on the reputation of the reporter for knowledge, accuracy
and integrity. Now, whether, in reporting a case of alleged
pneumonia, the reporter simply state that it was a case of
pneumonia, presenting such or such characteristic symptoms,
or whether he present a minute and elaborate detail of all
the rational and physical signs of the patient, obtaining by
the aid of auscultation, percussion, mensuration and chemi-
cal and microscopical analysis — in either case, we have
nothing to depend upon but the scientific capacity and the
integrity of the observer.

If he have these qualities in a sufficient degree to obtain
with certainty the requisite physical and rational signs on
which to base a trustworthy diagnosis of pneumonia, his
statement of this diagnosis will be sufficient without the
details. If he have them not, no details which he might
pretend to give would be deserving of the slightest confi-
dence. These considerations annihilate the objection made
by Dr. Watzke to cases published by Gross and Boenning-
hausen in the Archiv.

IN "THE TREATMENT OF THE SICK. 237

In general, however, it were well to exclude, provisionally
at least, all cases of doubtful diagnosis.

While cases demonstrating the value and efficacy of the
high potencies were accumulating, a few cases were also
published in which,, the higher potencies having been used
without effect, a lower potency or a crude dose of the same
drug effected a cure. Dr. Black relates that in a case of
headache Lachesis30 only produced symptoms of nervous dis-
turbance, while Lachesis6 effected a cure. Dr. Trinks records
a case which had been treated by Hahnemann for nearly two
years with Rhus in a higher dilution without effect, and
which he himself cured within a few months by repeated
doses of the mother tincture of Rhus.

The angry controversy was brought to a temporary close
by Dr. Trinks' public letter to Dr. Stens, in which he states :
" I was born a skeptic. As to the wonder cures (cures by
the high potencies) published in the journals, I can only say,
I do not believe a word of them." "Non credo quia impos-
sibile est," seems to be the creed of Dr. Trinks — the impossi-
bility consisting in a mere assumption, on his part, that such
preparations cannot possess any power. This same argu-
ment— "non credo" — may, with equal force, be urged by
the allopathists against the first or third dilutions, which Dr.
Trinks is in the habit of using.

The argument proves too much. If Dr. Trinks may
dismiss with " I don't believe it," the testimony of those
who advocate the high potencies, on the same grounds may
these reject his accounts above referred to, of the cases in
which he alleges that the lower potencies were efficacious
where the higher had faile.d.

But the opponents of the high potencies were not
content with seeking to invalidate the testimony of the
advocates of these preparations. Some of them presented
records of cases in which they had made unsuccessful trials
of the high potencies. Of these, many were no doubt made
in good faith, and must be accepted as evidence that there

238 THE USE OF HIGH POTENCIES

are cases in which the high potencies fail to cure. But the
majority of these records are like those of Dr. Watzke,
referred to by him, in the CEsterreichische Zeitschrift, vol. ii.,
where he says, the patients on whom he tried the high poten-
cies suffered for most part from diseases in which there was
little reason to expect a favorable result from any remedy,
in whatever dose, for, he says, they were cases of " dis-
solving pulmonary tubercle, of fungoid tumor of the brain,
of cerebral and pulmonary apoplexy, of spinal paralysis,
of chronic hydrocephalus, valvular insufficience of the heart,
of fibrous tumor of the uterus, etc., etc.

Yet, no doubt, Dr. Watzke is one of those who would
exclaim against the unfairness of Andral in pretending to
test Homoeopathy in the Paris hospital, by giving a single
dose of a homoeopathic remedy to a patient laboring under
incurable disease !

Dr. Watzke himself, though so bitterly opposed to the
advocates of high potencies, is constrained to state in his
resume of the proving of Natrum muriaticum, in the fourth
volume of the Austrian Journal, " I am, alas ! — I say, alas !
for I would much rather have upheld the larger doses which
accord with current views — I am compelled to declare
myself for the higher dilutions. The physiological experi-
ments made with Natrum muriaticum, as well as the great
majority of the clinical results obtained therewith, speak
decisively and distinctly for these preparations." This is
strong language from an avowedly unwilling witness !

The conclusion to which an impartial estimate of the
evidence concerning the high potencies, up to the year 1850,
would lead, is well and justly expressed by a writer in the
British Journal of Homoeopathy, vol. v., p. 154:

" I. The high potencies do act

" 2. They act sometimes very energetically.

" 3. They often act curatively with surprising rapidity.

" 4. They sometimes cure where the lower dilutions have
failed — though the evidence on this point is scanty."

IN THE TREATMENT OF THE SICK. 239

The same writer gives the following points as still requir-
ing to be proved :

" i. That the higher are always to be preferred to the lower
dilutions ; or that they are generally to be preferred to them.

"2. That they will oftener succeed in curing than the
lower."

To these points may be added the question which at that
time was still an open question, viz., whether the higher
potencies were applicable and trustworthy in acute as well
as in chronic diseases.

During the last twelve years a large mass of evidence of
a most interesting and conclusive character has been accu-
mulated on this subject. Of so much of this as was fur-
nished by European observers, I proceed now to give a
brief summary. Inasmuch as the question has been the
subject of somewhat earnest personal controversy among
ourselves, and " scars may yet be tender," I prefer to pass
by, for the present, with a few trifling exceptions, all that
has been contributed by American practitioners. I shall
pass over also all endeavors that have been made to explain
or to limit by hypothetical reasoning on physiological
premises, the action of the high potencies. The question is
purely a practical and experimental one.

One assumed explanation, however, of the action of dyn-
amized remedies should be noticed, inasmuch as it will
enable us to state distinctly what we mean by a higher
potency.

It has been alleged^ that, admitting that an apparent devel-
opment of curative power does result from the potentizing
process in the case of some drugs at least, such as Silex, Gold,
Natrum muriaticum, etc., this is simply because this process
renders soluble these substances which, in the crude state,
are insoluble, or that it reduces the size of their particles to
such an extent that these particles are capable of entering
the smallest blood-vessels, and of thus coming into contact
with the diseased tissue and of acting directly upon it. This

240 THE USE OF HIGH POTENCIES

curative power which is pretended to be developed by potent-
ization is, they say, simply a facility of action produced by
minute subdivision.

Hypothetical explanation does not alter facts. If, how-
ever, the above were the sole explanation of the action of
potentized remedies, then it should result that the highest
development of the curative power should be reached in that
dilution in which the particles have been reduced to a size
appreciably less than that of a blood corpuscle. And,
indeed, this ground has been taken by some writers. Now,
arithmetical calculation, as well as microscopic observation,
fixes upon the third centesimal dilution as that in which the
above degree of subdivision has unquestionably been
attained. If this view were correct, then, dilutions higher
than the third should not display a curative power; or if
they do display such power, it should not be in any case
superior to that of the third dilution.

Now, if it should chance to result from actual, incontro-
vertible experiment, that potencies higher than the third do
display, with rare exceptions, a greater curative power than
the third or lower potencies, this superiority must be directly
attributable to the process of potentization.

I deem it right, therefore, to call all those potencies above
the grade of that of which the action admits a mechanical
explanation — "the higher potencies" The term will apply,
in this view, to all above the third centesimal.

In 1850 Drs. Wurmb and Kasper took charge of the
Leopoldstadt Hospital, in Vienna. Their views on the
subject of the dose were no secret. * They had no faith
whatever in the higher potencies. They were physicians of
much more than ordinary scientific attainments, and of great
devotion ; and Dr. Wurmb, at least, had few superiors in an
exact and thorough knowledge of materia medica. In their
"Clinical Studies," published in 1852, they thus express the
posological views with which they entered on the charge of
the Hospital :

IN THE TREATMENT OF THE SICK. 241

" We have given almost always the thirtieth decimal dilu-
tion, and only exceptionally a higher or a lower dilution.
* * We propose to adhere to this dilution for two
years longer, then to give another dilution for an equally
long period, and finally to give for a similar period still
another dilution. Such experiments as these are indispen-
sable to the solution of the question of the dose, but mani-
festly they are valid only in the case of disease with regard
to which the preliminary question, What can Nature do, and
what can Art? has already been definitely answered, and
in favor of the latter?"

Here is the plan of an experiment which, if faithfully
carried out, gives promise of some very conclusive data on
the subject of the dose. Such questions as this require for
their solution a multitude of instances such as can hardly
be gathered in private practice. But a hospital affords an
appropriate and sufficient field for their collection. The
hospital of Dr. Wurmb is the only one which has been
devoted to such uses.

Before the expiration of the three periods, of three years
each, involved in the plan as above stated, Dr. Kasper was
succeeded by Dr. Martin Eidherr, who has published in
the (Esterreichische Zeitschrift, for 1862, the result of the
ten years' experiment.

It seems that in 1 860 the Austrian Homoeopathic Society
of Vienna proposed as a subject for consideration the ques-
tion of the dose, inviting all homceopathists of all countries
to take part in the discussion. A large number of responses,
both verbal and written, were made to this invitation, some
of which are published in the Austrian Journal, for 1862.
Dr. Eidherr, the Editor of the Journal, remarks: "These
discussions have, as is well known, led as yet to no positive
result, because they rest exclusively on subjective grounds.
While some record most brilliant cures effected only by the
higher dilutions, others narrate similar cases cured only with
the lower. Consequently, the society regards the question
17

242 THE USE OF HIGH POTENCIES

as still an open one and calls for further communications on
the subject."

At this point it was suggested that the material in the
shape of clinical records which had been for ten years accu-
mulating in the archives of the Leopoldstadt Hospital might,
if collated, throw some further light on the subject.

Dr. Eidherr undertook the task. He resolved to confine
his investigations to a single disease, pneumonia (which by
the way is very prevalent in Vienna), for the reason that the
diagnosis of this disease is easy, and that, by means of the
physical signs, its course and progress and decline may be
more accurately followed and observed than is the case with
many other acute diseases.

During the ten years, from 1850 to 1859 inclusive, all cases
in the Leopoldstadt Hospital had been treated for the first
three years with the thirtieth decimal dilution, for the second
period of three years with the sixth, and for the remaining
four years with the fifteenth decimal dilution. It was pro-
posed to compare the results of the treatment of pneumonia
during these three periods.

But, in order to avoid [a fallacy in drawing conclusions
from this comparison, it was necessary, first, to inquire
whether the Genius Epidemicus was the same for these three
periods, or, if not the same, how great an influence, and in
favor of which period, did the difference exert?

To meet this preliminary question, Dr. Eidherr made a
study, first, of those conditions which favor the origin and
spread of pneumonia : and, second, of the prevalence and
course of pneumonia in the great General Hospital of Vienna
during the same periods of time.

The first section of his treatise consists of tabular state-
merits of the meteorological phenomena of the decennium in
question, and of the relations of these phenomena to the
prevalence of pneumonia as observed in the great General
Hospital of Vienna.

The second section comprises short and succinct accounts

IN THE TREATMENT OF THE SICK. 243

of the cases of pneumonia treated in the Leopoldstadt
Hospital during the three periods into which, as already
stated, the decennium was divided.

The third section contains a statement of the results of
the treatment by the different dilutions used during the
three periods in question, taking into account the modifying
influence of the different atmospheric conditions of these
periods.

The cases occurring during the three periods of time into
which the whole period of ten years was divided, are called
by Dr. Eidherr — Groups I, 2, 3.

Group No. i, embracing the years 1850, 1851 and 1852,
was treated exclusively with the thirtieth decimal potency.

Group No. 2, embracing the years 1853, 1854 and 1855,
was treated exclusively with the sixth decimal potency.

Group No. 3, embracing the years 1856, 1857, 1858 and
1859, was treated exclusively with the fifteenth decimal
potency.

A careful estimate of the different meteorological con-
ditions of these epochs leads Dr. Eidherr to the conclusion
that during the first epoch the atmospheric conditions were
most favorable to the prevalence and severity of pneumonia,
and therefore the least favorable for the treatment ; during
the second epoch least favorable for the spread and severity
of pneumonia, and therefore the most favorable for the
treatment.

In observing and recording cases of pneumonia in this
hospital, the physical signs have always been carefully noted,
and records have been made of the following points in the
history of each case :

1. The seat of the infiltration.

2. Its duration, reckoned from the time at which it was
first perceived to the time at which it was noticed that it
began to be resolved (?).

3. The time at which resolution of the infiltration began.

4. The time at which resolution was completed.

244 THE USE OF HIGH POTENCIES

5. The time at which all physical signs disappeared.

6. Duration of convalescence.

The comparison between the three groups is made with
reference to all of these points.

The results are stated as follows :

Group i, treated with the thirtieth decimal dilution ;

The average duration of the infiltration was three
days.

The average date of commencing resolution was the third
day.

The average date of completed resolution was 4.9 days
from the beginning.

The average date of vanishing of the physical signs was,
as concerns the infiltration, 7. 1 days ; as concerns the exuda-
tion, 12.3 days from the beginning.

The average duration of convalescence was 4.4 days.

Group 2, treated with the sixth decimal dilution during
the years 1853, 1854 and 1855 ;

The average duration of the infiltration was 4 . 1 days.

Resolution began, on the average, in 3.5 days, and was
complete in 6.9 days.

The physical signs disappeared, on the average, as
concerns the infiltration, in 9.3 days; as concerns the
exudation, in 20.5 days.

The duration of the convalescence was, on the average,
5.3 days.

Group 3, treated with the fifteenth decimal dilution, during
the years 1856, 1857, 1858 and 1859;

The average duration of infiltration was 3.4 days.

Resolution began in 3.2 days.

It was complete in 6.3 days.

The physical signs disappeared, so far as the infiltration
was concerned, in 10.3 days; so far as the exudation was
concerned, in 18.1 days.

Average duration of convalescence, 4.8 days.

To recapitulate the above —

IN THE TREATMENT OF THE SICK. 24$

The average duration of the infiltration was :
For Group I, 3.0 days.
2,4-1 "
3, 3-0 "

Resolution began :

For Group I, on the 3d day.

2, " 3-5 "

3, " 3-2 "
Resolution was complete :

For Group I, on the 4.9 day.

2, " 6.9 "

3, " 6.3 "
The physical signs of the infiltration vanished :

For Group i, on the 7.1 day.

2, " 9.3 "

3, " 10.3 "

The physical signs of the exudation vanished :
For Group I, on the 12.3 day.
" 2, " 20.5 "

" 3, " 18.1 "

Dr. Eidherr gives also a tabular statement of the average
number of days during which each case of each group
remained in hospital — that is, the total duration of each case
from its reception to its dismissal, as follows :

Group i, treated with the thirtieth decimal dilution; fifty-
five cases were treated ; their aggregate residence in the hos-
pital amounted to 680 days; or an average of 11.3 days
each.

Group 2, under the sixth decimal dilution; thirty-one
cases, 606 days ; an average of 19.5 days for each case.

Group 3, treated with the fifteenth decimal dilution; fifty-
four cases, and 795 days ; an average of 14.6 days for each
case.

246 THE USE OF HIGH POTENCIES

I now proceed to give as briefly as possible the conclusion
to which Dr. Eidherr is led by this careful study of his
statistics. He says: "This is the most extensive experiment
that has ever been made, bearing on the question of the
dose. Its subjects were 107 cases of pneumonia. Each
case was the subject of careful investigation. Every
imaginable care was taken to obviate every source of fallacy."
The experimenters were not radical homceopathists. Their
prepossessions were rather against the high potencies. I
can bear personal testimony to the fact that, in 1851, while
the thirtieth dilution was the standard used in the hospital,
Dr. Wurmb frequently expressed himself as believing that
statistics would decide in favor of lower dilutions. It was
not known how statistics had decided until Dr. Eidherr
made the analysis from which I have quoted, and which
shows that in every point of view the action of the thirtieth
dilution, in so acute and dangerous a disease as pneumonia, is
more certain and more rapid than that of the fifteenth or the
sixth dilution, and that the fifteenth is preferable to the sixth
dilution — or, to translate the decimal into the centesimal
scale, the fifteenth is better than the seventh, the seventh
than the third.

Against this record Dr. Trinks would raise in vain his cry
" non credo"

If we refer now to the points which were stated in 1850
as still requiring to be proved in relation to the high poten-
cies, we find the third question satisfactorily solved by this
experiment in the Leopoldstadt Hospital. For the exper-
iment proves beyond a doubt, that the higher potencies are
applicable and trustworthy in acute as well as in chronic
diseases.

It enables us also to give a probable affirmative answer to
the first question, and to say that the higher are, at least so
far as pneumonia is concerned, to be preferred to the lower
dilutions.

The second question, viz., whether higher dilutions will

IN THE TREATMENT OF THE SICK. 247

oftener succeed in curing than lower dilutions, is left unaf-
fected by this great experiment.

Let us now recapitulate the points at issue. I think we
may safely state that, up to the present time, experience
has established these facts : that the continued diminution of
the material quantity of a drug through the process of
potentization does not diminish the curative power of the
drug when homceopathically applied ; that, on the contrary,
the process of potentization does positively increase the
curative power of a drug when homceopathically used ; that
this increase of curative power is progressive, as far at least
as the fifteenth centesimal dilution, and is demonstrated
in the treatment of both acute and chronic diseases.

It was incumbent on the advocates of the higher potencies
to demonstrate not only that these preparations are effica-
cious, nor simply that they are equally efficacious with the
lower potencies, but that they are superior in efficacy.

This has been shown by the Vienna experiment up to a
certain degree. The seventh centesimal has been shown to
be superior in the treatment of pneumonia to the third, and
the fifteenth to the seventh. There is a natural desire to
find the limit of potentization. The Vienna experiment
gives us no reason to suppose that this limit has been
attained in the fifteenth potency.

Many most eminent practitioners assert for what are
technically termed the "high potencies," as great a superi-
ority over the fifteenth and thirtieth as the latter have been
shown to possess over the third. Cases are accumulating in
our journals which go to corroborate these assertions. We
cannot refuse to believe these narrations. While they have
not yet established a general superiority of the "high
potencies " (sixtieth to two hundredth) over the fifteenth
and thirtieth for the treatment of all cases, acute and chronic,
they nevertheless prove beyond dispute that the rapid and
permanent cure of both acute and chronic diseases is within
their scope.

248 THE USE OF HIGH POTENCIES

They establish, moreover, the fact that in many cases
these high potencies (the two hundredth, for example) cure
diseases in which the lower potencies of the same drug have
failed.

The determination of absolute superiority and of definite
limits of increase of curative power, is impossible from our
present data.

Among those who have long used the high potencies (in
particular the two hundredth), Dr. von Bcenninghausen
stands pre-eminent. It is true that his practice lies chiefly
among chronic diseases. Nevertheless, many acute diseases
are treated solely in accordance with his directions. He
has for many years used exclusively the two hundredth
potencies. His increasing fame and practice attest the
validity of the services which he renders to those who
consult him. The high character which he has always
borne as an acute and sagacious observer of natural phe-
nomena, the unblemished reputation which he has sustained
throughout his long and eventful life, cause his observations
and his statements to be received with implicit reliance and
belief by all who are at all cognizant of his social position.
He does not hesitate to express a decided conviction of the
great superiority of the high potencies over the lower, in
both acute and chronic diseases.

Dr. ^Egidi, who, after having, on their first introduction,
spoken favorably of the high potencies, retracted to some
extent this good opinion, has recently announced as the
result of a long course of experiment in his private practice,
embracing the history of more than 4,000 cases, a clear and
unequivocal preference for the high potencies in both acute
and chronic diseases.

Dr. Battman has, within the last two years, published a
series of cases of severe membranous croup, and of very
dangerous acute pulmonary affections, cured in a marvelous
manner with the two hundredth potency; and basing him-
self on these narrations, he makes a warm protest against

IN THE TREATMENT OF THE SICK. ,249

the irrational conduct of those homceopathists who, at the
same time that they object to the illogical conduct of the
allopathists in refusing even to listen to any evidence in
favor of Homoeopathy, obstinately close their own ears to
all that is alleged in behalf of the high potencies.

Of six physicians of Austria and Hungary who presented
written essays on the question of the dose to the Vienna
society, none denied the curative action, often prompt and
surprising, of the high potencies (one hundredth to the three
hundredth) in both acute and chronic diseases. Only one
expressed a doubt that they were in any case superior to the
lower potencies. Two did not hesitate to claim such superi-
ority for them in decided terms.

Dr. Wurmb, the head of the Leopoldstadt Hospital, states1
that often remedies in the higher dilutions act, where the
lower dilutions of the same remedy had failed to act. He
gives an instance in which Belladonna100 effected a cure in
chronic migraine, in which a lower potency of the same
remedy had failed to do any good. The one hundredth and
two hundredth potencies are now not infrequently adminis-
tered in the Leopoldstadt Hospital. Dr. Wurmb remarks2
that " since he has had experience with the one hundredth
dilution prepared by Dr. Eidherr, and has satisfied himself
of the wonderful effects which often result from them, he
prescribes them in suitable cases with greater preference than
the thirtieth or any other potency." He does not state
what he considers to be "suitable cases." It is probable
that he does not consider his experience to be great enough,
as yet, to justify him in laying down any general rules on
the subject. It is likely that he decides for each particular
case, according to his view of probabilities, and that he
cannot always give a clear reason for his preference of one
potency over another. Each case thus treated may be
regarded as in some sort an experiment — a contribution to
that multitude of instances from an analysis of which we
1 (Est., Zeit., I. 158, 1862. * Loc. cit. 3, p. 137.

250 THE USE OF HIGH POTENCIES

may hope to deduce, at some future time, a general law of
posology.

If, after this general view of the evidence on the subject
of the high potencies, it be appropriate for me, on such an
occasion as the present, to state my own experience and
methods, it may be done very briefly.

Before I had fairly entered to any great extent upon the
responsibilities of the practice of medicine, I had the advan-
tage of observing the practice of some very eminent physi-
cians and of listening to the counsel of others.

Not to mention American physicians, I heard in England
chiefly the advocates of the low and the lowest potencies.
The high potencies were at that time rarely mentioned in
England except in terms of ridicule. And the contempt
which the assumed non-material nature of these potencies
inspired in the matter-of-fact mind of that taurine nation-
ality, whose devotion to the pound avoirdupois is even
greater, if that were possible, than to the pound sterling,
was cordially extended to the intellectual acuteness and the
scientific acquirements of all who believed in these potencies
and who used them. Since that period the cause of the high
potencies has been nobly advocated in England, by a few of
those strong men, who are the true glory of the nation.

Passing from England to Westphalia, I enjoyed free and
full and long-continued opportunities to observe the practice
of Dr. von Boenninghausen, who used the two hundredth
potency exclusively. There was, certainly, in his practice,
less parade of scientific auxiliaries than I had seen at the
English hospitals or in the English dispensaries ; but I do not
think the diagnosis was less accurate on that account. I am
very sure that the success of the treatment left but little to
be desired. Though some acute diseases were here treated
with high potencies under my observation, yet the majority
were chronic cases, and, deeply impressed with the great
responsibility involved in my judgments, I was hardly ready,
from these observations, to conclude on the advantage of

IN THE TREATMENT OF THE SICK. 2$ I

using high potencies in a general practice. Nevertheless,
the effect of these observations was such as to satisfy me of
the efficacy of the higher potencies in all forms of diseases.
The question remained, "Are they superior to the lower?"
Stapf, who was then living in retirement, counseled me to
use the high potencies in chronic diseases, and thought the
medium potencies were all that could be desired in acute
diseases. He had no statistics of comparative observations
by which to justify his opinions.

In Vienna, Wurmb and Kaspar were in the middle of the
first epoch of the decennium of which Eidherr has given us
the analysis. They were treating all diseases with the thir-
tieth decimal dilution. Their examinations of patients were
minute and masterly, their prescriptions careful, their suc-
cess very striking.

Fleischmann, at the same time, was giving the mother
tincture or the lowest dilutions. His diagnosis was careless,
his success neither rapid nor, except as compared with heroic
allopathic treatment, very striking. His prescriptions were
not accurate. He did not individualize his cases, but pre-
scribed according to a coarse and rude generalization. On
the subject of the potency, his opinions, I learned from him-
self, were immovably made up. I perceived that he had
ceased to be capable of learning, although he still lived ; that,
in knowledge, as in stature, he had attained his growth;
ossification was complete in his perceptive intellect no less
than in his physical skeleton.

In Paris, Tessier was treating acute diseases in the hospital
Ste. Marguerite with the sixth, twelfth and fifteenth dilu-
tions. His success exceeded that of Fleischmann. It was
inferior to that of Wurmb, but it was easy to perceive how
inferior he was to that excellent physician in minute and
comparative knowledge of the materia medica.

In Paris, Dr. Perry was prescribing at his dispensary the
two hundredth potency, with but few exceptions, in all forms
of disease. The reports indicated a very wonderful success,

252 THE USE OF HIGH POTENCIES

but, from the nature of a dispensary practice, this could not
be made the subject of exact observation.

My conclusions from all these observations were favorable
to the high potencies, so far as to admit their energetic action
on acute as well as chronic diseases and their general supe-
riority in the treatment of the latter ; but I was not satisfied
that they were so trustworthy, as a general rule, in the treat-
ment of acute diseases as to be preferable to the lower poten-
cies. I therefore began, in my own practice, with the use of
the lower and medium dilutions (third to twelfth and
fifteenth) in acute diseases. When very sure that my
selection of the remedy was entirely correct and that the
case would not suffer should my first prescription prove
inert, I ventured, during the first few years of my practice, to
give a high potency in acute diseases. I now look back on
this period with wonder that the idea of a definite and direct
relation between the curative power and the material
quantity of a drug should have been so hard to eradicate
from my mind.

Experience of the action of the higher potencies, on my
own person, in very acute illness, first fully convinced me —
perhaps, because, in my own case I took the risk of trying
the experiment more freely and fully than I had ever done
in the case of others.

For the last five years1 I have used the high potencies
(two hundredth of my own manufacture and of Lehrmann's,
indiscriminately) in all forms of disease that occur in a
general practice. I am very sure that my practice has
grown more successful every year. While I trust that an
increasing knowledge of the Materia Medica may have con-
tributed greatly to this result, I cannot be mistaken in the
belief that much is also due to my more and more frequent
use of the high potencies.

I cannot say that every prescription has done everything
I expected or hoped from it. Nobody's practice can be

1 Written in 1863.

IN THE TREATMENT OF THE SICK. 253

free from painful failures. In such cases, wherever I have
been tolerably sure that my choice of remedy was correct, I
have repeated the same remedy in a higher or lower potency
as the case might be, and while I have collected from my
practice many instances in which a high potency has acted
promptly where a low had failed to act, I have noted only
one case in which a high potency acted but inefficiently
while a lower gave prompt and complete relief.

From my own experience, then, the presumption would
lie in favor of the high potencies in both acute and chronic
diseases.

A few instances will serve to illustrate what has been said.
They are presented only as illustrations, by no means as the
evidence on which my convictions rest.

A gentleman who had suffered many years from necrosis
of the femur was subject to acute attacks of periostitis. The
twelfth potency of Asafoetida was found to relieve his
suffering, and repeated doses of it generally effected a cure
within three or four days. ' After treating several attacks in
this way, I gave him, at the commencement of a fresh attack,
a dose of Asafcetida200. The cure was effected in the space
of six hours. A difference so remarkable was very obvious
to the patient, who, learning from me the difference between
this and my former prescriptions, requested to be treated
always thereafter with the two hundredth. Here, whatever
cavils may be raised about the diagnosis or other points, the
fact remains incontestable, that attacks which required for
their cure several days and repeated doses of Asafcetida12,
were cured in six hours by a single dose of the two
hundredth. Could it be that repeated treatment of these
attacks had modified their severity, and that the ameliora-
tion chanced to coincide, in point of time, with the change
of potency ? To satisfy myself on this point, I once reversed
the experiment, and without my patient's knowledge gave
the twelfth instead of the two hundredth potency. The
attack came on with its ancient severity and persistence,

254 THE USE OF HIGH POTENCIES

much to my patient's disgust, who was abundantly satisfied
with the high potency, but much ashamed of my want of
confidence.

Even after I had become quite satisfied of the superiority
of high potencies in most acute diseases, I yet hesitated to
employ them in a malady so fearful and so rapid as croup.
In this I still adhered to the low (the third) dilutions of
Aconite, or Spongia, or Hepar, as the case might require, or
to the watery (first centesimal) dilution of Bromium or
Iodine, if these remedies were indicated. Notwithstanding
I had actually witnessed most surprising success in Dr. von
Bcenninghausen's practice with the two hundredth potencies
in severe croup, I hesitated to use them. I argued to
myself: "These low potencies have served me well. The
majority use them. I do not know that the high are better,
even if they be as good. The success with them may be
exceptional. I dare not risk the loss of time which would
accrue from an unsuccessful experiment with them."

Thus it turned out that I never used the high potencies
until, three years ago, in the most severe case of membran-
ous croup I ever saw, the low potencies in which I had
always trusted failed me utterly, and I knew not what else
to do. A resort to the use of the two hundredth potencies
of Aconite, Hepar sulphuris and Spongia saved my patient
from this extremity of danger, and satisfied me that a trial
of the high potencies in the outset of an attack of croup,
instead of involving a risk of wasting time, does in truth
obviate such a risk from the employment of the lower
potencies. From this time on, in the treatment of croup, I
have uniformly begun with the two hundredth potency of
whatever remedy was indicated. My success has been more
uniform and much more rapidly attained than ever before.

My first use of a high potency of Bromine was accidental.
Called to prescribe for a severe case of croup, in which that
remedy was indicated, I found that the crude substance or a
low dilution was not to be obtained. I had the two

IN THE TREATMENT OF THE SICK. 255

hundredth potency in my pocket-case. I gave it with a
result equally happy, and much more speedy than I had
ever before witnessed. This was altogether contrary to my
preconceived notions concerning Bromine, and it summarily
upset a very pretty chemical theory I had formed.

As already remarked, I have sometimes met with facts of
a contrary significance. In a case of chronic asthma, of
great severity, I have recently found Glonoine of the greatest
service. I first prescribed the sixth potency, having no
other at hand. When the action of this dose was exhausted
I gave the two hundredth. The result was by no means
satisfactory. The sixth again produced happy effects as
before. Repeated experiments of this kind convinced me
that in this instance the high potency did not act so favor-
ably or so efficiently as the low. Whether this peculiarity
should be accounted for by assuming an idiosyncrasy on
the part of the patient, or a peculiarity of Glonoine which
renders it incapable of high potentization, or whether the
action of the Glonoine in this case will prove to have been
only palliative, and therefore temporary, is a question which
can only be solved by a wider experience than I possess in
the use of various potencies of this new but valuable
remedy.1

But this fact that a low potency succeeded where a higher
had failed, together with similar facts reported by other prac-
titioners, must have a bearing upon general conclusions.

In conclusion, I think the following statements are war-
ranted :

I. In prescribing, the first essential is the correct choice
of the remedy. The second point — which is also, in many
cases, though not always, essential — is the judicious choice
of the potency.

'The subsequent history of this case recurred with its original severity, and

confirms the suspicion that the great no form of Glonoine (nor of any other

relief afforded by Glonoine was pallia- remedy that I tried) availed to give

tive. After a few months the disease relief.

256 THE USE OF HIGH POTENCIES.

2. That, in both acute and chronic diseases, the prefer-
ence, other things being equal, is to be given to the higher
over the lower potencies. The experience of Wurmb shows
that, in severe pneumonia, the fifteenth is to be preferred to
the seventh and the seventh to the third (centesimal). I
should go further and say that, in general, preference should
be given to still higher potencies, even to the two hun-
dredth.

3. Experience shows that, while the majority of cases,
both acute and chronic, are cured more speedily by the high
than by the lower potencies, yet, in some cases, the converse
is observed. No explanation of this difference has been
discovered, nor can its occurrence be foreseen in any case.
While therefore the presumption, in every case, being in
favor of the high potencies, the treatment should be begun
with them, nevertheless, should no favorable result ensue,
recourse should be then had to lower potencies, provided
always there be a reasonable certainty that the remedy has
been rightly selected.

4. The question, whether the " high potencies " are more
generally successful than the lower, and in what proportion
they are so, is yet to be determined by statistics drawn from
methodical experiment.

5. A general law for the a priori selection of the potency
suitable for a concrete case, if such a law be possible, is yet
to be discovered

REPLY TO A LETTER ON HIGH POTENCIES.

The questions contained in the following letter, recently
received, represent a class of queries that are frequently
propounded both orally and in correspondence. It has
appeared not inappropriate to publish a general reply to
these and similar questions :

" i . In what form do you use these potencies, in the shape
of pellets or liquids?

" 2. Do you use the decimal or the centesimal scale in the
preparation of the high potencies ?

"3. Do you repeat the high potencies in rapid succession
in acute diseases, as you do the low preparations ?

"4. If you use pellets, do you consider them perfectly
reliable ? and how many, as a general rule, constitute a dose,
either dry or taken in water ?

"5. Do you alternate the high potencies, or do you rely
upon the single remedy ?

"6. Do you believe that the high potencies, from your
own experience in the use of them and from what you have
beheld in the practice of others, are far superior, in all
respects, to the low preparations as remedial agents ?

"Some of these questions may seem in themselves to be
insignificant, but I do not consider them so, for in making
my first > trial I wish to start right, that the experiment
may be made fairly, with a sincere desire to know the truth,
the whole truth, and nothing but the truth.

" In conclusion, let me say that you may rest assured your
answers to this communication will be kept perfectly private,
and no publicity (as coming from you) given them.

"Permit me to repeat that it is only a sincere desire to
18

258 REPLY TO A LETTER

seek out and find the truth that has led me thus to trouble

you."

We heartily respect our correspondent's earnest desire to
get at the "whole truth," and to "start fair" in his experi-
ment; and we respect his hesitation to use the high potencies
until he should have a reasonable assurance that in so doing
he would not be hazarding the interests of his patients. We
take this public manner of replying to his questions, partly
with a view of convincing him that we have no wish that our
"answers to this communication" should be "kept strictly
private." On the contrary, we should be glad to have
"publicity (as coming from us) given them." For they are
expressions of our honest convictions, the result of as careful
observations and as cautious and complete experiments as
we have up to the present time been capable of making.
They express our present opinion, — those views in accord-
ance with which we shape our daily practice.

But we hold ourselves bound by them only so long as
they shall continue to be our honest convictions. Should
further observation and more extended experience satisfy us
that any of our present positions are untenable we shall
gladly abandon them for others, and shall then, likewise, be
not only willing but anxious to have " publicity (as coming
from us) given " to these new views. The object of our
professional life is to find out the truth and to shape our
practice accordingly. Consistency to this object is true
consistency ; while consistency to any form of opinion or
doctrine that may at one time have been supposed to be the
truth and proclaimed by us as such, — consistency to such
opinion merely because we may have once publicly uttered it,
— this is the basest and most ignoble bigotry and cowardice.

In the article1 to which our correspondent refers, we had
no object but to express frankly and plainly the views which
govern us in the practice of medicine. We would call his
attention to the fact that the greater part of the article

1 " The Use of High Potencies in the Treatment of the Sick."

ON HIGH POTENCIES. 259

consisted of citations of the opinions and experiences of other
practitioners whose conclusions were but corroborated by
our own.

I. In what form do you use these potencies, in the shape of
pellets or of liquids ?

As a matter of fact, we use them in the form of pellets.
As a matter of faith, we know no difference between pellets,
pills, triturations or liquids. The pellet is merely a conven-
ient means for dividing a drop of liquid into a number of
equal parts, and it is for this object that we use them. We
have been in the habit of buying unmedicated pellets or
globules at Smith's Pharmacy, and medicating them with
liquid potencies of our own preparation. Pellets thus medi-
cated we find retain their remedial powers for several years
at least, — exactly how long we cannot say. They are so
much more portable and more convenient to administer than
liquids, that this furnishes us a sufficient reason for preferring
them to the liquid form of prescriptions. A writer in the
British Journal of Homoeopathy, some years ago, published
an essay on the Globule versus the Pillule, making out a
very bad case for the unlucky globule as calculated to bring
Homoeopathy into contempt in the eyes of persons not indoc-
trinated. There is something laughable, if it were not
deplorable, in this argument, the pith of which is this: "We
give small doses, to be sure, but let us not, by using the
pellet, appear to give small ones ; let us use as big a pill as
anybody that we may not seem to give a small dose, and
may not rudely jostle the prejudices of our patients."
But surely, if contempt would have damaged Homoeopathy,
this luckless science, despised, scorned, ridiculed, and, scores
of times, extinguished by Homeric laughter, should have
been done for long ago ! To adopt and defend this much
contemned science, and yet to shrink from the obvious
smallness of a pellet- dose — is not this "to strain at a gnat
and swallow a camel."

Nothing will gain the confidence of a patient so surely as

26O REPLY TO A LETTER

success ! His confidence, once gained by success, cannot be
shaken by the form of your dose ! Yes, it may though ! If
he sees that while your doctrines require you to give small
doses, you yet dissemble and juggle, and, by using large
pills and lozenges and mixtures, try to make it appear that
you are giving as large doses as your Old-School neighbor,
he will suspect that your faith in the system you profess is
not really strong, and he will have doubts of both you and
your system. The sick man who feels that you are curing
him, cares not a straw for the logical improbabilities of your
doctrines, nor for the scientific difficulties attending the expla-
nation of the action of your little dose. Large or small, —
much or nothing, — if, under your auspices, his health return,
he will have faith equally in yourself and in your methods.

We have been amazed at much that has been said and
written on this subject. Our own patients have rarely
remarked upon the pellet. One, who had never seen them
before, once said to us, " Do you really hope to cure me
with those tiny pills?" "Yes, certainly." "I should not
believe they could possibly have any power." "Why?
Because they are so fine and small fpr pills?" "Yes."
"Then, my dear sir, instead of regarding them as 'fine
pills? consider them to be very coarse granular powder, and
you cannot fail to be impressed, a priori, with their immense
power!" He perceived the absurdity of his objection,
which was to the outward form and not to the inherent
power. The success of the prescription satisfied him of the
virtue of little pills.

Another patient objected to the very small vials of my
pocket- case. I replied they were a matter of convenience
to me, but if he would be better satisfied I would, next day,
bring his dose in a quart bottle and pour out the same quan-
tity (pellets). He also perceived that his objection was
frivolous, and was content.

2. Do you use the decimal or centesimal scale in the prepa-
ration of the high potencies?

ON HIGH POTENCIES. 26 1

As a matter of fact, we use the centesimal scale in prepar-
ing the high potencies and all the potencies which we use,
and have used since we began to practice medicine. As a
matter of opinion we see no reason to prefer the decimal.
It does not insure a more uniform gradation as has been
claimed. The use of it leads to confusion and is to be
regretted. We prefer adhering to Hahnemann's scale. It
is easy to convert the one into the other in reporting cases
or in reading reports. If our correspondent will refer to the
article which prompted his letter, he will note that in the
treatment of pneumonia Wurmb and Eidherr used potencies
prepared on the decimal scale, which fact we there stated
and we reduced their numbers to the corresponding ones of
the centesimal scale. In general in this country where the
facts are not specifically stated, it is understood that the
centesimal or Hahnemann scale is intended.

Our own preparations were made in strict accordance with
Hahnemann's directions and so are the high potencies of
Lehrmann, as we have learned from Dr. von Bcenninghausen,
who directed their preparation, and from Lehrmann, himself.

3. Do you repeat the high potencies in rapid succession in
acute diseases, as you do the low preparations?

How shall such a knotty question be unraveled ? It
involves two assumptions, two beggings of the question,
viz. : i. That we do repeat the low potencies in rapid suc-
cession in acute diseases; and, second, that we make any
such distinction between acute and chronic diseases, as to
admit of a radical difference in our principle of prescribing.

i. We recognize but one rule touching the repetition of
the dose. It was laid down by Hahnemann and is as
follows : Do not repeat the dose of the remedy given until
the effects of the previous dose shall have ceased to be
evident. Our most grievous failures have come from a vio-
lation of this rule. Our most brilliant and complete suc-
cesses have coincided with a strict observance of it. If we
are sure that our remedy has been rightly selected, we

262 REPLY TO A LETTER

sometimes direct, particularly in cases that have been actively
treated by allopathic physicians before we were called, and in
which we apprehend a sluggish response to remedies, a
repetition of the dose every few hours, until some ameliora-
tion or decided aggravation appear, but we always order a
suspension of the remedy as soon as either is manifest.

2. We know of no clear distinction between acute and
chronic diseases on which to base a difference in treatment.
Indeed no difference whatever, unless it be one analogous
to that which Hahnemann laid down, viz. : that chronic
diseases are based on the awakening of miasms that had
hitherto lain dormant in the system.

For instance, is scarlatina an acute disease ? Assuredly it
is so regarded. Yet, on the third day, scarlatina often shows
that it has awakened and ingrafted itself upon the scrofulous
(or psoric ?) taint in the patient's constitution and then,
surely, it becomes typically chronic. This is an example
of what we see happen in all forms of disease. It prevents
an available distinction between acute and chronic diseases.

We can assure our correspondent that it is safe and
advantageous to strictly follow the Hahnemannian rule
about the repetition of the dose in acute no less than in
chronic diseases. But let us anticipate a possible confusion
in his mind. Some writers — Dr. Drysdale we are surprised
to see among them — seem to think that Hahnemann, when
he said, " Wait till the first dose shall have exhausted its
action," meant to say, "Do not repeat the dose until that
period shall have elapsed which I have indicated in the
Materia Medica as the duration of action of each drug."
This period for some drugs is several days, for others several
weeks or even months. We do not so understand him.
The duration of action of a remedy on the healthy subject
(prover) furnishes no criterion of the duration of its action
on the sick. Again, the duration of its action on one sick
person furnishes no criterion of the duration of its action on
another sick person. Surely the vital processes are much

ON HIGH POTENCIES. 263

more rapid in acute pneumonia than they are in tubercu-
losis. Is it not probable that the duration of action of a
dose of medicine would be shorter in the former than in
the latter ?

We suppose Hahnemann meant as follows : " If ameliora-
tion follows a dose of medicine, do not repeat the dose until
the amelioration ceases to progress, Then, if the symptoms
be the same as before, though mitigated in severity, repeat
the dose. If the symptoms be different, study the case
anew and make another selection of remedy." It is in this
sense that we have understood and that we apply Hahne-
mann's rule. Not pretending that we do not often, through
errors of judgment, infringe it, we are sure that whenever
we do so, misfortune follows, and that in proportion to our
faithfulness, so is our success.

In respect of the repetition of doses, as well as the form of
the prescription, we have no difficulty with our patients.
Patients are like soldiers; they believe in a man who believes
in himself. We say this in all humility, for, in a matter of
science, belief in one's self is faith in the laws one has under-
taken to carry out in practice. And if the physician show
confidence in his methods, his patients will yield themselves
implicitly to his guidance. The prejudice in favor of large
and many doses is a relic of past ages, when the practitioner
was paid, not for his skill and personal services, but for the
medicines he furnished, — a barbarous usage, which, along
with slavery, we received from our British progenitors.
Unlike them, we have discarded the former but not the
latter.

4. If you use pellets, do you consider them perfectly re-
liable? Assuredly, or else we would not use them. We
medicate them ourselves.

And, how many constitute a dose? If, properly medi-
cated, one is as good as one hundred. As there is a possi-
bility that, in medicating several thousands at one operation,
a pellet here and there may fail to get saturated, we usually

264 REPLY TO A LETTER

give about four to six. We use the smallest pellets as most
easily and surely medicated.

5. Do you alternate the high potencies, or do you rely upon
the single remedy ?

Here again our friend confounds a principle and quantity.
If it be right and advantageous to alternate the low, it is
right and advantageous to alternate the high potencies.
But, in fact, we do not alternate at all. We always rely on
the single remedy at one time. Dr. Drysdale says that
everybody alternates, and, therefore, there must be some
necessity for the practice. But his illustrations are so far
fetched, and his definition of alternation is so contrary to
the conceptions which all other homceopathicians, from
Hahnemann down, have had on the subject, that, notwith-
standing our respect for Dr. Drysdale, we must repeat, in
the very face of his learned paper, that we do not alternate.

Our understanding of the practice of alternation, and our
objections to it were stated, as well as we are able to state
them, in the American Homeopathic Review, June, 1863,
vol. iii., No. 12. x

We are opposed to it in theory, and we abjure it in prac-
tice. It is an abominable heresy. As a shot-gun maims
where the rifle would kill, so alternation may change and
modify and maim the disease, but it never does nor can
effect the clean, direct and perfect cure that a single remedy,
exactly homoeopathic, will accomplish. As a relic of the
polypharmacy which has been the stumbling-block of the
Old School, we loathe it. As a refuge of the careless pre-
scriber and slothful student, we despise it. As an anomaly
in homoeopathic practice, a fatal obstacle to progress in the
clinical portion of our Materia Medica, we deplore it.

6. Do you believe that the high potencies, from your own
experience in the use of them, and from what you have beheld
in the practice of others, are far superior in all respects to the
low preparations as remedial agents ?

1 See "Alternation of Remedies," in this book.

ON HIGH POTENCIES. 265

An affirmative answer is involved in the statement that
we use the high in preference to the low preparations.
For details we refer again to the article which prompted
our correspondent's letter. Personally we have suffered,
and do now suffer, from chronic organic disease, and from
occasional very violent acute attacks. We always use the
high potencies in these cases, preferring them to the low.
We use them in our family and among our friends. We
use them in general practice. Many of our friends and
patients, non-professional persons, know the fact and freely
say that they and their children are more speedily cured by
the high than by the low potencies.

N. B. The imaginations of our friends aforesaid are not
more lively than those of the average of other people.
Indeed, they are plain, matter-of-fact persons, possessing
much common sense, but, for the most part, no genius.
They prefer high potencies.

And now, having replied in detail to the queries of our
correspondent, let us add a few remarks which we beg him
to receive in good part.

To change the aspect of a case, to cause the original
symptoms to be supplanted by other symptoms, this is no
more a cure than "a strategic change of base" is a "victori-
ous campaign." Yet this may be effected by repeated doses
of a drug in a low potency, whether the drug be strictly
homoeopathic to the case or not. And a succession of such
changes and supplantings may be effected, day after day,
until finally the patient gets well or nearly so. Meanwhile
the patient may be amused by the varieties which each day
brings forth, and if he know nothing of a true homoeopathic
cure, but have heretofore had only the heroic treatment, he
may fancy he has been doing finely.

Now, in this way, with low potencies, a practitioner may
do quite a business on a very slender capital of knowledge.

Not so if he use the high potencies. With these no
change is effected in the case unless the remedy have been

266 REPLY TO A LETTER ON HIGH POTENCIES.

strictly homoeopathic to the case. They are like the rifle-
ball — if they hit, they kill; if not, there is no record of the
shot. There can be no good luck from scattering.

Now it will be perceived that the question of cures with
high and low potencies is not merely a question of potencies,
and our friend's trial will not be a fair one unless he make
sure that his selection of the remedy in each case in which
he tries the high potencies is strictly homoeopathic. If he
make sure of this and be correct in it, then let him go on in
confidence with his experiment. We bid him God-speed.

THE QUESTION OF THE DOSE.

In a report to the Homoeopathic Medical Society of the
state of New- York, on the "Use of High Potencies in the
Treatment of the Sick," published in this Review,1 I stated,
"that I have noted only one case in which a high potency
acted but inefficiently, while a lower gave prompt and com-
plete relief;" and, again, "that a general law for the a
priori selection of the potency suitable for a concrete case,
if such a law be possible, is yet to be discovered;" and,
again, "this fact that a low potency succeeded where a
higher had failed, together with similar facts reported by
other practitioners, must have a bearing upon general con-
clusions."

The question of the dose is manifestly an open one. Expe-
rience must be accumulated before we can hope to discover
a law for our guidance on the subject. Every fact bearing
on the question should have our candid and careful study.

In the report alluded to, a portion of the evidence in favor
of the high potencies was detailed. The following cases
present evidence on the other side and deserve particular
attention. They are published by Dr. Arnold, of Heidel-
berg, in the Homceopathische Vierteljahrschrift? together
with some very fair and ingenuous remarks by Dr. Arnold,
who, it may be remarked, is in the habit of using only the
lowest potencies or massive doses.

Psoriasis Guttata cured by Arsenic. — The power of the
preparations of Arsenic to cure psoriasis is so well known
that I should not publish this case, were it not that it fur-

1 North American Homoeopathic * Homceopathische Vierteljahrschrift,
Review, vol. 4, p. 303. January, 1864.

268 THE QUESTION OF THE DOSE.

nishes, in addition, a striking evidence of the fact, that even
in chronic diseases we are often obliged to give strong doses
even of the very heroic remedies if we would accomplish a
cure.

A lady, eighteen years old, whose childhood had been
healthy, and who had never had any sickness worth naming,
who felt perfectly strong and well, and had a blooming
appearance, and in whom no predisposing cause for any skin
disease could be discovered, observed several years ago, on
certain parts of the body, isolated, red, somewhat elevated
spots, on the surface of which small scales were visible.
Inasmuch, however, as she felt well and the spots had spared
the face and neck, she did not think it necessary to seek
medical advice. Gradually the spots became more numer-
ous, their dimensions also increased, and although the patient
had no other complaint, she was yet induced to seek the
advice of a physician on account of the itching, which was
often troublesome, especially at night.

Purgatives and the so-called blood-purifying tea (species
lignorum) had no result. In the spring of 1861 she came to
me. The eruption was over the whole skin with the excep-
tion of the face and hands ; the spots were large and
confluent. I gave her at first one grain daily of the sixth
decimal trituration of Arsenic. But as no change had
occurred in fourteen days, I changed to the fourth decimal
trituration, of which a grain was taken every forenoon. In
fourteen days I found a slight improvement, in that certain
spots seemed to be less red and did not itch so much at
night. I now intermitted the use of Arsenic for three weeks,
and after this period found again the old evil condition. One
grain of the third decimal trituration of Arsenic, which was
now given daily for fourteen days, wrought a more striking
improvement, as well in relation to the development and size
of the spots, which were much less, as also in respect to the
itching at night which had almost altogether ceased. But
inasmuch as, after a pause of fourteen days, this improve-

THE QUESTION OF THE DOSE. 269

ment had again partly disappeared, I felt myself obliged to
resort to a still stronger dose of the remedy in order not to
put the patience of my client to too severe a test. She now
received, once every day, two grains of the second decimal
trituration — that is, one-fiftieth of a grain of Arsenious acid.
The action of this dose resulted, after two weeks, in a very
striking improvement, which moreover maintained itself
during a suspension of the remedy for the next two weeks.
I therefore allowed the patient to continue the remedy for
two weeks longer, taking daily a two grain dose of the
second decimal dilution. The cure was complete and per-
manent; for a half year afterward I had an opportunity of
seeing the lady, and was assured that the recovery had been
lasting.

On the subject of the homoeopathic relation of Arsenic to
psoriasis, scarcely any physician who is familiar with the
effects of this remedy can entertain a doubt. I must confess,
too, that I have often seen a cure result from the use of the
sixth, but still more from the fourth decimal trituration of
this drug. Even in the case just related, the amelioration
might have proceeded to an enduring cure if the use of the
fourth trituration had been continued for a longer time.
But inasmuch as the patient had borne the Arsenic very
well, and not a single symptom of its pathogenetic action
had been apparent, even after a daily dose of two grains of
the second trituration, there was no reason for losing time in
the use of small doses. In any case, this is a new evidence
that in chronic diseases even very heroic remedies must
sometimes be given in very large doses.

Nasal Polypus cured by Calcarea. — A lady, aged fifty-five,
of respectable position in society, pale, of delicate constitu-
tion, small and rachitic from childhood, but never seriously
ill, perceived, several years ago, in the right nostril an
impediment to respiration. An examination by a physician
readily disclosed the presence of a mucous polypus. Various
remedies were administered during a long period without

2/0 THE QUESTION OF THE DOSE.

perceptible effect. Neither Mercurius dulcis, used as a snuff,
nor Corrosive sublimate in solution, to be inhaled, had a
noteworthy or enduring effect. The patient thought the
slight changes noticed were rather to be ascribed to the
weather, and especially to the dryness or moisture of the
atmosphere than to the remedies used.

Under these circumstances, the operation being proposed,
I was asked whether a cure was possible without operative
procedures. I declared that a cure by means of internal
remedies not only might succeed, but that it would have a
much more enduring result than the mechanical removal of
the growth could have ; and furthermore, that an operation,
in case it should prove necessary after an internal treatment,
would be more certain and more lasting in its result than
one without the previous use of corresponding remedies.

Having seen from Calcarea carbonica in several similar
cases a very striking and unmistakable curative action, I
prescribed the fourth decimal trituration of this remedy and
ordered at first one grain daily, and after eight days two
grains daily to be taken. After two months, the patient
appeared and reported that she had taken' the remedy four
weeks and then intermitted it for four weeks, and that no
change in her condition was observable. And I could
myself perceive neither increase nor decrease of the poly-
pus excrescence. This determined me to give the second
decimal trituration of Calcarea, one grain daily. After
fourteen days, the nostril having become more permeable,
and a diminution in the size of the polypus being percepti-
ble, although very trifling in degree, I allowed a pause of
four weeks in the use of the remedy. After this lapse of
time, the tumor had regained its former size ; the lady was
more than ever inclined toward the operation.

I concluded to wait upon her a few weeks longer, and
gave her the officinal lime-water, a tea-spoonful twice daily in
milk. Four weeks later the lady came again to me ; a most
careful investigation revealed no traces of the polypus. She

THE QUESTION OF THE DOSE.

informed me that there was amelioration after the very first
doses of lime-water, and that after a fortnight the nose had
felt entirely free, and since that time there had been no
aggravation.

The improvement has already lasted more than a year
without any further administration of the remedy. Repeated
examinations have failed to enable me to discover any trace
of the polypus.

THE BASIS OF TREATMENT.1

Hahnemann, throughout his works, takes every opportu-
nity to urge the insufficiency of a pathological theory of the
nature of a disease as the basis of the treatment. He every-
where urges that the only sure indication for every case is to
be found in the totality of the symptoms which the case
presents. One would think that nothing could be more clear
and convincing than his arguments on this subject.

His opponents declared that his method ignored medical
science, left no scope for pathology and diagnosis, and
reduced therapeutics to a degrading mechanical comparison
of symptoms. Very many homceopathists have so far
deviated from Hahnemann's method as to endeavor to blend
with the use of his doses and remedies, an application of
pathology as a basis of treatment. This endeavor can never
be successful, inasmuch as the function of pathology is to
furnish, not an indication for medical treatment, but simply
a means of elucidating and collating the symptoms. The
result has been a sad falling off from the standard of success
in practice which was established by Hahnemann and his
pupils. The points at issue are illustrated by the following
case:

Willie M., four years old, was brought to me December 3,
1863. He had been healthy since February, 1863, when he
is reported to have had a long attack of gastric fever, from
which he finally recovered with the affection about to be
described. This was a dyspnoea and wheezing, distinctly
perceptible at all times when the child was awake, and

*Read before the Horn. Med. Society of Oneida County, N. Y.,
June 2ist, 1864.

THE BASIS OF TREATMENT. 273

which, on making any exertion, were very much aggravated,
and resulted in an attack of convulsive cough with difficult
inhalation, the whole paroxysm resembling precisely what
is described as Millar's asthma or Laryngismus stridulus. It
was remarked that the child seemed to be free from dyspnoea
when sleeping soundly, but at no other time. On waking in
the morning he had always a hard fit of coughing, during
which he sometimes raised a little tenacious mucus. His
appetite was good, though somewhat capricious. He was
considerably emaciated ; his spirits were good, and he often
attempted to join in the sports of other children, but was
obliged soon to desist, because of the dyspnoea and cough
which every physical exertion caused and which greatly
fatigued him. On percussion and auscultation the lungs
were found resonant; the respiratory murmur was, of course,
masked by the loud wheezing.

The child had been taken, in September, to Professor A.
Clark, of New- York, who, after careful and repeated exami-
nations, had given a written diagnosis — "Chronic Laryn-
gismus." He gave a very unfavorable prognosis and the
advice to avoid all medication, save only a dose of some
antispasmodic during the violent attacks of dyspnoea. This
advice had not been followed. The child had been, through-
out his illness, under what I regard as very skillful homce-
opathic treatment I had once seen him in consultation, but
had not been able to suggest anything that proved of service
to him.

When now placed under my sole care, I well knew that
the child had already taken, without benefit, every remedy
which has symptoms at all resembling Millar's asthma or
any spasmodic affection of the respiratory organs. And it
was also evident, on even a cursory examination, that no one
of these remedies was clearly indicated by the symptoms of
the case.

I therefore resolved to follow, as implicitly as I could, the
advice given by Hahnemann for the examination of the
19

274 THE BASIS OF TREATMENT.

patient and the selection of the remedy. Dismissing from
my mind, then, every notion concerning the seat and prob-
able pathological nature of the disease, I examined the
patient and made the following record of the symptoms
which he presented.

1. Child emaciated, flesh soft, skin inclined to be yellow
(naturally fair — a blonde) and dry.

2. Appetite very good ; always calls for food as soon as a
coughing fit begins in the morning or forenoon.

3. The right hypochondrium hard, distended, tender to
the touch, painful on exertion and when he coughs. The
right shoulder is elevated and the spinal column laterally
curved ; dullness on percussion on the right side, extending
three fingers' breadth below the margin of the ribs.

4. Distension of the epigastrium which is tympanitic on
percussion, and tender to the touch.

5. Much rumbling of flatus in the abdomen.

6. Frequent ineffectual desire for stool ; stool scanty and
dry, occurring once daily or once in two days.

7. Cough dry; sometimes in the morning a very little
tenacious sputa ; always a coughing fit in the morning on
waking ; he has to sit up to cough ; cough excited by
eating and drinking, by rapid motion, by exertion, by crying
or" talking. The cough hurts his right side.

8. Constant wheezing and dyspnoea aggravated by exer-
tion and by lying down, relieved during sleep.

The tender age of the patient rendered it impossible to
obtain many subjective symptoms, such as usually facilitate
the individualization of cases, and the determination of the
appropriate remedy.

Before proceeding further in the narration of the case, I
desire to say a word upon its pathology. The symptoms
are before us : what shall our diagnosis be ? Is the case one
of spasmodic laryngeal disease, complicated by certain
gastro-enteric and hepatic affections? Or, is it a chronic
hepatitis, complicated by laryngismus ? Which affection is

THE BASIS OF TREATMENT. 2/5

primary, and which secondary? What relation do the
groups of symptoms bear to each other? Professor Clark
seems to have adopted the former view, regarding the gastro-
hepatic troubles as secondary, if indeed he paid any atten-
tion whatever to this complication. The homoeopathic
physicians who preceded me probably adopted the same
view and based their treatment upon it. Now if in so
doing they had happened to take a correct pathological
view, the result might have been favorable ; or if they had
adopted and. acted upon the second hypothesis, and this had
chanced to be the correct view, the result might have been
favorable.

But is it not obvious to every candid mind, that, in either
case, success in the treatment based upon a pathological con-
sideration of the case must depend on the correctness of the
pathological hypothesis — a matter in which certainty can
never be attained.

On the other hand, if we throw aside, as irrelevant, the
entire series of questions as to which is the primary disease
and which the secondary — which the original malady and
which the complication — if we say to ourselves: "Here is
a sick child ; let us examine and record those points in
which he differs from a healthy child," we get the series of
symptoms above recited, which are facts, indisputable,
unmistakable, the result of pure observation. If now, with-
out hypothesis or speculation, we seek to find and do find a
remedy which presents a series of symptoms corresponding
closely to those of the patient, experience justifies us in
believing that we shall have reached the utmost possible
certainty of correctly selecting the remedy.

Comparing the symptoms with the Materia Medica, we
perceive at once that the remedies whose names are usually
associated with Millar's Asthma, Laryngismus, etc., viz.:
Sambucus, Spongia, Cina, Lachesis, Hepar, Stannum, Chlo-
rine, etc., etc., do not cover the case, having but little
correspondence with groups i, 2, 3, 4, $, 6.

2/6 THE BASIS OF TREATMENT.

Nux vomica, on the other hand, covers these groups very
well, as will be seen by comparing Materia Medica. In
addition, it has violent paroxysms of cough in the morning
very early (676 and 677), excited by motion and exertion
(670, 671, 672), producing pain in the epigastric zone (689),
and accompanied by a desire to eat (my own observation).
It has also a well-marked dyspnoea.

The correspondence was so close that I had no hesitation
in giving Nux vomica.

Dec. 9, four powders of the 2OOth were given, one to be
taken every night, and the patient to report in ten days.

Dec. 21, the report was brought to me, that the child had
no more wheezing nor dyspnoea ; had been free from cough
for five days, can play long and vigorously without incon-
venience, is regular in his bowels, complains no longer of
pain or tenderness in the hypochondrium — in fact seems
to be perfectly well.

He deranged the digestion by eating candy at Christmas,
and had a slight return of pain in the hypochondrium, which
a dose of Sulphur relieved. He has ever since been entirely
free from dyspnoea and laryngeal spasm, and is in the enjoy-
ment of robust and perfect health.

If such a mode of practice as this be, as is charged,
unscientific — if it ignore the sciences of pathology and diag-
nosis as bases of treatment — thus much at least may be said
in its favor, that it far surpasses every other method in the
facilities it affords for the fulfillment of one not unimportant
object of the physician — the cure of the patient.

DIAGNOSIS IN HOMOEOPATHIC PRACTICE;

WITH COMPILATIONS FROM DR. KASPAR'S LECTURES.

It is an objection often urged against Homeopathy, that,
as a system of therapeutics, it dispenses with the necessity
for diagnosis. The objection is unfounded. For all pur-
poses of prognosis and hygienic management, we have as
great need of diagnosis as our brethren of the old practice.
And so we have in prescribing. We profess to prescribe
according to the " totality of the symptoms." But by this
we are far from meaning to imply {hat each symptom is
considered and prescribed for, independently of all the other
symptoms. On the contrary, while on the one hand, every
symptom must be taken into consideration as indispensable
to a true " picture of the disease," and hence, in this view,
no one symptom can be said to be less important than
another ; yet, on the other hand, the symptoms vary among
themselves in rank. Some are primary or idiopathic, others
are reflex or sympathetic. The latter are as important to a
"picture of the disease" as the former, but they are important
not simply as symptoms, but as sympathetic symptoms. Now,
to form a diagnosis is to distinguish from among the whole
number of symptoms, the idiopathic and sympathetic symp-
toms, to attribute each symptom, whether idiopathic or
sympathetic, to the organ or tissue which is in reality its
seat, and to form a just notion of the pathological con-
dition of that organ or tissue. That it is necessary for us to
make such a diagnosis before prescribing, follows at once
from the rationale of a homoeopathic prescription.

The homoeopathic practitioner having got "a picture"
of the disease he is about to treat, *'. e., having got the

2/8 DIAGNOSIS IN HOMOEOPATHIC PRACTICE.

" totality of the symptoms," proceeds to compare this
picture with the pathogeneses of various drugs. Now,
these pathogeneses are themselves " pictures of disease ; "
they are symptoms of drug-disease. As such, they are
.divisible into idiopathic and sympathetic symptoms ; the
organs, or tissues, in which they have their seat, and the
pathological conditions of these organs, may be various. In
seeking a drug whose symptoms shall correspond most
nearly to those of the disease to be treated, it is evidently
necessary to seek a drug, the idiopathic symptoms of which
shall correspond to the idiopathic symptoms of the disease,
and the sympathetic to the sympathetic ; a drug, too, whose
symptoms of either variety shall have the same seat as the
analogous symptoms of the disease, and shall result from a
similar pathological condition. But we cannot select this
drug without having^ previously formed a diagnosis, not
merely of the disease to be treated, but also of the various
drug-diseases or pathogeneses that constitute our Materia
Medica. This necessity may be illustrated by a reference
to errors into which a neglect of it leads us. Spontaneous
vomiting of bile by a child may be an idiopathic symptom
indicating abdominal derangement ; or, it may be merely
sympathetic of cerebral disturbance. Several drugs produce
vomiting of bile ; some directly or idiopathically, by affect-
ing the digestive organs ; others, by a reflex or sympathetic
action, their primary action being on the nervous centers.
According to our diagnosis of the disease in the child, and
of the drug-disease, we should give under the one view, Nux
vomica, Ipecacuanha, or their analogues ; or, under the
other, Belladonna. Again, depraved appetite, convulsive
movements, distorted vision, a peculiar aspect of distress,
may be the idiopathic expression of disorder in the nervous
centers, or may be 'sympathetic with irritation produced by
entozoa. In the one case we should select a remedy which
affects the nervous centers idiopathically, as Belladonna or
its analogues ; and in the other a remedy which acts idio-

DIAGNOSIS IN HOMCEOPATHIC PRACTICE. 2/9

pathically on the vegetative sphere, and affects the nervous
centers sympathetically, as Cina. Neglect to distinguish
between these varieties of symptoms has led compilers of
manuals to recommend Cina in hydrocephalus.

Moreover, it is requisite to determine the seat of the
symptoms, both in the disease and in the pathogenesis.
Pain and tenderness in the right iliac region, with local heat
and fever, may have their seat in the cellular tissue, in the
muscular or peritoneal layers, in the ccecum, or even, at
certain times, in the ovary. So might similar symptoms in
a pathogenesis arise from a pathological condition of these
various tissues. Evidently we cannot select our remedy
with certainty of its adaptedness, unless we make a diagnosis
both of the disease and of the pathogeneses of the drugs.

Again, tenderness in the coxofemoral region, pain on
moving the limb, and on pressing the great trochanter in
toward the acetabulum, may have its seat in the tissues of
the joint, or in the nerves that supply that region. And we
have drugs that affect the tissues of the joint, and others that
affect the nerves in question. We must select the former if
the joint, and the latter if the nerves be affected ; and in
order to make the selection we must previously make the
twofold diagnosis so often urged. Neglect of this has led to
the erroneous recommendation of Colocynth in hip-joint
disease. A twofold diagnosis, then, is a necessary pre-
liminary to a properly conducted homoeopathic prescription.

The diagnosis of the disease to be treated is to be made,
of course, where the disease is encountered, at the bedside.
But the diagnosis of the drug-diseases constitutes the syste-
matic study of the Materia Medica.

Our provings are a mass of symptoms, for the systematic
study of which some feasible method has been long a desid-
eratum. Their study and arrangement under the form of
a diagnosis furnish a method well calculated to fix the
characteristics of the drug in the memory, and at the same
time, as we have shown, practically useful to the prescriber.

280 DIAGNOSIS IN HOMCEOPATHIC PRACTICE.

Dr. Watzke and Dr. Kaspar, resident physicians in
Wurmb's Homoeopathic Hospital, in Vienna, have arranged
a number of remedies in the form of a diagnosis, the expo-
sition of which constituted the matter of lectures on Materia
Medica, delivered by Dr. Kaspar at the Hospital, in the
summer of 1851. l The substance of sixteen lectures by Dr.
Kaspar follows, from which the scope and aim of the
analysis will be evident ; and it may not be amiss to sug-
gest that these analyses are designed rather as aids in the
study of Materia Medica than as direct guides for practice,
and that, being greatly condensed, they require diligent
study and constant comparison with the Hahnemannian
pathogeneses.

NO. I. HEPAR SULPHURIS CALCAREUM.

Hepar has many close relations with Mercurius. The
distinction between them is, in fact, rather negative than
positive. Almost all the symptoms of Hepar are found
under Mercurius, but not all those of Mercurius under
Hepar.

Hepar, like Mercurius, develops its effects in the vegeta-
tive processes. Yet, whereas Mercurius increases to excess
the whole secretive activity, and thereby produces emacia-
tion (i. e., by excessive secretion, salivation, diarrhoea,
diaphoresis), the same character belongs to Hepar in a much
less degree. Hence Hepar produces no putrid collapse,
makes no penetrating impression upon, and alteration of,
the vital processes ; hence, too, it exerts no visible reflex
action upon the nervous life, as Mercurius. While the reso-
lutive, alterative action of Mercurius extends even to the
formation of new secreting organs (abscess, secreting pus),
Hepar possesses no such power. In the action of Hepar,
appears, in a slighter degree, the tendency to abnormal

1 These lectures the author attended. — ED.

NO. I. HEPAR SULPHURIS CALCAREUM. 28 1

secretion, and the resulting symptoms have, for the most
part, quite a different pathological foundation from that of
analogous symptoms of Mercurius.

The effects of Hepar appear most distinctly in the
lymphatic system, the activity of which it excites in a high
degree ; and hence it either, on the one hand, increases the
absorptive activity of the lymphatic system, or else, on the
other, causes a too abundant collection of lymph in the
glands, and, in consequence, obstruction, inflammation, and
suppuration of the glands. We find, therefore, among the
symptoms of Hepar, a great number indicating this character,
and we find the greatest number of symptoms in those parts
of the body in which the lymphatic vessels are most abundant,
neck, shoulder, bend of the elbow, dorsum of the foot, etc.

On the increased resorption, on the other hand, depend
a number of other symptoms in other organs, especially in
those in which the lymphatic vascular system is highly
developed.

Although I have so strongly insisted on this, as the sphere
of action of Hepar, I would not be understood to deny to it
any farther action. The excitation of organic activity can
never be circumscribed to a few determinate functions.

If the resorptive activity of the lymphatic be increased, so
will be also that of the venous system. The excretions will
be altered in quantity and in quality.

The action of Hepar is upon the periphery directly.
Hence we find congestion of the skin and mucous mem-
branes ; and, in consequence, redness, heat, swelling — in a
word, an inflammatory condition shown by prickings, eleva-
tions of the skin, rhagades ; a slight degree of suppuration
manifesting itself in rhagades, pustules, nodes, tubercles,
ulcers, also flashes of heat, and dull redness of parts rich in
blood — lips, cheeks, conjunctiva, etc.
• Partly in this way, and partly also by the fact of engorge-
ment and obstruction of the lymphatic glands, we may
explain the symptoms which appear in the skin.

282 DIAGNOSIS IN HOMOEOPATHIC PRACTICE.

Mucous Membranes. These are similarly excited. Their
secretion is not greatly increased. Often, indeed, it is
diminished ; and it is always thickened. The watery portion
being immediately absorbed again, the secretion becomes
viscous, even membranous.

1. In the Intestinal Tract, Heparmust produce diminution
of action ; hence anorexia, nausea, vomiting, acid eructations,
alienated taste, development of gas, etc., and, above all,
enfeebled peristaltic action, and this, again, causes pain
(meteorismus) and difficult evacuation even of soft faeces.

Add to these considerations, the irritation of the mucous
membrane consequent on the great number of lymphatic
vessels in it, and we may explain the several sensations and
pains in the alimentary tract, especially the frequent tenes-
mus and aggravation after every stool. The stools are
green, yellowish-brown, often mixed with blood.

2. In the Respiratory Organs we find a similar condition,
various sensations indicating thickening of the secretions ;
hence, difficult respiration, laborious, dry cough. This con-
dition, together with the puffy tumefaction of the mucous
membrane, which usually accompanies such a condition, will
explain to us the symptoms which we find especially in the
larynx.

3. In the Urinary Mucous Membrane appears the same
state of chemosis. Urine is scanty and dark, with abundant
salts so that, when evacuated, it is already turbid, or else it
soon becomes so.

4. The Salivary Glands are excited to a more abundant
secretion.

The action of Hepar on the Sanguine Vascular System
may be easily determined ; for if it excites one portion of
this system, the remaining portions must of necessity be also
excited, though in a less degree. Hence, febrile symptoms
are not wanting. They are still more clearly pronounced
when a somewhat violent inflammatory excitement has mani-
fested itself, producing its reflex action on the organism.

NO. I. HEPAR SULPHURIS CALCAREUM. 283

The general vascular excitement, however, can never assume
the character of pure, intense synocha.

The relations of Hepar to the Sexual System are unim-
portant. The menses appear too early, and are too copious.

Sensations. As every revulsion of the vegetative proc-
esses provokes various sensations, so does that produced by
Hepar. It is to be remarked, that pains? strictly speaking,
are seldom excited by it. The more frequent sensations are
itching, pricking, rending, and feeling as if beaten. (In
inflamed parts, however, burning, sticking, and tearing pains
are experienced.) Such sensations will be especially felt in
parts where lymphatic vessels course in greatest numbers,
the axilla, bend of the elbow, etc. : thus we have heat, redness,
and pain from the fingers to the shoulders ; needle stickings,
itching in the fingers, swelling in the fingers, and the same
condition in the thigh, ham, dorsum of the foot and the toes.

Characteristic Symptoms.

1. Pains. Various. Especially pressing and general
sensations.

2. Aggravation of Condition. At night, and by exposure
to cold.

3. Thickening of the secretions, swelling, inflammation
and suppuration of the glands.

Indications for Administration. Hepar may be indi-
cated—

1. In diseases of acute, sub-acute, and chronic form.

2. In diseases occurring in lymphatico-phlegmatic indi-
viduals, with white delicate skin, blond hair, disposition to
glandular swellings.

3. In all cases of glandular affection, as well for the
collective chronic process as for the individual acute exacer-
bations ; all scrofulous and tuberculous affections; enlarge-

1 The Germans distinguish between ing in the shoulder. Sensation is

Pain (Schmerz) and Sensation (Ge- general, as to extent, and indefinite,

fiihl). Pain is partial, as to extent, as to seat, e.g., oppression, lassitude,

and determinate, as to seat, e.g., stick- itching.

284 DIAGNOSIS IN HOMOEOPATHIC PRACTICE.

ment, inflammation, and suppuration of all lymphatic glands,
especially those of the neck; a similar condition of the
cellular tissue. Hence it is indicated in mesenteric diseases
of children; in frequently recurring angina ; in inflammation
of the salivary, cervical, and inguinal glands ; panaris ;
inflammation of the eyelids ; discharge of prostatic fluid.

4. All kinds of inflammation which pass into suppuration •
purulent exudations (pleuritis); abscess (for maturation,
Mercurius is preferable) ; hip-joint disease (caries).

5. Inflammation terminating in solid, membranous exuda-
tions ; acute catarrh ; laryngeal croup (after use of Aconite) ;
lymphangioitis, as well external as uterine ; phlegmasia alba
dolens; hooping-cough, after the stage of inflammation (?).

6. Abscesses and analogous formations.

7. The Mercurial Cachexy, Calvities after Mercury;
salivary fistula.

8. Cutaneous Affections. Crusta lactea ; Tinea ; Erysipelas
(after Belladonna) in scrofulous individuals. Generally in
scrofulous skin-diseases.

NO. II. CONIUM MACULATUM.

Conium belongs to that class of remedies which alter the
vegetative vital process in all its relations. Among the
vegetative functions, that of resorption suffers the first and
most marked alteration, being diminished in activity or
completely arrested. The great representative of this func-
tion is the lymphatic system, on which, therefore, Conium
exerts its primary and most striking action.

Next in degree, and of the same nature, is its action on
the venous system. The diminution of the vitality of this
system involves, on the one hand, diminished general
absorption, and on the other, retarded circulation of the
absorbed fluids. Hence, collections form in parenchymata
and cavities, either in the form of fluid infiltration or exu-

NO. II. CONIUM MACULATUM. 285

dation, or as hard tumors. In the lymphatics themselves
depositions occur, which sometimes give rise to tumors.
Such collections are hostile to the organism ; they serve as
excitants to the surrounding tissues ; hence, an inflammatory
condition not unfrequently arises in these formations, which
leads to their destruction. In some cases, however, the
contrary takes place, and the organ attacked becomes
altered.

On these general pathological momenta depend the
following Conium symptoms.

Skin. Tuberculous eruption, passing over into Furun-
culi ; Petechiae ; Erysipelatous cutaneous inflammations ;
Gutta Rosacea ; Ulcers ; Gangrenous ulcers.

Glands. Various pains, generally sticking or cutting,
especially in the mamma and mesenteric glands. Indura-
tion, suppuration, and alteration of the same ; hordeola ;
swelling of the tonsils. Pains in the liver. Inflammation
of the prepuce. Pressing in prostate, and discharge of
prostatic juice. Orchitis ; pain and swelling of testes.
The various symptoms in the breast and abdomen indicate
that the glands are attacked ; but the fact needs anatomical
demonstration. The general disturbance of the resorptive
function probably depends on paralysis of the ganglionic
system, in consequence of which all the vegetative functions
must be more or less disturbed.

Vascular System. The vascular system loses its energy.
The circulation becomes irregular, universally retarded and
enfeebled. Whatever excitation there may be depends
rather upon local causes than upon general stimulus.
Hence, the general thermogenesis will be rather below the
normal standard ; but it may be partially increased. Con-
sequently, in the Conium fever, coldness predominates ; the
pulse is slow and small. (Still, the contrary may occur;
the pulse may be quick and strong, and the heat partially
increased.) The blood in the venous system, therefore, will
be propelled slowly ; hence, this system will be gorged ; this

286 DIAGNOSIS IN HOMCEOPATHIC PRACTICE.

will be especially manifest in the abdomen. The blood does
not receive, on the one hand, the needed reparation, or, on
the other, the necessary elaboration ; it consequently tends
to fluidity and decomposition. Accordingly, cyanosis, ecchy-
mosis, ulceration, and haemorrhage may easily and often be
provoked. The results of every impediment of the circu-
lation are manifested, rather in the periphery ; hence, sev-
eral inflammatory conditions produced by Conium. More
frequently, however, the same cause favors the origin of
infiltrations. By virtue of these tendencies we have inflam-
mations of the eyes and eyelids, hordeola, inflammatory
epistaxis, haemorrhage from swollen livid gums, irritable
state of the throat, bleeding ulcers, haematuria, and inflam-
matory symptoms in the urinary organs.

From what has been said of the general primary action of
Conium, its reflex effect on the individual functions of the
vegetative sphere necessarily follow. We mention the con-
ditions of its action in general terms and in specialties.

The vegetation in general is depressed ; this is shown by
emaciation and change of color.

The secretions are in general diminished, because inter-
stitial absorption is diminished ; for secretion must necessarily
proceed pari passu with absorption ; and wherever this is not
the case, the increase of secretion over absorption must be
only in consequence of some local irritation, e. g., increase of
salivary, lachrymal, and prostatic secretions. Hence, vomiting
is rarely produced by Conium. And, sinpe Conium furnishes
scanty secretions, the stool is, for the most part, retained
and scanty. Urine is scanty ; the mucous membrane of the
urino- genital system is, for the most part, dry. The menses
are retained or retarded.

As specialty, it may be remarked that the intestines stand
in nearer relation to Conium than the stomach does (probably
because of their more intimate connection with the mesenteric
glands), and that the most various symptoms are produced
in them. The stool is generally scanty, with flatulence and

NO. II. CONIUM MACULATUM. 287

pain before evacuation. If the stools are abundant and
watery, so is the urine. The evacuation of urine is attended
by violent pressing and by burning. The sweat is, for
the most part, only partial, and is then accompanied by
heat.

Nervous System. The action of Conium on the nervous
system is considerable, yet certainly of minor importance
and often secondary, showing itself in spasms of various kinds;
it centers in the sensorium, where depression predominates.

Sexual System. The special relation of Conium to the
sexual organs, especially the female, is very important. Its
action is especially manifest in the breast and uterus, pro-
ducing in these organs swelling, changes arrested, or abnor-
mal secretion.

Condition. The Conium symptoms are aggravated at
night and early in the morning.

ANALYSIS.

1. Alters the vegetative functions by altering or modify-
ing resorption ; infiltrations or collections result, which tend
to decomposition. Increased venosity, and finally depraved
nutrition ; effects especially evident in the lymphatic system
and in all glands, and among these, first, the mesenteric.

2. Glands. In closest relation with female sex and
mamma.

3. Nervous System. Secondary Symptoms, manifested by
spasms.

4. Secretions. In general diminished.

5. Pains. No particular character.

6. Aggravation. Night and early morning.
Application. Conium corresponds to lymphatic, blond,

pale individuals ; to children, especially those with large,
soft abdomens, and tendency to glandular enlargements and
cutaneous eruptions ; to women, especially in connection
with uterine diseases or with leucorrhcea ; to women in the
climacteric period; to old women with collections in the

288 DIAGNOSIS IN HOMOEOPATHIC PRACTICE.

uterus ; to pregnant women ; also to individuals who are
easily excited ; to hypochondriacs.

Diseases in general. All those dyscrasias whose develop-
ment begins by deposition in the glandular system. Tuber-
culosis and scrofulosis, especially when these dyscrasias
concentrate in the mesenteric glands ; when, moreover, they
evince rather a passive character, and do not run a rapid
course, but gradually form deposits, and thereby give rise
to partial congestions; in the first periods of such affections,
so long as there is no especial colliquation, and while the
secretions are in general diminished. (If, on the other hand,
they show an active character, Hepar is indicated; when
colliquation has set in, Mercurius.}

1. Tuberculosis Meseraica. Tuberculosis gland ularum
maxillarum colli. Angina in tuberculoso without fever
(Conium alternated with Hepar).

2. Scrofulous and Tuberculous Cutaneous Affections,
especially lupus sub-cutaneus ; tubercles of the skin ; papules
with a white secretion.

3. Scrofulous and Sub-acute Ophthalmia, with great
photophobia especially, affection and suppuration of the
meibomian glands ; formation of tubercles on the eyelids ;
conjunctivitis, with little or no mucous secretion; keratitis,
especially when nebulae form ; also chronic nebulae.

4. Scrofulous Affection of the Ears, with swelling of the
parotids; albuminous, watery otorrhoea.

5. Scrofulous swelling of the nose. Ozaena.

6. Scrofulous Spinal Affection. Pott's curvature ; soft-
ening of vertebral column ; scrofulous coxalgia, which
develops slowly ; scrofulous and tuberculous caries.

7. In Fibrous Scirrhus, in so far at least as at the begin-
ning, it consists of albuminous infiltration, Conium may be
of service ; but generally when an affection of this kind in
the mammary or axillary gland is presented to our notice,
it is too late for its removal. If, however, rational symptoms
or hereditary taint give reason to anticipate or suspect the

NO. II. CONIUM MACULATUM. 289

commencement of such an affection, Conium would certainly
be among the most useful remedies, yet the symptoms of
Conium have rather the character of those of infarctus than
of developed fibroides, in which the knife alone avails.1

8. Induration in general of mamma and uterus (as well
after reduction of inflammation as in chronic form), with
discharge of mucus. All indurations ; not so markedly
indicated, however, in indurations resulting from inflam-
mation.

9. For the Carcinomatous diathesis Conium can do noth-
ing, even in the beginning.

10. In Atrophy of mamma and uterus, Conium may be
useful ; the conditions to which Conium corresponds often
coinciding with atrophy; numerous observations show its
especial applicability to affections of old women.

1 1. Results of Contusions ; hence, after difficult or instru-
mental labor.

12. Since the conditions already named are mostly con-
joined with discharge, Conium may be considered as anti-
leucorrhoeic. Chlorosis, amenorrhcea, and dysmenorrhoea,
when they depend on the same cause, indicate Conium;
yet these symptoms may be independent, and may still coin-
cide with the symptoms of Conium. To the same category
belong also sterility, milk-tumors, and affections caused by
the sudden removal of the child from the breast.

1 The later English authors are tumor, and not to the malignant Can-

disposed to confine the term Scirrhus cer in its first stage, that Coniura is

to the first stage of Cancer, before ul- applicable, and even in this, to benign

ceration takes place. Scirrhus, then, fibroides only in the formative stage,

is always a malignant affection. The During the year 1851, two patients in

Germans apply the term, however, Dr. Wurmb's Hospital, in Vienna, in

indifferently to such benign or malig- whom fibrous tumor of the uterus

nant tumors as from their physical was clearly recognized, were treated

character, hardness, merit the name. with Conium, In one, the tumor

From this character, the benign fibrous disappeared; in the other, it had

tumor (fibroides of Rokitansky) of the greatly diminished in size, when she

uterus or mamma is often called refused further treatment.

Scirrhus. It is to this species of C. D.

20

290 DIAGNOSIS IN HOMOEOPATHIC PRACTICE.

13. Affections of the Intestinal canal; seldom when these
are primary, — chiefly when they are combined with, or
rather are consequent upon, a general condition indicating
Conium. Vomiting during pregnancy; diseases of the
intestinal canal in tuberculous and scrofulous persons, espe-
cially scrofulous children.

14. Dry, nightly, tickling cough, especially in scrofulous
or aged persons ; evening dyspnoea ; pertussis, with much
vomiting ; asthma senile.

15. Feeble condition of old women and men; hysteria;
hypochondriasis in chaste wedlock.

NO. III. MERCURIUS.

Mercurius has been well proved. Its symptoms are
chiefly objective.

1. Its only primary effects are on the vegetative sphere,
which it affects in the highest degree, both quantitively and
qualitatively. It alters the vegetation so deeply and thor-
oughly, that it assimilates itself, as it were, to the whole
organism, decomposes and separates its organic constituents,
and becomes itself a new element of the organism. Hence
arises a new Mercurio-vital process, the natural vital process
having given place to the operation of Mercurius. All
other effects — viz., upon the nervous system — are sec-
ondary.

2. In the vegetative sphere, Mercurius attacks, first of all,
the secretive and resorptive processes. (The increased
absorption is not a secondary result of increased secretion.
Absorption, as well as secretion, is primarily affected, as
is shown by the rapid absorption of Mercurius by the exter-
nal skin.) It excites both of these processes to increased
activity. The secretions are therefore increased in quantity.
They are altered in quality. This alteration has reference
both to consistence and to intimate chemical composition.

NO. III. MERCURIUS.

In consistence, they become thinner and more fluid ; this
effect distinguishes Mercurius from remedies otherwise anal-
ogous, but which thicken the secretions. (Hepar, Conium.)
As to chemical composition, they become acrid and exco-
riating. This twofold alteration depends upon the peculiarity
of Mercurius, already stated (i): in the first place, this plas-
ticity of the secretions is diminished, and fluidation instead
of coagulation is brought about ; in the next, in the room
of the displaced plastic materials, whose decomposition it
effects, Mercurius insinuates and establishes itself.

3. Mercurius causes, first, a condition of excitation (even
to inflammation and suppuration). This is to be explained,
generally, by the stimulating action of Mercurius, and the
reaction of the organism. Then follows a torpid collapse of
the organic forces, — weakness even to exhaustion. This
results from the commencing decomposition induced by
Mercurius.

4. Mercurius penetrates the whole organism. No portion
escapes its action. Before all other parts, however, in sus-
ceptibility, stand: I. All the membranes and the glands
of the lymphatic system ; 2. The parenchymatous organs ;
and 3. The muscular and nervous systems.

EFFECTS IN GENERAL.

I. Vegetation. The vegetative function depends upon
the equality in activity ' of the secretive and absorptive
processes. If one or both of these be abnormally affected,
nutrition and assimilation (vegetation) will immediately
sympathize. Since Mercurius affects these processes pri-
marily, in a very high degree, vegetation must be deeply
affected. The vegetative process is retarded, and at last
entirely arrested, with the following phenomena :

i. As to Nutrition. General emaciation. Laxity; pale,
earthy hue of the skin and mucous membranes ; baldness.
Sponginess of the tissues, especially of the gums ; disposi-
tion to haemorrhage ; diseases of the bones, and, as a

2Q2 DIAGNOSIS IN HOMOEOPATHIC PRACTICE.

natural consequence, great weakness, increased by every
slight effort; great sensibility to all injurious influences;
violent thirst, double vision.

2. Assimilation (i. e,, with reference to vitality and con-
stitution of the blood) is most deeply affected. On the one
hand, the tone of the vessels is depressed ; and on the
other, the blood itself loses its plastic constituents, becoming
altered in composition. Hence, in general, the pulse is
increased in frequency, but is feeble (it may be also slow
and soft). In the beginning, however, congestion and even
inflammation occurs in individual organs ; but later, only
hyperaemia and stases in these and in the periphery. Exu-
dations often occur, partly because of the local inflammation
in the hyperaemic parts, and partly because of the increased
fluidity of the blood. Although, in consequence of the
decomposition of the blood, the venosity threatens to pre-
ponderate, this result is nevertheless obviated by the
excessive secretion, and anaemia or hydraemia is everywhere
manifest; or if venosity become manifest, it is of short
duration, showing itself in ecchymosis.

Secondary Symptoms. With the phenomena above-men-
tioned, the whole vital energy succumbs. The thermogenesis
will therefore be diminished. Thus, the chilliness, sensi-
bility to cold air, and desire for the warmest possible
temperature, are explicable. This is the general condition ;
there may be, however, temporary and partial excitement
of the vascular system ; and hence alternations of heat and
cold occur, which appear so much the more frequently, as
the erethistic condition is more highly developed.

II. Nervous System. The effects on the nervous system
spring from two causes: (i), a general cause, — the diminu-
tion and decomposition of the fluids, and the reduction of
the functions to an erethistic or even a torpid condition ;
and (2), a special cause, — the action of Mercurius upon the
membranes, which extends to the neurilemma and the
nervous centers.

NO. III. MERCURIUS. 293

1. The nervous power is diminished; hence, as regards
sensation, a feeling of great depression, as well as actual
prostration, restlessness and general indisposition; and, as
regards motion, a lack of power, the motions becoming
tremulous, indirect, and scarcely obedient to the will :
hence, mercurial trembling, loss of speech, dysphagia,
cough, etc.

2. By virtue of the special cause, the neurilemma being
attacked, true neuralgia occurs (prosopalgia mercurialis),
especially when single nerve-twigs are involved. The pain
is drawing and tearing, attacks generally but a single nerve ;
often changes its location, but sometimes* retains its seat for
months ; is aggravated by hygrometric changes, and by
changes of temperature. The left side is the most power-
fully affected.

3. As a general rule, only the nerves of sensation and
motion are attacked, the vegetative nerves suffering through
the local conditions.

4. The sensorium is generally depressed (save during
erethism) ; hence giddiness, irritability, mental disturbance,
mania, melancholy, loss of memory, imbecility.

III. Secretions in general. The secretions of every kind
are altered and increased. They become acrid, and the quan-
tity of some of their constituents is abnormally increased.

1. Sweat. Exceedingly copious, easily provoked, oily,
sour, giving a yellow tinge to the linen.

2. Of Mucous Membranes in general. Acrid, causing
therefore burning in the anus and tenesmus, tenesmus of
the bladder, and burning, before and after micturition. The
salivary secretion is characteristically increased. The pan-
creatic secretion is increased ; secretion of bile is increased ;
hence greenish-yellow stools.

3. Genital Organs. Glandular and urethral gonorrhoea ;
increased discharge of semen. Menses increased in quantity.
Leucorrhcea, sometimes mucous, sometimes purulent.

4. Respiratory Organs. The peculiarities of the secre-

294 DIAGNOSIS IN HOMOEOPATHIC PRACTICE.

tions induced by Mercurius are here less obvious. The
normal secretion seems often even diminished. Frequent
haemorrhage.

Abnormal Secretions. To this category belong:

(i.) The purulent decomposition of inflamed parts gen-
erally.

(2.) Formation of pustular eruptions.

(3.) Ulcers in general, as combining these two character-
istics. For, as to the former, the suppuration always pro-
ceeds from an inflammatory process, and is hence preceded by
signs of inflammation, — redness, heat, swelling, — especially
when occurring in the glands and cellular tissue ; hence
swelling of the gums, fauces, tonsils, epiglottis, parotid and
submaxillary glands and inflammation and suppuration of
the cervical, inguinal, meibomian and mammary glands.
Again, as to the latter, the eruptions caused by Mercurius
have the complete character of inflammation, with a ten-
dency to suppuration or to puriform collections. (The
irritative character of Mercurius, and the consequent reaction
of the organism, together with the tendency of Mercurius
to cause fluidity, induce the suppuration.) The pustule
formation is often incomplete ; hence erythema, eczema,
erysipelas, impetigo, rupia (large vesicles) ; or, in mucous
membranes, aphthae, herpes praeputialis. The eruptions
have this peculiarity, that on the spots originally occupied
by them, sequelae form — e. g., scales.

The mercurial ulcer originates in inflammation, removing
the epidermis, and producing a discharge of pus and sanies.
The ulcer rapidly increases in breadth and depth, soon
becomes indolent and spongy, and finally bleeds. The
circumference is red, the margins puffed. It most fre-
quently occurs in mucous membranes, and in the mouth
and on the genital organs.

5. Serous and Fibrous Tissues. These tissues become
irritated. A secretion takes place in the capsules of joints
and sheaths of muscles, fulfilling the conditions of rheu-

NO. III. MERCURIUS. 295

matism. In the serous sacs, collections of water form
(mercurial rheumatism), and also of pus. Inflammation of
the periosteum occurs, with deposition of new products,
e. g., gummata. The bones become dry and brittle, through
loss of fluidity.

IV. Mercurius excites the lymphatic glandular system in
general, even to inflammation and ulceration of the glands
(axillary, cervical inguinal, etc.), and at the same time
primarily stimulates in a very high degree, the absorption
in the lymphatic vessels. N. B. It affects especially the
salivary glands, increasing the secretion, inducing swelling,
inflammation and suppuration.

The Liver. Mercurius induces incomplete reproduction;
hence the fatty diathesis. It is indicated, before all other
remedies, in fatty disease of the liver, resulting from
depressed vegetation.

For the Spleen, Mercurius has little affinity. For the
Lungs, more than for the spleen.

ANALYSIS IN ANATOMICAL ORDER.

Head. Various sensations and pains. Congestion.

Eyes. Irritation, swelling sensation as of sand in the
eye, lachrymation, conjunctival congestion, photophobia,
ptosis, oedema of cellular tissue and conjunctiva, loss of
brilliancy in cornea, nebulae, amblyopia, amaurosis, iritis.

Ears. Inflammation with pustules, haemorrhage, deafness,
illusion of the sense ; pains.

Nose. Peculiar painfulness of nasal bones. Mercurius,
above all remedies, is related to the nose, especially to the
pharyngeal portion of it. Swelling and haemorrhage.

Face. Collapse, paleness, blue rings around the eyes.
(Edema, convulsive jerkings.

Teeth. Swelling, redness, burning, bleeding of gums;
looseness of teeth, aggravation of pain by cold applications,
and at night.

Mouth and Pharynx. At first, erythema; at the same

296 DIAGNOSIS IN HOMOEOPATHIC PRACTICE.

time oedema, vesicles, pustules, aphthae. The inflamed spots
are very sensitive and bleed easily. Swelling and dryness
of tongue, discharge of saliva. Difficulty in moving the
tongue, even to paralysis.

Throat, (Esophagus. Stiffness, swelling of pharynx,
pressing pain, and excoriation. Dysphagia. The tonsils
are first affected, then the gums.

Digestive Organs. I. Loss of appetite, nausea, bulimy,
metallic taste, no thirst, save a desire to moisten the dry
parts affected. 2. Digestion disturbed. Ructus, vomituritis,
collection of water in the mouth ; nightly nausea. Mucous
secretion increased and changed ; pancreatic juice altered.
Stomach pains. 3. Abdomen. Fullness, oppression, meteor-
ism, sensibility, sticking, cutting, pinching pains in liver. 4.
Stools. Frequent, with little or no discharge of solid or soft
faeces ; pappy, whitish-gray or green-yellow, sometimes
bloody, acrid and excoriating; tenesmus, pinching and
burning in anus, going on to inflammation, suppuration and
haemorrhage. Dysentery.

Mercurius has especial affinity for the two ends of the
digestive canal. The stomach and upper intestine are but
slightly affected ; often not at all.

Genital Organs. The mucous membrane is the part
chiefly affected.

1. Male. Swelling; formation of scales, vesicles, pustules,
ulcers, analogous to those of the mouth and pharynx ;
discharges, itching and burning ; discharge of semen without
pleasure ; gonorrhoea.

2. Female. CEdema : Leucorrhcea purulent, acrid. Men-
ses copious.

Respiratory Organs. Expectoration streaked with blood.
Mucous membrane light-colored ; its substance little affected.
Coryza, with acrid, purulent discharge. Trachea. Dry
irritation ; cough, with bloody sputa. Lungs, dyspnoea,
asthma, sticking pains, oppression.

Back and Limbs. In these parts are experienced all the

NO. III. MERCURIUS. 297

symptoms relating to skin, serous and fibrous membranes
and bones, e.g., itching, crawling, burning, lassitude, loss of
power — tearing, sticking, and throbbing pain, cracking of
the joints — cramps and trembling — oedema, exostosis.

Characteristics. Aggravation by cold, and at night;
from exposure to currents of air, and to change of weather ;
this applies to all the symptoms. Swelling and irritation
of the parts attacked, suppuration, ulceration, pustular erup-
tions. Increased and acrid secretions, salivation, diarrhoea,
gonorrhoea. Menses too copious. Sweat; trembling and
spasm, especially of the flexors. Osseous affections. Es-
pecial relation to those mucous surfaces which are nearest
the external skin.

Application, i . Generally. To individuals of a depressed
vegetation, of a tendency to mucous and bloody discharge,
to suppuration with hydraemia, to affections of the lymphatic
and glandular systems. To children in the period of denti-
tion ; to youths of feeble and leucophlegmatic temperament,
but not torpid, on the contrary, rather erethistic. In both
acute and chronic diseases; in the former, however, not
until the general excitement has somewhat abated, and the
inflammatory condition has become localized. In simple
inflammations as well as in formation of deposits.

2. As to erases. In all erases characterized by slow
depression of the plastic life, by increased and altered secre-
tions, and still more, by a tendency to suppuration or to
purulent exudation. All erases in which Mercurius is indi-
cated are characterized by erethism and never by torpor,
hence, Mercurius does not stand high on the list of antiscor-
butics, because in scorbutus there is mere collapse, and no
tendency to suppuration. Still in cases of scorbutus, with
manifest excitement combined with phlebitis, it is often
available. In other cases, Carbo vegetabilis, Arsenicum,
China, Arnica, Lachesis, are preferable. Mercurius is more
strongly indicated in the tuberculous and scrofulous erases
when the parts attacked threaten to inflame and suppurate,

298 DIAGNOSIS IN HOMOEOPATHIC PRACTICE.

and where erethism is present and ulceration threatens. As
to special erases :

1. In Tuberculosis. In the second stage, with tuberculous
ulceration and copious purulent expectoration, with fever
and gradual emaciation, Mercurius should never'bo. employed.
It is indicated only in an erethistic condition of the lungs —
hence not in pneumonia, rather in hectic fever in consequence
of pyaemia. In tuberculous affections of the bones with
tendency to caries. In necrosis.

2. In Scrofulosis, with ulceration or swelling of the glands,
otherwise Calcarea is preferable. Scrofulous affections of the
bones. Scrofulous ophthalmia. In rachitis, as distinct from
scrofula, probably not so appropriate as Calcarea.

3. In Syphilis, especially when the mucous membrane and
glands are affected — especially when ulcerated. Mercurius
has less affinity for the eruptions unless they be pustular
(Rupia). Not so well adapted to the syphilitic osseous
affections.

4. In Pytzmia, from absorption of purulent matters.
Except Arsenic, no better remedy is known for this crasis.
Also in erases that present similar symptoms to those of
pyaemia.

5. In the Inflammatory crasis, with mild fever with
tendency to localization, and inflammatory exudations in the
cellular tissue and glands. Pleuritis, meningitis, peritonitis.
Inflammation of the capsules of joints and sheaths of
muscles, with purulent, plastic exudations.

6. In the Typhoid crasis, Mercurius is scarcely indicated
unless in typhoid parotitis. But in puerperal fever it is a
most precious remedy against both the local affection and the
general condition. In metritis puerperalis, — affections of
the joints, and puerperal deposits (metastatic), because of the
general tendency to pyaemia.

7. In the Rheumatic crasis, seldom indicated, rather where
the periosteum is affected with aggravation by change of
weather.

NO. III. MERCURIUS. 299

8. In the CEdematic crasis, contra-indicated in anasarca or
ascites.

9. Mercurius is indicated in Icterus, with irritation of the
liver — febris biliosa.

10. In Exanthemata, vesicular, and pustular (seldom the
papular), both acute and chronic. In variola, when pyaemia
is established after the repercussion of the eruption. In
salivation ; in herpes zoster Mercurius vivus is a specific.
In benign furunculus (not in malignant), impetigo, miliaria,
eczema, crusta lactea.

INDICA TIONS IN ANA TOMICAL ORDER.

1. Head. Hydrocephalus acutus; abscesses in the scalp;
caries; syphilis.

2. Ophthalmia scrofulosa, and catarrhalis with purulent
secretion ; inflamed cellular tissue.

3. Otitis with purulent discharge.

4. Angina with tendency to suppuration. Tonsillitis.
Aphthae.

5. Swelling, inflammation and suppuration of the gums.

6. Glossitis; inflammation of cellular tissue and glands,
with irritation of all surrounding parts ; suppuration, ulcera-
tion, salivation, toothache, with ulcers from caries, stomacace
(compare Iodine).

7. Hepatitis, acute and chronic. Bilious derangements.

8. Enteritis, acute and chronic, when actual pus is formed
after the first stage.

9. Diarrhoea generally, with muco-purulent stools, green
and bloody, tenesmus, scanty stools, much tormina, burning
in rectum, no pains in the abdomen.

10. Proctitis, and proctalgia, with discharge of pus and
blood.

11. Dysentery in high grades, with purulent secretions,
tenesmus, scanty stool.

12. Inflammation of kidneys (and irritation after inflam-
mation), with irritation and purulent urine.

300 DIAGNOSIS IN HOMOEOPATHIC PRACTICE.

13. Inflammation of the bladder and urethra.

14. Gonorrhoea, ulceration of the genitals; oedema
praeputialis (especially in children, with slight erysipelas) ;
orchitis; leucorrhoea excoriating.

15. Metritis, especially lymphangioitis, leading to pyaemia.

1 6. Oophoritis (after Belladonna, and succeeded by
Platina). Hydrops ovarii. (Graphites ?)

17. Catarrh; not indicated unless there be purulent dis-
charge.

1 8. Myelitis.

19. Panaritis. (Mercurius yields only to Hepar in
efficacy.)

20. Psoitis; scrofulous coxalgia in incipience. When
suppuration already exists, Mercurius does not remove it.
Phlegmasia alba dolens.

21. Arthritis. White swelling.

22. Trembling, twitching of the features, as a secondary
phenomenon. Neuralgia.

NO. IV. ACONITE.

Aconite is the general representative of antiphlogistics.

Effects in general. I . Vascular System. It operates power-
fully as a direct excitant of the vessels, and produces, there-
fore, true synocha.

2. Aconite produces no crasis, and has, therefore, no
tendency to product-formation. Its action is purely
dynamic, viz.: the pulse is much accelerated, hard and
strong; thermogenesis is increased; thirst great; general
sensation abnormal.

3. It has a greater action on the more vascular organs —
hence above all, on the lungs, giving rise to various degrees
of excitement; next to the lungs it affects the periphery,
and, last of all, the intestines. Hence congestion of blood
to these parts, and haemorrhages.

NO. IV. ACONITE. 3<DI

4. It has no especial relations to the fibrous and mucous
tissues, although it exerts an inflammatory action on all
organs and tissues of the body. (Bryonia also has this
specific action, although it excites the vascular system less
intensely than Aconite.)

5. Its action on the Nervous System is secondary, i. The
sensorium is either excited in consequence of the vascular
excitement, — hence delirium, — or, 2. It is depressed by
reason of the vascular congestion ; hence sopor.

6. Aconite has characteristic morning and evening exacer-
bations ; the majority of the pains are sticking ; other pains
occur according to the nature of the organ attacked.

General Indications. Aconite is generally indicated, I.
In all inflammations in the beginning, against the vascular
excitement which always prevails, before the disease is fully
developed. Its action is brief, and does not interfere with
that of subsequent prescriptions. 2. As an alternating
remedy after the development of the disease, when the
vascular excitement continues.

Special Indications. I. (i.) Inflammatory Fever. (2.) In
all inflammations, a. While the vascular excitement is great,
and before any product has yet formed, b. When the
product is already forming, if the vascular storm has not
abated. (3.) Especially in inflammations of the serous and
fibrous tissues ; Aconite is preferable to all other remedies
in these cases — when the vascular excitement is great, and
a plastic exudation threatens (for less intense vascular
excitement and a threatened serous exudation, Bryonia) ;
hence in meningitis, pleuritis, peritonitis, under these con-
ditions.

2. In Ophthalmia, — acute, with febrile excitement, — a
sovereign remedy.

3. In the periods of dentition and menstruation with
vascular excitement. It does not disturb the menstrual
function.

4. Acute Rheumatism.

COL— V

3O2 DIAGNOSIS IN HOMOEOPATHIC PRACTICE.

5. Acute Catarrh.

6. Tuberculosis with febrile excitement.

7. Vascular affections. Arteritis, pericarditis, and endo-
carditis. In organic heart disease, for the periodical excite-
ment. (Aconite is preferable to Digitalis, which sometimes
leaves injurious sequelae.)

8. Violent dynamic congestions, depending on no organic
cause.

NO. V. CALCAREA CARBONICA.

Calcarea affects exclusively the vegetative system ; all
other action is secondary. The secretive and resorptive
functions are immediately stimulated to increased activity,
and a condition of irritation ensues. All organs and sys-
tems are affected, the nutrition of all being altered. The
lymphatic system is affected in a special degree ; and, in
the mode of this affection, the Calcarea symptoms resemble
the scrofulous process in its lower grades. Calcarea is a
chronic remedy, because it alters the erases ; also a sub-
acute, because the products of the altered erases provoke a
state of irritation. Its action is not stormy, but mild and slow.

1. Nervous System. Not specifically affected; the iso-
lated spasms that occur are secondary. Pains corresponding
to the nature of the organs attacked. Sticking pains, and
a sensation of rigidity, predominate.

2. Vegetation in General. A cachectic habit is induced ;
decrease of temperature ; puffiness of the soft parts ; laxity
and general debility, with increased sensibility to external
influences, — as changes of weather.

3. Vascular System. Moderate degree of fever; chill and
heat quickly alternating ; fugitive heats ; chilliness predom-
inates. Sweat breaks out easily, especially in the palms
and soles ; evening exacerbation. Thus, a fever resembling
that of Tuberculosis. The composition of the blood is not
primarily altered ; secondarily it is altered.

NO. V. CALCAREA CARBONICA. 303

4. Lymphatic System. Excitement and irritation. Re-
sorption is deranged, and its activity is increased ; the
glands are swollen, irritated, become the seat of a deposit,
and even pass into a state of inflammation. The glands
of the neck and mesentery are especially attacked.

5. Skin. Irritation, evinced by erythema, erysipelas,
papules, vesicles, pustules, bleeding ulcers, and scaling off of
the epidermis, especially on the head ; the skin ulcerates
easily, especially at tender points, — e. g., lips and margins
of eyelids, the inner surface of the arms, and the anterior
surface of the thigh, dorsum of the foot, and outer surface
of the ear, etc.

6. Mucous Membrane and Glands. Irritation. Secretion
rather diminished than increased.

ANALYSIS IN ANA TOMICAL ORDER.

1. Head. No especial symptom of cerebral disturbance.
Frequent congestion in consequence of the general irritation.

2. Eyes. Irritation and rigidity of the lids. Conjunctiva
reddened ; feeling as of sand in the eye ; photophobia ; the
secretion of the meibomian glands is thick and glutinous.
Lachrymal secretion increased.

3. Ears. Increased secretion of cerumen. Purulent
discharge ; deafness.

4. Nose. Ulceration of the alae; purulent, foetid dis-
charge. Dry obstruction.

5. Mouth. Gums red and swollen. Also the whole mouth
to the uvula. Salivation. Tonsils and palate swollen. Deg-
lutition difficult

6. Intestinal Tract. In stomach and abdominal canal
great sensibility to pressure ; burning and pinching pains.
Loss of appetite. Repugnance especially to meat, which
passes away undigested. Rancid, sour eructations. Faeces
long retained ; hence, tormina. Stools solid and dry, with
straining. Sometimes also diarrhoea (secretion being abnor-
mal in quality), watery and pappy, always scanty. The

304 DIAGNOSIS IN HOMOEOPATHIC PRACTICE.

intestinal secretion being abnormal, induces irritation ; hence,
spasm of stomach and intestine.

7. Liver. Irritation, especially in the biliary passages.

8. Urinary Organs. Pressing and sticking in the kid-
neys and bladder ; burning, dysuria, enuresis. Urine
diminished in quantity, and for the most part saturated
with saline constituents, and hence dark or turbid.

9. Genitals. Congestion' and swelling. As to sexual
functions, erethism ; and, as an alternate effect, diminished
instinct Sweating of the labia and scrotum (in gonorrhoea
and onanism, compare Sepia and Selenium, Bcenninghausen).
It is a most important remedy in connection with early
and too copious menstruation ; so much so, that it acts
favorably only when these conditions are present.

10. Respiratory Organs. Mucous secretion altered, — either
increased or diminished. Tenacious, thick mucus. Dryness
of throat ; dry cough, constriction of chest, with hoarseness
and roughness.

11. Muscles. Stiffness; pains in the joints, causing diffi-
culty of motion. (Calcarea favors the secretion of chalky
deposits in the synovial sac.)

12. Bone-pains from head to feet.

Characteristics. Calcarea affects primarily only the vege-
tative sphere ; from this its operation extends over the
whole organism, exciting moderately, producing irritation,
and appearing to favor a deposit of the earthy salts. The
lymphatic system of vessels and glands is first and most
deeply affected, being the seat of irritation, swelling, depos-
its, and their consequences. The skin and mucous mem-
branes are next affected ; the secretions are often diminished,
and often increased (when increased, only relatively), and
are generally acrid and sour. The whole nutrition suffers
very greatly. Menstruation is too early and too copious.
The pains are various ; chiefly a feeling of stiffness, with or
without sticking pains. Aggravation by change of temper-
ature, especially by cold, and at night. (Bcenninghausen

NO. V. CALCAREA CARBONICA. 305

designates many important symptoms, which are aggravated
in the morning, in contradistinction to corresponding symp-
toms of Causticum, which have evening aggravation. — C. D.)
Application. To youthful persons and females ; to those
who are badly nourished, pale, with affections of the skin
and mucous membranes ; to all, in short, who present the
scrofulous diathesis, or one like it ; especially at the period
of development ; dentition and puberty (menses too copi-
ous) ; moreover, for children generally. The symptoms of
Calcarea present a striking picture of erethistic scrofula,
for which diathesis it is eminently appropriate. (For the
cancerous diathesis, Arsenic ; for the chlorotic, Pulsatilla.)
Tuberculosis and Rachitis, with excitement and irritation.

1. Children who do not walk until after the usual age,
who manifest great irritability, have large, distended abdo-
mens, and scrofulous inflammations of the skin, — i. e., gen-
erally little vesicles producing crusts, chiefly on the head
and face, lips, nose, and eyes, — subjects to scrofulous ophthal-
mia, scrofulous ozcena, scrofulous affections of the ears, —
especially with a purulent discharge. In atrophia infantum,
without suppuration, Calcarea is better than Arsenic. In
osteomalacia ; swelling of the glands. Indigestion, with acid-
ity, in scrofulous subjects. Acid, pappy diarrhoea ; also
constipation. Helminthiasis in a scrofulous diathesis. What
is true of scrofula in general, is true also of tuberculosis.

2. Adults also ; in tuberculosis, with colliquative sweats.
Ophthalmia, with thick blennorrhoea. Ophthalmia which
has left behind it opacity of the cornea. Blennorrhoea nasalis.

3. Rheumatism, acute or chronic. Tendency to vesical
calculus.

4. Tonsillitis frequently recurring; general irritation of
tonsils.

5. Gastritis. Chronic, especially with acid formations.
Gastromalacia chronica, with evacuation of undigested faeces.
Disposition to catarrh, chronic catarrh, catarrh of bladder
and vagina.

21

306 DIAGNOSIS IN HOMOEOPATHIC PRACTICE.

NO. VI. BRYONIA ALBA.

Bryonia is in every respect closely allied to Aconite, as
well in its general relation to the vascular system as in its
special affinities.

1. Vegetation. It operates directly on the vegetation,
affecting especially the secretive process, producing a high
degree of irritation, sometimes even inflammation. First of
all, however, it increases the activity of the resorptive appa-
ratus ; that of the secretive function is a consequence.
(Compare Mercurius.) Bryonia induces the formation of
products, viz. : infiltration into the cellular tissue, and serous
exudations into the serous sacs. It produces no plastic
exudations (as Hepar and Mercurius do). The blood is
affected, as in the milder forms of typhus. By virtue of its
action on the resorptive and secretive functions, Bryonia has
especial affinities for the abdomen, where abound those
organs and tissues on which it especially acts, viz., serous,
fibrous, and mucous tissues.

2. Vascular System. The vascular system is excited in a
less degree than by Aconite. Its action is partial, i. e., is
exerted upon single organs. During the paroxysm of fever,
the chill predominates, occurring often in the midst of the
heat Thirst is very intense (because of the increased
resorption) ; sweat very copious.

3. Nervous System. • On the nervous system it acts, I.
probably directly, attacking the serous envelopes, the men-
inges and neurilemma; 2. mechanically, the excretions
which it induces, producing, by compression, a depressing
effect.

4. Skin. No especial relation. Irritation, oedema, and
vesicles, characteristic. No pustules.

5. Eyes. Irritation, serous secretion, especially attacks
the sero-fibrous tissues (keratitis, sclerotitis, iritis). The
secretions are at first watery ; later, they are purulent, thick
and tenacious.

NO. VI. BRYONIA ALBA. 3O/

6. Ears. A mild form of periostitis — watery discharge,
sticking pains, illusions and dullness of hearing.

7. Face. Generally paleness; frequently, however, fugi-
tive heat, swelling, with slight redness.

8. Digestive Apparatus. Irritation. Secretion of the
mucous membrane is at first thinned, then thickened, and then
altogether suppressed. Burning in the mouth and throat ;
difficult deglutition. The fibrous coats of the muscles are
especially affected, hence pain on turning the head, swallow-
ing, etc. (different in seat from pain of Belladonna). QEdema
of the gums, and of the whole .cavity of the mouth. Perios-
teum alveolorum affected ; excessive sticking pains through
the entire row of teeth, accompanied by oedema of the
gums, even to the roots of the teeth. Salivary secretion
increased and thin. Stomach. Digestion disturbed, in con-
sequence ructus, vomituritio, vomitus post pastum. Intes-
tine. Similar irritation ; constipation as well as diarrhoea
(serous) ; rather, however, an alternation of the two ;
pinching and burning pains. Peritoneum. Irritation.
Sticking pain, great sensibility. Hence, symptoms from the
liver, kidneys, bladder, and uterus (their peritoneal coats
being affected). The secretion of the liver is increased.
The stools are thin and green, from intermixed bile;
frequent vomiting of bile. The kidneys more deeply
affected, secretion diminished, urine clear. For the sexual
organs it has no affinity, except in so far as the serous
envelopes of the organs are concerned. CEdematous and
painful swellings of the testes.

9. Respiration. Irritation. Secretion, for the most part,
increased, thin and serous. Dyspnoea. Pleuritic inflamma-
tions, with exudation.

10. Rheumatismus Acutus. Pain, swelling, increased
temperature, redness, sensibility to changes of the weather,
inability to move the parts. Inflammation of the perios-
teum, especially of the head and face, with the characteristic
sticking pains.

308 DIAGNOSIS IN HOMOEOPATHIC PRACTICE.

The symptoms occur chiefly in the serous and fibrous tis-
sues.

Application. Bryonia is indicated in a condition between
synocha and typhus, resembling the former as respects the
vascular system, and the latter as respects the nervous (com-
pare Arnica). It is suitable for nervous and bilious tem-
peraments, persons of dry and spare habit, dark complexion,
excitable character, and predisposition to inflammation of the
membranous tissues ; for women and children in whom
excitability is great, but energy and stability of reaction only
moderate, who are inclined to lymphatic exudations and
accumulations, and to nervous diseases, and at the same
time, in an equal degree, to active congestions.

It is appropriate in all varieties of rheumatism, and in all
conditions in which catarrhal and rheumatic characters are
combined.

1. Typhus. The efficacy of Bryonia in the commence-
ment of typhus is attested by all homoeopathic writers ; but,
as in its very commencement typhus is not easily recognized,
the claims of Bryonia remain sub-dubio. In typhus versa-
tilis, however, with rheumatic pains, it is efficacious in all
stages. Also in complications of typhus, with meningitis
or pleuritis. In localized typhus, attacking the peritoneum
or pleura, it is a sovereign remedy.

2. Intermittent Fever. Only in those cases in which the
disease acts directly upon the ganglionic system, in which
the cold predominates, and thirst and pain in the limbs are
great, with accessory symptoms, e. g., serous diarrhoea and
sticking pains.

3. Skin. Urticaria. Morbilli with oedema, especially with
a vesicular eruption. Miliaria (copious sweat). Sweating of
the feet, not offensive. If offensive, Carbo-vegetabilis is
preferable.

4. Nervous Affections, of various kinds, having their seat
in the meninges and neurilemma. Oppression, dizziness,
staggering, etc.

NO. VI. BRYONIA ALBA. 309

5. Rheumatism. Acute, with serous exudations and
general vascular excitement.

6. Membranes. Inflammation of serous membranes, with
serous exudations containing plastic flocculi. Irritation of
meninges (in actual inflammation Belladonna is better). Con-
junctivitis. Hydrops oculi acutus. CEdema palpebrarum.
Otitis. Ozaena. Swelling of the face, with sticking pain or
without pain. Toothache, sticking pain, with extensive
swelling, increased by cold, alleviated by warmth. Periton-
itis, and hence hepatitis and enteritis serosae.

7. Gastric phenomena, especially serous diarrhoea. Also
renowned as a remedy for constipation. (The irritated con-
dition of the membranes induces diarrhoea, and probably, at
a later period, dryness of the membranes, and hence con-
stipation.)

8. Icterus, depending on chagrin, anger, excessive physical
efforts, and a sedentary mode of life.

9. Mastitis, in nurses, especially when the mamma is
somewhat cedematous with sticking pains, and the inflamma-
tion is slight (for violent inflammation, with hardness,
redness, and pressing pain, Belladonna; — Phosphorus, Bcen-
ninghausen).

10. Respiratory Organs. Pleuritis. Bronchitis with dimin-
ished secretion, much irritation, exciting a cough, and scanty
serous expectoration, raised with difficulty. In pneumonia
it is less frequently indicated ; only in pleuro-pneumonia, and
in pneumonia with great oedema. In bilious pneumonia (of
the right lower lobe). Bryonia has in general great affinity
to the biliary apparatus.

11. General. Pericarditis, endocarditis, hydrocele (Rhodo-
dendron). CEdematous glandular swelling. Sclereme.
Anasarca, especially acute oedema pedum.

In phlegmone colli experience has shown Bryonia to be a
most valuable remedy (Wurmb).

310 DIAGNOSIS IN HOMOEOPATHIC PRACTICE.

NO. VII. RHUS TOXICODENDRON.

GENERAL EFFECTS.

Rhus acts primarily on the vegetative system, affecting
especially the functions of resorption and secretion. All
other symptoms are reflex from these effects.

1. Its primary action is excitation (irritation).

2. It has especial relations to the membranes ; and
especially to the mucous membranes and external skin,
producing irritation and even inflammation.

SPECIAL ACTION.

1. Vascular System. Irritation, even to fever. The pulse
is hard, full, and frequent, and the heart impulse strong;
but the peripheral vascular system is more particularly
affected, and sometimes this alone. Hence the external
heat exceeds the internal; both, however, are abnormally
increased; thirst is very great. Vascular torpor is only a
secondary condition, and is, hence, no indication for
Rhus.

2. Nervous System. Secondarily affected. In case of
moderate vascular irritation, the nervous system is excited ;
in case of very great vascular irritation, it is depressed.
Hence, in the former case, great mental excitement, anxiety,
irritation, sleeplessness, or restless sleep with anxious dreams;
and, in the latter case, sinking of the powers, weakness even
to syncope, trembling, and convulsive jerkings.

3. Cerebral System. Specifically affected. Symptoms of
incipient typhus : headache, diminished mental activity,
uncertainty of movement, roaring in the ears, long apparent
pondering before answering a question. These cerebral
symptoms are present in every case of Rhus intoxication,
and are hence characteristic. Hence the applicability of
Rhus in typhus.

4. Nutrition. Depressed, but not in a very marked
degree.

NO. VII. RHUS TOXICODENDRON. 311

5. Secretions. I. In the higher grades of excitement, all
the secretions are diminished in quantity and thickened.
2. In the lower grades of excitement, they are increased in
quantity and thickened, or else they become serous. 3. The
Rhus irritation, unless it proceed to inflammation, is always
accompanied by serous discharges, in the form of evacua-
tions or of cedema.

TISSUES.

1. Skin. Especially affected. Even contact of the leaves
of the plant, or proximity to them, produces an eruption,
varying in intensity from the slightest erythema to the
gravest form of vesicular erysipelas. Vesicular formations
are characteristic of Rhus.

2. Mucous Membranes. I. Aphtha, swelling of the tongue;
cedema and swelling of tonsils, and vesicular angina ;
phimosis and paraphimosis, vesicular formations on the whole
penis, scrotum, and perineum, with cedematus swelling of the
neighboring parts. This Rhus cedema is everywhere hot
2. Dryness of the mucous membranes, and, in consequence,
difficult deglutition, tickling in the larynx, dry tongue, hoarse-
ness, dry and painful cough, burning in the chest, burning
pain in the stomach, nausea, repugnance to stimulating food,
as flesh, wine, etc.1

Intestinal Canal. Tardy action. Tenesmus ; painful
evacuation of dry, friable faeces, often light-colored ; also,
but less frequently, from the tendency to serous depositions,
thin serous stools. (See note.)

Urine. Diminished ; evacuation painful ; tenesmus, with
burning; emission by drops ; also, involuntary evacuation.
Urine turbid and scanty, with copious white sediment ; also,
increased in quantity and pale. (See note.) Region of the
bladder, sensitive.

1 These different conditions of the by different grades of intoxication.
mucous membrane depend on the Vide supra, Secretions, I and 2.
different degrees of irritation induced C. ^.

312 DIAGNOSIS IN HOMCEOPATHIC PRACTICE.

Sexual System. Excited ; a condition of erethism.

3. Serous Membranes. Secretion diminished; dryness,
cracking in the joints ; feeling of roughness and stiffness ;
sticking pains.

4. Sero-fibrous Tissues. Secretion diminished ; sensation
of stiffness in the sheaths of the muscles, causing pain and
difficulty of motion.

5. Osseous System. Periosteum is attacked; boring and
deep sticking pains in the malar and maxillary bones.

Characteristics. Aggravation during repose ; amelioration
by motion ; action often confined to one side, more frequently
the left side.

APPLICA TION.

General. I. To acute and sub-acute cases ; less frequently
to chronic. 2. In affections of the membranes, especially
if accompanied by an evident dyscrasia, and attended by
nervous phenomena. 3. In affections resulting from expos-
ure to rain while perspiring. (Boenninghausen.)

Special. I. Vesicular Cutaneous Diseases of all Varieties.
Erythema and erysipelas bullosum ; scarlatina miliaris ;
miliaria ; carbuncle ; and, generally, all cutaneous eruptions
that tend to gangrene. Herpes acutus ; crusta lactea ;
hydrargyrosis ; variola, with highly developed oedema and
great cutaneous irritation ; acute pemphigus ; cedema after
acute eruptions, with redness, heat and fever ; acute oedema
per se (Morbus Brightii ?).

II. Sero-fibrous Membranes. Acute and sub-acute rheu-
matism affecting the joints and muscles, characterized by
considerable swelling, redness, heat of the joint, pain
diminished by motion, increased by repose, with miliaria
and pustules around the joint ; rheumatism of the fascia lata.

III. Rheumatic Odontalgia. Tearing, boring pain over
the whole chin ; swelling, redness of the gums ; erysipelatous
swelling of the cheeks and region of the lower jaw, even to
the eyes and forehead.

NO. VII. RHUS TOXICODENDRON. 313

IV. Mucous Membranes. Acute catarrhs and inflamma-
tions ; laryngitis, bronchitis, gastritis, enteritis, etc., of
mild degree, attended by nervous phenomena.

1. Conjunctivitis, with cedema, vesicles and pustules ;
great pain, dryness, photophobia ; gluing together of the
eyelids ; pain on opening the eyelids, especially in scrofulous
subjects.

2. Otitis and pharyngitis.

3. Inflammation of prepuce and scrotum, with vesicles
and cedema.

4. Mucous diarrhoea, with great tenesmus ; first stage of
dysentery, scanty, frequent and painful stool.

V. Typhus and other Maladies, with Nervous Phenomena.
In the lower grade of typhus, in the first stage, everything
indicates Rhus ; predominant excitement ; constipation, or
frequent serous, greenish-yellow stools, especially if attended
by miliary eruption.

1. Miliaria puerperalis ; purpura haemorrhagia febrilis.

2. Catarrhal fever, when the nervous system is especially
involved.

3. Puerperal fever in the lower grades; peritoneal irrita-
tion without exudation, rather of a rheumatic character ;
exudation scanty, and not plastic.

4. Pleuritis of the same character as peritonitis, nervous
phenomena accompanying.

5. Pneumonia; difficult, thick, tenacious expectoration,
with slow and tedious resolution (Pneumonia notha).

6. Heart diseases, especially of the pericardium, attended
by nervous phenomena.

7. Lumbago ; paralysis in lumbar region.1

8. Intermittent fever. Nervous symptoms predominate.
During the paroxysm a rheumatic condition comes on.
Thirst and heat are very great During the sweat, miliaria
make their appearance.

1 Among the records of his large of the lumbar muscles in cows, after
veterinary experience, Boenninghausen calving, cured by Rhus, followed by
has many cases noted of paralysis Nux vomica. — C. D.

314 DIAGNOSIS IN HOMOEOPATHIC PRACTICE.

9. All diseases bearing a resemblance to rheumatism,
which, however, one hesitates whether or not to pronounce
typhus.

NO. VIII. COLCHICUM AUTUMNALE.

Colchicum ranks, in almost all respects, next to Bryonia.
It acts especially on the serous and fibrous tissues. Its
characteristic pains are sticking.

1. Differences. I. Bryonia is adapted rather to acute
diseases ; Colchicum to sub-acute and chronic. 2. Bryonia
affects the vascular system more deeply than Colchicum,
exciting fever. 3. Bryonia attacks the larger serous sur-
faces; Colchicum rather the smaller ones (articular serous
surfaces), and the sheaths of the muscles, rather the fibrous
and fibro-serous, than the purely serous tissues ; hence the
periosteum and muscular sheaths are especially attacked.

2. Mucous Membrane. The action of Colchicum resem-
bles that of Bryonia ; the secretions are diminished in
quantity, and thickened ; but Colchicum produces a far less
degree of irritation than Bryonia does ; hence its applica-
bility in chronic catarrh, with a moderately copious tenacious
mucous secretion (catarrh of old people).

3. Nervous System. No especial primary action.

4. Adaptation. Colchicum corresponds to the venous
constitution, the phlegmatic, melancholic temperament;
Bryonia rather to the nervous, erethistic temperament.

The pains of Colchicum, like those of Bryonia, are aggra-
vated by touch and by motion ; those of Colchicum, how-
ever, are worse in the evening and during the night ; while,
generally, the symptoms of Bryonia are aggravated in the
'morning on awaking.

Colchicum, like Bryonia, produces tearing, sticking pains ;
but those of Colchicum appear as tearing or sticking jerkings
through the periosteum, while the pains of Bryonia are

NO. IX. LEDUM PALUSTRE. 315

accompanied by the general, feeling, as if beaten (zerschla-
genheitschmerz) throughout the muscular system.

Colchicum, then, is more suitable when the excitation is
slight, — when the disease inclines rather to a torpid char-
acter, therefore to diseases of torpid, phlegmatic individuals.

5. Chief Sphere of Action. Rheumatism (sub-acute and
chronic, but not of very ancient date), chronic gout, with
thickened secretions, especially if characterized not so much
by pain as by impediments to the free motion of the parts
(semi-paralysis, quasi-paralysis). In the latter stages of
acute rheumatism Colchicum is often indicated. (Kaspar
appears to find frequently appropriate in acute rheumatism,
1st, Aconite; 2d, Bryonia; 3d, Colchicum.)

In dropsy, conjoined with a general torpid condition, with
little or no irritation, — dropsy after exanthematous diseases,
— also, but less frequently, in dropsical affections of the
synovial sacs, and of the thoracic cavities, — Colchicum is
indicated.

In diarrhoea, with plastic excretion and rheumatic com-
plication, characterized by great flatulence, — in a low grade
of autumnal dysentery, or rather in sanguineous diarrhoea
than in real dysentery, — Colchicum is appropriate.

In hydrops oculi, diseases of the sclerotica and cornea,
and especially opacity of the cornea, — and among affections
of the chest, in chronic catarrh, with scanty plastic secre-
tion, and great sensibility to changes of temperature, espe-
cially to cold air, — Colchicum shows itself efficacious.

NO. IX. LEDUM PALUSTRE.

Ledum ranks next to Colchicum in its action on the serous,
fibrous, and mucous membranes. Its action is more power-
ful than that of Colchicum, producing not only irritation
and an increased thickened secretion, but also a deposit of
solid, earthy masses.

316 DIAGNOSIS IN HOMCEOPATHIC PRACTICE.

Vascular System. In their relations to this system are
found the true distinctions between Bryonia, Colchicum, and
Ledum. Ledum affects the blood distinctly, producing a
definite crasis, viz. : a tendency to exudation of blood ; hence
we find it producing haemorrhages (which are not induced by
Bryonia and Colchicum). The blood has a special tendency
to the periphery. Moreover, Ledum has far greater rela-
tions to the periosteum and mucous membrane than either
Colchicum or Bryonia (of these two, Colchicum has the
greater affinity for mucous membranes and periosteum). The
pains of Ledum are, to a greater extent, sticking and tear-
ing, sticking as if caused by needles, as well in internal as
in superficial parts.

A characteristic of Ledum is a deficiency of vital heat,
inducing a predominant coldness and ehilliness. As in the case
with Bryonia and Colchicum, the sticking and tearing pains,
and also the symptoms that occur at night, are aggravated by
motion and by warmth. Like Bryonia, Ledum produces a
hot swelling, but it has an especial affinity for the hip and
shoulder.

Application. \. In chronic rheumatism Ledum is espe-
cially indicated when the secretion is scanty and thick, and is
no longer absorbed, but concretions begin to form, residua
in periosteal and cartilaginous envelopes, pain greatly
increased by motion. Ledum has a special affinity for the
regions of the hip and shoulder. The affection must not be
entirely chronic ; in such a case the mineral, remedies are
rather indicated, Calcarea, Mercurius, Iodine, etc. To be*
consulted in coxalgia, lumbago, arthrocace. In affections
of the bones, especially in the formation of nodes.

2. Chronic Cutaneous Affections. Transformations of the
epidermis. Ecchymoses (rather in chronic cases, such as
chronic morbus maculosus). Bleeding ulcers on the fore-
head. Tuberculous eruptions in drunkards.

3. Intermittent Fever. When the cold stage is of long
duration, with violent thirst. Neglected typhus, with I,

NO. X. SEPIA. 317

important anaemia, or 2, visible alteration of the blood
crasis (inducing, for instance, ecchymosis), or 3, affections of
the mucous membranes especially (nasal haemorrhage or
bloody expectoration without irritation).

4. Headache. Especially in the sequelae of syphilis, and
in mercurial poisoning.

5. Ophthalmia Chronica. A renowned remedy, espe-
cially in affections of the mucous membranes, with copious
secretion from the meibomian glands and opacity of the
cornea.

6. Dropsy, viz., Ascites. Ledum, like Colchicum, has a great
affinity for the abdominal organs, probably because of their
great venosity.

7. Chronic Pulmonary Catarrh. Even in pneumonia, if
the symptoms correspond, especially if the cough is accom-
panied by bloody expectoration, and threatens to become
chronic. Tuberculosis with haemoptysis.

8. Tubercular disease of the bones. Ulcers of skin and
gangrenous ulcers. (Hartmann.)

9. Gout. According to Rau's experience, one of the chief
remedies, even for maladies complicated with gout.

NO. X. SEPIA.

GENERAL EFFECTS.

Sepia is essentially a remedy affecting the vegetative
sphere. Its other effects are only secondary.

1. It has a transforming action, altering the erases. Its
action is slow, but deep and prolonged.

2. It diminishes the reproductive energy of the vegetable
sphere. This is made manifest —

a. Through the sluggish performance of the functions.

b. Through the deficient general nutrition.

3. Pains and isolated symptoms are but feebly pro-
nounced.

3l8 DIAGNOSIS IN HOMCEOPATHIC PRACTICE.

4. It has special relations to the portal system, and to the
female sexual system.

SPECIAL EFFECTS.

A. Primary. I. Digestion is impaired, acidity predominat-
ing; sour and foul eructations; tormina and meteorismus ;
chilliness after meals ; neither copious diarrhoea nor obstinate
constipation ; frequent tenesmus. Haemorrhoidal tumors ;
excoriation between the nates (corresponding to the acrid
character of the discharge).

2. On the Portal System and the Liver, a. Functions of
the Liver. In degree these are not greatly disturbed. In
kind the bile is altered ; it acquires a sour or foul character
(hence vomiting and diarrhoea) with too little alkali.

b. It induces also a change of texture in the liver, as is
manifested by the disturbed state of the circulation (numer-
ous stases).

c. The complexion is altered. The skin becomes yellow
and earthy- colored — like the wax of old church candles.
Puffiness of the soft parts ; there is no emaciation ; this appears
later — first, an increase of the fatty tissue, then laxity and
flaccidity, lastly, emaciation. Also, irritations of the skin,
showing itself in red spots with yellow areolae.

d. Mental depression ; sadness, inclination to anger.

3. Sexual System, a. Enfeebled condition, manifested
by erethism (sexual instinct without energy), — rapid
emissions, followed by great exhaustion and apathy after
coitus.

b. Profuse perspiration about the genital organs, especially
of females ; excoriation and itching.

c. Sepia has more relation to the female sex, yet is not to
be overlooked in reference to the male. Menses scanty or
suppressed, or else occurring too early. During the sup-
pression of the menses mental depression and apathy.

B. Secondary. I. Nervous System. a. The nervous
system, especially in the female sex, standing in the closest

NO. X. SEPIA. 319

relation to the sexual system, shows a tendency to erethism,
in consequence of which hysteric phenomena present them-
selves, which may increase even to spasms.

b. The sensations and pains of Sepia are indistinct in
character, and are, generally, feelings of weakness, apathy
and lassitude ; sometimes, however, they are more distinct,
occurring as burning, sticking or cutting pains — especially
in the loins (corresponding to the liver and sexual system).

2. Vascular System, a. Participates slightly in the effects
of Sepia, except in the easily provoked orgasms of blood to
the head and chest The symptoms chiefly unimportant
and secondary.

b. Vascular energy is diminished — so, consequently, is
the thermogenesis. Subjective and objective venosity;
passive congestions, perspiration ; palpitation, pulsations
felt over the whole body. These occur, but may well be
regarded as phenomena belonging to the nervous rather
than to the vascular system.

3. Secretive System. Only in so far generally affected, as
that the secretions and excretions present an abnormal
character, having a tendency to become sour and foul.
They are sometimes increased, sometimes diminished. The
increase of perspiration is most marked.

4. Respiratory System. A tendency to furnish a counter-
poise to the general condition ; hence, not unfrequently, a
condition of irritation, catarrh with even bloody expectora-
tion, cough, sometimes dry, sometimes moist — irritation of
the pleura.

5. Sexual System. The physiological connection between
uterus and mamma is here manifested by the emaciation and
flaccidity of the mammae, and the swelling and ulceration of
the nipples.

CHAR A CTERISTICS.

I. The Jains are dull; pain like paralysis is predominant.
Amelioration from warmth and violent motion. Aggravation
by repose and at night.

320 DIAGNOSIS IN HOMOEOPATHIC PRACTICE.

2. A peculiar cachectic aspect ; enfeebling of the vegeta-
tion. Predominant affections of the portal, hepatic and
sexual systems. Especially applicable to females. Gener-
ally menstruation scanty, suppressed, or precocious.

APPLICA TION.

A. General. I. Age. Sepia is especially adapted to
affections occurring at the climacteric period, in women
who were formerly excitable ; after long-continued depress-
ing mental affections, or great bodily or mental labor.

2. Aspect. An unmistakable aspect ; a peculiar yellow-
ish puffy complexion, rather fat. The tissues are soft and
flaccid ; they easily and quickly collapse and soon recover.

3. Temperament. Good-natured, yet easily excitable.

4. The affections complained of are not violent, often
disappearing altogether, and are concentrated in the digestive
and sexual sphere. A special indication, in addition to the
above, is a very slight acrid and excoriating discharge
ex genitalibus.

5. Although especially adapted to females, Sepia is also
applicable, variatis variandis, to the male sex, especially to
woman-like, soft-tissued men, who were formerly of a fiery
temperament, but have settled down into a sedentary, medi-
tative mode of life.

B. Special. I. Affections of tJie Digestive apparatus and
the Liver indicate Sepia, a. By sour and putrid formations,
manifested by eructations and habitual flatulence, and dis-
turbed digestion. Inveterate sub-acute pyrosis (in acute, not
appropriate, — compare Ipecacuanha, etc.). Pains in the stom-
ach, and cramps of the stomach and intestines after eating.

b. Pains in the hepatic and iliac region, excited by touch-
ing those regions ; hence, applicable in corresponding
affections of the liver generally ; in degeneration of the liver
and intestines, Sepia is applicable, at most, only in the
beginning ; later, other remedies come into play. ( Ascites
as secondary to hepatic affection.)

NO. XL GRAPHITES. 321

2. Sexual System, a. Uterus. Chronic infarctus ; indu-
ration. Acrid discharge ; laxity of the neighboring parts ;
blennorrhoea, prolapsus. Amenorrhcea and dysmenorrhcea
(menses being either too early or too late, and too weak).
Sterility, abortion, displacement of the uterus. Mucous
polypus.

b. Male Sex. Increase of sexual instinct, and at the
same time loss of sexual power. Erethism (in both sexes) ;
hence, frequent nocturnal pollutions, followed by great
exhaustion. Chronic, very profuse, corrosive gonorrhoea.

3. Nervous Affections. Nervous affection of the abdom-
inal organs and uterus; hence, melancholia and actual
hysteria ; megrim easily induced. Nervous toothache
during pregnancy and at the climacteric period. Irritatio
spinalis ; and, in consequence, paralysis of the lower part of
the trunk.

4. Cutaneous Affections. Herpes circinatus ; stinking
perspiration of the feet (not stinking, Bryonia). Psoriasis.

5. Affections of Eyes, Ears, and Nose. (As far as the
vascular system is concerned). Chronic ophthalmia, with
acrid secretion (abdominal ophthalmia, according to Pro-
fessor Rosas, of Vienna), and yellow sclerotica. Deafness,
in affections of the liver and abdominal organs. In
Ozoena, a very important remedy. Ulceration and eruption
about the mouth, with simultaneous disturbance of the
digestion.

6. Excretions. Constipation/with much tenesmus. Mucous
diarrhoea ; stinking cold sweat of the extremities.

7. Thoracic Affections. Tuberculosis. Affections of the
heart depending on abdominal disease. Palpitation. Inter-
mittent fever, cold predominating. Ulceration of the feet
Varices.

NO. XI. GRAPHITES.

Graphites resembles, in many respects, its chemical sis-
ters, the Carbons; less, however, in its general character,
22

322 DIAGNOSIS IN HOMOEOPATHIC PRACTICE.

than with reference to certain peculiar symptoms. Its
action is very extensive and energetic, affecting, in a
marked degree, the entire vegetative sphere. We find, in
the effects of Graphites, all the phenomena of a depressed
vegetative life, and a diminished assimilative activity, and
can only remark, as a specialty, the peculiar tendency to
the formation of pus. This specialty will be noted here-
after.

1. Vegetative Life. Almost no remedy attacks this sys-
tem with so great energy in proportion to the degree of
reaction which it excites. In tkis respect, Graphites stands
between Arsenic and the Carbons. The phenomena of
general and local excitement induced by it are pretty clear,
yet are only to be explained as secondary ; and they pro-
ceed only from the vascular system, and, in a very slight
degree, from the nervous system.

2. Secretions. In general, the secretions are diminished
and thickened. The character of decomposition is manifest
in a greater or less degree ; hence, the secretions are
offensive, of unnatural color and repulsive taste. As is
always the case when the character of decomposition pre-
vails, the serous secretions are increased.

3. Skin. Here we see, strongly developed, the phenom-
ena furnished by every disease which manifests a tendency
to morbid secretions, — viz. : itching, formation of pimples ;
irritation, with bluish-red papules of various size, having
an erysipelatous aspect. There is, however, a special
tendency to erythema, suppuration, ulceration ; hence,
serous vesicles, ulcers discharging pus and sanies, moist
eruptions, rhagades, scaly ulcers on all parts of the skin,
and on its transitions to mucous membrane, especially about
the mouth.

4. Mucous Membranes. In the mucous membranes, this
character of Graphites is still more distinctly manifested.
Their secretion is, for the most part, diminished ; hence,
they become dry. The secretions assume a thick, tenacious

NO. XL GRAPHITES. 323

character, are difficult of solution (or excretion), and have
a foul, saltish taste.

(i.) The Eye becomes turbid and dry, the lids cohere ;
they burn and are irritated.

(2.) In the Ear, a similar condition is manifested; buzzing
in the ear, and deafness.

(3.) Dryness of the Nose, inclination to sneeze, loss of
smell, or a foul odor constantly in the nose.

(4.) Mouth and Throat. Coated tongue; sensation as of
something fixed in the throat ; frequent endeavors to hawk
up something ; dryness of throat, hoarseness, tickling, burn-
ing, rawness ; dyspnoea, anxiety, dry laborious cough.

(5.) Intestinal Tract. Diminished stools; dryness and
burning in the urethra and vagina ; difficult and painful
micturition.

The tendency to ulceration appears most distinctly in
those mucous membranes which are in more immediate
contact with the atmosphere ; hence ulcerative pain, with
vesicles, pustules and ulcers, and corresponding discharges
from nose and mouth.

5. The Urinary Secretion is either diminished or increased;
more frequently diminished.

6. Menstruation. Diminished, retarded, enfeebled (Hahne-
mann).

7. The Seminal Secretion is likewise scanty, or fails
entirely ; hence diminished sexual instinct, and imperfect
ejaculation of semen.

8. Assimilation. Graphites diminishes the assimilative
action, inasmuch as the part destroyed by its primary,
decomposing action is not perfectly restored ; while at the
same time it enlarges it, inasmuch as it induces abnormal
deposits and secretions. The altered blood-crasis does not
permit a sufficient ^generation of the removed portions;
hence the vital turgor sinks, the tissues lose their elasticity ;
while the new tissues do not arrive at textual completeness.
Hence ensue collapse, flabbiness, discoloration of skin and

324 DIAGNOSIS IN HOMCEOPATHIC PRACTICE.

mucous membranes, loss of epidermis, falling out of the
hair.

Circulation is generally, at first, in a state of excitement ;
hence sometimes a general storm, but more frequently
partial congestions present themselves. Soon, however, the
circulation loses energy, becomes slow, idle, weak. As
everywhere, under such circumstances, so here also appear
soon an increased venosity, and then stases in the capillary
vascular system, which lead to exudations in the form of
oedema, ecchymosis, vesicles, etc.

In the lymphatic system, the same process goes on ; hence
swelling of the glands, induration, and irritation. In this
condition, a corresponding fever is evident, in which the
cold predominates, the heat being less general and less
violent ; coldness of greater part of the body, and heat only
here and there. Sweat and thirst, especially thirst, are often
violent, and, as in all enfeebled conditions, are easily and
speedily provoked by slight causes.

The nervous system partakes very little in the action of
Graphites, since this action is not excessive, rapid, nor
violent The phenomena that do occur are chiefly those of
depression ; hence the cerebral activity is markedly impaired.

The general sensation, according as it does with the
condition of the vegetative life, is depressed ; hence gen-
eral weakness, lassitude, relaxation of the tissues. Syncope
is easily induced, together with great anxiety. On this
account the feeling of lassitude is altogether the predominant
general sensation ; the other varieties of pain not being
constantly produced by Graphites, but being due to the
local conditions induced by it. The activity of the motory
functions is impaired ; these functions lack energy, but their
debility, never amounts to more than a very slight degree
of paralysis ; while, on the other hand, convulsive jerkings,
tremblings, and spasmodic phenomena are not unfrequently
present.

Particular Functions. I. Digestion is impaired. Graphites

NO. XL GRAPHITES. 325

has an especial relation to this process ; for several symp-
toms are peculiar to Graphites, viz. : salt, sour, foul taste in
the mouth, aversion, especially to meat and salt food, and
disinclination to other articles of food ; unpleasant sensation
before eating; during a meal, immediate unpleasant effects,
especially abdominal distension, borborygmi ; after eating,
many sufferings, burning, sticking, and stomach cramp,
singultus, nausea ; many marked secondary symptoms.

2. Intestinal Canal. At the same time with above digest-
ive phenomena, great meteorismus, discharges of flatus, and
cramps.

Liver and Spleen. Pain ; bilious vomiting. Stool gen-
erally retained solid, of a horribly offensive character ;
seldom watery.

Anus. Burning and pinching. Prolapsus, discharges of
blood ; haemorrhoidal tumors.

Urine. The urinary and genital systems are markedly
affected. *

APPLICATION.

Graphites is applicable, according to special indications, in
both acute and chronic diseases ; more frequently in chronic.
The acute conditions in which it is indicated cannot be
strictly and purely such, but rather be conditions growing
out of a chronic diseased state, corresponding in general
character to Graphites. Its province is the more highly
developed affections of the vegetative sphere, and we might
in this view call Graphites a high potency of sulphur ; for
no small number of symptoms is common to both remedies ;
in Graphites, however, they reach a higher grade of develop-
ment. This intermediate position of Graphites between
Sulphur and Arsenic and Carbon, indicates its very extended
sphere of action, which, however, is distinct from that of the
others, inasmuch as Graphites has so marked a tendency to
the ulcerative and corresponding processes.

Diseases in General. i. Cutaneous Affections. Those

326 DIAGNOSIS IN HOMCEOPATHIC PRACTICE.

which are disposed to suppuration. Ulceration with a
peculiar scanty discharge, and formation of fungous granu-
lations (hence panaritis). This ulcer is not easily healed —
presents, however, a certain degree of vitality, even of
irritation ; hence granulations form, or at least there is an
evident tendency to their formation. Scrofula and tubercle
do not generally correspond to Graphites, yet may do so in
individual forms, which are not infrequent.

Arthritis. Graphites is one of the very first remedies,
especially where there is no deposit, or a very slight one,
when it is probable that the sero-nbrous tissues, by their
dryness, aggravate the condition.

Diseases in particular. I. Skin is especially the province
of Graphites. Its distinctive character is this : a product
forms, the epidermis is removed, pustules and vesicles form
and re-form, or disappear, and are succeeded by scales ; the
pustules or scales fall away, and leave a raw place, difficult
to heal, and generally covered by a certain amount of
secretion, which, in the air, dries to a scab, scale, or mem-
brane, and covers the spot. Moreover, cutaneous secretions
are produced, which thicken and elevate the epidermis, and
form granulations of various kinds (horny, panaritic fungi).
Finally, to Graphites belong those skin diseases which are
followed by successive crops of little vesicles, which scab
over and so gradually cover large surfaces. In this category
belong eczema, herpes, impetigo, lichen (?), in the lower
grades; psoriasis, pityriasis, ichthyosis, scaly eruption on
the head, and falling out of the hair. Among the maladies
not herein included, and in which Graphites is indicated, is
erysipelas, which frequently returns, or has so slow a migra-
tion that gradually almost the whole body is covered by it.

2. Eyes. Often recurring inflammation, especially with
formation of ulcers. Scrofulous ophthalmia, with cohesions
of the lids and photophobia, especially in conjunction with
crusta lactea. Dryness of the conjunctiva.

3. Ears. Deafness, buzzing in the ears, when in a gouty

NO. XII. IPECACUANHA. 327

constitution, but especially when there is reason to suspect
dryness of the mucous lining of the ear, as, for example,
simultaneous dry catarrh of the nose, pharynx, etc.

Toothache, with swelling and ulceration of the gums.

Ulcers of the Month. Especially with offensive swellings
of the glands of the throat; frequent angina, with conse-
quent ulceration.

Dyspepsia.

Chronic Gastritis (Ulcus perforans). Flatulence very
great. Constipation, with occasional diarrhoea ; chronic
colic.

Genitalia. Swelling of prepuce, especially in children.

Herpes Prtzputialis. Burning on micturition. Want of
semen and lack of sexual instinct ; swelling and induration
of testes. Hydrocele. Enlarged ovaries ; amenorrhcea ;
Menses scanty, delayed, and painful.

Respiratory Organs. Dryness of mucous membrane;
hence chronic catarrh in many cases of tuberculosis ; great
roughness and hoarseness of the voice ; sensibility of larynx
or quick respiration, and on change of temperature, inducing
a tickling and spasmodic cough.

N. B. Applicable to the pyaemic and uraemic processes ;
to affections of the liver without degenerations.

NO. XII. IPECACUANHA.

Belongs to that class of remedies which act chiefly on the
nervous system. Its action is very moderate in degree;
hence not very striking. Its exciting action is exerted
chiefly on the thoracic plexus ; it stands therefore in a kind
of opposition to Nux vomica, which affects rather the
subdiaphragmatic ganglia.

I. Nervous System. The brain and spinal system are
scarcely affected; at most they are affected only by a reflex
action. Still less is the sensorium acted upon. Little or no

328 DIAGNOSIS IN HOMCEOPATHIC PRACTICE.

pain is induced ; at most it is secondary. The symptoms of
spasm are more numerous and better marked. Character.
The symptoms reveal a distinctly intermittent character,
in which they are rivaled only by Nux and Pulsatilla. The
pains suddenly appear and suddenly disappear. They are
aggravated at night (because the vegetative sphere is
especially affected). For the same reasons, similar symptoms
occur at the same time in various parts of the body.
Gastric phenomena are always present ; and organic sensation,
i. e., consciousness of defined organic conditions, in a high
degree; e. g., nausea, constant constriction of the chest,
premonitions of spasms, constrictive sensations in the salivary
ducts, in the urinary and sexual organs.

2. Vascular System. Great analogy to Nux. Ipecac-
uanha has little effect on the great vessels and the heart
(Nux affects the capillary system and the great vessels at
the same time); it has more especial affinity to the capillary
vascular system alone ; hence external coldness, and internal
heat, and vice versa, objective heat, but subjective coldness
of the skin, and vice versa.

3. Vegetation. Ipecacuanha excites and alters the vege-
tation. The secretions are in general diminished in quantity ;
in quality they are scarcely altered. There seems to
be no connection or mutual dependence between objective
and subjective phenomena. Sweat, urine, saliva, are for the
most part increased; other secretions, which require a
greater elaboration, for example, those of mucous membranes,
are diminished. Bile is generally increased. Haemorrhages
are frequent (because of the action of Ipecacuanha on the
capillary system), yet no profuse discharge of undecomposed
blood, threatening the organism. Ipecacuanha affects the
stomach and chest, but acts less strongly on the intestines.
Nausea, inflation, constrictive sensation, vomiting (scanty),
without giving relief, and the matters vomited not qualita-
tively altered. Foul taste, scratched feeling in the throat,
yet the tongue not foul, etc. The peristaltic action of the

NO. XII. IPECACUANHA. 329

bowels is diminished ; the antiperistaltic increased ; constipa-
tion, also watery diarrhoea.

Lungs. More important action, constriction, dyspnoea,
irritation inducing cough, increased sensibility, spasm,
diminished secretion.

Application. To pale, blonde individuals, women and
children. Disturbance of the vegetative nervous system, of
the stomach and lungs at the same time.

Special. I. Disorder of the stomach after an excess, if the
disturbance continue some time (for the more transient
disorders, Nux vomica, Pulsatilla, etc.). After typhus and
intermittent fever, for the remaining stomach affections,
chronic nausea, and vomiting. Indisposition after eating,
yet without loss of appetite. In particular the gastric
phenomena of pregnancy. All these ailments are generally
conjoined with chest affections, anxiety, constriction, etc.

2. Acute affections. Variola, morbilli, catarrh, in its last
stages.

3. Intermittent fever. It ranks with Nux vomica
Pulsatilla, and China, as one of the best remedies. The
fever in which it is indicated is characterized by gastric
phenomena of low intensity ; the chill predominates, and the
chest also, is affected ; the patient feels as if a hoop were
placed around the body.

4. Nervous fever in the beginning; cholera in the begin-
ning ; and in the sequelae of cholera.

5 Hemorrhage, from partial over-excitements, especially
in incipient tuberculosis in young girls; also in haemorrhage
from paralysis of the capillary vascular system, but never in
haemorrhage arising from general crasis, or decomposition.
Seldom in haemorrhage from the stomach and intestines;
oftener in that from the lungs and nose.

6. After the violence of acute pulmonary affections has
abated, when irritation remains. In chronic catarrh with
physical symptoms of a very low grade ; when the irritation
inducing cough, and the dyspnoea are great at periodic

330 DIAGNOSIS IN HOMOEOPATHIC PRACTICE.

intervals; hence, in all asthmatic cases. In all coughs with
a tendency to vomiting, if not violent, even in a slight
degree. Spasms during pregnancy. Abuse of China.

NO. XIII. CHINA.

China has much in common with Arsenic and Carbo
vegetabilis. It develops its effects on the vitality of the
blood ; debility ensues, like that induced by venesection, in
which the quantity and quality of the blood are altered,
and, in consequence, various functional disturbances mani-
fest themselves. The entire vegetation suffers, the tone of
the organism becomes enfeebled, the blood becomes thin
and watery, and the circulation lacks energy ; hence ensue
stases, haemorrhage, watery diarrhoea, abundant sweat and
urine.

Circulation. The energy of the circulation is diminished ;
the pulse becomes small and weak in consequence of the
anaemia ; hence, erethism and debility. (Carbo induces
debility, with torpor ; Arsenic, debility, with excitation,
presenting, therefore, a closer analogy to China.) The veins
become varicose ; the arteries, however, retain their tone.

Nervous System. Erethistically affected. Greatly in-
creased sensibility to all external influences. (China induces
greater sensitiveness of the scalp to external touch than
any other remedy does.) The affection of the nervous
system exercises a reflex action on the blood ; hence, also,
excitation alternating with depression. (Belladonna induces
a continuous, enduring excitation.)

Vegetation. The whole vegetation appears depressed, the
vital turgor diminished. The skin is pale and earthy, the
vessels being visible through it. The digestive function is
modified. For the liver, China has a special affinity, as
well as for the spleen, in enlargement of which a small
dose of China effects a speedy diminution of volume.

NO. XIII. CHINA. 331

China induces hyperaemia of both of these organs ; the
diminution is therefore a secondary effect. (Piorry's experi-
ments.)

To the Stomach, China bears important relations (espe-
cially to the solar plexus), enfeebling its activity, inducing
loss of appetite, without vitiating the taste. Nausea, and
disinclination for certain articles of ordinary diet, result from
the altered digestive activity and the altered secretions ; in
particular, water-brash, in consequence of the watery secre-
tions. The rest of the digestive canal is but little affected ;
watery stools, however, occur, in consequence of intestinal
paralysis ; hence, also, Lienteria.

To the Lungs and Genital Organs, China has no special
relations. The secretions of the mucous membranes are
watery and thin (cedema pulmonum). It is not specifically
indicated in anasarca, and it induces vesicles (miliaria) only
by inducing a general debility. To the uterus, no especial
affinity. The menstrual flow is increased in quantity and
in fluidity, with general weakness and anaemia.

Characteristic Symptoms. I. Pains. Sticking, tearing,
drawing, in particular lassitude, with a peculiar restlessness,
impelling to constant motion. Pain, as if after a journey
on foot.

2. Aggravation. By touch, motion, and by every kind
of physical or mental effort.

3. Very great sensitiveness to external influences, espe-
cially of the skin and the head, to the external touch.

4. Yellow, earthy hue of the skin.

5. Fever, chill predominating ; heat and cold but par-
tially distributed. Thirst during the cold, and between it
and the heat

6. Pulse generally quick, small, and soft.

7. Thirst during the cold stage.

8. Gastric affection ; water-brash.

9. Swelling and pain of liver and spleen.

10. Diarrhoea, watery and soft : slowly expelled.

332 DIAGNOSIS IN HOMCEOPATHIC PRACTICE.

11. Menses generally increased, but thin and watery.

12. Symptoms periodic in character.

13. Feeble condition after loss of vital juices, after haemor-
rhages, sweat, pollutions, onanism, etc.

SPECIAL INDICATIONS.

1. After all enfeebling maladies (intermittent and nervous
fever, etc.).

2. After great loss of fluids.

3. After mental exertions, night watchings, etc.
(i.) In atrophia infantilis and senilis.

(2.) In haemorrhages, only when they depend on debility,
on torpor of the vessels, and fluidity of the blood.

4. In chlorosis, China compares with Pulsatilla and Fer-
rum.

(i.) Pulsatilla is indicated when paleness predominates,
where emaciation is not yet marked, and where the turgor
vitalis is still present. Fluor Albus.

(2.) China, where there is a yellowish hue, gastric symp-
toms are conjoined, and the turgor vitalis is going or quite
gone.

(3.) Ferrum, where there are vascular erethism, fugitive
flashes of heat, diminished menstrual flow, but the blood of
a bright red color.

5. Hy drops from atony and anaemia.

6. Sequelae of liver disease. Ascites.

7. Sequelae of cutaneous disease. CEdema, cyanosis.

9. Typhus seldom, and only when accompanied by their
bilious diarrhoea.

9. Sequelae of cholera.

10. Intermittent fever. The experience of allopaths shows
that in this disease we should not neglect China. Dr. Kaspar
says he gives China in all cases of intermittent fever, in
which no other remedy is clearly indicated, even though the
indication be not very clear for China. The enlarged spleen
diminishes in a short time and permanently.

NO. XIV. PHOSPHORUS. 333

11. Gastric and bilious, according to their form. Gas-
tralgia.

1 2. Affections of liver and spleen. Enlargement of the liver.

13. Lienteria, a cardinal remedy. (Weakness of the
intestinal canal — a too thin gastric secretion.)

14. Nocturnal pollutions too frequent. Amenorrhoea ;
abortion ; delayed parturition ; chlorotic palpitation of the
heart. With reference to general sensibility ; compare China
with Cocculus and Ignatia.

NO. XIV. PHOSPHORUS.

Phosphorus acts directly upon the blood-life, modifying it
in a remarkable manner, producing a tendency to decom-
position, and causing ecchymosis, haemorrhage and depositions
in the parenchymatous organs. The pus. of which it induces
the formation is intermediate between true pus and sanies.
Phosphorus induces, in particular, a violent erethistic con-
dition of the whole vital process, acting first, upon the
nervous system, then by a reflex action upon the vascular
and the remaining system, and causing in its subsequent
action, apathy, torpor, and paralytic conditions.

1. Vascular System. Erethism is distinctly marked.
Sometimes it is general ; sometimes partial, affecting
especially the head and chest; chills predominate, but
excessive heat is often induced, and these sensations alter-
nate quickly with each other. Sensations resulting from a
partial erethistic condition in the head and chest accompany
almost all other symptoms. Throbbing of the vessels of the
head (also Belladonna). The general temperature is much
elevated. Thirst may be increased or absent. Sweat is
much increased.

2. Nervous System. Much excited. This excitement is
manifested in gayety and levity, in diminished sleep without
consequent suffering ; in restlessness and dreamful sleep, in

334 DIAGNOSIS IN HOMOEOPATHIC PRACTICE.

entire sleeplessness, even in delirium. The fantasy is exalted.
In the further action of Phosphorus apathy is induced ; the
mental activity and ability are diminished ; trembling and
jerking of the muscles are frequent, especially of the muscles
of the head, face and neck.

3. Nutrition. Impaired — as 'shown by the earthy com-
plexion, with the peculiar yellow tint, recognized in the
Phosphorus degeneration. The turgor vitalis is at first
increased, then depressed, emaciation resulting. The Secre-
tions are in general diminished, even to dry ness. (Sweat
and urine are (mechanically ?) increased).

4. Skin. Phosphorus has little affinity for the skin. It
induces the formation of papules and of ulcers, especially on
the points of transition between the mucous membrane and
the skin, and in the hollows of the joints (this is very
characteristic). Ecchymoses.

5. Eyes. Irritation, swelling, the conjunctiva is reddened,
and the cornea is rendered opaque; the globe of the eye
enlarges, and vesicles form in and around the eyes ; in con-
sequence, sensations as of clouds and sparks before the eyes
are induced, with a sensation as of sand in the eye, and
twitching of the eyelids.

6. Ears, Dryness.

7. Nose. Dryness, ulceration, sticking, efflorescence around
the nose.

8. Month. Dryness, furred tongue, vesicles, aphtJice,
difficult deglutition (because of the dryness). The pharynx
is irritated and inflamed.

9. Digestion. Disturbed, as is shown by loss of appetite,
disgust, nausea, scanty vomiting, acrid eructations.

10. Excretions. Sensation of heat through the whole
intestinal track, even to burning, relieved by Coffee. Various
pains. Great development of gas (meteorismus tympanitis).
Stools are scanty, of a pappy nature, green, also gray, thin
and frequent. Sometimes they are difficult and painful,
attended by tenesmus and burning in the anus.

NO. XIV. PHOSPHORUS. 335

11. Respiratory Organs. A Specific Action. Phosphorus
induces great dryness, roughness, hoarseness, laborious
cough, with a scanty, tenacious, muco-purulent and bloody
expectoration. The respiration is accelerated, with a feeling
of constriction, heat, congestion and sticking pain.

12. Genito- Urinary Organs. Inflammation of the kid-
neys (?). Diminution or increase of the urine ; burning in
the urethra, or involuntary micturition. The sexual instinct
is increased, showing itself in priapism, nymphomania,
pollution, powerless coitus, etc. Menstruation is too early
and too copious.

13. Bones. Phosphorus exerts a specific action, especially
on the jaw-bones, inducing inflammation and suppuration,
with a simultaneous formation of callus.

APPLICA TION.

Phosphorus is indicated as well in acute as in chronic cases,
— rather in acute diseases. In all conditions of nervous and
vascular irritation with debility, — hence in erethistic con-
ditions it stands before all other remedies. In the diseases
in which it is applicable, the transition is always easy to
torpor ; there is always a dyscrasia, approaching in character
the Typhoid dyscrasia.

Special Application. i. In typhus. The Phosphorus
pathogenesis is a perfect picture of erethistic typhus (cerebral
and abdominal). It is to be compared with Arsenicum,
which produces collapse, decubitus, and colliquative diarrhoea,
and is thereby distinguished from Phosphorus, which has no
diarrhoea.

In pneumo-typhus, where the diagnosis hesitates between
tuberculosis and typhus. In all cases in which inflamma-
tion takes on a nervous character, e. g., dysentery, pyaemia,
acute catarrh, with nervous symptoms.

2. To inflammation of mucous membranes Phosphorus has
a peculiar affinity, with a scanty muco-purulent secretion.
Hence, in ophthalmia with general vascular excitement ; in

336 DIAGNOSIS IN HOMOEOPATHIC PRACTICE.

pneumonia tuberculosa (frequent in Phosphorus factories), in
gastritis, enteritis, nephritis, and haematuria, with dark,
scanty, turbid urine.

3. Ostitis and necrosis, especially of maxillary bones.

4. Rheumatism. In bone diseases depending on rheuma-
tism. In diseases assuming a chronic form.

1. Day-blindness; photophobia, with spots and sparks
before the eyes. Otitis, with deafness after nervous fevers.
Polypus nasi. Dental caries.

2. Priapism, impotence ; amenorrhcea.

NO. XV. CHAMOMILLA.

Chamomilla affects directly both the animal and vegetable
nervous systems, — the latter in a greater degree. It acts
more decidedly on the sensitive than on the motory sphere.
Like Ignatia, it has no violent, long-enduring, or deep-felt
action. Nevertheless, by a long use of it, the vegetation is
seriously affected.

GENERAL ACTION.

1. In the animal nervous system. Motory sphere. Slight
spasms, or rather tremblings and twitchings, of short dura-
tion. The parts among which the middle spinal nerves are
distributed appear most strongly affected.

2. Vegetation. — The sensitive sphere is more affected than
the motory. I. Spasm occurs also in the vegetative muscular
system; but of a very feeble character. 2. Pain in stomach
and intestines is very considerable. When spasm occurs,
pain is always present predominating over the spasm (colic),
and very often pain occurs without spasm.

First the gastro- intestinal sphere is affected, — then the
thoracic.

i. Stomach. Dull sensations, pain, often also spasm.
Violent nausea interfering with appetite. Singultus when

NO. XV. CHAMOMILLA. 337

eating, ructus, vomituritio, vomitus, — all this being attended
by more or less pain. Sensation of fullness when the
stomach is empty, and vice versa. Anxiety in the epigas-
trium after eating ; drawing pains in the loins and hypochon-
dria ; accumulation of saliva in the mouth ; alienated taste ;
sometimes even vertigo ; loss of sense. Hence, in general,
aggravation after eating.

2. Intestine. Pain, flatulence, peristaltic motion increased,
anti-peristaltic motion induced.

3. Chest. Increased irritability of the lungs; hence
tickling, constriction, and anxiety.

4. Brain. Irritability, anger, chagrin, restlessness, anxiety,
weeping, groaning, fright, crying out, speaking during sleep,
and sudden starting, especially in children.

5 . Vascular System. Easily excited ; hence frequent con-
gestions of short duration. Contradiction of the objective
and subjective symptoms, e. g., external cold, and internal
heat, as in the case of Ignatia ; Chamomilla, however, has
pain and greater disturbance of sensation than Ignatia, and its
vascular excitement is greater, amounting to a considerable de-
gree of fever, even to delirium, and attended by violent thirst.

6. Blood. Little affected, unless by a long use of Chamo-
milla, which renders the blood less plastic and induces
chlorosis.

7. Secretions. Not altered, only increased, especially those
of the intestines and liver ; in consequence of the latter
effect, the excretions are more green in appearance, and
increased in quantity. Development of flatus.

8. Female Sexual System. Although this system is not
specifically affected, yet the menses and sexual instinct are
increased.

9. Aggravation of the pains by rest and warmth.

APPLICATION.

Chamomilla is applicable in erethism of the sensitive
nervous spheres ; hence, peculiarly appropriate for children,
23

338 DIAGNOSIS IN HOMGEOPATHIC PRACTICE.

and for women, especially during pregnancy ; for persons of
irritable temperament, prone to congestion, after chagrin
and anger. Among children's diseases, it is especially
appropriate for such as result from the use of milk either
always bad or rendered so temporarily by a fit of anger on
the part of the nurse, — inducing vomiting, cuttings in the
abdomen, etc. Chamomilla may be used, when indicated,
in all diseases, except in conditions of torpor and synocha,
or of great excitation ; hence, in sub-acute conditions,
hysteria, certain odontalgiae, with jerkings and distortion of
the face, aggravated by warmth ; in sub-acute rheumatism;
in mastitis. In erysipelas faciei it is renowned. In inter-
mittent fever, with abdominal symptoms characteristic of
Chamomilla. In diarrhoea, with violent pains ; abdominal
spasms before the evacuation ; stools pappy, watery, acid
and bilious. In gastric affections, especially after chagrin
and anger, with much thirst and heat Icterus, conse-
quent on a fit of anger, with great excitability. Important
in the period of dentition ; in the menstrual period, for
menstrual colic ; metrorrhagia with the characteristic symp-
toms of Chamomilla — false pains ; in several varieties of
asthma, with great sensibility. Ischias, cramp of the
calves.

NO. XVI. NUX VOMICA.

The primary action of Nux Vomica is exerted exclusively
upon the Nervous System, inducing, first, variation in the
intensity of action of that system, viz., excitation, soon
followed by torpidity, and secondly, alteration in its mode of
action.

The Motory or Centrifugal factor of the nervous system
is especially affected. The Central portions (the ganglia
and the spinal cord themselves) are more affected than the
peripheric, and above all the abdominal ganglia and those

NO. XVI. NUX VOMICA. 339

parts of the spinal cord in immediate connection with the
diaphragm.

1. Spinal Cord. The action of Nux is chiefly on the
motory or centrifugal factor, producing spasm, especially in
the abdomen and lower extremities, rather tonic than clonic,
induced by very slight exciting causes, even by change of
weather. Individual Symptoms. Jerkings, stiffness, cramp,
spasm of the pharynx, and of the anus, erection of the penis,
spasm of the bladder, in a word, of all the half voluntary
muscles, spasmodic distortion of the face and mouth. Tris-
mus, spasm of the tongue (followed by partial paralysis) of
the oesophagus and rectum. All of these symptoms are
followed by torpidity and temporary partial paralysis.

2. Vegetative System, Motory Factor. Dilatation and
contraction of the iris, spasm of the stomach and intestine.
The chief malady of this system, bearing close relation to
the symptoms of Nux is cardialgia, both presenting us
eructations, nausea, vomiting, constriction and protrusion of
the intestine, painful anti-peristaltic motion, palpitation,
pulse momentarily irregular.

3. Cerebral System. The character of the phenomena
induced by Nux in this system is similar to that above
depicted, but the phenomena are less strongly pronounced.
They are the reflex of those induced in the spinal and vege-
tative system. The Organs of Sense are strongly influenced,
but those functions which are peculiarly cerebral (i. e.y
sensorial functions, phantasy, etc.) are but slightly affected.
Susceptibility to mental and sensuous impressions is greatly
increased ; this condition is soon followed by one of apathy,
in which, however, consciousness is preserved. (N. B.
Under the action of Stramonium and Hyoscyamus, in a
corresponding condition, consciousness is lost.)

4. The Pains and Sensations excited by Nux are such as
usually accompany spasm — cramp-pains, jerkings, etc. A
feeling of exhaustion, a sensation as if beaten, is very
constantly observed.

34O DIAGNOSIS IN HOMCEOPATHIC PRACTICE.

Phenomena of the Vegetative Life generally.

1. Vascular System. Increased activity, soon followed by
exhaustion, hence Nux rather retards than accelerates the
circulation (causing congestions). The general effects of
Nux in this respect resemble those of Cocculus and Ignatia.
The frequently observed phenomenon of external cold with
internal heat (and vice versa) is important, as showing this
state of partial excitation and partial torpidity.

Character of the Fever. Violent chill, external heat with
internal cold, and vice versa. The thirst is slight, or there
is great thirst at the period of greatest coldness (showing
that the latter is a consequence of alteration of nervous
functions, and not of an immediate vascular excitement ;
this is shown, too, by the fact that drinking rather aggra-
vates than relieves the thirst).

2. Assimilation. The effects of Nux are very complex,
its especial action being upon the abdominal ganglionic
system. A habitus gastricus is the chief indication for its
administration ; a skin yellowish or earthy, eyes yellow or
dirty-looking, tongue coated, teeth yellow, irritability of
temper, hypochondriasis, hysteria.

3. Gastric Phenomena. These depend on alteration in
the mode of action of the nerves. The gastric secretion is
modified, the odor of the breath is unpleasant, the taste is
salt or bitter. These phenomena depend on the condition
of the stomach, and not upon any altered state of the
mouth (as appears from the fact that the sense of taste
retains its full power of distinguishing different articles
and qualities of food, a characteristic of Nux), bulimy or
anorexia. While eating, nausea, headache, tormina; after
eating, these symptoms are aggravated, eructations, vomit-
ing, which is never profuse, but is generally sour or bitter
mucus. Thirst, yet drinks are not well endured. Although
these symptoms occur after eating, they are also manifested
at other times — an evidence of the alteration of nervous
action.

NO. XVI. NUX VOMICA. 341

Morning Vomiting. The secretion of the stomach and
intestines, especially of the latter, is diminished in quantity
(hence constipation), as well as altered in quality (hence
irritation and tenesmus). Fseces are diminished in quantity,
hard, dark, and compact.

Hepatic System. On this system Nux acts powerfully.
Its effects are rather dynamic than organic. The secretion
of bile is markedly increased.

Genital System. Erethism, manifested by pollution, and
too rapid emission ; or again, as the result of over-excite-
ment, by loss of erectile power. Menstruation too early and
too copious.

Respiratory System. Spasmodic action. The secretion
of the mucous membranes is diminished ; they are irritable,
hence a cough is easily produced ; a dry, tickling cough,
with scanty, thick, tenacious expectoration. A frequent
sensation of constriction, arising partly from spasm, and
partly from congestion.

Characteristics. I. High excitement of the whole nervous
system, especially, however, of those parts of the spinal and
ganglionic system which lie below the diaphragm ; especial
relation to the motory sphere ; hence spasm, both tonic and
clonic.

2. Vascular System. Excitation and impediment, each
of these phenomena having the character of partiality.

3. Powerful effects upon the vegetation, especially in the
digestive canal ; hence gastric affections predominate. In
general, diminished secretions (hence constipation) ; irrita-
tion of the thoracic organs ; sexual erethism ; too early
menstruation. Seldom pain, with the exception of headache ;
rather, sensations are produced.

Administration. Nux is especially appropriate to diseases
of men, lean, of strong fiber, who take rich food, are given
to spirituous drink, and to mental labor ; in following dis-
eased conditions.

I. Nervous Affections. Spasm., general or partial, especially

342 DIAGNOSIS IN HOMOEOPATHIC PRACTICE.

of the lower part of the body, — especially those which involve,
at the same time, the muscles of both the animal and vege-
tative spheres; in all cases where Nux is indicated, conscious-
ness must be retained; cases in which pressure or warmth
applied to the vertebral column provokes the spasms. Tonic
spasm, in the forms of tetanus, trismus, eclampsia infantum,
etc. Nux is a very important remedy in cases of trembling
induced by metallic poisoning,1 and in saturnine colic.
Spasms of the pharynx and larynx, and of the diaphragm ;
angina pectoris. Spasm of the stomach; spasmodic vom-
iting, with scanty evacuation ; vomiting during pregnancy.
Hernia. Flatulent and menstrual colic.

Over-excitability of the senses. Irritation of the spinal cord.

2. Intermittent Fever. Nux is probably indicated in nine
cases out of every ten.2 These cases are distinguished by cer-
tain gastric phenomena ; the complexion is of a light icteric
hue ; there is obstinate constipation, with violent pain in
the loins. The cold predominates. Thirst is present, yet
drinking aggravates the symptoms.

3. In Typhus, Nux is only sympathetically indicated,
when there is continued constipation, or in the mild form
of typhus, attended by the peculiar gastric symptoms of
Nux.

4. Sub-acute and chronic muscular rheumatism; certain
forms of delirium tremens ; nervous vertigo, depending on
abnormal affections. Morning vomitus after a debauch.
Headache after meals ; the cephalic congestion always, if
conjoined with gastric phenomena.

5. In gastric derangements from use of coffee ; dynamic
affections of the liver. In hernia, both free and incarcerated.
In haemorrhoids. In neuralgia. In catarrh, with dry, labo-
rious, tickling cough ; with spasm, and even vomiting.

1 For poisoning by Arsenic, with * It will be remembered that these

trembling of the hands, in hat-makers, lectures were delivered in a suburb

they give, in the General Hospital of Vienna, in which a peculiar form

(Allopathic) of Vienna, sulphur, in of Intermittent Fever is endemic. —

drachm doses, and relieve the patient C. D.
generally in about four days.— C. D.

BELLADONNA.1

Belladonna excites simultaneously the nervous and vas-
cular systems, and is hence indicated neither in pure inflam-
matory fever, nor in pure nervous fever, but as a kind of
amphibious remedy in that condition in which the symptoms
of both appear, — in the " neurophlogosen " of Schonlein, in
the "febris inflammatoria nervosa" of Vogt, — hence not in
pure phlegmonous inflammation nor in pure spasm but in
inflammatory spasm.

I. VASCULAR SYSTEM. Strongly excited; most of all the
capillary system, in which the effects of Belladonna are
especially manifest in the skin, throat, head and lungs, con-
stituting an affection very similar to scarlatina. (According
to Schonlein, the scarlatina pulse is present.) Belladonna is
the Aconite of the capillary vascular system.

II. VEGETATION. Skin and mucous membranes, are
attacked ; hence, dryness of the throat and constriction,
increased thirst, diminished secretions, burning and spasms
of the stomach.

III. Although Belladonna affects powerfully the GLAND-
ULAR SYSTEM, yet it gives no especial characteristic indi-
cation.

IV. NERVOUS SYSTEM. Exaltation, alienation, and depres-
sion, the last only from large doses (bad provings), and
affording no special indication. This affection of the nervous
system depends not only upon the encephalon but also upon
the spinal cord; and the sensitive as well as the motor
nerves are affected; hence pains, convulsions, and tonic

1 Report of a Clinical Lecture by Dr. Wurmb, in the Second
Homoeopathic Hospital, Vienna.

344 BELLADONNA.

spasms, are first induced, and finally paralysis. Upon the
ganglionic system Belladonna acts as a depressing agent.

Characteristics. I. Pain. Oppression, pressing from
within outward and vice versa, also throbbing. The pain
conies on suddenly, rises quickly to its greatest intensity,
and suddenly vanishes or changes its seat. It is aggravated
in the evening and at night by coffee, wine, vinegar (hence
vinegar is no antidote) ; ameliorated by pressure and com-
pression.

Indications. I. Inflammation of the ear, erysipelatous ;
ditto of the throat and fauces with constriction, which serves
to distinguish Belladonna from Mercurius and from Nitric
Acid, which last is indicated where aphthae appear on the
tonsils. Also in malignant angina.

2. In pneumonia, typhus, and acute catarrh, with cerebral
complications. Tussis convulsiva more frequently requires
other remedies, as Hyoscyamus, Sulphur, Veratrum and
Cuprum.

3. Abdominal affections. Flatulent colic, sausage-like
inflation of the colon with pain in the umbilical region.
Hernia, in inflammatory condition. Hepatic congestion.
Icterus inflammatorius. Haemorrhoids with constriction of
the sphincter.

4. Nervous affections. Melancholy during pregnancy and
the puerperal state. Spasm with consciousness (peculiar to
Belladonna). Mania. Delirium tremens. Hydrophobia
(Wurmb has no experience ; would incline to expect more
from the animal poisons).

5. Nervous accidents. I. Clonic spasms in the upper part
of the body. Epilepsy. Chorea (with reference always to
\htgenius of the remedy), i. Congestio ad caput. Dis-
turbed menstruation. Raphania. 2. Pain. a. Prosopalgia
Fothergillii (also Ferrum Carbonicum) in cases in which
there is simultaneous vascular excitement. In purely
nervous cases it is not indicated. (Spigelia preferable.)
b. Toothache ; gums inflamed ; aggravated by cold. c. Sleep-

BELLADONNA. 345

lessness, especially of plethoric children. From nervous
over-excitement. (Coffea.) d. Certain particular nervous
maladies. I. Febris nervosa versatilis of the ancients, or
typhus in which the abdominal ulcers are wanting; 2.
Typhus cerebralis ; 3. Febris intermittens apoplectica.

6. Vascular diseases. I. Congestion. Pain in sinciput; great
sensibility to air and noise ; roaring in the head, sparks before
the eyes, especially in amenorrhoea and dysmenorrhcea ; apo-
plexy and its prodromena. In short, in every case in which
the allopath would resort to venesection. An antidote to
Hyoscyamus. 2. Inflammation, a. Of the brain and mem-
branes, especially in metastasis from scarlatina; delirium
ferox, dilated pupils, red face, spasms. In children during
dentition (when the irritation is too great for Chamomilla) ;
when tonic spasms occur (compare Hyoscyamus and Stra-
monium). The large cerebrum of children disposes them to
this affection ; hence Belladonna is appropriate as prophy-
lactic, b. Ophthalmia. I. Scrofulous ophthalmia, as an
intercurrent remedy in case of photophobia with vascular
injection (without this, Conium) and dryness of the eyes.

2. Catarrhal ophthalmia, with dryness of throat and cough.

3. Arthritic ophthalmia. 4. Internal ophthalmia, amblyopia
and recent amaurosis.

7. Sexual diseases. Metrophlebitis even in metastasis to
the parotid, the joints, etc. Mania puerperalis. Orgasm to
the uterus. Menses copious, black, clotted. A pressing
outward. Cutting lumbar pains extending round to hypo-
gastrium. Sensibility of the uterus. Affections before
and after menstruation. Labor-pains deficient from non-
dilatation (rigidity) of the os uteri.

8. Skin. i. Scarlatina, — the smooth variety, not the mili-
ary. In ordinary scarlatina Aconite and Belladonna alter-
nately. Also the same as prophylactics. Wurmb always
succeeds giving them in small doses (30) one remedy each
day in a single dose. Measles with affection of the head
and throat. Erysipelas, smooth form (the vesicular, Rhus).

346 BELLADONNA.

External erysipelatous inflammation of the ears. 2. Glands.
Inflammation of the salivary glands with affection of the
head. For the inguinal glands and testes slight affinity.
Inflammation of axillary glands during the climacteric
period, and when the swelling remains stationary and
resembles scirrhus and is worse during menstruation. Degen-
eration of the mamma, and erysipelatoid inflammation, but
not traumatic inflammation, in which Arnica in small doses is
indicated. Inflammation of the uterus with great haemor-
rhage, pressing outward.

A WEAK SPOT IN OUR MATERIA MEDICA.

The Homoeopathic Materia Medica is constructed upon
the results of provings on healthy subjects. Every day's
experience, in its application at the bedside, shows us that
the more accurate the prover's observation of the symptoms
which the drug produces in him, the more certainly can we
determine whether the drug is appropriate for our case.

We call certain drugs "well proved" because the state-
ments of symptoms are so clear, the discriminations, especially
of subjective symptoms, are so sharp and well defined, as
regards character, locality, direction and conditions, that we
get, by study of the proving, a vivid realization of the patho-
genesis, and can be sure whether a similarity exists between
it and our patient's array of symptoms. And, moreover, the
symptomatology of some of our "well proved" drugs is so
full and precise that we are able, particularly if we borrow a
little from the toxicologist, to construct a very complete
pathological theory of the drug-action, with which we may
compare our theory of the pathology of the patient's disease ;
and thus we may have the double satisfaction of a patho-
logical and a symptomatological correspondence between
patient and drug.

A reference to our Materia Medica, in so far as the symp-
toms of the respiratory organs are concerned, will illustrate
this point. How sharply defined, for example, are the indi-
cations for Aconite, Bryonia, Squilla, Phosphorus, Sulphur,
Chelidonium, Antimonium tartaricum, Spongia, Veratrum,
Bromine, and many other drugs! In other words, how
clearly do the symptoms reveal to us what part of the
apparatus is affected, and how it is affected, down to the

348 A WEAK SPOT IN OUR MATERIA MEDICA.

finest shades of difference ! And with what remarkable
precision and certainty, as compared with former medical
experience, are we enabled to prescribe in affections of the
respiratory organs !

A strong contrast with this precision and certainty is
presented by the indefinite indications we possess for pre-
scriptions in diseases of the sexual organs of women. Even
our " best proved " drugs furnish comparatively few symp-
toms referable to these organs ; and, of these few, the
language is generally so vague that we are at a loss to
determine what part of the apparatus may have been the
seat of the sensation described. Even the descriptions of
objective symptoms are often most unsatisfactory and indef-
inite. Compare, in evidence of this, the relative clearness
and fullness with which discharges, for instance, from the
respiratory, and from the female sexual organs have been
described by provers.

Here, then, is a weak spot in our Materia Medica ; and,
practically, it is one that we must greatly deplore. Women's
diseases constitute a large majority of our cases. For, at
least half of the community are women ; and, what with the
enforced illnesses contingent on maternity; upon evolution
and involution, which are often attended with serious dis-
eases ; because of our modes of living, which bear so hardly
upon woman ; upon the unequal struggle which, as yet,
women are forced to maintain, who wage alone the hard
battle of life, — this half of the community, as the records of
all of us must show, call for professional aid at least twice as
often as the other. And yet, in reference to their peculiar
diseases, our Materia Medica is weakest.

The reason and the remedy are not far to seek.

We have comparatively few symptoms of drug-action
upon women, because comparatively few women have been
provers of drugs. And the symptoms we have are lacking
in precision, because our women-provers, as a rule, have
been deficient in definite knowledge of the structure and

A WEAK SPOT IN OUR MATERIA MEDICA. 349

physiology of the organs distinctive of their sex, and have,
therefore, been, to some extent, incompetent observers.
They have often better described the symptoms of the
respiratory organs which they possess in common with men,
than of their own characteristic sexual organs ; a fact not
surprising, perhaps, but certainly, from the stand-point of
the Materia Medica, deplorable.

This want in our Materia Medica can be supplied only by
the voluntary labors of women as provers of drugs. And
that their provings may possess the requisite definiteness and
precision, the provers must have acquired such a degree, at
least, of professional knowledge as to understand the anatomy,
physiology and relations of the apparatus peculiar to their
sex. In other words, they must be, for this object, at least,
and to this extent, physicians. More especially is this neces-
sary as regards the symptoms produced upon the sexual
apparatus of women, since, in the work of defining and com-
prehending these symptoms, at least, they can receive no aid
from professional men.

None but women can do this work. None but women
educated in medical science can do it worthily and well, so
that our Materia Medica may be an efficient means for
the treatment of women's diseases. If this fact furnish an
argument for the medical education of women, the fault
lies in nature ! And if, engaged in the execution of such
a work as is here indicated, — so sorely needed, and which
they alone can perform, — women physicians should seek
admission to the privileges of our profession, I, for one,
could not imagine a more complete, nor a more beneficent
vindication of their right, than such a contribution to human
knowledge would be.

DIRECTIONS FOR DRUG-PROVERS,
GIVEN TO THE WOMEN WHO PROVED LILIUM TIGRINUM.

The object in proving a drug is to ascertain the changes
which the drug is capable of producing in the functions and
organs of the healthy body.

It is very important that each prover should know and
be able to recognize the various sensations and variations
of function to which she may, by peculiarity of consti-
tution, be subject when in average health ; so that she may
not, while proving a drug, mistake such natural variations
for effects of a drug.

The prover should have at hand, at all times, a note-
book, in which to record the times of taking the drug and
the doses, as well as the symptoms as they occur. The
record should be made as soon as the . symptom is per-
ceived, and the time of its occurrence and the circumstances
of the prover at the time should be recorded.

Before beginning the record of a proving, the prover
should inscribe in the note-book a statement of her age,
temperament, the sicknesses which she has had, and those
to which she has an inherited or acquired tendency ; also
whatever pains or sensations she may be habitually subject
to ; also any peculiar susceptibilities she may possess to
external influences of any kind, or to mental or moral or
emotional excitements, depressions, or perversions. Her
constitutional peculiarities respecting the menstrual function
should be carefully recorded ; regarding frequency, quantity,
character, and whatever inconveniences or sufferings pre-
cede, accompany, or follow menstruation ; such as headache,

DIRECTIONS FOR DRUG-PROVERS. 351

backache, colic, leucorrhcea, etc., together with peculiar
states of mind or emotion.

In describing sensations or pains which may occur during
a proving, it is not sufficiently definite to say " pain in the
head," " pain in the back," etc. The character and locality
of the pain must be exactly described in graphic language,
— stating, for example, that the pain is "cutting," "burning,"
" sticking," etc., — and specifying its location, and, if it move,
its course.

The prover should find out by experiment, and should
carefully state, what circumstances aggravate or ameliorate
the pain (or other symptom), and note its periodical recur-
rence, because periodicity is a very important element in
the history of the action of drugs. For example : is the
pain worse when the prover stands, or sits or lies down,
worse during exercise and better during rest, worse on first
waking, worse in the cold and relieved by heat, worse or
better from touch or pressure, etc., etc. All such condi-
tions of aggravation or amelioration should be carefully
recorded.

If the pain move from one part of the body to another,
the fact and the course of the pain should be recorded.

The sides of the body on which symptoms occur should
always be stated.

The times of occurrence, aggravation, and amelioration
are very important elements ; as, in the morning or after-
noon ; at night, before or after midnight, or waking from
sleep ; just before or after eating, etc., etc.

Changes in the quantity, quality, and appearance of the
natural secretions should be carefully described. The
urine, for instance, should be measured, and the quantity
per day recorded ; it should be tested for acid and albu-
men, and whatever sediment it may deposit should be
carefully described. Modifications of the menstrual func-
tions should be most carefully recorded ; such as its greater
or less frequency or quantity ; alterations of color and con-

352 DIRECTIONS FOR DRUG-PROVERS.

sistency ; whether acrid or not ; pains and discomforts of
body or mind which precede, accompany, or follow it.

Secretions not observed by the prover when in health —
such as leucorrhcea, unusual perspirations, etc. — should be
described, as to color, consistency, odor, nature ; whether
bland or acrid, times of occurrence, and circumstances which
increase or diminish them, and symptoms which accompany
them.

If organic symptoms occur, such as eruptions or sus-
pected enlargements or displacements of organs, it is well
to consult a physician in order to ascertain the exact condi-
tion, which should be carefully described.

The records should be full and minute. It is better to
be obliged to erase something afterward, than to risk the
loss of an important symptom by aiming at brevity.

The dose should be taken at a time when the prover can
rest, in mind and body, for a half hour after taking it.
The early morning is the best time, for then the prover
will have a chance to observe the action of the drug for
fifteen to eighteen hours without interruption by sleep. It
is better to begin with a small dose, gradually increasing it
until effects are recognized, and then to cease taking the
drug until these effects have ceased. It may then be
repeated in a somewhat larger dose. No danger of per-
manent illness is incurred by this mode of proving drugs.

During a proving, the prover should abstain from the
use of medicines, cosmetics and perfumes, but should make
no marked deviation from her usual diet and regimen.
Habits of so long standing as to have become " second
nature " should be continued in moderation, since to break
them off suddenly is to institute at once a morbid state.

LILIUM TIGRINUM.

A SUMMARY OF A FEW PROVINGS UPON WOMEN.

My studies have, for years past, shown me the weakness
of the Homoeopathic Materia Medica in respect of the physi-
ological effects of drugs upon the peculiar organism of
women. This is due to the fact that but few of the provers
to whose observation we owe our Materia Medica were
women. I have not been able to imagine any method by
which this deficiency in the Materia Medica could be sup-
plied, except by the voluntary acts of women, who should
undertake to prove drugs. And it has seemed to me
improbable that this work could be performed with the
requisite accuracy and intelligence unless the women who
should undertake it were educated in the medical sciences.
Finally, it appeared to me that women who had become by
education and acquirements members of the medical pro-
fession, would not be likely to take a hearty and efficient
part with us in the great work of perfecting the vital
element of our science, — the Materia Medica, — unless they
were recognized and received by us as fellow-workers on an
equal footing in every respect, for a similar reason to that
which led Mr. Dickens to decline the Queen's invitation to
give a reading at Windsor Castle, saying, " I will not appear
as an artist where I should not be received as a man ; "
and, conversely, I thought that if so received they would
respond cordially and generously to an invitation to engage
in the work for the promotion of medical science, and in a
department in which they alone could work, and the com-
pleteness of which would be forever a monument of their
ability and devotion.
24

354 LILIUM TIGRINUM.

When, therefore, at the session of the Institute in 1 869 a
resolution was pending which declared the eligibility of
properly qualified women to membership, I determined to
invite women who had joined the medical profession to
engage in the labor of proving drugs, feeling confident that
the results of their work would demonstrate how valuable
and indispensable it is to the completion and perfection of
our Materia Medica. The results even thus far have justi-
fied this confidence. More than thirty women, most of
them members of the profession, responded cordially to my
invitation, and entered upon the work of drug-proving.
One-third of the number have already reported results of a
satisfactory nature, and of which I here present a sum-
mary.

The drug selected for proving was the Lilium tigrinum —
the tiger-lily — which was introduced into the Materia
Medica by Dr. W. E. Payne, of Bath, Me., who had
communicated to us just enough to show that it had a
powerful specific action upon the female organism. The
symptoms were known, however, only to members of the
Institute. I thought that by engaging a number of provers
in different parts of the country, in a simultaneous proving
of this drug, utterly unknown to most, if not all of them, I
should receive reports which, if they should corroborate each
other, would be very conclusive as to the action of the drug.

Inasmuch as this drug belongs by right of discovery to
Dr. W. E. Payne, I have turned over to him the verbatim
reports received from my provers, that he might incorporate
them with his own, and prepare the whole for publication in
the Transactions of the Institute.

The first proving, and which I shall give in greatest
detail, was made under my own observation and direction,
by a lady of 30 years, unmarried, a practicing physician,
and who had always enjoyed good health, although quite
susceptible to the action of drugs.

No. i. She began her proving Oct. I, 1869, by taking

LILIUM TIGRINUM. 355

three drops of the ^ centesimal dilution of Lilium tigrinum
thrice daily. She reports as follows :

" I first noticed that I was more active ; things went
easily. There was no other effect for four days, unless it
was increased sexual instinct ; then a sweetish nausea, with
fullness of the abdomen, particularly after eating — even after
eating small quantities. But food does not increase the
nausea ; no desire to vomit.

" On the 6th day moral symptoms were developed. I do
not want to be pleased ; don't care to talk ; desire to sleep.
Slept well all night, with unpleasant dreams. Omitted
medicine two days, during whicli the nausea and full feeling
subsided. At intervals the skin of the abdomen felt stiff
and stretched. On the 7th day took five drops of the 3°,
and in a few hours the nausea was much increased,
with the same bloated sensation in the abdomen, par-
ticularly across the hips and in the region of the uterus;
darting pains in different parts of the head, some tearing
pain in the lower part of the abdomen from the region of
the ovary down both sides. I ate as much as usual, but
felt no appetite for it; was restless, with a desire to do
something, but no ambition. A sensation of pressure in
the vagina, and a pain at the top of the sacrum extending
to the hips.

" 8th Day. Worse on going to bed ; can't go to sleep ;
wild feeling in the head, as though I should go crazy and
no one would take care of me ; thoughts of suicide ; how
much opium would put me to sleep forever, and who
would find my body, and who would care ; nausea constant.

" loth Day. Pain in the right iliac region, better during
motion ; the head grows wild after I have been quiet for a
short time. At 2 P. M. of the loth day (Oct. 10), took five
drops of the 3°. Increased depressing weight over the
pubes; worse in the evening. The knees ache." No more
medicine was taken by this prover.

Eight days afterward (Oct. 2Oth), she came to me to state

356 LILIUM TIGRINUM.

her symptoms, her mind being in such a state that she could
not herself record them. The following symptoms had
come on on the 2Oth (ten days after last dose), and steadily
increased : A sensation in the pelvis as though everything
was coming into the world through the vagina. Last night
it was very distressing, and not relieved by change of
position. The dragging downward toward the pelvis is felt
as high as the stomach and even the shoulders ; not relieved
by lying down, though worse when standing ; a disposition to
place the hand upon the hypogastrium and press upward in
order to relieve the dragging sensation. Likewise an aching
and pressure across the lumbo-sacral region, and some
pressure upon the rectum. Likewise pressure and a crazy
feeling upon the vertex, so that she cannot write her
symptoms. To-day (22d), when walking, a sensation as if
everything were pressing down in the pelvis and into the
vagina, so that she inhales forcibly in order to draw up the
thorax and clear the pelvis.

She wants somebody to talk to her and entertain her.
Feels quite nervous ; wants to cry from a feeling of irritation
and of something wrong in the abdomen and pelvis. Feels
hurried and yet incapable, as if she had a great deal to do
and cannot do it ; much thirst ; drinks often, and much at a
time.

Bowels generally regular. Now she has alternately a solid
and a loose stool, several during the day, and a constant
feeling as though she must have a stool ; this feeling result-
ing from a sensation as if something were pressing against
the anterior wall of the rectum at the anus and about one
to three inches above it.

She is conscious of feeling nervous and irritable, and yet
says she feels jolly. Grumbling pain in right side of head
and teeth.

Yesterday, when walking, pain in both ovaries, worse in
the left, extending down the anterior and inner aspect of the
left thigh, as if it would be impossible to take another step ;

LILIUM TIGRINUM. 357

as soon as she extended the limb she must immediatly flex
it again, and then, because of a restless discomfort, must
again extend it At length she went to sleep on the back
with knees and thighs flexed.

She cannot tell which pelvic pain is the worse, that in the
back or that in the pubic region. The whole contents of
the pelvis seem to drag downward and forward and quite
from the epigastric region.

She cannot record her symptoms. Don't want to com-
plain, and yet don't avoid people. Feels bloated, but is not
so. Somewhat tender on pressure in the region of the
ovaries, especially the right.

Oct. 23. Aching in the pelvis between promontory of
sacrum and the*, pubes. It feels to her as if the aching were
not in the uterus but around it. She feels constantly the
two spots corresponding to the ovaries, and which ache and
feel like little coals of fire. In the pelvis, a feeling like a
dragging out, as if the whole contents were pushing down
into a funnel, the outlet of which coincided with the
vagina.

Oct. 25. For the last 36 hours constant desire for stool
from pressure on the rectum ; a stool every half hour, lumpy,
diarrhceic, with flatus ; constant tenesmus, and burning in
the urethra. These symptoms continued, along with those
before described, for several days. The pain in the right
ovary increased, until on the i6th she described it as if a
knife were inserted into the ovary and ripped down the groin
and the anterior part of the thigh ; the pain extended over
the lumbo-sacral region, and she must cry herself to
sleep. Somewhat relieved by pressure on the ovarian
region.

Diarrhoea and pressure on bladder continue without relief
until the 2/th. She remarks that her symptoms are all
worse when she gives up active resistance to them and con-
trol over herself, as for example, when she sits down to rest
or tries to go to sleep.

358 LILIUM TIGRINUM.

Oct. 28. Menses occurred at the regular day and normal,
but only while she keeps moving. The flow ceases when
she becomes quiet. She feels much hurried and driven, but
knows not why; walks fast and constantly, but aimlessly;
is much confused in mind.

Oct. 29. She noticed some heart symptoms, not very
definite. On the 3Oth, after walking, a sudden fluttering
sensation in the heart. This, like all other symptoms, is less
felt if she can busy herself much. A hurried feeling about
the heart with faintness and fluttering as though she could
make no exertion but must sit still. The seat of pain is the
apex of the heart. Twice she had a sharp pain there. Feels
hurried as though she must breathe quickly, yet does not.

The prover feels that her whole system has been pro-
foundly affected by the drug. " She is not the person she
once was ; " feels hurried but incapable ; no heart nor
strength for business ; discouraged and despondent.

Nov. i. A dry, single cough ; heart symptoms very
troublesome ; short of breath, especially on going upstairs.

Appetite very much increased, especially for meat, and
the more so the more pronounced the symptoms were. The
mental symptoms are striking ; she is averse to being alone,
which formerly she liked (but does not dread it). Her
sexual instincts, formerly dormant, are now quite strong ;
wits and intuitions dull and languid.

Nov. 10. The prover reports : She had been quite well
since the 4th, and supposed the action of the drug exhausted,
but on the 7th the bearing down sensation in the pelvis
returned ; everything seemed to be pressing out of the
vagina. This continued on the 8th like light labor pains.
Leucorrhcea also occurred (a thin acrid discharge, leaving
a brown stain). She had never before had it. All these
symptoms worse afternoon and evening till midnight. On
the Qth leucorrhcea had ceased, but in the afternoon it
returned worse than ever, and she could not sleep for the
pelvic distress.

LILIUM TIGRINUM. 359

Nov. ii. She feels depression; has pressure on bladder
and rectum ; is inert, yet restless and peevish ; leucorrhoea
continues. With these symptoms comes the desire again
for meat. Burning pain across the hypogastrium from groin
to groin. In short, the symptoms first experienced repeat
themselves. She had not taken any more of the Lilium
tigrinum. In addition she notices a peculiar mental con-
dition ; a desire for fine things of every kind. She is dis-
satisfied with what she has, and envious of others.

Nov. 12. While attending a lecture, much irritation in
the womb and a singular state of mind — desire to strike the
lecturer, and in the evening a disposition to swear at every-
body and everything, and to think and speak of obscene
things ; as these feelings came, the uterine pains passed away.
To-day the leucorrhoea ceased.

Nov. 13. She has been languid, dull, and forgetful since
the last report. Menses recurred (i4th) after an interval of
only two weeks ; a slight, dark, thick, and offensive dis-
charge.

Dec. i. It is eight weeks since she took Lilium tigrinum.
Yesterday, great hunger, and she ate largely, yet felt as if
she should starve. Felt the old hurry and incapacity ; the
old pains in head and teeth relieved by motion and occupa-
tion, followed by the diarrhoea and the pressure on the
bladder.

Dec. 4. She is now passing this, the third series of
symptoms produced by the Lilium tigrinum ; the passionate
excitement, the aching and burning pain in the ovaries (in
the right), which organs are distinctly defined to her sensa-
tion ; then despondency with aggravation at night and
diarrhcea in the morning; then pressing down in the pelvis
and burning all around the pubes and genitals, worse from 3
to 5 P. M., and passing away from 8 P. M., accompanied by
pressure on the bladder.

The symptoms on this occasion were so severe and dis-
tressing— physical no less than mental — that I could not

360 LILIUM TIGRINUM.

allow the prover to continue to endure them, and gave
Platina200 repeatedly, under which she gained speedy relief.

No. 2. To compare with the above, I will give an abstract
of a proving made under the supervision of Dr. W. E.
Payne, at about the same time, the provers having no com-
munication :

Mrs. P., aged 55, has ceased to menstruate.

Jan. 26, 1870, took a drop of the w centesimal. In the
evening, after griping pain, had free, faecal stool, followed by
acrid feeling in anus and rectum, a very rare thing for this
prover. During the night, a feeling in all the extremities as
if the blood were pushed outward ; restlessness ; heat and
pain in forehead and brow.

Next day a free stool, followed by acrid sensation at the
anus. Frequent desire to urinate during the day, with
scanty discharge and followed by an acrid sensation in the
urethra. These symptoms recurred daily with marked
aggravation about 5 P. M. till February 2. Diarrhceic stool
every morning, followed by acrid irritation at anus, con-
tinuing about an hour. Same symptoms with urine.

Feb. 2. Repeated medicine. Increase of the above
symptoms ; burning in palms and soles all night, with con-
stant desire to find a cool place for them ; some cutting pain
in the left mammary gland, with aching, beginning below
the nipple, deep in the breast, as though between the gland
and the ribs and extending around that side to the spine,
seeming to pass under the lower end of scapula, coming
on after retiring and worse when lying on the affected
side.

These symptoms continued and recurred daily; she
repeated the medicine, which was followed by a severe blind-
ing headache in the anterior part of the head, the peculiarity
of which was a sensation as if all the blood were pressing
outward through every aperture. The medicine was repeated
every third or fourth day. About the pth and loth, in the
left side of the abdomen (ovarian region) soreness to press-

LILIUM TIGRINUM. 361

ure ; darting pains at times in this region, extending to the
groin and pubes in front ; frequent desire to urinate.

On the 1 2th, the head being clearer and better, great
heaviness and pressure in the region of the womb, with
stinging and darting pain in the ovarian region.

I4th. The ovarian pains become more decided and ex-
tend down the left thigh.

This series of symptoms continued until the 2 1st, when
the ovarian pain continuing, there was also a bearing down
in the uterine region, with a desire to sustain the parts by
pressing upward with the hand against the vulva ; symp-
toms which continued and are described on the 25th as a
" pressing and bearing down sensation " in the whole of the
sexual organs, with a feeling as if the internal parts were
being pulled outward and downward from the mammary
and umbilical region through the vagina; irresistible desire
to press the hands against the vulva to prevent the internal
organs from escaping.

These symptoms continued to recur for a full month after
the last dose of Lilium, and the morning diarrhoea for more
than six weeks.

No. 3. This prover took Lilium3 in one dose a quarter
ounce. No symptoms were observed for two weeks. Then,
of which the most striking were those last in order, pain in
the lumbar region as though the back would break ; bearing
down pain in the pelvis, especially when walking ; pressure
and weight low down in the vagina.

She reports, also, a headache, as if the head were too full
of blood — as if the blood would issue from nose and ears.

No. 4. This prover, who had suffered from astigmatism,
and was hypermetropic, experienced from Lilium3, heart
symptoms, pain through the heart to the back, and a feeling
as if the heart were squeezed in a vice. She cannot walk
straight by going into a warm room, the symptoms having
occurred while walking in cold air.

Also, her eyesight became very dim. She took no more

362 LILIUM TIGRINUM.

medicine, and in about a month her eyesight was restored.
She then found that the astigmatism no longer existed.

No. 5. This prover describes the same headache as the
previous prover — pressure from within outward ; the same
nervous prostration, and a morning diarrhoea with much
tenesmus. She states the symptoms persisted for a month
after the last dose.

No. 6. This prover reports nervous tremulousness and
inability to apply the mind ; aggravation in the afternoon,
and a headache similar to the preceding. Also, menses
diminished in quantity, but occurring too soon. Likewise,
severe pains in the uterus; could not bear the weight of
clothing on the pelvis ; profuse acrid leucorrhcea. While
the pain in the pelvis was so severe, a vaginal examination
disclosed the fact that the uterus was anteverted ; a state of
things that had never before existed. During the pains
hysterical paroxysms.

Nos. 7. and 8. The same series of symptoms as above.

From this resume we may gather some of the chief charac-
teristics of Lilium. When taken in moderate doses the
effects are not immediate. Days elapse before unmistak-
able symptoms of the drug-action appear. But the effects
are very persistent, as the record of every prover shows.
They tend, moreover, to recur at longer or shorter intervals,
and in groups which preserve a definite order. Thus, prover
No. i, whose record I have given at greater length, reports
a third recurrence of a group of symptoms nearly two months
after the dose of Lilium. In male provers the same recur-
rence of symptoms in definite groups has been observed, with
an interval of comparative freedom from symptoms. The
simultaneous observation of these peculiarities in provers
residing far from each other, and not known to each other,
precludes any doubt of its genuineness.

Of the symptoms observed by women, as well as men, the
effects on the mind are noteworthy, and are of two varieties.
First, as noticed by Dr. Payne, anxiety and apprehension

LILIUM TIGRINUM. 363

that an incurable disease exists or is impending, and this
produces despondency. Second, as exhibited most decidedly
in prover No. I, and clearly, though less pronounced, in
several others, a consciousness of an unnatural state of mind
and feeling, which at last develops into an exalted condition
in which the prover is disposed to find fault with persons
and things, to exaggerate her own importance and excellence,
and look down upon others; conjoined with this is an exal-
tation of the sexual instinct. In several provers this state of
things has resulted in hysterical paroxysms. In prover No.
I it assumed such marked proportions that I was constrained
to put an end to it by administering Platina, the indications
for which are evident from the mental symptoms. Intel-
lectual activity is impaired in both men and women. Both
have complained of the feeling of hurry and restlessness,
which is so well described by prover No. I.

Menstruation is accelerated, in some cases recurring in
two weeks. The flow is very scanty.

An acrid, thin, brownish leucorrhoea was, to several prov-
ers, a troublesome symptom.

But the most striking symptoms, and those most widely
observed, relate to the pelvic organs. They did not gener-
ally present themselves until a number of days after the
proving was begun. They consist of a dragging or pulling or
forcing down sensation in the pelvis, as though the entire
contents of the pelvis were pulled down through the vagina,
or would issue from the vulva. This sensation is not con-
fined to the back or hips, — nor again to the hypogastric
region, — but is described as pervading the entire pelvis.
And the two provers in whom this symptom was most
marked describe the dragging as coming even from the
thorax, the mammary region, and the shoulders. So
marked is the sensation of downward and outward pressure
that the provers place the hand on the hypogastrium or the
vulva as though to prevent protrusion. In three provers,
physical inspection revealed the existence of anteversio

364 LILIUM TIGRINUM.

uteri, a trouble which none of them had ever before
experienced.

In this train of symptoms belong also the tenesmus of
bladder and rectum, and the diarrhoea and frequent micturi-
tion.

There is agreement of the provers respecting pains, burn-
ing or cutting, and tenderness in the region of the ovaries,
especially of the right ovary.

The symptoms generally are worse in the afternoon and
before midnight, except the diarrhoea, which seems to be a
morning diarrhoea.

If now, with the light which these provings afford us, we
seek to place Lilium tigrinum in its appropriate niche in
our Materia Medica, and to estimate its value by comparison
with other drugs, we observe, first : The uniform occurrence,
in so many provers, of pelvic symptoms, as well as the
demonstration, by physical examination, of the uterine dis-
placement, establish its a priori claim to rank among the
remedies for prolapsus and displacement of the uterus, for
catarrh of vagina and uterus, and for inflammation of the
ovary. And if we run a parallel with the symptoms of other
remedies, we find marked peculiarities which characterize
Lilium. In the morning diarrhoea, coming suddenly and
with tenesmus, it resembles Podophyllum, and Podophyllum
has, likewise, a general bearing down in the pelvis — con-
fined, however, to the lumbo-sacral region, while the mental
and moral symptoms produced by Podophyllum bear no
resemblance to those of Lilium. Moreover, in so far as my
own observation goes, Podophyllum both produces and
removes these pelvic symptoms only when they occur in
connection with certain symptoms of the digestive tract,
such as Lilium has no relation with.

Sepia produces, certainly, a bearing down sensation upon
the lumbar region, together with dragging and even sharp
pains from the region of the ovaries extending downward to
the pudenda, but besides that, Sepia presents us no symp-

LILIUM TIGRINUM. 365

toms of diarrhoea and irritation of rectum and anus, and no
such leucorrhcea as Lilium ; the conditions are very different.
The Lilium pains are aggravated in the afternoon, and
before midnight. They grow worse during repose and
when one's mind is passive ; worse, therefore, on lying down
and trying to compose one's self to sleep. Whereas, on the
other hand, the Sepia pains are worse from 9 A.M. to noon,
and are relieved by repose ; being aggravated by motion
and occupation. The state of mind produced by the two
drugs is very different. Almost the same differences exist
between Lilium and Pulsatilla.

Belladonna resembles Lilium in the bearing down sensa-
tion, both in the back and in the pubic region, and in the
fact that there is not immediate relief from repose. But,
on the other hand, Lilium gives no evidence of that general
affection of the organism, especially of the circulation,
which accompanies every well pronounced group of Bella-
donna symptoms. On the contrary, under Lilium, when
the patient suffered most, nutrition and appetite were not
impaired. They were even improved.

It is probable that further provings of Helonias dioica
will show a strong analogy between it and Lilium as regards
their action on the female organism. We know enough
already to recognize a difference in the mental symptoms.
Lilium dulls the intellect, produces a sensation of hurry
with inability, and a distress based on a clearly defined
apprehension of having some fatal or serious malady.
Helonias produces profound melancholy, deep, undefined
depression, with sensation of soreness and weight in the
womb, a " consciousness of a womb."

Platina seems to me to present the strongest features of
resemblance to Lilium, both in the pelvic symptoms and in
at least one phase of mental symptoms, and the result of
my trials with prover No. I shows its power to antidote
Lilium. But Platina does not present any of the symp-
toms of the intestinal tract which are so prominent under

366 LILIUM TIGRINUM.

Lilium nor are its effects on the function of menstruation
similar.

It will be observed that I have said nothing of the action
of Lilium upon the heart. This is because my provers were
not very markedly affected in that way (except one of
them), but chiefly because my purpose was to show the
action of the drug on the organs and functions peculiar to
women, and to demonstrate how valuable additions may in
a short time be made to Materia Medica in its weakest part
by the labors of professionally educated women heartily
engaged in this work, which none but such as they can
perform.

MUREX PURPUREA.

This substance was first introduced into the Materia
Medica by Dr. Petroz, of Paris, in some observations
published in the Revue Critique et Retrospective de la Matiere
Medicate, vol. iii., 1841.

Dr. Petroz does not state from what variety of the mollusk
which furnishes the purple coloring matter the specimen
employed by him in the proving was obtained. A coloring
substance, to all appearance identical, is found in various
genera of the family Muricidae as well as in the genus
purpura of the family Buccinidae.

Weber, of Paris, in his Codex des Medicaments Homceo-
pathiques on pharmacopee pratique et raisone'e, has the
following remarks :

" MUREX PURPUREA. Coquille a pourpre. It belongs
to the class of mollusks and to the family of Purpurifera.
There are several varieties which may have the same value
in Homreopathy, inasmuch as up to the present day the
only part used for experimentation has been the coloring
matter which furnishes the purple, and even this experimen-
tation has been made not upon the healthy subject, but
upon the sick.

"The ancients derived their purple dye from several
different mollusks, from the Biccinum, a variety found upon
the rocks, as well as from the Purpurea, which is the
" Coquille a pourpre," properly so-called, and which is
found not only upon the Phoenician coast, but also through-
out the Mediterranean. Recently a juice, analogous to the
purple dye, has been found in several conchiferae belonging
to the family of the Limacidae. This juice, which is viscous,

368 MUREX PURPUREA.

and, when first obtained, colorless, is found in a distinct
little sac which in the majority of these mollusks is situated
between the heart and the liver. When brought into
contact with the atmosphere this juice becomes successively
yellow, green, blue and finally a reddish purple.

" It is insoluble in water, alcohol or ether ; consequently,
for homoeopathic use, the first three attenuations should be
prepared by trituration."

Jahr and Catellan, in their Pharmacopeia, Paris, 1853, say :

" MUREX PURPUREA, purpura patula, cochlea veram pur-
puram fundens ; pourpre antique ; Purpurschnecke. An
oval shell furrowed transversely, studded with tubercles,
especially when young ; with a somewhat short helix, the
aperture bell-mouthed. Color, a blackish russet externally.
The columella of a russet yellow. The straight margin
white. This variety of shell inhabits the Mediterranean,
where it is pretty common. Its juice, which is the true
purple dye, is contained in a large fold in the form of a
pocket upon the back near the neck. It requires a good
deal of adroitness to collect this juice, for it is quickly thrown
out by the animal. The juice, after being taken from the
animal, is at first blue, and then of a beautiful green, finally
of a magnificent purplish red. Cloth dyed with it always
preserves its color."

The provings recorded by Dr. Petroz, and which are the
only ones that we possess, are, it must be confessed, frag-
mentary. So are the contributions of every individual
prover of every drug. So are the single stones, of which
when they are duly placed together, a stately mansion is
constructed. If the stones were neglected, because, when
regarded separately, they are nothing like a house, how could
they ever be brought together and built up, forming the
house ? If the results of each individual prover's or experi-
menter's labors are to be withheld on the ground that they
are fragmentary, how shall matter be accumulated for a
complete and exhaustive proving ?

MUREX

PURPUREA. 369

It has been further objected that Dr. Petroz's proving is
not a pure one, because his subjects had, two of them a
slight leucorrhcea, and the third a cutting uterine pain at
the time of the menstrual flow. Some, chief among them
Dr. Roth, of Paris, would rigorously exclude from the
Materia Medica Pura everything which does not rest upon
exact observation of the effect of drugs upon exclusively
and strictly healthy persons.

Etymologically, he is quite correct. A pure Materia
Medica has no business with a single symptom obtained
from observation on the sick, however slightly sick, or sick
in a way however foreign to the nature of the symptom in
question.

But in good part, the criticism of Dr. Roth is sheer
pedantry, not practical sagacity.

An ideal Materia Medica Pura should contain only symp-
toms obtained upon the absolutely healthy. Ages will
elapse before we can have a complete Materia Medica of this
kind. It is certainly an object worthy of unceasing labor.

The Materia Medica which we possess while made up in
good part of pure symptoms (symptoms observed upon the
absolutely healthy), contains also symptoms observed upon
those who are not absolutely healthy. The symptoms we
possess of certain medicines are wholly of the latter char-
acter. Cases occur in practice to which no remedy of which
we have pure symptoms corresponds, but which nevertheless
finds its simile and its individual specific in one of these
drugs of which we have no knowledge except the symptoms
it has produced upon the sick.

Now, the pedantry of the critic in his closet may exclude
from a pure Materia Medica every proving that is, so to
speak, impure, but the question for the practical man is this:
Shall any proving, however fragmentary, however impure,
which yet puts it in the power of the physician to cure even
a single case of disease, be cast out from the Materia
Medica ? The answer must be, let it remain for the sake of
25

370 MUREX PURPUREA.

these rare cases as a stimulus to pure and complete provings,
as a contribution to the clinical, if not, in pedantic literal-
ness, to the pathogenetic history of the drug !

The point of greatest importance in relation to the frag-
mentary provings, which are published from time to time,
and from a collection of which an exhaustive knowledge of
the drug is ultimately to be obtained, seems to us to be this,
that the name and condition of the prover should be attached
to each symptom, and that thus the student may be enabled
to judge for himself of the pureness and authenticity of the
symptoms.

The observations of Dr. Petroz are given in the following
with but little abbreviation. They are followed by some
clinical observations by Dr. Constantine Hering and other
practitioners. All together, these remarks should serve to
draw attention to Murex purpurea as a substance promising
rich returns to the careful prover.

MUREX PURPUREA, by Dr. Petroz, of Paris, from La
Revue Critique et Retrospective de la Matter e Medicale :

The entire scope of the action of therapeutic agents is
not easily recognized, even by those who have a profound
understanding of the Materia Medica based on experimenta-
tion on the healthy subject.

This difficulty explains the astonishment of practitioners
when they meet with unexpected results, the products of
some particular condition different from that which consti-
tutes the physiological state. The observations of these
effects in conditions very similar to each other, if collected
with care, should, after a time, constitute the second part of
the Materia Medica, which we might call the clinical, in
.contradistinction to the pure or experimental part.

The latter, however, the fundamental basis of the art of
curing, should be regarded as an inviolable law, the point of
departure of every positive notion, the sacred volume to
which we faithfully recur on every occasion on which we
may have been led away, by a sort of involuntary impulse as

MUREX PURPUREA. 3/1

it were, to that empiric method which has, up to the present
time, characterized the successively prevailing doctrines.

Experimentation on the healthy subject, while it produces
symptoms analogous to the majority of those observed in
the sick, has not been able to go so far as to produce those
disorders, whether functional or material, so serious, and yet
so common, which appall the most practiced and hardened
observer.

That the proving of a medicinal substance upon the
healthy subject should make known all the effects which it
is capable of developing, it must be repeated not only under
different conditions of age, sex, etc., but also under variable
conditions of susceptibility. But even if one succeed in
finding healthy individuals of very unusual susceptibility,
this is but trifling, compared with the susceptibility which
characterizes certain pathological conditions.

Furthermore, where is the physician, who, whatever his
devotion to science, would assume the right of pushing his
proving to the extent of endangering the life of the prover.

This difficulty of pushing experimentation far enough to
discover every medicinal property which a substance may
possess is relative, as I have said above, to the susceptibility
of the prover. Thus a young woman, very impressible and
courageous, presented to me, when under the influence of
Lycoperdon Bovista, symptoms which were the very image
of asphyxia from the fumes of charcoal. * * *

In proving a mimosa asperata she experienced several epilep-
tiform nervous symptoms.

But it is a rare thing to find individuals so well adapted to
this work. In default of them we must interrogate the path-
ological susceptibility, which, in its turn, may prove a fruitful
source of positive knowledge.

PATHOGENESY.

No. I. A woman, 46 years old, of nervous tempera-
ment, very impressible, but in good health.

372 MUREX PURPUREA.

One dose of Murex, fourth, was taken in six spoonfuls of
water. The first spoonful was taken January 5th, in the
evening.

Twelve hours after taking -the medicine, acute pain in the
right side of the uterus, which crossed the entire body and
extended upward to the left breast ; extreme feebleness of all
voluntary motions, the legs bend under her; irresistible
necessity of remaining seated ; confusion of ideas, repug-
nance to conversation, deep sadness.

At six P. M., palpitations of the heart, and throbbings of
the arteries in the neck.

In the evening, excessive fatigue, somnolence, heat of the
hands ; pulse 80. Pains in the knees ; pains in the loins,
sensation of excoriation and of burning pain, as if broken,
in the chest. The night was good.

January /th. The second spoonful, in the evening. Sharp
burning pain under the false ribs of the left flank, toward
the vertebral column, in paroxysms ; somnolence and sad-
ness ; difficult evacuation of faeces, stool requiring an enema
of tepid water. The stitch in the side has lasted the
whole day. In the evening, painful tension in the right
hypochondrium. Dry, infrequent cough. Dyspnoea. Voice
is changed and hoarse. The heaviness is much diminished.
No leucorrhoea since the first spoonful.

The third spoonful on the evening of the seventh.

8th. The night good. On awaking, feels well. The stitch
in the side has disappeared. Sensation of dryness and of con-
striction in the uterus. The heaviness has disappeared. No
leucorrhcea.

The fourth spoonful was taken on the evening of the
eighth.

9th. A good day. Natural stool. Fifth spoonful, eve-
ning.

loth. Very good day. Sixth spoonful.

nth. In the morning, a sensation of heaviness and of
dilation in the labia majora. The urine has a white deposit.

MUREX PURPUREA. 373

Expulsion of a small quantity of bloody mucus, after passing
water.

1 2th. A good day. In the evening the menses appeared
abundantly. Stool natural.

1 3th. Pain in the uterus, as if wounded by a cutting
instrument This sensation has been habitual during the
menstrual flow for many years.

No. 2. A woman, aged 38 years, of a sanguine tempera-
ment, sound mind, judicious powers of observation, good
health.

First day. The leucorrhoea having disappeared entirely,
pain in the occiput toward midday, pain in the arms below
the elbow.

Second day. On awaking, headache, which disappears on
getting up. During the day pains in the left temple, com-
ing and going. * * Toward the close of the day,
tightness in the occiput ; I involuntarily raise my hand to the
part affected, when the tightness passes from left to right; I
raise to the head the hand of the opposite side to that which
is the seat of the pain ; I bend my head backward because
it seems to me that this motion relaxes the nerves of the
occiput and of the neck ; constant desire to urinate during
the day ; at three o'clock in the afternoon, great desire to
sleep.

Third day. Headache as the evening before, and relieved
in the same way; sleep with troublesome dreams; I fled
from a troubled sea and found myself again in a meadow
with water ; during the day momentary heaviness of the
head ; at five o'clock my right cheek was burning ; in the
evening, twice, I had a very violent stitch on the left side of
the abdomen, downward ; it ascended perpendicularly and
lasted one minute; at nine o'clock, violent sleepiness.
During the day, pains in the legs from time to time, tight-
ness in the head on each side above the ears ; pains in the
breasts.

Fourth day. Painful dreams, headache on waking * *

374 MUREX PURPUREA.

pretty severe colic ; hunger during the day ; appetite pretty
good in the morning, but not at dinner ; pains in the breasts.

Fifth day. I will explain to you. The prover has not
dared write all that she has felt in the region of the genital
organs; excessive sexual desire, an excitement which will
and reason could hardly control.

Sixth day. The left cheek burning. Hunger during the
day ; in the evening, headache with pain, lasting about an
hour.

Seventh day. Troublesome dreams ; waked with a start,
in fear ; in the morning, leucorrhoea, very scanty, but green-
ish ; in the evening, flatulent colic. This is the seventh day
of medication, and since the second day I have been very
much constipated ; to-day I could not go to stool ; in the
evening I had headache in front of the forehead. I have
forgotten to say that, during the first days, in the morning
before breakfast, I coughed several times. In the evening,
when breathing, I had wheezing in the chest; for several
days, I experience, during the day, paroxysms of anguish,
of fear and dread.

No. 3. A woman, aged 39 years, of sanguine-lymphatic
temperament.

First day. At two o'clock and at four, I have had sharp
but transient pains above the cerebellum. Less of leucor-
rhoea, but always mixed with blood.

Second day, Friday. Since noon, the head embarrassed
and a little heavy; little disposition to work; at half-past
two o'clock, buzzing in the ears, and increased heaviness in
the head, relieved about four o'clock ; about half- past six, I
was taken with a sharp pain in the abdomen on the left side.
It was acute and extended over the whole abdomen ; not
equally intense, but felt in different spots, like a sharp point ;
the left side of the abdomen remained sore the whole even-
ing. The leucorrhcea scanty and not mixed with blood. In
bed, pains in the renal and lumbar regions, and a decided
heat above the thighs persistent.

MUREX PURPUREA. 375

Third day, Saturday. Less heaviness of the head ; but
little leucorrhcea, but it is thicker ; not mixed with blood ;
the sore spots of the left side of the abdomen are less sensi-
tive, but are still occasionally felt ; some lancinating pains ;
the heat of the thighs has disappeared, but that of the hip
region continues even when not recumbent.

Fourth day, Sunday. This morning, on going to stool,
the blood had disappeared, and up to one o'clock, blood was
mingled with leucorrhcea ; about three o'clock I experienced
a severe pain above the right temple ; a little pain in the
thighs ; I have remarked that since taking the medicine the
pains in the loins and hips are greater. In the evening, on
going to stool, the blood flowed copiously; this day, but
little 'leucorrhoea. For two days, pains in the breasts.

Fifth day, Monday. No blood to-day ; but little leucor-
rhcea ; but, on rising, pains under the left thigh, very sensi-
ble on touching the part. This continued throughout the
day. Some lancinating pains in the womb ; the hips are
painful ; no heat of the thighs, either in bed or when up.

Sixth day, Tuesday. No blood; but little leucorrhcea.
The pain below the thigh is less severe, but the part is
always sensitive to the touch. The breasts have been very
painful, and in bed I have had sharp and painful lancinations
in them. The pains of the thighs and of the loins have
almost disappeared.

Seventh day, Wednesday. During the night I waked
with a start, and a violent desire to urinate. Urinated very
copiously. No blood nor leucorrhcea during the night, a
good deal during the day. Heaviness of the head and even
dizziness, but since taking the medicine, and even before, I
have not had so good a day. I have observed that since
taking the medicine I lose my memory, and even find my
words with difficulty.

.Eighth day, Thursday. Ceased to take the medicine.
The day has been a very bad one. Very severe pains in
the breasts, loins and thighs. Distress in the abdomen,

376 MUREX PURPUREA.

resembling that which I feel at the approach of the menses ;
and we are now at the 2Oth of August, — they should not
come until the 5th of September. Desire to sleep, dullness
of head ; labor is irksome.

This evening, no more pains except in the thighs, always
below and toward the middle. When urinating during the day
blood appeared slightly ; scarcely any leucorrhcea, but very
thick and yellow. I have remarked that I suffer more when
sitting than when walking, and the pains, which I cease
to feel when walking to and fro, return almost immediately
when I resume the sitting posture. Good sleep and appetite.

Ninth day, Friday. Good night ; yet on first waking,
and also several times during the night on waking, I had
pretty severe pains, such as attend the menses ; anguish.

The breasts, to-day, have been less painful; no more
blood in the leucorrhoea, and at stool scarce any leucorrhcea ;
no pain in loins but extreme lassitude and pains in the legs
and knees. No lancinations. A good day.

Headache, however, and frequent transient sharp pain in
the right temple. My headache, which continues this
evening is more on the right side than on the left.

Clinical Observations. No. i. Madame J., mother of several
children whom she nursed, enjoyed very good health up to
her forty-fifth year. At this period she began to have
irregularity of the menses and soon to complain of painful
weariness in the loins, of a sensation of weight in the
hypogastrium and more particularly in the rectum, all of which
gave her great concern ; deep sadness at the approach of the
menses, which were very abundant for several days, and
were attended with great pain caused by the expulsion of
large coagula. Subsequently, the flow, which lasted ten or
twelve days, became russet- colored and finally serous. The
interval from one period to the next was only about ten
days, during which the above symptoms diminished without
entirely ceasing, and at the recurrence of the menstrual flow
re-appeared with their original severity.

MUREX PURPUREA. 377

Exploration, by means of the speculum, revealed the pres-
ence of a soft, violet-colored enlargement of the neck of
the uterus ; a large excoriation on its anterior aspect, which
was caused to bleed by a slight touch, induced recourse to
cauterization, after which the patient was enjoined to observe
absolute repose and a light not very abundant diet. The
menses subsequent to the operation were less abundant,
without coagula and consequently less painful and of shorter
duration ; the secondary symptoms were also less marked.
This improvement did not last longer than a few months,
when the symptoms returned with increased violence.
Walking, or standing for a long time became almost impossi-
ble ; the pain at the appearance of the menses became again
violent, for the expulsion of large coagula; during the
periods of suffering, the pulse was small and frequent;
emission of urine was impossible ; a copious sweat covered
the patient's body. Sabina 33^, in 120 grammes of water,
given in spoonful doses, every half hour, moderated the
severity of the symptoms without much abridging their
duration. Eight days afterward the patient took Murex
purpurea4, five centigrammes in 180 grammes of water (a
spoonful morning and evening).

Under the influence of this remedy, the painful weariness
of the loins, of the thighs, the weight upon the rectum, the
leucorrhcea, the itching occasioned by it and the pains in the
hypogastrium diminished and then disappeared.

The menstrual epoch, which was retarded several* days,
occurred as before the sickness, except that there was the
weakness resulting from the antecedent sufferings. A second
dose, like the first, was given, immediately after the cessation
of the menses. From that time she was restored to perfect
health. Eighteen months have elapsed, during which she
has led an active and sometimes a fatiguing life, without her
health being at all impaired.

No. 2. Madame F., 30 years of age, of a sanguine-lymphatic
temperament, mother of two children, was subject, in infancy,

378 MUREX PURPUREA.

to violent attacks of cough, caused by congestion of the lungs,
the results of a psoric taint (retrocession of itch). These
attacks ceased to appear about the time of her first preg-
nancy, another organ becoming then the center of the con-
gestion and the seat of disorders of another character. The
patient began by experiencing a sensation of pressure
toward the genital organs; some months after her first con-
finement, a heavy weight pressing upon the rectum, swelling
of the haemorrhoids, greenish yellow leucorrhaea, sometimes
bloody, and discharge of pure blood by the vulva at stool.

Thrilling pains in the lower extremities. Painful weariness
in the loins, in the nates ; very great debility which rendered
walking very difficult, often impossible, at the period of the
menses. To these symptoms, which kept growing more
intense, there was added a painful aching in the whole
hypogastrium ; it caused an inexpressible anguish and fre-
quent syncope, which ceased when the menses began to
appear ; soon these became excessive, accompanied by
spasms in the abdomen, together with sharp lancinations in
the uterus.

Several cauterizations had been made, the operator having
been induced to resort to them (as he is reported to have
said) by the tumefaction of the cervix, in which there were
several deep fissures. The body of the uterus, more volu-
minous than natural, was very much inclined forward, the
cervix resting upon the posterior wall of the pelvis. This
positkm must, no doubt, have aggravated the pains.

The cauterization, although often repeated, did but little
good. It was given up, and for several months longer the
sufferings were the same. Immediately after the menstrual
period, five centigrammes of Murex 4 were given in 1 20
grammes of water ; the patient took a spoonful every morn-
ing. The symptoms perceptibly diminished before the
ensuing menstrual period. The latter was attended with
but little suffering, and the flow was less than usual. Above
all, the leucorrhcea was decidedly diminished. A second

MUREX PURPUREA. 379

dose, given in the same way, as soon as the flow had ceased,
was sufficient to re-establish the health of the patient, who
for the last year has continued to be well.

From these two observations and others analogous to
them, one may deduce principles of a useful application.
They will find their place hereafter.

RESUME OF THE PATHOGENETIC SYMPTOMS OF MUREX PURPUREA,
BY DR. PETROZ.

Head.

1. Confusion of ideas, repugnance to conversation, deep
sadness in the evening ; first day.

2. Pain in the occiput toward midday ; first day.

3. Headache on awaking, which disappears on rising ;
first day.

4. During the day, pain in the left temple, which goes
and comes.

5. Heaviness of the head from time to time, which leaves
at intervals great clearness in the ideas ; second and third
day.

6. At the end of the day, tightness behind the head,
which causes her to raise the hand involuntarily to the seat
of the pain ; when the pain is on the left side she raises the
right hand, and vice versa. Desire to bend the head back-
ward ; this motion relieves the head and neck ; second day.

7. The head is heavy for short periods of time ; third day.

8. The right cheek burns toward evening ; third day.

9. Tightness of the head behind the ears ; third day.

10. The left cheek burns in the morning ; sixth day.

11. Headache (heaviness) lasting one hour; sixth day.

12. Pressive frontal headache; seventh day.

13. Confusion in the head, sleepiness ; labor is irksome;
eighth day.

14. Pressive pain in the right temple ; ninth day.

15. Pain in the occiput, very acute, but of short duration ;
first day.

380 MUREX PURPUREA.

1 6. Head confused, heavy ; indisposition to work ; second
day.

17. Buzzing in the ears and increased heaviness in the
head ; second day.

1 8. Diminution of memory, difficulty in finding words.

19. Heaviness of the head as when the atmosphere is
close.

20. The nose is cold all day so that she is much incom-
moded thereby ; third day.

Thorax.

21. Palpitation of the heart, throbbing of the arteries of
the neck ; first day.

22. Pain in the thorax as if broken.

23. Incisive burning pain under the false ribs (left side),
and toward the spine ; second day.

24. Dry infrequent cough, oppression ; second day.

25. The voice is changed, hoarseness ; second day.

26. Pain in the mammae ; third and fourth days.

27. Cough in the morning before breakfast ; first day.

28. Wheezing in the chest in the evening when breathing;
seventh day.

29. Severe pains in the mammas ; eighth day.

30. Sharp lancinations in the mammae.

Stomach.

31. Hunger during the day, in the morning; none at
dinner.

32. Hunger the sixth day.

Abdomen.

33. Evacuation difficult ; second day.

34. Painful tension in the right hypochondrium ; second
day.

35. Colic; fourth day. Colic in the evening; seventh
day. Constipation which lasts five days and more. Uneasi-

MUREX PURPUREA. 381

ness in the abdomen like that which is caused by the
approach of the menses ; their appearance is retarded fifteen
days ; eighth day.

36. Acute pain like a sharp point in the left side of the
abdomen extends and is felt in different isolated spots ; the
left side of the abdomen remained painful the whole evening ;
second day.

37. The same symptoms less severe; third day.

38. Pressure upon the anus like painful points; first
day.

Genital Organs.

39. Acute pain in the right side of the uterus which
crosses the body and ascends to the left mamma ; first day.

40. Sensation of dryness and of constriction in the uterus ;
second day.

41. Sensation of weight and of dilation in the labia
majora ; seventh day.

42. Pain as if wounded by a cutting instrument in the
uterus ; seventh day.

43. In the evening (third day), two violent lancinations,
lasting one minute, in the left side of the abdomen in an
upward direction.

44. Excitement of the genital organs ; desire so violent
as to fatigue the reason.

45. Greenish thick leucorrhcea; seventh day. The same
(third day) diminished but thicker ; eighth day.

46. The leucorrhcea becomes bloody ; ninth day.

47. Return of bloody discharge from the vulva on going
to stool (fourth day) a part of the day ; it ceases and
re- appears.

48. Venereal desire renewed by the slightest touch ; sec-
ond day.

49. Heaviness in the vagina during the existence of the
pain in the abdomen.

50. Throbbings in the uterus ; fifth day.

382 MUREX PURPUREA.

51. Watery leucorrhoea lasting only a half day; second
day.

Urinary Organs.

52. Urine with white sediment. Discharge of a small
quantity of bloody mucus after the passage of urine ; fifth
day.

53. Frequent call to urinate during the day; second day.

54. When urinating slight bloody discharge ; eighth day.

55. Frequent need to urinate during the night, urine
colorless ; third day.

56. Urine fcetid ; the odor much resembling that of Vale-
rian ; this odor soon diminishes and disappears ; third day.

Trunk.

57- Pain in the loins. Sensation of burning, of excoria-
tion ; first day.

58. Pain in the loins; eighth day.

59. Pain in the loins when lying down, pain in the hips
(second to third day) especially in bed.

60. Pain around the pelvis ; third day.

Extremities.

6 1. Extreme feebleness in the voluntary movements.
The limbs give way and there is irresistible desire to remain
seated ; first day.

62. Pain in the knees ; first day.

63. Heat in the hands ; first day.

64. Pain in the arms below the elbows (first day) ; simple
pain in the legs from time to time ; third day.

65. Pains of very great weariness in the thighs (eighth
day); pain of contusion in the front and middle of the
thighs.

66. Extreme lassitude, pains in the legs and knees ; ninth
day.

67. Sharp heat in the anterior part of the thighs ; second
day.

MUREX PURPUREA. 383

68. On rising, acute pain in the middle anterior portion
of the left thigh ; she cannot bear to have it touched ; it
lasts the whole day ; fifth day.

69. Sensation of throbbing in the anterior part of the
thigh.

Sleep.

70. Drowsiness ; first day.

71. Drowsiness and sadness ; second day.

72. At 9 P. M. great desire to sleep.

73. Sleep with troublesome dreams; fleeing from a tur-
bulent ocean she found herself in a plain full of water ; third
day.

74. Troublesome dreams (fourth day) ; ditto (seventh
day), waking with fright.

75. Sleep interrupted by pains altogether similar to those
which sometimes accompany the menses (third day) ;
anguish.

76. Wakes with a start and a violent desire to urinate ;
urine abundant.

General Symptoms.

77. Excessive fatigue ; first day.

78. Sensation of anguish during the day, feeling of fear,
of indefinite fright; for several days the sufferings are
greater when sitting than when walking ; when walking they
cease, and re-appear on sitting down.

79. Sensation of dryness in the skin, as if it would crack.

PROVINGS ON PATIENTS, by M. de B., furnished by Dr.
C. Hering.

January I2th, 1852. Taken by a lady, aged 38 years, of
sanguine-nervous temperament. She has been ill eight
years of prolapsus uteri. For more than a year she was
unable to stand. For several years she has suffered excru-
ciating pain. Her mind is in a very gloomy state.

384 MUREX PURPUREA.

She has been under my care about three years, and has
constantly but slowly regained health. She can now ride
about ten miles and rest in an hour afterward; can sew
about eight hours in a day, but must rest frequently, and
has never passed a day without lying down. Her mind has
gradually recovered its cheerfulness, and she has been for
several months desirous of society, which even one year
since she could not at all endure.

I directed her not to take any other medicine for ten days
before the Murex. She has taken three doses at intervals
of ten days. The symptoms have been the same each time,
only much more intense than the first dose. I gave her the
two hundredth dilution ; she took it in the morning as soon
as she had risen. For the first four hours she felt nothing.
Then she felt a debility of the entire muscular system ; a
sinking of the stomach ; an enlargement of the bowels ; a
distinct feeling of the womb ; and great sensitiveness of the
bowels, with sharp pain running up from the groin to the
socket of the right hip. A sensation as of the creeping of a
snake over the entire region of the short ribs, upon the left
side ; great depression of spirits ; it seemed to her that she
was hopelessly ill. She was obliged to go to bed and lie
there. These symptoms continued for nearly a week, with-
out abatement, and at the end of a week she felt about as
usual, except that she was rather gloomy in mind. The
second and third doses produced the same symptoms, but
less intense.

No. 2. A lady, aged about 30 years, of sanguine-nervous
temperament, had been for five years subject almost con-
stantly to pain in her right hip, and a feeling of sinking at
the stomach, which incapacitated her for sewing or knitting.
She took but one dose and said, " It made me miserable. I
was so low-spirited that I gave up everything. I had no
strength left. My stomach seemed gone, and an intolerable
creeping pain in my right hip kept me from getting any
ease in any position." I ought to add that this lady had

MUREX PURPUREA. 38$

been so well for the last eight months that I had not been in
attendance upon her. The duration of the effect of the
medicine in her case was about five days.

No. 3. A lady, aged 23 years, of sanguine-nervous tem-
perament. I had treated her during the year past for pro-
lapsus uteri, with the ordinary debility in the lumbar region,
palpitation of the heart, sinking at the stomach, etc., that
usually accompany that affection. She recovered rapidly
and seemed to be in sound health for the last six months.
She took three doses of Murex at intervals of ten days, and
perceived no effect whatever.

The following case, wrnch occurred under my own observa-
tion, presents some points of interest :

Mrs. C., aged 28 years. Seven years ago, about four
months after her marriage, she had a miscarriage and subse-
quently a prolapsus uteri and so-called ulceration of the
cervix, for which she was under local (allopathic) treatment
for a period of eighteen months. Three years ago, after
unusual exercise under circumstances of great emotional
excitement, she had a recurrence of the prolapsus, under
which she suffered for some time.

June 3Oth. After taking unusually violent exercise, the'
patient was suddenly subjected to terrible mental excite-
ment.

July 1st. She applied for medical treatment. She has
bearing down sensations ; a feeling as if the internal genitals
were being pushed out, with great nausea and faintness, and
a peculiarly distressed sinking sensation in the epigastrium.
A vaginal examination reveals a slight prolapsus, a very long
cervix, but no ulcerations. There was utter loss of appetite
and great despondency.

In consequence of the great faintness and " sinking at the
stomach" (which, Dr. Lippe says, is a strong characteristic
of Murex), in addition to the other symptoms which indi-
cated this remedy, Murex purpurea6 was prescribed, a
26

386 MUREX PURPUREA.

powder every four hours (no higher potency being at
hand).

July 3d. The patient reports that in fifteen minutes after
taking the first powder, she felt very hungry and ate some-
thing. After the second powder, a still greater degree of
hunger ; she again took food. After the third powder, she
expressed herself as "half starved" and had to have a
hearty meal prepared, which she ate. She slept well.

July 4th. After the first powder, this morning, the same
sensation of hunger, though in a less degree than yesterday.
In the region of the uterus she felt much better.

July 6th. Has gained in every way. Felt quite well as
regards the uterine symptoms and the sinking at the
stomach, until this evening, having been frightened by a
dog, she fainted. This brought back the symptoms of July
1st, which, however, were soon relieved by Murex, and
have not since returned.

PLATINA.1

Preparations for medicinal use. Chemically pure Platina,
which is soft, and may be cut with a knife, is dissolved in
aqua regia by the aid of heat, the resultant golden yellow
solution diluted to a sufficient extent, and a clean smooth rod
of steel suspended in it, on which the Platina precipitates,
forming a crystalline coating. This precipitate, which may
be easily rubbed off the rod, is several times washed in
distilled water (until free from acid), and then well dried
between layers of bibulous paper. One grain of this pre-
cipitate, triturated for two hours with ninety-nine grains of
milk sugar, forms the first centesimal trituration of Platina.
The further dynamizations are prepared in the usual manner.

Literature. Stapf and Gross, Archiv. i., I : Hahnemann,
Chronic Diseases, v.

Action. Platina develops its effects as well in the province
of the brain as in that of the spinal cord, and of the great
nervous branches proceeding from it. The great splanchnic
nerves, distributed in the abdomen, and, in particular, the
nerves of the uterine system given off from the hypogastric
plexus, are especially affected by Platina. From this
specific action, no inconsiderable number of symptoms seem
to result which are quite peculiar to this remedy, as well
moral affections as many aches and pains. Hence this
remedy, as will be seen, is especially appropriate for diseases
of females, such as we often meet in women and maidens.
Whether Platina is suitable only for irritable, excitable
females, with predominant activity of the sexual functions, as
the majority of writers assume, and among them Stapf and

1 Adapted from the German of Dr. Veit Meyer.

388 PLATINA.

Gross, the provers of it, who, by the way, made their
provings on a very excitable 'young woman, I shall leave
undetermined. For myself, I have had frequent occasion to
administer Platina, and have obtained the very best curative
results in appropriate diseased conditions, occurring in
phlegmatic women of lax fiber. This observation, too,
appears to me to stand by no means in opposition to the
totality of the Platina symptoms, but rather to accord most
clearly with them. For, on a critical review of what has
been made known concerning the action of the remedy, we
find that all or by far the greater part of its symptoms bear
the character 9f depression, but not that of erethism. A lack
of energy, a lack of electric tension of the nerves, if I may so
express myself, seems to me more clearly manifest in Platina
than in any other remedy. And although we find, it is true,
isolated phenomena which seem to indicate a contrary action,
yet we regard these only as reflex or alternate effects ; and,
indeed, they occur in so isolated a manner as almost to
disappear before the mass of symptoms which justify the
view I have taken. It may be that a farther proving of this
drug, which, by the way, is very desirable, would disprove
our assumption : for the present, however, we can only hold
to that proving of which we are already in possession. In
this proving we find, in every system on which Platina
acts, the stamp of relaxation, of diminished energy, of
depression, of torpor. As well in the psychical and sensuous,
as in the sensitive, motor, and vegetative nervous systems,
we see this character manifested by the trembling, the
sensations of chilliness, the coldness and paralysis which are
so frequently present. The assertion will be demonstrated
when we come to consider the passive and negative relation
of Platina to the sympathetic system as the regulator of
the entire vascular system in the human body. But Platina
presents no phenomena of hyperaemia, no independent or
primary inflammation, no strikingly accelerated circulation.
Hence, we find no alterations in the pulse, such as the

PLATINA. 389

learned and careful provers would certainly have signal-
ized had they occurred during the proving.

We have gained, then, several general positions with
reference to the sphere of action of Platina.

1. A negative position, viz. : that it does not directly
affect the blood life.

2. That it exerts its greatest power upon the brain and
spinal cord, and especially in several particular provinces of
these nervous centers ; and, finally,

3. That it depotentizes and depresses the nervous life.
Let us now seek to determine these characteristic qualities

in the individual phenomena of the drug, and inquire, first,
how and how far the action of Platina is manifest on the
brain and spinal cord, and what changes this drug is able to
effect in the individual spheres of these central organs. But,
in giving a true picture of the action of Platina, I cannot
be expected to adhere closely to the organic order of the
individual parts of the nervous system. I shall rather bring
first to view those phenomena which stand forth most
strikingly among the symptoms of Platina, and arrange the
others subsequently in the order of their importance. Thus,
then, in surveying the isolated Platina symptoms, we
encounter a pathological picture which we have not unfre-
quently occasion to meet in women — I mean hysteria.

In the delineation of this picture, we begin by the recital
of those symptoms which relate to the proximate cause of
this affection :

I. DISTURBANCES IN THE UTERINE SYSTEM.

The following symptoms clearly indicate this :

In both groins, painful drawing, as if the menses were
about to set in.

Pressing in the hypogastrium, with a feeling of weakness,
as before the menses.

Painful pressing down toward the genitals, as if the

390 PLATINA.

menses were commencing ; sometimes with tenesmus, draw-
ing through the groins over the hips to the sacrum, where
the pain continues longer.

Painful sensibility and constant pressure in the pubic
region and in the genitals, with almost constant internal
chilliness and external objective coldness (except in the
face).

In the evening, in bed, the painful pressure as if from the
menses commencing ceases immediately, but is felt again in
the morning, after rising.

Cutting in the hypogastrium, as if before the menses, with
drawing headache.

On the second day of the menses, cutting in the abdo-
men ; then, pressing down in the groin, alternating with
pressure in the genitals, with increased congestion and dis-
charge of blood.

Pressing in the abdomen, and depression of spirits, with
copious menstrual flow.

Menses six days too early, with diarrhoea.

Menses fourteen days too early, and very copious.

Menses six days* too early, and lasting eight days, with
drawing pain in the abdomen the first day.

The first day of the menses, discharge of much clotted
blood. Voluptuous tingling in the genitals and in the abdo-
men, with oppressive anxiety and palpitation; thereupon,
painful pressure low in the genitals, with relaxed feeling and
sticking in the sinciput.

Leucorrhoea like white of egg, without sensation, only by
day, sometimes after urinating, sometimes after rising from
her seat.

If we consider these symptoms connectedly, we see that
the disturbances excited in the uterine system by Platina
consist chiefly in certain spasmodic affections and pains, and
in the too early appearance of the menstrual discharge.
This anticipation of the menses, however, does not result
from an abnormal, congestive overloading of the uterus with

PLATINA. 391

blood, as we have heretofore seen to be the case with
Aconite, and as others have observed of Pulsatilla and
Crocus, in the case of which remedies the clearly marked
alternations in the character of the blood discharged, in
addition to many other phenomena indicative of hyperaemia,
are evidence of such a condition. The too early and too
long-continued menstruation of Platina depend not so much
on sanguineous congestion as, rather, on atony of the nerves
and vessels of the uterus, whereby a condition resembling
anaemia is induced, which is indicated in the symptoms
"pale and sunken face; pale, wretched aspect for several
days." (The heat and redness of face are alternate effects.)
This atonic condition is evidenced, too, by the already men-
tioned symptom, " painful sensibility, etc., with almost con-
stant internal chilliness and external objective coldness;"
since, indeed, as we shall soon see, chilliness and coldness
are peculiar to Platina.

Proceeding with the further delineation of the Platina
hysteria, to which we have a good clue in the symptoms,
" pressing in abdomen, with ill-humor, attending the copious
menses," we shall see what is the nature of the psychical
affection.

II. DISTURBANCES IN THE PSYCHICAL SPHERE OF
THE NERVOUS SYSTEM.

Depression, despondency, taciturnity.

She thinks she is neglected, and stands alone in the
world.

Anxiety, with flushes of heat and trembling of the hands.

Great anxiety, with violent palpitation of the heart, when-
ever she would speak in company, so that speaking becomes
irksome to her.

Anxiety as though she should die or lose consciousness,
with trembling in every limb, oppressed breathing, and
violent palpitation of the heart.

392 PLATINA.

Anxiety in region of the heart, and apprehensiveness, as
if she must soon die, with disposition to weep, and actual
weeping.

Great restlessness of disposition, — she can rest quietly
nowhere, — with melancholy which renders even the most
joyous objects disagreeable to her. She thinks she is not
fit for the world, is tired of life, but has the greatest dread
of death, which she believes is at hand.

Morose and ill-content.

Discontent with the whole world ; everything is a con-
straint; with inclination to weep.

Sad and morose, she sits alone, without speaking, and
cannot resist sleep ; then, inconsolable weeping, especially
when spoken to.

Silence and involuntary weeping, even after being
addressed in the most friendly manner, so that she is angry
at herself for it.

Disposition to weep, and weeping after receiving a mild
reproof.

Ill-humored, and disposed to weep ; often obliged to
weep involuntarily, which relieves her.

Disposition to weep, and melancholy ; worse in her cham-
ber, better in the open air.

Sad and morose the first morning ; the next, indescribably
happy, especially in the open air, so that she could have
embraced everything, and made merry over the saddest
objects.

Very lachrymose, and easily touched by causes quite too
trivial.

Very earnest and silent the first day; the next day,
everything presents itself to her in a ridiculous aspect

Chilliness and shuddering, mingled with fugitive heat, with
ill-humored taciturnity in the open air; later, pleasant
warmth throughout whole body, with return of cheerfulness.

Great cheerfulness, so that she could dance, a half hour
after weeping.

PLATINA. 393

Great cheerfulness for two days ; everything seems joyous,
she could laugh at the saddest object ; third day, great melan-
choly in the morning and evening, with weeping, even over
joyous or ridiculous objects, and also when spoken to.

Involuntary disposition to whistle and sing.

Very fretful and irritable, even at things and words that
are quite innocent, so that she could sometimes strike at
herself and her friends.

No remedy gives us so striking a picture of the hysteric
perversion of the disposition as Platina. The depression
and anxiety which often increase in intensity, even up to
actual apprehension of death, so that, as I have sometimes
experienced at the bedside, patients make every provision
and arrangement for the disposition of their affairs after
death, are characteristic indications of hysteria as well as of
the Platina disease. Platina, however, is most especially
appropriate in that form of hysteria in which the disposition
to weep, and the fear of death, which is thought to be at
hand, accompany all the other morbid phenomena. I
remember a case in which a mother was compelled, on
account of debility, to wean her child earlier than she had
wished to do so. Several days after I was called to her, and
on entering the chamber found her friends wringing their
hands as they surrounded her bed; for the patient, who
never ceased weeping, spoke amid anxiety and apprehension,
of nothing but her death, and how fearful it was to have to
die so young. She had already made all testamentary
arrangements. The most careful investigation could discover
nothing morbid in the mammae, which were still distended
with milk, but not hard; even the pulse had not varied
from its normal condition. My exhortation to dismiss these
thoughts of death, for which there existed, I assured my
patient, not. the slightest ground, was gently rejected, as was
also at first the medicine I ordered for her ; and she told me
with tears, that she had merely sent for me that she might
see me once again before her death. Finally, I succeeded

394 PLATINA.

in getting her to take a grain of the third trituration of
Platina. When I saw the patient again in the evening, the
fear of death and the weeping had vanished, and the depres-
sion which still remained yielded the following day to
her accustomed cheerfulness. She became healthy, and
remained so.

Moreover, we find in the just enumerated moral symptoms
of Platina, the alternations of cheerfulness and sadness, of
laughing and weeping, which are peculiar to hysteria, —
just as, generally in nature, exaltation so often follows
depression or alternates with it.

The same condition of depression we observe, too, in the
perceptive faculty, as is shown by the following symptoms :

Illusion of fancy upon entering the room after a walk of
one hour, as if everything around her were very small, and
everybody inferior to her, both in regard to body and mind,
and as if she herself were tall and elevated; the room
appears gloomy and disagreeable to her, accompanied with
slight anguish, sad and vexed mood, vertigo, and uncomfort-
able feeling in the midst of a society that she was generally fond
of; all this passes off in the open air when the sun shines.
Looking down contemptuously and pitifully upon people,
whom at other times she respects, against her will, in
paroxysms. During her contemptuous turns she is suddenly
attacked with canine hunger, and eats in a greedy, hasty,
manner ; when the regular meal-time arrived she had lost all
her appetite. Proud feeling. Cold, absent, indifferent in
company of friends ; she only answers when she must, and
is only half conscious of what she says; after having
answered, she reflects whether her answer had been suitable;
she is constantly absent without knowing where her thoughts
are roaming. She imagines she does not belong to her
family ; after a short absence all things appear changed
to her ; absence of mind ; she listens to conversations
around her, but after they are terminated she has forgotten
what she heard. Great absence of mind ; she hears not

PLATINA. 395

what is said to her, even when addressed with great emphasis.
Not disposed to intellectual labor ; dull, stretching sensation,
as of a board before the forehead, passing attacks of vertigo
in quick succession, in the evening when standing, as if she
would lose her consciousness ; violent vertigo, she dares not
move her eyes ; more in day-time than at night ; generally
when she is attacked with palpitation of the heart.

The characteristic feature of these Platina illusions is the
proud exaltation of one's self above other persons, who are
regarded as contemptible. This circumstance also has its
origin in a depressed moral activity, as is shown by the
related symptoms, " the chamber seems gloomy and un-
pleasant," "anxious apprehension," "ill-humor, vertigo, and
discomfort,'.' etc., and the "alleviation in the open air." Hence,
too, Stapf and Gross recommended Platina as "a very welcome
specific remedy for a not infrequent kind of melancholy."

The sleep, too, gives a clear indication of disturbance in
the psychic nervous system. In this relation we are to con-
sider the following symptoms :

Excessive weakness and drowsiness in the evening ; falls
asleep after midnight, with tearing in the ball of the toe ; she
wakes in the night in a sort of stupor, and is unable to col-
lect her senses; wakes about midnight; ideas which she is
unable to repel crowding upon her mind, no sleep until
morning ; anxious dreams, and gloomy thoughts, and sad
visions when waking suddenly ; anxious, confused dreams of
war and bloodshed. She dreams of fires, wants to go there,
but cannot get ready, with her preparations of toilet, etc.
He wakes in the morning with a peevish and anxious mood
as if he had suffered injury during his sleep.

I might continue to describe hysteria in the words of the
Platina symptoms ; for many more alterations of functions
induced by this remedy might easily be made to contribute
to the completion of the picture. I shall mention, however,
in this relation, only the digestive disturbances, the spasmodic
affections, and the pains induced by Platina. But I fear to

396 PLATINA.

lead, by this course, to the erroneous supposition that all the
other phenomena of Platina belong also to hysteria, and
thus to the false conclusion that Platina is only and exclu-
sively a remedy for hysteria ; whereas, on the one hand,
not every form of hysteria finds its remedy in Platina, and
on the other, Platina is a remedy for several other morbid con-
ditions, not only of women, but also of men. To guard against
this error, I must forbear to cite further the Platina symp-
toms resembling hysteria, but would not wish to deter others
from studying and estimating their relations and correspond-
ence. First, however, I must call attention to a few other
symptoms of Platina, nearly related to hysteria, less
important than those already cited, but still characteristic.
It not unfrequently happens in hysteria, that a feeling of
indescribable anxiety, with respiratory embarrassment, or
a spasmodic constriction of the oesophagus, is experienced.
This condition, generally denominated "hysteric asthma,"
is depicted in the following symptoms of Platina :

Sudden arrest of breathing in the throat, as takes place
when walking against the wind. Oppressed breathing, with
warm rising from the pit of the stomach to the pit of the
throat; she has to take deep breath; accompanied with a
hoarse voice, going off again with the oppression. Impeded
respiration from weakness of the chest; deep breathing, as if
a load were oppressing the chest ; frequent deep breathing
without oppression of the chest; asthma, as if laced too
tightly, with heavy, slow breathing.

Another trouble frequently attendant on hysteria is the
so-called clavus hystericus, a peculiar, tense, pressing,
squeezing headache, appearing in paroxysms, and confined
to a small spot.

The following symptoms may be referred to this con-
dition : cramp-pain in the right temple in the afternoon ;
cramp-pain in the forehead, as if between screws; cramp-
like tension in the temples, as if between screws ; com-
pression in the forehead, in paroxysms; sudden and short

PLATINA.

397

pressing from without, inward in the vertex ; pressure under
the right frontal eminence, increasing and decreasing in
paroxysms; sudden attack of contusive pain in a small spot
of the left parietal bone ; dull pressure in the right parietal
bone, as of a plug being lodged in it ; violent boring in the
center of the forehead, decreasing gradually, and finally
disappearing.

Let us now leave the subject of hysteria, and consider the
farther action of Platina on the healthy body ; and, first :

III. THE DISTURBANCES IN THE VEGETATIVE
NERVOUS SYSTEM.

Viscid and slimy in the mouth the whole day, especially
after a meal, also in the morning, with very bad humor;
occasional conflux of water in the mouth ; sensation in the
upper part of the tongue as if burnt, increased by rubbing
the teeth over it ; scraping sensation in the throat, as if raw,
in the evening after lying down, and on the day following,
sometimes accompanied with an irritation resulting in short
cough ; sweet taste on the tip of the tongue ; no appetite ;
she relishes the first mouthfuls, but she is soon replete; she is
speedily satisfied at supper owing to great sadness, later she
eats; pinching in the umbilical region after a meal, as if
diarrhoea would come on ; empty eructations in the morning;
loud eructations in the morning, and after dinner; sudden
gulping up of a bitter sour fluid, inducing cough and a scrap-
ing sensation in the throat ; nauseous feeling in the region of
the stomach ; qualmishness in the region of the stomach in
the morning ; continual nausea, with great faintness, anxious-
ness, and a trembling sensation through the whole body in
the forenoon; desire to vomit, without vomiting, coming
and going increasingly accompanied with great qualmish-
ness and uneasiness in the limbs.

Stomach. Pressure in the pit of the stomach, also when
touching it ; pressure in the pit of the stomach after eating

398 PLATINA.

bread and butter, as if he had eaten something that had not
been digested; repletion in the stomach and abdomen, as if
overloaded, in the morning before breakfast, with a good
deal of empty eructation ; distension of the pit of the
stomach and the stomach itself, with a scratching and tear-
ing sensation in the stomach ; drawing pain, with pressure
under the pit of the stomach, as if occasioned by a strain ;
contractive pain around the pit of the stomach, as if she had
laced herself too tightly, with a suffocative sensation ; pain-
ful sensation around the pit of the stomach, as if she had
laced herself too tightly, with sensation as if it would go
off by eating; oppression around the pit of the stomach,
independent of breathing; pinching in the region of the
scrobiculus cordis, and shortly after sensation as if press-
ing into the hypogastrium, as if flatulence were crowding
down ; the sensation went off when a desire for emission
of flatulence made its appearance, which, however, took
place with great difficulty, the sensation in the groin
returned all the time, with distension of the abdomen ;
creeping in the pit of the stomach, rising into the throat, as
if she had swallowed little particles of a feather, vomiturition
ensued ; itching in the region of the stomach going off by
friction ; fermenting sensation in the region of the stomach ;
dull beating as with a hammer in and near the pit of the
stomach, in the region of one of the cartilages of the ribs
(immediately) ; violent stitches on the right side near the pit
of the stomach ; dull shocks in the pit of the stomach ;
violent dull stitching shocks in the pit of the stomach, slowly
going and coming; gnawing and writhing sensation in the
stomach early in the morning, with canine hunger and accu-
mulation of water in the mouth, not relieved by eating.

Abdomen. Colic toward evening increased by raising
one's self in the bed, and then ceasing gradually ; great dis-
tension of the abdomen in the evening ; spasmodic disten-
sion of the abdomen in several places, causing elevations
and depressions on the surface ; sensation in the whole of

PLATINA. 399

the abdomen, as if she had laced herself too tightly ; sensa-
tion in the whole abdomen, as of being pinched together
from the umbilicus to the back ; painful pinching under the
left short ribs; jerking pinching in various parts of the
abdomen ; jerking drawing in the right side of the abdomen,
with some arrest of breathing ; a darting pain through the
abdomen, succeeded by weariness of the knees ; drawing
through the abdomen, from the chest toward both groins,
this drawing terminates in the genital organs, where it
causes a pain ; a writhing sensation around the umbilicus,
with oppressed breathing, and a tremulous sensation through
the whole body ; very painful stitch deep in the abdomen
above the umbilicus', when suddenly raising one's self after
cowering ; dull stitches in the middle of the umbilicus ; dull
shocks in the abdomen, at intervals, below the short ribs ;
stitches in the abdomen in the morning ; fine stinging in the
right side of the abdomen, moving in the umbilical region
when lying upon the affected side, but increasing when lying
on the left side; anxiety in the whole abdomen, succeeded
by a pain in the abdomen as after fright, accompanied by
a desire as if diarrhoea would come on; slight burning
around the umbilicus ; sudden burning darting from above
downward in the right side of the abdomen ; burning sensa-
tion in a small spot of the left side of the abdomen, in parox-
ysms ; sudden jerking, resembling a dull shock in a small
spot in the abdominal integuments; dull contusive pain
below the umbilicus in the integuments ; dull shocks, a sort
of beating in the region of a true lower 'rib; motion in the
abdomen as of flatulence; rumbling in the epigastrium
before breakfast ; rubbing sensation in the abdomen, before
breakfast, with a pinching anxiety in the intestines ; emission
of short, interrupted flatus, sometimes difficult; copious
emission of flatulence.

Constipation, lasting several days.

Constant tenesmus.

Frequent ineffectual desire for stool, or with scanty stool,

400 PLATINA.

which passes only part at a time, with violent straining and
painful sensation of weakness and tension in the abdominal
muscles.

Difficult stool, with cutting, burning, and protrusion of
the varices.

Stool hard, as if burned, with slight tenesmus before and
after it.

Scanty, tenacious stool, cohering like clay, with long press-
ing and straining of the abdominal muscles.

Papescent stool in the morning, half digested and some-
what bloody ; afterward, increased tension in the left hypo-
chondrium and loins.

Papescent stool in the evening, with ^scarides.

Tenesmus, with evacuation of a piece of tape-worm.

Violent, noisy evacuation after dinner, first thin, then
solid, expelled in fragments almost pulverulent, with great
straining ; after the expulsion he feels a shaking and shud-
dering, especially in the upper part of the body ; and after
rising from stool he feels a slight pain and weakness about
the umbilicus; considerable tenesmus, even when the stool
is not hard, and after every stool a violent stitch in the anus,
with subsequent cramp-like contraction of the nates, extend-
ing toward the small of the back.

Shuddering after stool and urination.

Much discharge of blood from the anus.

Tingling tenesmus in the anus, as if diarrhoea would set in,
every evening before going to sleep, at the same hour each day.

Burning in the rectum during stool, and, afterward, violent
itching.

Violent, dull stitches in front part of the rectum, so that
she could cry out.

Urine pale yellow in the morning, clear as water in the
afternoon.

Very red urine, with white clouds.

Urine becomes turbid, and leaves a red stain on the sides
of the vessel.

PLATINA. 4OI

If we cast a glance over all these symptoms, we find here
torpor of the intestinal canal distinctly pronounced. The
flatulent colic, which is clearly depicted in the symptoms,
depends, here, on a paralytic weakness of the whole intesti-
nal tract. The peristaltic action is diminished ; hence an
inordinate development or retention of intestinal gas, and
manifold digestive disorders, as consequences. Eructations,
nausea, anorexia, partial or complete, oppression at the
stomach, fullness, distension of the stomach and abdomen,
distension of an isolated part of the abdomen and drawing
in of the rest, cutting, gnawing, wrenching, gurgling, finally,
discharge of flatus, sometimes very troublesome ; constipa-
tion, very dry or papescent stools, containing half-digested
matter, — all these phenomena furnish clear evidence of the
torpidity of the muscular fiber, or, rather, of the diminished
activity of the intestinal motor nerves. Homceopathists are
acquainted with several remedies which develop in a high
degree the signs of flatulence and its attendant difficulties.
I mention only for example Colocynth, which is sure to
occur to the mind of every homceopathist when flatulence is
mentioned. But the flatulence of Colocynth depends rather
on an abnormal composition of the gastric juices, and a
vicious bilious secretion ; hence the bitter taste, the green
vomiting, the abdominal pain after anger, the altered color
of the stools. The Platina symptoms, on the other hand,
indicate by no means an altered composition of the fluids
necessary to digestion; and nothing is left to which to
attribute the flatus and other abnormal symptoms of the
intestinal canal, save a diminished activity of the intestinal
muscular fiber.

IV. AFFECTIONS OF THE MOTORY NERVOUS APPARATUS.
SPASMODIC PHENOMENA.

Cramp-like feeling of contraction darts suddenly through
the head from the right temple to the left; then, feeling of
27

l-hv

4O2 PLATINA.

dullness, as if too tightly bound, with trembling, both sides
of the head.

Cramp in the cervical muscles, as if from lying on too
hard a pillow ; worse on motion.

Cramp in the hand on exerting it.

The finger is drawn crooked, with painful drawing up in
the arm on bending the arm.

At night, after rising, cramp and contraction of the soles
of the feet.

Great inclination to violent, almost spasmodic, yawning.

Yawning, afternoon, without sleepiness.

Frequent yawning, afternoon, so violent, her eyes overflow.

Violent yawning after a meal, so that the cervical muscles
become painful.

A chill runs over the whole body after yawning.

Jerking of the muscles in the legs after walking a little.

Cramp-like jerking here and there in the limbs, like
throbbing.

Painful trembling of the whole body, with throbbing in
the vessels.

Trembling sensation, at times, through the whole body.

First, a trembling sensation in the hands and feet, then
chilliness and violent trembling of the whole body, as if in
the most violent chill, with chattering of the teeth, the face
at the same time being warm and the hands cold.

The trembling, which, standing midway between spasm
and paralysis, is often met with in the pathogenesis of
Platina, and is associated in it with many other morbid
phenomena, leads us very naturally to disturbances of
another nature in the province of the motory nervous
system.

PARALYTIC PHENOMENA.

Weakness in the nape of the neck ; the head sinks for-
ward.

Weakness in the nape ; she cannot hold up the head.

PLATINA. 403

Relaxed feeling in both arms, as if they had held up
something heavy ; diminished by moving them to and fro,
but returning immediately when they are at rest, with draw-
ing, as on a thread, from the shoulder to the hand.

Sudden paralysis, as after an apoplectic fit, in a small
spot, now of the right, now of the left arm.

Heaviness of the arms.

Feeling as if paralyzed in the left arm ; she has to let it
sink down ; much worse when resting the arm on the chair,
when sitting, even when leaning the shoulder against the
chair.

Weariness and weakness of the left arm, with drawing
in it.

Paralytic feeling in the right fore-arm, drawing from above
downward.

Weakness, with trembling disquiet in the thighs, especially
toward the knees, as when tired by walking, felt only when
sitting.

Weakness in thighs (and whole limbs), as if beaten, with
tremulous uneasiness in them, when sitting and standing.

Great weakness in the knee-joints and their neighborhood,
more when standing than when walking, worst when going
upstairs.

Weakness in the knees when walking, also in the thighs
when sitting, as if fatigued by walking.

Tottering when walking, as if the limbs had no firm
footing.

Weakness, especially when sitting ; the feet feel as if over-
fatigued, and are full of trembling uneasiness.

The phenomena resembling paralysis are much more
clearly defined than are the spasmodic affections. The
whole muscular system appears dormant, and seems to have
lost its tone. Even in sitting and leaning the body against
a solid object, this weakness and laxity of fiber are significant
enough to warrant the conclusion that many forms of disease
resembling paralysis must find a remedy in Platina. Thus,

404 PLATINA.

on the motor nerves, our remedy acts as a depressing agent,
taking from them their wonted energy and only here and
there, through its inroad upon their activity, provoking
spasmodic phenomena of slight importance.

Let us now go farther, and see whether the distinctive
characteristic of Platina displays itself in any other nervous
system subject to the control of the brain.

V. AFFECTIONS OF THE SENSITIVE NERVOUS SYSTEM.

We have here phenomena of two kinds to consider, —
Anesthesia and Pain.

A . —A N&STHESIA .

Tensive, numb feeling in the whole sinciput, as after a
blow, extending as far as the nasal bone ; numb feeling in
the sinciput, as if constricted, in a warm room full of persons,
increased after a short time to a violent pressing together,
with a sensation as of a dull digging up, with impatience
and ill-humor, and heat on the upper part of the body,
especially in the head, as if the sweat of anguish would
break out ; in the evening, when in the cool air, he feels an
unusual heat, and, when beginning to walk, a painful
shaking of the brain, as if a ball were knocking against the
skull ; afterward the same sensation is felt when lying in
bed, accompanied with a slight roaring in the ears; when
the pain abates he falls asleep.

Feeling of coldness, creeping, and numbness in the whole
right side of the face.

Cramp-like painful feeling of numbness in the left side
of the zygoma.

Tensive feeling of numbness in the zygomata and mastoid
processes, as if the head were compressed by screws.

Feeling of numbness in coccyx, as if after a blow when
sitting.

PLATINA. 405

Tensive feeling of numbness in the nape of the neck, just
at the occiput, as if bound together.

Sensitive feeling of numbness and trembling of the right
thumb, in the morning, as if contused.

Trembling feeling of numbness in the knees, and extend-
ing to the feet, as if too tightly bound.

Feeling of numbness, and weakness, and dull pressure on
the inner side of the bend of the left knee, when sitting.

Cramp-like jerking of the legs from above downward,
with a feeling of stiffness, which is also felt in the feet when
sitting, especially in the evening.

Tremulous, creeping uneasiness in the legs when sitting,
with feeling of numbness and stiffness, especially increased
in the evening, and also in bed.

Feeling of numbness and weariness, in the feeling only,
when sitting, as if after standing a long time.

B.— PAINS AND SENSATIONS.

The true character of Platina is clearly depicted in the
feelings of dullness and numbness. Now, even if we assume,
with the majority of physiologists, that pain consists in an
exalted activity of the sensitive nerve, then, notwithstanding,
Platina produces, as we shall see, no small number of pain-
ful sensations, still, paradoxical as this may at first view
appear, the general character of Platina, viz., that of depres-
sion, is clearly manifested in the form which the Platina
pains assume. No substance which acts on the human body
leaves unaffected the sensitive nerves so easily and quickly
excitable. Hence, we find, that in all provings of drugs on
the healthy body, a greater or less number of pains occur.
But for the very reason that flam so frequently accompanies
the pathological modifications of the organism, it is incapable
of serving, in its generality as pain, as an index for the dis-
covery of the peculiar character of a drug. If we received
it as our guide, we should always, of necessity, infer an

406 PLATINA.

increased activity. It is necessary, therefore, to examine the
determining conditions in which the pains originate, in order
to form an opinion as to whether the pains are induced by
congestion or anaemia, by inflammation, or by a condition of
paralysis, etc., etc. In determining the character of a drug,
then, the pains and sensations, inasmuch as they occur
almost universally, are to be subordinated and accommodated
to the other phenomena. Perhaps the kind of pain, whether
more of a sticking or squeezing, more of a tearing or con-
tracting, more of a pressing or pinching pain, stands in some
relation to the nature of the drug which produces the pain,
and so may contribute somewhat to the unfolding of the
latter. We shall lay no greater stress, however, on this
assumption, which is quite hypothetical, than on this, that
the kind of pain depends on the tissue in which it originates.

I will enumerate briefly the various pains and sensa-
tions which Platina excites, naming, at the same time, the
parts in which they especially occur ; and I have endeavored
to indicate, by the order of succession, what kinds of pain
occur most frequently, and what kind less often.

Cramp-pain (head, forehead, temples, orbital margins,
ears, nose, zygoma, lower maxilla, teeth, fauces, chest, nape,
throat, fore-arm, hand, fingers, hips, limbs, thighs, legs, calf,
tarsus, heel, toes).

Oppression (head, eyes, nose, zygoma, epigastrium, ribs,
genitals, chest, back, shoulders, fore-arm, ham, sole of foot,
toes).

Oppression, wave-like, over the right orbit.

Pressing (forehead, rectum, GENITALS).

Pressing together (forehead).

Pressing inward, cramp-like (temples, vertex).

Tension (temples, orbital margins, globe of the eye, chin,
nape, hips, thighs, ham, calf, dorsum of the foot, toes).

Drawing (head, ears, teeth, gullet, epigastrium, abdomen,
scapula, hand, finger, thigh, knee, calf, heel).

Drawing together (head, temples, epigastrium, abdomen).

PLATINA. 407

Tenesmus (anus).

Jerking (nose, soles of the feet).

Sticking (head, meatus auditorius, cheeks, gullet, gastric
region, abdomen, rectum, praecordia, back, axilla, hand,
cruro-tarsal joint, ball of the foot, toes).

Crawling, itching, prickling, tickling (temples, lower
maxilla, corners of the eyes, face, nose, tongue, epigastrium,
arms, genitals, chest, thyroid region, hand, ringers, thumbs,
limbs, knees, ankle-bones, soles of feet, toes).

Chafing (orbital margins, tips of ears, nose, cheeks, parts
about the mouth, chin, genitals, scrotum, hand, feet, and
soles).

Burning (head, eyes, ears, tongue, region of umbilicus,
abdomen, rectum, chest, arm, elbow, hand, knee, toes).

Pain as from a blow or thrust (head, temples, arch of
eyebrow, abdomen, coccyx, shoulder, arm, limbs, thighs,
knee).

Numbness and feeling as of paralysis (head, cheeks, lips,
nose, face, zygoma, chin, coccyx, nape, arm, fore-arm, hand,
thumb, limbs, thighs, knees, hollow of the knee, feet).

Feeling of coldness (head, eyes, cheeks, lips, face, chin,
scapula, hand).

Throbbing and throbbing pain (teeth, region of stomach,
ribs, fore- arm, legs, toes).

Soreness (eyes, lips, palate, back, legs, ankle-joints, and
bones).

Tearing (ears, thigh, dorsum of foot, toes).

Shocks and blows (chin, epigastrium, chest, back, skin, calf).

Startings (ears, chin, legs).

Jerking and jerking pain (upper lip, gastric region
(visible), abdomen, fore-arm, limbs).

Feeling as if burned (upper lip, tongue).

Feeling as if beaten (arm, thigh).

Feeling as if dislocated (knee, ankle).

Feeling as if contused (head, mastoid process, elbow,
thumb, knee).

408 PLATINA.

Pain of excoriation (back, scapula).

Pinching (umbilical region, epigastrium, abdomen).

Dull pains (head, teeth, arm, thigh).

Cutting (abdomen, dorsum of foot).

Digging (forehead, ears, teeth).

Boring (forehead).

Scratching (gullet).

The pain most frequently encountered in Platina provings
is cramp-pain. We meet with this in almost every part of
the body. The following symptoms, for example, present
modifications of it.

"Tensive pain in both upper orbital margins, extending
to the globe of the eye itself; they are, as it were, com-
pressed.

" In the left ala nasi cramp-like jerkings at regular inter-
vals ; cramp-like jerkings at regular intervals in a small spot
below the external knuckle of the right hand."

The sensation of pressing inward, too, is a very frequent
symptom of Platina. In addition to the instances in which
this is distinctly expressed, the following, among other
symptoms, seem to belong to this sensation:

" In the left side of the forehead, a sudden, fugitive
pressing inward, as by a dull body.

" Fugitive pain in the middle of the vertex, a pressing
inward.

"Dull pain in the right parietal bone, as if a plug were
forced there.

" In the middle of the back, on the right, near the spine,
violent pain, as if a sharp plug were fixed ; on pressing upon
it, pain like a sore wound, continuing a long time.

" Behind, on the left mastoid process, pressing pain, as
if by a dull instrument ; on pressure, pain as from a con-
tusion.

" On a small spot, above, on the thorax, painful sensa-
tion, as if one pressed powerfully on it, with a dull body."

Just as frequent as the cramp-pain is in the muscular

PLATINA. 409

tissue, is the feeling of itching in the skin. We find it under
various forms, e. g. :

" On the upper margin of the orbit a kind of sore, eating
sensation, as if caused by excoriation.

" On the scrotum a frequent sore, corrosive sensation, as
if from excoriation by woolen cloth, so that he must change
his position frequently, especially when sitting, also when
lying in bed ; many days, above and around the ankle-joint
and bones, a smarting and sore gnawing sensation ; if, when
walking, the clothes strike against the uncovered foot, the
part pains as if raw and excoriated ; sticking, gnawing in a
small spot on the left sole, compelling him to scratch the
part.

" Tingling in the nose, as from snuff, or as before epistaxis,
compelling him to rub the nose, causing the eyes to water,
and inducing a vain desire to sneeze.

" On the knuckles and finger, a burning prickling, as if he
had touched stinging nettles, compelling him to scratch
vigorously.

" On the left elbow, a kind of sore burning, as if scraped,
or abraded by woolen cloth.

" On the right temple, formication, passing down the right
side of the cheek and lower jaw, with a sensation of cold.

" Formication and sensation as of a cold breeze in the left
hand.

" At a little spot on the left parietal bone, at intervals, a
kind of dull, corrosive sticking."

A peculiarity of the itching, burning, prickling, etc., is,
that the scratching and rubbing, to which they usually
compel the patient, afford only a very brief amelioration.

Nearly related to the cramp-pain of Platina, is the sensa-
tion of contraction and constriction, to be found in the
following symptoms :

" The head seems to him, as it were, compressed in a
frame ; a dull, painful sensation.

" Cramp-pain in the forehead, as if between screws.

410 PLATINA.

" In a somewhat warm room (with many persons), first a
feeling of dullness in the sinciput, as if contracted ; this
increases more and more to a violent headache, first, in the
right temple, later, in the whole head, but always worst in
the forehead ; a dull, sometimes dizzy compression, with
very cross and impatient humor ; at the same time heat in
the upper part of the body, especially the head; an anxious
sweat seems about to break out ; every minute, a flash of
heat runs over him ; nothing relieves this condition, which,
if it moderate for an instant, returns quickly with violence.
In the evening, when standing in the cool air, he is uncom-
monly warm (no thirst). When beginning to walk, after a
short rest, the brain is painful, as if shaken, or, as if a sensi-
tive ball, lying loose in the head, struck against the cranial
walls. In the evening, in bed, in addition to the dull feeling
in the forehead, a roaring in the ears ; then, when the pains
abate, he sleeps.

" Tensive, dull feeling in the nape of the neck, just on the
occiput, as if tightly bound together.

" A kind of spasmodic contractive sensation darts quickly
and suddenly from the right temple, through the head, to
the left temple ; later, the head feels numb and trembling
on both sides, as if a cloth were wound tightly about it.

" In the left great toe, a painful sensation, as if tightly
bandaged."

It is characteristic of the morbid phenomena induced by
Platina, that they often appear at regular rhythmical inter-
vals, and, beginning feebly, become more violent, and then
again diminish in intensity.

" In the epigastrium, to the left, a few violent, dull stitches
like shocks, at long intervals.

" In the left ulna, two inches from the wrist, at intervals,
pain in every position, like a kind of jerking, especially in
the tendons.

" Below the knee, from the right tibia down, painful shocks
at irregular intervals, as from a dull instrument.

PLATINA. 411

" A pressing cramp-pain in the left temple, beginning
moderately, and rising and falling in severity.

" In left side of thorax, a cramp- like pain, moderate at
first, gradually increasing, and then decreasing.

" On top of the right shoulder, a pain as from a blow,
moderate at first, then gradually increasing, and then
decreasing."

A farther peculiarity of the Platina symptoms is that they
become aggravated by sitting and standing, and are alleviated
by walking, — a feature agreeing exactly with the general
character of the drug.

The following symptoms come under this head :

" When sitting and standing, a painful feeling of weakness
in the whole right limb, especially in the superficial muscles
of both thighs, as if beaten, with a tremulous uneasiness.

" When sitting, a dull pain, as from a fall, in the head of
the left thigh.

" Great weakness in the knee-joints and surrounding parts,
even when sitting, but especially when standing, making him
sway back and forth involuntarily.

" When walking, he feels but little weakness ; but, so soon
as he sits, the feet are as if tired, trembling, and full of
uneasiness."

Another characteristic of the Platina symptoms is the
evening exacerbation.

" Spasmodic jerkings down the left thigh, and feeling of
numbness in the legs and feet when sitting, especially 'in the
evening.

/'Feeling of fatigue in the soles, with a sensation as if
they were swollen around the ankles. When sitting, the
fatigue ascends gradually into the calves, with a sensation as
if they were stretched, in the evening.

"In the afternoon and evening she feels in her worst
humor."

A farther peculiarity of Platina, which should not be over-
looked, is that strikingly prominent sensation of cold and

412 PL A TIN A.

chilliness which, as already stated, attends many phenomena,
and often appears independently. We shall be less likely to
regard this chilliness and feeling of coldness as a febrile
symptom, or a disturbance in the sphere of the Sympathetic,
inasmuch as we perceive no reaction of any kind, — heat,
sweat, or change of pulse.

These phenomena of chill and coldness are, here, rather a
reflex action on the sensitive nervous system, dependent on
the torpor peculiar to this drug. I do not therefore hesitate
to cite here the following symptoms :

" Chill, with chattering of the teeth, in the evening, when
undressing.

" Constant feeling as if he should freeze, with frequent
shuddering down the limbs, especially in the open air, even
when it is warm.

" Cold, with shivering over the whole body, down to the
feet.

" Cold chill running over the back.

" Shivering from cold, evening.

" Constant shuddering through the whole body, especially
the limbs.

"Frequent shuddering from above, down the arm and the
whole body, with horripilation.

"A shiver runs over her when she steps from her chamber
into the open air.

" Sudden shiver on head, chest, and arms, after entering a
warm* room.

" Shivering in the forenoon, with drowsiness.

" She becomes suddenly quite warm, and fancies she looks
very red, although her complexion is as usual."

I have dwelt at somewhat greater length on the functional
affections of the sensitive nerves, because it is in just these
effects that many peculiarities and characteristic features of
Platina are most strikingly prominent; for phenomena present
themselves here, as we have seen, which serve as important
points in the general indications of the remedy.

PLATINA. 413

It only remains, for the sake of completeness, to cite a few
symptoms, which, even if of no great importance, yet serve
to fill out the picture of the Platina disease. These symp-
toms relate to the organs of special sense :

VI. AFFECTIONS OF THE SENSORIAL NERVOUS SYSTEM.

" Painful drawing around the left eye, seeing as if through
gauze, and sensation as of the eyes being agglutinated. The
eyes are painful when using them in the evening, at candle-
light, and when exerting them ; they first itch, obliging her
to rub them ; then they suppurate, are very painful, see a
tremulous and twinkling light, obliging ' her to close them,
and making it impossible for her to see any object.

" Tingling of the ears ; tingling of the ears, afterward
tearing in the same ; whizzing in the ears, with stitches in
the head ; noise in the ears, as of the wind blowing into them,
increased by the least noise to such an extent that she has
great difficulty in hearing others ; roaring in the right ear ;
noise in the right ear, as of the wing of a large bird ; dull
roaring and rolling in the ear every morning, and afterward
every evening after lying down, at the same hour for several
weeks ; dull roaring in the right ear, with obtusion of the
head from a sort of cramp-like pressure; jerks in the right
ear like distant thunder."

Finally, a few symptoms belonging to the male genital
system remain to be cited :

"Erections toward morning.

" Constant erections during sleep, with amorous dreams.

"Constant erections at night without seminal emission, and
without many dreams.

"Embrace with little pleasure, and very brief."

These symptoms agree with the general character of
Platina. The erections are, if I may use the expression,
passive, and are attended by no desire; hence, erections

414 PLATINA.

without emission and embrace of short duration with very
little pleasure.

Having thus taken a survey of the general and special
sphere of action of Platina, I shall now consider several
remedies that are related to it, and briefly refer to the
diagnostic difference between them and Platina. First of all
I name Asafoetida. This remedy, as well as Platina, exhibits
many of the phenomena of hysteria, but of an altogether
different form of that disease. Menstruation, too, is rendered
more frequent by Asafcetida ; still, however, it remains scanty.
The hysteric perversion of the disposition and morale are
clearly induced, it is true, by Asafcetida, and even the globus
hystericus is present ; but then Asafcetida fails to induce the
disposition to weep, the fear of death, the absent-mindedness,
the self-exaltation above others, which are so peculiar to Platina.

The affections of the vegetative nervous system induced
by Asafcetida are eminently of a spasmodic nature, as well
as those induced by Platina; but they seem to depend
partly upon a peculiar gastric condition and partly on
obstructions in the portal system. Asafoetida affects the
periosteum, for which Platina has no affinity at all. On the
other hand, Asafcetida has the trembling, the cramp-like
sensations, ceasing and re-appearing at regular intervals,
aggravated by sitting, and ameliorated by walking, in com-
mon with Platina, although with various modifications and
under different conditions. The paralytic condition is not so
clearly developed in the action of Asafoetida. But the
phenomena which most strikingly distinguish Asafcetida
from Platina are the symptoms of congestion and fever,
which, as we have seen, are altogether wanting to the latter.
Hence it follows, that torpor and inactivity, and prostration
of the functions, do not make up the character of Asafoetida;
but, as a rule, most of its effects upon the brain and spinal
cord appear to be reflex effects from affections of the vegeta-
tive nervous system, whereas the action of Platina upon
these central organs is independent and primary.

PLATINA. 415

Crocus, although far more widely different than Asafcetida
from Platina, may yet be reckoned among the related
remedies, because, perhaps, of its affinity for the female
organism, and of its action on the morale and the disposition.
The too early and too copious menstruation and the
metrorrhagia which Crocus induces depend, however, on an
overloading of the uterine vessels with blood ; hence, the
blood is black and clotted; and, hence, the haemorrhages
which occur also in other organs are easily provoked by
motion or exertion. The moral effects are directly opposed
to those of Platina. In the case of the latter we have weep-
ing and fear of death ; in that of the former, laughing and
unrestrained merriment; but the frequent alternation of
cheerfulness and sadness is a feature common to both
remedies. When I add, in conclusion, that the majority of
the morbid phenomena of Crocus are induced by congestions,
venosity, and other abnormal states of the vascular system,
we at once perceive the distinctions between the remedies.

Pulsatilla is in several aspects similar and related to
Platina. But, from the very fact that it is a polychrest, —
that is, that it acts in very many ways, and exerts its healing
power in a great number of acute as well as chronic diseases,
— the difference of its character from that of Platina may,
notwithstanding their similarity, be clearly seen. It would
lead me too far to unfold this difference in all its aspects ;
this may be done with greater propriety when treating of
Pulsatilla. Only this much I may say: that the similarity
of Pulsatilla to Platina is shown most clearly in their
respective moral effects, and in their action on the female
sexual system. But even in these symptoms there are
important differences, the psychical effects of Pulsatilla con-
sisting chiefly in fretfulness, complaint, and lamentation, and
the disposition to weep which belongs to this remedy, arising
rather out of these conditions ; whereas, the weeping induced
by Platina is a result of apprehensiveness and of weakness
of disposition.

41 6 PLATINA.

With regard to menstruation, Pulsatilla induces a number
of abnormal symptoms, retards the menses, and causes a
discharge of black clotted blood. Hence, Pulsatilla is not
improperly regarded as antidote to Platina.

Last of all, it remains to mention Plumbum aceticum,
which shows much resemblance to Platina in its spasmodic
and paralytic symptoms ; but whereas in the case of Platina
these are primary, in that of Plumbum they are secondary.
On this account, too, Platina is the remedy for certain cases
of lead-colic. These two metals stand almost in the same
relation that Arsenic and Carbo vegetabilis hold. The
tendency to decompose everything of an organic nature is
common to these two remedies ; but Arsenic induces this
decomposition after a previous over-excitement and too
strong impression upon the organism, while the peculiarity
of inducing decomposition is a part of the primary action of
Carbo.

The dose in which Platina may be given is various. I have
generally given the second or third trituration, with the best
results ; but I doubt not that it is active in higher potencies,
this being attested by the experience of competent physi-
cians.

REMARKS ON RUMEX CRISPUS.

My clinical experience of the last two years has given me
a feeling of great gratitude to Dr. Joslin, for his introduction
of Rumex Crispus to the profession by his excellent proving.
The value of the published proving is much enhanced by
the publication of the daily records of each prover, which
enable the student to appreciate the consecutive action of
the drug much more perfectly than the Hahnemannian
scheme allows, while the latter, again, is indispensable to the
prescriber.

I have used Rumex chiefly in acute catarrhal affections of
the larynx, trachea and bronchi. In these cases it seems to
me to present a close analogy in its action, to Belladonna,
Lachesis, Phosphorus and Causticum. Without assuming
to present an exhaustive analysis of the action of Rumex
on the respiratory organs, I proceed to state the indica-
tions for its use to which my studies of it thus far have
led me.

Rumex diminishes the secretions, and at the same time
exalts in a very marked manner the sensibility of the mucous
membrane of the larynx and trachea, exceeding in the extent
of this exaltation any remedy known to us. The cough
therefore is frequent and continuous to an extent quite out
of proportion to the degree of organic affection of the
mucous membrane. It is dry, occurs in long paroxysms, or,
under certain circumstances, is almost uninterrupted. It is
induced or greatly aggravated by any irregularity of respira-
tion such as an inspiration a little deeper or more rapid
than usual, by the inspiration of air a little colder than
that previously inhaled, by irregularity of respiration and
28

418 REMARKS 'ON RUMEX CRISPUS.

irregular motion of the larynx and trachea such as are
involved in the act of speech and by external pressure upon
the trachea, in the region of the supra-sternal fossa. These
phenomena show a very great morbid irritability of the
mucous membrane of the larynx and trachea.

The subjective symptoms are rawness and soreness in the
trachea, extending a short distance below the supra-sternal
fossa and laterally into the bronchi, chiefly to the left ; and
tickling in the supra-sternal fossa and behind the sternum,
provoking the cough ; this tickling is very annoying and
very persistent, and is often but momentarily, and sometimes
only partially, relieved by coughing. The cough occurs
chiefly, or is much worse in the evening, after retiring, and
at that time the membrane of the trachea is particularly
sensitive to cold air and to any irregularity in the flow of air
over its surface, so that the patient often covers the head
with the bedclothes to avoid the cold air of the apartment,
and refuses to speak or even to listen to conversation, lest
his attention should be withdrawn from the supervision of
his respiratory acts, which he performs with the most careful
uniformity and deliberation, — and all in the hope of pre-
venting the distressing tickling and the harassing cough which
would ensue from a neglect of these precautions. I have
frequently witnessed this state of things during the last three
years, and have invariably given prompt relief with Rumex.

In the group of remedies in which I have placed Rumex
(along with Belladonna, Lachesis, Phosphorus, Causticum),
it stands pre-eminent in respect to the extreme sensibility
of the tracheal mucous membrane. All of these remedies
produce symptoms identical in kind. The characteristic of
each is to be found in the relative degree in which each
symptom is pronounced in the different remedies, quite as
much as in the possession by any one of them of symptoms
not produced by the others.

Thus Belladonna, Lachesis and Rumex, produce each, a
dry cough, induced by tickling in the larynx or trachea and

REMARKS ON RUMEX CRISPUS. 419

provoked by deep inspiration, by speaking, and by external
pressure on the larynx or trachea. Each produces soreness
or rawness of the larynx or trachea. The cough of each is
spasmodic and long-continued, and is worse at night after
retiring. But, apart from the fact that Belladonna and
Lachesis act more upon the larynx, and Rumex more upon
the lower part of the trachea, we observe that, in the case
of Lachesis, the slightest external pressure on the larynx or
trachea produces violent and long-continued spasmodic
cough ; the patient cannot endure the least constriction in that
region, not even the ordinary contact of his clothing. There
is, moreover, a sense of fullness in the trachea and a very
painful aching in the whole extent of the os hyoides. In
the case of Belladonna not only is cough produced to a
moderate extent by pressing upon the larynx, but soreness
and pain are experienced with a sense of internal fullness
and soreness which at once suggest the presence of acute
laryngitis submucosa. In Rumex, on the other hand,
there is no sensibility, strictly speaking, of the trachea, but
simply such an irritability of the mucous membrane that
cough is produced by the change of position induced in that
membrane by external pressure on the trachea. As regards
the extent and intensity of this symptom, Rumex holds a
lower rank than the other remedies named.

But the irritability of mucous membrane by virtue of
which cough is induced by hurried or deep inspiration or by
speaking, while it is common to Belladonna, Lachesis,
Rumex and Phosphorus, is produced in the most exalted
degree, as we have already seen, by Rumex, which, as
regards this symptom, takes first rank. A sensation of
rawness or roughness in the larynx, trachea and bronchi is
produced by each of the four remedies above named, but
the locality and the degree in which it is produced vary in
such a manner as to serve in some measure as a character-
istic of each. It is most marked in Phosphorus and Bella-
donna, less prominent in Rumex, and least of all in Lachesis.

420 REMARKS ON RUMEX CRISPUS.

In Belladonna and Lachesis it is most marked in the larynx -y
indeed it is almost confined to that region. Rumex pro-
duces it in the trachea and upper part of the bronchi, while
Phosphorus induces it in the whole mucous tract from the
larynx to the smaller bronchi; and, moreover, in the Phos-
phorus proving this "rawness" of the air-passages is accom-
panied by a no less characteristic sense of weight and
constriction across the upper part of the thorax, which
indicates an affection of the finer air-tubes and of the air-
vesicles of such a character as seriously to impede the func-
tion of respiration. In considering this last symptom we
must mention Causticum also, which produces " rawness "
extending the whole length of the sternum.

All five remedies, again, produce hoarseness ; Phosphorus,
Causticum and Belladonna most eminently, Rumex less
decidedly, and Lachesis in a still less degree. As regards
complications, Belladonna and Lachesis apply especially to
those which involve the fauces and pharynx, and are acute,
the one of a sthenic, the other of an asthenic character;
Phosphorus to those of the pulmonary tissues of a definite
inflammatory character, and Rumex to certain affections of
the lungs and their envelopes of which the nature is not
clearly defined in the proving. They are indicated by pains,
generally sub-acute, in the upper part of the lung near the
clavicle and axilla, and more frequent in the left than in the
right lung.

In addition to these observations on the respiratory
organs, I have noticed, in one case, the cessation of a brown
watery diarrhoea after the administration of Rumex. A boy
of five years had brown watery diarrhoea, chiefly in the
morning, having five stools from five to nine A.M., attended
with moderate griping pain in the lower part of the abdo-
men. This continued several days, notwithstanding two
prescriptions which I made for it. Observing that the boy
had a cough which presented the characteristic features of
the Rumex cough, I gave that remedy, and both diarrhoea

REMARKS ON RUMEX CRISPUS. 421

and cough were speedily cured. The symptom " brown
watery diarrhoea" occurs once in the provings. In relating
this case I cannot forbear remarking that had I been more
careful to collect and consider the totality of the symptoms,
embracing cough as well as diarrhoea, I should have given
Rumex at first, instead of making two blundering prescrip-
tions on the basis of a partial view of the symptoms which
embraced the diarrhoea alone.

The following case from my clinical record will illustrate
the character of the Rumex cough :

M., aged twenty- two, of feeble constitution, strumous,
subject for several years to sub-acute rheumatism ; has had
a severe cold for several days, and is now confined to the
bed. The pulse is quick, not hard, no, skin moderately hot
and dry, face somewhat flushed. Respiration embarrassed
not so much by any constriction of the chest as by the
violent and long- continued cough which follows any attempt
to make a full inspiration. A physical examination of the
chest reveals no abnormal condition. The patient complains
of roughness and soreness in the lower part of the trachea
and behind the upper third of the sternum, much more per-
ceptible when she coughs. The cough is dry, slightly
hoarse, very violent and fatiguing to the patient. It is pro-
voked by a tickling in the supra-sternal fossa; is induced
by pressure upon the trachea in that region, and especially
by talking and by deep inspiration or by the inspiration of
cool air. This irritability of the trachea increases very
markedly after 7 P. M., so that the patient suffers exceedingly
from the constant tickling and violent cough. She can pre-
vent them only by respiring with very great caution and
deliberation, by avoiding all distractions of speech and con-
versation, and finally she draws the bedclothes over the
head in order to avoid inhaling the cool air of the chamber.

This patient states that she has frequently had such coughs
as this, and they have proved very obstinate although under
skillful homoeopathic treatment. I gave Rumex 12 in solution,

422 REMARKS ON RUMEX CRISPUS.

a tea-spoonful every two hours. After the second dose there
was complete relief. The next evening, a very slight dispo-
sition to cough. No further symptoms.

I supplied the patient with Rumex30, and advised her to
use it at once on the occurrence of such a cough, and I am
informed that she has always succeeded in subduing the
cough within twelve hours.

REMARKS ON GUAO.1

The Guao is undoubtedly the " Comocladia dentata,"
belonging to the same family as the Rhus toxicodendron
and venenata, and the Anacardium occidentale or Cashew-
tree. Lindley describes it as follows : 2

" Anacardiacea. Comocladia dentata (Guao). St. Domingo
and Cuba. A tree. Stem erect, not much branched. Leaves
pinnated, shining and green above ; with a round rachis six
inches long ; leaflets six to ten on each side, with an odd
one, oblong, acuminate, spring-toothed, veiny and somewhat
downy at the back. Juice milky, glutinous, becoming black
by exposure to the air, staining the linen or the skin of the
same color, only coming off with the skin itself, and not
removable from linen by washing even if repeated for many
years successively. It is supposed by the natives of Cuba,
that it is death to sleep beneath its shade, especially for
persons of a sanguine or fat habit of body. This is firmly
believed, and there can be no doubt that it is the most
dangerous plant upon the island."

An interesting article upon the " Comocladia dentata
(Guao)," by J. G. Houard, M. D., Philadelphia, comprising
contributions toward a proving of this plant, and some
symptoms removed by its administration, was published in
the Philadelphia Journal of Homoeopathy?

It seems not irrelevant to call attention to the fact that
the Guao (Comocladia dentata) may possibly, from the
similarity of the names, be confounded with the Guaco
(Mikania guaco), a totally different plant.

1 Notes appended to a Paper on * Flora Medico, page 289, $ 598.

Guao, written by Dr. Jose" J. Navarro, 'Vol. iv. (No. 2), page 73 el seq.%

of Cuba. American Homoeopathic Re- May, 1854.
view, vol. iii., March.

424 REMARKS ON GUAO.

The Guaco (Mikania guaco) is a climbing plant used in
Central and South America as an antidote to the poison of
serpents. It is incidentally alluded to by Humboldt:1
"The liana, called vejuco de guaco (Mikania), which M.
Mutro has rendered so celebrated, and which is the most
certain remedy for the bite of venomous serpents."

" Forster, Schomburgh, Poppig and Tschudi, agree that
in South America the Mikania guaco is the best remedy for
the bite of venomous serpents, and that it has in innumer-
able instances demonstrated its specific curative power. The
freshly expressed juice of this creeping plant is dropped into
the somewhat dilated wound, the surrounding parts are
repeatedly rubbed and covered with the bruised leaves, and
the juice at the same time also internally taken. It is effica-
cious against the bites of the most venomous serpents. It is
also used as a prophylactic."2

Turchetti states that Guaco locally applied destroys the
specific property of the pus from a chancre, and prevents the
production of a second chancre by inoculation. He also
claims for it positive curative powers in syphilis.3

Lindley speaks of the Guaco as follows4 : " Aristolochiaceae
(Guaco). - The Guaco of the Caraccas, reported to be a
powerful remedy for the bites of serpents, is said by Dr.
Hancock to be some plant of this genus."

In fatAllgemeineHomoeopathischeZeitung;* in a letter from
Bordeaux it is stated, "A Mexican physician has sent hither
a plant, Houacou" (evidently the same as Guaco), "which has
proved very curative, in Mexico, in certain very severe mal-
adies possessing great similarity to cholera. Our physicians
have made successful experiments with it; out of eight
patients to whom it was given, six were cured. * * A few
drops administered on a lump of sugar restored a distinct
pulse to a patient who had already become quite pulseless."

1 Travels, Bohn's edition, vol. ii., 3 Schmidt's Jahrbuch, Bd. 101, p.

page 364. 1 68.

* Homceopathische Vierteljahrschrift, * Flora Medica, page 344, $ 915.

4> 39I~392- 6 Vol. i., page 128, December, 1832.

REMARKS ON GUAO. 425

In the Allgemeine Homceopathische Zeitung,1 reference is
made to an article by Dr. J. G. Houard, of Philadelphia, in
the North American Journal of Homoeopathy?- This article is
a translation of a Spanish pamphlet on Guaco in cholera. It
gives no other name than Guaco to the remedy used and no
description of the plant from which it was derived, but refers
to an article on the subject by Dr. Chalmers, an allopathist,
in the Diario of Havana.

In the Zeitschrift fur Homozopathische Klinik? it is stated
that Guaco was recommended in cholera by Dr. W.
Valentin. It had already been recommended in 1853 by
Otto, of Copenhagen, for gout, asthma, rheuma ; by Chabert,
in Mexico, for cholera, and in 1836 had been used with good
effect in cholera, by Czeterkyn, in Poland. In 1 840, Jobst pub-
lished a pamphlet on the subject giving communications from
the then President of Venezuela, Dr. Vargas of Caraccas.
According to the latter, Guaco (in form of tincture) is used in
Caraccas in the following diseases: it cures the bites of
poisonous snakes; of the scorpions; prevents hydrophobia ;
antidotes poisons ; is useful in relieving pain from wounds
resulting from falls or floggings (it would be valuable in
boarding-schools and on the plantation) ; favors menstrual
flow and removes constipation; is efficacious against affec-
tions of the liver, obstinate ulcers; is said to prevent and
cure cancer; has a happy effect in spasm of the stomach and
consumption, when the latter depends upon menstrual dis-
turbances ; cures asthma ; cures tertian and all fevers com-
plicated with chill ; is a powerful anthelmintic ; restores the
functions of the stomach in feeble persons, and stimulates the
circulation ; cures megrim radically ; alleviates toothache4, —
a goodly list of virtues !

We have no complete proving of Mikania guaco, although

1 Vol. liv., page 6, 1857. Materia Medico, i., ii. — Jobst "Ueber

2 Vol. ii., page 16. Guaco. Stuttgart, 1840. Wien.

3 Vol. iii., page 94, June, 1854. Wochenschrift, 44."
*Dierbach Neue Entdeckung, in

426 REMARKS ON GUAO.

the editor of the Allgemeine Homoeopathische Zeitung states
that one. has been made by Dr. Elb, of Dresden.

Dr. Elb refers to this in an article on "Spinal Diseases"1
(of which we hope soon to present a notice to the reader) in
the course of which he gives the pathogenesis of Guaco in
so far as it relates to symptoms of the spinal nervous system.

1 Allgemeine Homccopathisehe Zeitung, 61, 22 and 43.

REMARKS ON SPIGELIA.1

To take a general view of the action of Spigelia upon the
organism, it may be said to be manifested chiefly upon the
nervous system of animal life. Spigelia is eminent among
the remedies of our Materia Medica for the extent to which
its action seems to be exerted upon the nerves themselves
or their envelopes. Upon the substance of the nervous
centers, however, its action is probably very slight.

I. Spigelia excites the nerves of special sense in a marked
degree, and this without any clearly defined inflammatory
affection of the organs of special sense. In this regard, it
differs from Belladonna, Rhus, and other remedies which
excite particularly the nervous system of animal life. But
there is an exception to this statement. In the tissues of
the eye Spigelia excites inflammation, its symptoms giving
a well-marked picture of rheumatic sclerotitis.

Spigelia exerts a marked action on the trifacial nerve,
producing prosopalgia, which involves the orbit, the zygoma
and the superior maxilla ; also upon the nerves of the tongue;
perhaps also upon the portio dura. The prosopalgia of
Spigelia is distinguished by sticking, burning pains with
subsequent swelling and soreness of the parts affected. In

, N. Y., March 26, 1877. Dr. Dunham was its author, and it

* * * * In the fifth volume of should appear in any collection of his

the American Homoeopathic Review, writings. Dr. Dunham's reasons for

page 537, is an article on Spigelia wishing it to appear as mine were, that

purporting to have been read by me he was writing so much for the

in October, 1864. It is true that I Review, that he was glad to have

read it, and by request of Dr. Dun- some other name appear occasionally.
ham it went as my paper, although C. W. BOYCE.

I did not write a word of it.

428 REMARKS ON SPIGELIA.

this respect it closely resembles the prosopalgia of Colchi-
cum, from which, however, it is distinguished by the remark-
able exaltation of the special senses and by the general
nervous erethism and excitement and intolerance of pain
which characterize Spigelia, whereas Colchicum on the other
hand has an equally remarkable tolerance of pain, and
patient, enduring disposition, with a general semi-paralyzed
condition.

2. There is no evidence of any definite modification of
the organic substance of any part of the body, unless such
action upon the pericardium be inferred ex usu in morbis.

3. The sphere of action of Spigelia is not extensive. It
embraces the nerves of animal life and of special sense, and
the fibrous, and perhaps the muscular, tissues of the heart and
of the smaller extremities.

The effect of Spigelia upon the heart's action seems to be
due to a morbid condition which the drug excites in the
pericardium, and hence its value in pericarditis.

4. The pains of Spigelia are sticking, tearing, and burn-
ing pressing. They are aggravated by motion and in the
afternoon and at evening. They often prevent sleep. There
is great lassitude and heaviness of the limbs. , Great sen-
sibility of the whole body to touch; the least touch on
any part of the body sends a shudder through the whole
frame.

5. There is no marked periodicity in the symptoms.

Let us now examine more closely the different parts of the
body chiefly affected.

Head. There is vertigo when looking down and when
walking. The memory is impaired, and mental effort is very
irksome.

The headache is very characteristic and presents a good
picture of a form of so-called "nervous headache." In
general, the sensations are dullness, heaviness and pain in
the head ; the pain is much increased by shaking or jarring
the head, as by walking, especially if one make a misstep,

REMARKS ON SPIGELIA. 429

or cough or sneeze ; by moving the facial muscles ; by
speaking aloud or by any loud noise, as well as by touch or
by a bright light. These things increase the pain so that
it seems as though the head would burst ; the patient is
compelled to support it with the hand, or to bind it around.
(Here we have headache with over-sensibility of the senses
of sight, hearing and touch, with relief from binding the head.
These symptoms resemble the headache of Silicea, which
has likewise exaltation of the special senses and relief from
binding up the head, but it is to be carefully noted, as
characteristic, that the relief to the Spigelia headache
comes from the pressure of the bandage, while to the Silicea
headache, the relief is from the warmth; for «warmth
relieves the Silicea headache, while it rather aggravates the
headache of Spigelia.)

The pains are a heaviness and feeling as of a load or
weight in the head ; a pressing from without inward, aggra-
vated by stooping forward, unless the forehead is supported
by the hand ; a sensation of swashing and surging of the
brain within the cranium (compare China and Rhus and
Apis) at every step, or on the least motion, or when speaking
loudly, and very severe when a false step is made or the
body is jarred ; relieved tjy repose. This swashing sensation
is often accompanied by a tearing, digging pain in some small
well-defined portion of the head; generally, semi-lateral, as,
for example, in the left parietal region, or the space extend-
ing from the left occiput to the left forehead. As regards
the localities affected, the pain is generally circumscribed
and is often confined to one side ; more frequently the
left.

The occiput is the seat of many pains which extend into
the nape of the neck causing stiffness and at the same time
restlessness. In the forehead and, in the frontal protuber-
ances we find pulsating stitches; pressure from without
inward ; boring and burning pains ; the latter are probably
superficial and seated in the supra-orbital nerve. In the

430 REMARKS ON SPIGELIA.

frontal protuberances tearing pain extending into the eye
and aggravated by motion of the globe of the eye.

In the temporal region we find pulsating stitches, pressure
inward and burning, extending into the zygoma.

We pass now to the Eyes, which are acted upon not only
as regards the tissues, especially the muscular and fibrous
tissues, but also as regards the special sense of vision.

In addition to the affections of the eye proper, we find in
the left orbit pressing neuralgic pains extending down to the
zygoma and leaving on the zygoma a tumor which is sensi-
tive to the touch.

The conjunctiva is moderately inflamed. There. is moder-
ate paki as if sand were in the eye, a slight secretion of
muco-pus and bland lachrymation.

The affection of the deeper tissues of the eyeball is shown
by the dull and flat aspect of the eye, the supra-orbital pains,
redness and inflammation of the sclerotic with ptosis, pain
in eye and brow ; the eyeball is painful when moved and
feels tense as if too large for the orbit (Paris quadrifolia) ;
sticking pain in the eye. The eye is painful when moved
in any direction (Bryonia), an intolerable pressive pain, so
great that, rather than endure it, the patient, when desirous
of looking from side to side, move,s the whole head, instead
of merely the eyeball. Heat and burning in the eyes.

Vision. The sensibility of the retina is increased, inducing
photophobia. It is likewise perverted, causing illusions, as
if hairs or feathers were on the lashes, and these illusions
are increased by wiping the eyes ; sparks and a sea of fire.
The pupils are dilated.

The sense of hearing is exalted in connection with the
headache.

In the zygomatic region of the left side of the face, burn-
ing or tearing pressive pains which leave a dull sensation of
swelling as the pain abates. There are stitches from the
upper maxilla to the vertex.

We pass now to the symptoms of the thorax.

REMARKS ON SPIGELIA. 431

There are stitches in the -chest in various parts; and on
both sides, most frequently the left. These stitches are gen-
erally from within outward, and are aggravated by respira-
tion (most by inspiration) and by motion. They occur
under the nipple of either side, and, on the left side, are
directed toward the scapula and left arm.

The following symptoms: violent stitch in the left side
just under the heart recurring periodically ; stitch in the
diaphragm on the left side, so violent as to arrest breathing ;
dull stitches, synchronous with the pulse, in the region in
which the heart's impulse is felt ; stitches between this spot
and the epigastrium ; — these symptoms, together with those
which denote modified action of the heart, viz. : very violent
pulsation, audible to the patient and visible to the by-stand-
ers ; violent palpitation and anxiety ; tremulous motion of
the heart ; palpitation increased by sitting down and bend-
ing forward, and by deep inspiration and retention of the
breath ; palpitation as soon as he sits down after rising in
the morning, and, in the praecordial region, a heavy painful
pressing load causing constriction and anxiety with cutting
and griping as from wind in the abdomen ; — these symptoms
all clearly point to an affection of the heart and pericardium,
and, in such diseases, clinical experience has shown Spigelia
to be of exceeding value.

CLINICAL INDICATIONS. It is evident from our hasty and
partial review of the symptoms, that Spigelia may be clearly
indicated in cases that would come under the following
groups:

i. Headaches ; generally semi-lateral, so-called nervous;
accompanied by great exaltation of the special senses (com-
pare Silicea, Conium); aggravated by motion, noise, light and
thought ; involving generally the left eye and orbit without
congestion of the head. In such affections (if attended, as
frequently, by nausea and vomiting, they resemble "sick head-
aches ") Spigelia compares with Silicea, Belladonna, Apis,
Ignatia, Thuja, Sanguinaria.

432 REMARKS ON SPIGELIA.

2. In Sclerotitis. Also in nasal catarrh when the dis-
charge is chiefly from the posterior nares into the pharynx,
and attended by neuralgic affections of the pharynx and
region of the ear and lower jaw, provided always the general
symptoms correspond.

3. Above all, in acute or sub-acute affections of the heart
which present symptoms similar to those of Spigelia above
quoted, it is an invaluable remedy ; as for example, in acute
pericarditis, with anxiety and weight in the praecordia,
stitches through the heart arresting respiration, oppressed
and accelerated palpitation so forcible as to be audible and
visible, and excited or aggravated by change of position or by
the slightest motion. In such cases, Spigelia compares with
Aconite, Bryonia, Kalmia, Lachesis, Naja. And with the
new remedy Cactus grandiflorus.

DR. HARLEY ON CONIUM MACULATUM.

The idea of a Materia Medica Pura — a collection of the
effects of drugs upon the healthy — did not originate with
Hahnemann. He, himself, quotes several of his prede-
cessors— notably Haller, who explained and urged the
necessity of such a collection, as the only means of acquiring
an exact knowledge of the relations of drugs to the human
organism, and a possible key to their therapeutic use. But
Hahnemann was the first physician who seriously devoted
a large part of his life to the labor of ascertaining these
effects, and making such a collection. Many a critic has,
to his own satisfaction, demolished Hahnemann's work, and
shown the fallacy of his demonstration of the value of prov-
ing on the healthy. And, until very recently, the task
of systematically developing the pure, that is the physiologi-
cal, Materia Medica has been left to our own school of
medicine. But the same mysterious mental and moral
influences which have " drifted " the dominant school into
admissions of the (at least partial) truth of the law, similia
similibus curantur ; into advocacy of the single remedy (in
theory at least) ; and into the concession that the thera-
peutic power of a drug is not necessarily in the direct ratio
of the quantity, have recently overtaken prominent physi-
cians, especially of England ; and Sir Thomas Watson has
distinctly pointed to a pure Materia Medica as a possible
way to a therapeutic law, and an escape from the present
chaos of therapeutics. And Dr. John Harley, of London,
in the Gulstonian Lectures of 1868, on "The Old Vegetable
Neurotics," has given us an installment of the " pure Materia
Medica" of the future, as the allopathists understand and
29

434 DR- HARLEY ON CONIUM MACULATUM.

propose to construct it. His work presents the physiologi-
cal action and therapeutic use of Hemlock, Opium, Bella-
donna and Henbane, alone and in combination.

It is worthy of our most thoughtful study. We must
not allow a pardonable feeling of satisfaction that the oppo-
nents who would have overwhelmed with scorn our Materia
Medica Pura, have now come to build such a structure for
themselves after our plan ; nor hug ourselves in self-suffi-
ciency because they disdain to use the materials we have
fathered.

While we have labored in our departments of Materia
Medica and Therapeutics, the allopaths on their side have
not been idle. The sciences of physiology, pathology and
organic chemistry have, through their industry, made won-
derful advances, and now all the resources which these
sciences afford them are brought to assist our opponents
in their physiological provings of drugs. It behooves us,
with minds devoid of prejudice and conceit, and with a
teachable spirit, to scrutinize their labors and canvass their
achievements, that we may profit by their contributions
to useful knowledge, and avoid the errors into which, through
an erroneous application of these auxiliary sciences, they
may chance to fall.

The first drug treated by Dr. Harley is the Conium mac-
ulatum. We propose to give a summary of his pathogenesis,
and his views of the therapeutic uses of this drug, and then
to give a parallel summary of Hahnemann's provings and
of our clinical experience, with reflections upon the similari-
ties and differences. A similar treatment of the other
remedies discussed by Dr. Harley will follow.

Some remarks in the preface are worthy of quotation.
Dr. Harley says :

" My object throughout has been to ascertain, clearly and definitely, the
action of the drugs employed on the healthy body in medicinal doses, from the
smallest to the largest; to deduce simple practical conclusions from the facts
observed ; and then to apply the drug to the relief of the particular condi-
tions to which its action appeared suitable."

DR. HARLEY ON CONIUM MACULATUM. 435

A homoeopathist might almost have written this, certainly
the first section. But in the deduction "of simple practical
conclusions from the facts observed," the door is opened to
hypothesis and error; and how can one "apply the drug to
the relief," etc., unless one possess a therapeutic law express-
ing the relation between such "conditions" and the patho-
genetic " facts observed " ? Here are the weak points of Dr.
Harley's system. Until he shall have a therapeutic law,
other than the general rule, "causa sublata, tollitus effectus"
he will be unable to apply the remedy therapeutically,
except through the intervention of two hypotheses, one in
pathology, to account for the symptoms of the patient, and
the other in pathogenesy, to explain the phenomena pro-
duced in the drug-proving; and the introduction of hypoth-
eses into a scientific induction makes way for error.

Dr. Harley devoted much time to an examination of the
relative value of the different officinal preparations of Conium,
most of which he regarded as destitute of medicinal power.

Discarding the Tinctura conii fructus the Tinctura conii
(dried leaf), and the Extractum conii, of the London
Pharmacopoeia, as positively or comparatively inert, he
describes the mode of making the Succus conii, which he
regards as a uniform and very active preparation. We may
say, briefly, that his process is substantially the same as that
employed by Messrs. H. M. Smith & Brother, the well-
known Homoeopathic Pharmaceutists of New-York. Pereira
wrote in 1858: "In the present state of uncertainty with
respect to the real physiological operations of Hemlock, it is
obviously impossible to lay down indications for its use
which can be much relied on." Dr. Harley proved Conium
first on himself and says : " Having assured myself of the
effects of Hemlock in my own person, I have thus been able
to fully appreciate its operations in others, and proceed much
more boldly than I could have done without such personal
knowledge." It would be a satisfaction to add, "more
intelligently " also.

436 DR. HARLEY ON CONIUM MACULATUM.

" Physiological Action of Hemlock, — The first effect of Hemlock is a depres-
sion of the motor function; and its last is the complete obliteration of all
muscular motion derived from the cerebro-spinal motor tract.

"After taking 3 iij- of the Succus conii, I set out walking; and three-fourths
of an hour after the dose I felt a heavy, clogging sensation in my heels.
There was a distinct impairment of motor power. I felt, so to speak, that
'the go ' was taken out of me. It was not that I felt fatigue just then, but it
seems as if a drag was suddenly put upon me, and that it would have been
impossible to walk fast if urged to do so. After walking about a mile up-hill
this sensation was very decided, and on putting a foot on the scraper at the
door the other leg was shaky, and felt almost too weak to support me. My
movements appeared clumsy to myself, and it seemed necessary that I should
make an effort to control them. At the same time there was a sluggishness of
the adaptation of the eye. My vision was good for fixed objects ; but when an
uneven object was put in motion before the eyes, there was a haze and dimness
of vision, producing a feeling of giddiness. The pulse and pupils were unaf-
fected. These were the whole of the effects; and, after continuing for an hour,
they rapidly disappeared and left me in the possession of my usual vigor.

"2. If a strong, active individual take five or six drachms of the Succus on
getting up in the morning, and start off for a long -walk, he will be overtaken in
the course of half or three-quarters of an hour with a feeling of general tired-
ness, and a special weakness of the knees, as if he had been regularly tired out
by walking all day to the full extent of his powers. If he be unusually active
and strong he will not, perhaps, yield to the inclination to rest, but will proceed
slowly on his way, feeling a strange lightness and powerlessness of the legs,
with a tendency to drop forward on his knees. This will be associated with
some giddiness, and a feeling of heaviness over the eyes. At first the feeling
of languor will be most oppressive, but it will soon become more tolerable; and
if he should continue the journey for an hour, he will find that the feeling of
fatigue has by this time nearly passed off. In the course of another hour he
will be as active as ever.

" 3. The following were the effects produced in my own person during a
period of rest, and they contrast well with the foregoing :

" Three-quarters of an hour after taking five drachms and a half of Succus
conii, on raising my eyes from the object on which they had been fixed to a
more distant one, the vision was confused, and a feeling of giddiness suddenly
came over me. That these symptoms were due to impairment of power in the
muscular apparatus employed in the adaptation of the eye, was obvious to me ;
for, so long as my eyes were fixed on a given object, the giddiness disappeared,
and the definition and capacity of vision for the minutest objects were unim-
paired. But the instant that I directed the eyes to another object, all was haze
and confusion, and I felt giddy ; and in order to recover my vision and dismiss
the sense of giddiness, it was necessary to lay hold upon some object, as it were,
with my eyes, and rest them securely upon it. It was clear to me that the
adjusting muscular apparatus of the eye was enfeebled, and its contractions so
sluggishly performed that they could no longer keep pace with the more active
movements of the external muscles of the eyeball.

DR. HARLEY ON CONIUM MACULATUM. 437

"Within ten minutes of the appearance of this disorder of vision a general
muscular lethargy affected me, and the eyelids felt as heavy as if they were
oppressed with the deepest drowsiness. The pupils were considerably dilated.
I sat down to note these observations, but, being afraid to maintain this posture
lest the rapidly increasing muscular lethargy should get the better of me, I
rose up again and tried to shake it off. An hour and a quarter after taking the
dose I first felt decided weakness in my legs. The giddiness and diminution of
motor power continued to increase for the next fifteen minutes. An hour and
a half after taking the dose these effects attained their maximum, and at this
time I was cold, pale and tottering. The pulse, which had been emotionally
excited by the sudden accession of the foregoing symptoms, was now sixty-
eight, quite regular, and of undiminished force and volume. The legs felt as
if they would soon be too weak to support me. There was a positive diminu-
tion of voluntary power in every part of the muscular system, and this nearly
amounted to complete paralysis as far as the hamstring and levator palpebrse
muscles were concerned. At one time the greatest exertion was required to
elevate the eyelids. The mind remained perfectly clear and calm, and the
brain active throughout; but the body seemed heavy and well-nigh asleep.
After continuing for about half an hour at their maximum, the symptoms
began rapidly to decline, and within three hours and a half after taking the
dose they had totally disappeared. **#*»#

"A delicate young woman, of inactive habits, took four drachms of the
Succus. Twenty minutes afterward, and while attending to her usual duties,
she experienced nausea and giddiness. She dropped an inkstand which she
was holding in her hand, and was unable to walk, and she was placed in the
recumbent posture. These symptoms came on with alarming swiftness, and
the pulse went up to one hundred and twenty-six from emotional excitement (?) ;
but, in a few minutes the heart regained its usual quietude, and she remained
perfectly comfortable and calm, but without power to move the arms or legs.
An hour after taking the medicine there was nearly complete muscular paraly-
sis ; the eyelids were closed, the pupils widely dilated, and the mind clear,
calm and active, and she expressed herself quite comfortable. She tried persever-
ingly to raise the eyelids when I requested her to do so, but she was quite unable
to separate their margins. The pulse and respiration were normal; the
surface warm. At the end of an hour these symptoms passed off, and after
three hours she had completely recovered her activity and resumed her duties.

The next day she complained of slight wearisome pain in the muscles of the
legs **#*»»*#**

"I proceed now," continues Dr. Harley, "to consider in detail the action of
Conium upon the nervous system. The earliest indications of the operation of
the medicine are invariably those that arise from the depression of the motor
function of the third pair of nerves. They are giddiness, the sensation of a
heavy weight, depressing the eyelids, or actual ptosis; a dull, lazy or fixed
expressionless stare, like that of a drunken person ; dilatation of the pupils.
After moderate doses, the interference of vision is only such as results in
haziness, as if a thin film of transparent vapor were floating between the eye
and the object. * * * It occurs independently of any dilatation

438 DR. HARLEY ON CONIUM MACULATUM.

of the pupils, and is compatible with good definition for fixed objects. It is
due to imperfect adjustment of the refracting media of the eye from partial
paralysis of the ciliary branches of the third nerve. It is through these minute
branches that the individual first becomes conscious of the effects of the
Hemlock, and if he should be reading at the time he will suddenly find the
occupation fatiguing, and very soon afterward it may be impossible, and he
will be glad to close the eyes to relieve himself of the symptom, and, as the
muscular lethargy begins to be felt, content to lie perfectly still, as if asleep.

" In full doses the depressing influence involves the other branches of the
nerve, and the lazy movements of the eyeball, or dull, fixed and occasionally
•divergent stare, indicate the partially paralyzed condition of the external
muscles of the eyeball; while more or less drooping of the upper lids expresses
a similar condition of the levator palpebrse.

" Double vision, from inability to maintain the convergence of the optic axis,
excepting as a very evanescent effect, is a comparatively rare result of the
action of Hemlock. I have only observed it in a few persons. In one of
these, a delicate invalid, confined by weakness and ovarian disease chiefly to
the recumbent position, two drachms of the Succus conii produced full effects,
accompanied by double vision. This was a constant symptom; it came on
half an hour after taking the medicine, and lasted twenty minutes.

" After having taken the Hemlock for six months, she told me, as often as I
happened to see her during the operation of the medicine, that she saw each
object in the room double, that my eyes were also doubled, and that she felt as
if she were squinting.

"Dilatation of the pupil occurs usually after only very large doses, and then
it is often but slight, and only observable in a subdued light, the excitement of
strong light overcoming the tendency to dilate, just as the exertion of a strong
will strengthens for a time an enfeebled limb.

" The absence of any preponderating action of the muscles, supplied by the
fourth and sixth pairs of nerves, shows that they are equally affected with the
third pair.

"A proportionate diminution of power is also observed in the muscles
supplied by the motor branches of \hz fifth and seventh pairs. The contractile
power of the m. orbicularis, in particular, is distinctly weakened.

" Upon the eighth pair the action of Conium is not very apparent in a state of
health ; but in the spasmodic affections, arising from irritation of this nerve, its
influence is very decided.

"As to the hypoglossal nerve, I have never observed any decided loss of
voluntary power in the tongue during the action of Conium, unless, as in
chorea, some derangement of this center pre-existed. *****

"In the absence of irritation, functional or lesional, it is equally difficult to
recognize any particular influence upon the spinal cord. Hemlock affects the
motor function of this part of the nervous system last of all, and, short of a
poisonous dose, it does not interfere with its motor activity, or reflex function
as it is called, in any appreciable degree. * * * * * * *

" When, however, there is a morbid excitability of the reflex function of the
spinal cord, the influence of Conium in subduing it is powerful and direct.

DR. HARLEY ON CONIUM MACULATUM. 439

" Conium, then, in a state of health, and in the fullest medicinal doses that
we can venture to give, exerts its power chiefly, if not exclusively, upon the
motor centers within the cranium. And of these the corpora striata, of course,
are the parts principally affected.

" Excepting, then, the reflex action of the cord, the whole motor function of
an individual, under the full influence of Conium, is actually asleep ; and this is
the simplest view that we can take of the physiological action of Hemlock. It
is to the corpora striata, to the smaller centers of motion, and to the whole of the
motor tract, precisely what Opium is to the brain of a person readily influenced
by its hypnotic action; and just as Opium tranquilizes and refreshes the over-
excited and weary brain, so does Conium soothe and strengthen the unduly
excited and exhausted centers of motor activity. * * * * *

" The influence of Conium appears to be in proportion, not to the muscular
strength of the individual, but to his motor activity. * * * A dull, inactive
child requires, to produce a given effect, only half the quantity that a lively,
active one does."

This observation is in conformity with the law ; the more
similar the symptoms the smaller the dose.

" Upon the cerebrum, Hemlock is powerless. I have never been able to
recognize the least narcotic, nor directly hypnotic, effects.

" Like the cerebrum, the sensory part of the nervous system is altogether
unaffected directly by the action of Conium. Its anodyne power in certain
diseases may be fairly attributed to muscular relaxation in the diseased parts
rather than to a direct influence upon the sensory nerves. * * *
Of its anodyne influence upon the facial branches of the fifth nerve, I have
been unable hitherto to obtain other than very doubtful evidence. * *

I think that we may trace the anydone influence, which Hemlock undoubtedly
exercises over the sensory branches of the fifth nerve, to the power that it
possesses of calming the general irritability of the motor centers. * *
Conium has no influence upon the circulating organs, upon the secretions or
excretions, or directly upon nutrition. Its influence upon the sexual functions
is traceable to a direct action upon the spinal cord."

After thus describing the physiological action of Conium,
Dr. Harley discusses its therapeutic value, giving examples
which comprise all the cases in which he has used Hemlock
alone. He gives the following general conclusion : "Hemlock
given in doses which fall far short of producing its proper
physiological action, is useless in the treatment of diseases
for which it is adpated." The homceopathist will perceive
that Dr. Harley comes to this conclusion, because he regards

440 DR. HARLEY ON CONIUM MACULATUM.

and uses Hemlock as "adapted" only to cases to which it is
enantiopathic.

" In selecting Hemlock as a remedy in the treatment of nervous diseases,
* * * we must be guided by that simple view of its physiological
action which I have now so fully stated ; and then the only question to be pro-
posed will be, is there irritation, direct or reflex, of the motor centers ? If
there be, Conium is the appropriate and hopeful remedy."

The homceopathist will ask : May there not be many
varieties of such irritation, varieties in kind, extent, and
complication ? And again : May not the results of irrita-
tion occurring in individuals of different idiosyncrasy be
very various ? And are all such varieties to find their
" appropriate and hopeful remedy " in Conium ? How con-
stantly, then, will Conium be prescribed in our daily prac-
tice ; for how few cases fail to present " irritation, direct or
reflex, of the motor centers " !

Dr. Harley gives examples of the beneficial action of
Conium in cases presenting tendencies to convulsions. A
case of epilepsy was ameliorated. Muscular tremor and
chorea were cured; but the rapidity of the cure in the
six cases of chorea is not such as a homoeopathic physician
would consider creditable. Dr. Harley does not ascribe
cKorea to a perversion of the co-ordinating function. He
doubts if there be such a function, and regards chorea as
due to " an undue excitability of the motor centers, which
throw off impressions so rapidly that the will is puzzled to
control them." If this be all that chorea is, Conium
according to Dr. Harley, should cure every case. As a
matter of fact, we see a great variety of symptoms in differ-
ent cases of chorea, and similarly we see great varieties
in the modifications which different medicines produce in
the motor functions. Dr. Harley's (the physiological) method
takes no account of such varieties. It is not broad enough
for the facts of nature with which it assumes to deal.

He proposes to use Conium in tetanus, and has employed
it in spasm of the oesophagus and stomach ; in the globus

DR. HARLEY ON CONIUM MACULATUM. 44!

hystericus ; in spasmodic cough, laryngismus stridulus, and
pertussis ; in paraplegia, and in concussions of the spine,
and in exhaustion and irritability of the sexual organs.

He speaks highly of Conium as a remedy in inflammatory
diseases of the eye, and gives six cases of "strumous
inflammation of the conjunctiva, more or less involving
the cornea and iris, successfully treated by Conium alone
and unaided by external applications. The speedy relief
from the photophobia, lachrymation, and spasm of the
orbicularis has often surprised me." He accounts for its
action on the ground, that "in producing complete mus-
cular relaxation it acts beneficially in relieving pain and
tension, and thus removing irritation." It is difficult to
believe that strumous ophthalmia (keratitis) depends on
"spasm of the orbicularis and corrugator supercilii." Con-
junctivitis palpebralis, at least, is well established, and, in
most cases, destructive keratitis has set in before the spasm
becomes a prominent symptom. Dr. Harley gives an
excellent case of this disease cured in three months by two
drachm doses of Conium every second day. I shall give
the record of a severe case cured in one month by a few
doses of Conium200.

In cancer he considers Hemlock a palliative, in that it
allays muscular spasm, and thus mitigates pain. In glandu-
lar enlargements, and in cerebral diseases, he has found no
benefit from Conium.

In these citations we have given a fair and full view of
Dr. Harley's provings of Conium, and experience in its
therapeutic use. He admits its imperfectness, but seems
to regard this as relating to extent rather than to method or
principles.

Let us now reflect a moment on this method of regarding
and stating the physiological effects of a drug. • How satis-
factory it appears to have the entire action of a drug con-
densed in one crisp generalization like this of Dr. Harley,
instead of having to read page after page of symptoms

442 DR. HARLEY ON CONIUM MACULATUM.

arranged in anatomical order ! And how easy seems the
application of such a generalization to therapeutics, possess-
ing, as we do, the law. Let us not, however, be led astray
by such fascinations ! Such generalizations are not possible
in the present state of medical science. So long as there
occur in the healthy body, phenomena physical, mental or
psychical, which we cannot fully explain by known physio-
logical processes — and there are thousands ; so long as the
sick present symptoms physical, mental or psychical, which
we cannot account for by well-understood pathological proc-
esses— and their name is legion, — so long will it be impos-
sible to reduce phenomena and symptoms respectively to a
general physiological or pathological formula. And, con-
versely, whoever, in his therapeutic philosophy includes
only such phenomena of symptoms as he can thus explain
and account for, disregarding or overlooking all others,
binds therapeutics to the slow chariot- wheels of physiology
and pathology, and forbids that more rapid progress of this
practical department of medicine which is possible under a
therapeutic law that turns to account every phenomenon of
pathogenesy, and every symptom of the patient. This will
appear more clearly when we come to study the homoeo-
pathic proving of Conium.

CONIUM MACULATUM.

The following remarks are based upon the proving pub-
lished by Hahnemann in the "Chronic Diseases," volume
iii., second edition :

General Analysis, i. The action of Conium upon the
vital power is very peculiar. It depresses the sensorium,
weakening the memory, producing mental lassitude and dull-
ness, with difficulty in expressing one's ideas; and yet,
under its action, the special senses are abnormally acute, at
least those of sight, smell and hearing. The pulse is
enfeebled and irregular, but in no other way does the invol-
untary muscular system appear to be affected. Power of
locomotion is not impaired, but extreme lassitude and
debility are manifest throughout the body, indisposing to
physical exertion. Clonic spasms of the muscles of the face,
arms and hands, have been observed.

2. There is not much in our proving of Conium that
shows a marked action on the organic substance, never-
theless Hahnemann's acute observation enabled him to per-
ceive indications for a clinical application of it, which has
demonstrated that it must possess the power to alter pro-
foundly the structure of various parts of the body ; as for
example, the glandular substance, the substance of the
cornea, the skin, and the uterus and its appendages.

Among the symptoms of Conium, those of the disposition
are very well marked and characteristic. The prover is much
depressed and disposed to weep, yet easily aroused to anger,
averse to companionship, and inclined to shun society, yet
dreads to be alone. Sexual desire in the male is easily
aroused, even by the mere presence of women, yet the

444 CONIUM MACULATUM.

sexual organs appear so much enfeebled that seminal emis-
sions take place under these circumstances, and sometimes
without erection. In like manner in the female, the menses
appear too early, but are scanty, the flow being accompanied
by many accessory symptoms, among which extreme ten-
derness of the mammary glands is very characteristic.

The muscular lassitude is most marked in the early morn-
ing ; the arms and legs feel tired and sore, the knees tremble,
and after a short walk the prover is exhausted and must lie
down. The symptoms generally are worse at night, espe-
cially the cough, and the pains are worse during repose.

With these general remarks, we pass to a more detailed
consideration of the symptoms, in anatomical order.

Conium produces the following effects upon the mind and
disposition : Depression, sadness, under which tears come
easily, excessive anxiety, or else unnatural indifference, with
depression. The prover seems sunk in thought, and is
apprehensive respecting the present or the future. Dislike of
society, and yet a dread to be alone ; — this apparently incom-
patible symptom reminds one of the incongruities of hysteria,
and has been very often verified in practice. Hahnemann
urges upon us the importance of attending to the symptoms
of the mind. This is a characteristic mind-symptom of
Conium. Upon the sensorium it produces vertigo, which is
experienced when rising from the recumbent or sitting
posture, when rising after stooping ; or, on the other hand,
when going down-stairs ; and it is often worse when lying
down — a symptom which is noteworthy in connection with
Dr. Harley's speculations upon the physiological action of
Conium. Memory seems to be enfeebled, as is likewise the
power of comprehending what one reads, or of correctly
expressing one's self. Nevertheless, Hahnemann remarks
that the provers of Conium are unusually susceptible to the
action of wine or alcohol, and we shall see that the special
senses are abnormally acute under its influence.

Of the head symptoms, we remark, first, as to the charac-

CONIUM MACULATUM. 445

ter of the pains : an aching pain, which is sometimes confined
to one side of the head, feels like a heavy downward press-
ure, and is increased by motion of the eyes ; sometimes in
the occiput, like a heaviness when one sits leaning forward;
sometimes in the temples and over the eyes, like a pressure
from within outward. Second. Tearing pains, as a morning
headache, as if the brain were torn. Third. A drawing
pain in the forehead and temples, and a piercing pain from
within outward. The headaches are generally worse during
motion and from a sudden jar or shock, such as a false step,
which sometimes produces a digging pain in the head ; and
the brain seems to be sensitive, speaking and noise producing
an unpleasant concussion in it.

In the eyes heat and burning ; itching and piercing pains
in the canthi, or a smarting as if some acrid substance had
been introduced into the eye. In the eyeball, aching,
increased by reading, and in the evening, by closing the eye.
The white of the eye is sometimes red and inflamed ; the
tears are abundant, overflowing the lids, and are very acrid.
The lids are thick and inflamed, pustules appearing upon
them. The special sense is variously affected. Photophobia
is among the symptoms. A short-sighted prover was
enabled to see much farther than usual. Transient blind-
ness, or dimness of vision, was noted by others; while
others describe appearances as if threads or white clouds
or luminous spots were moving in front of the eyes, and as
if when reading, the lines upon the printed page moved up
and down. These eye-symptoms, produced upon the
healthy, afford us a more valid reason for using Conium
in strumous ophthalmia than Dr. Harley's physiological
explanation of its action could do.

In the inner ear, sharp shocks from within outward were
felt when swallowing, and piercing pains and aching ; pain-
ful tension behind the ear and piercing pains in the mastoid
process. The cerumen was blood-red in color ; the special
sense abnormally acute, and painfully so, every noise caus-

446 CONIUM MACULATUM.

ing the prover to start. The provers complained of rushing,
roaring and ringing noises in the ear, with throbbing, as of
the pulse; when blowing the nose the ears feel as if
obstructed.

The sense of smell is very acute, perhaps perverted ; a
prover -stating that he seemed to smell tar, as though it were
in the posterior nares.

On the lips, vesicles appear near the vermilion border,
and are very sore.

Drawing pains and fine stitches in the gums and teeth.
The toothache is aggravated by cold food ; the gums bleed
easily, and the teeth feel as if they were loose ; the tongue
is dry and swollen ; deglutition difficult and painful, from
soreness of the throat. Speech is difficult, probably for the
above reasons.

Appetite is diminished ; the taste is not blunted, but
provers complain of a sour, foul or bitter taste, especially in
the throat Eructations occur, sometimes tasteless, some-
times sour or offensive, or tasting of the food; sometimes
they are incomplete and produce pain in the stomach.
Nausea and vomiting of mucus occur, sometimes early in the
morning, sometimes after eating, sometimes toward evening.

Digestion is much disordered, as we see by the symptoms
which occur soon after eating ; rapid distension of the abdo-
men after eating only a little milk ; distension in the epigas-
tric zone after eating but little ; it impedes respiration ;
nausea, vomiting and hiccough after eating ; sour taste and
eructations, and rising of sour liquid in the mouth after
eating. Aching and pressing in the epigastrium. It extends
from the epigastrium up to the pharynx, and feels as if a
ball were rising to the throat. Other parts of the organism
are affected at the same time. After eating, provers men-
tion aching in the back of the neck, vertex and forehead,
with nausea ; a gentle heat seems to pass from the stomach
through the arms to the fingers, and then the hands appear
as if dead.

CONIUM MACULATUM. 447

t
In the right hypochondrium 'an aching increased by

inspiration ; in the left hypochondrium, an aching tension,
extending lower down in the abdomen, with a sensation of
heaviness throughout the abdomen.

In the abdomen, a constrictive pain, with an involuntary
drawing of the abdomen up toward the thorax, and a press-
ing and aching pain. Cutting and piercing pains in the
abdomen, with some degree of sensibility to pressure, are
noted, along with the accumulation of flatus in the intestines.
Pains in the groins as if swollen.

As regards the stool, we find under Conium frequent desire
for an evacuation, with scanty discharge or none at all ; also
liquid diarrhoeic stool with colic, discharge of flatus, and
much mucus, or undigested food, or even blood. At night
the evacuations are involuntary. The stools are preceded
by cutting in the abdomen and accompanied by burning,
pressing or cutting pains in the rectum ; and are followed,
whether they are diarrhceic or not, by a sensation of
general weakness and trembling, or even faintness.

The urine is high-colored, and there is frequent desire to
pass it, and the stream is interrupted ; there is a spasmodic
pressure in the region of the neck of the bladder, and a
sharp, piercing pain from without inward after urinating;
severe cutting pains in the urethra during the act of passing
water. Passing water does not relieve the desire to do so.
In women, when passing water, pressure upon the uterus
and cutting pains.

In the male sexual organs, cutting pain through the
scrotum to the root of the penis; pressing and tearing pains
in the testes; frequent emissions of semen at night and
even during the day, excited by the presence of women ; on
the other hand, deficient erections or complete impotence.

In the female sexual organs, violent itching of the
pudenda, and even within the vagina, day and night for a
good while, most just after menstruation. The menses
appear too soon, but are scanty; they are preceded by

448 CONIUM MACULATUM.

dry heat over the whole body, anxious dreams, and a
depressed and anxious state of mind, and by piercing pains
in the region of the liver ; worse when lying down at night,
or on inspiration.

Leucorrhoea occurs, of a white acrid mucus, which
produces much burning, and is preceded by pain in the
abdomen.

In the respiratory organs, we notice a catarrhal condition ;
abundant discharge of mucus from the nose, with hoarse-
ness, rawness of the throat and cough. The cough, which
is forcible and frequent, appears to loosen some mucus in
the chest, which, however, the patient cannot expectorate
until some time has passed, when a slight cough brings it up.
In the throat, a constant tickling and itching, provoking
a dry, teasing cough. The cough becomes worse on lying
down at night, and even threatens to end in vomiting ; it
produces shocks in the head and pain in the abdomen.
These cough symptoms, especially the teasing, dry cough
on lying down at night, have often been verified in practice.

Respiration is short and labored, especially inspiration ;
pains of various kinds are described, as cutting pains in both
sides of the chest, increased by inspiration ; tension and
weakness in the chest ; palpitation of the heart, especially
after drinking ; it is visible to others as well as felt by the
prover.

The mammae are hard, very painful to the touch (espe-
cially during menstruation), with stitching pains, at night, in
them. The nipples itch, and when rubbed, burn.

In the back are observed, in the sacral region and between
the scapulae, stitches and tensive drawing pains, much
increased by moving the arms upward ; severe aching in
the sacral region from walking a short distance, followed by
nausea and lassitude ; stitches in the sacrum when standing,
with drawing through the lumbar vertebrae.

In the extremities, lassitude and weakness, more marked
in the lower extremities, with numbness of fingers and toes,

CONIUM MACULATUM. 449

the former looking as if they were dead. There are also
piercing and tearing pains throughout the extremities and in
the joints, particularly in the elbow and hip joints.

Conium appears to produce disposition to sleep, in the
early morning and by day, so great as to be almost irresist-
ible. The sleepiness continues in the evening, yet the
prover does not get to sleep until late, and the sleep during
the night is disturbed and interrupted, and attended by heat
of the body and twitching of the arms and hands, and much
depression, with disposition to weep, and by bad dreams.
As before remarked, the sleep is prevented and interrupted
by dry, teasing cough — a symptom which has received
numberless clinical verifications.

Of fever, no well-marked paroxysms are described. A
coldness, without thirst, occurs in the morning, with vertigo
and depression of spirits ; slight heat in the afternoon, with
thirst, attended by relief of the head symptoms ; sweat in
the evening, quite abundant during the first sleep ; or dur-
ing the night ; sweat only of the legs ; or, again, sweat early
in the morning on awaking, of the legs, although they are
cold. The pulse is irregular, as regards both force and
frequency.

Upon the skin, Conium produces on various parts of the
body a fine, hardly visible eruption, which itches considerably.

Ulcers already existing in provers assume, under its
action, a blackish color, discharge an offensive ichor, and
bleed and pain. Swollen glands become the seat of piercing
pains and soreness.

Before we proceed to consider the therapeutic applications
of Conium, it will be interesting to turn to Dr. Harley's
statement of its physiological effects, as observed by him. ]
He comprises its entire action in this brief statement:
" Conium, then, in a state of health, and in the fullest
medicinal doses that we can venture to give, exerts its
power, chiefly, if not exclusively, upon the motor centers

1 See previous Article.
30

450 CONIUM MACULATUM.

within the cranium. And, of these, the corpora striata, of
course, are the parts chiefly affected."

The peculiar symptoms of the mind and disposition, the
abnormal acuteness of the special senses, the characteristic
concomitant symptoms of the stool, are not mentioned in
his record ; perhaps because the doses which he used in
proving were so large that the violent symptoms provoked
by them masked such subjective phenomena as these ; per-
haps, and probably, because they were not susceptible of
physiological explanation, and could, therefore, have no sig-
nificance and no therapeutic value for him. We, fortunately,
have a means of applying to therapeutic uses, symptoms to-
which we have not yet found the physiological key. Our
therapeusis, therefore, is not held back by the short-comings
of our pathology, however greatly it might be re- enforced
by the perfection of that science.

Therapeutic Applications. As might be inferred from the
symptoms, Conium has been frequently and successfully
used in mental affections. Elwert reports1 a case of insanity
which had for two years been unsuccessfully treated allo-
pathically. The peculiarity of the case was the regular
alternation in the condition of the patient. For ten days he
would be depressed, melancholy, taciturn, fearful, with rest-
less nights ; the succeeding ten days excited, violent, irri-
table, mischievous. Conium8, a dose every fourth day.
He seemed well after the second dose, but the remedy was
continued, as a precautionary measure, for several months,
in smaller and less frequent doses.

Elwert reports2 another case of melancholy with enlarged
spleen, cured by Conium.

I have had occasion, more than once, to prescribe for cases
in which, although there was evidently uterine disease exist-
ing, yet no characteristic indications for treatment could be
found in the uterine symptoms.

lAIlgemeine Homteopathische Zeit- *Allgemeine Homceopathische Zeit-
ung, ix., p. 196. ung, ix., p. 198.

CONIUM MACULATUM. 451

The peculiar mental symptoms — depression, timidity,
taciturnity, aversion to society, and at the same time a
dread of being alone — induced me to give Conium, with
very satisfactory results, as regards both mental and uterine
symptoms.

In affections of the eyes, Conium has been much and
satisfactorily used. Tiilff says,1 speaking of hordeola :
" Conium will be useful where the trouble recurs ; where
several hordeola become indurated, and, on occasion, inflame
again." He places Staphysagria beside Conium in this
regard. Its chief application, however, has been in scrof-
ulous ophthalmia.

Knorre says:2 "Photophobia is either a symptom of
inflammation of the eye, or an independent, purely nervous
condition of the eye, without participation of the vascular
system. In the latter case the photophobia is often con-
joined with spasmodic closure of the lids. When it is
impossible to open the lids, the inflammation of the lids is
generally an index of inflammation existing within the eye.
Usually, the scrofulous photophobia is conjoined with a pale
reddish discoloration of the globe of the eye, which appears
like a projecting seam around the cornea, or else there are
visible only a few scattered blood-vessels in the conjunctiva.
It is wonderful how quickly and certainly Conium relieves
such cases ; but where the inflammation predominates and
the photophobia is not so marked, Conium is not so effica-
cious.

Knorre, Frank, Segin, Marschall and Thorer publish in the
Allgemeine Homoeopathische Zeitung, and in Hygea and Prakt-
ische Beitrdge, cases illustrating the action of Conium in
strumous ophthalmia. In all of these cases, the photophobia
was the prominent symptom. In most of them, the flow of tears
.was excessive and the liquid acrid, producing much inflam-
mation of the lids; ulcers and obscuration of the cornea

1 Homceopathische Vierteljahrschrift, * Allgemeine Homceopathische Zeit-
iii., p. 195. ung, v., p. 88.

I- K \ S t C

452 CONIUM MACULATUM.

were noticed in some cases. In this connection, the follow-
ing case may be of interest :

A girl of six years had been treated three months for
"ulcer of the cornea," by applications of a crystal of sulphate
of copper, and was brought to me in the following condition :
The eyes were forcibly closed ; the head bent down and,
when possible, buried in a pillow or in the mother's dress,
to avoid the light. On any attempt to open the l|ds, a
copious flow of tears gushed out, and the spasmodic closure
was so firm that I could not get a view of the globe of the
eye. If the lids were forcibly separated, the eye was rolled
upward so as to hide the cornea. The sclerotic was not
deeply colored; the conjunctiva palpebralis thick, dark-red
and velvety. The edges of the lids were thickened, excori-
ated and covered with light scabs. I had to accept the
statement of my allopathic predecessor that there was a deep
ulcer on each cornea.

The general health was good. I gave Conium200, a dose
every night. In one week the photophobia had so far
diminished that I could get a view of the cornea. A
large but not deep ulcer was visible on the right cornea, a
smaller one on the left. Lachrymation much less; the lids less
inflamed. The Conium was continued, but less frequently.
In one month from the beginning of treatment, the photo-
phobia had ceased ; the ulcers were healed, leaving a pearly
opalescence in the right cornea, which, from observation of
other cases, I think will disappear within a year or two.

Had there been disorder of the digestion and constipation,
such as clearly to indicate Nux vomica in this case, I should
have given it, and expected, under its action, great
amelioration of the photophobia; such having been my
experience in cases of this kind.

Rentsch reports 1 two cases of deafness, in both of which the
deafness had been preceded and was accompanied by symp-
toms of disorder of the liver. The deafness seemed to depend

1 Allgemeine Homaopathische Zeitung, xxxviii., 92, and xxxviii., 90.

CONIUM MACULATUM. 453

on accumulation of hardened and dark cerumen, which,
being removed, and Conium administered, the deafness passed
away. It would appear that the deafness depended on the
accumulation of cerumen, and was cured by its removal; but
it is noteworthy that the liver symptoms ceased under the
action of Conium, and that the cerumen did not accumulate
again.

Kammerer reports x a case of " cancerous ulcer " of the
lower lip, from pressure of tobacco-pipe, promptly healed,
under the internal and external use of Conium first.

Caspari relates2 a similar case — scirrhus of the lower lip
of two years' standing, already ulcerated. Under Conium 15
the ulcer healed and the tumor diminished. Six weeks
after treatment began, however, the patient had the tumorv
removed by a surgeon. How far the favorable action of
Conium could have availed in this case, we are, therefore,
unable to know.

In Gastralgia, Dr. Werber states3 that he has found Conium
always an excellent remedy, where there was a tendency to
constipation, the patient being of lymphatic constitution;
and he relates a case cured by it, speedily, the symptoms
being: painful spasm of the stomach, a feeling as if the
stomach contracted, or of a heavy burden upon the stomach ;
she could not bear tight clothing ; the pain never entirely
ceased, but was sometimes moderate, and then gradually
became very severe ; tendency to constipation ; an obstinate,
wearisome, spasmodic cough, which aggravated the gastralgia,
the cough increased by talking, running, and by emotion.

Dr. Gauwerky reports a cure of cancer in the stomach,
and Dr. Stens of cancer on the lip, with Conium ; the details
not given.4

Drs. Biirkner and Heil report5 cases of cancer of the

1 A rchiv, viii., part 2, p. 70. * Allgemeine Homaopathische Zeit-

* Archiv, iv., part 2, p. 24. ung, xliv., p. 7°-

3 Hygea, vi., p. 321. 6 HirschePs Zeitschrift, iv., pp. 67,

58, I30-

454 CONIUM MACULATUM.

stomach and perforating ulcer of the stomach respectively,
in which the diagnosis can hardly be questioned, and which
were ultimately fatal. Conium, however, caused such
marked improvement in both cases, that we may suppose
they might have been cured, had they come under treatment
earlier.

Dr. Battmann reports1 a case of enlargement of the
mesenteric glands, ending in suppuration and a large abscess,
which was opened near the umbilicus. The patient was
terribly reduced, the abscess continued to discharge and the
tumor to grow until Conium was administered, when
improvement set in and the boy rapidly recovered.

In enfeebled conditions of the male sexual organs, whether
these result from self-abuse or from excessive venery,
Conium has proved a valuable remedy. Lobethal, Ehrhardt,
Marschall, Hartmann, bear witness to its value.

I have used it successfully where, along with weakness,
there also was much sexual erethism, amatory thoughts
occurring and even emissions being provoked by the mere
presence of women, to the great annoyance of the patient.
In this regard, Conium belongs to the same group as Sepia,
Selenium, and Gelseminum.

Hahnemann 2 suggests that Conium would be an efficient
remedy in that kind of hypochondriasis which befalls
unmarried men of chaste habits. It is singular that Dr.
Harley should have been led to hold similar views. (Or is it
not?)

Griesselich 3 says that Conium relieves delayed and scanty
menstruation, accompanied by symptoms which point to
congestions in other organs, and especially when the
mammae are lax and shrunken.

Hartmann says:4 "Conium is an excellent remedy when
menstruation fails to appear, but instead thereof, every four

1 Allgemeine Homceopathische Zeit- 3 ffygea, xxi., p. 195.
ung, liv., p. 163. * Therapie, ii., p. 610.

* Materia Medico. Pur a, iv., p. 238.

CONIUM MACULATUM. 455

weeks, th'ere is great sensitiveness of the outer and inner
pudenda; constant dry heat of the body, without thirst;
with anxious dreams and heaviness in all the limbs ; disposi-
tion to weep ; res'tlessness ; anxious care about every trifle ;
and piercing pain in the region of the liver, often lasting
several days, and much enfeebling the whole body." I
would add to the above, tenderness of the mammae.

Hartmann likewise says : " In the hysterical attacks and
spasms no remedy is more suitable than Conium often is.
Most of the symptoms in these cases originate in the sexual
system. The patients often complain of itching in and
about the pudenda, with pain like the downward pressure
of the uterus, and stitches in the vagina ; menses suppressed
or deficient; leucorrhoea acrid, with frequent constricting
pains in the abdomen ; pressure in the oesophagus, as if a
ball were rising from the stomach to the pharynx ; depres-
sion ; discontent ; disposition to weep when alone. Palpita-
tion and pain with every pulsation, as if a knife were thrust
through the occiput, with irregular pulse.

Clinical experience has shown the power of Conium
to arrest the growth of fibrous tumors of the uterus, as I
have had several occasions to observe. The indications
must, in such cases, be derived from the concomitant
symptoms. One which I have several times observed, and
which has led me to the successful use of Conium, is this :
"Symptom 441, after every stool, trembling weakness."

Tumors of a suspicious nature in the mammae have been
caused to disappear by the use of Conium. They are
generally the seat of piercing pains, much worse at night.
The rest of the gland is abnormally tender. I have had
several such cases.

Hartung reports l a " tumor of the right mamma, of a
stony hardness, irregular surface, the seat of stitching pains ;
upon it a raw, irregular, moist elevation ; swelling of the
axillary glands. All disappearing under Conium.

1 Hygea, xxiii., 135, from Fragmenta der hinterlassenen Schriften.
Hahnemanri's.

456 CONIUM MACULATUM.

Caspari reports a scirrhus of the left breast following a
blow, cured by Conium.

In a case of mine in which Conium relieved the pains,
but did nothing more, Clematis erecta caused the disappear-
ance of the tumor.

The action of Conium in curing spasmodic, dry cough,
worse in the evening and at night, and greatly fatiguing the
patient, is witnessed by many writers. Hartmann,1 Kase-
mann,2 Hirsch,3 Mayrhofer,4 Hartmann.5 I have, myself,
very often observed its happy action in such coughs. Like-
wise, in whooping-cough, it has been frequently used with
good effect; chiefly, I think, however, when, upon the
spasmodic affection a sub-acute bronchitis had supervened,
attended by a cough of the above character.

Hirschel relates6 that a tuberculous youth had, for a long
time, a tickling cough, dry, provoked by a spasmodic tick-
ling in the larynx, which was not tender on pressure. The
cough came on about six P. M., continued several hours, and
was very wearisome. Conium2, one dose, cured the cough.

Schwenke reports7 a singular case. In a lad of thirteen
years, a noise, apparently from the larynx, like tha — h,
tha — h, was heard, with respiration so loud and disturbing
that he was dismissed from school. The muscles of the
right side of the face were subject to spasmodic twitchings,
which preceded an increase of the noise. He also com-
plained of spasmodic pressure in the region of the glottis ;
swelling of the glands. Conium6 effected a permanent cure.

Cures of eczema are reported by Hartlaub, Seidel and
Schron.

Enlargement and induration of the glands, in whatever
locality, find in Conium, according to Hartmann, their most

1 Therapie, i., 115. 5 Allgemeine Homocpathische Zeit-

* Hygea, x., 359. ung, ii., 109.

3 Allgemeine Homaopathischc Zeit- 6 Zeitschrift, i., 77.

ung, iv. , 308. 7 Allgemeine Homceopathischc Zeit-

4 Hygea, xviii.,495. ung, lx., 152.

CONIUM MACULATUM. 457

frequently efficient remedy ; a statement confirmed by much
clinical testimony.

These citations might be widely extended. What has
been said will suffice, however, to show the application of
Conium, according to the Homoeopathic law, and will
suggest an interesting comparison with Dr. Harley's paper.

REMARKS ON MEZEREUM.

The late Dr. Wahle, of Rome, one of the most distin-
guished, of Hahnemann's own pupils, and well known by his
acquirements in the science of Materia Medica, considered
the proving of Mezereum, which was first published in the
fourth volume of the Archiv, to be both erroneous and
defective.

It is no very uncommon thing to find a Homoeopath who
considers a portion or the whole of our Materia Medica
defective. But the peculiarity which distinguished Wahle
was this : whenever he saw an error or a defect, he thought
it his duty rather to go to work and correct the error or
supply the defect, than simply to expose them and denounce
the Materia Medica, taking credit meanwhile for his own
acuteness. Accordingly, he instituted a new proving of
Mezereum, of which a number of the symptoms are here
given. They were given me by his son, the present Dr.
Wahle, from whom we may expect a volume of his father's
provings when peace and liberty shall prevail in the Papal
States !

Scalp and Face.

1. The head is covered with a thick, leather-like crust,
under which thick and white pus collects here and there,
and the hair is glued together.

2. OD the head, great, elevated white scabs, under which
ichor collects in quantity, and which begins to be offensive
and to breed vermin.

3. The scabs on the head look chalky, and extend to the
eyebrows and to the nape of the neck.

REMARKS ON MEZEREUM. 459

4. Gray, earthy complexion.

5. The child scratches the face continually; it becomes
covered with blood. The face and forehead are red and
hot, with great restlessness and peevishness. In the night
the child scratches its face so that the bed is covered with
blood in the morning; and the face is covered with a scab
which the child keeps constantly tearing off anew, and on
the spots thus left, raw, large, " fat " pustules form.

6. The ichor from the scratched place excoriates other
parts.

7. The skin of the face is of a deep inflammatory redness,
and the eruption is " fat " and moist. (Impetigo.)

8. A honey-like scab around the mouth.

Kidney.

9. Sticking in the kidney and pain as if torn.

Menses.

10. Menses too frequent, and lasting too long.

Larynx.

1 1 . In the larynx a tickling as if with a feather, which
causes coughing. When he has eaten anything he must
cough until he vomits it up again. The vomited matter is
sour or bitter.

12. Cough, with retching and scratching, or scraping in
the pit of the throat, as if something sweet lay there which
cannot be coughed up.

13. Between six and seven A. M. moderate cough — at no
other time.

14. Dry cough day and night, with emaciation and loss
of strength, with tensive pains across the thorax.

15. Sticking in the right side of the thorax.

(Note by Dr. Wahle. Mezereum cures no small propor-
tion of cases of whooping-cough.)

460 REMARKS ON MEZEREUM.

Inferior Extremities.

1 6. Between the Glutaei, four large scabs surrounded by
dark redness and on hardened bases.

17. Itching in the hollow of the right knee.

1 8. Pains in the periosteum of the long bones, especially
the tibiae, worse at night and in bed ; at this time the least
touch is intolerable.

19. The whole shin is covered with elevated white scabs.

General.

20. Itching and burning in the arms and legs, and, on
scratching, violent stickings as with needles.

21. The fiery red inflammation of the knuckles of the left
foot extends over the instep and calf, and hard tubercles
form in the cellular tissue, which itch on the slightest touch,
and violent burning pains ensue.

Skin.

22. Blotches break out over the whole body.

23. Eruption — pale red, itching after scratching. The
scabs are adherent and depressed in the center.

24. Ulcers, covered with thick, whitish, yellow scabs,
under which thick yellow pus collects.

25. Throbbing around the ulcer, and, encircling it, a
bright red areola with burning pain.

26. In the ulcers, burning pain in the evening in bed.

27. Around the ulcers, fiery red areolae, shining like a
mirror.

28. Vesicles appear around the ulcers, itching violently
and burning like fire. After eight days these vesicles dry
up, leaving scabs, the tearing off of which causes great pain
and retards the healing.

29. The parts affected feel, on being touched, as if
swollen, which is not the case.

30. Linen or charpie sticks to the ulcers ; when it is torn
away they bleed.

REMARKS ON MEZEREUM. 461

These symptoms suggest at once the applicability of
Mezereum to Crusta lactea, to various forms of pure Impeti-
go, and to some of those mercurial or mercuric-syphilitic
ulcers on the lower extremities which often prove so difficult
to cure. I have frequently had occasion to witness the
prompt curative action of Mezereum in these affections, in
which I have generally used the two hundredth potency.
This has proved efficacious in cases in which the lower
dilutions have been inert.

The characteristics of the Mezereum skin-diseases are
well defined in the above symptoms, viz. :

Itching occurring in the evening when in bed, aggravated
and changed to burning by touch or by scratching. Sensi-
tiveness to touch.

Ulcers with an areola, sensitive and easily bleeding, pain-
ful at night; the pus tends to form an adherent scab, under
which a quantity of pus collects. A close relationship is
shown by these symptoms to exist between Mezereum and
Arsenicum, Asafostida and Mercurius.

DEAFNESS CURED BY MEZEREUM.

G. W. W., aged seventeen years, small, but well pro-
portioned and of good constitution, healthy since his ninth
year, has been deaf since he was four years old. When
three years of age, he had an eruptive disease of the whole
scalp, which, after resisting for a year all the milder
methods of allopathic treatment, was finally caused to disap-
pear, in the following manner : A tar-cap was placed upon
the head, and when firmly adherent to the scabs, was violently
torn off. The scabs came with it, leaving the whole scalp
raw. This raw surface was moistened with a saturated
solution of nitrate of silver. The eruption did not re-
appear ; but from that time the child was deaf.

"The condition of the youth now excites the earnest
solicitude of his friends. His inability to move in society,
or to get a situation in business, on account of his deafness,
has produced a morbid state of mind. He broods over his
infirmity, and secludes himself even from his own family."

Under these circumstances, he applied to me to be cured
of his deafness. His present condition is as follows : He
is quite unable to hear ordinary conversation, and has never
heard a sermon in his life. A loud-ticking lever watch can
be heard at a distance of three and a half inches from either
ear. On application of the watch to his forehead, or to the
teeth, he hears it distinctly. Occasional buzzing noises in front
of the ears. A physical examination of his ears reveals the
following condition : The external meatus is abundantly sup-
plied with soft, normal wax. The membrana tympani is white,
opaque, and evidently thickened. When the patient attempts
to inflate the middle ear (which he accomplishes, with great

DEAFNESS CURED BY MEZEREUM. 463

difficulty, by closing both mouth and nose and making a
forcible expiration), the membrana tympani becomes but
very slightly convex, and it is impossible to distinguish
its distended blood-vessels. There has evidently been a
deposit in the substance of the membrane. On examination
of the throat, it appears that the orifice of the eustachian
tube is free.

Feb. 3, 1857. Patient received a powder containing
three globules of Mezereum30, to be taken on retiring.

Feb. 24. Thinks he hears better — "every sound seems
much louder than before." Hears my watch at a distance of
four and a half inches from the right ear, and four and a
quarter from the left ear. Saccharum lactis.

March i. Has not improved during the last week. Meze-
reum30, three globules.

March 27. Hears my watch, with the right ear, six and
a half inches, and with the left ear, seven inches. Saccha-
rum lactis.

April 20. Hears my watch, with the right ear, at a
distance of ten inches, and with the left, at a distance of
fourteen inches. Hears ordinary conversation easily, with
attention. Saccharum lactis.

Sept. 28. Has been steadily improving until three weeks
ago, when he became more deaf again, without apparent
cause. Mezereum30, three globules, on retiring.

Jan. 26, 1858. Hears my watch at a distance of fourteen
inches from the right ear, and twenty-four inches from
the left ear. Deafness returns when he takes cold, but
disappears with the cold. Mezereum30, three globules, on
retiring.

March 19. To his surprise, on going to church, although
seated at the extreme end of a very large building, he dis-
tinctly heard the whole sermon — for the first time in his life.
On physical examination, the opacity of the membrana tym-
pani is found to have disappeared, and its elasticity to have
sensibly increased.

464 DEAFNESS CURED BY MEZEREUM.

May 24. Patient writes me that he has obtained, with-
out difficulty, a situation in a store, and that he is no longer
conscious of being deaf. His sole difficulty is that, as he has
the reputation of being deaf, everybody shouts at him.
His father writes, that the son's hearing is " perfectly
restored."

REMARKS. The success of the treatment resorted to in
this case warrants a few remarks upon its rationale. Here
was a case which presented to the practitioner apparently
nothing on which to base a prescription. There was a thick-
ened membrana tympani — nothing more. The work of
thickening had probably been accomplished years ago. Here
was a pathologico-anatomical condition, but no pathological
process and, consequently, there were no abnormally per-
formed functions — or, in other words, no symptoms of
disease — from which to draw indications for the treatment.
The pathologico-anatomical condition threw no certain light
on the pathological process which had produced it — just as
a knowledge of the town, at which a traveler has arrived,
gives no certain clue to the road by which he reached it.

But, as Hahnemann advised his disciples, the history of a
case is often of the utmost importance in determining the
treatment. In the case before us the coincidence between
the violent removal of the tinea capitis by nitrate of silver,
and the appearance of the deafness, was too marked to
escape notice. It could not fail to occur to the practitioner
that the scalp disease was one phase of a psoric affection, as
Hahnemann would have called it, or of a dyscrasia, as the
modern school of German pathologists would say (for the
doctrine of the dyscrasias is but a rehash of Hahnemann's
psora theory), and that this affection, disturbed in its locali-
zation upon the scalp, had transferred itself to the tissues of
the ear. It further occurred to me that, since in this latter
localization there were no sufficient indications for a pre-
scription, I might find such indications in the phenomena of

DEAFNESS CURED BY MEZEREUM. 465

the former localization upon the scalp. I accordingly
addressed myself to the task of getting a complete picture
of this affection, which had disappeared thirteen years before.
By good fortune, the mother of the patient was possessed
of a good memory, and of very excellent powers of descrip-
tion, and from her I learned that " thick, whitish scabs, hard
and almost horny, covered the whole scalp. There were
fissures in the scales, through which, on pressure, there
exuded a thick, yellowish pus, often very offensive. There
was great itching, and a disposition to tear off the scabs
with the finger-nails — especially troublesome at night"

The remedy which corresponds most closely, in its patho-
genesis, with the above group of symptoms, is undoubtedly
Mezereum. In the introduction to the proving of that drug,
in the Chronic Diseases, vol. iv., Hahnemann recommends
it for moist eruptions of the scalp. In the proving, in the
Archiv, vol. iv., many symptoms point to a similar erup-
tion— itching, especially, at night; but the conclusive group
of pathogenetic symptoms is the following, from a new
proving of Mezereum, by the late Dr. Wahle, of Rome, of
which the manuscript was shown me by his son, the present
Dr. Wahle :

" Head covered over with a thick leather-like crust, under
which thick white pus collects here and there, and the hair
is glued together; on the head, great, elevated, irregular,
white scabs, under which pus collects in quantity, and
becomes offensive and breeds vermin. The child keeps
scratching its face and head at night, and continually tears
off the scabs."

The resemblance between these groups of symptoms was
so striking that Mezereum was at once selected as the
remedy for this case of deafness, just as if the scalp affection
had been still in its original, form, and had been the imme-
diate object of the prescription.

It not unfrequently occurs that we are called upon to
prescribe for what seem rather results, of morbid actions,
31

466 DEAFNESS CURED BY MEZEREUM.

than active diseases. In such cases it would seem that we
may often successfully base a prescription upon the symp-
toms of a diseased condition which no longer exists, but
which form in reality a part of the case. It may not be
amiss to call attention to the completeness of the corrobora-
tion which this case affords (were any needed) of Hahne-
mann's psora theory. It is hardly necessary to say that
Hahnemann had no idea of restricting the appellation psora
to itch, as we understand that term, that is to the disease
caused by the acarus. On the contrary, in his Chronic
Diseases, vol. iv., he expressly includes under it various
forms, as "Itch, Tinea Capitis, Herpes, etc."

CROUP CURED BY BCENNINGHAUSEN'S
POWDERS.

On the evening of January 24th, I received a message to
the effect that a little boy, aged eighteen months, fat and
healthy, was slightly feverish, and somewhat hoarse. I was
requested to send some medicine. I sent a powder of
Aconite12, mentioning to the messenger that croup might
perhaps be threatening, and requesting to be sent for on the
first indications of that disease. The next morning I was
told that the child was not much better, and was requested
to visit it in the course of the day. I went immediately.
As soon as the hall-door was opened, I heard the hoarse
ringing respiration of the child, which was in the second
story, and which I found sitting up in its crib, with an
expression of great anguish, breathing at the rate of 35 in
the minute and with great labor. There was but little cough;
occasionally, an effort which resulted in a hoarse dry bark,
but which was immediately suppressed, apparently because
it interfered with respiration. The face was turgid and of a
purple hue. The hands were frequently applied convul-
sively to the larynx, but as a general thing the child was
quiet, looking with pitiful appealing eyes to the by-stander as
if for aid. The skin was hot and dry except on the fore-
head, which was moist and cool, pulse hard, not full, 130.
On saying to the mother, " The child is exceedingly ill," I
was told, " He has been as bad if not worse all night." He
had vomited once, about an hour before my arrival, bring-
ing up a small piece of tough membrane.

Here was a case of membranous croup of great severity,
which had been in full blast at least twelve hours before I

468 CROUP CURED

was called to it ; in which the purple turgid face and the
exhausted aspect of the child showed that the powers of
life had already begun to fail under the imperfect decarboni-
zation of the blood. Considering the gravity of the case,
and its long duration before treatment was begun, I hesitated
to give the powders recommended by Bcenninghausen, but
gave at once Bromine, first centesimal, in water, a tea-
spoonful of the solution every fifteen minutes.

At the end of two hours the child was in no respect
better; the pulse was weaker and more frequent; there had
been no relief for an instant to the labored character of the
respiration, which numbered now 40 in the minute. I gave
Hepar sulphuris, second trituration, alternately with the
Bromine. At the. end of two hours there was still no change
for the better ; the disease was steadily advancing, as it
seemed, to a fatal termination. Already it had reached a
point at which I have seen both Guersant and Trousseau at
the Enfans Malades refuse to perform tracheotomy, on the
ground that the disease had, by its long duration, so pre-
vented oxygenation of the blood and consequent renovation
of tissues that a favorable issue could not be hoped for.
I determined now to give the Bcenninghausen powders ;
waiting therefore a half hour from the time at which the last
dose of the Hepar was given, I gave a powder of Aconite200,
to be followed at intervals of a half hour by Hepar 20°,
Spongia200, and this series repeated (the method indicated
in a foot-note to my translation of Boenninghausen's article).1
It was now 5 P. M., a time of day after which croup gen-
erally begins to be aggravated. At 7 o'clock the child was
greatly relieved, respiration 30 in the minute, much less
labored, the sound softer, cough rather more frequent and
somewhat loose in sound. I left a second series of the pow-
ders to be taken at intervals of one hour. The child slept at
ii P. M., and at intervals during the night, and the next
morning was so much better that it seemed unnecessary

1 American Homoeopathic Review, vol. ii., p. 212.

BY BCENNINGHAUSEN'S POWDERS. 469

to give more medicine, although I left a series of the pow-
ders to be given in case of a relapse. They were not given,
however. The child recovered rapidly without relapse or
sequelae of any kind, and on the fifth day was as well as
usual.

This was unquestionably the most severe case of croup
that I have ever seen recover in this or any country.
Judging from my experience with Bromine and Hepar in
other cases, I have no hesitation in saying that, not acting
more evidently and more promptly than they appeared to do
in this case, nothing whatever was to be hoped for from them.
In croup, if they act beneficially at all, they do so promptly.
It seems impossible, therefore, to ascribe the recovery of this
child in any degree to these remedies or tq^deny the curative
action of the Bcenninghausen powders.

CHRONIC DIARRHCEA CURED BY A SINGLE
DOSE OF A HIGH POTENCY.

Charles C , aged ten years, has had diarrhoea ever

since he was four years old ; has been subjected to various
modes of treatment, including the Homoeopathic, but with-
out any material benefit. He is of good height for his age,
but is emaciated to an extraordinary degree ; — not only are
his tissues utterly devoid of fat, but the muscles are wonder-
fully attenuated^- — my thumb and finger meet with ease
around the middle of his arm. Nevertheless, he is active
and full of fun. His appetite is prodigious ; thirst very
great ; he complains of distress in the epigastric region,
which is much greater just before a stool, compelling him to
press his hand upon that region and bend forward ; this is
relieved to some extent by a movement of the bowels. The
epigastrium is sensitive when touched. The abdomen is
greatly distended ; this is habitual ; it is hard and tympa-
nitic; by forcible manipulation, one can detect hard ovoid
bodies, deep in the abdomen, as large as a pigeon's egg.
The number of stools in twenty-four hours varies from five
to twenty. They are copious, pappy, of a dark greenish-
brown color, quite offensive. They occur chiefly during a
period from 4 A. M. to noon — seldom after noon or before
midnight. Though so copious, they do not produce faint-
ness or a sense of weakness, nor does the boy complain of
debility, although aware that he is not so strong as other
boys of his age. On the contrary, he is lively and full of
mischief, his chief complaint being of the very frequent pain
in the upper part of the abdomen, which he describes as a
" grumbling pain," and sometimes, " a very sharp squeeze."

Of the particulars of his previous treatment I could learn

CHRONIC DIARRHCEA CURED. 4/1

but little. During the summer preceding my first visit to
him he had been under homoeopathic treatment (not in this
village1), and I was told that he had taken a good deal of
Arsenicum, which, however, to the great surprise of his phy-
sician had done him no good.

And, indeed, on a hasty review of the symptoms, it might
seem extraordinary that Arsenicum should have failed to
cure the case. The dark, pappy, offensive stools, preceded
by tolerably acute pain in the abdomen, with great and
excessive emaciation, comprehend, to speak with the pathol-
ogists of our school, the essential features of this present
disease of the alimentary canal, and, moreover, present a
fair simile to the Arsenicum disease. A careful examina-
tion, however, will show that some even of these symptoms
vary in important aspects from the corresponding symptoms
of Arsenicum, while other symptoms which betray the
diathesis of the patient are quite at variance with those of
Arsenicum. For example, in the first place, the thirst,
although very great, is not satisfied by a small quantity of
water, as in the Arsenicum disease ; the stool, though
similar in color, consistency and odor to that of Arsenicum,
is copious, that of Arsenicum being, like all the secretions
under that drug, scanty. It is not attended by as great a
sense of exhaustion as one would expect to find. Indeed,
the debility and muscular weakness are much less than one
would suppose must result from a diarrhoea so copious and
of so long duration, whereas in the Arsenicum disease, the
general prostration is much greater than can be accounted
for by the actual drain upon the system. In the second
place, the aggravations occur in the mornings, while in the
Arsenicum disease they occur almost exclusively in the
evenings. The abdomen is distended and hard, making the
child quite pot-bellied, whereas Arsenicum produces retrac-
tion of the abdominal walls and concavity of the abdomen.
The appetite is very great, a symptom which is not charac-
teristic of Arsenicum.

1 Newburgh, N. Y.

472 CHRONIC DIARRHCEA CURED

Then it appears, although the symptom to which my
attention was first called, as being the symptom of chief
importance, seemed to point to Arsenicum as its remedy,
yet the conditions and concomitants of that symptom and
the general symptoms of the patient did not at all demand,
but decidedly contra-indicated, that remedy.

But with what propriety can the diarrhoea, the frequent
liquid stool, be regarded as the symptom of chief impor-
tance, the primary symptom, so to speak ? It is that symp-
tom which would first strike the observation of the patient's
friends, because so decidedly objective in its character ; but
it is obviously a secondary phenomenon, depending on the
diseased state of the alimentary canal and of the mesenteric
glands ; and this diseased state depended unquestionably
upon a general depressed state of the vascular and nervous
systems, or upon a modified vital action, which is mani-
fested in those general symptoms, upon which we predicate
distinctions of dyscrasia and diathesis. Taking this view of
the case, it is evident that to assign the chief place in our
scheme of symptoms to the diarrhoea, would be to prescribe
for symptoms (and secondary ones at that) rather than for
the whole morbid state of the patient. But if, in accordance
with the view I have indicated, we give but a secondary
place to the diarrhoea, it becomes easy to find a remedy for
our case. The distended, prominent abdomen, the indurated
and enlarged glands, the excessive appetite, the great thirst,
demanding large draughts of water, the pain in the upper part
of the abdomen just before the stool, the tender epigastrium,
the copious and long-continued diarrhoea, without correspond-
ing exhaustion, — all these symptoms combine to exhibit a
condition which finds its exact simile in Calcarea carbonica.
Moreover, although Calcarea does not produce stools of the
color met with in this case, yet the conditions of stool
produced by Calcarea correspond to those of the case in
hand. The aggravations of Calcarea are frequently in the
morning, and the pain in the abdomen is relieved by warmth

BY A SINGLE DOSE OF A HIGH POTENCY. 473

as in this case. Calcarea carbonica, therefore, was selected
as the appropriate remedy, and the propriety of giving it
being so obvious that I could not suppose it had been over-
looked by the physicians who had previously attended the
lad, and there being every probability that, if they gave it
at all, they gave it in low potencies, I concluded to give the
two hundredth. Two globules were accordingly dissolved
in four ounces of water, and a tea-spoonful of the solution
ordered to be given every four hours. For the week pre-
ceding this prescription the boy had had twenty stools daily,
and very great pain.

On the third day after the remedy was administered, I
called again. The lad had had but one stool daily since the
day after my visit ; and during the ten months which have
since elapsed, his bowels have moved regularly, but once
daily, the stool being in all respects normal. In the space
of one month the lad became so ruddy and plump — having
gained twenty-two pounds in weight — that I should not have
known him. As he gained flesh and strength, the rotundity
of the abdomen disappeared, and at the end of the third
month the indurated abdominal glands were no longer to be
felt. He received no medicine besides the single dose of
Calcarea carbonica'200, above mentioned.

It may seem incredible, and I confess I cannot explain it,
that a drain so long established and so copious could be
instantaneously checked without producing at least tempo-
rary disturbance of some other character. The fact, how-
ever, does not admit of dispute.

In a review of this case, two points seem worthy of notice.

1. The prompt and enduring action of the high potency.
I would not venture to say that a low potency would not
have acted as promptly ; certainly, however, nothing better
could be imagined or desired.

2. The great importance of paying careful regard, in the
selection of a remedy, to the general symptoms of the
patient, as denoting the dyscrasia, and to the conditions
(time and character of aggravation, etc.) of every symptom.

PTERYGIUM CRASSUM CURED BY A SINGLE
REMEDY IN A HIGH POTENCY.1

The following case is thought worthy of special notice for
several reasons. It presents an instance of a diseased con-
dition which, being on the surface of the eye, may be made
the subject of constant observation :

Such a condition has never, so far as my knowledge goes,
been produced by any remedy. It is not contained in any
proving. A homoeopathic prescription for it must therefore
be based upon the general characteristic symptoms which
the patient may present, and to which corresponding symp-
toms may be found in some drug-proving.

The writer had never treated a case before, and does not
recall any record of a cure made by homoeopathic remedies.
He was not, consequently, influenced in the selection of a
remedy by any knowledge ex usu in morbis.

The patient was not encouraged to expect a cure, but
looked forward to a surgical operation as a matter of neces-
sity. There can be no ground, then, for ascribing the cure
to faith, the last resort of the credulous incredulous, to whom
it is easier to believe that a grave and material disease can
be cured by imagination, the intangible, than by a high
potency, the imponderable !

The cure was effected by a single remedy, in a high
potency, the two hundredth (prepared by myself).

J. N. S., a farmer, aged fifty-five years, — generally in good
health, — has had for three years a pterygium upon each eye.
Starting from the inner angle of the eye, this morbid growth,

1 Read before the Homoeopathic Medical Society of Cayuga County,
N. Y., June 22, 1864.

PTERYGIUM CRASSUM CURED. 475

which was thick, opaque, and richly supplied with large
blood-vessels, and much resembled a strong muscle, extended
over the sclerotic, had invaded the cornea with a thick, broad
extremity, and now covered more than one-half of the pupil,
rendering the patient nearly blind.

The conjunctiva of the remaining portion was deeply
injected. The eyes were filled in the morning with a muco-
purulent secretion.

The patient was unable to endure artificial light, and com-
pelled to carefully protect the eyes during the day-time.
Reading was out of the question at all times.

Within the last six months the growth of the pterygium
had been very rapid.

The eyes were very painful, especially in the evening and
at night. The pain was in the inner angle of the eye, a
pricking, smarting pain, seeming to be situated deep in the
globe. Dust in the atmosphere greatly aggravated the pain.
In addition there was a very severe pressure at the root of
the nose and across the supra-orbital region. There was
considerable lachrymation, especially in the evening.

The effect of this disease was to entirely incapacitate the
patient for every kind of business.

In this condition the patient placed himself under my care
about the 1st of July, 1863. He had been advised that an
operation for the removal of the pterygium was the only
thing to which he could look for relief, but had also been
told that in the present inflamed condition of the eyes, and
at the unfavorable season of midsummer, the operation would
expose him to no inconsiderable danger of sequelae that
might be very disastrous. He had been counseled to endure
his present symptoms until the weather should become
colder and more favorable for the operation.

His motive, therefore, in coming to me was to get some
palliation of his suffering, some temporary relief, that the
summer months might be made more tolerable to him.

I gave him no encouragement to believe that I could 'do

476 PTERYGIUM CRASSUM CURED

more than slightly palliate his sufferings ; for, as has been
already remarked, I had never treated a pterygium, and
never heard of a homoeopathic cure of one.

Seeking a homoeopathic remedy for the case, as it has
been stated, I could get no light from the objective symp-
toms, since no proving contains anything like them.
Nothing remained but the subjective symptoms. Of these
the pain, smarting and pricking, and which was singularly
confined to the inner angle of the eye and seemed deep-
seated, the pushing pain at the root of the nose, the marked
aggravation in the evening, — these symptoms together sug-
gested Zincum metallicum.

In the proving of Zincum we find (symptoms 194, 197,
205, 209), biting, pricking and soreness in the inner angle
of the eyes ; lachrymation, especially in the evening ; inflam-
mation and redness of the conjunctiva; suppuration of the
inner angle with soreness, — many of these symptoms being
aggravated in the evening ; symptom 248, " Pressure on
the root of the nose, as if it would be pressed into the head,
almost intolerable," together with 249—25 1 of a like sig-
nificance.

The other symptoms of the patient being well covered by
those of Zincum, I concluded to give this remedy.

I felt the more hope of some benefit from it, from the fact
that my (allopathic) preceptor, who had much experience
and success in the treatment of diseases of the eye, had
often said that Sulphate of zinc, applied externally, had a
more beneficial effect in pterygium than any other astringent
or caustic application.

Now, as Sulphate of zinc is by no means so powerful an
astringent or caustic as many other substances that are com-
monly used as applications in such cases, certainly the supe-
riority of Zinc could not be attributable to its mere posses-
sion of those properties which it has in common with other
collyria, as, for example, Nitrate of silver, Sulphate of
copper, etc., etc. It must be due, then, to s"ome specific

BY A SINGLE REMEDY IN A HIGH POTENCY. 4/7

quality of the Zinc. In passing, -let me venture the remark,
that in clinical observations like the above, made by sagacious
allopathic observers, we may often find valuable hints to
supplement our pathogenetic knowledge of drugs.

To return to the case, I determined to give the two
hundredth potency of Zinc, the case being, as it seemed to
me, a very fine one for experiment with a high potency.

I gave four powders of sugar of milk, each containing
three globules of Zincum metallicum200, and ten additional
powders containing nothing but sugar of milk ; a powder
to be taken dry on the tongue, every night on retiring ; the
patient to report on the fourteenth day. No change to be
made in diet, regimen, or occupation. No external applica-
tions to be made.

July 15. The patient presented himself and stated that on
the third day after he began to take the powders he began
to feel much better, and that now he was entirely free from
pain and discomfort and from lachrymation. The morning
secretion was much less. I thought the eye appeared less
inflamed, but beyond this there was no change in its physi-
cal condition. I gave sugar of milk and requested a report
in a fortnight, or sooner, in case the pains should return.

August I. No return of pain. The pterygium has cer-
tainly diminished in size ; it is not so thick and luxuriant as
formerly. Sugar of milk.

August 10. The patient came to apprise me of a return
of the pains to moderate extent. I gave three powders of
Zincum metallicum200, to be taken every night on retiring.

August 20. The pains disappeared after the first powder
and have not returned. The pterygium is evidently de-
creasing.

Twice again the pains returned, and on each occasion I
gave a powder of the Zincum200. By the end of October,
the time fixed for the operation, the pterygium had dimin-
ished so far that it was only a little colorless ridge in the
extreme inner angle of the eye, the sight was entirely

4/8 PTERYGIUM CRASSUM CURED.

restored, the patient could use his eyes freely both by day
and in the evening ; there was no longer any thought of the
operation ; in fact, it would have been hard to find anything
to operate upon.

At the present date there is no trace of the pterygium
remaining upon the left eye. In the inner angle of the
right eye there is a small speck yet visible.

PANAMA FEVER CURED BY ARSENICUM.

A. J., aged thirty, strong, muscular and hitherto healthy,
sent for me. He had been exposed about eight weeks
before, while on the isthmus of Panama, to unusual vicissi-
tudes of weather, and three weeks after he left Panama had
sickened with chill, fever, vomiting, etc., more or less
severe, which, however, he succeeded in suppressing by
large doses of quinine, so as to be able to travel for a few
days at a time. Three days before I saw him he was taken
with an unusually severe chill, followed by high fever and
alternations of chill and fever, with severe constitutional
symptoms, which continued, notwithstanding large and re-
peated doses of quinine, until I found him in the following
condition :

Though still quite stout he had lost flesh greatly, having
decreased in weight thirty pounds during the last month.
His face was of a dusky red hue, hot and dry, eyes injected,
dry and ferrety, the pupils contracted, with a very restless,
anxious expression. The patient had constant thirst, though
satisfied with a single swallow of water at a time. The
stomach was excessively irritable — drink was rejected as
soon as taken ; a profound disgust for food of all kinds. The
tongue was covered with a thick, brownish coat, and felt to
the patient dry, though not actually so. When protruded,
the tongue trembled and was moved involuntarily back and
forth, in spite of efforts to keep it still. The hands trembled
excessively when held out, and the patient complained of
indescribable weakness and prostration. Nevertheless, there
was uncontrollable restlessness, it being literally impossible
to remain for more than an instant in one position — the

480 PANAMA FEVER CURED BY ARSENICUM.

recumbent posture was intolerable ; alternations of chill
and heat, partial and fugitive in character, were experienced,
each lasting about fifteen minutes, the heat yielding for a
few moments to a partial, clammy sweat, which was soon
succeeded by chill again. There were dyspnoea and short,
dry cough. The spleen was much enlarged and dull on
percussion. During the last two nights the patient had
been unable to sleep at all, but had been exceedingly rest-
less and uncomfortable, tormented by thirst. The pulse was
140, very quick, small and wiry. The head was confused,
and I found the sensorium much clouded, it being difficult
to get definite answers to my questions ; there was, how-
ever, a constant effort to give expression to a sense of great
uneasiness and vague apprehension of severe illness.

No one who has been at all conversant with Panama
Fever could fail to recognize the gravity of the above. I
expected to have a long and perhaps a doubtful battle with
the disease, and proceeded accordingly to make arrange-
ments for an indefinite sojourn on the part of my patient,
who. was not a resident of this place.1 From the symptoms
as detailed, there could be no doubt of the prescription
required at the moment. The excessive prostration, con-
joined with the great nervous and vascular erethism, the
irritability of the stomach, the great thirst, satisfied for the
moment by a small quantity of water, — the intermingled
heat, chill and partial sweat, presenting at no time a definite
paroxysm of intermittent, — along with the dyspnoea and
anxiety, and the peculiar pulse, weak and yet excited, made
it a matter of course that I should give Arsenicum, which
as the indications were so clear that the selection of the
remedy could not be a matter of doubt, I gave in the two
hundredth potency, deeming this a very fair case, both as
regards the clearness of indication and the severity of the
disease, for the demonstration of the power of the high
potencies. I gave at 4 P. M. a powder of Saccharum lactis
1 Newburgh, N. Y.

PANAMA FEVER CURED BY ARSENICUM. 481

containing ^two globules of Arsenicum200, to be taken dry,
and to be followed by a similar powder every four hours.

The following day I found that my patient had slept
three hours the night before ; his stomach, no longer
irritable, tolerated beef tea and toast, the chills and heat
occurred about once in four hours, lasting for a few moments
only; cough and dyspnoea had disappeared. Prostration
still excessive, restlessness moderate, intelligence good,
tongue and hands less tremulous. Arsenicum200 as before,
every six hours.

The third day. A better night, no chills or heat to-day,
strength increasing; no restlessness. Arsenicum200 every
eight hours.

The fourth day. Slept well last night, feels like walking
out ; appetite good, tongue clean. Saccharum lactis.

The fifth day. Feels quite well and strong.

The next day he resumed his journey. In such a case,
one would apprehend a relapse after the expiration of one,
two or three weeks. I have made -especial inquiries respect-
ing my patient, and find that nothing of the kind has
occurred. It is three months since I prescribed for him,
and he has steadily gained strength and flesh, and is to all
appearance well.

• A CASE CURED BY MAGNESIA CARBONICA.

Mrs. S., aged twenty- seven years, fair and stout, has been
married six years, but never pregnant. Before marriage,
menstruation was normal ; soon after marriage, it became
irregular, as follows : menses would appear at intervals of
three or four months, and the flow would continue, with
scarcely an intermission, for twelve or fourteen weeks. The
discharge was generally dark and thick, accompanied by
pain, more or less severe. During the flow the patient
became quite feeble and anaemic, although not apparently
emaciated.

She applied to me, March 16, stating that she had been
flowing since March 1st; the discharge being thick, dark and
abundant, and attended by unusually severe, labor-like pains,
night and day. She was already very feeble ; and, judging
from past experience that she would continue to flow in this
way for at least two months, she apprehended a degree of
prostration that would utterly disable her. I gave Platina200,
a dose every night. The flow continued, although daily
diminishing in quantity, for one week, and then ceased.
The patient immediately began to regain strength. There
was no re-appearance of menses until June 16, when they
came on as before, but without pain, continued two days,
ceased for twenty-four hours, re-appeared, and continued
until July 4. During this time Platina200 was taken as
before. July 18, menses re-appeared, the flow being very
abundant, dark, and somewhat coagulated. The patient
was weak, had no appetite, and complained of pain and
much commotion in the abdomen. Platina having failed to
produce a lasting effect, China, Crocus, and Hamamelis were

A CASE CURED BY MAGNESIA CARBONICA. 483

given, but without satisfactory results. The flowing con-
tinued from July 18 to September 12, when the patient's
condition of debility was quite deplorable. I now found
her symptoms to be as follows : the flow was not quite so
dark, very profuse, but much more profuse during the night
and on first rising than it was during the day. On rising in
the morning, the patient experienced a contracting pain in
the abdomen, and a sharp upward stitch in the rectum,
followed by a discharge of coagula from the vagina. There
was not much flowing during the day, while throughout the
night it was abundant. She was very weak, and had much
headache and no appetite. I gave Mag'nesia carbonica200, to
be dissolved in water, a tea-spoonful every four hours until
better. September 16, she reported that after taking
Magnesia carbonica for two days the flowing at night
ceased ; now, after four days, the flowing had entirely ceased.
The improvement in general condition had been remarka-
ble. From this time, the progress of the patient was all that
could be desired. In five weeks menstruation re-appeared
and pursued a normal course, and there has been no recur-
rence of the former long-standing troubles.

The prescription of Magnesia carbonica in this case was
followed by very prompt and complete relief. The symp-
tom which led to it was the " condition " of the flowing, viz.:
" worse during the night." Shall we now, on the strength
of this conformation of this unusual (we might say unphysi-
ological) symptom, pronounce the latter a " characteristic,"
or a "key-note " of Magnesia carbonica ? It was certainly
the symptom in the case which struck me as most remarka-
ble (for I do not remember meeting it before in practice),
and the fact that I found it in the proving of Magnesia car-
bonica determined me to give that remedy. But would it be
safe to rely on this symptom alone as a " key-note " and
always give Magnesia carbonica when we meet the symp-
tom in practice? No doubt we should sometimes brilliantly
succeed, but I am sure we should often fail. At least one

484 A CASE CURED BY MAGNESIA CARBONICA.

other remedy has the same symptom, flowing worse at night,
viz., Bo vista; and still others may have it. Between these
two remedies, the distinction is easily found in the diversity
of the other symptoms.

Magnesia carbonica produces 1 too frequent and too
profuse menstruation; the flow, which is dark and thick,
being more profuse at night,2 corresponds with my case in
every particular.

Bovista, on the other hand,3 makes menstruation tardy and
scanty ; the flow, which is watery, being most abundant at
night.4

These remedies, so different, agree in this one symptom,
"increase of flowing at night." We could avoid error in a
prescription only by taking cognizance of the totality of the
symptoms, — Hahnemann's approved method. Should we
venture to base a prescription on this remarkable symptom
alone, as a characteristic or "key-note," we should probably
fail in half our cases.

Ex uno disce omnes. There is no royal road to knowledge
of the Materia Medica.

1 Chronic Diseases, Symptoms 500 to Medica, vol. iii., Bovista; Symptoms
525. 382 to 394.

2 Symptom 510. 4 Symptom 385.

3 Hartlaub and Trinks' Materia

. OVARIAN TUMOR CURED BY COLOCYNTH.

On October 10, 1864, I was requested to visit Mrs. C. E.
H., aged about thirty-eight years. She gave me the follow-
ing history : She had been always in good health, married
ten years, but never pregnant. While traveling in France
in 1854, she was attacked with what was then called acute
peritonitis. She was confined to her bed several years.
Partially recovering, she consulted Trousseau, who discovered
the right ovary inflamed and somewhat enlarged. From
this time she was more or less unable to walk, and suffered
much from a tumor, which gradually developed in the pelvis,
between the uterus and the rectum, and which was pro-
nounced by Trousseau to be an enlarged and prolapsed
ovary.

In 1863 she came to New-York, and placed herself under
one of our most experienced gynecologists, who confirmed
Trousseau's diagnosis, pronounced the case incurable, and
advised a sparing resort to anodynes to mitigate severe suf-
fering. I found Mrs. H. confined to her sofa ; she had not
left her room for a year. A firm, elastic tumor occupied the
space between the uterus and vagina anteriorly, and the
rectum posteriorly, completely occluding the vagina, and
rendering defecation very difficult. It seemed not to be
adherent to the walls of either passage. Attempts at
walking induced paroxysms of acute pain across the hypo-
gastrium, in the sacral region, and around the hip-joint ;
from here the pains extended down the groin and along the
femoral nerve. The pain was relieved by flexing the thigh
upon the pelvis ; and always induced or aggravated by
extending the thigh. Even without the provocation of

486 OVARIAN TUMOR CURED BY COLOCYNTH.

motion there were frequent and severe paroxysms of pain,
as above described. The appetite was not good, and
digestion feeble; but the general condition of the patient
was good. Nervous sensibility was very great. The pains
had been ascribed to the pressure of the tumor upon the
sacral nerves.

The patient had a dread of taking opiates, and had used
them sparingly. I was requested to mitigate the pains, if
possible, — no hope being entertained of a cure. With no
definite expectations of accomplishing a radical cure, I pre-
scribed Colocynth200; a few pellets to be taken whenever a
paroxysm of pain came on, and to be repeated every hour
during the paroxysm. This prescription was based on the
results of the Austrian proving of Colocynth, which confirm
and amplify the provings of Hahnemann.

November I . I learned that the paroxysms had been less
frequent, much shorter, and milder; the remedy appearing
to control them.

March I, 1865. The patient walked half a mile to my
office and reported that she had had no pain for a month.
She could walk half a mile daily without fatigue or pain,
and had resumed the charge of her household after an
interval of nine years. She thought the tumor had become
somewhat smaller. Being about to sail for Europe, she
desired some more Colocynth, that she might be provided
in case pain should return.

June 9, 1869. Mrs. H. has just arrived from Europe. I
find her perfectly well. There has been no return of pain
since 1865. The tumor disappeared from its position
between the vagina and rectum in the autumn of 1865, and
was plainly perceptible in the abdomen, about as large as a
Sicily orange. It has since disappeared entirely, and nothing
of the kind can now be discovered. Was this really an
ovarian tumor ? No doubt appeared to be entertained by
the eminent physicians who preceded me in the case. Did
the Colocynth cause its absorption ? The patient has no

OVARIAN TUMOR CURED BY COLOCYNTH. 487

doubt on this point. Why should it not have done so ?
Because we have no record of any action of Colocynth,
except on the intestinal mucous membrane, and on certain
plexus of nerves ? Fortunately, the action of remedies is
not restricted to the measure of our imperfect a priori
knowledge of them.

A reviewer in the British Journal takes exception to a
statement of mine, that a remedy, when indicated by a
well-marked group of symptoms, will often remove, not
merely those, but also other groups apparently unconnected,
— in fact, the whole disease. This case is in point. And yet
I can hardly doubt that, in such cases, a complete proving,
were it possible, would show that the remedy does produce
likewise these seemingly unconnected symptoms, — in fact, a
picture of the whole disease, Indeed, on examining the
Austrian proving, we find Frolich reports two brief prov-
ings on women, both of which show the action of Colocynth
on the ovaries. Had we well-instructed women-provers,
how much more we should know of the action of drugs !

BAPTISIA AS A HAIR-WASH.

Miss A. S., forty-two years old, of light complexion,
spare figure, very excitable, and prone to dwell upon her
own ailments and disabilities, consulted me in December,
1 864, for chronic constipation ; to palliate which, she had
been in the habit of taking daily, a pill of extract micis
vomica and aloes.

Under the use of sulphur200, followed by albumina200, she
became able to dispense with her purgative pill, having a
regular stool every day.

On the 2Oth February, i8"65, she applied to me again with
the following symptoms :

" The day before, her eyes began to smart and feel as
though she had been exposed to wood-smoke. They felt
full of dust; the conjunctiva of the globe was injected ; there
was a discharge of muco-purulent matter from the eyes this
morning.

" Fluent coryza, the discharge being thin, not acrid, a
sore spot, feeling raw, internally on the left side of the
pharynx ; these symptoms are aggravated by exposure to
damp, cool air. Headache, a pressure backward in the
entire frontal region ; severe pain from the right side of the
occiput to the right frontal protuberance.

" She feels ill, in an undefinable way ; feels weak ; half
depressed in spirits, half apprehensive of some coming evil.
Feels as though some unknown but irresistible influence had
possession of her and she were about to be ill, or to meet
with some misfortune."

Her face was flushed, but there was no heat of skin ; the
pulse was about eighty, soft and slightly irregular.

BAPTISIA AS A HAIR-WASH. 489

Something, I cannot tell what, struck me as incongruous
in the patient's appearance and symptoms, and led me to
doubt whether her condition were an idiopathic disease. I
said to her, " You seem to me to be under the influence of
some drug or poison. What have you taken ?" She pro-
tested that she had taken no medicine. The similarity of
her condition to my idea of the symptoms of Baptisia, came
forcibly to my mind, and I asked, " Have you not taken or
in some way used the tincture of the Baptisia?" After
some hesitation, she replied : "I have been using for several
days a hair- wash, composed chiefly of the tincture of Wild
Indigo. Could that have anything to do with my symp-
toms?"

I forbade the hair- wash, and gave nitric acid™.

A week passed before the symptoms disappeared, those
of the eyes lingering longest.

NEW- YORK, Dec. i, 1867.

CHLORINE IN SPASMUS GLOTTIDIS. No. i.

In the year 1850, after submitting to the manipulations of
a dentist, I was advised to wash the mouth with a solution
of Chlorine. A weak solution of Chlorine gas in cold water
was accordingly prepared, and I proceeded to rinse the
mouth with it. Scarcely had the liquid been received into
my mouth, when I became sensible of a spasmodic action of
some part of the respiratory organs of the following charac-
ter : Inspiration was unimpeded, and could be effected in
the natural manner, but expiration was absolutely impossible,
and this impossibility arose, if I might trust my sensations,
not from any inability of the muscles of expiration, but from
a closure of the rima glottidis. Expiration being felt to be
impossible, inspiration was again attempted, and was accom-
plished, fully and easily, although the act was attended
by a slight crowing noise. Expiration, which was again
attempted, was impossible as before. By these successive
operations, the lungs became inflated to a most painful
degree, but, so firmly did the glottis appear to be closed,
that it seemed as though air might pass through any part
of the thoracic walls more readily than by the way of the
larynx. This arrest of respiration having endured for about
a minute, the face becoming turgid and livid, partial coma
supervened, the spasm relaxed, and respiration became free
again.

In 1852, I had an opportunity of witnessing the effect
of a strong accidental inhalation of chlorine gas by an adult.
The same phenomena of comparatively free, but crowing
inspiration, and of absolutely obstructed expiration presented
themselves ; the face became extremely livid, convulsive

CHLORINE IN SPASMUS GLOTTIDIS. NO. I. 491

movements of the extremities began, and the patient became
partially comatose. I administered ammonia by olfaction ;
the spasm relaxed, and consciousness returned along with
normal respiration.

These experiments show a power in chlorine to produce
the following condition : Spasm of the glottis, which inter-
feres but little with inspiration, giving to it a crowing sound,
but which prevents expiration. During the continuance of
the spasm, the respiratory acts consist of a succession of
crowing inspirations, each followed by an ineffectual effort at
expiration, the whole serving to inflate the chest to a most
painful extent, and attended at last by turgescence of the
face, and more or less complete coma, with or without con-
vulsive movements of the extremities, and during which the
spasm relaxes.

In the Proving of Chlorine/ a similar effect is indistinctly
indicated. Pereira says : " If an attempt be made to inhale
undiluted chlorine gas, it produces spasm of the glottis.
Twice I have suffered severely from the accidental inhala-
tion of it; and each time it gave the sensation of constric-
tion of the air-tubes, such as might be produced by a
spasmodic condition of the muscular fibers of the bronchial
tubes." The peculiar nature of the chlorine spasm, viz.,
that it affects expiration almost exclusively, is not mentioned
by Pereira.

Bearing in mind the odium which has been attempted to
be cast upon some of our colleagues for flooding our litera-
ture with "fragmentary provings," which serve no purpose
but to " cumber the Materia Medica," and to annoy our
practitioners with an " emb arras de richesses" (as if it were
not worth while to publish and to study anything, however
" fragmentary," if it furnish us the means of curing, were it
but a single case ! ), I might have abstained from publishing
the above symptoms of Chlorine, had not the following case
demonstrated their practical value.

1 In vol. ii. of the Ncues Archiv.

492 CHLORINE IN SPASM US GLOTTIDIS. NO. I.

June 24th. A female infant, seven months old, well devel-
oped and large, the fourth child of healthy parents, was
brought to me with the following history : Having been
previously in perfect health, she was seized three weeks
ago, with a spasmodic affection of the respiratory organs.
Suddenly and without any warning, she would make a long
inspiration, with a slight crowing noise ; an attempt to
exhale would be made, but without success ; another crow-
ing inspiration followed by a forcible, but ineffectual effort to
exhale ; and this would be repeated until the child became
blue around the mouth, and sank into partial uncons-
ciousness, when free respiration would take place, and the
child would generally sink into a deep sleep. Frequently
toward the close of an attack, convulsive movements of the
extremities would be noticed, and once, general spasm
occurred. At first, these attacks came on only after some
excitement, or on the child being startled. They frequently
occurred during sleep, arousing the child suddenly, and they
were most frequent from midnight to 7 A. M. Within the
week before I saw her, they had become very frequent — as
many as thirty to forty, occurring during the twenty-four
hours. The child had begun to emaciate rapidly, had lost
appetite, strength and playfulness, the face was pale and
bloated, and the eyes had a dull and glassy expression.
The child had been under most skillful homoeopathic treat-
ment since the commencement of the attacks, and as she
failed to improve, change of air was recommended, and she
was brought to Newburgh. The climate failing to benefit
her, the child was placed under my care. The case seemed
all the more serious from the fact that, last year, the parents
had lost an older child, a boy, with the same affection. In
the fourth week of the disease, of which the course had been
in every respect similar to that of the infant above narrated,
convulsions supervened, and the child died at the end of the
sixth week. This child was under enlightened allopathic
care. It may be interesting to note, that the autopsy

CHLORINE IN SPASMUS GLOTTIDIS. NO. I. 493

revealed no malformation, and no organic lesion ; simply
emaciation and atrophy.

On careful examination of my little patient, I could
discover nothing abnormal in the condition of the heart or
lungs, and no sign of disease that was not fairly attributed
to the frequent recurrence of these spasms, with the venous
congestion consequent upon them. It was evidently a case
of spasmus glottidis (asthma thymicum, asthma millari,
asthma laryngeum infantum, laryngismus stradulus), and
had advanced almost to the second or convulsive stage in
which the prognosis is decidedly unfavorable.

The remedy which is recommended before all others for
this disease, in our hand-books and repertories, is Sambucus.
The symptom on which this recommendation is based is the
following: "Slumber with half-open eyes and mouth; on
awaking from it, he could not draw a breath, and was
compelled to sit up, whereupon respiration was very hurried,
with wheezing in the chest, as if he should suffocate ; he
lashed about with his hands ; the head and face were
bloated and bluish ; he was hot, without thirst ; weeping at
the approach of a paroxysm, — all this without cough, and
especially at night, from twelve to four o'clock." On com-
paring this picture with the case under consideration, we
find correspondences in the general characters of the affec-
tion. The spasmodic embarrassment of respiration, the
absence of fever and of cough, the occurrence of the
paroxysms suddenly, chiefly at night, and on awaking, show
a general appropriateness of Sambucus to spasms of the
larynx and bronchial tubes. But we seek in vain for the
unequal disturbance of the inspiratory and the expiratory acts,
which are the individual, and therefore the characteristic,
peculiarity of the case under consideration. And failing to
find this, we should, as a matter of course, expect that
Sambucus would fail to cure, or in any way to affect the
case. And this had been the fact. So, too', of Lachesis
and several other remedies which, as well as Sambucus, had

494 CHLORINE IN SPASMUS GLOTTIDIS. NO. I.

already been tried before the case came under my care.
In this very peculiarity, which was characteristic of the case,
the similarity of Chlorine was most striking. And it was
with the utmost confidence of a happy result, that I deter-
mined, after a careful examination of the case, to administer
Chlorine. I accordingly prepared a saturated solution of
Chlorine gas in water at 60° Fahrenheit, and made from
this the first centesimal dilution, in which the odor of the
Chlorine could be faintly perceived.

Of this I ordered twenty drops to be dissolved in four
table-spoonfuls of water, and a tea-spoonful to be given to the
child every three hours. (A porcelain spoon was used.) I
also directed a few drops to be placed in the child's mouth
at the beginning of each paroxysm, if this should be
possible.

The first dose was given at four P. M., June 24th. During
the preceding twenty-four hours the child had had forty
paroxysms. During the succeeding twenty-four hours there
occurred but four paroxysms, only one of which began with
any severity, and this one was instantly arrested midway by
a few drops of the solution placed upon the child's tongue.
During the night of the 26th not a single paroxysm. Im-
provement in the general condition of the patient now
became apparent ; appetite and playfulness returned ; the
bloated aspect of the face and the dullness of the eye dis-
appeared. On the 2/th the paroxysms increased in number
and severity. On examining the solution, I found that it
had changed in character, and no longer contained Chlorine.
A fresh solution was prepared, and thenceforward it was
prepared afresh every second day. From this time, July
1st, the remedy was continued ; a dose every four hours,
when, the spasms having wholly ceased, and the child
appearing well, it was finally discontinued. On the 2d July
a slight spasm occurred, and the child appeared feverish and
excited, with greenish diarrhoea. I found a lower incisor
pressing strongly upon the gum, which was hot and swollen,

CHLORINE IN SPASMUS GLOTTIDIS. NO. I. 495

and which I forthwith lanced. In two hours the child had
lost every trace of illness. Since this date she has continued
in good health, with the exception of some trifling disorder
attendant upon dentition.1 There has been no sign of a
recurrence of the spasm of the glottis.

I am aware that children who are subjects of this disease
have occasionally periods of exemption from its attacks,
though this is not the case when the attacks are so frequent
and also violent as in the above case, and it is possible that
this child may be again attacked under provocation of diffi-
cult dentition or of some equally powerful exciting cause.
As there can be no doubt, however, of the controlling power
of chlorine over the first attack, I should have no misgivings
about its success in subsequent attacks, should the condition
be the same as before.

In connection with the above remarks upon Chlorine, it
may not be amiss to call attention to a kind of spasm of the
glottis occasionally produced by chloroform, and which
strikingly resembles the spasms produced by Chlorine. Now,
by the presence of an alkaline solution, chloroform is readily
decomposed, and Chlorine set free. The question at once
suggests itself whether in these cases of spasms such a
decomposition has been induced by the reaction of the
alkaline saliva upon the vapor of chloroform, and whether
the spasm is caused by the Chlorine thus set free.

In this case, the spasm of the glottis constituted the whole
of the morbid condition. But sometimes spasm of the
glottis occurs as a complication of some affection of the
throat or of the respiratory apparatus, and in such cases
Chlorine may be of great service. In the winter of 1853, I
visited in consultation a case of scarlatina, in which slough-
ing of the pharynx to a great extent had taken place and in

1 Marshall Hall advises, that in this even daily scarifications, of the gums,

disease special attention should be Until the 2d of July there was no sign

paid to the state of the gums, if, as is of irritation of the gums, which had

generally the case, it occur during been carefully examined by me every

dentition, and he advises frequent, day.

496 CHLORINE IN SPASMUS GLOTTIDIS. NO. I.

which spasm of the glottis had set in, threatening to cause a
speedily fatal termination. The attacks of spasm were
almost constant, the child, a boy of eight years, scarcely
rallying from one paroxysm before another came on. The
character of the spasm was precisely such as I had seen
produced by Chlorine. Chlorine water was administered,
and the spasms ceased instantly, with but one or two very
slight recurrences.

CHLORINE IN SPASMUS GLOTTIDIS. No. 2.

More than three years ago, I published1 an account of
the effects of the inhalation of Chlorine gas in two instances,
with the record of a case in which the symptoms of the
disease were so similar to the effects which I had witnessed
and experienced from the inhalation of Chlorine, that I was
induced to administer a solution of Chlorine gas in water.
The case was rapidly cured. The following case furnishes
additional evidence of the value of Chlorine in certain spas-
modic affections of the glottis :

December I2th, 1862. J. S., aged fifty-two years, has
suffered from follicular pharyngitis ; has had the larynx and
fauces swabbed, burned and penciled with nitrate of silver
until he could endure it no longer. For two years he has
not been under medical treatment. He now suffers much
from pain in the throat, and has an habitual cough and
expectoration of glairy mucus. Within three days the cough
has assumed a spasmodic character, with the following
peculiarities :

The desire to cough results from a tickling and a sensation
of rawness behind the thyroid cartilage. When the patient
seeks to yield to this desire, he finds it impossible to expel
the air from the chest, as is required in the act of coughing.
The cough is therefore abortive, although the desire grows
continually more and more intense. The obstruction to the
free and sudden expulsion of air, which would constitute a
cough, he describes as resulting from an apparent constriction
just below the larynx. At the same time he can draw air
into the lungs quite freely.

1 Vol. ii. of the American Homoeopathic Review, 1859 : " Chlorine in
Spasmus Glottidis. No. I."

33

498 CHLORINE IN SPASMUS GLOTTIDIS. NO. 2.

This freedom of inhalation and impeded exhalation,
together with the constantly increasing tickling in the larynx
which compelled the patient to make very energetic but
unavailing efforts to cough, continue until he sinks, ex-
hausted and covered with sweat, upon a couch, when the
spasm seems to relax and he can cough and exhale with
comparative freedom. These paroxysms recur about every
two hours.

I prepared immediately a weak solution of Chlorine gas
in cool water, so weak that the odor of the gas could scarcely
be detected, and when one of the paroxysms was at its
height, administered a tea-spoonful. ' The effect was magical.
The spasm relaxed immediately and the tickling was allayed.
The dose was repeated every two or three hours, as the
tickling recurred, and in the course of twenty-four hours the
disposition to a recurrence of the paroxysms had ceased.

Several days afterward the patient applied to me for a
quantity of "that solution," stating that since h^ had taken
it, his throat had been more comfortable and his voice better
than they had been since the day when he was unhappily
persuaded to allow caustic to be applied to his throat.

CHLORINE IN SPASMUS GLOTTIDIS. No. 3. .

Several years since I published1 an accidental proving of
Chlorine, with some cases of spasm of the glottis in which
I had used it with advantage.

Last month I was called to a child, two years and a half
old, which had just been brought home from the country,
and was supposed to be at the point of death. Five weeks
before, it had sickened with scarlatina, which, according to
the physicians in attendance,2 had become complicated by
diphtheria, and this by inflammation of the right lung and
deposit therein. An abscess had formed and discharged
externally on the neck; leaving an ulcer about two inches
long and one and a half broad, which exposed the cervical
muscles, and showed no disposition to heal ; copious and
very offensive discharge from both ears ; the throat seemed
to be full of a thick, yellow matter, very offensive, which
the child would occasionally eject, but seemed, for the most,
to be unable to move either up or down. . Any attempt
to examine the throat, or, on the part of the child, to
open the mouth to take food or drink, or any attempt to
cough, produced a fearful spasm of the glottis, which seemed
to admit the air well enough but to prevent its exit, and
which lasted until the child became livid and sank exhausted.
And this constituted, in the opinion of my predecessors, the
insuperable obstacle to the child's recovery. The spasm
prevented its tasting food. No food had been taken for
a week, and very little during the entire illness. The child
was now very feeble and greatly emaciated. Its death had
been hourly looked for by the doctors.

1 American Homoeopathic Review, 2 Allopaths of excellent professional
vol. ii., pp. 18 and 448: " Spasmus standing.
Glottidis. No. i."

5OO CHLORINE IN SPASMUS GLOTTIDIS. NO. 3.

I prepared immediately some Chlorine water,1 diluted,
until the gas was just perceptible, and gave to the child.
He took a mouthful and began to choke with the spasm ;
I immediately placed near his face a handkerchief, wet with
strong Chlorine water, so that he might inhale the gas.
The spasm ceased instantly and he swallowed. I left orders
for a similar procedure whenever, from any cause, whether
coughing or swallowing, the spasm should be induced. It
never failed to arrest the spasmodic action and enable the
child to swallow, or to eject the matter from the throat.
A number of days elapsed before the child could make
an articulate sound, or any sound. The doctors had thought
the diphtheria had induced paralysis of some of the pharyn-
geal muscles, and perhaps others, and hence the spasm in
the associate and neighboring muscles. And it may be so.
They regarded the spasm an insuperable obstacle to recovery.
It was evident to every attendant that the Chlorine relaxed
the spasm and enabled the child to swallow. His subse-
quent improvement was uniform and rapid under Carbo
vegetabilis200.

It may be, by and by, some esteemed friend will tell
me2, " I have used Chlorine in a case presenting exactly
these symptoms, and it failed," and may thence conclude
that I am mistaken in ascribing the successful issue of
my case to Chlorine. I suppose I shall reply : There are
two possible fallacies. I have stated the symptoms which
led me to give Chlorine, but they may not comprise the
real symptoms which constituted the case a case for Chlorine,
just as the judge may give a righteous judgment, but
may base it, in his written opinion, on most erroneous prem-
ises. So, on the other hand, you, in your case, may have
found exactly the same symptoms which I described, but you
may have overlooked something else in your case which
constituted it an essentially different one from mine. The

1 American Homoeopathic Review, 2 United States Medical and Sur-
ii., 370. gical Journal, vol. iv., p. 408.

CHLORINE IN SPASMUS GLOTTIDIS. NO. 3. 5<DI

sciences of pathology and semeiology are too imperfect to
admit of these back strokes of criticism overthrowing posi-
tive evidence by negative. Why, they are not admitted
in chemistry, and hardly, even in astronomy ! I shall urge
these considerations in reply, but feebly, doubtless, and to
no purpose, and shall at last fall in with the current of the
day, which, who can resist ? and shall read the old proverb,
"Seeing is not believing;" and shall give in my adhesion
to the scientific motto of our time : " Belief is human ; but
to doubt divine."

ON THE ELIMINATION THEORY.1

MY DEAR DOCTOR: Your favor of the nth inst was
received on the I2th. I should have been glad to send a
few words of greeting to the Connecticut State Homoeopathic
Society, if I had known earlier the date of your meeting.
As it is, I have no more time than to call your attention in
a few words to the importance which the " Elimination
Theory" is now assuming, among the allopaths, in relation
to disease and its treatment. For centuries back it has
been suggested, every now and then, by some wise man,
that the secretions and excretions of patients are the results
of efforts which nature is making to get rid of some poison-
ous morbific matter ; and that the true indication is to favor
rather than to check these excretions. But, in general, the
practice of allopaths has been to check and suppress them,
as though they regarded the discharges themselves as being
the disease. Now, as you must have noticed, Dr. George
Johnson, of King's College Hospital, London, a very high
authority, comes out with a statement and argument apply-
ing the " Elimination Theory " to Cholera. He holds that
the evacuations and vomited substances result from an effort
of nature to get rid of a poison, and that they should be
encouraged and not be checked.

He opposes absolutely the sedative and astringent treat-
ment by opium, tannin, kino, etc., and advises cathartics
and emetics, and he says that applying this method, by
treating cholera with castor-oil, in 1849 and 1854, he gained
a very remarkable success.

1 Communication to the Secretary of the Connecticut State
Homoeopathic Society.

ON THE ELIMINATION THEORY. 503

Now, let it be observed that the treatment of such a
disease as cholera by purgatives and emetics is, in a certain
rude way, a homoeopathic treatment. The remedies which
we find most successful, viz., Veratrum, Cuprum, Ipecacu-
anha, are classed by allopaths as emetics and cathartics.
This is another instance of the fact, which has been noticed
in other departments of pathology and therapeutics, that
the most advanced medical philosophy is slowly bringing
allopaths round to the same practical position to which
Hahnemann's practical sagacity and observation led him
seventy years ago, before there was a possible basis for
medical philosophy as it now exists.

One other point : Dr. George Johnson, detailing his cases
of cholera treated by castor-oil, says he would have been
still more successful had he not erred by using excessive
doses. He found he must use small doses. This was Hahne-
mann's experience when he began to prescribe according to
the homoeopathic law, and it has been the experience of
every succeeding experimenter. And the more strictly the
law is followed in all minutiae, the smaller must be the dose,
if we would get all possible good, avoiding all unnecessary
evil effects. It is in this way that homoeopaths have been
gradually led to use, first attenuated medicines, and finally
the higher potencies.

CHOLERA.1
I.

There can be no doubt that Asiatic Cholera, which has
prevailed during the past summer in various parts of Europe,
has been brought to our shores. Reasoning from analogy,
we have good grounds for believing that it will be epidemic
in the Atlantic states next summer. It is, therefore, the
part of prudence in us to refresh our knowledge of the
history and character of this terrible disease, and of the
causes which seem to favor its propagation, in order that we
may be the better able to meet the great practical problems :
HOW TO WARD IT OFF, AND HOW TO DEAL WITH IT.

I. HISTORY. Like all invasions and all epidemics, cholera
comes from the East, marching westward. It is known to
have existed in the delta of the Ganges since 1629. But in
1817 it appeared in Hindostan, as a wide-spread and terribly
fatal epidemic. From Calcutta and Jessore its progress was
westward, although it spread also into China and the Indian
Archipelago. In July, 1821, it had reached Muscat in
Arabia, and in 1823 it touched the Georgian frontier of

'Of the following paper, Sections i. allopathic physicians; as, for example,

to iv. were written for and published in Mr. Wilde, of Dublin, the distin-

a non-medical journal, the Independ- guished aural surgeon, atul Dr. Mc-

ent, in November and December, 1865. Laughlin, of London, Inspector of

To avert any possible charge of Cholera Hospitals for the Golden
presenting an ex parte case, the testi- Square District, in 1854-55.
mony to the superiority of homreo- To these sections a fifth is now
pathic treatment in Cholera was chiefly added, on the Prevention and Treat-
taken from the writings of impartial ment of Cholera. — C. D.
Government officers, or of hostile NEW- YORK, April 20, 1866.

CHOLERA. 505

Russia. Thence it spread northward through Russia, Poland
and Austria, extending in July, 1831, to St. Petersburg and
Cronstadt, and in October, to Berlin, Vienna and Hamburg.
In October, 1831, it appeared in Sunderland, England,
having been brought from Hamburg. It extended to Lon-
don in February, 1832, appearing first in the immediate
neighborhood of the shipping. From England it crossed to
France, breaking out, March 23d, in Paris, where in one
month it carried off 20,000 persons.

It was conveyed in an emigrant vessel from London to
Quebec, where it appeared June 8, 1832. A few weeks later
it became epidemic in the city of New- York, where it pre-
vailed with great fatality until late in the autumn. It
re-appeared in 1834.

In 1847 and J848 cholera again invaded Europe from
the East. December 8, 1848, the packet-ship "New-York"
arrived at quarantine at Staten Island, N. Y., having on
board a number of passengers sick with cholera. Several
had died on the voyage. From this infection, cholera pre-
vailed at quarantine for several weeks, and two or three cases,
which were traced to this vessel, occurred in this city.

Again, February 13, 1849, cholera broke out on board
the packet-ship "Liverpool," on her way to this port. There
were fifty cases, of which forty died. During the succeed-
ing months of spring and early summer, several vessels suc-
cessively brought the disease to the quarantine ; but it did
not become epidemic in the city of New- York until June,
1849. It prevailed until October. In the summer of 1854
it was again epidemic in New- York.

In June, 1865, we heard of cholera as prevailing at Mecca,
and on the route from Mecca to Alexandria. It was very
fatal at Alexandria, Cairo and Constantinople. It extended
to Jerusalem and along the shores of the Mediterranean and
Adriatic. At Marseilles, we have reason to believe, it was
and is still quite fatal, although no official reports have been
allowed to be published. At the present time, November,

506 CHOLERA.

1865, it prevails extensively in Paris. The cases which
recently arrived at our quarantine were from Paris, by way
of Havre. A few cases have appeared at Southampton,
England. We may hope that the influence of winter
will prevent the malady spreading at present, but we
should look for its re-appearance as an epidemic next
summer.

The characteristic features of an attack of Asiatic cholera
are, in brief, as follows : In the chest and at the pit of the
stomach, a distressing anxiety and sense of oppression. Gene-
ral, and often extreme, prostration. Nausea, faintness, loud
rumblings in the bowels. Sudden and forcible vomiting of
a milky or watery fluid, in large quantities. Evacuations
from the bowels, consisting of a similar watery substance,
containing white floating grains. These vomitings and
evacuations are attended and followed by spasms, tremors,
and very rapid loss of the heat of the body. The skin becomes
cold, clammy, and shriveled. The fingers look like those of
a washerwoman ; the skin has lost its elasticity, and if
pinched into a ridge it retains that form for a long time.
There is often great thirst ; but, in many cases, the liquid
is no sooner swallowed than it is forcibly ejected from the
stomach. The extremities are frequently the seat of very
painful cramps.

Severe cases pass on, in the course of eight to sixteen
hours, to the stage of COLLAPSE. Indeed, the most severe
cases may almost be said to commence with collapse. In this
condition the features are pinched and sunken ; the skin is
of a bluish color, icy cold, and clammy; the tongue is cold,
and the hands are corrugated. The voice is husky and faint,
and the breath is cold. The pulse is frequent, very small,
and often imperceptible. The evacuations from the stomach
and bowels become less and less frequent as this stage
becomes more fully developed ; and, in most cases, they
entirely cease several hours before death. The secretion of
urine is suspended. The thirst is intense. The external

CHOLERA. 507

surface of the body is very cold, but the patients complain
of an internal burning heat.

During the whole course of the disease the mind is clear
and composed. It is very remarkable that, although fully
aware of their condition and danger, the majority of cholera
patients manifest a singular apathy and indifference with
regard to the result. The stage of collapse may last from
two to twelve hours. In a majority of cases it ends in
death. In the more fortunate minority, reaction sets in,
marked by returning warmth and re-established secretions.

It is to be noted that the more rapidly fatal the case,
the earlier the collapse occurs, and the less abundant are
the evacuations. In the most terribly rapid cases, which
destroy life in a few hours, there are almost no evacuations.
It is evident, therefore, that death, in cholera, does not come
from the drain on the system resulting from the evacuations,
and, consequently, mere astringent remedies will not cure
cholera.

During an epidemic of cholera, diarrhoea is very prevalent.
It almost always precedes an attack, and doubtless predis-
poses to it. ' Instant attention should therefore be paid to
such premonitions. In like manner, slight cramps are often
felt. They should be regarded as premonitions, and medi-
cal advice should be sought at once.

The mortality of cholera has been very uniform. In
1830-32, on the continent of Europe and in Great Britain,
the deaths in private practice were about 39 ^ Per cent,
of the cases; in hospital practice they were about 57*^
per cent.

In Great Britain, there occurred, in 1831-33, 137,080
cases of cholera, of which 52,547 died, or about 38^ per
cent. In subsequent epidemics the figures have been about
the same. From the official returns in the daily newspapers
o/ New- York, in 1849, it appears, that in this city there
occurred, in a period of fifty-two days, 2,631 cases, of
which 915 died, or 34.78 per cent. The resident physician

508 CHOLERA.

reported, as treated in the hospitals, i ,02 1 cases ; of which
880, or 53.71 per cent, died.

These facts are startling ; but they are nevertheless facts.
Instead of striving to avoid and ignore them, we should
calmly accept them as incentives to our next topic : The
study of the causes which favor the occurrence and increase
the malignity of epidemic cholera.
/

II.

In coming to consider the causes which favor the occur-
rence and spread of cholera, and increase its malignity,
we are met by the questions: Is cholera contagious, — that
is, does it spread by touch or contact? Or, on the other
hand, does it exist in a community by virtue of some poison
diffused through the atmosphere, and to which all persons
in 'the community are alike exposed, and under the influence
of which all who are predisposed to the disease sicken,
whether they had been previously in the presence of cholera
patients or not ?

The ablest minds in the medical profession have sought to
solve these questions and have come to different conclusions.

In favor of the contagiousness of cholera, its general line
of march has been urged as an argument. It followed
established routes of travel : along the track of Eastern
caravans; from Asia to Moscow ; thence to St. Petersburg;
thence to Berlin and Hamburg ; from Hamburg on board
a vessel bound to England, and from this vessel to Sunder-
land, the port at which she arrived; from Sunderland through-
out England.

Again: Professor Simpson, of Edinburgh, traced cholera
from London, by a vessel, to Leith, where the sick of this
vessel were placed in quarantine on a hospital-ship. The
nurses of this hospital-ship were attacked with the disease,
no other cases of it having as yet occurred in Scotland. On
shore, it first assailed persons who had been in communi-

CHOLERA. 509

cation with the sick in hospital. In this manner the first
six cases that occurred in Scotland were traced to the ship
which had arrived from London, where cholera was pre-
vailing, and on which, during her voyage, passengers sick-
ened of cholera.

In the same way Professor Alison traced the first four
cases in Edinburgh. And these two very eminent physi-
cians had no doubt of the contagiousness of cholera in
the epidemic in question.

So, too, Mr. Moir, of Musselburg, showed that the first
twenty-three cases of cholera in Prestonpans could be traced,
by an unbroken chain of contact with the person or the
clothing of cholera patients, back to a first case, which came,
already ill, from a district in which cholera then existed.

During the first epidemic in the United States, a vessel
took some cases to Charleston, S. C. They were strictly
quarantined under military guard. Many of the soldiers
took the disease and died. So did some of the physicians
and nurses who were sent from the city to take care of the
sick. But not a case occurred in the city nor in any person
who had not been in contact with the sick.

Such facts as these can hardly be explained on any theory
of chances.

On the other side of the question, epidemics of cholera are
authentically described, in which the spread of the disease
could not be sufficiently accounted for by its mere con-
tagiousness. An English commission, sent to investigate
this very question, reported that in Asia, Turkey and Russia,
the history of cholera precludes the idea of its having spread
solely by contagion, or of its being an eminently contagious
disease. Instances are adduced of its invading a large
district or city, at several distant points simultaneously, and
of its attacking so many persons within a short space of time
that the doctrine of contagion alone would be inadequate to
explain the facts.

The strictest quarantine has not kept out the disease ; as,

5IO CHOLERA.

for example, at Moscow, where, to no purpose, a large
garrison preserved around the city a prohibitive cordon, kept
with a strictness known only in the Russian army.

At Charleston, although quarantine kept the cholera out
in 1832, it was of no avail in 1833. Though it seemed to
preserve New- York in December, 1848, yet cholera passed
its barriers in June, 1849.

Finally, it has been observed that, in some places and at
some seasons, although cholera has been introduced and
persons have been exposed to its infection, yet it does
not extend — certainly not for a long time. This was the
case in London in 1831, and in New- York in December,
1848. On other occasions it spreads like wild- fire, as at
Paris, in 1832, where, in one month, it carried off 20,000
persons.

But this last argument is not conclusive against the con-
tagiousness of cholera ; for the same apparent reluctance to
extend itself was observed in the case of the plague (univer-
sally regarded as contagious) in Cyprus, 1759. It has been
observed of small-pox and of typhus on some occasions.

From all the evidence on this subject we may conclude
that, while in certain epidemics cholera has undoubtedly
been introduced and propagated by contagion, yet the
degree of contagiousness of the disease has greatly varied in
different places, at different times and under different cir-
cumstances. We think that "contagiousness is not an essen-
tial attribute " of this (if of any) disease ; " it is an accident,
depending upon many modifying causes" (Russell); and
that, in most cases of disease (cholera as well as other
diseases), the question is not so much one of kind (contagious
or not contagious) as rather one of degree (highly contagious
or slightly so).

It appears that, at all times, there have been requisite for
the prevalence of cholera in a community a peculiar state of
the atmosphere and peculiar local conditions. And, almost
always, those who are attacked by cholera are found to have

CHOLERA. 5 1 1

been previously subjected to the influence of certain predis-
posing causes.

Admitting, therefore, the importance of contagion as a
means of conveying the seed of cholera, we perceive that
there must be in the individual in whom the seed is planted
a congenial soil ; and there must be, likewise, in the gen-
eral conditions of atmosphere and mode of life to which
that individual is subjected a favorable climate. If these
be lacking, the seed will not germinate and bear fruit after
its kind.

Let us inquire what conditions constitute this favorable
climate and congenial soil ; what are some of the predispos-
ing causes of cholera.

1. CLIMATE AND TOPOGRAPHY. Hot climates and the
warm season of the year predispose to cholera. The
epidemic, of 1817 began in a hot summer in Hindostan. In
all climates the disease has been temporarily checked, if not
extinguished, by cold weather. The apparent exception in
Russia is explained by the habits of the Russian people —
the great heat and the extreme filth of their winter habita-
tions. The epidemic of the past autumn in France seems
to have been checked by the coming on of cool weather.

Cholera has prevailed most severely, though not exclu-
sively, along the sea-coast and in the course of large rivers, —
more particularly where the land is low, flat and swampy, or
imperfectly drained. The low "made land" of commercial
cities is its favorite feeding-ground. In this cholera resem-
bles typhus and diphtheria.

2. HYGIENIC CONDITIONS. No fact is better established,
and none is more important to be widely known, than this :
That wherever FILTH abounds there cholera makes itself at
home. The exhalations from an undrained soil, saturated
with the washings of uncleaned streets; an atmosphere
tainted by the effluvia from accumulated decaying garbage

512 CHOLERA.

and from animal and human excretions — these furnish a
climate in which the seed of cholera will rapidly develop and
grow with rank luxuriance. This is demonstrated by both
positive and negative evidence.

In London, cholera was longest prevalent and was most
deadly in the uncleansed and overcrowded tenement houses.
In New- York, in 1832, it began in Cherry and Roosevelt
streets, and then appeared in Reade, Duane and Washing-
ton streets. It raged furiously at the Five Points, in the
"rotten row" in Laurens street, and at Corlaer's Hook. In
1849 it first appeared in Baxter street, then in Mulberry
street. It then broke out in Stanton and in Thompson
streets. Whoever is familiar with these localities will recog-
nize in their names the synonyms of vegetable decay and
animal filth, and will also know them as the undrained sites
of ancient swamps and ponds, the water of which still stands,
sending up vapors through their oozy soil. See General
Viele's recent pamphlet and map, " The Topography and
Hydrology of New- York."

On the other hand, it is stated on good authority that not
a single case of cholera occurred in any of the new " Model
Lodging Houses " of London, which are clean, dry, light
and well ventilated, and which are not allowed to be over-
crowded. In 1849, m Philadelphia, which, with the partial
exception of two districts, was prepared for cholera by
thorough cleansing, only 747 persons died of that disease,
while in New- York 5,071 died of it. Boston was still more
carefully purified, and the cholera confined itself to a few
narrow lanes and crooked streets of the city.

But the impure air that favors cholera is not found in
filthy, narrow streets alone. It may exist in splendid houses,
upon our cleanest and broadest avenues, if the sewers which
drain the houses be defective, clogged, or not ventilated. It
may exist in ANY sick-room, anywhere, if ventilation and
cleanliness of person and of furniture be neglected.

CHOLERA. 513

3. PERSONAL HABITS. It is universally conceded that the
free use of alcoholic drinks predisposes to cholera. It should
be remembered, however, that habitual drunkards are also
habitually filthy, and irregular in their habits, and are often
destitute. Those who, having previously abstained from
liquor, resort to its free use for the purpose of warding off
cholera, thereby only increase their liability to the disease.
On the other hand, those who are habituated to the moderate
use of wine run a risk if they suddenly discontinue this habit.

Excesses and extremes of all kinds predispose to cholera.
Excessive filth does so. So does excessive bathing, with a
view to extreme cleanliness ; for it reduces the heat of the
body, and debilitates the system. The inordinate use of
either animal or vegetable food is a predisposing cause.
But so, 'most emphatically, is fasting or abstinence, especially
as regards animal food. The excessive mortality from
cholera in Paris, which we have mentioned, occurred during
the fastings of Lent. Nothing like it occurred at any other
period. In a part of Louisiana, where nearly all the people
are Papists, the mortality during a cholera epidemic was
quadrupled during and after a three days' fast.

Anything, in food or regimen, that irritates the bowels
predisposes to cholera. So does fatigue or violent exercise.
Reduction of the temperature of the body by exposure to
night air or by excessive bathing has the same effect.

But the most powerful of all predisposing causes are
moral: fear, depressing dread — PANIC! We should strive
against this in every way. And we shall be most likely to
avoid panic this summer if we now faithfully employ every
means to ward off the disease we dread.

III.

From a study of the history and the predisposing causes
of the cholera, we turn to the practical questions: How
may we ward off the disease ? Or how, if it come among
34

514 CHOLERA.

us, may we circumscribe its extent and moderate its malig-
nity ?

Preventive measures may be collective, undertaken by the
state, for the common good ; or individual, set on foot by
individuals, or single families, for their own benefit

QUARANTINE. Do its advantages compensate for the
inconveniences and sufferings to individuals, and the great
losses, by restrictions on commerce, which it involves ?

It is not known that quarantine regulations have ever
protected any community during the entire course of any
epidemic. Yet, on the other hand, there is abundant evi-
dence that a strict quarantine has interposed, for a time at
least, an effectual bar to the advance of the disease, thus
postponing its visitations, though it could not prevent them.
To all who properly value human life above convenience in
journeying and the uninterrupted flow of trade, this fact is a
sufficient argument in favor of a strict quarantine.

Indirectly, a quarantine may operate for good or for evil.
For good, if, while it postpones the invasion of cholera for
three or six months, it nevertheless warns us to prepare for
its inevitable coming. For evil, if, by its temporary success
in staying the pestilence, it deludes us into fancying that the
destroyer will pass us by, and that we need take no care to
set our houses and cities in order against his coming. For,
it is probable that, by the aid of a rigid quarantine, we gain
the advantage of ample warning and of time to adopt the
necessary hygienic measures for mitigating the severity and
circumscribing the extent of the disease.

The chief of these measures is the removal of decaying
organic matter from our houses and neighborhood. Epi-
demics of cholera have been very aptly called "Providential
admonitions to ' clean up.'" They come with the graduated
severity characteristic of Providential warnings. We see
them far off. Their approach is gradual. At last they come
to our doors ; and there their advance is stayed for a time

CHOLERA. 515

by change of season or by our quarantine. During all this
time, if we have understood the warning, we may have been
diligently removing from our midst the predisposing causes
of the disease. In proportion to our promptness in taking
warning, and to our diligent faithfulness in preparing, will be
the gentleness of the final visitation. When, last June, we
heard of cholera in Egypt, we should have begun to clean
our city. Now that it has knocked at our doors, we have
still, in all likelihood, some weeks in which to make ready.

Of course, our streets must be cleaned. And means
should be taken to prevent garbage being thrown into the
streets. Many families throw refuse into the streets,
through ignorance and carelessness. A friendly word in
explanation of the bad consequences that result from it
would be more effective in preventing it than a city ordi-
nance. Every citizen may make it his duty to make such
representations and expostulations to his delinquent neigh-
bors. In so doing he will subserve his own interests.

But the greater part of the bad air of our houses comes
from cess-pools and sewers. Cess-pools and privy-vaults
should be emptied and cleansed during the cold winter
months. Drains leading from houses to cess-pools or sewers
should be carefully cleared, and all traps in such drains or in
soil-pipes should be opened and cleansed. It will be found
in many instances, that traps in waste and soil pipes, and
under kitchen-sinks, although they allow water to pass, are,
nevertheless, often clogged with considerable quantities of
most offensive matter.

DRAINAGE. Many houses in New- York and its suburbs
stand upon "made ground," which is not properly drained.
The cellars and surrounding grounds are damp. Such
localities should, if possible, be well drained. If this be
impossible, the cellars and lower stories must be kept
thoroughly ventilated, and the walls and cellar floors fre-
quently whitewashed, to destroy the fungi which dampness

5l6 CHOLERA.

and confined air develop. It must not be forgotten that
ventilation requires provision for both the entrance and egress
of currents of air.

VENTILATION. Wherever air stagnates, whether in cel-
lars or elsewhere in houses, there dampness collects, and the
lower forms of vegetation develop, and an atmosphere
results which predisposes to disease. In apartments which
are constantly occupied by human beings, the exhalations
accumulate upon the walls and taint the atmosphere.
Frequent applications of whitewash and abundant ventilation
are suitable correctives. These remarks apply to all of our
residences, and not merely to tenement houses and out-
buildings.

DRINKING-WATER is often made impure by decaying
vegetable or animal matters, and is then a fruitful source of
disease. Wells dug near privies or cess-pools, or near which
drains are laid, should always be examined with reference to
this fact.

From some of the dangers thus far enumerated the resi-
dents of New- York are exempt. But, to a greater extent
than most other people, they are endangered by

UNVENTILATED SEWERS. The sewers receive the refuse
from our houses. If the sewers were properly constructed,
this refuse would never stagnate in them. But even so,
decomposition of organic matter must continually go on in
them, evolving noxious gases. To prevent these gases
from flowing back into the houses through the waste and
soil pipes, stench-traps are placed in these pipes. They
consist of an elbow formed in the pipe, and in which water
remains, constituting a barrier to the backward flow of the
gases. But this is an effective barrier only so long as the
gases are subjected to no upward pressure. If the gases be
subjected to such pressure, they bubble up through the

CHOLERA. 517

water in the trap, and pass into the house through the
outlets of bath-tubs, wash-basins, and closets.

Now, it is notorious that in but few of the sewers of New-
York is the flow of matter unimpeded. No provision is
made for the outlet of gases from the sewers. The gases
accumulate, and, by this accumulation and by the heat
evolved in their generation, they become subjected to press-
ure. They bubble up through the stench-trap, and pervade
the house. Thus

OUR HOUSES VENTILATE OUR SEWERS ! Our refuse is
discharged into the sewers, only that it may there be con-
verted into poisonous gases, and be received again, in that
form, into our houses. The more completely, under these
circumstances, a house is provided with the " modern con-
veniences," the more deadly a habitation it is ! There are
houses in Fifth avenue and in Twenty- third street which have
illustrated these facts by the sad experience of their inmates.

In many houses there are, besides the main stench-trap
already described, secondary traps under each basin, closet,
or sink. In these cases, the portion of pipe intervening
between the main and the secondary traps becomes a
"closed chamber," in which the poisonous gases forced up
from the sewer are confined. Any increase of temperature,
even the varying heat of the house, will expand these gases,
and cause them to bubble up through the secondary traps,
and into the house, as before.

These most serious dangers may be obviated by ven-
tilating the sewers or the waste-pipes. The latter can be done
for himself by every householder. It is only necessary to
connect with his waste or soil pipe, just below the uppermost
trap, a small pipe, which shall be led up through the roof,
and shall open into the atmosphere, allowing the gases to
escape. This will prevent any pressure of gas below the
traps. Personal observation and experience have convinced
us of the great value of this ventilation of waste-pipes. On

518 CHOLERA.

a large scale, ventilation of sewers in English towns has
reduced the mortality from typhus to one-half its former
amount.

It should be noted that, as many of the predisposing
causes of cholera are the same as those of typhus and of
diphtheria, so preventives of the former are also preventives
of the latter hardly less deadly maladies.

It is a question of practical importance whether, in case it
has been impossible to empty and clean cess-pools and vaults
before the appearance of cholera, it would be safe to do so
after the disease has begun to prevail. We think not. It
would be better not to disturb the accumulation of organic
matter. But we may intercept the gases which arise from
these collections, and may hold them, employing for this
purpose a mixture of substances which chemically unite with
the gases and substances which mechanically absorb them;
as, for example, a mixture of equal parts of ground plaster
and of pulverized charcoal (or coal ashes) with the addition
of one-eighth part of copperas (sulphate of iron). This
should be spread upon the surface of the contents of the cess-
pool or privy- vault.

As regards the measures to be adopted by individuals to
ward off cholera, they must consist mainly in the avoidance
of those things which have been specified as predisposing
causes of the disease.

Excesses of all kinds are to be avoided — excesses of absti-
nence as well as of use.

The very free use of vegetable food, especially of the
coarser kinds.

Indulgence in alcoholic drinks.

Exposure to night air ; to cold ; to undue fatigue of any
kind ; to mental depression.

But it would be unwise to make, during the prevalence of
an epidemic, sudden and violent changes in habits, which,
though bad, are nevertheless long-established habits. "It is
not safe to trade horses when crossing a stream."

CHOLERA. 519

IV.

If, in spite of the measures by which we had hoped to
ward it off, cholera come among us as an epidemic, we shall
find it to our advantage to have well considered beforehand,
and determined, how we may best deal with it. This is a
question for each individual to settle for himself, since the
responsibility is his.

The obvious answer, as indicating the wisest course, would
be: "I will seek medical advice." But it is all important to
know what are the earliest signs that medical advice is needed.

Dr. Guerin, in his elaborate report on cholera to the
French Academy, lays great stress on the "fact" that
almost every case of decided cholera is preceded by, what
he calls, a " curable stage ; " a period during which the
patient suffers from a diarrhoea, or some other derangement
of the digestive organs. This may last even for a week or
ten days. It is often, apparently, so slight a deviation from
health that, in ordinary times, one would think it hardly
necessary to consult a physician or take remedies for it
But an experienced physician would at once recognize it as
a choleraic diarrhoea — as, in fact, cholera in the preliminary,
or, as Guerin calls it, the "curable stage." The patient
should place himself under medical treatment as early as
possible in this stage. This stage cannot be so described as
to enable a non-medical person to distinguish it with cer-
tainty from a common diarrhoea. Nor is it possible to give
such directions for its treatment as would be proper for a
large part of the community, without modification to suit the
constitutional peculiarities of each individual.

If " one man's meat is another man's poison," so, much
more frequently, is his medicine. No faith should, there-
fore, be placed in remedies or nostrums that are offered
as " sure cures " for everybody, in every stage of cholera,
etc. Each patient requires a treatment especially adapted
to his particular constitution, and to his actual condition.

52O CHOLERA.

Many persons are so fortunate as to have a medical
adviser who commands their entire confidence ; who has
attended them through dangerous illnesses, has studied
and appreciated their constitutional peculiarities and tenden-
cies, and to whose care they would, under any emergency,
unhesitatingly intrust their lives. To such persons no better
advice can be given than this : " Consult your physician ;
be advised by him how to guard against cholera, how to
meet its first advances, and then, resolving to follow his
counsels implicitly, go about your business with an easy
mind." But many are not thus happily situated. They
have no trusted medical adviser. Even now, in anticipation
of the coming of cholera, they are anxiously looking for the
soundest medical counsel, and for that system of medical
treatment which offers, in its statistics, the strongest guar-
antees of success. For intelligent members of the com-
munity well know that there are radical differences in the
views of medical men as regards the proper and the most suc-
cessful treatment of cholera as well as of all other diseases.

It were a foolish affectation to ignore these differences.
For the information, therefore, of those whose minds are
not settled, but who are in quest of facts on the subject
of these differences in modes of medical treatment, I will
give in this section a summary of the statistics of the treat-
ment of cholera under the two principal antagonistic systems
of medicine.

As might naturally be supposed, and for obvious reasons,
the mortality of patients treated in hospitals is always much
greater than that of patients treated at their own houses.

From 1831 to 1848 the mortality of cholera patients
treated by the ordinary, " regular," or allopathic treatment
at their own houses, throughout Europe, was one in two and
a half cases, or more than 39 per cent. In hospital practice,
during the same period, and under the same method, the
mortality was one in one and a half cases, or more than
57 per cent.

CHOLERA. 521

During the same period the mortality of patients treated
at their own houses, by homoeopathic physicians, was one
death in eleven cases, or a little more than 9 per cent.

In homoeopathic hospitals, the mortality was one in three
and one-twelfth cases, or a little more than 33 per cent.

In the city of New- York in 1832, the mortality under
allopathic practice was : in hospitals, 50 per cent. ; in private
practice, 33 per cent.

In 1849 the mortality under allopathic practice was: in
hospitals, 53.7 per cent. ; in private practice, 34.7 per cent.

During this epidemic in New- York, the aggregate mor-
tality under homoeopathic treatment, under many disadvan-
tages, was 15 per cent.

Summing up the whole number of patients hitherto re-
ported as treated homceopathically, in Europe and America,
both in private and in hospital practice, we find a mortality
of 9 per cent, while the most favorable statement of mor-
tality under allopathic treatment is 32 per cent.

But these reports of the results of homoeopathic treatment
have, although most unjustly, been called in question. It is
proper to authenticate them by citing the action of govern-
ment officials, who are not interested in the disputes of
physicians, and by quoting the words of distinguished medi-
cal men who are not homceopathists.

Dr. Gerstel, of Vienna, and Dr. F. F. Quin, now a vener-
able and distinguished practitioner in London, treated cholera
iin Tischnowitz, Moravia, in 1831. At the close of the
epidemic, a report was made to the Austrian Government
by the inspector. It concludes as follows :

" The proportion of deaths, compared with other places in
which the epidemic raged, was small. The homoeopathic
treatment, which was carried out to a great extent by Dr.
cGerstel, .was .the cause of this favorable result. (Signed)

DR. VICTOR MEKARSKY VON MERK,

" K. K. Inspector."

522 CHOLERA.

In 1836 cholera visited Vienna a second time. The prac-
tice of Homoeopathy was at that time forbidden in Austria,
but permission was obtained to open a Homoeopathic
Cholera Hospital. I state the result in the words of Mr.
Wilde, of Dublin, the distinguished aural and ophthalmic
surgeon, who is no friend to Homoeopathy. He says:1

" Upon comparing the report made [by the government
inspector, who visited the hospital daily] of the treatment of
cholera in this hospital with that of the same epidemic in the
other hospitals of Vienna at a similar time, it appeared that
while two-thirds of those treated by Dr. Fleischmann
(homoeopathic) recovered, two-thirds of those treated by the
ordinary methods, in other hospitals, died. This very extra-
ordinary result led Count Kolowrat, Minister of the Interior,
to repeal the law relative to the practice of Homoeopathy."

Thus the very fact that the practice of Homoeopathy has
been sanctioned by law in Austria since 1836, is an eternal
monument and testimony to the superior success of the
homoeopathic treatment of cholera.

In Paris, in 1848-50, Dr. Tessier, in the Hospital St.
Marguerite (Hotel Dieu, annexe), treated cholera patients in
his wards homoeopathically. The general report, made, not
by Tessier, but by allopathists, gives for his wards a mor-
tality from cholera of 34^ per cent., while in the other
wards and hospitals the mortality was 5 7 per cent.

In 1854, in Great Britain, Government established a
Medical Council to gather returns of the treatment and
mortality of cholera under every method, and to report to
Parliament

When the report was submitted to the House of Com-
mons, it was noticed that the returns of the homoeopathic prac-
titioners and of the London Homoeopathic Hospital were
not included in it. The House of Commons thereupon called
for these rejected returns, and they were presented in a sepa-
rate report, entitled " Return to an Address of Hon. House

1 Austria and its Institutions, p. 275.

CHOLERA. 523

of Commons, dated May 17, 1855; for copies of any
letters ; * * together with copies of any returns that have
been rejected by the Medical Council."

This return gives the statistics of the London Homoeo-
pathic Hospital, attested by Dr. McLoughlin, an eminent
allopathic physician, who was government inspector of
cholera hospitals, by appointment of the same medical
council which rejected the returns !

The mortality of cholera in the Homoeopathic Hospital
was 16.4 percent.

Under allopathic treatment, during the same epidemic, the
Medical Council's return to Parliament gives the mortality as
59.2 per cent.

In a public letter contained in the report of the Homoeo-
pathic Hospital, and addressed to one of the physicians of
this hospital, Dr. McLoughlin, Government Inspector, says : l

" You are aware that I went to your hospital prepossessed
against the homoeopathic system ; that you had in me, in
your camp, an enemy, rather than a friend. * * * That there
may be no misapprehension about the cases I saw in your
hospital, I will add that all I saw were true cases of cholera,
in the various stages of the disease ; and that I saw several
cases which did well under your treatment which I have no
hesitation in saying would have sunk under any other.

" In conclusion, I must repeat to you what I have already
told you, and what I have told every one with whom I have
conversed, that although an allopath by principle, education,
and practice, yet, was it the will of Providence to afflict me
with cholera, and to deprive me of the power of prescribing
for myself, I would rather be in the hands of a homoeopathic
than an allopathic prescriber.

" I cannot suppose that anything I have said above can be
of value to the homoeopathic system ; but, such as it is, you
are at full liberty to make what use you please of this letter

"LONDON, February 22, 1855."

1 See " Return to House of Commons."

524 CHOLERA.

Let it be remembered, as a grand result of statistics
hitherto, that in the cholera the homoeopathic treatment
saves 91 in 100 cases; allopathy saves never more than 68
in 100 cases.

These are facts, and they are re-assuring facts ! The wise
will heed them.

V.

The homoeopathic treatment of cholera, as of every
disease, requires, in order to the attainment of the greatest
success, a strict individualization of cases, and a special
modification of the treatment to meet the peculiarities of
each case. This can be done only by a skillful and experi-
enced homoeopathic physician ; and no general directions
for treatment can be published which will give the best possi-
ble method for treating each person attacked with cholera.
Those, therefore, who are within reach of a physician, should
summon him at the earliest moment. The following
memoranda are offered for the assistance of such as have no
physician at hand.

The subject divides itself into questions of:

1. PROPHYLAXIS, or PREVENTION of CHOLERA.

2. TREATMENT of CHOLERINE, or PRELIMINARY DIAR-
RHOEA.

3. TREATMENT OF CHOLERA PROPER.

i. PROPHYLAXIS. The fundamental principle of the
homoeopathic practice of medicine is this : that a sick
person is to be treated by the administration of a drug
which has been found, by experience or observation, to
produce upon healthy persons symptoms very similar to
those which the sick person presents.

CHOLERA. 525

In accordance with this great principle, it is clear that if
the symptoms which a drug produces upon healthy persons
are known, it is possible to foresee and to foretell what
kinds of sickness that drug will cure.

In this way, long before cholera had invaded Europe, on
its first westward march, Hahnemann, having become ac-
quainted with the action of these drugs upon the healthy,
perceived and announced that Camphor, Veratrum album,
and Cuprum metallicum, would be the most efficacious
remedies for cholera, and so it proved.

A similar application of the same law induced Hahne-
mann to recommend one or another of these remedies
(according to circumstances), as prophylactics, or prevent-
ives of cholera. The great weight of testimony compels us
to believe that this use of prophylactic remedies has saved
very many who would otherwise have been attacked. Dr.
A. Cricca, of Smyrna, in a report dated September 28,.
1865, says of those who, under his directions, used the
prophylactic remedies : " Out of the very considerable
number of persons of all classes and conditions (600 families
or about 3,000 individuals) not one (to our knowledge) has
been attacked with real cholera. Their slight derangements
of stomach have been easily cured by Veratrum album."

The selection of the prophylactic remedy must, to some
extent, be governed by the nature of the epidemic, and
therefore the best preventive cannot always be determined
until the epidemic has appeared, and its peculiar nature has
been ascertained.

Cuprum. But, as a general rule, both in Europe and in
this country, Cuprum has been considered the most efficient
preventive. A dose of Cuprum metallicum should be taken
every third day, on rising in the morning. It was noticed
that during the epidemic of 1 849, in Paris, workers in brass
and copper escaped the disease.

Sulphur. In some epidemics, Sulphur has been the best
prophylactic. It will be suitable if the diarrhoea which

526 CHOLERA.

prevails at the same time as the cholera, and the diarrhoea
which precedes many cases of cholera, be of the character
hereinafter described, as indicating Sulphur. It should be
taken as directed for Cuprum.

2. PRELIMINARY DIARRHOEA. It has been stated that
almost every attack of cholera is preceded by a diarrhoea,
which may last from six hours to six days, and which, if
promptly treated, is almost always easily cured.

During the prevalence of an epidemic of cholera, every
diarrhoea, however slight, should be regarded as being,
possibly, a preliminary to an attack of cholera, and should
at once receive careful attention. At the same time, it is
all-important that the patient should not give himself up to
fear and panic. Let him use his utmost self-control to keep
his mind calm and his faculties clear, so that he may be able
to observe his own condition and note its changes. Every-
thing should be done quietly, and without precipitate haste.
Prompt attention to the diarrhoea is advised, not so much
because the patient's condition is already a perilous one, but
rather that he may prevent it becoming such.

As soon as diarrhoea occurs, the patient should go to bed
and be warmly covered, but not so as to produce perspira-
tion. He should keep the recumbent position as long as
diarrhoea continues, using a bed-pan when the bowels move.
If thirsty, he may drink cold water, but in moderate quanti-
ties. The food should be light, but nutritious, and taken
frequently in small quantities. The appropriate remedy
should be taken without delay.

If the diarrhoea come on in the night, no matter how
slight it may be, the patient should immediately call
assistance, or begin to treat it. He must on no account
wait until morning, as many do, thereby losing precious
time.

The following remedies are likely to be suitable :

Sulphur. If the diarrhoea comes on in the night, after

CHOLERA. 527

midnight, the stools being yellow, pappy, and attended by
great urgency, though the urging is often ineffectual; and
if, at the same time, there are cramps in the soles of the
feet, Sulphur should be taken, a dose every two hours,
until relief is experienced. It is a general rule that doses of
medicine should not be repeated after the patient has begun
to improve, nor so long as improvement continues to
progress.

Phosphoric acid. If the evacuations are light- colored,
liquid, copious, and not attended by pain ; if the tongue is
covered with a gluey mucus, and there are cramps in the
arms, with a general sense of weakness, Phosphoric acid is
the remedy. Take as above.

Arsenicum. If the evacuations are frequent, small in
quantity, liquid, dark-colored, and quite offensive ; attended
by sharp pain very low in the abdomen and by burning in
the rectum, and followed by great prostration of strength ; if,
likewise, the patient has great thirst, drinking but little at a
time, and is very restless in body and anxious in mind, he
should take Arsenicum, as directed for Sulphur.

Croton tiglium. If the evacuations are sudden and very
copious, consisting of a large quantity of yellow water,
which passes with a rush, and if an evacuation occurs every
time the patient drinks, Croton tiglium is the remedy. Take
as directed for Sulphur.

Veratrum album. If the diarrhoea is watery, copious,
and very painful, and is accompanied by copious vomiting,
which is repeated every time the patient drinks, and by cold-
ness and blueness of face and hands, and cold sweat on the
forehead, Veratrum album must be taken, and repeated
every fifteen minutes until warmth returns and water can be
retained on the stomach.

3. CHOLERA. A case may pass gradually from choleraic
diarrhoea into real cholera; or a neglected diarrhoea may
apparently cease for a time, and then cholera may suddenly

528 CHOLERA.

supervene ; or cholera may come (it rarely does so) without
warning.

In the last two cases, symptoms resembling those already
described as characterizing COLLAPSE are present. The
patient suddenly loses strength, and looks pinched and blue.
The skin becomes very cold ; the voice husky and deep ; the
skin of the fingers shrivels. There are intense distress and
anguish at the pit of the stomach and burning in the bowels.
The patient tosses in agony. There are cramps in the calves,
and sometimes nausea and vomiting, with cold sweat; but,
generally, the evacuations, both up and down, are moderate
and infrequent.

Camphor. This is the form of the disease for which
Camphor has been proved to be so excellent a remedy.

In addition to the administration of Camphor, the patient's
extremities should be vigorously rubbed, and bottles of hot
water applied to them until the natural heat is restored. The
room should be well ventilated, and cold water given freely
if desired.

Carbo vegetabilis. Sometimes the collapse is still more
marked. Even at the outset, the tongue and very breath
are cold. The voice is extinct. There is no vomiting,
diarrhcea, spasm, or pain. The urine is suppressed. Give
Carbo vegetabilis every five minutes, until warmth returns.

Veratrum album. When the evacuations are profuse, both
upward and downward, consisting of rice-water and frothy
fluids, with great anguish in the abdomen, thirst for cold water,
which is taken in large quantities, but is vomited as soon as
swallowed ; with contracted features, cold sweat on the fore-
head, hands and feet, moderate cramps in hands, feet and
calves; with suppression of urine, — Veratrum album should be
given ; a dose every five minutes until decided improvement
is manifest.

In cases requiring Camphor the COLLAPSE is the most
prominent feature. In those which require Veratrum album,
the EVACUATIONS and the COLDNESS are the most promi-

CHOLERA. 529

nent symptoms. But in those cases which call for Cuprum,
the SPASMS or CRAMPS are most prominent.

Cuprum metallicum. When the evacuations are not very
copious, but the spasms in the chest and stomach are very
painful, with great tenderness to touch, the spasms coming
on in paroxysms, both in the stomach and in the extremities ;
the thirst is moderate ; the vomiting is allayed, for a time, by
drinking water ; the face is blue and cold ; the respiration
short and labored; the voice husky; and the urine sup-
pressed, give Cuprum metallicum as directed for Veratrum.

ADMINISTRATION OF REMEDIES. Where medicines in
liquid form are used, a drop of the liquid, on sugar or in
water, may be used as a dose ; where used in the form of
powder, as much as would lie on a three-cent piece ; where
globules, three or four.

Inconvenient results have been observed from the use of
too large and too frequent doses of Camphor ; and the pub-
lic should be cautioned against using Camphor without a
clear indication of its necessity. Where too much has been
taken, it produces terrible anguish and burning at the pit of
the stomach, so great as to drive the sufferer almost to
despair. A few globules of Phosphorus will promptly anti-
dote the Camphor and relieve the patient

35

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II
DUE

vi

SRLF

WB930

D917h

1877

Dunham, Carroll 1828-77
Homeopathy the science of therapeutics