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Jonathan Klarfeld 


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London : J. M. DENT & SONS, Ltd. 
New York: E. P. BUTTON & CO. 

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translator's preface .... 
introduction ..... 

author's PREFACE ..... 

translator's note 

organon of the rational art of healing 




. xxvii 

. xxviii 













The original suggestion that Hahnemann's 
Organon was worthy of a place in Every- 
man's Library came from the late Mr. James 
Speirs, and was supported by the British 
Homoeopathic Association, of whose Council 
Mr. Speirs was a member. Mr. J. M. Dent 
looked favourably on the proposal, but was 
naturally anxious to make clear that the Organon 
is put forward here as a piece of history rather 
than as a contribution to polemics. For this 
reason the original edition of 1810 was selected 
for presentation, as it both constitutes a land- 
mark in medical history and is less controversial 
than the later editions. The name of Robert 
Dudgeon is inevitably bound up with the render- 
ing of Hahnemann's works into English, but 
inasmuch as Dr. Dudgeon worked from the 
latest and fullest edition, another translator had 
to be sought for this, the original edition. The 
association of Dr. Dudgeon with Hahnemann is 
maintained, however, in Part H of this volume, 
for the translations of the essays contained 
therein are from his pen. His version of the 
Organon has also been for me a court of appeal 
and constant help in difficulty, and it remains 
by far the most valuable record for any one 


desirous to test the truth of Hahnemann's 

In preparing my translation I have had the 
advantage of the co-operation of Mr. James 
Speirs, until his sudden and untimely death, 
and the invaluable assistance of my friend, Dr. 
T. Miller Neatby, M.A., who has constantly 
criticized the work both as physician and as 
writer, giving a value to this version which it 
would otherwise have lacked. To him I render 
my most hearty and grateful thanks : indeed, I 
am deeply conscious that his aid will count for 
no small proportion of any acceptance which this 
volume may win. 

C. E. Wheeler. 

35, Queen Anne Sf., W. 
March, 27, 19 13. 


The Organon of Samuel Hahnemann is one 
of those books whose effect upon the world has 
been, in its intensity, out of all proportion to 
the extent to which its pages have been read. 
It is the foundation upon which the structure of 
Homoeopathy has been built. Its successive 
editions (five in Hahnemann's lifetime) embodied 
the ripe experience and confident beliefs of its 
author, and old-fashioned as its phraseology 
sounds to-day, and out of date as many of its 
conceptions appear, it is not too much to say 
that the principles of Homoeopathy, and even the 
most effective art of applying those principles, 
are expressed in the Organon in a way that 
might easily be modified in the phrasing, but 
must remain unaltered in the essence for any 
who wish to test this method of practical thera- 
peutics. But the storm of anger and opposition 
that broke over Hahnemann and his method 
was the very worst atmosphere for the calm dis- 
passionate enquiry which he eagerly desired, 
but which he and^his followers have longed for 
in vain. Individtials have granted the enquiry 
(thus, indeed, has the system made its converts), 
but the Profession, never. Consequently less 
than five per cent, of the practitioners of medicine 
at any time have had even a remote acquaint- 
ance with the Organon, with the result that its 
undoubted effect has been exerted indirectly and 
Hahnemann has lost much honour that should 
have been his. The difference between the 



orthodox medical practice to-day and the practice 
of a century ago (tiie first edition of the Organon 
appeared in 1810) is very great. Pasteur and 
Lister and their followers have revolutionized 
surgery, but the therapeutics of drugs (the sphere 
of Homoeopathy) have also changed exceedingly, 
and practices like bleeding and blistering and 
drastic measures of that order have almost dis- 
appeared. Yet to Hahnemann's contemporaries 
these drastic procedures seemed the only way 
of salvation, and though founded on the wildest 
theories, which in their turn were supported by 
hardly a shred of evidence or experiment, they 
were yet persisted in with that blind optimistic 
confidence which has seldom been found lacking 
among the descendants of ^sculapius. Gradu- 
ally from 1 8 10 up to the present time the scene 
has changed, and although physicians still de- 
plore the lack of method shown in giving medi- 
cines, and although many of the most famous 
of them express an almost universal scepticism 
of the value of drugs, they have at least learnt 
caution and the powers of recovery that belong 
to unaided Nature, and seldom to-day do they 
load the balance against the patient after the 
authentic fashion of their predecessors. The 
march of science, that is of exacter knowledge, 
through the century has counted for much in 
this change of attitude, but tlrc influence of the 
constant presence of even the small minority of 
believers in Homoeopathy has been a force that 
cannot be overlooked. While bleeding and 
salivation and purgation and drastic methods of 
counter-irritation were confidently proclaimed as 
essential to the treatment of disease, there was 
always after 1810 a remnant that refused these 
methods and demonstrated to all who would see 


that patients recovered more surely and more 
speedily in the hands of those who used only 
minute doses of simple remedies.^ 

Granted that many cures attributed to Homoeo- 
pathy may have been really due to natural 
powers of recovery working unhindered, what 
more damning indictment of the older methods 
could possibly be presented? If it be held (as 
many hold who admit the effectiveness of 
Homoeopathy), that its work was purely to 
demonstrate the recuperative powers of Nature 
unimpeded by the physician, that negative 
achievement of Homoeopathy would yet suffice 
to place the name of Hahnemann among those 
who have benefited mankind. 

Therefore, as an historical work, the Organon 
may be offered to every man as a book of great 
interest, a book whose effects, negative and 
positive, have reached many to whom its contents 
have been unknown and to whom the name of 
its author has been only a synonym for crazy 
theorizing and unprofitable speculation. But 
there is another claim to attention which may 
be urged on behalf of the book, a claim that will 
be better realized if it is approached through a 
brief account of Hahnemann and of the nature 
of his work. 

Hahnemann was born at Meissen in Saxony 

^ Of the superior results obtained by Homoeopathy while 
the drastic means of treatment were still in popular use there 
can be no doubt whatever. Everywhere the official influence 
of the Profession was used to decry and suppress the heresy, 
and it was only through the conviction of state-governing 
bodies that Homoeopathy's results were so good, that its 
adherents obtained leave to practise. The clause in the 
English Medical Act which ensures the status of Hahne- 
mann's followers was directly due to. the vastly superior 
results obtained by them in treating cholera in London. 


in the year 1755. His parents, though poor, were 
filled with a sense of the value of knowledge and 
obtained for him such education as they could. 
By dint of great natural aptitude and diligence 
he made the most of the opportunities so obtained; 
and he was able, in process of time, not only to 
complete his medical studies and obtain his 
degree, but also to become an erudite man. His 
knowledge of languages was unusually exten- 
sive, including besides his native German, Eng- 
lish, French, Italian, Greek, Latin, Hebrew, 
Arabic and Spanish. Therefore in all his 
voluminous studies of the medical wisdom of 
the past he w^as able to consult each author in 
his own tongue. But his bent was ever to 
science rather than to literature. He was deeply 
religious and the Bible has left its mark upon 
his style of writing; but there are few or no 
traces in his works of the great political and 
literary movements that synchronized with parts 
of his long life. The Organon exhibits a pas- 
sionate desire for exact and clear statements, a 
desire which, at any rate to the English mind 
seems at times to conflict with the structural exi- 
gencies of the German tongue. Indeed, his 
desire for clarity leads him into repetitions which 
end in confusion, and the Organon is hardly to 
be recommended as a model of style. But 
throughout it is at least w^orkmanlike, clear in 
thought, arduously painstaking and full of pas- 
sionate conviction, yet withal moderate and 
argumentative through all its apparently dog- 
matic utterance. No unprejudiced person can 
rise from its perusal without a respect for Hahne- 
mann, and what is true of the Organon in this 
respect is true of all the other writings of this 
great physician. 


Up to the year 1790, that is until he was thirty- 
five, he worked at his profession and at other 
branches of science, especially at chemistry. In 
this last field he was responsible for much 
admirable work, and witness to his ability is 
furnished by the great Berzelius, who said of 
him, "The man might have been a great 
chemist " : testimony the more to be valued as 
Berzelius had no fraction of interest in or sym- 
pathy with Hahnemann's medical opinions. 
As a physician Hahnemann was recognized by 
1790 as one of the best in Germany. Hufe- 
land, the leader of the German medical pro- 
fession at this time, spoke thus of him, and 
retained a staunch regard for him and a 
high opinion of his abilities, though he never 
followed him into Homoeopathy, nor even, as 
far as appears, submitted it to any practical 

As a physician Hahnemann made several most 
competent and valuable contributions to general 
medicine; among them may be specially men- 
tioned his rational and humane teaching with 
regard to the treatment of the insane, and his 
practical hints on the management of epidemics, 
in both of which matters he was much in advance 
of his contemporaries and virtually anticipated 
all the modern points of view. But in spite of 
his standing in the world of medicine, he was 
profoundly dissatisfied with the art of medicine. 
The smallest knowledge of the treatment that 
was current and orthodox in his day is enough 
to explain his dissatisfaction, for dangerous 
practices were then deduced from almost base- 
less theories to an extent nearly incredible, and 
although Hahnemann's caution and sound sense 
kept him from the worst pitfalls, he was left in 


the helpless state of having no alternative method 
to supply the place of all that his reason rejected. 
By 1790 he had almost withdrawn from practice 
and was earning his living by translating 
medical works. At this time he was engaged on 
Cullen's Materia Medica, and being dissatisfied 
with Cullen's explanation of the action of cin- 
chona bark in relieving and curing ague, he 
took the scientific and rational course of personal 
experiment in order to test the matter. It is 
needless to state that the treatment of ague by 
cinchona was one of the few really satisfactory 
pieces of treatment in Hahnemann's day, and, 
not unnaturally, speculation was rife as to the 
reason of this definite curative relation between 
drug and disease. Hahnemann's experiment 
consisted in taking a large dose of cinchona 
bark while in good health and noting its effect 
upon his own healthy body. To his surprise he 
found reproduced upon himself all the chief 
phenomena (and even many of the minor symp- 
toms) of a paroxysm of ague. When the attack 
passed off, a second dose produced a second 
paroxysm, and Hahnemann was presently face to 
face with the fact that this drug, which so often 
cured ague was capable of reproducing in his 
own healthy body the phenomena of ague. Like, 
in fact, cured like. Cinchona bark does not 
invariaLly produce this effect on the healthy, 
even in large doses, but the general truth of 
Hahnemann's observation, though sometimes 
questioned, has been amply confirmed ; and Pro- 
fessor Lewin, the great German authority on 
Materia Medica, who has no leanings to Homoeo- 
pathy, not only quotes this experiment of Hahne- 
mann, but endorses it as illustrating a genuine 
result of the drug, and confirms it with similar 



cases. There are always individual reactions to 
individual drugs, but it may be taken as estab- 
lished that cinchona bark tends, at any rate, to 
produce phenomena similar to those which it can 
cure, although the extent of the tendency varies 
in different experimenters. 

This experiment was a ray of light to Hahne- 
mann, for it suggested a possible clue to curative 
relations between drugs and cases of disease, a 
clue which he eagerly followed up. Those, and 
they are not a few, who are ignorant of his 
life and work, and yet brand him as a shallow, 
crackbrained dreamer or designing charlatan, 
are apt to think of him as rushing forth into 
the world with a complete system of medicine 
erected on the foundation of one doubtful ex- 
periment. The truth is far other than this. As 
soon as the cinchona experiment suggested to 
Hahnemann the possibility that the principle of 
like to like might prove a general Law of Heal- 
ing, he began a systematic study of the records 
of medicine in the search for instances. He 
soon found numbers, many of which were men- 
tioned in a preface to the Organon, which in 
this edition is summarized shortly, as its interest 
is technical and professional only. But over and 
over again Hahnemann found that a drug pre- 
scribed empirically had proved itself capable of 
curing conditions similar to those which it could 
produce. The records of medicine, in fact, gave 
plenty of encouragement to his now dawning 
belief that similia similihus was a genuine Law 
of Cure. But he did not neglect present experi- 
ment while searching out past experience. He 
returned to medical practice, and as opportunity 
offered he prescribed drugs for the diseases 
whose symptoms they could counterfeit, and 


noted his results. Having interested a few 
friends in his experiments, he now began to lay 
the foundations of his vast work on Pure Materia 
Medica, his reason being that, in order to pre- 
scribe homoeopathically, that is, on the basis of a 
similarity of symptoms between drug and dis- 
ease, it is necessary to have a full knowledge of 
drug-symptoms. Such knowledge was largely 
to seek, because in spite of the work of a few 
previous experimenters like Haller and Stoerck, 
the effects of drugs upon the healthy, apart from 
cases (comparatively rare) of poisoning, could 
only be known from records of over-dosing in 
sickness, records wherein drug-symptoms and 
disease-symptoms were intermingled and con- 
fused. In order to gain a knowledge of pure 
drug action "provers" had to be enlisted, 
healthy and devoted persons who would take 
drugs in sufficient quantities to produce clear 
symptoms, and by recording these symptoms 
would begin the task of constructing clear 
symptom-pictures of remedies for comparison 
with the symptom-pictures of cases of disease. 
Hahnemann and a few of his friends attacked 
this herculean task and continued it year after 
year, until a mass of exact knowledge was avail- 
able with regard to the effects of drugs such as 
had never existed before; knowledge which re- 
mains the more important part of the homoeo- 
pathic Materia Medica, although a century of 
continued experiment and clinical experience has 
added to it and clarified it. 

In research and in experiment six years 
passed, and in 1796 Hahnemann felt justified in 
publishing a first statement of his beliefs. This 
appeared in Hufeland's Journal, the leading 
medical periodical of that day. In the article 



Hahnemann stated his theory, and adduced in 
its favour the evidence of the past as well as 
the results of experiment. While this article is 
the presentation of a case by a man who believes 
in it, it is not a dogmatic assertion so much as 
a plea for further experiment. The plea was 
denied, as virtually all the pleas of homoeopathy 
to be tested before it is condemned have been 
denied. The first stirrings of the storm of 
obloquy and hatred which it was the fate of 
Homoeopathy to rouse were already audible, but 
Hahnemann returned to his experiments un- 
deterred. In 1805 appeared the first collection 
of drug symptoms, the forerunner of Materia 
Medica Pura which appeared in instalments 
between 181 1 and 1827; and in 1806 another 
essay on the general theory of Homoeopathy 
which formed a kind of preface to the Organon. 
Ten years more of unwearying experiment have 
passed by, and Hahnemann can at least claim 
that he has shrunk from no effort to establish 
the truth by the only means known to science, 
experiment and observation. But between 1796 
and 1806 appeared various essays on points 
related to the lawswii/fa similibus curentur ("Let 
likes be treated with likes "), a law which after 
sixteen years of labour he felt justified in pro- 
claiming. In 1801, for instance, appears the 
first hint of that practice which, more than any 
other, is associated in the mind of every man 
with Homoeopathy, the practice of administering 
drugs in minute and, ultimately, in infinitesimal 
doses. Though to many this practice is of the 
essence of Homoeopathy, it is, strictly speaking, 
an unessential addition to the central law. The 
law of Hahnemann and of Homoeopathy governs 
only the choice of the remedy, and when a drug 


is given to cure a disease the symptoms of which 
it can counterfeit when given to the heahhy, 
then, consciously or unconsciously, Homoeopathy 
is practised, be the doses large or small or in- 
finitesimal. Unconscious Homoeopathy is not 
uncommon, and instances now and then appear 
in orthodox journals. Seeing that by the 
homoeopathic law drugs are chosen that act 
similarly to diseases, it would seem only reason- 
able to use them with caution lest the condition 
be aggravated, but the precise amount necessary 
for any particular case is a matter for the 
physician to decide from his own experience. 
Hahnemann and his followers appeal always to 
experience and experiment. They say in effect : 
"We have made certain experiments and we 
find a certain constant relation to exist between 
drugs and diseases. Of this we are so confident 
that we cannot admit an adverse opinion not 
founded on experiments equally painstaking. 
But among ourselves we find considerable 
divergences as to the best dosage for individual 
cases. JNIost of us have found drugs active in 
quantities minute or infinitesimal, but we can 
lay down as yet no law of dosage comparable 
to the law of selection of the remedy. We sus- 
pect that just as there is an optimum remedy for 
any given case, so there is an optimum dosage. 
Our experiments universally lead us to dosage 
much smaller than that customary with non- 
homoeopathic physicians, but the exact range of 
it should, we think, be a matter of individual 
experience and experiment." This at least 
would sum up fairly the present position among 
homoeopathists with regard to the question of 
the dose. It is entirely secondary to the choice 
of the remedy, and it is that choice and not the 


amount of the drug actually administered that 
stamps a treatment as homoeopathic. 

In 1 8 10 appeared the first edition of the work 
before us, The Organon of Rational Medicine, 
which is here translated as it stands, with the 
omission only of such notes as have a purely 
technical interest. Exactly twenty years of 
arduous experiment and close observation had 
passed since the first gleam of a possible law- 
flashed on Hahnemann's mind. Right or wrong, 
at least he cannot be justly accused of haste or 
scanty consideration. All that he could do 
scientifically to test his case he has done, and 
he rightly speaks now with confidence and some 
scorn of any who should (and actually did) con- 
demn his conclusions without any enquiry into 
those experimental bases upon which his con- 
clusions rest. Although the first edition went 
oflf but slowly, five editions in all were published 
in Hahnemann's lifetime, and the work became 
and has remained the chief foundation-stone of 
Homoeopathy. Hahnemann never ceased to 
observe and to test, and the later editions of the 
Organon contain a good deal of additional 
matter embodying his later experience, but 
nothing that conflicts with the essential prin- 
ciples laid down in the first edition. Especially 
he came to develop views concerning the origin 
of chronic diseases and the best method of 
treating them homoeopathically, which modify 
some of the paragraphs here set forth and add 
a good deal of fresh material. With those 
views we have here little to do. The Organon 
is presented in this edition as a work of profound 
historical interest and value, not as a polemic 
in favour of a cause. Though a day should 
come when Hahnemann's views are proved 


erroneous (and that day is not yet), the Organon 
would still retain an historical and personal in- 
terest which makes it unnecessary to preface it 
with any full controversial argument. It will 
suffice to say of Hahnemann's views on chronic 
diseases that although his theories have by no 
means found universal acceptance among his 
followers, the practice he founded upon them 
has proved itself of real value, and those who 
have accepted the theoretical basis and built 
their practice on it most definitely are generally 
those who have proved most successful in deal- 
ing with chronic diseases. In this, the first 
edition of the Organon, insistence is only laid 
upon the law of treating likes with likes. That 
is now, as then, the central law of Homoeopathy 
to which the small dosage of remedies and the 
theories of chronic diseases are accessory but 
not essential. Hahnemann died in 1843 full of 
years, having won the enthusiastic respect and 
honour of a large number of the laity and the 
no less earnest hatred and scorn of most of his 
profession. Homoeopathy has never been the 
faith of more than a small minority of medical 
men, but it has spread all over the world and 
can count its adherents and its hospitals and 
dispensaries everywhere. In Europe, inasmuch 
as the ban of official medicine has been pub- 
lished against it, and its followers have been 
denied all chance of holding teaching posts or 
influential positions, it has had to strive against 
great odds and make its way in the teeth of an 
opposition none the less powerful because 
founded chiefly on ignorance and prejudice. 
Still it has held its own and gained ground. 
Governments have refused to join in the pro- 
fessional attack upon it, and although in Europe 


there are no homoeopathic schools, and although 
every convert has to be won from the ranks of 
those who have been officially taught to regard 
it as folly or charlatanism, still it makes its 
converts. The minority hold to it because they 
have tested its claims and found them valid. 
The majority decry it because (in almost every 
case) they have little or no knowledge even of 
its aims, and still less experience of its practical 
application. In America, less hampered by 
tradition, it has had a fairer field, and though 
even there the faith of a minority, it neverthe- 
less numbers its doctors by the thousand and 
possesses its own schools and colleges. 

General medical science has enormously ad- 
vanced since the days of Hahnemann, for, thanks 
mainly to Pasteur and Lister, surgery is a great 
beneficent force, and although leaders of medi- 
cine still bewail the lack of exact therapeutic 
methods, yet their art is now fairly free from 
the reproach of doing active harm. The early 
results of Homoeopathy were contrasted with the 
results of men whose methods were dangerously 
drastic, while modern medicine is sceptical of 
its power to heal, but careful not to hurt, and 
this is a great gain. Homoeopathy as an art is 
concerned only with the use of drugs in diseases. 
All that pertains to surgery and to the accessory 
branches of medicine is as much within the 
power of the followers of Hahnemann as of any 
others, and they have not been slow to avail 
themselves of these gains of knowledge. But 
they retain the faith that, in the sphere of the 
application of drugs to diseases, the law of 
similars is a weapon potent to relieve and cure 
with swiftness and certainty w^henever its in- 
dications are clear. Moreover,^ certain advances 


of modern science give them confidence that 
they have in Homoeopathy a genuine law of 
tissue reaction. For the study of protoplasm 
has led to the formulation of certain biological 
laws, universally accepted, concerning its re- 
action to stimuli; and the fundamental law of 
such reactions applying to all stimulating agents, 
whether chemical (as e. g. drugs), electrical, 
mechanical or other is that the same agent which 
in relatively large doses can damage or destroy 
life activity, can in a relatively smaller dose stim- 
ulate it. Whence it follows that if by experiment- 
ing with drugs upon the healthy we have learned 
the tissues which these agents have it in their 
power to injure (and we deduce this from the 
symptoms exhibited), and if we find these same 
tissues manifesting by similar symptoms the 
injurious effects of disease, then we can con- 
fidently administer small doses of the drugs 
which we have independently found to have the 
power of damaging those tissues, knowing that 
the STYiall dose will act as a stimulus to those 
very cells that need a stimulus ; and this is to all 
intents the homoeopathic law. This approxima- 
tion to the law has been worked out by biologists 
untainted with the heresies of Hahnemann, and 
has led at least one distinguished teacher of 
Materia Medica, Professor Hugo Schuiz of 
Greifswald, to conclusions which he is suffici- 
ently open-minded to admit resemble those of 
Homoeopathy. This admission has prevented 
most of his orthodox colleagues from studying 
his work and has brought a certain amount of 
obloquy on his head. 

But now Bacteriology (which was a sealed 
book to Hahnemann, though he gained a pre- 
scient glimpse of some at least of its contents 


when he met with cholera) comes upon the scene 
to make a practical application of these biological 
laws, and from them to develop the modern 
"vaccine " treatment. This treatment is founded 
upon the observed facts first that certain micro- 
scopic organisms (bacteria) are by their multi- 
plication in the body the specific agents of certain 
diseases; second, that the body elaborates 
specific defences and offences by which to resist 
and overcome them; and third that when this 
defensive and offensive mechanism is insuffi- 
cient it can often be stimulated to sufficiency by 
the administration of a remedy manufactured by 
growing the specific causal germ or germs out- 
side the body, and from these ''cultures " making 
a preparation known as a vaccine. In other 
words the germ (somewhat modified) is the 
remedy for the disease that the germ itself pro- 
duces. And if this is not Homoeopathy it is 
difficult to know by what other name to call it. 
The growth and success of vaccine treatment 
has actually been a great encouragement to 
homoeopathists, and many great bacteriologists 
have in recent years come to speak with less 
acerbity of Homoeopathy, and the general pro- 
fessional bitterness has largely abated. Add to 
this the newest theories of physics and the dis- 
covery of the powers of radium, which render 
the action of the infinitesimal at least more 
credible, and it must be admitted that the lapse 
of a hundred years has made the fundamental 
dogma of the Organon not less, but more de- 
serving of the test of experiment. Enormously 
as some of the great scourges of mankind have 
been brought under control, there are few in- 
habitants of the civilized world that are not at 
one time or other in need of a physician. It 


concerns every man that no avenue of possible 
help should be left unexplored. Now it is un- 
deniable that from a variety of reasons, easily 
explicable, the theories of the Organon and the 
practice founded on them have not received 
the bare justice of a satisfactory testing. In the 
main the few who have tested them have come 
to believe in them, and have been willing to 
endure ostracism and ill-will for their faith, but 
the many have been content with a scornful 
denial of statements which they have never 
troubled to investigate. There is no room here 
for a consideration of personal rights and 
wrongs; the issues of life and death, health and 
disease, are too grave. It would not be worth 
while to perpetuate a difference even in order to 
win justice for Hahnemann as neither dreamer 
nor charlatan, but a great physician. But until 
this possible source of strength to medicine is 
amply tested and once for all confirmed or dis- 
proved there must be an uneasy feeling of a 
possible waste of power and some smouldering 
rancour and ill-will. There is no adequate test 
but that of personal experiment, patient and 
oft-repeated, but before experiment must come 
curiosity and a desire for conviction positive or 
negative. This curiosity and this desire hardly 
exist, but no one sufficiently scientific to avoid 
prejudice could read the Organon without first 
wondering and then testing. Out of the multi- 
plication of experiments should come at last a 
full and fair conviction. 


Truth for which all the eager world is fain, 
Which makes us happy, lies for evermore 
Not buried deep but lightly covered o'er. 
By the wise Hand that destined it for men. 


The testimony of all ages is in nothing more 
unanimous than in maintaining that the art of 
healing is an art of conjecture (ars conjecturalis) : 
no art therefore has less right to refuse a search- 
ing enquiry into the soundness of its basis than 
this art upon which health, the dearest earthly 
possession of man, is founded. 

I count it to my credit that in recent days I 
have been alone in subjecting it to a serious 
impartial investigation, and that I have laid 
before the world in signed or anonymous pub- 
Ucations the convictions which have resulted 

Through this enquiry I found the road to 
truth, upon which I have to tread alone, a road 
far removed from the common highway of 
medical routine. The further I advanced from 
truth to truth, the further did my conclusions 
move from that ancient structure which, having 
been built out of opinion, is now only main- 
tained by opinion, although I allowed no single 
one of my conclusions to stand unless fully con- 
firmed by experiment. 

The results of these convictions are stated in 
this book. It remains to be seen whether 
physicians who intend to deal fairly with their 



consciences and with humanity can open their 
eyes to the health-giving truth, or whether they 
will continue to abide by their baleful tissue of 
arbitrary conjectures. 

This warning at least I would give at the 
beginning, that indolence, desire for ease, and 
obstinacy make service at the altar of truth 
impossible, and that only freedom from pre- 
judice and tireless zeal avail for the most holy 
of the endeavours of mankind, the practice of 
the true art of healing. But the physician who 
works in this spirit follows close after God, the 
Creator of the world, whose creatures he helps 
to uphold, and whose approval makes his heart 
thrice blessed. 


In the original edition, between the preface 
and the body of the work, Hahnemann inserted 
an introduction, devoted mainly to a record of 
applications of the homoeopathic law made un- 
consciously by other physicians and recorded by 
them. This introduction is therefore mainly of 
a technical interest and is here omitted, but some 
idea of the care and thoroughness of Hahne- 
mann's investigations can be formed from the 
fact that he quotes nearly two hundred and fifty 
instances of unconscious Homoeopathy, most of 
them not isolated cases, but records of repeated 
experiences; and supports them by the evidence 
of no fewer than four hundred and forty physi- 
cians mentioned by name, with a reference to 
the source from which each opinion is derived. 


Original Works. — Inaugural Thesis {Conspectus affeduum 
spasmodicoru77i cctiologicus et therapeutiais, qiiem dissertatione 
inaugurali medica . . . submittit S. H.), Erlangen, 1779; Direc- 
tions for Curing Old Sores and Ulcers {Anleitung alte Schdden nnd 
faule Geschwiire grilndlich zu heilen), Leipzig, 1784; On Arsenical 
Poisoning, its Treatment and Judicial Detection ( Ueber die Arsenik- 
vergiftjcng, ikre Hiilfe und gerichtliche Ausmittehmg), Leipzig, 
1786; Instructions for Surgeons concerning Venereal Diseases, 
with a New Mercurial Preparation ( Unterricht fi'ir Wunddrzte iiber 
die venerischen Krankheiten, nebst eijtemnezien Qtieksilberprdparaie), 
Leipzig, 1789; Pharmaceutical Lexicon {Apothekerlexicon), in 4 
vols., Leipzig, 1 793-1 799; Preparation of the Cassel Yellow 
{Bereitung des Casseller Gelbs), Erfurt, 1793 ; Essay on a New 
Principle for Ascertaining the Curative Power of Drugs ( Verstuk 
iiber ein neues Princip zur Auffindung der Heilkrdfte der Arzneisub- 
stanzen), from Hufeland's Journal der Praktischen Arzneykunde, 
1796 ; Cure and Prevention of Scarlet Fever {Heilung imd Verhii- 
tung des Scharlach-Fiebers), Gotha, 1801 ; reprinted, 1844 ; The 
Effects of Coffee {Der Kaffee in seinen Wirktingen), Leipzig, 1803 ; 
trans, into French by E. G. von Brunnow, 1824 ; into English by 
Mrs. E. Epps, 1855 ; Fragmenta deviribiis medicanientorurupositivis 
sive in sano corpore hujnanis observatis, Leipzig, 1805 ; Organon 
of Rational Healing {Organon der rationellen Heilkunde), 1810 ; 
2nd ed., 1819 ; 3rd ed., 1824; 4th ed., 1829; 5th ed., 1833; 
6th ed., 1865 ; trans, into French by E. G. von Brunnow, 1824 ; by 
Dr. A. J. L. Jourdan, 1832 ; into Spanish by Lopez Pinciano, 1835 ; 
into English by R. E. Dudgeon, 1849 ; Materia Medica Pura 
{Peine Arzneimittellehre\ in 6 vols., Dresden, 1811-1821 ; 2nded., 
1822-1827; 3rd ed., 1830-1833 ; trans, into Italian by Dr. F. 
Romani, 1825 ; into Latin by E. Stapf, G. Gross and E. G. 
von Brunnow, 1826- 1828 ; into French by A. J. L. Jourdan, 1834 ; 
into Spanish by Lopez Pinciano, 1835 ; into English by R. E. 
Dudgeon, 1880 ; Chronic Diseases, their Nature and Homoeopathic 
Treatment {Die chronischen Krankheiten. ihre eigenthilmliche Natur 
und hombopathische Heihmg), in 4 vols., Dresden and Leipzig, 
1828-1830; 2nd ed., in 5 vols., 1835-1839 ; trans, into French 
by A. J. L. Jourdan, 1832 ; into English by Dr. G. M. Scott, 
1842 ; into Spanish by R. de T. Villannera, 1849 ; The Lesser 
Writings of S. H., collected and translated .by R. E. Dudgeon, 



1 85 1 and 1852 ; H.'s Therapeutic Hints, collected and arranged 
by R. E. Dudgeon, 1894. 

Biography and Criticism. — Das Leben und Streben S. H., by 
J. Muehlenthor, 1834; Ein Blick auf H. und die Homoopatkik, by 
E. G. von Brunnow, 1844; trans, into English by J. Norton, 1845 ; 
A Biographical Monument to the Memory of S. H., by C. Fischer, 

1852 ; H. : a Biographical Sketch, by R. E. Dudgeon, 1852 ; Die 
Homoopathik H.'' s oder die Heilkundeder Erfahrung, by C. Hencke, 
1861 ; On H.'s Merits, Errors and Critics, by M. Roth, 1872 ; Dr. 
A H.'s des Begrunders der Homxopathie , by F. Albrecht, 1875 ; 
Ecce Medicus ; or, H. as a man and as a physician, by J. C. Burnett, 
1881 ; H. as a Medical Philosopher, The Organon, etc., by R. 
Huges, 1882 ; A Bird's Eye View of H.'s Organon of Medicine, by 
J. H. Clarke, 1893 ; The Life and Letters of Dr. S. H., by T. L. 
Bradford, 1895 5 The Influence of the Therapeutic Teaching of H. 
in 1796 upon the Study and Practice of Medicine in 1896, by A. 
C. Pope, 1905; Knaves or Fools? by C. E. Wheeler, 1908. 






C. E. WHEELER, M.D., B.S., B.Sc. 







The physician has no higher aim than to make 
sick folk well, to pursue what is called the Art of 


The highest ideal of cure is the speedy, gentle 
and enduring restoration of health, or the re- 
moval and annihilation of disease in its entirety, 
by the quickest, most trustworthy, and least 
harmful way, according to principles that can 
readily be understood, (the Rational Art of 

If the physician clearly perceives what it is in 
disease in general and in each case of disease 
in particular that has to be cured (knowledge of 
disease, knowledge of the requirements of disease 
or disease-indications) : if he clearly perceives 
what is the healing principle in medicine 
generally and in each medicine in particular 
(knowledge of the powers of medicines) : if in the 
light of clear principles he can so adapt the 
healing virtue of the drug to the illness that is 
to be cured that recovery must follow, and if he 



has the abihty not only to select the particular 
remedy whose mode of action is most suitable 
for the case (choice of the remedy or indicated 
medicine), but also to choose the exact quantity 
of the remedy required (the suitable dose) and 
the fitting period for its repetition, if, I say, he 
knows all these things and in addition recog- 
nizes in every case the hindrances to lasting 
recovery and can remove them, then truly he 
understands how to build up his work on an 
adequate basis of reason, and he is a rational 
practitioner of the healing art, 

He is also a maintainer of health, if he knows 
the causes that may disturb health and excite 
disease and how to remove them from healthy 

It may be granted that every disease must 
depend upon an alteration in the inner working 
of the human organism. This disease can only 
be mentally conceived through its outward signs 
and all that these signs reveal ; in no way what- 
ever can the disease itself be recognised. 

The invisible disease producing alteration in 
the inward man together with the visible altera- 
tion in health (the sum of the symptoms) make 
up that which is called disease : both together 
actually constitute the disease. 

Author's note. — Therefore I do not know how 
that morbid change in the Inward of the body 
which occurs in disease could have been re- 
garded as a thing existing by itself and outside 


the disease, as a condition of the disease, as its 
inner, immediate primal cause {prima causa), 

A thing or a condition demands a first proxim- 
ate cause only in order to come into existence; 
where the thing or condition actually exists it 
requires no further originating, no first and 
proximate cause, for its continued existence. 

Thus a disease, once established, endures 
independently of its proximate, exciting, primal 
cause : endures without further need of its 
cause : endures even if its cause no longer 
exists. How, then, can the removal of the cause 
be held to be the principal condition of the cure 
of the disease ? It is impossible that the primal 
cause of its flight should cleave to a flying 
bullet, and the alteration which we can perceive 
in it is only an altered kind of existence — an 
altered state, and it would be more than absurd 
to maintain that this state could not be funda- 
mentally removed, that this bullet could not be 
brought again to rest, except by an investigation 
into the prima causa of its flight and then by 
the removal of the prima causa thus meta- 
physically ascertained, or as (others would ex- 
press it) by the removal of those alterations in 
the inner being of the bullet upon which its 
flight is dependent. 

In no wise ! A single impulse of equal power 
exactly opposed to the flight of the bullet, brings 
it at once to rest, without impossible meta- 
physical inquirings into the inner being of the 
bullet in flight. 

All that we need to know are the symptoms 
of the flight of this bullet, that is to eay the force 
and the direction of its motion, in order to set 
against it a counter-force of equal strength in a 
direction exactly opposed, and so at once compel 
it to immobility. 

B 2 


This is also (it may be said in passing) an 
example of the way in which alterations can 
naturally be made in abnormal conditions of 
physical things, namely, through their exact 
opposites. Thus boiling water can be swiftly 
reduced to a moderate temperature by the addi- 
tion of a certain quantity of snow; an acid loses 
its acidity and becomes a neutral salt through 
the action of an opposing alkali ; the over- 
stretched material strives to contract ; the com- 
pressed to expand; the over-dry substance to 
absorb moisture from the air, and so on ; and 
in this way most alterations of abnormal con- 
ditions in the physical world are effected by 
Nature by means of their opposites. But the 
living organism of animals must obey widely 
different laws for the removal of the altered con- 
dition which is the result of disease; here the 
law of opposites which is adapted to the altera- 
tion of non-living physical nature is of no avail. 

There must be a curative principle present in 
medicine; reason divines as much. But its 
inner nature is in no way to be perceived by us; 
its mode of expression and its outward effects 
alone can be judged by experience. 


The unprejudiced observer, knowing the 
worthlessness of abstract speculation which can- 
not be confirmed by experience, is unable, how- 
ever acute he may be, to take note of anything 
in any single case of disease, except the changes 
in the condition of the body and soul which are 
perceptible by the senses, the so-called disease 
phenomena, symptoms in fact; in other words, 


he can note only such falHngs away from a 
former state of heahh as are recognizable by the 
patient himself, the friends in attendance, and 
the physician. All these perceptible signs make 
up together the picture of the disease. 

As, then, in disease there is nothing to lay 
hold of except these phenomena, the disease can 
be only related to the required remedy through 
the symptoms, by means of which, in fact, it 
both makes known the need of the patient for 
help and points to the kind of help that is 
required. And thus this symptom-complex, this 
outward reflection, which is a representation of 
the inward being of the illness, is the only means 
whereby it is possible to discover a remedy for 
it, the only means which can indicate the most 
appropriate agent of cure. 


A disease in its whole range is represented 
only by the complex of morbid symptoms. 

Author's note. — i. All exact observation 
teaches that a serious illness requiring treatment 
practically never consists of one single symptom, 
and that a single serious symptom seldom if 
ever occurs alone. Almost always there are 
several notable signs of disease and deviations 
from the normal health simultaneously present 
in the patient, which make up the unity of the 
morbid condition, however little at first sight 
some of them seem to be related to one another. 
A single slight symptom is not an illness calling 
for treatment. 

Author's note. — 2. Formerly physicians, not 
knowing how otherwise to render help in cases 
of disease, sought to combat by remedies one 


single symptom out of several and if possible to 
suppress it — a one-sided proceeding which under 
the name of "symptomatic treatment " has justly 
aroused general condemnation, because thereby 
not only was no benefit gained, but much 
damage was inflicted. One single symptom is 
no more the actual disease than one foot is the 
whole man. 

It is not conceivable, nor can any experience 
in the world establish it, that there should 
remain, or could remain, anything but a state 
of health when all the symptoms of disease (the 
whole complex of perceptible phenomena) are 
removed, or that the disease-causing alteration 
in the inward of the organism should in that 
event continue unextinguished. 


The invisible disease-producing change in the 
inward man and the complex of outwardly per- 
ceptible symptoms are consequently determined 
by one another reciprocally and inevitably ; both 
together make up the disease in its entirety, that 
is, constitute such a unity that the latter must 
stand or fall simultaneously with the former, 
that they must exist together and disappear 
together, so that whatsoever is able to call out 
a group of definite symptoms, must have caused 
in the body that corresponding inward morbid 
change which is inseparable from the outward 
appearances of disease. Otherwise the appear- 
ance of the symptoms would be impossible : 
and similarly whatever removes permanently 
the complex of outward signs of disease must 
simultaneously have removed the inward morbid 
change, because the banishing of the former 


without the disappearance of the latter is incon- 

Author's note A foreboding dream, a super- 
stitious fancy, a solemn prophecy that death 
must infallibly occur on a certain day and at a 
certain hour, have not seldom produced all the 
symptoms of commencing and progressive ill- 
ness and of approaching death and have even 
caused death itself at the hour predicted. Now 
this would not have been possible without the 
simultaneous setting in motion of an inward 
change corresponding to the outward and visible 
symptoms; hence in such cases all the signs of 
approaching death have frequently been dis- 
pelled, and a state of health suddenly restored, 
by some skilful deception or contrary conviction, 
and this again could not occur without the 
removal of the inward alteration which was 
threatening life. 


Now since, when cure is effected through the 
removal of the whole range of the perceptible 
signs and symptoms, the inward change which 
caused the symptoms is also removed (that is, 
the totality of the disease), it follows that the 
physician has only to clear away the entire 
symptom-complex in order also to get rid of 
the inward alteration — in other words, to remove 
the whole disease, the disease itself, a feat which 
must always be the only aim of the rational 
healer; for the essence of the art of medicine 
consists in compassing the restoration of health, 
not in searching for the change in the inward 
and hidden things, a quest which can tend to 
nothing but fruitless speculation. 

Author's note. — It is only through a misuse 
of the desire to reach the eternal, sown in the 


spirit of man for nobler purposes, that these im- 
pudent attempts have been made upon the realm 
of the impossible, those speculative broodings 
over the essential nature of the medicinal powers 
of drugs, over vitality, over the inner invisible 
working of the organism in health and over the 
changes of this hidden inner working which 
constitute disease — in other words, over the 
inner nature and essence of illness. 

All that mankind has apprehended of animal 
magnetism, galvanism, electricity, attraction and 
repulsion, earth magnetism, caloric, phenomena 
of gases, and other objects of chemical and 
physical enquiry, is far, far wide of the compre- 
hensive, clear, and fruitful explanation of even 
the smallest function in the living organism, 
whether healthy or diseased. What innumer- 
able unknown powers and their laws may be 
involved in the regulation of the living organs, 
powers and laws of which we know nothing and 
for whose recognition we should need infinitely 
more and infinitely finer senses than we have ! 
When the physician maintains that research 
into such things is necessary, then he shows a 
misconception of the capacities of men and a 
misunderstanding of the requisites for the work 
of healing. 

The more that profound intelligences devoted 
themselves to this "research into the secrets of 
Nature," the more did fruitless hypotheses come 
to birth, full of contradictions. All history 
teaches this, and so also teaches the judgment 
of the best informed among healthy minds. 

If only it had served the practice of medicine 
in the slightest degree — if all this subtle investi- 
gation had revealed the true remedy for the least 
of diseases, it might yet pass for desirable ! 

Listen to the wise and upright Sydenham : 


"Quantulacumque in hoc scientiae genere acces- 
sio etsi nil magnificentius quam odontalgias aut 
clavorum pedibus innascentium ciirationem, 
edoceat longe maximi facienda est, prae inani 
subtilium speculationum pompa, — quae fortasse 
medico ad abigendos morbos non magis ex usu 
futura est, quam architecto ad construendos 
aedes music^e artis peritia." 

Yet behold ! All imaginable theories con- 
cerning the functions, the inner form, and com- 
position of the living brain in health and in dis- 
ease, all the countless speculations concerning 
the nature of inflammation, all hypotheses as 
to the nature of water and caloric, never availed, 
in the world's historv, to furnish a hint or an 
indication of the specific remedy for the phrenitis 
caused by sunstroke ! Loflfler discovered it 
accidentally to consist in sprinkling the skin 
with hot water, and the rational (homoeopathic) 
system of medicine can easily and swiftly by 
its simple laws find this and other specific 
remedies, without metaphysical racking of the 
brains and without the need of waiting for the 
happy chance which mav be delayed for a 
thousand years. 

Inasmuch, then, as in disease nothing that 
expresses the need for assistance can be dis- 
covered by observation except the complex of 
symptoms, it follows that it is precisely the 
totality of the perceptible symptoms, and that 
alone which must afford the significant indica- 
tion in disease for the selection of a remedy. 


Again, since the healing principle of medicine 
cannot itself be actually perceived, and since in 


pure experiments by the most acute observers 
nothing can be determined in drugs which con- 
stitutes them medicines except their power to 
bring about distinct changes in the health of the 
human body and to excite, especially in the 
healthy, various unmistakable symptoms of dis- 
ease ; it follows that, if medicines act as remedies, 
they only make known their inner healing 
principle and bring their remedial power into 
play through this ability to cause symptoms. 
And it follows also that, when we wish to decide 
which among several remedies is the most appro- 
priate for any individual case of illness, we can 
put our confidence only in those disease-pheno- 
mena which medicines produce in healthy 
bodies ; for these form the only evidence of their 
inherent tendency to cure. 


If, then, disease has nothing to show by re- 
moval of which it can be changed into health, 
save the complex of its symptoms, and if, further, 
medicines can show nothing of their power of 
healing except their tendency to excite disease- 
symptoms, it follows that medicines, to be true 
remedies, must uproot and remove the symp- 
toms of illness by the power of the symptoms 
which they themselves can excite. 

If, now, experience should show (and indeed 
it does show) that a given disease-symptom is 
only removed by the very medicine which has 
produced a similar symptom in a healthy body, 
then it would be probable that this remedy is 
able to uproot that disease-symptom by virtue 
of its tendency to call forth a similar one. 



If, further, it should be shown (and, indeed, 
this also is shown) that the very medicine which 
has given rise in a healthy body to all the 
symptoms shown by the illness which it is 
desired to cure, can remove by its medical use 
the whole complex of disease-symptoms (that is, 
the whole existing disease), and change the con- 
dition to one of health, then it cannot be doubted 
that the law has been discovered whereby this 
medicine has brought recovery to this disease, 
namely, the law: "Similar symptoms in the 
remedy remove similar symptoms in the 

Now as experience shows incontestably in 
regard to every remedy and every disease, that 
all remedies without exception cure swiftly, 
thoroughly and enduringly, the illnesses whose 
symptoms are of like order with their own, we 
are justified in asserting that the healing power 
of 'medicines depends on the resemblance of their 
symptoms to the symptoms of disease: or in 
other words, every medicine which, among the 
symptoms which it can cause in a healthy body, 
reproduces most of those present in a given 
disease, is capable of curing that disease in the 
swiftest, most thoro^igh, and most enduring 


This eternal, universal law of Nature, that 
every disease is destroyed and cured through 
the similar artificial disease which the appro- 
priate remedy has the tendency to excite, rests 
on the following proposition : that only one 
disease can exist in the body at any one time, 


and therefore one disease must yield to the 

Author's note, — The few examples which have 
been brought forward to the contrary are all too 
much under suspicion of possible misinterpre- 
tation to be taken for clear and indubitable 


To every disease the organism reacts in a 
special and individual way. Since its nature is 
bound fast to unchanging laws of unity, it can- 
not react to a new disease or receive it unless 
indeed it ceases to react to the first disease. If 
the later disease is unable to remove the earlier 
and is forced upon the organism too long, then 
both combine to make a single third disease, 
which is called a complicated disease. These 
propositions are based on the following facts. 


A natural ^ chronic disease present in the body 
resists the appearance of a new chronic disease, 
unless at least the later be a miasmatic or 
endemic disorder and the body remain unduly 
exposed to it over a considerable period of time. 
In such a case, as usually the two diseases are 
dissimilar, the later cannot extinguish the earlier 
homoeopathically, and either the former, if it is 
a weaker disease, is suspended as long as the 
latter endures (as Schoepf saw an itching skin 
eruption disappear when the patient was attacked 
by scurvy, to return, however, after the scurvy 
was cured), or the two disorders combine into 
one so-called complicated disease; which, 
though complicated, always presents a single 

1 /.e. not artificial. See note to S. 25. 


disease-picture, intermediate between the disease- 
pictures of the two disorders, and can be treated 
and cured homoeopathically by the totality ol 
the newly united symptom-complexes just like 
a simple disease. From the time of the second 
infection up to the time of the combination of 
both into a third single but complicated disease, 
the first infectio^i is latent. 

But incomparably more frequent than the 
blending and consequent complication of natural 
diseases, are the artificial disorders, produced 
when unsuitable remedial measures are applied 
for a long time to bodies attacked by chronic 
disease. For such remedial measures, having no 
impulse similar to that of the disease for which 
they are given, are unable to remove it and cure 
it homoeopathically ; but on the contrary they 
attack the body over a long period of time in a 
dissimilar way, and thus gradually bring about 
an inner reaction of a dissimilar kind, in short, 
an artificial chronic disease, which unites with 
the original chronic disease and so builds up a 
new monstrous disorder, a complicated malady, 
which is often of a very obstinate kind.. 

Author's note, — Many cases published in 
medical journals with requests for suggestions 
as to treatment are of this kind, as are also many 
chronic disease-histories related in medical 
works. Of a like order are the numerous cases 
where venereal disease is not cured by lengthy 
treatment with unsuitable preparations of 
mercury, but combines with chronic mercury- 
poisoning to make a horrible blend of compli- 
cated disease (masked venereal disease), which 
can now no longer be cured with mercury (the 


remedy for syphilis), but must be treated with 
liver of sulphur (the remedy for mercurial 


If, on the other hand, when chronic disease is 
present, the patient is attacked with a new, more 
local, and therefore less severe disease, which has 
no resemblance to the first and therefore cannot 
cure it homoeopathically, then usually the chronic 
disease is suspended as long as the local disorder 


If a long-standing chronic disease, whether 
natural or artificial, is present, it will, being the 
stronger, repel from the organism a new acute 
natural disease of a different kind, and often also 
an acute disorder artificially induced. 

Translator's note. — Here and elsewhere Hah- 
nemann means by artificial diseases those affec- 
tions which are the result of drug-taking, or 
procedures like vaccination, or the use of blisters, 
setons or issues, all of which were very frequently 
and drastically used in his day. For instance, 
in a note to this aphorism he quotes Jenner as 
maintaining that rickets prevents, vaccination 
from "taking," and that even regular coffee- 
drinking is apt to render vaccination ineffective. 
The former would be an instance of a natural 
chronic disease repelling an acute artificial dis- 
ease, the latter of an artificial chronic disease 
(coffee-poisoning) having the same effect. 
Neither of Jenner's statements would be im- 
plicitly accepted to-day, but the effect of one 
disease on another is a subject upon which it 
is still difficult to dogmatize, and Hahnemann's 
general propositions seem to be borne out, at 


any rate in some instances. In any case, in 
reading these and the next few aphorisms it is 
important to remember that Hahnemann is now 
seeking for an explanation of certain facts which 
he had observed concerning the relations between 
drugs and diseases. His explanations and his 
examples from natural diseases have not all the 
power of conviction which they seemed to have 
in his day, but the facts which these aphorisms 
attempt to explain remain founded on experiment 
and observation, and can only be confuted by 
further experiment and observation. Hahne- 
mann claimed that "likes are the best means of 
treating likes." Only experiment can show 
whether this is a true statement, and if experi- 
ment confirms Hahnemann, we can doubt or 
reject his explanation as to the 7nodus operandi 
of his law without impugning the law's validity. 


But if, when the organism is suffering from a 
chronic illness, a new and acute disease attacks 
it and proves stronger than the first disease, but 
does not resemble it, then the chronic disorder 
gives rise to no symptoms (lies latent) while the 
acute disease runs its course, but reappears after- 
wards unchanged. 


When the organism suffering from an acute 
disease becomes infected with another acute dis- 
ease of a dissimilar kind, the disorder which is 
the weaker of the two gives way, but is not 
destroyed, only remaining latent until the 
stronger has run its course. 

Author'' s note. — An eruption^ of measles will 
disappear as soon as small-pox papules become 


visible, and wlien these are healed, the eruption 
of measles, latent till then, appears again and 
runs its ordinary course. 1 have seen the swell- 
ing in a case of parotitis (mumps) disappear 
when vaccination took effect, and only when the 
cow-pox had run its course did the swelling and 
fever characteristic of mumps reappear and run 
thereafter their usual course. Again, a case of 
scarlet fever with tonsillitis was interrupted and 
suspended for four days while cow-pox vesicles 
developed (Jenner). 

But if, on the contrary, an acute infection 
attacks an organism already suflfering from a 
similar acute disease, then the stronger infection 
uproots the weaker entirely and removes it 


Two acute diseases meeting in the same 
organism never blend into one; the cases 
hitherto cited in evidence are only apparent 
examples of such a fusion. 


Further, if a chronic disease is already present, 
and a very similar acute disorder attacks the 
patient, the chronic disease is destroyed by the 
acute and homoeopathically cured. 

Author's note. — Leroy saw a very chronic and 
obstinate ophthalmia in a boy disappear per- 
manently after an attack of small-pox, a disease 
\vhich has itself the power to cause violent in- 
flammation of the eyes. 

An obstinate ophthalmia was cured by Dezo- 


teux by inoculation of small-pox. Other similar 
cases have been observed. 

The great homoeopathic Law of Cure rests on 
this law of man's nature, revealed by experience, 
that diseases are only destroyed and cured by 
similar diseases. The homoeopathic law may be 
thus formulated : that a disease can only be 
destroyed and cured by a remedy which has the 
tendency to produce a similar disease, for the 
effects of drugs are in themselves no other than 
artificial diseases. 

The tincture of an ounce of cinchona-bark 
mixed with a couple of pounds of water and 
swallowed in the course of twenty-four hours 
will certainly produce a cinchona fever of several 
davs' duration. A warm foot-bath of an arsenical 
solution or the application of an arsenical oint- 
ment to the scalp ^ will no less certainly bring 
about an arsenical fever lasting at least a fort- 
night, than residence in a marshy district in 
autumn will cause intermittent fever. A girdle 
of mercurial plaster round the loins will cause 
mercurial poisoning no less quickly and surely 
than wearing the shirt of a person affected with 
the itch will produce an attack of the itch. A 
strong infusion of elder flowers or a few berries 
of belladonna are just as much disease-producing 

1 Arsenic in Hahnemann's day was used in doses which 
now seem terrifying, and most preparations of it were far 
stronger than any now employed. Symptoms of arsenical 
poisoning would not be produced by the external use of 
modern pharmacopocial preparations except in patients of 
extraordinary susceptibility to the drug. 


forces as inoculated vaccine-matter, or a viper- 
bite, or a great shock, and every one of these 
influences, just because it has the po^ver to pro- 
duce disease, can become a remedy and a force 
to counteract disease, as soon as it is opposed 
to a similar disorder already existing in the body. 
So that all that we call medicine is no other 
than the power to produce disease, and all true 
remedies are no other than substances capable 
of arousing in the organism an artificial disease 
similar to the natural disease which it is thereby 
able to destroy and to remove. 

When, by the laws of rational therapeutics we 
have found the medicine which is best adapted 
for curing a given disease and have applied it 
as a remedy, it is clear that the sick organism 
is, as it were, inoculated with a new- disease 
(counter-disease) by virtue of the disease-force 
in the drug; but it must be owned that this 
artificial counter-disease possesses unusual ad- 
vantages over all natural counter-diseases. 


The invisible influences whereby the ordinary 
diseases of mankind are produced are all too 
little known, and are all too little under our 
command, for us to use them for the production 
of diseases at our will, and thus as remedies 
against diseases of longer standing. 

Translator's note. — The "influences" invisible 
to Hahnemann are many of them visible enough 
to-day in bacteriological laboratories, and are 
used as remedies in a way quite comparable to 
that which Hahnemann suggests in this and the 
following paragraphs. 



Even the miasms, which might conceivably be 
inoculated for the removal of certain diseases, 
are too few in number to be used even to a 
limited extent as remedies. 

Translator's note. — In these days before 
bacteriology, a miasm corresponded to what 
would now be called a bacterial disease. Years 
afterwards, when Hahnemann came in contact 
with cholera, he conceived the agent of that 
disease to consist of "animalcul^e " invisible to 
any means of sight that science then possessed, 
and his suggested rules for dealing with epi- 
demics are not only extraordinarily sound, but 
owe their soundness to the fact that Hahne- 
m^ann's conception of the mode of transmission 
of infection was not far from the truth. 


Even if we were able to produce various 
natural diseases artificially and at will, they are 
either not sufficiently analogous to the disease 
under treatment, and therefore not helpful, or 
they are of longer duration than the original 
disorder, and hence, even when they have over- 
come it, they frequently remain a considerable 
time in the body, seldom disappear of them- 
selves, and usually require artificial remedies 
before they are defeated and finally removed. 


On the other hand, the disease-producing 
powers usually termed "drugs" or "medicines" 
can be used for purposes of cure, with infinitely 
greater ease, far more certainty and with a range 
of choice almost unlimited; we can give to the 
c 2 


counter-disease thereby aroused (which is to 
remove the natural disease that we are called to 
treat) a regulated strength and duration, because 
the size and weight of the dose lies at our com- 
mand; and as every medicine differs from every 
other and possesses a wide range of action, we 
have in the great multitude of drugs an unlimited 
number of artificial diseases ready to hand, which 
we can oppose with decisive choice to the natural 
course of the diseases and infirmities of mankind, 
and so, swiftly and surely, remove and extinguish 
natural disorders by means of very similar dis- 
eases artificially produced. 


As it is now no longer doubtful that the dis- 
eases of men consist merely of certain groups of 
definite symptoms, and may be destroyed and 
changed into health (which is the order of pro- 
ceeding in all genuine cures) by a medicine truly, 
but only by such a medicine as can artificially 
excite similar disease-symptoms, it follows that 
tlie art of cure is comprised in finding an answer 
to these three questions — 

1. How can the physician discover what he 
needs to know of the disease in order to cure it? 

2. How can he discover the individual disease- 
producing powers of medicines which are to act 
as counter-diseases for the cure of natural 
diseases ? 

3. How can he most efficiently turn these arti- 
ficial disease-producing powers (medicines) to 
account for the cure of natural diseases ? 

As to the first point, the enormous number 
and variety of diseases might easily persuade us 


into a conviction that they cannot possibly be 
individually considered or even retained in the 
memory ; and that they cannot be cured unless a 
comprehensive survey be first made of them and 
a separation effected, (upon the basis of certain 
common characteristics,) into a few small classes, 
each of which may then with comparative ease 
be treated as one disease by a common method. 

Diseases, infirmities and illnesses present, 
however, appearances so endlessly various that 
such a forcible grouping into separate divisions, 
however apparently necessary, can hardly serve 
any useful purpose from the point of view of 


The division of diseases into general and local 
seems to have been commonly observed. 


But the human body is, in its living state, a 
unity, a complete and rounded whole. Every 
sensation, every manifestation of force, everv 
inter-relation of the material of one part, is 
intimately concerned with the sensation, force- 
manifestations and inter-relations of all the other 
parts; no part can suffer without involving all 
the rest in suffering (greater or less) and in 

This oneness of life forbids the idea that any 
bodily disease can remain completely and abso- 
lutely local so long as it is not confined to a part 
of the body entirely shut off horn all the rest. 
The remainder of the system simultaneously 
suffers more or less, and betrays its suffering in 


this or that symptom. Every powerful medicine 
produces amongst other actions an effect upon a 
disease apparently local, even when applied to a 
distant part or taken internally, and the remedy 
specifically fitted for the general disease (of which 
the local manifestation is always but a part or 
symptom) relieves also the local affection which 
is far removed and apparently isolated. 


A second division of diseases into febrile and 
afebrile, though highly esteemed, labours under 
a similar disadvantage. There is no general 
agreement as to which characteristic signs and 
symptoms should be included in the definition 
of fever, and which should be rejected; and 
among the greater number of theories and de- 
finitions of fever there is none that does not 
include symptoms which are also found more or 
less in diseases which are universally considered 
among the most afebrile. The most febrile pass 
over into the most afebrile by imperceptible 
degrees, a fact which shows that a sharp division 
between the two is only artificial and not natural. 

TransJator^s note. — Hahnemann wrote long 
before the days of clinical thermometers. But 
even with that absolute means of estimating 
fever, the presence or absence of a rise of tem- 
perature would still by itself be an insufficient 
basis for the classification of diseases. 

The nomenclature or classification of the 
countless varieties of disease, even if it could 
be accomplished with tolerable accuracy and 
completeness, would serve the physician only 
as a natural historian, in the way that the classi- 


fieation of other natural phenomena and natural 
objects is of value in general natural history. 
In other words, it would aid his historical per- 
ception by means of a tabulated and ordered 
survey. But for the physician as a practitioner 
of the art of medicine it would be of no value 
whatever. For the true art of treating disease 
cannot rest content with such simple one-sided 
resemblances as suffice for the classification of 
diseases into genera and species. On the con- 
trary, it must make the most complete survey 
of every single case of disease that comes to be 
treated before it can select the remedy exactly 
suitable thereto, that is, before it can deservedly 
be called a well-founded and rational art of cure. 
Translator' s note, — Increased knowledge of the 
outside causes of disease, such as is afforded by 
bacteriology and the allied sciences, has now 
given at least a partial classification of the great- 
est value to the physician, both in the prevention 
of disease and in the diagnosis and prognosis 
of individual cases. But it still remains as true 
as when Flahnemann insisted on it, that the 
treatment of each case must be an individual 
treatment, and such classifications as w^ere pos- 
sible a century ago only tended to obscure that 
fundamental fact with which the physician has 
alwavs to reckon. 


Nature has no nomenclature or classification 
of disease. She produces individual diseases, 
and insists that the true physician shall not 
treat in his brethren the systematic combination 
which makes up a genus of disease (a kind 
of confounding together of different diseases), 
but shall always treat the individuality of each 


individual case of disease. And she forbids the 
therapeutic treatment of groups of diseases con- 
structed merely in the imagination of men, for 
such treatment is a crippling of the divine work 
of healing; on the contrary, she enjoins the 
treatment of individual disease, which she has 
wisely created as distinct entities. 

Author^ s note. — Huxham, deserving of honour 
for his acute insight no less than for his tender 
conscience, says {Op. Phys. Med.) : "Nihil sane 
artem medicam pestiferum magis unquam irrepsit 
malum, quam generalia quaedam nomina morbis 
imponere, iisque aptare velle generalem quandam 

The rational nature of the art of medicine 
manifests itself pre-eminently in the rejection 
of all systematic and other prejudices, in the 
refusal to act without good grounds, in the 
adoption of every possible measure to achieve 
the desired action, and in confining attention 
as much as possible to that which can be de- 
finitely ascertained. Correspondingly the char- 
acteristic of the rational and thorough physician 
is, pre-eminently, attention to the divergences 
and differences of diseases, and also of drugs or, 
in other words, the careful investigation of the 
individual signs of every single disorder and 
of the individual mode of action of every single 


Every disease epidemic in the world differs 
from every other, excepting only those few which 
are caused by a definite unchangeable miasm. 
Further, even every single case of epidemic and 
sporadic disease differs from every other, those 


only excepted that belong to the collective dis- 
eases noted elsewhere. Therefore the rational 
physician will judge every case of illness brought 
under his care according to its individual char- 
acteristics. When he has investigated its in- 
dividual features and noted all its signs and 
symptoms (for they exist in order to be noted), he 
will treat it according to its individuality (i, e. 
according to the particular group of symptoms 
it displays), with a suitable individual remedy. 

Such a direct, unprejudiced and rational pro- 
cedure will demonstrate wherein he differs from 
every physician who does not trouble to investi- 
gate the case of disease thoroughly, but (to suit 
his own convenience) generalizes regarding it, 
labels it according to the conjectural system 
which he affects, and models his treatment en- 
tirely on this conjecture. 

Certain diseases are caused by a special agent 
of contagion (an individual miasm of a suffi- 
ciently definite kind), for instance, the plague 
of the Levant, small-pox, measles, true smooth 
scarlet fever, venereal disease, the itch of wool- 
makers, as well as rabies, whooping-cough, plica 
polonica, etc. These diseases seem to. be so 
definitely distinguished in their course and char- 
acter that, whenever they appear, they can be 
recognized by their persistent signs as old 
acquaintances. Therefore it is possible to give 
each of them a definite name and to attempt to 
establish for each of them a regular and staple 
method of treatment. 

It may well be that there are yet other diseases 
attributable to a "miasm" which we cannot yet 
demonstrate, besides those that belong to certain 


localities and climatic conditions and those that 
are endemic in certain scattered regions: e.g. 
autumnal marsh-fever, yellow fever, sea-scurvy, 
framboesia (yaws), pellagra, etc. Further, there 
are a few diseases arising either from a single 
uniformly acting cause or from a combination 
of several definite causes acting simultaneously, 
which can readily be classed together to some 
extent, as, for instance, gout, and possibly also 
membranous croup and Miller's asthma. These 
diseases are little less deserving of their special 
names because the symptom-group remains 
tolerably constant, on the whole, for each of 
them, and therefore each is adapted to a definite 
and almost established treatment. 


But the case is very different when we con- 
sider a number of other diseases probably arising 
from the concurrent effect of several pathogenic 
causes which do not unite in the same w^ay for 
the production of the disorder. These diseases 
often differ from one another in regard to several 
important symptoms, and hence cannot ever be 
treated all with the same remedies. 

To this class of disease belong the widely 
differing varieties of epilepsy, catalepsy, tetanus, 
chorea, "pleurisy, phthisis, diabetes, angina pec- 
toris, prosopalgia, dysentery, and other condi- 
tions represented by names which the schools 
have given to disease-states that often differ 
fundamentally and only resemble one another in 
a few symptoms. By maintaining an alleged 
identity it was possible to establish for them an 
identical treatment, but the very different results 
obtained by the pursuit of this method are alone 
enous^h to refute the supposed identity of disease 


upon which the method is founded. As col- 
lective names they may have a certain value, but 
none as the special names of identical disease- 
conditions : for then they lead the physician 
astray into a uniform empirical medicinal treat- 
ment, to the detriment of his patients. 

Author^ s note. — Thus, for instance, there are 
several varieties of diabetes, that is, several dis- 
eases essentially different classed together under 
this one name. At the first casual glance thev 
seem to resemble one another in one or more 
Symptoms, but to maintain therefore that they 
represent cases of one and the same disease is 
erroneous. If the individual cases are carefully 
examined it will be found in almost every one 
of them that there are symptoms differing widely 
from those present in other cases, and svmptom's 
present in some and absent in others. Even the 
urine often varies much in its character, although 
the inventors of the name diabetes attached a 
very great importance to their discovery of a 
special character therein ; sometimes it passes 
rapidly into vinous or acetous fermentation, at 
other times it only becomes mouldy, and so forth. 
If one kind of diabetes can be cured with am- 
monium sulphate, many other kinds will fail to 
respond to this remedy. Alum would seem to 
be of advantage in a few cases, and again in 
others neither alum nor ammonium sulphate 
w^ould appear to be of any use. How can these 
be cases of one disease which differ so much in 
their svmotoms and require such varving treat- 
ment ? These manifold disease-conditions mav 
indeed be called kinds of diabetes^ but not simplv 
diabetes, lest the false impression be created bv 
this name that they are all cases of one simple 
well-defined disorder. He who has cured one case 
of facial neuralgia with mercurial ointment will 


soon find three or four cases for which this oint- 
ment will not in the least avail, although he will 
call them all by the same name. If each of these 
names only stood for diseases which were always 
identical in character, then it would be impossible 
that the remedy which succeeded once should 
ever fail, for if the diseases are identical they 
must yield to identical treatment. But as mani- 
festly they do not so yield, they clearly demon- 
strate that in spite of bearing the same name 
they are essentially different disorders, wherein 
insufficient pains have been taken to discover the 
distinguishing symptoms. Certainly these vari- 
ous disease-states might be called kinds of facial 
neuralgia, for they are not all of them always 
one and the same disease. And so it is with the 
other diseases mentioned, and yet others of a 
similar sort. 


And so, finally, with regard to other diseases, 
the greater the variety of morbid conditions 
embraced under one name (conditions distantly 
resembling one another in respect of one or two 
symptoms, but differing widely in the vast 
majority of their phenomena and peculiarities), 
the more unsuitable does the name become and 
the more dangerous the tendency which the name 
encourages towards empirical treatment. Such 
ambiguous names as ague, dropsy, consumption, 
leucorrhoea, haemorrhoids, melancholia, mania, 
etc., can be taken as examples. 

Author's note. — What myriads of so-called 
agues there are, differing widely from one 
another, having in common at most the pheno- 
mena of chills and heat and something of an 
intermittent type, and often not even that ! 


Closer investigation of their other symptoms 
reveals that almost every one of these differing 
kinds is a disease sui generis. With what right 
are many most different diseases classed under 
the one name of jaundice, when all their symp- 
toms but one are different, and that one, yellow- 
ness of the skin, depends on a disturbance of 
bile-excretion which may arise from very differ- 
ent causes ? So also among the symptoms of 
countless very dissimilar illnesses there is found 
oedema; but who would classify under the com- 
mon name of dropsy all these most different 
diseases as if they were one, on account of a 
single symptom, very conspicuous it is true, but 
not therefore always important, often indeed not 
important at all ? And likewise with the other 
examples cited. 

How, with any appearance of reason, can 
diseases be grouped under general names when 
they have often only a single symptom in com- 
mon, and how can such a classification justify 
their similar medicinal treatment ? And if the 
medicinal treatment is not to be identical in all 
the cases — as it cannot be without detriment to 
the patients — what is the use of identical names 
which imply an identical treatment? These 
names, therefore, are so misleading, useless, and 
harmful that they ought to exercise little in- 
fluence upon the treatment of a rational physi- 
cian. He, at least, knows that he has to form a 
judgment on diseases and to cure them not on 
the basis of a vague similarity in a single 
symptom, but under the guidance of the whole 
complex of signs and symptoms presented by 
each individual patient, whose sufferings he must 


investigate exactly to the exclusion of mere 
hypothesis and conjecture. 

Even those far-reaching diseases which may 
be spread abroad by infectious material during 
an epidemic, the great number of so-called 
putrid, bilious, nervous fevers (hospital, jail or 
camp fevers), or other contagious fevers, are very 
different in their characterand their course at every 
time of their occurrence. Every fresh epidemic, 
for instance, of the so-called putrid fever appears 
in many of its most striking symptoms unlike 
all previous epidemics of the same name, because 
there is a different miasm at the root of each 
epidemic. It is counter to all logical exactitude 
to give to this very different disorder the old 
name and thus to be misled by the misuse of a 
name into employing the same medicinal treat- 
ment for this epidemic as for former epidemics 
of the same designation. 

In the case of such epidemic or sporadic dis- 
orders we can only consider as similar, for the 
purposes of curative treatment, the various cases 
that occur in each separate outbreak, which in 
this respect is fitly called a collective disease. 
These cases we can treat on similar lines, with 
due regard to the greater or lesser variations 
from type w hich appear in each single case. 


For every epidemic includes a number of very 
similar cases of disease ; but different epidemics 
differ very markedly one from another and can 


neither be rightly called by the same or a similar 
name, nor treated indiscriminately with the same 

These epidemics, to which no constant and 
universally suitable name can be given (since at 
every fresh appearance among the nations they 
present an altered form and different groups of 
signs and symptoms), are best considered as 
collective diseases. But under this designation 
they should be grouped with that extensive class 
which is made up of all other diseases, illnesses, 
and disorders which arise from the concurrence 
of causes and forces differing wddely in their 
number, strength, and kind. Indeed, these in- 
fluences are of an infinite variety, and hence 
arises the infinite diversity of the diseases from 
which the great race of man has suffered and 
still suffers in the w^orld. 


All things that have any individual influence 
(and their number is legion) can affect our 
organism and bring about changes therein, be- 
cause our organism stands in relation to all parts 
of the universe in a constant action and reaction. 
And every such influence produces a distinct 
change of its own in virtue of its own distinct 
and unique nature. 

How different then, may I not say, how in- 
finitely different, must those diseases be, which 
result from the action of these innumerable 
forces ! Often the forces are inimical in the 
highest degree w^hen they affect our bodies with 


more or less of simultaneity, or in succession in 
different qualities and varying strengths. And 
in addition our bodies vary so much in so many 
external and internal individualities and peculi- 
arities and the conditions of life are of such 
manifold variety that no human being exactly 
resembles another in respect to any imaginable 

Author's note. — Some of these influences, 
which predispose to disease or produce it, are 
the countless number of emanations, more or 
less harmful, given off from organic and in- 
organic substances ; the many different kinds of 
gas, each with a different irritative power, which 
disturb or alter our nervous systems in our 
dwellings and workshops, or stream out against 
us from water, earth, animals and plants; the 
lack of sufficient nutriment for the maintenance 
of full vitality or of pure, fresh air; excess or 
deficiency of sunlight or of electricity; varying 
atmospheric pressure and varying dampness or 
dryness of the air ; the properties and possible 
ill effects, as yet unknown, of high mountain 
regions and of low-lying lands and deep valleys ; 
the peculiarities of climate and situation in great 
plains, in deserts without water or plant life, on 
the sea coast or near swamps, on hills, in woods 
or in places exposed to various prevailing winds; 
the influence of very changeable weather or of 
long-continued unchanging weather; the in- 
fluence of storms and other meteorological con- 
ditions; exposure to air that is too hot or too 
cold ; the effect of too much or too little artificial 
warmth, either from clothing or heated rooms; 
the hampering of limbs by certain forms of 
dress ; the habitual taking of food or drink which 
is too hot or too cold; hunger, or thirst, or ex- 
cessive eating, or excessive drinking; or the 


power to injure the body medicinally which some 
articles of diet possess, such as wine, brandy, 
beer adulterated with more or less harmful herbs, 
impure drinking water, coffee, tea, indigenous or 
foreign spices; or the unknown but possibly 
injurious effects of certain plants and animals 
used for food; or injurious properties that 
articles of diet may acquire through careless pre- 
paration, spoiling, substitution or adulteration ; 
want of cleanliness of person or clothes or dwell- 
ings; harmful substances that get into food 
through uncleanliness or carelessness in pre- 
paration or storage; the inhaling of injurious 
vapours in sick rooms, mines, stamping-mills, 
stations for the roasting and smelting of ore; 
the dust which may surround us from stuffs 
made in factories and workshops laden with 
many dangerous substances; neglect of various 
police-regulations for the safety of the common 
weal ; excessive bodily exertion ; overworking of 
one or other organs of body or mind; various 
unnatural postures acquired in various occupa- 
tions; want of use of certain parts of the bodv 
or general laziness; irregular times of rest, of 
meals, of work; excess or deficiency of sleep at 
night; especially excessive mental exertion, or 
mental work of an unpleasant and compulsory 
nature, or such as excites or wearies certain 
faculties of the mind; or violent uncontrollable 
passions, such as anger, fear and vexation, etc. 


Hence arises the unimaginable number of 
different diseases of body and mind; diseases 
so different that, strictly speaking, it is hardly 
too much to say that each has only existed once 
in the world. Therefore (except for those few 


diseases caused by a definite unchanging miasm, 
and probably a few others) every epidemic or 
sporadic collective disease is to be regarded and 
treated as a nameless, individual disorder, which 
has never occurred before exactly as in this case, 
in this person and in these circumstances, and 
can never in this identical form appear in the 
world again. 


Since Nature herself produces diseases of so 
individual a kind, no rational medical art can 
exist which does not strictly individualize each 
case of disease — that is, which does not regard 
each case of disease as distinct and unique, 
which in truth it is. 


This individualizing examination of each case 
of disease as it appears demands from the 
physician nothing but freedom from prejudice, 
sound sense, attention in observing and exact- 
ness in tracing the picture of the disease. 


The patient relates the course of his suffer- 
ings ; those in attendance on him tell of his com- 
plaints and his general condition ; the physician 
sees, hears, and observes by his other senses, 
what is altered and unusual in the patient. He 
writes down all that the patient and his friends 
have said, using their exact expressions. Keep- 
ing silence himself, he allows them to say all 
they wish, if possible without interruption. At 
the outset the physician requests them to speak 
slowly so that he can commit to writing as much 
as he wishes. 


Author's note. — Every interruption breaks the 
train of thought, and the speakers thereafter 
seldom or never express themselves exactly as 
they would otherwise have done. 


Every statement of the patient or his friends 
is written in a separate paragraph, so that all 
the different symptoms are ranged one below 
the other. In this way the physician can make 
additions to any record which at first was too 
vague or inexact. 


When patient and friends have said all they 
wish to say, the physician examines each symp- 
tom more closely in the following way. He 
reads over the symptoms one by one as they 
were related and asks for further details about 
each one; for instance, he asks, "At what time 
did this symptom appear?" "Before taking the 
medicine ? whilst taking the medicine ? or only 
some days after leaving off the medicine ? " 
"Exactly what kind of pain was it?" "What 
was its exact position ? " " Did the pain come 
in paroxysms at different times, unaccompanied 
by any other symptom ? " " How long did it 
last?" "At what time of day or night was it 
at its worst, and at what hour did it cease ? " 
"What was the exact character, in plain words, 
of this or that symptom or circumstance ? " 


In this way the physician obtains more exact 

knowledge of each symptom, but he never frames 

his questions in such a way that-the patient can 

answer with a simple "Yes" or "No" (that is, 

D 2 


he never suggests the answer). If care is not 
taken in regard to this, the patient will be misled 
into giving an affirmative or negative answer 
that is untrue or half true or inexact, in order 
to save himself trouble or (as he thinks) to please 
his questioner, and therefrom a false disease- 
picture and an unsuitable treatment will neces- 
sarily result. 

Author's note. — For instance, the physician 
should never ask either patient or friends such 
questions as "Did you not observe this or 
that ? " " Is it not a fact that the condition was 
so and so ? " since such suggestions lead to false 


If in the course of these voluntary statements 
nothing has been said of certain parts or func- 
tions of the body, the physician enquires con- 
cerning those parts and functions ; but he always 
uses general expressions, so that his informants 
are compelled to speak in detail. 

Author's note. — Thus, "What is the character 
of the stools ? " " How freely does he pass 
urine ? " " How does he sleep by day, and how 
by night?" "What is his disposition?" 
"What about thirst, or any special taste in the 
mouth ? " "What kinds of food and drink does 
he like, what does he most dislike ? " " Has 
each kind of food its natural taste or an altered 
one ? " " Is there anything to say about his 
head, his limbs, or his abdomen ? " 


It is upon the patient that most reliance must 
be placed in regard to his sensations, except in 
cases of malingering. When, therefore, the 



patient has given the physician the necessary 
information either voluntarily or at least without 
prompting, so that the disease-picture is toler- 
ably complete, then the physician may ask more 
detailed questions. 

Author's note, — For instance, "How often do 
the bowels act, and what is the exact character 
of the stools ? " " Is defecation painful ? " " Of 
what did the vomit consist? " "Is the evil taste 
in the mouth bitter, or sour, or putrid, or of what 
character ? " " How does he behave when 
asleep ? " " Does he moan or cry out or speak ? " 
"Does he lie only on his back?" "If not, on 
which side ? " "When did the rigor come on ? " 
" How long did the cold stage last ? " " And the 
hot stage ? " " How great was the thirst ? " 
"When did he sweat?" etc. 


When full notes have been taken of all these 
particulars, the physician records what he him- 
self has observed in the patient and ascertains 
whether all or part of this is characteristic of the 
patient w^hen in health. 

Author's note — For instance, the physician 
observes how the patient behaved during the 
visit; whether he was morose or sad; whether 
he was drowsy or in any way dull of under- 
standing; whether his voice was hoarse or low, 
or how otherwise he spoke ; what was the colour 
of his face, of his eyes, and of his skin generally ; 
the state of his tongue, of his breath, of his 
special senses; whether his pupils were dilated 
or not; and how swiftly they reacted to light; 
how he lay, and what efforts he made to raise 
himself; and anything else in his condition 
which may strike the physician as noteworthy. 



The symptoms and sensations of the patient 
during a course of medicine do not furnish a 
pure picture of the disease. On the contrary, 
those symptoms and sensations from which he 
suffered before the use of the medicine or some 
time after he has ceased to take it give the true 
fundamental conception of the original form of 
the disease, and the physician must take par- 
ticular note of these. Indeed, if the disease is 
chronic and the patient has been taking medicine 
up to the time when he is seen, he should be 
left some days entirely without medicine, and 
the physician should defer the exact examination 
of the disease-symptoms until the permanent 
features of the old disease appear unaffected in 
their purity by treatment, and a faithful picture 
of the original disorder can be constructed. 

But if the threatening character of an acute 
disease admit of no delay, and if he cannot dis- 
cover what symptoms were present before the 
treatment was begun, the physician must content 
himself with the observation of the diseased con- 
dition, altered though it is by medicines, in order 
that he may at least combat the existing disorder 
with a suitable remedy. 


If the disease has any striking and obvious 
cause, the patient (or, at least, his friends when 
questioned privately) will mention it, either 
voluntarily or in answer to careful questioning. 

Author's note — Any cause of a disgraceful 
character, which patient or friends may not will- 


ingly confess, demands skilful questioning on 
the part of the physician or else private informa- 
tion. Such causes, for instance, are poisoning, 
attempted suicide, debauchery, over-indulgence 
in wine or spirits, over-eating, and venereal dis- 
ease; and in another sphere disappointed love, 
jealousy, domestic unhappiness, grief, ill-usage, 
baulked revenge, or injured pride. Or again 
some physical defect may be concealed, such as 
rupture or prolapse, etc. 

When enquiring into the condition of a patient 
suffering from a chronic disease, the physician 
must investigate and weigh carefully the cir- 
cumstances of the patient in regard to his 
ordinary occupation, his customary mode of 
living, his diet, his household surroundings, and 
so forth, so that any factor that is exciting or 
maintaining the disease may be discovered and 

In chronic diseases the investigation of the 
signs of disease mentioned above and of all 
others must be as careful and detailed as possible 
and must take note of the most minute peculiar- 
ities. This last is necessary, partly because 
these minute peculiarities are specially character- 
istic of chronic diseases and least resemble the 
features of acute illnesses, and therefore for the 
purpose of cure cannot be too exactly noted ; and 
partly because patients become so accustomed 
to their prolonged sufferings that they pay little 
or no heed to the lesser accessory symptoms, 
which are none the less characteristic and often 
have a very important bearing on the choice of 
the remedy. Indeed, they almost look upon 


these symptoms as a necessary part of their con- 
dition, almost as a state of heahh ; for after five, 
ten, or twenty years of suffering they have all 
but forgotten the sensation of genuine health 
and can hardly believe that these lesser or greater 
departures from the normal have anv relation to 
their principal malady. 


Further, patients differ so widely one from 
another that some of them (especially hypo- 
chondriacs so-called and other hypersensitive 
persons impatient of suffering) set forth their 
complaint in too vivid a light, and describe their 
symptoms in exaggerated language in order to 
make the physician more anxious to relieve them. 

Author's note. — Pure invention of symptoms 
is never met with in hypochondriacs, even in 
the most impatient. A comparison of the symp- 
toms they complain of at various times, as when 
the physician gives them nothing at all, or gives 
them only a placebo, demonstrates this. Only 
something must be deducted on the score of 
hyperbolic language and the use of superlatives, 
or at least the strength of their expressions must 
be attributed to their hypersensitiveness. From 
this point of view the very exaggeration that 
marks the descriptions of their symptoms be- 
comes an important feature in the picture of the 
disease. It is a different matter when we are 
dealing with the insane or with rascally 


Other patients, of an opposite type of character, 
omit to mention a number of symptoms, partly 
from indolence, partly from misplaced modesty, 
partly from lack of intelligence, or else they 


describe them vaguely or assert that some of 
them are of little consequence. 

Now surely, on the one hand, the physician 
must listen most carefully to the patient's de- 
scription of his symptoms and sensations, and 
especially must he be prepared to believe the 
actual expressions which the patient himself 
uses to explain his sufferings, because they are 
frequently altered and incorrectly stated by 
friends and attendants. But as surely, on the 
other hand, in all diseases and especially in 
chronic diseases, the discovery of the true and 
complete disease-picture and of its individualities 
demands particular insight, scepticism, know- 
ledge of human nature, wariness in enquiry, and 
patience of the profoundest kind. 


On the whole the physician will find the in- 
vestigation more easy in acute diseases or those 
of short duration, because both patients and 
friends have recent and vivid memories of all 
symptoms and departures from the health which 
has been so lately lost. Here, too, the physician 
requires to know all that can be known ; but he 
has less occasion for enquiry since the know- 
ledge which he desires is for the most part 
spontaneously given. 

In the investigation of the symptom-complex 
of epidemic or sporadic diseases it matters no- 
thing whether or no anything similar has 
appeared in the world before under this or that 
name. The novelty or strangeness of an illness 


makes no difference either to the examination or 
to the cure of it; for in any case the physician 
must look upon the clear picture of any prevail- 
ing disease as a thing new and unknown, and 
he must give it a thorough individual examina- 
tion, if he wishes to be a rational practitioner of 
medicine. For him no conjecture can take the 
place of truth, nor dare he consider that he 
knows, in whole or in part, any case of disease 
brought to him, unless he has carefully studied 
all its manifestations ; the more so as every pre- 
vailing illness (as exact investigation reveals) is 
in many respects a distinct phenomenon, very 
different from all previous diseases of a similar 
name. Epidemics due to a miasm that remains 
constant, as, e. g. small-pox, measles, and so 
on, form exceptions to this rule. 


It may well happen that in the first case of an 
epidemic the physician will not obtain a complete 
picture of the disease at once; for such a col- 
lective disease only reveals the totality of its 
symptoms and signs to the exact observation of 
several cases. Nevertheless, the physician who 
examines with care can often arrive so near to 
the true position, even with the first or second 
case of an epidemic, that he forms a character- 
istic picture of it in his mind and thereby even 
at that early stage discovers a suitable counter 
disease-force for it, a remedy adapted to its 


In the course of recording the symptom-com- 
plex of several cases of this kind, the disease 
picture, at first only sketched in, becomes stead- 


ily more complete; not longer and more wordy, 
but almost always shorter, more easily recogniz- 
able, more characteristic, including more of the 
totality of this collective disease. Then the 
general symptoms of little importance and in- 
dividuality (such as malaise, weariness, want of 
sleep, want of appetite, and so forth) retreat into 
the background, and the more striking and 
peculiar symptoms, belonging to few diseases 
and of rarer occurrence, began to stand out and 
to make up the characteristic picture of this 

Author's note, — If the physician has found 
for the earlier cases a remedy approximately 
suitable, and still more if he has found the 
almost specific remedy, he will either find the 
later cases confirm the suitability of his first 
choice (selected upon a true, albeit incomplete, 
conception of the disease), or he will find himself 
led to a more suitable remedy, and finally to 
the most suitable, the specific, remedy. 


When once the whole complex of symptoms, 
the picture of any particular kind of disease, is 
exactly drawn out, then the most difficult part 
of the physician's task is finished. Then he has 
it always before him ; he can study it in all its 
details, in order to discover an effective opposing 
force, an artificial counter disease-force, similar 
to the existing disorder, chosen out of the 
symptom-lists of all the medicines which are 
known to him ; and when in the course of treat- 
ment he wishes to learn the effect of the remedy, 
he need only remove from the original complex 
of disease-symptoms those that have been ameli- 
orated, and add any new symptom that has 


The second point in the task of a rational 
practice of medicine concerns the choice of the 
homoeopathic remedy. This is that artificial 
disease-producing power whereby the patient can 
be, as it were, inoculated with a similar illness, 
an artificial counter-disease which by the resem- 
blance of its symptoms can overcome and ex- 
tinguish, and thus radically cure, the disease 
from which the patient suffers. 


To this end individual remedies must be 
known in all their power as disease-exciting 
agents. That is, as far as possible, all the 
disease-symptoms and alterations in the body 
which various remedies have the power to pro- 
duce must be known before any one remedy can 
be chosen to combat the natural disease under 


If, in order to discover this, a medicine is 
given to a sick person, little or nothing of its 
pure effects is seen, because the effects which it 
is especially desired to observe, namely, the 
alterations in the state of the body resulting 
from the medicine, are so mingled with the 
symptoms of the existing natural disease that 
they can be recognized only doubtfully or not 
at all. 


To avoid this and to discover what distinctive 
alterations, symptoms and signs various medi- 
cines could produce in the health of body and 
mind, in other words, what elements of disease 
they tended to arouse, there was no course more 


natural than to administer them experimentally 
to healthy people in moderate doses. 

Author's note, — The great Albrecht von 
Haller recognized this necessity long ago (in 
the preface to Pharm. Helvet.) : Nempe primum 
in corpore sano medela tentanda est, sine pere- 
grina ulla miscela : odoreque et sapare ejus 
exploratis, exigua illius dosis ingerenda et ad 
omnes, quae inde contingunt, affectionum ex- 
cretiones adtendendum. Inde ad ductum phae- 
nomenorum, in sano obviorum, transeas ad 
experimenta in corpore aegroto," etc. 


As soon as I undertook this task with resolu- 
tion, not a few powers of artificial disease were 
revealed to me in the course of an observation 
conducted at no small sacrifice and with the 
greatest possible care. These can now^ be em- 
ployed with exact certainty for arousing counter- 
diseases, that is, as homoeopathic remedies for 
natural disorders. 


Many lists of symptoms recorded in older 
writings also came to my notice, which furnish 
examples of the ill effects of powerful substances 
when swallowed by healthy persons in large 

Author's note, — It was never suspected that 
the first foundation of a knowledge of drugs had 
been laid by these histories of drug-diseases. 
Hitherto this knowledge had remained almost 
entirely conjectural, that is, had hardly existed 
at all. 

The agreement of my observations on the real 
effects of medicines with these older records 


(albeit the latter were not recorded for purposes 
of therapeutics), and even the agreement of these 
accounts with others of a similar kind, must 
readily convince us that drugs produce morbid 
alterations in the healthy human body in accord- 
ance with established, unalterable laws, and that 
each has power to excite its definite, individual, 
invariable symptoms of disease. 


In those older descriptions of the effects, fre- 
quently dangerous, produced by the swallowing 
of over-doses of medicines, it is often noticeable 
that symptoms of a kind entirely opposed to 
those which were first observed appear in the 
later stages of these melancholy occurrences. 

I also in my own early experiments observed 
such late-appearing symptoms fairly frequently 
(though far less often than in the older accounts 
referred to, because I did not experiment with 
such immoderate doses) ; but I found in con- 
tinuing my experiments that, as surely as I used 
smaller doses, so surely did these late symptoms 
appear but rarely, while the early symptoms were 
observed in far greater number and with no 
less clearness, especially when I redoubled my 
care in observation and avoided everything 
which could possibly hinder the exactness of the 


The fact that the frequency of these later 
symptoms (which may be called ''negative" or 
"secondary") is greatest when large doses are 
given, and diminished in exact ratio to the 
diminution of the dose, shows that the secondary 


symptoms are only a kind of after-disease due 
to large doses following upon the cessation of 
the early symptoms ("positive" or ** primary" 
symptoms). It is a kind of opposite or reactive 
condition, analogous to the customary process 
of life wherein everything seems to go on by a 
series of alternating states. 

Author^s note. — As sadness usually follows 
upon excessive joy, liveliness upon sleep, heat 
upon chill, and vice versa, 


After the administration of every powerful 
medicine a considerable number of different 
symptoms appear, a whole series of occurrences 
and signs of disease, which are all primary 
symptoms if the experimental dose was not 
excessive. These more frequent primary 
symptoms are the chief effects of the medicines 
viewed as artificial disease-producing forces. 

Among these there are not a few symptoms 
which are partly, or in some circumstances en- 
tirely, opposed to other symptoms which have 
appeared earlier or may appear later. These 
are not therefore to be regarded as secondary 
symptoms or the after-disease produced by the 
medicine, but only as the alternating phase of 
the paroxysms of the positive (or primary) drug- 


When medicines are administered to the 

healthy, some symptoms follow more often, some 

less often, and some only appear very seldom. 

The most unusual symptoms and those which 


appear most regularly are the most valuable as 

Author's note, — Idiosyncrasies are often no 
more than these rare but real effects of drugs on 
persons who, although healthy, possess a special 
sensitiveness to the action of special substances. 
Thus the handling of some kinds of sumach 
causes skin-eruptions in certain people, and eat- 
ing mussels causes erythema and urticaria in 
others. Again, some horses and cows have been 
suddenly killed by eating leaves of yew, while 
other animals of the species are affected but 


Every medicine produces special effects which 
are never exactly counterfeited by any other. 


As every species of plant differs from every 
other species in its external form, in its in- 
dividual mode of life and growth, in its taste 
and in its smell, and as every mineral and every 
salt is certainly different from every other in 
external appearance as well as in its inner 
physical and chemical peculiarities (whereby any 
confounding of one with another should surely 
have been prevented), so assuredly are they all 
different in their power to produce disease (and 
therefore also in their power to heal). Each 
substance effects alterations in the health and 
condition of the human body after its own dis- 
tinct and definite fashion, a fashion which for- 
bids the substitution of any other substance for 

Author's note. — Whosoever exactly knows 
and rightly values the extraordinary difference 
between the effects of one. drug and those of any 


other, can easily see that from a therapeutic point 
of view there can be no equivalent remedies, no 
surrogates. Only those who do not know the 
pure and definite effects of different medicines 
can be guilty of such substitutions. Thus the 
minerals wherein a later and more cunning 
chemistr}^ has discovered new and individual 
metals, differing widely from all others, were 
held by our ignorant ancestors for stones and 
earths of no value; thus, too, children confound 
things essentially most different because they 
hardly know their external appearances, far less 
their true worth and their inner and most vary- 
ing peculiarities. 


Substances belonging to the animal and vege- 
table kingdom are most powerful as medicines 
in their crude state. 

Author's note. — Those plants and animals 
which are used for food have the advantage 
over others of possessing a larger proportion 
of nutritious material, and differ from the 
others in that their medicinal powers in the 
raw state are either not so strong or, when they 
are strong, are lessened and destroyed by dry- 
ing (as those of the arum and peony root) by 
expression of the poisonous juices (as of cas- 
sava), by fermentation (as of sour gherkins), 
by smoking and by the action of heat (in roast- 
ing, frying, baking, boiling), or are antidoted 
and rendered harmless by the addition of salt, 
sugar, and above all vinegar (in sauces and 
salads). Even most medicinal plants lose some 
or all of their power by such procedures. The 
juice of the heroic plant is often reduced to an 
inactive pitch-like substance by the heat com- 
monly used in making an extract. The expressed 


juice of the most deadly plants in their fresh 
state, if allowed to stand for only one day in a 
moderately warm place passes into complete 
alcoholic fermentation and is deprived of much 
of its medicinal strength ; but if it is left to 
stand for another one or two days till the acetous 
fermentation is complete, all specific medicinal 
power vanishes ; the deposit is then quite harm- 
less and resembles wheat-starch. 

In order to examine the effects of medicines 
it must be remembered that strong drugs (so- 
called "heroic") will display their effects when 
given in quite small doses, in healthy, even 
robust persons. Those of lesser power must be 
given in more material quantities for the purpose 
of these experiments, but the weakest drugs can 
only be tested upon such subjects as are free 
from disease, but at the same time are delicate, 
excitable and sensitive. 


The physician planning these experiments, 
upon which hang the welfare of generations of 
men, should choose no medicines but those which 
he knows well and of whose purity and potency 
he is entirely convinced. 


Each of these medicines must be administered 
in a perfectly simple and unadulterated form, 
in powder, or alcoholic tincture, or (if they are 
salts and gums) in watery solution, so as to 
procure only individual effects of each substance. 
As, however, infusions of plants in water and 
fresh plant-juices are spoilt by fermentation 
within a few hours, drugs belonging to these 


classes must either be administered without 
delay as soon as they are prepared, or fermenta- 
tion must be delayed by the addition of a little 
spirit of wine, or avoided by the use of a larger 
quantity of alcohol. 


For the purpose of these experiments every 
drug must be given alone and quite pure, without 
admixture of any foreign substance ; and nothing 
of a similar kind must be taken either at the 
same time or shortly before or after the dose 
of medicine. 


The healthy person who is the subject of the 
experiment must take, while fasting, about such 
a dose as is commonly used in medical practice. 
It is best given in solution, and no food should 
be taken for some hours afterwards. The sub- 
ject must be willing to pay strict attention to his 
condition without losing his mental tranquillity. 


If (as is best) the effects of this single dose 
are to be observed over a period of several days, 
the diet must be strictly regulated. As far as 
possible it should be of a simple nutritious char- 
acter without condiments ; and green vegetables 
and fresh roots should be avoided as they all 
have some disturbing medicinal action in what- 
ever v/ay they are prepared. The drinks should 
be those usually taken, as little stimulating as 


The subject must refrain from any kind of 
excesses, especially sexual excess. 

E 2 



If no result follows the first dose, or at least 
nothing clear and definite, a second dose of 
double the quantity should be given on the 
second day, and if this also produces no effect, 
then a still stronger dose on the third day. 


This repetition, however, will seldom be re- 
quired if both the experimenter and the physician 
are equally observant. To obtain a pure result, 
at least as regards the regular succession of 
the symptoms, it is far better to see whether 
the experiment cannot be carried through by the 
administration of a single dose, and only to 
give another dose of the same drug after (say) 
some w^eeks; or better still, after a considerable 
time, to administer a single dose of a different 


In this way the order of appearance of the 
drug-symptoms can be better observed than 
when a second dose of the same medicine is 
given soon after the first; also the duration of 
the action of a drug on the human body is more 
certainly determined by the administration of a 
single dose than by any other method. 


When, however, it is desired to investigate 
the symptoms themselves, especially those of a 
medicine of little power, without regard to dura- 
tion of action or succession of symptoms, then 
the preferable method is to give it every day 
in an increasing dose or several times a day in 
the same dose. In this way the powers of even 


the weakest drug, as yet perhaps unknown, will 
come to light. 


All the individual symptoms of a drug do 
not appear in any one person selected for experi- 
ment, nor do they all appear at once or on the 
same day, but some appear in one person and 
some in another, and yet in such a way that 
some or many of the symptoms will be found 
in a fourth or tenth prover which appeared 
earlier in the second or sixth or seventh ; more- 
over, they will not all appear precisely at the 
same hour. 


The number of disease-elements which a 
medicine can produce is only brought near com- 
pleteness by repeated observations on many 
suitable persons. 


In conducting such an experiment with a 
definite medicine the smaller the doses, up to a 
certain point, the more surely (within limits) 
will the primary symptoms, unmixed with 
secondary, appear conspicuous in the proving; 
provided always that the observation is con- 
ducted with the most minute attention and aided 
by the choice of a prover who is in every respect 
temperate, self-observant and sensitive. 

When over-large doses are employed, not only 
do the secondary symptoms play a large part, 
but the primary sym.ptoms appear in so con- 
fused and sudden and precipitate a manner that 
they cannot be exactly observed ; to say nothing 


of the danger, which cannot be a matter of 
indiflerence to any one who cares for his fellows 
and regards the least of mankind as a brother. 


The subjects of the experiment must be able 
to express their sensations exactly and clearly. 


In the investigation of these drug-symptoms 
all suggestion must be as rigidly avoided as in 
the examination of the symptoms of disease. 
The greater part of what is recorded as the 
genuine result of experiment must be the volun- 
tary statements of the prover; nothing must be 
conjectural, nothing guessed at, and as little as 
possible should consist of answers to formal 
questions ; least of all should the record contain 
expressions relating to sensations with which the 
prover has been previously prompted, or the 
results of questions that suggest the answers 
"Yes" or "No." 


In order to render these important state- 
ments as accurate as possible it is a good plan, 
as soon as any symptoms or sensations of the 
prover are written down, to make him repeat his 
description, so that, when his second account is 
identical with the first, it may be recorded in 
that form, and when the accounts vary he may 
be confronted with both and invited to choose 
and confirm the statement which is nearest to 
the truth, and thereby render true, pure and 
striking the picture of the drug disease which 
has been discovered through his aid. The 
physician who is observing the experiment adds 


to the description whatever alterations in health 
he has himself observed in the prover. 


The record of the more definite and striking 
symptoms must be accompanied by a note of 
the time that elapsed between the giving of the 
dose and the appearance of the symptoms, the 
time of day at which they appeared, their dura- 
tion, and all contingent circumstances; those 
symptoms that are observed more often in the 
same way should be underlined, and the doubt- 
ful ones followed by a mark of interrogation or 
enclosed in brackets until perhaps the doubt 
concerning them is removed by the confirmation 
of other experiments. 


The w^eightiest experiments in drugs remain 
those conducted by the closely observing and 
unprejudiced physician upon himself. 


Even in diseases, especially in chronic dis- 
eases, the symptoms of a remedy can sometimes 
be discovered beneath the symptoms of the 
original disorder. But it is a subject. for the 
higher art and should be left to masters of 
observation alone. 


If we have thus tested on healthy persons a 
number of medicines, and have carefully and 
faithfully recorded all the disease-elements and 
symptoms which as artificial disease-producing 
forces they are able to arouse^ then we possess 
a Materia Medica, a collection of the genuine 


positive mode of action of simple medicines, a 
codex of Nature wherein is registered a con- 
siderable list of the individual symptoms and 
disease-elements of each powerful and tested 
drug just as the observation of the experimenter 
discovered them. Among these are to be found 
the elements of many natural diseases which can 
be cured through the likeness herein established. 


In such a Materia Medica there is nothing 
conjectured, asserted without proof, imagined, 
invented; but all is the pure reply of Nature to 
careful questioning. 


Truly only a considerable supply of medicines 
thus accurately known in their positive modes 
of action can serve our turn, and enable us to 
discover a remedy for every one of the innumer- 
able natural cases of disease. 

Author's note, — When thousands of exact and 
tireless observers, instead of one as hitherto, 
have laboured at the discovery of these first 
elements of a rational Materia Medica, what 
will it not be possible to effect in the whole 
extent of the endless kingdom of disease ! Then 
the art of medicine will no longer be mocked 
at as an art of conjecture lacking all foundation. 


Nevertheless even now there are but few cases 
of disease for which, even out of this small 
supply of provings,^ a suitable analogue of 
counter disease-force (i. e. a remedy) cannot be 

^ " Fragmenta de viribus medicaminum positivis." — Hah- 
nemann, 1805. 


found which will bring about a restoration ot 
health gently, swiftly and enduringly without 
any marked perturbations. This fact depends 
on the manifold variety of symptoms and the 
abundance of disease-elements which every one 
of the powerful medicines hitherto tested has 
already displayed in its positive action on the 
healthy body. In spite of the limited choice of 
remedies (even now not completely known), 
incomparably more and better cures can be 
achieved by this method than by the so-called 
general methods or any other of all the irrational 
non-homoeopathic ways of treatment. 


Whenever in the provings of one or other of 
these medicines, tested in their positive action by 
observations on the healthy body, we find a 
symptom-complex analogous to that of a given 
natural disease, that medicine will, nay, must, 
be the most suitable counter-force for the de- 
struction and extinction of that natural disorder ; 
the specific, or completely suitable, remedy is 
discovered in that medicine. 

If now the counter disease-force (the drug) is 
entirely suitable by its likeness of symptoms 
(that is, if it be selected on the ground of its 
homoeopathicity), and if, further, it is admin- 
istered properly, then the natural disease, how- 
ever threatening or severe, however encumbered 
with many symptoms, will depart almost un- 
noticed in a few hours, provided it has not been 
of long duration. If it is of longer standing, it 
will be a few days before it disappears. In either 
case practically none of the pathogenic symptoms 
of the drug, that is, of the artificial counter- 


disease will be observed. In rapid and hardly 
noticeable sequence, there comes only health ; 
the natural and the artificial disease both swiftly 
and gently vanish, without perceptible reaction ; 
there has been a true dynamic annihilation. 


Here we arrive at the third point in a rational 
system of therapeutics, the most suitable method 
of administering the homoeopathic remedy in 
cases of disease. 


If a patient complain of one or two trivial 
symptoms, which have but recently appeared, 
the physician should not look upon this as a 
complete disease requiring therapeutic aid. A 
slight alteration in diet and mode of life will 
usually be enough to make an end of such an 
illness. But if the patient complain only of one 
or two violent symptoms, the physician will 
generally find, on examination, other, though 
lesser, symptoms, which make up a complete 
disease-picture. This is generally the case with 
chronic disorders, of which more hereafter. 


The more severe an illness is, the more omin- 
ous and striking usually are the symptoms of 
which it consists. But thereby the more surely 
also is a suitable remedy discovered for it, if a 
sufficient number of medicines, tested in their 
positive actions, is at our disposal. Among the 
symptom-groups of many drugs it is not as a 
rule difficult to find one whose particular disease- 
elements and symptom-complex present a very 
similar picture to those of the natural disease, 


thereby constituting it a suitable counter disease- 
agent ; this is the desired remedy. 


In this search for a specific homoeopathic 
remedy, that is, in this comparison of the totality 
of the symptoms of the natural disease with the 
symptom-lists of available medicines, the more 
striking and unusual of the characteristic symp- 
toms of the disease should especially be kept in 
view; for it is precisely to these symptoms that 
analogues must be found among the disease- 
symptoms of the drug which is to be the most 
suitable remedy. On the other hand the general 
signs, like loss of appetite, weariness, discom- 
fort, disturbed sleep, and so forth, are of little 
significance when unaccompanied by more pre- 
cise indications, because they are found in the 
symptomatology of most drugs as of most 
natural diseases. 


If, then, the counter disease-picture, con- 
structed from the symptom-list of the remedy 
held to be most suitable, contains in the greatest 
number and closest resemblance, these striking 
and characteristic symptoms of the disease that 
is to be cured, then this medicine affords the 
most apt artificial counter-disease for this case 
of illness, and is, in short, the specific remedy. 
The disease will be removed and extinguished 
without any disturbance, often even within the 
period of action of the first dose. 


I say, without disturbance. For in employing 
this most suitable counter disease-force, only 


those drug-symptoms are called into play which 
correspond to the disease-symptoms (and the 
first destroy the second) ; the other and often 
very numerous symptoms found in the symptom- 
list of the suitable remedy remain entirely latent 
because they find nothing to correspond to them 
in the disease-condition. Nothing of them will 
be noted in the condition of the patient, which 
will improve from hour to hour; presumably 
because the whole power of the specific remedy 
is concentrated on those disease-symptoms which 
resemble its own and is entirely devoted to the 
destruction of these similar symptoms. 

Author's note. — Yet there is no homoeopathic 
remedy, however suitably chosen, which may not 
in the course of its action on a very excitable 
and sensitive patient, cause at least one, prob- 
ably very trifling, unwonted disturbance, a little 
new symptom. For it is almost impossible that 
medicine and disease should cover each other in 
their symptoms as exactly as two triangles with 
equal angles and equal sides cover each other. 
But generally these unimportant differences are 
readily adjusted by the individual energy of the 
living organism, and only patients of unusual 
sensitiveness are aware of them ; recovery goes 
steadily forward, unless prevented by errors in 
the conduct of the patient's life or by excitement 
of the passions. 

Translator' s note — In more modern phrase- 
ology it might be said that drugs have an indi- 
vidual power, in sufficient doses, of affecting 
certain body-tissues, often indeed a large number 
of tissues. When these tissues are affected by 
disease in a way resembling the action that the 
drug exerts upon them, they, being rendered 
more sensitive by disease, will respond to the 
stimulus of a smaller dose of the homoeopathic 


remedy than was originally required to call out 
symptoms in the healthy provers. But the 
smaller dose, which can affect the diseased and 
thereby sensitized tissues and can probably 
cause amelioration, is not strong enough to 
arouse symptoms in tissues which have remained 
normal, in spite of the fact that the drug pos- 
sesses a distinct relation to these tissues. Con- 
sequently symptoms due in the provers to dis- 
turbances of these tissues (w^hich ex hypothesi 
remain normal in this particular patient) do not 
appear as a result of administering the drug, 
unless in unduly sensitive subjects, and then 
only to a small extent. 


But although it is certain that a suitably 
selected homoeopathic remedy gently destroys 
and removes disease, without arousing such 
special symptoms of its own as are not present 
in the patient, that is, without exciting sufferings 
of a new and serious kind, yet it usually causes, 
as it W'Cre, a slight aggravation of the patient's 
condition in the first hour or two after its admin- 
istration. This aggravation so closely resembles 
the original disease that it seems to the patient 
to be a real worsening of his symptoms. But it 
is in reality no more than the onset of a very 
similar medicinal disease rather more powerful 
than the original disease. This slight homoeo- 
pathic aggravation during the first hours (which 
is, in fact, a very good prognostic sign that the 
acute disease will probably yield to the first 
dose), is quite as it should be; for naturally the 
drug-disease must be somewhat stronger than 
the illness if it is to overcome arid extinguish it; 
even as an analogous natural disease can only 


remove and destroy another when it is the 
stronger (S. 28). The smaller the dose of the 
homoeopathic remedy, the less will be this 
aggravation of symptoms appearing in the first 
hours. ^ 

Yet the dose of a homoeopathic remedy can 
hardly be made so small that it will not over- 
come and ameliorate its analogous disease, in- 
deed completely cure and banish it (S. 244). It 
is, therefore, easily to be understood why even 
the very smallest dose of a homoeopathic remedy 
always causes a small homoeopathic aggravation 
of this kind, albeit a very mild one, in the first 
hours after its administration. 

Author's note — This aggravation, an exalta- 
tion of the drug-symptoms over the analogous 
disease-symptoms has been observed by other 
physicians when by chance they have employed 
a homoeopathic remedy. The use of viola 
tricolor at first caused an aggravation in the 
skin-eruption which it ultimately (homoeopathic- 
ally) cured (Leroy, Heilk, fur Mutter). 

Since the number of medicines exactly tested 
in regard to their positive action is as yet only 
moderate, it sometimes happens that only a 
smaller or greater part of the symptoms of a case 
of disease can be found in the symptom-register 
of the most suitable medicine. Consequently 
this incomplete counter-disease force must be 
employed for lack of a complete one. 

^ This corresponds to the experience of the use of vaccines 
and the "negative" and "positive " phases of Sir Almroth 


In such a case a complete undisturbed cure 
by this drug is naturally not to be anticipated. 
After its use many more symptoms may appear 
in the patient than were previously present as a 
result of the disease. These will not prevent the 
uprooting of a considerable part of the disorder, 
nor the establishment of a fair commencement of 
a cure; but nevertheless, complete cure may be 
impeded by these accessory symptoms. 

The small number of homoeopathic symptoms 
shown by the best-selected medicine is little or 
no hindrance to cure, if these few symptoms for 
the most part correspond to the characteristic 
and specially striking features of the disease. In 
such a case cure follows the use of the remedy 
swiftly and almost undisturbed. 


If, however, few of the outstanding character- 
istic symptoms of the disease can be paralleled 
in the symptomatology of the chosen drug, and 
if it corresponds to the disease chiefly in such 
general symptoms as nausea, weariness, dis- 
turbed sleep, discomfort, and so forth, and in 
little else; then, if no remedy more exactly 
homoeopathic can be found among such agencies 
of counter-disease as are known, the physician 
can promise himself but little immediate favour- 
able result from the use of the drug. 

Such a case, however, is rarq even with the 
number, as yet small, of medicines known in 
their positive actions; and the bad effects of 


administering such a remedy are lessened as 
soon as another, more suitable, medicine can be 

Thus, if accessory symptoms of some moment 
occur after the use of the first selected medicine, 
which is not exactly homoeopathic, this first dose 
should not be allowed to exhaust itself and 
expose the patient to the full duration of its 
action ; but the altered disease-state should be 
freshly examined, and a new disease-picture 
made from the combination of the remaining 
original symptoms with those that have just 

We shall then more easily find among our 
known medicines an analogue to the new disease- 
picture just presented, and a single dose of this 
remedy, if it does not entirely destroy the dis- 
ease, will bring recovery much nearer. And if 
even this drug is not enough to achieve a com- 
plete cure, we proceed similarly with the repeated 
examination of the disease-condition and the 
repeated selection of the most suitable homoeo- 
pathic counter-force till our object is achieved 
and the patient is completely restored to health. 


If on the first examination of a disease and 
the first choice of a remedy it is found that the 
symptom-complex of the illness cannot be effect- 
ually covered from the symptom-register of a 
single medicine (owing to the insufficient num- 
ber of medicines which are known) ; and if 
further it is found that tw^o medicines contend 
for preference, the one corresponding more 


closely to one part of the symptom-complex and 
the other more closely to another part; then it 
is not desirable to give one medicine after the 
other without further close examination, nor to 
administer both together, for no one can foresee 
how the one may hinder and perturb the action 
of the other (S. 235, 256). 


It is far better first of all to give only the one 
which on the whole seems more suitable. It will 
certainly ameliorate the illness in part, but will 
on the other hand bring out a new range of 


When this happens, the homoeopathic law 
allows no second dose of the same medicine to 
be given. But at the same time the other remedy, 
which seemed suitable upon the first indications 
for the second half of the symptoms, must not 
be given without consideration and a further 
enquiry into the condition left after the use of 
the first medicine. 

Far rather in this case, as always when a 
change has come about in the disease-condition, 
the present remaining symptom-complex must 
be considered anew and without regard to the 
second remedy which at first seemed partly suit- 
able, in order that the counter-force most adapted 
to the present new condition may be selected 
without prejudice. 


It seldom happens that the medicine which 
at first appeared the second best will now be 


indicated. But if, indeed, this very remedy ap- 
pears after the new examination at least as suit- 
able as any other, then it deserves the more con- 
fidence, and should be straightway administered. 

It is only in cases of long-standing chronic 
disease, not subject to any notable change, which 
possess definite stable fundamental symptoms, 
that sometimes two medicines almost equally 
homoeopathic can be used with advantage in 
alternation ; ^ and even that is only to be toler- 
ated as long as amongst the number of proved 
remedies there is none that offers a group of 
symptoms altogether or almost parallel to those 
of the chronic disease in question. If there 
should be such a remedy, then it alone and un- 
aided will do all that is required, and will cure 
swiftly and enduringly and without perturbation. 


A similar difficulty in the art of healing arises 
in cases where the number of disease-symptoms 
is too limited. This contingency demands the 
most careful attention ; for if the difficulty which 
it creates is now removed, then almost all the 
difficulties which hinder the therapeutic art are 
disposed of, except the lack of remedies 
homoeopathically known. 

The only diseases which seem to have but few 
symptoms, and are therefore more troublesome 
to cure, are those which may be called incom- 
plete, since they present only one or two leading 

1 Hahnemann never regarded this procedure as other than 
a make-shift, and in later years ceased to recommend it. 


symptoms, and these obscure almost all the rest. 
They belong for the most part to chronic 


Their principal symptom may be either of an 
external character or may affect an internal 
organ ; as, for instance, headaches of years' dura- 
tion, long-standing diarrhoea, cardialgia, and so 
forth. The first class are usually termed local 


In incom.plete diseases of the second kind, it 
is often due to the physician's want of obser- 
vation that the symptoms which are actually 
present and which make up the complete dis- 
ease-picture, are not fully discovered. 


There are, nevertheless, a few illnesses which, 
after all preliminary examinations (S. 63-81, 
S. 178-182), present but one or two marked and 
violent symptoms and leave all others only 
vague and shadowy. 

To deal successfully with such rare cases the 
first procedure is to choose the counter disease- 
force which is best indicated by these few 

Sometimes, indeed, it will happen that this 
remedy, chosen most carefully in accordance 
with the homoeopathic law, albeit from few 
symptoms, will actually prove to be the exact 
counter-force required to destroy the existing 
F 2 


disease. This is the more Hkely to occur, the 
more striking, strange, and characteristic are 
the few disease-symptoms present. 

But more often the medicine so selected will 
prove only partially suitable, since there was no 
complex of many symptoms to guide to a 
decisive choice. 


In this case the medicine, which has been 
chosen as exactly as possible, but is neverthe- 
less not completely homoeopathic, will cause 
accessory symptoms while counteracting a dis- 
ease to which it is only partially analogous. A 
similar sequence of events has been already 
noted as likely to occur when the choice of a 
remedy is incomplete from lack of sufficient 
counteracting forces, i, e, lack of exact know- 
ledge of a sufficient number of medicines. The 
accessory symptoms and phenomena, which 
appear in these circumstances out of the symp- 
tomatology of the drug, are intermingled with 
those of the patient's condition, but are at the 
same time themselves to be regarded as symp- 
toms of the disease, although they were not 
experienced before the administration of the 
medicine. Entirely new symptoms will appear, 
or symptoms hardly perceived before will become 
more marked. 

Translator's note. — That is to say, the effect 
of a drug on a diseased body is, to a large 
extent, influenced by the nature of the disease, 
and forms, as it were, a commentary upon it, 
from which more knowledge of the disease can 
be acquired. 


The accessory phenomena and newly appear- 
ing symptoms of disease must not be attributed 
entirely to the medicine. They originate from 
it, but they are always and only such symptoms 
as this particular disease had the latent power 
to produce in this particular body, symptoms 
which the medicine, as an agent having a similar 
tendency, merely elicited and caused to appear.^ 
In a word, the entire symptom-complex now in 
evidence is to be regarded as that of the disease 
itself, as its actual existing condition, and as 
such it is to be treated. 

Thus the choice of the remedy, which was in 
this case almost unavoidably imperfect, yet 
serves to make the symptom-complex complete 
and so to facilitate the discovery of a second 
homoeopathic counter disease-force which shall 
be more exactly adapted to the needs of the case. 

Therefore, after the action of the single dose 
of the first medicine is completed (unless the 
violence of the newly appearing symptoms de- 
mand more speedy aid) a new examination of 
the disease must be undertaken ; the status 
morbiy as it now is, must be exactly noted, and 
a second homoeopathic remedy chosen according 
thereto, which shall be exactly suitable to the 
immediate condition. This is the more readily 
and exactly done, because the group of symptom's 
has become more numerous and more complete. 

^ Except when they usher in the final-death agony, or can 
be traced to some error in the mode of living, outbreak of 
violent passion, etc. 


Among incomplete diseases (S. 147) the so- 
called local disturbances take an important place. 

These local diseases, unless they have arisen 
a short time previously from an external lesion, 
always depend upon an inner malady extend- 
ing throughout the whole organism ; and the 
medicinal treatment of them must, therefore, also 
have regard to the whole organism, if it is to be 
reasonable, consistent, and effective. 


No so-called local malady arising from internal 
causes and persisting in a definite region can be 
thought of as produced without the consent (as 
it were) of the rest of the general health, and 
without the participation of the other sensitive 
and irritable parts of the body and the other 
living organs. Thus the amelioration and even 
complete cure of maladies which appear isolated 
on the most distant parts of the skin, by means 
of a small dose of a remedy homoeopathically 
chosen, placed on the tongue or introduced into 
the stomach, can only be explained by the 
general acute sensitiveness to medicinal powers 
and the ready, alert response to drug-force which 
permeate all parts of the living organism. 

Such cures are best effected when the physician 
takes into account all noticeable alterations in 
the patient's general condition, and thus finds 
himself in a position to draw a complete outline 
of the disease-picture before seeking among the 
medicines known to him for a clearly marked 
counter-force to the whole complex of symptoms. 


general as well as local. In this way a choice 
can be made which is completely homoeopathic. 


By means of this medicine employed intern- 
ally (not externally) the general disease-condition 
of the body is removed simultaneously with the 
local disorder, and the first and the last are cured 
together. This proves that the local malady 
depends on a disease of the body as a whole, and 
is only to be regarded as one of the most 
important symptoms in a general disease. 


This is so true that, when any remedy locally 
applied has cured without other aid and has 
restored health (as it has occasionally done), it 
has only been able to do so by exercising 
homoeopathically a healing influence upon the 
inward disease-condition, and it would have 
cured equally well had it been administered only 
internally and not externally at all. 

Author's note. — Thus some eczemas are re- 
moved by the external use of cantharides and 
some other eruptions by a similar use of mer- 
curial preparations; but none of them are cured 
so that general health ensues, unless these ex- 
ternal remedies have also the power to remove 
the inseparably associated inner disease-con- 
dition and have, therefore, affected the whole 
organism with their healing power. 


It would seem, indeed, as though the cure of 
such a malady would be hastened, if the remedy 
recognized as truly homoeopathic to the whole 
disease complex were not only administered 


internally but also applied externally; seeing 
that the local affection usually strives to isolate 
itself (although it can never do this completely 
in the living organism), and that it is true that 
medicines act more speedily on the part to which 
they are applied than to more distant regions. 

Author's note. — If cherry laurel water is in- 
jected into the bowel of an animal, its spasmodic 
action first appears in the lower limbs and later 
in the upper, while this order is reversed if the 
drug is swallowed. 

1 66 

Nevertheless, this simultaneous use of a 
remedy externally and internally in diseases 
where the local symptoms are the more marked, 
has this great disadvantage, that through the 
local application these principal symptoms (/. e. 
the local affection) will be destroyed before the 
internal disease is destroyed. Consequently 
through their disappearance it becomes difficult 
or even impossible in many cases to decide 
whether in addition the whole disease has been 

Translator's note. — The belief that grave 
symptoms might ensue if skin diseases were sup- 
pressed was shared by most physicians in 
Hahnemann's time. This belief is not now 
widely held. The subject is a difficult one and 
hardly ripe for dogmatism. What Hahnemann 
fears in these paragraphs is the grave danger 
that the patient may seem to be cured with the 
disappearance of the skin eruption and so pass 
out of observation before he has really recovered. 


A similar but, if possible, greater disadvantage 
generally follows the practice of using an active 


remedy (even if homoeopathic) only in local 
application to the local disease (in other words, 
the principal symptom), unless it has been pre- 
viously administered internally to bring about 
the entire destruction of the general disease. 
For then it is even more unlikely that the remedy 
when only locally applied should have simul- 
taneously acted so powerfully and completely 
on the inner organism as to remove and destroy 
the total disease as well as its local symptoms. 
This favourable result will only occur in the 
very rare cases in which the inner disease is but 
slight and the external affection is so extensive 
that the topical application will have been made 
over a considerable area of the body. 


In all other cases the simple external appli- 
cation of a small quantity of the remedy will 
not exert upon the inner organism an action 
nearly powerful enough to destroy the inner and 
often chronic and deep-seated disease. Even 
if its proportionately more rapid curative action 
promptly avails to remove the local lesion, which 
is merely the most prominent symptom of dis- 
ease, the inner malady still remains and the case 
has become more serious than before. 


For if the local affection is made to disappear 
by this local incomplete treatment, then the in- 
ternal treatment necessary for the complete cure 
of the total disease remains in vague obscurity; 
for now only the other and ill-marked symptoms 
remain, symptoms which are not so constant 
and persistent as the local symptoms, and often 
are not characteristic enough to enable a clear 


and comprehensive picture of the disease to be 


The physician in his search for a suitable 
internal treatment must remain in doubt whether 
the homoeopathic remedy apparently indicated 
has entirely destroyed and removed the whole 
disease; for the most important and persistent 
symptom (the local lesion) has already vanished. 
He will have to work in semi-darkness, and thus 
will either give too much or too little of the 
remedy, or he will employ it too long or not 
long enough for complete cure; and thus the 
patient suffers. 

If the remedy which is completely adapted to 
the disease has not been discovered before the 
local symptoms have been removed either by the 
knife or by some destructive or desiccating local 
application, the case necessarily becomes more 
difficult on account of the uncertain and in- 
sufficiently characteristic nature of the remaining 
symptoms. For the external and principal 
symptoms, which would have led most surely to 
the choice of the exact remedy and would have 
confirmed the choice by responding to its in- 
ternal use, have been removed from observation. 


If the external phenomena were still present, 
then their failure to disappear would show that 
the inner treatment was not yet complete ; if, on 
the contrary, they disappeared under internal 
medication alone, that would constitute a con- 
vincing proof that the disease was uprooted and 
that the desired recovery from the whole disease 
was achieved — a priceless advantage. 


The disappearance of local symptoms as a 
result of local treatment is almost always com- 
pensated in Nature by the increase and develop- 
ment of the other symptoms, hitherto virtually 
latent although recognizable, and by the appear- 
ance of new disease-phenomena. That is to 
say, there is a heightening of the remaining 
symptoms that make up the general disease. 
This result of a local application is usually 
wrongly called a driving inward of the external 
disorder upon the nerves or the "humours." 

In some diseases this awakening of the other 
symptoms, after removal of the local manifesta- 
tions, only takes place gradually, so that the 
aggravation of the patient's condition is only 
perceived after some lapse of time. 

On the other hand, some other diseases pre- 
senting local symptoms show a sudden acute 
development of their remaining and generally 
internal symptoms when the important local 
manifestation has been removed by topical 
applications. This acute aggravation of the 
disease may be most alarming, and often ends 
rapidly in death. Here the local phenomena 
not only serve the end of hindering the develop- 
ment of the internal symptoms, as in chronic 
and sluggish cases of disease, but also seem to 
be raised to the position of the chief symptom, 
the symptom which, as it w^ere, for the time 
absorbs the intensity and danger of the other 
symptoms and prevents their perilous develop- 
ment. The most melancholy experience teaches 


how irrational it is in these cases, as well as in 
the others, to abolish the relatively beneficent 
local symptoms by a purely local treatment. 


Fortunately the life-activity of the organism 
itself sometimes causes the return of the local 
symptom which has been artificially abolished; 
it is less desirable to attempt to do this by 
artificial means. Even inoculation is frequently 
unsuccessful, because as a rule the local disease 
inoculated is not the original one, but another 
which bears only a superficial resemblance to 
the first. 


The rational cure of all such diseases depends 
entirely on the internal administration of a 
medicinal force, suitably adapted by its homoeo- 
pathy to the whole symptom-complex, whereof 
the local symptom is but the most characteristic 
sign among a number of others. If this remedy 
is given internally, and if in addition a suitable 
regimen is ordered, the local application of the 
specific medicine will hardly ever be found 

Author^s note. — Different diseases require 
different rules of treatment in this respect. For 
some, local applications of the indicated remedy 
are most dangerous, for others, harmless or 


The difficulty of effecting a homoeopathic cure 
of these incomplete diseases (among which the 
local diseases, so-called, should be mostly 
classed) depends principally, as has been already 
said, on the fact that they so seldom present 


more than one outstanding symptom. The 
remaining symptoms, which with the local 
manifestation complete the disease-picture, re- 
main in the background and escape the attention 
of most observers. 


This difficulty can only be overcome by more 
searching and careful observations and inquiries. 


To this end, if the patient complains only of a 
few severe symptoms and can furnish no others 
at the first examination, the physician does best 
to defer his judgment as to the curability of the 
disease and its curative treatment. These dis- 
eases are nearly always chronic and will not 
suffer permanently from a delay of several days^ 
during which all deviations from health in the 
patient, great or small, can be more carefully 
investigated until every one, even of the trivial 
and hitherto unnoticed symptoms, has been 
elicited and exactly noted. 

Author's note. — Local symptoms are hardly 
ever acute except when they are "metastases." ^ 

^ A metastasis is a severe localized symptom which appears 
naturally in acute diseases, apparently as an attempt to 
transfer them to an outward and less vital part of the 
organism, and so to save the inner life from the danger that 
threatens it. In such cases, although the local symptom at 
the moment masks the others, yet the remaining symptoms 
are more easy to discover owing to the phenomena which 
preceded the metastasis, and by taking these together with 
the local appearances, the entire symptom-complex and 
disease-picture can be obtained and a suitable homoepathic 
remedy selected ; cure then proceeds rationally and radically. 
In these cases it is especially dangerous "to attack the local 
symptoms with topical applications alone. 



In a chronic case of this kind the physician 
will encourage the patient to divert his attention 
from his local ailments and to take note of the 
accessory signs and symptoms however small. 
In this way special symptoms will be elicited 
which the patient had hitherto overlooked on 
account of the insistent nature of the more 
obvious malady. 

Author's note. — If the patient stubbornly de- 
clines to make any further observations and 
insists on treatment without delay, it is advisable 
to treat him for a few days with some un- 
medicinal preparation instead of a drug, in order 
to gain time for the discovery, by further exact 
investigation, of all morbid changes in his con- 
dition. It is a harmless deception which will 
bring to light most of the special symptoms of 
his disease. 


These other peculiarities of the patient, both 
the greater and the less, will aid the physician 
to obtain a complete view of the disease as a 
whole ; and careful inquiries into the state of 
various bodily functions, a close observation of 
the manner and appearance of the patient, to- 
gether with any information furnished by friends 
and asked for, if necessary, in secret, will add 
to the tale of facts already obtained all the 
additional information necessary for successful 


In this way the physician will seldom fail to 
discover the entire symptom-complex of any 
chronic disease however obscure. Then from 
the disease-elements found among the remedies 


that have been tested on healthy persons he can 
select the counter-force most similar to the 
natural disorder, that is, the exact homoeopathic 
remedy. Here also the most special and char- 
acteristic symptoms of the disease must above 
all others be found in the remedy which is to 
prove appropriate. 


If the drug first chosen actually corresponds 
to the disease in its entirety it must cure it. 
But if, owing to the insufficient number of fully 
proved drugs and the consequent restriction of 
our choice, the medicine selected is not exactly 
homoeopathic, then it will arouse new symptoms 
which will in their turn point the way to the 
next remedy likely to prove serviceable. 


Mental diseases appear to supply the next 
class of malady which is troublesome to cure. 
But actually they are not much more difficult to 
deal with than other incomplete diseases, among 
which they may be reckoned. 


Indeed, they are in no wise really an excep- 
tional class of disease, though often sharply 
separated off from others in classification. For 
in every other kind of disease the condition of 
the mind and of the disposition is invariably 
altered in some w^ay, and the disposition and 
mental characteristics of the patient form symp- 
toms of prime importance in all cases which the 
physician has to treat. Such symptoms must be 
included in the totality of disease-phenomena if 
a rational homoeopathic cure is to be achieved. 



This point is of such importance that it is not 
too much to say that the mental symptoms of a 
patient often form the determining factor in the 
choice of the medicinal counter-force. They are 
the characteristics which the observant physician 
can least of all afford to overlook. 


The creator of medicinal virtues has had 
particular regard to this important feature of 
disease, namely, alterations in the mental and 
moral condition ; for there is no drug in the 
world of any power which does not produce in 
healthy persons very marked mental and moral 
changes, which are different for every different 


We shall, therefore, ne\er learn to cure 
rationally or homoeopathically, unless we con- 
sider in every case of disease these alternations 
in mind and disposition, and choose as a 
counter-force the remedy which is capable of 
causing similar alterations. 

Author's note. — Thus aconite will never bring 
about a speedy or lasting cure in a patient of 
quiet, equable disposition ; nux vomica is as 
little serviceable to gentle phlegmatic patients, 
Pulsatilla as little to the gay and happy, ignatia 
as little to those who are imperturbable and dis- 
inclined either to fear or to vexation. 


Thus all that there is to say concerning the 
cure of diseases of the mind and spirit can be 
compressed into a few words. They can be 


cured, like all other diseases, by those remedies, 
and those alone, which possess a counter-force 
most nearly resembling their own, a counter- 
force which has been displayed in symptoms 
produced on the mind and body of healthy 


The so-called mental and emotional diseases 
are, for the most part, no more than diseases of 
the body wherein the characteristic symptoms 
of disturbance in mind and disposition have 
more or less swiftly increased, while the bodily 
symptoms have more or less swiftly diminished, 
until finally a most striking disproportion is 
attained, almost like the disproportionate ap- 
pearance of a local disease. 


Cases occur not infrequently where a so-called 
bodily disease which is threatening to life (a 
disease of one or other of the important organs 
or an acute dangerous disease) becomes changed 
into melancholia or mania by an increase in 
psychical symptoms which have been present in 
lesser degree from the first. Then all the bodily 
symptoms lose their threatening character, de- 
creasing to such a degree that their obscured 
but persistent existence is only to be detected 
by the persevering physician who is also gifted 
with fine powers of observation. In a word, 
they assume the form of incomplete diseases, 
local diseases, as it were, in which the mental 
symptoms w^hich at first were mild and un- 
important increase until they are the chief 
svmptoms. Then they take the place, to a large 
extent, of the other symptoms, which they 
palliate by their own intensity; this is a process 


which we have already noted in considering 
local disorders. 

Translator's note. — These were the days when 
instruments of exact physical examination 
(stethoscope, thermometer, etc.) and the aids of 
the laboratory were nearly all unknown. Ap- 
pearances can never again be as misleading even 
to the careless as they often were in Hahne- 
mann's day to the most careful. 

Therefore in dealing with these diseases, as 
with those of sections 180 and 181, the investi- 
gation of the symptom-complex demands the 
greatest perseverance, fine observation, most 
careful discrimination and a detailed enquiry if 
we would discover the bodily symptoms in dis- 
eases of the mind. The exact appreciation of 
the particular characters of each individual 
change in mind and disposition is, of course, of 
the first importance, and when combined with a 
knowledge of the bodily symptoms will lead 
to the discovery of the remedy appropriately 
homoeopathic both in its mental and bodily 
symptomatology, and so will lead to the ex- 
tinction of the disease. 


For the determination of the non-mental 
symptoms the greatest aid is derived from a 
clear description of all the phenomena of the 
previous bodily disease which, through the one- 
sided exaggeration of its mental and emotional 
symptoms, developed into a mental disease. 

The comparison of these earlier symptoms 
with the existing symptoms will show that the 


first have persisted, although obscured and 
now hardly perceptible ; and a characteristic 
symptom-picture of the disease can thus be 
better constructed. 


If the mental disease is not fully developed 
from a bodily disorder, and if it remains doubt- 
ful whether it has not resulted from faults of 
education, evil habits, perverted morals, super- 
stition or ignorance, the decisive criterion will 
be that disorders due to the latter causes yield 
to careful remonstrances, reasonable representa- 
tions, consolation or serious advice, while true 
mental diseases speedily grow worse, melan- 
cholia becomes more melancholy, spiteful mania 
becomes more exasperated, and the nonsense of 
the fool becomes even more devoid of reason. 


Nevertheless there are certain diseases of the 
disposition which have not simply developed out 
of bodily diseases; but, on the contrary, with 
but slight implication of the body, originate and 
endure from emotional causes, such as continued 
anxiety, worry, vexation and exposure to terror 
or fright. In time this kind of emotional disease 
affects the bodily health, often very adversely. 


Emotional diseases of this order, originating 
in the mind, are precisely those which can be 
rapidly transformed into health, both of mind 
and body, by psychical means, such as a display 
of confidence, friendly remonstrance, sensible 
advice, and often by well-concealed deceptions. 
Their cure by such measures, however, can only 
G 2 


be achieved while they are yet recent and the 
bodily conditions little disturbed by them. 

Aidhor's note. — Mental and emotional dis- 
eases arising from bodily causes, which can 
only be cured by suitable homoeopathic remedies, 
demand also and always a careful and appro- 
priate psychical demeanour towards the patient 
on the part of attendants and physicians ; a 
helpful kind of mind-regimen, as it were. To 
furious mania there must be opposed quiet fear- 
lessness and cool resolution ; to doleful lamenta- 
tion a mien of silent sympathy ; to imbecile 
chattering, silence, but not inattention ; and of 
disgusting behaviour and foul speech no notice 
whatever should be taken. Destructive acts and 
injuries must be prevented without reproaches 
to the patient, and everything must be arranged 
to avoid any corporal punishment. For as in 
mental disorders there can be no sense of wrong- 
doing, so by all human justice there should be 
no punishments. Contradiction, eager explana- 
tions, violent correction and harshness are as dis- 
astrous to the mind and soul of such patients as 
timid yielding at the wrong time. Above all, con- 
tempt, deceit and fraud exasperate these patients, 
and aggravate their condition. A semblance 
must always be maintained of treating them as 
reasonable beings. On the other hand, all kinds 
of disturbing external influences should be re- 
moved. When for any case of disease of mind 
or disposition an exact homoeopathic remedy has 
been chosen according to the truly delineated 
picture of the disease-condition (and this is the 
easier from the unmistakable character of the 
mental symptoms, which are the most important 
ones), then even the minutest dose will bring 
about the most striking improvement in a very 
short time, an improvement denied to the 



strongest doses of all unsuitable drugs, though 
repeated even to an extent dangerous to life. 
I affirm that the superiority of the homoeopathic 
over all other imaginable methods is nowhere 
shown in so triumphant a light as in the relief 
of long-standing mental and emotional diseases 
which have originated from bodily diseases or 
developed simultaneously with them. 

Translator's note, — Hahnemann, apart from 
homoeopathy, was one of the earliest pioneers 
in the humane treatment of insanity, and de- 
serves a credit for his theories and practice in 
this regard which is too seldom accorded to him. 
In the time of the Organon the ordinary routine 
treatment of the insane was as barbarous and 
revolting as it was ineffective. 


No other diseases require any special direc- 
tions for their cure. They obey, all of them, 
the eternal law of homoeopathy, to which there 
is no exception. 


Hitherto, then, we have reviewed those cir- 
cumstances of the disease which have the great- 
est bearing upon the choice of the homoeopathic 
remedy. Now we pass to the special laws of 
rational treatment in the mode of employing the 


Every improvement in an acute or a chronic 
disease, however small it be, provided it is 
definitely progressive, is a condition which 
absolutely forbids any further administration of 
any medicine as long as it lasts. , This is because 
the good is not yet exhausted which the dose 
of medicine already taken can effect, and any 


fresh dose of any medicine would disturb the 
process of inriprovement. 


This admonition is the more important because 
the exact time-Hmits of the action of remedies 
is hardly known with certainty in any single 
case. Therefore, so long as improvement con- 
tinues, so long must we assume that, at least in 
this case, the period of action of the remedy is 
not exhausted. 

Author's note. — Some remedies seem to ex- 
haust their power in about twenty-four hours, 
but not many; others take a few days or a 
number of days, some even weeks, to complete 
their effects. 


Hence it follows that, when the remedy is 
exacdy homoeopathic in its action the ameliora- 
tion will persist even after the time of action 
of the drug is expired. The good work will 
not be interrupted even if a second dose is not 
given until several hours (or, in chronic diseases, 
actually days) have elapsed after the period of 
remedial action has ended. The part of the 
disease already destroyed will not be renewed, 
and improvement will remain remarkably evident 
even without the administration of another dose. 

When the continuous improvement that 
follows the first dose of the remedy homoeo- 
pathically appropriate to the disease does not go 
on to the complete restoration of health (as it 
often will), the stationary period that ensues 
indicates generally the limit of action of the 
given remedy. Before this time it is needless 


and unreasonable, nay, it may be positively 
harmful, to repeat the dose. 


Even the remedy which has proved so helpful 
may do nothing but harm if repeated before 
improvement has come to a standstill in all 
respects; because until then the counter-force is 
no longer necessary in such measure as a new 
dose would supply. Indeed, in a disease which 
is easily influenced and not chronic, the first 
dose of the best selected medicine will have 
already caused in the course of its own active 
period all the good, all the desired alterations 
which the physician can achieve for the moment 
— all the health attainable for that time, in fact; 
another dose of the same drug given before the 
period of action of the first is ended would alter 
this advantageous condition, and therefore must 
do harm, causing a medicinal disease to be 
mingled with the remaining natural symptoms, 
causing, in fact, both a change and an aggrava- 
tion of the disease. 

Author's note. — Failure to observe this rule 
is punished by an aggravation of the disease, 
which either becomes more threatening or slower 
to recover. 


When there comes an end to the improvement, 
which has gone steadily forward though not to 
complete recovery, a precise examination of the 
present improved aspect of the disease will show 
a small and altered symptom-group, to which a 
second dose of the former medicine would no 
longer be suitably homoeopathic. Another 
counter-force is required, more^ adapted to the 
remaining phenomena of the disease. 



If, consequently, the dose of a remedy that 
has been chosen with all care cannot complete 
the restoration to health within the period of its 
activity (as in most cases of recent disease it 
can), obviously nothing better can be done 
for the remaining, though much ameliorated, 
malady than to give a dose of another remedy 
chosen for its exact suitability to the symptoms 
still unremoved. 


Only when a disease of a threatening type 
shows no improvement, or still more when the 
condition has grown slightly worse, must a dose 
of another remedy exactly adapted to this 
stationary or aggravated state of disease be given 
before the end of the active working-time of the 
first medicine, which has shown by its failure 
that it was not homueopathic to the case. 


Even more certainly the keen-sighted physi- 
cian who has a clear perception of the disease 
condition, as soon as he realizes that he was 
mistaken in the choice of the remedy last given 
(this in urgent cases will be evident after six, 
eight or twelve hours), and observes the state 
of the patient growing clearly, even though only 
slightly, worse from hour to hour, is not only 
permitted, but compelled by his duty, to correct 
his error by the choice of a new remedy which 
shall be not only tolerably suitable, but abso- 
lutely the one best adapted to the existing state 
of disease. 



Even in chronic diseases it is seldom really 
desirable to give the same medicine a second 
time, even after the active period of the first dose 
has expired, and this is particularly true at the 
commencement of treatment. 


When a single thoroughly suitable specific 
medicine cannot immediately be found it is 
generally best to give as intercurrent remedies 
one or two medicines chosen on the ground 
of the characteristic original disease-symptoms. 
These drugs, used alternately with the principal 
remedy, although insufficient in themselves to 
achieve a cure, yet forward it more surely than 
does the repetition once or twice of the original 
medicine, wdiich, being chosen in accordance 
with the fundamental disease-symptoms, was 
reasonably held to be the most suitable, and yet 
proved not so completely adapted to the case as 
to cure it without further aid. 


If, however, it should be found that the best 
result follows the continued administration of the 
first-selected medicine (as may be the case when 
the counter-force is remarkably similar to the 
chronic disease-force), then, while each succes- 
sive dose is left to act for the whole period of 
its effective power, a smaller quantity should be 
given each time, so as not to disturb the process 
of the improvement, but rather to take the case 
along the shortest path to the desired end of 



So soon as the chronic disease (a disease, say, 
of ten, fifteen or twenty years' standing) has 


yielded to a single completely suitable (or 
specific) remedy, or to a remedy as nearly 
adapted to the case as possible (aided perhaps 
by the intercurrent use of the next most appro- 
priate medicine), then after three or six months 
the principal remedy must again be given at 
intervals first of one week and later of several 
weeks, each successive dose being smaller than 
its immediate predecessor, until all tendency of 
the organism to relapse into its chronic disease 
has been extinguished. 


The careful observer recognizes the exact 
moment for the repetition of the dose when one 
or other of the original disease-symptoms re- 
appears in a mild degree. 


But if it is found that this procedure is not 
thoroughly effective, and that the patient is only 
kept from a relapse by the use of doses as big 
as, or bigger than, the first dose of the remedy, 
then, although these doses are still followed by 
good results, we have a sure sign that the cause 
that produced the disease is still at work, and 
that there is some circumstance in the mode of 
life or the surroundings of the patient which 
must be changed before a permanent cure can 
be made. 


Among the signs which give evidence in all 
diseases (especially in acute diseases) of a slight 
improvement or worsening not perceptible to 
every one, the surest and most illuminating are 
those that concern the condition of the patient's 
mind and his demeanour. In the case of even 


a very slight change for the better there appears 
a greater sense of ease, increasing calmness and 
freedom of spirit ; a kind of return of the natural 
healthy state. On the other hand, the signs of 
the slightest change for the worse are exactly 
opposite ; a more constrained, uneasy, self-pity- 
ing condition of mind and spirit, of the whole 
demeanour, and of all the postures and actions, 
a condition noted by close observation more 
easily than it can be described in words. 


The other new symptoms, either of improve- 
ment or the contrary, soon leave no doubt in the 
mind of the observant and attentive physician 
of the course the disease is taking. But there 
are patients who are either unable or unwilling 
to give an account, whether of improvement or 
worsening, so that their mere statements are of 
little value without other evident signs. 


But even with such persons conviction is 
easily attained when we realize that, if no new- 
signs of disease appear after the use of the 
remedy, and if the patient complain of no new 
symptoms hitherto unexperienced, then the 
medicine must either have brought about a 
thorough change for the better, or be about to 
cause such a change when more time is allowed 
to develop it. On the other hand, if the patient 
relates this or that new occurrence or important 
symptom (the sign that the exact homoeopathic 
remedy has not been chosen), then, although he 
may assure us in a good-natured way that he 
feels better, we must not put any confidence in 
this assurance, but must regard his condition as 


a more serious one, and the evidence of this fact 
will before long be forthcoming. 


As certain symptoms of medicines, when 
tested on healthy human beings, appear several 
hours or even several days later than other 
symptoms, so they cannot remove the corre- 
sponding symptoms in disease except after a 
corresponding lapse of time, however speedily 
they destroy symptoms of a different order, a 
fact which need not surprise us. 

Author'' s note. — Thus the tendency of mercury 
to cause deep circular. ulcers with inflamed and 
tender margins does not show itself in the prov- 
ings for some days or even weeks. Similarly it 
will not cure such ulcers in the first few days. 


If we have the choice we should prefer for the 
cure of chronic diseases medicines of long dura- 
tion of action ; and medicines of a short active 
period for the rapid acute cases, that is, diseases 
which tend to frequent changes of condition. 


The reasonable physician will take pains to 
avoid making favourite remedies of those which, 
from being frequently indicated, have chanced 
to be frequently useful to him. For if he does 
so he will often neglect some rarer remedies 
which would in certain cases have served him 


Further he will not from a mistrustful weak- 
ness of judgment despise any remedies, because 
they have failed him when given without suitable 


indications. He will not avoid them without 
good reasons, being mindful of the truth that 
only that remedy deserves respect and preference 
among the counter-forces of disease which corre- 
sponds most exactly to the symptom-picture of 
any given case, and that no paltry prejudices 
should influence his serious choice of the best 
medicine for his purpose. 


If we bear in mind the necessary and desirable 
smallness of the doses required in homoeopathic 
practice it is easy to understand that during 
treatment every substance in the diet which 
might act in any medicinal way must be for- 
bidden, so that the minute dose shall not be 
overpowered or extinguished by some artificial 


This careful enquiry into possible hindrances 
to cure is the more important in chronic diseases, 
because such disorders commonly originate, at 
least partly, in the harmful influences just men- 
tioned and in other errors in the mode of life 
which, though unrecognized, are often harmful. 
When they do not so originate they are all the 
more difficult to treat. 

Translator's note. — Here follows a long list of 
articles of diet and circumstances of life that may 
be harmful. Coffee and tea rank high in Hahne- 
mann's judgment as noxious influences. 


The most appropriate regimen to accompany 
the medicinal treatment of chronic diseases con- 
sists in the removal of such hindrances to re- 
covery and the prescription of such opposite 


conditions as are necessary ; exercise in the fresh 
air; simple, suitable and unspiced food and 
drink; surroundings uplifting to the spirit, etc. 


In acute diseases, on the other hand (except 
conditions of actual delirium), the subtle and 
unerring perceptions of the life-instinct which 
are then aroused speak so clearly and definitely 
that the physician need only warn nurses and 
attendants to offer no opposition to this voice of 
nature either by refusing the patient anything 
that is strongly desired, or by persuading him 
to take anything that his instinct may reject. 


Certainly the desires of the patient suffering 
from an acute disease are chiefly for such food 
and drink as give palliative relief ; they are not, 
as a rule, of a medicinal character, and they 
merely supply a kind of need. Any slight 
hindrance to the radical removal of the disease 
which the moderate gratification of these desires 
might cause is easily counteracted and overborne 
by the suitable homoeopathic remedy and by the 
life-force thereby liberated. 


The reasonable physician must have to his 
hand the strongest and most genuine medicines 
before he can have confidence in them as counter- 
forces (remedies). He must convince himself of 
their genuine character. 


It should be a matter of conscience with him 
to assure himself without any doubt, in every 
case, that the patient receives the correct and 
genuine medicine. 



The medicinal powers of indigenous plants or 
of those that can be obtained in a fresh state are 
obtained most completely and certainly, when 
their freshly expressed juice is immediately 
mixed with an equal part of spirits of wine; 
such preparations retain their strength, wholly 
and always, unimpaired if they are kept in a dark 
place in well-stoppered glass bottles. 

Author^s note, — Although equal parts of 
alcohol and freshly expressed juice form the best 
preparations for effecting the precipitation of 
albuminous matter and preventing all possible 
fermentation and deterioration, yet for plants 
which contain much thick mucus or a superfluity 
of albumen (e. g. Symphytum, viola tricolor, 
sethusa cynapium, solanum nigrum, etc.) a 
double quantity of spirit of wine is commonly 
desirable. When this has stood in a close- 
stoppered bottle for a day and a night the pre- 
cipitated albuminous material can be filtered off 
and the clear preparation kept for therapeutic 


Other plants, w^hich are exotic, or cannot be 
obtained in a fresh state, should never be taken 
on trust in a powdered state. The reasonable 
physician will convince himself of their genuine- 
ness by handling them in their untouched whole 
condition before he makes any use of them as 

Author's note. — Certain precautions are neces- 
sary in order to keep these drugs in the state of 
powder. The whole and untouched plants even 
when fully dried always retain a certain quantity 
of water, not sufficient indeed while the substance 
remains whole and unpowdered to impair its 


dryness and promote decomposition, but far 
more than sufficient when the substance is in 
its fully divided condition. When powdered 
they will decompose and become mouldy unless 
this moisture is driven off. Animal or vegetable 
drugs, stable enough in the entire state, w411 not 
furnish a stable unchangeable powder unless this 
extra moisture is got rid of. This is best done 
by drying the powder over a water-bath till all 
the small pieces of it are as easily separated as 
fine sand and readily fall to dust. In this con- 
dition it can be kept for ever in sealed bottles. 
All vegetable and animal preparations not pre- 
served in air-tight vessels gradually lose more 
and more of their medicinal power. 


As every medicine acts most definitely and 
effectually in solution the wise physician will 
administer all medicines in this way, except 
those whose nature requires that they be given 
in the powdered form. All other preparations 
but these make the comparison of observations 
difficult and the estimation of the dose of every 
powerful medicine uncertain. 

Metals, salts, and other preparations of this 
kind, whose purity cannot be recognized without 
elaborate tests, should only be used by the 
rational and responsible physician when they 
have been prepared under his own eyes. 

In no case is it necessary for cure to use more 
than one single simple medicinal substance at a 


It is difficult to conceive how there could ever 
be the smallest doubt that it is more logical 
and reasonable to prescribe a single tested medi- 
cine for a disease than a mixture of several. 


For the rational physician finds at once all 
that he can desire in quite simple medicines 
given singly, artificial disease-producing powers, 
which by their homoeopathic might can over- 
come, extinguish and radically cure natural 
diseases. Therefore he will always act accord- 
ing to the general maxim : " Quod fieri potest 
per pauca non debet fieri per plura"; and he will 
never use as remedies anything but single 
simple medicines. It is wholly unknown how 
two or more medicines mixed together may 
hinder and alter one another in their actions on 
the human body ; on the other hand, a simple 
medicine used in diseases whose symptom-com- 
plex is exactly known, will cure, if it is exactly 
and homoeopathically adapted to the case; and 
at the worst, if it is not rightly chosen and can- 
not therefore be of service, its use can yet add 
to our knowledge of drugs, because the new 
symptoms excited by it in such a case afford 
confirmation of those which the drug has already 
shown in experiments on the healthy. 

If a medicine is exactly and specifically chosen 
and fully homoeopathic to a case of disease, then 
it will affect the original disorder favourably, 
even if given in too large a quantity; but there 
will be an unnecessary and ovqr-powerful im- 
pression made on the organism through the 
excessive size and intensity of the dose. 




For if the change in the organism produced 
by the overdose of the remedy, homoeopathic as 
it was to the original disease, be too violent, 
then besides the increase in the homoeopathic 
aggravation (S. 132) there follows an unnecessary 
weakening of the patient after the active period 
of the drug has ended. Further, if the dose was 
very excessive, then after the increased primary 
drug-symptoms (S. 132) there ensue symptoms of 
its secondary action, a kind of medicinal after- 
disease of an opposite character to the first. 


As at the present date hardly any medicine 
can be found that is so completely homoeopathic 
to a case of disease as to correspond to it exactly 
and mathematically in each and every point 
(S. 131, note), so the new symptoms, which were 
unimportant when a small dose was given, are 
aggravated into severe maladies of many kinds 
when the dose is too considerable. 


For these and many other reasons the reason- 
able physician (who always follows the best 
method in practice because it is the best, and 
refuses to depart from it at the bidding of blind 
custom) will choose only the most suitable dose 
of the indicated remedy, so that hardly a sign 
of aggravation of the disease will be aroused 
(S. 132); that is, will choose a dose which as a 
counter-force only just exceeds the disease-force 
against which it is directed. 



This apparent aggravation and increase of the 
existing disease which resuhs from the use of 
the homoeopathic remedy should be hardly per- 
ceptible, and then only in the first hour or two 
after its administration. 


One of the chief laws of homoeopathic thera- 
peutics is the following : the counter-force 
chosen as exactly as possible for the removal 
of a natural disease-force should be so calculated 
that it will only just attain its object and will do 
the body no harm in any way through unneces- 
sary strength. 

Now, as the smallest quantity of medicine 
naturally disturbs the organism least, we should 
choose the very smallest doses, provided always 
that they are a match for the disease. 


Universal experience has shown that the very 
smallest doses of drugs chosen for their homoeo- 
pathicity to diseases are a match each for the 
corresponding disorder. For if the disease does 
not manifesdy arise from a serious morbid 
change in some important organ, hardly any 
dose of the homoeopathically selected remedy 
can be so small as not to be stronger than the 
natural disease and so overcome it. 

The ordinary observer has no conception how 
extraordinarily sensitive the body becomes to 
drugs when it is diseased, and especially to drugs 
chosen homoeopathically. 
H 2 



Therefore every patient is in the highest de- 
gree susceptible to suitably applied medicinal 
forces. There is no person, however robust, 
even though only suffering from a chronic or 
so-called local disease, who will not soon feel 
the desired change in the affected part if he 
takes the helpful and homoeopathically chosen 
medicine even in the smallest dose imaginable — 
who will not, in a word, be much more affected 
thereby than would a day-old but healthy infant. 


This being the case, the true physician will 
pursue the rational course and give the chosen 
homoeopathic remedy in just so small a dose as 
will overcome and destroy the existing disease 
without further ado. A dose so small will reduce 
to its lowest limits any possible harm that might 
result from a failure to select the exact remedy 
at the first choice, a possibility that must always 
be reckoned w-ith since human abilities may 
easily err. At the worst, even if the wrong drug 
be administered, the smallness of the dose will 
render it far too weak to resist the natural energy^ 
of the body and the swift opposition of the more 
exactly adapted homoeopathic remedy, by the 
use of which the mitial mistake will be recti- 
fied, and any small ill effects of that mistake 


The fact that one dose, or a little more, of a 
certain homoeopathically chosen medicine usually 
overcomes and destroys the analogous disease, 
and that every dose which is unnecessarily 
powerful affects the body more than is required, 
explains the following important observation. 


which holds good in most cases : namely, that 
a certain quantity of a remedy has a more power- 
ful effect when given at intervals in divided 
doses than when given all at one time. 


Eight drops of almost any medicinal tincture 
given in one dose have only a quarter of the 
effect of eight drops of the same tincture given 
every four hours or every two hours in drop 


If dilution is also employed (whereby the dose 
gains a greater power of expansion), an exces- 
sive effect is easily produced. But there is no 
small difference in the effects of a dilution which 
is, as it were, only superficial and a dilution 
which is so intimate and uniform that every 
smallest part of the fluid medium contains a due 
proportion of the dissolved medicine ; the former 
is much less powerful than the latter. 

Thus the intimate mixture produced by adding 
a single drop of a tincture to a pound of w^ater 
and shaking vigorously, if administered in doses 
of two ounces every two hours, will produce 
more effect than a single dose of eight drops of 
the tincture. 


From the experience last mentioned, that the 
power of a medicine in solution is much in- 
creased by intimate mixture with a large volume 
of fluid, it follows undeniably that, in order to 
make the dose of the homoeopathic remedy as 
small as is possible and necessary it must be 
given in the smallest possible bulk. 



Moreover, the strength of action of a dose 
does not vary in exact proportion to its quantity. 
Eight drops of a tincture given in one dose do 
not produce four times the effect of two drops, 
but only about twice the effect. A mixture of one 
drop of a tincture with ten drops of an un- 
medicated fluid, given in drop doses, will not 
produce ten times the effect of drop doses of a 
mixture ten times as dilute, but only about (or 
scarcely) twice the effect, and so on in the same 
ratio, so that even a drop of the highest dilution 
must possess, and does in fact show, a very 
considerable power. 


The action upon the living human body of 
the remedial counter-force which constitutes a 
medicine is so profound and spreads from those 
sensitive areas well supplied with nerves, to 
which it is first applied, throughout the whole 
organism with such inconceivable rapidity and 
completeness that this action must be called 
spirit-like. It is almost as spirit-like as the 
action of vitality itself, by which its power is 
reflected on the organism. Drug-action borrows 
a kind of life from the power of response to 
specific impressions, the sensitiveness, and irri- 
tability, possessed by living bodies. 

Every part of our bodies that possesses the 
sense of touch is able to receive the influence 
of medicine and distribute its power all over the 
other parts of the organism. 


The tongue, mouth and stomach are certainly 
the parts most sensitive to medicinal impressions. 


and drugs applied to these regions, especially in 
solution, act with greater power and rapidity on 
all points of the body. 


The interior of the nose, and the rectum, as 
well as parts denuded of skin, wounded or ulcer- 
ating surfaces, permit an action of medicines on 
the whole organism which is nearly as penetrat- 
ing as if the drugs had been taken by the mouth. 


On the other hand, the external surfaces of 
the body covered with epidermis are less adapted 
to receive the action of medicines. The most 
sensitive parts, it is true, allow a certain amount 
of drug power to pass to the nerves and from 
them to the whole body, but far less than the 
amount that so passes when the drug is taken 
by the mouth or injected into the rectum. 


Therefore in certain cases, where the need- 
ful medicine cannot be given by the mouth 
(although, even if it cannot be swallowed, the 
mere taking of the drug into the mouth cavity 
often produces the full medicinal effect), and 
where it is not convenient or desirable to give 
it by the rectum, in such cases, I say, if the 
patients are quick of response to medicines, the 
mere external application of the drug in solution 
to the most sensitive external parts {e, g. the pit 
of the stomach, or the lower abdomen) will often 
achieve a result not much inferior to that ob- 
tained when the drug is given internally. But 
the medicine must for this purpose be used in a 
stronger form and spread over a large surface; 


and, if this proves not enough, it should be 
rubbed in, or administered (in still stronger 
solution) by means of baths to the whole or part 
of the body. 

Author's note, — Rubbing in seems to heighten 
the action of medicines by making the skin more 
sensitive to the medicinal force which is thence 
communicated to the whole body. If friction 
be used to the under part of the thigh, then the 
mere subsequent application of mercurial oint- 
ment is as effective as if the ointment itself had 
been rubbed in. 


Among causes which have given rise in 
general practice to the use of large doses the 
employment of drugs as palliatives ranks 

Author's note. — How exactly opposite are the 
methods of using drugs as palliatives and using 
them homoeopathically, is shown by the fact that 
in the first method as much of the drug is needed 
as can be borne, and in the second as little as it 
is possible to give consistently with producing 
the desired effect. 


By the palliative use of drugs, which is the 
exact opposite of the homoeopathic art of heal- 
ing, the attempt is made to overcome certain 
symptoms of disease by means of certain known 
symptoms of medicines. 


As by means of medicines so used the con- 
dition produced is not in the least similar to that 
of the disease (as it is with the homoeopathic 
method), but the exact contrary ; so there ensues 


on such drug-administration not the least initial 
(apparent) aggravation, but on the contrary an 
almost immediate improvement in the patient's 
symptoms. In the first hour after receiving a 
palliative the patient feels himself much relieved, 
a sensation that practically never occurs after the 
administration of the homoeopathic remedy. 


Under the homoeopathic remedy the whole 
disease-condition is quickly vanquished, extin- 
guished, and destroyed (not in the first hour 
certainly, but later on in gradually increasing 
measure) by the counter-force of the specific 
medicine. But with a palliative, given according 
to the law, contraria contrariis ciirentur^ only 
one single symptom of the disease is relieved, 
quickly, by the exactly opposed symptom of the 
drug; perhaps because the opposites by a kind 
of mutual fusion neutralize one another dynamic- 
ally (though only for a time), and in this way 
the disease-symptom loses its influence on the 
organism as long as the power of the opposed 
medicinal symptom lasts. 


The original malady seems to disappear at 
once at the beginning of the palliative treatment. 
But it is not removed, not extinguished ; as soon 
as the opposed action of the palliative is ex- 
hausted and ceases to work (which takes place 
in a few hours or days), the malady returns, with 
an intensity actually increased by the addition 
of the after-effects (''secondary" symptoms) of 
the palliative, which (being opposed to the 
"primary" symptoms) are very like the original 
disease-symptoms and thus seriously and per- 
manently aggravate the patient's condition. 



Palliative treatment follows a course quite con- 
trary to that of homoeopathic treatment in that 
the patient is most relieved in the first hour after 
receiving the medicine, less in the second hour, 
still less in the third, and so on, until with the 
cessation of action of the primary opposite drug- 
symptoms the tendency to secondary action sets 
in and the patient becomes worse than he was 
before the palliative was administered. 


Now, in order to renew the deceptive improve- 
ment, it is necessary to increase the dose of the 
palliative continually, often to give very large 
doses of it, because each successive dose has to 
cover up not only the natural disease-symptoms, 
but also the aggravation of the disease-condition 
which results from the secondary action of the 
previous dose. 


Unless the dose of the palliative is increased, 
the temporary improvement becomes continu- 
ously less, and finally imperceptible, and there 
follows an increased aggravation of the disease. 


Every medicine is a palliative (antagonistic 
and contrary in action to a principal symptom 
of disease) when it only relieves in doses which 
have to be continuously increased. 

Author's note, — The irrational character of 
palliative treatment is self-evident, for the patient 
requires a radical cure, not a temporary, illusory 
improvement which ends in a strengthening of 
the original malady. Such treatment is also 


mistaken, because by it only one symptom is 
attacked and that often only the twentieth part 
of the disease and of its whole complex of pheno- 
mena. In other words palliative treatment is 
treatment which is symptomatic and not 
remedial. It was fortunate that so little was 
known of the individual symptomatology of 
drugs ; otherwise too frequent a use might have 
been made of them for the purpose of combating 
opposite conditions. There remained but few 
actions of this kind available. Coffee was given 
for a tendency to drowsiness ; the primary power 
of opium to constipate was used for diarrhoea, 
even of a chronic kind; its action in causing a 
heavy stupefying sleep was used for chronic 
wakefulness, and the state of insensibility and 
stupor which it can extend over the whole 
sensorium was employed to relieve every imagin- 
able kind of pain ; the tendency to constipation 
was treated with large doses of irritating purga- 
tives and laxatives that caused frequent evacua- 
tions; a deficiency of body-heat and so-called 
weakness of the stomach were remedied by 
stimulating spices and alcoholic drinks ; inflam- 
mation by cooling substances; heat of the body 
by blood-letting; even chronic cases of almost 
complete paralysis of the bladder were energetic- 
ally attacked with the powerful irritant action of 
cantharides, etc. But experience showed, often 
too late, how seldom health was thereby restored, 
and how frequently increased disease or worse 


Only in the emergencies most threatening to 
life, e, g. asphyxia, coma from lightning-stroke 
or suffocation, freezing, and so forth, is it per- 
missible and desirable to restore, at least as a 


preliminary measure, the sensibility and power 
of response to stimuli (the physical life) by 
means of strong coffee, or gentle electrical 
shocks, or some stimulating strong-smelling 
application, and so gain time until, if necessary, 
a homoeopathic remedy can be chosen for the 
condition. To this category belong also the 
different antidotes to acute poisonings. 


Further, a homoeopathic remedy is not to be 
regarded as unsuitably chosen if a few of its 
symptoms are only palliatives {antipathic) to 
some of the less important minor symptoms of 
the disease, provided only that the other, and 
especially the well-marked, individual and 
characteristic principal symptoms of the disease 
are met and covered by the same remedy homoeo- 
pathically, i.e. through resemblance of drug to 


In such a case none of the ill consequences 
are seen which generally follow the one-sided 
palliation of a single disease-symptom. Com- 
plete recovery ensues without accessory symp- 
toms or after-troubles, but in such a way that 
those symptoms which were here attacked only 
by the opposed (palliative) symptoms in the 
sphere of action of the medicine, usually do not 
disappear until the drug's action is entirely 

Translator's note. — Here follows a long note 
of Hahnemann's, explaining another method of 
treatment often adopted in his day, which de- 
manded large doses of drugs. It consisted in 
administering remedies calculated to act not 
directly against the disease-symptoms, but on 


other parts of the body. Thus skin-diseases 
would be treated with purgatives and all the 
class of counter-irritants. Blisters, setons and 
bleeding belong to this category of remedies. 
Hahnemann points out that, although the 
disease-symptoms are sometimes lessened at 
first by this method, they usually return as 
soon as the ''revulsive" treatment so-called is 

Author's note. — Employing the homoeopathic 
method, the rational physician will very seldom 
find it necessary to employ the drastic method 
of evacuations, upwards or downwards, except 
when quite indigestible or foreign or poisonous 
substances have been taken into the stomach or 

Sometimes the use of some undynamic (non- 
homceopathic) remedies is useful. Such are 
fatty substances which mechanically or physic- 
ally loosen the compactness and solidity of 
fibres : tannin which thickens living fibres almost 
as much as it does dead ones ; charcoal which 
lessens the evil odour of unhealthy parts of the 
living body just as it destroys that of dead 
things : chalk, alkalies, soap, and sulphur, which 
can chemically decompose and so neutralize and 
render harmless corrosive acids and metallic 
salts in or on the human body ; acids and 
alkalies, which may influence concretions in the 
bladder; the actual cautery and caustics of 
various kinds. The use of blood-letting, or of 
leeches, which as a rational procedure is rarely 
indicated, need not be expounded here. 


Hahnemann was a ready and prolific writer, 
and his own works, apart from his numerous 
translations of medical works, form a long list. 
From the lesser writings, as collected by Dr. 
Robert Dudgeon and translated by him into 
English, I have selected four as a kind of 
supplement to the Organon. The first three 
appeared in The Friend of Health, of which two 
parts were published, the first in 1792 and the 
second in 1795. They have a very real value 
even to-day, and that in two ways. First of all 
they testify strongly to the keen observation, 
the shrewdness and the essentially practical 
nature of Hahnemann, a man as far removed 
as possible from the dreamer or impostor for 
which he is sometimes ignorantly taken. In 
days when the science of public health did not 
exist, when Bacteriology and all the light which 
it throws upon infection and immunity was 
unknown, careful observation and shrewd deduc- 
tion alone led Hahnemann to formulate these 
suggestions (far too much in advance of his age 
to be accepted), of which it is not too much to 
say that by far the greater part of them would 
hold good to-day, and in a cou^ntry where the 
latest resources of civilization are unavailable 



most of his plans could be followed with nothing 
but advantage. 

But these three essays have another interest, 
and that is an historical and sociological one. 
For both by the things Hahnemann recommends 
and the things he discountenances, and by the 
conditions he assumes, we catch glimpses of the 
state of society at the end of the eighteenth cen- 
tury, the manner of life and the daily surround- 
ings of the German people, which are both 
deeply interesting to the curious and valuable 
to the sociologist. The fourth essay, Aesculapius 
in the Balance y was written in 1805, and forms 
an admirable preface to the Organon, inasmuch 
as it gives more than a hint of the chaotic state 
of medicine into which the Organon attempted 
to bring some order. It, too, has its sociological 
value, especially in its glimpses of the relations 
of doctors and apothecaries and of the methods 
of ordinary treatment ; but beyond this it throws 
a light on one great reason for the ill-will which 
Homoeopathy aroused, by clearly showing how 
powerful were the vested interests directly 
threatened by Hahnemann's theories and prac- 
tice. Vested interests inevitably fight for sur- 
vival and attack those that come into conflict 
with them with rancour and persistence. It was 
not the least of the misfortunes of Hahnemann 
that, by their very nature, his doctrines aroused 
this opposition ; but it is not altogether to the 
credit of the judgment of later generations that 
the rancour which arose from a threatened 
monopoly should remain to cloud and prejudice 


a reasoned enquiry, long after the monopoly was 
overthrown. The essay Mscidapius in the 
Balance, therefore, will always retain more than 
merely an historical interest. The translations 
are those of the late Robert Ellis Dudgeon, 
M.D., whose long life was a constant endeavour 
to honour the memory of Hahnemann and ex- 
tend the scope of his doctrine, and to whose 
memory I should wish to dedicate this reprint 
of some of his work. 

C. E. W. 



For every kind of poisonous exhalation there 
is in all probability a particular antidote, only 
we do not always know enough about the latter. 
It is well known that the air of our atmosphere 
contains two-thirds of a gas that is immediately 
fatal to man and beast, and extinguishes flame. 
Mixed up along with it is its peculiar corrective; 
it contains about one third of vital air, whereby 
its poisonous properties are destroyed; and in 
that state only does it constitute atmospheric air, 
wherein all creatures can live, grow and develop 

The suffocative and flame-extinguishing ex- 
halations in cellars in which a quantity of yeast 
or beer has fermented, is soon removed by 
throwing in fresh slaked lime. 

The vapour developed in manufactories where 
much quicksilver is employed, together with a 
high temperature, is very prejudicial to health; 
but we can in a great measure protect ourselves 
against it by placing all about open vessels 
containing fresh liver of sulphur. 

To chemistry we are indebted for all these pro- 
tective means against poisonous vapours, after 
we had discovered, by means of chemistry, the 
exact nature of these exhalations. 

But it is quite another thing with the conta- 
12 115 


gious exhalations from dangerous fevers and 
infectious diseases. They are so subtle that 
chemistry has never yet been able to subject 
them to analysis, and consequently has failed to 
furnish an antidote for them. Most of them are 
not catching at the distance of a few paces in 
the open air, not even the plague of the East; 
but in close chambers these vapours exist in a 
concentrated form and then become injurious, 
dangerous, fatal, at a considerable distance from 
the patient. 

Now as we know of no specific antidotes for 
the several kinds of contagious matters, we must 
content ourselves with general prophylactic 
means. Some of these means are sometimes in 
the power of the patient, but most of them are 
solely available by the nurse, the physician, and 
the clergyman, who visit the sick. 

As regards the former of these, the patient, if 
not too weak, may change his room and his bed 
every day, and the room he is to occupy may, 
before he comes into it in the morning, be well 
aired by opening the doors and all the windows. 
If he have curtains to his bed he may draw them 
to, and let the air circulate once more through 
his room, before the physician or clergyman 
comes to visit him. 

The hospitals used by an army in a cam- 
paign, which are often established in churches, 
granaries, or airy sheds, are for that reason 
much less liable to propagate contagion, and 
also much more beneficial for the patients than 
the stationary hospitals, which are often built 
too close, low, and angular. In the latter, the 
nurses, physicians, and clergymen often run 
great risks. And what risks do they not con- 
stantly run in the half-underground damp 


dwellings of the lowest class of the people, in 
the dirty cellars of back courts and narrow lanes 
that the sun's reviving rays never shine in, 
and the pure morning air never reaches, stuffed 
full with a crowd of pauper families, where pale 
care, and whining hunger seem for ever to have 
established their desolating throne ! 

During the prevalence of contagious diseases 
the poisonous qualities of the vitiated air are 
concentrated in such places, so that the odour 
of the pest is plainly perceptible, and every time 
the door is opened, a blast of death and desola- 
tion escapes. These are the places fraught with 
greatest danger to physician and clergyman. 
Is there any mode whereby they can effectually 
protect their lungs from the Stygian exhalation, 
when the crying misery on all sides appeals to 
them, shocks them, and makes them forgetful of 
self ? And yet they must try to discover some 
preventive ! How are they to do so ? 

I have said above, that we may gradually 
accustom ourselves to the most poisonous 
exhalations, and remain pretty w^ell in the midst 
of them. 

But, as it is the case with accustoming our- 
selves to everything, that the advance fro7n one 
extreme to the other must he made with the 
utmost caution^ and hy very sm^all degrees, so 
it is especially with this. 

We become gradually accustomed to the most 
unwholesome prison cells, and the prisoners 
themselves with their sighs over the inhuman 
injustice of their lot, often, by their breathing 
and the exhalations from their bodies, gradually 
bring the few cubic feet of their atmosphere into 
a state of such pestilential ^malignity, that 
strangers are not unfrequently struck down by 


the most dangerous typhoid fevers, or even have 
suddenly died by venturing near them, whilst 
the prisoners themselves, having been gradually 
accustomed to the atmosphere, enjoy a tolerable 

In like manner we find that physicians who 
see patients labouring under malignant fevers 
rarely and only occasionally, and clergymen 
whose vocation only requires them to pay a visit 
now and then, are much more frequently in- 
fected than those who visit many such cases in 
a day. 

From these facts naturally proceeds the first 
condition for those who visit such sick-beds for 
the first time, "that they should in the com- 
mencement rather see their patients more fre- 
quently, but each time stay beside them as short 
a time as possible, keep as far away as possible 
from the bed or chamber utensil, and especially 
that they should take care that the sick-room be 
thoroughly aired before their visit." 

After these preliminary steps have been taken 
with proper caution and due care, we may then, 
by degrees, remain somewhat longer, specially 
beside patients with the slighter form of the dis- 
ease, and of cleanly habits ; we may also approach 
them sufficiently close to be able to feel their 
pulse and see their tongue, taking the precaution 
when so near them, to refrain from breathing. 
All this can be done without any appearance of 
affectation, anxiety, or constraint. 

I have observed, that it is usually the most 
compassionate, young physicians, who, in epide- 
mics of this sort, are soonest carried off, when 
they neglect this insufficiently known precau- 
tion, perhaps from excessive philanthropy and 
anxiety about their patients; that on the other 


hand, the hard-hearted sort of every-day doctors 
who love to make a sensation by the large 
number of patients they visit daily, and who 
love to measure the greatness of their medical 
skill by the agility of their limbs and their 
rapidity, most certainly escape infection. But 
there is a wise middle path (which young clergy- 
men who visit the sick are counselled to adopt)^ 
whereby they may unite the most sensitive and 
warmest philanthropy with immunity to their 
own precious health. 

The consideration "that a precipitate self- 
sacrifice may do them harm but cannot benefit 
the patient, and that it is better to spare one's 
life for the preservation of many, than to hazard 
it in order to gratify a few," will make the above 
first precaution acceptable, viz. — by very gradu- 
ally approaching and accustoming ourselves 
to the inflamniatory material of the contagion, 
to blunt by degrees our nerves to the impression 
of the miasm (morbid exhalation) otherwise so 
easily communicable. We must not neglect to 
impress the same precautionary measures on the 
attendants of the sick person. 

The second precaution is "that we should, 
when visiting the patient, endeavour to maintain 
our mind and body in a good equilibrium." 
This is as much as to say, that during this 
occupation we must not permit ourselves to be 
acted on by debilitating emotions ; excesses in 
venery, in anger, grief and care, as also over- 
exertion of the mind of all sorts, are great 
promoters of infection. 

Hence to attend either as physician or clergy- 
man a dear friend sick of the prevalent fever is 
a very dangerous occupation, as I have learnt 
from dear-bought experience. 


We should endeavour moreover to preserve 
as much as possible our usual mode of living, 
and whilst our strength is still good we should 
not forget to take food and drink in the usual 
manner, and duly apportioned to the amount of 
hunger and thirst we may have. Unusual 
abstinence or excess in eating and drinking 
should be carefully avoided. 

But in this respect no absolute dietetic rules 
can be laid down. It has been said that one 
should not visit patients when one's stomach is 
empty, but this is equally erroneous as if it were 
to be said one should visit them with an empty 
stomach. One who like myself is never used to 
eat anything in the forenoon, would derange his 
digestion and render himself more susceptible 
of infection were he, following the old maxim, 
to eat something for which he had no appetite 
and visit his patients in this state; and vice 

On such occasions we should attend more than 
ordinarily to our desires for particular articles 
of diet, and procure if possible that for which 
we have most appetite, but then only eat as much 
as will satisfy us. 

All over-fatigue of the body, chills and night- 
watchings, should be avoided. 

Every physician who has previously been 
engaged in practice, every clergyman and nurse, 
will of course have learned to get over the 
unnecessary repugnance he may feel. 

Thus we become gradually habituated to the 
occupation of tending patients suffering from 
malignant fevers, which is fraught with so much 
danger and cannot be compensated by any 
amount of pecuniary remuneration, until at 
length it becomes almost as difficult to be in- 


fected at all as to get the smail-pox twice. If 
under all these circumstances we retain our 
courage, sympathizing compassionate feelings, 
and a clear head, we become persons of great 
importance in the state, not to be recompensed 
by the favour of princes, but conscious of our 
lofty destiny and rising superior to ourselves, 
w^e dedicate ourselves to the welfare of the very 
lowest as well as the highest among the people, 
and we become as it were angels of God on 

Should the medical man experience in himself 
some commencing signs of the disease, he 
should immediately leave off visiting the patient, 
and if he have not committed any dietetic or 
regiminal error, I would recommend, notwith- 
standing I have endeavoured in this book to 
avoid anything like medicinal prescriptions, the 
employment of a domestic remedy, so to speak, 

In such cases I have taken a drachm of cin- 
chona bark in wine, every three-quarters of an 
hour, until all danger of infection (whatever kind 
of epidemic fever the disease might be) was 
completely over. 

I can recommend this from my own experi- 
ence, but am far from insisting upon the per- 
formance of this innocuous and powerful pre- 
caution by those who are of a different opinion. 
My reasons would be satisfactory if I could 
adduce them in this place. 

But as it is not enough to protect ourselves 
from infection, but also necessary not to allow 
others to come in the way of danger through us, 
those who have been engaged about such 
patients should certainly not approach others too 
nearly until they have changed the clothes they 


had on when beside the patients for others, and 
the former should be hung up in an airy place 
where no one should go near them, until we 
again need them to visit our patients. Next to 
the sick-room, infection takes place most easily 
by means of such clothes, although the person 
who visits the patient may not have undergone 
any infection. 

A highly respectable and orderly individual 
w^ho for years had never walked anywhere, but 
only to his office at the fixed hours, had a female 
attendant with whom he was on very friendly 
terms, an old good-natured person, who without 
his knowledge employed all her leisure hours in 
making herself useful to a poor family living 
about a hundred yards from his house, who were 
lying sick of a putrid fever, the prominent 
character of which was a malignant typhoid 
fever. For a fortnight all went on well ; but 
about this time the gentleman received some 
intelligence of a very annoying and depressing 
character, and in a few days, although to my 
certain knowledge he had seen no one affected 
with such a disease, he got, in all probability 
from the clothes of his attendant who was often 
very close to him, exactly the same kind of 
malignant fever, only much more malignant. I 
visited him as a friend with unreserved sym- 
pathy as I ought, and I fell sick of the same 
fever, although I had been already very much 
accustomed to infection. 

This case, together with many other similar 
ones, taught me that clothes carry far and wide 
the contagious matter of such fevers, and that 
depressing mental emotions render persons sus- 
ceptible to the miasm, even such as are already 
used to its influence. 


It would appear that the lawyer who draws up 
a will, the notary and the witnesses would, on 
account of not being habituated to such impres- 
sions, run much greater risk of being infected 
in these cases. I do not deny it; but for them 
there are modes of escape which are not so 
accessible to the other persons of whom we have 

Where there is nothing, the sovereign has lost 
his rights, there is no will to be made. But when 
wealthy persons wish to make their last will and 
testament on their sick bed, there are two circum- 
stances in favour of the lawyer and his assist- 
ants. As in the formalities of a legal testament, 
the patient's bed often cannot remain in its usual 
situation, and as moreover it is essential for such 
a testament that the testator should be in full 
possession of his intellectual faculties, it follows 
that for those patients who are not absolutely 
poor another room and another bed may be got 
ready, thoroughly aired and free from infectious 
atmosphere. They do not need to remove thither 
until all this has been properly performed a short 
time before. 

The weakness of the intellect in such patients 
generally keeps pace with their corporeal weak- 
ness, and a patient who possesses sufficient 
strength of intellect to make his will would not 
allege that he is too weak to be removed to 
another bed and room. 

How little chance there is of the legal officials 
catching the infection under these circumstances 
(provided they take moderate care not to ap- 
proach the patient nearer than necessary), I need 
not dwell upon. 

I should mention that after one has once 
accustomed himself to any particular kind of 


miasm, for example the bloody flux, the nerves 
remain for a considerable time, often for years, 
to some degree insensible to the same kind of 
disease, even though during all that time we 
may have had no opportunity of seeing patients 
affected with that disease, and thus as it were of 
keeping the nerves actively engaged in keeping 
up this state of specific unsusceptibility. It 
gradually goes off, but more slowly than one 
would suppose. Hence with moderate precau- 
tion, a nurse, a physician, or a clergyman, may 
attend dysenteric patients this year if they have 
had to do with similar patients several years 
previously. But the safest plan is to employ 
even in this case a little blameless precaution. 

But as the superstitious amulets and charms 
of our ancestors' times did harm, inasmuch as 
full credit was given to their medicinal virtues, 
and better remedies were consequently neglected, 
so for like reasons the fumigations of the sick 
room with the vapour of vinegar, juniper-berries 
and the like, is inadvisable, although the majority 
of my colleagues highly recommend it, and 
assert that the most infectious miasms of all 
kinds have thereby been overpowered and driven 
away, and thus the air purified. 

Being convinced of the contrary, I must 
directly contradict them, and rather draw upon 
myself their disfavour than neglect an oppor- 
tunity of rendering a service to my fellow- 
creatures. But as the spoiled (phlogisticated, 
foul, fixed, etc.) air can never be restored to 
purity or turned into vital air by means of these 
fumes, and as there is not a shadow of a proof 
that the subtle contagious exhalations, w^hose 
essential nature is quite unknown to us and not 
perceptible to our senses, can be weakened. 


neutralized, or in any other manner rendered 
innocuous by these fumes, it would be foolish, 
I would almost say unjustifiable, by recommend- 
ing such fumigations for the supposed purifica- 
tion of the air, to encourage ordinary people in 
their natural indolence and indisposition to 
renew the air of their apartments, and thereby 
expose every indifferent person who comes in 
contact with them to a danger to his life, which 
will be all the more obvious and great, the more 
confident he has been made by the futile repre- 
sentation that, without driving away the disease- 
spreading miasm by means of repeated draughts 
of air, the pestilential atmosphere of the sick 
room has been converted into pure healthy air 
by means of simple fumigations with vinegar 
and juniper berries. That is just like the old 
superstition of hanging an eagle-stone at the hip 
of the woman in labour, at the very moment 
when all hopes of saving her, even by the 
forceps, are over. 

When a physician or clergyman enters an un- 
fumigated chamber he can at once tell by his 
sense of smell whether his needful order to air 
the room has been obeyed or not. All sick 
people make a disagreeable smell about them. 
Therefore the freedom from smell of a chamber 
is the best proof that it has previously been aired, 
but if fumigations have been had recourse to, 
the latter becomes doubtful and suspicious. 
Neither the physician nor the clergyman, neither 
the sick-nurse nor the patient, require perfumes 
when they have to think and speak seriously 
concerning a matter of life and death. They 
should never be used ! 


in a letter to the minister of police 


You will, no doubt, yourself, see the 
results that the infection that was brought to 
* * ^ four weeks ago might produce if its farther 
spread be not arrested, still I consider it to be a 
duty, as I have, here and there, had considerable 
experience in extensive epidemics, to offer my 
mite at the altar of fatherland, in the form of 
some unpretending propositions. 

Taking into account the malignancy of this 
fever, if the epidemic be left to itself, it may, in 
the course of half-a-year, at this season, and in 
the present condition of the town, sweep away 
about 250 individuals, a considerable human 
capital, seeing that it is especially adults, the 
most useful class, that will first and most cer- 
tainly be cut off by it. Should it, as soon will 
happen, once penetrate into the damp dirty 
houses of the poor, who are already often ren- 
dered liable speedily to catch the disease, by 
unhealthy, miserable fare, by sorrow and depres- 
sion, it is difficult, very difficult, to extinguish 
it in these situations. In addition to this, there 
is the carelessness of the common people, who 
incline to Turkish fatalism, as the most con- 
venient of all creeds respecting Providence, and 
their want of reflection in only considering as 
dangerous what they can see with their eyes, 
such as a flood or a conflagration. From these 



they will flee, but they are indifferent to a mur- 
derous pestilential vapour, because it does not 
fall within the cognizance of their coarse senses. 
So the ignorant person fearlessly approaches a 
charged electric battery, and smilingly enters 
the pit filled with poisonous gases, though his 
predecessor may just have been brought out of 
it dead. Every one thinks he possesses enough 
strength to resist the enemy of life. But vain 
are his expectations; the giant himself if breathed 
on by the breath of death sinks down, and the 
wisest loses his consciousness. Resistance is not 
to be thought of. In flight, in flight alone, is 

The only means on which we can rely for 
checking epidemics in their birth, is the separa- 
tion of the diseased from the healthy. But if it 
be left to the public to preserve themselves from 
infection, every one for himself, even with the 
help of published advice, experience teaches us 
that all such recommendations do little good — 
and often, in spite of the best intentions, cannot 
be carried out. 

But just as the police, when a conflagration 
breaks out in the town, do not leave it to the 
caprice of the possessor of the house to extin- 
guish the fire in the way he thinks fit, but them- 
selves make the necessary arrangements, and 
erect the fire-stations to be employed without 
delay, if necessary in opposition to the will, and 
even in spite of the resistance of the owner of 
the tenement — acting upon the just principle that 
the security of the community ought to weigh in- 
finitely more than the property of an individual 
— in like manner, I assert it ought not to be left 
to the individual's caprice to nurse his relatives 
affected with infectious disorders, in his house, 


since it is not to be presumed that he has either 
sufficient power, or judgment, or opportunity, 
to prevent the spread of the disease, and no 
amount of wealth on his part, no damages ex- 
pressible in figures, can compensate for the Ufe 
of one, not to speak of many famiHes, fathers, 
mothers, husbands, wives, children, endangered 
by him. 

Of a truth if ever the better part of the public 
ought anxiously to look to the authorities and 
to the police for protection, it is in the case 
of the invasion of epidemics, if the pro- 
tecting divinities of fatherland do not stretch 
forth their powerful hands on that occasion, 
where else can we look for deliverance from the 
danger ? 

I could easily exhibit a picture of the most 
frightful scenes, that still haunt me from similar 
epidemics, whereby the most uncosmopolitan 
soul must be deeply moved — but to you, sir, such 
things are not unfamiliar, and you require not 
such reasons to induce you to put your hand to 
the work. 

Taking for granted, then, that you concede 
the above premisses, I make bold to make the 
following preliminary proposals, for whose 
efficacy experience is my warranty, and thereon 
I stake my honour. 

They may all be set in action in the course 
of a few days; in this case speed saves expense 
and human life. 

1. Let an hospital or other public building 
without the gates of the town be prepared, solely 
for the reception of such patients ; the court-yard 
must be surrounded by a stone or wooden fence, 
as high as a man. 

2. From twenty to thirty cheap bedsteads are 


requisite, provided with straw mattresses and 
frieze coverings. 

3. The male and female nurses — of whom 
there should be one for every four or five 
patients — must always remain in the house with 
their patients, and should never go outside the 
door. The food and medicines they require 
should be brought to them daily in the open 
court by persons who should immediately after- 
wards retire, so that the two parties shall not 
approach within three paces of each other, and 
nothing should be brought from the house into 
the town. 

4. In order to enforce this regulation, place a 
guard of two soldiers before the outer door, 
which they, only are to open, and command them 
to let none but these persons and the physician 
and surgeon in and out. 

5. A small sentry-box formed of boards will 
protect them from the weather, outside of which 
should hang a linen (or, still better, an oil-cloth) 
cloak for the physician and surgeon, which they 
should put on when they enter the house and 
lay aside on leaving it. 

6. The medical officers should get a written 
notice of the mode in which it is desirable that 
they should protect themselves and others from 
infection, and the attendants of the sick should 
get instructions of a similar character. 

7. All who fall ill of this malignant nervous 
fever in the town (the police officers should get 
a gratuity for all they detect) should be removed 
to the hospital by their friends in a covered 
sedan chair, kept for this purpose in the court- 
yard of the hospital, and there they should be 
taken care of and cured — (at the expense of their 


Persons so dangerous to the community cease 
to belong to their friends; from the nature of 
their malady they come under the surveillance 
and care of the state, like a highwayman, a mad- 
man, a murdering quack-doctor, an incendiary, 
a robber, a poisoning courtesan, etc. They 
belong to the state until they are rendered in- 
nocuous. Salus publica periclitatur is the simple 
standard for determining all the wholesome regu- 
lations of a philanthropic police in such cases. 
To forbear pulling down neighbouring houses 
during a spreading conflagration, in consequence 
of the unreasonable request of their owners, this 
is a fault that no police now-a-days would 
commit. In the case wc allude to, however, 
there is no pulling down, but on the contrary, 
building up. Men's lives, not houses, are to be 

Should my patriotic general propositions meet 
with your approbation, 1 shall not fail, if no one 
else does it, to treat of the subject in greater 
detail, and to furnish, in writing, the additional 
plans for the general weal, as circumstances pre- 
vent me taking a personal share in them. 

If I could thereby prevent some misfortune, 
I should feel myself richly rewarded. But the 
reason why I, a private individual, occupying 
no official post, and not intimately connected 
with this country, wish to lend my aid in this 
matter, is owing to this, that I think that in such 
public calamities the motto should be sauve qui 
pent! and hence I am wont to exert myself to the 
utmost, and to save what can be saved, be it 
friend or foe. 

I am, etc.. 

Dr. H. 


More Particular Directions 

The police officials ought to ascertain where 
any person has been suddenly taken ill in the 
town, or has suddenly complained of headache, 
rigour, stupefaction, or has rapidly become very 
weak and delirious; they should report what 
they learn to the appointed physician, who, after 
a rapid but careful examination, during which he 
attends to the directions below for avoiding in- 
fection, sees that the patient is conveyed to the 
hospital. At the same time the police officer 
receives his fixed remuneration.^ 

The large hall of the hospital should be 
divided longitudinally by means of a partition 
of boards; the one part so divided to form the 
patient's ward, whilst the other and much nar- 
rower division forms a kind of passage, into 
which the bedstead of each patient, which should 
be placed on castors, may be pushed through a 
trap-door in the partition, in such a manner as 
that only the patient in the bed shall come into 
the passage, whereon the trap-door falls-to again. 
Here the physician examines the external and 
internal condition of the patient, in the presence 
of the surgeon, then he causes him to be pushed 
back into the ward, and the next patient to be 
brought forward, and so on. 

But before performing this examination, and 
indeed before the arrival of the physician, all the 

^ If this remuneration be considerable (about a thaler 
[3J. 6d.] for the discovery of every case of this kind), the 
progress of the epidemic will be speedily checked, there will 
soon be no more sick to be separated from the healthy. 
The sick will be discovered in time, before they can (easily) 
communicate the infection. Again in human life saved and 
in the smaller sum required, will be the manifest result. 

K 2 


windows of the passage should be opened in 
order to air it. Before the patients are brought 
in they must be closed. 

The physician, accompanied by the surgeon, 
both covered with the oil-cloth cloak, ^ visits the 
patients twice a day, and questions them at a 
distance of three paces. If he require to feel 
their pulse, he must do this with averted head, 
and immediately afterwards wash his hand in 
a basin containing water and vinegar. If the 
patient's face be directed towards the light, it is 
not difficult to observe the state of the tongue at 
a distance of three paces. At a less distance it 
is scarcely possible to avoid the danger of in- 
haling the patient's breath,^ whence the con- 
tagious principle spreads farthest and most 

When the patient has a clean tongue,^ as is 
found in those who are most dangerously ill, it 
is often advisable to give him large quantities 
of bark and wine, in place of any other medicine; 
and as it is to be apprehended that the nurse 
might make away with the wine, it is better to 
prescribe the bark and wine mixed, or for the 
physician to mix it himself. After every visit 
the medical officers should wash their hands and 
faces in vinegar and water. 

^ When the disease is particularly malignant in its char- 
acter, it is advisable to have a hood attached to the cloak, 
which the medical officer may draw over his head when he 
makes his visit, for it has been observed that the contagious 
matters attach themselves most readily to wool and hair. 

- The odour of the contagious miasm of malignant typhus 
fever is a kind of earthy, mouldy smell, like that from old 
graves newly opened. It has little or no resemblance to the 
odour of putrid flesh. 

^ This disease was chiefly a gaol-fever without anything 
in the first passages. 


The nurses must also be warned not to hold 
their faces near the patient's mouth, and after 
every time they raise up, turn or touch the 
patient, they should immediately wash their 
hands and faces. It is advisable to use a mix- 
ture of vinegar and water for the purposes of 

Each bed should be provided with a linen 
mattress well stuffed with straw,^ over which is 
spread a linen sheet, and on this a piece of oil- 
cloth,^ about three feet in length, whereon the 
nates and back of the patient lie. 

There should be two frieze-coverlets for each 
bed, in order that the one may hang all day long 
in the open air, whilst the other is covering the 
patient. They should be washed once a week 
by the nurses, together with the rest of the 
patient's linen, either in the open courtyard, or 
beneath a shed only covered at top. They should 
first be washed clean in merely tepid water with 
soap, and subsequently scalded with boiling 
water, care being taken to avoid the steam that 
rises, and they should not be washed a second 
time until the whole is almost quite cooled 

1 Mattresses equally, smoothly, and firmly stuffed with 
some vegetable substance, as barley-straw, hay or moss, are 
for this object preferable to feather beds. The former allow 
the exhalations to pass through, do not retain the miasm so 
long, and as they are not so yielding form no wrinkles, and 
are cooler : they prevent the formation of these often fatal 
bed-sores {sphacelus a decubitii) so often met with in 
malignant fevers. 

■^ By its smoothness it prevents the formation of bed 
sores, and catches the f?eces that often pass involuntarily in 
patients seriously ill. They may be easily removed without 
soiling the bed linen or mattress, which has a very bad 
effect on the purity of the air. 

2 A washerwoman in America had to wash some dirty 


The oil-cloth should also be frequently wiped 
with a wet cloth. 

Every day at noon all the windows of the sick- 
room should be opened, and a draught of air 
kept up for an hour, during which the patients* 
beds should be pushed through into the ante- 
room, and remain there all the time. 

In the centre of the ward should stand a stove, 
heated from within.^ 

The most trustworthy of the nurses must be 
responsible for the accurate carrying-out of these 
directions, as well as those of the physician. 

Those nurses who have already attended 
patients affected with the complaint are more 
secure from infection than those who have not. 
To the former should be assigned the duty of 
the more immediate attendance on the patients. 
A new nurse should during the first days only 
be employed in work at some distance from the 
patients, such as scrubbing, sweeping, etc., 
until she is gradually habituated to the miasm. 

clothes, that had been brought over by a ship from England 
(among them were some that had been worn by a person 
who had recently recovered from small-pox in London), and 
she was immediately thereafter infected with malignant 
small-pox Boerhaave has brought forward abundant proof 
of the frequency and facility with which washerwomen are 
infected. He recommended soap not to be used in washing, 
probably because he thought that the miasmatic matter was 
more apt to be volatilized by it ; but this danger is only to 
be apprehended from the employment of hot water, 

^ Stoves heated by a fire in their interior, and still more 
open fire-places, renew the air of the room very effectually as 
long as the fire burns (and also to a certain extent at other 
times), because the flame must always have fresh nourish- 
ment from the air which it draws through the vent-hole of 
the stove in large quantity. At the same time pure fresh air 
penetrates through the chinks of the windows, or through 
the air-holes above them, into the room. 


The state of the heahh of the whole household 
should be every day carefully investigated by 
the physician, even though they consider them- 
selves to be quite well. They should each day 
be reminded of the directions for their own 

The excrements of the patients should be 
carried in well-covered night-stools to the most 
distant part of the court or garden, and there 
emptied in such a way that the wind shall blow 
the exhalations from them away from the bearer. 
This should be done by those of the nurses who 
are most habituated to the contagious virus (not 
by the new-comers), upon a thick layer of saw- 
dust, and the ordure immediately covered with 
one or several bundles of lighted faggots or 
straw, whereupon the nurse should withdraw, 
and allow the excrement to be consumed by the 

Two of the attendants who have been longest 
in the service should be appointed the bearers 
of the sedan-chairs, for the purpose of fetching 
new patients from the town. For this purpose 
they should each time put on clean clothes, and 
apply to the sentry, who will give them from a 
chest in the sentry-box a clean Imen cloak, which 
they are to put on, leaving their house cloak 
hanging up on the outside of the sentry-box; 
they fetch the patient in the chair, and when 
they have brought him within the inner door 
(whence he is removed by others into the sick- 
ward), they take off their clean cloak and return 
it into the custody of the sentry. 

All the attendants, male and female, should 
wear a linen cloak in the house, reaching down 
to the feet; this should be washed at least once 
a fortnight. 


The attendants cook the meals for themselves 
and the convalescents, but they ought to be 
supplied daily with fresh meat and vegetables; 
half a pound of the former should be reckoned 
as the daily allowance of each person. The male 
attendants should get about three pints of good 
beer a-piece, the females somewhat less. 

They should get double the amount of the 
daily w^ages usual in the town. It would be well 
to promise them additional remuneration in the 
event of the happy termination of the epidemic. 
It is inconceivable the power to prevent infection 
possessed by the beneficent emotions, hope, con- 
tent, comfort, etc., as also by the strengthening 
qualities of good living, and of that liquor that 
is so refreshing to such people, beer ! 

They should moreover have no lack of wood, 
soap, vinegar, lights, tobacco, snuff, etc. 

If a clergyman is wanted for any of the 
patients, his visit must be paid in the presence 
of the physician, and the same formalities must 
be gone through as when the latter makes his 
visit, namely, the passage must be well aired 
before the bed containing the patient is pushed 
through the trap-door. The physician instructs 
him how near and in what manner he may 
approach the patient.^ 

When a patient dies he must be immediately 
pushed through on his bed into the passage, and 
left there until the physician has convinced him- 
self of his decease. The corpse is then to be 
covered with straw, and carried out on his bed 
into the courtyard or dead-house, where he is to 
be put, along with the clothes in which he died, 

^ By incautiously approaching the beds of such patients, I 
have frequently seen the most promising young clergymen 
infected and die. 


into a coffin well stuffed with straw; the corpse 
should be covered with straw and, in the pre- 
sence of the physician and clergyman, conveyed 
to the churchyard in silence. The grave should 
be four feet in depth, and the coffin should rest 
upon a layer of faggots, and straw piled up on 
the top of it up to the level of the top of the 
grave. After the lapse of three days in this 
manner, the grave should either be covered with 
earth, or, still better, the straw ignited and the 
miasmatic virus consumed along with the corpse, 
or at least dried till it is rendered innocuous. 
This is a precautionary measure that cannot be 
too forcibly recommended. 

When a' patient recovers so as to be able to 
be restored to his friends, he should be taken 
into a clean room, the key of which should be 
kept by the physician alone, and there put into 
a bath and w'ell washed over all the body, not 
excepting the hair, at first with clean warm water, 
and then sprinkled all over with vinegar before 
being finally dried. He is then to put on the 
clean clothes which his friends have sent him ; 
and all his old clothes, without exception, are 
to be burnt in the courtyard, in the presence of 
the physician,^ and finally he is to be accom- 
panied home by the physician and surgeon. 

Whenever a patient has recovered or died, the 
wooden close-stool he has used must be burnt 
in the open air, and the pot de chamhre broken 
and the fragments thrown into the fire. 

After the epidemic has been subdued, the male 
attendants should not be dismissed until they 

1 Too much care cannot be taken to secure the destruc- 
tion of such things, as the paltry love of gain of the nurses 
induces them to keep them for themselves, in spite of the 
danger to themselves and others of doing'so. 


have whitewashed the whole of the interior walls 
of the house, not only the sick ward, but every 
other room, and the temales not until they have 
thoroughly scrubbed all the floors, all the wood- 
work and all the utensils. 

The sick-ward should then be heated in the 
early morning as much as possible, at least up 
to 100° Reaum., and after this heat has been 
kept up for two hours, all the windows should be 
opened and kept so till night. 

Before they quit the house, both male and 
female attendants should bathe themselves, each 
sex in separate apartments, and all their articles 
of clothing and the linen they have used during 
their residence in the hospital should be placed 
in an oven of about the temperature of a baker's 
oven after the bread has been removed (about 
120° Reaum.), and kept there for at least a 
quarter of an hour,^ the vent-hole being duly 
regulated the time. 

After this is done, all the other linen or 
woollen articles which have been used by the 
patients, the straw mattresses (after taking out 
the straw), the towels, sheets, etc., should also 

1 The pestiferous miasmata which have become attached 
to clothes, linen, beds, etc., can according to my observations 
be expelled from such things and destroyed by no means 
more certainly than by a heat of upwards of 100° Reaum., 
the higher the temperature the better, even should the 
articles suffer a little from its effects. The celebrated Cook 
expelled in this manner the morbific vapours that had 
become attached to the cabins of his ships and infected the 
walls ; the efficacy of this measure is well known. The 
earliest physicians discovered the wholesome effect of fire 
and heat in destroying the plague virus, and their excellence 
is corroborated in our infectious epidemics by Howard, Lind, 
and Campbell. It is moreover remarkable that all the 
infection of typhus fever ceases when ships are under the 


be exposed for fully an hour to the same heat 
in the oven, and thereafter the bedsteads, after 
they have been well scoured, should be put in 
the oven and left there till it cools. 

The straw of the mattresses, the accumulated 
sweepings, rags, bandages, scrubbing clothes, 
brooms, and other articles of small value, should 
be burnt in the courtyard in the doctor's 

In his presence the attendants should leave 
the house all together and the sentinels should 
be withdrawn. 

The house may be allowed to stand empty, 
and reserved for similar purposes on a future 
occasion, one of the best-deserving male attend- 
ants, with his wife, being allowed to live in it 
gratuitously as housekeepers. Their business 
would be to see that the building is kept in good 
repair (in case it is required for another 

A house of this description and so arranged 
might subsequently be used with the greatest 
advantage, with some slight modifications, in 
epidemics of small-pox, measles, dysentery, and 
other infectious maladies dangerous to the popu- 
lation, and might be the means of preserving 
many useful citizens to the state. 

There might be a few beds kept there per- 
manently for the reception of all sick journey- 
men, beggars and trampers from the inns and 
lodging-houses (a fine being imposed for the 
concealment of such cases), whereby a source of 
epidemics of no small importance, but one that 
is frequently overlooked, might be effectually 
checked at its origin. 

This should be the duty imposed upon the 
housekeeper in return for his free dwelling, but 


at the same time he should receive an adequate 
(not paltry ^) remuneration for each patient who 
recovers, when he leaves the house. 

^ If the remuneration be not very small, he and his friends 
take good care to be ever on the watch for any such patients 
that may have slipped into the town, and he will do his 
utmost to obtain it as speedily as possible by the rapid 
recovery of the patient, to the great advantage of the state 
(and of the patients). 


A WELL-ORDERED policc should take care that 
rag-gatherers are not allowed to live anywhere 
but in isolated houses near the paper-mills/ nor 
should they be permitted to have in any house 
in the town a place where they may deposit the 
rags by little and little, only to remove them 
when they have collected a large quantity. The. 
regulations prevalent in Electoral Saxony should 
be adopted, viz. that the rag-gatherer should 
keep in the open street with his barrow or cart, 
by some signal summon around him those who 
have rags to sell, and not remain in the town 
with his collection of rags, but go into the 
country, and when he puts up at a country inn, 
leave his cart in the open courtyard, or before 
the door of the inn ; in a word, leave it in the 
open air. He should be forbidden, under penalty 
of imprisonment, to pick out from his heap of 
rags and sell to others for their use any articles 
of clothing that may be still lit for wear. 

They should also be forbidden to wear such 
articles themselves or put them on their children, 
which they will often do, to the great detriment 
of their health, as I have observed. I have seen 
a malignant epidemic of small-pox spread over 
the country from so doing. 

The paper-mills should be so arranged that 
the supply of the crude rags should be kept in 
well ventilated buildings far away from the 

^ Which should never be built close to t^wns and villages. 



dwelling houses, and the reception of the rags 
from the gatherer, and the weighing of them, in 
order to determine the sum he is to receive, 
should be carried on in a covered shed, open on 
all sides. 

The dealers in old clothes should only be 
allowed to carry on their trade in open shops, 
and should not be permitted to sell them in their 
houses under penalty of imprisonment. All the 
linen and articles of clothing they have for sale 
in their shops should be previously washed, not 
excepting even the coloured and woollen articles ; 
and a police officer should be charged to examine 
if they be washed, who should overhaul the 
whole contents of the shop on undetermined 
days. Every article that he finds still dirty 
should become his property after having shown 
it to the inspector of police in the presence of 
the dealer.^ 

It should only be permitted to the burghers of 
the town to deal in old clothes. Jews engaging 
in this trade should be deprived of their letters 
of protection. Women found carrying it on 
should be put in the House of Correction. 

The civic-crown merited by him who improves 
the prisons has been gained from us Germans 
by an Englishman — Howard. Wagnitz follows in 
his steps. It is inconceivable how often the most 
destructive vapours are concentrated in these 
dens of misery, fraught with death to those that 
enter them ; how often their visitors are pre- 

1 Should it be feared that such an article of clothing, 
probably worn by a sick person, miojht prove dangerous to 
the policeman, it should be considered that the poor broker, 
in order to avoid such a loss, will most certainly take care to 
have none but clean washed things in his shop, and thus the 
police agent will have little or nothing to confiscate. 


maturely sent to the grave by fatal typhus. 
Destructive epidemic diseases often have their 
origin in these death-laden walls. 

There are several kinds of prisons. I shall 
here allude only to those where the imprison- 
ment is for life and to those gaols where prisoners 
guilty of capital crimes are kept until the termina- 
tion of their trial (often for several years), the 
visitation or inspection of which is not unfre- 
quently the cause of infectious diseases. Even 
when the prisoners themselves have not been ill 
of such fevers, their exhalations, their breath, 
and the miasm lurking about their dirty clothes, 
have often occasioned malignant fatal fevers. 
Heysham, Pringle, Zimmermann, Sarcone and 
Lettsom adduce a number of cases of this kind. 

Now as in the true spirit of laws that are free 
from all barbarity, even the punishment of death 
should have (and can have) no other aim than 
to render an incorrigible criminal innocuous, 
and to remove him from human society, what 
else can both these kinds of imprisonment be 
except rendering the prisoner harmless, in the 
former case for life, in the latter for a certain 
time pending the duration of the trial. None but 
Syracusan tyrants could dream of uniting a more 
inhuman intention with such prisons. 

If then the gaol even for capital offenders can 
and ought to be nothing but a means of depriv- 
ing them of all opportunity of injuring society, 
in that case every torture that is unnecessarily 
inflicted on them when thus in custody is a crime 
on the part of the police, I only allude here to 
the pain inflicted on them by unhealthy (disease- 
producing) prisons. In order to avoid this, 
prisons should never be raised less than four 
feet above the ground, and the openings of the 


windows, while they are sufficiently narrow, 
should be always so long as to allow the free 
access of fresh air. Where two windows oppo- 
site each other cannot be obtained (which is the 
best plan), there ought to be at least three 
windows for each small cell. The floor should 
either be paved with slabs of stone or, better, 
with rounded stones, so that it may be deluged 
and scrubbed, once a week, with boiling water. 
The walls and roofs should be lined with wooden 
boards, like the peasants' houses, in order to 
allow of their being also washed with hot water,^ 
as is customary with the country people. By 
these means these dismal habitations are at all 
events rendered dry residences, and the cachexias 
and tumours so frequently met with in such as 
have undergone a long imprisonment are in a 
great measure prevented. If it were possible 
to construct an air-hole for the purpose of carry- 
ing off the deteriorated vapours into the open 
air, gaols would thereby lose much of their 
dangerous aptitude to generate pests. The 
prisoner should have at least once a week a 
bundle of fresh straw for his bed. His bed- 
cover, together with his clothes and linen, should 
be washed at least once a week in hot water. 
He himself should be forced, before putting on 
his clean clothes, to wash his body all over. His 
chamber utensil should be emptied daily, and 
rinsed out with boiling water. He should be 

^ The exhalation from these wretched creatures, that con- 
stantly tends to decomposition, and the animal poison 
developed from their breath, whereby the air of their narrow 
cells is deteriorated, attaches itself in great quantity to the 
walls of gaols, and in course of time degenerates into a 
pestilential miasm ; by the process above described it is 
removed and washed away by the boiling water. 


allowed to walk about in the open air at least 
once a week, for at least an hour at a time. 

When he is removed from prison, his cell must 
be prepared for the reception of future prisoners 
by washing anew the floor, the walls and the 
roof with hot water, and by placing a small 
stove in it, the funnel of which goes out at the 
window. With this the cell is to be heated very 
highly, so that the heat shall almost take away 
one's breath (up to 120° Reaum.), and then the 
sieve snould be again removed, supposing it is 
not allowed to have one in the cell. 

If not, an iron tube communicating with the 
open air should open in the floor of the cell, pass- 
ing in winter through a heated stove,^ in order 
to conduct in a supply of fresh warm air. ^ 

It is great cruelty to shut up many prisoners 
together without allowing at least 500 cubic feet 
of space and air for each. If this be not allowed, 
the better ones among the prisoners are exposed 
to much annoyance by the bad behaviour of the 
worse ones ; and it is incredible the rapidity with 
which that most destructive of all animal poisons, 
the virus of the most fatal pestilence, is gener- 
ated. Police authorities, be humane ! 

I scarcely need to remark, that the (often long- 
continued) imprisonment of debtors who are fre- 
quently deserving of compassion, ought. to be 
made at least as innocuous for the health of the 
prisoners, of the turnkeys, and of those who visit 
them, etc., as that of criminals. 

When foreign prisoners or field-hospitals are 
introduced into a healthy country in time of war, 
whether temporarily or permanently, the author- 
ities, if they have it in their power to act, should 
take care that an epidemic is not thereby brought 
into the country. 


Prisoners of war, who are not unfrequently 
suffering from typhus and putrid fevers, in their 
transit through a country, are generally, when 
remaining for the night in towns, lodged in the 
town-halls, apparently in order that they may 
be kept more securely- But how often has this 
practice given rise to the spread of epidemics ! 

It would be safer to quarter them in large 
coach-houses, stables, barns, etc., outside the 
town, to make them lie undressed on straw mat- 
tresses, keeping them warmly covered in winter, 
and in this manner retaining them until their 
march can be renewed.^ If the season of the 
year admit of it, they must be compelled to wash 
each other's clothes and linen with hot water, 
and to dry them in the open air. 

The most destructive pestilences are most 
easily engendered by mlitary hospitals. It 
would be the most disgraceful barbarity, even in 
an enemy, to erect them in the middle of towns. 

But if, nevertheless, this is done, there remain 
for the poor townsman, if they bring pestilence 
along with them, as they usually do, very few 
means of preserving the life and health of him- 
self and family, and these he should carefully 
attend to. 

If he will not or cannot leave the town, he 
must at all events avoid all intercourse and com- 
munication with the sick, with infected houses, 
and even with those who frequent such houses. 
If they bring him anything he should take it from 
them at his house-door or in the open court. 
Should it be articles of clothing or linen, he 
should not make use of them before he has 

^ On the march they have plenty of air and exercise ; in 
this way they get rest and warmth, and are incapacitated 
from making their escape. 


plunged them into hot water mingled with 
vinegar, in the open court, or thoroughly fumi- 
gated them with sulphur. Should it be articles 
of food/ let him not partake of them before pre- 
paring them on the fire, or otherwise heating 

Infectious diseases have even been communi- 
cated by money and letters; the former may be 
washed in boiling water, the latter fumigated 
with sulphur. 

Although the animal poisons called infectious 
miasmata are not infectious at the distance of 
several paces in still open air, so that we may 
(with the exercise of great care) preserve our 
house free from infection in the midst of houses 
where the malady is raging, we should remember 
that a draught of air can carry the miasm arising 
from a sick person to a distance of many paces, 
and then occasion infection. 

On that account we should avoid traversing 
narrow lanes where we should have to pass close 
by a sick person, and for a similar reason we 
should shun narrow passages through houses. 
Above all we should refrain from looking into 
an open window and conversing with people in 
whose house or room cases of infectious disease 
may exist. 

Acquaintances kiss each other or shake hands ; 

^ A person who is exposed to the danger of infection, 
should not allow his courage to sink, should not leave off 
any of his accustomed comforts, rest, exercise, food, or drink ; 
but he should also carefully avoid all excess in any of these 
things, as also in passions, venereal excitement, etc. The 
other prophylactic measures that should be adopted will be 
found in the'first part of the " Friend of Health." A slight 
increase of stimulants, such as wine, tobacco and snuff, is 
said to be a powerful prophylactic against infectious 
L 2 


this ceremony should be omitted when the 
danger is so imminent; as also drinking out of 
another's glass. 

At such times we should never bring second- 
hand furniture ^ into our premises. 

Domestic animals that are given to rove, such 
as dogs and cats, often carry about with them 
in their hair the virus of infectious diseases. For 
security's sake it is advisable to get rid of them 
at such times, and not to allow strange dogs or 
cats to approach us. 

The drying up of marshes and old ditches 
close to human dwellings has frequently been 
the occasion of the most murderous pesti- 

If the fosse surrounding the town is to be 
cleared out or dried up, as is highly desirable 
for the health of the inhabitants of all towns, 
this work should only be undertaken in the depth 
of winter. The water should be carried off in 
the form of ice-layers, and the ice that forms 
again in a few nights should next be taken away, 
and so on till no more water remains. 

^ I have seen putrid fevers occur periodically for many 
years in the country, merely by old furniture, which had 
belonged to persons who had died of such affections, coming 
into other families by purchase. 

- I saw the fortieth part of the inhabitants of a large town 
die of typhus, in consequence of the incautious draining of 
the town fosse. 

Whenever the slime of such a town fosse, which may have 
been accumulating for many, perhaps hundreds of years, is 
deprived of the fresh water covering it, the half putrefied 
animal matters contained in it immediately pass into the last 
stage of decomposition. This last stage of decomposition of 
animal substances is infinitely more poisonous than all the 
previous ones, as we may see in the rapid fatality of the 
exhalations from cesspools which have not been, cleared out 
for thirty years or more. Of this more hereafter. 


But as the removal of the mud from town- 
ditches is much preferable to letting it gradually 
dry up, seeing that throughout the whole time 
required for the latter, noxious vapours are con- 
stantly exhaling, there is no better time for 
removing it than in severe cold. The mud which 
* is in a state of putrefaction is always warm, and 
never freezes so much as to prevent its being 
easily dug out in winter. We can also more 
readily dispense with draught-cattle on account 
of the excellent condition of the roads in severe 
frosty w^eather. 

After great inundations on fiat land, the spon- 
taneous drying up of which cannot be expected 
to take place m a short time, it is requisite that 
all should lend a hand to cut ditches through 
and round about the inundated country; but if 
it is impossible to drain off the water into the 
river on account of its low level, a number of 
small windmills must be erected in order to 
pump off the water as quickly as possible and 
dry the land; for if this be not done the water 
readily takes on the putrefactive process, giving 
rise from spring to autumn to dysenteries and 
putrid fevers. 

The low-lying houses that have been inundated 
by the water are a fertile source of epidemic 
diseases (see Klockhoff). The police authorities 
must see that every householder digs a deep 
ditch round his premises, and especially round 
his dwelling-house ; that he has all his windows 
and doors open for the greater part of the day ; 
that he occasionally lights fires even in summer: 
and that in winter, at all events before he rises 
in the morning, all the doors and windows are 
left open for an hour at a time. 

There are places that are destitute of the (often 


unacknowledged) benefit of a sufficient supply 
of fresh flowing water, in place of which the in- 
habitants are obliged to make use of spring- or 
rain-water brought from a distance, or to put up 
with rain-water only. In all such cases they 
collect their supply of water for a long time in 
large reservoirs, in which it becomes stale in a 
few days and furnishes a very unwholesome 
drink, the source of many diseases. Soon, it 
again becomes clear and inodorous; but in a 
short time the putrefaction recommences, and so 
it goes on until the water is all consumed, the 
greater part of it in a very bad state. I shall not 
here attempt to determine whether these disad- 
vantages might not be obviated by the construc- 
tion of artificial aqueducts on no very expensive 
scale, or of (very deep) w^ells ; but I am con- 
vinced that in flat localities on firm soil it is 
possible to resort to one or other of these plans, 
whatever may be alleged against it by the paltry 
parsimony of many corporations, who look on 
unmoved whilst many such communities gradu- 
ally die out. In the absence of such a radical 
cure, I would advise every householder to keep 
his supply of water in casks, in which for every 
400 pounds of water one pound of powdered 
w^ood charcoai should be thrown, which, accord- 
ing to the discovery of Lowitz, possesses the 
power of preserving water from putrefaction and 
of making stale water sweet. The clear fluid 
may be drawn off when required through a tap 
provided with a tight linen bag. 

A similar precaution against the production 
of disease is adopted in large ships that go to 
sea, which are often reduced to great straits on 
account of a deficient supply of fresh water. But 
many causes conspire in ships to produce de- 


structive ^ diseases. Among these are the mode 
of feeding the crew so much in vogue, with often 
half-decayed, dried, and saUed meat, with un- 
wholesome fatty substances of various kinds; 
the want of fresh air when during continued 
storms they have to pass many days together 
below deck with the port-holes closed, when the 
exhalations from their bodies increase to a pesti- 
lential foetor ; the exhaustion of the sailors when 
kept at work too long, during which their wet 
clothes check the perspiration. These causes 
engender and keep up scurvy, dysentery, and 
other maladies. 

The risk of such disorders may be avoided by 
the following measures : supplying vegetable 
food, and in the absence of green herbs, dried 
legumes that so easily ferment; sauerkraut; 
sometimes brown sugar in place of oil ; brandy 
for strengthening ; meat-soups boiled dow-n and 
dried, in place of kept meat; malt-liquor to drink 
in addition to w^ater; the division of labour into 
eight hours' work ; care that the crew have always 
dry clothes to put on, and that their habits are 
cleanly; frequent pumping out of the necessary; 
and the purification of the air between decks by 
means of large braziers of burning charcoal 
according to Cook's method. The frequent 
washing with sea-water of the various utensils, 
the floor, the w^alls and the decks, must not be 
neglected. If powdered charcoal be mingled 
with the sea-water used in scrubbing, the stench 
of the walls will be effectually got rid of. In 

^ Major Nante observed during the war betwixt England 
and North America a pestilential gaol-fever break out on 
board the fleet lying off the Havana, of such severity that 
numbers of men who seemed to be in perfect health died 
after an illness of not more than from three to four hours. 


addition to all this care should be taken not to 
take on board sick persons, or such as have 
scarcely recovered from illness; and all the 
utensils and furniture should be frequently 
exposed to the air on deck when the weather is 

By the employment of Sutton's method of con- 
ducting leaden pipes into all parts of the ship 
which all terminate in the kitchen fireplace, the 
deteriorated air will most certainly be drawn off 
by the fire. But Cook's braziers do much more, 
for they heat the walls, and thus destroy the 
contagious matter much more effectually. Hale's 
ventilators (a kind of wooden bellows) are little 
used in ships. Would not the so-called garden- 
cress (lepidium sativum) be a valuable vegetable, 
or at all events be useful on board ship as a 
medicine, in order to diminish the noxious 
matters in the first passages ? The facility with 
which its seed grows is well known. We only 
need to strew it upon a piece of old w^et sailcloth, 
and cover it with unravelled pieces of old moist- 
ened tow. 

In towns where no rapid stream of water can 
be conducted through even the small streets 
wherein the animal excrements, the washing- 
water, the urine and other impurities of men ana 
animals can be carried off without doing any 
harm, covered cesspools cannot be dispensed 

These cesspools are always a bad thing for the 
health of man, from their aptitude to engender, 
or at least to promote, pestilence. 

In order to render them as innocuous as pos- 
sible, they should be built up with masonry, not 
only on the roof and walls, but they should also 
be paved on the floor with stones cemented to- 


gether, in order that the putrefying impurities 
may not sink into the ground, but be capable 
of being taken clean away. They must be 
frequently cleansed out, and the odour removed 

The time selected for cleansing them should 
be during the prevalence of a strong wind, more 
especially one from the north, north-east, east 
or south-east, and those days should be avoided 
when a long period of warm rain, calm and 
foggy weather, with a low state of the barometer 

Though we are not able to adduce any in- 
stances in which the exhalations from old privies 
have spread a pestilence of any duration, yet no 
good police which attends to the health of the 
community should permit them ; and moreover, 
cases have occurred where workmen suffocated 
in such places have spread such a virulent ex- 
halation from their clothes, that many of those 
approaching them have been cut off by typhus 

In order to avoid the pestilential poison pro- 
ceeding from animal substances in the last stage 
of putrefaction, the most destructive of all 
poisons, the removal of such murderous pits 
should be advised, and no sensible person will 
object to this. 

But when they are already in existence and 
require to be cleared out, we must not go to work 
incautiously. The simplest method of freeing 
such pits from their poisonous exhalations is 
always the lowering into them of small loose 
bundles of ignited straw attached to a wire, since 
there is rarely in them any inflammable gas that 
might endanger the house by its ignition. These 
bundles are to be let down to the depth at which 


they will almost be extinguished by the vapour, 
and then they should be allowed to burn out. 
This process is to be repeated with larger and 
larger ignited bundles until the stratum of gas is 
removed to the very floor of the pit, and atmo- 
spheric air occupies the place of the fire-extin- 
guishing gas. But our precautionary measures 
should not cease here : for it is not only want of 
atmospheric air that kills the workmen in such 
situations, but still more the vapour that rises, 
though not to any great height in consequence of 
its weight, from stirring up the human excrement 
that has entered on the last stage of putrefaction. 
In order to render this as harmless as possible, a 
quantity of dry faggots ignited should be thrown 
into the pit, sufficient to cover all the bottom of 
it, and there they should be left till they are 
totally consumed. The heat thus generated will, 
after the lapse of an hour, have rendered the 
odour innocuous to at least a foot in depth. This 
quantity should then be removed by the work- 
men ; faggots are then to be burnt as before on 
what is beneath, whereupon the next layer is 
removed, and so on until it is all cleared away. 

Should it really prove true that the most of 
our police authorities have abolished burials in 
churches, we should not be thereby set quite at 
our ease. The old graves still exist in our 
churches, in which the last and most poisonous 
stage of decomposition of the dead bodies has 
not yet ceased to emit its destructive emana- 
tions.^ Hence alterations and building opera- 

1 It should be borne in mind that the most fatal gas 
generated by the last stage of putrefaction does not readily 
rise, but is heavy, and not unfrequently reposes in a low 
stratum above the corrupting matter, until it is stirred up, 
and is thus rendered dangerous to life. 


tions in the floor of such churches are fraught 
with manifest danger to the life of the workmen 
and the congregations in tlie churches, whence 
diseases may spread over a considerable portion 
of the population. 

In June 1773 a grave was opened in the church 
of Saulieu in Burgundy, and church-service per- 
formed soon afterwards, in consequence of 
which, 40 children and 200 grown-up people, 
together with the clergyman and sexton, were 
assailed by the exhalation that arose, and carried 
off by a malignant disorder. Moreover it has 
not yet been perfectly ascertained how many 
years the contagious principle may remain 
attached in undiminished virulence to the buried 
corpses of those who have died of malignant 

In many countries the lying in state of all 
bodies is very properly forbidden. But in others 
where not so much enlightenment prevails, in- 
fectious diseases are often propagated by the 
exposure of such poisonous bodies, of which I 
could adduce many examples from Saxony. 

In 1780 a girl brought a putrid fever with her 
to Ouenstadt from Aschersleben. All her 
numerous brothers and sisters and her parents 
took ill of it, one after the other, but they all 
gradually recovered except one grown-up 
daughter, who died of bed-sores. I took the 
greatest pains to prevent the disease being pro- 
pagated to others from this house. I succeeded 
in this for five months, until this girl died and 
had to be buried. The young men of the village 
bore the body in a coffin nailed up according to 
my directions, to the grave. Here, from their 
attachment to the deceased, they disobeyed the 
strict orders given by my friend, the clergyman ; ; 


they forced open the lid of the coffin in order to 
see the corpse once more before it was let down 
into the grave. Others, moved by curiosity, 
approached. The third and fourth day there- 
after all those that had been guilty of this action, 
lay mortally sick of this fever, as also all those 
who had come near the grave (some of them 
from neighbouring villages), to the number of 
eighteen, of whom only a few escaped death. 
The epidemic of putrid fever spread around at 
the same time. 

Is it not desirable that those important person- 
ages in the state called inspectors of the dead 
and corpse-washers, w^hose business it originally 
was to form a silent judgment respecting the 
kind of death that had occurred and to verify 
the decease, should receive from the juridical 
medical officer accurate instructions on this by- 
no-means easy point, before undertaking such 
an important — such an exceedingly important — 
duty ? How many lives of those apparently dead 
might they not be instrumental in restoring, how 
many cases of murder might they not detect; 
and, what interests us peculiarly in this place, 
how often might they not discover that some 
who have died without having been seen by any 
physician, might have laboured under contagious 
diseases ! 

We should not be too rash with bodies brought 
to the dissecting-rooms, nor receive such as we 
may suspect to have died of contagious diseases, 
nor keep the subjects until they are in the last 
stage of putrefaction, nor, for the sake of 
bravado, have too much to do with macerated 
parts in a state of extreme decomposition, and 
often melting away under our touch, w^hich can 
no longer teach us anything. Examples are not 


wanting of the students who were merely looking 
on being rendered dangerously ill thereby. 

But chiefly are the contagious pestilences in 
towns harboured, renewed, promoted and ren- 
dered more contagious and more murderous, in 
the small low old houses situated close to the 
town-walls, huddled together in narrow damp 
lanes, or otherwise deprived of the access of fresh 
air, where poverty dwells, the mother of dirt, 
hunger, and despondency. In order to save 
firing and the expensive rent, several miserable 
families are often packed close together, often 
all in one room, and they avoid opening a window 
or door to admit fresh air, because the cold would 
enter along with it. He alone whose business 
takes him into these abodes of misery can know 
hov\^ the animal matters of the exhalations and 
of the breath are there concentrated, stagnant 
and putrefying; how the lungs of one are 
struggling to snatch from those of another the 
small quantity of vital air in the place, in order 
to render it back laden with the effete matters of 
the blood; how the dim, melancholy light from 
their small darkened windows is conjoined with 
the relaxing humidity and the mouldy stench of 
old rags and decayed straw ; and how grief, envy, 
quarrelsomeness and other passions strive to rob 
the inmates completely of their little bit of health. 
In such places it is where infectious pestilences 
not only smoulder on easily and almost con- 
stantly when a spark falls upon them, but where 
they take their rise, burst forth and even become 
fatal to the wealthy citizens. 

It is the province of the authorities and the 
fathers of the country to change these birth- 
places of pestilence into healthy, happy human 
dwellings. Nothing is left for me but to turn 


my face away from them and to keep my 
compassion to myself. 

If, however, the inmates of them be not with- 
out employment, their systems, accustomed to 
meagre fare and hard work, resist infections 
tolerably well; but when they are out of work, 
when dearness of the first necessaries of life and 
famine prevail among them, then, from these 
dirty sources of misery and woe, diseases of 
malignant character and pestilences perpetually 
issue. It is only since the feartul years 1771, 
1772, and 1773 that some rulers have learned, 
from the dangers to which they themselves were 
exposed, to provide for the safety of their many 
thousand subjects by establishing corn-granaries 
and flour-magazines against seasons of scarcity. 
I must make the general observation belong- 
ing to this place, that most of our towns are not 
adapted, nor calculated, to promote health. High 
town-walls and ramparts are now generally 
acknowledged to be useless for towns that are 
not fortified. That they are injurious by pre- 
venting the access of fresh air will also be readily 
conceded. But that the masses of houses of most 
towns are too closely huddled together is not yet 
generally seen, and when it is, it is attempted, 
but without success, to be excused, by the greater 
facilities offered for business and trade by having 
everything within a small circle. 

In towns about to be built it should not be 
allowed to build houses higher than two stories, 
every street should be at least twenty paces in 
width and built quite straight, in order that the 
air may permeate it unimpeded ; and behind every 
house (the corner houses perhaps excepted), 
there should be a courtyard and a garden as 
broad and twice as long as the house. In this 


way the air may be readily renovated : behind 
the houses in the considerable space formed by 
the adjoining gardens, and in front in the broad 
straight streets. This arrangement would be so 
effectual for suppressing infectious diseases and 
for preserving the general health/ that if it were 
adopted most of the precautionary measures 
against pestilence I have inculcated above would 
be rendered to a great degree superfluous. What 
advantages in this respect do not Neuwied, 
Dessau, etc., possess ! 

The handsome, roomy high and airy butchers* 
shops we meet w^ith in some towns (e. g, Dres- 
den) are not so good as the open butchers' stalls 
standing in market places and only covered by 
a roof. A putrid stench is always concentrated 
in the shops built for the sale of meat. 

The shops for the sale of stock-fish and her- 
rings should be situated in the open air, at the 
outside of the city-gates; the disgusting stench 
that proceeds from them is sufficient evidence of 
their unwholesomeness. 

Were it possible to banish entirely from the 
interior of towns all the manufactories and ware- 
houses of the butchers, soap-boilers, parchment- 
makers, catgut spinners, glue-boilers, and all 
other trades that are engaged with animal sub- 

^ The deteriorated air in closely built towns with high 
houses is especially injurious to children, and skives rise to 
those deformities of the beautiful human figure denominated 
rachitis, which consists of a softening of the bones, combined 
with laxness of the muscles, inactivity of the lymphatic 
system, and a high degree of irritability. The non-medical 
observer does not readilv notice the large number of these 
pitiable little monstrosities in closely built towns, partly 
iDecause a great many of them sink into the grave in the first 
years of their life, partly because the cripples who escape 
conceal themselves for shame from the public gaze. 


stances that become readily decomposed, and to 
transfer them to special buildings outside the 
town-gates, this would be a great advantage as 
regards infectious diseases. 1 have seen many 
butchers' houses in narrow lanes completely 
cleared of their inmates in epidemics, whilst the 
houses in the neighbourhood suffered much less 

It is astonishing how the indolence of that 
class of men who cherish their prejudices inspires 
them with such deep respect for some things that 
appear horrible to them, so that there is with 
them but little difference ^ betwixt them and 
things that are holy. It can only be attributable 
to this unaccountable prejudice that the bodies 
of dead domestic animals^ as also those persons 
who have to do with them, have been considered 
as not to be meddled with and as exempt from 
the regulations of a good police. Owing to this, 
great confusion and injuries to the health of the 
community have resulted. In this place I shall 
only complain of the custom of leaving the 
bodies of dead domestic animals in the open air, 
on greens and commons not far removed from 
the dwellings of man, a custom so opposed to 
all ideas of the preservation of health.- If, as 

1 It is curious that in almost all lan£,mages the same 
expressions are applied to the most horrible as well as to 
the most revered things — schaudervoll^ sacer, aiuficl, are 
instances in point. 

- Does this custom originate in the vanity of man, who 
thinks to vindicate his right to the title of sole lord of crea- 
tion by assuming to be alone worthy of the high honour of 
being buried beneath the ground, and to show his supreme 
contempt for animals (even of such as are most useful and 
most valuable to us), gives them the vilest names and leaves 
them unburied in the open air, in defiance of Nature which 
seeks to conceal all putrefying processes from the public 


is assuredly the case, all putrefying animal sub- 
stances make a horrible impression on our senses; 
if, moreover, all contagious diseases are hatched 
in corruption ; how can we imagine that such 
large masses of putrefying flesh of horses and 
horned cattle, particularly during periods of 
great mortality among cattle, can be a matter of 
indifference as far as human health is concerned. 
The thing speaks for itself ! 

It is in large well-regulated towns only that I 
have met with some (although seldom sufficient) 
attention directed to the sale of spoilt foody 
especially animal food. In districts where fish 
abound, many kinds, especially smaller ones, 
are brought to market with all the signs of 
putrefaction upon them. They are chiefly pur- 
chased by poor people, because they are cheap 
— nobody gives himself any concern about the 
matter, and the labourer when he is taken ill 
throws the blame of his sickness on any cause 
but the right one. Nobody concerns himself; 
the seller of this pernicious food returns home 
after having pursued his avocation unimpeded. 
The authorities who may perchance hear of it, 
say to themselves : Where there is no complaint, 
there is no judge. Can such be called Fathers 
of the town ? 

Other kinds of spoilt food can also produce 
infectious typhus fever. 

In large manufactories and work houses where 
the workpeople live in the house, those who fall 
ill should, whenever they commence to complain, 
be immediately separated from the healthy work- 
men, and kept apart until they have completely 
recovered their health. And even where the 
workmen reside out of the house but come to 
work together in large workrooms, it is the duty 


of the master manufacturer, especially at the 
time of the prevalence of epidemics, to send 
home immediately such of the workmen as begin 
to complain of illness. Great care should be 
taken always, but especially when disease is 
about, to have the workrooms and warerooms 
well aired and clean. 

Public schools are generally places for the 
diffusion of contagious diseases, such as small- 
pox, measles, scarlet fever, malignant sore-throat, 
miliary fever (whooping-cough ?), and many skin 
diseases. If schoolmasters in general were given 
to attend more to the physical and moral training 
of their pupils than to cramming their memories, 
much mischief of this character might be pre- 
vented. It should be impressed upon them not 
to admit any sick child to the classes, whose 
altered appearance betrays the commencement 
of a disease. Besides, a sick child can learn 

In times of prevailing sickness the clergymen 
should publicly warn the members of their con- 
gregations, not to come to church when they are 
feeling indisposed, and thereby expose their 
neighbours to danger. 

I cannot here enter into details regarding the 
power of bad arrangements in poor-houses^ 
houses of correction, orphan asylums and invalid 
hospitals, as also of ordinary hospitals and in- 
firmarieSy in producing and promoting infectious 
diseases; and still less can I describe the best 
plans for such institutions designed for ^ the 
relief of the most miserable classes of society. 
The subject is too important, and in many re- 
spects much too vast to be dismissed here with 
a few words. 


Ars autem tarn conjecturalis cum sit (praesertim quo nunc 
habetur modo) locum ampliorum dedit non solum errori 
verum etiam imposturae. — Baco de Verulam, Augin. 

After I had discovered the weakness and errors 
of my teachers and books, I sank into a state of 
sorrowful indignation, which had nearly alto- 
gether disgusted me with the study of medicine. 
I was on the point of concluding that the whole 
art was vain and incapable of improvement. I 
gave myself up to solitary reflection, and re- 
solved not to terminate my train of thought until 
I had arrived at a definite conclusion on the 

Inhabitants of earth, I thought, how short is 
the span of your life here below I with how many 
difficulties have you to contend at every step, in 
order to maintain a bare existence, if you would 
avoid the bypaths that lead astray from moral- 
ity. And yet what avail all your dear-bought, 
dear-wrung joys, if you do not possess health ? 

And yet how often is this disturbed — how 
numerous are the lesser and greater degrees of 
ill-health — how innumerably great the multitude 
of diseases, weaknesses and pains, which bow 
man down as he climbs with pain and toil 
towards his aim, and which terrify and endanger 
his existence, even when he is supported by the 
rewards incident to fame, or reposes in the lap 
of luxury. And yet, oh man ! how lofty is thy 
descent ! how great and God-like thy destiny ! 

^ Published at Leipzic in 1805. 
M 2 1^3 


how noble the object of thy Hfe ! Art thou not 
destined to approach by the ladder of hallowed 
impressions, ennobling deeds, and all-penetrat- 
ing knowledge, even towards the Great Spirit 
whom all the inhabitants of the universe wor- 
ship ? Can that Divine Spirit who gave thee 
thy soul, and winged thee for such high enter- 
prises, have designed that thou shouldst be 
helplessly and irremediably oppressed by those 
bodily ailments which we call diseases ? 

Ah, no ! The Author of all good, when He 
allowed diseases to injure His offspring, must 
have laid down a means by which those torments 
might be lessened or removed. Let us trace the 
impressions of this, the noblest of all arts, which 
has been devoted to the use of perishing mortals. 
This art must be possible — this art which can 
make so many happy; it must not only be pos- 
sible, but already exist. Every now and then a 
man is rescued, as by miracle, from some fatal 
disease ! Do we not find recorded in the writings 
of physicians of all ages, cures in which the dis- 
turbance of the health was so great that no other 
termination than a miserable death seemed pos- 
sible? Yet such cases have been rapidly and 
effectually cured, and perfect health restored. 

But how seldom have these brilliant cures 
been effected when they were not rather ascrib- 
able, either to the force of youth overmastering 
the disease, or to the unreckoned influence of 
various fortunate circumstances, than to the 
medicines employed ! But even were the number 
of such perfect cures greater than I observe them 
to be, does it follow from that that we can imitate 
them with similarly happy results? They stand 
isolated in the history of the human race, and 
they can but very seldom, if at all, be reproduced 


as they were at first occasioned. All we see is, 
that great cures are possible; but how they are 
to be effected, what the power, and the particular 
circumstances by which they were accomplished, 
and how these are to be controlled so that w^e 
may transfer them to other cases, is quite beyond 
our ken. Perhaps the art of healing does not 
consist in such transferences. This much is 
certain : an art of medicine exists, but not in our 
heads, nor in our systems. 

*'But," it is urged in reply, "are not people 
cured every day in the hands of thoughtful 
physicians, even of very ordinary doctors, nay, 
even of most egregious blockheads ? " 

Certainly they are; but mark what happens. 
The majority of cases, for the treatment of which 
a physician is called in, are of acute diseases, 
that is, aberrations from health which have only 
a short course to run before they terminate either 
in recovery or death. If the patient die, the 
physician follows his remains modestly to the 
grave; if he recover, then must his natural 
strength have been sufficient to overcome both 
the force of the disease and the usually obstruct- 
ing action of the drugs he took ; and the powers 
of Nature often suffice to overcome both. 

In epidemic dysentery, just as many of those 
who follow the indications afforded by Nature, 
wdthout taking any medicine at all, recover, as 
of those who are treated according to the method 
of Brown, of Stoll, of C. L. Hoffmann, of 
Richter, of Vogler, or by any other system. 
Many die, too, both of those treated by all these 
methods, and of those who took no medicine; 
on an average just as many of the one as of the 
other. And yet all the physicians and quacks 
who attended those who recovered boasted of 


having effected, a cure by their skill. What is 
the inference? Certainly not that they were all 
right in their mode of treatment; but perhaps 
that they were all equally wTong. What pre- 
sumption for each to claim, as he did, the credit 
of curing a disease, which in the milder cases 
uniformly recovered of itself, if gross errors in 
diet were not committed ! 

It were easy to run through a catalogue of 
similar acute diseases, and show that the restora- 
tion of persons who in the same disease were 
treated on wholly opposite principles could not 
be called cure, but a spontaneous recovery. 

Until you can say, during the prevalence of an 
epidemic dysentery for example, " Fix upon those 
patients whom you and other experienced per- 
sons consider to be most dangerously ill, and 
these I will cure, and cure rapidly and without 
bad consequences." Until you can say this, and 
can do it, you ought not to vaunt that you can 
cure the dysentery. Your cures are nothing but 
spontaneous recoveries. 

Often — the thought is saddening ! — patients 
recover as by a miracle when the multitude of 
anxiously changed and often repeated nauseous 
drugs prescribed by the physician is suddenly 
left off or clandestinely discontinued. For fear 
of giving offence, the patients frequently conceal 
what they have done, and appear before the 
public as if they had been cured by the physician. 
In numerous instances, many a prostrate patient 
has effected a miraculous cure upon himself not 
only by refusing the physician's medicine, but 
by secretly transgressing his artificial and often 
mischievous system of diet, in obedience to his 
own caprice, which is in this instance an im- 
perious instinct impelling him to commit all 


sorts of dietetic paradoxes. Pork, sauerkraut, 
potato-salad, herring, oysters, eggs, pastry, 
brandy, wine, punch, coffee, and other things 
most strongly prohibited by the physician, have 
effected the most rapid cure of disease in patients, 
who, to all appearance, would have hastened to 
their grave had they submitted to the system of 
diet prescribed by the schools. 

Of such a kind are the apparent cures of acute 
diseases. For those beneficial and useful regula- 
tions for the arrest of pestilential epidemics, by 
cutting off communication with the affected dis- 
trict, by separation and removal of the sick from 
the healthy ; by fumigation of the affected abodes 
and furniture with nitric and muriatic acid, etc., 
are wise police regulations, but are not medicinal 

In the infected spots themselves, where a 
further separation of the infected from the 
healthy is not to be thought of, there the nullity 
of medicine is exhibited. There die all, if one 
may be allowed the expression, who can die, 
without being influenced by Galen, Boerhaave, 
or Brown, and those only who are not ripe for 
death recover. Nurses, physicians, apothecaries, 
and surgeons, are all alike borne to their grave. 

At the same time it is undeniable, that even in 
such calamities, so humiliating to the pride of 
our art, occasional, but rare cures occur, effected 
obviously by medicine, of so striking a character, 
that one is astonished at so daring a rescue from 
the very jaws of death ; these are the hints 
afforded by the Author of Life "that there is 


But how did it act here ? What medicine did 
the real good? What were the minute particu- 
lars of the disease, in order that- we may imitate 


•the procedure when such a case recurs ? Alas I 
these particulars are and must remain unknown ; 
the case was either not particularly observed or 
not reported with sufficient exactness. And the 
medicine? No; a single medicine was not 
given ; it was, as all learned recipes must be, an 
elixir, a powder, a mixture, etc., each composed 
of a number of different medicinal substances. 
Heaven knows which of them all did good.^ 
"The patient also drank an infusion of a variety 
of herbs; the composition of this I do not recol- 
lect, nor does the patient remember the precise 
quantity he took." 

How can any one imitate such an experiment 
in an apparently similar case, since neither the 
remedy nor the case are accurately known ? 
Hence all the results attempted by future imi- 
tators are deceptive ; the whole fact is lost for 
posterity. All we see is, that cure is possible; 
but how it is to be effected, and how an indefinite 
case can tend to perfect the art of medicine, that 
we do not see. 

"But," I hear exclaimed, "you must not be 
too severe upon physicians, who are but men, 

^ Let it not be asserted "that all the substances only did 
good because of their combination, that naught must be 
added to, nothing taken from, it to enable us to repeat 
the fact." Many ingredients are never of equal goodness 
and power in any two chemists' shops, not even in the same 
shop at different times. Even the same mixture will be 
different in the same shop to-morrow from what it was to-day, 
according as one ingredient was added sooner than the 
other, more fully pulverized, or rubbed-up more strongly with 
the other ingredients, according as the atmospheric temper- 
ature was lower to-day, to-morrow higher, the ingredients 
more accurately measured to-day than to-morrow, or 
according as the preparer of the prescription was more 
attentive to-day, less to-morrow ; and many other circum- 
stances may occur to mar human calculations. 


amid the hurry and bustle which infectious dis- 
eases in circumscribed spots bring with them." 
"In chronic diseases he will come off more 
triumphant ; in these he has time and cool blood 
at his service in order to exhibit openly the truth 
of his art, and in despite of Moliere, Patin, 
Agrippa, Valesius, Cardanus, Rousseau and 
Arcesilas, he will show that he can heal not only 
those who would get well of themselves, but that 
he can cure what he will and what he is asked to 
cure." Would to Heaven it were so ! But as a 
proof that physicians feel themselves very weak 
in chronic diseases, they avoid the treatment of 
them as much as possible. Let a physician be 
called to an elderly man, paralysed for some 
years, and let him be asked to exhibit his skill. 
Naturally he does not openly avow how impotent 
this art is in his hands, but he betakes himself 
to some byway of escape — shrugs his shoulders 
— observes that the patient's strength is not 
sufficient to enable him to undergo the treatment 
(in general a very exhausting, debilitating pro- 
cedure in the hands of ordinary practitioners), 
speaks with a compassionate air of the unfavour- 
able season and inclement w^eather, which must 
first be over, and of the healing herbs of spring, 
which must be waited for before the cure can be 
attempted, or of some far-distant mineral waters 
where such cures have been made, and whither, 
if his life be spared, the patient will be able to 
proceed in the course of six or eight months. 
In the meantime, not to expose himself, he 
orders something, of the effects of which he is 
not at all sure ; this he does in order to amuse 
the patient and to make a little money out of 
him at the same time ; but certain relief he can- 
not give. At one time he wishes to remove the 


asthenia by internal or external stimulants; at 
another fortify the tone of the muscular fibre with 
a multitude of bitter extracts,^ whose effects he 
knows not, or strengthen the digestive appar- 
atus with cinchona bark; or he seeks to purify 
and cool the blood by a decoction of equally 
unknown plants, or by means of saline, metallic 
and vegetable substances of problematic utility, 
to resolve and dissipate suspected but never ob- 
served obstructions in the glands and minute 
vessels of the abdomen ; or by means of purga- 
tives he thinks to expel certain impurities which 
exist only in his imagination, and thereby hasten 
by a few hours the sluggish evacuations. Now he 
directs his charge against the principle of gout; 
now against a suppressed gonorrhoea; now 
against a psoric acridity, anon against some 
other kind of acridity. He effects a change, but 
not the change he wished. Gradually, under the 
pretext of urgent business, the physician with- 
draws from the patient, comforting himself and 
at length the patient's friends when they press 
him for his opinion, that in such cases his art 
is too weak. 

And that his so vaunted art is too weak, on 
this comfortable, soft pillow he reposes in cases 
of gout, consumption, old ulcers, contractions 
and so-called dropsies, cachexias of innumerable 
varieties, spasmodic asthmas, angina pectoris, 
pains, spasms, cutaneous eruptions, debility, 
m.ental affections of many kinds, and I know not 
how many other chronic diseases. 

1 We often read in the histories of cases, even of distin- 
guished physicians, such observations as this : " I now gave 
the patient the bitter extracts " — as if the bitter vegetable 
substances were not all very various in their peculiar 
actions ! 


In no other case is the insufficiency of our art 
so strongly and so unpardonably manifested as 
in those distressing diseases from which hardly 
any family is altogether free; hardly any in 
which some one of the circle does not secretly 
sigh over ailments, for which he has tried the 
so-called skill of physicians far and near. In 
silence the aflfiicted sufferer steals on his melan- 
choly way, borne down with miserable suffering, 
and, despairing in human aid, seeks a solace in 

"Yes," I hear the medical school whisper 
with a seeming compassionate shrug, "Yes, 
these are notoriously incurable evils; our books 
tell us they are incurable." As if it could com- 
fort the million of sufferers to be told of the 
vain impotence of our art ! As if the Creator 
of these sufferers had not provided remedies for 
them also, and as if for them the source of 
boundless goodness did not exist, compared to 
which the tenderest mother's love is as thick 
clouds beside the glory of the noonday sun ! 

"Yes," I hear the school continue to apologize, 
"the thousand defects in our civic constitution, 
the artificial, complicated mode of life so far 
removed from Nature, the chameleon-like luxury 
enervating and deranging our natural constitu- 
tion, are answerable for the incurable character 
of all these evils. Our art is quite excused for 
being incapable of the cure of such cases." 

Can you then believe that the Preserver of our 
race, the All-wise, did not design these com- 
plexities of our civic constitution and our arti- 
ficial mode of life to increase our enjoyment here, 
and to remove misery and suffering? What 
extraordinary kind of living can that be to which 
man cannot accustom himself without any great 


disturbance of his health ? The fat of the seal 
and the train-oil eaten with bread made of dried 
fish-bones as little prevents the Greenlander from 
enjoying health in general, as does the unvaried 
milk-diet of the shepherds on the Swiss moun- 
tains, the purely vegetable food of the poorer 
Germans, or the highly animal diet of the 
wealthy Englishman. Does not the Vienna 
nobleman accustom himself to his twenty or 
thirty covers, and does he not enjoy just as much 
health as the Chinese with his thin rice soup, 
the Saxon miner with nothing but potatoes, the 
South Sea islander with his roasted bread-fruit, 
and the Scottish highlander with his oatmeal 
cakes ? 

I am ready to admit that the contest of con- 
flicting passions and of many enjoyments, the 
luxurious refinement, and the absence of exercise 
in fresh air that prevail in the labyrinthine 
palaces of great cities, may give occasion to more 
numerous and more rare diseases than the simple 
uniformity that obtains in the airy hut of the 
humble villager. But that does not materially 
alter the matter. For our medical art is as im- 
potent against the water-colic of the peasant of 
lower Saxony, the tsbmer of Hungary and 
Transylvania, the radesyge of Norway, the 
sihhens of Scotland, the hotme of Lapland, the 
pelagra of Lombardy, the plica polonica of 
certain Sclavonic tribes, and various other dis- 
eases prevalent among the simple peasantry of 
various countries, as it is against the more aris- 
tocratic disorders of high life in our large towns. 
Must there be one kind of medical art for the 
former, and another for the latter; or if it were 
only once discovered, would it not be equally 
applicable to both ? I should think so ! 


It may not certainly exist in our books, nor 
yet in our heads, nor be taught in our schools, 
but there is such a thing for all that; it is a 

Occasionally a regular brother practitioner 
stumbles by a lucky hit upon a cure which aston- 
ishes half the world about him, and not less 
himself; but among the many medicines he em- 
ployed he is by no means sure which did good. 
Not less frequently does the neck-or-nothing 
practitioner, without a degree, whom the world 
calls a quack, make as great and wonderful a 
cure. But neither he nor yet his worshipful 
brother practitioner with a diploma knows how 
to eliminate the evident and fruitful truth which 
the cure contains. Neither can separate and 
record the medicine which certainly was of use 
out of the mass of useless and obstructing ones 
they employed; neither precisely indicates the 
case in which it did good, and in which it will 
certainly benefit again. Neither knows how to 
abstract a truth which will hold good in all 
future time, an appropriate, certain, unfailing 
remedy for every such case that may occur here- 
after. His experience in this case, remarkable 
though it seemed, will hardly ever be of service 
to him in any other. All that we learn is, that 
a helpful system of medicine is possible; but 
from these and a hundred other cases it is quite 
manifest that as yet it has not attained the rank 
of a science, that even the way has yet to be 
discovered how such a science is to be learned 
and taught. As far as we are concerned, it 
cannot be said to exist. 

Meanwhile, among these brilliant but rare 
cures there are many (vulgarly called Pferdekuren 
[horse cures]), which, however great the noise 


they might make, are not of a character to be 
imitated, salti niortali, madly desperate attempts 
by means of the most powerful drugs in enor- 
mous doses, which brought the patient into the 
most imminent danger, in w^hich life and death 
wrestled for the mastery, and in which a slight 
unforeseen preponderance on the side of kind 
Nature gave the fortunate turn to the case : the 
patient recovered himself and escaped from the 
very jaws of death. 

A treatment with a couple of scruples of jalap- 
resin to the dose is by no means inferior in 
severity to the helleborism of the ancient Greek 
and Roman physicians. 

Such modes of treatment are not very unlike 
murders, the result alone renders them un- 
criminal, and almost imparts to them the lustre 
of a good action, the saving of a life.^ 

This cannot be the divine art, that like the 
mighty working of Nature should effect the 
greatest deeds simply, mildly, and unobservedly, 
by means of the smallest agencies. 

The ordinary practice of the majority of our 
practitioners in their treatment of diseases re- 
sembles these horrible revolutionary cures. 
They partially attain their object, but in a hurt- 
ful way. Thus they have to treat, for example, 
an unknown disease accompanied by general 
swelling. On account of the swelling it is in 
their eyes a disease of daily occurrence ; without 
hesitation they call it dropsy (just as if a single 

1 Thus a cruel usurper vibrates betwixt the scaffold and 
the throne, a small unfortunate accident brings his head to 
the block, and he dies amidst the curses of the nation ; or a 
small moment of luck that did not enter into his calculations 
puts the crown on his head, and the same nation falls down 
and worships him. 


symptom constituted the essential nature of the 

whole disease !), and they briskly set to work 

with the remark: "The water must be drawn off, 

and then all will be right." Away they go at 

it, attacking it with a frequent repetition of 

drastic (so-called hydragogue) purgatives, and, 

see ! what a wonderful event takes place — the 

abdomen falls, the arms, the legs, and the face 

grow quite thin ! " Look w^hat I can do, what 

is in the power of my art; this most serious 

disease, the dropsy, is conquered ! with only 

this slight disadvantage, that a new disease, 

which nobody anticipated, is come in its 

place (properly, has been brought on by 

the excessive purgation), a confounded lien- 

tery, which we must now combat with new 


Thus the worthy man comforts himself from 
time to time, and yet it is impossible that such 
a procedure can be called a cure, where the dis- 
ease, by means of violent unsuitable medicines, 
only loses a portion of its outward form and 
gains a new one; the change of one disease for 
another is not a cure. 

The more I examine the ordinary cures, the 
more I am convinced, that they are not direct 
transformations of the disease treated into health, 
but revolutionizings, disturbances of the order 
of things by medicines, which, without being 
actually appropriate, possessed power enough to 
give matters another (morbid) shape. These 
are what are called cures. 

"The hysterical ailments of yonder lady were 
successfully removed by me ! " 

No ! they were only changed into a metror- 
rhagia. After some time I am greeted by a 
shout of triumph: "Excuse m€ ! I have also 


succeeded in putting a stop to the uterine 

But do you not see how, on the other hand, 
the skin lias become sallow, the white of the 
eye has acquired a yellow hue, the motions have 
become greyish-white, and the urine orange- 

And thus the so-called cures go on like the 
shifting scenes of one and the same tragedy ! 

The most successful cases among them are 
still those where the revolution effected by the 
drug develops a new disease of such a sort, that 
Nature, so to speak, is so much occupied with it 
as to forget the old original disease and let it go 
about its business, and is engaged with the arti- 
ficial one until some lucky circumstance liberates 
it from the latter. There are several kinds of 
such lucky circumstances. The leaving off of 
the medicine — youthful vigour — the commence- 
ment of the menstrual flow or its cessation at the 
proper periods of life — a fortunate domestic 
occurrence ; or (but this is certainly of rare 
occurrence, still it sometimes happens like a 
ternion in the game of lotto) among the many 
medicines prescribed pell-mell, there lay one that 
was appropriate and adapted to the circum- 
stances of the case — in all these instances a cure 
may occur. 

In like manner, mistakes of the chemist re- 
specting the medicines and signs in prescriptions 
have often been the occasion of wonderful cures. 
But are such circumstances recommendations for 
the (till now) most uncertain of all arts? I 
should rather think not. 

By treatment the ordinary physician often 
understands nothing more than a powerful, 
violent attack upon the body with things that 


are to be found in the chemist's shop, with an 
alteration of the diet, secundum artenij to one of 
a very extraordinary, very meagre character. 
"The patient must first be powerfully affected 
before I can do him any good; I wish I could 
but once get him regularly laid up in bed ! " 
But that the transition from bed to the straw 
and the coffin is so very easy, infinitely easier 
than to health, he says nothing about that. 

The physician of the stimulating school is in 
the habit of prescribing in almost every case an 
exactly opposite diet (such is the custom 'of his 
sect) : ham, strong meat-soups, brandy, etc., 
often in cases where the very smell of meat 
makes the patient sick, and he can bear nothing 
but cold water ; but he too is by no means spar- 
ing in his use of violent remedies in enormous 

The schools of both the former and the latter 
class authorize a revolutionary procedure of this 
sort : " No child's play with your doses," say 
they; "go boldly and energetically to work, 
giving them strong, as strong as possible ! " 
And they are right if treating means the same 
thing as knocking down. 

How does it happen that, in the thirty-five 
centuries since yEsculapius lived, this so indis- 
pensable art of medicine has made so little pro- 
gress? What was the obstacle? for what the 
physicians have already done is not one hun- 
dredth part of what they might and ought to 
have done. 

All nations, even remotely approaching a state 
of civilization, perceived, from the first, the 
necessity and inestimable value of this art; they 
acquired its practice from a caste who called 



themselves physicians. These affected, in almost 
all ages, when they came in contact with the 
sick, to be in perfect possession of this art; but 
among themselves they sought to gloze over the 
gaps and inconsistencies of their knowledge by 
heaping system upon system, each made up of 
the diversified materials of conjectures, opinions, 
definitions, postulates, and predicates, linked 
together by scholastic syllogisms, in order to 
enable each leader of a sect to boast respecting 
his own system, that here he had built a temple 
for the goddess of health — a temple worthy of 
her — in which the inquirer would be answered 
by pure and salutary oracles. 

It was only the most ancient times that formed 
an exception to this rule. 

We were never nearer the discovery of the 
science of medicine than in the time of Hippo- 
crates. This attentive, unsophisticated observer 
sought Nature in Nature. He saw and described 
the diseases before him accurately, without addi- 
tion, without colouring, without speculation.^ 
In the faculty of pure observation he has been 
surpassed by no physician that has followed 
him. Only one important part of the medical 
art was this favoured son of Nature destitute of, 
else had he been completely master of his art : 
the knowledge of medicines and their applica- 
tion. But he did not affect such a knowledge — 
he acknowledged his deficiency in that he gave 
almost no medicines (because he knew them too 
imperfectly), and trusted almost entirely to diet. 

^ The speculative writings under his name are not his, 
neither are the three last books of the aphorisms. The want 
of the Hippocratic lonicisms, the absence of the very 
peculiar language of this man, must convince any one of this, 
who knows anything about such matters. 


All succeeding ages degenerated and wandered 
more or less from the indicated path, the later 
sects of the empirics — worthy of all respect — and 
to a certain degree, Aretaeus,^ excepted. 

Sophistical whimsicalities were pressed in to 
the service. Some sought the origin of disease 
in a universal hostile principle, in some poison 
which produced all maladies, and which was to 
be contended with and destroyed. Hence the 
universal antidote which was to cure all diseases, 
called theriacaj composed of an innumerable 
multitude of ingredients, and more lately the 
niithridaticum, and similar compounds, cele- 
brated from the time of Nicander down almost 
to our own day. From these ancient times came 
the unhappy idea, that if a sufficient number of 
drugs were mixed in the receipt, it could scarcely 
fail to contain the one capable of triumphing 
over the enemy of health — while all the time the 
action of each individual ingredient was little, 
or not at all known. And to this practice Galen, 
Celsus, the later Greek and Arabian physicians, 
and, on the revival of the study of medicine in 
Bologna, Padua, Seville, and Paris, in the 
Middle Ages, the schools there established, and 
all succeeding ones, have adhered. 

In this great period of nearly two thousand 
years, was the pure observation of disease neg- 
lected. The wish was to be more scientific, and 
to discover the hidden causes of diseases. These 
once discovered, then it were an easy (?) task 
to find out remedies for them. Galen devised 
a system for this purpose, his four qualities with 

^ Graphic as are his descriptions of disease, he yet only 
described them amalgamated together in complete classes, 
from many individual cases of disease : this Hippocrates did 
not do, but modern pathologists do it. 
N 2 


their different degrees; and until the last hun- 
dred and fifty years his system was worshipped 
over our whole hemisphere, as the non plus ultra 
of medical truth*. But these phantoms did not 
advance the practical art of healing by a hair*s- 
breadth ; it rather retrograded. 

After it had become more easy to communicate 
thought, to obtain a name by writing hypotheses, 
and when the writings of others could be more 
cheaply read — in a word, after the discovery of 
printing — the systems rapidly increased, and 
they have crowded one on another up to our 
own day. There was now the influence of the 
stars, now that of evil spirits and witchcraft; 
anon came the alchymist with his salt, sulphur, 
and mercury ; then Silvius, with his acids, biles, 
and mucus; then the iatromathematicians and 
mechanical sect, who explained everything by 
the shape of the smallest parts, their weight, 
pressure, friction, etc. ; to these succeeded the 
humoral pathologists, with certain acridities of 
the fluids; then the tone of the fibres and the 
abnormal state of the nerves was insisted on by 
the solidists ; then, according to Reil, much was 
due to the internal composition and form of the 
most minute parts, while the chemists found a 
fruitful cause of disease in the development of 
various gases. How Brown explained disease 
with his theory of excitability, and how he 
wished to embrace the whole art with a couple 
of postulates, is still fresh in our recollection ; to 
say nothing of the ludicrously lofty, gigantic 
undertaking of the natural philosophers ! 

Physicians no longer tried to see diseases as 
they were; what they saw did not satisfy them, 
but they wished by a priori reasoning to find out 
an undiscoverable source of disease in regions 


of speculation which are not to be penetrated by 
terrestrial mortal. Our system-builders delighted 
in these metaphysical heights, where it was so 
easy to win territory ; for in the boundless region 
of speculation every one becomes a ruler who 
can most effectually elevate himself beyond the 
domain of the senses. The superhuman aspect 
they derived from the erection of these stupend- 
ous castles in the air concealed their poverty in 
the art of healing. 

"But, since the discovery of printing, the pre- 
liminary sciences of the physician, especially 
natural history and natural philosophy, and, in 
particular, the anatomy of the human body, 
physiology, and botany, have greatly advanced." 
True : but it is worthy of the deepest reflection 
how it comes that these useful sciences, which 
have so manifestly increased the know-ledge of 
the physician, have contributed so little to the 
improvement of his art; their direct influence is 
most insignificant, and the time was when the 
abuse of these sciences obstructed the practical 
art of healing- 
Then the anatomist took upon him to explain 
the functions of the living body; and, by his 
knowledge of the position of the internal parts, 
to elucidate even the phenomena of disease. 
Then were the membranes, or the cellular tissue 
of one intestine, continuations of the membranes 
or cellular tissue or another or of a third intes- 
tine; and so, according to them, was the whole 
mystery of the metastasis of diseases unravelled 
to a hair. If that did not prove sufficient, they 
were not long in discovering some nervous fila- 
ment to serve as a bridge for the transportations 
of a disease from one part of the body to another, 

N 2 


or some other unfruitful speculations of the same 
kind. After the absorbents were discovered, 
anatomy immediately took upon herself to in- 
struct physicians in what way medicines must 
permeate them, in order to get to that spot of 
the body where their remedial powder was 
wanted; and there were many more of such 
material demonstrations put forward, much to 
the retardation of our art. It often reigned 
despotically, and refused to acknowledge every 
physician who handled his scalpel otherwise 
than according to the mode taught in the schools 
— who could not, without hesitation, give the 
name of each little depression on the surface of 
a bone, who could not, on the instant, give the 
origin and insertion of every smallest muscle 
(which sometimes only owed its individual exist- 
ence to the scalpel). The examination of a 
physician for a degree consisted almost solely 
in anatomy : this he was obliged to know off by 
heart, with a most pedantic precision ; and if he 
did this, then he was prepared to practise. 

Physiology, until Haller's time, looked only 
through the spectacles of hypothetical conceits, 
gross mechanical explanations, and pretensions 
to systems, until this great man undertook the 
task of founding the knowledge of the pheno- 
mena of the human body upon sensible observa- 
tion and truthful experience alone. Little has 
been added since his time, except so far as newly 
discovered products, newly discovered physical 
powers and laws, have conspired to explain the 
constitution of our frame. But from these, little 
has been incontrovertibly established. 

In general, natural philosophy often offered its 
services, somewhat presumptuously, to explain 
the phenomena in the healthy and diseased 


body. Then were the manifest laws which, in 
the inorganic world, regulate the extrication, 
confinement, and diffusion of caloric, and the 
phenomena of electricity and galvanism, applied, 
without change and without any exception, to 
the explanation of vital operations; and there 
were many premature conclusions of a similar 

But none of the preliminary sciences has 
assumed so arrogant a place as chemistry. It is, 
indeed, a fact that chemistry explains certain 
appearances of the healthy as well as the dis- 
eased body, and is a guide to the preparation of 
various medicines ; but it is incredible how often 
it has usurped the right of explaining all physio- 
logical and pathological phenomena, and how 
much it has distinguished itself by authorizing 
this or that medicine. Gren, Tromsdorff, and 
Liphardt may serve as warning examples of this. 

It is, I repeat, a matter for most serious re- 
flection, that while these accessory sciences of 
medicine (in themselves most commendable) 
have advanced within these last ten years to a 
height and a maturity which seems not to be 
capable of much further advancement, yet, not- 
withstanding, they have had no marked bene- 
ficial influence on the treatment of disease. 

Let us consider how this has happened. 

Anatomy shows us the outside of every part 
which can be separated with the knife, the saw, 
or by maceration ; but the deep internal changes 
it does not enable us to see ; even when we 
examine the intestines, still it is only a view of 
the outside of these internal surfaces that we 
obtain ; and even were we to open live animals, 
or, like Herophilus, of cruel memory, dissect 
men alive, so little could we penetrate the minute 


structure of parts lying remote from view, that 
even the most inquisitive and attentive observer 
would relinquish the task in dissatisfaction. Nor 
do we make much greater discoveries with the 
microscope, unless the refracting power favour 
us with optical illusions. We see only the out- 
side of organs, we see only their grosser sub- 
stance; but into the innermost depths of their 
being, and into the connection of their secret 
operations no mortal eye can ever pierce. 

By means of pure observation and unpre- 
judiced reflection, in connection with anatomy, 
natural philosophy, and chemistry, we have a 
considerable store of very probable conclusions 
regarding the operations and vital phenomena of 
the human body (physiology), because the pheno- 
mena in what is called a healthy body remain 
pretty constant, and hence can be observed fre- 
quently and, for the purposes of comparison, from 
all the different points of view afforded by the 
various branches of knowledge bearing upon them . 
But it is no less true than striking and hum- 
bling that this anthropological or physiological 
knowledge begins to prove of no use as soon as 
the system departs from its state of health. All 
explanations of morbid processes, from what we 
know of healthy ones, are deceptive, approaching 
more or less to what is untrue; at all events, 
positive proofs of the reality and truth of these 
transferred explanations are unattainable; they 
are from time to time refuted by the highest of 
all tribunals — experience. Just because an ex- 
planation answers for the healthy state of the 
frame, it will not answer for the diseased. We 
may admit it or not as we please, but it is too 
true, that in the moment w^hen we attempt to 
regard the state of the disease physiologically, 


there drops before our previously clear light of 
physiology a thick veil — a partition which pre- 
vents all vision. Our physiological skill is quite 
at fault when w^e have to explain the phenomena 
of morbid action. There is almost no part of it 
applicable ! True, we can give a sort of far- 
fetched explanation, by making a forced trans- 
ference and application of the physiological 
systems to pathological phenomena; but it is 
only illusory and misleads into error. 

Chemistry should never attempt to offer an 
explanation of the abnormal performances of the 
functions in the diseased body, since it is so 
unsuccessful in explaining them in the healthy 
state. When it predicts what, according to its 
laws, must happen, then something quite differ- 
ent takes place,- and if the vitality overmasters 
chemistry in the healthy body, how much more 
must it do so in the diseased, which is exposed 
to the influence of so many more unknown 
forces. And just as little should chemistry 
undertake to give a decision upon the suitable- 
ness or worthlessness of medicines, for it is 
altogether out of its sphere of vision to determine 
what is properly healing or hurtful, and it pos- 
sesses no principles and no standard by which 
the healing efficacy of medicines, in different 
diseases, can be measured or judged of. 

Thus has the healing artist for ever stood 
alone — I might say forsaken — forsaken by all 
his renowned auxiliary sciences — forsaken by all 
his transcendental explanations and speculative 
systems. All these assistants were mute, when, 
for example, he stumbled upon an intermittent 
fever which would not yield to purgatives and 
cinchona bark. 

"What is to be done here? -what is with sure 


confidence to be set about ? " he inquires of 
these his oracles. — Profound silence. — (And thus 
they remain silent up to the present hour, in 
most cases, these fine oracles.) 

He reflects upon the matter, and comes, after 
the fashion of men, to the foolish notion, that 
his uncertainty what to do here arises from his 
not knowing the internal nature of intermittent 
fever. — He searches in his books, in some twenty 
of the most celebrated systematic works, and 
finds (unless they have copied from one another) 
as many different explanations of intermittent 
fever as books he examines. Which of them is 
he to take for his guide? They contradict one 

By this road he finds he will make no progress. 

He will let intermittent fever just be inter- 
mittent fever; and turn his attention solely to 
learn what medicines the experience of bygone 
ages has discovered for intermittent fever, be- 
sides cinchona bark and evacuants. He proceeds 
to search, and to his amazement discovers that 
an immense number of medicines have been 
celebrated in intermittent fever. 

Where is he to begin ? Which medicine is he 
to give first; which next, and which last? He 
looks round for aid, but no directing angel 
appears, no Hercules in bivio, no heavenly in- 
spiration whispers in his ear which of all the 
number he ought to select. 

What is more natural, what more appropriate 
to the weakness of man, than that he should 
adopt the unhappy resolution (the resolution of 
almost all ordinary physicians in similar cases !), 
"that as he has nothing to direct his choice to 
the best, he had better give a number of the most 
celebrated febrifuge medicines mixed together in 


one prescription. How will he ever otherwise 
get to the end of the long list, unless he take 
several at a time ? As he can find no one who 
can tell him if there is any difference in the 
actions of these different substances, he con- 
siders it better to mix together many than 
few ; ^ and if the operation of each of these 
different ingredients really differs from that 
of the others, it would certainly, he thinks, be 
better, in this case, to collect several and many 
such reputedly antifebrile substances in one 

receipt." . . . 

"Among the many substances in his elixirs, 
pills, electuaries, mixtures, and infusions, surely 
(thus he philosophizes) there must be one which 
will do good. Perhaps the most effectual 
happens also to be the freshest and most power- 
ful medicine therein ; and perhaps the substances 
less adapted or even obstructive to the cure are 
happily the weakest in yonder chemist's shop. 
Perhaps ! yes we must hope for the best, and 
trust to good luck ! " 

Periculosce plenum opus alece! What are we 

1 The learned excuse for the great complexity of our 
ordinary prescriptions, " that most of the ingredients were 
added from rational reasons, that is to say, on account of the 
particular indications in each case— and that regular pre- 
scriptions must have an orthodox form, a basis (fundamental 
medicine), a corrective (something added in order to correct 
the faults of the basis), aji adjuvant (an auxiliary substance 
to support the weakness of the basis), and a7i excipient (a 
substance that supplies the form and vehicle)— is partly 
palpable school-cunning, like the latter excuse— partly fancy, 
like the former. For why does the opium you add not cause 
sleep, why do your additions of neutral salts fail to open the 
bowels, and your aqua sambuci to keep the skin moist ? 
Why does that not happen, as a rule, for which you added 
each particular substance, if it was properly indicated as you 
allege ? 


to think of a science, the operations of which are 
founded upon perhapses and bhnd chance? 

But suppose the first or second or all the trains 
of mixed drugs have not done any good, then I 
must ask : Whence did your authors derive the 
information, that A or B, or Y or Z, was useful 
in intermittent fever ? 

" It stands written of each of these remedies 
in the works on Materia Medica." 

But whence is their knowledge obtained ? Do 
the authors of these books anywhere assert that 
they themselves have given each of these sub- 
stances alone and uncombined in intermittent 
fever ? 

"Oh no! Some give authorities, or quote 
other works on Materia Medica ; others make the 
statement without any reference to its source." 

Turn up the original authorities ! 

"The most of these have been convinced not 
by personal experience ; they again refer to some 
antiquated works on Materia Medica, or such 
authorities as these : Ray, Tabernaemontanus, 
Trajus, Fuchs, Tournefort, Bauhin, and Lange." 

And these ? 

"Some of them refer to the results of domestic 
practice; — peasants and uneducated persons, in 
this or that district, have found this or that 
medicine useful in a particular case." 

And the other authorities ? 

"Why, they aver that they did not give the 
medicine by itself, but, as it became learned 
physicians to do, combined with other simples, 
and found advantage from it. Still it was their 
impression that it was this drug, and not the 
other simples, that was of service." 

A fine thing to rely on truly, a most delightful 


conviction, grounded upon opinions destitute- 
even of probability ! 

In one word : the primary origin of almost all 
authorities for the action of a simple medicine is 
derived, either from the confused use of it, in 
combination with other drugs, or from domestic 
practice, where this or that unprofessional person 
had tried it with success in this or that disease 
(as if an unprofessional person could distinguish 
one disease from another). 

Truly this is a most unsatisfactory and turbid 
source for our proud Materia Medica. For if 
some of the common people had not, at their 
own risk, undertaken experiments, and com- 
municated the results of these, we should not 
have known even the little we do at present about 
the action of most medicines. For, with the 
exception of a few distinguished men, to wit, 
Conrad Gesner, Stoerk, Cullen, Alexander, 
Coste, Willemet, have done, by administering 
simple medicines alone and uncombined, in 
certain diseases, or to persons in health, the rest 
is nothing but opinion, illusion, deception. 
Marcus Herz thought the water-hemlock cured 
phthisis, although he gave it combined with 
various other drugs. ^ On the other hand, to me 
the statement of Lange (in his Med. Domest. 
Brunsv.) is of much greater weight, namely, 
that the common people have employed it un- 
combined in this disease, frequently with good 

^ This is the general but most unjustifiable procedure ot 
our medical practitioners : to prescribe nothing by itself— no^ 
always in combination with several other things in an artistic 
prescription ! " No prescription can be properly termed 
such," says Hofrath Gruner in his Art of Prescribifig^ 
"which does not contain several ingredients at once" — so, in 
order to see clearer, you had better put out your eyes ! 


effect, than what the worthy doctor thought; and 
for this simple reason, because he gave it mixed 
with other drugs, while the others gave it simply 
by itself. 

The Materia Medica of remote antiquity was 
not worse furnished. Its sources were then the 
histories of cures effected by simples, recorded 
in the votive tablets; and Dioscorides and Pliny 
have manifestly derived their account of the 
operation of simple medicines from the rude 
observations of the common people. Thus, after 
the lapse of a couple of thousands of years, we 
are not a step advanced ! The only source of 
our knowledge of the powers of medicines, how 
troubled is it ! and the learned choir of physicians 
in this enlightened century, contents itself with 
it, in the most serious contingency of mortals, 
when the most precious of earthly possessions — 
life and health — are at stake ! No wonder that 
the consequences are what they are. 

He who, after such experience of the past, 
still expects that the art of medicine will ever 
make a single step towards perfection by this 
road, to such an one Nature has denied all 
capacity of distinguishing between the probable 
and the impossible. 

To fill to the brim the measure of deception 
and misapprehension attending the administra- 
tion of medicine to the sick, the order of apothe- 
caries was instituted, — a guild which depends for 
existence on the complicated mixtures of drugs. 
Never will the complicated formulae cease to pre- 
vail, as long as the powerful order of apothe- 
caries maintains its great influence. 

Unlucky period of the mediaeval age, which 
produced a Nicolaus the ointment-maker (Myrep- 


sus), from whose work the Antidotaria and 
Codices Medicamentarii were compiled in Italy 
and Paris ; and in Germany at first in NUrnberg, 
about the middle of the sixteenth century, the 
first Dispensatorium was written, by the well- 
meant zeal of the youthful Valerius Cordus. 
Before these unhappy events, the apothecaries 
were merely unprivileged vendors of crude 
drugs, dealers in simples, druggists. (At the 
utmost, they might have some theriac, mithri- 
date, and a few ointments, plasters, and syrups, 
of the Galenic stamp, ready on demand, but 
this was optional on their part.) The physician 
bought only from those who had genuine and 
fresh materials, and mixed these for himself, 
according to his own fancy; but nobody pre- 
vented him from giving them to his patients in 
their simple and uncombined state. 

But from the time when the authorities intro- 
duced dispensatories — that is, books full of com- 
pound medicines, which were to be kept ready 
made — it became necessary to form the apothe- 
caries into a close corporation, and to give them 
a monopoly (on condition that they should have 
always a stock of ready prepared medicinal mix- 
tures), whereby their number was fixed and 
limited, in order that there should not be too 
many of them, which might cause these costly 
compounds to hang upon their hands and 
become spoilt. 

It is true, that after the authorizing of the 
complicated mixtures in dispensatories, which 
was the first step to mischief, had been taken, 
the second — the granting a privilege of the 
exclusive sale of these expensive mixtures to 
apothecaries — was neither an unexpected nor an 
unjust proceeding ; but had the public approval 


of these senseless mixtures not preceded it, then 
the trade in single medicinal substances would 
have remained as it was at first; and there would 
have been no need of apothecaries' privileges, 
from which infinite injury has gradually accrued 
to the healing art. 

The earliest dispensatories, and those nearly 
down to our own time, called each compound 
formula by an alluring name after the disease 
which it was to remove, and after each, the mode 
of its administration was described, and numer- 
ous commendations given of its virtues. By 
this the young physician was led to employ these 
compositions in preference to the simple medi- 
cines, especially as the former were authorized 
by the government. 

The privileged apothecaries did what they 
could to increase the number of these formulas, 
for the profit derived from these mixtures was 
immensely greater than would have been derived 
from the sale of the simple drugs employed in 
their composition ; and thus, gradually, the small 
octavo dispensatory of Cordus grew into huge 
folios (the Vienna, Prague, Augsburg, Branden- 
burg, Wiirtemburg, etc., dispensatories). And 
now there was no known disease for which the 
dispensatory had not certain ready-made com- 
pounds, or, at least, the formulas for them, 
accompanied by the most eulogistic recommenda- 
tions of them. The professor of the healing art 
was now prepared, when he had such a receipt- 
book in his hand, — full of receipts for every 
disease sanctioned by the highest authorities in 
the land ! What does he want more to make 
him perfect as a healer of disease? How easy 
has the great art been made to him ! 

It is only quite lately that a change has taken 


place in the matter. The formulas in the dis- 
pensatory have been shorn of their auctioneering 
titles, and the number, especially of those which 
were to be kept ready compounded, has been 
lessened. Still plenty of magisterial formulae 

The spirit of the advancing age had at length 
expunged from the list of drugs the pearls and 
jewels, the cosdy bezoar, the unicorn, and other 
things, which were form.erly so profitable to the 
apothecaries; simple processes for preparing the 
medicines were laid down ; no one now required 
alcohol to be ten times rectified, or calomel twelve 
times distilled; and the establishment of more 
stringent price-regulations for the chemists 
threatened to convert their hitherto golden shops 
into silver ones, when things unobservedly took 
a turn more favourable to the apothecary, and 
more disastrous to the art of medicine. 

The former medicinal laws ^ had already 
begun to restrict the compounding of the mix- 
tures to the apothecaries, and thus, in some 
measures, to impose restrictions on the physi- 
cians. The more recent statutes completed the 
work by preventing physicians from converting 
the simple drugs into compound mixtures for 
themselves, as well as forbidding them to give 
any medicine direcdy to the patients, and, as the 
expression was, "to dispense." 

Nothing could have been done better adapted 
to ruin the true art of medicine. 

Such regulations may have been adopted from 
one of three reasons: — 

ist. Was it owing to the notorious ignorance 
of the physicians of the present day, which 

1 For example, the Constitutiones Fredericill Imperatoris, 


rendered them unable to prepare a tolerable com- 
bination of drugs, or even to measure out the 
simple medicines, that they were prevented from 
executing this mechanical operation on account 
of incompetence, as midwives are not allowed to 
use forceps ? If this was the case (what a dread- 
ful supposition !) how could they write a pre- 
scription, that is, directions for combining a 
variety of substances in the most proper manner, 
if they themselves were not masters of the opera- 
tion which they described? 

2nd. Or were they made in order to enrich the 
apothecaries, whose incomes suffered by the 
physicians themselves dispensing their medi- 
cines? If the whole system of medicine existed 
for the benefit of the apothecaries alone, — if 
people fell sick solely for the profit of apothe- 
caries — if learned men became physicians, not so 
much for the purpose of curing the sick, as for 
the sake of assisting the apothecaries to make 
their fortunes — then there would be good reasons 
why the dispensing of medicines was forbidden 
to physicians, and a monopoly of it confirmed to 
the apothecaries alone. 

:^rd. Or were they passed for the benefit of 
patients? One would suppose that medicinal 
laws would be made chiefly for the benefit of 
the sick ! Let us see, if it were possible that 
patients could be benefitted by these laws. 

By not himself dispensing, the physician loses 
all dexterity, all practice in the manipulations 
necessary for the compounding together of 
various substances which generally act chemic- 
ally on each other, and decompose one another 
more or less in this process or the other. He 
gradually becomes less experienced in this art, 
until at last he can no longer give any detailed 


and consistent directions at all,' until at length 
he gives directions for compounding that are 
full of contradictions, and make him the laugh- 
ing-stock of the apothecary. He is now 
completely at the mercy of the apothecary; 
and the doctor and patient must be content 
to take the medicine as the apothecary or his 
assistant (or even his shop-boy) pleases to 
compound it. 

If the physician wants to order equal parts of 
myrrh rubbed up with camphor in the form of 
powder, he very likely does not know, from his 
want of acquaintance with pharmaceutical mani- 
pulations, that these two substances never can 
form a powder; but the longer these two dry 
substances are rubbed together, the more they 
become converted into a greasy mass, a kind of 
fluid. Then the apothecary either sends to the 
patient this soft mash, instead of a powder, with 
a sarcastic observation, much to the annoyance 
of the physician; or he deceives the doctor, to 
keep in his good graces, and gives the patient 
something different from what the doctor pre- 
scribed, some brown powder, smelling of cam- 
phor. Or the physician, perhaps, writes a pre- 
scription for hemoptysis, consisting of alum and 
kitchen-salt rubbed together. Now, although 
each of these substances, separately, is dry, yet 
out of the triturated combination no powder 
results, but a fluid, which the physician, not 

1 It soon comes to this, indeed this is almost universally 
the case ; the physician no longer attempts to invent a 
prescription for himself, he must copy all his prescriptions 
from some well-known prescription manual, in order to avoid 
the danger of committing pharmaceutical blunders and 
contradictions, if he attempted to compose a prescription 
for himself. 


♦ himself accustomed to dispense, could never have 
anticipated. What will the apothecary do in a 
case like this ? He must either annoy or deceive 
the writer of the prescription. 

Now, can these and a thousand other similar 
collisions tend to the welfare of the patient ? 

Errors, mistakes of every kind, which the 
apothecary or his assistants commit in the pre- 
paration of the compound, through ignorance, 
hurry, confusion, inaccuracy, or deceit from 
interested motives, are, to the man of science and 
knowledge, who wishes to test such a combina- 
tion, a problem, w^hich, when vegetable sub- 
stances constitute the ingredients, it often defies 
his powers to solve, — how much more so for a 
physician who has never had an opportunity of 
acquiring a practical knowledge of pharmacy, 
or of compounding the medicines himself, indeed 
is prohibited from doing so ! How is he ever to 
discover the adulterations or the mistakes which 
the person who makes up his prescription may 
have committed? If he cannot detect them 
(which, owing to such limitations of his know- 
ledge, is very probable), what mischief must and 
does thence accrue to the patient ! If he cannot 
detect them, what an object of ridicule he must 
be, when his back is turned, to the apothecary's 
shopboys ! 

By forbidding physicians themselves to dis- 
pense, the apothecary's income is secured in the 
most satisfactory manner. What regulations 
respecting the prices of drugs can check his over- 
charges? And even if the prices of the drugs 
are fixed by law, his conscience often does not 
prevent him from employing a cheaper substitute 
(quid pro quo), instead of the expensive one that 
is prescribed. Many apothecaries have carried 


on this kind of deception to a great extent. This 
practice has been in vogue for more than fifteen 
hundred years. We may learn something of 
this sort from Galen's little book, entitled /Ze/ot 
avnPaWofjiSvcov ; and the multitude of books which 
treat of the adulteration of drugs and deceptions 
practised by the apothecaries, constitute of them- 
selves no small library. 

How well adapted is the whole business of 
treatment for the welfare of the sick ! 

"But the medicinal regulations do not provide 
only for the apothecary, they are for the interest 
of the physician also ! The latter gets fourpence 
for every prescription.'" 

So, the same for a prescription that he copies 
out of a printed receipt book as for one that it 
takes him an hour to compose ! Since that law 
was passed, of course he prefers making use of 
borrowed, ready-written (i, e. unsuitable) pre- 
scriptions; he can write a number of such ones 
in the course of a forenoon — but he must write 
a great many more than are good for the patient^ 
because he is paid by the number of his pre- 
scriptions, and because he requires many four- 
pences in order to live, to live well, to live in 
style ! 

Alas ! we may bid adieu to the progress of 
the art, to the cure of the sick ! 

Not to speak of the degradation to a learned 
man, to an artist of the highest rank, as the 
physician ought to be — to be paid by the number 
of his prescriptions (like the copyist by the 
number of the sheets he copies), or by the 
number of his courses (like a common mes- 
senger), it seems to me that the result is not 
commensurate with the arrangement. The 
physician becomes a mechanical workman, his 


occupation becomes a labour that requires the 
least reflection of all trades; he writes pre- 
scriptions (it matters not what) for whose 
effect he is not answerable, and he pockets his 

How can he be made responsible for the result, 
when he does not prepare the medicine himself ? ^ 
The preparation is entrusted by the state to 
another (the apothecary), who also is not answer- 
able for the result (except in the case of palpable, 
enormous mistakes), and over whom we have no 
control with respect to many inaccuracies in the 
preparation of compound medicines, for after the 
mixture is made, it is absolutely impossible in 
many cases to prove that which ought to be 
proved against him. 

From the very nature of the thing — it concerns 
the cure of the noblest of created beings, it con- 
cerns the saving of human life, the most difficult, 
the most sublime, the most important of all 
imaginable occupations ! — from the very nature 
of the thing, I repeat, the physician should be 
prohibited, under the severest penalties, from 
allowing any other person to prepare the medi- 
cines required for his patients; he should be 
required, under the severest penalties, to prepare 
them himself, so that he may be able to vouch 
for the result. 

But that it should be forbidden to the 

^ Properly speaking, the business of treatment is a kind of 
contract which the patient makes with the physician alone ; 
do ut facias. The physician solemnly promises to give his 
aid and to administer efficacious medicines prepared in the 
best way — a promise which, with such legal arrangements, he 
cannot redeem, and which can only be performed by a third 
party, the apothecary, who is not bound by any contract to 
the patient. What inconsistency ! 


physician to prepare his own instruments for the 
saving of life — no human being could have fallen 
on such an idea a priori. 

It would have been much more sensible to 
prohibit authoritatively Titian, Guido Reni, 
Michael Angelo, Raphael, Correggio or Mengs 
from preparing their own instrun>ents (their 
expressive, beautiful and durable colours), and 
to have ordered them to purchase them in some 
shop indicated ! By the purchased colours, not 
prepared by themselves,^ their paintings, far 
from being the inimitable masterpieces they are, 
would have been ordinary daubs and mere 
market goods. And even had they all become 
mere common market goods, the damage would 
not have been so great as if the life of even the 
meanest slave (for he too is a man !) should be 
endangered by untrustworthy health-instruments 
(medicines) purchased from and prepared by 

Under these regulations should there happen 
to be one single physician who should wisely 
wish to avoid that injudicious mode of prescrib- 
ing multifarious mixtures of medicines, and for 
the weal of his patients and the furtherance of 
his art should wish to prescribe simple medicines 
in their genuineness, he would be abused in 
every apothecary's shop until he abandoned a 
method that was so little profitable to the apothe- 
cary's purse; he must take his choice of either 
being harassed to death or of abandoning it and 
again writing compound prescriptions. In this 

^ I never knew any great enamel-painter who did not 
require to prepare his own colours, if he wished to have 
permanent, brilliant colours, and to produce masterpieces ; 
if he be forbidden to prepare his own colours he will not be 
able to furnish any but wretched daubs. " 


case what course would ninety-nine doctors out 
of a hundred choose ? Do you know ? I do ! 

Therefore adieu to all progress in our art ! 
Adieu to the successful treatment of the 
sick ! 

Richard Clay <5r» Sons, Limited, London and Bungay. 


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