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tKlb.S'
HU a.
The Monthly
Homoeopathic Review
Vol. 46, No. 2.]
FEBRUARY 1, 1902.
[Price is.
EDITED BY
DRS. POPE, DYCE BROWN & EDWIN A. NEATBY.
(Jonfmfsj
65
Homoeopathy Defined. By Alfred C. Pope, M.D. ... ... ••• 71
Allopathic Leavings. By Stanley Wilde, L.R.C.P., L.R.C.S. (Edin.) ... 89
The Aims of the Twentieth Century Fund. By D. Dyce Brown, M.A., M.D. 91
The Twentieth Century Fund. Statement by Dr. Byres Moir ... 97
% 22U 225 X_
Sound Advice
Reviews .
Pocket Manual of Homoeopathic Materia Medica : Comprising the Charac¬
teristic and Cardinal Symptoms of all Remedies. By William
Boericke, M.D. ...
Cardiac Debility. By Herbert Nankivell, M.D.
Meetings.
British Homoeopathic Society ... ... ••• ••• ••• *00
Notabilia.
Two Lectures on some thoughts on the Principles of Local Treatment in
Diseases of the Upper Air Passages. (Continued from January) ... 103
Obituary.
Dr. Francis Edmund Boericke ...
Correspondence .
Medical Ethics v. Scientific Progress
A Warning ...
126
127
LONDON:
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MONTHLY HOMOEOPATHIC REVIEW.
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65
THE MONTHLY
HOMCEOPATHIC REVIEW.
SOUND ADVICE.
It may have caused our readers some wonder to see in
our January issue so much space taken up with the
re-printing from the British Medical Journal of a large
part of a long lecture (the first of two lectures) by Sir
Felix Semon. Such reprints are often looked on as
mere “ padding,” and passed over with a slight glance.
But this one is an exception, and, though long, we con¬
sidered that we should be wanting in our duty to our
colleagues, the majority of whom are not members of
the British Medical Association, and who consequently
do not see its Journal, were we to pass over these admirable
lectures in silence. They are not only admirable in
themselves for the masterly manner in which the subject,
a comparatively limited speciality, is treated, which,
however, in itself might not interest some of our readers,
but their value especially consists in the broad, judicial,
judicious, and philosophical views expressed as to the
right mode of treatment, and as to the mode of surgical
practice which is rampant at the present day. We
therefore deem it our duty to point out here the special
features of these lectures, and to advise every one of our
colleagues, whether taking up this speciality more or less
or not, to study them carefully. The lectures are entitled
“Some thoughts on the principles of local treatment in
Diseases of the Upper Air Passages,” and were delivered
Vol. 46, No. 2. 6
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at the Medical Graduates’ College and Polyclinic on
October 2nd and 9th, 1901, by Sir Felix Semon, M.D.,
F.R.C.P. It might be suggested that the lectures could
have been “ boiled down ” for our pages, but we think that
everyone who reads them will agree with us in judging
that such a course would have been impossible without
taking out the pith of the whole thing, The actual words
of the lecturer required to be given in full in order to
produce the impression they were designed to make.
Had we, as homoeopaths, ventured to make the statements
and enunciate the views expounded by Sir Felix, we should
have been told we were behind the age, and not appreciative
of the strides that surgery has made in the last thirty
years, or even twenty years, and our suggestions would
have been smiled at by surgical members of our school,
tq say nothing of the sneers of our friends of the old school.
It needed a man in authority, a man whose position in
the profession is of the first order, and whose statements
could not lightly be gainsaid, to speak as Sir Felix has
done. Many a man of lesser authority and position
would have shirked the onus of speaking out freely,
though his views might be sound, for fear of obloquy
and of being “ sat on ” by his colleagues. We therefore
honour Sir Felix Semon for his manly courage in express¬
ing himself as he has done. We thank him for it, and
for his sound and much-needed advice. He begins by
quoting with approbation from Dr. Goodhart’sl address
at the meeting of the British Medical Association at
Cheltenham, in which he (Dr. Goodhart) says : “ With
what impatience do men and women in the present day
rush into the not always sufficiently repellent arms of
surgery. A little pain unnerves them, and all they know
of surgery is its successful side. It is a day of great things,
and why should they not have the benefit of these advances ?
And so with an ache here or a pain there they undergo
an operation.” “ And further on he says of ‘ doctors ’:
‘ I do not doubt, I say, that every one of us does his best
for the man that consults him, but I am not sure that in
attending to the exigencies of the immediate present we
do sufficiently take heed of the future. And our failings
in this respect are closely bound up with those of our
patients, for we in our place are so anxious to overlook
nothing and to cure disease, so enthusiastic in our belief
in our power to accomplish what we wish. First may be
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67
put a morbid readiness on our part to detect disease.
Engaged as we are in this pursuit, there comes a risk that
we too little appreciate the wide range of health, that is,
how good a state of health is compatible with numberless
slight and even sometimes considerable departures from
normal, We tend to make our standard too severe for
practical purposes.” Sir Felix Semon then continues:
“ It did not require Dr. Goodhart’s further specific
charge, namely, that * throats and noses suffered terribly
from this lust of operation that has beset the public/ to
convince me that I could not do better than to introduce
what I have long intended to say on the question of the
principles of local treatment in diseases of the upper air
passages, than by quoting the above wise words, for they
tersely and accurately describe, in my opinion, the present
state of the question. Not that I wish to bring a special
charge against my own special branch. Dr. Goodhart’s
fearless denunciation shows that the * lust of operation ’
is, indeed, a general characteristic of the present phase
of medical development. But coming from the general
to the particular, and speaking of such matters only of
which I can claim personal cognisance, I am afraid I must
fully endorse his statement so far as diseases of the upper
air passages are concerned. Not only is local or operative
treatment of these parts resorted to in numberless cases
where, to say the least, it is not required; not only do
operations of inestimable value in really suitable cases
become discredited through being performed wholesale ;
not only is the old war-cry against specialism, namely,
that it engendered narrow-mindedness, heard again,
and this time, I am afraid, with greater justification than
on previous occasions; but, worst of all, laryngology and
rhinology as a whole are being held responsible for the
over-zeal of one advanced section.”
These weighty words do not imply that Sir Felix
decries operative procedure. Far from it. He only
points out the prevalence of this “ lust of operation ”
which is so prominent at the present day. He very
clearly shows by accurate description what cases are
suitable for, and require operation, while equally clearly
he describes those in which operation is not required,
is not justifiable, and is often injurious. Surgery has
wonderfully advanced in recent years, and results have
been attained by it which could not otherwise have been
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attained, and so far from decrying surgical operation in
cases really requiring it, we gladly recognize that it can
do what therapeutical treatment cannot. Cases which,
if taken in time, might be easily remediable under suitable
medical treatment, are allowed to go on till such an amount
of diseased tissue forms as to be beyond the remedial scope
of drugs. These are the cases for operation. But in
the present day one cannot fail to see that cases of certain
forms of disease, however slight, are at once relegated to
surgery, and this it is that Sir Felix Semon deplores.
Even in the case of that popular and recently discovered
disease “ adenoids,” as soon as their presence is diagnosed
the advice is, "Have them removed.” And patients'
parents now look on this as the only thing to be done.
Whereas in the knowledge and practice of us all, and as
Sir Felix clearly states, many cases of adenoids do not
require to be interfered with surgically, but get quite
well under therapeutic constitutional treatment. It may
require a little time and patience, but they do get well.
Such examples are those, as Sir Felix points out, where
the symptoms produced are slight and in no way interfering
with health, and, in fact, are often for a time completely
absent, recurring, only for a time, with a transient catarrh.
All these diseases, of which adenoids might be taken as
an example, are due to constitutional causes, which develop
a local malady, and by constitutional treatment they can
be cured, unless they have, as we already have said, been
allowed to go on untreated till the local mischief is too far
advanced to be influenced by drugs. And yet these cases,
when operation is not called for, and when the triumph
of therapeutic treatment is so well demonstrated, are at
once relegated to operation. In the old school one may
pardon this “ lust of operation,” since their remedial
measures, in the shape of drugs, are so limited, but in the
homoeopathic school there is no excuse with such a number
of potent remedies in their hands which are known by
large experience to influence in a striking manner the
disorders of health which produce these local troubles.
We are glad to see Sir Felix Semon speak so clearly and
fearlessly on these points, denouncing operation when
unnecessary, and advocating therapeutical and hygienic
treatment instead. It may be said that surely these
remarks have nothing to do with homoeopathic prac¬
titioners. But there is a considerable impression abroad,
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and we fancy there is just a little bit of ground for it,
that homoeopaths who practise surgery are influenced
by this surgical “ boom,” or as Dr. Goodhart and Sir
Felix Semon term it, the “ lust of operation.” They
may be unconsciously influenced by the wish not to be
behind their colleagues of the old school, and the temptation
to get rid of the disease quickly and at once is strong.
Hinc illce lachryma . We consider that homoeopaths,
of all men, ought to be in the forefront of those who adopt
therapeutic treatment in the first place, and perseveringly,
and only resort to operation when the case does not
improve as expected, or when the case presents itself
at the outset as so far advanced in extent, and in the
interference with health and development, as to unmistak¬
ably demand operative proceedings. We quite readily
admit that unfortunately a large proportion of examples
of the classes of disease we are referring to have already,
when first presenting themselves for advice as hospital
out-patients, reached the stage when operation is inevitable.
And continuing our example of adenoids as a type of the
class of disease we are speaking of, if operation were
uniformly successful there would be much to be said for
early operation. But it is well known that disappoint¬
ment not infrequently occurs in the recurrence of the
complaint, while some serious results have occasionally
followed unnecessary operations, as Sir Felix points out.
We hold it is the duty of homoeopathic surgeons to strive
to show what therapeutics can do in cases not absolutely
requiring immediate operation. It is their duty to their
patients who consult them as homoeopaths, and it is their
duty also to the great cause of homoeopathy which they
represent. Although in the above remarks we take
adenoids as our text, and are only following the lead of
Sir Felix Semon, they apply also to other diseases which
are remediable by patient therapeutic treatment. We
cannot keep too closely in our minds the great doctrine
that local diseases are in reality due to constitutional
causes, and are really only the local manifestation of
general disordered health. This w r as strongly insisted
on by Hahnemann, whose views were far in advance
of his age, and at the present day are found to be in
harmony with the most recent views of pathology. And
it is quite refreshing to hear Sir Felix Semon speak as
he does on the mistake, to put it in a mild way, of operating
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when there is no distinct necessity. Had we penned
these remarks some time ago we should have been taken
to task for advocating a retrograde treatment. But now
we can speak out when we are backed by such an authority
as Sir Felix. At the present time, when a new “ plan
of campaign ” is being started for the more active and
energetic pushing of homoeopathy by means of the
“ Twentieth Century Fund,” and the large scheme of
development sketched out by Dr. Burford in his presi¬
dential address at the British Homoeopathic Society, it
is doubly imperative on all of our school to develop the
full resources of homoeopathy and show what can be
done by its benign methods. We should not allow our¬
selves to be led into the “ lust of operation ” merely because
it is quick and shows immediate results, disregarding its
being in many cases unnecessary, to say nothing of the
tendency to recurrence, with consequent dissatisfaction
to the patient and his relatives. We have ourselves, and
others have also, cured cases of adenoids by therapeutic
measures when they had been relegated to the surgeon
by other advisers, and such a record ought to be the pride
of homoeopaths. These remarks, though specially on
adenoids as our illustration, apply to other diseases in
which the triumphs of homoeopathy have teen shown,
but where nowadays operation is resorted to at once on
the ground of quickness and brilliant result, and for fear
of possible consequences if the case is not operated on.
This fear Sir Felix Semon also speaks of, and shows how
often it and its prophecies of impending evil have teen
groundless. His remarks on the necessity of making
sure that the symptoms produced by any local disease are
sufficient to justify operation, or, as he puts it, “ the
necessity of a proper proportion being observed between
the gravity of the disease and that of the interference ”
are admirable and well worth the study of all. They
ought to be “ read, marked, learned, and inwardly
digested ” by all. So also are his carefullv-argued-out
paragraphs on the reflex disturbances supposed to be
produced by trivial nose and throat conditions. These
are at the present day brought prominently forward by
some surgeons as a reason for operations, often of a severe,
serious, and even dangerous character, when it is a question
whether these reflex disorders have any connection
whatever with the trivial abnormality in the nose or
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Rt^eSf^b m i?l902 hiC HOMOEOPATHY DEFINED. 71
throat. And Sir Felix points out that men and women
can be perfectly well in health and comfort with a trivial
abnormality in some part of the body, which had best
be left alone, but which is seized on by operators as
requiring surgical interference. Had it not been that
we resolved to print these two remarkable lectures
in full we should have had to make many extracts in
support of our remarks, but this now is rendered un¬
necessary. We can only in this article draw attention
to the main points in the lectures, give them our hearty
support, and trust that every one of our readers will
peruse carefully and thoughtfully every word in them.
They are not to lie skipped over, but fully read and care¬
fully pondered.
HOMCEOPATHY DEFINED.
By Alfred C. Pope, M.D.
In directing the use of a given medicine for the purpose
of curing or relieving diseases, with the object, that is,
of modifying or altering the tissues and functions of the
body in the direction of health, the physician bases the
choice of his remedy upon one or other of several principles.
This is denied by some, who assert that there is no such
thing as a therapeutic principle. “ Empirical,” we have
been told, “were the foundations of the practice of medicine
in the days of old, and empirical are they still.” But
even empiricism may be regarded as a therapeutic principle
—that principle, viz., which dictates the choice of a medicine
as a remedy in a given case, because it had previously
proved effective in a similar form of disease.
It is impossible that a physician should prescribe without
having some reason for the selection he has made, based
upon the real or supposed properties of the drug he orders.
This may be found, in certain cases, in the supply of one
of the constituents of the body, which has apparently
become deficient in quantity or altered in quality, such
as iron in chlorosis or phosphate of lime in rickets. Useful
as this method of treating disease occasionally is, it is the
morbid tendency to give rise to such a deficiency that
we have to correct, in order to cure, rather than mechanic¬
ally to supply the lacking material.
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72
HOMCEOPATHY DEFINED.
Some causes of ill-health, such, e.g.> as epizoa and
entozoa, we can remove directly. The parasiticide is
in such cases indicated by the presence of the parasite.
Here, however, we oftentimes have to deal with a condition
of ill-health over and above that caused by the presence
of the parasite—a condition conducive to its growth and
nourishment, and then the mere selection of a parasiticide
will be insufficient to completely relieve the patient.
The antipathic principle is that which commonly
suggests a larger number of medicines as remedies than
any other —contraria contrariis curantur is the formula
expressing it. Thus opium , which produces drowsiness
in health, is given to remedy sleeplessness. The aperient
is chosen because its physiological action is to produce
diarrhoea; when the urine is defective a substance is
prescribed which is known to excite the secretion of large
quantities of urine in health.
Superficially looked at, this plan sounds very plausible.
But when put to the test of experiment its uselessness
as a means of cure Incomes only too apparent, while
on the other hand, as one on which a palliative may be
prescribed, and relief thereby afforded for a time, it is
that on which all physicians are in some few instances
of incurable and painful disease, and in some depending
upon mechanical obstruction, such, for example, as
stricture of the rectum, called upon to prescribe. But
to hope to cure constipation by purgatives or sleeplessness
by narcotics is to entertain a delusion, to attempt it is
to be led into a snare ; and it is the having done s.o which
has, I believe, led to that general scepticism as to the
value of medicines at all which has been so prominent a
feature of therapeutics during the last fifty years.
The allopathic principle directs the prescription of a
medicine operating directly on a part of the tody at a
distance from that which constitutes the centre of disease.
Of this, croton oil given in apoplexy is an example. It is
one which tends to complicate disease rather than to
relieve it; to create additional mischief rather than to
cure that which already exists.
Finally, I come to consider the homoeopathic principle.
Homoeopathy consists in prescribing a medicine which,
when taken in health, will produce a condition similar
to that we desire to cure. It is thus the very reverse
both of the antipathic and of the allopathic principles.
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HOMOEOPATHY DEFINED.
73
That such a principle is one which is available in practice
has been recognized since the days of Hippocrates. The
history of medicine throughout all ages, and more especially
during the last century, teems with illustrations of the
successful empirical uses of drugs which on investigation
prove to have a homoeopathic relation to the condition
in which they were prescribed. Of the former, Hahnemann
collected a considerable series and published them in his
Organon der Heilkunst , and my colleagues, Dr. Dyce
Brown and the late Dr. Drummond, of Manchester,
have each published a large number of the latter.
We find, then, in the sfudy of empirical medicine a
sufficient amount of a priori evidence of the possibility
of the principle similia similibus curentur being one
leading to the selection of medicines capable of assisting
in the cure of disease. The question indeed comes to be,
not whether homoeopathy is true, not whether a homoeo-
pathically prescribed drug is a means of cure, but, first,
in how large a proportion of cases of disease it is so ; and
secondly, whether it enables us to cure more rapidly,
more safely, and more pleasantly than any other principle.
These are questions which experience, and experience
alone, can enable us to answer. This experience has been
furnished in abundance during the last hundred years,
and it teaches us that, with but few exceptions—exceptions
which were very clearly set forth by Dr. Hughes in a
lecture delivered at the London Homoeopathic Hospital
in 1882 and afterwards published in the Homoeopathic
Review for August of that year—this principle can be
advantageously adopted in nearly all instances. With regard
to the second question, this century of experience answers
it in the affirmative with unmistakable clearness and
emphasis. The evidence which has been adduced from
hospital and private practice, from the treatment of
epidemic diseases of the virulence of cholera and yellow
fever, from the maintenance of health in large public
institutions where in illness the inmates are treated
homoeopathically, attests that when medicines are pre¬
scribed homoeopathically disease is less fatal, its deviation
is less protracted, convalescence is less tedious, and those
sequelae which are occasionally met with after some acute
diseases are less frequent than when they are given on
any other principle known in therapeutics.
We practise homoeopathy, then, when we prescribe
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74 HOMCEOPATHY DEFINED, fifito.
medicines capable of producing in healthy persons a
condition like that we desire to cure. That we may so
practise it is essential in the first place that we ascertain
what conditions of ill-health drugs will give rise to.
Prior to the time of Hahnemann knowledge of the
iictions and uses of drugs was derived mostly from tradition
obtained by accident or from experiments on the sick ;
while of late years such knowledge has been sought for
by experiments on the lower animals.
A few years previously to Hahnemann's recognition
of the law of similars as a therapeutic guide, von Stoerck
and Stahl had made a few experiments with drugs upon
persons in health. These, however, were for the most
part resultless; and necessarily so, for as the late Dr.
Bristowe has said, “ We must admit the truth of the
homoeopathic view of the relations between medicines
and diseases before we can admit the special value
of investigations conducted only on the healthy.”
Hahnemann was, however, the first physician system¬
atically to examine the properties of medicines by observing
the effects they produce upon man in a state of health.
The experiments made by him were numerous, conducted
systematically, and in strict accordance with a series of
rules laid down by him in the Organon. The results are
given in the words of the experimenters themselves.
There was no terse theorising as to the tissues affected
or the manner in which they were influenced. The
symptoms produced, the sensations experienced, and the
appearances to which each substance gave rise have alone
been recorded. Hence these observations are valuable
for all time. Had they been given to us in the form of
inferences from the symptoms they would ere now have
been of little service. Pathology and physiology were during
the first years of this century in their infancy, and the
major portion of the physiological and pathological
theories based upon the supposed knowledge of that day
have given place to others—the result of wider and deeper
researches.
In addition to experiments made upon human beings,
cases of poisoning have furnished much valuable and
exact information as to the effects of drugs. In some
instances, too, we may add to our stock of knowledge on
1 Brit. Med. Journal , August, 1881 .
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HOMCEOPATHY defined.
75
this subject by studying the effects of over-dosing during
illness. Here, however, great caution is requisite in
drawing conclusions in distinguishing between the.
symptoms produced by disease and those excited by the
drug.
Experiments upon the lower animals are useful in so.
far as they enable us to trace back to certain tissues the
symptoms evoked during life. To rely solely upon such
observations in order to acquire a knowledge of the effects
of drugs upon human beings is misleading in many ways.
Different species of animals are often differently affected
by the same substance; while the functions of life are
differently performed by different species.
Moreover, in order accurately to compare disease
occasioned by ordinary causes with such as has been
produced by a drug, we require the expression both by
the patient and the prover of symptoms of sensations.
The existence of a morbid condition can only be realized
by symptoms and signs. It is- by these that we frame
our diagnosis, by these that we differentiate between
bronchitis, pneumonia and pleurisy; and it is by these
that we distinguish the most suitable medicine to prescribe
from one that is less appropriate.
It is often alleged against homoeopathy that it is a plan
of prescribing for symptoms to the neglect of conditions.
This is far from being the case. The condition is in truth
reflected, revealed by the symptoms, but then it is so not
by individual symptoms, but by all, by the totality of
them. It is the antipathic method which regards symp¬
toms merely, and then only some one or two especially
prominent ones. Now whatever theory may be entertained
as to the nature of a morbid process, be it the result of
one of the ordinary causes of disease or of a poison, if the
symptoms produced in both instances are closely similar
we have every reason to believe that the tissue affected
and the manner in which it is disturbed are in both
instances alike. Hence it comes that when prescribing
by the light of the totality of the symptoms we are most
surely prescribing for the disordered condition which
gives rise to those symptoms.
It is, then, by experiments upon healthy men and
women, and by the results of poisoning with individual
drugs, that we learn the pathogenetic properties of our
medicines. It is thus that our Materia Medica has been
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76 HOMOEOPATHY DEFINED,
built up; from these sources it is that we are enabled
to prescribe homoeopathically.
Having by researches of this kind been placed in a
position to use a medicine, we have next to consider how
it must be given. In the first place it must be given as
it was proved or experimented with, viz., alone and uncom¬
bined with any other. To give two or more medicines
in one draught is to give a substance regarding the action
of which we can only guess, the effects of each when taken
alone may be known, but what will be the result of their
collective administration cannot, for lack of previous
experiment, be predicted with any degree of certainty.
In order then that we may know what we are doing, we
must limit our prescription to one medicine. While in
order to practise homoeopathy it is essential to give but
one medicine at a time, doing so has other advantages of
no small importance. Not the least of these is that when
a medicine is prescribed in its simple form we are able
to determine its value in* a given case with far greater
accuracy than it is possible for us to do when it forms a
part of a mixture. Knowing from our experiments with
a given drug upon healthy persons the organs and tissues
on which it acts, for which it has a special affinity, we are
able to prescribe it specifically, and by giving it alone we
know that no other parts of the body are influenced by
our prescription. In this way we avoid all possibility of
producing perturbation in organs and tissues which are
so far comparatively healthy.
While the most satisfactory and the safest practice
is on all occasions to prescribe a single medicine, a method
has been commonly adopted in some cases of giving two
medicines in alternation, leaving an interval of time
between the dose of each, of greater or less length according
to the degree of acuteness of the illness we are endeavouring
to control.
On scientific grounds this practice is indefensible. In
all cases it should be our endeavour to discover a medicine
presenting in its proving symptoms similar to all of those
in the case before us. At the same time experience has
largely ratified the propriety of this latter plan in certain
instances. Notably has it done so in acute disease when,
with local inflammatory action, there is at the same time
high fever. The fever is checked by aconite, which is
inadequate by itself to control active inflammation of
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77
tissue. Take for example the case of pleurisy. Here
experience has taught us that by giving aconite alternately
with bryonia, disease is more rapidly relieved than when
we give either medicine alone. The proving of aconite
directs us to its use in sthenic fever, just as that of bryonia
does to its employment in inflammation of the pleura.
Though approaching the practice of polypharmacy this
method of alternation still differs from it. Each medicine
is given by itself, and, being so acts upon the part for
which it has an affinity ; an interval of time being allowed
to elapse before a second is given, there is small opportunity
for any complication of influences to arise. Again, when
two medicines are given alternately they are so because
the entire morbid condition is not completely covered
in its similarity by either. Hence the one may be assumed
to influence the part for which it has been shown to have
an elective affinity, and the other that on which it has
been found to operate. While, by being given in small
doses, the improbability of the action of the one interfering
with that of the other may fairly be Regarded as
considerable.
While, then, our aim should ever be to give but one
medicine at a time, we must be prepared to deviate from
this course in some cases; these b3ing, for the most part,
either such as are acute or chronic diseases of a complicated
form.
Secondly , the homcBopathically selected medicine must
not only be given in the form in which it was proved,
in that in which it gave rise to the symptoms which have
suggested it as a remedy, but it must be prescribed in a
small dose.
When we reflect upon what w r e are doing when giving
a patient a homceopathically indicated medicine, the
reasonableness, nav, the necessity, for the small dose
cannot fail to be apparent. In so prescribing, we are
giving a drug which previous experiment has assured
us influences the health of the very tissue or organ that
disease has rendered especially and peculiarly susceptible
to the influence of that drug. If, then, a given dose of
a drug will excite irritation in a tissue which is healthy,
which has from the mere fact of its being healthy a certain
power of resistance, how much less will be required to
affect that tissue w hen disease has diminished that power
of resistance. We may l;>e perfectly sure that it must
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78
HOMCEOPATHY DEFINED.
be considerably smaller, and that were we to give a large
dose we should but aggravate existing mischief.
When, however, we come to discuss the question, How
much smaller must be the therapeutic than the physio¬
logical dose ? our difficulties begin.
Nothing has contributed more to deter enquiry into
the value of homoeopathy as a therapeutic method than
the use of infinitesimal doses by those who have practised
homceopathically. This has arisen mainly from the
fact that medicines having, for the most part, been used
either anti- or allo-pathically, and therefore necessarily
in large doses, those who have become habituated to this
method have been unable to conceive of the possibility
of small doses, even when prescribed on a totally opposite
basis, having any influence on the tody. They have
felt so sure that nothing of the kind could happen that
they have refused to make any attempt to solve the
question by the only method capable of effecting its
solution— experiment. To argue that because five grains
of calomel are necessary to purge the towels, therefore
it is impossible that an infinitesimal dose of mercury can
cure an ulcerated sore throat, is obviously absurd. How
has it been ascertained that five grains of calomel are
required to increase the alvine evacuations? By experiment.
How has it been ascertained that an infinitesimal dose of
mercury will cure an ulcerated sore throat ? By experi¬
ment. Both conclusions must to—as they have been—
arrived at by experience. They involve a question which
nothing else will settle. “Experience,” says Sir John
Herschell in his Discourse on Natural Philosophy , “ Experi¬
ence once recognized as the fountain of all our knowledge
of nature, it follows that in the study of nature and its
laws, we ought at once to make up our minds to dismiss
as idle prejudice, or, at least, to suspend as premature,
any preconceived notions of what might or ought to be
the order of nature in any proposed case, and content
ourselves with observing as a plain matter of fact
what is.”
To this court of experience has been brought the
question of the dose of a homceopathically indicated
medicine in disease.
Of the necessity for giving but comparatively small
doses of medicines which stand in a homoeopathic relation
to the diseases in which they are prescribed, and of their
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HOMCEOPATHY DEFINED. 79
sufficiency, we have evidence which can hardly fail to
impress the enquirer into homoeopathy in the Handbook
of Therapeutics by Dr. Sidney Ringer. Many homoeo-
pathically indicated medicines are endorsed as remedies
by that widely-accepted authority; and wherever they
are so, the dose advised is much smaller, very much
smaller than that which has ordinarily been employed.
Thus the dose of aconite in inflammatory fever is stated
to be \ to J a drop. Of ipecacuanha in vomiting, a single
drop. Of corrosive sublimate in dysentery, yforth of a grain
is deemed sufficient. In infantile diarrhoea, half drachm
or drachm doses of an infusion of camomile flowers is
the dose recommended. The homoeopathicity of these
medicines to the conditions stated is too obvious to render
its demonstration necessary, while we all know that
the first exclamation of a practitioner of forty years ago
on reading such statements would have been, “ How can
such small doses have any effect ? ”
Dr. Ringer has tried these small doses, in the circum¬
stances in which he names them, and has found them to
be effectual. Other physicians from the time of Hahne¬
mann onwards have tried very much smaller doses under
similar conditions and have found them to be equally
serviceable.
We see, then, that we have both reason and experience
endorsing the principle of giving a smaller dose than that
known to excite a pathogenetic action, when the medicine
is one which is homoeopathically related to the morbid
condition we have to cure.
During the first few years of his homoeopathic practice,
Hahnemann used medicine in doses somewhat similar
to those now advised by Dr. Ringer. Subsequently,
he reduced the dosage to very infinitesimal proportions—*
led, as he tells us, to do so by experience. He has also
stated that such infinitesimal doses are essential to success
in prescribing homoeopathically, and in the later years
of his career he declared the thirtieth dilution—represent¬
ing the decillionth part of the original substance—to be
the best possible dose in all cases. This conclusion he
also bases on his experience. Illustrations of this experi¬
ence he has unfortunately left us no record. While,
however, we have ample evidence that medicines so
infinitesimally divided do, when given homoeopathically,
produce curative results, we have also abundant testimony
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80 HOMOEOPATHY DEFINED. U bS^ySS^!^&
that there is, save in exceptional instances, for the detec¬
tion of which we have moreover no clue, no necessity for
such minute doses.
As a matter of fact the dose of the homoeopathically
indicated medicine is influenced by a variety of circum¬
stances, such as, for example, the temperament of the
patient. Different individuals exhibit great difference
in susceptibility to the action of different medicines.
The choleric temperament has been observed to display
the greatest susceptibility and the lymphatic the least,
while the nervous exhibits a degree of sensibility to
medicinal action which is especially well marked.
The female is more easily influenced by medicine than
the male, while the two extremes of life are more readily
acted upon than the middle-aged.
Again, in a dry climate susceptibility to medicinal
influence is increased, while in one that is damp it is
diminished. In acute disease the action of the lower
dilutions has teen generally found more satisfactory than
has that of such as are higher, while in chronic cases
the reverse is very commonly regarded as being the test
practice. It is tolerably certain, I think, that medical
men engaged in active family practice, a large proportion
of whose work lies in the treatment of acute disease,
exhibit a preference for the lower dilutions and even the
crude drug, while the higher dilutions are preferred
mainly by gentlemen engaged in consulting practice and
who are mostly occupied with the treatment of chronic
ailments.
Then, again, certain medicines seem to be more effective
in a low dilution, while others are so in such as are high;
but even here the differences of opinion are so wide as to
compel the conclusion that they have teen formed either
upon a narrow basis, or that all the factors which should
have been considered in arriving at them have not had
due w r eight attached to them. Thus the late Dr. Madden
and the late Dr. Bayes have said that chamomilla is most
useful in the twelfth dilution, while Hirsch asserts that
to be of any service it must be given in the infusion.
Dr. Bayes pronounces the eighteenth dilution. of bryonia
as that which is test adapted to those cases of rheumatism
in which it is indicated, while Dr. Yeldham tells us that
he has had the greatest success with two or three drop
doses of the pure tincture, and the late Dr. Black with
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HOMOEOPATHY PEFTS-ED.
SI
the first, second or third dee- hiid so I might go on with
a large number of medicine? which are erediiod irr some
practitioners with being of greater value in one dose and
by others in another.
In the instances of such medicme* as mhJivr. $ili&a.
carbonate of lime , and lycvpodimn. nearly all the great
advantages which they have suyphed to the sick and the
physician have been obtained from the sixth, twelfth and
thirtieth dilutions. This is a fact which it is impossible to
deny, however extraordinary, however inexphcable it
may and does appear. To the min d of Hahnemann the
marvellous nature of the fact was no less present tlian it
is to us. He felt also how great would be the advantage
if some explanation could be given of it : if some means
could be found capable of accounting for it. It was this
longing for an interpretation* which must be present
to every intelligent physician and scientific enquirer when
brought face to face with a fact so incomprehensible, as
the medicinal power of a substance previously regarded
as inert, and that. too. in an amount of the utmost attain¬
able infinitesimality, that led Hahnemann to devise what
is called the dynamisation theory.
Thls theory* assumes that by the processes of rubbing
and shaking, particles of matter acquire a power of influ¬
encing the health of the body that they did not previously
possess, and that this power Is retained in very infinitesimal
particles to an extent which Is quite consistent with their
efficiency as medicinal agents. Hahnemann knew that
medicines very highly diluted did influence the health ;
he had proved, and his friends had proved, that fact at
the bedside too often to make it doubtful. So far all was
experiment and observation, and then came the desire
for explanation; and to gratify this desire the imagination
was brought to bear* upon it ; and when once we make
use of the imagination to solve physical problems we may
rest assured that we are entering on a course which is
full of risk, full of uncertainty. There would indeed
seem to be a by no means inconsiderable lmsis of proliable
truth for Hahnemann’s theory; for there is nothing
improbable in the supposition that powerful and active
friction should develop latent force in sulistanees appar¬
ently inert. No amount of friction can create medicinal
power in any form of matter, but it may set free that
which previously was latent. This idea was well worked
Vol. 40 No. 2 o
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82 HOMCEOPATHY DEFINED.
out by Mr. Sonstadt in a paper published by- him in the
Homoeopathic Review (vol. xiv). Every molecule of all
simple or chemically combined substances, he writes,
when “ in its entire state contains most of its energy in
a closed circuit (somewhat as does a magnet with its
keeper on), and while in this state so much of its energy
is potential, not actual. Every such molecule may be
torn asunder, and when divided the energy l>efore latent
Incomes apparent as force and able to do work.” After
some comment on this, he goes on to say, ” In the homoeo¬
pathic triturations at a certain stage of the process the
molecules are torn asunder by mechanical force (or by
forces engendered by mechanical force) and retained
asunder, thereby keeping an active virtue which appears
only momentarily in chemical processes.” There is,
therefore, nothing impossible, nothing absurd in the
dynamisation theory when this is restricted to conveying
the idea of liberating, and thereby converting into actual
force such as was potential. But if we were to hold that
by incessant rubbing we could create force, could produce
that which did not previously exist, or that such a process
could with advantage—that is to say, with an ever-
increasing development of force—be carried on ad infinitum,
then we should have passed the line when fact and obser¬
vation would Ijear out our conclusions ; and I feel tolerably
sure that at least 99 per cent, of homeopathic physicians
think so too.
I conclude, then, with regard to the question of the
dose, that in all cases where the homeopathic principle
is the basis of selection, the dose prescribed must lx» smaller
than that which is capable of producing a condition
similar to that it is desired to cure. Further, it is known
that in certain circumstances, and particularly with
certain medicines, better results are obtained in some
instances with low dilutions—that is, comparatively
speaking, large or material doses—and in others with
the higher dilutions, that is with infinitesimal doses.
As to the comparative frequency with which the lower
dilutions or such as are higher are preferable, there is
no sounder method of arriving at a conclusion than by
referring to the exj)erienee of physicians who have estab¬
lished a claim to our confidence as accurate observers
and honest recorders of their observations.
Fifty years ago, after many years of extensive and
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iEraWB?* homceopathy defined. 83
careful observation, Dr. Arnold, the then Professor of
Pathology in the University of Heidelberg, wrote : “ That
guided l3y experience he had arrived step by step at the
position that it is never necessary to administer medicine
in any dilution or trituration higher than the sixth decimal*”
And he adds that it is very seldom and only with very
susceptible patients and very powerful medicines that he
ever went so high as the fifth or sixth dilution, confining
himself generally to the first or second dilution or tritura¬
tion. In the six lowest decimal dilutions and tritura¬
tions he considers that we possess a scale suitable to
afford the corresponding doses for all present known
diseases.
Similar evidence has been laid before us at different
times by Dr. Drysdale, Dr. Black, Dr. Yeldham, and
others. In each instance, too, it must be remembered
these gentlemen had in their earlier experience l>een to
a considerable extent guided by the injunction of Hahne¬
mann to use only the thirtieth dilution.
This experience teaches us not that the higher dilutions
are inoperative, but that, for the purpose of obtaining
good results with homceopathically selected drugs, they
are unnecessary, that fully as good results can be secured
with more material doses.
It is possible enough that, now and again, in persons"
whose susceptibility to medicinal action in general, or
to that of certain drugs in particular, a few drops of a
low dilution may produce a temporary aggravation of
som? symptoms, but whatever risk of this kind there
may lie, it is rarely great and never important; while the
remark of Hahnemann in one of his earliest papers that
“ scarlet fever is a much more serious evil than a few
troublesome symptoms produced by a somewhat too
large dose of belladonna ” may l)e applied to all diseases
and all medicines.
For my own part, while I have frequently witnessed
good results from medicines given in a high dilution,
I am quite sure that I have much more uniformly done
good with the lower.
Further, when using low dilutions we have it in our
power to ascertain the actual presence of medicinal matter;
and that we should be able thus to test the integrity of
our pharmaceutical preparation is a matter of considerable
importance. When employing higher dilutions we have
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84
HOMCEOPATHY DEFINED.
not this control, and must either rely on someone else
or make them ourselves.
As a general rule, then, it is well to rely chiefly upon
the lower dilutions. At the same time, when having
prescribed a medicine in such a form which we are perfectly
satisfied from a study of the Materia Medica corresponds
accurately to a patient’s state, it is found that improve¬
ment does not follow which ought to occur—change the
dilution rather than the medicine.
Such, then, are the principles of that method of drug
selection known as homoeopathy.
A medicine is prescribed which is known by previous
experiment—not as in empiricism on the sick—not as is
still too exclusively the case by pharmacologists on the
lower animals, but by experiment on healthy human
beings, to produce a condition similar in all its features
to that it is sought to cure. Such a condition is recognized
both in the action of the drug and in the person of the
patient, by the symptoms both subjective and objective
which it presents.
This medicine is given in the form in which it was
experimented with, and without being mixed with any
other drug.
Further, the dose in which it is given is one w T hicli is
smaller than that necessary to evoke the symptoms which
enable us to see in it a suitable remedy for our patient's
case.
To carry this therapeutic method into practice one form
of medical knowledge is especially important, viz ., the
pathogenetic action of drugs. Unless we fully understand
what effects the drugs we use will produce upon healthy
human beings, it is impossible for us to prescribe them
in disease.
What then is the kind of knowledge of the action
of a drug which is required ?
First of all we must form a study of the effects it pro¬
duces to determine the direction in which it modifies or
disturbs the health of the body. But we must go further
than this.
- We must know how it influences the tissues, must
understand its mode of action, the kind of action it exerts,
or at any rate must be well informed as to how it manifests
its influence upon them. The simple fact that a drug
produces diarrhoea is not sufficient to justify us in
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^dS)fl?b I Ti902 hiC HOMCEOPATHY defined.
85
prescribing that drug in every case of diarrhoea we meet
with. In order to get a truly curative agent in such a
case, we must endeavour to ascertain the morbid con¬
dition of which the diarrhoea is the practical outcome,
both in the case of the drug and of the disease. At any
rate, we must ascertain the mode in which the drug
diarrhoea and the natural diarrhoea are expressed. The
character and frequency of the stools, the presence or
absence of pain, and when present, its position, its
character, and the conditions under which it is aggravated
or relieved—these, together with concomitant symptoms,
symptoms that are present at the same time in the head,
chest, or other part of the body, must be carefully studied,
ere we can be fully satisfied that we have a homoeopathic
remedy for our case of diarrhoea.
In forming a diagnosis, in the endeavour, that is, to
trace the diarrhoea to some specially disturbed tissue or
condition, we direct our attention to just such circum¬
stances as those now detailed; on the results of our
enquiries do we form our conclusion as to the disease
with which we have to deal. The action of a drug on
the healthy body gives rise to an artificial disease, and
the tissues affected are to be ascertained precisely in the
same way as they are in natural disease. Hence we have
to study the actions of drugs much in the same manner
as we have to investigate the processes we call diseases.
We have to examine the symptoms produced by each
drug, and endeavour to trace them to some definitely
disordered condition. Occasionally our best designed
efforts in this direction will fail, and then we fall back
upon a minute comparison of the indications of the morbid
process at work, with those afforded by drugs of the
morbid processes they set up. Feeling, in so doing,
thoroughly assured that when the manifestations—the
symptoms—are, in their totality, closely alike, the con¬
ditions determining both are very similar.
While, then, the right comprehension of a medicine’s
sphere of action, or a correct understanding of the nature
of its effects on individual organs and tissues are essential
to enable us to appreciate the value, interpret the meaning,
and gather the connection of the various symptoms
occurring in different parts of the body—we must not
rest satisfied with this amount of knowledge. We must
carefully study the individual peculiarities of each drug,
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86 HOMOEOPATHY DEFINED.
if we desire to be as successful in curing disease as the
means at our disposal admit of our being.
It is to allow of our prescribing, not merely for
diseases, but for cases'of disease, that the Materia Medica
has received that amount of painstaking, careful and
minute examination that it has done from Hahnemann,
and from all who have endeavoured to follow in his foot¬
steps.
To ascertain the pathogenetic properties of drugs ex¬
periments on a large scale, conducted in a singularly
careful manner were instituted by Hahnemann and
his pupils on themselves and their friends. These were
carried on during many years, and their results recorded
and arranged by Hahnemann in his work entitled The
Materia Medica Pur a. It was termed pure not because
Hahnemann assumed it to be spotless or faultless, but as
being free from fiction, that is from preconceived theory
or hypothetical notions, and as embodying the results
of pure observation of the phenomena produced by drugs
upon the healthy organism. Further, cases of poisoning
have supplied a most valuable source for studying the
action of drugs. Experiments similar to those made by
Hahnemann and his pupils were undertaken by Professor
Jorg, of Leipsic, in 1824, by a society of Viennese phy¬
sicians in 1842. American observers have also largely
added to our knowledge of the effects of drugs, and in few
instances we are indebted to some of our own countrymen
for similar experiments.
The manner in which Hahnemann arranged the results
of his experiments, cutting them up into an anatomical
scheme instead of presenting them as they occurred, has
added greatly to our difficulties in getting at the real
action of the substance. The efforts of modern authors,
in studying individual drugs and in comparing their
pathogenetic effects with the clinical results which have
followed their use, have, however, done much to deprive
Hahnemann's plan of its disadvantages.
The vast number of symptoms recorded as the effect
of some drugs is a cause of much bewilderment at first
sight. But a little study and reflection will soon disperse
the cloud thus raised. It must be remembered that
Hahnemann carefully noted every apparent disturbance
of health in every one of his provers; he has published
every symptom he could find attributed, with apparent
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homceopathy defined.
87
justice, to every case of poisoning he could meet with in
medical literature. Hence, we often find the same symp¬
tom frequently repeated in different words, each being
numbered as though it were a different symptom or
indication of some other form of disturbed health. This
alone sufficiently explains the large array of symptoms
met with in our registry of drug-provings.
The same comprehensiveness and minuteness of obser¬
vation accounts for the considerable number of symptoms,
which physicians, who are accustomed to pay attention
only to the grosser and more marked indications of
disease, not unnaturally regard as trivial, as fanciful, and
as unworthy of notice. That they are often important,
that they are indeed real manifestations of morbid action,
and that they have proved of value in deciding the
relative claims of two otherwise similarly-acting remedies,
is the testimony of every physician who has surmounted
those prejudices of education which run counter to their
taking notice of such phenomena, and been ultimately
guided in his selection by them.
In studying the results which have thus been accumu¬
lated for the purpose of converting a drug into a remedy,
we must in the first place obtain a clear conception of the
sphere of a medicine’s action. We must gather from the
symptomatology whether the nervous system, the cir¬
culation, or the great function of nutrition is most
disturbed ; what tissues, whether serous, fibrous, mus¬
cular, or areolar, are throughout the body most prone to
be affected. The reading of the symptoms by the light
which physiology and pathology have afforded will seldom
fail to give us an accurate knowledge of the general action.
We thus learn whether the organism is excited or depressed,
whether the class of cases to which the medicine will prove
homoeopathic is characterised by sthenia or asthenia.
The information thus attained is, as will easily be seen,
often of the highest value in practice.
Secondly. Having studied its general action, we next
investigate the local modifications produced by our
medicine. W T e carefully examine the symptoms which
have been oljserved in each organ, and from this exam¬
ination we ascertain for what organs it has an elective
affinity. It is in the fact that each drug influences one
or more organs in preference to others, that we find
a chief reason for our confidence in prescribing specifically.
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HOMOEOPATHY DEFINED. M ^S r fFeb° ( TflW?
Further, having ascertained the organ for which a
drug has this elective affinity, we enquire on what part
of the organ, what particular tissue of it, its action is
excited. Is it, for example, the malpighian circulation,
or the secretory cells of the convoluted tubes that a medicine
attracted to the kidney attacks ?
And yet, again, we must discover the kind of action it
sets up. Does a given drug stimulate in the first instance,
or is it a depressant ? It sets up morbid action in a given
part of a given organ—and then comes the question,
What is the nature of the action thus set up ?
Regarded in its true light, the study, so far, of a
medicinal proving is but the introduction to its clinical
application. It enables us to understand more clearly its
individual peculiarities, to recognize, more readily, the
forms of disease in which these peculiarities are likely
to occur, and to group the whole symptomatology in a
manner calculated to fix a large though rough proportion
of it in our memories.
But in not a few, especially chronic cases, there is but
one course to pursue, and that it is a tedious, wearisome
course, is true; nevertheless, it is one that is eminently
satisfactory in its results. Having examined a case with
the utmost thoroughness, w T e look up the symptoms one
after the other in the Repertory, or index of individual
symptoms produced by drugs that have been experimented
with, and then by reference to the proving or series of
experiments made with the drug to which the repertory
has directed us, ascertain how far its effects include not
only the symptom or symptoms the repertory has credited
it with the power of producing, but all others which
reflect the patient’s condition.
In the early days of homoeopathy, ere the genius, so
to speak, of the proved drugs was fairly understood, and
before any considerable body of clinical evidence had
confirmed the estimates that had been formed of the
sphere of each, this method was inevitable in all cases,
it is so still in some; though as pathology and pharma¬
cology approach nearer to perfection, such cases diminish
in number. “ So many morbid states,” says Dr. Hughes,
“ are known to us only as an assemblage of phenomena
that there is no other way of treating them than by
comparing them at the time with our pathogenetic
records, and fitting drug symptoms to those of disease.”
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ALLOPATHIC LEAVINGS.
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This minute comparison of the symptoms produced
by a drug with those present in a case of disease appears
not only mechanical but simple and easy. All, however,
that is necessary in order to convince an enquirer that he
must bring specially trained intelligence to bear upon
carrying it out is, that he should try it. At the same time,
one great object that we should ever have in view, is—■
so to perfect our knowledge of pathology and pharmacology
as to lessen the number of cases in which the mere
mechanical method is the best that we can resort to when
applying the law of similars in practice.
For the purpose of performing a personal study of
Materia Medica no enquirer into practical homoeopathy
can do better than read carefully the last edition of Dr.
Hughes’ work on Pharmacodynamics.
The Lectures on Materia Medica by the late Dr. Carroll
Dunham, of New York, form another and very valuable con¬
tribution to our knowledge of the action and uses of drugs.
The Hahnemann Materia Medica, published by the
Hahnemann Publishing Society, though containing but
few medicines, is the work which of all others enables
one to gain a fuller insight into the effects of drugs, and
at the same time to study their effects in relation to in¬
dividual cases better than any.
Some years ago an enormous work in ten volumes,
edited by Dr. Allen of New York, placed at our disposal
a large collection of observations. The index to it
simplifies its consultation greatly. At the same time
repeated examinations have revealed the fact, that it is a
work which requires considerable revision, and one also
which might with advantage be greatly diminished in
bulk by excluding from it a number of drugs of little or
no value.
But by far the most useful and reliable work on the
effects of drugs upon the human lx>dy which the student of
materia medica can resort to, is The Cyclopcedia of Drug
Pathogenesy, edited by Dr. Hughes and the late Dr. Dake.
Monkton, near Ramsgate, Jan., 1902.
ALLOPATHIC LEAVINGS.
By Stanley Wilde, L.R.C.P., L.R.C.S. (Edin.).
A.B., bus driver, set. 60, ran the spike of a harness buckle
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90 ALLOPATHIC LEAVINGS.
into his right forefinger, which set up inflammation and
suppuration. He attended as out-patient at the local
hospital, where the finger was several times incised to
evacuate pus. Notwithstanding this, and local antiseptic
treatment, the finger refused to heal, and the 'patient
was informed that nothing further could be done , and
that he must have the member amputated .
As he afterwards told me,* he felt that his occupation
would be gone if he lost his finger. In his extremity,
someone recommended him to “ try homoeopathy,” and
so he came under my care. The finger was certainly in
a bad state ; slashed about by incisions, suppurating,
and looking unhealthy and altogether rather hopeless.
Surmising that the healing process was prevented by a
septic state of the blood, I presented Lachesis 6 every two
horn's.
Three days afterwards the patient came saying that
he felt tetter in himself than he had teen since the accident,
and, already, the finger had a healthier appearance.
A lotion of Calendula was kept constantly applied as
a compress.
Improvement steadily set in, and at the end of ten days
Silicea 3 was substituted for the lachesis.
This constituted the whole treatment, and in four
weeks from the time he came under my care the finger
was well, and the man is now driving his bus as usual.
W. I)., let. 26, contracted syphilis two years ago in
India. Has teen under much treatment and excessive
drugging, especially by iodide of potassium, which has
left him in a very low and debilitated condition. He
stated that he could not stand any more of it, and desired
to try what homoeopathy would do for him. Present
state : Seems mentally sluggish, apathetic and depressed.
Speaks slowly and with a certain amount of difficulty.
Gets acute pains in the head, worse at night. Pulse
slow; circulation feeble; much chilliness. On walking
he is inclined to stagger, and the gait is uncertain. The
knee-jerk was deficient, but not absent. No eye-symptoms;
no pains in the legs.
Aurum mur. 2x, two drops four times a day, was pre¬
scribed in June, 1901, and he continued the remedy,
with manifest improvement, until October. A great
change was then noticeable in the patient. He was alert.
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THE twentieth century fund. 91
walked steadily and normally, spoke more briskly, and
seemed altogether a new man. The pains in the head
were also greatly benefited, and he now only had occasional
pains, referred to the right mastoid region. Acid, fluoric,
6 , followed by Silicea 6x, gave him relief, and, after two
years of inability to do any kind of work, he is now turning
his attention to obtain employment.
J. M., set. 49, tailor, has been suffering for the last
twelve months from the effects of over-work and worry,
during which time he has been under four doctors who
had, to use his own w r ords, “ drenched me with tonics
which haven't done me a bit of good,” in fact, he had been
growing steadily w r orse. He came to me on September
30, 1901, complaining of being dreadfully low and de¬
pressed ; cannot sit to his work ; has to rush out of the
house if he attempts it. Says that if he lies down during
the day he has uncontrollable thoughts of suicide. Suffers
much from insomnia; w akes in early morning about
2 or 3 o'clock, and cannot sleep again, and feels very bad
then. Has obscure nervous sensations, and pains about
his head. Pulse small and feeble.
Prescribed Aurum mur. 2x, four times a day, with hot
beef-tea at bedtime, and some light nourishment on
awaking in the early morning.
The report of the case from my note-book is as follows :—
Oct. 8.—Feels better, less depressed, and is beginning
to sleep better. Rep.
Oct. 18.—Going on well. Rep.
Oct. 25.—Looking very much better, and sleeping
well now; spirits greatly improved; says his friends
“ wonder what he has been doing with himself.''
After this his attendance became less regular, but at
his last visit he informed me he had resumed his occupation
as a tailor for the first time for over a year.
Cheltenham, Jan., 1902.
THE AIMS OF THE TWENTIETH CENTURY FUND.
By D. Dyce Brown, M.A., M.D.,
Consulting Physician to the London Homoeopathic Hospital.
The aim of the Fund is the promotion of the interests
of homoeopathy in its widest acceptation. I do not propose
to enter fully into detail, as the details have not yet been
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92 THE TWENTIETH CENTURY FUND.
decided on by the subscribers, but merely to put forward
prominently the general aims to be kept in view in
eliciting the support of the whole homoeopathic body,
both medical and lay.
First, there is the field of advance and progress among
ourselves. We shall be glad of, and hope to obtain prov¬
ings of new drugs carried out in a complete manner such
as will be deteimined on by the management, and also
to obtain re-provings of drugs which have hitherto been
imperfectly proved and are relied on chiefly for their
tried clinical value. This clinical value, though important
in itself, is still more so, and will command more general
confidence, when shown to be in harmony with full and
complete provings. The Fund would probably endeavour
to assist, pecuniarily and otherwise, those who will under¬
take this work and who could not without Such help
accomplish it. It would also endeavour to assist such
promising young homoeopaths to visit other schools,
continental or American, as may be decided on and to
study their methods. And to assist young men in
the prosecution of special studies for which they may
seem markedly fitted. It should endeavour so to organize
a mutual co-operation of the homoeopathic hospitals and
dispensaries of the United Kingdom as to utilize to the
full their practice and results, while it would endeavour
to promote the establishment of new cottage hospitals
by the advice, influence and co-operation of the subscribers.
It will thus aim at organizing on a practical basis and in
a spirit of union all the available sources of strength in
our cause. These aims are so far confined to ourselves,
and our mutual progress and co-operation, and so
to equipping ourselves for more active elements of
propaganda.
II.—But the ultimate aim is the most important
and far-reaching of all. That is to adopt a distinctly
militant attitude in pushing the claims of homoeopathy
and our rights as fully qualified practitioners among
the old school practitioners, recent graduates and students,
and also among the public, and so compel attention to
our doctrines and practice. The ignorance of these—our
doctrines and practice—among the doctors of the old
school is simply lamentable. Men, astonishing to relate,
think nothing of giving an adverse opinion on a subject
on which, when straightly questioned, they show they
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TWENTIETH CENTURY FUND. 93
know nothing about, and what is more astonishing, do
not scruple to admit, after giving an opinion, that they
knew nothing about the subject. And this is in the
twentieth century—a course of action that in any other
sphere of knowledge would be treated with the contempt
it deserves. It is all the more necessary to carry the
war into the enemy’s camp, since, as is well known, a
very considerable number of our remedies are used sub
rosa by the old school, but only in an empirical manner
on the authority of Dr. So-and-so. Such empirical
practice cannot but frequently fail to attain the desired
result, and as a consequence the said remedies, “new
remedies ” as they are called, are relegated to the past,
and in the hands of those few who have a smattering of
homoeopathy and use these remedies knowingly, homoeo¬
pathy is much injured. They say “ We have tried so-and-
so and it was a failure,” the failure being due to the
ignorance of the method of using the remedies, a method
which these practitioners do not care to take the trouble
to study and learn. How can anyone make full use of
a new tool unless he previously takes pains to know what
it will or will not do, and how it is intended to work ?
Such information we propose to give, not only in the
quiet, easy-going way we have hitherto adopted by means
of our journals and societies, since our journals are not
seen by the old school except in an infinitesimal degree
and by accident, as it were, while the presence at our
societies of any old school visitor is a very rare occurrence.
We want specially to get at the post-graduates, students,
and the young practitioners, since those in full practice
are afraid to openly l>e suspected of touching the imclean
thing for fear of possible consequences. Still we must
get at them also, and keep “ pegging away ” in the hope
of ultimate success and in the belief that such, success
must sooner or later reward us. How is this, then, to
be accomplished ?
(1) We must have a systematic course of lectures on
our two special subjects : (a) Materia Medica ; and (b)
Practice of medicine. We must at first confine ourselves
to these two branches, which sharply distinguish and
differentiate the homoeopathic and allopathic practices.
Whether these courses of lectures shall be delivered in
London only, or, as has l;>een proposed, in the leading
provincial cities in rotation, if not permanently, as well
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94 THE TWENTIETH CENTURY FUND.
as in London, is a matter of detail to be afterwards settled.
But they must lie commenced in London, and when the
lecturers have been selected they must lie sufficiently
paid for their time and labour. There may be some
difficulty in getting at the names of post-graduates,
students and practitioners who would be really glad to
know something reliable of the doctrines and practices
of homoeopathy, but it can be done; it lias been done
lief ore, and it can lie done again. The mode of doing this
is a method of detail in management. Next, at the end
of a course of lectures, there must be an examination of
those who wish it, in their knowledge of homoeopathy
and their consequent fitness to practise it successfully.
Those who pass this examination ought to receive an
official statement of the fact in the form of a certificate
or some kind of document equivalent to a diploma (also
a matter of detail) which would at once give a young
man a position when he commenced private practice,
and 1 x 3 an assurance to his patients that he is really com¬
petent to treat them satisfactorily. Such a document
would be a really valuable asset in the hands of any young
practitioner.
We shall Ije told that this is in some measure a revival
of the former “ London School of Homoeopathy.” Well,
and if it is, why not ? Many successful schemes in all
branches of literature, science, and business have failed
once and again, and have ultimately been a complete
success when its promoters were in earnest and resolved
not to let one failure lie a reason for counsels of despair.
Let us therefore determine to have another “ tiy ” and
yet- another, if necessary, till we succeed. Our motto
must lx* “ Try, try, try again ” till the goal is reached.
We must succeed in time, and now is the time for our
resuscitation of the course of lectures. Many a young
man who would gladly know about homoeopathy has
to complain that there is no means of his learning it
except by the private study of books, which to one nurtured
in old school works seem difficult, dry, or even hopeless.
Let us, therefore, once more give such the opportunity
they would wish.
Again, the clinical teaching in the hospital wards and
in the out-patient department must be energetically used
to act as a complement and practical illustration of the
teaching inculcated in the lectures. After examining each
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^ri^f^b m iTl 902 hiC THE twentieth century fund. 95
case for themselves and agreeing with the teacher in the
diagnosis, the students should be told what medicines
are more or less indicated, and why, and why one out
of this list is selected rather than the others for prescription.
In our own experience we have found that half a dozen
cases thus utilized will give more sound and valuable
teaching than a cursory walk round a ward with a few
general remarks, or than a whole roomful of out-patients
who are rapidly prescribed for and sent away with a
certain medicine. With these two methods, the lectures
and the clinical teaching, a student will in six months,
or still better in a year, learn sufficient to start him fairly,
and with confidence in himself, in homoeopathic practice.
(2) We must also adopt other methods to reach those
who cannot, or will not, come to the lectures and clinical
teaching. How to carry out these aims is a matter of
detail to be afterwards discussed. But we consider that
the publication of special literature, on similar lines to
the “ Homoeopathic League Tracts,” for example, giving
a clear description of our tenets and practice, should be
systematically sent to all practitioners of the old school.
Though a large number of such would probably consign
this literature to the waste-paper basket, \ve believe a
sufficient number would read them, and we never know
how they may l>e thought over or what fruit they will
yield. Our part is to sow the seed and wait for the appear¬
ance of the ear and the grain.
In the future, how near we cannot say, this compara¬
tively small scheme of the lectures will develop into a
complete school of medicine. This cannot be even looked
for till the hospital has 120 beds, as till then it cannot
be recognized legally as a teaching hospital. And while
the complete building of the hospital capable of holding
120 teds is impossible at present, owing to the existing
lease of premises intervening between the main building
and the corner of Queen's Square, we must patiently
wait, and meantime te content to work on narrower
lines.
In carrying out our scheme of lectures, etc., we must
ignore any fear of sensitiveness on the part of the old
school, and fight for ourselves and our rights. The more
we seem to te afraid of active measures, the less progress
we shall make, the less we shall te respected, and the
more will they gradually but surely attempt to absorb
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96 THE TWENTIETH CENTURY FUND,
us and our views, and then turn round triumphantly
and say, “ This is not homoeopathy, but what we have
been using for long.” This must not be. We must show
a determined front, marshal our forces, and fight for our
rights and our existence as the party in the profession
who believe they are the custodians of the greatest law
in medicine ever discovered, and who, in virtue of this
custody, are bound to do all in their power to propagate
the truth, however distasteful such propaganda may be
to our opponents. We shall in the end be successful,
and we shall, moreover, win the respect of our opponents,
who are British, and who in their hearts admire an
honest, courageous and determined enemy. Let us
therefore resolve to use every endeavour to further our
glorious cause among those whose opposition is largely
due to ignorance, and to teach them by every method
in our power what one may term without irreverence
the Gospel—the Evangel—the Good News of the greatest
Truth in medicine.
Last, but not least, we must take the public into our
confidence, show them that we are in earnest, that our
beliefs are practical ones, and that we need their co-
operation and sympathy in a very up-hill battle. If we
do this we shall be strengthened in a wav we could not
be if we kept the battle entirely in our own hands. In
these democratic days public opinion rules everything. Its
aid is enormous, and if this aid is neglected we have only
ourselves to blame in the issue of the struggle. It is with
this feeling that on the “ Grand Committee ” it is resolved
to have a large number of laymen, and, we believe, of
ladies, and thus to make the “ plan of campaign ” one
in which the whole clientele of homoeopathy will be united
to effect our object. We all know how intensely interested
our patients are in the development and spread of the
beneficent system of treatment in which they so believe,
and to which they trust their lives in the most serious
illnesses, and they will, we are sure, gladly co-operate
with the medical element in furthering any reasonable
methods of propaganda. The public have really as much
interest in the spread of homoeopathy as we doctors have:
they rejoice when they hear that the doctrines they
believe in are making steady progress, and look for the
time, as we do, when homoeopathy will become the
dominant practice, when, as in some parts of America,
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THE twentieth century fund. 97
homoeopaths are in the majority instead of being as here
in a minority. The relation between the medical pro¬
fession and the public is a mutual one. If the public
cannot get on without the doctors, the doctors cannot
exist without the support of the public. From them
also comes the large share of the pecuniary aid which is
necessary for the existence of hospitals and dispensaries,
and for the canying out of any important scheme of
advance such as we now aim at. And we shall be much
surprised if, when the details of the Twentieth Century
Fund programme are duly announced, they do not throw
themselves, heart and soul, into the movement. Let us
gladly invoke their sympathy and aid, give them a large
share in the governing management of the scheme, avail
ourselves of their advice and business capacity, and so
with such a powerful homoeopathic phalanx show to the
world what can be accomplished by their and our united
efforts.
THE TWENTIETH CENTURY FUND.
Statement by Dr. Byres Moir.
Owing to an inadvertence we were unable last month to
chronicle the progress of the Twentieth Century Fund
since its inception. Here following is an epitome of its
headway up to the present:—
The Council of the British Homoeopathic Society,
acting on instructions from the first Sessional meeting,
have appointed an Interim Committee to develop the
scheme and submit it for discussion and approval at a
public meeting to be called early in this year. To this
meeting all the members of the Society, and all the in¬
fluential lay friends of homoeopathy, will be summoned.
The invitation will be issued at an early date.
Intimations of subscriptions toward the fund have
been received in gratifying degree by the Treasurer. An
old and honoured friend of homoeopathy (Capt. Cundy,
of Surbiton), at present heads the list with an offer of
£250. The first announcement of subscription (from Dr.
Spencer Cox) was made w r ithin a few hours of the
Presidential address. At the time of public meeting we
have reason to expect a first list of subscriptions of a very
satisfactory character will be announced.
Vol. 46, No. 2. 7
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REVIEWS.
Monthly Homoeopathic
Review, Feb. 1, 1901.
Several distinguished lady friends of homoeopathy have
formally joined the movement, and we anticipate material
aid from a Ladies' Branch of this forward movement.
The members of the Interim Committee (the President,
Mr. Knox Shaw, and Dr. Byres Moir), will be glad to
receive further names of Ladies desirous to associate
themselves with the organization of the fund.
Besides professional men, an important body of laymen,
comprising many of the leading names in British homoeo¬
pathy, have joined the movement. So soon as a special
description of the aims and objects of the fund, now being
written by one of our best known professional literary
men, is in circulation, we look for numerous and weighty
further additions to the list of lay homoeopaths in Great
Britain, as co-operating with us.
Prom our professional brethren already appealed to,
a most gratifying response, in many instances an enthusi¬
astic response, has been received. Not only statements
of personal adhesion have been sent in, but a long list of
names of influential homoeopaths, has teen compiled,
on information supplied by our colleagues. The movement
is already of national dimensions ; the more widespread
and fervid the interest evoked the more permanent will
be the issue. We close with a suggestion to all who have
not yet responded to the Committee's circular, to do so with¬
out further delay.
REVIEWS.
Pocket Manual of Homoeopathic Materia Medica, comprising
the Characteristic and Cardinal Symptoms of all Remedies.
By William Boericke, M.D., Professor of Materia Medica
and Therapeutics at the Hahnemann Hospital College of
San Francisco. San Francisco: Boericke & Runyon
Company, 1901.
The aim of this excellent book is fully achieved by its author.
It is intended to be carried in the pocket, and is of such a size
as renders this an easy matter, although it consists of 562 pages.
In order to make it possible for so much to be carried in the
pocket, it is printed on very thin but beautiful paper, and the
type is so clear as to be no strain on the eyes when driving
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REVIEWS
99
about. The aim of the book is that it should be a constant
reference-book in daily practice, to refresh the memory, and
assist the busy practitioner in selecting the right remedy,
when actually engaged in his daily round. It contains as the
author says, “ The maximum number of reliable Materia Medica
facts in the minimum space.” And so it does. Each medicine
is prefaced by a general short sketch of its action, and then
in the schema form, we have the essential symptoms of each—
so clearly and concisely put. The dosage is left purposely
wide, and only suggestive—not dogmatic. Dr. Boericke’s
position as Professor of Materia Medica and Therapeutics
renders him peculiarly the suitable man to make this epitome
of drug-symptoms, and he has succeeded in his task in an
admirable manner. It is one of the most perfect little books
of the kind we have seen. It would be difficult to select
examples of his method, as each drug is treated in the same
careful and clear manner. But, beginning with A, aconite,
sesculus, aloe, anacardium and apis are excellent examples.
No book of this kind could be written without someone finding
out here and there an omission of what he looks on as an
important symptom, or mode of expressing it, but these are
so few as to make the exception prove the rule. Thus in apis,
when describing the diarrhoea, Dr. Boericke omits to draw
attention to the morning form of it, which is very charac¬
teristic, pathogenetically and clinically, and which is seldom
missed in cure by the remedy. Again in hydrastis, in describing
the tongue, the yellow stripe down the centre is hardly clearly
enough indicated. But these omissions are very few, and
one gets in a minimum space a clear and full epitome of “ the
characteristic and cardinal symptoms ” of each drug. The
symptoms peculiar to women have been “ examined and
enriched ” by Dr. Jas. W. Ward, the eminent gynaecologist of
San Francisco. This of itself ensures these symptoms being
reliable and accurate clinically. Under the letter U, caulo-
phyllum, chamomilla, chloralum and cimicifuga are admirable
presentments. As a sample of our author’s general sketch of
a drug before the detail of symptoms, opium is a fair example.
Here it is : “ The effects of opium, as shown in the insensibility
of the nervous system, the depression, drowsy stupor and torpor,
the general sluggishness and lack of vital reaction, constitute
the main indications for the drug when used homoeopathically.
All complaints are characterized by sopor. They are painless ,
and are accompanied by heavy , stupid sleep , stertorous breathing ,
sweaty skin. Dark mahogany-brown face. Want of sen¬
sitiveness to the action of medicine. Reappearance and
aggravation from becoming heated.” We give also the des¬
cription of the throat-symptoms of phytolacca : “ Much pain
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MEETINGS.
Monthly Homoeopathic
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at root of tongue ; soft palate and tonsils swollen. Sensation
of a lump in throat {Bell. Lack.) Throat feels rough, narrow.
Tonsils swollen, especially right; dark-red appearance.
Shooting pains into ears on swallowing. Pseudo-membranous
exudation, greyish white; thick tenacious, yellowish mucus,
difficult to dislodge. Cannot swallow anything hot ( Lach .).
Tension and pressure in parotid gland. Ulcerated sore throat
and diphtheria, throat feels very hot; pain at root of tongue
extending to ear. Uvula large, dropsical. Quinsy: tonsils
and fauces swollen; cannot swallow even water. Mumps. 11
We would strongly advise our busy colleagues to possess them¬
selves of this first-class vade-mecum. It takes up no room,
and will be of the greatest assistance in the daily rounds. We
congratulate Dr. Boericke on having produced such a valuable
and clear pocket-guide.
Cardiac Debility , By Herbert Nankivell, M.D., Consulting
Physician to the Hahnemann Convalescent Home. London :
E. Gould & Son, 1901.
We are glad to see that Dr. Nankivell has published the admir¬
able paper he read at the British Homoeopathic Congress in
Liverpool in September. His paper has already appeared in
full, with his excellent illustrations, in our pages, and no
doubt has been read with as much pleasure and profit by
those who were not present to hear it as by those who were.
The paper was in all senses a first-class one, and that this was
the unanimous feeling of those who were privileged to listen
to it testifies to its value. We need not therefore review the
pamphlet in detail, as it is in the hands of all our colleagues
through the medium of our pages, but we strongly advise any
who have not yet read it to do so at once. And we trust it
may come under the notice of our confreres of the old school,
who will learn much from it, and especially in the use of many
remedies of which they are probably ignorant. We wish it a
very wide circulation.
MEETINGS.
BRITISH HOMEOPATHIC SOCIETY.
The fourth meeting of the session 1901-2 was held at the
London Homoeopathic Hospital, on Thursday, January 2nd,
1902. Dr. Burford, of London, president, in the chair.
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MEETINGS. ;
101
New Members.
The following gentlemen were duly elected members of the
Society. Mr. Arthur Avent, L.R.C.P., L.R.C.S. Ed., L.F.P.S.
Glasg., L.S.A. Lond., of the Towers, Hampstead Road, Hands-
worth, Birmingham; Mr. Henry Arthur Clifton Harris,
M.R.C.S., L.R.C.P. Lond., of the London Homoeopathic
Hospital; Mr. Austin Edward Reynolds, M.R.C.S., L.R.C.P.
Lond., L.S.A., of Highcroft, Shepherd’s Hill, Highgate.
Section of Medicine and Pathology.
A paper was read by Dr. J. W. Ellis, of Liverpool, entitled :—
Neurasthenia and its Treatment by Homoeopathic Medication ,
of which the following is an epitome :—
In introducing the subject, Dr. Ellis alluded to the objections
that have been made to the use of the term neurasthenia as
being “ high-sounding and new-fangled,” and as meaning no
more than the more generally understood “ nervous debility.”
His experience, however, had led him to prefer the newer word
as the designation “ nervous debility ” is so frequently used
in connection with certain quack advertisements, and its use
to a sensitive patient may convey a painful and erroneous
impression and tend to shake his confidence in his doctor.
Neurasthenia is essentially a disease of civilised life, the
greater number of sufferers being met with among the pro¬
fessional classes. While it may follow any exhausting illness,
neurasthenia usually results from physical or, more frequently,
mental overwork, especially if this be combined with any
depressing influence.
A feature of neurasthenia is the variety and protean character
of its symptoms, the disease often changing its type during
the attack. The headache of this disease is usually charac¬
teristic, a dull, wearying pain, or a sense of weight or pressure,
having for its seat the occiput, from whence the pain extends
down the neck to the shoulders and arms or down the back;
or the head may feel as if it were compressed by a tight-fitting
cap or iron band. There is usually hypergesthesia of the scalp
with a sensation of crawling or numbness. Some complain
of muscular twitchings, but these head-symptoms have this
in common, they are invariably brought on or made worse
by any attempt at mental occupation or by emotion. Slight
vertigo accompanied by nausea and vomiting are often ex¬
perienced.
The mental condition of neurasthenics is often wretched
in the extreme. Some failure of mental power is an early
symptom. There is difficulty in concentrating the attention
on any work that may be in hand, and the loss of will power
causes the patient to lose confidence in himself, so that he
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cannot bring himself to perform even such a simple action as
writing an ordinary letter. A state of irritability of temper
and despondency is induced bordering on melancholia or even
monomania.
Insomnia is another frequent symptom in sufferers from
nervous exhaustion and may take one of two forms: either
an inability to sleep at all until the early hours of the morning,
or, more frequently, the patient goes to sleep easily, awakes about
2 a.m. and lies awake with the mind in a state of great activity
until 6 or 7 a.m., then falls into a heavy sleep often full of
horrible dreams, to awake later feeling more tired than when
he went to bed. Neurasthenic patients frequently suffer from
some affection of the eyes. The retina is in such a condition
of exalted sensibility that any attempt to use the eyes for reading
or writing causes pain.
So also are the auditory centres in a state of hyperaesthesia,
and such slight noises as the rustling of paper or silk cause
distress. Connected, too, with the auditory apparatus is the
pulsation, synchronous with the heart beats, that is very
annoying to some patients who complain of never being able,
as it were, to get away from the consciousness of having a
heart. There is often considerable pain in the spinal region,
extending either the whole length of the spinal column or
localised in the cervical or sacral, while many cases of coccy-
godynia are certainly neurasthenic. These spinal pains are
invariably made worse by movement. Neurasthenic patients
very frequently suffer from various forms of circulatory dis¬
turbance. Palpitation may be attended by a feeling of faint¬
ness, but actual syncope is far from common. Throbbing of
the abdominal aorta is a symptom that gives rise to much
discomfort. The medical attendant need feel no anxiety if
a certain amount of bladder irritability and a small trace of
albumin in the urine be constantly present. There may also
be unusual sexual excitement. In the other sex, neurasthenia
may be a result of ovarian or uterine suffering, but a large
proportion of cases met with in general practice of pelvic con¬
gestion, are simply localised manifestations of a general
diminution of nerve-force. An early symptom in neurasthenia
is muscular feebleness. Sometimes the loss of power is so
great as to preclude all kinds of locomotion. Or there may be
an appearance of increased muscular activity—twitchings and
contractions of the muscles of the neck and face, and “ fidgets ”
and cramps of the legs.
In the face of the pessimistic dictum of Professor Osier that
“ medicines are of little avail, strychnia in full doses is often
beneficial,” Dr. Ellis expressed his thankfulness for the teaching
of Hahnemann for the treatment of nervous exhaustion.
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No drug causes symptoms which so closely resemble those of
neurasthenia as picric acid , and no medicine had been found
to give such generally successful results. Oxalic acid is perhaps
more suitable where pain is a prominent symptom (as in spinal
neurasthenia), and where the stress of the attack falls upon
the digestive rather than the sexual functions. Phosphoric
acid seems to be particularly indicated when vaso-motor
depression is marked. Phosphorus might be reserved for those
cases in which vertigo is a prominent symptom, and will also
be found useful in cases of neurasthenia where sexual irrita¬
bility is a marked feature of the disorder. The iron salts have
a decided influence in depressing the tone of the vaso-motor
system, especially the phosphate and picrate of iron.
Three others deserve a place in this category though on a
somewhat lower standpoint. These are the oxide and phosphide
of zinc and silica. There are also several that are distinctly
efficacious in the various complications of neurasthenia, such
as cactus, spigelia, and nitroglycerine.
The discussion which followed was opened by Dr.
Goldsbrough, who dwelt upon the importance of discriminating
hysteria from neurasthenia, and then upon the characteristic
union of weakness with increased irritability, which was the
conspicuous feature of the latter condition in whatever organ
or system of the body it was found. He alluded to the import¬
ance of dilution in picric acid and other medicines, and
mentioned valerian and anacardium as useful. Drs. Dudgeon,
Dyce Brown, Byres Moir, Mr. Dudley Wright, Drs. Blackley,
Roberson Day, Stonham, Jagielski, and the president also
spoke, and Dr. Ellis replied.
NOTABILIA.
TWO LECTURES ON SOME THOUGHTS ON THE PRIN¬
CIPLES OF LOCAL TREATMENT IN DISEASES OF THE
UPPER AIR PASSAGES.
Delivered at the Medical Graduates’ College and
Polyclinic on October 2nd and 9th, 1901,
By Sir Felix Semon, M.D., F.R.C.P. 1
(Continued from page 61.)
“ But already previous to its appearance the unavoidable
reaction had occurred in the profession itself. Mr. Arbuthnot
Lane took up the cudgels against the massacre of the innocents
1 From the British Medical Journal , November 2nd and 9th, 1901.
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in two papers published in 1897 and in 1899. In the first he
declared that operative procedures were, in his opinion and
experience, ‘ quite unnecessary,’ and that ‘ systematic venti¬
lation of the lungs and naso-pharynx provided us with a means
not only of applying to the naso-pharynx such force as is exerted
by air being forcibly drawn through it, but by oxygenating
the blood more fully and removing more thoroughly the
carbonic acid, etc.’ All these desirable results were to be
obtained by systematic 4 breathing exercises,’ in poorer cases
a printed slip being given to parents containing the following
simple instructions : 4 Put the child on its back three times a
day for half an hour at the time, and make it breathe in and
out as deeply as possible through the nose, the mouth being
kept shut.’ The second paper brought important modifications
of these sweeping statements. Whilst in 1897 the author
had declared that operative procedures were 4 quite unnecessary,’
and that 4 unfortunately for the patients, surgeons under thfe
influences of the suggestion of Wilhelm Meyer had considered
that the secondary infection of the so-called pharyngeal tonsil
was the primary cause of the obstruction of the naso-pharynx,
and had hoped to cure the patients by cutting away a varying
portion of the substance,’ he was good enough to admit in
1899, that after all there was a 4 very small proportion’ of
cases in which the operation was required in order to 4 establish
a through way,’ or to 4 telescope the duration of treatment.’
He says in conclusion : 4 The only circumstances under which
I can understand the surgeon being warranted in attacking
the pharyngeal tonsil are : (1) When the condition has been
so thoroughly neglected that the child is unable to drive air
through the naso-pharynx, when development has been long
in abeyance until the enlarged pharyngeal tonsil has been
effectually removed; (2) When for some reason or another,
such as considerable difficulty in forcing air through the nose,
ear trouble, important school or other arrangements, peculiar
circumstances, etc., it is necessary or desirable to telescope
the duration of treatment; and (3) When the child is too
young to do what it is told. ’
44 1 think it is a very great pity indeed that Mr. Arbuthnot
Lane should not have stated in his first paper the indications
admitted in his second, which 4 warrant the surgeon ’ in teles¬
coping the duration of the treatment. Had he done so, it
would have been seen, I feel sure, that apart from his absolutely
unproven theoretical ideas as to the origin of adenoids, the
difference which separated him from the moderate section of
his surgical confreres was not one of kind, but only of degree.
For this moderate section also advises operation in such cases
only as he admits as legitimate in the concluding sentences
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of his second paper, and so far as matters of fact are concerned,
the only real point of contention between him and them is this,
that the cases in which operation should be performed, in his
experience, constitute ‘ a very small proportion only * of the
whole number, whilst they find that the very circumstances
enumerated by him—long-standing neglect, very considerable
obstruction, deficient development, ear troubles, important
school or other arrangements, ‘ peculiar circumstances,’ young
age of the patients—are met with considerably more frequently
than in ‘ a very small proportion only.’
“ Meanwhile, however, the wholesale condemnation of the
operation in his first paper, and particularly the suggestion
of the ‘ breathing exercises ’ had caught on. Society, ever on
the outlook for some novel sensation, is as fond of changing
its medical fashions as any other. Yesterday it was the bone-
setter, the marvellous voice-producer, a new method of dieting,
hygienic underclothing of some particular kind, antipyrin,
massage, thyroid tabloids, antifat, et hoc genus omne , that were
the rage of the town ; to-day it is some new medical genius—
‘ a perfect wonder, my dear ’—just discovered by a leader of
society or a prima donna; the Kneipp cure, or its degenerate
progeny, the sandal craze; Christian Science, rheumatism
rings, a new brand of Moselle, electric fight baths, that are in
everybody’s mouths. What it will be to-morrow nobody
knows; it is characteristic of Society’s rages that they almost
always have a very ephemeral existence. Thus with the
adenoid mania : The question, ‘ Have your children already
been done ? ’ was really becoming a little stale; fresh fields
and pastures new were wanted ; the difficulty was only to find
something original that would suitably replace the old fashion.
At last the revelation came—breathing exercises ! ‘ I thank
thee for that word ’ must have been the thought of many a
professor of calisthenics, massage, gymnastics, and corpulence
curer with a keen eye to business, who perceived that here a
new and promising opening offered itself. No sooner said than
done : departments for ‘ breathing exercises ’ were opened,
the public flocked to them in their thousands, a roaring trade
was and is being done at this moment, and children galore,
who otherwise would have been operated upon by the doctors,
are now, if reports be true, cured or enormously improved by
so simple a means as breathing exercises.
“ But are they ’?
“Well, gentlemen, I may be an incurable sceptic, but I have
no hesitation in telling you that I do not believe for a moment
that a single child which has got well-marked adenoids has
been, or ever will be, cured by breathing exercises, all reports
to the contrary notwithstanding. J mean no disrespect to
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Mr. Arbuthnot Lane, but I cannot help saying that the whole
idea seems to me preposterous. Whether adenoids be secondary
to ‘ infection of the nasal mucosa ’ or not, there can, at any rate,
be no doubt that they obstruct in well-marked cases the airway,
and thereby most efficiently prevent that ventilation of the
lungs which, according to Mr. Lane himself—and, may I add,
according to every reasonable observer before him who has
worked at the subject—is of such enormous importance. It
logically follows that the obstruction, whether primary or
secondary, must be got rid of as a first step towards enabling
the patient to breathe freely and to ventilate his lungs. This
surgeons have hitherto done—and no doubt will continue to
do—by ‘ telescoping the treatment,’ or, in other words, re¬
moving the obstruction in the quickest and most complete
way—that is, by operation—just as they would do under
analogous circumstances in any other part of the body. But,
according to Mr. Lane, this is, with a very few exceptions,
‘ unnecessary, imperfect and unscientific,’ since it deals only
with an effect, and not with the primary source of infection.
In view of the many thousands of cases, which beyond the
shadow of a doubt have been cured by the unnecessary, im¬
perfect, and unscientific treatment—and, mark you, by this
treatment alone—which Mr. Lane condemns, it certainly
demands some courage to make such a statement. His adver¬
saries, however ‘ unscientific ’ they may be, certainly have
facts on their side. And if it should be called 4 unscientific ’
to say plainty that the rationale of his treatment was a mystery
to them, I for one must plead guilty to that soft impeachment.
How a genuine lymphoid hypertrophy can ever be expected to
be dispersed by ‘ breathing exercises ’ completely passes my
understanding. Is it by the air being forcibly drawn over it ?
If that were possible, will Mr. Lane explain how it is that in so
many cases of much developed adenoids there are at the same
time much-enlarged tonsils ? It would seem to me that if
forcible breathing could disperse lymphoid tissue in those cases
in which nasal breathing is reduced to a minimum, and in
which the patients have thus been compelled to forcibly breathe,
not for half an hour three times a day, but all days and all
nights for many months or even years, the effect of the forcible
passage of air ought certainly to show itself in the disappearance
of the enlarged faucial tonsils, which in structure are so very
similar to adenoids. But, unfortunately for Mr. Lane’s theory,
these do not disappear; on the contrary, they flourish !—
On what grounds, then, are ‘ breathing exercises ’ expected
to act beneficially in cases of genuine hypertrophy ? Are they
to do wonders by imparting ‘ force ’ to the naso-pharynx;
or is it thought that half an hour’s ‘ oxygenation ’ of the blood
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three times a day in twenty-four hours will in such a miraculous
way alter the constitution as to make the actual obstruction
of the air passages disappear ? I fail to discover other argu¬
ments in Mr. Lane’s papers, and I hope he will not be too
indignant with me if I frankly state that his 4 breathing exer¬
cises ’ appear to me simply in the light of a scientific glorification
of the obsolete advice referred to in the introduction of this
lecture, and so freely administered to the unfortunate sufferers
before Wilhelm Meyer’s beneficent discovery, 4 Keep your
mouth shut. Shut your mouth.'
“ Not that I despise breathing exercises in their proper place.
On the contrary, for many years before Mr. Lane ever gave
public utterance to his ideas, I, like, I dare sav, most operators,
have been in the habit of telling mothers that after the re¬
moval of the obstruction, they must insist on the child’s learning
to breathe through the natural air channel—namely, through
the nose, and that if admonition alone failed to cure the habit
of mouth breathing, engendered by months’ or years’ impossi¬
bility of breathing through the nose, they must use for some
time some simple contrivance which covered the child’s mouth
completely, and compelled it to breathe through the nose.
An apparatus of that sort was recommended many, many
years ago by Professor Guye, of Amsterdam, under the name
of 4 contra-respirator.' It is nothing else but an anticipation
of Mr. Lane’s leading idea, the only difference being, in my
humble opinion, that it brings in 4 breathing exercises ’ in
their proper place, whilst Mr. Lane, if he will excuse me for
saying so, seems to me to put the cart before the horse.
“Now, I shall probably be told that all my theoretical objections
go for very little in view of the fact that the patients were
cured by the breathing exercises. But, I repeat, is it a fact %
I do not believe it. Not that I doubt the good faith of those
who think that they have seen cures, but I feel convinced that
in such cases transitory congestion of the lymphoid tissue in
the vault of the pharynx has been mistaken for actual hyper¬
trophy. In such cases I can easily enough imagine what has
happened. The lymphoid tissue, being very vascular, easily
becomes the seat of catarrhal inflammation, when it swells
considerably, and pro tern, may present all the symptoms of
genuine adenoids. Now suppose that a child was taken during
such an attack to a medical man because the mother wished him
to see the patient 4 at his worst/ a casual examination might
easily enough result in the verdict 4 adenoids, ’and in the advice
‘ operation.’ The mother, dreading operation, decides that
a trial should first be given to the 4 breathing exercises ’ of
which she has heard so much of late. The child is put through
a course which lasts several weeks, if not months, and all the
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symptoms disappear. That exactly the same result would
have been obtained if the child had simply been taken a little
care of, but otherwise been left alone, does not, of course,
enter for one moment into the consideration of the happy
mother (and how could it ?). Lavish praise is heaped upon
the breathing exercises to which alone the credit of the recovery
4 given ; and the doctor is severely blamed for having recom¬
mended a perfectly unnecessary operation. Considering the
frequency of these inflammatory attacks, and the readiness
with which nowadays the advice to remove adenoids is given,
the number of such cases, in all probability, is very considerable,
and it is easily enough intelligible that they should have lent
colour to a perfectly honest belief in the efficiency of breathing
exercises. But beliefs are not facts, and how little the actual
facts agree with Mr. Lane’s teaching the following case, which
recently occurred in my own practice, will show you.
“ A little girl had suffered for a long time from well-marked
obstruction of the naso-pharynx, mouth-breathing, thick
voice, snoring at night, commencing pigeon breast, tendency
to colds, earache, anaemia, and weak state of general health.
At the suggestion of the family doctor she was taken to a
distinguished surgeon, who diagnosed, as the family doctor
had already done, adenoids, and recommended their removal.
The parents being much averse to operation, took the opinion
of another authority, who advised breathing exercises. The
child was placed under a professor of Swedish gymnastics,
who makes, I am told, a speciality of such exercises, and for
two months assiduously went through a course. Meanwhile,
the parents flattered themselves that they observed considerable
improvement in the child’s symptoms, whilst the family doctor
was unable to perceive it. Whilst still under the treatment
the child caught pneumonia and nearly died. During the
acute disease her respiratory difficulty was so obviously in¬
creased by the impossibility of breathing through the nose that
the family adviser insisted that after her convalescence yet
another opinion should be taken. I was consulted, and found
the naso-pharynx crammed full of adenoids. Remember, this
child had been treated for two months with breathing exercises !
I, of course, warmly supported the family doctor’s and the
first consultant’s advice; the parents at last consented. The
child was operated upon by the surgeon first consulted, who
found, he told me afterwards, the naso-pharyngeal cavity, as
I had found it, crammed full of genuine adenoids, and who
added that he had quite recently received a letter from the
father, warmly thanking him for the genuine improvement
which since the operation had taken place in the child’s local
symptoms and general health.
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“ It did not require the lesson taught by this ease to convince
me of the untenability of Mr. Lane’s teaching, but it is valuable
as showing that practical experience no less strongly than
theoretical consideration militates against what I am afraid
1 must call an exaggeration in the ultra-conservative direction.
“ But whilst thus defending Wilhelm Meyer’s beneficent
discovery against the onslaught of a solitary adversary, I am
at least equally anxious to save it from the much more dangerous
indiscretion of its injudicious friends. There is not the least
doubt in my mind from what comes under my personal
observation, that a great amount of over-operation of slipshod
nature is going on with regard to adenoids, and if we wish to
prevent a good operation from falling into bad repute, it seems
to me necessary to come to a much more precise understanding,
as to the conditions under which operative interference should
be recommended and how it should be carried out, than exists
at present.
“ I would deduce the following principles as helpful:
“ With regard to the question of operation, adenoids may
fitly be subdivided into three classes, according to whether
they cause: (a) permanent, ( b) periodical and transitory,
(c) no symptoms.
“ The first class, the ‘ typical adenoids,’ embraces the cases
in which respiratory obstruction, open mouth, snoring, thick
voice, deafness, are all, or some of them, always present, and
in which the altered type of respiration may have already led
to the peculiar deformities of the face and chest, and to a general
debilitated state of health. In this class—in my experience
a very large one—I consider operation absolutely indicated,
and I advise it the more strongly the further away the child
is from the period of puberty, at which often enough, though
by no means always, spontaneous atrophy of the growths
occurs. For even if the condition should never become com¬
plicated, as it so often is in these cases, by inflammatory ear
affections, or by one or another of the febrile diseases of child¬
hood, the mere alteration of the natural type of breathing and
the deficient aeration of the lungs will, if unrelieved for years,
leave their ineffaceable traces in the physiognomy, physique,
and entire mental and bodily development of the patients.
Seeing that all these serious consequences of the obstruction
of the air-way and hearing channels can be prevented by so
simple and comparatively safe an operation as the removal of
adenoid vegetations, I hold it to be the practitioner’s bounden
duty strongly to urge operation in this category of cases. It
is the one which has established the well-deserved fair fame of
the operation, the result of which under such circumstances
is always very gratifying and often truly astounding. In
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exceptional cases this applies also to the removal of adenoids
in adults, but such cases are, in my experience, extremely rare.
M Much more difficult is the question of operation in the
second class, in which free intervals alternate with periods of
nasal obstruction and impairment of hearing, or attacks of
earache, and even of otitis media. This is the category pre¬
viously referred to, in which during the free intervals only a
very moderate, or hardly any, organised hypertrophy of the
lymphoid tissue may be present, but in which on the slightest
catarrhal provocation so much congestion and engorgement
occurs, that for the time all the symptoms of the first class—
the genuine adenoids—are closely simulated. It may well be
that opinions with regard to the advisability of operation in
one and the same case belonging to this class should diametrically
differ according to the period at which the little patient is seen.
A. sees him 4 at his worst,’ a mouth-breather, snuffing, with
thick voice, very deaf, and with some otorrhoea, and strongly
advises operation. B. sees him a few weeks later, when the
acute attack has passed off and all these symptoms have tem¬
porarily disappeared, and cannot understand why A. should
have recommended operation.
“ I may observe here that I am afraid that, owing to our
great familiarity with the affection, some of us pay insufficient
attention to the—often enough rather emphatic—statements
of the parents, governesses, or nurses as to the periodicity
of the symptoms. This, however, is a very important point.
It is just this class of cases in which the most experienced may
make mistakes. Suppose he urges strongly that the operation
should be performed as a prophylactic measure, suppose that
the advice is not followed, and that nothing serious occurs,
he is certain to be put down by the parents as an alarmist and
fanatical operator. Should the child meanwhile have gone
through a course of 4 breathing exercises,’ it is they which
get the kudos of the improvement. Suppose, on the other
hand, that, guided by the desire to spare the child a possibly
unnecessary operation, one votes against operation, or, at any
rate, in favour of postponement, and that unfortunately
shortly afterwards acute ear complications should arise, or an
abscess form in one of the lymphatic glands, or pulmonary
troubles occur, to which these patients seem rather prone—
one is equally severely blamed for not having spoken more
strongly in favour of an operation which might have obviated
all these deplorable and sometimes lasting consequences. What
I would recommend under these circumstances, although no
formula will fit all cases, and occasional errors of judgment
are almost unavoidable, is this : If a child be brought to you
4 at his worst,’ but with a definite statement that these attacks
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111
occurred only very rarely, that they lasted but a short time,
and that in the intervals the child enjoyed perfect health;
if you find some soft swelling of the lymphoid tissue in the
vault of the larynx, but no evidence of organic ear disease; and
if altogether you gain the impression that the child had been
brought much more because the mother was anxious than
because there were any really urgent symptoms, express a desire
to see the child again under, what would be for it, normal
circumstances, and postpone the decision with regard to opera¬
tion until then. If the symptoms be more grave, particularly
if there should be marked deafness, perforation of the tympana,
otorrhoea, enlargement of the lymphatic glands in the neck,
a tuberculous family history, vote in favour of operation as a
preventive of more serious events, which, in view of the cir¬
cumstances named, might reasonably be expected. If you
are in doubt yourself—as in these 4 half-way house ’ cases the
most experienced observer often enough is—let me recommend
you to lay as clear and non-alarming a statement as possible
of the actual conditions and of the various possibilities of
development before the parents, and let them decide themselves.
This course will equally protect you against being called an
4 alarmist ’ and 4 very fond of operations ’ on the one hand,
and against being accused of having 4 neglected ’ the case on
the other.
“ Concerning the third class, I have only to repeat what I
have said in the earlier part of this lecture, namely, that
adenoids which do not cause any symptoms do not, in my
opinion, require removal. One often enough in the course of
a methodical examination of the upper air passages discovers
a not inconsiderable amount of lymphoid tissue in the vault
of the pharynx, which evidently has never done any harm,
just as one often enough sees somewhat enlarged faucial tonsils
which have never given rise to the least inconvenience. Such
innocent hypertrophies should, I feel sure, be left alone, par¬
ticularly in adults, and all the examiner might tell the patient,
in order to safeguard himself against an imputation, that he
had 4 overlooked ’ the condition, is, that there was a slight
fulness, but that this, unless it should cause any symptoms,
did not require operation.
44 These are the suggestions which I have to make with regard
to the indications for operation. You will probably be sur¬
prised that amongst them I have not mentioned, by one single
word, the so-called 4 reflex neuroses ’ for which they are so
frequently undertaken. Well, gentlemen, in my second
lecture you will hear that I am a great sceptic with regard to
4 reflex neuroses ’ arising from the upper air passages in general,
and I will say at once that I am particularly so with regard to
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reflex neuroses said to be due to adenoids. I am not in the habit
of doubting the reports of others, simply because I have had
no analogous experiences, and I have already told you as was
my duty, that obscure affections of the most different kinds
have been attributed to adenoids, and are stated to have been
cured by their removal. Personally, however, I must say that
I have never performed any operation for adenoids for the
express purpose of curing one of these reflex neuroses, though
I need hardly tell you that in the course of the last twenty
years plenty of these cases have come under my notice. In
such of these cases in which I found an insignificant amount of
adenoid tissue and none of the classical symptoms accompanying
it, I have not been able to bring myself to the belief that asthma
epilepsy, enuresis, and similar neuroses, which had been
ascribed to the adenoids, were really due to them, and I have
therefore not seen my way to advise operation. But in cases
in which besides the reflex neuroses ascribed to them the
adenoids caused actual tangible respiratory and auditory
symptoms—and 1 have seen a good many of such cases too—
I have operated, always thoroughly explaining to the parents
beforehand, in order to avoid disappointment, that I advised
operation only for the sake of removing the obstruction which
interfered with breathing, hearing, and general development,
and that I could give no promise whatever as to the cure of
the reflex neurosis. That caution in my practice has turned
out to have been a very judicious one, for in not one single case
have 1 ever seen a so-called reflex neurosis disappear after
removal of adenoids in such a manner that I could rightly
have spoken of a causal relation between the two. True, in
a few cases I heard long afterwards that asthma, enuresis,
epilepsy, etc., from which little patients of mine had suffered
at the time of the operation had disappeared, or at any rate
diminished ; but then, it is well known that these neuroses
often enough improve spontaneously, and in all my cases the
interval between the operation and the commencement of the
improvement had been much too long to justify me in attribut¬
ing the improvement to the operation itself, or to its influence
upon the general health. On the other hand, I know positively
of not a few of my own cases in which, though the general
health had been materially improved and the direct symptoms
due to the adenoids completely disappeared, the reflex neuroses
persisted for many years afterwards with undiminished
intensity. Only quite recently I saw a boy of 9, who six years
ago was sent to me for most troublesome salivation, said to be
due to adenoids. Adenoids there were, certainly, and in such
quantities as to seriously interfere with the child’s breathing
and general development: but why they should cause the
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salivation was more than I could understand without taking
refuge in most artificial theories. I advised and performed the
operation for the general reasons just named, but I strongly
warned the mother that. I could not in the least promise dis¬
appearance of the salivation. When I saw my little patient a
few weeks ago he had developed into a very fine strong boy.
but the ptyalism was just as unpleasantly there as it had been
six years ago. Similar things I have seen in connection with
asthma, stuttering, stammering, . enuresis, epilepsy. Ex¬
periences of this kind fully warrant me, I think, in strongly
advising j^ou not to be too sanguine with regard to the connec¬
tion of adenoids and reflex neuroses. To promise positively a
cure of the latter if only the adenoids be removed, as I know
has been but too often done, I consider simply unwarrantable.
“ Finally, in this connection let me warn you, as others have
already done before me, against too hastily diagnosing adenoids
from facial appearance and nasal obstruction alone. Although
the ‘ adenoid face ’ in a fully-developed case is characteristic
enough, deformities of the nose itself and of the hard palate,
as well as enlargement of the posterior ends of the lower turbin¬
ated bones, may closely simulate the symptoms produced by
adenoids, and it ought to be an invariable rule, therefore, to
decide for operation on the strength of thorough examination
only—a rule which, I am afraid, is not always adhered to. As
to the examination itself in a good many cases, particularly
in elder children and in adults, posterior rhinoscopy will suffice,
without the unpleasant investigation by the finger being
resorted to. In all cases, however, in which there is the least
doubt, I strongly advise you to employ digital exploration,
which in these cases, I do not hesitate to say, is greatly superior
to mere inspection, inasmuch as it gives you much more reliable
information about the quantity of growths present than is
afforded by the rhinoscopic mirror.
“ So far as the operation itself is concerned, I would impress
you with one principle : Operate thoroughly !—I have not
the least wish to lay down dogmatic rules as to the technique
of the operation, although I hold very strong opinions on that
point as well. But, whatever method you may employ,
operate thoroughly, gentlemen, and never forget that the
question is not whether the child is forty-two seconds and a
half or five minutes under the anaesthetic, provided that the
latter be administered, as in these cases it always ought to be,
by a competent anaesthetist, but whether there is to be a
recurrence or not.
“ Next to over-operation, I have no hesitation in saying that
nothing has so much damaged the reputation of the operation
than the frequency of so-called “ recurrences ’ observed of
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late years. No doubt, perfectly genuine recurrences will
occasionally take place, even after very thorough operations;
but such an event is, in my own experience as well as in that
of all thorough operators with whom I have discussed that
question, very rare indeed, and 1 have not the least doubt that
what is commonly called a ‘ recurrence ’ is in the enormous
majority of cases in reality ‘ incomplete operation.’ One
must have seen such cases shortly after operation in order
to be enabled to judge in what an incredibly slipshod manner
the operation is nowadays but too often done and how the
cry ‘ recurrence ’ has come to be raised. A whiff of gas, a
little scraping with the finger-nail, and behold ! the ‘ operation ’
has been performed, and the parents are left in the belief that
all has been done that could be done. A few months, nay,
even weeks, after the ‘ operation ’ the old symptoms come on
again; the parents in distress seek another opinion, and,
when they are told that the operation has to be performed
anew, ask in despair : ‘ But don’t they always grow again h ’
“ Against this class of 4 recurrences ’ there is only one safe¬
guard, but it is a very efficient one : thoroughness of operation,
and this thoroughness must be preached until it is generally
practised. I need hardly say that this thoroughness is not
equivalent to violence. Unfortunately, whilst one very
frequently meets with instances of under-operation, one
occasionally comes across sad examples of the other extreme.
I have seen cases in which the operator had so proceeded that
the ugliest adhesions had formed in the naso-pharyngeal
cavity and between the soft palate, the pillars of the fauces
and the posterior wall of the pharynx. An aspect, in fact,
resembling that of cicatrisation in congenital or tertiary
syphilis, and in these cases the articulation of the victims was
materially and lastingly impaired. That certainly is not the
kind of thoroughness I recommend. But the desirable
thoroughness I have in view can only be obtained, so far as
I can see, by the operator being in the position of not being
hurried unduly by the brief duration of the anaesthesia, nor
by the fear of any untoward event during the operation itself.
44 Personally I have not the least doubt that these conditions
are most ideally obtained by (a) chloroform being selected as
an anaesthetic in these cases; and by ( b ) the patient being
operated upon in the recumbent position with his head well
bent over the back of the operation table. If chloroform be
quietly and slowly administered by a competent anaesthetist,
and never pushed to the abolition of the cough reflex, it intro¬
duces, to the best of my conviction and experience, no amount
of danger into the operation, and it gives the operator time to
remove the growths thoroughly. If the recumbent position
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be adopted, with the head well over the table, there is no
danger of blood or a loose fragment of adenoids penetrating
into the larynx or lower air passages. These—as I consider
them—most essential conditions having been secured, the
operator can then at his ease thoroughly remove the growths,
by whatever instruments he prefers (personally I almost
always use the two models of Gottstein’s curette, the curved
and the straight one, and Hartmann’s laterally-cutting curette,
whilst in exceptional cases only I employ Woakes’s modification
of Loewenberg’s forceps). The operation ought not to be
considered as finished until the operator, by thorough digital
exploration, has convinced himself that not a vestige of lymphoid
tissue projecting over the surface of the mucous membrane
has been left behind. Should the tonsils have to be removed
at the same time, I usually remove the adenoids first and the
tonsils afterwards. Only when the tonsils are so large that
it is impossible to introduce instruments into the naso-pharyn-
geal cavity, without impeding respiration, I remove them first.
1 have heard my method described as ‘ fussy,’ but it is safe, and
it certainly yields infinitely fewer recurrences than that of the
lightning operator. No after-treatment of any kind is necessary
beyond keeping the patient in bed for twenty-four hours, and
in the house for two to three more days, an aperient being
given the first evening, if there should be a rise of temperature.
I warn especially against any ‘ antiseptic ’ injections being
made through the nose. It is many years since I gave them
up completely, and I am glad to be able to state that I never
since have had an acute ear complication.
“ Others may prefer other methods. I have not the least
wish to assert that the method I recommend is the best, or
the only one by which success may be secured, but from long
and ample experience I can honestly state that it answers all
reasonable requirements, and if you proceed by it, selecting
suitable cases only for operation, you may be confident that
you will maintain the prestige of one of the most salutary
operations of modern times.
“ If, in conclusion of this lecture, I were to briefly summarise
the advices given in it, I should say this : In all purely local
affections of the upper air passages there are certain cases in
which all reasonable men will agree that local treatment is
required, and others in which the moderate section at any
rate will be unanimous that it is not. Between these two
classes there is the very large intermediate one in which every¬
thing is a question of ‘ degree,’ and in which opinions may
legitimately differ as to whether local treatment should be
adopted or not. Far be it from me to assert that occasionally
mischief may not be done by doing too little, but if 1 endeavour
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to judge impartially the current of opinion at the present
moment, I have no hesitation in stating that if at all, we err
at the present moment in the opposite direction, and I cannot
better sum up the advice which I think should at this juncture
be given, than by reminding you of Talleyrand’s celebrated
counsel to a young diplomatist who for the first time was sent
on an independent and responsible mission: 4 Above all, not
too much zeal! ’ ”
Lecture II.
2. Local Manifestations of General Systemic Diseases.
44 Of the systemic diseases in which throat and nose complica¬
tion occur, and which may require local treatment, tuberculosis,
syphilis, and affections of the central nervous system are the
most important. True, there are many other systemic affec¬
tions in which the upper air passages may participate. Thus
pharynx, larynx, and nose may be severely affected in lupus
and leprosy; dry pharyngitis may be a very unpleasant
symptom in diabetes; granular pharyngitis is very often
found in general anaemia and chlorosis; laryngeal oedema
may occasionally be observed in Bright’s disease; ulceration
and perichondritis of the larynx may occur in typhoid and
other acute fevers; influenza may lead to empyema of any of
the accessory cavities of the nose, to laryngeal paralysis and
to many other complications affecting the upper air passages;
gout, rheumatism, urticaria, pemphigus, actinomycosis, and
small-pox may implicate nose, pharynx, and larynx; and
this list could easily be extended. But the throat and nose
complications in many of the affections just named are rare,
and some require no local treatment whatever, except an
occasional palliative ; while in other instances—as in laryngeal
stenosis, or in empyema of the antrum due to any of the affec¬
tions named—they must be treated exactly as if the affection
were purely local. Thus there is no need for me to enter
specially upon them. Matters, however, are somewhat
different in systemic affections belonging to the first group.
Here experience has furnished us with certain valuable prin¬
ciples, which, in addition to the individual requirements of
each case, ought always to be considered, when the question
of local treatment of throat and nose complications arises.
Tuber culosis.
44 This applies particularly to tuberculosis. I need not speak
of the frequency and importance of its laryngeal complications,
which but too often, in the complex of symptoms, unfortunately
play the role of the predominant partner, and urgently require
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relief. A patient suffering from laryngeal tuberculosis, who
cannot eat and drink on account of the difficulty and pain
accompanying the act of swallowing, will, of course, go more
rapidly downhill than he otherwise would do because he is
prevented from assimilating the amount of nourishment
indispensable to combat the inroad of the general disease. To
tell such an unfortunate person, as was generally done twenty
years ago, and as is done, 1 am afraid, but too frequently now :
‘ Take care of your general health and let your larynx take
care of itself ’ is to my mind not much better than a cruel
mockery, though it is, of course, not intended as such. Un¬
fortunately he who gives that cheap advice altogether forgets
to instruct the patient how he is to take care of his general
health when he cannot swallow. Here it is obviously the duty
of medical art to step in and help, and the only question is
whether this help should be of a purely palliative, or, if possible^
of an actively curative character.
‘‘Now this question, simple as it seems, is extremely difficult
to answer, and nothing could better illustrate what I have
said in my first lecture as to the frequently shifting character
of modern therapeutic views than the various answers given
to it in the course of the last twenty years.
“ As recently as 1881 the late Professor Krishaber, of Paris,
stated verbatim in the discussion on the pathology of laryngeal
phthisis which took place at the International Medical Congress
of London, as the result of his long and extensive experience:
I will not say that tuberculous laryngitis is incurable. I
maintain only that the local therapeutic means in use are
ineffective, and that they are damaging rather than useful. 7
Although most of the other speakers on that occasion did
not take so gloomy a view, yet the general opinion was anything
but cheerful with regard to the influence of local measures
upon laryngeal tuberculosis. Shortly afterwards, however,
Professor Krause, of Berlin, introduced the lactic acid treat¬
ment, and this in turn was quickly followed by its combination
with scraping of laryngeal tuberculous ulcers. The most
enthusiastic advocate of this method was Dr. Heryng, of
Warsaw, who for a good many years never tired of extolling
its virtues, and demonstrating at medical gatherings patients
with ‘ cured ’ laryngeal tuberculosis, and instructive specimens
of completely cicatrised laryngeal ulcers from patients who
later on had succumbed to the ravages of the pulmonary
disease. The pendulum of public opinion now swung in the
exaggeratedly hopeful direction. Any number of ‘ cures 7
of laryngeal tuberculosis were reported, and more and more
energetic surgical measures for its treatment were recom¬
mended : Deep scarification of the swollen epiglottis and
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aryteno-epiglottic folds; removal of diseased arytenoid
cartilages; thyrotomy and scraping of the whole laryngeal
mucous membrane; nay, even removal of the whole larynx,
each found its enthusiastic advocates.
“In the midst of all this progressively radical surgical treat¬
ment the introduction of tuberculin for a short time threatened
to supersede it altogether. No better field for observation
of the effects of the magic fluid could be desired than the
larynx. We all injected, and waited in breathless silence for
the healing and the cicatrisation of the laryngeal ulcers. But,
alas ! our hopes were doomed to disappointment; beyond the
fact that the ulcers assumed a somewhat cleaner aspect no
curative effect was observed, and within a very few months
from the introduction of the treatment, the man, whose
eightieth birthday the whole medical world prepares to celebrate
this week with great rejoicings, my venerated great teacher,
Professor Virchow, added to the countless obligations under
which he had laid our science, by showing beyond doubt the
dangers of the new method. As a result of his demonstration
it was, except by a very few faithful adherents, thrown over
as suddenly as it had come into fashion, and we all returned
to combating the local effects of the disease by local means.
But somehow the enthusiasm had cooled down, and during
the last few years very little has been heard of the local treat¬
ment of laryngeal tuberculosis in comparison with the pane¬
gyrics of some ten years ago. On the most recent occasion
when the question was discussed—namely, at this year’s
meeting of the British Medical Association—many speakers
related their views and experiences concerning the indications,
forms, and results of the local treatment of laryngeal tuber¬
culosis, but no new facts were elicited; and Dr. StClair
Thomson—rightly, 1 think—stated that practically no progress
had been made during the last six or seven years, and that the
subject was in a very unsatisfactory condition.
“ The views I have myself formed from personal experience
on the question of local treatment in laryngeal tuberculosis
are the following :—
“ In the first place, I think we should as much as possible
avoid the word ‘ cure ’ when speaking of the chances of such
treatment, for it is distinctly misleading in this connection.
We have to deal with local manifestations of systemic disease,
not with a purely local process ; and even if we succeed in
arresting the particular local manifestations against which
our efforts are directed, we cannot, unfortunately, promise
our patient that the arrest will be a permanent one, nor that,
even if the exact spot in which we have been working should
lastingly remain free, quite similar manifestations, causing
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similar painful symptoms, may not within a very short time
after the end of a really successful treatment break out in the
immediate vicinity of that spot. The disappointment under
such circumstances is always cruel. Nevertheless, seeing
that it is our first duty to give relief if we possibly can, and
that there is, at any rate, a fair chance of the result being
permanent, we must, of course, have recourse to proper local
treatment in suitable cases; but, in view of the uncertainty
just named, it will be wise, and may spare the patient and his
friends bitter disillusion, not to talk of a ‘ cure,’ but of relief
which we trusted would be more than passing, although that
could not be definitely promised.
“ Secondly, in no disease perhaps is there greater need for
individualisation and for treating each case on its own merits
than in laryngeal tuberculosis. Simply to identify, as I am
afraid is done very often, the presence of that complication
with the idea that it must be actively treated with lactic acid,
and possibly by curetting, would be a mistake similar to
identifying the diagnosis of laryngeal cancer with the idea
that thyrotomv must be performed. In both instances routine
practice would ultimately and inevitably lead to valuable
methods becoming discredited. When deciding whether
any and if so what form of local treatment should be adopted
in laryngeal tuberculosis, everything—the form, the situation,
and the extent of the local manifestation has to be carefully
considered. So long as there is merely infiltration with
unbroken surface, be this infiltration of a pseudo-oedematous
or of an indurative form, I strongly advise in principle to
leave matters alone. I know that some authorities recommend
submucous injections of guaiacol, creasote, or perchloride
of mercury, etc., and others removal of the tumefied parts
by means of curettes, forceps, snares, followed by energetic
applications of lactic acid. Of the submucous injections I
have no personal experience. Of the surgical measures named,
I admit that in some cases the dysphagia is so great that
energetic procedures may have to be resorted to. In a case
of my own in which, so far as could be judged, the epiglottis
alone was the seat of an enormous tuberculous infiltration,
which rendered swallowing practically impossible, whilst
there was no evidence of pulmonary disease at all, the whole
of the epiglottis was removed after subhyoid pharyngotomy
with temporarily very satisfactory, though unfortunately
but transitory, results. A year after the operation both lungs
were found to be extensively diseased, and ulceration had
occurred in the stump of the epiglottis and in the neighbouring
parts of the cicatrix. But, unless the dysphagia renders
drastic measures imperative, I feel sure it is much better in
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cases of tumefaction without ulceration not artificially to
produce a breach of the surface, and I think that the correctness
of that advice is being gradually and more generally followed.
If the tumefaction be so considerable as to produce serious
laryngeal stenosis, tracheotomy may be indispensable to
prevent suffocation, and a few cases have been reported in
which the rest given by that operation to the diseased organ
appeared to have an actually curative effect upon the laryngeal
infiltration. But this is a result which certainly cannot be
expected to follow regularly, and on the whole it will be much
better to reserve the operation for urgent cases only.
“ Should there be already ulceration when the patient comes
under observation, the questions of its situation and its extent
are of paramount importance. If there be one ulcer or a few
not too large and well-circumscribed, the chances of arresting
the local mischief by appropriate local treatment are by no
means bad, particularly when the ulcers are situated on the
vocal cords, the ventricular bands, or in the interarytenoid
fold. Ulcers of the epiglottis, the mucous inembraiie over
the arytenoid cartilages, the aryteno-epiglottidean folds, or
in the subglottic cavity are not nearly so easily accessible to
local treatment. Should the ulceration be almost universal
and be accompanied by caries and necrosis of the cartilaginous
framework of the larynx or of large parts of it, the curative
chances of local treatment are very small indeed.
“ The local treatment will accordingly have to vary greatly
under these different circumstances. In cases belonging to
the first category, energetic lactic acid treatment, if necessary,
combined with scraping or removal by double curette or
cutting forceps of the tuberculous deposits, will sometimes
yield very gratifying results. I now look back upon a number
of cases of my own thus treated, not large, it is true, but still
gratifying enough, in which treatment of this kind has resulted
in lasting arrest of the laryngeal mischief. One ought even
not to be discouraged if, either in the scar of the hardly-healed
ulcer or in its neighbourhood, fresh ulceration should occur.
In a few of my own cases repetition of the treatment—which
occasionally had to be resumed several times at longer or
shorter intervals—ultimately led to lasting cicatrisation and
freedom from pain and dysphagia. But no general rule can,
I think, be laid down about such repetitions of the treatment,
and I cannot sufficiently emphasize that in this large category
every case must be treated according to its individual features.
“ In cases belonging to the second class the technical diffi¬
culties are much greater; the affected parts recede under the
touch of instruments, and as a rule the results are less satis¬
factory than those obtained in the interior proper of the larynx.
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Still, so long as there is a reasonable chance of arresting the
process, I consider it not merely legitimate, but clearly indicated,
to tty and do so, as it is just in these cases of commencing
ulceration of the epiglottis, the mucous membrane over the
arytenoids, or the aryteno-epiglottic folds, in which the con¬
comitant pulmonary process may not be at all much advanced,
that the patient’s chances are most jeopardised by the dysphagia
depending upon the laryngeal complication. Should intra-
laryngeal measures fail and the dysphagia be excessive, or
should a subglottic ulceration spread to the posterior wall of
the larynx, external operations may be considered. In a few
cases of that kind thyrotomy, followed by thorough scraping
and application of pure lactic acid to the seat of the former
ulcer, has yielded satisfactory results. In a case of my own
thus treated the patient has now, I am glad to say, remained
quite well for four years. But the external wound in these
cases is very apt to become infected during the operation, and
a second extensive operation may be necessary to remove the
infected tissues. This occurred in my own case and in various
others that have been reported. Hence operations of this
kind should not be lightly undertaken, and should be reserved
for exceptional cases. They may of course be absolutely
required if laryngeal tuberculosis should manifest itself, as
it occasionally, though rarely, does in the form of a distinct
tumour, which cannot be removed intralaryngeally.
“ In the third category, in which the whole, or nearly the
whole, of the mucous membrane of the larynx is one mass of
ulceration, and in which there is often in addition evidence
of perichondritis and chondritis or even of caries, necrosis,
and exfoliation of one or several of the laryngeal cartilages,
curative local measures are, in my experience and belief,
practically out of the question. Very heroic procedures,
I know, are sometimes undertaken even in this class of cases,
necrotic arytenoids are removed in toto with their swollen and
ulcerated mucous coverings, and pure lactic acid or very strong
solutions of that drug are forcibly rubbed in all over the larynx.
I am not aware that such measures have ever acted beneficially
whilst they may intensify the violence of the local process,
and they are certain, in spite of previous cocainisation and
subsequent orthoform insufflation, to increase for a time the
patient’s sufferings. To remove a tuberculous larynx deliber¬
ately I consider hardly justifiable. Palliative local measures
alone are, in my opinion, suitable in the great majority of this
class of cases, and nothing has so well served me to soothe
pain and render swallowing possible as insufflation of orthoform.
Its effects last much longer than those of cocaine, menthol,
or morphine, and its dose has not to be rapidly increased like
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that of the drugs just named. Nor are general toxic symptoms
ever observed. *' It has been accused of producing sloughing;
I have never seen it cause such an undesirable effect.
“ Thirdly, in cases of laryngeal tuberculosis the patient’s
general health and pulmonary condition have always to be
taken into consideration when deciding upon the question
of local treatment. It must not be thought that even some¬
what advanced lung disease or slight habitual feverishness
necessarily contra-indicate local treatment of the larynx.
I have often enough seen general beneficial results even under
such conditions from arresting the laryngeal complication.
But when practically the final stage of pulmonary phthisis
has been reached, with marked hectic fever and cachexia, or
when the tuberculous process is of the miliary type, I consider
local treatment of the larynx other than palliative distinctly
contra-indicated, and I would strongly warn against unduly
exalting the laryngeal complication under such circumstances
at the expense, as it were, of the pulmonary disease.
“ Fourthly and finally, it is most important when local
treatment has been decided upon in a case of laryngeal tuber-
' culosis, that it should be efficiently carried out. This would
seem to be almost a truism, but indeed it is not, and I think
some plain speaking here is necessary.
“ Within my own knowledge often enough when energetic
lactic acid and curetting treatment has been recommended,
that advice has been only partially carried out, and in such a
half-hearted way as to make it practically ineff ective. Whilst
the rationale of the treatment consists in the removal of the
tuberculous ulcer and in the production of a healthy cicatrix,
which purposes can only be obtained by thoroughly scraping
the diseased area, or even removing parts of it with cutting
forceps or double curette, and by subsequently energetically
rubbing into the raw surface left behind a strong solution of
lactic acid, carried to the part on a strong, stiff’, properlv-bent
instrument, such as Krause’s wool-carrier—all this, be it
remembered, under the guidance of the laryngeal mirror—
I'find that the first part of the treatment, namely, the removal
of the tuberculous tissue, is often omitted altogether, and
that the rubbing in of the strong lactic acid solution is replaced
by the application ‘ somewhere ’ in the throat of a weak
solution by means of a camel-hair brush, or by the substitution
of a ‘ weak spray of lactic acid.’ The result is of course nil ,
and the patient, who had been encouraged to hope for relief,
is greatly disappointed. I venture to say that this is hardly
fair, either to the patient, the method, or to the original adviser.
I certainly consider it much less—if at all—derogatory for a
medical man to frankly tell his patient that the suggested
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treatment to be effective demanded an amount of special
technical skill which he did not possess, and that he therefore
would advise him to put himself in practised hands to have
it properly carried out, than that he should spoil fair chances
by ineffective execution. The simple truth of the matter
is that this treatment should as much remain in the hands of
experts as, say, the intralaryngeal removal of intralaryngeal
growths. However, I may add that seeing the frequency of
laryngeal complications in pulmonary tuberculosis, and the
encouraging results of the sanatorium treatment of the latter,
every physician attached to a sanatorium should, I think,
make himself enough of an expert to effectively carry out,
during the patient’s stay at the sanatorium the local treatment
of laryngeal complications if required.
“ I know full well that what I have said about the principles
of local treatment in laryngeal tuberculosis does not nearly
exhaust the subject. Thus, I have not so much as mentioned
the necessity of combining in all cases a rational general with
the local treatment. But this I hope I may take as self-
understood, and I trust that my remarks, incomplete as they
are from pressure of time, may help you to decide in doubtful
cases whether any, and if so what, form of local treatment
should be adopted. I have only to add that in pharyngeal
tuberculosis, which fortunately is very rare, the energetic
application of strong lactic acid solutions has been at least
temporarily beneficial in the very few not hyperacute cases
I have seen, whilst in the very acute form I consider that only
palliatives are desirable. In nasal tuberculosis, which also
is rare, the tuberculous deposits and ulcers should be thoroughly
removed and cleaned by scraping, followed by lactic acid
applications. Unfortunately, however, there is a great tendency
towards recurrence in this form, no matter how thoroughly
the local treatment may have been carried out.
Syphilis.
“ Of the next disease on our list, syphilis, I need only say
that I have for many years ceased to include local treatment
as a routine measure in the treatment of specific affections of
the upper air passages. This, of course, does not mean that
I oppose local treatment in this class of cases if actually required.
On the contrary; in cases, for example, of caries and necrosis
of the bones in tertiary syphilis of the nose, of extensive
adhesions in the pharynx as a result of tertiary ulceration of
that part, of fibroid stenosis or advanced perichondritis of the
larynx of syphilitic origin, local treatment, and this of the
most energetic kind, may have to come into play. But what
I mean is that in my experience no daily applications of sulphate
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124
NOTABILTA.
Monthly Homoeopathic
Review, Feb. 1,1902.
of copper or nitrate of silver to the ulcerating surfaces are
required in addition to proper constitutional treatment. I
served my specialists apprenticeship in a school in which
such applications were considered most important, but, as
I have already stated on a previous occasion, since I have
gradually discontinued them and relied upon constitutional
treatment only, I have not found that improvement has taken
place more slowly than in former days.
{To be concluded in our next Issue.)
Digitized by boogie
Monthly Homoeopathic
Review, Eeb. 1,1902.
OBITUARY.
125
OBITUARY,
Dr. Francis Edmund Boericke.
We regret to learn the death of Dr. F. E. Boericke, the
originator and head of the well-known firm of Boericke and
Tafel, of Philadelphia and New York, pharmacists and pub¬
lishers. We take the following notice from the Philadelphia
Public Ledger , of December 19th, 1901, giving an interesting
sketch of the life and career of a remarkable man.
“ Dr. Francis Edward Boericke, a prominent homoeopathic
pharmacist, died on Tuesday at his residence at 6386^Drexel
Road, Overbrook, aged 75 years. He had been an invalid for
the last fifteen years.
“ Born in Glauchan, Saxony, in 1826, Francis Edmund
Boericke came to this country during the Revolution of 1848,
and made his home in this city. His father was a prominent
manufacturer and exporter of woollen goods in' Glauchan.
Soon after his arrival here the young man obtained a position
as book-keeper with Plata, at Fourth and Chestnut Streets,
a well known dry goods merchant and the Saxon Consul.
Following this he became a partner in Andre’s music store in
Chestnut Street. In 1852 he joined the Church of the New
Jerusalem, and opened a store where religious books were sold
in Sixth Street, below Chestnut. A year later he was induced
by Dr. Constantine Hering to turn his attention to the prepara¬
tion of homoeopathic medicines, and by his proficiency and
industry soon gained the confidence of leading homceopathists
in the country. In 1854 he married Miss Eliza Tafel, and in
1869 associated with himself in the pharmacy business as a
partner Adolph Tafel, his brother-in-law, who had retired
from the Civil War with the rank of Major.
“ Dr. Boericke was graduated from the Hahnemann College
in 1863. He received a scholarship and delivered lectures on
pharmacy for some time. In 1864 he added to his business
an establishment for publishing homoeopathic works, and soon
enlarged his trade by establishing branches throughout the
country. In 1895 Major Tafel died, and after that the firm
consisted of Dr. F. A. Boericke, and Adolph L. Tafel, sons of
the original members.
“ Dr. Boericke is survived by his widow and nine children.”
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126
CORRESPONDENCE.
CORRESPONDENCE.
MEDICAL ETHICS v. SCIENTIFIC PROGRESS.
To the Editors of the “ Monthly Homoeopathic Review .”
Gentlemen, —Pardon me for saying that I venture to think
your remarks in your current number, with respect to the
editor of the Edinburgh Medical Journal , scarcely justified.
In the management of all large business or literary trans¬
actions it is necessary to give general instructions to clerks
with the understanding that they will exercise their intellectual
powers in carrying out matters of detail. That “ clerk ” or
“ assistant,” it appears to me, was possessed of no mean intellect,
for he dared not allow himself to believe that a paper from a
gentleman who had graduated as M.D., Lond., besides holding
the diplomas of three London Medical Colleges, could contribute
a paper which would be unwelcome to the editor of his journal.
The polite apologies of the editor, which reveal a certain
amount of veiled shame and a desire to avoid a preposterous
explanation should also be accepted, for, what would have
become of his journal had the paper of Dr. Roberson Day
appeared in it!
The latter has chosen to recognize the existence of a law
underlying the action of drugs on the human body propounded
by Hahnemann, expressed by the phrase “ Similia similibus
curantur ”—a law which has since been supported by a very
large number of facts published in the orthodox medical journals
and books, and collated by Dr. R. E. Dudgeon and others.
In this he has committed an unpardonable sin, for which he
must be ostracised and his writings “ boycotted ” by all
respectable members of his profession, and also excluded from
taking part in the proceedings of medical scientific bodies so
far as the law of the country will allow, for, has he not thereby
professed “ an exclusive or special system ” ?
It would be difficult to conceive a parallel so ludicrous among
other scientific societies. Take, for example, the announcement
by certain physicists of the existence of the law underlying the
relation of the specific heats of the elementary bodies to their
atomic weights, or, MendelejefTs law of periodicity. There
was a time when many gaps existed and many of the elements
apparently declined to obey such laws, leading to the belief
that the facts pointed out as supporting their existence were
a mere chain of coincidences, although with the increase of
our knowledge these apparent exceptions have steadily fallen
into line, and gaps have been filled to such an extent that no
sane being would now dispute the existence of such laws.
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Monthly Homoeopathic
Review, Feb. 1, 1902.
CORRESPONDENCE.
127
Let us try to imagine the Royal Society, on the early pro¬
mulgation of these physico-chemical laws, daring to ostracise
some of its Fellows who acknowledged them, and to boycott
the papers of those who propounded them! Yet, I submit,
this is a close parallel to the action of the British medical
profession with regard to the law of similars propounded by
Hahnemann. If this law does not exist by all means let it so
be shown, as it has not yet been shown, in a scientific manner,
but until this has been done the attitude of the medical pro¬
fession is, to borrow Dr. Day’s expressions, illogical, untenable
and incomprehensible.
Surely the time is not far distant when medical ethics will
no longer be allowed to hinder the advance of medical science.
Bromley, Kent, Yours faithfully,
Jan. 10th, 1902. John M. Wyborn, F.C.S.
A WARNING.
To Die Editors of the “ Monthly Homoeopathic Review .”
Gentlemen
A gentleman called on me three weeks ago and pre¬
sented his card, C. C. Perry, M.D., New York. This was at
5 p.m., but I was in bed and did not wish to see him. He
represented, however, that he wished to see me as a friend,
and was therefore shown into my bedroom. He addressed
me in a free and unconventional style, and talked about %
many mutual friends in America—Drs. Helmuth, Marcy,
Norton, Kraft, Wesselhoeft, &c. On my suggesting I was
too weak for more conversation, he remarked that he had
not taken quite sufficient money for his journey to London:
would I lend him a sovereign till the next day, when I
should assuredly have it again. I was too weary to argue
with him, and to save bother lent him the money, which
I have not, nor ever will, see again. I write this to warn my
colleagues.
Yours truly,
Pendennis, Northampton. A. C. Clifton.
(The editor of The Homoeopathic World issued lately a
similar warning. This man attempted the same game with
ourselves, but failed in his object.— Eds. M.H.R.).
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128
CORRESPONDENTS.
Monthly Homoeopathic
Review, Feb. 1,1902.
NOTICES TO CORRESPONDENTS.
*** We cannot undertake to return rejected manuscripts.
Authors and Contributors receiving proofs arc requested to correct
and return the same as early as possible to I)r. Dyck Brown.
The Editors of Journals which exchange with us are requested to
send their exchanges to the office of the Itevieio, 59, Moorgate Street,
London, E.C.; or to Dr. Dyck Brown, 29, Seymour Street, London, W.
Dr. Pope, who receives several, has retired from practice for the last
two years, and now lives at Monkton, near Ramsgate.
London Homeopathic Hospital, Great Ormond Street.
Bloomsbury. —Hours of attendance: Medical (In-patients, 9.30;
Out-patients, 2.0, daily) ; Surgical, Out-patients, Mondays and
Saturdays, 2.0; Thursdays and Fridays, 10 a.m. ; Diseases of Women,
Out-patients, Tuesdays, Wednesdays and Fridays, 2.0; Diseases of
Skin, Thursdays, 2.0; Diseases of the Eye, Mondays and Thursdays,
2.0; Di-eases of the Throat and Ear, Wednesdays, 2.0; Saturdays,
9 a.m. • Diseases of Children, Mondays and Thursdays, 9 a.m. ; Diseases
of the Nervous System, Wednesdays, 2.0; Operations, Tuesdays and
Fridays, 2.30; Dental Cases, Wednesdays, 9 a.m.; Oithopnedic Cases,
Tuesdays, 2 p.m. ; Electrical Cases, Wednesdays, 9 a.m.
Letters, etc., have been received from —Dr. Charles W. Hayward
(Liverpool) ; Dr. John D. Hayward (Liverpool); Dr. Stanley Wilde
(Cheltenham); Dr. Galley Blackley (London); Mr. J. M. Wyborn
(London) ; Messrs. Boericke & Tafel (Philadelphia); Dr. Stonham
/London); Dr. A. C. Clifton (Northampton): J)r. W. Schwabe
(Leipzig).
BOOKS RECEIVED.
The Homoeopathic Pharmacopoeia of the United States. Second
Edition. Boston, 1901. A Text-book of Gynaecology , by James C.
Wood, M.A., M.D. Second Edition. Philadelphia, 1902. Preventive
Medicine , by an English Member of the Brussels International Con¬
ference of 1898. 1901. Homoeopathic World , January. Medical Era,
December and January; Chicago. Homoeopathic Recorder , December ;
Philadelphia. Calcutta Journal of Medicine, Nov. and Doc. Journal of
Obstetrics and Gyncecology , January ; London. Homoeopathic Journal
of Pediatrics, January; Buffalo. Vaccination Enquirer , January.
Saint Andrew, January 9. Homoeopathic Envoy , January; Lancaster,
U.S.A. American Medical Monthly , December; Baltimore. The
Clinique, December. Minneapolis JJonueopathic Magazine, December.
Medical Brief, January. ZeiUchrift filr J[ombopathische Pharnmcie,
December; Leipzig. San Francisco Examiner, January S.
Palters, Dispensary Reports, and Books for Review to be sent to Dr. I). Dyck
Brown, 29, Seymour Street, Portraitn Square, W. ; or to Dr. Edwin* A. Neatby,
178, Haverstock Hill, N.W. Advertisements and Business communications to be
sent to Messrs. F. Gould & Son, Limited, 59, Moorgate Street, E.C.
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Fbbbuaby 1] MONTHLY HOMCEOPATHIC REVIEW.
[ 1902 .
THE NATURAL AND ONLY GENUINE
CARLSBAD SALT
fIN CRYSTALS OR POWDER) is prepared from and contains all the constituents
of the famous
‘SPRUDEL SPRING’^ CARLSBAD
the water of which is largely prescribed in cases of CHRONIC GASTRIC CATARRH,
HYPERJEMIA of the LIVER, GALL-STONES, DIABETES, RENAL CALCULI,
GOUT, and DISEASES of the SPLEEN, &c.
The CARLSBAD SPRUDEL SALT in Potvder has the great advantage in not
being affected by change of temperature or exposure to the atmosphere, and therefore in
this form is the most reliable.
W* To avoid imitations , see that the wrapper round each bottle bears the signature of the
SOLE AG-ElsTTS,
INGRAM & ROYLE, LTD.,
Ei^ST PAUL’S WHARF, 26, Upper T>)an\es St., E.C. ^nd at Liverpool & Bristol.
Samples Free to Members of the Medical Profession on application.
SUGAR OF MILK
(Purified by Hahnemann’s Method),
FOR TRITURATIONS.
Prepared by precipitation with Alcohol , the process being carried on m
utensils which are reserved exclusively for this purpose, thereby ensuring
a perfectly pure sugar.
w" By this process all the albuminous substances contained in the whey are entirely
removed , and the existence of such impurities as albutnose and other poisonous
products of decayed albumen is prevented.
E. GOULD & SON, Ltd., 59, Moorgate Street, LONDON, E.C.
“There are two distinct classes of tinctures in homoeopathic pharmacy
to-day, one prepared from the dry drug, or, more frequently, from
allopathic extracts and tinctures; this is the way the cheap tinctures are
made that supply those who regard cheapness of more importance than
quality in medicine The other class in homoeopathic pharmacy, supplied
from fresh plant tinctures, tinctures made from plants so fresh from
mother earth that they would grow again if replanted. These tinctures
cQntain the real curative forces .”—Homoeopathic Recorder
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February 1] MONTHLY HOMOEOPATHIC REVIEW.
[1902.
TRITURATION TABLETS.
Each containing One Grain of any Trituration.
****************************
THESE ARE MOT RECOMMENDED IN CASES WHERE PILULES CAN BE
PREPARED, BUT AS AN ACCURATE AND CONVENIENT FORM FOR
DISPENSING THE INSOLUBLE MEDICINES.
****************************
THEY ARE NOT COMPRESSED,
BUT MOULDED.
COMPRESSED TABLETS USUALLY
CONTAIN TALC (a magnesium silicate
analogous to Hahnemann’s Silicea), GENER¬
ALLY USED WITH COMPRESSING
MACHINES Besides this they are VERY
INSOLUBLE.
NO ADDITION OTHER THAN SPIRIT IS REOUIRED
IN MOULDING THESE TABLETS.
-.*////////////✓/✓✓/✓✓//✓/✓✓✓///////✓/////////"
Each Tablet contains one grain of trituration, and they are put up in
bottles containing 100, 300 and 1,000 respectively
TABLETS NOT IN STOCK WILL BE FURNISHED 01S SHORT NOTICE .
E. GOULD & SON, Ltd., 59, Moorgate Street, London, E.C.
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February 1]
MONTHLY HOMCEOPATHIC REVIEW.
[1902.
THE NATURAL MINERAL WATERS OF
IVICHYl
CELESTINS.
For Diseases of the Kidneys, Gravel, Gout, Rheuma¬
tism, Diabetes, etc.
GRANDE-GRILLE.
For Diseases of the Liver and Biliary Organs, etc,
HOPITAL. For Stomach Complaints.
All the above mix well with Wines and Spirits.
CAUTION. —Each Bottle from the State Springs bears a Neck Label with the
words “ Yichy-Etat ” and the names of the Sole Agents—
INGRAM & ROYLE, LTD.,
LONDON: I LIVERPOOL: I BRISTOL:
26, Upper Thames Street, E.C. | 19, South John Street. | Bath Bridge.
NOW COMPLETE.
Parts I., II. and III., Large 8vo, pp. 96. Price 4/- each.
Part IV., pp. 144 . Price 6/-.
IN ONE VOLUME. Cloth. Price 21/-.
A Repertory to % Cyclopaedia
of Drug Pathogenesy.
_A_IDT I InTO ZEIS SYMPTOMATTJM
Compiled by
RICHARD HUGHES, M.D.
“It should be understood that, outside of its importance as a complement of
the Cyclopoedia of Drug Pathogenesy , this work will form a distinct repertory in
itself; the most reliable and valuable, up to the present time, of any repertcry
in homoeopathic literature.”— New England Medical Gazette.
London: E. GOULD & SON, Ltd., 59, Moorgate Street E.C.
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February 1] MONTHLY HOMCEOPATHIC REVIEW.
1902.
HAHNEMANN’S MATERIA MEDICA PDRA.
Translated from the latest German Editions by R. E. Dudgeon, M.D.,
with Annotations by Dr. R, Hughes. Two vols 36s.
This work gives the most faithful and complete English translation of
the latest editions of the Materia Medica of the Master of the homoeopathic
school. It has been carefully edited, and contains improved versions of
the original, whereby both the faithfulness and the readableness of the
translation have been greatly improved. Every real student of homoeo¬
pathy should possess this book.
E. GOULD & SON, Ltd., 59, Moorgate Street, London, E.C.
THE TEMPERANCE CRITIC,
Monthly, 2d. Of all Newsagents.
The April issue contained Racial Familiarity with Alcohol,
by G. Archdall Reid, M.B.
„ May „ „ Scientific Report on Heredity of
Inebriety.
„ June „ „ Sugar and Alcoholism.
OfficeBRETT’S, 5, PILGRIM STREET, LONDON, E.C.
Third Edition, enlarged and revised, price 5s.
Modern Household Medicine.
A GUIDE TO THE MODE OF RECOGNITION
AND THE
RATIONAL TREATMENT
(Homraopathic, Hydropathic, Hygienic and General)
OF DISEASES AND EMERGENCIES INCIDENTAL TO DAILY LIFE
By CHARLES ROBERT FLEURY, M.D.
Licentiate of the Royal College of Physicians, London; Member of the Royal College of Surgeons,
England; formerly Clinical Resident at the Richmond Surgical, Whitworth Medical, and Harawlcke
Fever Hospitals, Dublin: and late Medical Officer to the Peninsular and Oriental Company, in the
East Indies, China and the Mediterranean.
“The therapeutic information conveyed is sound, although the doses recommended are to say
the least, unnecessarily large. With the general hygienic and dietetic sections we in the main
a,gree.”—Monthly Homoeopathic Review.
“The emigrant or the colonial cannot possess himself of a more useful vade mecum than the
book we have been discussing. It reflects the utmost credit upon the author, and in the hands of
p.ny intelligent person its information may be the means of doing incalculable service to those in
need. This, the second edition, has been revised and enlarged; it is issued in a very handy sized
volume, and is admirably printed in very clear typ e.”—Colonial Trade JournUi.
E. GOULD & SON, Ltd., 59, Moorgate Street, London, E.C.
And all Homoeopathic Chemists and Booksellers
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[1902.
SUCCUS CALENDULAS.—The expressed juice of
Calendula has been found by many practitioners to possess healing properties
superior to those of the alcoholic tincture, and it is now preferred by many
as a topical application in spray and on dressings in all cases which indicate
the use of Calendula. It contains only sufficient alcohol to preserve it.
Supplied by E. Gould & Son, Ltd., 59, Moorgate Street, London, E.C.
H AVERSTOCK HOUSE, Cheriton Place, Folkestone, conducted on
Christian and Temperance principles. Every comfort for those
not strong (non-infectious) and others. Those unable to walk taken to
and fro to sea front and Leas Shelter in bath chairs (free) morning and
afternoon. Private sitting-room if desired. Terms: Board residence, 2 to 3
guineas weekly; reduction October to Easter. Cycles housed.—Miss
Woodward (Member of Royal British Nursing Association). Telegrams,
“Comfort.” Book Central Station.
H OUSE SURGEON (qualified), wanted for the Homoeopathic Hospital,
Birmingham. Salary J6100 with board. Applications with copies of
testimonials to be sent to Mr. P. W. Walker, 18, Waterloo Street, Birmingham.
E STABLISHED HOMEOPATHIC PRACTICE for disposal at once in
one of the leading towns of South Africa. Splendid opening for
an enterprising man. Easy terms. Apply “W.,” E. Gould & Son,
Ltd., 59, Moorgate Street, London, E.C.
Just Published. 36 pp., Illustrated. Price Is.
fJARDIAC DEBILITY. A paper read before the British Homoeopathic
^ Congress, held at Liverpool, 1901. By Herbert Nankivell, M.D.
London : E. Gould & Son, Ltd., 59, Moorgate Street, E.C.
Just Issued.
THE P RACTICE OF MEDICINE. By A. C. Cowperthwaite, M.D.,
A Professor of Materia Medica and Therapeutics, Chicago Homoeopathic
Medical College; Ex-President American Institute of Homoeopathy, etc.
A handsome volume of . 1039 pages. Cloth, 30s. Half Morocco, 35s.
PRACTICAL MEDICINE. By F. Mortimer Lawrence. 1901. 15s.net.
A London : E. Gould & Son, Ltd., Moorgate Street, E.C.
N EW WORK. Practice of Medicine, containing the Homoeopathic
Treatment of Diseases, by Pierre Jousset, M.D. Translated from
the Third French Edition with additions and annotations by J. Arschagonni,
M.D. 38/- nett. E. Gould & Son, Ltd., 59, Moorgate Street, E.C.
Published Quarterly. Price 2s. 6d.
THE JOURNAL OF THE BRITISH HOMOEOPATHIC SOCIETY,
A Edited by Richard Hughes, M.D. Containing papers read before the
Society, and a Summary of Pharmacodynamics and Therapeutics. John
Bale & Sons, Ltd., 85, 87, 89, Great Titchfield St., Oxford St., London, W\
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[1902.
®f * “ DICULE S”
A new and portable form of Homoeopathic preparations
lately introduced.
Unlike similar preparations, “ Dicules” are not medicated with
tinctures of dried vegetable substances (except when such are official),
or by evaporation of fresh plant tinctures.
They will be found to retain, in a high degree, the volatile
constituents of the fresh vegetable juices peculiar to homoeopathic
pharmacy, and hence form the best substitute for the tinctures.
The method by which “ Dicules ” are prepared renders them
capable of being more thoroughly medicated than pilules. Each
“ Dicule ” represents an exact quantity, namely, one minim (equivalent
to about two ordinary drops) of any attenuation.
To those accustomed to use the stronger forms of medicines they
are especially recommended.
They also form a good accompaniment to the trituration tablets
of insoluble drugs, and are particularly adapted for pocket cases and
chests of medicines in the solid form.
They are sold in bottles at 9d., 1/-, 1/9, 3/- and upwards.
E. GOULD & SON, Ltd.,
59, MOORGATE STREET, LONDON, E.C.
Third Edition. Revised and Enlarged, cloth 10s. 6d.; half bound, 14s.
THE BRITISH
Homeopathic Pharmacopeia.
PUBLISHED FOR THE
Hritisft, Homoeopathic Society,
BY
E. GOULD & SON, Ltd., 59, Moorgate Street, E.C.
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[1902.
ABBREVIATED CATALOGUE
OF THE LATEST
AMERICAN HOIVUEOPATHIC PUB LICATIONS.
The ABC Manual of Materia Medica and Therapeutics.
G. Hardy Clark. 197 pages. 1901. 5/* net.
Practical Homoeopathic Therapeutics. Dewey. 1901. 12/6 net
Characteristics of the Homoeopathic Materia Medica. M. £.
Douglass. 1901. 25/-.
Mental Diseases and their Modern Treatment. S. H. Talcot.
1901. 12/6.
A Monograph of Diseases of the Nose and Throat. George
H. Quay. 2nd Edition. 1900. 6/6 net.
A Systematic Alphabetic Repertory of HomoBopathic Remedies.
Antipsoric, Antisyphilitic and Antisycotic. Boenninghausen. Translated by
C. M. Boger. 1900. 15/- net.
Skin Diseases. Their Description, Etiology, Diagnosis and Treatment.
M. E. Douglass. Illustrated. 1900. 17/6 net.
New, Old and Forgotten Remedies. Anshutz. 1900. 10 /- net.
Leaders in Typhoid Fever. Nash. 1900, 3/- net.
Key Notes and Characteristics. H. C. Allen. 2nd Edition. 1900.
10/- net.
Children: Acid and Alkaline. Duncan. 1900. 3/-net.
Repertory of the Urinary Organs and Prostate Gland. Morgan
1899. 15/- net.
Diseases of Children. Raue. 1899. lb/- net.
A Practice of Medicine. Arndt. Ia99. 40/- net.
Leaders in HomcBopathic Therapeutics. Nash. 1899. 12/6
Renal Therapeutics. Mitchel. 1898. 10/- net.
Therapeutics of Facial and Sciatic Neuralgias. Lutze. 1898.
6/6 net.
Veterinary HomoBopathy in its Application to the Horse.
Hurndall. 1896. Cloth, 10/- net.
The Chronic Diseases. Hahnemann, 1896. Half-Morocco, 50, - net.
Essentials of Homoeopathic Therapeutics. Dewey. 2nd Edition.
1898. 7/6 net.
Essentials of Homoeopathic Materia Medica. Dewey. 3rd Edition
1899. 9/- net.
Bee Line Therapia and Repertory, Jones. 1899. 10/- net.
The Twelve Tissue Remedies. 4th Edition. Boericke and Dewey.
1899. 12/6.
Ophthalmic Diseases and Therapeutics. Norton. 2nd Edition.
1898. 25/- net.
E. GOULD & SON, Ltd., 69, Moorgate Street, London, E.C.
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[ 1902 .
TONIC WINE.
DIGESTIVE. NON-IRRITANT.
A CARDIAC TONIC.
A natural Wine which dees not contain Coca, Kola, or
any like drug.
This wine has now thoroughly established its reputation, and has
been prescribed with success by many of the leading homoeopathic
practitioners for some years past.
It is eminently suited to persons of a nervous temperament who
suffer from weakness of the heart’s action, and weak digestive powers.
It has no irritating effect on the mucous membranes like most wines
and spirits.
It raises the vitality , while whisky and other spirits, however much
diluted, lower it.— (Foods: By Dr. Edward Smith, F.R.S.)
Nearly all wines (except the most expensive) and spirits irritate
the mucous membranes of the alimentary canal, causing flatulence,
ultimate depression of spirits, &c.
Persons of gouty or rheumatic disposition, who drink no other
alcoholic liquors, may use this wine with great benefit.
As it creates no craving for stimulants, its use as a tonic may be
discontinued at any time without inconvenience. By raising the vitality
it tends to enable patients to dispense with the use of alcohol altogether.
44 Vocalists would do well to give the new 4 tonic wine ’ a trial. It is
undoubtedly the best wine now in the market, as it raises the vitality and
assists digestion, and does not contain coca, kola, or any like drug. In flavour
it resembles a pure dry hock, and we can, from experience, recommend it
to all vocalists, as it brightens the voice without the af:er depression
which generally follows the use of wines, &c .”—The Gentleman's Journal ,
August, 1892.
It is sold in half bottles at 16 /- per doz., carriage free.
E. GOULD & SON, Ltd.,
59, MOORGATE STREET, LONDON, E.C.
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Hahnemann’s Therapeutic Hints. Collected and arranged by
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Now ready. Crown 8vo, 208 pp., cloth. Price 3s. 6d.
Diseases of the Heart and Arteries; Their Causes,
NATURE AND TREATMENT. By John H. Clarke, M.D., C.M. Edin.
Fourth Edition. Price 3s. 6d.
Homoeopathy in Venereal Diseases. By Stephen Yeldham,
L.R.C.P. Ed., M.R.C.S. Eng., Consulting Surgeon to the London Homoeopathic
Hospital, Fellow, and late President of the British Homoeopathic Society, etc. Edited,
with additions, and an Original Chapter on Spermatorrhoea, by Henry Wheeler.
L.R.C.P. Lond., M.R.C.S. Eng., late Surgeon to the London Homoeopathic Hospital.
This work is based on experience gained during half a century of active practice.
Price 2s.
Dogs in Health and Disease, as Typified by the Grey-
HOUND. By John Su tcliffe Hurndall, M.*R.C.V. S.
Seventh Edition, enlarged and revised. Post free, Is. 6d.
Taking Cold (the cause of half our diseases); Its Nature,
CAUSES, PREVENTION, AND CURE: Its frequency as a cause of other
diseases, and the diseases of which it is the cause, with their diagnosis and treat-
ment. By John W. Hayward, M.D., M.R.C.S., L.S.A.
Third Edition, enlarged and revised, pp. 728. Price os.
Modern Household Medicine; a Guide to the Mode of
RECOGNITION AND THE RATIONAL TREATMENT OF DISEASES AND
EMERGENCIES INCIDENTAL TO DAILY LIFE. By Chablbb Robert
Fleury. M.D., Licentiate of the Royal College of Physicians, London; Member ot
the Royal College of Surgeons, England; formerly Clinical Resident at the
Richmond Surgical, Whitworth Medical, and Hardwicke Fever Hospitals, Dublin;
and late Medical Officer to the Peninsular and Oriental Company, in the East
Indies, China, and the Mediterranean.
Second Edition. Strongly bound, cloth boards. Price Is. 6d.
Chronic Sore Throat (or Follicular Disease of the
PHARYNX). Its Local and Constitutional Treatment, with Special Chapters
on THE ART OF BREATHING, and HYGIENE OF THE VOICE. By
E. B. Shuldham, M.D., Trin. Coll., Dublin, M.R.C.S., M.A. Oxon.
Sixteenth Thousand. Revised and enlarged, pp. 264. Price ,2s. 6d.
The Principal Uses of the Sixteen most Important, and
FOURTEEN SUPPLEMENTARY HOMOEOPATHIC MEDICINES. Arranged
according to the plan adopted in Physicians’ Manuals, and designed for those who
require a full ana comprehensive Guide, in a condensed and easy form. Compiled
from the Standard Medical Works of Jahr, Hull, Hempel, Bryant, Hale, &c.
Fourteenth Thousand. Enlarged and modernised. Price 2s. 6d.
Family Practice; or, Simple Directions in Homoeopathio
DOMESTIC MEDICINE. Compiled from the Standard Medical Works of Jahr,
Hull, Hempel, Bryant, Hale, «c.
“ This little work differs from most of the Guides for Domestic Practice, in having the treat¬
ment of each disease so arranged and divided, that each particular aspect of the complaint has
its own special medicinal ana accessory treatment distinctly stated. .The medicines are not
confined to a fixed number, but in every case the best remedies are given, and the dose is clearly
indicated in each instance.*
Seventh Edition. Price Is,
The Family Homceopathist; or, Plain Directions for
THE TREATMENT OF DISEASE. By E. B. Shttldham, M.A., M.D., etc.
“We have no hesitation in saying that Dr. Shuldham*s little book is both interesting and
useful. It is thoroughly practical, moreover; and without confusing the reader with a host of
remedies, only a few of which are of frequent use, he points to such as have been well tested in
practice and have received the confidence of all who have used them .’’—Homosopathic Review.
E. GOULD & SON, Ltd, 59 Moorgate Street, E.C.
UNIVERSITY OF MICHIGAN
3 9015 07671 5518
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February 1] MONTHLY HOMOEOPATHIC REVIEW.
[1902.
NO. 31.
MOROCCO CHEST FOR
TRAVELLING
The above Chest is arranged to hold the
largest quantity of each medicine in the
smallest space, and contains 30half-eunce
bottles of Tinctures, Triturations, or
Pilules, specially selected to suit any
particular climate, in the upper part; and
6 half-ounce stoppered bottles of Exter¬
nal Tinctures, Lint, etc., in the drawer.
Inside the lid are placed Arnica and
Calendula Plasters, a Drop Conductor,
and a Trituration or Pilule Spoon. The
whole Chest being only 6J inches long,
61 inches broad, and 4£ inches high.
Price (retail) £2 15s.
No 32
MOROCCO POCKET CASE.
Containing 36 one-drachm tube phials
of Tinctures or Pilules in the most
Portable form, with Arnica and Calendula
rlasters.admirahlyadapted for travelling,
^rice (retail) 28 <
Nu 34.
TOURIST’S
MOROCCO POCKET CASE.
Specially adapted to the requirements
of families while travelling or away from
home. Tt contains 24 one-drachm tube
phials of Tinctures or Pilules for internal
use. a supply of the principal external
Tinctures, Arnica and Calendula Plasters,
Lint and Oiled Silk. It is very portable
and compact. Price (retail) 30s
No. 35.—A similar Case, containing
two-drachm bottles of Tincture? and
Pil ules and a larger supply of the External
Tinctures, etc. Price (retail) 40s
FLAT DOUBLE-FOLDING
ALL-MOROCCO
POCKET CASES.
Containing 24 half-drachm tube phiai»
of the remedies, with A rnica and Calends
Plasters Price (retail) 20s.
30 ditto ... » 258.
* 36 ditto ... * 28s.
48 ditto ... * 388.
60 ditto ... - 458.
II.LUSTRATED LIST OP MEDICINE CHESTS, &C.
iVoir Ready. Poet Fret.
E. GOULD & SON. LTD..
Chemists to the London Homoeopathic Hospital,
59. MOORGATE STREET, LONDON, E.C.
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