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flOSIDN  MEDICAU  UBRARY 

IN  THE 

•MNCIS  ^ifiDUNTWAY 

UBRARV  OF  MEDICmg 

BRITISH    JOURNAL 


HOMCEOPATHY. 

EDITED  BY 

K.  E.  DUDGEON,  M.D., 
EICHAKD  HUGHES,  L.K.C.P. 


TOL  XXXTII. 


n  cxKTiB  miTAfl,  m  dddiib  libkbtab,  m  oMiimrs  oHAxirie. 

FCBLISHED  FOK  THX  FROPKIET0R3  BT 

SENBT    TTJENBE,    170,     FLEET     STREET, 
LONDON. 

KAY  BB   lUD    AX80   PKOH 

EDlflBimOH:   J.  C.  POPTAeE,  117,  FXINCESS   BTHEET. 

DUBLIN:  I.  A.  RAY,  GREAT  GZOKGE  STREKT. 

NEW  lOBK,  U.S. :   BOERICKE  ft  TAyEL,  lU,  QBADD  SIB££T. 

IIDOOCIJ^XII. 


CONTENTS  OF  No.  OXLVH. 

PAOB 

HOMCEOPATHIC  F0S0L06T.  AN  INTRODUCTOEY  LEGTUKE  TO  TH£  WINTER 
OOUBSE  OF  MATERIA  AKD  THERAPEUTICS,  DELIVERED  IN  THE  LONDON 
SCHOOL  OP  HOIKEOFATHT.    BT  DIL  RICHARD  HUGHES  .  .1 

MEDICAL  AND  OTHER  NOTES  COLLECTED  ON  A  HOLIDAY  TOUR  TO  ARCA- 
CHOX,  BIARRITZ,  PAU.  AND  OTHER  PRINCIPAL  WATERING  PLACES  IN 
THE  PYRENEES.    BY  DR.  ROTH    .  .15 

NOTES  ON  DIABETES.    BY  FRANCIS  BLACK,  M.D.       .  .43 

NOTES  ON  THE  MORE  REGENT  CHAPTERS  OP  THE  CYPHER  REPERTORY. 
BY  DR.  DRY8DALE  .....  81 

REVIEWS. 

XRUFTITE  PETERS :  SCARLET  FEVER,  MEASLES,  SMALLPOX,  8co.    BY  WILLIAM 

TALLANCY  DRURY.  MJ).,  M.RJA.,  kc       ,  .79 

NATRUM  MURUTICUM  :  AS  TEST  OP  THE  DOCTRINE  OF  DRUG  DYNAMIZA- 
TION.    BT  JAS.  COMPTON  BURNETT,  M.D.,  PJLG.S.  .81 

THE  6EBM  THEORIES  OF  INFECTIOUS  DISEASES.    BY  JOHN  DRYSDALE,  M.D.      88 

CLINICAL  LECTURES  UPON  INFLAMMATION  AND  OTHER  DISEASES  OF  THE 

EAR.    BY  ROBERT  T.  COOl^R*  A.B.,  M.D.  Tsur.  Coxx.,  DiTBLUi  86 

MISCELLANEOUS. 

Tbe  LondflB  SciMwl  of  HomcBOMthy.  93.— The  lute  Madame  HahneDumii,  9&— Medical 
LOeialitj  Tested  and  found  Wanting,  106. 

OBnvAmz  .*— Dr.  F.  F.  Qnin,  109. 

Boou  Ricirfio,  113. 


CONTENTS  OF  No.  OXLVXH. 

NOTES  OH  DIABETES.    BY  FRANCIS  BLACK,  MJ)<       .  .    llS 

ON  THE  USE  OF  ALCOHOL  IN  HEALTH.    BY  R.  £.  DUDGEON,  MJ).    .  .    183 

MEDICAL  AND  OTHER  NOTES  COLLECTED  ON  A  HOLIDAY  TOUR  TO  ARCA. 
CHON,  BIARRITZ,  PAU,  AND  THE  PRINCIPAL  WATERING  PLACES  IN  THE 
PYRENEES.    BY  DR.  ROTH  .  .    163 

A  NOTE  ON  PICRIC  ACID.    BY  DR.  HUGHES  .  .169 

REVIEWS. 

ENCYCLOPifiDIA  OF  PURE  MATERIA  MEDICA.    BY  T.  P.  ALLEN,  A.M.,  M.D. 

VOL.  VIU.— PLUMBUM— 8ERPENTARIA      .  .  .177 

CLINICAL  THERAPEUTICS.    BY  SEMFLE  S.  HOYNE,  A.M.,  M.D.  .    178 

mgEASKS  OF  INFANTS  AKD  CHILDREN,  WITH  THEIR  HOM(EOPATHIC  TREAT- 
MENT.   EDITED  BY  T.  C.  DUNCAN,  M.D.  .178 

A  TABULAR  HANDBOOK  OP  AUSCULTATION  AND  PERCUSSION  FOR  STUDENTS 

AND  PHYSICUNS.    BY  HERBERT  C.  CLAPP,  A.M.,  M.D.     .  .179 

THIS  YEAR'S  PROGRESS.    BY  J.  C.  BURGHER,  M.D.    .  .180 

THE  URINE  OF  THE  NEW  BORN.    BY  J.  PARROT  AND  ALBERT  ROBIN  .    181 

8CLER0T0MIE.     SON    MANUEL  OPERATOIRE,   SE8    INDICATIONS    ET    SON 

ACTION  PHY8I0L0G1QUE.    PAR  L£  DOCTEUR  DE  KEERSMAECKER  .    181 

REMEDIES  FOR  PERIODIC  PAIN.    ARRANGED  BY  EDWARD  T.  BLAKE,  M.D.   .    188 

IS  DIPHTHERU  PREVENTABLE  ?    BY  EDWARD  T.  BLAKE,  M.D.  .    183 

HOMCEOPATHY  VINDICATED.    BY  E.  W.  BEKRIDGE,  M.D.  .188 

HOW  10  TAKE  CARE  OF  OUR  EYES.    BY  HENRY  C.  ANGELL,  M.D.    .  .    186 

OORSO  TEORETICO-PRACTICO-ALFABETICO  DI  MEDICINA  OMEOPATICA.    PEL 

PROF.  CATALDO  CaVALLARO  .186 

MEDICAL  CHEMISTRY.    BY  C.  GILBERT  WHEELER    .  .187 

OX  THE  NEGLECT  OF  PHYSICAL  EDUCATION  AND  HYGIENE  BY  PARLIA- 
MENT AND  THE  EDUCATION  DEPARTMENT.    BY  DR.  BOTH  .    188 

8PECUL  REPORT  OF  THE  HOM(BOPATHIC  YELLOW  FEVER  COMMISSION 
ORDERED  BY  THE  AMERICAN  INSTITUTE  OF  HOMCEOPATHY  FOR  PRE- 
SENTATION TO  CONGRESS  .  .  .189 

OUR  FOREIGN  CONTEMPORARIES  .190 

MISCELLANEOUS. 

Reply  to  Dr.  Dxredale'a  Objections  to  the  Recent  Chapters  of  the  Cypher  Repertory.  By 
£.  W.  Bemdge,  M.D.,  3U.— Pond's  Spbyfnograph,  318.— Law  or  Rule?  By  JEUchard 
H^ea,  M.D.,  319. 

Books  Rkcsived,  23*. 


CONTENTS  OF  No.  OXLIX. 

FAOK 

MEDICAL  AND  OTHER  NOTES  COLLECTED  ON  A  HOLIDAY  TOUR  TO  ARCA- 
CHON,  BIARRITZ,  PAU.  AND  THE  PRINCIPAL  WATERING  PLACES  IN  THE 
PYRENEES.    BY  DR.  ROTH  .    S2G 

THE  RECONSTITUTION  OF  THE  MATERIA  MEDICA.    BY  DR.  HUOHKS  .    SS7 

CASES  WITH  REMARKS.     BY  ROBERT  T.  COOPER  M.D,  T.C.D.  .    871 

REVIEWS. 

EVOLUTION.  OLD  AND  NEW;  OR,  THE  THEORIES  OF  BUFFON,  DR.  ERASMUS 
DARWIN,  AND  LAMARCK,  AS  COMPARED  WITH  THAT  OF  MR.  CHARLES 
DARWIN.    BY  SAMUEL  BUTLER  .  .878 

HOM(EOPATHIC  THERAPEUTICS.    BY  S.  LILIENTHAL,  M.D.    .  .983 

LFXrrURES.  CLINICAL  AND  DIDACTIC,  ON  THE  DISEASES  OF  WOMEN.     BY 

R.  LUDLAM.  M.D.    FOURTH  EDITION  .884 

SOME  REMARKS  ON  8IMILIA  SIMILIBUS  CURANTUR.     BY  W.  B.  DUNNING, 

LECTURES  ON  MATERIA  MEDICA.    BY  CARROLL  DUNHAM,  M.D.  .    386 

THE  GUIDING  SYMPTOMS  OF  THE  MATERIA  MEDICA.     BY  C.  HERING.  M.D. 

VOL.  1.  ABIB8-ABM0RACBA  .888 

EYE  NOTES.    BY  DR.  C.  H.  VILAS.    Nob.  1  and  S        .  .390 

EAR  NOTES.    BY  THE  SAME  .  .290 

AN  ILLUSTRATED  REPERTORY  OF  PAINS   IN  CHEST.    SIDES,  AND   BACK: 
THEIR  DIRECTION  AND  CHARACTER  CONFIRMED  BY  CLINICAL  CASES. 
BY  ROLLIN  R.  GREGG,  M.D.  .891 

THE  MODERN  PHYSICIAN  AND  FAMILY  DOCTOR:    A  MONTHLY  JOURNAL  OF 

DOMESTIC  MEDICINE.  HYDROPATHY,  AND  SANITARY  SCIENCE  .  .    393 

GOLD  AS  A  REMEDY   IN  DISEASE,  NOTABLY  IN  SOME  FORMS  OF  ORGANIC 
HEART   DISEASE,   ANGINA    PECTORIS,   MELANCHOLY,   TiEDIUM   VIT£, 
SCROFULA.  SYPHILIS.   SKIN  DISEASE,  AND    AS  AN  ANTIDOTE  TO   THE 
ILL   EFFECTS   OF    MERCURY.      BY   JAMES    COMPTON    BURNETT,   M.D., 
St  K.W.S.    .........    xyx 

A  BIOGRAPHICAL  RETROSPECT  OF  ALLOPATHY  AND  HOMCEOPATHY  DURING 
THE   LAST   THIRTY   YEARS,   WITH   CASES.    BY  !IUGH  HASTINGS,  M.D., 
M.BkC.S.,  L.S.A.,  flcc.  .......    394 

OUR  FOREIGN  CONTEMPORARIES  .398 

MISCELLANEOUS. 

The  Pnetitioner,  SIO.— Bm  StingB  iu  RheimiAtism,  813.— Arnica  in  Boils,  816.— Briliah  Homooo- 
pathic  Congress,  318. 

CORRESPONDENCE    .......  ^    319 

Books  Rscbivxd,  330. 

ApranDTZ :— Pstbogenetic  Record,  by  Dr.  BinniDOB. 


CONTENTS  OF  No.  CL. 

OVARIOTOMY.    BY  PROFESSOR  WM.  TOD  HELMUTH,  M.D.      .  .  .381 

HISTORY  OF  HOM(EOPATHY  IN  AUSTRIA.    BY  DR.  EDWARD  HUBER  .    330 

NOTES  ON  DIABETES.    BY  FRANCIS  BLACK.  M.D.       .  .346 

REVIEWS. 

THE  ENCYCLOPEDIA  OF  PURE  MATERIA  MEDICA.  A  RECORD  OF  THE 
POSITIVE  EFFECT  OF  DRUGS  UPON  THE  HEALTHY  HUMAN  ORGANISM. 
EDITED  BY  T.  F.  ALLEN,  A.M.,  M.D.    VOL.  IX.  SILICBA—THVJA  .  .    873 

ESSAYS  ON  OPHTHALMOLOGY.    BY  GEORGE  EDWARD  WALKER,  F.R.C.S.,  8cc.  .    373 
OUR  FOREIGN  CONTEMPORARIES  .  .377 

MISCELLANEOUS. 

Congress  of  British  Homceopathic  Practitioners,  404. 

Books  Rbcbitxd,  406 

Appvudix  :— Pathogenetic  Record,  by  Dr.  Bkebidgx. 


THE 


BRITISH   JOURNAL 


OT 


HOMGEOPATHY. 


HOMOEOPATHIC    POSOLOGY. 

An  Introductory  Lecture  to  the  Winter  Course  of  Materia 
and  Therapeutics^  delivered  in  the  London  School  of 
Homoeopathy^  Oct.  7th,  1878. 

By  Dr.  Richard  Hughes: 

Thbue  is  one  topic  on  which  I  must  enlarge  ere  we 
begin  again  our  detailed  study  of  the  Materia  Medica.  I 
have  spoken  of  the  modifications  imposed  upon  this  course 
orinstruction  by  the  fact  of  its  being  delivered  in  a  School 
of  Homoeopathy,  But  I  find  that  I  have  omitted  any 
special  notice  of  what^  to  many  minds,  would  seem  the 
most  peculiar  feature  of  that  which  I  shall  say.  I  refer  to 
the  minute  dosage  with  which  I  shall  so  often  have  to  deal. 
The  pharmaceutic  processes  I  have  described  as  character- 
istic of  homoeopathy  have  for  their  main  object  the  reduc- 
tion of  the  drug  to  fractional  proportions,  of  which  the 
third  degree  already  represents  the  millionth  part  of  a  grain 
or  a  drop,  while  I  shall  have  to  speak  familiarly  of  the  sixth, 
the  twelfth,  and  even  the  thirtieth.  You  will  be  warranted 
in  demanding  of  me  some  explanation  and  vindication  of 
such  unwonted  dosage ;  and  it  will  be  my  pleasure,  as  well 
as  my  duty,  to  give  it  you. 

VOL.  XXXVII,   NO.   CXLVII. JANUARY,    1879.  A 


2  HomoEopathic  Fosoloyy, 

Now  the  first  and  chief  reason  of  my  dealing  with  these 
minute  quantities  of  drugs  is,  that  their  use  is  a  fact  in  the 
history  of  homoeopathy.  I  have  already  told  you  h6w 
Hahnemann  early  followed  up  the  enunciation  of  his  new 
principle  by  a  reduction  of  the  dose  of  medicines  given  in 
accordance  with  it^  and  how  in  later  times  he  pushed  the 
attenuation  of  his  remedies  to  the  elevated  degrees  I  have 
just  mentioned.  If  any  of  you  desire  to  follow  him  step 
by  step  in  his  progress^  from  1796  to  1839,  you  will  find 
the  means  of  doing  so  in  the  article  on  the  subject  con- 
tained in  the  British  Journal  of  HomtBopaihy  for  April, 
1878.  As  it  was  not  till  after  1811  that  he  began  to  make 
professional  converts  to  his  system,  it  came  to  them  all  with 
the  infinitesimal  dose  as  a  part  of  it,  and  was  by  them  all 
carried  out  therewith.  Most  of  them,  moreover,  went  on 
with  their  master  in  his  further  developments  of  attenua- 
tion, and  some  have  since  pushed  far  beyond  him  in  the 
process.  The  result  is  that  the  great  bulk  of  the  homoeo- 
pathic experience  on  record  has  been  obtained  by  means  of 
minute  dosage,  and  no  little  of  its  pathogenesy  owns  a 
similar  origin.  I,  as  a  teacher  in  a  School  of  Homoeo- 
pathy, have  to  deal  with  it  historically — as  it  actually  is 
and  has  been ;  and,  whether  I  myself  approved  of  them  or 
not,  infinitesimals  must  necessarily  play  a  large  part  in  the 
lessons  it  is  my  duty  to  give. 

But  I  am  fully  prepared  to  maintain  the  tenableness  in 
itself  of  the  homoeopathic  posology,  and  to  advocate  it  as  a 
most  important  and  beneficent  part  of  Hahnemann's  thera- 
peutic reform. 

In  the  first  place,  comparative  smallness  of  dosage  is  the 
logical  and  obvious  corollary  of  similia  similibus  curentur. 
It  needs  no  argument,  as  I  have  said,  to  show  that  the 
ordinary  doses  of  Arsenic,  against  which  even  a  healthy 
stomach  needs  to  be  shielded,  would  increase  the  irritation 
of  one  already  inflamed,  for  which,  nevertheless,  the  homoeo- 
pathic principle  would  direct  its  being  given.  The  quan- 
tity administered  must  be  reduced  accordingly.  Nor  are 
Hahnemai)nn  and  his  avowed  followers  the  only  witnesses 
to  the  practical  necessity  of  this  proceeding.     Whenever  a 


by  Dr,  Hughes.  3 

piece  of  homoeopathic  practice  has  been  borrowed  by  the 
practitioners  of  the  old  school^  the  small  dose  has  alwajs 
gone  band  in  hand  with  the  similar  remedy.  Drops  of 
Ipecacuanha  wine  were  unknown  to  the  ordinary  posology 
UDtil  the  drug  began  to  be  used  to  check  vomiting  instead 
of  to  cause  it ;  and  similar  novelties  in  the  way  of  dosage 
abound  in  the  Therapeutics  of  Dr.  Binger^  and  in  the  like* 
minded  communications  of  Dr.  Dessau  to  his  New  York 
colleagues.*  I  may  appeal  to  such  facts  as  the  best  answer 
to  the  argument  lately  advanced  by  Dr.  Decaisne  in  France^ 
and  Dr.  Barr  Meadows  in  this  country^  that  the  aggrava- 
tion caused  by  similarly-acting  remedies  in  the  ordinary 
quantities  proves  their  unsuitableness,  and  that  the  diminu- 
tion of  dose  merely  evades  the  difficulty  by  reducing  their 
action  to  nullity.. 

But  this  argument,  valid  as  it  is^  establishes  only  the 
relative  smallness  of  the  homoeopathic  dose.  We  must  go 
farther  to  ascertain  what  its  positive  littleness  may  be^  and 
to  warrant  any  measure  of  the  astonishing  exiguity  it  has 
actually  attained. 

Now  I  would  here  suggest  that  dose  is^  to  begin  with^ 
a  mere  arbitrary  matter.  There  is  nothing  in  nature  cor- 
responding to  drachms  and  scruples  and  grains^  and  there 
is  no  reason  why  that  particular  number  of  molecules  which 
go  to  make  up  the  last-named  quantity  should  be  desig- 
nated by  a  whole  number^  while  all  below  it  must  be 
expressed  by  fractions.  Yet  the  result  of  its  being  so  is 
that  in  the  grain  we  seem  to  have  got  to  the  ultima  Thule  of 
ordinary  smallness^  and  any  further  division  strikes  us  as 
strange.  Again,  it  is  evident  that  all  our  notions  of  dosage 
are  derived  from  the  quantities  of  drugs  it  has  been  found 
necessary  to  give  to  produce  their  physiological  effects  on 
the  system — to  set  up  purgation  or  emesis^  the  sedation  of 
aa  aching  nerve  or  the  relaxation  of  muscular  spasm.  If 
the  so-called  "  alterative'^  medication  had  attained  a  larger 
place  in  therapeutics^  these  notions  might  have  been  modi- 
fied. It  has  always  been  recognised  that  a  different  posology 
holds  good  with  regard  to  remedies  of  this  kind ;  that^  as 

•  New  York  Medical  Becord,  July  28. 1877. 


4  Homceopathic  Posology, 

no  physiological  eflfect  was  sought^  but  only  a  gradual  extin- 
guishment of  the  morl)id  etate^  the  dose  necessary  to  be 
given  was  purely  a  matter  of  experience.  Now  it  cannot 
be  too  clearly  recognised  that  all  homoeopathic  remedies  are 
'' alteratives^'  in  this  sense;  and  hence  that  any  standard 
of  dosage  taken  from  such  medication  as  aims  to  produce 
physiological  effects  is  inapplicable  to  them. 

Further,  it  is  obvious  that,  even  without  taking  such 
distinctions  into  account,  dose  is  a  shifting  quantity.  It 
varies,  as  every  one  admits,  within  certain  limits,  according 
to  age  and  sex,  the  strength  or  weakness  of  the  patient,  and 
the  amount  of  medicinal  susceptibility  he  possesses.  It 
varies  through  a  still  wider  range  with  the  different  drugs 
we  administer.  Take,  for  instance,  two  remedies  renowned 
of  old  in  the  treatment  of  cutaneous  disease — Dulcamara 
and  Arsenic.  Carrere,  the  introducer  of  the  former,  adminis- 
tered it  in  tablespoonfuls  of  a  decoction  made  in  the  propor- 
tion of  an  ounce  to  a  pint,  while  the  latter  is  given  in  small 
doses  of  a  solution  (Fowler's),  which  contains  only  1  part  in 
120,  sometimes  requiring  (as  in  a  case  of  Mr.  Hunt's)  that 
even  minims  of  this  shall  be  broken  up  into  fractions,  which 
yet  prove  curative.  So,  when  another  potent  substance — 
Phosphorus — ^is  introduced  (as  lately  by  Mr.  Ashburton 
Thompson)  into  the  ordinary  practice,  no  one  is  surprised  at 
his  recommending  its  employment  in  hundredths  of  a  grain. 
With  the  alkaloids  we  get  further  still  in  the  realm  of 
minuteness,  even  as  regards  physiological  action.  Take  the 
influence  of  Atropia  in  dilating  the  pupil.  The  "  atropised 
gelatin"  prepared  by  Savory  and  Moore  under  the  direction 
of  Mr.  Ernest  Hart  purports  to  contain  but  Todasd^^  ^^  & 
grain  in  each  disk ;  yet  it  answers  its  purpose  excellently 
well.  Professor  Donders  (cited  in  the  fourth  edition  of 
Pereira's  Materia  Medica)  finds  that  in  dogs  the  attenuation 
of  Atropia  may  be  carried  up  to  To^^th  before  the  effect 
becomes  doubtful ;  and  it  is  possible,  from  the  experiments 
of  Rossbach  and  Frohlich,  that  the  doubtfulness  arose  from 
contraction  being  produced  by  the  drug  when  reduced  below 
the  dilating  point.  Professor  Donders^  moreover^  adds : — 
'*  The  sensitiveness  of  the  eye   to  Atropia,  indeed,   excites 


by  Dr.  Htghes.  5 

astoDishment^  when  we  consider  that  of  the  single  drop  of 
attenuated  solution  which  suffices  to  produce  dilatation  pro- 
bably not  a  fiftieth  part  is  absorbed/^     Nor  is  it  the  pupil 
only  that  these  dilute  applications  to  the  eye  can  effect.     Dr. 
Harley  records  an  observation  of  ''  congestion  of  the  entire 
eonjunctiva^  with  dryness  of  the  membrane  and  dull  aching 
pain  in  the  eyeball^  lasting  for  several  hours/^  occurring 
after  the  instillation  of  twelve  drops  of  a  solution  of  one 
part  in  400^000  of  water.     We  have  only  to  go  somewhat 
lower  in  the  scale  of  fractional  minuteness  to  see  the  drug 
affecting    the   whole  organism   from    within.      Dr.   Ringer 
finds  the  800th  of  a  grain  of  Atropia,  subcutaneously  in- 
jected, sufficient  to  dry  up  the  whole  surface  of  the  body, 
even  when  freely  perspiring  in  the  Turkish  bath ;  and  Dr. 
Harley  writes  of  this  substance — *'  An  infinitesimal  quantity 
— z  mere  atom — as  soon  as  it  enters  the  blood  originates  an 
action  which  is  closely  allied  to,  if  it  be  not  identical  with, 
that  which  induces  the  circulatory  and  nervous  phenomena 
accompanying  meningitis,  enteric,  or  typhus  fever.^'     Aco- 
nitine  carries  us  a  step  farther.    The  300th  of  a  grain  of  this 
alkaloid*  was  found   by    Dr.   Miluer    Fothergill    sufficient 
actually  to  kill  a  rabbit  of  3  lbs.  weiglt;  while  guinea-pigs 
are  jso  extraordinarilv  sensitive  to  its  lethal  influence  that 
one  weighing  a  pound  died  in  three  hours  and  a  half  after 
the  administration  of  Tnoth  of  a  grain.     After  these  expe- 
riences yon  will  not   be  surprised  to  hear  that  Professor 
Arnold,  of  Heidelberg,  found   tetanus  readily  produced  in 
frogs  by  ^^s^h.  of  a  grain  of  strychnia.     Even  the  toscoso^I^ 
caused  increased   reflex  excitability ;   and  in  one  of  these 
creatures,    which    the    day    before    had    been    tetanic   for 
some  hours,   after  j^sos^^  ^^  he^ii  administered  to  it,  but 
had  quite  recovered,  a  slight  attack  came  on  in  half  an  hour 
after  receiving   the  ^^^ogg^th,  which  ended,  after  some  hours, 
in  its  death. 

With  these  poisons  and  alkaloids,  then,  we  haveclearly  got  far 
on  the  road  to  another  standard  of  dosage.  The  French  millu 
gramme — i,  e.  ^th  of  a  grain — is  found  the  most  convenient 
unit  for  them,  and  even  this  (as  M.  Gubler  has  announced 
in  regard  to  Aconitine)  has  to  be  further  divided.     We  have 


6  HomoBopathic  Posology, 

got  a  long  way  towards  infinitesimals,  even  for  the  produc- 
tion of  physiological  effects;  and  it  would  be  very  unwise  if 
we  refused  to  look  ahead^  and  see  what  further  reduction 
may  be  necessary  when  we  seek  for  pure  therapeutic  results 
on  the  principle  of  similarity.  If  drop  doses  of  Ipecacuanha 
wine  are  sufficient  to  check  vomiting,  while  drachms  are 
needed  to  cause  it^  then,  if  '^  an  infinitesimal  quantity — a 
.  mere  atom^'  of  Atropia  will  originate  the  pyrexial  process 
in  the  bloody  how  minute  must  be  the  quantity  which, 
on  the  same  principle,  will  be  appropriate  to  extinguish 
it  I 

Yet  again.  There  are  many  substances  which  are  inert 
in  their  crude  state,  but  which,  when  rubbed  up  with  some 
indifferent  vehicle  so  as  to  ensure  a  fine  division  of  their 
particles,  become  active  enough.  We  have  a  familiar  instance 
in  Mercury,  which  as  pure  quicksilver  may  be  swallowed  by 
the  pound,  but  which^  when  intimately  mixed  with  confec- 
tion of  roses  or  with  chalk,  becomes  a  potent  drug.  It  is 
now  recognised  that  the  amount  of  oxidation  which  takes 
place  in  the  preparation  of  blue-pill  and  grey  powder  is  very 
small,  and  that  minute  subdivision  is  of  the  essence  of  the 
process.  Now  Hahnemann,  as  you  are  aware,  has  largely 
developed  this  mode  of  preparing  drugs,  introducing  the 
improved  method  of  a  graduated  trituration  with  sugar  of 
milk.  The  metals — gold,  silver,  platinum,  zinc,  together  with 
such  neutral  substances  as  charcoal,  flint,  and  lycopodium, 
are  wakened  to  energy  by  this  potent  process,  and  show 
themselves  capable  of  no  little  influence  upou  the  organism. 
It  is  obvious  that  since  in  this  way  a  real  development 
of  power  is  effected,  there  must  be  a  certain  stage  in  the 
process  at  which  the  drug,  inert  in  its  crude  state,  begins 
to  be  active,  and  another  at  which  this  newly-awakened 
energy  is  at  its  height^  after  which  all  further  attenuation 
must  have  a  contrary  effect.  At  this  second  stage  the 
triturated  substance  [stands  on  the  same  level  with  a  medi- 
cine of  similar  character  which  is  active  from  the  first; 
so  that  a  grain  of  Silica  2  may  be  equal  to  one  of  Hepar 
sulphuris  ip,  though  in  actual  quantity  of  the  drug  the  latter 
is  to  the  former  as  10,000  to  1.     Thus,  with  the   medi- 


by  Dr.  Hughes.  7 

cines  made  sucb  by  tritaration  a  very  minute  fraction  may 
be  the  nnit  of  their  strength  and  the  standard  of  their 
physiological  activity ;  while  a  still  more  infinitesimal  quan- 
tity will  be  appropriate  when  they  are  used  as  remedies 
upon  the  homoeopathic  principle.  I  have  mentioned  the 
second  trituration  here  because  it  was  in  those  from  the 
first  (as  Aurum  and  Argentum)  to  the  third  (as  Carbo)  that 
Hahnemann  proved  medicines  of  this  kind. 

We  have  arrived^  then,  at  the  conclusion  that  when 
administered  in  conditions  similar  to  those  which  they 
cause^  medicines  must  be  given  in  smaller  doses  than  would 
be  necessary  for  such  causation ;  and  that  the  exiguity  thus 
required  may^  from  the  natural  activity  of  the  substance,  or 
from  the  degree  of  attenuation  at  which  its  energies  begin 
to  appear^  be  very  considerable,  reaching  sometimes  to  such 
fractions  as  the  thousandth^  the  ten-thousandth,  and  even 
the  millionth  of  a  grain.  It  may  have  to  go  thus  far,  but 
it  need  hardly  go  farther.  To  attenuations  of  this  degree 
Uahnemans  was  led  when  first  (in  1799)  he  began  to  use 
infinitesimals,  and  for  some  years  after  he  seems  to  have 
remained  at  the  same  point,  more  often  descending  below  it 
than  rising  above  it.  To  such  potencies,  moreover,  a 
number  of  his  followers — ^and  these  not  of  least  eminence — 
have  confined  themselves,  when  they  have  found  it  neces- 
sary to  ascend  alK)ve  the  mother  tincture  or  the  crude  drug. 
Drysdale  and  Kidd,  Yeldham  and  Black  in  this  country ; 
Trinks  and  Arnold  in  Germany ;  Cretin  in  France ;  Gray  in 
America — these  are  homoeopathists  of  no  small  note,  who 
tell  us  that  in  the  first  six  decimal  potencies  they  find  all 
the  attenuation  they  need,  when  they  need  any  at'  alL  On 
the  other  hand,  the  reasonableness  of  so  far  diluting  potent 
drugs,  when  homoeopathically  employed,  is  denied  by  none. 
Dr.  Ringer  may  recommend  his  hundredth-of-a-grain  doses 
of  corrosive  sublimate  in  dysentery,  and  Mr.  Hunt  may 
come  down  to  the  480ih  of  a  grain  of  Arsenic  in  psoriasis, 
and  no  one  will  gainsay  them.  One  of  the  latest  critics  of 
Homoeopathy — Dr.  Rogers,  in  his  Present  State  of  Thera^ 
peutici,  says  : — "  I  can  well  imagine  that  certain  energetic 
remedies  may  act  more  or  less  in  doses  of  the  1st,  2nd,  or 


8  Hommopathic  Posology, 

3rd    dilations   of   the    decimal   scale/'  ue,    in   the    tenth, 
hundredth,  or  thousandth  of  a  ^ain. 

So  far  you  have,  I  imagine,  followed  me  without  diffi- 
culty. There  is  nothing  in  reason,  nothing  in  the  nature  of 
things,  to  render  doubtful  the  apparent  testimony  of  experi- 
ence, when  ic  speaks  of  the  efficacy  of  similarly-acting 
medicines  in  the  attenuations  from  the  3rd  or  2nd  down- 
wards. If  homoeopathic  posology  had  only  taken  this  range, 
I  should  have  had  nothing  further  to  urge,  and  could  now 
have  left  the  subject  in  your  hands,  confident  of  your 
acceptance  of  my  position.  I  wish  indeed  that  I  could  have 
done  so,  and  that  the  method  of  Hahnemann  had  not  been 
weighted  with  anything  in  the  way  of  dosage  less  defensible 
than  the  thousandths  and  millionths  with  which  I  have 
been  dealing.  But  here  again  I  must  remind  you  that  my 
duty  is  not  to  express  my  own  preferences,  but  to  teach 
you  homoeopathy  as  actually  existing  and  historically  devel- 
oped. I  must,  therefore,  take  into  account  that  from  1808 
onwards,  Hahneman  is  found  raising  the  potencies  of  several 
of  his  medicines  far  above  the  3rd,  dealing  with  billionths, 
trillionths,  quadrillionths,  octillionths,  at  length  reaching 
the  decillionth,  and  in  1829  fixing  this  last  proportion  as 
most  suitable  for  all  drugs.  I  must  recognise  the  fact  that 
the  majority  of  his  disciples  have  followed  him  in  the  em- 
ployment of  these  higher  fractions,  and  are  using  them 
more  or  less  largely  in  their  practice  at  the  present  day. 
Nor  can  I  shut  my  eyes  to  the  later  development  of 
attenuation  up  to  the  200th  dilution ;  and  to  the  knowledge 
that  potencies  of  this  strength,  of  undoubted  pharmaceutic 
reality,  have  been  warranted  as  active  by  such  men  as 
Bonninghausen,  Dunham,  Tessi^r  and  von  Grauvogl,  and 
by  the  first  two  at  least  esteemed  of  more  efficacy — both  in 
acute  and  chronic  disease — than  any  lower  dilutions.  I 
cannot  ignore  these  facts;  and  more,  I  do  not  feel  justified 
in  presenting  them  to  you  as  a  mere  recorder,  with  such 
unsympathetic  reluctance  as  to  influence  you  against  their 
acceptance.  Much  as  I  regret  the  necessity  of  employing 
the  higher  infinitesimals,  I  cannot  but  acknowledge  it. 
The  testimony  in  their  favour  is  overwhelming ;  the  evi- 


by  Lr.  Hughes.  9 

deuce  of  their  efficacy  undeniable.  My  own  experience  of 
SQch  dilutions  as  the  6th  and  12thy  and  (with  some  reme- 
dies) of  the  30th,  is  such  as  to  make  me  join  with  unques- 
tioning acclamation  in  their  praise.  I  have  no  practical 
knowledge  of  the  200ths ;  but  if  I  had  no  other  fact  before 
me  than  their  constant  use  by  so  scientific  and  successful  a 
physician  as  Carroll  Dunham,  I  should  be  content  to 
acknowledge  their  legitimacy. 

But  here^  too,  we  must  inquire  how  far  the  apparent 
t^timony  of  experience  is  supported  by  reason^  by  science^ 
hy  observation. 

1.  I  fear  that  reason  has  nothing  to  say  in  our  favour. 
We  have  good  logical  ground  for  reducing  our  dose  below 
the  point  at  which  it  can  aggravate  the  existing  malady^  or 
iujnre  healthy  parts;  but  we  have  none  for  carrying  our 
attenuation  further  than  this.  We  seem^  therefore^  to  have 
effected  all  reasonable  ends,  even  with  the  ;nost  potent 
poisons,  when  we  have  reached  the  thousands  and  millionths 
of  which  I  have  hitherto  spoken ;  and  the  same  may  be 
said  of  the  inert  substances  whose  properties  are  first 
elicited  by  trituration  and  dilution.  Unless  some  evidence 
should  be  brought  before  us  to  prove  that  we  actually 
develop  power,  as  we  go  on  attenuating  after  the  Habne- 
mannian  method,  reason  must  certainly  frown  upon  the 
higher  potencies.  I  shall  examine  presently  the  theories  of 
'*  dynamisation ''  which  have  been  put  forward  to  support 
this  conclusion,  and  I  fear  I  shall  not  be  able  to  endorse 
them.  I  must,  then,  for  myself  at  least,  give  up  any 
countenance  from  the  side  of  reason  for  this  part  of  my 
position. 

2.  The  relation  of  science  to  us,  however,  is  at  first  sight 
very  encouraging.  No  one  can  have  followed  the  re- 
searches of  the  last  thirty  years,  and  considered  the  sizes 
dealt  with  in  thermal  and  luminous  undulations,  and  in 
the  molecules  and  atoms  of  matter,  without  feeling  that 
infinitesimals  of  a  most  minute  character  are  acquiring 
undoubted  place  and  reality  in  the  world  of  being.  All 
the  work  of  the  universe,  all  the  actions  of  life,  are  seen  to 
be  carried  on  by  these  tiny  existences ;  in  their  little  micro- 


10  Homwopathic  Posoloffy, 

cosm  forces  of  all  kinds  plav^  and  in  them  begin  all  changes 
whether  normal  or  morbid.  It  seems  at  first  sights  I  say^ 
that  we  are  only  following  in  the  same  track  when  we 
present  our  drugs  in  a  state  of  the  finest  molecular  sub- 
division^ when  we  seek  to  counteract  abnormal  motions  of 
the  ultimate  particles  of  matter  by  vibrations  as  minute  as 
their  own. 

And  to  a  great  extent  we  are^  T  thinks  quite  justified  in 
claiming  the  support  of  science  for  our  proceedings.  The 
existence  and  the  energy  of  the  infinitely  little  have  been 
substantiated  thereby^  and  no  one  is  now  warranted  in 
rejecting  effects  because  their  supposed  causes  are  inappre- 
ciable by  coarse  sensation.  But  I  fear  that  if  we  make 
too  much  of  the  analogies  of  the  minute  quantities  with 
which  scientific  speculation  deals^  we  shall  find  we  have 
enlisted  a  dangerous  ally,  one  who  will  leave  us  when  most  we 
need  assistance.  It  must  be  remembered  that  the  concep- 
tion of  the  atomic  constitution  6f  matter,  while  suggesting 
how  infinitesimally  small  are  its  ultimate  particles^  implies 
also  that  it  is  not  infinitely  (in  the  strrct  sense  of  the 
word)  divisible.  You  must  come  at  last  to  atoms  (a, 
rifjLvio) — particles  which  can  be  divided  no  farther;  and 
then  any  subsequent  attenuation  can  but  reduce  their 
number  until  all  trace  of  them  disappears  from  the 
vehicle.  Now  molecular  science  has  so  far  advanced  that 
it  has  seemed  practicable  to  estimate  approximatively  the 
size  of  the  ultimate  atoms  of  matter.  Sir  W.  Thompson, 
Clerk-Maxwell^  and  others  have  attacked  this  problem^  and, 
though  their  solutions  of  it  differ  pretty  widely^  none  have 
gone  further  than  the  affirmation  that  a  trillion  of  such 
atoms  may  be  contained  in  a  space  of  xt^Sjo^h  of  an  inch  cube.* 
Now^  making  all  allowance  for  the  molecular  contraction 
which,  as  Jollykas  shown,  attends  upon  all  attenuation  of 
chemical  solutions,t  this  will  hardly  carry  us  beyond  our 
12th  potency.  At  higher  degrees  than  this  the  presence 
of  any  atoms  of  matter  whatever  must  become  increasingly 
doubtful. 

*  See  Monthly  Microtcopical  Journal,  March,  1876,  p.  113. 
t  See  y.  Granvogl's  Text-hooh  of  Somaopathy,  pt  il,  §  221. 


by  Dr.  Hughes.  11 

This   is    the    latest  word  of  theoretical  science  on    the 
subject,  and    its    practical  observations  point  in  the   same 
direction.        Chemical    tests,  applied    to    those    substances 
which  are  readily  recognised  thereby,  follow  them  up  with 
decreasing  clearness  to  the  third  attenuation,  and  there-— or 
thereabouts — ^lose  them.     The  spectroscope  carries  our  vision 
farther  still ;    but  the  9th  dilution  is  the  highest  point  from 
which  any  response   has  been  forthcoming  to  this  potent 
detector.      The  microscope,  used  upon  the  triturations,  has 
yielded  similar  results.     Under  a  power  of  300  diameters, 
Br.  Mayrhpfer  has  traced  metallic  particles  up  to  the  10th, 
11th,  and  (in  the  case  of  precipitated  tin)  even  the  13th  and 
14th  attenuations,  but  no  further.     "  Moreover,  the  visible 
particles  of  the  substances/^  he  •  says,  '' become   gradually 
smaller  and  fewer  as  the  triturations  advance,  and  at  last  cease 
altogether.''    Up  to  a  certain  point,  then,  we  gain  by  this  pro- 
cess.   "  A  patient  who  takes  a  grain  of  the  3rd  trituration  of 
tin  or  arsenic,  swallows  no  less  than  576,000,000  particles, 
each  of  which  possesses  all  the  properties  of  the  metal,  and 
from  their  minute  size  can  freely  penetrate  to  all  parts  of 
the  organism,  and   develop  their  peculiar  effects  on  every 
part.''    But,  if  trituration  is  carried  on,  ^'the  atoms  becoming 
always  smaller  and  more  mobile,  at  length  come  to  be  so 
moch   so  that  they  elude  the  triturating   force/'     If,  on 
the  other  hand,  they  are  (according    to  our   usual   plan) 
mixed  from  this  point  with  a  fluid  menstruum,  either  they 
are  suspended  therein,  when  it  is  obvious  that  their  number 
must  decrease  a  hundredfold  with  each  successive  dilution, 
or  they  undergo  a  true  solution,  when  they  are  as  divisible 
as  matter  itself,  but  no  farther. 

When  now  we  turn  to  observations  on  the  animal  body, 
corresponding  conclusions  have  to  be  drawn.  M.  Davaine, 
io  experimenting  with  septicsemic  blood,  was  led  to  try  in 
what  fractional  proportion  it  still  retains  its  virulence.  H,e 
found  that  by  employing  the  graduated  Hahnemannian  method 
of  dilution,  he  could  reproduce  the  disorder  by  inoculating 
other  animals  (rabbits)  with  the  millionth,  the  billionth,  the 
trillionth,  ancl  at  last  the  ten-trillionth  of  a  drop  of 
blood.     Above  this   point,  however,   no  effects  were   pro- 


12  Homoeopathic  Posology, 

duced.  Again^  therefore^  science  goes  a  long  way  with  us. 
It  shows  that  matter  can  be  carried  by  the  homoeopathic 
process  of  attenuation  above  the  9th  centesimal  degree  with- 
out ceasing  to  be  present  or  losing  the  activity  proper  to  it. 
But  at  this  point  it  leaves  us  in  the  lurch,  and — without 
denying  it — gives  no  warrant  to  the  supposition  that  the 
same  thing  will  hold  good  at  further  stages  of  the  process. 

From   Science  as  such,  then — Science  unconnected  with 
Medicine — we  receive  countenance  for  our  infinitesimals  so 
far,  that  up  to  about  the  12th  centesimal  dilution  we  can 
depend  upon  the  presence  of  some  particles,  however  few  or 
small^  of  the  original  drug.      But  the  very  support  which  it 
gives  us  up  to  this  point  turns  into  opposition  when  we  go 
beyond  it ;   for,  if  every  test  finds  less  and  less  response  as 
it  mounts  higher  in  the  scale  of  dilution,  it  implies   that 
there    is    a    progressive    diminution    in    the   quantity  and 
energy  of  the  matter  present,  and  that  we  must  at  last  get 
to  an  end  of  it.     And^  again^  if  when  we  have  reached  the 
ultimately  visible  particles  of  matter,  we  see  them  diminish- 
ing in  number  as  we  attenuate  farther,  must  it  not  be  so 
with    those    still    smaller    particles    into   which    matter  is 
ultimately  divisible?      At  the  12th  dilution  we  are  a  good 
way  off  from  the  30th,  and  there  is  a  great  gulf  between  us 
and  the  200th.     How  are  we  to  bridge  it  over  ?  how  fill  up 
the  yawning  void  ?     Now  at  this  point  come  in  the  theories 
of  ^*  dynamisation  '^  which  have  attracted  so  much  attention 
in  the  homoeopathic  controversy — much  more,  indeed,  than 
their  intrinsic  importance  deserves.     They  imply  that  the 
processes    of  trituration    and    succussion   with   which    our 
attenuations  are  made  more  than  compensate  for  the  reduc- 
tion of  the  mass  of  the  medicinal  substance,  that  they  actually 
deyelope  power,  and  this  to  an  indefinite  extent,  so  that  the 
higher  dilutions  are  more  potent  as  medicines  than  the  lower^ 
the  30th  than  the  3rd,  the  200th  than  the  SOth,  and  so  on 
ad  infinitum.     By  some  of  Hahnemann's  followers,  who  are 
more  imaginative  than  philosophical,  this  dynamisation  has 
been  supposed  to  result  from  a  transference  of  the  whole 
thing  from  the  realm  of  matter  to  that  of  spirit.*     I  can 

•  I  must  admit  that  his  own  language  in  kter  days  favoon  the  same  idea. 


hy  Dr.  Hughes.  18 

only  say  that  I  know  nothing  of  such  conceptions  as  applied 
to  natural  things ;   they  are  to  me  alike  uncoogenial   and 
unintelligible.      Others,  with  a  more  just  idea  of  the  matter 
in  hand,  have  endeayonred  to  apply  to  it  the  doctrine  of  the 
correlation  of  foroe^  and  have  argued  that  the  energy  put 
forth  by  the  triturator  or  succusser  must  be  converted  into 
increased  force  on  the  part  of  the  drug  so  treated.     But 
they  have  not  shown^  on  the  one  hand,  that  it  may  not  be 
accounted  for  by  the  heat  and  electricity  developed  in  the 
process,  and  on  the  other,  that  the  power  of  drugs  to  affect 
the  organism  is  a  "  force/'  in  the  sense  that  heat  and  light 
and  such  like  are  forces,  so  that  it  has  equivalence  and  correla- 
tion with  other  modes  of  motion.     It  seems  rather  to  be  a 
fixed  and  inalienable  property,  peculiar  to  each  substance 
possessing  it.     The  same  objection  holds  good  to  the  hypo- 
thesis advanced  by  my  friend  Dr.  Allen,*  that  the  energy  of 
the  drug  is  transferred  to  the  vehicle,  so  that  although  no 
particles    of    the   original    substance   remain    therein    the 
medicinal  force  is  not  lost.     If,  morever,  it  were  so,  it  is 
obrious  that  no  further  potentisation  would  be  possible  when 
once  the  drug  had  attained  its  ultimate  subdivision,  and, 
parting  with  its  force  to  the  surrounding  menstruum,  dis- 
appeared from  the  scene.     From   about   the  12th  to  the 
18th  dilution,  then  (if  the  calculations  I  have  specified  are 
correct),  all  capacity  of  change  must  cease,  and  we  have  in 
hand  nothing  but  a  medicated  water  or  spirit,  incapable  of 
further   dynamisation.      Dr.   Allen   refers    to  the   French 
observations  with  septic  blood   as  illustrating  this  trans- 
ference of  energy  to  a  vehicle.     But  he  forgets  that  after 
the  ten-trillionth   (i,e.   19th    decimal)   dilution   had   been 
reached,  which  is  about  the  estimated  extent  of  the  divisi- 
bility of  matter,  no  further  effect  was  manifested. 

I    may   refer  you  to  a  short   but  able  paper  by  Mr. 

bat  I  think  that  he  med  the  t<»nn  "spiritualisation"  metaphoricallj.  He 
nppoaed  matter  to  he  infinitely  divisihlei  saying  in  the  last  edition  of  the 
Organum  (1833) :  "  A  suhstance  diyided  into  ever  so  many  parts  mnst  still 
always  contain  in  its  smallest  conceiyahle  parts  gomewhat  of  this  snhstanoe,  and 
(he  smallest  conceivahle  part  does  not  cease  to  he  tome  of  this  snhstanoe,  and 
cannot  possihly  heoome  nothing." 
*  See  New  York  Journal  of  Homaopathy,  ii,  1. 


14  Homceopathic  Posology, 

Proctor  in  the  thirty-first  volume  of  the  British  Journal  of 
BomcBopathy,  on  *'  The  Theory  of  Dynamisation/'  as  a 
complete  examination  and^  I  thiuk^  refutation  of  these 
ideas. 

You  will  observe  that  I  have  said  nothing  about  the 
potencies  lately  employed  in  America^  in  which  the  1000th 
becomes  a  new  uuit^  and  the  scale  is  run  rapidly  up 
until  now  the  millionth  and  ten  millionth  are  supposed  to 
have  been  reached.  I  must  reject  these^  not  upon  the 
grounds  of  science  and  reason^  but  upon  those  of  pharmacy. 
They  are  simple  impossibilities.  It  is  easy  to  calculate  that^ 
if  Hahnemann's  directions  are  followed,  upwards  of  2000 
gallons  of  spirits  of  wine  would  be  required  for  making  the 
millionth  potency  of  a  single  medicine^  to  say  nothing  of  a 
million  clean  bottles ;  and^  as  not  more  than  four  potencies 
could  be  made  in  a  minute,  each  receiving  its  due  number 
of  shakes,  that  incessaut  labour  at  the  rate  of  twelve  hours 
a  day,  and  six  days  a  week,  would  yet  occupy  more  than  a 
year  in  the  process  !  Even  if  machinery  be  employed,  the 
time  taken  could  not  be  reduced  much  more  than  one  half, 
and  as  power  of  some  kind  must  be  supplied,  considerable 
expenditure  would  be  incurred.  Whenever,  accordingly, 
we  are  able  to  learn  the  process  by  which  these  potencies 
are  prepared  (and  the  tendency  is  to  keep  it  a  secret),  we 
always  find  it  other  than  that  recognised  among  us,  and 
illegitimate  in  itself.  Jeuichen's  preparations,  which  first 
broke  ground  in  this  new  field,  are  now  known  to  be 
simply  succussions  of  an  ordinary  attenuation  without  fur- 
ther dilution — ten  of  such  shakes  being  reckoned  as  pro- 
ducing a  potency  one  step  higher  in  the  scale.  The  pre- 
parations which  go  under  the  names  of  Fincke  and  Swan 
are  manufactured  by  what  is  called  '^  fluxion,''  t.  e.  by 
allowing  a  stream  of  water  to  be  propelled  with  some  force 
into  a  phial  containing  a  hundredth  part  of  a  drug,  each 
emptying  of  which  is  reckoned  as  diluting  it  one  step  far- 
ther in  the  centesimal  scale.  Even  in  this  way  an  im- 
mense time  must  be  taken  to  produce  such  potencies 
as   are    named  ;*   and   how    utterly   untrustworthy  is    the 

*  Jenichsu,  purported  to  produce  the  60,000th  potency.     Dr.  Dudgeon  has 


Holiday  Tour  in  the  Pyrenees.  15 

result  !*  My  advice  to  you,  therefore^  is  to  keep  altogether 
clear  of  these  obscure  and  objectionable  practices^  and  to  set 
down  any  residts  which  seem  to  ha?e  been  obtained  by 
mediciDes  so  prepared  to  their  being  other  than  what  they 
assume  to  be. 

Putting  these^  tben^  out  of  sight,  and  limiting  ourselves 
to  such  attenuations  as  have  been,  and  can  be,  prepared  in' 
I  proper  way^  our  conclusion  must  be  that  while  we  are 
fully  warranted  in  expecting  action  from  those  below  the 
3rd^  and  are  not  without  countenance  in  similar  hopes 
from  those  up  to  the  12th,  beyond  this  range  we  have- 
nothing  to  depend  upon  but  observation  and  experience. 
While  we  are  not,  therefore,  to  ignore  curative  results  ob- 
tained from  30ths  and  200ths,  we  must  be  wary  about 
admitting  them,  requiring  the  warrant  either  of  the  capacity 
of  the  observer,  or  of  a  full  statement  of  the  facts  of  each 
case.  Upon  these  principles  I  shall  act  in  dealing  with  the 
materials  of  my  present  course. 


MEDICAL  AND  OTHER  NOTES  COLLECTED  ON  A 
HOLIDAY  TOUR  TO  ARCACHON,  BIARRITZ, 
PAU,  AND  OTHER  PRINCIPAL  WATERING 
PLACES  IN  THE  PYRENEES. 

By  Dr.  Roth. 

The  following  notes,  made  for  my  own  use,  are  pub- 
lished at  the  wish  of  several  of  my  friends ;  they  have  been 
collected  partly  firom  my  own  observations  and  partly  from 

shofm  that,  working^  five  hours  a  day,  and  allowing  a  second  for  each  shake, 
it  would  take  him  five  weeks  to  raise — according  to  his  method — a  single  drug 
to  this  height. 

*  Dr.  Burdick,  of  New  York,  who  has  eminent  scientific  qualifications, 
has  lately  shown,  by  calculation  and  microscopical  investigation,  that  the 
potency  which  Dr.  Swan  represents  as  m.m.  (i.e,  thousand  thousandth,  or 
millionUi),  "  cannot  exceed  the  tenth  centesimal  of  Hahnemann,  and  is  liable 
to  be  much  lower"  {Hahn.  Monthly,  Nov.,  1877). 


16  Holiday  Tour  in  the  Pyrenees, 

the  interviews  which  I  had  with  mv  professional  brethren, 
who^  without  any  formal  introductions^  answered  all  my 
inquiries  with  the  greatest  promptitude,  and  I  have  much 
pleasure  in  thanking  them  herewith  publicly  for  their  kind- 
ness ;  I  have  also  taken  extracts  from  several  pamphlets, 
the  titles  of  which  I  have  named,  in  order  to  enable  those 
wishing  to  know  more,  to  obtain  the  required  information. 

After  the  labours  of  the  Great  International  Congress  of 
Hygiene  at  Paris  were  finished,  I  proposed  visiting  the 
watering  places  of  the  Pyrenees,  which  in  general  are  very 
little  known  to  the  majority  of  English  practitioners,  who, 
therefore,  make  very  little  use  of  them,  although  many  of* 
their  patients  might  be  benefited  both  by  the  waters  and 
climate.  French  physicians  practising  as  consulting  phy- 
sicians at  the  numerous  French  watering  places  object  to 
faire  la  reclame  as  many  German  medical  men  do,  many  of 
whom  yearly  visit  England  in  order  to  introduce  themselves 
and  their  waters  to  the  profession ;  if  the  French  would 
only  imitate  the  practice  of  their  German  colleagues  there 
is  no  doubt  that  the  present  prevailing  ignorance  regarding 
French  mineral-waters  and  watering-places  would  be  con- 
siderably diminished.  Only  very  few  English  practitioners 
visit  the  watering-places  in  the  Pyrenees,  and  this  is  another 
reason  why  such  a  small  number  of  English  patients  are 
sent  there ;  English  continental  residents  resort  more  fre- 
quently to  these  waters. 

We  left  Paris  in  the  evening  and  arrived  two  hours  later 
at  Orleans,  made  the  tour  of  the  town  in  the  morning,  and 
having  seen  the  statue  of  the  Maid  of  Orleans,  and  the 
houses  of  Agnes  Sorel  and  some  other  celebrities,  we  con- 
tinued our  journey  through  one  of  the  most  fertile  parts  of 
France,  including  the  interesting  towns  of  Blois  and 
AngoulSme,  to  Bordeaux,  where  we  arrived  the  same 
evening  in  time  to  take  a  drive  and  have  a  look  at  this 
apparently  very  rich  town ;  its  flourishing  state,  I  was  told, 
is  owing  principally  to  its  commerce  with  England,  and  its 
large  export  of  Bordeaux  wines. 


by  Dr.  Roth,  17 


Abcachon. 


An  hoar's  railway  journey  from  Bordeaux  brought  us  to 
Arcachon^  where  about  100^000  people  resort  annually  for  the 
sea  bathings  while  a  considerable  number  of  patients  suffer- 
ing from  asthma^  consumption,  bronchial  catarrh,  and  other 
complaintd,  pass  the  winter  in  the  pine-forest,  which  has  an 
average  temperature  of  10^  C.  in  winter,  and  26°  C.  in 
summer ;  on  the  seacoast  the  winter  average  is  8°  and  the 
summer  20^.  Besides  the  Grand  Hotel  there  are  many 
other  hotels,  private  houses,  and  in  the  forest  beautiful 
villas  ready  for  the  accommodation  of  visitors ;  a  beautiful 
casino,  built  in  oriental  style  and  standing  in  its  own 
grounds,  provides  various  amusements  as  well  as  hydro- 
pathic treatment  and  baths  of  sea  and  ordinary  water,  also 
resinous  baths,  water  mixed  with  the  sap  of  pine  trees.  By 
chance  I  got  an  introduction  to  the  present  proprietor  of 
the  renowned  villa  Pereira,  the  grounds  of  which  are  beauti- 
fully laid  out;  I  here  had  an  opportunity  of  meeting  an 
asthmatic  patient  who  is  only  well  in  Arcachon;  the  un- 
comfortable symptoms  returning  when  leaving  the  place. 
Dr.  Hamean,  who  has  been  acting  for  many  years  as 
Mededn  Inspecteur,  told  me  that  he  has  only  seen  one  real 
cure  of  a  consumptive  in  this  place,  which  he  has  described 
in  his  pamphlet  on  Arcachon;  but  many  patients  with 
asthma  and  chronic  catarrh  of  the  bronchial  mucous  mem- 
branes, and  all  with  erethistic  temperament  have  been 
frequently  relieved  alid  cured ;  Dr.  Hamean  was  kind  enough 
to  give  me  a  copy  of  his  pamphlet,  from  which  the  following 
notes  are  taken. 

The  climate  of  Arcachon,*  comprised  in  the  Giroudin 
climate,  is  analogous  to  that  of  Bordeaux  as  regards  gene- 
ral influences,  but  with  peculiarities  which  are  owing  to— - 

1.  The  proximity  of  the  sea,  from  which  Arcachon  is 
separated,  due  west,  only  by  a  series  of  dunes  covered  with 
pine  forest,  and  by  the  large  harbour  of  the  Bassin,  which 
has  its  opening  to  the  south. 

*  '  Tie  Climate  of  Arcaohon,'  by  Dr.  S.  Hamean,  an  English  translation,  by 
J.  Badflift,  published  by  King  &  Co.,  London,  1874. 

VOL.  XXXVll,  NO.   CXLVII. JANUARY,    1879  B 


18  Holiday  Tour  in  the  Pyrenees, 

2.  Tiie  obstacle  which  this  forest  opposes  to  the  force 
of  the  west,  south-west,  south  south-east^  and  east  winds. 

3.  The  extent  of  the  Basain  over  which  the  north  and 
north-east  winds  must  pass  in  order  to  reach  Arcachon, 
being  thus  charged  with  a  certain  degree  of  moisture,  tend- 
ing to  correct  their  parching  action,  which  cools  them  in 
summer,  and  warms  them  in  winter. 

4.  The  temperature  of  the  sea,  which  is  higher  than 
that  of  the  air  during  the  cold  season  and  lower  during  the  hot. 

5.  The  evergreen  shelter  of  the  pine-forest,  a  shelter 
quite  insufficient  to  ward  off  the  heat  of  the  sun  when  shade 
is  sought,  but  which  rather  augments  its  intensity  by  the 
calmness  of  the  air  both  in  winter  and  summer. 

6.  The  hygrometric  state  of  the  atmosphere,  which  would 
present  a  disagreeable  humidity  did  not  the  extremely 
porous  soil  render  any  stagnation  of  water  impossible. 

7.  The  very  remarkable  ozonometric  state,  which  reaches 
the  highest  degree  of  B^rigny^s  scale,  in  the  forest  during 
the  winter. 

8.  The  vegetation  rich  and  green  at  all  times. 

9.  The  presence  of  resinous  emanations. 

10.  The  slight  elevation  of- the  ground  above  the  level  of 
the  sea,  and  consequently  the  greatest  possible  barometric 
pressure. 

Like  all  maritime  climates,  especially  those  of  the  west 
coast  of  Europe,  near  which  the  Gulf  Stream  passes,  the 
climate  of  Arcachon  is  not  extreme.  Less  hot  in  summer 
than  that  of  countries  in  the  same  latitude,  it  is  less  cold  in 
winter.  This  latter  difference,  very  marked  on  the  shore  of 
the  Bassin  in  calm  weather,  may  even  amount  to  two  or 
three  degrees  above  the  temperature  of  the  forest  itself. 
But  when  the  wind  blows,  recourse  must  be  had  to  the 
shelter  of  the  trees  and  the  protection  of  the  dunes. 
Nevertheless,  the  prevailing  winds,  north-west,  west,  and 
south-west,  are  not  cold,  since  they  have  passed  over  the 
immense  extent  of  the  ocean  in  order  to  reach  Arcachon ; 
but  they  are  sometimes  violent,  and  chill  by  reason  of  their 
violence.  When  they  prevail,  from  December  to  February, 
for  several  consecutive  days,  they  do  so  continuously,  night 


by  Dr.  Roth.  19 

and  daj,  without  interruption ;  therefore  we  do  not  experi- 
ence in  the  south-west  that  phenomenon,  so  common  on  the 
diore  of  the  Mediterranean,  of  a  sudden  transition  from  the 
temperature  of  the  day  to  that  of  the  night. 

Besidence  in  the  heart  of  the  resinous  atmosphere  of 
Arcachon  is  suitable  in  phthisis  of  the  irritative  form,  with 
predominance  of  the  nervous  temperament^  either  primitive 
or  acquired ;  and  is  unsuitable  when  the  lymphatic  tempera- 
ment of  a  torpid  form  predominates.  Whence  we  get  the 
final  and  more  general  formula — the  action  of  a  pine  atmo- 
sphere is  sedative  to  the  nervous  system.  .  .  .  Thus,  chil- 
dren affected  with  chronic  bronchitis  have  generally  derived 
benefit  from  their  sojourn  at  Arcachon.  .  But  here,  again,  it 
is  especially  among  those  who  were  of  a  nervous  temperament 
that  the  quickest  and  best  results  have  been  observed.  .  .   . 

Bnt  in  the  management  of  children  affected  with  chronic 
bronchitis,  and  frequently  even  in  the  case  of  adults,  Hamean 
insists  on  following  the  example  of  Buchan,  on  the  discon- 
tinuance of  the  constant  wearing  of  flannel,  never  to  cover 
the  chest  with  flannel  for  any  length  of  time,  and  to  with- 
draw it  in  the  case  of  those  who  are  in  the  habit  of  wearing 
it.  In  this  latter  case  it  is  necessary  to  take  great  pre- 
cautions against  the  dangers  of  too  sudden  a  change ;  the 
best  plan  is  to  replace  the  flannel  waistcoat  by  an  ample 
and  thick  over-all  woollen  garment.  That,  however,  is  not 
enough^  but  we  must  aim  at  freeing  the  patient,  as  soon  as 
possible^  from  all  superfluous  weight  of  clothes.  The  same 
day  that  the  flannel  is  taken  off  vigorous  friction  on  the 
body  and  arms  is  commenced  with  a  towel  soaked  in  very 
cold  water^  gi^ug  four  or  five  brisk  rubs  in  every  direction. 
The  patient  then  dries  himself  immediately  with  a  very  dry, 
bat  not  a  warm,  towel ;  dresses  quickly,  in  a  thicker  suit 
than  usual  the  first  few  days,  then  gradually  resumes  his 
ordinary  dress,  and  a  healthy  reaction  soon  produces  a  sen- 
ation  of  comfort.  This  practice,  borrowed  from  the  northern 
nations,  our  masters  in  comfort,  not  only  replaces  flannel 
with  great  advantage,  but  is  also  the  best  preservative 
against  colds  and  chills.  It  is  to  be  desired  that  it  should 
be  domesticated  among  us,  and  that  it  should  become  as 


20  Holiday  Tour  in  the  Pyrenees, 

indispensable  as  the  ablutions  of  ordinary  cleanliness.  .  •  « 
Still  less  can  it  be  admitted  that  the  viciuitj  of  the  sea  air 
goes  for  anything  in  the  beneficial  action  of  a  sojourn  in  the 
forest,  since  it  has  been  so  frequently  observed  that  it  was 
only  necessary  for  the  invalids  who  have  derived  most 
benefit  from  their  residence  in  the  forest  to  walk  occasionally 
on  the  shore  in  order  to  endanger  the  improvement  that  had 
taken  place.      ... 

At  the  outset  of  the  malady^  where  there  is  only  a 
threatening  of  disease  (unless  the  temperament  absolutely 
requires  a  residence  in  the  forest  or  on  the  shore),  the  pass- 
ing from  one  district  to  another  is  advised,  avoiding,  on  the 
one  hand,  the  violent  shore  winds,  and,  on  the  other,  the 
extreme  heat  of  the  forest.      .     .     • 

The  most  favorable  countries  are  precisely  those  in  which^ 
as  in  the  South  of  Europe,  variations  of  temperature  occur 
every  day,  without  very  great  extremes,  and  in  which  the 
seasons  are  clearly  defined. 

A  short  walk  on  the  shore  has  sufficed,  in  the  case  of 
some  eminently  nervous  and  impressionable  invalids,  to 
bring  back  accidents  which  would  have  been  extinguished 
in  the  sedative  atmosphere  of  the  forest. 

At  Dr.  Hamean's  investigation  and  that  of  the  municipal 
body,  the  Compagnie  du  Midi  commenced,  in  the  year  1862, 
the  erection  of  its  elegant  winter  villas,  now  forty  in  number. 
The  spot  chosen  was  in  the  region  of  the  dunes,  which  are 
the  warmest  sheltered  spots  in  the  forest,  protected  from 
the  force  of  the  wind,  and  presenting  the  maximum  of  resin- 
ous emanation^  and  consequently  of  sedative  action.  ' .    •     . 

In  other  places  pleasures  have,  it  may  be,  their  utility ; 
but  here,  for  natures  which  must  be  tranquillised  at  any 
price — which  must  be  guarded  against  every  drain  on  the 
nervous  system — the  quiet  amusements  which  will  spring 
up  naturally  among  acquaintances,  as  the  colony  of  strangers 
augments,  will  always  be  sufficient. 

It  is  because  we  do  not  meet  with  consumption  in  those 
numerous  families  of  resiniers  whose  profession  is  trans- 
mitted from  father  to  son  from  time  immemorial,  and 
because  they   have  attributed    this    remarkable   immunity 


by  Dr.  Roth,  21 

to  the  reanous  air,  that  physicians  have  thought  of  using  it 
as  a  therapeutic  agent. 

"  The  resiniers  differ  much  from  the  other  inhabitants. 
Less  intellectual  and  less  active,  they  are  nowise  inferior  as 
regards  frankness  and  gentleness  of  character,  and  they 
excel  in  sobriety.  It  is  principally  in  physique  that  the 
difference  is  striking;  they  are  small,  thin,  of  a  swarthy 
complexion,  and  they  have  a  certain  appearance  which 
renders  them  easily  distinguishable/'      ... 

''The  resiniers  are  eminently  of  a  bilious  phlegmatic 
temperament.  If,  in  the  flower  of  their  age,  a  predomi- 
nance of  the  sanguineous  system  can  be  perceived  in  a  few 
subjects  these  cases  are  rare,  and  are,  as  it  were,  only  a 
transient  gleam  which  scarcely  forms  an  exception.  Their 
maladies  rarely  have  an  acute  character,  and  when  they 
have  they  always  present  themselves  under  a  bilious  type,'' 
and   .    .    .    they  are  subject  to  very  few  diseases. 

All  the  facts  confirm  the  sedative  influence  of  the 
atmosphere  of  the  pines. 

Dr.  Hamean's  final  conclusions  are — 

1.  That  the  climate  of  Arcachon  is  sedative  to  the  nervous 
^tem. 

2.  That  it  places  certain  consumptives  in  a  medium  favor- 
able to  the  cure  of  their  disease,  and  always  to  some  degree 
of  amelioration  at  least,  when  there  is  a  predominance  of  the 
nervous  system. 

3.  That  it  favours  the  cure  of  chronic  bronchitis  in  the 
lame  conditions. 

4.  That  it  is  unsuitable  to  every  disease  of  the  chest  in 
persons  of  a  torpid  lymphatic  temperament. 

5.  That  it  is  suitable  to  most  asthmatics. 

I  may  mention  that  in  the  middle  of  the  so-called  basin  of 
Arcachon  nine  to  ten  millions  of  oysters  are  yearly  produced 
on  the  Bird  Island — hie  d^Oiseaux. 

BlAKBITZ. 

From  Arcachon  we  travelled  for  five  hours  in  the  train 
ihrough  the  Landes^  a  flat,  sandy  country,  previously  covered 


22  Holiday  Tour  in  the  Pyrenees, 

by  the  sea^  but  dow  planted  with  pine  forests^  which  have 
improved  both  the  sanitary  state  of  the  country  and  the 
material  condition  of  the  previously  very  poor  inhabitants. 
Since  the  American  civil  war^  when  the  importation  of  tur- 
pentine was  prevented  or  diminished,  the  price  of  this  article^ 
which  is  to  a  large  extent  produced  in  the  Landes,  has  con- 
tributed to  the  improved  state  of  the  inhabitants.  The  ma- 
jority of  the  trees  are  bled;  that  is^  a  large  incision  is  made 
and  a  part  of  the  bark  removed,  in  order  to  permit  the  sap 
to  be  collected  in  earthenware  jars,  which  are  fixed 
below  the  incision.  This  sap,  when  concentrated,  is  the 
turpentine. 

A  few  miles  before  Bayonne  the  vicinity  of  the  Pyrenees 
changes  the  character  of  the  country,  and  this  change  con- 
tinues as  far  as  Biarritz,  which  is  mostly  built  on  the  cliff 
facing  the  Atlantic  Ocean. 

This  place,  which  only  a  few  years  since  was  the  habita- 
tion of  fishermen  only,  and  almost  unknown,  now  presents, 
to  patients  as  well  as  to  tourists,  all  that  is  wanted,  either 
for  pleasure,  comfort,  or  for  cure. 

A  mild,  invigorating  sea,  an  even  climate,  a  radiant  sun, 
and  a  splendid  shore,  unequalled,  as  the  inhabitants  believe, 
in  Europe,  are  to  be  found  at  Biarritz,  which  is  at  present 
one  of  the  most  frequented  watering-places  in  France. 
Many  English  visitors  are  to  be  found  here  at  all  seasons. 

The  first  visitors  arrive  at  the  end  of  May,  and  from  that 
time  the  season  begins  in  all  its  splendour.  According  to 
the  guide  of  Biarritz,  the  sky  is  pure  without  a  cloud,  the 
air  mild,  the  sun  warm,  and  all  fruits  and  flowers  appear. 
In  fact  all  nature  is  clothed  in  its  summer  garments,  and 
decked  with  fresh  and  lasting  colours. 

Biarritz  has  two  seasons,  viz.  summer  and  autumn.  The 
first  season  lasts  from  May  to  July,  and  is  specially  adapted 
to  those  who  require  special  comfort  and  rest. 

From  July  to  the  end  of  October  is  the  season  for  strangers, 
tourists,  children,  and  the  upper  classes.  The  number  of 
Spanish  visitors  is  very  great  at  this  season. 

At  Biarritz  there  are  three  sea-bathing  places. 

The   Forte- Vieux  is  the  resort  of  the  morning  bathers. 


by  Dr.  Roth.  23 

There  the  sea  is  calm^  protected  from  the  wind^  and  washed 
on  to  a  smooth  and  sandy  shore. 

The  bathing  at  the  Grande- Plage  is  suited  for  those  Ijm-i 
phatic  and  strumons  children  and  adults^  and  all  those 
who  require  the  tonic  and  invigorating  effects  of  the  strong 
and  powerful  waves  which  follow  each  other  in  quick  sue* 
c^sion,  and  often  knock  the  bather  down,  even  when  he  is 
only  up  to  the  waist  in  the  water ;  the  sea  being  quite  open 
on  this  Grande-Plage,  the  length,  the  quickness,  and  the 
shock  of  the  waves,  cause  a  very  strong  reaction. 

The  bathing  hours  here  are  from  6  till  10  to  11  a.m.,  and 
from  4  to  6  p.m.  It  is  very  often  the  case  that  people  bathe 
twice  a  day,  a  large  number  of  spectators  standing  or  sitting 
on  the  beach,  and  the  groups  of  bathers,  usually  concentrated 
in  smaller  or  larger  patches,  form  a  most  amusing  spectacle, 
which  is  often  interrupted  by  the  shouts  of  the  bathers  as 
they  are  knocked  down  by  the  waves,  and  by  the  merry 
laughter  of  the  spectators.  Before  the  bathers  return  to 
the  dressing  cabinets  they  dip  their  feet  in  small  tubs  of 
water  to  get  rid  of  the  sand,  and  in  the  cabinets  they  can 
have  for  a  penny  a  warm  foot  bath,  which  contributes,  as  I 
know  by  personal  experience,  to  the  comfort  of  the  bather, 
prevents  shivering,  and  tlius  assists  the  reaction  of  the 
body.  It  is  desirable  to  have  this  warm  foot  bath  intro- 
duced in  our  watering-places.  There  are  also  in  the  hotels 
and  other  houses  appliances  for  hydropathic  treatment,  and 
the  various  warm  and  artificial  mineral  water  baths. 

The  Casino  contains  reading-  concert-  ball-  and  refresh- 
ment-rooms.       * 

Some  English  families,  who  like  the  mildness  of  the 
climate  and  its  even  temperature,  remain  at  Biarritz  during 
the  winter,  form  quite  a  community^  and  return  every  year, 
at  the  same  time  to  seek  the  calm  and  fresh  air  of  this 
shore,  and  pass  several  winter  months  without  frost  or  snow. 

I  must  refer  those  interested  in  the  various  beautiful 
excursions  which  make  a  sojourn  at  Biarritz  very  agreeable, 
to  the  English  and  French  guide-books.  I  had  three 
addresses  of  good  hotels,  viz.  Maison  Rouge,  Grande  HStel, 
and  Hdtel  Gardires,  and,  to  my  surprise,  found   on    my 


24  Holiday  Tour  in  the  Pyrenees, 

arrival  that  all  three  are  the  names  of  the  same  house.  The 
family  Oardires  appear  to  be  very  well  known  in  the 
South  of  France  and  the  Pyrenees^  because^  besides  the 
large  hotel  at  Biarritz^  another  brother  has  the  great  Hdtel 
de  France  at  Pau ;  and  a  daughter  of  this  Madame  Tavern 
is  the  proprietress  of  the  Hdtel  de  France  at  Eaux 
Bonnes.  In  my  capacity  of  a  London  Physician  I  was  very 
well  treated,  and  can  recommend  all  these  houses  to  those 
of  my  colleagues  who  visit  the  Pjrrenees ;  but  during  the 
season  it  is  desirable  to  telegraph  in  time  for  rooms.  The 
winter  prices  for  the  pensionaires  at  the  H6tel  Garderes  at 
Biarritz  are  very  reasonable. 

After  a  stay  of  four  days  we  left,  much  invigorated,  for 
Pau. 

Pau. 

"  This  well-known  winter  residence  is  on  the  top  of  a  slope 
insensibly  inclined  towards  the  north,  and  sharply  cut  on 
the  south,  as  by  a  cli£f  of  150  feet  in  height,  at  the  foot  of 
which  flows  the  Gave,  and  presenting  at  this  side  the  spec- 
tacle of  a  splendid  circle  of  lofty  mountains,  at  a  distance 
of  from  20  to  25  miles.''     .     •     . 

"  According  to  Sir  Alexander  Taylor,  the  order  of  the 
frequency  and  duration  of  the  winds  is  thus  summed  up— 
''North-west   .  112  days.  East  .81  days. 

West   .  .     55     „  North-east       •  24     „ 

North .  •     52     ,,  South-east       .  24     „ 

South  .  •     44     „  South-west      .  23     „ 

''  The  Atlantic  currents  cause  the  frequent  rain  at  Pau 
during  140  days,  and  about  48  inches  annually.^ 


» 


The  hygrometric  table  of  Pau  during  the  decade  1858 — 64 

according  to  Dr.  Ottley. 


Hygrometer. 

Bunfill. 
Indies. 

Winter 

81 

88 

7-3 

Sjiring 

76 

48 

16-9 

Sammer 

72 

80 

9-0 

Autumn 

79 

84 

10*3 

Annual 

77 

...       140 

43-5 

by  Dr.  Roth.  25 

"  The  inyalid  is  irritated  at  the  least  wind  as  a  deception, 
and  regards  each  sunless  day  as  a  fatality  which  must  be 
detrimental  to  him/' 

"  The  altitude  above  the  sea-level  is  nearly  700  feet/'  .  .  . 

''  The  climate  of  Pau  is  damp  in  the  meteorological  sense 
of  the  word,  but  this  dampness  has  not  the  disadvantages 
ordinarily  dreaded,  because  the  soil  is  gravelly,  very  porous, 
and  as  the  oscillations  of  temperature  are  never  very  great  in 
one  day,  the  condensation  of  the  vapour  of  atmospheric  water 
need  not  be  dreaded  as  in  the  Mediterranean  region/'  .   .  • 

"  According  to  the  physicians  who  have  studied  the  coun- 
try, the  inhabitants,  the  B^arnais,  have  a  certain  slowness  of 
circulation,  and  their  diseases  a£fect  the  sub-acute  type. 
Bhenmatism,  however,  is  frequent  there.  Longevity  is  re- 
markable in  this  population.  One  in  45  of  the  inhabitants 
die  annually,  whereas  the  mean  in  France  is  one  in  89.  lu 
a  period  of  twenty  years  (1822 — 1842)  there  were — 


"  Deaths  at  from  65  to  70 

yean 

of  age 

...     847 

70  „  80 

» 

...     720 

80  „  85 

tf 

...     820 

85  „  90 

99 

...     161 

95  ^,100 

$9 

...     103 " 

Pau  has  20,000  inhabitants,  is  a  chief  town  of  a  depart- 
ment, and  offers  to  its  fluctuating  population  all  the  pleasures 
of  large  towns.  Its  inhabitants  are  warm  and  hospitable 
towards  strangers,  and,  being  very  desirous  to  retain  them 
by  making  their  residence  agreeable,  omit  nothing  that 
might  contribute  to  their  comfort  and  their  amusement. 
Therefore,  the  winter  colonists  there  are  always  numerous, 
always  satisfied. 

During  the  winter  of  1867-1868,  Dr.  Lahillone  was  struck 
by  the  effect  caused  by  some  meteorological  phenomena  on 
several  patients  suffering  from  '  diseases  of  the  respiratory 
organs;  he  had  already  previously  observed  that  when  he 
was  called  to  one  of  his  tuberculous  patients  in  consequence 
of  an  aggravation  of  the  symptoms,  he  had  either  on  the 
Kame  or  following  day  to  see  several  more  of  his  tuberculous 
patients.     The  symptoms  of  all  were  more  or  less  similar. 


26  Holiday  Tour  in  the  Pyrenees, 

either  a  return  of  a  catarrh^  of  a  coogh^  of  a  slight  hsemop- 
tms,  or  of  some  streaks  of  blood  mixed  with  the  expectora- 
tioD,  or  some  derangements  of  the  digestive  organs^  or  some 
special  symptoms  of  the  nervous  system,  which  have  no 
connection  with  the  pulmonary  affection. 

All  the  patients^  although  in  various  degrees,  appeared 
to  be  under  the  influence  of  some  general  atmospheric  causes 
which  produced  analogous  effects. 

The  patients  did  not  suffer  from  the  prevalent  medical 
constitution,  but  from  an  atmospheric  constitution;  there- 
fore, the  principal  meteorological  signs,  viz.  the  pressure 
of  the  .air,  the  relative  moisture,  the  temperature,  the  state 
of  the  sky,  the  time  and  period  of  rain  and  fog,  &c.^  have 
been  registered. 

Finding  that  the  various  numbers  of  the  above  named  data 
did  not  give  the  desired  result,  it  was  finally,  and  after  many 
previous  failures,  decided  to  make  use  of  two  graphic  lines 
in  order  to  make  the  meteorological  changes  more  evident  and 
useful  for  practical  purposes.  Dr.  Lahillone  in  one  of  these 
lines  represents  the  geometric  plan  of  the  daily  barometric 
averages,  the  other  line  represents  the  daily  average  of  the 
relative  humidity.  The  different  curves  of  these  two  lines 
show  the  equal  or  unequal  state  of  several  days,  the  length  of 
the  various  periods  during  which  the  variation  of  the  atmo- 
spheric changes  take  place ;  if  these  different  periods  are 
compared  with  the  coincident  changes  of  the  morbid  sym- 
ptoms most  interesting  and  very  useful  data  for  regulating 
the  hygiene  of  the  patients  might  be  collected.  My  aim 
is  only  to  call  the  attention  of  my  colleagues  to  the  excel- 
lent idea  of  Dr.  Lahillone,  and  those  who  are  more  interested 
on  this  important  subject  will  find  the  details  in  his  work 
on  Pau,  Etude  de  Meteoroloyie  Medicate  au  point  de  vue 
des  maladies  des  vols  respiratoires,  Bailliere,  1869. 

In  the  same  pamphlet  the  doctor  finds  fault  that  the  pa- 
tients do  not  go  to  Pau  before  November  and  December. 
The  majority  remain  with  their  families  till  the  variations 
of  the  autumnal  seasons  aggravate  their  symptoms,  and  till 
they  find  themselves  thus  reminded  that  they  must  be  off. 
The  autumn  is  usually  very  agreeable  at  Pau,  and  in  No- 


by  Dr.  Roth.  27 

vember  there  is  what  is  called  the  summer  of  Saint  Martin. 
Preceding  the  colder  season  patients  who  arrive  after  the 
new  year  are  usually  more  seriously  ill  than  those  who  come 
early. 

"  We  have  left  too  late ''  are  sad  words  often  repeated  by 
the  patients ;  one  week's  delay  has  frequently  sufficed  to 
aggravate  the  disease  and  make  it  less  liable  to  be  relieved 
by  curative  means,  especially  by  the  climate. 

Another  mistake  is  leaving  Fan  too  early,  during  the 
first  fine  days  in  March  and  April,  although  the  atmo* 
spheric  variations  are  frequent  and  very  irregular ;  before  the 
first  fortnight  in  May  people  cannot  rely  on  the  weather. 
The  patients  going  too  soon  north,  are  always  exposed  to 
meet  with  the  end  of  the  winter,  and  thus  to  lose  in  the 
course  of  a  few  cold  days  the  full  benefit  obtained  during 
six  months  of  sacrifice  and  patience. 

Others  encouraged  by  the  improvement  and  strength  they 
have  gained  are  anxious  to  make  excursions  into  the  moun- 
tains, to  the  sea-side,  or  to  Spain ;  these  voyages  under- 
taken during  the  variable  spring  season,  are  frequently  the 
cause  of  a  serious  return  of  the  scarcely  improved  illness,  or 
of  the  loss  of  the  strength  just  obtained. 

All  persons  sufiTering  from  chronic  respiratory  diseases,  as 
tubercles,  bronchitis,  pulmonary  congestion  and  inflamma- 
tion, require^  with  very  few  exceptions,  to  remain  in  the 
south  during  several  winters,  and  afterwards  to  pass  in  an 
intermediate  station  one  or  two  winters ;  otherwise  there 
is  not  much  chance  of  a  lasting  recovery  if  they  are  too 
soon  exposed  to  a  rough  and  cold  winter  in  the  north. 

Pan  is  suitable  for  patients  who  want  a  calming  and 
soothing  influence,  and  it  happens  frequently  that  patients 
with  an  irritable  temperament,  unable  to  bear  another  cli- 
mate, arrive  in  February,  March,  and  April,  and  have  thus 
lost  the  best  part  of  their  time. 

Finally,  patients  should  be  reminded  that  they  visit  Pan 
for  the  sake  of  their  health,  and  not  merely  for  their  plea- 
sure. Moderate  and  not  fatiguing  amusements  and  dis- 
tractions are  most  useful,  but  dancing,  hunting,  and  other 
exhausting  exercises    are  not    suitable  for   persons  whose 


28  Holiday  Tour  in  the  Pyrenees, 

mode  of  life,  whose  hygiene,  and  daily  exercise,  and  amuse- 
ments are  to  be  as  strictly  attended  as  any  medicinal  pre- 
scription. 

In  fine  weather  it  is  all  right  to  be  in  the  open  air,  but 
there  is  no  excuse  for  patients  accepting  an  invitation  to  the 
theatre  or  an  evening  party,  especially  as  the  exposure  to 
the  much  cooler  night  air  is  most  dangerous  to  patients 
suffering  from  pulmonary  diseases. 

I  hope  that  Dr.  Lahillone  will^  as  he  told  me,  soon  pub- 
lish a  short  and  practical  work  on  the  watering  places  in 
the  Pyrenees ;  as  he  has  passed  for  almost  ten  years  the 
summer  season  in  Cauterets,  we  have  reason  for  expecting 
much  practical  information. 


The  Watering  Places  in  the  Pyrenees. 

At  Pan  the  railway  journey  ceases,  and  Mr.  Gharderes 
kindly  provided  me  with  a  tourist  map  of  the  Pyrenees  as 
proposed  by  himself,  and  with  addresses  of  the  best  hotels. 
After  passing  in  an  open  carriage  through  a  beautiful  coun- 
try with  numerous  villas,  we  passed  after  two  hours  the  hills 
near  Sevignac,  where  the  splendid  valley  of  Ossau  begins^ 
and  the  Pic  du  Modi  is  first  seen.  This  lovely  valley  extends 
for  16  kilometres  to  Laruns,  where  the  splendid  road  ascends 
towards  Eaux  Bonnes  and  Eaux  Chaudes  in  large  zig-zags. 
The  most  beautiful  views  of  the  valley  d'Ossau  and  of  the 
high  mountains  are  constantly  seen,  and  add  to  the  charm 
of  the  lovely  scenery. 

With  theexceptionof  Bagneres  de  Bigorre  and  of  Bagneres 
de  Luchon,  all  the  other  principal  watering  places  in  the 
Pyrenees  are  situated  in  smaller  or  larger  glens  or  valleys^ 
everywhere  surrounded  by  more  or  less  high  mountains, 
which  shelter  those  places  against  the  cold  winds ;  every- 
where the  air  is  mild  but  still  refreshing,  and  more  or  less 
invigorating  according  to  the  various  heights,  which  are 
at— 


by  Br.  Roth.  29 

Eksx  Bonnes     748  metres  «=  2244  feet.        In  the  foar  larger 

EanxCfaaadM 675      „       »  2025    „  places,  viz.  Eaox  Chau- 

Caoterets 992      „       =  2976    „  des,  Cauterets,  Bigorre, 


StSanTenr        770 

M 

=  2310 

n 

and   Lnchon,   casinos. 

Baiegea     1232 

» 

-  3696 

a 

theatres,  concerts,  con- 

Bagncres de  Bigorre. . .  551 

» 

=  1653 

>» 

tribute  to  the  amuse- 

Bagnerce de  Lncbon. . .  629 

f> 

=  1887 

9f 

ment  of  the  visitors. 

These  watering  places  have  beautiful  walks  in  the  imme- 
diate neighbourhood^  with  very  fine  views^  and  all  patients 
who  have  sufficient  strength  make  excursions  either  on 
horseback  or  in  open  carriages  to  the  various  fine  spots  in 
the  Pyrenees ;  they  are  usually  accompanied  by  experienced 
guides,  who  look  very  picturesque  in  the  Basque  dress  with 
the  red  coat. 

Eaux  Bonnks, 

The  Eiablissement  Thermal  is  situated  at  the  top  of  the 
principal  street,  which  is  steep ;  in  the  drinking  hall  I  saw 
two  rows  of  persons  standing  one  behiud  the  other,  and  while 
forming  queue  approaching  the  principal  spring,  where  two 
persons  were  constantly  filling  the  drinking  glasses  of  the 
patients,  who  with  their  glass  in  band  filed  up  to  the  right 
and  left,  the  majority  of  them  mixing  their  mineral  water 
with  some  syrup.  The  various  bottles  of  syrup  with  the 
names  of  the  patients  on  them  were  placed  on  long  shelves 
on  both  sides  near  the  spring.  There  are  six  springs  which 
give  about  75,307  litres  of  mineral  water  containing  princi- 
pally sodic  and  calcic  sulphur ;  130,000  bottles  are  yearly 
exported,  and  about  8  to  10,000  patients  and  tourists  visit 
the  place  yearly ;  the  waters  are  used  for  drinking,  bathing, 
and  gargling.  There  is  a  special  room  in  the  etad- 
Hssemeni  for  gargling,  and  at  the  first  moment  1  did  not 
know  what  the  people  were  doing  when  I  saw  them  standing 
each  in  a  small  compartment,  and  their  hind  aspect  only 
visible ;  the  gargling  process  appears  here  to  be  in  vogue 
in  the  various  chronic  throat  complaints,  which  in  the  other 
watering  places  are  treated  more  by  inhalations  and  pulve- 
risation.    Dr.  Pidoux,  an  old  practitioner  and  author   of  a 


80  Holiday  Tour  in  the  Pyrenees, 

well  known  work  on  consumption^  and  on  Eaux  Bonnes,  is 
the  medical  inspector,  who  very  kindly  told  me  that  at  least  60 
per  cent,  of  all  the  patients  at  Eaux  Bonnes  are  consump- 
tive, that  the  rest  suffer  from  chronic  pharyngitis,  laryngitis, 
and  bronchial  catarrh.  He  told  me  that  the  combination  of 
sodic  and  calcic  sulphur  is  only  to  be  found  there,  and 
to  this  combination  many  cures  are  due.  The  patients 
are  advised  to  return  for  several  seasons  and  to  driuk  at 
home  the  waters  about  the  end  of  December.  Although  the 
majority  of  the  patients  leave  in  August,  the  doctor  told 
me  how  fine  September  and  even  October  are  in  this  place. 
In  his  medical  report  for  1878,  **  Un  aper9u  sur  les  cures 
preventives  des  maladies  de  poitrine  par  les  eaux  minerales 
d'Eaux  Bonnes,^'  he  mentions  that  chronic  diseases  can  be 
treated  prophylactically,  because  in  many  cases  it  is  not  im- 
possible to  know  beforehand  to  which  chronic  disease  there 
is  a  special  disposition ;  hereditary  tendency,  and  the  com- 
plaints from  which  a  child  suffers,  more  frequently  might 
give  a  clue  for  finding  out  the  special  disposition.  Dr. 
Pidoux  admits  the  existence  of  three  chronic  diseases, 
which  cause  all  the  other  chronic  diseases — scrofulosis, 
arthritis  (including  gout  and  rheumatism),  and  syphilis  are 
these  elementary  chronic  diseases. 

Herpetismus,  the  fourth  elementary  chronic  disease  added 
by  Bazin,  is  for  Pidoux  only  a  transition  disease  with  innu- 
merable forms.  Herpetismus  is  thus  considered  the  original 
cause  of  all  internal  and  external  chronic  diseases,  which 
degenerate  and  combine,  and  with  the  three  fundamental 
diseases  give  rise  to  a  host  of  mixed  chronic  diseases,  which 
finally  are  the  connecting  link  between  the  capital  chronic 
diseases  and  those  organic  and  ultimate  diseases,  which 
cause  death.  By  observing  other  laws  of  this  natural  or 
artificial  process  of  degeneration,  fusion,  and  mixture  of 
diseases,  science  would  arrive  to  the  prevention  of  chronic 
disease  in  infancy  and  youth,  and  thus  a  new  social  medicine 
could  be  created,  which  is  the  medicine  of  the  species,  and 
the  highest  branch  of  therapeutics.  I  have  just  alluded 
to  the  views  of  Pidoux  (which  were  admitted  twenty 
years  ago  by  Professor  Kiiss,  of  Strasbourg,  who  also  sought 


by  Dr.  Roth.  81 

the  transfonnatioii  of  chronic  diseases,  especially  of  syphilis, 
throngh  hereditary  causes),  because  they  are  only  a  modified 
Tiew  of  Hahnemann's  idea  of  psora,  syphilis,  and  sycosis,  being 
the  causes  of  chronic  diseases.  Pidoux  does  not  exclude 
saline  and  chlorinated  mineral  waters  in  his  preventive  treat- 
ment, but  he  considers  their  action  less  deep,  and  believes 
that  sulphur-waters,  especially  the  old  spring  {vielle  source) 
of  Eanx  Bonnes,  is  more  stimulating  and  more  tonic  and  that 
its  effect  is  more  intense.  It  is  his  conviction  that  to  this 
spring  belongs  the  most  suitable  means  for  counteracting 
the  effects  of  arthritic  degeneration  (degenerescence),  and  of 
preventing  many  pulmonary  consumptive  diseases ;  he  con- 
siders this  spring  as  the  most  complete,  or  rather  that  it 
contains  the  maximum  of  the  good  qualities  of  all  the 
sources  belonging  to  the  same  family. 

It  is  strange  that  a  theory  propounded  by  Hahnemann, 
and  given  up  by  most  of  his  followers,  should  find,  although 
in  another  form,  an  advocate  in  one  of  the  most  eminent 
physicians  at  the  watering  places  in  the  Pyrenees. 

The  waters  of  Eaux  Bonnes  are  in  their  physical  and 
chemical  properties  very  similar  to  those  of  Eaux  Chaudes, 
and  having  collected  more  notes  on  the  latter,  I  refer  my 
friends  to  the  next  article. 

Besides  the  reading  rooms  in  the  large  hotels  there  are 
a  casino,  small  theatre,  beautiful  walks  and  promenades  in  the 
immediate  neighbourhood  of  Eaux  Bonnes,  and  excursions 
in  all  directions  contribute  to  the  amusements  of  patients 
and  tourists.  A  number  of  goats  are  brought  every  even- 
ing into  the  village,  as  many  of  the  Spanish  visitors  and 
patients  like  goats'  milk  for  supper  and  breakfast.  In  the 
lai^e  open  place,  where  a  good  music  band  plays  every 
afternoon,  I  saw  something  like  a  gymnastic  apparatus  for 
a  basque  game  played  on  Sundays ;  there  is  a  tub  filled  with 
water  moving  round  a  horizontal  bar  fixed  by  two  vertical 
stands ;  the  player  has,  while  running  under  the  tub,  which 
is  about  eight  or  nine  feet  high,  to  place  a  long  rod  through 
a  hole ;  if  he  misses  the  hole,  the  contents  of  the  tub  pro- 
cure him  an  involuntary  shower  bath,  which  causes  much 
merriment  among  the  public. 


32  Holiday  Tour  in  the  Pyrenees, 

Eaux  Chaudes. 

From  Eaux  Bonnes  we  made  an  excursion  to  Eaux  Chaudes, 
which  is  about  one  hour  distant ;  the  road  leads  down  to- 
wards Laruns^  but  before  coming  to  this  place  it  branches  off 
into  another  fine  glen  (gorge)^  amongst  high  mouutaina, 
where  the  village  forms  one  long  street  as  there  is  scarcely 
enough  space  for  the  houses,  which  are  all  let  to  the  visitors. 
The  Etablissement  Thermal  is  the  most  conspicuous  building 
and  contains  the  reservoirs  for  the  mineral  waters,  the 
springs  for  drinking,  the  swimming  and  other  baths  as  well 
as  douches.  Dr.  Lemonnier^  who  has  been  here  for  many 
years,  gave  me  kindly  all  the  information  I  wished  regarding 
the  principal  complaints  which  are  treated  here.  To  these 
belong  the  majority  of  uterine  diseases,  especially  sterility 
and  amenorrhoea,  rheumatic  compilaints  after  metastasis, 
various  forms  of  neuralgia,  and  the  effects  of  mental  overwork 
and  over  excitement,  some  kinds  of  dry  eczema.  Besides  the 
fine  air  and  some  beautiful  walks,  and  the  casino,  which 
is  not  too  much  frequented,  there  are  no  special  amusements 
provided  for  the  patients;  and  in  the  negative  effects  of  the 
absence  of  amusements^  Dr.  Lemon uier  finds  an  accessory 
means  in  many  cures  of  overworked  brains.  With  regard 
to  the  quantity  of  sulphur  the  waters  of  Eaux  Chaudes 
belong  to  the  weakest  in  the  Pyrenees.  No  consumptive 
patients  are  to  be  sent  to  this  place,  where  the  sun  recedes 
at  3.30  p.m.  behind  the  high  mountains. 

It  is  situated  nearly  on  the  frontier  of  France,  at  an  altitude 
of  680  metres,  and  at  the  extremity  of  the  Valley  of  Ossau, 
which  forms  one  of  the  most  picturesque  parts  in  this  chain 
of  the  Pyrenees.  The  Eaux  Chaudes  constitute,  from  a 
geological  point  of  view,  together  with  the  Eaux  Bonnes,  to 
which  they  are  closely  related,  a  family  distinct  from  the 
other  sulphurous  sources  of  central  France.  In  fact,  whilst 
most  of  these  latter  flow  from  the  same  bed  of  granite  rocks, 
the  springs  of  Eaux  Bonnes  do  not  appear  until  after  having 
traversed  beds  of  limestone,  and  the  springs  of  Eaux 
Chaudes  at  the  point  of  junction  of  the  limestone  with  the 
granite,  in  a  fissure  nearly  parallel  to  the  bed  of  the  river 


Ce. 

?. 

Le  Clot           

36-25 

97-26 

L'Esqnirette  (warm) ... 

85- 

95- 

Le  Bej           

83-5 

92*3 

L'Esqnirette  (tempertOe) 

81-60 

88-7 

Baudot           

82-50 

90-9 

1  rffcrrpBHOC         *••         •.• 

24-85 

75-83 

MiDvielle         

10-60 

61-08 

by  Dr.  Roth,    ,  83 

of  Ossan^  from  the  spring  of  Rey  to  that  of  Clot^  whence  it 
happens  that  in  the  springs  of  Eaux  Bonnes  and  Eaux 
Chaudes  the  proportion  of  the  lime  salts  is  always  greater 
than  in  the  sulphurous  springs^  which  have  their  origin 
solely  in  the  granite  rocks. 

The  springs  at  Eaux  Chaudes  are  divided  into  warm, 
temperate^  and  cold^  viz. : 

Hot  Bpriii^ 

Temperate 
springs 

Cold  gpriogs 

Le  Clot  is  used  for  baths^  douches^  and  drinking. 

Esquirette  is  the  only  spring  which  has  a  large  amoant 
of  gas  escaping  by  an  intermittent  effervescence. 

Rey  is  less  nsed  for  drinking^  but  more  for  baths  and 
doQches. 

Baudot  and  Larressec,  especially  the  latter,  are  only  used 
for  drinking. 

Mmoielle  is  the  coldest,  and  mostly  used  for  drinking. 

Physical  Properties,  6;c.*  —  At  the  moment  that  the 
Eaux  Chaudes  gush  forth,  whatever  their  temperature  may 
be,  they  are  always  perfectly  limpid  and  colourless ;  but  when 
seen  in  a  large  volume,  as  in  the  bathing  tubs,  especially  in  the 
''Pisdne,^^  the  swimming  baths,  where  the  mineral  waters  are 
only  very  slowly  renewed,  they  have  a  slight  bluish  tint,  which 
proves,  without  doubt,  the  absorption  of  the  surrounding 
carbonic  acid,  the  partial  decomposition  of  the  alkaline  sili- 
cates, and,  finally,  the  formation  of  a  small  quantity  of  the 
higher  poly-sulphides  of  sodium. 

The  thiee  prmeipal  springs  of,  Le  Clot      furnish  S9,600  litres  in  24  hours.'] 

L'fisqnirette    „      89,600    „  ,r 

LeRey  „      66,160    „  „ 

The  temperature  of  the  waters  does  not  vary  except  to  the 
extent  of  one  or  two  degrees. 

*  From  Miude  Physique  ei  Clinique  sur  lea  Eaux  Chaudes,  par  KM.  Hialhe 
et  J.  Lefort. 

VOL.  XXXVII,  NO.  CXLVII. JANUARY,  1879.  C 


34  Holiday  Tour  in  the  Pyrenees, 

It  has  been  noticed  that  the  spring  of  Minvielle  has  lost 
its  heat  a  little  since  1866.  All  the  springs  of  the  Eaux 
Chaudes  contain  much  more  mineral  matter  than  those  of  a 
higher  temperature. 

Hydrochloric^  nitric^  and  sulphuric  acid  mixed  with 
these  waters,  do  not  give  rise  to  any  gaseous  action,  the 
odour  of  these  waters  becoming  only  more  intense  by  the 
evolution  of  hydric  sulphide  at  the  expense  of  the  alkaline 
sulphides. 

With  the  water  of  Minvielle  there  is  a  slight  whitish 
deposit  on  adding  basic  acetate  of  lead. 

With  the  mineral  waters  sulphate  of  copper  gives  a  slight 
brown  precipitate. 

Tartar  emetic  gives  a  clear  yellow  colour  with  the  water, 
but  with  that  of  Minvielle  the  colour  is  hardly  visible. 

The  sulphurous  property  of  the  Eaux  Chaudes  is  such, 
that  if  some  of  the  water  is  placed  in  a  bottle^  sealed  up, 
and  sheltered  from  the  rays  of  the  sun,  it  is  remarked, 
after  a  few  months,  that  the  odour  of  hydric  sulphide  is 
much  stronger  than  even  in  the  waters  themselves. 

The  quantity  of  carbonic  acid  or  carbonate  contained  in 
these  waters  is  in  a  direct  ratio  to  their  temperature  and  the 
amount  of  mineral  matter  that  they  contain  (see  Table 
below). 

These  waters  contain  also  silicate  of  potassium  3(Si03KO}, 
but  a  little  of  magnesic  silicate. 

The  springs  of  Baudot  and  Larressec  contain  nearly  as 
much  chloride  of  sodium  as  those  of  Le  Clot,  Le  Rey,  and 
L'Esquirette. 

These  springs  contain  many  calcic  salts,  and  only  traces 
of  magnesia  and  oxide  of  iron. 

Alumina  is  found  in  the  waters  at  all  temperatures. 

Carbonic  add. 


Tempemtare. 
Cc. 

Saline  Residue, 
per  litre. 

perlibri 
a  0^  and  a 

Le  Clot 

86-23 

0.348 

2*43 

L'Esquirette  ... 

3500 

0-342 

2-43 

Le  Rey 

33-50 

0-338 

2-05 

Baudot 

25-50 

0-334 

1-28 

Larressec 

24-35 

0-328 

0-81 

Minvielle 

10-60 

0-270 

0-63 

by  Dr.  Roth. 


85 


Dr.  Filhol  has  analysed  the  waters  of  Eaux  Chaudes, 
which  contain  in  a  litre — 


Salphide  of  Sodinin 

0*0087  grammes. 

Carbomite  of  Sodium    ... 

0-0350 

•f 

Sulphate  of  Caldum     . . . 

0-1030 

»» 

„           Sodium 

0-0420 

tt 

Chloride  of  Sodium 

0-1160 

ft 

Silicate  of  Calcium 

00060 

>» 

„         MagneBium 
„         Aluminium 

y  traces 

Glairine  and  Iodine 

traces 

0-8087 


According  to  Dr.  Lemonier,  the  following  is  a  list  of 
the  percentages  of  sodic  chloride  and  sodic  sulphide  at  the 
TarioiiB  springs : 


LeClot     ... 

L'Eaquirette 
Le  Bey 
Baudot 


.*• 


MinYielle 


Sodic  Chloride. 
-097806 
-092100 
•120627 
•114106 
•114106 
•088025 


••• 


Sodic  Sulphide. 
-007930 
•008086 
•009174 
-008897 
•008086 
•004048 


Messrs,  Mialhe  and  Le  Fort's  table,  shounng  the  proportion 
of  simple  bodies  of  acids  and  of  bases  contained  in  a 
litre  of  water  of  the  various  springs  at  Eaux  Chaudes, 


LeClot 

I/Eaqnir- 
etta 

LeBey. 

Baudot. 

Lamaaec. 

MinTieUa. 

Solphar    

f- 

Ghaodei. 

0-008625 

0-0037580-003565 

0003665 

0KX)8675 

0-001607 

rChkrhydric     

0-0661 

0-0666    O056& 

0-0559 

00554 

00839 

m  \  Salphorie 

0O811 

0K)807 

0-0798 

0-0817 

00776 

0*0658 

1-^  Silicic       

0-0550 

0K)546 

0-0640 

0O531 

0-0526 

0-0520 

<  1  Carbonic 

0-0048 

0-0048 

0-0040 

0-0025 

0-0016 

0-0010 

viodhydric 

traces 

traces 

traces 

traces 

traces 

traces 

Boriqae     

? 

? 

? 

? 

? 

? 

Pbtuh 

0-0079 

0-0071 

0-0069 

0*0066 

0-0061 

0-0042 

Soda 
""■■  •••    •••     ...     •■«     ••• 

00922 

0-0920 

0-0874 

00881 

0-0869 

0*0611 

Chalk 

^"■•^                  •••           sat            •••            ••• 

0-0284 

00280 

00273 

0-0267 

0-0266 

0-0239 

Ammonia    and     lithiayl 

magnesia     and     aln-  1 
mina,  oxide  of   ironi  | 

traces 

traces 

traces 

traces 

traces 

traces 

iffganie  matters    ...     J 

0-329125 

0-826558  0-817965 

0-818165 

0-310276 

0*243009 

86 


Holiday  Tour  in  the  Pyrenees, 


Messrs.  Mialhe  and  J,  LeforVs  quantitative  table  of  salts 
contained  in  a  litre  of  the  springs  of  Eaux  Chaudes. 


L'Esqoii- 

Le  Clot. 

ette 

LeRey. 

Baudot. 

Larreaaec 

Minrielle 

Sodic  sulphide 

Chaudei. 

0-00882 

000913 

0-00868 

0-00868 

0-00870 

0*00391 

Calcic        

traces 

traces 

traces 

traces 

traces 

traces 

Hy  dric  salphide       

traces 

traces 

traces 

traces 

traces 

traces 

Sodic  chloride 

00899 

00891 

0-0889 

00896 

0-0887 

0-0543 

Chloride  of  lithium 

traces 

traces 

traces 

traces 

traces 

traces 

Iodide  of  soda 

traces 

traces 

traces 

traces 

traces 

traces 

Carbonate  of  soda    

00119 

00119 

00097 

0*0058 

00038 

00024 

Sulphate  of  soda      

00718 

0072B 

0-0715 

00773 

0*0706 

0-0053 

„           ammonia 

traces 

traces 

traces 

traoes 

traces 

traces 

„           lime       

00690 

00680 

00663 

00648 

0*0643 

0-0580 

Borate  of  soda 

? 

? 

? 

? 

? 

P 

Silicate  of  potash     

00307 

00275 

00267   0-0255 

0-0237 

0-0163 

Silicic  acid        

0  0322 

0*0342 

0*0343 

0-0342 

00350 

0-0399 

Organic  matter        

Total     

traces 

traces 

traces 

traces 

traces 

traces 

0-31432 

0-31283 

030608 

0-30578 

0*294800*18011 

1 .  The  springs  of  Eaux  Chaudes  have  an  identical  com- 
position and  a  common  origin. 

2.  The  spring  of  Minvielle,  although  having  the  same 
origin  as  the  others^  receives  continually  soft  waters,  which 
reduce  its  mineralisation  and  temperature. 

3.  The  hotter  the  springs^  the  greater  the  quantity  of 
mineral  matter. 

4.  They  differ  according  to  the  part  of  land  from  which 
they  rise. 

5.  Besides  sodic  sulphide  all  these  waters  contain  calcic 
sulphide  and  sulphuretted  hydrogen. 

6.  The  waters  of  Eaux  Chaudes  are  of  the  same  nature  as 
those  of  Eaux  Bonnes. 

7.  Their  mineralisation  and  temperature  are  not  always 
constant ;  nevertheless,  the  variation  is  not  much. 

The  following  notes  are  taken  from  Etudes  Cliniques 
et  Physiologiques  sur  les  Eaux  Chaudes,  par  le  Docteur 
Lemonnier.     Paris,  1870. 

The  physiological  and  therapeutical  action  of  the  waters 
of  Eaux  Chaudes  is,  in  some  cases,  very  complex^  and  appa- 


by  Dr.  Roth.  37 

rently  so  contradictory  in  others^  that  it  is  very  difficult, 
in  fact  hardly  possible  to  describe  it  under  a  general 
heading. 

Whilst  they  promote  the  appearance  and  increase  the 
flow  of  the  menses  and  the  bleeding  of  piles^  in  other  cases 
they  retard  and  moderate  these  flows;  they  constipate  or 
loosen  the  bowels^  increase  or  diminish  the  quantity  of  urine^ 
produce  or  diminish  perspiration,  cause  and  cure  eruptions 
of  the  skin,  increase  or  diminish  mucous  secretion,  bring  on 
and  relieve  coughing,  cause  sleep  or  restlessness,  relieve  pain, 
and  finally  increase  or  diminish  the  deposit  of  fat. 

This  diversity  of  action  depends,  it  is  true,  very  much 
upon  the  constitution  of  the  patient,  as  well  as  on  the 
manner  of  using  the  water. 

The  most  general  and  complex  effects  which  are  shown  in 
the  majority  of  cases  amongst  those  who  reside  at  Eaux 
Chandes,  whilst  undergoing  a  more  or  less  protracted  treat- 
ment, are^  increase  of  appetite,  sleep,  and  a  longing  for 
exercise  j  diminished  desire  for  study  and  intellectual  occupa- 
tions ;  leanness  rather  than  stoutness,  especially  in  the  begin- 
ning; increased  stoutness  follows  a  cure  or  amelioration. 

Action  on  the  Skin. — A  darker  pigmentation  of  the  skin 
as  well  as  of  the  nails  and  hair,  and  its  rubbing  off  in 
scales,  which  makes  many  patients  say  that  their  skin  comes 
off  like  bran,  are  very  general.  The  same  effect  takes 
place,  even  on  those  parts  which  are  not  bathed,  as  the  face, 
neck^  shoulders^  and  hands — parts  which  are  more  frequently 
exposed  whilst  moist  to  the  action  of  the  air,  thus  causing 
a  disintegration  of  sulphuretted  hydrogen.  The  healing 
powers  of  the  waters  are  well  shown  by  their  quick  healing 
action  on  ulcers  when  applied  in  the  form  of  a  poultice ; 
neither  the  blistering  nor  cauterising  of  the  skin  can  be  kept 
up  during  the  use  of  the  bath,  because  the  waters  heal  the 
8ore  surface  so  soon.  Formerly  the  bather  had  often  to  pay 
very  much  for  a  few  pieces  of  Glairine ;  experience  has 
now  shown  that  poultices  damped  with  the  water  have  the 
same  beneficial  effect  in  the  cicatrisation  of  wounds.  These 
poaltices  are  especially  beneficial  in  cases  of  eczema,  having, 
besides,  the  advantage  of  relieving  the  lancinating  pains  and 


88  Holiday  Tour  in  the  Pyrenees, 

violent  itchings.  After  a  few  baths  the  skin  becomes  more 
moist^  the  perspiration  more  abundant ;  the  patient  digests 
better^  feels  less  the  heaviness  of  the  head^  but,  above  all^  the 
feeling  of  weight  on  the  chest. 

How  is  it  that  profuse  perspiration  is  arrested  and  modified 
by  the  employment  of  the  same  bath  ?  A  cure  of  this  kind 
occurred  last  season  at  the  baths  of  le  Rey  and  at  the  same 
temperature,  32^  C. ;  the  patient  was  cook  to  a  doctor  at 
Bayonne,  who  returned  for  the  third  time  (she  had  not 
been  seen  for  the  last  two  years)  to  lessen  her  copious  and  ex- 
hausting perspiration.  Another  patient  was  a  woman  at- 
tacked with  rheumatic  nodes  on  both  arms  and  wandering 
rheumatic  pains,  which  did  not  diminish  until  she  perspired 
freely  by  the  sole  use  of  the  waters  for  the  first  few  days.  Later 
on  she  took  douches,  which  caused  her  to  perspire  more ; 
she  was  relieved  by  the  sole  use  of  the  bath.  She  had  a 
similar  perspiration  from  the  internal  use  of  the  waters. 
Thus,  under  the  influence  of  the  same  agent  two  constitu- 
tions reacted  physiologically  in  two  opposite  directions. 

It  was  mentioned  above  that  the  tingling  caused  by  ec- 
zema often  disappeared  during  the  bath,  and  under  the  in- 
fluence of  compresses  soaked  in  the  sulphurous  water.  But 
a  lively  pricking  of  the  skin  and  eruptions,  which  are  not 
always  very  easily  classified,  are  often  suddenly,  and  some- 
times a  few  hours  later,  developed  in  the  same  bather. 

The  case  is  mentioned  of  a  lady  who,  in  consequence  of 
the  bath,  got  red  spots  on  the  back  and  shoulders  similar  to 
measles ;  half  an  hour  after  the  third  bath  these  spots  di- 
minished, and  within  a  week  they  disappeared  entirely  with- 
out any  other  influence  on  her  complaint,  which  was  enlarge- 
ment of  the  neck  of  the  uterus.  It  often  happens  that 
persons  in  good  health  complain  of  being  stung  during  the 
bath,  although  no  marks  are  to  be  seen  ;  this  does  not  hap- 
pen when  the  water  has  become  desulphurised  by  exposure 
to  the  air  during  the  night,  which  thus  proves  that  this 
peculiar  action  is  due  to  the  sulphuretted  hydrogen,  which 
possesses  the  double  property  of  soothing  and  exciting  under 
certain  unknown  conditions. 

Action  on  the  Mucous  Membranes, — The  waters   have 


by  Dr.  Roth.  39 

been  used  for  the  nose  and  pharynx  in  the  form  of  injec- 
tions and  gargles ;  as  they  cause  a  sensible  quickening  of 
the  capillary  circulation  as  well  as  a  thick  and  abundant 
secretion  rich  with  epithelial  debris  and  give  a  healthy  co- 
lour to  the  tissues.  Excoriations  of  the  neck  of  the  uterus 
deatrise  quickly  but  are  generally  accelerated  by  the  appli- 
cation of  lunar  caustic  or  tincture  of  sodine.  A  case  is 
mentioned  where  the  granulations  of  the  cervix  uteri  en- 
tirely disappeared  under  the  influence  of  the  bath^  without 
pharmaceutical  means,  after  a  very  long  treatment ;  at 
the  end  of  ten  or  twelve  days  the  leucorrhoea  nearly  entirely 
ceased,  the  cervix^  previously  gorged,  diminished  in  weight 
and  volume,  while  the  uterus  ascended  and  got  into  its 
proper  position.  Similar  results  are  obtained  in  the  treat- 
ment of  pharyngeal  and  palpebral  affections,  the  secretions 
of  which  are  increased,  after  which  a  reaction  takes  place 
and  the  cure  is  complete.  The  internal  use  of  the  waters 
frequently  produces  flatulence  and  gives  rise  to  wind  of  a 
ralphuiy  nature.  In  many  cases  the  liver  is  acted  upon, 
causing  a  copious  secretion  of  slaty  and  bottle-green  coloured 
stools.  A  large  number  of  people  are  constipated  by  the 
vater;  in  these  cases  a  febrile  state  is  manifested  and  the 
feces  of  the  patient  are  of  a  deep  brown  colour,  owing^  no 
doubt,  to  the  formation  of  a  sulphide  of  iron.  Colics  and 
diarrhoea  are  produced  by  the  use  of  the  waters  if  exposed 
to  the  air  only  for  two  or  three  hours. 

When  the  liver  is  acted  upon  by  drinking  the  desulphu- 
rised water^  i.e.  solely  by  its  alkaline  element,  it  never  pro- 
duces alkaline  cachexia,  and  the  urine  does  not  become 
alkaline, — ^it  loses  its  acidity,  that's  all.  Under  the  same 
influence  acid  eructations  and  acidity  of  the  stomach  cease. 

These  desulphurised  waters  can  be  drunk  with  impunity 
without  either  weakening  the  constitution  or  impoverishing 
the  blood,  even  after  drinking  two  or  three  litres  a  day ;  it 
thus  forms  a  good  purgative  and  liquefies  the  blood. 

The  water  causes  gravel  composed  of  urates  in  the  urine. 

The  case  is  mentioned  of  a  merchant  from  Orthes  who 
had  never  passed  gravel,  but  who,  under  the  influence  of  a 
quantity  of  desulphurised  water,  passed  three  calculi  one 


40  Holiday  Tour  in  the  Pyrenees, 

centimetre  loDg  and  4  mm.  broad^  which  were  cut  in  facets 
corresponding  with  each  other  so  exactly  as  to  leave  no 
doubt  that  they  formed  one  large  stone. 

Dr.  Lemonier  experimented  on  himself  bydrinking  during 
four  successive  days,  eight  tumblers  of  the  water  of  the  source 
of  Clot,  and  on  the  fifth  day  he  collected  the  urine,  which 
amounted  to  845  c.  centimetres.  The  urine  was  strong 
acid  and  very  little  red  gravel  was  deposited  on  the  base  of 
the  vessel.  The  weight  of  the  gravel,  which  was  separated 
by  filtering,  was  075  gr.,  that  of  the  urea  18*25  gr.  The 
same  experiment  was  made  a  week  later  under  the  same 
circumstances  and  same  temperature^  with  this  difiTerence, 
that  the  ordinary  drinking  water  was  substituted  for  the  eight 
tumblers  of  the  mineral  water ;  in  this  second  experiment^ 
the  weight  of  the  gravel  was  0'70  gr.,  and  that  of  the  urea 
13*50.  The  sulphur  waters  appear  to  expel  and  not  to 
accumulate  the  urates. 

Effects  on  Innervation. — The  waters  and  the  climate  appear 
to  act  rather  as  a  soothing  than  an  exciting  e£fect  on  the  intel- 
lectual functions;  but  oa  the  animal  functions  they  cer- 
tainly produce  a  vivifying  effect,  especially  on  the  digestion, 
locomotion,  sexual  power,  capillary  circulation,  on  the  pro- 
cess of  assimilation,  dissimilation^  the  action  of  the  skin  and 
the  mucous  membranes. 

The  immediate  effect  of  a  bath  of  32^  or  33^  C.  produces 
on  the  majority  of  patients  suffering  actually  from  pain,  a 
sudden  sensation  of  their  pains. 

Cases  similar  to  those  mentioned  by  Bordeu  have  been 
also  observed  by  Lemonier. 

It  is  the  custom  of  the  country  to  place  patients  suffer- 
ing in  consequence  of  a  fall  or  of  contusions  into  the  bath, 
and  to  leave  them  there  for  an  hour. 

A  young  Englishman  who  was  violently  thrown  out  of 
the  carriage  suffered  horribly  from  pains  in  the  whole  body, 
especially  of  the  left  temple  and  left  shoulder ;  a  tolerably 
copious  ^hsemorrhage  through  the  ear  caused  a  suspicion  of  a 
fracture  of  the  base  of  the  skull.  The  patient  was  about  ten 
minutes  in  the  bath,  began  to  talk,  and  scarcely  complained 


by  Dr.  Roth.  41 

of  any  pain,  and  two  hours  later  he  continued  in  his  carriage 
bis  joamey  to  Pau  as  if  nothing  had  happened. 

Twoworking  raen,  one  of  whom  fell  from  a  high  poplar^  and 
the  other  who  was  suddenly  crushed  by  the  sudden  rolling 
down  of  large  stones,  suffering  very  much,  and  shrieking 
terribly,  are  placed  in  the  bath ;  a  quarter  of  an  hour  later 
the  pains  almost  entirely  disappeared,  and  they  afterwards, 
without  any  assistance,  returned  to  their  inn. 

Numerous  eases  of  neuralgia — for  instance,  one  of  a  shoe- 
maker of  Pau  and  of  a  peasant  woman  from  Oleran  are 
named  who  were  placed  in  the  bath  at  the  time  of  pains,  and 
these  disappeared  as  if  by  magic. 

Toothache  is  often  relieved  successfully  by  using  the  waters 
for  drinking  or  gargling.  Many  such  patients  are  relieved  or 
apparently  cured  while  they  are  in  the  bath,  and  the  real 
cure  is  obtained  by  the  longer  period  of  rest  which  is  ob- 
tained by  the  use  of  the  bath  till  the  intermission  of  the 
pain  after  twenty-four  hours. 

Thus,  sciatica,  lumbar-abdominal-neuralgia,  eyebrowache, 
and  temporal  neuralgia  are  relieved  and  cured.  Dr. 
Lemonier  mentions  also  the  case  of  a  young  lady  who 
had  a  scar  of  a  wound  caused  by  the  explosion  of  a  per- 
cossion  cap ;  she  came  to  use  the  waters  in  hopes  that  the 
foreign  body  which  was  still  buried  in  the  middle  part  of 
the  right  thigh  would  be  thrown  out.  She  could  absolutely 
not  walk,  because  the  slightest-  movement  caused  very 
sharp  pain.  After  the  second  bath  she  began  to  move 
the  limb  slightly  without  too  great  a  pain,  and  after  twenty 
baths  and  douches  walked  without  pain  and  without  support, 
although  the  foreign  body  was  not  removed.  This  hypos- 
tenic  action  is  not  always  without  reaction  if  the  bath  and 
the  douches  are  too  long  used.  A  more  or  less  febrile  state 
follows  and  the  patient  is  obliged  to  suspend  the  treatment, 
and  herein  consists  the  great  difference  of  the  pure  waters 
and  desulphurised  waters.  These  last  having  a  smaller 
analgesic  effect  never  produce  the  febrile  reaction;  they 
are  absolutely  soothing  either  by  the  loss  or  by  the  modi- 
fication of  the  sulphuretted  hydrogen,  which  appears  to  be 
the  principal  agent  in  the  pure  waters.     The  drinking  of 


42  Holiday  Tour  in  the  Pyrenees. 

these  waters  causes  a  sort  of  drunkenness^  and  their  power 
of  curing  '*  migraine ''  depends  on  the  special  power  which 
makes  them  a  cephalic  remedy.  The  source  Minvielle 
seems  to  have  the  most  powerful  effect  in  this  respect, 
and  it  is  this  which^  as  was  mentioned  before,  permits  the 
sulphuretted  hydrogen  mostly  to  escape,  although  it  con- 
tains less  sulphur.  This  kind  of  drunkenness  is  more  fre- 
quent at  the  bath  and  at  the  douche ;  very  sensitive  persons 
feel  at  the  moment  they  enter  the  bath  room  this  sensa- 
tion, which  seems  to  have  an  effect  similar  to  that  produced 
by  ansesthetic  substances,  and  it  was  necessary  to  supply  better 
means  of  ventilation  in  all  the  "  cabinets ''  where  baths  and 
douches  are  given,  in  order  to  counteract  this  in6uence. 

The  physiological  as  well  as  the  therapeutical  action  of 
the  Eaux  Chaudes  is  shown  by — 

1.  The  effect  on  the  epidermis  and  the  epithelium  of  the 
mucous  membrane,  which  causes  greater  activity  of  the  ca- 
pillary, lymphatic,  and  subjacent  blood-vessels,  which  is 
manifested  by  a  tendency  to  suppress  mucous  and  purulent 
secretions,  and  to  bring  on  cicatrisation  of  ulcers  and  the 
resolution  of  chronic  stoppages  and  passive  congestions. 

2.  By  an  increased  action  of  the  liver,  which  can  be  mo- 
dified by  the  use  of  desulphurised  water. 

3.  By  an  ansesthetic  power,  followed,  if  the  action  is  pro- 
longed, by  a  reaction  in  a  contrary  direction. 

4.  By  the  expulsion  from  the  organism  of  the  superabun- 
dant plastic  and  thermogenic  substances,  and  expulsion  whick 
is  specially  increased  by  the  internal  use  of  the  desulphu- 
rised waters. 

5.  By  a  reconstituent  effect  due  both  to  climate  and  the 
use  of  the  waters. 

{To  be  eoiUinued,) 


43 


NOTES  ON  DIABETES. 
By    Ebancis    Black,    M.D. 

The  treatment  of  diabetes  has  been  ably  discussed  by 
Dr.  Hughes  in  this  Journal,  and  fully  considered  by  Dr. 
Neatby  in  a  paper  read  to  the  Brit.  Horn.  Society.*  My 
object  in  contributing  these  notes  is,  not  that  I  can  give 
anything  new,  but  that  I  wisn  to  add  my  experience  of  a 
disease  which  is  comparatively  rare,t  &i^d  which  presents 
g;reat  difficuties  in  its  pathology,  and  therapeutics.  The 
investigation  of  diabetes  involves  so  many  details  hinging 
on  accurate  views  of  the  most  difficult  points  in  physiolo^^y, 
and  the  most  complex  problems  in  organic  chemistry,  that 
when  we  add  to  these  our  imperfect  acquaintance  with  the 
drag  pathogenesis  of  glycosuria,  one  cannot  but  feel  that  we 
have  not  yet  reached  the  first  step  in  all  scientific  inquiry, 
a  knowledge  of  our  own  ignorance. 

In  giving  such  a  sketch  of  the  history  of  diabetes  as  may 
facilitate  the  examination  of  the  question  as  to  the  nature 
of  this  disease,  it  is  sufficient  to  commence  with  the  work  of 
Dr.  Rollo  (1797),  who  attributed  this  affection  to  a  morbid 
change  in  the  powers  of  digestion  and  assimilation.  He 
supposed  that  the  sugar  of  the  disease  is  formed  in  the 
stomach  chiefly  from  vegetable  food.  He  therefore  advised 
the  cutting  off  all  the  supplies  of  vegetable  matter  taken  as 
food,  with  the  use  of  emetics  and  narcotics. 

In  1837  Dr.  Macgregor  detected  sugar  in  the  blood,  also 
in  the  vomit  of  a  diabetic  patient,  who  had  been  fed  for 
three  days  on  roast  beef  and  water.  He  concluded  that 
what  ought  to  be  converted  into  healthy  chyle  was  changed 
into  saccharine  matter,  and  thus  entered  the  circulation. 

*  "  On  Diabetes/'  by  Dr.  Richard  Hughes,  ^rit,  Joum^  of  Mom.y  vol.  xxiv, 
p.  108;  Dr.  Neatby,  Trans,  Brit,  Horn.  Soe,,  1864,  vol.  iii,  p.  482. 

t  According  to  Dickenson  there  occurred  in  England  and  Wales  from 
1861 — 1870  one  death  from  diabetes  to  eviery  3509  inhabitants,  and  to  every 
682  deaths  from  all  causes ;  and  in  Scotland  one  to  every  4895  persons,  and  to 
every  916  deaths  from  all  causes. 


44  Notes  on  Diabetes, 

Bouchardat  (1841  to  1846)  continued  these  views,  and 
held  that  the  quantity  of  sugar  contained  in  the  urine  was 
in  direct  ratio  to  the  quantity  of  starchy  aliment  and  sugar 
taken  by  the  patient.  He  considered  that  in  the  diabetic 
patient  the  transformation  of  amylaceous  matter  was  rapid^ 
and  took  place  in  the  stomach,  whilst  in  the  healthy  person 
the  transformation  was  slow,  and  took  place  in  the  intestines. 
Bouchardat  introduced,  in  a  more  perfect  form,  the  dietary 
recommended  by  Rollo,  and  invented  a  gluten  bread  which 
in  France  still  goes  by  his  name. 

But,  in  spite  of  such  diet,  sugar  still  appearing  in  the 
urine,  it  was  evident  that  there  was  some  other  source  than 
the  starch  and  sugar  taken  as  food.  Then  various  theories 
appeared,  such  as  Mialhe's,  who  said  that  sugar  was  destroyed 
in  a  sound  organism  by  the  alkalinity  of  the  blood,  but  that 
in  a  diabetic  patient  the  blood  is  too  little  alkaline,  so  that 
the  sugar  could  not  be  destroyed ;  on  this  view,  though  the 
theory  was  soon  proved  to  be  wrongs  was  founded  the  alka- 
line treatment. 

In  a  few  years  later  (1848)  Claude  Bernard  attributed  the 
origin  of  diabetes  to  nerve  lesions,  and  announced  that  sugar 
was  formed,  in  the  liver  as  a  normal  process  in  all  animals^ 
and  that  this  formation  occurred,  independently  of  diet,  in 
carnivorous  as  well  as  in  herbivorous  animals,  and  that  its 
production  was  confined  to  the  liver.      He  also  showed  that, 
by  wounding  the  floor  of  the  fourth  ventricle,  a  temporary 
glycosuria   could   be   produced ;    also,  by  pricking  a  little 
higher  up,  an  increase  only  in  the  quantity  of  urine  was  often 
excited ;   thus  demonstrating  not  only  cerebral  influence  in 
producing    glycosuria   and    polyuria,    but    also   how   these 
two  diseases  may  exist  separately.     In  1861  he  discovered^ 
in  the  liver,  the  matter  from  which  the  sugar  was  formed, 
calling  it  glycogenic  matter.     Considering,  therefore,  dia- 
betes to  arise  from  a  natural  and  physiological  function  of 
the  liver,  either  from    direct  irritation,  or  indirectly  from 
irritation  of  the  nerves,  the  treatment  he  recommended  was 
at  one  time  sedatives,  at  another  by  means  capable  of  acting 
upon   the   nervous   system,    such    as    setons.    Bromide   of 
potassium^  electricity,  &;c. 


by  Dr,  Francis  Black,  45 

The  views  of  Bernard  were  held  as  established  facts  until 
the  appearance  of  Dr.  Pavy's  work^  on  the  Nature  and 
TreatmefU  of  Diabetes  in  1862.  By  a  series  of  very  careful 
experiments  he  shows  that  this  power  of  the  liver  to  form 
sugar  is  a  post-mortem  result,  the  nervous  system  during 
life  preventing  its  formation;  he  therefore  objects  to  the 
term  glycogenic  matter  as  incorrect,  and  calls  this  sugar- 
forming  substance  amyloid  matter.* 

In  an  appendix  to  this  paper  I  have  given  an  abstract  of 
the  arguments  and  experiments  supporting  Dr.  Favy^s  views 
which  I  am  inclined  to  regard  as  the  most  probable  explana- 
tion of  diabetic  phenomena.  In  accordance  with  Dr.  Pavy's 
theory  diabetes  is  due  to  some  cause  which  destroys  the 
iobibitory  power  of  the  sympathetic  nerves  over  the  liver, 
so  that  sugar  passing  into  that  organ  is  no  longer  converted 
into  amyloid  matter  (the  glycogen  of  Bernard),  but  passes 
noassimilated  into  the  circulation,  and  thence  is  discharged 
by  the  urine.  Diabetes,  according  to  these  views,  may  be 
stated  as  due  to  two  causes — -firsts  the  assimilative  power  of 
the  liver  is  diminished,  so  that  sugar  which  arrives  there  is 
not  converted,  or  only  in  part  converted,  into  amyloid  matter, 
and  thus  passes  into  the  general  circulation,  and  is  thence 
dischai^ed  by  the  urine ;  second,  the  inhibitory  power  over 
the  glycogenic  function  of  the  liver  is  Impaired,  and  thus 
permits  the  amyloid  matter  being  converted  into  sugar. 

Under  the  first  kind  of  diabetes  there  may  be  two  different 
condition8--one  where  the  disease  is  primarily  in  the  diges- 
tive organs,  being,  in  fact  a  form  of  dyspepsia,  where  an  abnor- 
mally small  proportion  of  sugar  is  converted  into  lactic  acid,  and 
thns  more  saccharine  matter  enters  the  portal  vein,t  and  is 

*  Trnvj,  Natwre  and  Treatment  of  Didbetet,  2nd  edit.,  1869,  p.  59. 

t  Senator  eajS  aiso  into  the  chyle  as  weU  as  into  the  portal  vein.  He  draws 
attention  to  a  remarkable  case,  which  has  been  almost  passed  in  silence  in  recent 
litentore,  reported  by  Andral  {Comptee  Sendust  1856,  xzxiv,  p.  468),  where 
diabetes  had  existed  with  complete  obliteration  of  the  portal  vein,  as  proved  on 
post-mortem  examination  (Ziemssen,  vol.  xvi,  pp.  952  and  955).  The  general 
view  being  that  sugar,  being  very  soluble  and  diffusible,  readily  passes  from 
the  afimentary  canal  into  the  blood-vessels  in  compliance  simply  with  the  law 
of  osmosis ;  it  passes  not  into  the  general  circulation  as  in  the  case  with 
matters  absorbed  by  the  lacteuls,  but  through  the  portal  veins  to  the  liver. 
{oide  Appendix). 


46  Notes  on  Diabetes^ 

carried  into  the  liver,  than  this  organ  can  assimilate.  The 
other  condition,  where  no  abnormal  quantity  of  sugar  is  car- 
ried to  the  liver,  but  where  the  powers  of  the  liver  are  defec- 
tive, and  allow  the  sugar  to  pass  without  being  converted 
into  amyloid  (glycogenic)  matter. 

I  shall  now  report  a  few  cases  which  have  come  under  my 
own  care. 

Case  1. — A  clergyman,  set.  48,  who  for  more  than 
twelve  years  has  been  a  martyr  to  gout,  which  has  distorted 
most  of  his  joints,  and  rendered  him  unable  to  walk,  con- 
sulted me  in  December  1874  for  diabetes.  It  has  been 
present  ten  months,  and  of  late  has  increased,  causing  ema- 
ciation, loss  of  strength,  and  great  mental  depression.  The 
urine  varies  in  quantity  from  three  to  four  quarts  a  day,  and 
the  sp.  gr.  has  for  long  averaged  from  1032  and  is  now 
1040,  and  giving  a  very  deep  stain  when  boiled  with  Liq, 
Pot. 

The  digestion  is  weak,  and  easily  disordered  ;  the  bowels 
are  generally  constipated,  but  often  this  alternates  with  an 
exhausting  diarrhoea  of  a  mucous  character,  mixed  with  hile 
and  attended  by  flatulence.  With  such  attacks  he  expe- 
riences great  exhaustion  and  mental  depression.  The  feet, 
knees,  joints  of  hands  and  elbows,  are  much  distorted  by 
gouty  swellings. 

The  patient  has  for  years  been  in  the  habit  of  taking  much 
and  a  great  variety  of  medicines,  and  especially  of  late  for 
the  diabetes,  the  last  being  Opium. 

As  the  rigorous  diet  he  has  pursued  seems  to  keep  up 
and  increase  the  gouty  diathesis,  I  ordered  a  relaxation  of 
it,  allowing  the  free  use  of  lemons,  oranges,  and  grapes,  and 
more  green  vegetables  at  dinner ;  also  maccaroni  and  a  little 
bread.  He  was  ordered  to  take  Phos.  ac,  ^  gtt.  iij,  at  noon, 
and  Trit.  leptandrine  1,  gr.  iij,  morning  and  evening.  As 
soon  as  the  biliary  disturbance  passed  away  the  Lept,  was 
stopped,  and  the  Phos.  ac.  continued,  with  now  and  then 
an  occasional  dose  of  Ignatia. 

At  the  end  of  a  fortnight  the  urine  fell  to  between  two 
and  three  quarts,  the  sp.  gr.  1030,  and  at  the  end  of  six 
weeks  to  two  quarts ;  sp.  gr.  1026.     These  remedies  were 


by  Dr.  Francis  Black,  47 

given  at  longer  intervals  until  March,  interrupted  occa- 
sionally by  the  occurrence  of  biliary  disorder  and  diarrhcei^ 
for  which  lod.  mere,  I,  followed  by  China  Ix,  were  found 
efficacious ;  the  Lept.  lost  its  effects. 

In  March^  from  some  undiscoverable  cause,  the  amount  of 
sugar  in  the  urine  and  the  quantity  increased ;  Uranium,  in 
Tarioua  doses,  from  3x  down  to  Ix,  was  tried  for  two  weeks 
with  no  benefit,  and  with  a  decided  loss  of  strength  and 
flesh.  Phos.  dx  gtt.  ij,  was  then  given  once  a  day  for  some 
time,  and  then  at  longer  intervals  ;  soon  after  its  commence- 
ment improvement  in  strength  and  spirits  set  in,  followed 
by  a  marked  change  in  the  urine,  so  that  by  the  end  of 
May  it  rarely  exceeded  two  quarts,  sp.  gr.  1022  to  1024,  and 
no  trace  of  sugar,  the  high  sp.  gr.  being  due  to  urates.  For 
a  period  of  six  months  no  sugar  was  present,  and  since  then^ 
owing  to  marked  imprudence  in  diet,  it  returned  twice ;  but, 
after  care  in  diet  and  a  few  doses  of  Phos.  ac.  ^,  it  disap- 
peared in  both  instances  within  ten  days. 

For  several  years  the  urine  has  always  deposited  a  dark, 
cayenne-looking  sand  (uric  acid'*^),  in  addition  to  lithates  of 
ammonia.  When  the  uric  acid  increased  much  it  was  always 
the  precursor  of  an  acute  attack  of  gout,  and  the  treatment 
of  these,  after  the  diabetes  had  passed  away,  was  often  very 
troublesome. 

Id  the  gouty  paroxysm  I  found  Aocn,,  Bry.^  Colch.  of  little 
use;  in  its  more  chronic  state,  with  considerable  effusion  into 
the  knees  and  ankles.  Led.  Ix  seemed  of  service ;  but  the 
relief  was  very  decided  when  I  commenced  the  treatment  by 
giving  on  the  first  day  a  mild  aperient  in  the  shape  of  half 
a  Tamar  lozenge ;  then  for  two  days  Iodide  of  potassium 
4  gr.  morning  and  evening.  On  the  third  day  the  improve- 
ment was  always  most  marked.  The  dose  of  the  Iodide  was 
latterly  reduced  to  2  gr.  The  patient's  old  experience  con- 
vinced him  an  aperient  was  needed,  and  probably  in  this 

*  Lifcldo  acid  grsTel  ia  often  fonnd  in  saccharine  urine  in  greater  or  lera 
qnantitj ;  and  in  fiiToorable  caees  of  the  disease  the  qaantity  of  this  acid  is 
often  verj  considerable.  Its  absence  and  then  its  reappearance  with  lithate 
of  ammonia  is  a  good  sign.  {Prout  an  Stomach  and  Renal  Diseases,  5th  edit., 
pp.  25  and  546. 


48  Notes  on  Diabetes^ 

case  the  post  hoc  was  the  propter  hoc.  He  is  now  (1878) 
able  to  move  about  with  more  freedom  than  he  has  done  for 
years^  he  is  freer  from  gout,  with  improved  digestion,  and  no 
sugar  in  the  urine,  the  diet  being  unrestricted. 

Remarks, — This  case  is  satisfactory  as  regards  the 
disappearance  of  the  diabetes  and  the  great  improvement  ia 
the  gout.  In  estimating  the  amount  of  credit  to  be  placed 
to  the  drugs,  deductions  must  first  be  made  in  the  benefit 
arising  from  stopping  the  amount  and  variety  of  physic 
which  the  patient  had  for  long  been  taking ;  second,  the 
advantages  due  to  the  ordinary  diet  for  diabetics,  and  this 
further  increased  by  the  addition  of  certain  fruits.*  After 
these  deductions  there  remains  a  fair  balance  to  the  drugs 
administered,  and  I  am  induced  to  attribute  fully  aa  much, 
if  not  more,  to  the  Lept,,  lod.  m.,  and  //n.,  than  to  the 
Phos,  ac.  As  regards  the  Phos,  ac,  he  had  taken  that  pre- 
viously as  a  slightly  acidulated  drink  without  any  benefit, 
and  when,  on  account  of  exhaustion,  I  gave  Phos.  he  always 
found  a  very  speedy  benefit  from  that,  which  he  was  never 
conscious  of  while  taking  the  Phos.  ac.  The  Uranium  had 
no  apparent  action.  The  combination  of  inveterate  gout 
and  diabetes  led  me  at  first  to  form  an  unfavorable  prognosis, 
but  the  experience  of  this  case,  and  the  further  knowledge 
that  glycosuria  is  more  common  in  connection  with  gout  than 
is  generally  supposed,  leads  me  now  to  consider  such  cases 
as  fairly  amenable  to  treatment ;  the  probability  is  that  such 
glycosuria  is  due  to  causes  traceable  to  abnormal  digestive 
processes.  For  instance,  the  conversion  of  sugar  into  lactic 
acid  in  the  stomach  may  be  restricted,  and,  further,  the  im- 
paired action  of  the  pancreas  and  small  intestines  may  allow 
of  its  absorption  in  greater  quantities  than  the  liver  can 
assimilate,  there  may  also  be  a  change  in  quality  as  well  as 
quantity.t     This  patient,  when  the   diabetes  first  showed 

*  According  to  Luchsinger  and  Salomon  inuUne  and  levulose  (froit-aagar) 
increase  the  amount  of  glycogen  in  the  liver,  bat,  a«  Kuelz  has  obaenred,  they 
may  be  taken  by  various  diabetics  with  impunity,  i.  e.  without  any  effect  upon 
the  proportion  of  grape-sugar  in  the  urine.  {ZienuMen,  Cyclop,  Med.,  vol.  xvi, 
p.  953.) 

t  Dr.  Jules  Cyr  {Traiti  de  V Alimentation,  Paris,  1869,  p.  873)  quotes 
M.  Marchal  (dc  Calvi),  whose  theory  is  that  gravel,  albuminuria,  and  diabetes. 


by  Dr.  Francis  Black.  4d 

itself,  was  stout,  as  gouty  patients  often  are.  Some  writers 
gire  eorpulenee  as  a  special  predisposing  cause  of  diabetes. 
In  Case  2  the  patient  was  stout  during  the  whole  course  of 
the  disease..  Gout,  corpulence,  and  diabetes  existing  to- 
gether present  the  conditions  in  which  exercise  and  hot-air 
btths  are  so  useful,  for  they  tend  to  get  rid  of  non-azotized 
products. 

Case  2. — ^A  lady,  set.  50,   dark  complexion,  well   made, 
and  of  average  constitutional  strength,  who  has  long  led  an 
active,  intellectual  life,  was,  after  great  fatigue  and  mental 
exertion,  attacked  by  cold    in  the  early  spring    of  1874. 
Her  medical  attendant  from  various  symptoms  feared   the 
existence  of  diabetes,  which  the   high  specific  gravity  and 
examination  of  the  urine  confirmed.    The  ordinary  diet  of  dia- 
beti<»  was  enforced  and  various  remedies  prescribed.     At  first 
the  relief  was  decided,  then  as  summer  came  on  the  ailment 
increased,  and  general  health  suffered.       The  last  remedy 
tried  was  Codeine ;  this  disagreed  with  her  and  she  consulted 
me  on  September  2l8t,  1874.     The  patient  has  lost  muscu- 
lar strength  to  a  great  extent ;  any  mental  exertion  is  painful ; 
a  distressing  want  of  decision,  great  emotional  susceptibility. 
Great  susceptibility  to  cold  and  damp ;  an  absence  of  sunshine 
renders  her  most  uncomfortable.     Sight  weak  ;  cold  perspi- 
rations affecting  generally  one  side  of  face  and  neck,  excited 
by  slight  depressing  causes.    Appetite  good,  comfortable  while 
eating,  but  a  quarter  of  an  hour  after  the  tongue  gets  dry, 
great  thirst  and  general  discomfort,  with  great  sinking  feeling 
at  the  epigastrium ;  bowels  constipated ;  motions  often  pale, 
with  a  sense  of  uneasiness  in  hepatic  region.     Urine  varies 
from  3  to  4  pints,  sp.  gr.  1036,  giving  a  very  dark  tint  when 
boiled  with  lAq.  pot. 

The  diet  she  has  followed  consists  in  a  great  exclusion  of 
amylaceous  and  saccharine  substances.  She  finds  it  neces- 
sary to  take  a  little  porter  at  dinner,  other  stimulants  dis- 
agree. 

No  change  was  made  in  the  diet ;  the  patient  was  warned 
to  avoid  all  attempts  at  mental    exertion,  and   to  be  very 

are  merely  vuied  mamfefltationB  of  the  uric  diathesis ;    hence  the  powerful 
influence  to  be  expected  from  diet  in  these  ailments. 

VOL.  XXXVII,  NO.  CXLVII.— 'JANUA&Y,  1879.  D 


50  Notes  on  Diabetes, 

careful  as  to  exercise.  Ign.  \,  2  drops  morning  and  evenin§^, 
was  prescribed  from  the  17th  September  until  October  2nd. 
The  depressed  state  of  the  nervous  system  was  improved, 
the  thirst  less,  the  bowels  more  regular,  no  change  in  urine. 
Phos.  ac.  Ix,  gtt.  iij,  afterwards  increased  to  gtt.  yj,  was 
given  night  and  morning,  with  occasionally  a  dose  of  Ignaiia. 
This  was  steadily  continued  until  the  end  of  December,  ex- 
cept when  intermitted  for  a  few  days  on  account  of  the 
motions  being  pale,  and  uneasiness  being  experienced  in 
hepatic  region  ;  these  symptoms  yielded  readily  to  Dig.  1.  A 
threatening  of  bronchial  and  hepatic  congestion  was  checked 
by  Kal,  Inch,  and  Hep.  s.  During  this  time  there  was  a 
gradual  improvement  in  general  health,  the  thirst  disappeared, 
the  urine  generally  about  2  or  3  pints,  the  sp.  gr.  from  1020 
to  1028,  giving  a  faint  amber  shade  when  boiled  with  Liq. 
pot.  In  this  state  the  patient  continued  gradually  gaining 
ground  during  the  spring  and  summer,  taking  occasionally 
Phos.  ac,  sometimes  Dig.  1,  at  other  times  Ign.,  but  often 
weeks  without  any  medicine.  In  October  she  complained 
much  of  sharp  pain  in  instep,  extending  outside  right  ankle 
up  leg ;  no  swelling  or  redness,  but  the  pain  prevents  walk- 
ing. In  December  she  began  to  complain  of  rheumatic  pains 
in  arm ;  various  remedies,  Kal.  bich.,  Actea^  Rhus,  Led.,  &c., 
had  no  effect  in  relieving  the  pain.  As  the  cold  weather 
set  in,  especially  during  damp  and  sunless  days,  the  sp.  gr. 
varying  during  January  from  1030  %o  1034,  giving  a  dark 
colour  when  boiled  with  Liq.  pot. ;  the  quantity  rarely  ex* 
ceeded  3  pints.  During  this  month  sharp  strangury 
showed  itself.     Remedies,  Canth.  of  no  use.  Aeon,  useful. 

In  February  suppuration  took  place  in  the  axilla  with 
swelling  of  axillary  glands ;  and  though  the  sp.  gr.  fell  on  the 
4th  to  1022,  it  gradually,  day  by  day,  rose  again  to  1032. 
Hep.  s.  3x,  then  lod.  Ix. 

February  28th. — Great  mental  exhaustion,  and  sudden 
and  frequent  loss  of  vision,  so  that  she  cannot  while  it  lasts 
read  or  write ;  the  gums  bleed  easily  and  several  teeth  are 
loose.  The  urine  in  quantity  about  3^  pints,  of  sp.  gr. 
1028 ;  dark  colour  when  boiled  with  Liq.  pot.  lod.  Ix.  and 
Phos*  8x  were  given  night  and  morning  on  alternate  days. 


by  Dr.  Francis  Black,  51 

March  10th. — The  blind  attacks  have  ceased,  feels  better^ 
axillary  swellings  gone^  urine  sp.  gr.  1020.     Continued. 

After  March  22nd^  the  weather  being  cold  and  damp, 
there  was  indigestion^  pale  motions^  return  of  cold  perspi- 
ration and  nervous  depression,  which  led  to  the  use  of  Dig^ 
Ix,  alternated  now  and  then  with  Ign. 

After  this  state  passed  away  there  was  no  improvement 
in  the  urine,  and  a  trial  of  Uranium  in  various  dilutions 
having  no  results^  I  urged  the  patient  to  go  to  a  warmer 
and  sunny  climate,  recommending  a  course  of  the  waters  at 
Vichy  to  be  followed  by  a  winter  at  Mentone. 

The  course  at  Vichy,  drinking  a  pint  of  the  Puits  Chomel 
in  the  morning,  and  one  of  VHdpital  in  the  afternoon,  with 
baths  every  day,  had  a  very  decidedly  good  eflfect,  and  this 
in  spite  of  the  weather  being  cold  and  damp.  The  heat  of 
mouth,  the  thirst  and  headache,  which  in  England  were 
very  constant,  disappeared ;  in  the  course  of  three  weeks 
the  sp.  gr.  fell  from  1033  to  1025,  and  the  quantity  of 
sugar  from  35  grammes  in  the  litre  to  6  grammes.  She 
travelled  to  Mentone  during  wet  weather  in  October^  caught 
cold,  and  on  her  arrival  was  attacked  with  severe  strangury ; 
the  urine  diminishing  to  2  pints,  sp.  gr.  1015.  She  remained 
in  bed,  applied  hot  fomentations,  and  finding  no  relief  from 
Ac<m.  or  Canih,,  she  took  Dig.  Ix  ;  soon  after  commen- 
cing this  the  urine  rapidly  increased,  amounting  to  8  pints  in 
twenty-four  hours,  and  with  relief  to  the  general  oppres- 
sion. During  November  she  took  Ign.  alternately  with 
Dig,* 

*  The  foUowing  table  gives  the  medidnes  and  state  of  urine  during 

Norember: 

Medidne.  Date.  -  Sp.gr.  Qaantit|r. 

Nov.  Pints. 

2>^.l'gtt.  iv    ...  4  ,..  22  ...  li 

ff  fp        ...  o  •••  ^A  •  •  Ay 

No  medione  ......  6  ...  25  ...  li 

Ignaiial    8  ...  18  ...  li 

„            9  ...  16  ...  2 

No  medicine  ......  10  ...  18  ...  2;^ 

JDig.l^   11  ...  18  ...  2i 

12  ...  18  ...  2i 


52  Notes  an  Diabetes, 

This  lady  returned  in  June  to  England,  having  passed  the 
winter  and  spring  with  great  comfort  at  Mentone ;  the  urine 
during  that  time  keeping  normal  in  quantity,  sp.  gr.  averaging 
1020.  She  began  to  enjoy  life,  regained  mental  vigour,  and 
was  able  to  ride  for  hours  on  a  donkey  without  fatigue.  She 
was  able  to  do  without  stimulants  and  followed  little  or  no 
restriction  on  her  diet.  Rarely  taking  any  medicine,  an 
occasional  dose  of  Ign.  when  depressed,  or  of  Dig,  whea 
liver  was  inactive,  and  motions  clay-coloured. 

She  had  not  been  in  England  five  weeks  (though  this 
was  in  July)  before  the  thirst  returned,  the  bowels  became 
costive,  the  depressed  mental  powers  and  muscular  weak- 
ness returned,  the  amount  of  urine  increased  to  between  6 
and  7  pints,  the  sp.  gr.  rose  from  1020  to  1084.  This  re- 
lapse was  attributable  partly  to  mental  causes,  but  especially 
to  wet  weather.  No  remedies  seemed  to  have  any  effect ; 
in  September  the  sp.  gr.  had  risen  to  1040,  with  great  con- 
stitutional disturbance,  and  the  formation  of  an  abscess  in 
the  vulva.  Then  for  a  fortnight  Hep.  s.  3x  was  given,  and 
as  soon  as  the  patient  could  travel,  I  advised  Vichy,  and 
the  winter  and  spring  at  Mentone.  This  was  followed  by 
results  not  so  good  as  in  the  previous  year.  This  patient 
is  so  sensitive  to  damp  and  absence  of  sunshine  that  she 
has  wisely  determined  for  the  present  not  to  return  to  Eng- 
land ;  but  even  in  the  more  favoured  climate  of  Italy,  the 
influence  of  a  damp  atmosphere  combined  with  absence  of 
sunshine  speedily  tells  on  her.  She  is  able  to  follow  nearly 
ordinary  diet,  and  finds  doing  so  have  now  no  influence  on 
the  urine.  The  condition  which  is  now  most  troublesome 
is  occasional  attacks  of  burning  and  itching  of  urethra  and 
surrounding   parts,  sometimes  violent  prurigo  confined  to 


No  medicine  18  ...  16  ...  2i 

Jjfnaiial    14  ...  16  ...  U 

16  ...  18  ...  2 

No  medicine  16  ...  16  ...  H 

JHg.l^   17  ...  22  ...  li 

18  ...  15  ...  2i 

No  medicine  19  ...  16  ...  2 

M         20  ...  16  ...  2i 


by  Dr.  Francis  Black.  58 

the  intenml  surface  of  thigh.  Warm  hip  baths  of  bran  tea 
give  relief^  yaried  occasionally  by  glycerin  with  almond 
emnlsions.     Rhus,  Dvic,^  Ars.  give  little  relief. 

Remarks, — ^The  disease  in  this  case  may  be  said  to  be 
at  a  standstill^  even  considerably  diminished^  the  danger  for 
the  future  being  not  in  errors  of  diet^  but  the  malign  influ- 
ence of  emotion^  mental  strain^  and  cold  or  damp  weather^ 
especially  the  last.  Her  age  is  much  in  her  favour,  for  after 
fifty  the  disease  runs  generally  a  much  milder  course^  andte 
subject  is  better  able  to  bear  the  disturbances  of  nutrition 
due  to  the  presence  of  sugar  in  the  blood. 

This  patient^  who  is  very  intelligent,  attributes  her  im- 
proTement  firsts  and  principally,  to  a  change  in  England 
from  a  moist  to  a  comparatively  dry  atmosphere,  to  ad- 
herence to  the  strict  injunction  to  avoid  rigorously  all 
mental  and  emotional  exercise,  to  live,  in  fact,  like  a  mere 
vegetable ;  secondly,  to  the  waters  of  Vichy  and  the  climatic 
influence  of  Italy ;  then,  in  last  order,  come  the  drugs,  of 
these  she  gives  first  rank  to  Ign,  and  Dig, ;  Aconite  she  found 
often  relieye  the  thirst,  and  sometimes  the  bladder  sym- 
ptoms. The  diet  was  at  first  a  factor  in  the  amelioration, 
but  latterly  a  freer  use  of  amylaceous  substances  was  in- 
dulged in.  In  this  case  Dig.  is  well  indicated  by  the  pale 
motions,  the  feeble  pulse,  the  palpitation  of  heart,  and 
general  weakncfss.  If  the  present  views  of  diabetes  are 
correct,  the  liver  may  fairly  be  considered  an  organ  whose 
condition  will  be  often  expressed  by  symptoms,  though 
many  of  its  post-mortem  appearances  may  be  put  down  as 
retults  rather  than  as  causes  of  the  disease.  For  practical 
uses  the  condition  of  the  liver  may  be  considered  as  one  of 
excess  of  action,  shown  in  increased  biliary  secretion. 
Medicines  found  useful— £ep/.,  lod.  m.,  China;  and  a 
diminished  action  shown  in  pale  stools— Di^.,  Kah  bich., 
and  Hep,  s.  Friction  over  the  liver  and  wet  compress 
seemed  useful  in  both  conditions.  Nitric  acid,  a  very  valu- 
able remedy,  was  not  required  in  these  cases. 

The  sinking  at  the  epigastrium,  and  the  general  emo- 
tional susceptibility  were  good  indications  for  Ignatia, 
strengthened   by    the   circumstance  that   preparations    of 


54  Note9  on  Diabetes, 

Strychnine  have  produced  glycosuria  (?).  The  Phos.  ac, 
though  at  first  useful  in  a  measure,  latterly  lost  all  beneficial 
action. 

The  patient;  until  decided  improvement  had  been  esta- 
blished, felt  it  absolutely  necessary  to  take  a  small  amount 
of  stimulant,  and  after  various  trials  she  found  good  porter, 
a  pint  a  day,  suit  her.  I  tried  an  experiment  with  clnret, 
but  it  failed.  In  France  some  practitioners  have  great  faith 
in  good  Bordeaux  wine,  given  freely,  even  to  the  exclusion 
of  any  other  liquid.  Bordeaux  wiue  thus  taken,  combined 
with  exercise,  carried  to  slight  fatigue,  is  reported  as  being 
sufficient  to  bring  about  amelioration  without  any  medicine. 
In  this  case  exercise  was  proposed,  but  the  muscular  weak- 
ness so  comtDon  with  diabetes  prevented  a  proper  use  of 
this  means ;  but  when  a  certain  improvement  allowed  of 
donkey  rides  the  benefit  was  manifest.  Bouchardat  was  the 
first  to  advocate  exercise,  and  his  experiments  show  that 
sugar  in  the  urine  decreases,  and  even  wholly  disappears^ 
under  the  influence  of  muscular  movements. 

The  use  of  stimulants  is  a  disputed  point;  my  decided 
inclination  is  to  do  without  them ;  but  cases  will  occur^ 
such  as  this  one.  when  in  small  quantities  they  are  benefi- 
cial. Dr.  Prout,  a  good  authority  on  such  a  point,  writes, 
"  I  have  seen  more  relief  from  thirst,  and  more  support 
given  by  porter  in  diabetic  cases,  than  by  any  other  similar 
means  *'  (loc.  cit.,  p.  41). 

The  malt  used  in  making  porter  is  heated  almost  to 
charring,  which  modifies  the  saccharine  principle,  and  gives 
the  dark  colour.  It  is  owing  probably  to  this  that  many 
diabetic  individuals  can  assimilate  porter  with  whom  ales 
disagree. 

Of  all  the  remedies  recommended  in  diabetes  there  seems 
to  be  a  great  consensus  of  opinion  in  favour  of  certain  alka- 
line mineral  waters,  e.  g,  Carlsbad  and  Vichy.  Their  utility 
as  baths  and  taken  internally  is  confirmed  by  general  expe- 
rience. The  presence  of  gout  or  much  liver  derangement 
is  a  further  indication,  especially  for  Carlsbad. 

In  Case  3  the  friends  of  the  patient  were  desirous  to  try 
Vichy  \  but  the  feverish  condition  and  weakness  of  patient^ 


by  Dr.  Francis  Black.  56 

with  snspieioii  of  grave  nervous  disorder  as  exciting  canse, 
led  me  to  forbid  its  ase.  No  satisfactory  reason  has  been 
given  for  the  efficacy  of  these  waters.  If  they  often  fail  to 
care^  they  at  least  very  often  retard  the  disease. 

Case  3. — A  delicate-looking  lad^  set.  15,  one  of  a  highly 
nerroos  family^  had^  when  he  consulted  me^  been  suffering 
from  diabetes  for  six  months ;  the  disease  had  been  recog- 
nised for  the  last  seven  weeks^  when  the  patient  was  placed 
an  a  strict  diabetic  diet.  This  and  such  remedies  as  Sulph,, 
Ver,,  Calc,  have  produced  no  effects  on  the  urine,  the  average 
quantity  of  which  is  about  seven  pints ;  sp.  gr.  1045,  giving 
a  very  dark  stain  with  Liq.  pot. ;  for  the  last  ten  days  the 
sp.  gr.  has  varied  from  1040  to  1042,  and  one  day  fell  to 
1038;  no  albumen  to  be  detected.  He  has  greatly  lost 
muscular  power;  after  slight  exercise  the  eyes  become 
bloodshot.  He  flushes  readily,  the  cheeks  almost  purple, 
the  nose  pale ;  easily  fatigued  mentally ;  the  sleep  is  fair, 
and  he  rarely  requires  to  pass  urine  during  the  night ;  great 
thirst ;  tongue  generally  pale  with  red  tip,  sometimes  a  dirty 
Air;  bowels  costive,  occasionally  clay-coloured  motions, 
sometimes  relaxed ;  the  skin  dry,  the  palms  of  the  hands 
hot;  the  pulse  100,  weak;  temp.  99'4°.  The  physical 
signs,  as  regards  lungs,  heart  and  liver  are  normal. 

I  recommended  immediate  change  to  a  warmer  climate^ 
and  advised  great  caution  as  to  fatigue  in  travelling.  The 
steady  use  of  Phos,  ac,  Ix  was  prescribed,  and  if  that  in 
three  weeks  failed  to  try  Uran.  nit.  8x. 

He  was  furnished  with  the  following  directions  : — Phos. 
ac.  Ix,  to  be  taken,  with  more  or  less  intervals,  for  three 
weeks.  If  by  that  time  no  change,  then  Uran.  nit.  3x  to  be 
tried.  Geh.  to  be  taken  at  night  when  there  was  feverish- 
ness.  Big.  Ix  when  liver  became  in  active  and  when  chest 
is  iuTolved,  to  take  Kal.  bich.  3x.  The  diet  to  be  the 
ordinary  one  of  diabetics,  but  milk,  which  had  formerly  been 
forbidden,  to  be  taken.  Tepid  baths  occasionally  and  spinal 
washing.  This  patient  tried  various  places  in  the  Riviera, 
the  journey  to  which  proved  most  fatiguing,  and  at  last  he 
fixed  on  Mentone. 

In  two  months  the  result  of  several  reports  was^  no  im- 


56  Notes  on  Diabetes^ 

proTement.  The  urine  while  taking  Phos.  ac.  varied  from 
three  to  five  pints^  the  sp.  gr.  from  1039  to  1045;  some 
days  the  quantity  was  even  less  than  in  health,  but  with  no 
diminution  of  thirst  and  exhaustion.  Under  the  use  of 
Uranium  the  average  quantity  was  about  four  pints,  sp.  gr. 
ranging  from  1042  to  1046 ;  the  quantity  of  sugar  being 
then  from  6  to  8  gr.  to  the  ounce  of  urine,  which  was  about 
the  amount  when  he  left  England. 

There  being  no  improvement  in  the  general  symptoms, 
and  such  a  condition  of  the  urine^  I  advised  the  patient  to 
place  himself  under  direct  medical  care.  A  year  has  elapsed 
since  then.  He  has  consulted  various  medical  men  practising 
homoBopathically,  and  has  tried  various  climates,  but  the 
result  has  unfortunately  been  a  slow  but  steady  increase  of 
disease. 

Remarks, — Diet,  favourable  climate,  and  various  remedies 
have  had  no  effect  in  checking  the  disease.  These  circum- 
stances, combined  with  the  age  of  the  patient,  point  to  a  very 
unfavourable  prognosis ;  this  is  rendered  still  graver  when  the 
probability  is  that  a  profound  change  in  his  nervous  system  is 
the  source  of  the  diabetes.  The  quick  pulse  (100)  and  high 
temperature  99*4^  are  not  common  in  diabetes,  its  charac- 
teristics being  rather  absence  of  fever,  and  generally  a  low 
temperature  95*9^  to  977°  being  met  with,  and  it  has  fallen 
as  low  as  93*2°  in  axilla  in  advanced  cases.  This  case  pre- 
sented in  a  marked  degree  the  inability  to  stand  the  fatigue  of 
travelling,  a  condition  very  common  in  diabetes,  and  to  be 
carefully  remembered ;  the  need  of  this  precaution  was 
impressed  on  me  by  the  experience  of  case  2.* 

In  this  case  and  in  the  others  the  question  needed  to  be 
answered,  how  much  water  or  other  liquid  may  be  safely 
taken.  The  answer  was  as  much  as  the  thirst  actually  de- 
mands, provided  it  is  not  taken  in  large  quantites  at  a  time, 

*  "  As  illnstautions  of  the  frail  tenure  of  life,  and  fatal  results  from  slig^ht 
causes  in  diabetes,  I  may  mention  that  within  the  last  few  years  no  less  than 
four  individuals  have  died  from  the  fatigue  and  excitement  incidental  to  a 
journey  from  the  country  to  consult  me.  In  all  these  different  cases  it  may  be 
observed  that  the  individuals  were  in  their  ordinary  state  of  health  when  they 
left  home,  and  their  deaths  could  only  be  ascribed  to  the  fatigue  incidental  to 
travelling." — Prout,  loc,  cit.,  p,  32. 


by  Dr.  Francis  Black.  67 

uid  bardly  any  daring  meals  or  for  an  hour  after^  and  with 
the  caution  to  the  patient  that  thirst  increases  in  proportion 
to  the  immoderate  indulgence  in  the  use  of  water.  Water 
IB  an  absolute  necessity  in  order  to  aid  in  carrying  the  sugar 
through  the  blood  to  be  eliminated  by  the  kidneys ;  if  the 
direction  be  gi^en  to  sip  it  in  small  quantities  at  all  times^ 
especially  during  dinner^  the  digestive  powers  are  not  injured^ 
a  point  of  consequence,  as  the  use  of  green  vegetables  is 
useful  to  diabetics,  and  their  digestion  is  generally  easy, 
provided  the  patient  abstains  from  drinking  while  taking 
them.  Drinks  acidulated  with  lemon  juice  or  currant  juice, 
and  water  charged  with  carbonic  acid,  are  grateful  and  relieve 
thirst.  As  a  simple  diluent,  Prout  thinks  highly  of  distilled 
water.  Milk,  whey,  buttermilk,  and  cold  beef  tea  are  sub- 
stitutes for  water,  they  diminish  thirst  and  at  the  same  time 
afford  nourishment.  The  use  of  tea  and  coffee  must  de- 
pend on  each  individual  case;  the  prepared  cocoas  and  cho- 
colate are  to  be  avoided. 

There  is  a  circumstance  forgotten  in  the  history  of  this 
ease, — as  a  child  he  was  subject  to  eczema,  and  for  about 
a  month  (the  first  he  spent  at  Mentone)  a  papular  and  itchy 
eruption  appeared  on  the  back  and  various  parts  of  the  body, 
but  without  any  relief  to  the  diabetes.  I  mention  this  as  some 
of  his  medical  attendants  held  strongly  with  Hahnemann's 
psora  theory. 

Dr.  Prout  says,  "  Were  I  permitted  to  draw  a  general  in- 
ference from  my  experience,  I  should  say,  that  diabetes 
nsually  follows  cutaneous  affections,  and  accompanies  (per- 
haps precedes)  the  affections  of  the  cellular  tissue.  Thus, 
I  have  several  times  heard  patients  observe,  that  they  were 
formerly  subject  to  eruptions  in  various  parts  of  the  body, 
but  that  such  eruptions  disappeared  after  the  diabetic  com- 
plaint became  established.  Nor  do  I  remember  more  than 
three  or  four  instances  in  which  diabetes  actually  accom- 
panied a  severe  cutaneous  affection.^'     (Loc.  dt.,  p.  34.) 

Case  4.— A  young  gentleman,  aet.  14,  small  but  well  and 
strongly  made,  and  of  a  healthy  family,  began  to  complain 
in  the  early  summer  months  of  a  sense  of  dulness  and 
weariness,  and  with  the  increasing  weakness,  he  experienced 


58  Notes  on  Diabetei. 

diminished  Tision.  These  symptoms  existed  for  about  six 
weeks  before  medical  advice  was  sought  in  August.  The 
medical  attendant  pronounced  the  case  to  be  one  of  dia- 
betes  ;  he  ordered  no  medicine^  but  a  strict  diet^  consisting 
in  the  exclusion  of  saccharine  and  amylaceous  substances. 
The  result  was  soon  very  marked,  the  patient  began  to  feel 
lighter^  the  sight  improved,  the  urine  diminished  from  9^ 
pints  to  5^,  and  the  thirst  abated.  He  came  under  my 
care  in  September,  when  the  urine  averaged  about  6  pints, 
pale  and  flocculent  looking,  owing  to  the  presence  in  large 
quantities  of  earthy  phosphates,  giving  a  deep  stain  when 
boiled  with  lAq.  potassa,  sp.  gr.  1035.  The  skin  very  dry, 
general  weakness,  and  a  dull  heavy  look.  Phos.  ac,  Ix 
gtt.  V,  morning  and  evening  for  four  days,  two  days'  rest, 
and  so  continued  for  three  weeks. 

October  19th. — The  average  sp.  gr.  and  quantity  of  urine 
remains  unchanged,  giving  a  deep  stain  when  boiled  with 
lAq.  pot.  No  diminution  of  phosphates.  The  general 
strength  and  appearance  have  improved ;  less  thirst ;  bowels 
regular.  He  has  gained  since  September  11th,  6^  lbs.  in 
weight.  Repeat,  Phos,  ac,  Ix,  increasing  after  ten  days  the 
dose  to  gtt.  viii.  Ordered  flannel  clothing  and  a  hot  air 
bath  twice  a  week. 

November  8th. — The  skin  is  much  moister,  thirst  varies, 
but  the  appetite  is  not  voracious  as  formerly.  Pulse  108. 
The  urine  as  before,  giving  by  the  fermentation  test  12  gr. 
of  sugar  to  the  ounce.  Uran,  nit,  3x,  gr.  i,  night  and 
morning;  continue  hot  air  baths  three  times  a  week. 

26th. — Sleeps  better,  general  appearances  improved,  skin 
moister,  perspires  much  more  freely  in  baths  than  he  at  first 
did ;  feels  better  after  the  bath.  Pulse  106.  The  urine 
one  day  fell  to  4^  pints,  the  average  is  5  pints,  sp.  gr.  1032, 
giving  by  fermentation  test  15  grains  of  sugar  to  the  ounce. 
Phosphates  diminished. 

The  patient  is  getting  tired  of  gluten  bread,  to  be  allowed 
Prout^s  bran  and  egg  cakes,  almond  biscuits,  more  milk, 
grapes  and  oranges.  Repeat  Uran,  3x,  and  then  1.  Hot 
air  baths. 

PeCember    11th. — Appearance    slightly  improved^    skin 


by  Dr.  Francis  Black.  69 

moist;  still  tbirst;  pnlse  96^  weight  71^  lbs.  Urine  averages 
4^  pintS;  sp.  gr.  1029^  giving  a  deep  stain  with  Liq.  pot. 
Less  phosphates.     Repeat  Uran,    1  every  second  day. 

Jannary  7th.— He  continued  in  his  usual  state^  when  I 
heard  from  his  father  that  his  son  towards  the  middle  of 
December  lost  his  appetite  and  complained  of  nausea  and  vo- 
miting. No  assignable  cause.  On  the  21st  he  had  epistaxis ; 
on  the  22nd  and  23rd  great  exhaustion  and  rapid  pulse ; 
on  the  24th  '^  difficulty  of  breathing,  but  no  pain^  and  on 
Christmas  morning  he  passed  gently  away  as  if  he  were 
asleep/'  The  fatal  event  occurred  at  a  distance,  so  I  was 
unable  to  have  an  examination  of  the  urine,  which  in  quantity 
contiDned  the  same.  No  post-mortem  examination  was 
made. 

Remarks. — ^Yielding  readily  to  diet  is  considered  a  very 
favoarable  sign ;  but  it  cannot  always  be  depended  on,  as 
these  mild  cases  not  unfrequently  cease  to  present  this  cha- 
racter, and  run  slowly  or  rapidly  into  the  graver  forms  where 
diet  has  no  influence.  But  in  this  case  the  value  of  this 
&7orable  sign  was  considerably  diminished  by  the  age  of 
the  patient  and  the  condition  of  the  pulse ;  the  presence, 
also,  of  so  much  phosphates  in  the  urine  tended  to  render 
the  prognosis  a  serious  one.  Age  is  all  important  in 
the  prognosis,  for  a  confirmed  case  under  20  rarely  if  ever 
recovers.  The  lives  of  all  diabetics  are  very  uncertain,  and 
in  this  instance,  even  with  a  certain  amount  of  improvement, 
and  the  fair  promise  of  more,  a  sudden  and  unexpected 
death  took  place.  Death  was  due  to  diabetic  coma,  a  com- 
bination of  nervous  disorders,  to  which  Front  attributed  the 
deaths  of  those  cases  already  alluded  to  (p.  56)  as  arising 
from  fatigue.  The  sudden  accession  of  such  deadly  sym- 
ptoms has  as  yet  met  with  no  satisfactory  explanation. 
Agitation,  over  exertion  and  fatigue,  are  the  usual  causes  of 
SQch  a  seizure,  but  in  this  instance  no  assignable  cause  can 
be  given. 

Case  5. — ^A  well-grown  boy,  set.  14,  whose  mother  is 
healthy,  but  whose  father  died  of  phthisis,  has  for  at  least 
a  year  suffered  from  confirmed  diabetes.  He  has  been 
subjected  to  a  restricted  diet,  and  he  has  taken  a  variety  of 


60  Notes  on  Diabetes. 

Bedatives  and  tonics,  bnt  withont  any  amelioration  of  his 
symptoms. 

When  he  came  nnder  my  care  there  were  no  anhjective 
symptoms  of  stomach  derangement.  The  tongne  is  swollen, 
fissnredy  and  red  at  tip ;  the  bowels  are  costive.  He  com- 
plains of  great  thirst  and  feebleness ;  the  appetite  is  almost 
▼oraeioas.  The  nrine  varies  from  6  to  8  pints,  with  a  sp. 
gr.  ranging  from  1030  to  1040,  and  giving  a  stain  deep  as 
treacle  when  boiled  with  Liq.pot.  This  patient  was  under  my 
caresix  months,during  which  time  he  took^r^.,  Cupr.,  Plumb., 
Phos.  ac.f  and  Nux  votn.  in  various  doses  and  dilutions. 
I  varied  the  restricted  diet,  I  tried  milk,  cod  liver  oil,  glycerin, 
&c.  I  used  various  hydropathic  appliances  but  all  in  vain. 
At  the  end  of  the  six  months  he  was,  with  the  exception  of 
a  slight  gain  in  strength,  in  the  same  condition  as  when  I 
first  saw  him. 

He  was  induced,  while  using  my  last  prescription,  by  a 
follower  of  Dr.  Coffin^s,  to  take  Lobelia  in  emetic  doses;  this 
was  continued  for  a  week,  then  violent  diarrhoea  with  pros- 
tration set  in  and  he  sank  in  a  few  days. 

Remarks, — ^No  cause  could  be  assigned  for  the  diabetes, 
there  was  no  hereditary  predisposition,  and  the  patient  had 
all  the  advantages  which  affluence  can  procure.  I  did  not 
give  Uranium  because  at  that  time  this  remedy  was  unknown. 
I  could  add  a  few  more  cases,  but  I  attach  no  importance 
to  them  as  affording  therapeutical  data,  for  either  they  were 
cases  in  the  last  stage,  or  only  a  few  weeks  under  my 
care. 

{To  he  eonHnmed,) 


61 


NOTES  ON  THE   MORE  RECENT   CHAPTERS  OF 
THE  CYPHER  REPERTORY. 

By  Dr.  Datsdale. 

The  welcome  addition  just  made  by  Dr.  Dudgeon  to  the 
Cypher  Repertory  calls  for  our  hearty  acknowledgments  of 
its  immense  comprehensiveness  and  minute  bee-like  accu- 
racy of  details.  These  are  not  to  be  appreciated  at  their 
just  value  by  merely  looking  at  the  book ;  but^  to  be  fully 
understood^  and  to  feel  full  gratitude  to  the  author  for  his 
enormous  labour^  we  must  use  it  daily  in  practice  with  the 
earnest  desire  to  cover  accurately  the  symptoms  in  actual 
cases.  No  one  who  does  so  will^  I  am  sure,  be  disappointed. 
When^  therefore^  I  proceed  to  make  a  few  criticisms  it  must 
be  understood  they  apply^  not  to  the  correctness  of  the 
work^  but  to  certain  deviations  from  the  original  plan^ 
which  I  think  can  be  shown,  instead  of  being  a  help,  as  the 
author  intended,  throw>  in  reality,  difficulties  in  our  way,  not 
only  in  using  this  new  part,  but  in  the  use  of  those  parts 
already  in  our  hands. 

In  the  first  place  I  regret  to  find  that  the  order  and  con- 
tents of  the  sections  are  altered.  Section  II  is  given  to 
concomitants,  and  Section  III  to  conditions,  instead  of  vice 
vend,  as  in  the  rest  of  the  Cypher  Repertory.  Again,  the 
general  order  of  pains  is  put  into  Section  IV  instead  of 
preceding  the  classes  of  pain  in  Section  I ;  and  Section  V, 
instead  of  containing  peculiar  symptoms  not  susceptible  of 
arrangement  elsewhere,  is  occupied  by  the  complete  sym- 
ptoms of  scalp,  which  properly  might  have  gone  into 
Section  VI,  or  into  a  new  chapter.  The  reason  given  for 
these  changes  is  that  Dr.  Dudgeon  thinks  them  an  im- 
proved and  a  more  natural  arrangement.  It  is  not  necessary 
to  dispute  this  position  in  order  to  condemn  it.  If  it  were 
a  thousand  times  a  better  plan  that  would  be  no  justifica- 
tion for  changing  one  that  we  were  accustomed  to,  and 
it  each  person  adopts  a  new  plan  with  each  new  chapter  of 


62  Notes  on  the  more  Recent 

the  work  it  will  simply  become  useless^  for  it  is  impossible 
to  work  with  arbitrary  symbols  if  they  are  capriciously 
changed  in  each  chapter.  When  the  whole  is  finished  and 
a  new  edition  is  called  for  it  may  be  desirable  for  the  then 
managing  committee  to  change  many  things^  and  settle 
what  is  to  be  the  uniform  plan  for  the  next  edition^  but  till 
then  no  change  ought  to  be  made^  and  I  trust  that  the 
Repertory  and  the  publishing  committees  will  make  it  im- 
perative that  the  plan  should  be  uniform  with  the  original 
one  before  any  future  part  is  accepted  for  printing.  As 
each  part  requires  a  certain  discretion  in  the  plan  within  the 
fundamental  limits^  it  would  be  well  that  workers  should 
send  in  their  plan  before  the  execution  of  it  proceeds  farther 
than  enough  to  make  the  plan  obvious.  Otherwise  much 
labour  may  be  wasted  if  the  plan  be  found  out  too  late  to 
have  transgressed  the  limits  of  the  system^  and  to  bCj  there- 
fore, inadmissible.  In  respect  to  the  particular  alterations 
of  the  sections,  although  it  is  not  necessary  to  discuss  them, 
I  may  say  that,  for  my  part,  I  see  no  advantage  in  them, 
and  in  case  of  a  new  edition  would  vote  for  the  old  mode. 
In  the  next  place  Dr.  Dudgeon  has  not  only  made  new 
abbreviations  for  the  new  medicines^  but  has  altered  some 
of  the  old  ones.  This  surely  must  be  from  mere  inadvert- 
ence ;  but  to  prevent  such  in  future  the  Repertory  committee 
should  make,  or  superintend  the  making,  of  all  new  abbre- 
viations, and  let  no  worker  use  any  new  abbreviations  until 
it  has  been  submitted  to  and  approved  of  by  the  commit- 
tee. While  on  this  subject  I  may  say  that  Dr.  Hay  ward. 
Dr.  Clifton,  and  I  have  gone  over  the  various  lists  of  abbre- 
viatioDs  and  made  them  uniform,  and  we  recommend  that, 
on  the  printing  of  the  next  list^  the  medicines  should  be  ar- 
ranged in  the  alphabetical  order  of  the  abbreviations  instead 
of  that  of  the  medicines,  in  order  to  facilitate  the  finding  of 
the  meaning  of  the  less  familiar  abbreviations. 

To  come  to  matters  of  detail,  I  regret  that  Dr.  Dudgeon 
has  deviated  from  the  rule  that  each  special  character  symbol 
of  the  chapter  should  be  indicated  by  its  own  Old  English 
letter.  For  in  Part  I  of  Chap.  I A  stands  for  '^apathy,  indiffer- 
ence/' &C.J  while  in  Fart  II  A  stands  for  ''increased  intel- 


Chapters  qf  the  Cypher  Repertory.  68 

lectaal  powers/'  It  may  be  said  these  form  in  reality  two 
different  chapters,  and  thus  the  similarity  of  symbols  does 
not  matter.  Bat  it  does  matter  very  much,  for  the  boundary 
between  mental  and  moral  symptoms  is  not  at  all  clearly 
defined  to  the  average  medical  or  patient  mind,  and  we  may 
not  know  to  which  part  the  symptom  belongs ;  hence  the 
symbols  should  have  been  different.  For  example,  we  find 
at  p.  41.  Part  I,  U^  has  a  list  of  medicines  which  dispose  the 
patient  "  to  kill  some  one,^^  which  does  not  contain  can.*— 
sec. — str.y  while  these  medicines  occur  in  Part  II :  f  contains 
them  under  the  heading  "  desire  to  kill.'' 

To  a  certain  extent  it  may  be  truly  said  that  this  is 
unaToidable,  as  Part  I  contains  more  headings  than  there 
are  letters  in  the  alphabet;  but  supplemental  letters  are 
added  in  Part  I,  and  it  perhaps  would  have  been  better  to 
make  all  the  few  headings  of  Part  II  of  supplemental  letters. 

The  paragraph  in  the  preface  (p.  ii)  explaining  the 
meaning  of  the  small  letter  in  the  character  symbol  is 
nothing  new,  as  that  is  the  plan  of  the  rest  of  the 
Repertory. 

At  p.  iii  of  the  preface  is  indicated  an  addition  to  the 
old  repertorial  plan,  which,  as  it  does  not  conflict  with  it,  is 
admissible,  viz.  the  small  letter  above  the  line  under  the  list 
of  pains  in  regions  indicating  the  particular  spot,  e.ff. 
^^men^,"  in  the  burning  pains  of  the  forehead,  means  that 
the  pain  is  seated  over  the  left  eye.  However,  it  adds  to 
the  confusion  introduced  in  the  next  paragraph,  for  here 
there  is  an  alteration  against  which  we  must  protest,  viz. 
when  he  uses  the  small  letter  previously  employed  for  varie- 
ties of  character  for  symbols  for  locality — e.  g.  at  p.  269, 
mider  "*  k*.  Boils,"  we  find  '^led^  k^,"  which  means  that  the 
seat  of  the  symptoms  is  ^'  f,''  i.  e.  the  forehead,  and  that, 
besides  boils,  there  are  pimples,  which  precisely  reproduces 
the  symptom  of  the  proving,  ^'Pimples  and  boils  on  the 
forehead." 

Now,  at  Chapter  VII — Pace- — the  method  of  indicating 
such  a  symptom  is  already  given,  e.g.  "F.  sul**^,"  which 
means  ''  red  spots  and  elevations  on  the  forehead."  The 
alteration  in  the  new  chapter  is,  therefore,  superfluous^  and 


64  Notes  on  the  mare  Recent 

• 
can  only  cause  confusion  and  needless  trouble  to  one  using 
the  Repertory  as  a  whole. 

I  do  not  at  present  see  any  objection  to  indicating  the 
general  character  and  distribution  of  the  pains  by  the  letter 
added  to  the  pain  instead  of  to  a  separate  I  (the  symbol  of 
''pain'').  But^  as  above  said^  I  see  no  advantage  in  re- 
moving that  heading  to  Section  IV,  and  I  see  a  great 
defect  in  making  the  lists  incomplete.  At  Section  lY^ 
p.  264  ei  seq.y  there  is  a  symbol  which  is  not  explained^ 
and  which  I  failed  to  discover  the  meaping  of,  viz.  two 
strokes  between  different  cyphers^  thus :  ''  trn.  p.  :=:  V^ 
ign**".  =  y V  kc.  &c.  On  asking  the  meaning  from  Dr. 
DudgeoD^  he  explained  that  it  was  merely  used  to  separate 
the  different  kinds  of  pain  from  one  another.  If  this  means 
that  the  different  kinds  are  separate  symptoms  I  do  not 
know  why  the  semicolon  used  throughout  the  Repertory  is 
superseded  by  a  new  and  unexplained  symbol. 

But  the  greatest  defect  of  all,  and  one  which  is  shared 
in  by  Dr.  Nankivell's  chapter,  i.  e,  "  Stools,^'  is  the  want  of 
the  proper  ''  collective^'  headings^  as  they  are  directed  to  be 
made  in  the  original  introduction.  For  example,  we  find 
a  heading  pain  "  undefined/'  or  "  so  stated"  or  "  generally/' 
which^  instead  of  being  a  collective  in  the  proper  sense^  is 
merely  an  arbitrary  list  of  some  ill-observed  symptoms. 
Thus^  at  p.  153^  under  "  Pain  undefined,"  there  follows  a 
list  of  eighty-nine  medicines  ending  with  "  &c."  Among 
these  eleven  have  an  adjunct  of  one  character  symbol. 
According  to  the  principle  of  the  collectives  and  selects^  this 
should  mean  that  these  are  all  the  pains  in  the  head^  in- 
cluding all  its  subordinate  parts,  which  have  any  character 
symbol  in  addition  to  pain.  If  it  does  not  mean  this  the 
list  is  perfectly  useless.  But  surely  this  cannot  be  correct. 
Accordingly  I  find,  in  looking  through  the  same  page  only, 
in  subordinate  headings,  the  following  medicines  omitted  in 
above  list,  or  standing  without  adjunct,  lye.  p. —  ph-x.  q  — 
sil.  i' —  mr-s.  q ;  and  on  subsequent  pages  quantities  of  simi- 
lar instances.  Hence,  just  as  in  Nankivell's  chapter,  we 
have  a  number  of  perfectly  useless  lists  instead  of  the  most 
valuable  true  collective  lists,  which  are  the  only  modes  of 


Chapters  of  the  Cypher  Bepei'tory.  65 

finding  the  concomitant  symptoms  within  the  chapter.  The 
concomitants  in  their  proper  section  belong  exclusively  to 
symptoms  in  other  regions.  There  should,  of  coursCj  be  no 
SQch  worthless  headings  as  "  pain'^  or  '^  coldness^'  or  ''  con- 
gestion/' fcc.,  so  stated^  or  "undefined^'  or  ''generally/' 
bat  in  every  instance  a  true  collective^  into  which  all  the 
symptoms  are  sifted  with  the  character-adjuncts  alone,  and 
acne  of  the  subordinate  varieties^  conditions,  or  concomitants. 

I  have  gone  over  the  headings  "  colduess^^'  "  congestion/' 
&c.^  and  find  the  same  defects.  I  cannot  but  object  to  the 
heading  "  general ''  pain  in  the  head,  which  occurs  so  often. 
Iq  nine  cases  out  of  ten  in  the  Materia  Medica  this  merely 
expresses  the  same  as  **  undefined/'  and  shares  in  the  errors 
of  that  word.  In  the  tenth  case  it  really  means  pain  all 
o?er  or  through  the  head,  and  in  that  case  it  should 
oome  xmder  I'  of  the  general  character  and  distribution 
of  pains,  which  is  here  erroneously  relegated  to  Section  lY^, 
and  there  the  variety  I'  is  omitted^  so  that  we  cannot  ascer- 
tain the  medicines  which  really  produce  the  pain  all  over. 
They  are  swamped  in  the  flopd  of  "  general''  pains.  Not 
only  does  this  omission  of  true  collectives  impair  ex- 
tremely the  utility  of  the  whole  new  chapters,  but  it 
adds  enormously  to  the  coat  of  printing  details,  which 
are  not  only  of  no  use^  but  are  actual  incumbrances.  To 
show  this,  I  may  go  through  a  part  of  the  heading  p— 
"  Heat  of  the  head" — and  write  it  out  as  it  ought  to  be, 
according  to  the  original  plan,  which  is  followed  in  the 
Repertory  elsewhere. 

'^  Heat  of  head  "  written  as  directed  in  the  original  plan  : — 
abi. — ac-x.d^. — ^aco. ;  g*  ^  ['  ^°  ^"^7  ^^^  B-  ^  increased 
growth  of  hair,  but  aco.  is  not  there*]  sesc. — seth. — aga.hh. ; 
q. — alo.  ;  x. — alm.q. ;  w. — amb. — am-ma*. — aml.VIII*. — 
ang. — ^ant.Vl*. — ^ap-a. — ara. — ag-n. ;  i'.VlP. ;  i*.q. — ari. — 
am. — a8t.q.VlIl*.— au-n.q. — bap. — bad.d.I. — ba-c.g^'.Vl'. — 
bel. ;  aa.  [This  should  be  '^  redness  of  scalp/'  but  bel.  is  not 
found  there.t] — ber.;  hh. — bis. — ^bor. — bry. — ceu. — ca-c.d. ; 

*  [Mea  culpa  !  the  g  ought  to  be  preceded  by  "fi,**  denoting  ''Btnall  feeling 
of  head."— R.  E.  D.]. 
t  [The  symptom  of  the  original  proving,  "  Heat  and  redness  only  on  the 

VOL.  XXXVll^  NO.  CXIVII. JANUARY^  1879,  £ 


66  Notes  on  the  more  Recent 

q. — C-C8. — ^c-ph.T. — cln.I. — cam. ;    VI*. — cn-i.VI*. — can. 

VIII*.— cthl.— cb-a.— cb-v.I. ;      II\ — ca-x.III^— car. 

C8C. cau.  ;     VI*. ;      d. cep. — cr-b. chd.  ;     I.— chi.q. 

VIII*. — cn-8. — cmf.i*.VIII*.  &c.  In  this  way  we  may  go 
through  the  whole  list  of  two  columns,  eliminating  all 
adjuncts  except  character-symbols,  including  pain.  By  this 
means  we  shall  have  a  clear  list,  not  difficult  to  look  through, 
of  all  medicines  having  heat  combined  with  any  other 
character-symptoms  in  the  head,  but  without  the  minor 
varieties,  conditions,  and  concomitants,  all  of  these  being 
found  in  full  in  their  proper  places.  Besides  making  it 
more  easy  to  look  through,  this  plan  would  save  the  expense 
of  printing  597  letters  and  figures — many  being  Greek  and 
the  figures  double — in  this  short  space. 

Besides  the  above  list  of  adjuncts  being  superfluous,  it  is 
not  even  complete,  and  thus  it  does  not  give  a  complete 
reference  to  the  character  symptoms  of  its  own  chapter. 

Again,  in  Section  IV  the  '^  course  and  progress  of  sym- 
ptoms "  are  omitted  and  ouly  the  direction  of  pains  given. 
This  is  surely  a  great  mistake,  even  if  the  facts  are  given 
scattered  through  the  other  sections,  although  I  have  not 
found  them  yet.  It  is  most  convenient  to  find  all  narratives 
of  change  of  symptoms  collected  in  one  section. 

Section  IV  is  also  omitted  altogether  in  Chapter  II,  which 
is  a  great  loss.  Where  are  we  to  look  for  say  vertigo,  followed 
or  preceded  by  heada<ihe,  loss  of  sight,  nausea,  or  any  other 
symptom  ? 

I  cannot  but  conclude  with  an  expression  of  regret  that 
the  above  changes  of  plan  have  been  made,  for  even  if  they 
had  been  improvements  unquestionablyi  it  would  have  been 
wrong  to  have  made  any  change  which  impairs  the  facility 
of  working  the  plan  of  the  Cypher  Repertory  as  a  whole  till 
a  new  complete  edition  is  brought  out.  But  the  majority 
of  the  changes  are  not  improvements,  and  on  the  contrary 
impair  very  much  the  efficiency  of  the  present  part,  besides 
adding  enormously  to  the  cost  of  it  by  unnecessary  printing 
of  the  complete  adjuncts   in  the  imperfect  collective  tests. 

head  "  ( JB.  A.  M,  L.,  S.  184),  is  so  vague  that  I  did  not  feel  called  on  to  enter 
it  anywhere  except  here. — B.  £.  D.] 


Chapters  of  the  Cypher  Repertory »  67 

I  therefore  propose  that,  besides  the  tests  at  present  im- 
posed^ before  receiving  any  chapter  the  Repertory  Committee 
should  inspect  the  actual  plan  and  working  out  of  the  chap- 
ter, and  refuse  to  pass  any  fundamental  deviations  from  the 
original  plan.  And  to  avoid  the  hardship  of  the  rejection 
of  such  a  laborious  work  as  the  complete  chapter,  that  it 
should  be  a  rule  to  send  in  each  chapter  to  the  Committee 
as  soon  as  sufficient  is  done  to  show  the  nature  of  the 
plan  of  the  chapter. 


Remarks  by  Dr.  Dudgeon. 

I  can  have  no  objection  to  a  searching  criticism  of  my  work 
in  this  new  part  of  the  Repertory,  especially  by  Dr.  Drysdale, 
the  original  inventor  of  the  Cypher  Repertory,  and  I  think  I 
may  be  able  to  show  that  I  have  not  deviated  needlessly  or 
thoughtlessly  from  th^  plan  pursued  in  other  parts  of  this  work. 
That  I  have  not  done  so  in  ignorance  will  be  obvious  to 
SDy  one  who  considers  that  the  first  two  published  chapters  of 
the  Repertory,  those,  namely,  relating  to  the  eye  and  ear, 
were  my  work,  and  that  these  parts  were  executed  rigidly 
on  the  original  plan. 

But  I  found  in  working  at  the  head  that  I  could  not 
adhere  to  the  original  plan  without  great  difficulty  nor 
without  adding  greatly  to  the  labour  of  the  practitioner.  Mj 
sole  idea  has  been  to  render  the  search  for  symptoms  as  easy 
as  possible,  and  I  believe  no  one  who  uses  this  part  wilt 
find  any  difficulty  in  discovering  whatever  symptom  he  wants, 
prorided  it  be  among  the  pathogenesies  analysed  in  this  part. 

I  was  limited  to  three  chapters,  already  fixed  as  Disposi- 
tion and  Mind,  Sensorium,  and  Head,  because  the  next  part 
of  the  Repertory,  "Eyes,"  is  Chapter  IV.  Otherwise  I  could 
have  made  one  chapter  of  "  Disposition,"  and  another  chapter 
of  ''Mind.''  I  have  got  over  this  difficulty  by  dividing 
this  Chapter  into  two  Parts,  which  are  equivalent  to  two 
Chapters.  These  two  Parts  are  indicated  by  separate  signs, 
thus.  Part  I,  "Disposition  or  Moral  Symptoms,^'  has  for 
its  sign  the  Greek* "  a,"  whereas  Part  II,  "  Mind,  or  Men- 


68  Notes  on  the  more  Recent 

tal  Symptoms/^  has  for  its  sign  ^'a}."  Attention  to  this 
will  at  once  show  the  unteuableness  of  Dr.  Drysdale's 
criticism  about  the  special  character-syiuptom  being  indi- 
cated by  its  own  old  English  letter.  The  two  Parts 
must  be  considered  as  two  distinct  Chapters,  and  each  Part 
has  its  own  old  English  letters^  but  no  confusion  can 
result  from  this,  for  except  in  its  own  Part  each  old  Euglish 
letter  is  invariably  preceded  by  the  special  sign  of  that  part. 
Thns^  p.  23,  second  col.,  1.  8,  clo.  it.a^b^ ;  this  will  read  in 
full  '^  Chlorine,  Fear  of  losing  senses,  depression  of  spirits, 
loss  of  memory .''  In  this  case  the  "fl^'  not  being  pre- 
ceded by  a  sign  signifies  that  it  is  a  symptom  of  this  Part, 
but  the  *^  ftp "  being  preceded  by  the  sign  "  a} "  shows 
that  it  belongs  to  Part  II,  of  which  this  is  the  sign.  Take 
another  example  from  Part  II.  At  p.  55,  second  coL,  lines 
2,  3,  We  find  under  '^  V*  Inability  to  fix  thoughts,^'  '^  ang. 
a^.af^.,a^^4.  This  will  read  ''  angtutura,  inability  to  fix 
thoughts,  increased  inventive  faculty,  uneasiness,  pleasant 
anticipations,  in  the  afternoon.''  Here  it  is  obvious  tbat  the 
symbol  "  a**  '^  refers  to  this  Part,  whereas  the  symbols 
'*  f'*,a?^''  being  preceded  by  "  a,'*  refer  to  Part  I,  so  thht,  pace 
my  critic,  there  is  no  possibility  of  confounding  the 
symbols  of  the  one  part  with  those  of  the  other. 

Again,  the  ''  Violence  that  disposes  the  patient  to  thrash 
or  kill  some  one  "  in  Part  I  is  not  necessarily  a  symptom  of 
mental  derangement,  whereas  the  ''  Desire  to  kill "  in  Part 

II  is  a  maniacal  symptom,  and  consequently  is  properly 
placed  in  this  Part.  There  are  only  three  medicines  which 
have  the  murderous  propensity  in  Part  I,  viz.  chi.,  hep., 
and  hyo.  Of  these  the  last  only  might  perhaps  have  beeu 
included  in  Part  I. 

Objection  is  made  to  my  transposition  of  Sections  II  and 

III  of  Chapter  III,  and  of  course  generally  to  my  placing 
concomitants  first  and  conditions  last,  but  I  fail  to  see  how 
that  can  create  any  confusion,  as  the  concomitants  (so-called) 
are,  as  a  rule,  subject  to  the  same  conditions  as  the  main 
symptom,  and  as  the  signs  remain  the  same  as  in  other 
parts  of  the  work,  it  can  make  no  difference  to  legibility 
whether  we  say  ''  Headache  in  the  evening  with  giddiness,'' 


Chapters  of  the  Cypher  Repertory,  69 

or  **  Headache  with  giddiness  in  .the  eyening ; ''  though  as 
the  giddiness  is  equally  in  the  evenings  the  latter  arrange- 
ment seems  the  more  correct. 

Dr.  Drjsdale  objects  that  I  have  no  section  for  "  Pecu- 
liar symptoms  not  susceptible  of  arrangement  elsewhere/' 
bnt  that  I  oonceiye  is  a  merits  for  I  haye  not  met  with  any 
pecaliar  symptoms  that  could  not  be  naturally  placed  under 
appropriate  headings  throughout  the  part.  The  multipli- 
cation  of  sections  cannot  surely  be  held  to  be  adyantageous, 
I  would  rather  say  the  contrary. 

In  like  manner  I  haye  sayed  another  Section-^Section 
VI — in  other  parts  of  the  work  deyoted  to  "  Anatomical 
Regions/'  owing  to  the  peculiarity  of  this  part^  which  enabled 
roe  to  giye  the  seat  of  the  pains  or  symptoms  all  throughout 
Chapter  III.  Had  I  unnaturally  dissociated  the  anatomical 
regions  firom  the  first  section,  I  should  haye  been  unable  to 
make  Sections  II  and  III^ '' Concomitants^' and  ''Conditions/' 
as  complete  as  they  are,  and  the  practitioner  would  haye  had 
to  turn  the  leaves  oyer  backwards  and  forwards  in  a  most 
aggravating  manner,  whereas  by  my  simple  contriyance  he  can 
at  once  lay  his  finger  on  any  condition  or  concomitant  con- 
nected with  any  part  of  the  head  or  any  minute  subdiyision 
of  that  part. 

The  two  entries  I  have  thus  saved  have  been  utilised  by 
being  devoted  to  Scalp  and  Hair,  which,  had  not  the  plan 
of  the  work  been  already  fixed^  would  have  demanded  sepa- 
rate chapters. 

The  alterations  I  have  made  in  the  abbreviations  of  the 
medicines  may  be  less  justifiable^  but  they  are  very  few^  and 
seemed  to  me  to  render  the  abbreviations  less  liable  to  be 
confounded  with  one  another.  As  far  as  I  know  they  are 
only  three  in  number. 

The  original  abbreviation  of  Allium  cepa  was  '*  a-ce."  I 
have  it  '*  cep."  that  of  Allium  sativum  was  formerly  •'  a-sa./' 
it  is  now  ''  all.''  My  reason  for  making  this  change  was 
that  the  abbreviation  of  Alcohol  sulphuris,  ''  aUs.,"  might 
readily  be  misread  as  standing  for  Allium  sativum,  whereas 
"all."  would  never  be  mistaken  for  the  other ;  and  '*  cep."  is 
certainly  as  suggestive  of  A.  cepa  as  the  former  sign^ ''  a-cp." 


70  Notes  on  the  more  Recent 

I  have  also  made  "  oca "  the  abbreviation  for  JSry- 
thoxylon  coca,  in  place  of  *'  ery/^  As  the  drug  is  usually 
called  ''  coca/'  and'  manj  might  forget  its  generic  name^  I 
thought  the  abbreviation  '^ery/'  might  lead  to  confusion^ 
and  readers  might  easily^  without  referring  to  the  index,  mis- 
take it  for  one  of  the  two  EryngiumSy  or^  if  not  strong  in 
orthography,  even  for  Erigeron  or  Erecthiles. 

However,  if  my  trivial  alterations  are  not  considered  ina- 
provements — for  improvements  I  intended  them  to  be — I 
am  willing  to  cry  "  Peccavi  I " 

One  real  error  has  been  pointed  out  in  my  list  of  abbre- 
viations, and  that  is  that  I  have  used  the  same  abbrevia- 
tion, *'  mel.,"  for  both  Melastoma  and  MeUlottts,  The 
abbreviation  for  the  first  should  be  *'  mis.,''  the  other  may 
remain  as  it  is.  This  will  involve  the  correction  of  only 
two  entries,  viz.  at  p.  190,  first  coL,  line  10,  for  **  mel." 
read  ^^mls.,"  and  the  same  alteration  should  be  made  at  p. 
274,  first  col.,  line  9  from  bottom. 

Dr.  Drysdale  makes  a  very  vigorous  protest  against  my 
method  of  dealing  with  collective  headings.  I  have  design- 
edly deviated  from  the  directions  in  the  introduction,  and 
I  believe  without  disadvantage  to  those  who  consult  this 
part.  If  I  had  adhered  to  the  orignal  plan  I  must  have 
had  long  lists  of  medicines  with  nothing  to  indicate  where 
the  pain  or  character  was  seated,  and  no  indication  of  the 
precise  character  of  the  pain,  but  attended  by  some  other 
character,  wliich  would  have  added  but  little  to  the  precision  of 
the  symptom.  Thus,  one  of  these  lists  would  have  contained 
a  number  of  medicines,  perhaps  some  60  or  70,  with  such  a 
symptom  as  '^  Headache  and  heat,''  but  without  a  hint  aa 
to  what  kind  of  ache  it  was  or  where  in  the  head  it  was 
seated.  Now,  on  turning  to  the  heading,  '^  Heat  of  head  " 
and  casting  the  eye  over  the  list  of  medicines,  those  medi- 
cines which  have  these  symptoms  in  connection  with  head- 
ache will  be  at  once  seen,  and  the  character  of  the  head- 
ache also.  The  same  with  the  other  headings,  such  as 
"  Congestion,"  "  Fulness,"  *'  Heaviness,'*  &c.  But  not  only 
this,  the  attendant  pain  is  repeated  in  each  anatoitaical 
or  local  subdivision  of  the  character,  and  among  the  pains 


Chapter 9  of  the  Cypher  Repertory.  71 

themselves,  even  when  vagae,  like  ''  undefined  pain/'  or 
"  aching  pain/'  the  attendant  character  of  heat,  fulness, 
congestion,  fee,  will  always  be  found. 

If   I  had  stuck  to    the   original  plan  of  '*  collectives  '* 
and   '^  selects/'   the  practitioner  would  certainly  have  seen 
at  a  glance  what  medicines  had  combined  '*  pain  and  heat 
of  head/'  but  he  could  have  learned  nothing  further  from 
the  list ;  he  could  not  have  seen  what  kind  of  pain  nor  where 
precisely  it  was  seated  in  the  head.     Now,  by  my  plan  the 
practitioner  can  see  at  a  glance,  not  only  what  medicines  have 
pain  and  heat,  but  he  sees  under  **  heat "  the  precise  cha- 
racter of  the  pain,  and  if  he  knows  what  part  of  the  head 
the  pain  is  in  he  will  in  an  instant  see  the  anatomical  seat  of 
the  pain,  what  medicines  have ''heat"  connected  with  pain  of 
that  particular  part,  and  the  kind  of  pain  too.     The  same 
information  he  will  get  under  the  different  pains  in  the  great 
regional  divisions  of  the  head.     Surely  the  precision  gained 
by  this  plan  would  be  cheaply  purchased   by  a   little  extra 
trouble  on  the  part  of  the  consul ter  of  this  pfirt,  but  as  it  is 
actually  attended  by  no  more  trouble  .than  there  is  in  con- 
sulting a  vague  group  of  ^'  collectives  "  and  *^  selects ''  on  the 
old  plan,  the  advantages  of  my  plan  are  obvious.     I  do  not 
know  why  Dr.  Drysdale  says  my  list  of  adjuncts  to  "Heat" 
is  not  complete.     I  believe  he  will  find  it  quite  complete, 
as  well  as  the  adjuncts  to  all  the  other  character-symptoms, 
with  the  exception  of  ^'  q.  Heaviness,"  p.  139,  where  curtail- 
ment was  necessary. 

The  lists  of  medicines  in  Chapter  III  terminated  by  an 
"&c."  are  made  up  chiefly  of  medicines  of  which  a  sym- 
ptom is  recorded  without  any  adjunct,  and  which  symptom 
could  not  appear  uuless  placed  in  this  list.  The  "  &c."  is 
used  to  indicate  that  there  are  many  more  medicines  which 
have  the  same  kind  of  pain,  but  which,  having  adjuncts  or 
conditions  or  concomitants  or  a  more  defined  anatomical 
seat  that  precisionise  them,  will  be  found  in  their  appropriate 
section  or  under  the  portion  of  the  chapter  that  refers  to  the 
precise  locality. 

It  is  objected  that  I  have  not  indicated,  either  by  a  sign 
or  a  heading,  "  Fains  all  over  the  head."     If  there  are  any 


72  Notes  on  the  more  Recent 

snch  pains,  they  will  be  amoug  the  ''  Pains  in  the  head 
generally/'  and  repeated,  if  they  have  concomitants  or 
conditions,  in  Sections  IT  and  III  under  the  rubric 
*'  Oen."  But  the  fact  is  I  was  unable  to  discriminate 
among  the  recorded  symptoms  of  the  Materia  Medica  what 
symptoms  were  fairly  entitled  to  this  description.  In  very 
few  instances,  indeed,  does  the  prover  say  that  the  pain 
involved  his  whole  bead ;  but  possibly  when  he  describes 
his  pain  or  symptom  as  '^  in  the  head/'  without  further 
specification,  he  often  means  in  the  whole  head ;  otherwise, 
surely  he  would  have  said  if  it  was  in  the  forehead^ 
temples,  occiput,  or  other  part.  Therefore  I  have  done 
what  I  believe  to  be  the  best,  and  entered  under  the 
heading  of  '^  Pain  in  thie  head  generally  '^  all  those  pains 
which  are  not  ascribed  by  the  prover  to  any  special  part  of 
the  head.  It  may  be  that  some  of  those  pains  were  not  all 
over  the  head  or  did  not  involve  the  whole  head,  but  in  the 
absence  of  any  localisation  by  the  provers  I  could  do  no 
more  with  those  symptoms  than  refer  them,  as  they  do,  to 
the  head  '^  generally.^'  If  such  pains  do  not  involve  the 
whole  head — as  most  likely  many  of  them  do  not — ^the 
indefiniteness  is  the  prover's  fault  not  mine. 

Dr.  Drysdale  is  mistaken  in  saying  that  the  heading 
'^  General  pain  '^  occurs  frequently.  It  does  not,  in  fact, 
occur  at  all.  There  is  a  frequent  heading  of  ''  undefined 
pain,''  which  is  quite  en  regie,  and  includes  all  pains  not 
otherwise  specified ;  but  the  heading  ''  Gen.,  "  in  Sections 
II  and  III,  does  not  refer  to  the  pain  but  to  its  seat,  which 
is  stated  by  the  prover  to  be  in  the  head,  but  not  further 
localised. 

Dr.  Drysdale  is  again  mistaken  in  saying  that  the 
*'  Course  and  progress "  of  the  pains  is  omitted  in  Sec- 
tion lY,  Chapter.  III.  On  the  contrary,  this  is  given  in 
full  detail  in  that  section. 

Dr.  Drysdale  says  the  omission  of  a  Section  IV — i.  e. 
a  '' course  and  progress''  section  from  Chapter  II — is 
a  "  great  loss."  If  he  had  investigated  the  matter 
more  closely  he  would  have  found  that  the  loss  of  such 
a  section  is  not    very  great.      On    looking    through   the 


Chapters,  of  the  Cypher  Repertory,  73 

Materia  Medica  I  have  onlj  been  able  to  discover  six 
medicines  which  possess  symptoms  of  vertigo  that  couid 
have  been  referred  to  such  a  section,  and  it  is  very 
doubtful  if  even  these  few  symptoms  could  have  all  been 
appropriately  so  placed.  There  is  first,  under  **  her./'  a 
vertigo  with  several  other  symptoms  said  to  be  followed  by 
rigor,  but  it  is,  at  all  events,  doubtful  if  the  vertigo  stopped 
when  the  rigor  came  on^  so  I  have  placed  the  rigor  among 
the  concomitants.  2.  Bov.  has  vertigo  preceded  and 
followed  by  headache.  8.  Pho.  has  ''  vertigo,  then  nausea,^' 
and  ''  vertigo,  thereafter  hypochondriacal  humour.''  4.  Rn-b. 
has  "  V.  followed  by  headache  '^  and  '^  v.  in  forehead,  imme- 
diately afterwards  transient  pressure  there.''  5.  Sel.  has 
"  almost  constant  vertigo,  followed  by  nausea  and  vomit- 
ing.'' 6.  Tep.  has  '^  vertigo  and  headache,  immediately 
afterwards  vomiting."  I  think  any  one  will  agree  with  me 
that  all  these  symptoms  may  equally  well  be  registered^  as 
I  have  done  these,  among  the  concomitants  of  vertigo.  In 
short,  had  I  endeavoured  to  make  a  section  in  Chapter  II 
corresponding  to  Section  lY,  it  would  have  been  something 
like  Herr  Anderson's  famous  chapter  on  ^'  Snakes  in 
Iceland." 

The  sign  ''  =  "  which  seems  to  have  perplexed  Dr. 
Drysdale  is  only  employed  in  Section  IV  of  Chapter  III  to 
separate  the  varieties  of  pains  in  that  portion  of  the  section 
de?oted  to  '^  general  character  and  distribution  of  pains,"  the 
lists  being  arranged  by  pains  and  not  in  the  alphabetical 
order  of  the  medicines.  All  the  medicines  following  a 
Boman  numeral  as  far  as  the  sign  ''  =,"  have  the  same 
pain  as  that  indicated  by  the  Roman  numeral.  It  is  perhaps 
not  the  best  sign  that  could  be  adopted,  but  I  could  not 
find  a  better,  all  others  being  engaged  in  other  ways. 

Throughout  this  part  all  the  changes  I  have  made  do 
not  in  the  least  affect  the  facility  of  using  the  work  by  those 
accustomed  to  use  the  other  parts,  for  there  has  been  no 
introduction  of  arbitrary  symbols  different- frum  those  em- 
ployed in  other  parts  of  the  work.  The  alterations  have 
been  necessitated  by  the  peculiarities  of  the  region.  In 
constructing   the  repertory  of  different  regions  a  certain 


74  Notes  on  the  more  Recent 

licence  sbould  be  allowed  the  worker  to  introduce  any 
alterations  in  matters  of  detail  that  seem  to  be  required  by 
the  region  he  is  engaged  on^  provided  always  that  the 
same  system  be  retained  as  regards  the  general  plan  and 
the  symbols  originally  adopted.  As  each  chapter  has  its 
own  peculiar  symptomSi  so  also  has  it  certain  elements  that 
differ  from  any  other  chapter^  and  any  deviation  in  matters 
of  detail  rendered  necessary  by  the  pectdiarities  of  the 
chapter  should  be  explained.  I  have  endeavoured  to  do 
this  in  the  prefatory  ''  explanatory  remarks ''  to  this  part 
of  the  Repertory ^  and  I  believe  that  a  practical  employment 
of  the  work  will  convince  any  one  that  my  alterations  have 
increased  the  utility  of  the  work  and  the  facility  with  which 
any  symptom  may  be  discovered,  while  no  material  altera- 
tion has  been  made  in  the  plan  of  it ;  and  I  am  sure  that 
those  accustomed  to  use  the  other  parts  will  find  no  diffi- 
culty whatever  in  using  this  one. 

In  a  work  of  this  complexity  no  doubt  some  typogra- 
phical errors  have  escaped  my  notice.  Some  have  been 
pointed  out  in  the  subjoined  critique^  and  I  will  mention 
here  a  few  others  that  have  escaped  my  corrections  while 
the  work  was  going  through  the  press.  At  p.  192,  in  the 
"  Anatomical  seat ''  of  ''  Crown.'*  the  letters  a,  b,  c,  d, 
indicating  the  precise  locality,  should  have  been  preceded 
by  a  capital  C ;  thus,  C*,  C^  C^  C*.  Again,  at  p.  253, 
Ist  col.,  line  7  from  bottom,  "  a05**.''  should  be  "a»".  At 
p.  271,  2nd  col.,  line  16,  *'k^''  should  be  "kV  At 
p.  282,  2nd  col.,  line  18,  "  aco*.''  should  be  ''  aco.g.'' 

The  following  review  is  by  Dr.  Berridge,  and  will  be 
published  in  The  Organon.  The  author  is  a  very  competent 
judge  of  repertory  work,  as  he  has  laboured  assiduously  in 
the  same  field  : 

"  Excepting,  perhaps,  in  the  case  of  those  remarkable  pheno- 
mena who  try  to  carry  the  whole  Materia  Medica  of  our  School 
in  their  heads,  Nature  having  kindly  provided  them  with  skulls 
of  extra  thickness  in  order  to  withstand  the  expansive  force  set 
up  by  the  fermentation  of  symptoms  which  must  be  continually 
going  on  within,  a  Bepertory  or  Index  to  the  same  is  a  necessity. 


Chapters  of  the  Cypher  Repertory.  75 

If  Hahnemann  deemed  it  needful  to  append  an  Index  to  bis  first 
Materia  Medica,  the  Frcbgmenta^  though  but  twenty-seven  medi- 
cines were  referred  to  therein,  with  how  much  more  reason  should 
we  demand  the  same,  now  that  our  proved  remedies  may  be 
counted  by  the  hundred.  The  most  difficult  question  to  solve, 
however,  is  the  arrangement  of  such  a  work.  The  law  of  Similars  9 
like  all  Nature's  laws,  is  indeed  simple ;  but  to  apply  it  success- 
fully in  every  case, — hoc  optUy  hie  labor  eat ! 

"  Most  symptoms  are  complezy  i.  e.  they  consist  of  two  or  more 
elements ;  therefore,  as  it  is  impossible  to  say  beforehand  under 
what  rubric  tbe  physician  may  look  for  a  symptom,  it  is  necessary 
that  each  symptom  should  be  referred  to  under  every  heading 
where  it  can  be  looked  for,  that  is,  under  the  heading  of  each  of 
its  elements.  This,  however,  is  not  all.  Were  our  Materia 
Medica  absolutely  perfect,  t.  e.  had  we  elicited  every  possible 
symptom  from  every  possible  medicinal  substance,  such  a  plan 
w6uld  suffice ;  as  the  case  stands,  however,  we  often  find  gaps  in 
our  provings  which  we  need  to  fill  up  by  Analogy y^  till  further 
Imowledge  enables  us  to  act  with  greater  certainty.  For 
example: — ^We  lately  met  with  a  case  of  rheumatism  of  the 
heart,  with  marked  aggravation  about  3  a.m. ;  the  character  of 
the  pain  was  fairly  described  under  KaM,  but  no  aggravation  of 
that  particutar  pain  at  3  a.m.  has  been  hitherto  observed.  Yet, 
as  such  aggravation  has  been  recorded  in  connection  with  so 
many  other  symptoms  of  the  drug  that  it  is  accepted  as  a  charac- 
terigtic,  we  selected  that  remedy  from  Analogy,  and  effected  a 
speedy  and  permanent  cure.  Another  patient  complained  of  a 
pain  in  the  right  side  of  the  loins,  like  an  instrument  going 
straight  through  to  the  right  side  of  the  abdomen,  on  the  head 
of  which  some  one  knocked.  We  could  not  find  such  a  symptom 
in  the  Materia  Medica,  but  knowing  that  Sulphwric  Acid  produces 
a  similar  pain  in  the  head,  we  reasoned  from  Analogy  that  it 
would  be  found  to  be  the  SimiUimvm,  to  this  symptom  aJso,  and 
the  result  justified  our  conclusion.  These  cases — and  we  could 
quote  many  more — prove  without  a  doubt  that,  in  addition  to  a 
simple  verbal  Index,  we  need  OoUedivee  of  symptoms  which  may 
^ee  in  any  particular  point,  either  as  to  Locality^  Specific 
(Procter,  Oeneral  Character,  Sequence  and  Direction,  Conditione, 
or  Concomitante,  Tet,  when  all  this  is  done,  there  is  still  one 
thing  wanting ;  such  a  work  woidd  be  merely  a  reference  to  the 


76  Notes  on  (he  more  Recent 

symptoms — a  mere  skeleton — and  therefore  in  many  cases 
insufficient  at  the  bedside  of  the  patient  for  lack  of  the  Materia 
Medica  itself.  How  is  this  problem  to  be  solved  P  Can  we  ever 
obtain  a  Repertory  which  shall  be  at  once  complete  and  handy 
— a  Materia  Medica  arranged  Bepertorially  in  fact — or  must  we 
for  ever  remain  in  the  dilamma  of  the  celebrated  old  lady  who 
for  years  tried  in  vain  to  procure  the  smallest  Bible  in  the  largest 
print? 

**  This  problem  is  one  to  which  we  have  given  our  attention  for 
some  years,  and  the  only  practicable  solution  seems  to  us  to  be 
that  ttoo  kinds  of  Bepertories  are  needed.  Fortunately,  Nature 
herself  helps  us  here,  those  cases  which  are  most  perplexing 
through  paucity  or  obscurity  of  symptoms,  in  which  therefore  we 
chiefly  need  to  resort  to  Analogy,  being  for  the  most  part  chronic^ 
allowing  us  leisure  to  refer  to  our  Materia  Medica  at  home; 
while,  on  the  other  hand,  the  symptoms  of  acute  cases,  where  a 
delay  of  a  few  hours  might  be  fatal,  are  usually  so  clear,  that  a 
Bepertoiy  more  simply  constructed,  but  yet  containing  the  full 
symptomatology,  is  sufficient. 

"  The  typal  forms  of  these  two  classes  of  Bepertories  are  that 
of  Bdnninghausen  (including  his  Pocket-hook),  and  Jahr's 
Oerman  Bepertory.  While  both  these  works  have  much  in 
common,  as  any  two  Repertories  must  have,  there  is  one  impor- 
tant difference,  which  will  be  seen  by  comparing  the  respective 
sections  on  the  Chest.  Bonninghausen's  Bepertory  shows  the 
'  skeleton '  form  thereof,  abounding  in  invaluable  collectives  of 
conditions,  sensations,  and  localities,  but  without  the  Materia 
Medica  itself ;  on  the  other  hand,  Jahr's  work  contains  a  con- 
densed Materia  Medica  in  sections,  followed  by  a  Bepertory, 
which,  however,  lacks  the  completeness  of  its  predecessor.  On 
the  basis  of  these  two  works  have  most  subsequent  Bepertories 
been  compiled.  Our  own,  of  which  only  the  volume  on  the  Eyes 
has  yet  been  published,  is  based  on  the  former  of  these  two 
models,  but  with  greater  fulness  and  detail ;  the  latter  plan  was 
followed  in  the  Pathogenetic  OyclopcBdia.  The  latter  work,  how- 
ever, proved  too  cumbersome  for  clinical  use,  while  for  consulting 
practice  the  addition  of  the  Materia  Medica,  already  contained 
elsewhere,  was  unnecessary.  A  new  and  most  ingenious  system 
of  cyphering  the  symptoms — first  we  believe  resorted  to  by  Dr. 
Mure,  of  Brazilian  fame — ^was  adopted,  by  means  of  which. 


Chapters  of  the  Cypher  Repertory .  77 

while  the  bulk  of  the  Bepertory  was  kept  within  reasonable 
limits,  the  entirety  of  each  symptom  could  be  given. 

''The  plan  of  cyphering  is  briefly  this.  The  symptoms  (with 
the  exception  of  the  pains)  are  cyphered  by  Boman  letters ;  the 
paau  by  Boman  numerals ;  symptoms  necessarily  belonging  solely 
to  special  sections  by  old  English  letters ;  eondUUms  by  Arabic 
nmnerals  (ameliorations  being  signified  by  the  numeral  being 
bracketed,  the  same  being  implied  also  when  the  name  of  a  medi« 
cine  is  in  Italics)  ;  concomitants  by  Greek  characters ;  and  lastly, 
the  abbreviations  of  the  medicines  always  consisting  of  three 
letters,  they  cannot  be  confounded  with  the  cypher  itself.  To 
give  an  example :  At  page  149,  under  '  w.  Motion  in  brain,'  we 
read  'w*^.  Bising  and  sinking.  F.  bel.  I.  31  (12),'  which  means 
that  BeUadonna  has '  Bising  and  sinking  in  forehead,  with  unde- 
fined pain,  worse  in  walking,  better  by  pressure.'  This  symptom 
is  repeated  under  each  of  its  various  elements,  unth  the  remmnder 
of  the  symptoms  in  cypher y  so  that  under  whatever  rubric  it  is 
looked  for,  there  it  is  found  in  fvXl, 

"In  the  present  chapters  some  improvements  of  detail  have 
been  introduced ;  especially  we  like  the  transference  of  '  Complex 
pains '  to  a  separate  rubric,  thus  bringing  into  clearer  light  those 
medicines  which  produce  the  symptoms  in  an  uncomplicated 
form.  The  author  also  has  informed  us  that  the  original  sources 
have  always  been  referred  to,  and  no  symptoms  (except  those  of 
Houat,  which  he  seems — we  think  unnecessarily — to  distrust) 
have  been  intentionally  omitted. 

'^  We  would  just  make  one  suggestion,  namely,  that  future 
chapters  should  be  more  condensed.  In  a  Bepertory  we  do  not 
need  to  give  the  merely  verbal  differences  of  the  Materia  Medica ; 
'Confusion,'  and  'Dull  stupid  feeling,'  might  advantageously 
have  been  united,  and  we  certainly  should  not  have  separated 
'  Confusion,  as  if  intoxicated,'  from  '  Dull  stupid  feeling,  as  if 
intoxicated,'  Space  would  have  been  saved,  without  sacrifice  of 
accuracy,  had  the  three  symptoms, '  Head  feels  as  large  as  a 
bushel,' '  Head  feels  as  large  as  a  barrel,'  and  '  Head  feels  enor- 
mously large,'  been  comprised  under  one  rubric.  Neither  do  we 
think  that  Dr.  Dudgeon  should  have  separately  registered  and 
cyphered  the  variety  of  laughter,  'Laughter  to  deaih*  unless 
prepared  to  verify  its  practical  utility  by  a  cure ;  and  with  all 
due  respect  to  his  skill,  and  in  spite  of  the  dictum  of  a  Professor 


78  Notes  an  the  Cypher  Repertory. 

of  HomoBopathic  ( !  ?  )  Materia  Medica  in  America,  who  recently 
described  certain  post-moriew,  changes  as  a  condition  which '  called 
for  Hepwr^  we  doubt  whether  he  has  ever  performed  ilycd  feat ! 
These  are,  however,  only  trifles,  and  we  merely  mention  them 
because  an  observance  of  trifles  constitutes  perfection,  and  per- 
fection is  no  trifle. 

''  The  Cypher  'Repertory  is  now  published  from  the  Mental 
symptoms  to  the  Stools,  and  other  chapters  are  in  progress.  We 
cannot  conclude  this  notice  better  than  by  advising  all  to  procure 
the  work  at  once,  and,  use  it.  Doubtless  a  difficulty  in  using  the 
cypher  will  be  felt  at  first.  The  plan  we  adopted  was  first  to  use 
it  like  the  ^  skeleton  '  Bepertories,  without  the  cypher ;  then  by 
degrees  the  latter,  the  meaning  of  which  can  always  be  ascertained 
by  reference  to  the  index,  became  clear,  till  now  we  are  so  con- 
versant with  it  that  we  often  use  it  as  a  species  of  shorthand. 
The  present  volume  is,  without  exception,  the  most  complete  of 
any  yet  published  on  the  same  subject,  and  as  such  is  an  indis- 
pensable addition  to  our  libraries. 

"We  wiU  take  this  opportunity  of  correcting  a  few  errors 
which  have  crept  in.  At  page  34  the  symptom,  *  Very  sensitive 
disposition,  she  weeps  at  receiving  thanks,'  belongs  to  Lycop., 
not  Lachesis.  In  the  Pathogenetic  Cyclopaedia,  pp.  355,  420,  we 
read,  under  SahadiUay  *  Constant  headache,  tension ;  the  first  day 
only  in  the  forehead,  the  next  day  in  the  whole  head,  relieved  by 
looking  fixedly  at  something  or  thinking  of  something.'  Hempdl 
gives  the  same.  Allen  gives  it,  as  revised  hy  Hering,  thus  : 
'  Constant  headache,  like  a  heaviness ;  on  the  first  day  it  was  felt 
only  in  the  forehead,  on  the  following  day  in  the  whole  head ;  less 
violent  when  staring  or  reflecting.'  These  symptoms  are  taken 
from  Stapf's  Beitrdge,  published  in  1836,  p.  177,  sympton  41 ; 
but  in  the  Archiv,  published  in  1825,  4th  volume,  3rd  part, 
p.  126,  symptom  26,  we  read,  'Portwahrend  Kopfweh,  ein 
Spannen ;  den  ersten  Tag  nur  in  der  ^tim,  den  f  olgenden  Tage 
im  ganzen  Kopfe ;  wenn  er  starr  wohin  sicht,  oder  uber  etwas 
sinnt,  wieder  starker ;'  i,  e,  again  stronger,  not '  minder  stark,'  less 
strong.  This  proves  the  absolute  necessity  of  always  referring  to 
the  originals.    Lastly,  at  page  259,  last  line,  for  '  nit.'  read  *niL* " 

As  regards  the  symptom  of  Sabadilla  alluded  to  above^ 
I  may  say  that  Dr.  Berridge  is  quite  right  as  to  his  facts^ 
but  it  is  not  quite  so  easy  to  determine  which  of  the  two 


Eruptive  Fevers,  by   W,   V.  Drury.  79 

readings  of  the  symptom  is  the  correct  one^  as  he  seems  to 
think.    The  original  proving  of  Sabadilla  by  Stapf  appeared 
in  the  Arckiv.     A  revised  and  considerably  enlarged  prov- 
ing of  it^  also  by  Stapf,  was  published  in  the  Beitrdge^  and 
this  symptom,  observed  by  a  young  doctor^  indicated  by  the 
letter  H,  is  altered  not  only  in  the  manner  indicated,  but 
a  palpable  mistake  in  the  same  symptom  is  also  corrected, 
vis.  "  Tage  "  to  "  Tag ;"  nevertheless,  on  consideration^  I 
am  inclined  to  agree  with  Dr.  Berridge  in  thinking  that  the 
first  reading  of  the  condition  may  be  the  more  correct,  as  the 
same  prover  contributes  another  symptom — S.  39  {Beitr.), 
"  Headache  caused  by  continued  attention;"  and  yet  another 
— S.  14  {Beitr.)y  "  Thinking  is  difficult,  and  causes  head- 
ache."    So  that  it  is  quite  possible  that  Stapf  might  have 
made  a  mistake  when  he  corrected  '^  wieder  starker  "  of  the 
first  oopy  into  "  minder  stark  "  of  the  second.      Still  there  is 
room  for  a  difference  of  opinion  on  this  subject ;  and,  on 
the  whole,  I  am  inclined  to  let  the  symptom  stand  as  Stapf 
gave  it  in  his  last  edition. 


REVIEWS. 

En^tive  Fevers :  Scarlet  Fever,  Measles,  Smallpox,  ifc. 
Being  a  Course  of  Lectures  on  the  Exanthemata,  de- 
livered at  the  London  Homoeopathic  Hospital^  by 
William  Vallancy  Drury,  M.D.,  M.B.LA.^  &c. 
London :  Gould  and  Son,  1877. 

Ws  sincerely  apologise  to  Dr.  Drury  for  the  long  time 
that  has  elapsed  between  the  receipt  of  his  book  and  this 
notice  of  it.  The  omission  was  entirely  accidental,  and  is 
to  Qs  a  matter  of  regret. 

These  lectures  are  marked  by  a  consummate  acquaint- 
ance with  the  diseases  treated  of,  and  much  practical  skill, 
derived  from  the  author's  great  experience  and  rare  powers 
of  observation. 

The  description  of  the  various  forms  of  scarlatina,  its 
complications  and  sequelae,  is  fully  up  to  the  mark  of  the 


80  Reviews. 

science  of  the  present  day.  We  can  completely  endorse 
his  remarks  upon  the  latent  form  of  scarlatina,  which  is  a 
more  frequent  form  of  the  disease  than  is  commonly  sus- 
pected. We,  too,  have  seen  cases  of  undoubted  scarlatina 
which  could  only  be  recognised  as  such  by  the  charac- 
teristic sequelse,  such  as  desquamative  nephritis  and  anasarca. 

We  can    also   bear  testimonv  to  the  truth  of  his  remark 

• 

about  the  danger  attending  slight  wounds  in  a  person  in- 
fected by  malignant  scarlatina,  even  before  the  ezanthem 
has  manifested  itself.  A  remarkable  case  of  this  sort 
occurred  in  a  young  gentleman  of  our  acquaintance,  who^ 
without  being  aware  of  it,  had  been  exposed  to  the  infection 
of  scarlatina,  and  before  any  symptom  of  the  disease  had 
appeared  had  the  trivial  operation  of  snipping  the  frffinum 
preputii  performed  by  Mr.  Syme,  of  Edinburgh.  This 
was  followed  by  extensive  sloughing  of  penis  and  scrotum ; 
and  it  was  only  after  this  that  the  scarlatinal  rash  appeared. 
The  case  terminated  fatally. 

The  therapeutics  of  scarlatina  are  laid  down  in  a  most 
satisfactory  manner,  and  the  indications  for  the  various 
remedies  are  given  with  clearness  and  precision.  Some 
interesting  illustrative  cases  enhance  the  value  of  the 
author's  treatment. 

Dr.  Druiy  is  not  very  certain  about  the  value  of  Bella'* 
donna  as  a  prophylactic  of  scarlatina.  The  truth  of  this 
question  seems  to  be  that  Belladonna  is  really  preventive  iu 
some  epidemics  of  scarlatina,  but  not  in  others.  Hahne- 
mann says  it  is  only  prophylactic  of  the  form  of  scarlatina 
attended  by  a  smooth  eruption.  The  scarlatina  attended 
by  a  rough  or  measly  eruption  is  probably  a  different 
disease;  perhaps  that  exanthem  which  has  of  late  years 
been  distinguished  by  the  Oerman  name  rotheln. 

Dr.  Drury's  observations  on  measles,  roseola,  rotheln, 
and  chicken-pox,  are  interesting  and  instructive. 

In  his  treatment  of  erysipelas  he  does  not  mention 
Arnica^  a  remedy  most  conspicuously  homoeopathic  to  severe 
forms  of  the  disease,  and  which  has  been  strongly  recom- 
mended by  Dr.  Cooper.  We  have  seen  it  very  useful  in 
cases  of  erysipelas  with  a  tendency  to  the  formation  of  bullae. 


Nairutn  muriaticum,  by  Dr.  J,  C.  Burnett.  81 

The  chapter  on  smallpox  is  well  written  and  eminently 
practical.  This  is  followed  by  an  account  of  inoculation^ 
interesting  chiefly  in  a  historical  point  of  yiew^  as  it  is 
illegal  to  resort  to  the  practice  in  this  country. 

The  Tolume  concludes  with  a  chapter  on  vaccination; 
and  we  are  glad  to  perceive  that  Dr.  Drury  is  a  staanch 
npholder  of  the  efficacy  of  vaccination  as  a  prophylactic  of 
smallpox^  though  he  does  not  like  the  present  compulsory 
enforcement  of  the  operation^  and  would  "  prefer  persuasion 
to  force  in  a  matter  of  this  kind/' 


Natrum  muriaticum .-  as  test  of  the  doctrine  of  Drug  Dyna^ 
mizaticn.  By  Jas.  Compton  Burnett,  M.D.,  F.B.G.S. 
Gould  and  Son. 

Dr.  BuBNETT  tells  us  that  he  has  published  this  little 
book  as  a  history  of  the  steps  by  which  he  was  led  to  a 
beUef  in  the  doctrine  of  dynamization,  and  as  a  help  to  others 
in  attaining  the  same  faith.  We  think,  however,  that  he 
is  under  a  little  misapprehension  as  regards  the  attitude  of 
homceopathists  towards  this  doctrine.  They  do  not,  as  we 
understand  it — at  any  rate  with  few  exceptions— question 
the  facts  out  of  which  the  theory  has  grown ;  they  merely 
reject  that  interpretation  of  them  which  supposes  any  new 
force  or  property  to  be  developed  by  Hahnemann's  graduated 
attenuation,  with  trituration  or  succussion.  Fine  subdivision, 
extension  of  surface,  and  thorough  solution  are  the  results 
obtained  by  such  processes ;  and  these  seem  to  them  verte 
CQusm  sufficient  to  account  for  the  energy  acquired.  Dr. 
Burnett  does  not  discuss  the  theory  from  its  scientific  side, 
as  his  foUow-townsman  Mr.  Proctor  did  not  long  ago  in 
this  Journal  ;*  he  merely  brings  forward  another  body  of 
ftets  of  the  kind  which  the  theory  was  designed  to  explain. 

As  facts,  however^  many  of  the  cases  related  by  him  are 
of  much  value,— convinciug   to  opponents,  instructive  to 

*  See  ToL  zzzi,  p.  446. 
▼OL.  XXXVIIi  NO.  CXLYII.— JANUARY^  1879.  V 


82  Reviews, 

friends.  While  confirroing  our  previous  knowledge  of 
Natrum  muriaticum  as  a  potent  medicine  in  promoting 
healthy  nutrition  when  defective,  and  checking  chronic 
intermittents^  it  adds  several  spheres  of  usefulness  to  the 
drug.  Deficient  excretion  by  bowelsi  kidneys,  and  skin 
seems  helped  by  it ;  and  lithuria,  polyuria,  and  chronic  hic- 
cough brought  on  by  Quinine  have  disappeared  under  its 
use.  One  of  the  most  interesting  points  made  is  its  valae 
in  morbid  chilline$B  of  the  system.  A  remedy  which  pro- 
motes the  calorifacient  as  well  as  the  nutritive  processes  of 
the  body  is  one  highly  to  be  prized.  Dr.  Burnett  gsye,  in 
nearly  all  his  cases,  the  sixth  trituration,  in  six-grain  doses 
pretty  frequently  repeated.* 

We  have  only  two  suggestions  to  make  in  taking  leave 
of  this  publication.  The  first  is,  that  Dr.  Burnett  should 
take  a  little  more  pains  with  his  style.  One  who  can  think 
and  speak  with  so  much  vigour  should  express  himself  in  a 
less  slipshod  manner.  His  bits  of  translation,  moreover, 
are  crabbed  to  a  degree.  Our  second  point  is,  that  our 
esteemed  colleague  must  be  warned  against  too  great  a  ten- 
dency to  appeal  ad  populum.  We  have  noticed  a  little  of 
this  in  his  previous  publications,  and  there  is  rather  too 
much  of  the  ad  captandum  character  in  the  style,  to  say 
nothing  of  the  appearance,  of  this  brochtare.  We  hope  that 
Dr.  Burnett  will  take  these  hints  in  good  part,  as  made 
because  we  think  too  highly  of  his  powers  to  be  content  to 
see  them  diverted  from  their  proper  exercise  in  the  path  of 
truly  professional  literature. 


The  Germ  Theories  of  Infectious  Diseases.     By  John 
Dbtsdale,  M.D.     London  :   Bailliere,  1878. 

No  subject  bearing  on  matters  medical  or  pathological 

*  He  will  hardly  please  hereby  those  with  whose  views  his  may  otherwise 
harmonise.  A  very  moderate  representative  of  the  Hahnemannian  school — 
Dr.  Hawkes,  of  Chicago^relates  how,  when  a  student  told  him  that  he  hsd 
been  taking  Natrum  muriaticum  6  for  an  intermittent  without  success,  he 
replied  that  he  might  as  well  have  taken  a  pinch  from  a  salt  barrel. — Amer, 
Somctopaihitt,  Sept.,  1878,  p.  93. 


Br.  Drysdale  on  the  Germ  Theories.  8S 

has  of  late  years  exercised  the  minds  and  taxed  the  in- 
genuity of  scientific  men^  medical  and  othe%  than  the 
possible  origin  of  diseases^  especially  infectious  and  epi- 
demic diseases^  from  minute  microscopic  or  ultra- micro- 
scopic organisms^  presumably  floating — they  or  their  seeds 
— ^in  the  air  we  breathe  or  lurking  in  the  folds  of  the 
dresses  we  wear. 

The  subject  of  the  germ  origin  of  diseases  has  been 
popularised  in  this  country  by  the  essays  and  lectures  of 
Tyndall,  who  has  a  wonderful  way  of  impressing  on  his 
hearers  and  readers  that  he  knows  more  about  any  subject 
on  which  he  discourses  than  any  one  else.  Not  long  ago 
we  came  upon  a  striking  proof  of  the  extent  to  which,  the 
subject  has  been  popularised  by  reading  in  some  noTcl  of  a 
Seotch  doctor  who  was  constantly  boring  his  hearers  with 
his  tiews  upon  what  he  called  the  ^^jurrum  *'  theory. 

So  much  has  been  written  about  the  germ  theory  that 
inevitably  a  good  deal  of  nonsense  has  been  said  about  it ; 
sweeping  inferences  have  been  drawn  from  insufficient  data, 
and  many  things  stated  as  facts  which  subsequent  research 
has  proved  to  be  myths.  Bnt  as  so  many  long-headed 
savants  have  been  devoting  their  minds  and  their  re- 
searches to  the  subject,  it  is  inevitable  but  that  much  light 
has  been  thrown  on  the  subject,  and  it  needed  only  the 
advent  of  an  acute  and  logical  mind  fully  conversant  with 
all  sides  of  the  controversy,  and  himself  a  practical  student 
of  the  subject,  to  make  order  out  of  the  chaos  of  discordant 
opinions. 

No  man  could  be  better  fitted  for  this  task  than  our  former 
co-editor  Dr.  Drysdale,  The  subject  has  been  familiar  to 
him  before  many  of  the  existing  controversialists  were 
born,  as  it  already  occupied  the  attention  of  Fletcher, 
whose  great  work  on  pathology  was  edited  by  our  friend 
more  than  thirty-five  years  ago.  He  is  further  fitted  for 
the  task  by  being  himself  one  of  the  most  zealous  and 
successful  inquirers  into  the  life-history  of  the  minutest 
organisms,  as  his  numerous  contributions  to  the  Micro^^ 
scqncal  Journal  testify. 

In  the  work  before  us  he  gives  a  most  masterly  view  of 


84  Reviews, 

the  whole  question,  statiDg  with  fairness  and  circumstan- 
tiality the  theories  of  those  from  whom  he  differs,  as  well 
as  of  those  with  whom  he  partially  agrees.  It  is  but  a 
small  pamphlet  of  seventy-four  pages  in  which  he  does 
this,  and  we  trust  that  all  who  are  interested  in  the  matter, 
and  that  will  include  all  medical  practitioners  and  many 
others,  will  possess  themselves  of  this  essay  and  give  it  a 
careful  perusal. 

We  may  give  a  brief  summary  of  Dr.  Drysdale's  conclu- 
sions, but  our  space  will  not  allow  us  to  give  the  arguments 
by  which  he  enforces  his  views  ;  for  these  the  reader  must  go 
to  the  essay  itself. 

Dr.  Drysdale  does  not  altogether  deny  that  some  infec- 
tious diseases  may  be  carried  by  organised  germs  of  the 
nature  of  bacteria;  but,  he  says,  there  are  only  two 
diseases  where  there  is  anything  like  satisfactory  evidence 
for  this  origin.  These  are  anthrax  or  malignant  pustule, 
which  seems  to  be  always  connected  with  a  minute 
organism  termed  Bacillus  anthracis,  and  relapsing  fever, 
which  has  hitherto  been  always  found  to  be  attended  by 
the  presence  of  a  spirillum  in  the  blood. 

The  other  infectious  diseases  are  caused  by  the  grafting 
of  degraded  bioplasts  into  the  healthy  body. 

This  statement  will  not  convey  much  meaning  to  those 
not  conversant  with  the  literature  of  the  subject,  so  we 
may  give  a  brief  explanation  of  what  is  meant.  In  health 
the  mucous  corpuscles  secreted  from  the  mucous  epithelium 
when  thrown  off  are  either  dead  or  cease  to  live  after  a  short 
time.  Similarly  the  white  corpuscles  of  the  blood  soon 
lose  their  vitality  when  out  of  the  blood-vessel.  But  in 
disease,  especially  those  of  a  febrile  character,  these  bodies, 
which  are  minute  masses  of  protoplasm,  or  bioplasm  as 
Beale  calls  them,  become  degraded,  and  in  this  condition, 
generally  under  the  form  of  pus-coipuscles,  they  maintain 
an  amoeba-like  vitality  for  a  considerable  time — as  any  one 
may  convince  himself  by  examining  microscopically  the 
urine  from  a  patient  affected  with  cystitis.  He  will  there 
find  numerous  corpuscles  projecting  processes  in  all  direc- 
tions, just  like  amosbae.     Now  these  degraded  bioplasts  are 


Dr.  Drysdale  on  the  Germ  Theories.  85 

eapaUe  of  UYing  on  and  propagating  and  reprodncing  them- 
idTes  when  transplanted  into  an  appropriate  living  body ; 
they  floarish  and  maintain  a  peculiar  existence  in  that 
bodj^  just  as  the  grafted  bud  does  in  the  tree. 

There  is  no  need  in  supposing  any  other  than  protoplasm 
masses,  the  degenerated  secretion  of  animals  or  yegetables^ 
are  the  exciting  cause  of  infectious  and  malarious  diseases. 

We  have  only  given  the  merest  hint  of  the  contents  of 
Dr.  Drysdale's  essay.  We  must  refer  the  reader  to  the 
essay  itself  for  the  reasoning  by  which  these  views  are 
supported  and,  as  we  thinks  convincingly  proved^  and  for 
the  interesting  illustrative  facts  adduced. 

The  theory,  supported  with  such  logical  reasoning  by 
Br.  Drysdale,  has  its  practical  uses.  By  it  the  infectious 
diseases  are  removed  from  the  department  of  natural 
history,  to  which  the  parasitic  germ  theory  would  have 
consigned  them,,  and  restored  to  the  domain  of  medicine 
proper,  thereby  affording  some  hope  of  their  extinction  or 
mitigation  by  the  medical  art.  This  hope  lies  in  the  em- 
ployment of  the  morbid  poisons  themselves  as  curative  or 
prophylactic  agents.  Two  examples  of  such  employment  are 
known  to  us :  viz.,  the  prophylaxis  of  smallpox  by  the  em- 
ployment of  vaccination,  and  the  cure  of  pannus  by  the 
inocnlation  of  the  secretion  of  purulent  ophthalmia  into  the 
diseased  eye.  This  cure  was  discovered  by  Jaeger,  of  Vienna, 
in  1812,  and  successfully  employed  by  Piringer  in  a  large 
nnmber  of  cases.  It  was  first  successfully  employed  in  this 
country  by  Dr.  Dudgeon  in  1844,  and  the  case  was  published 
in  the  London  and  Edinburgh  Monthly  Journal  of  Medical 
Science  for  May,  1844,  and  will  be  found  in  the  2nd  vol. 
of  this  Journal.  Dr.  Drysdale  gives  the  following  rationale 
of  the  cure  of  pannus  by  this  method : — ^^  The  plastids  of 
the  conjunctiva  and  cornea  are  in  a  state  of  germinal 
degradation,  with  so  great  a  loss  of  formative  power  that 
they  cannot  produce  the  compact,  transparent,  healthy  form 
of  these  tissues.  Then  the  infective  partial  bions  inocu- 
lated unite  with  thein,  exciting  a  temporary  increase  of 
similar  protoplasmic  matter  and  profuse  non-living  secre- 
tion.   When  this  subsides,  the  effect  of  the  stimulus  to  the 


86  Reviews. 

fixed  plastids  is  seen  in  rejuvenesceDce  or  regeneration  of 
their  fall  germinal  faculty  and  formation  of  healthy  tissue 
anew.  The  result  of  this  operation  does^  indeed,  strike  the 
observer  as  in  reality  a  renewal  of  youth,  or  a  new  birth  of 
the  part.  The  tendency  of  the  plastids  in  a  state  of  ger- 
minal degradation  or,  in  fact,  variation,  to  revert  to  their 
original  state,  which  is  the  cause  of  spontaneous  as  well  as 
all  other  cures,  seems  to  be  here  wanting,  even  to  the 
extent  that  ordinary  medicinal  stimuli  specifically  adapted 
fail  to  rouse  it,  and  the  more  powerful  stimulus  of  living 
matter  seems  to  be  required.  Here,  also,  in  the  cure,  we 
have  an  analogy  with  the  influence  of  the  stock  in  grafting. 
With  these  splendid  examples  before  us,  one  of  the  chief 
aims  of  medicine  should  now  be  to  turn  these  fearful 
engines  of  power  into  agents  of  protection  against,  and  cure 
of,  the  very  evils  produced  by  their  uncontrolled  natural 
operation.  *  *  *  *  Happy  they  who,  with  intel- 
lectual ability,  have  the  leisure  and  the  opportunity  to 
devote  themselves  to  experimental  research  directed  towards 
this  object.  For  some  among  them  is,  assuredly,  reserved 
a  place  in  the  temple  of  Fame,  beside  the  name  of  Jenner, 
as  benefactors  of  the  human  race  !" 


Clinical  Lectures  upon  Inflammation  and  other  Diseases  of 
the  Ear.  By  Robert  T.  Cooper,  A.B.,  M.D.  Trin. 
Coll.,  Dublin.  Loudon:  The  Homoeopathic  Publishing 
Company,  1878. 

This  little  volume  contains  the  lectures  delivered  by  Dr. 
Cooper  to  the  students  attending  the  class  of  the  London 
School  of  Homoeopathy  during  the  winter  session  of  1877-8, 
the  author  occupying  the  post  of  Aural  Physician  to  the 
London  Homoeopathic  Hospital.     If  we  are  not  mistaken 


Dr.  Cooper  on  Diseases  of  the  Ear.  87 

this  is  the  first  attempt  at  a  treatise  on  any  special  diseases 
of  the  ear  that  has  proceeded  from  the  pen  of  one  of  our 
schoo],  and  we  give  it  a  hearty  welcome. 

Dr.  Cooper  first  gives  a  definition  of  the  words  used  to 
express  the  difierent  regions  of  the  ear,  and  lays  particular 
stress  on  the  importance  of  understanding  the  term  middle 
ear,  which  he  defines  to  include  the  cavity  of  the  tympanum 
with  its  closing  membrane  and  ossicuila,  the  Eustachian 
tube,  and  the  mastoid  cells,  the  external  ear  including  the 
auricle  and  meatus  extemus,  and  the  internal  ear  being  the 
labyrinth,  consisting  of  the  vestibule,  semicircular  canals,  and 
cochlea.  We  may  observe  that  by  some  oversight  the 
running  title  of  the  book  throughout  is  '^  Inflammation  of 
the  Middle  Ear,^'  which  is  not  strictly  correct,  as  Dr.  Cooper 
treats  of  diseases  of  the  internal  and  external  ear  also,  some 
of  which  are  not  inflammatory.  Perhaps  it  is  owing  to  the 
poverty  of  our  homoeopathic  literature  on  the  subject  of 
maladies  of  the  ear,  or  perhaps  it  may  be  because  Dr. 
Cooper's  experience  of  their  homoeopathic  treatment  has  not 
been  of  very  long  duration ;  but  whatever  the  cause,  we 
detect  in  this  treatise  a  decided  allopathic  flavour.  We 
mean  that  the  treatment  in  many  cases  savours  more  of  the 
operative  character  of  the  ordinary  aural  surgery  than  of 
the  careful  homoeopathic  drug-selection  we  should  expect  to 
meet  in  a  work  by  our  colleague,  who  is  so  well  known  by 
his  judicious  selection  of  the  homoeopathic  remedies  for 
diseases  of  other  parts  of  the  human  frame.  Thus,  he  says, 
in  cases  of  suspected  inflammation  of  the  middle  ear,  when 
the  auditory  canal  is  red  and  tender,  and  there  is  earache, 
if  on  examining  the  mastoid  process  there  be  tenderness  on 
pressure  there  and  inflammatory  redness,  we  may  be  pretty 
sure  the  mastoid  cells  are  involved  in  the  inflammation,  and 
that  purulent  matter  is  endeavouring  in  vain  to  make  its 
way  out  through  the  external  skin,  and  so  we  should  '^  cut 
freely  down  to  the  bone,  so  as  to  divide  the  periosteum  as 
well  as  the  occipital  fascia,  and  thus  give  exit  to  the  pent* 
up  discharge.^' 

Now^  it  strikes  us  that  we  would  have  to  cut  a  little 
farther  in  order  tp  reach  the  mastoid  cells,  and  perforsite 


88  Reviews. 

the  boDy  Bhell  in  which  they  are  encased  in  the  mastoid 
process^  and  we  doubt  if  we  should  give  much  relief  even  by 
such  an  operation.  Surely  Dr.  Cooper  has  never  performed 
the  operation  he  advises.  For  our  own  part  we  have  treated 
numerous  cases  of  inflammation  of  the  middle  ear — otitis 
media  purulenta — and  we  have  never  seen  one  instance 
where  the  purulent  secretion  contained  or  believed  to  be 
contained  in  the  mastoid  cells  was  discharged  externally 
through  the  mastoid  process.  Of  course^  we  do  not  deny 
the  possibility  of  such  a  catastrophe,  but  we  doubt  that  it 
could  occur  without  accompanying  necrosis  or  ulceration  of 
the  mastoid  process. 

Again^  we  doubt  very  much  the  pathognomonic  value  of 
the  sensitiveness  of  the  small  lymphatic  gland  over  the 
mastoid  process  as  indicative  of  inflammation  of  the  mastoid 
cells.  If  such  inflammation  exists  very  probably  the  gland 
there — if  the  patient  happen  to  have  one — is  likely  to  become 
painful  and  swollen ;  but  a  gland  in  that  situation  is  often 
swollen,  painfal,  and  inflamed,  from  quite  other  causes. 

"  Acute  otitis  generally  always  commences  with  earache/^ 
says  Dr.  Cooper.  We  think  the  '^generally''  might  be 
omitted  here  with  advantage  to  the  grammar  and  as  more 
consonant  with  the  facts ;  at  the  same  time  earache,  even  of 
the  most  severe  type,  is  no  certain  sign  that  otitis  is  present. 
But  practically  we  have  found  Dr.  Cooper's  remedy  for 
earache  depending  on  inflammation,  viz.  Aconite,  very 
efficacious  in  earache  of  the  severest  type  where  there  is  no 
sign  of  inflammation. 

''When  we  place  a  watch  or  a  tuning-fork  upon  the 
mastoid  process  the  non-transmission  of  vibrations  would 
imply,  if  acute  inflammation  be  present,  complete  blocking 
up  of  the  cells,  and  therefore  the  necessity  for  operative 
procedure  in  the  shape  of  incision  over  the  mastoid  process, 
while  from  the  partial  transmission  of  sound  we  might 
augur  the  retention  of,  at  all  events,  some  air  in  the  cells. 
This  non-transmission  of  vibrations  may  in  this  way  often 
determine  us  as  to  whether  we  are  to  operate  or  not " 
(pp.  21,  22). 

We  cannot  help  thinking  that  Dr.  Cooper  is  here  wrong 


Dr.  Cooper  an  Diseases  of  the  Ear.  89 

both  in  his  acoustics  and  his  surgery.  That  deafness — 
consequently  inability  to  perceive  the  vibrations  of  a  tuning- 
fork  or  the  ticking  of  a  watch  applied  to  the  mastoid  pro* 
oesB— often  accompanies  otitis  media  is  well  known^  but 
it  is  not  likely  that  the  condition  of  the  mastoid  cells  would 
prevent  the  transmission  of  vibrations^  and  it  is  an  error  to 
sappose  that  the  perception  of  these  vibrations  is  in  any  way 
dependent  on  the  mastoid  cells  being  filled  with  air.  The 
bony  structure  of  the  mastoid  process  it  is  which  conducts 
the  sounds  so  well^  but  they  can  be  conducted^  though  not 
equally  well^  by  the  soft  tissues,  and  less  well  by  fluids.  So, 
as  in  otitis  the  bony  structure  still  remains,  the  conducting 
power  of  the  mastoid  process  is  unaffected.  A  stethoscope 
conducts  sounds  equally  well  whether  hollow  or  solid,  and 
the  hollow  stethoscope  is  unaffected  in  its  power  of  trans- 
miting  vibrations  by  being  filled  with  cotton  or  water. 
In  pneumonia,  when  the  lung  is  hepatised  and  its  air-cells 
filled  with  fibrin  or  viscid  fluid,  the  vibration  of  the  voice  is 
heard  with  even  greater  distinctness  than  when  the  air-cells 
are  filled  with  air.  On  the  other  hand,  when  there  is  fluid 
m  the  pleura  the  vibration  of  the  voice  is  transmitted 
much  less  distinctly  or  even  not  at  all.  We  would  rather 
ascribe  the  deafness  in  otitis  to  some  change  in  the  auditory 
nerve,  produced  by  the  inflammation  causing  temporary 
paralysis,  and  hence  would  not  base  on  this  symptom  an 
indication  for  cutting  down  on  the  mastoid  process.  Most 
religions  people^  it  has  been  said,  are  better  than  their 
creeds,  so  we  believe  Dr.  Cooper  to  be  less  sanguinary  than 
his  teaching  would  lead  us  to  suppose,  and  we  do  not 
believe  that  he  whips  out  his  knife  to  cut  down  on  the 
mastoid  process  when  his  patient  with  otitis  fails  to  perceive 
the  vibrations  of  his  tuning-fork. 

Dr.  Cooper  gives  a  case  of  acute  otitis  from  Wilde's 
Aural  Surgery  to  show  how  bad  the  orthodox  treatment  is, 
and  he  says :  "  Allow  me  to  give  in  a  case  like  this  two  or 
three  drops  of  mother-tincture  of  Pulsatilla  in  a  little  water, 
every  third  or  fourth  hour,  and  I  undertake  to  say  all 
evidence  of  inflammation  would  at  the  end  of  twelve  hours 
be  slight^  and  that  in  all  probability  the   shooting  pain 


90  Reviews, 

would  have  altogether  disappeared'^  (p.  24).  We  think 
Dr.  Cooper  would  have  produced  a  better  impresaioQ  had 
he  given  from  his  own  practice,  or  from  the  records  of 
homoeopathy,  an  actual  case  where  the  virtues  of  Pulsatilla 
were  shown  in  this  way.  But  we  doubt  much  if  Dr. 
Cooper  could  have  found  in  our  homoeopathic  literature  any 
cases  to  justify  his  sanguine  expectations  relative  to  the 
curative  .power  of  Pulsatilla  in  otitis.  He  would  certainly 
find  some  instances  in  which  it  had  cured  otalgia  with  the 
rapidity  mentioned,  but  we  fear  that  is  all.  The  series  of 
cases  of  otitis  media  purulenta  treated  by  Professor  Rafael 
Molin,  of  Vienna,  and  recorded  in  our  thirty-fourth  volume^ 
p.  141,  et  seq.,  are  the  best  recorded  examples  of  this 
disease  homoeopathically  treated  we  are  acquainted  with^ 
and  Pulsatilla  was  not  one  of  the  medicines  employed  in 
the  treatment.  Of-  course  Dr.  Cooper  has  a  right  to  say 
that  had  Pulsatilla  been  employed  the  cure  would  have  been 
effected  sooner,  but  he  could  do  so  more  effectively  could 
he  show  a  case  or  cases  in  which  Pulsatilla  did  actuallv 
remove  the  inflammation  in  twelve  hours.  Our  own  experi- 
ence of  this  very  severe  disease  is  that  the  inflammation^ 
under  the  most  favourable  circumstances,  lasts  from  two  to 
three  days,  and  at  the  end  of  that  time  the  accumulated 
pus  bursts  through  the  membrana  tympanic  and  the  patient 
rapidly  recovers,  generally  with  unimpaired  hearings  though 
more  or  less  impaired  hearing,  or  even  perfect  deafness^ 
may  have  been  present  during  the  inflammatory  stage. 
The  membrana  tympani  usually  soon  repairs  the  injury- 
inflicted  on  it  by  the  escape  of  the  pus.  Dr.  Cooper  speaks 
highly  of  the  value  of  paracentesis  of  the  membrana  tympani 
in  inflammation  of  the  middle  ear,  and  we  will  not  deny 
that  it  might  be  advisable  to  perform  this  delicate  operation 
in  cases  of  otitis  media  purulenta,  but  if  we  consider  the 
amount  of  fever  (often  with  delirium)  and  prostration  that 
generally  accompany  this  disease,  the  operation  is  much 
more  simple  to  prescribe  than  to  perform.  Then  as  relief 
is  obtained  naturally  in  a  day  or  two  it  seems  hardly 
worth  while  running  the  risk  of  injuring  the  patient  per- 
manently by  at^tempting  one  of  the  most  delicate  operations 


Dr.  Cooper  on  Diseases  of  the  Ear.  91 

on  a  restless,  tossiog,  delirious  patient.  If  the  paracentesis 
oonld  be  performed  safely  we  admit  it  might  be  advisable^  but 
as  it  seldom  can,  we  think  the  risk  of  doing  harm  outweighs 
the  advantage  to  be  derived  from  a  somewhat  earlier  exit  to 
the  pent-up  secretion. 

Dr.  Cooper  has  a  very  ingenious  theory  respecting  the 
action  of  glycerine  in  the  cure  of  certain  cases  of  deafness^ 
vhich  he  ascribes  to  its  power  of  effecting  endosmosis  and 
exosQQosis  through  the  membrana  tympani. 

In  speaking  of  Meniere's  disease,  Dr.  Cooper  is  very 
severe  on  some  imaginary  practitioners  ^*  who,  despising 
pathology,  would  look  upon  the  tinuitns  and  vertigo  of 
ceromen  as  an  indication  for  drug  administration  equal  in 
importance  with  a  like  symptom  arising  from  exudation 
within  the  vestibules.''  He  inveighs  against  the  teaching 
of  those  ''  who  would  have  us  depend  upon  symptoms  alone 
as  our  guide  to  treatment  *'  as  '*  utterly  fatuitous  '*  (what-, 
ever  that  may  mean — something  awful,  no  doubt).  Now  we 
would  observe  that  until  the  last  few  years  we  knew  abso- 
lutely nothing  at  all  respecting  the  tinnitus  and  vertigo 
dependent  on  changes  occurring  within  the  labyrinth,  and 
as  regards  this  very  disease  (Meniere's)  it  is  only  by  the 
symptoms  that  we  can  infer  its  pathology,  and  its  symptoms 
alone  can  be  our  guide  to  its  treatment.  We  do  not  see 
that  it  is  so  very  scientific  first  to  infer  from  the  symptoms 
that  the  disease  is  Meniere's,  and  then  to  prescribe  Salicylate 
of  Soda  or  Qmnine  for  the  pathological  name.  Nor  does  it 
seem  utterly  unscientific  to  collect  the  symptoms,  vertigo, 
tinnitus,  deafness,  &c.,  and,  comparing  them  with  the  known 
pathogenetic  effects  of  these  two  drugs,  select  that  one 
which  reproduces  these  symptoms  with  the  greatest  similarity. 
We  suppose  Dr.  Cooper's  lectures  were  delivered  before  Dr. 
Byce  Brown's  admirable  lectures  on  Meniere's  disease,*  and 
hence  no  reference  to  them  was  possible  in  the  text,  but  we 
think  Dr.  Cooper  might  have  called  attention  in  a  note  to 
the  observations  of  his  fellow-lecturer.  We  think  it  not 
very  likely  that  a  practitioner  of  ordinary  capacity  would 
attach  any  value  at  all  to  the  ''  tinnitus  and  vertigo   of 

*  Reported  in  the  JTbm.  Uw,  for  September  and  October,  1878. 


92  Reviews, 

ceramen  as  an  indication  for  dmg  administration/'  He 
wonld  donbtless  look  upon  them  as  an  indication  for  using 
the  syringe,  for  of  course  he  would  naturally  look  into  the 
patient's  ear  before  forming  his  opinioUi  and  would  then 
discoTer  the  cause  of  the  symptoms.  If  he  will  not  or 
cannot  examine  his  patient's  ear  with  the  speculum,  he 
cannot  be  considered  a  practitioner  of  ordinary  capacity,  and 
any  mistakes  he  may  make  would  not  excite  our  wonder. 

Dr.  Cooper  describes  at  length  and  gives  woodcuts  of  several 
ingenious  alterations  he  has  made  in  ear  specula  and  syringes^ 
and  his  book  terminates  with  some  interesting  cases,  >from 
which  we  learn  that  he  has  seen  considerable  advantage  in 
the  treatment  of  chronic  aural  catarrh  and  of  noises  in  the 
ear  and  deafness  from  Hydrastis,  and  from  Calc.  phos.  in 
deafness  depending  on  enlarged  tonsils. 

On  the  whole  we  can  strongly  recommend  Dr.  Cooper's 
work  as  a  very  interesting  and  important  addition  to  our 
homoeopathic  literature,  and  if  it  does  not  show  in  every  part 
a  very  profound  knowlege  of  the  pathology  and  thera- 
peutics of  ear  diseases^  it  shares  this  defect  in  common  with 
most  of  the  works  on  the  ear  with  which  we  are  acquainted. 
Where  Dr.  Cooper  can  rely  on  his  own  experience  and 
observation  he  is,  as  usual,  very  original  and  practical. 


98 


MISCELLANEOUS. 


The  London  School  of  HomcBopathy.    By  Dr.  Bates  * 

1.  Dr.  Drysdale  and  his  party  haTing  again  attacked  the 
"  School,"  this  time,  nominally  on  a  question  of  finance,  I  deem 
it  but  light  to  reply  on  the  whole  questions  of  difference  between 
Br.  Diysdale  and  his  friends  on  the  one  hand,  and  the  managers 
of  the  School  on  the  other  hand. 

2.  The  whole  question  lies  in  this,  Dr.  Drysdale  and  his 
friends,  on  the  one  hand,  have  formed  their  ideal  of  what  the 
School  ought  to  be;  they  contemplate  a  school  without  any 
distinddye  name  (but  teaching  homoeopathy  tub  roid),  and  they 
desiie  that  the  School  should  be  wholly  detached  from  the 
Hospital. 

3.  The  managers  of  the  School,  on  the  other  hand,  desire  to 
adhere  to  the  programme  laid  down  from  the  first  in  their 
prospectus,  under  which  they  appealed  for  support,  viz.  that 
the  School  should  be  founded  for  the  express  purpose  of 
instnicting  medical  men  and  students  in  homoeopathy,  both 
theoretically  and  practically.  Theoretically  by  lectures,  practi- 
cally by  clinical  teaching  in  the  London  Homoeopathic  Hospital, 
or  in  some  other  hospitid  in  which  homoeopathy  should  be 
practised  to  the  satisfiiction  of  the  committee. 

4.  Br.  Drysdale  and  his  friends  desire  to  make  our  lectures 
take  the  place  of  the  ordinary  courses  of  lectures  on  the  same 
Buhjects,  and  to  obtain  state  recognition  for  them,  so  that 
attendance  on  our  lectures  on  Materia  Medica  and  Therapeutics, 
and  on  Principles  and  Practice  of  Medicine  shall  count  in  a 
atodent's  course  of  study,  in  place  of  those  given  at  the  ordinary 
schools. 

5.  Hhe   School   management   have   taken  a   more  catholic 

*  We  hare  numbered  the  paragrapha  for  the  purpoae  of  ref erenoei 


94  Miscellaneous, 

view,  and  desire  only  to  provide  additional  instruction  in 
homoeopathy  until  it  becomes  an  integral  part  of  a  liberal 
medical  education  in  the  other  schools. 

6.  Dr.  Drysdale  and  his  friends*  scheme,  if  carried  out  would 
force  us  into  a  sectarian  and  opposition  scheme,  necessitating 
the  formation  of  a  new  medical  school,  and  possibly  the  establish- 
ment of  a  new  medical  diploma.  We  hope  to  so  teach  homoeo- 
pathy as  to  break  down  the  prejudice  which  has  hitherto  excluded 
its  teaching  from  the  ordinary  schools. 

7.  Finally  our  scheme  is  easily  accomplished  with  the  funds  at 
our  disposal ;  theirs  would  need  at  least  ten  times  what  we  have 
been  able  to  obtain. 

8.  It  is  greatly  to  be  deplored  that  Dr.  Drysdale  and  his 
friends  have  taken  the  means  of  outside  agitation  and  opposition 
in  place  of  arguments  within  the  council  of  the  School  (on  which 
two  of  their  number  have  seats).  By  this  agitation  a  grave 
direct  loss  has  accrued  to  our  funds,  and  Dr.  Drysdale  now 
goes  the  lamentable  length  of  still  further  directly  attempting 
to  injure  our  financial  position  by  an  appeal  to  his  friends  to 
cease  their  subscriptions  until  he  and  they  gain  their  point,  and 
over-ride  the  wishes  of  the  majority. 

9.  His  present  pretence  is  that  our  payment  of  three  hundred 
and  fifty  guineas  to  the  Hospital  is  bad  in  policy  and  injurious  to 
the  true  interests  of  the  School.  He  would  divide  the  School 
from  the  Hospital,  or  at  least  he  woiild  have  us  obtain  the  clinical 
advantages  from  the  Hospital  without  pat/in^  for  them, 

10.  The  managers  of  the  School,  on  the  other  hand,  maintain 
that  clinical  instruction  is  a  very  necessary  part  of  the  School's 
teaching.  That  since  the  funds  of  the  Hospital  are  insufficient 
to  support  half  the  number  of  beds  which  it  can  supply  (in  all, 
the  Hospital  contains  sixty-five  beds,  but  can  only  support  thirty 
with  the  funds  at  its  disposal)  the  School  should  set  apart  as 
large  an  amount  of  its  funds  as  it  can  afford  to  open  a  larger 
number  of  beds  for  clinical  teaching.  On  the  calculation  that 
thirty-five  guineas  a  year  support  one  bed  annually,  the  School 
has  hitherto  paid  350  guineas  a  year  to  the  Hospital,  and  thus 
kept  open  ten  beds  a  year,  which  would  otherwise  have  been 
closed. 

11.  I  leave  the  question  now  to  the  good  sense  of  the  readers. 
If  we  are  to  carry  out  our  original  idea,  which  was  to  educate 


The  London  School  of  Homceopathy.  95 

medical  men  in  homoeopathic  medicine  and  surgery,  practically 
and  theoretically,  in  order  to  supply  the  homcBopathic  public  with 
reliable  practitioners,  I  do  not  see  how  we  can  spend  the  funds 
entrusted  to  us  better  than  by  subsidising  lecturers  until  the 
School  becomes  large  enough  to  be  self-supporting,  and  by  paying 
a  reasonable  sum  to  the  Hospital  for  the  use  of  its  beds  and 
dispensary. 

12.  The  Liyerpool  Homoeopathic  Medico-Chirurgical  Society 
wrote  a  letter  to  the  committee  of  our  School  in  the  same  strain 
as  that  adopted  by  Dr.  Drysdale.  I  do  not  see  how  the  London 
School  of  Homoeopathy  could  in  any  way  submit  its  concerns 
either  of  finance  or  management  to  another  society.  We  must 
act  in  accordance  with  our  own  rules  and  with  the  wishes  of  the 
majority  of  our  subscribers  and  donors,  whose  wishes  I  am  sure 
I  hare  £iirly  represented  aboye. 

Bemarks  on  theforegotngy 
By  Drs.  Dbysdalx,  Blags,  and  DxrnGEOir. 

§1.  We  hare  not  attacked  the  '*  School,"  but  we  are  at 
present  endeavouring  to  defend  its  very  existence  from  the 
present  managers,  the  committee  of  the  School,  who,  mainly 
composed  of  hospital  officials,  are  diverting  the  funds  from  the 
proper  purpose  of  the  School. 

§  2.  We  do  not  propose  to  teach  homoeopathy  8uh  rosdy  but 
desire  that  the  same  lectures  should  be  given  by  the  same  men 
in  the  same  words,  under  a  title  analogous  to  the  most  successful 
•diool  in  America,  the  Boston  University. 

§  §  3  and  4.  We  desire  both  to  teach  homoeopathy  and  to 
bave  our  lectures  recognised  now,  just  as  will  ultimately  happen, 
when  the  truth  of  the  homoeopathic  law  of  therapeutics  is  uni- 
Tersally  acknowledged  in  medicine.  This  question  is  too  large 
to  be  reargued  in  the  present  place.  Dr.  Bayes'  remarks  are 
merely  a  repetition  of  his  former  appeal  to  the  popular  and 
superficial  view  of  the  subject,  which  we  have  sho^n  to  be  an 
anachronism  in  the  present  state  of  things.  To  this  Dr.  Bayes 
gives  no  reply,  and  we  therefore  refer  the  reader  to  our  former 
letter. 

§  5.  We  do  not  understand  the  "  catholicity  "  of  the  plan 
which  would  add  a  new  school,  with  a  sectarian  title,  to  the 


96  Miscellaneous. 

already  existing  school.    We  desire,  on  the  contrary,  to  teach 
the  truth  in  a  school  of  medicine  simply. 

§  6.  We  do  not  at  all  desire  to  get  up  a  '*  sectarian  and  oppo- 
sition scheme  necessitating  the  formation  of  a  new  medical 
school,  and  possibly  the  establishment  of  a  new  medical  diploma," 
on  the  contrary,  our  earnest  wish  is  that  Ihe  School  should  be 
so  conducted,  that  its  lectures  should  count  in  the  ordinary 
examinations  required  by  the  existing  Examining  Boards.  The 
only  occasion  when  we  have  ever  heard  of  the  recommendation 
of  a  separate  school  and  new  diploma,  was  in  a  paper  read  lately 
before  the  British  HomoBopathic  Society  by  Dr.  Bayes  himself, 
which  met  with  almost  unanimous  condemnation  from  the  mem- 
bers in  the  discussion  that  followed  it. 

§  7.  We  do  not  pretend  that  our  plan  is  easy  to  accomplish, 
and  we  grant  that  the  present  plan  of  spending  one  half  of  our 
funds  on  the  Hospital's  ordinary  expenses,  and  the  other  half  on 
lectures  delivered  to  a  few  qualified  medical  men  who  may 
happen  to  be  in  London,  is  very  easy  to  accomplish,  but  what 
is  the  value  of  the  accomplishment  ? 

§  8.  Our  appeal  to  the  subscribers  to  suspend  the  payment  of 
their  subscriptions  is  forced  upon  us  by  the  refusal  of  Dr. 
Bayes  to  grant  a  fair  discussion  of  the  subject.  We  warned  him 
that  this  must  be  the  necessary  effect  of  his  refusal,  but  he  per- 
sisted in  telling  us  that  the  appeal  to  a  committee,  composed 
mainly  of  hospital  officials  and  others  already  pledged  to  take 
the  subsidy,  was  a  perfectly  satisfactory  proceeding.  How  the 
plan  answered  Dr.  Bayes'  expectations  was  shown  by  what 
actually  happened  this  year  (1878) .  A  sub-committee,  consisting 
of  certain  members  of  the  council  and  some  other  gentleknen,  was 
appointed  to  discuss  certain  points  having  special  reference  to 
the  contemplated  New  Medical  Act  Amendment.  This  sub- 
committee, at  which  were  present,  if  we  remember  rightly,  Drs. 
Bayes,  Drysdale,  Black,  Dudgeon,  Hughes,  and  J.  Jones,  met  on 
May  13th,  1878.  A  proposition  that  the  subsidy  from  the 
School  to  the  Hospital  should  be  discontinued,  was  proposed  for 
discussion  at  the  next  meeting.  No  meeting  was  called  until 
the  5th  November.  At  that  meeting  were  present,  Dr.  Bayes, 
Mr.  Vaughan  Morgan,  who  holds  the  double  office  of  Treasurer 
to  the  School  and  Treasurer  to  the  Hospital,  Drs.  Kidd,  Black, 
and  Dudgeon.     A  majority  of  those  present,  viz.  Drs.  Sadd, 


The  London  School^  of  Homotopathy ,  97 

Black,  and  Dudgeon,  supported  a  recommendation  that  the  sub- 
sidy from  the  School  to  the  Hospital  should  be  discontinued  after 
1879,  Dr.  Dudgeon  expressing  the  opinion  that  it  should  be  dis- 
continued at  once.  This  was  opposed  by  Dr.  Bayes  and  Mr. 
Yaughan  Morgan.  The  Committee  of  Management  of  the 
School  met  on  the  11th  November,  and  unanimously  resolved  not 
to  adopt  the  recommendation  of  the  sub-committee. 

It  is  a  great  mistake  to  suppose  that  we  are  opposed  to  clinical 
instruction  in  the  School,  on  the  contrary,  we  deem  it  of  essential 
importance,  but  we  believe  it  can  be  obtained,  and  is  obtained, 
at  the  Hospital  independently  of  the  subsidy  from  the  School. 
The  clinical  instruction  given  by  Drs.  Hughes  and  Cooper  is 
entirely  confined  to  out-patients ;  that  given  by  Drs.  Dyce 
Brown  and  Galley  Blackley  is  partly  out-patients  and  partly  in- 
patients. Were  there  even  only  thirty  beds,  and  were  these 
divided  between  two  clinical  teachers  for  a  certain  period,  say 
six  months,  in  place  of  being  shared  by  four  at  the  same  time, 
each  clinical  teacher  would  have  fifteen  beds  for  the  purpose  of 
clinical  instruction,  a  number  of  beds  equal  to  that  at  the  com- 
mand of  several  of  the  best  teachers  in  University  College  Hos- 
pital. Fleiachmann's  Hospital  in  Vienna,  which  has  furnished 
such  admirable  statistics,  and  which  has  told  so  powerfully  on 
the  profession,  did  not  contain  more  than  thirty  beds.  With 
the  handsome  legacy  left  to  the  hospital  by  Dr.  Quin,  the 
namher  of  beds  in  the  Hospital  can  easily  be  kept  up  to  the 
Tequirements  of  the  clinical  teachers,  without  drawing  upon  the 
scanty  resources  of  the  School.  One  of  the  arguments  used  at 
the  above  meeting  was,  that  by  giving  350  guineas  to  the  Hos- 
pital, the  Treasurer  of  the  School  (who  is  also  the  Treasurer  of 
the  Hospital)  would  possess  an  equal  number  of  votes  for  use  at 
the  general  meetings  of  the  Hospital,  the  advantage  of  which  we 
were  unable  t^  appreciate. 

§  9.  The  School  was  originally  founded  as  separate  from  the 
Hospital,  and  if  we  use  the  Hospital  by  paying  its  staff  for  teach- 
ing, we  confer  the  greatest  possible  benefit  on  the  Hospital, 
thereby  giving  its  managers  the  advantage  of  being  able  to  appeal 
for  subscriptions  for  a  hospital  with  a  school.  This  Dr.  Bayes 
calls  taking  clinical  advantages  without  paying  for  them  ! 

§  10.  No  school  could  be  expected,  or  ever  was  expected,  to 
devote  half  its  funds  as  a  subsidy  to  the  ordinary  expenses  of  a 

▼OL.  XXXVII,  NO.  CXLVII. JANUARY,  1879.  G 


98  Miscellaneous. 

hospital.  The  pretext  for  taking  them  in  this  instance  was  that 
ten  additional  heds  could  be  opened.  No  such  addition  has 
been  made,  and  now  we  are  told  that  the  subsidy  is  to  prevent 
ten  of  the  present  beds  being  given  up. 

§  11.  Nevertheless,  Dr.  Bayes  goes  on  to  say  that  we  cannot 
spend  the  School  money  better  than  by  subsidizing  the  lecturers 
until  the  School  becomes  self-supporting.  That  is  precisely  our 
own  contention,  onlv  we  do  not  make  use  of  the  word  "  subsi- 
dize,*'  but  simply  say  that  the  School  money  was  subscribed  to 
pay  the  teachers  and  nothing  else,  and  that  it  should  not  be 
squandered  in  the  attempt  to  supply  the  deficiency  of  the  Hos- 
pital subscriptions.  There  are  surely  other  and  better  means 
of  doing  that,  and  certainly  the  presence  of  a  good  staff  of 
teachers  kept  there  by  the  school  must  be  the  greatest  possible 
assistance  for  getting  subscriptions  to  the  Hospital. 

§  12.  As  regards  the  action  of  the  Liverpool  Medico-Chiror- 
gical  Society,  we  do  not  feel  called  upon  to  make  any  remark. 
They  are  a  body  of  independent  gentlemen,  and  have  done  what 
they  think  best  for  the  welfare  of  homoDopathy,  and  we  tmat  the 
general  body  among  us  will  follow  their  example. 


The  late  Madame  Hahnemann. 

OvB  short  obituary  of  the  widow  of  the  illustrious  founder 
of  homoBopathy,  in  our  July  number,  has  apparently  excited 
some  angry  emotions  in  the  breast  of  one  of  her  admirersy  who 
has  addressed  to  us  the  following  letter  and  would-be  refutation 
of  our  assertions  regarding  the  deceased  lady.  The  original  is  in 
French,  but  we  give  a  literal  translation : 

''  2b  the  Editor  of  the  British  Journal. 

''  Sir, — ^A  notice  in  your  Journal  of  the  1st  July  last  contains 
some  utterly  erroneous  statements  respecting  Madame  Hahne- 
mann, whom  science  and  humanity  have  had  the  misfortune  to 

lose. 

''  Whilst  she  was  alive  such  assertions  could  never  have  been 
ventured  to  be  made. 

'*  On  behalf  of  the  illustrious  widow  of  the  immortal  founder  of 
homoeopathy,  her  friends  remain  to  expose  falsehood  and  calumnyi 
and  to  unmask  tbem  to  the  eyes  of  those  who  venerate  truth. 


The  late  Madame  Hahnemann,  99 

^Appended  are  some  recitations  which  I|  submit  to  your 
loyalty,  begging  you  to  be  so  good  as  to  publish  them  in  your 
next  number.  I  send  along  with  them  the  pamphlet  relating  to 
the  process  instituted  by  M.  Orfila,  Dean  of  the  Medical  Faculty 
of  Paris,  where  you  will  find  evidence  of  the  respect  and  admira- 
tion felt  for  Madame  Hahnemann,  not  only  by  her  friends  but 
by  her  enemies. 

"  By  a  letter  dated  the  4th  of  November,  Dr.  Pitet,  editor  of 
the  Journal  entitled  Btbliotheque  Homceopathiqve,  and  general 
secretary  of  the  Federal  Hahnemannian  Society,  No.  6,  £ue  St. 
Georges,  Pans,  expressed  to  me  his  wish  to  join  his  protest  to 
mine,  sharing  my  hope  that  your  feeling  of  justice  would  lead 
jou  to  repair  as  soon  as  possible  the  flagrant  injustice  done  to  an 
unassailable  memory,  but  a  sudden  and  cruel  death  has  juat 
lemored  him  from  his  numerous  friends  and  clients. 

"  I  beg  you,  sir,  to  accept  the  assurance  of  my  sentiments  of 
esteem. 

"  Sanchxs, 
*'  Homme  de  Lettres,  attach^  k  la 
''  Prefecture  de  la  Seine. 

"  ?un,  22nd  November,  1878, 

*•  77,  Bne  de  Vangizard." 

The  following  statement  accompanies  the  above  letter. 

**  Mile.  Marie  Melanie  d'Hervilly  only  changed  her  feminine 
garments  for  male  attire  when  she  was  an  artist,  and  when  she 
vent  alone  into  the  country  to  sketch  some  beautiful  views  and 
landscapes. 

"  The  wearing  of  male  attire  by  lady  and  girl  artists  when  they 
go  to  set  up  their  easel  in  solitary  places,  in  order  to  pursue  their 
artistic  studies,  is  not  only  a  recognised  habit  in  France,  it  is  in  a 
manner  obligatory  on  them.  It  is  a  protection  that  saves  them 
from  the  regards  of  the  curious,  and  which  delivers  them 
especially  firom  the  persecutions  to  which  a  lone  woman  would 
be  exposed  if  found  in  complete  solitude,  and  perhaps  far  from 
instance  ;  it  is  a  warranty  of  high  morality. 

''  Mile.  d'Hervilly  went  to  see  Dr.  Hahnemann  not  so  much 
CD  aecount  of  her  own  health  as  that  of  her  mother,  who  had 
been  given  up  by  the  principal  physicians  of  Paris. 

"  It  was  Hahnemann  who  wished  to  leave  Germany,  where  he 


I 


100  Miscellaneous. 

bad  suffered  so  much  from  the  intrigues,  the  calumnies,  and  the 
wicked  acts  of  his  medical  disciples^  who  were  all  jealous  of  him. 
Madame  Hahnemann  sacrificed  everything  for  his  sake,  even  her 
beautiful  country,  which  sb^  would  have  left  for  ever,  had  he  pre- 
ferred remaining  in  Coethen. 

"  It  was  at  the  reiterated  entreaty  of  bis  new  wife  tbat  the 
doctor  consented  to  divide  his  fortune  among  all  his  children,  and 
to  accept  the  sacrifice  of  her  renunciation  of  the  half  of  this 
fortune  which  was  hers  by  right,  which  sacrifice  Habnemaim 
characterised  rs  fabulous  disinterestedness. 

"Moreover,  Madame  Hahnemann  placed  her  own  fortune, 
which  was  considerable,  at  her  husband's  disposal. 

'^  Hahnemann's  patients  in  Paris  were  very  numerous.  True, 
but  they  were  chiefly  composed  of  a  great  number  of  poor  people, 
all  of  whom  he  treated  gratuitously.  The  immense  number  of 
patients  who  flocked  to  him  caused  it  to  be  thought  that  he  made 
a  great  deal  of  money.     This  was  a  mistake ! 

'*  When  the  doctor  died,  on  the  2nd  July,  1848,  Madame 
Hahnemann  continued  to  treat  patients,  hut  without  any  remunera- 
turn  whatever.  (This  is  corroborated  by  the  accompanying  pam- 
phlet  about  the  prosecution  she  underwent  by  the  Medical  Faculty 
of  Paris,  incited  by  the  Dean,  M.  OrfiU,  and  which,  contrary 
to  the  expectations  of  this  gentleman,  was  a  moral  triumph 
for  the  accused.) 

''  If  the  funeral  of  Hahnemann  was  on  a  modest  scale,  that  was 
certainly  not  from  any  parsimonious  spirit,  but  solely  in  obedience 
to  the  last  wish  of  the  deceased,  and  if  there  is  nothing  to  dis- 
tinguish his  grave  the  reason  of  this  is  that  it  was  wished  to  pro- 
tect it  from  posthumous  outrages  on  the  part  of  jealous  physicians, 
seeing  that,  even  during  his  life,  his  bust  in  his  own  drawing- 
room  had  been  insulted. 

"  It  is  incorrect  to  say  that  after  his  marriage,  and  during  his 
residence  in  Paris,  Hahnemann,  under  the  influence  of  his  wife, 
ceased  his  intercourse  with  the  chief  representatives  of  his  system. 
On  the  contrary,  he  always  corresponded  continuously  with  all 
the  homoeopathic  physicans,  good  and  bad,  throughout  the  whole 
world ;  with  the  former  to  applaud  and  encourage  them,  with  the 
latter  in  order  to  set  them  right.  (This  is  proved  by  the  numerous 
letters  he  received,  as  also  by  his  replies,  which  still  exist  in  manu- 
script.) 


The  late  Madame  Hahnemann,  101 

"  When  about  the  end  of  last  year  Dr.  Bayes  wrote  to  Madame 
Hahnemann  on  the  subject  of  the  Organan  and  some  manuscripts, 
she  replied  to  him  that  she  was  quite  willing  to  give  them  up, 
but  that  having,  like  so  many  others,  lost  her  fortune  owing  to 
the  war  of  1870-71,  she  reqtiired,  in  return  for  the  cession  she 
might  make  of  these  precious  documents,  that  there  should  be 
made  among  the  homoeopathic  physician  of  London  and  their 
patients  a  subscription  sufficient  to  recompense  her.  But  Madame 
Hahnemann  never  indicated  to  Dr.  Bayes  what  sum  should  be  sub- 
scribed. If  she  delayed  the  publication  of  the  OrganoUy  that  was 
by  the  express  orders  of  Hahnemann,  who  shortly  before  he  died 
advised  her  to  wait  until  men's  minds  should  be  settled,  in  order 
that  his  method  might  not  be  exposed  to  controversies  and  dis- 
cuuions  which  he  should  not  be  there  to  reply  to.  So  he  left  it 
to  her  to  determine  the  opportune  moment  for  the  publication. 

"Hahnemann's  second  marriage  was  of  great  advantage  to 
hoDKBopathy,  for  it  prolonged,  his  life  for  eight  years,  and  this 
gave  him  time  to  complete  his  work. 

"  Hahnemann  often  said  to  his  friends  and  children  (the  letters 
of  his  daughters  and  of  all  the  members  of  his  family  bear  witness 
to  this)  that  he  owed  the  prolongation  of  his  life  to  this  sublime 
angel  of  devotedness  sent  by  God  to  reward  him  for  his  labours, 
to  make  him  forget  the  sorrows  and  deceptions  of  all  sorts  he 
had  endured  during  his  long  career,  and  to  give  him  a  preliminary 
taste  of  the  future  life. 

**  Here  is  a  letter,  among  hundreds  of  others,  which  he  wrote 
to  Dr.  Mauro  on  the  4th  October,  1840 : 

"*M.  IB  DooTBrB, — I  received  with  an  inexpressible  feeling 

of  gratitude  Mr. 's  poem  which  you  had  the  goodness  to 

send  me.  I  am  grateful,  not  because  this  poem  exalts  my  public 
merits,  but  on  account  of  the  justice  it  renders  to  homoeopathy. 
The  sentiments  of  attachment  you  kindly  express  touch  my  heart. 
I  am  very  sorry  I  have  not  your  personal  acquaintance,  but  I 
trust  that  at  some  future  time  you  vnll  give  me  the  pleasure  of 
embracing  you.  I  am  thankful  to  the  writer  who  takes  an 
interest  in  my  dear  M61anie ;  it  is  to  her  I  owe  my  happiness  and 
my  life.  God,  in  granting  me  this  treasure,  desired  to  fill  the 
measure  of  His  benefits,  for  in  her  He  has  also  given  me  the  most 
able  and  zealous  of  my  disciples  in  homoeopathy,  which  she  prac- 
tises among  the  poor  with  an  unheard-of  success.     She  is  my 


102  Mi$cettaneou$. 

aBBiBtant  in  all  mj  laboiin,aBd  in  order  to  follow  me  flbe  gave  up 
painting  and  poetry,  in  which  she  excelled.  She  left  heaven  in 
order  to  follow  me  to  ike  abode  of  evffM^  ;  but  her  whole  happi- 
neBB  is  centred  in  me.  She  BajB  God  rewards  her  Buffioiently  by 
mj  invnlnerable  health.    She  is  an  angel  on  earth.' 

"  This  moral  repose,  this  paradise  on  earth,  wUh  hi$  guardian 
angely  chiefly  contributed  to  maintain  the  spirit  of  Hahnemann 
in  all  its  lucidity,  thereby  permitting  him  to  bring  his  work  to 
the  highest  degree  of  perfection.'* 

We  willingly  give  the  above  documents  all  the  publicity  their 
author  desires  for  them ;  the  more  so,  as  far  from  being  a  refuta- 
tion of  what  we  said  in  our  July*number,  they  distinctly  corrobo- 
rate many  of  the  facts  relative  to  Madame  Hahnemann  dLere 
recorded;  and  where  we  differ  we  can  easily  prove  our  corre- 
spondent to  be  mistaken. 

We  mentioned  the  well-known  fact  that  Madame  Hahnemann 
travelled  to  and  from  Coethen  in  male  attire  as  a  pure  piece  of 
history,  and  without  any  idea  of  insinuating  that  there  was  any- 
thing improper  in  the  disguise.  We  might  have  related  a  little 
comic  anecdote  in  connection  with  MUe.  d'HervlUy's  gentle- 
manly appearance  on  her  arrival  at  the  hotel,  which  is  too  good 
to  be  forgotten.  The  barber  attached  to  the  hotel,  as  was  the 
custom  at  Coethen,  presented  himself  the  following  morning  to 
inquire  if  the  gentleman  wished  to  be  shaved,  but  on  entering 
the  bedroom  was  struck  with  consternation  on  finding,  in  place 
of  the  supposed  gentleman,  an  elegant  lady  lacing  her  stays. 
We  are  quite  willing  to  believe  on  M.  Sanches*  authority  that 
the  assumption  by  a  French  lady  of  the  masculine  costume  is 
*'  une  garantie  de  haute  morality,"  but  as  we  never  implied  that 
it  was  immoral,  we  are  inclined  almost  to  regard  M.  Sanches' 
eagerness  to  defend  it  as  an  illustration  of  the  old  saying — qui 
8*excuse,  s'accuse. 

We  accept  with  pleasure  the  explanation  that  it  was  not  her 
own  health,  but  that  of  her  mother,  that  rendered  a  daily  con- 
sultation with  Hahnemann  necessary;  and  yet  this  assertion 
hardly  agrees  with  that  of  her  advocate,  M.  Chaix  d*Est-Ange, 
at  p.  22  of  the  pamphlet  alluded  to,  which  says  that  Mile. 
d'Hervilly  went  to  Coethen  to  consult  Hahnemann  about  her  own 
health,  and  says  nothing  about  her  mother.  But  we  are  unwilling 
|k>  believe,  without  further  evidence,  that  Hahnemann  desired  to 


The  late  Madame  Hahnemann.  108 

quit  Gfermany  in  conaeqnence  of  the ''  intrigues,  calumnieB,  and 
wicked  acts  of  his  medical  diBciples,  who  were  all  jealous  of  him." 
We  find  no  trace  of  this  in  the  history  of  his  relations  with  his 
Oennan  disciples ;  but,  on  the  contrary,  nothing  but  respect  and 
Tenention  of  the  disciples  for  their  great  master. 

The  account  we  gave  of  the  division  of  Hahnemann's  fortune 
among  his  family  is  not  invalidated,  but,  on  the  contrary,  con- 
firmed  by  that  given  in  the  above  document. 

The  shabbiness  of  the  funeral  obsequies  is  not  denied,  and  if 
it  was  in  obedience  to  Hahnemann's  express  desire,  we  have 
nothing  to  say. 

The  reason  alleged  for  erecting  no  monument  of  any  sort  to 
distinguish  his  grave  appears  to  us  rather  &r  fetched,  for  we 
pramne  that  the  guardians  of  the  cemetery  of  Montmartre  could 
easily  prevent  any  "  outrages  posthumes  de  la  part  des  medecins 
jaloox"  had  any  one  been  so  foolish  as  to  desire  to  commit 
such  an  indecency.  We  have  a  better  opinion  of  lus  medical 
eonntrymen  than  our  correspondent  seems  to  have. 

We  do  not  doubt  that  Hahnemann  kept  up  a  lively  corre- 
spondence with  many  of  his  disciples,  but  this  does  not  invalidate 
oar  statement  that  he  was  not  very  cordial  in  his  intercourse 
with  many  of  his  most  scientific  disciples  during  the  period  of 
his  Bojoum  in  the  French  capital. 

The  account  given  above  of  Madame  Hahnemann's  proposal  to 
Br.  Bayes  is  inconsistent  with  the  statements  in  her  letter  to 
oar  colleague.  In  that  letter  she  said  that  the  German  invasion 
had  deprived  her  of  her  property,  and  that  she  was  now  totally 
dependent  on  her  practice  for  her  livelihood — which  does  not 
look  as  if  she  practised  entirely  gratuitously  as  M.  Sanches 
anerts — that  in  order  to  edit  the  last  edition  of  the  Organan^ 
which  Hahnemann  had  bound  her  by  a  solemn  promise  not  to 
entruat  to  other  hands,  she  would  have  to  withdraw  from 
practice.  If  she  did  this  she  would  require  a  sum  to  be  raised 
bj  the  English  partizans  of  homoBopathy  that  would  yield 
her  an  income  equivalent  to  that  she  sacrificed  by  giving  up  her 
practice.  She  did  not  name  any  specific  sum  ;  the  sum  we 
mentioned  was  our  estimate  of  what  would  be  required  to  be 
raised  in  England  in  order  to  comply  with  Madame  Hahnemann's 
conditions.  We  do  not  think  we  over-estimated  the  sum  thi^t 
would  be  required,  rather  the  reverse. 


104  MtMceUaneout. 

We  cannot  reconcile  M.  Sanches*  statement  of  the  reason  for 
delfljingthe  sixth  edition  of  the  Organon  with  a  letter  written  by 
Hahnemann  himaelf  to  Dr.  Hirschfeld  on  the  16th  March,  1S43, 
and  qooted  by  Madame  Hahnemann's  advocate  at  the  trial.  He 
there  sajs :  **  I  have  resolved  to  retire  from  practice  before  I  am 
forced  to  do  so  by  the  weakness  of  old  age,  and  by  God's  grace 
I  will  bring  out  the  siith  edition  of  my  Organon,  which  will  be 
more  complete  than  the  others."  This  does  not  look  as  if  be 
wished  the  publication  to  be  delayed  for  thirty -five  years. 

We  have  not  a  doubt  that  Hahnemann's  life  was  rendered 
rerj  pleasant  for  him  in  Paris  bj  his  second  wife,  and  we 
distinctly  said  so,  so  on  this  point  we  are  quite  at  one  with  our 
correspondent,  though  we  did  not  speak  of  the  lady  in  M. 
Ranches'  high-flown  Ghtllican  hyperbolical  style  as  *"  un  ange 
sublime  de  d^vouement."  Translated  into  plain  English  this 
probably  means  that  the  lady  took  great  care  of  her  octogenarian 
husband. 

That  Hahnemann  lived  eight  years  after  his  migration  to  Paris 
does  not  necessarily  imply  that  his  life  was  prolonged  by  eight 
years  in  consequence  of  his  second  marriage,  as  M.  Sanches 
asserts,  for  we  might  just  as  reasonably  assert  that  he  woald 
have  lived  sixteen  years  longer  had  he  not  been  subjected  to  all 
the  excitements  of  his  second  nuptials  and  subsequent  Paris  life. 

That  the  last  eight  years  of  his  life  were  advantageous  to 
homcBopathy  we  altogether  doubt.  Ills  literary  activity  ceased 
after  quitting  Germany,  and  as  Madame  Hahnemann  refrained 
from  publishing  his  latest  alterations  of  the  Organon^  we  cannot 
judge  whether  he  made  any  improvements  in  it  or  not.  Judging 
from  the  little  value  of  the  emendations  he  made  in  the  fourth 
and  fifth  editions  of  the  Organon^  we  do  not  anticipate  that 
homcBopathy  will  gain  much  by  the  publication  of  the  sixth 
edition. 

Our  reader.^  will  now  be  able  to  judge  for  themselves  if  our 
notice  of  Madame  Hahnemann,  published  in  our  July  number, 
contains,  as  M.  Sanches  asserts,  *'  des  assertions  completement 
erroni^es/'  and  if  there  is  anything  in  it  that  can  be  fittingly 
characterised  as  "  le  mensonge  et  la  calomnie."  These  epithets, 
had  they  been  applied  to  our  article  by  some  phlegmatic  Briton, 
we  and  he  would  have  felt  justified  in  taking  no  notice  of 
the  so-called  refutations,   but  we    do   not   attach    the  sam^ 


Medical  Liberality  Tested  and  found  Wanting.      105 

meoniog  to  them  when  proceeding  from  an  excitable  Frenchman. 
Some  of  our  G-allican  neiglibours  are  so  much  in  the  habit  of 
UBiDg  strong  language  that  when  they  call  a  man  ''a  liar  and 
a  calumniator  "  thej  only  mean  that  they  differ  from  him  in 
opinioD,  juBt  as  they  talk  of  a  woman  who  marries  an  old  man  and 
tries  to  make  him  comfortable,  in  place  of  flirting  with  younger 
men,  as  '*  un  ange  sublime  de  d^vouement  envoye  par  Dieu,"  and 
as  they  term  the  comfort  thus  enjoyed  by  the  old  man  ^'  un 
avant-gout  precurseur  de  la  vie  future."  The  redundancy  of 
the  expression  "avant-gout  precurseur"  is  worthy  of  remark. 
Unless  we  saw  the  actual  letter  in  Hahnemann's  handwriting, 
we  should  doubt  the  expression,  "  Elle  a  quitte  le  del  pour  me 
Buiyie  dans  le  s^jour  des  douleurs,"  being  his.  As  his  faithful 
Melanie  acted  as  his  secretary  and  wrote  most  of  his  letters,  we 
think  we  may  put  down  this  elegant  expression  to  her  credit. 
Whatever  Hahnemann  desired  to  say,  his  angelic  amanuensis 
would,  no  doubt,  take  care  ^  que  cela  f{lt  toum6  gentiment." 


Medical  Liberality  Tetted  and  found  Wanting. 

We  had  not  been  without  hopes  that  liberality  of  thought  and 
feeling  in  the  medical  profession  had  been  growing  of  late  years, 
and  that  nothing  but  opportunities  were  wanting  to  bring  to 
Kght  a  very  different  spirit  from  that  which  prevailed  twenty 
years  ago.  The  action  of  the  Birmingham  practitioners  with 
reference  to  membership  of  the  Midland  Institute  some  two 
jears  ago  strongly  encouraged  our  hopes,  and  we  have  not 
abandoned  them  as  regards  our  own  country.  Two  recent 
occnrrences,  however,  show  that  in  the  United  States  and  in 
British  India  the  practitioners  of  medicine  are  still  living  in  the 
dark  ages  of  prejudice  and  intolerance,  and  must  be  left  to  grow 
yet  awhile  ere  we  can  hope  to  associate  with  them  as  brethren. 

The  story  of  what  has  recently  occurred  in  Calcutta  was  fully 
told  by  our  Monthly  contemporary  for  December,  and  we  need 
not  repeat  it  in  detail  here.  It  is  sufficient  to  state  that  Dr. 
Sircar,  a  graduate  and  fellow  of  the  Calcutta  University,  a 
physician  of  unblemished  character  and  recognised  zeal  for 
Bcienee,  was  considered  by  the  authorities  of  the  University  a 
•citable  person  to  b^  placed  on  th^  Senate,  and,  as  every  membey 


106  BliseelUmeoui. 

of  tliftt  bodjr  thonld  belong  to  one  or  other  of  tbe  Facnlties 
they  naturaUj  placed  him  on  that  of  Medieine.  Ebreupon  acose  a 
loud  protest  on  the  part  of  the  other  members  of  the  faculty, 
ending  in  their  resignation  (with  a  single  exception)  in  a  body. 
On  inqniiy  being  made  as  to  the  ground  of  this  action  on  their 
part  their  reply  was  **  that  they  were  nnable  to  associate  them- 
selyes  as  a  fiMmlty  of  medicine  with  a  member  who  professes  and 
practises  hommopathy.'*  Dr.  Sircar  thereupon  wrote  a  letter 
asking  why  this  simple  exercise  of  his  medical  freedom  should 
disqualify  him  for  professional  fellowship,  and  anticipating  the 
only  tenable  ground  of  complaint  by  showing  that  he  had  never 
"  professed  or  practised  homoeopathy  as  an  exdusive  system,*'  so 
as  to  bind  himself  to  no  other,  but  had  simply  gone  somewhat 
further  in  recognising  its  yalue  than  Hippocrates,  Hufeland, 
Listen,  and  Bmnton,  whose  words  he  quotes.  To  this  the 
members  of  the  faculty  make  the  following  astonishing  reply : — 
They  *'do  not,  in  the  very  faintest  degree,  desire  to  impose 
restrictions  upon  the  most  perfect  freedom  of  opinion  and  practice 
in  medical  science,  nor  do  they  pretend  to  condemn  a  profes- 
sional brother  for  entertaining  views  divergent  from  their  own  : 
they  simply  maintsin  that  homoDopathy  is  based  upon  principles 
and  methods  of  inquiry  which  are  diametrically  opposed  to  what 
tbey  believe  to  be  the  true  principles  and  methods  of  sound, 
logical,  inductive  reasoning,  and  careful,  and  thoroughgoing 
research,  and,  entertaining  such  a  belief,  they  necessarily  feel 
that  there  can  be  no  common  meeting  ground  of  thought  and 
opinion  between  themselves  and  individusls  who  profess  and 
practise  homoopathy."  That  is  to  say,  in  plain  words,  you  may 
believe  and  practise  what  you  think  reasonable  so  long  as  it  is 
not  something  which  we  think  unreasonable.  What  prospects  are 
there  for  liberty,  for  truth,  for  progress,  in  such  an  attitude  as 
this? 

Dr.  Sircar  has  borne  himself  admirably  through  this  contest, 
and  may  be  assured  of  the  sympathy  of  his  colleagues  every- 
where, as  he  has  had  that  of  his  fellow-citizens  (expressed 
through  the  press)  and  of  the  Senate,  which  has  sustained  its 
action. 

The  American  incident  to  which  we  have  referred  is  best 
related  in  the  following  leading  article  from  the  New  York 
Medical  Beeord  for  August  10th,  1878.    We  have  recently  been 


Medical  lAberaliiy  Tested  and  found  Wanting .     107 

raeeirmg  this  excellent  journal  as  an  *^  exchange/'  and  are 
pleased  to  find  in  its  columns  the  same  courtesy  and  liberality 
vhieh  hare  led  to  its  being  sent  to  us. 

^HomcBopathy  and  Exelumeness. 

^  The  Medical  Society  of  the  County  of  New  York  at  its  last 
meeting  had  a  question  brought  before  it  by  the  Comitia  Minora 
(Executive  Committee)  which  involyes  many  important  con- 
siderations. It  appears  that  one  of  the  members  of  the  Society 
had  requested  the  Comitia  to  inform  him  officially  whether  the 
lecent  action  of  the  Homoeopathic  Society  of  the  State  of  New 
York  released  its  members  from  the  ban  of  exclusireness  as  regards 
consultations  which  has  heretofore  been  placed  upon  them  by 
the  profession.  It  will  be  remembered  that  this  actipn  of  the 
HomcBopathic  Society  was  reported  in  our  columns  some  months 
ago. 

"The  Code  of  Ethics  of  the  American  Medical  Association 
upon  this  point  reads  as  follows : 

"  *  But  no  one  can  be  considered  a  regular  practitioner  or  a  fit 
associate  in  consultation  whose  practice  is  based  on  an  exdusiye 
dogma  to  the  rejection  of  the  accumulated  experience  of  the 
profession  and  the  aids  actually  furnished  by  anatomy,  physiology, 
and  organic  chemistry.' 

"  The  exclusive  dogma  referred  to  at  the  time  when  this  code 
was  formulated  was  probably  that  of  Homoeopathy,  viz.  that  all 
diaeases  should  be  treated  in  accordance  with  the  proposition 
timlia  Hmilibus  eurantitr. 

"  It  has  long  been  notorious  that  many  professed  homoBopaths 
bave  not  as  a  fact  treated  their  patients  exclusively  in  the  man- 
ner indicated.  For  years  many  of  them  have  selected  their 
remedies  upon  allopathic  and  antipathic  as  well  as  upon  homoeo- 
pathic indications.  In  view  of  the  fact  that  at  all  their  colleges, 
iuiatomy,  physiology,  chemistry,  and  the  other  fundamental 
branches  of  a  medical  education  are  taught,  it  would  be  absurd 
^  Bay  that  they  do  not  avail  themselves  of  the  aids  furnished  by 
these  branches  of  science.  It  is  indeed  quite  recently  that  they 
hare  made  a  public  declaration  bearing  upon  these  facts. 

"  Under  the  circumstances,  then,  the  Comitia  haye  been  asked 
to  state  their  opinion  as  to  whether  the  so-called  liberal  homoeo- 


108  MisceUaneovs. 

paths  are  really  excluBive  practitioners  under  the  code.    The 
reply  was  as  follows : 

"  *  That  strict  adherence  to  the  proposition,  "  Similia  similibus 
eurantur,**  in  the  selection  of  medicines  and  the  rejection  of 
''  the  aidtfumiihed  hy  aftatom^f  physiology,  pathology ,  and  orgamie 
chemiitry,^*  constitutes  exclusiveness.' 

" '  Those  who  do  not  reject  the  aids  referred  to,  and  who  do 
not  prescribe  homceopathically  when  better  ways  are  known  to 
them,  are  not  exclusive.  The  only  exclusiyes  in  this  country 
known  to  the  Comitia  Minora  are  a  minority  of  the  HomcBopathic 
Medical  Society  of  the  County,  and  the  members  of  the  Eclectic 
Medical  Society,  the  constitution  of  whose  State  organisation 
excludes  the  employment  of  "  antimonials,  mercurials,  and  vene- 
section." ' 

*'  The  adoption  of  this  portion  of  the  Comitia's  Beport,  when 
brought  before  the  Society,  gave  rise  to  considerable  discussion, 
and  was  finally  rejected  by  a  vote  of  82  to  20,  a  goodly  number 
of  members  present  not  voting. 

"  There  is  very  little  doubt,  on  the  one  hand,  that  the  report  of 
the  Comitia  was  technically  correct,  and  on  the  other  hand,  there 
was  a  great  deal  of  opposition  to  consulting  with  professed 
homoeopaths  on  any  terms.  It  was  this  latter  feeling  which 
undoubtedly  influenced  the  vote.  Under  these  circumstances, 
as  in  many  others,  societies  frequently  decide  points  at  issue 
from  prejudice  rather  than  reason. 

"  A  careful  examination  of  this  question  leads  us  to  the  belief 
that  the  Comitia  could  not  have  met  it  in  any  other  manner 
than  they  did,  and  that  the  action  reveals  the  fact  that  the  Code 
is  defective,  insomuch  as  it  does  not  at  present  cover  what  the 
majority  of  ihis  Society  believe  to  be  the  requirements  of  this 
case.  If  it  is  the  desire  of  the  Society,  or  of  the  regular  profes- 
sion to  exclude  from  professional  fellowship  all  those  who  are 
connected  with  homoeopathic  organizations,  or  who  practise 
homoeopathy,  then  it  will  be  obviously  necessary  to  enact  a  suit- 
able bye-law  or  procure  a  necessary  amendment  to  the  Code. 

"  The  importance  of  a  strict  interpretation  of  the  facts  would 
be  readily  perceived  were  such  a  ease  of  alleged  violation  of  the 
Code  brought  to  trial.  The  laws  which  govern  the  profession  of 
tlie  State  of  New  York  confer  upon  the  County  Sociecies  certain 
powers  and  privileges,  among  others  that  of  adopting  any  bye- 


Ohiiuary—Dr .  F.  F,  Quin,  '  10& 

kw8  they  choose,  so  long  as  they  are  not  contrary  to  the  sta- 
tutes. 

"  The  Medical  Society  of  the  State  of  New  York  has  adopted 
a  Code  of  Ethics  as  a  portion  of  their  hye-laws,  and  there  is  little 
doabt  if  a  member  of  their  Society  were  convicted  of  a  breach  of 
the  Code  for  consulting  with  a  liberal  homosopath,  that  any  and 
erery  court  in  the  State  wonld  reverse  the  decision  of  the  Society 
on  the  grounds  of  illegality,  and  thus  place  the  charter  of  the 
Sodety  in  jeopardy.  The  reason  for  this  statement  is  obvious 
enough  when  we  consider  that  no  member  of  a  society  can  be 
convicted  of  an  offence  that  is  not  provided  for  by  its  bye-laws  ; 
and  as  there  is  no  provision  against  consultations  with  homcep- 
paths  as  such,  but  simply  against  them  as  ezclusives,  when  their 
ezclusiveness  is  dropped  that  portion  of  the  Code  necessarily 
becomes  null  and  void.  If  it  is  desired  to  exclude  them  in  con- 
sequence of  their  belief  in  the  ability  of  prescribing  in  accord- 
anch  with  the  law  of  similars,  it  will  be  necessary,  as  before 
stated,  to  provide  for  thom  by  new  enactments." 

The  "if  "  here  speaks  for  itself.  There  is  no  doubt  that  such 
is  the  wish  of  the  majority  who  annulled  the  judgment  of  their 
own  Executive  Committee ;  and  in  any  other  profession  but  that 
of  medicine  its  very  statement  would  be  sufficient  to  bring  down 
a  storm  of  condemnation.  That  it  has  remained  without  disavowal 
by  those  whom  it  concerns  is  sufficient  to  show  the  unen- 
lightened state  of  the  medical  men  of  the  County  of  New  York. 

In  the  &ce  of  such  facts,  we  can  only  sigh  out,   ^^  Spero 


OBITUARY. 


Dr.  F.  P.  QTJIN. 

On  the  24th  November  last  there  passsed  from  among  us  one 
vbose  name  has  been  conspicuous  in  the  annals  of  British  homoeo- 
pathy for  upwards  of  half  a  century.  A  native  of  Scotland,  the 
subject  of  this  notice  was  born  in  the  year  1799 ;  at  his  death  he  was 
therefore  in  his  eightieth  year.  He  took  his  degree  at  Edinburgh 
in  1820,  and  was  fortunate  in  soon  afterwards  being  appointed 


110  Obituary, 

physician  to  the  late  King  of  ^the  Belgians,  then  Prince  Leopold, 
with  whom  he  travelled  on  the  Continent.  We  believe  he  first 
became  acquainted  with  homoeopathy  at  Naples,  and  was  satisfied 
that  it  was  a  real  advance  in  therapeutics.  He  is  commonly  said 
to  have  introduced  homoeopathy  into  England  in  1827,  and  no 
doubt  he  did  practise  the  system  during  his  occasional  visits  to 
England,  but  he  was  not  estabUshed  in  practice  until  several 
years  later.  Previous  to  his  settlement  in  England  homoeopathy 
had  been  employed  at  our  court ;  Queen  Adelaide  having  got 
over  Dr.  Stapf  to  treat  her  for  some  malady,  and  Dr.  Belluomini 
liaving  enjoyed  a  moderate  amount  of  practice.  However  Stapf 's 
flying  visit  and  Belluomini's  limited  sphere  of  operation  exercised 
no  influence  on  the  spread  of  homoeopathy  in  this  country,  and 
it  was  not  till  the  advent  of  Dr.  Quin,  shortly  followed  by  Mr. 
Leaf's  importation  of  Dr.  Curie,  that  homoeopathy  can  be  said 
to  have  gained  a  footing  among  the  English  public.  For  ihia 
purpose  these  two  men  were  admirably  qualified  each  in  his  own 
way.  Dr.  Quin's  large  acquaintance  with  members  of  the  upper 
ranks  of  society,  and  his  charming  social  manners,  contributed 
greatly  to  tbe  dissemination  of  homoeopathic  treatment  among 
the  aristocracy,  while  Dr.  Curie's  plodding  zeal  and  pains- 
taking devotion  to  dispensary  and  hospital  work,  brought  homcs- 
opathy  to  the  knowledge  of  the  lower  stratum  of  English  life. 
Two  such  centres  of  proselytism  soon  attracted  a  crowd  of  earnest 
medical  inquirers,  and  it  is  a  moot  point  which  of  these  two 
pioneers  of  our  system  could  claim  the  largest  number  of  con- 
verts. Dr.  Quin  survived  his  French  contemporary  by  fourteen 
years,  but  his  influence  on  homoeopathy  was  not  much  felt 
during  those  years,  as  his  poor  health  compelled  him  to  retire 
almost  completely  from  any  prominent  participation  in  the 
public  acts  of  homoeopathy  and  latterly  forced  him  to  abandon 
his  private  practice. 

Dr.  Quin  has  not  contributed  largely  to  the  literature  of 
homoeopathy  during  his  long  career.  His  chief  literary  pro- 
duction was  a  treatise  in  French  on  the  homoeopathic  treatment 
of  cholera,  which  disease  he  had  had  an  opportunity  of  treating 
in  1831,  at  Tischnovitz  in  Moravia,  having  taken  temporarily  the 
place  of  Dr.  Qerstel,  who  had  charge  of  the  patients,  during  Dr. 
Q-erstePs  illness.  He  edited  Hahnemann's  Fra^tnenta  de  Virtbus 
and  the  Fharmawpcria  SomoBopathioa^  and  we  believe  translated 


Dr.  F.  F.  Qwin.  Ill 

Hahnemann's  Beine  Arzneimittellehre  into  English,  and  even  had 
the  translation  print€d,  but  why  he  did  not  publish  it  we  have 
neTer  been  able  to  learn.  He  contributed  besides  an  interesting 
paper  on  neuralgia  to  the  fourth  volume  of  this  Journal.  But 
though  Dr.  Quin  did  not  contribute  much  to  the  scientific 
deyelopment  of  homoeopathy  he  was  a  great  power  in  its  external 
advancement.  In  addition  to  making  our  system  known  to  a 
large  circle  of  the  most  intellectual  classes  of  society,  he  was 
the  founder  of  the  British  Homoeopathic  Society  and  the  chief 
promoter  and  supporter  of  the  London  HomoBopathic  Hospital. 
We  understand  he  has  left  a  handsome  legacy  of  £200  to  the 
Society  he  was  so  long  connected  with  as  President,  and  that  the 
bulk  of  his  fortune  has  been  made  oyer  to  trustees  on  behalf  of 
the  Hospital  he  was  mainly  instrumental  in  establishing. 

Dr.  Quin's  intercourse  with  his  colleagues  was  always  distin- 
gmahed  bj  frankness  and  cordiality,  and  his  acts  of  kindness 
towards  many  of  the  younger  members  of  our  profession  are 
remembered  with  gratitude.  Like  many  others  who  haye 
attuned  to  eminence,  he  was  yery  fond  of  haying  his  own  way, 
and  did  not  always  bear  opposition  to  his  yiews  with  philosophic 
calmness,  but  on  the  whole  we  must  allow  that  his  influence  on 
our  homoBopathic  world  has  been  decidedly  fayourable,  and  it  ia 
to  the  high  standard  he  set  up  that  homoeopathy  is  indebted  in 
•ome  degree  to  the  present  respectable  and  respected  position 
of  its  practitioners.  Perhaps  had  he  wielded  the  power  he  at 
one  time  undoubtedly  possessed  oyer  his  colleagues  in  order  to 
ioduce  them  to  take  up  a  more  aggressive  attitude  towards  the 
orthodox  system  he  might  have  gained  for  homoeopathy  a  greater 
temporary  eelat^  but  we  doubt  if  such  pushing  strategy  would 
have  been  advantageous  to  homoeopathy  in  the  long  run.  We 
believe  he  exercised  a  wise  discretion  in  restraining  the  ardour 
of  his  young  colleagues,  and  always  insisting  that  they  should 
heep  well  'within  the  bounds  of  professional  etiquette.  The 
instances  within  our  knowledge  where  these  principles  have  not 
been  observed  do  not  serve  to  invalidate  the  safe  tactics  pursued 
and  enjoined  by  our  deceased  colleague. 

Perhaps  Dr.  Quin  will  be  remembered  by  a  wider  circle  as  an 
amusmg  companion  and  a  wonderful  story-teller,  than  as  a 
homoeopathic  doctor :  for  to  the  last  almost  he  was  a  welcome 
guest  at  the  tables  of  some  of  the  highest  personages  in  the  land 


112  Books  Received. 

and  like  Yorick  he  invariably  contrived  to  set  their  tables  "  on 
a  roar."     "We  may  say  of  Dr.  Quin,  what  we  have  no  doubt  he 
would  have  felt : 
"  Principibus  placuisse  viris  non  ultima  laus  est.*' 


BOOKS    RECEIVED, 


Cyelopadia  of  the  Practice  of  Medicine.  Edited  by  Dr.  H.  von 
ZiEMSBEN.  Vol.  VIII,  "  Diseases  of  the  Chylopoetic  System." 
London  :  Sampson  Low.     1878. 

The  Uncyclopadia  of  Pure  Materia  Medica.  Edited  bv  T.  F. 
Allen,  A.M.,  M.D.  Vol.  VIII.  New  York :  Boericke  &  Tafel, 
1878.     London  :  Turner,  170,  Fleet  Street. 

The  Oerm  Theories  of  Infectious  Diseases.  By  J.  Dbysdale, 
M.D.     London :  Bailliere,  1878. 

Natrum  Muriaticum.     By  J.  C.  Buenett,  M.B.     1878. 

The  Nerves.    By  Dr.  Henbt  Belcheb.    London:  G-ould,  1878. 

Clinical  Lectures  upon  Inflammation  and  other  Diseases  of  the 
Ear.  By  E.  T.  Coopeb,  M.D.,  &c.  London  Homceopathic 
Publishing  Company.     1878. 

Hygienic  Medical  Handbook.  For  Travellers  in  Italy.  By 
C.  LiBEBALi,  M.D.    Rome.     1878. 

Row  to  Take  Care  of  our  Eyes,  By  H.  C.  Anoell,  M.D. 
BoHton.     1878.     London  :  Turner,  170,  Fleet  Street. 

St.  Louis  Clinical  Record. 

The  HomoBopathist. 

Eevue  Homaeopathique  Beige. 

The  Monthly  Homaopathic  Revieto. 

The  Hahnemannian  Monthly. 

The  American  Homceopathic  Observer. 

The  United  States  Medical  Investigator. 

The  North  American  Journal  of  Homceopathy. 

The  New  England  Medical  Gazette. 

El  Oriterio  Medico. 

Bihliothhque  Homosopathique. 

L'Art  Mddical. 

Bulletin  de  la  Sociiti  Med.  Horn,  de  France. 

The  Calcutta  Journal  of  Medicine. 

Allgemeine  homoopathische  Zeitung. 

Ohio  Medical  and  Surgical  Reporter. 

The  Homceopathic  World. 

The  Hommopathic  Times. 

V Homoeopathic  Militante. 

The  Organon. 

El  Hahnemanniano  (a  new  Havana  Journal). 


TH2 


BRITISH   JOURNAL 


ow 


HOKEOPATHY. 


NOTES     ON     DIABETES. 
By  FsANCis  Black^  M.D. 

(ConHwusdfrom  p,  60.) 

Abtificial  Gltcositria* 

Accurate  diagnosis  of  a  disease  is  necessary  to  the 
kmation  of  a  correct  picture  for  which  the  therapeutic 
ualogne  is  to  be  found ;  and  for  accurate  diagnosk^  of 
ntany  diseased  states  the  characteristics  of  the  urine  are 
all-important,  as  offering  direct  indications  in  the  choice 
^  a  remedy.  It  is  now  familiar  knowledge  that  the 
diaracter  of  the  urine  often  gives  the  clue,  not  only  to  a 
fenal  lesion,  but  to  constitutional  disease.  In  Hahnemann's 
active  career  this  knowledge  was  not  valued  ;  chemistry 
and  the  microscope  had  done  little  or  nothing  for  the 
examination  of  the  urine,  hence  in  his  materia  medica  the 
Qiioary  symptoms  are  limited  to  general  appearances,  and 
addom  afford  characteristic  indications.  Characteristic  indi- 
cations have  the  great  advantage  of  limiting  the  selection 
of  a  drug  to  a  small  group  of  medicines,  and  this  is  still 
Mher  restricted  by  the  mode  in  which  the  disease  affects 
the  individual  patient  under  examination ;  the  investigation 
of  the    individual    patient    hinging,    not   on    nosological 

VOL.  XXXVII,  NO.  CXLVIII.— APRIL,  1879.  H 


114  Noie8  on  Diabetes ^ 

arrangements  or  pathological  theories^  but  on  a  careful 
consideration  of  all  the  objective,  and  subjective  morbid 
phenomena  viewed  with  all  the  aid  science  affords.  Granted 
all  the  aids  of  semeiology,  another  factor  is  often  required, 
and  that  is  experience.  The  law  of  similars  suggests  the 
remedy,  but  it  is  experience  which  coins  the  ingot,  and 
gives  the  mint  stamp  of  currency. 

Independently  of  all  theory  diabetes  may  be  considered 
to  consist  in  the  inability  to  assimilate  sugar,  aud  the 
majority  of  its  symptoms  being  attributable  to  the  amount 
of  sugar  iu  the  blood,  and  consequently  appearing  in  the 
urine,  glycosuria  is  the  characteristic  symptom,  and  the 
important  question  is — 

Under  what  conditions  is  artificial  diabetes  met  with  ? 
Hermann  says  grape  sugar  occurs  in  minute  quantities 
iu  the  blood,  in  the  liver,  in  the  muscles,  and  in  the 
urine.*  Bernard  considers  glycsemia  a  constant  physio- 
logical fact.f  Pavy  agrees  with  him,  but  believes  Ber- 
iiard's  statement  of  the  amount  too  high ;  and  he  attri- 
butes this  to  an  error  in  the  analytic  process,  whereby  a 
reducing  substance  is  formed,  and  a  certain  amount  of  the 
reaction  is  due  to  this,  and  not  entirely  to  the  sugar. 
Bernard  puts  the  normal  proportion  of  sugar  in  blood  at 
1  per  1000 ;  below  that  he  considers  that  nutritive  action  is 
not  carried  on  to  its  full  extent ;  while  above  3  per  1000  the 
limit  of  capacity  is  passed,  and  sugar  appears  in  the  uriue.^ 

Healthy  urine,  on  the  autliority  of  Briicke  (1858),  aud 
later  on  that  of  Bence  Jones,  contains  the  very  slightest 
traces  of  sugar;  Seagen  (1872)  and  others  contradict  this.§ 
C.  Bernard  says  that  in  man  and  in  animals  it  is  extremely 
difficult,  not  to  say  impossible,  to  detect  directly  very 
slight  proportions  of  sugar.  He  thinks  it  possible  it  does 
contain  it,  but  that  it  cannot  be  formulated  as  an  absolute 
truth.  II     Pavy  considers  there  is  no  abrupt  line  of  demarca- 

•  PhyMiology,  p.  18. 

t  Lectures  translated  in  Lond,  Med,  Sec,  vol.  i,  p.  739. 
X  '•  Pavy*8  Lectures,"  Lancet^  1878,  p.  484. 
§  Hermann,  loc.  cit.,  p.  110. 

II  He  makes  a  statement,  which  ought  to  be  borne  in  mind  in  conducting 
such  researches,  that  there  are  in  normal  urine  certain  reducible  matters  which 


by  Dr,  Francii  Black.  115 

tion  or  distinction  of  an  absolute  kind  between  the  urine  of 
bealth  and  that  of  diabetes^  but  there  is  a  marked  quantita- 
ti?e  difference. 

All  authorities  are  agreed  that  directly  any  notable 
extent  of  sugar  finds  its  way  into  the  blood  {glyatmia)^ 
the  urine  is  sure  to  become  correspondingly  saccharine 
{glycosuria  or  mellituria). 

What  is  the  source  of  glycamia  ?  Bernard  answers,  the 
destruction  of  glycogen,  whereas  Pavy  and  others  consider 
glycogen  a  misnomer,  as  the  substance  called  by  that  name 
is  never  normally  the  source  of  sugar,  but  is  formed  from 
the  sugar  carried  to  the  liver,  and  ought  to  be  styled 
amyloid  matter.  Glycogen  or  amyloid  matter,  whichever 
view  be  taken,  is  the  important  factor  in  glycaemia.  It  is 
a  dextrine-like  substance,  which  is  very  easily  converted 
into  sugar  by  certain  ferments.*  It  is  met  with  in  small 
quantities  in  the  muscles,  but  its  principal  seat  is  in  the 
hepatic  cells,  where  it  is  always  found  under  healthy 
circumstances.  The  hepatic  cells  appear  to  possess,  in 
addition  to  their  property  of  excreting  bile,  a  specific 
glycogen-formiug  action. 

The  presence  of  glycogen  in  the  liver  is  very  much 
dependent  on  food ;  in  proportion  as  the  latter  is  rich  in 
carbo-hydrates  so  does  the  former  increascf 

In  warm-blooded  animals  it  has  been  shown  by  experi* 
meut  that  glycogen  is  derived  in  the  liver  from  sugar  by 
the  formation  of  an  anhydride  ;  but  if  diabetes  is  artificially 

may  deoeiTe  and  make  one  belieye  in  the  presence  of  sngar  (loc.  cit.,  p.  72&). 
Pary  also  aUudes  to  the  presence  of  lithic  acid  affecting  the  reaction.  To 
obriatc  this  the  nrine  oaght  to  be  first  treated  with  acetate  of  lead,  and  then 
vith  ammonia  added  to  the  filtrate.  The  lead  precipitates  the  lithic  acid. 
{Lancet,  1878,  p.  448.) 

*  That  glycogen  or  amyloid  matter  needs  some  ferment  for  its  saccharine 
cooTersion  is  proved  by  Pavy  and  Schiif  s  experiments,  on  hybernating  frogs 
whose  livers  contain  glycogen,  but  no  ferment,  the  sugar  puncture  is  on* 
SQccesafuL 

t  Gnpe  sugar,  cane  sugar,  levnlose  and  inuline,  sugar  of  milk,  and  espe- 
cially glycerine,  are  great  producers  of  glycogen.  Mannite  and  gum  have  no 
effect ;  fat  causes  a  very  slight  increase  of  hepatic  glycogen ;  white  of  e^%  and 
fi^rine  bave  no  effect. 


116  Note$  on  Diabetet, 

induoed  in  these  animals,  feeding  with  sugar  does  Bot»  as 
it  normally  does,  cause  the  liver  to  contain  glycogen. 

Numerons  experiments  justify  the  condnsion  that  gly- 
cogen can  neither  pass  into  the  blood-vessels  nor  be 
transformed  into  sugar  under  natural  circumstances,*  bat 
that  under  certain  morbid  conditions  this  transformation 
takes  place,  that  then  sugar  finds  its  way  into  the  circula- 
tion and  makes  its  appearance  in  the  urine,  giving  rise  to 
glycosuria,t  which,  if  permanent  and  marked,  is  described 
as  diabetes. 

The  morbid  cofutitions  which  have  been  found  to  induce 
artificial  diabetes  are — 1st,  By  puncturing  the  floor  of  the 
fourth  ventricle  with  the  point  of  a  needle  on  the  spot 
comprised  between  the  origin  of  the  vagi,  and  the  acoustic 
nerves  transitory  diabetes  is  set  up.  The  same  result 
follows  section  of  the  medulla  oblongata,  injury  of  the 
inferior  cervical  ganglion,  or  of  the  nerves  which  proceed 
from  it  to  the  ganglion  stellatum.  The  glycosuria  is 
always  attended  by  polyuria;  the  extreme  limit  in  rabbits 
five  to  twenty-four  hours,  in  dogs  a  little  longer.  A 
renewal  of  the  puncture  excites  ihe  diabetes.  The  liver  is 
always  found  congested  after  these  experiments. 

2nd.  Various  agents  which  cause  a  suspension  of  the  func- 
tions of  animal  life  while  the  organic  functions  remain  intact 
induce  glycosuria,  such  as  concussions  of  the  brain  and 
spinal  cord,  various  forms  of  apoplexy,  Curare,  Chloroform, 
Morphia,  Nit,  of  Amyl,  and  all  irrespirable  gases  which 
excite  auesthesia.     The  same  conditions  can  be  produced 

*  This  is  opposed  to  Bernard's  views,  who  considers  glycogen  is  normaUy 
converted  into  sugar,  and  that  sach  sugar  is  absolutely  necessary  to  the 
maintenance  of  health.  Shortly  before  his  death  he  submitted  a  report  to  the 
Academy  of  Medicine  {Comptet  Bendut,  Izxxiii,  No.  6,  translated  in  Lond* 
Med.  Record,  1874),  respecting  his  views  and  answering  Pavy's  objections. 
On  the  other  side,  Pavy  has  explained  the  correctness  of  his  own  experiments 
and  deductions,  aud  attributes  Bernard's  results  to  error  in  his  quantitative 
analysis,  and  he  points  this  out  in  a  long  chemical  argument.  I  think  Pavy's 
views  are  right.  Pavy's  latest  lectures  were  given  before  the  College  of 
Physicians.    {Lcmeet,  1878.) 

t  Continued  observations  show  that  a  slight  glycosuria  in  phthisical  and 
gouty  persons  is  of  fkr  more  common  occurrence  than  is  generally  supposed. 


by  Dr.  Francis  Black.  117 

esperimentally  by  pithing  a  dog  and  maintaining  the  circu* 
lation  bj  artificial  respiration  for  about  an  hour,  the  urine 
becomes  highly  saccharine. 

In  all  these  instances  the  liver  is  found  much  congested ; 
these  agents  are  supposed  to  affect  the  vaso-motor  supply 
of  the  liver^  cansing  irritation  of  the  nenres  according  to 
Bernard,  and  paresis  according  to  Pavy. 

Insensibility  is  a  necessary  condition.  Eckhardt  maintains 
that  the  experiment  with  curare  does  not  succeed  unless 
the  animal  is  so  completely  paralysed  as  to  necessitate  the 
need  of  artificial  respiration.*  After  giving  the  full  dose 
of  Curare  to  a  dog  the  urine  for  the  first  three  to  ten 
nunntes  before  sugar  appears  is  much  diminished  or  quite 
sappressed,  then  polyuria  sets  in  with  the  glycosuria 
(Eckhardt). 

3rd.  Various  agents  which  hurry  the  hepatic  circulation 
or  canse  hypersemia  of  the  liver  produce  thereby  saccharine 
urine. 

Bernard  mentions  the  case  of  a' man  wh6  received  a  blow 
on  the  liver  from  the  hoof  of  a  horse ;  his  urine  became 
utccharine,  and  continued  so  until  the  results  of  the  contu- 
non  ceased.f 

Pa?y,  in  various  experiments,  has  shown  that  impedi- 
ment to  the  circulation  produces  glycosuria.  Irritation  of 
the  substance  of  the  liver  with  needles  or  passing  electric 
corrents  through  these  needles  renders  the  urine  saccharine. 

A  dog  becomes  glycosuric  if  the  portal  vein  is  tied,  and 
the  animal  fed  on  amylaceous  substances;  the  urine  becomes 
alkaline  and  the  appetite  voracious.  If  nitrogenous  food  is 
iobstituted  for  amylaceous  the  glycosuria  ceases.  Bernard 
calls  this  an  alimentary  glycosuria.:^  Strange  to  relate, 
the  dogs  recover  from  this  operation. 

Under  this  same  head,  as  affecting  the  circulation  in  the 
liver,  are  to  be  reckoned  the  following  list  of  substances 
which  cause  glycosuria  when  they  are  injected  into  the 
veins,  especially    the    portal   vein  : — Dilute   solutions   of 

*  Lond.  Med.  Sec^  1873,  p.  65a 

t  Le^am  de  PhynoL  Eaper.,  Parif,  1835,  p.  846. 

X  Land.  Med.  Beoord,  i,  p.  645. 


118  Notes  on  Diabetes, 

common  salty  Tarious  salts  of  soda,*  such  as  the  carbonate, 
acetate,  Talerianate,  phosphate,  hjposulphide,  lactic  acid, 
phosphoric  aetd,  ether,  alcohol,  turpentine,  ammonia,  de- 
fibrinated  arterial  blood,  corrosive  sublimate,  and  even  gum 
arabic  To  this  list  is  to  be  added  salts  of  uranium,  which 
were  introduced,  in  Leconte's  experiments,  probably  only 
bjr  the  stomach,  and  not  by  the  veios. 

Pavy  attributes  the  glycosuria,  in  these  instances,  to 
interference  with  the  functional  working  of  the  liver 
through  the  medium  of  the  blood  traversing  its  veins. 
These  various  solutions  introduced  into  the  veins  have  the 
effect  of  breaking  up  the  blood-corpuscles,  and  this  may 
exercise  a  marked  fermentive  action  on  the  conversion  of  the 
glycogen  of  the  liver  and  elsewhere,  or  they  may  act  by  hurry- 
ing the  hepatic  circulation,  so  that  sugar  brought  to  the  liver 
is  rapidly  washed  through  and  not  converted  into  glycogen. 
It  requires  a  deeper  knowledge  of  the  physiological  working 
of  these  various  substances  to  determine  whether  their 
influence  is  a  specific  one  on  the  vaso-motor  nerves  of  the 
liver  or  merely  the  result  of  chemical  and  mechanical 
action,  but  the  probabilities  are  greatly  in  favour  of  the 
latter  mode  of  action  being  the  true  explanation.  How 
far  these  experiments  help  in  therapeutics  will  be  partly 
answered  by  examining  more  fully  iuto  two  substances 
which  have  the  repute  of  being  specific  remedies,  viz.  phos- 
phoric acid,  and  the  muriate  or  other  salts  of  uranium. 

Phosphoric  acid. 

Dr.  Hughes  considers  this  acid  to  be  a  '^similar''  to 
glycosuria^  and  gives  as  his  authorities  Dr.  Ringer  and  Dr. 
Pavy.t  The  passage  in  Dr.  Ringer's  work  (p.  118)  is: 
^*  Phosphoric    acid   has    been    recommended    in    diabetes. 

*  ThoM  experiments  of  Bock  and  Hoffman  have  been  lately  repeated  by 
Sckhardt;  be  finds  that  the  substance  supposed  to  be  sugnr,  and  which 
reduces  Fehling^s  solution,  has  no  action  on  polarised  light.  Qrape  sugar  has 
the  property  of  turning  the  ray  of  polarised  light  to  the  right.    (Lond.  Med 

JUe.,  1873). 

Pharmaeod^fnamics^  p.  48. 


by  Dr.  Francis  Black.  1 1 9 

GriesiDger,  who  has  carefully  studied  the  action  oF  tliis 
medicine,  considers  that  it  does  more  harm  than  good.  He 
poshed  the  acid  to  the  extent  of  an  ounce  daily^  and  found 
that  this  dose  increased  the  sugar/'  If  Dr  Ringer  had 
stated — Griesinger  has  carefully  studied  diabetes^  but  most 
tmperfectly  examined  phosphoric  acid^  he  would  have  ex- 
pressed the  opinion  which  seems  very  evident  to  me  in 
reading  his  treatise.  It  gives  very  full  information  as  to 
the  symptoms,  course,  &c.^  of  the  disease^  but  very  scanty 
teaching  as  to  the  drug  therapeutics,  barely  two  pages 
devoted  to  phosphoric  acid,  and  this  space  nearly  occupied 
by  two  cases.* 

He  reports  first  a  case  of  confirmed  diabetes  of  four 
years'  standing,  in  which  he  had  first  tried  rennet^ 
according  to  Dr.  Otf  s  plan  ;  that  failing  he  prescribed 
Ac.  Phos,  dil.  {fFuri.  Pharm.),  at  first  in  doses  of  3ij, 
then  jvj,  and  on  the  third  day  it  was  increased  to  53 ;  this 
dose  was  taken  from  the  24th  February  to  March  15th. 
The  quantity  of  urine  and  sugar  slightly  increased.  The 
second  case  with  the  same  doses  is  reported  still  more 
briefly,  and  with  the  same  result.  He  then  alludes  to  a 
case  of  stomach  disease  reported  by  Siebert  {Deutsche  KHnik, 
1852,  p.  205),  who  supposes  a  slight  case  of  diabetes  was 
brought  on  ''during  or  after  the  administration  of  Phos- 
photic  add  and  Aq.  Lcmrocerasi"  These,  with  the  know- 
ledge of  Pavy's  experiments,  in  which  sugar  appeared  after 
injecting  Phosphoric  acid  into  the  blood,  are  his  reasons  for 
condemning  this  acid. 

A  writer  in  the  British  Journal  of  Homoeopathy  (vol.  xxxi, 
p.  143),  reviewing  Dr.  W.  Roberts's  work  on  Urinary 
Diseases,  observes,  ''and  all  that  is  said  of  it  [Phos.  ac.)  is 
the  following  report  of  the  worthless  experiment  of  Grie- 
singer : — He  prescribed  dilute  Phosphoric  acid  to  the  extent 
of  an  ounce  daily.  At  first,  and  under  the  smaller  doses, 
the  patient  seemed  to  do  very  well ;  but  after  ten  days  with 
the  fall  quantity  the  volume  of  the  urine  and  the  proportion 
of  sugar  slightly  increased,  and  the  genera]  state  of  the 
patient  grew  worse.'' 

*  ArehivfSir  Fk^tiologiiehe  HeUhunde,  1859,  p.  60. 


120  Not€9  on  Diabetes, 

The  term  worthless  applies  here  to  the  tberapeatic 
conclusion;  it  is  as  applicable^  on  the  evidence,  to  the 
pathogenesis  of  phosphoric  acid.  Orfila's  experiments  show 
this  acid  to  be  an  irritant  of  the  stomach  and  duodenum  ; 
is  it,  then,  surprising  that  in  such  lai^e  doses  it  injured 
the  digestive  functions  of  OriesingeHs  patients,  and  thus 
rendered  their  conditions  worse  ?  There  is  a  very  general 
consensus  in  favour  of  certain  alkaline  mineral  waters  in 
diabetes,  but  because  occasionally  some  patients  are  rendered 
worse  by  them,  is  this  an  argument  that  these  waters  excite 
glycosuria,  when  such  a  symptom  is  never  found  to  arise  in 
those  rheumatic,  gouty,  and  hepatic  patients  who  resort  to 
Vichy  and  Carlsbad  ? 

Phosphoric  acid  may  be  capable  of  causing  glycosuria, 
but  it  cannot  be  proved  by  the  testimony  of  Oriesinger. 

Dr.  Pavy's  experiments  with  phosphoric  acid  were 
undertaken  to  ascertain  what  influence  acids  had  on  the 
supposed  combustion  of  sugar  in  the  lungs.  He  had 
previously  shown  that  a  solution  of  200  grains  of  carbonate 
of  soda  rapidly  injected  into  the  circulation,  so  as  to  satu- 
rate the  liver  and  render  it  swollen,  effected  a  disappearance 
of  the  amyloid  substance,  so  that  the  diabetic  puncture  had 
no  effect.* 

Desirous  to  see  the  behaviour  of  the  mineral  acids,  he 
selects  phosphoric  acid  because  it  can  be  injected  without 
causing  coagulation  of  the  blood.  His  experiments  of 
injecting  it  by  the  oesophagus  into  the  stomach  had  no 
effect  on  the  urine,  for  the  acid  was  immediately  vomited. 
He  then  placed  various  dogs  under  the  action  of  chloroform, 
and  injected  into  the  jugular  vein  of  some,  into  the 
duodenum  of  others,  a  quantity  of  acid  varying  from  ^\9a  to 
3ij  and  5ij  with  an  equal  quantity  of  water.  Half  an  hour 
was  occupied  in  injecting.  He  found  it  necessary  to  push 
the  quantity  to  the  extreme  point  the  animal  could  bear 
without  dying  under  the  operation.  A  quantity  sufficient 
to  destroy  the  coagulability  of  the  blood,  and  to  affect  the 
liver  was  necessary  for  the  production  of  glycosuria;  a 
quantity  short  of  this  yielded  no  resultf     Pavy  considers 

•  Quft  Hotp,  ReporU,  1861,  p.  195.  f  Loc.  cit,  p.  213. 


by  Br.  Francis  Black.  121 

that  it  acts  apparently  by  the  direct  chemical  agency  of  an 
icid  on  the  blood  circulating  through  the  liver.  He  views 
these  experiments  as  adding  another  significant  fact  to  our 
knowledge,  but  not  as  yet  giving  any  available  assistance  in 
anravelling  the  nature  of  diabetic  disease. 

Experiments  involving  so  severe  an  operation  under  the 
influence  of  chloroform  (which  of  itself  produces  glycosuria), 
and  with  such  large  doses,  are  of  no  value  in  illustrating 
the  phjsiological  action  of  phosphoric  acid. 

The  Materia  Medica  of  Hahnemann  throws  no  light  on 
this  point,  further  than  that  Ac.  phot,  increases  much  the 
secretion  of  urine. 

The  only  provings  of  this  substance  as  regards  its  renal 
action  that  I  can  find  are  two^  one  by  Bocker,*  the  other 
by  Paul  Sicks-t  * 

Dr.  Booker's  experiments  were  conducted  in  1858  and 
1855  with  great  care,  and'  a  miniite  quantitative  analysis  is 
given.  ^  The  result  was  that  phosphoric  acid  does  not 
change  the  ordinary  constituents  of  the  urine,  and  no 
appearance  of  sugar  is  reported.  On  taking  100  drops  of 
Phosphoric  acid  (one  gramme  free  from  water)  he  found  the 
excretion  of  the  acid  as  weU  as  of  potash  was  increased,  and 
that  in  proportion  to  the  quantity  of  phosphoric  acid  taken 
BO  the  system  excretes  more  of  the  acid  when  the  dose  is 
fniaU  than  when  it  is  large.  CI.  Miiller  points  out  further 
that  Bocker  in  his  experiments  found  that  the  urea  was 
ificreased,  but  the  uric  acid  diminished. 

CI.  Miiller  draws  attention  to  Sicks'  elaborate  experiments 
^th  phosphate  of  soda  to  ascertain  the  relation  of  phos- 
phoric acid  in  the  urine  to  the  amount  of  phosphoric  acid 
taken  into  the  system.  ''He  found  that  not  only  was 
the  whole  of  the  phosphoric  acid  taken  into  the  system 
^ain  passed  off^  but  the  normal  excretion  of  phosphoric 
acid  seemed  to  be  daily  increased ;  on  the  other  hand,  during 
the  taking  of  the  phosphoric  acid  the  earthy  phosphates 
diminished  in  quantity.    But  the  most  remarkable  thing  was 

*  Truitlated  in  Brii.  Joum.  Som.,  xvi,  666. 

t  Beferred  to  by  Dr.  CL  Mnller  in  his  excellent  paper  in  Br.  J.  Som.,  xvii, 
1B59»664. 


122  Notes  on  Diabetes ^ 

that  the  amount  of  urine  increased  with  the  additional 
consumption  of  phosphoric  acid,  which  acted  therefore  as  a 
diuretic ;  for  by  an  equal  temperature  and  amount  of  water 
consumed,  the  administration  of  one  grain  of  Phosphoric 
acid  invariably  produced  168  cubic  centimetres,  and  two 
grains  836  cubic  centimetres  more  urine  than  the  normal 
quantity.  Sicks  makes  no  remarks  upon  any  other  change 
in  the  urine,  as  the  presence  of  albumen  or  sugar/' 

The  glycosuria  of  phosphoric  acid  can  only,  as  yet,  be 
demonstrated  by  the  above  experiments  of  Pavy,  and  these 
are  of  a  character  which  show  that  the  artificial  diabetes 
cannot  be  considered  a  specific  symptom,  but  one  due  to 
poisonous  quantities  acting  locally  on  the  blood  and  the  liver, 
and  therefore,  taken  by  itself,  of  little  value  in  treating 
pathological  diabetes. 

Uranium. 

The  attention  of  the  profession  was  first  attracted. to  this 
remedy  by  a  communication  from  Dr.  F.  S.  Bradford  in 
the  North  American  Journal  of  Homoeopathy  (vol.  viii,  1860), 
in  which  he  states  that  he  was  led  to  consider  Uranium  as 
a  probable  remedy  in  diabetes  from  Leconte's  statement  of 
its  physiological  action.  This  statement  is  briefly  given  iu 
a  review  of  various  works  on  glycogenesis.* 

The  passage  is  :  **  Harley  injected  irritating  substances, 
such  as  dilute  solution  of  ammonia  or  aether,  into  a  branch 
of  the  portal  vein,  and  after  some  time  found  sugar  in  the 
urine.  Hence,  it  is  not  impossible  that  abnormal  matters 
may  be  sometimes  absorbed  from  the  intestine  by  the 
mesenteric  veins,  and  produce  a  similar  effect ;  we  may 
thus  probably  explain  the  fact  that  Leconte  always  found 
sugar  in  the  urine  of  dogs  slowly  poisoned  by  small  doses 
of  Uranium/* 

The  Nitrate  of  Uranium  has  been  proved  by  Dr.  E.  J. 
Blake  on  three  human  subjects  and  nineteen  animals,  and 
his  conclusion  is  that  these  experiments  do  not  support  the 
statement  of  Leconte.f 

*  Brit,  and  For,  Med.-Chir,  Rev^y  ziz,  p.  44. 

t  Dr.  Blake's  resultf,  physiological  and  therapeutic,  were  published,  1866, 


by  Dr.  Francis  Black.  123 

Dr.  Blake  does  not  give  a  farther  account  of  Leconte's 
experiments  than  the  above  statement.  I  have  looked 
in  vain  through  numerous  French  journals,  but  the  only 
Botice  I  can  find  of  the  work  is  a  very  short  review  in  the 
Arch.  Gen,  de  Med.* 

The  resumi  of  the  physiological  portion  is,  ''  The  mu- 
riate of  uranium,  which  has  not  hitherto  been  the  subject 
of  medical  research,  is  an  energetic  poison;  introduced 
into  the  stomach  it  penetrates  easily  the  gastric  mucous 
membrane.  Within  the  three  or  four  first  days  which 
follow  its  ingestion,  sugar  is  found  in  abundance  in  the 
nrine  when  it  is  possible  to  procure  it,  for  the  secretion  of 
urine  and  action  of  bowels  afe  suspended  on  the  second  or 
third  days.'' 

Even  this  short  notice  of  LeConte's  experiments  shows  a 
marked  peculiarity  m  the  glycosuria;  it  is  attended  by 
greatly  diminished  flow,  and  at  last  complete  suppression 
of  nrine,  a  feature  which  at  once  distinguishes  it  from 
pathological  diabetes,  where  polyuria  is  always  present. 

With  such  a  condition  of  kidney  the  scanty  urine  may 
have  been  charged  with  iithic  acid,  and  eftn  albumen ;  if 
80,  the  question  may  be  raised,  was  sugar  really  present  in 
abundance?  may  not  its  appearance  have  been  due  to  a 
substance  which,  though  not  sugar,  has .  the  power  of 
reducing  copper  ?  There  are  several  such  substances. 
In  Dr.  Blake's  experiments  there  is  little  indication 
as  to  the  quantity  of  urine,  but  it  is  quite  clear  there 
was  no  diminution,  and,  above  all,  no  suppression.  In 
Br.  Blake's  Experiment  Y  on  a  full-grown  tom  cat 
there  is  copious  salivation  after  hypodermic  injection  of  one 
drop  of  Ist  dec.  dil. ;  this  continued  after  various  injections, 
and  on  the  eighth  day  twenty  drops  of  sat.  sol.  into  right 
hind  thigh.  Urine  is  natural  in  quantity,  and  pale,  turbid, 
contains  sugar^  with  copious  albumen  and  chlorides.      This 

in  the  Br.  J,  of  Horn,,  and  then  as  a  valnable  contribntion  to  the  Hakn.  Mat. 
Med. 

*  For  1854,  p.  728.  Leconte'B  views  are  contained  in  a  thesis  presented  to 
the  Faculty  of  Med.  in  Paris,  1858,  entitled  2>e  Pemplai  de  ^awtate  d^nranium 
daut  la  recherche  dee  phoephatee  et  de  eon  action  tosique  et  phyeiologique,  par 
A.LeeoiUe. 


124  Notes  on  Diabetes, 

is  tbe  only  mention  of  glycosuria  in  the  yarioiiB  experiments. 
Was  it  the  copious  albumen  which  reduced  the  copper  test  ? 

To  explain  the  disparity  between  Leconte  and  Dr.  Blake's 
results  as  to  glycosuria  it  is  alleged  the  former  experiments 
were  all  on  dogs,  and  tbe  latter  on  cats  and  rabbits,  and 
only  on  two  dogs. 

This  objection  has  some  force,  but,  on  the  other  hand,  it 
is  sometimes  easier  to  excite  glycosuria  in  the  rabbit  than 
in  the  dog,  and  glycosuria  can  be  induced  in  rabbits  after 
the  injection  of  some  substances,  but  this  same  experi- 
ment fails  in  dogs.  Inhalation  of  carbonic  oxide  will 
produce  diabetes  in  the  dog  but  not  in  the  rabbit. 
Section  of  splanchnics  produces  polyuria  in  the  dog,  but 
not  in  the  rabbit ;  albumen  is  a  normal  constituent  in  cat's 
urine,  but  not  in  dog's.  But  this  objection  raises  the  far 
more  important  question.  Does  the  appearance  of  artificial 
glycosuria  in  a  dog,  cat,  or  rabbit,  prove  that  it  will  arise 
from  similar  causes  in  man  ?  Seeing  the  marked  difference 
in  these  three  animals  it  is  not  unlikely  that  in  man  there 
may  be  different  results.  Glonoine  (nit,  of  ox.  of  glycol.), 
which  acts  so  quickly  and  so  powerfully  in  minute  doses  on 
man,  appears,  in  cats  and  rabbits,  to  have  little  or  no  efi^ect, 
even  when  pushed  to  a  dose  (thirty  drops)  that  would  kill  a 
man.*     Many  similar  instances  could  be  cited. 

The  glycosuria  produced  in  dogs  by  mur.  uran.  is  of  a 
kind  not  similar  to  pathological  diabetes.  Experiments  in 
future  had  better  be  confined  to  men  and  women,  and  so 
far  as  they  have  been  conducted  what  are  the  results  ?  In 
Dr.  Blake's  proving  the  young  female  suffering  from  chronic 
albuminuria  may  be  excluded  as  a  doubtful  subject  for 
experiment,  but  in  the  two  other  cases,  where  the  details  are 
minutely  given,  and  the  urine  scientifically  and  carefully  ex- 
amined, there  is  a  slight  increase  of  the  urine,  but  no  sugar. 

Dr.  Buchner  reports  a  proving  of  nit.  uran.  on  Dr.  Koch ; 
he  took  from  a  half  to  two  grains,  but  does  not  say  how  or 
how  long.  The  principal  symptoms  were  vomiting,  at  first 
much  urine,  later  scanty  urine,  dry  hard  motions,  increase 
of  thirst,  but  no  desire  for  beer.     No  sugar  was  discovered 

•  Field,  Med,  Timet  and  Qaz^  Mar.  20th,  185& 


by  Dr.  Franc%9  Black.  125 

in  the  urine.*  These  four  experiments  give  negative 
results,  but  they  have  this  value,  that  they  are  given  in  detail, 
whereas  the  only  experiments  on  the  positive  side  are 
de6cient  in  these  particulars. 

Dr.  Magdeburg,  in  giving  his  reasons  for  selecting  nit. 
uran.  in  a  case  of  diabetes,  remarks  :  '^I  have  satisfied 
^Dyself  by  my  own  experiments  that  after  several  weeks' 
ingestion  of  small  doses  of  mur.  uran.  or  nit.  by  healthy 
persons,  sugar  can  be  found  in  the  urine.f 

It  is  unfortunate  that  Dr.  Magdeburg  l^as  published  no 
further  details  of  these  experiments,  leaving  nothing  further 
than  these  few  words  embodying  results  of  the  greatest 
interest.  It  ought  to  be  a  canon  in  all  physiological  experi- 
ments, no  results  shall  be  accepted  unless  details  of  the 
experiment  are  given. 

In  addition  to  the  agents  already  named  which  produce 
glycosuria,  but  in  a  form  not  likely  to  be  indicated  in  patho- 
Ic^cal  diabetes,  attention  may  be  directed  to  some  sub- 
stances which  are  said  to  excite  saccharine  urine,  viz.  arsenic, 
phosphorus,  lead,  strychnine,  zinc.  Unfortunately  the 
details  which  accompany  this  statement  are  very  scanty,  and 
require  verifying  and  enlarging. 

Granvogl  writes :  "  In  Heller^s  Archiv  fur  Chemie  und 
Microscopie  (Feb.,  1852),  I  found  it  mentioned  that  sugar 
vas  found  in  the  urine  after  breathing  any  sort  of  setherial 
vapour,  after  the  use  of  arsenic,  lead,  antimony,  mercurial 
Kalts^  quinine,  opium,  &c.''j: 

Aitken  says  the  internal  use  of  arsenic  and  quinine  has 
also  been  said  to  have  induced  saccharine  urine. § 

In  a  review  of  giy oogenesis ||  the  writer  remarks :  "  Dr. 

*  EinehelFs  Zeit.fUr  H<m.  KUm.,  Nov.  15th,  1878,  p.  168. 

t  Dr«  Dudgeon  wrote  last  month  to  Dr.  Magdeburg,  Wiesbaden,  requesting 
the  detailed  proyings  for  publication  in  this  Journal,  as  they  have  not  appeared 
in  any  journal.  The  letter  was  returned  from  Wiesbaden  with  the  notice 
"  Adressat  gestorben."  Dr.  Magdeburg's  death  excludes  aU  chance  of  examin- 
ing into  the  details  of  his  experiments. 

X  2*175.  §  Praetioe  of  Med^  Yol.  ii,  p.  136. 

II  BrU.  cmd  For,  Med,  Sev,,  1851,  vol.  ii,  p.  44.  Dr.  Br}' don's  was  the 
Harreian  prize  essay  for  1856,  not  published  at  the  date  of  the  review.  I  can 
find  no  copy  of  it  in  three  medical  libraries* 


126  Notes  on  Diabetes, 

BrydoD  is^  as  far  as  we  know,  the  only  British  observer  who 
has  succeeded  in  confirming  Reynoso^s  statement  that  the 
internal  use  of  arsenic  and  quinine  gives  rise  to  saccharine 
urine/' 

According  to  Saikowsky  and  Lucksinger  the  formation  of 
glycogen  ceases  when  the  hepatic  cells  are  rendered  inca- 
pable of  performing  their  function  by  poisoning  with  arsenic 
and  phosphorus,  and  during  such  poisoning  no  glycosuria  is 
present f  and  the  diabetic  puncture  has  no  effect  in  inducing 
it,  whereas  with  curare  poisoning  the  puncture  succeeds. 

Strychnine  was  injected  into  the  veins  in  fatal  doses  by 
Bernard,  so  that  the  glycosuria  excited  may  not  be  a 
specific  eSect. 

Zinc. — Dr.  von  Tunzelman,  in  describing  three  cases  of 
chronic  poisoning  from  water  supplied  through  zinked  iron 
pipes,  which  was  fouud  on  analysis  by  Dr.  Frankland  to 
contain  no  lead^  but  fifty-eight  graius  of  zinc  to  the  gallou, 
observes — the  mother  (of  the  two  young  ladies^  who  were 
also  afi\;cted)  has  been  sufifering  the  whole  time  since 
their  return  from  the  north  from  pain  in  the  lumbar  and 
renal  regions^  and  latterly  also  from  giddiness  and  anorexia^ 
with  nausea  and  vomiting  occasionally,  also  a  good  deal  of 
griping  pain  at  times  in  the  abdomen,  with  tendency  to 
diarrhoea.  The  urine  on  examination  was  dark  amber 
colour,  somewhat  turbid,  but  becomes  clear  on  boiling; 
odour  after  standing  sickening  and  whey-like,  causing  a 
suspicion  of  sugar ;  reaction  acid  ;  sp.  gr.  1023,  no  albumen  ; 
sugar  distinctly  present,  though  in  small  quantities,  by 
Morris  and  Trommer's  tests.  The  deposit  was  urate  of 
ammonia,  with  a  few  crystals  of  oxalate  of  lime.* 

Asparagus,  in  Dr.  Harley's  own  case,  excited  glycosuria, 
but  failed  to  do  so  in  Dr.  E.  T.  Blake's  experiment.f 

Asclepias  vincetoxicum  is  said  to  cause  polyuria  in  sheep, 
but  no  mention  is  made  of  glycosuria. 

The  results  of  the  examination  of  agents  which  excite 
glycosuria,  however  interesting  they  are  in  a  physiological 
sense,  are  not  very  useful  as  indicating  remedies  according 
to  the  homoeopathic  law.     But  the  frequent  occurrence  of 

•  Br.  J.  Horn,,  1874,  xxrii,  p.  612.  f  ^*m^.,  xxviii,  1870,  p.  206. 


by  Dr.  Francis  Black.  127 

artificial  gljcosaria  and  of  simple   pathological  glycosuria 
gives  great  promise  that  careful  experiments  on  the  human 
subject   will   yield    satisfactory  results.      Glycosuria    does 
not  constitute  diabetes    no   more  than    albuminuria   con- 
stitutes Bright's  disease,  but  it  is  the  characteristic  sym- 
ptom.    It  leads  back  to  glycsemia,  and  that  points  to  an 
unknown  pathological  condition  which  is  the  cause  of  the 
malassimilation.       Morbid    anatomy    as    yet    throws    no 
light  on   a  fixed   lesion  as  the  cause  of  diabetes ;    hence 
specificity  of  seat  is  absent,  and  thus  is  lost  a  material  aid  in 
selecting  a  remedy.     When  a  disease  is  so  functional  and 
constitutional  as   diabetes,  when   its  commencement  is  so 
difficult  to  trace  and  marked  by  no  appreciable   signs,  it 
becomes  of  great  importance  to  have  glycosuria  well  marked 
in  the  pathogenesis  of  a  remedy.     Attacking  certain  sym- 
ptoms may  often  palliate,  may  even  sometimes  cure,  but 
such  practice  is  merely  tentative,  and  can  never  impart  the 
scientific  satisfaction  which  the  application  of  a  true  simili- 
mum  affords. 

Prognosis. 

Tbe  question  which  directly  interests  us  is — Does  the 
experience  of  the  homceopathic  or  specific  school  furnish  a- 
nore  favorable  prognosis  than  that  of  the  ordinary  school  f 
To  rightly  answer  this  question  it  is  needful  to  bear  in 
mind  certain  facts  which,  if  ignored^  vitiate  the  conclusions. 

Diabetes  is  generally  a  chronic  disease,  and  in  its  con- 
firmed form  usually  lasts  from  one  to  three  years ;  more 
than  60  per  cent,  of  the  cases  collected  by  Griesinger  ter- 
minated fatally  within  that  time.  These  were  principally 
hospital  cases,  and  therefore  occurring  among  the  poor,  but 
with  them  tbe  disease  is  more  rapidly  fatal  than  in  the 
classes  where  the  comforts  of  life  are  enjoyed.  Prout's 
experience,  probably  the  largest  of  any  observer,  and  drawn 
principally  from  the  well-to-do  class,  is  to  this  effect : 

"  Within  the  last  thirty  years,  I  have  seen  more  or  less 
of  nearly  seven  hundred  instances  of  diabetes,  and  of  this 
great  number,  as  far  as  minor  and  concomitant  symptoms 


128  Notes  on  Diabetes, 

have  been  concerned^  no  two  cases  have  been  exactly  alike, 
or  have  been  benefited  by  exactly  the  same  treatment,  so 
greatly  diversified  is  this  apparently  simple  form  of  disease. 
The  disease  has  occurred  to  me  in  one  instance  in  a  child 
only  five  years  old,  and  about  a  dozen  times  in  young 
persons  between  eight  and  twenty  years  of  age,  of  whom 
four  were  females.  Of  these  dozen  cases  not  one  has  lived 
to  grow  up,  and  the  greater  proportion  have  died  in  various 
ways  after  a  comparatively  short  course  of  the  disease. 
With  respect  to  the  duration  of  diabetes,  I  know  at  present 
but  two  instances  in  which  the  afiection  was  clearly  ascer- 
tained to  exist  in  its  perfectly  developed  form  ten  years  ago. 
As  stated  in  the  text,  however,  I  believe  the  disease  some- 
times exists  for  many  years  in  its  incipient  stages/'* 

Bence  Jones  tells  of  a  clergyman  who  was  still  in  good 
health,  although  Prout  had  detected  sugar  in  his  urine 
sixteen  years  before.  Dickinson  describes  the  case  of  an 
innkeeper  who  had  had  marked  diabetes  for  fifteen  years, 
and  who  while  in  tolerable  health  was  passing  200  grammes 
of  sugar  daily. 

Diabetes  is  a  disease  slower  in  its  course  and  subject  to 
more  intermissions  after  forty-five  than  previous  to  that 
age,  and  elderly  people  suflfer  much  less  from  its  effects 
than  the  young.  Hence  records  of  permanent  cure  or 
marked  alleviation  of  cases  under  forty-five,  especially  under 
thirty,  are  of  much  greater  value  in  estimating  the  utility  of 
remedial  measures  than  those  drawn  from  persons  above 
forty-five  years  of  age. 

There  are  numerous  cases  of  well-marked  diabetes  where 
all  or  nearly  all  saccharine  and  farinaceous  substances  being 
excluded  from  the  diet,  the  patients  remain  free  of  gly- 
cosuria as  long  as  such  diet,  with  attention  to  bodily  and 
mental  health,  is  observed.  Such  recoveries  are  conditional, 
and  results  drawn  from  drugs  under  such  circumstances  are 
most  fallacious. 

Again,  there  are  cases  of  an  almost  intermittent  cha- 
racter, where  for  mouths  the  disease  seems  in  abeyance,  and 
the  patient  is  able  to  digest  hydrocarbons,  and  then,  from 

*  Piout,  loc.  cit,  p.  86. 


by  Dr.  Francis  Black.  129 

exposure  to  very  slight  causes,  the  diabetes  returns.  It  is 
important  to  bear  in  mind  this  behaviour  of  diabetes^ 
''  upon  which,  besides  diet,  still  other  circumstances,  such  as 
climate,  season  of  the  year^  mental  disposition,  and  the  like 
haye  an  influence,  in  order  that  we  may  not  hastily  ascribe 
the  favorable  changes  in  the  patient's  condition  to  a  drug, 
as  has  happened  often  enough/^* 

Cases  where  restricted  diet  and  change  of  climate  have 
no  effect  are  generally  serious.  Those  who  have  had 
experience  in  hospital  practice  agree  that,  no  matter  what 
the  medical  treatment  adopted  and  without  any  change  in 
the  character  of  the  diet,  diabetics  usually  show  signs  of 
improvement  for  some  time  after  they  are  admitted  into  the 
wards  of  an  hospital.f 

''There  is  hardly  a  medicine  in  the  ordinary  Pharma' 
copcna/^  writes  Dr.  Richardson,  ''  that  has  not  been  used, 
and  what  is  extraordinary,  too,  used  with  success.''^  Senator 
mak^  a  similar  observation. § 

That  sugar  is  much  more  frequently  present  in  the  urine  in 
adranced  than  earlier  life  all  inquiries  fully  corroborate,  and 
the  fact  is  not  without  value  in  estimating  the  duration  and 
probable  issue  of  the  disease  and  value  of  remedies.  Dr.  Mac- 
lachlan  often  found  sugar  abundantly  present  in  the  urine  of 
old  people  without  any  constitutional  disturbance^  sometimes 
not  even  diuresis.  || 

Bearing  these  remarks  in  mind  in  connection  with  the 
mifavorable  prognosis  given  in  all  systematic  treatises  on 
diabetes,  what  conclusion  but  one  can  be  drawn,  and  that 
one  not  favorable  to  drugs  ? 

To  report  recoveries  as  cures,  to  attribute  the  cure  ever 

*  Ziemwen,  loc.  cit.,  vol.  ztI,  p.  977. 

t  PaTy,  loc.  cit.,  p.  26a 

t  Os  Diabetes,  p.  101. 

§  '*  We  may  tAj,  without  exaggeration,  that  there  is  scarcely  any  agent 
among  the  great  store  of  dmgs  of  all  periods  and  all  countries  which  has  not 
at  one  time  or  another  heen  employed  against  diahetes,  and  from  which  a 
Ktolt  has  not  heen  recorded,  even  if  only  at  the  hands  of  its  commenders  and 
propsgaodists."    (Ziemssen,  loc.  cit,  toI.  xtI,  p.  992.) 

il  DUeatee  of  Advaneed  Life,  Lond.,  1863,  p.  599. 

▼OL.  XXXVIT,  NO.  CXLYIII. APBIL,   1879.  I 


130  Note$  on  Diabetes, 

to  the  drug,  forgetful  of  all  other  important  agenciea,  to 
score  all  hits  and  omit  all  misses,  has  ever  been  the  bane  of 
therapeutics. 

In  estimating  the  value  of  drugs^  especially  specifics^ 
it  is  absolutely  necessary  to  bear  in  view  these  facts  in  the 
history  of  diabetes,  so  as  to  guard  against  the  variouB 
errors  of  the  therapeutic  mind,  not  the  least  of  which  is  an 
nnconscious  vanity,  unduly  persuading  us  of  the  reality  of 
unreal  cures. 

Taking  the  experience  of  such  men  as  Yenables,  Front, 
Pavy,  Bence  Jones,  Dickinson,  Giersteiner,  Senator,  &c., 
the  opinion  is  that  diabetes  in  general  is  an  incurable 
disease,  since  complete  and  permanent  recovery  occurs  only 
occasionally.  After  middle  age  the  disease  may  be  pro- 
tracted many  years,  and  in  assuming  an  intermittent  form 
life  may  be  enjoyed  without  much  suffering.* 

Let  us  now  see  what  the  authors  of  systematic  trea- 
tises on  Specific  Medicine  say.  Jousset  regards  the 
homoeopathic  treatment  of  diabetes  as  still  very  little  ad- 
vanced.f  Kapfa  considers  the  prognosis  always  doubtful, 
and  the  homoeopathic  treatment  is  as  yet  without  any 
sure  and  fixed  foundation,  and  as  yet  there  is  no  physio- 
logical proving  which  shows  the  presence  of  sugar  in  the 
system. t  Baehr  says  :  "  Diabetes  generally  terminates 
fatally.  Only  a  few  permanent  and  complete  cures  are 
recorded  .   .   .  The  treatment  of  diabetes  is  generally  hope- 

*  Dechambr^  (JEUinhin's  Abstract  of  Med.  Sciences,  vol.  xvi)  mentions  that 
sugar  occurs  naturally  and  habitually  in  the  urine  of  old  people.  Dr.  Beuce 
Jones,  however,  says  he  has  failed  to  discover  any  proofs  of  sugar  being 
habitually  present  in  the  urine  of  aged  people.  In  the  29  cases  reported  by 
Dr.  Bence  Jones,  11  were  above  sixty  years  of  age,  and  6  of  these  were  above 
seventy  years  old.  Of  these  11  cases,  in  2  the  disease  was  intermittent ;  in 
6  the  quantity  of  urine  was  scarcely,  if  at  all,  increased,  but  the  disease  had 
probably  existed  for  sixteen  years ;  in  1  albuminous  urine  was  present  and  the 
diabetic  symptoms  very  slight ;  in  1  above  seventy  the  disease  existed  in  its 
intensity ;  in  10  of  the  11  cases  it  was  so  slight  that  the  general  symptoms 
hardly  declared  it.  He  also  observed  that  the  urine  of  digestion  of  old  people 
is  not  unf  requently  saccharine,  while  no  sugar  can  be  detected  at  other  periods 
(Med.'Chir.  Trans.,  vol.  xxxvi). 

f  Siemens  de  M4d,  Pratique,  2nd  edit.,  voL  i,  p.  116. 

X  Therapie,  vol.  ii,  p.  718. 


by  Dr.  Francis  Black.  131 

less ;  indeed  we  must  confess  that^  even  under  homoeopathic 
treatment,  patients  have  not  been  materially  benefited/'  * 
Dr.  Hughes  is^  I  think,  more  sanguine  than  these  writers, 
at  least  I  judge  so  from  his  expressions  in  the  paper  already 
alluded  to^  and  from  his  remarks  in  his  Pharmacodynamics, 
and  later  still  in  his  Manual  of  Therapeutics. ^^  I  am  sorry 
to  differ  from  a  writer  who,  in  these  admirable  works,  has 
shown  so  much  ability,  medical  and  literary,  combined  with 
such  patient  research  and  good  discernment,  but  I  cannot 
draw  so  favorable  a  comparison  as  he  is  inclined  to  do  in 
favour  of  the  specific  school.  His  hopes  are  founded 
partly  on  his  individual  experience,  but  mainly  on  our 
possessing  two  drugs  presenting  the  characteristic  symptom 
of  glycosuria.  But  these  two  remedies.  Phosphoric  acid  and 
Vramum^  do  not,  I  fear,  present  glycosuria  in  a  form  which 
is  therapeutically  of  value,  and,  taking  the  most  favorable 
view,  it  can  only  be  said  this  important  symptom  rests  on 
presumption. 

I  cordially  agree  with  him  that  to  the  homoeopathic  law 
we  must  look  for  real  curative  treatment  in  diabetes,  but 
onr  success  is  yet  in  the  fature,  because  our  materia  medica 
is  still  very  imperfect  in  the  pathogenesis  of  artificial  glyco- 
suria, and  we  have  yet  much  to  learn  regarding  pathological 
diabetes.  Gladly  would  I  credit  that  in  diabetes  Phos^ 
phoric  acidikM  won  its  greenest  laurels,  did  I  not  know  that 
in  traditional  medicine  this  remedy  has  been  employed  in 
diabetes  long  before  its  use  by  homoeopathic  practitioners. 
I  can  find  no  cases  of  diabetes  treated  by  onr  school  until 
after  1825,  but  Nicolas  and  Guendeville  (Paris,  1803) 
landed  Phosphoric  acid  as  a  remedy;  soon  after,  in  this 
eoantry,  it  was  recommended  by  Latham,  and  later  by 
Veuables  in  1825.  Since  then  it  has  been  a  recognised 
remedy  in  ordinary  practice,  praised  by  some  and  condemned 
by  others.  Homoeopathic  practitioners  have  simply  in  this 
instance  borrowed  from  traditional  medicine.  With  the 
exception  of  Uranium  and  Asclepias  tnn.,  there  is  not  a 
single  remedy  employed  by  homoeopathic  practitioners  which 

*  Scieitee  of  Therapeutics,  vol.  i,  p.  620. 
t  2nd  edit,  part  ii,  p.  841. 


182  Notes  on  Diabetes. 

has  not  previousty  been  used  with  reported  success  in  the 
records  of  traditional  medicine.* 

I  have  carefully  read,  I  may  safely  say,  all  the  cases  of 
diabetes  reported  in  our  publications,  and  taking  into  account 
the  ominous  omissions  of  failures,  I  think  the  specific  school, 
with  an  occasional  power  to  cure,  but  more  frequently 
simply  to  control  or  alleyiate,  has  its  laurels  still  to  gain- 
Success  ought  to  be  its  fortune,  for  it  possesses  a  rule  to 
guide  it  in  the  adoption  of  traditionally  useful  remedies, 
and  a  powerful  stimulus  to  ascertain,  by  provings,  clear 
views  as  to  the  occurrence  of  glycosuria  and  its  attendant 
symptoms. 

{2\f  be  eomHnmed.) 

•  Dr.  G.  Oehme,  of  Staten  Iiland,  N.T.»  givei  in  HineheVs  KUmJc,  May, 
1878,  p.  72,  an  abstract  of  all  the  caaef  of  diabetes  he  has  been  able  to  find  in 
homoBopathic  literature  in  the  fiftj  years  extending  from  1822  to  1878.  The 
following  is  the  list  of  remedies : — Ad.  phoi^  Ad,  dmL,  Arg.^  An,^  Atelep,  v^ 
Cantk^  CarboUe  ao,,  Ckima,  CIm.,  An.  ^n.,  CoL,  Cmpr^  BH^  Hydrogem 
kyperosrid^t  KreoD^t  Laeh,,  Magn,,  Mur.  «.,  Nwc  e.,  Plh.,  Bat,,  Thuja,  8uL, 
Uram.  To  this  list  I  may  add  Calc.,  CoId,  phot,,  Cham,,  lod,  m„  Dig^  Atrop,, 
Camph.,  Bo9.,  Chemeph,,  Srigon,,  JSuphai,  par,,  Chran,,  HgdraH.,  Semeoio, 
TrUlium,  and  Ver.,  BuoaUfptuD,  To  oonclnde  all  these  remedies  are  homoeo- 
pathic to  the  yarions  phases  of  diabetes  because  they  occur  in  homoeopathie 
literature  would  be  a  great  mistake. 

''A  daw's  not  reckoned  a  religious  bird« 
Because  it  keeps  a-cawing  from  a  steeple.'' 


It  is  proposed  to  publish  in  next  number  a  list  of  all  medicines  which  seem 
to  have  been  useful  in  diabetes,  and  under  each  medicine  to  give  an  abstract  of 
all  published  cures  in  which  it  has  been  used,  toj^ether  with  any  other  cases 
which  may  be  contributed.  By  this  means  it  is  hoped  some  useful  clinical 
indications  may  be  arrived  at  The  Editors  will  be  happy  to  publish  any 
communications  forwarded  to  them.  It  is  desired  that  failures  as  weU  as 
cures  be  communicated. 


133 


ON  THE    TISE   OP  ALCOHOL  IN  HEALTH. 

By  B.  E.  DuDGBON,  M.D. 

Thx  readers  of  the  Caniemporary  Review  have  no  doubt 
been  mach  edified  by  the  short  essays  by  eminent  medical 
aathorities  on  the  nse  of  alcohol  that  have  lately  appeared 
in  its  pages,  which,  if  they  do  not  teach  much,  at  all  events 
serve  to  emphasize  the  popular  saying  about  doctors  differ- 
ing. I  do  not  intend  here  to  criticize  these  works  of  art, 
but  only  to  give  my  own  views  respecting  the  drinking  of 
alcoholic  liquors  by  persons  in  health. 

To  many  persons  it  would  seem  that  there  could  be  no 
doubt  that  the  moderate  aud  regular  use  of  alcohol,  in  the 
form  of  beer,  wine,  or  spirits,  is  not  only  not  injurious,  but 
eminently  wholesome.  They,  and  their  fathers  before  them, 
and  their  brothers  and  sisters  and  wives  around  them,  and 
their  children  rising  up  about  them,  have  taken  some 
alcoholic  liquor  as  a  regular  ingredient  of  their  meals  all 
their  lives,  and  they  would  as  soon  think  of  going  without 
their  dinner  altogether  as  of  dining  without  their  accus- 
tomed liquor.  Their  health  is  good  under  this  regimen,  and 
they  do  not  see  why  any  one  should  question  its  whole- 
someness.  They  will  quote  any  number  of  authorities, 
sacred  and  profane,  ancient  and  modern,  for  the  propriety 
and  advantage  of  drinking  alcohol  in  some  shape  or  other, 
and  they  are  quite  sure  that  if  they  left  off  their  drinking 
habits  they  would  rapidly  deteriorate  in  health,  in  strength, 
in  spirits,  and  in  capability  of  working  mentally  or 
physically. 

And  the  united  testimony  of  universal  mankind — of 
course  I  mean  civilised  European  mankind,  and  exclude 
Rechabites,  Mahommedans  and  savages — ^is  in  favour  of  the 
innocuousness  and  wholesomeness  of  alcoholic  drinks  taken 
in  moderation.  Every  one,  of  course,  has  his  own  idea  of 
what  constitutes  moderation;  that  is  a  variable  quantity. 


134  On  the  Use  of  Alcohol  in  Health, 

from  one  glasB  to  several  bottles.  Wine  is  eyen  credited 
with  causing  truthfulness,  as  in  the  saying  in  vino  Veritas, 
and  even  of  eliciting  virtue  itself^  for  does  not  Horace 
say — 

Namtur  et  prisci  Catonis 
Saspe  mero  calaisse  virtus  ? 

Great  poets  in  all  ages  and  all  countries^  from  Anacreon  in 
Greece  to  Bums  in  Scotlond^  have  sung  the  praises  of 
alcohol.  And  little  poets^  too^  down  to  the  bards  of  the 
music  halls^  who^  in  the  intervals  of  composing  their  poems 
to  the  great  god  Jingo,  write  odes  in  praise  of  every  diflferent 
brand  of  champagne,  but  the  quality  of  the  verse  is  on  a 
par  with  that  of  the  ^'  fizz  '^  that  is  sold  in  those  places 
under  high-sounding  names.  Philosophers,  statesmen, 
theologians,  sportsmen,  the  learned  and  the  unlearned, 
humanitarians,  philanthropists,  workers  with  their  brains 
and  workers  with  their  arms,  have  shown  by  their  example 
their  belief  in  the  beneficial  action  of  alcohol.  Who 
could  doubt  the  propriety  of  drinking  in  such  good  com- 
pany ?  Doctors,  too,  are  among  the  most  strenuous  advo- 
cates for  the  regular  use  of  alcohol.  Other  medicinal 
agents  may  have  their  day  and  then  fall  into  disrepute,  but 
alcohol  maintains  its  reputation  as  a  never-failing  resource, 
not  only  for  curing  disease  but  for  sustaining  strength  and 
health.  Health  I  do  we  not  drink  health  to  our  friends  in 
brimming  bumpers  ?  To  be  sure  there  may  be  some 
reason  to  doubt  that  this  is  regarded  as  a  proof  of  the 
health-giving  quality  of  wine,  for  we  drink  to  our  friend's 
health,  and  are  not  so  selfish  as  to  intend  thereby  to  pro- 
mote our  own  health,  so  the  custom  of  health-drinking  may 
be  akin  to  those  classic  libations  to  the  gods,  where  the  wine 
was  not  given  to  the  deity  but  poured  out  on  the  ground. 
If  the  idea  was  that  the  wine  does  good,  we  would  surely 
give  it  to  the  person  we  are  toasting,  not  drink  it  our- 
selves. 

But  custom,  from  prebistorical  times  to  the  present  day, 
commends  drinking  as  suitable  for  all  occasions.  If  we  are 
sad  we  drink  wine,  for  does  not  Solomon  tell  us  to  ''give 
wine  to  those  that  be  of  heavy  hearts  ?''     "  Diluitur  cura 


by  Dr.  K  E.  Dudfyeon.  135 

mero^"  says  Ovid^  and  ''vino  pellite  curas/'  says  Horace, 
If  we  wish  to  be  merry  we  drink,  and  again  quote  Solomon, 
who  says,  what  we  all  know,  "Wine  maketh  merry/'  If 
we  part  from  our  sweetheart  we  drink : 

Qo,  fetch  to  me  a  pint  of  wine. 

And  fill  it  in  a  ailyer  tassie^ 
That  I  may  drink  before  I  go, 

A  service  to  my  bonnie  lassie. 

If  we  welcome  home  a  long  absent  friend  we  celebrate  his 
retarn  in  an  extra  glass  or  two.  If  we  have  nothing  else 
in  particular  to  do  we  can  always  while  away  the  hour  with 
a  glass  of  something.    Like  Anacreon  we  can  cry — 

Fm  me,  boy,  as  deep  a  draught 

As  e'er  was  fill'd,  as  e'er  was  qoaiPd. 

Or,  if  oppressed  with  the  cares  that  wait  on  grey  hairs>  we 
ask  with  Horace — 

Cnr  non  sub  altA  7el  platano,  yel  hftc 
Finn  jacentes  sic  temeri,  et  ros& 
Canos  odorati  capillos, 

Dnm  licet,  Assyriiqae  nardo 
Pofcamns  nncti  ?    Dissipat  Evins 
Curas  edaces. 

A  very  pleasant  picture  of  enjoyment,  barring  the  pomatum. 

We  clinch  our  bargains  with  a  glass,  we  drink  to  keep 
out  the  cold,  to  keep  off  the  heat,  to  protect  us  from  the 
damp,  to  counteract  the  effects  of  a  too  dry  atmosphere. 
We  drink  in  order  to  help  us  to  digest  an  excess  of  food, 
aad  we  drink  to  supplement  meagre  fare.  We  drink  at 
nigbt  to  make  us  sleep  soundly,  and  we  drink  in  the 
morning  to  wake  us  up.  We  drink  before  dinner  to  give 
08  an  appetite,  and  we  drink  after  dinner — well,  I  don't 
know  why — probably  because  we  like  it.  Indeed,  this, 
after  all,  is  the  true  reason  for  all  this  drinking — because 
we  like  it — ^the  others  are  but  excuses  made  in  order  to 
persuade  ourselves  that  we  do  not  drink  for  mere  sensual 
gratification. 

We  drink,  then,  because  we  like  it — inventing  all  sorts  of 
excuses  to  divest  our  act  of  its  selfish  character — and  we 


136  On  the  Use  of  Alcohol  in  Health, 

like  it,  not  only  because  it  tastes  nice,  and  because  it  makes 
us  merry,  but  because  the  practice  is  recommended  to  us  by 
tradition,  by  custom,  by  our  doctor,  and  by  everybody, 
because  it  is  associated  with  hospitality,  sociality,  pleasant 
memories  of  happy  days,  and  of  jolly  companions.  With 
the  faculty  we  all  have  of  remembering  the  pleasant  and 
forgetting  the  unpleasant,  we  dwell  fondly  on  the  nights 
when  we  sat  round  the  festive  board  quaffing — 

Beamin'  awats  that  drank  diyinelj, 

and  forget  the  disagreeables  of  the  morning  waking.  We 
quote  Solomon  to  the  effect  that  wine  makes  merry,  but 
forget  that  that  sage  also  said,  "  wine  is  a  mocker.''  "  At  the 
last  it  biteth  like  a  serpent  and  stingeth  like  an'  adder.'^ 
We  enjoy  seeing  Falstaff  quaffing  his  cup  of  sack,  and  we 
think  Cassio  rather  a  pitiful  fellow  when  he  querulously 
asks  ^*  why  men  should  put  an  enemy  into  their  mouths  to 
steal  away  their  brains."  We  sing  with  the  jolly  post  boys 
that  ''  wine  cures  the  gout,  the  colic,  and  the  tisick,''  and 
we  do  not  stop  to  inquire  if  "  cures  "  is  not  a  misprint 
for  ''  causes.''  We  rather  think  that  King  Macbeth's  hall 
porter  has  said  the  worst  he  can  of  wine,  that  it  "  provokes 
nose  painting,  sleep^  and  urine."  Now,  nothing  can  be 
better  than  sound  sleep,  nor  more  wholesome  than  a  free 
action  of  the  kidneys,  and  as  for  nose  painting,  why,  a  red 
nose  is  eminently  respectable,  and  we  sing  about  a  fine  old 
English  gentleman  who  *'  quaffed  his  cup  of  good  old  port 
to  warm  his  gay  old  nose,"  or  we  even  join  in  Blueskin's 
boisterous  song,  "  Jolly  nose  !  the  bright  rubies  thHt  garnish 
thy  tip  are  dug  from  the  mines  of  Canary,"  as  if  the  painted 
nose  were,  on  the  whole,  an  honourable  distinction. 

We  like  alcohol,  not  only  because  it  is  pleasant  to  the 
taste,  but  because  it  causes  a  break  in  the  often  dreary 
monotony  of  our  lives,  it  removes  for  the  moment  that 
ennni  which  throws  a  sombre  shade  over  everything,  it  gives 
us  a  glimpse  of  a  brighter,  more  cheerful  condition  of 
things  than  we  are  accustomed  to,  it  enables  us  to  throw 
off  for  a  while  the  carking  cares  that  sadden  our  existence, 
and  to  forget  the  sorrows  and  miseries  by  which  we   are 


by  Dr.  R.  E.  Dudgeon.  137 

sorronnded.  It  does  all  this,  as  we  know,  at  the  expense 
of  our  health,  of  onr  bodily  and  mental  faculties  in  the  not 
remote  fiiture,  and  is  inevitably  followed  by  an  increase 
of  the  mental  enmii  for  which  we  take  it ;  but  still  we  take 
it  to  be  rid,  for  even  a  fleeting  moment,  of  the  intolerable 
harden  of  ennui.  Even  those  whose  lines  are  laid  in 
pleasant  places^  who  have  the  means  and  the  opportunity 
for  gratifying  every  wish,  will  often  long  for  a  change,  and 
seek  it  in  alcoholic  stimulants.  This  desire  for  a  change 
in  the  daily  routine^  be  it  of  play  or  of  work,  is  manifested 
in  the  earliest  childhood.  Without  apparent  reason,  chil- 
dieo  will  be  naughty,  even  at  the  risk  of  severe  punishment ; 
the  real  reason  is  that  they  find  the  monotony  of  good 
behaviour  intolerable.  This  intolerance  of  monotonv,  even 
of  s  monotony  of  delight,  is  shown  in  the  Mosaic  record 
of  man's  origin,  where  the  first  human  pair  sinned  them- 
selfes  out  of  the  perfect  garden  of  delights,  and  preferred 
the  risk  of  death  and  the  certainty  of  punishment  to  the 
everlasting  sameness  of  its  cloying  sweetness. 

Is  it  possible  that  alcoholic  drinks,  though  lauded  by 
poets,  advised  by  sages,  allowed  by  theologians,  recommended 
by  doctors,  and  sanctioned  by  Holy  Writ,  are  not,  after  all, 
good  for  persons  in  health,  that  their  regular  use  is  very 
apt  to  transform  health  into  disease  ?  ^'  Generous  wine  " 
is  but  a  euphemism  for  *'  intoxicating  liquor.''  What  is 
"intoxicating  *^  It  is  etymologically  equivalent  to  "  poison- 
ous.'' Can  "  generous  wine  "  taken  by  a  healthy  person  in 
moderate  quantities  in  a  regular  manner  be  poisonous  ?  I 
do  not  mean  drunk  in  the  immoderate  quantities  sung  by  the 
poets,  nor  yet  in  the  regular  allowance  of  our  grandfathers' 
time,  when  drinking  set  in  heavily  every  day  after  dinner, 
and  a  boy  to  loosen  the  neckcloths  of  the  guests  as  they  fell 
below  the  dining  table  was  a  part  of  the  regular  establish- 
ment  in  some  gentlemen's  houses,  when  "  no  daylights  and 
no  heel  taps  "  was  the  rule  for  every  toast,  and  the  toasts 
were  numerous  and  in  quick  succession.  My  inquiry  is 
directed  to  the  more  moderate  drinking  at  present  in 
fashion,  a  glass  or  two  at  luncheon  and  a  glass  or  three  at 
dinner ;  can  that  do  harm,  can  that  do  good  to  a  healthy 


188  On  the  Use  of  Alcohol  in  Health, 

person  ?     Is  he  the  better  or  the  worse  for   it  ?     I  can 
imagine  the  contemptuous  smile  that  will  arise  at  the  idea  of 
a  man  being  the  ''  worse  for  liquor  **  after  a  glass  or  two  or 
three  of  wine.    "Why,  every  doctor  will  tell  you  that  you  will 
be  all  the  better  for  that  quantity.     Well,  no^  not  every 
doctor,  but  nearly  every  doctor ;  certainly  most  of  those  who 
hsve  lately  aired  their  wisdom  in  the  columns  of  the  Con^ 
temporary.     Doctors  and  all  agree  that  a  healthy  man  runs 
the  risk  of  losing   his  health  if  he  drinks  a  large  quantity 
of  wine>  if,    in  scientific  jargon,  he  passes  the  limit    of 
''  physiological  saturation/'  but  doctors  are  not  agreed  as  to 
what  this  limit  is,  and  if  they  attempt  to  define  the  limit, 
instances  will  crop  up  to  their  confusion  of  hearty  old  gentle- 
men, approaching  their  twentieth  lustrum,  who  have  drunk, 
say,  two   bottles  of  port  wine>  daily  as  long  as  they  can 
remember,    or   longer.     Well,  such   instances   are   surely 
proof  positive  that  wine,  even  in  considerable  quantities,  is 
not  injurious — is,  in  fact,  beneficial — to  a  healthy  person, 
£or  how  else  could  a  man  attain  the  age  of  ninety  odd,  and 
be  fit  for  travelling  to  "  Jerusalem,  Madagascar,  and  North 
and  South  Amerikee''  (as  in  a  case  within  my  own  knowledge), 
drinking  daily  a  couple  of  bottles  of  port  wine.     Such  cases 
are  surely  staggerers  to  those  who  would  insist  upon  the 
harmful  effects  of  the  regular  use  of  alcohol.     Such  cases 
surely  prove  the  beneficial  effects  of  even  excessive  quantities 
of  alcohol  regularly  imbibed ;   for  two  bottles  of  port  wine 
would  be  going  beyond  the  limits  of  "  physiological  satura- 
tion." Would  not  the  best  plan  to  meet  such  cases  be  to  deny 
their  truth  ?    But  then  "  facts  are  chiels  that  winna  ding,'' 
and   we  must  accept  our  vigorous  two>  bottle  nonagenarians 
and  make  the  best  of  them.     We  know  how  many  healthy 
men  have  succumbed  to  a  daily  consumption  of  alcohol  a 
long  way  short  of  two  bottles  of  port.     The  fact  is,  there 
are   some  persons   who   can   get  used    to  and  apparently 
flourish  on  what  would  be  death  to  others.     We  have  seen 
opium  eaters,  apparently  enjoying  good  health,  who  could 
every   day  consume  as  much  opium   as  would   send   ten 
ordinary  persons  to  sleep  for  ever.     A  Styrian  peasant  will 
eat  as  much  arsenic  at  a  meal  as  would  kill  half  a  dosen 


by  Dr.  R.  E.  Dudgeon.  139 

EDglishmen.      We    all   know   the   baleful  effects    of  the 

inhalation  of  a  small  quantity  of  sewer  gas  on  some  people^ 

aod   yet   as    fine    specimens    of   healthy,    fosj,    muscular 

humanity  as  we  could  desire  to  see,  may  be  seen  every  day 

issuing  from  those  trap  doors  in  our  London  streets  that 

lead  to  and  from  the   sewers^  where  a  great  part  of  their 

lives  is  spent.     We  need  scarcely  do  more  than  mention 

the  sad  case  of  King  Mithridates,  who  had  so  habituated  him- 

self  to  the  use  of  poisons  that  when  at  leugth  he  wished  to 

commit  suicide  he  could  not  find  a  poison  that   had  the 

slightest  effect  on  him.     This  may  be  a  myth,  and  so  may 

also  the  story  of  the  Caliph  of  Bagdad,  or  Shah  of  Persia, 

or  some  other  Oriental  potentate^  who  had  so  saturated 

himself  with  poisons  that  he  had  to  get  a  fresh  wife  every 

night,  one  embrace  sufficing  to  kill  his  bride,  and  when  he 

wished  to  slay  an  obnoxious  courtier  all  he  had  to  do  was 

to  spit  in  his  face.     But,  however  incredible  these  stories 

may  be,  there  «is  no  doubt  of  the  fact  that  some  people  may 

gradaally  accustom  themselves  to  take  enormous  quantities 

of  poisons  without  apparently  being  a  bit  the  worse.     So 

may  people  accustom  themselves  to  the  use  of  intoxicating 

drinks  to  such  an  extent  as  to  be  able  to  imbibe  preposterous 

quantities,  not  only  without  getting  tipsy,  but  apparently 

vith  no  appreciable  injury  to  their  health.     Like 

Mjnheer  Van  Dank,  though  he  never  was  drank. 

Sipped  hiB  brandy  and  water  gaily. 
And  he  qnenched  his  thirst  with  a  qnart  of  the  first. 

To  a  pint  of  the  latter  daily. 

But  the  question  I  have  put  myself  to  answer  is  not  how 
far  the  human  constitution  can  bear,  as  many  of  our 
ancestors  did^  the  daily  imbibition  of  alcholic  liquors  up  to 
the  limit  of  "  physiological  saturation,'^  or  a  trifle  beyond  it. 
Nor  would  I  inquire  if  the  more  modern  habit  of  "  nipping,'' 
that  is,  of  taking  drops  of  wine  or  spirits  frequently  during 
the  day,  is  wholesome  or  not ;  we  may  take  it  for  granted 
that  it  is  hurtful,  ffuita  cavat  lapidem  non  vi  sed  sape 
cadendo,  which  may  be  freely  translated,  "  frequent  '  wee 
draps '  wear  out  the  strongest  constitution." 

My  inquiry  relates  to  moderate  drinking  only.     Mode- 


.  I 


140  On  the  U$e  of  Alcohol  in  Health, 

rate  I  seductive  word  I  We  can  all  prate  about  the  Tirtue  of 
moderation.  Some  of  as — who  might  be  the  modern  repre- 
sentatives of  that  very  respectable  sect,  the  Pharisees — may 
even  think  it  is  our  duty  to  show  the  example  of  moderation 
to  our  weaker  brethren  who  are  given  to  the  vice  of  im- 
moderate drinking.  Abstinence  they  think  is  weak,  tem- 
perance is  heroic,  and  shows  that  we  can  control  while 
indulging  our  appetite, 

In  modention  placiag  all  onr  glory. 

They  point  with  smug  satisfaction  to  their  own  example. 
It  adds  a  flavour  and  an  aroma  to  our  daily  glass— or 
bottle,  as  the  case  may  be — to  think  that  by  our  modera- 
tion we  are  preaching  a  fine  sermon  and  giving  a  useful 
moral  lesson  to> — somebody  or  other — ^we  do  not  too 
curiously  inquire  whom.  With  such  pleasant  reflections 
the  wine  ^'  goeth  sweetly  down,^'  as  wise  Solomon  hath 
it,  and  it  becomes  almost  a  duty  to  drink,  in  order  to  show 
that  we  can  leave  off  on  this  side  of  the  limit  of  "  phy- 
siological saturation,'^  and  are  not  like  other  men — if  not 
publicans,  at  all  events,  their  customers — who  drink  till  they 
become,  in  their  alcoholic  jargon,  "fresh,''  "tight,"  or 
"sprung"— or  whatever  the  latest  euphemism  may  be — or 
even  '^  drunk,*'  if  we  can  make  out  what  that  state  really  is. 
A  few  days  ago  we  read  of  a  clergyman  who  was  brought 
up  before  the  magistrate  for  singing,  dancing,  and  preaching 
in  front  of  a  public  house ;  but  the  constable  who  arrested 
him  would  not  admit  that  he  was  drunk,  because  he  was 
still  able  to  sit  on  a  chair.  Others  go  further,  and  declare 
that  no  man  is  drunk  as  long  as  he  is  able  to  lie  flat  on  the 
grass  without  holding  on  by  it.  But,  of  course,  drunkenness 
in  this,  or  even  in  any  minor  degree  down  to  mere  "  fresh- 
ness," which  we  presume  is  the  slightest  degree  or  the 
incipient  stage  of  tipsiness,  is  an  abomination  to  the  mode- 
rate drinker  who  prides  himself  on  his  temperance.  He 
will  come  to  look  upon  himself  as  permitted  by  Holy  Writ 
to  take  his  wine  as  a  commendable  drink,  for  does  not 
David  say  that  '*  wine  maketh  glad  the  heart  of  man,"  and 
Jotham,  in  his  fable  of  the  trees,  goes  still  further,  and  says. 


by  Dr.  R.  E.  Dudgeon.  141 

"  wine  which  cheereth  God  and  man.''  Again^  **  strong 
wine"  was  poured  '*  as  a  drink  offering  to  the  Lord/' 
which  it  would  not  have  been  had  it  been  objectionable  to 
the  Deity. 

And  then  St.  Paul  distinctly  discourages  abstinence  or 
teetotalism  when  he  says  to  Timothy^  ''Drink  no  longer 
water,  but  use  a  little  wine  for  thy  stomach's  sake,  and  thine 
often  infirmities/'  on  which  occasion   he  omits   to  say,  ''  I 
speak  as  a  fool."     Incidentally  it  may  be  remarked   that 
all  amateur  doctors  recommend  their  nostrums  for  stomach 
snd  other  infirmities   without  a  suspicion  that   they    are 
generally   fools  for  their  pains.     Though  regular   doctors 
usually    prescribe  with    a    certain    amount    of   difiSdence 
as  to  the  effect  of   their   prescriptions,  the   non- medical 
adviser  is  never  conscious  of  the  slightest  doubt  respecting 
the  cnrative  results  to  be  obtained  from  his  specific.     The 
theologian  may  display  some  modest  hesitation  in  the  inter- 
pretation of  an  obscure  text,  but  he  is  sure  of  the  remedial 
powers  of  his  specific  for  rheumatism.     The  mathematician 
may  not  be  very  confident  of  his  solution  of  a  problem,  but 
he  knows  that  a  certain  pill  will  infallibly  cure  your  stomach- 
ache.   The  mechanician  will  not  be  absolutely  sure  that  his 
machine  will  do  the  work  he  proposes,  but  he  will  give  you 
as  nnfailing  receipt  for  your  toothache.    The  learned  Grecian 
will  put  forward  his  interpretation  of  a  classical  phrase  with 
some  diffidence,  but  he  has  no  mistrust  of  his  cure  for  your 
lumbago.     So  also  the  apostle;  though  he  may  allow  the 
possibility  of  an  error  in  his  opinion  as  to  the  proper  line  of 
conduct  for  his  disciples  to  adopt  in  certain  cases,  he  has  no 
manner  of  doubt  that  water-drinking  is  pernicious  when  your 
stomach  is  weak,  and  that  wine  will  put  it  all  to  rights. 

With  these  scriptural  testimonies  to  the  value  of  his 
&Tonrite  beverage,  it  is  not  to  be  wondered  at  that  the 
modem  christian  will  sometimes  inveigh  against  water 
drinking  as  a  sinful  rejection  of  the  good  gifts  of  God,  and 
a  cowardly  shrinking  from  his  duty  to  practise  the  truly 
christian  virtue  of  moderation  in  the  use  of  a  beverage  which 
the  conseusus  of  mankind,  and  the  authority  of  Scripture 
have  declared  to  be  pleasant  and  wholesome. 


142  On  the  Use  of  Alcohol  in  Health, 

Bat  it  is  not  of  drinking  alcoholic  fluids  for  any  exalted 
notion  of  setting  a  good  example  of  moderation  that  I  would 
now  speak.  Of  course  I  do  not  deny  the  powerful  moral 
effect  that  the  contemplation  of  the  squire  or  the  parson 
sipping  his  fine  old  port,  and  yet  stopping  far  short  of 
''  physiological  saturation/'  may  have  on  Hodge  at  the 
public  house  swilling  his  adulterated  gin  or  his  drugged  ale. 
And  yet,  perhaps,  if  Hodge  stops  short  of  '*  physiological 
saturation  **  that  may  be  owing  rather  to  the  emptiness  of 
his  pockets  than  to  the  fine  moral  example  of  moderation  at 
the  Hall  or  the  Vicarage.  Nor  do  I  care  to  inquire  if 
alcoholic  fluids  quicken  the  intellect  and  enable  us  to 
perform  greater  mental  feats  than  we  could  without  their 
aid.  It  may  be  that  in  doing  so  the  intellect  fares  some- 
what like  the  peau  de  chagrin  of  Balzac's  tale,  and  that 
each  spirituous  call  upon  it  is  followed  by  a  sensible  diminu- 
tion of  its  integrity.  Wit  and  humour  have  always  been 
thought  to  be  greatly  promoted  by  alcohol,  and  yet  the 
wittiest  member  of  the  present  Parliament  is  that  rollicking 
teetotaller,  the  genial  advocate  of  the  Permissive  Bill, 
whose  wit  bubbles  forth  in  an  inexhaustible  stream  like  the 
sparkling  mountain  spring,  and  not  in  the  intermittent  gushes 
elicited  by  the  artificial  excitation  of  alcoholic  stimulants. 

The  question  I  have  set  myself  to  answer  is  this  :  Is  the 
regular  and  moderate  use  of  alcoholic  drinks  beneficial  to 
the  health  of  a  healthy  person  ?  This  is  a  simple  medical 
question  and  is  apart  from  all  high  moral  purposes,  socia- 
bility, hospitality,  and  other  minor  virtues.  To  answer  it, 
we  must  ask  what  are  the  physiological  effects  of  alcohol  on 
the  healthy  human  frame  ?  These  are  somewhat  difficult  to 
arrive  at,  as  many  physiological  effects  have  been  ascribed 
to  it,  and  of  course  its  effects  differ  much  according  to  the 
dose  in  which  it  is  taken,  its  purity,  and  the  constitutional 
peculiarities  or  idiosyncrasies  of  the  provers.  But  the 
physiological  effects  of  alcohol  on  the  human  frame  that 
seem  to  be  best  established  by  experiment  are  that  it  retards 
digestion  and  reduces  the  temperature  of  the  body.  So  that 
the  ordinary  pleas  for  its  use,  viz.  that  it  promotes  digestion 
and  makes  us  warm,  are  not  borne  out  by  physiological 


by  Dr.  R.  E.  Dudgeon.  143 

obseiratioD^  and^  however  much  they  are  believed  in,  are  con- 
trary to  fact.  To  the  healthy,  then,  the  use  of  alcohol  for  the 
purpose  of  promoting  the  digestion  of  food  is  altogether  a 
mistake.  In  many  cases  it  may  itself  be  a  kind  of  food 
easily  digested,  but  it  undoubtedly  interferes  with  the 
digestion  of  other  food.  In  this  it  acts  in  an  opposite 
sense  to  what  is  commonly  believed  of  cheese,  which  is  said 
(probably  erroneously,  like  most  popular  dietetic  maxims) 
to  digest  everything  but  itself,  whereas  alcohol  suffers 
nothing  to  be  digested  until  it  is  disposed  of.  In  thus 
interfering  with  the  digestion  of  more  appropriate  food,  it 
causes  a  variety  of  dyspeptic  and  other  ailments.  If  the 
quantity  taken  be  slightly  in  excess  of  what  can  readily  be 
got  rid  of,  we  have  quickened  hearths  action,  dry  tongue  at 
night,  perverted  taste,  loss  of  appetite,  and  headache  in  the 
morning.  Or  if  the  quantity  taken  be  not  sufficient  to 
cause  these  acute  symptoms,  it  may  yet,  if  regularly  taken 
for  a  lengthened  period,  insidiously  cause  graver  chronic 
maladies,  such  as  bilious  derangement,  gastralgia,  weakened 
digestive  powers,  gout,  rheumatism,  lumbago,  sciatica,  hypo- 
chondriasis, and  many  other  more  or  less  serious  diseases. 

Tha/t  the  habitual  use  of  alcoholic  stimulants  greatly 
diminishes  the  digestive  powers  has  been  demonstrated 
lately  on  a  large  scale  by  the  increased  quantity  of  food 
consumed  by  sailors  on  temperance  ships.  There  are 
morbid  states,  undoubtedly,  in  which  alcohol  is  an  appro- 
priate pabulum,  but  for  the  healthy  it  is  not  the  proper  food, 
and  they  would  do  well  to  avoid  its  habitual  use,  and  even 
if  they  take  it  occasionally  they  should  remember  that  they 
do  so  at  the  risk  of  causing  at'  all  events  temporary  de- 
rangement of  some  of  their  functions. 

The  other  physiological  effect  of  alcohol  alluded  to  above 
is  diminution  of  the  normal  temperature  of  the  body.  This 
is  contrary  to  the  popular  view,  which  regards  alcohol  as  a 
means  of  making  the  body  warm.  *^  Take  a  glass  to  keep 
out  the  cold ''  is  considered  good  advice  to  a  friend  about 
to  take  a  journey  on  the  top  of  a  coach  on  a  frosty  day. 
But  though  well  meant,  like  most  gratuitous  advice,  it  is 
not    based    on  sound    physiological    data.       The   alcohol 


144  On  the  Use  of  Alcohol  in  Health, 

renders  us  in  fact  more  sasceptible  of  cold,  and  though, 
by  its  narcotic  properties^  it  renders  us  at  first  less  sensitive 
to  the  low  temperature^  this  effect  soon  passes  off  and  we 
feel  more  chilly^  and  the  thermometer  shows  that  oar  tem- 
perature is  reduce^i.  Hence  we  soon  feel  the  wish  for  a 
repetition  of  the  alcoholic  dose  to  dull  the  sense  of  cold  the 
first  dose  occasioned^  and  if  we  go  on  drinking  while  con- 
tinuing exposed  to  the  frosty  air,  we  run  great  risk  of 
being  chilled  down  to  the  extinction  of  life.  During  a 
very  cold  winter  I  passed  at  Vienna  the  stiff  stark  bodies 
of  sentries  frozen  at  their  post  were  almost  daily  brought 
iuto  the  military  hospital  called  the  Josephinum^  and  it 
was  alleged  that  their  death  by  freezing  was  occasioned  by 
their  having  indulged  in  drams  of  schnapps  before  going  on 
duty.  My  friend  Dr.  Bae^  who  has  had  as  much  experi- 
ence of  low  temperatures  in  his  Arctic  explorations  as  any 
man  alive,  says  that  he  found  it  most  dangerous  to  permit 
any  of  his  men  to  take  alcohol  in  any  form  during  their 
journeys^  and  that  the  only  way  health  and  strength  could 
be  preserved  was  by  enforcing  strict  teetotalism.  I  could 
adduce  hundreds  of  other  instances  to  show  the  chilling 
effects  of  alcohol,  but  the  above  will  suffice  to  show  that 
the  idea  of  alcohol  keeping  out  the  cold  is  a  popular  fallacy, 
and  that  if  we  wish  to  guard  ourselves  against  the  evil 
effects  of  a  low  temperature  we  should  abstain  entirely 
from  its  use. 

The  inference  to  be  deduced  from  the  above  is  that  the 
daily  regular  and  moderate  use  of  alcohol  is  not  only  useless 
to  the  healthy,  but  extremely  apt  to  do  harm.  A  convic> 
tion  of  this  will,  I  am  sure,  be  very  agreeable  to  some  poor 
people  who  thmk  that  the  daily  imbibition  of  a  certain 
quantity  of  alcohol  is  beneficial,  and  who,  not  being  able  to 
afford  the  luxury  of  quaffing  the  premiers  cms,  are  forced  to 
conteut  themselves  with  beer  or  spirits  or  inferior  wines, 
which  afford  no  gratification  to  their  palates,  but  which  are 
taken  almost  as  a  medicine  of  orthodox  nastinees.  It  will 
be  a  great  boon  to  the  purses  as  well  as  the  stomachs  of 
these  poor  people  to  be  convinced  that  water  is  much  more 
wholesome,  as  they  already  know  it  to  be  much  nicer.     To 


by  Dr.  R.  E.  Dudgeon.  145 

those  who  can  afford  the  best  wines  I  do  not  believe  the 
knowied^  that  wine  is  nnnecessary,  if  not  injurious^  will  be 
of  any  importance^  for  thej  will  scarcely  be  induced  to 
forego  the  accustomed  gratification  of  their  palate  by  the 
fear  of  future  sufferiug^  and  perhaps,  on  the  whole,  it  is  as 
well  that  they  should  go  on  ^'  proving  "  for  us  the  effects  of 
the  regular  and  irregular  use  of  alcoholic  liquids,  and  if 
they  are  occasionally  laid  up  with  gout,  why  that  is  a 
diversion  from  the  otherwise  agreeable  monotony  of  their 
lives,  and  besides  being,  as  Lord  Chesterfield  declared,  a 
very  gentlemanly  disease,  it  will  help  to  swell  the  doctor^s 
income,  which,  from  the  purely  professional  point  of  view,  is 
no  small  advantage.  As  the  raison  d'etre  of  a  doctor  is  to 
care  diseases,  it  may  seem  an  impertinence  for  us  to  offer 
advice  to  the  healthy,  as  it  is  manifestly  not  our  business  to 
prevent  people  making  themselves  ill,  in  fact  it  is  a  very 
uobosiness-like  proceeding  on  our  part ;  for,  supposing  we 
did  succeed  in  our  benevolent  intention,  we  would  thereby 
pat  a  stop  to  our  interesting  pathological  studies  and 
researches,  besides  destroying  our  own  means  of  existence. 
But  such  is  the  disinterested  character  of  doctors  that  they 
have  at  all  times  attended  as  much  to  the  prophylaxis  as  to 
the  cure  of  disease,  and  have  always  honestly  and  earnestly 
pointed  out,  to  the  best  of  their  ability,  how  people  might 
preserve  their  precious  health  and  so  avoid  becoming  the 
doctor's  clients.  But  in  most  cases  their  voice  has  been  like 
the  voice  of  one  crying  in  the  wilderness,  no  one  heeding  it, 
sad  people  have  gone  on  transgressing  every  sanitary  law, 
sod  thus  contracting  diseases  whereby  they  become  tribu- 
taries to  the  doctor.  A  little  school-board  girl  lately 
defined  "  a  nobleman ''  as  ''  a  person  who  gains  his  livelihood 
by  riotous  living ;  '^  she  might,  with  equal  felicitVj  have 
defiued  ^^  a  doctor  '^  as  "  a  person  who  gains  his  livelihood  by 
the  riotous  living  of  others,^'  or  at  least  by  their  sins  against 
the  laws  of  health  promulgated  by  the  medical  faculty. 

With  the  knowledge  that  alcohol  even  in  moderation  is 
apt  to  prove  injurious,  there  would  seem  to  be  required  some 
modification  of  the  conventional  grace  before  meat,  when  we 
sit  down  to  a  meal  intending  to  drink   wine.     In  place  of 

VOL.  XXXVII,  NO.  CXLVIII. APRIL,  1879.  K 


146  On  the  Use  of  Alcohol  in  Health, 

expressing  our  thankfulness  for  what  we  are  about  to 
receive,  we  should  rather  deprecate  the  merited  penalty  for 
transgressing  the  laws  of  healthy  dietetics.  This  know- 
ledge^ too,  will  add  a  fresh  zest  to  the  toast  we  drink  to 
our  friend's  health.  We  shall  feel  that  we  are  reallv 
making  a  sacrifice  of  ourselves  in  our  eagerness  to  show 
him  how  much  we  esteem  him.  It  will  be  as  thoagh  we 
said :  ^'  See,  my  dear  fellow,  I  love  you  so  much,  I  am 
willing  for  your  sake  to  pour  down  my  throat  this  fiery 
liquid,  which  is  perhaps  fraught  with  very  unpleasant  con- 
sequences to  myself;  at  all  events  I  am  ready  to  run  the 
risk  in  order  to  show  my  affection  for  you/'  Health  drink- 
ing will,  under  these  circumstances,  be  divested  of  the 
anomalous  character  it  presents  when  we  think  the  wine  we 
drink  to  our  friend's  health  does  good  to  the  drinker.  Now 
that  we  know  that  it  will  probably  do  us  harm,  we  will 
naturally  feel  a  glow  of  satisfaction^  as  having  really  per- 
formed an  act  of  self*denial  and  incurred  some  little  risk 
for  another's  sake.  It  is  only  to  be  feared  that,  seeing  the 
self'immolating  character  of  many  people,  and  their  eager- 
ness to  display  their  willingness  to  make  sacrifices  for  their 
fellow-creatures,  they  may  take  too  seriously  to  health 
drinking,  and  may  fall  martyrs  to  indiscriminate  and  too 
general  displays  of  their  affection  in  this  way.  To  prevent 
such  a  catastrophe  a  paternal  government  (if  we  had  one, 
which  alas !  we  have  not,  at  least  only  a  kind  of  step- 
fatherly  one)  might  fix  a  maximum  for  the  number  of 
healths  to  be  drunk  on  ordinary  occasions,  beyond  which 
no  person  should  be  allowed  to  sacrifice  himself,  and  for 
very  special  occasions,  when  it  is  desired  to  exceed  this  maxi- 
mum, require  a  licence  to  be  taken  out,  just  as  beer-houses 
have  to  take  out  a  licence  ^'  to  be  drunk  on  the  premises.^' 
Though  convinced  of  the  inutility  and  the  danger  to 
health  of  the  constant  and  regular  drinking  by  healthy 
persons  of  alcoholic  fluids,  even  in  the  most  moderate 
quantities,  I  am  well  aware  that  abstinence  from  alcohol, 
though  advantageous  in  a  sanitary  point  of  view,  is  by  no 
means  a  panacea  for  securing  health.  To  hear  the  fanatics 
declaim  we  might   almost  imagine  that  their  special  hobby 


by  Dr.  R.  B.  Dudgeon.  147 

is  the  one  thing  required  to  keep  everything  right.  Thus, 
an  enthusiastic  advocate  of  vegetarianism  lately  declared  in 
the  Times  that  abstinence  from  animal  food  would  not  only 
keep  us  all  healthy,  but  would  prevent  all  mistakes  and 
lapses  in  religion,  morals,  and  politics.  Another  seemed  to 
think  a  vegetable  diet  would  convert  mankind  to  "  fonetik '' 
spelling  and  every  other  virtue.  A  French  physician  has 
recently  announced  that  all  the  diseases  that  afflict  human 
beings  are  caused  by  the  pernicious  habit  of  eating  their  food 
cooked,  and  that  if  they  would  only  eat  their  chops  and 
steaks  raw  they  would  certainly  enjoy  health  and  longevity. 
Tobacco  counter-blasters  are  still  a  numerous  company ;  to 
hear  them  talk  one  would  suppose  that  they  believed  all  human 
physical  and  moral  maladies  to  be  due  to  the  accursed  nicotian 
weed.  The  teetotallers  frequently  write  and  orate  as  if  absti- 
Benoe  from  alcoholic  liquors  were  the  one  thing  needful  to 
preserve  health  and  morals  intact.  But  total  abstinence, 
though  good,  is  not  alone  sufficient  to  keep  people  in  health. 
Setting  aside  alcoholic  liquors,  we  are  liable  to  fall  into  a 
hundred  pitfalls  whereby  our  health  may  be  jeopardised. 
We  may  eat  too  much,  or  we  may  partake  of  indigestible 
food ;  for  all  that  appears  on  the  best  spread  tables  is  not 
equally  digestible ;  we  may  smoke  too  many  cigars  or  pipes, 
ve  may.drink  too  much  tea  or  coffee,  we  may  be  exposed  to 
excessive  cold,  or  heat, or  damp.  We  may  work  too  much  with 
our  muscles  or  our  brains.  We  may  undergo  exciting  or  de- 
pressing emotions  or  exhausting  passions.  Indeed  we  cannot 
SToid  all  or  many  of  these  disturbers  of  health.  Nor,  indeed, 
do  we  try  always  to  avoid  them.  On  the  contrary,  we  often 
purposely  court  them.  Were  life  to  be  spent  in  living  in 
strict  conformity  with  the  known  laws  of  health  it  would  be 
scarcely  worth  having.  In  our  business,  our  pleasure,  our 
love  of  sport,  in  acts  of  friendship,  or  in  our  wish  to  please 
or  to  shine,  we  brave  the  risk  of  disease,  and  often  death,  from 
fatigue,  from  over  study,  from  accident,  from  exposure,  from 
infection,  from  draughts,  from  heats,  from  damp,  from  indi- 
gestible food,  from  impure  water,  and  think  nothing  of  it. 
And  so  with  alcohol  drinking.  With  a  full  knowledge  that  we 
do  not  require  it,  and  that  it  may  do  us  harm,  we  sip  with  gusto 


148  On  the  Use  of  Alcohol  in  Health, 

the  delicious  nectar  our  host  places  before  us.  And  no  great 
harm  results  from  so  doing.  But  to  take  a  daily  regular  allow- 
ance of  indifferent  wine,  or  beer^  or  spirits,  is  not  so  pleasant 
as  that  we  should  persist  in  it  when  we  know  that  it  is  not 
beneficial^  but,  on  the  contrary,  most  decidedly  injurious  to 
our  health  in  the  long  run. 

Writers  who  admit  the  uselessness  of  alcohol  to  persons 
in  health  will  still  allow  its  utility  to  some  healthy  persons 
when  exhausted  by  bodily  fatigue  or  mental  exertion. 
There  is  no  doubt  of  the  immediately  reviving  and  appa- 
rently invigorating  effects  of  alcohol  under  these  circum- 
stances, but  this  is  not  always  the  case,  and  the  momentary 
revival  is  certain  to  be  followed  by  a  corresponding  depres- 
sion, showing  that  the  alcohol  was  not  a  food  for  the 
exhausted  nervous  system,  but  an  excitant  that  must  injure 
the  nerves  it  stimulated.  A  cup  of  tea,  or  coffee,  or 
chocolate,  or  a  basin  of  good  soup,  or  a  slice  of  bread  and 
butter,  or  even  a  good  rest  aloae,  is,  under  these  circum- 
stances, worth  all  the  alcoholic  stimulants  that  were  ever 
invented,  and  leaves  no  injurious  consequences.  The  body- 
exhausted  by  fatigue  will  often  turn  against  stimulants  and 
reject  them.  I  remember  when  somewhat  younger  than 
now  walking  with  two  companions  fifty  miles  in  one  day — 
no  great  feat  for  the  Westons  and  O'Learys  of  the. present 
day,  but  not  a  bad  walk  for  a  youth  without  previous 
training.  When  we  got  home  one  of  us  had  a  glass  of 
stout,  the  other  a  cup  of  tea,  and  the  third  went  to  bed 
without  partaking  of  anything.  The  two  latter  were  quite 
comfortable,  and  rose  next  morning  refreshed  by  sound 
sleep;  the  unfortunate  youth  who  drank  the  stout  imme- 
diately became  sick,  passed  a  bad  night,  and  could  not  get 
up  until  the  afternoon  of  the  following  day. 

Many  advocates  for  abstinence  in  youth  and  middle  age 
insist  on  the  utility  of  alcoholic  stimulants  for  old  people. 
This  I  believe  to  be  a  great  mistake.  In  advanced  life  we 
are  still  less  capable  of  resisting  the  toxical  effects  of 
alcohol;  accordingly  we  see  that  people  who  have  drunk 
moderately  all  their  life  have  passed  through  the  earlier 
periods  without  suffering,   but   in  their  old  age  they  are 


by  Dr.  R.  E.  Dudgeon.  149 

subject  to  goutj  gravel,  dyspepsia^  liver  complaints,  impaired 
inteliect,  aud  other  conseqaences  of  alcoholic  stimulation. 

The  toxical  effects  of  alcohol  are  most  observable  in  the 
case  of  the  dipsomaniac,  in  whom  the  smallest  quantity 
will  create  an  irresistible  craving  for  more  and  more  until 
the  unfortunate  yictim  is  reduced  to  a  state  of  utter  want 
of  self-control  aud  insensibility  to  all  feeling  of  self- 
respect.  The  only  cure  for  such  cases  is  total  abstinence. 
Nothing  short  of  this  will  suffice,  and  the  abstinence  must 
be  continued  for  life,  for  alcohol  never  ceases  to  be  a  poison 
for  him,  nor,  so  far  as  my  experience  goes,  does  the  craving 
for  drink  ever  leave  him.  The  dipsomania  was  originally 
induced  by  a  long  course  of  moderate  drinking,  and  may 
suddenly  develop  itself  in  any  moderate  drinker.  This  is  a 
strong  reason  for  discouraging  even  a  moderate  regular  use 
of  alcoholic  stimulants  in  apparently  healthy  persons. 

I  have  said  nothing  about  the  use  of  alcohol  in  disease. 
The  orthodox  school,  having  lost  confidence  in  all  the  heroic 
remedies  of  former  days,  still  stand  up  for  the  remedial 
virtues  of  alcohol  in  a  vast  number  of  cases  in  which  the 
patient  would  be  better  without  it.  But  it  will  be  difficult 
to  dissuade  them  from  prescribing  it  in  these  cases,  for 
luch  is  the  poverty  of  their  resources,  and  such  the  destitu- 
tion— as  regards  remedies — ^to  which  they  have  been  reduced 
bv  the  rational  light  the  new  therapeutics  have  let  in  on 
medical  treatment,  that  thev  have  no  substitute  to  offer  for 
their  present  excessive  use  of  alcohol  in  disease.  With  the 
spread  of  rational  principles  and  the  diffusion  of  sound 
knowledge  respecting  the  real  effects  of  alcohol  on  the 
buman  frame,  doctors  will  eyentually  have  to  abandon  this 
last  '^  sheet  anchor ''  of  orthodox  treatment,  or,  at  all 
e¥eDts,  to  confine  its  use  to  those  few  cases  in  which  it  is 
medicinally  required,  the  number  of  which  grows  yearly 
smaller  and  smaller.  I  shall  not  attempt  to  indicate  the 
particular  diseases  or  morbid  conditions  which^  in  my 
opinion,  call  for  the  use  of  alcohol  medicinally,  but  I  may 
mention  what  effects  1  have  observed  from  its  disuse  by 
tolerably  healthy  persons  previously  accustomed  to  take  it 
9s  a  regular  accompaniment  to  their   daily  meals,  or,  at 


150  On  the  Use  of  Alcohol  in  Health, 

leasts  to  one  or  two  of  these.  Better  appetite  for  all  meals, 
absence  of  sick  headaches  and  **  biliousness,^'  more  equable 
spirits  and  temper^  sounder  sleep,  less  liability  to  catch 
cold,  less  actual  feeling  of  cold  in  cold  weather,  and  hence 
less  or  no  need  for  flannels  or  great  coats,  at  least  when  ia 
exercise,  longer  retention  of  the  bodily  heat  and  comfort- 
able feeling  when  bathing  in  cold  water,  freedom  from 
those  little  rheumatic  pains  that  often  annoy  without  laying 
us  up,  as  also  from  lumbago,  sciatica,  effusions  into  the 
knee-joints,  and  those  twinges  in  the  big  toe  that  serve  to 
remind  the  most  temperate  driuker^that  he  too  might  get  a 
fit  of  gout,  just  like  a  great  statesman  or  a  retired  admiral,  if 
he  subjected  himself  to  the  same  amount  of  steady  drinking. 

The  use  of  alcohol  among  the  European  races  belongs  to 
the  same  category  as  the  employment  of  other  poisons  by 
other  races,  such  as  hashish  by  the  Turks,  coca  by  the 
Peruvians,  opium  by  the  Chinese,  betel  by  the  Polynesians, 
arsenic  by  the  Styrian  peasant,  and  tobacco  by  all.  The 
consumer  of  alcohol  vainly  endeavours  to  persuade  himself 
that  his  favourite  beverage  is  a  nourishing  and  strengthen- 
ing food ;  it  is  just  as  much  a  poison  as  any  of  those  other 
substances,  and  it  has  ruined  the  health  and  slain  as  many 
of  its  votaries  as  ever  they  have  done.  The  sooner  this 
fact  is  known  and  acknowledged  the  better  will  it  be  for 
the  future  happiness  of  mankind,  for  with  this  knowledge 
few  will  care  to  persevere  with  regular  drinking,  even  of  a 
moderate  description^  as  they  will  know  that  they  spend 
their  money  on  what  does  them  no  good,  and  may  do  them 
much  harm.  Though  a  poison  to  the  healthy^  like  the 
other  stimulants  used  by  other  races,  it  is,  like  them,  a 
medicine,  and  if  its  use  is  confined  to  those  cases  in  which 
it  is  required  as  a  medicine,  it  will  prove  as  much  a  blessing 
as  it  is  now  a  curse  to  humanitv. 

When  the  truth  that  alcohol  is  not  a  food,  in  any  true 
sense  of  that  word,  is  generally  admitted,  our  friends  the 
publicans  will  surely  come  to  see  that  their  present 
denomination  of  '*  licensed  victuallers "  is  a  misnomer. 
One  of  two  courses  would  seem  to  be  alone  open  to  them. 
Either  they  must  give  up  the  sale  of  their  alcoholic  prepara-^ 


by  Dr.  R.  E.  Dudgeon.  151 

tions  and  take  to  selling  wholesome  victuals^  in  consonance 
with  their  name,  or,  oontinuing  to  sell  their  spirituous 
tbominations,  thej  must  in  consistency  change  their  deno- 
mination. Probably  Sir  Wilfrid  Lawson  would  recommend 
them  to  call  themselves  '^  licensed  brain-poisoners '/'  but  I 
do  not  think  they  would  willingly  accept  that  appellation 
unless  some  compensating  advantage  were  to  go  along 
with  \t,  such  as  a  prolongation  of  the  period  during  which 
they  may  exercise  their  evil  calling.  Their  discarded  name 
might  be  appropriately  transferred  to  their  dangerous  rivals 
—the  coffee-house  keepers — who  are  increasing  at  such  a 
pleasant  rate  all  over  the  country. 

A  knowledge  that  alcohol  is  a  poison  and  cannot  be  used 
bj  the  healthy  without  the  risk  of  injury  to  health  will  be 
far  more  effectual  than  any  pledge  for  keeping  reasonable 
people  from  the  regular  use  of  alcoholic  stimulants,  and 
will  greatly  diminish  their  desire  to  indulge  in  drinking 
eren  on  festive  occasions.  A  brimming  glass  of  the  finest 
vintage  will  lose  somewhat  of  its  aroma  if  we  see  in  the 
depths  of  its  purple  sheen  a  promise  and  potency  of  future 
aches  and  pains.  To  him  who^  conscious  of  the  toxic 
nature  of  alcohol,  will  still  persist  in  drinking  his  daily 
allowaoce^  ''  the  invisible  spirit  of  wine  "  in  each  bumper 
will  seem  to  say  : 

"  For  this,  be  tare,  to-night  thoa  sbalt  have  cramps, 
Side-stitches  that  shall  pen  thy  breath  up;  urchins 
Shall  for  that  vast  of  night  that  they  may  work 
All  exercise  on  thee ;  thou  shalt  be  pinched 
As  thick  as  honeycombs,  each  pinch  more  stinging 
Than  bees  that  made  them.    •    •    • 
*    *    *    111  rack  thee  with  old  cramps; 
Fill  all  thy  bones  with  aches ;  make  thee  roar, 
That  hearts  shall  tremble  at  thy  din." 

Under  these  threatenings  methinks  his  taste  for  regular 
drinking  will  soon  subside. 

**  Districtus  ensis  cui  super  impi& 
Cervice  pendet,  non  Sicule  dapes 
Dulcem  elaborabunt  saporem.'' 

For  the  unfortunate  subject  of  dipsomania  a  pledge  of 


152  Holiday  Tour  in  the  Pyrenee$, 

total  abstinence  may  be  exacted^  but  it  is  seldom  kept.  I 
have  more  hopes  of  staying  the  evil  by  the  gradual  discon- 
tinuance of  the  conventional  regular  drinking  of  persons  of 
sound  body  and  mind  than  of  curing  it  when  it  has  been 
developed  by  this  time-hallowed  custom — ^a  custom  more 
honoured  in  the  breach  than  in  the  observance. 


MEDICAL  AND  OTHER  NOTES  COLLECTED  ON  A 
HOLIDAY  TOUR  TO  ARCACHON,  BIARRITZ, 
PAU,  AND  THE  PRINCIPAL  WATERING 
PLACES  IN  THE  PYRENEES. 

By  Dr.  Roth. 

(ConHmted  from  page  42.) 

Cautekets. 

After  having  made  an  interesting  excursion  to  the  foot 
of  the  Pic  du  Midi  from  Eaux  Chaudes,  and  after  having 
spent  three  days  most  agreeably  in  Eaux  Bonnes,  we  con- 
tinued our  route  in  an  open  carriage  across  the  mountains. 
The  road  over  the  Col  d'Aubisque^  5130  feet  high^  and  over 
the  Col  du  Couret^  4350  feet  high^  is  constantly  surrounded 
by  au  always  changing  panorama  of  high  mountains.  We 
stopped  at  Argelez  for  an  hour ;  this  has  a  fine  situation  on 
the  slope  of  the  Oez,  which  is  3300  feet  high.  Many 
English  tourists  stop  here  for  a  month  in  the  spring,  while 
the  trees  are  in  flower.  This  place  is  half  an  hour  distant 
per  rail  from  Pierrefitte^  and  within  another  hour  and  a  half 
a  beautiful  mountain  road  leads  to  Cauterets,  where  Dr. 
Lahillone  took  us  round  the  Grand  Etablissement^  which  is 
provided  with  all  the  latest  improvements^  and  contains  the 
baths^  swimming  bath,  and  douches,  inhalation  rooms,  casino, 
and  museum.  Cauterets  is  about  3000  feet  high,  in  a 
narrow  valley  between  high  mountains.  To  the  east  is  the 
high  Peyraute,  to  the  south  the  Peguere.  The  first  covered 
with  forests  of  fir  trees,  the  latter  with  fir  and  beech  trees. 


by  Dr.  Roth,  153 

Between  the  two  the  top  of  the  Moun6  is  seen  in  the  east. 
To  the  north-east  is  the  Peyrenere^  with  its  three  points 
covered  with  pastnrage.  To  the  north  the  range  of  the 
Cabaliros  is  seen.  These  high  mountains  shelter  the  place 
in  all  directions,  and  the  air,  although  mild,  is  very  refresh- 
ing, and  there  is  no  doubt  that  the  climate  contributes  very 
mach  to  the  cure  of  the  many  thousands  of  patients  who 
visit  the  place  every  year  during  the  season  from  the  15th  of 
May  till  the  end  of  September.  The  place  is  full  of  lodging 
houses,  and  several  grand  hotels,  of  which  the  H6tel  de 
France  and  the  Hdtel  d^Angleterre  are  the  most  frequented. 

There  are  about  twenty-six  spriugs  and  thirteen  etab- 
lissements,  which  are  usually  divided  into  two  group?. 
The  one  that  of  Cauterets  proper^  and  the  other  the  group 
of  the  South.  The  large  Etablissement  built  of  grey 
marble  of  the  Pyrenees,  and  specially  provided  by  the 
springs  des  Espagnols  and  de  Cesar  Nouveau,  belongs  to 
the  first  group,  and  to  the  same  group  belong  the  ten 
springs  of  des  CEufs,  which  have  a  temperature  of  55^  to 
61^,  and  furnish  daily  400,000  litres  to  the  Etablissement 
des  (Eufs ;  further,  Bruzaud,  Rieumizet,  Vituw-Cisar,  with 
110,000  litres  daily,  Pause  Vietuv,  Pause  Nouveau,  and 
Socher,  with  120,000  litres  per  day,  which  contains,  besides 
sulphur,  jod  and  iron. 

At  a  distance  of  5400  feet  from  Cauterets,  and  much 
Ugher,  are  the  springs  of  la  Railliere,  temperature  89^, 
Petit-SairU'Sauveur,  le  Pr6,  Mauhourat,  les  Yeux,  sources  du 
Bois,  which  belong  to  the  second  group. 

These  numerous  springs,  .with  a  temperature  ranging 
from  89^  to  61^,  and  the  various  chemical  compositions, 
ftre,  besides  the  climate,  the  great  remedies  to  which 
Cauterets  owes  its  name.  The  physiological  effects  of  each 
spring  on  the  healthy  body  have  not  yet  been  sufiSciently 
studied,  and  consequently  their  therapeutic  effects  are  of 
more  or  less  value  according  to  the  powers  of  observation, 
and  the  experience  of  the  physicians  residing  during  the 
season  in  the  place.  I  have  tried  to  compile  in  the  follow- 
ing notes  taken  from  Dr.  Lahillone's  Histoire  des  Fontaines 
de  Cauterets,  all  what  I  believe  is  most  interesting  to  the 


154  Holiday  Tour  in  the  Pyrenees, 

busy  practitioner  who  wishes  to  have  some  idea  of  Cauterets. 
Those  who  have  time  and  take  interest  in  the  history  of 
the  use  of  mineral  waters  will  be  amply  repaid  for  their 
trouble  by  reading  the  interesting  book  I  have  just  named, 
which  contains  the  titles  of  other  works  on  Cauterets. 


The  Springs  of  Cauterets, 

''  The  principal  mineral  ingredient  of  these  waters  is  suU 
phuret  of  sodium ;  the  other  elements,  chlorates,  alkaline 
and  earthy  sulphates,  silicates,  nitrogen,  and  carbonic  acid 
gases,  are  held  in  yariable,  but  always  very  minute  quanti- 
ties. From  the  small  quantity  of  mineral  matter  contained, 
these  hot  springs  may  justly  be  compared  to  those  of 
Gastein,  Laudeck,  Ragatz,  Plombieres,  Schlangenbad, 
Teplitz,  &c."     ... 

''  Whatever  be  the  compounds  of  sulphur  (and  the  latest 
researches  of  Dr.  Garrigon  on  the  chemical  composition  of 
the  Eaux  Bonnes  show  that  these  are  not  yet  certain),  one 
is  justified  in  asserting  that  this  element  plays  but  a  very 
secondary  part  as  a  product  of  decomposition  in  this  mineral 
water.  The  action  it  exercises  upon  the  skin  or  mucous 
membranes,  whether  directly  or  by  its  compounds,  is  always 
weak.  Nevertheless,  with  regard  to  the  reflex  actions 
resulting  from  this  influence,  there  is  no  ground  for  sup- 
posing the  former  to  be  in  proportion  to  the  latter,  on 
account  of  its  various  idiosyncrasies/' 

"  It  is  known  only  that  sulphur  is  not  changed  in  the 
stomach,  that  in  the  intestine  it  is  partly  changed  into 
sulphuretted  hydrogen  and  alkaline  sulphurets,  which  pass  in 
part  ?uto  the  blood.  That  which  is  unchanged  is  eliminated 
directly  from  the  body.  The  alkaline  sulphurets  which 
have  entered  the  blood  produce  sulphuretted  hydrogen,  or 
sulphates,  or  even  basic  products,  which  are  excreted  by  the 
kidneys.  The  sulphuretted  hydrogen  is  excreted  by  the 
skin  or  by  the  pulmonary  mucous  membrane.  Besides,  it 
has  been  proved  by  experiment  that  the  physiological  action 
of  the  alkaline  sulphurets  is  identical  vrith  that  of  sulphur- 


by  Dr.  Roth.  155 

etted  bvdrogen.  One  sees^  therefore,  that  this  gas  becomes 
the  most  important  factor  of  the  compounds  of  the  sul- 
phurous  water.     It  takes  oxygen  from  the  blood. 

''  This  gas  enters  the  body  in  three  ways^  by  the  Inngs, 
the  intestines,  and  the  skin.  It  is  likewise  excreted  by 
these  same  channels  when  it  has  been  formed  in  the  body. 

.  .  .  '^Clinical  observation  has  long  recognised  the 
good  effects  of  sulphur  upon  the  abdominal  circulation, 
especially  in  haemorrhoids.  Hufeland  employed  sulphur, 
assisted  by  mild  laxatives,  in  piles. 

"  It  must  not  be  forgotten,  however,  that  years  before 
the  time  of  this  celebrated  physician,  Bordeu  had  proved 
the  good  effects  of  the  springs  of  Cauterets  in  chest  com- 
plaints when  associated  with  abdominal  affections,  antici- 
pating by  his  genius  the  explanations  of  contemporary 
science.  *  There  are  many,^  he  wrote,  '  who  complain  of 
their  chests,  although  their  troubles  are  really  produced  by 
the  action  of  the  abdominal  viscera ;  this  is  a  fact  which 
physicians  should  bear  well  in  mind.' 

"If  we  consider,  besides,  the  action  of  sulphuretted 
hydrogen  upon  the  nervous  system,  according  to  the  phy- 
siolc^ical  law  of  physical  stimuli,  we  must  allow,  as  the  final 
result  of  this  action,  a  diminution  of  the  morbid  irritability. 
This  gas  affects  the  heart  in  two  ways,  in  the  first  place 
through  the  vagus  nerve,  by  its  effect  upon  the  respiratory 
centres  of  the  spinal  cord  (the  frequency  of  respiration 
being  diminished) ;  secondly,  through  the  muscular  substance 
of  the  heart  itself  (diminished  irritability  of  its  tissue),  on 
tccount  of  the  disoxygenisation  of  the  blood  which  supplies 
the  spinal  ganglia  of  the  heart/' 

"  In  fact,  observation  proves  that  under  the  influence  of 
compounds  of  sulphur,  the  bile  secretion  is  increased  by  the 
waste  products  resulting  from  the  destruction  by  the  sul- 
phuretted hydrogen  of  the  used  blood-corpuscles,  which 
have  passed  into  the  vena  portae  system.  Thus  this  system 
Acqmres  a  more  active  circulation,  and  the  morphological 
changes  of  the  connective-tissue  corpuscles  are  more  active 
and,  in  some  degree,  more  energetic. 
*  "  The  action  of  the  sulphuretted  hydrogen  is  shown  on 


156  Holiday  Tour  in  the  Pyrenees, 

the  skin  and  mucous  membranes  by  the  hypersmia^  by  the 
papillary  turgescence^  by  the  more  rapid  growth  of  the 
epidermic  and  epithelial  elements^  by  an  ultimate  sedative 
influence  upon  the  morbid  irritability  of  the  cutaneous  and 
bronchial  nerves. 

''  Hence^  these  waters  are  useful  in  diseases  connected 
with  abdominal  plethora  and  metallic  poisoning,  in  chronic 
pneumonic  catarrh^  complicated  by  diseases  of  the  spleen, 
the  liver^  and  the  intestines;  in  nervous  affections  where 
a  sedative  influence  is  necessary^  in  certain  affections  of  the 
skin  and  mucous  membranes  where  it  is  needful  to  stimulate 
the  growth  of  the  cellular  elements  and  to  modify  the 
vitality  of  the  deeper  layers/' 

''  The  works  of  the  brothers  Byasson  on  the  Mauhourat 
spring,  those  of  M.  Dupourcau  on  the  amount  of  sulphur 
in  the  various  springs  and  pump-rooms  of  Cauteret,  are  the 
most  worthy  of  attention/' 

**  M.  Candelle,  in  a  recent  work,  has  ascertained  with 
much  ability  the  effects  which  the  sulphurous  springs  pro- 
duce on  certain  affections  of  the  cardiac  circulation  com- 
plicating other  abdominal  or  constitutional  ailments.  He 
has  found  that  the  drinking  of  the  waters  of  Cesar  and  La 
Kaillere  may  produce  palpitation  of  the  heart,  precordial 
pains,  and  the  reappearance  of  abnormal  cardiac  murmurs 
in  those  predisposed  to  these  ailments/' 

"  Candelie  has  ascertained  more  precisely  this  difficult 
therapeutic  pointy  advising  a  sulphurous  treatment  only  to 
anaemic  patients/' 

''  Valentines  (Handbuch  d.  Allgemeinen  u,  speciallen  BaU 
nioiherapie)  places  the  hot  sulphurous  springs  of  the 
Pyrenees  in  a  separate  group^  basing  this  distinction  on  the 
small  amount  of  mineral  matter  contained^  on  the  soil 
whence  the  springs  arise^  on  their  high  temperature,  and  on 
their  level  above  the  sea  (which  may  attain  nearly  4000 
feet).  They  therefore  resemble  the  hot  springs  which  are 
called  ^  Indifferent^^  with  which  they  have  many  points  of 
similarity  from  a  therapeutic  point  of  view. 

''  The  greater  part  of  the  sulphur  which  is  contained  in 
these  springs  is  combined  with  sodium.     The  presence  of 


by  Dr.  Roth.  157 

sulphuretted  hydrogen  is  hardly  perceptible ;  and  this  gas  is 
only  found  as  a  product  of  their  decomposition.  Besides 
the  sulphur  compounds  are  found  chloride  of  sodium,  sul- 
phate and  carbonate  of  sodium,  silica,  alkaline  silicates,  and 
a  certain  amount  of  organic  matter ;  carbonic  acid  is  want- 
ing, and  its  place  is  taken  by  a  certain  quantity  of  nitrogen. 
Such  is  the  general  composition  of  these  waters/' 

''  According  to  Oigot-Suard,  Cisar  and  lea  Eapagnols  are 
the  most  sulphurous  of  the  springs. 

Cisar,  lea  Eapagnola,  Mauhouraty  and  lea  (Eufa  are  the 
most  alkaline;  Mauhourat  and  lea  (Eufa  contain  more 
chlorides  than  Ceaar  and  lea  Eapagnola^  and  do  not  differ 
from  each  other  except  that  lea  (Eufa  possesses  a  larger 
quantity  of  chloride  of  sodium. 

La  Raillere  is  unique  in  possessing  silica^  a  remarkable 
quantity  of  sulphate  of  sodium,  and  fewer  alkaline  salts 
than  the  other  springs/^ 

According  to  M.  Byasson,  the  waters  of  Mauhourat 
are  revivifying,  slightly  exciting,  and  useful  in  gravel. 
Their  use  is  indicated  in  the  various  forms  of  chloro-ansemia 
connected  with  gastric  and  functional  disturbances,  in  dys- 
pepsia connected  with  gout,  gravel,  or  rheumatism,  at  cer- 
tain stages  of  phthisis,  and  as  a  preparation  or  aid  to  the 
sulphur  treatment  properly  so  called.^'     .     •     . 

"  The  brilliant  results  from  these  waters  in  affections  of 
the  throat  and  chest,  the  continually  increasing  success  of 
those  of  Mauhourat  in  dyspepsia,  have  gradually  attracted 
tU  dyspeptic  patients  from  La  Baillere.^' 

''At  present,  as  formerly,  one  meets  a  great  number 
of  patients  who  prefer  the  waters  of  La  Raillhre  to  those 
of  Mauhourat,  and  this  will  probably  always  be  the  case  as 
long  as  the  intestinal  mucous  membrane  requires  to  be 
gently  excited  to  obtain  a  directly  derivative  effect.  The 
Mauhourat  springs,  on  the  contrary,  increase  the  action  of 
the  kidneys/'     .     •     . 

''  When  the  heart  is  complicated  either  with  a  pulmonary 
affection,  gout  or  rheumatism,  it  seems  to  be  more  prudent 
to  employ  the  Mauhourat  springs. 

**  Ciaar  and  lea  Eapagrwla  have,  it  is  true,  a  powerful  action 


158  Holiday  Tour  in  the  Pyrenees, 

on  the  kidneys,  but  this  action  is  always  more  lively  and 
disturbing  than  that  of  Mauhourat,  although  .their  waters 
are  easily  digested  on  account  of  their  alkaline  properties. 

'^  No  one  has  ever  denied  the  specific  action  of  the  La 
Raill^re  waters  upon  the  mucous  membrane  of  the  respira- 
tory passages.  Thermal  influenzas  and  baemoptyses  have 
even  been  described  as  due  to  similar  waters,  which  have 
been  considered  as  accidental  though  useful  derivations 
(Pidoux),  but  this  has  been  denied  by  other  authorities. 

''  It  is  certain  that  sulphurous  waters  have  a  powerful 
influence  upon  the  bronchial  epithelium,  increasing  its 
activity  of  growth,  and  thus  augmenting  the  amount  of 
expectoration.  The  essential  condition  in  a  treatment  of 
mineral  waters  is  a  good  diagnosis  of  the  disease. 

**  M.  L.  Wetzlar,  of  Aix-la-Chapelle  (Ueber  die  HeUunV" 
kungen  der  Aachener  Schwefelthermen,  1862),  remarks  truly 
that  sulphurous  waters,  even  of  the  same  spring,  may  be 
employed  in  different  diseases  with  equal  success.  This  is 
due  to  such  diseases  proceeding  from  the  same  cause. 
Thus,  an  interruption  of  a  cutaneous  secretion  may  pro«* 
duce  a  rheumatic  attack,  a  skin  disease,  paralysis,  or 
neuralgia ;  therefore  sulphurous  springs  which  re-establish 
the  cutaneous  secretion  are  efficacious  in  such  dissimilar 
diseases,  and  we  can  understand  the  reason  without  having 
recourse  to  some  theory  of  diathesis.  The  causes  of  disease 
must  therefore  be  taken  into  account  in  understanding  the 
action  of  these  waters,  although  this  must  not  be  always 
followed  as  an  axiom. '^ 

"  Wetzlar  quotes  Kortum  (Die  warmen  Mineralguellen  in 
Aachen,  1817),  as  follows  : — 'If  more  water  is  drunk  than 
is  necessary,  and  thus  is  rapidly  eliminated,  it  fatigues  and 
weakens  the  stomach ;  but  if  it  passes  quickly  into  the  urine 
it  seems  simply  to  purify  the  renal  system  and  tract  by 
Altering  the  blood.  If  the  water  excites  too  copious  a 
perspiration  the  patient's  energy  is  diminished  ;  if  it  purges 
weakness  results  without  beneflt.'  Weltzlar  advises  weak 
or  rheumatic  patients  to  drink  water  in  bed.  The  former 
physicians  of  Cauterets  often  gave  the  same  advice.*'      .      . 

"  Gigot-Suard  has  described  the  physiological  and  palho- 


by  Dr.  Roth.  159 

genetic  action  of  the  external  use  of  the  Cauterets'  water  in 
an  excellent   chapter  of  his  Etudes    Medicates  et    Scien- 
tifiques,  1866,  describing  the  influence  of  the  water  used 
in  baths,  douches,  inhalations,  gargles,  and  pulverisations. 
His  experience  led  him  to  admit  that  normal  temperature  of 
33°  to  SS""  centigrade  (91°— 95*^  F.),  of  the  waters  of  CSsar, 
ks  Espagnols,    and     Pause    Nouveau,    have   in    so   far    a 
different  primary  effect  from   the  waters  of  other  springs, 
that  the  pulse  quickens  instead  of  slackening  speed  during 
the  bath.     The  effect  of  a  bath  taken  at  a  suitable  tem- 
perature, viz.  one  which  gives  a  feeling  of  comfort  to  the 
patient,  and  if  its  duration  is  proportioned  to   his  sensi- 
tiveness and  strength,  is  to  calm  and  strengthen  him.     The 
skin  becomes  agreeably  heated,  respiration  and  the  circula- 
tion are  calmed  and  made  slower,  the  urinary  secretion  is 
increased,  more  blood  being  sent  to  the  skin,  all  its  glands 
are  induced  to  secrete.     The  sleepiness  which  follows  the 
bath   is  not  at  all  a  sign  of  weakness,  but  is  due  to  its 
sedative  influence.     A  bath  of  ordinary  water  sometimes 
weakens  under  the  same  conditions,  while  baths  of  these 
waters  always  strengthen. 

"  Wetzlar  has  found  that  nervous  patients  cannot  bear  a 
long  bath,  and  that  those  whose  skin  is  soft  and  delicate 
should  not  remain  so  long  in  the  water  as  when  the  skin  is 
harsh  and  dry.  Psoriasis  and  pityriasis  are  better  influenced 
1)7  sulphurous  waters  than  eczema.  A  patient  with  articular 
spellings,  the  result  of  gout  or  rheumatism,  should  remain 
a  longer  time  in  the  bath  than  one  suffering  from  neuralgia. 
The  tonic  effect  of  these  springs  is  not  limited  to  the  skin, 
the  muscles  and  nerves  are  also  influenced.  Hence  the 
good  effects  obtained  in  cases  of  paralysis  and  atrophy  ; 
some  of  the  latter  cases  require,  according  to  Wetzlar,  a 
bath  of  two  hours'  duration. 

''The  bath  must  not  be  employed  in  the  acute  stage  of 
any  cutaneous^  neuralgic,  gouty,  or  rheumatic  affection. 
The  exciting  effects  of  a  sulphur  bath  are  considered  by 
Benmont  as  secondary  and  due  to  a  certain  quantity  of 
sulphuretted  hydrogen  gas  penetrating  the  skin  and  mucous 
meodbranes  by  absorption  and  diffusion.     These  effects  may 


160  Holiday  Tour  in  the  Pyrenees, 

produce,  according  to  Gigot-Suard,  what  has  been  called 
la  poussie,  from  simple  itching  or  pricking  mure  or  less 
severe,  and  of  greater  or  less  extent^  to  vascular  eruptions, 
pruriginous  pustules,  boils/^  &c. 

'^  It  is  a  fact  that  a  certain  quantity  of  sulphuretted 
hydrogen y  although  very  minute,  hardly  a  milligramme  ia 
200  litres,  is  found  mixed  with  much  watery  vapour  ia 
the  baths,  douch  rooms,  and  in  the  covered  promenades ; 
and  that  a  daily  visit  of  several  hours  to  the  drinking 
rooms  and  within  the  walls  of  these  establishments,  is  not 
without  some  influence  on  the  health  of  the  patients/'  •  . 

''  Observation  has  shown  that  the  effects  produced  upon 
country  people  who  pass  most  of  their  time  at  Cauterets  ia 
an  atmosphere  saturated  with  watery  vapour  and  sulphu- 
reted  hydrogen,  are  more  rapid  and  more  energetic  than 
upon  patients  who  only  remain  just  as  long  as  is  absolutely 
necessary  for  the  treatment/' 

'^  It  may  not  be  possible  to  determine  the  modus  operandi 
of  the  reflex  action  of  these  baths,  but  observation  proves 
that  a  bath  taken  at  the  ordinary  temperature  of  the  body, 
at  any  one  of  the  chief  springs,  increases  the  nutritive 
changes  and  activity  of  the  skin,  and  diminishes  the  excit- 
ability of  the  heart,  as  well  as  muscular  and  nervous  irrita- 
bility. The  springs  of  Rocker  and  Rieumisez,  when  mixed, 
form  baths  containing  very  little  mineral  matter,  which  are 
very  useful  for  calming  the  nervous  system  when  over- 
excited by  the  thermal  treatment  or  by  disease/' 

''According  to  Baumann  (die  Wilbader,  akratothermen 
oder  iudifferenten  Thermen),  a  bath  at  a  higher  temperature 
than  that  of  the  patient  raises  his  temperature  in  three 
ways,  first,  directly,  by  giving  up  heat  to  the  body,  secondly 
and  thirdly,  but  indirectly  by  preventing  radiation  and 
watery  excretion,  and  by  increasing  the  internal  production 
of  animal  heat  by  an  accelerated  respiration  and  circula- 
tion. 

''Warm  baths  are  also  suitable  for  weak  constitutions 
where  the  healthy  distribution  of  heat  is  effected  with  diffl- 
culty,  as  well  as  for  diseased  states  which  require  an  addi- 
tional supply  of  heat  to  ensure  nutrition,  and  in  which  the 


by  Dr.  Roth.  161 

phenomena  of  oxydation  are  languid.  Again^  as  the  skin 
excretes  the  waste  products  resulting  from  muscular  action^ 
it  will  be  understood  that  functional  disturbances  of  the 
skin  will  cease  under  a  treatment  of  warm  baths. 

"With  regard  to  the  nervous  system  warm  baths  increase 
the  conducting  power  of  the  nerves,  while  baths  at  the 
ordinary  temperature  regulate  this  function;  hence,  the 
former  are  suitable  for  cases  of  paralysis,  and  the  latter  for 
cases  of  bypersesthesia.^' 

Muscular  activity  is  increased,  diminished,  and  regulated 
according  to  the  various  temperatures  applied. 

The  mineral  vapour  baths  will  be  found  useful  in  some 
skin  diseases,  chronic  rheumatism,  paralysis,  Bright^s  dis- 
ease, some  forms  of  pharyngeal,  laryngeal,  and  uterine 
catarrhs. 

The  half  bath  and  foot  bath  in  constantly  changing  or 
flowing  water  are  frequently  used  with  success  at  Cauterets 
whenever  a  derivation  is  desired  from  internal  organs. 

The  application  of  the  waters  at  various  temperatures  is 
combined  with  a  mechanical  power,  under  the  form  of 
general  or  local  douches,  ascending  and  descending  showers, 
and  also  applied  alternately,  first  warm  and  cold,  and  vice 
versd. 

The  effects  of  ordinary  hydrotherapeutics  are  thus  com- 
bined and  increased  by  the  use  of  the  various  springs ;  all  of 
them  have  some  more  or  less  special  influence. 

Although  the  uselessness  of  gargarisation  has  been  suffi- 
ciently demonstrated  by  Gigot-Suard,  and  by  Elrishaber,  it 
is  Btill  used,  and  several  '*  tours  de  force  "  proceedings  have 
been  invented  for  this  purpose  and  are  still  used  at 
Cauterets. 

BatUire  and  Cisar^  used  internally,  show  already  in  the 
course  of  a  few  days  their  effects  on  the  mucous  membranes 
of  the  pharynx  and  larynx,  and  Lemonnier  advises  his 
patients  not  to  strain  themselves  by  gargarising,  as  the 
desired  effect  can  be  produced  by  inhalation  or  drinking. 
The  regular  therapeutic  application  of  sulphurous  inhalation 
and  pulverisation  has  not  yet  taken  place,  I  may  add  that 
the  walks  in  the  immediate  neighbourhood  of  Cauterets  are 

VOL.  XXXVII,  NO.  CXLVIII. ^AFRIL,  1879.  L 


I 


162  Holiday  Tour  in  the  Pyrenees, 

beautiful  and  the  views  charming;  the  extent  of  these 
views  increases  with  the  height  of  the  various  walks^  and 
every  patient  and  tourist  has  opportunities  of  enjoying  the 
beauties  of  the  scenery  in  proportion  to  his  powers  of 
walking  and  ascending  the  mountains,  either  on  horseback 
or  in  light  open  carriages. 

In  the  whole  neighbourhood  of  Cauterets^  extending  to 
Pierrefitte  and  Luz,  the  high  roads  are  daily  watered  twice 
a  day  in  summer,  thus  the  traveller  is  not  in  any  way 
inconvenienced  by  dust^  and  the  evaporation  of  the  water 
causes  a  most  agreeable  sensation  of  freshness.  A  can- 
tonnier^  as  the  road-makers  are  here  called^  is  employed  for 
three  kilometres,  and  is  provided  with  a  special  hollow 
shovel  with  raised  edges,  which  he  dips  in  the  tiny  rivulets 
running  along  one  side  of  the  road  filled  with  clear 
water,  and  throws  the  water  as  he  walks  slowly  across  the 
road.  It  is  to  be  hoped  that  instead  of  this  hard  human 
labour  they  will  soon  employ  elastic  pipes,  which  will 
enable  one  man  to  water  a  longer  extent  of  road,  and  with 
less  trouble. 

Although  I  have  visited  a  great  part  of  the  Continent,  I 
do  not  remember  to  have  seen  any  high  road  kept  so  well 
watered  as  in  this  district  of  the  Pyrenees. 

We  arrived  at  Luz  after  a  most  charming  drive  of  two 
hours  from  Cauterets,  and  on  our  route  to  the  extraordinary 
scenery  of  the  well-known  Cirque  de  Gavami  visited  St. 
Sauveur. 

St.  Sauveur. 

This  watering  place  is  also  known  as  Luz-St.  Sauveur, 
and  in  consequence  of  the  Empress  Eugenie  having  been 
sent  here  for  treatment  became  more  known  about  fifteen 
years  ago. 

It  is  situated  at  the  southern  extremity  of  the  valley  of 
Luz,  and  at  the  entrance  of  the  glen  (gorge),  which  ends  at 
the  celebrated  Cirque  of  Gavami,  which  is  one  of  the  most 
frequented  parts  of  the  Central  Pyrenees.  The  village 
consists  of  about  fifty  houses  and  four  large  hotels,  forming 


by  Dr.  Roth. 


168 


one  street  on  the  slope  of  a  high  mountain  and  near  a 
rapid  torrent. 

Although  it  is  770  metres  (2810  feet)  high,  the  mildness 
of  the  temperature,  the  usual  calm  atmosphere,  the  hygro* 
metric  state  of  the  air,  make  the  climate  ionic  and  calming y 
especially  suitable  for  neryous,  irritable,  and  such  patients 
as  are  exhausted  by  long  suffering. 

The  springs  of  the  baths  (la  source  des  bains)  and  the 
etablissement  are  in  the  middle  of  the  village.  The  waters 
used  for  drinking,  bathing,  and  douches  are  limpid,  trans- 
parent, have  an  hepatic  taste^  and  have  the  characteristic 
smell  of  rotten  eggs.  The  temperature  is  84^  C,  and  a  litre 
contains  22  milligrammes  of  sulphate  of  sodium  (sulfur  de 
sodium). 


A  litre  contaiiMy  according  to  Ti 

lUiot's  analysis : 

Solpliide  of  sodium 

0-0218 

Chlorine         „ 

0-0096 

Sulphate  of  loda 

0-0400 

Silicate  of      „ 

00704i 

M        chalk  (calcium)  . 

0K)062 

0-0081 

n        alumina 

0-0070 

Organic  matters 

0-0820 

Boric  acid  and  iodine 

traces 

0-2500 

The  spring  of  Honsalade,  used  more  for  drinking,  is  clear 
and  firesb,  temp.  21^  Centigrade,  tastes  agreeably,  although 
salphurons,  and  contains,  according  to  Filhol,  18  milli^ 
([rammes  of  sulphide  of  sodium.  It  is  easily  digested  and 
diuretic.  Within  three  kilometres  are  the  chalybeate 
waters  of  Yiscos  and  Saligos,  and  a  bituminous  spring  at 
Viscos. 

Dr.  Caulet,  who  has  been  during  the  last  six  years 
medical  inspector,  told  me  that  in  consequence  of  the  small 
quantity  of  mineral  water,  not  more  than  200  patients  can 
be  placed  at  the  same  time  under  treatment.  It  is  essen- 
tially  a,  or  rather  the,  ladies^  watering  place  in  the  Pyrenees, 
although  Eaux  Chaudes  is  also  considered  as  a  special 
watering  place  for  ladies. 


16^  Holiday  Tour  in  the  Pyrenees, 

Women  who  do  not  suffer  from  uterine  diseases  feel, 
after  the  use  of  a  few  baths^  pains  and  spasms  of  the  womb, 
followed  by  a  watery  serous  secretion  from  this  organ. 
Chronic  parametritis  and  perimetritis,  which  Scanzoni  con- 
sidered incurable,  are  cured  here.  In  all  forms  of  uterine 
disease,  besides  the  general  bath,  douches  into  the  rectum 
are  successfully  used.  When  Dr.  Caulet  uses  local  douches 
in  the  vagina,  he  applies  a  kind  of  perforated  speculum 
formed  of  thick  silver  wire.  He  believes  that  this  contri- 
butes to  lessening  the  irritation  of  the  vaginal  mucous 
membrane  by  external  mechanical  means. 

The  following  notes  on  the  physiological  effects  of  the 
St.  Sauveur  water  on  the  tactile  and  thermal  sensations 
of  the  skin  have  been  extracted^ from  Dr.  Caulet's  interesting 
pamphlet,  the  title  of  which  is  Eludes  analytiques  sur  la  cure 
de  Saint  Sauveur,  Paris,  Bailliere,  1878.  It  is  my  agree- 
able duty  to  thank  Dr.  Caulet  herewith  both  for  the  kind 
information  and  the  pamphlet  he  has  given  me. 

Physiological  Effects  of  the  Waters  of  St.  Sauveur. 

"  Tactile  sensations  of  the  skin  felt  during  the  bath. — 
It  is  a  well-known  fact  that,  among  the  various  sulphurous 
springs  of  the  Pyrenees,  the  water  of  St.  Sauveur  is  parti- 
cularly striking,  owing  to  its  peculiar  softness  and  agreeable 
unctuosity — properties  which  are  not  special  to  this  place, 
being  found  more  or  less  in  the  neighbouring  waters ;  here, 
however,  they  are  developed  to  such  a  degree  that  they 
virtually  constitute  a  distinct  character  of  the  place,  a  fact 
which  is  corroborated  by  all  observers  visiting  the  Pyre- 
nees. 

"Although  the  origin  and  causes  of  this  unctuosity  is 
not  thoroughly  known,  that  of  St.  Sauveur  is  attributed  to 
the  presence  of  salts  having  an  alkaline  reaction,  such  as 
sulphide  of  sodium,  alkaline  silicates,  &c.,  as  well  as  to  a 
great  quantity  of  organic  matter  in  solution.'' 

''The  patients  experience  the  following  sensations,  an 
agreeable  oiliness  and  softness  which  causes  everything  to  be 
soapy,  oily,  velvety,  frothy,  and  mucilaginous.'' 


by  Dr.  Roth.  165 

''The  intensity  of  the  sensation  is  very  variable,  and 
considerable  differences  are  observed  with  regard  to  this 
effect  among  the  bathers/^ 

*'  In  some  the  oily  and  soapy  sensation  is  so  well  marked 
that  a  sort  of  disagreeable  sensation,  somewhat  distressing, 
is  felt  on  various  parts  of  the  body,  especially  on  the  palmar 
aspect  of  the  hands  and  fingers,  and  on  the  soles  of  the  feet — 
impressions  more  readily  felt  when  these  parts  come  in 
contact  with  some  other  part  of  the  skin.  Others,  when 
they  have  taken  a  certain  number  of  baths,  experiencing 
nothing  disagreeable  in  the  treatment,  appreciate  the  oili- 
ness.  Finally,  there  are  those  who  experience  nothing 
dnring  the  whole  time  of  treatment/' 

"There  are  some  who  appreciate  very  much  the  soft  or 
hard  qualities  of  ordinary  water,  either  in  a  bath  or  other- 
wise, yet  who  experience  in  the  warm  water  of  St.  Sauveur 
no  other  tactile  sensation  than  that  of  an  ordinary  hot  soft- 
water  bath^  not  even  when  washing  their  hands  alternately 
with  mineral  and  ordinary  waters.  But  these  are  excep- 
tions. The  greater  number  of  the  bathers  more  or  less 
experience  the  sensations  that  we  have  mentioned,  and 
eyery  year  numbers  of  patients,  chiefly  '  neuropathic ' 
women,  are  to  be  seen  returning  to  the  place  in  order  to 
enjoy,  so  they  say,  the  special  action  of  the  mineral  water 
on  the  skin,  and  the  effects  which  they  attribute  to  it.'' 

"Persons  who  were  most  sensibly  affected  by  the  unc- 
tnoos  characters  of  St.  Sauveur  water,  often  presented 
marked  alterations  of  tactile  sensibility  (anaesthesia),  and 
painfiil  sensibility  (hypersesthesia) ;  many  times  there  were 
some  patients  who  did  feel  the  unctuosity,  but,  never- 
theless, had  cutaneous  sensibility  quite  intact,  though 
examined  in  the  various  ways." 

"  But  observation  shows  that  at  St.  Sauveur  among  the 
so-called  nervous  and  various  primary  neuropathic  cases,  as 
well  as  among  chronic  cases  of  every  nature  complicated 
with  the  nervous  element^  there  exists  a  pretty  nearly 
constant  relation  between  the  intermediate  curative  effects 
of  the  hot  treatment y  and  the  perception  of  the  unctuosity 
in  the  bath  by  the  patient. 


166  Holiday  Tour  in  the  Pyrenees, 

"  This  relation  is  more  remarkable  among  those  endowed 
with  that  Tariety  of  skin  of  which  the  delicacy,  whiteness, 
and  lustre  can  be  compared  with  satin ;  it  is  this  skin 
which  forms  one  of  the  most  beautiful  features  of  woman/' 

'^  Very  often  under  these  circumstances  patients  quickly 
perceive  the  unctuous  sensation,  and  through  it  experience 
a  feeling  of  well-being,  enjoyment,  and  pleasure. 

"  Local  pains  adventitious  or  allied  to  visceral  affections 
(of  uterus,  bladder,  &;c.),  as  well  as  those  neuropathic 
miseries  known  under  the  name  of  'vapeurs,'  'restless- 
ness/ setting  on  edge  of  the  nerves,  &c.,  have  been  seen  to 
diminish  considerably,  and  disappear  from  the  first  days  of 
the  treatment.  The  habitual  feelings  of  weariness  and  of 
painful  lassitude  (pseudo-paralytic  weakness),  are  to  chronic 
disease  what  '  oppressio  virium '  is  to  acute  disease,  but 
still  they  are  of  a  truly  nervous  constitution ;  for  instance, 
chronic  neuralgia^  pains  in  the  stomach,  the  return  of  con- 
vulsive attacks,  8ce.  Nevertheless,  during  the  five  years 
that  Dr.  Gaulet  has  studied  the  effects  of  St.  Sauveur 
he  has  not  noticed  a  single  cure  (in  nervous  diseases) 
among  those  patients  who  did  not  feel  the  unctuous 
impression.'' 

"  It  is  a  constant  and  well-known  fact  that,  all  things 
being  equal,  those  who  do  not  experience  the  unctuous 
sensation  in  the  bath  undergo  the  cure  less  well.  Those  in 
whom  cutaneous  sensation  is  refractory  to  this  impression  of 
the  mineral  waters,  are  not  at  all  improved.^' 

**  At  St.  Sauveur,  where  the  source  of  the  baths  is  used 
directly  on  the  spot,  and  at  its  natural  temperature,  the 
water  shows  the  same  composition  as  the  waters  of  the  C^sar, 
which  is  the  hottest  and  richest  in  sulphur  at  Cauteret, 
viz.  23  milligr.  of  sulphide  of  sodium  per  litre,  t.  e.  6*30 
grammes  for  a  bath  of  300  litres.'' 

Cutaneous  thermic  sensations, — ''  The  principal  spring  of 
the  baths  upon  which  the  reputation  of  St.  Sauveur  is  based, 
has  a  temperature  of  34*5^  C,  is  collected  in  two  little 
reservoirs,  whence  it  is  distributed  to  the  contiguous  bath« 
rooms ;  the  water  preserves  at  the  same  time  its  heat  and 
sulphurous  properties.     Thus,  the  average  temperature  of  the 


by  Dr.  Roth.  167 

baths  varies  from  34'2^  C.  to  32*8^  C.  from  the  room  nearest 
to  and  the  room  farthest  away  from  the  source.  It  is  in  this 
last  that  the  warmth  is  called  temperate  :  this  circum- 
stance is  necessary  to  be  remembered  in  order  to  refute  the 
opinion  which  praises  the  mildness  of  the  action^  and  the 
soothing  virtues  of  the  cure  when  these  mineral  waters  are 
at  a  low  temperature.  Frigus  sedat  nervoSy  without  doubt. 
This  axiom  would  be  applicable  to  those  patients  who  find 
the  bath  of  St.  Sanveur  cool^  but  these  are  exceptions,  as 
the  majority  of  the  patients  feel  the  bath  at  32^  either 
tepid  or  decidedly  warm. 

"  With  a  temperature  varying  from  34*^  to  38®  the  baths 
appear  cool  or  temperate  to  some^  indifferent  to  many^  and 
decidedly  agreeable  and  even  warm  to  the  greater  number 
(especially  women). 

"  Those  patients  who  find  the  bath  at  34®  cool,  would  find 
an  ordinary  bath  too  hot  or  even  insupportable  at  the  same 
temperature^  and  would  not  take  any  except  at  80®  or 
32®  C. 

"  Those  who  find  the  bath  at  the  first  instant  of  immer- 
sion either  agreeable  or  fresh  feel  the  warmth  increases  by 
degrees^  and  the  water  is  finally  felt  very  warm  ;  at  the 
same  time  the  skin  reddens^  the  breathing  quickens^  the 
pulse  becomes  frequent  and  fuU^  the  countenance  is  ani- 
mated, and  the  forehead  is  sometimes  covered  with  perspira- 
tion. These  effects  last  more  or  less^  but  generally  do  not 
wear  off  in  the  longest  bath  ;  the  patient  comes  out  in  full 
reaction,  preserving  a  feeling  of  strength  and  energy  for  the 
rest  of  the  day. 

Others,  on  the  contrary^  who  find  the  water  warm  on 
entering^  believe  after  a  short  time  that  the  temperature  is 
rapidly  subsiding ;  they  feel  gradually  overcome  by  the  cold, 
and,  after  various  disagreeable  sensations^  end  by  shivering. 
Although  they  may  add  fresh  warm  water,  rub  themselves, 
and  move  about,  they  do  not  regain  their  natural  warmth. 
The  state  of  horripilation  lasts  as  long  as  they  remain  in 
the  bath,  and  have  a  kind  of  malaise  for  the  rest  of  the 
day.  Even  to  these  patients  the  treatment  may  do  good, 
bat  it  can  easily  become  injurious  if  not  well  directed.     If 


168  Holiday  Tour  in  the  Pyrenees, 

the  patient  leaves  the  bath  before  feeling  the  shiverings, 
i.  e.  before  the  first  symptoms  of  cold  are  manifested^  a 
good  reaction  nearly  always  follows^  and  a  feeling  of  well- 
being  lasts  all  day.  With  these  precautions  the  treatment 
is  well  borne  and  does  good.  If,  on  the  contrary,  the 
patient  stops  in  the  bath  too  long,  in  spite  of  the  chill,  it  is 
found  that  the  cure  becomes  difficult  and  injurious  (frigus 
nervis  inimicum^,  and  the  sensations  of  uneasiness  and 
chill  succeeding  such  a  bath  have  a  most  injurious  effect  in 
nervous  diseases.  In  the  course  of  five  years  Dr.  Caulet 
has  seen  only  four  patients  with  this  predisposition  to  chills 
and  shivering ;  these  were  obliged  to  give  up  the  treatment 
and  had  to  resort  to  the  source  of  Honsalade,  which  has 
only  22^,  is  specially  used  internally,  but  also  applied  in 
another  etablissement  under  form  of  douches  and  baths, 
for  which  other  purpose  it  is  artificially  warmer,  has  a 
special  action  on  the  utero^ovarian  system,  and  cures  the 
catarrh,  inflammation,  and  neuralgia  of  these  organs,  the 
ailments  of  puberty  and  menopausia  (climacteric  years), 
bad  consequences  after  childbirth,  sterility,  disposition  to 
fausse  couche,  chronic  and  various  forms  of  metritis,  peri- 
uterine phlegmonia,  ovaritis,  chronic  dysmenorrhcea,  the 
various  forms  of  spasmodic  and  hypersesthetic  hysteria, 
facial  and  intercostal  neuralgia,  and  the  various  conditions 
known  as  irresistible,  impressionable,  and  nervous  constitu- 
tions, chronic,  muscular,  and  articular  rheumatism ;  in  cases 
of  erethic  phthisis,  which  cannot  bear  the  waters  of  £aux 
Bonnes  and  Cauterets,  gastralgia,  with  prevalence  of  dys- 
peptic symptoms,  and  especially  with  flatulence ;  in  catarrhal 
affections  of  the  bladder  when  dependent  on  chronic 
inflammation  of  this  organ  St.  Sauveur  was  also  useful. 


169 


A  NOTE  ON  PICRIC  ACID. 
By  Dr.  Hughes. 

In  the  number  of  the  Monthly  Homceopathic  Review  for 
December^  1871^  I  gave  an  account  of  what  was  then 
known  of  the  properties  of  Picric  (or  carbazotic)  acid.  I 
related  the  experiments  of  Erb  with  the  alkaline  picrates ; 
the  provings  of  Dr.  Couch  on  the  human  subject^  made 
iritb  the  pure  acid ;  and  the  studies  and  further  provings 
of  the  drug  for  which  we  are  indebted  to  Dr.  Samuel 
Jones. 

Since  that  time  Drs.  Couch  and  Jones  have  unhappily 
quarrelled  over  their  offspring.  The  controversy,  though 
personally  painful  from  the  heat  and  acrimony  with  which 
it  has  been  conducted^  has  yet  proved  useful  in  elucidating 
the  subject^  and  in  leading  to  further  experimentation. 
We  have  now^  moreover,  Dr.  Allen^s  pathogenesis  of  the 
acid,  including  the  original  provings  of  it  made  by  Parisel. 
It  seems  well,  therefore,  to  give  to  British  readers  our 
present  knowledge  of  the  drug. 

Dr.  Jones,  in  some  experiments  made  respectively  upon 
two  students  and  himself,  found  Picric  add  to  diminish 
oxidation  in  the  former^  who  were  in  normal  health,  but  to 
increase  it  in  him — ^his  health  being  much  below  par  at  the 
time.*  He  connected  this  action  with  Erb's  observation 
of  the  destructive  influence  of  the  alkaline  picrates  on  the 
red  corpuscles  (the  oxygen-carriers)  of  the  bloody  and  I 
followed  him  in  so  doing.  Dr.  Couch,  however,  has  shown 
that  Erb's  results  were  obtained  equally  when  the  picrates 
were  mingled  with  blood  outside  the  body ;  and  no  altera- 
tion was  found  in  the  blood  in  dogs  poisoned  by  himself 

*  The  evidence  of  this  action  was  the  increase  of  the  nric  and  phosphoric 
acids  in  the  orine,  and  the  diminution  of  the  sulphates  and  chlorides,  with  the 
students,  while  in  his  own  case  the  reverse  obtained.  (In  my  article  in  the 
UoMUf  Somaopathic  Setdew  these  results  are,  hj  mistake,  stated  in  th^ 
ooDTerse  sense.) 


170  A  Note  on  Picric  Acid, 

with  the  pare  Picric  acid  crystals.  He  jastly  infers^ 
therefore,  that  the  action  is  a  chemical  one  onlj,  and  is 
probably  due  to  the  alkaline  bases  rather  than  to  the  acid 
with  which  they  were  united. 

This,  however,  would  not  weaken  the  conclusions  to  be 
drawn  from  Dr.  Jones's  own  experiments  as  to  the  power 
of  the  acid  to  cause  sub- oxidation,  and  to  cure  it.  Bat 
these  also  Dr.  Couch  proceeds  to  impeach.  He  argues* 
that  the  deviations  from  the  normal  standard  discovered  by 
Dr.  Jones  in  his  provers'  urine  were  not  greater  than  occur 
in  health ;  and  states  that  his  own  experiments  on  animals 
show,  from  small  doses,  a  primaiy  increase  of  all  the 
constituents  of  the  urine,  with  secondary  diminution, — ^from 
large  doses,  the  converse  sequence  of  phenomena.  To  this 
Dr.  Jones  repliesf  by  relating  another  case  besides  his 
own,  in  which  Picric  acid,  given  upon  the  indications 
supplied  by  his  provings,  effected  a  noteworthy  change. 
As  this  is  one  of  the  practical  results  of  the  controversy, 

we  give  it  in  full. 

"  Mabquette,  Michioan, 

Monday,  July  23rd,  1877. 

"  Prof.  S.  A.  Jokes,  Ann  Arbor. 

"  My  dear  Professor, — Tour  reprint  On  the  Indications  for 

the  Use  of  Picric  Acid  came  duly  to  hand,  reminding  me  of  my 

promise  to  write  and  let  you  know  concerning  my  progress. 

Please  accept  thanks  for  pamphlets. 

•  •••••• 

**  1  have,  as  far  as  my  knowledge  of  Picric  acid  goes,  got  a 
splendid  Picric  acid  patient.  He  is  a  prominent  man  here. 
Has  been  treated  by  all  the  physicians,  old  and  new,  and  now 
has  come  to  me  and  wants  me  to  try  and  do  something  for  him. 
The  first  time  1  saw  him  I  knew  he  was  ansemic,  but  did  not 
think  of  Picric  acid  till  1  saw  your  remark  on  urohaematia  in 
Progressive  Pernicious  AnsBmia  in  your  pamphlet.  I  have 
examined  his  urine  several  times,  and  shall  now  make  quantita- 
tive examinations  for  several  days.  The  urine  is  dark,  and  gives 
the  prettiest  specimen  of  urohsBmatin  you  ever  saw — a  very  dark 
cherry  red,  you  might  call  it  darkish  brown.     He  is  run  '  way 

*  Somaopathie  Times,  April,  1878. 
f  Ibid.,  June. 


by  Dr.  Huffhe$.  171 

down.'  The  amount  of  lurea  is  low.  Have  not  made  full  quanti- 
tatiye  examinations,  but  will  do  so  to-daj,  and  send  results.  I 
am  anxious  to  cure  him  if  I  can,  for  all  the  physicians  think  him 
'  gone.' 

<*  From  what  I  know  of  the  sjmptoms  of  Picric  acidf  his  are 
almost  perfect.  The  headache  is  Picric  acid,  and  the  prostration 
almost  perfect.  Vomits  a  good  deal;  his  hands  and  face  are 
whit^  and  pale  as  death.  This  was  one  of  the  things  which  made 
me  think  of  urohsematin. 

**  Very  truly,  your  pupil, 

(Signed)        Fbaitk  N.  White." 

The  following  report  of  this  case  was  subsequently  sent  to  my 
assistant,  G^o.  A.  Taber,  M.D. 

"  John  T.  M— ,  »t.  62  ;  weight  140  lbs. ;  July  26th.  Patient 
quite  prostrate.  Ears  transparent ;  face,  neck,  lips,  and  hands 
are  of  a  death-like  whiteness.  Were  he  dead  could  not  haye 
appeared  more  pale.  The  whole  action  of  the  patient  is  of  a 
Mogy'  character. 

"  He  vomits  from  three  to  five  times  a  day ;  the  matter  vomited 
beingof  a  bright  yellow  colour,  and  very  bitter.  Never  vomits 
food  lately  eaten.  Has  not  the  faintest  idea  of  what  aggravates 
or  brings  on  the  attacks.  They  come  on  suddenly  without  any 
warning. 

''Is  easily  prostrated;  the  slightest  exertion  obliging  him  to 
quit.  Often  the  prostration  caused  by  some  little  out-door  work 
in  the  morning  compels  him  to  keep  his  bed  the  remainder  of  the 
day.  Sometimes  feels  like  dropping  down  where  he  is,  as  though 
he  .were  unable  to  reach  the  house.  Mouth  badly  ulcerated ; 
tongue  smooth,  cracked,  having  the  appearance  of  an  alligator's 
hide.  Mouth  very  dry;  the  dry  feeling  commencing  in  the 
throat  and  working  upward,  causing  him  to  drink  often,  but  little 
at  a  time ;  cannot  double  the  tongue ;  a  feeling  as  though  tongue 
would  crack  were  it  not  moistened ;  sensation  as  of  a  lump  back 
of  the  thyroid  cartilage,  very  troublesome  when  swallowing. 
Appetite  poor ;  no  desire  for  any  particular  kind  of  food,  eats 
what  is  set  before  him ;  what  he  eats  tastes  good  and  seems  to 
digest  well. 

"  Betires  about  10  p.m.  always  prostrate,  but  in  a  short  time  it 
passes  away,  and  he  quickly  goes  to  sleep.    He  awakens  a 


172 


A  Note  on  Picric  Acid, 


number  of  times  in  the  night  to  moisten  his  tongue,  but  readily 
goes  to  sleep  again.  When  he  awakens  in  the  morning  feels 
quite  strong,  but  this  soon  passes  away,  and  he  dreads  passing 
the  day.  Has  been  constipated  since  last  January  —  eight 
months ;  has  an  evacuation  once  in  four  or  five  days ;  stool  hard 
as  a  rocky  sometimes  bloody ;  great  straining,  with  pain  during 
and  after ;  easing  up  after  a  little.  In  complaining  of  his  heacU 
says  his  head  feels  bad  all  through,  but  the  pain  is  on  the  right 
side,  extending  from  forehead  back,  and  in  the  top  of  the  orbit  of 
the  eye.  Eeels  better  in  a  cool  room,  or  lying  down ;  is  inclined 
to  be  drowsy ;  sometimes  feels  as  though  he  could  sleep  all  day ; 
when  walking  upstairs  or  up  a  hill  has  a  sensation  as  if  the  stairs 
pr  ground  were  coming  up  to  meet  him  ;  vertigo  on  rising  from 
bed,  chair,  or  a  stooping  position,  and  immediately  after  work. 
Last  April  and  May  was  unable  to  retain  his  urine  ;  it  was  very 
hot,  almost  scalding,  but  soon  passed  off,  leaving  him  yery  weak. 
Has  no  erections ;  in  fact  says  he  has  nothing  with  which  to 
make  one.  As  he  began  to  fail  and  go  down,  the  scrotum  began 
to  lengthen  and  hang  down  (he  says)  almost  to  his  knees,  and  his 
penis  to  go  up  into  his  body  until  it  was  less  than  an  inch  long. 
As  he  began  to  get  stronger  his  bag  came  up  and  his  penis  went 
down.  (I  don't  know  if  this  is  of  any  value,  but  give  it  as  he 
gave  it  me.) 

"Treatment. — Picric  acid,  6*  trit.,  every  two  hours.  On 
examination  of  the  urine  find  a  very  distinct '  colour  *  for  urohte- 
matin.  The  bottom  of  the  chamber  covered  with  a  deposit  of 
free  uric  acid. 

"  Quantitative  examinations  give  the  following  results  : 


Date. 

July  26 
27 
29 


Qnantitj  Urea  in  Uric 

in  cc.      Sp.  gr.    React.       KT&ina.  acid. 


>* 


>f 


1150 

1021 

Acid 

17-7422 

10811 

31895 

10120 

900 

1-020 

»> 

13-8852 

•9360 

2-4030 

•9360 

750 

1-024 

>» 

9-9750 

•7350 

2-4075 

-8400 

Mean. 

13-8672 

-9174 

2-6500 

•9293 

Phoi-  Sol.       Chlo- 

phatet.        phatea.     rides. 

11-73 

8-28 

10-65 

10-22 


**  July  27th. — No  vomiting  since  he  took  first  dose ;  no  evacua- 
tion for  two  days.  Continue  Pic.  ac,  6*  trit.,  every  three 
hours. 

"29th. — No  vomiting.  Had  a  passage  yesterday,  and  one 
to-day ;  no  headache ;  feels  stronger.  Continue  Pic.  ac,,  6'  trit., 
every  four  hours. 

''August   3rd. — 4  decided  change.      The  countenance    has 


by  Dr.  Hughes. 


173 


aasmned  a  more  healthy  appearance.  He  awoke  at  4  a.m.,  and 
worked  in  the  garden  till  breakfast ;  walked  down  street  (down  a 
hill) ;  went  into  the  woods  after  berries ;  and  at  5  p.m.  I  found  him 
walking  up  and  down  the  walk  in  front  of  his  house,  and  when  I 
asked  the  cause  of  all  this  he  replied  he  was  taking  some  exercise. 
Eats  three  times  as  much  as  he  did  a  week  ago  ;  says  he  feels  as 
though  he  could  hardly  eat  enough.  Continue  Pie,  ae,,  6'  trit., 
once  a  day. 

*'  Made  quantitative  analyses  for  August  18th  and  19th,  with 
the  following  results : 


Qnantity 
Bite.       in  c.c     Sp.  gr.    React. 


Urea  in 
g:rBin9. 


Uric        Pho8-  Sol-  Chlo. 

add.       phates.       phatet.       rides. 


Aug.  18  I  1820  j  1016  I  Acid 
„  19  )  1820  I  1*022  I 
Mean 


n 


15-4998 

•3667 

2-2750 

1^2012 

28*3649 

•1900 

1.9008 

10032 

19*4323 

2733 

20879 

1-1022 

15-288 

12-8040 

14*046 


"  September  1st. — Bowels  very  regular,  says  he  has  hardly  lost 
a  day ;  splendid  appetite,  sleeps  weU,  no  prostration ;  can  walk 
up  and  down  hill  without  its  affecting  him ;  can  feel  the  strength 
be  daily  gains ;  his  countenance  is  becoming  quite  brown  and 
healthy.  Says  he  is  now  in  good  health,  and  that  nothing  ails 
him;  works  all  day  long;  has  not  vomited  since  he  took  the 
first  dose;  he  is  growing  stronger  daily.  Discontinued  the 
medicine. 

"  He  has  been  troubled  to  a  certain  extent  in  this  way  for  three 
jears.  The  prostration  came  on,  lasting  only  a  few  days  or  a 
week  or  two.  No  vomiting  or  any  other  disturbance,  save  the 
proBtration.    During  these  times  he  has  been  constipated. 

"This  year  it  came  on  unusually  early,  about  the  5th  of 
February,  and  he  commenced  going  down,  and  had  been  gradually 
going  down  hill  until  I  saw  him.  When  I  took  him  he  said  he 
never  expected  to  get  any  better.  All  his  acquaintances  thought 
he  could  hardly  live  through  the  summer.  Now  he  is  as  well 
and  even  better  than  many  who  predicted  his  death.'* 

I  now  beg  leave  to  contrast  the  first  and  the  second  mean,  to 
•how  how  the  "  theory  advanced ''  on  the  d  priori  of  Dr.  Taber's 
thesis  agrees  with  the  apotteriori  of  the  clinic. 


Una  in  graina.  Uric  acid.  Phoiphatefl.  Sulphates.    Chloridti. 


UtMean  ... 
and  „  ... 
Diiferences 


18*8672 

19-4323 

+  5-5651 


•9174 

*2733 

—•6441 


2-6500 

a^0879 

—•5621 


•9298 

11022 

+  •1729 


10-220 

14*046 

+  d-826 


174  A  Note  on  Picric  Acid, 

The  ''  theory  adyanced  "  from  the  analyses  in  the  laboratory 
is,  that  in  the  healthy  prover  Picric  acid  causes  a  plus  of  uric 
acid  and  phosphates,  and  a  minus  of  sulphates  and  chlorides. 
These  are  the  nutrition-disturbing  effects  of  Picric  add,  and 
they  show  the  relative  conditions  that  must  exist  when  Picric  acid 
is  indicated  as  an  hiematosic  remedy. 

The  therapeutic  effect  of  Picric  acid  must  induce  diametrically 
opposite  plus  and  minus  conditions,  and  this  ''  opposite "  is 
demonstrated  in  our  student's  bit  of  'prentice  work. 

In  Dr.  Allen's  Encyclopadia,  however,  a  still  further 
answer  is  given  to  Dr.  Couch's  objection.  Tabular  views 
are  given  of  the  proportion  of  the  constituents  of  the  urine  of 
Dr.  Jones's  principal  prover  ;  first,  in  health ;  secondly^  while 
taking  the  acid;  and  thirdly,  for  some  time  afterwards. 
It  is  quite  apparent  from  these^  that  although  the  increase 
of  uric  and  phosphoric  acid,  and  the  diminution  of  the 
chlorides,  which  occurred  during  the  medication,  might  not 
exceed  the  oscillations  of  average  health,  they  greatly  exceeded 
that  of  the  health  of  the  prover  in  question.*  This,  with 
the  therapeutic  results  obtained,  suffice,  I  think,  to  prove 
that  Dr.  Jones's  view  of  the  relation  of  the  drug  to  oxida- 
tion is  sound.  These  primary  and  secondary  actions,  and 
opposite  effects  of  large  and  small  doses,  are  somewhat 
confusing.  What  we  want  is  to  get  at  the  one  essential 
and  fundamental  pathogenetic  action  of  each  drug  which 
can  be  used  upon  the  principle  similia  similibus  for  thera- 
peutic purposes.  This,  in  regard  to  the  influence  of  Picric 
acid  on  nutrition,  Dr.  Jones  seems  to  have  given  us  in  the 
word  sub'Oxidatian,  thereby  connecting  it  with  ArgerUum 
nitricum,  and  adding  another  potent  weapon  to  our 
armoury. 

The  discussion  as  to  the  exact  nature  of  the  blood- 
coloured  urine  caused  by  the  acid,  and  as  to  the  correctness 
of  Dr.  Jones's  previous  estimate  of  it,  we  may  pass  over  as 
of  little  moment.  Whatever  the  colouring  matter  may  be, 
it  is  not  derived  from  the  blood,  but  is  some  modification 

*  In  the  table  at  p.  528,  the  decimal  point  of  the  mean  chlorides  daring 
medication  ia  put  in  the  wrong  place  j  instead  of  76'911»  it  should  stand  as 
7-69U. 


by  Dr.  Hughes.  175 

of  Picric  add  itself.  It  will  be  of  more  interest  to  give 
the  results  of  Dr.  Couch's  further  experimentation  with  the 
drug.  He  obtained  in  animals  a  further  ▼erification  of  that 
depressing  and  disorganising  effect  on  the  nervous  centres 
which  his  former  provings  had  disclosed.  Among  other 
things^  he  examined  the  eyes  of  his  dogs  with  the  ophthal- 
moscope, and  found  in  every  case  (four)  venous  congestion. 
The  results  of  a  more  detailed  investigation  by  Dr.  Norton 
are  stated  thus : 

"  October  12th. — This  morning  I  examined  the  eyes  of  a  dog 
chronically  poisoned  with  Picric  acid,  that  Dr.  Couch  had  sent 
me.  Pupils  dilated  with  atropine.  Ophthalmoscopic  appear- 
ances of  the  two  eyes  are  similar,  refractive  media  clear,  optic 
nerve  apparently  slightly  hypersBmic,  retinal  vessels,  especially 
the  veins,  enlarged ;  thin  streaks  of  reddish  colour  in  choroid, 
prohably  physiological,  and  due  to  want  of  pigment ;  above  optic 
nerre  in  particular,  immense  white  patches  of  exudation  are 
obflenred*  with  some  hemorrhagic  spots.  It  is  impossible  to  say 
whether  they  are  in  the  retina  or  choroid,  as  there  are  several 
points  in  favour  of  each." 

''22nd. — ^This  morning  the  dog's  eyes  were  sent  to  me  for 
microscopical  examination.  Optic  nerve  entrance  much  swollen 
snd  infiltrated ;  masses  of  yellowish-white  exudation  are  observed, 
extending  from  the  nerve  into  the  various  portions  of  the  retina ; 
others  are  unconnected  with  the  nerve  entrance.  In  some 
places  these  points  have  a  white  glistening  look,  but  generally 
partake  of  the  appearance  noted  above.  The  whole  retina 
appears  as  if  infiltrated ;  small  extravasations  are  found  on  the 
optic  nerve  and  in  the  retina.  The  choroid  was  normal  as  far  as 
examined.  Owing  to  an  accident  the  different  retinal  layers 
could  not  be  seen." 

The  poison  was  also  found  to  produce  "  spasms,  both 
tonic  and  clonic,  which  have  a  striking  resemblance  to 
those  produced  by  strychnia.^'  This  may  seem  curious  when 
it  is  added  that  ''under  the  influence  of  the  drug  the 
animals  betray  great  weakness  and  lassitude ;  especially  is 
this  noticeable  of  the  hind  legs,  they  being  scarcely  able  to 
support  the  already  attenuated  body,  which  sways  constantly 
from  side  to  side ;  the  tail,  too,  is  as  limp  as  a  wet  rag,  and 


176  A  Note  on  Picric  Acid, 

cannot  be  made  to  either  wag  or  curl/'  Bat  Drs.  Ringer 
and  Murrell  have  recently*  adduced  considerations  which 
account  for  this  apparent  anomaly.  They  maintain  that 
tetaniform  phenomena  are  due  to  a  diminution  or  destruction 
of  the  resistance  of  the  cord^  ''  so  that  an  impression 
couTeyed  throngh  an  afferent  nerve  can  spread  throughout 
the  reflex  portion  of  the  central  nervous  system,  and  produce 
tetanus/'  Such  diminished  resistance  may  coincide  with 
unimpaired  functional  activity  of  the  cord,  as  with  Strychnia, 
or  with  more  or  less  paralysis  of  it,  as  they  have  ascertained 
in  relation  to  Gebemium  and  the  Buxus  sempervirens,  and 
as  Dr.  Couch  seems  to  have  shown  with  Picric  acid. 

Another  symptom  observed  by  Dr.  Couch  was  entire 
anaesthesia  and  analgesia  of  the  posterior  extremities.  He 
also  noticed  the  same  marked  erethism  of  the  sexual  organs 
in  his  dogs  which  was  so  prominent  in  the  human  provers, 
and  relates  a  case  of  masturbation  in  which  the  30th 
dilution,  given  to  ''  cool  the  blood,''  proved  (according  to 
the  patient)  "  altogether  too  cooling." 

My  own  experience  with  Picric  acid  is  quite  confirmatory 
of  this  power  exerted  by  it  over  abnormal  sexual  irritation. 

*  See  MedioO'Chirwrgical  Trafuaetiont  for  1876,  and  Journal  qf  jMotomy 
and  P^iioUffy,  vol.  xi. 


177 


REVIEWS. 


Encyclcpadia  of  Pure  Materia  Medica.  By  T.  F.  Allbn^ 
A.M.^  M.D.  Vol.  viiiy  Plumbum  Serpentaria.  New 
York :  Boericke  and  Tafel.  London :  Turner,  170^ 
Fleet  Street^  E.G. 

We  hope  that  we  shall  not  be  doing  anything  towards  pro- 
voking Dr.  Allen^s  ostracism^  through  weariness  on  the  part 
of  his  colleagues  of  hearing  him  praised  ;  but  we  really  have 
no  other  mode  of  expressing  our  sentiments^  as  we  receive^ 
time  afiter  time,  such  volumes  as  those  he  is  sending  forth. 
Nor  are  we  alone  in  our  estimation  of  his  work ;  for  we 
observe  that  the  Soci^t^  Medicale  Homoeopathique  de 
Fraooe  has  just  conferred  upon  him  and  his  coadjutors  the 
highest  honour  it  has  in  its  power  to  bestow,  its  honorary 
membership.  The  volume  of  Materia  Medica  now  before 
tis  is  simply  invaluable.  Its  pathogenesis  of  Plumbum 
alone,  containing  in  its  4163  symptoms  every  observed  effect 
of  the  drug,  makes  it  indispensable  to  every  homoBopathist,  as 
hitherto  we  have  had  no  collection  of  the  physiological 
effects  of  this  important  metal  on  which  we  could  depend. 
But  it  also  gives  us  Podophyllum,  Prunus  spinosa,  Rumex 
crispus,  Sanguinaria,  and  Santoninum,  and — ^to  crown  all — 
a  fall  pathogenesis  of  Secale,  embracing  1022  symptoms 
produced  by  it.  We  mention  these,  as  practically  made 
available  to  us  for  the  first  time ;  but  we  need  hardly  say 
that  the  old  medicines  included  in  the  series — as  Pulsatilla 
and  Rhus — are  fully  presented, — the  former  receiving  fresh 
light  from  the  provings  of  P.  Nuttalliana,  the  latter  fr^m 
those  of  Rhus  venenata. 

Another  volume  (which  is  promised  for  this  spring)  will 
complete  the  work,  and  then  we  shall  only  have  to  wait  for 
the  Index — which  is  announced  as  in  preparation — ^to  have 
every  material  to  our  hand  for  practising  homosopathicaUy 
according  to  Hahnemann's  fullest  method. 

VOL.  XXXVIl,  NO.  CXLVIII. APRIL,  1879.  M 


1 78  Reviews, 


Clinical  Therapeutics.  By  Tbmple  S,  Hoyne,  A.M., 
M.D.,  Professor  of  Materia  Medica  and  Therapeutics 
in  the  Hahnemaun  Medical  College  of  Chicago.  Parts 
III — VI.  Duncan  Brothers:  Chicago.  London: 
Turner,  170,  Fleet  Street,  E.C. 

In  our  number  for  July,  1877,  we  noticed  the  first  and 
second  parts  of  this  publication,  and  expressed  oar  sense 
of  its  usefulness.  The  four  parts  since  published  have  now 
reached  us,  and  we  can  repeat  our  former  judgment  of  Dr. 
Hoyne's  work.  There  are,  indeed,  numerous  faults  in  it, 
both  of  omission  and  of  commission ;  and  these  sometimes 
strike  unpleasantly  the  close  student  of  its  pages.  But  he 
readily  condones  them  in  the  end  for  the  sake  of  the  mass 
of  information  and  observation  relative  to  the  drugs  discussed 
which  the  author  brings  before  him,  and  which  materially 
aid  him  in  filling  in,  for  his  mind^s  eye,  the  picture  of  their 
action.  With  this  reservation,  and  the  recommeudation  of 
an  occasional  granum  salis  to  correct  too  enthusiastic  state- 
ments,* we  can  cordially  commend  the  book. 


Diseases  of  Infants  and  Children,  with  their  Homoeopathic 
Treatment.  Edited  by  T.  C.  Duncan,  M.D.,  assisted 
by  several  physicians  and  surgeons.  Parts  II  and  III. 
Chicago :  Duncan  Brothers.  London :  Turner,  170^ 
Fleet  Street,  E.C. 

Thts  work  also  is  appearing  in  parts,  and  we  noticed  the 
first  of  them  in  our  number  for  Oct.,  1878.  We  have  now 
two  more,  completing  the  first  volume,  and  carrying  us 
down  to  the  end  of  the  all-important  digestive  disorders  of 
infancy  and  childhood.  Dr.  Duncan's  pages  are  unfortu- 
nately not  without  the  literary  faults  with  which  we  have  so 
often  had  to  reproach  the  journal  he  edits  ;  and  we  fear  that 
to  many  minds  they  will  prejudice  unfavourably  the  work  he 

*  E,g,  **  In  cancerous  affections  of  the  eye  we  have  teen  better  results  from 
Arsmucum  than  from  any  other  remedy.  We  have  known  three  cases  cured 
by  Fowler's  solution,  and  quite  a  number  by  the  6th  and  80th  potencies !" 


Auscultation  and  Percussion^  by  Ih\  Herbert  Clapp.   179 

Iiaa  done^  and  blind  tbem  to  the  industry  displayed  and 
the  useful  information  brought  together.  In  these  latter 
respects,  however^  the  author  deserves  all  credit.  The  best 
critics  of  the  book  will  be  the  busy  practitioners  and  com- 
mencing students  for  whom  it  is  doubtless  compiled ;  and 
if  these  find  it  profitable^  it  would  ill  become  reviewers  to 
carp.  We  are  bound  to  say^  however,  that  it  hardly  comes 
up  to  our  standard  of  excellence  ;  and  that  we  miss  origin- 
ality even  in  the  features  where  we  might  fairly  have 
expected  it.  One  who  has  been  '^  formerly  lecturer  on 
diseases  of  children  in  Hahneman  Medical  College  and 
Hospital  of  Chicago/'  and  who  is  **  Consulting  Physician 
Chicago  Foundlings'  Home ''  (Americans  are  too  busy  to 
insert  prepositions  and  articles),  ought  to  have  considerable 
personal  experience  in  his  specialty;  and,  as  a  homoeo- 
pathist,  should  be  able  to  add  to  our  knowledge  of  the 
specific  therapeutics  of  children's  diseases.  Of  such  obser- 
vation from  the  life,  however,  we  have  very  little.  We  do 
not  complain  of  the  copious  quotations  from  Hartmann, 
Teste,  and  Guernsey,  though  they  might  have  been  given  in 
less  detail.  But  we  do  expect  that  a  writer  like  Dr. 
Duncan  should  give  his  own  experience  of  the  value  of  their 
lecommendations,  and  should  supplement  them  by  many 
contributions  of  his  own.  If  he  had  done  this  we  should 
have  had  much  more  satisfaction  in  his  book. 


A  Tabular  Handbook  of  Auscultation  and  Percussion;  for 
Students  and  Physicians.  By  Herbert  C.  Clapp,  A.M., 
M.D.     Boston  :   Houghton,  Osgood  and  Company. 

This  little  book  is  excellently  conceived  and  perfectly 
executed.  It  is  designed  to  remind  students  and  prac- 
titioners of  the  distinctive  physical  signs  of  the  diseases  of 
the  chest ;  and  it  does  so  by  a  series  of  tabular  views,  each 
of  which  presents  a  coup  d'oeil  of  its  part  of  the  subject. 
For  students  it  must  be  an  invaluable  gathering  up  of 
what  they  have  learned  in  the  lecture-room  and  the  hospital 
wards;  and  it  will  prove  of  no  less  use  to  the  physician. 


180  Reviews, 

''  It  is  hardly  to  be  expected/'  as  the  author  jastly  says, 
''  that  practitioners  who  do  not  make  a  specialty  of  heart 
and  lung  diseases^  even  if  they  have  at  some  time  carefully 
studied  into  the  subject,  and  have  been  well  posted,  can 
retain  in  their  memories  for  immediate  use  every  point 
necessary  for  a  delicate  physical  diagnosis.  If  the  case  be 
at  all  obscure,  they  feel  the  necessity  of  consulting  some 
authority.  In  such  emergencies  the  busy  doctor  may 
appreciate  such  a  time  and  labour-saving  contrivance  as  the 
present.  It  often  needs  only  a  word  here  and  there  to 
revive  memories  of  extensive  reading.^' 

Dr.  Clapp  is  instructor  in  auscultation  and  percussion  in 
the  Boston  University  School  of  Medicine,  and  physician  to 
the  heart  and  lung  department  of  the  College  Dispensary. 
We  congratulate  both  institutions  on  having  so  intelligent 
and  capable  an  officer  as  this  book  shows  its  author  to  be. 


This  Yearns  Progress,  Address  delivered  before  the 
American  Institute  of  Homoeopathy,  by  the  President, 
J.  C.  BuaoHER,  M.D.,  at  the  opening  of  its  thirty- 
first  annual  session,  June  18th,  1878.  Philadelphia: 
Sherman  and  Co. 

Dr.  Burgher  has  sent  us  a  copy  of  this  excellent 
address,  and  we  have  read  it  with  much  pleasure.  We 
commend  it  to  our  colleagues  in  this  country,  as  showing 
what  is  being  done  in  America  after  the  pattern  of  our  own 
Binger  and  Phillips.  The  experiences  and  confessions  of 
Drs.  Wetmore,  Piffard,  Dessau,  and  Hall,  here  quoted,  will 
be  read  with  much  interest.  They  are  surface  indications 
of  a  deep  under-current,  which  must  ere  long  come  up  in 
the  shape  of  a  recognition  of  the  truth  which  there  is  in 
the  method  of  Hahnemann.  ^'  Although,^'  as  Dr.  Burgher 
says,  "  the  scientific  practice  of  homoeopathy  is  probably 
limited  to  about  one  eighth  of  the  entire  medical  profession 
of  this  country,  it  empirically  pervades  the  entire  practice 
of  medicine.     In  every  direction  the  principles  we  advocate 


Sclerotomies  181 

are  covertly  incorporated  into  standard  allopathic  works, 
and,  amid  manj  fruitless  efforts  to  conceal  the  fact,  are 
lai^ly  taught  in  an  empirical  way  in  allopathic  medical 
schools/' 


The  Urine  of  the  New  Bom.  By  J.  Pabbot  and  Albjsbt 
Robin.  Translated  from  the  Archives  G^nSraUs  de 
MSdedne,  1878,  by  Gbo.  E.  Shifman,  M.D.  Chicago : 
Foundlings'  Home  Press. 

Ba.  Shipman  has  done  well  to  extract  and  translate 
these  excellent  observations,  made  in  a  field  as  yet  un* 
worked,  and  promising  important  diagnostic  results.  We 
now  know  the  normal  composition  of  the  urine  of  infants, 
and  are  in  a  position  to  detect  the  beginnings  of  constitu- 
tional change  by  deviations  therefrom.  The  great  point  is 
the  urea.  "  A  new-born  child,  who  takes  in  twice  as  much 
azote  as  an  adult,  excretes  by  the  urine  six  times  less  of  it 
than  he,  and  nevertheless  absorbs,  on  the  average,  more 
oxygen.  In  a  word,  he  burns  less,  though  he  receives  more 
that  is  combustible  and  more  of  the  burner.^'  When 
"  athrepsia,'^  by  which  word  the  authors  designate  failure 
of  assimilation  in  these  subjects,  is  imminent,  the  urea 
increases  greatly.  We  may  always  suspect  that  this  has 
occurred  when  the  urine,  which  should  be  pale  and  neutral, 
alters  in  these  respects.  Anything  beyond  the  slightest 
degree  of  colour  or  acidity  suggests  excessive  elimination  of 
nitrogen,  and  calls  for  immediate  medical  attention. 


Sckrotomie,  son  manuel  opiratoire,  ses  indications  et  son 
action  physiologique.  Par  le  Uocteur  De  Eeebb- 
MAECKEB.     Brussels:  H.  Manceaux. 

This  little  brochure^  reprinted  from  UHomoRopathie 
MHitante,  will  be  read  with  much  interest  by  all  who  culti- 
vate diseases  of  the  eyes  as  their  specialty.     As  we  have  no 


182  'Reviews. 

homoeopathic  oculists  in  this  country,  it  is  useless  to  go 
into  the  surgical  details  discussed  by  our  Belgian  confrhre. 
To  us,  the  chief  point  of  value  is  the  consideration  of  the 
pathology  of  glaucoma  into  which  Dr.  De  Keersmaecker 
enters,  and  the  statements  he  makes  with  regard  to  the 
value  of  Aconite  in  its  treatment.  Anstie  had  long  ago* 
called  our  attention  in  England  to  the  frequent  association 
of  glaucoma  with  neuralgia,  using  its  occurrence  as  one 
among  many  evidences  of  the  central  origin  of  true  neu- 
ralgic pain.  Dr.  De  Keersmaecker  refers  the  increased 
ocular  tension^  which  is  the  essence  of  glaucoma,  to  dis- 
order of  the  trigeminal  nerve;  and  Schroff's  experiments 
bear  him  out  in  inferring  that  Aconite  is,  upon  these  data, 
one  of  its  most  promising  remedies.  He  promises  us,  in  a 
fuller  treatise,  of  which  the  present  is  but  a  sketch,  an 
account  of  his  experience  with  the  drug,  which  has  been 
very  satisfactory. 


Remedies  for  Periodic  Pain.\     Arranged  by  Edward   T. 
Blake,  M.D.,  M.R.C.S.,  F.B.H.S.     Steward  :   Reigate. 

''  This  list,''  Dr.  Blake  writes,  '^  has  been  compiled 
with  the  trust  that  much  human  misery  may  be  mitigated 
by  its  means,  and  that  many  poor  sufferers  may  be  led  to 
employ  these  safe  and  convenient  remedies  without  flying 
to  the  use  (?)  of  alcohol  as  an  anodyne.^'  The  list  includes 
twelve  remedies,  and  symptoms  are  given  whose  predomi- 
nance should  call  for  each.  It  would  have  been  better,  we 
should  have  thought,  to  add  to  each  medicine  its  charac- 
teristic indications. 


Is  Diphtheria  Preventable?  Sewage-Poisoning ^  its  Causes 
and  Cure.  By  Ed.  T.  Blake,  M.D.  London  :  Hard- 
wicke  and  Bogue,  1879. 

This  is  a  reprint  of  Dr.  E.  Blake's  paper  read  before  the 

*  Newralgia  and  the  Diseases  that  resemble  it,    1871.     P.  102. 
t  That  ii,  djrsmenorrlKBa. 


HomcBopathy  Vindieatedj  by  Dr.  B.  W,  Berridffe.    183 

British  HonKBopathic  Society,  and  published  in  its  Annals. 
It  oontaius  much  useful  advice  on  the  proper  construction 
of  the  sanitary  arrangements  of  houses,  illustrated  with 
drawings  and  designs  by  the  author,  which,  if  carried  out, 
would  doubtless  effect  a  great  diminution  in  the  number  of 
diseases  attributable  to  the  admission  or  retention  of 
impurities  in  dwelling-houses.  We  are  glad  that  Dr. 
Blake  has  published  his  admirable  paper  in  a  separate 
popular  form,  and  have  hope  that  it  will  do  all  the  good  he 
anticipates  from  it. 


Himcsopathy  Vindicated.  A  reply  to  Dr.  Joseph  Kidd's 
Laws  of  Therapeutics.  By  E.  W.  Berridoe,  M.D. 
Liverpool :  Holden,  1879. 

Ir  we  might  suggest  a  slight  alteration  in  the  title,  we 
would  say  that  "  Homoeopathy  vindictively  vindicated  " 
would  give  some  notice  of  its  spirit.  It  is  very  cleverly 
written,  and  would  have  been  a  deal  more  pleasant  to  read 
if  the  language  of  the  author  were  not  so  very  strong.  No 
doubt  Dr.  Kidd  has  laid  himself  open  to  criticism  in 
many  of  the  opinions  he  has  expressed  in  his  book ; 
still.  Dr.  Berridge's  criticism  would  have  been  more 
effective  if  he  had  not  gone  to  work  in  such  a  sledge- 
hammer style.  If  Dr.  Kidd  is  censurable  for  his  scepti- 
cism respecting  the  power  of  highly  diluted  medicines, 
what  shall  we  say  of  Dr.  Berridge's  credulity  when  he 
actually  quotes  the  following  assertions  as  if  they  were 
incontrovertible  facts  ? 

"In  1859  there  were  treated  by  myself  in  the  town  of 
Carlisle,  Pa.,  over  160  cases  of  scarlet  fever  with  the  200th  and 
Mgher  potencies  exclusively ;  mortality  konb  ;  the  allopaths 
lost  over  90  per  cent.,  and  the  survivors  were  crippled  for  life." 
**!  have  attended  cholera  patients ;  xever  lost  one.'* 
**lt  was  our  duty  to  attend,  some  five  years  ago,  a  very  large 
namber  of  cases  of  malignant  smallpox,  then   raging  as  an 


184  Reviews. 

epidemic  in  this  city.  Many  prominent  persons  came  under  our 
care ;  we  nerer  made  any  external  application ;  came  out  of  the 
epidemic  with  flying  colours ;  hot  a  case  pitted." 

These,  says  Dr.  Berridge,  are  *'  statistics  vouched  for  by 
Dr.  Ad.  Lippe,  of  Philadelphia/'  Gibbon  writes : — *'  Abu 
Rafe,  servant  of  Mahomet,  testifies  to  the  wielding,  as 
a  buckler,  by  Ali,  of  the  ponderous  gate  of  a  fortress^ 
which  he  and  seven  other  men  could  not  lift.  Abu  Bafe 
was  an  eye-witness,  but  who  will  be  witness  for  Abu 
Bafe?''  So  Dr.  Berridge  may  say.  Dr.  Lippe  vouches 
for  the  above ;  but  we  may  be  permitted  to  inquire,  who 
vouches  for  Dr.  Lippe  ? 

Carlisle,  Fa.,  was,  according  to  Johnston,  a  town  of  6000 
inhabitants  in  1867,  and  according  to  Petiit's  Directory 
for  1877-8,  it  has  six  homoeopathic  practitioners,  among 
whom  the  name  of  Dr.  Lippe  does  not  appear,  he  being, 
as  is  well  known,  a  resident  in  Philadelphia.  We  presume 
Dr.  Lippe  resided  in  Carlisle,  Fa.,  in  1859,  where  he  gives 
us  to  understand  he  treated  upwards  of  150  cases  of  scarlet 
fever.  That  is  a  goodly  number  of  cases  of  scarlet  fever 
to  fall  to  the  share  of  one  practitioner  in  one  year,  in  a 
town  of  6000  inhabitants,  doubtless  containing  many  other 
practitioners  of  both  schools,  though  possibly  the  number 
of  homoeopathic  practitioners  in  the  town  was  not  so  great 
then  as  now.  The  disease  must  have  been  of  quite  an  un- 
heard of  malignancy,  as  the  allopaths  only  succeeded  in  saving 
10  out  of  100  of  the  cases  thev  treated.  It  must  have 
been  more  virulent  than  any  epidemic  of  cholera,  yellow 
fever,  or  plague  on  record ;  for  even  this  paltry  decimal 
fraction  of  survivors  were  *'  crippled  for  life."  Dr.  Lippe 
was  an  eye-witness  for  this  incredible  result.  Well,  all  we 
can  say  is,  who  will  be  witness  for  Dr.  Lippe  ? 

As  regards  the  assertion  of  our  transatlantic  Abu  Rafe 
that  he  attended  a  very  large  number  of  cases  of  malignant 
smallpox,  and  that  not  a  case  pitted,  sceptics  might  say  that, 
from  anything  that  appears  in  Dr.  Lippe's  statement,  they 
may  all  have  died  and  thus  had  no  opportunity  of  pitting. 

We  venture  to  say  that  the  publication  of  such  state- 
ments does  more  harm  to  homoeopathy  than  any  sceptical 


CavaUaro's  Homoeopathy.  185 

utterances  by  Dr.  Kidd  with  respect  to  some  of  Hahne- 
mann's doctrines;  and  their  indorsement  by  Dr.  Berridge 
seriously  detracts  from  the  force  of  his  arguments  against 
Dr.  Kidd's  work. 


How  to  take  Care  of  our  Eyes.  By  Henbt  C.  Anobll^ 
M.D.  3rd  Edition.  Boston  :  Roberts^  1878.  London  : 
Tamer,  170,  Fleet  Street,  E.G. 

This  is  an  excellent  little  popular  book  on  the  subject  of 
the  eyes  and  vision.  It  has  already  gone  through  several 
editions  in  America,  and  an  English  edition  has  lately  been 
published  by  Messrs.  Hardwicke  and  Bogue.  We  can 
safely  recommend  it  to  all  who  feel  that  their  eyes  are 
groinng  defective,  and  to  all  who  are  interested  in  the 
preservation  of  their  sight,  as  it  contains  as  much  good 
advice  respecting  the  preservation  of  the  sight  as  respecting 
the  remedying  of  actual  defects.  Indeed,  as  a  popular 
work  it  will  be  more  useful  for  the  former  than  for  the 
latter  purpose,  as  it  is  impossible  to  write  instructions  for 
the  selection  of  glasses,  &c.,  for  many  defects  of  the  refrac- 
tive media  of  the  eyes  that  shall  be  available  by  a  non- 
medical person. 


Corio  teoretico-pratico-alfabetico  di  Medicina  Omeopatica, 
pel  Prof.  Cataldo  Cayallaro.  2nd  Edition,  Vols. 
I,  II,  III,  IV.     Palermo,  1871-6. 

Whilb  we  are  talking  in  this  country  of  bringing  out  a 
Therapeutic  Encyclopaedia  on  the  homoeopathic  treatment 
of  disease,  our  Italian  colleagues  have  been  for  some  years 
in  possession  of  one,  the  second  edition  of  which  now  lies 
before  as.  This  large  work  in  four  volumes  is  a  monument 
to  the  industry  of  Dr.  Cavallaro ;  but  we  are  bound  to 
confess  the  work  is  very  unequal,  though  by  one  hand,  or, 
we  might  say,  because  by  one  hand,  as  no  doctor    can 


186  Reviews, 

possibly  know  all  diseases  equally  well ;  the  intention    is 
better  than  the  execution.      It  is  evidently  a  compilation^ 
though  very  few  authors  are  referred  to,  and^  as  far  as  we 
can  see,  none  of  Hahnemann's  school ;   so  that  for  all  that 
appears,  the  wisdom   it  contains  has  all  issued  from   Dr. 
Cavallaro's  own  brain.      *'  Italia  fara  da  se  /"      And  yet 
the  iufurmation   to  be  found   in   it,    with  respect   to  the 
diseases   and    their    treatment,  differs  in    no  considerable 
degree  from  what  we  read  in  other  works  on  homoeopathic 
treatment,   especially   those    of  the  domestic    sort.      The 
conscientiousness   of  the  author  is   forcibly  illustrated  by 
the  careful  manner  in  which  he  gives  a  separate  paragraph 
to  every  name  of  disease,  although   many  of  his  names  are 
merely    bynonyms  of  the  same  diseases.      An  instance  of 
this  is  the  disease  which  he  calls  ^'  Fehbre  nervosa  o  tifQidta^' 
typhoid  or  nervous  fever.     We  have :— 1,  F,  nervosa  gene- 
rale,  2,  F.  n.  acuta,  3,  F,  n,  adinamica,  4,  F.  n.  atassica,  5, 
K  n,  catarrale,  6,  F.  n.  cerebrale,  7,  F.  n.  comatosa,  8,  F. 
n,  continua,  y,  F.  n.  grave,  10,  F,  n.  gastrica,  11,  F.  n.  gas* 
trica  versatile^   12,  F.  n.  infiammatoria,   13,  F.  n.  intermit^ 
tente,  14,  F.  n.  lenta,  15,  F.  n.  puirida,  16,  F.  n.  rheumatica, 
17,  F.  n.  semplice,    18,  F.   n.  stupida,  19,  F.   ».  tifoidea, 
20,  Tifo  abdominale,   21,   T,   cerebrale,  22,    T.  pulmonale, 
23,  F.  tifoidea  dei  bambini.     Then   we  have  another  large 
section    of  Febbre  gastrica   with   fourteen   different   kinds 
separately  described,  many  of  which  are  mere  varieties  of 
the  typhoid  or  nervous  fever,  just  as  many  of  the  supposed 
varieties  of  the  typhoid  fever  are  merely  different   names 
for   the  same   affection.      Then   we  have  enormously  long 
lists  of  the  medicines  for  these  fevers,  accompanied   by  the 
indications    for    their    use.     Thus,   for  typhoid   fever    the 
author  gives  the  indications  fi)r  Aeon.,   Apis,  Am.,  Ars., 
Bapt.,  Bel ,  Bry.,   Calc,  Camph,,  Canth.,  Carb,  v.,  Cham., 
China,    Cimicif,,   Cocc,    Colch.,    Cupr,,   Gels,,  Dig,,    HeL, 
Hyo,,    Ign,,   Lack.,    Lachnant,,    Lye,    Mag,    m.,    Merc, 
Mosch,,  Mur.  ac,  Nat.  m.,   Nitr.  ac,  Nitr.  sp.,  Nux  m., 
Nux  v.,  Dpi.,  Phos.,  Phos.  ac.  Puis.,  Rhus,  SecaL,  Spig., 
Staph.,  Stram.j  Suiph.,  Valer.^  Zinc     The  list  is  formid* 
able  enough,  but  it  might  pass  if  the  indications  given  for 


Medical  Chemistry y  ^c,  by  C.  G.  Wheeler.  187 

the  medicines  were  correct.  But  this  we  cannot  say  is  the 
case.  Here  are  the  author's  indications  for  the  employ- 
ment of  BapiiHa  in  tvphoid  : — "  In  the  first  stage,  from 
the  moment  the  disease  commences  to  manifest  itself^  the 
patient  seems  apathetic^  does  not  wish  to  go  out^  feels  full 
of  anxiety^  is  afraid  of  something  about  to  happen  to  him 
without  knowing  what  it  is;  dull,  stupefying  headache; 
hrowu,  furred,  dry  tongue,  particularly  in  the  centre;  foul 
breath ;  falls  asleep  while  speaking ;  when  he  lies  down 
complains  of  not  being  able  to  sleep,  because  he  cannot 
compose  himself ;  countenance  expressive  of  stupefaction ; 
stupor  with  delirium ;  whilst  replying  to  a  question  he  falls 
sound  asleep  in  the  middle  of  a  sentence.  If  this  remedy 
is  promptly  administered  at  this  stage,  or  at  the  commence- 
ment of  the  disease,  the  patient  falls  into  a  copious  perspi-  ' 
ration,  and  convalescence  quickly  takes  place/' 

We  are  sure  that  none  of  our  colleagues,  who  are  in  the 
habit  of  prescribing  Baptisia  in  typhoid,  will  recognise  the 
above  as  indications  for  its  use.  All  diseases  are  treated 
by  Dr.  Cavallaro  with  equal  confidence. .  He  has  even  a 
longish  section  on  the  latest  disease  with  which  we  are  threat- 
ened— the  Oriental  or  Bubonic  Plague — and  he  gives  a  list 
of  the  medicines  that  he  imagines  are  indicated  for  it. 
Onr  readers  may  be  curious  to  know  what  they  are — 
^sen,,  Laeh.,  Carb,  v.,  Chin,,  Hydrocyan,  acid,  Lauroc, 
Kreot.,  Verat. 

On  the  whole  we  cannot  extol  Dr.  Cavallaro's  work  as 
likely  to  prove  of  much  value  to  the  scientific  practitioner. 
Still,  it  may  be  useful  as  a  reminder  of  the  medicines  that 
hare  been  employed  or  recommended  by  homoeopaths  in  all 
the  different  ailments  and  diseases  of  the  human  body. 


Medical  Chemistry,  including  the  Outlines  of  Organic  and 
Physiological  Chemistry.  By  C.  Gilbert  Wheeler, 
Professor  of  Chemistry  in  the  University  of  Chicago  and 
in  the  Hahnemann  Medical  College.     Chicago,  1879. 

"  Ukder  which  king,  Bezonian  ?**     Mr.  Wheeler  seems 


188  Reviews, 

to  occupy  the  same  post  in  the  allopathic  and  the  homoeo- 
pathic schools  of  Chicago.  And  after  all,  we  do  not  see 
why  he  should  not,  being,  as  we  presume,  competent  to 
fulfil  the  duties  of  a  double  professorship.  Chemistry  is 
just  one  of  those  branches  of  medical  science— so-called — 
that  admits  of  no  colouring  by  the  therapeutic  tenets  of  its 
teacher.  This  seems  a  very  useful  little  book,  and  espe- 
cially acceptable  to  those  who  desire  to  obtain  a  general 
knowledge  of  the  progress  made  by  organic,  and  especially 
medical  chemistry,  of  late  years,  and  the  last  changes  that 
have  been  introduced  into  its  nomenclature.  We  can 
heartily  recommend  it  to  students  of  both  schools. 


On  [the'' Neglect  of  Physical  Education  and  Hygiene  by 
Parliament  and  the  Educational  Department.  By  Dr. 
Roth.      London  :  Bailliere,  1879. 

Dr.  Roth  here  takes  a  pessimist  view  of  the  future  of  the 
British  race  unless  they  quickly  reform  and  attend  to  their 
physical  education.  He  proposes  that  Government  should  in- 
troduce this  branch  of  education  into  all  the  Board  schools, 
as  well  as  into  the  army.  Even  drilling,  which  alone  has  been 
introduced  into  the  Board  schools,  is  quite  insufficient,  and 
its  iusufficiency  has  been  acknowledged  by  the  army  aatho« 
rities,  who  have  now  introduced  gymnastics  as  a  part  of  the 
soldier's  training.  Dr.  Roth  is  an  enthusiast  on  the  subject, 
and  he  speaks  with  authority,  for  he  possesses  a  perfect 
knowledge  of  it.  His  zeal  led  him  to  send  a  commis- 
sioner to  inquire  into  the  state  of  physical  education 
on  the  Continent,  and  the  reports  of  this  commissioner  are 
not  the^^least  interesting  part  of  the  pamphlet.  They  show, 
moreover,  that  we  in  England  are  far  behind  most  conti- 
nental nations  in  the  matter  of  enforcing  physical  education 
as  an  integral  part  of  the  national  education.  We  trust  Dr. 
Roth's  views  will  command  the  attention  of  the  proper 
authorities,  and  prevent^that  physical  degeneration  which  is 
going  on,  and  threatening  to  make  the  true-bom  Briton  a 


Report  of  Homoeopathic  Yellow  Fever  Commission.     189 

poor   creature   unfit  to  cope  eyen  with  savages^  like   our 
actual  enemies  the  Zulus^  on  equal  terms. 


Special  Report  of  the  HomoRopathic  Yellow  Fever  Commission 
ordered  by  the  American  Institute  of  Homceopathy  for 
presentation  to  Congress.     New  Orleans^  1879. 

The  yellow  fever  of  last  year  proved  a  very  disastrous 
epidemic  in  the  Southern  States  of  America.     It  created 
([oite  a  panic^  and  inhabitants  of  towns  fled  in  terror  at  its 
approach.       On  the  other  hand,  many  heroic  deeds  were 
performed  and  much  benevolence  was  displayed  by  doctors 
and  others  in  connection  with  the  epidemic.     A  lady^  Mrs. 
EUxabeth  Thompson,  of  New  York,  sent  out  to  the  infected 
district,  at  her   own  expense,  a  commission  of   allopathic 
physiciaas,  to  collect  facts  and  statistics  and  offer  sugges- 
tions for  the  treatment  of  the  disease.     The  result  of  their 
inquiry  was  so  unsatisfactory  and  taught  so  little  that  was 
not  known  before,  and  offered  so  little  in  the  way  of  sug- 
gestions for  the  treatment  of  the  disease,  that  this  benevolent 
lady  was  induced  to  send  out  another  commission,  composed 
this  time  of  homoeopathic  physicians,  with  Dr.  Holcombe 
for  chairman  and  Dr.  Verdi  for  secretary.      Their  report 
now  lies  before  us,  and  though  it  is  a  mere  abstract  of 
what  will  appear  in  greater  detail  in  a  future  work,  it  shows 
OS  the  superiority  of  the  homceopathic  method  in  the  treat- 
ment of  this  disease  in  no  doubtful  manner.     The  commis- 
sion invited  all  the  homosopathic  practitioners  in  the  infected 
districts  to   communicate  to  it   the  results  of  their  treat- 
ment of  the  fever.     It  met  on  December  2nd,  1878,  at  a 
hotel  in  New  Orleans,  and  was  very  cordially  received  by 
their  colleagues.     Reports  were  received  from  thirty-seven 
practitioners,  twenty-three  of  whom  had  been  more  or  less 
folly  employed  during  the  actual  epidemic,  and  seven  had 
practised  during  former  epidemics  of  yellow  fever. 

The  following  facts  appeared  from  an  analysis  of    the 
various  reports : 

1945  cases  of  yellow  fever  were  treated  homcsopathically 


190  Our  Foreign  Contemporaries. 

in  New  Orleans^  with  a  loss  of  110  cases,  showing  a  mor- 
tality of  5*6  per  cent. 

1969  cases  were  treated  in  towns  outside  of  New  Orleans, 
with  a  mortality  of  151  =  7*7  per  cent. 

The  proportional  mortality  was  less  in  negroes  and 
mulattoes  than  in  white  persons. 

2100  cases  were  treated  in  the  much  milder  epidemics 
between  1853  and  1878,  with  a  loss  of  360  patienU  =  8*7 
per  cent. 

Total  number  of  cases  treated  homoeopathically  6569^ 
deaths  360,  mortality  =  5*4  per  cent. 

1089  of  these  cases  were  in  children  under  fifteen,  of 
whom  48  died  ==  4*4  per  cent. 

The  total  number  of  recoveries  after  black  vomit  was  125. 
The  total  ascertained  number  of  cases  of  yellow  fever 
treated  allopathically  in  New  Orleans  was  23,540,  and  the 
deaths  recorded  amounted  to  4056  ==  17*2  per  cent.  The 
commissioners  say  the  mortality  was  much  greater,  as 
hundreds  of  deathtt  by  yellow  fever  were  reported  as  malarial 
haemorrhagic  fever,  pernicious  fever,  congestive  fever,  cerebro- 
spinal meningitis,  &c. 

The  medicines  found  of  use  by  the  horaoeopathists  were, 
for  the  first  stage.  Aeon.,  Bell.,  Bry,,  and  for  the  second 
stage,  Arsen.,  Carb.  veg.,  and  Croialus. 

A  good  deal  of  interesting  matter  relating  to  the  sup- 
posed causes  of  yellow  fever,  and  the  measures  advisable  for 
its  prevention,  will  be  found  in  this  pamphlet. 

We  look  forward  with  interest  to  the  '*  fiill  and  technical 
report  "  which  is  to  be  published  by  the  American  Institute 
of  Homoeopathy,  and  trust  that  the  labours  of  our  colleagues 
have  succeeded  in  eliciting  the  best  remedies  for  this  dire 
disease,  and  the  best  means  for  its  prevention. 


Our  Foreign  Contemporaries, 
AMERICA. — It  is  nine  months*  since  we  have  been  able 

*  This  Dotice  was  written  and  partly  printed  for  our  last  number,  from 
which  at  the  last  it  was  crowded  out.    As  it  would  have  required  much 


America.  191 

to  DOtice  tbe  homoeopathic  jonmals  of  the  United  States. 
We  must  make  up  for  the  omission  by  embracing  as  manj 
of  them  as  possible  in  our  present  survey. 

North  American  Journal  of  Homceopathy,  Nov.,  1877 — 
Aogust,  1878. — As  usual^  we  give  first  place  to  our  fellow- 
qnarterlj,  of  which  we  have  four  numbers  before  us.  One 
of  their  chief  and  most  valuable  features  is  the  translation^ 
bj  the  editor,  of  Dr.  Gerstel's  exhaustive  essay  on  2!incum, 
which  runs  throughout  them,  and  adds  greatly  to  our  know* 
ledge  of  this'  medicine.  We  will  speak  of  the  other  notice- 
able points  in  each  number  separately. 

In  that  for  November  of  last  year  Dr.  Lilienthal  makes 
a  curious  mistake  when  he  speaks  of  the  action  of  Cannabis 
mdica  in  gonorrhoea^  saying  that  he  has  been  disappointed 
in  it.  No  wonder  he  has^  for  no  one  has  warranted  it 
theran.  What  we  call  Cannabis  indica  is  a  resin  de- 
veloped in  the  Eastern  variety  of  the  hemp  plant^  and 
possessing  (so  far  as  we  know)  neurotic  properties  only. 
The  irritant  of  the  urethra  is  the  Cannabis  sativa  of  the 
colder  climes ;  and  with  this  as  an  anti-gonorrhoeal  medicine 
no  one  need  be  dissatisfied^  if  only  he  gives  sufficient  doses. 

In  February  Dr.  Hering  begins  a  series  of  '*  arrange- 
ments" of  Schiissler's  tissue-remedies,  intended  as  a  re- 
publication of  his  American  edition  of  that  author's  book, 
embodying  all  freshly  acquired  knowledge  about  the  medi- 
cines therein  contained.  Calcarea  fluorica,  phosphorica, 
and  stdfikurica,  Ferrum  phosphoricum^  and  Kali  muriaticum 
are  treated  of  in  the  numbers  before  us.  Dr.  Hering  tells 
US  that  at  the  meeting  of  homoeopathic  physicians  of  Switzer- 
land^ held  at  Scbaffhausen  in  1877^  the  subject  of  Scliiissler's 
therapeutics  was  introduced^  and  Kali  phosphoricum  and 
Magnesia  phosphorica  acknowledged  to  be  great  remedies. 
Dr.  Hering  himself  says  the  same  of  Ferrum  phosphoricum. 
He  does  not  vouch  for  the  correctness  of  Schiissler's 
doctrines^  or  assent  to  his  limitation  of  our  Materia  Medica 
to  twelve  remedies ;  but  thinks  that  in  the  drugs  he  com- 
mends to  our  notice  we  have  several  (and  among  them  some 

alteration  to  bring  it  down  to  the  preBent  time,  it  has  seemed  best  to  leave  it 
u  it  standi. 


192  Our  Foreign  Contemporaries. 

new  ones)  of  unusual  value.  Of  those  included  in  the 
present  list  we  may  mention  that  Calcarea  sulphurica  is 
said  by  Schiissler  to  act  with  more  intensity  in  most  cases 
where  Hepar  has  heretofore  been  given,  and  that  Quaglio 
and  Koeck  confirm  his  statement  as  to  its  greater  power. 
Dr.  Hering  notes — "this  is  willingly  confirmed  by  the 
one  who  introduced  the  old  Hepar  in  suppurations/' 

In  the  May  number  Dr.  Allen  gives  us  an  excellent  case 
of  fissure  of  the  anus  cured  by  Ratania  8^  which  we  should 
have  transferred  to  our  pages,  had  it  not  already  been 
brought  under  the  notice  of  British  homoeopathists  in  the 
Monthly  Homeopathic  Review  for  August. 

The  August  number  contains  the  first  of  a  promised  series 
of  contributions  from  the  pen  of  Dr.  Ludlam,  who  will  each 
quarter  review  the  progress  of  gynaecological  knowledge  in 
both  schools  of  medicine,  with  notes  and  comments  of  his 
own.  This  section  of  the  North  American  will  be  deservedly 
a  favourite  one. 

The  same  number  contains  two  deliverances  on  the  ques- 
tion so  much  agitating  the  minds  of  our  American  brethren 
at  present,  viz.  whether  those  who  allow  themselves  to  be 
recognised  as  '' homoeopathists ''  are  thereby  bound  to 
practise  nothing  but  homoeopathy.  Dr.  P.  P.  Wells  main- 
tains that  they  are,  on  the  ground  that  similia  similibus 
curantur  is  "  one  of  Nature's  laws,''  and  therefore  immutable, 
imperative,  and  admitting  of  no  exception  or  qualification. 
This  position  of  his  has  been  challenged.  Further  on  will 
be  found  Dr.  Hughes's  contribution  to  the  settlement  of  the 
question.  Dr.  Lilienthal,  while  condemning  all  careless  and 
licentious  practice,  stands  for  the  '^liberty  of  medical  opinion 
and  action "  which  Carroll  Dunham  demanded,  and  aptly 
cites  Hahnemann  himself  on  the  point. 

New  England  Medical  Gazette,  Jan.— Oct.,  1878.— The 
October  number  of  the  Gazette  is  the  last  we  have  received, 
and  of  the  present  series  the  issues  for  February  and  March 
have  failed  to  reach  us.  This  nice-looking  and  well-priuted 
journal  well  sustains  its  reputation  as  an  organ  (mainly)  of 
Boston  homoeopathy,  and  fairly  represents  its  intelligent 
and  liberal  character.     It  reports  fully  the  doings  of  the 


America.  193 

Boston  University  School  of  Medicine  and  of  the  Massa- 
chusetts  Homoeopathic  Society,  besides  containing  many 
useful  communications  from  individual  practitioners.  While, 
however,  we  have  read  no  number  without  interest,  we  find 
nothing  to  note  or  extract  save  the  following  rather  startling 
contribution  from  Dr.  Conrad  Wesselhoeft,  to  which  the 
attention  of  our  chemists  especially  should  be  directed. 

Trituration  of  Silica.* 

Dr.  S.  Whitney,  who  is  engaged  in  perfecting  our  means  of 
triturating  insoluble  substances  to  the  greatest  degree  of  fineness, 
has  submitted  to  me  certain  specimens  for  microscopic  examina- 
tion, together  with  certain  questions.  The  substances  were  : — 1 . 
Crude  silica  ground  by  itself,  without  sugar  of  milk  (which  I  shall 
deognate  with  the  letters  S.  L.),  for  three  quarters  of  an  hour  or 
more.  2.  Equal  parts  of  silica  and  S.  L.  ground  for  three 
qiurters  of  an  hour.  3.  Some  crude  silica  precipitated  from  a 
solution  of  potash,  which  appears  in  the  form  of  fine  powder. 

4.  A  specimen  of  stannum  triturated  with  three  parts  of  S.  L. 
With  regard  to  the  substances,  the  following  questions  were 

propounded: — 1.  Are  the  particles  of  the  drug  increased  in 
number  as  they  pass  through  each  trituration  ?  2.  Are  they 
smaller  in  the  third  than  in  the  second  trituration  ?  3.  In  the 
several  triturations  are  the  particles  of  silica  in  a  finer  state  of 
division  than  the  particles  of  the  S.  L.  ?  4.  What  reason  have 
we  for  supposing  that  in  the  third  trituration  the  particles  of  the 
drug  are  a  million  times  smaller  than  the  particles  of  sugar  P 

5.  What  is  the  best  method  of  reducing  insoluble  substances  to  the 
greatest  degree  of  fineness  compatible  with  the  requirements  of 
the  mode  of  attenuation  as  hitherto  practised  P 

I  do  not  feel  prepared  to  answer  the  above  questions  in  full 
detail  at  present,  having  been  engaged  for  some  time  in  perfect- 
ing a  more  extended  report  for  the  American  Institute  of 
Homceopathy,  which  will  embrace  all  those  facts  and  observations 
for  which  time  and  space  are  insufficient  just  nowr.  These  obser- 
vations will  therefore  be  limited  by  the  specimens  above  named. 

The  reason  for  triturating  silica  in  these  difierent  ways  was  for 
the  purpose  of  ascertaining  the  effect  of  that  process  upon  it 

*  The  nUcea  of  the  Materia  Medica,  now  called  HUea,  or  nlicic  acid. 

VOL.  XXXVII,  NO.  CXtVIII. — APEIL,  1879.  N 


194  Our  Foreign  Contemporaries. 

under  different  conditions.  It  has  been  assumed  by  Hahnemann, 
and  since  his  time  by  most  others,  that  silica,  like  many  insoluble 
substances,  became  capable  of  '*  dynamization  "  and  of  solution 
after  undergoing  the  process  of  trituration  for  the  third  time 
{Chronic  Diseases,  2nd  ed.,  vol.  i.  Introduction,  p.  182  et  seq.). 
Without  discussing  for  the  present  the  solubility  of  silica,  it  is  of 
prime  importance  to  decide  whether  that  substance  is  actually 
reduced  to  a  greater  degree  of  fineness  or  subdivision  with  each 
successive  trituration.  Microscopic  examination  ofsilica-tritura- 
tions  prepared  according  to  the  centesimal  scale  is  very  unsatis- 
factory. "We  can  find  a  few  coarse  particles  of  silica  in  the  first, 
a  very  few  in  the  second,  and  none  in  the  third.  It  is,  therefore, 
easy  to  assume  that  in  successive  triturations  the  particles  of 
silica  have  been  so  far  reduced  as  to  become  invisible.  To  test 
this  problem  the  proportion  of  silica  to  S.  L.  in  one  specimen  was 
increased  to  even  parts,  another  specimen  of  silica  was  ground  by 
itself,  while  a  third  specimen  of  pure  silica,  which  had  not  been 
subjected  to  trituration,  was  examined  in  its  natural  state.  The 
examination  was  made  with  the  microscope  as  the  most  direct  and 
available  means  known  for  that  purpose  to-day.  Though  it  is 
not  difficult  to  examine  transparent  substances  by  transmitted 
light,  much  is  lost  in  this  way  that  can  only  be  seen  by  direct 
light  (from  above).  Till  within  five  years  it  was  impossible  to 
observe  opaque  objects  with  powers  ranging  above  two  or  three 
hundred  diameters  at  the  most.  But  with  the  improved  means 
of  to-day,  like  Prof.  Abbe's  Illuminator,  *  it  is  easy  to  see  minute 
objects,  opaque  as  well  as  translucent,  magnified  from  six  to  seven 
hundred  diameters,  as  perfectly  defined  as  with  transmitted  light. 
Experiments  will  show  how  far  such  an  apparatus  served  my 
purpose. 

A  sample  of  pure  unground  silica  was  placed  upon  a  glass  slide 
and  examined  with  transmitted  as  well  as  direct  light.  Both 
methods,  but  especially  the  latter,  brought  the  particles  of  silica 
clearly  into  view,  and  permitted  their  measurement  with  an  eye- 
piece micrometer.  It  was  quite  an  easy  matter  to  see  the  laigest 
as  well  as  the  smallest  particles.  The  largest  measured  in  length 
and  breadth  1-2  mm.  to  1-50  mm.  These  can  be  seen  with  the 
naked  eye,  but  among  them  were  extremely  small  particles.  Seen 
with  a  low  power  of  forty  diameters,  they  were  as  minute  as  it 

*  M.  Schultze's  Arehiv/ur  Microtc.  Anatomic,  vol.  iz,  p.  496. 


America.  195 

was  possible  to  see.  Supposing  that  there  might  be  still  smaller 
ones,  higher  powers  were  gradually  employed;  and  while  the 
miniite  points  glistening  upon  a  dark  ground  were  enlarged  to 
the  eye,  no  others  appeared  after  one  hundred  diameters  were 
reached.  Nor  did  a  magnifying  power  of  six  hundred  and  sixty 
diameters  reveal  any  minuter  points  than  those  already  seen,  and 
these  carefully  measured  had  a  length  and  breadth  not  exceeding 
1-1800  mm.  (1  mm.  equals  about  1-700  of  an  inch.) 

Supposing,  of  course,  that  the  process  of  trituration  would  in- 
crease the  difficulty  of  observation  by  reducing  the  particles  to  so 
great  a  degree  of  fineness  as  to  exceed  the  powers  of  the  micro- 
scope, a  portion  of  a  trituration  of  silica  made  with  one  half  its 
volume  of  sugar  of  milk  was  dissolved  in  a  watch-glass,  by  care- 
folly  wanning  it.  The  silica  was  made  to  settle  at  the  bottom 
by  gently  shaking  and  rotating  the  glass.  The  clear  solution  of 
S.  L.  was  drawn  off  with  a  pipette,  and  water  again  added,  and 
wanned,  to  dissolve  the  S.  L.,  and  this  process  repeated  till 
fregaent  recourse  to  the  microscope  proved  that  no  more  crystals  of 
S.  L  were  present.  I  cannot  here  describe  all  the  difficulties  of 
getting  rid  of  the  S.  L.  and  the  means  of  distinguishing  it  from 
silica.  A  great  many  trials  perfected  the  methods  of  doing  so, 
and  having  succeeded,  I  proceeded  to  examine  the  triturated  silica 
upon  a  slide,  as  usual.  It  was  to  my  surprise  difficult  to  see  any 
marked  difference  between  it  and  the  previous  untriturated  silica. 
The  largest  particles  in  the  trituration,  if  reduced  at  all,  measured 
1-2  mm.,  while  the  smallest,  followed  up  by  the  high  powers, 
measured  no  less  than  1-1800  mm.  If  there  was  any  difference 
at  aQ  between  this  and  the  untriturated  silica,  it  was  that  in  the 
former  there  were  fewer  large  particles. 

ITnder  the  force  of  the  assumed  divisibility  by  trituration,  some 
may  think  that  with  one  hundred  grains  of  S.  L.  one  grain  of  silica 
would  have  been  more  minutely  divided.  It  is  not  so.  The 
more  S.  L.  we  use,  the  less  is  the  chance  of  crushing  the 
particles.  The  less  S.  L.  we  use,  the  more  easily  some  substances 
like  copper,  gold,  lead,  &c.,  are  comminuted,  as  I  can  illustrate 
by  numerous  trials,  which  I  shall  make  known  in  due  time. 

To  add  a  ^rther  test  to  the  above,  a  sample  of  pure  silica 
was  ground  by  itself  for  nearly  an  hour,  and  examined  upon  a 
slide  with  various  powers  of  the  microscope. 

Here  alone  it  was  possible  to  affirm  a  change  in  the  silica. 


196  Our  Foreifjn  Contemporaries. 

This  had  been  somewhat  reduced  ;  the  largest  particlea  measured 
3-100  mm.  very  uniformlj.  But  the  smallest  ones  did  not  reach 
bejond  1-&00  mm.  in  smallness. 

Hence,  with  regard  to  silica,  I  can  affirm  that  its  particles  do 
not  increase  in  number  a  hundredfold  in  trituration  with  S.  L. 
They  cannot  be  smaller  in  the  second  or  third  trituration,  as  they 
are  not  reduced  in  the  first. 

It  is  impossible  to  compare  the  particles  of  silica  or  any  other 
drug  with  the  S.  L.  of  the  trituration ;  for  we  either  have  to  dis- 
solve it  and  wash  it  away,  or  to  view  it  in  conglomerated  masses. 
As  far  as  silica  is  concerned,  we  have  no  reason  to  suppose  that  in 
the  third  trituration  its  particles  would  be  a  million  times  smaller 
than  those  of  the  crude  substance  ;  for,  as  above  shown,  tritura- 
tion with  S.  L.  does  not  affect  it,  while  trituration  without  the 
sugar  reduces  it  slightly,  but  only  the  coarsest  fragments. 

A  number  of  other  substances,  like  charcoal,  gold,  copper,  lead 
and  tin  have  also  been  carefully  examined ;  a  specimen  of  the 
stannum-trituration  mentioned  above,  was  treated  like  the  silica 
by  being  forced  from  S.  L.  by  the  process  of  washing  before 
microscopic  examination.  It  was  likewise  examined  in  solution 
on  a  slide,  both  while  the  S.  L.  was  in  a  state  of  solution  and 
after  it  had  congealed  to  a  clear  mass  upon  a  slide,  which 
revealed  that  it  had  been  reduced  to  a  great  degree  of  fineness, — 
its  particles  measuring  1-600  to  1-1200  mm.  Having  only  this 
specimen,  no  fair  conclusion  could  be  formed  as  to  the  result  of 
farther  trituration.  But  judging  from  the  behaviour  of  the  other 
metals,  tin  will  not  undergo  greater  comminution  by  repeated 
trituration,  of  which  proofs  will  be  offered  in  another  article. 

As  every  one  may  see  for  himself  by  repeating  these  obser- 
vations, the  limit  of  divisibility  of  the  metals  is  soon  reached. 
As  a  rule  it  does  not  reach  beyond  the  second  trituration,  if  so 
far.  Different  means  of  treatment  bring  forth  different  result*. 
The  only  observer  in  our  school  who  threw  some  light  on  this 
subject  was  MayrhofeVy  in  1844s,*  who  claimed  to  have  traced 
some  metals,  e.g,^  gold,  platina,  &c.,  as  far  as  the  tenth  and  four- 
teenth dilutions.  Segin\  is  also  quoted  as  an  authority  who 
made  a  few  examinations  at  a  time  when  the  microscope  and  its 
methods  of  manipulation  were  not  sufficiently  advanced.  The 
improved  instruments  since  that  time  permit  abetter  view  of  this 

*  0$Btr,  Zeitsehr,/.  Somc$op.,  vol.  1, 1844.  f  Syf§a, 


America.  197 

rabject,  which  it  was  impossible  to  obtain  at  Sahnemann's  time  ; 
ftnd  BTen  Mayrhqfer's  instrument  (Ploessrs),  though  better  than 
Segin*8,  could  not  afford  the  flatness  of  field  nor  the  defining 
power  of  present  instruments ;  nor  did  he  possess  the  proper 
means  of  illumination  of  opaque  objects,  which  are  now  so  well 
seen  with  Abbe's  illuminator. 

As  to  the  solubility  of  silica,  I  would  say  that,  if  soluble,  this 
property  does  not  depend  on  extreme  comminution,  which  is  far 
from  being  reached  by  the  ordinary  method  of  trituration.  If 
the  pathogenetic  efiects  attributed  to  it  really  sprang  from  it, 
they  did  not  proceed  from  solubility  of  the  silica,  but  possibly 
from  the  minuteness  of  the  particles  as  found  in  the  crude  as  well 
as  in  the  ground  silica,  which  are  five  or  six  times  smaller  than  a 
blood-corpuscle,  measuring  about  1-150  mm.  We  know,  how- 
eyer,  that  silica  exists  in  an  insoluble  and  in  a  soluble  state ; 
and  though  this  was  known  since  1823,  about  which  time  Ber- 
zeliusmade  it  known,  pharmacists  and  physicians  persisted  in 
assuming  the  insoluble  silica  to  become  soluble  by  trituration,  and 
in  neglecting  the  soluble  form  altogether, — that  form  in  which  it 
is  contained  in  the  soil  and  in  which  it  is  assimilated  by  plants. 
We  have  no  eyidence  that  in  its  amorphous  insoluble  form  it  is 
soluble  in  water  or  in  alcohol. 

Hence  silica,  like  carbon,  should  be  subjected  to  a  new  series  of 
provings,  both  of  the  silicic  acid  and  the  metal  silicium,  also 
known  since  1823. 

In  order  to  render  these  and  similar  observations  valid,  it  is 
necessary  that  many  physicians  should  repeat  the  observations 
upon  this  subject.  One  man's  evidence  is  of  value  only  to  him 
who  obtained  it ;  it  is  desirable  that  it  should  be  either  refuted  or 
confirmed,  for  on  it  hinges  much  that  is  of  far-reaching  im- 
portance. What  we  need  is  exact,  careful  observation  by  many. 
So-called  facts  should  not  be  transcribed  from  generation  to 
generation  without  repeated  scrutiny,  and  without  bringing  them 
under  the  tests  of  improved  methods. 

From  the  October  number  we  learn  with  pleasure  that  in 
a  new  journal — ^the  New  York  Medical  and  Surgical  Brief 
— a  writer  (Dr.  E.  J.  Fisk)  reports  four  cases  of  pain  and 
inflammation  affecting  the  testicle  rapidly  relieved  by  drop- 
doses  of  the  mother  tincture  of  Pulsatilla,  and  (unlike  most 
similar  borrowers)  gives  the  credit  where  it  is  due, 


198  Our  Foreign  Contemporaries, 

Hahnemannian  Monthly, — Jan. — July,  1878.-^— We  are 
sorry  to  say  that  these  numbers  are  the  last  we  shall  have 
of  the  Hahnemannian y  at  any  rate  for  the  present.  The 
publishers,  Messrs.  Boericke  and  Tafel,  say  that  they  "  con- 
sider it  as  a  suspension ''  only ;  but,  the  chief  cause  being 
that  it  did  not  pay,  and  involved  them  in  an  annual  loss 
of  five  or  six  hundred  dollars,  it  seems  hardly  likely  that 
— having  the  North  American  also  on  their  hands — ^they 
will  care  to  take  up  the  burden  again.*  We  are  aorry  for 
the  loss,  for  the  journal,  ever  since  Dr.  McClatchey 
assumed  the  editorship,  had  been  growing  in  value,  and 
had  become  quite  the  best  of  the  American  monthlies. 

The  numbers  before  us  are  full  of  interesting  matter, 
though  there  is  not  much  that  we  can  note  or  extract. 

lu  that  for  January  Dr.  J.  C.  Guernsey  shows,  by  a 
paper  on  Angina  Pectoris,  that  he  is  treading  in  the  steps  of 
his  worthy  father  in  the  endeavour  to  characterise  our  reme- 
dies, but  also— we  must  sav — in  the  eflPort  to  include  too 
many  uuder  the  heading  of  each  form  of  disease.  He  is  in 
error,  by  the  way,  in  speaking  of  Arsenicum  as  *'  the  remedy 
that  cured  completely  Dr.  Samuel  Hahnemann "  of  this 
disease.  It  was  an  attack  of  suffocative  catarrh  his  recovery 
from  which  he  ascribed  to  Arsenic. 

The  following,  from  the  February  number,  illustrates  an 
action  of  Ipecacuanha  which  is  sometimes  overlooked,  as 
well  as  the  importance  of  an  unirritating  diet  in  chronic 
intestinal  irritations. 

A  Case  of  Chronic  Diarrhoea. 
By  W.  L.  Dodge,  M.D.,  Philadelphia. 

^liss  T — y  aged  27,  of  nervous  temperament,  residing  in  Balti- 
more, came  to  Philadelphia  to  be  treated  for  a  diarrhoea  of  two 
years'  standing.  Her  father  had  died  of  chronic  diarrhoea.  She 
came  to  me  September  12th.  She  was  then  weak,  emaciated, 
and  having  from  six  to  twenty  stools  a  day.  Stools  yellow,  with 
a  good  deal  of  pain,  and  constant  pain  at  runbilicus,  which  pre- 

•  We  are  liappy  to  say  that  from  Janauary  1st  iu  the  present  year  the 
IlahmemaHHiaM  reucwed,  uiuler  the  eUiior^liip  of  Dr.  W.  H.  Winslow^  its 
suspended  existence;  and  will,  wo  hope,  continue  to  instruct  us  for  a  long 
t'me  to  come. 


America.  199 

rented  her  from  Btanding  straiglit.  Tongue  dean,  and  a  good 
deal  of  nausea  at  timee.  GttTe  Ipecac.  1*  trituration,  one  grain 
eveiy  three  hours,  confined  her  to  a  milk  diet,  to  be  taken  every 
two  hoQrs,  and  then  no  more  than  half  a  glass  at  a  time.  The 
seoond  dose  of  Ipeccte.  removed  all  pain,  and  in  three  weeks  she 
returned  cured.  Gained  very  much  in  strength  and  flesh  during 
treatment.  Ordered  her  to  keep  up  milk  diet  for  three  months, 
and  to  take  a  dose  of  Ipecac,  eveTj  second  night  for  two  or  three 
months.  Beceived  a  letter  from  her  to-day,  November  1st,  saying 
she  had  continued  well.  I  have  found  Ipecac,  1'  superior  to 
Sulphur  or  any  other  drug  for  the  majority  of  cases  of  chronic 
diarrfacea.  Have  treated  a  great  many  cases  of  diarrhoea  con- 
tracted during  the  late  war,  caused  by  miasmatic  poison,  which 
bad  lasted  for  years,  and  had  been  considered  incurable  by  allo- 
pathic physicians,  yet  which  yielded  readily  to  Ipecac,  and  milk 
diet.  It  is  useless  to  attempt  to  cure  a  case  of  chronic  diarrhoea 
without  confining  a  patient  strictly  to  a  milk  diet,  taken  often  in 
small  quantities  at  a  time,  and  to  be  continued  for  a  long  time 
ifter  the  diarrhoea  has  ceased,  for  the  reason  the  bowels  become 
80  weakened  that  if  permission  is  given  to  take  a  stronger  diet 
they  will  go  too  far,  and  bring  on  a  diarrhoea  again.  I  have  used 
Ugh  and  low  potencies  of  Ipecac.y  but  come  back  to  the  1'  with 
more  satisfactory  results. 

In  Marcb  Dr.  Allen  calls  attention  to  the  dictum  of  the 
"  key-note  *'  school^  that  Phosphorus  is  indicated  especially 
in  tall^  slender  people.  He  thinks  that  this  applies  only  to 
the  pulmonary  cases  demanding  the  drug^  while  in  diseases 
of  the  nervous  system  to  which  it  is  suitable  the  patient  is 
often  fat.  "In  fatty  degenerations,  fatty  muscles^  fatty 
^eart^  fatty  liver^  especially  if  the  skin  assumes  an  icteric 
hne  and  the  respiration  becomes  difficult,  and  if  the  patient 
be  sleepy  and  duU,  we  may  sometimes  witness  enormous 
accumulations  of  adipose  matter  relieved  by  Phosphorus^* 
This  is  as  it  should  be^  considering  the  pathogenesis  of 
the  drug. 

Dr.  Dodge  here  gives  us  another  excellent  case^  which 
we  must  quote  entire. 


200  Our  Foreign  Contemporaries. 

QeUeminum  in  Puerperal  Convulsions. 
By  W.  L.  Dodge,  M.D.,  Philadelphia. 

Was  called  to  see  Mrs.  G.,  twenty-four  years  of  age,  one 
month  before  her  expected  confinement  with  her  fourth  child. 
Had  a  midwife  with  her  three  previous  confinements  and  had 
each  time  an  easy  labour.  Found  her  suffering  with  intense 
headache,  hands  firmly  clencbed,  feet  like  ice,  head  hot  and  face 
bloated.  I  saw  that  I  had  a  case  of  puerperal  convulsions  to 
deal  with.  Ordered  bottles  of  hot  water  to  feet,  cold  water  to 
head,  and  sent  to  my  office  for  Gelseminum  0 ;  her  pulse  was  then 
120,  and  bounding  ;  within  five  minutes  after  my  arrival  she  had 
her  first  convulsion,  and  six  in  rapid  succession,  the  most  severe 
I  ever  saw.  There  were  no  signs  of  labour,  only  a  slight  dilatation 
of  mouth  of  the  uterus  ;  the  water  had  broken  the  day  before,  the 
midwife  said  who  had  been  in  attendance  ;  the  bed  was  then  wet 
through.  I  put  20  drops  Gelseminuvi  6  in  one  half  glass  of 
water,  and  gave  a  teaspoon ful  every  five  minutes.  I  had  great 
difficulty  in  getting  her  to  swallow  the  first  few  doses.  In  one 
half  hour  relaxation  of  muscles  began  to  take  place  and  convul- 
sions lightened,  and  within  one  hour  she  had  regained  her 
consciousness ;  pulse  softer  and  all  symptoms  better. 

The  next  morning  found  her  bright  and  cheerful,  headache 
nearly  all  gone,  from  which  she  had  suflered  constantly  for  two 
weeks.  I  kept  her  in  bed  nearly  all  the  time  for  ten  days,  and 
gave  Gelseminum  S'^  every  three  hours.  Then  I  was  sent  for 
again  and  found  her  in  hard  labour,  with  the  vagina  dry  and  hot. 
I  then  introduced  about  one  ounce  or  more  of  lard  into  the 
vagina,  thoroughly  lubricating  the  parts,  and  in  ten  minutes  she 
was  delivered  of  a  fine  healthy  girl. 

I  have  been  surprised  many  times  at  the  rapidity  of  cures  from 
the  properly  selected  remedy  in  diseases,  especially  of  this  charac- 
ter ;  more  so  because  I  practised  allopathy  for  several  years,  and 
used  to  think  if  opium  and  bleeding  did  not  cure,  that  a  patient 
must  die  or  suffer  on  until  nature  took  pity  on  him  and  saved  his 
life.  No  one  can  become  more  disgusted  with  the  old  mode  of 
treatment  than  one  who  has  tried  to  save  life  with  it,  and  then 
has  seen  the  rapid  2iudi  perfect  cures  performed  by  homojopathv. 

With  this  we  must  take  our  leave  of  our  excellent  con- 
temporarv;  hoping  that  its  editor  and   many  of  his   fellow* 


America,  201 

workers  may   find  other  spheres  for  their  activity^  which 
otherwise  would  be  lost  to  us. 

American  Observer^  Feb. — June^  1878. — Our  supply  of 
this  journal  continues  to  be  defective.  The  numbers  men- 
tioned above  are  the  only  ones  which  have  reached  us  from 
September,  1877^  to  the  present  time. 

In  the  February  number  we  meet  with  a  phenomenon 
which  we  shall  hope  to  see  multiplied  as  time  goes  on.  It 
is  that  of  a  practitioner  of  the  old  school  who  avows  before 
his  brethren  his  (qualified)  acceptance  of  the  homoeopathic 
law  and  its  corollaries  as  to  dose,  yet  retains  his  place  among 
them.  The  gentleman  who  takes  this  wise  and  manly 
course  is  Dr.  S.  W.  Wetmore,  of  Bufi^alo.  His  paper  here 
given,  which  was  read  before  the  Medical  Association  of  that 
city,  is  as  pleasant  to  us  as  it  must  have  been  surprising  to 
its  hearers  ;  and,  joined  to  the  similar  communication  made 
by  Dr.  Dessau,  of  New  York,  seems  likely  to  prove  an 
important  precedent. 

The  March  number  contains  an  amusing  duel  (if  it  were  not 
too  sad  to  see  such  contention  among  brethren)  between  Dr. 
Lippe  and  Dr.  Jones.  The  editor  has  had  the  cruelty  to 
print  Dr.  Lippe^s  letter  verbatim^  and  an  astonishing 
production  it  is.  Later  on  in  the  same  number.  Dr.  Jones 
is  called  out  by  Dr.  Swan,  and  these  two  interchange  shots. 
The  Michigan  professor — himself  of  the  school  of  Hering 
and  Dunham — ^has  pronounced  himself  (as  Dr.  Allen  also  has 
done)  an  irreconcilable  opponent  of  the  extravagances  and 
impostures  which,  under  the  name  of  '^  Hahnemannianism,'' 
are  now  corrupting  in  America  the  homoeopathy  the  master 
left  us.  The  attempt  of  The  Organon  to  naturalise  them  in 
this  country  is  hardly  likely  to  prove  successful.  Dr.  Jones 
ends  by  saying — *'  The  question  at  issue  is,  shall  our  school 
be  sacrificed  by  its  fag-ends — by  those  who  have  never 
grown  up  to  Hahnemann's  standard^  or  by  those  who  have 
hypertrophied  (or  fatty-degenerated)  beyond  it  ?  That  is 
the  ^question  at  issue,'  and  there  is  equal  danger  at  either 
extreme.  Of  the  result  there  can  be  no  doubt,  for  both 
ends  will  eventually  separate,  slough  ofi^,  leaving  a  sound 
middle  portion.     Meanwhile,  escharotics  are  ^indicated'  to 


202  Our  Foreign  Coniemparariei. 

hasten  the  process.''     He  offers  hit ''  little  stick  of  caustic '' 
as  a  contribution  for  the  purpose. 

The  numbers  for  May  and  June  contain  two  interesting 
communications  upon  the  treatment  of  diphtheria.  The 
first  is  from  Dr.  Nichol,  of  Montreal,  relating  his  uniformly 
favourable  experience  with  Apis  (5th  and  6th  decimal 
triturations)  in  an  epidemic  of  the  disease :  all  the  patients 
had  puffiness  about  the  eyes.  The  second  is  a  touching 
account,  by  Dr.  H.  W.  Taylor,  of  Crawfordsville,  Indiana 
of  the  death  ^  of  two  of  his  children  from  the  malady 
under  the  ordinary  remedies,  and  of  the  recovery  of  the 
three  remaining  ones  under  a  saturated  solution  of  Kali 
chloricum. 

American  HomoBopathist,  Jan. — ^Nov.,  1878. — ^We  are 
now  receiving  this  journal  regularly,  and  find  it  a  profitable 
addition  to  our  literature.  The  following  articles  in  the 
eleven  numbers  before  us  are  worthy  of  notice. 

January. — A  paper  on  ^^Arsenicum  in  Malarial  Diseases,'^ 
by  Dr.  Lucius  Morse,  of  Memphis,  is  well  worth  reading  by 
those  who  have  such  affections  to  treat.  He  finds  it  most 
serviceable  when  the  '^  dumb  chills  "  of  malarial  cachexia  are 
present,  and  as  a  prophylactic  when  the  earliest  symptoms 
of  malarial  poisoning  show  themselves.  Constant  coldness 
and  desire  to  hover  over  the  fire  are  special  indications  for  it. 
It  is  not  so  useful  in  acute  attacks  of  intermittent  fever, 
but  acts  well  sometimes  in  the  treatment  of  relapsing  cases. 
He  gives  the  triturations  from  the  3rd  to  the  6th  decimal, 
and  follows  Hahnemann's  injunction  to '' triturate  a  good 
while." 

In  the  same  number  Dr.  Burt  relates  a  very  favourable 
experience  with  Mercuritu  cyanatus  in  diphtheria.  After 
using  it  for  three  years  in  "  many  scores  of  cases,"  without 
a  single  death,  he  has  acquired  such  confidence  in  it  that 
now,  as  soon  as  he  has  a  clear  case  to  treat,  he  at  once 
prescribes  the  drug,  ''with  a  feeling  of  almost  absolute 
certainty  of  curing  the  patient."  In  two  at  least  of  his 
patients  the  deposit  had  invaded  the  larynx.  He  gives  the 
8^  trituration.  At  the  end  of  the  article  he  candidly  adds 
a  recently  occurring  fatal  case,  making  his  first  failure ;  but 


America.  208 

this  does  not  outweigh  the  experience  stated  above.  He 
also  tells  how  be  poisoned  a  dog  with  the  drug,  injecting  it 
under  the  skin,  with  the  result  of  producing  paralysis  of  the 
heart  and  (as  seen  post  mortem)  inflammation  of  the 
larynx. 

Dr.  Holcombe  follows  with  two  cases  of  albuminuria  in 
youths  (the  frequent  occurrence  of  which  has  lately  been 
noted  by  British  obserrers),  in  which  Euonymin  I,  given 
because  of  the  hepatic  symptoms  present^  proved  curative. 

February. — Some  interesting  experience  with  Kalmia  in 
rheumatism  is  here  recorded  by  Dr.  Louis  Faust.  It  is 
when  the  pains  haunt  the  neck,  shoulders,  and  arms,  that 
he  finds  it  so  useful.  He  mentions  that  on  proving  the 
drug  he  was  compelled  several  times  to  stop  taking  it,  as 
the  neuralgia  it  caused  became  unbearable.  He  ''can 
unhesitatingly  say  that  it  will  cure  oyer  half  the  cases  of 
fiicial  neuralgia.^' 

Dr.  Boyce  gives  us  in  the  same  number,  as  a  ''  charac- 
teristic "  of  Lachesis  in  diphtheria,  ''  a  steady,  hard  ache 
&U  over/^  making  the  patient  constantly  toss  about  in 
search  of  relief;  and  Dr.  Woody att  tells  us  how  useful 
Gelsemium  is  in  that  paresis  of  the  external  rectus  muscle 
of  the  eye  which  it  so  readily  causes. 

March. — Dr.  J.  R.  Haynes,  of  Pittsburg,  contributes  to 
this  and  some  subsequent  numbers  his  experience  with 
Ipecacuanha  as  an  antidote  to  the  opium  or  morphia  habit. 
He  gives  per  day  five  drops  of  the  mother-tincture  for  every 
grain  of  morphia  (or  its  equivalent  in  opium)  which  the 
patient  has  been  accustomed  to  take. 
The  following  is  worth  extracting  : 

China  off.  in  Camumption. 
By  C.  £.  FisHEB,  M.D.,  San  Antonio,  Texas. 

No  remedy  do  I  find  more  frequently  indicated  in  the  treat- 
ment of  night  sweats  of  consumption  than  Ghina  in  the 
lower  dilutions — Ist  to  3rd.  Gases  of  night  sweats  which  have 
long  baffled  medical  treatment,  allopathic  and  homoeopathic, 
have  readily  yielded  to  China,  1st  or  2nd,  repeated  every  two 
hours,  to  the  satisfaction  of  myself  and  the  great  delight  of  the 


204  Our  Foreign  Contemporaries, 

patient.  But  eeldom  has  it  failed  me.  Now  and  then  I^ho».  acid 
OP  Silicea  are  called  for,  but  for  a  very  large  majority  of  a  goodly 
number  of  cases  treated,  China  has  proven  itself  to  be  the  remedy. 
The  sweat  is  usually  very  copious  and  exhaustive,  slightly  stain- 
ing the  linen,  not  especially  offensive,  leaving  the  skin  clammy 
and  sticky.  It  is  generally  more  copious  from  the  chest,  neck, 
and  forehead,  and  occurs  the  moment  the  patient  drops  into  a 
sound  sleep.  When  this  train  of  symptoms  is  present,  China 
Ist  to  3rd  is  loudly  called  for,  and  in  nearly  every  instance  will 
respond  to  the  call  in  a  very  gratifying  manner. 

August. — The  same  writer  here  contributes  some  notes 
on  the  therapeutics  of  chronic  nasal  catarrh.  He  finds 
Mercurius  iodatus  '*  indicated  in  more  cases  than  all  other 
remedies  in  the  Materia  Medica  combined."  A  chief 
indication  for  it  is  '^  collection  of  tough^  yellow  mucus  in 
the  posterior  nares^  which  partially  drops  into  the  throat, 
causing  constant  inclination  to  hawk  and  spit,  in  order  to 
clear  the  throat  and  nose."     He  gives  the  2nd  trituration. 

September. — Dr.  Hale  cites  a  case  in  which  Jaborandi, 
given  daily  for  a  week,  caused  (left)  unilateral  sweating, 
cold ;  and  Dr.  Boyce  relates  one  of  pain  after  urinating,  of 
long  standing,  cured  by  Sarsapanlla  200. 

November. — Dr.  George  Lee,  of  Fremont,  Ohio,  sends 
to  this  number  a  case  of  enlargement  of  the  left  ovary  dis- 
appearing under  Apis,  3rd  trituration  ;  and  Dr.  Hale 
reports  one  of  paresis  of  the  cardiac  vagus  (pulse  160]  in 
which  Lachesis  200  was  curative.  Snake-poisoning  is 
observed,  by  Dr.  Brunton  and  Sir  J.  Fayrer,  to  cause  this 
very  condition. 

United  States  Medical  Investigator.  Jan. — Oct.,  1878. 
— We  have  mentioned  the  recommendation  of  Sticta  in 
bursitis.  In  the  Investigator  for  January  1st  Dr.  E.  C. 
Price  writes  :  "  I  am  sorry  I  did  not  keep  a  record  of  the 
cases  of  that  sometimes  troublesome  affection,  bursitis, 
which  I  have  cured  with  Sticta.  I  think  they  amount  to 
nearly  twenty.  It  is  the  first  remedy  I  think  of  in  those 
cases." 

In  the  number  for  March  Ist  Dr.  F.  H.  Foster,  of 
Chicago,   relates  a  case  of  interstitial  keratitis  recovering 


America.  205 

in  an  unusual  short  time  under  Mercurius  iodaius  internally 
and  Atropia  locally,  viith,  Spigelia  for  the  pains  when 
severe. 

In  that  of  April  1st  the  editor^  Dr.  Duncan,  cautions  us 
against  neglecting  an  inflammatory  state  of  the  urinary 
organs  in  children,  and  treating  it  as  simple  '^  enuresis." 
He  pathetically  ends  thus : — *'  I  speak  feeling  for  I  know 
whereof  I  affirm/' 

April  15th  brings  us  a  grave  case  of  haemorrhage  from 
the  kidneys,  gi?en  up  by  the  faculty  of  the  other  school, 
and  cared  by  Phosphorus  6  and  30.  It  is  reported  by  that 
always  instructive  writer.  Dr.  Hawkes. 

In  the  number  of  May  1st  Dr.  Lippe  announces  that  a 
homoeopathic  publishing  society,  after  the  model  of  our 
H.  P.  S.^  has  been  formed  in  America,  with  Dr.  Hering 
for  president.  The  first  work  to  be  published  will  be  one 
entitled  Guiding  Symptoms y  by  this  venerable  physician. 
Although  "  none  but  strictly  homoeopathic  works ''  will  be 
published  by  the  Society,  t.  e,  homoeopathic  in  Dr.  Lippe's 
acceptation  of  the  term,  yet  we  of  a  more  liberal  school 
need  not  disdain  what  good  it  can  bring  us,  and  should 
send  our  ten  dollars  for  a  share  to  the  treasurer.  Dr. 
Moore,  of  Germantown,  Pennsylvania,  which  will  entitle  us 
to  receive  all  publications  at  cost  price. 

The  following  case,  from  the  same  number,  is  of  some 
interest  : 

Vaw-fnotor  Neurosis — A  Case — Recovery   occurring  under  the 
Internal  Use  of  PlimbtHn  6x  a/nd  the  Local  Use  of  Atropine, 

By  W.  H.  WooDTATT,  M.D.,  Chicago. 

Head  before  tfae  Military  Tract  Medical  Society,  December  5tb,  1877. 

Mrs.  D— ,  aet.  29.  The  left  eye  became  aifected  two  weeks 
before  her  first  visit  to  me.  Supposed  she  had  taken  cold  and 
that  it  had  settled  in  the  eye.  The  symptoms  were  of  a  mild 
character  during  the  first  week,  but  for  the  past  five  or  six  days 
have  been  severe.  Careful  examination  developed  the  following 
pictore : — Drooping  upper  lid ,  intense  photophobia ;  very  pro- 
fuse lachrymation  of  hot  tears  ;  peri-comeal  injection^  deep  bluish 


206  Our  Foreign  Contemperaries, 

red  in  colour,  marked  at  the  corneal  margin,  and  fading  off 
towards  the  reflexial  fold  of  conjunctiva ;  slight  redness  of  the 
conjunctiva  of  the  lid  from  the  presence  of  the  hot  tears,  but  no 
mucons  discharge.  Cornea  very  delicately  hazy  throughout  its 
entire  extent,  as  if  breathed  upon  so  as  to  dim  its  lustre ;  and  at 
the  lower  inner  quadrant  the  opacity  was  a  little  denser,  and 
seemed  as  if  it  might  develop  into  an  ulcer.  Cornea  not  nor- 
mally sensitive  to  touch.  Pupil  contracted.  Vision  impaired, 
being  20-200.  The  tension  of  the  eyeball  was  diminished. 
Neuralgic  pains  were  experienced  in  and  around  the  eye,  worse 
at  night.  When  a  four-grain  solution  of  Atropine  was  applied 
to  the  conjunctiva,  the  iris  did  not  dilate  fully,  but  the  dilatation 
was  regular.  Arsenic  6x  was  prescribed  every  two  hours,  but 
during  two  days'  use  did  no  good  that  was  apparent.  The  Atro- 
pine was  applied  regularly  three  times  a  day,  but  the  iris 
remained  at  about  three  quarter  dilation.  Finding  a  defective 
carious  molar  in  leftupper  jaw,  which  gave  her  some  trouble,  and 
recognising  the  possibility  of  its  being  the  cause  of  the  trouble  in 
the  eye,  Flantago  6i  was  given  every  two  hours  until  she  could 
go  to  the  dentist  and  have  it  cared  for.  After  twenty-four  hours' 
use  of  this  drug  the  eye  appeared  the  same  as  at  the  first  visit. 
Plumbum  met.  6x  was  then  given  every  two  hours.  The  eye  com- 
menced to  get  better  immediately  ;  lachrymation  lessened ; 
photophobia  diminished ;  pain  abated ;  cornea  cleared ;  pupil 
dilated ;  sight  improved.  The  remedy  was  taken  during  seven 
days,  and  at  the  end  of  the  time  sight  was  emmetropic,  and  all 
inflammatory  symptoms  had  disappeared.  The  carious  tooth  had 
not  been  removed.  The  symptomatic  indications  for  Fliimbwn 
which  suggested  its  use  are,  "bluish-red  coloured  sclerotica, 
eontraction  of  the  pupils,  mistiness  of  sight." 

The  above  case  is  only  worthy  of  being  reported  to  this  Society 
because  it  is  one  of  a  type  of  cases  occurring  more  frequently 
than  is  recognised  in  every-day  practice,  and  presenting  some 
features  which  will  be  overlooked  unless  the  cases  are  examined 
carefully. 

This  particular  case  might  pass  as  one  of  diffuse  inflammation 
of  the  cornea,  or  perhaps  as  one  of  inflammation  of  the  cornea 
and  iris ;  and  yet  a  careful  examination  shows  that  there  is  pre- 
sent also  a  disturbed  condition  of  the  cervical  sympathetic  nerve. 
A  little  more  critical  study  of  its  symptoms  make  it  appear  that 


America,  t07 

the  condition  is  primarily  due  to  changes  in  the  cervical  sympa- 
thetic. 

Contracted  pupil,  drooping  eyelid,  marked  injection  of  the  con- 
janctiva,  with  increased  temperature,  are  recognised  results  of 
paralysis  of  the  sympathetic  vaso-motor  nerves;  diminished 
teorion  of  the  eyeball,  haziness  of  the  cornea,  impaired  vision 
and  neuralgic  pains  in  and  around  the  eye,  have  also  been  traced 
to  the  same  cause. 

Cases  reported  in  our  literature  for  years  have  indicated 
the  presence  and  potency  of  some  cause  behind  what  was 
revealed  through  the  gross  changes  occurring  in  the  tissues  of 
the  eye.  These  cases  have  been  called  by  different  names  accord- 
ing as  the  conjunctiva,  the  cornea,  or  the  iris  exhibited  the  most 
striking  changes,  but  in  every  case  it  was  observed  that  the 
symptoms  as  a  whole  were  not  fully  explained  by  the  local 
changes. 

Attention  has  only  recently  been  called  to  the  fact  that  these 
different  cases  are  to  be  properly  comprehended  only  by  con- 
sidering them  in  relation  to  the  cervical  sympathetic  nerve. 
Without  stopping  now  to  give  the  details  of  cases  which  would 
illustrate  all  the  different  aspects  that  the  trouble  may  present, 
according  as  it  develops  to  a  greater  or  lesser  extent,  and  accord- 
ing as  it  may  involve  the  conjunctiva  or  the  iris  in  the  most 
marked  degree,  but  bearing  in  mind  the  peculiar  symptoms 
which  point  clearly  to  a  neurotic  cause,  we  may  by  a  combined 
effort  work  out  a  set  of  remedies  which  will  be  curative  in  every 
instance.  The  subject  is  worthy  of  very  elaborate  treatment,  and 
is  occupying  the  mind  of  some  of  our  special  workers  not  a  little. 
It  is  hoped  that  this  short  report  may  excite  interest,  quicken 
observation,  and  lead  to  a  trial  of  remedies  which  may  net  have 
suggested  themselves  under  a  less  accurate  diagnosis.  Many 
similar  cases  have  unquestionably  been  treated  to  recovery,  and 
it  is  highly  important  that  we  should  compare  notes,  in  order  to 
determine  what  remedies,  if  any,  have  exerted  a  curative  influence 
upon  the  disease. 

In  the  number  of  May  1 5th  there  is  a  very  instructive 
article  by  Dr.  J.  H.  Miller,  on  *'  Coffee  as  a  Beverage.^' 
It  is  too  long  for  transference  to  our  pages,  but  will  amply 
repay  oonsoltation.     His  conclusion  is  as  follows : 

**  In  view   of  my  own  experience,   and  of  the  effects 


208  Our  Foreign  Contemporaries, 

recorded  by  so  mauy  observers  regarding  coflfee,  I  can 
scarcely  esteem  Hahnemann's  array  of  ills  set  forth  against 
the  beverage  as  overdrawn.  Its  constant  excessive  use  is 
undoubtedly  productive  of  much  distress.  The  greatest 
sufferers  are  women  and  children^  both  because  of  greater 
nervous  irritability  and  of  sedentary,  indoor  life.  Active 
muscular  exercise  and  open-air  dwelling  seem  greatly  to 
coanteract  the  ill-effects  of  coffee.  Hence  men,  labourers 
or  soldiers,  are  less  frequently  subject  to  ailments  traceable 
to  the  use  of  the  drink,  and  oftentimes  derive  positive 
benefit  from  it.  As  a  means  of  counteracting  the  exhaust- 
ing effects  of  long  rides  or  marches,  of  severe  labour,  and 
of  exposure  in  inclement  weather,  coffee  is  invaluable." 

June  1st. — We  here  notice  a  case  of  exophthalmic  goitre, 
treated  by  Dr.  Mitchell  with  Arsenicum  (30th  decimal 
trituration).  Its  subject  was  weak,  anaemic,  and  cyanotic, 
and  had  osdematous  and  cold  extremities.  After  five  weeks 
of  the  medicine  "  the  improvement  was  very  marked.  She 
had  gained  eleven  pounds.  The  exophthalmos  had  so  far 
disappeared  that  the  bulging  of  the  eyes  was  hardly  notice- 
able. The  cyanosis  and  dropsy  had  gone,  and  the  appear- 
ance of  the  complexion  was  more  healthy.  The  pulse  had 
dropped  to  84^' — it  had  been  120. 

August  1st. — Dr.  P.  W.  Poulson,  of  Council  Bluffs, 
Iowa,  declares  that  the  two  great  remedies  for  cholera 
infantum  are  Chininum  arsenicosum  and  Kreosote.  Dr. 
Hale  introduces  a  "  new  uterine  motor  *'  in  the  shape  of 
the  mistletoe,  Viscuni  album. 

Aug.  15th. — Dr.  G.  W.  Bowen  here  communicates  some 
facts  relating  to  the  action  of  the  sweet  clover,  Melilotus 
officinaliSj  which  indicate  a  power  on  its  part  of  producing 
so  severe  a  headache  that  it  ought  to  find  a  place  in  the 
treatment  of  cephalalgia.  It  is  a  medicine  which  deserves 
study.  Dr.  Carmichael  sends  another  proving  of  Equisetum 
hyemale,  which  promises  to  be  an  important  medicine  in 
urinary  disorders. 

We  have  often  mentioned  Dr.  Hawkes'  excellent  clinical 
lectures  in  the  Investigator.  Here  is  a  bit  of  one,  which  is 
the  more  instructive  as  confirming  some    indications  for 


America.  209 

Sulphur,  hardly  so  well  known  on  this  side  of  the  Atlantic 
as  on  the  other. 

Clinical  Cases.  By  W.  J.  Hawkbs,  M.S.,  Professor  of  Physiology 
and  Clinical  Medicine  in  Hahnemann  Medical  College  and 
Hospital,  Chicago. 

The  first  case  presenting  this  morning  is  our  old  friend  with 
the  badly  smelling  feet.  Those  of  you  who  have  seen  this  case 
from  the  first  will  remember  that  when  he  first  came  before  us 
it  seemed  impossible  to  elicit  any  constitutional  symptoms  what- 
erer.  He  said  he  was  perfectly  well  in  every  other  respect.  He 
was  evidently  a  gentleman  in  every  respect,  and  came  here  as  a  last 
resort,  having  been  made  acquainted  with  some  of  the  old  chronic 
cases  cured  in  Hahnemann  Hospital  Climes.  There  was  no 
loom  here  for  question  as  to  cleanliness ;  he  bathed  his  offending 
members  two  or  three  times  daily,  and  had  taken  every  possible 
precaution,  but  still  the  distressing  odour  remained,  ¥nnter  and 
Bumner,  for  years,  so  that  his  life  was  rendered  miserable. 

Am  I  have  said,  no  amount  of  questioning  seemed  to  elicit  any 
constitutional  symptoms  whatever,  and  we  prescribed  Silioea  on 
the  general  symptom  of  "badly  smelling  sweat  of  the  feet." 
This  remedy  was  given  in  the  various  potencies,  from  the  lowest  to 
the  highest,  for  two  months,  without  any  impression  having  been 
made  upon  the  disease.  A  disease  it  is,  as  is  any  other  abnormal 
condition  of  the  body,  and  the  result  in  this  case  demonstrates 
that  it  must,  like  other  diseases,  be  treated  according  to  the 
peculiar  features  of  the  patient. 

After  we  had  become  convinced  that  Silicea  was  not  the 
remedy,  another  effort  was  made  to  find  some  better  guide  to  the 
remedy  than  the  general  one  of  stinking  sweat  of  the  feet.  We 
adopted  the  plan  of  beginning  at  the  head  and  questioning  all 
the  way  down  to  the  feet,  and  of  going  into  his  past  history  as 
My  as  possible.  The  result  justified  the  means,  and  the  following 
symptoms  were  discovered : 

A  gnawing  empty  feeling  at  the  pit  of  the  stomach  an  hour  or 
BO  before  dinner  time,  not  constant,  but  frequent  enough  to  be 
noticeable  when  his  attention  had  been  called  to  it;  an  occa- 
sional dry,  burning  heat  on  the  soles  of  the  feet  at  night,  even 
when  cold  through  the  day ;  and  the  acknowledgment  of  the  fact 
that  he  once  had  had  the  itch,  which  his  mother  had  suppressed 

VOL.  XXZYII,  NO.  CXLYIII. APRIL,  1879.  O 


210  Our  foreign  Caniemporaries. 

by  a  free  use  of  "  sulphur  and  lard."  Here  was  a  very  good 
picture  of  Sulphur  in  a  man  who  had  "  no  symptoms  whateTer." 
Sulphur  in  a  high  potency  was  prescribed.  The  patient  reported 
in  two  weeks  he  had  not  noticed  the  offensive  odour  so  much  for 
the  past  few  days.  He  was  allowed  to  go  without  a  repetition 
for  two  weeks  longer,  as  we  see  by  the  record  in  the  clinic 
book ;  and  at  the  end  of  that  time  he  reported  no  odour  for  the 
period,  but  said  the  weather  had  been  unusually  cool,  and  pro- 
bably that  was  the  cause.  No  medicine  but  Sac,  lac,  was  giyen, 
and  at  the  end  of  two  weeks  he  reported  a  little  odour  during  a 
few  warm  days  ;  other  days  no  odour. 

It  is  now  six  months  since  he  took  the  one  'prescription  of 
Sulphur,  It  has  been  repeated  but  once  during  that  time,  and 
he  has  not  been  troubled  with  any  disagreeable  odour  from  his 
feet  since.  He  is  without  doubt  permanently  cured.  The 
"  empty,  gone  "  feeling  at  the  stomach  disappeared  during  first 
two  weeks,  and  has  never  returned  since. 

The  points  worthy  of  note  in  the  treatment  and  result  in  this 
case  are — First,  there  is  no  disease  of  which  it  can  be  truthfully 
said  that  a  certain  one,  or  a  certain  six,  remedies  will  cure  it, 
and  no  others  are  or  will  be  needed.  We  must  seek  the  consti- 
tutional peculiarities  of  each  patient,  and,  other  things  being 
equal,  select  the  remedy  accordingly.  Second,  it  is  not  necessary 
to  repeat  the  dose  while  we  are  sure  the  patient  is  improving 
under  the  first  impression  produced. 

Case  2  is  that  of  a  young  man  aged  twenty,  who  has  had 
dysentery  for  a  period  of  between  four  and  five  years.  He  has 
gone  through  the  usual  routine  of  the  old  school ;  and  has  been 
under  the  care  of  at  least  one  good  homoeopathic  physician  of  this 
city  for  one  whole  year,  without  permanent  benefit. 

As  we  found  him  he  was  having  from  five  to  ten  bloody  stools 
in  the  twenty -four  hours.  He  had  generally  one  or  two  at  night. 
The  time  of  aggravation  was  almost  always  in  the  early  morning. 
Generally  had  to  rise  at  about  6  a.m.,  when  he  was  obliged  to 
hurry.  There  was  considerable  straining  and  tenesmus.  He 
complained  of  cold  feet  in  the  daytime ;  but  said  even  then  they 
burned  on  the  soles  at  night.  We  found  also  that  he  was  fiunt 
and  empty  about  11  a.m.  Sulphur  6th,  30th,  and  2000th  have 
completely  cured  him.  It  is  now  six  months  since  he  came 
under  our  care,  and  four  months  since  his  old  trouble  has  shown 


America,  311 

itself.    He  was  then  feeble  and  unable  to  do  any  work ;  he  is 
now  at  work  every  day,  and  calls  himself  perfectly  well. 

September  Ist. — The  following  is  worth  extracting : 

MoKTBOSE,  Pa.,  Jnly  15th. — Would  like  to  call  the  attention 
of  the  profession  to  the  use  of  Nitrite  of  Amyl  in  apoplexy. 
Was  called  on  March  21st,  1878,  to  see  a  patient  about  6  p.m., 
snd  found  him  lying  on  his  back  in  bed,  where  he  had  been 
placed ;  face  purple,  and  looked  as  though  the  blood  would  burst 
from  every  pore ;  snoring  breathing,  and  perfectly  unconscious. 
Hj  heart  sank,  for  I  thought,  of  course,  he  was  as  good  as  dead, 
but  the  use  of  Nitrite  of  Amyl  in  congestive  headache  came  to  my 
mind,  and  sending  to  my  office  for  the  little  which  I  had,  satu- 
rated a  doth,  and  being  raised  to  sitting  position  passed  it  up 
and  down  gently  about  four  inches  from  nostrils,  and  immediately 
the  blood  began  to  recede,  and  in  twenty  minutes  the  face  had  a 
normal  appearance.  Of  course,  it  so  happened  that  no  rupture 
o{  blood-vessels  occurred  before  my  seeing  him.  He  was  left 
with  numbness  of  the  whole  left  half  of  body,  and  complained  of 
lamp  in  throat,  for  which  Oeh.  was  prescribed,  and  is  to-day 
well.  Would  like  physicians  to  give  it  a  trial,  provided  they 
ba?e  an  opportunity,  and  report  result.  H.  D.  Baldwht. 

Himtmopathic  Times,  Jan. — Nov.,  1878. — The  editors 
of  this  journal  have  commenced,  with  the  April  number, 
their  promised  Betrospect  of  Homoeopathic  Literature, 
beginning  where  the  last  voliune  of  Bane's  Becord  left  off. 
It  seems  thoroughly  done,  and  is  well  arranged.  For  this 
alone  our  colleagues  should  subscribe  for  the  Times, 
beginning  with  its  sixth  volume.  They  will  find  in  it, 
besides  other  matter  of  interest,  a  controversy  between 
Brs.  Couch  and  Jones  with  respect  to  Picric  acid,  which  is 
very  instructive  as  regards  the  drug,  though  painful  in  the 
acrimony  of  the  combatants.  The  only  paper  we  have  to 
extract  is  the  following,  which  belongs  to  the  therapeutics 
of  a  little-known  disease  : 

Laryngimus  stridulus.    By  J.  N.  TiLDXir,  M.D.,  Peekskill,  N.Y. 

Two  cases  of  this  disease  have  recently  been  under  my  treats 
ment,  with  resulta  so  satisfactory  that  I  hope  a  short  account  of 


212  Our  Foreign  Contemporaries. 

them  may  not  be  unintereBting.  It  is  not  unusual  for  children 
during  a  fit  of  anger  to  suffer  from  a  slight  temporary  suspension 
of  respiration,  but  from  which  they  do  not  suffer  any  bad  effect. 
This  slight  temporary  suspension  of  respiration  is  to  be  distin- 
guished from  a  condition  amounting  to  serious  disease,  which  is 
known  by  different  authors  by  the  various  terms — Laryngismus 
stridulus,  internal  convulsions,  child  crowing,  spasm  of  the 
glottis,  &c. 

The  etiology,  pathology,  and  treatment  of  this  affection,  have 
in  the  old  school  been  subject  to  as  many  theories  and  specula- 
tions as  there  were  authors  to  write  upon  them,  and  the  general 
conclusion  seemed  to  be  that  hygienic  measures  were  of  greater 
importance  than  medication.  One  authority  states  that  the 
prognosis  should  always  be  guarded,  as  these  cases  are  always 
serious.  Another,  no  less  an  authority  than  Dr.  Tanner,  says 
that  "convalescence  is  always  tardy;"  but  without  further 
digression  let  us  proceed  to  consider  the  cases  above  alluded  to. 

Case  1. — A  delicate  child,  8Bt.  8  months,  artificially  fed, 
digestion  in  perfect  condition.  His  paroxysms  were  always 
precipitated  by  crying  from  anger.  They  were  characterised  by 
a  sudden  and  complete  cessation  of  respiration,  as  if  the  rima 
glottidis  were  completely  closed  to  the  entrance  of  air,  and 
accompanied  by  alarming  lividity  of  the  face,  lasting  for  from 
ten  to  twenty  seconds,  when  the  first  inspiration  would  be 
accompanied  by  a  shrill  crowing  sound  almost  identical  with  the 
characteristic  inspiration  of  hooping-cough.  After  this  pro- 
longed inspiration  the  breathing  would  be  irregular  and  sighing, 
and  the  discoloured  features  would  be  followed  by  pallor,  accom- 
panied with  great  prostration,  and  cold  perspiration  lasting  for 
half  an  hour  or  more.  These  alarming  attacks  occurred  at 
irregular  intervals,  sometimes  daily,  often  at  longer  periods. 
Strict  attention  to  regimen,  abundant  out-door  recreation  was 
directed,  and  Belladonna  1st  dec.  given  internally  every  two 
hours  while  awake.  A  marked  diminution  in  the  severity  of  the 
symptoms  was  at  once  noted,  and  after  a  few  days'  treatment  the 
attacks  ceased  entirely. 

Case  2. — Child,  »t.  9  months,  suffering  from  teething  and 
indigestion,  had  paroxysms  every  time  he  waked  from  sleep.  In 
this  instance  they  consisted  of  ineffectual  spasmodic  efforts  at 


America.  213 

respiration,  attended  with  the  same  shrill  crowing  sound  men- 
tioned as  occurring  in  the  other  case.  This  patient  did  not  have 
BO  much  congestion,  nor  were  the  paroxysms  followed  with  so 
great  prostration  as  in  the  previous  patient ;  but  during  the 
attacks,  which  lasted  one  or  two  minutes,  it  seemed  as  if  the 
little  fellow  must  surely  suffocate. 

The  difference  of  symptoms  noted  in  the  two  cases  was  pro- 
bably owing  to  the  fact,  that  in  the  first  case  the  rima  glottidis 
was  entirely  closed,  and  in  the  second,  although  rigid  and 
unyielding,  it  was  open  sufficiently  to  allow  the  entrance  of  a 
limited  amount  of  air. 

The  treatment  was  the  same  in  this  case  as  in  the  preceding 
one— Belladonna — and  the  result  was  equally  prompt  and  satis- 
factory. The  paroxysms  were  at  once  ameliorated,  and  after 
three  or  four  days  there  were  no  more  symptoms  of  them. 

Although  we  cannot,  even  in  a  majority  of  cases,  hope  for  so 
sudden  and  perfect  a  remedial  effect  as  was  produced  in  these 
patients,  yet  they  give  us  a  nice  illustration  of  the  brilliant 
results  which  the  law  of  similars  is  capable  of  giving,  and  at  the 
same  time  show  its  superiority  over  the  bewildering  maze  of 
speculations  in  which  old  school  authorities  indulge  when 
treating  upon  this  disease. 

St.  Louis  Clinical  Review.  March — Nov.,  1878. — Under 
this  name  we  have  to  welcome  another  accession  to  our 
periodical  literature.  It  hails^  as  its  name  imports,  from 
the  great  western  city  of  St.  Louis ;  and  is  edited  by  Dr. 
Philo  Valentine^  the  Professor  of  the  Theory  and  Practice 
of  Medicine  in  the  Missouri  Homoeopathic  College  there 
existing.  From  the  staff  of  this  institution,  and  of  the 
Good  Samaritan  Hospital  connected  with  it,  it  expects  and 
receives  contributions;  and  it  specially  lays  itself  out  to 
report  the  meetings  of  societies,  which  it  does  very 
pleasantly  and  thoroughly. 

Among  other  papers  of  note,  we  may  mention  an  excel- 
lent protest  against  medical  creeds  by  Dr.  J.  P.  Dake ;  a 
telling  series  of  cases  of  bsemorrhage  arrested  by  Hamamelis 
(including  two  of  vicarious  menstruation),  from  the  pen  of 
the  editor ;  some  experiei^ce  with  the  new  remedy,  Piper 


214  Our  Foreign  Contemporaries. 

methysticwn — the  kava-kava  of  the  Sandwich  and  Samoan 
islanders — hj  its  prover.  Dr.  Oriswold,  of  San  Francisco ;  a 
thoroughly  scientific  article  on  keratitis  specifica,  by  Dr. 
J.  A.  Campbell  (he  finds  homoeopathic  treatment  capable  of 
materially  shortening  the  progress  of  the  disease) ;  and  a 
plea  for  scientific  re-provings,  by  Dr.  Lucius  D.  Morse,  in 
which  he  endorses  Dr.  Dake's  proposals.  We  have  not 
space  for  any  extracts  this  time ;  but  when  next  we  review 
our  American  contemporaries,  we  expect  to  find  something 
well  worth  citing  in  the  St,  Louis  Clinical  Review. 


MISCELLANEOUS. 


BepUf  to  Dr.  Drysdale^s  Objections  to  the  Recent  Chapters  of  the 

Cypher  Bepertory, 

By  E.  W.  Bebbidqe,  M.D. 

Db.  Dbtsdaxe,  I  think,  took  an  unwise  step  when  he  published 
his  objections  to  the  recent  chapters  of  the  above  work  so  soon 
after  its  publication.  The  apparent  di£Sculties  of  the  work  are 
quite  sufficient  to  deter  many  a  beginner  from  using  it,  without 
the  additional  non-incentive  of  being  told  that  the  new  alterations 
are  so  many  hindrances.  The  deed  is  done,  however ;  and  now 
all  that  remains  is  for  Bepertory-users,  and  especially  Bepertory- 
workers,  to  give  their  opinion  as  to  which  plan  is  the  best. 

Dr.  Drysdale  brings  forward  this  general  objection  to  all  im- 
provements, that  no  change  should  be  made  in  a  work  of  this 
kind  till  a  new  edition  is  called  for.  This  objection  is  hazdly 
valid,  considering  that  in  Chap,  xiv,  arranged  partly  by  Dr.  Drys- 
dale himself,  certain  features  (^.y.  the  complete  list  of  pains  in 
umbilical  region)  are  found  which  do  not  occur  in  the  earlier 
parts ;  but,  waiving  all  this,  I  claim  that  the  necessary  conditions 
do  exist,  for  to  all  intents  and  purposes  this  is  a  new  edition.  It 
must  not  be  forgotten  that  the  first  three  chapters  of  Mind,  Sen- 
sorium,  and  Head  were  first  published  in  another  form  under  the 


Recent  Chapters  on  the  Cypher  Repertory 4       215 

oame  of  Hbe  PathogeneHe  Oyclopcsdia,  the  sabsequent  parts  being 
issued  in  the  form  of  the  Cypher  Repertory^  and  bearing  the  title 
of  Vol,  Hofihe  Path.  Cyelop.  Most  assuredly,  then,  these  same 
first  three  chapters  in  their  present  form  constitute  Part  lofa 
new  edition  ;  and  this  fact,  coupled  with  the  facts  that  some  of 
the  subsequent  parts  are  nearly  out  of  print,  and  will  soon  require 
to  be  rewritten,  rendered  it  perfectly  justifiable  for  Dr.  Dudgeon 
to  make  what  alterations  he  thought  best. 

The  following  are  the  objections  raised  by  Dr.  Drysdale : 

(1.)  That  tiie  relative  position  of  concomitants  and  conditions 
is  reversed.  The  new  order  is  certainly  unfamiliar,  but  it  is 
scientific,  and  I  do  not  see  that  it  can  cause  the  least  difficulty 
in  the  practical  use  of  the  work.  In  former  chapters  the  con- 
comitants in  the  ume  organ  were  separated,  by  the  conditions, 
firom  those  in  other  organs;  in  this,  all  the  concomitants  are 
placed  together,  as  is  right. 

(2.)  That  the  general  order  of  pains  is  put  into  Section  IV 
instead  of  preceding  the  classes  of  pains  in  Section  I.  This  is 
eminently  proper.  Section  IV  consists  of  '*  Course,  Direction, 
and  Progress ;"  surely  a  pain  in  head,  shooting  from  before 
backwards,  comes  under  this  heading  as  naturally  as  a  pain  shoot- 
ing from  the  head  to  the  face  ;  and  such  a  quality  of  pain  as 
*^  Periodical,"  being  one  of  general  and  not  specific  character,  is 
far  more  appropriately  placed  with  the  other  symptoms  of  general 
character  {e.g.  from  within  outwards)  than  at  the  end  of  the  lists 
of  specific  character-symptoms.  This  is  the  plan  I  have  adopted 
in  my  Eye  Repertory y  and  in  this  case  I  feel  that  imitation  is  the 
sincerest  form  of  fiattery. 

(3.)  That  the  old  Section  V — Peculiar  Symptoms — ^is  abolished. 
Perfectly  right;  to  make  a  separate  section,  as  is  done  in 
Chap.  YI,  ioTfour  eymptoms  is  an  anomaly.  Such  headings  as 
^Peculiar  Symptoms"  and  "General  Symptoms"  too  often 
serre  as  a  refuge  for  the  destitute,  into  which  all  kinds  of  hetwo- 
geneoos  symptoms  are  unceremoniously  thrust ;  the  fitness  of 
the  Bepertory-maker  for  his  task  is  shown  to  a  great  extent  by 
his  being  able  to  arrange  these  symptoms  in  appropriate  order 
with  the  rest ;  and  if  there  are  any  left  which  obstinately  refuse 
to  be  arranged,  it  is  far  simpler  to  place  them  at  the  end  of  the 
fost  (as  at  p.  160)  than  to  remoTe  them  altogether  to  a  new  section. 

(4.)  As  to  the  new  abbreviations  of  the  nances  of  three  medi- 


216  Miscettanetnis. 

oines  I  will  say  nothiDg ;  it  is  a  matter  of  taste.  I  will,  howeyer» 
mention  that  Dr.  Dudgeon  in  his  reply  has  overlooked  two  other 
alterations  which  he  has  made,  yiz.  that  he  has  the  symbol  aru. 
for  Arum  triphyllum^  that  being  in  the  earlier  parts  the  symbol 
for  Arum  maculatum,  a  remedy  which  he  omits;  and  also  the 
symbol  oZ-m.,  instead  of  Nankivell's  abbreviation  o-aa.  {Ol.jee. 
oiellt),  for  Oleum  morrhua.  Let  me  also  point  out  that  he  has 
used  the  old  symbol  of  al-s.  (Alcohol  iulphurit)  as  well  as  er>«. 
{Oarhoneum  tulphuratum),  though  both  signify  the  same  substance; 
we  also  find  the  same  plant  appearing  as  lyp,  (Lyeaperncum 
eiculentum)  and  8o4,  {Solanum  Ufcopersicum).  These  latter  slips* 
however,  only  lead  to  a  few  duplicate  symptoms. 

(5.)  Dr.  Drysdale*s  plan  of  arranging  the  list  in  the  alphabe- 
tical order  of  the  abbreviations,  instead  of  the  medieinei,  is 
perfectly  correct ;  indeed,  I  suggested  it  to  Dr.  Dudgeon  myself, 
but  it  was  unfortunately  too  late  to  alter.  As  soon,  however,  as 
the  last  volume  of  Allen  appears,  a  complete  list  could  be 
prepared  and  published. 

(6.)  I  cannot  find  that  Dr.  Drysdale  has  made  aUuaion  to 
another  excellent  change  adopted  by  Dr.  Dudgeon ;  viz.  abolish- 
ing the  old  Chap.  VI — Anatomical  Begions.  This  was  a  most 
unscientific  arrangement,  for  Section  I  is  really  the  chief  Anato- 
mical Begion  of  the  Chap.,  and  there  is  no  reason  why  the  sub- 
regions  should  be  placed  as  far  from  it  as  possible.  They  ought 
to  follow  immediately  afterwards,  as  they  do  in  my  own  £fye 
Bepertory ;  here,  again.  Dr.  Dudgeon's  alteration  is  a  great  step 
in  advance. 

(7.)  Dr.  Drysdale's  objection  that  the  same  special  character 
cypher  is  used  in  both  parts  of  Chap.  I  for  different  symptoms 
is  completely  answered  by  Dr.  Dudgeon. 

(8.)  His  objection  that  in  Part  I  the  symptom  '*  desire  to 
kill "  occurs,  and  also  in  Part  II,  with  a  different  list  of  medi- 
cines in  each,  is  also  fairly  met  by  the  author,  who  shows  that  in 
the  latter  case  it  is  a  form  of  mania,  and  is  so  arranged.  It 
would,  however,  I  think,  have  been  an  advantage  if,  while  the 
latter  rubric  remained  as  it  is,  these  medicines  were  also  added  to 
the  former,  with  the  cypher  of  Mania  added  to  them.  So  also 
the  medicines  causing  Suicidal  Mania  (p.  67)  might  advan- 
tageously be  added,  with  their  appropriate  cypher,  to  the  similar 
rubpc  at  p.  83,  Ad, 


Recent  Chapters  of  the  Cypher  Repertory.         217 

(9.)  Dr.  Dudgeon's  plan  of  signifjing  the  anatomicftl  region  by 
a  Binall  letter,  led/'k^  instead  of  F.led.h^  is,  I  think,  calculated 
to  saye  space.  Moreover,  as  far  as  change  is  inyolved,  Dr. 
Bijsdaie  has  himself  done  the  very  same  thing ;  for  whereas  in 
the  Eye  and  Ear  chapters  Dr.  Dudgeon  has  signified  the  ana- 
tomical region  by  placing  the  cypher  thereof  after  the  symptom, 
sod  fit  hraekete^  Dr.  Drysdale  in  the  subjacent  chapters  has 
placed  the  cypher  before  the  medicine  and  without  brackets, 

(10.)  Dr.  Drysdale's  great  objection  is  the  absence  of  *^  selects." 
I  hare  carefully  examined  his  remarks,  but  cannot  find  that  these 
"  lelects "  are  of  the  slightest  use.  If  in  such  a  rubric  as 
"Vertigo,"  which  is  found  under  nearly  every  remedy,  only 
those  medicines  were  mentioned  which  produced  vertigo  with 
some  condition  or  concomitant  or  other  peculiarity,  siich  a  list 
would  have  great  value ;  but  according  to  Dr.  Drysdale's  plan 
all  the  conditions  and  concomitants  of  other  regions  should  here 
be  omitted — a  decided  deviation  from  the  rule  which  orders  that 
every  symptom  should  be  given  in  full  under  every  rubric  where 
it  can  possibly  be  looked  for.  Dr.  Dudgeon's  reply  to  this 
charge  is,  I  think,  conclusive.  Collectives  are  useful  for  refer- 
ence and  analogy,  but  they  should,  if  used  at  all,  be  carried  out 
JkUy,  as  in  my  own  Repertory,  and  this  the  Cypher  Repertory 
ne? er  professed  or  attempted  to  do. 

(11.)  Dr.  Drysdale  complains  that  Chap.  II  has  no  Sec- 
tion lY.  Had  not  Dr.  Drysdale's  own  arrangement  of  the 
cypher  necessitated  a  separate  chapter  for  '' Sensorium,"  this 
chapter  might  have  been  easily  amalgamated  with  the  Head 
chapter,  and  no  difficulty  would  have  arisen.  Dr.  Dudgeon 
defends  himself  by  saying  that  there  are  only  six  symptoms  of 
the  kind  referred  to,  and  that  to  establish  a  separate  section  for 
these  would  be  folly ;  he  therefore  placed  them  with  the  con- 
comitants. I  do  not  think  that  they  ought  to  be  among  the 
concomitants,  seeing  that  they  are  reaSlj  sequences  ;  yet  there  is 
no  need  for  a  separate  section.  In  Chap.  I  Dr.  Dudgeon  has 
placed  such  symptoms  as  Varieties  immediately  after  the  sym- 
ptoms itself  (see  pp.  12,  &c.)  ;  Dr.  Drysdale  did  the  same  thing 
in  Chap.  lY,  p.  88.  Were  this  plan  adopted,  it  would  answer 
every  purpose, 

(12.)  Dr.  Dudgeon  has  also  introduced  another  great  improve- 
|nent,not  allu4ed  to  by  Dr.  Drysdale ;  viz.,  that  the  concomitants 


218  Mi$eeUaneou$. 

from  other  organs  are  not  (aa  formerlj)  signified  bj  a  Greek 
cliaracter  on! j,  bnt  after  the  Greek  character  the  cypher  fixr  the 
symptom  itself  is  given ;  so  that  in  this  new  volume  we  have 
signified  not  onlj  the  concomitant  organ^  bnt  also  the  concomi- 
tant $gmptom9  of  that  organ^  which  is  an  immense  advantage  to 
the  physician. 

In  conclusion,  I  have  used  (and  freely  criticised)  the  Cypher 
Beperfoty  since  1867,  and  I  consider  that,  without  donbt,  the 
present  part  is  the  best,  both  in  execution  and  arrangement^  of 
any  yet  published  ;  and  if  the  votes  of  the  users  of  this  Repertory 
are  taken,  I  shall  certainly  give  mine  in  favour  of  Dr.  Dudgeon's 
alterations  being  adopted  for  the  future. 


FofuTs  Sphygmograph. 

This  ingenious  little  instrument  seems  to  be  a  great  improve- 
ment on  the  sphygmographs  hitherto  in  use,  one  great  objection 
to  the  employment  of  which  has  hitherto  been  their  expense, 
their  cumbersomeness,  the  time  occupied  in  adjusting  them,  and 
their  liability  to  get  out  of  order. 

Pond's  sphygmograph  is  cheaper  than  those  that  have  pre- 
viously been  offered  to  the  public ;  it  is  small  and  handy,  and  can 
be  adjusted  and  tracings  taken  with  it  in  less  time  and  with 
hardly  more  trouble  than  is  required  for  taking  the  temperature 
of  a  patient.  Its  mechanism  is  extremely  simple,  and  can  hardly 
get  out  of  order.  Little  or  no  instruction  is  required  in  order  to 
use  it  with  perfect  success.  After  seeing  it  once  applied  we  had 
no  difficulty  in  using  it  on  every  patient  we  saw  the  same  day. 

It  may  be  used  with  the  vmst-holder,  whereby  equable  pres- 
sure is  secured,  or  detached  from  the  holder  and  held  by  the 
operator.  A  little  practice  is  required  to  enable  us  to  keep  up 
the  same  pressure  without  using  the  holder,  so  that  at  first  the 
holder  should  be  employed.  The  tracings  are  made  on  smoked 
mica  or  smoked  paper,  by  means  of  a  fine  needle  acted  on  by 
very  sensitive  levers  that  receive  the  impulse  of  the  radial  artery 
by  means  of  a  rubber  propagator  that  is  pressed  down  over  the 
artery.  The  tracing  can  also  be  taken  on  a  slip  of  white  paper 
in  ink.    Another  contrivance  connected  with  the  instrument  is 


Law  or  Rule  ?  219 

•  Bmall  mirror,  which  10  used  to  throw  the  reflection  of  the  stui 
or  a  candle  on  a  board,  whereby  the  pahationa  of  the  artery 
are  capable  of  being  exhibited  to  a  class  on  a  yery  large  scale. 

A  little  clock-work  machine  propels  the  slip  of  paper  or 
mica  through  the  instrument  at  an  uniform  rate,  and  the  tracings 
of  the  pulse  made  by  its  means  are  beautifully  distinct. 

We  have  much  pleasure  in  drawing  the  attention  of  our 
colleagues  to  this  American  improvement  on  Marey's  instrument, 
aad  we  are  sure  that  it  will  often  be  a  great  help  in  the  diagnosis 
of  many  obscure  diseases,  not  of  the  heart  only  but  of  other 
oigans. 

The  instrument  may  be  used  to  take  cardiac  tracings  as  well 
as  those  of  the  arteries.  It  is  sold  by  most  surgical  instrument 
makers. 


Law  or  Bute  ?   'By  Bichahd  Hughes,  M.D. 

As  the  following  communication,  made  to  the  North  American 
Journal  of  Somceopathy  for  November,  1878,  may  have  some 
interest  for  British  rea^rs,  we  transfer  it  to  our  pages. 

"The  August  number  of  the  North  American  YoAyiBt  come 
into  my  hands,  and  I  have  read  there  the  paper  of  my  friend,  Dr. 
P.  P.  Wells,  entitled :  *  What  is  Homoeopathy  ?  and  what  the 
Poflsibilities  and  Duties  of  its  practice  V  I  have  found  in  it  the 
interest  and  instruction  which  have  never  failed  me  in  anything 
proceeding  from  his  pen ;  but  I  have  also  regretfully  found  that, 
if  the  position  he  here  takes  up  is  that  which  he  is  henceforth  to 
occupy,  there  is  a  wide  gulf  between  his  conception  of  the  truth 
and  my  o?m.  Such  a  discovery  might  not  greatly  disturb  my 
mind,  were  Dr.  Wells  other  than  he  is ;  but  I  cannot  easily  be 
content  to  stand  in  antagonism  with  one  whom  I  so  much  respect. 
I  have  felt  it  my  duty  to  think  out  the  grounds  of  my  difference 
from  him ;  and  I  venture  to  submit  them  here  for  his  apprecia- 
tion and  that  of  your  readers. 

"The  point  which  touches  me  most  nearly  is  Dr.  WeUs* 
denunciation  of  the  reduction  of  homoeopathy  to  a  mere  '  rule  of 
practice,'  which  he  stigmatises  as  '  a  crime  for  which  our  language 
fails  to  give  a  designation  sufficiently  condemnatory.'    Now  I 


320  Miscellaneous. 

have  just  been  repeating  this  *  crime '  in  the  second  edition  of  mj 
Manual  of  Therapeutics^  having  first  perpetrated  it  some  nine 
years  ago.     I  haye  defined  homoDopathy  as  '  the  treatment  of 
disease  bj  medicines  selected  according  to  the  rule  *  similia 
smilihus  cureniur* — 'let  likes  be  treated  hj  likes.'    And  in  a 
note  hereto  I  have  written  :  '  I  prefer  this  putting  of  the  motto 
— which  is  indeed  Hahnemann's  origiual  formula — ^to  the  affirma- 
tion similia  similibus  eurantur  usually  adopted  at  the  present 
time.    I  have  no  desire  to  quarrel  with  the  latinity  of  the  latter; 
though  the  use  of  '  euro '  in  the  sense  of '  cure '  is  at  least  un« 
familiar.    But  in  the  present  state  of  our  knowledge  I  think  it 
wise  to  state  our  principle  as  a  rule  of  art  rather  than  as  a  law  of 
science.*    I  have  carefully  considered  Dr.  Wells'  objections  to 
this  course  of  proceeding,  and  I  find  there  what  I  must  call  a 
confusion  between  the  idea  of  law,  as  science  uses  the  term,  and 
that  which  belongs  to  it  in  the  sphere  of  morals  and  politics. 
Dr.  Wells  says, '  It  is  another  important  element  in  the  nature 
of  law,  that  it  is  wholly  mandatory.    It  commands.    It  neither 
solicits  nor  permits.'    Now  this  is  true  enough  of  a  moral  or  a 
criminal  law,  but  it  is  entirely  incorrect  when  applied  to  a  so- 
called  law  of  nature.    The  latter  is  simply  an  expression  of  a 
certain  general  fact  which  we  perceive  in  the  order  of  the  universe; 
and  it  takes  the  form,  not  of  a  mandate,  but  of  an  affirmation. 
'  Thou  shalt  not  kill ' — here  is  the  law  of  duty  :  the  law  of  nature  is 
such  as  this — '  all  matter  attracts  all  other  matter  in  direct  pro- 
portion to  its  mass  and  in  inverse  proportion  to  the  square  of  its 

distance.' 

''  The  real  question,  then,  is  whether  homoeopathy  is  such  a 
law  as  this.  It  is  an  inference  from  certain  observed  facts :  shall 
we  state  the  inference  by  an  affirmation,  universal,  exclusive, 
unchanging,  that  *  likes  are  cured  by  likes,'  or  by  a  practical 
conclusion,  admitting  of  qualification  and  exception, '  let  likes 
be  treated  by  likes?'  Dr.  Wells ' (somewhat  dogmatically,  I 
think)  declares  for  the  former  alternative ;  I  must,  more  humbly, 
follow  Hahnemann  himself  in  thinking  the  latter  the  utmost  for 
which  we  have  warrant.  It  requires  a  vast  number  of  observa- 
tions and  experiments  ere  we  can  formulate  a  new  law  of  nature, 
while  a  rule  of  art  can  be  deduced  from  a  very  few  particulars 
— its  application  being  a  speedy  test  of  its  validity.  I  cannot 
think  that  we  are  justified  in  affirming    absolutely  that  all 


Law  or  Rule  ?  221 

morbid  stateB  are  curable  by  their  Bimilars,  or  that  they  are 
better  cured  thus  than  by  any  other  means;  I  can  only  feel 
borne  oat  by  the  facts  when  I  a£Srm  that  my  practical  wisdom 
lies  in  following  out  the  rule  "  let  likes  be  treated  by  likes  "  as 
My  aB  I  am  able. 

''Dr.  Wells  maintains  that  the  superior  success  of  homoDO« 
pathic  treament,  as  established  by  statistics,  proves  the  law  of 
similars  to  be  one  of  nature's  laws.  Surely  this  is  inferring  too 
maeh,  if  law  is  to  be  taken  in  the  absolute  sense  he  claims  for  it. 
The  facts  only  prove  that  those  who  are  wise  enough  to  recognise 
the  validity  of  the  homoeopathic  rule,  gain  a  great  advantage 
thereby.  To  make  them  simply  more  would  require  two  assump- 
tions:— 1.  That  the  physicians,  whose  practice  furnishes  the 
figures  in  question,  should  always  have  strictly  adhered  to  the 
law ;  2.  That  their  measure  of  success  should  have  been  uniform 
for  all  diseases — ^not  merely  an  average  struck  after  balancing 
mccesses  and  failures.  Can  either  of  these  assumptions  be 
anstained  ?  As  regards  the  former,  it  is  sufficient  to  state  that 
the  largest  share  of  the  totals  employed  in  the  comparison  of 
hospital  practice  under  the  two  systems  is  due  to  Fleischman, 
whose  practice  was  by  no  means  characterised  by  that  strict 
conformity  to  the  homoeopathic  method  which  Dr.  Wells 
requires.  He  was  what  the  Germans  called  a  '  specificker,' 
fitting  his  remedies  to  diseases  rather  than  to  individuals ;  his 
potencies  were  chiefly  those  from  the  1st  to  the  4th  decimal ; 
and  one  who  followed  his  practice  for  a  time  told  me  that  he  not 
imeommonly  alternated.  As  testimony  on  the  latter  point  I 
may  cite  the  recently  published  statistics  of  the  homoeopathic 
and  allopathic  sides  of  the  Pesth  Hospital.  Dr.  Bakody  can 
daim  the  palm  in  all  diseases  but  one,  t.  «.,  typhoid  fever ;  and 
in  this  his  mortality  compares  unfavourably  with  that  of  his 
colleagues  of  the  old  school.  He  charges  his  lack  of  success  to 
the  want  of  provision  for  cold  bathing,  by  the  use  of  which,  in 
the  ordinary  practice,  the  prospects  of  recovery  from  fever  have 
been  so  greatly  widened.  Whether  this  be  so  or  not,  the  fact 
remains ;  and,  while  exceptio  prohat  regulam^  it  disproves  any 
sapposed  law. 

*'I  submit,  therefore,  that  Dr.  Wells  is  not  justified  in 
denouncing  it  as  a  crime  to  represent  the  homoeopathic  prin* 
ciple  as  a  rule  of  art  rather  than  as  a  law  of  science.    In  pro- 


222  Miscellaneous. 

pounding  the  latter  position  as  one  of  obligation,  be  seemB  to  me 
going  bejond  tbe  facts,  as  he  is  certainly  unwarranted  by  any 
authority.  This  being  so,  I  cannot  feel  the  force  of  his  protest 
against  the  attitude  which  the  great  majority  of  our  school 
assume  with  regard  to  similia  similibus,  and  which  seems  to  me 
well  expressed  by  the  New  York  Homoeopathic  Society.  If  in 
homoeopathy,  as  propounded  by  Hahnemann,  we  recognised  a 
law  of  nature,  such  as  Newton  propounded  under  the  name  of 
gravitation,  we  should  have  nothing  to  do  but  to  obey  it  and 
utilise  it  as  best  we  could.  But  accepting  it  as  he  gave  it  us-^ 
as  an  empirical  rule  of  art,  deduced  from  obseryation,  it  is  for  us 
to  work  it  whereyer  applicable,  and  to  suffer  it  to  find  its  own 
place  among  other  rules  similarly  obtained.  '  Let  contraries  be 
treated  by  contraries,'  is  one  of  these,  not  less  potently  accre- 
dited and  more  obviously  reasonable.  We  have  observed  and 
experimented  with  the  two,  and  have  concluded— as  Hahnemann 
did — that  the  method  of  contraries  is  that  of  temporary  pallia- 
tion, that  of  similars  of  permanent  cure.  But  it  is  quite  con- 
ceivable— and,  as  I  think,  demonstrable — that  there  are  some 
morbid  states  which  are  so  temporary,  and  at  the  same  time  so 
distressing,  that  antipathic  palliation  is  all  they  require,  and 
that  by  giving  the  patient  the  benefit  of  this,  you  do  best 
to  help  him  in  his  need.  If  this  be  so — and  it  is  purely  a  ques- 
tion  of  experience — we  are  bound  to  avail  ourselves  of  contraria 
contrariis.  We  therefore  decline  to  bind  ourselves  beforehand 
by  any  obligation  to  follow  a  certain  method  to  the  exdusion  of 
all  others.  The  method  in  question  must  find  its  predominance 
in  our  practice  by  its  own  inherent  merits,  not  by  the  adventi- 
tious weight  of  prescription  and  authority.  I  can  conceive  of 
no  other  position  than  this  which  it  is  legitimate  for  a  physician 
to  take  up. 

**  But  Dr.  Wells  seems  to  say,  if  you  think  thus,  why  call 
yourselves  homoBopathists  at  all?  why  not  take  the  name  which 
truly  denotes  your  position — that  of  eclectics  ?  My  answer  is, 
that  we  do  not  call  ourselves  homoBopathists.  The  term  is  used, 
for  convenience  sake,  to  designate  those  who  accept  the  method 
of  Hahnemann  as  valid,  in  contradistiuction  to  those  who  reject 
and  ignore  it.  But  we  do  not  put  it  on  our  door-plates  or  pro- 
fessional cards ;  we  do  not  allow  ourselves  to  be  so  described  in 
general  directories.    When  we  sanction  the  use  of  our  names  in 


Law  or  Rule  ?  223 

the  BrUUh  SonuBopathie  Directory,  it  is  as  of  those  who  are 
'cbieflj  gaided  in  the  treatment  of  the  sick  bj  the  law  of 
similars.'  '  We  are '  (I  quote  from  the  preface  to  the  edition  of 
1870)  *  physicians  and  surgeons,  not  mere  homoeopathists  or  Hah- 
nemannians.  The  name  of  sect  or  sectary  is  as  unpleasant  to  us  as 
to  any  of  our  medical  brethren.  But  a  legacy  of  medical  and 
luBtorical  truth  has  devolved  upon  us,  which  it  is  our  duty  and 
should  be  one  of  our  highest  privileges  to  receive  and  preserve, 
imtil  the  work  of  the  greatest  therapeutic  discoverer  is  acknow- 
ledged as  a  fact,  not  denounced  as  a  fallacy,  and  law  which  he 
evoked  accepted  as  the  chief,  if  not  the  only,  means  of  thera- 
peutic progress.' 

"  Besides  this  (which  is  merely  incidental)  the  only  way  in 
which  we  stamp  ourselves  as  in  any  way  distinct  from  the  pro- 
fession at  large,  is  our  membership  of  homcsopathic  societies,  our 
service  in  homoBopathic  institutions,  our  contributions  to  homcBO- 
pathic  journals.  Do  we  in  any  way  bind  ourselves  thereby  to  an 
eiclusive  adoption  of  the  method  so  designated  P  Surely  not. 
The  rules  of  no  society  or  institution  of  the  kind  require  any  such 
engagement  firom  their  members  or  oflSicers.  They  are  the  homes 
of  freedom,  not  of  restriction ;  and  we  resort  to  them  because  we 
find  there  that  liberty  which  is  denied  us  in  the  corresponding 
organisations  of  the  old  school.  We  believe  in  homoeopathy,  we 
rank  ourselves  among  its  adherents,  and  we  claim  our  right  to 
profess  and  practise  it.  If  this  right  is  denied  us  in  our  natural 
fellowship,  we  must  seek  or  form  others ;  but  we  do  not  thereby 
create  for  ourselves  a  new  bondage,  and  abdicate  our  right  to 
make  as  much  or  as  little  use  of  our  newly-acquired  method  as 
we  judge  best. 

**  If  my  honoured  friend  cannot  receive  me  to  professional  com- 
munion on  these  terms,  I  should  deeply  regret  it,  but  should  be 
unable  to  modify  them.  I  could  not  satisfy  my  conscience  as  a 
physician  by  anything  short  of  them  ;  and  I  believe  that  in  so 
speaking  I  am  expressing  the  mind  of  nine-tenths  (if  not  more) 
of  those  who  have  recognised  the  method  of  Hahnemann." 


224 


BOOKS   RECEIVED. 


Romceopathy^  Fait  and  FreietU,  By  Walteb  Balls- 
Headlet,  M.A.,  M.D.  Cantab.    Melbourne,  1878. 

Medical  Chemistry;  including  the  Outlines  of  Orga/nie  and 
Physiological  Chemistry.  By  C.  Gilbert  Wheeleb.  Chicago, 
1879. 

On  the  Negleet  of  Fhysieal  Education  and  Hygiene  by  Farlia' 
ment  and  the  Educational  Department,  By  Dr.  aoth.  London : 
BaUliitre,  1879. 

Special  Report  of  the  Homcsopathic  Yellow  Rver  Commission, 
New  Orleans,  1879. 

Homasopathy  Vindicated,  A  Beplj  to  Dr.  J.  E[idd's  Laws  cf 
Therapeutics.     Bj  E.  W.  Bebbidoe^  M.D.     Liverpool,  1879. 

House  and  Home.    A  Journal  for  all  Classes. 

Index  Medicus.    Vol.  I,  No.  1.     New  York. 

Sewage  Foisoning ;  its  Causes  and  Cure.  By  Edwabd  Blake, 
M.D.    London :  Hardwicke  and  Bogue,  1879. 

A  Test  of  the  Efficacy  of  the  High  Dilutions  published  by  the 
Milwaukee  Academy  qf  Medicine.    December,  1878. 

Lectures  on  Localization  in  Disease  of  the  Brain.  By  3.  M. 
Chabcot.  Translated  by  E.  P.  Fowleb,  M.D.  New  York, 
1878. 

Lectures  on  Brighfs  Disease  of  the  Kidneys,  By  J.  M. 
Chabcot.  Translated  by  H.  P.  Millabd,  M.D.  New  York : 
Wood  and  Co.,  1878. 

LilienthaVs  Homoeopathic  Therapeutics,    New  York,  1879. 

Dublin  Journal  of  Medical  Science. 

St.  Louis  Clinical  Record. 

The  American  Homoeopath. 

Sevue  Homoeopathique  Beige. 

The  Monthly  Homoeopathic  Review. 

The  Hahnemannian  Monthly, 

The  American  Homoeopathic  Observer. 

The  United  States  Medical  Investigator. 

The  North  American  Journal  of  Homoeopathy, 

The  New  England  Medical  Gfazette. 

El  Oriterio  Medico, 

Biblioth^que  Homoeopathique. 

L^Art  Medical. 

Bulletin  de  la  Sociiti  MSd.  Hom.  de  iranee, 

Allgemeine  homoopathische  Zeitung. 

The  Homoeopathic  World. 

The  Homoeopathic  Times, 

V  Homoeopathie  Militante, 

The  Organon. 


THE 


BRITISH   JOURNAL 


ov 


HOMGSOPATHY. 


MEDICALi  AND  OTHER  NOTES  COLLECTED  ON  A 
HOLIDAY  TOUR  TO  ARCACHON,  BIARRITZ, 
PAU,  AND  THE  PRINCIPAL  WATERING 
PLACES  IN  THE  PYRENEES. 

By  Dr.  Roth. 

Baesoes. 

Fbom  Luz  and  St.  Sauyenr  a  yery  fine  new  road  leads 
to  the  renowned  bath  of  Bareges,  which  is  8696  feet  above 
the  level  of  the  sea ;  during  the  whole  distance  of  eight 
kilometres,  the  road  is  constantly  ascending.  A  short  dis- 
tance before  Bareges  are  the  sulphur  thermes  of  Bargun 
(temperature  31*2^  C),  which  are  used  internally,  as  well  as 
externally  for  baths  and  douches,  by  patients  whose  nervous 
Bystem  is  more  irritable,  and  who  require  a  more  soothing 
infloence. 

Barnes  consists  of  one  long  street  on  the  Save  (river)  of 
Bastan,  between  two  high  mountains — the  Ayr^  on  the 
south,  and  the  Labar  Blancs  on  the  north.  In  winter  all 
the  houses  are  buried  by  twelve  to  fifteen  feet  of  snow,  and 
the  whole  population  emigrates,  as  in  some  other  watering 
places  in  the  Pyrenees. 

TOL.  XXXVII,  NO.  CXLIX. JULY,  1879.  F 


226  Holiday  Tour  in  the  Pyrenees, 

The  temperatare  of  the  eight  springs  Taries  from  31°  to 
45°  C. ;  they  belong  to  the  most  exciting  springs  of  the 
Pyrenees,  and  supply  about  260,000  litres  of  mineral  wat«r 
in  twenty-four  hours.  Dr.  Vergers,  the  principal  consult- 
ing physician,  has  been  here  for  more  than  twenty-fiFC 
years,  is  also  professeur  agr^e  at  Toulon,  and  a  man  of 
much  experience.  He  told  me  that  he  is  still  learning 
every  year  more  about  the  use  and  application  of  the 
waters,  which  are  most  beneficial,  according  to  his  experi- 
ence, in  chronic  syphilis,  in  strumous  and  scrofulous 
diseases,  in  gout  and  rheumatism,  especially  in  rheumatisma 
nodosum,  and  in  several  forms  of  eczema.  Dr.  Vergers  has 
also  mentioned  the  diJOTerence  of  the  development  of  the 
facial  bones,  especially  of  the  lower  jaw,  in  many  patients 
suflfering  from  curvature.  I  have  for  many  years  been 
struck  by  the  difference  of  the  outlines  of  both  sides  of  the 
face  and  the  unequal  development  of  the  lower  jaw,  and 
have  often  pointed  out  to  my  patients  and  their  fnends  the 
difference  of  the  two  halves  of  the  face.  At  present  I  have 
a  scoliotic  patient,  a  girl  of  eleven  years,  under  my  care, 
whose  greater  development  of  the  lower  jaw  is  very  marked^ 
but  has  never  been  observed  by  the  parents.  Last  year  I 
had  a  similar  case,  where  one  half  of  the  face  had  a  convex 
outline,  while  the  other  was  almost  straight.  I  do  not 
remember  to  have  read  any  observations  on  this  unequal 
development  of  the  face,  and  I  beg  to  call  the  attention  of 
my  colleagues  to  this  abnormal  development  of  the  face. 
Many  years  ago  I  attributed  the  convex  outline  of  the 
lower  part  of  the  face  to  the  constant  oblique  position  of  the 
head  which  is  so  frequent  in  scoliotics ;  but  now  I  attribute 
it  in  many  cases  to  an  unequal  development  of  the  bones, 
especially  in  rhachitic  and  strumous  constitutions. 

As  chronic  diseases  of  the  joints  are  frequently  relieved 
or  cured  by  the  waters  of  Bareges,  I  have  extracted  and 
translated  the  following  notes  from  Dr«  Le  Bret's  pam- 
phlet :— 


by  Dr.  Roth.  227 


On  the  Treatment  of  Joint  Diseases  by  the  Waters  of 

Bareges. 

The  employment  of  sulphurous  waters  in  the  treatment 
of  joiut-diseases,  Tiz.  white  swellings  and  congestiye  con- 
ditions of  joints,  has  been  long  known.  Nevertheless,  the 
latest  works  on  surgery  and  medicine  omit  this  therapeutic 
agent  in  giving  the  preference  to  irritants,  electricity,  com- 
pressioD,  antiphlogistics,  or  complete  rest,  according  to  the 
different  stages  of  the  disease.  Bonnet,  of  Lyons,  wrote, 
"Experience  shows  without  doubt  the  great  superiority  of 
the  treatment  of  joint  affections  by  sulphurous  springs  as 
compared  to  home  treatment/' 

The  chemical  analysis  of  the  Bareges  springs  shows  that 
they  belong  to  the  class  of  sodic  sulphurous  waters.  Their 
temperatures  vary  from  29°  to  44°  C.  (85''  to  110°  F.) 

The  waters,  in  the  form  of  the  simple  bath,  the  plunge, 
the  weak  but  hot  douche  (110°  F.),  and  as  drinking  water, 
comprise  the  therapeutic  elements  which  are  employed. 
Chronic  arthritis,  especially  tumor  albus,  form  the  largest 
percentage  of  the  cases  treated  at  Bareges.  All  varieties  of 
the  degenerations  may,  however,  be  met  with  in  diseases  of 
the  joints,  which  may  be  easily  understood  when  we  re- 
member the  different  tissues  which  constitute  a  joint.  Even 
in  Boyer's  time  it  was  believed,  as  now,  that  rheumatic  and 
Bcrofidous  diathesis  was  the  most  common  cause  of  white 
svelUngs.  In  many  patients,  in  the  absence  of  scrofula, 
strictly  speaking,  an  exaggerated  lymphatic  temperament 
predominates ;  external  violence,  a  fall,  contusion,  a  sudden 
stretching,  sometimes  exposure  to  damp  cold,  have  been 
sufficient  to  develop  the  disease.     .     .     . 

Chronic  disease  of  the  knee  is  one  of  the  complaints  most 
frequently  treated  at  Bareges.  Among  80  patients,  16  were 
adults  from  thirty  to  fifty  years  of  age,  a  few  adolescents, 
and  only  3  children.  These  patients  did  not  exhibit  a 
scrofnlous  diathesis.     •     .     • 

The  exciting  and  persistent  influence  of  rheumatism  in 
causing  many  joint-diseases  is  not  to  be  gainsaid.     •     •     . 


228  Holiday  Tour  in  the  Pyrenees, 

Blennorrhagia  and  the  consequences  of  the  puerperal  state 
are  only  credited  with  four  cases. 

Amongst  32  cases,  14  had  lasted  only  a  year,  8  for  two 
years,  6  from  three  to  five  years,  3  for  four  or  five  months. 
A  single  patient  had  a  chronic  affection  which  had  lasted 
six  years.  As  the  rheumatic  element  was  a  chief  cause  in 
the  etiology  of  the  joint-diseases  which  come  for  treatment 
to  Bareges,  it  will  be  understood  that  those  cases  in  which 
the  disease  attacks  the  soft  parts  of  the  knee  are  especially 
suitable  for  treatment. 

Usually  there  is  a  true  arthritis,  characterised  by  swelling, 
stiffness,  impossibility  of  extending  or  flexing  the  joint 
beyond  a  certain  amount,  most  frequently  without  pain  or 
signs  of  degeneration  of  the  bones  or  ligaments  in  the  in- 
^  terior  of  the  joint.  Muscular  atrophy,  weakness  of  the 
lower  extremity,  added  to  a  difficulty  in  walking,  complete 
the  picture.  In  5  cases  hydrarthrosis  was  present,  the 
intracapsular  effusion  having  set  in  with  the  arthritis.  .   .   . 

The  duration  of  the  bath  never  exceeds  an  hour,  whether 
in  the  large  tank  or  in  the  private  bath.  The  douche  is 
applied  for  iifteen  minutes;  the  temperature  and  the 
amount  of  mineral  matter  contained  in  the  douche  (the  latter 
being  sufficient  to  remove  8  per  cent,  of  the  oxygen  in  the 
atmosphere  of  the  room),  demand  more  attention  from  a 
therapeutic  point  of  view  than  the  force  with  which  the 
douche  is  applied.  The  water  of  the  Tambour  spring, 
given  in  doses  of  from  two  to  four  glasses  daily,  combines 
effective  internal  treatment  with  that  of  the  bath  and 
douche. 

Bareges  boasts  of  an  eminently  therapeutic  water,  con- 
stant in  its  mineral  constituents,  whose  influence  experience 
has  proved.  Accessory  conditions,  such  as  height  above 
the  sea-level,  a  bracing  atmosphere,  or  other  auxiliary 
influences,  are  found  here  as  in  its  rivals  in  the  Pyrenees. 

In  a  treatment  of  knee-joint  disease,  on  an  average  thirty 
baths  and  twenty  douches  are  required ;  still  in  some 
idiosyncrasies  the  indolent  nature  of  the  disease  has  required 
as  many  as  sixty  baths  and  forty  douches.  Sometimes  the 
nature  of  the  disease  and  the  general  state  of  the  patient 


by  Dr.  Roth.  229 

has  obliged  tlie  discontinuance  of  the  douche^  and  the 
employment  only  of  the  bath  and  the  drinking  of  the 
ivaters. 

It  is^  however,  only  in  the  first  stage  of  chronic  arthritis 
that  Bareges  treatment  is  of  use,  namely,  where  the  tumor 
albas  is  limited  to  cartilaginous  lesions,  serous  effusions, 
and  to  functional  derangements ;  but  where  there  is  caries, 
necrosis,  or  osteitis^  or  if  there  is  bony  ankylosis,  no  effect 
can  be  expected.  In  forty-one  cases  of  knee  affection 
treated  at  Bareges,  twenty<*two  were  improved,  thirteen 
cured,  four  unsuccessful,  one  aggravated,  and  one  death, 
doe  to  the  stimulating  effect  of  the  treatment. 

Improvement  is  usually  shown  by  the  gradual  diminu- 
tion of  the  swelling,  if  present,  and  by  the  resolution  indi- 
cated by  the  congestion  of  the  periarticular  tissues ;  the 
bony  prominences  become  more  visible  as  in  the  healthy 
state,  and  the  knee  recovers  its  lost  form;  the  movements 
of  extension,  and  especially  of  flexion,  are  gradually  affected, 
and  walking  becomes  practicable  again  in  different  degrees 
according  to  the  individual  case ;  in  all,  however,  exercise 
increases  the  power  daily. 

Two  affections  left  by  arthritis  resist  this  treatment ;  one 
is  the  dry  crackling  well  known  to  sufferers  froin  chronic 
rheumatism,  which  is  due  to  the  degeneration  of  the 
cartilages  and  to  an  insufiScient  quantity  of  synovia;  the 
other  is  the  atrophy  involving  either  all  the  muscles  of  the 
corresponding  limb  or  the  extensor  muscles.  Happily, 
these  consequences  of  arthritis  and  prolonged  loss  of  power 
lessen  under  the  influence  of  exercise. 

A  cure  is  rarely  effected  during  the  course,  or  by  the  close 
of  a  first  therapeutic  course.  It  is  impossible  to  fix  how 
aoon  after  the  Bareges  treatment  the  amelioration  produced 
by  it  will  end  in  a  complete  resolution  of  the  affection.  .  .  . 
All  the  health  resorts  where  chronic  diseases  find  appro- 
priate remedies  become,  in  some  degree,  meeting  places  for 
their  visitors  for  many  successive  summers,  and  Bareges 
proves  the  success  of  its  treatment  in  this  way  also.  Cases 
are  known  where  the  application  of  the  waters  are  not 
suitable,  and  which  is  worthy  of  remark,  we  do  not  now  speak 


230  Holiday  Tour  in  the  Pyrenees, 

of  those  formal  connter-indications  which  are  shown  in 
local  disorders,  or  in  symptoms  of  advanced  cachexia  which 
oblige  patients  to  refrain  from  both  baths  and  donches. 
Dr.  le  Bret  mentions  the  case  of  a  swollen  knee-joint  of 
one  year's  standing  in  a  young  patient.  There  was  no 
change  in  the  colour  of  the  skin  or  any  phenomena  of  actual 
inflammation ;  fourteen  baths  were  given  from  a  temperate 
spring  and  five  douches,  which  caused  congestion,  pain  in 
the  knee,  with  febrile  and  other  symptoms.  .  .  .  Dr.  le 
Bret  has  shown  the  bad  influence  of  sulphurous  springs 
on  certain  ulcers,  which  become  coated  with  false  diphtheritic 
membranes  or  become  gangrenous.  .  •  .  Surgeons  recog- 
nise a  form  of  cozalgia  in  children,  where  the  diagnosis 
reveals  only  a  pain  produced  by  pressure  at  the  level  of  joint, 
showing  itself  by  the  exaggerations  of  certain  actions  in 
conjunction  with  a  bad  position  of  the  limb.  In  those  well- 
marked  cases  where  a  lymphatic  and  scrofulous  state  is 
present  the  sulphurous  treatment,  combined  with  the 
mountain  air,  is  crowned  with  success.  It  must  be  under- 
stood that  in  acute  rheumatism  it  is  necessary  to  forbid  the 
use  of  the  Bareges  waters.  Nevertheless,  exceptional  cases 
are  to  be  found  where  patients  coming  to  the  sulphurous 
springs  immediately  after  an  attack  of  acute  rheumatism 
go  away  cured  without  further  attacks.  Dr.  le  Bret  quotes 
the  case  of  a  young  man,  who  for  two  months  was  a  prey  to 
attacks  of  rheumatism  in  the  joints.  When  he  came  to 
Bareges  he  had  (edematous  swelling  round  the  ankles, 
internal  pain  on  pressure,  and  was  unable  to  walk.  The 
constitution  appeared  much  debilitated.  A  score  of  baths 
and  some  gentle  douches  removed  all  his  symptoms.  No 
accident  occurred  to  counteract  the  good  effect,  and  a  year 
after  he  was  in  robust  health.  Dr.  le  Bret  also  describes 
another  form  of  joint  disease,  which  is  neither  gout  nor 
rheumatism,  to  which  he  gives  the  name  of  "  rheumatiame 
noueux^'  (rheumatoid  arthritis).  When  the  nodosities  do 
not  show  much  degeneration  of  the  affected  parts,  and  if 
the  patient  is  still  young  and  of  good  constitution,  be  has  no 
doubt  that  Bareges  treatment  checks  this  disease,  usually 
thought   almost  incurable.  .  .  .     Dr.  le  Bret  intends  to 


by  Dr.  Roth.  281 

proTe  that  sulphurous  springs  have  a  powerful  action  on  the 
different  stages  of  scrofulous  osteitis.  •  .  .  The  curative 
effects  of  sulphurous  waters  in  general^  and  those  of  Bareges 
in  particular^  in  chronic  arthritis  are  well  known ;  the  use  of 
them  is  especially  indicated  when  rheumatism,  a  lymphatic 
temperament,  and  a  scrofulous  diathesis  are  united  in  pro- 
ducing tumor  albus,  and  when  the  soft  and  bony  tissues 
are  not  too  degenerated.  The  douche,  whose  force  and 
temperature  are  inyariable,  should  be  administered  with  care. 
Its  topical  effects,  with  regard  to  the  strong  reaction  they 
provoke,  may  sometimes  surpass  their  object,  awaken  sharp 
pains,  and  give  rise  to  new  inflammatory  symptoms,  either 
in  the  synovial  membrane  or  in  the  bony  tissues  of  the 
extremities.  A  double  property  characterises  the  results 
obtained  from  the  treatment  of  arthritis  by  these  waters^ 
viz.  first,  resolutive  local  action  favouring  the  absorption  of 
plastic  deposits,  which  thicken  the  tissues  and  impede  the 
play  of  the  joint ;  secondly,  restoration  of  the  general  health, 
to  which  the  height  of  this  mountainous  region  contri- 
butes. 

The  improper,  too-long-continued  use  of  the  sulphur 
waters  causes  the  thermal  fever.  As  soon  as  the  first  signs 
of  this  are  observed  the  patient^s  treatment  must  be  inter- 
rupted, and  calming  bath  of  bran,  barley,  milk,  &c.,  are 
used. 

Baregine^ 
also  called  glairine,  sulf  urose,  pyr^neine,  luchonin,  &c.,  is  an 
amorpho-gelatinous  substance,  sometimes  whitish  and  trans- 
parent, or  blackish  and  opaque,  agreeable  to  the  touch ;  it 
is  found  as  a  deposit  of  many  sulphur  waters,  and  used  for 
curative  purposes,  especially  in  affections  of  the  skin  when 
the  epidermis  and  deeper  layers  of  the  skin  are  split, 
raggedy  and  even  in  ulcers  of  the  skin. 

The  effects  of  Bareges  in  Paralysu  preceded  by  Dry  Colic/^ 
Dr.  Armien's  attention  being  directed  to  many  cases  of 

*  The  following   Dotes  are  extracted  and  translated  from  Dr.  Aimien's 
pampUet,  pnbliahed  in  1864 


232  Holiday  Tour  in  the  Pyrenees, 

consecutive  paralysis  and  dry  colics^  I  give  tbe  result  of  hia 
experiences  on  the  treatment  of  the  complaint. 

M.  Bassigny^  in  1881^  after  landing  at  Couron,  in  Guiana, 
a  swampy  plain  on  the  sea  shore,  was  attacked  by  Tiolent 
colic  pains,  as  a  sequence  after  a  chill  caused  by  dampness 
and  living  near  the  river ;  he  suffered  from  obstinate  con- 
stipation and  green-coloured  vomiting ;  he  thought  he  had 
been  poisoned,  and  suffered  most  excruciating  pain  in  the 
back  and  extremities.  He  was  treated  with  hot  baths, 
cataplasms  on  the  stomach,  and  by  purgatives.  The  attack 
lasted  a  fortnight,  without  relief  or  sleep ;  the  patient  was 
in  a  nervous  state  of  excitement,  which  was  only  relieved  by 
the  bath.  Finally  he  was  able  to  pass  some  motions,  and 
soon  was  cured.  Lavements  with  tobacco  leaves  seemed  to 
calm  the  nerves,  but  for  two  days  it  produced  some  wan- 
dering. At  the  end  of  a  year  some  attacks  of  colic  inter- 
vened, and  during  the  intervals  attacks  of  diarrhoea  and 
intermittent  fever.  On  returning  to  Cayenne,  during  a 
crisis  of  colic  and  vomiting,  he  was  attacked  with  cerebral 
symptoms  with  coma,  loss  of  memory,  facial  paralysis,  and 
loss  of  power  and  sensation  in  the  arms  and  legs,  but 
without  convulsions. 

The  colics  returned  every  two  or  three  weeks,  and  lasted 
four  or  five  days.;  the  pain  in  the  joints  increased,  renewed 
attacks  of  coma,  followed  by  paralysis  of  the  extensors  of  the 
upper  and  lower  extremities.  The  colics  continued  to 
increase. 

On  his  arrival  and  entrance  to  the  hospital  at  Bordeaux 
he  was  attacked  with  dry  colic  and  bilious  vomiting;  the 
pains  in  the  limbs  increased ;  tepid  baths,  cataplasms  on 
the  abdomen,  were  tried  without  effect;  purgatives  were 
vomited  without  any  aperient  effect.  In  1863  he  arrived 
at  Bareges;  after  forty  baths  and  twenty  douches,  he 
returned  to  America  in  a  very  satisfactory  condition,  the 
paralysis  and  nodosity  of  the  joints  having  in  a  great  way 
disappeared. 

A  Creole,  without  being  ill,  never  addicted  to  drink  to 
excess,  was  attacked  only  whilst  on  land  and  in  marshy 
districts  after  frequent  chills.     The  attacks  were  renewed  at 


by  Dr.  Roth.  238 

longintenrals  and  under  Tarying  hygienic  conditions ;  finally, 
cerebral  symptoms,  identical  to  those  produced  by  drink, 
interrened  to  complicate  the  disease,  and  were  followed  by 
partial  paralysis  of  the  extremities,  with  nodosity  of  the 
joints;  all  these  complaints  were  rapidly  ameliorated  bythe 
use  of  the  waters  of  Bareges. 

In  1862  there  was  a  case  of  a  sailor,  »t.  25,  coming  from 
Mexico  on  sick  leave,  with  enlargement  of  the  spleen ;  he 
Ii&d  had  dry  colic  for  a  year,  with  slight  palsy  of  the  fore- 
srm.  The  colic,  with  obstinate  constipation  and  cramps, 
came  on  only  five  months  after  his  landing  in  Mexico,  whilst 
in  camp  in  the  environs  of  Vera  Cruz.  Intermittent  fever 
came  on  soon  ufter.  It  'seems  that  this  dry  colic  is  only 
met  with  on  land  under  different  hygienic  conditions,  by 
badly-defined  tellaric  and  atmospheric  conditions,  amongst 
which  marshy  miasmas  and  a  high  temperature  play  a  great 
part. 

In  onr  temperate  climate,  during  the  hot  season,  we  often 
see  violent  colics  produced  by  the  cold  night  Bir  on  the  un- 
covered body.  These  attacks  are  purely  nervous;  there 
are  no  stools,  but  sharp  abdominal  pains,  vomitings,  and 
cramps. 

The  Madrid  colic  seems  to  be  caused  by  the  sudden 
cooling  of  the  body  whilst  hot  and  perspiring ;  this  is  caused 
in  warm  climates  through  carelessness. 

M.  Coste  noticed  that  this  intestinal  neuralgia  came  on 
suddenly,  presented  never  the  symptoms  of  lead  poisoning, 
though  followed  by  palsy  of  the  limbs.  A  certain  relation 
has  been  observed  between  gout  and  lead  colic ;  the  pains  and 
the  articular  enlargements  in  these  two  diseases  were  allied 
by  the  fact,  that  there  was  an  excess  of  uric  acid ;  the  same 
effect  being  seen  in  Devonshire  colic,  the  difference 
between  lead  and  dry  colic  being  that  in  the  latter  case  the 
symptoms  come  on  suddenly,  whilst  in  the  other  they  are 
produced  more  slowly ;  also,  when  people  engaged  as  house 
painters,  or  in  lead  mining,  &;c.^  leave  off  their  dangerous 
employment,  they  are  more  liable  to  chills  and  other 
influences,  which  prepare  and  bring  on  an  attack  of  dry 
colic. 


234  Holiday  Tour  in  the  Pyrenees, 

A  case  is  mentioned  of  general  paralysis  following  dry 
colic,  contracted  two  years  before  in  Cochin  China,  by 
working  with  minium  and  white  lead,  which  in  the  hospital 
of  Toulon  was  relieved  by  sulphur  bath  and  Aconite; 
the  patient's  right  arm  was  atrophied,  the  right  hand  weak, 
flexion  of  fingers  incomplete,  touch  obtuse;  lower  extremi- 
ties emaciated ;  hyperaesthesia  of  the  skin  on  the  right  side  ; 
flexion  of  the  left  foot  incomplete ;  this  foot  swells  slightly 
in  the  evening;  right  foot  can  scarcely  be  mo?ed.  This 
patient  has  been  very  considerably  improved  after  thirty-six 
baths  and  twelve  douches,  and  a  complete  cure  is  reasonably 
expected. 

Similar  observations  are  given  where  Bareges  had  a  good 
eflect. 

I  have  no  doubt  that  the  mountain  air  contributes  very 
much  to  the  constitutional  improvement.    Except  excursions 
and  nice  walks,  very  little  is  done  in  Bareges  for  the  amuse- 
ment of  the  patients.     The  military  hospital  contains  several 
hundred  beds,  and  many  wounded,  sufiering  from  the  pain- 
ful after-efiects  of  the   wounds  contracted  in  battle    and 
under  very  unfavorable  circumstances,  have  found  here  not 
only  relief,  but  have  been  restored  to  perfect  health.  Many 
of  my  colleagues  will  find  the  use  of  the  so-called  Bareges 
baths  very  efficacious  in  many  chronic  diseases  even  in  their 
private  practice,  as  I  have  lately  myself  experienced  in  a  case 
of  what  is  usually  called  chronic  rheumatic  arthritis ;  fingers, 
hands,  wrists,  ankle-joints,  and  insteps  have  been  swollen 
and  enlarged  for  seven  months.     A  professional   man  in 
large  practice  and  generally  considered  successful,  had  in 
vain^  during  seven  months,  tried  to  cure  the  child  about 
three  and  a  half  years  old.     After  my  visit*  to  the  Pyrenees 
and  what  I  had  seen  there,  I  prescribed  every  other  day  a 
sulphur  bath,  with  half  a  drachm  of  Sulphate  of  Potassitim, 
for  fifteen  to  twenty  minutes.     After  the  first  six  baths  the 
child  had  considerably  improved,  all  the  swellings  diminished; 
incapability  of  passing  urine  intervened,  and  was  relieved 
by  tincture  of  cantharides  in  very  small  doses.     The  sul- 
phur baths  have  been  continued,  and  when  I  saw  the  child 
the  last  time  she  walked  and  ran  about,  made  use  of  the 


by  Dr.  Both.  285 

fingers  and  hand^  although  the  enlargement  of  the  yarious 
parts  bad  not  yet  entirely  subsided. 

Bagnsbes  de  Bioobre. 

After  onr  visit  to  Bareges  we  returned  to  the  railway 
station  at  Fierrefitte^  because  the  drivers  asked  exorbitant 
prices  for  transporting  us  across  the  mountains ;  travellers, 
especially  English^  should  never  agree  to  pay  more  than  the 
usual  terms,  which  certainly  vary  sometimes  according  to  the 
larger  number  of  tourists.  After  an  hour's  travel  by  rail  we 
bad  to  stop  for  three  hours  at  Lounies,  which  during  the 
last  ten  or  fifteen  years  has  been  resorted  to  by  a  large 
Bamber  of  pilgrims  from  all  parts  of  France^  and  also  from 
Spain,  in  order  to  visit  the  cave  where  the  shepherd  boy 
thought  he  saw  the  Virgin ;  this  apparition  was  the  cause 
of  a  large  church  being  built  over  the  cave,  of  several  con- 
vents being  erected  in  its  neighbourhood,  of  some  nice  walks 
being  laid  out  in  its  vicinity,  and  of  a  double  line  of  huts 
and  shops  a  mile  long  erected,  where  nothing  but  candles, 
rosaries,  and  large  and  small  statues  of  the  Lourdes  virgin 
are  sold  by  thousands;  the  candles  are  offerings  to  the 
church  and  cave,  like  the  sacrifices  in  olden  times,  while  the 
rosaries,  pictures,  and  statuettes  serve  as  souvenirs  of  the 
pilgrimage. 

The  church  is  full  of  votive  offerings,  framed  inscriptions 
in  needlework,  expressing  thanks  to  the  virgin  for  favours 
granted,  for  misfortunes  prevented,  for  diseases  cured,  and 
health  restored ;  there  was  one  large  inscription  in  white 
marble  where  a  daughter  expresses  thanks  for  the  instan- 
taneous and  miraculous  cure  of  her  mother,  who  was  struck 
with  paralysis  caused  by  disease  of  the  spinal  cord ;  there 
are  numerous  similar  inscriptions  which  tell  how  the  legion 
of  ignorant  believers  in  the  miraculous  resort  to  Lourdes  in 
the  vain  hope  of  being  instantaneously  cured.  To  see  an 
instantaneous  cure  of  paralysis  caused  by  disease  of  the 
spine  was  unhappily  not  my  lot,  but  I  did  see  a  great  number 
of  blind,  lame,  and  deformed,  who,  notwithstanding  a  longer 
stay  at  Lourdes,  still  retained  their  infirm  condition. 


236  Holiday  Tour  in  the  Pyrenees, 

My  companions  could  not  make  oat  how  people  could 
perseTere  in  their  belief  of  the  wonderful  cures  when  they 
saw  the  number  of  invalids  of  all  kinds  loitering  about.  I 
could  only  answer^  in  the  words  of  the  great  poet^  ''  Even 
the  gods  fight  in  vain  against  stupidity  and  prejudice/' 

To  me^  personally,  the  aspect  of  the  pilgrims^  of  whom 
the  majority  were  women,  led  by  their  priest^  the  number  of 
invalids,  and  the  shops  with  their  contents^  caused  a  most 
painful  sensation^  as  I  stood  wondering  that  such  a  scene 
should  take  place  in  the  so-called  enlightened  nineteenth 
century^  and  in  a  civilised  country  like  France. 

'  After  another  hour's  drive  through  the  town  and  suburbs^ 
which  are  very  pleasantly  situated  in  a  plain  surrounded 
by  hills^  we  continued  our  journey  by  rail^  and  arrived  safely 
at  Bigorre,  where  the  Hdtel  de  Paris,  recommended  by 
Mr.  Garderes^  offered  us  all  the  comforts  we  required. 

The  following  notes  are  taken  from  a  pamphlet  by  Dr. 
A.  Cascua,  a  young  physician,  who  had  the  advantage 
of  obtaining  his  principal  data  from  Dr.  Dejeane,  a  well- 
known  practitioner  at  Bigorre,  whom  I  herewith  thank 
for  having  been  so  kind  as  to  accompany  me  to  the  various 
springs  and  establishments,  and  to  give  me  the  results  of 
his  experience. 

Bigorre,  with  her  10,000  inhabitants  and  1650  feet  above 
the  sea-level,  is  sheltered  by  the  surrounding  hills  from  all 
winds  except  the  north,  which  is  not  very  cold  in  winter, 
but  which  in  summer  contributes  to  the  diminution  of  heat 
in  the  valley,  as  the  town  is  situated  between  the  plain  of 
Tarbes  and  the  charming  valley  of  Campan,  well  known  by 
its  marble  quarries. 

According  to  the  observations  of  Ganderax,  made  in 
July,  August,  and  September,  the  average  of  the  tempera- 
ture in  summer  is  from  14^  to  16°  C,  while  the  maximum 
does  not  exceed  27°;  the  south-east  wind  is  the  most  fre- 
quent, and  the  sudden  variations  of  the  temperature  are  here 
much  less  frequent  than  in  the  other  watering-places  of  the 
Pyrenees. 

Sailaignac,  an  author  of  the  last  century,  mentions  that 
the  fame  of  Bigorre  is  traced  to  mythological  times,  and 


by  Dr.  Roth.  237 

tbat  Mara,  wonuded  at  the  siege  of  Troy,  was  the  first  to  be 
cured  by  these  waters,  which  Apollo  had  detected.  Id  olden 
times  the  Basques  inhabited  the  country,  and  when  the  Gauls 
were  conquered  by  the  Romans  these  latter  frequently 
resorted  to  these  waters,  known  as  the  vicus  acquensis ; 
traces  of  Roman  roads  and  inscriptions  on  the  medals  of 
Augustus,  Trajan,  and  Marcus  Aurelius,  serve  to  prove  that 
these  roads  were  well  known  to  the  Romans ;  the  Vandals, 
Visigoths,  Moors,  and  Normans,  followed  each  other  in  the 
possession  of  this  country,  and  after  the  treaty  of  Bretigny 
for  sixty  years  it  belonged  to  England. 

The  first  known  medical  treatise,  Du  bon  usage  des  Eaux 
de  Bagneres,  by  La  Guth^re,  was  published  in  1659  at 
Toulouse,  and  I  find  not  less  than  twenty-six  titles  of 
medical  works  which  have  been  published  up  to  1875. 

There  are  more  than  fifty  springs,  which  are  divided  in 
sulphuric  iron,  and  saline  arsenical ;  but  the  most  celebrated, 
and  to  which  most  marvellous  cures  are  ascribed,  are  those 
to  which  the  name  of  "  Salut'^  has  been  deservedly  applied. 
The  ''  Etablissement  de  Salut'^  is  situated  about  8000  feet 
frou)  the  town  at  the  foot  of  the  mountain  Garros :  a  beau* 
tiful  road  lined  with  large  trees,  in  a  charming  little  valley, 
leads  to  it*  Omnibuses  and  carriages  bring  the  weaker 
patients  to  the  bath,  while  those  who  can  walk  the  short 
distance  may  do  so  hy  a  lovely  pathway  through  the  small 
forest.  As  Dr.  Casena  has  made  use  of  the  works  of  Gan- 
derax,  Pambrun,  and  Alban  de-  la  Garde,  many  of  the 
following  notes  are  due  to  these  afuthors. 

PhyHcal  Properties  of  the  Salut  Waters. 

I.  La  Source  de  la  Montague  has  a  flow  of  water  equal 
to  aboat  144,000  litres  in  twenty-four  hours ;  its  tempera- 
ture is  33°  C,  or  92°  Tahr. 

II.  La  Source  de  VIntirieur  furnishes  180,000  litres  in 
twenty-four  hours,  and  ii;s  te^nperi^ture  is  82°  C.  or 
90*5^  Fahr.  The  water  drank  in  the  pump-room  placed  at 
the  entrance,  as  well  as  tbat  of-  the  ascending  douche  at 
the  foot  of  the  central    staircade,  is '  obtained  from  this 


238  Holiday  Tour  in  the  Pyrenees, 

in.  La  Source  de  la  Pompe  gives  784,000  litres  every 
twentv-four  hours.     The  temperature  is  89^  Fahr. 

The  water  from  these  springs  is  pure  and  limpid ;  it  is 
unctuous  to  the  touch,  and  softens  the  skin ;  it  does  not 
mark  paper  or  linen.  A  few  minutes  after  the  bath  a 
feeling  of  suppleness  is  felt  through  the  whole  body.  The 
taste  of  th^  Salut  waters  is  slightly  insipid,  a  little  bitter, 
and,  in  spite  of  its  lukewarm  temperature,  never  nauseous. 
Its  digestibility  and  lightness  are  such  that  many  glasses 
can  be  drunk  in  succession  without  unpleasantness.  Its 
specific  gravity  is  the  same  as  that  of  distilled  water.  On 
entering  the  bath  one  feels  a  slight  sensation  of  freshness, 
which  idmost  immediately  gives  way  to  an  inexplicable  feel* 
ing  of  comfort.  During  the  bath  numerous  globules  of  gas 
arise,  form  into  clusters,  and  at  the  least  movement  disap- 
pear on  the  surface  of  the  water. 

The  water  in  the  bath  is  incessantly  removed ;  it  is  an 
important  advantage  for  the  bather  to  be  in  this  continual 
mineral  current. 

Chemical  properties. — In  1869  Dr.  Alban  de  la  Garde 
analysed  the  Salut  water.  The  following  table  is  due  to 
him : 

Nitrogen,  Carbonic  Add,  and  Oxygen  Oases. 

Chloride  of  magneninml    ^  ^  ,    0-216  grammes 

sodiam       J 


» 


Sulphate  of  calciam         •  •  •    1*670 

„          magneBiom     .  •  •    0*405 

„          sodium           •  •  •    0*033 

Bicarbonate  of  caldam    .  •  •    0*107 

„                magnesium  •  •    0*070       „ 

iron         .  .  .    0*010       ^ 

Arseniate  of  sodium         •  •  •    0-007       » 

Phosphates  of  calcium  and  of  alumen  .    0*007       j« 

Silicate  of  calcium            .  .  •    ^^5       „ 

Lithium    .            •            •  •  1 

Manganese           .           •  •  ^Traoes, 

Copper     a  •  .  • 


Fluoride  of  calcium  •  •  1 0*068 

Orflranic  mAttera   .  •  •  J 


Organic  matters 


Total    •  •    8*767  grammes. 


by  Dr.  Roth.  289 

The  water  contains  a  small  quantity  of  arsenic^  and  the 
Bagneres  waters  have  a  slight  alkaline  reaction. 

The  Salat  water  has  the  remarkable  peculiarity  that,  at 
the  end  of  certain  hot  summers,  it  becomes  sulphurous, 
giving  off  the  odour  peculiar  to  sulphurous  springs,  and 
bronzing  a  silver  coin  in  eight  or  ten  minutes,  while  for 
the  rest  of  the  year  it  is  alkaline  and  without  smell. 

Physioloffical  properties, — ^At  the  moment  of  immersion 
ifae  bather  feels  a  slight  instantaneous  sensation  of  fresh- 
ness, followed  by  a  feeling  of  great  comfort,  which  lasts  as 
long  as  the  bath.  "  In  the  bath  the  pulse  generally  becomes 
large  and  fuU^  and  is  hardly  accelerated.^'  On  leaving  the 
bath  a  sharp  sensation  of  cold  is  felt,  immediately,  however, 
followed  by  reaction,  which  restores  the  state  of  bodily  com- 
fort felt  in  the  bath.  The  bather  is  inclined  for  exercise, 
the  limbs  feel  more  supple,  and  his  appetite  returns.  "  Agi- 
tated sleep,  a  feeling  of  excitement,  fulness  of  blood,  at 
other  times  lassitude,  tingling  sensations  in  the  limbs,  a 
difficulty  in  keeping  quiet  in  bed,  and  sleeplessness,  are  often 
witnesses  to  the  modifying  effect  of  the  mineral  water  on  the 
nervona  system.  Soon  these  symptoms  disappear,  and  the 
sedative  and  strengthening  action  shows  itself.  In  most 
individuals  this  sedative  effect  is  obtained  by  the  first  bath. 
Sleep  becomes  calmer  and  deep,  the  nervous  trembling  of 
the  hands  lessens  and  disappears,  the  pains  are  not  so  severe, 
and  the  frequency  of  the  various  crises  diminishes.  The 
recurrence  of  menstruation  is  often  hastened,  and  the  stools 
are  more  copious  and  frequent.'^ 

Effects  of  the  use  of  the  Salut  water  taken  internally. 
—The  water,  with  its  slight  taste,  is  taken  without  disgust, 
>nd  very  easily  digested.  A  short  time  after  taking  it  one 
feels  hungry,  and  digestion  is  more  easy.  It  aids  the  secre- 
tions of  the  intestines,  the  liver,  and  pancreas,  and  quickens 
the  abdominal  circulation ;  the  stools  become  more  abundant, 
less  solid,  more  frequent,  and  of  various  colours,  thus  show- 
ing intestinal  hyperaemia. 

The  experiments  of  M.  Lemonnier  on  himself  prove  that 
the  Salut  waters,  taken  in  small  quantities,  are  slightly  diu- 
^c  j  bat  this  action,  noticed  by  Secondat  as  early  as  1750, 


240  Holiday  Tour  in  the  Pyrenees^ 

is  mach  more  appreciable^  and  becomes  considerable  when 
large  quantities  of  this  easily-digested  water  are  taken. 
Then  the  urine  becomes  abundant,  often  containing  an 
excess  of  urates.  According  to  Dr.  de  la  Garde,  ''on 
an  average  a  third  more  urine  is  passed  than  water 
drunk.'' 

To  sum  up,  the  Salut  waters  act  chiefly  as  sedatives  to 
the  nervous  system,  increase  and  regulate  the  circulation, 
increase  the  activity  of  the  secretions  of  the  skin  and  ali- 
mentary canal,  consequently  improve  the  appetite  and 
digestion,  and  are  strongly  diuretic. 

Therapeutic  properties. — ^These  waters  have  a  modifying 
action  in  herpetic  affections  by  an  alterative  action  on  their 
predisposing  morbid  or  diathetic  causes.  According  to  Fer- 
rand,  the  ''  specific  remedy  (arsenic)  does  not  act  by  directly 
attacking  the  essential  cause  of  the  disease,  or  by  neutralising 
the  specific  morbid  agent.  Thus,  5 — 10  milligrammes  of 
arsenic  daily  are  useful  in  febrile  affections,  as  in  tubercular 
patients,  in  improving  digestion  by  its  sedative  influence  on 
the  excited  circulation.  Arsenic  acts  also  as  a  sedative  of  the 
circulation  when  it  is  functionally  disturbed,  without  any 
febrile  condition,  and  increases  the  appetite  by  stimulating 
the  stomach.'' 

The  other  ingredients  in  the  Salut  waters  tend  to  produce 
results  similar  to  those  attributed  above  to  arsenic.  It 
contains  indeed  iron,  according  to  Gubler,  ''  un  r&x>rporant 
et  un  tonique  analeptique  par  excellence.''  It  also  contains 
alkaline  chlorides,  which  stimulate  oxidation  (Rabuteau) 
and  increase  the  number  of  the  red  blood-corpuscles  (Plon- 
viez),  and  alkaline  carbonates,  which  liberate  free  carbonic 
acid  and  gently  stimulate  the  mucous  membrane  of  the 
stomach.  Finally,  there  are  sulphates,  which  promote  an 
intestinal  hypersecretion,  according  to  Rabuteau,  and  help 
to  eliminate  a  certain  quantity  of  water  and  of  organic 
crystalloid  waste  matters. 

(1.)  The  tepid  thermal  baths  may  be  prolonged  beyond 
an  ordinary  bath. 

(2.)  At  equal  temperatures  the  thermal  water  is  more 
agreeable  and  soft  to  the  touch  than  ordinary  water* 


by  Dr.  Roth.  241 

(3.)  Thermal  water  heals  sores  resultiDg  from  wounds^ 
barDS,  &c.^  more  rapidly  than  ordinary  water;  and 

(4.)  Cores  diseases  refractory  under  ordinary  baths. 

The  Saint  baths  have^  like  the  ordinary  warm  baths^  a 
sedative  action  on  the  pulse  and  nervous  system,  remove 
physical  and  intellectual  fatigue^  promote  an  agreeable  feel- 
ing of  warmth  and  well-being,  which,  beginning  at  the  skin, 
soon  pervades  the  whole  body.  They  relax  the  skin  and 
muscles^  increase  the  patient's  sensitiveness  to  atmospheric 
▼ariations^  and  promote  sleep.  They  alleviate  pain  and 
diminish  inflammation  in  a  large  number  of  cases  of  phleg- 
masia and  other  afiections.  They  cleanse  the  skin  of  much 
filth,  the  product  of  sweaty  dust^  and  fatty  matters,  soften  it 
and  maintain  its  suppleness  and  elasticity,  and  help  to 
render  it  more  capable  of  fulfilling  its  various  functions 
of  absorption,  transpiration,  secretion,  excretion^  sensa- 
tion, &c. 

The  Saint  baths  differ,  howevier^  from  ordinary  baths  in 
some  points,  such  as  the  amount  of  calm  produced  on  the 
nervous  system,  in  the  tonic  effect,  &c.  Thus  the  action  of 
tbejirsenic,  of  the  alkaline  chlorides  and  carbonates,  of  the 
snljAi^es,  and  of  the  bath  in  general,  are  suflScient  to  ex- 
plain the  increased  appetite  and  improved  digestion  which 
follow  the  use  of  the  waters.  But  it  appears  impossible  to 
explain  how  these  waters  cure  those  cases  of  severe  hemi- 
crania,  of  obstinate  dyspepsia,  and  of  various  nervous  diseases 
which  have  resisted  all  other  treatment,  both  therapeutic  and 
hydropathic,  and  which  improve  rapidly  by  the  internal  or 
external  employment  of  the  Salut  water. 

Saint  waters  have  a  favorable  action  in  many  diseases  as 
nnlike  as  they  are  numerous,  viz.  in  cases  of  neurosis, 
dyspepsia,  migraine,  and  in  diseases  of  the  central  nervous 
system.  The  following  observations  are  taken  from  Dr. 
Bejeane's  notes,  and  published  by  Dr.  Cascua. 

Case. — Mr.  C — ,  of  Venddme,  1875.  Patient's  life  has 
always  been  very  regular.  The  mucous  membrane  of  the 
alimentary  canal  and  the  skin  were  chiefly  affected.  The 
slightest  irritation  applied  to  the  skin  caused  an  eruption 
mostly  of  an  eczematous  character.     Mr.  C —  suffered  also 

VOL.  XXXVII,  NO.  CXLIX. JULY,  1879.  Q 


242  Holiday  Tour  in  the  Pyrenees, 

from  an  aphthous  affection  causing  irritation  in  the  throat, 
with  dry  cough  in  the  morning,  followed  by  the  expectora- 
tion of  a  small  pellet  of  muco-albuminoid  matter.  Appetite 
very  varying.  His  food  was  limited  exclusirely  to  roast 
meat^  eggs,  fish,  and  wine.  Vegetables  apparently  overtaxed 
the  stomach;  in  fact,  digestion  was  always  very  difficult, 
with  flatulence  and  discomfort  of  the  abdomen ;  meals  were 
usually  followed  by  one  or  two  liquid  stools,  accompanied 
with  much  flatus.  If  the  bowels  were  confined  spontaneously 
or  by  any  medicine,  great  heaviness  of  the  head  was  imme- 
diately felt,  with  giddiness,  general  malaise,  and  lumbago. 
These  various  symptoms  having  resisted  all  ordinary  treat- 
ment, the  patient  was  sent  to  Bigorre. 

Treatment. — Salut  baths^  two  glasses  of  Salut  water 
daily,  and  douches  taken  at  the  hot  springs  were  prescribed, 
with  the  result  that  the  patient  left  much  improved. 

Case. — Mr.  R.  F — ,  aged  38,  July,  1875.  Ill  two  years. 
His  liver  had  been  enlarged,  but  is  now  of  normal  size. 
The  patient  suffers  from  occasional  pain  in  the  stomach, 
accompanied  by  much  accumulation  of  flatulence;  no 
tumour  present.  Therapeutic  agents  with  hydropathic 
treatment  gave  some  relief,  but  the  pain  was  very  obstinate, 
and  digestion  very  bad.  Vichy  waters  were  tried  last  year 
without  benefit.  It  was  a  case  of  dyspepsia  and  gas- 
tralgia. 

Treatment. — Salut  baths,  drinking  the  waters,  and  warm 
douches  were  prescribed ;  the  patient  left  much  improved, 
almost  cured. 

Case. — Mr.  D — ,  suffered  from  vertigo,  due  to  some 
lesion  of  the  stomach.  He  digests  badly,  without  appetite ; 
complains  very  much  of  his  head  and  giddiness;  his  legs 
sometimes  fail,  causing  him  to  fall;  he  feels  sick  at  the 
same  time,  but  does  not  lose  consciousness. 

TVeatment, — Salut  baths  and  drinking  the  waters  effected 
a  complete  cure. 

Case. — Mr.  P — ,  of  Bordeaux,  aged  40,  July,  1876. 
Had  suffered  for  ten  years  from  chronic  gastritis,  induced 
by  overwork,  with  cramps  in  the  legs  sufficient  to  prevent 
sleep ;  for  the  last  two  years  attacks  of  very  severe  gastralgia. 


by  Dr.  Roth.  243 

Tomiting  necessitating  a  diet  of  cold  milk,  white  meats, 
and  fish. 

Present  state. — Stout,  florid,  no  history  of  alcoholic 
distress.  No  appetite,  never  feels  inclined  to  eat.  Con- 
stipated, with  very  dry  evacuations.  The  tongue  a  little 
coated  at  the  top;  digestion  long  and  painful.  Stomach 
disteoded,  painless  cramps,  sometimes  severe  headaches. 

Treatmeni. — Baths  and  drinks  of  Salut  water,  with 
thermal  douches.     After  a  few  davs  the  douches  felt  too 

r 

warm  to  the  patient,  so  they  were  omitted.  Mr.  F —  left 
much  improved,  sickness  quite  gone. 

These  cases  show  that  dyspepsia  accompanied  by  vomiting 
was  not  only  improved  but  cured  by  the  Salut  waters. 
Cases  in  which  dyspepsia  is  accompanied  by  a  diseased 
condition  of  the  uterus,  and  where  migraine  is  of  very  old 
standing  and  unaffected  by  ordinary  therapeutic  agents,  are 
suitable  for  treatment  at  Bigorre,  with  the  probability  of 
much  reUef,  if  not  of  a  perfect  cure. 

Case. — Madame  de  S — ,  July,  1875.  Nervo-lymphatic 
temperament;  enjoys  tolerable  health,  but  is  not  strong. 
Some  fifteen  months  ago  menstruation  was  delayed,  accom- 
panied by  gastric  troubles.  She  might  almost  be  considered 
pregnant.  This  lasted  about  two  and  a  half  months,  when 
she  was  seized  with  pains  analogous  to  those  of  parturition, 
followed  by  a  serious  attack  of  haemorrhage,  which  continued 
with  much  pain  for  several  days.  After  some  months  the 
menses  were  again  missed  for  three  periods  successively; 
pregnancy  was  again  suspected ;  an  attack  of  haemorrhage 
similar  to  the  last  followed,  even  more  copious  and  longer 
eontinued. 

By  the  internal  and  external  use  of  the  Salut  waters  the 
patient  was  perfectly  cured.  Some  time  afterwards  Madame 
de  S —  became  enceinte^  and  was  delivered  at  full  term  of 
a  healthy  child. 

Characteristic  symptoms  of  hysteria  are  successfully 
treated  by  a  stay  at  Bigorre. 

Attacks  of  hysteria,  more  or  less  severe  or  simulating 
more  or  less  perfectly  cases  of  paralysis,  are  often  most 
discouraging,  both  to  patient  and  physician,  and  are  generally 


244  Holiday  Tour  in  the  Pyrenees, 

obstinate  under  every  sort  of  treatment;  yet  the  Salut 
waters  often  exert  a  calming  effect. as  gratifying  as  unex- 
pected^ although,  if  wrongly  administered^  harm  instead  of 
good  may  result. 

Treatment  by  Salut  waters  is  contra-indicated  in  cases  of 
articular  rheumatism.  Dr.  Dejeane  was  the  first  to  point 
out  this  fact,  confirmed  by  Dr.  Cascua  from  his  own  personal 
experience,  having  suffered  from  an  attack  of  severe  general 
articular  rheumatism  a  few  years  ago.  He  had  occasion 
recently  to  try  some  experiments  with  the  Salut  waters,  and 
took  a  few  baths,  about  11  a.m.  daily,  at  the  beginning  of 
September.  Obscure  pains  appearing,  however,  in  the 
joints,  he  was  obliged  to  give  up  the  baths,  the  pains  almost 
at  once  ceasing. 

In  all  the  cases  above  quoted  the  length  of  treatment 
was  from  20 — 26  days. 

Indications  for  the  use  of  Salut. — An  over-excited  con- 
dition of  the  nervous  system  is  the  most  prominent  symptom 
in  those  cases  which  have  been  successfully  treated,  where 
there  has  probably  been  more  or  less  congestion  of  the 
nervous  centres.  Dyspepsia,  especially  so-called  nervous 
dyspepsia,  where  the  nervous  trouble  directly  affects  digestion 
by  a  harmful  influence  upon  the  circulation  of  the  digestive 
organs,  are  suitable  for  treatment  by  Salut,  especially  if  the 
urine  is  not  overloaded  with  urates,  and  if  no  gouty  diathesis 
be  present.  These  cases  of  uric  diathesis  should  be  sent 
rather  to  Vichy,  though  the  latter  is  not  suitable  for  some 
cases  of  gout  or  disease  of  the  liver,  where  one  of  the 
following  complications  is  present : — Cardiac  disease,  dropsy, 
organic  disease  (cancer,  tubercle,  &c.),  Bright's  disease, 
anaemia,  &c. ;  these  are  far  more  suitable  for  Salut  treatment. 
Even  a  gouty  patient  without  any  complication  will  find 
more  relief  here  if  the  nervous  element  predominate  in  the 
case. 

Migraine. — Where  there  is  not  only  pain  but  disturbance 
of  the  facial  circulation,  and  at  times  nausea  or  vomiting 
is  curable  by  the  Salut  waters,  where  the  disease  is  due 
solely  to  an  over-excited  condition  of  the  nervous  system, 
so   that   this  treatment  is   recommended    in    all   cases  of 


by  Dr.  Roth,  245 

migraine  preceded  or  accompanied  by  intense  nervous  dis- 
tarbance. 

Neurotic  diseases. — The  treatment  of  all  cases  where 
there  is  severe  nervons  excitability  and  erethismas  is  usually 
successful.  So  also  in  uterine  disease  accompanied  by  much 
nervous  disturbance  sufficiently  severe  to  prevent  satisfactory 
treatment  by  ordinary  remedies.  In  diseases  of  the  uterus 
the  difference  in  the  effects  of  St.  Sauveur  and  Salut  is 
that  the  St.  Sauveur  sulphur  waters  are  most  successful  in 
chronic  uterine  affections^  helping  also  to  calm  the  nervous 
system.  The  difference  of  action  is  as  follows  : — Both  are 
sedative,  and  act  beneficially  on  the  local  condition,  but  St. 
Sauveur  effects  this  by  acting  directly  on  the  uterus,  while 
Salut  acts  by  its  directly  sedative  effect  on  the  excited 
coudition  of  the  nervous  system,  and  only  secondarily  on 
the  uterine  disease,  caused  by  the  state  of  the  nervous 
centres.  Therefore,  Salut  treatment  is  to  be  preferred 
vhere  the  nervous  trouble  is  the  primary  one.  In  many 
cases  the  best  results  are  obtained  by  treating  uterine 
affections,  first  by  Salut  waters,  and  when  the  nervous 
excitability  has  been  calmed,  to  proceed  to  the  employment 
of  the  waters  of  St.  Sauveur. 

Salut  given  carefully  may  be  very  useful  in  cases  of 
phthisis  with  more  or  less  severe  erethismus,  especially 
during  attacks  of  nervous  excitability.  The  same  is  the 
case  with  cardiac  disease  with  excessive  nervous  irritability, 
and  of  anaemia  under  similar  conditions.  The  various 
other  waters  at  Bagneres  de  Bigorre,  having  the  same 
chemical  properties  as  the  Sault  waters,  give  analogous 
results,  although  experience  has  proved  that  none  can  rival 
the  latter  in  its  characteristic  efficacious  and  energetic 
effects. 

The  only  other  watering  place  in  Europe  which  can  be 
compared  to  Bagneres  de  Bigorre  according  to  Dr.  Con- 
stantin  James  is  that  of  Pfeffers,  a  dreary  place  compared 
to  the  pleasant  and  smiling  landscapes  of  the  former,  with  its 
social  advantages  and  amusements,  so  helpful  to  the  hypon- 
driacal  patient. 

Conira-indications  for  treatment    by   Salut, — -  Cases  of 


246  Holiday  Tour  in  the  Pyrenees, 

acute  articular  rheumatism,  with  its  sequelse,  are  not  suit- 
able for  treatment  by  the  Salut  springs ;  this  may  be 
partly  due  to  the  comparatively  low  temperature  of  the 
water,  although  the  Foulon  spring  at  Bagneresi  which  is 
hardly  a  degree  higher  in  temperature,  and  has  almost  the 
same  chemical  constitution,  effects  the  most  surprising 
results  in  cases  of  articular  rheumatism.  It  is,  however, 
found  that  even  in  articular  rheumatism  Salut,  taken  inter- 
nally and  combined  with  Foulon  baths,  give  very  good  results, 
especially  if  any  dyspepsia  is  present. 

Pulmonary  disease,  and  especially  phthisis,  are  not 
suitable  for  this  treatment ;  the  chief  objection  is  the  low  tem- 
perature of  the  water,  but  such  cases  may  be  benefited  by 
drinking  the  latter,  especially  if  nervous  excitement  is 
present. 

According  to  M.  de  la  Garde  pregnant  women  should 
avoid  the  Salut  baths. 

The  uric  diathesis,  uterine  diseases,  and  anaemia,  are  all 
contra-indications  for  the  employment  of  the  Salut,  except 
where  there  is  much  nervous  irritation,  and  then  only 
internally. 

Adjuvants  to  Treatment  by  Salut  Jfaters^ 

The  different  springs  of  Bagneres  may  be  divided  into 
three  groups,  sulphurous,  chalybeate,  and  saline  chalybeate, 
as  all  diseases  accompanied  by  much  nervous  excitement  are 
acted  upon  beneficially,  but  this  condition  of  the  nervous 
system  is  often  accompanied  by  complications  which  may 
be  much  relieved  by  the  employment  of  the  other  springs  of 
Bagneres,  as  the  sulphurous  waters  of  Labasshre  in  torpid 
pulmonary  affections;  the  chalybeate  waters  in  anaemia,  which 
is  so  frequent.  Dr.  Dejeane  recommends  the  chalybeate 
waters  a  few  days  after  the  Salut  treatment  has  been  fol- 
lowed by  the  effect  of  calming  the  nervous  erethismus. 
He  also  employs  the  astringent  Salies  waters  as  an  injec- 
tion in  cases  of  leucorrhoea  where  other  symptoms  indicate 
Salut.  The  saline  Lasserre  waters  are  useful  in  constipa- 
tion. The  principal  aid  to  treatment  is  also  hydropathy,  to 
which  the  remarkable  effects  of  the  Salut  waters  are  some- 


by  Dr.  Roth.  247 

times  attributed.  When  the  waters  are  taken  internally 
the  effects  must  be  watched^  especially  in  cases  of  dyspepsia. 
Meals  ought  to  be  substantial  and  nutritious,  and  at 
regular  hours.  Dr.  Lemonnier  advises  abstinence  from  dry 
vegetables^  peas^  haricot  beans,  lentils,  cabbage,  heavy 
pastry,  cheese,  preserved  butter,  &c. 


Bagneaes  de  Luchon. 

All  those  who  are  not  pressed  for  time  should  drive  from 
Bigorre  to  Luchon,  across  the  mountains,  because  the  road 
is  one  of  the  nicest  in  that  part  of  the  Pyrenees,  and  leads 
across  the  Col  d'Aspine  through  a  splendid  forest  of  old  fir 
trees.  After  leaving  the  forest,  at  a  height  of  4500  feet, 
the  view  opens  on  a  most  beautiful  panorama  of  the  sur- 
rounding high  chain  of  mountains,  amongst  which  the  Pic 
da  Midi  is  the  highest,  and  where,  during  the  last  few 
seasons,  an  old  general  makes  highly  interesting  meteorolo- 
gical observations.  After  leaving  the  Col  d'Aspine  we  had 
excellent  views  in  our  descent  of  2500  feet  in  the  valley  of 
Arreau  and  passed  the  night  in  the  town  of  Arreau.  The 
next  morning  we  continued  our  journey  across  the  Col  of 
Peyresourde,  which  is  150  feet  higher  than  the  Col  d'Aspine, 
and  after  a  drive  of  four  hours  we  arrived  at  midday  at 
Luchon,  where  the  H6tel  du  Bains  has  been  justly  highly 
recommended. 

Luchon,  1887  feet  above  the  level  of  the  sea^  in  the  most 
eastern  corner  of  the  valley  of  the  same  name,  is  the  chief 
place  of  the  canton,  has  4000  inhabitants,  and  consists  of 
the  old  and  new  towns.  The  old  is  built  immediately  at 
the  foot  of  the  high  mountains,  which  shelter  the  place 
during  the  winter  months;  the  new  town  contains  the 
majority  of  the  hotels,  lodging-houses,  and  is  built  more  for 
the  visitors,  tourists,  and  patients,  of  whom  many  thousands 
resort  to  this  celebrated  and  very  pretty  watering  place, 
which  has  one  of  the  largest  etablissements,  with  a  front  of 
300  feet  and  depth  of  150  feet.  The  great  entrance  hall 
is  decorated  with  nice  frescoes ;  the  baths  are  in  communica- 


248  Bjlidaf  Tour  im  t\e  Pyrti^tt, 

tion  vitb  m  foriterraneaii  fmlienr  excavated  in  the  rock, 
which  M  y/X)  feet  Iod^,  7  feet  high,  and  a»iit  5  feet  wide, 
la  tbii  gaiJfrrr,  where  manT  dypiozains  are  growing,  the 
mib^ral  waters  arc  collected  for  the  supply  of  the  baths, 
which  are  vutcd  here  \u  all  forms  as  general  and  local  bath^, 
swimming-baths,  all  kinds  of  doaches,  rapjur;  the  bathing 
UMtmn  Ate  at  a  smaller  or  larger  size,  some  proTided  with 
awningn,  others  with  rentilators,  in  order  to  enable  the 
patient  to  inhale  more  or  less  of  the  solphnr  rapours 
according  to  the  special  direction  of  the  phjsician.  A 
committee  of  physicians  has  been  consulted  before  this 
etablissement  was  built,  and  therefore  it  contains  many 
special  contriTances  which  are  wanted  in  other  watering- 
places.  For  the  convenience  both  of  patients  and  their 
medical  men,  there  are  consulting  rooms  in  the  etablisse- 
ment, where  at  certain  days  and  hours  the  patients^  before 
entering  the  baths,  can  have  medical  advice. 

Of  the  fifty-four  springs  at  Luchon  forty-eight  are  sul- 
phurous, and  form  the  best  known  series  of  graduated  and 
modified  sulphur  springs,  varying  in  temperature,  in  the 
quantity  of  sulphur  they  contain,  as  well  as  in  their  com- 
bination. The  forty-eight  springs  of  sulphuretted  sodium 
have  a  temperature  varying  from  30^  Centigrade  (d'Etigny 
nro.  2)  to  66^  (Bayen) ;  their  sulphuration,  or  quantity  of 
sulphur  they  contain,  varies  from  0*0064  of  sulphur  of 
sodium  in  a  litre  (Richard,  inferieure,  nro.  1)  to  0*0786  (in 
Bayen),  and  0*0915  (in  Bosquet).  600,000  litres  of  sulphur 
water,  and  about  900,000  of  the  cold  saline  water,  con- 
stitute the  daily  supply ;  notwithstanding  this  large  supply, 
the  patients  are  obliged,  at  their  arrival,  to  go  to  the  Eta- 
blissement and  ask  for  a  number.  According  to  this  number 
thoy  are  admitted  to  the  various  baths;  the  price  of  the 
bath  varies  according  to  the  season  and  to  the  hours  chosen. 
All  French  poor,  the  patients  of  the  Luchon  Hospital,  all 
military  men,  many  civilian  officers,  all  foreign  and  French 
medical  men,  are  exempt  from  paying  for  the  use  of  the 
waters.  It  is  my  duty  to  thank  Dr.  Ferras  for  the  in- 
formation he  gave  me  while  showing  me  the  etablissement, 
and  Dr.  Dulac,  oue  of  the  senior  physicians,  for  his  com- 


by  Dr.  Roth.  249 

manication  regarding  the  diseases  in  wfaicli  the  waters  are 
principallj  useful.  Scrofulous^  rheumatic,  arthritic^  syphilitic 
aSections^  are  the  principal  classes  of  disease  suitable  fur 
Luchon;  but  very  much  depends  upon  the  riff  hi  use  of  the 
waters^  which  an  intelligent  medical  man  can  only  learn  by 
observation,  experience,  and  individualisation  of  each  patient. 
It  happens  frequently  here,  as  well  as  in  other  sulphurous 
baths,  that  the  patients  are  over-excited  through  the  inju- 
rious use  of  the  mineral  waters,  and  suffer  from  thermal 
fever;  therefore,  those  who  send  patients  to  the  Pyrenees 
should  advise  them  to  carry  out  strictly  the  instructions  of 
the  practitioners  under  whose  care  they  place  themselves. 

The  climate  is  mild,  and  in  summer  the  north  wind  cools 
the  great  heat.  It  is  not  advisable  for  patients  to  go  to 
Luchon  hefore  the  end  of  May.  July  and  August  are  con- 
sidered the  best  months  for  those  who  use  the  baths.  Those 
who  wish  to  know  more  about  these  waters  I  must  refer  to 
the  works  of  Drs.  Fonsan,  Filhol,  and  Lambrou,  Gourraud. 
Br.  Dulac  wiU  probably  soon  publish  the  results  of  his  large 
experience  during  many  years'  practice  in  Luchon. 

The  following  nine  springs  are  used,  either  alone  or  in 
various  combinations,  at  the  etablissemeut : — La  Reine,  51 ; 
La  Orotte,  48 ;  La  Blanche,  36 ;  Bichard,  43 ;  Pr^,  45 
Bordeu,  69  ;  Sosquet,  44 ;    Ferras,  83 ;    and  Etigny,  36 
The    numbers     show     the    temperature    in    Centigrades 
Although  all  these  waters  are  limpid  and  clear  at  the  spring 
some  of  them  change  when  collected  in  the  reservoirs ;  they 
are  cloudy  and  appear  whitish,  as  if  mixed  with  milk.    This 
is  due  to  a  change  of  the  sulphur,  which,  from  its  dissolved 
state,  is  deposited  in  the  form  of  a  kind  of  powder.     The 
odour  of  sulphur  is  remarked  in  all  but  Pre,  Bayen,  Bordeu, 
and  smell  more  intensely.     At  present  it  is  believed  that 
the  sulphydrate  of  sulphur  of  sodium  is  the  sulphuric  com- 
bination which  gives  to  Luchon  its  characteristic  qualities. 

Bordeu  and  Bosquet  are  considered  soothing  and  sedative ; 
used  in  lymphatic,  scrofulous,  and  nervous  affections. 

Bichard,  superieure  and  inf^rieure,  are  specially  used  in 
rheumatic  and  skin  diseases. 

Blanche  is  prescribed  to  nervous  persons. 


250  Holiday  Tour  in  the  Pyrenees^ 

Grotte,  snperieure  and  inferieure^  are  slightly  exciting. 

Reine  is  a  strong  stimulant. 

Ferras.— Both  springs  are  nsed  in  gastralgia. 

Pre. — ^The  internal  use  prescribed  for  lymphatic  and 
scrofulous  persons. 

The  etablissement  is  open  in  winter ;  and^  besides  the  four 
large  classes  of  diseases  named  before^  the  following  are 
frequently  relieved  or  cured  in  Luchon  : — Asthma,  several 
pulmonary  chronic  affections^  catarrh,  enlargement  of  ab- 
dominal organs^  crussa  lactea,  suppressed  menstruatiou^ 
painful  scars,  anchylosis^  exostosis^  rheumatic  nodosities. 

Herpes  and  its  various  forms  are^  according  to  Durand- 
Farrel^  successfully  treated  by  the  waters  which  contain  the 
sulphate  of  sodium ;  all  the  herpetic  akin  diseases,  as  chronic 
eceema  with  intolerable  itching,  also  when  complicated  with 
psoriasis  guttata,  pityriasis^  psoriasisi  papular  herpes,  pru- 
rigo and  lichen,  chronic  urticaria,  pemphigus,  and  exfoliating 
herpetic  affections,  are  frequently  relieved  and  cured ;  but 
the  various  springs  must  be  carefully  chosen,  not  only 
according  to  the  state  of  the  disease,  but  also  according  to 
the  susceptibility  of  the  patient. 

Herpetic  affections  of  the  mucous  membranes,  especially 
the  angina  granulosa,  affecting  larynx  and  pharynx^  or  one 
of  these  organs,  and  other  throat  complaints,  are  frequently 
treated  by  the  douche  pulverisee  and  by  the  internal  use  of 
the  springs  of  Pr4.  In  the  beginning  of  the  treatment  the 
irritation  is  increased,  and  when  there  is  swelling  of  the 
vocal  cords  the  voice  gets  still  more  hoarse,  the  bronchial 
secretions  are  increased,  and  although  the  bronchorrbcea 
might  be  very  copious,  the  sputa  are  less  thick,  contain 
more  air,  and  are  easily  expectorated,  and  have  frequently  a 
greenish  hue. 

Chronic  inflammation  of  the  external  meatus  auditorius  is 
often  caused  by  herpes,  and  Dr.  Fousan  considers  it  a  patho« 
gnomonic  symptom  of  a  herpetic  diathesis;  the  mucous  mem- 
brane does  not  suppurate,  as  in  scrofula,  but  is  rather  dry, 
and  exfoliates  like  pityriasis.  The  tympanum  is  also  frequently 
diseased,  and  deafness  is  either  temporary  or  permanent  if 
the  tympanum  is  perforated ;  chronic  coryza  is  also  a  ire- 


Ay  Dr.  Both. 


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252  Holiday  Tour  in  the  Pyrenees, 

quent  symptom^  which  caused  hypertrophy  of  the  mucous 
membrane  of  the  Eustachian  tube.  Besides  the  general 
treatment  the  sulphur  waters  are  used  locally  under  the  form 
of  pulverisation^  of  vapour,  and  of  injections  in  the  Eustachian 
tube. 

In  herpetic  chronic  blepharitis  the  waters  of  the  spring 
Romains  are  used  for  lotions,  and  also  under  the  form  of 
pulverised  douches. 

Another  herpetic  affection^  chronic  ozsena,  usually  accom- 
panied by  the  most  disagreeable  foetor,  by  wl^ch  both  the 
patients  and  the  persons  near  them  suffer,  is  often  cured  in 
Luchon,  if  the  ulcers  are  not  too  deep,  and  have  not  per- 
forated the  septum ;  in  these  cases  the  strongest,  the  most 
exciting,  and  the  warmest  sulphur  waters  are  used  as  injec- 
tions into  the  nasal  cavities,  which  must  be  well  bathed  and 
washed  in  all  directions.  A  cure  is  almost  certain  if  there 
is  only  hypertrophy  of  the  nasal  mucous  membrane,  and  the 
ulcers  are  but  superficial,  although  the  secretion  might  be 
very  abundant  Sometimes  an  unexpected  cure  takes  place 
when  the  deep  ulcers  cicatrise. 

If  dyspepsia  is  caused  by  herpetic  diathesis  it  is  very 
painful,  and  resists  the  usual  treatment.  This  kind  of  dis- 
pepsia  is  cured  by  the  sulphur  waters,  while  in  all  other 
forms  of  stomach  diseases,  in  gastritis,  gastralgia,  dys- 
pepsia, &c.,  sulphur  waters  are  not  only  useless,  but  very 
injurious. 

Herpetic  complaints  of  the  mucous  membranes  of  the 
urethra,  vagina,  and  uterus,  are  also  relieved  and  cured 
by  sulphur  waters.  Previous  or  coexistent  herpetic  affections 
of  the  skin  will  guide  the  medical  man  in  making  his  dia- 
gnosis regarding,  the  nature  of  the  various  affections  of  the 
mucous  membranes,  and  whenever  a  herpetic  diathesis  is 
present  the  sulphur  water  will  prove  most  useful. 

Oout  and  its  concomitant  effects  on  the  joints,  under  the 
form  of  swelling,  congestion,  inflammation,  nodosities, 
incomplete  anchylosis,  and  on  the  skin,  certain  varieties  of 
intertrigo,  prurigo,  pemphigus,  cirrhosis,  mentagra,  and 
eczema,  which  Bazin  ascribes  to  an  arthritic  diathesis,  are 
treated  more  frequently  merely  by  the  external  use  of  the 


by  Dr.  Roth.  258 

sulphur  waters,  because  the  stomach  of  gouty  patients  does 
not  digest  sulphur  waters.  Alkaline  remedies  are  used  inter- 
nall?,  and  carbonate  of  soda  is  also  often  added  to  the  sulphur 
bath.  The  aim  of  the  treatment  is  to  change  the  chronic 
arthritic  affections  into  acute  ones,  and  therefore  those 
springs  which  contain  the  maximum  of  the  alkaline  sulphides 
and  hyposulphides  are  used,  besides  the  vapour  bath  and  the 
polrerised  douches,  while  Yichy  and  Vals  waters  are  given 
daring  the  meals. 

Although  scrofulous  and  lymphatic  patients  are  very  fre- 
ijaently  advised  to  use  saline  waters,  they  bear  very  well  the 
treatment  by  sulphur  waters,  the  full  bath,  douches,  hot  or 
cold,  applied  alternately;  the  most  exciting  waters,  containing 
the  largest  amount  of  sulphur,  are  used  externally,  while 
they  drink  Reine^  Grotte,  and  Pr^  nro.  1.  The  more 
serious  cases  are  obliged  to  return  to  Luchou  during  several 
seasons.  Strumous  inflammations  of  the  joints  are  often 
cured,  and  anchylosis  would  frequently  have  been  prevented 
by  an  earlier  visit.  All  scrofulous  complaints  of  the  osseous 
system — as  osteitis,  periostitis,  osteomyelitis — as  well  as  of 
the  chronic  inflammation  of  the  mucous  membranes  of  the 
iiose,  pharynx,  and  conjunctiva,  find  a  remedy  in  the 
numerous  springs  of  Luchon. 

A  great  number  of  syphilitic  patients  who  have  taken 
too  large  a  quantity  of  mercury  are  cured  by  the  sulphur 
waters,  while  these  aggravate  usually  all  syphilitic  sym- 
ptoms if  no  mercury  has  been  taken ;  very  large  doses  of 
mercury  can  be  taken  without  causing  salivation  or  derange- 
ment of  the  stomach  as  long  as  the  patient  uses  the  waters. 
Df.  Gourraud  mentions  that  he  has  seen  the  scars  of  pa- 
tients who,  after  the  recent  healing  of  infecting  chancres, 
have  used  five  or  ten  baths,  first  to  swell,  then  to  inflame ; 
afterwards  a  very  slight  superficial  and  extended  ulcer 
formed  in  the  epithelial  strata^  with  a  copious  but  not 
thick  suppuration.  The  patients  are  usually  much  alarmed^ 
and  anxious  to  apply  local  remedies,  because  they  fear  the 
reappearance  of  the  old  chancre.  Every  local  remedy  except 
rice  powder  must  be  avoided,  and  within  ten  or  fifteen  days, 
during  which  the  suppuration  lasts,  a  considerable  improve- 


254  Holiday  Tour  in  the  Pyrenees, 

ment  is  observed;  the  scar  is  mach  softer  and  smaller, 
althoagh  a  slight  induration  is  still  felt ;  this  is  by  degrees 
absorbed,  and  finally  disappears  entirely.  The  treatment 
Taries  according  to  circumstances,  as  patients  are  visiting 
the  baths  for  the  purpose  of  curing  existing  syphUitic  sym- 
ptoms, or  only  for  the  sake  of  passing  a  test  cure^  whether 
tbey  are  really  cured;  herpetic,  arthritic,  or  scrofulous 
patients  infected  with  syphilis  mu$t  also  be  treated  according 
to  the  various  symptoms  and  combinations.  According  to 
Dr.  Gourraud — 

1.  The  waters  of  Luchon  are  no  specifics  against 
syphilis. 

2.  They  assist  the  action  of  mercury  promote  the  absorp- 
tion and  elimination  of  this  medicine,  and  prevent  its  bad 
effects. 

8.  When  used  alone  they  increase  the  syphilitic  sym- 
ptoms, especially  of  the  skin ;  they  are  most  useful  in 
bringing  out  latent  syphilis,  but  never  cure  the  complaint. 

4.  They  assist  in  forming  a  better  diagnosis,  and  in 
distinguishing  the  syphilides  from  the  herpetic,  arthritic, 
and  scrofulous  symptoms. 

5.  They  core  the  bad  effects  of  mercurial  poisoning. 

6.  A  perfect  cure  can  be  ascertained. 

7.  One  course  of  treatment  may  be  sufBcient  for  a  cure, 
but  this  is  not  to  be  considered  as  a  perfect  one,  as  long  as  a 
second  course,  and  merely  of  sulphur  treatment,  has  not 
caused  any  reappearance  of  previous  syphilitic  symptoms. 

These  remarks  also  prove  that  working  men  poisoned 
by  lead  or  mercury  will  be  most  benefited  by  the  waters. 

For  chronic  diarrhoea,  especially  when  combined  with 
gonorrhoeic  rheumatism,  in  suppressed  gonorrhoea,  the 
waters  are  used  externally  as  baths,  vapour  baths,  injections, 
and  also  internally ;  in  acute  gonorrhoea  the  waters  are 
injurious;  wounds,  painful  scars,  ulcers,  abscesses  and 
fistulas,  chronic  rheumatic  enlargements,  and  osseous  nodo- 
sities, in  which  Bareges  is  so  successfully  used,  are  also 
treated  at  Luchon,  where  the  melancholic  and  hypo- 
chondriac patients  have  more  opportunities  for  distraction 
and  amusement. 


by  Dr.  Roth.  255 

The  obstructions  caused  by  phlebitis  and  lymphangitis, 
the  impediment  caused  in  veins  by  thrombus,  as  well  as 
various  forms  of  rheumatic  affections,  are  relieved. 

Lately,  the  number  of  consumptive  patients,  and  of  those 
suffering  from  chronic  bronchitis  and  chronic  pleurisy,  who 
visit  Luchon,  has  also  considerably  increased,  as  well  as 
those  who  suffer  from  various  neuralgic  and  other  pains,  and 
from  paralytic  and  paretic  affections;  the  various  uterine 
diseases  are  also  numerously  represented  at  Luchon.  Dr. 
A.  FoDsan  (in  his  Recherches  but  les  Eaux  MinSrales  des 
Ptprenees]  describes  the  history  and  cure  of  a  hypertrophied 
uterus  with  deep  ulcerations,  which  has  lasted  four  years. 

This  case  is  very  remarkable,  because  during  four  years 
the  very  enlarged  uterus  could  not  be  even  replaced ;  the 
fall  history  is  also  copied  in  Dr.  Gourrand^s  interesting 
book,  Le  traitement  thermal  a  Bagneres  de  Luchon.  Gynae- 
oological  and  laryngoscopic  specialists,  at  present  so  lavish 
with  their  caustics,  may  learn  that  cures  can  be  performed 
without  these  caustics. 

The  principal  iron  springs  of  Luchon  are  Cassel-Vieil 
Salles,  Baringnas,  Trebon,  and  Chat,  contain  sulphate  of 
iron,  and  some  of  them  also  crenate  of  iron ;  they  are  used 
in  ausemia,  chlorosis,  and  whenever  aglobulia  is  present 
from  any  cause,  and  assist  the  effect  of  sulphur  water  in 
lymphatic  complaints;  although  they  do  not  contain  car- 
bonic acid,  they  are  still  digested,  and  increase  the 
appetite. 

Chat  contains  the  largest  amount  of  mineral  substance, 
but  as  this  spring  is  at  some  distance  it  is  not  so  much 
Qsed.  The  iron  waters  are  usually  drunk  at  meals,  for 
which  purpose  daily  a  fresh  supply  of  bottles,  filled  in  the 
luorning,  is  sent  to  the  hotels.  When  it  can  be  managed 
it  is  better  for  the  patient  to  walk  to  the  iron  springs,  and 
thus  the  walk  will  assist  in  the  digestion  of  the  iron  waters. 
Lately  a  new  iron  spring,  called  Sourronis,  has  been  found, 
which  contains  also  arsenic,  which  will  be  an  additional 
remedy  in  herpetic  diseases,  and  general  weakness. 

The  whey  cure  belongs  also  to  the  adjuvants  of  Luchon, 
but  the  whey  is  made  only  of  cow's  milk,  although  in  other 


256  Holiday  Tour  in  the  Pyrenees. 

places  it  is  made  of  goat's  milk ;  whey  is  used  in  habitual 
coDstipatioD,  abdominal  irritatioUy  and  abdominal  plethora; 
in  bronchial  catarrh  with  irritating  cough  ;  in  gravel  and 
chronic  catarrh  of  the  bladder.  One  to  five  or  six  glasses 
of  whey  are  taken  at  shorter  or  longer  intervals,  but  they 
are  also  used  as  baths,  either  alone  or  mixed  with  sulphur 
water,  which  produces  a  more  calming  effect. 

Although  I  have  tried  to  give  a  very  short  outline  of 
the  therapeutic  value  of  the  justly  celebrated  watering 
places  in  the  Pyrenees,  and  merely  to  point  out  the 
class  of  diseases  which  may  find  their  relief,  this  paper 
has  considerably  exceeded  the  proposed  length.  My  aim 
was  to  call  the  attention  of  those  who  know  nothing  or 
very  little  of  the  subject  to  the  beneficial  springs  and  the 
beautiful  scenery,  and  so  induce  them  to  make  themselves, 
either  personally  or  by  books,  more  acquainted  with  the 
effects  of  these  waters.  They  will  thus  not  only  benefit  their 
patients  but  themselves,  because  they  are  sure  to  meet  in 
their  practice  with  many  chronic  cases  in  which  the  ordinary 
means  are  useless ;  and  when  the  patient  cannot  go  to  the 
Pyrenees,  artificial  sulphur  baths  will  sometimes  produce 
unexpected  results,  still  more  when  assisted  by  the  internal 
use  of  mineral  waters.  I  have  already  mentioned  (p.  284) 
a  case  in  which  my  experience  of  the  treatment  at  the 
Bareges  baths  enabled  me  to  treat  successfully  a  case  that, 
without  such  experience,  I  should  have  been  unable  to  cure. 
May  those  who  have  read  these  notes  be  still  more  suc- 
cessful than  their  collector,  whose  work  and  trouble  will 
thus  be  sufficiently  rewarded. 


X 


257 


THE  RECONSTITUTION  OP  THE  MATERIA 

MEDICA. 

By  Dr.  Hcohes. 

The  primary  requisite  for  our  carrying  out  the  law^  *^  let 
likes  be  treated  by  likes/^  is  that  the  two  elements  of  the 
comparison  shall  be  before  us.  We  have  the  one  in  the 
patients  entrusted  to  our  care^  but  the  other  oiust  be  sup- 
plied to  us  beforehand.  A  collection  must  be  made  of  the 
observed  effects  of  drugs  on  the  healthy  body^  and  such 
further  experiments  must  be  instituted  as  are  necessary  to 
complete  the  picture'  of  the  action  of  each.  The  results  of 
the  latter^  amalgamated  with  the  former,  give  us  the  second 
element  of  our  comparison :  they  form  the  "  Materia 
Medica'^  of  Homoeopathy.  The  name  is  of  course  wrongly 
applied,  as  it  properly  denotes  the  drugs  themselves ;  but  it 
has  so  long  been  in  use  among  us  for  the  other  purpose  that 
it  mast  stand. 

That  we  owe  to  Hahnemann^  not  only  the  establishment 
of  the  law  of  similarity^  but  the  first  and  largest  contribu- 
tion of  material  for  carrying  it  out^  we  all  gratefully  acknow- 
ledge. But  it  is  a  matter  of  general  regret  that  he  should 
have  presented  in  the  form  in  which  we  have  them  the  mass 
of  observations  and  experiments  accumulated  by  him.  The 
groups  of  drug-effects  which  he  gleaned  from  books  and 
obtained  from  bis  own  and  others'  provings  have  been  broken 
lip  into  their  component  elements ;  and  these  have  been  put 
into  their  appropriate  places  in  a  schema,  mainly  anatomical, 
without  note  of  origin,  connection,  or  sequence.  The  result 
is  that  the  two  pictures  between  which  we  have  to  seek  for 
resemblances  have  little  in  common.  All  diseases,  and 
nearly  all  patients,  present  a  morbid  state  which  is  an 
organic  whole,  which  has  its  linked  history,  its  orderly  evo- 
lution, its  association  of  symptoms  primary  and  secondary, 
essential  and  sympathetic.  To  treat  such  a  state  by  a 
similarly-acting  medicine,  the  pathogenetic  effects  of  that 

VOL.  XXXVII,   NO.  CXLIX. JULY,  1879.  R 


258  The  Reconslitution  of  the  Materia  Medico^ 

medicine  ought  to  be  recorded  for  us  in  a  corresponding 
manner.  Instead  of  this,  they  are  given  us  in  a  form  which 
would  only  be  paralleled^  were  we  to  write  down  our 
patients'  existing  phenomena  and  sensations  in  the  order  of 
the  Hahnemannian  schema ;  and  then,  instead  of  comparing 
two  organic  wholes  together^  were  mechanically  to  cover  one 
symptom-list  with  another. 

The  misfortune  has  been  doubled  by  the  fact  that^  very 
naturally^  most  of  the  immediate  disciples  of  the  master  who 
followed  him  in  the  task  of  proving  have  imitated  him  in 
the  mode  of  presenting  the  results  obtained  by  them. 
Stapfy  Hartlaub  and  Trinks,  Hering,  Helbig — they  all  gave 
us  pathogenesies  in  schematic  form,  thinking  that  thereby 
they  had  supplied  all  that  was  needed.  It  has  thus  come 
about  that  the  great  mass  of  our  Materia  Medica  exists  ouly 
in  this  shape ;  and  that  when  collections  of  it  have  been 
madCj  the  new  matter  added  has  been  conformed  to  the 
predominant  type,  although  the  sources  from  whence  it  has 
been  derived  contain  it  in  more  intelligible  statement.  It 
was  so  with  Jahr  and  with  Noack  and  Trinks;  and  it  is  so 
in  the  later  and  greater  work  of  Allen,  which  must  be  our 
Materia  Medica  (as  it  well  deserves  to  be)  for  many  years 
to  come. 

I  have  elsewhere*  endeavoured  to  account  for  Hahne- 
mann's having  proceeded  after  this  manner,  and  to  show  in 
what  way  such  pathogenesies  of  drugs  may  be  fruitfully 
used.  But  that  we  cannot  learn  our  Materia  Medica 
therefrom  is  generally  admitted  ;  and  many  attempts  have 
been  made  to  present  the  action  of  its  constituents  in  a 
better  way.  Of  two  of  the  latest  of  these^  now  before  me, 
I  propose  to  form  some  estimate  at  this  time.  They  are 
from  the  pens  of  Dr.  Jousset  and  Dr.  Espanet  respectively. f 
The  former  of  these  needs  no  introduction  to  our  readers. 
The  latter  has  been  favorably  known  in  his  own  country  by 
his  TraiU  meihodique  de  Matiert  Midicale  et  de  Thhu- 
peutique,  published  in  1861 ;   and  though  this  work  has  not 

*  Manual  of  Fharmaeodynamics,  3rd  ed.,  p.  7,  8. 

f  See  VArt  Medical  for  February  and  Bull,  de  la  Soc.  M4d.  Horn,  de  France 
for  April,  1879. 


\ 


i 


by  Dr.  Hughes.  259 

been  translated  into  English,  and  is  little  known  among  us^ 
its  title  is  sufficient  to  show  that  he  is  an  expert  in  the 
subject  on  which  he  now  speaks.  He  thinks  that  the  time 
has  come  to  recommeuce  this  treatise  of  his  on  an  altogether 
different  plan  ;  and  in  the  article  published  in  the  Bulletin 
be  lays  down  the  principles  on  which  he  proposes  to 
vork,  and  gives  a  specimen  of  their  application  in  the 
instance  of  Belladonna.  Dr.  Jousset  simply  states  that  he 
hns,  with  some  friends,  undertaken  to  edit  a  treatise  on 
Materia  Medica  and  Therapeutics;  and  illustrates  his  mode 
of  working  bv  a  study  of  Digitalis.  This  he  publishes,  {o 
elicit  from  his  colleagues  any  criticism  and  counsel  they  may 
be  able  to  give  in  aid  of  his  further  labours.  It  is  obvious 
that  the  commencement,  by  such  men,  of  such  undertakings 
as  these  is  no  unimportant  matter,  and  that  it  demands  from 
all  who  are  acquainted  with  the  subject  the  fullest  attention 
and  the  freest  expression  of  opinion.  The  following  pages 
are  my  own  humble  contribution  to  the  discussion. 

I.  Dr.  Jousset — to  take  him  first — limits  himself,  like 
Hahnemann,  to  a  statement  of  the  facts  of  the  case.  He 
makes  no  attempt  to  account  for  the  phenomena  of  the  action 
of  Digitalis  on  the  healthy  body,  but  simply  details  them. 
On  the  other  hand,  he  does  his  utmost  to  present  them  in 
the  association  and  order  of  their  occurrence.  He  begins 
with  an  excellent  description  of  poisoning  by  the  drug,  in 
its  two  forms — that  which  he  caWs  foudroy ante  d^embUe  and 
that  which  is  rather  progressive.  He  then  arranges  the 
principal  symptoms  manifested  under  such  circumstances 
under  the  head  of  troubles  of  the  nervous  system,  of  the 
gastro-intestinal  and  urinary  organs,  and  of  the  circulation 
and  respiration,  ending  with  the  exterior  aspect  and  the  post- 
mortem appearances.  Next,  he  classifies  after  a  similar 
nmnner  the  effects  of  ponderable  but  not  toxic  doses  of  the 
drug,  using  for  this  purpose  the  provings  and  citations  of 
Hahnemann,  as  well  as  observations  of  others.  He  concludes 
"^\i\i  the  indications  for  the  use  of  Digitalis  in  the  treatment 
of  disease,  following  here  a  nosological  order.  The  whole 
article  occupies  eighteen  of  the  large  octavo  pages  of  UArt 
MidicaL 


260  The  Reconstitution  of  the  Materia  Medica, 

In  estimating  the  value  of  this  mode  of  presenting  a 
medicine,  we  have  only  to  consider  how  far  it  is  calculated 
to  impress  on  the  mind  of  a  student  the  essential  features 
aud  characters  of  the  drug  under  review.  Now  I  have  no 
hesitation  in  saying  that  Dr.  Jousset  has  made  a  most 
happy  selection  from  the  recorded  observations  of  the  action 
of  Digitalis,  so  that  no  effect  of  the  drug  which  is  of  physio- 
logical or  therapeutical  interest  is  omitted  from  his  enume- 
ration. His  description,  moreover,  of  the  evolution  of  its 
toxic  effects  supplies  a  framework  in  which  the  separate 
symptoms  afterwards  detailed  find  their  due  place  and  order. 
Any  one  who  has  made  himself  master  of  the  eleven  pages 
devoted  to  the  pathogenetic  side  of  the  subject  has  learned 
all  that  he  need  know  a  priori  of  the  effects  of  Digitalis  on 
the  healthy  body,  so  far  as  the  phenomena  are  conctmed. 

But  here  my  satisfaction  becomes  qualified.  I  hold  that 
the  student  requires  to  know  something  of  the  meaning  of 
the  facts  brought  before  him,  so  far  as  that  meaning  can 
be  perceived ;  that  he  is  imperfectly  furnished  for  the  use 
of  a  medicine  in  disease  unless  some  of  the  significance  of 
its  pathogenesy  is  revealed  to  his  mind.  To  take,  for 
instance,  the  action  of  Digitalis  on  the  heart.  Dr.  Jousset 
tells  us  that  in  the  foudroyante  form  of  poisoning,  the 
pulse  is  small,  uncountable,  sometimes  completely  absent, 
and  the  heart-beats  precipitate  and  hardly  perceptible,  with 
irregularity  as  recovery  ensues;  that  in  the  progressive 
variety  the  pulse  is  at  first  strong  and  hurried  without  irre- 
gularity, beating  120  or  140  in  a  minute;  that  when  the 
effect  is  less  pernicious,  this  rapidity  is  succeeded  by  slow- 
ness, which  from  small  doses  occurs  at  once.  Again,  in 
summing  up  this  part  of  the  drug^s  action,  he  states  that 
strong  doses  ''  paralyse  the  heart  and  the  arteries  after 
having  excited  them,''  while  still  larger  quantities  paralyse 
from  the  first;  and  that,  of  feeble  doses,  '^  strong  and 
retarded  cardiac  impulse  is  the  primitive,  feeble  and  accele- 
rated the  secondary,  effect.''  All  this  is  true  and  useful 
enough,  but  what  does  it  mean  ?  The  heart  is  a  hollow 
muscle,  contracting  rhythmically  under  the  influence  of  the 
ganglia  embedded  in  its  substance^  and  regulated   by  the 


\ 


by  Dr.  Huyhes.  261 

opposing  influence  of  the  pneamogastric  and  sympathetic 
fibres  coming  to  it  from  the  central  nervous  system.    What 
is  meant  by  its  being  **  paralysed  V*   Is  it  the  cardiac  muscle 
itself  that  is  incapable  of  responding  to  the  nervous  im- 
pulses^ or  the  nervous  centres  which  have  no  power  to  send 
forth  their  commands  ?     Is  the  alteration  of  the  rate  of  the 
heart's  pulsation  due  to  inhibitory  or  accelerating  influences 
transmitted  to  it  from  above^  or  to  some  change  in  the 
organ  itself?     These  are  questions  of  no  mere  speculative 
interest :  on  their  decision  depends  our  view  of  the  use  of 
the  drug  as  a  remedy.     If  it  paralyses  the  cardiac  nerves 
only,  it  cannot  strengthen  and  tone  up  a  dilated  ventricle 
by  its  homoeopathic  action.    If  it  retards  the  heart  otherwise 
than   through  the  vagi,  slow  pulse  is  no  indication  for  it 
when  induced  by  their  inhibitory  influence.      Dr.  Jousset 
knows  as  well  as  I  do  that  it  has  been  ascertained  that  they 
are  the  channels  through  which  Digitalis  retards  the  heart ; 
and  he  probably  knew  before  I   did  that  Claude   Bernard 
had  found  the  drug  to  be  a  direct  muscle-poison.     To  have 
told  the  student  this  would  have  given  him  a  precious  clue 
through  the  mazes    of  the  phenomeoa  displayed^   and   it 
would  have  shown  him  where  the  drug  is  primarily   (i.e. — 
to  my  mind — really)  homoeopathic^ — viz.  where  the  pulse  is 
simply  slow^   or  where  the    cardiac    muscle    is    of   feeble 
vitality. 

This  leads  me  to  say  that  I  regret  to  see  Dr.  Jousset 
commit   himself   to    the    theory    of    '^  secondary   homoeo- 
pathicity/'  as  advocated  by  Dr.  E.  M.  Hale^  which  brings 
into  our  practice  a  large  (if  not  the  whole)  range  of  antipathic 
medication,   with   dosage  accordingly.      He  propounded  it 
at  last  year's  Paris  Congress,  but  tentatively  only  :  here  he 
assumes  it  as  an  accepted  truth.     I  have   already  argued 
against  it  in  this  Journal,*  and  must  now  repeat  my  protest. 
According  to  our  author,  Digitalis  is  to  be  given  just  as  it 
is  given  in  the  old  school,  when  the   condition   known    as 
*^  asystolia^'  is  present  in  cardiac  disease ;  when  the  heart 
heats  so  rapidly,  feebly,  and  irregularly,  that  it  does  not  All 
the  arteries, — these  themselves  being  deflcient  in  tension,  so 

*  See  vol.  xxxvi,  p.  219. 


262  The  Rtconslitvtion  of  the  Materia  Medica, 

tbat  the  kidnevs  secrete  little,  and  the  tissues  become  water- 

logged.      It  is  to  be  so  employed  by  homoeopathists,  on  the 

ground  that  just  such  a  state  is  caused  as  a  secondary  effect 

of  largish  doses  and  a  primary  effect  of  very  large  ones ;  but, 

the  drug  being  thus  only  ''  secondarily  homoeopathic/'  the 

stronger  doses  must  be  given.      Dr.  Jousset  here  says  that 

he  has  often  succeeded  in  asystolia  with  grain  doses  of  the 

first  and  even  second  decimal  trituration  of  the  leaves ;  but 

in  his  Elements  de  Medecine  he  speaks  of  a  decoction  as  the 

only  form  in  which  it  is  effectual^  advising  from  two  to  four 

grammes  of  the  leaves  to  100  grammes  of  water, — four  to  six 

spoonfuls  in    the  twenty- four  hours.       When   the  former 

dosage  influences  the  patient's  condition,  I  can  well  believe 

that   the   drug   acts  by  its    homoeopathic    relation  to   the 

enfeeblement  of  the  muscular   walls  of  the  heart,  alwavs 

present  in  such  cases.      But  when  it  has  to  be  administered 

iu  quantities  large  enough  to  induce  its  primary  action,  i.e*. 

to  retard  the  heart  through   the  vagi  and   to  spur  on  its 

pulsations  and  the  contraction  of  the  arteries  through  the 

sympathetic,  we  are  surely  setting  such  action  up.     And  if 

we  do  so,  in  what  do  we  differ  from  our  brethren  of  the 

other  school,  and  where  are  we  to  stop  ?       Their  prevailing 

method  is  to  induce  the  physiological  action  of  the  drugs 

they  employ.     If  this  be  done  in  the  part  affected  (affected, 

of  course,  in  the  opposite  manner),  the  practice  is  antipathy, 

or  enantiopathy ;  if  elsewhere,  it  is  alloeopathy,  (now  less 

correctly  called  allopathy).      So  Hahnemann  taught,  and  I 

see  no  escape  from  the  position.     If  we  begin  adopting  the 

former,  on  the  plea  of  its  being  secondary  homoeopathy,  and 

proportion   our  dosage   accordingly,  our  opponents  iu   the 

other  camp  will  have  a  potent  weapon  to  use  against  us. 

We  say, — ^you  are  taking  our  similar  remedies,  small  dose 

and  all,  and  refusing  to  acknowledge  the  law  under  which 

they  act,  using  them  empirically,  or  explaining  away  their 

apparent  homoeopathicity.       They  will  say  in  return, — ^you 

are  taking  our  contrary  remedies,  full  dose  and  all,  under  a 

plea  which  to  us  at  least  is  transparently  futile.      Of  course, 

it  may  be  that  such  remedies  are  necessary,  and  in  the  case 

of  Digitalis  I  am  iuclined  to  think  that  such  necessity  really 


\ 


by  Dr.  Hughes.  268 

exists ;  but  let  us  freely  acknowledge  them  for  what  they 
are. 

These  are  my  only  objections  to  the  method  of  Dr. 
Jousset^s  working,  as  illustrated  by  his  present  article.  He 
will  permit  me^  however^  to  point  out  some  slight  errors  in 
detail. 

At  p.  108  he  says  that  the  symptoms  of  Hahnemann  and 
his  pupils  were  obtained  from  ^^  the  extract  or  the  powdered 
leaves  of  the  plant/'  Now,  in  the  Fragmenta  de  viribus 
Hahnemann  tells  us  that  he  obtained  his  symptoms  with 
the  expressed  juice  of  the  leaves.  In  the  Materia  Medica 
Pura  he  directs  the  seeds,  and  in  the  Chronic  Diseases  the 
^ho\e  plants  to  be  used  in  making  the  tincture ;  whence  we 
may  infer  that  from  such  preparations  the  new  symptoms 
of  the  pathogenesies  there  given  were  elicited. 

At  p.  109  '* Wittersing"  should  be  "Withering.'' 

At  p.  115  Dr.  Jousset  says  that  clinical  experience  does 
not  furnish  us  with  any  information  as  to  the  efficacy  of 
Digitalis  in  tubercular  meningitis.  In  my  Pharmacodynamics 
I  have  referred  (p.  347)  to  two  instances  of  its  successful 
iise,*  and  have  cited  Pereira  as  accounting  it  '^a  most 
valuable  agent  in  the  arachnitis  of  childhood." 

II.  I  turn  now  to  Dr.  Espanet,  His  essay  is  a  more 
elaborate  one,  and  his  aim  more  ambitious.  I  shall  not 
have  to  complain  of  him  for  refraining  to  interpret  the 
symptomatology  of  his  selected  drug,  though  I  may  have  to 
<liffer  from  him  as  to  his  mode  of  doing  it.  Let  me  first, 
however,  consider  the  principles  he  lays  down. 

1.  In  the  first  place^  he  tells  us  (p.  747)  that  '^it  is  an 
incontestable  fact  that  all  maladies  and  all  drugs  have  a  pri- 
mordial action  on  the  great  sympathetic,  and  in  the  first 
place  on  the  vaso-motor  nerves."  Now  I  must  challenge 
this  statement.  Dr.  Espanet  has  gone  from  one  extreme 
to  another  in  his  way  of  regarding  this  part  of  the  nervous 
system.  In  his  treatise  he  says  that  ^^the  point  of  depar- 
ture and  of  elective  choice  with  Belladonna  is  the  brain,  and 
not  the  ganglionic  nervous  system,  in  which  it  differs  from 
Calcarea,  Arsenicum,  &c."     Here  he  evidently  assumes  the 

*  In  vols,  vii  and  xi  of  this  Joamal. 


264  The  Recomtitution  of  the  Materia  Medica, 

old  notion  about  the  sympathetic — that  it  presided  over  the 
vegetative  functions.  Now  he  elevates  it  to  a  place,  both 
in  disease  and  in  drug-action^  which  seems  to  me  quite 
as  unwarrantable,  according  to  our  present  knowledge. 
The  yaso-motor,  like  the  musculo-motor,  nerves  are  ani- 
mated from  the  cerebro-spinal  centres,  and  their  relation  to 
the  sympathetic  ganglia  with  which  they  are  connected  at 
various  parts  of  their  course  is  very  obscure.  To  make 
this  one  portion  of  one  system  of  the  body  the  seat  of  the 
*'  primordial  action^'  of  all  drugs  and  all  maladies,  to  assume 
that  all  disorder  and  morbid  change  is  primarily  due  to 
circulatory  disturbance,  cannot  (I  maintain)  be  supported 
or  allowed. 

Dr.  Espaoet  makes  a  kindly  allusion  to  my  own  work  in. 
this  field,  characterising  it  as  an  endeavour  ''  to  establish 
the  point  of  departure  of  the  action  of  drugs  in  definite 
portions  of  the  nervous  system,'*  But  if  there  is  one  point 
more  than  another  on  which  I  have  insisted^  it  is  that  the 
primitive  action  of  drugs  need  not  be,  often  is  not,  upon  the 
nervous  system  at  all ;  that  they  may  affect  plants,  which 
have  no  such  system,  as  well  as  animals ;  that  any  portion 
of  living  matter — be  it  muscle,  membrane,  cell,  or  fibre — 
may  feel  their  influence,  and  manifest  it  accordingly.  I 
feel  sure  that  we  shall  not  understand  the  action  of  medi- 
cines, or  their  relation  to  disease,  until  we  recognise  this 
truth. 

I  fear,  therefore,  that  the  fundamental  physiological 
assumption  on  which  Dr.  Espanet  proceeds  in  his  interpre- 
tations of  drug-action  is  one  which  I  cannot  concede;  and 
that  divergence  of  view  is  inevitable. 

2.  I  have  next  to  consider  certain  rules  laid  down  by  our 
author  in  respect  of  our  acceptance  and  use  of  the  patho- 
genesies  of  the  existing  Materia  Medica. 

He  begins  by  a  profession  of  faith  which  I  regret  that  I 
cannot  join  him  in  making,  ^'  All  the  pathogenesies 
published  by  Hahnemann,  or  under  his  name,  and  the 
greater  number  of  those  which  we  owe  to  groups  of  experi- 
menters, are  of  scrupulous  exactness.''  Now,  if  the  earlier 
pathogenesies  of  the  Fraymenta  de  viribus  and  of  the  Reine 


\ 


by  Dr.  Hughes.  265 

Arzneimiiiellehre  were  alone  in  question^  we  might  assent  to 
this  proposition.  But  in  respect  of  the  copious  symptom- 
Usts  of  the  Chromschen  Krankheiien,  how  can  we  give  a 
similar  accoant  1  It  is  well  known  that  Hahnemann's  own 
cootributioDs  to  this  collection^  which  form  the  greater  part 
of  its  bulk,  were  almost  entirely  obtained  from  patients 
taking  the  different  drugs,  every  fresh  symptom  occurring 
in  them  being  set  down  to  the  medicine  which  was  being 
administered.  An  interestiug  instance  of  the  fallacy  of  this 
method  of  obtaining  pathogeuesies  is  supplied  in  a  recent 
number  (that  for  May,  p.  283)  of  the  Monthly  Homoeopathic 
Heview.  Dr.  John  Clarke,  of  Ipswich,  a  recent  and  valu. 
able  accession  to  onr  ranks,  is  there  describing  the  good 
efiectH  of  Nairum  muriaticum  in  catarrh,  and  he  relates  two 
symptoms  as  occurring  in  himself  while  taking  the  drug,  which 
he  considers  as  pathogenetic  effects  of  it.  They  may  be  so, 
M  they  have  both  appeared  in  healthy  provers  (the  Austrian 
experimenters)  taking  it.  But  when  we  observe  that  one 
of  these  was  a  herpetic  patch  at  the  extremity  of  the  nasal 
Beptum,  and  remember  how  often  herpes  labialis  occurs  in 
connection  with  catarrh,  we  see  that  it  would  have  been 
quite  unjustifiable,  without  independent  confirmation,  to  set 
this  symptom  down  as  a  pure  effect  of  the  drug.  Dr. 
Clarke  says — '*  a  herpetic  vesicle  in  this  situation  is  quite 
new  to  me.''  It  may  be  so,  but  everything  must  have  a 
beginning.  I  was  attending  a  schoolboy  the  other  day  for 
a  sore  throat,  for  which  he  was  taking  Mercuriua  solubilia  6. 
At  my  third  visit  I  found  his  chin  covered  with  herpetic 
vesicles.  Shall  I  add  this  to  the  pathogenesis  of  the 
medicine? 

I  must  therefore  question  the  stability  of  a  superstructure 
raised  on  such  sandy  foundations.  But  I  find  myself  still 
less  able  to  agree  with  Dr.  Espanet  when  he  proceeds  to  the 
opposite  task,  viz. :  *^  to  retrench  from  the  pathogenesies 
the  symptoms  which  encumber  them,  and  which  render 
their  interpretation  so  difficult.'^  His  first  rule  is*—''  In«- 
determinate  symptoms,  and  those  which  are  not  en  rapport 
with  the  chief  features  of  the  medicine,  are  to  be  erased/' 
This  is  a  somewhat  '^  indeterminate''  canon,  and  among  the 


206  The  Reconsiitutim  of  the  Materia  Bfedica, 

KymptoiDs  condemned  by  it  we  find  cited  S.  135  of 
Cocculus — "  Aversion  to  food  and  drink."  Now  this  was 
observed  by  Hahnemann  in  a  case  of  poisonin§^^  of  which  I 
have  pven  the  outline  in  the  third  edition  of  my  Pharma^ 
codynamics  (p.  300) ;  and  as  regards  its  first  point  it  has 
been  abundantly  confirmed  by  clinical  experience,  as  is 
shown  by  the  type  in  which  ''extreme  aversion  to  food" 
stands  in  Allen's  Encyclopedia.  Another  rule  is  that 
"  vagrue  symptoms,  contributing  nothing"  (in  Dr.  Espanet's 
opinion)  *^  to  the  physiognomy  of  the  medicine,  and  only 
expressing  its  action  upon  a  single  experimenter,  are  to  be 
omitted."  But  among  the  specimens  given  we  find  this  of 
Arsenicum — ''  he  sleeps  on  the  back,  his  left  hand  on  his 
head"  (it  should  be  "  under  his  head" — unter  den  Kopf^  not 
Bur  la  tile).  Now  I  have  met  with  this  tendency  to  raise 
the  hands  to  the  head  in  more  than  one  case  of  poisoning 
by  Arsenic^  and  should  be  quite  loth  to  lose  it  as  a  possible 
indication  for  the  remedy. 

My  objection  to  Dr.  Espanet's  mode  of  choosing  the 
materials  for  his  analyses  and  syntheses  is  that  it  is 
uncritical.  It  is  bar.ed  upon  subjective  considerations, 
instead  of  upon  the  only  sure  ground  of  the  value  of  the 
source  of  supply.  I  never  find  any  appreciation  of  the 
authorities  for  the  several  symptoms.  Those  of  the  Reine 
Arzneimettellehre  and  of  the  Chronischen  Krankheiten^  those 
of  Hahnemann  and  his  fellow-observers  and  the  citations 
from  authors,  are  all  thrown  together  without  distinction ; 
certain  of  them  are  eliminated  for  a  priori  reasons ;  and 
with  the  remainder  his  edifice  is  built  up.  I  cannot  think 
that  by  such  a  course,  obviously  illegitimate  in  the  case  of 
anv  other  science,  we  can  arrive  at  sound  conclusions  in 
pharmacodynamics. 

3.  We  come  now  to  our  author's  mode  of  dealing  with 
his  materials,  and  here  I  shall  have  the  pleasure  of  agreeing 
much  more  largely  with  him.  Dr.  Espanet  writes  like  a 
roan  of  science  and  culture ;  and,  though  I  must  dispute 
some  of  the  details  of  his  generalisations^  his  manner  of 
proceeding  is  all  that  I  could  desire. 

He  presents  his  facts  avowedly  in  the  same  manner  as 


\ 


by  Dr.  Hughes.  267 

Dr.  Jousset ;  viz.  beginning  with  a  sketch  of  the  poisonous 
action  of  his  drug  in  its  lower  and  higher  degrees,  and  then 
describing  its  effects  as  seen  in  the  provers  under  the 
headings  of  **  Intellectual  Faculties,"  *' Animal  Facul- 
ties," and  "Vegetative  Functions/*  He  goes  on  to 
Btate  its  "mode  of  action"  (the  maniire  d'etre  of  its 
symptoms, — their  origin^  nature,  seat,  rhythm,  conditions, 
order,  succession  and  association,. and  termination);  its 
"  sphere  of  action ;''  its  "  electivity  ;"  and  its  "  characteris- 
tics/' He  next  speaks  of  its  therapeutic  effects ;  and  ends 
by  mentioning  the  medicines  complementary  to  it.  It  is 
evident  that  a  study  of  the  constituents  of  our  Materia 
Medica,  conducted  on  such  principles,  and  by  a  competent 
hand  like  Dr.  Espanet^s,  can  hardly  fail  of  being  profitable. 

Let  us  see  how  it  has  been  done  in  the  case  of 
BeUadonna. 

The  account  given  of  the  action  of  the  drug  in  toxic 
doses  is  less  instructive  than  Dr.  Jousset's,  as  it  does  not 
represent  the  phenomena  in  their  order  of  development,  but 
merely  gives  a  list  of  them.  To  one  unacquainted  with  the 
subject  it  would  hardly  convey  a  defined  idea  of  the 
Be)]adonna*intoxication.  The  description  of  the  symptoms 
elicited  by  the  provers  would  be  much  more  satisfactory^ 
▼ere  it  not  for  the  lack  of  critical  discrimination  of  which  I 
have  already  complained.  It  seems  startling  to  hear  of 
"  hemiplegia'*  and  "  partial  paralysis,  changing  its 
seat,'^  as  induced  by  "  doses  pathogenetiques "  (dis- 
tinguished thus  from  ^' doses  toxiques").  On  examina- 
tion, these  phenomena  are  found  to  have  been  taken  from 
Greding,  and  the  original  shows  them  to  have  occurred 
during  a  succession  of  epileptic  paroxysms,  so  that  they  are 
worthless  as  pathogenetic  effects  of  the  drug  which  the 
patient  was  taking.  I  should  be  glad  to  know,  moreover, 
whence  Dr.  Espanet  got  the  symptom  "elancements  et 
rongeur  dans  le  vagin."  It  is  not  in  Hahnemann,  or  in 
Allen's  copious  additions  to  his  pathogenesis. 

Turning  next  to  the  endeavour  at  a  synthesis  of  the 
symptomatology  of  the  drug,  I  find  it  vitiated  to  a  larice 
extent  by  the  unphysiological  conceptions  which  the  author 


/ 


268  The  Reconstitution  of  the  Materia  Medica, 

seems  to  entertain  as  to  the  functions  of  the  vaso-motor 
nerves.  Thus — *'the  contraction  of  the  pupils  coincides 
with  the  paleness  of  the  face,  and  with  the  primary  spasm  of 
the  vessels/'  Now  I  actual!  v  see  no  evidence  of  the  co- 
existence  of  these  phenomena.  Hahnemann  and  his  fellow- 
observers  are  the  only  authorities  among  the  24-1  collated 
by  Allen  who  have  observed  contraction  of  the  pupils,  and 
none  of  them  mentions  pale  face  in  connection  with  it. 
Moreover,  if  it  were  so,  and  the  pallor  depended  on 
"  spasm  of  the  vessels  '^  from  sympathetic  excitation,  the 
pupils  ought  to  be  dilated  rather  than  contracted.  I  have 
endeavoured  to  show,  in  my  Pharmacodynamics  and  else- 
where, that  the  state  of  the  pupil  induced  by  Belladonna  is 
a  local  effect  of  the  drug,  unconnected  with  its  general 
influence  on  the  brain,  and  one  that  cannot  be  relied  upon 
as  a  homceopathic  indication  for  the  choice  of  the  drug  in 
cerebral  affections.  Again,  "  the  contracted  capillaries''  (of 
the  first  stage  of  the  drug's  action,  as  hypothetised)  ''  chase 
the  blood  towards  the  centres  (external  coldness,  pallor, 
internal  heat) ;  the  pressure  of  the  column  of  blood  in  the 
vessels  is  augmented  (hardness  of  the  pulse) ;  the  action 
extends  to  the  nervous  centres,  to  the  hemispheres,  causing 
disturbance  of  perceptions  and  of  sensibility ;  to  the  tuber- 
cula  quadrigemina,  producing  contraction  of  the  pupils,  to 
the  corpora  striata,  and  without  doubt  to  the  cerebellum,  as 
shown  by  the  disorder  of  the  movements.''  But  does  Dr. 
Espanet  suppose  that  the  excitation  of  the  vaso-motor 
centres,  which  he  invokes  to  explain  the  phenomena,  causes 
contraction  of  the  superficial  arteries  only  ?  These  centres 
surely  control  the  arterial  calibre  throughout  the  body ;  and 
any  strong  contraction  therein  induced  (as  in  the  first  stage 
of  an  ague  fit)  chases  the  blood  into  the  veins,  and  induces 
passive  engorgement  of  the  internal  organs  (especially  of 
the  liver  and  spleen).  That  nothing  of  this  kind  manifests 
itself  in  poisoning  by  Belladonna  shows,  I  think,  that  iU 
stimulating  influence  on  the  ganglionic  centres  (though  an 
undoubted  fact)  is  but  one  part,  and  not  the  most  important 
one,  of  its  action. 

4.  Dr.  Espanet   lastly    depicts   the  therapeutic  range  of 


by  Dr.  Hughes.  269 

Belladonna,  He  proceeds  somewhat,  like  Hartmann^  in- 
dicating^ symptomaticallj  aud  pathologically,  the  place  it 
holds  in  the  treatment  of  neuroses^  neuralgias,  fevers^  iuflana- 
mations,  hsemorrhages^  chronic  maladies  and  miscellaneous 
affections.  This  part  of  his  work  seems  to  me  excellently 
done^  and  I  have  no  special  comment  to  make  upon  it^  save 
to  qoestion  the  correctness  of  speaking  of  the  pulse  in  febrile 
states  which  indicate  the  remedy  as  ''  hard  and  slow/'  It  is 
very  much  otherwise  in  scarlatina,  to  which  it  is  so  typically 
suitable ;  and  indeed  such  a  state  of  pulse  seems  to  me 
entirely  out  of  relation  with  either  the  physiological  or  the 
therapeutic  influence  of  Belladonna, 

I  hare  now  completed  my  examination  of  Dr.  Espanet's 
''Essay  towards  a  scientific  constitution  of  the  Materia 
Medics^  after  a  method  which  simplifies  aud  facilitates  its 
study/'  I  regret  that  my  task  has  had  to  be  one  of  fault* 
finding  rather  than  of  appreciation.  I  hope,  indeed^  that  I 
have  not  seemed  to  ignore  the  merits  of  the  work,  which  are 
incontestable ;  but  I  fear  that  its  defects  are  fatal  to  the 
usefulness  of  any  complete  Materia  Medica  thus  constructed. 
Besides  those  which  I  have  noted  in  detail,  I  must  pass 
upon  Dr.  Espanet's  writing  here  the  verdict  I  had  expressed 
upon  it  iu  his  former  treatise — that  it  is  '^  brilliant,  but  too 
imaginative."  There  is  a  lack  of  solid  basis  for  his  state- 
ments, of  discriminated  observation  and  weighed  testimony, 
which  gives  a  sense  of  unreality  to  them  :  the  whole  thing 
seems  up  in  the  air.  Not  a  single  name,  save  Hahnemann's 
ovn,  is  cited  in  evidence  of  anything  which  is  said ;  and  the 
easy  way  in  which  *'  hemiplegia ''  is  thrown  in  among  the 
pathogenetic  effects  of  the  drug,  as  if  it  were  quite  a  common 
occurrence  among  provers,  is  not  favourable  to  acceptance 
of  the  writer's  own  judgments. 

I  may  be  challenged,  having  thus  expressed  myself 
unsatisfied  with  the  work  of  these  two  eminent  writers,  to 
say  how  I  would  myself  have  the  Materia  Medica  presented, 
as  I  am  in  full  agreement  with  them  as  to  the  necessity  of 
improvement  upon  the  present  mode.  I  would  reply,  that  a 
series  of  drug-studies,  of  the  scope  of  Dr.  Espanet's  Bell  a  * 
donna,  and  conducted  with  the  judgment  of  Dr.   Jousst  I's 


270  The  Reconstitution  of  the  Materia  Medica. 

Digitalis,  could  not  but  be  valuable.      They  would  require, 
liowever,  ou  the  part  of  their  writers  a  due  acquaintance 
with  the  original  sources  from  which  our  pathogenesies  are 
drawn ;  a  dealing  with  the  extant  symptomatology  after  the 
recognised   methods  of  textual  criticism,  in  which  objective 
shall  predominate    over    subjective    considerations;    sound 
physiological  and   pathological  knowledge ;  and  the  capacity 
for  taking   a   wide  survey  of  the  homoeopathic  experience 
with    drugs    as    put    on    record    in    all    countries.       But 
I    apprehend    that    such  studies  could  only  include  those 
medicines     of    whose   action    we   have    the   further  know- 
ledge   which  toxicology  gives,  at   any   rate   together  with 
those  whose  provings  we  have  in  detail.      The  mass  of  drugs 
whose   pathogenesies  v^e  possess  in  schema-form   only  are 
insusceptible  of  such  treatment;  or,  if  subjected  to  it,  yield 
but  skeletons  of  bare  statement  or  pictures  of  wholly  imagi- 
nary outline.      It  is  impossible,  therefore,  thus  to  present 
the  whole  Materia  Medica ;  aud  while  I  would  have  such 
studies  of  individual  drugs  multiplied  indefinitely,  I  should 
deprecate  any  attempt  to  substitute  them  for  our  existing 
symptomatology.      Let  this  stand  as  it  is,  and  let  our  work 
upon  it  be  something  like  that  of  theologians  upon  their 
sacred   books.     As  with  them,  let   our  best  endeavours  be 
made  to  enrich,  to  purify,  and  to  illuminate  the  text.     Then 
let  those  competent  for  the  task  give  us  commentaries  upon  it, 
elncidating  its  language.    Let  the  teachers  of  Materia  Medica 
in  our  schools  publish   from  time  to  time  their  systematic 
lectures,   embodying   (as  they  must  <lo)  all  the  side-lights 
which   from  toxicology^   from  the  physiological  laboratory, 
and  from  therapeutic  experience  they  can  bring  to  bear  upun 
its  studv.*     These  will  answer  to  treatises  on  doctrinal  aud 
practical    theology ;     and    then,    for    the    sermons    which 
expound   and    apply  particular   texts,    let  us  have   clinical 
records    showing   the   bearing   of    pathogenetic    symptoms 
upon  the   phenomena    of    disease.       In    this    way,  while 
we     shall    lose    no    grain    of    fact    which   can    be  made 

*  This,  I  may  say,  is  the  work  which  I  have  iny^elfendeavoared  to  do  in  my 
Pharmacodynamics ;  so  that  when  Dr  EspBnet  blames  me  for  "deducing  too 
exclusively  from  toxicology  and  clinical  experience  the  properties  of  medicines" 
he  is  only  describing  the  limitations  of  any  seU'imposed  task. 


Cases  with  Remarks^  271 

available  in  the  oomparisoD  of  drug-action  with  dis- 
ease, there  will  be  supplied  to  everv  student  of  the 
Materia  Medica  a  general  knowledge  of  its  constituents,  of 
their  sphere  and  ki^d  of  action,  of  their  characteristic 
features  and  ascertained  effectiveness,  which  shall  send  him 
forth  fully  equipped  for  using  them  in  the  treatment  of 
disease.  There  is  thus  abundance  of  work  for  all  who 
desire  to  labour  in  the  field  of  Materia  Medica,  and  the 
more  there  is  done  of  the  kind  the  better  for  the  future 
practitioners  of  our  method. 


CASES  WITH  REMARKS. 

By  Robert  T.  Cooper,  M.D.,  T.C.D., 
Physician^  Diseases  of  the  Ear,  London  Homoeopathic 

Hospital. 

I. — An  Obscure  Ear  Case. 

It  will  serve  our  purpose  best  to  first  report  the  case 
upon  which  we  wish  to  comment,  and  then  to  append 
remarks. 

The  case  is  this.  A  boy  of  three  years  old  was  brought 
to  me  to  our  local  dispensary^  suffering  for  seven  months 
from  sleeplessness.  His  mother  states  that  he  has  never 
slept  well ;  be  is  always  fretful.  There  is  no  irritation  of 
the  seat  or  other  worm  symptoms,  although  six  weeks  ago 
he  was  troubled  with  thread-worms.  His  appetite  is  vari- 
able, and  the  bowels  are  inclined  tu  be  confined.  The  teeth 
of  the  upper  jaw  are  much  decayed,  but  without  history  of 
toothache.  The  boy^s  head  is  large,  his  forehead  square 
and  prominent,  and  large  veins  course  over  it. 

He  rolls  his  head  about  very  much  on  his  pillow. 

On  first  seeing  him,  17th  January,  1879,  I  prescribed 
Terehinthina,  third  decimal,  3  drops,  to  go  over  the  week. 

24th. — In  every  way  better ;  he  has  slept  better  than  he 
has  done  for  months,  in  fact,  quite  well^  and  his  bowels  are 
more  regular. 


271  Cases  with  Remarks, 

Prescription  continued. 

31  St  (Friday). — Till  three  o'clock  this  morning  has  been 
quite  well^  but  since  that  hour  had  not  slept.  Prescribed 
same  dose  of  Apis  meL,  third  decimal. 

7th  February  (Friday), — Has  been  sleeping  quite  well, 
but  since  Saturday  has  had  much  discharge  from  the  left 
ear. 

After  continuing  the  Apis  met.  for  the  next  week^  Kali 
hydriodicum,  in  the  second  decimal,  was  given  for  the 
otorrhoea,  with  soreness  of  the  ear  to  the  touch ;  and  by  the 
28th  February  he  left  quite  well. 

Simple  and  imperfectly  reported  as  is  the  above  case^  it 
will  help  to  teach  us  many  a  lesson. 

The  symptoms  are  very  commonplace,  and  may  appear 
unworthy  of  publication ;  and  yet,  to  a  reflective  mind,  I 
think  they  constitute  a  key-note  to  the  diagnosis  and  treat- 
ment of  a  large  proportion  of  the  acute  as  well  as  the 
chronic  affections  of  childhood. 

I  pass  over  the  fact  that  I  did  not  examine  the  child^s 
ears;  it  is  sufficient  excuse  that  an  available  opportunity 
was  not  aflPorded  me.  The  case  is  taken  from  the  books  of 
a  general  dispensary,  and  was  treated  along  with  a  crowd  of 
others,  before  I  had  read  Dr.  Woakes'  admirable  little  work 
on  Deafness,  Giddiness,  and  Noises  in  the  HeadJ^  In  this 
work,  and  at  pp.  20,  21,  we  read,  ''One  of  the  most  sug- 
gestive of  these  (i.e.  the  symptoms  following  upon  acute 
otitis)  is  rolling  of  the  head  from  side  to  side,  because  in 
my  mind  it  points  unmistakably  to  labyrinthine  mischief. 
By  this  I  mean  that  the  expansion  of  the  auditory  nerves 
in  the  internal  ear  has  become  a  participator  in  the  disease 
to  the  extent  of  disturbing  the  equilibrating  apparatus,  of 
which  the  semicircular  canals  form  a  part.  The  fact  thut 
this  organ  of  equilibration,  constituted  by  the  semicircular 
canals,  is  an  integral  part  of  the  auditory  apparatus,  gives 
to  the  diseases  of  this  region  an  interest  extending  far 
beyond  the  conditions  of  deafness  only.'' 

And  he  goes  on  to  remark — '*  This  symptom,  rolling  of 

*  H.  E.  Lewis,  London,  1879. 


by  Dr.  Robert  T.  Cooper.  273 

ihe  head  from  Hde  to  side,  I  regard  as  the  counterpart  of 
teriigo  witnessed  in  later  life^  when  the  intrinsic  circulation 
of  the  labyrinth  is  deranged,  or  its  contents  are  pressed 
upon  from  without,  as  in  Meniere's  disease/' 

In  our  case  the  connection  between  this  rolling  of  the 
head  and  aural  disease  is  established  bv  the  subsequent 
onset  of  the  ear-discharge.  That  mischief  existed  in  the 
ear,  that  it  was  the  primary  focus  of  irritation,  and  that 
such  cases  ought  to  have  attention  paid  to  them  from  the 
first  are  all  indisputable  facts. 

Bat  let  us  further  consider  the  symptoms.  These  fret- 
ful, irritable,  uneasy,  large-headed,  large  frontal-yeined 
children  are^  I  need  not  say^  very  often  the  subjects  of 
tubercular  meningitis  with  its  accompanying  cerebral 
effusion. 

That  many  of  the  minor  symptoms  of  children  owe  origin 
to  incipient  meningitis  is  obyious  to  any  conversant  with 
their  diseases. 

Now,  in  children  a  vascular  connection  exists  between 
the  ear  and  brain.  To  again  re-quote  Dr.  Woakes  (p.  14), 
''  At  this  (the  petro-squamosal)  fissure  the  dura  mater  dips 
down  into  the  cavity  of  the  tympanum,  becoming  continuous 
with  its  muco-periosteal  lining.  This  process  of  dura  mater 
carries  with  it  a  rich  endowment  of  vessels  derived  from  the 
middle  meningeal  artery,  and  which  are  the  vessels  proper 
to  the  cavity.  In  the  progress  towards  adult  life  this  fissure 
becomes  more  or  less  obliterated,  though  the  vascular  con- 
nection with  the  arteries  remains.^' 

There  is  probably  no  affection  to  which  children  are  more 
hable  than  ear-ache ;  few  children  attain  adult  life  without 
experiencing  the  tortures  of  an  ear-ache ;  but,  as  I  have 
•hovn  in  my  work  on  Inflammation  of  the  Ear,  and  as  we 
*ee  from  this  case  of  ours,  the  ear  may  be  affected  without 
any  pain  whatever,  so  that  the  inference  is  forced  upon  us 
that  if  not  the  starting-point,  it  certainly  is  the  accompani- 
ment of  a  large  proportion  of  the  diseases  of  child-life. 

Take  such  as  our  case;  a  sub-acute  otitis  exists,  this 
disturbs  the  circulation  of  the  base  of  the  brain,  the  incipient 
symptoms  of  which,  irritability,  fretfulness,  and  loss  of  sleep 

VOL.  XXXVII,  NO.  CXLIX. JULY,  1879.  8 


274  Ca$t$  with  Remarkt, 

secure  attention.  These,  in  the  hands  of  the  allopath,  would 
be  obscured  hj  a  wretched  opiate,  and  in  those  of  some  so- 
called  homoeopaths  by  monobromide  of  camphor ;  repose  is 
accepted  as  evidence  of  improTement ;  parent  and  physician 
are  satisfied,  but  nature  regards  as  vain  mockery  efforts  all 
but  malicious.  She  will  none  of  them;  the  irritation  is 
there,  in  the  ear,  and  in  the  brain.  Soon  it  spreads  along 
the  sympathetic  system,  a  dyscrasia  is  set  up,  and  in  the 
height  of  our  learning  we  declare  the  child  scrofulous.  If 
the  head  swells  (in  our  case  it  had  began  to  do  so)  we  aay 
the  case  is  one  of  tubercular  meningitis ;  if  the  condition  of 
lowered  vitality  fevours  the  development  of  worms,  we 
declare  it  a  case  of  ascarides,  and  probably  ascribe  to  these 
the  origin  of  all  the  evils,  while  if  the  abdomen  swells  and 
the  child  emaciates,  we  pronounce  it  to  be  affected  iritfa 
tabes  meeenterica;  the  idea  of  looking  into  the  ear  never 
occurs  to  us. 

Such  is  the  way  in  which  children  have  hitherto  been 
treated,  and  it  were  time  we  paid  eloser  attention,  not  alone  to 
the  treatment,  but  also  to  the  diagnosis,  of  their  complaints. 

But  the  effusion  in  the  ear  occasions  indirect  pressure 
upon  the  organ  of  equilibration,  the  semi-circular  canals. 
We  have  seen  the  symptom  that  points  to  their  involve- 
ment, and  let  us  ask,  may  it  not  be  that  the  function 
disturbance  in  St.  Vitus'  Dance,  and  the  tissue  disturbance 
in  rickets  often  owe  origin  to  no  more  extensive  alteration  of 
structure  than  that  that  obtains  in  a  sub-acute  otitis,  where 
pressure  is  exerted  upon  the  auditory  nerve-expansion. 

Whatever  else  is  uncertain,  this  is  established ;  the  ear  is 
a  fruitful,  if  not  the  main  source,  of  infantile  disease. 

Equally  true  is  it  that  in  Turpentine  we  possess  a  drug 
appropriate  in  every  way  to  infantile  disorders.  Witness  its 
vesical  irritabilities,  its  rectal  and  its  cerebral  disturbances, 
and  then  ask  ourselves  if  we  possess  its  compeer  as  an 
infantile  remedy. 

Turpeniine  will  not  kill  an  adult,  but  it  will  easily  poison 
a  child ;  it  will  affect  his  brain,  his  stomach,  his  lungs, 
kidneys,  bladder,  and  rectum ;  the  very  brain  (in  animals) 
will  smell  strongly  of  it ;  muscular  strength  diminishes^  the 


by  Dr.  Robert  T.  Cooper.  276 

power  of  co-ordination  becomes  impaired,  fe?er  is  set  np, 
Tomiting,  thirst,  and  diarrhoea. 

In  Apis  meUif,  we  have  a  remedy  that,  as  pointed  out  by 
me  in  a  paper  read  this  session  before  the  British  Homoeo- 
pathic Society,  exerts  an  effect  upon  intra-labyrinthine 
pressure;  and,  in  connection  with  these  remarks,  it  is 
significant  that  Burt  of  America  advocates  its  claims  as  our 
premier  remedy  in  tubercular  meningitis. 

A  case  of  severe  Blepharospasm  cured  with  an  unusual 
remedy. — ^The  interest  attaching  to  the  case  we  are  going  to 
report  is  so  great  as  an  example  of  a  most  painful  and  intract- 
able complaint  dispersed  very  obviously  and  very  completely 
by  a  single  and  insufficiently  known  remedy,  that  although 
the  treatment  pursued  is  not  in  accordance  with  that  which 
would  meet  with  the  approval  of  the  majority  of  the  readers 
of  this  journal,  yet  still  I  feel  sure  its  publication,  on  the 
mere  score  of  utility,  will  be  acceptable  to  us  as  practical 
physicians.  If  it  lead  some  of  our  more  active  spirits,  be 
they  Transatlantic  or  European,  to  inquire  further  into  the 
physiological  action  of  a  drug  once  a  favourite  with  curers 
of  disease,  but,  alas !  at  the  present  day  neglected  and  all 
bnt  forgotten,  a  purpose  sufficiently  useful  will  have  been 
attained. 

Fred.  E — ,  a  stout-looking  little  fellow  of  four  years  old, 
was  brought  by  his  mother  to  the  West  London  Homoeo- 
pathic Institution  in  the  February  of  1877,  with  what  seems 
to  have  been  a  particularly  obstinate  example  of  strumous 
ophthalmia. 

The  history  is,  that  two  years  ago  he  had  an  attack  of 
whooping-cough,  followed  by  herpes  of  the  right  arm  and 
right  cheek,  and  then  by  inflammation  of  both  eyes. 

His  mother  has  been  taking  him  most  of  this  time  to 
Uoorfields  Ophthalmic  Hospital,  but  instead  of  improving 
matters  they  seem  simply  to  torture  him  yet  more.  The 
child's  general  health  seems  to  be  fairly  good. 

I  at  first  put  him  upon  Calcarea  carboniea  3rd  dec, 
to  be  taken  during  the  day,  with  a  drop  of  ^  Tincture  of 
Hhus  toxicodendron  in  three  doses  every  night ;  and  at  the 


276  Cases  with  Remarks, 

same  time  ordered  an  alum  and  white»of-egg  poultice  at 
bed-time. 

The  condition  of  the  eyes  at  this  time,  I  must  mention, 
was  one  of  frightful  hypersesthesia,  and  the  torture  the  poor 
child  had  undergone  from  repeated  examinations  of  the  eyes 
at  Moorfields  had  led  him  to  dread  a  doctor  as  he  would  a 
hangman* 

It  was  simply  impossible  to  effect  a  separation  of  the  lids, 
and  I  had  to  content  myself  with  the  statement  that  for  six 
months  he  had  not  opened  his  eyes  by  daylight,  and  that,  if 
anything,  they  were  becoming  worse. 

For  the  first  week  the  above  remedies  were  gone  on  with 
benefit  to  his  general  health,  except  that  he  caught  a  fresh 
cold. 

Belladonnna  <^,  five  drops,  to  go  over  the  week,  was  now 
given;  but  the  eyes  got  worse  when  taking  it,  possibly 
from  our  having  left  off  the  alum  poultices. 

Then  (27th  February,  1877)  he  had  Soda  chhraia  ^, 
three  drops,  to  go  over  the  week,  substituted  for  the  Calcarea 
carb.  of  the  first  week,  the  alum  poultices  and  BJius  tox. 
being  gone  on  with. 

Up  to  the  middle  of  March,  treatment  had  resulted  in 
steady  improvement,  and  the  report  then  was — ''He  can 
open  his  eyes  very  fairly,  and  does  so  the  moment  I  ask 
him,  even  in  front  of  a  glare  of  gaslight,  and  for  the  last 
two  weeks,  for  the  first  time  for  many  months,  he  has 
rested  well  at  night/' 

During  the  succeeding  week,  however,  he  changed  for 
the  worse,  and  then  Sulphur  was  given,  followed  the  next 
week  by  Merc,  cor,,  but  without  improvement.  Soda 
chlorata  was  then  given  by  itself  (3rd  April) ;  but  although 
under  it  his  eyes  improved,  the  improvement  was  confined 
to  being  able  to  open  them  more  frequently. 

After  this  we  gave  him,  from  time  to  time,  Calcar.  carb. 
in  the  30th ;  Argent,  nitr.,  Soda  chlorata^  and  Rhus  tox.^  all 
these  in  the  3rd  decimal  potency.  Then  he  had  Fer.  pernio 
tricum,  one  drop  of  the  B.  P.  tincture  to  go  over  a  week. 
This  improved  his  general  state  very  decidedly^  but  his 
eyes  remained  in  statu  quo. 


by  Dr.  Robert  T.  Cooper.  277 

Ferrum  pyrqpho».,  10  grains  for  a  week,  did  still  more 
for  bis  healthy  and  sabsequently,  in  response  to  indications, 
he  had  Aconitum  nap.,  3rd  decimal;  Atropia^  3rd  decimal; 
Acid,  sulph.,  2nd  decimal;  Soda  chlorata  ^;  and  all 
without  result  so  far  as  the  intolerance  of  light  went. 

Then  (16th  July,  1877)  I  put  him  upon  Scrophtdaria 
nodosa  ^,  fourteen  drops,  for  a  fortnight;  and  the  next 
report  (14th  August)  is — ^*  Is  better  in  every  way,  opens 
his  eyes,  even  in  the  strongest  sunlight/^  He  had  not 
been  able  to  open  them  for  more  than  a  second  (in  April 
only)  since  the  middle  of  March. 

The  boy  was  after  this  sent  to  the  country ;  and  once, 
when  there,  the  eyes  threatened  to  give  trouble,  which  was 
immediately  subdued  by  the  same  medicine;  except  for 
this  he  has  ever  since  remained  perfectly  well^  and  there  is 
no  corneal  opacity. 

The  above  case  is  better  designated  by  the  simple  and 
significant  term  "  blepharospasm'^  than  by  the  comprehen- 
sive but  inaccurate  one  of  '^  strumous  ophthalmia.'^ 

The  physiological  tracing  of  the  case  requires  no  assump- 
tion of  the  presence  of  struma  or  of  psora,  albeit  that  in 
Scrophularia  it  found  its  remedy.  The  pneumogastric 
uerve^  irritated  in  the  whooping  -  cough,  disperses  its 
irritability  along  its  afferent  fibres  sent  to  the  brachial 
plexus,  which,  regulating,  as  it  does,  the  capillaries  of  the 
skin  of  the  fore-arm,  manifests  its  disturbance  by  a  crop  of 
herpes,  and  then  (I  say  then  upon  assumption,  as  our 
history  is  not  full  or  precise  as  to  the  sequence  of  events) 
the  branches  given  off  to  the  superior  cervical  ganglion, 
and  from  it,  distributed  to  the  cheek,  take  on  action; 
while,  lastly,  those  branches  that  go  to  form  the  cavernous 
plexus  are  affected,  and,  distributed  as  these  are  to  the 
muscles  and  nerves  of  the  orbit,  then  is  induced  a  local 
vaso-motor  disturbance,  denominated  much. more  justly  ble- 
pharospasm than  strumous  ophthalmia. 

Such,  at  all  events,  is  the  explanation  of  the  etiology  of 
the  above  case  in  accordance  with  Dr.  Woakes'  teaching 
in  his  admirable  little  work  on  Deafness^  Giddiness,  and 
Noises  in  the  Head. 


278 


REVIEWS. 


Evoluiiim,  Old  and  New;  or  the  theories  of  Bt^am,  Dr. 
Erasmus  Darwin,  and  Lamarck,  aa  compared  with  that 
of  Mr.  Charlee  Darwin.  By  Samuel  ButleEj  author 
of  'Erewhon/  ^The  Fair  Haven,'  *Life  and  HabU*  &c. 
(op.  4).     London :  Hardwicke  and  Bogue^  1879, 

A  WORK  on  "  Evolution''  iQight  be  considered  to  be  out- 
side the  range  of  literary  productions  proper  for  review  in  a 
periodical  with  the  special  title  we  hare  adopted,  and  yet 
our  readers  must  be  by  this  time  accustomed  to  find  in  our 
pages  notices  of  works  as  little  connected  with  our  special 
therapeutics  as  the  one  before  us.  Besides,  the  modern 
doctrine  of  evolution  fills  so  great  a  space  in  the  thoughts 
of  thinking  men  that  its  consideration  cannot  be  altogether 
inappropriate  in  a  periodical  that  professes  to  be  in  the  van 
of  scientific  progress,  and  moreover  the  doctrine  itself  has, 
by  our  German  contemporaries,  been  made  use  of  to 
elucidate  some  of  the  facts  of  our  own  therapeutics,  whether 
successfully  or  not  we  need  not  at  present  attempt  to 
determine.  Anyway  the  subject  is  of  sufficient  present 
interest  to  excuse  us,  if  we  devote  a  small  portion  of  our 
space  to  the  consideration  of  a  work  of  such  originality  as 
this  of  Mr.  Butler. 

The  circumstance  that  the  author  is  not  known  as  a 
scientist,  and  has  not  distinguished  himself  by  any  special 
researches  in  natural  history,  will  no  doubt  militate  somewhat 
against  the  serious  consideration  of  his  views  by  professional 
scientists.  And  the  other  circumstance,  that  Mr.  Butler  is 
known  as  the  author  of  a  work  of  satirical  fiction  like 
Erewhon,  and  of  a  piece  of  clever  mystification  like  7%«  Fair 
Haven,  must  prejudice  him  in  the  minds  of  serious  philo- 
sophers, when  he  comes  before  them  as  the  antagonist  of 
the  almost  universally  credited  doctrine  of  ''natural 
selection.''  Such  a  prejudice,  we  are  convinced,  served  to 
deter  many  of  the  exponents  of  science  from  looking  at  his 


Evolution,  Old  and  New.  279 

previoot  work,  Ltfe  and  Habit,  as  aagbt  else  than  an 
elaborate  satire  on  proFalent  opinion  regarding  the  origin 
of  species.  And  yet  this  work,  though  in  some  parts 
vritten  in  a  strain  of  banter,  strongly  recalling  the  ingenious 
nonsense  of  Erewhon^  is  replete  with  profound  and  original 
reasoning  and  incisive  criticism  of  some  of  the  most  cherished 
doctrines  of  Darwin  and  his  followers,  which  it  would  be 
difficult  for  the  modem  evolutionists  to  answer,  so  they  were 
fain  to  let  it  alone,  pretending  to  regard  it  as  Kjeu  d' esprit 
qaite  outside  the  domain  of  practical  science. 

The  present  work  is  written  in  a  more  serious  style,  and 
is  evidently  the  outcome  of  a  laborious  investigation  of  the 
whole  theory  of  evolution.  It  displays  a  depth  of  patient 
research  and  an  acuteness  of  reasoning  that  remove  it 
altogether  from  the  region  of  mere  dilettante  superficiality, 
and  place  it  in  the  front  rank  of  critical  works  on  the 
evolution  theory.  The  author  has  taken  infinite  pains  to 
Sflcertain  the  true  history  of  the  theory,  and  has  given  us  a 
succinct  view  of  its  origin  and  progressive  development.  In 
doing  this,  he  has  considerably  abated  the  accredited  claims 
of  Mr.  C.  Darwin  to  originality,  and  he  has  shown  that 
where  the  great  modern  apostle  of  evolution  has  departed 
from  the  positions  taken  up  by  his  predecessors  in  this 
field,  he  has  by  no  means  improved  on  the  older  doctrines. 

The  opening  chapter  sets  forth  a  question  which  is  the 
key-note  to  the  work.      It  is  thus  stated  : 

"  Can  we  or  can  we  not  see  signs  in  the  structure  of 
animals  and  plants,  of  something  that  carries  with  it  the 
idea  of  contrivance  so  strongly  that  it  is  impossible  for  us 
to  think  of  the  structure  without  at  the  same  time  thinking 
of  contrivance  or  design  in  connection  with  it  ?" 

This  qneationy  he  says,  it  is  his  object  in  the  present  work 
to  answer  in  the  afiSirmative.  This,  the  teleological  or 
porposive  view  of  nature,  has  been  held  chiefly  by  theolo- 
gians, but  has  been  rejected  with  scorn  by  the  exponents  of 
latter-day  evolutionism;  chiefly,  it  seems  to  us,  because  it 
teemed  to  be  necessarily  connected  with  the  theological  idea. 
Mr.  Butler  quotes  the  weU-known  introductory  passage  in 
Paley's  Natural  Theology.     He  admits  the  truth  of  Paley's 


280  Review9. 

ailment  as  to  a  design  aud  a  designer,  but  differs  entirety 
from  him  as  to  who  and  where  the  designer  is.  Paley,  of 
conrse,  as  a  theologian,  makes  the  designer  external  to  the 
organism  designed ;  our  anthor  makes  the  organism  its  own 
designer. 

In  lAfe  and  Habit  he  had  already  endeavoured  to  show 
that  the  production  of  parts  and  organs  and  all  their  modi- 
fications was  caused  by  the  endeavours  of  the  living  being, 
whether  animal  or  plant,  or  parts  thereof,  to  attain  certain 
desirable  objects.  An  individual  organised  being  is  not  to 
be  looked  on  as  a  totally  inexperienced  isolated  personality, 
but  as  a  being  containing  within  itself  the  accumulated  expe- 
rience of  all  its  ancestors,  possessing  the  memory  of  all  the 
efforts  of  its  predecessors  to  attain  certain  results,  and  this 
memory  serves  it  to  do  all  that  its  progenitors  had  learned 
to  do,  to  start  from  the  advanced  point  they  had  already 
attained,  and  to  effect,  in  its  own  person,  new  modifications 
in  its  organism  calculated  to  improve  on  the  processes 
adopted  by  them,  and  under  novel  circumstances  to  develop 
new  organs  or  modifications  of  existing  organs  suited  to 
these.  The  term  memory,  as  applied  to  the  performance 
of  acts  that  have  for  countless  generations  been  performed 
by  its  ancestors,  is,  he  explains,  not  the  conscious  effort 
generally  understood  by  that  word,  but  an  unconscious 
memory  or  automatic  action,  such  as  we  observe  to  take 
place  in  regard  to  actions  that  have  been  very  frequently 
performed. 

He  illustrates  this  by  reminding  us  that  when  any  action 
is  so  frequently  performed  that  it  becomes  a  habit  we  are 
unconscious  of  any  effort  in  doing  it,  and  the  more  perfectly 
the  action  is  performed  the  more  utterly  is  the  consciousness 
of  it  lost.  Thus,  walking,  which  was  originally  performed  by 
painfully  conscious  efforts,  after  a  while  is  performed  without 
any  conscious  effort.  The  same  with  other  acquired  actions,  as 
reading,  playing  on  a  musical  instrument,  and  so  forth. 
These  actions  only  become  perfect  when  all  conscious  effort 
in  doing  them  is  lost.  So  the  animal's  development  of 
itself,  from  the  primordial  cell  to  the  perfect  animal,  has 
been    repeated    so    often    through    countless   generations 


Evolution,  Old  and  New.  281 

that  it  has  become  a  habit,  and  is  carried  on  without 
eonsdousness,  i.  e.  automatically. 

We  are  so  used  to  associate  the  so-called  mental  functions 
of  will^  purpose^  memory,  &c.^  with  a  complex  organised 
structure  like  the  brain,  that  we  are  apt  to  overlook  the 
numerous  proofs  around  us  of  these  mental  qualities  being 
possessed  by  animals,  and  even  by  plants  which  are  destitute 
of  brains.  Indeed,  we  see  all  these  mental  faculties  displayed 
in  the  amoeba,  which  moves  about,  makes  itself  arms  and 
legs  according  to  its  wants,  assimilates  the  pabulum  it  likes 
and  rejects  that  it  deems  unsuitable,  turns  aside  from  other 
an)(eb»  for  fear  of  injury,  or  makes  haste  towards  some 
beloved  one  of  its  own  species,  by  whom  it  allows  itself  to  be 
absorbed  and  annihilated  in  a  delicious  Nirwhana.  And  yet 
the  being  that  gives  all  these  evidences  of  will,  design, 
memory,  affection,  and  emotion,  is  but  a  transparent 
droplet  of  structureless  protoplasm.  Who  that  has  watched 
the  pus  globule  in  urine  tentatively  throwing  out  feelers  and 
limbs  in  all  directions  in  order  to  see  if  it  cannot  adapt  itself 
to  the  novel  circumstances  in  which  it  finds  itself^  and  at 
length  giving  the  matter  up  in  despair  and  submitting  to 
its  fate,  not  without  a  brave,  though  vain,  struggle  for 
existence,  can  doubt  that  each  cellule  of  our  living  body  has 
its  own  instincts,  its  wishes,  its  aversions,  its  memories  and 
purposes  ?  So  little  respect  had  Buffon  (as  our  author  shows 
us)  for  the  notion  that  the  brain  is  the  centre  of  perceptions 
and  the  seat  of  the  sensations,  that  he  regarded  it  merely  as  the 
pabulum  to  nourish  the  nerves  which  struck  their  roots  into 
it,  as  a  flower  sends  its  roots  into  the  earth  of  the  flower- 
pot. If  he  were  to  make  a  choice  he  would  rather  refer 
the  centre  of  sensation  and  of  all  the  vital  powers  to  the 
diaphragm,  or  if  it  must  be  located  in  the  head,  then  he 
would  rather  place  it  in  the  meninges^  and  certainly  not  in 
the  medullary  part  of  the  brain. 

The  production  of  varieties  of  species  and  genera  is  deter- 
mined by  the  different  circumstances  or  surroundings  of  the 
organised  being  and  its  efforts  to  adapt  itself  to  these  circum- 
stances. The  slight  modifications  caused  by  these  efforts 
gives  an  advantage  to  the  individuals  in  whom  these  modi- 


282  Reviews. 

fications  appear  over  those  who  have  not  broaght  about  theM 
modifications  in  their  struggle  for  existence,  and  this  is  ia 
fact  the  explanation  of  the  *'  sorriyal  of  the  fittest/'  These 
useful  modifications  being  transmitted  to  the  offspring  are 
improved  by  them^  and  in  this  way  varieties,  species^  and 
genera  are  in  the  lapse  of  ages  produced  and  perpetuated. 

This  doctrine,  or  something  like  this,  Mr.  Butler  shows 
from  their  writings  to  have  been  held  by  Buffbn,  Dr. 
Erasmus  Darwin,  and  Lamarck;  and  he  holds  it  to  be 
more  rational  and  true  than  the  ''doctrine  of  natural 
selection  ''  promulgated  by  Mr.  Charles  Darwin,  which  haa 
been  so  generally  accepted  in  our  day.  Mr.  Darwia^s  doctrine 
briefly  stated  is,  that  from  no  known  cause  animals  and  plants 
have  a  tendency  to  develope  modifications  of  their  organs  (to 
'^sport'^  as  the  botanists  say)  and  that  such  of  these  modifica- 
tions as  are  useful  to  their  possessors  gain  them  ail  advantage 
over  other  individuals  who  have  not  developed  these  accidental 
modifications,  so  that  those  survive  while  these  perish.  Accord- 
ing to  Mr.  Butler  the  modifications  of  the  organism  whereby 
new  varieties  and  species  are  produced  are  purposive  or  teleo* 
logical,  while,  according  to  Mr.  Darwin,  they  are  not  pur* 
posive  at  all,  but  purely  accidental.  In  Mr.  Butler^s  view 
the  modifications  of  plants  and  animals  that  lead  continually 
to  the  formation  oi  new  species  and  genera  are  the  result 
of  the  efforts  of  the  living  organisms  to  adapt  themselTes  to 
surrounding  conditions,  while,  according  to  the  Darwinian 
doctrine  of  "  natural  selection,^'  surrounding  conditions  are 
the  detis  ex  machind  constantly  on  the  watch  to  encourage 
modifications  of  organisms  produced  by  haphazard.  Which 
is  the  more  rational  theory  we  leave  the  reader  to  judge ; 
which  are  best  supported  by  facts  he  must  decide  for  himself 
by  studying  the  works  and  authorities  on  either  side. 

We  have  not  space  to  reproduce  here  Mr.  Butler's  argu- 
ments in  support  of  his  view,  but  we  must  say  they  are 
very  ingenious  and  well  and  clearly  stated ;  and  the  passages 
he  quotes  from  the  older  authors  above  named,  and  others 
we  have  not  mentioned,  fully  justify  him  in  claiming  them 
as  witnesses  on  his  side.  We  would  earnestly  advise  all 
who  feel  an  interest  in  the  important  subject  of  evolution 


Hommopathic  Therapeutics.  28H 

and  the  origin  of  species  to  read  Mr.  Butler^s  book^  which, 
while  it  is  thoroughly  well  reasoned  out  and  logical^  sparkles 
all  over  with  quaint  flashes  of  humour  and  racy  satire  that 
make  it  anything  but  dull  reading. 


Honueopatkic  Therapeutics.    By  S.  Lilibnthal^  M.D.    New 
York :  Boericke  &  Tafel.     London  :  Triibner  &  Co. 

This  Tolume  is  on  the  plan  of  Jahr's  Clinical  Guide,  but 
its  702  closely-printed  pages  of  large  octavo  supply  far  more 
information  than  that  work  ever  pretended  to  do.  It  is  a 
product  of  great  industry  on  the  part  of  its  author^  and  is 
likely  to  be  of  considerable  service  to  many  a  young  practi- 
tioDer^  while  not  without  usefulness  in  the  way  of  reminder 
to  those  more  advanced.  It  must  be  taken^  however,  with 
a  strong  seasoning  of  modern  knowledge  about  disease,  which 
Br.  Lilienthal  has  shown  good  evidence  of  possessing,  but 
which  he  hardly  displays  in  his  present  undertaking.  We 
meet,  for  instance,  with  an  article  on  **  Atrophy  of  the 
Spinal  Marrow/'  which  identifies  it  with  the  locomotor 
ataxy  (posterior  spinal  sclerosis)  of  the  present  day  and  the 
tabes  dorsalis  of  the  past^  but  which  gives  as  its  most  useful 
remedies  **  Alum,,  N.  vom.,  Sulph./*  and  states  that  Jahr 
treated  (does  he  mean  successfully  ?)  twenty-one  cases  of  it 
with  rare  doses  of  Nua^  vomica  and  Sulphur.  They  '^  arose 
from  onanism ;  were  accompanied  with  hypochondria^  de- 
spondency, and  aversion  to  life;  and  the  characteristic 
unsteadiness  of  the  limbs  and  the  peculiar  formication  of  the 
back  were  present  in  every  case.''  Surely  Dr.  Lilienthal 
mnst  see  that  these  are  cases  of  simple  spinal  exhaustion 
from  sexual  excess^  and  have  nothing  to  do  with  progressive 
locomotor  ataxy. 

Dr.  Lilienthal  rarely  cites  authorities;  and  the  plan  of 
bis  work  probably  excludes  them.  But  we  think  he  should 
have  brought  forward  some  evidence  when  he  has  made  such 
surprising  statements  as  that  '^  one  of  the  principal  remedies 
for  angina  pectoris  seems  to  be  Hepar "  (p.  24),  and  that 


284  Reviews, 

*'  for  morbus  maculosus  Werlhofii  the  prindiml  remeij  is 

HoweTer,  with  all  deductions,  the  book  is  a  valuable  one  ; 
and  its  indefatigable  compiler  deserves  our  best  thauks. 


Lectures,  Clinical  and  Didactic,  an  the  Diseases  of  Women  ^ 
By  B.  LuDLAM,  M.D.,  Professor  of  the  Medical  and 
Surgical  Diseases  of  Women  in  the  Hahnemann  Medical 
College  and  Hospital  of  Chicago.  Fourth  edition* 
Chicago :   Duncan,  Brothers. 

Ws  reviewed  the  second  edition  of  this  book  of  Dr. 
Ludlam's  in  our  thirty-6rst  volume^  and  testified  our  high 
appreciation  of  it.  Its  appearance  now  in  a  fourth  showa 
that  others  have  felt  similarly  about  it;  and  to  the  same  effect 
speaks  its  translation  into  French,  which  is  just  announced 
as  having  been  completed  by  Drs.  Claude  and  Dorion.  This 
latest  issue  contains  unchanged  the  matter  of  the  second 
edition,  if  we  may  judge  by  the  number  of  lectures  atid 
pages ;  but  two  more  of  the  former  are  appended— one  on 
ovariotomy,  in  which  operation  Dr.  Ludlam  seems  to  have 
had  considerable  experience  and  success^  and  the  other  on 
puerperal  endo-metritis.  To  the  first  of  these  we  must  be 
content  to  refer  our  surgical  readers ;  the  second  contains 
matter  of  practical  interest  for  us  all.  The  clinical  history, 
diagnosis  and  general  management  of  the  disorder  of  which 
he  treats  are  given  with  the  author's  wonted  fulneals  and^ 
clearness;  and  some  valuable  remarks  are  made  about 
remedies.  Arsenicum  is  declared  to  be  **  even  more  im- 
portant in  puerperal  endo-metritis  than  it  is  in  the  non- 
puerperal variety  of  the  disease/'  Dr.  Ludlam  reiterates 
his  praise  of  Veratrum  viride  as  more  effective  than  Aconile 
in  the  various  forms  of  pyrexia  occurring  in.  the  lying-in 
woman;  but  he  conjoins  alcohol  with  it  when  there  is 
septic,  quinine  when  there  is  purulent  infection.  Of  the 
latter  he  gives  from  four  to  six  grains  in  divided  doses  daily. 
He  concurs  in  the  commendations  givento  Calcarea — ^'another 
puerperal  polychresf  (besides  Veratrum  viride)  he  calls 
it — as   promoting   uterine  involution    when    it   has    been 


Remarks  on  Similia  Similibus  Curantur,  285 

hindered  by  any  cause ;  and  he  speaks  well  of  Tartar  emetic 
(3x)  in  the  hyperplasia  that  follows  idio-metritis,  and  of 
Apis  in  the  induration  resulting  £rom  exo-metritis  (t.  e. 
inflammation  of  the  cellular  tissue  about  the  uterus). 

We  are  pleased  to  see  that  Dr«  Ludlam^s  work  has  attained 
the  honour  of  translation  into  French,  as  mentioned  above. 
We  trust  that  in  this  form  it  will  give  to  our  colleagues 
on  the  Continent  the  same  instruction  and  pleasure  it  has 
long  conveyed  to  English  readers^ 


Some  Remarks  on  Similia  Similibus  Curantur,     By  W.  B. 
Dunning,  M.D.     Hartford,  XJ^S.A. 

This  paper,  read  originally  before  the  Homoeopathic  Me- 
dical Society  of  the  State  of  Oounecticut,  has  been  thought 
worthy  of  separate  publication,  as  furnishing  an  explanation 
of  the  action  of  similar  remedies.  It  proceeds  upon  the 
doctrine  of  re-action,  and  puts  it  very  clearly  and  plausibly. 
This  was  always  Hahnemann's  thought  about  the  rationale 
of  the  homoeopathic  process;*  but  it  was  connected  by  him 
with  his  views  about  the  primary  and  secondary  action  of 
medicines.  Dr.  Dunning  avoids  this  complicating  element, 
as  well  as  the  theory  of  the  opposite  action  of  large  and 
small  doses  in  health.  He  argues  that  a  drug,  when  intro- 
^doced  into  the  system,  impresses  some  part  of  it  in  a  mor- 
bid way,  and  in  so  doing  encounters  its  vital  reaction.  It 
depends  upon  the  quantity  administered,  or  upon  the  sus- 
ceptibility and  energy  of  the  frame,  which  of  these  shall 
prevail ;  whether  the  drug  shall  bend  the  vital  functions  out 
of  their  due  course,  or  whether  these  shall  react  against  it 
--of  course,  in  the  opposite  direction.  True  pathogenetic 
effects  he  supposes  to  be  of  the  former  order,  while,  when 
given  as  a  remedy  for  such  conditions  otherwise  induced, 
the  medicine — ^if  the  dose  be  small  enough— excites  the  coun- 
terbalancing vital  reaction,  and  restores  the  equilibrium. 

There  are  obvious  objections  to  this  rationale  of  homoeo- 

*  See  Monthly  Som,  Seview,  xxi,  140. 


286  Beviewi. 

pathie  care,  but  it  is  hardly  profitable  to  make  them.  Dr. 
Dunning's  object  is  to  remove  a  stumbliDg  block  out  of  the 
way  of  practitioners  of  the  old  school,  who  are  arerse  to 
accepting  a  merely  empirical  law.  If  his  ingenious  argu- 
ment should  commend  itself  to  them,  we  should  be  loth  to 
hinder  their  acpeptance  of  the  truth  by  casting  any  doubt 
upon  his  explanation  of  it. 


Lectures  on  Materia  Medica.     By  Carroll  Dunham,  M.D. 

2  vols. 

These  volumes  constitute  the  second  and  third  of  the 
series  of  the  lamented  author's  collected  writings^  the  first  of 
which  we  reviewed  some  time  ago  under  its  title  of  '^  Ho- 
moeopathy the  Science  of  1? herapeutics/'  They  contaii^ 
eight  lectures  upon  the  general  principles  of  studying  and 
applying  the  Materia  Medica,  and  articles  upon  fifty-two 
separate  drugs,  the  whole  being  preceded  by  an  afiectionate 
sketch  Df  the  life  and  character  of  the  author  by  Dr.  Kellogg. 

The  lectures  upon  general  principles  embody  Dr.  Dun- 
ham's frequently-expressed  views,  with  his  wonted  clearness 
of  thought  and  lucidity  of  style.  The  distinction  between 
the  sphere  of  hygiene  and  that  of  therapeutics,  the  value 
of  symptomatology,  the  importance  of  the  anamnesis,  the 
contrast  between  the  '^  pathognomonic "  symptoms  which 
determine  the  nature  of  the  disease  and  those  "  character- 
istic ''  ones  which  indicate  the  remedy, — all  these  points  are 
well  made  and  sustained.  As  more  novel,  we  note  the  answer 
made  to  the  objection  urged  against  similia  sAmilibus  curantur 
by  some,  that  it  is  a  merely  empirical  law,  resting  on  no  ra- 
tional understanding  of  the  causes  of  the  phenomena.  Dr. 
Dunham  aptly  argues  that  the  same  thing  is  true  of  the 
greatest  generalisations  of  physics,  as  the  laws  of  gravitation 
and  of  chemical  combination ;  but  that  they  are  not  less  valu- 
able and  fruitful  for  all  that.  We  observe,  too,  that  he  agrees 
with  Fletcher  in  his  description  of  the  nature  of  drugs^ 
speaking  of  them  as  '*  special  stimuli ''  in  contrast  with  the 


Lecturer  on  Materia  Medica,  S87 

fjvneral  stimuli — heat,  lights  electricity^  &c.  Another  very 
satisfactory  thing  is  the  hearty  regard  he  displays  for  phy- 
siology and  pathology,  however  little  he  will  allow  their 
interpretations  and  hypotheses  to  take  the  place  of  the  actual 
facts  of  the  ease.  He  proclaims  the  essential  importance  of 
a  knowledge  of  these  sciences  **  for  the  proper  study  of 
symptoms  before  we  get  ready  to  prescribe  for  our  patients/' 

The  articles  upon  particular  drugs  are  of  very  unequal 
▼slue.  Some  of  them— «s  those  on  Aconite,  Bryonia,  Rhufy 
ftc. — ^are  reprints  of  the  studies  in  the  Materia  Medica  which 
have  at  Tarious  times  appeared  from  his  pen,  chiefly  in  the 
pages  of  the  American  HomoBopathic  Review.  Their  value  was 
uniT^rsally  recognised ;  and  the  present  reviewer  urged  upon 
Dunham,  in  1876,  the  desirableness  of  collecting  them 
into  one  pablication.  They  come  to  us  rounded  from  his 
own  band ;  and  several  other  medicines  are  treated  of  in 
a  similar  manner,  giving  the  impression  that  he  had  pre- 
pared them  to  follow  those  already  put  in  print.  A  number 
of  the  drugs,  however,  are  discussed  in  a  very  brief  and 
fragmentary  way  ;  and  the  impression  is  given  that  we  have 
only  the  notes  upon  them  from  which  he  lectured  extempore 
to  his  class.  A  few  additions  have  been  made  (apparently 
by  the  editor)  from  other  sources,  including  his  last  paper, 
that  on  Sepia,  published  after  its  recent  re-proving  by  the 
American  Institute. 

Speaking  of  the  editing,  we  cannot  but  regret  that  it  was 
not  committed  to  professional  rather  than  retained  in  merely 
kindred  hands.  A  good  many  clerical  errors  might  thus 
have  been  avoided  (such  as  this  about  Hering's  proving  of 
Laehens — ''the  result  was  published  in  'Archiv,'  and  in 
his  monograph  *  Schlangengift ' '') ;  and  we  should  hardly 
have  had  the  inconvenience  of  possessing  two  volumes  of 
Materia  Medica  without  distinction  of  1  and  %,  or  of  finding 
no  publisher's  name  on  the  title  page ;  to  say  nothing  of  the 
absence  of  an  index. 

These  are  small  matters,  however,  and  we  have  to  thank 
Dr.  Dunham's  family  (now,  alas  I  limited  to  his  children) 
for  this  further  instalment  of  the  precious  legacy  bequeathed 
us  by  him,  and  to  commend  it  to  all  our  readers. 


288  Reviews. 


The  Guiding  Symptoms  of  the  Materia  Medica.  By  C. 
Hebino,  M.D.  Vol.  1.  Alnes^Armoracea.  Phila- 
delphia :  J.  M.  Stoddart  &  Co. 

As  we  mentioaed  in  our  last  number^  an  enterprise^  after 
the  fashion  of  our  Hahnemann  Publishing  Society^  has  been 
started  in  America^  and  the  present  rolume  is  its  first 
undertaking.  It  is  to  be  the  first  of  a  series  of  ten, 
carrying  on  the  same  subject. 

Dr.  Hering's  preface  states  that  this  work  is  principally 
a  collection  of  cured  symptoms — produced  as  well  as  cured, 
or  simply  cured.  But  it  also  includes  many  on  the  ground 
of  their  having  been  observed  on  more  than  one  herithy 
person.  These  are  marked  as  '^  confirmed/'  those  produced 
and  cured  as  ''  verified  '^ ;  and  each  kind  admits*  of  two 
degrees,  according  as  the  confirmation  or  verification  has 
been  rare  or  frequent.  **  Characteristics  "  also  are  denoted 
by  a  special  sign,  as  explained  at  the  outset.  The  whole 
collection  is  intended  to  supply  the  "  guiding  symptoms  " 
for  the  use  of  each  drug. 

The  venerable  author  has  more  fully  explained  the 
thought  which  has  prompted  his  work  in  a  communication 
to  the  April  number  of  The  Organon,  He  recognises,  with 
Bomewhat  of  regret,  that  Dr.  Allen  has  yielded  to  BritiaM 
influence  in  excluding  the  so-called  '*  clinical "  symptoiQS 
from  his  Encyclop€edia.  We  are  proud  to  bear  the  onus^ 
if  ours  it  is,  of  this  most  salutary  determination  on  his 
part ;  and  we  are  quite  sure  that  his  work  would  not  have 
gained  the  acceptance  it  has  met  with  throughout  the 
homoeopathic  world  unless  such  restriction  had  been  ob^ 
served.  We  do  want,  first  of  all,  a  collection  of  the  pure 
pathogenetic  effects  of  drugs ;  and  it  is  strange  that  any 
disciple  of  Hahnemann,  considering  his  teaching  and  example^ 
should  grudge  it  us.  But  we  fully  aqknowledge  that  there 
is  other  work  to  be  done,  and  that  Dr.  Bering's  undertakiDg 
fulfils  a  part  of  it. 

Of  the  execution  of  the  work  it  is  difficult  to  speak  critically. 
The  validity  of  the  symptoms  themselves,  and  of  their  coo- 


Guiding  Symptoms  of  the  Materia  Medica.         289 

firmatioBs  and  yerifications^  rests  solely  upon  Dr.  Hering's 
anthority.  No  references  are  given  to  the  cases  from  which 
the  latter  are  derived^  and  none  but  of  the  scantiest  kind  to 
the  proYings  which  warrant  the  former.  However,  the 
author's  extensive  knowledge  and  unwearied  industry  must 
recommend  his  markings  to  us  as  the  result  of  a  sufficiently 
^de  survey  of  the  facts  of  the  case.  Of  his  judgment  we 
cannot  feel  so  sure,  remembering  all  his  sayings  and  doings 
in  the  past;  and  we  may  count  upon  there  being  a  large 
proportion  of  chaff  mixed  with  any  wheat  he  may  give  us  in 
the  form  of  symptoms.  *^  It  has  been  my  rule  during  life/' 
he  says^  '^  never  to  accept  anything  as  true  unless  it  came 
as  near  mathematical  proof  as  possible  in  its  domain  of 
science^  and  on  the  other  hand^  never  to  reject  anything  as 
false  unless  there  was  stronger  proof  of  its  falsity .''  So 
tbat^  if  a  symptom  has  once  been  placed  under  a  medicine 
by  any  hand^  the  evidence  which  would  lead  him  to  expunge 
it  must  be  still  nearer  mathematical  proof  than  is  possible  in 
its  own  domain  of  science !  Probably  this  is  the  reason  why 
Dr.  Hering  has  retained  ''leucorrhoea,  copious^  tenacious^ 
yellow '^  among  the  symptoms  of  Aconite,  It  has  been 
shown*  that  Hahnemann  took  it  from  a  case  of  Stoerck's^ 
in  which  a  tumour  in  the  iliac  region  disappeared  under 
the  action  of  the  drug^  its  subsidence  being  accompanied 
with  the  vaginal  flux  above  described:  If  any  one  now 
recorded  such  a  case,  Dr.  Hering — ^like  every  one  else- 
would  conclude  that  the  discharge  came  from  the  tumour  as 
it  emptied  itself,  and  would  be  the  last  to  set  it  down  as  a 
pathogenetic  effect  of  the  drug  the  patient  was  taking. 
Bat,  since  Hahnemann  has  admitted  it,  no  demonstration  of 
its  inyalidity  can  procure  its  expulsion.  Dr.  Hering  marks 
it,  indeed,  as  having  been  confirmed,  and  that  frequently ; 
but  no  corresponding  symptom  appears  in  Allen's  patho- 
genesis, and  it  is  a  most  unlikely  effect  of  such  a  drug  as 
Aconite, 

Well,  we  must  take  Dr.  Hering  as  he  is,  for  better  and 
for  worse.  There  can  be  no  question  of  his  having  supplied 
a  mass  of  valuable  matter  in  the  present  work.     Apart 

*  See  Monthly  Horn.  SevieWf  xvii,  699. 
VOL.  XXXVIl^  NO.  CXLIX. JULY,  1879.  T 


290  Reviews. 

from  his  selections  and  markings  of  symptoms,  the  intro- 
ductory accounts  of  the  successive  proviugs  of  the  various 
drugs  are  full  of  interest,  and  are  only  marred  by  the  lack 
of  references ;  while  the  sections  "  tissues/'  "  stages  of  life 
and  constitution/'  and  '^  relationship/'  which  close  each 
symptom  list,  often  convey  very  useful  information.  We 
recommend  every  one  who  desires  a  thorough  knowledge  of 
his  Materia  Medica  to  take  a  share  in  the  American 
Homoeopathic  Publishing  Company,  and  so  to  become  a 
possessor  of  Dr.  Hering's  work  at  cost  price. 


Eye  Notei.     By  Dr.  C.  H.  Vilas.     Nos.  1  and  2. 
Ear  Notes.     By  the  same. 

''These  notes/'  says  the  author,  ''were  prepared  to 
assist  in  the  study,  and  form  the  basis  of  the  didactic 
lectures  on  the  embraced  subjects  as  given  by  the  author  at 
the  Hahnemann  Medical  College  and  Hospital,  Chicago. 
They  are  necessarily  concise,  condensed,  and  elementary  in 
their  character^  and  are  in  no  sense  designed  to  take  the 
place  of,  or  in  any  way  supersede,  the  treatises  on  the 
subject,  but  are  intended  to  suggest  the  topics  to  be  further 
studied,  to  pick  out  of  the  mass  of  writings  the  essential 
fundamental  principles  and  main  diagnostic  points,  and  to 
suggest  the  line  of  treatment.  *  Their  cordial  reception,  not 
only  by  students,  but  by  practitioners^  has  seemed  to  be 
sufficient  reason  for  a  publication  more  general  than  was 
originally  intended/' 

The  above  statement  will  suffice  to  show  the  nature  of 
these  "  Notes."  They  are  inscribed  upon  a  number  of 
cards,  each  containing  one  or  more  diseases ;  and  a  great 
deal  of  information  is  conveyed  by  them  in  a  very  condensed 
form.  They  will  hardly  be  so  useful  to  practitioners,  who 
require  fuller  discussion  of  the  subjects,  as  to  the  students 
for  whom  they  were  intended;  but  even  to  the  former  a 
glance  at  them  may  often  supply  a  suggestive  reminder. 
They  are  to  be  obtained  of  Dr.  Vilas  himself  at  the 
Hahnemann  College  and  Hospital,  Chicago. 


An  Illustrated  Repertory.  291 


An  Illustrated  Repertory  of  Pains  in  Chest,  Sides,  and 
Back:  their  Direction  and  Character  confirmed  by 
Clinical  Cases.  By  Rollin  R.  Gregg,  M.D.  Chicago: 
Duncan  Brothers. 

This  book  is^  as  its  name  imports,  an  illustrated  repertory. 
Views  are  given  of  the  front,  back,  and  sides  of  the  chest 
and  abdomen ;  and  on  the  surface  of  these  parts  are  traced 
arrows  indicating  the  course,  direction,  and  character  of  the 
stitching  pains  experienced  there  by  the  provers  of  drugs. 
In  the  accompanying  letterpress  the  symptoms  thus  figured 
are  printed  in  full. 

We  think  the  idea  a  very  happy  one,  and  likely  to  prove 
of  much  usefulness.  Patients  often  complain  of  anomalous 
pains,  and  are  glad  to  get  relief  from  them,  though  neither 
the  sensations  they  have  nor  the  remedies  we  employ  are 
related  to  deeper  complaints  for  which  we  may  be  treating 
them.  We  can  best  help  them  by  administering  a  drug 
which  has  caused  similar  pains  on  the  healthy  subject ;  and 
such  a  drug  can  be  much  more  rapidly  found  by  looking  at 
one  of  Dr.  Gregg's  plates  than  by  turning  over  the  pages  of 
an  index  to  the  Materia  Medica.  It  may  sometimes 
happen,  moreover,  that  these  pains  have  a  true  pathological 
reUtion  to  the  patient^s  whole  morbid  state ;  in  which  case 
the  remedy  homoeopathically  indicated  by  them  may  do 
good  generally,  and  may  even  prove  to  be  the  true  simile  of 
the  malady.  Dr.  Gregg  gives  some  instances  in  which  this 
seems  to  have  obtained. 

We  could  have  wished  that  Dr.  Gregg  had  sought  more 
satisfactory  sources  for  his  symptoms  than  those  which  he 
enumerates,  viz.  '  Hahnemann's  Chronic  Diseases,'  the 
'  Symptomen  Codex,'  and  Hull's  '  Jahr's  Symptomatology/ 
To  assume,  as  he  does,  that  "  all  the  symptoms  given 
there  were  procured  by  trials  of  the  several  drugs  upon  well 
persons"  is  as  dubious  in  fact  as  it  is  in  English. 


292  Reviewi. 


The  Modern    Physician  and  Family   Doctor:    a  Monthly 
'  Journal  of  Domestic  Medicine,  Hydropathy y  and  Sanitary 
Science,     Allen,  Stationers'  Hall  Court,  E.G. 

We  have  received  the  first  number  of  this  new  Journal ; 
but  are  unable  to  see  any  raison  d'Stre  for  its  appearance 
beyond  that  of  advertising  its  editor^  the  address  of  whose 
consulting  rooms  is  given  at  the  close  of  two  articles  in  it 
proceeding  from  his  pen.  We  shall  not  add  to  the 
publicity  thus  sought  by  mentioning  his  name  here. 


Gold  as  a  Remedy  in  Disease,  notably  in  some  forms  of 
organic  heart  disease,  angina  pectoris,  melancholy,  tisdium 
vita,  scrofula,  syphilis,  skin  disease,  and  as  an  antidote 
to  the  ill  effects  of  mercury.  By  James  Compton 
Burnett,  M.D.,  F.R.6.S.  Homoeopathic  Publishing 
Company. 

Db.  Burnett,  whose  little  book  on  Natrum  muriaticum 
we  reviewed  in  our  January  Number,  follows  it  up  here  with 
a  similar  monograph  on  Aurum,     Similar,  we  mean,  in  size, 
appearance,  and  style;    but  hardly  so  in  contents.     The 
former  publication  owed  its  chief  value  to  the  numerous 
cases  from  the  author's  own  experience  therein  recorded. 
The  present  one  has  very  few  of  these,  and  indeed  hardly  bears 
out  the  promise  of  its  title-page  and  preface,  which  latter 
says  that  "  in  homoeopathic  practice  it  (gold)  is  neglected.'' 
We  were  surprised  by  this  statement,  but  felt  that  if  Dr. 
Burnett  had   evidence   to    show  its   curative    power   over 
''organic  heart  disease"  and  angina  pectoris,  it  might  be 
warranted  so  far  as  these  maladies  were  concerned.     The 
only  fact  of  the  kind,  however,   which  he  himself   brings 
forward  is  a  case  of  rheumatic  endocarditis  (in  which  in- 
deed it  seems  to  have  acted  exceedingly  well) ;  to  which  he 
adds  a  similar  one  from  Frank's  MagasAn,  and  refers  to  a 


Gold  as  a  Remedy  in  Disease.  393 

care  of  angina  pectoris  made  with  it  by  Kafka.     This  is 
scarcely  more  than  saggestive. 

The  real  value  of  the  book  (and  it  has  much)  lies  in  the 
copioas  collection  it  contains  of  the  observations  made  in 
the  old  school  as  to  the  action  of  gold^  pathogenetic  and 
curative.  We  only  miss  the  recent  experience  with  it  in 
aterioe  and  ovarian  indurations  reported  by  Martini  in  the 
old  school,  and  Tritscher  in  our  own  ranks.  Dr.  Burnett's 
own  cases^  we  have  said,  are  few ;  and  such  an  one  as  that 
of ''dropsy/'  at  p.  102,  should  hardly  have  been  published, 
as  no  examination  seems  to  have  been  instituted  to  deter- 
mine whether  it  was  of  cardiac  or  renal  origin.  The  fol- 
lowing observation^  however^  is  very  lifelike  and  practical : 

"Not  unfrequently  one  is  consulted  about  the  non- 
thriving,  pining  condition  of  boys;  they  are  low-spirited, 
lifeless,  their  memories  are  bad,  they  are  not  up  to  the 
mark,  and  are  lacking  altogether  in  boyish  go ;  the  tongue 
is  commonly  coated  at  the  back,  and  the  appetite  for  plain 
food  is  bad.  They  are  the  despised  ones  at  cricket  and 
football,  and  at  school  they  are  not  wanting  in  taste  for 
books,  but  still  they  take  no  position  in  their  forms.  '  I 
do  not  know  what  it  is,  but  he  does  not  seem  to  get  on/ 
These  boys  are  not  necessarily  vicious  or  given  to  naughty 
habits,  but  they  are  maudlin  and  unmanly  fellows. 

''  Examine  the  testes,  and  you  will  find  them  mere  pen- 
dent shreds,  just  on  the  verge  of  atrophy. 

''A  short  course  of  Avrum  foliatum,  3rd  trituration,  four 
or  five  grains  three  times  a  day,  seems  to  act  like  magic  on 
them ;  they  brighten  up,  eat,  work,  play,  and  sleep  like  boys 
should,  and  their  comrades  begin  to  take  some  account  of 
them  in  the  playground  and  cricket-field.  They  become 
altogether  more  manly,  and  spend  less  time  over  their  books, 
and  yet  take  better  places  in  their  classes.  Now  look  again 
at  the  before-mentioned  glands,  and  you  will  find  them 
larger,  firmer,  and  well  suspended.'' 

This  experience  bears  upon  the  question  raised  at  p.  186, 
as  to  the  nature  of  the  melancholia  curable  by  Aurum.  Dr. 
Burnett  rejects  the  doctrine  that  it  takes  its  origin  in  the 
Uver  or  testes,  and  maintains  it  to  be  a  primary  brain  dis- 


294  Refnew$. 

order.     At  the  Middletown  Asylum,  however,  Aurum  has 
been  found  useless  in  true  cerebral  melaucholia.* 

We  must  not  omit  to  mention  that  Dr.  Burnett  has 
enriched  his  book  with  a  short  but  actiye  proving  of  his 
medicine  on  his  own  person. 


A  Biographical  Retrospect  of  Allopathy  and  Homceopathy 
during  the  last  thirty  years,  with  cases.  By  Hugh 
Hastings,  M.D.,  M.R.C.S.,  L.S.A.,  &c.  London : 
Turner  (no  date). 

The  much-enduring  Job  expressed  a  desire  that  his  ad- 
versary had  written  a  book,  no  doubt  that  he  might  have 
had  the  satisfaction  of  writiug  a  withering  review  of  it  in 
one  of  the  journals  of  the  period,  or  in  whatever  in  those 
days  answered  the  purpose  of  our  newspapers  and  magazines. 
Our  desire,  on  the  contrary,  is  that  some  of  our  friends 
would  not  write  books ;  for  it  is  no  pleasant  task  to  review 
publications  like  the  one  before  us  where  we  cannot  find 
anything  to  praise. 

The  title,  A  Biographical  Retrospect  of  Allopathy  and 
Homceopathy^  is  queer.  Biographies  of  men  and  women, 
or  even  of  dogs  and  horses,  we  can  understand;  but  it 
passes  our  comprehension  to  understand  what  is  meant  by 
a  biography  of  a  system  of  medicine. 

The  opening  sentence  of  this  Biographical  Retrospect  is, 
like  the  title,  a  marvellous  specimen  of  the  author's  funny 
notions  respecting  the  meaning  of  words  : 

'^  Whether  the  Darwinian  hypothesis,  as  a  universal  cosmical 
law,  be  biologically  correct,  or  in  agreement  with  ethnology 
and  biblical  cosmology,  one  thing  is  certain,  that  during  the  last 
fifty  years  medicine  and  surgery  have  undergone  a  great  evolu- 
tion, or  progress,  in  their  allied  sciences — pathology,  physiology, 
anatomy,  chemistry,  and,  would  that  we  were  enabled  also  to 
add,  therapeutics." 

One  would  think  that  there  can  be  no  doubt  of  thera- 

•  See  Homaopathie  Timet  for  May,  1879. 


Biographical  Retrospect.  295 

pentics  having  nndergone  a  great  revolution  during  the  last 
fifty  years,  but  whether  that  is  equivalent  to  an  evolution 
or  not  we  will  not  undertake  to  decide. 

We  will  not  attempt  to  give  a  detailed  review  of  Dr. 
Hastings^  book.  It  is  evidently  addressed  more  to  the 
public  than  the  profession,  and  if  there  is  anything  bio- 
graphical about  it,  it  is  a  kind  of  biography  of  Dr.  Hastings 
himself,  relating  how  the  author,  '^  after  an  experimentum 
erucem  {He)  on  Baconian  axioms,^'  became  a  convert  to 
homoeopathy,  and  practised  so  many  years  in  Cheltenham 
and  so  many  years  on  Brixton  Hill  with  immense  success, 
testified  to  by  numerous  complimentary  letters  from  grate- 
ful patients,  duly  set  forth  in  an  appendix  of  selected  cases, 
that  constitutes  the  largest  portion  of  the  book. 

The  author  gives  a  curiously  incorrect  account  of  Hahne« 
mannas  discovery  of  the  homceopathic  therapeutic  rule  of 
practice,  and  he  says : 

*•  The  town  of  Leipsic,  from  which  he  was  obliged  to  fly,  owing 
to  the  persecution  to  which  he  was  subjected  because  of  his  new 
doctrine  of  disease  and  the  cure  thereof,  has  now  erected  a 
marble  statue  to  his  memory." 

As  matters  of  fact,  Hahnemann  left  Leipzic  on  account 
of  prosecutions  instituted  against  him  by  the  apothecaries 
for  dispensing  his  own  medicines,  which  was  an  infringe- 
ment of  their  legal  rights.  The  statue  erected  to  his 
memory  in  Leipzic  was  not  erected  by  the  town  of  Leipzic, 
but  by  his  admirers  in  all  countries;  and  it  is  not  a 
marble  but  a  bronze  statue. 

Respecting  doses.  Dr.  Hastings  says  : 

'*  The  mother  tinctures  may  do  in  chronic  cases,  and  medical 
men  in  consulting  rooms,  whose  patients  are  generally  of  this 
class,  may  find  strong  tinctures  the  best ;  but  those  who  have  to 
combat  acute  diseases  in  the  sick  room,  will,  I  think,  find  the 
lower  dilutions  their  mainstay,  at  least  this  is  my  experience." 

He  talks  (p.  18)  of  '^  a  gentleman  with  such  an  analytic 
and  inquiring  calibre  of  mind.^' 

At  p.  28  we  find  the  following  remarkable  statement : 
**  If  we  wish  to  quiet  a  raging  fever  we  give  a  medicine — 


296  Reviews. 

Aconite,  e.g, — becaase  its  febrifuge  properties  have  been  tested 
in  healthy  persons,  and,  ergo^  according  to  our  law  of  cure, 
eimilia  eimilibui  eurantur,  it  becomes  in  fever  an  an^tfebrifuge.*' 

Hitherto  we  have  always  supposed  Aconite  to  be  a  febri- 
fuge in  the  fevers  for  which  it  is  indicated.  We  suppose 
Dr.  Hastings  means  that,  but  he  says  the  opposite.  He 
repeats  this  wonderful  statement  at  p.  137  :  *^  Aconite,  the 
most  powerful  antifebrifuge  medicine  known.'' 

At  p.  31  he  says,  "  in  five  grains  of  the  first  decimal 
trituration  of  homoeopathic  mercury  there  is  about  a 
grain/'  whereas  every  one  knows  that  it  contains  exactly 
half  a  grain. 

Here  is  another  erroneous  piece  of  arithmetic.  Speaking 
of  Dr.  Bridge's  report  of  St.  Bartholomew's  Hospital : 

He  says,  **  159, 947  patients  were  prescribed  for  as  out-patients 
in  1877,  i.  i.  at  the  rate  of  about  forty  per  hour ;  but,  be  it 
observed,  these  forties,  by  a  system  of  some  legerdemainiem  (tie), 
are  examined  and  prescribed  for  in  two  hours,  from  9  till  11 
o'clock — that  is  to  say,  at  the  rate  of  1333  a  minute  !*' 

This  calculation  can  hardly  be  said  to  be  according  to 
Cocker. 

Here  is  another  funny  passage : 

**  Homceopathy,  in  taking  the  symptoms  of  the  disease  for  its 
guide  in  selecting  the  suitable  medicines  for  the  disease,  listens  to 
the  voice  of  suffering  nature,  as  expressed  by  pains,  objective 
symptoms,  such  as  the  pulse,  tongue,  stethoscope,  clinical  ther- 
mometer, &c." 

We  were  not  previously  aware  that  stethoscopes  and 
thermometers  were  objective  symptoms,  but  we  live  to  learn. 

At  p.  52  are  some  remarkable  allopathic  and  homoeopa- 
thic statistics,  '^  carefully  compiled  from  hospital  reports," 
whereby  it  appears  that  the  average  aUopathic  mortality  in 
dysentery,  typhoid  fever,  diarrhoea,  and  pneumonia,  is  37*2 
per  cent,  while  the  homoeopathic  mortality  is  only  1*1  per 
cent.  It  is  a  pity  the  hospitals,  where  these  wonderful 
results  were  obtained,  were  not  mentioned. 

We  are  informed  on  the  next  page,  that  our  friend  Dr. 
Bouth,  of  the  Fallacies,  who  is  alive  and  well,  is  "Dr. 


Biographical  Retroipect.  297 

Bonth,  the  late  venerable  Provost  of  Magdalen  College^ 
Oxford/' 

The  statistics  of  the  homoeopathic  and  allopathic  treat- 
ment of  yellow  fever,  given  by  Dr.  Hastings,  do  not  accord 
with  those  we  gave  in  our  last  number.  *^  It  is  stated/' 
says  Dr.  Hastings,  '^  that  12,000  persons  have  died  of 
the  fever  in  the  United  States,  and  that  it  has  cost 
£40,000,000." 

As  we  never  remember  to  have  seen  diseases  appraised 
at  a  money  value,  we  cannot  say  if  forty  millions  of  pounds 
sterling  is  a  high  price  for  12,000  of  yellow  fever  cases  or  no. 
Perhaps  Dr.  Hastings,  in  his  next  edition,  will  kindly  tell  us 
the  money  value  of  other  diseases,  such  as  cholera,  pneumonia, 
typhoid  fever,  and  some  others,  in  order  to  enable  us  to 
arrive  at  an  opinion  on  the  subject. 

The  capillaries,  arteries,  veins,  and  absorbents,  are.  Dr. 
Hastings  informs  us  at  p.  55,  '^  the  drains  and  sewers  of 
'  the  house  we  live  in,'  "  t.  e.  the  body. 

At  p.  62,  he  says : 

"I  never  go  past  those  noble  institutions — our  hospitals — 
without  a  shudder  at  the  thought  of  such  philanthropic  buildings 
being  under  the  control,  medically,  of  the  allopaths." 

If  Dr.  Hastings  shudders,  what  must  be  the  sensations 
of  the  philanthropic  buildings  themselves  f  We  would 
suggest  to  Dr.  Hastings  to  write  at  his  leisure  a  ''  bio- 
graphical retrospect "  of  the  "  philanthropic  buildings  "  of 
London. 

But  we  are  tired,  as  I  dare  say  our  readers  are  also,  of 
setting  forth  the  absurdities  contained  in  this  little  book. 
Were  we  to  try  to  expose  them  all,  we  should  simply  have 
to  transfer  almost  the  whole  work  to  our  pages. 

The  only  thing  in  the  book  that  strikes  us  as  being 
worthy  of  remark  is  the  successful  treatment  of  some  cases 
of  severe  diseases  of  stomach,  liver,  and  uterus,  with  acetic 
add.  The  cases  are  said  to  be  cancer  of  liver,  stomach, 
and  womb ;  but  the  evidence  of  their  being  these  diseases 
is  not  satisfactory.  They  are  certainly,  according  to  the 
description,  severe  cases,  and  the  acetic  acid  seems  to  have 
been  of  great  use* 


298 


Our  Foreign  Contemporaries, 

GERMANY. — Allgemeine  Homoopathische  Zeitunff, — 
We  resume  our  notice  of  this  periodical  at  the  twenty-fifth 
number  of  the  ninety-sixth  volume.  Dr.  Eoch^  of  Phila- 
delphia^  gives  an  attempt  at  an  explanation  of  the  retention 
of  this  efficacy  by  the  homoeopathic  dilutions.  He  considers 
that  the  medicinal  power  of  drugs  are  correlative  forces 
similar  to  those  of  light,  motion,  heat,  electricity,  and  mag- 
netism, and  that  these  forces  are  released  or  set  free  by  the 
rocesses  of  trituration  and  succussion.  Further,  that  the 
medicinal  power  and  the  morbific  influence  conduct  them- 
selves towards  one  another  like  alkalies  and  acids,  and  that 
by  their  affinity  a  neutralisation  ensues,  whereby  the  mor- 
bific noxa  is  neutralised. 

Dr.  Eunkel  continues  his  cases  by  Lacheiis,  and  gives 
the  following  additional  cases : 

4.  A  woman,  set.  66,  suffered  for  a  long  time  from  attacks 
of  dyspncBa    every  two    to  three  days,  commencing  with 
vertigo,  and  accompanied  by  throbbing  in  the  left  side  of  the 
chest  and  pale  face,  and  terminating  with  cold  sweat  in  the 
face.     The  attacks  lasted  about  half  an  hour.     During  them 
she  had    prickling  in  the  left  arm  down  to  the  finger-tips, 
which   were  cold,   especially  the   first  two  fingers.     Stool 
every  other  day.     Complexion  dirty  grey.     Stomach-ache 
some  days  previously  from  a  chill.     On  the  12th  March^ 
1873,  Lachesis  30,  to  be  taken  for  three  days,  was  pre- 
scribed.    On  the  15  th  she  had  a  severe  attack,  and  on  the 
21st  another  that  lasted  three  hours;  another  slight  attack 
the  same  evening.     On  the  25th  and  26th  slight  indica- 
tions.     Since  then  well.     On  the  20th  February,  1874,  she 
had  a  dose  of  Sepia  for  dyspnoea,  with  immediate  relief. 

5.  A  merchant's  clerk,  set.  20,  applied  on  the  Slat 
August,  1874.  Since  the  new  year  he  had  suffered  from 
paresis  of  the  whole  of  the  left  side  (arm,  leg,  pectoral 
muscles),  with  the  exception  of  the  cervical  muscles  of  that 
side,  which  are  tense,  so  that  the  movement  of  the  head  is 
impeded.     The  paralytic  weakness  is  worse  in  windy  and 


Germany,  299 

snltiy  weather,  better  after  a  meal  or  when  heated  with 
work.  He  cannot  drink  a  long  draught,  must  pause  every 
moment.  Lachesis  SO  for  three  days.  6th  September. — 
Paralytic  weakness  less,  can  now  button  his  right  shirt- 
sleeve with  the  left  hand,  and  drink  without  interruption. 
Improved  until  the  5th  October,  when  he  thought  he  had 
an  aggravation,  but  accompanied  by  other  symptoms.  This 
was  removed  by  Caust.  200. 

6.  A  woman,  set.  35,  had  suffered  for  five  years  from 
icterus  and  cardialgia.  Her  malady  came  on  immediately 
after  a  nervous  (typhoid)  fever.  When  she  has  the  cardialgia 
she  must  sit  doubled  up,  her  knees  pressed  against  her 
chest.  Pain,  aching,  came  on  two  hours  after  eating ;  was 
often  transiently  relieved  by  eating  and  by  external  warmth. 
Great  prostration,  faeces  white,  urine  "  qnite  black.'^  Weather 
has  no  effect ;  sleep  bad,  but  relieves.  Pulse  quick.  Cannot 
bear  sour  things.  Anorexia.  After  Lachesis  200,  at  first 
worse,  then  better,  could  eat  a  little  and  sleep.  Then 
improvement  ceased.  The  taste  became  bad;  the  stools  that 
had  became  normal  were  again  white  and  rather  diarrhoeic. 
Sacch.  lad.  For  four  months  she  remained  well,  then  she 
had  a  recurrence  of  the  old  symptoms,  and  got  Lachesis  200. 
She  remained  well  for  two  years,  and  had  again  an  attack 
of  the  old  complaint,  for  which  Lack,  30  was  prescribed 
with  success. 

7.  A  farmer,  set.  37,  had  suffered  from  1872  from  an 
eruption  on  the  legs.  Before  this  had  cardialgia,  better 
after  eating,  but  recurring  with  greater  violence  two  hours 
afterwards.  This  went  off  when  the  eczema  appeared. 
The  eruption  is  also  on  the  back  and  on  other  parts  of  the 
body  to  a  small  extent.  The  legs  are  completely  covered 
by  it.  Violent  itching,  especially  during  windy  weather, 
with  incrjease  of  eruption.  After  scratching  exudation  of 
serum  with  relief.  Every  fresh  eruption  comes  on  in  the 
form  of  blisters,  which  burst  and  form  thin  crusts.  Tearing 
pain  day  and  night,  increased  by  hanging  the  limbs  and  by 
motion.  Flatulence,  crossness,  irritability,  very  profound 
sleep.  Tongue  thickly  furred,  often  bad  taste,  very  cold 
feet  in  winter.    Sulph.,  Lye,  Phos,,  Rhus,  Sep,,  improved 


800  Our  Foreign  Contemporaries. 

the  general  health,  but  did  not  affect  the  eruption.  On  the 
27th  Februarj,  1876,  he  got  Lachesis  80.  Up  to  the  15th 
August  improvement  went  on,  but  then  new  symptoms 
appeared,  and  the  gastric  symptoms  were  still  present. 
Carb.  r.  80,  alternately  with  Lack.,  every  week  proved  very 
^useful.  On  4th  July,  1877,  he  got  a  dose  of  Aurum  30. 
Since  then  quite  well. 

8.  A  clergyman,  set.  29,  had  had  influenza  nine  months 
previously.  On  recovering  he  got  cardialgia.  Pain  con- 
strictive. Duration  of  attacks  two,  three,  or  five  hours. 
The  pain  comes  when  the  stomach  is  empty.  Twice  he 
had  an  attack  on  the  receipt  of  disagreeable  news  after  a 
meal.  Great  prostration  after  an  attack.  Faeces  some- 
times too  light  coloured.  After  each  attack  the  liver  is 
very  sensitive  to  pressure.  On  4th  November,  1873,  he 
got  Lack.  200.  First  report  29th  Juue,  1876  :  Had  only 
one  attack  since  taking  the  medicine.  The  stomach  pains 
have  returned  violently  for  the  last  fortnight.  They  gene- 
rally end  with  vomiting.  Lack,  30 ;  thereafter  three 
attacks,  then  rest  for  four  weeks.  Towards  the  end  of 
August  the  attacks  reappeared.  Lack,  30,  alternately  with 
Lye,  30,  every  ten  days  was  successful. 

We  find  nothing  further  of  an  original  and  practical  char- 
acter until  we  come  to  Number  5,  Vol.  xcvii,  and  here  we 
find  an  involuntary  proving  of  Apis  tnel.,  extracted  from  the 
Wiener  Med.  Preae.     A  girl,  set.  25,  was  suddenly  attacked, 
without  known  cause,  by  the  following  symptoms : — ^Face 
bloated,  cyanotic,  respiration  slow,  difficult;  commencing 
pulmonary    oedema ;    sensorium    confused.       Pulse   small, 
quick,  extremities  cool.     All  the  right  arm  swollen,  cubital, 
axillary,  and  cervical  glands  on  the  right  side  enlarged.    On 
offering  water,  which  the  patient  urgently  demanded,  sudden 
convulsions,  with  an  expression  of  the  utmost  anxiety  in  the 
face,  as  in  hydrophobia.     Convulsions  also  occurred  when 
the  physician  accidentally  took  hold  of  the  forefinger.     In 
the   middle  of  this  finger  a  bee-sting  was  observed  to  be 
sticking,  surrounded  by  a  small  red  areola.     On  removing 
this  the-  convulsions  ceased,  and  with  that  the  dread  of  water. 
The  patient  rapidly  recovered  and  next  day  was  quite  well. 


Germany.  301 

except  weakness.  She  said  that  the  symptoms  commenced 
almost  immediately  after  she  perceived  the  sting. 

In  this  No.  and  No.  6^  Dr.  Mossa  has  an  article  on 
opium.  He  shows  from  the  Materia  Medica  that  opium 
causes  very  violent  colic^  and  he  relates  among  others  (from 
pablished  homoeopathic  records)  the  following  case,  which 
occurred  in  his  own  person  : — One  evenings  in  the  winter 
of  1875,  he  was  seized  with  colicky  pains,  t.  e.  contractive, 
cutting,  twisting  pain  in  the  bowels  from  the  navel  towards 
the  bladder,  which  at  first  recurred  at  long  intervals.  In 
bed  the  pains  increased  in  violence,  the  free  intervals  being 
ever  shorter.  The  abdomen  was  tense ;  in  the  left  hypo- 
gastric  region  a  ball-like  lump  was  felt,  the  size  of  an 
orange.  He  tossed  about  with  the  pain,  could  find  no  relief  in 
any  position;  sitting  bent  together  or  lying  on  the  back 
was  equally  intolerable.  He  experienced  also  a  sensation 
as  if  a  portion  of  the  bowel  was  tightly  retracted  against 
the  spinal  column.  He  was  one  time  cold,  another  hot. 
He  had  to  get  out  of  bed  and  walk  slowly  about  the  room, 
bent  double.  Then  came  on  first  eructations,  then  vomit- 
ing, at  first  of  food,  then  of  sour-tasting  mucus,  and  urging 
to  pass  water.  BeU.  and  Coloc.  did  no  good.  An  enema 
brought  away  a  stool,  but  without  relief.  The  flatus  became 
thereafter  mobile  and  passed  themselves  through  the  swell- 
ing of  the  bowels  with  difficulty,  as  if  there  was  a  con- 
striction. Thus  passed  three  quarters  of  the  night  in  pain. 
At  length  he  took  five  drops  of  a  solution  of  morphia  made 
for  subcutaneous  injection.  On  this  relief  was  obtained,  so 
that  he  could  remain  in  bed.  Sleep  came  on  with  perspira- 
tion, and  on  awaking  at  3  a.m.  well,  but  exhausted,  though 
free  from  pain.  The  abdomen  in  the  region  of  the  swell- 
ing was  still  somewhat  painful  on  pressure,  but  this  went 
off  in  the  course  of  the  day. 

In  No,  7  Dr.  Hendrichs  relates  the  following  case : — 
The  patient,  a  woman,  aged  32,  had  been  suffering  for 
three  months  from  weariness,  thirst,  increased  secretion  of 
urine,  and  swollen  feet,  and  was  treated  for  diabetes,  but 
no  examination  of  the  urine  was  made.  She  now  com- 
plained of  boring  pain  in  the  umbilical  region,  much  in- 


808  Our  Foreign  Contemporaries. 

creased  by  touching.  The  clothes  could  not  be  borne. 
There  was  great  tenderness  of  the  sacral  and  renal  regions. 
These  pains  were  described  as  burning.  She  could  only  lie 
on  her  back.  The  secretion  of  urine  had  diminished,  but 
the  thirst  continued.  The  pain  in  the  navel  was  relieved 
by  passing  urine  freely,  but  aggravated  when  the  urine  was 
scanty  and  high  coloured.  Obstinate  constipation  for  four 
or  five  days.  On  passing  urine  cutting  pains,  and  after- 
wards enormous  tenesmus.  Complete  sleeplessness  for  three 
weeks,  she  slept  neither  day  nor  night.  The  menses  had 
ceased.  No  sugar  or  albumen  in  the  urine.  After  Arsen. 
3,  the  boring  pains  ceased  for  some  days,  but  the  back 
pains  became  all  the  worse.  Nux  v.,  Sulph.,  Bell.,  did  no 
good  in  three  weeks.  After  this  period  the  following  new 
symptoms  occurred : — Shooting  pains  in  the  hepatic  region, 
boring,  pressing  pain  in  forehead  and  root  of  nose,  which 
produced  occasionally  a  stupefied  state.  Phos.  4  diminished 
the  sensitiveness.  Phos.  3,  in  three  days,  removed  all  the 
pains.  But  there  came  on  vomiting  of  food,  which,  how- 
ever, went  off  in  a  few  days  on  continuing  the  Phos. 

A  woman,  aged  83,  had  been  long  under  treatment; 
complained  chiefly  of  stomach  ailment.  In  the  morning 
she  had  nausea  and  much  sour  eructation.  Constant 
empty  feeling  in  stomach  relieved  by  a  small  morsel  of 
food.  Otherwise  loss  of  appetite.  Also  obstinate  consti- 
pation. Sore  pain  when  urinating,  afterwards  tenesmus. 
The  third  and  sixth  dorsal  vertebrae  sensitive  to  pressure. 
The  pain  usually  burning.  She  must  sit  in  a  bent  position. 
At  the  same  time  oppression  in  the  chest,  as  from  a  tight 
band.  This  sensitiveness  dates  from  her  seventeenth  year, 
and  had  hitherto  been  treated  as  a  rheumatic  affection. 
She  was  incapable  of  doing  anything.  Menstruation  pain- 
ful. She  got  Phos.  4,  but  as  this  seemed  to  do  no  good, 
she  got  3,  and  then  2.  In  fourteen  days  she  was  quite 
cured  of  all  these  symptoms. 

An  eye  affection  in  a  girl  of  17.  She  had  been  fruit- 
lessly treated  by  the  most  renowned  oculists  since  her  fifth 
year.  She  had  great  infiltration  of  the  cornea^  staphyloma; 
the  eyeball  looked  like  a  lump  of  flesh.     At  the  tame  time 


Germany.  308 

nocturnal  pains  of  a  boring  description  in  the  orbits.  Was 
quite  cured  in  six  days  by  Ilex  aquafolium. 

Dr.  Theuerkauf  mentioned  a  case  of  hypopion  with  great 
pain,  in  which  Plumbum  6  caused  absorption  and  effected  a 
complete  cure  in  six  weeks. 

Dr.  Kayser  cured  a  hypopion  caused  by  iritis  with  An  en. 

Dr.  Stens^  jiin->  had  a  patient^  an  unmarried  woman, 
aged  38^  who  consulted  him  for  an  eruption  on  the  upper 
lip.  For  many  years  she  had  in  spring  and  fall  suffered 
from  dysenteric  evacuations  (bloody  mucus  with  tenesmus), 
for  which  Merc.  cor.  and  Nitr.  ac.  were  given  in  vain.  The 
affection  of  the  lip  always  recurred  in  spring  and  autumn, 
and  the  stool  was  preceded  by  coryza,  with  watery  secretion 
from  the  nose^  whereby  the  upper  lip  was  rendered  red  and 
became  covered  with  blisters  and  scabs.  The  whole  affec- 
tion was  quickly  and  perfectly  cured  by  Rhus  1. 

In  No.  9  Dr.  Goullon,  jun.,  relates  the  following  patho- 
genetic effects  of  Salicylic  acid  given  to  a  patient  suffering 
from  gout.  At  first  there  occurred  confusion  of  the  head, 
a  swaying  feeling,  slight  vertigo.  It  was  as  if  he  had  lain 
long  and  suddenly  rose  up.  Then  there  came  on  acoustic 
symptoms.  He  imagined  he  heard  music.  The  sounds  often 
roused  him  out  of  his  sleep.  Sometimes  the  noise  is  like 
the  buzzing  of  a  swarm  of  bees  or  of  flies  in  the  open  air 
when  there  is  great  stillness.  There  were  copious  sweats, 
red  urine  depositing  a  considerable  sediment,  but  these 
symptoms  might  be  the  effect  of  the  gout.  A  more  charac- 
teristic symptom  was  severe  and  constant  pressure  in  the 
abdomen,  with  the  feeling  of  displaced  flatus,  as  if  the 
flatus  was  very  persistent.  The  seat  of  this  tiresome  pressure 
was  sometimes  in  the  hypochondria,  sometimes  lower  down 
in  the  bypogastrium.  At  the  same  time  constipation  for 
several  days.  There  is  also  a  firmly  seated  pressure  at  the 
side  of  the  sternum,  with  a  feeling  as  if  the  bone  were 
painful.  Another  striking  symptom  was  a  bilious,  bitter 
taste.     Some  patients  experience  total  loss  of  appetite. 

In  No.  11,  under  the  heading  '^  Crumbs,"  a  certain  E.  S. 
gives  notes  of  the  practice  of  the  late  Dr.  Kirsch,  of  Mentz, 
which  are  not  without  their  interest  for  practitioners. 


304  Our  Foreign  Contemporaries. 

For  pleuritic  exudations  :  Alumina. 

Retention  of  urine^  consequent  on  gravel  and  calculus  : 
Sanffuinaria, 

Natr.  mur.  is  often  useful  after  Acid.  nitr. 

Old  gonorrhoea :  Thuja  30 ;  also  two  doses  of  Nux  v,, 
then  Sulph, 

Caries:  Ruta. 

Fungous  gonitis :  Conium  and  local  application  of  EmplasL 
dcutm, 

Natr.  mur,  is  often  useful  where  changes  of  weather  and 
draughts  of  air  do  not  aggravate. 

Morbus  mac.  Werlhofii :  in  one  case  of  syphilitic  origin 
Add.  sulph,  was  very  beneficial. 

Psoriasis :  Sepia,  Graphites. 

Natr.  mur.  is  often  useful  after  Apis, 

Ruta  is  useful  in  detachment  of  the  retina. 

Anacardium  when    in    syphilis   the  mental   powers  are 
diminished. 

Pulsatilla  is  equal  to  Thtiffa  as  a  remedy  for  sycosis. 

Conium  :  a  sycosis  remedy. 

Cancer  of  the  rectum :  Sepia  almost  specific. 

Epilepsy  :  Glonoin,  when  the  attacks  are  frequent^  almost 
daily. 

Baryta  cures  hypertrophy  of  the  tonsils^  especially  of 
the  left  side. 

Phosphorus  stopped  purpura  hsemorrhagica  from  all  cavi- 
ties of  the  body  in  a  case  of  soft  cancer  of  the  mamma. 

Caries  of  the  sternum  :  Mezereum. 

Oout :  Sabina  in  burnings  Arnica  in  shooting  pains. 

Silica  :  after  its  employment  an  asthma  disappearedi  and 
gummy  nodes  were  formed  in  the  skull,  the  clavicle^  and 
some  ribs. 

TabeS|  with  paralysis  of  the  optic  nerve  ;  Gelseminum, 
Rhus,  Lycopodium,  Sulph.  200^  Plumbum. 

Lymphoma  in  the  neck^  with  sieve-like  holes  :  Arsenicum, 

Chronic  pneumonia  and  tuberculosis^  which  caused  occa- 
sional inflammation:   Calcarea  bromata  ih  low  potencies. 

Prunus  spinosa  :  ovarian  cyst  and  dropsy. 

Herpes  preputialis  :   which  occurs  periodically  after  mer- 


Germany.  *'      S05 

curial  treatment^  and  is  situated  internallj,  is  almost  always 
venereal  and  infectious. 

Carcinoma  ventriculi  frequently  occurs  in  syphilitics. 

Ulcus  ventriculi :  Bryon.  and  Phos. 

Chancre  and  nasal  syphilis  :   Carbo  an. 

After  Sulph.,  Sarsaparilla  is  very  useful  in  all  the  ail« 
ments  of  scrofulous  children. 

Chalazion  in  the  eyelid  was  cured  by  touching  with 
Spiritus  cictUa. 

Carcinoma  ventriculi :  in  the  latter  stage  Aurum  is  useful^ 
particularly  when  very  few  subjective  symptoms  are  present. 

A  general  spotty  syphilid  broke  out  four  years  after  a 
cured  chancre  after  one  dose  of  Sulph.  200. 

Arthrocace :  Emplastrum  cicuiie. 

Spinal  meningitis  with  symptoms  in  the  lower  extre- 
mities: Secale. 

Phthisical  diarrhoeas :  nine  tenths  curable  by  Verat  2. 

Pains  from  calculus  and  renal  gravel :  Colocynth  the  chief 
remedy. 

Assafcetida  taste  in  the  mouth  :  Nux  vom. 

Dysecoia  after  scarlatina  :  Bellad.  800. 

Boman  baths  a  panacea  in  aural  maladies. 

linctura  china  is  often  useful  in  phthisis  when  the 
dilutions  are  useless. 

Aurum  3  :  in  pleuritic  exudations. 

Idem :  in  extreme  dyspnoea  attending  serious  heart 
aflfections. 

Causiicum  caused^  as  a  curative  effect^  a  perfect  itch-like 
eraption  that  was  infectious.  In  another  case  a  similar 
eruption  appeared  after  Aurum,  and  infected  several  per- 
sons.    No  acari  could  be  discovered. 

Ovarian  dropsy  :  Colocynth. 

Add.  nitr.  and  Apis  in  cancer  of  the  tongue. 

Gelseminum :  sleeplessness^  with  chronic  cerebral  irrita- 
tion and  throbbing  in  head  and  body. 

Atropin,  3rd  trit.^  an  excellent  remedy  in  gastralgia. 

Exophthalmic  goitre :  five  cases  cured  by  Verairum. 

Bright's  disease :  to  drink  cold  dandelion  tea  instead  of 
water. 

VOL.  XXXVII,  NO.  CXLIX.— JULY,  1879.  ^ 


806  Our  Foreign  Contemperaries. 

Ulcus  ventriculi :  in  severe  hsemorrhage  Carb.  veg. 

Lymphoma  in  the  neck  with  hectic  feyer :  Phos.  and 
Graph. 

Leacorrboea  during  pregnancy  :  chief  remedy^  Conium. 

Leueorrhoea  in  chlorosis :  Natr.  mur. 

Valerian  of  excellent  service  in  hysteria  and  rheuma- 
tism. 

Loud  snoring  in  sleep  often  owing  to  hypertrophy  of  the 
tonsils  :  hence  Baryta. 

Belladonna  rapidly  relieved,  in  the  case  of  a  young  girl 
with  pulmonary  tuberculosis  and  permanent  tickling  cough, 
after  abuse  of  Opium.  Bell,  is  the  antidote  of  the 
latter. 

Peritonitis,  with  tympanites  and  paralysis  of  the  tonsils  : 
Phos.  and  Carb.  veg. 

Typhlitis  :  Merc,  the  chief  remedy. 

LacheHi  was  of  much  use  in  a  man  of  seventy-three 
with  atheromatous  arteries. 

Corallium  rubrum  has  all  the  symptoms  of  preputial 
gonorrhoea  and  chancre.  One  case  of  the  latter  cured 
by  it. 

Falling  out  of  the  hair  in  syphilitics  indicates  Thuja. 

Valerian  was  of  immediate  use  in  a  case  of  spasm  of  the 
stomachy  with  sleeplessness  and  wandering  pains. 

Petroleum  produced  excellent  effects  in  chronic  diar- 
rhoeas. 

Urticaria  chronica  :  high  potencies  of  BAua,  Apis,  and 
Calc.  c. 

Magnes.  carb, :  chronic  affections  of  the  nose  where 
everything  else  fails. 

Cactus  grand. :  in  phthisical  fevers  and  perspiration,  with 
asthma  and  violent  action  of  the  heart,  when  it  is 
doubtful  whether  cardiac  or  pulmonary  disease  will  be  deve- 
loped—almost specific. 

Soapy,  frothy  expectoration  indicates  Mezereum. 

Paralysis  of  the  optic  nerve :  Plumbum. 

In  No.  12  Dr.  Mayntzer  relates  with  much  circumlou* 
tion  the  following  case,  which  we  condense.  A  girl,  nineteen 
years  old,  had  suffered  for  two  years,  during  which  she 


Germany.  807 

had  been  treated  allopathically  without  result,  from  a  neuralgic 
affection,  which  came  on  every  eyening  in  the  arms  and  lasted 
a]l  night,  disappearing  in  the  daytime^  and  leaving  behind 
a  sensation  of  paralytic  weakness.  Both  arms  were  the  seat 
of  tearing  pains  \  pressure  and  movement  increased  the  pain. 
The  hands  were  affected  with  tremblings  formication,  and 
numbness^  and  the  fingers  were  spread  out  and  could  not 
be  bent.  Silica  6  and  Calc.  c.  6  were  given,  to  be  taken 
successively.  The  first  dose  of  Silic.  produced  no  effect. 
After  the  second  dose  of  SiL  the  pains  were  better,  and  she 
could  sleep  a  little.  The  third  night  she  slept  quite  well. 
The  sixth  day  all  the  pains  were  gone,  and  she  was  quite 
welL  After  the  fifth  day  she  took  the  CalCy  though  l)y 
this  time  she  was  almost  cured. 

In  No.  11  Dr.  Bojanus  relates  the  following  case  of 
chancre : — ^A  gentleman,  aged  35,  married,  and  the  father 
of  several  children,  three  weeks  after  an  impure  coitus  got 
a  syphilitic  ulcer  on  the  glans  penis,  which  he  treated  with 
sundry  external  domestic  remedies,  but  without  any  good 
result.  When  seen,  the  ulcer  had  a  diameter  of  about 
2  cm.,  was  of  irregular  round  shape,  flat,  with  dirty  grey 
fundus,  as  if  eaten  out,  and  secreting  a  fetid,  gluey,  yel- 
lowish, opaque  fluid ;  the  borders  were  but  slightly  elevated, 
hard,  jagged,  and  surrounded  by  a  hard,  greyish-blue  ring. 
The  slightest  touch  caused  bleeding  and  pain.  This  ulcer 
developed  from  a  vesicle,  was  at  first  small  and  deep^  but 
extended  and  flattened  gradually.  The  patient's  health 
was  not  otherwise  disturbed,  except  that  his  gums  were  red 
and  easily  bled,  but  this  he  had  had  before  the  infection. 
He  got  Carb,  veg.  3,  one  grain  night  and  morning.  After 
eight  days  the  ulcer  had  altered  its  appearance  3  it  did  not 
bleed  so  readily,  had  a  cleaner  appearance,  and  the  fcetor 
had  ceased.  The  gums  too  were  better,  the  .redness  and 
bleeding  when  touched  were  ameliorated.  The  same  remedy 
was  continued  for  eight  days  longer  without  any  change  in 
the  disease.  Carb.  veg,  6  was  now  given,  two  drops  night 
and  morning.  In  the  next  eight  days  improvement  was 
observed,  granulations  were  seen  in  the  ulcer,  and  the  bor- 
ders showed   signs   of    cicatrisation ;    the   secretion   was 


i08  Our  Foreign  Contemporaries. 

laudable^  yellow,  thick,  and  without  smell ;  the  gums  also 
were  improved.  The  same  dilution  repeated  did  no  further 
good,  hence  Carb.  veg.  12  was  given,  and  in  the  following 
three  weeks  80.  During  this  time  the  ulcer  had  diminished 
to  one  fifth  of  its  former  size.  But  now  improvement 
ceased.  On  this  Carb.  veg.  200  was  given,  20  globs,  in 
8  oz.  water,  a  tablespoonful  night  and  morning.  During 
the  next  eight  days  the  ulcer  was  quite  healed  and  covered 
with  healthy  skin.  The  gums  also  were  now  quite  normal. 
Fifteen  years  have  elapsed  and  not  a  trace  of  syphilitic 
disease  has  been  observed. 

In  No.  18  Dr.  Sorge  gives  some  cases  treated  by  him 
with  Tinet,  sem.  cardui  Marue.  1.  The  wife  of  a  dentist, 
thirty-two  years  old,  had  been  several  times  between  1871 
and  1874  treated  by  him  for  pains  in  the  stomach,  which 
were  usually  rapidly  removed  by  Chelidon.  On  the  25th 
January,  1878,  he  learned  that  the  lady  had  suffered  a  fort- 
night  previously  from  cutting  pains  in  the  bowels,  and  a 
feeling  as  if  diarrhoea  would  ensue ;  after  a  few  days  these 
symptoms  gave  place  to  a  tiresome  dry  cough,  worse  at 
night  and  getting  loose  in  the  morning ;  at  the  same  time 
there  was  an  aching  pain  in  the  swollen  spleen,  which,  as 
well  as  the  left  lobe  of  the  liver  and  the  gastric  region, 
was  sensitive  to  touch  ;  little  appetite,  constant  eructations. 
Sorge  considered  the  cough  as  a  sympathetic  symptom 
occfusioned  by  the  affection  of  the  liver  and  spleen,  and  on 
account  of  the  painfulness  on  touch  he  prescribed  Unci. 
sem.  cardui  Maria,  three  drops  every  three  hours.  On  the 
81st  Jan.  the  report  was :  cough  almost  gone,  appetite 
good.  The  first  days  after  commencing  the  medicine  the 
pain  in  the  left  side  became  worse,  and  then  went  off  com- 
pletely. On  continuing  the  medicine  for  a  few  more  days 
the  cough  went  off  completely.  2.  A  lady,  thirty-five  years 
old,  suffered  from  perceptible  swelling  of  liver  and  spleen. 
Tenderness  of  the  peritoneal  covering  of  these  organs  was 
removed  by  Bryonia,  the  irritable  condition  of  the  organs 
themselves  by  Carduus  Marue.  1st  April :  she  complained 
of  cough,  with  pain  in  chest  and  abdomen ;  for  this  Bry. 
was  given.     8rd  April:  Stitches  in  liver  and  spleen,  with 


Germany,  809 

violent  cough^  which  caused  two  attacks  of  vomiting ;  she 
coughed  all  dsj,  from  6.S0  to  11  p.m.  not  at  all^  then  until 
midnight,  and  also  from  3  a.m. ;  there  was  but  little  ex- 
pectoration. Ipec.  2,  five .  drops  every  two  hours.  6th 
April :  no  change.  As  the  cough  appeared  to  proceed  from 
the  old  liver  and  spleen  affection  Tinct.  Card,  Mar.  Rade^ 
macheri  was  given,  three  drops  every  three  hours.  The 
cough  then  rapidly  subsided ;  attacks  of  cutting  pains  in 
the  bowels  came  on  for  several  days,  but  no  other  medicine 
was  given.  3.  At  the  end  of  1840  the  housekeeper  of  a 
tradesman  complained  of  very  tiresome,  dry  cough,  and  as 
this  was  accompanied  by  gastric  symptoms  the  Tinct.  Card, 
Mar.  was  given,  and  effected  a  cure  in  two  days.  Dr. 
Jacobi  cured  many  cases  of  varicose  ulcers  of  the  legs  with 
the  1st  dec.  dilution  of  Tinct.  card.  Mar.  Sorge  cured 
one  similar  case  with  the  same  remedy,  and  Dr.  Burckhard 
had  a  similar  experience. 

In  the  same  number  Dr.  Hendrichs  gives  his  experience 
of  cases  treated  with  Arsenicum.  He  himself  had  been 
troubled  with  prosopalgia  some  years  previously,  which  came 
on  without  ascertainable  cause.  It  came  on  slightly  at 
first^  but  gradually  becoming  more  violent.  At  first  it  was 
intermitting^  but  the  intermissions  gradually  became  rarer 
and  shorter,  and  continued  of  a  uniform  degree  of  severity, 
with  the  exception  of  some  frightful  aggravations.  The  teeth 
were  also  affected,  they  became  set  on  edge  and  loose.  Many 
remedies  were  tried,  but  Spiff.  30  and  Araen.  30  alone 
seemed  to  be  of  use.  The  attacks  went  off  gradually.  One 
nndecayed  tooth  dropped  out.  Some  years  later  a  similar 
attack  came  on.  Ars.  30  and  Spiff.  80  were  of  no  use. 
The  part,  at  first  intermittent,  became  remittent,  and  at 
length  continuous.  He  then  took  Arsen.  2  trit.,  a  dose 
every  half  hour.  The  pain  was  immediately  relieved,  and 
went  off  slowly.  Two  incisors  fell  out  on  this  occasion. 
After  some  years  later  he  had  a  third  attack.  He  allowed 
the  attack  to  go  on  until  the  teeth  became  loose.  He 
then  took  Arsen.  2,  a  dose  every  quarter  of  an  hour.  In 
an  hour  the  pain  went  off  entirely  without  causing  the 
loss  of  a  tooth.  Since  then  he  has  cured  several  proso- 
palgias with  the  same  attenuation  of  Arsenic, 


310 


MISCELLANEOUS. 


The  Fractiiioner. 

Of  all  the  medical  periodicals  published  in  this  or  anj  other 
country  with  which  we  are  acquainted  the  Fractitioner  is,  to  our 
thinking,  the  most  delightful  reading.  From  the  first  it  has 
been  distinguished  by  a  liberality  towards  writers  of  our  school 
that  we  may  look  for  in  vain  in  contemporary  periodicals  avowedly 
devoted  to  orthodox  physic.  The  Fractitioner  would,  indeed, 
contemptuously  reject  the  epithet  ^'  orthodox  '*  as  applied  to  its 
principles  ;  it  professes  to  be  an  organ  of  "  rational "  medicine, 
and  as  we  all  profess  to  be  rational  practitioners,  it  does  not 
deter  partisans  of  the  rational  method  of  homoBopathy  from 
sending  commuuications  to  it.  Some  of  these  communications  it 
admits  to  its  pages,  consequently  we  find  in  it  a  greater  variety 
of  articles  than  are  to  be  met  with  in  the  columns  of  more  exclu- 
sive periodicals.  Not  only  does  it  not  fear  to  speak  of  homoeo- 
pathy without  the  usual  contemptuous  sneers  of  orthodox  writerB, 
but  it  even  admits  articles  written  by  declared  homoeopaths  as  wall 
,as  papers  written  by  crypto-homo&opathists  who,  without,  mention- 
ing the  unpopular  word,  recommend  modes  of  treatment  derived 
from  the  method  of  Hahnemann.  Several  articles  by  our  esteemed 
colleague.  Dr.  Edward  Blake,  have  appeared  in  recent  numbers, 
and  the  last  few  numbers  have  contained  a  series  of  papers  firom 
the  pen  of  the  venerable  essaiyist,  Dr.  Sharp,  on  the  LatM  of 
Healing  by  Druffs,  which  are  distinguished  by  their  outspoken 
character.  To  the  last  of  these  papers,  published  in  the  June 
number,  the  editor  appends  the  following  note : 

"  We  have  published  the  papers  of  Dr.  Sharp  in  the  pages 
of  the  Fractitioner  because  they  direct  attention  to  a  most 
valuable  means  of  forwarding  therapeutics,  viz.  the  investigation 
of  the  action  of  drugs  by  experiments  with  them  on  healthy 
persons.  This  mode  of  experiment  is  insufficient  of  itself  to 
afford  us  the  knowledge  which  is  requsite  for  the  rational  treat- 


The  Practitioner.  811 

ment  of  diBea«e.  It  must  be  combined  with  experiments  upon 
animals  (a  mode  of  investigation  which  Dr.  Sharp  completely 
repudiates),  for  no  observations  of  the  action  of  drugs  on  man 
can  enable  us  to  analyse  their  mode  of  action.  The  conditions 
are  too  complex,  and  they  must  be  artifically  simplified.  But, 
on  the  other  hand,  while  we  know  the  modus  operandi  of  drugs 
chiefly  from  experiments  on  animals,  there  are  minute  points  in 
their  action  which  can  hardly  be  learned  except  by  observations 
on  man,  and  we  hope  that  many  young  students  and  practitioners 
of  medicine  may  be  induced  to  take  up  the  study,  and  thus 
further  medical  science.  As  there  are  many  drugs  which  in 
small  doses  will  produce  an  action,  the  contrary  of  that  which 
they  produce  in  large  ones,  it  is  evident  that  homoeopathy  and 
antipathy  are  one  and  the  same  thing  as  regards  drugs,  and  differ 
only  in  dose.  The  folly  of  all '  pathies '  is,  therefore,  self-evident, 
and  it  is  equally  plain  that  all  those  who  hold  them  should 
acknowledge  their  mistake,  and  again  join  the  main  body  of  the 
profession  who  have  throughout  followed  the  right  course,  and 
have  striven  through  all  difficulties  to  find  out  rational  methods 
of  treatment  based  on  exact  knowledge  of  pathology  and  phar- 
macology." 

With  this  last  sentiment  we  cordially  agree,  except  that  we 
do  not  hold  that  the  "  main  body  of  the  profession  "  have  hitherto 
followed  this  right  course.  If  the  editor  will  pursue  his  inquiries 
a  Uttle  further  he  wiU  find  that  this  right  course  has  hitherto 
only  been  followed  throughout  by  the  small  phalanx  of  rational 
practitioners  who  have  carried  out  "  the  rational  method  of  treat- 
ment based  on  an  exact  knowledge  of  pathology  and  pharmaco- 
logy "  introduced  by  Hahnemann.  An  intelligent  pursuit  of 
this  course  will  inevitably  land  the  inquirer  in  the  therapeutics 
which  guide  the  practitioner  to  select  for  the  cure  of  a  disease 
a  remedy  that  experiment  and  observation  show  to  have  an  elec- 
tive a£&nity  for  the  same  organs  and  parts  of  the  system  as  are 
implicated  in  the  disease.  This  in  the  present  condition  of  know- 
ledge can  only  be  ascertained  by  a  careful  testing  of  drugs  on  the 
healthy  human  body.  The  knowledge  of  their  mode  of  action  to 
be  obtained  by  lethal  experiments  on  animals  will  not  help  us  in 
many  ca8es,for  supposing  that  did  reveal  to  us  the  mode  of  action 
of  many  drugs,  to  apply  them  in  human  diseases  would  require  an 
equally  accurate  knowledge  of  the  mode  of  action  of  the  morbific 


312  Miscellaneous, 

agents  that  cause  these  diseases,  which  is  not  ascertainable  or,  at 
all  events,  is  oot  jet  ascertained  with  regard  to  most  of  the 
diseases  we  have  to  treat.  No  doubt  the  perfection  of  thera- 
peutics would  be  attained  if  we  knew  the  exact  pathological 
changes  produced  by  all  drugs  and  all  diseases ;  but  this  perfec* 
tion  is  far  from  being  jet  attained,  and  seems  to  us  hardlj 
attainable  with  our  present  means.  In  the  mean  time  it  is 
evident  that,  with  the  exception  of  one  or  two  remedies  which  have 
been  discovered  accidentallj,  the  great  majoritj  of  real  remedial 
drugs  for  diseases  have  been  discovered  bj  the  method  of  proving 
medicines  on  the  healthj.  To  go  no  further  than  this  same 
number  of  the  Practitioner  we  find  that  the  first  paper  in  it  is 
one  "  On  the  Influence  of  Aconite  in  controlling  Pneumonia," 
and  how,  we  maj  ask,  was  this  controlling  power  of  Aconite  in 
pneumonia  discovered  unless  bj  the  Hahnemannian  method  of 
testing  the  drug  on  the  healthj  human  organism  ?  The  said  paper 
gives  striking  corroboration  to  the  excellence  of  the  minimal  dose 
of  the  homcBopathic  method,  for  the  doses  given  were  mostlj  but 
one  minim,and  in  one  of  the  cases  onlj  half  a  minim.  Once  only  was 
the  larger  dose  of  two  minims  given,  but  that  was  quicklj  reduced 
to  one  minim.    The  results  obtained  were  remarkably  beneficial. 


Bee  Stings  in  Bheumatism. 

[The  following  case  was  forwarded  from  over  the  water  to  one 
of  the  editors  of  The  Organon  for  insertion  in  that  periodical,  but 
was  bj  him  handed  to  us  on  the  plea  that  the  treatment  was 
too  mixed  for  his  journal,  the  virus  of  several  species  of  bees 
having  been  used  for  one  case,  but  that  it  might  not  be  unsuitable 
to  our  less  exclusive  pages.  We  beg  distinctlj  to  repudiate  the 
insinuation  made  bj  a  friend  that  the  editor's  real  reason  for 
rejecting  a  case  where  a  bee  was  the  remedj  emplojed,  was  because 
he  had  alreadj  one  in  his  bonnet ;  that  could  not  be  so,  for  to  our 
certain  knowledge  the  gentleman  in  question  wears  a  hat  and  not 
a  bonnet.] 

One  daj,  not  a  great  while  ago,  Mr.  Middlerib,  who  is  a 
constant  reader  of  the  New  York  Weekly,  read  in  his  favourite 
paper  a  paragraph  copied  from  the  Praeger  LandwirthsehafilickeB 
Wochenblatt,  a  German  paper,  which  is  an  accepted  authority 


Bee  Stings  in  Rheumatism,  313 

on  mcli  points,  stating  that  a  sting  of  a  bee  was  a  sure  cure  for 
rheamatism,  and  citing  seyeral  remarkable  instances  in  which 
people  had  been  perfectly  cured  by  this  abrupt  remedy.  Mr. 
Middlerib  did  not  stop  to  reflect  that  a  paper  with  such  a  name 
as  that  would  be  very  apt  to  say  anything  ;  he  only  thought  of 
the  rheumatic  twinges  that  grappled  his  knees  once  in  a  while, 
snd  made  life  a  burden  to  him. 

He  read  the  article  several  times,  and  pondered  over  it.  He 
understood  that  the  stinging  must  be  done  scientifically  and 
thoroughly.  The  bee,  as  he  understood  the  article,  was  to  be 
gripped  by  the  ears  and  set  down  upon  the  rheumatic  joint,  and 
held  there  until  it  stung  itself  stingless.  He  had  some  mis- 
givings about  the  matter.  He  knew  it  would  hurt.  He  hardly 
thought  it  could  hurt  any  worse  than  the  rheumatism,  and  it  had 
been  so  many  years  since  he  was  stung  by  a  bee,  that  he  had 
almost  forgotten  what  it  felt  like.  He  had,  however,  a  general 
feeling  that  it  would  hurt  some.  But  desperate  diseases  require 
desperate  remedies,  and  Mr.  Middlerib  was  willing  to  undergo 
any  amount  of  suffering  if  it  would  cure  his  rheumatism. 

He  contracted  with  Master  Middlerib  for  a  limited  supply  of 
bees,  humming  and  buzzing  about  in  the  summer  air,  as  Mr. 
Middlerib  did  not  know  how  to  get  them.  He  felt,  however, 
that  he  could  safely  depend  upon  the  instincts  and  methods  of 
bojhood.  He  knew  that  if  there  was  any  way  in  heaven  or  earth 
whereby  the  shyest  bee  that  ever  lifted  a  two  hundred  pound 
man  off  the  clover  could  be  induced  to  enter  a  wide  mouthed 
glass  bottle,  his  son  knew  that  way. 

Por  the  small  sum  of  one  dime  Master  Middlerib  agreed  to 
procure  several,  to  wit :  six  bees,  sex  and  age  not  specified ;  but, 
as  Ur.  Middlerib  was  left  in  uncertainty  as  to  the  race,  it  was 
made  obligatory  upon  the  contractor  to  have  three  of  them  honey 
and  three  humble,  or  in  the  general  accepted  vernacular,  bumble- 
bees. Mr.  Middlerib  did  not  tell  his  son  what  he  wanted  those 
bees  for,  and  •the  boy  went  off  on  his  mission  with  his  head  so  full 
of  astonishment  that  it  fairly  whirled.  Evening  brings  all  home, 
and  the  last  rays  of  the  declining  sun  fell  upon  Master  Middlerib 
with  a  short,  wide*mouthed  bottle  comfortably  populated  with 
hot,  ill-natured  bees,  and  Mr.  Middlerib  with  a  dime.  The  dime 
and  the  bottle  changed  hands.  Mr.  Middlerib  put  the  bottle  in 
bis  coat  pockety  and  went  into  the  house,  eyeing  everybody  he 


314  Miseettaneoui, 

met  Terj  saspiciously,  as  though  he  had  made  up  his  mind  to 
sting  to  death  the  first  person  who  said  *'  bee  "  to  him.  He  con- 
fided his  guilty  secret  to  none  of  his  family.  He  hid  his  bees  in 
his  bedroom,  and  as  he  looked  at  them  just  before  putting  them 
away  he  half  wished  the  experiment  was  safely  over.  He  wished 
the  imprisoned  bees  did  not  look  so  hot  and  cross.  With  exquisite 
care  he  submerged  the  bottle  in  a  basin  of  water,  and  let  a  few 
drops  in  on  the  heated  inmates  to  cool  them  off. 

At  the  tea  table  he  had  a  great  firight.  Miss  Middlerib,  in  the 
artless  simplicity  of  her  romantic  nature,  said: 

**  I  smell  bees.    How  the  odour  brings  up " 

But  her  father  glared  at  her,  and  said,  with  superfluous  harsh- 
ness and  execrable  grammar : 

"  Hush  up !  You  don't  smell  nothing." 

Whereupon  Mrs.  Middlerib  asked  him  if  he  had  eaten  any- 
thing that  disagreed  with  him,  and  Miss  Middlerib  said : 

"  Why  pa!"  and  Master  Middlerib  smiled  as  he  wondered. 

Bed-time  at  last,  and  the  night  was  warm  and  sultry.  Under 
various  false  pretences,  Mr.  Middlerib  strolled  about  the  house 
until  everybody  else  was  in  bed,  and  then  he  sought  his  room. 
He  turned  the  night-lamp  down  until  its  feeble  ray  shone  dimly 
as  a  death-light. 

Mr.  Middlerib  disrobed  slowly — very  slowly.  When  at  last  he 
was  ready  to  go  lumbering  into  his  peaceful  couch,  he  heaved  a 
profound  sigh,  so  full  of  apprehension  and  grief  that  Mrs. 
Middlerib,  who  was  awakened  by  it,  said  if  it  gave  him  so  much 
pain  to  come  to  bed,  perhaps  he  had  better  sit  up  all  night.  Mr. 
Middlerib  checked  auother  sigh,  but  said  nothing,  and  crept  into 
bed.  After  lying  still  a  few  moments  he  reached  out  and  got  his 
bottle  of  bees. 

It  was  not  an  easy  thing  to  do  to  pick  one  bee  out  of  the 
bottleful  with  his  fingers,  and  not  get  into  trouble.  The  first  bee 
that  Mr.  Middlerib  got  was  a  little  brown  honey-bee  that  wouldn't 
weigh  half  an  ounce  if  you  picked  him  up  by  the  ears,  but  if 
lifted  by  the  hind  legs,  would  weigh  as  much  as  the  last  end  of  a 
bay  mule.    Mr.  Middlerib  could  not  repress  a  groan. 

''  What's  the  matter  with  you  P"  sleepily  asked  his  wife. 

It  was  very  hard  for  Mr.  Middlerib  to  say  he  only  felt  hot, 
but  he  did  it.  He  didn't  have  to  lie  about  it  either.  He  did 
feel  very  hot  indeed — about  86  all  over,  and  197  on  the  end  of 


Bee  Stings  in  Rheumatism.  315 

his  thumb.  He  reversed  the  bee,  and  pressed  the  warlike 
terminus  of  it  firmly  against  the  rheumatic  knee. 

It  didn't  hurt  so  badly  as  he  thought  it  would. 

It  didn't  hurt  at  aU. 

Then  Mr.  Middlerib  remembered  that  when  the  honey-bee 
Btabs  a  human  foe  it  generally  leaves  its  harpoon  i&  the  wound, 
and  the  invalid  knew  that  the  only  thing  this  bee  had  to  sting 
with  was  doing  its  work  at  the  end  of  his  thumb. 

He  reached  his  arm  out  from  under  the  sheet,  and  dropped  his 
disabled  atom  of-  rheumatism  liniment  on  the  carpet.  Then, 
after  a  second  of  blank  wonder,  be  began  to  feel  around  for  the 
bottle,  and  wished  he  knew  what  he  did  with  it. 

In  the  meantime  strange  things  had  been  going  on.  When  he 
caught  hold  of  the  first  bee,  Mr.  Middlerib,  for  reasons,  drew  it 
out  in  such  haste  that  for  the  time  he  forgot  all  about  the  bottle 
and  its  remedial  contents,  and  left  it  lying  uncorked  in  the  bed, 
between  himself  and  his  innocent  wife.  In  the  darkness  there 
had  been  a  quiet  but  general  emigration  from  that  bottle.  The 
bees,  their  wings  clogged  with  the  water  Mr.  Middlerib  had 
poured  upon  them  to  cool  and  tranquilise  them,  were  crawling 
aimlessly  about  over  the  sheet.  While  Mr.  Middlerib  was  feeling 
around  for  it,  his  ears  were  suddenly  thrilled,  and  his  heart  frozen 
by  a  wild,  piercing  scream  from  his  wife. 

"Murder! I'  she  screamed;  '* murder!  Oh!  help  me!  Help! 
help!" 

Mr.  Middlerib  sat  bold  upright  in  bed.'  His  hair  stood  ou 
end.    The  night  was  warm,  but  he  turned  to  ice  in  a  minute. 

"  Where  in  thunder —  "  he  said  with  pallid  lips,  as  he  felt  all 
over  the  bed  in  frenzied  haste — *'  Where  in  thunder  are  them 
infernal  bees  ?" 

And  a  large  "  bumble,"  with  a  sting  as  pitiless  as  the  finger 
oi  scorn,  just  then  climbed  up  the  inside  of  Mr.  Middlerib's 
night-shirt,  until' it  got  squarely  between  his  shoulders,  and  then 
felt  for  his  marrow,  and  said,  calmly  : 

**  Here  is  one  of  tbem." 

And  Mrs.  Middlerib  felt  ashamed  of  her  feeble  screams  when 
Mr.  Middlerib  threw  up  both  his  arms,  and  with  a  howl  that 
made  the  windows  rattle,  roared : 

"Take  him  off!  Oh,  land  of  Scott !  somebody  take  him  off !" 

And  when  a  little  honey-bee  began  to  tickle  the  sole  of  Mrs. 


316  Miscellaneous. 

Middlerib's  foot,  she  shrieked  that  the  house  was  bewitched,  and 
immediatelj  went  into  spasms. 

The  household  was  aroused  by  this  time.  Miss  Middlerib 
and  Master  Middlerib  and  the  servants  were  pouring  into  the 
room,  adding  to  the  general  confusion  by  howling  at  random  and 
asking  irrelevant  questions,  while  they  gazed  at  the  figure  of  a 
man,  a  little  on  in  years,  arrayed  in  a  long  night-shirt,  pawing 
fiercely  at  the  unattainable  spot  in  the  middle  of  his  back,  while 
he  danced  an  unnatural,  weird,  wicked  looking  jig  by  the  dim 
religious  light  of  the  night-lamp.  And  whUe  he  danced  and 
howled,  and  while  they  gazed  and  shouted,  a  navy-blue  wasp, 
thai;  Master  Middlerib  had  put  in  the  bottle  for  good  measure 
and  variety,  and  to  keep  the  managerie  stirred  up,  had  dried  his 
legs  and  wings  with  the  comer  of  the  sheet,  and  after  a  prelimi- 
nary circle  or  two  around  the  bed  to  get  up  his  motion  and 
settle  down  to  a  working  gait,  he  fired  himself  across  the  room, 
and  to  his  dying  day  Mr.  Middlerib  will  always  believe  that  one 
of  the  servants  mistook  him  for  a  burglar  and  shot  him. 

Not  one,  not  even  Mr.  Middlerib  himself,  could  doubt  that  he 
was,  at  least  for  the  time,  most  thoroughly  cured  of  rheumatism. 
His  own  boy  could  not  have  carried  himself  more  lightly  or  with 
greater  agility.  But  the  cure  was  not  permanent,  and  Mr. 
Middlerib  does  not  like  to  talk  about  it. — Burdette,  in  2f.  Y. 
Weekly. 


Arnica  in  Boils. 

Dr.  Planat,  of  Nice,  claims  that  Arnica  has  the  power  of 
aborting  an  eruption  of  boils  with  extraordinary  rapidity,  except 
when  due  to  diabetes.  His  method  of  employing  it  is  very 
simple.  In  order  to  render  its  action  on  the  small  vessels  ener- 
getic, he  applies  it  directly  to  the  inflamed  spot  in  the  form  of  an 
ointment,  of  which  the  formula  is  as  follows : — Extract  of  fresh 
Arnica  leaves,  5iiss  ;  honey,  5vss.  If  the  mixture  is  too  fluid  he 
adds  powdered  Lycopodiumt  or  some  other  inert  powder,  until 
it  acquires  the  proper  consistency.  It  is  then  spread  pretty 
thickly  on  a  bit  of  oiled  silk  or  diachylon  plaster,  and  applied  to 
the  boil.    It  is  rarely  necessary  to  renew  the  dressing  more  than 


Arnica  in  BoUs.  317 

once  in  twenty-four  hours.  As  a  rule,  two  or  three  dresBings  are 
eDough  to  make  a  furuncle  abort.  A  curatiye  action  is  also 
obtained  by  the  internal  administration  of  the  drug.  Dr.  P — 
gives  three  to  four  drops  of  the  tincture,  largely  diluted,  every 
two  hours,  and  he  has  seen  the  furuncular  eruption  disappear 
Tcry  rapidly  under  the  treatment. — 8t.  Louis  Med,  Jour, 

Br.  Planat  is,  no  doubt,  a  homosopathist,  and  his  use  of  Arnica 
in  boils  is  no  novelty  in  our  school.  The  most  remarkable  thing 
about  his  paper  is  its  admission  into  the  pages  of  an  allopathic 
journal.  This  tardy  recognition  by  the  old  school  of  the  curative 
▼irtnes  of  Amiea  in  boils  is  a  more  hopeful  sign  of  progress  in 
therapeutic  knowledge  than  the  following  passage  in  a  lecture 
ktely  delivered  at  St.  Mary's  Hospital  by  Dr.  Bobert  Farquhar- 
Bon: 

"  But  of  all  the  occasional  offenders  of  this  sort  against  com- 
fort and  even  life  is  Amiea,  which  is  commonly  resorted  to  by 
the  ignorant  public  as  a  sovereign  remedy  for  sprains.  It  is 
pretty  generally  recognised  among  medical  men,  no  doubt,  that 
it  now  and  then  produces  erysipelatoid  inflammation  of  skin, 
but  book-knowledge  of  this  kind  makes  little  impression  in  com- 
parison with  the  observation  even  of  a  single  case.  Professor 
Hebra,  of  Vienna,  is  one  of  the  most  persistent  and  strenuous 
opponents  of  Amiea,  and  I  well  remember  his  vigorous  denuu'* 
ciation  of  its  real  effects  from  the  text  of  a  very  acute  inflamma* 
tion  of  both  hands,  for  which  it  was  responsible,  and  where  the 
skin  was  covered  with  huge  blisters,  and  almost  running  into 
gangrene.  A  year  or  two  ago  I  had  the  opportunity  of  seeing  a 
typical  case  in  the  person  of  an  old  lady,  to  whose  sprained  arm 
anon-professional  man  had  applied  a  weak  solution  of  tincture 
of  Amiea,  contrary  to  my  advice.  A  true  erysipelas  started 
from  the  point  of  application,  and  slowly  spread  over  the  whole 
bodj,  causdng  much  irritation  and  discomfort  and  depression, 
And  greatly  retarding  her  recovery  from  what  would  otherwise 
have  proved  a  comparatively  trifling  injury.  Phillips  {Materia 
Mediea  and  Therapeutics)  tells  us  that  if  we  use  a  watery  solution 
we  are  safe  from  the  effects  of  the  irritating  ingredient  which 
alcohol  extracts,  but  the  experiments  of  Garrod  (Materia  Mediea, 
artiele  Amiea)  seems  to  me  to  have  given  a  death-blow  to  the 
partisans  of  Amiea  as  an  aid  to  the  absorption  of  effused  blood, 
and  my  advice  to  you  is  to  let  this  drug  take  its  rightful  place 


318  Miscellaneous. 

among  those  subBtances  of  extinct  reputation  which  Btill  continue 
to  sleep  peacefully  in  the  JBharfnaeopaia,^^ — Brit,  Med.  Jour., 
Feb.  15th,  1879. 

The  business  of  a  professor  of  Materia  Medica  we  should  haye 
thought  was  to  discover  drugs  that  had  a  powerful  action  on  the 
human  body  in  order  to  employ  them  medicinally  in  disease,  just 
as  the  business  of  constables  is  to  discover  rogues,  and  conyey 
them  to  the  lock-up.  But  Dr.  Farquharson  seems  to  have  as 
little  stomach  for  the  utilisation  of  powerful  drugs  in  his  thera- 
peutics as  Dogberry  had  for  the  arrest  of  knaves. 

Bogh.^Xoji  th«U  comprehend  aU  yagrom  men ;  yon  are  to  hid  any  man 
stand,  in  the  princess  name. 

W<Ueh.—VLo^  if  'a  will  not  stond  P 

Dogh, — Why  then  take  no  note  of  him,  bnt  let  him  go;  and  presently  call 
the  rest  of  the  watch  together,  and  thank  Qod  yoa  are  rid  of  a  kna?e. 

Verg. — If  he  will  not  stand  when  he  \e  bidden,  he  is  none  of  the  prince'f 
subjects. 

So  this  medical  Dogberry,  after  tellins  his  audience  that 
Materia  Medica  comprehends  all  substances  that  have  a  physio- 
logical action  on  the  human  body,  advises  them  when  they  meet 
with  one  that  has  a  very  decided  and  specific  action  of  its  own, 
to  take  no  note  of  it,  but  let  it  go,  and  presently  thank  God 
that  they  are  rid  of  an  "  offender  against  comfort,*'  and  he 
adds,  after  the  manner  of  Verges,  that  if  a  drug  displays  any 
physiological  action,  it  is  none  of  the  subjects  of  his  Materia 
Medica,  and  should  be  allowed  ''  to  sleep  peacefully  in  the  Fhar 
tnacopoBta,** 


British  Hammopathic  Congress. 

This  year's  Congress  will  be  held  at  Malvern,  on  Thursday, 
September  11th.  The  Presidential  Address  (by  Dr.  Hughes) 
will  be  upon  "  Homoeopathy ;  its  present  state  and  future 
prospects."  For  further  particulars  the  monthly  journals  should 
be  consulted. 


319 


CORRESPONDENCE. 


To  the  Editors  of  the  '  British  Jowmal  ofHomosopathy.^ 

From  a  passage  in  p.  339  of  the  June  number  of  the  Monthly 
Bomceopathic  Review^  it  would  appear  that  the  writer  imagines 
that  I  have  refused  1)o  continue  my  subscription  to  the  School  of 
Homodopathj,  and  ha?e  tried  to  induce  others  to  do  so.  This  is 
a  mistake.  I  intend  to  give  it  for  five  years,  as  originally  promised, 
but,  for  the  reasons  given  some  months  ago,  to  postpone  the  pay- 
ment till  some  subsequent  time  for  any  year  in  which  the  managers 
devote  the  bulk  of  the  money  to  a  purpose  not  contemplated  when 
my  subscription  was  promised,  viz.  the  subsidy  to  the  ordinary 
expenses  of  the  hospital.  They  have  taken  the  money  for  this  year, 
but  if  they  do  not  do  so  in  1880, 1  will,  of  course,  pay  them  my 
third  subscription,  and  afterwards  in  the  same  way  in  due  course. 

Permit  me  also  to  express  my  regret  that  this  writer  should 
identify  his  opinions  with  the  existence  of  this  school,  and  pro- 
nounce all  who  differ  from  him  to  be  opponents  of  the  school. 
I  have  been  from  the  beginning  one  of  the  warmest  friends  of  the 
school,  and  deem  it  my  duty  to  do  my  best  for  its  welfare,  without 
pronouncing  that  those  who  differ  from  me  are  opponents  of  the 
schooL  Judged  by  his  own  rule  the  writer  of  the  above  article 
is  an  opponent  of  the  school.  For  before  proposing  the  appoint- 
ment of  a  '^  recognition  committee,"  I  submitted  the  proposal 
to  the  Honorary  Secretary,  who  approved  and  promised  to  sup- 
port it  cordially,  and  when  brought  forward  it  was  discussed  and 
unanimously  carried  at  the  annual  meeting.  It  is,  therefore,  an 
action  of  the  school  which  the  anonymous  writer  prejudges  and 
ridicules  in  the  above  article.  This  is  greatly  to  be  deplored,  as 
the  difficulties  of  this  object  are  naturally  so  great  that  it  will 
require  all  our  united  strength  to  face  them.  Such  an  article, 
though  of  no  official  value,  is  hurtful  to  the  school  by  promoting 
discord  and  half-heartedness,  and  ought  not  to  have  been  written 
before  the  committee  had  had  time,  at  least,  to  give  in  their 
report,  whatever  the  opinions  of  the  editors  may  be. 

lam, 

Tour  obedient  servant, 

John  Dbysdaue. 


320 


BOOKS    RECEIVED, 

UssentiaU  of  Diet.  By  the  late  E.  H.  Buddock,  M.D.  2nd 
edition,  by  E.  B.  Shuldham,  M.D.  London :  Horn.  Publ.  Co., 
1879. 

Allen's  EneyelapcBdia,    Vol.  IX. 

Lectures  on  Materia  Mediea.  By  Cabboll  Dufhah,  M.D. 
2  vole.    New  York,  1878. 

On  the  Climate  of  Davos  am  Platz,  with  Treatment  of  Con- 
sunwtion.    By  A.  C.  Pope,  M.D.    London  :  Gould,  1879. 

MorseSf  HI  and  Well :  Homoeopathic  Treatment  of  Diseases  and 
Injuries,  ^c.  By  Jahss  Moobb,  M.B.C.Y.S.,  and  Thomas 
MooBE,  M.B.G.y.S.    8rd  edition.    London :  Epps. 

A  new  form  of  Nervous  Disease.  By  W.  8.  Seabls,  A.M., 
M.D.    Philadelphia,  1879. 

Pott's  Disease.  By  Newtok  M.  Sha7feb,  M.D.  New  York, 
1879. 

A  Biographical  Retrospect  of  Allopathy  and  Homceopathy  during 
the  last  thirty  years.  By  Hugh  Hastings,  M.D.  London :  Turner. 

On  Spasmodic  Stricture  of  the  Urethra,  By  H.  B.  Sands, 
M.D.    New  York. 

Urethrismus  or  Chronic  Spasmodic  Stricture.  By  F.  N.  Otis, 
M.D.    1879. 

Somceopathic  Therapeutics.  By  S.  Lilisnthal,  M.D.  New 
York,  1879. 

Lectures,  Clinical  and  Didactic^  on  the  Diseases  of  Women.  By 
B.  LuDLAH,  M.D.    4th  edition.     Chicago,  1879. 

Some  Remarks  on  Similia  Similibus  Ourantur.  By  W.  B. 
Dunning,  M.D.    Hartford,  1879. 

The  Guiding  Symptoms  of  the  Materia  Mediea.  By  C.  Hebing, 
M.D.    Vol.  L     PhOadelphia,  1879. 

St.  Louis  Clinical  Record. 

The  American  Homoeopath. 

Revue  Homceopathigue  Beige. 

The  Monthly  HomoBopathic  Review. 

The  Hahnemannian  Monthly. 

The  American  Homoeopathic  Observer. 

The  United  States  Medical  Investigator. 

The  North  American  Journal  of  Homoeopathy. 

The  New  England  Medical  Gazette. 

JBl  Criterio  Medico. 

L'Art  Medical. 

Bulletin  de  la  Sociiti  Med.  Hom.  de  France. 

Allgemeine  homoopathische  Zeitung. 

The  Homoeopathic  World, 

The  Homoeopathic  Times. 

V Homoeopathic  Militante. 

The  Organon. 

Index  Medicus.    New  York,  April,  1879. 


THE 


BRITISH   JOURNAL 


07 


HOMGEOPATHY. 


OVARIOTOMY. 
By  Professor  Wm.  Tod  Helmxjth^  M.D. 

Operation  at  Ward'a  Island  Homceopathic  Hospital.    Case  conducted  and 
reported  by  £.  Gueskbbt  Baj7KIN,  A.M.,  M.D.,  Honse  Surgeon. 

Henrietta  Anderson^  set.  50^  CaDadian,  wife  of  a 
mechanic^  was  admitted  to  the  hospital  May  6th^  1879.  She 
bad  always  enjoyed  good  health  up  to  the  spring  of  1874^ 
irfaen  she  noticed^  for  the  first  time^  an  unnatural  prominence 
of  the  abdomen.  This  was  also  about  the  time  of  her 
menopause.  She  had  never  conceived^  having  had  neither 
children  nor  miscarriages^  and  from  girlhood  had  been 
regular  in  her  menses.  She  had  always  been  accustomed 
to  lead  an  active  life  in  the  care  of  her  household  affairs. 
The  enlargement  of  the  abdomen  caused  no  particular 
annoyance  for  the  next  two  years ;  it^  however^  continued 
steadily  to  increase  in  size.  She  consulted  several  physicians, 
and  one  year  ago  came  to  the  notice  of  Prof.  Helmuth^ 
who  diagnosed  her  case  as  an  ovarian  tumour^  and  advised 
an  operation.  Being  of  a  somewhat  nervous  disposition 
she  preferred  to  delay  any  surgical  procedure. 

For  the  next  year  she  continued,  more  or  less^  to  attend 
to  her  domestic  duties,  as  she  had   been  heretofore  accus- 

VOL.  XXXVII,  NO.  CL.— OCTOBER,  1879.  X 


822  Ovariotomy^ 

tomed,  until  early  this  spring  when  the  enlargement  of  the 
abdomen  became  so  burdensome,  and  her  health  so  mach 
impaired,  that  she  again  came  to  Prof.  Helmutb,  who  advised 
her  to  come  to  the  hospital. 

The  patient's  condition  on  entrance  to  the  hospital  was 
not  very  encouraging  for  an  operation.  There  was  great 
anaemia  and  much  emaciation,  and  the  orarian  face  with 
the  characteristic  thinness  about  the  neck  strongly  marked. 
She  walked  around  and  was  moderately  comfortable.  The 
abdomen  measured  in  circumference  forty-three  inches. 
Some  of  the  fluid  was  withdrawn  with  the  aspirator  and 
examined  under  the  microscope,  aud  found  to  contain  blood 
and  oil  globules,  pus-corpuscles,  and  Drysdale's  corpuscles 
in  abundance,  couflrming  the  diagnosis.  It  was  intended, 
by  careful  hygiene  and  diet,  to  place  the  patient  in  as 
favorable  a  condition  as  possible  for  an  operation,  but  this 
plan  was  unfortunately  frustrated  by  the  appearance  of  sym- 
ptoms of  peritonitis  on  May  11th,  five  days  after  her 
admission  to  the  ward.  She  complained  of  flushes  of  heat 
and  cold  running  over  the  body  with  burning  pains  in  the 
abdomen.  There  was  vomiting,  from  time  to  time,  of  a 
bright  green  bilious  matter,  and  excessive  action  of  the 
salivary  glands;  the  temperature  was  100^,  and  pulse  100. 
Aconite  was  administered ;  but  the  temperature  continued 
steadily  to  rise,  and  on  May  13th  was  lOS^^^.  Crels. 
1^  and  Ars.  3',  in  alternation,  were  then  giveu,  and  the 
temperature  fell  to  10 1|^^;  the  pulse  remained  about  the 
same.  There  was  little  or  no  appetite,  and  great  prostra- 
tion. 

From  this  time  up  to  May  24th,  the  date  of  operation, 
the  patient  grew  rapidly  weaker,  the  pulse  varied  from  90 
to  100,  and  the  temperature  from  99^  to  102^,  indicating 
that  there  was  some  suppurative  process  within  the  tumour. 
Bel,  1*,  Chin.  0,  and  Merc,  sol,  1*,  were  also  administered 
at  intervals  for  several  changes  of  the  symptoms,  with  some 
temporary  relief.  A  small  amount  of  stimulants  and  the 
lightest  and  most  easily  digested  food  were  given  because 
of  the  irritability  of  the  stomach. 

The  patient's  friends  were  informed  that  death  was  not 


by  Dr.  Tod  Helmuth.  828 

far  distant^  and  that  an  operation  under  these  circamstances 
would  be  attended  by  the  gravest  dangeis.  The  patient 
herself  was  conscious  of  her  condition.  Nevertheless^  both 
she  and  her  friends  expressed  themselves  willing  to  have  the 
tumour  removed  immediately,  in  hopes  that  the  small  chance 
of  recovery  might  fall  to  her  lot. 

Accordingly,  after  consultation  with  several  gentlemen  of 
the  visiting  staff,  and  at  the  desire  of  the  patient's  friends, 
Prof.  Helmuth  decided  to  perform  ovariotomy  immediately. 
On  May  24th,  at  4.15  p.m.,  the  patient  was  placed  upon 
the  operating  table  in  the  hospital  amphitheatre.  Before 
administering  the  ether  the  pulse  was  100^  and  temperature 
101^^.  The  atmosphere  had  been  previously  disinfected 
by  use  of  the  carbolic  spray,  the  operation  being  per- 
formed under  the  same.  All  the  sponges,  instruments, 
towels,  linen,  clothes  of  assistants,  and  everything  connected 
with  the  operation,  were  carefully  carbolised. 

Before  commencing  Prof.  Helmuth  made  a  few  remarks, 
explaining  the  desperate  condition  of  the  woman  about  to 
be  operated  upon,  but  that  insomuch   as  the  patient  and 
her  friends  knew  the  unfavorable  circumstances  attending 
the    case,  and  also  appreciated  that  the   removal  of   the 
tumour  would  give  the  only  possible  chance  for  recovery, 
at  their  solicitation  he  had  decided  to  perform  ovariotomy. 
An  incision  in  the  median  line,  about  three  inches  in  length, 
was    made,   commencing  about   half   an    inch  below    the 
nmbilicus.      The    abdominal    walls    were    then    dissected 
down  to  the  peritoneum.     All  bleeding  having  ceased,  the 
peritoneum  was  raised  with  a  pair  of  forceps,  nicked,  the 
director  introduced,  and  the  covering  incised,  thus  exposing 
the  sac  of  the  tumour.     A  steel  sound  was  then  run  in 
between  the  sac  and  the  abdominal  walls,  and  the  adhesions, 
which  were  quite  extensive,  broken  up.     The  tumour    was 
then  punctured  with  a  Spencer  Wellb^  trocar  aud  the  fluid 
contents  allowed  to  run  off.     The  fluid  was  of  a  dark  choco- 
late colour,  thick  and  opaque.     The   sac  was   then  firmly 
secured  and  withdrawn  from  its  position  in  the  abdomen, 
the  greatest  precaution  being  used  that  none  of  its  contents 
should  escape  into  the  peritoneal  cavity;  this  was   accom- 


824i  Ovariotomy, 

plished  by  an  assistant  holding  the  edges  of  the  incision 
tightly  to  the  walls  of  the  tumour.  The  sac  was  drawn 
onty  the  remainder  of  the  fluid  allowed  to  escape,  and 
adhesions  to  the  transverse  colon,  omentum,  and  small 
intestines,  separated.  The  adhesions  to  the  omentum  were 
extensive.  The  transverse  colon  during  the  operation 
protruded  through  the  incision,  and  was  immediately 
replaced.  The  omentum,  covered  with  shreds  and  clots, 
was  withdrawn  with  the  tumour,  cleansed,  and  was  also 
replaced. 

The  pedicle,  which  was  on  the  right  side,  was  then  ligated 
and  the  sac  removed.  Silk  ligatures  were  used  and  the 
stump  of  the  pedicle  allowed  to  remain  within  the  abdomen 
with  the  ligatures  attached.  The  peritoneal  cavity  was 
then  sponged  and  washed  out,  a  glass  drainage  tube,  provided 
with  a  cork,  introduced,  and  the  incision  sewed  up  with  three 
wire  sutures.  The  wound  was  then  dressed  with  oakum, 
covered  with  layers  of  lint  saturated  with  a  solution  of 
carbolic  acid,  and  the  whole  protected  with  a  mackintosh 
held  in  place  by  a  firm  abdominal  bandage.  During  the 
operation  three  hypodermics  of  whiskey,  of  vixxx  each,  were 
given,  the  patient  seeming  several  times  as  if  unable  to 
survive. 

The  fluid  contents  of  the  sac  weighed  37^  lbs.  and  the 
sac  itself  2^  lbs.,  making  the  total  weight  of  the  tumour 
40  lbs. 

The  cyst  was  multilocular  and  contained  numerous  small 
cysts  embedded  in  the  walls.  Upon  examination  the 
internal  surface  was  found  to  have  undergone  suppuration  in 
several  places,  especially  in  the  posterior  surface,  where  there 
were  patches  of  pus,  and  the  tissue  broke  down  easily. 
The  patient  was  then  placed  upon  a  water  bed  in  an  apart- 
ment which  had  been  previously  cleansed  and  disinfected^ 
the  atmosphere  here  also  having  been  carbolised.  Bottles  of 
hot  water  were  placed  to  the  extremities,  which  were  a  little 
cold.     The  pulse  was  120. 

For  the  next  two  hours  brandy  and  water  was  admi- 
nistered every  twenty  minutes.  She  recovered  from  the 
effects  of  the  ether  at  8.10  p.m.,  when  the  pulse  was  108 


by  Dr.  Tod  Helmvth.  825 

and  the  general    conditioa  favorable.     At  9  o^clock  she 
complained  of  severe   pain   in  the  abdomen,  which   lasted 
until  10.30   p.m.^   when   she  again    began  to  feel  chilly. 
Heat  was  applied  to  the  extremities  and  the  natural  warmth 
of  the    parts   soon  restored.     At   11    p.m.   was  sleeping 
quietly,  pulse  100,  respiration  39.     Entries  of  the  patient's 
condition  were  made  in  the  hospital  record  every  two  hours 
daring  the  next  eight  hours ;  there  were  no  changes  noted, 
the  pulse   remained  about  108,  the  urine  was  drawn  with 
the  catheter,  and  the  patient  was  quite  comfortable,  with 
the  exception  of  now  and  then  a  sharp  pain  in  the  abdomen. 
Kice  water    and    brandy  were    given    at   short    intervals. 
May  25th,  at  3.30  a.m./the  temperature  was  99^^.     8  a.m., 
temperature  100^  and  pftilse  100.     ,On  removing  the  dress- 
ings, a  copious  discharge  of  bloody  serum  was  found  to  have 
saturated  the    oakum   and    bandages.     Tho    cork  of   the 
drainage  tube  was  then  removed   and  about  an   ounce  of 
bloody  serum  i^ithdrawn   by  means  of  the, aspirator  with  a 
gum  elastic  catheter  attached  ;  the  catheter  was  introduced 
into  the  peritoneal  cavity,  through  the  drainage   tube.     At 
4  p.m.  the  dressings  were  again  changed,  and  found,  as   in 
the  morning,   saturated  with  a    bloody  serous   discharge. 
She  had  been  quite  comfortable  up  to  this   time,  when  she 
b^an  to  coinplain  of  intense  thirst,  the  temperature  was 
100^,  and  there  was  considerable  tympanitis.     Ars.  3^,  6  gr. 
eveiy  three  hours,  was  then  given,  and  the  patient  allowed 
to  take  broken  ice  ad  libitum.     At  7.30  the  dressings  were 
found  to  be  wet  with  the  serous  discharge,  and  were  accord- 
ingly renewed.     The  entries  in  the  record  book  show  no 
change  until  3.30  am.  (Ma^  26th),  when  the  temperature 
fell  to  99f ,  and  the  pulse  was  104. 

She  had  slept  for  the  past  four  hours,  waking  up  at 
short  intervals  and  receiving  nourishment.  The  dressings 
were  changed  at  this  hour  also,  and  a  drachm  of  fluid  with- 
drawn from  the  tube. 

10  a.m« — She  feels  comfortable.  Pulse  114;  tempe- 
rature 100^^.  On  changing  the  dressings,  about  an  ounce 
and  a  half  of  semi-purulent  matter  was  withdrawn  by  the 


826  Ovariotomy, 

aspirator.  The  same  form  of  nourishment  was  still  oon- 
tinued^  rice  or  barley  water^  and  iced  brandy-and-water. 

At  6.30  p.m. — There  was  a  sudden  appearance  of  nausea 
and  vomiting  of  yellowish  watery  material.  Gave  Ipecac.  Ix 
every  twenty  minutes^  which  seemed  to  relieve  this 
unfavorable  symptom.  Changed  the  dressing  this  even- 
ing, and  withdrew  about  three  drachms  of  semi-purulent 
matter. 

May  27th,  at  3.30  a.m. — Condition  was  the  same,  tem- 
perature (rectal)  was  100,°  and  pulse  100.  Dressed  the 
incision  at  this  hour  again,  withdrawing  with  the  aspirator 
about  two  drachms  of  pus. 

11  a.m. — Dressings  changed.  Temperature  100^^;  pulse 
114.  Gave  Quin.  Sulph.,  gr.  iij,  every  four  hours  during 
the  day  ;  at  4  p.m.  changed  the  dressings  as  before,  and  at 
8  p.m.  also.  After  withdrawing  about  half  an  ounce  of  pus, 
the  abdominal  cavity  was  thoroughly  washed  out  with  warm 
water  carbolised,  1 — 100,  at  a  temperature  of  98**.  The 
temperature  and  pulse  were  the  same  before  and  after  the 
intra-peritoneal  injection,  the  pulse  being  102  and  tempe- 
rature 101^.  In  employing  the  intra-peritoneal  injection, 
after  withdrawing  all  the  pus  which  could  be  accomplished 
by  the  aspirator,  the  tube  being  moved  gently  around,  the 
water  was  allowed  to  run  in  from  a  fountain  syringe,  then 
removed  with  the  aspirator  again.  The  use  of  the  aspirator 
with  the  flexible  catheter  attached  effects  the  washing  out 
of  the  cavity  in  a  very  satisfactory  manner.  Great  pre- 
caution must  be  taken,  however,  not  to  allow  any  of  the 
intestines  to  be  drawn  up  through  the  openings  in  the 
catheter,  lest  they  might  be  injured,  an  accident  very  likely 
to  occur  when  the  silver  catheter  is  used. 

In  using  the  intra-peritoneal  injection  the  following 
morning  (May  28th),  the  cold  douche  was  applied. 

A  pitcher  of  cold  water  was  poured  over  the  abdomen, 
which  had  been  protected  by  a  rubber  sheet,  the  water 
being  allowed  to  run  over  the  side  of  the  bed,  where  pails 
were  placed  to  receive  it. 

6  p.m. — Condition  about  the  same  ;  the  brandy  was  still 
continued,  and  beef  tea  was  now  given  also.     Before  and 


by  Dr.  Tod  Helmuth.  827 

rfter  each  douche  and  peritoneal  injection,  the  pulse  and 
temperature  were  taken.  In  some  instances  there  would  be 
DO  change^  but  usually  the  temperature  would  fall  about 
one  fifth  of  a  degree,  and  the  pulse  rise  five  or  six  beats. 
For  the  next  three  days  the  douche  and  injections  were  kept 
np  three  times  in  twenty-four  hours,  at  1  and  8  o^clock  in 
the  morning  and  at  5  iu  the  afternoon,  and  at  each  in- 
jection about  four  ounces  of  fetid  pus  was  removed.  The 
quinine  was  continued  as  before. 

.  On  May  Slst  there  was  intensely  warm  weather;  the 
patient  up  to  this  time  had  been  quite  strongs  to  all  out- 
ward appearances ;  she  now  complained  very  much  of  the 
heat,  and  seemed  to  begin  suddenly  to  lose  all  strength ; 
the  temperature  was  99|^  in  the  morning  and  lOOj^  in  the 
evening;  the  quinine  and  brandy  were  still  continued. 
There  was  less  pus  withdrawn,  and  that  of  a  less  offensive 
odour.  An  attempt  was  made  to  give  milk  and  lime  water, 
but  the  stomach  refused  to  hold  it.  Rectal  injections  of 
cod-liver  oil  and  lime  water  were  then  administered. 

On  June  1st  the  warm  weather  continued,  and  the 
patient's  unfavorable  condition  grew  more  marked.  Cham- 
pagne was  substituted  for  the  brandy^  and  the  beef  tea  and 
quinine  continued. 

Jane  2nd^  a.m. — Patient  is  failing,  seems  much  weaker. 
Temperature  100J°,  pulse  114,  before  the  morning,  intra- 
peritoneal injection;  after,  temperature  100J°,  pulse  116.  A 
.considerable  quantity  of  pus  still  continued  to  be  withdrawn 
at  each  dressing.  At  about  midnight  diarrhcea  appeared, 
and  she  had  eight  movements  in  as  many  hours ;  lead  and 
opium  suppositories  were  administered  with  relief,  but  she 
continued  to  grow  weaker.  The  cod -liver  oil  injections 
were  of  course  discontinued. 

On  June  3rd  the  bandages  were  changed,  and  the  intra- 
peritoneal injection,  the  nineteenth  and  last  time,  adminis- 
tered, but  no  douche  was  applied ;  the  temperature  was  99^, 
and  pulse  126,  there  was  profound  prostration,  and  the 
patient  was  evidently  moribund.  Hypodermics  of  brandy 
were  given  at  intervals.  She  continued  to  grow  weaker,  and 
died  quietly  at  6.10  p.m. 


828  Ovariotomy, 

The  patient  lived  ten  days  and  two  hours  after  the  opera* 
tion.  There  had  been  administered^  in  all,  nineteen  intra- 
peritoneal injections.  The  first  injection  was  used  on  the 
third  day  after  the  operation.  The  douche  was  applied 
sixteen  times ;  entries  of  the  patient's  condition  were  made 
in  the  hospital  records  about  every  six  hours,  both  night 
and  day.  The  utmost  care  was  employed  in  regard  to 
disinfection,  the  attending  surgeon  abstaining  from  all  other 
charge  of  the  rest  of  the  wards,  and  the  day  and  night 
nurses  in  charge  had  nothing  to  do  with  any  ither  patient 
A  carbolic  spray  was  kept  in  operation  continuously,  and  a 
sheet  wet  with  carbolic  was  placed  over  the  door  of  the  room. 

The  following  is  a  report  of  the  autopsy  held  on  Jane 
4th,  at  2.30  p.m. : 

Height,  6  feet  2  inches;  weight,  78  pounds;  circum- 
ference of  abdomen,  25^  inches ;  circumference  of  chest,  28 
inches;  circumference  of  head,  23  inches;  emaciation  extreme; 
rigor  mortis  absent. 

Tirade  cavity. — Pericardium :  some  adhesions  near 
apex,  fluid  normal. 

Heart :  weight  5  ounces ;  left  ventricle,  calcareous  secre- 
tions all  along  the  base  of,  and  also  below  the  aortic  valve  in 
the  ventricle,  also  in  the  ascending  aorta;  tissue  somewhat 
soft;  walls  slightly  hypertrophied ;  ante-mortem  clots  in 
right  ventricle ;  right  side  of  heart  normal. 

Lungs :  left,  weight  9  ounces ;  hypostatic  congestion  of 
lower  lobe,  slight  fibrous  degeneration  in  apex.  Bight, 
weight  10  ounces ;  apex  adherent ;  oedema  of  lower  lobe, 
slight  emphysema  of  upper  lobe ;  small  cavity  and  fibrous 
degeneration  also  in  upper  lobe. 

Abdominal  and  pelvic  cavities, — Liver :  weight  2  pounds 
14^  ounces ;  gall  bladder  engorged ;  capsule  of  liver  slightly 
adherent;  tissue  normal. 

Spleen :  weight  2^  ounces ;  tissue  bright  red,  otherwise 
normal. 

Kidneys :  left,  weight  4  ounces ;  capsule  adherent ;  tissues 
anaemic;  small  abscesses  scattered  throughout  in  the  pyra- 
mids. Right,  weight  8  ounces;  several  large  multiple 
abscesses,  and  also  smaller  ones  scattered  throughout. 


by  Dr.  Tod  Helmuih.  329 

Stomach  distended  with  gas. 

Intestines,  large  and  small,  distended  with  gas ;  all  the 
intestines  were  adherent  to  one  another,  and  to  the  abdo- 
minal walls  posteriorly  and  laterally.  They  were  congested 
and  covered  with  a  purulent  exudation,  somewhat  greenish 
in  colour.  There  were  about  10  ounces  of  very  offensive 
putrid  pus  in  the  cavity. 

The  stump  of  the  pedicle  was  in  good  condition,  and  the 
ligature  in  its  place.  The  whole  peritoneum  was  gangre- 
nous, black,  and  covered  with  the  same  greenish  exudation 
which  covered  the  intestines.  The  stump  of  the  pedicle 
was  free  from  gangrene.  There  was  a  small  portion  of  the 
omentum  remaining  adherent  to  the  abdominal  parietes,  it 
was  perfectly  black ;  the  remainder  of  the  omentum  appears 
to  have  been  destroyed  in  the  gangrenous  process. 

Uterus  somewhat  retroverted;  there  was  a  small  cyst 
about  the  size  of  a  hen's  egg  attached  to  the  right  ovary. 

Bladder  normal. 

Cituse  of  death. — Asthenic  peritonitis  with  gangrene. 

Note. — ^The  unsuccessful' issue  of  this  case  in  noway 
detracts  from  its  great  interest,  the  chief  points  being,  first, 
the  dangerous  condition  of  the  patient  when  the  operation 
was  undertaken,  indeed,  had  I  not  been  aware  of  the  success 
which  has  been  attained  by  Mr.  Keith,  of  Edinburgh,  I 
certainly  should  have  thought  operative  interference  un- 
justifiable. The  second  -point  is  the  rapid  reaction  from  a 
condition  of  collapse,  more  profound  than  I  have  ever 
seen,  either  in  my  other  ovariotomies,  or  indeed,  after  any 
surgical  operations  I  have  ever  performed.  The  third  item 
is  the  value  of  the  intra-peritoneal  injections,  and  the 
manner  in  which  they  were  employed,  for  which  I  am 
indebted  to  my  senior  assistant.  Dr.  Bankin,  who  so  faith- 
fully tended  and  recorded  the  case.  And  the  fourth  point  is 
the  uniform  decrease  in  temperature  after  the  cold  douche 
to  the  abdomen  had  been  employed.  Indeed,  the  patient 
begged  for  both  the  intra-peritoneal  injections  and  the  cold 
douche  as  being  grateful  in  the  extreme. 


830 


HISTORY  OF  HOMOEOPATHY  IN  AUSTRIA.* 
By  Dr.  Edward  Huber,  of  Vienna. 

It  would  hardly  be  possible  to  ascertain  the  exact  time 
when  the  Hahnemannian  therapeutic  principle  attracted  the 
attention  of  an  Austrian  physician,  or  to  which  one  of  the 
crownlands  he  belonged.  Altschul  places  the  commencement 
of  homoeopathy  in  Bohemia  in  1817,  which  seems  to  be 
corroborated  by  this,  that  the  Nestor  of  our  Vienna  Homoeo- 
pathic Society,  Professor  Veith,  had  his  attention  first  drawn 
to  homoeopathy  in  the  following  year  (1818)  by  the  Regi- 
mental Surgeon  Hrastiansky,  of  Klattau.  In  1819  we  find 
the  district  physician  in  Oberhollabrunn  (Lower  Austria),  Dr. 
Gassner,  and  Surgeon  Mussek,  of  Seefeld,  near  Oberholla- 
brunn^ practising  according  to  Hahnemann's  principles. 
Although  at  this  period  homoeopathy  does  not  appear  to 
have  been  much  known  in  Austria,  yet  in  1819  it  was 
forbidden  to  be  practised. 

The  Court  of  Chancery's  decree  on  this  subject,  of  the 
21st  October,  1819,  says  : — '^  His  Majesty  has  been  graci- 
ously pleased,  with  high  resolve,  to  command  that  Dr. 
Hahnemann's  homoeopathic  mode  of  treatment  shall  be 
universally  and  strictly  forbidden."  This  interdict  seems 
to  have  been  promulgated  rather  by  way  of  a  prophylactic. 
The  originator  of  it  seems  to  have  been  Dr.  Stift,  Physician- 
in-Ordinary  to  the  Emperor  Francis  I,  who,  as  a  privy 
councillor,  presided  over  sanitary  and  educational  affairs, 
and  exercised  great  influence  over  the  Emperor.  But,  not- 
withstanding this  decree,  homoeopathy  began  to  extend  from 
the  beginning  of  the  year  1820.  In  Prague  we  find  at  this 
period  Staff- Surgeon  Dr.  Marenzeller,  who  was  at  the  same 
time  physician  to  His  Imperial  Highness  the  Archduke  John, 
and  Dr.  Scheller  practising  our  method  of  treatment.  In 
Graz  there  were  Dr.  Maxl,  Dr.  Maly,  Surgeon  Herwitz,  and 
Dr.  Menz,  the  last  of  whom   removed   to  Vienna  in   1824. 

*  From  SamnU,  Wistenchajt,  Ahhandl.  a.  d,  Qeh.  d.  Mom.,  No.  2. 


History  of  Homoeopathy  in  Austria,  881 

In  1825  Sui^eon  Fischer  removed  to  Briinn^  after  Laving 
since  the  year  1818  commenced  to  make  trials  of  homoeo- 
pathic remedies  in  chronic  diseases  at  Eibenschiitz^  Saar 
and  Bossitz^  in  Moravia.  Here  he  found  two  partisans  of 
the  new  system  before  him^  Mr.  Steigentersh,  a  merchant, 
and  Mr.  Albrecht,  who  held  a  civil  appointment  under  govern- 
ment. The  first  had  gone  through  a  course  of  surgical 
education,  and  during  the  French  war  had  served  in  the 
medical  department  of  the  army.  As  he  possessed  medical 
knowledge  he  succeeded  in  making  a  number  of  converts  to 
oar  doctrines  amongst  the  more  intelligent  citizens  of 
Briinn,  and  in  the  upper  ranks  of  society ;  but  he  almost 
confined  his  practice  to  chronic  cases. 

Albrecbt,  who  was  a  diligent  correspondent  of  Hahne- 
mann's, employed  himself  particularly  in  the  preparation  of 
homoeopathic  remedies.  A  great  sufferer  himself,  he  was 
compelled  on  his  own  account  to  study  the  sphere  of  action 
of  the  remedies,  and  this  was  of  great  use  to  him  in  his 
practice*  But  as  neither  of  these  gentlemen  had  a  medical 
diploma,  it  was  reserved  for  Fischer  to  make  great  strides 
in  the  path  that  had  been  prepared  for  him.  He  soon 
succeeded  in  gaining  the  confidence  of  the  inhabitants  of 
Briinn,  so  that  in  a  short  time  he  had  a  numerous  and 
select  clientele.  But  as  he  was  only  a  surgeon  he  was 
not  qualified  to  treat  internal  diseases,  and  his  opponents 
employed  this  circumstance  in  order  to  make  his  position 
oncomfortable*  Frequently  summoned  before  the  tribunals, 
and  threatened  to  be  deprived  of  his  diploma,  he  preferred 
quitting  Briinn  to  giving  up  his  mode  of  practice,  which 
experience  had  shown  him  to  be  so  useful.  In  1881  he  went 
to  Rugem,  six  miles  from  Briinn,  where  he  was  appointed 
to  the  medical  care  of  the  Benedictine  institution.  Here 
he  pursued  his  beneficent  calling,  which  was  scarcely  ever 
interfered  with,  and  the  clergy,  country  gentry,  and 
peasants  of  that  district  gave  their  full  confidence  to  the 
homoeopathic  treatment. 

But  let  us  return  to  the  year  1820  and  to  our  capital. 
Br.  Veith,  canon  and  preacher  in  the  cathedral,  who 
died  in   1876,  after  passing  his   medical  examinations  in 


J 


832  History  of  Homoeopathy  in  Austria, 

1820,  aud  devoted  himself  to  theology,  began  to  practise 
homcBopathy  in  1825  with  great  success,  whilst  his  brother. 
Professor  E.  Yeith,  practised  the  homoeopathic  method  in 
the  Veterinary  Hospital.  The  latter  had  been  converted 
to  the  new  doctrine  by  Dr.  Menz.  He  had  suffered  for  many 
years  from  cardialgia,  and  after  fruitless  allopathic  treat- 
ment, which  for  a  long  time  was  conducted  by  the  cele- 
brated professor  Dr.  Hildebrandt,  was  cured  completely  in 
two  months  by  Mens  with  Ignatia,  This  was  the  cause 
of  his  conversion. 

Staff-Surgeon  Dr  Marenzeller  contributed  most  to  the 
spread  of  Hahnemann's  doctrines  in  Vienna.     The  cause 
of  his  removal  from  Prague  to  Vienna  was  the  following: 
— ^Among  the  soldiers  in  'Hungary  there   occurred  many 
cases  of  intermittent  fever  with  a  great  percentage  of  fetal 
cases.       Count    Henry    Harde^g,   afterwards    Oeneral   of 
Cavalry,  a  true  adherent  of  homoeopathy,  recommended  to 
a  regimental  doctor  the  new  method  of  treatment,  and  as 
this  gentleman  stated  that  he  was  reduced. to  despair  in 
consequence  of  the  unfavourable  results  of  his  treatment  the 
count  gave  him  some  Nux  vomica  and  Ipecacuanha.     He 
commenced  to  treat  cases  with  these  remedies.     The  results 
were  very  satisfactory;  they  excited   much  attention,  and 
the  Emperor  Francis   I.    heard    of   them.     He  forthwith 
summoned  Adjutant- Oeneral  Kutschera  to  his  presence  in 
order   to    obtain    full   particulars.     By  his    advice  Count 
Hardegg  himself  gave  an  account  of  the  treatment  pursued, 
and  the  Emperor  determined  on  sending  for  Dr.  Maren- 
zeller to  come  to  Vienna  in  order  to  put  the  new  method  to 
the  test.     By  a  decree  of  his  Majesty  it  was  ordained  that 
clinical  trials  with  the  homceopathic  treatment  should  be 
made  in  I.  R.  Medico-Chirurgical  Joseph's  Academy,  which 
were  to  begin   on  the  2nd  April,   1828.     A  ward   in  the 
garrison   hospital  was  alloted  to   Dr.   Marenzeller  for  his 
trials.     The  twelve  beds  in  it  were  supplied  in  this  way : — 
Every    four   cases    were   selected    alternately    by    Maren- 
zeller and  two  commissioners  (professors  of  the  Academy). 
These  and   generally  about  forty  other  physicians  accom- 
panied Marenzeller   in    his  morning   and    evening    visits. 


by  Dr.  Edward  Huber.  383 

Every  ten  days  the  two  commissioners  were  replaced  by 
two  others,  so  that  for  a  period  of  sixty  days  Professors 
Scherer  and  Wagner,  Y.  Zimmermann  and  Toltenyi,  Zang 
and  Jager,  Bischoff  and  Hager,  Romer  and  Fischer, 
Schwarzer  and  Sax  were  appointed.  In  the  period  from 
22nd  April  to  2nd  May  Professors  Zang  and  Jager  acted  as 
commissioners,  and  they  gave  a  separate  unfavourable  report 
on  the  homoeopathic  treatment.  Daily  records  were  kept  of 
the  course  of  the  diseases,  and  the  histories  of  the  cases  were 
given  up  to  the  direction  immediately  after  the  dismissal 
or  transfer  of  the  patients.  Unfortunately  Staff-Surgeon 
Marenzeller  kept  no  copy  of  them,  and  the  originals — pro- 
bably owing  to  the  influence  of  the  imperial  physician  in 
ordinary.  Dr.  Stift — were  never  published,  and  disappeared. 
Of  the  forty-six  cases  treated,  which  the  Staff-Surgeon's 
son.  Dr.  Adolphus  Marenzeller,  one  of  the  busiest  homoeo- 
pathic practitioners  at  present  in  Vienna,  published  from  the 
very  imperfect  notes  of  his  father,  we  select  the  following : 

2.  Pleuritis,  postea  febris  nervosa.  The  pleurisy  was 
removed  in  five  days;  a  chill,  however,  brought  on  the 
status  nervosus,  which  was  completely  removed  after  five 
days  more  of  treatment. 

3.  Icterus  cum  psora.  A  very  instructive  case,  seeing 
that,  in  addition  to  the  icterus  and  scabies,  there  was  also 
diabetes.  A  cure  was  effected  in  twenty  days.  China, 
Merc,  sol.,  and  Carbo  veg.  were  the  remedies  employed. 
The  patient  left  the  hospital  in  good  condition,  though  he 
had  previously  been  much  emaciated. 

8.  Erysipelas  faciei  et  meningitis.  The  latter  affection 
came  on  in  the  course  of  the  former.  The  patient  im- 
proved^ but  he  did  not  take  the  medicine  on  two  days,  but 
always  spat  it  out  immediately.  All  those  present  doubted 
that  be  would  get  through,  and  yet  he  was  dismissed  con- 
valescent on  the  eleventh  day.     (Bellad,,  Rkus.) 

10.  Febris  tertiana.  After  six  days  the  patient  could  be 
transferred  to  the  convalescent  department.      {Tgnatia,) 

11.  Febris  tertiana.  Convalescent  in  four  days.    (Pulsat.) 

12.  Hepatitis.     An   extremely   important    case,  as  the 


334  History  of  Homoeopathy  in  Austria^ 

degree  of  infiammatioa  was  yery  great,  and  convalescence 
set  in  in  the  course  of  seven  days.     {China.) 

17.  Syphilis.  This  is  the  case  of  primary  chancre 
mentioned  by  Zang  in  his  separate  report,  in  which  no 
amelioration  ensued  after  a  treatment  of  three  weeks.  It 
was  a  malignant  chancre  on  the  frsenum,  and  the  patient 
was  affected  with  other  symptoms  besides.     {Merc,  sol,) 

18.  Angina.     Cured  in  three  days.      {Bellad.) 

19.  Parotitis  cum  febri  subinflammatoria.  Cured  in 
three  days.      {Ignat,) 

21.  Febris  quotidiana.     Cured  in  five  days. 

22.  Febris  quartana.     Convalescent  in  seven  days. 

28.  Angina.     Cured  in  three  days.      {Bellad.) 

25.  Diarrhoea  sanguinea.     Cured  in  three  days.      {Merc, 

80L) 

27,  38,  35,  45.  Febris  tertiaua.  Cured  in  eight,  thir- 
teen, three,  and  six  days. 

29.  Angina.  Cured  in  three  days.      {Bellad.) 

81.  Extension  of  the  inflammation  to  the  right  lung. 
Sputa  sanguinolenta,  tendency  to  tertian  fever  (Prof.  Zang), 
and  yet  cured  in  sixteen  days.     {Aeon.,  China,  Aurum.) 

32.  Pleuritis  cum  nota  gastrica.  Convalescent  in  three 
da  vs. 

34.  Pleuritis.  Cured  in  seven  days.  The  patient  was 
extremely  full-blooded.      {Aconite.) 

42.  Diarrhoea  aquosa.     Cured  in  three  days.      {Cham.) 

43.  Febris  quotidiana.     Convalescent  in  eight  days. 
The  cases  not  mentioned  were  either  transferred  soon 

after  admission,  or  the  effect  was  not  remarkable,  though 
as  good  as  that  seen  in  the  ordinary  allopathic  practice,  or 
the  duration  of  the  treatment  was  not  given,  or,  lastly 
they  were  transferred  at  the  close  of  the  trial. 

Dr.  Gliicker,  who  was  present  at  the  visits,  told  Dr. 
G.  Schmid  that  he  was  particularly  struck  by  the  cure  of 
a  chronic  cough,  for  which  the  patient  had  already  been 
treated  allopathically  for  a  year. 

The  cause  of  the  discontinuance  of  the  homoeopathic 
treatment  was  this: — Four  criminals  were  told  that  they 
were  brought  into  the  hospital  in  order  to  be  experimented 


by  Dr.  Edward  Ruber.  885 

on.  The  consequence  was  that  they  offered  active  opposition 
and  induced  other  patients  to  do  the  like.  Thus^  the  trial 
ended  in  the  middle  of  May^  much  too  soon,  and  to  Maren- 
zeller's  great  grief.  Had  it  been  longer  continued  it  had 
doubtless  broken  at  once  the  iron  bonds  of  incredulity  and 
prepossession,  and  Marenzeller,  with  his  high  culture  and 
self-sacrificing  enthusiam^  was  just  the  man  to  have  suc- 
ceeded in  doing  this. 

About  the  middle  of  the  period  during  which  the  trial 
lasted,  Marenzeller  had  an  audience  of  the  Emperor,  who 
gave  him  a  most  gracious  reception,  and  showed  his  satis- 
faction with  the  results  obtained,  of  which  he  was  informed 
by  daily  reports,  by  asking  the  staff-surgeon  if  he  thouglit 
that  four  apothecaries  would  be  enough  for  Vienna. 

The  report  of  the  professors  of  the  Academy,  as  commis- 
sioners during  the  trial^  said  that  from  it  no  opinion  could  be 
given  regarding  the  value  of  the  method  or  the  reverse. 
Professor  Zang,  as  has  been  mentioned,  published  a  separate 
report,  in  which  he  sought  to  break  a  lance  with  homoeo- 
pathy after  having  already  given  a  report  of  his  ten  days' 
service  as  commissioner  along  with  Professor  Jaeger.  If 
we  consider  the  general  report,  as  also  the  circumstance  that 
only  one  voice  was  raised  iigainst  the  homoeopathic  treat- 
ment, that  one  of  the  commissioners,  Professor  Zimmermann, 
soon  afterwards  declared  himself  a  convert  to  the  new 
doctrine,  that  the  opposition  never  published  the  clinical 
records  of  the  trial,  we  cannot  fail  to  see  that  the  results 
of  Marenzeller^s  trial  in  the  Joseph's  Academy  were  not 
unfavourable  to  homoeopathy.  The  cases  cited  above  certify 
to  this.  Further,  we  must  consider  when  and  under  what 
circumstances  the  trial  was  made.  The  localitv  was  an 
allopathic  hospital,  where  everything  is  at  variance  with  the 
principles  of  the  new  school,  and  where  the  nurses  are 
hostile.  Moreover,  the  representation  made  to  the  patients 
that  they  were  the  subjects  of  an  experiment  was  not  favour- 
able to  rapid  recovery.  One  of  the  patients  (No.  8)  openly 
confessed  that  for  two  days  he  would  not  take  the  medicine, 
and  it  is  possible  that  others  followed  his  example.  Had 
the  trial  been  unfavourable  to  homoeopathy,  how  is  it  to  be 


336  History  of  Hommopathy  in  Austria^ 

explained  that  Marenzeller^  who  bad  a  large  practice  in 
Prague,  wished  to  give  up  his  position  there,  and  one  year 
after  the  termination  of  his  clinical  trial,  viz.  in  the  middle 
of  1829,  he  settled  at  Vienna  ? 

Hahnemann's  method  of  treatment  now  spread  with 
great  strides  in  the  capital.  Marenzeller  was  besieged  by 
patients,  so  that  from  early  morning  until  late  at  night  he 
was  constantly  engaged  in  practice.  At  that  time  there 
were  practising  in  Vienna,  besides  Marenzeller,  who  died 
in  1854,  Menz,  the  two  Yeiths,  Lichtenfels^  Schafer,  Lederer, 
senr.,  Gliicker,  Wrecha,  and  Arnold  Lowi. 

Homceopathy  was  introduced  into  Salzburg  in  1830  by 
Dr.  Hartung,  of  whom  we  shall  have  more  to  say  by-and- 
by.  Dr.  Tonaillon  began  to  practise  homoeopathy  in 
Schwarzach  (Duchy  of  Salzburg)  in  the  same  year. 

The  new  system  was  introduced  into  Lemberg  in  1830 
by  Dr.  Schr^ter,  a  disciple  of  Hahnemann,  and  it  gradually 
extended  throughout  Galicia. 

Homoeopathy  received  a  great  impulse  by  the  brilliant 
results  of  the  treatment  of  cholera  in  1831.  The  results 
were  so  striking  that  in  the  year  1882  a  homoeopathic 
hospital  was  established  in  Gumpendorf  (Vienna),  whose 
first  physician  was  Dr.  G.  Schmid.  This  was  brought 
about  by  the  aid  of  Count  Coodenhoven,  through  whose 
instrumentality  the  Sisters  of  Mercy  were  brought  to 
Vienna,  to  whom  the  care  of  the  hospital  was  assigned. 
In  Briinn  Dr.  A.  Gerstel  proved  the  superiority  of  our 
system  over  the  old  method  in  the  treatment  of  cholera,  and 
his  success  was  testified  to  in  a  flattering  manner  by  the 
authorities. 

In  the  commencement  of  1830  we  find  Pater  Faustus,  as 
he  was  called,  the  well-known  Prior  of  the  Brothers  of 
Mercy  in  Laibach,  practising  homoeopathy  with  brilliant 
results.  After  the  suppression  of  the  order  he  practised  as 
a  private  individual,  and  his  cures  made  such  a  sensation 
that  many  families  in  Laibach  sought  his  aid,  and  they 
remain  faithful  to  the  new  method  to  this  day. 

In  the  year  1834  many  of  the  adherents  of  homoeopathy 
in  Trieste  joined  together  to  invite  a  homoeopathic  physician 


by  Br.  Edward  Hubet,  S3  7 

to  come  among  them.  Dr.  Ginzel^  of  Naples/  being 
guaranteed  a  certain  income,  removed  thither,  and  was  con- 
sequently the  first  practitioner  of  homoeopathy  in  our 
maritime  town^  where  he  remained  till  1845. 

Bat  homoeopathy  being  still  forbidden  to  be  practised,  its 
practitioners  suffered  much  from  the  intrigues  and  persecu- 
tions of  their  opponents.  Some  were  summoned  before  the 
tribunals,  and  their  medicines  confiscated.  Marenzeller,  as 
we  are  assured^  hid  his  in  a  hole  in  the  stove.  In  Vienna 
the  persecution  of  homoeopathy  went  so  far  that.Stift  made 
the  police  seize  the  medicines  in  the  houses  visited  by 
homoeopathic  practitioners. 

On  the  6th  June^  1885,  the  Imperial  Commission  of 
Studies  in  Vienna  addressed  to  the  Medical  Faculty  of 
Prague — as  it  is  said,  at  the  request  of  the  Duchess  of 
Lucca — three  questions,  which  they  were  required  to  reply 
to: 

1.  Is  homoeopathy  a  scientific  system? 

2.  If  so,  ought  the  free  practice  of  homoeopathy  to  be 
allowed  ? 

8.  Should  homoeopaths  be  permitted  to  dispense  their 
own  medicines  ? 

Professors  Krombholz  and  Nusshard  were  commissioned 
to  reply.  With  regard  to  the  first  question  both  said  that 
they  were  unable  to  give  an  opinion,  because,  on  account  of 
the  prohibition  to  practise  homoeopathy,  they  had  not  given 
the  subject  any  consideration.  But  Prof.  Krombholz  held 
that  it  must  be  considered  to  be  a  scientific  system,  and 
that  its  free  practice  ought  to  be  allowed.  The  sick-bed, 
he  said,  was  the  true  test,  which  would  either  consign  it  to 
an  early  grave  or  endow  it  with  new  life. 

The  decision  as  to  the  practical  value  and  the  degree  of 
confidence  to  be  given  to  the  homoeopathic  method  was 
entrusted  to  the  clinical  professor,  Dr.  Nusshard.  The 
first  question  he  pronounced  upon  in  a  spirit  of  uncompro- 
mising opposition,  which, was  founded  more  on  deeply- 
rooted  prejudice  than  on  any  comprehensive  knowledge  of 
the  subject.  But  this  first  anathema  was  soon  retracted 
by   himself,    and   the   more   he   became    acquainted  with 

VOL.  XXXVII,  NO.  CL.*— OCTOBSB,  1879,  T 


338  History  of  Honueopathy  in  Austria, 

homceopatby  the  more  favourable  his 'opinion  of  it  became. 
At  length  he  gave  utterance  to  the  following  opinion : — ^'  It 
would  be  treason  to  humanity  and  to  science  to  act  in  a 
hostile  manner  towards  a  medical  system  that  might  prove 
of  incalculable  benefit  to  suffering  humanity/' 

The  cholera  epidemic  of  1886  gave  us  a  great  step 
forwards.  Dr.  Fleischmann  was  at  that  time  the  head 
physician  of  the  Gumpendorf  Hospital.  He  had  been 
cured  by  the  brothers  Veith  of  a  very  painful  and  long* 
continued  sciatica^  after  fruitless  allopathic  treatment,  in 
the  year  1828,  and  thereby  converted  to  our  method. 
Fleischmann  treated  in  his  hospital  732  cases  of  cholera^ 
of  whom  488  recovered,  and  214  a  third  of  the  patients 
admitted — died,  whilst  in  the  other  Vienna  hospitals  in  the 
same  epidemic  at  least  one  half  of  the  cholera  patients 
succumbed.  This  favourable  result,  which,  together  with 
that  of  private  practice,  spoke  distinctly  in  favour  of  the 
new  method,  induced  a  number  of  manufacturers  and 
householders  to  send  a  deputation  to  the  Emperor  Francis  T, 
with  a  request  that  the  prohibition  of  the  practice  of 
homoeopathy  in  the  Imperial  States  might  be  removed. 
Some  other  influences  may  also  have  been  at  work  ;  but,  in 
brief,  this  decree  of  the  Court  of  Chancery  of  the  10th 
February,  1837,  was  promulgated  through  all  the  states : 

^^  His  I.B.  Majesty  deigns  to  decree  that  from  the  6th 
February,  1837,  the  decree  of  the  13th  October,  1819,  by 
which  the  practice  of  homoeopathy  was  universally  and 
strictly  prohibited^  should  be  repealed.  The  provincial 
governments  are  informed,  that  in  respect  of  the  main- 
tenance of  the  rules  and  regulations  relative  to  the  entrance 
of  unqualified  persons  into  the  practice  of  homoeopathy,  as 
also  relative  to  the  preparation  of  medicines  in  the  towns 
and  rural  districts,  further  orders  will  be  considered  by  His 
Majesty,  and  the  result  communicated.'' — ('  Police  Rules 
and  Begulations/  vol.  66,  p.  48.) 

What  contributed  greatly  to  increase  the  estimation  of 
homoeopathy  was  Staff-Surgeon  Hartung's  cure  of  Count 
Badetsky.  The  I.R.  Councillor  and  Staff-Surgeon  Dr. 
Jaeger,  in  complete  accord  with  Dr»  Hartungi  as  ordinary 


by  Dr.  Edward  Huber,  839 

pbysician^  and  Prof.  Flarer,  as  consultant^  had  expressly 
pronounced  the  disease  to  be  scirrhus  of  the  orbit^  which 
threatened  to  develop  into  open  cancer^  which  must  be 
certainly  fatal.  He  was  compelled  to  make  this  diagnosis 
and  hopeless  prognosis  in  consequence  of  the  presence  of 
aU  the  recognised  characteristic  signs  of  the  disease.  In 
an  official  report  presented  to  the  Ministry  of  War  in 
Vienna  he  bad  so  described  the  malady  and  alleged  the 
nature^  seat^  and  duration  of  the  disease^  and  the  advanced 
age  of  the  illustrious  patient^  as  circumstances  that  inter- 
posed great  difficulties  to  a  cure^  and,  indeed,  that  a  cure 
was  impossible,  either  by  art  or  by  nature. 

In  spite  of  this  Hartung  succeeded  in  curing  the  dis- 
tinguished commander  by  homoeopathic  medicines.  Fifteen 
years  later  this  fact  was  called  in  question  by  an  allopathic 
journalist.  The  ordinary  physician  of  Radetzky  at  that  time^ 
Upper-Staflf-Surgeon  Dr.  Wurzian,  undertook  to  convince  the 
opponents  of  their  error,  in  a  letter  he  addressed  to  the 
editor  of  the  journal  in  which  the  denial  of  the  cure  had 
appeared.  This  having  come  to  the  knowledge  of  the 
hoary  field-marshal,  he,  out  of  gratitude  to  the  service 
rendered  to  him  by  homoeopathy,  could  not  refrain  from 
writing  the  following  autographic  letter  in  order  to  settle 
the  matter  : 

"  My  DEAE  Wurzian, — "  Having  learnt  that  malicious 
doubts  have  been  raised  respecting  the  efficacy  of  homoeo- 
pathy, I  hereby  inform  you  that  my  afiection  of  the  eye, 
in  1841,  was  cured  by  the  late  Staff-Surgeon  Dr.  Hartung, 
solely  and  alone  by  the  aid  of  homoeopathy .'' 

'*  Radbtzky." 

Viemia;  13th  December,  1866. 

On  the  80th  May,  1842,  the  hospital  of  the  Sisters  of 
Mercy  in  Linz  was  opened.  This  town  had  already  become 
acquainted  with  homoeopathy  through  Dr.  Bergmann.  The 
foundation  and  the  prosperity  of  this  institution  was  greatly 
promoted  by  the  professor  of  theology,  Rechberger,  who 
applied  to  the  Superior  of  the  Sisters  of  Mercy  in  Vienna 
for  a  homoeopathic  physician  to  direct  the  hospital.     The 


§40  History  of  ffomoeopathy  in  Auttria, 

latter  induced  Dr.  S.  Reiss^  who  had  been  taught  homoeo- 
pathy by  Dr.  Fleischmann  in  the  Gumpendorf  Hospital^  to 
accept  the  post^  which  he  retained  until  his  death  in  1870. 

In  this  decennium  two  other  homoeopathic  hospitals  were 
established^  namely^  that  at  Eremsir  (Moravia)  in  1845,  and 
that  at  Steyer  (Upper  Austria)  in  1849. 

Whilst  homoeopathy  was  spreading  slowly  but  surely 
among  medical  men  and  the  public^  in  1842  Prof.  Toltengi 
wrote  against  it^  endeavouring  to  discredit  it^  and  to  make 
it  appear|illegal  and  dangerous^  and  denying  it  any  scientific 
basis. 

This  hostile  attack  induced  Drs.  Fleischmann,  Hampe^ 
Wurmb^  and  Watzke  to  form  a  defensive  alliance  for  the 
purpose  of  meeting  such  opponents.  Not  content  with  the 
reply  which  proceeded  from  Watzke's  pen  they  resolved  to 
found  a  society  whose  objects  were  to  advance  homoeopathy 
and  develop  the  Materia  Medica. 

After  some  preliminary  meetings  in  order  to  make  the 
rules  and  determine  on  the  procedure,  the  first  regular 
meeting  of  the  society  was  held  on  the  15  th  December, 
1842,  and  reports  of  a  proving  of  CohcyrUh  brought 
forward. 

In  the  following  year  Aconite,  Gentiana  crudata,  and 
Natrum  muriaticum  were  proved,  and  Hahnemann's  provings 
of  these  medicines  corroborated.  The  society  also  received 
the  necessaiy  permission  for  the  publication  of  a  Homoeo- 
pathic Journal. 

In  1844  the  number  of  members  of  the  society  resident 
in  Vienna  amounted  to  seventeen,  who  undertook  the 
reproving  of  Thtffa  and  Bryofda. 

In  1845  the  legal  authorisation  of  the  society  was 
obtained.  In  this  year  Argentum  metal,  and  nt^r.,  the 
Hall  iodine  Spa  water,  and  the  Ischl  brine  were  proved. 

The  year  1846  was  almost  entirely  occupied  in  proving 
Sulphur,  in  which  almost  all  the  members  took  part. 

An  important  advantage  was  secured  for  homoeopathy  by 
the  following  High  Chancery  decree  relating  to  the  dispens- 
ing of  medicines  by  practitioners  by  the  Emperor  Ferdinand 
I,  dated  9th  December,  1843  :*— ''  In  regard  to  regulations 


by  Dr.  Edward  Hub^,  341 

applicable  to  the  homoBopathic  method  of  treatment^  H.I.B. 
Majesty  has  been  pleased  to  order  :  The  laws  relating  to 
illegal  practice  of  medicine  and  surgery  and  to  quackery  in 
general  are  applicable  to  the  homoeopathic  method.  The 
necessary  mother  tinctures  and  preparations  must  only  be 
prescribed  from  the  legal  pharmacies^  but  these  medicines 
may  be  then  diluted  and  triturated  by  the  physicians  and 
surgeons  who  profess  the  homoeopathic  method  of  treatment^ 
and  dispensed  to  their  patients,  but  without  charge ;  but 
these  medicines  must  always  be  provided  with  a  label  on 
which  the  name  of  the  medicine  and  the  degree  of  its 
dilution  or  trituration  is  to  be  accurately  marked,  and 
signed  with  the  name  of  the  physician  or  surgeon. 

^'  If  in  the  practice  of  the  homoeopathic  method  there  is 
reason  to  suspect  that  a  physician  or  surgeon  has  acted  in 
an  Olegal  manner,  the  matter  is  to  be  judged  not  by  the 
faculty  alone,  but  physicians  distinguished  for. their  theore- 
tical and  practical  skill  in  the  homoeopathic  method  are  to 
be  consulted,  and  judgment  is  to  be  given  after  a  considera- 
tion of  all  the  circumstances  in  accordance  with  the  regula- 
tions'^  &c. 

Another  decree  of  the  date  I9th  December  gave  the 
legal  sanction  to  the  establishment  of  a  society  of  homoeo* 
pathic  physicians  for  the  purpose  of  physiological  provings  of 
medicines,  on  the  basis  of  the  regulations  for  the  establish- 
ment of  societies  in  Austria. 

It  was  only  after  this  that  the  Proving  Society  became 
legalised.  On  the  2nd  January,  1847,  a  meeting  was 
held  at  which  the  officers  of  the  society  were  elected,  the 
laws  to  be  submitted  to  the  authorities  confirmed,  and  other 
business  of  the  society  transacted.  Bi-monthly  meetings 
were  held  at  which  Count  von  Coodenhoven  attended  as 
Government  commissary.  In  this  year  Coccinellaj  Agaricus 
muscar.,  Euphrasia,  and  Guaiac.  were  proved. 

In  1848  the  number  of  the  members  of  society  amounted  to 
sixty,  but  the  political  events  of  the  period  paralysed  for  a 
time  the  activity  of  the  society.  On  the  8rd  May  the  last 
meeting  was  held,  after  which  a  pause  of  two  years  ensued, 
the  next  meeting  being  held  on  the  8th  June,  1850.     That 


842  History  of  Hommopathy  in  Austria, 

the  number  of  homoeopaths  constantly  increased,  is  in  great 
measure  owing  to  the  physician-in-chief  of  the  Oumpendorf 
Hospital^  Dr.  Fleischmann,  who,  from  1841  nntilhis  decease 
in  1868,  was  r^etained  on  the  registry  of  the  Vienna  Uni- 
versity as  teacher  of  practical  homoeopathy. 

Dr.  Zlatarovich,  Professor  of  Pharmacodynamics  at  the 
Joseph's  Academy  (which  post  he  retained  until  the  academy 
was  dissolved  in  1848),  probably  converted  some  of  his 
students  to  the  new  doctrine.  It  is  remarkable  that  he 
should  have  retained  his  post  so  long  after  having,  by 
becoming  a  member  of  the  Proving  Society,  publicly 
declared  his  adoption  of  homoeopathy.  He  endeavoured  to 
obtain  legal  sanction  for  the  practice  of  homoeopathy  in 
military  hospitals. 

In  1849  Dr.  Altschul,  of  Prague,  presented  a  petition  to 
the  Ministry  of  Education  for  the  establishment  of  a  chair 
of  theoretical  and  practical  homoeopathy  in  the  University 
of  Prague.  After  obtaining  the  legal  qualifications  he  was 
appointed  to  teach  homoeopathy,  and  a  dispensary  was 
granted  to  him,  where  many  young  physicians  were  instructed 
in  the  practice  of  homoeopathy. 

In  1850,  at  the  instigation  of  Drs.  Wurmb  and  Watske, 
a  second  homoeopathic  hospital  was  established  in  Vienna. 
In  the  petition  submitted  to  the  Oovemment,  in  which  both 
engaged  to  serve  without  salary  for  eight  years,  statistics 
were  given  showing  the  necessity  for  9uch  an  institution. 
In  reply  to  this  the  needful  funds  for  its  establishment  and 
maintenance  were  granted.  Here  Wurmb  delivered  dinieal 
lectures,  which  were  attended  by  a  number  of  native  and 
foreign  homoeopathic  physicians.  From  this  school  issued 
Dr.  Chevalier  von  Kaczkowski,  who,  In  1857,  settled  in 
Lemberg,  and  published  a  translation  of  Lutze's  Manual  of 
Homaopathy,  and  edited  a  homoeopathic  quarterly  journal, 
which  unfortunately  was  abandoned  after  two  years  on 
account  of  insufficient  number  of  subscribers ;  it  contributed 
much  to  the  spread  of  Hahnemann's  doctrines.  Thanks  to 
his  unwearied  exertions,  homoeopathy  continued  to  gain 
ground,  and  in  1868  a  petition  fon  the  establishment  of  a 
homoeopathic  hospital  and  dispensary  in  Lemburg  was  pre- 


by  Dr.  Edward  Huber.  348 

aented  to  the  Oallidan  Parliament^  signed  by  1200  of  the 
most  considerable  landowners^  officials^  tutors^  clergy  and 
medical  men.     Unfortunately  this  petition  did  not  succeed. 

When  the  Vienna  Society  resumed  its  meetings  in  1850, 
it  continued  its  activity,  proofs  of  which  are  to  be  found  in 
the  proTings  of  Lycapodiutn,  Glanoine,  Ferrum  acet,,  Eupion, 
Pkctranikus  fruticosus,  Opium,  Aloes,  and  J.  O.  Miiller's 
provings  of  animal  medicines  (saliva  and  hydrophobic 
poison,  &c.)- 

But  the  provings  of  drugs  gradually  fell  off,  so  that  at 
leAgth  it  was  resolved  to  change  the  title  from  '^  Society  of 
Austrian  Physicians  for  Physiological  Provings,'^  to  "  Society 
of  Austrian  Homoeopathic  Physicians/'  Also  the  qualifica- 
tion for  membership  of  the  society  by  proving  medicines 
was  given  up.  The  labours  of  the  society  were  now  con- 
fined to  furnishing  articles  on  homoeopathic  subjects  and 
practical  essays.  The  number  of  the  members  is  now 
forty-three. 

The  organ  of  the  Sodety,  The  Austrian  Journal  of 
Homaopaihy,  was  published  in  1844 — 8,  by  Fleischmann, 
Hampe,  Watzke,  and  Wurmb,  in  four  volumes.  After  an 
interruption  of  several  years,  two  more  volumes  were  pub- 
Kshed  in  1857,  edited  by  Dr.  J.  O.  Miiller,  and,  finally. 
Dr.  Eidherr  edited  it  in  1862  and  1863.  Since  then  the 
society  has  ceased  to  issue  a  journal. 

In  1857  the  third  and  largest  Vienna  homoeopathic 
hospital  was  established  in  Sechshaus,  which  continues 
under  the  excellent  management  of  its  chief  physician. 
Dr.  J.  O.  Miiller,  but,  on  account  of  its  distance  from  the 
capital,  is  little  visited  by  homoeopathic  physicians. 

Staff-Surgeon  Dr.  Wank,  who,  in  1866,  removed  from 
Venice  to  Gorz,  was  the  first  homoeopathic  physician  there, 
and  in  a  short  time  he  brought  the  new  doctrine  into  great 
repute,  to  which  his  success  in  a  malignant  epidemic  of 
measles  chiefly  contributed. 

The  best  proof  of  the  progress  of  homoeopathy  in  recent 
times  is  afforded  by  the  fact  of  two  hospitals  being  en- 
trusted to  its  followers,  one  in  Baden,  near  Vienna,  in 
1867,  and  one  in  Zwittau,  in  Moravia,  in  1868. 


844  History  of  Uomaopathy  in  Austria, 

In  1869  a  lay  society  for  homoeopathic  veterinary  medi- 
cine was  established  in  Mattsee,  in  Salzburg^  under  the 
name  of  '^  Hahnemannia/'  As  its  constitution  was  for- 
bidden by  the  provincial  governmenti  it  was  only  by  a  decree 
of  the  ministry  of  the  interior  remoring  this  prohibition 
that  it  became  established  the  following  year. 

At  the  instigation  of  Drs.  Streintz  and  Seidel  and  the 
priest^  Joh.  Legate  a  society  of  medical  and  lay  adherents 
of  homoeopathy  was  established  in  Graz  in  1878  under  the 
name  of  ''  Hahnemannia/'  It  has  above  100  members^ 
and  possesses  a  considerable  library. 

The  partisans  of  homoeopathy  had  to  fight  an  arduous 
battle  in  the  commencement^  but  now  their  brilliant 
successes  gained  for  them  a  good  position,  but  it  is  greatly 
in  need  of  lectureships  and  hospitals.  Altschul  did  much 
in  his  position  as  university  teacher,  but  since  his  death  no 
one  has  taken  his  place. 

Fleischmann  in  Vienna  was  nominally  a  teacher,  but  his 
large  practice  and  his  office  of  physician  to  the  Oumpendorf 
Hospital  left  him  no  time  for  teaching,  so  that  his  post, 
which  has  not  been  filled  up  since  his  death  in  1868,  was 
not  of  much  use  for  instruction  in  the  homoeopathic  doc- 
trines. Moreover,  the  Oovernment  did  nothing  to  support 
him.     Hence  he  gave  no  clinical  lectures. 

In  order  to  supply  this  want  Dr.  G.  Schmid  in  1878  pub- 
lished a  pamphlet,  JVhat  is  urgently  required  in  Modem 
Medicine,  in  which  he  set  forth  the  advantages  of  our 
system,  and  urged  the  necessity  for  establishing  lectureships 
on  homoeopathy.  In  consequence  of  this  pamphlet  a  gentle- 
man of  scientific  acquirements,  and  fully  conversltnt  with 
the  circumstances  of  homoeopathy,  got  up  a  petition  to 
Parliament  requesting  the  establishment  of  three  chairs — 
one  for  general  instruction  in  homoeopathy,  another  for 
Materia  Medica  combined  with  an  institution  for  proving 
medicines,  and  the  third  for  homoeopathic  clinical  instruc- 
tion, which  he  alleged  was  required  in  order  to  promote 
therapeutics.  When  the  petition  was  presented  to  Farliar 
ment  on  the  4th  December,  1875,  the  decision  was  put  oflf, 
because  a  similar  one  was  expected  from  the  Graz  Hahne- 


by  Dr.  Edward  Huber.  845 

mannia  Society.  "When  this  latter  petition  was  presented 
the  decisioD  was  still  deferred^  and  at  last  the  subject  was 
referred  to  a  Committee  of  Professors  of  the  Medical  Faculty. 
The  result  might  have  been  foretold.  Had  the  professors 
been  as  firmly  convinced  of  the  nullity  of  homoeopathy  as 
they  said^  they  would  certainly  not  have  hesitated  to 
permit  such  a  trial  of  it. 

In  conclusion  we  may  mention  that  homoeopathy  finds 
many  partisans  and  propagandists  among  the  laity.  In 
Upper  Styria  alone  there  are  about  fifty  priests^  who^  fur- 
nished with  boxes  and  books^.  treat  the  people  with  gene* 
rally  good  results. 

The  highest  nobility  even  takes  part  in  this  work. 
People  flock  in  crowds  to  Count  Gustavus  Auersperg,  on 
the  borders  of  Styria^  on  account  of  his  successful  treatment. 
The  well-known  philanthropist^  Princess  Wilhelmina  Auer- 
sperg^  may  be  seen  at  her  property  in  Bohemia  going  from 
cottage  to  cottage  treating  the  sick  peasantry^  either  all 
alone  or  in  conjunction  with  homoeopathic  practitioners. 
In  Zleb,  in  Bohemia^  she  built  a  homoeopathic  hospital  for 
the  poor  country  people^  with  twelve  beds^  of  which  Dr. 
Kohont  is  physician.  In  1846  a  homoeopathic  hospital 
for  the  poor  was  established  by  Countess  Harrach^  at  Nech- 
anitz^  in  which^  during  the  three  first  years,  404  patients 
were  treated. 

In  the  course  of  this  year  a  homoeopathic  children's 
hospital^  with  forty  beds^  was  opened  in  Vienna,  endowed 
by  the  Imperial  Councillor/Upper  Staff- Surgeon  Dr.  Taubes, 
Chevalier  von  Lebenswerth,  formerly  physician  to  the 
Archduke  John. 

It  was  only  after  a  severe  struggle  by  brilliant  curative 
results  that  homoeopathy  has  attained  its  present  position. 
We  must  acknowledge  our  obligations  to  the  original 
champions  of  our  cause,  who  are  now  mostly  all  dead,  and 
endeavour  to  tread  in  their  footsteps ;  for  Hahnemann's 
doctrine  must  spread  and  blossom  to  the  advantage  of 
suffering  humanity. 


846  Notes  on  Diabete$, 


NOTES  ON  DIABETES. 
By  F&ANcis  BiiACK^  M«D. 

iM^«  182.) 


TflE  varioiis  theories  of  diabetes  are  uncertain  foondations 
for  treatment,  bat  numerous  observations  daring  the  last 
twenty-five  years  give  data  for  a  simple  statement  of  what 
diabetes .  is*  The  healthy  system  possesses  the  power  to 
assimilate,  and  then  to  make  use  of  the  absorbed  sugar,  so 
that  it  is  not  found  in  the  urine  except  in  the  minutest 
quantities.  In  diabetes  there  exists  a  want  of  assimilative 
power  over  the  saccharine  principle,  and  from  this  defect 
sugar  escapes  into  the  urine. 

In  health  sugar  disappears  from  view,  and  as  a  final  issue 
contributes  to  force  production ;  in  diabetes  it  fails  to  be 
utilised,  and  passes  through  the  system  unconsumed.*  It 
thus  gives  rise  to  a  double  set  of  symptoms ;  first,  from  a 
power-producing  substance  being  withdrawn  from  the 
system;  secondly,  this  excess  of  sugar  circulating  in  the  blood, 
and  saturating  the  various  organs  gives  rise  to  various  lesions, 
at  first  functional,  and  then  organic. 

The  indications  for  treatment  are— first,  to  lessen  the 
supply  of  sugar  and  sugar-forming  substances,  to  place  the 
patient  in  the  best  hygienic  circumstances;  secondly,  to 
seek  for  some  agent  which  has  curative  power  to  correct  the 
mal-assimilation  of  sugar ;  and  failing  this,  to  find  remedies 
which  can  stay  the  general  exhaustion,  and  local  injury  to 
various  organs. 

Diet. — The  first  end  is  attained  in  a  great  measure  by 
substituting  animal  for  vegetable  food,  and  again  by 
selecting  from  the  latter  those  which  contain  least  sugar  or 
starch.  The  difficulty  is  that  such  diet  can  only  be  carried 
out  to  a  certain  extent  consistently  with  health,  and  the 

*  Mnrchiioii  sapposes  the  glycogen  secreted  in  the  liver  combines  with 
nitrogenf  and  forms  an  asotised  protoplasm,  which  maintains  the  nutrition  of 
the  \>lood  and  tissues. — "  Croonian  Lectures,''  Lancet,  1874,  vol.  i,  p.  430. 


bf  Dr.  Francis  Slack.  847 

comfort  of  the  patient;  and  in  nearly  all  cases  requires 
relaxing  and  altering  from  time  to  time.  The  diet  must^  as 
a  rule,  be  mixed^  as  an  excess  of  albuminoids  is  exhausting 
to  the  stomachs  of  all  diabetics^  and  is  especially  injurious 
in  gouty  habits^  where  it  is  so  important  to  lessen  the  pro- 
duction of  uric  acid.  Variety  in  the  bill  of  fare  is  of 
importance,  as  loathing  of  food  is  a  great  enemy  to  healthy 
digestion.  The  quantity  as  well  as  the  quality  of  food  and 
drinks  must  be  considered,  for  the  craving  for  solid  and 
liquid  aliments  is  very  apt,  if  indulged  in,  to  lead  to 
mischief.  The  regulated  quantity  ought  also  to  be  taken  at 
intervals  of  four  to  six  hours,  and  at  the  time  of  taking 
solid  food,  and  for  an  hour  or  two  afterwards  all  fluids 
should  as  much  as  possible  be  abstained  from.  This 
abstaining  from  fluids  is  of  great  consequence  when  green 
vegetables  form  a  large  element  in  the  meal,  and  is  the  best 
safeguard  against  flatulence.  In  many  cases  it  is  prudent 
to  make  a  gradual  alteration  in  the  ^iet,  especially  in  the 
diminution  of  liquid. 

Too  great  care  cannot  be  bestowed  on  preserving  the 
integrity  of  the  digestive  organs,  for  in  a  disease  such  as 
diabetes  where  there  is  a  constant  drain  of  a  substance  rich 
in  potential  energy,  failure  in  digestion  leads  to  rapid  and 
serious  changes,  of  which  atonic  dyspepsia  is  not  the  least. 

Food, — All  kinds  of  batcher  meat  underdone,  selecting 
those  which  the  patient  relishes  and  digests  most  easily ; 
game,  fish,  shell  fish,  cheese,  oils,  butter,  vegetables.  A 
free  use  of  butter  and  oily  substances  often  stimulates  the 
flow  of  saliva,  and  thus  diminishes  thirst.  All  vegetables 
containing  much  starch  are  to  be  avoided  as  much  as  pos- 
sible, viz.  potatoes,  turnips,  beet,  parsnips,  artichokes,  but 
the  green  portion  of  plants  are  admissible  and  useful,  viz. 
salads,  spinach,  greens,  cabbage,  especially  the  outer  and 
greener  leaves,  cucumber,  cress.  Farinaceous  substances  to 
be  forbidden,  espeeially  sago,  tapioca,  arrowroot,  starch; 
but,  except  in  very  confirmed  cases,  some  fbrm  of  bread  may 
be  allowed.  Bread  made  with  undressed  flour,  or  even 
with  an  extra  quantity  of  bron,  is  iqpst  suitable  and  most 
nourishing ;  it  has  the  further  advantage  of  pot  adding  to 


848  Notes  on  DMet€$, 

the  constipation  I  which  is  so  frequent  in  diabetes.  Various 
breads  £rom  which,  the  starch  has  been  washed  from  the 
flour  have  been  used  under  the  name  of  gluten  bread  ;  this 
is  made  up  in  the  form  of  loaves  and  biscuits. 

Dr.  Prout  considers  cakes  made  of  well^washed  and  thea 
welUdried  bran  mixed  with  eggs,  milk^  and  butter,  baked  ia 
a  quick  oven,  as  much  more  palateable,  and  more  easily 
chewed  than  gluten  bread.* 

Dr.  Pavy  recommends  as  a  variety  biscuits  made  of  egg9 
and  ground  sweet  almonds ;  he  finds  them  palateable  and 
digestible.f 

A  cheap  bread  can  be  made  having  Iceland  moss  as  its 
basis. 

Burnt  bread  crumbs  form  an  excellent  substitute  for 
gluten  bread. 

M.  Daunecy,  of  Bordeaux,  makes  a  wheaten  bread  of 
flour  previously  terrified,  and  has  ascertained  that  this  is 
incapable  of  conversion  into  glucose,  and  gives  great  relief 
to  diabetics.^ 

Sugar  is  to  be  carefully  avoided,  as  also  fruits  contain- 
ing much  sugar,  such  as  pears,  apples,  figs ;  but  currants^, 
lemons,  oranges,  grapes  are  allowable.  Patients  often  miss 
the  use  of  sugar  in  their  food,  especially  in  tea  and  cofiee ; 
as  substitutes  glycerine  has  been  recommended  by  Oarrod 
and  Beale,  and  now  Senator  says,  ''I  would  give  mannite 
the  unqualified  preference."§ 

Liquids. — ^The  use  of  water  ought  to  be  restricted,  for 
its  indulgence  increases  the  diuresis,  and  thus  aggravates  the 
thirst.  As  the  sudden  abstraction  of  fluids  in  diabetic  cases 
is  sometimes  followed  by  unpleasant  consequences,  the 
quantity  should  be  gradually  diminished.  As  the  craving 
is  for  cold  liquids,  Prout  advises,  when  this  is  great,  that  all 
liquids  should  be  taken  in  a  tepid  state.  Fluids,  beyond 
very  small  quantities,  ought  not  to  be  taken  along  with 

*  Sold  by  Blatchley,  862,  Oxford  Street,  London,  who  also  sells  a  bnn 
mixture,  carefully  prepared  on  Dr.  Camplin's  prescription,  with  directions  for 

use. 
t  Sold  by  Hill,  60,  Bishopsgate  Street,  E.G.,  London. 
%  BuU.  de  ThSrap.,  April  80th,  1873, 
I  Loc.  cit.,  p.  989, 


bp  Dr.  Prancis  Slack.  349 

solid  food.  Milk  is  allowable  in  all  cases,  but  on  this  point 
there  is  a  difference  of  opinion ;  but  Prout,  a  good  authority, 
advocates  its  use.  Donkin  strongly  recommends  a  diet 
restricted  to  skimmed  milk,  but  physicians  of  good  repute 
consider  such  restriction  positively  injurious.*  Whey  and 
butter-milk  are  allowable.  Distilled  water  and  spring  water 
charged  with  carbonic  acid  gas  alleviate  thirst  more  readily 
than  common  water. 

Alcoholic  stimulants.— The  need  of  stimulants  in 
most  diseases  is  a  mooted  question,  and  in  diabetes 
opinion  seems  much  divided  ;  but,  mndoubtedly,  there 
are  some  cases  in  which  the  moderate  and  judicious  use 
is  beneficial.  Fermented  liquors  containing  sugar,  such 
as  champagne,  sparkling  Moselle,  sherry,  port,  cider,  and  rich 
ales  are  forbidden.  Porter  and  bitter  ale  are  taken  with 
advantage  in  some  cases.  Red  Bordeaux  wines  allowable ; 
they  were  used  much  by  Bouchardat  as  a  remedial  mea- 
sure. 

When  stimulants  are  absolutely  required,  good  whisky 
and  brandy,  freely  diluted,  are  the  safest.  Koumiss  has 
lately  been  recommended ;  a  form  of  it  suited  to  diabetes  is 
sold.  Tea  and  coffee,  if  not  otherwise  contraindicated,  are 
allowable,  also  cocoa  made  from  the  nut,  but^  all  prepared 
cocoas  and  chocolates  are  forbidden. 

ExsRCisE. — ^Bouchardat  first  showed,  and  his  statement 
has  recently  been  confirmed  by  Erielz,  that  sugar  and 
other  secretions  in  the  urine  may  decrease  and  wholly  dis- 
appear for  the  time  being  under  the  influence  of  muscular 
movements  pushed  to  the  extent  of  exciting  perspiration. 
But,  undoubtedly,  exercise  of  a  much  more  gentle  kind  is 
osefiil,  and  confirmed  diabetics  are  generally  unable  to 
take  quick  or  severe  exercise.     In  cases  of  great  feebleness 

*  Dr.  Ker  kindly  f^mishefl  me  with  the  following  interesting  experiences 
with  skim*milk  of  a  retired  Indian  general,  aged  69,  who  has  been  diabetic  at 
intervals  since  1872 : 

**  Firti  week. — On  the  first  day  took  a  tumblerful  of  skim-milk  every  three 
hours,  taking  six  in  all.  On  the  second  day  took  seven  tnmblerfuls ;  on  the 
third  ^ght ;  on  the  fourth  nine ;  on  the  fifth  ten ;  on  the  sixth  eleven ;  on 
the  seventh  twelve.  Second  week, — On  the  first  day  took  one  imperial  pint 
and  tentumblerfuls;  on  the  second  two  pints  and  eight  tumUers;  on  the 


350  Notes  on  Diabeiti, 

it  is  safer  to  trust  to  such  passive  movements  as  are  reoom- 
mended  by  Dr.  Roth,^  and  these  may  be  supplemented  by 

third  three  pints  and  six  tamhlen ;  on  the  fourth  four  pints  and  four  tnmblerB ; 
on  the  fifth  five  pints  and  two  tnmhlen;  on  the  sixth  six  pints;  on  the 
seventh  seven  pints ;  and  so  on  for  six  weeks.  On  the  sevemtk  weei  be  took 
in  addition  about  half  a  pound  of  roast  meat  E^kU  wedk,^Thnt  qoaxten 
of  a  pound  of  meat,  green  vegetables,  and  rather  less  milk.  Nimik  week,^ 
The  same,  with  the  addition  of  Van  Abbotf  s  bran-gluten  biscuits.  Temtk,-- 
The  same.  Elevemth.-^The  same,  with  beef-tea  thickened  with  Van  Abbotf  s 
semoU  or  maccaroni.  Twelfth. — The  same,  with  tea  or  coffee  and  fish. 
TkirteeiUh. — The  same,  with  butter,  cream,  fat  and  gravj,  eggs  or  potted 
meat»  and  Van  Abbott's  parmesan  cheese.  Fourteenth. — ^The  same^  or  lamb^ 
veal,  tongue,  chicken,  turkey,  game,  and  8onp»  without  flour  and  starchy 
vegetables.  F^teeiUh, — Fish  and  shell-fish.  Sixteenth. — ^Any  green  vegetable 
but  peas  and  beans.  Seventeenth. — Plain  instead  of  skim-milk,  with  coffee  or 
tea  at  breakfast.  Eighteenth, — The  same,  with  the  addition  of  unskimmed 
milk  at  tea.  Nimeteenth. — ^The  same,  and  brown  bread  at  dinner.  Twentieth 
— ^The  same.  TSeenty-firtt.-^^toifn  bread  at  breakfast  as  well  as  at  dinner. 
Tfoenty^eeeond. — ^The  same,  with  white  bread  at  dinner.  TSoemty-third. — The 
same.  Twenijf-fowrth. — White  or  brown  bread  at  breakfast  and  dinner. 
Twenty-fiftK — The  same.  Tmenty-eixth. — From  this  time  he  took  potato  and 
other  farinaceous  articles,  but  no  sugar  or  sugary  food. 

**  This  course  began  on  May  7th,  1877,  and  ended  on  the  following  November 
4th.  The  first  effect  of  the  exclusive  skim-milk  diet  was  headache,  which 
continued  for  three  or  four  days.  Then  diarrhoea  set  in  and  continued  more 
or  less  till  other  articles  were  added  to  the  dietary,  the  stools  sometimes 
passing  involuntarily.  At  first  large  quantities  of  bile  were  passed.  The 
urine  was  scanty,  high-coloured,  and  charged  with  bile.  He  lost  six  pouids 
in  weight  in  the  first  four  weeks.  But,  whereas  when  he  commenced  the 
treatment  he  was  passing  sugar  to  the  extent  of  eight  grains  to  the  ounce  of 
urine,  in  one  week  it  fell  to  half  a  grain  to  the  ounce,  and,  in  a  fortnight*  the 
urine  was  {pronounced  by  a  practical  analyst  to  be  free  from  sugar.  It 
remained  free  from  sagar  till  November  8rd.  Sugar  returned,  however, 
almost  immediately  after  that  date  in  consequence  of  returning  to  such 
articles  of  diet  as  potatoes  and  rice.  In  a  fortnight  sugar  was  found  to  the 
extent  of  two  grains  to  the  ounce  of  urine.  He  accordingly  left  off  bread  and 
farinaceous  food,  and  a  fortnight  afterwards  there  was  no  sugar  to  be  found  i 
the  specific  gravity  was  1028,  and  the  quantity  passed  in  the  twenty-four 
hours  fifty-seven  ounces,  and  the  acidity  normal. 

"  Since  then  his  urine  has  remained  free  from  sugar  as  long  as  he  abstahied 
from  farinaceous  food,  and,  on  the  contrary,  sugar  has  returned  whenever  he 
has  not  abstained.  No  medicine  but  quinine  has  done  his  disease  any  good« 
and  that  medicine  does  not  cure  him." 

*  "Medical  Qymnastics,"  in  various  numbers  of  this  Journal,  9,g,  vol.  xii« 
p.  601. 


hy  Dr.  Prands  Black.  85l 

hot  air  baths.  Whenever  there  is  evidence  of  hepatic  dis- 
turbance there  is  an  additional  reason  to  press  exercise  in 
the  open  air^  especially  on  horseback,  so  as  to  guard  against 
stagnation  of  blood  in  the  liver.  Diabetics  often  suffer  so 
much  from  languor  that  persuasion  is  needful  to  enforce 
exercise.  Dr.  W.  Bichardson  gives  in  the  experience  of 
his  own  case  the  benefits  of  exercise.  He  urges  the  regular 
and  daily  walk  to  be  carried  out  patiently  and  perseveringly, 
80  that  the  task^  at  first  difficult  and  unpleasant^  becomes  at 
last  positively  a  pleasure.* 

Atmosphebe. — ^Dryness,  and  sunshine  are  very  great  aids 
in  relieving  the  diabetic  ;  damp  and  cold  combined  are  their 
greatest  enemy ;  hence  the  need  of  warm  woollen  clothings 
and  the  choice  of  a  suitable  climate. 

Baths. — Tepid  baths^  temp.  84^  to  94^,  tend  to  pro- 
mote a  healthy  action  of  the  skin^  but  for  those  persons 
who  can  bear  it  the  hot  air  bath  is  a  more  efficacious  means. 

Dr.  W.  Ilichardson  {loc.  cit.)  found  advantage  in  his  own 
case^  and  in  that  of  others^  from  the  use  of  tepid  baths  con- 
taining carbonate  of  soda^  taken  twice  a  week.  The  benefit 
of  Vichy  as  a  curative  agent  is  no  doubt  partly  attributable 
to  the  alkaline  tepid  bath  taken  daily. 

Mo&AL  means. — Freedom  from  all  worry  and  emotion^ 
complete  mental  repose^  and  the  surroundings  of  a  cheerful 
society  are  most  valuable  auxiliaries  in  treating  diabetes. 
The  neglect  of  moral  and  mental  precautions  is  one  of  the 
most  frequent  causes  of  relapse  in  this  ailment.  '^  Fret  not 
thyself  is  an  exhortation  of  the  Psalmist^  which  is  of  in- 
calculable benefit  in  all  diseases. 

D&UGS. — The  choice  of  diet,  and  other  hygienic  means^  is 
the  easiest  and  most  satisfactory  part  of  the  treatment  of 
diabetes ;  the  difficulties  commence  when  a  drug  has  to  be 
selected  to  correct  the  malassimilation  of  sugar. 

The  homoeopathic  formula,  owing  to  the  scanty  and  im- 
perfect knowledge  of  artificial  glycosuria,  affords  as  yet  no 
satisfactory  guide. 

The  discovery  of  small  groups  of  initial  symptoms  is 
almost  impossible,  for  it  is  a  peculiarity  in  diabetes  that 

•  On  J>taitf<M»  p.  91. 


95i  tfotes  on  Diabetes, 

a  marked  condition  of  the  disease  may  exist  without  exciting 
suspicion  in  the  patient's  mind.* 

From  the  seat  of  the  disease  it  is  rare  to  procure  indica- 
tions in  the  treatment  of  diabetes,  except  in  cases  where 
injuries  of  the  brain  or  spine  are  traceable  as  exciting  causes, 
for  pathological  anatomy  gi?es  no  certain  information. 

It  may  be  alleged  by  some  that  it  is  needless  to  consider 
the  abnormal  presence  of  sugar  in  the  urine,  and  that  the 
totality  of  the  symptoms,  according  to  the  rule  of  Hahne- 
mann, is  the  true  guide  in  seeking  for  a  simile.  No  direc- 
tion has  been  more  abused,  and  less  understood ;  its  truth 
and  importance  are  founded  on  the  word  totality.  It 
means  as  true  and  as  perfect  a  picture  of  the  disease  as  can 
be  drawn,-  cleared  of  all  speculative  views,  but  to  ignore  the 
condition  of  the  urine  in  diabetes  is  as  imperfect  as  to 
publish,  as  complete,  a  list  of  the  dramatis  persons  of  Hamlet 
with  the  title  character  omitted. 

At  present,  then,  from  lack  of  knowledge,  selections  must 
be  made  from  among  those  remedies  which  have  a  certain 
amount  of  traditionary  value,  e.g,  Phos,  ac,  Uran.  nU., 
Phos.,  Ars.,  Nuw  vom.,  Morph, ;  f  to  this  list  may  be  added 
Silica,  Atrop.,  and  Lactic  acid,  and  of  untried  remedies 
Curare ;  after  these  the  choice  may  be  extended  to  such  drugs 
as  have  an  hepatic  affinity.  The  very  evident  connection  of 
glycogen  with  the  liver,  and  the  very  important  functions 
that  organ  performs  in  addition  to  the  secretion  of  bile, 
especially  its  share  in  the  formation  of  urea,  justify  the  hope 
that  through  this  class  of  hepatic  medicines  a  reliable 
remedy  may  be  discovered  for  diabetes.  { 

*  Pmritos  vulvas  is  often  the  first  sign  in  middle-aged  females.  The 
following  case,  related  bj  Dr.  Follet,  is  interesting.  A  ladj,  aged  26,  appa- 
rently in  robost  health,  complained  of  weight  after  eating,  accompanied  bj 
flushing  and  giddiness.  Some  of  her  finger*  and  toe-tails  had  fallen  off; 
there  was  no  trace  of  inflammation  in  matrix.  Remembering  that  he  had 
seen  the  patient's  father,  who  was  not  syphilitic,  suffer  from  falling  off  of 
the  nails,  and  who  in  eighteen  months  died  of  diabetes,  he  examined  the 
urine,  and  found  it  to  contain  six  grammes  of  sugar  to  the  litre  (Gar. 
hehdwn.  de  Med.,  1874,  No.  5).  Sexual  weakness  in  the  male  is  often  the 
first  symptom  to  excite  his  attention. 

t  See  p.  182  for  a  fuller  list. 

%  The  frequent  occurrence  of  diabetes  in  gouty  patients,  and  the  evident 


by  Dr.  Francis  Black.  353 

Phosphoric  acid^  as  already  shown  (p.  131)^  was 
adopted  from  ordinary  practice,  and  the  doses  in  which  it 
bas  been  given  by  the  homoeopathic  school  have  been  large, 
amounting  often  to  the  officinal  quantity,  but  benefit  has 
been  ascribed  to  minute  doses.*  Dr.  Prout,  whose  experience 
was  probably  the  largest  in  England,  writes :  "  I  have  been 
disappointed  with  the  use  of  Phosphoric  acid;  it  has  not  in 
my  hands  produced  the  good  effects  some  have  ascribed  to 
it/'  He  thinks  more  favorably  of  the  Phosphate  of  Iron 
(loc.  cit.,  p.  50). 

The  published  cases  of  cure  by  Phos.  ac.  are  not  suffi- 
ciently numerous  to  afford  reliable  data  for  peculiar  clinical 
indications,  and  the  same  remark  applies  to  Uranium.  Dr. 
Hughes  writes  :  ^^  I  feel  more  and  more  convinced  that  the 
main  one  is  that  which  I  have  laid  down  when  lecturing  on 
Uranium,  that  it  is  best  suited  to  cases  originating  in 
dyspepsia  or  assimilative  derangements,  while  Phos.  ac, 
excels  it  when  the  starting-point  of  the  disease  is  the 
nervous  system/'t  When  such  a  diagnosis  can  be  made 
the  indication  is  good,  but  in  three  fourths  of  diabetic  cases 
the  task  is  a  very  difficult  one. 

Phosphorus  has  been  suggested  by  Kafka  as   a  prob- 

marked  connection  of  gout  with  impaired  functional  disturbance  of  the  liver, 
gives  a  further  importance  to  looking  among  hepatic  drugs  for  a  remedy. 
Br.  Lecorch^,  in  a  paper  submitted  (June,  1872)  to  the  Academy  of  M^ecine 
in  Paris,  considers  glycosuria  as  the  result  of  uzoturia,  and  he  makes  the 
remark,  "  in  the  most  successful  cases  of  patients  apparently  cured,  because 
they  ceased  to  be  glycosuric,  they  none  the  less  died  diabetic,  that  is  to  say, 
azoturic."  He  strives  to  stop  the  loss  of  urea  by  Opium,  Arsenic,  Valerian, 
tea,  coffee,  and  fatty  substanoes. — (Lond.  Med.  Bev.f  1874,  p.  32.) 

Recent  observations  show  the  liver,  in  addition  to  a  biliary  and  glycosuric 
function,  to  be  not  only  a  blood-forming,  but  a  blood-destroying  and  puri- 
fying organ ;  that  it  contributes  in  a  great  degree  to  the  destruction  of  albumi- 
nous matter  derived  from  food  and  textures,  and  the  formation  of  urea  and 
lithicacid,  which  are  subsequently  re-eliminated  by  the  kidneys.— (Murchison's 
"  Croonian  Lectures,"  Lancet,  1874,  vol.  i,  p.  502.) 

*  The  evidence  in  favour  of  very  minute  doses  is  far  from  being  satis- 
factory, e.  g.,  a  man,  ag^d  40,  weakened  b}'  diabetes,  which  three  months' 
allopathic  treatment  had  failed  to  relieve,  is  completely  cured  in  eight  days 
by  the  administration  of  ^"hos.  ac.  30,  treated  by  Dr.  Pompili. — (Extract  by 
Dr.  Oehme,  Kom.  JKlinik.,  July,  1873,  p.  107.) 

t  Therapeuiics,  2nd  edit.,  p.  244. 
VOL.   XXXVII,  NO.  CL. — OCTOBER,  1879.  Z 


854  Notes  on  Diabetei, 

able  remedy^  but  be  gives  no  clinical  experience  of  its  use. 
In  Case  No.  1  (p.  47)  it  appeared  to  the  writer  to  exercise  a 
decidedly  more  marked  effect  than  Pho$.  ae. ;  the  patient 
always  felt  stronger  after  its  use,  whereas  the  acid  appeared 
to  produce  no  immediate  perceptible  action.*  It  is  a  drug 
which  has  a  powerful  physiological  action  on  the  nutrition 
of  the  liver,  and  this,  with  its  well-known  therapeutic  value 
in  diseases  of  the  brain  and  nervous  system,  suggest  a  trial 
of  this  remedy  in  diabetes,  either  when  the  gouty  diathesis 
is  present  or  disease  of  the  bndn  is  the  exciting  cause. 
It  may  also  be  useful  as  a  palliative  in  the  latter  stages  of 
diabetes,  when  the  lungs  get  disorganized  by  cheesy  dege- 
neration, or  when  cerebral  symptoms  show  themselves.t 

Ubakium  is  used  in  the  form  of  the  muriate  and  nitrate, 
and  it  may  be  regarded  as  one  of  the  remedies  which  has 
a  fair  claim  to  farther  trial  in  diabetes.  Eight  years' 
experience  of  Muriate  of  Uranium  confirms  Dr.  Jousset's 
favorable  opinion  of  it ;  he  finds  this  remedy  rarely  effects  a 
radical  cure,  but  it  nearly  always  brings  about  a  considerable 
amelioration  in  the  general  state  of  the  patient.}  My  own 
experience,  added  to  a  careful  review  of  other  cases,  leaves 
me  to  form  not  quite  so  favourable  a  view  of  its  efficacy. 
Dr.  Jousset  considers  excessive  thirst  as  the  principal  indica- 
tion, but  this  is  a  symptom  present  in  every  marked  case  of 
diabetes. 

Dr.  Hughes  regards  Uranium  with  favour,  especiaDy  in 

*  Dn.  Madden  and  Hughes  (JBrit.  Joum.  ffom^  vol.  xxi,  p.  99)  remark : 
*'  It  iff  possible  that  the  cnratiye  power  of  Pho€.  ae,  orer  diabetes  may  be 
connected  with  the  influence  of  Photphorut  npon  the  lirer.  If  so,  it  woold 
be  desirable  to  ascertain  whether  the  base  itself  is  not  a  more  powerful 
remedy  than  the  acid." 

t  Schnlzens  foand  that  In  animals  poisoned  by  Phogphartu  the  processes  of 
oxidation  are  arrested  in  the  organism,  but  thoae  of  decomposition  by  ferment 
go  on.  In  snch  animals  nrea  disappears  from  the  nrine,  and  is  replaced  by 
leucine  and  tyrosine,  which  in  the  healthy  organism  are  converted  into  urea. 
No  sugar  appears  in  the  urine,  but  a  kind  of  lactic  acid  is  found  in  quantities 
exactly  proportional  to  the  amount  of  sugar  afforded  to  the  »tiiimy|i»  by  their 
food. — (Dr.  Lauder  Brunton  "  On  Diabetes/'  in  Beynolde*  System  of  Medi- 
eine,  1879,  vol.  v.) 

X  Elemens  de  Med,  Pratigw,  2nd  edit.,  vol.  i,  p.  116. 


by  Dr.  Francis  Black.  355 

cases  of  pejptogenic  origin^  and  wbere  marked  dyspepsia  is 
present  * 

The  presence  of  albuminuria  in  conjunction  with  glyco- 
suria may  be  suggested  as  an  indication  for  Uranium.  In 
one  of  Dr.  Magdeburg's  cases  there  were  traces  of  albu- 
men. This  drug  has  generally  been  given  in  doses  of  the 
lower  decimal  triturations;  t}iere  are  also  a  few  reported 
cases  of  its  efficacy  in  higher  dilutions.  A  well-marked 
case  is  reported  in  the  Lancet  (June  ISth,  1874)  by  Mr. 
Kennedy^  where  a  sixth  of  a  grain  of  the  nitrate  was  given 
three  times  a  day,  and  gradually  raised  to  the  third  of  a 
gnun;  in  a  week  the  improvement  was  marked.  This 
patient,  aged  17^  had  never  menstruated,  and  there  was  no 
history  of  fright  or  error  in  diet  to  account  for  the  diabetes. 
The  prominent  symptoms  were  great  weakness,  harsh  dry 
skin,  voracious  appetite,  and  great  constipation.t 

In  two  cases  reported  by  Dr.  Magdeburg,}  where  con« 
aiderable  amelioration  followed  its  use,  there  was  consider* 
able  derangement  of  the  digestive  organs.  One  case  was  a 
lady,  aged  68,  a  gourmand,  and  an  indulger  in  the  free  use  of 
wine;  her  appearance  was  good;  she  suffered  from  dryness 
of  the  mouth,  and  not  unfrequently  complained  of  a  sensa« 
tion  as  if  hairs  were  in  it.  The  skin  was  very  dry,  with 
mealy  scaly  appearance.  The  subject  of  the  other  case 
was  a  broken-down,  decrepid  man,  of  a  very  gouty  habit ; 
he  suffered  much  from  disturbance  of  the  digestive  organs ; 
the  tongue  was  red  and  painful,  with  a  slimy  grey  coating ; 
dislike  to  flesh  meat.  Dr.  Magdeburg  gave  a  quarter  of  a 
gramme  (2nd  dec.  trit.),  divided  into  four  doses,  daily.  He 
remarks^  although  with  this  attenuation  there  is  no  specific 
taste^  still  less  any  disturbing  action  in  the  stomach,  yet  it 
generally  happened  between  the  second  and  the  sixth  day  of 
its  exhibition  the  patient  experienced  disgust  at  it.  Hence 
he  found  it  necessary  to  suspend  its  nse  occasionally. 
Dr.  Lewder  published  a  very  satisfactory  case  occurring 

*  Two  cases  reported  by  bim  in  Brit,  Joum,  ffotn.,  vol.  xxi,  p.  969. 
t  Srit,  Joum.  Hom,^  vol.  xxzii,  p.  573. 

{  Brit.  Joum.  Mom.,  vol.  xxziv,  p.  67>  from  Hirscbel's  Sbtn.  Klinik.t 
Bd.  XX,  No.  14. 


356  Notes  on  Diabetes^ 

in  an  elderly  lady,  where  the  action  of  Uranium  was 
marked ;  the  patient  ultimately  died  diabetic.  The  pro- 
minent symptoms  were :  very  constant  thirst  ;  tongue 
reddish  at  edges ;  no  appetite  for  solids ;  obstinate  consti- 
pation ;  urinary  tenesmus ;  eczema  in  various  parts ;  ema- 
ciation. Uranium  3z  trit.  was  given  three  times  a  day; 
the  relief  was  soon  apparent  and  attended  with  a  very 
marked  diminution  of  these  symptoms^  with  a  great  gain  in 
flesh,  and  happiness.* 

In  addition  to  a  case  of  diabetes,  alluded  to  by  Dr. 
Drysdale,  in  his  Use  of  Specifics,  where  without  any  change 
of  diet  benefit  followed  the  use  of  Nitrate  of  Uranium^f 
two  more  cases  treated  by  him  will  be  found  in  this  paper, 
under  the  head  of  Atropine,  where  Uranium  had  its  share 
in  checking  the  glycosuria. 

Dr.  Ker  reports  : — "  My  experience  of  Uranium  nitricum 
in  diabetes  is  more  favorable  than  yours.  I  have  scarcely 
given  it  in  a  single  case  without  some  improvement,  and 
occasionally  a  great  deal  of  improvement,  following.  Ooe 
marked  case,  that  of  a  lady  over  seventy  years  of  age,  had 
all  her  symptoms  modified  to  the  better  as  soon  as  I  gave 
her  Uranium  nitricum,  in  one-drop  doses  of  the  first  decimal 
dilution.  The  quantity  of  urine  fell  from  five  quarts  daily 
to  five  pints.  Her  strength,  which  was  nearly  gone,  re- 
turned in  a  great  measure.  Her  nutrition  improved,  and 
she  gained  flesh;  thirst  disappeared,  and,  with  it,  a  dis- 
tressing dryness  of  the  mouth ;  costiveness  of  the  bowels 
ceased,  and  the  appetite  became  natural.  The  improvement 
was  maintained  for  a  month  only,  and  then  the  urine  in- 
creased in  quantity  again.  But  it  has  never  returned  to 
five  quarts,  and  the  other  symptoms  are  still  favorable, 
though  sugar  is  still  being  passed. 

^'  Other  cases  I  have  had  a  like  experience  with.  Oqc 
old  lady,  now  aged  eighty-six,  has  had  attacks  of  diabetes 
at  intervals  for  the  last  six  years,  and  I  never  give  any 
other  medicine  than  Uranium  nitricum  V^  in  doses  of  one 
drop,  repeated  four  times  a  day.      Such  treatment  has^  on 

*  Dr.  E.  T.  Blake,  Uranium,  in  Sahn.  McU.  Med.,  p.  24. 
t  Brii,  Joum.  Horn.,  vol.  xxv,  p.  596. 


by  Dr.  Francis  Black,  357 

three  separate  occasions^  brought  about  the  disappearance  of 
sugar  from  the  urine  in  about  three  weeks.  Another  case, 
that  which  benefited  so  greatly  by  the  exclusive  use  of 
skim  milk  (vide  p.  349)^  has  been  always  relieved  by  the 
same  medicine,  the  patient  saying,  ^  It  is  the  only  medicine 
that  does  me  any  good/  That  is  strong  testimony  from 
one  who,  during  the  last  eight  years,  has  tried  every  dia- 
betic, medicine  known.  I  have  only  lost  one  case  of 
diabetes,  and  that  was  a  boy  of  fifteen.'^ 

Arsenic. — Little  is  yet  known  of  its  action  in  glyco- 
genesis.  Grauvogl  quotes  from  Heller  that  sugar  is  found 
in  the  urine  after  Arsenic  has  been  taken.*  According  to 
Scirkowsky  and  Luchsinger,  the  formation  of  glycogen 
ceases  when  the  hepatic  cells  are  rendered  incapable  of 
performing  their  functions  by  poisoning  with  Arsenic. 
This  action  on  animals  suggested  to  Leube  its  administra- 
tion in  diabetes.f 

Arsenic  has  been  used  in  ordinary  |  and  in  homoeopathic 
practice  in  the  treatment  of  diabetes,  but  with  no  very 
decided  results.  It  may,  however,  be  ranked  as  one  of 
those  means  which  have  an  ameliorating  influence  in  this 
disease,  in  some  cases  actually  diminishing  the  excretion  of 
sugar,  in  others  having  no  action,  and  the  reason  of  such 
varying  action  not  being  apparent.  If  the  glycogenic  pro- 
perty could  be  established  it  would  encourage  the  further 
use  of  Arsenic,  for  its  general  action  bears  a  great  resem- 
blance to  many  of  the  symptoms  of  diabetes,  e.g.  thirst, 
dry,  red-edged,  and  fissured  tongue,  impaired  digestion, 
polyuria,  and  exhaustion. 

Kafka  suggests  Arsenic  as  a  remedy.  He  notes  a  case 
where  it  relieved  thirst,  dry  mouth,  craving  appetite,  and 
polyuria;  no  examination  is  given  of  the  urine.  The  patient 
died  of  lung  disease. 

*  Archivfur  Chemie  und  MicroscopU,  Feb.,  1862,  quoted  Id  Mandbuch  der 
Horn,,  U,  p.  175. 

t  Senator,  loc.  cit.,  p.  936. 

X  Senator  says  it  was  long  since  recommended  by  Berndt,  and  in  more 
recent  times  by  Derergie  and  Leabe.    V.  Pap  found  it  useful  in  mild  cases 
^{Wiener  Med.  IPresie,  1876,  Nos.  13  and  14.)     Devergie's  paper  appeared 
in  Oaz,  Ued,  PariSf  1870,  No.  22. 


858  Notei  on  Diabetes, 

Graavogl  relates  the  cure  of  a  drunkard  considered  by 
him  to  be  suffering  from  diabetes^  where  horrible  thirsty 
emaciation,  and  exhaustion,  with  odd  hallucinations,  were 
the  prominent  symptoms.  He  recovered  under  the  action 
of  Arsenic  in  three  months  (Oehme,  HirschePs  Horn.  Klinik,, 
Mai,  1878,  p.  73).  Oehme  quotes  another  case  from  Kafka  of 
a  chlorotic  girl,  where  Ars.  3,  given  three  times  a  day,  rapidly 
removed  thirst  and  polyuria,  but  this  patient  was  evidently 
suffering  from  diabetes  insipidus,  not  mellitus.  In  an 
advanced  case  of  diabetes,  where  increased  thirst,  entire 
extinction  of  sexual  desire,  emaciation,  and  loosening  of 
front  teeth  are  recorded  as  the  prominent  symptoms,  no 
benefit  was  experienced  from  the  use  of  various  remedies, 
including  Arsenic  in  dilution,  but  after  taking  ^  gr.  of 
Arsenic  every  week,  and  then  every  five  days,  the  patient 
improved  much  in  two  months.     Recovery  not  permanent. 

Sorge  says  he  found  Ars.  useful  in  two  cases,  but  he  gives 
no  particulars  [Br.  J.  Hom,^  xxxiii,  p.  544). 

Arsenic  may  be  considered  as  indicated  where  there  are 
eruptions  on  the  skin  and  tendency  to  boils;  where  the 
vagina  and  vulva  become  subject  to  redness,  swelling,  and 
pruritus ;  when  the  teeth  become  loose,  and  the  skin  dry 
and  mealy-looking ;  when  the  lungs  become  involved ;  when 
albumen  is  present  in  the  urine,  and  in  advanced  cachexia, 
where  the  kidneys  have  suffered,  and  there  is  oedema  of  legs. 

Opium  and  some  of  its  preparations  have  long  held,  in 
traditionary  medicine,  the  first  place  as  useful  agents  in 
controlling  diabetes.  They  have  hitherto  been  used  in  fall 
doses,  to  which  the  diabetic  show  a  remarkable  tolerance, 
though  there  is  also  abundant  evidence  of  harm  from  the 
extent  of  the  dose.  They  present,  in  their  pathogenesis,  a 
similar  glycosuria,  and  as  many  of  the  general  symptoms  of 
diabetes  as  Fhos,  ac.  and  Uranium ;  they  ought,  therefore, 
not  to  be  ignored  by  the  specific  school,  but  merit  a  trial, 
under  certain  circumstances^  in  moderately  small  doses,* 
e.g.  when  there  is  evidence  that  some  cerebral  condition, 
such  as  congestion  after  an  injury,  is  the  exciting  cause 
of   glycosuria;    when   constipation   proves   a   troublesome 

*  Dr.  Hnglies  suggests  it  in  V.  aeutm  and  {touUamru, 


by  Dr.  Francis  Black,  859 

symptom;  when  the  mental  state  is  one  of  dolness  and 
sadness^  with  weakness  of  the  memory  and  of  the  mus- 
cular system;  when  the  skin  is  dry,  and  great  itehing 
eiperienced.  Morphia  is  generally  employed  in  prefer- 
ence to  opinm.  Of  late  Codeia  has  been  recommended 
by  Dr.  Pavy;  the  other  constituents  of  opium  have  no 
chnical  value. 

Curare  has  glycosuria  in  its  pathogenesis,  but,  as  already 
noticed  (p.  116),  not  similar  to  ordinary  pathological  diabetes. 
It  is  a  drug  of  whose  finer  shades  of  specific  action  little  is 
known,  but  in  the  paucity  of  true  remedies  for  diabetes  it 
is  worthy  of  remembrance,  especially  when  cerebral  and 
spinal  lesion  is  the  exciting  cause  of  the  glycosuria ;  also 
when  there  is  great  nervous  debility.  Br.  Hughes  alludes 
to  Curare  as  a  possible  remedy  in  that  rapid  and  fortunately 
rare  form  of  diabetes  (D.  acuius  and  acutissitnus),  where 
life  is  threatened  in  a  few  weeks. 

Nux  VOMICA. — There  is  little  published  evidence  in 
homoeopathic  records  of  the  utility  of  this  medicine.  Dr. 
Teldham  has  found  Nux  vomica  of  much  use  in  diabetes.f 
One  case  is  very  cursorily  reported  by  Oehme  (loc.  cit.). 
Another  interesting  case  is  given  by  Br.  E.  J.  Blake.  The 
subject  was  a  married  lady  of  a  gouty  habit.  She  was 
placed  on  a  strict  diet,  compresses  were  applied  at  night  to 
the  loins,  hot-air  baths  were  prescribed,  and,  in  conjunc- 
tion with  these,  Ntua  vom.  8^  and  Calc.  carb.  6%  one  hour 
before  meals,  on  alternate  days.  Very  satisfactory  progress 
was  made.  The  swelling  and  irritation  of  the  vulva,  the 
tormenting  thirst,  the  dryness  of  skin,  the  marked  languor, 
and  copious  urination  all  passed  away.;]:  To  which  of  these 
various  agents  is  the  benefit  to  be  attributed  f  The  gouty 
habit  may  be  considered  an  indication  for  Nux ;  also  the 
existence  of  dyspepsia,  characterised  by  gastrodynia  and 
headache.  It  is  useful  in  relieving  the  mental  conditions 
which  often  arise  in  diabetes,  such  as  sadness  or  irritable, 
vacillating  temper,  great  sensitiveness  of  the  nervous  system, 

*  2^l«r<ip0«ifiaf,  2nd  edit.,  p.  245. 

t  Tram,  Brit,  Bom.  8oc.,  1864»  vol.  iii,  p.  458. 

X  Brit,  Jouim,  Som^  voL  xxviii,  p.  206. 


360  Notes  on  Diabetes^ 

attended  by  odd  sensations  in  the  limbs,  and  fidgets.  Spinal 
Jesions  as  the  exciting  cause  may  be  regarded  as  an  indi- 
cation. 

In  ordinary  practice  Nux  vomica  and  its  preparations  are 
held  in  esteem  by  some  practitioners.  Dr.  Dickinson  con- 
siders Strychnine  of  all  medicines  the  most  constantly 
useful ;  he  prescribed  it  in  full  doses.* 

Belladonna  and  Atbopine. — The  former  medicine  has 
been  tried  in  diabetes  in  the  ordinary  school,  but  according 
to  the  latest  writer,  with  no  good  results.  The  latter  has  no 
published  testimony  in  the  specific  school  in  its  favour.  Dr. 
Drysdale,  from  the  marked  thirst  in  its  pathogenesis,  has 
been  induced  to  try  it,  and  the  two  following  cases  show 
its  action,  though  being  given  in  alternation  with  Uranium 
the  results  must  be  divided. 

20th  February,  1877. — Captain  G — ,  «t.  45,  a  captain 
of  an  American  merchant  ship.  Has  hitherto  done  his 
duty,  and  only  complains  of  thirst  and  general  debility. 
Urine  5  pints,  sp.  gr.  1035,  reaction  acid,  no  albumen, 
sugar  40  grains  per  1000,  urea  24*8  grains  per  1000,  little 
deposit.  Atropine  1,  gr.  ij,  for  six  days  j  then  Uran,  nit.  1, 
gr.  ij,  for  six  days,  and  so  on  alternately. 

27th. — Less  thirst ;  quantity  of  urine  about  4  pints ; 
slight  headache ;  appetite  not  excessive  j  bowels  costive ; 
irritable  temper.  He  was  then  going  tP  sail,  so  I  gave  him 
a  course  to  take  on  the  voyage.  Atropine  3rd  dec,  for 
four  daysj  then  Uran,  nit.  1,  for  fourteen  days;  then  Nux 
vom.  1st  dec,  for  four  days,  followed  by  Uran.  nit.,  for 
fourteen  days,  and  then  Atropine  2nd  dec,  for  four  days, 
&c.     A  dose  to  be  taken  night  and  morning. 

On  7th  March,  1877,  he  returned,  and  the  urine  showed 
— sugar  none,  urea  37*2  grains  per  1000 ;  some  slight  deposit 
of  uric  acid  and  oxalate  of  lime.     Health  quite  good. 

On  October  10th,  1877,  he  returned,  and  reported  that 
last  April  his  urine  was  examined  in  America,  and  reported 
free  from  sugar.  Since  then  he  has  married,  feeling  well 
and  eating  common  diet  all  summer ;  but  for  a  month  or 
80  has  begun  again  to  feel  dry  in  the  mouth  and  pass  more 

*  Diseases  of  Kidneys,  1876,  p.  135. 


by  Dr.  Francis  Black.  361 

nrine,  but  thirst  not  great.  On  analysis  the  urine  showed 
277  per  1000  of  sugar,  and  specific  gravity  1030.  To 
repeat  the  course  as  before. 

This  patient  was  quite  well  when  seen  in  the  spring  of 
1879. 

Captain  S — ,  set.  about  40,  also  a  ship  captain  on  active 
service. 

On  2nd  February,  1876,  complained  only  of  dry  mouth, 
pains  in  loins,  and  general  debility.  Urine  showed  sp.  gr. 
1040,  sugar  in  ^considerable  quantity,  but  not  accurately 
detected. 

Atp,  1,  sig.  1,  4,  7,  10;  Uran.  nii.  1,  sig.  2,  3,  5,  6 ; 
11>  12.  The  powders  to  be  taken  as  numbered,  dis- 
solved in  three  tablespoonfuls  of  watei:,  one  spoonful  every 
day.  He  improved,  and  then  went  on  his  voyage,  with  a 
coarse  of  Nit.  Uran.  and  Atropine.  He  remained  well  all 
summer,  and  on  common  diet. 

On  23rd  December,  1875,  was  seen  again,  and  complained 
of  pain  in  loins,  for  which  he  got  Terebinth. 

On  10th  January,  1877,  complained  only  of  a  slight 
numb  feeling  in  legs,  for  which  he  got  Cocculus  1st 
decimal,  n.  m. 

On  14th  September,  1877,  reported  that  he  had  been 
veiy  well  all  summer,  and  on  common  diet ;  but  had  com- 
plained off  and  on  of  that  numb  tingling  in  the  feet  iind 
hands.  But  on  analysis  the  urine  showed  sp.  gr.  1032, 
acid  reaction,  sugar  21  per  1000,  urea  13*5  per  1 000.  He 
was  then  put  on  restricted  diet,  and  a  dose  of  Uran.  nit.  1, 
night  and  morning,  with  one  of  Veratrina  3,  at  noon 
daily. 

On  the  1st  October. — Sp.  gr.  1025.  He  feels  very  well, 
and  only  feels  the  tingling  now  and  then.  He  has  taken  a 
less  restricted  diet  than  ordered.     Continued. 

20th. — Feels  quite  well  and  has  taken  much  exertion 
without  fatigue  and  common  diet.  Urine  3  pints,  sp.  gr. 
1027,  no  sugar,  urea  32  per  1000. 

The  patient  was  quite  well  in  the  spring  of  1879. 
Caeasot£  has  had  its  advocates.     Bahr  (loc.  cit.,  vol.  i, 
p,  6^)  reports   a  case   where  it  first  disagreed,  probably 


S62  Notes  m  Diabetes^ 

from  orer-lAi^  doses,  then  China  wis  usefiil.  After  this 
Creosote  was  returned  to^  and  was  followed  by  complete 
disappearance  of  the  sngar.  Oehme  giyes  an  abstract  of 
a  case  where  a  man,  aged  twentv-eight,  suffering  from 
marked  diabetes,  quite  recovered  after  the  continuous 
administration  of  Creosote  pills.  Another  case  he  gives  is 
of  no  therapeutic  value  {Horn.  Kl.,  1873,  p.  89).  Jousset 
(loc.  cit.,  p.  116)  says  Creosote  rendered  him  some  service, 
but  he  is  unable  to  fix  its  indications.  Prout,  whose 
experience  is  the  largest  of  any  English  physician,  says  :— 
"  Like  many  other  remedies,  some  of  them,  as,  for  instance, 
Creosote,  have  sensibly  diminished  the  quantity  of  urine  and 
its  immediate  consequences,  but  here  their  good  effects  have 
ceased,  and  neither  these  nor  any  other  remedies  that  have 
yet  been  proposed  exert  to  my  knovcledge  any  direct  effed; 
in  improving  the  saccharine  quality  of  the  urine ''  [Stomoeh 
and  Renal  Diseases,  p.  51). 

Silica. — This  remedy,  so  valuable  in  the  specific  thera- 
peutics, has  lately  been  tried  in  ordinary  practice,  and 
among  its  uses  Dr.  Battye  reports  its  action  in  diabetes. 
His  article  appeared  in  the  Edin.  Med.  Jour.  (vol.  xx^ 
Nov.,  1874),  and  is  abridged  in  the  Br,  J.  Horn.  (vol.  xxxiii, 
p.  89). 

He  reports  two  cases  of  mild  glycosuria,  the  first  of 
them  doing  remarkably  well  in  six  weeks ;  all  the  sugar 
had  vanished  from  the  urine,  and  the  sp.  gr.  was  reduced 
to  1015.  A  relapse  at  the  end  of  a  year  yielded  to  treat- 
ment as  before.  The  second  case  improved  very  much  in 
six  months,  though  it  is  not  stated  that  all  the  sugar  dis- 
appeared ;  after  the  lapse  of  a  year  he  was  still  improving. 

Then  come  three  cases  of  pronounced  diabetes.  The 
first  ended  fatally  in  spite  of  the  sp.  gr.  of  the  urine  being 
reduced  occasionally  to  1015,  thus  eridently  showing  the 
power  of  the  drug,  although  the  action  could  not  be  main- 
tained. The  second  case  improved,  but  the  patient  went 
away  and  was  lost  sight  of. 

The  third  case,  a  middle-aged  man,  lost  forty  pounds  in 
weight  in  four  months;  the  constitutional  symptoms  of 
diabetes  fully  developed  themselves.     The  sp.  gr.  cf  the 


by  Dr.  Francis  Black.  368 

urine  varied  from  1034  to  1037^  with  large  amounts  of  sugar, 
tested  by  Professor  Rodgers  and  Nimsely,  the  quantity 
passed  being  not  less  than  six  pints  by  night  and  perhaps 
as  much  more  bv  dav.  After  three  weeks'  fruitless  treat* 
ment  with  Perchloride  of  Iron  and  Chlorate  of  Potash,  he 
was  placed  on  the  Silica,  one  grain  night  and  morning. 

Daring  the  first  four  months  the  sp.  gr.  scarcely  altered, 
but  after  four  months  it  ran  down  to  1028,  and  at  the  end 
of  seven  months  was  1017,  and  gave  no  trace  of  sugar. 
Since  then  health  and  strength  have  been  quite  re-established, 
and  at  the  end  of  three  years  his  weight  is  nearly  up  to  its 
original  mark^  and  not  a  symptom  of  diabetes  is  to  be 
found  in  him.  In  the  treatment  of  these  cases  there  was 
DO  restriction  of  diet. 

These  reports  are  very  interej^^inj^,  but  knowing  how  many 
medicines  have  been  vaunted  as  curative  in  diabetes  which 
have  not  stood  the  ordeal  of  experience,  further  trials  are 
required  before  the  therapeutic  stamp  of  true  coin  can  be 
placed  on  Silica. 

Lactic  acid  has  been  recommended  by  Cantani,  and 
used  with  considerable  success  by  others  in  diabetes.  An 
erroneous  theory  as  to  the  function  of  the  liver  in  secreting 
Lactic  acid  led  him  to  try  it.  Senator  classes  it  rather  as 
a  dietetic  agent,  that  is,  it  is  a  substitute  for  the  Lactic  acid 
which  in  health  is  converted  in  the  stomach  from  sugar, 
and  this  conversion  may  be  restricted  in  diabetes.  Lactic 
add  is  entirely  oxidised  in  the  blood ;  it  is  used  up  there, 
and  becomes  a  source  of  power,  which  does  not  occur  in  the 
same  manner  with  grape  sugar,  which  finds  its  way  into  the 
blood.  The  dose  has  been  from  75  to  1000  grains^  given 
daily,  in  8  to  10  ounces  of  water.  The  danger  from  con- 
tinued use  of  such  or  larger  doses  is  the  probability  of 
exciting  acute  rheumatic  polyarthritis.  Foster  made 
observations  on  two  diabetic  patients,  in  whom  the  pro- 
longed administration  of  Lactic  acid  invariably  produced 
this  disease  in  a  perfectly  characteristic  form,  the  symptoms 
always  subsiding  when    the  medicine  was    discontinued.'*^ 

*  The  Synthesis  of  Acate  Bhenmatism,  Srit.  Med.  Journ.,  Dec.  1871. 


364  Soles  on  Diabetes, 

This  result  has  been  observed  by  other  witers.  Two  cases 
of  diabetes  are  reported,  but  without  dtails,  in  which  5 
or  6  drops  of  Lactic  acid  1st  dec.,  given  twice  a  day,  proTed 
effectual.*  It  is  still  a  question  to  be  decided  if  minute 
doses  are  sufficient  to  elicit  the  undoubted  good  results  of 
Lactic  acid  in  diabetes. 

Natkuu  sulphuricum. — ^Aegidi  records  a  case  occurring' 
in  a  man  aged  43,  where  a  great  number  of  ordinary 
homoeopathic  remedies  failed  {Sul.,  Calc.,  Phos.  ac.,  Phos., 
Mer.,  Ars.,  Sil.,  Magn,  m.),  until,  under  the  idea  that  the 
patient  had  gonorrheal  cachexy,  one  dose  of  Thuja  30  was 
given ;  then,  as  the  patient  was  supposed  to  have  a  ''  hydro- 
genoid  constitution,''  Natr.  Sul.,  3,  five  drops  four  times  a 
day,  was  given  for  four  months  with  complete  success. 
Dr,  Aegidi  remarks,  *'  This  remedy  failed  completely  the 
same  year  in  another  case,  which,  however,  was  yielding  to 
a  remedy  of  surprising  power,  which  he  declines  to  name 
until  further  experiments  have  made  him  better  acquainted 
with  its  employment. 

The  case  was  well  marked,  e.  g,  great  weakness,  bodily 
movements  difficult,  pain  in  the  ankle-joints,  heaviness  of 
feet.  After  sleeping  in  the  morning,  fatigue  and  power- 
lessness  ;  all  the  ailments  aggravated  during  rest ;  thirst  all 
the  forenoon,  with  internal  chilliness ;  confusion  of  head 
pressive  frontal  headache,  especially  after  meals ;  noise  in 
the  ears,  sometimes  vertigo,  followed  by  nausea  and  diffi- 
culty of  swaUowing  {Br.  J.  Horn.,  xxii,  p.  164,'  from  Alia. 
Horn.  Z/^.,  November  16th,  1863). 

Argentum  was  suggested  by  Hahnemann  as  a  remedy 
likely  to  cure  some  forms  of  diabetes.  There  is  little  or  no 
clinical  confirmation  of  this.  Riickert  [Klin.  Erfahrungeti, 
2,  p.  49)  mentions  a  case  which  was  relieved  by  Arg.  fol\ 
but  died  of  tuberculosis  afterwards.  The  symptoms  were 
emaciation,  great  weakness,  face  sallow,  urine  turbid, 
sweetish  tasting,  profuse ;  scrotum  and  feet  oedematous.  The 
lack  of  chemical  examination  mars  the  value  of  the  case. 

Helonin,  active  principle  of  Helonias  Dioica,  has  not  been 
shown  to  excite  glycosuria,  whatever  renal  action  it  may 

•  Brit.  Joum,  Horn,,  vol.  xxxiii,  p.  359. 


by  Dr.  Francis  Black,  365 

otherwise  have.  Dr.  Paine  (an  Eclectic)  details  a  case 
occurring  in  a  man,  aged  26,  where  Helonin,  given  every 
two  hours  during  the  day,  for  sixteen  consecutive  days,  had 
a  very  beneficial  effect  in  reducing  the  sugar.  With  this 
and  Quinine  and  Cod^iver  oil,  and  occasionally  Iron,  a 
cure  was  soon  effected.  He  says  several  other  marked 
cases  have  been  treated  in  a  similar  way  and  with  the 
same  results  (Hale,  New  Remedies,  2nd  edit.,  p.   586). 

Bhusin,  Trillin,  Lycopin. — Dr.  A.  Stokes,  in  his  analysis 
of  Dr.  Grover  Coe's  work  on  Concentrated  Organic  Remedies, 
notes,  "  Diabetes. — Rhusin,  tonic  and  astringent,  valuable ; 
Trillin^  tonic;  Lycopin  of  remarkable  eflScacy,  two  to  four 
grains  ter  die,  regulate  the  bowels  with  Hydrastin,  valu- 
able" {Br.  J.  Horn.,  xxii,  p.  74). 

Quinine  arsenite  also  Iodide  of  Potassium  recommended 
by  Kafka  (loc.  cit.  2,  p.  714). 

"  Nux  v.,  Aco.y  SuL,  Chin,,  Bell.,  and  some  other  rerne* 
dies  "  of  marked  benefit,  in  a  widow,  aged  47,  where  fifteen 
pints,  containing  a  pound  of  sugar,  were  passed  daily.  No 
symptoms  given  (Dr.  Sharp,  Br,  J,  Horn.,  ix,  p.  589). 

Mineral  water. — ^The  consensus  of  medical  opinion  is 
greater  in  favour  of  certain  mineral  waters  than  of  any  of  the 
numerous  drugs  used  in  diabetes.  The  waters  most  in 
repute  are  those  of  Yichy  and  Carlsbad ;  the  rationale  of 
their  beneficial  action  does  not  yet  admit  of  any  satisfactory 
explanation.  The  latter  is  to  be  preferred  when  there  is 
evident  hepatic  derangement,  or  the  patient  gouty,  and  able 
to  stand  the  aperient  action  which  follows  the  use  of  Carls* 
bad,  but  not  necessarily  of  Vichy  water.  These  waters  rarely 
bring  about  a  radical  cure,  but  they  are  very  eflBcacious 
in  modifying  the  disease,  and  moderating  its  course.  Vals 
(Ardeche)  in  France,  is  recommended  by  some,  as  also 
Neuenahr,  near  Remagen,  on  the  Khine,  but  they  have 
still  their  reputation  to  make. 

Some  mineral  springs  in  the  centre  of  France  are 
strongly  recommended  by  M.  Gubler,  especially  for  diabetics 
who  are  anaemic*  He  names  Rouzat  (saline  and  ferru> 
ginous).   Saint   Maurice,   Vic    de    Comte,    Saint  Nectaire 

*  Lond,  Med.  Becord,  1874,  p.  708. 


366  Soies  on  Diabetes, 

(warm  nline,  and  cod  tains  arsenic) ,  bat  he  gives  the  pre* 
ference  to  La  Bourbonle^  which  is  a  warm  saline  spring 
containing  more  arsenic  than  any  known  mineral  water. 
It  has  a  reputation  in  skin  and  stmmons  conditions,  is 
easily  borne  by  weak  stomachs,  and  is  said  to  be  very 
efficadons  in  "organic  cachexias/'  It  is  about  half  an 
hour's  drive  from  the  famous  springs  of  Mont  Dore,  which 
al«o  contain  arsenic. 

When  failure  to  correct  the  malassimilation  of  sugar 
arises,  and  this,  unfortunately,  is  too  often  the  case  in  con- 
firmed diabetes,  recourse  must  be  had  to  such  remedies  as 
meet  the  general  exhaustion,  and  the  local  injuiy  to  various 
organs. 

Dbbilitt  may  be  met  by  Phos.y  Pho$.  ac.,  Ars.,  Chin,, 
Mosch.,  Camph,,  Picric  ac.  ;  it  is  rarely  benefited  by  alcoholic 
stimulants,  especially  in  the  last  stages. 

Thirst. — ^A  feeling  of  thirst,  dryness,  and  burning  in 
the  throat  often  seriously  distress  the  patient,  and  being 
local  manifestations  of  the  general  lack  of  fluids  due  to  the 
increased  secretion  of  kidneys  they  are  difficult  to  relieve, 
but  they  are  also  partly  due  to  the  actual  presence  of 
sugar,  for  they  are  most  intense  an  hour  or  two  after  meals, 
and  may  be  present,  as  in  Case  No.  2  (p.  57),  with  low 
specific  gravity  and  scanty  urine,  the  sugar  accumulating 
in  the  blood  instead  of  being  eliminated  by  the  kidneys. 
Aeon,  was  useful  in  this  condition  j  Atropine  and  Ars.  may 
also  be  indicated ;  fomentations  to  the  loins  and  a  free  use 
of  diluents.  The  sense  of  thirst  led  Dr.  Drysdale  to  pre. 
scribe  Atropine  in  the  cases  reported  (p.  360).  Remark- 
able dryness  of  the  mouth  is  a  very  distinctly  marked  action 
of  this  drug^  and  even  a  moderate  dose  renders  the  central 
part  of  tongue,  t  :c  palale^  mid  back  of  the  oesophaguSy  as  dry 
and  glazed  as  ;^  /cr.  it  also  excites  polyuria,  and  tenesmus 
of  the  urinary  (  •5^ins. 

Digitalis  mny  ai^o  L'  a^^cfnl,  and  it  beai^s  in  several 
points  a  resemblance  iv>  \^\c  [vwvvfA  3v><ipto}xis  of  diabetics. 
Dr.  Lauder  Bruntou  \\  s  oi>  f  rvcd  tlint  Digitalis  causes 
thirst.  When  experiuaeiiliij,:<  ua  himself  with  this  dnig^  the 
excretion  of  urine  was  greatly  increased  on  one  occasion  by 


by  Dr.  f^raneis  Black.  367 

its  use.  Shortly  afterwards  intense  thirst  came  on,  which 
obliged  him  to  drink  more  than  his  usual  allowance.* 
Thirst  is  relieved  by  fatty  foods,  and  liquids  acidulated  with 
Carbonic  acid  and  lemon  juice. 

Constipation  is  yery  generally  present,  and  its  diminu* 
tion  invariably  quickly  follows  the  action  of  any  remedy 
which  tells  on  the  saccharine  assimilation;  failing  these, 
recourse  may  be  had  to  Nua^,  Op.,  SuL,  Alumina.  Enemata 
are  rarely  useful.  When  the  constipation  proves  obstinate, 
causing  headache  and  hepatic  disturbance,  a  mild  aperient 
is  required.  Of  these  a  small  glass  of  Friederichshall  or 
Himyadi  Jams  water  is  most  e£Scacious,  giving  relief  to  the 
whole  system.  It  is  a  curious  circumstance  that  no  sugar 
is  found  in  the  solid  fseces,  only  when  there  is  diarrhcea. 

LivsK. — This  organ  is  very  frequently  affected  function- 
ally ;  organic  changes  rarely  take  place,  except  in  the  last 
stages  of  diabetes.  The  functionfd  derangement  is  gene- 
rally shown  in  diminished  appearance  of  bile  in  the  faeces, 
and  this  is  a  eondition  more  difficult  to  relieve  than  when 
there  is  increased  flow.  In  the  former  case  Dig.,  Kali 
bich,,  Mer.  sol.,  lod,  m.,  Hep.  «.,  Sul,,  are  the  most  useful 
remedies ;  in  the  latter  case  Ewmymin,  Iridin,  Leptandrin, 
PodophyUin,  Merc,  corr.j  lod.  m.,  Nit.  ac,  are  indicated. 
But  there  may  be  much  liver  disturbance  without  the  bile 
secretion  being  apparently  affected ;  it  may  fail  in  perform- 
ing the  important  function  of  converting  the  albuminoid 
matter  circulating  through  it  into  urea,  a  soluble  product 
which  can  be  readily  excreted  by  the  kidneys,  and  in  lieu 
of  this  there  is  a  deposit  of  lithates  and  insoluble  lithic  acid 
in  the  urine,  the  general  disturbance  expressing  itself  by 
headache,  frontal,  sometimes  occipital,  occasionally  vertigo, 
languor,  weariness  in  the  limbs,  uneasiness  about  liver  or 
scapular  regions,  tongue  large,  furred,  and  often  indented 
at  sides,  loss  of  appetite,  flatulence,  great  depression  and 
irritability  of  temper,  constipation,  with  dark  or  pale  motions, 
or  normal  colour,  sometimes  alternating  with  diarrhoea, 
intermitting  pulse,  and  palpitation  of  heart.     For  such  a 

*  Article  on  "  Diabetes/'  in  Bejfnoldt^  8y$tem  of  Medicine,  1879^  voL  v^ 
p.  808. 


368  Notes  on  Diabetes, 

state  the  best  remedies  are  Nux,  LyCy  Nit.  ac,  Merc,  corr., 
lod,  wi.,  Chtlid,  The  effect  of  these  is  sometimes  better 
marked  after  one  or  two  doses  of  such  remedies  as  Euon,, 
Lept.,  Irid.,  Pod,,  given,  in  doses  from  a  tenth  to  half  a 
grain,  so  as  to  secure  their  physiological  action. 

Rheum  is  also  a  remedy  homoeopathic  to  much  of  this 
condition,  but  its  efficacy  is  best  shown  when  given  in  a 
dose  sufficient  to  act  slightly  on  the  bowels ;  it  then  can, 
with  advantage,  be  followed  up  by  Nwv,  Strychnia,  or  Nit. 
ac.  This  hepatic  condition  is  often  attended  by  chronic 
catarrh  of  the  fauces,  indicating  Kali  bich.,  Nit.  ac,  lod.  m., 
Hep.  s.  Dr.  Sharp  has  found  Chamomilla  useful  in  two 
diabetic  cases  with  hepatic  symptoms.* 

Ammonium  muriaticum  {Chloride  of  Ammonium)  is  a 
remedy  which  is  so  useful  in  functional  derangement  of  the 
liver  attended  especially  by  lithaemia,  and  when  the  catarrh 
of  the  fauces  extends  to  the  stomach,  that  it  is  strange  it  is  so 
little  used  by  the  homoeopathic  school.  Noack  and  Trinks, 
in  their  Arzneimitellehre  (p.  47)  give  a  long  list  of  diseases  in 
which  it  is  used  by  the  old  school,  so  corresponding  with  its 
employment  by  the  homoeopathic  school  that  they  may  well 
remark :  "  Is  not  all  this  homoeopathic  doctrine  and  prac- 
tice V^  Great  thirst  is  a  marked  symptom,  also  increased 
excretion  of  urine,  especially  at  night.  Urea  is  always 
excreted  in  abnormally  large  amounts  by  diabetics,  and, 
according  to  Boecker's  experiments.  Chloride  of  ammonium 
increases  the  nitrogenous  solids  of  the  urine;  the  mean 
daily  increase  he  found  to  be  not  less  than  seventy-four 

grains.t 

Liver  disturbance  is  also  frequently  present  in  the  gouty 

diabetic   patient,   and   probably  is  an  important   factor  in 

producing  gout.     With  manifestations  of  gout  this  hepatic 

disturbance  requires  Colch.,  Nux  v.,  Kal.  iod, ;  all  of  these, 

especially  the  first  and  the  last,  act  better  in  tangible  doses. 

Kal.  iod.  is   also  indicated  when  there  is  suspicion  of  a 

syphilitic  taint.     Kafka  {Therapie,  vol.  ii,  p.  709)   quotes 

Professor   Jaksch,   who  is    of  opinion  that  diabetes    often 

depends  on  inherited  or  latent  syphilis. 

*  Essays  on  Medicine,  p.  791.  f  Parkes  on  ihe  Urine,  p.  165. 


by  Dr.  Francis  Black.  360 

Uainart  and  sexual  organs. — The  secretion  of  urine  is 
sometimes  much  and  rapidly  diminished  below  the  normal 
quantity,  causing  general  disturbance  from  the  non-elimi- 
nation of  sugar,  and  producing  local  distress  in  the  form  of 
strangury,  with  excessive  itching  of  the  labia^  and  sense  of 
fulness  in  vagina.  Remedies  :  Aeon.,  Camph.,  Tereb.,  Canth., 
KaL  b.  In  an  obstinate  case  of  this  kind,  where  diabetes 
had  long  existed,  the  writer  found  a  wineglass  of  Hunyadi 
J^QOB  gives  very  marked  temporary  relief. 

Frequently  eczema  of  the  labia,  attended  with  distressing 
itching  ispresent;  this  irritation  may  extend  down  the  thighs. 
Less  frequently  in  men  balanitis,  phymosis,  and  paraphymosis 
are  set  up.  These  conditions  are  probably  due  to  the  local 
action  of  the  sugar,  and  the  existence  of  a  peculiar  fungus, 
bat  the  sugar  in  the  blood  seems  to  have  some  specific 
irritation  on  these  parts,  for  in  Case  No.  2  the  labial  and 
vaginal  symptoms  were  always  worst  when  the  urine  was 
almost  suppressed,  and  the  glycosuria  ceased. 

If  the  general  specific  remedies  which  give  the  greatest 
relief  to  the  glycosuria  cease  to  act,  and  under  such  circum- 
stances Ars.  is  well  indicated,  recourse  must  be  had  to  such 
local  applications  as  boraz,  muriate  of  ammonia,  chamomile 
tea,  and  glycerine  with  almond  emulsion ;  this  last  has 
proved  most  useful  in  the  writer^s  experience.  The  regular 
use  of  the  catheter  with  females  is  reported  to  have  dimi- 
nished the  distressing  irritation. 

LuNOs. — ^Not  unfrequently  chronic  pneumonia  leading 
to  phthisis  appears  in  confirmed  diabetes.  That  the  lungs 
at  last  become  involved  is  not  a  matter,  of  surprise,  for  in 
diabetes  the  respiratory  power  is  early  affected,  the  amount 
of  carbonic  acid  excreted  and  of  oxygen  inhaled  is  less  than 
usual ;  they  lose  the  power  which  healthy  persons  possess  of 
storing  up  oxygen  in  the  body  during  the  night  for  utilisa- 
tion during  the  day. 

Remedies  :    Phos,,  Ars.y  lod.^  Hep.  s. 

Nervous  system. — ^There  is  an  increasing  opinion  that 
some  kind  of  textural  change  in  the  brain  stands  at  the 
foundation  of  diabetes,  especially  occurring  in  the  young, 
though  such  may  not  so  often  be  the  case  when  this  disease 

VOL.  XXXVII,  NO.  CL.-— OCTOBER,  1879.  A  A 


870  Notes  on  Diabetes, 

affects  those  past  middle  life.  There  is  also  a  conneetion^ 
due  to  hereditary  predisposition,  between  diabetes  and 
diseases  of  the  nervous  system,  particularly  epilepsy  and 
mental  affections.  Pathological  anatomy  shows  sometimes 
the  medulla  oblongata  affected  by  degeneration,  sometimes 
by  inflammatory  softening,  sometimes  by  the  pressure  of  a 
tumour.  Are  such  conditions  always  the  exciting  cause,  or 
are  they  the  results  ?  Dickinson  noticed  dilatation  of  the 
arteries,  and  perivascular  spaces  to  be  so  frequent  that  he 
considers  this  condition  to  be  peculiar  to  diabetes  ;  as  also 
the  same  state  in  the  spinal  cord,  the  substance  sometimes 
hardened,  sometimes  softened.  But  the  constancy  of  their 
appearance  is  disputed.^ 

The  presence  of  such  states  if  established  indicates  for  the 
cerebral  class  Acon.y  Atrophy  Phos.,  Arg.^  Aur.y  Kal.  iod, 
and  for  the  spinal,  Nux  v.,  Ver,,  SiL,  Phos. 

There  is  sometimes,  a  partial  cerebral  congestion  which 
may  run  on  to  apoplexy.  Remedies :  Aeon,,  Atrop,,  Op., 
Nitrite  of  Amy  I ;  or  it  may  take  a  form  of  coma  peculiar  to 
the  diabetic,  which  from  the  theory  that  it  is  due  to  acetone 
in  the  blood,  of  which  there  is  no  evidence,  has  been  styled 
acetonsemia.  It  may  occur,  as  in  Case  No.  2  (p.  59), 
without  any  assignable  cause;  in  others  it  is  generally 
agitation  or  over-exertion  which  excites  these  fatal  symptoms. 
If  the  attack  comes  on  slowly  as  in  Case  No.  2,  the  remedies 
indicated  are  Morphia  or  Atrop, ;  if  in  a  rapid  form,  then 
either  Nitrite  of  Amyl  in  inhalation  or  stimulating  doses  of 
either  Carbonate  of  Ammonia  or  Moschus  dissolved  in  ether 
suggest  themselves  as  possible  remedies. 

FuauNCLEs,  and  Carbuncles.  The  former  occur  in  all 
the  stages  of  diabetes,  the  latter  are  generally  confined  to 
the  confirmed  cases  where  the  disease  has  told  on  the  con- 
stitution, and  in  these  circumstances  they  are  often  the 
cause  of  death.  The  simple  furunculus  requires  little 
interference;  Arnica  or  Phos.  internally,  with  poultices, 
followed  by  application  of  pitch  plaster.  Carbuncle  is  a 
much  more  serious  condition.     Arnica  and  Arsenicum  have 

•  Dn.  Taylor  and  Qoodhart  on  the  "Nerrooi  System  in  Diabetei/'  Onj/'* 
Ho9p.  lUp<MrU,  1877. 


by  Dr.  Francis  Black.  371 

been  recommended^  but  iu  the  writer's  experience  they  have 
not  modified  the  course^  though  the  latter  may  diminish  the 
exhaustion  which  attends  the  sloughing  stage.  Silica  and 
Hepar  8.  are  supposed  to  exercise  a  useful  influence  in  the 
suppurative  stage.  The  experience,  already  quoted,  of  Dr. 
Battye  of  the  beneficial  action  of  the  former  in  diabetes 
gives  it  a  further  claim  when  carbuncle  is  forming.  The 
action  of  Hepar  is  increased  by  its  free  local  application. 

Dr.  Thomas^  in  an  interesting  report  of  four  cases  of 
diabetes  occurring  in  connection  with  the  gouty  diathesis, 
corpulency,  and  carbuncular  inflammation,  writes  :  '^  I  would 
here  remark,  before  passing  on,  that  I  do  not  advocate  the 
indiscriminate  use  of  the  knife  in  carbuncles.  I  have 
treated  many  by  incision,  and  they  have  all  done  well ;  on 
the  other  hand,  I  have  also  treated  a  few  with  medicine  and 
poaltices  &c.,  and  so  far  these  have  done  well.  I  am  quite 
convinced  that  carbuncles,  like  all  other  diseases,  vary  much, 
and  cannot  be  treated  upon  one  invariable  plan ;  but  my 
rule  would  be  to  leave  the  carbuncle  alone  if  I  found  the  skin 
sloughing  quickly,  while  on  the  other  hand,  if  the  tendency 
to  spread  was  great,  I  should  incise  it.''  He  also  states 
that  in  one  of  the  cases  he  tried  the  treatment  of  carbuncles 
vith  caustic,  a  mode  recommended  by  Mr.  Augustine 
Pritchard,  of  Bristol,  as  being  both  safer  and  quicker  than 
Any  other.  Dr.  Thomas  tried  it  upon  three  occurring  in  a 
stout  corpulent  diabetic,  but  in  spite  of  it  they  spread 
^pidly,  and  each  had  to  be  crucially  divided  before  it  could 
be  arrested.  '*  The  plan  I  adopted  at  last,  and  found  most 
successful,  was,  when  one  was  discovered,  to  divide  it 
thoroughly,  carrying  the  incision  (as  Mr.  Syme  so  strongly 
insists)  a  little  distance  beyond  the  limits  of  the  disease. 
I  then  plugged  the  wound  with  lint  moistened  with  turpen- 
tine. This  quickly  set  up  healthy  suppuration,  and  so 
destroyed  the  diseased  action.'^  ♦ 

*  Since  the  above  was  in  type  I  have  received  the  following  case  from 
*^.  Dudgeon  :— 

A  gentleman,  sot.  59,  who  had  long  resided  in  India,  but  had  been  in 
Europe  for  the  last  ten  or  twelve  years.  He  was  snbject  to  the  recnrrence  of 
>gnUb  symptoms,  rigor  followed  by  heat,  on  the  occnrrence  of  any  acute 
aSdction,  such  as  cold,  dyspepsia,  &c.    In  the  beginning  of  July  last  he  was 


372  Reviews. 


REVIEWS. 


ne  Psweyclopadia  of  Pure  Materia  Medica.  A  record  of 
the  poeitive  eflfect  of  drugs  npon  the  healthy  haman 
organism.  Edited  by  T.  F.  Allkn,  A.M.,  M.D. 
Vol.  IX.  SiUeea^^Th^a.  New  York  and  Philadelphia : 
Boericke  and  Tafel.  London:  Turner,  170,  Fleet 
Street. 

The  present  year  is  to  witness  the  conclnsion  of  Dr. 
Allen's  great  undertaking ;  and  its  penultimate  volume  has 
already  been  for  some  mouths  in  our  hands.  It  reaches, 
as  will   be  seen,  to  Thuja^  whose  exhaustive  re-proving  by 

leised  with  acute  interooctAl  neuralgic  pun,  wmnlating  plenrisj  in  the  left 
tide  of  the  chert  inferiorlj.  Thii,  after  a  few  day*  treatment  with  Bry^ 
•nhfided,  and  he  went  to  Scotland  for  a  change.  When  he  left  there  wis,  and 
had  heen,  nothing  remarkable  aboat  the  urinary  organs,  excepting  occuioDal 
irritability  of  the  bladder  and  the  appearance  of  an  increased  quantity  of 
vesical  mucus.  When  in  Scotland  he  wrote  me  that  he  felt  extremely  weak 
and  prostrated,  and  that  he  had  frequent  desire  to  pass  water,  which  came 
away  in  unusual  quantity.  At  the  same  time  he  had  vague  and  inegolar 
aguish  attacks.  I  urged  his  return  home,  and  when  he  arrived  I  examined 
the  urine,  which  was  still  passed  in  enormous  quantity,  the  exact  amount  per 
diem  was  not  ascertained,  but  the  secretion  was  vexy  large  and  frequent.  He 
had  to  take  a  railway  carriage  compartment  to  himself  coming  from  Scotland,  as 
he  was  obliged  to  urinate  so  frequently,  and  at  night  he  had  to  get  up  at  least 
every  hour  to  empty  his  bladder.  I  found  the  specific  gravity  only  1025,  bat 
the  Liq,  pot.  test  showed,  by  its  deep  brown  colour,  a  considerable  amount  of 
sugar;  no  albumen  or  anything  else  abnormal  in  the  urine.  I  prescribed 
appropriate  diet  and  Phot,  ao,  Ix,  two  to  four  drops  three  times  a  day.  Under 
this  treatment  the  secretion  of  urine  gradually  diminished  in  quantity,  and  at 
the  end  of  three  weeks  it  was  normal  in  amount,  sp.  gr.  1016,  and  not  a  trace 
of  sugar  could  be  discovered  by  the  Liq,  pot,  test.  I  should  mention  that 
while  the  diabetic  symptoms  were  present  the  thirst  and  the  craving  for  food 
were  very  great,  but  these  subsided  with  the  diabetic  symptoms,  and  his  strei^^ 
improved  so  much  that  he  was  at  the  end  of  three  weeks  able  to  resume  his 
very  active  and  responsible  duties  in  connection  with  a  most  important 
Qovemment  office.  Of  course,  sufficient  time  has  not  elapsed  to  enable  me  to 
decide  if  the  cure  is  permanent,  but  at  present  (20th  Sept.)  he  u  appaiently 
in  perfect  health. 


Mr.  G.  E.  Walker  on  Ophthalmology.  873 

the  Austrian  physicians  is  for  the  first  time  incorporated 
with  Hahnemann's.  The  same  is  to  be  said  of  Sulphur, 
which  has  here  a  pathogenesis  of  4085  symptoms.  Of 
other  new  matter^  we  have  for  the  first  time  a  full 
collection  of  the  toxic  effects  of  Strychnia,  Tabacum^ 
Terebinthina  and  Thea ;  we  have  large  additions  to  the 
pathogenesies  of  Silicea  and  of  Stramonium  ;  we  have  that  of 
Tarantula,  hitherto  almost  unavailable,  and  an  excellent 
presentation  of  some  of  the  old  provings,  as  those  of  Spigelia, 
Spongia,  Stannum,  &c.  Fuller  information  than  ever  is 
given  as  to  the  manner  in  which  the  experiments  were 
conducted^  so  that  we  can  tell  precisely  the  value  of  each 
symptom ;  and  for  Sulphur  we  have  the  advantage  of  Dr. 
Dunham's  verifications,  as  far  as  Hahnemann's  symptoms 
extend. 

Since  the  above  was  in  type  we  have  received  the  10th 
and  last  vol.  of  the  Encyclopedia,  We  propose  to  give  an 
account  of  the  entire  work  in  our^next  number. 


Essays  on  Ophthalmology.     By  George  Edward  Walker, 
F.R.C.S..  &c.     London  :  Churchill,  1879. 

This  is  a  remarkable  little  volume,  full  of  originality  and 
displaying  a  thorough  practical  acquaintance  with  the  sub- 
jects of  which  it  treats,  and  which  are  handled  by  the 
author  in  an  unconventional  manner. 

The  main  portion  of  the  work  is  occupied  with  glaucoma 
and  its  treatment.  The  author  says  he  never  was  entbu-t 
riastic  about  iridectomy  as  a  remedial  measure  in  acute 
glaucoma,  for  he  is  convinced  that  even  where  it  seems  to 
succeed  at  first  the  ultimate  effect  is  often  very  disastrous, 
and  vision  is  completely  lost.  Several  such  cases  having 
occurred  in  his  own  practice  he  was  induced  to  try  Hancock's 
operation  for  dividing  the  ciliary  muscle,  but  seeing  serious 
objections  to  this  method  he  devised  an  operation  for  cutting 
the  ciliary  muscle,  which  he  calls  '^  hyposcleral  cyclotomy," 
and  which  is  performed  in  this  manner  : — ''The  patient 
▼as  fully  etherised  in  a  sitting  position,  then,  the  lids  being 


374  Rtintwi. 

opened  by  the  wire  speculum^  I  pinched  up  the  conjunctiva 
with  toothed  forceps  slightly  to  the  inner  side  of  the  vertical 
diameter  below^  and  then  thrust  perpendicularly  through 
the  cornea,  well  within  transparent  tissue,  a  very  narrow 
knife,  edge  upwards,  exactly  opposite  to  the  point  held  by 
the  forceps ;  then,  depressing  the  handle  so  as  to  bring  the 
knife-edge  parallel  to  the  curve  of  the  tunics,  I  thrust  it 
through  the  iris,  and  slowly  withdrew  it,  cutting,  as  I  did 
so,  everything  up  to  the  sclerotic.  I  felt  a  distinct  sensation 
as  of  cutting  a  gristly  body  as  I  made  the  return  incision.'' 
(This  he  afterwards  tells  us  was  occasioned  by  the  knife 
cutting  through  the  fibres  of  the  ciliary  muscle,  but  surely 
any  one  who  has  dissected  the  eye  must  know  that  cutting 
through  the  extremely  fine  and  soft  fibres  of  the  ciliary  muscle 
could  never  have  communicated  the  sensation  of  cutting 
through  a  *'  gristly  body ;''  probably  the  ciliary  processes  were 
divided  at  the  same  time  to  cause  this  sensation.)  ^'  The  pupil, 
up  to  this  time  of  a  medium  size,  dilated  at  once  towards 
the  wound,  and  then  all  round.  Some  aqueous  and  then  a 
little  blood  followed  the  withdrawal  of  the  knife,  and  the 
eye  was  then  bound  up.''  The  operation  was  attended  with 
complete  success.  The  dull,  heavy  pain  was  at  once 
relieved,  and  some  smarting  pain  remained  for  a  short  time, 
soon  followed  by  absolute  ease. 

This  operation — ^if  only  equally  successful,  and  the  author 
asserts  that  it  is  much  more  so — is  a  decided  improvemeut 
on  iridectomy  with  its  unsightly  disfigurement  of  the  eye. 

The  author  gives  a  case  (at  p.  40)  which  seems  to  show 
that  acute  glaucoma  may  be  produced  by  the  instillation  of 
Atropine^  which  may  be  a  useful  hint  to  us  as  showing  that 
Atropine  or  Belladonna  may  be  useful  homceopathically 
in  curing  acute  glaucoma;  but  we  believe  that  the  best 
results  have  hitherto  been  obtained  by  the  frequent  adminis- 
tration of  Aconite  in  acute  glaucoma.  He  is  of  opinion 
that  chronic  glaucoma  may  be  cured  by  the  frequent  instil- 
lation of  Eserine  (the  alkaloid  of  the  Calabar  bean).  He 
accounts  for  this  by  the  physiological  fact  that  oontractioa 
of  the  ciliary  muscles  (which  Eserine  induces)  is  attended 
by    au    opening    of  the    discharge  pipes  of   the    anterior 


Mr.  G.  E.  Walker  on  Ophthalmology.  875 

chamber,  whereby  the  aqueous  humour  escapes  and  tension 
is  relieved.  The  solution  of  Eserine  he  uses  varies  in 
strength  from  1  grain  to  ^^nd  part  of  a  grain  to  the  ounce. 
He  generally  alternates  the  use  of  Eserine  instillation  with 
that  of  a  4-grain  solution  of  Strychnia  sulphate.  The  over- 
use of  EserinCg  he  incidentally  remarks,  is  capable  of  causing 
glaucoma,  so  that  its  curative  effect  may  be  an  instance  of 
homoeopathic  treatment. 

Mr.  Walker  believes  that  accommodation  for  distance  is 
not  merely  passive,  depending  on  the  elasticity  of  the  capsule 
of  the  lens,  as  is  generally  held  to  be  the  case,  but  that  it 
is  owing  to  an  active  contraction  of  the  radial  fibres  of  the 
ciUary  muscle,  and  hence  must  be  esteemed  a  voluntary 
muscular  action.  He  adduces  some  experiments  made  on 
his  own  eyes  with  Daturine  and  Eserine  to  prove  this,  but 
they  are  hardly  sufficient  to  settle  this  question.  He  also 
beUeves  that  myopia  is  occasionally  caused  by  spasm  of  the 
ciUary  muscle,  and  that  this  form  of  myopia  is  readily 
relieved  by  instillation  of  atropine.  He  adduces  several 
striking  cases  in  corroboration  of  this  view. 

His  next  essay  is  on  the  differential  diagnosis  and  treat- 
ment of  exophthalmos  of  intra-cranial  and  intra-orbital 
origin,  which  is  weU  worth  attention,  but  as  his  conclusions 
are  founded  on  the  observations  of  two  cases  only,  it  would 
be  premature  to  say  that  he  has  absolutely  proved  the 
correctness  of  his  views. 

The  next  essay  is  on  that  destructive  ophthalmia  known 
by  the  name  of  gonorrhoea],  which  includes  many,  if  not 
all,  of  the  virulent  cases  of  ophthalmia  neonatorum.  He 
condemns  the  treatment  by  solutions  of  lead  or  lunar 
caustic,  and,  in  fact,  all  the  other  methods  in  common  use, 
which,  he  says,  are  all  distinguished  by  their  indifferent 
success,  and  he  is  satisfied  that  the  application  of  moist 
heat  is  the  most  powerful  agent  for  preventing  and  limiting 
this  severe  suppurative  inflammation.  Lint  moistened  with 
a  lotion  of  sulphate  of  zinc  (2  grs.  to  the  oz.)  is  laid  over 
the  eyes  and  covered  with  gutta  percha.  By  this  means 
not  only  was  the  disease  cured  in  the  early  stages,  but 
in  which  the  cornea  was  ulcerated  and  perforated  were 


376  Reviews. 

cared  and  the  sight  of  the  eye  saved.  If  farther  experience 
should  corroborate  the  utility  of  this  treatment  it  will  be  a 
great  gain  to  practical  medicine.  We  notice  that  in  one 
case  Aconite  was  used  by  the  author,  which,  we  should 
imagine,  had  something  to  do  with  this  favourable  result* 
This  treatment  he  has  found  equally  successful  in  the 
purulent  ophthalmia  of  infants  and  in  the  gonorrhceal 
ophthalmia  of  adults.  Mr.  Walker  does  not  seem  to 
attach  much  importance  to  the  Sulphate  of  Zinc  in  the 
lotion.  He  mainly  insists  on  the  wet  lint  being  completely 
covered  with  the  waterproof. 

A  favourite  mode  of  treating  neuro-retinal  atrophy  has 
been  for  some  time  back  the  administration  of  nux  vomica 
or  strychnia  to  the  verge  of  tetanus.  The  results  were  not 
very  encouraging.  Our  author  has  been  more  successful  with 
the  instillation  of  a  neutral  solution  of  Sulphate  of  Strychnia 
gr.  iv  to  1  oz.,  of  distilled  water.  He  mentions  that  a  form  of 
this  disease  is  often  occasioned  by  smoking  strong  tobacco. 
He  also  conceives  that  great  loss  of  blood  by  profuse 
catamenia  and  flooding  after  labours  is  sometimes  a  cause 
of  neuro-retinal  atrophy  in  the  offspring.  All  such  cases 
are  benefited  by  the  instillation  of  Strychnia. 

The  last  essay  is  on  sympathetic  ophthalmia,  and  the 
author  is  an  advocate  for  early  enucleation  of  the  injured 
eye,  though  he  confesses  that  there  are  some  cases  in  which 
enucleation  does  not  suffice,  and  where  vigorous  mercurial 
treatment  is  required  in  addition,  and  still  other  cases, 
where  the  sympathetically  inflamed  eye  is  not  benefited  by 
enucleation  and  subsequent  mercurialisation,  but  where 
the  inflammation  once  set  up  goes  on  until  the  vision  is 
irreparably  lost. 

On  the  whole,  we  are  much  pleased  with  the  essays, 
which  will  raise  their  author  to  the  position  of  an  original 
authority  on  some  of  the  most  serious  diseases  of  the  eye, 
and  we  are  of  opinion  that  the  rational  practitioner  of  what- 
ever school  may  gain  a  great  deal  of  instruction  firom  them. 
It  may  be  of  advantage  to  us  to  adopt  the  author's  method 
of  applying  ophthalmic  remedies  locally  to  the  eye,  and  not 
confine    ourselves  to    their    administration  by  the  mouth. 


Germany.  877 

The  local  employment  of  Eserine,  Morphia  and  Strychnine 
especially  seem  to  have  been  singularly  efficacious  in  the 
author's  hands,  and  perhaps  we  might  find  that  some 
of  our  remedies/  such  as  Greheminum,  Euphrasia,  Ruta, 
Phosphorus,  &c.^  might  also  with  advantage  be  used  in  the 
iray  of  instillation,  with  more  decided  efiects  than  we  have 
hitherto  obtained  by  their  external  exhibition. 


OUE  FOREIGN  CONTEMPORARIES. 

GERMANY. — AUgemeine  Homoopathische  Zeitung,  vol. 
xcvii.  No.  18  {continued  from  p.  809). — In  1871  a  man 
consulted  Dr.  Hendrichs  him  with  lupus  on  the  left  side  of 
the  face,  spreading  over  two  thirds  of  the  face.  He  treated 
him  for  a  year  with  Ars.  30  and  Lye,  80  without  the  slightest 
benefit.  The  second  year  he  gave  Ars.  2  (one  dose  every 
night).  This  was  continued  with  several  intermissions,  and 
the  patient  got  180  doses.  The  result  was  satisfactory,  the 
lupus  ceasing  to  spread  and  getting  a  better  appearance. 
The  patient  was  not  contented,  and  gave  up  the  treatment. 
He  tried  several  other  doctors,  but  the  lupus  continued 
to  increase.  lu  August,  1875,  he  came  back  to  Hendrichs* 
By  this  time  the  disease  had  spread  all  over  the  left  side 
of  the  face,  and  had  eaten  away  the  half  of  the  ear.  The 
back  of  the  hand  and  a  portion  of  the  forearm  were  also 
affected.  He  now  got  Ars.  2,  a  dose  twice  daily.  By 
September,  1878,  the  lupus  was  completely  healed. 

In  No.  19  Dr.  Dorr  mentions  that  he  had  cured  with 
Arsen.  inwardly,  and  Carbolic  acid  externally,  a  case  of 
lupus  of  the  right  side  of  the  face. 

Dr.  Hendrichs  found  low  dilutions  of  Nuof  vom.,  2  or  1, 
very  efficacious  in  some  severe  cases  of  proctalgia.  He  also 
cured  a  bad  case  of  eczema  of  the  hands  with  Rhus  2,  after 
an  ineffectual  employment  of  Graph,,  Carbo,  Sulph,,  and 
Rhus  itself  in  higher  dilutions. 

Dr.  Nothlichs  found  Naphthalin  very  efficacious  in 
asthma. 

VOL.  XXXVII^  NO.  CL.-«-OCTOBEB,  1879.  B  B 


878  Our  Foreign  Contemporaries, 

In  No.  21  Dr.  Dorr  relates  a  case  of  adyanced  locomotor 
ataxy  with  amblyopia  amaurotica,  which  he  cured  in  a  few 
weeks  with  Acid,  picrotoxicum  Sx. 

Dr.  Simrock  mentions  three  cases  of  violent  and  trouble- 
some chronic  bronchial  catarrh  with  cyanosis  of  the  face^  and 
complicated  with  eczema  of  the  lips^  to  which,  on  account 
chiefly  of  the  latter  symptom,  he  gave  OL  croton  8x,  with  a 
perfectly  successful  result. 

In  No.  24  Dr.  Sigmundt  relates  a  case  of  very  severe 
colic  from  renal  calculus,  descending  through  the  urethra, 
cured  by  Cotocynth  8,  in  a  very  short  time.  He  was  called 
to  see  the  patient,  a  man  aged  86,  at  5  a.m.  He  found  him 
suffering  from  horrible  pains  in  the  abdomen.  The  pain 
was  shooting,  involved  the  region  of  the  flexnra  coli  sinistri 
and  spleen,  and  spread  downwards  to  the  bladder  and  rec- 
tum. There  was  ineffectual  straining  to  urine  and  stool  and 
empty  eructations.  The  regions  mentioned  were  very  sensi- 
tive to  pressure,  and  the  abdomen  was  distended.  The  pains 
were  constant  but  varied  in  degree ;  they  sometimes  came  in 
paroxysms  of  intolerable  agony.  The  patient  could  not  lie 
in  bed,  but  ran  about  the  room  groaning,  bent  double,  the 
hands  pressed  on  the  abdomen.  Skin  cool,  moist;  pulse  80, 
weak.  The  previous  day  he  had  had  three  loose  stools, 
and  the  pains  had  commenced  about  midnight,  increasing 
gradually  in  violence.  Coloc.  8,  in  half  a  pint  of  water,  a 
mouthful  every  quarter  of  an  hour.«  The  first  dose  gave 
relief,  he  was  soon  able  to  lie  in  bed,  and  by  9  a.m.  he  was 
quite  free  from  pain.  In  the  course  of  the  day  he  passed 
nine  small  stones,  from  the  size  6i  tt  pin's  head  to  that  of  a 
pea«  They  were  round,  not  quit6  smooth,  of  red  colour 
and  rather  hard,  but  could  be  crushed.  Their  chemical 
composition  was  uric  acid.  During  the  next  day  four 
more  stones  were  passed  and  a  considerable  quantity 
of  gravel.  Under  the  use  of  a  diet  chiefly  of  vegetable 
substances,  and  Coccionella  the  gravel  gradually  dis- 
appeared^ and  the  urine  became  dear,  and  the  patient  was 
soon  quite  well. 

Dr.  Kock  relates  the  case  of  a  peasant  woman  who,  three 
weeks  after  confinement,  was  terribly  frightened  by  a  fire 


Germany^  879 

that  broke  out  in  a  neighbouring  house.  She  jumped  out 
of  bed^  ran  into  the  street  in  her  night-dress,  and  the  same 
night  had  a  severe  rigor,  followed  by  heat^  headache^  and 
abdominal  pains.  Then  she  went  raving  mad^  and  talked 
constantly  about  fire^  manifesting  the  utmost  degree  of 
terror.  The  physician  in  attendance  advised  her  removal 
to  an  asylum^  but  her  husband^  not  agreeing,  sent  for  Kock. 
fiemembering  that  Dr.  Buchner  bad  observed  that  ''  dreams 
with  fear  of  fire  "  constantly  occurred  after  the  employment 
of  Aurumy  Kock  gave  Aur.  fnur.  nat.  4,  a  dose  night  and 
morning,  which  speedily  cured  the  woman.  After  this  she, 
while  apparently  quite  well,  was  subject  to  fits  of  laughing 
and  almost  ecstatic  e^icitement  and  exhilaration.  This  lasted 
a  confiiderable  time  and  resisted  all  the  remedies  mentioned 
in  the  manuals  for  such  symptoms.  At  last  Agar.  muse.  3 
was  giveuj  which  completely  restored  her  to  her  normal  con- 
dition of  mind. 

In  the  early  numbers  of  vol.  98  there  is  a  good  proving 
of  Cardvus  Maria  by  Dr.  Buchmann^  so  well  known  by 
his  masterly  proving  of  Chelidonium,  This  new  proving  is 
a  valuable  addition  to  our  Materia  Mediea,  and  we  regret 
that  it  has  not  been  incorporated  in  the  supplement  to 
vol.  X  of  Allen's  Eneyclopadia. 

In  No.  6,  vol.  98,  there  is  a  report  of  some  of  the  cases 
treated  in  the  New  Children's  Hospital  of  Vienna^  endowed 
by  the  liberality  of  the  late  Dr.  von  Lebenswarth,  whereby 
we  perceive  that  this  hospital  has  already  begun  to  be  of 
good  service. 

In  No.  7  there  is  given  an  extract  from  the  Annual  of 
the  Barefooted  or  Lesser  Brothers  of  the  Order  of  BL 
Francis  qf  Thann^  for  the  year  1517,  which  seems  to 
show  that  diphtheria^  which  by  many  is  held  to  be  a  new 
disease,  was  not  unknown  in  ancient  times,  and  that  epi- 
demics of  it  occurred  which  proved  fatal  to  vast  numbers. 
The  passage,  which  we  translate  from  the  old  German 
dialect,  is  as  follows  : — ^'  About  Lent  there  occurred  in  the 
land  an  unknown  disease ;  the  tongue  and  throat  of  the 
patients  became  white  as  if  covered  with  mould ;  they  could 
neither  eat    nor  drink;    this  was  accompanied   by   cruel 


880  Our  Foreign  Contemporaries, 

headache  and  pestilential  fe^er^  which  deprived  the  patients 
of  reason,  ^nd  destroyed  nearly  2000  persons  in  Basel 
alone  in  the  space  of  eight  months ;  here  and  in  Miilhansen, 
Altkirch,  Rnffach^  Gebwiler,  Sulz^  many  died,  also  in  the 
whole  of  Lower  Elsass  and  Swabia.  For  a  loog  time  no 
remedy  could  be  found  for  this  malady ;  at  length  it  was 
discovered  that  he  who  wonld  be  cured  must,  in  addition 
to  other  means  employed  by  the  physicians,  have  his 
mouth  cleansed  till  blood  came,  every  two  hours,  and  then 
washed  clean  with  honey.  Sec" 

In  No.  8  Dr.  ProU  relates  a  case  which  he  diagnosed  as 
ulceration  of  the  stomach.  The  patient  was  a  widow  lady, 
seventy-eight  years  old,  who,  though  good-natured,  was  of 
a  very  fiery  disposition,  occasioned,  as  Dr.  ProU  thinks, 
partly  by  her  constant  residence  in  the  hottest  part  of  the 
town,  partly  by  her  repeated  over-indulgence  in  red  wine, 
which  in  Nice  is  looked  upon  as  an  indispensable  aid  to 
digestion.  When  she  began  to  have  her  catamenia,  as  they 
were  for  a  few  years  scanty  and  painful,  she  was  advised  to 
take  some  allopathic  secale  powders  for  them,  which  brought 
on  the  most  frightful  metrorrhagia.  Although  she  re- 
covered from  this,*  it  left  a  weakness  in  the  eyes,  especially 
the  right,  and  in  the  stomach.  She  complained  of  constant 
heat  in  both,  and  when  the  menopause  came  (she  was  never 
pregnant)  she  got  cataract  in  the  right  eye  and  the  com- 
mencement of  cataract  in  the  left,  and  she  suffered  con- 
stantly from  rheumatic  pains  in  the  whole  body  and  from 
continued  heat  in  the  stomach  and  bowels. 

At  the  commencement  of  December,  1877,  she  deter- 
mined to  be  no  longer  treated  allopathically,  so  she  sent  for 
Dr.  ProU.  He  was  told  that  her  inflammation  of  the 
stomach  had  become  so  violent  that  the  priest  had  been  sent 
for  to  administer  extreme  unction.  He  found  her  in  a 
horrible  state  of  excitement,  with  a  quantity  of  allopathic 
medicines  on  the  table  by  her  bedside,  together  with  con- 
centrated beef  tea,  pieces  of  half-raw  beefsteak,  and  strong 
red  wine,  which  she  was  taking  to  keep  up  her  strength. 
But  after  every  mouthful  she  swallowed  she  had  indescrib- 
able burning  pains  in  the  stomach,  with  inclination  to  vomit. 


Germany.  381 

and  often  vomiting  up  all  she  had  taken^  but  no  bloody 
only  a  few  brown  streaks.  Every  stool^  which  only  occurred 
after  repeated  enemata,  was  very  hard  and  extremely  pain- 
ful. Status  presens :  I,  amblyopia  amaurotica^  right  eye 
occasionally  very  red^  hot;  2,  countenance  deady  pale 
(Hippocratic) ;  3^  frequent  severe  vertigo  and  frontal  pain ; 
4^  tongue  furred  white^  red  at  the  tip ;  5^  constant  eructa- 
tion; 6^  thirst  not  very  great ;  7,  appetite  not  quite  gone  ; 
8,  taste  salt  and  sour ;  9^  lungs  and  heart  sound ;  10,  in 
the  whole  epigastrium,  especially  in  the  scrobiculus  cordis, 
constant  aching  and  burning  like  fire,  so  that  the  bed 
clothes  must  often  be  renewed  in  order  to  cool  her;  11, 
abdomen  much  distended,  hot  to  the  touch  ;  12,  urine  dark 
jellow,  scanty,  with  sour  reaction;  13,  constipation,  feet 
and  legs  cold ;  14,  pulse  100 ;  15,  respiration  accelerated. 
No  emaciation  since  the  end  of  October,  when  her  present 
illness  commenced.  On  the  touch,  in  the  region  of  the 
eighth,  ninth,  and  tenth  vertebrae,  a  constant  aching  burn- 
ing pain.  The  disease  commenced  with  frequent  eructa- 
tions, nausea,  inclination  to  vomit,  for  which  she  had  got 
purgatives,  but  as  these  weakened  her,  strengthening  food 
was  given.  Attacks  of  retching  came  on  every  half  hour 
and  brought  the  patient  to  .the  last  stage  of  weakness, 
almost  syncope. 

Dr.  ProU  prescribed  an  exclusive  milk  diet,  and  water 
that  had  been  boiled  and  cooled ;  nothing  more.  He  would 
prescribe  medicine  next  day.  This  prescription  was  declared 
to  be  impossible  to  be  carried  out,  as  she  had  not  drunk 
milk  for  sixty  years,  and  could  not  digest  it.  He  insisted 
upon  it,  and  the  milk  was  given  in  very  small  quantities 
and  was  well  borne.  At  the  evening  visit  he  found  that 
she  had  taken  repeated  teaspoonfuls  of  milk,  which  seemed 
to  relieve  her,  and  the  retching  was  rarer.  No  medicine 
was  prescribed.  The  following  night  was  rather  restless,  but 
every  attack  was  allayed  by  milk,  which  was  not  vomited ; 
only  a  few  sour-smelling,  slimy  masses  were  ejected,  but 
no  more  blood  flakes.  In  the  morning  the  pulse  was  90. 
Less  restless.  She  had  taken  two  cupfuls  of  milk,  and 
retained  them.      In  the  evening  the  pulse  was  90,     Vomit- 


S82  Otir  Foreign  Contemporaries. 

iDg  u  before.  On  the  third  dhj  she  took  two  capfuls  of 
milk  with  dislike.  Appetite  returning,  bnt  the  bnniiDg 
and  tension  in  the  abdomen,  the  anxiety  before  the  Tomiting, 
and  the  painful  emetations  continued.  Prescribed  Carb. 
T,  6xy  10  drops  in  100  grammes  of  distilled  water;  10 
drops  on  the  tongue  altematel  j  every  two  hours  with  milk, 
t.  e.  one  hoor  milk,  the  next  hour  Carb,  On  the  fourth  day 
she  had  a  quieter  night.  The  burning  less  severe,  abdomen 
less  distended.  Passage  of  flatus  fer  the  first  time,  which 
gave  relief.  Sickness  as  before.  Stool  still  black,  passed 
by  means  of  enemata.  Pulse  90.  Carb.  10  was  continued 
till  the  seventh  day.  After  this  no  more  sickness.  Tongue 
clean,  but  very  often  burning  pain,  which  on  the  ninth  day 
became  unusually  severe,  and  was  not  allayed  by  Carb. 
Great  thirst,  but  very  little  water  suffices  to  quench  it. 
Appetite  gone.  Secretion  of  saliva  stopped.  The  fiery 
hot  feeling  continues,  but  is  no  longer  relieved  by  throwing 
off  the  clothes.  Milk  is  more  grateful  now  warm  than 
cold.  The  sickness  and  vomiting  of  slimy  brownish  flakes 
returned.  She  tossed  about  anxiously  in  bed,  and  this  was 
followed  by  a  kind  of  fainting  or  fear  of  death.  Prescrip : 
Arsenicum  10,  two  drops  every  hour,  whereon  relief  ensued ; 
then  every  two  hours,  alternately  with  a  cup  of  warm  milk. 
This  was  continued  for  two  days,  and  great  improvement 
ensued.  Now  Ars.  20  was  given  three  times  a  day,  and 
the  pains  having  returned  on  the  fifteenth  day  Ars,  SO  was 
prescribed,  which  in  two  days  produced  great  improvement. 
The  Ars.  was  now  discontinued,  and  nothing  but  milk  and 
water  given,  of  which  she  drank  a  quart  daily  with  relish. 
In  spite  of  the  manifest  improvement  she  had  frequently 
vertigo,  and  the  heat  of  the  abdomen  continued,  as  also  the 
burning  pain  in  the  stomach  (pylorus)  and  back,  for  which 
Ars,  no  longer  did  good.  There  came  now  a  general 
itching  of  the  skin  aggravated  by  scratching.  Along  with 
this  there  were  always  hard  motions,  mingled  with  coagula  of 
blood,  great  weakness,  greyish-blue  coloration  of  the  lips 
and  gums,  pulse  hard,  100,  sad  disposition,  the  amblyopia 
increased  almost  to  blindness,  bluish  swelling  of  the  right 
nostril,  and  discharge  of  a  brownish  fluid.     Intense  thirst, 


Qermany.  383. 

increase  of  the  urine^  and  palpitation  of  the  heart.  For 
these  symptoms  Arg.  nit.  10  was  given  every  three  hours* 
Od  this  the  pains  began  to  diminish  internally  and 
gradually  went  away^  also  the  dark  colour  of  the  mucous 
membranes  and  stools.  After  three  days  she  got  appetite 
for  solid  food,  and  toast  and  bread  crusts  soaked  in  milk 
were  allowed  and  well  borne.  She  also  drank  two  quarts 
of  milk  per  diem.  She  then  got  white  fish,  and  afterwards 
farinaceous  food.  The  Arg.  was  continued  for  several  days 
in  different  dilutions.  Eleven  days  after  commencing  the 
Arff.  she  could  leave  her  bed.  On  the  twenty-first  day  she 
could  take  ordinary  mixed  food  (except  soups  and  butcher's 
meat)^  her  only  drinks  being  milk  and  water,  All  the 
symptoms  disappeared  except  the  amblyopia^  especially  of 
the  right  eye.  After  two  months  she  could  eat  all  kinds  of 
food^  and  even  butcher's  meat.  Acids  only  were  for* 
bidden.  Two  years  have  now  elapsed  and  this  lady  is  now 
better  than  ever^  with  the  exception  of  the  amblyopia.  She 
eats  everything,  drinks  wine,  and  goes  out  every  day 
for  some  hours.  If  she  now  experiences  any  heat  of  the 
stomach  she  takes  a  small  dose  of  Carbo.  veg,,  and  the  heat 
at  once  goes  off.  She  continues  to  drink  milk  with 
relish. 

In  No.  9  is  an  extract  from  the  Berliner  Med.  JVochenschr., 
vol.  XV,  No.  88,  giving  the  experience  of  Dr.  Bogomolow 
with  regard  to  the  efficacy  of  the  ordinary  black  beetle 
(Blaita  orientalis)  in  dropsy  depending  on  heart  and  kidney 
affections.  It  diminished  the  dropsical  swellings,  increased 
the  urine  and  eliminated  the  albumen,  and  increased  the 
perspiration. 

In  No.  10  Dr.  Criiwell  relates  two  cases  of  chronic  hoarse- 
ness cured  by  Carbo.  veg.  12. 

In  No.  19  Dr.  Criiwell  relates  the  following  case : — A 
girl,  aet.  20,  blonde,  unmarried,  being  unable  to  obtain  a 
situation  as  domestic  servant,  had  remained  at  home  for 
three  months,  during  which  time  she  occupied  herself  with 
needlework.  On  the  1st  March  she  came  into  the  doctor's 
house  as  housemaid.  She  was  extremely  thin  and  pale, 
and    her    eyes    were    conspicuously    surrounded    by   red 


884  Out  Foreign  Coniempararie$. 

borders.  After  a  fortnight  she  sought  advice  for  her  ejes. 
Dr.  Criiwell  fouod  the  conjunctiva  of  the  lower  lid  covered 
with  palCj  not  very  elevated,  granulations,  the  left  eye 
being  the  worst.  He  prescribed  Arsen,  iod.  6x,  three  times 
a  day.  In  eight  days  the  red  edges  and  the  granulations 
had  quite  disappeared,  and  they  have  not  since  returned. 

In  No.  22  Dr.  Kock  relates  the  following  curious  case: 
— -A  lady  had  for  a  fortnight  suffered  from  a  peculiar  cough, 
for  which  she   had  tried  various  domestic   remedies  and 
taken  Spigelia  and  Nux  vomica  without  result.     After  every 
meal,  while  sitting  in  her  chair,  she  was  affected  with  palpita- 
tion of  the  heart,  which  was  worse  when  she  lay  down  on 
the  sofa^  when  she  was  affected  with  cough.     The  palpita- 
tion and  cough  were  ameliorated  by  rising  up,  sitting  up 
erect,  or  on  lying  on  something  hard,  a.  g.  when  she  placed 
beneath  her  back,  two  hands'  breadths  above  the  pelvis,  a  hard 
sofa  pillow.     The  cough  was  dry,  with  a  feeling  of  fulness 
in  the  upper  part  of  chest,  t.  e.  a  hand's  breadth  below  the 
clavicles.  The  palpitation  was  so  violent  that  she  felt  like 
blows  from  the  back  to  the  sternum,  whereupon  she  must 
cough.    The  feeling  was  like  (as  she  expressed  it)  a  locomo- 
tive ejecting  its  steam ;  this  sensation  came  from  the  back, 
and  when  it  occurred  she  must  cough  two  or  three  times ;  if 
she  suppressed  the  cough,  the  blows  became  more  violent, 
so  that  she  must  now  cough  with  increased  violence,  but  the 
sensation  often  would  go  off  without  cough  if  she  expired 
forcibly.     This  cough  and  palpitation  lasted  always  an  hour 
after  eating,  but  it  sometimes  came  on  when  she  fasted  too 
long,  but  this  did  not  always  happen.     Percussion  revealed 
nothing  abnormal.     When  the  stethoscope  was  applied  to 
any  part  of  the  sternum  the  cough  was  immediately  excited. 
The  heart's  sounds  were  stronger,  and  the  beats  quickened. 
In  the  upper  part  of  the  chest  on  both  sides  the  breathing 
was  much  interrupted.     There  was  no  expectoration.     The 
only  cause  that  could  be  ascertained  was  perhaps  catching 
cold,  or   carrying   about   a   sick  child.     The  woman  was 
thirty-one  years  old,  and  the  mother  of  four  children.     She 
had  never  previously  suffered  from  affections  of  the  respira- 
tory organs,  and  all  her  functions  were  normal.     Dr.  Kock 


Germany,  385 

prescribed  Calc.  muriat.,  4th  trit.^  a  small  quantity  on  the 
tongae  every  three  hoars.  On  visiting  her  next  day  she 
had  no  congh  after  breakfast^  and  no  sense  of  the  inward 
blows.  The  medicine  was  continued  in  smaller  doses  every 
four  hours.  The  following  day  he  was  informed  that  she 
was  able  to  lie  down  after  dinner  without  the  recurrence  of 
the  former  symptoms^  and  she  never  afterwards  was  troubled 
with  them. 

In  No.  28  the  editor  has  an  article^  in  which  he  accounts 
for  the  insufficiency  of  the  homoeopathic  chairs  established 
in  allopathic  universities  by  pointing  out  that  the  lectures 
delivered  were  not  made  compulsory^  that  the  opposition  to 
them  by  the  other  members  of  the  medical  faculty  is  bitter 
and  unceasing^  that  students  are  deterred  from  attending 
them  by  the  fear  of  the  examiners^  who  are  all  of  the  hostile 
camp,  and  that  the  wards  of  the  hospital  set  apart  for  the 
demonstration  of  the  results  of  homiBopathic  treatment  and 
for  clinical  instruction  are,  by  the  intrigues  of  the  allopaths, 
only  supplied  with  incurable  and  hopeless  cases.  Hence  it 
comes  that  the  professors  lecture  to  empty  benches,  and 
that  homoeopathy  derives  no  advantage  from  the  existence 
of  these  chairs,  that  have  been  forced  on  an  unwilling 
faculty  by  the  actiju  of  the  Government.  He  says  that 
the  American  plan  of  having  complete  medical  schools, 
where  all  the  branches  of  medical  science  are  taught  ''  in 
the  light  of  homoeopathy,^^  is  the  only  plan  that  can  be 
successful,  but  that  this  plan  is  impossible  to  be  adopted  in 
Germany. 

A  notice  is  given  in  this  journal  of  the  new  method  of 
iUuminating  the  interior  of  the  bladder  by  electric  light,  the 
invention  of  Dr.  Nitze,  of  Dresden,  but  the  details  of  the 
method  are  not  given. 

HtrschePs  Zeiischrift  far  homoopathische  Klinik. — ^We 
resume  our  notice  of  this  periodical  with  No.  7  of  vol.  xxiii 
(xxvii). 

The  editor.  Dr.  Lewi,  relates  a  case  of  nephritis  hsemor- 
rhagica  post  scarlatinam.  A  boy,  set.  3,  had  been  treated 
ftllopathicaUy  about  four  weeks  previously  for  an  eruptive 
disease,  which  was  apparently  scarlatina  that  had  not  had 


886  Our  Foreign  Coniemporaries. 

a  fall  development  of  the  exanthem.  There  was  a  sort  of 
miliary  eruption  in  Tarious  parts  of  the  body,  the  papules 
varying  in  size  from  an  extreme  minuteness  to  that  of  a 
millet-seed,  some  of  them  being  seated  on  a  slightly 
reddened  base.  The  eruption  is  chiefly  on  the  back,  abdo- 
roen^  chest,  face,  arms,  and  legs.  The  fingers  show  slight 
desquamation,  as  also  the  tip  of  the  nose.  Face,  hands, 
and  feet  are  mdematous,  so  also  is  the  abdomen  slightly. 
Percussion  over  the  region  of  the  bladder  is  extremely  pain- 
ful. The  skin  is  white  and  moist.  He  has  profuse  sweats 
without  relief.  The  temperature  and  pulse  are  slightly 
increased.  Sleep  disturbed.  Excessive  thirst  after  mid* 
night.  Frequent  talking  and  screaming  in  sleep.  He  was 
subject  to  curious  convulsive  attacks^  during  which  be 
frequently  stood  on  his  head.  Tongue  white,  furred  at 
the  back.  Appetite  not  bad,  longing  for  pastry  and  apples. 
Stool  constipated,  only  hard  lumps  coming  away  after 
straining.  For  half  a  year  whenever  he  sat  down  to  stool 
and  passed  anything  he  leapt  up,  as  if  mad,  crying  ''it 
stinks,  it  stinks  1^'  and  cannot  be  soothed  until  the  utensil 
is  taken  away.  The  urine  is  passed  with  great  straining  in 
drops ;  it  was  usually  alkaline  or  neutral.  In  the  fore- 
noon it  was  of  a  blood  colour,  in  the  afternoon  brown  or 
even  blackish  in  colour,  and  in  spite  of  its  alkalinity  it 
contained  a  large  quantity  of  uric  acid  sediment.  The 
microscope  showed  a  quantity  of  blood-corpuscles  and 
granular  and  hyaline  epitheliid  oasts,  with  vesical  mucus 
and  a  considerable  quantity  of  albumen;  this  and  the 
alkalinity  were  evidently  owing  to  the  admixture  of  blood. 
He  was  evidently  suffering  from  hssmorrhagic  parenchy- 
matous nephritis,  the  consequence  of  abnormal  scarlatina. 
After  putting  him  on  easily  digestible  nourishing  diet,  he 
got  Calc,  curb.  6,  then  Puis.,  Merc,  Ferrum,  and  Phos» 
phorus^  all  without  result,  for  four  weeks.  During  this 
time  the  desquamation  increased.  Then  he  was  affected 
every  morning  with  temporary  blindness,  which,  however, 
lasted  but  a  short  time  each  day.  He  now  got  Secale  com, 
8x,  tliree  times  a  day.  Under  this  medicine  the  urine  lost 
its  bloody  character  and  became  acid ;  its  colour  also  became 


Crermany,  887 

normal.  The  other  symptoms  abo  gradually  disappeared, 
and  in  two  months  from  the  commencement  of  the  treat^i 
ment  he  was  quite  well. 

In  No.  11  Dr.  Heyberger  relates  some  cases  of  nseyns : — 
1.  A  female  infant^  six  weeks  old^  had  on  the  right  side  of 
the  npper  lip  a  nsems  that  looked  like  a  bruise.  She  was 
bom  with  it^  and  it  had  ircreased  considerably  in  size  since 
her  birth.  It  was  of  a  bluish  cokmr,  the  size  of  a  scarlet 
bean,  and  projected  like  a  nipple  from  the  lip.  Under 
the  use  of  Bellad.  8  this  swelling  gradually  subsided  and 
ultimately  disappeared.  2.  This  was  a  male  infant^  one 
tad  a  half  month  old,  who  had  on  the  right  side  of  the 
chest  a  nsevus  of  a  iriolet-red  colour.  It  occupied  a  fourth 
part  of  the  side  of  the  chest,  was  raised  above  the  skin,  and 
had  an  irregular  surface.  Under  BelL  8  it  disappeared  in  a 
few  weeks.  3.  A  female  child,  two  months  old,  had  a 
Dseytis  on  the  left  auricle.  It  was  of  a  violet-red  colour, 
the  skin  was  hypertrophied  and  uneven,  the  blood-vessels 
small.  This,  too,  disappeared  in  a  short  time  under 
Beli.  3. 

In  No.  12  Dr.  Hartlaub  relates  a  case  of  severe  stomach 
affection,  which  he  diagnosed  as  carcinoma  ventriculi,  and 
which  was  cured  with  Phos  80,  but  the  correctness  of  the 
diagnosis  seems  to  us  extremely  doubtful. 

Dr.  Heyberger  relates  a  case  of  hypertrophy  of  the  heart 
in  a  boy,  aged  ten  years,  cured  by  lod,  8  in  about  six 
months. 

Dr.  Gtoullon,  d  propos  of  a  case  of  dysentery  cured  by 
Carbolic  acid,  shows  the  homoeopathicity  of  the  treatment 
by  citations  from  the  pathogenesis  of  this  drug. 

In  No.  13  Dr.  Lembke  relates  three  cases  of  non-homoe- 
pathic  cures.  The  first  was  that  of  a  man,  sixty-eight 
years  old,  who  for  several  weeks  had  general  dropsy.  The 
limbs,  face,  and  body  were  swollen.  He  could  neither  lie 
nor  eat.  He  had  cough  and  scanty  urine.  He  had  been 
treated  allopathically  without  benefit.  Tartar,  boraxat.  was 
first  given,  but  did  no  good.  After  some  days  he  got 
Sqvxlla  ^,\0  drops  every  two  hours.  This  caused  a  great 
flow  of  urine,  and  in  eight  days  all  the  dropsical  swelling 


S88  (har  Foreign  Coniemporarie$. 

had  disappeared  and  the  patient  waa  qaite  well.  The  next 
ease  waa  that  of  a  young  woman  who,  in  the  third  month 
after  marriage,  had  a  miscarriage.  Hemorrhage  continued 
for  three  months  afterwards,  but  she  said  nothing  about  it 
nntil  her  strength  became  so  exhausted  that  she  wss 
attended  for  four  months  hj  two  physicians,  who  gave  her 
all  sorts  of  remedies  without  stopping  the  dischai^e.  At 
length,  at  the  suggestion  of  a  firiend,  an  old  woman  was 
called  in,  who  did  nothing  but  ruh  her  abdomen  with  her 
hands,  whereupon  the  bleeding  stopped  and  the  menses 
returned  regularly,  and  after  this  she  had  three  children, 
and  never  had  any  more  haemorrhage.  The  third  case  was 
an  old  ship's  captain,  ninety  years  of  age,  whose  limbs,  face, 
body,  and  chest  were  dropsical,  and  he  had  a  congh  with 
mucous  expectoration.  He  got  01,  terebinth,  in  doses  of  a 
teaspoonful.  The  water  rapidly  disappeared,  the  old 
man  was  restored  to  health,  and  lived  three  or  four  years 
afterwards,  dying  at  last  of  old  age. 

In  No  14  Dr.  Gk>ullon  relates  a  case  of  chronic  ulcer  of 
the  left  side  of  the  tongue  with  great  pain,  which  was  much 
aggravated  by  Merc.  9ol.  3,  but  was  treated  with  Apu  4 
alternately  with  SUie.  12,  and  latterly  with  SUic.  alone,  and 
was  cured  in  a  fortnight. 

In  No.  16  Dr.  Ooullon  gives  a  couple  of  cases  of  gouty 
rheumatic  pains  in  the  joints,  worse  after  resting,  in  which 
SalieyUc  acid  was  of  benefit.  He  mentions  that  this  remedy 
is  often  useful  in  cracking  of  the  joints. 

Among  other  cases  related  by  Dr.  Schelliug  we  extract 
the  following: — ^A  woman,  aged  forty-nine,  family  liring, 
strong  and  sanguine,  was  much  reduced  by  care  and  sorrow. 
In  July,  1869,  she  complained  of  pain  in  the  stomach 
and  precordium,  nausea  and  weakness;  then  she  got 
mucous  diarrhoea  with  pinching  in  the  abdomen,  eructationsi 
chills  and  heats,  great  thirst,  and  disturbed  sleep.  Then 
she  became  yellow  all  over,  especially  in  the  face  and  eyes. 
She  got  a  variety  of  domestic  remedies,  but  grew  daily 
worse,  and  in  four  days  she  became  so  weak  that  she  could 
not  leave  her  bed ;  no  appetite,  food  makes  her  sick,  eruc- 
tations, stomachache,  motions  white,  urine  icteric,  breath- 


Oermany.  889 

ing  oppreBsed,  alternate  chills  and  faeats^  sleep  disturbed 
and  nnrefreshing.  On  the  25th  of  August  she  got  Aeon, 
20  in  the  evenings  and  on  the  26th  Araen.  40  every  two 
hours.  27th. — ^More  sleep,  urine  clearer^  breathing  anxious^ 
weak.  29th. — Sleep  still  disturbed  but  more  refreshings 
some  appetite,  urine  lighter ;  is  out  of  bed  ;  Ars.  4S^  every 
three  hours.  Ist  Sept. — ^Appetite  and  sleep  returned^ 
urine  normalj  skin  much  less  yellow,  eyes  clearer ;  An,  and 
Sulph.  20.     6th. — Quite  well. 

In  No.  17  Dr.  Schelling  relates  several  cures  by  Cotchu 
cum-. — 1.  A  stout  man/ 32  years  old,  was  always  well  until 
antumn,  when  he  got  a  chill  when  working  hard  on  the 
railway.  He  had  catarrh  and  cough,  and  thought  he  was 
cored  after  taking  some  domestic  remedies,  but  thereafter 
he  had  frequent  attacks  of  weakness^  rigors^  and  pains  in 
the  limbs,  especially  in  cold  damp  weather,  with  headache 
and  vertigo.  Whilst  these  symptoms  got  worse  and  better, 
he  complained  of  pain  in  back  and  chest,  with  loss  of 
appetite  and  feeling  of  fulness  and  pressure  in  the  scro- 
biculas  cordis.  In  December  his  sufferings  increased 
greatly,  and  to  these  were  added  burning  pains  in  stomach 
and  chest,  with  drawing  and  shooting  from  the  chest  to  the 
back,  pinching  in  the  abdomen,  especially  towards  evening 
aud  into  the  night,  with  frequent  urging  to  urinate ;  urine 
scanty  and  opaque  yellow,  passed  with  great  scalding ;  rigor ; 
cold  feet  prevent  him  sleeping  till  midnight ;  sleep  uneasy 
and  full  of  dreams.  On  the  15th  December  he  got  Colch. 
5  three  times  a  day.  On  the  17th  much  relieved,  the 
burning  in  chest  and  shooting  in  back  gone,  the  urine 
clearer  and  without  urging,  chills  also  less,  sleep  quieter. 
Colch.  every  three  hours.  On  the  18th  all  right  except  the 
pressure  in  the  scrobiculus  cordis;  Colch.  The  following 
day  quite  well. 

2.  A  man,  aged  69,  very  subject  to  affections  of  the 
stomach  and  bowels,  affected  with  an  inguinal  hernia,  had, 
while  working  in  the  fields  in  summer,  complained  for  eight 
weeks  of  pain  in  back  and  sacrum,  with  frequent  call  to 
make  water,  which  scalded.  In  July,  in  consequence  of  a 
chill,  he  got  toothache  in  one  eye-tooth,  which,  after  eight 


S90  Our  Foreign  Camtemporaries. 

dajBy  WM  relieved  by  warm  fomentations,  and  ended  in 
Bwelling  of  the  cheek,  whereupon  the  back  and  loin  pains 
increased,  and  at  the  end  of  July  extended  to  the  chest. 
He  got  so  bad  that  he  was  unable  to  walk  or  work  on 
account  of  the  pains,  and  sought  adnce.  On  the  7th  of 
August  the  following  symptoms  were  noticed  -.—Burning  in 
stomach  and  chest;  little  appetite;  pressure  and  tension 
after  a  little  food  ;  flatulent  distension  of  the  stomachy  with 
pain  in  the  scrobiculus  cordis ;  frequent  discharge  of  fetid 
flatus ;  frequent  call  to  make  WAter,  with  scanty  discharge 
of  burning  urine,  which  is  dark  yellow  and  cloudy,  de<- 
positing  white  flakes  on  standing.  Day  and  night  violent 
pains  ;  tearing  and  shooting  in  the  back,  loins  and  sacrum, 
with  twitching  in  the  thighs  down  to  the  knees,  especially 
on  the  right  side.  At  night  he  can  hardly  And  an  easj 
position ;  sleep  none,  or  only  short  and  uneasy ;  at  the 
same  time  he  has  constant  rigors ;  cold  extremities ;  face 
pale  grey,  the  lips  dry  and  bluish  red.  He  got 
Colch.  5  every  three  hours.  The  following  day  he  was 
relieved^  the  pains  were  better.  On  the  third  day  he  had 
no  pain  when  reposing,  only  when  going  about ;  sleep 
quieter;  urine  copious,  and  passed  without  discomfort. 
The  following  day  he  went  about  his  work  without  difficulty. 
No  relapse  occurred. 

8.  A  girl  of  18j  in  whom  the  menses  had  not  yet 
appeared,  suffered  for  several  weeks  in  autumn  from  diar« 
rhoea  day  and  night,  with  rumbling  in  the  bowels  without 
pain,  appetite  good,  but  difficulty  of  going  to  sleep  before 
midnight.  She  complained  of  constant  ice-cold  hands  and 
feet ;  they  did  not  get  warm  even  in-  mild  weather,  and  the 
hands  got  stiff,  thin,  and  cold  on  walking  in  the  open  air 
and  washing.  She  suffered  much  from  chaps  on  the  skin, 
and  every  winter  from  chilblains  and  cramp  in  the  hands. 
She  got  one  dose  of  Colch,  4.  By  this  one  dose  she  was 
cured  of  the  cramp  in  the  hands  and  the  diarrhoea,  but  the 
coldness  of  the  extremities  returned. 

In  No.  18  Dr.  Mossa  relates  a  case  of  severe  cardialgia 
in  a  young  man,  aged  20,  which  was  worse  when  moving, 
better  when  lying  and  sitting,  but  sometimes  went  off  when 


Germany.  891 

he  took  violent  exercise  and  got  into  perspiration.  The 
pain  was  as  if  a  stone  lay  in  the  stomach.  His  appetite 
was  good^  but  the  pain  was  excited  by  eating.  He  was 
soon  cared  by  Argent,  nit.  3,  a  dose  four  times  a  day. 

Dr.  Lewi  relates^  in  No.  20,  the  following  case  of  melan- 
cholia acuta,  cum  migratione  noctuma  et  oonatu  suicidii. 
A  girl^  aged  18,  of  rather  limited  intelligence  and  of  shy 
disposition,  had  already  sufiPered  for  some  years  from  attacks 
of  melancholy.  These  attacks  became  very  frequent. 
She  was  sent  to  be  treated  at  the  town  hospital,  but  no 
good  result  followed ;  the  attacks  became  more  frequent 
and  more  violent.  Status  prmsenM. — She  is  apparently  of 
good  constitution,  only  rather  pale.  No  derangement  of 
any  of  the  functions.  Her  father,  who  was  a  robust  man, 
living  in  comfortable  circumstances,  had  unexpectedly 
committed  suicide.  The  present  attack  had  already  lasted 
four  or  five  days.  She  is  restless,  does  not  sleep  at  night, 
but  wanders  about  the  house  under  the  impression  that  she 
has  committed  some  great  crime^and  that  she  is  not  worthy 
to  live.  During  all  this  time  she  would  neither  eat  nor 
drink.  She  must  be  constantly  watched^  for  once  she  ran 
off  to  the  police  office  to  denounce  herself  as  a  criminal, 
and  once  she  attempted  to  hang  herself.  She  is  always 
worst  at  night.  To  t^e  doctor  she  accused  herself  of  the 
supposed  crime,  and  expressed  her  fears  that  she  would  be 
taken  up  by  the  police.  She  twisted  her  hands  together, 
and  continually  changed  her  position.  Her  expression 
indicated  the  deepest  grief.  Two  doses  of  Nux  vomica 
were  given  without  effect.  She  then  got  Arsen.  Gx,  two 
drops  in  water  for  a  dose.  The  effect  was  marvellous.  The 
first  dose  calmed  her  greatly,  she  passed  a  quiet  night  of 
refreshing  sleep,  and  next  morning  she  was  quite  well  and 
spoke  perfectly  rationally.  Four  years  have  since  elapsed, 
and  she  has  remained  well,  without  the  slightest  recurrence 
of  the  attacks. 

In  No  22  Dr.  Lewi  relates  a  severe  case  of  ophthalmia 
scrofulosa  after  measles,  with  ulceration  of  the  cornea, 
'which  was  rapidly  cured  by  Hep.  sulph.  6x. 

In   No.  8   of  vol.  xxiv   are   two  observations   by  Dr. 


392  Our  Foreign  Contemporaries. 

Hejberger  on  nearalgia  cored  by  Sqna : — 1.  A  womaoj 
about  forty,  after  getting  wet  while  engaged  in  field  labour, 
got  joint  rheumatism  with  pain,  that  lasted  three  days. 
Soon  afterwards  she  got  pains  in  the  teeth,  upper  jaw,  and 
temples  of  the  left  side,  which  gradually  increased,  and,  espe- 
cially at  night,  were  of  frightful  intensity,  remitting  towards 
evening,  the  pains  boring,  shooting,  and  burning  in 
character.  Ary.  rdtr.  did  no  good,  but  after  a  few  doses  of 
Sepia  8  the  pains  went  off  as  if  by  magic.  2.  A  young 
lady,  of  twenty-one,  after  being  heated,  drove  at  night 
in  a  carriage,  and  did  not  notice  that  the  windows  were 
open,  whereby  she  was  chilled.  Two  days  later  she  got 
violent,  apparently  rheumatic,  pains  in  the  teeth,  that  became 
intolerable  at  night.  The  pains  spread  from  the  teeth 
through  the  upper  jaw  and  the  temples  of  both  sides,  but 
were  worst  in  the  left  side,  and  went  to  the  top  of  the  bead 
and  occiput.  All  sorts  of  domestic  remedies  were  employed, 
and  two  carious  teeth  extracted  without  affecting  the  pain^ 
which  got  worse.  The  doctors  in  attendance  gave  Bark  in 
large  doses,  which  caused  the  pains  to  increase  enormously 
in  intensity.  She  then  sought  the  advice  of  Dr.  Heyberger, 
who  gave  Sepia  3,  after  two  doses  of  which  the  pain  com- 
pletely disappeared. 

In  No.  4  the  editor  commences  a  paper  on  the  oriental 
bubo  plague,  which  is  continued  through  several  numbers, 
and  gives  a  tolerably  complete  account  of  this  serious 
disease. 

In  the  same  number  is  a  paper  giving  a  series  of  experi- 
ments on  the  lower  animals  with  Carbolic  acid. 

Dr.  Mossa  gives  an  account  of  Keppler's  investigations 
respecting  acute  Saponin  poisoning. 

In  No.  8  Dr.  Froll  relates  the  following  case  : — ^A  young 
lady  of  elegant  appearance,  apparently  in  the  best  of  health, 
with  all  the  functions  in  order,  was  affected  with  such  a 
fetid  breath  that  no  one  could  come  near  her  without  dis- 
gust. As  she  was  engaged  to  be  married  in  three  months 
she  was  very  anxious  to  lose  this  disagreeable  symptom. 
On  examination  the  nasal  and  buccal  mucous  membrane 
was  quite  normal,  her  teeth  were  perfect,  the  tongue  clean. 


Prance.  893 

the  stomach  in  good  condition,  no  eractations^  no  congh. 
Percussion  and  auscultation  showed  that  the  lungs  were  all 
rights  and  yet  the  breath  was  horribly  fetid.  The  eyes^ 
nose^  and  lips  showed  a  scrofulous  type^  and  she  had  when 
a  girl  had  enlarged  cervical  glands.  She  got  Aurum. 
muriat.  lOz,  a  dose  every  morning.  After  two  weeks  of 
this  medicine  the  smell  had  nearly  disappeared,  and  a  fort- 
night later,  when  no  more  medicine  was  given,  she  had  not 
the  slightest  remains  of  her  disgusting  affection.  In  three 
months  «he  was  a  happy  bride. 

In  our  April  number  we  made  some  progress  in  over- 
taking the  arrears  of  American  homoeopathic  journalism. 
On  the  present  occasion  we  must  begin  with  an  attempt 
to  do  the  same  for  France,  Belgium,  and  Italy. 

FEANCE. — Our  last  review  of  the  periodical  literature 
of  this  country  (October,  1878)  brought  it  down  to  June 
in  last  year.  We  have,  therefore,  more  than  a  twelvemonth^s 
way  to  make  up  \  but,  on  the  other  hand,  have  only  two 
journals  of  which  to  treat,  as  the  Bibliothique  Homceopathique 
seems  to  have  come  to  an  end  with  the  lamented  decease  of 
its  editor^  Dr.  Fitet.  At  leasts  we  have  received  no  number 
of  it  since  that  October,  1878. 

UArtM6dical,  July,  1878 — August,  1879.— This  journal, 
too,  has  to  lament  the  death  of  its  redacteur-eU'Chef,  but  to 
it  (though  not  indeed  to  homoeopathy  in  France)  the  loss 
is  merely  nominal,  as  Dr.  Davasse — ^the  prey  to  a  mortal 
malady — had  long  ceased  to  be  able  to  discharge  his  office, 
and  the  girant  responsable  ei  actuel  has  been  Dr.  Jousset. 
A  tribute  from  his  pen  to  his  late  colleague  adorns  the 
number  for  July  in  the  present  year.  We  translate  its 
touching  and  dignified  conclusion. 

"  And  now  that  death  has  done  its  work,  one  can  apply 
to  Jules  Davasse  the  ancient  inscription  which  marks  the 
entrance  of  a  Roman  cemetery  :  '  Happy  is  the  dead,  since 
he  is  at  rest.'  He  is  at  rest  from  his  labours,  from  the  con- 
tradictions of  his  life,  and  the  sufferings  so  long-drawn-out 
of  his  malady  \*^  he  is  at  rest  with  our  master^  J.  F.  Testrier. 

*  Dr.  Davasse  died  of  locomotor  ataxy, 
VOL.  XXXVII,  NO.  CL. OCTOBEE,  1879,  C  C 


394  Our  Foreign  Contemporariei. 

There  he  has  rejoined  Timbart,  Escallier,  Gabalda,  J. 
H^lot,  Milcent,  Maillot^  Champeaux,  the  first-fruits  of  that 
band  of  internes  who,  with  the  generosity  of  yoath,  sacrificed 
their  fature  prospects  in  the  hospitals  to  their  attachment 
to  that  which  they  regarded  as  the  truth  in  therapeutics, 
and  also,  it  must  be  said  (for  the  sentiment' does  them 
honour),  to  friendship  for  a  master  unjustly  persecuted. 
Those  who  survive  are  old  and  wearied,  but  not  dis- 
couraged ;  the  thankless  task  they  fulfil  finds  them  day  by 
day  at  the  breach,  and,  although  convinced  that  they  are 
too  old  to  assist  at  the  triumph  of  therapeutic  reform,  of 
the  advent  of  that  triumph  they  do  not  doubt  for  a 
moment.  And  why  should  they  doubt?  The  study  now 
so  general  of  the  physiological  action  of  medicines,  the 
demonstration  of  the  law  of  similars  by  the  very  writings 
of  their  adversaries,  small  doses  replacing  those  of  perturb- 
ing magnitude,  the  general  proscription  of  polypharmacy, 
even  the  common  use  of  granules — <lo  not  these  constitute 
sufficient  signs  of  the  approaching  triumph  of  the  truth  ? 
Assuredly,  we  shall  not  have  the  satisfaction  of  seeing  the 
victory,  or  of  tasting  the  joy  of  those  who  triumph ;  but  we 
are  of  a  school  where  it  is  taught  that  '  he  that  planteth  is 
nothing,  and  he  that  watereth  is  nothing,  but  God  who 
giveth  the  increase/  And  when  we  shall  have  rejoined 
J.  Davasse  in  those  high  realms  where  reigns  absolute  tnith, 
what  to  us  will  be  the  hurrahs  of  earthly  success  ? 

'  As  for  you,  ancient  colleagues,  who  have  had  the  weakness 
to  join  our  persecutors,  it  is  you  who  have  to  lament.  The 
war  you  have  waged  against  us  is  an  unjust  war,  because  we 
were  not  unknown  to  you.  You  lived  in  our  intimacy  during 
the  happy  days  of  our  intemai ;  you  were  our  colleagues,  and 
you  have  broken  from  that  sacred  fellowship  which,  despite 
your  injurious  doings,  toe  have  never  forgotten.  You  know 
well  that  we  are  neither  ignoramuses  nor  charlatans;  our 
life  has  been  honest,  always  open  to  your  view;  and  yet 
you  have  associated  yourselves  with  our  persecutors ;  you 
have  become  the  accomplices  of  those  who  have  first  deprived 
us  of  the  possibility  of  cultivating  the  science  which  you  know 


Prance.  805 

we  lore  by  excluding  us  from  the  lios|)itals,  and  now  refuse 
us  the  consideration  which  is  due  to  every  honourable 
practitioner  of  medicine. 

I  ^''It  is  yon^  I  repeat^  who  have  to  lament ;  and  I  hope  that 
you  may  live  long  enough  for  the  triumph  of  the  therapeu- 
tic reforms  to  which  we  have  sacrificed  ourselves  to  make 
you  exclaim  :  Well^  after  all^  Davasse  and  his  friends  were  in 
the  right/^ 

The  fourteen  numbers  of  VArt  Medical  now  before  us 
contain  several  fresh  clinical  lectures  by  Dr.  Jousset, 
presenting  all  the  excellences  of  the  published  series^  to 
which  we  hope  that  they  will  some  day  form  a  companion 
volume.  In  them  also  is  concluded  the  treatise  of  Dr. 
Fredault,  La  cellule  vivante  et  la  thSorie  du  protoplasma, 
of  which  we  spoke  in  our  last  notice.  Dr.  Fredault  cannot 
accept  the  protoplasmic  theory  of  life,  and  puts  very  forcibly 
the  objection  that  it  fails  to  account  for  the  morphology  of 
animated  nature,  the  development  and  perpetuation  of  so 
many  distinct  specific  forms.  Dr.  Ravel  also  continues  to 
enrich  the  pages  of  this  journal  with  his  learned  collections  of 
testimony  on  points  pathological  and  therapeutical;  and 
Br.  Imbert-Gourbeyre  maintains  his  corresponding  fame  as 
a  pharmacologist  by  an  article  (May,  1879)  on  poisoning  by 
arseniuretted  hydrogen. 

While  every  number  of  this  ably  conducted  journal 
presents  something  to  instruct  and  interest  the  actual 
reader,  there  are  few  points  in  the  present  series  on  which 
a  survey  such  as  ours  can  dwell.  We  would  only  note 
two — ^the  articles  by  Dr.  Claude  in  the  May  number  on  the 
treatment  of  nocturnal  enuresis  and  of  chemosis,  and  that 
by  Dr.  Cramoisy,  in  June,  on  the  use  of  Aconite  in  cholera. 
Dr.  Claude  begins  by  speaking  of  the  occasional  value  of 
Belladonna  in  the  first-named  complaint,  relating  two  cases 
in  which  it  proved  successful  in  his  hands,  in  the  dilations 
from  the  third  to  the  thirtieth.  He  admits,  however,  that 
it  often  fails,  and  calls  attention  to  the  claims  of  Equisetum 
to  greater  confidence.  He  then  adds  to  the  observations 
previously  published  by  him  as  to  the  elBcacy  of  Guaraa  in 
conjunctivitis,  when  chemosis  occurs,  two  others  not  less 


396  (har  Foreign  Contemparariei. 

satisfactory.  Here,  too,  it  acted  well  in  the  6th  dilation, 
while  in  his  former  cases  he  had  given  the  1st  decimal.  Dr. 
Cramoisy  furnishes  some  farther  evidence  of  the  value  of 
Aeomie  (given  in  the  mother*tincture)  in  choleraic  conditions* 
He  justly  takes  credit  for  being  the  first  to  perceive  the 
appropriateness  of  the  remedy,  and  to  apply  it  in  practice 
tJi  Dranee ;  but  he  most  not  say,  as  he  does,  "  before  the 
application  which  I  made  of  it  in  1865,  Aconite  had  never 
been  given  in  cholera.''  The  ''  numerous  researches ''  by 
which  he  says  he  has  satisfied  himself  of  this  have  hardly 
extended  to  American  homoeopathic  literature,  or  he  would 
have  found  Dr.  Hempel  taking  up  the  same  position  as  that 
which  he  now  holds  in  the  epidemic  of  1849. 

Bulietim  de  la  Societe  Medicate  Homccopaihique  de  France^ 
July,  1878 — July,  1879. — ^The  numbers  of  this  journal  for 
August,  September^  and  October,  1878,  have  failed  to 
reach  us,  in  spite  of  our  reclamations;  and  those  of  June 
and  August  have  not  been  received  at  our  present  writing 
(August  20th).  The  nine  numbers  before  us  maintain  their 
wonted  excellence,  but  present  little  to  note  or  extract. 
We  would  call  attention  to  a  mistake  made  by  Dr.  Tessier 
in  speaking  (at  p.  126  of  the  May  number)  of  the  treatment 
of  plague.  He  refers  to  Hahnemann's  pre-indication  of 
the  remedies  for  cholera,  and  gives  them  as  having  been 
Cuprum^  VeratrHm,  Arsenicwm,  and  Camphor,  If  he  will 
refer  to  Hahnemann's  writings  on  the  subject,  he  wiU  see 
that  Arsenicwm  was  not  mentioned  by  him.  At  p.  728  of 
the  same  number.  Dr.  Jousset  mentions  that  Hahnemann 
gives  "  gangrene ''  among  the  symptoms  of  BeUadonna,  and 
justly  expresses  doubt  as  to  the  correctness  of  the  observa- 
tion. He  speaks  of ''  deux  paragraphes  "  as  containing  this 
symptom ;  we  can  only  find  one,  S.  1268  of  the  patho- 
genesis  in  the  third  edition  of  the  first  volume  of  the  Materia 
Mediea  Pura.  This  is  indeed  most  erroneously  cited  from 
the  author  to  whom  it  refers,  as  may  be  seen  at  p.  664  of 
vol.  xxxi  of  our  Journal.  It  should  read — **  death  forthwith 
ensued,  and  a  universal  gangrene  throughout  the  body, 
which  in  a  short  time  became  black  throughout,  and  so 
flaccid,  that  the  cuticle  adhered  to  the  sm^jeon's  hands.'' 


France,  397 

If  Dr.  Jousset  will  tell  us  where  to  find  the  second 
paragraph  of  which  he  speaks^  we  may  be  able  to 
giye  him  a  similar  explanation.  The  number  is  chiefly 
occapied  with  the  essay  of  Dr.  Espanet^  on  the  reconstitu* 
tion  of  the  Materia  Medica^  which  we  have  discussed  in  our 
last  issue. 

In  the  May  number  we  read  the  following  regrettable 
announcement: — ^'On  the  initiative  of  our  colleague^  Dr. 
Gonnard,  the  gathering '^ — the  late  Paris  Congress — ''moved 
by  his  persuasive  eloquence,  took  a  grand  resolve ;  it  named 
a  commission  for  studying  a  plan  whereby  there  should  be 
a  collective  teaching  of  homoeopathy  at  Paris.  This  com- 
mission has  elaborated  a  well-defined  scheme^  formulated 
by  the  author  of  the  proposal ;  it  has  been  submitted  to  you 
with  unanimous  assent.  Alas  for  the  fate  of  mundane 
affairs  !  This  ingenious  conception  has  become  abortive  in 
the  face  of  the  impossibility  of  finding  a  neutral  ground  on 
which  we  could  agree.  What  can  you  expect,  gentlemen  ? 
We  can  easily  decree  teachings  but  we  cannot  command 
harmony.'^  It  seems  as  difficult  to  agree  about  a  School  of 
Homoeopathy  in  Paris  as  it  has  been  here  in  London. 

In  the  same  number  Dr,  Gonnard  relates  a  case  of  osteo- 
malacia, occurring  in  a  woman  at  the  climacteric  age,  in 
which  the  progress  of  the  disease  has  been  entirely  checked 
by  Phosphorus  and  Calcarea,  each  in  the  30th  dilution, 
administered  for  six  months,  fortnight  by  fortnight,  with  a 
corresponding  interval  of  repose  between  each  alternation. 
At  p.  39^  last  line  of  the  text,  ^'acidum"  should  read 
"  aurum" 

We  will  notice  the  July  number  when  we  have  received 
its  predecessor  of  June. 

Bxbliothique  Homceopathique,  July — October,  1878. — In 
departing  its  life  this  journal  has  left  us  something  to 
extract.  The  passage  occurs  in  the  August  number,  in  the 
course  of  a  lecture  delivered  (it  does  not  say  where  or  to 
whom)  by  Dr.  Eruger.  *'I  have  myself  observed  certain 
effects  of  Sepia.  I  used  the  third  trituration,  i .«.,  one  contain- 
ing the  millionth  part  of  the  substance.  I  intermingled  some 
doses  of  the  12th  dilution^  which  represent^  a  septilliontb 


898  Our  Foreign  Contemporaries. 

part.*  Now  this  minute  fraction  sensibly  augmented  the 
effects  of  the  drug^  which  showed  themselves  in  a  peculiar 
fermentation  of  the  bloody  slight  fever,  diseagreeable  sense 
of  nausea^  ebullition  in  all  the  vessels,  heat  at  the  stomach 
and  in  the  lungs^  noises  in  the  ears^  troublesome  dreams, 
determination  of  blood  to  the  head.  But  the  most  remark- 
able effect  was  the  being  awakened  with  a  starts  by  violent 
beatings  of  the  heart,  slow  and  regular,  as  in  hypertrophy^ 
felt  strongly  in  the  head,  and  producing  a  slight  feeling  of 
anxietas.  After  about  a  minute  this  ceased  abruptly,  and 
it  felt  as  if  the  cardiac  pulsations  were  entirely  arrested.  I 
anxiously  sought  to  feel  the  heart  beat  at  its  normal  place^ 
and  did  not  recover  calmness  until  1  had  found  it^  or  rather 
until  it  returned  under  my  fingers.  This  was  at  4.30  a.m. 
On  that  night  I  had  taken  a  dose  of  Sepia  4,  and  had  felt 
a  contractive  sensation  in  the  forehead,  followed  by  a  peculiar 
itching.  Next  morning  I  discovered  at  the  same  spot  an 
eruption  of  a  vivid  rose-red,  formed  of  little  round  spots, 
circling  like  a  crown  the  roots  of  the  hair.  At  noon  it  was 
still  there^  on  the  right  side.  On  the  chest,  where  I  had 
felt  a  similar  itching,  little  yellow  spots  appeared.  On 
another  day  I  experienced  persistent  irritation  at  the  nape 
of  the  neck^  with  a  sensation  to  the  touch  as  of  the  presence 
of  small  elevations. 

^'  The  itching  vas  considerable^  very  different  from  that 
caused  by  insects,  returning  instantly  after  scratching.  It 
seemed  as  if  the  fingers  were  unable  to  disperse  the  ebulli- 
tion of  blood  accumulatod  at  this  point,  It  gave  me  the 
impression  of  an  internal  irritation  without  external  cause. 
I  experienced  also  at  the  apex  of  the  chest  slight  drawing 
pains,  which  went  immediately  to  the  forehead^  becoming 
there  dull  and  pressive  in  character.  Is  there  not  some- 
thing strange  in  this  communication  between  the  two  sets 
of  spots  ?  The  various  sensations  had  quite  an  unwonted 
feeling  to  me^  one  at  once  lively  and  fugitive.  I  had  never 
felt  anything  just  like  them.  1  could  compare  them  to  the 
effect  produced   by  arrest  of  perspiration  {Sepia   is  muck 

*  We  need  hardly  point  ont  that  Dr.  Krnger's  arithmetic  is  at  £aolt, 
Hahnemann's  12th  dilation  ia  a  qnadrillionth. 


Belgium.  399 

employed  for  this  accident).  I  experienced  besides  a  great 
feebleness  of  the  limbs  when  walkings  and  a  general  excess 
of  moisture  in  the  alimentary  canal/' 

JlELGlVM.—UHomcRopathie  Miliiante,  July,  1878— 
July,  1879. — ^This  new  journal,  under  the  management  of  its 
active  editor.  Dr.  Gailliard,  continues  to  flourish,  contributing 
much  to  our  polemical  literature,  and  somewhat  to  our  prac- 
tical. It  is,  we  confess,  a  little  too  militant  for  our  taste,  but 
perhaps  the  circumstances  of  its  country  require  that  it 
should  be  so. 

The  collection  of  facts  relating  to  the  physiological  action 
of  Quinine^  by  Dr.  Ch.  de  Moor,  is  continued  throughout 
these  numbers,  and  is  of  much  value.  Dr.  Gailliard  him- 
self contributes  to  each  some  similarly  obtained  observa* 
tions  as  to  the  pathogenetic  action  of  various  drugs ;  and 
the  same  indefatigable  writer  has  once  more  gone  at  length 
into  the  question  of  the  poison  which  was  administered  to 
Socrates,  maintaining  (with  Dr.  Imbert-Gourbeyre)  that  it 
was  our  Conium  maculatum.  Other  communications  of  note 
are  as  follows. 

In  the  August  number,  Dr.  van  den  Berghe  relates  a 
case  of  chronic  hydrocephalus,  cured  by  Calcarea  and 
Sulphur^  in  the  30th  and  200th  dilutions;  and  Dr.  van  den 
Heuvel  has  some  practical  observations  as  to  the  place  of 
Rkus  in  typhoid  fever.  *'  During  its  march,*'  he  writes, 
"  on  the  eighth,  tenth,  or  twelfth  day,  in  the  midst  of  an 
abatement^  there  often  supervenes  an  aggravation  of  the 
fever  and  of  the  general  condition,  nearly  always  accom- 
panied with  a  liquid  evacuation,  fetid,  but  not  very  abun- 
dant. This  means  that  erythema  of  the  intestine  has 
declared  itself^  and  that  from  thence  to  ulcerations,  to  per- 
forations, to  adhesions,  to  intestinal  haemorrhages,  there  is 
but  a  step.  This  state  of  things  occurs  in  nearly  every 
typhoid  fever.  .  .  Those  who  have  tried  it  are  satisfied 
that  a  simple  dose  of  Rhus,  given  at  the  moment  when  one 
suspects  the  presence  of  this  intestinal  erysipelas,  nearly 
always  arrests  at  once  the  cortige  of  accidents  we  have  to 
dread,  and  permits  the  disorders  to  terminate  in  a  happy 
convalescence  on  the  eighteenth  or  twenty-first  day.'' 


400  Our  Foreign  ContemporarieM. 

In  the  September  number  Dr.  EenenB  oommmiieates 
some  cases,  showing  that  the  ancient  repute  of  PheUandriwn 
in  pulmonary  disease  is  not  unwarfanted,  and  can  be  sub* 
tained  by  its  use  in  infinitesimal  doses.  He  gave  the  6th 
dilution. 

In  December  we  find  a  series  of  cases  of  cure  of  men- 
tagra^  by  Dr.  van  den  Berghe.  He  finds  Sulphur  the  remedy 
for  the  dry  form^  Graphites  for  the  humid. 

In  February,  we  find  another  incorrect  account  of 
Hahnemann's  prescription  of  the  homoeopathic  remedies  for 
cholera.  It  is  represented  (by  Dr.  De  Eeersmaecker)  as 
having  been  made  in  1848,  at  Paris.  Hahnemann  died  in 
1843,  and  his  recommendations  about  the  treatment  of 
cholera  were  written  at  Coethen  in  1881. 

In  April  we  were  startled  to  find  the  editor  declaring  that 
there  were  "deux  cent  quatorze  joumauv  de  m^decine 
homoeopathique  actuellement  publics  "  in  the  United  States. 
We  give  his  own  words,  that  we  may  not  be  representiDg 
him.  For  this  astonishiDg  statement  he  refers  to  the 
United  States  Medical  Investigator  for  February  15  th ;  but 
what  is  said  there  is  "  no  less  than  214  Homoeopathic 
journals  have  been  started  in  the  United  States/'  This  is 
a  very  different  thing  from  saying  that  that  number  are 
published  at  the  present  time.  It  would  be  more  correct 
to  set  them  down  at  eight. 

The  last  three  numbers  reproduce  at  full  length  the 
essays  of  Drs.  Espanet  and  Ozanam^  on  the  reconstitution  of 
the  Materia  Medica  and  on  the  acid  diathesis  respectively, 
which  have  appeared  in  the  Bulletin  of  the  French  Society. 
We  regret  such  wholesale  transfers^  when  the  language  is 
the  same,  as  they  indispose  the  readers  of  one  journal  to 
take  the  other ;  and  our  aim  should  rather  be  to  induce 
as  many  practitioners  as  possible  to  become  acquainted  with 
the  periodical  literature  of  their  school,  and  so  to  give  it  the 
sustenance  it  so  much  needs.  We  cannot^  moreover^  ap- 
prove of  Dr.  Oailliard's  claiming  (in  July)  that  "  if  Secaie 
causes  uterine  haemorrhage  it  is  solely  because  it  can 
provoke  such  flux/'  He  must  know  that  the  occurrence  of 
metrorrhagia  under   the  action    of  ergot  is    a   very  rare 


Belgium.  401 

phenomenon ;  and  that  its  power  of  checking  haemorrhage 
from  the  uterus  is  much  more  readily  explained  by  the 
contracting  influence  it  unquestionably  exerts  upon  unstriped 
muscular  fibre.  There  are^  of  course,  cases  to  which  Secale 
is  homoeopathic,  and  here  it  will  act  well  in  infinitesimal 
doses ;  but  these  are  correspondingly  rare.  Such  excessive 
claims  for  our  method  weaken  the  real  force  of  the  evidence 
in  its  favour. 

Revue  Homceapathique  Belge^  July,  1878 — July,  1879. — 
Contrary  to  the  fears  we  expressed  in  our  last  notice,  the  Revue 
continues  to  flourish  by  the  side  of  its  rival.  We  hope 
it  may  long  continue  to  do  so. 

The  chief  feature  of  the  numbers  before  us  is  a  study  of 
the  homoeopathic  treatment  of  constipation,  by  Dr.  Bernard, 
which  runs  throughout  them,  and  displays  much  erudition 
and  industry.  We  hope  it  will  appear  in  a  separate  form, 
as  it  deserves  to  do.  Dr.  Bernard  also  communicates 
(August  1878  and  June  1879),  some  interesting  remi- 
niscences of  a  year  spent  by  him  in  Paris,  in  1860,  during 
which  he  enjoyed  much  intercourse  with  the  then  luminaries 
of  French  homoeopathy.  From  the  January  number  we  learn 
of  the  formation  of  a  new  socioty  at  Brussels,  under  the  title 
of  *^  Association  Centrale  des  Homoeopathes  Beiges.^'  Why  it 
should  be  required,  seeing  that  a  '^  Societe  Homoeopathique 
Beige  ''  already  exists  in  that  city,  we  can  hardly  see ;  but 
our  Flemish  colleagues  probably  know  best  about  their  own 
afiPairs.  The  rivalry  here  does  not  seem  due  to  the  quarrel 
which  has  elsewhere  divided  homoeopathists  into  two  distinct 
camps — that  between  pure  Hahnemannism  and  more  liberal 
views  of  the  system.  From  a  paper  read  by  Dr.  Martiny, 
editor  of  the  Revue^  at  the  first  meeting  of  the  new  society, 
we  extract  the  following,  which  bears  upon  some  questions 
recently  discussed  among  ourselves : — "  We  fear  not  the  light, 
we  earnestly  ask  for  it ;  we  do  not  dread  comparison  :  we 
wish  that  students  of  medicine  should  have  an  opportunity 
of  learning  our  method ;  but  for  this  it  is  necessary  that 
there  should  be  professors  who  are  au  courant  with  its 
history  and  its  literature,  who  have  sufficient  practical  ex- 
perience iQ    it^  and   who  have  sounded  the  depths  of  the 


402  Our  Foreign  Caniemporaries. 

nnmeroos  questions  which  belong  to  it.  We  do  not  wish 
that  our  confreres  of  the  old  school  should  believe  us 
animated  by  the  spirit  of  sect  or  system  in  that  which  we 
propose.  If  there  are  patients  who  wish  to  be  treated 
homoeopathically,  they  ought  at  least  to  be  able  to  secure 
physicians  acquainted  with  the  method ;  if  there  are  students 
and  practitioners  of  medicine  who  wish  to  practise  homoeo- 
pathy, they  ought  to  have  means  of  studying  it:  No  faculty 
of  medicine  in  this  country  will  supply  this  supplementary 
teaching ;  it  is  ui^nt  to  draw  the  attention  of  the  Gt>Tem- 
ment  to  this  deficiency,  so  lamentable  from  the  point  of 
view  of  a  great  number  of  our  fellow-citizens.  TTe  do  not 
hesitate  to  declare  it ;  the  teaching  of  homoeopathy  ought 
to  have  a  supplementary  character.  All  those  who  are 
destined  to  practise  homoeopathically  are  also  initiated  in 
every  branch  of  medical  knowledge.  The  new  system 
cannot  have  any  influence  on  the  sciences  auxiliary  to 
medicine,  nor  can  it  affect  the  teaching  of  mechanical 
surgery  or  of  the  obstetric  art.'' 

In  the  May  number  Dr.  Loosvelt  contributes  another 
characteristic  symptom  of  Lycopodium^  which  he  thinks 
worthy  to  rank  with  the  celebrated  *'  fan-like  motion  of  the 
aks  nasi/'  It  is  that  the  patient  sleeps  with  the  eyes  half 
open.  This  is  well  known  to  be  a  phenomenon  of  serioas 
import ;  and  if  Lyeqpodium  can  improve  the  vital  condition 
it  indicates,  another  leaf  will  be  added  to  the  laurel-crown  of 
that  great  medicine. 

ITALY. — Bivista  Omtopa/tca.-^This  journal  continues  to 
reaeh  us,  at  somewhat  irregular  intervals.  It  is  doubtless 
of  value  to  the  homoeopathic  practitioners  of  its  oountiy, 
but  it  presents  little  original  matter  which  can  be  utilised 
as  a  contribution  to  the  common  stock  of  our  literature. 

AMERICA. — ^The journals  of  the  United  States  were  last 
surveyed  by  us  in  our  April  number;  but,  as  there  mentioned, 
the  notice  was  written  for  that  of  January,  and  does  not 
therefore  come  down  beyond  November,  1878.  Since  that 
time,  several  changes  have  taken  place  in  the  periodical 
literature  of  the  country.  Of  the  journals  we  have  pre- 
viously had   to   notice,  the    Ohio   Medical  and   Surgical 


America.  408 

Reporter  and  the  California  Medical  Times  have  ceased  to 
appear.  The  American  Homceopathist  has  dropped  the  final 
''isf  from  its  title^  and  is  now  published  at  New  York ;  while 
its  place  has  been  taken  at  Chicago  by  a  new  yentnre,  the 
Medical  Counsellor,  which  we  have  not  yet  seen.  Two  other 
accessories  to  our  exchange  list  are  the  HomoBopathic  News 
and  the  American  Journal  of  Electrology  and  Neurology, 
Of  the  former  we  have  received  two  numbers^  for  July  and 
August  (1879)  respectively,  purporting  to  be  the  94th  and 
95th  of  an  old,  the  46th  and  47th  of  a  new  series.  It  is 
published  at  St.  Louis,  and  edited  by  Dr.  Groodman.  Its 
chief  occupation  seems  to  be  the  giving  a  risume  of  the 
other  homoeopathic  journals  of  the  English  tongue.  The 
second  is  a  new  undertaking,  and  is  conducted  by  Dr. 
Butler,  late  medical  officer  to  the  Middletown  Lunatic 
Asylum,  Though  Messrs.  Boericke  and  Tafel  are  the 
publishers,  and  the  contributors  to  the  first  number  are  all 
known  as  homoeopathists,  there  is  nothing  to  prevent  the 
journal  from  becoming  a  neutral  ground,  where  men  of  all 
schools  can  combine  to  relate  their-  observations  in  the  field 
which  it  cultivates. 

Of  the  older  journals,  we  hear  of  the  continued  existence 
of  the  Cincinnati  Medical  Advance,  though  we  never  see  it. 
The  rest  continue  to  reach  us,  and  we  will  begin — ^if  we 
cannot  finish — a  notice  of  their  salient  points. 

We  are  reluctantly  compelled-  by  want  of  space  to  leave 
our  review  of  the  American  periodicals  until  our  next 
number,  where  we  hope  we  may  be  able  to  give  them  due 
attention. 


404 


MISCELLANEOUS. 


Comgreu  ofBritM  Homaopmthic  Ppg^iiiomer^ 

Thb  Congress  was  held  this  jear  on  the  lllh  September,  at 
Great  Malvern,  and  was  attended  by  about  rorty  practitioners. 
Dr.  Bichard  Hughes  was  President,  and  commenced  the  proceed- 
ings bj  reading  an  address,  which  was  attentively  listened  to.  As 
our  readers  will  have  an  opportunity  of  reading  it  in  the  columns  of 
our  monthly  contemporary,  we  shall  not  attempt  to  give  an  abstract 
of  it,  further  than  to  say  that  it  was  concerned  with  the  present 
position  and  future  prospects  of  homoBopathy.  After  the  address  Dr. 
Herbert  Nankivell  read  a  paper  on  cases  of  consumption  treated 
hjAnenie,  HepiBTf  the  Mineral  Water  of  Eaux-JBonnes,  and  Zach- 
narUhes,  and  on  the  influence  of  a  winter  residonoe  at  Bavos  on 
pulmonary  disease.  A  discussion  followed,  the  speakers  being  Dr. 
Holland,  who  mentioned  several  cases  that  had  fallen  tinder  his 
own  observation,  which  had  derived  much  benefit  from  Dr.  Nanki- 
vell's  treatment  at  Bournemouth ;  Dr.  Hay  ward,  who  objected  to 
the  treatment  as  being  empirical,  and  the  cases  not  fair  specimens 
of  homoeopathic  treatment ;  Dr.  Pope,  who  differed  from  the  author 
with  respect  to  the  value  of  Davos  as  a  winter  residence  for  con- 
sumptives ;  Mr.  Stephens,  who  extolled  the  advantages  of  Cannes 
as  a  winter  resort  for  consumptives ;  Dr.  Pearce,  and  Df.  Drury, 
who  mentioned  that  Colorado  had  a  high  reputation  in  phthisical 
cases.  He  stated  that  consumptives  were  benefited  by  a  residence 
in  moderately  elevated  localities,  but  that,  if  they  went  above  a 
certain  height,  in  place  of  deriving  benefit  they  suffered  injury. 
Dr.  Nankivell  replied  to  the  objections  of  Dr.  Hayward,  and  con- 
tended that  his  treatment  was  thoroughly  homoeopathic. 

In  the  absence  of  Dr.  Burnett,  Dr.  Pope  read  his  paper  "  On  the 
Bevival  and  Further  Development  of  Organopathy  during  the  First 
Half  of  the  Present  Century,"  in  which  he  gave  an  account  of  tbe 
peculiar  system  of  Bademacher  and  his  disciples.  Some  remarks 
on  this  subject  followed  from  Dr.  Dudgeon,  who  mentioned  tiiat 


British  Stomceapathic  Congress,  40$ 

an  account  of  Bademacher's  system  was  given  in  an  early  Tolume 
of  this  Journal  under  the  title  of  •*  The  Modem  Paracelaists ;"  from 
Dr.  Hayward,  who  considered  that  Dr.  Burnett's  paper  was  just 
such  an  essay  as  was  suited  for  a  Homoeopathic  Congress^  and  Dr. 
Jagielski,  who  criticised  severely  the  method  of  Bademacher. 

The  afternoon's  sitting  was  occupied  hy  a  paper  "On  the 
Homoeopathic  Treatment  of  Internal  Aneurism,"  hy  Dr.  Flint, 
which  gave  rise  to  an  animated  discussion,  and  hy  a  lively  con- 
troversy respecting  the  recent  action  of  the  London  School  of 
Homoeopathy  in  regard  to  the  proposed  recognition  of  the  lectures 
of  the  University  of  London. 

Tlie  place  of  meeting  of  the  Congress  for  1880  was  fixed  for 
Leeds,  on  the  second  Thursday  of  September,  Dr.  Teldham  being 
elected  President. 

A  dinner  at  the  Imperial  Hotel  concluded  the  proceedings  of 
the  Congress,  at  which  numerous  speeches  were  made  and  great 
harmony  prevailed. 

A  printed  letter  was  distributed  to  the  members  of  the  Congress, 
addressed  to  them  by  Dr.  Hilbers,  of  Brighton.  In  this  letter 
Dr.  Hilbera  regrets  that,  ^'  owing  to  adverse  circumstances,*'  he  is 
unable  to  be  present,  because  he  observes  that  "  the  principal  sub* 
ject  of  discussion  is  the  present  and  future  prospects  of  homoeo- 
pathy," a  subject  on  which  he  conceives  himself  capable  of 'throw- 
ing some  light."  Now,  Dr.  Hilbers  is  entirely  mistaken  in  sup- 
posing that  ^  the  present  and  future  prospects  of  homoeopathy " 
were  to  be  a  principal  subject  of  discussion,  for  the  fact  is  the 
OD^  allusion  to  the  present  state  and  future  prospects  of  homoeo- 
pathy was  in  the  President's  Address,  which,  according  to  in- 
variable castom,  is  not  a  subject  of  discussion  at  all.  Hence,  the 
members  of  the  Congress  cannot  too  much  congratulate  themselves 
on  the  fiict  that  '^  adverse  circumstances "  prevented  Dr.  Hilbers 
from  coming  to  the  Congress,  for  had  he  been  present  he  would 
have  found  his  mouth  sealed  as  to  the  subject  of  the  President's 
Address,  and  it  b  to  his  absence,  regretted  by  himself,  but  rejoiced 
in  by  the  members  of  Congress,  that  we  are  indebted  for  the 
valuable  light  he  throws  on  the  present  and  future  of  homoeopathy. 
According  to  Dr.  Hilbers,  "  the  truth,  the  whole  truth,  and  nothing 
bat  the  truth  "  is  that,  in  this  country,  homoeopathy  is  at  present 
''rapidly  going  to  the  dogs,  and  its  future  prospects  are  that,  ere 
long,  it  will  have  gone  to  the  dogs,  unless  something  is  done  to 


406  Miicelianeous. 

check  its  downward  ooone."  The  cause  of  this  downward  coarse 
of  homcDopathjy  Dr.  Hilbers  asserts,  is  n^lect  of  the  teaching  of 
Hahnemann.  Oar  hold  on  public  confidence  is  thereby  '*  shaken 
and  this,  alas !"  he  walls,  "  is  not  only  trae  as  regards  our  skill,  but 
as  regards  oar  intregrity  (sic)  also."  Now,  Dr.  Hilbers  may  be, 
and  no  doabt  is,  very  attentive  to  his  p's  and  q's,  but  it  is  eyident^ 
from  the  pecoliar  orthography  of  the  word  we  have  italicised,  that 
he  is  not  sufficiently  careful  about  his  r's,  which  he  intrades  into 
unauthorised  places.  Dr.  Hilbers  thinks  that  the  downward  course 
of  homceopathy  may  be  checked  by  more  careful  study  of  the 
Materia  Medica,  but  at  the  same  time  he  inveighs  against  the  only 
complete  Materia  Medica  we  possess,  viz.  Allen's  JEncyelopadia ; 
and  he  refers,  in  terms  of  adulation,  to  (besides  Hahnemann's 
works)  ''Curie's  ^itome  of  Jahr^  a  most  excellent  work,  now 
almost  forgotten,  Noack  and  Trink's  Mandbuchy  Buckert's  DanteU 
lung,  and Boenninghausen's  Manual  of  Therapeuiici" 

As  Jahr*i  Manual  has  always  seemed  to  us  a  most  confused 
and  confusing  jumble  of  all  sorts  of  symptoms,  pathogenetic  and 
clinical,  without  any  indication  as  to  their  sources,  we  would  be 
sorry  to  aUow  [that  Curie's  epitome  of  this  wretched  patchwork 
was  ''  a  most  excellent  work,"  and  are  glad  to  know  that  it  is  ''  now 
almost  forgotten."  We  should  have  thought  that  an  author  who 
is  so  zealous  in  recommending  the  two  Q«rman  works  mentioned 
might  have  known  that  the  name  of  the  chief  author  of  the 
Hanibuch  is  *<  Trinks  "  and  not  ''  Trink,"  and  that  the  author 
of  the  Darttellung  is  ''  Biickert "  not  "  Buckert."  But,  though 
homoeopathy  is  "  going  to  the  dogs,"  Dr.  Hilbers  is  able  to  discern 
''  one  bright  spot  on  the  homoeopathic  horizon,"  and  that  is  ''  the 
course  of  lectures  which  Dr.  Dyce  Brown  is  delivering  in  London." 
To  be  sure  Dr.  Hilbers  has  not  heard  any  of  them,  but  he  has 
heard  ''  from  those  who  are  fully  competent  to  form  an  opinion  that 
they  are  as  excellent  in  execution  as  they  are  admirable  in  concep- 
tion." Surely  Dr.  Hilbers's  admission  that  there  are  some  persons 
^  fully  competent  to  form  an  opinion  "  on  the  excellence  of  Dr. 
Dyce  Brown's  lectures  is  another  "  bright  spot  on  the  homoeopathic 
horizon,"  for,  judging  from  previous  utterances  of  Dr.  Hilbers,  we 
had  come  to  the  desolating  conclusion  that  there  was  but  one  person 
in  this  country  fully  competent  to  form  an  opinion  on  any  point 
connected  with  homoeopathy,  and  that  was  Dr.  Hilbers  hinutel£ 
How  many  such  fully  competent  men  there  may  be  we  know  Dot^ 


British  Homceopathic  Congress.  407 

bat  surely  the  existence  of  even  two  or  three  such  competent  men, 
may  serve,  if  not  to  prevent,  at  least  to  retard,  the  downward  course 
of  homoeopathy  '*  to  the  dogs."  If  homoeopathy  must  eventually 
go  to  the  dogs,  perhaps,  on  the  whole,  it  is  more  satisfactory  that  it 
should  go  to  these  intelligent  animals  than  be  monopolised  by  other 
less  intelligent  creatures,  who  are  fully  competent  to  write  down 
their  name  without  the  aid  of  a  literary  Sexton. 

Now,  as  is  well  known,  Dr.  Brown  argues  for  the  homoeopathic 
action  of  blisters,  and  prescribes  mustard  and  iodine  as  external 
homoeopathic  applications,  besides  advocating  the  application  of 
nitiate  of  Silver  to  an  ulcerated  os  uteri,  and  swabbing  the  diseased 
part  in  follicular  pharyngitis  with  a  solution  of  nitrate  of  silver, 
gr.  XX,  ad  ^ ;  and  he  says,  *^  We  charge  our  opponents  with  preju- 
dice, but  we  forget  that  we  ourselves  may  be  equally  prejudiced,  and 
for  fear  of  using  what  seems  to  savour  of  allopathy,  we  may  neglect 
to  use  what  may  sometimes  be  of  benefit  to  our  patients/'  As, 
according  to  Dr.  Hilbers,  Dr.  Brown's  teachings  are  the  ''one  bright 
spot  on  the  homoeopathic  horizon,"  perhaps  he  will  find  in  these 
specimens  no  departure  from  the  teachings  of  Hahnemann,  and 
nothing  resembling  that  '' homceopathised  allopathy,"  or  ''alio- 
pathised  homoeopathy,"  so  detested  by  himself. 

Dr.  Hilbers  ''  fears  that  the  remnant  that  is  left  of  what  was  once 
the  British  Journal  of  Somwopathy  may  be  sorely  vexed  with 
him "  for  having  given  us  a  bit  of  his  mind  (''  leoa/oi  ammam 
«Mam,"  he  classically  puts  it) .  We,  the  remnant  alluded  to,  hasten 
to  calm  Dr.  Hilbers's  apprehensions.  So  far  firom  being  vexed  at 
what  Dr.  Hilbers  has  said,  we  are  quite  delighted  with  it,  for 
had  he  refrained  from  writing  this  most  instructive  letter  we  might 
have  been  left  completely  in  the  dark  as  to  the  condition  of  homoeo- 
pathy in  the  present  and  its  prospects  in  the  future ;  and  how  could 
we  ever  have  known,  except  from  Dr.  Hilbers  himself^  that  he  is 
almost,  if  not  quite,  the  sole  representative  of  homoeopathy  in  this 
coantry  who  abides  by  the  teaching  of  Hahnemann  and  who  con-^ 
riders  Curie's  Epitome  ofJahr  **  a  most  excellent  work  ?'* 


408 


BOOKS   RECEIVED. 


Handbook  of  Practical  JIBdmfery.  By  J.  H.  Mabsden,  A.M.f 
M.D.    New  York. 

The  Homoeopathic  Therapeutics  of  Uterine  and  Vaginal  Dis^ 
charges.    By  W.  Eggeet,  M.D.    New  York :  Boericke.    1878. 

Transaetione  of  the  Homoeopathic  Pharmaceutic  Association  of 
Great  Britain.    May,  1879. 

Homoeopathic  Therapeutics.  By  S.  LilisitthaLjM.D.  Second 
Edition.    New  York :  Boericke  &  Tafel.    1879. 

A  System  of  Surgery.  By  W.  T.  Helmuth.  Fourth  Edition. 
New  York :  Boericke  <&  Tafel.    1879. 

Notes  on  the  Position  and  Progress  of  Homoeopathy  in  the 
United  States.    By  A.  C.  Pope^  M.D.    London :  Gould,  1879. 

Allen's  Encychpmdiay  vol.  z.  New  York :  Boericke  &  Tafel. 
1879. 

Archives  de  la  Medicina  Homeopatica.    Barcelona. 

St.  Louis  Clinical  Becord. 

The  American  Homoeopath. 

Bevue  Homoeopathique  Beige. 

The  Monthly  Homoeopathic  Beview. 

The  Hahnemannian  Monthly* 

The  American  Homoeopathic  Observer. 

The  United  States  Medical  Investigator. 

The  North  American  Journal  of  Homoeopathy. 

The  New  England  Medical  Oazette. 

El  Griterio  Medico. 

L'Art  Mddical. 

Bulletin  de  la  Sociiti  MSd.  Hom.  de  France* 

Allgemeine  homoopathische  Zeitung. 

The  Homoeopathic  World. 

The  Homoeopathic  Times. 

V  Homoeopathic  Militante. 

The  Organon. 

The  Medical  Herald. 

The  Medical  Becord, 


INDEX  TO  VOL.  XXXVH. 


Aeeommodatioii,  Walksk's  views  con- 
ceming,  375 

Aeon,  in  ebolen,  396 

AlbummnrU,  cwMiyiMn  in,  203 

Alcohol  in  health.  Dr.  Dudgbon  on,  133 

Allbn  onra/oNta  in  fissure  of  anus,  192 

Allen's  EneyelojMedia,  toI.  Tiii,  177; 
— ,  vol.  ix,  372 

Jmjfl  nUrite  in  apoplexy,  211 

Akgxll,  Dr.,  How  to  Take  Care  of  war 
'fifct,  by,  185 

Anus,  fissure  of,  raJUmia  in,  192 
.  dfu  in  diphtheria,  202 ;  — ,  in  enlarge- 
ment of  ovary,  204 ;  — ,  involnntary 
proving  of,  300 

Apoplexy,  amy/  mtrUe  in,  211 

Aresebon,  Dr.  Roth  on,  17 

Arf.  nit,  in  cardialgia,  390 

AnUa  in  boils,  316 ;  ^,  Dr.  PAsav- 

H  ARSON  on,  317 
,<dneme  and  its  oomponnds,  Dr.  Bui- 
niOGK  on,  ^ffp.  353,  369 

Anenie,  indications  for,  in  agne,  202; 
— ,  in  exophthalmie  goitre,  208 ;  — , 
in  hvpopion,  303 ;  — ,  in  prosopslgia, 
309;  — ,  in  lupns,  377 ;  — ,  in  jaun- 
dice, 388 ;  — ,  in  melancholia,  391 

An.  iod.  in  granular  conjonctiva,  383 

Asthma,  fupkihakn  in,  377 

Amrum  in  mania,  379 ;  — ',  in  fonl 
breath,  392 

Anteultation  and  Pereweion,  Handbook 
of,  bj  Dr.  CI.APP,  179 

Anstria,  History  of  Homoeopathy  in,  by 
Dr.  HuBBR,  330 

Auitrian  Joumaiqf  Homosopathy,  estab- 
lishment of,  343 

BsgD^res  de  Bigorre,  Dr.  Roth  on,  235 
Btgneres  de  Luchon,  Dr.  Roth  on,  247 
Bsr^ges,  Dr.  Roth  on,  227 ;   — ,  in 

paralysis,  231 
Batxs,  Dr.,  on  the  London  School  of 

Homceopathy,  93 


BeUadomui  in    laryngismus    stridnlns, 
211 ;  — ,  in  naevns,  387 ;  -~,  in  enn- 
resis  noctnma,  395 
Bee-stings  in  rheumatism,  312 
Bbrmdob,  Dr.,  on  the  head  chapter  of 
Cypher  Repertory ,  74  ;  — ,  homoeo- 
pathy vincticated  by,  183 ;  — ,  on  the 
Cypher  Repertory,  214 
Biarritz,  Dr.  Roth  on,  21 
BiognpkUial  Retro^^eet  qf   Allopathy 
and  HonuBOpathy,  by  Dr.  Hastings, 
294 
Black,  Dr.,  on  diabetes,  43, 113 
Blakb,  Dr.  E.,  Remediee  for  Periodie 
Paint,  by,   182;    — ,  1$  Diphtheria 
Preventable  T,  182 
Blatta  orient,  in  dropsy,  383 
Blepharospasm,  ecrophularia  in,  275 
Breath,  fetid,  anr.  in,  392 
Bronchial  catarrh,  ol.  erot.  in,  378 
BuROHBBt  Dr.,   7!le   Ymt's  Progrete, 

180 
Burnett,  Dr.,  on  natmm  muriatieum, 

81 ;  — ,  on  yold,  292 
Bursitis,  etieta  in,  204 
Butlbr,  S.,  BooMion,  Old  and  New, 
by,  278 

Cole.  nntr,f  in  a  curious  affection,  384 
Cannabis  indiea  not  useful  in  gonor- 

rhcBa,  191 
Carbo  vey.  in  chanero,  307  ;    ^-,  in 

hoarseness,  383 
Carbolic  acid  in  dysentery,  387 
Cardttoma  ventrienli,  pAot.  in,  387 
Cardialgia,  lacheeis  in,  299,  300;  — , 

org.  nit.  in,  390 
Carduue  MaritB  in  liver  affection,  308 ; 

— ,  proving  of,  379 
Catarrh,  chronic  nasal,  mere.  iod.  in,  204 
Caoterets,  Dr.  Roth  on,  152 
Cavallaro,  Dr.,  Medidna  Omeopatiea, 

by,  185 
Cephalalgia,  meUbtw  in,  208 


VOL.  XX.VTII|   NO.  CL. OCTOBER,  1879. 


DD 


410 


Index, 


Chain  of  houMMiMith  j,  came  of  iniitlUty 

or,8S5 
Chanoe,  mtI.  m^.  in,  307 
Cbemistrj,  medioU,  by  Dr.  Whsblbk, 

187 
CAtiM  in  eontamptioB,  203 
Ckm,  orwit.  in  cholera  infantiim,  208 
Cholera,  treatment  of,  in  Gampendorf 

Hospital,  338  ;  — ,  aeon,  in,  396 
Cholera  infantum,  ekm.,  mrt.,  and  Areor. 

in,  208 
Clapp,  Dr.,  aoscultation  and  percussion, 

179 
CUmeal  Tker^tetUiett  by  Dr.  Hotnk, 

178 
Cqfee  as  a  hererage,  ill-effbeta  of,  207 
Coieh^  cases  cored  by,  389 
Colic,  i;ptiiM  in,  301 ;  — ,  renal,  coloc.  in, 

378 
Cohe.  in  renal  colic,  378 
CoojunciiTitis,  gfuarmi  in,  395 
Congress  of  British  Homoeopathic  Prac- 
titioners, 318.  404 
Consumption,  c^im  in,  203 
CooPBB,  Dr.,  lectures  on  diseases  of  the 

ear,  by,  86;  — i  cases,  with  remarks, 

271 
Comes,  ulceration  of,  hep.  in,  391 
CrotoH  oil  in  bronchial  catarrh,  378 
Cypher  Repertory,  Dr.  Drtsdalb,  on 

recent  chapters  in  the,  61 ;  — ,  Dr. 

DuDOBON  on,  67  ;  — ,  Dr.  Bbbridob 

oo»  74,  214 


DATxaaB,  Dr.,  death  of,  393 

Diabetes,  Dr.  Black  on,  43;  — ,  eases  of, 
46, 49, 55, 346, 372 ;  — ,  diet  in,  346 ; 
— t  liquids  in,  348 ;  -*,  alcoholic  sti- 
mulants in,  349 ;  — ,  exercise  in,  349 ; 
—  baths  in,  351 ;  — ^  drugs  in,  351 ; 
hoe*  ae,  in,  353 ;  — ,  phoe.  in,  353  ; 
uran.  in,  354 ;  are,  in,  357  ;  — ,  eur- 
are  in,  359 ;  — ,  nux  vom.  in,  359 ; 
^,  belL  in,  360,  ireoe,  in,  361 ;  — , 
fOie.  in,  362 ;  — ,  lae.  ae.  in,  363  ;— 
not.  t.  in,  364 ;  — ,  ary.  in,  364  ;  — 
heUm,  in,  364 ;  mineral  water  in,  365 

Diarrhoea,  ip«e.  in,  198 

D^htheria,  ie  it  prevemtaile  t  by  Dr.  B. 
Blakb,  182  ;  — ,  apie  in,  202 ;  — , 
mere,  cyan,  in,  202;  — ,  indications 
for  iaeheeie  in,  203 

Dropsy,  hiatta  in,  383 ;  — ,  eguiila  in, 
387 ;  — ,  tereb.  in,  387 

Drurt,  Dr.,  on  eruptiTC  ferers,  79 

Drysdalb,  Dr.,  on  recent  chapters  of 
the  Cypher  Repertory,  61 ;  — ,  On 
Germ  Theoriee  <f  It^fictioue  Dieeaeee, 


82;  — ,  on  the  London   School  of 

Homoeopathy,  319 
Dudobon,  Dr.,  on  the  head  eh^iter  of 

Cypher  Repertory ,  67;  — ^  on  alcohol 

in  health,  133 
DuvcAN,  Dr.,  Dieeatee  of  Ii^omU  aad 

Children,  by,  178 
Durham's  Leeturee on  Materia  Medtea, 

286 
DcNNiNO  on  ftm.  ttat.,  285 
Dysentery,  earb,  ae.  in,  387 

Ear,  Leeturee  on  Dieeaeee  of  the,  by  Dr. 

COOPBR,  86 

Bar  case,  an  obscure,  by  Dr.  Coopbr, 

271 
Bar  notes,  by  Dr.  Vilab,  290 
Eaux  Bonnes,  Dr.  Roth  on,  29 
Baux  Chaudes,  Dr.  Roth  on,  32 
Eczema,  iaehnie  in,  299 
Electric  light  for  exploring  the  bkdder, 

385 
EneyeJopetdia  of  Pure  Materia  Mediea, 

Allbn'b,  ¥oL  viii,  177;  — -i  voL  ix, 

372 
Enuresis  noctuma,  belL  in,  395;  — » 

equieetum  in,  395 
Equieetum  in  urinary  disorders,  206; 

— ,  in  enuresis,  395 
Eruptive  fevers.  Dr.  Drurt  on,  79 
Euonymin  in  albuminuria,  203 
EooMion,  Old  and  New,  by  S.  Botlxb, 

278 
Exdusiveness  and  homoeopathy,  107 
Exophthalmic  goitre,  areenic  in,  208 
Exophthalmos,  differential  diagnosis  e4 

375 
Eye  Notee,  by  Dr.  Vilab,  290 
J^ee^  How  to  take  Care  qf  our,  by  Dr. 

Anobll,  185 

Feet,  fetid  sweat  of,  eu^fh.  in,  209 

Oeleemintim  in   puerperal  coutuIsIobs, 

200 
Qerm  theories  of  infections  diseases,  Dr. 

Drtbdalb  on. 
Glaucoma,  Walkbr  on,  373 ;  — ,  caused 

by  atrop.,  374 ;  — ,  cured  by  sseria^ 

374 
Glycosuria,  artificial,  113 
Cfold,  by  Dr.  Bvrnbtt,  292 
Gouty  pains,  ea&e.  ae.  in,  388 
Grbog'b  lUmetrated  Repertory,  291 
Guarma  in  conjunctivitis,  395 
Guiding   Symptome    qf   the   Materia 

Mediea,  Hsrimg'b,  288 
Gumpendorf  Hospital,  estaUishaent  of, 

336 


Index. 


411 


HflMnorrbage,  kamam,  in,  213 
Hahnemann,  Mme.,  M.  Sanohbs  on, 

98 
HamameHa  in  hemorrhage,  213 
Haktuno's  cnre  of  Radktzkt,  338 
Hastings,  Dr.,  BiograpMeal  Reiroapeet 

rf  AUapatky  and  Homceopathy,  by, 

294 
Heirt,  hypertrophy  of,  toil,  in,  387 
HiuiuTH,  Dr.,  ovariotomy,  by,  321 
HsmiNG  on  ScHussLBR'a  remedies,  191 
HiRiNo's    Guiding  Symptonu  of  the 

Materia  Mediea,  288 
HiLBBES,  Dr.,  on  the  present  state  and 

fatnre  prospects  of  homceopaihy,  405 
Hosneness,  ear^. «.  in,  383 
Hotnk's  Tkeregmttieg,  178 
HmBE,  Dr.,  History  of  Homceopaithy  in 

Aastria,b^,330 
Hdohbs,  Dr.,  on  honuBOpathic  posology, 

1;  — ,  on  pierie  acid,  169;  — ,  on 

law  or  rule,  219 ;  — ^,  on  the  reconsti- 

tntion  of  the  materia  medica,  257 
Hydrocephalus  cnred  by  ctde,  and  rajpA., 

399 
Hypopion,j9Jii]ii^iM  in,  303 ;  — ,  ar$enic 

in,  303 
Hyposderal  cydotomy,  373 

Iteg  in  staphyloma,  302 
Ilkitirated  JUpertory,  Grboo's,  291 
lod,  in  hypertrophy  of  heart,  387 
Ipeeaeuanha  in  diarrhoea,  198;  «-,  in 
the  opinm  habit,  203 

Jinndice,  ors.  in,  388 

Xahnia  in  rheumatism  and  fkcial  nearal- 

gia,203 
KiBBsiiABccBB,  Dt.  de,  on  sclerotomy, 

187 
Keratitis,  mere.  iod.  in,  205 
Kidneys,  haemorrhage   from,  phoe,  in, 

205 
KiaacB,  Dr.,  practice  of,  304 
Kreowte,  in  cholera  iofantom,  208 
laekeeii  in  diphtheria,  indications  for, 

203 
X«efteiiff  in  dyspnoea,  298;  — ^,  in  paresis, 

298 ;  — ,  in  cardia^a,  299,  300,  in 

ecuma,  299 
Laryngismus  striduhis,  beUad.  in,  211 
Law  or  role.  Dr.  Huohbs  on,  219 
Leopoldstadt  Hospital,  esublishment  of, 

342 

LiuBNTHiAL'a     HomcBcpathie    Thera- 

peutiee,  283 
liver  disease,  eardmu  marke  in,  308 
Loeomotor  ataxy,  aeidpierotOM,  in,  378 


Ludlow's  Leoturee^   CUnieal  w»d  IK- 

dactie,  284 
Lnpos,  art.  in,  377 
Lycop,,  characteristic  symptom  of,  402 

Mania  with  dread  of  fire,  aurum  in,  379 
Materia  Medica,  reconstruction  of  the. 
Dr.  Huohbs  on,  257;  — f  Joussbt 
on,  259;  — ,  Espanbt  on,  263;  — , 
Durham's  lectures  on,  286 
Medical  liberality  tested,  105 
Melancholia,  are.  in,  391 
Melilotvs  in  cephalalgia,  208 
Mentagra,  ni^A.  and  graph,  in,  400 
Mere,  cyan,  in  diphtheria,  202 
IftfTC.  tod.  in  chronic  nasal  catarrh,  204  ; 

— ,  in  keratitis,  205 
Modem  Phytieian,  the,  292 

Nievas,  bell,  in,  387 

N(^hthaUn  in  asthma,  377 

Nairum  muriaticum.  Dr.  Burnbtt  on, 

81 
Neglect  of  physical  education,  by  Dr. 

Roth,  188 
Nephritis  hemorrhagica,  385 
Neuralgia  of  arms,  tU.  and  eaic.  in,  306 ; 

— ,  eep.  in,  392 
Neuro-retinal  atrophy,  curable  by  «/rycA» 

nine,  376 
Nux  vom.  in  proctalgia,  377 

Ophthalmia  gonorrhoica,  treatment  of, 

375 
Ophthalmia,  sympathetic,  376 
Ophthalmic  rem^ies,  local  application 

of,  376 
Ophthalmology,  Walkbr's  essays  on, 

373 
Opium  in  colic,  301 
08teomalacea,pAof^and  eale,  in,  397 
Ovariotomy,  by  Dr.  Hblmuth,  321 
Ovary,  swelling  of,  «[ptt  in,  204 

Paresis,  laeheeie  in,  298 

Parrot  and  Robin  on  the  urine  of 
the  new-born,  181 

Pan,  Dr.  Roth  on,  24 

Periodic  pain,  remedies  for,  by  Dr.  £• 
Blakb,  182 

Phosphoric  acid  in  diabetes,  118,  353 

Photphorue  indicated  in  fatty  degenera- 
tions, 199 ;  — ,  in  haemorrhage  from 
kidneys,  205 ;  — ,  in  abdominal  pains, 
301,  302;  -—fin  carcinoma Tentriculi, 
387 

Pierie  acid.  Dr.  Huohbs  on,  169 

Pierotoxie  aeid  in  locomotor  ataxy,  378 


412 


Index. 


■Fkimhm  in  TMO-molor  ■enrotit,  205 ; 

— ,  in  hypopion,  303 
PondTs  iphfgmogimph,  218 

PotolOgy,    iKHDOM^Mthic,    Dr.    HUGHU 

on,  1 
PraeHiumer,  the,  on^proTiDg  drags,  310 
Prague,  report  on  homflBoptthy  by  pro- 

fenoTB  in,  337 
ProcUlgia,  mur  oom.  in,  377 
Protoptlgia,  an,  in,  309 
Protoplmtmic  theory,  Frednolt  on,  395 
Promgt  of  medicines  by  Vienna  Ho- 

moBopetbie  Society,  340 
Poerpenl  oonTnlfions»  ^eUemmwm  in, 

200 
Pul$atiiU  in  inflamed  tettide,  197 
Pyrenees,  watering  places  of  the.  Dr. 

Roth  on,  15, 152,  227 


QuiN,  Dr.,  death  o(  109 


of 


Raobtzkt,  care  of  malignant 

.  eye,  338 
Xatama  in  fissnre  of  anas,  192 
Rheamatism,  bee-stings  in,  312 
Ekui  in  eraption  on  lip,  303; 

typhoid,  399 
Roth,  Dr.,  on  the  watering-places 
the  Pyrenees,  15,  152,  227;  — ,  on  the 
neglect  of  physioU  education,  188 


— .  In 


of 


St.  Sauveur,  Dr.  Roth  on,  162 
SaUeyUe  acid,  pathogenetic  effects  of, 

303;  — ,  in  goaty  pains,  388 
Salut   waters,    physical    properties   of 

237;  — ,  physiologies!  properties  of, 

239;  — ,  therapeutic  uses  of,  241 
Saru^riUa  in  pain  after  vomiting,  204 
Schmid's    pamphlet   on  homoeopathy, 

344 
School  of  Homoeopathy,  Dr.  Batkb  on 

the,  93 ;  — ,DrB.  Drtbdale,  Black, 

and  DuDOiOK  on  the,  95 ;  — ,  Dr. 

Drtbdalx  on,  319 


Sdeititomy,  Dr,  db  Knmsif  abckch  ob, 

181;  — ,hyposderal,373 
Serapkularia  in  blepharospasm,  275 
Secaie  in  metrorrhagia,  401 
Sechshaos    Hospit^  establishment  ef, 

343 
Sep.  in  nenndgia,  392 ;  — ,  pathogenetie 

effects  o^  397 
SUiea,  tritoratioa  of.  Dr.  C.  Wbbsbb- 

HOBfT  on,  193  ;  — ,  in  oleeratioB  of 

tongue,  388 
SuicAR,  Dr.,  and  the  Senate  of  the 

CilcntU  University,  105 
SphvgmogTBph,  Pond's,  218 
Squillm  in  dropsy,  387 
Suphyloma,  ileg  in,  302 
5/tcfa  in  bursitis,  204 
Stomach,  ulceration  of,  380 
Suiphtar  in  fetid  sweat  of  feet,  209 


Terebinth,  in  dropsy,  388 
Testicle,  inflammation  of, 

197 
Ton  gue,  ulceration  of,  tiL  in,  388 


Uf 


UraniMm  in  diabetes,  122 

Urinary  disorders,  equieetum  in,  208 

Urinating,  pain  after,  eam^ariUa  ia, 

204 
Urine  of  the  new-born,  Paabot  and 

Robin  on,  187 

Vaso-motor  neurosis,  plwmbwm  in,  205 
Vienna,  public  trial  of  homoeopathy  in, 

333 ;  — ,  foundation  of  Homoeopathie 

Society  in,  340 
Vilas,  Ey€  notu  and  Bar  notee,  290 

Walksh'b  fiuoiff  on    Ophiheiteetoft, 

378 
Whbblbr'b  Medical  Chemiairy,  187 
Wbbsblhobft,  Dr.  C,  on  tritoration  of 

«t^tea,103 

Yellow  fever,  special  report  on,  189 


FBISTBD  BT  J.  ■.  ADLASD^  BASTHOLOMBW  GXOSB. 


i 


BKITISH    JOURNAL 

or 

HOMOEOPATHY. 

EDITED  BY 

K.  E.  DUDGEON,  M.D., 

AMP 

BICHABD  HUGHES,  L.B.O.P. 


VOL.  XXXTIII. 


ta,  n  DTBin  ubkrtab,  ix  ownBCB  chixitai. 


PUBLISHED  F0&  THE  PBOFKIBTORS  XY 

iENBT     TUBNEB,    170,     FLEET     STREET, 
LONDON. 

lUT   BB   Silt    U£0  rBOK 

XDINBUKOBi    I.    C.  POTTAOG,  IIT,  PRINCESS   STREET. 

DUBLIN:  I.  A.  BAY,  \i,  NASSAU  STREET. 

MW   YORK,  U.S.;   BOERICKE  k  TAyEL,  1«,  GRAND  STREET. 


PBIMTliD  BT  J.  B.  ADLAUD,  BAKTHOLOMISW  CL06iw 


coNTEairps  OF  No.  eiii. 

PASS 

ALLEN'S  KTCYCLOP^DIA       .......       1 

THE  REGEMEBAllON  OF  MATEEU  MEDICA.    BY  J.  P,  DAKE,  M.A.,  H.D.         .     13 
EFfECTB  OF  POISONS  .  .  .  .23 

REVIEWS. 

DIB  HOMOEOPATHIE  AM  KBANKENBETTE  EKFBOBT.    YON  DR.  PAUL  SICK  .     88 
THE  PATHOLOGY  A2(D  TREATMENT  OF  HEREDITARY  SYPHILIS.     BY  H.  C. 
JESSEN;  M.D.,  kc.  .......     4S 

A  SYSTEM  OF  SURGERY. '  BY  WILLIAM  TOD  HELMUTH,  MJ).  .  .     46 

LECTURES  ON  CLINICAL  MEDICINE.    BY  DR.  J0US8ET  .  .46 

THE    HOMGBOPATHIC    THERAPEUTICS    OF    UTERINE   AND  VAGINAL    DIS- 
CHARGES.   BY  W.  EGGERT.  M.D.  .48 
THE  MEDICAL,  SURGICAL,  AND  HYGIENIC  TREATMENT  OF  DISEASES  OF 

WOMEN.    BY  EDWIN  M.  HALE,  M.D.  .49 

A  TEXT-BOOK  OF  ELECTRO-THERAPEUTICS  AND  ELECTRO-SURGERY.     BY 

JOHN  BUTLER,  M.D..  L.R.C.PJB.,  L.RC.8I.  .  .  .60 

CONDENSED  MATERIA  MEDICA.    BY  C.  HERING  .  .61 

HOMCEOPATHIG  THERAPEUTICS.    BY  8.  LILIENTHAL,  M.D.    .  .61 

THE  GROUNDS  OF  A  HOMQBOPATH'S  FAITH.    BY  SAMUEL  A.  JONES.  M.D.      .      68 
A  GUIDE  TO  HOMCBOPATHIC  PRACTICE.    BY  J.  D.  JOHNSON.  M.D.     .  .      63 

THE  HOM(EOPATHIC  PHYSICIAN'S  VISITING  LIST  AND  POCKET  REPERTORY. 

BY  ROBERT  FAULKNER,  M.D.       .  .64 

SILVERLOCK'S  MEDICAL  PRACTITIONER'S  VISITING  LIST  AND  DIARY.  1880  .      64 
NEW  PART  OF  THE  'CYPHER  REPERTORY*  .  .  .  .      64 

OUR  FOREIGN  CONTEMPORARIES  ,  ,  .66 

CLINICAL  RECOKD. 

SULPHUR  IN  CHRONIC  ULCER  OF  THE  LEGS.   BY  A.  G.  SANDBER6,  L.R.C.P  JId.     69 
MYOPIA  FROM  A  BLOW.    THE  MECHANISM  OF  ACCOMMODATION.    BY  R.  E. 

DUDGEON,  M.D.    ........     «0 

VACCINATION  AND  SMALLPOX.    BY  DR.  DUDGEON    .  .  .63 

MISCELLANEOUS. 

A  Letter  of  Halmemann,  64.— The  Secret  Revealed,  66.— Speedy  dure  of  Nasal  PolTpi,78.— 
Lilhim  tisimnm,  its  Action  on  the  Eje,  79. — Discontinuance  of  'HinchePs  Zeitschiift,' 
88.— Berberis  Aqoifohnm,  84.— Society  for  Improrement  of  the  Physique  of  the  Blind,  89. 

CaajastommttcE :— Dr.  Blaek  and  the  alleged  Glyoogenic  Property  of  Uranium,  90. 

Obituaxt  :— Dr.  Joa£  Nnnes  y  Pemia,  91.— Charles  J.  Hempe^  M.D.,  98. 

B»ox8  Rbcxitxd,  96. 

Apivroix  :«Fa[thogenetie  Reeord,  ky  Dr.  BixuDei. 


CONTENTS  OP  No.  OLH. 

on  THE  ACTION  OF  DRUGS  ACCORDING  TO  THE  LAW  OF  SIMILARS.    BY 

DR.  FREDAULT    ........     97 

"ZTMOnCS."    BY  EDWARD  T.  BLAKE,  M.D.  .  ».    180 

ON  PYREXIN  OR  PYROGEN  AS  A  THERAPEUTIC  AGENT.  BY  DR.  DRYBDALE  140 
TRANSACTIONS  OF  THE  PARIS  CONGRESS  OF  1878     .  .  .166 

REVIEWS. 

CURABILrrY    OF    CATARACT    WITH    MEDICINES.     BY    JAMES    COMPTON- 

BURNETT,  M.D.,  &e.  .  .166 

STAMMERING  AND  ITS  RATIONAL  TREATMENT.  BY  E.  B.  8HULDHAM,  MJ).,  9sc  166 
PHOTOGRAPHIC  ILLUSTRATIONS  OF  SKIN  DISEASE.  BY  G.  H.  FOX,  A.M.,  M.D.  171 
MATERU  MEDICA  AND  SPECIAL  THERAPEUTICS  OF  THE  NEW  REMEDIES. 

BY  EDWIN  M.  HALE,  M.D.    VOL.  H  .  .178 

THERAPEUTICAL  MATERIA  MEDICA.    BY  H.  C.  JESSEN,  M.D.  .    178 

MEDICAL  CHEMISTRY,  INCLUDING  THE  OUTLINES  OF  ORGANIC  AND  PHY- 
SIOLOGICAL CHEMISTRY.    BY  C.  GILBERT  WHEELER  .  .174 
CUB  FOREIGN  CONTEMPORARIES                                                                           .174 

MISCELLANEOUS. 

FhysidaBS  and  Snrgeons  Praetising  Homoeopathy,  1879, 176.— Solvents  of  GaU-stones,  176. 

CoRXBsroRDBif  ex :— The  British  Homoeopathic  Pharmacopoeia,  17dt— Educational  Require- 
ments for  Homoeopathic  Teaching,  177.— The  New  Derelopment,  181. 

Books  BxoBrrzD,  1^. 

ArrsKDii :— Pathogenetic  Record,  hy  Dr.  Bbbudob. 


CONTENTS  OP  No.  CLin. 

PAOB 

INTESTINAL  OBSTRUCTION.    BY  JOHN  W.  HATWARD,  M.D.  .    1» 

BEUNTON  ON  PHABMAC0L06Y  AND  THERAPEUTICS.    BY  JOHN  H.  CLARKE. 

GALL-STONES.    BY  c'  B.  KEK,  M.D.    .'  I  '.  '.  '.    SS3 

REVIEWS. 

UNA  DELIBERAZIONE  DEL  CONSIGLIO  SUPERIORS  DELLA  PUBLICA  ISTRU- 

ZIONE   DEL   REGNO   D'lTALIA   DELLA   MEDICINA  OMEOPATICA   NELLE 

UNIVERSITA  DELLO  STATO  AL  TRIBUNALE  DELLA  PUBLICA  OPINIONS. 

MEMORIA  DEL  DOTT.  COMM.  G.  E.  MENGOZZI  .    S«7 

PATHOGENETIC  OUTLINES  OF  HOM(EOPATHIC  DRUGS.    BY  DR.  CARL  HEI- 

NIGKE.  OP  LEIPZIG.  TRANSLATED  BY  DR.  EMIL  TI ETZE,  OF  PHILADELPHIA    SM 
HAY  FEVER:   ITS  CAUSES.  TREATMENT,  AND  EFFECTIVE  PREVENTION.    BY 

CHARLES  HARRISON  BLACKLEY.  M.D.      .  .    8S5 

LICENSED  tXETICIDB.    BY  N.  P.  COOKE,  M.D.,  LL.D.,  OF  CHICAGO     .  .    SiS 

BOSTON  UNIVERSITY  TEAR  BOOK,  1879  .    SM 

OUR  FOREIGN  CONTEMPORARIES  .9(7 

CLINICAL  RECORD. 

ALBUMINURIA.    BY  T.  ENGALL,  M.R.C.S.  .386 

MISCELLANEOUS. 

Alcoek'i  Poroiu  Plaiten,  br  C.  B.  Ker,  MJ).,  899.— Temperatare  of  the  Breath,  hypr. 
Dudgeon,  994.— Prize  lor  an  EaaaT  on  Hjgiene,  997.— The  Arnica  Eraptkm,  »n.— 
Genorera  Water,  999.— A  Nev  Sphygmograph,  bj  Dr.  Dudgeon,  999.— International 
HonuBopathic  Convention,  1881,  S6l. 

Boou  BxciiTSD,  804. 


CONTENTS  OF  No.  OLIV. 

HdM(EOPATHY  IN  RUSSIA      .  .801 

CASE  OF  ASCITES  AND  ANASARCA.    BY  DR.  DRYSDALE  .831 

TRITURATIONS  .894 

REVIEWS. 

DISEASES    OF    INFANTS    AND    CHILDREN.   WITH    THEIR    HOMOEOPATHIC 

TREATMENT.    EDITED  BY  T.  C.  DUNCAN,  M.D.,  ASSISTED  BY  SEVERAL 

PHYSICIANS  AND  SURGEONS.    VOL.  II     .  .841 

SURGICAL  DISEASES  AND  THEIR  HOMCEOPATHIC  THERAPEUTICS.    BY  J.  C. 

GILCHRIST,  M.D.  .841 

TRANSACTIONS  OF  THE  AMERICAN  INSTITUTE  OF  HOMCEOPATHY,  1877  AND 

1878  .843 

TRANSACTIONS  OF  THE  HOMCEOPATHIC  MEDICAL  SOCIETY  OF  THE  STATE 

OF  PENNSYLVANIA.    VOL.  II.  1874—1878   .  .844 

THE  GUIDING  SYMPTOMS  OF  OUR  MATERU  MEDICA.    BY  C.  HERING.  MJ). 

VOL.11.    ARmCA—BROMlVM  .  .  .    8« 

MATERIA  MEDICA  AND  THERAPEUTICS,  ARRANGED  UPON  A  PHYSIOLOGICAL 

AND  PATHOLOGICAL  BASIS.    BY  CHARLES  J.  HEM  PEL.  M.D.  .    848 

A  MANUAL  OF  PHARMACODYNAMICS.    BY  RICHARD  HUGHES.  L.R-C.P.Ed.    .   846 
MANUEL  DE  THERAPEUTIQUE  SELON  LA  METHODE  DE  HAHNEMANN.  PAR 

RICHARD  HUGHES,  L.R C.P.Ed.    .  .    M7 

HANDBUCH  DER  IIOMOEOPATUISCHEN  ARZNEIWIRRUNGSLEHRE.  VON  DR. 

MED.  CARL  HEINIGKE     .  .    S47 

PATHOGENETIC  OUTLINES  OF  HOMCEOPATHIC  DRUGS.    BY  UK,  MED.  CARL 

HEINIGKE.    TRANSLATED  BY  DR.  TIETZE  .  .847 

THE  NATURE  AND  TREATMENT  OF  SYPHILIS.  AND  THE  OTHER  SO-CALLED 

"CONTAGIOUS  DISEASES."    BY  CHARLES  ROBERT  DRYSDALE,  MJ)..  kc.  .    85 
OUR  FOREIGN  CONTEMPORARIES  .  ...    850 

MISCELLANEOUS. 

An  Irish  Medicnl  Bull,  367-— American  Inititnte  of  Homoeopathy,  876.— NoiaeleH  Cntkiaj, 
876.— Pathogenetic  Record,  377.— Dr.  Dudgeon'i  Pocket  Sphygmograph,  377.— Inter- 
national College  of  Hygiene,  377. 

Obitvast  :— Constantinc  Bering,  378. 

Books  Reciitxd,  880. 

IrroKX,  881. 

Apkndix:— Pathogenetic  Record,  by  Dr.  BsstiDOS. 


THE 


BRITISH   JOURNAL 


ov 


HOMCEOPATHY 


ALLEN'S    ENCYCLOPAEDIA.* 

The  publication  of  the  concluding  volume  of  the  great 
undertaking  which  will  henceforth  be  known  by  the  above 
familiar  appellation  imposes  a  special  duty  upon  us.  At 
the  first  announcement  of  the  work  in  1874  (see  our 
number  for  April  of  that  year)^  and  at  the  appearance  of 
each  of  its  successive  volumes,  we  have  sought  to  greet  it 
with  our  warmest  welcome,  and  at  the  siame  time  to  aid  in 
its  perfecting  by  our  strictest  criticism.  Now  that  it  is  all 
before  us,  however,  it  seems  right  that  we  should  attempt 
to  lay  before  our  readers  a  deliberate  account  and  estimate 
of  a  work  which,  for  many  years  to  come,  will  be  the 
Materia  Medica  of  Homoeopathy,  at  any  rate  for  all  of  the 
English  speech. 

Dr.  Allen's  work  grew  out  of  the  necessity  which  exists 
for  the  bringing  together  of  the  pathogenetic  material  we 
possess  wherewith  to  work  the  law  of  similars.  Our 
provings  have  appeared  as  they  have  been  made  in  journals, 
in  monographs,  or  in  such  works  as  Hahnemann's  and 
Jorg's ;  they  are  scattered  through  a  series  of  volumes 
which  every   year  increases  in  length,  and  in  proportion 

*  The  SneifcloptBdia  of  Pure  Materia  Medica.  A  Record  of  the  positive 
effects  of  drugs  upon  the  healthy  human  organism.  Edited  hy  T.  F.  Allen, 
A.M.,  M.D.  With  contrihntions  from  Drs.  Hughes,  Bering,  Dunham,  Lippe, 
and  others.    10  vols.    1874—1879. 

TOL.  ZXXTIII,  NO.  CM. JANUARY,  1880.  A 


2  Allen^s  Mneychpadia. 

becomes  inaccessible  to  practitioners  at  large.  The  need 
of  collections  of  these  records  has  been  felt  from  the  early 
days  of  our  history,  as  is  shown  by  the  publication  of 
StapFs  Beitrdge  (from  his  Archiv)  and  Hartlaub  and 
Tnnks'  ArzneimitteUehre  (from  their  AnndUn).  It  was 
supplied,  on  as  large  a  scale  as  the  time  required,  by  the 
manuals  of  Jahr  and  of  Noack  and  Trinks — the  former,  in 
its  various  English  dresses,  having  long  been  the  ordinary 
text-book  for  homoeopathic  physicians  in  this  country  and 
in  the  United  States.  Its  older  editions  being  exhausted, 
our  enterprising  American  publishers  planned  a  new  onCi 
and  sought  for  professional  aid  towards  having  it  so  edited 
as  to  bring  it  down  to  the  present  day.  Dr.  Allen,  into 
whose  hands  the  work  ultimately  came,  had  no  difficulty  in 
seeing  that  Jahr's  presentation  of  his  matter  was  as  in- 
adequate as  the  matter  itself  was  imperfect ;  and  that,  to 
do  justice  to  the  requirements  of  the  case,  an  entirely  new 
work  must  be  set  on  foot.  All  extant  provings  niust  be 
brought  together,  re-translated  where  necessary,  and  re- 
arranged ;  the  old  collections  from  authors  must  be  re- 
plenished from  later  sources,  and  new  symptom-lists  com- 
piled from  these.  The  pathogeneses  of  the  new  Materia 
Medica  Pura  must  be  as  complete  for  their  own  day  as 
Hahnemann  made  his  for  the  time  of  their  publication. 
He  ofiSered  to  undertake  this  work  as  editor,  and  Messrs. 
Boericke  and  Tafel  accepted  its  responsibilities  as  publishers. 
As  soon  as  the  project  was  known  offers  of  help  came  in. 
Dr.  Hering  undertook  to  supply  the  recondite  literary  in- 
formation in  his  possession,  Drs.  Dunham  and  Lippe  to 
furnish  verifications,  Dr.  Hughes  to  revise  and  illuminate 
Hahnemann's  citations  from  authors.  The  first  volume, 
containing  640  pages  of  imperial  octavo,  was  issued  in 
November,  1874.  The  publishers  hoped  then  to  complete 
it  in  five  or  six  similar  volumes,  and  to  have  the  whole  out 
by  1876.  Ten  volumes,  however,  have  been  required  to 
contain  the  accumulated  and  accumulating  matter,  and  it 
was  not  till  last  autumn  that  the  tale  was  complete. 

Five  years,  then,  having  elapsed  between  the  appearance 
of  the  first  volume  and  the  tenth,  it  was  to  be  expected 


Attends  Encyctopadia»  8 

that  Dr.  Allen  would  have  fresh  material  for  the  pathoge- 
neses of  many  of  the  earlier  medicines.  Accordingly,  it  is 
only  the  first  238  pages  of  his  tenth  volume  which  are 
occupied  with  the  concluding  numbers  of  his  alphabetical 
series,  viz.  the  medicines  from  Tilia  to  Zizia.  The 
remainder  consists  of  a  "  Supplement/'  bearing  date  April, 
1879,  and  containing  additions  to  the  symptom-lists  of 
numerous  medicines,  with  some  pathogeneses  which  are 
absolutely  new.  There  are,  finally,  some  ''Notes  and 
Corrections  '^  supplementary  to  those  issued  with  the  third 
volume.  These  last  should  be,  as  far  as  possible,  incorpo- 
rated in  the  text  by  all  possessors  of  Dr.  Allen's  work ;  and 
no  one  should  conclude  that  he  has  before  him  the  com- 
plete pathogenesis  of  any  drug  contained  in  the  first  nine 
volumes  without  looking  to  see  if  it  has  any  fresh  sym- 
ptoms in  the  tenth. 

Taking,  now,  a  survey  of  the  whole  work,  we  would  first 
speak  of  its  materials.  In  our  comment  on  the  specimen 
medicine  {Aconite)  first  furnished,  we  made  the  following 
suggestions : 

''  1.  That  the  materials  of  the  collection  shall  consist 
only  of  such  provings^  &c.)  as  are  on  record" 
This  was  to  exclude  symptoms  privately  supplied  to  the 
authors,  and  only  introduced  as  from  ''  H.  N.  S.,  40th  dil.,'' 
"T.  C.  D.,  60th  dil.,''  and  so  forth.  It  was  obvious  that 
he  might  be  flooded  with  such  dubious  observations,  and 
that  his  readers  would  have  no  means  of  checking  their 
value.  In  the  reproduction  of  Aconite  in  his  first  volume^ 
Dr.  Allen  has  supplied  references  which  show  that  these 
symptoms  are  on  record ;  and  he  has  throughout  his  work 
adhered  consistently  (with  a  few  well-warranted  exceptions) 
to  the  salutary  rule  we  ventured  to  lay  down.  Our  school 
has  thus  been  spared  the  incorporation  of  the  multitudinous 
pathogenetic  effects  which  Dr.  Swan  and  some  like-minded 
persons  imagine  they  have  elicited  from  attenuations  of 
different  kinds  qf  milk  I 

''2.  That  the  bracketing  and  correcting  (where  neces-' 
sary)  of  the  symptoms  taken  by  Hahnemann  from  authors  be 
done  with  the  utmost  thoroughnesSi^' 


4  Attends  Eneyelopadia. 

Dr.  Allea  has  since  left  this  part  of  his  work  entirely  in 
the  hands  and  to  the  responsibility  of  one  of  the  editors 
of  the  British  Journal  of  Homoeopathy,  so  that  we  cannot 
criticise  it  in  onr  present  article.* 

"  3.  That  no  mere  *  clinical '  symptoms  be  admitted/' 
The  editor  had  some  difficulty  in  bringing  himself  to  aban- 
don altogether  these  fascinating  bat  illegitimate  addi- 
tions to  the  Materia  Medica.  His  first  and  second 
volumes  contained  a  few^  but  in  June^  1875^  he  announced^ 
in  the  Hahnetnannian  Monthly,  that  '^in  future  no  symptoms 
will  be  admitted  unless  they  ha?e  been  obtained  by  proving 
the  drug/'  The  misleading  effect  of  admitting  these  is  seen 
in  the  pathogenesis  of  Benzoicum  acidum  contained  in  the 
second  volume.  Here^  S.  66  {"  extensive  ulcerations  of  the 
tongue^  with  deeply-chapped  or  fungoid  surfaces '')  and  175 
(''troublesome^  constant,  dry,  hacking  cough,  after  sup- 
pressed gonorrhoea  ")  are  purely  clinical,  as  reference  to  the 
original  will  show ;  but  they  have  escaped  the  distin- 
guishing cipher,  and,  till  the  corrections  in  the  last  volume 
appeared,  they  have  stood  as  pathogenetic  effects  of  the 
drug. 

We  have  thus  every  reason  to  be  satisfied  with  Dr. 
Allen's  collection  of  material  for  his  work,  as  his  mode  of 
proceeding  has  become  conformable  to  our  initiatory  sug- 
gestions. We  have,  however,  one  exception  to  take.  It  is 
not  to  his  admission  of  the  provings  of  Cimex  lectularius 
and  the  similarly  nasty  substances  which  Dr.  Mure  has 
introduced  into  our  Materia  Medica.  Dr.  Dake  has  stoutly 
protested  against  the  insertion  of  these  :  we  agree  with  him 
in  disliking  them,  but  wd  do  not  see  how  Dr.  Allen  could 
reject  them.  It  is  otherwise,  however,  with  the  symptom 
lists  of  Houat.  In  our  twenty-seventh  volume  we  gave 
an  account  of  the  first  part  of  the  Nouvelles  Donnies  of 
this  writer,  and  showed  the  utterly  untrustworthy,  and 
indeed  impossible,  character  of  the  pathogeneses  therein 
furnished.  We  were  sorry,  therefore,  to  find  in  Dr.  Allen's 
first  two  volumes  Houat's  symptoms  of  Anantherum,  Bella-^ 
donna  and  Bufo  given  without  a  word  of  caution^  as  a  list  of 

*  See  our  vol.  zxziii,  pp.  308  and  461. 


Allen* 8  Encyehpadia.  6 

observed  effects  of  these  substances.  In  the  third  volume 
an  improvement  was  made.  Under  Cubeba  we  read^  as 
an  appendix  to  the  list  of  authorities — ''  Houat's  proving, 
from  Nouvelles  Donates  de  Mat.  Med.  This  truly 
astonishing  collection  of  symptoms  is  put  by  itself,  since 
there  is  no  way  of  determining  what  is  pathogenetic,  and 
what  clinical,  and  since  there  is  no  intimation  of  how  the 
symptoms  were  obtained  :  in  these  days  all  accounts  of 
scientific  experiments  must  be  accompanied  by  a  most 
complete  detail  of  methods,  that  they  may  be  verified/' 
Such  relegation  to  a  separate  category  was  next  best  to 
entire  omission,  which  we  should  have  preferred ;  and  it 
was  again  performed  in  the  fourth  volume  as  regards 
Cwrare.  In  the  fifth,  however,  we  had  to  express  our 
regret  at  finding  the  pathogenesis  of  Kali  iodatum  spoiled 
by  the  incorporation  of  these  apocryphal  symptoms ;  and 
probably  our  remonstrance  did  not  stand  alone,  as  Houat's 
contribution  to  our  knovf ledge  of  Piper  nigrum  was  omitted 
altogether  from  the  seventh  volume,  and  his  symptoms  of 
Bolmia  and  Sarracenia  were  treated  in  the  eighth  like 
those  of  CtAbeba  and  Curare  in  the  third  and  fourth. 

So  far,  then — save  as  regards  Belladonna  and  Kali 
iodatum — no  harm  has  been  done  to  those  who  intelli- 
gently use  Dr.  Allen's  Encyclopadia.  When,  however,  we 
heard  that  an  index  to  his  work  was  in  preparation,  we  felt 
anxious  lest  it  should  refer  to  Houat's  symptoms  as  if 
standing  in  the  same  category  with  the  rest ;  an  error 
which  (we  may  say)  the  compilers  of  the  British  Repertory 
are  sedulously  avoiding.  Dr.  Allen  has  dispelled  our  fears, 
however,  in  a  paper  he  has  published  in  the  August 
number  of  the  North  American  Journal  of  HomoBopathy, 
entitled  "  Shall  Houat's  provings  be  considered  reliable  ?'' 
His  conclusion,  after  examination  of  the  facts,  is — ^'  It  is 
quite  evident  that  Houat's  collection  (with  the  exception  of 
his  provings  of  Belladonna)  has  no  place  in  a  pure  Materia 
Medica  {his  symptoms  will  not  appear  in  the  index  to  the 
Encyclopedia,  for  the  editor  of  that  work  is  unable  to 
distinguish  the  pure  from  the  impure).''  We  cannot  agree 
with  him  in  excepting  the  symptoms  of  Belladonna,     He 


6  Attends  Eneyelopmdia. 

argues  their  barmonionsness  with  the  known  action  of  the 
drug ;  but  this  will  not  substantiate  a  list  of  893  sTmptoms 
purporting  to  have  been  obtained  by  him  between  August 
and  November  with  the  15th  dilution^  and  containing 
(among  other  symptoms)  ''tettery  eruptions,  with  scabs, 
scales,  and  ulcerations,  on  the  scalp,''  ''eyes  projecting, 
sparkling,  furious,  sometimes  expressionless,  dull,  and 
clouded,"  *'  face  pale,  yellow,  earthy/'  Nor  can  we  accept 
the  explanation  of  the  symptoms  ascribed  to  other  drugs, 
by  which  Dr.  Allen  endearours  to  save  Houat's  credit. 
That  writer  admits  the  incorporation  of  clinical  symptoms 
into  his  lists ;  and  it  is  this  ''  abominable  fallacy,"  as  Dr. 
Allen  justly  calls  it,  ''  which  has  poisoned  the  fountains  of 
our  Materia  Medica  from  Hahnemann  to  the  present," 
that  has  (in  his  opinion)  ''rendered  Houat's  provings 
unreliable  as  guides  to  the  true  homoeopathist,  though  they 
may  be  of  some  value  to  the  empirical."  We  cannot 
think  that  they  are  thus  explained.  To  Houat's  sym- 
ptoms of  Sarracenia  Dr.  Allen  appends  the  note :  '^  Most 
astonishing,  and  apparently  impossible. — ^T.  F.  A."  But 
are  they  less  astonishing  or  more  possible  if  regarded  as 
clinical  symptoms?  Are  we  really  to  believe  that  this 
almost  inert  vegetable  substance  has  cured,  in  Dr.  Houat's 
hands,  ^'hard  nodosities  and  tumours  of  the  tongue;" 
"inflammation  and  swelling  of  the  spermatic  cords  and 
testicles,  with  burning  and  pulsative  pains;"  "the  uterus 
swollen,  as  if  filled  with  cysts ;"  "  deformity  of  the  thorax 
and  back,  as  in  rachitis;"  "emaciation;"  "anasarca;" 
and  similar  conditions  profusely  scattered  about  its  long 
symptom  list  ?  Are  we  to  accept,  on  Houat's  authority,  a 
power  on  the  part  of  Cubeba  to  cure — ^not  the  familiar 
gonorrhoea  with  which  it  has  long  been  associated — but 
mania,  marasmus,  haemorrhages,  and  partial  paralysis  ?  To 
this  we  are  committed  if  we  suppose  the  catalogues  now  in 
question  to  consist  of  genuine  "  clinical  symptoms."  Nay  : 
it  is  far  wiser  and  safer  to  reject  them  altogether  as 
fabrications,  and  the  greater  the  scorn  and  indignation  with 
which  we  do  it  the  less  likely  is  the  imposture  to  be 
repeated. 


Allen's  Encyclopedia,  7 

We  pass  now  to  Dr.  Allen's  presentation  of  his  matter. 
We  found  in  his  specimen  medicine  too  little  information 
as  to  the  anthorities  for^  and  subjects  of,  the  symptoms 
obtained   by  proTing,  while  those  observed  in  poisoning 
cases  were  thrown  together  indiscriminately  under  the  head 
''  toxicological.^'     This  last  we  could  not  approve^  and  we 
desiderated  fuller  and   more  detailed  information  in   the 
section  '*  authorities/'     The  improvement  which  has  taken 
place  in  this  respect  as  the  work  has  gone  on  is  very  great. 
Compare    (for    instance)    the    '^authorities''    section   for 
AgaricuM  in  the  6rst  volume  with  that  for  Natrum  muriam 
ticum  in  the  sixth.     We  mention  these  two  as  having  both 
been   re-proved  by  the  Austrian   SotSiety.     For  Agaricua 
we  have  a  bare  list  of   forty-eight  names^  and  are  told 
in  a  note  that  12  to  30^  and  48^  are  Austrian  provings. 
Where   these   are   to  be  found,  who   the   experimenters 
were,  what  doses  they  took  and  how  often, — of  all  this 
no  account  is  given.     Turn  to  Natrum   muriaticum,  and 
in  the  list  of  authorities  itself  we  come  upon  ^'  Nos.  8  to  43 
from  the  Austrian  provings,  Oest.  Zeit.  /.  Horn./  vol.  iv." 
Then  follows  the  catalogue  of  names,  the  doses  taken  by 
each  and  their  repetition  being  stated.     If  the  same  person 
tested  both  the  crude  salt  and  its  attenuations  his  symptoms 
It  the  one  period  have  a  mark  to  distinguish  them  from 
those  of  the  other;  and  if  he  were  the  subject  of  any 
existing  or  habitual  derangement  of  health  this  is  stated 
in   a   note.      Hahnemann's  notes,  moreover,  which   were 
omitted  from  the  specimen  medicine,  have   (as   we  sug- 
gested) been  uniformly  given. 

We  must  now  say  a  word  upon  the  markings  of  the 
symptoms.  In  his  original  preface,  the  editor  explained 
the  significance  to  be  attached  to  these.  **  Symptoms 
which  have  been  repeatedly  cured  by  the  drug  are  distin- 
guished by  stars,  with  italics,  or  full-faced  type ;  the  latter 
class  is  most  important.  Symptoms  in  italics^  without 
stars,  have  been  repeatedly  observed  upon  provers^  but  not 
yet  verified  on  the  sick."  In  obtaining  these  '^  verifi- 
cations" he  acknowledges  the  help  of  Drs.  Dunham  and 
Ijippe.     The  contribution^  of  the  former  reac^  to  Lycopoi 


8  AUef^s  Eneyclopmdia. 

dkim,  when  thej  were  tenoinated  by  his  lamented  death; 
a  fly-leaf,  coDtaioing  the  numbers  of  the  symptoms  marked 
by  him,  was  supplied  to  all  subscribers  to  the  work.  Dr. 
Lippe,  who  had  already  sent  the  editor  the  numbers  of  the 
symptoms  in  his  'Text-Book'  which  he  had  himself 
Tcrified,  now  undertook  to  go  over  Dr.  Allen's  MS.  and 
add  his  stars,  which  he  has  done  from  Manganum  onwards. 
Besides  these,  ''  other  rerifications  have  been  inserted  by 
the  editor,  after  consulting  nearly  the  whole  of  the  homoeo- 
pathic literature.'^  The  extent  of  the  examinations  thus 
made,  and  the  amount  of  the  yield,  may  be  estimated  by 
the  article  "  Clinical  Symptoms  of  Lycopodium,''  contri- 
buted by  Dr.  Allen  to  the  North  American  Journal  of 
Homctopathy  for  August,  1877.  These  verifications  con- 
stitute a  valuable  feature  of  the  EncyclopiBdia,  and  a 
beginning  student  might  do  worse  than  make  a  list  of  them, 
at  any  rate  for  the  principal  medicines,  or  learn  them  by 
heart. 

This,  then,  is  the  work  which  Dr.  Allen  has  given  us. 
Before  concluding  our  survey,  let  us  concentrate  our  atten- 
tion upon  a  particular  medicine.  Dr.  Dunham  did  this  as 
regards  Aconite  on  the  appearance  of  the  first  volume  ;* 
let  us  do  it  now  for  Belladonna, 

The  article  upon  this  drug  appears  at  p.  67  of  Dr.  Allen's 
second  volume.  Some  corrections  are  made  in  it  at  p.  639 
of  volume  iii,  and  p.  657  of  volume  x ;  the  latter  volume 
also  contains  an  addition  to  the  pathogenesis.  With  its 
predecessor  it  gives  Belladonna  2681  symptoms,  derived 
from  285  distinct  observers,  and  this  excludes  all  effects  of 
Atropia,  which  has  an  article  to  itself. 

We  will  first  make  Dr.  Allen's  own  corrections.  They 
are  only  fourteen  in  number,  and  chiefly  consist  of  single 
letters  or  figures.  Where  whole  numbers  have  to  be 
altered,  it  is  through  a  reference  having  been  made  to 
Hahnemann's  pathogenesis,  and  inserted  without  being 
made  to  correspond  with  the  fresh  numeration  of  the 
Encyclopedia.  The  only  considerable  error  (evidently  of  a 
copyist)  is  in  S.  2312,  where  we  are  told  (in  vol.  x)  to  read 

•  North  American  Joum,  of  ffom,,  Feb.,  1875, 


Allen's  EncychpiBdia.  9 

for  "  worms  in  "  "  warmth  out  of  all  the  pores/'  which  is 
certainly  a  very  different  thing. 

The  first  paragraph  refers  the  plant  to  its  Linnsean  and 
natural  orders^  and  gives  its  English  and  German  domestic 
names,  with  its  mode  of  preparation  for  homoeopathic 
practice.  We  next  have  the  list  of  "  Authorities.'^  Of 
these,  the  first  eighty-five  are  stated  to  be  from  Hahne- 
mann's pathogenesis  in  vol.  i  of  the  22.  A.  M.  L.  His  own 
name  and  those  of  his  fourteen  fellow-provers  stand  as 
they  are  given  by  him,  for  we  have  no  information  about 
them.  But  after  each  of  the  remaining  names,  which 
belong  to  authors  from  whom  he  has  quoted,  a  clause 
follows,  stating  the  circumstances  of  their  observation, 
whenever^  that  is^  their  originals  were  accessible.  In  the 
case  of  Greding,  from  whom  so  many  symptoms  are  taken^ 
we  have  a  list  of  the  patients  in  whom  they  appeared,  and 
the  reference  of  each  symptom  to  him  is  accompanied  by 
a  mention  of  the  case  in  which  he  observed  it.  As  his 
patients  consisted  of  epileptics,  epilepto-maniacs,  and  pure 
maniacs^  it  is  of  obvious  importance  to  have  this  knowledge^ 
that  we  may  know  how  to  estimate  epileptiform  and 
maniacal  phenomena  when  ascribed  on  his  authority  to  the 
drug.  We  then  have  a  series,  mostly  of  poisoning  cases, 
taken  from  the  various  collections  which  have  been  made 
(as  Hencke's  in  the  Vierteljahrachrift  and  that  of  the 
Hahnemann  Materia  Medico),  and  from  general  medical 
literature^  English,  American,  French,  and  German.  Of 
the  care  here  taken  we  have  an  evidence  in  the  follow- 
ing observation: — "141  to  176  are  taken  from  Boch's 
regum4  in  J.  de  L  Soc.  Gal  (Mat.  Med.),  4,  402,  where 
references  are  furnished,  but  no  details.  On  subsequent 
critical  research,  most  of  these  additional  authorities  given 
by  Both  have  been  found  to  refer  to  the  effects  of  Bell, 
when  given  to  patients ;  they  are  therefore  omitted,  though 
the  subsequent  numbering  could  not  be  changed  without 
great  trouble.^'  It  was  this  pathogenesis,  we  may  note,  on 
which  Dr.  Espanet  founded  his  study  of  Belladonna  noticed 
in  our  July  number  last  year.  To  each  of  the  names  here 
given  a  statement  is  made  of  the  subject  of  the  poisoning 


10  AUen^i  Eneychpmdia. 

or  proving ;  and  it  is  onlj  in  the  last-^'^  Macfarlan^  proving 
with  the  6"^  (Fincke) " — that  we  have  to  regret  the  intro- 
daction  of  an  unpublished  observation  of  sufficiently  dubious 
value. 

Let  us  now  test  the  accuracy  of  Dr.  Allen^s  translations 
and  quotations  as  r^ards  this  medicine.  It  would  be 
tedious  to  do  so  throughout  its  range ;  we  will  take^  there- 
fore^ two  limited  sections — ^those  containing  the  symptoms 
of  the  abdomen  and  of  the  sexual  oi^ans  respectively. 

S.  1863  to  1461  comprise  the  section  '^  Abdomen/' — 
Hahnemann's  corresponding  tract  containing  56  symptoms. 
We  have  begun  by  ascertaining  how  these  have  j^een 
reproduced.  Six  we  find  omitted,  viz«  S.  660^  665^  660, 
678,  681,  and  687 ;  and  we  cannot  say  that  any  are  mere 
duplicates,  so  as  to  warrant  their  being  passed  by.  Of  the 
remaining  50  the  rendering  k)f  44  seems  unexceptionable, 
but  with  six  we  have  to  find  some  little  fault.  Thus :  in 
S.  1S87  (corresponding  to  Hahnemann's -S.  638)  '^abdo- 
men" should  be  ''duodenum"  (Zwolffingerdarms).  In 
S.  1485  (S.  646  Hahn.)  **  in  the  evening  "  is  omitted.  In 
S.  1430  (S.  647  Hahn.)  it  should  be  "  hard,"  not  ''  heavy" 
weight.  In  S.  1414  and  1449  (S.  644  and  648  Hahn.) 
''  abdomen  "  should  be  '^  hypogastrium "  (Unterbauch,  a 
word  Dr.  Allen  translates  thus  in  every  other  place  of  its 
occurrence).  In  S.  1458  (675  Hahn.)  ''grosse  Stiche" 
should  hardly  be  rendered  **  severe :"  the  word  seems  rather 
to  express  the  breadth  (as  it  were)  of  the  needle  which 
pierced  the  parts. 

We  have  next  8  symptoms  taken  from  other  parts  of 
Hahnemann's  schema,  on  the  ground  of  their  having  some 
relation  to  the  abdomen.  The  rendering  of  one  only  of 
these  we  have  to  criticise,  S.  1868  (628  Hahn.).  Dr.  Allen 
gives  it — ''  Fulness  below  the  short  ribs  when  stooping ; 
fulness  at  the  pit  of  the  stomach  and  darkness  before  the 
eyes."  In  the  original^  however,  the  semicolon  occurs  after 
"  Ribben :"  it  is  the  fulness  at  the  epigastrium  and  cloud- 
ing of  vision  which  occur  on  stooping. 

Of  the  remaining  symptoms,  20  are  from  Houat's 
manufactory.      Of    their   value    (rememl^ring   that  thev 


Allen^s  Encyclopedia.  11 

purport  to  have  been  obtained  from  the  15th  dilution  in 
three  months)  we  may  form  an  idea  from  the  first  and 
third — "  Swollen^  painful  liver^  presenting  swellings  like 
abscesses/'  "  Cramps  of  the  liver  (!)^  inyolving  the  chest 
and  exciting  paroxysms  of  cough  ^and  suffocation."  We 
advise  the  student  to  draw  his  pen  through  the  whole  of 
them.  The  others  are  derived  from  several  poisonings  and 
provings — consisting^  from  the  former  source,  mainly  of 
meteorism,  with  occasional  pain  and  tenderness^  from  the 
latter,  of  various  sensations  connected  with  flatulence. 

We  pass  now  to  the  sexual  organs.  Belladonna  has  but 
slight  pathogenetic  influence  upon  these.  Hahnemann 
only  gives  them  30  symptoms  out  of  his  1440,  and  Dr. 
Allen  can  add  but  5  more  from  poisonings  and  provings — 
two  of  which  are  merely  general  statements.  The  inex- 
haustible invention  of  Houat,  however,  fills  his  section  with 
20  others,  which  may  share  the  fate  of  his  abdominal 
symptoms,  to  which  they  are  fully  comparable.  Of  Hahne- 
mann's 30,  11  are  not  found  here.  Of  these,  8  have  been 
transferred  to  other  parts  of  the  pathogenesis ;  but  the  change 
canilbt  always  be  commended.  For  instance.  Dr.  Allen 
retains  S.  789,  which  states  that  during  the  menses  great 
thirst  was  experienced  by  one  of  Oreding's  patients  taking 
the  drug ;  but  he  omits  S.  786—8,  which  affirm  the  same 
thing  as  to  other  coincident  affections.  Still  less  defensible 
is  the  omission  of  S.  795.  This  has,  indeed,  been  given 
among  the  abdominal  symptoms  (S.  1451) ;  but  it  so 
obviously  belongs  to  the  femsde  sexual  organs  that  it  should 
have  been  repeated  or  referred  to  here.  The  leaving  out 
of  Hahnemann's  symptoms  771,  781  and  785  has  not  even 
transference  to  explain  it.  Of  those  remaining,  we  have 
some  fault  to  find  with  five.  In  S.  1614  (777  Hahn.) 
''tumour"  seems  almost  too  large  a  word  for  the 
""  Knoten  "  of  the  original.  In  S.  1629  (784  Hahn.)  the 
reference  is  wrongly  given  to  Langhammer :  it  is  one  of 
Hahnemann's  own  observations.  S.  1645  is  a  repetition  of 
S.  1638,  and  has  no  existence  in  the  original.  S.  1637 
and  1647  are  placed  by  Dr.  Allen  among  those  of  the 
female  sexua}  organs ;  but  in  Hahnemann's  list  they  occur 


12  The  RegtneratUm  of  Materia  Mediea, 


in  the  midst  of  those  of  the  male  genitals,  and  he  seems  to 
haye  intended  that  the  two  should  follow  one  another  in 
separate  eat^ories. 

The  results  of  oar  examination  have  hardly  been  as 
uniformly  faTonrable  as  we  could  have  wished ;  but  how  few, 
after  all,  are  the  errors,  how  admirable  the  genersl 
accuracy  of  the  compilation  I  A  new  translation  of 
Hahnemann's  pathogeneses  is  certainly  not  rendered  super- 
erogatory by  what  Dr.  Allen  has  done ;  but  for  all  else  his 
work  may  be  accepted  as  both  complete  and  trustworthy. 
When  he  has  completed  its  practical  usefulness  by  the 
index  to  its  ten  volumes  now  preparing  under  his  super- 
intendence, he  will  haye  furnished  to  homoeopathic  literature 
a  contribution  which  will  long  remain  its  central  feature,  its 
most  yalned  possession ;  and  will  have  inscribed  his  own 
name  among  those  most  cherished  in  the  annals  of  our 
history. 


THE    REGENERATION   OP   MATERIA   MEDICA. 
By  J.  P.  Da«,  M.A.,  M.D.,  Nashville,  U.S.A. 

I. 

In  the  study  of  the  science  of  numbers  we  first  learn  the 
properties  and  powers  of  numerals,  considered  by  and 
among  themselves,  and  thus  gain  a  knowledge  of  pttre 
mathematics. 

Going  farther,  when  we  bring  these  numerals  into  use 
in  the  measurement  of  land,  the  navigation  of  seas,  and  the 
study  of  movements  among  bodies  on  the  earth  and  in  the 
heavens,  we  gain  a  knowledge  of  mixed  or  applied  mathe- 
matics. 

This  distinction  has  long  been  recognised  as  not  onlr 
proper  but  necessary  to  a  clear  understanding  of  things 
mathematical.     And  the  order  has  been;  from  the  be^in- 


by  Dr.  /.  P.  Dake.  18 

ning  of  mathematical  science,  first  the  pure^  and  then  the 
mixed.  I  speak  of  science  here  as  the  orderly  arrangement 
of  elements  empirically  discovered,  brought  before  the  mind 
in  a  comprehensible  and  useful  shape. 

Arithmetic^  algebra,  geometry,  trigonometry,  conic  sec- 
tions, tbe  calculus,  these  belong  to  pure  mathematics. 

Surveying,  navigation,  natural  philosophy,  astronomy, 
these  are  representatives  of  the  mixed. 

One  well  acquainted  with  the  properties  and  powers  of 
numerals  in  their  varied  relations  to  each  other  may  pass 
on  readily  to  their  applications  and  uses  where  measure- 
ments of  any  kind  are  to  be  made  in  the  avocations  of 
daily  life. 

So,  in  medicine,  we  must  first  learn  the  absolute  proper- 
ties and  powers  of  various  drugs,  as  shown  in  the  healthy 
human  organism,  and  the  knowledge  thus  gained  we  term 
Pare  Materia  Medica. 

In  proceeding  farther,  when  we  bring  the  pathogenesis 
thus  learned  into  comparison  with  the  manifestations  of 
disease  in  the  sick,  obeying  the  law  similia,  and  cures 
result  from  the  drugs  employed,  we  are  led  to  a  knowledge 
of  Mixed  or  Applied  Materia  Medica. 

Here,  as  in  mathematics,  the  order  is,  first,  the  pure, 
then  the  mixed;  first,  a  knowledge  of  how  the  drug  by 
itself  a£fects  the  human  organism  when  in  health,  and 
afterwards  how  it  affects  it  in  disease. 

The  human  organism  in  health  is  not  exactly  the  same 
medium  or  reflector  of  drug  influence  that  it  is  in  sickness. 
The  differenee  in  the  character  of  results  is  well  marked 
and  appreciable,  the  former  being  direct,  simple,  and  posi« 
tive,  while  the  latter  is  indirect,  complex,  and  uncertain. 

Pure  Materia  Medica  is  required  not  only  in  medicinal 
therapeutics  but  likewise  in  practical  toxicology  and  experi- 
mental physiology. 

As  in  mathematics  so  here  the  master  of  the  pure  is 
prepared  to  make  generalisations  and  applications,  reaching 
out  into  several  departments  of  the  arts  and  sciences,  each 
having  its  own  field. 

With  such  an  understanding  of  the  relative  position  and 


14  Th^  Regeneration  of  Materia  Medica, 

importance  of  Pure  Materia  Medica  we  proceed  to  consider 
the  methods  for  its  attainment. 


II. 

Whatever  mention  had  been  made  of  the  study  of  drug 
properties  by  experimentation  with  drugs  upon  persons  in 
health  it  is  a  plain  matter  of  history  that  before  Hahne- 
mann no  one  pursued  it  to  any  extent  nor  with  any  success. 

Upon  his  discovery  of  the  relationship  necessary  between 
positive  drug  effects  and  the  exponents  of  disease  in  the 
human  body  such  experimentation  became  a  thing  not  of 
speculative  but  of  practical  moment. 

An  understanding  of  that  relationship  or  law  of  core 
could  avail  nothing  for  those  unacquainted  with  drug  affec- 
tions. The  very  first  work  of  Hahnemann^  therefore,  was 
the  testing  of  medicines  upon  himself^  his  associates,  and 
followers. 

I  need  not  here  speak  of  the  difficulties  he  encountered 
by  reason  of  individual  poverty,  and  the  ignorance,  and 
prejudice,  and  perverseness  of  the  medical  world  about  him, 
nor  yet  of  the  measure  of  success  which  he  realised. 
Suffice  it  to  say  his  early  gatherings,  published  under  the 
modest  title  Fragmentary  Observations  relative  to  the 
Positive  Powers  of  Medicines  on  the  Human  Body,  and  the 
first  pathogeneses  furnished  by  himself  and  by  persons 
immediately  under  his  direction  and  scrutiny,  were  more 
reliable  than  the  larger  gatherings  and  less  thorough 
provings  afterwards  brought  together  under  the  more  pre* 
tentious  title  Materia  Medica  Pura  and  in  the  Chronic 
Diseases. 

How  the  high  standard  of  excellence,  at  first  planted  by 
Hahnemann,  became  gradually  lowered,  and  how  side 
streams  from  one  source  and  another,  bringing  in  impari- 
ties, came  finally  to  vitiate  the  great  reservoirs  of  patho- 
genesy  I  shall  not  stop  to  relate.  In  this  Journal,  and  in 
various  other  publications  from  the  hand  of  Dr.  Dudgeon, 
as  well  as,  more  recently^  from  the  discriminating  pen  of 


by  Dr.  /.  P.  Dake.  15 

the  junior  editor^  Dr.  Hughes^  such  information  has  been 
repeatedly  laid  before  the  profession. 

III. 

In  view  of  the  great  importance  of  a  pure  Materia 
Medica^  and  of  the  evident  cormptions  of  that  now  bearing 
the  name^  I  desire  to  make  an  earnest  appeal  to  the 
profession  in  behalf  of  more  exact  methods  of  drug  experi- 
mentation. 

In  the  July  number  of  this  Journal^  Dr.  Hughes,  writing 
upon  '^  The  Beconstitution  of  the  Materia  Medica/'  after 
noticing  the  plans  put  forward  by  Dr.  Jousset  and  Dr« 
Espanet  for  the  better  arrangement  and  display  of  drug 
symptoms,  coneludes  as  follows : 

"It  is  impossible,  therefore,  thus  to  present  the  whole 
Materia  Medics,  and  while  I  would  haye  such  studies  of  indi- 
ndnal  drugs  multiplied  indefinitely,  I  should  deprecate  any 
attempt  to  substitute  them  for  our  existing  symptomatology. 
Let  this  stand  as  it  is,  and  let  our  work  upon  it  be  some- 
thing like  that  of  theologians  upon  their  sacred  books.  As 
with  them,  let  our  best  endeavours  be  made  to  enrich,  to  purify, 
and  to  illuminate  the  text.  Then  let  those  competent  for  the 
ta^  give  us  commentaries  upon  it  elucidating  its  language. 
Let  the  teachers  of  Materia  Medica  in  our  schools  publish 
from  time  to  time  their  systematic  lectures,  embodying  (as  they 
must  do)  all  the  side  lights  which  from  toxicology,  from  the 
hpysiological  laboratory,  and  from  therapeutic  experience  they 
can  bring  to  bear  upon  its  study.  These  will  answer  to  treatises 
on  doctrinal  and  practical  theology ;  and  theu,  for  the  sermons 
which  expoimd  and  apply  particular  texts,  let  us  have  clinical 
records  showing  the  bearing  of  pathogenetic  symptoms  upon  the 
phenomena  of  disease.  In  this  way,  while  we  shall  lose  no  grain 
of  fact  which  can  be  made  available  in  the  comparison  of  drug* 
action  with  disease,  there  will  be  supplied  to  every  student  of 
the  Materia  Medica  a  general  knowledge  of  its  constituents,  of 
their  sphere  and  kind  of  action,  of  their  characteristic  features 
and  ascertained  effectiveness,  which  shall  send  him  forth  fully 
equipped  for  using  them  in  the  treatment  of  disease. 


16  The  Regeneration  of  Materia  Medica, 

"  There  is  thus  abimdauce  of  work  for  all  who  desire  to  labour 
in  the  field  of  Materia  Medica,  and  the  more  there  is  done  of 
the  kind  the  better  for  the  future  practitioners  of  our  method." 

The  reading  of  these  words^  especially  such  as  liken  our 
present  Materia  Medica  to  the  ''  sacred  books "  of  the 
theologians^  suggested  the  theme  of  my  present  writing. 
I  said,  in  my  mnsings^  how  can  our  books  of  syn^ptoma- 
tology  be  like  the  books  of  the  Bible  ?*  Did  they  come  as 
we  see  them  by  supernatural  revelation  ?  Must  all 
remain  unchanged  except  as  illuminated  by  classical  re- 
search and  expounded  by  clinical  experience  ? 

In  view  of  what  Dudgeon  and  Hughes  and  others,  who 
have  endeavoured  to  hunt  oat  the  sources  of  Materia 
medica,  have  said  of  the  imperfections  of  our  drug  sympto- 
matology, and  in  view  of  what  is  well  known  of  its  insuf- 
ficiency by  every  experienced  and  intelligent  practitioner  of 
homoeopathy,  I  asked  myself — Is  it  possible  that  we  must 
sit  down  content  with  the  ''  text ''  of  Materia  Medica  we 
now  have?  Is  there  nothing  attainable  that  may  be  more 
perfect,  more  reliable,  more  useful?  Can  we  do  nothing 
but  "  illuminate,^'  comment  upon,  compare  and  classify,  or, 
perhaps,  extend  the  symptoms  now  recorded  f 

Shall  we  have  no  correction  of  errors,  no  purification, 
except  as  brought  by  the  ''  side-lights ''  of  toxicology  and 
the  slow,  halting,  stumbling  advances  of  clinical  experience? 

In  short,  is  it  not  possible  for  us  to  have  a  pure  Materia 

*  My  friend  Dr.  Dake  strangely  misanderstandfl  me  when  he  sapposes  me 
to  liken  onr  "  books  of  symptomatology "  to  '*  the  books  of  the  Bible.''  I 
pnrposely  used  the  general  term  "  sacred  books  "  as  corering  those  of  all 
religions  that  have  them ;  and  my  actaal  comparison  was  not  between  the 
two  classes  of  records  themselves,  but  related  to  the  use  it  seems  desirable  to 
make  of  them.  Drs.  Jousset  and  Espanet  would  suhstitvtt  their  expositions 
of  drug-action  for  the  pathogeneses  on  which  they  are  based.  I  deprecate 
this  proceeding ;  but  certainly  not  upon  the  ground  of  the  infallibility  or 
adequacy  of  our  present  symptomatology.  I  have  myself  applied  pretty 
"  free  handling  **  to  it  at  various  times,  and  entirely  go  with  Dr.  Dake  in  his 
endeavours  to  set  on  foot  a  systematic  and  scientific  re-proving  of  our  medi- 
cines.  I  beg  him  and  his  readers,  therefore,  not  to  consider  me  the  an- 
tagonist he  has  imagined  me  to  be,  but  his  sincere  sympathiser  md  well- 
wisher. — R.  H. 


by  Dr.  J.  P.  Dake,  17 

medica,  such  as  was  at  first  contemplated  by  HahaemaDii 
and  always  demanded  by  the  law  similia  ? 

Starting  up  from  my  musings^  and  remembering  that 
medicine  is  not  theology;  that  our  knowledge  of  drug 
properties  and  powers  comes  not  by  revelation^  but  by  ob- 
senration  and  experiment ;  that  the  methods  of  science  are 
not  the  methods  of  religion ;  that  what  we  would  have  we 
must  earn  by  dint  of  severe  application  and  study;  and 
encouraged  by  the  great  achievements  of  man  in  other 
departments  of  human  inquiry  and  labour^  I  concluded  that 
Hahnemann  was  not  a  visionary  when  he  said  we  must  learn 
the  character  and  capabilities  of  medicines  from  their  effects 
npon  persons  in  health. 

If  similia  be  the  law  of  cure^  and  if  to  obey  it  in 
practice  we  must  have  a  pure  pathogenesy,  surely  in  the 
economy  of  Providence  and  the  invariable  order  of  nature, 
the  method  and  means  for  its  attainment  cannot  be  with- 
held from  us. 

Nor  have  they  been  withheld.  In  place  of  the  master, 
with  a  few  followers,  struggling  with  poverty,  surrounded 
by  discouragements  and  bitter  opposition,  what  do  we 
behold  to-day  ? 

Thousands  of  followers  with  millions  of  clients,  among 
the  most  intelligent  and  wealthy  people  of  the  earth;  a 
number  of  well-appointed  and  well-managed  schools,  with 
hundreds  of  students,  male  and  female,  qualified  and  ready 
to  act  as  drug  provers— ^scores  of  experts,  capable  of  apply- 
ing every  necessary  test  or  means  in  the  diagnosis  of  drug 
affections,  and  good  examples  of  delicate  and  thorough 
experimentation,  with  various  agents  in  the  human,  as  well 
as  brute  organism,  in  the  search  for  physiological  facts. 
Favoured  thus  with  provers  and  means,  inducements  and 
examples,  it  may  be  asked — What  has  kept  the  Homoeo- 
pathic School  so  long  from  the  realisation  of  its  greatest 
desideratum,  a  pure  Materia  Medica  ? 

To  answer  this  question    properly  would  require   more 
space  than  allowed  me  in  a  medical  journal. 

Hahnemann,  in    his  exceeding    anxiety    to    extend  the 
armamentarium  from  which  to  draw  the  necessary  similimum, 

^OL.  XXXVIII,  NO*  CLI.— -JANVAaYi  1880.  B 


18  The  Regeneration  of  Materia  Medica. 

departed  from  the  plan  of  drag  investigation,  by  him  so 
well  shadowed  forth  in  Hufeland'e  Journal  as  early  as  the 
year  1796^  and  gathered  great  quantities  of  drug  symptoms 
from  trials  upon  the  sick^  concerning  which  he  had  so  truly 
said:* 

Either  nothing  happens,  or  there  Occur  aggravations,  changes, 
ameliorations,  recovery,  death,  without  the  possibility  of  the 
greatest  practical  genius  being  able  to  divine  what  part  the  dis- 
eased organism  and  what  the  remedy  played  in  effecting  the 
result.    They  teach  nothing  and  only  lead  to  false  conclusions. 

His  volumes  of  Chronic  Diseases  especially  display  sym- 
ptoms thus  obtained  ;  and  Jahr^s  Manual,  and  every  other 
compilation  of  drug  symptoms  having  the  same  rubric^  has 
presented  only  a  hash  and  rehash  of  the  pathogenetic  with 
the  curative^  the  direct  with  the  indirect,  so  that  we  have 
had  almost  anything  but  a  pure  Materia  Medica. 

The  followers  of  Hahnemann  who  have  undertaken  to 
prove  drugs  have  nearly  all  imitated  his  faults,  seldom 
making  the  least  improvement  upon  his  method. 

Care  has  not  been  exercised  to  exclude  the  almost 
countless  symptoms  belonging  to  individuals  of  different 
temperaments  and  habits,  and  in  various  circumstances, 
noticed  probably  for  the  first  time  by  the  self-watchings 
and  introspection  practised  while  acting  as  drug  provers. 
These  have  been  placed  to  the  credit  of  the  doses  taken  and 
passed  into  the  Materia  Medica  as  drug  symptoms  I 

Improved  means  of  diagnosis  have  rarely  been  employed 
to  ascertain  the  conditions  and  appearances,  the  deeper 
graven  lines,  of  drug  action  in  the  human  organism.  The 
subjective  has  greatly  exceeded  the  objective  and  the  un- 
certain the  certain. 

Provers  have  laboured  under  a  variety  of  disqualifications, 
besides  being  scattered  here  and  there  away  from  competent 
direction  and  scrutiny. 

Led  on  by  the  mischievous  notion  that  it  is  the  duty  of 
every  practitioner,  amidst  the  hurry  and  cares  of  profes- 
sional life,  to  act  as  a  drug  prover,  physicians  have  recorded 

•  SufeUmd'i  Journal,  vol.  ii,  part  ill,  1796. 


hy  Dr.  J.  P.  Dake.  19 

thousands  of  abnormal  thoughts  and  feelings  and  appear- 
ances in  themselves  as  drug  effects,  which  were  due  entirely 
to  the  disturbing  influences  of  the  sick-roomj  of  medicines 
handled^  and  of  numerous  other  causes  more  potent  than 
the  attenuated  doses  generally  placed  on  trial.  But  I  can- 
not enlarge.  In  the  TVansactions  of  the  American  Institute 
of  Homoeopathy  for  the  years  1857^  1873^  and  1874^  and  in 
the  transactions  of  the  World^s  Homoeopathic  Convention, 
Philadephia,  1876,  may  be  found  a  more  extended  showing 
of  the  faults  inherent  in  our  current  methods  of  developing 
drug  pathogenesy. 

IV. 

The  point  to  which  I  would  call  especial  attention  is  the 
paramount  importance  of  having /ac/«  well  ascertained  and 
carefully  sifted,  genuine  drug  symptoms,  for  Dr.  Hughes, 
Dr.  Jousset,  Dr.  Espanet,  and  others,  to  arrange  for  safe 
and  convenient  reference  in  works  upon  Materia  Medica. 

Generalisations  and  arrangements  are  of  little  worth  if 
the  symptoms  generalised  and  arranged  are  not  drug  effects. 
If  there  is  every  reason  to  believe  that  one  half  of  the 
symptoms  in  hand  are  spurious,  coming  from  other  than 
drug  influence,  the  strict  symptomatologist  will  be  puzzled 
and  led  astray  no  less  than  the  pathologist ;  and  the  writer 
of  text-books  for  the  student  and  of  manuals  for  the  prac- 
titioner must  feel  that  his  work  is  clothed  in  doubts,  and 
that  it  comes  far  short  of  the  demands  of  medical  art,  to 
say  nothing  of  the  unsatisfied  claims  of  medical  science. 

The  difSculties  realised  by  Dr.  Hughes  and  other 
teachers  in  arriving  at  the  real  character  and  sphere  and 
uses  of  the  numerous  agents  in  our  drug  armamentarium 
presented  themselves  to  me  twenty-folir  years  ago,  when  I 
stood  before  a  large  class  of  earnest  students  in  the  College 
at  Philadelphia  endeavouring  to  teach  the  homoeopathic 
Materia  Medica. 

When  I  examined  the  sources  of  our  symptomatology  and 
realised  what  they  had  been  I  was  convinced  that  a  large 
part  of  the  symptoms  recorded  must  be  due  to  other  than 


20  The  Regeneration  of  Materia  Medica. 

drug  iufluences ;  and  when  I  remembered  bow  long  it  had 
taken  the  medical  world  to  correct  errors  of  fact,  to  set 
aside  UBcless  and  mischievous  things  once  Taunted  as 
valuable  remedies,  I  had  little  courage  to  compare^  arrange^ 
and  enforce  the  materials  embraced  in  our  current  works 
upon  Materia  Medica. 

I  am  well  aware  of  what  has  been  done  since  that  day 
toward  purification  and  greater  certainty,  and  am  compelled 
to  say  that  it  amounts  to  very  little. 

I  have  contemplated  with  wonder  the  vast  labours  of 
several  writers,  notably  those  of  Dr.  Gross,  Dr.  Hering, 
and  Dr.  Allen,  in  gathering  and  arranging  thousands  upon 
thousands  of  symptoms,  placing  them  before  earnest  prac- 
titioners and  before  an  intelligent  people,  as  though  they 
were  properly  ascertained  drug  effects. 

The  fact  that  clinical  experience  during  a  period  of 
seventy  years  since  the  active  spread  of  homoeopathy  began 
has  done  little  or  nothing  toward  the  separation  of  the 
**  chaff''  from  the  wheat  in  our  symptomatology  shows  how 
useless  it  is  to  expect  purification  from  that  source. 

Dr.  Allen  in  his  great  EncycloptBdia  has  endeavoured  to 
avoid  the  spurious  by  the  aid  of  the  side  lights  of  classical 
research  and  the  rejection  of  dishonest  provings,  and  yet 
see  the  vast  amount  of  '^  chaff''  remaining. 

That  his  work  is  not  a  Materia  Medica  Pura  is  the  fault 
of  the  current  methods  of  drug  experimentation  and  not 
one  of  his  head  or  heart.  When  provings  are  properly 
made  thousands  of  symptoms  will  be  cast  away  at  the  start, 
which  being  once  published  along  with  the  genuine  can 
never  be  detected  and  cast  out  by  any  amount  of  sick-room 
experimentation.  And  not  only  will  the  worthless  be 
separated  from  the  ^good,  but  the  good  will  be  vastly 
increased  and  enhanced  in  value. 

I  cannot  regard  our  present  pathogenesy,  then^  as  at  all 
comparable  to  the  "  sacred  books  "  of  the  Bible,  as  being 
fixed  in  quality  and  quantity,  subject  to  no  improvement  or 
change  except  by  the  ''  illuminating  "  and  **  expounding " 
influences  of  literary  research  and  clinical  experience. 

I  see  little  prospect  of  a  Materia  Medica  at  all  in  keeping 


by  Dr.  J.  P.  Dake.  21 

with  the  grand  law  similia  till  the  work  of  experimentation 
is  remoTed  from  the  field  of  the  busy  practitioner  and  from 
the  hands  of  credulous  men  and  committed  to  experts^ 
supplied  with  proper  provers  and  means  of  diagnosis^  and 
laboratories,  and  means  of  publication. 

The  signs  of  the  times  are  auspicious.  A  few  weeks 
ago^  as  Chairman  of  the  Bureau  of  Materia  Medica, 
Pharmacy,  and  Provings  in  the  American  Institute  of 
Homoeopathy,  I  received  the  folio wing^communication  from 
a  society  of  high  standing  in  the  United  States.  .1 
present  it  here  as  an  evidence  both  of  the  need  and  of  the 
method  of  obtaining  a  more  reliable  symptomatology : 

Buffalo,  N.T. ;  July,  1879. 

To  the  Chairman  of  the  Bureau  of  Materia  Medica,  Pharmacy, 
and  Provings,  in  the  American  Institute  of  Homoeopathy. 

J.  P.  Dake,  M.D.,  Nashville,  Tenn., 

At  the  third  Annual  Session  of  the  American 
Ophthalmological  and  Otological  Society,  held  at  Lake  George, 
June  24th  and  25tb,  1879,  the  following  motion  prevailed : 

"  That  a  Committee  of  three  be  appointed  by  the  President  of 
the  Optbalmological  and  Otological  Society,  for  the  purpose  of 
conferring  with  the  Chairman  of  the  Bureau  of  Materia  Medica, 
Pharmacy,  and  Provings,  in  the  American  Institute  of  HomoBO- 
pathy,  with  the  view  of  perfecting  the  ophthalmic  and  aural 
examinations  during  the  proving  of  remedies." 

In  fulfilling  the  spirit  of  this  motion,  the  Committee  would 
suggest  to  the  Bureau  the  advisability,  should  it  meet  your 
approval,  of  having  careful  examinations  of  the  eye  and  ear  made 
by  specialists  before,  during,  and  after  the  action  of  the  drug ; 
the  former  to  determine  the  condition  of  the  visual  function,  of 
the  fundus,  of  the  accommodation,  of  the  refraction,  and  of  the 
extrinsic  muscles;  and  the  latter  to  show  the  state  of  the 
external  auditory  canal  and  membrana  tympani,  with  a.  careful 
record  of  the  hearing  power. 

All  of  which  is  most  respectfully  submitted. 

P.  Paek  Lewis,  M.D.,  Buffalo. 

H.  C.  HouoHTON,  M.D.,  New  York. 

W.  H.  WooDTATT,  M.D.,  Chicago. 

But  practitioners  who  treat  affections  of  the  eye  and  ear 


22  The  Regeneration  of  Materia 

are  not  alone  in  finding  our  drag  provings  insufficient  for 
their  porpose*  Complaints  have  come  also  from  gynecolo- 
gists and  from  writers  upon  affections  of  the  heart,  of  the 
langs,  and  of  the  kidneys,  time  and  again.  The  means  of 
diagnosis  daily  used  by  them  in  the  examination  of  cases 
have  not  been  employed  during  the  proving  of  remedies, 
which  they  are  endeayouring  to  apply  under  the  law  of 
similars. 

I  may  here  mention  another  hopeful  sign,  that  in  the 
University  of  Michigan,  one  of  the  foremost  educational 
institutions  of  America,  the  Regents  have  inaugurated  a 
department  of  ''  Experimental  Pathogenesy  "  in  connection 
with  the  Chair  of  Materia  Medica  in  the  Homoeopathic 
College.  The  friends  of  this  movement  look  forward  to 
the  time  when  the  State  of  Michigan  shall  appropriate 
sufficient  funds  to  render  the  experimental  department  of 
great  practical  benefit  to  the  medical  world. 

If  the  practitioners  and  lay  friends  of  homoeopathy  in 
England  and  the  countries  of  Europe  and  America  would 
unite  their  energies  and  means  in  the  promotion  of  such 
work,  only  a  few  years  would  pass  till  we  would  have  a 
Materia  Medica  such  as  Hahnemann  dreamed  of,  and  such 
as  would  render  his  law  similia  of  much  greater  practical 
benefit  to  suffering  humanity  than  it  has  yet  become. 

In  conclusion  I  must  be  allowed  to  say,  and  to  say  with 
emphasis,  that  our  Materia  Medica  needs  not  only  to  be 
reconstituted,  but  regenerated  ;  so  that  in  making  patho- 
logical deductions,  comparative  arrangements,  repertories, 
epitomes,  comments,  and  illustrations,  we  may  have  some 
assurance  that  we  are  dealing  with  things  probable  and 
not  simply  possible  in  drug  symptomatology. 


23 


EFFECTS    OF   POISONS. 

(Ctrntimtedfrom  Vol.  JLSIZn,  p  .Za6.) 

Sausage  poUoning — botulismus — allantiasis.  -^  Attempts 
to  ascertain  and  separate  the  toxical  agent  in  this  form 
of  poisoning  have  hitherto  completely  failed^  and  all 
is  conjecture  regarding  its  nature.  The  search  in  this 
direction  cannot  be  aided  by  experiments  on  the  lower 
animals^  as  it  seems  to  be  man  alone  who  is  susceptible  of 
its  action.  Whatever  the  nature  of  the  poison  may  be  it 
is  probably  the  result  of  the  slow  putrefaction  of  animal 
substances.  The  disease  it  produces  is  quite  peculiar.  It 
is  geographically  limited  to  a  few  localities.  Most  of  the 
cases  have  occurred  in  the  Black  Forest;  fewer  in  other 
parts  of  Grermany ;  only  two  are  recorded  as  having  oc- 
curred in  France^  and  one  only  in  England.  It  is  sup- 
posed that  something  faulty  in  the  mode  of  preparing 
sausages  in  Swabia  leads  to  the  development  of  a  poisonous 
matter  in  them^  but  all  statements  on  this  sutqect  are 
guesswork.  Sausage-poisoning  generally  attacks  several 
members  of  a  family  who  have  partaken  of  the  tainted 
food.  The  disease  generally  runs  a  subacute  or  chronic 
course.  The  first  symptoms  usually  occur  in  from  eighteen 
to  twenty-four  hours.  The  sufferers  complain  first  of 
general  discomfort  and  nausea^  pain  and  weight  in  stomach , 
followed  by  diarrhoea  and  vomiting  ;  often  colicky  pains  are 
the  first  symptoms.  Sometimes  the  affection  commences 
with  vomiting,  retchings  vertigo^  cloudiness  of  vision,  and 
difficulty  of  swallowing.  Again,  the  gastro-intestinal  sym- 
ptoms may  be  absent^  and  the  other  symptoms  just  men- 
tioned, with  muscular  weakness,  may  constitute  the 
disease.  Dyspnoea  and  prsecordial  anxiety  are  often  among 
the  early  symptoms.  In  the  majority  of  cases  there  is  seen 
so  much  weakness  that  the  patient  must  keep  his  bed. 
The  vomiting  and  other  gastric  symptoms  decline  or  cease 
and  give  place  to  the  nervous  symptoms.     These  are  giddi- 

•  Month,  Mom.  £09.,  1869,  p.  340, 


24  Bffeeti  of  Paisom . 

ness,  headache^  and  an  apathetic  comatose  condition.  The 
weakness  is  not  definite  paralysis^  but  only  extensive  mas- 
cnlar  weakness.  There  are  sometimes  complaints  of  dimi- 
nished sensibility  of  the  finger  tips  and  crawling  feelings  in 
extremities  and  back.  The  most  extraordinary  symptoms 
are  those  of  the  visual  apparatus.  There  is  diminished 
visual  power,  with  cloud  or  mist  before  eyes,  and  sometimes 
sparks.  Very  soon  double  vision,  the  powers  of  the  ocular 
muscles  are  greatly  diminished,  and  there  is  often  ptosis. 
Sometimes  the  rectus  externus  is  paralysed.  The  pupils 
are  dilated  and  the  accommodation  greatly  lessened.  Some- 
times total  blindness  has  occurred.  There  is  generally 
more  or  less  aphonia  and  a  croupy  cough.  The  dysphagia 
often  culminates  in  perfect  aphagia.  The  tongue  is 
hampered  in  its  movements  and  speech  becomes  stammering 
and  unintelligible.  There  is  great  dryness  of  mouth,  a 
diffused  or  speckled  redness  of  the  mucous  membrane  of 
mouth  and  pharynx,  sometimes  aphthous  formations,  and 
the  tongue  has  a  whitish  coat.  There  is  constantly  consti- 
pation, and  occasionally  retention  of  urine.  The  patients 
often  complain  of  hunger,  but  the  dysphagia  prevents 
nourishment  being  taken.  Thirst  is  rare.  The  pulse 
grows  feeble  and  slow,  sometimes  vanishes  altogether.  The 
skin  is  pale  and  mucous  membranes  livid.  The  surface  feels 
cold.  There  is  rapid  emaciation  caused  by  inability  to 
swallow,  the  attempt  to  do  so  often  bringing  the  food  into 
the  windpipe.  Death  is  generaUy  preceded  by  a  comatose 
or  soporous  condition,  sometimes  with  slight  general  convul- 
sions. Those  cases  that  recover  have  a  very  slow  conval- 
escence, in  which  the  disorders  of  vision  and  the  dysphagia 
often  persist  long,  and  the  strength  is  long  of  returning. 
The  post-mortem  appearances  are  of  a  negative  character. 

Poisonous  cheese, — The  effects  are  colicky  pains,  vomit- 
ing, diarrhoea,  disgust  at  food,  vertigo,  anxiety,  diplopia, 
headache,  weariness,  and  muscular  weakness.  The  affec- 
tion sometimes  terminates  fatally. 

Poisoning  by  Metals  and  their  Salts* 
Lead. — Acute  poisoning  may  be  caused  by  the  use  of 


Effects  of  Poiions.  25 

badly-glazed  earthenware  ;  of  metallic  vessels  soldered  with 
impure  solder  containiDg  lead  ;  also  by  partaking  of  food 
coloured  with  lead  pigments,  and  in  children  after  licking 
playthings^  visiting  cards^  &c.,  covered  with  lead  paints. 
Infants  have  been  poisoned  by  rubber  nipples  coloured  with 
white  lead.  The  quantity  of  sugar  of  lead  required  to 
produce  severe  or  fatal  poisoning  is  from  two  to  three 
drachms  and  upwards.  The  symptoms  are  those  of  corro- 
sive gastritis.  The  milder  cases  are  often  only  shown  by 
obstinate  constipation.  The  course  is  always  very  acute, 
death  or  recovery  taking  place  in  from  twenty-four  hours 
to  a  few  days.  Post-mortem  appearances, — Those  of  acute 
gastro-enteritis,  the  mucous  membrane  is  covered  with 
tough  white  coagula,  the  tissue  beneath  is  red  and  softened. 
The  best  antidotes  are  the  alkaline  sulphates ;  when  these 
are  not  at  hand  milk  and  white  of  egg  are  useful. 

Chronic  lead  poisoning. — This  may  be  produced  by  the 
prolonged  administration  of  moderate  doses  of  sugar  of 
lead,  by  the  use  of  plasters  containing  lead,  by  the  contact 
of  the  metal  in  the  manufacture  of  white  lead,  bv  white- 
and  red-lead  paints,  by  the  lead  weights  used  in  loom 
weaving,  by  handling  gas-  or  water-pipes,  or  types,  by  the 
glaze  used  in  pottery,  by  the  colours  used  for  tinting 
papers,  by  the  lead  preparations  used  in  colouring  bristles 
and  making  enamel.  Cosmetics  containing  lead,  ill-glazed 
crockery,  beer  drawn  through  lead  pipes,  beer  and  wine  in 
bottles  in  which  are  some  shots  (used  to  clean  bottles), 
snuff  packed  in  spurious  tin-foil,  hair-inattresses  in  which 
the  hair  has  been  dyed  black  by  lead,  have  all  caused 
chronic  lead  poisoning.  Water,  especially  soft  water, 
flowing  through  lead  pipes  or  kept  in  lead  cisterns,  or 
wooden  ones  painted  with  lead  colours,  has  frequently 
caused  chronic  poisoning.  [Another  cause  of  lead  poisoning 
has  lately  been  discovered  by  Dr.  Alford,  of  Taunton — 
bread  ground  by  millstones,  the  cracks  or  holes  in  which 
have  been  stopped  up  with  lead.] 

Persons  affected  with  chronic  lead  poisoning  have  skin  of 
a  yellowish  hue,  and  usually  a  thick  black  line  on  the 
edges  of  the  gums,  most  strongly  marked  on  the  upper 


26  BffecU  of  Poi$am$. 

jaw.  The  pfttieiits  experience  an  insipid  sweetiali  taste^  and 
hare  werj  fetid  breath,  and  oecaaionally  Terj  slow  polae. 
Emaciation  is  generally  obaerred.  The  lead  disease  as- 
somes  four  principal  forms: — 1,  coBc,  2,  arthralgia, 
S,  paralysisy  4,  enoephal<^athia  and  amanrosis  satnmina. 
Of  these  the  coHc  is  the  most  freqnent^  and  the  other 
forms  are  less  frequent  in  the  order  just  given. 

Lead  coUc^^lt  sometimes  comes  on  suddenly,  but 
generally  after  weeks  of  moderate  wandering  pains,  some- 
times soon  after  eating,  but  often  independent  of  food. 
There  is  loss  of  appetite,  sweetish  taste,  constipation  or 
diarrhoea.  The  actual  colic  lasts  only  for  a  few  minntes,  bat 
there  is  besides  continual  griping  and  cramp  in  the  bowels. 
Pressure  usually  relicTes  the  pain.  The  seat  varies; 
generally  it  is  about  the  navel,  but  sometimes  in  the  upper 
or  lower  part  of  the  abdomen,  and  rarely  in  the  kidneys. 
There  is  often  tenesmus  present,  sometimes  strangury  or 
retention  of  urine,  and  some  pain  extending  along  ureters  or 
spermatic  cord  to  kidneys  or  penis,  also  shooting  pains  in 
breasts.  Retraction  of  the  abdomen  and  constipation  are 
seldom  absent.  This  retraction  is  often  so  great  that  the 
bodies  of  the  vertebrae  can  be  seen  through  the  skin  of  the 
abdomen.  Sometimes  there  is  swelling  of  the  abdomen  and 
sometimes,  in  place  of  constipation,  diarrhoea.  Violent 
vomiting,  preceded  by  ineffectual  retching,  is  a  common 
occurrence.  It  generally  occurs  during  the  remission  of 
the  colicky  pains.  The  vomited  matters  are  usually  mixed 
with  bile.  There  is  generally  slight  jaundice.  The  pulse 
is  peculiar;  it  is  often  diminished  to  thirty  beats  per 
minute  and  irregular  in  frequency,  but  not  intermittent. 
Respiration,  on  the  other  hand,  is  quickened.  There  is 
little  or  no  fever.  The  appetite  is  diminished,  the  urine 
usually  concentrated,  and  often  contains  albumen.  The  colic 
and  sdl  the  symptoms  are  worst  at  night.  Relapses  are 
frequent  after  days  or  weeks.  The  .  duration  of  the 
disease  is  usually  not  more  than  a  week,  but  it  may  be 
much  prolonged  by  frequent  relapses.  Prognosis  usually 
favourable. 

Arthralgia  fafurmna.— After  prodromata  similar  to  those 


Effects  of  Poisons.  27 

of  colic  or  without  prodroma  there  come  tearing  and 
burning  pains  in  the  joints  or  the  muscles  over  them. 
These  pains  have  violent  exacerbations  and  remissions  until 
they  completely  disappear.  The  exacerbations  are  accom- 
panied by  cramps.  The  attacks  are  brought  on  by  excesses 
and  cold.  Pains  diminished  by  pressure.  There  are  no 
inflammatory  appearances.  The  joints  chiefly  affected  are 
those  of  the  lower  extremities,  especially  the  knees.  The 
muscles  oftenest  attacked  are  the  flexor  muscles.  The 
smaller  joints  are  rarely  affected.  There  is  often  a  tremor 
in  the  muscles  affected.     Prognosis  favourable. 

Lead  paralysis. — It  often  occurs  after  colic  or  arthralgia^ 

but  may  come  on  without  these  affections.     The  paralysis 

may  occur  as  early  as  the  third  day  of  exposure  to  lead,  or 

it  may  not  be  seen  until  after  fifty  years  of  exposure.     The 

upper  extremities  and  extensor  muscles  are  most  frequently 

affected.     Paralysis    of  the   extensors   of   the   hand   and 

fingers  with  freedom  of  the  supinator  is  the  best  known 

form  of  the  paralysis^  next  the  triceps  and  deltoid  are  most 

frequently    attacked.       When   the   lower    extremities    are 

involved  the  corresponding  extensor  muscles  are  the  seat  of 

the  affection.     Only  in  rare  cases  are  the  intercostal  and 

laryngeal  muscles  affected.     The  muscles  affected  do  not 

correspond  with  the  distribution  of  the  nerves.     Thus,  in 

the  common  paralysis  of  the  hand  and  fingers  the .  muscles 

involved  are,  as  a  rule,  those  supplied  by  the  radial  nerve, 

but  other  muscles  receiving  branches  of  this  nerve  remain 

unaffected.     Generally  the  limbs  of  both  sides  are  affected, 

and  the  same  muscles  in  both.     The  paralysis  is  sometimes 

confined  to  one  finger,  and  sometimes  it  spreads  over  all 

the  muscles  of  the  limb  and  even  over  the  whole  body. 

Sensibility  is  usually  unaffected  ;  often  there  are  pains  in 

the  affected  muscles  and  their  bones;  sometimes  there  is 

anaesthesia  of  the  skin  corresponding  to  the  distribution  of 

the  paralysis.  The  affected  muscles  rapidly  become  atrophied. 

The  muscles  may  lose  their  power  of  reaction  to  electrical 

currents.      Sometimes  there  is   tremor  of  the    paralysed 

muscles.     Usually  it  occurs  after  or  along  with  colic  or 

encepholopathy,  but  sometimes  without  any  prodroma, 


28  EffecU  of  Poisons. 

Encephalspaihia  saiwmina.  ~-  This  indndes  eclampsia, 
amaurosis,  maniacal  exatement^  stupor,  and  coma.  There 
is  often  albuminuria  along  with  it.  It  is  only  met  with  in 
cases  of  workmen  who  have  been  absorbing  large  quantities 
of  lead.  Poet*mortem  iuTestigations  have  only  yielded 
negatire  results.     Prognosis  always  unfsTourable. 

CoppsE  POISONING.— The  chief  sources  of  copper  poisoning 
•  are  cooking  food  in  copper  vessels,  and  colouring  confec- 
tionery and  fruits,  vegetables  and  pickles,  with  copper  pig* 
ments.     Oysters  in  beds  near  copper  deposits  sometimes 
contain  a  considerable  amount  of  copper. 

Acute  copper  poisoning. — ^The  symptoms  are  those  of 
severe  gastro-enteritis,  there  are  also  in  many  cases  some 
tenesmus  and  pains  in  the  large  intestine.  The  nerrous 
centres  sympathise.  Convulsions  frequently  come  on. 
Tetanus  is  said  by  some  to  be  a  fretjuent  occurrence. 
Some  think  that  a  scorbutic  condition  may  result  from  a 
protracted  case  of  acute  poisoning.  Post-mortem  shows 
intense  inflammation  of  the  mucous  membrane  of  the 
stomach,  sometimes  extending  downwards  to  the  duodenum 
and  upper  part  of  the  small  intestine. 

Chronic  copper  poisoning. — This  is  only  observed  among 
workers  in  copper  and  brass.  The  symptoms  are  very 
undecided.  Some  say  there  is  a  purple-red  line  at  the 
edge  of  the  gums.  Occasionally  there  is  gastro-intestinal 
catarrh,  and  one  case  of  copper  paralysis  has  been  recorded. 

Zinc  poisoning. — The  chloride  of  zinc  is  a  corrosive 
poison  of  the  most  virulent  character,  and  causes  symptoms 
analogous  to  those  caused  by  other  corrosive  poisons.  The 
sulphate  is  not  corrosive  but  irritant,  and  is  often  used  as 
an  emetic  in  the  dose  of  from  fifteen  grains  to  one  drachm. 
The  gastric  symptoms  are  not  very  distinctive,  and  there  are 
occasionally  nervous  symptoms  just  as  little  characteristic. 
In  one  case  of  poisoning  by  Chloride  of  Zinc  albuminuria 
and  hsematuria  were  observed.  The  chronic  poisoning 
observed  in  factories  consists  of  emaciation,  dyspnoea,  colics 
with  constipation  or  diarrhoea,  muscular  pains,  and  contrac- 
tions. 

Silver  poisoning. — Chronic  poisoning  is  observed  from 


Effects  of  Poisons.  29 

the  prolonged  medicinal  use  of  the  nitrate.  The  first  sign 
is  a  blaish  line  on  the  gums,  as  in  lead  poisonings  but  the 
most  characteristic  symptom  is  Argyria^  i.  e.  discoloration 
of  the  skin  and  mucous  membranes.  The  skin  assumes  a 
livid  bluish-grey  colour,  deeper  on  those  parts  exposed 
to  light.  Symptoms  of  gastro-intestinal  catarrh  and 
albuminuria  have  also  been  observed.  The  discoloration  of 
the  skin  and  other  parts  is  owing  to  the  deposit  of  metallic 
silver  granules. 

Mercueial  poisonino. — The  corrosive  preparations  of 
Mercury  are  Corrosive  sublimate  and  Mercuric  nitrate. 
Three  grains  of  the  former  have  in  some  instances  proved 
fatal  to  children  and  adults.  But  there  are  sublimate  eaters 
in  the  East  who,  by  its  habitual  use^  are  enabled  to  consume 
enormous  doses  without  injury.  One  of  them  is  said  to 
have  taken  as  much  as  two  scruples  of  sublimate  daily. 
The  action  is  said  to  be  similar  to  that  of  Ojnum^  only 
more  exciting. 

Corrosive  sublimate  causes  great  corrosion  of  the  mucous 
membrane  of  the  mouth,  oesophagus,  stomach,  and  intes- 
tines, and  develops  gastro-enteritis  of  the  severest  form. 
There  is  pain  in  mouth,  throat,  oesophagus^  and  stomach, 
violent  vomiting  and  diarrhoea,  with  painful  tenesmus,  and 
often  bloody  evacuations.  There  is  often  suppression  of 
urine,  the  greatest  prostration,  and  even  collapse.  It 
sometimes  affects  the  larynx,  causing  hoarseness  and  dys- 
pnoea. Death  may  take  place  in  from  half  an  hour  to  twelve 
hours.  If  the  patient  lives  longer  than  twenty-four  hours 
salivation  sometimes  occurs.  Post-mortem  shows  corrosive 
gastro-enteritis ;  the  mucous  membrane  of  the  mouth, 
throat,  and  oesophagus,  is  inflamed,  wrinkled^  and  covered 
with  a  white  coat.  The  mucous  membrane  of  the  stomach, 
especially  near  the  pylorus,  is  converted  into  dark,  tough 
eschars.  Sometimes  there  is  ulceration,  and  perforation 
may  ensue.  The  small  intestines  are  usually  normal,  but 
in  the  large  intestines  inflammation,  ulceration,  and  hsemor^* 
rhage,  are  often  seen. 

Chronic  mercurial  poisoning. — Although  pure  Metallic 
mercury  may  be    swallowed    in    large  quantities    without 


do  Sffecti  of  Potions. 

injury,  when  rabbed  up  with  fatty  substances  it  is 
readily  taken  into  the  circulation,  producing  physiological 
effects.  In  the  form  of  blue  pill  Metallic  mercury  is  also 
much  used.  Other  preparations  of  Mercury  are  also  em- 
ployed internally,  as  Calomel,  Mercurous  iodide,  and  Mer- 
curic iodide.  In  the  form  of  vapour  Mercury  is  also 
introduced  into  the  system,  as  in  the  workers  in  quicksilver 
mines  and  smelting  works,  those  engaged  in  manufacturing 
mirrors,  gilding,  &c.  The  vapour  from  Mercury  spilled  in 
a  shop  or  a  room  is  capable  of  producing  poisonous  effects. 
The  symptoms  of  chronic  mercurial  poisoning  by  any  of 
these  preparations  are  very  various.  These  are  eczema, 
anaemia,  rheumatoid  pains,  chronic  gastric  catarrh, 
enteritis,  diarrhoea  with  colicky  pains,  tenesmus,  evacuations 
slimy  and  bloody,  stomatitis,  salivation,  swelling  of  gums, 
fetid  breath,  croupous  exudations  on  gums,  with  ulceration 
beneath,  necrosis  of  the  jaw,  and  peculiar  fever.  Mercu- 
rial erethism  is  often  noticed,  characterised  by  great  mental 
excitability,  great  anxiety,  stammering  speech,  sleeplessness, 
frightful  dreams,  headache^  palpitation,  twitching  of  facial 
muscles.  Mercurial  tremor  is  of  various  degrees.  When 
severe  it  resembles  paralysis  agitans.  Convulsive  twitchiugs 
in  various  parts.  The  trembling  ceases  during  sleep.  Para- 
lysis often  comes  on  from  the  trembling ;  when  com- 
plete the  tremor  ceases.  Neuralgic  pains,  such  as  violent 
headache  and  toothache,  dragging  and  tearing  pains  in  the 
limbs.  Oppression  of  chest,  even  to  asthma.  Miscarriage  of 
pregnant  women.     Dropsy  and  albuminuria. 

Poisoning  by  Antimony.— Tartar  emetic  is  the  form  of 
the  metal  usually  employed  to  produce  poisoning.  The 
symptoms  are  those  of  severe  gastro-enteritis,  some  pain 
in  the  mouth,  throat,  and  along  the  oesophagus  to  the 
stomach.  Collapse  soon  appears.  In  some  cases  genuine 
tartar  emetic  pustules  are  developed  from  its  internal 
ingestion.  Post-mortem  examination  shows  gastritis, 
haemorrhage,  exudation,  and  infiltration  into  the  mucous 
membrane  of  the  stomach,  and  abundant  haemorrhage  into 
the  intestines.  Slight  ulceration  of  the  mucous  membrane 
of  the  bowels  has  frequently  been  seen. 


Mffect9  of  Poisoni.  31 

Poisoning  by  Saints  of  Iron. — This  is  rare.  A  gas- 
tritis of  slight  intensity  has  been  observed^  with  vomiting 
and  purging. 

Poisoning  by  Manganese. — It  is  said  to  caase  death  by 
paralysis  of  the  heart. 

Poisoning  by  Preparations  of  Chromium. — Workers 
who  handle  solutions  of  the  chrotnates  or  chromic  acid 
suffer  from  ulceration  of  the  hands  and  of  the  mucous 
membrane  of  the  nose  and  scrotum.  Internally  taken 
they  cause  severe  corrosive  gastro-enteritis^  evidently  owing 
to  their  escharotic  action. 

Poisoning  by  Tin. — Only  two  cases  are  known.  The 
symptoms  are  those  of  corrosive  gastro-enteritis.  Orfila 
says  it  causes  convulsions  and  paralysis. 

Poisoning  by  Bismuth. — Lebedeff  says  that  glycogen 
disappears  from  the  liver  after  long-continued  feeding  with 
bismuth. 

Poisoning  by  Thallium. — This  is  said  to  be  a  muscular 
and  cardiac  poison. 

(To  he  oofdinmed). 


S2 


REVIEWS. 


Die  Homoopathie  am  Krankenbette  erprobt.  Von  Dr.  Paul 
Sick,  Ist  Theil :  Die  Homoopathie  im  Diakotdssenhause 
zu  Stuttgart.     Stuttgart,  1879. 

The  post  of  physician  to  the  hospital  of  the  Deaconesses 
Institution  at  Stuttgart  haying  become  vacant  in  the  spring 
of  1866,  by  the  promotion  of  the  actual  physician  to  the 
Katharine  Hospital,  the  governing  committee  chose  Dr. 
Sick  for  the  vacant  post,  although,  or  we  may  perhaps  say 
because,  he  was,  though  a  young  man,  a  known  adherent 
of  the  homoeopathic  heresy. 

The  book  before  us  is  an  account  of  Dr.  Sick's  expe- 
rience in  the  homoeopathic  treatment  of  the  patients 
admitted  to  the  hospital  during  thirteen  years.  The 
hospital  is  described  by  the  author  as  being  provided  with 
everything  necessary  for  a  hospital.  The  number  of  beds 
for  the  reception  of  patients  from  without  is  thirty-six, 
but  the  space  available  would  allow  them  to  be  increased 
to  fifty.  There  are  besides  nine  beds  in  the  hospital  for  the 
sisters,  who  are  about  200  in  number. 

The  class  of  patients  admitted  to  the  hospital  is  not  the 
most  favourable  for  cure,  they  being,  for  the  most  part, 
elderly  persons  afflicted  with  chronic  maladies,  who  have 
taken  refuge  in  the  hospital  in  order  to  get  a  home  and 
care  for  their  declining  years.  Acute  cases  are  certainly 
admitted,  but  they  seldom  come  at  the  commencement  of 
their  illness,  but  usually  only  after  having  been  treated  for 
a  considerable  time  in  their  own  homes.  Hence  the 
statistical  table  that  Dr.  Sick  gives  of  the  cases  treated  by 
him  during  those  years  does  not  show  any  remarkable  results 
in  the  way  of  average  mortality,  but  the  general  character 
of  the  class  of  patients  admitted  may  be  judged  of  when  we 
mention  that  there  were  176  cases  of  phthisis,  64  cancers, 
111   put  down  as  poverty  of  blood  and  general  nervousness 


Dr.  Side's  Homeopathic  Treatment.  33 

(whatever  these  expressions  may  meRn)^  and  only  50  cases 
of  pneumonia  and  28  of  pleurisy. 

Dr.  Sick  has  special  chapters  on  twenty  of  the  chief 
diseases  treated  at  the  hospital  during  his  thirteen  years' 
service. 

The  first  disease  he  considers  is  typhus  (meaning  by  that 
term  what  we  call  typhoid).  But  the  cases  he  gives  have 
little  bearing  on  the  merits  of  the  homoeopathic  treatment. 
In  fact^  Dr.  Sick  does  not  believe  that  any  medicinal  treat- 
ment is  equal  to  the  cold-water  treatment  of  typhus^  and  he 
gives  us  a  few  cases  treated  on  the  method  of  Brand  by 
cold  baths  every  two  hours^  but  with  the  exception  of  one^ 
the  first,  they  do  not  seem  to  us  to  show  anything  beyond 
the  patient's  powers  of  endurance^  for  they  were  followed 
by  some  serious  symptoms,  such  as  haemorrhage  from  the 
lungs  or  bowels  or  other  serious  accidents,  which  compelled 
them  to  be  abandoned  and  other  treatment  resorted  to. 
However,  we  must  not  judge  of  the  efficacy  of  the  cold- 
bath  treatment  of  typhoid  by  the  scanty  statistics  the 
author  can  furnish.  There  is  no  doubt  that  in  the  hands 
of  Brand,  Jiirgensen,  Liebermeister,  and  others,  it  has 
proved  a  most  valuable  curative  means,  reducing  the  mor- 
tality in  the  hospitals  from  20  and  30  per  cent,  to  3  and  9  per 
cent.  In  the  face  of  these  well-known  facts  it  is  curious  to 
observe  the  estimate  of  the  value  of  the  cold-bath  treat- 
ment of  typhoid  made  by  Sir  W.  Jenner  in  his  lecture  on 
typhoid  fever  in  the  Lancet  for  15tb  November,  1879. 

"  The  treatment  of  typhoid  ieyer"  he  says,  "  by  cold  baths  when 
the  temperature  reaches  104^,  or  even  less,  is  very  greatly 
adopted  in  G-ermany  ;  but  neither  my  own  limited  experience, 
nor  the  evidence  adduced  by  others  in  its  favour,  has  carried 
conviction  to  my  mind  of  its  advantage." 

From  this  passage  we  must  conclude  that  in  Sir  W. 
Jenner's  hands  the  mortality  from  typhoid  is  under  3  or  at 
most  9  per  cent.  We  are  more  modest,  and  will  not  claim, 
even  for  homoeopathy,  as  low  a  percentage  of  mortality  as 
that  obtained  by  many  of  the  practitioners  of  the  cold-bath 
treatment.     We  subjoin  Dr.  Sick's  first  case  of  typhoid, 

VOL.  ZXXVIII,  NO.  CLI. — JANUARY,   1880.  •  C 


34  Reviews. 

which    is    a  good    instance  of    his    way  of    relating  his 
histories  of  cases  : 


"  E.  L — ,  a  student,  19  years  of  age,  was,  until  the  end  of  the 
third  week,  under  the  medical  treatment,  of  no  very  active 
character,  of  another  physician,  and  his  relations,  having  heard  of 
the  excellent  effects  of  the  water  treatment  in  other  cases, 
placed  him  under  the  care  of  the  author,  in  the  following  hopeless 
state  : — Extreme  weakness,  pale,  pinched  countenance,  jaw  hang- 
ing down,  constant  stupefaction,  can  scarcely  swallow  even  fluids, 
and  has  a  temperature  of  41-2°  C.  (105-8°  F.).  [S.  always  took 
the  temperature  in  the  rectum,  which  may  give  perhaps  1^ 
higher  temperature  than  in  the  axilla.]  Finding  that  there  wasa 
complication  with  disease  of  an  important  organ,  I  resolved  to 
try  the  cold  haths.  On  communicating  my  intentions  to  the 
directing  deaconess,  who  had  seen  many  cases  of  typhoid,  she 
asked, '  What  was  the  use  ?  The  patient  must  necessarily  die  soon 
and  it  would  he  said  that  I  had  killed  him  with  the  water.'  I 
persisted,  and  he  was  put  into  a  hath  with  the  water  at  15^  B. 
up  to  the  axillae,  and  tea  jugs  of  water  at  S°  B.  were  poured  over 
his  head  and  hack,  until  a  severe  chill  came  on,  which  happened 
generally  in  from  five  to  ten  minutes.  The  haths  were  at  first 
repeated  every  two  hours.  On  the  second  day  of  this  treatment 
the  patient  could  hardly  he  recognised.  He  was  perfectly 
conscious,  ate,  slept  naturally,  spoke,  could  assist  himself  a 
little,  in  short,  the  most  threatening  symptoms  were  all  gone. 
A  congestion  of  the  lung  which  occurred  on  the  fifth  day  of  the 
treatment  soon  went  off  again.  On  the  tenth  day  the  bathing 
could  be  left  off;  on  the  thirteenth,  he  was  free  [&om  fever.  A 
recrudescence  of  the  fever  (temp  41*3^)  from  eating  something 
indigestible,  which  he  afterwards  vomited,  soon  went  off  without 
any  remedy  besides  an  appropriate  diet,  and  the  patient  left  the 
house  a  few  week  later,  qidte  well  and  strong.'* 

But^  however  interesting  the  cases  of  typhoid  treated  by 
cold  baths  may  be  in  themselves^  and  however  much  the 
author  may  prefer  this  treatment  to  aught  medicinal^  our 
readers  will  hardly  thank  us  for  dwelling  long  on  this  part 
of  Dr.  Sick's  treatment.  So  we  shall  now  proceed  to  the 
next  section^  which  is  devoted  to  acute  rheumatism.  Dr. 
Sick  admits  the  specific  power  of  Salicylic  acid  in  rheuma- 


Dr.  Sick^s  Homoeopathic  Treatment,  '  35 

tism^  and  asserts  that  its  employment  in  the  Stuttgart 
Katharine  Hospital  was  followed  by  a  reduction  of  the 
average  duration  of  the  disease  by  nearly  seven  days^  but 
then^  he  says^  this  was  in  comparison  with  the  ordinary 
allopathic  treatment  with  quinine  and  morphia,  and  not  with 
a  specific  treatment.  He  doubts  if  the  salicylic  treatment 
is  superior  to  the  established  homoeopathic  treatment,  and 
he  says  that  if  Salicylic  acid  is  specific  in  the  high  tempe- 
rature of  acute  rheumatism,  it  is  so  by  virtue  of  its  homoeo- 
pathidty,  as,  according  to  Wolfsohn,  when  given  to  the 
healthy  it  raises  the  temperature  of  the  body.  The  trium- 
phal shouts  with  which  Salicylic  acid  was  at  first  received 
as  a  specific  for  rheumatism  have  not  been  altogether 
justified  by  experience,  for  in  spite  of  its  use  many  cases 
last  as  long  as  under  ordinary  treatment,  and  heart  and 
other  complications  are  far  from  unknown.* 

The  cases  treated  by  Dr.  Sick  included  among  them 
some  of  the  severest  character.  One,  a  youth,  aged  twenty, 
after  having  already  gone  through  an  attack  of  acute 
rheumatism  with  moderate  febrile  symptoms,  was  attacked 
with  endo-  and  pericarditis,  pleuritis,  peritonitis,  and  inflam- 
mation of  the  joints,  including  those  of  the  vertebrae,  and 
sternum.  The  functional  derangements  consequent  on  the 
cardiac  affection  were  very  severe,  the  skin  was  cold  and 
blue,  and  life  was  in  serious  danger.  The  treatment  lasted 
seventy-six  days,  but  the  patient  was  dismissed  in  the  most 
satisfactory  condition.  In  cases  of  very  elevated  tempe- 
ratmre  in  rheumatic  fever  Dr.  Sick  employs  the  cold  baths. 
One  case  had  nine  such  baths  within  forty-eight  hours,  with 
the  effect  of  bringing  down  the  temperature  permanently 
from  41'2°  C.  to  89*8°  C,  and  without  further  employment 
of  the  bath  the  temperature  became  normal  in  three  days. 
Dr.  Sick^s  medical  treatment  seems  to  be  of  the  most 
ordinary  homoeopathic  kind — Aconite,  Bryonia,  Spigelia  (for 
heart  complication),  and  Sulphur. 

Eleven  cases  of  scarlatina  were  treated,  and  all  recovered. 
They  are  unimportant  cases  occurring  in  grown-up  persons. 
On  the  other  hand.  Dr.  Sick  speaks  of  an   epidemic  of 

*  DU  Wvrhung  der  SalicyUawre  cmfden  SiofftoechtBl,  Kdnigsberg,  1876. 


36  Reviews, 

scarlatina  of  a  very  malignant  character  which  he  witnessed 
in  Stattgart  in  1862  and  1863.  In  this  epidemic  BeUadwna 
was  of  no  use  either  as  a  curatiTe  or  a  prophylactic.  The 
disease  was  of  a  typhoid  character^  and  Rhus  and  Areenic^ 
with  the  energetic  employment  of  cold  water^  proved  most 
serviceable.  Bright's  disease  was  a  common  consequence 
of  the  disease.  Besides  the  urinary  symptoms,  ursemic 
poisoning  showed  itself  in  some  cases  by  convulsions,  dis- 
turbance of  the  vision,  and  sopor.  The  remedy  for  this 
was  Phosphorus.  Dr.  Sick  is  not  aware  if  Phosphorus  . 
has  ever  hitherto  been  employed  for  Bright's  disease  and 
ursemia.  The  result  of  post-mortem  examinations  in  causes 
of  Phosphorus  poisoning  has  shown  that  it  can  produce  a 
state  of  the  kidneys  very  similar  to  that  in  Bright^ s  disease, 
so  that  he  alleges  his  treatment  in  these  cases  to  have  been 
distinctly  homceopathic.  It  would  be  better,  we  think,  to 
apply  some  such  name  as  acute  desquamative  nephritis  to 
the  kidney  affection  following  scarlatina,  and  reserve  the 
name  of  BrighVs  disease  (if  it  must  still  be  retained)  for  the 
chronic  form  of  nephritis,  which  has  been  so  thoroughly 
studied  of  late  years.  "  Bright's  disease  *'  has,  off  and  on, 
been  used  to  designate  such  a  large  number  of  dissimilar 
diseases,  having  nothing  in  common  but  albuminuria,  that 
we  think  the  less  it  is  employed  the  better. 

Diphtheritis  (of  which  but  eight  cases  were  treated  in 
the  hospital)  is  a  disease  for  which  the  author  thinks  he 
has  found  the  specific  remedy  in  Hepar^  one  dose  of  which 
(after,  perhaps,  a  preliminary  dose  of  Aconite  or  Belkuionna, 
according  to  indications)  he  considers  sufficient  for  the  cure 
of  the  whole  disease.  We  wish  sincerely  this  were  so,  but 
the  case  he  gives  in  illustration  of  his  practice  does  not 
appear  to  us  satisfactory.     Here  it  is  : 

"  M.  W — ,  a  Jady*s  maid,  otherwise  healthy,  took  ill  on  the 
29th  April,  1877,  with  fever  and  sore  throat,  and  as  the  physician 
in  attendance  considered  the  disease  diphtheria,  he  sent  the 
patient  into  the  Deaconesses'  Hospital  on  May  2nd.  The  malady 
was  confined  to  the  tonsils,  which  were  covered  by  thick  greyish- 
white  membranes.  On  account  of  the  severe  fever,  Aoon.  3  was 
given,   and  in  the  evening,  the  temperature  being    40*3^  C. 


Dr,  Sick's  Hommopathic  Treatment,  67 

(lOd""  F.),  she  got  a  dose  of  BelL  3.  On  the  ^rd  May,  the 
moming  temperature  was  40*2^,  the  evening,  41*1°,  and  no  im- 
provement  in  the  local  symptoms.  She  now  got  Sep,  6.  On  the 
moming  of  the  4th,  temperature,  morning  38*7,  evening  39*1^  G. 
(1Q2'2°  F.).  The  symptoms  now  gradually  declined.  From  the 
8th  she  was  quite  free  from  fever.  The  local  process  rapidly 
declined  from  this  one  dose  of  Hepar.^' 

Those  familiar  with  the  disease  as  it  occurs  in  this 
country  will  not  be  disposed  to  call  this  a  case  of  diphtheria^ 
but^  at  the  most^  a  case  of  catarrhal  sore  throaty  with 
diphtheroid  exudation^  such  as  we  often  see  in  ordinary 
practice. 

Another  case  the  author  gives  as  an  example  of  the  cure 
of  diphtheria  in  a  child  of  three,  after  the  process  had 
extended  into  the  larynx,  seems  to  us  not  to  bear  out  the 
diagnosis  of  the  author.  It  was  evidently  a  case  of  inflam- 
mation of  the  larynx,  but  its  croupy  or  diphtheritic  cha- 
racter is  not  apparent.  The  author's  only  evidence  of 
diphtheritic  exudation  is  the  presence  of  a  thin  pseudo-mem- 
brane^ the  size  of  a  sixpence,  on  the  upper  part  of  the  right 
tonsil.  As  this  so-called  false  membrane  persisted  un- 
changed from  the  2nd  to  the  11th  April,  then  disappeared 
every  evening  to  reappear  in  the  morning,  we  think  it  could 
not  have  been  a  diphtheritic  deposit.  At  least,  we  never 
saw  one  which  so  conducted  itself. 

In  one  case  Dr.  Sick  tried  von  Villers's  remedy,  the 
Cyanuret  of  Mercury.  He  first  gave  a  dose  of  the  80th 
dilutioify  but  as  no  effect  seemed  to  result^  he  then  gave  the 
remedy  in  the  6th  dilution,  and  the  disease  thereupon  began 
to  decline,  the  membrane  to  be  thrown  off^  and  the  cure 
was  complete  in  three  days.  Another  case^  where  Hepar 
failed^  or^  at  least,  did  not  bring  the  cure  very  far,  was 
treated  with  Merc.  cyan.  6,  every  four  hours,  and  recovered. 

He  relates  a  case  of  excessive  infiltration  in  the  con- 
nective tissue  and  gangrene  of  the  mouth  and  neck  occur- 
ring in  a  case  of  sore  throat,  which,  he  would  imply,  was 
diphtheritic,  but  for  which  he  offers  no  evidence.  The 
destruction  of  parts  went  so  far  as  to  lay  bare  several 
arterial  trunks,  threatening  fatal  haemorrhage,  which  had 


38  Reviews. 

to  be  guarded  against  by  ligature  of  the  common  carotid 
artery.     In  spite  of  this  the  patient  recovered  perfectly. 

We  have  not  space  to  give  a  complete  rhumi  of  what 
Dr.  Sick  says  respecting  all  the  twenty  diseases  for  which 
he  has  special  sections,  and  we  must  confine  ourselves  to  a 
more  desultory  notice  of  the  remainder  of  his  work.     In 
his  treatment  we  should  describe  Dr.  Sick  as  a  true  Hahne- 
mannian^  not  one  of  those  who  call  themselves  Hahne- 
mannians,  but  whose  practice  is  to  depart  as  far  from  the 
teachings  of  Hahnemann  in  one  direction  as  the  rationalist 
of  the  homoeopathic  school  strays  in  another.      On  the 
contrary.  Dr.  Sick  is  a  purist  of  the  old  Hahnemannian 
sort.     He  does  not  always  give  the  30th  dilution,  certainly, 
but  he  waits  for  the  exhaustion  of  the  action  of  one  dose 
with    exemplary  patience  before  giving  anotherj  and  has 
a  great  dread  of  the  effects  of  repeating  too  soon  the  dose 
of  a  remedy  that  may  have  been  indicated  at  first.     He  is 
a  firm  believer  in  the  necessity  of  what  is  called  the  '^  ho- 
moeopathic aggravation/'  and  he  says  if  we  fail  to  wait  for 
the  expiring  of  this  indispensable  phenomenon,  our  remedies 
will  only  irritate  the  nervous  system  of  the  patient,  and 
render  him  always   worse   and  worse,  until  his  condition 
becomes   intolerable  to  him,  and  he  rushes  off  again   to 
allopathy,  to  get  his  nerves  quieted  with  Morphia^  Qmndney 
or  Iron.     This  is  all  in  the  true  Hahnemannic  vein,  but  to 
us,  who  do  not  believe  in  homoeopathic  aggravations  and  in 
the  necessity  of  waiting  weeks  or  months  for  the  exhaus- 
tion of  the  action  of  a  dose  of  medicine,  it  has  a  queer, 
unpractical  ring   in  it;    and  if  Dr.  Sick's   patients  were 
irritated  by  the  doctor's  patience  in  waiting  for  the  exhaus- 
tion of  the    action  of  the  dose,  we  would  ascribe   their 
irritation  to  quite  other  causes  than  the  irritant  action  of 
his  medicines  on  their  physical  nerves,  and  if  they  threw 
themselves  into  the  arms  of  allopathy,  we  can  only  say  we 
think  they  served  their  doctor  quite  right. 

On  the  subject  of  gout  and  chronic  rheumatism  he  has 
not  much  to  say.  Acute  fits  of  gout  he  treats  successfully 
with  Aconite  and  Apis,  and  he  asserts  that  one  of  the  best 
remedies  for  constitutional  gout,  keeping  off  acute  attacks, 


Dr.  Sick^s  Homceopaihic  Treatment.  39 

18  Thuja  in  a  high  (meaning  the  80th)  dilation.     Bnt^  he 
says,  what  with  the  popularising   of  homoeopathy,  which 
means  the  interests  of  the  sellers  of  homoeopathic  medi- 
cines;  domestic  chests  full  of  homoeopathic  remedies  are 
80  universally  present   in  houses,  and  the  remedies  they 
contain  so  indiscriminately  used,  that  patients  are  mostly 
spoilt  for  the  employment  of  one  dose  of  a  truly  homoeo- 
pathic  remedy,  and  it  is  but  seldom  we  now  meet  with  a 
subject  who  has  not  already  been  saturated  with  all  manner 
of  incongruous  remedies  in  all  potencies ;  so  that  we  never, 
or  hardly  ever,  meet  with  a  virgin  soil  on  which  to  plant 
our  single  dose  of  a  high  potency  and  let  it  germinate  for 
weeks  or  months  with  the  confident  expectation  of  a  rich 
and  continuous  growth   of  curative  results.      If  such   be 
really  the  case,  and  if  the  single  dose  of  the  high  potency 
will  not  act  on  the  polluted  soil  of  well-dosed  patients^  then 
the  logical  inference  is  that  we  should  give  up  attempting 
to  cure  in  the  way  the  early  pioneers  of  homoeopathy  did, 
and  probably  the  modem  practice  of  not  diluting  medicines 
so  highly,  and  of  giving  them  in  more  frequent  doses,  meets 
the  altered  circumstances  of  patients,  and  is  a  justification 
of  those  who  depart  in  thi^  direction  from  Hahnemann's 
latest  teachings.     But,  perhaps,  there  is  another  cause  for 
the  expressed  disappointment  of  modem  exact  followers  of 
Hahnemann — ^we  do  not  mean,  of  course,  the  latest  develop- 
ment of  high-potency  Hahnemannians,  for,  as   yet,  these 
gentlemen  have  recorded  none  but  miraculous  cures — and 
that  is,  that  the  practice  of  the  old  school  having  changed 
so  much,  we  no  longer  meet  with  so  many  cases  which 
need  but  to  leave  off  strong  drags  in  order  to  get  rid  of 
their  firightfnl  sufferings,  and  for  such  a  dose  of  milk-sugar 
or  a  sniff  at  a  single  globule  was  equally  efiScacious,  pro- 
rided  only  the  strong  drugs  were  left  off.     Now,  we  have 
chiefly  to  do  with  diseases  that  are  not  produce4  by  over- 
drugging,  and  consequently  cannot   be    cured    by  merely 
learing  off  something,  but  require  the  oft-repeated  attack  of 
the  specific  medicine  for  their  cure. 

Dr.  Sick's  treatment  of  pneumonia  does  not  look  very 
successful  if  we  take  bis  gross  statistics — fifty  cases,  nine 


40  ReviewB. 

deaths,  a  mortality  of  18  per  cent.  This  is  very  different 
from  Flebchmann's  1058  cases  and  forty-eight  deaths,  or 
4*5  per  cent.,  and  even  greatly  inferior  to  the  results  of 
Diet?8  expectant  treatment  with  a  mortality  percentage  of 
7'4.  He  accounts  for  his  comparatively  large  mortality  by 
the  considerable  proportion  of  his  patients,  whose  ages 
ranged  from  fifty  to  eighty-seven,  seventeen  out  of  fifty. 
Of  the  remaining  thirty-three  patients,  whose  ages  ranged 
from  twelve  to  forty-nine,  three  died,  giving  a  mortality  of 
9  per  cent.  This  is  already  a  considerable  increase  on 
Fleischmann's  percentage,  and,  perhaps,  Dr.  Sick  was 
unfortunate,  in  that  two  of  his  fatal  cases,  between  twenty 
and  forty,  were  habitual  drunkards,  for  we  all  know  the 
fatality  of  pneumonia  in  such  cases.  Dr.  Sick's  remedies 
were  Aeon,,  Bry,,  Pho$,^  SuL  and  Ant,  i.,  and  his  usual 
potencies  8,  though  occasionally  80  was  used.  The  doses 
were  repeated  during  the  early  period  of  the  disease  as  often 
as  every  two  hours,  which  shows  that  the  author  is  not  a 
bigoted  adherent  of  the  Hahnemannian  dogma  of  non- 
repetition  of  the  dose.  Indeed,  we  must  do  Dr.  Sick  the 
justice  to  say  that,  except  in  the  matter  of  the  doses  and 
their  infrequent  administration,  in  chronic  diseases  mostly, 
he  is  not  an  out-and-out  partisan  of  Hahnemann's  doc- 
trines, for  he  rejects  Hahnemann's  theory  of  the  three 
miasms  of  chronic  diseases. 

In  reference  to  gall-stones,  he  mentions  a  case  of  a 
woman  of  forty,  who  was  extremely  liable  to  attacks  of 
gall-stones  and  jaundice,  for  which  she  had  long  been  treated 
with  Carlsbad  salts  and  homoeopathic  remedies,  such  as 
Sulph.  80,  Card.  mur.  8,  Nux  v.  80,  Graph.  80,  Bry.  80, 
Chel.  8,  Nat.  sul.  6,  01  tereb.  8,  Calc.  80,  and  at  length  the 
attacks  became  so  severe  and  frequent  that  she  was  admitted 
into  the  hospital,  and  treated  at  first,  with  no  particular 
result,  with  Col.  6,  Puis.  6,  and  Ars.  8.  It  was  not  till 
Arsen.  6,  three  drops  twice  a  day,  was  given  that  any 
rapid  improvement  came  on ;  and  under  its  use  the  jaundice, 
pain,  and  itching  of  the  skin  gradually  went  off.  The 
jaundice  and  itching  of  the  skin  had  lasted  for  nearly  two 
years.     The  Arsenic  was  continued  for  seven  months.    The 


Dr,  Siek^i  Homceopathic  Dreatment.  41 

result  was  perfect  re-establishment  of  the  health  and 
strength^  and  no  recurrence  of  the  attacks  of  gall-bladder 
colic. 

Dr.  Sick  believes  in  the  power  of  homoeopathic  medi- 
cines to  remove  the  morbid  symptoms  accompanying  the 
presence  of  tapeworm,  and  to  reduce  the  tapeworm  to  such 
a  condition  that  it  ceases  any  longer  to  throw  off  joints^ 
but  he  does  not  think  they  will  expel  the  worm.  In 
hospital  piactice  he  gives  Kousso,  and  finds  it  very  suc- 
cessful in  expelling  the  parasite. 

In  the  treatment  of  wounds,  such  as  gun-shot  wounds 
and  wounds  after  accidents  and  operations.  Dr.  Sick  is 
greatly  in  favour  of  Boilers  cotton-wool  bandage,  which  he 
employed  with  success  in  some  very  severe  wounds.  As 
BoUe's  treatment  of  wounds  was  published  in  the  Pop.  Horn, 
Zeitung  of  1864^  years  before  Lister  published  or  practised 
his  familiar  method,  and  as  in  some  points^  to  wit,  the  careful 
exclusion  of  air^  the  retention  of  the  dressing  undisturbed  for 
a  long  period,  and  the  employment  of  cotton-wool  in  place  of 
lint  or  charpie^  both  treatments  are  alike^  we  think  that  to 
BoUe,  rather  than  to  Lister^  the  profession  and  the  public  are 
indebted  for  the  introduction  of  these  innovations  in  surgical 
dressing,  which  are  now  considered  to  be  so  indispensable, 
but  which  are  so  directly  contrary  to  the  practice  of  former 
days.  BoUe's  plan  was  as  follows : — He  brought  the  edges 
of  the  wound  careftilly  tbgether^  then  covered  it  with  a 
layer  of  cotton- wool  soaked  in  Tincture  of  Arnica^  over  this 
he  placed  dry  cotton  wool,  then  a  layer  of  sticking  plaster, 
tightly  applied^  then  more  cotton  wool^  and  finally  a  roller 
bandage  to  keep  all  in  its  place.  In  this  way  he  formed  a 
dressing  impervious  to  air  and  any  infectious  matter  com- 
municable by 'air.  This  dressing  he  allowed  to  remain 
undisturbed  for  a  longer  or  shorter  period,  according  to  the 
severity  of  the  wound — ^four  weeks  being  a  not  uncommon 
period^  during  which  the  original  dressing  was  not  removed. 
Dr.  Sick  records  several  severe  cases  of  wounds  which  were 
received  into  the  hospital^  and  treated  on  this  plan  with 
remarkably  successful  results.  In  the  case  of  wounds  whose 
edges  could  be  brought  together,  the  dressing  on  being 


42  Review$. 

remoYed  after  a  fortnight  or  more^  showed  only  the  buHIbu^ 
of  the  cotton  next  the  wound  stiffened  with  the  secretion 
firom  the  wound  and  discoloured  with  blood  and  some 
exfoliated  epidermis  upon  it.  When  there  was  loss  of  sub- 
stance and  the  edges  of  the  wound  could  not  be  adjuBted,  a 
thick  layer  of  pus  was  found  between  the  dbcoloured  cotton 
and  the  red  granulating  cicatrize  but  the  secretion  had  no 
bad  odour  at  aU.  As  Belle's  dressing  seems  to  be  quite  as 
efficacious  as  Lister's,  and  not  nearly  so  troublesome^  we 
think  it  might  in  many  cases,  especially  in  private  practice, 
be  adyantageously  used  in  place  of  the  more  complicated 
process  of  our  countryman.  In  a  campaign  the  superior 
simplicity  of  BoUe's  method  must  be  a  great  recommenda- 
tion. Dr.  Sick  imagines  that  BoUe's  method  effects  such 
excellent  results,  excluding  spores,  bacteria,  and  the  like, 
from  the  wound.  But  then  he  believes  that  Lister's  plan 
succeeds  for  the  same  reason,  but  as  it  has  been  proved 
that  bacteria  flourish  in  any  quantity  under  Lister's  dress- 
ing, we  fancy  they  will  be  found  equally  well  under  BoUe's, 
and  hence  the  efficacy  of  either  method  cannot  depend  on 
the  prevention  of  the  development  of  microscopic  organisms. 
Probably  the  success  of  both  depends  on  the  prevention  of 
putrefactive  decomposition  of  an  altogether  different  kind. 
The  absence  of  foetor  in  the  discharges  after  the  dressings 
have  remained  unchanged  for  weeks  seem  to  point  to  this, 
and  probably  bacteria  and  other  micrococci  have  nothing  to 
do  with  rendering  wounds  dangerous  or  fatal. 

In  the  treatment  of  chronic  ulcers,  especially  those  of 
the  leg,  that  are  very  obstinate,  Dr.  Sick  is  an  advocate  of 
Schroth's  thirst  cure,  of  which  we  gave  an  account  in 
vol.  viii,  p.  262.  The  fever  produced  by  this  very  disagree- 
able ^^cure"  sometimes  runs  very  high.  •  In  one  case 
treated  at  the  Stuttgart  Hospital  it  presented  the  appear- 
ance of  typhus,  with  a  temperature  of  40°  C.  (104°  F.),  and 
a  slough  on  the  sacrum.  This  fever  is  to  be  combated  by 
the  cautious  administration  of  light  wine  or  water,  and  by 
packing  according  to  the  method  of  Priessnitz.  Dr.  Sick 
says  it  is  very  efficacious  with  these  old  ulcers,  and  others 
have  found  it  serviceable  in  old  gun-shot  wounds. 


On  Hereditary  Syphilis,  by  Dr.  H.  C.  lessen.        43 

Ob  the  wbole^  ve  are  much  pleased  with  this  little  book. 
It  is  pleasant  to  read  anything  from  the  pen  of  a  really 
practical  man^  who  has  had  good  opportunities  of  seeing  a 
large  number  of  cases  under  such  favourable  circumstances 
as  Dr.  Sick  enjoyed.  It  is  but  too  seldom  that  we  get 
anything  from  such  practical  men.  Fleischmann^  who 
enjoyed  such  advantages  in  his  position  at  the  head  of  the 
Gumpendorf  Homceopathic  Hospital,  hardly  ever  wrote 
anything.  Wurmb  and  Tessier  did  a  good  deal,  but  Dr. 
J.  0.  Miiller^  who  has  been  at  the  head  of  the  Sechshaus 
Hospital  so  many  years^  never  gives  us  the  benefit  of  his 
vast  experience.  Many  others  who  are  known  to  have 
immense  practices  keep  all  their  valuable  experience  to 
themselves.  It  would  be  more  to  their  credit,  and  do  more 
for  the  advancement  of  the  excellent  method  of  Hahnemann^ 
were  they  to  impart  their  experience  to  their  younger 
colleagues^  than  all  their  boasting  about  the  thousands  of 
patients  and  the  infinite  variety  of  the  diseases  that  have 
passed  through  their  hands.  The  number  of  contributors 
to  the  homoeopathic  literature  of  this  country  may  almost 
be  reckoned  on  one's  fingers,  and  not  all  of  them  enjoy 
the  largest  practices.  Many  of  our  eminent  practitioners 
never  enlighten  their  brethren  by  scrapes  of  their  pen,  and 
we  know  this  is  not  from  inability  to  do  so.  Want  of  time 
is  not  a  valid  excuse,  for  the  most  occupied  practitioner 
could  spare  an  hour  or  two  in  order  to  jot  down  some 
valuable  item  of  his  experience.  Perhaps  laziness  is  the 
only  reason  for  their  far  from  golden  silence. 


The  Pathology  and  Treatment  of  Hereditary  Syphilis.     By 
H.  C.  Jkssbn,  M.D.,  &c.     Chicago  :  1879. 

This  is  a  short  pamphlet  of  twenty-four  pages  on  a  long 
subject.  It  is  so  condensed  and  meagre  in  details  that  it 
seems  more  like  notes  for  future  expansion  into  lectures  or 
a  treatise  than  a  complete  work  on  the  subject.     Still,  it 


44  Reviews, 

may  be  very  useful  in  reminding  practitioners  of  the  modes 
of  production  of  hereditary  syphilis^  the  main  symptoms  of 
that  cachexiaj  and  the  general  method  of  homoeopathic  and 
dietetic  treatment  for  it.  Syphilis  has  been  so  much 
studied  of  late  years,  and  so  many  treatises  on  it  have  been 
published  by  illustrious^  careful,  and  much-experienced 
practitioners,  that  it  would  be  difficult  to  write  anything 
novel  or  original  about  it.  We  may  say  that  Dr.  Jessen 
is  an  adherent  of  the  doctrine  of  the  essential  diflference  in 
nature  of  the  poisons  that  produce  the  two  forms  of 
chancre,  the  soft  and  the  hard.  In  enumerating  the 
various  modes  in  which  syphilis  may  be  propagated  he 
omits  to  mention  that  the  mother  may  be  infected  by  the 
foetus  in  utero,  which  has  been  syphilised  by  a  syphilitic 
father. 

A  case  occurred  in  our  own  practice  which  illustrates 
this  curious  phenomenon.      A  gentleman    who  had   had 
syphilis   twelve   years   preriously,  which  after  developing 
secondary  symptoms  had  been  rapidly  cured  by  Mercury, 
and  who  had  for  some  years  at  least  been  apparently  quite 
free  from  taint  of  any  sort,  married  a  perfectly  healthy 
lady,  who  soon  became  pregnant.     Towards  the  latter  part 
of  her  pregnancy  she  became  covered  with  copper-coloured 
blotches  of  evident  syphilitic  character.     We  need  hardly 
say  that  she  had  no  signs  of  infection  of  primary  syphilis. 
We  told  her  what  was  the  cause  of  her  disease,  and  that 
the  probability  was  that  her  infant  would  be  diseased  and 
would  die.     Her  syphilitic  symptoms  went  on  increasing, 
and  at  or  near  the  full  term  she  was  delivered  of  a  child 
that  only  survived  a  week  or  two.     We  did  not  see  the 
child,  as  she  was  confined   in  the  country.     The  lady's 
syphilitic  symptoms  went  on  and  proved  very  serious,  laige 
ulcers  breaking  out  in  different  parts  of  the  body.     This 
case  illustrates  three  points  in  syphilidology,  first,  that  a  man 
may  be  apparently  quite  well,  and  that  for  many  years, 
and  yet  be  capable  of  begetting  a  syphilitic  child ;  second, 
that  a  woman  may  be  infected  from  her  foetus;  and  third, 
that  the  syphilitic  symptoms  may  appear  on  the  mother 
during  pregnancy. 


A  System  of , Surgery,  by  Dr,  Hebnuih,  45 


A  System  of  Surgery.  By  William  Tod  Helhuth^  M.D. 
Fourth  edition,  revised  and  corrected.  Boericke  and 
Tafel. 

This  edition  is  said  on  the  title  page  to  be  the  fourth^ 
but  the  preface  makes  it  the  third.  We  reviewed  the  second 
in  1874.  The  author  tells  us  that  in  its  present  form  the 
work  '^  has  been  rearranged^  many  portions  of  it  have  been 
entirely  rewritten^  and  while  much  new  matter  has  been 
added  a  great  deal  that  appeared  in  the  former  volume  has 
been  omitted.^'  It  now  makes  a  large  and  , handsome 
volume  of  over  1000  pages^  with  558  woodcuts ;  and  supplies 
to  the  homoeopathic  student  all  the  surgical  information 
ordinarily  necessary.  In  using  it^  he  has  the  satisfaction 
of  knowing  that  his  guide  is  no  mere  compiler^  but  a 
practical  surgeon  of  large  experience  and  eminent  operative 
skilly  who  thus  can  check  the  statements  he  quotes  from 
othersj  and  supply  much  from  his  own  storehouse. 

Our  previous  review  went  so  fully  over  the  contents  of 
Dr.  Helmuth's  work  that  it  would  be  repetition  to  follow 
the  same  course  now.  Many  of  the  criticisms  we  made 
upon  the  second  have  become  inapplicable  to  the  present 
edition^  from  the  thorough  revision  it  has  received ;  and  we 
have  few  of  our  own  to  add.  We  could  have  wished  that 
the  omissions  mentioned  by  the  author  had  included  the 
subjects  of  quinsy^  nephritis,  hepatitis,  and  such  like^ 
which  are  hardly  in  place  in  a  work  on  surgery,  and  are 
treated  quite  inadequately.  We  are  sorry  that  Dr.  Hel- 
muth  has  not  exercised  as  much  discrimination  in  his 
medical  as  in  his  surgical  quotations.  Such  a  statement  as 
this,  for  instance,  given  without  names  and  references,  is 
quite  valueless  : — '^  The  mercurial  preparations  are  often 
used*'  for  encephaloid  periosteal  cancer.  ^'  Some  have  highly 
recommended  the  oxymuriate  of  mercury,  and,  according 
to  other  authors,  the  treatment  has  proved  quite  effica- 
cious." The  following,  moreover,  must  on  other  grounds 
be  condemned  :  ''  The  principal  medicine  in  the  treatment 
of  this  disease  '^ — goitre — '^  is  iodine,  which  has  been  used 


46  Reviews. 

by  allopathic  practitioners  from  a  remote  date,  but  with  incon- 
siderable success,  from  its  improper  administration/'  Iodine 
was  only  discovered  in  1812,  but  its  employment  in  goitre 
has  been  attended  with  far  from  '*  inconsiderable  success ; '' 
and  there  is  no  recorded  experience  with  it  in  the  3rd  or 
6th  dilution  repeated  every  second  day  (as  Dr.  Helmuth 
recommends  its  being  given)  which  can  compare  with  the 
practice  of  the  old  school  in  its  administration.  We  have 
also  to  correct  a  statement  made  on  page  672.  It  was 
chhrine  water,  not  bromine,  which  Carroll  Dunham  advised 
for  spasm  of  the  glottis. 

Apart  from  such  faults,  the  work  seems  to  us  excellently 
well  done.  Dr.  Helmuth's  experience  in  the  medicinal 
treatment  of  surgical  disease  is  of  much  value  to  us  ;  and 
we  are  pleased  to  find  him  endorsing  to  the  full  the  usual 
high  estimate  among  us  of  Arnica  and  Calendula,  oiBerberis 
(which  he  gives  in  infusion)  for  biliary  colic,  and  of 
HydrastiB  for  (especially  epithelial)  cancer.  It  is  satisfactory, 
moreover,  to  hear  him  saying : — "  There  is  no  doubt  of  the 
efficacy  of  homoeopathic  medication,  not  only  in  the  early 
stages  of  strangulated  hernia,  but  in  advanced  states  of 
this  disorder,  soon  after  fascal  vomiting  has  commenced.  I 
am  positive  in  this  assertion,  and  speak  from  experience  in 
many  cases,  and  so  much  so,  indeed,  that  I  rarely  am  obliged 
to  operate  for  strangulated  inguinal  hernia.^' 

From  the  extracts  we  have  given,  it  will  have  been  seen 
that  Dr.  Helmuth  is  hardly  as  ready  with  the  pen  as  he  is 
with  the  knife.  He  has  given  us,  however,  a  useful  book ; 
and  none  of  us  who  has  anything  to  do  with  surgery  can 
afford  to  be  without  it. 


Lectures  on  Clinical  Medicine.  By  Dr.  Joussxt.  Trans- 
lated, with  copious  notes  and  additions,  by  B.  Ludlam, 
M.D.    Chicago :  S.  C.  Griggs  &  Co.    London  :  Turner. 

Ws  have  so  often  in  these  pages  expressed  our  high 


; 


Lecturis  On  Clinical  Medicine  hy  Dr.  Jousset.        47* 

appreciation  of  Dr.  Jousset^s  clinical  lectures  that  it  is 
with  special  pleasure  we  welcome  their  appearance  in  an 
English  dress.  We  are  yery  glad^  moreover^  that  the  task 
of  translating  them  has  been  undertaken  by  so  capable  a 
man  as  Dr.  Ludlam^  whose  own  clinical  lectures  on  Diph- 
theria and  on  Diseases  of  Women  are  deservedly  in  high 
repute  among  us^  and  who  has  both  the  practical  and  the 
literary  knowledge  requisite  to  reproduce  the  thoughts  of 
his  French  colleague  for  those  of  his  own  speech.  Not 
content^  too^  with  simply  translating^  he  has  copiously 
annotated  the  work — especially  those  parts  which  treat  of 
gynaecology — from  his  own  reading  and  experience^  and  has 
obtained  the  co-operation  of  some  of  bis  colleagues — among 
whom  we  may  specially  name  Drs.  Small  and  Vilas — in 
similar  contributions.  He  has  thus  enriched  English 
homoeopathic  literature  with  a  very  valuable  volume^  and 
we  tender  him  our  best  thanks  for  it. 

Dr.  Ludlam  translates  with  no  less  ease  and  grace  than 
he  writes ;  and  we  can  testify^  as  far  as  we  have  proved  it^ 
to  his  accuracy^  at  any  rate  when  it  is  medical  French  that 
has  to  be  rendered.  He  is  hardly  so  strong  when  his 
author  is  not  so  strictly  professional.  Thus^  ''  blanchir  '' 
is  the  habitual  phrase  in  France  for  the  laundress's  art^  so 
that  when  Bicord  says^  ^'  qu'on  blanchit  la  verole  mais 
qu'on  ne  la  guerit  pas/'  Dr.  Ludlam  should  hardly  render  it 
(p.  58)  '^  we  may  blanch  the  venereal  disease,  but  we  can- 
not cure  it/'  So  (p.  177),  Dr.  Jousset  quotes  Scarron's 
verse — 

**  Je  vis  Fombre  d'un  valet, 
Qui,  de  I'ombre  d'ane  brosse, 
Frottait  rombre  d'tin  carrosae— " 

as  illustrating  the  imaginary  character  of  old-school  thera- 
peutics. Dr.  Ludlam  translates  the  last  line^  '' brushed 
away  the  shadow  of  a  coach/'  which  destroys  the  consis- 
tency of  the  picture.  It  was  the  actual  coach  at  which  the 
valet  was  brushing,  though  both  man  and  thing  were 
shadows.  Again^  at  p.  285^  Dr.  Jousset  tells  how  the 
Academy  of  Medicine  once  welcomed  a  report  of  the  value 
of  Capsicum  in  hsemorrhoidsj  innocent  of  the  homoeopathic 


48  Bevtw>$, 

m 

origin  of  the  practice,  and  says^  **  cette  pr^ntation  de 
paivre  ne  manquaii  pas  du  sel"  which  Dr.  Ludlam  trans- 
lates^ ''  smacked  a  little  of  aalt/'  He  loses  there  by  the 
allusion  to  the  '*  Attic  salt  *'  of  wit,  which,  the  author  meant 
to  suggest,  seasoned  the  occurrence.  At  p.  840,  Dr. 
Ludlam  renders  "  pretend  "  by  our  English  *'  pretends/' 
but  it  simply  means  '^  alleges,''  without  implying  any 
judgment  as  to  the  mala  or  bona  fides  of  the  alleger. 
There  is  also  an  error  here  of  another  kind.  Dr.  Ludlam 
writes — ''  Stracky  of  Mayence  *  *  pretends  that  at  the 
end  of  four  days,  when  Viola  tricolor  is  taken  by  healthy 
persons,  the  face  becomes  oovered  by  thick  crusts."  Now 
there  is  nothing  about  healthy  persons  in  the  original, 
which  says  of  the  drug  : — **  Strack,  de  Mayence,  I'admi- 
nistrait  en  poudre,  dans  du  lait,  centre  les  croiites  lai- 
teuses,  et  il  pretend  qu'au  bout  de  quatre  jours  le  visage  se 
couvre  de  croiites  epaisses.''  Again,  "Plumbum  should 
produce  vaginismus,''  scarcely  represents  "  D'apr^  Richard 
Hughes,  Plumbum  our  ait  produit  le  vaginisme,'^  which 
states  what  has  been,  not  what  should  be. 

As  these  are  the  only  faults  we  have  to  find  with  Dr. 
Ludlam's  translation,  it  may  justly  be  inferred  that  our 
verdict  upon  it  must  be  extremely  favourable. 


The  Hommopathic  Therapeutics  of  Uterine  and  Vaginal  Dis- 
charges.  By  W.  Eqoert,  M.D.  Boericke  and  Tafel. 
London:  Turner. 

This  royal  octavo  volume  of  643  pages  is  a  repertory, 
embracing  every  imaginable  morbid  feature  connected  with 
the  discharges  to  which  women  are  prone,  and  every  possible 
concomitant  thereto.  As  the  latter  subject  embraces  the 
whole  female  organism,  it  is  not  surprising  that  three  fifths 
of  the  book  are  taken  up  with  it.  The  work  is  introduced 
by  a  preface  of  astonishing  English,  but  sound  "  Hahne- 
mannian ''  orthodoxy,  and  we  know  accordingly  what  must 
be  its  material.     All  the  symptoms  which  a  medicine  has 


Treatment  of  Diseases  of  fVomen,  by  Dr.  Hale,      49 

come  to  "  have/'  whether  pathogenetic  or  clinical,  derived 
from  recommendation  or  inference^  supplied  from  true 
sources  or  false,  verified  or  disqualified^  will  be  found  here 
without  discrimination.  The  ^'rage  before  the  menses'' 
and  ''  tenacious  leucorrhoea ''  of  Aconite,  so  completely  put 
out  of  courts  the  pathogeneses  of  Houat,  so  utterly  dis- 
credited^ are  used  as  freely  as  the  provings  of  Hahnemann 
and  the  clinical  verifications  of  Dunham.  Any  one  who 
uses  this  repertory^  therefore,  must  be  aware  that  he  is 
treading  upon  insecure  ground  ;  and  must  only  so  far  avail 
himself  of  its  help  as  to  lead  it  to  suggest  remedies  of 
which  otherwise  he  might  not  have  thought. 

Were  it  not  for  the  "  shoddy ''  of  its  materials^  we 
should  have  had  to  speak  with  commendation  of  this  book ; 
for  it  is  well  arranged^  and  very  handy  for  reference.  Even 
as  it  is^  the  practitioner  who  can  discriminate  between  the 
wheat  and  the  chaff  it  contains  may  employ  it  with  ad- 
vantage in  a  field  of  practice  for  which  we  certainly  want 
aid. 


The  Medical,  Surgical,  and  Hygienic  Treatment  of  Diseases 
of  Women,  especially  those  causing  Sterility,  the 
disorders  and  accidents  of  pregnancy,  and  painful  and 
difficult  labour.  Second  edition^  enlarged.  By  Edwin 
M.  Halb,  M.D.    Boericke  and  Tafel.   London :  Turner. 

This  book  is  as  widely  different  from  its  predecessor  as 
any  two  on  a  cognate  subject^  and  proceeding  from  the 
same  school  in  medicine^  could  well  be.  It  is  not  merely 
that  Dr.  Hale  has  written  a  treatise^  while  Dr.  Eggert  has 
merely  given  a  list  of  symptoms  and  medicines.  The  great 
difference  is  that  treatment  by  homoeopathically-acting 
internal  remedies^  which  is  all  in  all  to  Dr.  Eggert,  plays 
but  a  subordinate  part  in  Dr.  Hale's  therapeia.  He^ 
indeed,  professes,  no  less  than  the  other  writer,  his  belief 
that   ''the   law    of   cure,    enunciated    by  Hahnemann,  is 

VOL.  XXXVIII,  NO.  CLI.-— JANUARY,  1880.  B 


50  Reviews. 

universal  and  all-embracing;''  but  by  extending  it  to  local 
action^  and  hy  his  theory  of  primary  and  secondary  homo&o- 
pathioity,  already  expounded  in  these  pages,  he  is  able  to 
include  therein  pretty  nearly  the  whole  armamentarium  of 
caustics  and  antipathic  medicinal  agents  employed  in  the 
ordinary  treatment  of  uterine  afifection.  All  this  shows  the 
absurdity  of  using  names  to  designate  the  practice  of  any 
body  of  men,  where  the  quot  homines,  tot  sententi^  will 
always  to  some  extent  hold  good. 

Dr.  Hale's  volume  consists  of  an  enlarged  edition  of  a 
previously-issued  treatise  on  sterility  (which  had  not 
reached  us)  and  of  the  two  chapters  on  dystocia  contributed 
to  Dr.  Richardson's  System  of  Obstetrics,  of  which  we 
spoke  favourably  when  reviewing  that  work.  It  brings  to- 
gether a  great  deal  of  useful  matter,  obtained  both  from 
reading  and  observation,  bearing  on  these  two  subjects; 
and  will  be  found  of  much  use  to  all  among  us  who  culti- 
vate gynecology  and  practise  the  accoucheur's  art. 


A  Text-hook  of  Electro-Therapeutics  and  Electro-Surgery ^ 
for  the  use  of  Students  and  General  Practitioners.  By 
John  Butler,  M.D.,  L.R.C.P.E.,  L.R.C.S.I.  Second 
edition,  revised  and  corrected.  Boericke  and  Tafel. 
London :  Turner. 

Dr.  Butler,  whose  British  diplomas  at  once  commend 
him  to  our  favourable  notice,  has  given  in  the  above  volume 
a  most  excellent  treatise  on  the  use  of  electricity  in  medi- 
cine. He  has  gone  to  work  in  the  true  way  of  Hahnemanu, 
biy  first  ascertaining  and  recording  the  action  of  this  force 
upon  the  healthy  subject,  and  in  the  light  thereof  appreciat- 
ing its  reported  curative  action  in  disease.  Having  thus^ 
as  he  believes,  demonstrated  its  homoeopathicity  to  the 
affections  it  cures,  he  seeks  to  ascertain  its  precise  place  in 
therapeutics  and  the  indications  for  its  use  in  preference  to 
other  remedial  means.  Since  to  this  work,  so  indispensable 
for  practitioners  of  our  school,  he  adds  all  necessary  infor- 


Homceopaihic  Therapeutics^  by  Dr.  Lilienthal,        51 

matioa  as  to  the  choice,  maDagement,  and  application  of 
instruments,  and  as  to  the  aseso£  electrolysis  in  gynaecology 
and  surgery,  he  has  supplied  us  with  a  text-book  on  the 
subject,  complete  in  itself,  and  rendering — for  the  ordinary 
practitioner — any  other  superfluous.  It  is  written,  too,  in 
a  style  free  from  the  extravagances  which  disfigure  many 
treatises  on  electro-therapeutics,  and,  indeed,  in  a  spirit 
eminently  scientific  and  satisfactory.  Wp  have  much 
pleasure  in  introducing  it  to  our  readers. 


Condensed  Materia  Medica.     By  C.  Hering.     2nd  Edition. 
Boericke :  New  York,  1879.     London :  Turner. 

If  we  do  not  attach  much  value  to  this  work  our 
estimate  of  it  does  not  seem  to  be  that  of  Dr.  Heriag's 
American  colleagues,  for  here  we  have  it  in  a  second 
edition  with  five  additional  medicines  ^'  condensed  ^'  like 
the  others.  In  this  second  edition  m>ne  of  the  objections 
we  raised  to  the  work  in  its  first  edition  are  removed,  so 
we  must  rather  regret  thi^t  it  should  have  obtained  such  a 
considerable  popularity  as  this  reprint  seems  to  indicate. 


HomcBopathic  Therapeutics,  By  S.  ]Liiiii£NTHAL,  M.D. 
2Dd  Edition.  Boericke  :  New  York,  1879.  London  : 
Turner. 

This  is  practically  the  same  work  as  that  we  recently 
reviewed  in  these  pages.  The  stock  of  the  first  edition 
having  been  destroyed  in  the  disastrous  fire  that  consumed 
Boericke's  warehouse^  Dr.  Lilienthal  had  to  prepare  a 
reprint,  and  took  advantage  of  the  opportunity  to  '^  correct 
all  sins  of  omission  and  commii^ion  ^'  in  the  first  edition. 
We  do  not  pei;ceiye  th^t  he  has  corrected  any  of  the  sins, 
or  rather  we  should  say^  venial  errors,  ve  pointed  out  in 


52  Reviews. 

our  review,  probably  because  he  does  not  i^ee  with  as  in 
thinking  them  to  be  errors. 


The  Grounds  of  a  HomoBopaiVs  Faith.  Three  Lectures  bj 
Samuel  A.  Jones,  M.D.,  Professor  of  Materia  Medica, 
Therapeutics,  and  experimental  Pathogenesy  in  the 
Homoeopathic  Medical  College  of  the  University  of 
Michigan.     Boericke  and  Tafel. 

These  lectures  were,  as  the  title  page  states,  "  delivered 
at  the  request  of  Matriculates  of  the  Department  of  Medicine 
and  Surgery  (Old  School)  of  the  University  of  Michigan.'' 
They  display  all  the  bibliographical  knowledge  and  the 
vivacious  style  to  which  we  are  accustomed  in  the  pages  of 
this  clever  writer.  His  manner  of  late  has  grown  too 
Carlylese  to  be  original  or  (to  our  mind)  agreeable ;  but 
this  is  when  he  is  engaging  in  personal  controversy.  When, 
as  here,  he  is  occupied  with  pure  science,  nothing  can  be 
more  pleasant  reading  than  his  pages. 

The  argument  of  his  lectures  is  clear  and  forcible.  In 
the  first  he  demonstrates  (after  Carroll  Dunham)  that  the 
law  of  similars  establishes  its  claim  to  science  in  that  it 
enables  prevision,  illustrating  this  by  Hahnemann's  h  priori 
choice  of  the  remedies  for  cholera,  and  leading  up  thereto 
by  a  sketch  of  his  life  and  discovery.  In  the  second,  he 
proves  the  single  remedy  to  be  a  necessity  of  science, 
showing  how  all  real  advance  in  medicine  has  led  from 
poly-  to  mono-pharmacy.  In  the  third,  he  argues  that  the 
minimum  dose  is  an  inevitable  sequence  of  the  law  of 
similars  and  the  single  remedy ;  and  very  aptly  traces  the 
treatment  of  dysentery  in  the  old  school  from  the  monstrous 
prescriptions  of  Paulus  J&gineta  to  the  hundredth  of  a  grain 
doses  of  corrosive  sublimate  recommended  by  Professor 
Ringer.  He  makes  it  quite  clear  that  science  itself  is 
leading  the  better  men  of  the  old  school  to  these  three 
articles  of  the  homoeopath's  faith ;  and  we  hope  that  his 


A  Guide  to  Homceopathic  Practice.  53 

demonstrations  were  taken  to  heart  by  his  aadience,  for 
whom  nothing  could  have  been  better  designed.  The 
lectures^  as  published,  are  likely  to  prove  of  much  service 
to  well-affected  nien  of  the  old  school  into  whose  hands  they 
may  come. 


A  Guide  to  HomcBopathic  Practice,  designed  for  the  Use  of 
Families  and  Private  Individuals.  By  J.  D.  Johnson, 
M.D.     New  York  :  Boericke,  1880. 

As  long  as  homoeopathic  practitioners  are  not  to  be  met 
with  everywhere,  like  Newcastle  grindstones,  rats,  and 
Scotchmen^  and  as  long  as  ladies  and  gentlemen,  but 
especially  ladies,  will  wish  to  treat  the  ailments  of  their 
children^  selves,  and  friends  without  calling  in  the  doctor, 
so  long  will  domestic  works  on  homoeopathy  be  in 
demand  and  be  supplied.  In  fact,  domestic  works  are  the 
only  works  on  homoeopathy  that  have  a  very  large  sale, 
especially  in  this  country,  as  the  numerous  editions  of 
Laurie's  and  Ruddock's  manuals  testify.  Dr.  Johnson's 
seems  a  tolerably  good  specimen  of  this  class  of  works.  It 
errs  in  attempting  too  much.  It  need  hardly  be  said  that 
sach  diseases  as  inflammation  of  the  brain,  cerebro-spiual 
meningitis,  hydrocephalus,  pneumonia,  phthisis,  hydro- 
thorax,  hepatitis,  enteritis,  hernia,  Bright's  disease,  diabetes, 
puerperal  convulsions  and  peritonitis,  delirium  tremens, 
dropsy,  typhoid  fever,  yellow  fever,  tetanus,  and  some 
other  diseases  here  treated  of  cannot  safely  become  subjects 
of  domestic  treatment,  and  are  better  left  to  the  charge  of 
educated  physicians  and  surgeons.  A  useful  Materia 
Medica  of  the  fifty-six  medicines  mentioned  in  this  work 
forms  its  second  part,  and  the  index  is,  as  it  ought  to  be, 
very  complete.  On  the  whole  Dr.  Johnson^s  work  may 
prove  of  value  to  those  who  have  not  Hering's  or  one  of 
the  others  alluded  to  above, 


54  Reviews, 


The  Homceopathic  Physicians^  Visitinff  List  and  Pocket 
Repertory,  By  Robert  Faulkner^  M.D.  2nd  Edit. 
New  York  :  Boericke.     London :  Turner. 

Silverloek's  Medical  Practitioners'  Visiting  List  and  Diary, 
1880. 

Dr.  Faulkner's  Visiting  List  is,  as  its  name  implies^ 
intended  for  the  homoBopathic  practitioner^  and  a  useful 
repertory  accompanies  it.  It  is  not  arranged  for  any 
particular  year^  but  has  ample  room  for  a  record  of  every 
day  in  the  year.  It  is  handsomely  bound  in  black 
morocco,  and  is  of  a  size  adapted  to  the  pocket. 

SiLVERLOCK^s  Diary  has  been  politely  forwarded  to  us  by 
Messrs.  Armbrecht,  Nelson,  and  Co.  It  is  essentially  a 
work  for  an  old  school  practitioner^  but  besides  containing 
information  respecting  doses  of  all  sorts  of  medicines  on 
the  allopathic  scale,  and  other  items  that  are  of  value  to 
the  orthodox  practitioner  only,  it  contains  a  great  deal  of 
information  that  is  equally  valuable  to  the  homoeopathist. 

Either  of  these  works  may  be  used  by  any  practitioner, 
but,  on  the  whole,  we  prefer  the  arrangement  of  the 
English  work  to  that  of  its  American  rival,  notwith- 
standing the  repertory  in  the  latter^  which  may  prove 
useful  as  a  refVesher  of  the  memory,  that  it  is  rather 
meagre. 


New  Part  of  the  '  Cypher  Repertory,' 

We  call  the  attention  of  our  readers  to  the  new  part  of 
this  valuable  work  just  published.  It  contains  the  sym- 
ptoms of  the  Female  Genitals,  and  has  been  well  executed 
by  Drs.  Drysdale  and  Stokes,  who  have  already  contributed 
the  greater  number  of  chapters  to  this  work.  This  part  is 
paged  separately  as  it  is  rather  out  of  order  in  its  publica- 
tion, two  chapters  which  are  not  yet  published  intervening 
between  it  and  the  part  last  published. 


55 


OUR  FOREIGN  CONTEMPORARIES. 

AMERICA. — North  American  Journal  of  HomcBopalhy, 
No?.,  1878— Nov.,  1879.— The  November  number  of  this 
publication  contains  the  long-expected  pathogenesis  of  Palla" 
dium^  by  Dr.  Hering,  which  will  be  read  with  much  interest. 
The  metal  was  proved  by  thirteen  persons.  Dr.  Hering 
thinks  it  indicated  in  uterine  and  ovarian  disorders  like 
those  for  which  Platina  is  given,  when  the  mental  sym- 
ptoms characteristic  of  that  drug  are  absent.  The  editor 
continues  his  useful  translations,  giving  us  in  this  number 
the  beginning  of  Dr.  GersteVs  study  o{ Mezereum^  which  was 
prepared  for  the  World^s  Convention.  He  is  not  so  happy 
in  his  rendering  of  Dr.  Jousset's  clinical  lectures  on  pur- 
pura. The  author  relates  a  case  treated  at  the  H6pital  Yal 
de  Gr&ce,  for  the  sake  of  the  phenomena  which  occurred. 
Dr.  Lilienthal  assumes  that  the  patient  applied  to  Dr. 
Jousset  at  a  homoeopathic  dispensary,  and  received  Quinine^ 
&c.,  secundum  artem ;  and  then  exclaims,  *'  Is  this  the 
homoeopathy  of  France  ?  ^^  We  accordingly  have  The 
Organon  (to  which  UArt  Medical  is  probably  unknown) 
saying,  in  reference  to  this  translation,  '^  Dr.  Jousset's  cases 
are  simply  a  disgrace  to  homoeopathic  literature.''  Dr. 
Hale  extracts  from  the  Eclectic  Medical  Journal  a  cure  of 
a  reputed  case  of  diabetes  mellitus  with  an  infusion  of 
Lycopus  virginicus. 

In  the  February  number  we  again  meet  with  Dr.  Hering 
("Father  Hering,''  as  the  editor  aflFectionately  calls  the 
veteran  homoeopathist),  and,  much  to  our  gratification,  find 
him  departing  from  the  narrow  lines  of  his  party,  by  recom- 
mending the  use  of  Amyl  nitrite  by  inhalation,  as  a  pallia- 
tive in  angina  pectoris.  He  excellently  says  : — *'  The  old 
school  doctors  have  taken  from  us  dishonestly,  let  us  take 
from  them  honestly."  Dr.  von  Tagen  communicates  some 
more  facts  showing  the  power  of  Calcarea  phosphorica^ 
in  the   triturations  from  the  6th  to  the  30tb,  to  promote 


66  Our  Foreign  Contemporaries. 

ossification  in  fractures,  bone  disease,  &c.  Dr.  Lilienthal 
continues  the  translation  of  Gerstel's  Mezereum,  and  Dr. 
Berghaus  begins  that  of  Lohrbacher's  Causticum, 

In  May  we  find  a  very  able  paper  by  Dr.  W.  S.  Searle, 
entitled  ''  A  New  Form  of  Nervous  Disease/'  This  is  "  cha- 
racterised by  a  sensation  of  sudden  shock  or  blow,  or  ex- 
plosion, usually  located  in  the  occipital  region,  which  is 
sometimes  preceded  by  an  aura,  similar  to  that  of  epilepsy, 
and  is  always  followed  by  passive  congestion  of  the  cere- 
bellum/' His  remarks  on  the  pathology  of  this  affection — 
of  which  he  relates  nine  instances — show  thorough  ac- 
quaintance with  the  subject ;  and  it  is  interesting  to  find 
that  Argentum  metallicum  and  Digitalis*  prove  its  most 
useful  remedies.  We  should  like  to  know,  however,  where 
Dr.  Searle  found  ^'  electric  shock  terminating  in  an  explo- 
sion near  the  foramen  magnum  "  in  the  pathogenesis  of  the 
former  drug.  We  cannot  discover  it  in  Allen.  The  studies 
of  Mezereum  and  Causticum  are  continued.  The  remarks 
of  the  author  on  the  pathogenesis  of  the  latter  drug  display 
much  of  that  blind  credulity  about  medicinal  effects  which 
we  have  often  had  to  reprobate.  '^  Complete  paralysis,''  he 
writes,  ''is  very  rare  after  Sulphur,  while  it  occurs  fre- 
quently after  Causticum."  What  evidence  have  we  that  either 
of  these  drugs  (which  are  not  poisons)  ever  caused  anything 
like  '^  complete  paralysis  ?"  Another  translation  from  the 
German  is  Dr.  Buchmann  on  '^  Molecular  Attraction  and 
B/cpulsion."  He  supplies  a  crucial  experiment  illustrating 
the  specific  morbid  effect  of  undue  nutriment.  "  A  Bicinus 
purpureus  developed  itself  beautifully  by  manuring  it  with 
Chilian  saltpetre.  But  when  I  doubled  the  quantity  of 
saltpetre  in  the  solution  chlorophyll  discoloration  set  in  in 
the  centre  of  several  leaves,  they  shrank,  and  the  affected 
parts  of  the  leaves  died.  By  conveying  a  surfeit  of  nutritive 
matter  we  caused  a  pathogenetic  molecular  attraction 
instead  of  a  nutritive  one,  showing,  without  doubt,  a 
special  predisposition  of  some  cellular  territories  for  this 
combination." 

We  are  compelled  to  note  another  instance  of  unwarranted 

*  See  vol.  xxyii  of  this  Joomal,  p.  150. 


America.  57 

assertion^  this  time  from  the  clinical  side.  In  a  paper  on 
BerberiSf  Dr.  H.  V.  Miller  says  that  this  drag  ^*  has 
repeatedly  cured  fistulae  recti,  when  attended  with  bilious 
symptoms^  or  dry  troublesome  coughs/'  Bectal  fistulse  are 
not  so  easily  cured  by  internal  medication  as  this  state- 
ment would  lead  us  to  imagine. 

The  August  number  begins  with  a  paper  by  Dr.  Heringj 
entitled  "  Alternation  with  the  Antidote.''  Referring  to  his 
carious  recommendation  of  an  alternation  of  Colocynih  with 
strong  coffee  in  a  form  of  colic,  he  extends  a  similar 
countenance  to  the  administration  of  opiates  in  connection 
with  the  specific  remedy  where  great  pain  is  present. 
Verily,  this  princeps  among  the  Hahnemannians  must  be 
disturbing  the  minds  of  his  fellows  while  gladdening  ours. 
Of  Dr.  Allen's  interesting  article  on  Houat's  provings, 
which  follows,  we  have  spoken  elsewhere  in  our  present 
Dumber.  Dr.  McNeil  contributes  some  new  '^  Charac- 
teristics/' which  may  be  worth  recording : 

*' ApU. — ^In  intermittents,  when  daring  the  paroxysms 
the  lips  swell  and  are  painful. 

"  Ignatia. — Labour-like  pains  relieved  by  lying  without 
pillows,  and  with  the  foot  of  the  bed  elevated. 

''  This,  I  think,  will  be  found  useful  in  the  many  pains 
which  women  suffer  in  labour,  abortions,  dysmenorrhcea, 
&c.,  and  probably  in  those  found  in  the  other  sex. 

^'  Bhu8  tox. — Violent  colic  pains,  relieved  by  lying  on 
the  back,  with  the  lower  extremities  elevated  vertically/' 
We  suppose  this  means  on  the  mantel-piece ;  it  would  be 
difficult  otherwise  to  sustain  the  legs  in  such  a  position. 

"  Stdphur, — Children  cry  violently  without  any  discern- 
ible cause;  only  pacified  by  rubbing  or  by  taking  into 
cool  air. 

''  I  impute  the  crying  to  an  itching  that  torments  the 
child,  although  no  eruption  can  be  discovered."  Dr. 
Edward  Chapin  gives  the  outline  of  some  new  provings  of 
Apoeynumf  which  will  be  found  in  full  in  the  tenth  volume 
of  Allen's  Encyclopedia, 

Dr.    Hering,    whose  literary  activity  is   untiring,  has 
another    article  in  this  number  on  possible  remedies  for 


58  Owr  Foreign  Contemporaries. 

the  plagne^  and  at  its  close  begins  a  collection  of  the 
symptomatology  of  Lyssin  (as  he  now  styles  what  used 
to  be  called  Hydrophobin).  It  seems  that  that  which  has 
been  proved  and  employed  under  this  name  is  a  tritura- 
tion of  the  saliva  of  a  rabid  bitchy  obtained  in  1833. 
In  preparing  it^  Dr.  Hering  states  that  he  was  affected 
with  intolerable  feelings  of  apprehension. 

In  the  November  issue  we  have  a  proving  of  another 
rare  metal,  CtBsium,  by  Dr.  W.  E.  Leonard.  It  contains, 
with  its  predecessor,  several  translations  from  French  and 
German  sources;  and  some  further  contributions  to  the 
two  cognate  controversies  now  raging  among  our  American 
colleagues,  viz.  those  excited  by  Dr.  C.  Wesselhoeft^s  micro- 
scopic examination  of  our  triturations^  and  by  the  proposal 
emanating  from  Milwaukee  to  test  our  high  dilutions  by 
crucial  experiment.  We  hope  to  give  a  full  account  of 
these  matters  in  our  next  number. 

Throughout  this  series  of  the  North  American  Dr. 
Ludlam  continues  his  survey  of  the  gynaecological  litera- 
ture of  each  quarter,  and  makes  a  very  instructive  thing 
of  it. 

We  find  that  we  must  limit  our  notice  this  time  to  our 
quarterly  contemporary.  A  mass  of  numbers  of  the 
monthlies  lie  before  us,  and  we  shall  endeavour  to  survey 
their  contents  next  time. 


59 


CLINICAL    RECORD, 


Sulphur  in  Chronic  Ulcer  of  the  Legs. 
By  A.  Gr.  Saitdbebo,  L.R.C.P.Ed. 

James  P — ,  49  years  of  age,  a  compositor,  consulted  me  on 
September  20th,  1879,  for  a  chronic  ulcer  of  the  right  leg.  He 
had  suffered  from  the  ulcer  for  five  years.  The  patient  described 
its  commencement  as  follows : — "  Five  years  ago  I  noticed  a 
blister  on  my  leg,  this  broke  the  same  night,  and  has  never 
healed."  He  was  quite  well  previously.  No  history  of  syphilis, 
though  half  a  year  before  the  ulcer  appeared  he  had  gonorrhoea. 
The  patient  had  been  of  rather  intemperate  habits  before  the 
ulceration  appeared.  Since  that  time  he  had  been  attending 
St.  Bartholomew's,  Charing  Cross,  and  King's  College  Hospitals. 
The  leg  appeared  much  inflamed,  and  the  idcer  was  about  the 
size  of  a  florin,  and  of  an  unhealthy  brown  colour. 

The  patient  otherwise  was  in  a  good  state  of  health,  the 
only  other  symptom  complained  of  being  a  slight  irritation  over 
the  back.     The  leg  was  very  hot  and  painful. 

I  ordered  him  a  lotion  of  Aconite  (two  drachms  of  the  1*  tinc- 
ture to  one  third  of  a  pint  of  water)  to  be  applied  to  the  ulcer 
and  round  the  inflamed  parts ;  also  internally  Sulph.  3,  TY\j 
ter  die. 

September  27th. — He  was  rather  better.  Medicine  and  lotion 
repeated. 

October  Ist. — Repeat  medicine  and  lotion. 

4th. — Still  improving ;  the  idcer  seems  to  be  smaller.    Repeat. 

11th. — "  Not  quite  so  well,  the  pain  being  rather  severe  in  the 
leg."     Repeat  Aconite  lotion  and  Sulph.  3. 

18th. — Better  again.    Repeat  medicine  and  lotion. 

25th. — Repeat. 


60  Clinical  Record. 

Noyember  Irt. — Much  better.  The  ulcer  rapidlj  "  filling  up." 
Bepeat. 

8th.— Bepeat. 

15th.— TTloer  quite  healed,  nothing  remaining  but  the  redness 
of  the  leg. 

29th.— Still  well.  Bepeat  Sulph.  3.  Has  kept  at  work  all 
through  his  attendance. 


Myopia  from  a  blow.    The  meehanifm  qf  acoommodoHon, 

By  B.  E.  DmeEOK,  M.D. 


A.  B — ,  aged  about  twenty-six,  was  struck  by  the  cork  of  a 
soda-water  bottle,  let  off  beneath  him,  on  the  inferior  and  outer 
part  of  the  left  eyeball.  The  pain  caused  by  the  blow  was 
extreme,  and  the  viaion  much  affected.  Within  a  few  minutes  of 
the  accident  he  was  at  the  Moorfields  Ophthalmic  Hospital,  and 
his  sight  was  tested  by  a  medical  man  there.  Vision  was  very 
foggy,  and  fingers  could  only  be  seen  and  counted  at  a  small 
distance  firom  the  eye,  in  which  position  they  appeared  magnified. 
Ice  to  the  eye  was  prescribed.  On  going  home  he  saw  Mr. 
Engall,  and  as  the  pain  still  continued  of  an  intense  burning 
character,  and  as  blood  was  effbised  into  the  anterior  chamber, 
filling  it  inferiorly  almost  up  to  the  line  of  the  pupillary  border, 
Mr.  Engall  prescribed  Amiea  in  compresses,  which  soon  caused 
the  blood  to  disappear.  Pain  still  persisting  (it  lasted  for  three 
days),  and  the  eye  being  highly  injected,  Aconite  was  prescribed 
and  a  powder  of  Merc.  corr.  The  pain  and  inflammation  having 
subsided  the  pupil  appeared  egg  shaped,^  the  long  diameter 
perpendicular,  the  smaller  pointed  end  of  the  egg  directed  down- 
wards. By  this  time  the  vision  was  dear,  but  extremely  myopic, 
only  things  held  at  less  than  two  inches  from  the  eye  being  dis- 
tinctly visible,  and  then  highly  magnified.  Vision  beyond  this  was 
extremely  indistinct,  no  details  of  objects  being  distinguishable. 
Mr.  Engall  applied  BeUadotma^  which  caused  dilatation  of  the 
pupil,  but  had  no  effect  on  the  vision.  Bell,  was  also  given 
internally.  When  the  Belladonna  mydriasis  had  subsided  the 
pupil  appeared  round,  but  the  vision  remained  as  before.    Mr. 


Myopia  from  a  Blow^  Ifc.y  by  Dr.  Dudgeon.  61 

Engall  sent  the  case  to  me  a  week  after  the  accident.  I  found 
the  right  eye  nonnal  and  emmetropic,  but  in  the  left  eye  the 
papil,  though  not  much  dilated,  was  sluggish.  There  was  no 
pain,  unless  a  slight  tenderness  on  the  top  of  the  eyeball  could  be 
so  called,  the  refractive  media  of  the  eye  were  quite  transparent, 
and  there  was  little  or  no  vascular  turgescence.  A  book  had  to 
be  held  within  four  inches  of  the  eye  before  he  could  see  the 
letters  distinctly,  and  then  they  appeared  highly  magnified. 
There  was  no  dimness  or  fogginess  of  vision,  but  he  could  not  dis- 
tinguish the  details  of  objects  beyond  that  distance  from  his  eye. 
In  short,  the  eye  was  set  at  the  highest  possible  degree  of  accom- 
modation for  near  vision,  and  could  not  be  moved  from  that.  I 
prescribed  Fhysostigma  3x  every  three  hours,  and  after  one  dose 
he  was  able  to  see  objects  at  a  considerable  distance,  and  the 
following  day  the  sight  was  almost  as  good  as  ever.  I  saw  him 
again  eleven  days  after  his  former  visit — eighteen  days  after  the 
accident — and  found  his  vision  perfectly  normal,  distant  and  near 
objects  being  seen  in  the  most  perfect  manner.  The  papil,  too, 
was  normally  contractile.  There  was  some  tenderness  on  pressure 
on  the  top  of  the  left  eyeball,  and  some  conjunctival  vessels 
appeared  rather  too  plainly,  but  the  eye  could  be  pronounced 
welL 

This  -case,  I  think,  illustrates  the  views  I  have  repeatedly  set 
forth  with  regard  to  accommodation.  The  blow  on  the  lower 
and  outer  part  of  the  eyeball  had  tilted  the  lens  on  its  horizontal 
or  perhaps  oblique  axis  to  such  a  degree  that  the  lower  fibres  of 
the  ciliary  muscle  were  overstretched  and  paralysed,  if  not 
actually  lacerated.  The  lens  was  thus  in  the  position  of  accom- 
modation for  the  nearest  possible  distance,  and  the  weakened  or 
injured  portion  of  the  ciliary  muscle  was  unable  to  restore  it  to 
the  proper  place  required  for  distant  vision.  Were  the  views  re- 
specting accommodation  usually  held  correct,  this  condition  of  the 
vision  would  imply  a  continual  and  extreme  spasm  of  the  ciliary 
muscle,  so  as  to  keep  the  capsule  of  the  lens  in  a  state  of  laxness, 
and  allow  the  lens  to  assume  a  convex  form  by  its  own  elasticity. 
But  then  the  dilated  and  irregular  state  of  the  pupil  militates 
against  this  view,  not  to  mention  that  the  exciting  cause — a  sharp 
blow — is  more  likely  to  cause  paralysis  than  spasm  of  the  delicate 
ciliary  muscle.  The  circumstance  that  the  full  dilatation  of  the 
pupil  by  Belladonna  was  without  effect  on  the  myopia  is  another 


62  Clinical  Record, 

reason  for  disbelieving  in  any  spasm  of  tbe  ciliary  muecle.  On  the 
other  bandy  a  mechanical  turning  of  the  lens,  as  I  have  elsewhere 
explained,  will  shorten  its  focus  and  cause  any  conceivable  amount 
of  myopia.  The  degree  of  myopia  in  this  case  was  greater  than 
could  be  produced  by  the  utmost  effort  to  accommodate  the  eye 
for  near  ?i»ion,  and  it  was  permanent.  It  is  impossible  to  sup- 
pose a  spasm  of  the  ciliary  muscle — even  could  it  cause  this 
degree  of  myopia — lasting  for  such  a  length  of  time — a  whole 
week — without  any  painful  sensation,  and  even  resisting  the 
paralysing  action  of  Belladonna.  On  the  other  hand,  the  imme- 
diate effect  of  Fhyioatigma  might  favour  the  idea  of  spasm ;  for 
the  production  of  myopia,  which  is  usually  considered  to  be  owing 
to  general  ciliary  contraction,  is  a  pathogenetic  effect  of  Fht/so- 
stigma,  and  its  relief  would  be  a  homoeopathic  cure.  My  own 
idea  is  that  the  Fhysostigma  acted  remedially  on  the  overstretched 
or  paralysed  portion  of  the  ciliary  muscle,  restoring  its  tone 
gradually,  and  so  enabling  it  to  replace  the  lens  in  the  position 
adapted  for  distant  vision.  The  restoration  to  normal  accommo- 
dation power  was  not  effected  by  a  sudden  spring,  as  in  the 
natural  changes  from  near  to  distant  vision,  but  gradually, 
for  though  great  improvement  was  observed  soon  after  the  first 
dose,  it  was  not  complete  until  after  the  lapse  of  a  day  or  two. 


Vaccination  and  Smallpox,    By  Dr.  Bvdgeok. 

Miss  H.  S — ,  aet.  55,  was  exposed  to  the  contagion  of  small- 
pox during  the  early  days  of  March  last  in  the  following  way : — 
Her  housemaid  had  been  to  see  a  friend  in  the  house  of  a  medical 
practitioner,  a  strong  opponent  of  vaccination,  whose  children — 
all  except  one,  who  had  been  vaccinated  at  school  against  his 
father's  wish — were  lying  ill  with  smallpox,  to  one  of  whom  it 
proved  fatal.  The  housemaid  some  time  after  this  exposure  to 
infection  took  ill  with  feverish  symptoms,  and  her  mistress.  Miss 
9 — ,  being  fond  of  her,  nursed  her  until  the  2nd  March,  when  the 
disease  proving  to  be  smallpox,  she  was  sent  off  to  a  smallpox 
hospital  at  Haverstock  Hill.  Miss  S — ,  who  had  not  been 
vaccinated  successfully  since  infancy,  waa  vaccinated  on  the  8rd 


Vaccination  and  Smallpox,  by  Dr,  Dudgeon.  63 

March,  and  the  Yaccinia  ran  a  perfectly  normal  course ;  so  that 
on  the  lOtih  March  the  three  points  of  vaccination  displayed  the 
characteristic  appearance  of  normal  vaccinia.  On  the  11th  March 
febrile  symptoms  came  on,  which  increased  to  such  a  degree  next 
day  that  I  was  sent  for.  I  found  the  pulse  about  120,  the 
temperature  of  the  skin  103,  great  pain  in  the  back,  nausea,  and 
general  uneasiness.  I  looked  at  the  ann,  and  found  the  vaccinia 
perfectly  normal,  with  a  moderate  amount  of  redness  and  swelling 
around  the  vesicles.  The  patient  told  me  she  had  nursed  her 
smallpox  maid  before  being  vaccinated,  but  as  there  was  yet  no 
eruption  on  her  skin,  I  was  in  hopes  that  I  had  to  do  with  a  case 
of  rather  severe  vaccine  fever.  However,  the  following  day  there 
was  no  room  for  doubt,  she  showed  red  spots  all  over  face,  body, 
and  limbs,  aad  smallpox  eruption  soon  showed  its  characteristic 
appearance.  The  fever  immediately  ceased  on  the  development 
of  the  pustules,  which,  though  pretty  generally  distributed, 
were  moderate  in  number.  After  attaining  their  iiiU  develop- 
ment they  almost  suddenly  shrank  and  dried  up,  and  no  marks 
were  lefit.  It  is  to  be  remarked  that  the  vaceine  vesicles 
shrank  into  inaigoificanoe,  and  their  red  axeola  suddenly  die- 
appeared  on  the  ooeurrence  of  the  variolous  pustuks.  In  this 
case  the  system  had  received  the  in&etion  of  variola  be&re  that 
of  vaccinia ;  the  vaccinia  ran  its  course  nomially  up  to  the  ninth 
day,  by  that  time  the  variolous  infection,  having  completed  its 
period  of  incubation,  assumed  the  upper  hand,  causing  the 
vaccinia  to  abort.  In  its  turn  the  variola  was  evidently  modified 
by  the  vaccinia,  as  the  pustules  seemed  struck  with  a  sudden 
blight,  and  shrivelled  up. 


64 


MISCELLANEOUS. 


A  Letter  of  Hahnemann, 

Thi  following  letter  addressed  by  Hahnemann  to  the  Minister 
of  Public  Instmction  of  France  apropot  of  an  application  made 
to  G-oTemment  for  the  establishment  of  homodopathic  dispen* 
saries  and  hospitals  is  interesting  and,  as  far  as  we  are  aware  r  has 
not  hitherto  been  published.  It  was  communicated  by  Dr. 
Tessier  to  the  Homaaopathic  Medical  Society  of  France,  and  is 
published  in  the  Bulletin.  The  original  is  in  French.  The  year 
1885,  when  it  was  written,  is  the  same  year  in  which  the  fair 
M^lanie  d'Hervilly  trarelled  to  Coethen,  and  captivated  the 
founder  of  homooopathy  with  her  mature  charms.  May  we  not 
imagine  that  the  old  gentleman  was  assisted  in  its  composition 
by  his  French  charmer  P 

To  M.  the  MnnsTBR  or  Pitblio  IirsTBTTOTioir  or  Fbakcb  : 
Samxtxl  HAmrBKANir,  Discoyerer  of  Homceopathy. 

M.  LS  MiNISTBS, — 

I  read  in  the  Moniteur  that  you  have  been  pleased  to 
consult  the  Academy  of  Medicine,  in  order  to  ascertain  "  if  it  if 
desirable  to  establish  in  Paris  dispensaries  and  a  hospital  where 
the  sick  shall  be  treated  according  to  the  principles  of  homoDO- 
pathic  medicine." 

The  welfare  of  humanity  interests  me  too  intensely  to  allow 
me  to  remain  silent  before  a  question  of  such  importance.  M.  le 
Ministre,  my  conscience  forces  me  to  enlighten  yours,  which 
nobly  wishes  to  haQ  and  to  protect  the  most  important  of  all  the 
scien^,  that  which  restores  and  preserves  life ;  a  new  science 
trenchmg,like  all  new  discoveries,  on  some  private  interests,  and 
on  that  very  account,  wherever  it  seeks  to  estabUsh  itself 
encountering  oppositions  which,  in  order  to  hinder  its  propagation, 
compel  themselves  to  question  the  truth  of  its  principle. 


A  Letter  of  Hahnemann.  65 

All  the  systems  of  medicine  hitherto  invented,  regard  diseases 
as  capable  of  being  displaced  materially  by  violent  means, 
which  weaken  the  vital  force  with  bloodletting  and  evacuations 
of  all  sorts.  Homoeopathy,  on  the  contrary,  acting  dynamically 
on  the  vital  spirits,  destroys  diseases  in  a  gentle,  imperceptible, 
and  durable  manner.  Hence  it  is  not  merely  an  ingenious 
invention,  a  skilful  combination  that  produces  results  more  or 
lees  beneficial  in  its  application,  but  it  is  a  principle  of  eternal 
nature,  the  only  one  able  to  restore  to  man  his  lost  health.  The 
science  established  on  this  principle,  which  is  expressed  in  the 
sentence  similia  similihus  cu/rentur,  is,  and  will  continue  to  be 
in  opposition  to  all  the  medical  doctrines,  and  to  those  who 
practise  them  ;  consequently,  M.  le  Ministre,  you  cannot  accept 
for  itr  judges  those  who  are  unacquainted  with  it,  or  who  are 
directly  interested  in  opposing  its  progress. 

The  members  of  the  Academy  of  Medicine  of  Paris  are 
respectable  men,  but  it  should  not  be  forgotten  that  long  habit 
attaches  them  to  the  practice  of  an  imperfect  science,  which,  in 
the  absence  of  a  better,  has  hitherto  governed  the  health  of  man- 
kind. They  know  not  what  homoeopathy  is  ;  in  their  ignorance 
they  regard  it  as  a  chimera,  they  refuse  to  study  it,  are  unable  to 
conceive  its  effects  or  its  application.  I  do  them  the  justice  to 
believe  that  successful  results  may  convert  them,  but  it  is  requisite 
to  be  able  to  obtain  these  results,  and  the  chance  if  this  should 
not  be  submitted  to  their  approbation. 

Homoeopathy  only  demands  from  its  detractors  to  be  allowed 
to  prove  its  power ;  this  proof  will  be  the  more  evident  the  greater 
the  number  of  individuals  on  whom  it  is  produced.  A  homoeo- 
pathic hospital,  however  small,  if  it  be  well  ordered  and  exclu- 
sively subjected  to  the  influence  of  this  system  of  medicine,  is 
certainly  a  sure  means  of  convincing  people  of  its  excellence.  I 
entreat  you,  M.  le  Ministre,  to  be  guided  in  this  important 
matter  by  your  own  convictions,  which  you  may  enlighten  by 
applying  to  the  members  of  the  Homoeopathic  Society  of  Paris  ; 
consult  them  upon  the  principle  which  guides  us,  and  give  them 
the  means  of  showing  you  its  truth,  by  confiding  to  them  a  hos- 
pital, uninfluenced  by  the  adverse  superintendence  of  physicians 
of  the  old  school.  The  results  will  be  prompt  and  favourable.  I 
promise  this  by  my  long  experience,  and  entreat  you  to  credit 
the  word  of  an  old  man,  the  friend  of  humanity. 

▼OL.  XXXVIII,  NO.  CLI. JANUARY,  1880.  1 


66  Misceltanedtu. 

It  it  ouly  the  advantage  of  the  French  whom  I  lo?e,  and  no 
personal  interesty  that  guides  me  in  the  advice  I  make  bold  to 
proffer  to  70a  now,  and  I  shall  be  happy  to  be  able  to  answer 
your  questions  if  you  consider  it  requisite  to  have  more  detailed 
information. 

M.  Le  Ministre,  your  poet  Beranger  says — 

Combicn  de  temps  une  pens^, 
Vierge  obfcnre,  attend  ion  6poaz ! 
Let  M>ts  U  traitant  d'insent^ ; 
Le  sage  loi  dit :  Cachez  yoos. 
Mais  la  rencontrant  loin  dn  monde, 
Vnfou  qui  croit  an  lendemain, 
L'^poose ;  elle  doTient  f  econde 
Poor  le  bonhenr  da  genre  hnmain. 

This  is  my  story,  M.  Le  Ministre ;  at  eighty  years  of  age  I 
must  still  beg  my  fellow-creatures  to  pardon  me  for  doing  them 
good. 

I  trust  you  will  accept  my  observations,  and  cause  to  be  esta- 
blished in  Paris  an  independent  homooopathic  hospital,  sub- 
mitted to  your  jurisdiction  only,  whereby  my  wishes  will  be 
accomplished,  and  I  shall  be  rewarded  for  my  immense  labours. 

I  remain,  M.  Le  Ministre,  with  the  most  profound  respect. 
Your  very  humble  and  very  obedient  servant, 

Sakubl  HAHKSKAinr. 
Coethen,  Dnchy  of  Anhalt ; 
13th  February,  1835. 


The  Secret  Bevealed. 

A  OAT  in  a  bag  ia  an  object  that  excites  the  utmost  cariosity, 
if  not  awe.  It  is  a  concealed  mystery ;  a  hidden  secret  we  long 
to  disclose.  But  when  the  bag  is  opened  and  an  ordinary  pussy 
is  revealed,  curiosity  gives  place  to  indifference,  awe  to  contempt. 
While  the  cat  is  concealed,  and  only  betrays  its  presence  bj 
sundry  movements,  scrapings  or  low  growls,  we  are  apt  to  rxake 
all  sorts  of  conjectures  as  to  what  it  may  be — ^some  unknown 
monster,  some  ferocious  creature  with  poison  fangs  and  rattle, 
some  lovely  fowl,  or  some  hideous  reptile,  but  when  Tom  appeals 


The  Secret  revealed,  67 

We  feel  half  ashamed  of  our  previous  curiosity  and  other  emo- 
tions, and  rather  disposed  to  administer  a  disdainful  kick  to  the 
vulgar  beast  for  having  so  excited  us. 

The  mystery  that  has  so  long  hung  over  the  mode  of  prepara- 
tion of  the  high  potencies  of  the  notorious  Jenichen,  has,  it  strikes 
us»  been  of  much  the  same  character  as  that  surrounding  the  cat 
in  the  bag ;  and  now  that  our  contemporary  The  Organan  has 
revealed  the  secret,  we  feel  that  we  have  expended  a  useless 
amount  of  curiosity. on  an  insignificant  object  of  no  greater 
consequence  or  interest  than  the  cat  out  of  the  bag. 

We  can  imagine  the  owner  of  the  cat  in  the  bag  being  very 
unwilling  to  dispel  the  mystery  that  enshrouds  his  property,  and 
rather  liking  to  retain  the  importance  that  attaches  to  himself  as 
the  possessor  of  an  awe-inspiring  or,  at  least,  curiosity-exciting 
secret.  We  can  &ncy  him  resistiixg  the  entreaties  of  his  friends 
to  tell  what  was  within  his  precious  sack;  we  can  figure  his 
amusement  at  their  wide-of-the-mark  guesses.  Probably  the  only 
way  to  get  him  to  let  the  cat  out  of  the  bag  would  be  to  ''  rile  " 
him  by  persistently  declaring  there  is  nothing  in  it.  The  cat-in- 
the-bag's  owner  would  hardly  be  able  to  resist  such  treatment. 
Contempt  will  make  him  yield  when  entreaty  is  fruitless.  Un- 
like the  traveller  in  ^sop's  fable,  he  refuses  to  part  with  his 
cloak  to  the  genial  sunshine  of  solicitation,  but  thrower  it  off  at 
once  when  subjected  to  the  cold  shade  of  scepticism.  His 
consent  to  let  his  cat  be  seen  would,  we  expect,  be  promoted 
supposing  others  appeared  with  cats  in  bags,  and  were  by  no 
means  unwilling  to  let  their  cats  be  seen ;  but,  on  the  contrary, 
flaunted  them  before  his  face,  vowing  they  were  the  finest  cats 
ever  seen,  and  much  superior  to  his  poor  cooped-up  animal. 

Such  has  heen,  mutatiMtnutandu,  very  nearly  the  history  of  that 
homoeopathic  cat-in-the-bag — Jenichen's  mode  of  manufacturing 
his  so-called  high  potencies.  Drs.  Gross  and  Stapf  were  the  first 
patrons  of  these  novelties — ^not  that  Jenichen  was  the  first 
introducer  of  high  potencies,  so  called,  into  homosopathic  practice, 
for  Yon  Korsakoff  preceded  him  with  his  high  potencies  by 
infection,  as  we  showed  in  vol.  v.  The  novelty  of  Jenichen's  high 
potencies  was  their  mode  of  preparation,  which  he  kept  a  dead 
secret,  and  secrecy  also  was  a  novelty  in  homoeopathic  pharmacy ; 
if  these  gentlemen  knew  Jenichen's  method,  at  all  events  they 
did  not  reveal  it.    Dr.  C.  Hering  certainly  knew  it,  and  after  the 


68  Miscellaneous, 

death  of  Gro88  and  Stapf— if  not  before— was  the  only  one  who 
posseesed  the  secret. 

Hering  was  frequently  appealed  to  to  reveal  the  secret,  but  hia 
answer  was,  "  If  any  one  wishes  to  know  how  Jenichen's  prepa- 
rations are  made,  let  him  apply  to  Jenichen ;  I  know  it,  and  that 
is  sufficient  for  my  purpose."*  Solicitations  were  eyidentlj 
fruitless  to  get  the  cat  out  of  the  bag. 

Dr.  Bentsch,  of  Wismar,  a  very  scientific  man,  whose  physio- 
logical researches  in  the  domain  of  microscopic  organisms  resemhle 
in  some  ways  those  of  our  own  Drysdale,  was  constituted  the 
heir  of  Jenichen.  At  the  meeting  of  the  Congress  at  Leipzic  in 
1851  he  read  a  paper  giving,  from  the  writings  of  Jenichen  and, 
where  these  were  defective,  from  his  own  conjectures,  the  mode 
of  preparation  of  Jenichen's  potencies.  We  gave  an  account  in 
our  ninth  volume  of  our  impression  of  what  Bentsch  said  at  the 
Congress ;  not  an  abstract  of  his  paper,t  which  we  had  not  seen, 
and  which,  in  fact,  we  did  not  see  until  after  our  own  report  had 
been  published.  Well,  Bentsch's  guess  at  the  contents  of  the  bag 
did  not  succeed  in  inducing  Hering  to  let  his  cat  out ;  so  our 
venerable  friend  still  continued  to  pass  as  the  sole  and  en?ied 
possessor  of  the  mighty  secret. 

But  the  bag,  which  was  kept  tightly  closed  against  the  solicita- 
tions and  the  guesses  of  friendly  colleagues,  was  at  last  opened 
to  Dr.  Hughes's  contemptuous  remark  in  our  No.  of  last 
January,  that  these  high  potencies  are  *^  utter  impossibilities," 
equivalent  to  an  assertion  that  there  is  nothing  in  the  bag ;  that, 
in  short,  the  whole  affair  is  a  sort  of  homoeopathic  Mrs.  Harris, 
of  whom  the  sceptical  Mrs.  Prigg  said  *'  she  didn't  believe  there 
wasn't  no  sich  person."  Dr.  Hering,  more  fortunate  than  Sarah 
G-amp,  can  triumphantly  produce  his  Mrs.  Harris  in  the  flesh— 
he  has  a  real  cat  to  let  out  of  his  bag. 

He  was  probably  rendered  more  willing  to  do  this  by  the  crop 
of  rival  claimants  to  high-potency  fame  that  had  sprang  up  of 
late.  As  long  as  there  was  only  one,  poor  Fetters  of  Dessan, 
who  tried  to  make  high  potencies  according  to  Hahnemami's 
method,  Hering  had  no  difficulty  in  snuffing  him  out  with  the 
remark  that  his  potencies  had  been  tried  and  found  useless,  and 
although  Bummel  took  up  the  defence  of  Fetters,  and  even  sub- 

*  Brit.  Joum,  Horn,,  v,  p.  558. 

t  Allff.  Som,  ZeU^t  vol.  xlii,  Nos.  10  et  teq. 


The  Secret  revealed.  69 

jected  his  preparations  to  the  ordeal  of  a  solar  microscope,  it 
was  of  no  avail.  Jenichen  and  Jenichen  alone  would  go 
down,  and  henceforth,  for  some  time,  high  potencies  and 
Jeoichen's  preparations  were  conyertible  terms.  But  when  a 
crowd  of  high-potentizers  appeared,  each  with  his  cat  in  his  bag, 
which  he  made  no  pretence  of  concealing,  but,  on  the  contrary, 
which  he  displayed  to  all  the  world,  appealing  to  all  to  say 
whether  it  was  not  the  yery  perfection  of  cats,  and  especially  a 
thousand  times  better  than  that  old  affair  of  Jenichen's,  the 
possessor  of  the  last-mentioned  treasure  felt  that  imless  he  dis- 
played his  very  superior  animal  there  was  some  danger  that  its 
place  would  be  permanently  occupied  by  one  or  more  of  the  new 
claimants  for  admiration.  There  was  Dunham  with  his  200th8, 
made  by  £utening  his  bottles  to  a  mill-wheel ;  Eincke  with  his 
thousandths,  obtained  by  the  facile  process  of  putting  his 
dilution  bottle  under  a  water  butt,  and  letting  the  contents  flow 
through  it  at  their  leisure ;  there  was  Lehrmann  with  his  high 
potencies  made  one  way,  Boericke  with  his  high  potencies  made 
another  way ;  Swan  with  his  millionths,  and  Skinner  with  his 
ten  millionths.  The  ingenuity  of  some  of  these  potentizers  is 
displayed  in  the  complicated  machines,  automatic  and  other,  for 
taking  the  labour  of  potentizing  off  their  hands.  Evidently  one 
or  other  of  these  new  high-potencies,  some  of  which  go  up  to 
milHons,  will  soon  shoulder  the  Jenichen  potencies  out  of  the 
Bwim  altogether,  unless  it  can  be  shown  that  his  method  is  vastly 
superior  to  any  of  their  modern  rivals  with  their  new-fangled 
machinery.  So  its  custodian  resolves  at  last  and  at  length  to 
let  the  Jenichen  cat  out  of  the  bag,  and  he  chooses  The  Organon 
for  that  purpose.  Bather  hard  this  on  Dr.  Skinner,  who  has  his 
own  special  potencies,  and  his  own  ingenious  machinery  for 
potentizing. 

We  will  now  compare  the  accotints  given  by  Hering  and 
Bentsch  of  Jenichen  and  his  mode  of  preparing  the  high-poten- 
cies connected  with  his  name,  in  order  to  enable  our  readers  to 
judge  of  the  difference  between  them,  and  to  appraise  for  them- 
selves the  value  of  Dr.  Hering's  cat  in  the  bag. 

JRentsch',  Hering, 

Caap.  Jul.  Jenichen,  bom  Jenichen  belonged  to  a  noble 
at  Qotha  in  1787,  was  intended    family  of  North  (Germany  (what 


70 


Miscellafieous. 


by  his  father  for  the  profession 
of  law.  In  1814  he  went  to 
fight  as  a  mounted  volunteer 
rifleman.  Betumed  from  the 
wars  he  bought  a  property  near 
Ootha,  where  he  devoted  him- 
self to  training  horses  and 
veterinary    medicine.     When, 

_  • 

in  1821,  Duke  Ernst  erected  a 
national  manege  Jenichen  was 
appointed  Master  of  tha  Horse 
and  placed  at  the  head  of  the 
institution.  Owing  to  his 
skill  in  veterinary  medicine  he 
was  appointed  examiner  of  can- 
didates. After  the  death  of 
the  Duke,  the  manage  being 
done  away  with,  Jenichen 
went  back  to  his  property  and 
horse  training.  He  had  be- 
come acquainted  with  homoeo- 
pathy in  Gotha,  and  practised 
it  on  his  horses.  At  the  re- 
quest of  Baron  von  Biel,  of 
Weitendorf,  near  Wismar,  he 
undertook  the  management  of 
his  stables.  After  some  years 
he  retired  from  this  post  and 
settled  in  Wismar.  Here  he 
invented  the  high  potencies, 
and  whilst  preparing  them  he 
got  a  disease  of  the  feet  and 
legs,  which  caused  him  so  much 
pain  that  he  committed  suicide 
in  February,  1849. 

Jenichen  was  a  man  of  Her- 
culean strength.  He  once,  for 
a  wager,  dashed  his  flst  through 
a  door  panel,  and  he  exerted 
all  his  strength  in  the  prepa- 


became  of  the  "  von"  P) ;  he  dis- 
tinguished himself  as  a  caTalrj 
o£Scer  at  Waterloo.  After  this 
he  was  engaged  to  be  married, 
but  on  riding  to  his  bride's 
house  he  learned  she  was  dead, 
like 

"Th«  Ust  lord  of  BiTSZtfwood  to 
RaTenswood  did  ride, 
To  woo  a  dead  maiden  to  be  his 
bride." 

He  returned  home  alone,  and 
being  told  that  her  Life  might 
have  been  saved  by  homoeo- 
pathy, took  to  studying  that 
system  of  medicine.  Having 
acquired  a  knowledge  of  the 
practice,  he  devoted  all  his 
energies  to  curing  horses.  His 
muscular  strength  was  pro- 
digious. One  day  he  saw  a 
carriage  and  pair  dashing  down 
a  hill  at  full  speed.  He  caught 
hold  of  a  horse  with  each  hand 
and  brought  them  to  a  staad- 
still.  (The  size  of  the  horses 
is  not  stated ;  perhaps  it  was  a 
pony  carriage.)  The  carriage 
contained  the  Orand  Duke  of 
Gk)tha  and  his  lady.  (When 
was  the  Duchy  of  Gotha  made 
a  Grand  Duchy  f )  The  Grand 
Duke  invited  Jenichen  to  his 
house,  and  made  him  his  Master 
of  the  Horse.  The  British,  with 
their  characteristic  meanness, 
translate  this  title  (stallmeister) 
into  "  hostler. "  (We  don't  know 
who  Dr.  Hering  refers  to ;  as 
far  as  we  know  the  British  hare 


The  Secret  revealed. 


71 


ration  of  his  high  potencies. 
The  reason  why  he  made  high 
potencies  was  because  he  was 
discontented  with  the  potencies 
produced  on  the  method  pur- 
sued by  Hahnemann  (whether 
with  their  effects  on  horses  or 
men  we  are  not  told).  He  did 
not  think  better  of  Korsakoff's 
method,  and  resolyed  to  find 
one  for  himself.  He  had  the 
luck  to  make  a  great  discovery 
— no  less  than  a  new  law  of 
nature  {Natwrgetetx) ;  a  real  re- 
velation of  nature  {Natwrqffen- 
harung) — in  this  way  : — Find- 
ing a  bottle  of  the  29th  dilu- 
tion of  Plumb,  ac,  dried  up, 
the  cork  loose  and  dry,  the 
idea  occurred  to  him  to  poten- 
tise  from  this  bottle  up  to  the 
200th.  A  patient  affected  with 
hereditary  fetid  perspiration  of 
the  feet,  smelt  once  at  a  few 
globules  saturated  with  this  po- 
tency, and  in  a  few  days  was 
permanently  cured.  After  this 
Jenichen  began  all  his  high  dilu- 
tions of  earths  and  metals  from 
the  evaporated  29th  dilution. 
Bentsch  does  not  know  if  he  did 
this  with  other  medicines  be- 
sides the  metals  and  the  earths. 
He  thinks  it  probable  that 
Jenichen  began  to  potentise 
other  medicines  from  the  5th 
or  3rd  attenuation. 

For  the  potencies  from  200 
to  800  he  used  alcohol,  for 
those  from  800  upwards  the 


always  said  he  was  a  trainer  of 
horses,  on  the  authority  of 
Sentsch  and  others ;  we  don't 
remember  to  have  heard  him 
called  "hostler.")  At  the 
duke's  table  one  day  he  rolled 
up  a  silver  plate  as  if  it  had  been 
a  piece  of  pasteboard,  and  after- 
wards tore  the  roll  into  shreds 
as  if  it  had  been  a  newspaper. 
(No  wonder  the  G-rand  Duke 
did  not  retain  his  services  very 
long.  A  new  terror  will  be 
added  to  the  business  of  a  host 
if  the  guests  are  to  roll  up  their 
silver  plates  like  pasteboard 
and  afterwards  tear  them  to 
shreds  like  newspapers.  We 
have  heard  the  story  of  rolling 
up  a  silver  plate  with  the  fingers 
told  of  Count  Orloff,  a  Bussian 
ambassador,  but  the  tearing  it 
afterwards  to  shreds  is  new  to 
us.  Moral. — Don't  ask  athletes 
to  dinner  if  you  have  any  silver 
plate  lying  about.) 

The  high  potencies,  i,e.  up 
to  800,  are  made  in  bottles 
4i  inches  long  and  weighing 
i  oz.  Each  potency  gets  twelve 
strokes.  The  highest  potencies 
— from  900  upwards — are  made 
in  bottles  weighing  18  oz.,  in- 
cluding the  contents.  Each 
potency  gets  thirty  strokes. 
The  vehicle  used  is  the  water 
of  Lake  Schwerin,  which  is  as 
clear  as  crystal.  (Water  "clear 
as  crystal"  does  not  give  us 
information  as   to  its  purity. 


72 


Miscellaneous, 


water  of  Lake  Schwerin,  which 
is  as  clear  as  crystal. 

The  proportions  of  medicine 
to  vehicle  were,  up  to  200, 6  to 
2M;  for  those  from  800  to 
800,  1  to  800;  for  the  re- 
mainder 2  to  12,000. 

For  the  high  potencies  he 
nsed  bottles  4|  inches  high, 
I  inch  wide,  which  weighed  i 
an  ounce  (one  Loth),  He  used 
eight  such  bottles. 

For  the  highest  potencies  he 
employed  larger  and  heavier 
bottles,  which,  including  their 
contents,  weighed  18  ounces 
(86  Loth). 

Jenichen  sat  or  stood  strip- 
ped naked  to  the  waist,  holding 
the  bottle  in  his  fist  in  an 
oblique  direction  from  left  to 
right,  and  shook  it  in  a  vertical 
direction. 

The  fluid  at  every  stroke 
emitted  a  sound  like  the  ringing 
of  silver  coins.  He  paused 
afker  every  25th  potency,  and 
the  muscles  of  his  naked  arm 
vibrated.  At  first,  after  one 
day  of  potentising  he  had  to 
rest  about  a  week  to  recover, 
but  when  by  practice  he  got 
into  condition  he  would  go  on 
potentising  without  hurting 
the  muscles,  though  every 
stroke  shook  his  body  as  though 
it  was  electrified.  He  was 
latterly  able  to  give  8400 
strokes  in  an  hour. 

He  worked  at  his  voluntary 


Our  Thames  water  as  supplied 
by  the  companies  may  be  de- 
scribed as  "  clear  as  crystal," 
but  we  know  that  it  contains  a 
pretty  considerable  admixture 
of  organic  and  inorganic  sub- 
stances.) 

His  regular  proportion  of 
medicine  to  vehicle  for  the  high 
potencies  is  1  to  800,  for  the 
highest  potencies  2  to  12,000. 
But  he  does  not  know  the  exact 
proportion  of  composition  in 
the  highest  potencies. 

Dr.  Hering  gives  exactly  the 
same  account  as  Bentsch  of 
Jenichen*s  discovery  of  the  art 
of  making  high  potencies — 
which,  however,  he  does  Dot, 
like  Bentscb,  call  a  new-dis- 
covered law  of  nature  or  a 
revelation  of  nature — ^vie.  the 
dried-up  bottle  of  Plmmh.  ae. 
29.  The  cork  was  shrivelled 
and  loose  in  the  bottle's  neck, 
and  had,  perhaps,  been  so  for 
years.  He  filled  it  three  fourths 
full  of  alcohol,  shook  it,  and 
then  potentized  a  drop  of  this 
in  his  usual  way  with  800  drops 
of  alcohol  up  to  200.  With 
this  he  saturated  some  globules 
and  cured  with  them  a  stinking 
foot-sweat  of  two  years*  stand- 
ing. 

Ever  since  that  time  J.  made 
all  the  high  potencies  of  the 
earths  and  minerals,  as  also 
some  others,  from  evaporated 
phials.    (It  would  be  important 


The  Secret  revealed. 


73 


task  from  10  p.m.  till  3  a.m. 
keeping  himself  awake  by 
drinking  cold  black  coffee. 
He  always  took  everything  in 
the  shape  of  food  and  drink 
cold,  as  he  held  warm  food  to 
be  imphysiological,  and  he  was 
a  teetotaller. 

!From  200  he  gave  10  shakes 
for  each  potency,  from  300  to 
800,  12  shakes,  from  800  to 
M,000,  30  shakes  for  each 
dilation. 

fientsch  tBinks  that  for  every 
10,12,  or  30  shakes,  he  counted 
a  degree  of  potency.  He  thinks 
also  that  the  peculiar  efficacy 
of  Jenichen's  potencies  was 
owing  partly  to  their  being 
started  from  the  evaporated 
bottle  of  the  29th  dilution, 
which  he  terms  a  revelation  of 
a  natural  law,  partly  to  the 
violent  friction  of  the  fluid 
against  the  sides  of  the  bottle 
effected  by  his  giant  strength, 
partly  by  the  magnetic  power 
communicated  to  the  fluid  by 
his  enthusiasm  and  will. 


to  know  how  many  of  the  other 
medicines  he  potentized  in  this 
way,  and  if  he  did  not  make 
them  all  so,  at  all  events  it  is 
evident  from  what  Hering  says, 
that  he  did  not  confine  his 
remarkable  method  of  potentiz- 
ing  from  an  empty  bottle  to 
the  earths  and  metals ;  so,  for 
all  we  know,  he  may  have  so 
prepared  all  his  high  potencies. 
Hahnemann  taught  that  each 
dilution  should  be  made  with  a 
hundredth  part  of  the  previous 
potency ;  but  Jenichen,  whoso 
method  was  considered  so  in- 
finitely superior  to  Hahne- 
mann's by  some  of  Hahne- 
mann's immediate  disciples, 
and  who  enjoyed  revelations 
of  nature  denied  to  Hahne- 
mann, prepared  his  potencies 
from  an  empty  bottle.  If 
Hahnemann  took  for  his  motto 
similid  aimilihus  curentur,  it 
would  not  have  been  amiss  had 
Jenichen  adopted  the  motto  ex 
nihilo  nihil  Jit.) 


Our  readers  have  now  before  them  the  two  accounts  of 
Jenichen's  mode  of  preparing  his  high  potencies,  Eentsch's 
guesses,  and  Hering's  revelations,  and  they  may  judge  for  them- 
selves how  far  they  differ.  To  ourselves  the  difference  between 
them  is  much  about  as  important  as  that  between  the  traditional 
tweedledum  and  tweedledee.  They  both  say  that  the  process  of 
high  potentizing  commenced  with  a  phial  nominally  of  the  29th 
dilution  from  which  all  the  medicine  had  been  evaporated.  This 
to  Bentsch  is  a  physical  apocalypse  {Naturoffenhanmg),  Hering 
discreetly  omits  to  say  what  he  thipks  pf  it.     They  agree  in  th^ 


74  Miscellaneous. 

proportions  of  rehide  to  medicine,  1  to  300  for  the  high^  2  to 
12,000  for  the  highest  potencies.    They  agree  also  in  the  number 
of  shakes  given  to  each  dilution.      They  both  describe  the 
muscular   strength    of   this    person  as    prodigious.      Bentsch 
describes  him  dashing  his  fist  through  a  door-panel,  Hering  as 
stopping  a  carriage  and  pair  of  horses  madly  galloping  down  hill 
with  a  Orand-Duke  and  his  lady  (possibly  his  Grand-Duchess), 
and  afterwards  rolling  up  silrer  plates  and  tearing  them  in  stripe. 
The  only  point  on  which  there  is  a  material  difference  between 
these  two  authorities  is  where  Bentsch  suspects  that  Jenichen 
reckoned  each  10, 12,  or  80  shakes  as  a  degree  of  potency  irre- 
spectire  of  dilution.    There  is  apparently  no  foundation  for  this 
suspicion  in  Jenichen's  own  communications,  but^et  there  is 
nothing  in  them  to  render  it  impossible  that  such  was  the  case, 
and  Bentsch  says  the  circumstance  that  he  only  employed  eight 
phials  in  all  for  a  medicine,  and  had  them  scalded  with  hot  water 
for  each  subsequent  medicine,  rather  strengthens  Bentsch's  sup- 
position.    Moreover,  Jenichen  says  he  rested  after  every  25th 
potency,  and  that  the  200th  potency  received  2000  succusaion 
strokes.    Now,  8  x  25  =  200  and  8  x  250  =  2000,  which  looks  as 
though  one  bottle  were  used  without  pause  for  every  26  potencies, 
and  as  though  the  dilution  were  only  performed  eight  time8,and  not 
200  times,  as  it  would  have  been  according  to  the  Hahnemannic 
process.     Hering  offers  no  evidence  that  this  is  not  the  explana- 
tion of  Jenichen's  high  potencies,  unless  that  be  considered  as 
evidence  which  Jenichen  writes  to  Hering,  that  he  proposes  to 
make  a  special  potency  for  Hering  running  from  a  2000th,  and 
giving   it   10,000  strokes,  but  only  raising   it  eight    degrees 
thereby.      BonninghaTisen's  *'  conclusive  comments "  have  no 
bearing  on  the  subject. 

But  after  all,  what  does  it  matter  ?  The  only  point  of  interest 
in  connexion  with  the  whole  subject  to  us  is  this,  that  men  of 
standing  in  the  homoeopathic  world,  Hahnemann's  immediate  dis- 
ciples and  others,  could  encourage  an  ignorant  and  presumptuoas 
man  like  this  Jenichen  in  his  attempt  to  upset  the  teachings  of 
the  master  with  regard  to  the  preparation  of  homoeopathic  medi- 
cines, and  to  substitute  for  the  well-kno?m  and  well-tried  phar- 
maceutic processes  hitherto  practised  a  method  proceeding  from 
his  own  fancy,  without  a  single  proof  of  its  superiority,  which  set 
at  defiance  all  the  maxims  of  reason  and  experience,  and  would 


The  Secret  revealed.  75 

imply  that  the  proper  mode  of  making  our  pharmaceutic  prepa- 
rations is  to  commence  diluting  from  an  empty  bottle.    The  in- 
stances of  Jenichen's  practice,  published  after  his  death,  and 
which  there  is  no  reason  to  suppose  Stapf  and  Qross  knew  about, 
are  mostly  beneath  contempt,  either  &om  their  utter  triviality  or 
sheer  impossibility.    Here  is  one  of  each  : — *'  A  three-quarter- 
year  old  little  boy  suffered  from  diarrhoea  with  the  smell   of 
rotten  eggs,  cough,  and  rattling  of  mucus  in  the  chest.     Chamo- 
mill.  4000  removed  the  diarrhoea  by  the  next  day,  but  the  bron- 
chial catarrh  only  after  five  days."    Just  what  we  might  expect 
from  the  administration  of  nothing.    "  A  girl  of  eleven  had  suf- 
fered for  four  months  from  grey  cataract  of  the  left  eye.     One 
dose  of  Silic.  6000  cured  her  in  eight  days."    So,  on  the  testimony 
of  an  ignorant  horse  trainer  we  are  expected  to  believe  that  a  girl 
of  eleven  had  grey  cataract  of  one  eye,  and  further,  that  it  was 
cured  by  internal  treatment  in  eight  days.     Credat  Judseus !     Of 
what  value  can  be  the  assertions  of  a  man  who  is  either  so  igno- 
rant or  so  untruthful  as  to  make  such  a  statement  ?     Connected 
with  this  melancholy  incident  in  the  history  of  homoeopathy  we 
have  a  scientific  man  like  Bentsch  declaring  that  this  empty, 
bottle  pharmacy  is  a  revelation  of  nature — a  physical  apocalypse 
—a  newly-discovered  law  of  nature ;  and  we  have  the  sad  spec- 
tacle of  men  like  Gross  and  Stapf  encouraging,  if  not  enjoining 
this  vain  man  to  keep  his  process  a  secret,  thus  introducing,  for 
the  first  time,  into  homoeopathy  the  disreputable  secresy  of  the 
charlatan.    The  saddest  spectacle  of  all  is  that  of  the  honoured 
veteran  of  the  homoeopathic  Materia  Medica,  Dr.  Hering,  urging 
on  Jenichen,  from  across  the  Atlantic,  to  go  higher  and  higher. 
Thus  encouraged,  stimulated  by  the  applause  of  these  well-known 
disciples  of  Hahnemann,  see  the  wretched  author  of  these  innova- 
tions labouring  half  naked  every  night  from  10  to  3  at  his  useless 
work,  expending  his  prodigious  strength  on  succussing  successive 
dilutions  of  nothing,  each  stroke  of  his  Herculean  arm  making 
the  innocuous  liquid  in  the  bottle  ring  like  silver  money,  and 
causing  the  whole  house  to  shake.      His  giant  strength  and 
health  gave  way  under  his  self-imposed  task ;  but  still  he  toiled 
away  in  obedience  to  Hering's  wish,  and  for  Hering's  sake  gave 
still  more  shakes  to  each  dilution.     His  health  and  his  brain  at 
length  gave  way  under  this  incessant  toil,  and  he  put  an  end 
voluntarily  at  once  to  his  life  and  his  sufierings. 


76  Miscellaneous. 

This  miserable  episode  reminds  us  of  the  fable  of  the  frog 
swelling  and  puffing  itself  oat  to  imitate  the  ox.  "  Is  that  big 
enough?*'  cries  the  ambitious  reptile.  ''No!  bigger,  bigger!" 
cries  its  companion,  until  at  last  the  poor  creature  bursts  with 
its  efforts.  So  Jenichen  says  to  Hering,  **  Is  that  high  enough?" 
'*  No !  higher,  higher,  every  year  higher !"  cries  Hering ;  until  at 
length  the  wretched  man  succumbs  to  his  willing  efforts. 

The  manifest  duty  of  those  who  first  came  in  contact  with 
Jenichen  and  his  potencies  was  to  discourage  any  departure  from 
Hahnemann's  approved  method.  If  it  be  replied  that  they  did 
not  know  Jenichen's  method  of  preparing  his  so-called  high* 
potencies,  then  it  was  clearly  their  duty  either  to  insist  on  a  full 
and  complete  publication  of  his  process,  or  to  decline  to  have 
anything  to  do  with  them. 

Had  they  acted  in  the  interests  of  science  and  homoBopathy 
they  would  have  snubbed  the  poor  lunatic  from  the  first, 
thereby  saving  us  from  a  shameful  episode  of  credulity  and 
nostrum-mongering,  and  perhaps  preventing  the  melancholy 
self-sacrifice  of  a  half-witted  enthusiast,  whose  antecedents 
eminently  disqualified  him  for  the  office  of  revolutionising  and 
upsetting  Hahnemann's  pharmaceutic  processes. 

As  for  Dr.  Hering's  exclusive  possession  of  the  secret  of 
Jenichen's  mode  of  preparing  his  high  potencies,  our  readers  are 
now  able  to  estimate  the  value  of  this  for  themselves,  now  that 
Hering  has  himself  let  the  cat  out  of  the  bag.  We  now  see 
that  far  from  being  a  respectable  cat  it  more  nearly  resembles 
a  much  more  insignificant  animal.  JPitrturiunt  monies  naseetur 
ridiculus  mus !  The  process  of  parturition  has  been  long  and 
difficult,  and  the  result  is  like  the  starting-point  of  Jenichen's 
high  potencies — nothing  at  all ! 

After  this  corroboration  by  the  sole  possessor  of  Jenichen's 
secret  of  what  Eentsch  told  us  long  ago,  we  regret  that  we 
devoted  so  much  space  in  our  5th  vol.  to  a  consideration  of  thef« 
worthless  preparations.  The  highly  respectable  names  of  Drs. 
Gross  and  Stapf,  who  stood  sponsors  to  the  Jenichen  innovation, 
induced  us  to  attach  to  it  a  greater  importance  than  it  deserved. 
It  is  humiliating  to  observe  that  a  respectable  reputation,  real 
useful  work,  and  an  intimate  personal  acquaintance  and  friend- 
ship with  the  great  founder  of  homoeopathy,  failed  to  preserve 
some  of  his  immediate  disciples  from  such  arrant  gohemoueherie. 


The  Secret  revealed.  77 

No  sooner  does  a  muscular  horse-trainer,  with  no  knowledge  of 
medicine  except  what  he  has  attained  from  his  dilettante  practice 
among  horses,  announce  that  he  has  discovered  a  new  law  of  nature 
applicable  to  pharmaceutical  purposes,  than  these  respectable 
old  gentlemen  immediately  accept  his  doctrine  as  though  it  was 
a  new  revelation,  and  discarding  the  processes  for  preparing 
drugs  so  minutely  described  and  so  earnestly  enjoined  bj  Hahne- 
mann»  they  agree  to  substitute  the  method  proposed  by  this 
ignorant  '^  Sch warmer," — to  commence  making  their  attenua- 
tions with  an  empty  bottle. 

And  men  who  so  act,  and  others  who  make  what  they  call 
bigh  potencies  by  washing  out  bottles  with  ordinary  impure 
water,  actually  arrogate  to  themselves  the  title  of  Hahnemannians. 
It  would  seem  that  they  are  of  opinion  that  the  farther  they 
depart  from  BAhnemann's  directions  the  more  Hahnemannian 
they  become.  Wilkes  used  to  say  that  he  was  no  Wilkesite,  and 
we  may  with  still  greater  confidence  say  that  Hahnenuuin  was  no 
Hahnemannian,  as  the  term  is  applied  now-a-days. 

But  not  only  do  our  modem  Hahnemannians  depart  from 
Hahnemann's  precepts  and  example  in  the  mode  of  preparing 
medicines,  they  do  so  also  in  the  substances  they  introduce 
into  the  Materia  Medica.  Hahnemann  never  added  to  the 
Materia  Medica  any  substance  of  a  distinctly  non-medicinal 
character,  but  now  we  have  from  the  Hahnemannians  such  sub- 
stances as  white  sugar,  skim-milk,  dog's  milk,  moonshine, 
thunderbolts,  <fcc.  The  very  forces  of  nature  have  been  seized 
upon  and  potentized  by  these  enthusiasts — at  least  so  they  say. 
One  of  them  told  us  that  magnetic  power  was  now  among 
their  potentized  medicines.  On  asking  how  this  was  obtained  we 
were  told  that  some  milk-sugar  was  laid  on  a  magnet  for  some  time 
and  then  potentized  up  to  the  required  degree.  If  magnetism, 
why  not  the  correlative  forces — heat,  light,  and  motion  ?  Why 
not  sound,  colours,  the  qualities  of  substances,  as  hardness,  soft- 
ness, elasticity,  density,  weight  ?  Why  not  mental  emotions — 
fear,  rage,  love,  jealousy,  &c.  ?  In  short,  we  see  no  end  to  the 
absturdities  that  may  be  engrafted  on  homoeopathy  if  we  depart 
from  Hahnemann  and  become  "  Hahnemannian."  The  so-c^ed 
nosodes  or  products  of  disease  are  likely  soon  to  present  a  crop  of 
useless  and  repulsive  preparations  if  care  be  not  taken  to  confine 
them  to  the  true  morbid  infectious  viruses^  the  admission  even  of 


78  Miscellaneous, 

which  into  a  pure  Materia  Medica  is  of  doubtful  adrantage.  Am 
it  is  we  haye  Been  some  so-called  noBodes  that  might  moie 
correctly  be  termed  noaodditetj  and  we  deprecate  the  multiplica- 
tion of  these,  as  they  are  more  calculated  to  bring  ridicule  and 
contempt  on  homoeopathy  than  to  be  of  use  in  the  great  and 
honourable  calling  of  curing  disease. 


Speedy  Cure  of  Nasal  Polypi, 

This  painless  method  of  removing  nasal  polypi,  never  befoie 
made  public  by  the  originator,  is  an  apology  for  taking  a  smsll 
space  of  your  valuable  journal. 

Mr.  G.  M-— ,  let.  60,  ten  years  ago  applied  to  me  for  relief 
from  a  soft  polypus  in  the  left  nostril.  I  proposed  evulsion; 
but  not  liking  the  proposition  he  left,  and  I  never  heard  of  him 
until  last  May,  when  he  returned  with  another  polypus  in  the 
same  nostril.  I  advised  evulsion  once  more ;  he  declined  it  again, 
and  desired  me  to  cure  him  the  same  way  as  did  Dr.  6.  Ceccaiini 
the  first  time  (ten  years  ago).  On  inquiry,  Dr.  Geccarini  kindlj 
answered :  "  The  medicine  which  I  use  for  removing  nasal  polypi 
is  four  or  five  drops  of  pure  acetic  acid  injected  with  an  hypo- 
dermic syringe  within  the  body  of  the  polypus  once  only,  veiy 
seldom  twice ;  the  polypus  generally  drops  off  within  three  or 
five  days  without  discomfort  or  pain.  Disinfecting  lotion  will 
correct  the  offensive  odour."  With  this  information,  on  the  12th 
of  August,  in  presence  of  my  friend  Dr.  J.  L.  Little,  I  injected 
the  polypus  with  six  drops  of  chemically  pure  acetic  acid,  and 
instantly  we  saw  the  discoloration  of  it  from  red  to  white. 
Business  preventing  him  from  returning,  I  could  not  observe  the 
daily  progress ;  but  when  he  called  on  September  2nd,  he  had  only 
a  small  portion  of  it  yet  adhering  to  the  middle  turbinated  bone, 
the  other  having  dropped  off  the  fourth  day  after  the  injection ; 
this  remaining  portion  was  injected  with  four  drops  of  the  same 
acid,  and  on  the  third  day  dropped  off,  leaving  his  nose  clear, 
without  sore  or  a  vestige  of  it.  Neither  of  the  two  operations 
was  followed  by  any  unpleasant  symptoms,  save  a  slight  smarting 
from  the  pricking  by  the  needle  when  the  acid  was  injected. 
The  offensive  odour  arising  from  the  decaying  mass  was  corrected 


Lilium  tigrinumj  its  Action  on  the  £lye,  7d 

hj  a  weak  carbolised  wash.  The  long  interval  from  the  destruction 
of  the  first,  and  the  appearance  of  the  second — ten  years  between 
— precludes  the  possibility  of  this  last  being  a  portion  of  the 
first,  but  a  new  one. — Bespectfully  yours,  S.  Cabo. — JSeto  York 
Medical  Beeord, 


Zilium  tigrinum,  it$  Action  on  the  Eye, 

By  W.  H.  WooDTATT,  M.D.,  Professor  of  Diseases  of  the  Eye 
and  Ear,  in  the  Chicago  Homoeopathic  College. 

OiTE  of  the  early  provers  of  Lilium  iigrinum  was  at  the  time  of 
the  proving  wearing  convex  fourteen  glasses.  That  these  glasses 
were  not  accurately  fitted  to  the  actual  refractive  condition  of  the 
eye  seems  manifest  from  her  remarks  that  she  was  obliged  to  turn 
her  head  to  the  left  '^  in  order  to  see  the  whole  of  a  letter,  for 
example,  e,  p,  d^  and  /,  u.  When  looking  straight  forward  could 
see  only  the  straight  part  of  the  letter  and  not  the  curve.'*  The 
first  effect  of  the  drug  was  to  make  the  vision  worse,  but  ulti- 
mately it  was  better  than  ever  before,  for  she  was  then  able  to 
see  all  letters  clearly  without  turning  the  head. 

Evidently  a  marked  change  of  some  kind  had  been  produced 
here,  and  to  determine  its  exact  character  promised  to  place  in 
our  liands  a  remedy  of  much  value  and  of  a  somewhat  extended 
application. 

When  this  proving  first  came  under  my  observation  in  1871  or 
1872  the  opinion  was  ventured  that  the  lady  was  originaUy 
suffering  from  hypermetropic  astigmatism,  which  condition  would 
explain  the  peculiarity  observed  concerning  the  letters  f ,  p,  d,  &c. 
In  this  condition  the  curvatures  of  the  horizontal  and  vertical 
meridians  of  the  dioptric  media  were  different ;  the  focal  distance 
of  one  was  greater  than  that  of  the  other,  so  that  the  image 
of  an  object  being  clearly  defined  on  the  retina  when  viewed 
through  one  of  these  meridians  would  necessarily  be  blurred, 
because  out  of  focus,  when  seen  through  the  other.  It  is  a 
common  observation  in  ophthalmic  practice  that  patients  who 
are  astigmatic  do  tip  the  book  or  incline  the  head  at  different 
angles  in  order  to  see  clearly. 

At  that  time  I  was  not  aware,  and  indeed  I  believe  it  was  not 


80  Miscelianeous. 

knowiii  that  the  meridians  of  the  cornea  would  change  their 
curvatures  under  the  influence  of  the  drug.  It  has  since  heen 
demonstrated  hj  actual  measurement,  that  such  change  has 
taken  place  under  the  action  of  Calabar  bean,  and  that  a  corneal 
astigmatism  has  resulted  attributable  to  this  cause.  Not 
knowing  this  then,  it  was  not  even  suggested  that  the  proba- 
bilities for  and  against  the  changes  being  in  the  cornea  in  this 
case  should  be  considered,  but  the  conclusion  was  at  once 
accepted  that  the  original  astigmatism  was  located  in  the  lens, 
and  that  the  curvatures  of  this  body  had  been  altered  by  the 
peculiar  action  of  the  ciliary  muscle  induced  by  the  Lilium.  It 
may  assist  some  in  understanding  this  matter  if  it  is  added  that 
astigmatism  may  occur  either  in  the  cornea,  which  is  the  principal 
factor  in  the  dioptric  media,  or  in  the  lens,  and  is  a  want  of 
symmetry  in  the  curvature  of  the  different  meridians.  As  a 
rule,  in  all  eyes,  we  find  the  vertical  meridian  of  the  cornea 
shorter  than  the  horizontal,  while  the  reverse  obtains  in  the 
meridians  of  the  lens,  so  that  these  two  bodies,  as  a  rule,  correct 
each  other's  defects  and  make  the  eye  emmetropic.  We  do, 
however,  find  instances  in  which  the  defect  of  each  is  intensified 
by  the  other  instead  of  being  neutralised ;  and  we  further  find 
that  in  the  act  of  accommodation  the  principal  meridians  of  the 
lens  may  change  position,  so  that  at  one  time  they  may  overcome 
the  defect  in  the  cornea  and  at  another  increase  it. 

Both  bodies,  cornea  and  lens,  may,  when  examined  separately, 
show  lack  of  symmetry  in  their  meridians,  but  as  they  are 
usually  placed  in  the  eye  their  relation  is  such  as  to  produce 
symmetry  in  the  dioptric  media  as  a  whole.  Enough  has  been 
said,  however,  to  show  that  a  change  of  relation  may  occur,  and 
astigmatism  result,  and  that  the  ciliary  muscle  is  an  active  agent 
in  the  production  of  such  change. 

Applying  these  facts  to  the  case  of  the  prover  of  the  Liliumy 
it  was  opined  that  the  fibres  of  this  circular  muscle  were  not  of 
equal  strength,  and  that  in  one  meridian  contraction  was  not  as 
great  (or  was  greater)  than  in  its  opposite.  After  taking  the 
drug  the  prover's  vision  became  worse  and  the  "aggravation 
continued  for  more  than  four  weeks,"  but  after  this  vision  was 
much  better.  Precisely  what  change  took  place  could  have  been 
determined  by  testing  with  cylindrical  glasses,  but  this  was  not 
done,  and  we  are  left  to  conjecture  whether  there  was  present  in 


Lilium  tiffrinum,  its  Action  on  the  Eye.  81 

the  first  place  a  spastic  contractioD,  or  a  paretic  condition  of 
Bome  of  the  fibres  of  the.ciliarj  muscle,  and  accordingly  explain 
the  final  result.  More  recent  developments  have  only  tended  to 
make  this  conclusion  the  more  likely.  Since  that  proving  I  have 
employed  the  drug  more  or  less  in  the  treatment  of  myopic 
asOgmatumy  a  condition  in  which  one  meridian  is  normal  and  the 
other  requires  the  help  afforded  by  a  concave  glass.  Some  of 
these  cases  have  been  reported  from  time  to  time,  and  now  the 
number  is  sufficient  to  justify  the  conclusion  that  the  remedy 
performs  a  distinctive  use  in  the  relief  of  this  trouble. 

It  will  not  be  understood  that  the  relief  of  myopic  astigmatism^ 
occurring  in  the  crystalline  lens  and  being  due  to  spasmodic  con- 
traction of  part  of  the  fibres  of  the  ciliary  muscle,  necessarily 
embraces  the  full  action  of  the  drug  upon  the  eye.  More  power 
may  be  discovered  after  more  extended  use. 

Nevertheless,  a  careful  study  of  all  the  eye  symptoms  recorded 
in  the  provings  leads  me  to  think  that  they  have  their  explana- 
tion in  the  peculiar  condition  of  the  ciliary  muscle,  and  that  the 
symptoms  will  only  disappear  under  the  use  of  this  remedy  when 
they  spring  from  and  are  accompanied  by  this  pathological  con- 
dition. The  symptoms  are  such  as  are  comprised  under  the 
term  asthenopic,  but  it  ought  to  be  clearly  understood  by  the 
profession  that  these  same  symptoms,  and,  in  fact,  the  whole 
group  of  symptoms  included  in  the  name  asthenopia,  may  appear 
as  the  result  of  trouble  located  in  any  of  the  six  muscles  moving 
the  globe  or  in  the  ciliary  muscle. 

In  my  judgment  the  symptomatology  of  Zilium  becomes  ten- 
fold more  available  and  may  be  applied  with  tenfold  more 
scientific  accuracy,  when  studied  in  the  light  of  the  proximate, 
underlying,  causal,  pathological  condition.  The  same  is  true  of 
many  other  remedies.  The  asthenopic  symptoms  of  Nairum 
muriatieum  are  caused  by  insufficiency  of  the  internal  recti 
muscles.  When  this  muscular  condition  is  present  and  the 
symptoms  occur,  a  cure  can  be  expected  to  follow  the  adminis- 
tration of  the  remedy  almost  as  certainly  as  the  night  follows 
the  day. 

Symptoms  very  closely  resembling  those  of  JNiatrum  mur.,  and 
in  many  cases  which  I  have  recorded,  identical  ones  can  be 
relieved  by  Gelsemium  or  Cuprum  acetieum  if  (and  mark  the  if), 
they  are  caused  by  weakness  of  the  external  recti  muscles,  as  they 

VOL.  XXXVIIl^  NO.  CLl.-^JASVAEY,  1880.  V 


82  Miscellaneous, 

may  be.  Again,  a  paretic  condition  of  the  ciliaiy  muscle  may 
caose  to  appear  Bjmptoms  very  similar  to  those  recorded  in  the 
proyings  of  Lilium,  but  Argenifun  nitrieum  would  have  to  be  used 
to  reliere  them  when  springing  from  that  cause.  From  which 
statements  it  is  obvious  that  any  prescription  for  so-called 
asthenopia  lacks  precision  in  its  aim  unless  it  is  preceded  by  a 
careful  test  of  the  vision,  and  of  the  muscular  apparatus  of 
the  eye.  It  is  the  aim  of  this  short  study  of  Lilium  to  define 
specifically  the  scope  of  its  action  so  far  as  that  can  be  accom- 
plished firom  the  recorded  provings. 

The  appended  case  is  offered  for  the  new  features  it  contains, 
to  be  added  to  the  cases  already  published  illustrating  the 
action  of  this  drug.  It  is  one  in  which  the  symptoms  of  so-called 
asthenopia  were  evidently  due  to  a  general  spasmodic  contraction 
of  the  fibres  of  the  ciliary  muscle,  but  the  contraction  being 
greater  in  one  meridian  than  the  other. 

Oase, — Miss  W — ,  «et.  19.  Complains  of  inability  to  use  her 
eyes  without  discomfort.  During  the  past  year  any  attempt  to 
work  at  the  near  has  produced  redness  of  the  lid  edges  and  a 
hot,  sandy  feeling  in  the  conjunctiva.  She  finds  difficulty  in 
defining  the  unpleasant  sensation  with  words,  though  they  were 
pronounced  enough  to  cause  her  to  abandon  school  work  and  to 
feel  quite  apprehensive  about  her  vision.  Best  has  not  brought 
the  expected  relief. 

The  letter  test  was  as  follows : 

In  each  eye,  vision  |g?  With  -  48*=  aids  180*>,  vision  %%. 
Without  glasses,  No.  1  Jaeger  is  read  at  8^  inches  and  16  inches ; 
with  the  cylinders  it  can  be  read  at  23  inches  distant. 

Lilium  tigHnum^^  was  prescribed  four  times  daily.  I  was  able 
to  examine  these  eyes  again  on  the  following  day  when  vision 
was  Jg,  and  a  concave  00^  axis  180  made  vision  |g. 

Two  days  later,  vision  was  |g,  and  No.  1  was  read  at  18^  inches 
without  glasses. 

Four  days  later  still,  vision  |g  ;  No.  1  at  20  inches.  Up  to 
this  time  no  relief  from  the  unpleasant  sensations  had  been 
experienced. 

Three  days  later,  No  1  was  read  at  22  inches. 

Three  days  later.  No.  1  was  read  at  22i  inches.  The  eyes  now 
feel  relieved. 

Experience  with  homceopathic  remedies,  added  to  the  results 


Discontinuance  of '  HirscheVs  Zeitschtift,^  83 

of  observation  of  certain  anomalies  of  refraction  which  undergo 
spontaneous  changes,  leads  us  to  hold  subject  to  decided  modifi- 
cation much  that  is  taught  concerning  the  mechanical  treatment 
of  these  defects.  SufiBcient  has  already  been  published  to  show 
that  in  myopia,  hypermetropia,  presbyopia  and  astigmatism,  our 
remedies  have  a  sphere  of  action  which  cannot  be  overlooked 
without  decided  detriment  to  the  case  in  hand. — The  Medical 
Counselor^  vol.  i,  No.  7. 


jyiseontinuanee  of^HineheVe  ZeiUchrifi.^ 

Ik  the  last  number  for  the  year  1879  Dr.  Lewi,  the  editor, 
amiounces  that  the  journal  he  has  edited  since  the  death  of  Dr. 
Hirschel  will  not  be  continued.  The  reason  he  gives  for  its 
demise  is  rather  obscure,  not  to  say  mysterious.  Our  readers 
shall  judge  for  themselves. 

"  We  have  resolved  not  to  continue  this  journal,  because  for 
years  we  have  not  considered,  and  could  not  consider,  homoeo- 
pathy in  its  still  beloved  old  quasi-official  form  as  capable  of 
living  any  longer,  and  because  while  its  old  approved  powers  have 
been  during  the  last  few  years  violently  torn  away  one  after 
the  other,  no  scientific  substitutes  for  them,  worthy  of  the  name, 
have  been  discovered." 

This  seems  to  us  to  be  scarcely  intelligible.  If  Dr.  Lewi  has 
for  years  considered  homoeopathy  incapable  of  living,  how  comes 
it  that  he  has  for  years  been  conducting  a  journal  which,  if  it 
was  intended  to  prove  anything,  was  meant  to  show  the  vitality 
of  homoeopathy  p  Has  Dr.  Lewi  suddenly  become  a  renegade, 
like  some  we  have  heard  of  in  our  country?  The  following 
sentence  would  prepare  us  for  a  full  recantation  : 

"  We  retire  from  the  scene  of  our  activity,  after  having,  as  we 
believe,  attained  the  end  we  put  before  us,  viz.  to  have  proved 
homoeopathy  to  be  an  important  integral  constituent  of  medical 
science,  lut  hy  no  manner  of  means  the  last  word  of  medical  science , 
or  as  including  the  latter  in  itself;  and  thereby  we  have  pointed 
out  the  only  way  by  which,  sooner  or  later,  the  reconciliation  of 
the  part  with  the  whole  can  and  must  be  effected." 


64  MUceUaneous, 

We  shall  m\m  the  Zeit$ehrift,  and  trast  that  its  disappearance 
is  not  indicatire  of  a  real  decline  in  the  spread  of  homcBopathic 
truths  among  the  medical  profession  in  G^rmanj.  There,  as 
here,  we  know  that  the  avowed  adherents  of  homoeopathy  yearly 
diminish ;  hat  we  hope  that  there,  as  here,  the  tmths  of  homoeo- 
pathy permeate  traditional  medicine,  and,  like  the  little  bit  of 
leayen,  promise  eventually  to  leaven  the  whole  lump. 


Berberii  Aqui/olium.    By  &eob0e  Williak  WorrEEBVSir, 

M.D.,  N.T. 

Berherii  aquifolium  is  a  firm,  bushy  shrub,  of  the  natural  order 
Berheridaeea,  growing  to  the  height  of  four  or  five  feet,  in 
the  woods  of  Oregon.  It  delights  in  high  altitudes,  but  is  culti- 
vated in  gardens,  and  is  much  esteemed  as  a  flowering  shrub  on 
account  of  its  beauty.  The  leaves  are  pinnate,  and,  instead  of 
the  soft  bristles  of  the  Berheris  vulfforiSf  have  spinulose  teeth. 
They  are  leathery  in  texture,  dark  green  in  colour,  glossy,  and 
resemble  the  leaves  of  the  holly.  The  flowers  are  yellow,  and 
are  upright,  not  in  hanging  clusters,  as  on  the  Berheris  vulgaris. 
The  berries  are  intensely  sour  and  dark  coloured,  instead  of 
scarlet,  as  in  the  better  known  variety.  The  root  is  the  part 
used.  It  is  very  hard,  of  a  bright  yellow  colour,  and  an  intense 
but  agreeable  bitter.  Jungk  has  discovered  a  new  alkaloid  in 
this  berheris,  to  which  he  gives  the  name  Mdhonia,  Q^fi^^O^, 
It  differs  from  berheris  in  having  six  equivalents  less  of  carbon, 
and  two  more  of  hydrogen.  Mdhonia  does  not,  however,  repre- 
sent the  full  therapeutic  value  of  Berheris  aqutfolium,  and  is 
probably  only  one  of  several  constituents. 

I  have  proved  this  drug  quite  thoroughly  on  two  men  and 
three  women,  and  have  tested  it  clinically  in  a  wide  range  of 
cases.  The  provers  took,  under  my  direction,  the  fluid  extract 
of  the  root  (Parke,  Davis,  &  Co.),  in  doses  from  ten  drops  to 
three  ounces,  the  experiments  extending  over  about  three  months. 

The  characteristics  of  the  drug  are  tabulated  in  the  following 
scheme. 

Its  analogues  appear  to  be  Aurum,  Berheris  vul^.,  Bryonia, 


Berberis  Aqui/olium.  85 

Calcarea,    Capsieum,    Causticumj    Drosera,    Chrindelia^    Squar.^ 
Hydrastis,  Nux  vom.^  Oleander,  Ruta,  and  Spangia, 

Mental  sphere. — Unhappy  and  depressed ;  sudden  depression 
of  spirits  without  cause ;  profound  depression,  amounting  to 
anguish ;  hysterical  crying  at  frequent  intervals ;  nervous  and 
restless ;  disinclination  to  move ;  dull  and  stupid ;  disinclined  to 
do  anything,  but  not  sleepy ;  very  drowsy  in  the  daytime. 

ffead. — Dizzy  sensation ;  pain  on  right  side  (pressing  like  a 
weight) ;  pain  in  the  right  temple,  running  down  into  the  teeth. 

J?j/f<.— Hollow-eyed ;  burning  and  aching  in  the  eyes  as  if 
strained ;  film  before  the  eye ;  congestion  of  the  lower  palpebral 
conjunction. 

j^ote, — Stuffish  feeling,  with  discharge  of  greenish  yellow 
mucus. 

Face, — *  Blotches  and  pimples  on  the  face ;  yellow  skin ; 
flashes  of  heat  in  cheeks ;  pinched  expression  of  the  face ;  ^  im- 
petigo figurata ;  °  eczema  infantile. 

Mouth. — Increased  flow  of  saliva ;  bilious  taste  after  eating ; 
yellow  brown,  deeply-coated  tongue  ;  white,  pasty,  thick  coating 
on  tongue ;  tongue  feels  as  if  blistered ;  blisters  on  right  side  of 
tongue ;  scanty  expectoration ;  yellow,  sticky,  tenacious  ex- 
pectoration ;  expectoration  streaked  with  blood ;  soreness  in 
teeth  of  lower  jaw ;  soreness  in  the  salivary  glands ;  ^  cancer  of 
the  tongue :  dry  throat. 

Stomach. — Hungry  soon  after  eating ;  constantly  hungry,  but 
Btill  could  not  eat ;  hunger  with  aversion  to  food ;  canine 
hunger ;  sudden  nausea  after  eating ;  burning  in  stomach ;  bor- 
borygmi ;  cramp  in  stomach ;  no  appetite ;  heartburn. 

Abdomen. — Uneasy  feeling,  without  desire  for  stool ;  heat  in 
the  region  of  the  spleen;  burning  sensation  in  the  spleen; 
spleen  feels  as  if  it  had  been  struck ;  pain  in  hypogastrium. 

Stool. — Large,  loose,  free  movement  (four  times  first  day  of 
proving)  ;  hot,  griping  stool  (second  day) ;  light-coloured  stool, 
expelled  with  difBculty  ;  lumpy  stool,  looks  as  if  each  lump  was 
varnished ;  soft  stool,  expelled  with  great  difficulty. 

Urinary  ()rgan8. — Urine  less  than  normal,  clear  and  without 
sediment ;  urine  sherry-wine  colour ;  urine  enormously  increased 
in  quantity. 

Generative  Organs. — Slight  burning  in  vagina;  wind  &om 
vagina ;  bearing-down  pains ;  aching  as  if  menses  were  about  to 


86  Miscellaneous. 

come  on;  ^delayed  meiiBes  reBtoredJ(in  two  cases);  ^amenor- 
rhosa ;  Terj  decided  increase  of  sexual  desire. 

Ohest. — Unusual  weak  feeling  in  the  chest ;  "  have  wondeTed 
whether  it  was  the  beginning  of  consumption ;"  weakness  of  the 
upper  part  of  the  chest ;  oppression  as  of  a  weight  on  the  chest ; 
burning  heat  in  the  lower  left  lung ;  ^  phthisis  pulmonalis. 

Larynx. — Voice  very  weak, ''  as  if  a  damper  had  been  cloeed 
on  it ;"  drj,  nervous  cough. 

Upper  extremities. — Flashes  of  heat  and  burning  in  the  palms 
of  the  hands ;  tremor  in  hands  and  arms ;  inability  to  raise  the 
arms  from  the  side;  numbness  and  immobility  of  the  arms; 
lameness  of  the  arms ;  *  rheumatism  felt  only  when  moying  the 
part ;  prickling  on  the  outside  of  the  hand  and  forearm. 

Lower  extremities. — Heaviness  and  trembling  of  the  limbs; 
bruising  pain  in  the  extremities ;  cramp  in  left  leg ;  cramps  in 
the  calves  of  both  legs ;  inability  to  lift  the  right  foot ;  rheumatic 
tension  and  stiffiiess  of  the  legs. 

Fever. — Pulse  raised  fifteen  to  twenty  beats. 

Skin. — ^Salt  rheum  ;  ° eczema  impetiginodes ;  ^herpes  zoster; 
^rupia  syphilitica  and  escharotica ;  ^pityriasis  capitis ;  ^psoriasis 
diffusa. 

General  symptoms, — ^Weak  and  depressed ;  feels  very  tired 
without  cause ;  weak  and  tired  in  the  morning,  wants  to  go  back 
to  bed,  better  after  exercise ;  griping  pain  down  the  whole  right 
side ;  rheumatic  pain  on  right  side ;  rheumatoid  pains  over  the 
whole  body,  making  one  keep  very  still ;  bone  pains ;  °  scrofula; 
^  syphilis. 

The  mental  symptoms  appeared  nsually  on  the  second  day, 
continued  through  the  proving,  and  for  several  days  subsequently. 
The  pains  in  the  head  disappeared  during  the  latter  part  of  the 
proving,  and  were  transitory  and  recurring.  The  dizzy  sensation, 
worse  when  stooping  or  moving,  was  part  of  the  general  bilious- 
ness caused  by  the  drug. 

Upon  the  eyes  it  has  an  especial  action,  producing  a  sensation 
like  a  film.  Thej  look  weak,  as  if  tired.  In  one  prover,  the 
palpebral  conjunctiva  was  very  decidedly  injected.  This  feeling 
of  weakness  persisted  in  one  case  for  several  weeks  after  the 
medicine  was  suspended. 

The  increased  flow  of  saliva  was  probably  due  to  the  bitterness 
of  the  medicine,  but  the  other  mouth  symptoms  are  characteristic. 


Berberis  Aquifolium.  87 

The  bilious  coating  of  the  tongue  dated  from  the  second  or  third 
day ;  the  blistering  of  the  tongue  about  the  end  of  the  second 
week ;  and  the  soreness  of  the  saliTary  glands  and  dry  throat 
during  the  third  week. 

Dyspeptic  hunger  without  desire  for  food,  and  with  burning  in 
the  stomach,  was  noticed  from  the  first.  The  cramps  in  the 
Btomach  and  "no  appetite*'  occurred  during  the  second  and 
third  weeks.  No  direct  sensations  were  felt  in  the  liver,  but 
this  drug  evidently  affects  the  whole  glandular  system,  including 
the  liver.  Biliousness  was  a  marked  feature  in  all  the  provers, 
and  one  had  a  peculiar  waxy  look  like  the  beginning  of  jaundice. 
Upon  the  spleen  it  has  a  very  positive  action,  causing  intense 
burning  and  a  feeling  as  if  it  had  been  pounded.  This  burning 
in  the  spleen  was  a  very  marked  effect  in  all  the  provers,  com- 
mencing about  the  seventh  or  eighth  day,  and  persisting  until 
the  drug  was  discontinued,  producing  a  soreness  in  that  viscus  of 
which  the  provers  complained  bitterly. 

All  the  provers  had  large,  free,  dark  movements  on  beginning 
the  medicine ;  'One  had  hot,  bilious  diarrhoea.  This  was  followed 
by  light  coloured,  varnished,  constipated  stools.  Subsequently 
the  stool  became  soft  and  natural  in  quantity  and  colour,  but  too 
large,  and  expelled  with  great  difficulty.  If  pushed,  the  drug 
would  apparently  produce  paresis  of  the  rectum. 

It  had  a  manifest  effect  on  the  kidneys  of  all  the  provers,  but 
increasing  in  some  and  decreasing  in  others  the  amount  of  urine 
voided.  The  effects  on  the  generative  system  were  not  marked, 
except  a  peculiar  bubbling  of  wind  from  the  vagina  and  unusual 
sexual  desire  (same  person). 

On  either  the  third  or  the  fourth  day  each  of  the  provers  had 
what  seemed  like  a  bilious  cold,  the  throat  choked  with  mucus, 
the  voice  rough  and  somewhat  hoarse,  the  expectoration  yellow,, 
and  becoming  in  a  day  or  two  greenish.  The  throat  was  not 
relaxed,  the  prover  could  sing  in  tune  and  without  fatigue,  but 
the  voice  sounded  muffled,  as  if  a  damper  had  been  closed  in  the 
larynx.  This  condition  developed  by  the  fourth  week  into  a 
most  interesting  phenomenon.  The  peculiar  lack  of  timbre  in 
the  voice ;  the  oppression  and  weakness  of  the  upper  portion  of 
the  chest ;  the  dry,  irritative  cough ;  the  scanty,  tenacious,  blood- 
streaked  expectoration ;  the  pinched  expression  of  the  face ;  the 
previous  gastric  disturbance  and  the  present  languor  and  debility ; 


88  M%9cellaneou8. 

the  accelerated  pulfle  and  heightened  temperature ;  ga?e  a  start, 
linglj  vivid  picture  of  phthisis  pulmonalis. 

The  symptoms  in  the  extremities  presented  certain  pecoii- 
arities.  When  the  parts  were  perfectly  still  they  were  free  from 
pain,  though  sometimes  there  was  a  feeling  of  numbness,  and  a 
•ense  as  if  there  was  not  strength  of  will  to  lift  the  part.  On 
movement  there  were  cramps,  trembling  and  uncertainty  of 
motion,  and  pain.  The  latter  was  sometimes  severe,  and  re- 
sembled that  following  a  heavy  blow.  The  condition  simulated 
both  rheumatism  and  paralysis.  There  is  a  form  of  paralysis, 
arising  from  exposure  to  damp  cold,  which  includes  numbness, 
immobility,  and  pain. 

One  prover  noticed,  for  several  weeks  after  discontinuing  the 
medicine,  a  peculiar  prickling,  like  electricity,  on  the  back  of  the 
hand  and  outside  of  the  forearm.  This  lasted  only  momentarily, 
but  it  returned  frequently,  and  seemed  to  be  indepoDdent  of 
occupation,  position,  or  time  of  day. 

The  proving  gave  slight  indication  of  its  great  valae  in  skin 
disease.  Blotches  and  pimples  annoyed  the  provers,  and  they  all 
subsequently  noticed  that  the  skin  was  smoother  and  softer  than 
previous  to  the  proving  \  but,  though  it  was  given  in  as  large 
doses  as  the  stomach  would  stand,  nothing  more  serious  was 
developed. 

It  has,  however,  sterling  merit  in  the  treatment  of  skin  dis- 
eases, being  alike  useful  in  the  mere  roughness  caused  by 
exposure  to  wind  and  weather,  or  resulting  from  the  continued 
use  of  cosmetics,  up  to  the  acrid  corroding  ulcers  of  syphilis. 

It  is  equally  beneficial  in  many  diseases  of  the  mucous  aur> 
faces,  either  of  the  air  passages,  digestive  tract,  or  genito- 
urinary organs.  It  has  cured  for  me  obstinate  chronic  tonsillitis, 
chronic  parotitis,  and  chronic  trachitis,  with  scanty,  gummy, 
tenacious  expectoration.  But  it  will  go  deeper  than  these 
superficial  ailments,  and  in  incipient  phthisis  will  restore  gastric 
energy,  and  so  modify  the  tubercular  diathesis  as  to  remove 
every  vestige  of  pulmonic  disease.  Even  when  the  miachief  is 
considerable,  it  will  arrest  its  rapid  course,  bring  the  pulse  back 
to  its  normal  standard,  allay  local  irritation,  and  prolong  life. 

All  the  members  of  the  Berberidace€e  are  antiperiodic.  Ber- 
herU  aquifolium  is  eminently  so.  It  is  considered  by  some  as 
^(jual  to  Quinine*    It  is  certainly  superior  to  HydratUi  and 


•* 


Improvement  of  the  Physique  of  the  Blind.  89 

OtfiHan^  and  in  senBible  doses,  say  twenty  minims  of  the  fluid 
extract,  is  quickly  curative. 

In  more  moderate  doses,  three  or  four  drops,  it  quickly 
relieves  congestion  in  the  liver  and  kidneys,  increases  the  acti- 
vity of  the  spleen,  and  removes  hypertrophy  when  present,  both 
here  and  in  the  prostate. 

In  rheumatism,  I  have  seen  it  speedily  cure  when  the  pain 
was  like  that  firom  a  blow,  with  lameness  and  stiffness ;  or  when 
tbere  is  no  pain  except  on  movement — the  patient  dreads  to 
move  on  account  of  the  pain.  And  it  might  be  of  service  in 
paralysis  from  damp  cold,  as  shadowed  forth  in  the  pathogenesis. 

But  it  is  especially  in  what  are  called  blood  diseases,  syphilis, 
cancer  and  scrofula,  that  the  value  of  this  remedy  has  been 
shown.  In  secondary  and  tertiary  syphilis,  in  five  drop  doses  of 
the  Ix  dilution,  it  will  often  unaided  eliminate  the  morbific 
matter  from  the  system.  The  drug  has  been  so  recently  intro- 
duced that  its  exact  position  in  relation  to  other  blood  remedies 
cannot  yet  be  stated,  but  that  it  is  a  valuable  addition  is  evi- 
dent to  all  who  have  tried  it. 

I  have  never  used  a  dilution  beyond  the  2x,  and  I  usually 
prescribe  a  drachm  of  the  fluid  extract  in  four  ounces  of  simple 
syrup,  a  teaspoonful  every  two  to  six  hours,  pro  re  nata.  As 
there  have  been  spurious  articles  put  on  the  market,  I  would 
suggest  to  those  who  would  like  to  try  the  remedy,  that  they 
procure  Parke,  Davis  &  Co.'s  fluid  extract,  and  make  their  own 
dilutions,  as  that  is  the  preparation  with  which  the  above 
proving  was  made. — Hotnceopathic  Times, 


Society  for  Improvevnent  of  the  Physique  of  the  Blind. 

We  have  pleasure  in  calling  attention  to  this  Society,  whose 
objects  are  stated  in  the  following  extract  from  its  prospectus  : 

''  This  Society  has  been  formed  for  the  purpose  of  giving  the 
BiiHn)  better  health,  independent  power  of  using  their  bodily 
faculties,  in  order  to  enable  them  to  be  less  dependent  upon 
others,  and  thus  to  contribute  to  the  general  welfare  of  85,000 
to  40,000  blind  in  Great  Britain. 

"  The  Jirst  object  is  to  improve  the  physique  of  the  adult  blind 
of  both  sexes ;  the  seeond,  to  assist  the  physical  education  of 


90  Carrapandenee. 

blind  children ;  and  the  thirdj  to  prevent  blindness  as  &r  as 
possible,  hj  remonng  ignorance  regarding  the  hygiene  of  the 
eyes,  which  is  probably — besides  accidents  and  disease — ^tbe 
most  fertile  cause  of  blindness. 

<<  The  means  to  be  applied  are : — 

''  1.  To  train  a  few  blind  and  seeing  teachers  in  the  elements 
of  hygiene  and  physical  deyelopment ;  these  teachers  to  be 
employed  in  the  yarious  centres  where  blind  congregate,  for  the 
purpose  of  giving  the  adult  that  necessary  instruction  in  health 
and  in  the  mode  of  systematically  exercising  all  parts  of  the 
body ;  modeh  and  raised  drawings  of  the  various  positions  and 
exercises  will  assist  the  oral  instruction. 

'*  2.  To  induce  the  principals  of  blind  institutions  to  introduce 
the  free  exercises  as  an  obligatory  part  of  the  education  of  the 
young  blind  of  both  sexes. 

'*  3.  To  collect  information  about  the  origin  of  blindness,  and 
the  means  of  preventing  it  in  the  various  injurious  trades  and 
occupations.*' 

Our  colleague  Dr.  Soth  takes  a  warm  interest  in  it,  and  is, 
we  believCf  the  originator  of  it. 


CORRESPONDENCE. 


Db.  BlaCE.  Aim  THE  ALLEOBD  GlTCOGENIO  FbOFEBTT  Gf 

TJbaitiijm. 

To  the  Editori  of  the  *  British  Journal  of  Somceopathy.^ 

Oektlemek, — ^May  I  trouble  you  with  a  word  or  two  as  to  the 
relation  between  diabetes  mellitus  and  the  Salts  of  Uranium? 

Dr.  Black,  in  a  most  scholarly  and  exhaustive  r6sunU  of  the 
literature  of  "  Diabetes,*'  at  pages  123-4  of  vol.  zxxvii  of  this 
Journal,  speaking  of  my  one-and-twenty  provings  of  Uranium^ 
observes  that  in  one  animal  only,  and  that  on  one  solitary  occa- 
sion, was  sugar  found  in  the  urine.  It  occurred  in  conjunction 
with  copious  albumen,  and  Dr.  Black  very  naturally  asks  ''was 
sugar  actually  present,  or  was  it  not  the  albumen  which  reduced 
the  copper  P  " 

Fortunately,  this  admits  of  a  categorical  reply.    JU  was  not  the 


Obituary — Dr.  Joii  Nunez.  91 

albumen.  The  experimenter  was  at  the  time  perfectly  aware  that 
albumen  might  reduce  copper ;  so  in  every  instance,  where  albu- 
men was  present,  it  was  coagulated  by  heat  and  acid,  and 
removed  by  filtration  before  proceeding  to  the  sugar  tests.  These 
were  conducted  with  all  the  scientific  precautions  known  four- 
teen years  ago.  Newly-made  reagents  were  used,  and  the 
most  scrupulous  cleanliness  was  observed. 

Is  it  not  more  probable  that  Leconte,  having  no  particular 
reason  for  extra  care  and  caution,  should,  as  indeed  Dr.  Black 
suggests,  have  fallen  into  the  error  of  mistaking  albumen, 
existing  perhaps  in  deeply  pigmented  urine,  for  sugar?  It  is 
more  than  possible  that  Leconte's  celebrated  dogs  were,  like  my 
cats,  albuminurious.  Glycosuria  would  not  lead  up  to  suppres- 
sion, which  took  place  in  the  dogs,  whereas  albumen  would  be 
quite  likely  to  pass  on  to  that  stage. 

To  turn  to  another  point,  I  observe  at  p.  128  that  Dr.  Black 
has  rendered  the  word  of  the  review  in  the  *'  Archives  GSnirales  de 
MSdecine  "  as  the  "  muriate."  Leconte  employed  the  ''  azotate." 
It  would  have  been  well  had  Dr.  Black  rectified  this  slip  on  the 
part  of  the  reviewer.  It  is  misleading,  for  readers  would  natu- 
rally suppose  that  the  same  salt  which  produced  Leconte*s  effects, 
had  not  been  employed  in  my  experiments,  thus  considerably 
depreciating  them  in  scientific  value. 

This  explanation  ought,  of  course,  to  have  been  forthcoming  at 
an  earlier  date.  That  it  may  be  associated  with  last  year's 
volume,  perhaps  the  editors,  if  they  think  it  of  su£Scient  import- 
ance, may  deem  it  advisable  to  print  it  on  a  detached  leaf,  which 
could  be  bound  with  vol.*xxxvii. 

I  am,  GentlemeUi  Ac, 

Edwabd  T.  Blake. 


OBITUARY. 


Db.  JOSE  NUSEZ  T  PBENIA. 

The  name  of  Dr.  Nunez  or,  to  call  him  by  his  title,  the 
Marquess  of  Nunez,  has  been  long  identified  with  the  spread  of 
homoBopathy  in  Spain.  The  November  number  of  the  Criteria 
Medico  announces  his  death  at  a  good  old  age,  and  gives  us  a 


92  Obituary. 

biographical  sketch,  from  which  we  take  the  foUowing  particulars. 
He  was  bom  in  1805,  at  Beneventa,  in  Old  Castillo.     His  family 
was  noble.    After  his  school  education  was  finished  he  went  to 
the  UniTersity  of  YaUadolid,  and  studied  for  the  church.    He, 
in  facti  took  orders,  but  he  changed  his  mind  and  became  an 
advocate,  practising  at  Astorga,  where  he  got  a  large  practice, 
and  was  so  popular  that  he  was  elected  member  for  the  Province 
of  Leon.    At  this  time  the  war  of  the  succession  was  raging  in 
Spain,  and  Nunez  became  a  warm  partisan  of  Don  Carlos,  not  as 
a  soldier,  but  as  a  member  of  his  Assembly  of  Notables.    He  did 
not  continue  long  a  Carlist,  for  he  emigrated  to  France,  gave  up 
politics,  and  commenced  to  study  medicine  at  Bordeaux.    Here 
he  heard  of  homoBopathy  and  embraced  it.     He  commenced 
practising  it  at  Bordeaux  without  having  obtained  any  legal 
qualification,  was  prosecuted  and  condemned  by  the  tribunals  to 
pay  a  fine  of  one  franc,  which  was  almost  as  good  as  an  acquittal. 
He  returned  to  Spain  in  1844,  and  his  medical  certificates  ob- 
tained from  the  Faculty  of  Bordeaux  being  admitted,  he  was 
able  to  graduate  as  Bachelor  of  Medicine  at  Madrid,  and  soon 
after  obtained  his  degree  of  M.D.  at  the  University  of  Barcelona. 
All  this  was  somewhat  irregular,  and  his  adversaries    often 
taunted  him  with  not  having  obtained  his  medical  title  in  the 
proper  manner,  and  for  not  having  taken  out  the  courses  of 
medical  studies  required  by  Spanish  law.    However,  he  did  not 
mind' this,  but  began  to  practise  and  obtained  an  immense 
clientele  in  Madrid.    But  though  his  medical  education  was 
somewhat  defective,  his  acquaintance  with  homoeopathic  literature 
was  profound,  and  it  is  said  that  he  knew.the  works  of  Hahnemann 
BO  well  that  if  they  had  been  lost  he  could  have  written  them  over 
again.    He  was  the  veritable  apostle  of  homceopathy  in  Spain, 
though,  of  course,  he  was  not  the  introducer  of  it,  for  it  had 
been  practised  ever  since  1830,  and  several  works  had  already 
been  published. 

In  1846  he  founded  the  Madrid  Hahnemannian  Society,  of 
which  he  was  president  until  two  years  ago,  when,  on  his  retire- 
ment from  age  and  infirmities,  he  was  nominated  honorary 
president  for  life.  He  also  started  the  Boletin  de  la  Soeiedad 
Sahnemanniana,  which  was  replaced  by  the  Analet  de  Medidna 
HamcDOplUiea^  and  this  in  its  turn  was  superseded  by  the  Oriierio 
Medieo,  amounting  in  all  to  thirty-one  volumes.  These  periodicals 


Dr.  Charles  J.  HempeL  93 

contain  many  articles  from  Dr.  Nunez's  pen.  He  also  published 
a  monograph  on  the  Poison  of  the  Tarantuluy  and  sent  a  paper 
to  the  World's  Congress  at  Philadelphia,  entitled  Genesis  and 
Etiology  of  Acute  and  Chronic  Diseases  y  which  is  highly  spoken 
of.  His  practice  brought  him  in  a  great  fortune  and  a  distin- 
guished position.  In  1847  he  was  decorated  by  Napoleon  III  with 
the  Order  of  the  Legion  of  Honour.  He  was  for  some  years  the 
favourite  physician  of  Isabella  II  and  of  the  InfantaDon  Sebastian. 
He  was  successiyely  made  G-rand  Gross  of  the  Order  of  Charles  III 
and  of  Beneficence ;  Commander  of  Isabella  the  Catholic,  and  in 
1865  he  was  created  Marquess  of  Nunez.  He  was  last  year  elected 
Senator  of  the  Kingdom  by  the  Economic  Society  of  Leon.  In 
1850  he  obtained  the  royal  leave  to  establish  a  chair  and  a 
hospital  for  instruction  in  homoeopathy,  but  he  was  then  unable 
to  carry  out  this  scheme.  He  applied  in  vain  for  public  funds 
and  a  public  building  for  the  purpose.  Some  years  later  the 
Hahnemannian  Society  resolved  to  set  on  foot  a  subscription  to 
open  the  Hospital  of  St.  Joseph.  When  it  was  opened  Dr.  Nunez 
took  up  his  residence  in  it  in  order  to  be  able  to  devote  all  his 
time  to  it.  Possibly  the  anxieties  and  the  deprivations  of  his 
accustomed  ease  that  he  incurred  by  taking  up  his  residence  in 
the  hospital  may  have  contributed  to  hasten  the  death  of  the  old 
and  by  no  means  robust  man.  The  enthusiastic  character  of  the 
man  is  shown  in  this,  and  in  the  fact  that  he  obtained  leave  for 
his  body,  when  he  should  die,  to  be  buried  in  the  garden  of  the 
hospital,  and  he  had  caused  a  vault  to  be  constructed  for  its 
reception  there.  His  death  actually  took  place  almost  as  soon 
as  he  had  brought  the  hospital  into  good  working  order.  He 
left  by  will,  under  trustees,  3,000,000  reals  (£81,260)  for  the 
support  of  the  hospital.  Occupying  pretty  much  the  same  posi* 
tion  with  regard  to  homoeopathy  in  Spain  that  the.  late  Dr.  Quin 
held  to  homoeopathy  in  England,  the  resemblance  of  these  two 
illustrious  men  is  further  borne  out  in  their  munificent  benefac- 
tion  to  the  hospitals  they  founded. 


OHAELES  J.  HEMPEL,  M.D. 

Da.  Hempel  was  a  native  of  Bhenish  Prussia,  bom  at  Solin- 
gen,  a  manu&cturing  town  near  Cologne.  Having  received  a 
collegiate  education,  he  availed  himself  of  the  privilege  afforded 


94  Oituary, 

to  all  young  Pnisfliana  at  that  time  of  passing  a  military  examina^ 
tion.  Young  men  who  passed  through  this  ordeal  successfully 
being  entitled  to  postpone  entering  the  military  serrice  of  ProBsia 
until  the  completion  of  their  twenty-third  year,  the  doctor  pro- 
fited by  this  interral  to  go  to  Paris  and  attend  the  lectures  of  the 
distinguished  men  who  then  filled  the  chairs  in  the  XTniversity 
and  College  de  France. 

In  Paris  he  made  the  acquaintance  of  the  celebrated  Michelet, 
who  succeeded  Guiaot  as  Professor  of  History  in  the  College  de 
France,  and  whom  the  doctor  assisted  in  the  publication  of  his 
Hitiary  of  France.  The  six  months  he  resided  in  the  Professor's 
family  as  his  co-labourer  in  this  great  work,  constituted  one  of  the 
most  profitable  and  agreeable  periods  in  the  doctor's  life.  While 
attending  the  lectures  of  Baron  Thenard,  Gay-Lussac,  Dolong, 
Broussais,  and  others,  he  became  intimate  with  American  families 
residing  in  Paris,  and  was  induced  by  them  to  emigrate  to 
America. 

He  landed  in  New  York  on  the  5th  of  September,  1835,  the 
twenty-fourth  anniTorsary  of  his  birth.  He  always  regarded  this 
circumstance  as  a  remarkable  coincidence,  for  he  dated  the 
higher  intellectual  activity,  of  which  he  speedily  became  con- 
scious, from  the  day  when  he  landed  on  the  shores  .of  America. 
He  at  once  applied  himself  to  a  thorough  acquisition  of  the 
English  language,  read  the  English  and  American  classics  with 
a  passionate  fondness,  at  the  same  time  pursuing  the  study  of 
the  Italian  language  and  literature  with  great  zeal  and  enthu- 
siasm. Yery  soon  after  his  arrival  in  New  York  he  became 
intimately  acquainted  with  Signer  Maroncelli,  the  friend  of  Silvio 
Pellico,  and  with  the  other  members  of  the  Society  of  the  Car- 
bonari who  had  been  released  from  .the  dungeons  of  the  Spielberg, 
and  had  taken  refuge  in  the  United  States.  He  resided  two 
years  in  Signor  Maroncelli's  family,  where  he  imbibed  an  ardent 
love  for  music,  Italian  literature  and  erudition,  and  for  the  great 
and  exalted  ideas  of  social,  political,  and  religious  liberty  which 
the  members  of  the  Carbonari  entertained,  and  for  which  they 
had  suffered  martyrdom. 

While  enjoying  the  society  of  these  gentlemen,  and  cultivating 
his  taste  for  the  classical  literature  of  foreign  nations,  he  at- 
tended medical  lectures  of  the  then  recently  organised  Medical 
Department  of  the  University  of  New  York,  of  which  he  became 


l>r.  Charles  J.  liempel.  95 

one  of  the  first  graduates.  Among  his  intimate  friends  and  asso- 
ciates at  that  period  he  numbered  John  Manesca,  author  of  a 
new  system  of  studying  the  French  language,  and  otherwise  a 
gentleman  of  vast  intellect  and  scientific  attainments;  Parke 
Gt>dwin,  editor  of  the  Evening  Fost ;  Charles  A.  Dana,  co-editor 
of  the  Tribune;  Mr.  Eipley,  literary  critic  of  the  Tribune;  John 
C.  Bigelow,  late  ambassador  to  the  Court  of  France ;  Daniel  E. 
Sickles,  late  ambassador  to  the  Court  of  Spain ;  Albert  Brisbane, 
the  celebrated  socialist  writer;  Professor  Bush,  the  celebrated 
Hebrew  scholar  and  Swedenborgian  theologian,  and  a  number  of 
other  gentlemen  who  hare  since  rendered  themselves  conspicuous 
in  the  domain  of  literature  and  politics. 

All  these  gentlemen,  without  an  exception,  were  enthusiastic 
advocates  of  homoBopathy,  a  system  of  practice  which  had  won 
Dr.  HempePs  admiration  in  his  early  boyhood.  Drs.  Gram, 
Channing,  Gray,  Hull,  Hering,  and  others  among  the  oldest 
homoeopathic  practitioners  in  New  York  and  Philadelphia,  were 
his  friends  and  constant  companions,  to  whose  advice  he  was 
greatly  indebted  for  light  and  encouragment  in  the  arduous  path 
of  his  profession. 

Soon  after  graduating  he  began  his  translations  of  the  leading 
authorities  of  the  homcBopathic  school,  and  during  many  later 
years  wrote  numerous  exceedingly  able  medical  works,  which 
took  a  high  standing  in  that  line  of  literature  in  this  country  and 
Europe,  securing  him  a  name  foremost  in  the  medical  profes- 
sional literature  of  the  English  language.  A  bare  list  of  these 
works  would  occupy  a  considerable  space. 

Shortly  after  his  marriage  he  was  called  to  Philadelphia  to  fill 
the  Chair  of  Materia  Medica  and  Therapeutics  in  the  Homoeo- 
pathic Medical  College  of  that  city.  Here  he  laboured  three 
years  with  fervent  zeal  for  the  cause  of  homoeopathic  science, 
and  published,  as  the  result  of  his  efforts  in  that  direction,  his 
system  of  materia  medica  and  therapeutics,  which  was  hailed 
with  satisfaction  by  every  enlightened  practitioner  of  that  school. 
The  death  of  his  father-in-law  rendered  it  necessary  for  him  and 
his  wife  to  leave  Philadelphia,  and  take  up  their  residence  in 
Grand  Eapids,  to  look  after  the  interests  of  the  family  estate. 
There  he  became  engaged  in  a  large  and  lucrative  practice, 
which,  after  a  short  time,  he  was  obliged  to  relinquish  on  account 
of  failing  health,  and  at  last  entire  blindness. 


96  Booki  received. 

He  died  on  the  2nd  September,  1879,  aged  sixty-eight. 
The  new  edition  of  his  Therapeutief  is  nearly  ready  for  publi- 
cation.— HomcDopathie  Titnei. 


BOOKS   RECEIVED. 


The  Grounds  of  a  HomoBopatVe  Faith,    By  S.  A.  Jokes,  M.D. 

New  York.     1880.  ^^^ 

A  Guide  to  HomoBopathie  Practice.    By  S.  D.  Johnson,  M.D. 

New  York.    1880. 

Condemed  Materia  Mediea.  By  C.  Hsbino.  Second  edition. 
New  York.    1879. 

Transactions  of  the  Homoeopathic  Medical  Society  of  the  State 
of  Pennsylvania.    Fourteenth  Annual  Session,  1879. 

Lectures  on  Clinical  Medicine.  By  Dr.  P.  Joubset.  Trans- 
ated  by  Dr.  B.  Ltola^m.     Chicago.    1880. 

The  Pathology  and  Treatment  of  Hereditary  SyphiUs.  By 
H.  C.  Jessen.  M.D.    Chicago.    1879. 

American  Nervousness.    By  G.  M.  BiJED,  M.D.     Eichmond. 

1879. 
Morbid  JFbar  as  a  Symptom  of  Nervous  Disease.    By  Q-.  M. 

Baied,  M.D. 

The  Medical  Counselor. 

The  Homoeopathic  News. 

St.  Louis  Clinical  Becord. 

The  American  Homoeopath. 

Bevue  Homoeopathique  Beige. 

The  Monthly  Homoeopathic  Beview. 

The  Hahnemannian  Monthly. 

The  American  Homoeopathic  Observer. 

The  United  States  Medical  Investigator. 

The  North  American  Journal  of  Homoeopathy. 

The  New  England  Medical  Gazette. 

Bl  Criterio  Medico. 

L'Art  Midical. 

Bulletin  de  la  SociHi  Mid.  Hom.  de  Franoe. 

Allgemeine  homoopatUsehe  Zeitung. 

The  Homoeopathic  World. 

The  Homoeopathic  Times. 

L^  Homoeopathic  Militante. 

The  Organon. 

The  Medical  Herald. 

The  Medical  Becord. 


Arsenic  and  its  Compounds. 


885 


very  violent,  and  the  stage  of  collapse  for  the  most  part  occurs  late 
in  the  attack.  When  the  vital  powers  are  greatly  depressed  there 
may  he  a  coldness  and  lividity  of  surface,  which  is  confined  almost 
entirely  to  the  hands  and  feet ;  hut  the  hreath  is  never  cold,  and 
the  tongue  retains  its  warmth  and  redness  to  the  last.  The  eyes 
are  commonly  prominent,  glistening,  and  hloodshot,  and  the  skin 
around  them  is  often  tumid,  hot,  and  extremely  sensitive. 

Table  of  differences  between  the  symptoms  of  Arsenic  and  Cholera. 

Arsenic.  Cholera. 

(1)  A  feeling  of  faintness ;        (1)  A  feeling  of  discomforts 
no  previous  purging.  not  often  amounting  to  pain 

in  howels,  with  more  or   less 
purging. 

(2)  No  particular  pains  in 
stomach  or  howels. 

(3)  Sudden  attack  of  vomit- 
ing and  severe  purging;  the 
ejected  matters  being  bilious 
or  gruel-like,  never  bloody. 

(4)  Now  comes  the  pain 
in  stomach  and  bowels,  and 
the  great  thirst. 


(2)  Great  pain  in  stomach 
or  bowels. 

(3)  Vomiting ;  the  vomit 
being  dark  and  often  streaked 
with  blood. 

(4)  More  intense  pain,  and  a 
sense  of  a  burning  in  stomach 
and  bowels;  great  thirst  and 
excessive  purging ;  stools  dark 
and  sometimes  bloody. 

(5)  Skin  at  first  hot,  and 
circulation  excited;  the  extre- 
mities may  then  become  cold 
and  livid,  but  the  tongue  re- 
tains its  warmth  and  redness ; 
the  eyes  are  often  bloodshot, 
and  the  countenance  is  never 
BO  peculiarly  death-like. 


(5)  The  skin  has  never  been 
flushed  or  itching,  but  the 
whole  surface  of  it  has  rapidly 
become  cold  and  livid;  the 
breath  has  lost  its  warmth,  and 
the  tongue  and  lips  look  blue 
and  feel  cold.  The  counte- 
nance pinched ;  the  eye  glazed 
and  bloodless,  and  the  whole 
aspect  ghastly. 

410.  Pharmaceutical  Journal  and  Transactions^  1850,  vol.  ix, 
p.  238. 

Extract  from  the  Morning  Herald^  Oct.  9th. 

A  girl  named  Ellen  B —  died  from  inflammation  of  the  lungs 
produced  by  Arsenical  fumes. 

APPENDIX  B.  J.  H.  bb 


886  Pathogenetic  Record, 

411.  Pharmaceutical  Journal  and  Tranioetiont^  1S5Q,  tqL  ix, 
p.  2S5. 

The  houBehold  of  Mr.  Amos,  of  Witmealiam,  nev  Ipswich, 
•eren  or  eight  in  number,  were  seized  with  nausea  and  Tomitipg 
from  Anenie  in  food.    Xo  other  symptoms  given. 

412.  Pharmoeeuiical  Jaurmd  and  Tramtaeiunu,  1852,  voL  xi, 
p.  266. 

By  Mr.  Thornton  J.  Henpath. 

The  whites  of  three  eggSj  weighing  1624  grains,  were  mixed  with 
water  and  6*5  grains  of  dissolTed  Arstniotu  acid.  The  mixture 
was  eTaporated  to  dryness,  comminuted,  and  giren  in  food  to  a 
cat.  Ha^^g  eaten  one  fifth  or  one  fourth  of  the  powder,  it 
refused  the  rest ;  in  a  short  time  it  exhibited  considerable  uneasi- 
ness, vomited  repeatedly,  and  was  soon  afterwards  attacked  with 
all  the  symptoms  of  Arsenical  poisoning.  It  lingered  on  in  a 
state  of  extreme  torment  for  two  or  three  days,  and  then  died, 
refusing  food  to  the  last. 

413.  Pharmaceutical  Journal  and  fran^aetioM,  1SS2,  toV  xi, 
pp.  283—333. 

Copied  from  the  Wutem  Timet.    Case  of  Mr.  Huggios. 

229  sheep  were  dipped  in  Biggs'  sheep-dipping  composition- 
In  two  or  three  days  the  sheep  appeared  stiff,  and  could  scsureely 
walk,  tlxey  seemed  to  be  paralysed  ;  they  were  found  to  be  blis- 
tered, f^s  if  scalded.  After  a  week  they  would  fall  down,  and 
were  unable  to  ris^ ;  th^  blisters  became  worse  aud  broke  \  ab- 
sccBsea  were  formed  into,  the  bone^  Tw^ve  died ;  these  turned 
black.    The  ewes  lost  their  te^^ts. 

The  composition  contained  10  per  cent,  of  Arsenioui  add, 
60  per  cent  of  Sulphur^  12  per  cent,  of  Potash^  mi  18  per  cent 
of  fatty  matter. 

414.  Dublin  Q^arterlif  Journal  of  Medical  Science^  1864, 
vol.  xxxviii,  p.  470. 

Beport  of  Transactions  of  the  County  and  City  of  Cork  Mescal 
and  Surgical  Society.     Pj^per  by  Hr.  Pvimmin^. 
Befere^ice  to  viprious  cases,  for  which  see  above  ^pd  below. 
Case  1. — Last  spring  I  was  consulted  by  f^  gen^leu^^n  vho 


Arsenic  and  its  Compoimds.  3^7 

hivd  taken,  for  a  scaly  eruption  of  the  ear,  from  three  to  ^ix  drops 
of  Fowler'^  Solution  three  times  a  day  for  two  months.  The  dis- 
^aae  rapidly  yielded,  but  there  was  tingling,  itching,  and  partif^l 
desquamation  of  the  hands  and  feet.  The  dose  W4B  reduced,  and 
continued  thus  for  another  month,  when  \  was  sent  for  in  conse- 
quence of  gr^at  irritation  of  the  lower  extremitiea  and  symptoins 
of  inflammation  of  stomach.  To-day,  April  13th,  he  told  me 
that  he  hm»  never  since  felt  as  well,  or  as  equal  to  active  ^ertiom 
as  before. 

Case  2. — ^April  1st,  4  ^.m.,  I  was  callecl  to  see  a  man^  sst.  40, 
suffering  from  vomiting  and  diarrhoea.  He  had  f<^^  disinclined 
for  supper  the  previous  evening.  At  7  p.m.  vomiting  commenced, 
and  shortly  afterwards  diarrhGsa)  both  continuing  up  to  the  time 
of  my  visit.  He  was  then  lying  on  his  back,  extremely  pros- 
trate, cold,  pulseless,  and  thirsty ;  punch  and  brandy  had  faUed 
to  stimulate  him ;  pupils  dilated ;  surface  of  body  cold  and  dark; 
hands  blue  and  corrugated ;  countenance  pinched  and  anxious ; 
greilt  tenderness  of  epigastrium  and  abdomen  generally ;  tongue 
white.  At  10  a.m.  (after  treatment)  he  was  muctk  aa  before, 
except  that  he  was  warmer,  and  the  breathing  very  short  and 
hurried.  Ddarrhoea  and  vomiting,  which  had  ceased  during  my 
visit,  had  returned;  the  vomit  was  a  reddish  brown^  and  the 
stools  a  reddifdi  serum.  He  soon  died.  He  had  been  taking 
about  three  minima  of  Fowhr's^  Solution  three  times  a  day,  for  a 
skin  disease,  for  ten  or  twelve  months.  There  were  no  premoni- 
tory symptoms  of  Arsenical  poisoning  during  th^s  time. 

The  peculiar  silvery  whiteness  of  the  tongue  mentioned  by 
Begbie  [for  which  see  above — E.  "W.  B.]  is  exceedingly  charac- 
teristic of  the  first  constitutional  influence  of  Arsenic,  and  ^s 
seldom  absent ;  it  is  soon  followed  by  swelling  of  the  face,  red- 
ness and  itching  of  the  conjunctiva  and  eyelids,  dryness  of  fauces, 
and  occasionally  by  the  horizontal  red  line  within  the  lower  lid 
described  by  Mr.  Hunt. 

415.  Frovincial  Medical  and  Surgical  Journal,  1852,  p.  9. 

By  Mr.  J.  Skevington. 

November  14th  I  was  sent  for  about  9  a.m.  to  see  Mrs.  B — , 
set.  53.  I  found  her  vomiting  violently ;  she  complained  of  great 
heat  and  pain  frpm  mouth  ^o  stomach  \  was  very  faint^  ai^d  had 
epld  aweata.    She  said  she  had  taken  aome  tea  conti^ioing  a  Uttle 


388  Pathogenetic  Record. 

Carbonate  of  Soda.  She  said  it  tasted  very  peppery,  and  in  about 
three  minutes  after  the  tea  she  began  to  Tomit.  Pulse  was  about 
120,  small  and  irregular.  Skin  cold  and  clammT.  Purging  came 
on  in  about  a  quarter  of  an  hour,  with  intense  pain  in  abdomen, 
more  particularly  on  left  side.  I  sent  her  to  bed  and  applied 
bottles  of  hot  water ;  she  soon  became  warm,  and  afterwards  ex- 
perienced a  burning  heat  of  skin ;  breathing  was  difficult ;  eyes 
were  injected  with  blood,  and  appeared  as  if  they  were  leaving 
the  sockets,  with  intolerance  of  light ;  the  tongue  and  fauces  in 
many  places  had  the  appearance  of  having  been  recently  touched 
with  lunar  caustic;  there  was  great  difficulty  in  swallowing, 
violent  pain  in  head,  and  cramps  of  the  extremities ;  the  Tomit 
was  bilious;  the  anus  excoriated;  urine  scanty  and  scalding, 
scarcely  passing  any  for  two  days ;  voice  was  altered,  and  hoarse- 
ness lasted  a  fortnight. 

The  servant,  aged  about  35,  had  taken  some  of  the  tea,  and 
had  similar  symptoms,  though  not  quite  so  severe.  On  third  day 
she  had  violent  pain  and  swelling  of  the  tongue,  b'ps,  and  face, 
lasting  several  days. 

After  the  urgent  symptoms  were  removed  by  an  emetic  of 
Ipecac,  and  Hydrated  Peroxide  of  Iron,  they  were  both  very  ill 
with  inflammatory  fever,  but  were  convalescent  in  a  fortnight. 
Arsenic  acid  was  found  in  the  tea ;  probably  Arsenioue  acid  had 
been  introduced  into  the  Carbonate  of  Soda,  and  had  formed 
Arseniate  of  Soda. 

The  patient,  in  the  eight  or  ten  ounces  of  tea  she  drank,  took 
about  half  a  drachm  of  Arsenic, 

416.  London  and  Edinburgh  Monthly  Journal  of  Medical 
Science^  1841,  vol.  i,  p.  918. 

By  Dr.  Sallamea.  From  Gazette  Med,  de  PariSy  Sept.  25th, 
1841. 

Madame  X — ,  ast.  27,  took  about  a  gramme  of  Arsenic ;  the 
symptoms  commenced  from  half  to  one  hour  afterwards.  She 
recovered  under  treatment ;  but  eighteen  days  after  Dr.  S — 's 
last  visit  she  vomited  a  green  fluid  mixed  with  blood,  with  sensa- 
tion of  heat  at  epigastrium,  headache,  small  pulse,  constipation, 
and  diminution  of  urine.     Arsenic  was  found  in  the  urine. 

417.  London  and  Edinburgh  Monthly  Journal  of  Medical 
Science,  1844,  vol.  iv,  p.  396  [misprinted  in  Index  397. — ^B.  W.  B]. 


Arsenic  and  its  Compounds,  389 

By  M.  Berutti,  of  Turin.  From  Annates  de  Therap.y  Feb., 
1844,  which  again  is  copied  from  an  Italian  journal. 

Beference  made  to  Annates  de  Thirap.,  1843,  pp.  178,  374, 
837. 

On  Jan.  24th,  1843,  Berutti  gave  to  two  sheep,  about  four 
months  old,  eight  grammes  of  finely  powdered  Arsenious  Acid^ 
with  an  equal  quantity  of  salt,  and  thirty-two  grammes  of  the 
Arsenic  without  salt,  respectively.  In  two  hours  the  sheep 
which  had  the  latter  dose  appeared  dull  and  indisposed  to  move, 
lying  down  again  whenever  it  was  made  to  walk.  Excrement  of 
a  pultaceous  nature  and  dark  colour  was  passed.  In  three  hours 
the  belly  became  tympanitic,  it  seemed  very  feeble  and  indifferent 
to  external  impressions,  and  was  unable  to  keep  its  legs.  It 
died  within  four  hours.  From  the  moment  of  taking  the  poison 
it  passed  no  urine,  nor  ate  anything,  nor  gave  signs  of  suffering. 
The  other  sheep  also  passed  no  urine,  and  did  not  eat,  nor  had 
any  stool.  After  two  or  three  hours  it  became  dull  and  feeble, 
and  lay  down.  In  four  hours  it  had  tetanic  convulsions,  and 
died  very  rapidly.  After  death  the  lungs  and  right  side  of  heart 
were  loaded  with  dark  fluid  blood.  In  both  the  urinary  bladder 
was  empty  and  contracted. 

418.  Monthly  Journal  of  Medical  Science,  1861,  vol.  xiii, 
p.  483. 

Beference  to  paper  by  M.Barse,  in  Z'  Union  MSdicale,  Sept.  27th, 
1851. 

419.  British  and  Foreign  Medico- Chirurgical  Beview,  1856, 
vol.  xvii,  pp.  509-512. 

By  Dr.  Hartshome,  from  FhUadelphia  Medical  Examiner^ 
December,  185$; 

A  woman,  st.  about  22,  having  taken  but  little  food  for  a 
week,  retired  to  her  room  at  9  p.m.  March  29th,  1855,  and  was 
then  heard  to  be  gagging  and  choking  violently.  At  9  a.m.  next 
day  the  same  noise  was  heard.  It  was  ascertained  that  she  had 
taken  poison.  Dr.  Hersley  saw  her  at  11  a.m.,  fourteen  hours 
after  the  first  dose,  and  two  hours  after  the  second.  She  lay  in 
a  state  of  partial  cataleptic  stupor,  occasionally  varied  with  slight 
muscular  spasms.  She  took  an  antispasmodic  draught.  At  1  p.m. 
violent   pain  and  vomiting  suddenly  came  on.     The  Hydrated 


390  Pnthoffenetic  Record. 

Oxide  of  Iron  was  given,  with  Morphia,  cupping,  and  a  blister, 
&c.,  but  the  pain  and  Tx>miting  increased  in  seyeritj  till  the 
afternoon  of  April  let.  She  then  seemed  so  utterly  prostrated 
that  no  hopes  of  her  recovery  were  entertained,  either  by  herself 
o^  her  physicians.  She  said  the  first  dose  of  Artenie  (wb'ch  Was 
drj)  irritated  her  throat,  and  she  coughed  out  part,  but  retained 
about  a  teaspoonfhi.  Next  morning  she  swallowed  another  half 
teaspoonful,  with  the  same  difficulty.  She  felt  no  pain  till  she 
began  to  take  freely  of  drinks.  In  evening  of  April  Ist  tbe 
vomiting  and  pain  ceased,  and  reaction  commenced,  with 
extreme  feebleness,  cool  moist  skin,  temporary  cataleptic 
spasms,  inflammatory  tenderness  of  pharynx  and  whole  intestinal 
canal,  going  off  with  tormina,  tenesmus,  bloody  stools,  and 
strangury,  followed  in  a  ftw  days  by  an  acne-like  eruption  on  the 
skin.  She  was  well  in  three  months. 
Wooler*B  case  quoted  ;  see  above. 

420.  British  and  Foreign  Medieo-Chirurgical  Sevietc,  1859, 
vol.  xiiii,  pp.  617 — 520. 

Schroff's  experiments  referred  to,  in  Zeitsehrift  der.  k.  k. 
OesselUschaft  der  Aertze  zu  Wien,  January  11th,  1858  ;  Schaffer 
in  VierteljahrBchrift  f.  ger,  Med.,  July,  1858  ;  and  Claras,  in 
Schmidt^e  Jahrhucher,  October,  1858. 

Whitehead's  case  quoted ;  see  above. 

421.  Medical  Times  and  Gazette,  1857,  New  Series,  vol.  xiv, 
p.  56.    By  Dr.  J.  T.  Simpson. 

Lebert  says  of  the  application  of  Arsenic  in  cancer  {praiti 
Pratique  des  Maladies  Cancereuses,  p.  646)  that  at  the  end  of 
some  hours  violent  pains  commence  in  and  all  round  the  part, 
tumefaction  at  first,  and  subsequently  an  erysipelatous-like 
inflammation  speedily  succeed  the  pains,  and  it  is  only  towards 
the  end  of  five,  six,  or  eight  days  that  this  inflammation  begins 
to  diminish.  During  all  this  time  the  sufferings  are  sufficiently 
great  to  deprive  some  patients  of  all  rest  and  sleep,  and  ten  or^ 
fifteen  days  may  elapse  before  these  complications  disappear. 

Sir  Benjamin  Brodie  says  (Lectures  on  Various  Subjects  in 
Pathology  and  Surgery,  p.  335}  that  a  medical  mail  told  him  that 
many  patients  died  from  what  seemed  to  be  inflammation  of 
bowels  from  the  application  of  Arsenic  in  cancer. 


Arsenic  and  its  Compounds,  391 

422.  Zancei,  18^7-8,  vol.  ii,  p.  136. 
Bj  Professor  Brande. 

The  8ympix)m8  of  Arsenic  are  pain  and  sensation  of  biirhing 
throughout  the  alimentary  canal.  This  Duriiiiig  seidsatioh 
throughout  the  stomach  and  bowels  is  followed  by  vomiting  aiid 
purging,  and  generally  there  is  a  quantity  of  bloody  mucus 
thrown  otf  the  stomach.  Drinks  of  all  kinds  Ave  jbiejected  by  the 
stomach,  and  after  a  time  the  person  has  fainting  fits,  greiit 
thirst,  and  intense  heat  of  skin;  puls^  beizoui^d  sxh&U  and 
irregular,  and  there  are  violeiit  palpitations  and  dranips  in 
different  parts  of  the  body,  especially  in  the  eitr^tliitied  ;  cold 
sweats  supervene,  and  an  eruption  of  red  and  purple  Spots  upon 
the  skin  t>t6cedes  death.  Deliriuin  is  hot  usual.  Post-mortem 
appearances  are  &n  inflammatory  btate  of  stomach,  red  patches  of 
inflammation  being  found  upon  its  inner  or  mtlbous  coat,  and  if 
the  mucus  and  coagulable  lymph  eflfusigd  is  rubbed  off,  the  parts 
beneath  are  found  intensely  i*ed,  usually  tei*minating  abruptly  at 
a  given  point.  Generally  tbe  blood  in  the  large  vessels  is  found 
to  be  fluid. 

423.  Pharmaceutical  Journal  and  Transadtions^  1857,  vol,  ivi, 
p.  532. 

In  January,  1847,  several  hundreds  At  Hong  Eotig  Were 
poisoned  by  Arsenic  in  bread.  [Can  the  details  btt  obtained  ? — 
E.  W.  B.]. 

424.  Pharmacetitical  Journal  and  Transactions,  1858,  vol.  zvii, 
p.  42. 

By  Mr.  H.  Bell. 

Arsenical  powder  was  applied  to  the  skin  of  a  child.  It  caused 
excessive  irritation  of  skin,  a  wound  formed^  and  the  child  died 
in  great  pain. 

425.  Pharmaceutical  Journal  and  Transactions,  ifeSS,  vol.  xvii, 
p.  385. 

By  Dr.  Edwards. 

Jobn  Gl-uy,  of  Liverpool,  gave  Arsenic  to  his  wife.  She  imine- 
diately  perceived  it  had  a  sandy  taste  on  the  tongue,  and  very 
shortly  afterwards  there  was  a  burning,  tickling  sensation  in 
throat  and  swallow.  She  took  boi  coflee  in  large  quaniities, 
and  soon  vomited, 


392  Pathogenetic  Record, 

426.  Pharmaceutical  Journal  and  Transactions,  1858,  vol.  xvii, 
p.  436. 

Inquest  at  Shoreham  on  Mrs.  Puttick  and  her  son.  Three 
persons  took  Arsenic  in  food.  It  caused  great  pain,  Tomiting, 
and  purging,  and  two  died. 

427.  Pharmaceutical  Journal  and  Transactions,  1858,  vol.  xrii, 
p.  558. 

By  Dr.  A.  S.  Taylor. 

Halley's  case  quoted ;  see  above.  Beference  to  Chevallier*8 
paper  in  Annates  d^Sygiene  et  de  Midecine  Ligale,  tome  xxxviii, 
1847,  p.  .56. 

Bouchardat  says,  in  Annuaire  de  TherapeutiquCy  1846,  p.  209, 
that  the  workers  in  Schweinfurth  green  (AcetO'Arsenite  of 
Copper)  are  subject  to  serious  disorders  of  health.  They  some- 
times suffer  from  a  cutaneous  eruption,  with  oedema  of  face,  and 
boils  frequently  form  in  the  scrotum.  After  a  time  the  mucous 
membrane  of  nose  shows  signs  of  irritation ;  there  is  discharge  of 
fluid  from  nose,  with  abundant  salivation.  This  is  the  first 
stage.  In  the  second  stage  there  are  colicky  pains,  headache, 
and  prostration  of  strength. 

428.  British  and  Foreign  MedicO'Chirurgical  Review^  1859, 
vol.  xxiv,  p.  527. 

Copied  from  the  American  Medical  Monthly,  May,  1859. 

A  woman,  set.  46,  was  well  till  about  three  weeks  before  her 
death,  when  she  complained  of  general  indisposition,  and  a  sensa- 
tion of  heat  in  the  "  chest"  [?  stomach. — E.  W.  B.].  The  sym- 
ptoms advanced,  the  sense  of  burning  being  located  at  the  epi- 
gastrium, and  vomiting  soon  setting  in.  The  vomiting  always 
occurred  in  five  to  fifteen  minutes  after  food  or  drink.  A  second 
physician  now  saw  her,  and  found  she  had  symptoms  of  severe 
gastritis.  He  gave  Nitre,  Dover's  powder.  Ox  gall,  and  Quinine, 
and  a  Blister  to  stomach.  The  vomiting  continued ;  at  first  it 
was  yellow,  but  gradually  became  green,  and  towards  the  close 
of  the  case  became  dark,  bordering  on  brown,  and  containing 
spots  of  blood  and  a  thick  ropy  mucus,  which  could  be  lifted  out 
of  the  vessel  on  a  stick.  Whatever  she  swallowed  she  vomited, 
yet  she  craved  for  drink,  and  took  a  variety  of  fiuids.  During 
the  last  week  of  her  life  there  were  nervous  symptoms.    Extre- 


Arsenic  and  its  Compounds,  393 

mities  were  cold,  though  the  face  was  flushed ;  there  was  a  hesita- 
tion in  answering  questions  ;  partial  ansesthesia  of  hands,  slight 
impairment  of  voluntary  motive  power,  and  convulsive  tossings 
of  arms.  Languid  and  anxious  expression  of  face,  with  a  peculiar 
sharpness  of  eye.  Legs  and  feet  oedematous,  lips  swollen ;  urine 
scanty,  high  coloured.,  and  irritating  to  urethra.  No  diarrhoea 
till  thirty  hours  before  death,  the  stools  being  then  dark  and 
offensive.  The  breathing,  which  had  been  before  hurried,  became 
laboured  ;  stupor,  interrupted  but  once  by  a  wild  scream,  set  in ; 
and  the  scene  closed  with  complete  collapse.  Opittm  and  brandy 
were  given  on  the  last  day  (probably  three  ounces  of  Laudanum 
and  one  pint  of  brandy). 

Post  mortem  after  a  year. — Body  remarkably  preserved,  also 
all  the  viscera,  except  brain ;  the  muscles  retained  their  redness. 
Mucous  membrane  of  stomach  hard,  much  harder  than  natural, 
and  its  veins  large,  as  if  congested.  Contents  of  stomach  un- 
usually small,  and  like  coffee  grounds.  Parts  of  colon  and  rectum 
slightly  reddened.     Arsenic  was  found  in  body. 

429.  British  and  Foreign  MedicO'Chirurgical  Review,  1859^ 
vol.  xxvi,  p.  628. 

Prom  Toronto  Weekly  Olohe,  [See  another  account  in  No. 
183  of  Path.  Eecord,^B.  W.  B.] 

Dr.  £jng  poisoned  his  wife.  On  October  18th,  1858,  she  was 
seized  with  violent  internal  pains,  burning  sensation  in  throat, 
retching,  &c.,  which  lasted  till  November  3rd,  when  she  died. 

Post  mortem, — Stomach  engorged,  in  an  early  state  of  inflam- 
mation. Intestines  and  rectum  coloured.  Entire  surface  of 
peritoneum  dark.  Lower  part  of  right  lung  slightly  congested  ; 
liver  hard.  She  had  often  taken  a  white  powder,  which  she  said 
was  "  fiery  tasted."  It  caused  vomiting  of  dark,  greenish  matter. 
The  severe  pains  was  only  felt  during  the  vomiting.  Arsenic  was 
found  in  the  body. 

430.  American   Journal  of  Medical  Sciences,   1832,  vol.  xi, 

p.  546. 
By  Dr.  A.  A.  G-ould.    From  Medical  Magazine,  November, 

1832. 
C.  G — ,  «t.  23,  took  half  an  ounce  of  Arsenic  in  water  about 


394  Pathogenetic  Record. 

7  a.m.  He  had  taken  no  food  the  day  before.  In  about  half  an 
hour  he  began  to  yomit,  and  continued  to  do  so  for  some  time' 
About  10  a.m.  he  appeared  in  a  lethargic  state;  eyes  closed; 
would  anawer  no  questions  and  obstinately  resisted  all  attempts 
to  give  medicine  or  drinks.  Watery  discharges,  yellowish  and 
slightly  mixed  with  ftecal  matter,  were  constantly  occurring, 
involuntarily,  or  at  least  without  his  attending  to  them,  f  ulse 
rapid,  small,  and  feeble.  Skin  and  extremities  cold.  He  shrunk 
when  pressure  was  made  upon  abdomen,  but  gave  no  other 
indication  of  pain.  Milk  was  forced  down  him,  which  soon 
returned,  with  some  of  the  Arsenic,  After  resisting  all  attempts 
to  help  him  he  died  quietly  at  12.30  p.m.,  the  pulse  disappearing 
at  the  wrist,  and  the  blood  settling  under  the  nails  at  least  one 
hour  before  death. 

Poii  mortem  next  day.  Stomach  contained  more  than  a  pint 
of  whitish,  turbid  fluid,  in  which  floated  some  flocculent  masses, 
like  coagulated  milk.  He  had  taken  no  liquids  for  one  or  two 
hours  before  death,  and  none  subsequent  to  vomiting.  Two  or 
three  small  red  patches  near  cardiac  end  of  stomach,  such  as  are 
generally  seen  after  severe  vomiting.  The  mucous  membrine  of 
whole  intestinal  canal  appeared  as  if  it  had  been  macerated  for 
some  hours  and  then  thoroughly  washed ;  it  contained  no  faces. 

431.  American  Journal  of  Medical  Soienees',  1832,  vol.  xi.,  p.  529. 

From  Journal  Universal  et  Hehdom,^  September,  1882.  [No 
name  attached. — E.  W.  B.] 

L — i  »t.  19,  said  he  was  unwell  August  8th,  1831.  He  had 
diarrhoea  and  vomiting,  In  the  evening  I  found  hitn  thus  .— 
Countenance  calm,  cold ;  eyes  sparkling ;  tongue  cold  and  pale ; 
extremities  cold ;  pulse  thready.  In  twenty  minutes  more  he 
lost  his  speech,  and  died  in  eleven  hours.  The  median  vein  was 
opened,  but  there  was  no  discharge  of  blood. 

Post  mortem  in  thirty  hours. — Ventricles  of  brain  contained 
about  two  teaspoonfuls  of  reddish  serum.  Beyond  the  thalami 
optici,  in  the  two  yentricles,  there  was  a  softening  of  that  part  of 
the  cerebral  substance  which  forms  the  extern^  padet^d  of 
ventricles,  most  decided  in  a  space  of  three  and  a  half  liii^S  by 
bne  in  depth.  Fericardiutn  contained  about  a  teaspoonful  of 
serum.  Heart  soft,  flahby,  could  be  very  easily  torn.  In  right 
cavities  of  heart  wad  liquid,  livid  blood,  without  fibHndus  cldis ; 


Arsenic  and  its  Compounds,  395 

m  the  left  cavities  the  blood  wa&  similar,  but  there  wei*e  BOme 
small  fibrinoUB  coagula.  The  inferior  vena  cava  contained  liquid 
blood,  of  the  colour  of  wine  lees.  The  internal  membrane  waft 
slightly  reddened  (a  post-mortem  'change).  Lungs  crepitant 
throughout,  but  their  tissue  could  be  readily  toim,  especially  at 
posterior  portions,  where  they  were  filled  with  a  blackish, 
spumous,  and  as  if  purulent  liquid.  This  fluid  or  blood  existed  in 
large  quantities  in  both  lungs.  Miicbus  nietubirane  of  abdoixlihal 
viscera  presented  a  very  abundant  secretion  of  mucu^.  It  had  a 
yellow  tint  over  most  of  its  surface,  but  with  here  and  there 
brown  livid  patches,  especially  at  the  greater  curvature  of 
stomach.  Mucous  meihbrane  of  small  intestines  strongly 
injected  in  several  spots  of  three  or  four  inches  in  extent.  Birun- 
ner's  foUicliBS  very  numerous,  especially  towards  ileo-cojcal  valve 
and  duodenum.  Large  intestine  violently  inflamed  ih  several  spots, 
and  filled  with  a  large  quantity  of  fluid ;  its  mucous  membrane 
was  swollen,  and  near  ileo-coscal  valve  it  formed  ti  kind  bf  polypus. 
Bladder  contained  about  two  spoonfuls  of  a  turbid  and  as  it 
purulent  fluid ;  its  mucous  membirkne  was  highly  injected.  The 
tissue  of  kidneys  contained  fluid  analogous  to  that  in  the  lungs. 
Spleen  softened,  the  colour  of  wine  lees,  easily  torh.  LiVet 
large,  a  little  injected.  Great  sympathetic  nerves  injected. 
Evisry where  was  found  the  Altered  black  blood  so  often  seen  in 
cholera  patients.  Urinary  secretions  had  ceased,  and  bladder 
only  contained  a  white,  milky  fluid.     Arsenic  was  found  in  body. 

482.  Medwo-Chirwrgictd  BeviM,  1845^  New  Serii^s,  Vol  ii^ 
p.  236. 

De  Lafond's  paper  briefly  extracted  from  Memoir es  de 
VAeademie  Soyale  de  MMeeine,  torn,  xi,  1845. 

In  some  animals  poisoned  by  Arsenic  the  inflammation  of  the 
mucous  membrane  was  so  violent  that  in  an  hour  it  produced  the 
formation  of  several  metres  of  cylindrical  false  membiranes.  The 
Urine  was  greiitly  diminished. 

433.  I^ew  York  Journal  of  Medicine,  1860,  New  Series,  vol.  v> 
p.  268. 

Geoghegan's  cases  quoted ;  see  above. 

434.  New  York  Journal  of  Medicine,  1868,  Third  Series,  vol.  iv, 
p.  269. 


396  Pathogenetic  Record. 

Beference  to  paper  by  Imbert-Grourbeyre  in  Qtuette  MedieaU 
de  Farts,  January,  1858.  He  says  Arsenic  causes  paralysis, 
trembling,  pains  in  limbs,  contraction,  and  oonvulsions.  He 
relates  more  than  thirty  cases  proving  that  it  may  cause  para- 
lysis of  moyement,  or  of  sensibility  in  the  upper  or  lower  limbs, 
on  one  side  or  on  both. 

485.  FharmaceuHeal  Journal  and  Transactions,  1861,  2nd 
Series,  vol  ii,  p.  191. 

By  Dr.  Adam. 

Mr.  Dodd,  of  Wrangle,  was  seized  with  vomiting,  purging,  and 
coUapse,  and  died  the  same  evening  in  great  agony. 

Post  mortem.  —  Stomach  and  intestines  highly  inflamed. 
Arsenic  was  detected  in  the  body,  and  it  was  found  that  he  had 
taken  one  ounce. 

436.  Fharmaceutical  Journal  and  Transactions,  1861, 2nd  Seri^ 

vol.  ii,  p.  247. 

Three  workmen  of  Messrs.  Crum  and  Themliebank,  of  Glasgow, 
ate  some  potatoes  boiled  in  a  dish  which  had  contained  Arsenic 
and  Chlorate  ofFotash.    They  had  violent  pain  and  vomiting. 

487.  Fharmaceutical  Journal  and  Transactions,  1861, 2nd  Series, 
vol.  ii,  p.  286. 

From  Westmoreland  Gazette, 

A  stream,  called  Whitbeck,  rising  in  the  Blackcombe  Moun- 
tains, in  West  Cumberland,  contains  Arsenic,  It  at  first  caused 
in  those  who  drank  it  soreness  of  mouth,  and  aflTected  the  throat. 

488.  Fharmaceutical  Journal  and  Transactions,  1861,  2nd 
Series,  vol.  ii,  p.  885. 

Editorial. 

Bobert  Murton  and  others  were  seised  with  Tomiting,  and 
great  pain  and  thirst.  Arsenic  was  found  in  the  flour  they  had 
eaten. 

489.  Fharmaceutical  Journal  and  Transactions,  1861, 2nd  Series, 
vol.  ii,  p.  485. 

Editorial. 

M.  Bonniss,  of  France,  spread  a  green  Arsenical  powder  over 


Arsenic  and  its  Compounds.  397 

flowers.  In  the  course  of  a  fortnight  it  had  caused  eruptions  on 
face,  and  a  constant  taste  of  copper  in  mouth,  which  prevented 
him  taking  his  customary  food,  and  made  him  very  ill. 

44]0.  Fharmaceutical  Journal  and  Transactions,  1859,  vol.  zviii, 
p.  222. 

By  Dr.  W.  Hinds. 

Dr.  A.  Taylor's  case,  quoted  from  one  of  his  works.  A  young 
man,  after  having  been  engaged  for  nine  days  in  printing  with 
Arsemcal  green,  was  seized  with  coryza,  swelling  of  lips  and 
nostrils,  and  headache.  Next  day  he  had  severe  colic  and  great 
muscular  weakness. 

Dr.  Hinds  adds  that  a  paper-hanger  told  him  that  he  had 
repeatedly  got  so  ill  with  coryza,  dryness  of  the  throat,  and  pros- 
tration, while  hanging  green  paper,  that  he  has  been  compelled 
to  leave  the  room.  All  the  hangers  of  green  paper  say  they  often 
have  severe  symptoms  while  at  work.  In  all  these  cases  the 
symptoms  were  gastro-enteritic  irritation,  with  intermittent 
eoHcky  pains,  nausea,  prostration,  loss  of  muscular  power,  coryza, 
heat,  and  dryness  of  the  throat. 

441.  Fharmaceutical  Journal  and  Transactions,  1859,  vol.  xviii, 
p.  244. 

Editorial. 

Charles  Hill,  8dt.  28,  was  seized  on  waking  with  vomiting  and 
pains  in  stomach,  and  died  in  a  few  hours.  The  mucous  mem- 
brane of  the  stomach  was  found  highly  inflamed.  Arsenic  was 
found  in  the  body. 

442.  Fharmaoeutieal  Journal  and  Transactions,  1859,  vol.  xviii, 
p.  340. 

Editorial. 

Poisoning  of  200  people  at  Bradford  by  Arsenic  in  lozenges. 
Two  are  stated  to  have  died  with  symptoms  of  cholera.  [No 
farther  details  given  here. — E.  W.  B.] 

443.  Pharmaceutical  Journal  and  Transactions,  1859,  vol.  xviii, 
p.  417. 

By  Dr.  A.  S.  Taylor. 

A  friend,  whose  walls  were  covered  with  Arsenical  paper,  for 


898  Pathogenetic  Record. 

aoma  time  suffered  from  chronic  inflammation  of  eyes,  espociallj 
affecting  conjunctiya  of  eyelids.  On  remoying  the  paper,  the 
symptoms  disappeared. 

Mr.  Gay  tells  me  that  he  habitnaUy  used  a  room  papered  with 
4rienical  paper.  His  health  became  very  indifferent.  He  had 
colicky  pains  from  time  to  time,  and  occasionally  they  had  been 
yery  severe.  The  conjunctiva  of  eyes  were  inflamed  and  felt 
uncomfortable.  Latterly  he  had  a  severe  cough,  with  hoarseness 
an4  i^lmoat  entire  loss  of  voice. 

444.  Pharmaceutical  Journal  and  Transactions^  1859,  voL  xviii, 
p.  524. 

!Editorial. 

Trial  at  Newcastle  for  loss  of  850  sheep  by  Arsenical 
wash.  Many  sheep  were  ill,  foamiug  at  the  mouth,  shak- 
ing their  heads,  and  lying  down.  The  hands  and  arms  of 
the  men  which  had  been  in  the  liquor  became  sore  and  mortified 
and  sloughed,  and  they  were  ill  for  some  time.  The  dead  sheep 
were  swollen  and  black.    Arsenic  was  found  in  the  bodies. 

445*  Pharmaceutical  Journal  and  Transactions,  1862,  2iid 
Series,  vol.  iii,  p.  198. 

Trial  of  Delvaux,  of  Brussels,  for  poisoning  his  wife  with 
Arsenic,  referred  to ;  the  only  symptoms  given  are  vomiting  and 

pains  in  stomach. 

* 

446.  Pharmaceutical  Journal  and  Transactions,  1862,  2nd 
Series,  vol.  iii,  p.  243. 

Trial  of  three  persons  for  the  murder  of  Mrs.  Beamish. 

Mrs.  B —  and  her  family  were  seized  with  vomiting  after 
meals ;  the  youngest  child  had  convulsions  next  day,  and  died 
suddenly.  The  mother  also  died,  having  had  diarrhosa.  Arsenie 
was  found  in  her  body. 

447.  Pharmaeeutioal  Journal  and  TVansaetione,  1860^  2nd 
Series,  vol.  i,  p.  482. 

Ballenden's  cases  quoted ;  see  above.  Beference  made  to 
Blondlot's  paper  communicated  to  the  Paris  Aeademy  of  Sciemees, 

448.  Pharmaceutical  Journal  and  Transactions,  18i60»  2nd 
Seriesi,  vol.  i,  p.  618. 


Arsenic  md  its  Compounds.  89d 

Editorial. 

Sbimuel  W — ,  of  Seagrave,  died  from  Arsenic  in  f pod-  He  b*d 
Tioleot  yomitipg. 

A  woman  and  her  child  ate  the  food  containing  it.  They  both 
felt  a  smarting  sensation  in  mouth,  after  which  they  had  violent 
sickness  through  the  night.  The  woman  was  very  thirsty  for 
BCTeral  days  afterwards. 

449.  J^ew  Shfdenhm  Smety's  J^uhUcationet  1873,  Yo.1.  liz, 
p.  438 ;  1871,  vol.  1,  pp.  189,  62 ;  1863,  vol.  xix,  pp.  487,  49 ; 
1857,  vol.  X^Tiii,  p.  484  ;  1864,  vol.  3txiii,  p.  462  ;  186Q,  vol.  viii, 
pp.  434—7,  450—1,  458,  471 ;  1861,  vol.  x,  pp.  61,  225,  248, 
436  ',  1869,  vol.  xliii,  p.  444 ;  1865,  vol.  3p[v,  p.  27 ;  1862,  vol.  xv, 
pp.  134, 152,  415—6 ;  1875,  vol.  Ixv,  pp.  484,  455. 

Pases  by  Beese,  &c.,  quoted ;  see  above  and  below :  also  re- 
ference to  Guy  in  Mfih  JReport  of  ike  Medical  Officer  of  the 
frivjf  Cotmcil — Appendix;  Yirchow  in  ArcMv^  xlvii,  p.  524; 
Huber  in  Qesterreichuck^  Zeit8chr\ft  fur  practkche  Heiiiunde, 
4,  28 ;  Schaeffer  in  OnspckT's  VicrU\j(ihrsohrift^  14, 1 ;  Orfila  in 
Qazette  M6pit£mxj  1857,  I^a  139 ;  Orftbhachor  in  Oes^erreickiecke 
Zeitschrift,  4,  45  ;  Haffner  in  Deutsche  Zeitechrift  fur  die  Staais- 
Arzneikunde,  11,  2;  Prosper  de  Fietro  Santa  in  Annales 
d'S^iene,  19  ai^4  2Q  \  Trapani  in  Gazette  Medicals  de  Fari%  and 
Ann.  de  Thhrap,^  1860,  p.  168 ;  Bunzen  in  Kos^,  JHdende,  185, 
N OS.  17, 19,  and  Schmidfs  J.ahrhucL,  vol.  106,  p.  30 ;  Clemens 
in  Deutsche  Klinih,  1859, 10-2,  and  Camt-  Jahrh,^  vpl.  iii,  p.  293 ; 
Niemann's  Medico-Legal  Autopsies,^  3rd  hundred,  in  Henke,  vol. 
xxxix,  part  3,  cases  93-100;  Hoffman  in  Henke^  vol.  xxxi]?, 
p.  286 ;  Moutard,  Martin,  and  Sistach  in  An/nales  de  Th6rap.^ 
1862,  p.  110 ;  Eoussin  in  Annates  d' Hygiene^  vol.  xi^viii,  p.  179  ; 
in  M^cfijtfiil  de  Mim.  de  Med.  Milit.,  3  aer.,  9,  p.  136 ;  and  in 
Schmidt's  Jahrluch,  1864;^  vol.  1^,  p.  5  (a  rabbit  \^hich  had 
t^iken  Arseniatee  for  tlgree  months  without  injury^  became  ema- 
ciated on  being  deprived  of  them) ;.  Schmidt  and  Stnrzwege  in 
Moleschott's  Untersuch.,  and  British  and  Foreign  Med.  Ohir. 
Beviewy  Jan.,  1861 ;  Fokker  in  Zeitachrift  Allgem.  Oesterr.  Apot- 
Vereit^.,  v.  ix,  p.  249 ;  Marchi  in  Vierteljahr^chriftfur  Oerichtl. 
Med.y  vol  xviii,  p.  162 ;  ZeU^  in  Wurtem.  Corr.  Blatt.,  32,1860^ 
^nd  Schmidt's  Jahriuch.,  yol.  109,  p.  44  (case  of  hemiplegia); 
^4  Von  Veiel  in  Wurtemb.  Corr.  Blatt,  No.  24, 18€|0,  and  Canst 


100  Pathogenetic  Record, 

ToL  ▼,  p.  115  (out  of  700  patients  who  took  ^^-grain  doses  of 
Anenious  acid  for  skin  diseases,  he  often  met  with  conjanctintifl, 
dry  throat  and  nose,  irritati?e  cough ;  in  one  case  strangoiy,  and 
in  two  salivation). 

450.  Northern  Journal  ofMedidne^  1845,  vol.  iii,  p.  384. 
Allison's  case  quoted.    See  above. 

451.  American  Journal  of  Medical  Science^  1835,  vol.  xvi, 
pp.  239,  518. 

B7  Dr.  Leger;  communicated  to  the  Society  of  Practical 
Medicine  qf  Paris. 

A  child,  let.  18  months,  took  a  solution  of  the  Orey  Oxide  of 
CohaUy  commonly  called ''  fly -poison  "  (P  Arsenic^  see  No.  2d9  of 
Pathogenetic  Becord, — E.  W.  B.),  and  was  immediately  seized 
with  violent  colic.  She  lay  stiff  on  her  grandmother's  lap,  com- 
plaining of  violent  pain  in  belly.  Had  vomited  twice.  Hydrated 
Tritoside  of  Iron  cured  her.  Beference  to  experiments  by 
Lesueur,  communicated  to  Boyal  Acad,  ofMed.y  November  4th ; 
and  to  Boulay  in  Joum.  Heb,  dee  Prog,  dee  Sci.j  March  14th, 
1835. 

452.  Provincial  Medical  and  Surgical  Journal^  1849,  p.  611. 
By  Dr.  Samuel  Baddiffe. 

A  man  took  a  large  dose  of  Arsenic  about  5  a.m.  I  found  him 
about  8.30  a.m.  approaching  a  comatose  state,  and  there  had 
been  much  vomiting  and  purging.  He  died  comatose  a  little 
before  11  a.m. 

453.  Medical  Times  and  Gazette,  1868,  vol.  i,  p.  376 ;  1850, 
new  series,  vol.  i,  p.  519 ;  1851,  new  series,  vol.  iii,  pp.  294,  576 ; 
1866,  vol.  ii,  pp.  335-6 ;  1872,  vol.  ii.  p.  208 ;  1873,  vol.  ii,  p.  234 ; 
1857,  new  series,  vol.  xiv,  p.  319 ;  1857,  new  series,  vol.  xv, 
p.  404 ;  1859,  new  series,  vol.  xviii,  p.  175  ;  1860,  vol.  i,  p.  154 ; 
1860,  vol.  ii,  p.  168 ;  1874,  vol.  ii,  pp.  125,  355 ;  1875,  vol.  ii, 
p.  425 ;  1873,  vol.  i,  p.  490. 

Beference  to  Dupuy's  essay  on  Arsenic  furnished  to  the  Society 
de  Pharmacie  ;  Gibert's  Emploi  MSdicale  de  V Arsenic  dans  Us 
Maladies  de  la  Peau,  Paris,  1850 ;  Hoppe  Seyler  in  Centralbktt, 
1868,  434 ;  Lewison  in  Virchow's  Archives,  36,  15 ;  Saikowsky 


THE 


BRITISH   JOURNAL 


ov 


HOMCEOPATHY. 


ON    THE    ACTION    OF   DRUGS  ACCORDING   TO 

THE  LAW  OP  SIMILARS. 

By  De.  Pr^dault.* 

There  has  been  much  discussion  of  late  among  the  prac- 
titioners of  the  homoeopathic  school  on  medicinal  aggrava- 
tions^ primary  and  secondary  effects,  the  different  or  oppo- 
site characters  of  the  action  of  drugs  in  different  doses. 
Such  discussions  are  inevitable^  and  will  certainly  occur 
until  the  solutions  they  require  shall  have  been  discovered. 
For  the  questions  they  refer  to  are  of  considerable  import- 
ance to  therapeutics^  involvings  as  they  do,  many  secondary 
points  in  practical  medicine ;  and  the  interest  they  excite, 
the  persistence^  perhaps  tiresome  but  certainly  respectable^ 
with  which  they  are  repeated^  is  perfectly  legitimate. 

I  haye  long  hesitated  to  speak,  because  I  have  been 
maturely  considering  my  ideas,  and  because  I  had  a  natural 
reluctance  to  work  out  my  thoughts  upon  subjects  of  such 
difficulty.  Moreover^  the  view  I  took  of  them  tends  to 
modify  profoundly  one  of  the  principal  doctrines  of  the 
founder  of  homoeopathy ;  and  I  was  unwilling  to  express  my 
sentiments  until  I  had  carefully  examined  the  question. 

I  have  at  length  decided  to  publish  the  opinion  I  have 
come  to^  because  I  have  become  more  and  more  convinced 
that  the  theory  of  reaction  by  aggravation^  taught  by  Hah- 

*  From  VArt  MSdical,  November  and  December,  1879. 
VOL.  XXXVIII^  NO.  CLII, APRILj  1880.  Q 


98 


Fridauh  on  the  Action  of  Drug$. 


nemann  (and  it  is  of  this  that  I  would  speak),  exercises  an 
iDJarioas  inflaence  on  almost  all  the  questions  of  materia 
medica,  that  it  is  the  cause  of  the  obscurity  in  which^  in 
spite  of  all  the  efforts  of  his  disciples,  the  doubtful  questions 
mentioned  above  continue  to  be  involt ed. 

I  trust  to  be  able  to  show  clearly  that  it  is  necessary 
to  get  rid  of  an  unfortunate  theory  that  has  been  maintained 
and  imposed  with  too  much  persistence,  because  it  is  inju« 
rious  to  the  law  of  similars,  which  is  the  fundamental  point 
of  homoeopathic  treatment.  I  believe  also  that  T  am  able 
to  show  that  there  is  a  doctrine  more  truly  and  accurately  in 
consonance  with  the  facts  of  therapeutics  and  with  experi- 
ence ;  that  we  may  elicit  from  it  satisfactory  solutions  of 
several  questions  that  still  remain  doubtful ;  and  that  it  may 
be  very  useful  to  medical  practice. 

This,  then,  without  entering  into  too  much  detail,  is  what 
I  propose  to  do :  to  refute  an  erroneous  doctrine,  and  to 
substitute  for  it  another  on  certain  controverted  points,  with 
the  principal  arguments  in  its  favour. 

I  shall  speak  successively : — ^1.  Of  the  general  theory  of 
the  action  of  drugs  ;  2,  of  aggravations ;  3,  of  primary  and 
secondary  effects ;  4,  of  the  opposite  kind  of  action  of  dif- 
ferent doses ;  5,  of  the  different  action  of  different  doses ; 
6,  of  the  intimate  action  of  the  drug;  7,  of  the  suscep- 
tibility to  the  drug ;  and,  8,  I  shall  recapitulate  all  those 
questions  which  naturally  follow  and  are  connected  with  one 
another. 

I. 

In  the  first  place  I  go  to  the  heart  of  the  principal  ques- 
tion, and  inquire  How  do  drugt  act?  This  question 
includes  the  theories  of  aggravations  and  secondary  effects, 
theories  which  at  present  are  almost  inseparable  from  the 
law  of  similars. 

Like  ourselves,  Hahnemann  may  from  his  earliest  years 
have  heard  the  following  saws,  which  are  almost  as  old  as 
the  world :  that  the  evil  must  first  get  worse  before  it  can 
get  better ;  that  great  sinners  make  great  saints ;  that  the 
disease  must  attain  Us  height  in  order  to  make  the  tur'n 


Fridault  on  the  Action  oj  Drugs,  99 

towards  a  cure;  that  in  everything  it  is  the  excess  in  one 
direction  that,  as  in  the  oscillations  of  a  pendulum,  brings 
about  a  return  to  the  opposite  direction;  that  cold  brings 
heat,  &c.  He  may  have  been  more  struck  than  any  one  else 
in  reading  Hippocrates^  and  especially  John  Hunter,  where 
the  homoeopathic  idea  was  more  distinctly  taught  than  it  has 
ever  before  been,  so  distinctly,  indeed,  that,  as  I  have  shown 
in  my  IKstoire  de  la  MSdecine,  the  English  surgeon  may  be 
considered  as  the  real  precursor  of  the  German  physician. 
But  this  is  a  matter  of  secondary  importance.  The  main 
thing  is  that  Hahnemann  introduced  into  therapeutics,  in 
order  to  establish  it  there  as  a  general  and  absolute  rule, 
the  principle  of  the  above  saws ;  and  so,  according  to  him, 
the  medicine  cures  by  producing  an  aggravation  which 
brings  about  a  secondary  movement  of  reaction. 

The  whole  homoeopathic  school  has  been  so  deeply 
imbued  with  this  principle  that  but  a  small  number  of 
minds  has  escaped  being  influenced  by  it ;  few  of  us  have 
not  heard  it  said  when  an  aggravation  occurred :  so  much 
the  better^  that  is  a  sign  that  the  medicine  is  acting,  a  sign 
of  the  cure  which  is  about  to  take  place. 

Only  a  few  practitioners  have  denied  the  occurrence  of 
aggravations ;  some  have  asserted  that  they  are  less  nume- 
rous than  Hahnemann  alleged  them  to  be ;  but  no  one  has 
really  attacked,  with  a  view  to  substitute  another  for  it, 
the  theory  of  the  cure  based  upon  aggravations. 

Now,  as  long  as  a  more  correct  doctrine,  one  that  will 
explain  the  facts  more  accurately,  shall  not  have  been  sub- 
stituted for  this  theory,  our  scientific  situation  will  remain 
unaltered.  I  am  aware  that  many  dislike  theories,  but  the 
nature  of  things  is  opposed  to  this  sentiment,  and  we  must 
perforce  adopt  one  or  another ;  theories  cannot  be  dispensed 
with  in  matters  of  sciencej  we  cannot  get  on  without  them. 
Facts  are  only  facts ;  it  is  the  mode  in  which  we  view  them 
that  fixes,  frames,  arranges  them,  and  makes  them  scientific. 
Accordingly,  those  who  make  it  a  rule  to  have  nothing  to 
do  with  theories,  adopt  them  in  spite  of  themselves ;  if  they 
do  not,  they  remain  strangers  to  the  sure  progress  that 
theories  promote ;  empiricism  itself  cannot  escape  the  law. 


100  Fridatdi  on  the  Action  of  Drugs. 

I  afiSrin^theD^that  the  adage  that  says  thnt  good  may  accrue 
from  evil  ia  true  in  a  relative  and  restricted  sense ;  bat  it 
is  a  departure  from  truth  to  endeavour  to  elevate  it  into  a 
strict  and  absolute  principle  in  the  domain  of  therapeutics. 

Hahnemann  was  dassled  by  the  homosopathic  idea  he 
found  in  his  precursor,  John  Hunter,  under  the  seductive 
form  which  compared  the  action  of  a  drug  to  that  of  a 
disease  which  cures  another.  In  grasping  this  idea  of  a 
drug-disease  he  conceived  it  as  a  morbid  action  added  to 
that  already  present  in  order  to  cure  it,  in  accordance  with 
the  saw  that  an  excess  of  evil  produces  a  return  to  good. 

Still,  without  the  intoxicating  and  blinding  enthusiasm, 
which  I  cannot  help  attributing  to  him,  he  would  have  seen 
that  the  comparison  on  which  he  based  his  doctrine  was 
erroneous.  For  Hunter,  who  showed  him  so  conclusively 
that  a  disease  attacking  a  point  of  the  organism  cures  a 
disease  preriously  there,  neither  observed  nor  said  that  the 
cure  was  effected  as  a  consequence  of  a  preliminary  aggrava- 
tion. In  the  numerous  cases  confirmatory  of  Hunter's 
remark  he  cites,  Hahnemann  does  not  show  that  a  disease, 
by  establishing  itself  in  the  place  and  seat  of  a  prerious  one, 
and  thereby  curing  it,  commences  by  aggravating  it. 

Had  it  not  been  for  the  intoxication  caused  by  the  idea 
found  in  Hunter,  Hahnemann  would  have  certainly  under- 
stood the  subtle  thought  of  the  English  surgeon,  unless  he 
had  expressly  wished  to  dissent  from  him.  After  his 
remark  on  the  action  of  drugs,  which  he  believes  to  be  cura- 
tive in  the  same  way  as  one  disease  which  suppresses 
another,  J.  Hunter  adds,  with  much  acuteness  and  intelli- 
gence, that  it  is  doubtless  in  virtue  of  the  principle  that  the 
same  instrument  cannot  perform  two  different  actions  at  the 
same  time.  How  different  is  the  thought  in  the  two  men  I 
For  Hahnemann,  the  drug  produces  a  medicinal  disease 
that  aggravates  the  pre-existing  disease,  and  this  aggravation 
excites  a  secondary  reaction  that  brings  about  the  cure. 
For  Hunter,  the  medicinal  action  occupies  the  organic 
activity,  and  consequently  distracts  it,  diverts  it  from  the 
morbid  action  it  was  engaged  in,  in  order  to  allow  it  to 
return  b^  itself  naturally  to  its  normal  function. 


Fr6dault  on  the  Action  of  Drugs,  101 

The  two  points  of  view  are  quite  different^  and  we  can 
foresee  what  differences  they  may  produce  on  the  idea 
enteitained  respecting  medicinal  actions^  and  on  the  mode 
of  conducting  medical  treatment.  But  it  remains  to  be  seen 
which  will  be  proved  to  be  in  the  right  by  the  facts,  and 
which  has  given  the  most  satisfactory  theoretical  reason — 
Hahnemann,  who  founded  practical  homoeopathy,  or  Hunter, 
his  predecessor  and  precursor,  who  formulated  the  first 
thought. 

All  Hahnemann's  theory  is  based  on  the  necessity  of 
primary  aggravations  and  secondary  effects;  consequently 
these  are  the  two  points  we  have  to  examine  in  order  to 
form  an  exact  judgment  as  to  the  value  of  the  synthesis  that 
co-ordinates  them. 


II. 


Let  us  first  consider  aggravations. 

In  Hunter's  theory  it  may  be  said  that  they  are  of  little 
importance,  or  may  even  be  injurious;  for,  provided  the 
medicinal  action  engrosses  the  vital  activity,  and  makes  it 
forget  its  morbid  movement,  in  order  to  allow  it  thence- 
forward to  resume  naturally  its  normal  functions,  that  is 
its  principal  office ;  unless,  by  accentuating  the  morbid 
action,  it  happens  to  leave  it  still  in  full  vigour  after  having 
exhausted  its  own  action,  which  could  only  be  explained  by 
a  fixation  of  the  activity  in  its  vicious  habit. 

But  in  Hahnemann's  theory  the  question  is  quite 
otherwise.  Here,  the  aggravation  is  necessary  in  order  to 
obtain  the  effect  of  the  secondary  reaction ;  and  necessary 
to  this  extent,  that  if  the  author  failed  to  observe  it  he 
must  nevertheless  believe  that  it  occurred,  and  even  desire 
its  occurrence,  all' the  while  dreading  it,  for  it  calls  into  play 
the  secondary  effect,  which  must  not  be  too  weak,  for  then  it 
would  be  insufficient,  nor  yet  too  strong,  for  the  secondary 
effect  might  become  morbid,  as  it  sometimes  may  be.  The 
whole  mind  of  the  Uerman  physician  must  be  directed  to 
watch  for  aggravations,  perhaps  to  make  them  a  bogey,  so 
great    a    part    does   imagination   play  in  everything,  and 


102  Fridauli  on  the  Action  of  Drugs. 

thence  he  was  inevitably  led,  even  should  he  have  ffuled 
to  obserre  them^  to  anspect  their  presence  and  to  guard 
against  their  excess  by  diminishing  the  doses  of  the 
medicines.  All  these  things  are  fatally  linked  together. 
From  the  very  fact  of  their  obsenration,  aggravations  are 
for  Hahnemann  of  frequent  occurrence^  especially  from 
large  doses.  According  to  the  theory  they  ought  to  occur 
constantly. 

Tet  in  the  domain  of  observation  various  opinions  are  held 
by  his  disciples,  in  spite  of  the  theory.  Some  practitioners, 
it  is  true,  have  maintained  the  perfect  accuracy  of  his 
doctrines,  whilst  others  have  declared  that  aggravations 
are  less  frequent  than  he  has  alleged ;  and  others  have  even 
declared  that  they  do  not  occur  from  large  doses  short  of 
poisonous  ones. 

I  share  the  opinion  of  many  of  my  colleagues,  that  this 
last  opinion  is  going  rather  too  far,  but  I  nevertheless 
believe  that  the  opposite  opinion  is  also  an  extreme  one. 
There  are  very  few  physicians  who  swear  by  all  that 
Hahnemann  has  said,  as  though  it  were  gospel  truth ;  but 
even  among  this  small  group  of  firm  Hahnemannists  I 
doubt  if  there  be  a  single  physician  who  would  venture  to 
maintain  that  there  could  not  be  a  cure  without  aggravation  I 

There  is  reason  to  believe  that  the  majority  of  homceo* 
pathic  practitioners  have  been  taught  by  experience  to 
entertain  an  opinion  between  these  two  extremes,  believing 
aggravations  to  be  possible^  but  not  necessary,  and  relatively 
rare ;  and  this  is  in  agreement  with  the  facts  though  not 
with  the  theory. 

This  intermediate  opinion  is  a  formal  condemnation  of 
the  theory,  and  even  should  it  oscillate  betwixt  the  more 
and  the  less,  what  does  that  signify?  It  will  remain 
established  that  the  aggravation  is  not  necessary,  that  the 
cure  may  be  effected  in  the  majority  of  cases  without  it, 
and  consequently  by  another  process;  and  hence  the 
Hunterian  theory  assumes  all  the  value  which  in  my  opinion 
it  ought  to  have. 

The  fact  is  that  if  the  aggravations  are  not  a  general  law 
they  are  only  an  exceptional  law,  for  in  all  things  there  are 


Fridault  on  the  Action  of  Dru^s.  108 

only  these  two  kinds  of  laws :  general  laws^  and  exceptional 
laws.  The  theory  of  aggravations  is  relegated  to  the 
category  of  the  adage  whence  it  came :  pood  may  arise  out 
ofevil^  bnt  only  exceptionally^  as  the  wisdom  of  nations  would 
add. 

But  in  order  to  come  to  this  conclnsion  it  is  necessary 
to  understand  what  aggravations  are,  distinguishing  them 
as  exactly  as  possible  according  to  the  manner  in  which 
they  present  themselves,  which  those  who  have  written  upon 
the  subject  have  omitted  to  do. 

The  first  kind  of  aggravations  to  be  considered  are  what 
may  be  called  general  aggravations,  (hose  which  embrace  the 
whole  disease.  I  know  not  if  there  be  any  such  ;  for  my 
own  part  I  have  never  seen  them, — for  example,  a  pneu- 
monia aggravated  in  its  collective  phenomena,  or  an  eruptive 
fever,  or  a  typhoid  fever.  Nor  have  I  seen  a  pernicious 
fever  aggravated  by  Quinine,  and  yet  I  am  never  sparing  of 
its  employment,  and  I  think  that  in  such  cases  it  should 
not  be  given  sparingly.  I  can  quite  understand  how  it  is 
that  some  physicians  deny  absolutely  the  occurrence  of 
this  sort  of  aggravation,  but  there  are  often  aggravations 
that  cannot  be  denied. 

Thus  partial  aggravations  are  possible :  the  dyspnoea  of 
asthma  increased  or  excited  by  a  medicine  such  as  Arsenic, 
Coffea,  Ipecacuanha,  or  Moschus ;  so  also  Sulphur  fumes,  or 
the  exhalation  from  roasted  coffee,  have  been  observed  to 
bring  on  an  attack  ;  the  fits  of  coughing  in  a  bronchitis,  or 
even  in  a  pneumonia  or  a  hooping-cough,  are  sometimes 
increased  under  the  influence  of  a  medicine ;  rheumatic  pains 
are  sometimes  aggravated  by  Sulphur,  Arsenic,  or  some  other 
drug ;  an  eczema  will  occasionally  become  redder  and  more 
itching  under  the  action  of  Petroleum,  Sulphur  or  Arsenic ; 
a  dysuria  will  sometimes  become  more  marked  and  painful 
by  Colchicum  or  Cantharis.  I  have  never  seen  Belladonna 
increase  the  swelling  and  redness  of  sore  throat,  but  others 
say  they  have.  Again,  medicines  given  for  diarrhoea  or 
constipation  may  increase  these  states.  In  those  cases^ 
and  in  all  cases  of  that  kind,  there  is  no  real  aggravation  of 
the  disease  in  its  totality,  but  an  aggravation  of  some  local 


104  FridauU  on  the  Action  of  Drugs. 

pbenomenon  or  affectioo.  This  is  the  most  namerons 
group. 

I  believe  that  in  many  cases  sufficient  allowauoe  has  not 
been  made  for  the  actual  course  of  the  morbid  movement, 
and  that  many  of  these  aggravations  may  be  merely  the 
natural  course  of  the  disease.  We  may  also  say  that  in 
other  cases  the  disease  has  naturally  recrudescences  of 
violence,  even  after  a  medicine  has  been  taken  which  has 
temporarily  alleviated  it,  and  these  recrudescences  are 
ascribed  to  the  medicine  the  patient  is  taking  at  the  time. 
Still,  admitting  all  this,  there  yet  remains  a  certain  number 
of  undeniable  aggravations,  which  cease  when  the  medicine 
is  left  off  and  return  when  it  is  again  given. 

Their  number  is  doubtless  not  so  large  as  has  been 
stated,  and  they  are  exceptional  cases,  still  we  must  take 
them  into  account. 

In  the  third  place  there  are  relative  aggravations.  Thus, 
it  may  happen  that  on  discontinuing  the  medicine  and 
leaving  the  patient  alone,  the  disease  may  immediately 
commence  getting  better,  which  it  seemed  to  be  prevented 
doing  by  the  continuous  administration  of  the  remedy.  I 
remember  a  medical  student  who  had  mucous  patches  in 
his  mouth  and  throat,  and  who  had  been  taking  the  liquor 
of  Van  Swieten  for  a  fortnight  without  the  slightest  sign 
of  amelioration  ;  for  the  last  eight  days,  indeed,  the  treatment 
seemed  to  have  no  effect  whatever.  He  wished  to  increase 
the  dose,  but  instead  of  doing  so  I  made  him  leave  off  the 
smaU  teaspoonful  of  Van  Swieten  he  took  every  morning, 
and  in  the  course  of  two  or  three  days  amendment  was 
obvious  and  the  cure  was  accomplished  without  any  more 
medicine.  It  cannot  be  said  that  here  there  was  a  real 
aggravation,  but  there  was  a  period  of  cessation  of  amelio- 
ration, and  we  cannot  contend  that  this  period  of  cessatioa 
was  absolutely  necessary  for  the  cure.  Many  other  ana- 
logous examples  might  be  cited. 

In  the  fourth  place  there  are  the  accessory  aggravations 
consisting  of  the  pathogenetic  phenomena  of  the  medicines 
occurring  alongside  of  the  phenomena  of  the  disease.  For 
example,  the  arsenical  eruption  in  a  patient  who  is  taking 


Fredault  on  the  Action  of  Dtiigs.  105 

this  medicine  for  paralysis^  or  an  iodic  eraption  in  a  person 
taking  Iodine  for  something  quite  different.  These  aggra- 
vations, though  not  frequent,  are  occasionally  met  with,  and 
they  have  served  to  enrich  our  pathogeneses ;  but  besides 
being  exceptional^  they  give  no  support  to  the  theory  of 
aggravations.  They  are  a  side  action  which  may  do  harm 
to  the  patient  by  adding  to  his  sufferings,  or  they  may 
have  a  derivative  effect^  but  have  no  bearing  on  the  law  of 
similars. 

In  shorty  we  need  only  consider  the  partial  aggrava- 
tions, those  of  the  second  kind  of  which  I  have  just  spoken. 
Sut  it  must  always  be  remembered  that  even  these  are  of 
rare  occurrence,  and  that  on  that  account  they  cannot  justify 
the  deduction  of  a  general  therapeutic  law  from  them. 

It  cannot  be  denied  that  they  are  sometimes  useful,  and 
facts  may  be  cited,  as  I  will  show  hereafter,  where  they 
have  at  least  not  been  injurious.  Still  they  may  occasionally 
prove  dangerous;  Hahnemann  was  well  aware  of  this 
because  he  diminished  his  doses  in  order  to  avoid  them, 
but  was  not  always  successful  in  doing  so.  For  my  own 
part,  if  I  have  sometimes  observed  them  to  be  the  sign  of 
a  beneficial  reaction,  in  other  cases,  on  the  contrary,  and 
these  were  the  more  numerous,  I  have  found  them  to  be 
hurtful ;  so  that  I  have  been  led  to  think  that  with  some 
rare  exceptions  of  a  possible  ulterior  tolerance,  when  a 
medicine  causes  an  aggravation  some  other  medicine  may  be 
advantageously  substituted  for  it. 

To  conclude,  aggravations  are  rare;  and  only  some  of 
them  can  be  used  in  support  of  the  theory  ;  and  of  these 
only  a  few  can  be  useful,  whilst  many  of  them  are  hurtful. 
Hence  it  is  impossible  to  establish  a  general  therapeutic 
law  upon  these,  as  has  been  attempted,  by  saying  that  the 
medicine  produces  a  medicinal  disease,  which  by  being  super- 
added to  the  pre-existing  disease,  brings  about  a  curative 
reaction. 

III. 
We  shall  now  proceed  to  consider  the  secondary  effects. 


106  FridauU  on  the  Aetiofi  of  Drugi. 

the  second  point  of  the  theory;  the  reaetire  effects  that 
should  produce.the  cure. 

Hahnemann  asserted  Ami  medicines  produce  on  the 
health/  two  kinds  cf  eonseeotiye  eflfects :  first,  primary 
paHtogeBOtie  effsets ;  then  effects  the  opposite  to  the  first, 
which  he  calls  secondary.  For  example,  an  agent  causes 
a  diarrhosa  or  a  diuresis  aa  its  primary  effect,  then  consti- 
pation or  anuria  as  its  secondary  effect. 

Explaining  these  two  effects  on  the  sick,  he  said  that 
the  primary  effect  is  a  slight  aggravation,  and  the  secondary 
effect  a  curative  reaction ;  but  if  the  medicine  be  given  in 
too  large  a  dose,  the  primary  effect  is  a  dangerous  aggrava- 
tion, the  secondary  effect  a  morbid  reaction,  as  when  we 
give  too  strong  a  purgative  for  a  diarrhoea,  we  may  get  a 
more  severe  and  dangerous  diarrhoea,  or  a  secondary  and 
obstinate  constipation. 

The  ofaaervation  is  ^te  eorreet  and  nndcniable  in  regard 
to  certun  cases ;  but  I  propose  to  inquire  if  it  is  really  a 
medicinal  effect,  and  if  the  rule  as  laid  down  by  Hahnemann 
is  a  general  rule. 

It  has  been  objected  to  the  Hahnemannian  formula 
that,  by  the  interpretation  given  of  it,  the  curative  action 
is  antipathic,  since  this  action  is  produced  by  the  secondary 
effect  which  is  the  opposite  of  the  primary  effect,  correspond- 
ing to  the  morbid  phenomenon.  This  hostile  criticism  would 
be  justified  if  the  formula  of  Hke  cures  like  were  given  as  a 
metaphysical  doctrine ;  but  1  imagine  that  it  was  only  at 
a  much  later  period  that  Hahnemann  made  any  pretensions 
to  metaphysics,  in  which  he  was,  it  must  be  confessed, 
absolutely  deficient.  When  he  first  grasped  what  he  found  in 
Hunter,  he  only  saw  a  principle  of  indication  in  the  law 
of  similars ;  and  in  fact,  this  law  is  nothing  more  than 
that.  I  leave  this  unimportant  side  of  the  question  in 
order  to  consider  the  serious  arguments. 

In  the  first  place  I  observe  that  the  rule  of  secondary 
effects  is  general  for  all  the  morbid  phenomena  called 
in  general  pathology  *^  augmentations  or  diminutions  of 
the  functions/'  but  that  not  on  account  of  the  medicine^ 
but  rather   in    virtue  of   a  normal  law  regulating  these 


Fridatdi  on  IJte  Action  of  Drugs.  107 

phenoiDdnm  in  the  pathological  as  irril  as  the  physiological 
state.  In  all  these  cases,  it  sufSces  tliat  m  Auction  shall 
have  been  augmented  in  order  that  it  shall  afterwanh  riiow 
a  diminution ;  or  that  it  shall  have  been  diminished  in 
order  to  be  subsequently  augmented.  This  is  not  owing 
to  a  particular  and  determined  agent,  but  is  the  result  of  a 
physiological  law  of  compensation  and  equilibrium.  On 
each  occasion  when  the  activity  occurs  and  is  concentrated 
on  a  point,  it  is  afterwards  transferred  to  an  opposite  point 
in  order  to  effect  a  complementary  and  compensating  action  ; 
and  when  the  two  opposite  effects  can  be  produced  on  the 
same  point,  as  when  a  function  can  be  augnented  or 
diminished  from  the  moment  when  an  excess  oecurs  in 
one  sense^  another  is  afterwards  produced  in  an  opposite 
sense. 

Thus  it  is  impossible  to  augment  an  act  of  secretion 
by  any  means  whatsoeyer,  without  finding  the  contrary 
effect  succeeding  it  more  or  less  quickly.  After  saliyation, 
a  deficiency  of  saliva^  and  vice  ver$d ;  after  perspiration, 
dryness  of  the  skin,  and  after  dryness,  perspiration ;  after 
constipation,  diarrhoea,  and  after  diarrhoea,  constipation; 
after  anuria,  polyuria. 

And  so  also  with  regard  to  many  phenomena  which  are 
not  secretions:  after  the  acceleration  of  the  circulation, 
its  retardation,  and  the  contrary  effect,  which  we  observe 
so  often  in  the  case  of  nervous  persons ;  after  excitement, 
depression^  and  after  depression,  excitement ;  after  coldj 
beat,  as  after  heat,  cold  j  and  so  on. 

In  one  word^  as  regards  every  function  which  by  augmen- 
tation and  diminution  can  furnish  opposite  phenomena  in 
either  the  physiological  or  the  pathological  state,  it  suffices 
that  the  phenomenon  shall  be  produced  first  in  one  sense  in 
order  that  its  opposite  shall  afterwards  manifest  itself. 

It  is  therefore  perfectly  useless  to  invent  secondary 
effects  of  medicines  in  order  to  explain  a  double  phenomenon 
which  is  regulated  by  organic  laws  in  both  the  physiological 
and  the  pathological  state. 

But  this  fact  of  opposite  phenomena  is  only  produced  in 
cases  where  the  functions  can  be  augmented  or  diminished. 


log  FridauU  on  the  Action  of  Drug$. 


dologically  or  pathologically ;  it  does  not  show  itself  in 
cases  where  general  pathology  declares  that  there  is  a 
pervenum  of  yital  action ;  for  since  in  perrersion  there  is  no 
augmentation  or  diminution  of  functions^  neither  are  there 
compensating  opposite  phenomena. 

Thus  pain  has  no  opposite  phenomenon.     We  may,  it  is 
true,  say  that  hyperssthesia  follows  anaesthesia,  and  vice 
vend,  since  there  is  here  opposition  by  augmentation  in 
diminution  of  sensibility.     But  we  cannot  point  to  a  morbid 
phenomenon  the  opposite  of  pain^  which  is  a  perversion  of 
sensibility;  we  cannot  eren  comprehend  that  there  can  be  any 
such,  for  pleasure  is  the  opposite  of  pain,  and  no  one  has  ever 
seen  a  medicine  produce  first  pain  and  afterwards  pleasure, 
or  vice  vered.     In  like  manner  we  cannot  comprehend  and 
do  not   know  any  phenomena    the  opposite  of  catarrhs, 
inflammations,  gangrenes,  eruptions,  ulcerations.    Vomiting 
has  physiologically  no  opposite  phenomenon,  and  has  no 
secondary  pathogenetic  effect.     The  same  is  the  case  with 
sneesing,  cough,  spasms,  contractions.     Hemorrhages  also 
have    no  opposite  efl'ects,  unless  they  are  functional  and 
therefore  susceptible  of  a  more  and  a  less,  like  the  catamenial 
hsemorrhage,  which   may  be  augmented  or  diminished,  ac- 
celerated or  retarded,  and   which,  under  the  influence  of 
some  medicines,  may  like  any  other  action  present  succes- 
sively inverse  phenomena.  But  as  regards  other  hemorrhages 
which   are  a  perversion  of  action,  as   well  as  accidentally 
produced  hemorrhages  which  are  of  the  same  character,  and 
a  large  number  of  other  morbid  phenomena,  there  can  be 
for  them  no  opposite  secondary  phenomena,  because  there 
are  none  such  in  nature. 

We  may  therefore  conclude  that  there  are  a  great  number 
of  morbid  phenomena,  perhaps  more  than  half  of  those  that 
fall  under  our  observation,  which  have  not,  and  cannot  hare, 
opposite  morbid  phenomena,  and  for  which  there  cannot  be, 
nor  can  there  be  imagined,  secondary  pathogenetic  effects. 

This  is  as  much  as  to  say  that,  putting  the  most  favourable 
construction  on  the  facts,  Hahnemann's  curative  theory  is 
based  on  but  one  half  of  the  facts,  or  even  less ;  and  tbaA 
these  facts  referred  to  in  order  to  establish  his  views  of  the 


FrSdault  on  the  Action  of  Drugs.  109 

action  of  medicines  are  bat  the  result  of  a  physiological 
law.  But  there  is  even  more  than  this^  for  the  facts,  even 
those  in  favonr  of  his  yiew  express  just  the  contrary  of  that 
which  they  are  thought  to  imply* 

For  it  is  the  case  that  the  secondary  phenomenon  is  not 
a  curative  phenomenon  at  all,  but  when  it  does  occur  it  is 
io  truth  a  morbid  phenomenon.  If  a  patient  be  affected 
with  constipation,  and  the  secondary  effect  be  diarrhoea,  he 
passes  from  one  disease  into  another ;  he  is  not  on  that 
account  cured  of  his  first  disease ;  and  it  may  well  happen 
that  he  again  reverts  to  the  first  after  having  left  the 
second,  as  is  occasionally  seen.  The  phenomenon  produced 
is  morbid  :  you  cannot  believe  that  it  can  be  curative  except 
on  condition  of  being  transitory,  and  thus  you  will  not  know 
with  certainty  whether  the  cure  is  effected  by  it  or  by  the 
first;  you  must  confine  yourself  to  saying  simply  that  the 
medicine  cures  because  it  calls  on  the  vital  activity  to  take 
on  a  medicinal  action  which  diverts  it  from  its  morbid 
action.  Hahnemann's  explanation  therefore  is  incorrect,  it 
is  altogether  illusory. 

On  the  other  hand.  Hunter's  explanation,  as  I  have  given 
it  above,  is  precisely  that  to  which  you  must  come  if  the 
subject  is  presented  to  you  as  I  have  stated  it,  and  it  has 
the  double  merit  of  accounting  exactly  for  the  facts  and  of 
going  straight  to  the  point ;  let  alone  the  not  unimportant 
merit  of  making  the  practical  physician  see  more  clearly, 
and  not  troubling  him  incessantly  with  the  double  pre- 
occupation of  aggravations  and  secondary  effects,  the  former 
rarer  than  the  theory  supposes  them  to  be,  the  latter  also 
rarer  and  requiring  to  be  searched  for  and  expected,  when 
they  either  do  not  exist  or  even  when  they  exist  being 
incapable  of  producing  what  we  wish. 

The  formula  of  the  indication  is  the  same  in  both  theories, 
hut  is  more  simple  in  the  one  than  in  the  other.  The  one 
embarrasses  us  with  secondary  effects  which  do  not  even 
give  any  explanation  of  the  cure,  and  which  we  search  for 
in  vain  in  the  majority  of  cases ;  whilst  the  other  simply 
shows  us  that  the  medicine  cures  the  phenomena  similar  to 
those  it  produces  by  occupying  the  vital  activity,  in  order 


110  FridauU  m  iht  Actum  of  Drugs. 

mftenrards  to  leare  it  to  itself  to  resume  its  normal  coarse. 
And  by  its  meens  we  understand  better  how  it  is  that  it  is 
necessary  sometimes  to  go  on  giving  the  medicine  in  order 
to  keep  the  vital  activity  occupied  a  sufficient  length  of  time 
before  we  leave  it  to  itself ;  how  we  must  resort  to  its 
administration  again  and  again  in  order  to  preyent  the  vital 
activity  relapsing  into  its  bad  morbid  habit ;  how,  on  the 
other  hand,  in  some  cases,  it  is  sufficient  to  touch  it, 
however  lightly,  according  to  its  dispositions,  in  order  to 
enable  it  to  return  almost  immediately  iuto  its  normal 
ways. 

IV. 

These  explanations  are  of  great  consequence  in  their 
hearing  on  the  question  of  the  dose. 

There  are  frequent  discussions  on  the  questions  as  to 
whether  large  doses  are  preferable  to  small  ones,  and 
whether  the  action  of  the  medicine  varies  acoording  to  the 
dose.  These  questions  may,  no  doubt,  be  solved  directly 
by  experience ;  but  the  testimony  of  experience  cannot  be 
impaired  by  supplementing  it  by  a  theory  that  illuminates 
it,  whereas  a  clear  riew  of  its  results  may  be  injured  by  a 
theory  that  obscures  it.  In  this  respect,  it  cannot  be 
denied  that  the  theory  of  aggravations  and  secondary  effects 
is  an  obstacle  to  a  correct  appreciation  of  the  fiu^ts,  because 
one  of  its  necessary  deductions  is  that  the  action  of  small 
doses  is  the  direct  opposite  to  that  of  large  doses. 

For  were  it  true  that  large  doses  produce  a  primary 
effect,  followed  by  a  secondary  effect  contrary  to  the 
primary  one,  whilst  small  doses  cure  by  the  secondary  effiset 
without  the  primary  one,  it  must  follow  that  every  medidae 
produces,  in  a  small  dose,  an  effect  contrary  to  that  it 
causes  in  a  large  dose. 

There  is  in  this  a  strange  confusion,  seeing  that  a  eusa- 
tive  effect  is  compared  with  a  toxeial  effect.  The  patlu>- 
genetic  or  toxical  large  dose  produces  a  morbid  phenomenon  ; 
does  the  small  dose  also  produce  a  morbid  phenomenon^  as 
the  theory  would  imply  ?  Certainly  not ;  there  is  no  dear^ 
weU*de6nedj  authentic  instance  of  a  medicine  producing,  in 


Fridault  on  the  AeHon  of  Drugs.  Ill 

a  healthy  person,  two  eontrarj  effects,  in  large  and  in  small 
doses.  The  truth  merely  is  that  in  the  large  toxical  dose 
the  medicine  prodaces  toxical  or  pathogenetic  phenomena; 
and  that  in  the  weak  curative  dose  it  causes  effects  analo- 
gous to  those  which  it  produces  in  the  toxical  dose. 

The  eurative  effect  is  not  a  morbid  action,  it  cannot  be 
said  to  be  the  opposite  of  the  toxical  effect.  This  oppo- 
sition which  it  is  endeavoured  to  establish  could  only  be 
admitted  if  we  produced  by  a  small  dose  a  morbid  pheno* 
menon  the  contrary  of  the  primitive  phenomenon,  and  in 
that  case  our  patient  would  not  be  cured.  If  you  give  a 
constipation  to  a  patient  who  has  a  diarrhoea  you  do  not 
cure  him,  you  merely  substitute  one  disease  for  another, 
and  the  chances  are  a  hundred  to  one  that  if  the  constipa- 
tion ceases  the  diarrhcea  will  return.  This  is  not  a  cure ; 
a  cure  is  to  cause  a  patient  who  has  a  diarrhcea  or  a  con- 
stipation to  have  neither  the  one  nor  the  other,  but  to 
revert  to  the  normal  state.  Therefore,  the  cure  does  not 
consist  in  producing  a  morbid  state  the  opposite  of  that 
present,  but  in  re-establishing  the  normal  state,  and  when 
the  medicine  cures  it  is  not  because  it  develops  a  morbid 
phenomenon  the  opposite  of  that  which  is  produced,  but 
because  it  diverts  the  vital  activity  from  its  morbid  pheno- 
menon in  order  to  restore  it  to  its  normal  ways.  Hahne- 
mann's theory  is  here  radically  false;  Hunter's  is  much 
truer. 

The  theory  first  set  out  with  the  idea  that  one  thing  was 
obligatory,  vis*  the  aggravation  indispensable  for  the  pro- 
duction of  the  primary  phenomena  necessary  for  obtaining 
the  secondary  phenomena.  Afterwards,  seeing  that  the 
core  could  be  effected  without  aggravation,  it  invented  the 
idea  that  small  doses  produced  the  secondary  effect  without 
previous  primary  phenomena,  and  hence  that  the  small 
dose  has  an  action  the  direct  contrary  to  that  of  large 
doses.  But  this  is  evidently  an  erroneous  notion,  it  is 
purely  imaginary  to  suppose  that  the  curative  action  is  a 
secondary  phenomenon. 

How  can  this  be  accepted  when  it  is  proved  that  the 
eeoondary  effect  is  a  morbid  effect,  consequently  not  cura- 


112  Fridault  on  the  Action  of  Drufff. 

tive^  and  that  this  effect  does  not  exist  in  at  least  one  half 
of  the  cases?  When  a  morbid  phenomenon  has  no  possible 
contradictory  effect  in  nature^  as  we  have  seen,  and  when, 
therefore,  the  medicine  cannot  produce  any  such,  how  can 
we  allow  that  the  medicine  cures  by  producing  such  an  im- 
possible effect  ?     The  thing  is  absurd. 

We  should  obsenre  that  according  to  this  theory  medi- 
cines ought  never  to  cure  except  when  given  in  a  dose 
incapable  of  producing  any  pathc^enetic  effect,  since  it  is 
only  in  such  a  dose  that  they  could  produce  the  secondary 
without  the  primary  effect.  But  what  must  this  dose  be, 
when  it  is  shown  by  too  many  facts  to  admit  a  doubt  on 
the  subject,  that  in  every  dose,  even  iu  infinitesimal  doses, 
medicines  may  produce  their  pathogenetic  effects  alongside 
the  disease,  or  partial  aggravations  of  the  disease  ? 

It  would  at  least  be  requisite  that  the  medicine  should 
be  unable  to  cure  except  in  a  very  weak  dose,  as  far 
removed  as  possible  from  a  toxical  dose.  Then  how  does 
it  happen  that  so  many  cures  have  been  effected  by  massive 
doses  ?  How  is  it  that  in  England,  America,  and  even  in 
Germany,  the  general  tendency  of  homoeopathic  practi- 
tioners is  to  give  massive  doses,  or  first  decimal  attenua- 
tions f  Let  us  suppose  that  only  one  half  uses  by 
preference  strong  doses,  must  we  assume  that  this  large 
number  of  practitioners  amuse  themselves,  by  deceiving  their 
patients^  by  deceiving  themselves  in  order  to  deceive  their 
colleagues  ? 

Finally,  were  this  theory  true  we  ought  to  have  an  astonish- 
ing scale  of  contradictory  effects  according  to  the  doses  given ; 
from  a  non-toxical  dose  effects  contrary  to  toxical  effects; 
then  from  the  first  dilutions  there  is  another  contrary 
resembling  the  primary  effects ;  then  from  the  sixth  to  the 
twelfth,  from  the  twelfth  to  the  thirtieth,  and  so  on 
indefinitely,  a  succession  of  contradictions,  which,  to  sum 
up,  would  be  nothing  but  a  succession  of  morbid  phenomena 
that  would  never  result  in  a  cure. 

All  this  is  pure  romance.  In  reality  medicines  have 
only  two  possible  effects,  a  toxical  or  pathogenetic  effect 
and  a  curative  effect,  which  is  physiological.     As  to  alter- 


Fr6dault  on  the  Action  of  Drugs.  113 

nating  phenomena,  they  are  the  expression  of  the  physio- 
logical law  stated  above.  Practitioners  of  the  old  school 
have  fallen  into  the  same  confusion  that  Hahnemann  has 
led  us  into,  because  they  have  followed  our  lead,  of  course 
without  saying  so.  Their  want  of  loyalty  has  been  of  uo 
service  to  them  because  they  have  not  even  the  merit  of 
having  corrected  us.  Like  us  they  have  set  themselves  to 
look  for  primary  and  secondary  effects,  and  to  imagine  that 
the  curative  effect  depending  on  a  small  dose  is  the  secon- 
dary effect  of  a  large  dose  producing  primary  effects ;  and 
as  in  the  days  when  they  disputed  whether  Opium  was  sthenic 
or  asthenic,  we  now  see  them  expressing  the  same  doubt 
with  regard  to  Digitalis.  We  have  deceived  them  so  well 
while  deceiving  ourselves  that  they  also  fancy  they  see  a 
toxical  effect  and  a  physiological  effect  contrary  to  the 
former,  according  to  the  doses  given ;  because,  in  fact,  as 
the  secondary  action  of  mediciues  when  it  exists  is  the 
opposite  of  the  primary  effect,  agreeably  to  the  physiological 
law,  they  suppose  that  the  curative  effect  is  the  product  of 
the  secondary  action.  Hence  arises  an  insurmountable 
difficulty  to  know  what  is  toxical  and  what  is  physiological, 
as  we  see  in  what  has  been  writted  respecting  Digitalis. 
And  here  it  is  that  they  believe  they  see  the  normal  physio- 
logical action  in  the  morbid  phenomena  produced  by  the 
medicine.  Just  as  in  homoeopathy  it  is  believed  that  there 
may  be  pathogenetic  phenomena  which  are  not  toxical, 
whilst  it  is  not  perceived  that  since  these  phenomena  are 
a  derangement,  this  is  because  they  are  not  a  tiormal 
physiological  act.  On  all  sides  we  encounter  contradictions, 
from  which  there  is  no  escape,  because  there  is  a  perpetual 
confounding  of  the  toxical  with  the  physiological,  and 
because  it  is  soiight  to  oppose  the  weak  physiological  curative 
dose  to  the  large  toxical  dose. 

The  weak  dose  has  no  contrary  action,  but  only  a  simply 
physicdogical  action,  which  does  not  betray  its  existence 
externally  in  the  healthy  subject ;  it  cures  the  patient  by  a 
simple  physiological  process,  as  I  will  show  presently ;  for, 
I  repeat,  let  it  be  borne  in  mind  the  cure  is  not  a  particular 
and  perceptible  morbid  act,  it  is  an  imperceptible  return  to 

VOL.  XXXVIII,  NO.  CLII. — APRIL,   1880.  H 


114  Fridault  on  the  Actum  of  Drugs. 

the  physiological  state.  The  medicine^  the  agents  has  not 
and  cannot  have  more  than  two  actions :  the  one  toxical, 
which  deranges  the  ?ital  activity  and  betrays  itself  by 
morbid  phenomena;  the  other  physiological,  which  conse- 
quently can  only  produce  physiological  phenomena,  not 
morbid  effects,  and  which  only  cures  by  reason  of  its 
occupying  physiologically  the  vital  activity.  It  is  actually 
contended  that  these  two  actions  are  opposed  to  one  another 
like  two  movements  in  contrary  directions :  this  is  an  error ; 
they  are  only  two  different  movements,  opposed,  in  the 
sense  that  they  replace  one  another,  but  not  in  the  sense  of 
a  conflict  or  a  reaction ;  the  one  is  toxical,  the  other  physio- 
logical.  It  is  because  we  have  got  into  our  heads  the  idea 
of  a  conflict  of  the  life  against  the  disease  that  we  continue 
in  the  error  naturally  resulting  from  this  idea. 

The  study  of  the  intimate  action  of  the  medicine  will 
show  us  how  the  physiological  action  differs  from  the 
toxical  action^thout  being  contrary  to  it. 

V. 

Now,  the  ground  being  cleared  of  false  theories,  we 
should  inquire  if  the  action  of  a  medicine  can  vary  accord- 
ing to  the  doses  in  which  it  is  administered,  and  what  its 
variations  may  be.  All  we  have  to  do  is  to  interrogate 
toxicology,  pathogenetic  experiments,  and  medical  practice. 
Experience  only  can  teach  us. 

Toxicology  tells  us  that  according  to  the  dose  the  effects 
are  more  or  less  serious  and  numerous.  The  effects  of  a 
large  dose,  if  it  is  not  immediately  fatal,  are  produced  over 
the  whole  organism,  almost  all  the  secretions  are  affected; 
the  circulatory  system  is  also  involved  in  its  totality,  so 
also  the  nervous  system,  with  phenomena  varying  according 
to  the  agent  employed.  On  the  other  hand,  if  the  dose  be 
weak,  the  array  of  phenomena  is  less  considerable,  less 
severe ;  it  seems  as  if  the  effects  localised  themselves  on  some 
particular  points  only.  Thus,  Belladonna^  which  in  serious 
cases  of  poisoning  exerts  its  action  on  all  the  sensitive  and 
muscular  systems,  on  the  intestines,  the  heart,  the  bladder. 


FrSdault  on  the  Action  of  Drugs.  •    115 

in  slight  cases  will  only  exert  a  local  action  on  the  eyes^ 
the  stomachy  the  urine^  and^  perhaps^  the  intestines.  It  is 
in  slight  cases  of  poisoning  that  we  especially  observe  the 
localisation^  sometimes  on  one  point,  sometimes  on  another ; 
eruptions  or  partial  paralyses,  or  an  action  on  the  bladder, 
doubtless  according  to  the  susceptibilities  of  the  subject, 
since  they  vary. 

We  should  also  consider  that  if  the  agent  has  been  given 
in  small  doses  continued  for  a  long  time  it  localises  its 
action  still  more  precisely,  and  it  is  then  that  we  obtain 
the  most  of  those  effects  that  are  recorded  in  our  patho- 
genetic lists.  So,  also,  the  eruption  of  Phosphorus  has  been 
much  more  distinctly  developed  in  the  case  of  moderate 
doses;  and  the  caries  of  the  jaws  in  cases  where  its  action 
has  been  prolonged.  In  like  manner,  mercurial  trembling 
is  only  seen  very  rarely  in  persons  who  have  been  subjected 
to  an  abuse  of  mercurial  treatment ;  in  these  persons  saliva- 
tion and  gingivitis  are  the  rule,  whilst  the  trembling,  with 
emaciation,  belongs  to  gilders  on  metal  or  mirror  silverers. 

Similarly  in  pathogenetic  experiments — ^and  of  these  there 
are  a  great  number  in  Hale's  instructive  New  Remedies — we 
find  from  strong  doses  general  phenomena,  and  such  as  involve 
the  whole  organism,  which  are  reproduced  alike  in  most  of 
the  subjects,  and  afterwards  phenomena  localised  on  one  part 
or  another,  varying  according  to  the  subjects.  It  seemed  to  me 
that  there  is,  as  it  were,  a  collection  of  general  phenomena  from 
strong  doses,  that  do  not  appear  from  the  administration  of 
weak  doses ;  whereas  with  smaller  doses  there  is,  as  it  were,  a 
specificity,  a  particularisation  of  the  medicine,  which  shows 
itself  by  one  or  another  phenomenon  according  to  the  subject, 
no  doubt  owing  to  his  peculiar  disposition,  for  this  seems  to  be 
the  only  cause  that  can  be  adduced  in  order  to  explain  them. 

And,  finally,  in  practical  medicine  it  is  just  the  same. 
Allopathic  doses  are  akin  to  toxical  doses,  and  induce  a 
more  general  perturbation  of  the  organism  than  is  produced 
by  weak  doses.  It  is  in  such  cases  that  we  observe  severe 
localisations  of  the  medicines  on  the  intestines,  on  the 
urinary  organs,  on  the  throat,  lungs,  eyes,  and  nervous 
centres  ;  whereas  from  smaller  doses  with  the  first  attenua- 


116  Fredaidt  on  the  Action  of  Drugs. 

tions,  the  medicine  seems  to  exert  its  action  on  more  local- 
ised points,  and  on  fewer  points  at  a  time ;  and  from  still 
feebler  doses  there  occur  much  more  isolated  actions  which 
localise  themselves  in  a  more  precise  manner. 

Thus,  then,  to  express  what  I  believe  to  occur,  the  medi- 
cine has  not,  properly  speaking,  a  different  action  according 
to  the  doses  in  which  it  is  given ;  but  this  action  is  more 
violent  and  more  extensive  with  large  doses,  more  limited 
and  localised  with  attenuated  doses,  the  action  is  essentially 
the  same  whatever  be  the  dose ;  and  thus  it  is  that  we  see 
very  sensible  effects,  such  as  purging  and  diuresis,  produced 
just  as  well  with  infinitesimal  doses  as  with  allopathic  doses, 
according  to  the  susceptibility  of  the  patient.  I  have  seen 
Magnesia,  Ipecacuanha,  Tartar  emetic,  Bryonia,  produce 
alvine  evacuations  resembling  a  slight  purgation,  in  the  6th 
or  I2th  dilution ;  and  in  like  manner  I  have  seen  Digitalis 
12  cause  a  sedative  action  on  the  heart,  or  a  diuresis,  as 
marked  as  when  it  is  given  in  allopathic  doses,  but  certainly 
only  exceptionally,  and  by  reason  of  the  susceptibility  of  the 
patient ;  for,  generally  speaking,  there  are  effects  curative 
as  well  as  pathological,  some  of  which  are  best  seen  from 
strong,  others  from  weak  doses. 

I  said  just  now  that  certain  effects  have  been  chiefly 
obtained  from  slow  poisonings  or  from  provings  with  small 
doses,  whereas  great  perturbations  are  invariably  caused  by 
violent  poisonings.  Perhaps  we  may  say  in  a  general  way 
that  with  large  doses  the  action  is  chiefly  exerted  on  the  cir- 
culation and  on  the  principal  foci  of  evacuations,  the  liver, 
the  stomach,  the  intestines,  the  kidneys,  the  lungs,  the 
skin  ;  whereas  in  attenuated  doses  the  medicine  touches 
more  delicately  the  actual  structure  of  the  tissues,  and 
exerts  its  action  in  a  more  isolated  manner  on  the  peculiar 
life  of  the  organs.  If,  indeed,  we  reflect  that  the  organs 
have,  as  it  were,  two  lives,  the  one  functional  which 
responds  to  the  general  life,  and  brings  it  into  connexion 
with  the  other  functions ;  the  other  proper  to  each  organ, 
to  each  element  of  the  tissue,  and  which  is  their  own  peculiar 
life,  their  particular  action,  that  which  provides  for  the 
integrity  of  the  tissue  and  of  the  organisation ;  it  seems  to 


Fredault  on  the  Action  of  Drugs.  117 

me,  then,  that  in  a  large  dose  the  medicine  affects  the  func- 
tions in  their  totality,  whereas  in  a  small  dose  it  affects 
rather  the  vitality  of  the  organic  tissues  at  the  point  where 
it  acts. 

It  is  thus  that  I  explain  to  myself  the  difference  of  the 
effects,  depending  not  on  a  difference  of  action  of  the  medi- 
cine according  to  the  dose  given,  but  on  the  difference  of 
the  points  whereon  it  acts.  As  I  have  said,  large  doses 
appear  to  me  to  respond  rather  to  the  general  functions  in 
their  entirety,  and  small  doses  to  exert  their  action  more 
specially  on  the  isolated  morbid  phenomena  referable  to  an 
action  of  the  tissue  rather  than  to  the  functions  in  their 
entirety.  Thus,  I  have  seen  Digitalis  8000  put  a  stop  to 
nocturnal  cardiac  crises  which  came  on  regularly  at  a  certain 
hour,  which  neither  Quinine  nor  Digitalis  in  large  doses  was 
able  to  allay.  In  like  manner,  I  have  seen  Calcarea  and 
Plumbum  200  put  a  stop  to  epileptic  fits.  In  a  child 
affected  with  stridulous  laryngitis  recurring  at  night,  and 
which  had  lasted  several  weeks,  Plumbum  200  was  completely 
successful.  Kali  carb,  1200,  on  one  occasion,  put  ft  stop  to 
nocturnal  attacks  of  vomiting  which  had  occurred  every 
night  for  twelve  years.  So  many  analogous  facts  have  been 
recorded,  that  there  can  be  no  doubt  on  that  point ;  it  is 
especially  with  infinitesimal  doses  that  affections  of  a  very 
isolated  and  limited  character  can  be  cured.  We  are  all, 
I  believe,  familiar  with  many  similar  facts. 

To  resume,  large  and  small  doses  have  analogous  actions, 
but  the  former  are  more  apt  to  cause  a  general  disturb- 
ance of  the  organism,  the  latter  more  isolated  localisations ; 
both  occupy  the  vital  activity,  sometimes  more  violently 
and  extensively,  sometimes  more  subtly,  in  order  to  permit 
this  activity  to  return  by  itself  afterwards  to  its  normal  state  ; 
and  thus  it  is  that,  according  to  the  morbid  habit  of  this 
activity  (forthe  diseasemaybe  compared  to  a  vicious  habit  more 
or  less  deeply  rooted),  we  should  attack  sometimes  strongly 
and  broadly,  sometimes  lightly,  sometimes  continue  giving 
themedicine,8ometimesallownature  to  recover  its  equilibrium 
after  a  very  gentle  diversive  action,  more  or  less  marked. 


118  FredauU  an  the  Action  of  Drugs. 

VI, 

It  woald  certainly  be  desirable  to  know  more  about  tbe 
intimate  action  of  medicines,  but  shall  we  ever  know  the 
exact  process  of  any  phenomenon  whatever?  Will  there 
not  always  be  something  that  escapes  us,  and  that  will  be  an 
unattainable  desideratum  for  science  ? 

It  has  been  said  that  in  large  doses  medicines  have  a 
kind  of  chemical  action,  whereas  in  small  doses  they  have 
a  so-called  dynamic  action. 

I  confess  that  this  last  idea  of  an  action  of  forces  without 
matter,  for  this  idea  goes  that  length,  appears  to  me  incom- 
prehensible. The  more  I  endeavour  to  conceive  it,  the  less 
successful  am  I  in  apprehending  this  subtilisation  by  the 
dynamisation  of  matter,  which  would  reduce  it  to  a  pure 
force  without  material  substratum,  I  am  unable  to  com- 
prehend a  material  force  apart  from  matter,  and  no  one  has 
ever  been  able  to  explain  it  to  me  clearly. 

I  know  not  what  the  chemical  action  of  a  medicine  even 
in  medium  doses  can  be,  but  I  can  understand  that  there  is 
a  sort  of  conflict,  a  fight  between  the  medicinal  particle  and 
the  living  particle.  We  are  aware  that  lead,  copper,  arsenic, 
sulphur,  and  other  inorganic  substances  may  unite  them- 
selves to  the  structure  of  our  tissues,  remain  there  a  longer 
or  shorter  time,  and  be  expelled  therefrom  more  or  less 
quickly ;  and  thus  I  explain  to  myself  the  fight,  the  work, 
though  it  is  not  apparent,  that  may  take  place  in  this  con- 
flict* In  works  on  alimentation  we  are  told  that  organic 
substances,  vegetable  or  animal,  may  also  be  associated  with 
the  organic  life,  and  even  remain  stored  up  there ;  and  thus 
it  is  that  the  milk,  the  blood,  the  flesh  of  animals,  retain 
the  odour  and  the  essence  of  the  substances  they  feed  on. 
So,  also,  plants  smell  of  the  soil  on  which  they  grow,  of  the 
matters  with  which  they  have  been  manured.  In  this  way 
I  explain  the  association,  the  union,  more  or  less  durable, 
of  medicines  with  the  vital  activity ;  their  participation  in 
this  activity  and  the  modifications  that  may  result  from  it ; 
the  occupation  they  give  to  this  activity,  and  thereby  the 
diversions  they  may  give  to  it. 


FrSdanlt  on  the  Action  of  Drugs.  119 

What  is  there  extraordinary  in  medicines  uniting  or 
attaching  themselves  to  living  tissues,  particle  to  particle^ 
without  anything  being  apparent  except  the  cure  that  may 
result  therefrom ;  unless  the  dose  be  a  poisonous  one,  or 
unless  an  idiosyncrasy  on  the  part  of  the  patient  manifests 
some  discomfort  experienced  by  him  ?  Do  not  such  things 
happen  in  the  ordinary  course  of  life  ?  The  organism  is 
perpetually  in  conflict  with  substances  that  attack  it, 
particles  of  all  sorts  that  penetrate  it,  which  are  then  either 
destroyed,  or  united  and  assimilated,  or  expelled,  without  the 
occurrence  of  anything  very  remarkable  in  the  manifestations 
of  life.  The  balanced  harmony  of  the  vital  actions  is  com- 
patible with  a  plus  or  a  minus,  and  with  the  imperceptible 
modulations  which  vary  and  which  succeed  one  another 
without  end.  In  this  vortex  of  vital  modulations  the 
medicine  associates  itself  with  the  action,  and  occupies  it, 
without  anything  necessarily  resulting  therefrom  of  a  very 
striking  character  to  betray  its  effect. 

It  can  thus  be  very  well  understood  that  a  medicine  may 
occupy  the  vital  activity,  modifying  it  according  to  the 
conflict  produced,  and  thereby  diverting  and  deranging  it 
from  the  action  it  was  performing,  and  thus  turning  it 
away  from  its  morbidity,  without  the  external  manifestation 
of  any  very  striking  phenomena^  except  the  obvious  return 
to  normal  laws. 

In  cases  of  poisoning,  the  agent,  by  uniting  with  the 
living  molecule^  takes  violent  possession  of  it,  just  as  a 
caustic  destroys  an  external  part  to  which  it  is  applied  ;  or 
it  attaches  itself  to  the  uatural  substance  in  order  to  modify 
its  composition ;  and  in  both  these  cases  there  is  a  change, 
a  modification  of  the  vital  act  owing  to  the  modification  of 
composition.  We  understand  the  more  or  less  profound 
perturbation  which  betrays  itself  by  particular  morbid  or 
toxical  phenomena*  But  when  the  agent  is  not  toxical^ 
its  union  with  the  organism  can  give  rise  to  nothing  but 
a  normal  act  of  this  organism,  accustomed  as  it  is  to  conflicts 
of  this  kind  brought  upon  it  by  foreign  particles  which  it 
assimilates  or  rejects.  I  cannot  understand  how  this  conflict 
can  be  confounded  with  the  idea  of  a  struggle,  of  action  and 


120  FridauU  on  the  Action  of  DrugM. 

reactioDi  which  are  purely  imaginary,  and  which  have  no 
foundation  in  fact.  Even  when  the  action  is  toxical  it  is 
always  only  a  modified  act^  which  remains  modified  as  long 
as  the  agent  retains  possession  of  the  tissue^  and  which 
again  simply  becomes  normal,  more  or  less  augmented 
according  to  the  laws  of  physiology^  and  there  is  no  question 
of  any  other  phenomena. 

Thus,  as  far  as  we  can  view  this  medicinal  conflict,  the 
actual  details  of  which  are  hidden  from  us  and  will  perhaps 
always  remain  hidden,  as  far  as  we  can  judge  of  it  by  what 
observation  teaches  us,  and  what  physiology  allows  us  to 
analyse,  I  do  not  see  how  we  can  conceive  of  the  medicinal 
action  otherwise  than  as  a  transient  occupation  of  the  vitality 
by  a  special  agent  that  causes  it  to  accomplish  a  normal 
act,  and  thus  takes  it  out  of  the  morbid  course  it  was 
pursuing.  This  is  the  action  which  we  may  oppose  to  the 
toxical  or  pathogenetic  action,  from  which  it  differs  only 
by  an  opposition  of  effects,  not  by  a  contrariety  of  acts. 
For  we  cannot  say  that  there  is  produced  here  a  movement 
contrary  to  the  morbid  movement,  contrary  to  the  patho- 
genetic effect,  that  is  to  say  in  strife  with  these  movements. 
Such  a  strife  is  always  present  to  the  mind  when  we  think 
of  these  phenomena ;  such  a  strife  is  assumed  in  order  to 
imagine  a  curative  action  contrasting  with  a  morbid  or 
toxical  action,  or  a  reaction  of  nature  against  itself  in  a 
sense  opposed  to  the  action  it  accomplishes.  Whereas 
the  truth  is,  there  is  only  a  toxical  or  perturbing  action, 
when  in  the  conflict  the  agent  is  toxical  per  $e  or  by 
reason  of  the  dose  employed ,-  or  a  physiological  effect  of 
occupation  of  the  vital  activity  which  thus  returns  within 
its  normal  laws. 

And  this  confirms  what  I  have  said  above  respecting 
the  alleged  opposite  effects  of  different  doses.  There  are 
no  opposites  but  the  normal  or  physiological  state  and 
the  morbid  state  which  is  toxical  or  pathological;  the 
medicinal  agent  produces  the  one  or  the  other  only.  As  to 
the  other  effects,  called  alternating  or  primary  and  secondary, 
they  are  the  expression  of  a  physiological  law  as  we  have  seen. 
What  facts  and  reason  say  is  limited  to  that,  if  we  set  aside 


FrSdauU  on  the  Action  of  D/niffs.  121 

the  theories  and  the  confusions  which  have  accumulated  on 
this  point. 

It  is  said  that  Opium  causes  sleep  in  large  doses,  and 
prevents  sleep  in  small  doses ;  because  in  large  doses  it  is 
toxical^  and  in  small  doses  it  occupies  the  organism ;  but 
in  those  habituated  to  its  action  it  ceases  to  be  toxical  in 
the  doses  in  which  it  used  to  be  so^  and  becomes  a  simple 
occupier  of  the  vital  activity ;  or^  after  having  produced 
sleep^  the  natural  return  to  the  normal  state  is  the  pro- 
longed wakefulness  which  compensates  physiologically  the 
previous  exaggerated  sleep. 

Mercury  in  large  doses  is  toxical^  it  causes  an  semi  a  and 
diminution  of  the  blood-corpuscles ;  in  small  doses  it  is  a 
simple  occupier  of  the  vital  activity^  and  may  thus  aid 
in  the  reproduction  of  the  corpuscles  if  there  was  a  previous 
anaemia.  But  in  these  same  small  doses  it  will  not  increase 
the  blood-corpuscles  in  a  subject  who  has  enough  of  them^ 
because  this  medicine  has  not  two  opposite  actions  as  some 
say  it  has ;  it  has  only  a  toxical  and  a  physiological  action ; 
and  the  latter  does  not  per  se  increase  the  blood-corpuscles^ 
but  restores  the  normal  state  which  augments  the  corpuscles 
whose  number  has  been  diminished ;  or  it  is  transiently  one 
of  the  exciters  of  the  vitality. 

Arsenic  has  the  same  effects ;  in  large  doses  it  diminishes 
the  number  of  the  blood-corpuscles^  this  is  its  toxical  effect ; 
and  in  small  doses  it  increases  their  number  in  an  anaemic 
person  by  its  curative  effect.  But  per  se  this  small  dose  will 
not  increase  those  corpuscles  in  a  non-anaemic  person ;  it  may 
even  do  the  contrary^  and  act  as  a  toxical  dose  if  continued 
too  long. 

Diffitalis  increases  the  pulsations  of  the  heart  in  large 
doses ;  and  then  it  causes  a  contrary  effect  agreeably  to  the 
law  of  physiological  compensations.  In  small  doses  it 
excites  the  heart's  beats  in  a  patient  in  whom  these  are 
diminished^  by  occupying  the  cardiac  activity  and  bringing 
it  back  to  the  normal  state ;  but  this  small  dose  does  not 
produce  this  effect  in  a  healthy  person  whose  heart  beats 
normally ;  otherwise  we  must  believe  that  by  exaggerating 
the  normal  beats  it  produces  in  small  doses  toxical  effects 


122  Fs'idauU  on  the  Action  of  Drugs. 

contrary  to  the  toxical  effects  it  causes  in  large  doses,  which 
no  one  has  e^er  proved.  It  can  only  have  contrary  effects 
according  to  the  disposition  of  the  subject ;  just  as  water 
at  70^  is  a  cold  bath  for  a  febrile  subject  but  is  a  warm 
bath  for  one  that  has  been  frosen. 

We  may  take  all  the  medicines,  one  after  another,  as  far 
as  we  know  them,  we  shall  never  find  anything  more 
than  that — either  a  toxical  or  a  physiological  effect.  As 
regards  secondary  effects,  these  are  phenomena  produced 
by  an  increased  or  diminished  function ;  they  have  no 
existence  if  it  is  a  question  of  a  morbid  phenomenon  of 
perversion  of  action,  as  we  have  seen. 

It  should  be  expressly  stated  that  the  insensible  physiologi- 
cal action  is  not  the  only  one  that  can  be  curative,  and  that 
very  useful  medicinal  actions  may  be  obtained  by  weak 
toxical  doses,  in  accordance  sometimes  with  the  allopathic, 
sometimes  with  the  homoeopathic  law.  Thus  DiffUatis  in 
large  doses,  in  powder  or  infusion,  may  manifestly  diminish 
the  heart's  beats  and  the  arterial  pulsations,  so  as  to  reduce 
the  pulse  to  fifty  and  even  forty  pulsations,  which  is  a 
slight  toxical  effect,  and  thus  modify  in  a  very  sensible 
manner  affections  of  the  heart,  and  cause  a  copious  and 
useful  diuresis.  Hirtz  (of  Strassburg)  seems  to  have  em- 
ployed it  in  this  way  not  unsuccessfully  in  several  cases  of 
pneumonia. 

It  should  be  borne  in  mind  that  a  cure  may  be  obtained 
by  aggravation  which  is  a  toxical  action.  The  practitioners 
of  Algeria  who  have  had  to  do  with  epidemics  of  dysentery 
assert  that  they  have  often  been  successful  with  emeto- 
cathartics  which  acted  like  slight  toxical  agents;  for  in- 
duced emesis  and  diarrhoea  are  obviously  slight  toxical 
actions.  At  the  beginning  of  the  last  century  when 
Ipecuacanha  powder  was  first  used  in  dysentery,  it  was  given 
in  doses  which  always  caused  nausea  and  often  vomiting, 
that  is  to  say,  in  a  semi-toxical  dose.  Thus,  there  is 
obviously  in  medicine  a  large  number  of  toxical  actions, 
slight  it  is  true,  which  may  be  utilised  by  an  able  practi- 
tioner. 

But,  as  a  rule,  cures  according  to  the  law  of  similars  are 


FiidavU  on  the  Action  of  Drugs.  123 

effected  in  au  insensible  manner  by  physiological  action ; 
and  the  toxical  action  may  be  medicinal^  either  by  allopathic 
effect,  or  accidentally  according  to  the  law  of  similars. 


VIT. 

There  is  a  last  point  concerning  the  action  of  medicines 
that  I  wish  at  least  to  mention,  as  I  have  the  others, 
though  I  cannot  devote  to  it  the  space  it  deserves ;  I  refer 
to  the  susceptibility  to  the  medicine. 

All  physicians  are  well  aware  of  this  point  in  a  general 
way,  but  it  is  almost  always  lost  sight  of  when  it  is  of 
importance  to  allow  for  it.  It  is  well  known  that  medicines 
do  not  act  in  the  same  way  on  all  species  of  animals,  that 
plants  that  are  poisonous  to  man  are  not  so  to  certain 
animals.  It  is  more  than  probable  that  in  the  same  species 
some  races  are  more  sensitive  than  others  to  a  medicine ;  and 
perhaps  as  regards  certain  plants  whose  action  is  now  held  to 
be  less  dangerous  than  formerly,  this  change  is  accounted 
for  by  a  modification  of  the  races  of  mankind.  Our  in- 
formation on  this  subject  is  not  sufficient,  and  we  must 
wait  for  further  instruction. 

But  it  constantly  happens  in  the  course  of  our  medical 
practice  that  we  meet  with  different  individual  suscepti- 
bilities which  often  puzzle  us.  Either  we  expect  a  certain 
action  from  a  drug  which  fails  to  do  what  it  performed  in 
another  patient,  or  we  witness  a  manifestation  of  epipheno- 
mena,  of  accessory  pathogenetic  effects,  or  of  repulsions  on 
the  part  of  the  patient  shown  by  some  discomforts  which  he 
alleges  he  experiences,  and  which  we  did  not  expect. 

We  may  lay  it  down  as  a  general  rule  that  there  is  no 
person  capable  of  expressing  and  manifesting  all  the 
phenomena  that  a  medicine  can  produce  and  which  are 
recorded  in  our  pathogeneses.  The  effects  recorded  in  these 
pathogeneses  have  been  obtained  in  a  greater  or  smaller 
number  of  persons  who  were  evidently  susceptible  some  of 
a  certain  action  others  of  another.  And  on  this  point  we 
know  not  if  our  most  perfect  pathogeneses  are  really  perfect, 
for  perhaps  the  medicines  would  produce  other  unknown 


124  Fridault  on  the  Action  of  Drugs^ 

effects  on  a  subject  endowed  with  a  hitherto  untried  suscep* 
tibility. 

Thus,  when  we  give  a  medicine  according  to  the  law  of 
similarity,  we  are  as  if  we  admitted  in  principle  that  the 
pathological  state  of  the  subject  created  in  him  an  aptitude, 
a  susceptibility  to  respond  to  the  action  of  the  medicine  which 
attacks  the  diseased  part.  And  in  truth  it  is  rational  to 
admit  that  the  pathological  state  of  an  organ  renders  the 
vitality  of  this  organ  more  susceptible  than  any  other  to  be 
influenced,  disturbed,  attacked  by  our  agent.  Experience 
leads  us  to  believe  that  this  is  a  general  law,  since  in  a 
great  number  of  cases  the  facts  bear  us  out  in  this  view. 

Still,  it  may  happen,  from  some  causes  still  unknown^  that 
the  medicine  does  not  act,  or  acts  too  energetically.  Sup- 
posing it  does  not  act ;  this  is  demonstrated  to  us  in  all 
those  cases  where  we  fail  to  observe  an  effect  which  we  had 
noticed  in  other  similar  cases.  Supposing  it  acts  too 
energetically :  this  is  an  instance  of  partial  aggravation  or 
of  accessory  aggravation  of  which  I  have  already  spoken. 
And  these  two  cases  are  exactly  analogous  to  those  of  the 
pathogenetic  provings,  or  the  toxical  relations;  for  in 
toxicology,  as  in  pathogenesy,  certain  effects  are  produced 
on  one  subject,  others  upon  another;  ioft  one  the  toxical 
dose  is  very  weak  because  the  subject  is  rery  susceptible, 
whereas  for  another  much  stronger  doses  are  required  in 
order  to  produce  poisoning.  When,  for  example,  we  see 
accessory  aggravations,  as  I  have  termed  them — that  is  to 
say,  pathogenetic  effects  which  have  been  observed  in  patients 
from  every  dose — ^how  can  we  lay  down  a  fixed  rule  of  doses, 
and  affirm  that  such  a  dose  will  eause  toxical  effects  and  saeh 
another  dose  physiological  effects  f     That  is  impossible. 

The  effects  called  pathogenetic  are  nothing  but  very 
slight  toxical  effects,  where  the  patient  runs  no  risk  except 
that  of  suffering  a  little  or  of  having  some  epiphenomena ; 
whereas  the  physiological  effect  is  that  where  the  subject 
does  not  manifest  any  very  marked  phenomenon,  where  the 
conflict  betwixt  the  agent  and  the  organism  takes  place  in 
one  of  the  normal  physiological  occupations  (^  the  life,  at 
most  slightly  increasing  the  vitality  at  the  point  where  the 


Frfdault  on  the  Action  of  Drugs.  125 

conflict  occurs.  The  actual  dose  may  be  of  no  importance 
in  the  difference  of  the  two  actions,  the  toxical  and  the 
physiological ;  this  depends  on  the  susceptibility  of  the 
patient,  and  a  large  dose  may  be  just  as  physiological,  that 
is  to  say,  curative,  as  an  infinitesimal  dose,  and  vice  versd. 

Not  only  do  the  therapeutic  effects  prove  this,  but  we 
have  also  the  experiences  of  toxicologists  and  therapeutists. 
Why  has  there  been  so  much  discussion  respecting  the  true 
action  of  Opium  ?  and  why  is  a  similar  discussion  going  on 
about  the  effects  of  Digitalis  ?  Some  say  that  the  primary 
effect  of  Digitalis  is  to  retard  the  pulse,  to  paralyse 
the  heart;  whilst  others  say  that  its  primary  effect  is  to 
contract  it.  The  reason  of  this  is  that,  on  the  one  hand, 
experiments  on  animals  and  experiments  on  man  are  mixed 
up  together,  the  two  different  species,  whose  impression- 
ability to  the  medicine  may  be  quite  different,  being 
regarded  as  identical.  On  the  other  hand,  the  experiments 
on  man  being  also  contradictory ;  that  is  evidently  owing  to 
different  susceptibilities  in  the  same  species,  so  that  the  agent 
is  toxical  in  some,  physiological  in  others,  in  the  same 
dose. 

It  is  imposuble  to  fix  the  exact  limits  of  the  toxical  dose 
of  any  agent,  not  even  of  the  fatal  dose,  for  this  dose 
▼aries  remarkably  according  to  the  persons ;  and  for  slight 
toxical,  f  .e.  pathogenetic  effects,  there  are,  we  may  say,  no 
limits.  It  would  be  necessary  to  fix  their  limits  in  order  to 
establish  below  them  the  scale  of  physiological  doses,  and 
this  cannot  be  done,  because  in  every  dose  we  may  have, 
according  to  the  susceptibility  of  the  subject,  either  a  toxical 
or  a  physiological  effect.  The  only  thing  possible  to  do  is 
to  fix  a  very  elastic  mean  of  dangerous  doses,  as  is  usually 
done  in  the  formularies;  and  below  this  commence  the 
physiological  or  curative  doses  which  may  occupy  the  vital 
activity,  and  at  most  cause  some  partial  aggravations  or 
some  epiphenomena. 

I  will  only  mention  the  principal  lines  of  these  questions, 
for  it  would  take  up  too  much  space  to  enter  into  all  the 
details  necessary  for  their  full  elucidation.  On  this  special 
point  of  the  susceptibility  to  the  medicine,  we  might  inquire 


126  Fi'fdault  an  the  Action  of  Drugs. 

if  the  oppositions  and  alliances  of  morbid  predispositions,  in 
action  and  threatening  to  act,  be  not  a  considerable  element 
of  difficulty ;  but  this  is  a  subject  too  obscure  and  difficult 
to  be  treated  in  a  cursory  manner.  I  will  content  myself 
with  stating  that  the  law  of  susceptibilities  only  exhibits  the 
two  possible  actions  of  the  medicine,  as  I  haye  already  said, 
the  toxical  action  and  the  physiological  action ;  the  latter 
usually  curative,  the  former  capable  of  being  so  exception- 
ally. But  there  is  one  point  of  this  question  of  the  suscep- 
tibility of  the  patient  which  must  be  borne  in  mind,  that  is, 
the  possible  Tariation  in  two  opposite  senses,  that  of  tolerance 
and  that  of  intolerance. 

Thus,  on  the  one  hand,  the  patient  may  become  habituated 
to  the  medicine   in   such  a  way  that   after  having   been 
greatly  influenced   by  it,   the  action   afterwards    becomes 
physiological  and   imperceptible,  or  even  null,  to  such  a 
degree  that  it  would  seem  that  the  organism  receives  it 
without  paying  any  attention  to  it.     Thus  it  is  that  some 
medicines  in  large  doses,  or  even  in  small  doses,  may  first 
cause  an  aggravation^  or  only  the  semblance  of  an  aggrava- 
tion, and  thereafter  act  physiologically  so  as  to  effect  a  very 
distinct  cure.     The  tolerance  may  be  established  all  at  once, 
or  after  some  time  and  by  continuing  to  take  the  medicine. 
On  the  other  hand,  the  patient  may  at  first  be  apparently 
insensible  to  the  medicine  and  then  become  impressionable 
by  it  if  its  action  be  continued,  and  the  physiological  action 
may  be  established,  the  vital  activity  being  occupied  by  this 
action  and  diverted  from  its  evil  morbid  habit.     Thus  it  is 
that  a  well-indicated  medicine  may  be  continued  if  there  is 
time  to  do   so,  and  perseverance  may  be   crowned   with 
success.     But  just  as  tolerance  may  be  established,  so  also 
intolerance  may  occur  in  consequence  of  a  too  long  continu- 
ance of  its  action ;  and  medicines  which  have  acted  well  at 
first,  not  only  do  not  continue  their  curative  action  any 
longer,  but  produce  aggravations,  and  that  not  only  in  large 
doses  but  also  in  small  doses.      We  meet  with  patients 
who  after  having  thus  taken  a  course  of  medicines,  or  after 
having  been  subjected  to  treatments  directed  to  divers  objects, 
become  absolutely  incapable  of  being  acted  on  by  any  dose  ; 


Fredauli  on  the  Action  of  Drugs.  127 

they  manifest  only  irritation  and  aggravation  from  even  the 
smallest  doses. 

If  we  reflect,  we  shall  perceive  that  it  is  impossible  to 
explain  these  manifestations  of  tolerant  and  intolerant  sus- 
ceptibility on  the  theory  of  aggravations,  whereas,  on  the 
hypothesis  that  the  curative  action  is  simply  an  occupation 
of  the  vital  activity,  all  becomes  clear. 

VIII. 

To  recapitulate.  Hunter's  view  seems  to  me  to  present 
the  facts  in  a  truer,  exacter  light.  While  giving  full  credit 
to  Hahnemann  for  his  great  services  to  materia  medica, 
which  made  the  law  of  similars  applicable  to  practice^  and 
demonstrated  its  value,  I  venture  to  prefer  to  his  theories 
the  larger,  more  physiological,  and  at  the  same  time  more 
accurate,  views  of  his  predecessor.  The  law  of  similars 
aeems  more  correct  by  seeming  more  precise,  because  we 
perceive  more  clearly  how  the  medicine  in  the  physiological 
dose  cures  phenomena  similar  to  those  it  causes  in  the 
toxical  or  pathogenetic  dose.  We  thus  get  rid  of  the  theory 
of  aggravations  and  of  that  of  secondary  effects,  which, 
owing  to  the  confusion  attending  them,  are  constantly  giving 
rise  to  uncertainty.  We  see  more  distinctly  and  more  cor- 
rectly the  facts  bearing  upon  the  law  of  similars,  and  we  can 
better  appreciate  its  true  value,  and,  finally,  we  can  com« 
prehend  more  clearly  the  question  of  the  doses  in  a  general 
way,  although  many  questions  of  detail  are  still  obscure. 
The  treasures  of  materia  medica  and  the  practice  of  homoeo- 
pathy have  always  appeared  to  me  more  comprehensible 
from  this  point  of  view,  and  I  am  convinced  that  nothing 
but  advantage  is  gained  in  every  respect  by  getting  rid  of 
the  ancient  theories  and  adopting  other  views  which  throw 
greater  light  on  the  subject. 

By  its  toxical  or  pathogenetic  efiects  the  medicine  shows 
in  a  precise  manner  where  it  exercises  its  action  ;  and  the 
similarity  between  these  effects  and  the  morbid  phenomena 
to  be  cured  shows  that  the  medicine  exerts  its  action  on  the 
precise  point  where  the  vital  action  is  morbidly  modified. 


128  Fridault  on  the  Action  of  Druffs. 

As  I  have  shown  in  my  pamphlet  On  the  Relations  of  the 
Homoeopathic  Doctrine  with  the  Past  of  Therapeutics  (Paris, 
1852),  the  law  of  similars  is  the  most  exact  formula  of  the 
localisation  of  the  medicinal  action ;  the  medicine  cures  bj 
modifying  the  vital  state  morbidly  deranged  in  the  precise 
point,  sense  and  direction  where  it  is  deranged.  This  is 
the  first  point  of  the  doctrine  so  clearly  seen  by  Hunter, 
afterwards  demonstrated  and  made  practical  by  Hahnemann. 

In  the  second  place,  in  what  does  this  curative  modifica- 
tion of  the  medicine  consist?  Not  in  an  aggravation  or 
augmentation  of  the  morbid  derangement  for  the  purpose 
of  obtaining  a  reaction  in  an  opposite  direction,  because 
this  aggravation  occurs  but  rarely,  and  when  it  does  occur 
it  may  often  be  an  obstacle,  and  only  occasionally  an  advan- 
tage ;  and  because  the  reaction  in  an  opposite  direction  is  a 
mere  physiological  compensation,  and  is  necessarily  awant- 
ing  in  a  great  number  of  cases — ^about  one  half,  and 
when  it  does  occur  it  can  only  be  a  morbid  phenomenon 
not  a  curative  efiect*  The  proper  curative  action  is  quite 
difierent,  it  is  a  physiological  occupation  of  the  vital  activity 
by  the  curative  ageut,  which  thus  changes  the  morbid  aet 
which  was  going  on  into  a  physiological  aet,  and  cansea 
this  activity  to  return  into  its  normal  laws,  leaving  it  there 
when  itself  is  extinguished. 

The  action  of  a  small  dose,  or,  better  still,  of  a  physio- 
logical  dose,  is  not  and  cannot  be  said  to  be  contrary  to  the 
toxical  action  of  a  large  dose ;  for  the  contrary  can  only  be 
a  morbid  phenomenon  in  an  opposite  direction;  it  is  a 
difierent,  a  physiological  action,  which,  in  our  mind,  we 
oppose  to  the  toxical  action,  but  which  is  only  different. 

There  is  then  really  no  opposition  of  action  betwixt 
different  doses,  but,  nevertheless,  the  action  varies  according 
to  the  doses;  in  the  case  of  large  doses,  more  extensive^ 
more  multifarious,  exerting  itself  especially  on  the  actions 
of  general  functions  and  the  great  functional  systems,  the 
circnlation,  the  nervous  system,  the  digestion,  the  secret 
tions ;  and,  in  the  case  of  small  doses,  localising,  restricting^ 
its  influence,  acting  then  more  especially  on  the  proper 
life  of  the  tissues. 


Fr(dauU  on  the  Action  of  Drugs.  129 

In  every  case  the  intimate  nature  of  this  action  can 
only  be  explained  by  a  conflict  of  the  medicinal  molecule 
with  the  living  molecule ;  a  conflict  which  may  be  toxical  if 
the  dose  is  large  or  if  the  subject  is  too  susceptible^  which 
can  only  be  physiological  if  the  dose  is  small^  or  even  when 
it  is  large,  if  the  subject  be  not  too  impressionable.  This 
action  is  curative  because  it  is  physiological,  because  it  occu- 
pies the  vital  activity  in  acoordance  with  physiological  laws ; 
and  thus  it  is  imperceptible  in  its  action,  only  revealing 
itself  by  its  curative  effects.  The  physiological  dose 
occupies  the  vital  activity,  excites  it,  if  you  will ;  here  we 
have  an  action  not  contrary,  but  only  different  to  the 
toxical  action. 

Moreover,  we  must  always  bear  in  mind  this  impression- 
ability of  the  subject,  which  may  cause  a  medicinal  action 
to  show  itself  strongly  in  one  case  while  it  seems  to  be 
imperceptible  in  another,  and  that  in  any  dose;  which 
causes  a  large  dose  to  be  very  well  borne  and  to  act  only 
in  a  physiological  manner,  or  causes  an  infinitesimal  dose 
to  be  pathogenetic  and  not  tolerated ;  which  can  establish 
tolerance  in  some  subjects,  and  make  a  dose  at  first  toxical 
to  be  borne  and  to  act  only  physiologically,  or  a  small  dose 
that  at  first  can  be  borne,  to  oease  to  be  tolerated ;  and, 
finally,  which  can  render  the  subject  either  indifferent  to 
almost  any  action  we  try  to  excite,  or  impressionable  so  as 
not  to  be  able  to  tolerate  any  dose. 

But  if  we  consider  only  the  generality  of  cases  and  the 
general  laws,  we  may  say  that  a  medicine  acts  physio- 
logically in  small  doses  where  it  exerts  its  action  in  a 
toxical  or  pathogenetic  dose ;  so  that  the  medicine  cures  in 
this  way,  restoring  to  a  physiological  act  the  vital  activity 
whose  morbid  phenomena  are  similar  to  those  which  this 
same  activity  would  produce  if  the  medicine  acted  on  it 
toxically  or  pathogenetically. 

I  now  invite  my  colleagues  to  reflect  on  this  important 
question,  of  which,  as  I  have  said,  I  can  only  offer  them  a 
{general  outline. 


VOL,  XXXV III,  NO.  CLII. APRIL,  1880. 


130  Zymotics, 


«  ZYMOTICS/' 
By  Edward  T.  Blake,  M.D. 

Tfli  term  "  zymotic^*  is  nowadays  often  on  our  lips^  yet, 
were  we  required  to  give  a  strict  definition  of  it^  we  shouldj 
perhaps,  find  some  slight  difficnlty  in  doing  so. 

Of  course,  every  schoolboy  could  tell  us  that  the  term 
**  zymotic  **  is  drawn  from  a  Greek  word,  *^  Xjofin  '*  which 
signifies  *'  leaven,'^  and  it  has  been  supposed  that,  daring 
the  course  of  certain  diseases,  the  blood  undergoes  a  species 
of  fermentation.  But  there  is  not  the  slightest  evidence 
that  the  blood  can  or  ever  does  ferment.  Most  fermenta- 
tions are  carried  on  in  open  vessels,  and  are  followed  by 
more  fundamental  constitution-changes  than  we  ever  wit- 
ness in  living  blood.  It  is,  indeed,  scarcely  necessary  to 
say  tliat  current  views  of  the  physiology  and  pathology  of 
the  blood  have  undergone  of  late  so  great  a  revolution  that 
few  now  suppose  such  a  process  to  be  possible. 

Nevertheless,  the  word  "  zymotic  '^  will  probably  be 
retained,  because  it  is  a  convenient  term  for  a  class  of 
diseases  recognised,  indeed,  by  the  ancients,  but  whose 
distinguisliing  peculiarity,  preventabilUy,  was  neither  known 
nor  suspected  by  them.* 

By  the  term  ''  zymotic  ^'  sanitarians  have  come  to  mean 

*  Knowing  little  tnd  caring  less  for  the  g^eat  laws  of  Nature,  how,  indeed, 
coald  they  realize  that  each  terrible  penalties  were  bnt  her  In^JigDant  protest 
against  ignorance  and  infraction  of  those  laws !    Hence  some  other  caoae  had 
to  be  assigned,  and,  the  professions  of  priest  and  physician  being  so  oommonlj 
combined,  what  so  natoral  as  to  attribute  them  to  the  immediate  intervention  of 
an  outraged  Deity,  thns  making  them  serve  as  whips  for  moral  or  eccleaiastieal 
offences  I    Pious  as  was  this  view,  it  was  probably  as  much  opposed  to  the 
spirit  of  the  authoritative  writings  of  the  Christian  Church  (Luke  xiii,  1  to  5) 
as  to  the  principles  of  physical  science  themselves.    We  know  that  thia  feeling 
served  during  the  long  dreary  period  of  the  Dark  Ages  to  paralyse  aU  efitarts 
in  the  direction  of  sanatory  research.    Cleanliness,  which  had  been  an  Article 
of  Faith  in  the  Mosaic  economy,  was  also  made  an  essential  by  Mahomet,  but 
not,  alas !  by  the  Fathers  of  the  Christian  Church,  some  of  whom  seemed  to 
glory  in  personal  filth  and  in  the  abundance  of  parasitic  life. 


by  Dr.  E.  T.  Blake.  181 

preventable,  and  as,  in  this  country,  nnimported  malarious  dis- 
orders are  now  almost  unknown,  the  use  of  the  word  is  nearly 
narrowed  down  to  those  diseases  which  spread  either  by  con- 
tact, through  the  air  or  the  soil^  by  means  of  liquids,  as  water, 
milk,  sewage,  &c.,  and  more  rarely  by  solid  articles  of  food. 

Whilst  we  duly  recognise  that  the  term  '*  zymotic ''  has 
gradually  come  to  acquire  a  special  significance,  it  is  of  im- 
portance to  remember  that  when  Dr.  William  Farr  coined 
this  convenient  word  no  such  restricted  sense  existed  in  his 
mind.  Dr.  Farr  apparently  intended  by  ''  zymotic  "  what 
other  writers  have  meant  by  "general'*  [Wood],  by  *' spe- 
cific *'  [Walshe],  and  by  "miasmatic''  (not  marM-miasm 
alone). 

Dr.  Farr  divided  zymotics  into— 
1st.  Miasmatic. 
2nd.  Enthetic, 
3rd.  Dietic. 
4th.  Parasitic. 

We  well  know  that  this  division  brings  together  many  dis- 
similar disorders,  at  the  same  time  divorcing  diseases  whose 
alliance  stands  unquestioned.*  Yet  Registrar- Generals 
must  make  reports,  and  to  draw  them  up  they  must,  per- 
force, classify  diseases. 

There  is  no  doubt  that  by  ''  zymotic  "  we  had  better 
mean  preventable ;  and  as,  of  course,  the  question  then 
arises — What  diseases  are  preventable  ?  the  task  I  set  myself 
18  to  answer  that  question  as  accurately  as  the  present  very 
limited  extent  of  sanitary  research  enables  it  to  be  answered. 

As  obviously  the  measure  of  infectiousness  is  the  measure 
of  preventability,  we  must  think  first  of  that  class  of  condi- 
tions which  Sir  William  Jenner,  following  Walshe,  recog- 
nises as  the  '^  acute  specific  diseases.'^ 

The  European  zymotics  are  then : 

Smallpox  and  its  allies. 
Measles  and  its  modifications. 

*  DiarrhcBa,  e.^,  being  removed  from  diseases  of  the  alimentary  oanal,  to 
be  placed  between  dysentery  and  cholera. 


182  Zymotic  9, 

Scarlatina  and  Botheln. 

Typhua. 

Cerebro-tpinal  foyer. 

Enteric  fever. 

Belapsing  fever. 

Simple  continned  fever. 

Febricola. 

Agae  and  its  sequences. 

Remittent  fever. 

Simple  cholenu 

Whooping*  cough. 

Mumps. 

Influenza. 

Diphtheria. 

Glanders,  farcy,  and  grease. 

Malignant  pustule  [vesicle]. 

Phagedena  [also  sloughing  p.]* 

Hospital  gangrene. 

Erysipelas* 

Pyaemia. 

Puerperal  fever. 

Ephemera  [weed}. 

Bheumatism. 

Syphilis  and  gonorrhoea. 

Cancer  ? 

Pulmonary  consumption. 

Scurvy  and  purpura. 

Bickets. 

Anaemia  and  dropsy. 

Sunstroke. 

Drink  diseases. 

Ophthalmia. 

Pneumonia,  pneumonic  abscess. 

Pleurisy. 

*  ThiB  word  is  from  ▲.-S.  Modpmn,  to  hoot»  and  ii  connected  with  traxp 
(A.-S.  wipan) ;  therefore  should  not  he  tpelt  '*  hooping.'*  le  this  not  f aU  of 
interest,  reminding  us  that  oar  anQesters  howled  oirer  their  dead  aa  orientala 
and  savages  do  to  this  hour  ?  How  different  from  the  well-bred  sorrow — ^the 
subdued  grief  of  onr  day ! 


by  Dr.  E.  T.  Blake.  183 

/^Vesicular. 

ox       X.-X-     J  Ulcerative. 
Stomatitis  <  e. 

J  SappuratiTe. 

V.  Gangrenous  (cancrum  oris). 

Putrid  sore  throat. 

Sloughing  sore  throat,  (i^nanche  maligna). 

Pharyngitis  and  its  complications. 

Gastric  catarrh. 

Gastric  ulcer. 

H«matemesis» 

Dyspepsia. 

Enteritis. 

Typhlitis  and  perityphlitis. 

Dysentery. 

Diarrbcea. 

Hepatitis  (abscess). 

Peritonitis. 

Albuminuria. 

Cutaneous  affections,  especially  the  parasitic  forms. 

Certain  artificial  diseases  produced  by  chronic  poisoning 

in  the  way  of  trade  and  otherifise. 

Ague  is  a  typical  example  of  preventable  disease.  Every- 
one who  is  conversant  with  the  early  records  of  Britain, 
knows  what  a  terrible  scourge  it  has  been  in  this  country. 
The  fen  district  was  formerly  decimated  by  the  recurrent 
visitations  of  this  dreadful  disorder.  A  well-marked  case 
of  intermittent  is  now  a  curiosity^  even  in  the  fen  country 
itself^  thanks  to  the  wonderful  drainage-works  that  have 
been  carried  out  there.  Of  course  other  factors,  as  drier 
houses,  improved  water  supply,  better  clothing  and  food, 
and  the  introduction  of  the  **  Jesuit  bark,"  have  contributed 
their  aid  to  this  beneficent  result. 

Ague  was  once  endemic  in  the  South  of  London,'!'  but 

*  Tke  6oiitiiiaed  want  of  an  affeotWe  dam  to  prevent  the  rectorenoe  in  thii 
^strict  of  tbe  terribly  disastrons,  diBease-provoking  innndations  is  a  deep 
di^g^raoe  to  a  wealthy  city.  There  seems  to  be  little  donbt  that  the  modern 
system  of  deep-drainage,  so  excellent  in  itself,  contribntes  considerably  to  the 
floods  of  the  Surrey  side ;  they  may  therefore  be  expected  to  increase  steadily 
in  aererity. 


134  Zymotici, 

since  sewerage  operations  have  been  carried  oat  in  that 
district,  it  has  steadily  declined  and  is  now  unknown,  save 
as  an  imported  disease. 

Rheumatism,  even  in  the  acute  form,  is  not  alone  the 
result  of  cold  or  of  damp.  We  have  still  much  to  learn  as 
to  the  precise  part  played  by  the  nervous  system  in  the 
different  rheumatisms.  •  Here  is  an  example.  In  a  well- 
built  house,  on  a  dry  Surrey  sand-rock,  •  rheumatic  fever 
threatened  a  woman  of  80,  who  was  suffering  at  the  time 
from  symptoms  of  pelvic  congestion,  and  who  had  not  been 
exposed  in  any  •  way  to  the  effects  of  damp-cold.  The 
warning  passed  away  to  reappear  during  the  next  menstrual 
period,  as  classic  polyarticular  rheumatism  of  the  acute 
type,  again  wiihoui  exposure. 

The  occurrence  of  gonorrhoeal,  of  diphtheritic  rheumatism, 
and  of  the  anaemic  yariety,  tells  us  that  other  forms  of 
blood-poisoning,  besides  the  cutaneous  secretions,  may 
induce  this  disease,  and  amongst  these,  prolonged  exposure 
to  sewer-gas  will  probably  have  to  be  placed. 

Cancer,  at  first  flash,  seems  the  last  disease  in  the  world 
to  place  in  the  preventable  category.  But  some  curious 
and  most  significant  facts  have  of  late  years  come  out  in 
connection  with  this  terrible  disorder.  Dr.  Haviland  has 
shown  the  remarkable  rule  that  cancer  is  more  common  in 
alluvial,  low-lying  districts  than  on  the  more  lofty,  dry, 
primary  formations. 

The  observant  health  officer  for  Ilfracombe  assured  me 
that  he  had  witnessed  the  carcinomatous  tendency  linger- 
ing, and  recurring  in  badly-sewered  districts.  One  would 
think  that  this  must  be  an  instance  of  the  development  by 
insanitary  conditions  of  a  latent  taint  rather  than  the  direct 
result  of  poisoning  by  sewer  products. 

Pulmonary  Consumption, — ^A  remarkable  and  unexpected 
result  of  the  sewerage  of  towns  is  the  sudden  diminution  of 
the  cases  of  pulmonary  phthisis. 

As  empyema  with  perforation,  emphysema  with  bronchi- 
ectasis, pneumonic  abscess,  chronic  recurrent  pleurisy^ 
besides  a  considerable  variety  of  other  diseases  of  the  respi* 


by  Dr.  E.  T.  Blake.  135 

ratory  apparatus,  differing  widely  both  as  to  causation  and 
course^  are  returned  as  **  consumption/^  we  cannot  say  that 
**  tuberculosis  "  itself  is  especially  lessened  by  good  drainage^ 
in  which,  of  course,  the  removal  of  surface-water  forms  a 
considerable  factor,  still  the  result  is  equally  satisfactory 
from  a  sanatory  point  of  view,  for  it  shows  a  diminution 
(usually  of  about  ten  per  cent)  in  many  of  the  pulmonary 
diseases. 

This  is  a  valuable  set  off  against  a  few  ''  drain-diseases/' 
attributed  to  modem  methods  of  treating  waste  liquids, 
really  due  to  the  fact  that  too  many  architects,  builders, 
and  plumbers  plume  themselves  on  their  ignorance  of  the 
most  elementary  laws  of  pneumatics ;  too  often,  indeed, 
even  decrying  such  necessary  knowledge  in  others  as 
unpractical  and  visionary,  because  they  do  not  themselves 
chance  to  possess  it. 

It  is  not  for  one  moment  intended  that  every  case  of 
sore  eyes  or  sore  throat  is  zymotic,  but  that  certaiu  cases 
of  all  these  diseases  may  be  fairly  placed  in  the  preventable 
category. 

The  principal  diseases  preventable  by  general  attention 
to  health-conditions  have  now  been  enumerated. 

It  is  plain  that  in  the  nature  of  things  such  a  list  cannot 
be  absolute.  Had  it  been  constructed  a  century  ago  it  would 
have  consisted  of,  say  one  disease,  variola  ;*  and  perhaps  we 
should  then,  if  of  a  proper  conservative  spirit,  have  appended 
a  little  note  of  interrogation  in  brackets  I  Even  now  we 
scarcely  realize  how,  due  chiefly  to  the  energy  and  intel- 
ligence of  the  Army  Medical  Service,  there  has  sprung  up  a 
new  science  greater,  by  common  admission,  than  the  art  of 
healing,  inasmuch  as  it  invdlves  the  art  of  prevention, 
destined,  doubtless,  to  be  the  medicine  of  the  future. 
The  long  roll  of  preventable  diseases  is,  thank  God, 
destined  to  grow  longer  year  by  year,  not,  indeed,  by  the 
discovery  or  appearance  of  new  forms  of  suffering,  but 
because  daily  there  occurs  a  transference  of  diseases  from 
the  inevitable  list  to  the  zymotic  side. 

*  In  1780  vaccmation  was  not  generally  received,  it  had  been  foreshadowed 
by  Edward  Jenner  abont  three  yeara. 


186  Zymoties, 

A  political  parallel  may  aid  our  conception  of  what  is 
taking  place. 

If  we  imagine  all  tlie  countries  of  the  world  to  be  repre- 
sented by  diseases.  The  zymotics  being  under  British 
sway,  and  the  '' ine?itables ''  under  other  sovereignty. 
Now,  suppose  a  daring  and  determined  statesman,  of 
marked  imperialistic  prodiTities,  holding  the  reins  of 
government  in  such  a  country* 

From  time  to  time  he  selects  an  appropriate  tract  of  land 
and  taking  it  from  the  inevitables  adds  it  to  the  zymotic 
empire.  Under  such  circumstances,  just  in  proportion  as 
the  preventables  grow  and  increase,  the  non-preventables 
plainly  must  diminish  day  by  day. 

We  have  now  glanced  over  the  diseases  preventable  by 
general  precautions — precautions  which  cover  a  wide  area — 
embracing  such  questions  as  climate,  soil,  occupation, 
habit,  food,  clothing,  cleanliness,  &c.  These  it  Will  take 
generations  of  health-teachers  to  impress  on  mankind 
before  we  see  any  very  marked  result  of  their  praiseworthy 
efforts.  But  there  is  also  a  class  of  specially  preventable 
diseases  depending  on  grave  domestic  sanitary  defects. 
Such  diseases  we  see  daily,  but,  alas  !  we  too  frequently  fail 
to  recognise  and  relegate  them  to  their  true  cause.  These 
are  especially  due  to  the  introduction  into  dwelling  houses  of 
recent  products  of  organic  decomposition.  They  are  intro- 
duced principally  by  two  classes  of  vehicle  :  1st.  By  at- 
mospheric air.     2nd.  By  potable  liquids  and  solid  food. 

From  this  it  is  evident  that  they  must  gain  access  to  the 
system  by  way  of  the  respiratory  apparatus  in  the  one 
case,  by  way  of  the  digestive  organs  in  the  other.  Pro- 
ducing in  the  former  instance  diseases  of  the  nose,  mouth, 
throat,  and  air-passages ;  in  the  latter,  disorders  of  the 
alimentary  canal.  And,  as  a  matter  of  fact,  those  are  jnst 
the  localities  in  the  body  where  sanitarians  look  for  the 
symptoms  of  recent  sewage-poisoning.  In  older  cases, 
where  there  has  been  long-standing  exposure  to  mephitic 
air  or  to  other  methods  of  contamination,  more  deep-seated 
signs  are  seen.  This  will  be  observed  in  the  list  of 
*'  sewage-symptoms "  which  I  shall   presently   give.     The 


by  Dr.  E.  T.  Blake.  187 

list  18  imperfect,  bat  the  subject  is  new  ;  and  though  I  have 
been  aided  in  compiling  it  by  many  health  officers^  I  am 
perfectly  conscious  of  its  imperfections.  However^  it  will, 
I  trust,  prove  at  least  suggestive,  and  every  man's  experi- 
ence will  enable  him  to  add  to  and  tq  take  from  it,  accord- 
ingly as  fresh  facts  come  to  the  surface. 

Symptoms  of  Sewage-Poisoning ; 

Throat  affection ; 

Languor,  loss  of  appetite  and  spirits ; 

Anaemia ;  palpitation  ; 

Feverishness  \  sleeplessness  or  nightmare ; 

Dyspepsia;  nausea; 

Morning  diarrhoea  (erroneously  attributed  to  dentition 
irhen  occurring  in  the  very  young) ; 

Morning  headache  with  malaise ; 

Glandular  disease  proceeding  to  suppuration ; 

Skin  affections,  especially  vesicular  [Trend]  ;  shingles ; 
lierpes  of  mouth  or  tonsils,  prone  to  be  followed  by  tedious 
ulceration;  aphthae. 

Urticaria  [Slade-Kino;  Euwabu  Madden]. 

Eryripelas  after  operation,  especially  after  vaccination. 


Cellulitis    I    Circumscribed,  boils,  &c. 
(^    Diffuse^  at  or  near  onnces. 


Abscesses  of  various  kinds,  facial,  temporal,  axillary, 
inguinal,  pelvic,  more  especially  multiple  infantile  abscess. 

Quinsy  ?  Whooping-cough  f  Croupous  pneumonia  ?  Con- 
vulsions ?  Rheumatism  and  its  allies  ? 

To  differentiate  these  diseases  from  similar  disorders, 
owing  origin  to  causes  not  connected  with  sanitary  condi- 
tion, we  have  certain  tests.     Amongst  them  : 

1st.  The  numerical  test.  By  this  is  meant  that  we  see 
usually  two  or  more  inmates  of  a  house  suffering  in  a 
similar  way. 

2nd.  Obnoxiousness  to  treatment  ordinarily  successful. 

8rd.  Speedy  improvement  on  removing  the  cause  or  the 
patient. 


138  Zymoties, 

4th.  Inexplicable  recarrence  of  symptoms  in  children; 
obstinate  persistency  in  adults. 

Sewer  gas  is  a  compound  of  reiy  varying  composition,^ 
as  we  can  readily  understand  when  we  reflect  on  the 
extremely  complex  characters  of  the  constituents  of  sewaget 
itself.  When  we  think  of  the  products  of  decomposition  of 
this  seething  mass  of  material,  reacting  on  each  other  in  a 

*  OompoHHom  qf  the  airim  sewere. — The  air  in  aewen  Taries  greatlj  in 
oompoeition  with  the  amount  of  gasee  disengaged  and  the  degree  of  ventila* 
tion  in  the  lewer.  It  oontaina  carhonic  acid,  salphnretted  hydrogen, 
ammoninm  solphide*  nitrogen,  oxygen,  light  carhnretted  hydrogen,  ammonia, 
and  certain  fcBtid  vohttile  matters  allied  to  the  compound  ammoniai.  Sul- 
phnretted  hydrogen  has  heen  fonnd  to  the  extent  of  3  per  oent^  carhonic 
acid  16*9  per  cent.,  an^d  light  carbaretted  hydrogen  88'5  per  cent. ;  while  the 
oxygen  has  been  reduced  as  low  as  8  and  tlie  nitrogen  to  6*86  per  cent.,  but 
these  are  extreme  quantities.  In  weU-ventilated  sewers  the  sulphuretted 
hydrogen  has  been  reduced  to  a  mere  trace  and  carbonic  acid  to  0*807  per  cent, 
or  even  less,  whilst  oxygen  may  be  20*71  per  cent.  These  quantities,  how- 
ever, are  extremes  in  the  other  direction.  These  gases  are,  as  a  role,  of  far 
less  importance  than  the/aiid  organie  matter,  to  the  presence  of  which  the 
peculiar  odour  of  sewage  gas  is  doe,  and  the  exact  chemical  composition  of 
which  is  not  thoroughly  known.  Dr.  Odling  believes  it  to  be  carbo-ammo- 
niacaL  It  is  alkaline,  and  rapidly  decolorises  solotioni  of  potassium  perman- 
ganate. Sewer  air  contains  bacteria  and  promotes  the  growth  of  fon^;  meat 
and  milk  soon  taint  when  exposed  to  it. 

To  recapitulate ;  the  air  of  sewers  varies  considerably,  &o.  Its  oxygen  is 
generally  diminished,  and  may  even  be  as  low  as  2  per  cent.  Carbonic  add 
is  increased,  and  may  be  as  high  as  16*9  per  cent.  Sulphuretted  hydrogen  is 
present,  from  a  mere  trace  to  8  per  cent.  Carburetted  hydrogen,  ammonia, 
and  ammonium  sulphide  may  also  be  present;  but  certain  peculiar  volatile, 
foetid  organic  matters  are  also  pi'esent,  and  give  the  sewer  gas  its  peculiar 
odour,  &c. 

t  Sewage  consists  principally  of-~ 

Water. 

£xcrement> 

Urine. 

Paper. 

Bags. 

Kitchen  wa^,  cabbage-deansings. 

Wash-house  water,  soap,  soda. 

Stable  and  cow-house  refuse. 

Slaughter-house  blood  and  olEaL 

Factory  chemicals. 
These  elements  vary  greatly,  of  course*  in  different  towns. 


by  Dr.  E.  T.  Blake.  139 

nascent  state,  we  can  form  some  slight  idea  of  the  great 
Yariety  of  organic  gaseous  products  evolved  ! 

Yet  the  effects  of  the  sustained  inhalation  of  sewer  air, 
uncontaminated  by  tpedfic  germSy  are,  in  spite  of  its  un- 
stable nature,  sufficiently  well  marked  and  distinctive. 

1st.  Comes  a  characteristic  disturbance  of  the  sympathetic, 
and  especially  of  those  portions  which  control  digestion^ 
assimilation,  and  haemopoiesis. 

2nd.  The  skin  or  the  mucosa  is  attacked,  a  rash 
appears,  sometimes  papular  (urticaria),  more  frequently 
▼esicular.  Of  this  nature  are  the  ulcers  of  the  mouth  and 
tonsils,  attributed  to  such  widely  di£Pering  causes,  they  are 
usually  broken-down  vesicles.  At  times  the  affection  takes 
the  form  of  inflammation  of  the  skin  (erysipelas),  which 
may  be  associated  with  cellulitis  and  then  proceed  to 
abscess. 

8rd.  The  respiratory  system  may  suffer  when  we  get 
either  pseudo-croup  or  croupous  pneumonia. 

4th.  The  stress  in  certain  constitutions  falls  on  the 
musculo-articnlar  system,  inducing  various  rheumatoid 
conditions. 

We  have  considered  in  turn  a  great  group  of  preventable 
diseases,  depending  on  causes  lying  for  the  most  part  outside 
our  dwellings,  and  a  smaller  group  of  disorders  which  owe 
origin  to  ignorance  or  systematic  defiance  of  natural  laws, 
having  their  bearing  inside  or  in  near  connection  with  the 
houses  in  which  we  spend  at  least  a  third  part  of  each  day. 
It  is  plain  that  upon  the  condition  of  these  houses  not  only 
must  our  own  health  and  happiness  in  great  measure  depend, 
but  the  well-being  of  those,  also,  who  are  dearer  far  to  us  than 
our  own  lives.  But  after  all,  even  that  is  the  selfish  side  of 
the  question ;  there  is  another  aspect  of  the  affair,  altogether 
outside  ourselves  and  our  belongings.  I  know  that  I  shall 
find  a  ready  response  in  the  breast  of  every  member  of  the 
most  dignified,  because  the  most  disinterested,  of  professions, 
ivhen  I  assert  that  it  is  the  solemn  duty  of  us  doctors  to 
press  these  truths  home  on  the  laity  in  every  possible  way 
and  on  every  possible  occasion. 


140 


ON  PYREXIN  OR  PYROGEN  AS  A  THERA- 

PEUTIC  AGENT. 

Bj  De.  Detbdalx. 

In  studying  the  experimental  erideooe  bearing  on  the 
germ  theories  of  disease,  I  was  greatly  stmek  by  a  remark 
made  by  Dr.  Bardon  Sanderson  in  the  Brituh  MeiUeal 
Jtmmal  of  13th  Febraary,  1875.  It  was  as  follows  :  *'  Let 
me  draw  your  attention  to  the  remarkable  fact  that  no 
therapentieal  agent,  no  synthetical  product  of  the  labora- 
tory, no  poison,  no  drug  is  known  which  possesses  the 
property  of  producing  fever.  The  only  liquids  which  hare 
this  endowment  are  liquids  which  either  contain  Bacteria, 
or  have  a  marked  proneness  to  their  productiim.''  This 
last  clause  is  qualified  by  the  statements  elsewhere,  and 
from  other  sources,  that  the  feyer-producing  agent  is  a 
chemical  non-living  substance  formed  by  living  Bacteria, 
but  acting  independently  of  any  further  influence  from 
them,  and  formed  not  only  by  Bacteria  but  also  by  living 
pus-corpuscles,  or  the  liring  blood-  or  tissue-protoplasm 
from  which  these  corpuscles  spring.  This  substance  when 
produced  by  Bacteria  is  the  Sejmin  of  Panum  and  others., 
but  in  view  of  its  origin  aho  from  pus,  and  of  its  fever- 
producing  power,  Dr.  B.  Sanderson  names  it  Pyro^wn.  If, 
however,  it  is  to  be  also  used  therapeutically,  I  suggest  the 
more  neutral  name  of  Pyrewin.  I  cannot  admit  without 
qualification  the  statement  that  no  drug  or  poison  can 
produce  fever,  for  undoubtedly  Aconite^  Befladofma,  Araenie, 
Quinine,  Big^tiria,  GeUemiwum^  and  a  host  of  other  drugs 
do  produce  more  or  less  of  the  febrile  state  among  other 
efl^ects.  But  they  produce  it  only  after  repeated  doses  and 
contingently  on  the  predisposition  of  the  subject  of  experi- 
ment, and  thus  uncertainly  as  regards  any  individual  case 
or  dose ;  or  they  produce  it  as  a  part  of  a  variety  of  complex 
local  and  general  morbid  states,  of  which  it  may  be  a 
secondary  phenomenon.     It    is    therefore  practically  true 


On  Pyrexin  or  Pyrogen  as  a  Therapeutic  Agent.     141 

that  no  other  kaown  substance  induces  idiopathic  pyrexia 
certainly^  directly,  and  at  will  after  a  given  dose.  This 
directness  and  certainty  of  action  ought  to  make  it  a 
remedy  of  the  highest  value  if  it  ever  can  be  used  thera- 
peutically ;  and  if  the  law  of  similars  is  applicable  here  as 
it  is  in  so  many  other  instances,  we  ought  to  find  it  curative 
in  certain  states  of  pyrexia  and  certain  blood-disorders  to 
which  its  action  corresponds  pathologically.  In  order  to 
put  this  suggestion  to  the  test  practically,  let  us  first 
shortly  sum  up  the  symptoms  and  pathological  changes 
caused  by  Seprin  or  Pyrogen  freed  from  all  bacterial,  self- 
reproductive,  or  transmissible  cause  of  disease.  In  a  series 
of  experiments  by  Dr.  B.  Sanderson  on  dogs  after  a  non- 
fatal dose  of  Pyrogen  (i,e.  1^  cubic  centimetre  of  the 
aqueous  solution  per  kilogram  of  body  weight,  or  ^  grain 
of  the  solid  extract  for  an  ordinary  sized  dog),  the  animal 
shivers  and  begins  to  move  about  restlessly ;  the  tempera- 
ture rises  from  Z^  to  8^  C,  the  maximum  being  reached  at 
the  end  of  the  third  hour.  There  is  great  muscular 
debility ;  thirst  and  vomiting  come  on,  followed  by  feculent 
and  thin  mucous,  and  finally  sanguinolent,  diarrhoea  and 
tenesmus*  These  symptoms  begin  to  subside  in  four  or 
five  hours,  and  the  animal  recovers  its  normal  appetite  and 
liveliness  with  wonderful  rapidity,  I  mention  this  fact  as 
proving  that  the  septic  poison  has  not  the  slightest  tendency 
to  multiply  in  the  organism,  and  secondly,  as  rendering  it 
extremely  probable  that  when  death  occurs  it  is  determined 
not  so  much  by  alrine  disorders,  which  are  so  prominent,  as 
by  the  loss  of  power  of  the  voluntary  muscles  and  of  the 
heart.*  Another  proof  that  death  when  it  occurs  is  from 
failure  of  the  circulation  is,  that  in  non-fatal  cases  with 
well-marked  gastro-enteric  symptoms^  the  temperature  rises 
gradually  during  the  first  four  hours,  and  as  gradually 
subsides ;  whereas  in  fatal  cases  it  rises  rapidly  to  104°  F., 
and  then  declines  rapidly  to  below  the  normal  before  death, 
thus  indicating  failure  of  the  heart*  In  fatal  cases  from 
larger  doses,  the  above  symptoms  increase  to  intestinal 
h»morrhage,  purging,  collapse,  and  death.     Postmortem.^^ 

•  Brii.  Med,  Jimm,,  u,  1877,  p.  918. 


142     On  Pyrexin  or  Pyrogen  a$  a  Therapeutic  Agent* 

There  is  found  extravaMition  of  blood  in  patches  underneath 
the  endocardium  of  the  left  ventricle,  sometimes  on  the 
papillary  muscles^  sometimes  on  or  in  the  neighbourhood 
of  the  valvular  curtains.  Similar  though  less  marked 
appearances  are  seen  in  the  right  ventricle.  There  are 
similar  points  of  ecchymosis  on  the  pleura  and  pericardium. 
The  spleen  is  enlarged  and  full  of  blood.  The  mucous 
membrane  of  the  stomach  and  small  intestine  is  intensely 
injected  with  detachment  of  the  epithelium,  and  exudation 
of  sanguinolent  fluid  distends  the  lumen  of  the  gut.  These 
appearances  indicate  a  general  tendency  to  congestion  and 
capillary  hsemorrhage,  as  well  as  locally,  congestion  and 
capillary  stasis  of  the  gastro-intestinal  mucous  membrane, 
with  shedding  of  the  epithelium,  as  the  nature  of  the 
disorder.  The  state  of  the  blood  plays  a  great  part  in  the 
morbid  process ;  it  is  darker  in  hue,  and  the  corpuscles 
arrange  themselves  in  clumps  instead  of  rolls  ;  many  of  the 
blood-corpuscles  are  partially  dissolved  in  the  liquor  ean» 
gmnii,  communicating  to  it  a  red  colour :  a  large  quantity 
of  the  haemoglobin  is  lost  by  evacuation  of  the  bowels,  and 
conversion  into  bilirubin ;  the  partial  disintegration  of  the 
white  corpuscles,  by  liberating  the  fibrino-plastic  ferment,  is 
supposed  to  be  one  cause  of  the  capillary  stasis. 

The  symptomatic  and  pathological  effects  are  substantially 
the  same  in  man,  and,  indeed,  the  analogy  between  the 
symptoms  and  morbid  appearance  and  state  of  the  blood  in 
septicaemia  after  wounds  and  the  experimental  poisoning 
with  Sepsin  is  very  close. 

Now,  granting  that  the  powerful  agent  producing  these 
remarkable  effects  may  be  expected  to  act  therapeutically 
as  an  alterative  in  morbid  states  which  present  the  patho- 
logical simile  to  them,  what  are  these  morbid  states,  and 
how  are  they  to  be  recognised  in  the  complex  phenomena 
of  fever  in  the  human  subject  ?  To  answer  this  we  must 
enquire  what  is  the  cardinal  point  in  the  proximate  cause 
of  pyrexia  with  which  we  have  to  deal  in  employing  a 
directly  acting  remedy?  To  this  question — at  least  as 
regards  the  chief  phenomenon  which  determines  the  name 
pyrexia,  viz.  the  increased  heat— the  critical  review  of  the 


by  Dr.  Drysdale.  143 

experiments  of  Senator^  Leyden^  and  others  by  B.  Sander- 
son,* gives  a  reply. 

The  temperature  of  the  body  being  dependent  on  the 
production  and  discharge  of  heat,  of  which  the  former  is  a 
function  of  living  protoplasm,  the  latter  a  function  of  the 
organs  of  circulation,  respiration,  and  secretion,  the  ques- 
tion arises  whether  pyrexial  increase  of  temperature  depends 
upon  the  former  or  the  latter.  To  this  Dr.  B.  Sanderson 
thus  replies  (p.  45) : — **  Two  possibilities  are  open  to  us. 
One  is,  that  fever  originates  in  disorder  of  the  nervous 
centres,  that  by  means  of  the  influence  of  the  nervous 
system  on  the  systemic  functions,  the  liberation  of  heat  at 
the  surface  of  the  body  is  controlled  or  restrained,  so  that 
'  by  retention '  the  temperature  rises,  and,  finally,  that  the 
increased  temperature  so  produced  acts  on  the  living  sub- 
stance of  the  body,  so  as  to  disorder  its  nutrition.  The 
other  alternative  is  that  fever  originates  in  the  living 
tissues,  that  it  is  from  first  to  last  a  disorder  of  the  proto- 
plasm, and  that  all  the  systemic  disturbances  are  secondary. 
The  facts  and  considerations  we  have  had  before  us  are,  I 
think,  sufficient  to  justify  the  definitive  rejection  of  the  first 
hypothesis  in  all  its  forms ;  for,  on  the  one  hand,  we  have 
seen  that  no  disorder  of  the  systemic  functions,  or  of  the 
nervous  centres  which  preside  over  them,  is  capable  of 
inducing  a  state  which  can  be  identified  with  febrile 
pyrexia;  and,  on  the  other,  that  it  is  possible  for  such  a 
state  to  originate  and  persist  in  the  organism  after  the 
influence  of  the  central  nervous  system  has  been  withdrawn 
from  the  tissues  by  the  severance  of  the  spinal  cord.  We  are, 
therefore,  at  liberty  to  adopt  the  tissue-origin  of  fever  as  the 
basis  on  which  we  hope  eventually  to  construct  an  explanation 
of  the  process.^'  It  is  elsewhere  concluded  that  it  is  in  the 
protoplasm  of  the  blood  and  the  muscles  that  take  place 
those  changes  of  activity  and  disintegration  on  which 
depend  the  changes  of  temperature,  and  no  doubt  the 
other  essential  phenomena  which  characterise  fever. 

What,  therefore^  on  these  data,  are  we  to  expect  from 
an  agent  which  ishall  act  directly  as  curative  of  the  pyrexial 

•  See  Blue  Book,  1876,  No.  1,  Appendix. 


144     On  Pyrexin  or  Pyrogen  a$  a  Therapeutic  Agent. 

state?      Not   certainly  any   palpable   diaturbanoe  of  the 
nervous  system  which  can  iu  health  lower  temperature  by 
promoting  heat  discharge  as  is  expected  from  large  doses  of 
Quimne,  or  from  the  merely  physical  action  of  cold  baths ; 
nor  a  general  support  of  the  vital  powers  till  the  specific 
disease  runs  its  course^  as  is  expected  from  alcohol^  &c. 
But,  on  the  contrary,  a  simple  modification  of  the  exalted 
and  perverted  protoplasmic  action  in  which  the  proximate 
cause  of  pyrexia  consists,  which  shall  be  of  such  a  nature 
as  to  bring  it  back  to  health.     Let  us  assume  (without  any 
attempt  to  prove  it,  but  merely  to  give  an  intelligible  illus- 
tration in  explanation)  the  hypothesis  of  Beale,  that  the 
essence  of  inflammation  and  fever  consists  in  a  degenera- 
tion in  the  scale  of  biological  development  of  the  bioplasts 
of  the  blood  and  tissues,  which  involves  the  production  of 
a  more  rapidly  growing  and  disintegrating  kind  of  proto- 
plasm; our  most  complete  and   perfect  conception   of  a 
direct  remedy  would  be  that  of  an  agent  which  would  act 
as  a  specific  stimulus  to  the  affected  protoplasm,  and  bring 
back  its  germinal  development  up  to  the  normal  plane.     This 
has  long  been  my  view  of  the  action  of  Aconite  in  inflam- 
matory fever,  or,  at  least,  that  it  acted  directly  on  the 
pyrexically  affected  protoplasm,  and  not  on  the  vaso-motor 
nerves  or  centres  of  the  heart,  or  of  the  spinal  marrow ; 
for  reiterated  experience  has  shown  that  it  acts  in  far  too 
small  a  dose  to  exert  any  directly  depressant  effect  on  the 
heart  or  its  nerves,  or,  indeed,  any  perceptible  effect  on 
them  at  all.     Now,  the  living    matter  or  protoplasm  is 
capable  of  an  almost  infinite  variety  of  kinds  of  morbid 
action   according  to  the  predisposing  and  exciting  causes 
acting  on  it,  and  hence  pyrexia  may  vary  indefinitely  in  its 
character,  even  independently  of  the  addition  of  the  local 
lesion  proper  to  the  concrete  specific  fevors ;  so  no  directly 
curative  remedy  can  be  applicable  to  more  than  a  few 
forms  or  even  to  only  one,  e,g.  Aconite  suits  inflammatory 
fevers,  and  Quinine  malarious  intermittents,  while  they  would 
be  powerless  if  interchauged.     To  what  form  then  should 
vre  expect  Pyrexin  or  Pyrogen  to  be  applicable  ?     The  trae 
clue  to  this  is  given,  I  think,  by  the  state  of  the  blood,  for 


by  Dr,  Drysdale.  145 

that  is  the  most  marked  and  important  of  the  signs  of 
septicaemia;  the  local  congestions  and  extravasations  not 
being  so  constant  or  so  grave  as  respects  the  issue.     If 
ire  contrast  the  characteristic  hyperinotic  state  of  the  blood 
in  inflammatory  fever^  displaying  its   bright  colour^  buffy 
coat,  firm  coagulum,  and   the  adherence  of  the  red   cor- 
puscles in  rolls,  with  the  septicaemic  state  of  blood  already 
described^  showing  its  dark  and  dissolved  state^  loose  coagu- 
Inm,  the  red  corpuscles  adhering  in  clumps^  and  the  in- 
crease of  white  corpuscles,  we  shall  see  well-marked  grounds 
of  distinction.     This  latter  state  of  the  blood  is  very  similar 
to,  if  not  identical  with,  that  which  belongs  to  typhous  or 
adynamic  fevers,  and,  indeed,  in  describing  fatal  cases  of 
septicemia  after  wounds  the  analogy  of  the  symptoms  is  so 
great  with  these  fevers  that  the  word  ^*  typhous  '*  is  gene- 
rally used  in  describing  them.     Hence  the  shortest  discrimi- 
nation of  the  indications  for  the  use  of  Pyrexin  or  Pyrogen 
may  be  stated  to  be  the  typhous  or  typhoid  character  or 
quality  of  pyrexia,  using    these    adjectives   in    their  old- 
fashioned  sense.     For  although  the  clinical  discrimination 
of  enteric  fever  from  typhus  is  a  great  gain,  it  is  unfor- 
tunate that  the  word  "  typhoid  ^'  should  have  been  appro- 
priated to  the  former,  as  it  either  introduces  confusion  into 
our  nomenclature  or  deprives  us  of  a  hitherto  well-under- 
stood expression  of  the  character  of  pyrexia  as  distinct  from 
the  name  of  a  specific  disease.     We  shall  find  it  convenient 
to  go  back  to  the  terms  of  Cullen,  viz.  synocha,  for  inflam- 
matory fever,  the  typhous  or  typhoid  condition  for  the  low 
adynamic  or  asthenic  character  or  quality   of  fever,  and 
synochus  for  the  mixed  kind,  which  is  inflammatory  at  the 
beginning  and  typhous  at  the  end.     I  do  not  know  that  the 
more  accurate  discrimination  of  the  typhus,  enteric,  and 
relapsing  fevers  into  distinct  specific  diseases  gives  any 
ground  for  denying  the  existence  of  the  above  distinctions 
of  character  in  the  pyrexial  state  in  general,  and,  therefore, 
we   should   still   keep  up   the  words   inflammatory,    and 
typhous  or  typhoid,  as  expressive  of  different  qualities  or 
characters  of  fever,  and  not  of  distinct  febrile  diseases. 
As  Acofdie  is  well  known  to  be  the  most  important  of 

VOL.  XXXVIII,  NO.  CLII.— APRIL,   1880.  K 


146     On  Pyrexin  or  Pyrogen  a$  a  Therapeutic  Agent. 

the  remedies  for  the  synochal  or  inflammatory  pyrexia^  so 
the  most  summary  indication  for  Pyrogen  would  be  to  term 
it  the  Aconite  of  the  typhous  or  typhoid  quality  of  pyrexia. 
This  being  a  condition  and  not  a  distinct  disease,  it  is  to 
be  looked  for  as  occurring  in  a  variety  of  diseases  such  as 
the  typhus  and  enteric  fevers  themselves  always^  and  more 
or  less  it  may  occur  in  intermittents,  so-called  bilious 
remittents,  in  certain  varieties  or  stages  of  the  exanthemata, 
especially  scarlatina,  measles,  and  smallpox,  of  dysentery, 
and  of  epidemic  pneumonias,  diphtheria,  &c.  From  the 
gastro-enteric  symptoms  Pyrogen  may  possibly  also  apply 
to  some  stage  of  cholera,  and  to  yellow  fever.  It  is,  of 
course,  to  be  distinctly  understood  that  this  substance  is 
only  recommended  at  certain  stages  and  phases  of  these  dis- 
eases, and  entirely  as  a  remedy  of  a  secondary  or  subordinate 
character,  and  not  in  any  sense  as  a  epecifie  for  the  whole 
disease. 

Seprin  or  Pyrogen,  it  must  be  remembered,  is  only  a 
chemical  poison,  like  Atrqpin  or  serpent  venom,  whose 
action  is  definite  and  limited  by  the  dose,  and  it  is  in- 
capable of  inducing  an  indefinitely  reproducible  disease  in 
minimal  dose,  after  the  manner  of  the  special  poisons  of 
the  specific  fevers;  its  sphere,  therefore,  is  by  no  means 
commensurate  with  that  ol  these  diseases,  and  if  ever  true 
specifics  for  them  should  be  discovered  it  is  hardly  probable 
that  such  would  be  merely  chemical  non-living  agents.  At 
present  there  is  no  question  at  all  of  such  specifics.  The 
only  point  is  that  we  should  be  able  to  form  an  intelligible 
idea  of  the  way  in  which  a  margin  can  be  supposed  to  exist 
in  individual  cases,  say  of  enteric  fever,  smallpox,  or  yellow 
fever,  &c.,  in  which  a  directly  acting  medicine  can  do  good 
to  the  pyrexia  without  at  the  same  time  having  any  power 
to  check,  modify,  or  shorten  the  true  specific  disease. 
Observation,  I  think,  shows  that  such  li  margin  exists,  for 
we  are  all  familiar  with  the  immense  variety  in  the  d^ree 
of  severity,  especially  as  regards  the  pyrexia  existing 
between  cases  of  the  same  specific  fever  in  difierent  indivi- 
duals, while  at  the  same  time  the  cardinal  symptoms  are 
pronounced  sufficiently  to  leave  no  doubt  of  the  diagnosLs, 


by  Dr.  Drysdale.  147 

and  the  completeness  of  the  specific  process  is  also  shown 
fay  the  protection  against  subsequent  attacks  being  as  com- 
plete after  the  slight  cases  as  after  the  more  severe.  In 
scarlatina  and  smallpox  both  these  circumstances  are 
notorious^  and  the  astonishing  mildness  of  the  pyrexia  in 
some  case  of  enteric  fever^  in  which  the  local  diseased  pro- 
cess rnns  its  full  course,  is  well  known. 

When  we  take  these  facts  in  connection  with  the  theory 
of  Beale  that  not  all — ^nay,  not  even  the  majority— of  the 
new  bioplasts^  whose  formation  and  continued  multiplication 
constitutes  the  essence  of  fever  and  inflammation^  are,  in  a 
spedfic  contagious  disease,  themselves  specific^  and  capable 
of  conveying  the  disease,  we  can  easily  see  that  there  may 
be  in  each  specific  fever  a  large  margin  of  non-specific 
febrile  action  or  protoplasmic  change.  It  may  be,  and 
probably  is,  this  which  gives  the  severity  and  fatality  to 
certain  cases  by  its  excessive  amount  rather  than  the 
greater  intensity  of  the  specific  process^  owing  to  increased 
susceptibilities  of  the  patient  towards  the  specific  poison, 
although  no  doubt  that  is  also  a  factor  of  importance  in  the 
▼ariations  of  severity  in  different  individuals.  At  all  events, 
we  easily  see  from  the  above  considerations  the  reasonable- 
ness of  the  expectation  that  any  remedy  which  could  mode- 
rate and  control  the  concomitant  non-specific  pyrexia  in 
the  specific  fevers  would  thereby  palpably  diminish  the 
average  mortality,  even  though  it  could  not  cut  short  the 
specific  disease  itself.  Whether  Pyrogen  be  such  a  remedy 
remains  to  be  seen ;  at  present  we  have  only  to  show  that 
a  plaee  is  open  for  a  possible  agent  of  this  kind.  Our 
expectations,  also,  must  not  be  pitched  too  high,  becausOj 
for  innumerable  reasons,  as  we  all  know,  a  considerable 
mortality  must  attend  all  the  severe  specific  fevers,  and  the 
margin  wherein  positive  curative  treatment  adds  to  the 
value  of  good  negative  treatment  is  not  large.  Besides, 
from  the  very  character  oi  the  symptoms  and  stage  of  the 
disease  for  which  this  remedy  is  indicated^  it  must  often 
be  in  the  position  of  a  forlorn  hope.  Therefore,  it  is  only 
by  the  statistical  comparison  of  a  large  number  of  cases 
that  we  can  determine  how  far  lives  have  been  saved  by  it. 


148     On  Pyrexia  or  Pyrogen  as  a  Therapeutic  Agent, 

The  known  specific  fevers  do  not  by  any  means  exhaust 
the  possible  sphere  of  a  remedy  for  the  **  typhous ''  condi- 
tion of  pyrexia ;  for,  although  it  is  no  longer  the  fashion  to 
speak  of  the  synochus  of  Cullen,  yet,  as  far  as  my  experience 
goes  (and  I  doubt  not  other  practitioners  will  agree  with 
me),  the  list  of  species  or  Tarieties  of  continued  fever  in  this 
country  is  by  no  means  exhausted  when  we  name  the 
inflammatory,  rheumatic,  typhus,  enteric  and  relapsing. 
On  the  contrary,  we  all  meet  with  cases  of  feyer  which 
cannot  be  distinctly  referred  to  local  lesion,  and  cannot  be 
fairly  brought  under  any  of  the  above  names,  and  for  want 
of  a  more  definite  appellation  we  have  to  speak  of  as 
catarrhal,  gastric,  or  bilious  fever;  or  describe  in  some 
such  vague  way.  Many  of  these  are  synochal,  and  require 
Aconite  at  the  outset,  while  in  the  later  stages  a  more  ady- 
namic state  sets  in,  supposed  to  require  stimulants,  thus 
corresponding  to  the  synochus  of  Cullen.  In  the  specific 
fevers  also,  there  may  occur  more  or  less  of  this  primary  and 
secondary  quality  of  the  pyrexia  requiring  Aconite  at  the 
first  stage  and  (should  our  anticipation  prove  correct) 
Pyrogen  at  the  later  stages.  Doubtless  Cullen,  his  contem- 
poraries, and  for  long  his  successors,  described  and  treated  as 
synochus  many  cases  of  continued  fever,  which  were, 
in  reality,  enteric,  or  even  relapsing,  before  Henderson 
separated  the  latter,  or  Jenner  the  former,  from  the  general 
mass  of  continued  fevers ;  and,  no  doubt,  we  are  all  doing 
the  same  in  respect  to  other  species  to  be  discriminated  in 
future.  But  this  is  of  less  consequence  as  regards  medi- 
cinal treatment  as  long  as  we  are  guided  by  indications  for 
a  particular  quality  of  pyrexia,  and  not  the  concrete  disease 
in  which  that  may  occur.  If  the  discrimination  of  enteric 
fever  as  a  species  may  be  correctly  held  to  explain  away 
synochus  in  part,  yet  can  we  admit  that  the  supervention 
of  bacterial  growth  at  the  later  stage  will  account  for  all 
the  rest  ?  Certainly,  in  that  case,  the  sepsin  of  the  Bacteria 
would  produce  a  state  of  blood  analogous  to  the ''  typhous  ** 
state,  and  if  itself  the  cause  would  of  course  exclude  our 
remedy.  But  although  a  certain  growth  of  micrococci  does 
take  place  in  some  cases,  and  is  the  cause  of  complications 


by  Dr.  Drysdale.  149 

{e.  g.  ulcerative  endocarditis  in  smallpox),  yet  there  is  cer- 
«  tainlj  no'  proof  and^  I  think,  very  little  probability^  that  snch 
is  general  and  sufficient  to  account  for  the  phenomena, 
which  in  the  meantime  must^  therefore^  be  referred  to  a 
quality  of  the  disease. 

In  septicaemia,  metastatic  pyaemia,  and  puerperal  fever^itis 
more  difficult  to  see  any  possible  opening  for  a  remedy  of  this 
kind.  As  long  as  not  only  sepsin^  but  bacteria^  micrococci, 
and  their  germs  are  being  poured  into  the  system  from  the 
focus  of  infection  we  can  naturally  expect  nothing  good 
from  it ;  but  after  the  focus  is  removed  or  neutralised  by 
antiseptics  it  may  become  a  question  whether  the  artifi- 
cially prepared  Pyrogen  from  a  different  source  may  not 
be  curative  in  the  still  remaining  fever  and  blood  disorder. 
Likewise^  whether  it  may  not  be  a  preventive  of  traumatic 
pysemia  and  septicaemia  if  given  when  the  system  is 
verging  on  that  loss  of  vital  resistance  which  allows 
the  development  of  these  diseases.  The  above  objection 
applies  more  particularly  to  auto-infective  puerperal 
septicaemia,  or  that  form  which  is  apparently  sponta- 
neous^ t.  e.  not  arising  from  inoculation  of  specific  infective 
poison  such  as  that  of  erysipelas^  of  scarlatina,  or  of 
another  case  of  puerperal  fever  itself.  But  in  the  latter 
case  if,  at  an  early  stage,  this  remedy  can  control  the 
degree  of  pyrexia,  and  thus  hinder  the  loss  of  vital  resist- 
ance which  allows  the  development  of  metastatic  pyaemia  and 
septicaemia,  it  may  be  of  vital  importance  and  sensibly 
diminish  the  average  mortality  of  that,  at  present,  almost 
hopeless  disease.  For,  as  elsewhere*  said,  I  look  upon  the 
theory  which  attributes  the  specific  infective  poisons  to  par- 
tial bions  or  portions  of  diseased  protoplasm  thrown  off  by 
the  patient  (Beale),  to  be  true  rather  than  that  of  specific 
pathogenic  bacterial  parasites.  Disease  having  thus  begun 
in  a  subject  who  may  be  regarded  as  having  a  deep-seated 
wound,  vital  resistance  is  lowered  and  the  ubiquitous  putrefac- 
tive bacteria  grow  and  multiply  locally,  pass  ioto  the  system, 
and  add  the  fatal  complications  of  pyaemia  and  septicaemia. 

The  theory  of  the  engraftment  of  bacterial  septicaemia 

*  2*Atf  Oerm  Theories  of  Infeetunu  DUeaset,    London :  Baillidre, 


150     On  Pyrexin  or  Pyrogen  a$  n  Therapeutic  Agent. 

and  pysemia  as  a  aubordinate  pbenomenoB  upon  other  dia-  ^ 
eaaea,  witboat  die  inoculation  of  a  necesaarily  specific  kind 
of  Bacteria  may  be  shortly  stated  as  follows.  Tbe  viable 
germs  of  a  Tariety  of  kinds  ot  Bacteria  and  mierococci 
existing  constantly  in  all  ordinary  air  and  water^  and 
articles  of  food  and  drink,  eyen  in  some  after  cookings  we 
are  constantly  receiving  them  into  tbe  alimentary  canals 
air  passages,  and  any  open  wound.  But  just  as  constantly 
in  tbe  healthy  state  does  the  living  matter  consume  them 
and  prevent  their  development,  sudi  powers  being  summed 
up  in  tbe  term  vital  resistance.  Many  states  of  disease, 
however,  especially  traumatic  and  other  states  of  pyrexia 
and  local  stagnation  of  the  circulation,  so  far  lower  vital 
resistance,  that  the  accidental  Bacteria  germs  may  grow 
and  multiply,  and  thus  add  their  characteristic  noxious  ^beta 
to  the  former  disease.  Many  of  tbe  products  of  bacterial 
putrefaction,  especially  those  comprised  under  the  term 
Sepsin,  have  a  powerfully  poisonous  influence  in  lowering 
and  paralysing  vital  resistance,  and  thus  a  small  quantity  of 
complete  putrilage,  containing  both  living  Bacteria  and  septic 
products,  is  able  to  form  a  focus  from  which  septic  growths 
and  products  can  spread  and  infect  the  wh(de  system  fatally. 
But  if  the  same  amount  of  Bacteria  alone  is  carefully  wadied 
from  adhering  Seprin,  no  evil  follows,  for  the  vital  resistance 
at  the  spot  destroys  the  Bacteria  speedily.  This  was 
proved  by  Hiller,  who  injected  into  his  own  arm  a  whole 
Pravaz  syringeful  of  fluid  swarming  with  living  but  care- 
fully-washed Bacteria,  and  no  effect  was  produced  but  a 
transitory  redness  of  the  part.  If,  therefore,  Sq^sin  should 
prove  a  remedy  for  any  of  the  forms  of  pyrexia,  especially 
the  traumatic,  which  lower  vital  resistance,  to  that  extent 
we  may  expect  it  to  be  a  preventive  of  those  forms  of 
pyemia,  septicsemia,  and  so-called  blood  poisoning,  which 
depend  on  the  development  of  accidentally  introduced  germs 
of  Bacteria  and  micrococci. 

In  chronic  disease  there  may  also  be  an  opening  for  a  sub- 
stance like  this,  acting  so  powerfully  on  the  blood.  Here 
we  may  name  leucocy  thsemia,  and  possibly  pernicious  ansemia. 

It  may  be  said  that  the  analogy  is  not  great  between  the 


by  Dr.  Drysdale.  151 

action  of  Pyrogen  and  leucocythasmia ;  bnt  this  may  be 
merely  that  we  see  usually  an  early  stage  of  that  disease, 
whereas  the  final  stage  may  complete  the  resemblance.  I 
had  the  opportunity  of  following  to  its  dose  a  case  of  leuoocy- 
tbsemia  with  enlarged  spleen,  in  which  the  number  of  the 
white^corpuscles  almost  equalled  that  of  the  red.  For  many 
months  little  alteration  of  the  health  was  apparent,  except 
muscular  debility  and  liability  to  digestive  derangements. 
The  patient,  had,  however,  bled  over  much  when  a  tooth 
was  extracted,  and  also  was  subject  to  occasional  bleeding 
of  the  nose,  and  once  had  hsematemesis.  Then,  after  cold  or 
a  trifling  indigestion,  there  came  on  vomiting  and  purging, 
prostration,  fever,  delirium,  and  death,  in  about  a  week,-— 
the  course  of  the  disease  resembling  typhus  without  any 
diagnostic  mark  of  that  disease.  A  day  or  two  before 
death  there  was  large  extravasation  of  blood  under  the  skin 
of  a  large  surface  of  the  trunk,  a  portion  of  which,  drawn 
off  by  the  aspirator  during  life,  showed  a  tarry  colour  and 
consistence,  and  the  same  large  proportion  of  white  corpus- 
cles, but  no  Bacteria.  There  was  also  complete  deafness 
for  a  week,  and  nearly  complete  blindness  for  the  last 
three  days,  thus  reminding  us  of  the  retinal  haemorrhage  in 
aepticsemia.  After  death  the  only  appearance  of  importance 
was  the  enlargement  of  the  spleen.  In  this  case.  Phos- 
phorus^ Arsenic,  and  a  variety  of  medicines  failed. 

A  case  of  leucocythsemia  is  reported  by  Dr.  Gowers,*  in 
which  retinal  haemorrhage  is  described  and  figured.  Epis- 
taxis  is  also  mentioned  as  occurring  frequently,  but  the 
termination  is  not  given.  This  disease  would  seem  to  be 
analogous  to  a  long  drawn  out  first  stage  of  Sepsin  poisoning, 
therefore,  since  other  remedies  fail  I  would  be  inclined  to 
try  the  one  under  consideration. 

Such  is  an  a  priori  outline  of  the  possible  sphere  of 
action  therapeutically  of  this  powerful  pyrogenic  agent.  It 
is,  however,  only  an  outline,  as  the  characteristic  alterations 
of  the  blood  especially  are  too  meagre  and  general  to 
enable  us  to  fill  up  the  picture  and  give  exact  indications. 
TVbat  the  exact  state  of  the  blood  which  characterises  this 

*  Medieal  Ophthalmotcopif,  p.  812. 


152     On  Pyrexin  cr  Pyrogen  tu  a  Therapeutic  Agent. 

typhous  Btate  is^  is  not  yet  made  oat^  and  it  would  appear 
from  the  obserrations  of  Andral  and  Oavarret,  and  more 
recently  of  Baxter  and  ^illcocks,  that  the  blood-oorpnsclea 
are  less  affected  in  number  and  richness  in  haemoglobin 
than  might  ha^e  been  expected  in  many  cases  of  scarlet 
fever,  measles,  typhus,  and  typhoid ;  while,  on  the  other 
hand,  the  decrease  of  the  red  corpuscles  both  in  number 
and  richness  is  most  marked  and  rapid  in  paludal 
miasmatic  fevers.  The  indications  for  pyrexin  here  given 
are  entirely  h  priori  ^  as  the  foregoing  was  all  written 
before  a  single  therapeutic  experiment  was  made.  We  must, 
therefore,  expect  that  experience  may  correct  or  fill  up,  or 
contradict  a  large  part  of  the  above  anticipations.  In  order 
to  put  the  matter  to  the  test,  I  prepared  some  of  Panum's 
Sepein  in  the  following  three  different  ways. 

ModeM  of  prepa/raiion  ofSepein. 

1st.  Half  a  pound  of  chopped  lean  beef  was  put  into  one  pint 
of  water  from  the  tap  and  set  to  macerate  on  the  sunny  side  of 
a  wall  in  June,  1879.    As  the  weather  was  unusually  cold  and 
cloudy  no  pellicle  had  formed  in  fourteen  days,  so  it  was  left  a 
week  longer.    The  maceration  fluid  was  then  reddish,  thick,  and 
fetid;  this  was  strained  through  muslin,  then  filtered.     The 
filtration  was  slow  and  difficult.    The  filtered  liquid  was  then 
evaporated  to  dryness  in  a  water-bath  at  boiling  heat.    The  dry 
residue  formed  a  brownish  caky  mass,  which  was  then  rubbed  up 
in  a  glass  mortar  with  two  ounces  of  rectified  spirits  of  wine»  and 
then  allowed  to  digest  two  hours.    This  sprituous  maceration 
was  then  boiled  for  five  minutes,  then  filtered.    The  residue  on 
the  filter  was  then  thoroughly  dried  in  the  warm  chamber,  and 
formed  a  hard  brownish  mass,  weighing  fifty-four  grains.    This 
was  rubbed  up  with  640  minims  of  distilled  water,  allowed  to 
stand  an  hour  and  a  half,  and  then  filtered.    The  clear  amber- 
coloured  liquid  which  passed  through  is  the  watery  extract  or 
solution  of  Sepnn.    To  this  was  added  double  the  volume,  i.e. 
1080  minims,  of  Olyeerine,  and  labelled  '*  Pyrexin "  ^,  forming 
the  standard  solution  of  Sepsin,  of  which  one  minim  corresponds 
to  the  water  extract  of  -^^^th  of  a  grain  of  dry  Sepsin.    The  solu- 
tion is  amber-coloured,  and  remains  perfectly  clear  throughout, 


by  Dr.  Drysdale.  153 

and  without  any  trace  of  mould  fungi  on  the  sur&ce  eight 
months  after  preparation.  On  testing  by  subcutaneous  injection 
in  white  mice  in  quantities  from  one  minim  upwards,  and  with 
simultaneous  control  experiments  with  like  quantities  of  pure 
Olyeerine  diluted  with  one  third  water,  it  was  found  that  one, 
two,  and  three  minims  produced  palpable  effects,  though  not 
fatal,  while  four  minims  were  fatal  in  some  cases,  and  six  minims 
uniformly  so,  the  corresponding  control  experiments  being 
innocuous. 

2nd  Mode.  A  similar  maceration,  after  standing  fourteen  days 
in  July,  1879,  was  strained  through  a  linen  doth,  measured 
twelve  ounces,  of  a  deep  and  clear  solution.  This  was  at  once 
precipitated  with  twelve  ounces  of  strong  spirits  of  wine  (90^, 
mixed  thoroughly  by  stirring,  and  set  aside  to  stand  all  night. 
The  precipitate  was  buff-coloured,  and  very  bulky,  taking  up 
nearly  half  of  the  glass  beaker.  The  supernatant  alcohol  was 
decanted  off  and  the  precipitate  drained  upon  a  filter,  then 
washed  off  into  a  beaker  with  boiling  spirit,  made  up  to  twelve 
ounces,  and  boiled  over  the  lamp  for  five  minutes  with  constant 
stirring.  Filtered  and  washed  with  boiling  spirits.  The  preci- 
pitate was  removed  to  a  clock-glass,  and  kept  in  vacuo  over 
strong  sulphuric  acid  for  thirty-six  hours,  during  which  time  it 
shrivelled  into  a  small  compass,  and  became  blackish.  It  weighed 
forty-two  grains.  Now  treated  with  ten  parts  of  cold  water  for 
an  hour  in  a  mortar,  triturating  constantly.  Then  filtered  and 
washed  twice  over.  The  two  filtrates  and  washings  were  then 
evaporated  in  a  water-bath  to  dryness,  and  weighed  1*6  grain. 
This  was  triturated  in  an  agate  mortar  with  150  minims  of  a 
mixture  of  one  part  of  water  and  two  parts  of  Glycerine.  This 
was  marked  Sepein  or  JPyreain^  100  minims  =  1  grain.  The 
solution  is  not  complete,  and  fiocculent  particles  are  visible.  Of 
ihiB  three  minims  are  fatal  to  mice,  and  it  is  thus,  therefore, 
more  virulent  than  the  former  preparation,  but  from  the  small 
quantity  of  dry  precipitate  got  and  the  large  quantity  of  Alcohol 
consumed  in  the  process  it  is  not  one  to  be  recommended. 

8rd  Mode.  A  similar  maceration  of  the  nineteenth  day,  in  the 
open  air  of  a  cold  September.  The  filtered  maceration  liquid 
(ll'S  ounces)  was  mixed  at  once  with  two  volumes  of  rectified 
spirits  of  wine  and  precipitated.  The  precipitate  was  of  a  dull 
brown  colour,  and  the  solution  containing  it  was  allowed  to  stand 


154     Oil  Pffrejrin  or  Pyrogen  as  a  Therapeutic  Agent 

six  dajiy  then  filtered,  dnined,  and  washed  with  hot  apiritB  of 
wine.  The  precipitate  was  detached  from  the  filter,  dried  in  a 
warm  chamber  at  150°  for  eighteen  hours,  then  ground  Terj 
fine,  and  weighed  8*14  grammes  s  4i8f  grains.  This  was 
macerated  six  hours  over  a  water-hath  with  ten  parts  of  water, 
then  twenty  parts  of  QU/eerine  added,  and  filtered  under  pressure. 
The  fluid  was  Teiy  pale  amher^coloured,  and  keeps  perfectly  like 
the  mode  No.  1.  But  seven  drops  are  not  uniformly  fatal  to 
mice.  It  is,  therefore,  weaker  than  the  first  mode,  and  more 
Jleokol  is  consumed.  The  first  mode  is  preferahle  in  yielding  a 
product  of  sufficient  strength  and  in  tolerahle  quantity,  and 
with  moderate  expense  of  Alcohol.  But  it  has  the  drawhack  that 
the  preliminary  evaporation  is  attended  with  such  a  horrible  smelL 

As  above  said  these  preparations  were  tested  on  mice, 
which  animal  had  been  found  by  Dr.  B.  Koch  to  react  very 
like  the  human  subject  with  the  septic  and  anthrax  poisons. 
The  symptoms  observed  were  as  follows: — ^The  animal 
became  dull  and  languid,  ceased  to  eat;  then  appeared 
restlessness,  the  eyes  dim  and  sunken,  and  bleeding  from 
the  anus ;  then  a  quiet  stupor  till  death.  More  or  less  of 
these  symptoms  were  produced  by  all  the  doses,  from  one 
dose  upwards.  Bleeding  from  the  anus  was  perceived  in  all 
the  fatal  oases,  but  also  in  some  that  recovered. 

The  blood  of  the  animals  thus  killed  was  then  tested  by 
subcutaneous  injection  into  healthy  mice^  which  in  every 
instance  were  unaffiected.  It  was,  therefore,  not  infectious, 
and  we  have  thus  the  security  that  we  are  dealing  with  a 
simple  non-reproducible  chemical  poison,  whose  effects  can 
be  regulated  and  kept  within  perfectly  safe  bounds  by 
simply  limiting  the  dose. 

As  all  doses  below  six  minims  were  insu£Scient  to  kill  a 
mouse,  we  may  take  it  that  from  one  to  five  minims  would  be 
quite  safe  for  subcutaneous  injection  for  man.  How  much 
smaller  might  be  suflScient  for  the  curative  reaction  can 
only  be  determined  by  experience.  As  this  is  an  animal 
poison  like  snake  yenom,  it  may  require  to  be  used  subcu- 
taneously,  as  we  do  not  know  how  far  the  stomach  or  the 
mucous  membrane  may  not  impair  its  activity,  as  they  cer- 
tainly do  with  snake  poison.     This  also  can  only  be  deter- 


Transaction  of  the  Paris  Congress,  1878.  155 

mined  by  experiment,  and  it  maj  turn  out  to  be  effective  in 
the  much  more  convenient  way  of  administration  by  the 
mouth.  As  the  action  of  Sepsvn  it  speedily  exhausted,  it 
would  probably  be  necessary  to  repeat  the  dose  by  subcu- 
taneous injection  at  least  twice  a  day  in  acute  pyrexia ;  and 
from  the  nature  of  its  possibly  curate  operation,  we  would 
not  expect  a  rapid  or  palpable  lowering  of  febrile  heat  soon 
after  each  dose,  but  only  a  gradual  amelioration  of  the  disease. 

As  Sepsin  is  of  the  nature,  probably,  of  peptones,  and 
extremely  favourable  to  the  growth  of  accidental  Bacteria, 
whose  germs  exist  in  idl  ordinary  water,  it  should,  if  given 
internally,  not  be  prescribed  in  an  aqueous  mixture,  but 
dispensed  in  pure  Glycerine  or  in  Glycerine  with  one  third 
of  distilled  water,  and  the  dose  dropped  into  a  spoonful  of 
water  at  the  time  of  administering. 

Since  the  above  was  written,  I  have  had  some  experience 
with  Pyreitin  as  a  remedy,  both  suboutaneously  and  iut^- 
nally  used,  but  not  sufficient  for  publication.  So  far,  how- 
ever, the  results  have  been  favourable  and  give  good  promise. 
The  injection,  even  of  that  strong  Glycerine  preparation, 
excites  no  local  diaorder,  nor  any  general  septic  disturbance 
in  the  above  doses.  The  first  decimal  dilution  has  been 
given  interaally,  in  three-drop  doses  frequently  repeated,  to 
children  with  good  effect.* 


TRANSACTIONS  OF  THE  PARIS  CONGRESS 

OF  1878.t 

Wb  omitted  to  notice  in  this  JTournal  the  Homoeopathic 
Congress  held  in  Paris  in  1878 ;  but  our  British  colleagues 
were  fully  informed  as  to  its  proceedings  in  the  pages  of 
our  contemporaries,  the  Monthly  Homoeopathic  Review  and 
the  Homaopathic  World.     Its  Transactions  are  now  before 

*  Mewn.  Thompion  aad  Gapper,  chemists,  55,  Bold  Street,  LiTerpool,  have 
undertaken  to  prepare  Pjfremn  according  to  formula  No.  1,  to  ensore  ani- 
formity  of  strength  and  quality.  They  will  Axmish  it  in  the  form  ahoTe 
descrihed  as  J^frexin  ^,  and  also  in  the  first  decimal  dilution. 

t  Cfmptei  JteHdm  du  CansrSi  JnUmaHondU  d'MomcMpaikie,  Paris,  1879. 


156  TranMactions  of  the  Parit  Congreis,  1878. 

ufl,  and  we  propose  to  giye  some  account  of  them  to  our 
readers. 

The  occasion  of  the  gathering  was  the  ''  Exposition 
nniyerselle ''  which  was  held  in  the  French  capital  in  that 
year.  The  idea  at  first  seemed  to  be  that  another  meeting 
of  French-speaking  homoeopathists  should  take  place,  such 
as  those  which  met  in  1867  and  at  three  preyiotis  epochs. 
It  was  aeeordiuglj  styled  the  Fifth  Homoeopathic  Congress 
of  Paris.  Sabsequently,  however,  it  assumed  a  more 
general  character;  and  the  authorisation  given  to  it  by  the 
French  government  speaks  of  it  as  ^'  nn  Congres  interna^ 
iianal  d' Homoeopathic/'  Nor  was  it  unworthy  of  the 
title ;  for  among  the  names  which  appear  on  its  "  Liste 
g^n^rale  des  adherents/'  19  are  those  of  foreigners. 

The  organisation  of  the  Congress  was  entrusted  to  a 
Committee  representing  the  various  sections  into  which 
(unhappily)  the  homoeopathic  body  in  Paris  is  broken  up, 
and  consisting  of  M.M.  Bourdas,  Chancerel,  Qoddard, 
Herrman,  Jousset,  L^on  Simon,  and  Teste.  The  last 
named  was  its  president,  and  might  have  been  that  of  the 
Congress  itself,  but  that  illness  unfortunately  disabled  him 
from  atl  ending  it.  The  election,  therefore— which  took 
place  at  the  commencement  of  the  first  day's  proceedings — 
lay  between  Drs.  L^on  Simon  and  Jousset,  and  a  slight 
majority  gave  the  former  the  chair.  Dr.  Jousset'  was 
requested  to  undertake  the  ofBce  of  rice-president,  in  con- 
junction with  Dr.  Hughes  of  England,  Dr.  Gonuard  became 
"  secr^taire-g^n^ral/'  Drs.  Claude  and  V.  L^on  Simon 
''  secretaires*  ad  joints,''  and  Dr.  Gu^rin-Menerille  treasurer. 

The  plan  adopted  was  to  make  a  general  request  to 
homoeopathists  throughout  the  world  to  furnish  papers  for 
discussion.  Those  received  were  classified  in  three  diri- 
sions,  and  one  allotted  to  each  of  the  days  (August  12th, 
18th,  14th)  on  whidh  the  Congress  assembled.  On  the 
first  day  the  subject  was  ''  The  law  of  similitude,  its 
bases  and  its  range  :"  on  the  second, ''  Materia  Medica  and 
homoeopathic  practice :"  on  the  third,  "  Organisation  of 
homoeopathic  medicine.-— Institutions  (societies,  schools, 
hospitals). — Study  of  legal  reforms."     Those  papers  whose 


Transactions  of  the  Paris  Congress,  1878.  157 

anthora  were  present  were  read  by  them :  of  the  remainder 
a  hnetpricis  was  furnished  by  one  of  the  secretaries.  The 
Transactions — published  at  the  expense  of  the  Goyernment^ 
which  also  housed  the  Congress  in  the  Palais  de  PEzposi- 
tion — consist  of  a  short-hand  report  of  all  that  thus  came 
before  the  meetings^  with  the  discussions  that  took  place. 

Our  survey  of  them  finds  as  the  most  noteworthy  feature 
of  the  first  day^s  proceedings  a  paper  by  Dr.  Jousset  *'  On 
Homceopathic    Doses.^'       Beginning    by    affirming     that 
neither   the   pure    infinitesimalists   nor   the   advocates    of 
ponderable  doses  in  all  cases  have  clinical  experience  on 
their   sidcj  and  that  a  middle  course  (as  the  invariable 
prescription  of  the  third  or  sixth  attenuation)   loses  the 
advantages   of  either^  he  shows  that  those  who  practise 
omni  dosi  are  bound  to  inquire  into  the  reason  why  some- 
times  larger  and   sometimes  smaller  quantities  do   most 
good  to  their  patients.     Like  Dr.  Sharp^  he  looks  for  his 
law  of  dose  to  the  action  of  drugs  in  health ;  but  does  not 
find  it^  with  him,  in  the  simply  opposite  efiects  of  large  and 
small  doses.     He  fixes  upon  another  feature  of  the  pheno- 
mena which  many  of  us  would  equally  refuse  to  acknow- 
ledge as  a  pervading  one,  viz.  the  primary  and  secondary 
actions  of  medicines.     He  points  out,  after  Hahnemann, 
that,  the  weaker  the  dose,  the  more  purely  are  manifested 
the  primitive  efiects  of  the  drug;  while  larger  quantities 
tend  to  suppress  these,  and  to  produce  secondary  phenomena 
immediately.     Applying  now  the  law  of  similitude  to  the 
choice  of  dose,  he  argues  that  we  should  administer  appre- 
ciable quantities  (or  those  approximately  so)  ''  when  we 
have .  to  combat  a  symptom  which  recaUs  the  secondary 
action  of  the  medicine,  and,  on  the  contrary,  should  pre- 
scribe infinitesimal  doses  when  we  have  before  us  a  symptom 
corresponding  to  the  primary  stage  of  the  drug's  operation.'' 
We  have  giyen  Dr.  Joussef  s  view  in  full,  that  it  may 
not  be  misunderstood;  but  our  readers  will  see  at  once 
that  he  has  unwittingly  propounded  as  a  novelty  a  position 
familiar   to  us  as  taken  up  by  Dr.  E.  M.  Hale.     Our 
reasons  for  dissenting  from  it  have  already  been  stated  in 
this  Journal,  and  we  will  not  repeat  them  here. 


168  Tramactiant  of  the  Paris  Congre$$,  1878. 

The  programme  of  the  tecond  daj  preseated  a  list  of 
sixteen  papers,  very  few  of  which  of  course  coold  be  read, 
but  which  are  mostly  printed  in  the  Transactions.  The 
first  to  appear  there  is  a  verj  interesting  and  yalnable  paper 
bj  one  whose  writings  are  always  welcome  to  us — Dr. 
Meyhoffer,  of  Nice.  It  is  entitled  ''  A  Disquisition  on  some 
functional  and  organic  affections  of  the  Heart,  in  relation  to 
a  certain  number  of  hooKBopathic  remedies.''  The  medi- 
cines whose  action  he  characterises  are  Aconite,  Cactus, 
Areenie,  DigitaUe^  Phosphorus,  Coffea,  aud  the  prepara^ 
tions  of  lime.  His  remarks  upon  these  are  so  scientific 
and  withal  so  practical  that  we  will  reproduce  them  here. 

**  We  shall  follow  in  the  choioe  of  remedies  the  two  principal 
indications  furnished  by  the  morbid  states  we  bare  just  pictured, 
that  is,  on  the  one  hand  to  moderate  the  action  of  the  heart,  on 
the  other,  to  increase  its  vigour. 

"  To  the  first  of  these  indications  correspond  more  especially 
Aconite  and  Cactus  grandiflorus  ;  to  the  second,  Arsenic^  Digitalis, 
and  Phosphorus, 

"  But  the  morbid  conditions  are  not  always  so  clearly  defined : 
they  are  sometimes  very  complex,  and  demand  remedies  which 
fulfil  sereral  indications  at  the  same  time.  Among  the  crowd  of 
euch  substances,  we  limit  our  remarks  to  two,  Coffea  and  Caffeine, 
and  the  preparations  of  lime. 

^  All  the  physiological  experiments  made  with  Aeoniie  prore 
to  demonstration  that  this  agent  paralyses  the  yaso>motor  nerves, 
excites  the  action  of  the  heart,  and  at  the  same  time  irritates 
its  muscular  fibres.  Dilatation  of  the  arteries  and  capillaries, 
elevation  of  temperature,  force  and  fulness  of  the  pulse, 
energetic  impulse  of  the  hesrt,  violent  palpitations  with  precor- 
dial anguish,  are  such  well-known  efiects  of  this  plant  that  we 
have  no  need  to  enlarge  on  the  subject.  That  which  it  is  of 
importance  to  observe  is  that,  whenever  we  find  in  a  patient  the 
phenomena  we  have  just  seen  as  producible  experimentally  by 
Aconite^  we  can  be  sure  beforehand  of  relieving  them,  and 
causing  their  disappearance,  by  inducing  its  infiuence.  We  find 
then  in  Aconite  the  remedy  per  escellence  for  palpitstions  of  the 
heart  in  adolescents  and  plethoric  adults  ;  it  is  not  less  potent  in 
insufficiency  of  the  sortie  vslves,  with  a  strong  and  abrupt  pulse, 
vrith  throbbing  of  the  peripheric  arteries  and  dilatation  of  the 


-^ 


Transactions  of  the  Paris  Congress,  1878.  159 

capillary  network.  Its  action  is  not  manifested  only  in  causing 
tlie  rapid  disappearance  of  palpitations  and  cerebral  congestions, 
which  so  often  accompany  this  lesion ;  bat  one  finds  idso  that 
the  diastolic  bruit  in  the  carotids  (when  it  exists)  has  been  at 
the  same  time  sensibly  diminished.  This  transmitted  bruit, 
present  before  the  administration  of  this  medicine,  becomes  some- 
times scarcely  perceptible  after  the  patient  has  taken  three  or 
four  doses  of  it.  By  ''  dose  "  we  mean  one  or  two  drops  of  the 
first  or  second  decimal  dilution,  repeated  every  three  hours. 

''  All  the  aggravations  engendered  by  an  endocarditis  are  under 
the  control  of  Aconite  as  long  as  arterial  turgescence  pre- 
dominates ;  but  when  the  heart  itself  is  principally  affected  and 
the  vascular  disorders  are  but  the  consequence  of  its  exaggerated 
action,  we  should  betake  ourselves,  to  restore  its  equilibrium,  to 
Oactits  grandiflorus. 

**  This  medicine,  still  entirely  unknown  in  the  official  practice, 
is  called  to  play  a  grand  part  in  the  treatment  of  cardiac  maladies. 
According  to  Bubini,  who  was  the  first  to  make  us  acquainted 
with  it,  the  effect  of  this  plant  on  the  human  organism  is 
absolutely  identical  with  that  of  Aconite.  He  attributes  to  it 
a  value  equal,  if  not  superior,  to  that  of  its  analogue  in  all 
active  inflammations,  and  considers  it  an  irritant  of  the  heart 
itself  as  well^as  of  its  nerves.  My  experience  with  Cactus  only 
partially  confirms  the  statement  of  Bubini.  There  is  no  doubt 
in  my  mind  that  this  plant  affects  the  muscle  of  the  heart  more 
than  any  other  organ  or  tissue.  Its  action  on  the  nerves 
of  the  heart  is  nil.  The  vascular  dilatation,  the  force  and  fulness 
of  the  pulse,  which  we  observe  in  its  pathogenesis,  depend  on  its 
primary  effect  on  the  muscular  fibres  of  the  heart.  The  con- 
tractions of  the  latter  are  violent,  the  blood  is  thrown  with  great 
force  into  the  aorta,  and  yet  one  does  not  see  the  vascular  storm 
to  the  same  degree  as  under  the  infiuence  of  Aconite.  These 
reservations  made,  we  are  the  more  firee  to  declare  that  we  know 
no  remedy  which  displays  a  moderating  power  over  the  action 
of  the  hMrt  superior  or  even  equal  to  that  of  Cactus.  I  have 
used  it  with  a  success  which  has  never  failed  me  in  idiopathic 
hypertrophies  of  the  heart  in  young  people,  in  all  the  disturbances 
of  this  organ  so  frequent  in  the  course  of  mitral  and  aortic 
insufficiencies,  caused  now  by  endocarditis,  now  by  muscular 
strains.  There  is  here  even  a  danger :  that  of  allowing  one's  self 
to  fall  too  easily  into  routine. 


160         Tramactiom  of  the  Paris  Congress,  1878. 

"  0aetu9  does  not  augment  the  power  of  the  heart,  but  it 
moderates  and  regulates  its  action,  and  thus  economises  its  \ 

force.  This  agent  produces  no  effect  on  an  enfeebled  heart ; 
secondary  dilatation  and  the  cardiac  cachexia  are  no  more  within 
its  range  than  they  are  within  that  of  Aeonite,  The  latter 
medicine  is  much  less  frequently  indicated  than  Cktetut^  but  it 
sometimes  prepares  the  way  for  it.  Sensation  of  constriction 
(as  from  a  tight  girdle)  round  the  body,  and  pulsations  in  the 
epigastrium,  are  precious  indications  for  the  choice  of  Oaehu. 

"This  plant,  whose  virtue  is  so  great  in  the  treatment  of 
organic  affections  of  the  heart,  replaces  to  the  great  advantage 
of  the  patient  the  preparations  of  Bromide  of  JBotatiiwmy  and  of 
Dipitaliif  which  our  allopathic  colleagues  employ  in  these  cir- 
cumstances. •  It  does  not  weaken,  as  tiiey  do,  the  energy  of  the 
heart,  but  preserves  while  it  moderates  it. 

^  The  dose  of  Ottdm  should  vary  according  to  the  urgency  of 
the  case.  One  is  rarely,  however,  obliged  to  give  oftener  than 
every  two  hours  one  or  two  drops  of  the  second  decimal  dilution 
to  obtain  promptly  the  desired  effect. 

'*  The  attenuations  which  we  prepare  of  Oqfea  and  Oaffoine 
are  for  the  nerves  of  the  heart  what  Oaetus  is  for  its  muscle. 

**  The  action  of  Cqffea  is  exerted  in  an  elective  and  immediate 
manner  on  the  special  nerves  and  ganglia  of  the  heart,  inde- 
pendently of  the  vagi  and  the  sympathetic  trunks,  as  the  experi- 
ments of  Leven  have  clearly  shown.*  Its  influence  on  the  cardiac 
muscle  IB  indirect,  entirely  dependent  on  the  excitation  it  effects 
in  its  nervous  supply ;  the  accelerated  contractions  of  the  hearty 
the  increased  intra-vascular  pressure,  have  no  other  origin. 

**  As  a  remedy,  Oqfea  addresses  itself  to  those  palpitations  of  the 
heart  characterised  by  abundant  diuresis  which  we  call '  nervous.' 
A  drop  of  the  third  or  sixth  dilution  often  suffices  to  cut  short 
an  attack  of  tumultuous  action  of  neurotic  origin. 

"  Oqjffeine,  though  it  acts  as  only  an  indirect  stimulant  to  the 
cardiac  muscle,  is  nevertheless  manifested  to  be  a  potent 
auxiliary  to  DigitaliB  in  the  treatment  of  asystolia.  From 
simple  weakness  of  the  heart  to  its  passive  dilatation  (cardiac 
cachexy)  and  fatty  degeneration,  this  alkaloid  renders  the  most 
striking  service,  provided  that  it  he  given  onlg  in  email  doeee. 
We  have  found  two  centigrammes  three  or  foar  times  a  day 
sufficient  to  secure  regular  contractions  of  the  heart  and  an 

•  ArehwM  de  Pk^iioloffie,  1868,  t  i,  p.  179. 


TVamaciions  of  the  Paris  Congress,  1878.         161 

increased  quantity  of  urine.  It  was  by  this  means  that  we 
restored  sleep  and  obtained  the  nearly  entire  disappearance  of 
the  (edema  in  the  patient  who  formed  the  subject  of  our  third 
observation.  It  also  determined  more  vigorous  contractions  of 
the  heart  in  the  American  lady  subject  to  syncopal  attacks  of 
Biz  or  seven  hours'  duration,  and  in  the  physician  whose  case  I 
Laye  related.  To  these  I  gave  one  centigramme  of  Caffeine 
every  half  hour,  until  the  pulse  returned,  and  then  at  longer 
intervals.  If,  then,  one  can  obtain  from  such  small  doses  of  this 
alkaloid  effects  so  striking,  is  it  not  evident  that  in  following  the 
recommendations  of  Parrot,  who  leads  us  to  prescribe  from  twenty 
to  fifty  centigrammes  of  Caffei/ne  three  or  four  times  in  the 
twenty-four  hours,  we  shall  soon  finish  by  exhausting  the  vitality 
of  the  nerves  as  well  as  that  of  the  muscle  of  the  heart  P 

**  Digitalis  manifests  the  same  influence  over  the  muscular 
fibres  of  the  heart  as  Ccffeine  over  its  nerves ;  that  is  to  say,  it 
paralyses  them.  How  comes  it,  then,  that  the  allopaths  employ, 
like  us,  this  plant  and  its  alkaloid  as  a  tonic  for  the  heart? 
Some  physiologists  assert  as  an  explanation  of  this  contradiction, 
that  Digitalis  acts  as  a  moderating  agent  on  the  heart's  action 
in  regulating  the  influence  of  the  pneumogastrics.  The  expe- 
riences, however,  on  which  they  rely  are  very  contradictory,  and 
far  from  justifying  this  view.  The  question  is  very  simple; 
Digitalis y  in  small  doses,  augments  the  heart's  action,  while  in 
large  doses  it  destroys  it.  Our  colleagues  of  the  official  school 
know  this  so  well  that  they  prescribe  in  preference  one  to  two 
granules  of  Digitaline  a  day,  of  one  milligramme  each,  in  asys- 
tolia;  and  when  it  enters  into  their  plan  to  employ  stronger 
doses,  they  divide  them  by  long  intervals.  For  our  part,  we 
have  found  that  Digitaline,  in  the  second  or  third  decimal  tritu- 
ration, a  dose  of  five  centigrammes  two  or  three  times  a  day,  or 
a  simple  decoction  of  from  fifty  centigrammes  to  two  grammes 
of  the  plant  in  120  grammes  of  water,  is  sufficient  to  regulate 
the  contractions  of  the  heart  and  to  augment  the  intravascular 
pressure.  Thanks  to  this  remedy  and  to  its  auxiliary.  Caffeine^ 
one  can  often  bring  back  to  life  patients  whose  state  seems 
desperate. 

^*  Arsenic  is  the  remedy  for  the  incipience  of  the  cardiac 
cachexy.  The  heart  grows  feeble,  the  pulse  begins  to  show 
irregularities,  the  nights  are  troubled  by  oppression  and  anguish, 

VOL.  XZXVIIl,  NO.  CLII.— APRIL,  1880.  L 


162  Transactions  of  the  Paris  Congress,  1878. 

oedema  of  the  feet  appears  and  disappears.  The  fear  lest  fatty 
degeneration  should  have  commenced  to  invade  the  heart  is  a 
further  indication  for  the  choice  of  this  mineral.  Arsenic,  by  its 
profound  influence  on  nutrition,  is  capable  for  a  long  time  of 
holding  in  check  passiye  dilatation  of  the  heart,  and  maintaining 
the  equilibrium  of  the  circulation.  Dose:  four  to  six  drops  a 
day  of  the  dilutions  from  the  first  to  the  sixth. 

**  Not  less  important  than  Arsenic,  in  the  treatment  of  secon- 
dary dilatation  of  the  heart,  is  JPhosphorus;  but  it  corresponds  to 
a  more  advanced  degree  of  the  malady.  Asystolia  is  more  pro- 
nounced ;  bronchial  catarrh  has  become  more  or  less  permanent ; 
hiemorrhages  and  passive  pulmonary  congestions  are  produced ; 
dyspnoea  obliges  the  patients  to  pass  their  nights  in  an  armchair. 
It  is  especially  these  phenomena  of  pulmonary  stasis  which 
should  determine  the.  choice  of  the  present  remedy.  On  the 
other  hand,  it  seems  impossible  to  treat  steatosis  of  the  heart 
with  any  chance  of  success  without  the  aid  of  Fhosphorus.  We 
need  not  here  recall  the  rapidity  with  which  this  substance, 
introduced  into  the  organism  in  a  toxic  dose,  transforms  the 
muscular  fibres,  and  especially  those  of  the  heart,  into  a  fatty 
substance.  We  have  accordingly  found  the  metalloid  of  great 
value  in  degeneration  of  the  heart,  whenever  the  pulse  becomes 
irregular  and  intermittent,  and  vertigo  is  more  or  lees  per- 
manent. 

^*  This  agent  is  not  less  precious  in  insufficiency  of  the  sigmoid 
valves,  and  in  constriction  of  the  aorta  of  atheromatous  origin. 
The  pulse  is  small,  intermittent,  difficult  to  find  at  the  wrist; 
giddiness  and  faintness  indicate  the  ansemic  state  of  the  brain. 

**  For  dose,  I  habitually  give  a  drop,  three  or  four  times  a  day, 
of  the  third  dilution,  when  we  simply  have  to  re-establish  the 
regularity  of  the  circulation.  But  when  vertigo  predominates 
and  syncope  threatens,  I  giye  a  drop  of  the  fijrst  dilution  every 
two  hours. 

'^  It  finally  remains  for  me  to  say  a  few  words  upon  the  pre- 
parations of  Lime,  They  have  no  direct  affinity  for  the  heart ; 
but  by  their  well-known  infiuence  upon  nutrition,  the  Phosphate 
and  Mydrochlorate  of  Lime  ought  to  be,  and  are,  most  efifectual 
means  for  quieting  palpitations  of  the  heart  in  young  persons 
who  are  growing  rapidly.  It  would  not  be  amiss  to  give  them 
some  preparation  of  Iron ;  but  no  great  harm  would  be  done  by 


Transactions  of  the  Paris  CongresSy  1878.  163 

omitting  this  medicine  from  our  plan  of  treatment.  Eor  we 
have  to  do  here  with  no  mere  ansemia,  but  rather  with  an 
impoverishment  of  all  the  reparative  elements  caused  either  by 
defective  assimilation  or  by  excessive  expenditure.  Now  it  is 
just  this  vice  of  nutrition  which  Calcarea  corrects.  Let  us  say 
at  once  that  it  is  not  to  a  chemical  action  that  we  attribute  this 
salutary  influence,  but  to  the  vital  direction  the  drug  impresses 
on  the  cellular  nutrition.  The  evidence  of  this  is  in  the  dosage 
we  employ,  which  varies  from  the  first  to  the  thirtieth  dilution, 
one  to  six  drops  being  given  per  day.  In  the  affection  which  we 
are  now  considering  the  Fhosphate  of  Lime  will  generally  be  the 
best  preparation ;  but  we  should  prefer  the  Hydroehlorate  when 
there  is  a  tendency  to  gastro-intestinal  catarrh." 

The  next  memoir  presented  was  of  no  less  interest 
in  value.  It  was  from  M.  Teste^  and  its  subject  was  the 
use  of  Bromine  in  diphtheria.  The  author  makes  a  curious 
mistake  in  his  sketch  of  the  history  of  this  remedy.  He 
confounds  our  Hering,  who  proved  it  mainly  in  the  30th 
dilution,  with  Horing,  who  experimented  with  it  on  both 
men  and  animals  in  a  more  vigorous  fashion ;  and  accord- 
ingly states  that  *'  to  our  celebrated  and  venerable  confrlte 
of  Philadelphia  is  due  the  introduction  of  Bromine  into 
therapeutics  V^  He  justly,  however,  credits  Dr.  Ozanam 
with  having  first  established  its  efficacy  in  diphtheria ;  and 
follows  him  in  giving  it  (contrary  to  his  usual  practice)  in 
a  somewhat  crude  form,  viz.  the  eau  bromee,  a  solution  of 
about  the  strength  of  our  first  centesimal  potency.  Of 
this  he  administers  from  one  to  three  drops,  every  hour  in 
anginose  diphtheria,  every  quarter  hour  in  croupous.  His 
experience  leads  him  to  regard  this  medication  as  almost 
infallible  in  the  dreaded  makdy  in  question,  and  as  ''the 
most  precious  acquisition  that  the  art  of  healing  has  made  for 
a  hundred  years  past.^'  He  relates  several  cases  in  illustra- 
tion ;  and  in  some  of  them  the  curious  fact  comes  out  that 
milk  neutralises  the  action  of  Bromine,  and  must  accord- 
ingly be  forbiddeu  during  its  employment. 

The  absence  of  the  author  hindered  the  reading  of  this 
paper,  and  so  deprived  us  of  what  would  probably  have 


164  Transactions  of  the  Paris  Congress,  1878. 

been  an  animated  discussion  on  the  point  it  raises.  Some 
compensation  was  obtained^  however,  in  that  excited  by  the 
next  communication  but  one, — a  paper  by  Dr.  Cartier,  of 
Lyons,  on  *'  Homoeopathic  Posology.'^  It  contains  an 
account  of  several  cases,  treated  by  similarly-acting  reme- 
dies in  doses  somewhat  larger  than  we  are  ordinarily  wont 
to  administer.  One  was  of  acute  albuminuric  nephritis, 
with  anasarca,  from  cold  ;  in  which  Terebinthina  (the 
obvious  remedy)  was  given  in  a  mixture  of  a  teaspoonful 
of  the  oil  to  120  grammes  (about  4  oz.)  of  water,  of  which 
a  dessert-spoonful  was  taken  as  a  dose.  Another  was  of 
ulcer,  threatening  malignancy,  on  the  lower  lip,  healing 
under  Fowler's  solution  of  Arsenic,  two  or  three  drops  three 
times  a  day  ;  others  of  severe  inflammation  and  neuralgia, 
in  which  Aconite  proved  curative  in  fractional  doses  of  the 
mother- tincture.  In  the  first  two  other  remedies,  and  in 
the  second  Arsenic  itself,  in  infinitesimal  doses,  had  been 
employed  in  vain. 

These  narrations,  accompanied  by  some  remarks  pointing 
their  moral,  raised  quite  a  commotion  in  the  assembly. 
Member  after  member  of  the  Congress  rose  to  protest, — 
one  saying  that  he  thought  the  author  of  the  paper  had 
missed  his  way,  and  supposed  himself  to  be  at  the  Academic 
de  MSdecine ;  and,  although  Drs.  Meyhofier  and  Jousset 
came  gallantly  to  the  rescue,  so  strong  was  the  prejudice 
aroused,  that  the  meeting,  by  a  majority  vote,  decided  that 
Dr.  Cartier's  memoir  should  not  appear  in  the  Trans- 
actions. The  Committee  of  publication,  however,  has 
judged  it  wiser  to  print  it ;  and  we  have  the  benefit  of  its 
experiences  accordingly,  of  which  we  should  have  been 
sorry  to  have  been  deprived.  To  our  minds,  it  is  the 
discussion,  not  the  paper,  which  suggests  the  meeting  of 
an  old-school  rather  than  of  a  homoeopathic  society.  The 
kind  of  outcry  which  the  communication  of  cures  wrought 
with  infinitesimal  doses  would  have  evoked  in  the  former 
assemblage  is  here  echoed  a  me^'veille  because  the  quantities 
given  were  comparatively  large.  It  is  a  small  matter  that 
cures  were  wrought,  even  that  they  were  eflfected  by  medi- 
cines  conforming  to  the  law  of  similarity :  their  doses  "  ne 


Transactions  of  the  Paris  Congress,  1878,  165 

rentrent  point  dans  notre  cadre/'  and  so  they  had  best 
remain  unreported  !  Wherein  does  homoeopatbic  differ 
from  allopathic  bigotry  ?  The  only  point  of  distinction 
\vhich  comforts  us  is  to  find  a  Meyhoffer  and  a  Jousset 
standing  up  for  more  liberal  views :  we  should  have  looked 
in  vain  for  their  analogues  in  the  Acad4mie  de  MSdecine. 

Our  space  will  not  allow  us  to  give  an  account  of  the 
remaining  contributions  to  this  day^s  work.  They  were,  a 
paper  on  Purpura  Miliaris,  by  Dr.  Vincent  Leon  Simon,  a 
worthy  inheritor  of  an  honoured  name ;  one  on  Sea- 
sickness, by  Dr.  Chapiel,  of  Bordeaux ;  two  from  this 
country,  by  Drs.  Morrisson  and  Edward  Blake  respectively, 
the  one  discoursing  on  Amyl  nitrite,  the  other  on  the 
radical  cure  of  Uterine  Displacements ;  a  further  communi- 
cation from  Dr.  Cigliano,  of  Naples,  on  Splenic  Leucsemia;* 
and  some  warnings  by  Dr.  Espanet  against  '^  Dangerous 
Innovations  in  Homoeopathy,^^  among  which  he  includes 
the  substitution  of  new  remedies  for  well-tried  specifics^  the 
use  of  the  decimal  instead  of  the  centesimal  scale  of  dilu- 
tion, high  potencies  (i.  e.  above  the  30th),  the  mixture  of 
medicines,  and  Count  Mattei's  charlatanry. 

The  last  day .  was  devoted  to  miscellaneous  matters. 
Reports  of  the  two  homoeopathic  hospitals  of  Paris,  and  of 
the  existing  provisions  for  instruction  in  our  method 
throughout  the  world,  were  presented.  Proposals  for  a 
complete  French  Materia  Medica,  for  a  School  of  Homoeo- 
pathy in  France,  for  the  erection  of  a  monument  to 
Hahnemann  on  the  site  of  his  tomb  and  the  publication  of 
his  correspondence,  were  made  and  discussed.  The  Con- 
gress terminated  with  the  reading  of  two  papers  on  the 
general  aspect  of  our  position,  one  by  Dr.  Becker,  "  On 
the  duty  of  Municipalities  in  the  doctrinal  conflict  which 
divides  Homoeopathic  and  Allopathic  physicians  as  to  the  best 
mode  of  healing  -/^  the  other  by  Dr.  Ariza,  of  Madrid,  on 
'*  The  Causes  which  have  restrained  and  paralysed  the 
progress  of  Homoeopathy  of  late  years.*'  The  latter  is 
especially  worthy  of  consideration  by  all  who  have  the 
large    interests    of    our    system    at   heart.       His  practical 

*  See  vol.  XXXV  of  this  Journal,  p.  278. 


166  Revietvi. 

conclusion  is  that^  to  perfect  and  demonstrate  our  metbod, 
we  should  cultivate  specialties,  as  he  justly  says  they  do 
with  so  much  advantage  on  the  other  side  of  the  Atlantic. 

The  Transactions  of  the  Paris  Congress  of  1878  form 
thus  a  volume  full  of  present  interest  and  permanent  value ; 
and  we  shall  have  to  do  our  best  in  1881  if  we  are  to  pro- 
duce a  better. 


REVIEWS. 


Curabilitt/  of  Cataract  with  Medicines.  By  James  Comp- 
TON  Burnett,  M.D.^  &c.  London :  Homoeopathic 
Publishing  Company.     1880. 

Da.  Burnett  has  here  collected  in  a  pretty  little  volume 
all  the  information  we  can  derive  from  medical  literature 
respecting  the  medicinal  cure  of  cataract.  It  is  not  much, 
and  a  great  deal  of  it  is  nearly  worthless,  for  the  diagnosis 
is  so  often  unsatisfactory.  It  is  not  every  practitioner  who 
can  detect  a  cataract,  and  the  number  of  practitioners  who 
can  tell  what  kind  of  cataract  they  have  before  them  is  still 
more  limited. 

Indeed,  we  may  say  that  a  correct  diagnosis  of  other 
affections  of  the  eye  besides  cataract  is  not  always  made  by 
the  general  practitioner,  and  Dr.  Burnett  gives  us  what  we 
cannot  but  regard  as  an  erroneous  diagnosis  of  an  ophthal- 
mic affection  at  page  2^  et  seq.y  when  he  designates,  as  ^'  a 
case  of  panophthalmitis,''  what  was  evidently  only  a  severe 
case  of  probably  strumous  conjunctivitis.  The  extreme, 
photophobia  and  blepharospasm,  the  red  swollen  appear- 
ance of  the  eye  in  everting  the  lid  (probably  chemosis),  and 
the  rapid  cure  in  two  days,  point  to  strumous  conjunctivitis, 
and  are  utterly  inconsistent  with  panophthalmitis. 

As  a  rule,  soft  cataracts  are   more  curable  than  harcl 


On  the  Curability  of  Cataract,  by  Dr,  Burnett.     167 

onesy  capsular  than  lenticular^  peripheral  than  central* 
Hence  the  prognosis  for  a  hard  central  lenticular  cataract 
is  much  less  hopeful  than  for  a  soft  cataract^  a  capsular 
cataract^  or  a  peripheral  lenticular  cataract. 

Though  many  of  the  cases  recorded  as  cured  under 
homoeopathic  treatment  are  hardly  reliable^  enough  remains 
to  prove  that  cataract  has  been  cured  and  consequently  can 
be  cured  by  this  treatment,  and  by  allopathic  treatment  too 
for  that  matter,  as  Dr.  Burnett  shows. 

Perhaps,  instead  of  saying  that  cases  ^'  have  been  cured  '* 
by  homoeopathic  or  other  medical  treatment,  it  would  be 
more  correct  to  say  they  have  ^'got  well^'  under  such 
treatment,  as  cases  of  cataract  have  undoubtedly  got  well 
under  no  treatment  at  all.  The  following  two  cases,  which 
occurred  within  our  own  knowledge,  prove  this  : 

A  lady,  aged  about  50,  states  that  she  has  had  gra- 
dually increasing  cataract  of  the  left  eye  for  several  years, 
whereby  vision  was  nearly  entirely  lost  in  that  eye.     She 
now  drew  attention  to  it  as  it  seemed  to  be  decreasing. 
No  treatment  was  pursued,  and  in  the  course  of  two  years 
the  cataract  had  decreased  to  such  an  extent,  that  only  a 
slight  grey  speck,  like  a  pin's  point,  remained. 
The  second  case  is  still  more  striking — 
A  gentleman,  at  about  the  age  of  40,  partially  lost 
the  sight  of  the  right  eye,  without  apparent  cause.     His 
medical  attendant    said    the   loss    of  vision   was    due  to 
cataract.      Ten    years    afterwards,    when    examined,    the 
eye  presented  a  yellowish  white  opacity,  filling  the  pupil 
entirely.     The    sight    of    that    eye    was    entirely   gone. 
Two    years   later   the   opacity   had    entirely    disappeared, 
leaving  imperfect  vision,  the  lens  having  apparently  been 
absorbed,  probably  from  giving  way  of  the  capsule.     This 
imperfect  vision  of  the  previously  blind  eye  was  rather  a 
trouble  than  an  advantage  to  him,  as  it  interfered  with  the 
proper  vision  of  the  left  eye.     No  treatment  of  any  kind 
was  adopted. 

Such  cases  as  these  should  lead  us  to  be  modest  about 
claiming  for  our  treatment  the  disappearance  of  a  cataract. 
Dr.  Burnett  give;  nin^  cases  from  bis  own  practice,  which 


168  Beviews, 

cannot  be  called  very  satisfactory.  By-the-bye^  they  are 
numbered  very  oddly.  The  first  and  second  cases  are 
not  numbered  at  all^  the  third  case  is  numbered  "  Obs.  TV" 
the  fourth  case  is  "  Obs.  V/'  the  fifth  and  sixth  are  both 
"  Obs.  VI." 

In  the  firsts  second,  fourth,  seventh,  and  eighth  cases  no 
effect  was  produced  by  the  treatment  on  the  cataract. 

In  the  third  case,  where  the  cataract  was  stellate,  there 
was  some  improvement. 

In  the  fifth  case  (Obs.  YI)  it  is  stated  that  there  are 
lenticular  opacities,  but  in  the  description  that  follows  we 
are  at  a  loss  to  make  out  whether  the  symptoms  are 
subjective  or  objective.  There  was  obviously  some  im- 
provement from  the  treatment,  but  the  case  is  so  ill- 
reported  that  we  cannot  tell  how  much  or  wherein. 

The  sixth  case  is  of  cataract  in  a  gouty  old  gentleman ; 
it  is  stated  to  be  **  decidedly  improved"  by  Iodide  of 
Potash  {Potassium  is  probably  meant). 

The  ninth  case  seems  to  be  one  of  cataract  of  some  sort 
produced  by  excessive  indulgence  in  salt.  Reducing  the 
amount  of  salt  taken  to  moderate  quantity  seems  to  have 
removed  the  opacity. 

It  is,  of  course,  very  spirited  of  Dr.  Burnett  to  publish 
all  we  know  and  all  he  can  tell  us  about  cataracts  in  such  a 
pretty  little  book ;  but  the  real  information  he  is  able  to 
give  us  is  so  very  scanty  that  we  think  it  would  have  more 
appropriately  appeared  as  an  article  in  the  periodical  be  so 
ably  edits. 


Stammerinff  and  its  Rational  Treatment.  By  E.  B.  Shuld- 
HAM,  M.B.,  &c.  London  Homoeopathic  Publishing 
Company. 

This  little  book  is  very  pleasant  reading,  and  it  is 
evident  that  the  author  has  bestowed  a  considerable  amount 
of  thought  on  the  subject.  We  cannot  discover  from  what 
he  says  if  he  has  had  much  practical  experience  of  the 
treatment,  nor  does  h^  relate  any  cases  cured   by  himself, 


Treatment  of  Stammering^  by  Dr,  Shuldham.       169 

He  objects  much  to  most  of  Canon  Kingsley's  rules  for 
OTercoming  the  defect^  from  which  he  was  himself  a  suf- 
ferer until  the  age  of  forty ,  when  he  pronounced  himself 
cured^  after  persevering  efforts  to  overcome  the  difficulty  of 
pronouncing  certain  letters.  Dr.  Shuldham  lays  down 
8ome^  no  doubt^  excellent  arbitrary  rules  for  avoiding 
stammering,  but  we  have  seen  in  our  own  experience 
victims  to  the  affection  who  have  endeavoured  to  practise 
rules  like  these  and  other  rules  without  success.  Very 
likely  there  are  essentially  different  kinds  of  stammering, 
some  of  which  may  be  cured  by  attention  to  rules,  some  by 
medicine  and  some  not  at  all.  It  is  a  curious  fact  that 
some  stammerers  lose  their  defect  as  long  as  they  are  under 
the  inBuence  of  violent  emotion  or  passion^  while  the 
stammering  of  others  is  aggravated  by  these  very  causes. 
There  are  some  whose  stammering  is  only  intermittent, 
others  whose  defect  is  not  perceptible  when  singing. 
Possibly  the  stammering  of  some  .may  be  owing  to  insuffi- 
cient bodily  exercise,  and  what  increases  their  general 
muscular  vigour  may  remedy  the  want  of  co-ordination  in 
the  muscles  of  speech.  But,  indeed^  it  is  very  difficult  to 
arrive  at  any  definite  conclusions  as  to  the  cause  or  cure  of 
stammering,  and  it  is  scarcely  a  matter  that  would  come 
under  the  treatment  of  the  general  practitioner.  Those 
only  who  have  made  it  a  special  study  and  have  attentively 
watched  the  course  and  progress  of  the  affection  in  a  large 
number  of  cases  are  capable  of  enlightening  us  much  on 
the  subject.  Though  we  cannot  flatter  Dr.  Shuldham  so 
far  as  to  say  that  he  has  told  us  much  that  we  did  not 
know  before  about  stammering  and  its  cure,  we  can,  we 
thinks  say  that  he  has  written  a  very  amusing  little  book, 
sparkling  all  over  with  funny  anecdotes  and  jokes.  The 
unfortunate  subject  of  stammering  is,  indeed,  often  pro- 
ductive of  merriment,  and  the  stories  about  the  sorrows  and 
difficulties  of  stammerers  are  innumerable.  Dr.  Shuldham 
tells  us  one  of  a  stammering  tobacconist  in  Paris  into 
if^hose  shop  came  three  stammering  customers,  who  excited 
the  tobacconist's  wrath  by  their  stuttering  talk,  the  shop- 
man naturally  thinking    they   were    mQcking  him«     The 


1 70  Reviewi. 

enraged  cigar-dealer,  under  the  excitement  of  his  passion, 
swore  at  his  involuntary  tormentors  without  the  least  impedi- 
ment in  his  speech,  and  drove  them  out  of  his  shop  with  a 
stick.  There  is  a  somewhat  similar  story,  current  in  select 
circles,  about  a  stammering  carver  and  gilder  in  London,  only 
in  this  case  it  was  the  stammering  customer  who  avenged 
himself  on  the  unfortunate  tradesman  for  his  supposed 
impertinence.  Stammerers  are  perhaps  often  unduly  iras- 
cible, and  no  doubt  anger  often  causes  its  subject  to  stutter, 
for,  as  Bacon  remarked,  ''  Many  stutterers  are  very  choleric, 
choler  inducing  a  dryness  in  the  tongue/' 

That  stammering  may  be  cured,  and  that  it  has  been 
cured,  we  have  many  historical  examples  from  Demos- 
thenes down  to  Canon  Kingsley ;  but  we  imagine  that  one 
general  method  is  not  applicable  to  all  cases,  and  that  in 
most  the  advice  of  the  doctor  to  Macbeth  is  the  best  that 
can  be  given — ''  Therein  the  patient  must  minister  to  him- 
self.'^  Dr.  Shuldham  gives  a  list  of  the  medicines  '*  which 
may  be  found  useful  to  the  stammerer,'^  or  '^  may  not,'' 
we  might  add ;  and  Dr.  Kirscb,  in  our  fifteenth  volume, 
gives  two  more  medicines,  which  he  said  did  good  to  two 
stammerers;  but,  as  a  rule,  the  stammerer  would  be  apt 
to  say  to  his  doctor  as  Macbeth  said  to  his,  ''Throw 
physic  to  the  dogs  I  I'll  none  of  it/'  By  the  way, 
Shakespeare's  description  of  stammering  is  extremely  feli- 
citous— "  I  would  thou  could'st  stammer,  that  thou  might'st 
pour  out  of  thy  mouth,  as  wine  comes  out  of  a  narrow- 
mouth'd  bottle,  either  too  much  at  once,  or  none  at  all.'' 
We  are  glad  to  think  that  one  of  our  colleagues,  and  that 
a  man  of  such  varied  accomplishments  as  Dr.  Shuldham, 
should  have  given  his  attention  to  the  treatment  of  this 
common  and  very  annoying  defect,  and  we  shall  feel 
pleasure  in  directing  our  stammering  friends  and  patients 
to  try  his  method. 


On  Skin  Diseases,  by  Dr,  G.  H,  Fox,  171 

Photographic  Illustrations  of  Skin  Disease,  By  G.  H. 
Fox,  A.M.,  M.D.,  Cliaical  Professor  of  Dermatology, 
Starling  Medical  College,  Columbus,  O.  New  York  ; 
E.  B.  Treat. 

We  have  received  four  numbers  of  this  new  publicatiqp. 
Photography  alone  is  not  a  suitable  art  for  conveying  an 
accurate  idea  of  many  skin  diseases,  which  require  colour 
for  their  faithful  portrayal,  and  therefore  the  plates  in  this 
work  have  been  slightly  tinted  or  more  deeply  coloured 
where  that  was  necessary.  Small  photographs  would  be 
useless  for  many  of  the  cutaneous  diseases  while  they 
might  answer  well  enough  for  others.  Accordingly,  some 
of  the  photographs  are  almost  life  size,  as  the  first  two, 
comedo  and  acne ;  and  they  give  a  very  excellent  idea  of 
these  two  diseases.  Elephantiasis,  of  course,  did  not 
require  such  minute  detail.  Accordingly  Plate  4  gives  a 
photograph  of  the  whole  body  of  a  woman  affected  with 
this  disease.  Some  of  the  illustrations  we  imagine  would 
have  been  better  on  the  large  scale  of  the  first  two  plates, 
for  we  cannot  very  well  make  out  the  details  of  favus  and 
zoater  for  instance,  and  would  have  preferred  them  larger. 
But,  on  the  whole,  as  far  as  it  has  gone,  the  work  is 
excellent,  and  must  be  invaluable  to  the  student  and 
practitioner  who  are  unable  to  enjoy  the  advantages  of 
studying  skin  diseases  on  the  living  subject.  The  descrip- 
tive text  accompanying  the  plates  is  all  that  could  be 
desired  except  what  relates  to  treatment,  and  this  is  poor 
enough.  Of  course,  there  is  no  question  of  specific  or 
homoeopathic  treatment  in  this  work,  and,  indeed,  the  idea 
of  specific  treatment  for  cutaneous  diseases  seems  to  be 
scouted  by  the  author.  Even  eczema  is  treated  in  the 
vaguest  general  manner:  purgatives,  diuretics,  alkaline 
salts,  and  lithic  mineral  water,  seem  to  constitute  the 
author's  chief  reliance. 

The  work  will  be  completed  in  twelve  parts,  with  four 
plates  each,  and  if  the  remaining  plates  are  as  excellent  as 
those  already  published  this  will  be  the  most  valuable  worl^ 
of  the  sort  with  which  we  are  acquainted. 


172  Reviews, 

Materia  Medica  and  Special  Therapeutics  of  the  New 
Remedies,  By  Edwin  M.  Hale,  M.D.  Fifth  edition, 
revised  and  enlarged.  Vol.  II.  Special  Therapeutics. 
Boericke  and  Tafel.  London :  Turner^  170,  Fleet 
Street. 

'In  this  new  edition  of  his  now  well-known  book,  Dr. 
Hale  continues  to  divide  his  material  as  he  did  in  the 
fourth.  Its  second  volume,  containing  the  therapeutic  use 
of  his  medicines,  has  appeared  before  its  first,  which  is 
devoted  to  their  pathogenetics.  We  repeat  the  expression 
of  our  hope  that^  in  the  latter,  Dr.  Hale  will  see  it  good  to 
return  to  the  manner  of  his  two  earlier  editions,  and  give 
the  detailed  provings  of  the  new  remedies  which  exist, 
instead  of  a  dish  of  hash  made  from  these  in  the  shape  of 
a  "  symptomatology .''  Our  literature  is  being  flooded  with 
these  compilationSi  which^  however  useful  in  their  way, 
can  never  give,  the  insight  into  the  real  action  of  drugs 
which  is  derived  from  reading  the  daily  records  of  the 
experiments  made  with  them. 

Dr.  Hale  states  in  his  title-page  that  this  fifth  edition 
contains  thirty-seven  new  remedies^  but  in  his  title-page  he 
gives  a  list  of  thirty-nine.  Their  newness  is  of  various 
degrees,  some  being  familiar  enough  to  students  of  old- 
school  literature,  while  some  are  entire  novelties.  While 
the  special  value  of  the  book  continues  to  reside  in  its 
original  nucleus — the  account  of  the  action  of  the  indige- 
nous remedies  of  the  American  continent,  it  is  of  no  little 
service  to  have,  grouped  therewith,  some  information  about 
pretty  well  every  therapeutic  agent  which  has  been  pressed 
into  service  of  late  years.  The  value  of  the  several  articles 
is  very  unequal  (that  on  Jaborandi,  for  instance,  being 
quite  unsatisfactory) ;  and  the  work  bears  too  many  of 
those  signs  of  *'  raw  haste,  half-sister  to  delay,"  which  we 
have  often  had  to  lament  in  the  publications  of  our  trans- 
atlantic brethren.  But,  with  all  its  faults,  the  book  is  au 
indispensable  one  to  every  homoeopathic  practitioner ;  and 
Dr.  Hale  continues  to  deserve  our  gratitude  for  his  industry 
in  our  cause, 


i 


Therapeutical  Materia  Medica,  by  Dr.  lessen.        1^3 

Therapeutical  Materia  Medica ;  containing  the  Chief  Sym- 
ptoms  and  Clinical  Uses  of  216  Remedies,  arranged 
upon  a  new  and  available  plan  for  Study  and  Practice. 
By  H.  C.  Jessen^  M.D.  Chicago;   Halsey  Brothers. 

The  material  of  this  volume  is  said  to  consist  of  the 
'*  chief  symptoms  and  clinical  uses  of  the  most  important 
homoeopathic  remedies/'  The  compiler  nowhere  explains 
how  the  remedies  came  to  have  the  symptoms  he  ascribes 
to  them^  or  what  ^'  having  '^  them  means,  or  on  what 
principles  he  has  selected  some  as  ''chief  among  them. 
When  we  have  looked  over  a  few  of  his  lists,  howe^^r,  it 
becomes  apparent  that  he  has  been  working  upon  the  old 
vicious  principle.  He  has  taken  out  of  Jahr's  Codex  and 
similar  compositions  such  symptoms  as  commend  them- 
selves to  his  mind^  without  the  slightest  discrimination  (or, 
probably,  enquiry)  as  to  their  origin ;  he  has  mixed  these 
up,,  without  note  of  di£Pereuce,  with  morbid  phenomena 
supposed  to  have  disappeared  under  the  action  of  the 
several  drugs;  and  this  olla podrida  he  has  given  us  as 
the  '^ Materia  Medica^'  he  would  have  students  to  learn. 
"We  know  well  that  herein  he  is  erriug  in  good  company ; 
but  we  cannot  cease  to  protest  against  a  course  of  proceed- 
ing which  is  robbing  the  Materia  Medica  of  homoeopathy 
of  all  that  is  scientific  and  rational  and  real,  and  reducing 
it  to  the  chaos  in  which  Hahnemann  found  that  of  the  old 
school  when  he  began  his  labours. 

We   are  not  encouraged,  under  such  circumstances,  to 

consider  closely  the  "  new  and  available  plan  for  study  and 

practice  ^'    which    Dr.    Jessen    has    evolved  and    followed. 

TTben  we  find  a  coat  to  be  made  of  shoddy,  we  do  not 

trouble  ourselves  much  about  its  cut.     We  must,  neverthe* 

Jess,    say    that    his    method   of  presenting  on  a  level  the 

features  of  four  or  six  medicines  at  once  is  a  good  one,  and 

worthy  of  consideration  by  future  compilers.     In  fact,  the 

whole  volume  displays  evidences  of  industrious  work  of  no 

slight  degree ;  and  we  can  only  regret  that  it   has  been 

rendered    comparatively    useless    by    the    badness    of  the 

material  on  which  it  has  been  lavished. 


174  Our  Foreign  Contemporaries. 

Medical  Chemistry ^  including  the  Outlines  of  Organic  and 
Physiological  Chemistry,  Bjr  C.  Gilbert  WheeleRj 
Professor  of  Chemistry  in  the  University  of  Chicago^ 
and  in  the  Hahnemann  Medical  College.  Second  and 
revised  edition.     S.  J.  Wheeler,  Chicago. 

Wb  noticed  this  book  on  its  first  appearance ;  and  we  have 
only  to  repeat,  as  regards  its  present  issue,  the  commen- 
dation we  then  gave  it  as  presenting  in  a  compact  form  all 
that  it  concerns  the  student  to  know  concerning  the 
chemical  phenomena  of  the  organism. 


OUR  FOREIGN  CONTEMPORARIES. 

AMERICA.  We  are  prevented,  by  an  accident,  from 
giving  our  promised  survey  of  the  American  monthlies  this 
quarter ;  but  must  say  a  few  words  of  welcome  to  a  new 
one  which  has  appeared  in  the  present  year.  It  is  called 
T?ie  Clinique,  and  purports  to  be  "  a  monthly  abstract  of 
the  Clinics,  and  of  the  proceedings  of  the  Clinical  Society^ 
of  the  Hahnemann  Hospital  of  Chicago.^'  It  is  to  be 
mainly  practical,  and  at  any  rate  to  eschew  all  controver- 
sial articles.  The  first  two  numbers,  which  lie  before  us, 
are  full  of  valuable  matter ;  and  we  advise  all  homoeopathic 
practitioners  in  this  country  who  wish  to  see  the  actual 
working  of  their  method  illustrated  by  hospital  experience, 
to  send  the  equivalent  of  a  dollar  to  Dr.  Hoyne,  817, 
Wabash  Avenue^  Chicago^  in  return  for  which  they  will 
receive  The  Clinigue  for  a  twelvemonth. 


175 


MISCELLANEOUS. 


Fhyiieians  and  Swrgeons  Practising  HomcBopathyy  1879. 

Wi:  invite  the  attention  of  our  colleagues  to  a  picture  with 
the  ahove  title,  just  published  by  the  eminent  photographic  artists, 
Messrs.  Barraud  and  Jerrard,  of  Gloucester  Place.  It  represents 
128  British  practitioners  of  homoBopathj.  We  need  hardly  say 
that  the  likenesses  are  excellent.  The  grouping  is  done  with 
admirable  skill,  and  is  singularly  free  from  the  stiffiiess  that 
would  almost  seem  to  be  inevitable  in  a  large  number  of  figures 
that  must  of  necessity  have  their  faces  all  turned  towards  the 
spectator.  The  picture  represents  the  entrance  hall  of  a  build- 
ing of  magnificent  architectural  design,  which  the  spectator  may 
imagine  to  be  the  future  locality  of  the  School  of  Homoeopathy 
or  a  College  of  Physicians  of  the  future.  The  artists  deserve  great 
praise  for  the  execution  of  the  work,  which  will  be  a  valuable 
memento  of  a  considerable  number  of  the  chief  representatives  of 
homoeopathy  in  this  country  in  1879,  including  excellent  like- 
nesses of  the  late  Professor  Henderson  and  Dr.  Quin.  It  is 
published  in  two  sizes,  and  the  price  is  moderate. 


Solvents  of  GalUstones. 

Db.  Bttckleb,  of  Boston,  U.S.,  says  physicians  have  a  ready 
means  at  hand  of  dissolving  cholesterine  gall-stones  in  the  gall- 
bladder. This  is  the  conjoint  use  of  Chloroform  and  Succinate  of 
iron.  His  mode  of  using  these  remedies  is  to  give  ten  drops  of 
Chloroform  every  four  hours,  and  a  teaspoonful  of  Succinate  of 
iron  after  each  meal.  Chloroform  alone  will  often  sufSce  to 
dissolve  the  gall-stones,  and,  after  they  are  dissolved,  Succinate 
of  iron  should  be  given  in  teaspoonful  doses,  three  times  a  day 
for  four  to  six  months,  to  prevent  their  re-formation.  He  says : 
**  Of  all  the  certainties  of  medicine,  there  is  nothing  more 
al)solutely  sure  than  that  Chloroform  will,  in  every  instance, 
dissolve  calculi  in  the  gall-bladder.*'  Dr.  Lothrop  says  he  has 
treated,  with  complete  success,  more  than  twenty  cases  of 
cholelithiasis  by  the  use  of  Succinate  of  the  peroaide  of  iron 
alone. 


ife 


CORRESPONDENCE. 


Th£  British  Homkeopathic  Phabmacop<eia. 

To  the  Editors  of  the  *  British  Journal  of  Homoeopathy.^ 

Gentlemen,— The  second  edition  of  our  FharmacopcBia  haying 
been  for  some  time  out  of  print,  and  the  demand  for  the  work 
being  on  the  increase,  the  British  Homc^opathic  Society  have 
decided  to  proceed  at  once  with  the  preparation  of  a  new  edition, 
and  have  authorised  me  to  take  the  necessary  steps  for  the 
accomplishment  of  that  object. 

The  alterations  required  will  not,  I  hope,  be  many,  as  the  book 
has  been  generally  very  well  received.  Still,  something  more 
than  a  mere  reprint  is  needed,  as  some  fresh  matter  must  be 
added,  some  omissions  made,  and  any  known  errors  corrected. 

Through  the  kind  agency  of  Dr.  Eichard  Hughes,  we  hope  to 
get  some  criticisms  and  suggestions  from  our  American  brethren. 
If  successful  in  this  we  shall,  as  far  as  possible,  endeavour  to  make 
our  new  edition  even  more  acceptable  abroad  than  the  other 
was.  It  must,  however,  be  understood  that  there  will  be  no 
deviation  from  the  leading  features  of  the  last  edition.  The 
table  of  doses,  which  was  reluctantly  retained,  will  be  omitted. 

It  may  be  in  the  power  of  different  gentlemen  to  give  practical 
help,  some  in  the  way  of  corrections,  others  in  the  way  of 
experiment  ;  but,  in  whatever  shape  it  comes,  it  will  be  very- 
acceptable,  and  all  such  information  shall  receive  most  careful 
consideration. 

As  examples  of  the  points  that  information  is  required  about  I 
may  name : 

The  average  loss  of  moisture  of  plants,  which  engaged  a  good 
deal  of  attention  at  our  last  revision. 

Further  information  is  desired  as  to  the  exact  composition  of 
Mereurius  solubilis,  also  as  to  its  character  and  tests. 


Educational  Requirementifar  Homceopathic  Teaching.  177 

Additional  tests  for  Hepar  svlphurii  will  be  desirable. 

It  is  thought  that  a  change  is  needed  in  HomoBopathie 
pharmacj,  with  a  view  to  greater  purity,  in  our  process  of 
DUtillation.  Those  who  have  considered  this  may  be  able  to 
give  some  results  of  their  experience. 

Shortly  after  the  issue  of  the  second  edition  of  the  Pharma* 
copcDia,  Mr.  Isaac  Thompson  pointed  out  an  error  in  regard  to 
JPhosphoruf.  If  others  have  investigated  this  matter,  an  expres- 
sion of  opinion  as  to  the  results  obtained  by  Mr.  Thompson  and 
Mr.  Wybom  will  be  very  welcome. 

Mr.  Wybom,  who  gave  most  valuable  aid  in  bringing  out  the 
last  edition,  has  again  promised  his  assistance,  which  may  be 
regarded  as  a  guarantee  that  the  revision  will  be  a  careful  one. 

If  other  gentlemen  will  kindly  supply  any  information  that 
they  have,  or  will  say  in  what  way  they  can  help,  I  shall  be 
extremely  obliged,  and  shall  be  glad  to  hear  from  them  as  early 
as  they  can  make  it  convenient  to  write, 

I  remain,  yours  faithfully, 

William  Y.  Dbvbt. 

Bonnwmouth. 


Editcatiokal  Bbquibembhts  fob  HoicaoFATHic  TsAOHure, 
To  the  JEditors  of  the  *  British  Journal  of  Homoeopathy.* 

GsNTLEMSir, — Dr.  Jousset,  after  giving  a  full  report  of  the 
last  Annual  Meeting  of  the  Governors  of  the  London  School  of 
Homoeopathy  in  the  Art  Midical  for  November,  1879,  adds, 
a  propoi  of  the  report : 

<<  We  cannot  allow  this  report  of  the  meeting  of  the  GJ-oyemors 
of  the  London  School  of  Homceopathy  to  pass  without  remarking 
on  the  one  hand  that  our  sympathies  for  this  school  lead  us  to 
Bay  a  word  on  the  discussion  that  took  place,  on  the  other,  that 
the  questions  discussed  are  interesting  to  all  practitioners  who, 
under  whatever  title,  have  adopted  the  reforms  of  Hahnemann. 

^'  What  is  the  object  of  the  discussion  reported  here  P  Half 
tbe  lecturers  in  the  HomoBopathic  School  allege  that  they  teach 
allopathy  along  with  homcBopathy;  the  other  half  wish  that 
bomcdopathy  only  should  be  taught. 

This  question  is  badly  stated,  and  consequently  insoluble. 
Why  is  the  question  badly  stated  P 

VOL.  XXXVIIIy  NO.  CLII. — APaiL|  1880.  K 


178  Correspondence. 

"  Because  the  ezpreflsioiiB  hofnaopathj^  and  allopathy  are  epi- 
thets engendered  bj  the  war  excited  by  Hahnemann's  reforms ; 
because  the  expressions  are  false,  and  I  should  like,  if  it  were 
possible,  that  they  should  disappear. 

**  There  are  certainly  two  therapeutic  doctrines  under  obserTa- 
tion,  but  their  two  names  BrepotiHve  tkerapeuHes  and  9y9tematie 
therapeuHes. 

**  Fontive  therapeutie$  (I  do  not  say,  like  our  colleague,  Dr. 
Oaillard,  poHHvUt)^  rests  on  the  experimental  materia  medica 
created  by  Hahnemann.  l^ttewuUie  therapeutiea  comprises  all 
the  systems  taught  by  the  official  school,  and  before  our  reform 
this  therapeutics  was  founded  entirely  on  the  hypothetical  materia 
medica,  which  Bichat  defined  in  his  well-known  phrase.  And  if 
nowadays  this  materia  medica  does  not  bear  such  a  striking 
resemblance  to  the  Augean  stables  as  it  did  at  the  time  Bichat 
wrote,  this  is  owing  entirely  to  the  impulse  given  by  Hahnemann 
and  his  school  to  the  study  of  the  physiological  effects  of  drugs. 

"  In  our  opinion,  the  question  discussed  at  the  general  meeting 
in  London,  ought  not  to  be  to  decide  whether  allopathy  and  homoe- 
opathy should  be  taught,  but  more  simply  and  radically  whether 
the  teaching 'of  experimental  materia  medica  and  of  the  thera- 
peutics of  positive  indications  would  not  adequately  imply  the 
teaching  of  the  whole  domain  of  therapeutics ;  the  numerous  and 
contradictory  systems  known  by  the  name  of  allopathy  being 
reserved  for  the  chapter  of  the  history  of  therapeutics  P 

'*  We  do  not  hesitate  to  answer  this  question  in  the  affirmative. 

*'  The  study  of  experimental  materia  medica,  while  making  us 
acquainted  with  the  action  of  medicines  on  the  living  organiamy 
does  not  let  us  remain  ignorant  either  of  their  evacuant  action, 
or  of  their  revulsive  action,  or  of  their  action  on  pain.  And  the 
therapeutics  of  positive  indications  teaches  us  in  what  particular 
case  the  homodopathic  medication  should  be  replaced  by  eva« 
cuant,  derivative,  or  palliative  medication. 

"  Does  not  experimental  materia  medica  teach  us  that  in  suffi* 
cient  doses  opium  has  an  anaDsthetic  action  on  the  organism  p 
And  does  not  our  therapeutics  attest  that  in  painful  cancer, 
where  a  cure  is  impossible,  the  positive  indication  is  to  aUay  the 
pain,  and  consequently  to  administer  opium  in  its  palliative 
character  P 

"The  experimental  knowledge  of  the  actions  of  medidnes 


Educational  Requirements  for  Homoeopathic  Teaching.  179 

obvioufllj  comprises  the  purgative  action  of  sulphate  of  soda,  and 
positive  therapeutics  teaches  us  that,  in  a  case  of  retention  of 
&cal  matter,  without  mechanical  obstacles,  there  is  a  time  when 
purgative  treatment  is  positively  indicated. 

"  We  see  that  therapeutics  viewed  firom  this  elevation  is  but 
little  concerned  with  the  expressions  allopathy  and  homeoopathy  ; 
that  it  only  retains  them  in  order  to  designate  a  mode  of  action 
of  drags,  and  that  it  indudes,  on  the  one  hand,  all  the  medicinal 
actions  demonstrated  by  experimentation  on  the  healthy  indi- 
vidual ;  and,  on  the  other,  all  the  indications  which  rest  on  a 
positive  relation  betwixt  the  known  action  of  drugs  and  a  par- 
ticular pathological  state." 

I  press  the  above  observations  of  Dr.  Joasset  on  the  attention 
of  all  my  colleagues  who  consider  anxiously,  as  I  do,  the  future 
of  homoeopathy  in  England,  in  France,  and  in  Germany,  where  the 
circumstances  dependent  on  the  State  are  wholly  different  to 
those  existing  in  America.  In  the  United  States  progress  is 
most  satisfactory,  because  of  the  freedom  of  medical  education ; 
in  the  three  other  countries  the  condition  is  most  unsatisfactory, 
because  no  such  fiicilities  exist.  Optimist  views  are  most  popular, 
but  here  the  bare  truth  must  be  faced.  It  is  in  vain  to  conceal 
the  fact  that  in  the  countries  of  Europe  the  number  of  homoeo- 
pathic practitioners  have,  during  the  last  ten  years,  ceased  to 
increase  in  the  proportion  they  ought  to  do,  estimated  by  the 
general  population,  by  the  increase  of  wealth,  and  by  the  number 
of  the  whole  medical  profession. 

I  believe  the  great  obstacle  to  the  spread  of  homoeopathy  in 
Surope  is  isolation  from  the  medical  profession.  I  regret  this, 
not,  as  alleged,  because  it  excludes  individuals  from  certain  social 
and  medical  privileges,  although  the  injustice  of  that  is  crying, 
and  it  is  a  matter  of  wonder  that  the  educated  public  have  allowed 
it  to  remain  so  long,  but  because  it  limits  the  propagation  of  a 
knowledge  of  the  homoeopathic  law  ;  because  it  seriously  checks 
the  gain  of  converts  among  the  profession ;  and,  above  all,  because 
it  debars  us  from  assisting  in  the  education  of  medical  students, 
by  impressing  on  their  minds,  during  their  studies,  the  existence 
of  special  therapeutic  laws.  It  is  during  these  studies,  and  prior  to 
graduation,  that  the  medical  mind  is  most  readily  impressed,  and 
therefore  it  is  at  this  period  that  it  is  so  desirable  to  have  access 
to  the  student.    The  great  object  is  to  impress  on  the  medical 


180  Carreipofuknee. 

Btudent  the  supieme  importanoe  of  a  full  knowledge  of  tbe  phjr* 
Biological  action  of  all  remedial  agents,  and  how  we  interpret 
therapeuticaUj  one  aspect  of  those  actions.  The  complaint,  and 
it  is  a  fcrue  one,  is  that  therapeutics  are  taught  by  the  ordinary 
school  in  a  one-sided  fashion :  our  just  claim  for  recognition  is 
that  we  teach  it  in  all  its  breadth.  As  an  example  of  how  full- 
ness of  teaching  is  compatible  with  fidelity  to  the  homodopathic 
law,  I  give  the  concluding  paragraph  of  Dr.  Hughes'  "  Bella- 
donna,'* in  the  Hahnemann  Mat,  Med, 

^  In  conclusion,  I  hare  only  to  express  my  hope  that  this  pre- 
sentation of  the  physiological  action  of  a  potent  drug  will  be 
useful  to  my  medical  brethren,  whateyer  creed  they  hold.  It  is 
now  fiur  from  being  peculiar  to  the  school  of  Hahnemann  to 
maintain  that  to  use  drugs  properly  for  the  sick  we  must  know 
their  effects  on  the  healthy.  The  following  pages  are  just  a 
catalogue  raieonni  of  such  effects.  The  inferences  drawn  from 
them  as  to  therapeutic  application  are  governed  by  the  law 
'  similia  similibus  curantur,'  in  which  the  writer  has  the  fullest 
confidence.  But  he  has  not  been  altogether  unmindful  of  other 
directions  towards  which  the  actions  of  the  poison  point;  and 
any  who  prefer  to  use  the  drug  as  a  contrary  can  do  so  herefrom 
as  readily  as  those  who  use  it  as  a  similar.  Which  will  get  tbe 
greater  profit  out  of  it  as  a  remedy  is  another  question ;  and  a  ques- 
tion towards  the  settlement  of  which  such  a  collection  as  this  i^ 
a  necessary  contribution." 

I  am  fully  aware  that  the  difficulties  in  establishing  even  one 
recognised  teacher,  and  it  is  that  of  materia  medica  which  is 
most  important,  are  very  great.  It  is  impossible,  say  some ;  but 
if  the  non  po9sumue  were  a  valid  argument,  where  now  in  tbis 
world  could  truth  in  any  form  exist  ?  It  is  wrong,  it  is  a  breach 
of  faith,  exclaim  others,  for  professed  believers  in  homodopathy 
to  teach  the  ordinary  and  antipathic  use  of  remedies.  This 
judgment  rests  on  confounding  divine  or  moral  laws  with  thera- 
peutic rules.  The  greater  my  belief  in  the  homoBopathic  law 
the  more  I  could  feel,  as  a  teacher,  that  the  methods  of  ordinary- 
practice  afford  admirable  contrasts  and  excellent  foils  for  the 
demonstration  of  law  as  superior  to  hypothetical  therapeutics. 

The  very  efforts  to  overcome  the  obstacles  which  must  arise 
in  attempting  recognition  are  salutary,  and  the  necessary  agita* 
tion  offers  sound  and  justifiable  grounds  on  which  our  peculiar 


The  New  Development.  181 

therapeutics  are  brought  to  command  examination.  These 
efforts  would  testify  to  onr  catholic  scientific  spirit,  and  if  steadily 
sustained  must  bear  good  fruit,  even  if  they  failed  to  secure  legal 
recognition.  Until  recognition  is  realised,  lectures  on  some  of 
the  principal  remedies  common  to  both  schools  might  be  given 
with  adyantage,  if  the  lectures  were  framed  in  a  liberal  spirit, 
and  delivered  in  the  neighbourhood  of  a  large  medical  school. 

This  catholic  teaching  of  medicine  will  benefit  us  all  as  indi« 
▼iduals.  Constant  concentration  of  thought  on  one  point  almost 
al  frays  means  a  mind  in  one  attitude,  an  eye  that  regards  every 
object,  however  many  sided,  from. one  point  of  view  ;  hence  arise 
exclusiveness  and  narrownidss,  hence  medical  trades-unionism 
and  its  tyranny  to  homcdopathy  ;  hence  springs  the  exaggeration 
of  our  own  therapeutics,  ^d,  perhaps  therewith  of  our  own  im- 
portance^ . 

YRjfsciB  Slack,  M.D. 

B<rani6ixiOQtli« 


ThB    NkW    DsyELOBlIXNT.      . 

To  the  JEditorg  qfths  *  British  Journal  of  Somosopathy.* 

GEKTLEMEir, — It  gave  me  great  pleasure  to  see  in  the  January 
number  of  your  adva.nced  poutemporary.  The  Organon,  an  article 
by  one  of  the  editors^  entitled  ^'  High  Potencies  of  Nothings,"  for 
I  have  always  held  that  the  perfection  of  trei^tment  for  diseases 
of  the  most  serious  character,  commonly  regarded  as  incurable, 
would  be  just  that,  viz.  a  high  potency  of  nothing.  Casting  my 
eye  over  the  article,  I  saw  that  the  name  of  one  of  the  remedies 
employed  was  nia.  Now  itir,  we  know,  is  vulgar  G-erman  for 
nothing f  and  a  thrill  of  delight  ran  through  me  at  the  word.  Here, 
I  thought,  at  last  we  have  the  true  homoeopathic  remedy  for 
thosediseases  which  the  united  faculty  have  declared  "  nothing  will 
cure."  But,  alas !  I  found  on  reading  the  article  that,  though  it  is 
not  expressly  stated,  yet  the  context  leaves  it  beyond  doubt, 
that  the  Latin  and  not  the  German  nia  is  intended.  Snow,  in 
fact,  was  the  remedy  employed.  Now  the  hundred-thousandth 
dilution  of  9now  might  be  thought  by  some  to  be  very  much  the 
same  as  nothing,  and  methinks  I  hear  some  firivolous  punster 
perpetrating  a  silly  double  entendre  by  saying  "It's  enow  medicine*' 


182  Correspondence. 

(it*8  no  medicine).  But  mj  eager  search  for  the  real  remedy  for 
the  incorable  is  not  to  be  baulked  bj  untimely  jokes  or  contempt- 
ible puns.  I  am  quite  of  Dr.  Johnson's  opinion  that  a  man 
who  would  make  a  pun  would  be  capable  of  picking  jour 
pocket. 

I  had  almost  hoped,  on  reading  your  late  article,  entitled  "  The 
Secret  Bevealed,''  that  the  illustrious  Jenichen  had  discorered 
the  real  nis  or  aoAtay,  when  the  happy  thought  occurred  to 
him  of  making  his  high  potencies  from  an  empty  bottle,  but 
then  I  could  not  help  thinking  that  his  diluting  Tehiele,  the 
water  of  Lake  Schwerin,  might,  like  other  lake  water,  contain  a 
certain  or  uncertain  proportion  of  organic  and  inorganic  sub- 
stances that  might  vitiate  the  purity  of  the  original    empty 
bottle.    As  yet,  then,  the  real  nihil,  Germanioe  nix,  Angiice 
nothing,  has  not  been  introduced  into  the  sphere  of  practical 
medicine;  so  nis  is  still  a  desideratum.    When  found,  I  have 
not  a  doubt  in  my  own  mind  that  it  will  act  on  iiopaikte  rather 
than  on  homoeopathic  principles,  and  be  the  remedy  for  that 
large  class  of  patients  who  haTe  nothing  the  matter  with  them. 
The  nearest  attempt  that  I  have  heard  of  towards  obtaining  this 
sovereign  remedy  was  the  request  made  by  one  of  our  colleagues 
to  a  homoeopathic  chemist  to  prepare  for  him  the  o.h.  dilution  of 
a  drop  of  distilled  water.    The  request  unfortunately  came  feo 
nought,  as  the  chemist  pointed  out  that  it  could  not  possibly  be 
made  with  common  spring  water,  like  the  ordinary  high  potencies, 
and  the  practitioner  was  not  willing  to  stand  the  expense  of  the 
quantity  of  alcohol  that  would  be  required  for  the  process  of 
dilution.     But,  though  very  near,  a  high  potency  of  distilled 
water  is  not  the  absolute  nihil  or  nix,  so  some  other  plan  must 
be  adopted.    The  yacuum  globes  used  by  Mr.  Edison  for  hia 
new  electric  light  seem  to  me  a  hopeful  direction  in  which  to 
look.    But  perhaps  we  need  not  go  so  far  a-field,  for,  judging 
by  their  sa3rings  and  doings,  I  think  a  perfect  vacuum  may  be 
found  in  the  heads  of  many  of  our  opponents.    But  this  is  too 
complex   a  subject  to  be  considered  satisfactorily  in  a  mere 
letter.    With  your  leave  I  may  hereafter  write  an  article  treating 
the  whole  matter  in  full  detail,  and  setting  forth  my  reasons  for 
believing  the  heads  of  some  of  our  opponents  to  be  quite  empty, 
and  the  explanation  of  the  fact  that  ideas  do  sometimes  seem 
to  proceed  from  them  is  to  be  found  in  the  absolute  vacuity  of 


The  New  Devolopmeni.  183 

their  skulls,  their  ideas  being  merely  the  reverberations  or  echoes 
of  something  external  to  themselves. 

O  qwmta  ipeeiet  eerthrwn  nan  hdbet  t 

The  chief  practical  difficulty  that  occurs  to  me  in  connexion 
with  this  subject  is  not  so  much  the  obtaining  of  a  nihil^  but  the 
discovery  of  some  nihilistic  vehicle  for  diluting  it.  All  conceiv- 
able diluting  mediums  seem  to  parfcake  rather  of  the  nature  of 
an  aliquidf  whereby  our  inestimable  nihil  would  inevitably 
be  contaminated.  This  is  a  subject  well  worthy  the  consideration 
of  those  "  men  of  light  and  leading/'  the  editors  of  The  Organon^ 
and  I  doubt  not  that  if  they  will  lay  their  heads  together  they 
may,  by  such  "  consolidated  co-operation/'  be  able  to  discover 
something  of  an  analogous  nature  that  will  serve  as  an  appro- 
priate potentizing  medium  for  my  nihil. 

But  to  return  to  the  delightful  article  in  The  Organon  that 
induced  me  to  write  to  you.  Though  disappointed  in  jGinding  in  it 
my  long-sought-for  panacea,  it  presents  other  points  of  value  to 
medical  science  and  practice.  !nius,  it  reveals  a  simplification  of 
the  treatment  of  disease  which  bids  fair  to  supersede  the  cum- 
brous and  complicated  method  of  Hahnemann.  The  first  two  cases 
at  all  events  show  this  new  and  excellent  method,  which  is  to 
administer  the  very  agent  that  made  your  patient  ill,  in  the 
hundred-thousandth  potency,  and  it  will  cure  him.  Thus,  one  of 
the  writer's  patients  was  affected  disagreeably  by  the  matm^  so 
he  gave  Luna  cm.,  which  meana  the  hundred-thousandth 
dilution  of  the  ifuxm,  and,  presto !  the;  moon  loses  all  its  baleful 
influence  over  that  patient.  This  is  a^  most  valuable  hint.  To  a 
person  suffering  from  sunstroke  we  shall  only  need  to  give  8ol 
O.H.,  i.e,  the  hundred-thousandth  dilution  of  the  eun^  and  one 
dose  will  as  assuredly  cure  him  as  Luna  o.h.  cured  fche  moonstruck 
patient.  Similarly,  a  person  blinded  or  paralysed  by  a  flash  of 
lightning  will  be  readily  cured  by  FiUgur  o.M.  Fneasiness 
caused  by  light  will  yield  to  Lua  cm.,  sufferings  from  heat  to 
Oalor  O.H.,  and  so  on.  How  much  simpler  this  than  Hahne- 
mann's wearisome  method  of  proving  medicines  and  comparing 
the  symptoms  of  the  disease  with  those  of  the  medicines !  When 
this  new  method  comes  to  be  adopted  we  shall  get  through  our 
task  of  prescribing  so  much  more  expeditiously  and  satisfactorily. 
All  we  shall  have  to  do  will  be  to  ascertain  the  exciting  cause 
of  the  disease  and  administer  it  in  a  potentized  state.    No 


184  Carrespandenee. 

inqnirj  into  sympioma  nor  tedious  refieienoe  to  the  bead-splitting 
pathogeneses  of  our  present  Materia  Mediea  will  be  neceasarj. 
Pathology  and  pharmacodynamics  will  be  done  away  with,  and 
the  whole  duty  of  medical  man  will  consist  in  administering 
the  potentiaed  disease-producing  forces  of  nature  to  patients 
suffering  from  the  effects  of  these  forces  in  the  crude  state. 

To  some  it  may  appear  that  there  might  be  a  difficulty  in 
procuring  some  of  these  yaluable  agents.  But  with  respect  to  one 
of  these  at  least  this  difficulty  hss  been  overcome,  as  the  author 
has  already  potentised  Luma^  which  it  would  have  been  impossible 
for  him  to  do  unless  he  possessed  a  bit  of  the  moon.  No  doubts 
though  he  does  not  state  the  fact,  he  got  this  firom  an  illustrious 
and  fitf-trayelled  German  nobleman,  who  mentions  in  his  auto- 
biographical memoirs  that  he  j^ucceeded  in  visiting  that  satellite, 
and  that  he  brought  back  a  pocketful  of  it.  We  would  suggest 
to  the  fortunate  possessor  of  this  fragmenjb  of  Luna  the  desirabiiily 
of  having  an  accurate  analysis  made  of  it,  in  order  to  set  at  rest 
once  and  for  all  that  much  vexed  question  as  to  whether  or  no 
ihe  moon  is  made  of  green  cheese.  Possessing,  now,  the  wunm 
duly  potentised  for  medicinal  purposes,  we  may  hope  soon  to 
have  a  similar  preparation  of  the  much  more  powerful  moh 
fragments  of  which  will  .doubtless  be  found  lying  about  some- 
where, if  diligent  search  be  made  for  them. 

Nis^  of  course,  belongs  to  a  much  more  easily  procurable  dasa 
of  remedies,  which,  however,  are  in  the  same  category  as  Luna^ 
as  they  cure  in  the  fraction  the  maladies  they  produce  in  the 
gross.  No  one  who  reads  the  brilliant  cure  by  Nix  o.ic,  can 
doubt  that  «fioi9,  at  all  events  in  the  hundred-thousandth  dilu- 
tion, is  a  medicinal  agent  of  marvellous  power.  All  the  natural 
agents  that  in  their  excess  or  their  wrong  place  inflict  muck 
misery  on  human  beings  may,  by  the  process  so  effectually 
employed  by  the  author  of  this  article,  be  made  to  heal  the  dis* 
eases  tkey  occasioned.  How  many  persons  have  been  seriously 
injured  in  health  by  exposure  to  the  rain  !  One  drop  of  rmrn 
diluted  up  the  hundred-thousandth  would  be  an  infallible  remedy. 
So  with  Aa»{,  so  with  wind,  I  should  rather  say  windt,  for  some 
are  more  affected  by  the  east,  some  by  the  wes^  wind ;  the  north 
wind,  too,  and  the  south  have  each  their  several  victims.  The 
editor  of  The  Oryanon^  who  potentizes  Luna^  JVur,  and  Modern 
ouitraltM,  will  find  it  an  easy  task  to  bring  each  several  wind  to 


7^6  New  Development,  185 

the  CM.  potency,  to  serve  as  appropriate  remedies  for  the 
maladies  each  produces. 

During  the  fogs  that  prevailed  to  such  a  fearful  and  fatal 
extent  in  London  this  winter  the  idea  occurred  to  me  to  poten- 
tize  this  powerful  morbific  agent.    The  difficulty  was  to  find  an 
appropriate  diluting  vehicle.    Water  would  not  do ;  no  combina* 
tion  of  the  two  was  possible.    Alcohol  was  equally  unsuitable. 
At  length  the  brilliant  idea  occurred  to  me  tp  use  an*  as  the 
potentizing  medium.    Accordingly,  ^th  some  little  trouble,  I 
procured  a  powerful  sm^tk^s  beUowsv  havcjng  a  capacity  qf  some- 
what more  than  one  cubic  foot,  to  wit,  2000  cubic  inches  (a 
cubic  foot,  1728  inches,  according  to  Co<^ery  ])eing  an  awkward 
number  for  calculations) ;  this  I  erected  in  an  empty  room  at  the 
top  of  the  house.    I  liad  thp  .noszle  drawA  out  fine  and  bent 
downwards,  so  that  it  reached  tct  iiHthJn  2  lipes  of  the  bottom  of  a 
specially  constructed  bottle,  which  I  -had  previously  filled  with 
fag  taken  in  London  on  Christmas  day,  whfn  th^  fog  was  densest, 
on  the  roof  of  the  house,  90  a^.  tp  hay^  it  perfectly  pure  and  un- 
contaminated  by  any  exhalations  from  the  streets  or  sewers. 
The  bottle  I  used  for  collecting  and  pptenti^ing  the  fog  is  made 
of  the  best  flint  glass,  perfectly  annealed,  so  as  to  admit  of  being 
heated  to  any  degree  (and  I  should  subject  it  to  a  white  heat 
after  being  employed    for  one  medicine   before  using  it  for 
another),  and  ihimble'-ahaped,  that  is,  rounded  at  the  bottom 
internally,  so  as  not  to  offer  any  comers  in  which  a  portion  of 
the  gaseous  medicine  might  lurk,  and  so  escape  the  action  of  the 
dilating  Tehide.    It  is  of  the  exact  capacity  of  one  cubic  inch, 
and  has  no  shoulder  like  an  ordinary  phial,  so  that  every  portion 
of  each  dilution  must  come  under  the  influence  of  the  potentising 
▼ehide.    I  placed  a  thick  layer  of  cotton  wool  over  the  air-hole 
of  the  bellows,  so  that  the  entering  air  should  be  thoroughly 
filtered.    The  apparatus  being  thus  arranged,  I  waited  for  a  day 
when  the  atmosphere  was  perfectly  free  from  the  slightest  trace 
of  fog,  and  set  to  work.    I  blew  air  through  the  bottle  contain- 
ing the  fog  for  six  hours  continuously,  then  rested  for  one  hour 
and  recommenced.    In  this  way  I  worked  for  eighteen  hours,  in 
apells  of  six  hours  each,  with  only  one  hour  of  interval  between 
each  period  of  six  hours  for  meals  and  repose.    Nor  was  my  self- 
imposed  labour  done  in  a  perfunctory  manner,  for,  like  JenicheUy 
the  beads  of  perspiration  stood  on  my  foreheadi  and  though  I 


186  Carrespondenee. 

did  not,  like  him,  itrip  to  the  skin,  for  it  was  mid-winter,  jet 
mj  linen  was  dripping  wet  with  mj  exertions,  and,  again  like 
Jenichen,  each  stroke  of  my  powerful  arm  made  the  whole  house 
shake  to  its  foundations. 

I  found  that,  working  thus  regularly,  I  made  exactly  ten 
strokes  of  the  bellows  per  minute ;  this  multiplied  by  2000,  the 
number  of  cubic  inches  of  air  propelled  through  the  bottle  by 
each  stroke,  gives  the  degree  of  potency  communicated  to  the 
medicine  each  minute  as  20,000.  In  my  eighteen  hours*  work, 
therefore,  I  raised  the  potency  of  the  original  crude  fog  to 
21,600,000  degrees,  and  I  beliere  that  this  is  high  enough — ^for 
the  present,  at  least.  I  call  this  the  twenty-millionth  potencj, 
^  XX.1C.M.*'  The  odd  numbers  giro  a  liboial  margin  for  leakage, 
possible  weakness  of  some  of  the  strokes,  Ac.  Thin  is  a  long  way 
beyond  the  faTOurite  o.m.  dilution  of  the  writer  in  The  Orymion^ 
but  then  I  think  that  the  medicine  I  was  oigaged  on  demands 
a  higher  potentisation  than  the  substances  he  operated  on*  for 
it  stands  to  reason  that  the  more  fog  is  diluted  the  better  it  is 
for  the  human  constitution ;  so  I  do  not  think  the  twenty 
fnillionth  at  all  too  high.  It  was  with  readily  comprehensible 
feelings  of  pride  and  satisfiiction  that  at  the  end  of  my  hard  day's 
work  I  could  stick  a  label  on  my  bottle  marked  ^Nih^  xx.m.m.*'* 

Unfortunately,  after  I  had  obtained  my  preparation  of  Jfebula^ 
no  more  considerable  fogs  came  to  derange  the  health  and  try 
the  temper  of  the  Londoners,  so  that  I  hare  not  had  an  oppor« 
tunity  of  testing  the  efficacy  of  my  remedy.  Had  it  only  been 
got  ready  in  time  (but  having  to  wait  so  long  for  a  dear  day 
made  that  impossible)  how  many  of  the  thousands  who  fell 
Tictims  to  the  pernicious  fogs  in  the  metropolis  might  not  now 
be  alive  and  happy  by  taking  one  single  dose  of  IMmUt  xx.m.m.  ! 
Howeyer,  there  is  the  remedy,  prepared  with  infinite  trouble  snd 
care,  and  I  shall  be  happy  to  supply  any  of  my  colleagues  with  a 
few  globules  of  it  for  use  next  winter. 

If  this  mode  of  potentizing  medicinal  agents  by  filtered  air 

should  meet  with  the  approval  of  my  Hahnemannian  coUeaguee, 

I  propose  to  get  rid  of  the  labour  of  blowing  the  bellows  by 

•  I  observe  that  Dr.  Beichere,  in  the  Febroary  namber  of  the  K  Amk^ 
J<ntm.  of  JBbm.,  hai  proved,  greatly  to  hia  own  eatufaction  no  donbt^  that  tii* 
millionth  fluxion  potency  of  Drs.  Fincke,  Swan,  and  Skinner  ia  only  the  tenth 
centerimal  of  Hahnemann.  Bat  I  defy  him  to  prove  that  my  potencies  ara 
different  from  what  they  profess  to  be. 


The  New  Development,  187 

connectiog  it  with  a  gas  engine  of  two-hone  power,  which  will 
he  able  to  work  continuously  for  many  hours  at  a  time,  like  Dr. 
Skinner's  admirable  and  ingenious  automatic  fluxion  potentizer 
by  means  of  water.    I  shall  also  attach  to  the  nozzle  of  the 
bellows  a  dry-air  meter,  like  that  used  by  the  gas  companies, 
which  will  automatically  register  the  number  of  cubic  inches 
propelled  through  it  into  the  potentizing  bottle.     I  send  you  a 
drawing  of  the  complete  and  perfected  apparatus,  which  I  trust 
you  will  get  engraved  on  wood  or  steel  to  illustrate  this  letter.* 
With  this  machine  we  may  easily  prepare  potencies  of  the 
yarious  gases  that  are  known  to  produce  remarkable  effects  on 
the  healthy  human  subject,  such  as  oxygen^  hydrogen^  nitrogen^ 
earbonie  ticid,  sulphuretted  hydrogen,  the  choke  damp  of  coal 
mines,  nitrous  oxide,  ozone,  and  many  more.     I  would  recommend 
this  method  of  potentizing  the  various  winds,  the  air  of  different 
health  resorts,  and  the  morbific  (exhalations  from  marshes,  sewers, 
and  decomposing  vegetable  and  aninial  substances.    I  ought  to 
mention  that  globules  for  medicinal  purposes  are  impregnated 
with  the  remedy  by  merely  shaking  them  two  or  three  times  in 
the  bottle  containing  the  potency.    Any  number  of  globules 
may  be  so  medicated,  care  being  taken  not  to  let  the  potentized 
gas  escape  from  the  bottle  either  in  introducing  or  extracting 
the  globules.    Bemedies  so  prepared  I  propose  to  call  ^  pneu- 
matic potencies."    Plagiarists  beware !  the  name  is  copyright. 

The  vista  opened  up  to  us  by  the  grand  idea  of  using  highly 
potentized  natural  morbific  agents  to  cure  diseases  they  have 
caused  in  their  crude  state  (which  may  be  appropriately  designated 
'*  Physical  Apocalypse  No.  2,"  Jenichen's  happy  thought  of  com- 
mencing his  dilutions  from  an  empty  bottle  being,  according  to 
Bentsch,  No  1,  and  perhaps  my  notion  of  pneumatic  potencies 
may  deserve  to  be  called  No.  8)  promises  a  speedy  overthrow 
of  the  coarse  materialism  of  Hahnemann's  doses.  Imagine 
taking  a  gross  material  substance  like  ITwc  vomiea  or  Arsenic  and 
potentizing  up  to  the  thirtieth  degree  merely !  Why,  if  Hahne- 
mann were  still  alive  and  were  to  sport  such  gross  materialistic 
doctrines  he  would  be  quickly  expelled  from  the  refined  society 
of  the  Hahnemannians,  and  serve  him  right !    To  practise  the 

*  This  we  should  have  done  with  pleasure,  only  our  correspondent  omitted 
to  send  a  cheque  to  cover  the  cost  of  engraving  his  very  elaborate  design.— 
[Eds.]. 


188  Correipondence. 

homoDopathj  of  HshDemann  requiieii  a  certain  amount  of  labour 
and  brainBy  but  the  new  method  is  quite  above  that  sort  of  thing, 
and  Tequirefl  neither.  All  we  want  is  an  automatic  potentizer, 
which  only  needs  that  a  tap  should  be  turned  in  order  to  proyide 
us,  without  any  trouble,  with  the  cm.,  the  ic.if.,  or  the  c.ir.]C 
potency  of  anything  and  eyerything  (and  nqthin^  too,  by-and- 
by,  I  hope).  Practice  is  reduced  to  the  simplest  formulary. 
Enter  a  patient.  ''  What's  the  matter  ?'*  ''  I  drank  too  much 
port  wine  last  night,  and  now—"  **  Neyer  mind  your  symptoms ; 
take  this  globule  of  Fin.  Fori  o.m.,  and  you  need  not  come  again, 
for  you  will  certainly  be  all  right  by  ^o-^orrow  morning." 
Enter  another.  ''Ten  years  ago  I  had  syphilis,  and  now — ** 
''Enough  said,  swallow  this  SjfphUinum  c.H.,  and  be  off." 
Enter  another.  "  Last  night  I  got  into  a  towering  passion,  and 
to-day-^*'  '*  ^hat  will  do ;  Ira  c.m.  is  your  remedy.*'  Another. 
" I  chafed  myself  )iding  to  hounds  two  &ys,ago,"  "  All  right; 
CutU  tuilliB  ejL.^^  Another.  "I  tumbled  down  stairs  yesterday." 
"  Stone  or  wood  ?"  «  Stone."  "  What  ,stone  P"  «  aranite." 
"  The  remedy  for  your  hurl  whatever  that  may  be,  is  here.  Lapu 
granit.  cm."  Another.^  "'X  caught  cold  last  week.*'  **  You 
mean  cold  caught  you ;  take  this  and  be  cured,  Frigu9  cm.*' 

What  charming  simplicity !  What  a  contrast  to  the  lumbering 
old  process  insisted  on  by  jBEahnemann!  Instead  of  painfully 
inquiring  into  the  past  and  present  history  of  a  case,  and  care- 
fully registering  all  the  ininute  shades  of  symptoms,  with  all 
their  conditions  and  concomitants,  for  tiresome  comparison  with 
the  records  of  tedious  provings  of  medicines,  as  Hahnemann 
directs,  in  this  new  method  all  we  want  to  know  is  the  immediate 
exciting  cause  of  tiie  disease,  and  this  potentized  up  to  cm. 
gives  the  infallible  remedy. 

Among  the  remedies  of  the  future  alluded  to  above  I  have 
mentioned  Ira — anger,  I  observe  that  in  your  January  number, 
you  ask  ironically,  as  it  would  seem,  "Why  may  not  mental 
emotions,  such  as  fear,  love,  rage,  jealousy,  &c.,  be  potentized  ?  " 
Curiously  enough,  the  question  you  ask  sarcastically  has  received 
a  serious  answer  in  the  February  number  of  the  Medical  Record, 
We  are  there  informed  that  a  distinguished  scientist  with  the 
significant  name  Dunstmeier  (^apour-farfner)  has  actually  suc- 
ceeded in  collecting  what  he  calls  "  psychic  essences,"  that  is  to 
say,  mextal  emotume,  and  employing  them  as  pathogenetic  agents. 


The  New  Development.  189 

His  method  in  at  once  ingenious  and  simple.    He  has  found  that 
the  nose  of  a  dog  is  capable  of  receiving  and  retaining   the 
emotions  excited  in  other  animals.     Thus,  he   placed  twenty 
hares  in  a  cage,  and  introduced  a  dog  into  the  room  where  this 
cage  was.    The  hares  were,  of  course,  terrified  at  the  sight  of  the 
dog,  and  the  fear  they  exhaled  was  sniffed  up  by  the  dog  and 
deposited  on  its  nasal  mucous  membrane.    Dunstmeier  then 
killed  the  dog,  removed  its  nasal  mucous  membrane  and  olfactory 
nerves,  and  rubbed  them  up  in  a  mortar  with  glycerine  and 
water.     A  few  drops  of  this  administered  to  a  cat  made  her  so 
timid  that  she  ran  away  from  mice  offered  to  her.    A  small 
quantity  administered  subcutaneously  to  a  large  mastiff  made  it 
so  cowardly  that  it  slunk  away  from  a  cat.     The  author  himself, 
after  swallowing  a  little,  had  not  the  courage  to  believe  in  his 
own  great  discovery !    By  a  similar  experiment,  in  which  a  dog 
was  introduced  into  the  presence  of  a  lion,  he  succeeded  in 
isolating  the  soul-substance  of  courage  and  in  transmitting  it  to 
other  animals.     Similarly,  doubtless,  other  passions  and  emotions 
might  be  obtained,  and,  properly  potentized,  say  to  the  cm.  degree, 
might  be  used  as  valuable  remedial  agents.    In  short,  the  field 
opened  up  to  us  by  the  wonderful  discovery  of  this  German 
physiologist  promises  to  yield  a  rich  harvest  of  new  and  powerful 
remedies  for  a  large  class  of  psychical  maladies  that  have  hitherto 
baffled  the  skill  of  medical  practitioners.    I  would  be  inclined  to 
suggest  a  slight  alteration  or  modification  in  the  mode  of  collect- 
ing **  psychic  essences.''    There  is  a  scientific  objection  to  the 
employment  of  inferior — or  perhaps  I  should  say  different — races 
of  animals  for  the  pathogenetic  and  remedial  purposes  of  mankind, 
independently  of  the  moral  objection  with  which  the  anti-vivi- 
sectionista  have  made  us  familiar.    I  think  that  human  beings 
might  be  used  both  for  the  production  and  the  collection  of  these 
''soul-substances."    Men  (and  women  too)  occasionally  make 
great  displays  of  passions  and  emotions,  such  as  love,  jealousy, 
hatred,  anger,  fear,  &o.  An  intelligent  person  with  a  well-developed 
nose  (tornoneuieumque  datrtm  est  habere  nasum)  might  be  employed 
to  sniff  up  these  peyehie  eeeeneee  as  opportunity  offered.    I  do 
not  think  it  would  be  necessary  to  scrape  off  the  nasal  mucous 
membrane  of  the  collector ;  doubtless  the  mucus  alone  would 
contain  a  sufficient  supply  of  the  emotional  exhalatioiL    The 
collector  might  be  provided  with  pocket-hankerchiefs  ad  hoe 


190  Correspondence. 

made  from  calico  free  from  size  and  "  devil's  dust,*'  if  that  is 
procurable  from  our  manufacturersy  and  when  he  haa  diilj 
sniffed  some  well-developed  passion  he  might  immediately 
collect  the  secretion  from  his  olfactory  muooua  membrane  in  the 
usual  way,  and  the  handkerchief  thus  impregnated  with  the 
**  psjchic  essence"  might  be  macerated  in  alcohol,  and  the  tincture 
thence  obtained  potentised  up  to  cm.  for  future  employment  as 
a  sure  specific  remedy  for  the  corresponding  natural  psychical 
maladj.  I  look  forward  to  the  time  when  this  grand  diacorery 
of  the  learned  Dunstmeier  shall  supersede  the  present  clumsy 
method  of  obtaining  remedies  by  their  careful  proving  on  healthy 
persons,  for  if  it  be  possible  (as  Dunstmeier  proves  it  to  be)  to 
fix  the  effluvia  of  passions  and  emotions  on  the  nasal  mucous 
membrane,  to  be  afterwards  uaed  as  medicines,  then  why  not 
diseases  of  all  kinds,  which  must  surely  evolve  each  its  special 
emanation,  capable  of  being  collected  on  the  Schneiderian  mem- 
brane and  used  isopathically  to  cure  similar  diseases  oocnrring 
naturally.  When  we  have  brought  medicine  to  this  pitch  of  sim- 
plicity and  perfection  we  may  fiurly  be  said  sutpendere  omnia  nato, 
as  old  Flaccus  has  it.  Possibly  the  materia  medica  of  the  future 
may  consist  of  these  psychic  and  pathic  essences  obtained  in  the 
way  described  for  all  mental  and  miasmatic  maUdies,  the  common 
morbific  forces  of  nature,  such  as  sun,  moon,  snow,  hail,  rain, 
wind,  fog,  heat,  cold,  lightning,  sewer  gas,  mephitic  air,  Ac,  for 
diseases  produced  by  their  means,  all  these  remedies  being  duly 
potentised  by  the  fluxion  or  pneumatic  process  up  to  the  highest 
obtainable  potency;  and  for  desperate  and  hitherto  incurable 
cases  we  shall  soon  have,  £  hope,  that  incomparable  specific  above 
alluded  to — nihil.  Our  pharmacopoeia  will  then  vie  in  strangeness 
with  that  of  the  renowned  Dr.  Hornbook,  which,  as  Bums  tells 
UB,  contained 

Forbye  some  new,  uncommoii  wesponB, 

Urinos  spiritus  o'  capons, 

Or  mite-horn  shavings,  filings^  scrapings, 

DistiUed  per  se ; 
Sal  alkali  o'  midge-taU  dippings^ 

And  mony  mae. 

The  third  cure  mentioned  in  the  article  of  The  Organon  by 
MagneB  auetralie  o.ic.  of  sundry  pains  and  sensations  in  the  leg 
is  a  further  illustration  of  the  great  advance  of  the  new  system 


The  New  Development,  191 

beyond  the  clumsy  method  of  Hahnemann.  Here  the  character 
of  the  pains  is  evidently  of  no  consequence,  as  no  similar  pains 
are  recorded  in  the  proving.  The  condition  "  when  the  leg  hangs 
down/*  which  is  three  times  italicised,  is  evidently  the  key-note, 
and  one  symptom  in  the  recorded  proving,  though  it  no  way 
resembles  any  of  those  in  the  case,  has  a  similar  condition.  To 
be  sure  other  medicines  (such  as  Digitaiis^  FuU^illd)  have 
symptoms  occurring  under  a  like  condition,  and  it  is  not  very 
clear  to  the  uninitiated  why  Magnee  auHralis  should  have  been 
selected  ;  but  the  choice  of  this  remedy  shows  the  superiority  of 
the  true  Hahnemannian  to  the  ordinary  disciple  of  Hahnemann^ 
just  as  the  superiority  of  his  pharmaceutics  is  shown  by  the 
employment  of  the  refined  and  etherial  Magnee  australis  d.M.,  in 
place  of  the  gross  contact  with  the  corresponding  magnetic  poloi 
as  Hahnemann  in  his  ignorance  proposed. 

I  am  sorry  that  the  editors  of  the  new  periodical  should  have 
named  it  after  that  effete  work  the  Organon  of  Hahnemann. 
Why  did  they  not ''  go  the  whole  hog,"  so  to  speak,  and  call  it 
Novum  Organum  after  Bacon,  for  their  tenets  and  teachings  are 
as  fikr  ahead  of  the  Organon  as  Bacon  is  ahead  of  Aristotle. 

Mr.  Darwin's  evolution  doctrines  have  made  us  all  familiar 
with  the  wonderful  transformations  that  may  take  place  in  the 
course  of  aeons  of  ages,  but  who  could  have  anticipated  that 
within  forty  short  years  after  his  death  the  gross  homcBopathy 
of  Hahnemann  would  have  developed  into  the  ineffable  sublimi- 
ties of  the  Hahnemannians  P 

My  father's  brother ;  but  no  more  like  my  &ther 
Than  I  to  Hercolea. 

lake  the  author  of  the  article  in  The  Organon  I  have  a  supreme 
contempt  for  **  materialistic  mongrels,"  but  I  cannot  see  how 
these  poor  dullards  could  find  any  opportunity  to  poke  fun  at  his 
excellent  article,  supposing  they  are  capable  of  poking  fun  at 
an jthingy  which  I  doubt. 

With  all  respect,  I  beg  to  subscribe  myself 
Your  obedient  servant, 

AK  ImHATEBIALISTIO  THOBOrOHBRED. 
April  Ut,  1880. 

p^  g. — The  nom  de  plume  I  adopt  is  meant  to  express  my 
antagonism  to  those  antiquated  believers  in  Hahnemann*  with  his 
2r€>00  doses  and  his  tedious  insistance  on  the  necessity  of  cone- 


193  Books  received. 

•pondenoe  between  the  totality  of  the  symptoms  of  the  disease 
and  the  pathogenetic  effects  of  the  medicine,  whom  The  Organon 
has  so  felicitouslj  dubbed  **  materialistic  mongrels."  I  obsenre 
that  one  of  these  materialistic  mongrels  on  the  other  side  of  the 
Atlantic  has  had  the  impertinence  to  call  us  Kahnemanniana 
(who  ha?e  left  Hahnemann  so  &r  behind)  Sahnewutniaca ! 
When  an  opponent  resorts  to  the  pitiful  device  of  calling  names 
he  shows  his  dearth  of  rational  arguments. 

BOOKS    RECEIVED. 

National  Board  of  Health  Bulletin^  Washington. 

Medical  OhemUtry.  By  C.  Gilbert  Whbslrb,  Plrofeesor  of 
ChemistiT  in  the  University  of  Chicago,  and  in  the  Hahnemann 
Medical  College.    Second  edition.     Chicago,  1879. 

Owrttbility  rf  Cataract  with  Medicinee,  By  James  Comptov 
BuBKSTT,  M.I).  London :  HomoBopathic  Publishing  Company, 
1880. 

Isehl  et  96$  Enmrone,    Far  le  Dr.  H.  Kaabt.    Vienna,  1879. 

Stammering  and  its  Rational  Treatment,  By  B.  B.  Shcjlbham, 
M.B.     London :  HomoBopathic  Publishing  Company,  1880. 

Fhotographie  Illuetratiom  of  Skin  JDieeaeee.  Bj  G.  H.  Fox, 
M.D.    New  York :  Treat. 

Etude  eur  le  Traitemeni  Homasopathique  de  la  eonatipaHon. 
Par  M.  le  Dr.  Bebnabd,  de  Mons.    Bruxelles,  1880. 

The  Homoeopathic  Expositor,  January,  1880. 

The  Medical  Counsellor, 

The  Homoeopathic  Newe, 

St,  Louis  Clinical  Record, 

The  American  Homoeopath, 

Revue  Homoeopathique  Beige, 

The  Monthly  Homoeopathic  Review, 

The  Hahnemannian  Monthly, 

The  American  Homoeopathic  Observer. 

The  United  States  Medical  Investigator. 

The  North  American  Journal  of  HomoBopathym 

The  New  England  Medical  Gazette. 

El  Criterio  Medico. 

L^Art  Medical, 

Bulletin  de  la  SocUti  Mid,  Horn,  de  Fraiiioe. 

Allgemeine  homoopathieche  Zeitung. 

The  Homoeopathic  World. 

The  Homoeopathic  Times. 

L* Homoeopathic  Militants. 

The  Organon, 

The  Medical  Herald, 

The  Medical  Record, 


Arsenic  and  Us  Compounds.  401 

in  Oentralblatt,  1865,  353,  769  ;  Senfftleben  in  Centralhlatt,  1865, 
914 ;  Cunze  in  ZeiUehrifi  fur  rationelU  Med.,  28,  pt.  1,  p.  33 ; 
cases  of  poisoning  by  sheep- wash  and  fly-paper  at  Exeter  and  Not- 
tingham [for  which  see  local  papers  about  year  1851. — E.  W.  B.]  ; 
Hill's  paper  on  Arsenical  colours,  read  before  the  British  Medical 
Association ;  poisoning  of  children  at  Blackburn  by  Arseniate  of 
Soda  [see  local  papers  about  year  1873. — E.  W.  B.] ;   cases  in 
Report  of  North  Staffordshire  Medical  Society,  1855-6 ;  JSteport  of 
the  Trial  of  Madeleine  Smith  by  A.  F.  Trovine,  Edinburgh,  1857  ; 
Wales'   paper  on  Arsenical  Poisoning,  read  before  the  Belfast 
Clinical  Society  ;  Blondot's  paper,  read  before  the  Paris  Academy 
of  Sciences  ;  F.  Miiller  on  Arsenical  papers,  in  Berlin  MSd,  Zeituny, 
No.  24 ;  Dr.  G-eorge  Johnson's  lecture  before  the  National  Health 
Society;  Dr.  Guy's  report  (in  1862)   On  Alleged  Fatal  Oases  of 
Poisoning  by  Emerald  Oreen,  and  on  the  Poisonous  JEffects  of  that 
Substance  as  used  in  the  Arts;  poisoning  by  Arsenic  in  sheep's-head 
broth  at  Botherham  [see  local  papers  about  year  1875.  —£.  W.  B.]  ; 
and  Vogel's  remarks  [see  above. — E.  W,  B], 

454.  Braithwaite^s  Betrospect  of  Practical  Medicine  and  Surgery, 
1840,  vol.  i,p.  44  ;  1840,  vol.  ii,  pp.  237-42  ;  1841,  vol.  iv,  p.  222 ; 
1844,  vol.  ix,  p.  114 ;  1858,  vol,  xxxvi,  p.  374 ;  1858,  vol.  xxxvii, 
p.  396  ;  1848,  vol.  xviii,  p.  97  ;  1847,  vol.  xiv,  p.  126 ;  1852,  vol. 
XXV,  p.  423 ;  1850,  vol  xx,  p.  377  ;  1846,  vol.  xiii,  p.  42. 

Keference  to  cases  by  Deville,  Bevue  Medicale,  May  and  June, 
1839;  Lancet,  1840,  pp.  46-9,  1834-5,  vol.  i,  p.  516  ;  1838-9,  vol. 
i,  pp.  54,  827 ;  Oaeette  Medicale,  August  22nd,  1835  ;  Literary 
Qazette,  1835,  p.  166  (two  cases) ;  Medical  Gazette,  vol.  xix,  p. 
177  J  Brit,  and  Foreign  Med,-Chir.  Beview,  vol.  i,  p.  572  (6  cases), 
and  vol.  vii,  p.  563  ;  pamphlet  by  Bunsen  and  Berthold,  of  Gottin- 
gen ;  Puchell ;  Orfila  in  Bull,  de  VAcad,  de  Mid, ;  and  other 
cases  quoted  elsewhere. 

455.  Pharmaceutical  Journal  and  Transactions,  1860,  2nd 
Series,  vol.  i,  p.  556. 

By  Mr.  Charles  Heisch. 

Symptoms  of  Arsenic  eaters.  They  take  it  fasting  in  some 
warm  drink,  beginning  with  a  piece  the  size  of  a  pin's  head,  and 
iucreasing  to  that  of  a  pea.  The  first  dose  is  always  followed  by 
alight  symptoms  of  poisoning,  such  as  burning  pain  in  stomach  and 

APPENDIX  B.  J.   H.  CC 


402  Pathogenetic  Record. 

sicknesf ,  but  not  very  sevBre.  A  sudden  cessation  of  the  practioe 
causes  sickness,  burning  pains  in  stomach,  Ac.,  followed  by  death. 
Unless  they  gradually  give  up  the  practice,  they  inyariably  die 
suddenly  at  last. 

Mr.  — ,  an  Anenie  eater,  reports  that  in  his  case,  about  an  hour 
after  the  first  dose,  there  followed  slight  perspiration  with  griping 
pains  in  bowels,  and  after  three  or  four  hours  a  loose  evacuation  ; 
this  was  followed  by  a  keen  appetite,  and  a  feeling  of  excitement. 
With  the  exception  of  the  pain,  the  same  symptoms  follow  each 
increase  of  dose.  On  leaving  it  off  for  two  or  three  days  he  feels 
slight  languor  and  loss  of  appetite.  On  two  occasions  he  tried  to 
leave  it  off  altogether.  The  second  time,  on  the  third  day  of  the 
second  week  after  leaving  off  the  dose,  he  was  attacked  with  ikint- 
ness,  depression  of  spirits,  mental  weakness,  and  a  total  loss  of  the 
little  appetite  he  still  had  ;  sleep  also  entirely  left  him.  On  the 
fourth  day  he  had  violent  palpitation  of  heart,  accompanied  by  pro- 
fuse sweat.  Inflammation  of  the  lungs  followed,  and  he  was 
laid  up  for  nine  weeks.  He  thinks  that  had  he  not  been  bled  he 
would  most  likely  have  died  of  apoplexy.  The  results  on  both 
occasions  of  leaving  off  the  Anenie  were  precisely  the  same. 

Arsenic  eating  improves  the  complexion  and  general  appearance, 
and  the  persons  seldom  look  so  old  as  they  are. 

456.  Medieal  Timee  and  Gazette,  1859,  New  Series,  vol.  xviii, 
p.  43. 

By  Mr.  W.  B.  Kesteven. 

A  lady  for  ten  or  eleven  years  suffered  frequently  from  very 
severe  attacks  of  intestinal  derangement,  which  have  entirelj 
subsided  within  the  last  six  months.  For  the  last  twelve  years, 
exeept  the  last  eix  monthe,  her  sitting-room  has  been  papered  witb 
Arsenical  green  paper. 

457.  Medieal  Times  and  Gazette,  1859,  New  Series,  vol  xviii, 
pp.  94,  120. 

By  Mr.  John  Gay. 

My  study,  for  more  than  two  years,  has  been  papered  with  a  dark 
green  flock  paper.  From  that  time  the  health  of  myself  and  some 
of  the  inmates  of  my  house  became  indifferent^  A  servant  ^vho 
attended  to  the  study  was  attacked  with  a  severe  cough,  which 
evidently  had  its  seat  in  the  trachea  and  larynx,  and  has  ocoasionaUy 


Aritenic  and  it$  Compounds.  403 

been  laid  up  with  spasmd  resembling  attacks  of  colie^  She  fre* 
quentlj  went  into  the  country  with  the  greatest  advantage  to  her 
health,  but  on  her  return  her  old  symptoms  came  back,  and  she  is 
now  suffering  from  cough  most  severely,  and  is  feeble  and  wan. 
My  own  health  has  suffered  very  much  in  the  same  manner.  I 
have  been  obliged  to  go  to  the  country  at  times,  and  have  returned 
well,  only  to  be  revisited  with  my  household  maladies.  At  times  I 
have  been  tortured  with  flying,  apparently  neuralgic,  pains  in  chest, 
abdomen,  and  especially  in  tips  of  toes  ;  occasional  attacks  of  colic  ; 
inflamed  oonjunctivse,  which  had  become  chronic ;  and  lastly  hoarse- 
ness, followed  by  a  aevere  tracheal  cough,  from  which  I  am  now 
suffering  severely.  As  I  passed  most  of  my  evenings  in  the  study, 
I  had  the  dust  from  the  book-case,  &c.,  analysed,  and  I  found  it 
contained  Aceto-arsenite  of  Copper  and  another  copper  colour. 
After  removing  the  paper  the  symptoms  gradually  declined. 

458.  Medical  Timsi  and  Gazette^  1859,  New  Series,  vol.  zviii, 
p.  120. 

By  Dr.  Booke. 

A  member  of  my  household  has  been  constantly  suffering  for 
months,  since  a  green  paper  was  put  up  in  the  dining-room,  with 
obscure  colicky  gastro-intestinal  symptoms,  not  referable  to  any 
known  cause.     Arsenic  was  found  in  the  dust  of  the  room. 

459.  Pharmaceutical  Journal  and  Transactions^  1872, 8rd  Series, 
vol.  ii,  p.  606. 

By  Dr.  P.  A.  Simpson. 

The  Hindoos  use  Arsenic  as  an  aphrodisiac.  The  collapse  which 
follows  taking  a  large  dose  resembles  that  of  cholera. 

460.  Fharmaeeutical  Journal  and  Transactions,  2nd  Series, 
vol.  xi,  p.  161. 

By  Mr.  Hamilton. 

A  man  at  Waltham  was  suddenly  taken  ill  after  drinking  tea, 
and  died.  Mr.  Hamilton  considered  the  symptoms  to  be  those  of 
Snglish  cholera.  Twelve  more  persons  suffered  in  a  similar 
manner.  It  was  found  that  they  all  had  drank  water  from  a  bucket 
which  had  contained  Arsenic, 

461.  Medical  Times  and  Gazette,  1859,  New  Seiies,  vol.  zviii, 
p.  169. 


404  Pathogenetic  Record. 

By  Dr.  J.  J.  Wright 

My  library  was  hung  with  green  AnetUeal  paper.  Daring  the 
time  I  li?ed  in  that  houie,  and  never  before  or  since,  I  had  four  or 
five  severe  attacks  of  colic.  At  this  time,  extending  over  five  or 
six  years,  I  had  frequently  had  chronic  sore  throat,  and  had,  with 
other  members  of  the  family,  tenderness  about  margins  of  eyelids, 
worse  in  the  morning. 

A  paper-hanger  tells  me  that  he  never  covers  even  a  small  room 
withyr«en  paper  without  suffering,  for  two  or  three  days  afterwards, 
from  symptoms  resembling  those  of  a  very  bad  cold :  a  redness  and 
watering  of  eyes,  »tt^ne9$  and  irritation  of  nose,  soreness  of  lips, 
and  an  uncomfortable  feeling  about  throat. 

462.  jPharmace»tieal  Journal  and  Ihinu^tions^  1864,  2nd 
Beries,  vol.  v,  p.  878. 

Editorial. 

Miss  Huband  died  from  **  bilious  cholera  and  syncope."  Anenic 
was  found  in  her  body. 

463.  Fharmaeeutical  Journal  and  TramaeiionM^  1865, 2nd  Series, 
vol.  vi,  pp.  181 — 2, 

By  Dr.  A.  S.  Taylor. 

Beference  to  the  Bradford  cases  of  poisoning ;  see  above. 

[More  than  200  were  poisoned  ;  twelve  died  from  acute  poison- 
ing, and  five  from  the  chronic  effects  of  Arsenic,  Are  these  cases 
detailed  in  the  Bradford  journals  or  elsewhere  ? — E.  W.  B.] 

In  December,  1857, 340  children  at  a  school  at  Norwood  were 
poiiioned  by  Areenite  of  Soda  in  the  food ;  each  child  took,  on 
an  average,  one  grain  of  Arsenic,  The  symptoms  were  severe  pain, 
vomiting,  purging,  shivering,  and  discharge  of  mucous  fluid  from 
nose.  Seven  had  cough  of  a  croupy  character;  three  vomited 
blood  ;  and  one  passed  blood  from  bowels.  Some  had  inflammation 
of  stomach ;  of  these  six  only  were  under  treatment  at  end  of  first 
week,  and  one  did  not  recover  till  after  second  week. 

464.  Pharmaceutical  Journal  and  Transactions^  1878,  drd 
Series,  vol.  iii,  p.  76. 

From  Western  Daily  Press, 

Mrs  J — ,  took  at  least  1000  grains  of  Arsenic.  She  suffered 
from  intense  irritant  poisoning,  and  was  in  a  state  of  profound 
collapse. 


Arsenic  and  its  Compounds.  405 

465.  Pharmaceutical  Journal  and  Transactions,  1873,  8rd 
Seriea,  vol.  iii,  pp.  178,  736 ;  1874,  vol.  iv,  pp.  176,  745. 

Cotton's  cases  quoted,  see  above,  No,  359 ;  also  other  cases 
referred  to. 

466.  Fharmaeeutieal  Journal  and  Transactions,  1873,  drd 
Series,  vol.  iii,  p.  475. 

Editorial. 

A  woman  took  Arsenic  in  her  tea.  In  two  hours  she  had 
vomiting  and  purging,  and  a  burning  sensation  in  throat. 

467.  JPharmaceutieal  Journal  and  Tranactions,  1873,  3rd 
Series,  vol.  iii,  p.  641. 

By  Mr.  F.  J.  Barrett. 

A  correspondent  of  the  British  Medical  Journal  says  that 
severe  attacks  of  throat  disease,  closely  resembling  diphtheria,  at 
Melbourne,  Victoria,  &c.,  have  been  caused  by  Arsenical  wall 
papers. 

468.  JPharmaceutieal  Journal  and  Transactions,  1873,  3rd 
Series,  vol.  iii,  p.  471. 

Abstract  of  Dr.  Donkin's  lecture  to  the  Sunderland  Chemists* 
Association,  November  13th. 

Arsenic  sometimes  causes  violent  inflammation  of  stomach  and 
bowels,  and  so  destroys  life ;  on  other  occasions  it  causes  fatal 
sinking  of  the  heart's  action,  or  death  by  syncope ;  in  other  cases 
the  patient  gradually  sinks  into  a  deep  sleep,  and  dies  comatose. 

In  acute  poisoning  by  a  single  large  dose  the  poison  most 
frequently  begins  to  act  in  from  half  to  one  hour,  by  producing 
violent  inflammation  of  stomach  and  bowels.  The  patient  is 
suddenly  seized  with  faintness,  depression,  nausea,  and  sickness, 
with  intense  burning  pain  at  pit  of  stomach,  greatly  aggravated  by 
pressure ;  the  pain  then  extends  to  the  whole  of  abdomen,  and  violent 
vomiting  and  purging  ensue,  the  vomit  being  brown  or  turbid,  and 
sometimes  streaked  with  blood.  The  vomiting  is  very  violent  and 
persistent,  and  is  rendered  more  intense  by  swallowing  the  smallest 
quantity  of  any  substance  or  fluid,  and  is  not  followed  by  the 
slightest  relief.  The  purging  is  equally  persistent  and  painful,  and 
there  is  often  a  discharge  of  blood.     The  mouth  is  parched  and 


406  Pathogenetic  Record. 

there  is  intense  thirst,  with  a  sensation  of  burning  and  constriction 
in  throat.  The  pulse  is  exceedingly  feeble,  frequent,  and  irr^ular, 
often  quite  imperceptible;  oollapse  is  generally,  but  not  always, 
induced,  the  skin  becoming  cold,  clammy,  and  livid.  A  case  of 
Artenieal  poisoning  may  therefore,  at  first  sight,  bear  a  strong 
resemblance  to  cholera, /or  which,  however ^  ii  eannoi  he  mistaken 
on  a  careful  examination^  even  although  the  calves  may  be 
cramped.  There  is  much  jactitation  and  restlessness,  and  the 
countenance  is  generally  collapsed  from  an  early  period  and  expres- 
sive of  intense  torture,  anxiety,  or  even  despair,  and  the  eyes  ara 
injected,  red,  and  sparkling.  When  this  group  of  symptoms  has 
lasted  a  few  hours,  convulsive  movements  of  the  trunk  aud 
extremities  often  b^ns,  and  then  delirium,  followed  by  fatal  stupor. 
The  mind,  however,  often  remains  clear  to  the  last,  death  taking 
place  calmly,  though  it  may  be  preceded  by  an  attack  of  convul- 
sions. In  these  cases  death  frequently  occurs  at  the  end  of  twenty 
four  hours,  and  generally  before  the  end  of  the  third  day,  though 
some  cases  linger  a  few  days  more,  and  become  subacute.  When 
it  kills  by  syncope  there  is  a  faint  and  almost  imperceptible  pulse, 
cold  clammy  skin,  and  laborious  breathing,  sometimes  some  degree 
of  stupor,  and  sometimes  convulsions. 

In  chronic  cases  of  poisoning  the  primary  symptoms  are  constant 
pains  in  stomach ;  nausea,  and  vomiting,  especially  after  food  or 
drink  ;  griping  pains,  tenderness  and  distension  over  abdomen,  and 
obstinate  protracted  purging.     Tongue  is  red  and  dry,  and  there  is 
urgent  thirst.     Pulse   frequent,  small,   and  feeble.    After  a  few 
days    the   secondary   symptoms   begin  as  follows :   redness    and 
su£Fusion  of  eyes  and  intolerance  of  light,  salivation  and  ulceration  of 
gums,  a  discharge  from  nostrils,  cough  and  expectoration,  sometimes 
bloody,   strangury,   a  peculiar  eczematous  eruption  on  the  skin, 
emaciation  and  g^eat  muscular  prostration,  convulsions,  numbness 
and  tingling  in  fingers  and  toes,  ending  often  in  paralysis,  especially 
of  the  lower  extremities.     As  the  case  progresses  there  are  con- 
vulsions,   numbness,  stiffness,  tingling  and  paralysis  of  the  lower 
extremities  (sometimes  the  upper),  and  of  the  lower  half  of  body, 
generally  permanent,  and  ending  fatally. 

469.  JVew  Sydenham  Societtf's  Fuhlications,  1875,  vol.   Ixv,  p. 

188. 

Beference  to  Eathery's  paper  in  L' Union  Midicale^  xvii,  826. 


Arsenic  and  its  Compounds.  407 

Arsenic  causes  brownish  disoolorations  and  pustules,  so-called 
**  Arsenic  chancres." 


470.  New  Sydenham  Sooiety^s  Fuhlteations,  1875,  vol.  Izv,  p. 
450—2. 

Malmsten*s  case  quoted ;  see  Syyiea,  1873,  and  Nbrd.  Med^ 
Arch.y  1874 ;  also  Henry's  translation  of  it  fVom  London  Medical 
Meeordy  vol.  ii,  p,  441  (see  below). 

"Dr.  T.  Stevenson  adds  in  an  editorial  note  that  he  has  seen 
progressive  paralysis  of  motion  and  sensation^  beginning  at  feet  and 
extending  upwards  till  the  lower  respiratory  muscles  were  affected, 
from  the  use  of  Arsenious  acid.     The  patient  recovered. 

Fleck's  paper  referred  to  ;  see  Zeitschrift  f.  Biologic,  vol.  viii, 
p.  424,  and  Vierteljahrschrift/,  Gerichtl.  Med,  vol.  xviii.  p.  391. 
!Beference  to  Frost's  cases  of  poisoning  by  Arseniuretted  Hydrogen 
in  Vierteljahrschrift  f.  QerichtL  Med,  vol.  xviii,  p.  267. 

471.  Medical  Times  and  Oagetie,  1859,  New  Series,  vol.  xix,  p. 
526. 

By  Or.  S.  0.  Haberahon. 

In  a  case  of  poisoning  by  Arsenic  there  was  only  a  fenae  of  sore* 
ness  in  stomach  and  pain  from  violent  vomiting. 

472.  Lancety  1826,  vol.  x,  p.  276. 

Orfila's  experiments,  briefly  quoted  from  Journal  de  Chimie, 
April,  1826. 

Cass  1. — From  fifby  to  sixty  grains  of  the  Yellow  Sulphuret  of 
Arsenic  being  applied  to  the  cellular  tissue  of  the  internal  part  of 
the  thighs  of  dogs,  they  had  all  the  symptoms  of  Arsenical  poison- 
ing, and  died  between  the  fortieth  and  sixtieth  hours. 

^ost'mortem.-^The  limb  to  which  the  poison  bad  be^n  applied 
was  very  red ;  the  inflammation  extended  even  a  considerable  way 
in  the  abdominal  pariete^;  stomach  presented  soone  dark  violet 
spots,  and  several  small  ulcerations  having  a  brown  appearance,  all 
the  result  of  destruction  of  the  mucous  membrane.  The  interior  of 
the  ventricle  of  heart  in  some  cases  presented  several  deep  red  spots, 
ivhich  principally  occupied  the  carnese  columns,  and  penetrated  at 
least  one  and  a  half  lines  into  the  tissue  of  the  heart. 

Cabe  2.— The  same  eflects  were  caused  when  from   sixty  to 


408  Pathogenetic  Record. 

•eventy  gnuns  of  the  uime  were  ioiroduced  into  the  ftomaoh,  and  the 
OBsophagui  tied. 

Cass  3. — The  native  Orpisnent,  from  the  mines  of  Jojova,  in 
Hungary,  when  applied  to  the  cellular  tistue  of  dogs,  in  the  dote  of 
one  to  two  drachms,  kills  them  in  two  days. 

Pa#^«ifior/Mi.-»-Stomach  inflamed,  and  covered  with  numerous 
black  spots;  heart  and  small  intestines  presented  some  signs  of 
inflammation.     Lungs  a  little  red. 

Casb  4. — Bealgar  caused  similar  effects. 

4r73.  Lancet,  1829-80,  vol.  i,  p.  808. 

Reference  to  J.  B.  Coze's  case  in  3rd  vol.  of  Philadelphia  Medical 
Mueeum.     [I  cannot  obtain  this  volume. — ^E.  W.  B.] 

474.  Laneei,  1829-30,  vol.  i,  p.  744. 
Report  of  the  Weetmineter  Medical  Society. 

A  member  said  that  Areenie  produced  unusual  excitement  of  the 
system,  and  the  whole  frame  felt ''  wound  up  after  the  manner  of  a 
musical  instrument  overstrung."  Dr.  Stewart  said  that  Professor 
Chapman,  of  North  America,  told  him  that  Areenie  was  a  very 
powerful  aphrodisiac,  not  only  in  men  and  women,  but  also  in 
insects  (flies). 

475.  Pharmaceutical  Journal  and  Traneactione,  1875,  3nl 
Series,  vol.  v,  p.  81. 

By  Dr.  N.  P.  Hamberg. 

From  exposure  to  Arsenical  wall-paper  he  felt  in  the  morning  a 
heaviness  in  head  and  weariness ;  he  also  had  an  attack  of  rheu- 
matism in  the  legs  during  July,  1878,  which  still  lasted  during  the 
first  months  of  1874,  but  this  latter  symptom  he  considers  of 
doubtful  origin. 

476.  Pharmaceutical  Journal  and  Traneactione,  1875,  3rd 
Series,  vol.  v,  pp.  460,  734,  962. 

Notice  of  poisoning  of  more  than  fifty  people  near  Calatock, 
Cornwall,  by  Arsenic  in  tank-water ;  also  of  other  cases. 

477.  Medical  Times  and  Gazette,  1860,  vol.  ii,  p.  25. 
By  M.  Claude  Bernard. 

Corvisart,  in  his  work  on  Diseases  of  the  ffeart,  relates  the  cage 
of  a  girl  who  took  a  very  large  dose  of  Arsenic;  symptoniB  of 


Arsenic  and  Us  Compounds,  409 

poisoning  followed,  but  she  recovered,  and  died  several  months  later 
of  consumption.  A  large  pseudo-membranous  cyst  was  found  in 
the  stomach,  within  which  cyst  was  enclosed  a  solid  mass  of  Arsenic 

478.  The  Fractitioner,  1869,  vol.  ii,  p.  303. 
Reference  to  Hutchinson's  cases:  see  above. 

479.  Association  Medical  Journal^  1855,  vol.  iii,  pp.  1020-1, 
1062,  1081. 

Eeference  for  Arsenic  eating  to  papers  by  Vogt  and  Wibmer,  and 
Johnston's  Chemistry  of  Common  Life,  chap,  xxiii,  vol.  ii;  to 
Chamhers^  Joi^mal,  December  20th,  1851 ;  to  Gazette  des  HSpitauXf 
May  16th,  1854;  to  Tschudi's  paper  in  Wiener  Medieinische 
Wochenschrift ;  to  the  Monthly  Medical  Journal,  February,  1852; 
to  Yogt's  Arzeneimittellehre,  and  Medic,  Jahrh,  des  oester.  Staates^ 
1822. 

480.  Lancet,  1866,  vol.  i,  p.  642. 

Further  accoimt  of  Dodd's  cases  reported  above,  No.  93  of  Fatho^ 
genetic  Record, 

Dr.  Heath  said  that  on  January  4th  the  servant  girl  had  sore 
throat,  with  some  swelling  of  tonsils,  and  was  rather  feverish. 
George  B —  was  dying ;  he  was  extremely  weak,  and  had  a  very 
rapid  pulse.  There  was  a  loss  of  power  in  the  lower  extremities. 
There  was  a  faint  rash  on  the  upper  part  of  the  chest  like  that  of 
scarlatina.  Throat  inflamed,  and  adhering  to  uvula  and  left  tonsil 
was  an  exudation  like  that  of  diphtheria.  On  January  8th  John 
3 —  was  in  bed,  complaining  of  pain  in  lower  limbs,  as  also  loss  of 
power  and  a  feeling  of  numbness.  This  illness  had  come  on  after 
yomiting.  E.  B —  was  unable  to  leave  her  bed  from  paralysis  and 
weakness  for  more  than  five  weeks  after  she  left  the  farm. 

481.  Chemist  and  Drvyyist,  1869»  vol.  x,  p.  192. 

Beference  to  Tardieu's  paper  on  Poisonous  Dyes,  read  before 
Aeademie  ImpMale  de  Midecine,  February  23rd. 

482.  Medical  Times  and  Gazette,  1861,  vol.  ii,  p.  180. 
Extract  from  The  Times, 

A  medical  student  says  that  the  use  of  tobacco-pipes,  containing 
Arsenic  in  the  clay,  caused  in  many  sore  throats,  &o. 


410  Pathogenetic  Record. 

483.    Medical  Timee  and  Gazette^  1861,  vol.  ii,  p.  276. 

Editorial  account  of  Beamish'B  eaae ;  additional  {>articulan  to 
account  as  given  above,  No.  586  of  PeUkogeHetie  Beeord. 

A  poet-moriem  of  the  two  fatal  cases  showed  exooriationa  of  the 
lining  membrane  of  the  mouth,  and  inflammation  of  stomach.  The 
newspapers  report  that  the  woman  had  bnming  in  throat  and  exces- 
sive thirst. 

481.  Medical  Timee  and  Gazette,  1861,  vol.  ii,  p.  541. 

Report  of  Royal  Medical  and  Chirurgical  Society. 

Dr.  Harlej  injected  a  grain  of  common  Areenic  into  the  jogolar 
vein  of  a  cat.  In  three  minutes  convulsions  commenced,  and  in 
twenty- five  minutes  it  was  dead.  [A.  case  of  chronic  poisoning, 
with  coloured  plates,  was  also  given  at  the  meeting. — £.  W.  B] 
in  acute  poisoning  hj  Artenic,  the  morbid  changes  are  most  marked 
at  the  cardiac  end  of  the  stomach ;  in  chronic  cases,  towards  the 
pyloric  extremity.  The  more  gradual  the  poisoning  the  more  the 
Arsenic  acts  on  the  intestines,  and  the  less  on  the  stomach. 

485.  Lancet^  1857,  vol.  i,  pp.  360,  193  [misprinted  in  my 
"Index"  under  C^priMn.~-E.  W.  B.]. 

Beference  to  two  cases  of  Arsenical  poisoning  cured  by  Tobacco^ 
reported  by  Dr.  Eastman  in  Sillimah's  American  Journal,  May, 
1836.  In  one  case  large  doses  of  Tolaeco  caused  no  nausea,  though 
usually  the  patient  perfectly  loathed  it.     Mr.  Hinds*  cases  quoted. 

486.  Lathcet,  1857,  vol  i,  p.  415. 
By  Mr.  James  Moras  Churchill. 

I  saw  a  case  of  poisoning  by  swallowing  Arsenic  recover  under 
the  free  use  of  new  milk.  Dr.  Armstrong  told  me  that  two  persons 
having  taken  Arsenic  were  cured  by  large  doses  of  Laudanum. 

Beference  made  to  Dr.  Gordon  Smith's  Foreneie  Medicine. 

487.  Chemist  and  Druggist,  1878,  vol.  xiv,  p.  239. 
Editorial. 

A  boy  at  Hereford  complained  of  feeling  sick  and  ill ;  he  became 
much  worse  during  the  night,  and  all  that  could  be  elicited  from  him 
was  "  Its  all  the  fly-paper."  He  became  delirious,  and  died  in  great 
pain.    Arsenic  was  found  in  the  body. 


Arsenic  and  its  Compounds,  411 

488.  JPharmaceutieal  Journal  and  Transactions,  1866,  2Dd 
Series,  vol.  yii,  p.  38. 

Case  of  poisoning  of  the  Millingtons  at  Wrexham,  referred  to. 

489»  Pharmaceutical  Journal  and  Transactions,  1866>  2Qd 
Series,  yoI.  vii,  p.  243. 

From  Glasgow  Morning  Journal. 

Mrs.  K — ,  8Bt.  48,  and  her  daughter,  set.  5,  took  White  Arsenio 
about  9  p.m.,  the  former  about  a  quarter  of  an  ounce.  In  ten  or 
fifteen  minutes  the  child  had  pains  in  stomach,  and  vomited  two  or 
three  times.  Shortly  afterwards  the  mother  was  seiaed  with  violent 
spasmsy  and  what  she  termed  cramp  in  the  legs,  followed  by 
vomiting  lasting  many  hours,  during  which  time  she  was  very 
prostrate.  At  2  a.m.  Pr.  Bocherty  saw  them.  The  child  was 
very  ill  and  the  mother  (who  had  taken  more)  much  worse. 
Nothing  would  lie  on  her  stomach  ;  she  was  very  weak,  and  con- 
tinued to  vomit  a  greenish  matter  streaked  with  blood ;  features 
pinched,  eyes  sunken,  fingers  clenched,  nearly  pulseless,  and 
betokened  great  suffering. 

490.  Chemist  and  Druggist,  1870,  vol.  xi,  p.  217. 
Beference  to  poisoning  of  the  Harrison's  at  Derby  by  Arsenical 

washes  for  the  walls*  of  the  house. 

491.  Lancet,  1864,  vol.  i,  p.  684 ;  1830-1,  vol.  ii,  p.  680. 
Reference  to  cases  by  Guy,  in  Ranking^s  Abstract,  vol.  vii,  p.  247. 

Case  of  Cowfield  and  twenty  others  at  Nottingham,  June  7th,  1848, 
(no  symptoms  here  given),  and  Christison  in  London  Journal  of 
Medicine,  vol.  i,  p.  792 ;  and  Kerr  in  ^din.  Med.  and  Surg, 
Journal,  July,  1831. 

492.  Lancet,  1864,  vol.  i,  pp.  164,  224,  289. 
Case  of  poisoning  at  Croydon. 

Editorial  remarks, — Atlee,  set.  40  to  60^  his  wife,  st.  27,  and 
three  children  of  the  ages  of  8,  6,  and  4  years  died.  On  December 
14th  the  children  first  had  sickness  and  violent  vomiting.  The 
medical  certificate  was  that  they  all  died  of  typhoid  fever.  After- 
wards Arsenic  was  found  in  the  body  of  the  mother.  The  children 
died  on  the  22nd,  23rd,  and  24th,  and  the  mother  on  the  26th  of 
December. 

Dr.  Alfred  Carpenter*s  report  of  the  post-mortem  of  oue  of  the 


412  Pathogenetic  Record. 

children.  Lower  part  of  jejunum  somewhat  reddened  intemallj, 
hut  no  decided  trace  of  infiamination  till  the  middle  of  the  ileum 
waa  reached.  Here  were  large  fNitchea  of  inflammation  around  each 
cluster  of  Peyer's  glands ;  they  were  upon  the  surface  of  the  how«l 
most  distant  from  the  mesentery.  Some  of  the  patches  presented, 
when  examined  under  the  microscope,  heautiful  instances  of  arterial 
injection.  The  glands  were  much  more  decidedly  raised  heneath 
the  surface  of  the  mucous  membrane  than  is  natural.  These 
inflamed  patches  were  most  abundant  near  the  ileo-colic  valve; 
scarcely  any  change  below  that  part.  Heart  pale,  firmly  contracted, 
containing  only  a  very  small  clot  in  rig^t  auricle.  Large  veins  of 
thorax  contained  a  very  small  quantity  of  fluid  blood.  Scarcdy 
any  blood  flowed  from  the  cut  inferior  vena  cava.  (Hll-bladder 
completely  distended  with  bile.    Mesenteric  glands  slightlj  enlarged. 

Dr,  A,  8.  Taylor* $  report  of  the  poet-fnoptem  of  Mrs.  Atlee. 

Mucous  membrane  lining  stomach  frequently  reddened.  Strong 
patches  of  redness,  looking  like  that  of  inflammation  caused  by 
irritant  poison,  at  the  largest  end  near  the  cardiac  orifice.  Duode- 
num and  other  portions  of  small  intestines  showed  some  patchea  of 
inflammatory  redness.     Arsenic  was  found  in  body. 

493.  Chemist  and  Druggist,  1868,  vol.  ix,  p.  649 ;  1861,  vol.  ii, 
p.  85;  1862,  vol.  iii,  p.  21. 

Case  of  Mrs.  Landers,  of  Paisley,  poisoned  by  Arsenical  ointment 
applied  to  abscess  of  breast ;  quoted  from  Lancet,  1868,  October  Srd 
(see  below),  and  to  experiments  by  Schmidt  and  Sturtzwage,  and 
Paul's  case  (see  above). 

494.  Lancet,  1852,  vol.  ii,  p.  299. 
By  Mr.  Thomas  Bryant. 

Mr.  W.  C — ,  set.  80,  took,  when  drunk,  at  least  two  ounces  of 
Arsenic  about  9.15  p.m.,  July  11th.  I  saw  him  about  9.30  p.m., 
and  soon  gave  him  an  emetic  of  fyecacuanha  and  Tartar  emetic. 
At  11.80  p.m.  I  saw  him  again ;  the  emetic  had  acted  immediately, 
had  partly  sobered  him,  and  brought  up  a  quantity  of  dark-brown 
flaky  fluid  containing  Arsenic.  He  was  very  drowsy ;  akin  moist ; 
pain  on  pressure  over  pit  of  stomach ;  tongue  foul,  but  not  injected  ; 
bowels  purged  once  of  a  very  fluid  fetid  stool ;  pulse  100,  full  and 
strong.  The  stomach-pump  was  now  used,  barley-water  being 
injected;  the  fluid  withdrawn  was  more  opaque,  containing  some 


Arsenic  and  Us  Compounds.  418 

brown  cardj  material  and  Arsenic,  Ordered  a  scruple  of  Sulphate 
of  Zinc  every  two  boars. 

July  12th,  8.30  a.m. — Had  taken  four  dc^es  of  the  Zinc  ;  had 
▼omited  considerably  after  each  dose,  but  not  continually ;  the  fluid 
Tomited  was  clear,  with  brown  curdy  flakes  suspended  in  it,  and 
containing  Arsenic.  He  was  bathed  in  sweat ;  had  slight  pain  in 
abdomen,  increased  on  pressure,  but  at  times  very  severe ;  but  little 
dryness  of  throat ;  tongue  foul  and  slightly  injected ;  purged  three 
times,  stools  loose  and  dark ;  pulse  100,  full,  but  weak ;  felt  "  toler- 
ably well."  Ordered  Oiutor  Oil  and  Hydrated  Oxide  of  Iron,  At 
9  p.m.  nausea,  but  no  vomiting  since  11  a.m. ;  still  slight  abdominal 
pain;  tongue  foul,  but  very  slightly  injected;  three  stools,  with 
pain,  very  offensive,  dark,  and  one  looked  bloody ;  pulse  100,  full, 
and  of  more  power. 

13th. — Noon.  Had  a  good  night;  still  pain  over  abdomen, 
worse  on  pressure ;  tongue  the  same ;  two  stools ;  skin  moist ; 
pulse  96,  full,  and  of  good  power  ;  says  he  is  ^'  nearly  well." 

14th. — Altogether  better ;  less  pain  in  abdomen  ;  skin  moist ; 
tongue  cleaner  and  less  injected ;  no  nausea ;  two  stools,  loose,  very 
offensive  and  dark ;  pulse  the  same.  Ordered  Nitrous  ether  and 
Syos. 

15th. — ^Better,  no  tenderness  of  abdomen  ;  tongue  cleaner ;  no 
atool ;  pulse  96,  natural     Repeat  mixture,  and  take  Castor  oil, 

16th. — Four  stools,  containing  scybalsa  and  blood  ;  tongue  foul, 
but  not  injected ;  skin  cool.     Bepeat  OH, 

I7th. — Two  stools,  depositing  a  white  powder  and  containing 
blood ;  otherwise  much  better. 

18th. — Stools  natural,  but  loose. 

2l8t.— Well. 

495.  Lancet,  1830—1,  vol.  ii,  p.  75. 

Extract  from  Orfila's  Traiti  des  Uxhumations  Juridiques,  1831. 

(1.)  The  body  of  Celest.  Yeillet  was  exhumed  fifteen  days  after 
burial.  The  mucous  membrane  of  the  root  of  tongue,  pharynx,  up[)er 
part  of  larynx  and  cesophagus,  was  dark  red,  and  covered  with  a 
great  number  of  phlyctensB. 

(2.)  F —  was  exhumed  more  than  a  month  after  burial.  The 
cardia  and  pylorus  (which  were  covered  with  ecchymoses)  showed 
distinct  traces  of  inflammation.  Internal  lining  of  heart  and  large 
Teasels  was  covered  with  pink  spots. 


414  Pathogenetic  Record, 

(8.)  F —  (daughter)  was  exhumed  three  months  after  burial. 
The  mucous  membrane  of  intestinal  canal,  from  cBsophagos  to  rectum, 
was  ooTered  with  bright  red  spots,  apparently  the  result  of  acute 
inflammation.  Mucous  lining  of  small  intestines  and  oaBcum  eri- 
dently  inflamed,  and  in  some  parts  ulcerated. 

(4.)  F —  (father)  was  exhumed  nine  months  after  buriaL  In 
the  whole  length  of  intestinal  canal,  but  particularly  at  the  upper 
portion,  the  internal  surface  exhibited  numerous  red  spoU,  which 
appeared  caused  by  inflammation. 

Arsenic  was  found  in  the  bodies  of  all  four. 

496.  Practitioner,  1869,  vol.  iii,  p.  70. 
By  Dr.  B.  Sisson. 

From  the  number  of  cases  of  shingles  which  I  have  seen  oeour 
during  the  use  o^Areenic  I  conclude  that  they  stand  to  each  other  in 
the  relation  of  cause  and  effect.  I  myself  sufibred  from  shingles  after 
taking  five  minims  of  the  solution  of  Chloride  ofAreenie  thrice  a 
day  for  a  fortnight.  By  omitting  the  AreeniCy  and  taking  a  saline 
aperienty  the  disease  at  once  disi^peared. 

497.  Cfhemiet  and  Bruggiet,  1862,  toI.  iii,  p.  337. 
Editorial. 

E.  A.  A—-,  a  girl,  sot.  14,  died  from  sucking  artificial  flowers. 
She  was  suddenly  seized  with  pains  and  cramps  in  stomach,  and 
died  next  morning.  Mr.  Chandler  made  apost-mortem,  and  found 
ulceration  of  the  coating  of  stomach.  The  stomach  was  daik  red. 
Arsenite  of  Copper  was  found  in  the  flower. 

498.  Chemist  and  Druggist,  1863,  vol.  iv,  p.  112. 
Editorial. 

Mary  Ann  D —  died  from  Arsenic,  which  was  found  in  her  body 
by  Dr.  Taylor.  There  was  extensive  inflammation  through  the  whole 
of  the  inner  membrane  of  stomach,  every  part  was  inflamed,  and  tlie 
central  portion  of  membrane  was  entirely  destroyed,  so  that  the 
greater  part  of  it  came  away  in  flakes.  There  were  numerous  dots 
of  blood  on  surface  of  stomach. 

499.  London  Medical  and  Surgical  Journal,  1834,  New  Series, 
vol.  iv,  p.  765. 

Carles  and  Biett  show  that  the  most  common  effects  of 


Arsenic  and  its  Compounds,  415 

are  an  increase  of  heat  throughout  the  whole  body,  slight  buruing 
in  throat,  extending  even  to  stomachy  very  remarkable  increase  of 
appetite,  great  thirst,  and  diarrhoBa,  increased  urine,  sweats,  and 
shivers ;  sometimes  constipation. 

600.    Ohemical  News,  1859,  vol.   i,  p.    108;    1863,  vol.  viii, 

p.  307. 

From  Edinburgh  Review,     [No  name  given. — E.  W.  B.] 

An  Arsenical  wall-paper  gave  every  one  who  remained  long  in 

the  rooms  a  violent  cold.     The  paper-hanger  said  it  always  gave 

him  a  bad  sore  throat  and  running  of  the  eyes.     Piony's  case 

quoted,  see  above. 

501.  Chemical  Gazette,  1842-3,  vol.  i,  pp.  35,  341. 

£msmann*s  case  quoted,  see  above ;  Errard's  cases  quoted  from 
Gazette  Med,  de  Farts,  November  5th,  1842  [see  above,  and 
examine  original,  as  there  are  differences  in  the  translations. — 
E.  W.  B.] 

602.  Chemical  Gazette,  1842-3,  vol.  i,  p.  483. 

By  M.  Schindler  (from  Grafe  and  von  Walther's  Journ.,  26). 

ASter  inhaling  about  half  a  cubic  inch  of  the  Arseniuretted 
Sydrogen,  in  three  hours  there  was  giddiness,  heaviness  in  neigh- 
bourhood of  kidneys,  cold  over  whole  body,  shooting  pains  in  knee- 
joints  and  cold  in  extremities,  deadness  of  some  parts,  vomiting  of 
a  yellow-greenish,  bitter  mucus,  secretion  of  dark  red,  nearly  black 
urine,  intense  heat  in  abdomen,  dark  colouring  of  skin,  bleaching  of 
hair  in  the  dead  parts.     Becovered  in  seven  weeks. 

508.  Chemical  Gazette^  1848,  vol.  vi,  p.  228  36. 
By  F.  Wbhler  and  F.  Frerichs  (from  Liebig's  Annalen,  March, 
1848,  p.  885). 

1.  Two  grammes  of  a  dilute  solution  of  pure  Arsenic  odd  were 
introduced  into  the  stomach  of  a  half-grown  rabbit.  For  two  hours 
it  was  well ;  next  morning  it  was  dead.  A  great  amount  of  urine 
and  fteces  had  passed ;  texture  of  stomach  found  unaltered,  only 
in  Bome  limited  spots  there  was  slight  injection  of  vessels ;  faces 
quite  thin  in  large  intestines ;  mucous  membrane  a  very  deep  red. 

2.  Three  grammes  of  the  same  solution  was  given  to  a  young 
dog.  At  first  it  kept  perfectly  quiet,  then  began  to  vomit,  and 
threw  up  some  of  the  acid.  It  then  recovered,  and  appeared  for  two 
hours  quite  lively,  but  died  in  course  of  night.    There  was  diar- 


416  Pathogenetic  Record. 

rhosa.  Mucous  membrane  of  stomach  slightly  reddened  only  in  a 
few  circumscribed  places.  Small  intestines  coated  with  a  white 
mucous  stratum,  consisting  solely  of  cylindrical  epithelium.  Large 
intestine  empty,  and  ite  mucous  membrane  deep  red. 

3.  Three  grammes  of  pure  Arteniate  of  Lime  were  given  to  a  full- 
grown  dog.  At  first  it  remained  quiet,  and  after  two  hours  showed 
no  distinct  symptoms  of  illness ;  next  morning  it  was  dead.  Very 
liquid  faces  had  passed  off.  Stomach  contained  about  twenty 
grammes  of  a  mucous,  faintly-acid  liquid,  coloured  yellow  by  bile, 
with  numerous  strongly-injected  spots,  and  here  and  there  ecchy- 
moses  of  the  sia&e  of  a  lentil.  Mucous  membrane  reddened  through 
the  whole  intestinal  tracts,  but  nowhere  destroyed  by  inflamma- 
tion. 

504.  Medical  Commentaries^  1791,  ro\.  zv,  p.  209. 
Sherwen*s  experiments,  quoted. 

505.  Memoire  of  the  Literary  and  Fhiheophieal  Society  of 
Maneheeter,  1862,  drd  Series,  voL  i,  p.  208. 

By  Dr.  H.  E.  Roscoe. 

Reference  to  Yon  Tschudi^s  paper  in  Wiener  Medieinieche 
Wocheneehr\fi,  October  11th,  1851 ;  Kesteven's  papers  in  ^socio- 
tion  Medical  Journal,  1856 ;  Heisch's  paper  in  Journal  of  Phar^ 
maceutieal  Society,  May,  1860 ;  Dr.  Schidler's  papers  in  the  Gratz 
newspaper,  the  Tayee  Post,  March  30th,  April  8th,  1860 ;  and  Dr. 
Sohafer's  paper  in  Sitzunys  Berichte  der  Aeademie  d,  Wiesen* 
Bchaften,  1860,  band  xli,  p.  573;  and  Schallgruber's  paper  in 
Medidnischer  Jahrhueh.  d.  (Estr.  Staates,  1822. 

Dr.  Holler,  of  Hartberg,  ate  a  piece  of  Stjrrian  cheese,  which  is 
made  with  Arsenic,  and  had  a  slight  burning  in  throat,  as  from 
food  containing  much  spices,  and  afterwards  a  pleasant  warmth  in 
stomach  and  good  appetite.  Once  this  cheese  caused  vomiting  and 
colic. 

Mr.  Stem,  of  Kundorf,  says  a  man  took  a  larger  dose  than  usual, 
which  caused  violent  gastro-enteritis.  [This  paper  conclusively 
proves  the  practice  of  Arsenic'etiting, — E.  W.  B.] 

506.  Sdinhuryh  Medical  and  Suryieal  Journal,  1817,  vol.  xiii, 
p.  507. 

Review,  with  quotations,  of  Remarks  on  Arsenic,  ^c,  by  John 


Tftfi 


BRITISH   JOURNAL 


ov 


HOMCEOPATHY. 


INTESTINAL  OBSTRUCTION.* 
By  John  W.  Hatwabd  M.D. 

I  USE  these  words  in  the  singular^  as  indicating  a  generic 
disease ;  not  in  the  plural^  as  indicating  either  the  kinds  or 
the  causes  of  this  generic  disease.  I  mean^  by  them, 
Obstruction  of  the  Bowels. 

Intestinal  obstruction  may  be  temporary  or  permanent^ 
partial  or  complete. 

The  most  familiar  example  of  temporary  intestinal 
obstruction  is  simple  constipation,  whilst  organic  stricture 
affords  an  example  of  permanent  obstruction.  Permanent 
obstruction  may  result  also  from  impaction  by  foreign 
bodies,  such  as  gall-stones,  which  have  escaped  from  the 
gall-bladder  ;  or  from  masses  of  magnesia  or  chalk,  which 
has  been  taken  as  medicine ;  it  may  also  result  from  lead- 
poisoning;  from  twistiugof  the  bowel,  or  from  intussusception. 
Organic  stricture  may  arise  either  from  closure  of  the 
passage  by  enteritis  or  ulcer,  or  from  constricting  bands, 
or  from  twisting  of  the  bowel,  or  from  internal  hernia. 
And  any,  and  all,  of  these  causes  may  produce,  in  some 
cases  partial,  and  in  some  cases  complete,  obstruction. 

*  Bead  before  the  Liyerpool  Medioo-Chirargical  Society. 
VOL.  XXXVIII,  NO.  CLllI. JULY,  1880.  N 


194  Intestinal  Obstruction^ 

The  diagnosis  in  intestinal  obstruction  is  not  always 
easy ;  that  is  to  say^  it  is  not  always  an  easy  matter  to 
say  whether  an  obstruction  is  temporary  or  permanent^ 
partial  or  complete.  An  apparently  simple  constipation,  in 
fact,  may  prove  to  be  a  permanent  stricture;  and  an 
obstruction  at  first  apparently  complete  and  permanent  may 
eventually  prove  only  temporary^  or  at  least  only  partial. 
Nor  is  it  easy  to  decide  at  once  whether  it  is  dependent  on 
impactioUi  twisting,  intussusception,  or  stricture ;  nor  even 
what  is  the  exact  locality  of  the  obstruction.  The  true 
nature  and  locality  of  the  disease,  in  many  instances,  are 
only  discernible  after  some  days  of  watching.  Some  light 
may  be  thrown  upon  the  diagnosis  by  the  manner  of  onset. 
Simple  constipation  comes  on  gradually,  intussusception 
and  twisting  suddenly,  and  obstruction  by  gall-atones  is 
usually  preceded  by  a  painful  passage  of  the  calculi  from 
the  gall-bladder. 

This  uncertainty  in  the  diagnosis  is  a  matter  of  embar- 
rassment to  the  practitioner  and  a  source  of  danger  to  the 
patient,  at  least  in  allopathic  practice.  The  danger  to  the 
patient  is  great  in  allopathic  practice,  but  only  very  trifling 
in  homoeopathic  practice.  Happily  for  the  homoeopathic 
patient  in  this  disease  it  matters  but  little  what  the 
diagnosis  be ;  but  to  the  allopathic  patient  it  may  make  all 
the  difference  between  life  and  death.  '^If,''  says  Sir 
Thomas  Watson  writing  on  this  subject,  "  we  mistake  colic 
for  enteritis,  the  error  is  of  no  great  moment ;   but  the 

opposite  mistake,  which  is  more  common,  may  be  fatal 

Some  of  the  remedies  for  mere  colic  are  highly  dangerous 
when  there  is  inflammation  of  the  bowel.  •  .  .  Stimulants  are 
frequently  of  great  service  in  true  colic,  but  they  exasperate 
the  symptoms  and  increase  the  mischief  when  the  disease 
is  enteritis ;  and  indeed,  treatment  of  this  kind  will  sonoie- 
times  urge  colic  into  enteritis.'^  (II,  456.)    And  on  the  use 
of  purgatives,  he  says: — ^''Purgatives  given  by  the  mouth 
are  often  rejected  by  the  stomach  with  great  distress    to 
the  patient.     If  they  are  retained  and  fail  to  operate,  they 
must  do  more  harm  than  good.^'     (II,  460.)     ''  Purgatives^ 
however  mild,*'  says  Dr.  Bristowe,  writing  on  acute  intes- 


by  Dr.  John  JV.  Hayward.  195 

tinal  obstruction^  ''  can  do  no  good,  may  do  immense  harm, 
and  must  be  altogether  discarded/^ — Reynolds's  System  of 
Medicine,  III,  102. 

From  these  risks  and  dangers,  homoeopathic  practitioners 
and  patients  are  happily  free.  But  in  any  given  case  what 
is  to  be  done  ?  A  patient  presents  himself  complaining  of 
obstruction  of  the  bowels,  which  has  supervened  gradually  ; 
what  is  usually  done?  The  allopathic  practitioner,  of 
course^  orders  aperients  and  purgatives.  But  suppose  the 
case  be  enteritis  or  twisting,  or  intussusception,  internal 
hernia  or  organic  stricture,  then  the  patient  is  made  worse 
and  hastened  towards  his  grave  by  the  treatment.  The 
homoeopathic  practitioner  orders,  in  such  cases,  a  few  doses 
of  Plumbum^  Opium,  Nuce  vomica,  Bryonia,  Lycopodium,  or 
Alumina,  or  some  other  drug  capable  of  producing  similar 
symptoms  to  those  present  in  the  patient;  and  in  all 
probability  removes  the  disease  at  once ;  but  if  he  does 
not — if  he  does  no  good,  he  at  least  does  no  harm.  It 
may  be  said  the  homoeopathic  practitioner  prescribes  only 
for  the  symptoms ;  this  may  be  true ;  and  so  much  the 
better  for  the  patient ;  for  who  knows  what  the  essence  of 
the  disease  is  ?  Guessing  at  the  disease,  and  treating  this 
imaginary  disease  may  be  fatal  to  the  patient,  as  Sir  Thomas 
Watson  says. 

But  suppose  the  diagnosis  be  less  obscure,  from  the 
symptoms  having  come  on  more  suddenly,  and  it  be 
supposed  to  be  a  case  of  acute  intestinal  obstruction, 
depending  either  upon  intussusception,  internal  hernia, 
stricture,  or  enteritis ;  what  will  then  be  the  mode  of  pro- 
cedure? Why,  with  the  allopathic  practitioner,  notwith- 
standing the  protests  of  some  of  the  older  and  more  dis- 
tinguished teachers,  such  as  Russell  Reynolds,  it  will  still 
be  purgatives.     Even  Sir  Thomas  Watson  himself  says  : 

*^  Remember  therefore,  that  in  every  case  of  obstinate  costive* 
ness,  with  signs  of  inflammation  within  the  abdomen,  it  is 
absolutely  necessary  for  your  own  credit  and  subsequent 
comfort,  as  well  as  for  your  patient's  safety,  to  make  diligent  and 
thorough  enquiry  after  such  hernia  as  may  be  recognised 
externally. 


196  Intestinal  Obstruction, 

'*  But  often  you  find  nothing]  of  the  sort,  and  then  you  are 
at  liberty  to  proaecute  with  more  energy  and  decision  the 
purgative  plan  of  treatment.  You  prescribe  strong  doses  of 
jalap  and  calomel ;  black  draughts.  The  stomach  being  irritable 
you  give  pills  of  cathartic  extract,  and  repeat  them  at  short 
intervals ;  or  large  doses  of  calomel,  ten  grains  or  a  scruple, 
three  or  four  times  in  succession.  You  inject  stimulating 
clysters.  Then  you  are  driven  to  croton  oil ;  and  at  last,  in  some 
vague  hope  of  relaxing  spasm,  to  opiates.  If  symptoms  of 
inflammation  spring  up,  ycm  put  fairly  in  force  the  remedies  of 
inflammation,  and  especially  blood-letting.  But  all  is  in  Tain. 
The  medicines  are  vomited  ;  or,  if  retained,  they  serve  but  to 
augment  the  patient*s  distress,  producing  or  renewing  the  pain 
and  the  nausea.  It  is  extraordinary  how  comfortable  the  patient 
sometimes  becomes  upon  the  intermission  of  these  active 
attempts.  Now  and  then  he  suffers  tormina,  or  has  fits  of 
retching;  but  in  the  intervening  periods  his  sensations  and 
outward  condition  may  be  those  of  perfect  health  ;  only  there 
is  no  alvine  discharge. 

"  Now,  under  these  afflicting  circumstances,  the  question  will 
force  itself  upon  you — how  long  am  I  to  pursue  the  purgative 
system  ?  Common  sense,  and  common  humanity,  answer — ^you 
must  stop  it  the  instant  you  are  convinced  that  there  is  a 
mechanical  obstacle  which  cannot  be  overcome.  To  persist  in 
the  use  of  drastic  purgatives  after  that  conviction  is  to  inflict 
wantx)n  and  needless  torture  upon  the  patient.  But  how  are 
you  to  koow  this  P  That  is  one  difficulty.  And  how  are  you, 
believing  that  it  is  so,  to  satisfy  the  patient's  friends  that  his 
disorder  is  irremediable ;  and  to  resist  their  importunity  to  txy 
this  and  that ;  how  persuade  them  to  look  passively  on  while  their 
relative  is  slowly  perhaps,  but  surely,  perishing?  These  are  great 
and  terrible  difficulties. 

"  You  will  be  urged  with  all  imaginable  suggestions,  even  the 
most  absurd.  Crude  mercury  may  perhaps  be  one.'  Pounds  of 
this  metal  have  been  swallowed  in  such  cases,  in  the  hope,  I 
suppose,  that  it  would  force  a  passage  by  its  weight.  But  the 
obstacle  may  be  in  an  ascending  coil  of  intestine.  And  if  not 
experience  does  not  teach  us  to  put  any  faith  in  this  rude  mechanica! 
remedy.  It  has  often  done  mischief,  and  seldom  or  never  don< 
any  good.    The  metal  is  apt  to  become  oxidised  in  the  body,  an< 


by  Dr.  John  W.  Hayward.  197 

then  to  produce  very  distressing  salivation.  This  is  an  evil 
which  I  have  known  to  occur,  and  to  trouhle  the  patient  greatly, 
some  time  after  the  ineffectual  exhibition  of  large  doses  of 
calomel. 

*'  Dashing  cold  water  over  the  abdomen  and  the  lower  extremi- 
ties is  another  rough  expedient  which  is  sometimes  successful  in 
producing  evacuations.  It  was  adopted,  after  various  other 
measures  had  failed,  in  the  case  in  which  the  bowel  was  tied  down 
by  the  adherent  appendix  vermiformis ;  and  it  caused  the  empty- 
ing of  that  part  of  the  canal  which  lay  beyond  or  below  the 
internal  hernia.  It  is  plain  that  this  partial  success  can  be  of 
little  or  no  use  ;  certainly  of  none  that  can  compensate  for  the 
shock  and  annoyance  of  the  cold  affusion."     Yol.  II,  463,  464. 

True  it  is  that  Dr.  Brinton^  in  his  Croonian  Lectures, 
and  Dr.  Bussell  Reynolds,  in  his  System  of  Medicine,  depre- 
cate such  practice ;  and  it  is  to  be  hoped,  for  the  honour  of 
onr  profession  and  the  benefit  of  patients,  that  the  rising 
generation  of  practitioners^  at  all  events,  will  fully  discard 
it.  That  the  present  generation  has  not  yet  done  so  is 
positively  asserted  by  Mr.  Hugh  Owen  Thomas,  surgeon^ 
of  this  town^  in  an  elaborate  essay  on  the  subject ;  where 
he  says  (pp.  8,  9,  10,  12,  13,  14,  15)  : 

'*  These  two  reports  may  be  compared  with  what  is  done  in 
our  own  time.     We  take  for  example  a  case  reported  in  a  number 
of  the  London  Medical  Record,  June,  1877,  page  233,  when  on 
the   first  day   the   treatment  commenced  with  castor   oil  and 
enema.    Second   day — croton  oil,  two  enemata  of  senna    and 
Boda,  sulph.  in  the  morning  and  evening ;  the  same  day  third 
enema  of  senna  and  soda  sulph.,  and  belladonna  to  the  skin  over 
abdomen.    Third  day — calomel,  jalap,  and  belladonna  every  two 
hours,  and  insujQiation  of  air ;  the  intestines  being  distended  by 
forty  strokes  of  the  bellows.    Fourth  day— enemata  and  purga- 
tiv^e  pills  and  insufflation,  this  latter  was  repeated  '  with  redoubled 
energy.'    Fifth  day— thrice  action  of  the  bowels.     Sixth  day — 
the  belly  was  electrified  and  an  enema  of  mercury,  which  pro- 
duced abundant  motion  and  blood.     Seventh  day — 'a  glass  of 
castor  oil.'     The  treatment  failed  in  this  case  to  kill  the  patient ; 
b^  recovered. 


198  Intestinal  Obstruction,  ' 

**  Again,  in  the  Lancet  for  the  jear  1876,  a  case  of  intussus- 
ception of  the  large  intestine  is  reported.  The  treatment  adopted 
was  copious  warm  8oap-and*water  injections.  The  case  was 
fatal,  the  post-mortem  examination  showing  that  an  advanced 
degree  of  recoTcry  had  taken  place,  and  that  had  Dr.  Brinton's 
principles  been  thoroughly  carried  out  in  practice  there  was  a 
great  probability  that  the  patient  might  have  recovered. 

"  In  the  same  volume,  in  the  column  deyoted  to  correspondents, 
another  case  is  mentioned,  the  treatment  of  which  was  commenced 
with  an  enema  of  castor  oil  and  turpentine,  with  an  '  internal 
compound  to  stimulate  the  intestines,'  the  enema  being  repeated 
while  the  patient  was  sinking. 

"  It  may  probably  be  fresh  in  the  memory  of  the  reader,  the 
report  given  in  the  British  Medical  Association  Journal  of  the 
treatment  adopted  in  the  case  of  the  late  Madame  Du  Devant 
(better  known  as  G-eorges  Sand).  In  her  case,  evidently  one  of 
the  61ite  of  the  profession  was  invited  from  Paris  to  her  Chateau, 
near  Mohan t,  to  assist '  the  learned  men  of  the  parts  around* 
as  to  the  treatment  to  be  adopted,  with  the  result,  it  appears  to 
me,  of  a  repetition  of  that  treatment  which  some  of  the  contri- 
butors to  the  Medical  Physical  Journal  of  1824  would  have 
advised.  In  fact,  the  patient's  chance  of  recovery  would  have 
been  better  had  she  had  no  advice  at  all,  rather  than  the  injurioas 
interference  to  which  she  was  subjected. 

*^  I  will  take  another  example  from  a  recent  number  of  l^e 
Dublin  Journal  of  Medical  Science^  in  which  a  case  of  intestinal 
obstruction  is  recorded,  which  was  treated  on  the  first  day  with 
enemata    of   '  various    kinds,*    '  purgatives  of   different    sorts,^ 
*  including  castor  oil,  scammony,  calomel,  and  croton  oil.'     This 
treatment  was  continued  for  several  days,  when  a  change  of  plan 
seems  to  have  been  decided  upon,  and  extract  of  opium  was  given 
by  the  mouth  every  fourth  hour.     On  the  sixth  day  a  return  was 
made  to  the  previous  treatment  with  purgatives ;  rubbing  the 
bowels  with  warm  oil  had  been  constantly  persevered  with  during 
intervals  of  the  administration  of  medicines.    Sometimes  between 
the  sixth  and  ninth  day  the  distended  abdomen  was  relieved  of 
gas  by  puncture,  and  the  opium  treatment  was  again  resorted 
to  ;  then  about  the  tenth  day,  galvanism  was  appHed.     On  tbe 
fifteenth  day  castor  oil  and  rhubarb  were  administered,  with  the 
result  of  producing  a  return  of  most  of  the  symptoms  which  had 


by  Dr.  John  W.  Hay  ward.  199 

begun  to  abate.    This  case,  wonderful  to  relate,  surviyed  the 
treatment. 

"  Erom  the  foregoing  examples  and  others  which  have  come 
under  my  notice  during  the  last  ten  years,  I  am  convinced  that 
there  are  very  few  in  the  profession  who  are  acquainted  with 
Brinton's  labours,  and  fewer  acquainted  with  the  correct  treat- 
ment of  this  disease,  and  many  who  are  cognisant  of  his  views 
want  the  confidence  to  apply  them  undeviatingly  in  practice. 

*'  This  can  be  further  shown  by  a  comparison  of  the  paper  con- 
tained in  the  British  Medical  Association  Journal  for  1858,  p. 
117,  where  is  recorded  a  series  of  nine  oasea.  I  append  a  con- . 
densed  account  of  each.  The  first  case  was  treated  by  opiates 
and  enemata,  with  metallic  mercury,  and  the  patient  took  7  lbs. 
of  this  metal  and  yet  recovered. 

^^The  second  case  was  treated  by  calomel,  colocynth,  black 
draught,  castor  oil,  enemata,  turpentine  stupes,  and  a  pint  of 
newly  fermented  yeast,  and  recovered. 

"The  third  case  was  treated  by  calomel,  opium,  castor  oil, and 
enemata,  and  proved  fatal,  the  patient  succumbing  in  twelve 
hours. 

"  The  fourth  case  was  treated  with  purgatives,  and  died  on  the 
third  day. 

"  In  the  fifth  case  nearly  all  the  list  of  purgatives  was  tried,  also 
quicksilver  and  tobacco  enemata,  and  the  patient  died  on  the 
sixth  day. 

"  The  sixth  case  was  treated  by  purgatives,  and  proved  fatal  in 
thirteen  hours  after  the  commencemeut  of  the  attack. 

*^  The  seventh  case  was  treated  with  purgatives  and  tobacco 
enemata,  and  also  proved  fatal. 

^  The  eighth  case  was  treated  with  purgatives  and  opium,  and 
proved  fatal. 

''  The  ninth  case  was  treated  with  mild  aperients,  opium,  and 
enemata,  and  was  fatal  on  the  third  day. 

"  In  comparing  the  treatment  of  these  cases  with  that  of  one 
reported  and  discussed  before  the  Clinical  Society  of  London  so 
late  as  last  October,  and  reported  in  the  Lancet  of  the  21st  of 
the  same  month,  I  am  forced  to  the  conclusion  that  we  are  not 
improving  upon  the  treatment  practised  in  times  gone  by,  but 
rather,  retrograding.  This  case,  the  details  of  which  were  dis- 
cussed before  the  Clinical  Society,  appears  to  have  been  diagnosed 


200  Intestinal  Obstruction, 

as  one  of  intestinal  obatrnctiony  and  yet  the  details  of  treatment 
were,  daily  enemata,  hot  fomentations,  castor  oil,  croton  oil,  and 
turpentine ;  the  passage  of  a  long  tube  up  the  bowels,  inverting 
the  patient  and  shaking  him  in  the  inverted  position,  trocaring 
the  bowels,  kneading  and  manipulating  the  abdomen,  galvanism 
(with  the  intention,  it  is  reported,  of  exciting  peristaltic  action), 
the  administration  of  extract  of  aloes,  and  a  combination  of 
enemata  and  kneading ;  and  still  more  remarkable,  it  is  reported 
that  death  occurred  suddenly  and  unexpectedly  on  the  fifty-ninth 
day,  after  all  this  heroic  treatment.  Surely,  death  could  only  be 
expected,  as,  to  all  the  remedies  so  trying  to  the  patient's  powers 
of  endurance.  Was  superadded  a  very  serious  complaint. 

"  In  confirmation  of  my  assertion  as  to  how  imperfectly  the 
principles  of  treatment  are  understood  in  the  present  time  I  sub- 
join a  quotation  from  Dr.  J.  S.  Bristowe*s  recent  volume  on  the 
Theaiy  and  Fraeiioe  of  Medicine,  published  last  year,  advising 
treatment  for  intussusception,  page  728. 

*' '  In  those  cases,  however,  in  which  the  symptoms  of  obstruc- 
tion come  on  vaguely  and  without  evidence  of  association  with 
inflammatory  mischief,  it  is  generally  advisable  to  commence  the 
treatment  with  the  administration,  either  by  the  mouth  or  rectum, 
of  moderately  powerful  purgatives,  and  to  persist  in  this  treat- 
ment until,  by  their  failure  to  act,  and  by  their  causing  vomiting 
and  painful  bat  fruitless  peristaltic  movements,  their  inefficacy  is 
distinctly  shown.    It  sometimes  happens  that,  after  drastic  pur- 
gatives have  failed,  a  large  dose  of  some  simple  laxative,  such  as 
castor  oil,  acts  with  singular  efficacy.    In  aid  of  this  treatment, 
hot  baths,  fomentations,  or  ice  or  elecl^ricity  to  the  surface  of  the 
belly,  and  voluminous  enemata  of  gruel  or  of  water  may  severally 
be  employed.    If  those  measures  are  without  avail,  it  is  generally 
advisable  to  give  the  bowels  rest,  and  to  relieve  pain  hj  the 
repeated  use  of  adequate  doses  of  opium  or  of  belladonna^  the 
persistence  in  which  treatment  will,  by  relieving  spasm,  or  other- 
wise promoting  the  return  of  some  length  of  bowel  to  a  com- 
paratively healthy  condition,  not  unfrequently    result,  after  a 
shorter  or  longer  time,  in  an  effectual  and  sufficient  evacuation. 
If  this  treatment  fail  in  its  turn,  it  may  be  necessary  i^in  to 
solicit  the  action  of  the  bowels  by  the  employment  of  pui^tive 
medicines,  enemata,  and  the  like.    Such  is  the  routine  which 
XQust  be  generally  followed  in  pas^s  of  simple  obstruction,  ix^ 


by  Dr,  John  fF.  Hayward.  201 

which  the  cause  of  obetruction  is  obscure ;  aud  in  many  cases 
also  even  when  the  cause  is  distinctly  ascertained.' 

**  Here  we  are  advised  to  commence  with  powerful  purgatives, 
and  to  persist  in  their  use  until  we  have  evidence  of  their  in- 
jurious action  ;  then  mild  laxatives  can  be  tried,  aiding  all  these 
by  hot  fomentations,  electricity,  and  enemata ;  failing  in  all  these 
opium  or  belladonna  is  to  be  given ;  after  which  latter,  if  they  fail, 
a  return  to  purgative  and  enemata,  &c.,  is  counselled.  In  fact, 
it  may  be  noticed  that  there  is,  in  the  treatment  recommended, 
an  utter  absence  of  any  systematic  method  based  on  the  etiology 
of  the  difficulty  under  consideration.  These  lesions  are  of  such 
serious  import  to  life  that  it  were  better  to  practise  an  expectant 
method  than  to  incur  any  risk  by  giving  remedies  not  based  on 
successful  clinical  or  experimental  observation.  Many  cases  have 
been  reported  as  having  recovered  even  after  the  most  inefficient 
treatment,  which  to  my  mind  is  strong  evidence  that  with  a  more 
rational  treatment  the  mortality  would  be  decreased." 

There  are^  then^  now  in  the  old  school  four  principal  kinds 
of  treatment  of  acute  intestinal  obstruction^  viz.  the  pur- 
gative plan  just  referred  to ;  the  mild  tentative  treatment 
advocated  by  Russell  Reynolds ;  the  Opium  and  Belladonna 
treatment  advocated  by  Dr.  Brinton ;  and  the  mere  Opium 
treatment  with  very  small  diet  advocated  by  Mr.  Thomas. 

Reynolds  recommends  mild  enemas^  mild  aperients^  and 
very  small  diet.  Brinton  recommends  large  doses  of  Opium 
to  keep  the  bowels  quiet^  combined  with  a  little  Belladonna 
to  promote  peristaltic  action^  and  the  avoidance  of  all  pur- 
gatives, aperients,  and  even  enemas.  Thomas  deprecates 
all  attempts  to  move  the  bowels  by  either  purgatives  or 
enemas,  and  he  uses  Morphia,  subcutaneously  injected  two 
or  three  times  a  day,  for  the  purpose  of  keeping  the  bowels 
in  absolute  quietude,  his  object  being  to  prevent  any  action 
whatever  of  the  bowels,  and  this  he  would  do  for  seven, 
fourteen,  or  twenty-one  days,  or  even  longer,  giving  the 
while  only  the  smallest  quantity  of  nourishment. 

The  object  aimed  at  in  each  of  the  two  latter,  or  at  least 
in  the  last  plan,  is  not  to  attempt  to  cure  the  disease,  but 
simply  to  keep  the  bowels  quiet  and  to  prevent  their  acting 
at  all>  whilst  Nature  herself  cures  the  disease.     Now,  this 


202  Tnteitinal  Obitruction, 

object  is  certainly  best  served  by  the  simple  Opium  treat- 
ment of  Mr.  Thomas,  which  must  be  described,  however, 
as  simply  a  negative  treatment. 

I  need  scarcely  here  remark  that  we,  of  the  new  school, 
have  all  along  and  always  deprecated  the  use  of  purgatives 
and  even  aperients  in  such  cases,  and  I  may  say  that  we 
are  not  alarmed  at  the  proposal  to  forcibly  keep  the  bowels 
from  acting  at  all  for  seven,  fourteen,  or  twenty-one  days^ 
or  eVen  longer,  in  cases  of  enteritis,  intussusception,  internal 
hernia,  or  stricture ;  and,  further,  that  we  quite  believe  in 
the  necessity  of  absolutely  preventing  peristaltic  action,  for 
some  time  at  least,  in  such  cases,  and  that  forcibly  if  neces- 
sary, but  that  in  practice  we  do  not  find  this  enforcing 
with  Opium  necessary,  our  specific  medicines  being,  as  a 
rule,  quite  capable  of  doing  it. 

Mr.  Thomas  gives  some  striking  instances  of  recovery 
under  the  simple  Opium  treatment,  of  which  I  will  give  the 
three  following  (pp.  74,  79,  86)  : 

"  Case  No.  1. — During  the  early  part  of  this  year  I  was  called 
to  assist  in  the  treatment  of  a  case  of  supposed  intussuscep- 
tion.  The  gentleman  in  charge  of  the  case  informed  me  that  a 
fortnight  previously  the  patient  had,  whilst  at  work,  had  a 
sudden  action  of  the  bowels  followed  soon  after  by  a  good  deal 
of  colic  pain,  to  relieve  which  the  medical  attendant  was  called 
in ;  and  he,  attributing  the  cause  to  constipation,  administered 
purgatives,  enemas,  &c.,  which,  however,  had  given  the  patient 
no  relief.  When  I  examined  him  I  found  the  abdomen  very 
tender  on  pressure,  especially  in  the  right  hypogastric  region, 
with  moderate  distension,  and  frequent  vomiting,  which  had 
become  slightly  stercoraceous.  I  advised  the  discontinuance  of 
all  purgatives  and  all  interference  by  the  use  of  enemas,  and 
ordered  cold  cloths  to  the  bowels,  elevation  of  the  pelvis,  and 
morphia  administered  subcutaneously  night  and  morning.  Thu 
treatment  had  the  effect  of  diminishing  the  pain  and  partially 
arresting  the  vomiting,  which  now  only  occurred,  with  a  notable 
regularity,  about  once  in  twelve  hours.  The  distension  con- 
tinuing much  as  before,  the  morphia  was  continued,  sometimes 
twice,  and  at  others  three  times  a  day,  subcutaneously  for  the 
seven  days  succeeding  my  first  consultation,  with  the  effect  of 


by  Dr.  John  W.  Hayward.  203 

greatly  relieving  the  patient  from  paiu  and  the  partial  arrest  of 
the  vomiting ;  but  there  was  no  diminution  of  the  distension,  nor 
was  the  rapidity  of  the  pulse  much  diminished.  About  the 
eleventh  day  after  my  introduction  to  the  case  the  morphia  dose 
had  to  be  much  iucreased,  but  did  not  completely  ease  the  pain, 
and  diminish  the  rapidity  of  the  palse>  whilst  the  distension 
was  slightly  increased.  On  the  twelfth  day  of  my  co-operation 
in  the  treatment  the  patient's  condition  appeared  very  precarious, 
and  indicated  to  my  mind  that  if  in  the  course  of  a  few  hours 
the  symptoms  did  not  improye,  it  would  be  necessary  to  practise 
some  operative  interference,  lest  perchance  this  might  not  be  a 
case  of  intussusception  or  enteritis,  but  rather  one  of  the  various 
forms  not  usually  judged  amenable  to  therapeutical  remedies. 
This  opinion  was  based  on  the  fact  that  the  morphia  appeared 
not  to  have  sufficient  control  over  the  pain  or  the  pulse.  How- 
ever, to  my  delight,  when  we  met  in  consultation  the  next  day, 
I  was  informed  that  the  patient  had  passed  frequent  and  copious 
semi-liquid  stools,  with  great  relief  to  all  the  symptoms." 

"  Case  No.  6. — On  the  15th  of  December,  1874, 1  was  called 
to  attend  a  club  patient  of  mine,  Mr.  P.  M — ,  32  years  of  age, 
residing  at  B —  Street.  I  found  him  suffering  from  intense  pain 
in  the  abdomen,  attended  with  constant  vomiting,  which  was 
stercoraceous  in  character.  He  had  been  sick  some  days,  but 
judging  that  it  arose  from  simple  constipation  he  had  used  pur- 
gatives ;  consequently,  I  found  the  symptoms  much  aggravated 
when  called  to  attend  him.  I  immediately  injected  a  quarter 
of  a  grain  of  morphia  beneath  his  skin,  and  continued  to  do  so 
twice  daily  for  three  days,  with  the  effect  of  diminishing  the  pain 
and  decreasing  the  vomiting ;  but  the  distension  increased.  On 
the  fourth  day  I  commenced  to  inject  under  the  skin  a  half  a 
grain  of  morphia  four  times  a  day,  and  on  the  sixth  day,  finding 
the  distension  still  increased,  he  was  tapped  with  an  ordinary 
bladder  trocar  with  the  effect  of  relieving  him  of  a  good  deal  of 
gas,  which  collapsed  the  abdomen.  On  the  ninth  day  the  trocar- 
ing  was  repeated,  the  morphia  being  still  continued.  The  use  of 
the  trocar  was  repeated  at  intervals  of  three  days,  and  on  four 
occasions  in  all.  On  the  twenty-first  day  a  spontaneous  action 
of  the  bowels  took  place,  the  patient  being  much  relieved ;  yet 
the  opium  treatment  was  continued  for  some  days,  and  the  sym- 
ptoms gradually  resolved,  and  the  patient  recovered." 


204  Intestinal  Obstruction, 

**  Case  No.  8. — On  December  16th,  last  year,  at  midnight,  I 
was  requested  to  go  on  board  a  Swedish  vessel  in  the  Salthouse 
Dock  to  render  professional  assistance  to  one  of  the  crew.    On 
boarding  her  I  found  the  steward  in  great  pain.    His  previous 
history  was,  that  while  'straining  at  stool,'  he  felt  a  sudden 
pain  in  the  right  iliac  region,  no  diarrhoea,  thirst,  slight  accelera- 
tion of  pulse.    The  captain,  on  the  occurrence  of  the  pain,  had 
given  him  a  dose  of  Epsom  salts.    This  he  had  vomited  imme- 
diately.   My  examination  of  the  patient  was  made  in  about  one 
hour  after  the  accession  of  the  pain.    I  at  once  injected  under 
skin  a  quarter-grain  dose  of  morphia,  advised  abstinence  from 
all  food,  and  allowed  a  limited  quantity  of  drink,  frequently 
repeated  if  desired  by  the  patient.    Next  day,  at  9  a.m.,  I  sent 
my  assistant  to  visit  him,  with  instructions  that  if  in  pain  to 
inject  an  eighth  of  a  grain  of  morphia.    This  dose  was  given, 
and  at  4  p.m.  visited  him  myself,  and  was  informed  that  he  had 
vomited  twice  (but  slight  in  quantity)  during  the  night.    The 
iliac  region  was  still  tender,  slight  thirst,  pulse  accelerated.    I 
now  again  injected  a  quarter  of  a  grain  of  morphia  under  skin, 
previous  details  as  regards  diet  and  drink  to  be  adhered  to. 
Third  day  visited  and  found  that  he  had  vomited  once  only  since 
last  visit,  all  the  other  symptoms  being  the  same  as  those  present 
on  the  second  day.    I  now  advised  removal  to  my  hospital,  but 
before  removal  injected  a  quarter  grain  of  morphia,  2  p.m.    In 
the  evening  I  visited  him  in  the  hospital,  and  found  tongue  more 
furred,  no  increase  of  distension,  tenderness  still  present  on 
pressure  of  the  iliac  region,  temperature  100^  pulse  as  before, 
had  vomited  once  this  evening ;  repeated  half  grain  of  morphia. 
On  the  fourth  day,  at  9  p.m.,  injected  half  grain  of  morphia; 
symptoms  present  during  this  day,  pulse  no  change,  no  vomit, 
tongue  furred,  slight  tenderness  and  distension,  less  than  had 
hitherto  existed,  temperature  102^.    In  the  afternoon  he  passed 
suddenly  a  very  copious  liquid  stool.    No  food  was  allowed  until 
the  fourth  day ;  a  little  arrowroot  and  water  and  beef  tea  was 
allowed  this  day  in  response  to  the  patient's  request,  and  another 
half  grain  of  morphia  was  administered  under  the  skin  at  10 
p.m.    Filth  day,  9  a.m.,  gave  half  grain  of  morphia  under  the 
skin ;  at  12  noon,  passed  a  copious  pultaceous  motion,  pulse  7 
in  five  seconds,  temperature  101°,  tongue  furred,  no  vomit,  slight 
thirst;  half  grain  of  morphia  given  at  6  p.m.,  not  the  slightest 


hy  Dr.  John  W,  tiaytvard.  205 

tension  of  the  abdomen,  but  slight  pain  in  right  iliac  region  on 
pressure.  Sixth  day,  had  during  night  passed  several  small 
pultaceous  motions,  pulse  7  in  five  seconds,  temperature  99°, 
tongue  less  furred,  no  distension,  pain  in  iliac  region  diminishing ; 
no  morphia  given  in  the  morning ;  patient  wanted  to  return  to 
Sweden,  but  with  the  assistance  of  two  other  medical  friends  was 
persuaded  to  remain  another  week :  10  p.m.,  half  grain  of  morphia 
under  skin,  as  there  was  increase  of  pain.  Seventh  day,  pulse 
and  temperature  normal,  tongue  correct,  no  thirst,  pain  only  on 
firm  pressure  of  iliac  regiou,  bowels  acted  three  times  during  the 
day ;  half  grain  of  morphia  was  given  at  10  p.m.,  same  diet  con- 
tinued. Eighth  day,  apparently  well,  but  still  slight  pain  on  firm 
pressure,  continued  same  diet,  and  half  grain  of  morphia  under 
skin  at  bed.  Ninth  day,  all  abnormal  symptoms  absent,  and  the 
evacuations  passed  appeared  of  normal  consistence,  though  small 
ia  bulk,  indicating  that  all  accumulated  liquids  had  been  passed, 
consequently  the  conditions  permitting  the  spurious  diarrhoea 
which  often  follows  relief  of  obstruction  existed  no  longer/' 

These  cases  show  from  what  a  formidable  disease  the 
body  can  recover  when  left  to  itself;  nay,  what  Nature  can 
do  even  when  uuder  the  depressing  and  obstructing  influence 
of  Opium  poisoning  !  What^  then,  could  she  not  do  with 
perfect  quietude  and  the  assistance  of  judicious  specific 
treatment  ?  I  am  quite  satisfied  that  many  of  the  recorded 
fatal  cases  would  have  recovered  with  the  help  of  homoeo- 
pathic medication. 

But  before  going  into  the  homoeopathic  treatment^  let 
us  examine  the  pathology  of  intestinal  obstruction.  Passing 
over  the  obstruction  dependant  on  mere  torpor  or  inaction^ 
which  is  easily  put  to  rights  with  Opium,'  Plumbum^  Nux 
vom.y  Sulphur,  and  excluding  specific  stricture^  as  that  of 
syphilis,  which  must  be  met  by  Mercurius,  KaU  iodidum, 
Acidum  niiricum  ;  and  that  of  cancer,  which,  when  curable, 
is  so  by  Conium,  Arsenicum,  Hydrastis,  Hamamelis,  and  con- 
fining our  investigation  to  sudden,  acute,  or  inflammatory 
obstruction,  we  have  still  a  very  serious  disease  to  deal 
with.  Whether  the  cause  of  the  obstruction  be  impaction 
of  a  foreign  body,  twisting  of  the  gut,  intussusception, 
hernia,  or  stricture,  we  have  always  organic  closure  of  the 


206  tntesiinal  Obstruction, 

passage  of  the  gut^  attended  with  iuflammation.  In  some 
cases^  the  closure  is  absolute  and  complete^  at  least  for  a 
time  ;  and  much  faith  in  the  reparative  powers  of  nature  is 
needed  to  be  able  to  believe  that  recovery  is  at  all  possible. 
We  shall  not  have  time  to  review  all  the  varieties  of 
intestinal  obstruction ;  nor  is  it  necessary  we  should,  as 
much  the  same  treatment  is  required  in  all  of  them.  We 
will  then  take  intussusception.  In  this  disease  the  course 
of  matters  is  something  like  the  following : — A  portion  of 
the  bowel  becomes  abnormally  distended  with  flatulence, 
and  whilst  thus  distended,  an  unfortunate  peristaltic  action 
draws  down  a  few  inches  of , the  non-distended  bowel  above 
into  this  enlarged  portion ;  two  mucous  surfaces  and  two 
serous  surfaces  of  the  bowel  are  thus  brought  into  contact ; 
the  distending  gas  is  excluded  from  a  portion  of  the  enlarged 
bowel,  and  the  two  approximated  mucous  surfaces  irritate 
each  other,  especially  if  there  is  any  faecal  matter  between 
them ;  peristaltic  action  occurs ;  and  the  contained  portion  of 
the  bowel  becomes  constricted — strangulated — ^by  the  con- 
taining portion,  the  circulation  is  interrupted,  the  mucous 
membranes  swells  and  congestion  and  inflammation  super- 
vene. The  same  changes  take  place  in  the  two  approxi- 
mated serous  surfaces,  and  the  result  is  that  a  portion  of 
the  bowel  becomes  closed,  more  or  less  completely ,-  excessive 
and  inverted  peristaltic  action  is  then  excited,  producing 
pain,  increasing  the  inflammation,  and  causing  vomiting 
and  fever.  That  such  an  accident  should  occur  is  not  very 
surprising,  it  is,  indeed,  more  surprising  that  it  is  not  of 
very  frequent  occurrence.  A  small  and  temporary  invagi- 
nation may,  indeed,  be  of  frequent  occurrence.  It  is 
probable,  I  think,  that  such  an  accident  will  account  for  many 
of  the  temporary  attacks  of  abdominal  pain,  with  vomiting — 
the  so-called  ''  bilious  attacks  ^'  that  are  so  common — ^the  in- 
vaginated  portion  of  the  bowel  becoming  liberated  before  the 
occurrence  of  sufficient  inflammation  to  glue  it  to  the 
iuvaginating  portion ;  and  it  is  probable  that  all  such  cases 
would  terminate  thus  favourably  by  the  timely  assistance 
of  hot  fomentation  and  a  few  doses  of  an  appropriate 
specific  medicine  such  as  plb,^  iia?-v.,  col*,  aim,,  k-bi.,  bel.,  opi. 


by  Dr.  John  tV*  Hayward,  ^07 

Opium  is  a  medicine  very  homoeopathic  to  such  cases.  It 
produces  all  the  essential  symptoms  of  the  onset  of  acute 
intestinal  obstruction^  viz.  the  pain^  the  vomitings  and  the 
obstruction^  and^  indeed^  the  diarrhoea  also. 

1  need  not  go  into  any  proof  of  the  power  of  Opium  to 
produce  constipation^  we  are  all  perfectly  agreed  on  that ;  but 
I  may  offer  a  little  evidence  of  its  power  to  produce  vomit- 
ing, abdominal  pain^  tympanitis^  tenderness,  and  diarrhoea. 

In  our  collected  list  of  the  poisonous  effects  of  Opium^  as 
given  in  Allen^s  Encyclopadia,  I  find  over  sixty  instances 
of  very  characteristic  nausea  and  vomiting ;  over  seventy  of 
abdominal  pain ;  over  thirty  of  flatulent  distension^  gene- 
rally painful ;  and  over  thirty  of  diarrhoea. 

This  power  of  Opium  to  produce  a  condition  similar  to 
the  onset  of  intestinal  obstruction  will  account  for  the 
frequent  cure  of  such  attacks  by  the  old<fashioned  poppy- 
head  fomentation,  or  a  small  dose  of  Castor  oil  with  a  few 
drops  of  Laudanum^  and  for  the  still  more  frequent  cure  of 
the  apparently  initial  symptoms  by  Opium^  in  homoeopathic 
practice ;  and  for  some  of  the  cures  recorded  by  Mr.  Thomas. 

But  suppose  the  supervening  inflammation  has  been 
suiScient  to  glue  together  the  surfaces  and  completely  close 
the  bowel ;  what  are  the  resources  of  art  then  ?  As  already 
shown,  the  resources  of  the  old  school  are  few ;  the  best  of 
them  being  that  advocated  by  Mr.  Thomas,  viz.  to  forcibly 
prevent  peristaltic  action  by  large  doses  of  Opium,  leaving 
Nature  herself  to  do  the  cure.  In  the  new  school,  on  the 
contrary,  there  are  quite  a  number  of  medicines  capable 
of  grappling  with  this  disease  in  all  its  manifestations. 
The  principal  of  these  are  Acq.,  Am.,  Bel.,  Bry.,  Col,  Ctn., 
Cup.,  KM.,  Kre.,  Lye,  Merc,  Nx-v.,  Opi.,  Plb.,  Rhs.,  Sul., 
Ver.  With  these  and  hot  fomentation,  most,  if  not  all,  of 
the  curable  cases  can  be  cured.  With  them,  not  only  can  we 
assist  to  rectify  the  invagination,  but  we  can  relieve  the  pain, 
check  the  inflammation,  and  remove  its  results,  and  control 
the  peristaltic  action,  so  as  to  render  Morphia  injection 
quite  uimecessary. 

Should  there,  however,  occur  a  case  in  which  these  and 
all   other  homoeopathically    selected  medicines  did  really 


208  tntestinal  Obstructidn, 

fail  to  control  the  disease,  and  the  case  appeared  to  have 
passed  out  of  the  region  of  medicine  into  that  of  snrgery^ 
I  would  not  hesitate  to  resort  to  the  Morphia  injection^ 
feeling    sure^  with   Mr.    Thomas,    that    peristaltic   action 
must    be    controlled   bjr    some    means,    and    perfect    rest 
of  the   parts   maintained  for  some  time.     I  would  much 
rather  do  this  than  resort  to  abdominal  section  in  a  case  of 
intussusception.     For,   although   I    would    resort   to   this 
operation  at  once  in   a  well-diagnosed  case  of  impaction, 
internal  hernia,  or  stricture,  I  would  be  very  loath  to  do  so 
in  a  welUdiagnosed   case  of  intussusception ;  and  certainly 
not  after  it  had  existed  a  few  days,  for  then  this  would  be 
much  more  likely  to  ensure  a  fatal  termination  than  to 
prevent  it,   for  the  invaginated  portion  of  the   intestine 
could  not  then  be  withdrawn  without  rupture,  even  if  real 
gangrene  had  not  set  in,  which,  however,  it  would  have  done 
in  the  great  majority  of  cases.     In  cases   incurable  by 
medicine,  I  would  much  prefer  to  trust  to  the  reparative 
powers  of  Nature  herself,  than  resort  to  surgery ;  that  is,  I 
would  much  prefer  to  leave  the  invaginated  portion  of  the 
bowel  to  slough  and  come  away  in  its  own  time,  and  devote 
all  my  endeavours  to  moderate  the  inflammation,  and   the 
blood-poisoning,  which  would   result  from    absorption    of 
gangrenous  tnatters ;    and    to    supporting    the    patient's 
strength.     It  is  really  wonderful  what  cures  Nature  can 
perform  when  wisely  assisted,  and  even  when  left  to  herself; 
nay,  even  when  obstructed,  and  depressed,  and  thwarted  by 
rough  treatment,  or  large  doses  of  Ofdutn.     A  few  instances 
will  be  sufficient  to  indicate  this,  and  to  inspire  confidence 
in  the  ultimate  recovery,  even  in  desperate  cases.     ''  By 
far  the  most  interesting  and  important  event,''   says  Dr. 
Bristowe,  *'  is  the  sloughing  and  separation  of  the  included 
layers  of   bowel.     It  has  been    shown   that   almost    im- 
mediately after  the  occurrence  of  invagination  these  become 
oedematous,  intensely  congested,  and  infiltrated  with  blood ; 
and  it  might  be  supposed  from  the  obstruction  to  which  the 
vessels  supplying  them  are  exposed,  that  their  death  must 
necessarily  speedily   ensue.     In  many  cases,  however,  the 
patients  live  for  weeks,  and  even  months,  after  the  occur- 
rence of  invagination,  with  no  further  changes  in  the  con- 


by  Dr.  John  W.  Hayward.  209 

tained  tubes  than  those  dae  to  mere  congestion  and  swell- 
ings and  die  ultimately  from  the  effects  of  invagination,  the 
bowel  never,  even  to  the  last  showing  signs  of  either 
ulceration  or  gangrene/'  Reynolds* s  System  of  Medicine, 
p.  91,  vol.  iii. 

"  As  an  instance  of  remarkable  recovery,"  says  Mr.  Thomas, 
'^  from  intnssusception,  there  is  recorded  in  volume  16  of  the 
Isoneety  p.  16,  a  case  in  which  three  feet  of  intestine,  with  a 
portion  of  its  mesentery  attached,  came  away.  This  case  is 
reported  by  a  professor  of  anatomy,  a  guarantee  that  it  was 
intestine  that  was  passed. 

''In  volume  11,  p.  565,  Mr.  Abernethy  reports  a  case  where  a 
portion  of  the  intestine  sloughed  and  came  away.  The  treatment 
is  not  given  in  either  of  the  above  cases. 

"  In  the  Transactions  of  the  British  Medical  Provincial  Aseocia^ 
iiony  7th  volume,  a  case  is  reported  of  recovery  after  five  inches 
of  intestine  had  passed,  though  treated  by  the  purgation  method. 

"  My  friend.  Dr.  Tumour,  of  Denbigh,  informed  me  that  he  had 
a  case  where  a  large  portion  of  intestine  sloughed  and  came  away, 
bis  treatment  being  the  administration  of  opium,  the  use  of  which 
be  strongly  advocates  in  these  lesions.  Dr.  Bristowe,  in  his 
recent  volume,  reports  on  the  authority  of  Dr.  Peacock,  of  Lon- 
don, a  case  in  which  the  sufferer  passed  twelve  feet  of  gut,  and 
recovered.  This  extraordinary  and  unprecedented  report  induced 
in  me  some  doubt  of  its  correctness.  I  communicated  with  Dr. 
Peacock,  who  very  readily  favoured  me  with  a  reprint  of  his 
paper, '  A  case  of  invagination  of  the  intestines  followed  by  the 
passage  of  a  large  piece  of  bowel  by  the  rectum,'  originally  pub- 
lished  in  Transactions  of  the  Pathological  Society,  vol.  zv.  Erom 
a  perusal  of  his  paper  I  find  that  instead  of  twelve  feet  the 
portion  passed  measured  only  thirty-five  inches.  The  author 
^ves  a  short  history  of  twenty  cases  of  invagination  with 
sloughing  of  portion  of  intestine.  Case  18  is  reported,  on  the 
authority  of  Drs.  Harley  and  Bristowe,  as  having  passed  the 
almost  incredible  length  of  four  feet,  with  recovery,  the  period 
of  separation  varying  from  the  sixth  to  the  thirtieth  day." 

If,  then,  such  recoveries  can  take  place  without .  specific 
treatment  what  may  not  be  expected  to  follow  judiciously 
managed  treatment  with  specifics? 

VOL.  XXXVIII,  NO.  CLIII.^JULY,   1880.  O 


210  Intestinal  Obstruction, 

Now,  in  order  to  indicate  the  proper  homoeopathic  treat- 
ment^ let  as  review  the  symptoms  of  intussusceptioa. 

**  The  symptoms/'  says  Dr.  Bristowe  (p.  92,  Beynolds^s  System 
qfMedicins^  vol.  iii),  which  attend  intussusception  are  made  up 
partly  of  the  symptoms  of  intestinal  obstruction,  partly  of  those 
of  enteritis,  but  they  present  much  variety,  and  are  often  so  vague 
as  to  render,  for  a  time  at  least,  accurate  diagnosis  impossible. 
There  are  nevertheless  certain  characteristic  symptoms,  which,  if 
present,  point  pretty  certainly  to  the  existence  of  the  lesion  in 
question. 

*'The  commencement    of  intussusception  is  attended    with 
sudden  and  more  or  less  severe  abdominal  pain  of  a  griping  or 
twisting  character,  which  is  referred  usually  to  the  neighbourhood 
of  the  umbilicus.    This  generally  ceases  after  a  short  time  perhaps 
a  few  hours,  and  then  after  an  interval  of  comparative  or  total 
ease  returns  temporarily,  and  thus  perhaps  continues  to  recur 
remittently.    There  is  not  necessarily  any  abdominal  tenderness, 
and,  indeed^  the  patient  frequently  finds  relief,  as  in  colic,  by 
various  contortions  of  the  body  and  by  pressure  upon  the 
abdominal  parietes.     Sympathetic  vomiting  may  be  an  early 
symptom,  but  is  often  in  the  beginning  absent.    Constipation 
generally  follows  upon  the  sudden  attack  of  pain,  not,  however, 
immediately,  for  the  bowel  below  the  seat  of  lesion  may,  and 
does  generally,  continue  to  act  upon  its  contents  until  they  are 
completely  expelled ;  nor  necessarily,  because,  as  has  been  pointed 
out,  the  intussusception  does  not  in  all  cases  entirely  prevent  the 
passage  of  faecal  matters  from  above,  and  sometimes,  indeed, 
instead  of  any  tendency  to  constipation,  there  is  actual  diarrhoea. 
There  is  one  peculiarity,  however,  in  connection  with  the  intesldnal 
evacuations  which  is  rarely  absent ;  it  is  that,  very  soon  after  the 
occurrence  of  intussusception,  the  blood  which  escapes  from  the 
deeply  congested  mucous  surface  of  the  invaginated  bowel  mingles 
with  the  contents  of  the  bowel  below,  and  escapes  with  them  by 
stool  in  greater  or  less  abundance. 

''  The  symptoms  which  mark  the  subsequent  progress  of  the 
case  depend  partly  on  the  situation  of  the  intussusception,  partly 
on  the  degree  in  which  the  bowel  is  strangulated.  It  has  been 
shown  that  when  the  intussusception  involves  the  large  intestine 
actual  strangulation  occurs  somewhat  rarely,  and  the  case  tends 


by  Dr,  John  W.  Hay  ward.  21 1 

to  become  much  protracted.  In  this  event  the  symptoms  are 
apt  to  be  very  ill-defined,  the  paroxjms  of  pain  are  often  slight, 
and  recur  at  distant  intervals;  constipation  may  exist  at  the 
beginning  only,  or  may  occur  from  time  to  time,  and  it  may 
never  be  distinctly  present;  there  is  generally  more  or  less 
vomiting.  As  the  case,  however,  progresses  the  pain  often 
increases  in  severity,  t&e  vomiting  becomes  more  and  more 
incessant,  and  possibly  stercoraceous ;  the  alvine  evacuations 
either  continue  to  pass  or  become  re-established,  blood  and 
mucus  are  discharged  in  variable  quantities,  and  even  dysenteric 
diarrhcea  comes  on.  And  then,  after  a  longer  or  shorter  period, 
sometimes  after  two,  three,  or  four  months,  the  patient,  who  has 
been  gradually  getting  more  emaciated  and  feeble,  dies  of  simple 
exhaustion.  When  the  invagination  occupies  the  small  intestine 
strangulation  is  usually  of  rapid  occurrence,  and  its  occurrence 
adds  to  the  symptoms  of  mere  intussusception  those  of  enteritis. 
The  case,  therefore,  speedily  assumes  a  very  threatening  aspect. 
Pebrile  symptoms  manifest  themselves,  the  abdomen  becomes 
tender,  incessant  vomiting  comes  on,  and  the  bowel  becomes 
obstructed,  or,  at  all  events,  discharges  only  those  matters  which 
the  congested  and  gangrenous  tissues  pour  out.  Under  such 
symptoms  the  patient,  as  in  complicated  enteritis  or  internal 
strangulation,  may  speedily  succumb ;  but  sometimes,  at  a 
moment  when  the  disease  appears  to  be  still  progressing  un- 
favorably, the  constipated  bowel  begins  to  act,  offensive  stools 
mixed  with  blood  and  mucus  begin  to  be  discharged  with  more 
or  less  tenesmus,  vomiting  diminishes  or  ceases,  febrile  sym- 
ptoms abate,  and  aftier  a  longer  or  shorter  period  of  dysenteric 
symptoms  a  sequestrum  is  passed  per  anum,  in  the  form  of  a  dark 
fcBtid  gangrenous  mass. 

'<  The  most  characteristic  features  amongst  those  which  have 
been  enumerated  in  the  symptomatology  of  intussusception  are, 
first,  the  sudden  onset  of  the  malady  with  pain,  and  more  or  less 
constipation  and  vomiting,  and,  secondly,  the  discharge  of  blood 
per  anum  which  is  generally  present  even  from  the  beginning ; 
but  there  is  a  third  sign,  to  which  no  allusion  has  yet  been  made, 
which  is  perhaps  of  even  greater  importance,  namely,  the  pre- 
sence of  a  tumour.  It  can  scarcely  happen  that  any  length  of  a 
threefold  tube  of  intestine,  especially  when  its  layers,  one  or  all, 
are  congested  and  swollen,  can  be  present  without  forming  a 


212  Intestinal  Obstruction, 

tumour  capable  of  detection  by  careful  palpation  tbrougb  tbe 
abdominal  walls,  provided  at  least  these  be  not  too  &t  or  too 
rigid,  or  the  bowels  generally  be  not  too  much  distended  with  gas, 
or  tbe  abdominal  tenderness  be  not  too  great  to  admit  of  satis- 
factory examination.  The  presence  of  a  tumour,  indeed,  es- 
pecially in  the  case  of  ileo-c»cal  or  c<eliac  invagination,  may  often 
be  recognised  during  life,  and  that  the  tumour  is  an  intussus- 
ception may  also  often  be  recognised,  partly  by  its  cylindrical 
form,  partly  by  its  position,  but  especially  by  the  fact  that  it  may 
in  some  cases  be  detected  changing  somewhat  from  day  to  day  in 
form  and  direction  as  the  intussusception  increases,  and  may 
sometimes  also  be  felt  to  dilate  and  harden,  and  then  subside^ 
under  the  influence  of  its  peristaltic  movements.  Further,  in 
those  cases  in  which  the  intussusception  extends  low  into  the 
rectum,  its  lower  extremity  may  be  detected  with  all  ite 
characteristic  features  by  the  finger  inserted  into  the  anus." 

By  these  symptoms  the  homoeopathic  treatment  of  intus- 
susception is  pretty  clearly  pointed  out. 

According  to  Bristowe,  then,  the  onset  of  intussusception 
is  indicated  by  pain  of  a  violent^  griping^  twisting,  remit- 
tent character^  generally  in  the  umbilical  region^  relieved  by 
pressure  and  by  contortion  of  the  body,  and  accompanied  by 
vomiting  and  stoppage  of  the  action  of  the  bowels,  but 
unaccompanied  by  fever  or  excitement  of  the  heart. 

Now,  we  have  drugs  that  produce  these  symptoms  in  a 
very  marked  manner,  the  principal  ones  of  which  are  Cup., 
Plb.,  NX'V.,  CoL,  Aim.,  Bry,,  K-bi.,  Opi.  Most  of  the 
cases  will,  in  all  probability,  be  met  by  one  of  these ;  the 
proper  one  to  be  selected  for  any  given  case  must  of  course 
be  determined  by  the  Hnd  of  the  pain,  the  condition  of  tbe 
pain,  the  locality  of  the  pain,  and  the  concomitants,  such  as 
the  vomiting  and  the  obstruction  of  the  bowels,  and  the 
mental  condition  of  the  patient. 

Now,  as  a  rule,  the  pain  is  griping,  twisting,  violent, 
remittent ;  its  condition,  that  it  is  relieved  by  pressure  and 
contortion ;  its  locality,  the  umbilical  region ;  and  its  con- 
coipitants,  vomiting  and  obstruction  of  the  bowels.  IvTow, 
the  medicines  I  have  mentioned  produce  all  these  Bym- 
ptoms,   and  under  these  conditions,  ami  with  these  concomi- 


by  Dr.  John  W.  Hayward.  213 

tants^  and  so  they  meet  the  onset  of  the  disease  at  all 
points.  But  in  some  cases  the  obstruction  will  be  more, 
and  in  others  less,  complete ;  in  some  the  pain  will  be  more 
violent,  in  some  more  persistent ;  and  in  others  more  remit- 
tent, and  it  will  differ  somewhat  in  character  in  different 
cases;  and  so  also  the  mental  condition  will  differ  in 
different  cases.  In  the  case  of  Cup.  and  Plb.  the  pain  is 
most  violent,  and  the  obstruction  most  complete,  and 
apparently  from  paralysis  of  the  bowel ;  in  that  of  Nux-v, 
the  pain  is  more  crampy  and  remittent,  and  the  obstruction 
that  of  constriction  or  contraction  of  the  bowels ;  in  that  of 
Col.  the  pain  is  more  sharp  and  neuralgic,  and  the  obstruc- 
tion apparently  from  dryness  of  the  bowels;  in  that  of  Aim. 
the  pain  is  more  pinching,  and  the  obstruction  that  of  in- 
ability and  dryness  of  the  rectum ;  and  in  that  of  K-bi.  the 
pain  is  more  that  of  tissue  irritation,  and  the  obstruction 
that  of  enteritis.  With  Cup.  and  Plb.  the  vomiting  is  a 
very  prominent  symptom,  is  very  violent,  continued,  and 
conwdsive,  and  to  the  extent  of  blood  and  faeces.  With 
K'bi.  it  is  also  very  prominent,  in  rapid  successive  throes, 
bilious  mucus  bloody,  the  blood  bright  and  clotted;  with 
Col.  the  vomiting  is  less,  and  without  nausea,  serous,  yeUow 
bilious ;  with  Nx-v.  even  less,  and  is  sour,  mucus  bloody ; 
and  with  Aim.  still  less,  and  is  dry  or  mucous.  With  PW. 
the  MENTAL  CONDITION  is  dcprcsscd  and  restless ;  with  Col. 
angry,  irritable,  and  impatient;  K-bi.  listless,  indifferent, 
languid;  with  Aim.  low-spirited,  weeping,  and  hopeless; 
and  with  A^^r-t;.  irritable,  passionate,  morose,  sullen,  quarrel- 
some. One  or  more  of  these  medicines,  given  in  a  small 
dose — say  a  drop  or  grain  of  the  first  attenuation — every 
quarter  or  half  hour,  with  the  assistance  of  hot  fomentation, 
will  generally  put  a  stop  to  the  whole  affair  within  a  few 
hours.  There  are  several  other  well-indicated  medicines 
that  would  meet  special  cases,  such  as  Chi.,  Con.,  Bel.,  Aco., 
Kre.,  Rhs.,  Sab.,  Opi.,  some  one  of  which  might  be  indi- 
cated by  the  locality  of  the  pain  and  obstruction,  whether 
in  the  small  or  large  intestine,  or  other  peculiarity  in  the 
pain,  the  conditions,  or  the  concomitants. 

If  the  patient  be  seen  during  this,  the  first  stage  of  the 


214  Intestinal  Obstruction, 

attack,  the  disease  may  perhaps  be  arrested  at  once,  and 
not  allowed  to  proceed  any  further;   but  if  this  stage  be 
neglected   or  improperly  treated,  some  of  the  symptoms 
become  aggravated,  others  changed,  and  new  ones  developed ; 
for  instance,  the  vomiting  becomes  more  constant  and  pain- 
ful, and  perhaps  bloody,  even  fecal,  congestion  and  inflam- 
mation supervenes,  producing  tenderness  and   fever,  and 
causing  the  pain  no  longer  to  be  relieved  by  pressure  and 
contortion,  but  to  be  aggravated  by  these ;   some  gaseous 
distension  may  supervene,  and  instead  of  stoppage  of  the 
action  of  the  bowels  there  may  be  frequent  bloody  mucous 
evacuations,  with  straining;   the  pulse  becomes  rapid  and 
strong,  and  there  are  thirst,  foul  tongue,  disgust  for  food, 
and  perhaps  headache.     These  symptoms  are  produced  in  a 
very  distinct  manner  by  many  drugs,  the  principal  of  which 
are  Aco.,  Aim,,  Am,,  BeL,  Bry.,  Cch,,  Col.,  Cup.,  K-H,, 
Kre,,  Lye.,  Mr^c,  Nx-v.,  Dpi.,  Plb.,  Rhs.,  Sec,  Sab.,  Ver. 
The  selection  will  have  to  be  made  according  to  the  special 
manifestations  or  the  turn  that  the  disease  has  taken,  and 
in  consideration  of  what  medicines  have  been  already  used. 
The  additional  symptoms  of  tenderness  to  pressure,  fever, 
distension,  and  slimy  bloody  evacuations  are  also  markedly 
produced   by  each  of  the  medicines  named  for  the  onset, 
viz.  Plb.,  NX'V.,  Col.,  Aim.,  K^bi.,  but  if  each  one  of  these 
has  been  tried  and  failed,  resort  must  be  had  to  one  of  the 
following,  viz.  Aco.,  Am.,  Bel,,  Bry.,  Mr-c,  Rhs.,  and  if 
these  fail,  to  one  of  the  remaining  medicines,  viz.  Cch.,  Cv^., 
Kre.,  Lye,  Opi.,  Sec,,  Sab.,  Fer.     One  or  more  of  these 
medicines  will  require  to  be  given  every  quarter  hour  or  so, 
and  may  be  expected  within  a  day  or  two  to  remoye  the 
whole  disease,  and  render  it  unnecessary  to  resort  to  either 
Morphia  injections  or  abdominal  section. 

Should,  however^  the  disease  still  progress,  and  the 
inflammation  spread  more  to  the  peritoneum  and  along  the 
intestine,  there  will  be  still  further  increase  of  the  tender* 
ness  and  distension,  and  of  the  vomiting  and  the  bloody 
mucous  evacuations  and  straining ;  the  vomiting  will  become 
fsecal  and  perhaps  bloody  or  cofiee  ground,  and  the  evacua- 
tions perhaps  blackish  and  foetid  from  supervening  gangrene. 


by  Dr,  John  IV ,  Hayward.  215 

Here  ooe  or  other  of  the  previously  mentioDed  medicines 
must  be  selected^  or,  if  already  being  given^  must  be  per- 
severed with  if  still  indicated^  especially  the  Mr-c,  Rhs,, 
JBry.,  Ver.j  Sec,  Kre,,  Lye,  Ars.j  SuL  For  faecal  vomiting 
Cch.,  Plb.;  for  foetid  vomiting  Aco.,  Cub.,  Plb.,  Ver. ; 
for  bloody  vomiting  Aco,,  Am.,  Ars,,  Cub.,  K-bi.,  Lye, 
Mr-c,  NX'V.,  Opt.,  Plb.,  Sab.;  and  for  black  vomiting 
Aco.,  Ka-bi.,  Mr-c,  Plb.,  Sec,  Ver.,  and  perhaps  ure 
charcoal  should  be  given  in  quantity^  or  pure  carbolic  acid 
in  gr.  \  or  gr.  j — ^gr.  ij  doses^  and  perhaps  alcohol  should 
be  administered. 

I  apologise,  Mr.  President,  for  having  occupied  so  much 
time,  but  I  wished  to  do  what  I  could  to  show  the  un- 
reasonableness of  scepticism  of  the  power  of  medicine  to 
cope  with  acute  intestinal  obstruction,  or^  at  any  rate,  that 
depending  on  intussusception.  And  I  hope  I  have  suc- 
ceeded in  encouraging  our  undertaking  the  treatment  of 
such  cases  with  some  feeling  of  confidence  that  we  are  not 
mere  ''  stand-bys,'^  watching  nature's  struggles,  but  unable 
to  render  her  any  assistance. 

It  ought  not  to  be  thought  chimerical  to  believe  in  the 
possibility  of  medicine  assisting  reduction  of  intussusception 
and  internal  hernia.  That  certain  drugs  will  act  on  the 
bowels;  that  they  can  excite,  increase,  pervert,  diminish, 
and  even  arrest,  peristaltic  action  is  admitted  on  all  hands. 
If,  then,  drugs  can  derange  normal  peristaltic  action  where 
they  have  nature  against  them^  why  should  it  be  thought 
chimerical  that  they  should  be  able  to  assist  in  rectifying 
abnormal  action  where  they  have  nature  with  them  ? 

The  action  of  Cup.  and  Plb.  on  the  bowels  is  such  as  to 
produce  symptoms  very  analogous  to  those  of  intussuscep- 
tion and  internal  hernia,  and  so  is  that  of  Col.,  Nx^v., 
Aim.,  and  K-bi.  It  may,  therefore,  reasonably  be  presumed 
that  the  pathological  condition  they  produce  is  very  analo- 
gous to  that  existing  in  intussusception  and  hernia.  If,  then, 
they  can  produce  a  kind  of  intussusception  or  hernia,  why 
should  they  not  be  capable  of  curing  a  recent  intussuscep- 
tion? That  they  can  cure  symptoms  very  analogous  to 
those  of  intussusception  is  a  matter  of  almost  daily  experi- 


216       Brunton  on  Pharmacology  and  Therapeutics, 

ence  in  homceopatbic  practice.  And  we  do  know  that 
homcBopatbically  selected  medicines  have  considerable  power 
over  ^ortemal  hernia.  Why,  then,  should  they  not  have 
over  internal  hernia  and  intussusception  ? 

What  nature  shows  is  possible^  let  us  not  say  is  impos- 
sible. 


BEUNTON   ON   PHARMACOLOGY   AND    THERA- 
PEUTICS.* 

By  John  H.  Clarkb,  M.D. 

Unoeb  the  aboTe  title  Dr.  Brunton  has  recently  pub- 
lished the  lectures  he  delivered  in  1877  as  Gulstonian 
Lecturer  for  that  year.  The  preface  contains  no  note  to 
the  effect  that  any  great  advance  has  been  made  in  the 
science  during  the  last  three  years,  and  we  may,  therefore, 
fairly  conclude  that  the  book  embodies  the  latest  views  on 
pharmacology  of  those  who  practise  medicine  on  the  most 
approved  scientific  methods.  As  such  the  book  is  of  no 
small  value.  The  author  alike  ignores  any  rule  of  contraria 
conirariis,  or  Hmilia  similtbua,  as  being  of  comparatively  small 
value,  and  strikes  straight  through  all  at  what  he  conceives 
to  be  the  root  of  the  whole  "matter,  a  precise  knowledge  of 
physiology  and  pathology,  and  of  the  physiological  and 
pathological  action  of  drugs.  I  shall  not  stay  now  to 
examine  the  strength  of  the  position  he  takes  up,  but  will 
proceed  to  give  a  sketch  of  the  work. 

The  author  begins  with  a  history  of  the  progress  of 
medical  opinion  from  the  earliest  times,  and  a  rough  sketch 
of  the  various  theories  of  disease  and  drug  action  that  have 
in  turn  held  sway.  He  was  for  a  long  time  at  a  loss  to 
understand  how  it  came  to  pass  that  medical  progress  had 

*  Pharmaoology  and  TherapetUici ;  or.  Medicine,  PoH  and  JPresemi,     Bj 
T.  Lauder  Bronton^  M.D.«  F.B.S.,  &c.    Macmillan  &  Co^  1880. 


by  Dr.  John  H.  Clarke.  217 

been  so  alow^  and  it  was  only  when  a  lucky  remembrance 
of  childhood  came  into  his  mature  mind  that  it  was  all 
made  plain  to  him.  Ope  day,  when  the  author  was  a  very 
small  child  we  should  imagine,  he  was  playing  with  a  box, 
which,  for  all  that  is  stated,  was  in  perfectly  good  order, 
but  the  future  leader  of  therapeutic  science  ''  made  believe  " 
that  there  was  something  wrong  with  the  lock.  That  such 
a  child  should  have  proved  the  '^  father  of  such  a  man  ^'  of 
science  excites  no  small  astonishment  when  we  learn  that 
he  again  ''  made  believe  " — the  scientific  mind  is  necessarily 
the  opposite  of  believing — that  he  could  remedy  this  imagi- 
nary disorder  by  driving  into  the  lock  a  piece  of  ivory 
which  he  picked  off  the  box  for  the  purpose,  with  the  result 
of  ruining  the  lock  and  seriously  injuring  the  box. 

With  the  aid  of  this  illustration  Dr.  Brunton  explains 
how  it  was  that  medical  science  remained  so  long  in  a  back- 
ward state.  Medical  men  did  not  observe  facts,  but  only 
invented  theories. 

At  length  some  movement  was  made.  Disease  was  no 
longer  attributed  to  unseen  powers,  spirits,  gods,  demons, 
'&c.,  but  came  to  be  attributed  to  some  disturbance  in  the 
mechanism  of  the  body.  But  even  then  the  physician's 
ideas  of  the  mechanism,  and  of  the  curative  means,  were 
erroneous,  and  it  was  only  when  experiment  came  in  to 
correct  these  ideas  that  the  career  of  progress  really  began 
(p.  22).  The  medical  sciences  were  like  ships  tossed  about 
rudderless,  compassless,  on  a  unfathomable  sea,  and  when 
first  they  did  begin  to  move  they  had  only  dead  reckoning 
to  go  by.  Now,  at  length,  supplied  with  all  the  latest 
scientific  gear,  they  have  made  real  headway,  and  have 
come  within  sight  of  land  if  they  are  not  already  in  port. 
Anatomy  was  the  first  to  get  under  way,  but  minute 
anatomy  waited  for  Morgagni  to  give  it  a  start.  The 
practice  of  physic  started  with  Sydenham,  physiology  with 
Harvey,  pathology  with  John  Hunter^  and  as  for  pharma- 
cology— whilst  anatomy  has  been  moving  forward  these 
forty-five  centuries, — '*  it  is  little  more  than  as  many  years 
since  pharmacology,  the  youngest  of  the  medical  sciences, 
began   to   be  systematically  studied,^'  or — to  continue  the 


218       Brvnton  on  Pharmacology  and  Therapeutics, 

metaphor — worked.     That  ia  to  aay^  pharmacology  as  Dr. 
Brunton  anderstands  it. 

N0W4  however^  all  is  changed;  piloted  by  the  sister 
sciencesj  and  with  their  assistancej  pharmacology  is  fairly 
started  on  her  course. 

**  Slow  has  been  the  adrance  of  medicine  becanse  she  went 
astray ;  now  the  path  she  follows  is  right,  swift  is  her  progress, 
and  glorious  will  be  her  future  *'  (p.  197). 

These  latter  are  the  words  with  which  our  author  con- 
cludes his  lectures.  What  is  it  that  gives  him  such  high 
and  sanguine  hopes  f  It  is  this : — ^The  proper  methods  of 
working  at  the  subject  has  been  discovered.  Magendie  laid 
the  foundation  stone,  and  has  left  a  model  behind  him  in 
his  work. 

**  The  plan  he  pursued  wss  exceedingly  simple.  It  consisted, 
first,  in  preventing  the  drug  which  he  wished  to  examine  from 
reaching  the  particular  part  of  the  body  on  which  it  was  sup- 
posed to  act,  and  observing  whether  its  action  was  abolished  by 
this  procedure ;  secondly,  in  applying  the  drug  to  that  part  of 
the  body  only,  and  noting  whether  it  still  exerted  the  same 
action  as  when  applied  to  the  whole  body.  The  first  poison  with 
which  he  experimented  was  the  upas,  which  was  afterwards  dis- 
covered to  owe  its  activity  to  the  action  of  strychnia.  The  sym- 
ptoms produced  by  this  poison  led  him  to  think  that  it  acted  on 
the  spinal  cord.  This  supposition  he  tested  by  sUowing  the  upas 
to  act  as  far  as  possible  on  the  rest  of  the  body,  but  not  on  the 
cord.  He  then  found  that  the  symptoms  were  absent  so  long  as 
the  poison  did  not  reach  the  cord,  but  that  they  appeared  as  soon 
as  it  did  so.  He  next  tested  his  supposition  by  applying  the 
poison  to  the  cord  alone.  When  this  was  done  the  symptoms 
came  on  at  once,  although  all  other  parts  of  the  body  were  free 
from  the  poison.  The  demonstration  was  thus  complete — that 
the  symptoms  produced  by  the  upas  were  due  to  its  action  on  the 
spinaJ  cord,  and  on  it  alone"  (pp.  74,  75). 

It  is  unnecessary  here  to  trace  further  the  dying  agonies 
of  frogs  and  dogs  in  this  investigation ;  it  will  be  sufficient 
to  state  the  results  arrived  at.     They  are  four. 

1.  The  symptoms  produced  are  due  to  the  action  of  upaa 
on  the  spinal  cord,  and  on  that  alone. 


by  Dr.  John  H.  Clarke.  219 

2.  The  poifton  is  absorbed. 

8.  The  poison  acts  through  the  circulation. 

4.  The  convulsions  are  caused  by  action  on  the  spinal 
cord  J  and  not  on  the  brain. 

Following  accurately  Magendie's  plan,  Claude  Bernard 
demonstrated  the  physiological  action  of  woorara,  or  curara ; 
and  Dr.  Brunton  himself,  with  Dr.  Pye,  conducted  a  like 
investigation  into  the  action  of  "  cassa  "  or  ''  casca/'  another 
ordeal  poison  of  Western  Africa. 

The  chief  effects  of  the  latter  poison,  when  administered 
by  the  mouth,  are  vomiting,  purging,  and  loss  of  muscular 
power  or  co-ordination.  On  injecting  the  poison  under  the 
skin  of  an  animal  it  was  found  that  vomiting  took  place 
just  the  same,  but  no  purging,  showing  that  the  purging 
was  due  to  local  contact,  the  vomiting  to  action  through 
the  circulation.  Division  of  the  vagus  nerve  caused  vomit- 
ing to  be  much  less  severe,  proving  the  emetic  action  to  be 
due,  not  to  direct  action  on  the  stomach,  but  on  its  nervous 
centres. 

Was  the  purging  due  to  increased  peristaltic  action  or 
to  increased  secretion?  Introduced  into  an  isolated  loop 
of  intestine,  the  poison  caused  no  increase  of  secretion. 
Hence  it  was  inferred  that  the  purging  action  was  due  to 
increased  peristalsis. 

The  loss  of  muscular  power?  Neither  muscles  nor 
nerres  lost  irritability  by  its  application,  theiefore  the  cause 
could  not  be  there.  Attention  is  now  turned  to  the  spinal 
cord.  A  poisoned  frog  moves  sluggishly.  Reflex  activity 
is  impaired. 

Is  this  due  to  direct  action  on  the  cord,  or  caused  by 
imperfect  circulation  ? 

Two  frogs  must  decide  it.  One  is  poisoned  and  watched 
until  the  heart  stops.  The  circulation  of  a  second,  un- 
poisoned  frog,  is  at  that  instant  arrested  by  a  ligature  drawn 
round  the  large  vessels  close  to  the  heart.  In  both  animals 
reflex  action  (continuing  after  the  circulation  had  stopped) 
ceased  at  almost  exactly  the  same  moment.  The  cause  of 
the  loss  of  muscular  power  was  therefore  concluded  to  be 
due  to  alteration  in  the  heart's  pulsations. 


220       Bi-union  on  Pharmacology  and  Ther4q}€Utics, 

The  action  on  the  heart  ?  The  first  thing  noticed  is  that 
the  heart  beats  more  slowly.  The  ventricle  contracts  irre- 
gularly-dilating only  in  parts  in  diastole^  and  giving  the 
heart's  surface  a  pouched  appearance— finally  stopping  in 
systole,  the  auricles  continuing  to  pulsate  for  some  time 
after. 

A  moderate  dose  of  casca  injected  into  the  jugular  vein^ 
the  pulse  becomes  slow ;  a  further  dose  renders  it  quick ; 
another  lafger  dose  again  renders  it  slow. 

Is  the  slowing  due  to  action  on  the  medulla^  on  the  vagi, 
or  on  the  intracardiac  ganglia  f  In  a  poisoned  animal  divi- 
sion of  the  vagi  is  followed  by  immediate  quickening  of  the 
pulse,  showing  that  the  chief  slowing  action  was  exerted  on 
the  medullary  or  central  regulating  apparatus.  This  renders 
it  probable  that  the.  further  dose,  which  produces  quidcening 
of  the  pulse  after  a  first  has  produced  slowing,  acts  by  para- 
lysing the  ends  of  the  vagi  in  the  heart.  An  electric 
current  applied  to  the  vagus  after  casca  has  thus  quickened 
the  pulse  has  none  of  its  usual  slowing  effect  on  the  heart, 
showing  that  the  power  of  the  nerve  over  the  heart  has  been 
completely  abolished. 

The  further  slowing  of  the  heart  is  inferred  to  be  due  to 
action  on  the  intracardiac  ganglia,  or  on  the  muscular 
structure  of  the  heart  itself. 

These  observations  have  been  made  with  large  doses ; 
what  will  be  the  effect  of  small  ones  f 

Before  any  change  is  noticed  in  the  pulse  there  is  a  rise 
in  the  blood  pressure,  which  continues  after  the  pulse  has 
become  slow,  and  does  not  fall  during  the  cardiac  diastole. 
The  arterioles  must  have  become  contracted.  How  has 
this  been  brought  about  ?  The  chief  vaso-motor  centre  is 
in  the  medulla.  When  this  is  destroyed  arterioles  dilate 
and  blood  pressure  falls.  On  dividing  the  cord,  and  inject- 
ing casca,  the  blood  pressure  rises  higher  than  ever.  It  now 
lies  between  the  arterioles  themselves,  or  vaso-motor  ganglia 
not  contained  in  the  medulla. 

Division  of  the  sympathetic  in  the  neck  causes  the 
vessels  of  the  ear  of  that  side  to  dilate.  An  injection  of 
casca  in  an  animal  thus  treated,  causes  both  ears  to  turn 


by  Dr.  John  H.  Clarke.  221 

equally  pale.  Therefore^  the  rise  of  blood  pressure  is  due 
to  the  action  of  the  poison  on  the  muscular  fibres  or  nerves 
in  the  arterial  wall. 

As  these  experiments  suggested  many  points  of  com- 
parison with  the  action  of  Diffitalis,  it  was  next  determined 
to  compare  the  action  on  the  kidneys  of  the  drug  under 
examination  with  that  of  the  drug  last  named.  A  canula 
was  placed  in  the  ureter  of  an  ansesthetised  dog  and  the 
poison  administered  by  subcutaneous  injection.  The  general 
blood  pressure  increased^  and  the  secretion  of  urine  increased 
at  the  same  time.  An  extra  dose^  however,  as  in  the  case 
of  Digitalis,  whilst  it  still  further  increased  the  general 
blood  pressure,  completely  stopped  the  flow  of  urine,  showing 
that  the  drug  had  caused  such  extreme  contraction  of  the 
arteries  of  the  organ  as  to  cut  off  its  supply  of  blood 
altogether. 

Such  is  a  sketch  of  the  new  method  of  advancing  phar« 
macology.  The  author  next  proceeds  to  show  how  patho- 
logy comes  in  to  link  together  semeiology  and  pharmacology. 
He  sketches  a  case  where  there  is  palpitation  on  the  least 
exertion,  dyspno&a,  inability  to  lie  down,  lividity,  and  oedema. 
These  symptoms  are  traced  to  mitral  insufSciency. 

"  How,  then,  is  this  to  be  remedied  ?  Pirst  of  all,  it  woidd  be 
an  advantage  to  make  the  heart  beat  more  slowly,  for  when  it 
pulsates  rapidly  there  is  no  time  for  the  pulmonary  veins  to 
become  well  emptied  between  each  systole.  By  lengthening  the 
interval  between  them,  the  ventricle  has  time  to  become  better 
filled,  and  sends  a  fuller  current  into  the  wide  aorta,  and  a  pro- 
portionably  small  amount  back  into  the  pulmonary  veins  through 
the  narrow  chink  in  the  mitral  valves. 

"  Bat  if  this  were  all,  why  should  not  a  drug  like  aconite  serve 
our  purpose,  for  it  slows  the  heart  ?  The  reason  is  that  it  also 
weakens  it,  and  in  the  conditions  which  we  have  just  been  con- 
sidering, one  of  the  most  important  factors  is  weakness  of  the 
right  ventricle,  for  it  is  in  the  pulmonary  circulation  that  the 
resistance  lies,  and  one  of  our  most  important  tasks  is  to 
strengthen  the  propulsive  power  of  the  right  ventricle,  as  well 
as  to  remove  obstruction  in  front. 

''This  end  we  gain  by  employing  digitalis  or  casca,  which 


222       Brunion  an  Pharmacology  and  TherapeuiicSj 

increase  the  strength  at  the  same  time  that  thej  diminish  the 
rapidity  of  the  cardiac  contractions  '*  (p.  112). 

Next,  the  oedema  is  cousidered.  Mere  tying  of  a  vein 
will  not  cause  oedema  of  the  part  from  which  it  receives  its 
blood.  Vaso-motor  paralysis  must  be  occasioned  as  well^ 
or  the  contraction  of  the  arterioles  will  prevent  fluid  being 
poured  out  at  such  a  rate  that  the  lymphatics  cannot  take 
it  up  as  fast.  The  author  suggests  that  it  is  in  this  way — 
by  producing  contraction  of  the  arterioles — ^that  DiffilalU 
and  casca  act  in  removing  cardiac  dropsies  or  preventing 

them. 

It  is  somewhat  disappointing  that  Dr.  Brunton  does  not 
supply  his  readers  with  some  actual  cases  in  which  this 
elaborate  study  has  borne  the  expected  fruit. 

The  gain  to  therapeutics,  we  are  told,  through  the  present 
mode  of  pursuing  pharmacology  are  fourfold.  We  have 
new  remedies.  We  are  taught  how  to  use  our  old  remedies. 
We  learn  what  to  do.     We  learn  what  to  avoid. 

Palpitation  of  the  heart  not  due  to  organic  lesion  can  be 
met  by  Atropia,  which  completely  paralyses  the  ends  of  the 
vagus  in  the  heart,  and  no  amount  of  stimulation  to  the 
nerve,  direct  or  reflex,  can  then  stop  the  pulse.  It  also 
paralyses  the  sensory  nerves  of  the  hearty  and  is  thus  useful 
in  cases  where  the  organ  is  irritable  or  hyperssthetic.  Dr. 
Brunton  has  used  the  remedy  in  cases  of  the  kind  with 
success  where  the  disorder  was  quite  recent,  but  unsuccess- 
fully where  it  was  of  older  standing. 

Nitrite  qf  amyl  is  cited  as  an  example  of  the  fruits  of 
scientific  pharmacology.  Dr.  Brunton  noticed  in  a  case  he 
had  under  observation  night  and  day  for  some  time,  that  in 
the  attack  the  blood  pressure  rose,  and  the  pulse  became 
quick.  The  administration  of  Nitrite  of  amyl  cut  short  the 
paroxysms,  at  once  lessening  the  blood  pressure  and  slowing 
the  pulse.  Ordinarily,  Nitrite  of  amyl,  like  other  agents 
that  diminish  blood  pressure,  causes  quickening  of  the  pulse 
at  the  same  time.  For  this  remarkable  variation  no  ex- 
planation, scientific  or  otherwise,  is  advanced. 

Bromide  of  potassium  is  another  example  of  scientific 
medication.     It  lessens  reflex  action  generally.     This  does 


by  Dr.  John  H.  Clarke.  228 

not  explain  its  action  in  epilepsy^  but  has  made  it  of  service 
in  diarrhoea  and  other  affections  caused  by  reflex  influence 
from  the  uterus. 

The  ideas  of  the  author  on  chorea  are  sufficiently  remark- 
able to  deserve  quoting  entire. 

^  Nor  is  it  only  on  the  nerve  centres  that  we  are  able  to  act. 
As  Bernard  showed,  we  can  influence  peripheral  nerves  also  by 
our  drugs.  It  is  impossible  to  look  at  the  jerking  limbs  and 
irregular  movements  of  chorea  without  wishing  that  we  could 
load  every  muscle  with  lead,  and  still  its  useless  and  disturbing 
movements." 

(The  writer  of  this  article  confesses  that  such  a  use  of 
Plumbum  never  entered  his  unimaginative  mind.) 

''Sleep  will  do  this,  and  opium  will  produce  sleep,  but  we 
cannot  keep  the  patient  constantly  in  a  state  of  insensibility ;  we 
wish  to  leave  the  activity  to  the  mental  powers,  and  only  to 
quiet  the  muscles. 

^  This  we  might  do  by  curare,  but  we  have  another  remedy 
which  seems  still  more  suitable ;  for  conia  acts  on  the  motor 
nerves  in  the  same  way  as  curare,  and  methyl  conia  lessens  the 
functions  of  the  spinal  cord. 

^  Ordinary  hemlock  contains  both,  and  thus  the  succus  conii, 
by  deadening  the  motor  nerves  and  enfeebling  the  cord,  should 
render  movement  more  difficult  and  wearisome,  the  very  result 
we  desire  to  produce  (!).  We  should  thus  be  able  to  ameliorate 
the  symptoms,  even  though  we  may  not  touch  the  real  source  of 
the  disease  "  (p.  146). 

In  the  respiratory  sphere  pharmacology  has  not  much  to 
boast  of.  It  can  tell  us  that  Carbonate  of  ammonia  is  good 
in  cough  of  old  persons  because  it  stimulates  the  respiratory 
centre  and  increases  expulsive  expiratory  effort ;  that  Atropia 
stimulates  the  respiratory  centre,  and  at  the  same  time 
lessens  the  irritability  of  the  pulmonary  sensitive  nerves, 
and  is  therefore  useful  in  the  cough  of  debility ;  that  Hyos^ 
cyamus  acts  almost  in  the  same  way  as  Atropia, 

But  here  the  question  of  dose  comes  in,  and  ''  we  may 
not  get  the  result  we  desire  from  drugs  when  we  administer 
them  in  disease,  either  from  ignorance,  timidity,  or  from  the 


224       Brunton  on  Pharmacology  and  Hunq^eutics, 

action  of  the  drug  tgnm  other  organs  of  the  body  preventing 
its  being  pushed  to  a  sufficieni  extent.**  The  italics  are 
mine. 

Of  the  action  of  drugs  on  tbe  bronchial  secretion  experi- 
mental science  knows  nothing.  ''Experience  shows  that 
Tartar  emetic,  Ipecacuanha,  and  loiUde  of  potassium  will 
diminish  the  tenacity  of  mncus  and  aid  expectoration^  while 
balsams  will  lessen  the  profuse  secretion  in  bronchorrhosa. 
But  how  these  drugs  act  we  do  not  know,  and  it  is  a  com- 
fort  to  turn  to  the  action  of  remedies  in  digestion.'' 

We  can  see  digestion  going  on  under  our  eyes,  both 
within  the  body  and  without.  We  can  see  the  mucous 
membrane  of  the  stomach  exude  its  gastric  juice  when  we 
irritate  it  with  a  glass  rod,  or  when  a  dilute  alkaline  solu- 
tion is  swallowed. 

What  the  cause  of  hunger  is  cannot  be  definitely  stated. 
The  stomach  has  little  power  to  discriminate  sensations. 
The  bitterness  of  Quassia  or  Ctuinine  in  the  mouth,  and  the 
heat  of  mustard  or  cayenne,  are  felt  in  the  stomach  as 
appetite ;  '*  and  so,''  but  this  will  not  be  received  without  a 
question,  **  and  so  is  the  slight  irritation  caused  by  small  doses 
of  Tartar  Emetic  or  Arsenic,  which  on  this  account  are  said 
to  act  as  gastric  tonics.''  The  places  of  Quassia,  Bismuth, 
and  Strychnia  are  defined  on  scientific  grounds,  and  the  use 
of  Pepsin  and  other  digestive  substances  discussed. 

The  last  chapter  of  the  books  deals  with  ferments  or 
enzymes.  These  are  supposed  to  be  the  agents  which 
build  up  as  well  as  disintegrate  the  tissues.  Certain 
alkaloids  have  the  power  of  increasing  or  diminishing  their 
action,  e,g.  Morphia  or  Veratria^  according  to  dose.  Heat 
increases  the  action  of  the  ferments  causing  tissue  change, 
cold  diminishes  it — hence  the  action  of  cold  affusion  in 
high  temperature.  Salicylic  Acid  and  Quinine  also  have 
that  power,  reducing  temperature,  and  lessening  decomposi- 
tion of  albuminous  tissues,  as  evidenced  by  excess  of  urea. 

Whatever  may  have  led  to  high  temperature,  it  is  itself 
a  cause  of   mischief,   and    is    to    be   removed.     Quinine, 
Eucalyptus,  Salicylic  Acid,  are  given  to  lessen  the  inward 


by  Dr.  John  H.  Clarke.  225 

fire^  and  Aconite  to  slow  the  feverish  pulse.     When  these 
fail^  cold  water  will  succeed. 

''  But  collapse  still  sometimes  occurs  after  a  cold  bath,  and 
salicylic  acid  does  not  always  prevent  the  temperature  from 
rising. 

*'  Will  this  always  be  so  ?  I  think  we  may  confidently  answer, 
No.  We  will  yet  discover  remedies  to  prevent  the  collapse,  and 
to  keep  the  temperature  within  its  proper  limits.  Every  day 
is  enriching  medical  science  with  some  new  discovery,  diseases 
are  being  traced  more  precisely  to  their  origin,  the  action  of 
remedies  is  being  more  exactly  defined  and  localised.  Order  is 
beginning  to  appear  amongst  the  crowd  of  new  acquisitions  to 
our  knowledge,  and  isolated  facts  begin  to  range  themselves  under 
general  laws.  Pharmacology  is  allying  itself  to  chemistry,  and 
the  rigid  laws  of  the  latter  are  beginning  to  extend  to  the 
former"  (p.  194). 

Such  is^  I  believe^  a  fair  sketch  of  this  picture  of  modern 
therapeutics  from  the  standpoint  of  the  foremost  man  in 
what  is  termed  the  *^  rational  school  of  medicine.^'  It  cannot 
be  called  a  very  comprehensive  view.  It  is  probable  that 
few  will  share  Dr.  Brunton's  sanguine  expectations^  which 
are  high  in  proportion  to  the  narrowness  of  his  vision. 

At  the  same  time^  it  is  not  to  be  denied  that  the  medical 
world  is  much  indebted  to  the  patient  labourers  in  this  field. 
They  are  keen-sighted  if  not  far-sighted.  Perhaps  if  they 
had  had  any  idea  how  much  richer  a  harvest  was  to  be 
reaped  elsewhere  this  valuable  little  crop  would  never  have 
been  gathered.  We  cannot  afford  to  despise  the  help  that 
recent  discoveries  in  pathology  give  us  in  clearing  our 
ideas  as  to  the  processes  that  really  go  on  within  the  body^ 
and  we  accept  with  thankfulness  a  knowledge  of  the  tissues 
on  which  the  coarse  actions  of  drugs  are  exerted.  The 
difficulty  of  separating  primary  from  secondary  symptoms 
in  disease  and  drug  action  is  one  of  no  little  magnitude, 
and  if  we  knew  of  all  like-acting  drugs  as  we  know  of  casca 
whether  the  purgation  and  the  vomiting  are  local  actions 
or  dynamic,  and  if  dynamic,  whether  the  influence  is 
exerted  on  the  tissues  themselves,  or  on  distant    nerve- 

VOL.  XZXVII1|  NO.  CUII.— JULY,  1880.  P 


226       Brunian  on  Pharmacology  and  Therapeutics, 

centres,  it  would  be  an  immense  gain  in  clearing  our  ideas 
of  the  actions  of  the  remedies  we  use. 

Bat  if  these  were  the  only  means  of  adyancing  thera- 
pettticSf  the  results  which  seem  to  Dr.  Bruuton  so  cheering 
wouldj  I  thinkj   cause  the   hearts  of  some  of  us  to  sink 
within  us  on  contemplating  the  future  of  medicine.     To  mj 
mind  they  are  unsatisfactory  in  the  extreme.     What  do 
they  amount  to  ?     Simply  to  this^  that  the  seat  of  action 
of  some  drugs  has  been  ascertained  with  varying  degrees  of 
accuracy^  that  a  name  has  been  giveu  to  their  action — 
'  exciting,' '  depressing/  and  the  like — ^but  what  that  action  is 
in  its  essence  we  are  as  far  from  knowing  as  ever.     In 
former  days  we  understood  that  the  world  rested   on  the 
back  of  an  elephant.     Nowj  we  have  got  a  stage  or  two 
farther  on,  and  have  discovered  that  the  elephant  stands  on 
the  back  of  a  tortoise,  and  the  tortoise  stands  on  a  rock. 
But  the  rock  ?«— what  that  stands  on  we  have  yet  to  learn. 
When  Dr.  Brunton  informs  us  that  Bromide  of  Potassium 
lessens  reflex  action  generally,  we  understand  perfectly  well 
the  phenomena  to  which  he  refers,  but  he  must  not  delude 
himself  with  the  idea  that  that  is  the  same  thing  as  ex- 
hibiting the  noumenon  at  the  root  of  them  all.     When  he 
tells  us  that  Casca  strengthens  the  heart  as  well  as  slows  it, 
(p.  110)   we  are  inclined  to  ask  him  to  explain.     He  has 
shown  that  the  heart  acts  irregularly,  does  not  dilate  equally 
all   over,   and  at   last  stops  beating  in    a  spasm;   but  if 
this  is  a  true  strengthening  of  the  heart's  action,  then  it 
may  be  said  that  Strychnia  is  a  great  strengthener  of  the 
iystemic  muscles,  as   wituess  its  power  to  cause  tetanus. 
He  fails  to  show  any  difference  between  the  action  of  this 
drug  and  that  of  DigitaUs,  and  in  what  cases  the  one  would 
be  preferred  to  the  other.     He  professes  to  aim  at  a  direct 
method  of  treatment,  and  yet  in  nearly  every  case  his  chief 
object  seems  to  be  to  turn  the  flank.     Is  it  a  diarrhoea 
dependent  on  a  uterine  affection  7     Do  not  trouble  about 
the  uterus,  but  depress  the  reflex  centres  by  Bromide  of 
Potassium.     Is   the   heart    irritated    by    disorder   of  the 
stomach  ?     We  should  have  thought  the  stomach  the  first 
tbiiig  to  be  attended  to;  but  no,  make   a  flank  movement. 


by  Dr.  John  H.  Clarke,  227 

paraiyse  the  sensory  nerves  of  the  heart.  In  angina 
pectoris  we  find  the  blood-pressnre  increased^  and  be  is 
content  to  give  a  drug  that  lessens  blood-pressur*.  It 
never  seems  to  strike  him  that  it  would  be  mach  better  if 
we  could  discovet  on  what  the  increase  of  the  blood-pressure 
depends^  and  strike  thereat  with  his  remedy— ^t.  the  cause 
rather  than  at  an  effect.  When  Dr.  Brunton  can  give  a 
local  habitation  and  a  name  to  a  medicinal  action^  he  seems 
to  be  completely  happy^  and  wonders  whst  any  one  can  want 
to  know  more  about  it. 

But  even  the  advantages  just  named  are  not  always  to 
be  depended  on,  as  we  have  seen  above^  for  ignorance  may 
come  in,  or  timidity^  or  inability  to  push  a  drug  from 
effects  it  produces  other  than  those  you  wish  to  obtain. 

Dr.  Brunton  has  three  or  four  ruling  ideas,  three  or  four 
favourite  theories^  which  blind  his  eyes  to  as  many  facts,  as 
the  thecnries  of  the  ancients,  he  so  serenely  dismisses  to  limbo^ 
prevented  them  from  seeing.  Forgetting  that  man  is  a  theory- 
makings  theory-using  animal,  who  cannot  make  any  progress 
without  a  theory — something  to  see  by  (0eoipl(i>)'^-be  it  true  or 
be  it  false,  his  account  of  the  past  of  medicine  is  necessarily 
inadequate.  His  child-and-box  explanation,  which  seems 
to  give  him  more  pleasure  now  than  even  in  his  younger 
days,  and  to  which  he  reCttrs  again  and  again,  seems  to  me 
as  insufficient  as  it  is  childish.  The  patients  that  the 
physicians  of  old  had  to  treat  were,  at  any  rate^  diseased, 
and  not  sound  like  the  box.  That  they  formed  wrong 
theories  of  disease  there  is  no  doubt,  but,  at  any  rate,  these 
explained  the  facts  they  had  to  deal  with  better  than  any 
others  they  could  find,  and  considering  the  difficulty  of 
demonstrating  the  falseness  of  any  theory  in  this  region 
there  is  no  wonder  that  false  theories  reigned  so  long. 
That  they  should  have  attributed  properties  to  medicinal 
agents  which  really  did  not  belong  to  themi  is  no  marvel 
to  those  who  note  the  fashions  of  physic  in  this  nineteenth 
century,  and  see  the  various  kinds  of  ^drugging  that  go  on, 
and  who  know  the  difficulty  that  often  exists  in  deciding 
what  is  post  merely,  and  what  is  likewise  propter. 

Men  must  have  theories.     These  toen  of  ^etioe  who 


228        Brunton  on  Pharmacology  and  Therapeutics. 

profess  to  disregard  them,  and  care  only  for  facts^  are 
really  deluding  themselves.  What  science  teaches  us  is 
not  to  throw  away  theories,  but  to  keep  them  in  their 
proper  place.  To  adhere  to  them  so  long  as  they  throw 
light  on  facts,  but  not  to  let  them  take  the  place  of  facts. 
To  let  them  go  when  facts  clearly  point  the  other  way. 
Fact  and  theory  are  distinct  things,  related  to  one  another, 
but  each  having  its  own  place,  which  the  other  cannot  fill. 

I  have  said  that  Dr.  Brunton  has  three  or  four  ruling 
ideas.  One  of  them  is  an  exceedingly  materialistic  con- 
ception of  life  and  its  functions.  This  has  already  been 
hinted  at,  and  is  apparent  from  quotations  already  made. 
To  make  my  meaning  plainer,  I  will  extract  a  few  more 
passages. 

"  Why  should  the  law  which  governs  the  falling  of  a  stone  be 
better  known  to  science  than  the  laws  which  govern  us  in  dealing 
with  life  and  growth,  sickness  and  health  P  It  is  in  endeavouring 
to  answer  this  question  that  we  may  hope  to  bring  medical 
science  into  as  advanced  a  position  as  other  sciences.  An  ounce 
of  sulphate  of  magnesia  dissolved  in  half  a  pint  of  water  will 
precipitate  a  solution  of  baryta,  and  will  give  us  a  definite 
quantity  of  the  sulphate  of  baryta.  This  result  we  can  count 
on  with  infallible  certainty.  Given  as  a  purgative  and  we  cannot 
be  sure  of  its  action,  although  its  power  should  be  as  certain  and 
definite  in  the  human  frame  as  in  a  test-tube.  The  reason  that 
we  cannot  be  sure  of  its  action  as  a  remedy  is  because  of  iif* 
fereneei  in  the  eonditione  under  which  it  ie  acting.*'  [The  itah'cs 
are  mine.  It  is  generally  supposed  that  the  two  actions  are 
different  in  kind,"]  "  It  is  our  business  to  find  out  these  con- 
ditions, BO  that,  when  we  meet  them  again,  we  may  know  how  to 
meet  them.  For  there  ^is  an  invariable  relation  between  cause 
and  effect,  as  invariable  as  the  relation  between  an  unchecked 
falling  stone  and  the  earth  "  (p.  68). 

''Before  therapeutics  can  become  a  science  the  physician 
must  know  the  action  of  his  drugs,  just  as  the  locksmith  does 
that  of  his  keys,  and  since  pharmacology  is  still  so  young,  it  is 
little  wonder  that  medicine  is  as  yet  only  an*art "  (p.  66). 

**  Hope  rises  in  our  breasts  when  we  compare  the  wild  fancies 
of  our  predecessors  with  our  own  certain  knowledge,  and  we  look 
forward  to  a  bright  future  for  medicine  "  (p.  158). 


by  Dr.  John  H.  Clarke.  229 

"  Pharmacology  is  allying  itself  to  chemistry,  and  the  rigid 
laws  of  the  latter  are  beginning  to  extend  to  the  former.  We 
no  longer  attribute  the  power  of  drugs  to  an  inherent  energy, 
and  say,  with  Moli^re,  that  opium  causes  sleep  because  it  poBsesses 
a  ms  dormitiva.  We  are  beginning  to  look  upon  sleep  as  only 
one  link  in  a  chain,  the  beginning  of  which  is  a  chemical  affinity 
between  opium  and  certain  molecules  in  the  nerrous  system  " 
(p.  194). 

It  never  seems  to  strike  Dr.  Brunton  that  there  is  any 
reason  why  pharmacology  should  be  a  more  difficult  science 
than  chemistry.  Ordinary  writers  on  medical  subjects  are 
accustomed  to  pay  some  attention  to  what^  in  their  igno- 
rance, is  termed  vital  force.  This  is  the  force  that  con- 
stitutes the  difference  between  a  living  jelly-fisb^  and  one  that 
is  jufit  dead.  It  is  the  force  that  renders  it  impossible  for 
the  gastric  juice  to  digest  a  living  stomach,  and  the  absence 
of  which  renders  that  possible  after  death.  It  is  that  force, 
in  short,  that  underlies  all  the  phenomena  of  life.  True,  it 
has  not  been  weighed  and  measured  by  science,  and  there- 
fore Dr.  Brunton  seems  to  think  himself  entitled  to  ignore 
it  altogether.  Nevertheless,  acknowledged  or  unacknow- 
ledged, there  it  is,  an  unmeasured,  unknown  fact  in  every 
case,  raising  up  difficulties  without  number,  and  explaining 
why  the  sciences  of  life  are  in  such  a  backward  state  com- 
pared with  those  into  which  this  factor  does  not  enter. 

It  would  be  really  amusing  (if  one  could  dismiss  from 
one's  mind  the  sufferings  of  the  unfortunate  frogs  for  the 
time}  to  read  the  methods  by  which  this  new  evangel  of 
therapeutics  is  being  advanced.  They  are  as  clear  as  syl- 
logisms. The  results  come  out  as  naturally  as  the  ''Q.  E.  D/' 
of  a  problem  in  Euclid.  If  it  were  not  for  the  fact  that  it  is 
not  pure  but  applied  logic,  and  that  the  region  of  its 
application  is  not  so  well  defined  as  that  of  geometry,  we 
should  be  inclined  to  accept  the  results  as  final  and  all- 
sufficient.  Dr.  Brunton's  apparent  failure  to  see  this ;  his 
conviction  that  when  he  has  found  out  where  drugs  act,  he 
understands  their  action  ;  the  serious  way  in  which  he  even 
now  proclaims  the  good  news  of  the  coming  era ;  all  appeal 


230         Brunton  on  Pharmacology  and  Therapeutics, 

to  one's  sense  of  hamonr— -a  sense  in  which  he  himself 
appear  to  be  somewhat  lacking. 

What  but  a  most  materialistic  conception  of  life  conld 
have  suggested  to  the  author  such  views  as  those  on  chorea 
quoted  above  ?  Will  Dr.  Brunton  kindly  discover  for  us 
where  the  seat  of  this  disease  is  7  He  cannot  say  it  is  in 
the  motor  nerves,  or  in  the  spinal  cord ;  probably  he  may 
find  it  in  that  undiscovered  region  of  the  body  where  the 
union  between  mind  and  matter  takes  place.  His  proposed 
remedy,  ''  deadening  the  motor  nerves  and  enfeebling  cord/' 
is  not  likely  to  attract  many  sufferers  to  him. 

It  will  be  seen  that  his  idea  of  life  leaves  out  of  count 
the  question  of  idiosyncrasy — ^the  different  actions  of  the 
same  medicines  on  different  individuals — and  a  host  of  other 
questions  complicating  the  sciences  which  treat  of  living 
things. 

The  second  ruling  idea  to  which  I  would  direct  attention 
is  the  notion  that  medicine  is  at  last  on  the  right  track. 
After  a  protracted  childhood,  it  has  at  length  come  to  years 
of  maturity,  and,  travelling  on  the  path  of  experiment,  it 
may  speedily  expect  a  glorious  prime.  This  has  probably 
been  a  ruling  idea  in  the  minds  of  the  foremost  thinkers  on 
medical  matters  for  the  last  two  or  three  thousand  years. 
Without  it  they  would  have  lacked  a  most  useful  incen- 
tive to  work.  I  should  be  sorry  to  deprive  our  author  of 
this  incentive.  I  will  merely  suggest  the  possibility  of  the 
existence  of  other  and  better  tracks  than  that  he  affects^ 
some  knowu  already,  others  tq  be  discovered  in  the  future, 
and  pass  oq  to  the  third  ruling  idea  with  which  it  is  closely 
allied. 

Dr.  Brunton  has  a  profound  conviction  that  there  is  only 
one  way  of  advancing  therapeutics,  and  that  is  by  advancing 
pathology  and  physiology. 

"It  is  only  by  knowing  as  a  truth,  by  patient  study  and 
investigation,  the  exact  causes  of  disease,  that  we  can  avoid  it. 
It  is  only  by  knowing  these  causes,  the  value  of  the  remedies 
that  will  affect  them,  and  the  conditions  of  the  human  frame, 
under  which  these  remedies  can  have  their  full  influence,  that  we 
can  effect  a  cure  "  (p.  67). 


by  Dr.  John  H.  Clarke.  331 

Ona  is  inclined  to  ask^  Was  the  administration  of  a  drug 
by  Hippocrates  or  Dioscorides  ever  followed  by  the  result 
he  desired  to  obtain  ?  If  so^  was  it  by  this  exact  know- 
ledge tbat  \9t  here  spoken  of?  I  think  not.  Physiology 
and  pathology  have  done  much  to  correct  theories  of  drug 
action^  but  the  remedies  they  have  suggested  may  be 
counted  on  one's  fingers.  All  we  know«of  disease  is  the  sum 
of  the  symptoms^  signsi  and  morbid  anatomy  thQ  morbific 
agent  produces  when  it  finds  entrance  into  the  huQ;»an  body. 
Just  so  much  can  we  know  of  drug  action.  It  is  the  glory 
of  Habnemann  that  he  was  the  first  to  conceive  the  syste- 
matic studying  of  drugs  in  this  way  on  his  own  body  and 
on  others ;  and  to  have  discovered  that  there  is  a  fairly 
constant  relation  between  drug  disease,  and  disuse  pro- 
duced in  other  ways. 

Dr.  Brunton  knows  nothing  of  Hahnemann,  but  his 
''  vagaries''  (p.  31),  which h^  couples  with  those  of  Mei^mer, 
deriving  the  theories  of  both  from  Van  Helmont.  He  also 
takes  care  to  mention  that  Hahnemann  was  not  the 
originator  of  the  idea  of  '^similia  similibus,''  but  UippocrateSi 
and  I  suppose  imagines  that  to  the  father  of  medicine  is 
due  the  credit  of  the  working  out  of  the  idea  as  weU.  The 
ignorance  herein  displayed  is  not  creditable  to  the  editor 
of  the  leading  journal  of  therapeutics  of  the  old  school 
in  the  kingdom,  and  the  lecturer  on  i^^at^ri^  ipe^ica  in  one 
of  the  principal  schools.  It  would  be  just  as  creditable  to 
a  historian  of  science  to  know  that  Bacon  took  a  bribe,  and 
to  be  ignorant  of  the  fact  that  he  laid  the  foundation  of 
modem  science ;  or  for  a  statesman  to  know  that  Oliver 
Cromwell  had  a  wart  on  bis  nose,  aqd  not  to  know  that  he 
converted  the  Kingdom  of  England  into  a  Commonwealth. 
That  Hahnemann  had  his  vagaries,  and  made  mistakes,  there 
is  very  little  doubt,  but  that  he  founded  the  best  method 
of  studying  pharmacology  that  is  as  yet  known  is  a  fact  in 
magnitude  far  overshadowing  every  other  fact  about  him. 
It  may  not  be  too  venturesome  to  predict  that  in  the  course 
of  the  next  five  centuries  the  name  of  Hahnemann  will 
have  taken  its  rightful  place  in  the  Temple  of  Fame,  equal 
to  the  greatest  among  the  great  names  of  medicine,  and 


232  GalUstanei, 

that  the  name  of  Branton  will  have  assuDied  a  very  humble 
place  therein^  if  by  that  time  his  vagaries  and  his  deeds  of 
worth  are  not  alike  forgotten. 

A  fourth  idea  that  one  gathers  from  the  book  to  be  a 
leading  one  in  the  mind  of  the  author^  is  that  drags  have 
the  same  action  in  diseased  bodies  that  they  have 
in  healthy  ones.  After  discovering  the  action  of  a  remedy 
on  the  body  of  a  healthy  frog,  he  thinks  he  ought  at  once  to 
be  able  to  get  the  same  action^  if  desired^  on  a  diseased 
human  body.  That  he  does  not  always  succeed  is  apparent. 
We  have  only  to  refer  to  the  example  of  the  action  of 
Nitrite  of  amyl  quickening  the  pulse  in  health  and  slowing 
it  when  it  is  quick  in  angina  pectoris.  But  facts  like  these 
do  not  disturb  his  serenity.  He  is  like  the' ancients.  He 
has  his  theories,  which  carry  him  over  them  blindfold, 
merely  remarking  that  the  road  is  a  little  rough. 

Dr  Brunton  is  doing  good  work,  but  not  so  fruitful 
Rs  he  imagines.  He  is  working  better  in  his  field  than  be 
otherwise  would,  because  his  horizon  is  a  narrow  one  shut 
in  by  theories  which  prevent  him  from  beholding  facts  that 
lie  crowding  around.  We  take  what  he  gives  us  with 
thankfulness,  and  can  well  aflford  to  pardon  the  vagaries 
into  which  his  theories  lead  him  at  times.  Dr.  Brunton 
is  eminently  a  man  of  science,  but  we  cannot  concede  to 
him  the  rank  of  philosopher. 


GALL-STONES. 
By  C.  B.  Kbr,  M.D. 

The  following  case  I  describe  as  one  of  gall-stones^  and 
yet  the  proof  positive  that  biliary  calciili  caused  the  sym- 
ptoms I  cannot  give.  I  mean  that  no  such  calculi  were 
found  in  the  stools,  though  often  looked  for.  Perhaps 
*'  Hepatic  Colic  "  would  have  been  a  better  and  more  cor- 
rect description  of  the  disease,  but  that  designation  would 


by  Dr.  C.  B.  Ker.  288 

bave  indicated  onlj  that  colic  was  one  of  the  symptoms,  and 
that  the  liver  was  considered  to  be  the  offending  cause.  If 
gall*stones  did  not  cause  the  symptoms  about  to  be  described 
it  is  difficult  to  say  what  caused  them.  I  shall,  therefore, 
allow  the  present  heading  of  this  paper  to  stand. 

On  February  12th  of  this  year  I  was  sent  for  by  G.  M. 
E — ,  a  man  of  about  thirty-five  years  of  age.  He  told  me  that 
he  had  been  suffering  from  attacks  of  severe  pain  at  frequent 
intervals  for  about  eight  months,  those  intervals  being  from 
twenty-four  hours  to  three  weeks.  He  told  me,  also,  that 
he  had  suffered  about  a  year  ago,  when  in  Canada,  from  an 
attack  of  inflammation  of  the  liver.  Since  the  attacks 
began  he  has  lost  about  fifty  pounds  in  weight.  He  is  a 
spare,  bilious-looking  man,  and  depressed  in  his  spirits  and 
hopeless  about  himself. 

The  attack  commences  with  a  drawing-in  sensation  at  the 
ensiform  cartilage  or  a  little  below  it.  The  chief  pain  is 
at  that  spot  and  three  or  four  inches  to  the  right.  It  is 
unbearable  while  it  lasts,  and  he  generally  has  recourse  to 
narcotics  for  his  relief,  administered  by  the  mouth  or  sub- 
cutaneously.  He  describes  the  pain  as  tearing  and  burst- 
ing, and  coming  on  and  going  off  gradually,  and  culminat- 
ing in  about  four  or  five  hours.  The  whole  attack  lasts 
from  ten  to  twelve  hours.  There  is  absolute  anorexia  and 
much  nausea,  but  rarely  vomiting.  The  tongue  is  slightly 
furred  only.  The  urine  becomes  like  porter  and  the  stools 
like  putty  during  the  attacks,  but  quickly  resume  their 
normal  colour  when  they  are  over.  The  skin  of  the  whole 
body  becomes  jaundiced  also,  but  not  for  more  than  a  day 
or  two.  Flatulence  is  a  prominent  and  troublesome  sym- 
ptom. The  pulse  is  slow,  full,  and  soft  at  all  times,  and  is 
scarcely  at  all  influenced  by  the  attacks.  There  is  no  great 
tenderness  in  the  epigastric  or  hepatic  regions  during  these 
attacks,  and  none  at  all  during  the  intervals.  Nor  is  there 
any  swelling. 

His  general  health  was  good  till  the  attack  of  hepatitis 
in  Canada,  but  he  has  never  been  quite  well  since,  suffering 
at  intervals  from  symptoms  of  dyspepsia.  During  the  last 
six  or  eight  months,  while  these  attacks  have  been  going  on, 


284  GaU^itmea, 

he  has  lost,  as  I  have  said,  fifty  pounds  in  weight.  The 
bowels  are  habitually  costiye ;  there  is  slight  deafness ;  the 
skin  is  dry  and  hard,  and  itches  intolerably  after  hia 
attacks. 

The  medicines  which  appeared  to  me,  after  a  full  exami- 
nation of  his  case,  to  be  suitable  to  the  symptoms,  were 
Podaphyllin,  Terebinthina,  Sulphur,  and  Nitric  add,  and  I 
decided  on  commencing  the  treatment  with  the  last  named. 
Nitric  acid,  I  prescribed  the  third  decimal  dilution,  and 
asked  him  to  take  two  drops  in  a  table-spoonful  of  water 
three  times  a  day.  But,  as  may  be  supposed,  I  did  not 
content  myself  with  prescribing  a  medicine.  In  all  cases 
of  organic  or  functional  disease  of  any  part  of  the  ehylo- 
poietic  system  there  is  little  prospect  of  relief,  to  say  nothing 
of  cure,  unless  close  attention  is  paid  to  the  diet  of  the 
patient;  and,  in  most  cases,  a  complete  rcTolution  in  the 
food  regimen  is  necessary. 

I  found  that  he  was  in  the  habit  of  eating  and  drinking 
like  other  people,  and  that  animal  food,  in  the  shape  of 
butcher's  meat,  he  partook  of  largely.  I  deprived  him  of 
butcher's  meat  absolutely,  and  of  soups  and  broths,  and  of 
all  animal  food  but  milk.  Cooked  fruit  was  allowed  to  him, 
and  some  vegetables,  spinach  and  onions,  for  instance,  and 
any  article  of  farinaceous  diet,  and  plenty  of  oranges. 
Oranges  and  finely-strained  barley-water  were  granted  to 
him  ad  libitum  to  quench  his  thirst,  of  which  he  sometimes 
had  more  than  enough.  Barley-water,  I  take  this  opportu- 
nity of  saying,  and  especially  when  flavoured  with  lemon 
juice  or  (when  it  can  be  borne)  lemon  peel^  is  one  of  the 
safest  and  most  gratefVil  drinks  that  can  be  taken  by  the 
sufferer  from  chronic  disease  either  of  the  liver  or  kidney. 
It  is  food  as  well  as  drink.  The  sustenance  it  conveys  may 
alone  support  a  patient  for  many  weeks ;  and  it  is  the  moat 
time-honoured  of  all  invalid  recipes,  Hippocrates  himself 
having  frequently  prescribed  it  and  given  elaborate  formulas 
for  its  preparation. 

I  deprived  my  patient  also  of  all  stimulating  beverages, 
even  of  coffee  and  tea ;  and  I  asked  him  to  sponge  his  whole 
body  over  daily  with  water  as  hot  as  he  eould  bear.     I  pre- 


by  Dr.  C.  B.  Ker.  285 

scribed  also  for  him  the  drinking  of  cold  water  between 
meals  in  such  quantity  as  h6  could  reconcile  himself  to 
without  incommoding  his  stomach  or  exciting  repugnance ; 
and^  finally^  I  advised  him  to  wear  a  cold-water  compress 
over^the  pit  of  the  stomach,  so  as  to  include  a  considerable 
portion  of  the  hepatic  region,  and  to  renew  it  three  times 
in  the  twenty-four  hours. 

He  was  directed  to  be  a  great  deal  in  the  open  air,  on 
horseback  if  possible,  without,  however,  tiring  himself;  to 
clothe  himself  warmly  but  not  heavily ;  to  remove  from  a 
street  and  house  where  he  lived,  which  he  described  to  me 
as  dark  and  overshadowed,  damp  and  ill  drained  ;  and  to  free 
himself  for  a  time  from  the  worries  of  business,  by  which 
he  had  been  for  some  time  greatly  harassed. 

The  result  of  following  out  rigidly  these  instructions  was 
most  satisfactory.  In  five  days  my  patient  gained  three 
pounds  in  weight  j  there  had  been  neither  pain  nor  vomit- 
ing, the  yellowness  and  dryness  and  itching  of  the  skin 
had  disappeared,  and  he  had  gained  in  strength  as  well  as 
in  flesh. 

When  he  called  again,  nine  days  later,  he  had  gained 
still  more  ground.  He  had  added  twelve  pounds  more  to 
his  weight,  and  his  strength  had  increased  in  proportion. 
The  appetite,  as  is  so  often  the  case  in  liver  disorders,  was 
rather  too  good,  and  the  state  of  the  bowels  and  urine 
was  more  normal.  He  was  sleeping  well,  the  stomach 
digestion  was  good,  and  there  was  no  pain  nor  tenderness 
anywhere;  there  had  been  no  threatening  of  one  of  the  old 
attacks.     He  called  himself,  indeed,  perfectly  well. 

On  April  9th,  about  two  months  from  the  commence- 
ment of  his  treatment,  he  called  to  tell  me  that  he  had 
remained  wholly  free  from  his  attacks;  and,  again,  he 
reported  himself  on  June  drd  as  being  still  free  from  them. 
The  conclusion,  therefore,  must  be  come  to  that  the  treat- 
ment he  had  been  subjected  to  had  succeeded  in  its  object. 
Such  conclusion  appears  to  be  obvious  and  natural.  A 
certain  treatment  is  prescribed  and  followed  in  a  certain 
disease  with  the.  result  that  its  attacks,  which  had  been  in 
the  habit  of  showing  themselves  at  frequent  intervals,  some- 


286  OaU^Mtones, 

times  every  day,  ceased  to  exist  or  to  recur.     We  cannot 
help  saying  that  the  treatment  has  succeeded. 

But  what  was  that  treatment  ?  It  was  not  a  simple  but 
a  compound  one.  There  were  many  elements  in  it.  Did 
all  those  elements  work  the  cure  or  only  one  or  two  ? 
Would  one  agent  only  have  answered  the  purpose^  or  was 
it  necessary  that  there  should  be  several  ?  Several  there 
were,  as  I  have  indicated.  Nitric  acid^  an  exclusive  diet, 
hot-water  ablutions,  and  cold-water  compresses,  removal 
from  an  ill^drained  house  and  locality  to  one  higher  and 
drier,  and  one  besides,  which  I  have  neglected  to  mention 
in  its  proper  place,  the  kneading  and  shampooing  at  frequent 
intervals  of  the  hepatic  region. 

To  say  that  Nitric  acid  was  the  chief  agent  of  cure, 
would  be  saying  more  than  I  feel  disposed  to  do.  To  say 
that  the  cure  would  have  been  accomplished  without  it 
would  also,  I  believe,  be  too  much  to  assert.  Nevertheless, 
my  experience  in  disorders  of  the  chylo-poietic  viscera  leads 
me  to  say  that  had  that  medicine  not  been  supported  by 
the  other  agents  mentioned  the  result  would  not  have  been 
so  satisfactory.  Of  those  other  agents,  diet  must  rank  as 
the  most  important.  Had  I  been  reduced  to  the  necessity 
of  selecting  one  only  of  the  means  of  treatment  I  made  use 
of  in  this  case,  I  should  not  have  selected  Nitric  acid  but 
the  exclusive  diet.  Happily,  I  was  not  fettered  by  any 
such  limitation,  and  I  believe  that  not  one  of  the  agents  I 
prescribed  but  contributed,  in  a  greater  or  less  degree,  to 
the  recovery. 

A  difference  of  opinion  will  probably  be  entertained  by 
the  readers  of  the  facts  of  this  case  as  I  have  given  them. 
It  will  be  said,  I  have  no  doubt,  by  many  that  there  is  no 
proof  that  the  case  was  one  of  gall-stones.  There  is  cer- 
tainly no  such  proof.  At  the  same  time  the  argument  of 
exclusion  is  sometimes  allowed  to  be  a  strong  one,  and  in 
this  case  it  is  so.  If  it  was  not  a  case  of  gall-stones  what 
was  it  ?  All  the  symptoms  of  that  disease  were  present 
except  the  calculi  themselves— the  pain  and  the  cessation 
of  the  pain,  the  nausea  and  vomiting,  the  absence  of  tender- 
ness, the  jaundice,  the  slow  pulse,  the  complete  recovery. 


I 


by  Dr.  C.  B.  Ker.  2Sr 

A  very  careful  examination  of  the  stools  is  necessary  to  be 
made  before  it  can  be  said  that  no  calculi  are  present  in. 
them.  This  examination  I  should  have  made  myself^ 
whereas  1  entrusted  it  to  others  who  were  satisfied  that 
none  were  passed.  But  calculi  formed  of  inspissated  bile 
and  mucus  are  probably  broken  up  and  dissolved  in  their 
passage  through  the  intestines.  And  those  formed  of 
cholesterine  and  pigment-matter^  the  composition  of  the 
great  majority^  are  sometimes  very  small — as  small  as 
mustard-seeds.  When  so  small^  however^  they  are  passed 
generally  in  large  numbers  and  cause  as  much  pain  as 
solitary  and  large  ones^  but  their  presence  is  not  very 
readily  detected  in  the  stools^  their  colour  not  being  very 
different  from  that  of  the  stools  themselves. 

I  can  find  nothing  in  our  literature  which  throws  much 
light  on  the  pathology  or  treatment  of  gall-stones.  In  a 
paper  contributed  to  the  Brit.  Journ,  of  Homoeopathy,  in 
1867,  by  Dr.  O.  Buchmann,  of  Alvensleben,  there  are 
reported  some  cases  cured  by  Chelidonium  majus.  Dr. 
Drury  has  recommended  Calcarea  curb,  as  a  remedy  for  the 
attack.  Dr.  Hartmann  suggests  Chamomilla  and  Colocynth 
as  the  two  best  remedies,  and,  failing  these,  Digitalis.  In 
Baehr's  Science  of  Therapeutics  the  medicines  recommended 
are  Arsenic,  Veratrum,  Cocculus,  and  Belladonna,  but 
especially  Arsenic.  As  preventive  medicines  he  gives  Nux 
vomica  and  Sulphur,  and  mineral  waters,  especially  those 
of  Karlsbad,  Marienbad,  and  Kissingen. 

The  Oreek  and  Roman  and  Arabian  writers  knew  little, 
if  anything,  of  this  disease.  In  the  Books  of  Paulus 
^gineta  there  are  only  two  allusions  to  iti  One  is  to  be 
met  with  in  the  first  volume  {Translation  of  the  Sydenham 
Society),  at  p.  566,  and  is  to  this  effect : — ''  In  cases  of 
obstruction  of  the  liver/^  says  Alexander,  **  when  deobstru- 
ents  are  given  before  the  swelling  is  softened,  the  juices 
being  over-heated  become  like  stones,  and  cannot  be  dis- 
cussed.'^  The  other  is  not  so  certain  a  reference  to  gall- 
stones. It  is  to  be  found  at  p.  586  of  the  same  volume. 
Jaundice  is  being  described,  and  "  Avenzoar  says  that  the 
ducts  are  obstructed  aut  verruca  aut  pustula."     But  on  the 


238  Gail-stones, 

same  page  Haly  Abbas  is  made  to  say]: — '*  Some  relate  that 
calculi  are  formed  in  the  liver^  caecum^  and  colon/'  These 
allusions  may  or  may  not  prove  that  the  disease  in  question 
was  known  to  the  ancients.  If  known  there  is  nothing  to 
prove  it  beyond  the  passages  I  have  just  quoted. 

But  in  1565  Johann  Kentman,  of  DresdeUj  was  the  first 
to  describe  gall-stones;  and  since  that  date  medical 
literature  has  a  good  deal  to  show  upon  it.  Whether 
Sydenham  knew  the  disease  it  is  not  easy  to  say.  In  his 
chapter  on  the  bilious  colic  of  the  years  1670,  1671,  and 
1672,  there  is  much  to  lead  as  to  believe  that  the  symptoms 
described  are  those  of  gall-stones,  but  no  mention  is  made 
of  them. 

There  is  more  consensus  of  opinion  on  the  question  of 
the  treatment  than  on  that  of  the  pathology  of  gall-stones. 
As  to  treatment,  it  is  immediate  and  prophylactic.  The 
indications  for  the  immediate  treatment,  that  for  the  attack, 
arc  the  relief  of  pain  and  the  facilitating  the  passage  of  the 
calculus  or  calculi  along  the  ducts  and  into  the  duodenum. 

It  is  not  probable  that  the  pain  caused  by  the  passage  of 
a  calculus  along  the  ductus  communis  choledocus  can  be 
relieved  by  any  drug  that  is  not  a  narcotic  one.     At  the 
same  time  it  is  not  wise  to  have  recourse  to  such  a  drug  as 
soon  as  the  pain  becomes  severe.     Many  measures  should 
be  first  adopted,  and  many  there  are  that  have  been  recom- 
mended.     Drinking   hot    water   is   one   of   them.      This 
remedy   is   especially  useful   when    there  are  nausea   and 
vomiting  as  well  as  pain.     It  generally  stops  th^  vomiting 
in  a  short  time  and,  if  it  does  not  stop  the  pain,  it  lessens 
it.     And  the  probability  of  its  lessening  the  pain  is  all  the 
greater  if  heat  is  applied  outside  as  well  as  inside.     This 
may  be  done  in  the  shape  of  hot  stupes  or  hot  poultices, 
frequently  renewed.      The  relaxing   effect  of  this    moist 
external  and  internal  heat  may  cause  the  distension  of  the 
duct  through  which  the  stone  is  making  its  way,  and  its 
quicker  and  easier  discharge  into  the  intestine.     However 
we  may  explain   it,   the  fact  is   that    this   measure  often 
relieves  the  attack  greatly. 

A  hot  bath  sometimes  gives  great  relief,  especially  if  the 


by  Dr.  C.  S.  Ker.  239 

patient  can  remain  in  it  a  long  time,  till  he  is  obliged  to 
leave  it^  indeed,  by  faintuess.  Frequent  changes  of  position 
are  also  of  service,  as  are  massage  and  shampooing.  Iced 
water  inside  and  an  ice  poultice  outside  have  occasionally 
done  more  good  than  the  opposite  measure  just  recom- 
mended. I  am  afraid  that  we  have  no  absolute  guide  to 
our  choice  as  to  which  of  these  measures  is  most  suitable  • 
to  the  case  in  hand.  We  must,  therefore,  try  first  one  and 
then  the  other  if  the  first  fails.  Warm-water  injections 
are  amongst  the  means  had  recourse  to  which  are  often 
successful.  Venesection  and  emetics  are  now  scarcely  ever 
made  use  of.  In  the  Sydenham  Society's  Year  Book  for 
1862,  at  page  150^  we  are  told  that  a  M.  Abeille  "  found 
the  continuous  current  of  use  in  one  case  in  promoting  the 
discharge  of  a  gall-stone  as  large  as  a  pigeon's  egg,  which 
had  got  impacted  in  the  duct,  and  had  occasioned  several 
attacks  of  hepatic  colic/' 

Some  one  or  other  or  many  of  the  means  to  relieve  pain 
just  enumerated  having  been  applied,  and  the  pain,  never- 
theless, becoming  more  and  more  unbearable,  not  an  un- 
frequent  occurrence,  it  becomes  a  question  whether  we  must 
not  now  have  recourse  to  a  narcotic.  That  question  ought 
generally  to  be  answered  in  the  affirmative.  If  a  whiff  or 
two  of  Chloroform  suffices  to  relieve  the  pain,  perhaps  that 
drug  is  the  best  for  our  purpose.  The  eighth  or  sixth  of  a 
grain  of  the  Acetate  of  morphia  will  sometimes  arrest  pain 
in  less  than  an  hour,  as  will  twenty  drops  of  Laudanum. 
A  few  drops  of  the  mother- tincture  of  Belladonna  have  been 
given  in  the  height  of  a  paroxysm,  and  with  equally  good 
effect.  But>  as  I  have  said,  as  in  a  large  proportion  of 
cases  relief  is  gained  during  an  attack  by  safer  means  than 
narcotics^  those  means  should  be  tried  in  the  first  place^ 
and  not  till  they  have  failed  to  do  good  should  narcotics  be 
prescribed. 

But  prevention  is  better  than  cure.  What  means  have 
we  to  dissolve  calculi  already  formed  or  to  prevent  their 
formation  ?  Many  means  have  been  recommended  for  both 
those  purposes  with  greater  or  less  confidence.  The 
mineral  waters  of  Karlsbad,  Yichy^  Ems,  Marienbad^  Eger, 


240  Gall'Siones, 

and  FartOD,  are  said  to  be  capable^  not  only  of  disaolmg 
calculi,  but  of  preventing  their  formation^     It  is  certainly 
the  case  that   sufferers   resorting   to  those  waters    derive 
frequently  great  benefit  from  them.     But,  independently  of 
the  good  they  gain  by  the  change  of  air  and  scene,  and 
occupation   and  habit,  the  explanation   of   that  benefit  is 
probably  the  flow  of  bile  in  larger  quantities  which  drinking 
the   waters   causes,   a   flow,   by  the   way^  which   drinking 
largely  of  cold  water  is  said  by  many  to  bring  about  quite 
as  copiously  as  any  mineral  water.     The  increased  flow  of 
bile  corrects  the  disposition  to  its  sluggish  flow  or  stagnation, 
and  so  one  cause  of  the  formation  of  calculi  is  removed. 
No  satisfactory  proof  has  been  given  of  calculi  formed  having 
been  dissolved  by  such  waters. 

Mercury f  alkalies,  Chloroformy  T\irpeniine,  and  Sulphuric 
ether  are  among  the  remedies  for  which  it  is  claimed  that 
they  dissolve  calculi.  The  last  two  are  the  ingredients  of 
Durande's  celebrated  nostrum,  which  for  a  long  time  was 
considered  to  be  almost  an  infallible  remedy,  in  France 
especially,  where  it  is  still  much  employed.  But  it  is 
denied  that  Turpentine  is  a  solvent,  and  that  it  has  any 
specific  influence  upon  the  disease  or  its  effects,  and  Phos- 
phate of  soda  is  declared  to  be,  by  Dr.  Thudichum,  a  more 
serviceable  medicine  in  every  way.  It  is  not  claimed, 
however,  for  it  that  it  is  a  solvent.  Indeed,  the  opinion 
gains  ground  that  no  solvent  for  calculi  has  yet  been 
found. 

But  though  we  cannot  dissolve  calculi  it  is  not  so  dear 
that  we  may  not  prevent  their  formation.     The  case  given 
above  proves  that  something  may  be  done  by  treatment  to 
relieve  if  not  to  cure.     It  is  not  claimed  for  it  that  it  is  a 
cure.     Too  short  a  time  has  elapsed  for  that  question  to  be 
determined.     But  it  is  claimed  for  it  that  much  good  waa 
derived  by  the  means  employed,  and  that  the  good  done  is 
still  maintained.    Whether  attacks  will  return  remains  to  be 
seen,  but  in  the  meantime  the  nearly  constant  suffering  of 
eight  months  has  ceased.     Something  may,  therefore,  be 
done  by  following  a  strict  regimen.     This  has  always  been 
granted,  and  writers  accordingly  have,  nearly  all  of  them. 


by  Dr.  C.  B.  Ker.  241 

laid  down  strict  rules  for  the  observance  of  sufferers  from 
gall-stones.  Some,  however,  have  only  insisted  on  the 
importance  of  attention  to  diet,  but  said  nothing  as  to  what 
that  careful  diet  should  be. 

There  is  a  very  general  agreement  on  the  subject  of  fats 
and  oils  and  butter.  They  are  forbidden  by  nearly  all 
authorities.  But  butcher*s  meat,  as  a  rule,  is  not  excluded 
from  the  dietary,  nor  other  descriptions  of  animal  food, 
though  some  say  that  the  lighter  forms  only  should  be 
taken.  Trousseau,  for  instance,  recommends  a  vegetable 
diet,  but  not  to  the  exclusion  altogether  of  animal  food. 
As  to  alcohol,  curiously  enough  it  is  not  thought  necessary 
to  mention  it,  unless  the  recommendation  of  a  "  cooling 
diet "  refers  to  its  exclusion.  Sydenham  puts  in  a  claim 
on  behalf  of  small  beer  as  an  allowable  article  in  this 
disease,  if  I  may  be  allowed  to  construe  his  '^  bilious  colic  " 
as  meaning  gall-stones.  And  he  gives  the  following  singular 
prescription  : — Let  the  stomach  be  ''  washed  out  *'  with  milk 
and  beer  if  indigestion  is  tiie  cause  of  the  colic  I  Few  in 
these  days  would  have  the  courage  to  prescribe  that  mixture 
for  a  patient  suffering  from  a  paroxysm  of  hepatic  colic 
except  for  the  purpose  of  emptying  an  overloaded  stomach, 
but  even  in  such  case  he  would  probably  come  to  the  con- 
clusion that  a  safer  and  more  effectual  emetic  could  be  used. 
Sut  Sydenham  rarely  lets  slip  an  opportunity  of  prescribing 
his  pet,  London  small  beer,  which  he  says,  neither  sinks 
to  the  weakness  of  water  nor  rises  to  the  generosity  of 
wine. 

There  is  a  general  agreement  also  with  regard  to  other 
elements  of  the  prophylaxis  as  far  as  food  is  concerned. 
Very  digestible  articles  only  are  recommended,  and  each 
authority  has  his  own  idea  of  what  digestible  food  means. 
But  the  food  chiefly  prescribed  is  fruit,  cooked  or  uncooked, 
''laxative  herbs,'^  well-boiled  vegetables,  milk,  whey,  fish, 
boiled  rather  than  fried,  farinaceous  articles,  poultry,  gruel, 
plenty  of  liquids,  such  as  cold  water,  barley-water,  rice- 
water,  lemonade,  and  soda-  or  other  alkaline  waters. 

It  has  been  suggested  that,  as  gall-stones  affect  stall-fed 
cattle  in  winter,  and  the  disease  is  got  rid  of  as  soon  as  they 

VOL.  XXXVIII,  NO.  CLIII. — JULY,   1880.  Q 


242  GalUstones, 

are  turned  out  into  the  fieldj  grass  would  be  a  good  remedy 
for  buman  cattle  I  There  is  certainly  no  reason  why  this 
remedy  should  not  be  tried  ;  it  is  in  the  experience  of  us 
all  that  there  are  worse  things  to  eat  than  grass. 

It  is  scarcely  necessary  to  say  that  all  agree  as  to  the 
importance  of  exercise  on  foot  and  on  horseback^  and  on  the 
foUowing  out  strictly  what  are  generally  recognised  to  be 
the  rules  of  hygiene.  A  course  of  water  treatment  is  also 
often  recommended^  with  or  without  the  Turkish  bath,  or 
bathing  in  the  sea  if  it  can  be  borne.  Change  of  locality 
alsoy  if,  as  is  often  the  case,  the  residence  of  the  patient  is 
surrounded  by  nnsanitaiy  conditions.  But  such  genial 
rules  are  equally  to  be  impressed  upon  all  sufferers  firom 
chronic  disorders. 

There  is  not  very  much  to  be  said  that  is  positive  or 
absolute  on  the  pathology  of  gall-stones,  and  the  opinions 
expressed  upon  it  are  sufficiently  confficting.  For  instance, 
some  say,  and  Fletcher  is  of  them,  that  inflammation  is 
invariably  the  moving  agent  in  the  production  of  the  cslculi. 
The  majority  of  writers,  however,  assert  that  inflammation 
has  nothing  whatever  to  do  with  their  production.  Their 
opinion  is  that  from  local  or  constitutional  conditions  a 
chemical  change  takes  place  in  the  bile,  which,  accordingly, 
coagulates  and  forms  itself  into  calculi.  The  change  involves 
the  transformation  to  an  acid  fluid  of  what  had  formerly 
been  an  alkaline  one.  A  putrid  fermentation  tak^  place, 
it  is  said  by  some.  Dr.  Ooodeve  and  others,  which  causes 
the  decomposition  of  the  bile  and  the  formation  of  gall-stones. 

It  is  maintained  by  the  late  Dr.  Budd  that  their 
formation  is  owing  to  mechanical  causes,  and  in  some- 
thing like  the  way  scybala  are  formed  in  the  colon.  That 
is  to  say,  the  bile,  obstructed  in  its  onward  flow  by  some 
cause,  stagnates  in  its  ducts  or  in  the  gall-bladder;  the 
watery  part  of  the  bile  is  absorbed,  and  the  treacly  residuum 
condenses  into  small  masses  which  harden  into  calculi. 
But  even  Budd  is  not  satisfied  with  this  mechanical  expla- 
nation, for  in  another  place  he  says  that  the  presence  of 
calculi  always  argues  an  unnatural  state  of  the  bile;  not, 
however,  a  structural  disease  of  the  liver.     He  mentions  its 


by  Dr.  C.  B.  Ker.  243 

frequent  connection  with  organic  disease  elsewhere,  how- 
ever, especially  cancer,  and  this  connection  Frerichs  also 
notices.  The  latter  authority  gives  more  than  one  case  in 
which  cancer  of  the  head  of  the  pancreas  vas  the  evident 
cause  of  gall-stones  and  jaundice.  It  is  a  question  whether 
the  cancer  virus  or  the  mechanical  pressure  caused  by  the 
tumour  produced  the  jaundice  and  the  gall-stones.  It  is 
most  probable  that  vital  as  well  as  mechanical  causes  were 
at  work.  Fatty  degeneration  of  the  liver  is  sometimes  found 
in  connection  with  this  disease,  but  whether  as  a  cause  or  a 
consequence  has  not  been  determined.  Thudichum's 
opinion  is  that  the  cause  of  biliary  calculi  is  an  acid  state  of 
the  blood  resulting  from  a  process  of  putrefaction,  but  the 
primary  link  in  the  chain  of  causes  is,  he  thinks,  a  ferment 
absorbed  from  the  intestinal  canal.  He  believes,  too,  that 
obstructed  ducts  lead  to  changes  in  the  chemical  character 
of  the  secretions  of  those  ducts,  to  vitiated  bile,  therefore, 
and  to  a  diseased  condition  of  their  epithelial  lining,  which 
is  thrown  off  in  the  shape  of  casts  which  serve  as  nuclei  of 
gall-stones. 

Biliary  calculi  have  often  been  analysed,  and  their  com- 
position is  proved  to  be  a  very  complex  one.  The  chief 
ingredient  is  cholesterine,  a  fatty  substance  of  a  pearl-like 
appearance,  and  next  comes  bile  pigment.  These  two  are 
found  in  nearly  all  calculi.  Frerichs  gives  a  list  of  other 
substances  that  go  to  their  formation — cholepyrrhin,  chole- 
chlorin,  cholate  of  lime,  biliary  acids,  calcareous  salts, 
mucus,  epithelium,  uric  acid,  metallic  oxides,  earths,  alkaline 
salts,  and  fatty  acids  and  soaps. 

They  are  rarely  found  single.  Most  frequently  they  are 
found  in  lai^e,  sometimes  in  very  large  numbers,  as  many 
as  8000  having  been  found  in  one  person.  Their  size  varies 
greatly,  being  found  as  small  as  a  mustard  seed  and  as  large 
as  a  walnut,  or  even  a  hen's  egg.  Their  shape  also  varies, 
dependent  on  the  surroundings,  but  they  are  generally 
globular,  and  their  colour  is  brownish  or  greenish-yellow. 
Their  specific  gravity  is  nearly  that  of  water.  They  sink 
when  moist,  and  float  when  dry.  They  have  generally  a 
nucleus,  the  composition  and  character  of  which  is  not 


244  Gall-stones, 

ahrajs  the  same.  It  is  of  lime  or  mucus  or  cholepjrrhia 
(the  chief  colouriug  matter  of  bile)^  or  it  is  sometimes  a 
foreign  bodv,  a  small  gall-stone,  for  instance,  or  a  globule 
of  mercury  or  a^worm.  They  are  generally  saponaceous  to 
the  touch,  white  and  shining,  lamellar  in  structure,  easily 
fusible  and  inflammable,  and  soluble  in  hot  alcohol,  ether, 
and  turpentine ;  and  they  are  found  wherever  bile  is  found, 
eyen  deep  in  the  parenchyma  of  the  liver. 

It  may  appear   at  first   sight   strange  that   such  small, 
soft,  and  soapy  masses  should,  in  their  passage  through  the 
ducts,  cause  such  intolerable  pain,   pain  that  often  reduces 
the  sufferer   to  a  state   bordering  on  collapse.     But  it   is 
probable  that  that  pain  is  as  much  indirect  as  direct.     An 
angular,  rather  hard   calculus   (for  some   are  harder  than 
others)  may  cause  great   mechanical  irritation  in   passing 
through  a  narrow  duct,  tbe  diameter  of  which  is  less  than 
its  own,  and  great  pain  may  be  caused  in  consequence.     But 
the  involuntary  eflbrts  to  expel  the  foreign  body  may  be 
a  source  of  as   much  pain   as  that  due  to  the  mechanical 
cause.     But,  however  the  pain  may  be  explained,  it  is  one 
of  the  greatest  the  human  body  is  subject  to.     It  sometimes 
comes  suddenly  and  sometimes  goes  off  as  suddenly.     When 
It  continues  for  a  day  or  two  we  are  forced  to  suspect  that 
there   is  impaction   of  the  calculus.     This  state  of  things 
may  continue  for  many  months  or  even  longer,  and  end  in 
the  expulsion  of  the  stone.     A  lady-friend  of  mine  passed 
one  that  had  resisted  every  attempt  to  get  rid   of  it  for 
nearly   two   years.      Her   case   was    considered    hopeless. 
The  liver  enlarged  to  such  a  degree  that  it  filled  more  than 
half  of  the  abdomen,  and  she  was  reduced  to   a   state  of 
extreme  emaciation.     It  was  recommended  to  her  to  try  a 
remedy  given  in  an  American  publication,  small,  frequently 
repeated  doses  of  chloroform.     On  the  third  day  after  taking 
the  medicine  she  passed  from  the  bowel  a  calculus  of  about 
the  size  of  a  walnut.     That   was  about  three  months  ago. 
She  is  now  free  from  pain  and  jaundice,  gaining  flesh   and 
strength,  and  the  liver  has  shrunk  into  almost  its  natural 
dimensions. 

But  the  termination  of  such  cases  is  not  usually  so  happy. 


by  Dr.  C.  B.  Ker.  245 

After  some  time^  longer  or  shorter^  according  to  circum- 
stances;  the  impacted  stone  excites  inflammation  and  nice- 
ration^  and  sloughing^  and  perforation.  The  result  is  death 
or  recovery.  Deaths  if  the  stone  is  thrown  into  the  cavity 
of  the  abdomen^  and  peritonitis  consequently  excited.  Re- 
covery^ if  adhesions  of  adjoining  parts  allow  the  stone  to 
pass  into  the  intestines^  or  out  from  the  abdominal  walls. 

The  rule  in  the  ordinary  cases  is^  after  much  pain^  con- 
tinuing from  two  or  three  to  twelve  or  fourteen  hours, 
passage  of  the  calculus  into  the  duodenum  with  rapid  cessa- 
tion of  the  pain,  and  of  the  nausea  and  vomiting  which  so 
frequently  accompany  the  attacks.  The  jaundice  too,  when 
it  is  present, .  which  is  not  always,  yields  in  a  short  time, 
the  urine  becomes  normal  in  colour  again  and  the  stools 
•  show  bile.  The  patient  continues  well  till  the  next  attack, 
for  it  is  rarely  the  case  that  he  gets  off  on  the  terms  of  one 
only. 

As  many  cases  which  must  be  designated  as  gall-stones 
do  not  show  them  in  the  stools,  and  as  the  only  proof 
positive  of  the  existence  of  that  disease  is  a  gall-stone,  it 
will  naturally  be  asked  what  the  symptoms  are  which,  in 
the  absence  of  a  calculus,  give  us  a  right,  in  Trousseau's 
opinion,  to  diagnose  the  disease  to  be  one  of  gall-stones. 
They  may  be  said  to  be  these :  acute  pain,  frequently 
accompanied  by  rigors,  coming  suddenly  on  in  the  epigas- 
trium and  in  the  region  of  the  gall-bladder,  and  radiating 
sometimes  to  all  parts  of  the  trunk ;  no  tenderness  on 
pressure,  on  the  contrary,  relief  from  pressure ;  no  fever, 
nausea,  vomiting,  generally  of  glairy  acid  matter,  slow 
pulse,  and,  after  an  interval  of  varying  duration,  rapid 
cessation  of  the  pain.  The  case  is  all  the  more  clear  if, 
besides  these  symptoms,  there  are  jaundiced  skin,  bile  in 
the  urine  and  none  in  the  stools. 

There  are  several  reasons  why  gall-stones  are  not  more 
frequently  seen  in  the  stools  in  cases  of  this  disease.  In 
the  first  place,  when  they  are  looked  for,  which  is  not 
always,  it  is  not  very  elaborately.  Few  can  get  over  the 
natural  repugnance  to  undertake  such  an  examination.  A 
very  thorough  sifting  of  the  fseces  by  means  of  water  and  a 


246  Gall'Btones,  by  Dr.  C.  B.  Ker. 

sieye  is  necessary  if  we  wish  to  make  sure  of  tbe  presence 
or  absence  of  a  calcalas.  But  calculi  of  inspissated  bile 
and  those  of  verj  soft  consistence  may  be  dissolved  bj  the 
intestinal  secretions,  as  many  writers  allow^  and  aocordinglj 
never  reach  the  anus  at  all.  And  again,  biliary  gnvel 
may  escape  detection  if  of  the  same  colour  as  the  fteoesi  the 
size  of  each  particle  being  scarcely,  in  some  casesi,  larger 
than  those  of  sand. 

The  prognosis,  when  the  patient  is  not  old  nor  affected 
with  organic  disease  of  the  liver,  or  stomach,  or  pancreas, 
may  be  said,  in  the  majority  of  cases,  to  be  favourable. 
But  it  is  necessary  to  make  a  thorough  examination  of  a 
case  before  pronouncing  that  nothing  but  a  favourable  issoe 
need  be  anticipated. 


247 


REVIEWS. 


Una  deliberazione  del  Consiglio  Superiare  delta  PuJblica 
Istruzione  del  Regno  d'ltalia  delta  Medicina  Omeopatica 
nette  Universila  detlo  Stato  at  IHbunate  delta  Pvblica 
Opinione.  Memoria  Del  Dott.  Comm.  G.  E.  Menoozzi^ 
Professore  onorario  nella  Beale  Universitk  de  Boma. 
Boma  :  Astero  e  Comp.     1879. 

The  author  being  conyinced  of  the  advantages  of  homoeo- 
pathy and  of  the  futility  of  allopathy^  addressed  a  petition 
to  the  Minister  of  Public  Instruction^  praying  that  he  might 
be  allowed  to  give  free  instruction  in  homoeopathy  in  the 
Sroyal  University  of  Bome. 

The  minister,  to  Dr.  Mengozzi's  great  disgust^  referred 
his  petition  to  the  Superior  Council  of  Public  Instruc- 
tion, whose  members,  as  our  author  observes,  knowing 
nothing  about  homoeopathy,  were  an  incompetent  tribunal. 
The  Council  refused  the  request  of  the  petition  on  the 
ground  that  '^  homoeopathy  is  the  negation  of  all  the 
positive  sciences.^' 

This  insolent  rejection  of  his  prayer  by  an  ''  incompetent 
tribunal ''  was  naturally  displeasing  to  Dr.  Mengozzi,  whose 
estimation  of  homoeopathy  was  very  decidedly  different 
from  that  of  the  Council.  Dr.  Mengozzi,  who,  as  he  tells 
ns,  had  '^  deserted  the  standard  of  allopathy,  after  long 
meditations  and  great  love  for  suffering  humanity,  in  order 
to  fight  under  the  banner  of  homoeopathy,''  being  concerned 
at  the  deplorable  ignorance  of  Minister  and  Council  with 
respect  to  Hahnemann's  doctrines,  sent  them  one  of  his 
-works,  published  in  1873,  in  order  to  enlighten  them  on 
the  superexcellence  of  homoeopathy  and  the  irrationality  of 
allopathy. 


248  Reviews. 

Having  doue  this  he  tranquilly  awaited  the  result,  which 
he  imagined  could  not  fail  to  be  advantageous  to  humanity 
and  science,  in  America^  where  he  was  engaged  in  studying 
yellow  fever  in  order  to  discover  a  prophylactic  for  it. 

Of  course,  the  result  did  not  answer  his  expectations, 
and  he  was  forced  to  put  up  with  the  verdict  of  the  Superior 
Council,  viz.,  that  '' homoeopathy  is  the  negation  of  the 
positive  sciences.*' 

On  this  he  resolved  to  appeal  from  the  judgment  of  the 
Superior  Council  to  that  of  the  public,  hence  this  book. 

He  begins  by  claiming  for  Italian  philosophy  and  science 
a  character  as  high  as,  if  not  higher  than,  that  of  those  of 
other  countries,  and  he  rates  his  countrymen  for  preferring 
the  science  and  philosophy  of  France  or  of  Germany  to  their 
own,  and  for  adopting  eagerly  the  bad  points  of  these  and 
rejecting  the  good  ones. 

Dr.  Mengozai  gives  a  sketch  of  the  history  of  homoeo- 
pathy in  Italy — at  least,  he  gives  a  number  of  facts  asso- 
ciated with  homoeopathy  in  his  own  country,  some  of 
which  may  be  new  to  our  readers.  Ferdinand  I,  of  Naples, 
he  tells  us,  was  a  patron  of  homoeopathy.  The  Allopathic 
Royal  Academy  of  Medicine  of  Naples  hastened  to  offer  to 
scientists  ''an  exposition  of  the  Materia  Medica  and  Organon 
of  Hahnemann,'*  whatever  that  may  mean,  ''  which  greatly 
contributed  to  the  spread  of  homoeopathy.'*  Francis  I  did 
still  more  for  homoeopathy  in  1828  and  1829.  He  ordered  it 
to  be  introduced  into  the  Military  Hospital  of  the  Trinity. 
Ferdinand  II  did  more  for  homoeopathy  than  his  two  pre- 
decessors. On  the  occasion  of  cholera  in  Sicily  he  caused 
.instruction  in  relation  to  its  homoeopathic  treatment  to  be 
circulated.  He  likewise  gave  permission  for  the  foundation 
of  a  dispensary  and  academy  of  homoeopathy  in  Palermo. 
The  Duke  of  Lucca  called  to  his  court  the  homoeopathic 
physicians,  Drs.  Necker  and  Schmidt.  King  Charles 
Albert,  in  1839,  issued  a  decree  for  the  foundation  of  a 
homoeopathic  dispensary  at  Turin.  "The  great  soldier  of 
our  country's  battles,  Victor  Emanuel  II,  King  of  Italy, 
laid  the  undisplaceable  corner  stone  of  the  Boyal  Homoeo- 
pathic Establishment    or  Institute   in    Naples.''     An  im- 


MengozzVs  Memoria.  249 

posing  ceremonjTj  with  music  and  firing  of  cannons,  silver 
gilt  trowels,  and  attendant  freemasons  with  their  embroidered 
aprons  and  mystic  signs  and  wonders ;  addresses  from 
civic  dignitaries  and  gracious  royal  answers,  with  probably 
a  gala  representation  at  the  opera  and  a  general  illumina- 
tion^ flitted  through  our  mind  when  we  read  the  words,  but, 
alas !  like  much  of  Dr.  Mengozzi's  writing,  it  is,  we  fear^ 
only  to  be  taken  in  a  figurative  sense,  for  we  find  that  the 
''  Establishment  or  Institute  ^' — it  is  curious  that  Dr. 
Mengozzi  should  not  be  quite  sure  of  the  name,  though  he 
says  he  was  the  president — had  its  corner  stone  laid  by 
a  decree  issued  from  Turin,  and  that  since  then  the  edifice 
with  an  uncertain  name  and  an  undisplaceable  corner 
stone  has  been  removed  from  Naples  to  Rome.  A  copy  of 
the  decree  is  added,  whereby  it  appears  that  the  ^Maying  of 
the  undisplaceable  corner  stone  ^'  means  that  the  royal 
permission  was  given  to  the  National  Homoeopathic  Society 
to  adorn  the  sign-board  (insegna)  of  its  own  homoeopathic 
establishment  {del  propria  stabilimento  omeqpatico)  with  the 
royal  arms.  When  Humbert  succeeded  his  father  he 
graciously  continued  the  royal  protection  to  the  institute. 

Nor  was  homoeopathy  in  Italy  without  the  protection  of 
infallibility.  Popes  Leo  XII  and  Pius  YIII  were  always 
favourable  to  homoeopathy.  Gregory  XVI  permitted  Dr. 
Wahle  to  settle  in  Rome,  and  decorated  Dr.  Centamori  for 
his  services  in  curing  intermittents  with  Nuw  vomica. 
Pius  IX,  by  his  Council  of  Ministers,  reproved  the  Medical 
College  of  Rome  for  their  refusal  to  tax  the  accounts  of 
practitioners  using  homoeopathic  medicines.  Of  course  we 
don't  know  what  advantages  there  are  in  having  our 
accounts  taxed  (in  this  country  when  applied  to  lawyers' 
bills  we  know  that  it  generally  means  cutting  them  down 
often  to  a  very  small  figure),  but  Dr.  Mengozzi  seems  to 
think  that  it  was  something  grand  for  homoeopathy,  for  he 
says :  *'  Pius  IX  thus  broke  the  arms  with  which  the 
allopaths  imagined  they  were  going  to  destroy  the  greatest 
of  scientific  discoveries,''  viz.  the  therapeutic  law  Hm.  Bim.  cur. 

The  Academy  and  Dispensary  at  Palermo  were  pushed 
on  by  the  enthusiastic  and  erratic  Dr.  Mure ;  indeed,  in  his 


250  Reviews. 

book  Mure  sajs  thej  were  established  by  himself.  After 
Mare's  dep&rtare  to  convert  a  misbelieniig  world,  Mcurello 
took  his  place.  One  of  his  dicta  was,  "  without  homoeo- 
pathy there  is  no  salvation.''  We  don't  know  so  mnch 
about  Morello  as  we  do  about  More,  who  was  really  an 
extraordinary  person^  but  Dr.  Mengozsi  tells  as  he  was 
'*  illustrious/'  "  of  sovereign  intelligence,"  '^  the  most 
worthy  commentator  of  Hahnemann,"  ''a  lofty  reasserter 
of  the  discoveries  of  Italian  philosophy,"  and  so  on.  But 
we  cannot  help  observing  that  throughout  his  book  Dr.  Men- 
gozzi^ever  mentions  the  name  of  any  one  who  was  favourable 
to  homoeopathy  without  coupling  it  with  epithets  indicative 
of  the  most  sublime  qualities  of  mind  and  heart,  whereas 
the  opponents  of  homoeopathy  are  just  exactly  the  opposite. 

<<  The  magnanimous  and  sapient  Duke  of  Lucca  "  wished 
Dr.  Altomy  (is  this  our  old  friend  Attomyr  translated  into 
Italian  ?),  who  was  persecuted  by  the  Faculty  of  Medicine 
of  yienna,.^to  enter  his  service,  although  he  had  already 
Necker  and  Schmidt  at  his  court.  Homoeopathy  prospered 
in  Tuscany  under  the  intelligent  protection  of  the  Duke 
thereof. 

In  1847  ''the  illustrious  Morello,"  indignant  at  the 
refusal  of  the  Medical  Congress  at  Milan  to  allow  a  discus- 
sion about  homoeopathy  and  allopathy,  and  still  more  at 
their  offer  of  a  prize  for  the  best  memoir  on  the  merits  and 
objects  of  homoeopathy,  watched  his  opportunity,  and  when 
a  certain  Dr.  Lanciano,  who  seems  to  have  been  the  only 
candidate  for  the  prize,  published  a  Critical  E:tamination 
of  the  HomcBopathie  System,  Morello  was  down  on  him,  and 
demonstrated  that  the  author  was  ignorant,  not  only  of 
homoeopathy,  but  of  allopathy  too.  This  withering  criticism 
of  their  champion  caused  the  members  of  the  Congress  to 
blush  with  shame  at  having  chosen  Lanciano  as  the 
recipient  of  their  prize.  Morello  also  wrote  a  great  work. 
The  Philosophical  History  of  Medicine  in  Italy,  which  Dr. 
Mengozzi  says  was  pronounced  by  ''  Puccinotti  the  glory  of 
allopathy/'  himself  the  author  of  a  history  of  mediciae^  to 
be  unique,  and  as  filling  up  a  lacuna  in  medical  literature, 
but  the  only  quotation  of  the  glorious  Puccinotti  he  gives 


MengozzVa  Memoria.  251 

hardly  amounts  to  tbat.  It  nins :  '^  Nature  does  not  limit 
herself  solely  to  the  law  of  contraries  in  the  cure  of  diseases^ 
bnt  sometimes  she  follows  the  law  of  similars/' 

Another  hero  of  the  Palermo  Academy  is  Dr.  Tripi,  who 
published  a  Course  of  Homeopathic  Studies,  which  is  much 
praised  by  Dr.  Mengozzi.  Dr.  Cataldo  Carallaro,  another 
of  the  Palermo  school^  is  known  to  us  by  his  Corso  teorico 
praticOy  reviewed  by  us  last  autumn ;  our  estimate  of  its 
value  differs  considerably  from  that  of  Dr.  Mengozzi. 

A  work  was  published  against  homoeopathy  by  a  Milanese 
doctor^  whom  Mengozzi^  in  his  ever  superlative  style,  calls 
^'  il  miserabilissimo  Baiberti,'.'  but  his  mode  of  treating  the 
subject  was  sternly  rebuked  by  ^'\\  grandissimo  medico 
Bocco  Bucco ''  in  a  work  entitled  U Esprit  de  la  Midecine 
ancienne  et  nouvelle,  comparies,  which  was  saluted  by  all 
Europe  as  "  dottissima.'' 

In  Bomagna  a  homoeopathic  journal  was  established,  of 
which  Dr.  Placci  was  the  **  distintissimo  "  editor.  We  are 
not  told  the  name  of  this  journal,  but  those  of  the  Bivista 
Omiopatica  (why  do  some  Italians  write  omeopatica  and 
others  omiopatica  ?),  published  at  Bome  by  Dr.  PompiH,  and 
the  Clinica  Omiopatica  at  Padua  by  Dr.  Cogo,  which  are 
known  to  us,  are  given,  and  another  not  known  to  us, 
entitled  Annale  di  Mededna  Omeopatica  per  la  Sicilia; 
the  Neapolitan  homoeopathic  journal,  //  Dinamico,  is  not 
mentioned  by  him.  In  the  Sicilian  periodical  Dr.  Morello 
discourses  theoretically  in  such  a  way  that  allopathy  is  not 
only  killed  but  buried — ''  trova  la  sua  tomba  ^' — and  his 
practical  essays  keep  the  flame  of  Hahnemann's  doctrine 
burning  '^  vivissimo.'^ 

In  Piedmont  (what  part  not  stated)  homoeopathy  found 
an  asylum  in  the  Hospital  of  Providence  (it  is  to  be  hoped 
not  as  a  patient),  and  in  Nice  it  obtained  great  renown  by 
the  happy  cures  it  made.  Genoa  has  an  institute  (of  what 
kind  not  stated)  directed  by  the  '^  esimio  medico,''  Dr.  P. 
Oatti.  In  Turin  a  hospital,  founded  by  Father  CSottolengo, 
was  placed  under  the  homoeopathic  system,  and  another  was 
opened  at  the  expense  of  the  Marchesa  di  Barolo,  for  the 
purpose  of  curing  cases  pronounced  incurable  by  allopathy. 


252  Reviews. 

In  Rome  Ladelci  published  a  work  on  pathology  and 
therapeutics,  and  Salaghi  one  entitled  Paiologia  Nuova. 
Dr.  Mengozzi  himself  published  a  book  entitled  PhUo* 
sophical  Introduction  to  the  Study  of  Medicine^  for  which 
the  UniTcrsitj  of  Naples  sent  him  a  decree  of  "  benemerito 
delle  scienze  mediche/' 

This  is  nearly  all  the  information  respecting  the  history 
of  homoeopathy  in  Italy  we  can  elicit  from  Dr.  Mengozzi's 
work.  He  gives  a  brief  account  of  the  state  of  homoeo- 
pathy in  Europe,  from  which  we  learn  the  following 
respecting  our  own  country.  ''  Two  public  courses  of 
Homoeopathy  in  the  London  Homoeopathic  Hospital,  Pro- 
fessors Dr.  Dudyeon  and  Dr.  Hughes.^'  "  Directing  Com- 
mittee of  the  Faculty  of  Homoeopathic  Medicine  of  London." 
*'  Society  of  Homoeopathic  Publications  of  London.^'  ''  Lon- 
don Homoeopathic  Hospital.''  *'  Homoeopathic  Veterinary 
Clinic  of  the  British  Cavalry.''  "  Hahnemann  Convalescent 
Hospital,  London."  "  Public  Homoeopathic  Dispensary  at 
Liverpool."  **  Homoeopathic  Hospital  at  Edinburgh.'' 
"  Hahnemannian  Society  of  Worcester.''  Of  homoeopathic 
publications  he  mentions  the  Monthly  HomcBopathic  Review, 
directed  by  Drs.  Pope,  Dyce,  Brocen,  and  the  HomcBopaihie 
World,  directed  by  Dr,  Shuldham ;  but,  alas !  makes  no 
allusion  to  our  venerable  selves.  It  is  to  be  hoped  that  Dr. 
Mengozzi's  information  respecting  homoeopathy  in  Italy  and 
other  countries  is  somewhat  more  correct  than  his  know- 
ledge of  homoeopathy  in  Britain. 

The  second  chapter  contains  extracts  from  the  writings 
of  celebrated  old-school  doctors  unfavourable  to  allopathy 
and  favourable  to  homoeopathy,  many  of  which  have  been 
often  quoted,  but  some  of  which  are  new  to  us. 

The  third  chapter  is  ''  On  positive  Sciences  in  Cteneral/' 
in  which  he  tries  to  show  that  homoeopathy  is  a  positive 
science,  and  not,  as  the  Superior  Council  of  Education  de- 
clared, the  negation  of  all  the  positive  sciences,  and,  more- 
over^ that  it  is  in  accord  with  them  all. 

The  fourth  chapter  is  ^' Logic  in  relation  to  Homoeo- 
pathy," in  which  he  endeavours  to  prove  the  law  of  similaiB 
.to  be  a  fundamental  law  of  nature  and  of  all  the  sciences^ 


Mengozzi's  Memoria,  258 

and  that  the  law  of  contraries  is  error  baptized  by  law — that 
it  is^  in  fact^  the  negation  of  logic.  The  next  chapters^  on 
speculatiye  philosophy  in  relation  to  homoeopathy^  physiology 
in  relation  to  homoeopathy,  the  physio-chemical  sciences  in 
relation  to  homoeopathy,  mathematics  in  relation  to  homoeo- 
pathy, contain  a  great  many  quotations  from  writers  on  all 
the  subjects  which  the  author's  ingenuity  enables  him  to 
turn  to  the  support  of  his  view,  that  the  homoeopathic  prin- 
ciple pervades  all  the  sciences.  We  have  seen  this  sort  of 
thing  attempted  more  or  less  successfully  before,  and, 
indeed,  the  first  impulse  was  given  to  searching  after  more  or 
less  far-fetched  analogies  in  other  departments  of  science  by 
Hahnemann  himself ;  but  we  think  it  is  rather  remarkable 
for  its  ingenuity  than  its  utility,  though  doubtless  other 
minds  might  be  more  impressed  with  it  than  we  are. 

In  the  ninth  chapter  he  tells  us  that  the  University  of 
Naples,  having  been  applied  to  to  establish  a  Chair  of  Homoeo- 
pathy, gave  this  answer : — ^*  The  University  of  Naples  is 
not  a  fit  place  for  giving  instruction  in  homoeopathy,  because 
rational  medicine,  which  is  taught  there  on  the  basis  of  the 
natural  sciences,  excludes  allopathy  and  homoeopathy  and 
every  other  absolute  system.^'  This  was  not  unlike  the 
answer  given  by  Dr.  Sharpey  to  the  question  if  the  Univer- 
sity of  London  would  recognise  lectures  on  homoeopathy. 
^'  Certainly  not,^'  was  the  answer,  '^  neither  would  it  recog- 
nise lectures  on  allopathy  or  any  other  exclusive  system .'' 

We  now  come  to  the  occasion — ^the  exciting  cause,  as  it 
were— of  Dr.  Mengozzi's  work.  We  find  it,  we  think,  in  a 
note  at  the  end,  which  tells  us  that  the  medical  section 
of  the  National  Academy,  the  Italian  School  (of  which  Dr. 
Mengozzi  is  President  and  Founder),  in  view  of  the  declara- 
tion of  the  Superior  Council  of  Education,  that  Homceopathy 
is  the  negation  of  all  the  positive  sciences,  propose  to  award 
a  gold  medal  to  the  author  of  the  best  treatise  on  the 
following  subject : 

*^  To  determine  which  of  the  dominant  medical  doctrines 
constitutes  the  science  of  medicine  relatively  to  its  object ; 
which  of  them  reveals  the  relation  betwixt  the  disease  and 
medicine  in  order  that   we  may  effect   a  cure  by  human 


254  Seviewi* 

meatiB ;  which  poMesses  the  fdndameutal-  law  of  medicine^ 
and  consequently,  which  has  followed  the  straight  road  to  a 
Ic^cal  reconstruction  of  medicine;  in  other  words,  which 
possesses  the  type  of  science?  which  has  discoyered  the 
reasons  and  the  fundamental  laws  of  Materia  Medica  and 
Therapeutics  f  allopathy  or  homoeopathy — which  of  the  two 
is  true?" 

The  prise  to  be  awarded  to  the  most  meritorious  work 
by  the  Allopathic  Medical  Faculty  of  Berlin,  and  the 
Homoeopathic  Medical  Faculty  of  London. 

The  work  before  us  is  the  competing  essay  for  the  prise  of 
the  gold  medal  offered  by  Dr.  Mengozzi's  Italian  School, 
the  competitor  being  the  President  and  Founder  of  the 
school,  and  the  judges  being  the  Medical  Faculty  of  Berlin, 
which  would  certainly  turn  up  its  allopathic  nose  at  the 
whole  affair,  and  the  phantom  Homoeopathic  Medical 
Faculty  of  London.  Would  it  not  have  been  more  in  con- 
formity with  the  usual  practice  of  rational  beings  and  men 
of  the  world  if  Dr.  Mengozsi  had  first  of  all  ascertained 
whether  it  was  the  right  thing  for  the  president  and 
founder  of  a  so-called  school  to  compete  for  a  prize  offered 
by  his  school,  and,  that  settled,  to  have  inquired  if  the 
Medical  Faculty  of  Berlin  would  accept  the  position  of 
judge  offered  it,  and,  that  arranged,  to  have  asked  some 
English  friend  if  there  was  such  a  thing  as  a  Homoeopathic 
Medical  Faculty  in  London  ? 

The  matter  of  Dr.  Mengozzi's  book  is  not  all  bad^«many 
parts  of  it  are  really  good  and  interesting,  but  the  manner 
of  it,  with  respect  both  to  its  apparent  raison  d^Stre  and  the 
very  ''  high  falutin  ^'  style  in  which  it  is  mostly  written, 
appears  to  us  altogether  objectionable. 


Pathogenetic  Outlines  of  Homeopathic  Drugs.  By  Dr. 
Ca&l  Hbinioke,  of  Leipzig.  Translated  by  Dr.  Emll 
TiETZE,  of  Philadelphia.     Boericke  and  Tafel.     1880. 

We    have  already    seen   the    German  work  of  which 
this  is  a  translation,  but  intend  to  delay  our  review  of  it 


Hay  Fever,  by  Dr.  C.  H.  Blackley.  255 

until  it  is  completed  by  the  promised  Repertory  that  is  to 
be  compiled  by  Dr.  Fahlmann.  IV e  think  that  Dr.  Tietze 
might  have  waited  to  incorporate  the  Repertory  with  his 
translation^  which  is  imperfect  without  it.  The  translation 
is  very  well  done. 


Hay  Fever  :  its  causes,  treatment,  and  effective  prevention. 
By  Charles  Harrison  Blackley,  M.D.^  2nd  Edit. 
London :  Bailliere,  Tindall^  and  Cox,  1880. 

Dr.  Blackley^s  book  is  acknowledged  by  the  general 
consensus  of  the  profession  to  be  the  standard  work  on 
Hay  Fever.  The  value  of  this  new  edition  has  been  much 
increased  by  two  additional  chapters,  one  on  the  quantity  q£ 
pollen  necessary  to  produce  hay  fever,  an  exceedingly 
interesting  inquiry,  conducted  with  admirable  patience  and 
skill.  The  conclusion  from  it  is  that  ^o^h  of  a  grain  of 
pollen,  inhaled  each  twenty-four  hours,  suffices  to  bring  on  a 
mild  attack,  and  a  severe  attack  may  be  caused  by  ^th  of  a 
grain. 

The  chapter  on  the  prophylaxis  and  treatment  of  hay 
fever  will  be  the  most  interesting  to  sufferers.  The  main 
idea  in  the  prophylaxis  is  to  prevent  the  entrance  of  pollen 
particles  into  the  nostrils  or  eyes,  and  Dr.  Blackley  has 
constructed  some  instruments  that  seem  to  perform  this 
very  effectually.  In  addition  to  this  he  mentions  several 
precautions  those  liable  to  hay  fever  should  adopt,  which  he, 
a  sufferer  himself,  has  found  of  value.  He  also  mentions 
several  remedies  for  the  hay  fever  and  asthma  when  they 
are  present.  We  must  refer  oiir  readers  to  the  work  itself 
for  very  valuable  information  on  this  point. 


Licensed  Fceticide.      By  N.  P.  Cooke,  M.D,  LL.D.,  of 

Chicago.     Detroit,  1880. 

This  is  a  vigorous  protest  against  the    production  of 
abortion,  which  would  seem  to  be  called  for  if,  as  the 


256  Reviews. 

author  alleges,  **  one  half  of  the  aDOnal  increase  of  hamanity 
in  our  glorious  republic''   is   destroyed   artificially  before 
its  birth.     The  author  pronounces  foeticide  to   be  murder. 
The  laws  of  the  United  States  make  it  criminal,  but  if  it 
be  true  that  it  is  impossible  to  get  a  jury  in  America  to  con- 
Tict  for  the  offence,  there  seems  but  little  prospect  of  putting 
a  stop  to  the  practice.     Probably  the  awful  consequences 
of  abortion  to  the  fair  sex  the  author  describes  may  act  as 
a  more  powerful  deterrent  than  the  fear  of  a  criminal  pro- 
secution or  the  denunciations  of  moralists.     If  ladies  are 
well  assured  that  it  will  make  them  ^'  wan,  weird,  weasen, 
and  scrawny,''  they  will  hesitate  about  having  recourse  to 
getting   rid   prematurely  of    their   offspring,    unless  they 
should  think  that  there  are  evils  attending  gestation  and 
getting  viable  children  greater  than   their  own    wanness, 
weirdness,  weazenness,  and  scrawniness.  It  is  curious,  if  true, 
that  foeticide  should  be  so  much  more  common  in  America, 
where  there  is  plenty  of  room  for  almost  any  increase  of 
the  population,  than  in  this  over-populated  country. 


Boston  University  Year  Book,  1879. 

We  have  received  from  Professor  Talbot,  Dean  of  the 
Medical  Depai-tment  of  this  University  (which,  as  our 
readers  know,  is  officered  by  homoeopathists),  a  copy  of  its 
Year  Book  for  1879.  It  is  introduced  by  an  essay  from  the 
pen  of  the  President,  William  J.  Warren,  S.T.D.,  LL.D., 
entitled  **  Hopeful  Symptoms  in  Medical  Education," 
which  has  our  warm  concurrence ;  and  which  will,  we  hope, 
be  widely  circulated  throughout  the  States.  All  the 
existing  schools  and  colleges  of  the  University  seem  to  be 
in  active  and  successful  working  ;  but  our  chief  interest  is 
of  course  in  the  School  of  Medicine,  whose  progress  we 
have  noted  from  time  to  time  in  this  Journal.  We  find 
it  counting  a  list  of  127  students,  male  and  female,  in 
attendance  on  the  classes  of  the  last  Annus  Medicus,  and  a 


Out  Foreign  Contemporaries.  257 

large  and  strong  faculty  of  teachers.  The  homoeopathic 
procli?ities  of  the  latter  are  not  disguised^  but  they  are  not 
obtruded.  We  should  only  know  of  them,  were  we 
otherwise  ignorant,  by  the  list  of  text-books  recommended  to 
the  students  (among  which,  by  the  way,  we  note  with  some 
surprise  '^  Hahnemann's  Acute  and  Chronic  Diseases  ^' — we 
suppose  Hartmann's  books  are  meant) ;  and  by  the  pro- 
gramme  of  the  lectures  on  materia  medica  delivered  by  Dr. 
Heber  Smith.  These  comprise,  we  are  told,  ^'  the  toxico- 
logical,  pathogenetic,  and  therapeutic  relationship  of  drugs ; 
the  application  of  homoeopathic  provings;  the  past  and 
present  uses  of  drugs  by  other  than  homoeopathic  prac- 
titioners.^'  The  last  clause  bears,  it  is  evident,  upon  one 
of  the  questions  raised  with  reference  to  our  own  School. 

The  Boston  University,  and  especially  its  School  of 
Medicine,  has  our  best  wishes ;  and  long  may  the  latter 
retain  the  services  of  Professor  Talbot  as  its  guiding  head 
and  inspiring  soul. 


OUR  FOREIGN  CONTEMPORARIES. 

AMERICA. — ^In  our  January  number  we  commenced  the 
task  of  bringing  down  our  survey  of  the  homoeopathic  journals 
of  America  to  the  end  of  1879.  We  were  only  able  at 
that  time  to  deal  with  the  North  American :  the  remainder 
now  await  our  notice. 

Hahnemannian  Monthly.  Jan. — Dec,  1879. — When  we 
last  dealt  vrith  this  journal  (April,  1879)  we  mentioned  that, 
after  a  suspension  of  its  existence  for  the  six  months 
ranging  from  July  to  December,  1878,  it  had  begun  with 
1879  a  new  life  under  the  editorship  of  Dr.  W.  H.  Winslow, 
of  Pittsburg.  This  physician,  though  a  comparatively  new 
convert  to  homoeopathy,  has  conducted  his  journal  like  a 
veteran;  and  in  his  hands  it  has  been  even  a  better 
expositor  of  our  system  than   it  was  before.     From  the 

VOL.  XXXVIII,  NO.  CLllI, JULY,  1880.  B 


268  Our  Foreign  Coniempcr cries, 

twelve  numbers  before  ub  we  gather  a  few  gleanings  for  our 
readers. 

Jan. — ^Dr.  J.  P.  Dake  gives  here  (p.  3)  the  following 
valuable  definition  of  the  sphere  of  the  law  of  similars : — 
*'  Human  afiections  similar  to  those  producible  by  rnedi* 
cines  and  other  agencies,  existing  in  organisms  having  the 
integrity  of  tissue  and  reactive  power  necessary  for  recovery, 
the  efficient  causes  of  the  afifections  having  ceased  to 
operate.''  Dr.  Farrington  relates  (p.  8)  a  case  of  sup. 
pressed  lochia  accompanied  by  agonising  headache,  with  a 
sense  as  though  the  face  was  being  drawn  towards  the  root 
of  the  nose^  and  then  backwards  towards  the  occiput  as  tf 
by  a  string.  The  italicised  symptom  being  found"^  in  the 
pathogenesis  of  Paris  quadrtfolia,  this  remedy  was  adminis- 
tered in  the  SOth  dilution.  After  the  first  dose  the  dis- 
charge returned,  and  after  the  third  (four  hours  later)  the 
headache  ceased.  The  reporter  of  the  proceedings  of  the 
Paris  Congress  of  1878  gives  the  following  curious  render- 
ing  of  '^  the  four  words  of  our  eminent  co-labourer  and 
friend,  Imbert  Gourbeyre :  '  similiter,  elective,  omni  dos4B.' " 
The  preliminary  examination  of  medical  students  in  America 
is  verily  needed.  A  case  of  bee-stinging  is  quoted  from 
the  Wiener  Medicinische  Presse  which  is  worth  repro- 
ducing : — 

'^  A  servant  girl,  let.  26,  suddenly  fell  ill  without  any  known 
cause,  with  the  following  symptoms :  face  puffed  up,  cyanotic ; 
respiration  slow,  heavy ;  (sdema  of  the  lungs  developing ;  general 
sensation  diminished;  pulse  small,  frequent;  extremities  cooL 
The  whole  right  arm  was  swollen ;  axillary  and  cervical  glands 
were  enlarged.  The  offer  of  water,  which  was  much  desired, 
caused  convulsions,  with  an  expression  of  fear  in  the  face,  as  in 
hydrophobia.  In  the  same  way  convulsions  set  in  as  the  physi- 
cian accidentally  touched  the  index  finger  of  the  patient's  right 
hand.  In  this  finger  a  bee-sting  was  found  embedded,  and  sur- 
rounded  by  a  reddish  circle.  Upon  its  removal  the  convulsions 
ceased,  and  the  dread  of  water  disappeared.  The  patient  fully 
recovered,  and  was  able  to  work  the  next  day,  though  still  quite 

*  So  Dr.  Farrington  Myi ;  bat  we  read  it  thna,  "  U  seemed  as  tboogh  a 
thread  were  tightly  drawn  throagh  the  eye  to  the  middle  of  the  head.^ 


America.  259 

feeble.    She  stated  that  immediately  after  feeling  the  Bting,  and 
crofihing  the  bee  between  her  fingers,  the  symptoms  came  on." 

March. — ^Dr.  W.  J.  Martin  relates  a  case  in  which  that 
obscure  and  omiuons  symptom^  pain  in  the  stomach  follow- 
ing diphtheria,  disappeared  rapidly  under  Bryonia  30.  Dr. 
Seip  recommends  very  highly  the  use  of  powdered  bicarbonate 
of  soda  in  frost-bite.  He  sprinkles  it  directly  upon  the  part, 
and  covers  with  cotton  or  a  bandage.  The  pain  is  imme- 
diately relieved,  and  improvement  follows  rapidly.  Similar 
treatment  has  lately  been  advocated  as  specific  in  burns  and 
scalds.* 

May. — Dr.  Fletcher  relates  another  case  in  which  Puisa^ 
iilla  has  seemed  to  induce  spontaneous  version  in  false 
presentation.     Here  it  is  :— 

^'  On  February  12th,  1879, 1  was  called  to  an  obstetrical  case. 
Patient  was  of  a  sauguine  temperament,  sot.  35,  and  this  was  the 
seventh  time  she  had  become  a  mother.  On  my  arrival,  I  found 
the  patient  in  the  first  stage  of  labour.  She  had  been  partaking 
freely  of  black-pepper  tea,  and  she  was  bordering  on  the  con- 
vulsive state;  two  doses  of  Ver,  vir.  Ix  relieved  her,  and  on 
examination  I  found  the  child  lying  transversely  in  the  uterus 
(first  position,  shoulder  presentation).  There  had  been  no  move- 
ments of  the  child  (foetus)  perceptible  to  the  mother.  As  soon 
as  possible  I  administered  a  dose  of  FuUaiilla  12z,  and  in 
fifteen  minutes  the  foetus  commenced  to  change  position,  and  in 
thirty  minutes  from  time  of  first  dose  of  Puis.,  it  was  presenting 
in  first  position  of  the  vertex.  Did  FuU.  12x,  two  doses,  efiect 
thiB,  or  was  it  a  coincidence  ?" 

August. — A  paper  by  Dr.  Campbell,  of  St.  Louis, 
entitled  "  Hints  to  Frovers  regarding  the  Eye  and  Ear/^  is 
one  of  the  many  signs  which  make  us  hopeful  of  having  a 
scientific  Materia  Medica  one  day.  His  strictures  on  the 
superficial  and  confused  character  of  most  of  the  ocular  and 
aural  symptomatology  we  possess  are  very  just,  and  his 
suggestions  for  better  observations  are  full  of  wisdom. 
Will  he  not  make  some  himself  ?     Dr.  Mohr  recalls  atten- 

•  See  UuiM  Siatss  Med.  Iwoeitigator,  Feb.  15tli,  1879,  p.  150, 


260  Our  Foreign  Contemporaries, 

tion  to  the  old  doctrine  of  the  incompatibility  of  certain 
medicines,  not  of  course  in  combination,  but  in  succession* 
He  relates  some  cases  which  he  thinks  illustrative  of  such 
antagonisms,  but  to  our  mind  they  only  present  the  oscilla- 
tions common  to  all  chronic  affections. 

September. — Iodide  of  sulphur  is  a  remedy  about  which 
we  know  very  little ;  and  we  are,  therefore,  gratefiil  for  a 
communication  of  some  experience  with  it  made  by  Dr. 
Bradford,  of  Philadelphia^  to  this  number.  He  finds  it 
very  useful  in  chronic  catarrh  of  the  bladder,  with  prostatic 
involvement.  "  The  symptoms  calling  for  its  nse/^  he 
writes,  **  are  pains  in  the  prostate  gland^  constant  insufficient 
urination,  feeling  of  weakness  in  bladder,  incontiuence, 
mucous  deposit  in  urine.  I  have  used  it  for  a  year,  and 
have  yet  to  see  a  case  having  the  above  symptoms  that  it 
hns  not  relieved.''  *'  I  think,''  he  also  says,  '^  Sulph.  iod, 
to  be  adapted  to  impending  stricture  after  gonorrhoea, 
especially  when  chordee  is  present.  My  first  use  of  it  was 
in  such  a  case,  with  chordee,  very  painful  urination, 
twisted  stream,  yellow  discharge.  I  had  tried  all  the 
remedies  I  knew  of  without  success,  and  was  led  to  give 
the  Iodide  of  sulphur^  which  promptly  cured  the  whole 
trouble,  stricture  and  all."     He  gives  the  3x  trituration. 

There  is  in  this  number  a  short  proving  of  the  HypO" 
phosphite  of  lime^  and  in  that  for  November  a  similar  one 
of  the  Arseniate  of  soda. 

Besides  these  gleanings,  we  find  in  the  Hahnemannian  a 
number  of  papers  on  the  two  subjects  which  have  lately 
been  exercising  the  homceopathic  world  in  America, — the 
examination  of  triturations  under  the  microscope,  and  the 
testing  of  high  potencies.  Both  these  subjects,  howerer, 
demand  a  paper  to  themselves ;  and  this  we  hope  shortly  to 
give  them. 

New  England  Medical  Gazette.  Nov.,  1878 — ^Dec., 
1879. — The  last  two  numbers  of  this  journal  for  1878 
present  nothing  calling  for  notice ;  but  in  January,  1879, 
we  find  it  beginning  a  new  series,  under  a  new  editorship— 
that  of  Dr.  Herbert  C.  Clapp,  whose  excellent  Handbook  of 
Auscultation    and   Percussion  we  lately  noticed    in   these 


America.  261 

pagea.  It  is  somewhat  reduced  in  size^  but  has  certainly 
not  deteriorated  in  quality,  as  a  glance  through  its  twelve 
LTinibers  for  last  year  will  show.  We  will  go  through  them 
as  we  have  done  with  the  Hahnemannian. 

Feb. — Dr.  Cate^  of  Salem^  states  that  he  has  found  a 
gargle  made  of  one  drachm  of  Cubeba  tincture  to  two  thirds 
of  a  tumbler  of  cold  water  an  excellent  dissolvent  of  the 
diphtheritic  membrane. 

March. — Dr.  M.  V.  B.  Morse  reports  several  cases  in 
which  threatened  miscarriage  has  been  arrested  by  Viburnum 
prunifoUum,  in  the  Ix  dilution.  Dr.  L.  A.  Phillips  gives 
an  account  of  an  epidemic  of  diphtheria  occurring  in  a 
children's  home.  Ten  of  the  forty-seven  cases  were 
croupous.  The  first  three  died,  under  the  ordinary 
remedies,  including  Kali  bichromicum  3x.  "When,  however, 
the  latter  drug  was  used  in  as  strong  a  solution  as  could  be 
taken  without  causing  vomiting,  it  proved  so  effectual  that 
the  remaining  seven  cases  all  recovered. 

April. — Dr.  Irving  S.  Hall  relates  some  cases  which 
show  that  Morphiay  in  the  homoeopathic  attenuations,  has 
great  power  in  checking  vomiting,  as  we  know  it  has  in 
causing  it. 

June. — In  our  number  of  April,  1876,  we  quoted  from  a 
report  of  Dr.  Heber  Smith's  what  seemed  to  be  a  case  of 
poisoning  from  the  bite  of  the  tarantula.  This  gentleman 
now  comes  forward  to  state  that  the  view  he  took  of  the 
case  was  erroneous ;  that  the  spider  had  come  by  mail,  and 
decomposition  had  undoubtedly  commenced  in  it  at  the 
time  the  virus  was  introduced  into  the  system ;  so  that  the 
symptoms  were  such  as  might  come  from  dissecting  wound 
or  similar  animal  poisoning,  and  cannot  be  relied  upon  as 
effects  of  the  tarantula. 

September. — ^This  number  has  a  communication  from  Dr. 
Claude,  of  Paris,  relating  a  rapid  cure  of  a  trigeminal 
neuralgia  by  an  unusual  remedy,  Caniharis  (3rd  dil.).  The 
symptoms  were,  sudden  access  and  subsidence  of  the  attacks 
of  pain,  which  lasted  about  half  an  hour  at  a  time, 
contraction  and  twitchings  of  the  muscles  on  the  affected 
Bide  (the  right),  and  great  dilatation  of  the  pupils  during 


262  Our  Foreign  Contemporaries*  ^ 

the  paroxysms.     The  pain  was  compared  to  that  of  a  red-^ 
hot  iron  being  thrast  in. 

The  October  issue  contains  a  letter  from  another  distant 
quarter^  viz.  Adapazar^  in  Asia  Minor,  where  a  Dr.  Kaval* 
gian  is  upholding  the  good  cause  of  honioeopathy. 

The  December  number  gives  us^  from  the  pen  of  Dr. 
A.  H.  TompkinSi  two  more  cases  of  membranous  djsmenor- 
rhcea  cured  by  Borax.  Five-grain  doses  of  the  crude  drug 
were  given  in  one,  and  the  same  proportions  of  the  2Qd 
decimal  trituration  in  the  other. 

The  New  England  Gazette  continues,  as  is  fit,  to  report 
fully  the  doings  of  the  Boston  University  and  of  the  Mss- 
sachusetts  Homoeopathic  Society,  both  of  which  institutions 
seem  to  be  active  and  flourishing. 

American  Observer.  Jan. — Dec.,  1879. — Since  the 
beginning  of  last  year  this  journal  has  reached  us  much 
more  regularly  than  heretofore,  and  the  number  for  July 
is  the  only  missing  one.  We  should  prefer,  however,  to 
have  even  its  place  filled. 

February. — Dr.  Hiller,  of  San  Francisco,  whom  we  were 
pleased  to  see  over  here  last  spring,  reports  in  this  number 
a  case  of  ozena  (so  he  calls  it,  but  it  seems  to  have  been 
nothing  but  chronic  nasal  catarrh)  of  eighteen  months' 
standing,  cured  in  nine  days  by  Glanderine  6.  He  had 
previously  given  Merc,  biniod.  and  Aurum  without  mucb 
effect. 

March. — A  case  of  paralysis  of  the  oculo-motoriua  of 
syphilitic  origin,  apparently  cured  by  Mercurius  iodiUus  30> 
after  the  failure  of  substantial  doses  of  Iodide  of  potassium, 
is  reported  here  by  Dr.  George  Norton. 

April. — Dr.  E.  C.  Price  strongly  recommends  a  glycerole 
of  Arnica,  one  part  to  eight,  as  an  application  to  sore 
nipples.  It  should  be  used  as  soon  as  the  nipples  b^in 
to  feel  tender. 

August. — Dr.  Norton  again  appears  in  this  number  with 
a  case  of  haemorrhage  between  the  retina  and  choroid^  ia 
which  Lachesis  30  seemed  to  hasten  the  absorption  of  the 
blood,  and  Gehemium  80  to  favpur  the  reattachment  of  the 
retina. 


America  263 

December. — AffectionB  of  the  diaphragm  are  so  rarely 
diagnosed  and  treated  that  we  are  glad  to  extract  the 
following^  especially  as  it  confirms  the  remarkable  experi- 
ence of  Dr.  Madden  in  his  own  case  reported  in  yoI.  xxy  of 
our  own  jonmaL 

CUnieifuga  in  Myalgia  of  the  Diaphragm. 
By  Cljlbk  db  Muth,  M.D.,  Plymouth,  Mich. 

Case  1. — Mr.  B.  S.  W.,  set.  26,  student.  Has  for  years  been 
troubled  with  a  pain  which  is  most  severe  just  back  of  the  ensi- 
form  cartilage.  Erom  this  point  it  extends  to  either  side  and 
sometimes  to  back.  Pain  is  always  in  the  same  places — which  I 
found  to  be  the  attachments  of  the  diaphragm.  The  pain,  usually 
dull  and  continuous,  when  aggravated  by  deep  inspirations  or 
violent  exercise,  would  be  severe,  aching,  and  when  he  did  not 
get  his  meals  at  the  accustomed  hour  it  would  be  very  severe^ 
making  him  extremely  irritable ;  eating  always  relieved  him. 

He  had  been  treated  by  an  allopath  for  \*  neuralgia  of  the 
stomach,*'  and  by  an  homcnopath  for  ''  dyspepsia."  The  only  relief 
he  got  was  temporary  palliation. 

I  diagnosed  myalgia  of  the  diaphragm,  and,  relying  on  the  testi- 
mony of  Profs.  Hughes  and  Jones  of  the  efficacy  of  Oimici/uga 
in  such  cases,  gave  Oimioifuga  B  3  gtt.  four  times  per  diem. 

He  took  it  for  a  week  and  was  free  from  all  pains.  In  two 
weeks  he  felt  some  symptoms  of  it  which  were  quickly  dispelled 
by  a  few  doses.  When  I  last  saw  him  there  had  been  no  return 
of  the  complaint. 

Case  2. — Miss.  B.  S.,  st.  about  23,  seamstress  Had  a  head- 
ache for  several  weeks,  usually  commencing  in  morning  and 
lasting  all  day ;  would  sometimes  wake  with  it.  Usually  com- 
menced in  back  of  head  or  neck,  passing  over  head  to  forehead ; 
tiirobbing  in  vertex ;  very  weak  and  easily  prostrated  by  exertion ; 
in  the  afternoon  she  would  have  some  fever,  when  the  languor 
and  prostration  would  be  more  marked.  Ghive  her  QeU.  3x,  2 
gtt.  three  times  per  diem.  In  ten  days  she  returned  no  better, 
but  for  the  first  two  or  three  days  after  commencing  to  take  the 
medicine  she  had  folt  somewhat  relieved,  and  thought  if  I  would 
give  her  larger  doses  the  medicine  would  help  her. 

Ooncluding  I  had  overlooked  something  in  my  former  examina- 
tion, a  more  minute  investigation  was  instituted,  when  the  fact 


264  Our  Foreign  Contemporaries, 

was  disdosed  that  she  had  been  under  allopathic  treatment  for 
more  than  a  year,  bot,  unlike  most  persona  who  have  been  under 
treatment  for  any  length  of  time,  she  was  bo  reticent  in  regard 
to  her  troubles  that  it  was  only  by  the  most  persistent  questton- 
ing  that  I  learned  the  history  of  her  case.  ^'  Scientific  "  diagnosis 
had  located  the  trouble  in  liver  and  spleen,  for  which  she  had 
received  "  regular "  treatment  at  the  hands  of  four  allopaths 
without  receiving  any  benefit.  Having  learned  by  experience 
that  a  "  scientific  diagnosis  '*  was  as  likely  to  be  wrong  as  any 
other  I  insisted  on  a  thorough  examination,  which  resulted  in 
locating  the  trouble  almost  exclusively  in  the  diaphragm.  The 
pain  was  present  almost  all  the  time,  usually  dull  aching;  at 
times  sharp,  shooting,  or  cramp-like  pains,  aggravated  by  deep 
inspiration,  coughing  and  when  lying  down.  Her  sleep  was 
disturbed  by  horrible  dreams  of  burglars,  ^.  The  feverish 
condition  was  attributed  to  a  possible  slight  diaphragmitis. 
Bemembering  my  former  good  result  from  the  use  of  OiM.,  and 
the  headache  somewhat  resembling  the  effect  of  that  drug,  I  pre- 
scribed 

^    Cimieifagt,  5j; 
Alcohol,  3j ; 
M.    Thne  gtt  every  foxir  hours. 

In  a  week  she  returned  free  from  all  her  troubles  and  conse- 
quently very  happy.    There  has  been  no  return  of  the  disease. 

Case  8. — Miss  A.  B.,  sdt.  about  20,  had  been  under  allopathic 
treatment  for  "  a  stomach  difficulty  of  a  nervous  character"  for 
more  than  a  month.    Being  advised  by  Case  2  she  came  to  me. 
On  getting  the  exact  location  of  the  pain  I  found  it  plainly  out- 
lined the  diaphragm.    She  described  the  pain  as  '*  a  terrible  dull 
aching."     On  deep  inspiration,  sharp  stitches,  and  sometimes  the 
sharp  pains  would  occur  from  no  apparent  aggravating  cause. 
She  was  restless  at  night,  starting  up  in  her  sleep.    For  several 
days  previous  to  calling  on  me  she  had  almost  continuous  palpi- 
tation of  the  heart  and  headache,  with  throbbing  in  the  vertex. 
Prescribed  Cm.,  same  as  in  Case  2.    In  a  week  she  reported  that 
**  the  medicine  relieved  her  immediately,  and  after  the  third  day 
she  had  been  free  from  every  symptom  of  the  difficulty.*'    She 
has    remained  free   from  it  ever  since,  now  more  than  three 
months. 

In  two  of  these  cases  the  dull  pain  was  most  marked  in  the 


America.  265 

muscnlai^  attachments  of  the  central  leaflet  of  the  diaphragm,  and 
the  trouble  was  supposed  to  be  in  the  stomach.  In  the  second 
case  it  was  most  marked  in  the  attachments  of  the  lateral  leaflets, 
when  Ihe  mistake  was  made  of  locating  the  difficulty  in  liver  and 
spleen.  In  some  cases  the  pain  is  most  severe  in  the  fleshy- 
bellies  of  the  crura,  when  it  is  likely  to  be  mistaken  for  kidney 
trouble. 

The  sharp  pains  generally  follow  the  direction  of  the  muscular 
fibres  toward  the  central  tendon,  while  the  cramp-like  pains 
appear  to  be  in  the  vicinity  of  the  central  tendon*  the  dull 
pain  being  confined  mostly  to  the  attachments  of  the  diaphragm. 
Whether  the  treatment  of  these  cases  would  be  termed  "  homceo^ 
pathic  treatment,  pure  and  Hmple,^^  by  "  the  mighty  men  of  the 
east/'  or  not,  I  do  not  know.  But  I  do  know  that  it  was 
decidedly  efficacious. 

In  the  same  number  Dr.  E.  C.  Price  reports  a  case  of 
uterine  fibroid^ ''  apparently  more  than  an  inch  in  diameter/' 
which  disappeared  under  the  use  of  Bufo  33x. 

We  would  also  call  attention  to  the  three  cases  of  exci- 
sion of  the  rectum  related  by  Dr.  Helmuth  in  the  numbers 
for  March^  May^  and  June ;  to  the  lectures  on  Cantharis, 
by  Dr.  S.  A.  Jones,  in  those  for  June,  September,  and 
October;  and  to  the  excellent  reports  of  the  progress  of 
surgery,  from  Dr.  Bushrod  James,  which  adorn  every 
number.  Dr.  Hart's  treatise  on  the  Practice  of  Medicine 
is  continued  throughout,  but  as  we  suppose  we  shall  have 
the  opportunity  of  noticing  it  in  a  separate  form,  we  pass  it 
by  for  the  present. 

Homceopathic  Times.  Dec,  1878 — Dec,  1879. — This 
journal  continues  to  be  as  instructive  in  matter  and  as 
tinpleasing  in  form  as  ever,  or  rather  it  has  even  excelled 
itself  in  the  latter  respect  by  adopting  a  smaller  type.  Its 
**  Annual  Retrospect  of  Homoeopathic  Literature,''  which 
appears  as  an  appendix  to  each  number,  is,  with  its  copious 
index,  a  positive  boon,  and  should  make  all  homoeopathists 
subscribers  to  the  Times,  May  we,  as  among  those  who 
yalue  it,  mention  thai  the  numbers  for  May,  1879,  and  for 
February,  1880,  have  failed  to  reach  usf 

January. — The   following    bit    of    practical    experience 


266  Our  Foreign  Contemporaries. 

eeems  worth  extracting.  It  is  from  the  pen  of  Dr.  H.  C. 
Guernsey.  ''In  a  practice  of  thirty- five  years,  during 
which  I  have  treated  fully  4000  cases  of  childbed  sickness, 
I  have,  irutf^fuUy  and  honestly,  never  lost  a  case  by  uterine 
hemorrhage,  and  I  have  never  used  an  adjuvant  of  any  sort 
or  kind.  I  have  been  repeatedly  called  in  consultation 
with  other  physicians  in  these  cases^  and  have  always  seen  a 
happy  issue.  Also^  I  have  succeeded  allopathic  physicians 
when,  by  their  manner,  if  not  by  their  words,  they  have 
shown  the  interested  parties  that  they  had  no  hope  of 
saving  life — ^and  these  cases  I  have  invariably  saved.  I 
have  found  women  almost  insensible,  pulseless,  and  bathed 
in  a  cold  clammy  perspiration ;  *'  she  is  flooding  to  death,'' 
the  attendants  would  say.  Calling  at  once  for  a  tumbler 
of  water  and  a  teaspoon,  I  drop  a  few  little  pellets  of  China 
between  the  lips  of  the  dying  patient,  and  a  few  more  into 
the  tumbler  of  water,  and  I  give  her  a  teaspoonful  of  the 
solution  every  half  minute  or  minute,  and  so  continue  to 
do  till  I  can  distinguish  a  return  of  the  pulse,  then  I  give 
it  at  longer  intervals,  and  a  perfect  recovery  is  the  final 
result.  China  is  worth  infinitely  more  than  tens  of  thou- 
sands of  transfusions  or  any  quantity  of  brandy-and-water, 
or  any  other  possible  means  of  saving  life,  in  these  exceed* 
iDgly  dangerous  cases.'' 

In  the  same  number,  Dr.  Piersons  adds  another  differen- 
tial indication  between  Lachesis  and  Lycopodium  in  throat 
cases  to  commencement  on  the  left  and  right  sides  respec- 
tively ;  it  is  that  in  all  Lachesis  cases  hot  drinks  aggravate 
and  cold  relieve,  while  in  those  calling  for  Lycopodium 
exactly  the  opposite  effect  is  produced. 

March. — ^The  following  important  communication  from 
Dr.  Navarro,  of  Cuba,  we  quote  entire : — 

Tarantula  Cuhensis  {Arana  peluda^  Hairy  spider.) 
By  JosB  J.  Nayabbo,  M.D.,  Santiago  de  Cuba. 

The  Tarantula  Cuhensis  (Arana  pelnda,  hairy  spider)  belongs 
to  the  same  family,  genus,  and  species,  as  the  Tarantula  Mispama. 
As  this  one  is  already  so  well  known  to  the  profession,  I  omit 
the  description  of  the  one  under  consideration.    Besides,  in  1876, 


America.  267 

I  sent  a  specimen  of  the  hairy  spider  to  our  loved  and  lamented 
Carroll  Danham ;  and  those  who  feel  interested  sufficiently  in  the 
matter,  may  probably  gratify  their  scientific  curiosity  through 
the  kindness  of  Dr.  Dunham's  family. 

Although  apparently  alike,  these  spiders  differ  widely  in  their 
pathogenetical  and  therapeutical  effects.  The  Tarantula  Sispana, 
natiye  of  South  America,  and  introduced  in  our  Materia  Medica 
by  the  well  known  Dr.  Nunez  of  Madrid,  (Spain)  is  a  nervoua 
remedy,  acting  deeply  and  powerfully  on  the  cerebro-spinal 
system  ;  and  many  cases  of  chorea,  hysteria,  &c.,  have  been  cured 
by  this  precious  agent. 

The  Tarantula  Cuhensis,  on  the  other  hand,  seems  to  be  a 
tozaemic  remedy  acting  directly  on  the  blood  and  being  in  this 
way  an  analogue  of  Crotalus,  ApiSf  Arsenicumj  &c. 

The  bite  of  this  spider,  if  instantly  attended  to,  is  easily 
deprived  of  its  malignant  effects  by  the  local  application  of  a 
lotion  made  with  water  and  the  tincture  of  Ledum palustre.  But 
if  the  virus  is  already  absorbed  and  carried  into  the  circulation^ 
it  develops  the  following  symptoms : — The  bite  itself  is  painless* 
so  much  so  that  persons  bitten  in  the  night  are  not  sensible  of 
it  until  the  next  day,  when  they  discover  an  inflamed  pimple 
surrounded  by  a  scarlet  areola ;  from  the  pimple  towards  some 
other  point  in  the  body,  a  red  erysipelatous  line  is  seen,  marking 
the  course  followed  by  the  spider  over  the  skin  after  biting — so 
corrosive  is  the  nature  of  this  virus.  The  pimple  swells,  gradu- 
ally increasing  in  size,  the  erysipelatous  inflamed  areola  spreads 
wider  and  wider,  chills,  followed  by  intense  burning  fever,  gene- 
rally supervene  on  the  second  or  third  day,  accompanied  by  great 
thirst,  anxiety,  restlessness,  headache,  delirium,  copious  per- 
spiration and  retention  of  urine.  The  pimple  in  the  mean  time 
grows  larger  and  becomes  a  hard,  large  and  exceedingly  painful 
abscess,  ending  by  mortification  of  the  integuments  over  it,  and 
having  several  small  openings  discharging  a  thick  sanious  matter 
containing  pieces  of  mortified  cellular  tissue,  fascifis  and  tendons ; 
the  openings,  by  growing,  run  into  each  other*  forming  large 
cavities.  At  this  period,  the  fever  takes  the  intermittent  type, 
with  evening  paroxysms*  accompanied  by  diarrhoea  and  great 
prostration. 

This  does  not  take  place  in  every  case  of  the  spider's  bite,  for 
much  depends  on  the  constitution  of  the  patient  and  the  treat- 


268  Out  Foreign  Vontetnporariei, 

ment  adopted ;  but  still,  I  hft^e  known  of  two  cases  io  delicate 
children  where  the  bite  proved  fatal.  The  majority  of  cases 
recover  after  a  period  of  from  three  to  six  weeks.  I  once 
attended  a  black  man  of  about  thirty  years  of  age  bitten  by  this 
spider;  I  was  called  during  the  second  stage;  he  then  had 
diarrhcea,  intermittent  fever,  and  prostration ;  the  opening  left 
by  the  emptying  of  the  abscess  in  the  left  gluteal  region  was  large 
enough  to  admit  my  fist.  He  recovered  in  two  weeks  under 
Anenieum, 

With  these  facts  before  me,  or  rather,  in  view  of  these  |iroo* 
ingtf  I  decided  to  try  the  remedy  in  my  practice.  By  introducing 
into  a  glass  jar  full  of  pure  alcohol  one  of  these  spiders  alive,  I 
prepared  the  mother  tincture  according  to  Dr.  Bering's  method. 
As  by  the  effects  of  anger  the  spider  threw  off  the  poison,  the 
alcohol  changed  from  a  colourless  liquid  to  light  yellow.  !From 
this  tincture  I  prepared  the  6th  decimal  dilution,  and  this  is  the 
preparation  I  have  used  where  indicated.  From  the  cases  in  my 
experience  I  will  cite  the  following  in  proof  of  the  never  failing 
law,  Similia  Hmilihui  eurantur, 

Don  M.  B — ,  let.  72,  good  constitution,  called  me  to  treat  him 
for  an  abscess  in  the  back  of  his  neck,  whose  burning,  excruciating 
pain  had  completely  banished  sleep  for  the  last  six  or  seven 
nights. 

There  was  fever  with  great  thirst  and  prostration ;  on  examina-> 
tion  I  found  it  to  be  a  regular  anthrax^  with  all  the  accompany* 
ing  train  of  symptoms.  Bpe.  Tarantula  cub,,  one  dose  every  two 
hours ;  after  the  second  dose  the  pain  was  greatly  relieved,  and 
that  very  night  the  patient  was  able  to  sleep  through  the  whole 
night.  Under  the  use  of  this  remedy  the  patient  recovered  witb- 
out  using  any  other,  except  Silicea  to  aid  cicatrization. 

Donna  A.  B — ,  et.  61,  past  the  climacteric,  thin  spare  body, 
delicate  constitution,  had  an  anthrax  in  the  interscapular  region, 
with  severe  burning  pain ;  unable  to  sleep  from  the  excessive  pain, 
Tarant,  eub,  in  a  few  days  made  a  complete  cure. 

I.  L — ,  coloured  man,  set.  26,  had  a  large  hard  abscess  in  the 
right  thigh,  exceedingly  painful  and  inflamed,  no  fever,  the  glands 
in  the  groin  swollen,  indurated  and  painful.  $d  Tarant.  cub. 
every  three  hours.  After  the  second  dose  the  pain  was  com* 
pletely  relieved,  and  six  days  after  the  abscess  and  swollen  glands 
had  disappeared  by  resolution. 


America,  269 

M.  C— >  a  little  girl  of  nine  years,  was  taken  ill  with  tonsillitis. 
Besides  several  local  applications  and  domestic  remedies,  had 
taken  Mercur,  bin,,  Bell,^  Aeon,,  and  other  homoBopathic  remedies 
prescribed  by  an  amateur.  When  called  to  see  her,  I  found  high 
fever,  delirium,  red  face,  and  both  tonsils  so  swollen  that  suffoca- 
tion was  feared.  A  few  doses  of  Tarant,  cub,  dispersed  the 
swelling  and  accompanying  symptoms  in  a  few  hours. 

Donna  F.  L.  de  B — ,  st.  84,  delicate  constitution,  had  a  large 
anthrax  in  the  back  of  the  neck  ;  had  been  treated  for  two  weeks 
by  three  physicians  of  the  old  school,  with  local  applications,  first 
emollient  and  then  caustic.  At  last  the  knife  was  resorted  to, 
with  stimulants  internally,  and  Hydrate  of  chloral  and  Morphine 
to  relieve  the  burning  agonising  pain — ^all  to  no  effect,  for  the 
patient  grew  worse  daily.  Upon  examination,  I  discovered  that 
the  whole  of  the  muscular  and  cellular  tissues  were  destroyed 
from  the  neck  to  the  waist  and  from  shoulder  to  shoulder,  leaving 
a  cavity  about  six  inches  long  and  four  wide,  at  the  bottom  of 
which  several  of  the  dorsal  vertebrae  were  plainly  visible ;  there 
was  also  infiltration  of  the  surrounding  tissues,  and  the  patient 
had  quotidian  fever  and  diivrrhgea.  After  the  fourth  dose  of 
J^irant,  cub.  the  pain  was  completely  relieved.  On  the  third  day 
the  line  of  demarcation  was  formed,  and  two  days  afterwards  the 
surrounding  mortified  tissues  came  off.  With  the  continuance 
of  this  remedy  and  an  occasional  dose  of  8ilicea,  the  patient  was 
entirely  cured  in  seven  weeks  from  my  first  call. 

These  are  only  a  few  of  the  many  cases  in  which  Tarant  cub, 
has  given  complete  satisfaction  in  my  practice.  I  have  used  it 
with  success  in  syphilitic  buboes,  painful  boils,  and  all  kinds  of 
abscesses  where  pain  or  infiammation  predominates.  Its  power 
to  relieve  pain  in  these  cases  is  wonderful,  acting  we  might  say 
as  an  anodyne.  The  observations  of  one  man,  however,  cannot 
establish  the  reputa(tion  of  a  remedy ;  and  for  this  reason  I  bring 
these  facts  and  confirmatory  clinical  cases  before  the  profession 
for  investigation.  Perhaps  by  instituting  regular  provings  with 
this  substance,  new  symptoms  might  be  developed,  and  the  real 
value  of  the  remedy  definitely  ascertained.  With  this  object  in 
,viewy  I  send,  together  with  this  communication,  some  of  the 
mother-tincture  of  Tarantula  cubennBy  which  I  place  at  your  dis- 
.posaL  And  I  shall  be  happy  to  afford  any  further  information 
if  desired,  and  to  supply  with  the  tincture  any  member  of  the 


270  Our  Foreign  Conlew^ranes. 

profession  who  is  desiroos  to  iiiTestigate  tlie  riitae  of  this  remed  j. 
(Dr.  Alfred  K.  Hills  wiU  famish  the  tincture  to  those  who 
desire  it.) 

(Bead  before  the  Horn.  Med.  Soc.  of  N.  T.  Conntj.) 

We  must  do  the  same  with  the  paper  which  oommences 
the  April  number,  as  it  containa  some  of  the  longJooked- 
for  results  of  the  homcsopathic  treatment  of  the  insane  aa 
carried  out  at  the  New  YoriL  State  Asylum. 

Om  ike  Treatment  of  Memtdl  andNervoue  Dieeatee, 

By  Skldev  H.  TaiiCoit,  A.M.,  M.D.,  Medical  Superintendent^ 
New  York  State  Homooopathic  Asylum  for  the  Insane, 
Middletown,  N.  T. 

This  paper  is  designed  to  embody,  in  brief,  the  clinical  expe- 
riences gained  at  the  asylum  under  our  charge  during  the  year 
1878.  In  it  we  shall  seek  to  ^'  mirror  the  ritslity  of  our  thought,*' 
not  alone  by  recording  a  series  of  suooessful  experiments  in 
medicsting  the  insane,  but  also  by  presenting  n^atire  or  non- 
curatiye  results  of  treatment  in.  certain  yarieties  of  cases. 

The  knowledge  that  there  are  forms  of  mental  disease  unlikely 
to  recover  under  the  most  jGiTOurable  circumstances,  and  in  which 
all  known  methods  of  treatment  have  been  &ithfiilly  tried,  with 
only  failures  for  results,  is  next  in  imp^nrtance,  to  the  honest 
physician,  to  those  facts  which  demonstrate  our  ability  to  cope 
successfully  with  some,  at  least,  of  the  formidable  phages  of  in- 
sanity. 

We  shall  proceed  at  first  with  the  more  pleasant  part  of  our 
work,  that  of  presenting  the  favourable  effects  of  medication,  and 
leave  the  dregs  of  disappointment  and  defeat  for  the  closing 
draught. 

In  a  general  way  it  may  be  stated  that  the  treatment  of  the 
insane  with  remedies  applied  according  to  the  homodopathic  law 
of  cure  has  been,  thus  far,  a  most  interesting  and  fruitful  experi- 
ment. It  has  been  demonstrated,  beyond  a  doubt,  by  results 
gained  in  the  asylum,  that  the  most  violent  cases  of  maniacal 
excitement  may  be  safely  cared  for,  treated,  and  restored  to  health, 
without  resorting  to  massive  doses  of  somniferous  drugs.  Indeed, 
the  pathological  conditions  induced  by  the  latter  often  form  com<- 
pUcations,  or  combinations,  with  the  original   disease  againat 


America.  271 

which  the  recuperatire  forces  of  nature  are  powerless.  Homoso- 
pathic  treafcment  conserres  the  life  forces  of  the  patient,  and 
seeks  to  avoid  the  aggravation  of  primarj  symptoms.  Thus,  in 
a  long-continued  and  tedious  affection  like  insanity  the  curative 
methods  of  the  homceopath  tend,  we  helieve,  to  the  piloting  of 
a  patient  through  the  imminent  perils  of  his  disease  with  the 
greatest  possible  safety  and  certainty.  Brief  and  imperfect  as 
our  experiments  have  been  they  have  yet  been  followed  by  some 
very  interesting  developments,  and  from  these  a  few  deductions 
may  now  be  drawn. 

The  remedies  most  used  at  the  asylum  are  those  whose  effects 
upon  the  healthy  were  "  proved  "  many  years  ago,  and  the  *'  veri- 
fication "  of  whose  symptoms,  in  a  curative  sphere,  has  been  de- 
monstrated at  the  bedside  of  the  sick  repeatedly  and  satisfactorily. 
In  other  words  "  old  remedies,''  like  "  old  friends,"  have  been 
our  main  reliances.  A  few  of  the  new  remedies  have  been  used, 
and  in  occasional  instances  with  gratifying  results.  Drugs  whose 
primary  effects  are  largely  manifested  by  their  action  upon  the 
circulatory  apparatus,  the  heart  and  its  conduits,  have  most 
frequently  proven  themselves  effectual  in  modifying  the  symptoms 
and  promoting  the  recovery  of  those  suffering  with  mania.  Hence 
we  find  Aconite  and  Veratrum  viride  playing  an  important  part 
in  the  early  stages  of  this  disease,  which  are  marked  by  such  an 
unnatural  and  exalted  excitement. 

The  distinguishing  differences  between  Aconite  and  Verat  vir, 
are  these : — In  Aconite  there  is  great  mental  anxiety';  in  Verat,  vir. 
excessive  physical  unrest.  The  Aconite  patient  is  fearful  of  the 
future,  and  terribly  apprehensive  of  approaching  death;  the 
Verat.  vir,  patient  is  depressed,  but  comparatively  careless  of 
the  future.  The  Aconite  face  is  flushed  bright  red,  or  is  pale, 
with  moderate  congestion ;  Verat.  vir.  has  intense  cerebral  con- 
gestion, with  a  face  flushed  to  a  purple  hue  and  hot,  or  it  is  cold, 
•with  a  pale  bluish  cast.  The  Aconite  case  has  great  thirst,  and 
gulps  water  eagerly ;  the  Verat.  case  has  a  dry,  hot  mouth,  which 
feels  scalded,  but  the  thirst  is  moderate.  The  muscles  of  the 
Aconite  patient  are  tense,  and  the  whole  mental  and  physical  con- 
ditions are  like  those  of  an  instrument  strung  to  the  highest  pitch  ; 
the  Verat.  patient  is  relaxed  and  restless,  has  nausea,  retches  and 
vomits  profusely,  has  muscular  twitchings,  and  constantly  changes 
his  position.    In  short,  the  Aconite  patient  has  mental  anxiety 


272  Our  Foreign  Contemporaries. 

with  phjtical  tenBion ;  while  the  Verai,  vir,  patient  has  a  lower 
grade  of  mental  nnreflt  with  physical  relaxation. 

Treading  closely  npon  the  heels  of  Aconite  and  VenU,  vir,^  and, 
in  fact,  contesting  strongly  for  the  palm  of  supremacy,  are  Bella- 
donna and  Hyoseyamue.  Frohably  no  remedy  in  the  Matena 
Medica  possesses  a  wider  range  of  action,  or  greater  powers  for 
removing  abnormal  conditions  of  the  brain,  than  BelL  Its  sym- 
ptoms are  clear,  well-defined,  unmistakable;  its  action  sharp, 
vigorous,  and  profound.  It  is  the  powerful  supplementary  ally 
of  Aconite  in  removing  the  last  vestiges  of  cerebral  congestion, 
and  beyond  this  it  subdues,  hke  magic,  the  subtle  processes  of 
inflammation.  Its  symptoms  are  so  familiar  to  eveiy  student  of 
Materia  Medica  that  it  would  be  unprofitable  to  repeat  them 
here;  so  we  will  only  state  that  a  marked  and  happy  effect 
follows  the  use  of  Bell,  in  cases  where,  in  addition  to  the  flushed 
face,  dilated  pupils  and  throbbing  arteries,  we  have  a  mental  con- 
dition which  manifests  itself  by  the  most  positive  ebullitions  of 
rage  and  fury ;  and  where  the  patient  tosses  in  vague,  spasmodic 
restlessness ;  attempts  to  bite,  strike,  tear  clothes,  strip  herself 
naked,  and  make  outrageous  exhibitions  of  her  person.  While 
in  this  state  BeU,  patients  are  exceedingly  fickle  and  constantly 
changing ;  now  dancing,  singing,  laughing,  and  now  violent  vnth 
intolerable  rage.  The  speedy  disappearance  of  such  a  grave*  and 
serious  train  of  symptoms  after  Bell,  is  administered  prodaims 
its  unmistakable  power  in  a  manner  that  needs  no  eulogy.  The 
magic  workings  of  this  protean  drug  are  also  manifest  in  the 
relief  of  symptoms  directly  antipodal  to  those  mentioned  aboTe. 
When  you  have  a  patient  whose  face  is  flushed  to  an  intense 
reddish  purple  hue,  pupils  widely  dilated,  eyes  having  a  fixed  stony 
glare  and  utterly  insensible  to  light ;  heavy,  almost  stertorous 
breathing ;  stupid,  dazed  condition  of  the  mind,  so  that  he  cannot 
be  roused  to  speak ;  inclined  to  remain  quiet,  but  with  occasional 
muttering,  incoherent  delirium,  marked  rigidity  or  steady  ten- 
sion of  all  the  muscles — ^then  you  may  give  Bell,  in  the  confident 
expectation  of  reaping  an  early  harvest  of  good  results. 

The  excitable  Bell,  patieut  requires  a  minimum  dose  of  the 
drug,  while  the  stupid  one  is  affected  most  readily  and  favourably 
by  oft-repeated  doses  of  the  let  centesimal  or  even  the  Ist  decimal 
dilution. 

The  'Hyoicyamus  patient  is  very  excitable,  but  less  frenzied  than 


America.  273 

the  Belh  patient;  is  very  talkative,  mostly  good-natured  and 
jollj,  but  occasionally  has  savage  outbursts;  is  inclined  to  be 
destructive  of  clothing,  obscene,  with  a  tendency  to  expose  the 
person .  JSyoscyamut  is,  perhaps,  more  often  indicated  as  a  remedy 
for  female  patients  than  Bell.,  the  latter  being  frequently  called 
for  among  the  male  insane. 

Following  the  remedies  already  mentioned  in  the  treatment  of 
mania  come  Cantharit^  Laelieeit,  Nux  vomica^  Bhue  to».^  Sulphur , 
Thuja,  and  Veratrum  album,  CantharU  very  notably  fills  a  niche 
apparently  unoccupied  by  either  Bell.,  Syos.,  or  Verat,  alb.  The 
Gantharie  patient  has  mental  exhibitions  somewhat  similar  to 
Bell,  and  Hyoe.,  i.e.  frenzied  paroxyms  of  an  exalted  type ;  bites, 
screams,  tears,  and  howls  like  a  dog.  As  an  invariable  accom- 
paniment there  is  always  great  excitement  of  the  sexual  organs. 
In  the  latter  respect  Cantharis  resembles  Hyoe.  and  Verat.  alb,^ 
but  these  latter  drugs  comingle  the  psychical  with  the  physical — 
the  Hyos.  patient  displaying  lively  fancies  in  connection  with 
erotic  desires,  and  the  Veratrum  patient  uniting  religious  senti- 
ment with  lustful  tendencies ;  but  the  Cantharie  case  is  strictly 
and  solely  the  victim  of  lechery  for  its  own  sake,  a  result  of 
intense  erethism  of  the  sexual  organs,  impelling  him  to  seek 
immediate  physical  gratification.  Such  patients  are  inordinate 
masturbators  of  an  acute  type.  Proper  restraint  and  the 
administration  of  Canth,  often  afford  prompt  and  happy  relief, 
both  from  the  sexual  excitement  and  from  the  paroxysm  of  mania. 
Very  scanty  arine,  and  frequent  micturition  are  characteristic  of 
the  Cantharie  patient. 

For  loquacity  Lach.  has  been  repeatedly  verified  as  a  valuable 
remedy ;  Nux  vom,  is  useful  in  cases  that  are  irritable,  cross, 
ugly,  obstinate :  Bhue  tax.  and  Hyoa.  relieve  suspicions  of  having 
been  poisoned,  the  former  remedy  being  particularly  adapted  to 
low,  typhoid  conditions.  Sulphur  is  useful  as  an  intercurrent ; 
and  also  for  fantastic  mania,  where  the  patient  is  inclined  to  deck 
himself  with  gaudy  colours,  or  puts  on  old  rags  of  bright  hues  and 
fancies  them  the  most  elegant  decorations.  Sulphur  seldom 
achieves  a  cure  by  itself,  but  sometimes  seconds  with  vigour  the 
efforts  of  other  drugs. 

Veratrum  album  is  a  remedy  whose  sphere  of  usefulness  com- 
prehends both  profound  prostration  of  the  physical  forces  and  a 
most  shattered  condition  of  the  intellectual  faculties.    The  fame 

VOL.  XXXVIII^  NO.  CLIII.t — JULY,  1880.  S 


374  Our  Foreign  Contemporaries. 

of  this  drag  extends  over  a  period  of  more  than  three  thousand 
years.    It  is  related  that,  **  about  the  year  1500  before  our  era, 
a  certain  Melampus,  son  of  Amithaon,  a  most  celebrated  angor 
and  physician,  first  at  Pylos,  then  among  the  Argivea,  is  said  to 
have  cured  the  daughters  of  Proetus,  king  of  the  Argivee,  who, 
in   consequence  of  remaining  unmarried,  were  seised  with  sn 
amorous  furor,  and  affected  by  a  wandering  mania.    They  were 
cured  chiefly  by  means  of  V^rairum  Mwm^  given  in  milk  of  goats 
fed  upon  Fer<tirum^  which  Melampus  had  observed  to  produoa 
purgative  effects  upon  these  animals."    In  the  State  Homcso- 
pathio  Asylum  for  the  Insane,  in  this  nineteenth  century,  ▲.  n. 
we  have  verified  the  homoBopathicity  of  VerairMm  in  "  amorous 
furor  "  and  "  wandering  mania,"  particularly  where  these  sym- 
ptoms of  peculiar  excitement  are  followed  by  great  mental  de- 
pression and  tendency  to  physical  collapse.    In  aneieot  days  the 
drug  was  given  until  cathartic  effects  were  produced.    In  these 
later  tiir.es  we  have  found  a  more  aeoeptable  method  of  use,  and, 
with  small  doses,  secure  fayourable  results  without  aggravating 
purgation.    The  Veratrwm  patient  combines  the  wildest  vagaries 
of  the  religious  enthusiast,  the  amorous  frenzies  of  the  nympho- 
maniac, and  the  execrative  passions  of  the  infuriated  demon,  each 
of  these  manifestations  struggling  for  the  ascendancy,  and  causing 
the  unfortunate  victim  to  writhe  and  struggle  witb  his  mental 
aiid  physical  agonies,  like  the  dying  Laocoon  wrestling  with  the 
serpents  of  Minerva.    This  anguish  is  short-lived.    The  patient 
soon  passes  from  this  exalted  and  firenzied  condition  into  one  of 
deepest  melancholia,  abject  despsir  of  salvation,  imbecile  taci« 
tumity,  and  complete  prostration  both  of  body  and  mind.    The 
extremities  become  cold  and  blue,  the  heart's  action  weak  and 
irregular,  the  respiration  hurried,  and  all  the  ol]jeetive  syn^toms 
are  those  of  utter  collapse.    At  the  same  time  the  mind  passes 
into  a  Stygian  gloom,  from  which  it  very  slowly  emerges. 

With  such  a  picture  before  us  we  can  scarcely  hesitate  in  the 
choice  of  a  remedy,  and  Verairum  is  the  one  selected.  To  be  sure 
some  of  these  cases  are  past  the  grace  of  medicine,  yet  the  earnest 
use  of  this  long-tried  drug  has  frequently  repaid  us  by  marked 
improvement  following  its  administration,  and  in  seyeral  oaaec 
complete  recovery  has  resulted. 

We  haye  written  somewhat  hurriedly  of  a  few  remediee  most 
frequently  used  in  recoyering  cases  from  mania.    We  come  now 


America.  276 

to  speak  of  those  successfullj  applied  in  the  treatment  of  melan- 
cholia. Mania  and  melancholia,  alternating  as  thej  frequently  do 
in  some  patients,  often  require  the  same  or  similar  remedies.  It 
is  not  the  name  of  the  disease,  but  the  array  of  symptoms  that 
indicates  the  choice  of  a  drug.  Still,  for  purposes  of  conyenience 
we  sometimes  group,  under  the  name  of  a  disease,  certain  drugs 
most  often  applicable  in  the  cure  of  that  disease. 

Digitalis  rises  to  promiuence  in  this  connection,  not  so  much 
by  reason  of  the  fame  it  has  acquired  in  *'  the  books,"  but  on 
account  of  the  excellent  effects  following  its  use  where  homoBo- 
pathically  indicated,  and  thus  administered  to  the  patients  in  our 
wards.  We  use  it  mostly  when  the  patient  is  in  a  dull  and 
lethargic  condition ;  the  pupils  are  dilated  to  their  widest,  yet 
all  sensibility  to  light  or  touch  seems  lost ;  the  pulse  is  full, 
regular,  or  but  slightly  intermittent,  and  very  slow.  The  slow 
pulse  is  the  grand  characteristic,  and  upon  this  indication  Digi^ 
talis  may  be  given  with  much  assurance  that  relief  will  follow 
speedily,  if  relief  be  possible.  We  notice  that  the  Digitalis 
patient,  when  rallying  from  his  melancholic  stupor,  often  moans 
a  good  deal,  and  his  eyes  are  all  afloat  in  tears.  Belief,  howeyer, 
speedily  follows  this  bursting  of  the  lachrymal  fountains. 

It  has  long  been  supposed  and  advocated  that  Aurum  was  the 
princely  remedy  for  suicidal  melancholia.  Our  experience  at  the 
asylum  has  not  sustained  this  theory.  Aurum  has  often  been 
prescribed  in  such  cases,  but  usually  without  good  results. 
Another  remedy,  which  we  have  tried  repeatedly,  has  generally 
''  bit  the  case  "  most  happily ;  and  that  remedy  is  Arsenieum. 
My  mind  has  been  exercised  in  solving  the  mystery  of  Arsenicum's 
happy  effect  in  cases  of  suicidal  tendencies,  while  the  much- 
vaunted  Aurum  has  repeatedly  failed  to  sustain  its  whilom  repu- 
tation. Our  conclusion  is  this.  The  patients  which  Arsenicum 
has  relieved  have  been  those  whose  physical  condition  would 
warrant  the  administration  of  that  drug.  They  have  been  much 
emaciated  ;  with  wretched  appetites ;  a  dry,  red  tongue,  shrivelled 
skin ;  haggard  and  anxious  in  appearance ;  and  evidently  great 
bodily  sufferers.  It  would  seem  as  if  the  mental  unrest  of  these 
patients  were  due,  in  the  main,  to  physical  disease  and  consequent 
exhaustion,  and  their  desire  to  commit  suicide  is  evidently  for 
the  purpose  of  putting  an  end  to  their  temporal  distresses.  On 
the  other  hand>  the  Aurum  suicidal  patients  (that  is,  the  few 


276  Our  Foreign  Contemporaries. 

patientf  Aurum  has  seemed  to  benefit),  are  luuallj  in  fair  physical 
health,  but  have  experienced  some  unfortunate  disaster  of 
the  affections,  have  had  trouble  with  friends,  fancy  they  haye 
been  slighted,  persecuted,  or  wronged,  and  out  of  reyenge  or 
disgust  for  the  irksome  trials  of  life  seek  an  untimely  end  by 
their  own  hands.  Such  cases  are,  with  us,  more  rare  than  the 
bodily  sufferers  whose  ills  are  relieved  by  Areemeum.  Hence^ 
perhaps,  the  repeated  triumphs  of  the  latter  drug,  and  the  failure 
of  Antrum.  Each  drug  has  its  own  individual  sphere  of  action* 
beyond  which  it  becomes  a  comparatively  inert  and  useless  i^ent. 

When  we  have  a  patient  suffering  with  melancholia,  who  is 
constantly  moaning  and  muttering  to  herself,  walks  all  the  time, 
looking  down,  is  disinclined  to  talk  and  angry  if  any  one  speaks 
to  her,  tries  to  get  away  from  her  friends  if  they  seek  to  comfort 
her,  sleepless  at  night  and  uneasy  during  the  day,  then  we  have 
given  Chamomilla  with  most  decided  and  salutary  effect.  JTairum 
miuriatiewn  also  affords  relief  to  patients  given  to  much  crying, 
their  continual  weeping  being  of  the  open-and-above-board 
variety  ;  while  the  grief  of  the  IgnoHa  patient  is  more  passive 
and  concealed.  The  FuUatilla  case  weeps  easily,  but  smilea 
through  her  tears,  and  is  readily  pacified  for  the  time  being,  but 
quickly  relapses  into  the  depths  of  sorrow  when  the  words  of 
comfort  cease.  The  Oaetui  patient  is  sad  and  hypochondriacal, 
and  has  frequent  palpitations  of  the  hearty  with  a  corresponding 
palpitation,  so  to  speak,  in  the  top  of  the  head.  We  have  found 
Thuja  to  benefit  patients  who  have  tenacious  fixedness  of  ideas, 
are  always  harping  on  one  string,  and  indulge  in  the  strangest 
and  most  unnatural  fancies.  Such  cases  are  quarrelsome  and 
talkative,  or  very  reticent,  won*t  speak  to  or  look  at  a  person, 
and  manifest  great  disgust  if  spoken  to  by  others. 

Lilium  tigrinum  and  Sepia  find  important  place  in  the  treat- 
ment of  depressed  and  irritable  females.  The  troubles  of  such 
cases  originate  largely  in  the  mal-performance  of  duty  on  the 
part  of  the  generative  organs.  Both  LtUvm  and  Sepia  cases  are 
full  of  apprehensions,  and  manifest  much  anxiety  for  their  own 
welfare.  In  the  iS^pio  case,  however,  there  is  likely  to  be  found 
more  striking  and  serious  organic  changes  of  the  uterine  organs ; 
while  the  Idlium  case  presents  either  functional  disturbance  or 
very  recent  and  comparatively  superficial  organic  lesions.  Lilium 
is  more  applicable  to  acute  cases  of  melancholia,  where  the 


America.  277 

uterus  or  ovarieB  are  inyolyed  in  moderate  or  subacute  inflam- 
mation, and  where  the  patient  apprehends  the  presence  of  a  fatal 
disease  which  does  not  in  reality  exist.  The  Lilwm  patient  is 
sensitive,  hjpersBsthetical,  tending  often  to  hysteria.  She  quite 
readily  and  speedily  recovers,  much  to  her  own  surprise,  as  well 
as  that  of  her  friends,  who  have  been  made  to  feel  by  the  patient 
that  her  case  was  hopeless.  The  Sepia  patient  is[sad,  despairing, 
sometimes  suicidal,  and  greatly  averse  to  work  or  exercise. 
There  is,  however,  oftentimes  a  good  reason  for  such  a  patient's 
depression,  for  too  frequently  she  is  the  victim  of  profound 
organic  lesions  which  can,  at  best,  be  cured  only  by  long,  patient, 
and  persistent  endeavour. 

We  have  spoken  thus  far  of  remedies  which  are  applicable  to 
those  forms  of  insanity  which  are  in  a  measure  curable.  We 
now  approach  the  more  discouraging  portion  of  our  essay,  that  of 
recording  tbe  vanity  of  our  attempts  in  treating  cases  of  epileptic 
and  masturbatic  insanity,  of  dementia  and  general  paresis. 

It  has  often  been  our  good  fortune  to  relieve  the  immediate 
and  distressing  symptoms  of  the  epileptic  with  sensible  doses  of 
the  Jetea  racemosa.  Under  its  action  the  fits  have  been  lessened 
in  frequency,  and  sometimes  removed  altogether  for  several 
months.  But  we  are  impelled  to  state  that  neither  this,  nor  in 
fact  any  remedy  we  have  yet  tried  (and  we  have  tried  many),  has 
BO  far  removed  the  symptoms  as  to  enable  us  to  claim  a  positive, 
perfect,  and  permanent  cure.  The  Aciea  roe.  develops  the  best 
results  among  those  patients  who  have  remarkable  heat  in  the 
back  of  the  head,  and  extending  down  the  back,  during  the  con- 
vulsions, and  who  complain  of  great  soreness  in  the  muscles  of  the 
neck  and  shoulders  after  the  convulsions  have  subsided.  Time 
and  experience  may  yet  solve  the  problem  how  to  cure  the 
epileptic  insane ;  but  thus  far  it  remains  a  riddle  deep  as  the 
unfathomed  mysteries  of  nature.  For  masturbation  we  have 
giren  Agnus  eastus,  JDamiana,  Ficric  acidf  Phos.y  Fhos.  acidy 
Nux  vomieay  but  in  scarcely  an  instance  could  the  relief  obtained 
be  considered  fully  curative.  The  Biniodide  of  mercury  is  a 
remedy  said  to  be  efficacious  in  such  cases,  and  we  are  now  using 
it  in  some  apparently  suitable  cases. 

There  is  this  to  be  considered  in  our  treatment  of  masturbatic 
insanity,  that  cases  of  this  sort  which  reach  an  asylum  are 
usually  so  far  gone  in  their  terrible  ways  as  to  be  non-amenable 


278  Our  Foreign  Coniemporaries, 

to  ftDy  treatment.  If  otben,  witH  more  recent  cases  to  deal 
with,  baTO  had  happier  experiences  we  shall  be  glad  to  learn  of 
them  their  methods  and  the  remedies  used. 

Our  dementia  cases  hare  been  treated  with  Calearea  earb.^ 
Pho9phoru9,  Anacar^um,  and  a  few  other  drugs.  An  improve- 
ment in  their  general  condition  has  often  followed  the  use  of  the 
ftboye  remedies;  and  we  look  upon  such  cases  as  affording  a 
somewhat  hopeful  iBeld  for  future  experiment  and  research. 
Still  we  are  unable  to  record  complete  recoyery  from  dementia 
through  medication,  except  in  a  yerj  few  instances. 

In  general  paresis  we  have  observed  relief  from  immediate  and 
threatening  symptoms  through  the  administration  of  alcohoL 
Verairum  virids.  Bell,,  Nus  vom,^  and  Fko9,^  have  also,  tempo- 
rarily, held  the  disease  in  check,  but  in  this  grave  and  singular 
disease  we  have  wrought  no  cures,  earnest  though  our  endeavoars 
have  been. 

In  thus  recording  our  fisilures  we  have  this  for  consolation 
that  the  forms  of  disease  in  which  homoBopathic  drugs  have  thus 
hx  proved  unsuccessful,  are  those  already  declared  incurable 
by  physicians  of  long  and  vast  experience.  We  shall  never  rest, 
however,  nor  pause  in  our  labours,  until  the  fountain  that  holds 
healing  waters  for  these  unfortunates  is  discoveired.  Those  who 
life  in  the  darkness  of  incurability  to-day,  may  bask  in  the 
brilliant  sunlight  of  health  a  single  decade  hence.  A  brief  defeat 
does  not  discourage  us ;  but  we  engage  in  the  work  of  exploring 
and  excavating,  and  in  the  application  of  new  discoveries,  dug 
out  from  the  yet  but  partially  explored  mine  of  medicine,  with 
undaunted  hearts,  and  with  unwavering  expectations.  The  fruits 
of  medical  enterprise,  like  the  fruits  of  the  orange  tree,  do  not  all 
ripen  at  once.  The  flavour  of  those  already  matured  is  both 
pleasing  and  grateful.  We  believe  that  more  will  ripen  on  the 
very  branches  whence  blasted  ones  have  fallen.  In  conclusion,  we 
feel  impelled  to  state  that  the  more  earnestly  we  study  its  tenets, 
and  the  more  fully  we  are  brought  to  understand  the  delicate 
intricacies  of  the  homoeopathic  law  of  cure,  and  the  more  fullyr 
we  apply  the  precepts  of  that  law  in  our  treatment  of  the  sick, 
the  more  firmly  are  we  convinced  of  its  comprehensive  and  far- 
reaching  efficacy. 

In  the  same  number  Dr.  Morgan,  of  Ithaca,  relates   a 
case  of  cardiac  dropsy,  with  mitral  regurgitation,  in  which 


America.  279 

Cactus  20  (after  ^  and  Sx  had  been  given  without  effect) 
oansed  complete  disappearance  of  the  effusion^  as  well  as  great 
relief  of  the  heart  symptoms. 

September. — Dr.  Talcott  here  gives  as  another  excerpt 
from  his  Middletown  experience. 

Natrum  mimaticum  in  Melancholia — a  Case, 
Mrs.  P—  was  admitted  to  the  asylum  April  3rd,  1879.  She 
had  been  gradually  £uling  in  health  and  spirits  for  nearly  a  year. 
When  received  she  had  the  appearance  of  an  old  woman,  although 
bat  about  thirty-fi?e.  Her  features  were  pale,  thin,  drawn, 
sallow,  and  haggard.  The  patient  was  very  restless,  ansBmic,  and 
feeble,  having  had  a  poor  appetite  and  slept  but  little  for  several 
weeks.  She  complained  of  headache,  mostly  in  the  occiput ;  was 
incoherent  in  speech,  constantly  repeating  short  expressions,  such 
as :  "  tell  me  the  story  ;  **  "give  me  the  papers ; "  "  they  know ;  *' 
and  other  disconnected  remarks.  Her  breathing  was  laboured, 
inspiration  lengthened,  expiration  very  brief.  She  was  much 
given  to  frequent  and  profuse  ebullitions  of  tears.  Was  quite 
thirsty  and  chilly  at  intervals.  Patient  had  taken  Chloral  hydrate 
for  sleeplessness,  with  indifferent  results.  Natrum  muriaticum 
was  at  once  prescribed  and  steadily  continued.  The  first  night, 
under  this  and  no  other  remedy,  she  slept  one  and  a  half  hours ; 
the  second  night  she  slept  four  hours,  and  within  five  days  she 
slept  sufficiently,  and  continued  to  do  so  until  discharged. 

The  improvement  in  this  case  was  steady  and  continuous.  The 
symptoms  and  conditions  successfully  combated  with  Natrum 
mur.  were :«— a  general  and  persistent  aniemia ;  a  previously  long- 
continued  headache ;  an  appearance  of  premature  old  age ;  and 
profuse,  uncontrollable  weeping.  It  may  also  be  proper  to 
remark  that  the  patient  had  a  history  of  intermittent  fever 
quenched  with  quinine. 

In  less  than  two  months  the  patient  had  rallied  from  profound 
physical  prostration,  and  equally  profound  mental  depression ; 
and  in  less  than  three  months  from  date  of  admission  she  was 
discharged,  a  fat,  rosy,  healthy  and  happy  young  woman.  Who 
can  say  that  the  fountain  of  eternal  youth  is  not  a  salt  spring  ? 

October. — The  valuable  commanication  regarding  £er- 
beris  aquifottum,  made  by  Dr.  Winterbum  to  this  number^ 
we  have  already  extracted  in  our  April  issue. 


2K80  Our  Foreign  Contemporaries. 

December. — A  case  of  repeated  passage  of  gall-stoiiesy 
going  on  for  six  years,  is  here  given  by  Dr.  Buckingham 
Smith.  Dr.  Thayer's  treatment  with  China  (3rd  dil.)  was 
adopted,  with  immediate  relief  and  gradual  postponement  of 
the  attacks,  so  that  after  six  months  they  ceased,  and  had 
not  returned  for  two  years  when  the  report  was  made. 
Dr.  Freeman  criticises,  in  this  number,  Dr.  Allen's  transla- 
tions of  Hahnemann's  Oerman  in  his  Encyclopedia,  and 
shows  that  some  rather  grave  inaccuracies  have  crept  in. 
We  are  informed  by  Dr.  Allen  that  the  haste  with  which 
his  work  was  prepared,  amid  the  pressure  of  other  duties, 
undoubtedly  led  to  a  failure  at  times  of  the  careful  super- 
vision he  would  have  wished  to  give  it,  but  that  he  is  going 
over  all  his  translations  with  a  German  professor,  and  will 
publish  a  complete  list  of  emendations. 

United  States  Medical  Investigator,  Nov.,  1878 — Dec., 
1879. — ^The  Investigator  continues  its  fortnightly  appearance, 
and  is  as  practical  as  ever,  though  its  orthography  continues 
to  make  us  sigh.  We  must  ran  rapidly  through  the 
twenty-eight  numbers  which  lie  before  us. 

Nov,  1. — Dr.  Vose,  of  Portland,  reports  a  case  of 
empyema,  in  which — after  paracentesis — Calcarea  stdphwica 
(13x)  was  given  instead  of  the  usual  Hepar  sulphtiris,  as 
recommended  by  Schiissler.  Complete  recovery  ensued, 
with  restoration  of  the  normal  shape  of  the  chest  Dr. 
Fahnestock  relates  two  cases  of  convulsions  and  coma  in 
pregnancy,  with  anasarca  and  scanty  urine  loaded  with 
albumen,  in  which  the  subcutaneous  injection  of  a  strong 
extract  of  Apocynum  cannabinum  caused  free  diuresis,  with 
disappearance,  first  of  the  nervous  symptoms  and  then  of 
the  dropsy. 

Nov.  15. — Dr.  Mitchell,  of  Chicago,  communicates  a  case 
of  acute  Bright's  disease,  following  pneumonia,  in  which, 
after  Belladonna,  Apis  and  Arsenicum  had  done  but  little, 
Asclepias  syriaca  proved  rapidly  and  completely  curative. 

Dec.  15. — Dr.  Woodward,  of  the  same  city,  gives  here 
an  interesting  study  of  Borax,  in  which — among  other 
things — he  mentions  a  case  in  which  the  Ix  trituration, 
given    freely    for  catarrhal    fever,   seemed    to    cause   ''an 


America.  281 

engorgement  of  the  uterus,  with  bearing-down  pains  and 
prolapsus;  this  condition  was  attended  by  increased  heat  iu 
the  vagina,  and  was  finally  relieved  spontaneously  by  a 
profuse  discharge  of  albuminous  leucorrhcea  that  appeared 
clear  and  glutinous/'  His  colleague  at  the  Chicago  Homoeo- 
pathic College,  Dr.  Foster,  lays  down  from  experieuce  the 
following  rules  as  to  the  pulse  in  childbed  : 

''A  pulse  rising  much  above  100  right  after  delivery 
warns  us  of  impending  haemorrhage;  place  now  the  hand 
upon  the  uterus,  and  it  is  already  distended  big  with 
coagttla.  It  has  other  meanings  also^  but  it  never  means 
that  all  is  well. 

"  A  pulse  of  60  or  less  at  the  same  period  means  shock 
or  injury^  and  it  will  be  followed  sooner  or  later  by  a 
proportionately  high  pulse,  and  a  slow  recovery. 

*'  A  pulse  of  96,  scarcely  varying  from  day  to  day,  means 
that  the  pelvic  organs  are  wounded^  and  must  struggle  hard 
to  accomplish  their  metamorphosis. 

"A  pulse  of  75  when  your  patient  lies  down,  which  rises 
to  85  or  more  when  she  rises  up^  and  flitters  between  80 
and  100  four  times  a  minute  while  she  is  up,  means  that 
said  patient  will  get  better  every  day  if  we  keep  her  down, 
and  worse  every  day  if  we  let  her  up. 

''But  a  pulse  of  from  75  to  78^  which  is  the  same 
whether  the  patient  lies  down,  or  walks  about,  or  sits  up, 
is  a  pulse  that  I  never  yet  detected  in  any  but  a  thorou^ily 
recovered  patient.'' 

Jan.  1. — ^A  case  of  traumatic  tetanus  is  reported,  signed 
"  A.  B.  Hicks/'  in  which  five  drops  of  Ntup  vomica  ^  were 
given  every  fifteen  minutes  till  a  drachm  had  been  taken, 
when  the  spasmodic  condition  relaxed,  and  the  patient  fell 
into  a  quiet  sleep ;  after  which  he  made  a  rapid  recovery. 

Jan.  15. — We  have  often  mentioned  the  excellent  clinical 
lectures  given  by  Dr.  Hawkes.  Here  is  a  good  case  from 
one  of  them : 

Cabs  2891. — This  patient  came  first  to  this  clinic  a  little  over 
a  year  ago,  Nov.  8th,  1876.  He  was  forty  years  of  age.  He 
had  had  rheumatism  for  about  six  years.    The  cause  of  the  rheu- 


282  Our  Foreign  Caniempararies. 

matism  was  his  getting  yerj  wet  in  a  anow-atonn,  the  immediate 
result  of  which  waa  pain  and  atifiheaa  of  the  neck»  which  condi- 
tion passed  down  into  the  right  shoulder  and  arm.  He  was  con* 
fined  to  bed  three  weeks.  The  arm  had  been  powerless  up  to  the 
time  of  his  fir.<^t  appearance  here.  At  that  time  the  arm  from 
the  shoulder  to  elbow  was  atrophied  and  shrivelled  to  sach  an 
extent  that  it  was  not  one  fourth  as  large  as  the  other  arm.  It 
could  not  be  raised  except  hj  the  help  of  the  other  hand,  and 
was  continually  becoming  smaller  and  weaker.  His  whole  bodj 
was  more  or  less  affected  bj  the  disease ;  but  the  severest  effects 
were  felt  in  this  arm.  The  pain  was  excruciating  at  night; 
especially  before  a  storm,  which  be  could  foretell  twenty-four 
or  thirty-six  hours.  He  was  always  most  miserable  in  damp 
cloudy  weather,  especially  before  a  storm ;  the  severity  of  the 
pains  being  in  a  measur<3  ameliorated  after  the  storm  had  fairly 
set  in. 

He  was  usually  worse  at  night,  especially  between  12  and  2 
o'clock,  when  he  would  be  compelled  to  get  up  and  walk  around 
his  room  for  relief,  which  moderate  motion  in  a  measure  brought. 
From  suffering,  loss  of  sleep,  &c,,  he  had  been  reduced  almost  to 
a  skeleton,  his  weight  being  only  about  one  hundred  pounds, 
although  of  large  frame  and  tall.  He  had,  as  is  the  case  with 
the  majority  of  patients  presenting  here,  been  everywhere  and 
tried  everything  within  his  power,  with  the  painfully  monotonous 
results  of  a  steady  loss  of  strength  on  his  part,  and  a  no  less 
steady  increase  of  the  diseaae. 

The  case,  I  assure  you,  looked  very  unpromising.  Was  it  pos^ 
sible  to  restore  form,  strength,  and  ease  to  that  ahrivelled,  power- 
less, and  aching  member  P  The  report  from  week  to  week,  and 
from  month  to  month,  gives  the  answer. 

The  remedy  prescribed  was  Mhus  iox.  200.  The  characteristic 
symptoms  indicating  the  remedy  were :  first,  the  cause — getting 
wet  in  a  storm — the  cause  of  a  gi?en  case  of  disease  may  often 
be  an  indication  for  the  remedy.  Second,  the  pains  were  always 
foorte  before  a  rain  storm,  from  rest^  and  after  midnight,  better 
after  the  storm  had  broken,  in  dry  weather,  and  from  gentle 
motion. 

I  had  forgotten  to  mention  that  the  patient  was  not  strictly 
temperate,  and  was  in  the  habit  of  taking  JUbrphine  to  allay  tiie 
pain.    These  facts  added  greatly  to  the  gravity  of  the  case. 


I 


America.  288 

Noyember  1 7th,  one  week  later,  he  reported  general  improye- 
ment.  Thia  report  was  repeated  from  week  to  week  for  a  few 
months,  and  later  he  would  report  eyery  month,  but  gradually 
improying  aU.  the  while.  For  instance,  December  20th  he 
reports,  "  Much  better,  arm  getting  stronger,  sleep  pretty  well 
first  three  or  four  hours  of  the  night." 

January  10th.  Gaining  slowly ;  can  cut  kindling-wood  with 
right  arm  now ;  right  arm  is  warm,  and  feels  quite  natural  (it 
had  been  cold  and  clammy  at  first)  ;  yery  little  pain. 

24th.  Wheeled  in  a  ton  of  coal  to  day.    Getting  on  nicely. 

Feb.  28th.  Improying  steadily. 

April  4th.  Still  improying,  walked  ten  miles ;  Friday  and  so  on 
up  to  the  present  time  (Dec.  15th).  Tou  all  hear  what  he  now 
has  to  say  for  himself.  His  right  arm  is  large  and  strong  and 
V>ell,  He  tells  us  that  he  now  weighs  one  hundred  and  fifby-fiye 
pounds — ^a  gain  of  fifty-fiye  pounds  in  little  oyer  a  year.  Those 
of  you  who  saw  him  then  will  hardly  recognise  him  now. 

He  has  had  no  remedy  but  Rhut  ioa,  in  potencies  yarying 
from  3rd  to  the  2000  during  the  whole  time,  excepting  one  week 
of  Uitrie  acid.  Oftentimes,  as  the  record  shows,  he  receiyed  only 
placebo  for  months  at  a  time,  with  a  steady  improyement 
through  aU. 

This  case  will  illustrate  two  points  of  yalue ;  yiz. :  the  power  of 
homodopathic  medicine  in  chronic  cases  commonly  regarded  as 
hopeless ;  and  the  adyantages  of  adhering  to  the  indicated  remedy* 
instead  of  flying  from  one  to  another  at  eyery  new  symptom 
which  may  arise  during  the  progress  of  the  case  under  treatment. 

In  one  year  this  patient  has  been  changed  irom  a  useless. 
Buffering  wreck  to  a  comparatiyely  comfortable,  useful  member 
of  society,  able  to  support  himself  and  family.  You  haye  seen  it 
done,  and  how  it  was  done ;  and  it  should  encourage  you  to  hold 
out  hope  to  the  no  matter  how  badly  afflicted. 

Feb.  1. — ^The  following  communication^  from  the  same 
Dr.  Foster  as  we  haye  quoted  aboye^  is  worth  extracting 
from  this  number. 

Nitrie  acid  for  Ohronic  Enlargement  of  the  liver. 

In  reply  to  Y.  Hayes'  inquiry  on  this  subject  in  The  United 
Statee  Medical  Inteetigatcr  of  Jan.  15th,  I  would  like  to  suggest 
the  trial  of  Nitric  add  low.    I  uiei^  the  second  decimal  dilution^ 


284  Owr  Foreign  Caniemporaries. 

And  order  about  six  drops  of  the  oame  to  be  taken  in  an  ounce  of 
water  immediatelj  after  each  meal — ^the  medicine  to  be  continued 
for  a  month  if  neceesarj ;  that  is  to  say,  unless  the  symptomfl 
disappear  in  less  time.    To  illustrate  I  herewith  report  a  case. 

Willie  L — 9  aged  twel?e,  was  brought  to  mj  office  bj  his  mother 
two  months  ago.  The  ladj  informed  me  that  the  boj  had  had 
ague  when  living  in  New  York  State  three  years  ago,  and  that 
aince  then  his  abdomen  had  been  very  large,  and  was  beoommg 
more  so  from  month  to  month,  until  now  she  was  ashamed  to  see 
him  on  the  street.  The  boy  was  weak,  his  muscles  flabby,  his 
appetite  abnormally  voracious,  and  his  colour  sickly.  I  prescribed 
Nitrio  aeid  as  above,  and  asked  to  see  him  again  in  about  a  month. 
At  the  end  of  that  period  he  was  wonderfully  improved.  His 
mother  affirmed  that  his  abdomen  was  already  reduced  almost  to 
its  proper  size,  and  a  glance  was  sufficient  to  confirm  her  state- 
ment. At  the  same  time  the  morbid  appetite  and  the  entire  train 
of  associated  morbid  symptoms  had  disappeared  proportionally. 
Ordered  a  continuance  of  the  medicine  twice  daily  for  a  fortnight, 
at  the  end  of  which  period  I  expect  to  find  him  cured.  I  may 
add  that  the  boy  had  been  under  Old  School  treatment  when  in 
the  east,  and  that  his  physician  there,  a  gentleman  of  undoubted 
skill*  had  diagnosticated  his  case  as  one  of  enlarged  liver — ^the 
result  of  malarial  fever. 

This  case  may  serve  to  illustrate  the  specific  relation  of  NUrie 
aeid  to  the  liver  in  other  forms  of  hepatic  disturbance.  Thus, 
strong  smelling  urine,  for  which  we  prescribe  this  drug,  orange- 
coloured  urine,  and  urine  containing  a  small  amount  of  bile,  are 
products  probably  of  hepatic  disorder,  and  are  concomitants  of  a 
generally  morbid  condition,  which  Ifitrie  add  will  most  frequently 
relieve.  Hence,  its  importance  in  mild  but  continuous  "  bilious- 
ness," in  "  dumb  ague,"  or  latent  malarial  poisoning. 

It  will  also  promptly  modify  the  offi^nsive  coffee-ground  dis- 
charge that  sometimes  takes  place  from  the  uterus  several  days 
after  laboiur,  and  which  is  often  found  taking  the  place  of  the 
normal  flow  at  the  climacteric.  Of  course,  the  mere  fiust  that 
Nitric  aeid  will  thus  modify  certain  excretions  is  of  little  moment^ 
were  it  not  that  it  does  so  by  more  profound  modifications  wrought 
in  the  organism.  These  excreta  are  but  prominent  signs  of  a 
morbid  state  of  the  blood,  and  thus  of  the  blood-making  organs, 
and  this  morbid  state  JSFUrio  aeid  cures. 


America,  285 

In  gleet  and  tertiary  Byphilis  it  is  not  to  be  lightly  esteemed. 
Syphilitic  alcers  and  syphilitic  disease  of  the  bones,  indicated  by 
^  bone-pain,"  often  yield  readily  to  Nitric  acid.  So  likewise  do 
ozsBna  and  suppurative  otitis.  In  the  pathogenesis  of  Nitric  acid 
all  of  these  points  will  be  found  succinctly  and  clearly  set  forth 
— except  that  relating  to  enlarged  liver^  which  I  do  not  find. 
But  this  as  well  as  the  others  named  I  have  seen  abundantly 
verified  in  a  few  years*  practice.  In  tertiary  syphilis  I  have 
obtained  the  best  results  from  the  higher  attenuations. 

Feb.  15. — Dr.  J.  D.  Johnston  relates  three  cases  of  cure 
of  constipation  with  Silica  30,  given  upon  Dr.  Guernsey's 
indication  of  the  stool,  after  having  been  partially  expelled 
with  much  effort  and  straining,  receding  into  the  rectum. 
Dr.  Berurenter  mentions  two  cases  of  night  terrors,  referred 
to  stoppage  and  dryness  of  the  nose^  removed  by  Gehe^ 
minum,  ^'J.  W.  M.^'  relates  two  cases  of  dysuria,  of 
some  standings  rapidly  cured  by  Apia  3  and  6. 

March  15. — Dr.  Stout  communicates  some  favourable 
experiences  with  Melilotus  officinalis  in  prosopalgia  and 
gastralgia.  Dr.  B.  F.  C.  Browne  finds  Kali  permanganium, 
hypodermically  injected  and  sprayed  into  the  throat  in  a 
Ix  solution^  almost  specific  in  diphtheria.  The  value  of 
Equisetum  hyemate  in  enuresis  is  growing  so  manifest  that 
we  think  it  well  to  extract  this  latest  report  illustrating  it. 

{To  he  eoiUinued  in  our  next.) 


286 


CLINICAL    EECOBD. 


AUmminuHa.    By  T.  Ekoau.,  H.B.C.S. 

Iir  the  year  1864  Theodore  P — ,  aged  8  years,  came  under  mj 
care  for  porrigo  of  the  scalp,  pustules  in  the  nose,  gummy  eyelids, 
and  excoriations  behind  the  ears.  Under  the  action  of  Bin- 
iodide  of  mercury,  of  Hepar  sulph,^  and  of  Sulphur,  he  got  well. 

In  March,  1866,  he  was  brought  to  me  suffering  from  a 
swelling  of  the  face.  As  he  now  dwelt  some  considerable  distance 
from  me,  and  there  was  a  homoeopathic  physician  residing  within 
a  few  miles  of  his  home,  I  advised  his  parents  to  avail  themselveB 
of  his  services.  This  they  did,  and  I  heard  no  more  of  the  case 
until  August,  when,  the  medical  attendant  having  declined  the 
further  treatment  of  it,  the  parents  applied  again  to  me  to  under- 
take it,  which,  at  considerable  inconvenience,  I  undertook  to  do. 
On  August  6th,  1866, 1  paid  him  my  first  visit. 

The  account  I  received  from  his  friends  was  that  Theo- 
dore, now  five  years  of  age,  had  been  under  treatment  four 
months.  At  the  commencement  of  his  illness  he  had  vomited 
green-yellow  frothy  fluid,  and  this  had  persisted  for  six  weeks ; 
he  now  vomits  on  and  off  it  he  takes  any  liquid  food.  He  has 
had  great  pain  in  various  parts  of  his  body  ;  has  it  about  the 
navel  now.  Sometimes  the  bowels  act  three  or  four  times  a  day, 
with  green  slimy  motions,  other  days  they  are  quite  right. 
Sometimes  passes  undigested  food.  If  he  takes  milk  diarrhosa 
ensues.  Urine  is  sometimes  profuse,  at  others  scanty;  until 
three  years  old  was  profuse,  and  he  used  to  wet  about.  Sleep 
restless  at  night  at  times,  at  others  sleeps  better ;   can  lie  to 

do  BO. 

Has  a  red  eruption  on  the  skin,  which  is  dry,  and  which  itches 
very  much  after  taking  a  bath.     Has  general  anasarca.     The 


Albuminuria.  287 

body  measures  86  inches  round ;  the  thighs  and  legs  are  pro- 
portionally swollen. 

Albumen  was  shown  to  exist  in  the  urine,  both  by  boiling, 
and  by  nitric  acid.     Arsenicum  3rd. 

August  8th,  reported  to  me ;  more  urine  has  been  passed,  which 
is  clearer.  Motions  healthy;  the  legs  enormously  swollen.   Arsen. 

10th.  (Visit.)  Urine  acid ;  no  deposit  with  nitric  acid  and 
yery  little  by  heat.  Microscope  showed  mucous  corpuscles  and 
a  small  quantity  of  urate  of  soda.    Arsenic  3rd. 

17th.  Vomits  at  times  a  yellow  fluid,  yet  eats  directly  after. 
Slimy  mucus,  with  which  he  passed  a  worm-like  piece  of  mucus. 
Urine  more  profuse.     Arsen  8rd. 

August  (Visit).  The  abdomen  is  less;  is  now  twenty -fi^e 
inches.  The  left  leg  is  also  less.  Sleeps  better.  Ate  eggs  for 
breakfast  and  roast  mutton  for  dinner  to-day.  Pain  at  the 
naTel.  Itching  of  the  skin.  Gkts  a  cough  when  the  wind  is 
easterly.  Perspires  in  the  upper  part  of  the  body  at  night. 
Urine  is  clear ;  it  soon  became  ammoniacal  and  fetid,  and  showed 
crystals  of  triple  phosphates.    Mere,  viv,  and  Arsenicum, 

25th.  (Eeport.)  Morning  urine  acid  ;  highly  albuminous  by 
boiling  and  by  nitric  acid  ;  it  soon  became  alkaline  and  showed 
crystals  of  triple  phosphates.  Urine  scanty,  a  few  drops  of 
blood  had  passed  with  it.  Size  of  belly  the  same,  twenty-five 
inches,  but  the  leg,  which  was  smaller,  is  now  much  swollen 
again.     Picks  his  nose. 

81st.  (Visit.)  Pulse  84.  Legs  and  body  much  less.  Does 
not  perspire.  Tongue  clean.  Bode  out  in  his  perambulator  for 
two  hours.    Arsenic  1st  trit. 

September  7th.  (Visit.)  Both  legs  are  less  and  body  much 
less.  Is  yery  restless,  and  gets  faint  in  his  sleep  and  grinds  his 
teeth.    Urine  profuse.     Arsen,  Ist  trituration. 

14ih.  (Visit.)  Mucus  in  the  urine.  Albumen  less.  Body 
and  legs  less.    Arsen. 

31st.  Body  and  feet  smaller ;  right  leg  swells  more  than  the 
left.  Scrotum  gets  sore.  Seyeral  times  a  day  he  has  symptoms 
of  ooryza,  which  cannot  be  accounted  for.  (Is  this  the  effect  of  the 
Arsenic?  Probably  not,  as  the  symptom  is  not  mentioned  again, 
although  the  medicine  was  continued.)  Feels  sinking  in  the 
morning.  No  diarrhoea.  Had  formerly  on  his  legs  an  erysipe- 
latous redness ;  now  a  coyering  of  thick  dandriff.    Arsen. 


288  Clinical  Record. 

28th.  (Beport.)  Lips  and  eyelids  are  swollen  in  tbe  DigKU 
Body  and  feet  are  less  swollen.     Anen. 

October  6th.  (Yisit.)  Tbe  skin  is  not  so  rough.  He,  in  his 
sleep,  constantly  moves  his  legs  up  and  down  and  starts.  Ha 
has  been  walking  abont  to-day.  The  urine  is  very  thick.  Eyes, 
face,  and  upper  lip  are  swollen.  Pulse  small,  96.  Perspires  in 
the  head  and  fitce.  Is  rery  thirsty.  Bowels  not  acted  for  two 
days.    Arsen.  8. 

12th.  (Visit.)  He  has  swollen  more  the  past  week,  especially 
at  night ;  can  walk  a  little.  Urine  sp.  gr.  10*18  ;  it  was  paraed 
after  tea,  and  is  probably  mixed  with  much  water ;  is  floccnleot 
when  treated  with  nitric  acid  and  heat'.  Ar^en,  Ist.,  3  grains 
daily. 

15th.  (Beport.)  Diarrhoea  of  undigested  food,  preceded  bj 
green  motions.     Pkap,  acid. 

19th.  Diarrhoea  with  evacuations  of  undigested  food.  Has 
vomited  a  little  greenish  fluid.     Mere,  eulph. 

26tb.  (Visit.)  Every  day  since  last  report  he  has  passed 
greenish  undigested  motions;  vomited  last  night  a  greenish 
fluid. 

27tL  The  urine  I  brought  away  last  night  had  not  much 
deposit;  that  passed  yesterday  morning  had  none  (Was  this 
owing  to  the  greenish  vomit  and  greenish  diarrhoea  ?)  Albumen 
much  less.    Mere,  eulph. 

November  8rd.  (Visit.) — Urate  of  ammonia  in  the  urine,  as 
shown  by  inspection,  Eace  is  swollen  at  times ;  now  the  peculiar 
feeling  of  hardness  in  the  legs  is  less.  Bowels  are  relaxed ;  has 
not  been  sick.  When  he  was  out  he  got  out  of  his  perambulator 
and  ran  away  firam  his  nurse.     Mer.  ndph. 

6th.  A  good  quantity  of  albumen,  earthy  phosphates,  and 
urate  of  ammonia,  in  the  urine.     G-o  back  to  Arsen.  1st  trit 

16th.  Bowels  are  regular.  Passes  great  quantity  of  clear 
urine ;  it  is  clear  after  standing  all  night.  Much  less  of  urates 
and  of  albumen.    Acid  reaction.    Areen.  1st,  in  solution. 

27th.  Temper  very  violent.  Sleeps  well.  Bowels  not  relaxed, 
but  copiously  relieved.  Buns  about  all  day.  The  eyelids  and 
upper  lip  swell  very  much.  Nose  is  red,  and  when  cold  is  blue. 
The  skin  round  the  neck  has  a  bluish  and  coppery  colour.  The 
veins  of  the  left  groin  are  very"  large,  and  look  very  blue.  Peet 
are  pufiy  at  times,  but  are  less  so  since  they  have  been  rubbed. 


Albuminuria.  289 

Bowels  twentj-fiye  inches  round.  In  the  urine  voided  in  the 
evening  a  great  quantity  of  urates  and  of  albumen ;  probably 
these  are  derived  from  the  food.    Mer.  viv,  1  grain  daily. 

December  5th.  (Visit.)  He  cannot  sleep  the  early  part  of  the 
night.  Temper  is  very  violent.  Less  albumen;  that  in  the 
morning  urine  greatest.    Bell,  2x,  3  drops  daily. 

10th.  Urine  no  worse.  The  scrotum  itches  a  great  deal.  The 
swelling  is  entirely  gone.     No  urates.    Arsen,  1st  trit. 

20th.  Better ;  no  urates,  and  less  albumen,  in  both  morning 
and  evening  urine.    Arsen.  1st.  trit. 

28th.  The  other  children  have  had  the  mumps,  and  he  has 
them  now.    Mer.  viv. 

1867,  January  7th.  With  the  mumps  he  had  a  profuse  per- 
spiration, which  reduced  the  swelling  considerably.  The  eyelids 
are  very  puffy  and  white  in  the  morning ;  the  skin  of  the  legs  at 
the  ankle  bag  a  good  deal ;  he  can  walk  a  mile.  TJrine  is  better 
in  colour,  and  has  less  deposit.    Arsen  2x. 

21st.  He  is,  on  the  whole,  better,  but  the  legs  and  hands 
swell  if  the  urine  is  not  profuse ;  on  one  occasion  the  abdominal 
swelling  was  followed  by  two  quarts  of  urine  being  passed,  and 
now,  if  the  urine  is  not  plentiful,  the  swelling  comes.  Arsen.  2, 
1  grain  daily. 

February  12th.    Urine  albuminous,   with  great  deposit   of 
urates.    Mer.  mv  1st  trit. 

25th.  (Visit.)  When  the  feet  perspire  the  swelling  of  the 
lower  extremities  is  less,  or  does  not  take  place.  The  neck  and 
the  eyelids  swell  at  times.  The  superficial  inguinal  veins  are 
much  enlarged;  that  side  of  the  abdomen  is  larger  than  the 
opposite.  The  swelling  is  too  diffused  to  be  caused  by  the  colon. 
£y  boiling  no  deposit  in  either  morning  or  evening  urine.  Mer, 
viv.  1st  trit.,  every  morning. 

March  9th.  Morning  urine  loaded  with  urates ;  that  of  the 
evening,  free ;  no  albumen  by  Nitric  acid.  Mer.  tiv.  1,  i  grain 
daily. 

20th.  The  swelling  has  returned ;  some  nights  not  any,  and 
^hen  it  reappears.  Bowels  were  confined,  but  now  are  better ; 
no  sweats,  but  cold  clammy  feeling  on  the  body.  The  feet  are 
Slow  dry  ;  formerly  perspired  a  good  deal.  Has  had  a  bath  once  a 
^i^eek.    Urine  varies ;  on  and  off  clear  and  thick ;  urates  in  it ; 

VOL.  XXXYIII,  N6.  CLIII. JULY,  1880.  T 


290  Clinical  Record. 

no  albumen  when  treated  with  Nitric  acid  and  heat.    The  lirer 
is  probably  the  cause.    Mer,  viv. 

April  5th.  No  dropsy  since  last  visit.  Skin  becomes  yellowish 
at  times.  Deposit  less  in  quantity,  consisting  of  mucus  with 
crystals  of  uric  acid ;  no  albumen  or  urates. 

May  2nd.  Superficial  inguinal  yeins  look  enlarged  and  blae. 
Is  very  sleepy  in  the  morning.  Bowels  act  once  in  two  days. 
Motions  very  dark.  Bestless  and  fretful  some  days.  Upper  lip 
swells  always  in  the  momiog.  Urine  clear ;  no  albumen  ;  no 
deposit.  Breath  smelt  badly.  Mer»  viv.,  1  grain  three  times  a 
wee&. 

21st.  Has  had  some  premonitory  symptoms  of  the  former 
attack.  The  eyes  were  swollen.  No  sickness,  nor  nausea.  Tbe 
blue  inguinal  and  abdominal  veins,  which  had  nearly  disappeared, 
have  again  appeared.  Perspires  little  except  in  the  head.  Urine 
is  thick  and  less  in  quantity.  Complexion  becomes  white  and 
unhealthy-looking  at  times.     Mer,  viv.,  1  grain  daily. 

June.  The  swelling  of  the  body  is  less.  Complains  of  pain  at 
the  extremity  of  the  penis  on  lying  down  and  on  moving  about ; 
not  worse  after  passing  urine.  No  albumen.  Areen.  1,  3  grains 
daily. 

July  10th.  (Beport.)  Last  year,  in  an  east  wind,  the  face, 
lips,  and  eyelids  swelled,  and  they  did  so  yesterday;  have 
decreased  to  day.  No  swelling  in  the  legs  now.  Pain  at  the 
glans  or  prepuce.  Whilst  under  the  care  of  the  physician,  when 
better  he  would  get  worse  if  the  wind  changed  to  the  east.  No 
albumen,  but  earthy  phosphates.     Jreen. 

August  9th.  Very  little  swelling.  The  eyelids  are  a  little 
swollen.  The  inguinal  and  hypogastric  veins  are  not  so  large ; 
they  increase  at  night.  No  albumen.  Areeny,  1  drop  of  3rd 
daily. 

All  subsequent  accounts  reported  the  boy  as  quite  well,  in 
which  state  he  has  continued  until  the  present  time  (1880). 

Ohsermtions. — What  was  the  case  here  narrated  P  That  it  was 
one  of  albuminuria  there  can  be  no  question,  as  far  as  testa  will 
establish  that  point ;  but  was  it  a  case  of  desquamative  nephritis  ? 
At  an  early  stage  of  tbe  disease  I  thought  that  once  I  saw  some 
uriniferous  casts,  but  the  result  of  the  treatment  leads  me  to 
the  belief  that  they  were  probably  only  urates  which  assumed 
that  shape.    It  is  probable,  therefore,  that  it  was  a  case  of  BCTore 


Albuminuria.  291 

inflammation  of  the  kidney,  although  the  extensiye  dropsy 
accompanying  it  (according  to  some  pathological  views)  would 
indicate  that  it  was  a  clear  case  of  Bright*6  disease.  Whether  it 
were  so  or  not,  happy  shall  I  be  if  the  treatment  adopted  will 
aid  any  one  in  the  management  of  this  terrible  malady. 

The  increase  of  symptoms  when  the  wind  was  in  the  east 
seems  also  to  indicate  that  it  was  a  case  of  renal  congestion, 
from  the  effect  which  this  wind  produces  upon  the  skin,  which 
view  gets  further  confirmation  from  the  dry  condition  of  the 
skin  of  the  invalid  and  the  presence  of  urates  in  the  urine,  both 
of  which  improved  before  the  albumen  disappeared. 

Had  the  eruption  on  the  scalp  any  influence  in  producing  the 
disease  P  This  began  two  years,  and  was  well  for  fifteen  months, 
before  the  general  dropsy  appeared,  yet  in  this  interval  the  boy 
had  attacks  of  sickness,  with  occasional  swelling  of  the  face,  which 
precludes  the  idea  that  it  was  a  case  of  suppressed  scarlatina. 

As  regards  the  dose,  little  permanent  benefit  was  produced 
with  the  medicine  attenuated  to  the  third  degree,  but  permanent 
benefit  resulted  from  the  use  of  the  same  medicine  in  a  more 
material  form,  and  the  cure  appeared  to  be  due  more  to  the  low- 
ness  of  the  dilution  employed  than  to  the  quantity  administered. 


J 


299 


MISCELLANEOUS. 


AteocVt  Poroui  Pkutert.    By  C.  B.  S:eb,  M.D. 

It  is  as  well  to  know  that  these  plasters  are  capable  of  doiDg  a 
great  deal  of  harm  as  well  as  good.  That  thej  may  act  like 
irritant  poisons  on  the  system  the  foUowiog  case  proves. 

A  patient  of  mine,  between  fifty  and  sixty  years  of  age,  about 
six  weeks  ago  put  a  porous  plaster  on  his  right  arm,  just  below 
the  elbow,  having  been  recommended  to  do  so  for  rheumatism 
which  had  harassed  him  for  three  or  four  months.  He  kept  it  on 
only  twenty-four  hours,  being  forced,  at  the  end  of  that  time,  to 
tear  it  off,  in  consequence  of  the  itching  and  burning  it  occa- 
sioned. The  surface  which  had  been  covered  by  the  plaster 
already  showed  a  bright  red  surface  and  a  crop  of  vesicles  so 
crowded  together  that  a  pin's  head  could  scarcely  have  found  a 
place  between  them.  There  was  a  good  deal  of  swelling  also. 
In  less  than  twelve  hours  afterwards  discharge  from  the  vesicles 
began,  and  continued  for  three  days.  This  discharge,  which  was 
of  a  serous,  gummy  character,  was  very  profuse,  and  saturated 
the  dressings  placed  upon  the  arm,  and  the  shirt  and  coat  as  well. 
The  swelling  extended  to  the  whole  arm,  from  shoulder  to  fingers, 
till  it  became  nearly  twice  its  normal  size.  The  axillary  glands 
became  enlarged  and  painful,. and  the  use  of  the  hand  also  was 
fettered  and  painful.  This  swelling  and  glandular  induration, 
and  tenderness  lasted  about  a  fortnight. 

But  the  poison  of  the  plaster  did  not  expend  itself  locally  only. 
At  all  the  orifices  of  the  body  symptoms  showed  themselves  which 
were  sufficiently  distressing.  Both  eyelids  became  baggy  and 
oedematous.  Considerable  swelling  of  the  upper  lip  showed 
itself.  The  ears  also  got  red  and  swollen.  The  anus  swelled  as 
if  infiltrated  largely  with  serum,  and  itched  unbearably.  The 
prepuce  also  swelled  so  as  to  threaten  phimosis  and,  when  the 


Alcock's  Porous  Plasters,  293 

glans  was  exposed,  paraphimosis.  The  scrotum  became  hard 
and  corrugated  and  shrunk  in  size  to  half  its  natural  dimensions, 
and  thrust  both  testicles  up  into  the  abdomen.  The  itching  on 
the  scrotum  was  described  as  being  simply  intolerable.  For 
about  three  weeks  sleep  could  be  had  onlj  in  short  snatches,  and 
mj  patient  was  reduced  to  a  most  lamentable  state  of  exhaustion 
and  depression.  He  told  me  that  he  never  before  had  expe- 
rienced 80  great  a  prostration  of  physical  and  mental  energies. 
There  was  one  singular  exception  to  injury  done  to  the  whole 
system  by  the  plaster.  The  appetite  never  failed,  nor  did  the 
digestive  power.  Indeed,  the  latter,  which  is  generally  bad, 
rather  improved  than  otherwise.  The  urine,  however,  was  scanty 
and  high-coloured  for  three  weeks.  The  bowels  continued  in 
their  usual  condition  of  costiveness. 

The  present  is  the  state  of  things  six  weeks  after  the  applica- 
tion of  the  plaster.  There  is  an  urticarious-like  eruption 
on  the  wrists  and  backs  of  the  hands,  the  itching  of  which, 
at  different  periods  of  the  day,  nearly  drives  him  crazy.  He 
tells  me  that  he  never  before  understood  the  expression  "  volup- 
tuous itching."  Now  he  perfectly  realises  it.  If  he  begins  to 
scratch,  a  feeling  of  not  only  relief  but  of  bliss  almost  overcomes 
him  and  makes  him  dread  the  taking  bis  fingers  off  the  skin.  He 
feels  like  the  drunkard  in  the  presence  of  a  glass  of  brandy.  He 
knows  he  will  do  himself  harm,  but  harm  he  prefers  to  do  him- 
self rather  than  refrain  from  that  which  gives  him  such  exquisite 
gratiffcation.  I  say  harm  advisedly,  for  he  allows  that  the 
intervals  of  ease  from  the  itching  are  longer  when  he  does  not 
scratch.  The  skin  is  harsh  and  dry  over  the'  whole  body,  his 
sleep  is  still  bad,  his  energies  are  still  at  a  low  ebb,  and  he 
still  feels  poisoned. 

That  Alcock*B  plasters  are  useful  agents  in  many  cases  there 
can  be  no  doubt.  But  such  an  experience  of  its  action  as  I  have 
given,  and  I  have  no  reason  to  believe  that  it  is  a  solitary  one, 
should  make  us  think  -  twice  before  recommending  them.  They 
should  be  placed  in  the  same  category  as  Arnica,  an  agent  which 
is  now  tiniversally  recognised  as  a  most  valuable  and  yet  dangerous 
one.  In  the  case  of  both  it  will  be  as  well  to  make  some  inquiry 
as  to  the  constitution  of  the  patient  before  prescribing  them. 


294  Miscellaneous. 


Temperature  qfike  Breath.    By  Dr.  Duooeoh. 

Iir  the  Louisville  Medical  Herald  for  Maj  last  there  is  a 
letter  from  Dr.  E.  S.  Clark,  describing  how  he  accidentailj  found 
that  on  breathing  on  a  clinical  thermometer  through  his  coat- 
sleeve  for  about  five  minutes,  the  thermometer  registered  a  tem- 
perature of  108°.  On  other  occasions  he  could  not  make  the 
mercury  rise  higher  than  103^  105'',  or  106°.  A  friend,  bj 
wrapping  the  bulb  in  woollen  cloth  and  breathing  on  it  for  the 
same  length  of  time,  brought  the  mercury  up  to  109i°.  Dr.  Clark 
is  quite  unable  to  account  for  the  high  temperature  thus  pro- 
duced, and  does  not  even  suggest  any  explanation  of  it. 

I  hare  made  a  number  of  experiments  on  myself  and  others 
suggested  by  Dr.  Clark's  letter.  I  find  that  by  rolling  up  a 
thermometer,  not  very  tightly,  in  several  folds,  from  ten  to 
twenty,  of  a  silk  handkerchief,  and  breathing  out  through  the 
silk,  just  over  the  bulb — ^inspiration  being  performed  by  the  nose 
— the  thermometer,  after  about  five  minutes,  will  always  exhibit 
a  considerable  rise  of  temperature.  Sometimes  it  will  not  rise 
higher  than  100°,  more  often  to  102°  or  103°,  but  occasionally 
much  higher  temperatures  are  obtained,  104°,  105°,  106°,  107°;  and 
even  108°  having  been  occasionally  indicated.  I  have  never  sent 
the  mercury  up  above  108°,  but  this  temperature  has  been 
observed  on  several  occasions.  *  I  cannot  state  what  are  the 
precise  conditions  under  which  higher  or  lower  temperatures 
are  produced,  but  I  can  mention  a  few  circumstances  apparently 
influencing  their  development. 

It  makes  but  little  difference  what  the  material  is  in  which 
the  thermometer  is  wrapped.  Similar  rises  of  temperature  may 
be  obtained  whether  the  enveloping  substance  be  a  silk,  cotton, 
linen,  or  woollen  fabric.  A  higher  temperature  is  developed  if 
the  enveloping  fabric  is  closely,  than  if  it  is  loosely,  wrapped 
round  the  thermometer.  The  highest  temperature,  108°,  oc- 
curred on  the  26th  May,  when  the  weather  was  warm,  after 
pretty  hard  exercise,  and  when  sitting  quietly  after  dinner. 
Under  apparently  precisely  similar  conditions,  the  temperature 
at  other  times  did  not  rise  higher  than  104°  or  105°.  In  the 
cooling  room  of  a  Turkish  bath  after  having  been  subjected  to  a 
temperature  of  170°  my  breath  raised  the  temperature  to  104°. 


Temperature  of  the  Breath,  295 

I  met  two  friends  in  the  bath,  one  raised  the  thermometer  to 
103°,  the  other  not  beyond  102*^.  The  lowest  temperatures 
obtained  bj  breathing  seem  to  occur  when  the  weather  is  cold, 
causing  the  body  to  feel  chUly.  I  should  observe  that  th& 
temperature  taken  under  the  arm  was  always  normal  in'  these 
experiments,  i,  e.  it  ranged  between  98°  and  99°. 

The  cause  of  the  high  temperatures  obtained  in  this  way  is  not 
quite  clear.  Either  the  temperature  produced  is  the  actual 
temperature  of  the  breath,  which  yaries  in  the  way  above 
described  at  different  times  and  under  different,  as  yet  unascer- 
tained, conditions,  or  the  heat  indicated  in  the  thermometer  is 
produced  by  the  passage  of  the  breath  through  the  fabric, 
the  heat  being  caused  either  by  the  friction  of  the  air  on  the 
fibres  of  the  material  or  by  the  condensation  of  the  moisture  of 
the  breath,  it  being  a  well-known  physical  fact  that  a  vapour 
passing  into  the  liquid  form  evolves  heat. 

To  the  assumption  of  the  latter  as  the  source  of  the  heat 
observed  there  is  this  objection :  that  supposing  the  breath  which 
keeps  the  moisture  suspended  as  vapour,  on  issuing  from  the  lungs 
has  the  temperature  of  the  interior  of  the  body,  viz.  98  5°  (in 
the  physiological  works  it  is  stated  to  be  95°  or  97°)  it  can  only 
be  for  a  very  short  time  that  the  silk  fabric  will  condense  this 
moisture ;  only  as  long,  namely,  as  its  temperature  is  below 
that  of  the  breath,  but  in  a  very  few  seconds  the  tempera- 
ture of  the  enveloping  medium  becomes  higher  than  the 
supposed  temperature  of  the  breath,  so  in  place  of  condensing 
the  moisture  of  the  latter  it  would  tend  to  dissipate  it  still  more. 

Whether  the  friction  of  the  breath  upon  the  fibres  of  the 
material  through  which  it  passes  be  the  cause  of  the  rise  of  tem- 
perature is  difficult  to  ascertain.  I  am  not  aware  of  any  experi- 
ments* to  show  that  air  passing  through  such  a  material  raises 
the  temperature  of  the  latter.  In  my  experiments  I  find  that  it 
does  not  make  much  if  any  difference  whether  the  exposed  air 
be  propelled  strongly  through  the  material  or  whether  the 
breathing  be  performed  gently  and  without  effort.  If  the 
friction  theory  be  correct  the  harder  we  blow  the  higher  the 
temperature  should  be,  that  is  to  say,  within  certain  limits,  for  if 
the  air  was  much  compressed  its  expansion  would  tend  to  lower 
the  temperature.  I  tried  to  settle  this  point  by  isolating  the 
bulb  of  the  thermometer  from  any  enveloping  material  and  ex- 


296  MUcellaneouM. 

posing  it  only  to  the  breath.  To  do  this  I  placed  the  thermo- 
meter in  a  glass  tube  open  at  both  ends,  packing  it  round  with 
cotton  wool  in  such  a  way  that  the  bulb  stood  out  free  in  a  space 
about  half  an  inch  in  height  at  the  top  of  the  tube.  I  wrapped 
round  the  tube  a  silk  handkerchief,  and  applying  my  lips  to  the 
top  of  the  tube  where  the  thermometer  bulb  was,  breathed  in  it 
for  five  minutes.  .  The  temperature  did  not  rise  above  d5^  On 
breathing  into  the  end  of  the  tube  where  the  bulb  was  through 
a  good  many  folds  of  silk,  not  in  contact  with  the  bulb,  the 
temperature  rose  in  five  minutes  to  102^.  But  this  proTes  little 
one  way  or  another.  In  the  first  experiment,  where  the  lips  were 
applied  immediately  to  the  tube,  a  higher  temperature,  that 
might  have  been  communicated  to  the  bulb  by  the  breath,  would 
be  lost  by  radiation  to  the  cooler  lips,  and  in  the  second  experi- 
ment, the  folds  of  silk  on  the  mouth  of  the  tube  might  merely 
have  served  to  retain  the  heat  in  the  tube,  and  consequently  on 
the  bulb,  which  was  before  lost  by  radiation  to  the  lips. 

Is  it,  then,  possible  that  the  high  temperatures  observed  really 
do  correctly  show  the  heat  of  the  breath  at  the  time  ?  Several 
circumstances  seem  to  point  to  this  as  the  real  solution  of  the 
enigma.  The  great  differences  that  are  observed  in  the  tempe- 
rature at  difierent  times  would  seem  to  show  that  the  temperature 
of  the  breath  varies  according  to  some  unascertained  conditions. 
This,  I  think,  I  have  made  out,  viz.  that,  ecsteris  paribui^  higher 
temperatures  are  obtained  when  the  surrounding  atmosphere  is 
warm  than  when  it  is  cold. 

Now,  if  the  breath  has  these  high  temperatures  on  leaving  the 
lungs^  which  we  presume  are  themselves  of  the  average  tempera- 
ture of  the  interior  of  the  body,  i.e.  not  above  99^  or  100^ — ^whence 
comes  all  this  heat,  and  what  does  it  imply  P  We  know  that  the 
process  of  respiration  is  attended  by  an  interchange  of  oxygen  (from 
the  air)  and  carbonic  acid  (from  the  blood) — the  volume  of  carbonic 
acid  evolved  being  rather  less  than  that  of  the  oxygen  absorbed. 
In  addition  a  considerable  quantity  of  moisture  is  exhaled  from 
the  blood.  Now,  the  conversion  of  the  oxygen  gas  into  a  liquid 
in  the  blood  Ib  attended  by  an  evolution  of  heat,  and  the  conversion 
of  carbonic  acid  from  the  fluid  to  the  gaseous  state  is  attended 
by  an  evolution  of  cold — so  to  speak — so  that  these  two  will 
about  neutralise  one  another,  but  the  conversion  of  the  fluid 
water  in  the  blood  to  the  gaseous  state  must  be  attended  hj  a 


Prize  for  an  Essay  on  Hygiene.  297 

still  further  loss  of  caloric,  so  that  it  is  difficult  to  see  how  the 
process  of  respiration  could  be  attended  bj  an  increase,  it  ought 
rather  to  be  attended  by  a  diminution  of  caloric ;  hence  some 
physiologists  have  regarded  respiration  as  a  means  of  cooling  the 
body.  If  then  the  breath  issuing  from  the  lungs  have  really  the 
high  temperature  shown  in  the  above  experiments,  how  is  this 
great  elevation  of  temperature  produced?  In  physiological 
works  we  find  it  stated  that  the  expired  air  has  a  temperature  of 
only  06^  or  97^,  but  breathing  on  the  thermometer  in  the  manner 
described  raises  its  temperature  as  high  as  108°  occasionally,  so 
if  this  is  not  merely  an  effect  of  the  friction  of  the  expired  air 
among  the  fibres  of  the  material  enveloping  the  thermometer, 
the  production  of  such  a  great  amount  of  heat  remains  a 
mystery. 

Ify  experiments  seem  to  show  that  the  temperature  of  the 
breath  is  greater  when  the  loss  of  heat  by  the  skin  is  less,  as 
when  the  surrounding  air  is  warm,  and  less  when  the  surface  of 
the  body  parts  with  more  heat,  in  consequence  of  a  diminished 
temperature  of  the  air ;  in  other  words,  the  breath  is  hotter  when 
the  heat  of  the  body  cannot  escape  by  other  ways. 

That  the  act  of  respiration  does  not  heat  the  blood  is  shown  by 
the  experiments  of  various  physiologists,  which  prove  that  the 
arterialised  blood  in  the  lefl  ventricle  is  actually  cooler  than  the 
venous  blood  in  the  right  ventricle,  though  this  is  denied  bj 
other  observers. 

The  above  experiments  would  seem  to  show  that  by  the  act  of 
respiration  a  quantity  of  caloric  is  got  rid  of,  and  further,  that 
the  quantity  thrown  off  by  respiration  is  greater  the  less  the 
heat  exhaled  or  radiated  by  the  skin.  That  the  facts  are  as  I 
have  stated,  any  one  may  easily  convince  himself  by  repeating  the 
experiments.  What  their  explanation  is,  is  a  problem,  the  solu- 
tion of  which  will  no  doubt  be  easy  to  professional  physiologists. 


Prize  for  an  Essay  on  Hygiene. 

Wb  are  requested  to  announce  that  the  Soci^t£  Fran9aiBe 
d' Hygiene  offers  prizes  for  essays  on  the  following  subjects: 

1.  Hygiene  of  the  second  period  of  infancy  to  the  age  of 
education  {age  seolaire),  that  is  to  say,  from  two  to  six  years, 


298  MUcellaneow. 

iadudiDg  everythiog  relating  to  hygiene  properly  so-caHed, 
comprising  the  normal  development  of  the  organs  of  the  senses, 
but  without  touching  on  infantile  pedagogy. 

2.  Hygiene  and  pedagogy  of  model  satlet  d*anle.  The 
hygienic  part  will  refer  exclusively  to  the  special  locality  of  the 
salUf  d*atiU,  The  pedagogic  part  will  have  for  its  exclusive 
object  the  harmonious  development  of  the  body  and  the  intelii* 
geuce. 

For  each  of  these  subjects  ore  offered  a  gold  medal  (the  gift 
of  a  member  of  the  British  Homosopathic  Society),  a  silver 
medal,  and  three  bronae  medals. 

The  essays  in  French,  English,  Italian,  or  German,  should  be 
sent  to  the  Society,  Bue  du  Dragon,  80,  Paris,  before  the  1st  of 
January,  1881.  The  author's  name  to  be  contained  in  a  sealed 
envelope  with  a  motto  corresponding  to  that  on  the  essay.  The 
essays  not  to  exceed  thirty  pages  of  12mo.  The  prize  essays  to 
be  the  property  of  the  Society,  which  will  publish  them  with  the 
authors*  names. 


The  Arnica  Eruption. 

Db.  Firri^BD,  of  New  York,  believes  that  the  erysipelatoid 
eruption  often  following  the  application  of  the  Tincture  of  arnica 
18  owing  to  the  flowers  from  which  the  tincture  was  made  con- 
taining the  larvas  of  the  Atherix  maeulatus,  an  insect  of  acrid 
and  irritating  properties.*  He  says  that  a  tincture  prepared  from 
the  flowers  free  from  the  insect  will  not  cause  the  erysipelatoid 
rash,  nor  yet  a  tincture  prepared  from  the  root.  If  this  is 
correct,  the  moral  would  be  to  prepare  our  tincture  as  Hahne- 
mann directs,  from  the  whole  plant  before  its  flowering  time,  or 
alternatively  from  the  root  of  the  plant,  or,  as  the  British  Fhar- 
macopoeia  directs,  from  the  root  of  the  plant  only,  but  not  as  the 
Homoeopathic  Pharmacopona  directs,  from  the  entire  fresh  plant 
(period  of  growth  not  stated),  or  alternatively  from  the  dried 
flowers  only.  But  is  it  true  that  the  Tincture  of  arnica  uncon- 
taminated  by  the  insect  alluded  to  is  incapable  of  producing  the 
arnica  rash  ?    In  Hahnemann's  proving,  which  was  probably 

*  Mercier  in  1811  called  attenUon  to  this  fact     It  waa  mentioned  by  Dr. 
C.  Hering  at  tbe  World's  Convention  in  1876. 


1 


A  New  Sphygmograph.  299 

made  with  a  tincture  prepared  according  to  his  own  directions, 
we  find  that  one  of  the  symptoms  is,  "  After  touching  the  skin 
with  the  tincture  there  arises  an  itching  miliary  rash."  Some 
years  ago  the  writer  was  called  to  see  a  lady  for  whom  an  allo- 
pathic practitioner  had  prescribed  a  lotion  containing  Arnica 
tincture^  which  was  made  up  at  an  ordinary  chemist's  (and  so 
presumably  of  the  tincture  made  from  the  root).  This  lady  had 
a  severe  outbreak  of  the  characteristic  arnica  erysipelas,  and  she 
sent  for  the  writer,  because,  as  she  said,  she  knew  that  Arnica 
was  a  homosopathic  remedy,  and  so  she  thought  he  would  best  be 
able  to  cure  it.  While  it  remains  a  doubtful  point  whether  the 
Arnica  tincture  owes  its  frequently  observed  acridity  to  an  insect 
in  the  flowers,  it  would  be  well  to  act  on  Hahnemann's  directions, 
and  not  prepare  our  tincture  from  the  flowers,  but  from  the 
green  plant  before  flowering  time,  or  from  the  root  only. 


Oenoveva  Water, 

This  is  another  candidate  for  popularity  as  a  dinner  water. 
Like  Selters  (commonly  called  Seltzer),  ApoUinaris,  and  Wil- 
Iielm*8  Quelle,  it  contains  a  very  small  amount  of  inorganic  con- 
stituents, and  a  very  large  amount  of  free  carbonic  acid.  The 
chief  salt  is  mag^iesia,  which  communicates  a  hardly  perceptible 
l)itteme8S  to  the  water,  and  doubtless  imparts  to  it  some  medi- 
cinal virtues.  It  is  a  very  pleasant  dinner  water,  and  mixes  well 
-with  wine  or  spirits.  We  have  no  doubt  it  will  become  a 
general  fayourite  when  it  comes  to  be  known* 


A  HfevD  Sphygmograph,    By  Dr.  DtmoEOir. 

Ths  application  of  the  finger  to  the  pulse  is  far  from  being 
able  to  reveal  to  us  all  the  pulse  has  to  teach  us.  With  the 
finger  we  can  tell  little  more  than  the  number  of  beats  per 
minute,  the  strength,  and  the  regularity  or  irregularity  of  their 
beats.  But  the  sphygmograph  tells  us  a  great  deal  more  about 
the  pulse.  It  shows  us  the  various  elements  of  which  each  pulse 
beat  consists,  and  the  relative  proportion  these  diflerent  elements 


800  Miseelianeous. 

bear  to  one  another,  and  whether  one  or  other  of  them  is  defi- 
cient or  in  excess.  It  shows  us  every  irregularitj  in  duration 
and  in  strength  in  a  considerable  number  of  beats,  and  it  pre- 
serres  for  us  the  exact  condition  of  the  pulse  at  tbe  time  of 
taking  it  for  comparison  with  its  state  at  another  time.  In 
short,  the  value  of  the  sphjgmograph  has  been  testified  to  by 
all  who  hare  used  it.  Why,  then,  is  it  not  more  generally 
employed  P 

The  answer  to  this  question  is,  I  belieTe,  because  the  sphygmo- 
graphs,  hitherto  offered  to  the  profession  are  so  cumbrous  and  ao 
difficult  to  use,  besides  being  so  expensive,  that  their  ose  in 
ordinary  general  practice  is  impossible.  The  objections  to  its 
constant  employment  would  be  removed  by  the  iuTention  of  an 
instrument  which  should  have  none  of  the  disadvantages,  wbUe 
it  offered  all  the  excellences  of  the  instruments  hitherto  known 
to  the  profession,  the  use  of  which  has  almost  been  confined  to 
hospital  practice. 

The  instrument  I  have  the  pleasure  of  introducing  to  my 
colleagues  fulfils,  as  I  think,  all  the  requirements  of  a  sphymo- 
graph  for  daily  and  constant  use.     It  is  small,  and  therefore 
portable,  light,  simple  in  construction,  not  liable  to  get  out  of 
order,  easily  repaired,  if  broken,  by  the  nearest   watchmaker, 
easily  applied  to  the  wrist,  it  requires  no  wrist  rest,  and  can  be 
used  with  equal  iacility  whether  the  patient  is  standing,  sitting, 
or  lying.     With  it  the  pulse  may  be  taken  almost  as  quickly  as 
it  can  be  felt  with  the  finger.    In  sensitiyeness  it  is  certainly  not 
inferior  to  any  of   those  hitherto  used,  and  the  markings  it 
produces  on  the  smoked  paper  are  as  distinct  as  could  be  desired. 
There  is  a  simple  contrivance  for  regulating  the  pressure  of  the 
spring,  so  that  it  can  be  increased  or  diminished  with  the  greatest 
facility,  and  the  force  of  the  arterial  beat  seen  at  a  glance. 

To  l^e  ingenuity  and  skill  of  Mr.  John  Oanter,  of  19,  Crawford 
Street,  Montagu  Square,  I  am  indebted  for  carrying  out  all  the 
details  of  this  instrument,  and  I  cannot  speak  too  highly  of  his 
inventive  powers  and  the  thorough  manner  in  which  he  interested 
himself  in  perfecting  an  instrument  apparently  so  foreign  to  his 
own  special  art.  Sut  in  reality  it  his  complete  knowledge 
of  all  the  details  of  watch-making  that  has  enabled  him  to 
suggest  and  carry  out  modes  of  overcoming  all  the  diffi- 
culties in  the  construction' of  a  sphygmograph  adapted  to  the 


J 


International  Homeopathic  Convention,  1881.       801 

daily  use  of  the  busy  practitioner.    Mr.  Gkinter  will  be  prepared 
to  supply  tbe  profession  with  this  instrument  in  a  few  days. 

Smoked  papers  are  required  for  taking  the  drawings  of  the 
pulse.  A  good  stout  glazed  note  paper,  cut  into  appropriate 
lengths,  which  any  stationer  or  bookbinder  will  do,  is  smoked  by 
being  held  over  burning  camphor.  The  tracing  made  by  the 
needle  is  permanently  preserved  by  pouring  over  it  some  quickly- 
drying  yamish.  I  have  found  the  best  to  be  that  which  photo- 
graphers call  "  crystal  Tarnish,"  which  may  be  obtained  at  any 
shop  where  photographic  requisites  are  sold. 


international  HomcBopathic  Convention,  1881. 

The  committee  appointed  at  the  Liverpool  Congress  in  1877, 
have  drawn  up  the  following  circular  for  transmission  to  repre- 
sentative homoeopaths  in  various  parts  of  the  world. 

"  Deab  Colleague, — At  the  close  of  the  *  World's  Homoeo- 
pathic Convention  *  which  met  in  Philadelphia  in  1876,  it  was 
determioed  to  hold  a  similar  meeting  every  five  years  in  some 
principal  city  of  Europe  or  America ;  and  a  general  wish  was 
expressed  that  the  seat  of  the  next  gathering  might  be  in  London. 

'*  On  this  determination  and  desire  being  communicated  to  the 
Congress  of  British  Homoeopathic  Practitioners  meeting  in 
Bristol,  in  September,  1876,  it  was  unanimously  resolved  that 
Buch  a  Convention  should  be  held  in  London  in  1881,  and  that 
the  Congress  would  undertake  the  arrangements  necessary  for 
the  purpose.  A  Committee,  consisting  of  the  undersigned,  was 
thereupon  appointed  to  draw  up  a  plan  of  proceeding ;  and  its 
report,  which  is  herein  enclosed,  was  accepted  at  the  Congress  of 
1877,  and  the  Committee  re-appointed,  with  instructions  to  obtain 
adhesions  and  contributions. 

*^  The  latter,  viz.  reports  of  progress  and  papers  to  be  discussed 
at  the  meetings,  we  are  soliciting  from  individual   physicians 
practising  homoeopathically  throughout  the  world.     But  we  now 
request  your  good  offices  towards  interesting  the 
in  our  proposed  gathering,  by  bringing  the  subject  before 

,  and  also  towards  making  it  known  to  the  Homoeo- 
pathists  of  your  in  such  way  as  you  may  think  best. 

"  The  exact  time  and  place  of  meeting,  with  the  office-bearers, 
etc.,  will  be  finally  decided  at  the  Congress  we  shall  hold  in  Sep- 


802  MUcellaneoui. 

tomber,  1880 ;  and  information  thereof  will  be  dolj  forwarded  to 
you,  and  pubUabed  in  all  Britiah  HomoDopathic  Joamala. 

'^  Hoping  to  hear  from  you  ere  long,  and  to  find  your  serrioeB 
enlisted  in  the  cause,  we  remain  very  &ithfully  yours,  E.  B. 
DuDGSoir  (Chairman),  W.  BA.rss,  A.  CLiyxoK,  A.  C.  Popi, 
B.  HcoHsa  {Secretary), 

**  All  Communications  to  be  addressed  to  the  Secretaiy,  Br. 
Hughes,  Brighton,  England." 

Report  of  the  Committee  (referred  to  in  letter)  appointed  to  make 
arrangemenU  for  holding  a  *'  WorUPe  Homoeopathic  Gbavtffi- 
tion  *'  'in  London,  in  1881,  preeented  to  and  adopted  hf  Ike 
Britiih  MomcBopathio  Congreee  Meeting  in  Liverpool,  Sep- 
tember, 1877. 

Tour  Committee  beg  to  report  that  they  have  had  several 
meetings  ;  and  after  much  consideration,  and  in  conference  with 
the  lamented  President  of  the  last  Convention,  Dr.  Carroll  Dan- 
ham,  have  agreed  upon  the  following  recommeiidatioDS,  which 
they  present  for  the  acceptance  of  the  present  Congress : 

**  ScHsicB  FOB  THE  Wobld's  Hoic(bofathio  Cohtbktiok,  1881. 

*'  1.  That  the  Convention  shall  assemble  in  London  at  such  time 
and  during  such  number  of  days  as  may  hereafter  be  determined. 

*'  2.  That  this  meeting  take  the  place  of  the  Annual  British 
HomoBopatbic  Congress,  and  that  its  officers  be  elected  at  the 
Congress  of  the  preceding  year ;  the  Convention  itself  being  at 
liberty  to  elect  honorary  Vice-Presidents  from  those  foreign 
guests  and  others  whom  it  desires  to  honour. 

'*  8.  That  the  expenses  of  the  meeting  be  met  by  a  subscrip- 
tion from  the  homoeopathic  practitioners  of  G-reat  Britain ;  the 
approximate  amount  to  be  expected  from  each  to  be  named  as 
the  time  draws  near. 

''4.  That  tlie  expenses  of  printing  the  Transactions  be  de- 
frayed by  a  subscription  from  all  who  desire  to  possess  a  copy  of 
the  volume. 

*^  5.  That  the  Convention  shall  be  open  to  all  medical  men 
qualified  to  practise  in  their  own  country. 

"  6.  That  all  who  attend  shall  present  to  the  Secretary  their 
names  and  addresses,  and  a  statement  of  their  qualifications; 
and,  if  unknown  to  the  officers  of  the  Convention,  shall  be  intro- 
duced by  some  one  known  to  them,  or  shall  bring  letters  credential 


International  Homcsopalhic  Convention,  1881.       303 

from  some  HomcBopathic  Society,  or  other  recognised  representa- 
tive  of  the  ay  stem. 

^'  (a)  That  members  of  the  Convention,  as  above  characterised, 
shall  be  at  liberty  to  introduce  visitors  to  the  meetings  at  their 
discretion. 

"  7.  That  the  Committee  be  authorised  to  enter  into  communi- 
cation with  physicians  at  home  and  abroad  to  obtain — 

''  (a)  A  report  from  each  country  supplementary  to  those 
presented  at  the  Convention  of  1876,  recounting  everything  of 
interest  in  connection  with  homcBopathy  which  has  occurred 
within  its  sphere  since  the  last  reports  were  drawn  up. 

^'  (h)  Essays  upon  the  various  branches  of  homcsopathic  theory 
and  practice,  for  discussion  at  the  meetings,  and  publication  in 
the  Transactions ;  the  physicians  to  be  applied  to  for  the  latter 
purpose  being  those  named  in  the  accompanying  schedule. 

**  8.  That  all  essays  must  be  sent  in  by  January  Ist,  1881,  and 
shall  then  be  submitted  to  a  committee  of  censors  for  approval  as 
suitable  for  their  purpose. 

''9.  That  the  approved  essays  shall  be  printed  beforehand, 
and  distributed  to  the  members  of  the  Convention,  instead  of 
being  read  at  the  meetings. 

"  10.  That  for  discussion  the  essays  shall  be  presented  singly 
or  in  groups,  according  to  their  subject-matter,  a  brief  analysis  of 
each  being  given  from  the  chair. 

"  11.  That  a  member  of  the  Convention  (or  twO)  where  two 
classes  of  opinion  exist  on  the  subject,  as  in  the  question  of  the 
dose)  be  appointed  some  time  before  the  meeting  to  open  the 
debate,  fifteen  minutes  being  allowed  for  such  purpose,  and  that 
then  the  essay,  or  group  of  essays,  be  at  once  opened  for  discussion, 
ten  minutes  being  the  time  allotted  to  each  speaker.   ' 

''  12,  That  the  order  of  the  essays  be  determined  by  the  im- 
portance and  interest  of  their  subject-matter,  so  that,  should  the 
time  of  the  meeting  expire  before  all  are  discussed,  less  loss  will 
have  been  sustained. 

''  13.  That  the  Chairman  shall  have  liberty,  if  he  sees  that  an 
essay  is  being  debated  at  such  length  as  to  threaten  to  exclude 
later  subjects  of  importance,  to  close  its  discussion. 

"U.  That  the  authors  of  the  essays  debated,  if  present, 
shall  have  the  right  of  saying  the  last  word  before  the  subject  is 
dismissed. 


804  Books  received. 

^*  16.  That,  ai  at  the  first  CanTeiition,  the  subjects  of  the 
essays  and  discussions  shall  be — 

**  (a.)  The  Institutes  of  Homodopathj. 

'<  (h.)  Materia  Medica. 

"  (e.)  Practical  Medicine. 

**  (d.)  Surgical  Therapeutics^  including  diseases  of  the  Sye 

and  Ear. 
**  (e.)  OynACologj.*' 
At  a  subsequent  meeting  of  the  Committee^  it  was  determiDed 
that  the  gathering  shall  be  known  as  the  '*  Iniemaiional  EomcBO- 
paihie  Convemtum.** 


BOOKS    RECEIVED. 

ffoff  Feter^  ii$  GartMct,  Treatment^  and  Sf&eiive  Prevmtum, 
Bj  dHAS.  Habbisoh  Blacklvt,  M.D.  2nd  edit.  Londcm: 
Bailli^re,  Tindall,  and  Cox.    1880. 

7}ran9aetiafi9  of  the  Homaopaihie  Medical  Society  of  ike  State 
of  Penneylvania.  Sessions  1874-78.  YoL  ii.  Philadelphia. 
1880. 

Lieeneed  Fatieide,    By  Dr.  N.  F.  (Toou.    Detroit.    1880. 

Sea^ekneee ;  ite  Symptoms^  nature^  ond  TreatwteitL  Bj  &. 
M.  BiABD,  A.M.,  M.i).    Trent,  Nev  York.    1880. 

Zl  DinamicOf  Cfiomale  medico-omioptttieo.    Napoli. 

The  Jlomceopathie  Hxpoeitor,  January,  1880. 

2%tf  Medical  Couneellor. 

The  Homoeopathic  Newe, 

St.  Louie  Clinical  Record. 

The  American  Somcscpath. 

Sevue  JBLomoBopathique  Beige, 

The  Monthly  tiomoeopathic  Bevicio. 

The  Hahnemannian  Monthly, 

The  American  Homceopathic  Oheerver. 

The  United  Statee  Medical  Inveetigator. 

The  North  American  Journal  of  Homoeopathy. 

The  New  England  Medical  Oazette, 

Bl  Oriterio  Medico. 

L'Art  Midieal, 

Bulletin  de  la  SociSti  Mid.  Horn,  de  France. 

Allgemdne  homoopatKieehe  Zeitung 

The  HomcBopathie  World. 

The  Homoeopathic  Timee. 

L^  Homoeopathic  Militante. 

The  Organon. 

The  Medical  Herald. 

The  Medical  Becord.  • 


THB 


BRITISH   JOURNAL 


ov 


HOMGEOPATHY. 


HOMOEOPATHY  IN  RUSSIA. 

The  publication  in  German  of  the  Essay  sent  by  Dr* 
Bojanus^  of  Moscow,  to  the  World's  Convention  at  Phila- 
delphia— when  it  will  be  published  by  our  American  col- 
leagues this  deponent  saith  not— enables  us  to  lay  before 
our  readers  a  short  history  of  the  introduction  and  pro- 
pagation of  homoeopathy  in  Russia^  which  may  prove  of 
interest  to  those  not  afflicted  with  Bussophobia. 

Homoeopathy  was  introduced  into  Russia  by  non-medical 
converts  in  the  year  1823.  Dr.  Adam^  who  had  made  the 
acquaintance  of  Hahnemann,  and  whose  name  is  familiar  to 
us  in  connexion  with  the  proving  of  Carbo  animalis^  about 
that  time  settled  in  St.  Petersburg^  where  homoeopathy  was 
quite  unknown.  Adam  was^  however^  more  devoted  to 
agricultural  than  to  medical  pursuits,  and  contributed  little 
or  nothing  to  the  spread  of  the  new  doctrine.  It  appears^ 
from  a  letter  of  Dr.  Stegemann's,  dated  2nd  February, 
1825,  and  published  in  the  Archiv,  that  he  was  then 
practising  homoeopathy  with  zeal  and  success  in  Dorpat 
(Livonia).  Stegemann,  who  seems  to  have  been  the  pioneer 
of  homoeopathy  in  the  Baltic  provincesj  was  a  Prussian, 
studied  under  Vogt,  Hehn  and  Trechart  in  Jena,  was 
summoned  to  St.  Petersburg  to  attend  to  some  Grand 
Duke,  was  created  State  Councillor,  married  and  settled 
down  in  Dorpat,  was  sent  for  to  Riga  in  1823,  where  he 
cured   a  lady  of  epilepsy  who   had  been   subjected  to  all 

VOL.  XXXVIII,  NO.  CLIV.— OCTOBER,  1880.  U 


306  Hommopathy  in  Russia. 

kinds  of  treatment  without  effect,  whereby  he  converted 
her  husband^  Mr.  C.  Kaule,  who  there  and  then  set  himself 
to  study  medicine^  and  became  a  successful  practitioner  of 
homoeopathy^  but  was  persecuted  by  the  old-school  authori- 
ties in  1831. 

Stegemanuj  who  had  left  Riga,  returned  to  that  town  in 
1833^  then  transferred  himself  to  Dorpat,  where  he  practised 
homoeopathy  for  some  time.  Not  long,  however,  for  he 
died  in  Switzerland  in  1835. 

Professor  Lahmen,  of  Dorpat,  published,  in  1825,  a  Tery 
temperate  pamphlet  on  the  position  of  homoeopathy  in 
relation  to  traditional  medicine. 

In  1827  an  equally  temperate  article  on  homoeopathy 
was  published  by  Dr.  Marcus,  of  Moscow,  in  a  medical 
periodical  published  in  the  Russian  language.  Inconaistently 
enough,  though  Marcus  wrote  so  moderately  about  homoeo- 
pathy, even  admitting  that  medicine  was  under  considerable 
obligations  to  it,  he  afterwards  took  a  decided  part  against 
the  system. 

In  1824  Dr.  Bigel,  of  Strasburg,  was  appointed  physician 
to  the  Grand  Duke  Constantiue  Paulovitch,  and  accom- 
panying him  to  Dresden  he  there  became  acquainted  with 
homoeopathy  and  published  a  work  on  its  dogmas  the 
following  year.  In  1829  he  was  entrusted  by  the  Grand 
Duke  Constantino  with  the  care  of  a  hospital  for  the 
children  of  soldiers  in  Warsaw,  and  he  treated  them 
homoeopathically.  In  1836  he  published  a  domestic  homoeo- 
pathic guide. 

In  the  summer  of  1825  Dr.  Seidlitz,  the  superior  phy- 
sician of  the  St.  Petersburg  Marine  Hospital,  became  ac- 
quainted with  Dr.  Adam,  and  was  so  struck  by  some  cases  he 
witnessed,  that  he  took  up  the  new  system  with  much  zeal. 
But  finding  that  his  syphilitic  patients  did  not  escape 
secondary  symptoms  when  homoeopathically  treated,  he  gave 
up  homoeopathy. 

The  success  of  Dr.  Schering  in  the  homoeopathic  treat- 
ment of  Egyptian  ophthalmia,  that  broke  out  in  the  Cadet 
School  of  St.  Petersburg  in  1825,  was  so  striking  in  com- 
parison with   the  results  obtained   by   allopathy,  that   the 


Homceopathy  in  Russia.  307 

Czar  Nicholas  resolved  to  introduce  the  homoeopathic 
treatment  into  the  army.  But  previous  to  doing  so  he 
resolved  to  have  more  extensive  trials  made  with  it. 

Dr.  Herrmann^  of  Dresden^  came  with  the  Countess 
Ostermann  Polstog^  in  1837,  to  St.  Petersburg.  Here  he 
had  very  brilliant  success  in  an  epidemic  of  dysentery,  and^ 
at  the  request  of  the  Grand  Duke  Michael^  he  went  to 
Tultschin  in  order  to  treat  in  the  hospital  of  the  Imperial 
Guards  patients  suffering  from  fevers  of  various  sorts, 
dysentery,  and  other  acute  disorders.  For  this  he  received 
a  salary  of  12,000  roubles.  The  salary  apparently  excited 
the  envy  and  jealousy  of  the  other  military  doctors,  who 
received  but  700  roubles  for  their  services.  So  they  con- 
trived that  a  number  of  cases  of  incurable  diseases  should 
be  sent  into  the  homoeopathic  department,  though  this  was 
contrary  to  the  intention  of  the  Grand  Duke.  During  the 
three  months  of  Dr.  Herrmann's  service,  he  treated  164 
patients,  of  these  123  were  cured,  18  convalescent  at  the 
end  of  the  trial,  18  remained  ill,  and  6  died.  Of  these  6 
deaths,  2  were  from  phthisis,  1  from  typhus,  1  from 
diarrhoea,  1  from  gangrene,  and  1  from  hypertrophy  of 
spleen  and  liver.  Under  these  untoward  circumstances  the 
trial  of  homoeopathy  was  unfair,  and  the  experiment  was 
considered  to  have  shown  that  homoeopathy  possessed  no 
superiority  over  the  old  system. 

When  Herrmann  returned  to  St.  Petersburg,  by  com- 
mand of  the  Emperor,  he  made  another  trial  of  homoeo- 
pathy in  the  military  hospital, — Dr.  Giegler  conducting  at 
the  same  time  experiments  on  expectant  treatment  in  a 
similar  number  of  beds.  The  experiment  was  carried  on 
for  a  year,  but  long  before  the  expiry  of  that  time,  Giegler 
was  converted  to  homoeopathy,  and  another  doctor  had  to 
be  appointed  to  carry  on  the  expectant  treatment.  The 
official  report  of  the  result  of  this  trial  is  given  by  Dr. 
Seidlitz,  already  mentioned  as  having  coquetted  with  homoeo- 
pathy, but  now  its  bitterest  opponent,  in  a  work  written  by 
him,  in  which  he  employs  the  strongest  language  he  can 
think  of  to  show  his  abhorrence  of  the  system  that  once 
nearly  seduced  him  from  his  allegiance  to  orthodox  physic. 


308  Homeopathy  in  Russia. 

This  report  shows  that  in  five  months  395  patients  were 
treated,  of  whom  341  recovered,  and  23  died,  showing  a 
mortality  of  1  in  15.  At  the  same  time  in  the  other 
departments  of  the  general  hospital,  8188  patients  were 
treated,  of  whom  4203  recovered,  and  435  died,  showing  a 
mortality  of  1  in  10.  The  comparison  is  not  quite  jast, 
as  phthisical  and  dropsical  patients  were  excluded  from  the 
homoeopathic  wards,  among  whom  the  mortality  is  very 
great.  But,  on  the  other  hand,  from  these  wards  vene- 
real diseases,  eye  affections,  and  many  external  maladies 
were  also  excluded,  among  whom  the  mortality  is  little 
or  none.  In  short  the  medical  authorities  reported  un- 
favourably of  the  homoeopathic  trial,  which  a  judicious 
cooking  or  annotating  of  the  figures  made  it  easy  for  them 
to  do,  and  nothing  came  of  this  trial,  which  was  intended 
to  be  of  a  comparative  character,  but  in  which  the  conditions 
necessary  for  a  fair  comparison  could  not  be  maintained. 
The  report  sums  up  with  a  recommendation  that  the  prac- 
tice of  homoeopathy  should  be  forbidden  in  all  land-,  sea-, 
and  civil-hospitals. 

What  else  eould  we  expect  when  a  body  of  avowed  oppo- 
nents to  homoeopathy  was  set  to  report  on  the  comparative 
merits  of  the  allopathic  and  homoeopathic  treatment  ?  He 
must  be  a  bungler  who  would  not  be  able  to  make  the 
worse  appear  the  better  cause,  if  that  worse  was  his  own. 
As  Dr.  Bojanus  says,  ''  The  only  judgment  in  our  power 
upon  this  report  is  to  express  our  wonder  at  the  irony  of 
fate  that  men  who  had  no  idea  of  what  homoeopathy  is,  and 
who  refused  to  inquire  into  it,  should  sit  in  judgment  on  it 
with  the  predetermination  to  condemn  it,  and  thus  become 
the  catchpoles  of  one  who  is,  and  ever  will  be,  a  benefactor 
of  humanity.'' 

Falsified  by  this  condemnatory  report,  an  attempt  was 
made  by  the  allopaths  to  pursue  their  victory  and  inflict  a 
fresh  blow  on  homoeopathy.  For  this  purpose  a  proposal  was 
made  in  the  Council  of  State  to  suppress  the  dispensing  of 
medicines  by  practitioners  ;  but  this  was  counteracted  hj  a 
decree  of  the  Minister  of  Culture,  Prince  L.  N.  Galitzin, 
who  appointed  a  committee   of  three  homoeopathic  practi- 


Homceopathy  in  Russia,  809 

tioners  to  report  on  the  proposal^  which,  of  course,  they 
advised  should  be  rejected,  and  the  issue  was  that  the  central 
homceopathic  laboratory  was  founded  in  St.  Petersburg. 

This  saved  homoeopathy  from  the  destruction  with  which 
it  was  threatened,  but  the  recommendation  of  the  medical 
authorities  not  to  allow  the  practice  of  homoeopathy  in  any 
public  hospital  was  carried  out,  and  is  still  the  law  in  Russia. 

In  1831,  Dr.  Tscherwinzky  treated  in  Schitomir  four 
hundred  cases  of  cholera,  of  whom  only  twelve  died — at  least, 
so  he  says. 

Nothwithstanding  the  success  of  homoeopathy,  not  only 
in  cholera, but  in  other  severe  diseases,  the  medical  authorities 
of  the  old  school  prevailed  upon  the  Czar  Nicholas  to  issue 
a  ukase  in  which  all  medical  boards  were  required  in  case 
of  a  death  under  homoeopathic  treatment  to  make  a  chemical 
analysis  of  the  medicine  given.  In  order  that  they  might 
be  able  to  do  this,  each  practitioner  of  homoeopathy  was 
required  to  give  his  remedies  in  double,  that  the  analysis 
might  be  performed.  The  stupidity  of  the  whole  thing 
seems  not  to  have  struck  any  one,  and  so  this  wonderful 
ukase  became  part  of  the  civil  code. 

Dr.  Bojanus  gives  us  whole  pages  of  the  regulations  and 
articles  adopted  into  the  civil  code  referring  to  the  practice 
of  homoeopathy.  It  is  a  wonder  the  system  was  not 
regulated  out  of  existence  in  Russia.  With  so  many  pains 
and  penalties  threatened  to  those  who  committed  the 
slightest  infraction  of  these  laws,  physicians  and  patients 
must  have  felt,  when  giving  or  taking  homoeopathic  remedies, 
possibilities  of  Siberia,  or  at  least  the  knout  looming  at  them 
in  the  future.  But  doubtless  the  laws  were  but  seldom 
acted  on,  and  gradually  fell  into  contempt.  They  reveal 
the  benevolent  intentions  of  the  dominant  sect  towards  the 
new  candidates  for  patients'  favours. 

One  effect,  however,  the  machinations  of  the  enemy  had, 
that  for  thirty  years  it  was  impossible  to  have  a  homoeo- 
pathic society,  or  to  establish  a  homoeopathic  periodical,  and 
the  greatest  difficulty  was  encountered  in  publishing  any 
work  on  homoeopathy  in  the  Russian  language.  The  will 
of  an  autocrat  like  Nicholas,  who  wished  homoeopathy  to 


310  HanuBopathy  in  Rugria, 

be  introduced  into  the  army,  and  to  establish  a  Chair  of 
Homoeopathy  in  the  medical  school^  was  powerless  against 
the  dogged  opposition  of  the  partisans  of  old  physic. 

When  the  cholera  invaded  Russia  in  1830,  there  was 
already  a  considerable  number  of  practitioners  of  homoeo- 
pathy in  the  Empire;  St.  Petersburg,  Moscow,  Kaluga, 
Koursk,  Tver,  Nischni  Norgorod,  Orenburg,  Kasan,  Sara* 
tow,  TamboT,  Riga,  Tiflis,  Warsaw,  and  many  other  towns, 
had  their  homoeopathic  practitioners.  Dr.  Bojanus  gives 
us  the  names  of  these  practitioners,  but,  with  the  exception 
of  Brutser  of  Riga,  and  Bigel  of  Warsaw,  we  confess  we 
never  heard  of  any  of  them.  A  better  known  name  in 
connection  with  homoeopathy  is  that  of  a  layman.  Count 
Ssemen  Nikolojewitsch  Korsakoff,  to  whose  perverted 
ingenuity  we  owe  the  introduction  into  homoeopathic  practice 
of  the  hiffh'potencies,  which  have  taken  such  a  surprising 
development  of  late,  and  which  have  done  so  much  to  render 
our  system  ridiculous  in  the  eyes  of  adversaries.  He  was  not 
the  only  Russian  layman  who  took  an  active  part  in  the 
spread  of  homoeopathy.  Admiral  Count  Mordwinoff  showed 
his  homoeopathic  zeal  and  knowledge  by  contributing  in  1831 
an  article  on  homoeopathy  to  the  Jrchw.  It  is  in  French, 
and  bears  on  the  subject  of  small  doses. 

Korsakoff  we  know  stood  very  high  in  Hahnemann's 
esteem.  The  following  letter  from  Hahnemann,  fonnd 
among  his  papers,  seems  to  show  that  besides  being  the 
actual  author  of  the  high-potency  mania,  he  gave  Hahne- 
mann the  hint  for  administering  remedies  by  olfaction, 
which  at  one  time  was  in  great  favour  with  the  master. 

**  I  admire  the  zeal  with  which  yon  devote  yourself  to 
the  beneficent  homoeopathic  art^  not  only  in  order  to  give 
yonr  aid  to  your  own  family  and  to  your  neighbours,  but 
also  in  order  to  penetrate  into  the  secrets  of  nature,  which 
your  valuable  notes  show  you  are  doing.  I  am  pleased 
with  the  happy  idea,  contained  in  one  of  those  given  to  my 
nephew,  to  fix  on  the  suitable  medicine  by  olfaction.  I  have 
seen  a  corroboration  of  this.  With  all  my  powers  I  seek  to 
discover  above  all  what  will  benefit  my  neighbour  and  do 
good  to  mankind.     T  consider  this  to  be  the  best  thing  for 


Homoeopathy  in  Russia.  311 

a  mortal  to  do  in  this  short  life^  and  believe  that  you 
think  so  too.  Continue  the  activity  that  is  gratifying  to 
the  sensitive  heart,  and  I  beg  you  to  think  well  of  yours 
truly,  S.  Hahnemann.'^ 

The  number  of  Korsakoff's  contributions  to  homoeopathic 
literature  is  considerable.  The  Archiv  contains  a  good 
many. 

Alexander  Peterson  was  another  unqualified  person  (he 
was  an  apothecary,  which  corresponds  to  our  chemist  and 
druggist,  not  to  a  L.S.A.),  who  did  a  good  deal  in  the  way 
of  propagating  homoeopathy  in  Russia.  He  treated  many 
patients  and  contributed  several  papers  to  StapPs  Archiv. 

A  good  deal  of  desultory  homoeopathic  treatment  seems 
to  have  prevailed  in  Russia  at  the  period  of  the  invasion  of 
cholera  in  1830-1 ;  some  of  it  a  little  queer,  such  as  that 
of  Dr.  Seuber,  of  Wischni  Wolotschok,  who  says  that  he 
treated  209  cholera  cases,  93  of  these  would  not  have 
homoeopathic  treatment,  so  he  had  to  treat  them  allopathi- 
cally,  of  these  69  died,  whereas  of  the  116  whom  he  treated 
homoeopathically,  he  only  lost  23. 

Admiral  Mordwinoff  collected  all  the  statistics  he  was 
enabled  to  procure  of  the  homoeopathic  treatment  of  cholera 
jn  Russia,  and  gives  them  in  a  table.  The  grand  total  is 
1273  cases,  1162  recoveries,  and  111  deaths,  a  mortality  of 
under  8  per  cent.  Of  course  these  statistics  n^ake  no  pre- 
tension to  exactitude,  and  most  likely  included  many  slight 
cases  that  the  practitioner  imagined  might  have  become 
severe  had  he  not  interfered  promptly  with  his  remedies. 

About  1831,  M.  Wratzky,  a  nobleman,  completed  a 
translation  of  the  Organon  into  Russian. 

The  results  of  the  homoeopathic  treatment  of  cholera  being 
widely  published,  gave  a  fresh  impulse  to  the  spread  of  the 
new  system  in  Russia. 

From  1841  to  1844,  Dr.  Ooldenberg  was  accorded  a 
division  of  the  Catherine  Hospital  in  Moscow,  during  which 
period  he  treated  homoeopathically  1274  patients^  with  an 
average  mortality  of  6  per  cent. 

In  Babai  (Charkow),  General  Schtscherbinin  founded  a 
homoeopathic  hospital,  of  which  Dr.   Grurtfocund   was  the 


312  Homceopathy  in  Russia. 

physician  in  1842-8,  during  which  time  he  treated  1048 
patients  with  a  mortality  of  less  than  6  per  cent.  The 
further  history  of  this  hospital  is  not  known. 

Prince  Leonidas  Galitsin  instituted  a  hospital  for  homoeo- 
pathic treatment,  which  remained  till  1860  under  the  care 
of  Dr.  Schweikert,  and  was  then  shut  up  owing  to  the  death 
of  its  patron.  No  information  has  been  published  respect- 
ing the  results  of  the  treatment  beyond  a  notice  in  the 
Hygea  from  Dr.  Johannseu  that  both  allopathic  and 
homoeopathic  treatment  was  pursued  in  it,  which  was  denied 
by  Dr.  Schweikert* 

A  homoeopathic  hospital  for  the  labouring  classes  was 
founded  in  St.  Petersburg  in  1848,  but  nothing  is  known 
about  it. 

Dr.  Dahl,  an  army  surgeon,  was  converted  to  homoeo- 
pathy by  witnessing  the  good  effects  of  homoeopathic  treat- 
ment in  the  cure  of  a  relative.  He  became  a  zealous 
convert*  When  he  retired  from  the  army,  being  appointed 
chief  of  the  Chancellery  of  the  Home  Minister,  he  per- 
suaded the  minister  to  devote  a  portion  of  the  large 
hospital  for  working  women  to  a  comparative  trial  of  the  old 
and  new  systems.  One  hundred  beds  were  accordingly  put 
under  the  care  of  the  homoeopathic  practitioner.  Dr.  Staider, 
and  an  equal  number  under  that  of  an  allopathic  practi- 
tioner, patients  being  sent  to  one  or  other  division  alter- 
nately without  selection.  The  trial  lasted  eight  years,  from 
1847  to  1855,  and  the  following  were  the  grand  results 
obtained : 

Homaopaikie  Dwiiiam.  Attopaikie  Dkrision. 

Pfttientf  admitted,  6900.  Patients  admitted,  2782. 

„        ieooTered,6144.  „        recovered,  2886. 

»        died,           766.  „        died,           413. 

Mortality- 12-81%.  MortaUty  «=  14-80%. 

Average  period   in    hospital,  24|  Average   period  in  hos|ntal,  27| 

days.  days. 

Cost  of  medicines  for  the  8  years.  Cost  of  medicines  for  8  years,  5600 

960  roubles.    The  shorter  duration  roubles, 
of  the  treatment  makes  a  saving  of 
18,225  meals,  or  1298  roubles  at  the 
prices  of  the  period. 


Homceopathy  in  Russia.  813 

Though  the  number  of  beds  was  alike,  it  will  be  observed 
that  more  than  twice  the  number  of  patients  were  treated 
in  the  homoeopathic  than  in  the  allopathic  wards.  After 
DahFs  resignation  of  his  office  on  the  death  of  his  chief, 
the  homoeopathic  department  was  cold-shouldered  out  of 
existence,  things  being  made  so  disagreeable  for  Dr. 
Steuder  that  he  resigned,  the  beds  that  had  given  such  good 
results  were  quietly  relegated  to  the  old  treatment.  It 
would  seem  that  the  most  brilliant  contrast  offered  to  the 
view  of  all  by  the  homoeopathic  treatment  is  powerless  to 
move  the  tradition-trammelled  mind  to  regard  the  new 
system  with  aught  but  loathing. 

A  sort  of  excrescence  or  degeneration  of  homoeopathy 
created  in  Russia  a  certain  amount  of  interest  about  this 
period.  This  was  the  so-called  atomistic  method  of  treat- 
ment' invented  by  Dr.  Mandt.  Mandt  was  not  exactly  a 
quack,  though  his  proceedings  cannot  be  altogether  approved 
of.  He  was  physician  to  the  Emperor  Nicholas,  and 
filled  that  post  from  1836  until  the  death  of  the  Czar  in 
1853.  He  was  also  a  professor  of  clinical  medicine,  a 
diagnostician  of  reputation,  and  a  man  of  considerable  intel- 
lectual powers  and  scientific  attainments.  He  contended 
that  the  mucous  membranes  were  the  chief  source  of  all 
diseases,  and  he  classified  all  medicines  according  to  their 
action  on  these  membranes,  without,  of  course,  indicating 
the  source  whence  he  derived  his  knowledge  of  their  action 
—for  he  dared  not,  of  course,  mention  the  word  homoeo- 
pathy without  imminent  risk  of  losing  his  exalted  position. 

I.  Drugs  that  act  on  the  vegetative  life.  To  these 
belong : 

a.  Those  that  act  peculiarly  on  the  mucous  membranes : 
Nux  vom.,  Carduus  maricB,  Natr,  nitr.,  Bell. 

b.  Those  that  have  a  destructive  action  on  the  processes 
of  assimilation  :  Ars.,  lod,,  Sulph.,  Calc.  mur.,  Carbo^  Ferr. 

c.  Those  corresponding  to  the  circulation :  Camph,, 
Mosch,,  Aeon.,  China,  Dig.,  Am. 

II.  Drugs  that  act  on  the  animal  life. 

a.  Those  corresponding  to  a  state  of  exaltation  of  the 
nervous  system :  Cupr.,  Zinc.,  BJius. 


31 1  Homoeopathy  in  Russia, 

b.  Those  corresponding  to  a  state  of  depression  of  the 
nervous  system  :  Hyos.^  Opium, 

III.  Specific  remedies :  on  the  mucous  membrane  of  the 
duodenum,  Phos.;  on  that  of  the  colon,  Bry.;  on  the  ulcera- 
tive process  of  the  bowels,  Jlrg.  nii. ;  on  the  degenerative 
process,  Merc.  corr.  He  gives  a  list  of  the  several  medi- 
cines with  their  indications,  and  describes  his  mode  of 
prescribing.  He  generally  gives  two  medicines  in  oombi-* 
nation,  and  one  of  them  is  always  Nux  vomica,  whidi  seems 
to  be  his  panacea.  Thus,  he  gives  Nwe  vom.  in  combina- 
tion with  Aeon,,  Bell.,  Bry,,  Dig*^  Cup,,  dm*,  or  some  other 
drug.  In  some  cases  he  advises  the  application  of  one  or 
two  leeches,  and  does  not  eidnde  ointments^  especially 
sine  ointment. 

Of  course  the  source  of  Mandfs  so-called  atomistic 
method  is  easily  recognised,  and  so  enamoured  was  the 
Csar  of  it  that  he  caused  Mandt's  book — ^written  in  German 
— ^to  be  translated  into  Russian,  and  a  copy  sent  to  all 
medical  officers  of  hospitals  with  a  recommendation  to 
employ  Mandt's  method;  which  shows  how  much  this 
powerful  Czar  miscalculated  his  own  power. 

With  the  death  of  Nicholas  Mandt's  star  set.  He  was 
even  accused  of  having  killed  his  golden  goose  without  the 
pretence  of  justification  which  iSsop^s  goose-slayer  would 
allege.  He  had  to  make  tracks  out  of  St.  Petersburg  as 
fast  as  he  could.  He  went  to  Berlin,  and  there  published 
a  vindication  of  his  treatment  of  the  Czar. 

An  incident,  rich  in  the  elements  of  comedy,  occurred  in 
connexion  with  homoeopathy  in  Russia  in  1836.  In  the 
German  St,  Petersburger  Zeitung,  No.  32,  there  appeared  an 
article  signed  by  our  old  friend  Seidlitz  and  a  Dr.  Weisse, 
announcing  that  the  St.  Petersburg  Society  of  Corresponding 
Physicians — whose  secretary  Seidlitz  was — ^proposed  to  give 
a  prize  of  fifty  Dutch  ducats  for  an  essay.  The  announce^ 
ment  was  as  follows : 

*'  The  St.  Petersburg  Society  of  Correapouding  Physicians, 
starting  from  the  conviction  that  all  cases  of  disease  treated 
homoeopathically  are  only  examples  of  the  natural  course  of 
morbid  conditions  in  the  organism,  such  aa  rational  physi- 


HomcBopathy  in  Russia.  315 

cians   can  rarely  see^  and  that   only  when   they  purposely 
abstain  from  treatment^  wishes : 

'^  That  the  histories  of  cases  of  disease  contained  in  the 
whole  homoeopathic  literature  should  be  reviewed^  critically 
elucidated^  and  arranged^  so  that  the  course  of  development 
of  whole  classes  and  genera  of  diseases^  as  also  of  particular 
diseases^  should  be  exhibited  in  the  clearest  possible  way ; 
the  result  of  these  researches  must  be  compared  with  the 
normal  development  of  disease  in  the  Hippocratic  sense. 
At  the  same  time  the  phenomena  which  usually  precede 
the  favourable  as  well  as  the  unfavourable  termination  of 
diseases  treated  homoeopathically,  as  also  the  metaschema- 
tisms  of  morbid  a£Fections  are  to  be  prominently  exhibited/' 

At  the  same  time  all  polemics  against  homoeopathy  as  a 
system,  and  against  homoeopathic  practitioners,  were  to  be 
avoided,  and  the  prize  was  to  be  awarded  to  the  essay  which 
should  most  fulfil  the  expectations  of  the  Society. 

The  unconscious  humour  of  this  offer  does  not  seem  to 
have  struck  its  authors.  It  reminds  us  of  one  of  our  old 
Edinburgh  professors  who,  at  his  monthly  examination  of 
his  class,  asked  one  of  his  auditors  '*  What  is  the  treatment 
of  organic  disease  of  the  heart  t"  To  which  the  student 
replying  "  I  consider  all  treatment  in  organic  disease  of  the 
heart  equally  futile ;''  the  enraged  professor  replied,  ^'I 
don't  want  you  to  tell  me  what  you  think,  sir,  but  what  I 
think." 

Though  the  allopaths  did  not  see  the  comical  absurdity 
of  this  offer,  it  was  immediately  detected  by  their  homoeo- 
pathic  colleagues,  and  a  good  deal  of  ridicule  was  thrown 
upon  it.  £ven  some  allopathic  writers,  especially  the  editor 
of  Schmidt's  Jahrbucher  (vol.  xxix,  p.  264),  observed  that 
it  was  so  palpably  unscientifie  that  it  was  undeserving  of 
notice.  Dr.  Erutzer,  of  Riga,  well  known  in  homoeopathic 
literature,  soon  afterwards  offered  a  prize  of  100  Dutch 
ducats  for  an  essay  that  should  give  a  fair  and  scientific 
statement  and  elucidation  of  the  cases  of  disease  published 
in  homoeopathic  works,  and  draw  logical  inferences  from 
them^  even  should  these,  far  from  fulfilling  the  expectations 
of  the  society,  go  directly  counter  to  them. 


316  HonuBopaihy  in  Russia. 

Brutzer  appointed  a  committee  of  fi^e  foremost  members 
of  the  medical  faculty  to  award  the  prize^  and  he  named 
two  years  as  the  time  within  which  competing  essays  might 
be  sent  in — ^the  time  of  the  allopathic  society  being  only  one 
year.  He  advertised  bis  offer  in  namerous  Russian  and 
other  papers. 

Only  one  essay  was  sent  in  to  compete  for  the  allopathic 
prize.  It  was  decided  as  having  best  come  up  to  the 
society's  expectations^  which  it  could  hardly  have  failed  to 
do,  as  it  had  no  rivals.  The  author.  Dr.  Simaon,  of 
BreslaUi  on  receiving  the  fifty  ducats  handed  them  over  as  a 
donation  for  some  poor  Russian  people  who  had  suffered  by 
a  conflagration,  remarking  that  homoeopathy  would  thus 
prove  useful,  though  indirectly,  to  some  people.  Though 
Dr.  Simson's  essay  was  deemed  worthy  of  the  prize,  the 
Allopathic  Society  did  not  publish  it  in  order  to  allow  others 
to  judge  of  its  merits.  Omne  ignotum'pro  maffnifico,  they 
doubtless  thought. 

An  essay  was  sent  in  for  Dr.  Brutzer's  prize  with  the 
motto  **  Est  modus  in  rebus,  &c.,''  but  which  the  committee 
considered  had  not  completely  fulfilled  the  conditions  laid 
down  by  the  prize  giver,  and  consequently  the  prize  was  not 
awarded  to  the  essayist.  But  eight  months  after  the  last 
day  for  sending  in  competing  essays  had  elapsed,  another 
essay  was  sent  in  for  Dr.  Brutzer's  prize,  with  the  very 
appropriate  motto  '^  Justice  for  Ireland,^'  and  this  was  con* 
sidered,  though  not  quite  fulfilling  Dr.  Brutzer's  conditions, 
as  deserving  a  prize,  and  the  judges  awarded  it  half  of  the 
prize  offered.  The  author  proved  to  be  Dr.  Heubel,  of 
Wulk  (Lithuania).  Dr.  Brutzer  pledged  himself  to  publish 
the  essay  as  soon  as  possible,  but  this  was  never  done,  at  the 
author's  request,  it  would  appear.  The  author  of  the  unsuc- 
cessful essay,  who  proved  to  be  Dr.  CrouUon,  Senior,  of 
Weimar,  was  not  quite  pleased  with  this  arrangement,  and 
wrote  that  Brutzer,  when  he  sent  back  his  essay  to  him, 
remarked  that  he  wondered  any  one  could  take  his  offer  in 
earnest,  as  it  was  only  intended  as  a  demonstration  against 
the  offer  of  the  Allopathic  Society.  On  this  Dr.  Heubel,  the 
author  of  the  essay  with  the  '^  Justice  for  Ireland  '*  motto, 


Homwopathy  in  Russia.  817 

wrote  that  he  had  actually  got  the  fifty  ducats  paid  him,  so 
that  Brutzer's  offer  of  prize  was  a  reality  and  no  joke  at  all. 

Brutzer  is  the  author  of  a  learned  work,  published  at 
Riga,  in  1838^  entitled  Attempt  at  a  scientific  foundation  of 
the  Homceopathic  principle,  which  is  a  very  sensible  and 
well- written  production,  and  was  intended  to  be  the  intro- 
ductory chapter  of  a  complete  Manual  of  Hommopatky^ 
which,  however,  has  never,  as  far  as  we  know^  been  pub- 
lished. Things  seem  only  to  get  half  done  in  Russia; 
hospitals  commenced  with  enthusiasm  are  shut  up  after  a 
year  or  two ;  homoeopathy  develops  in  the  hands  of  a  Mandt 
into  a  sort  of  half-breed  between  the  two  systems ;  books 
are  begun  but  never  finished,  and  the  chimsera  of  high 
potencies  which  haunts  us  in  more  western  countries  origi- 
nates in  the  half-cracked  brain  of  a  Russian  nobleman. 

Seidlitz  was  assailed  with  letters  from  old  friends  and 
colleagues  showing  the  advantages  of  homoeopathic  treat- 
ment, and  trying  to  convert  him.  He  published  the  letters 
with  his  replies,  thinking  the  latter  probably  much  better 
than  the  former.  His  correspondents  might  have  spared 
themselves  the  trouble  of  trying  to  convert  the  secretary  of 
the  Allopathic  Society,  his  very  name^  suggestive  of  a 
hydragogue  cathartic^  might  have  convinced  them  that  the 
tadk  was  hopeless. 

A  very  pretentious  work  in  three  volumes^  professing  to 
be  a  thorough  examination  of  the  homoeopathic  doctrines, 
was  published  about  this  time,  the  author  being  one 
Wolsky.  His  ideas  of  what  homoeopathy  is  may  be  learned 
from  one  or  two  extracts. 

'^  When  a  patient  vomits  from  thirty  to  forty  times  in  an 
hour,  and  is  thereby  in  great  danger,  according  to  the 
principle  of  homoeopathy  a  remedy  must  be  given  him  which 
causes  a  similar  disease,  t.e.  vomiting  thirty  or  forty  times 
in  an  hour,  in  order  that  he  should  be  cured  homoeopathi- 
cally  dto,  tuto  et  jucunde.  He  dies  of  course  during  the 
action  of  the  remedy.'' 

"  In  order  to  cure  a  patient  suffering  from  a  mania  for 
infanticide^  who  has  already  killed  two  of  his  five  children, 
a  remedy  must  be  given  which  produces  in  him  a  similar 


318  Homceopathy  in  Russia. 

disease,  so  that  in  order  to  recover  cito,  tuio  tt  jucunde^ 
according  to  homoeopathic  rules,  he  must  murder  two  more^ 
or  still  better,  all  three  of  his  remaining  children.'' 

This  stuff  would  hardly  be  worth  mentioning  were  it  not 
that  the  allopathic  journals  of  Russia  were  unanimous  in 
their  laudations  of  it,  and  professed  to  consider  it  as  a  fine 
statement  and  a  complete  refutation  of  homoeopathy. 

Dr.  Bojanus  gives  a  long  list  of  works  on  homoeopathy 
published  in  Russia,  extending  from  1834  to  1875,  which 
shows  that  the  laudators  of  Wolsky's  tract  might  have  ea»ly 
acquired  a  knowledge  of  what  homceopathy  is  had  they 
so  wished.  Almost  all  these  works,  it  should  be  observed, 
are  translations  or  reprints  of  works  that  have  appeared  in 
other  parts  of  the  world  ;  the  original  literary  activity  of  the 
Russian  homoeopaths  does  not  seem  to  have  been  very  great. 
Another  thing  remarkable  in  this  list  is  the  number  of  works 
that  are  published  at  the  residences  of  the  editors  or  transla- 
tors, as  if  the  difficulties  of  getting  recognised  publishers  to 
publish  the  works  had  been  insuperable,  as  no  doubt  in  many 
instances  they  were. 

Another  outbreak  of  cholera  occurred  in  1848-9,  in  which 
the  homoeopathic  treatment  showed  superior  results. 

A  homoeopathic  hospital  containing  twenty-two  beds  for 
the  peasants  of  the  imperial  estates  was  established  in 
Nishni  Novgorod,  at  first  under  the  direction  of  an  Englisk 
layman,  a  certain  Edward  Stmbing,  later  under  that  of  Dr. 
Schruber,  who  retained  the  post  from  1853  to  1863^  during 
which  period  the  number  of  the  beds  was  increased  from 
twenty-two  to  forty.  After  Schruber's  departure  to  Moscow 
the  hospital  was  discontinued  from  want  of  a  homoeopathic 
practitioner. 

In  1856  an  attempt  was  made  by  Dr.  Deriker  to  obtain 
permission  to  found  a  homoeopathic  society,  but  the  permis- 
sion was  not  granted  by  the  authorities.  As  a  preliminary 
condition  the  homoeopaths  were  required  to  prove  the  effica- 
cacy  and  advantage  of  homoeopathy  to  a  committee  of  allo- 
pathic doctors  of  the  stamp  of  Seidlitz,  Wolsky,  and  Co., 
with  what  result  might  be  easily  foretold. 

Though  unable  to  get  leave  to  form  a  society,  permission 


HomcBopathy  in  Rusria,  319 

was  obtained  to  publish  a  periodical  in  the  German  lan- 
guage, which,  under  the  title  of  Journal  der  Homoopathischen 
Heilkunde  was  issued  regularly  for  three  years  (1861-63),  but 
then  died  for  lack  of  subscribers. 

Though  the  formation  of  a  homoeopathic  society  was 
prevented  by  the  impossible  conditions  imposed  by  the 
authorities,  the  publication  of  a  homceopathic  periodical  seems 
to  have  suggested  to  the  allopaths  to  publish  the  conditions 
under  which  they  proposed  to  allow  a  society  to  be  insti- 
tuted. 

*  These  consisted  of  a  great  number  of  questions,  which, 
unless  they  were  answered  to  the  satisfaction  of  the  domi- 
nant medical  authorities,  the  latter  could  not  allow  the  for- 
mation of  a  homoeopathic  society.  A  few  specimens  will 
sufiSce. 

'^  How  does  homoeopathy  produce  dilatation  of  the  pupil 
with  a  view  to  operation  or  inspection  of  the  eye  ?  " 

"  What  sure  solvent  of  biliary  and  urinary  calculi  does 
homoeopathy  possess  ?  " 

''  How  does  homoeopathy  expel  intestinal  worms  ?  ^'  &c. 

These  questions  were  purposely  framed^  as  is  evident,  in 
order  that  the  answers  should  be  unsatisfactory  to  the 
hostile  judges. 

Replies  of  the  most  complete  character  were  made  by  the 
homoeopaths  to  this  absurd  demand.  Deriker  himself  gave 
a  most  complete  answer  in  the  newly-established  homoeo- 
pathic periodical,  in  which  he  showed  the  animus  of  the 
whole  business,  and  exposed  the  ignorance  that  marked 
their  definition  of  homoeopathy,  and  the  insincerity  of  the 
whole  proceeding.  In  this  answer.  Dr.  Deriker  completely 
turns  the  tables  on  his  opponents,  convicting  them  not  only  of 
ignorance  respecting  homoeopathy,  but  of  wilful  mistatements 
and  false  assumptions  respecting  their  own  allopathic 
system.  On  the  whole,  the  publication  of  their  elaborate 
Programme  did  more  harm  than  good  to  the  cause  of 
old-school  physic. 

The  progress  made  by  homoeopathy  in  Russia  from  the 
period  of  the  second  outbreak  of  cholera  until  now  has  been 
very  steady,  and  the  number  of  its  practitioners  has  greatly 


820  Hommopathy  in  Russia. 

increased  in  all  parts  of  the  empire.     lu  Poland  particalarly 
the  increase  has  been  very  considerable,  and  in   Warsaw, 
unlike  many  other  places,  the  practitioners  of    the  two 
schools  are  generally  on  very  friendly  terms.     In   1867  a 
ward  was  granted  to  Dr.  Wenjawsky  in  the  clinical  hospital 
of  the  Faculty,  where  the   patients  were  treated  hom(Bo« 
pathically,  and    the    results  were  so    favourable    that  the 
hospital  administration  were  disposed  to  increase  the  number 
of  the  beds  in  the  homoeopathic  department.     But  several 
cases   that  were    dismissed  incurable   from  the  allopathic 
wards  having  been  cured  in  the  homoeopathic  department, 
and  the  results  being  published,  the  authorities  suddenly 
discovered  that  the  ward  hitherto  devoted  to  homoeopathic 
treatment  was  required  for  vivisection  purposes,  and  Dr. 
Wenjawsky  was  ejected,  and  the  friendly   feeling  of   the 
old  school  towards  the  new  was  abruptly  terminated. 

In  1869  permission  was  at  length  accorded  for  the  for- 
mation of  a  homoeopathic  society,  which  immediately  set 
about  the  establishment  of  a  dispensary  by  subscription. 
In  1870  the  number  of  members  amounted  to  128.  Since 
then  the  number  of  members  has  greatly  increased.  It  has 
now  218. 

In  1872  Dr.  Von  Grauvogl  was  invited  by  the  Governor 
of  Finland  to  give  lectures  on  homoeopathy  at  Helsingfors, 
which  he  did,  and  had  a  good  audience,  among  them  two 
military  doctors  of  high  rank,  and  the  chief  of  the  medical 
Faculty  of  the  University.  By  command  of  the  Emperor 
two  wards  in  the  military  hospital  were  confided  to  him  vrith 
an  honorarium  of  4000  roubles.  The  hospital  work  was 
carried  on  for  seven  months,  but  during  all  that  period  not 
a  single  acute  case  was  sent  in,  they  were  all  serious 
chronic  diseases,  many  incurable.  The  results  obtained 
under  such  conditions  were  of  course  not  very  brilliant. 
Dr.  Yon  Grauvogl  did  not  find  his  sojourn  in  Finland  very 
agreeable,  for  all  the  time  he  was  there  the  most  violent 
personal  attacks  were  made  on  him  in  the  public  papers. 
The  intrigues  of  the  allopathic  physicians  at  length  procured 
his  departure  from  Helsingfors,  but  the  Czar  accorded  him  a 
decoration. 


Case  of  Ascites  and  Anasarca.  821 

St.  Peteraburg  has  at  present  seventeen  homoeopathic  prac- 
titioners^ and  three  veterinary  surgeons.  Moscow  has  seven 
homoeopathic  practitioners.  Riga  has  4^  and  in  addition  the 
very  pngnacious  lay  homoeopath  V.  Von  Gruczewsky.  Many 
other  towns  less  known  to  the  English  have  each  their 
homoeopathic  practitioner^  and  no  doubt  if  medical  practice 
were  freer^  Russia  would  soon  have  many  more  partisans 
of  Hahnemann's  doctrine. 


CASE  OP  ASCITES    AND  ANASARCA. 

By  Dr.  D&tsoale. 

A  MAN  of  32  was  seen  first  on  the  28th  December^  1879. 
He  reported  that  for  some  months  his  habits  had  been 
irregular  and  intemperate,  and  that  in  October  he  had  con- 
sulted a  doctor  for  **  wind  and  indigestion/'  with  constipa- 
tion, bad  appetite^  and  fulness  after  meals,  especially  after 
soups.  In  November  his  abdomen  began  to  swell,  and  a 
fortnight  afterwards  the  feet  and  legs  also.  The  swelling 
increased,  and  in  the  beginning  of  December  a  cough  and 
difficult  breathing  came  on.  He  had  been  treated  with 
Spiriius  Mindereri,  Cardamoms  and  Gentian;  Castor  oil, 
Oil  of  Ruta  and  Terebinth;  Bromide  of  Potassium  and 
Chloral  hydrate ;  Pills  of  Elaterium,  Jahpin^  Aloin,  and 
Podophyllum,  all  combined ;  Bromhydric  acid  and  Syrup  of 
Tolu.  Notwithstanding,  the  disease  continued  to  increase, 
and  on  the  24th  December  he  weighed  at  the  Turkish  bath 
15  stone  7  pounds,  and  his  girth  round  the  waist  on  the 
28th  was  forty-three  inches.  The  chief  symptoms  on  the 
28th  were :  oedematous  swelling  of  the  feet  and  legs,  and 
at  times  of  the  thighs  and  scrotum  ;  distension  and  fluctua- 
tion in  the  abdomen  ;  the  physical  signs  of  the  liver  cannot 
be  made  out,  owing  to  the  distension ;  no  appetite,  much 
thirst ;  tongue  flabby  and  furred ;  urine  scanty  and  turbid, 
not  albuminous ;  pulse  rapid  and  small,  no  organic  disease 

VOL.   XZXVIII,  NO.  CLIV. OCTOBER,  1880.  X 


322  Can  of  Ascites  and  Anasarca, 

of  the  beart ;  two  or  tbree  loose  stools  daily  ;  great  general 
debility.  In  addition  to  these  symptoms  there  was  frequent 
cough,  dry  and  choking  in  paroxysms,  on  slight  changes  of 
temperature ;  dyspnoea  in  walking,  especially  on  the  least 
ascent ;  can  only  lie  on  the  right  side ;  serous  effusion  in  the 
right  pleura,  up  to  one  inch  above  the  nipple,  in  the  sitting 
posture.  Considering  the  want  of  appetite,  the  thirst,  and 
the  probable  state  of  the  mucous  membrane  of  the  stomach 
and  of  the  liver,  induced  by  irregular  living  and  excess  of 
alcohol,  in  which  the  skim-milk  diet  is  often  so  beneficial,  I 
put  him  at  once  on  that  plan  of  diet,  giving  no  food  at  all  except 
skim  milk,  beginning  with  three  and  gradually  increasing  to 
six  pints  in  the  twenty-four  hours.  At  the  same  time,  as 
the  cough  and  pleuritic  exudation  were  the  more  immediate 
indications  for  medicine,  Bryonia  and  Cantharis  were  given 
in  alternation  every  three  hours  in  the  dose  of  one  drop  of 
the  first  decimal  dilution.  On  the  2nd  of  January,  1880, 
he  complained,  in  addition,  of  pain  in  the  right  hypo- 
chondrium  and  diarrhosa  of  dark  loose  stools.  One  dose 
of  Leptandrin  in  the  first  decimal  trituration  was  inter- 
posed daily,  and  Bryonia  and  Cantharis  and  the  pure  skim- 
milk  diet  continued  till  the  10th  of  January,  when  he  had 
gradually  improved  as  regards  the  cough  and  dyspnoea ;  the 
cough  was  nearly  gone,  and  the  effusion  in  the  chest  for  the 
most  part  absorbed,  but  the  girth  round  the  waist  had 
increased  to  forty-four  inches ;  the  urine  was  rather  copious 
and  the  stools  were  loose,  but  now  pale  coloured.  He  now 
got  two  drops  of  the  pure  Tincture  of  Chelidonium  four 
times,  and  one  dose  of  the  first  trituration  of  Aurum 
muriaiicum  twice,  each  day  of  twenty-four  hours.  This 
was  continued  till  the  24th  January,  when  he  felt  better, 
but  with  much  hunger  and  sinking  and  craving  for  solid 
food,  so  he  was  allowed  to  have  one  solid  meal  a  day,  and 
the  rest  of  his  diet  skim-milk,  in  proportionate  quantity. 
The  general  feelings  were  improved  and  the  bowels  were 
moved  twice  a  day,  soft,  but  of  natural  colour ;  the  urine 
was  copious,  but  the  girth  of  the  abdomen  had  increased  to 
fortv-five  inches.  The  Aurum  was  continued  twice  a  dav, 
aud  instead  of  Chelidonium^  Apocynum  carmabinum,  in  the 


by  Dr.  Drysdale.  823 

dose  of  one  drop  of  the  pure  tincture^  was  given  four  times 
a  day. 

On  the  7th  of  February  an  improvement  had  taken  place 
in  all  respects ;  the  urine  exceeded  the  milk  drunk  by  half  a 
pint,  and  the  abdomen  measured  one  inch  and  a  half  less 
than  last  time^  and  perspirations  had  come  on  at  night.  The 
swelling  of  the  legs  and  feet  had  varied  all  the  time,  and 
was  now  decidedly  less.  He  feels  altogether  better  and 
walks  out  a  little  in  the  open  air.  Continue  Aurum  and 
Apocynum  as  before. 

On  the  14th  of  February,  girth  forty-one  inches ;  urine 
very  copious,  much  more  than  milk  drunk.  Legs  and  feet 
natural  in  size,  and  health  and  strength  improved ;  has 
taken  a  glass  of  beer  with  his  one  solid  meal.  Continue 
medicine. 

On  the  21st  of  February,  girth  thirty-eight  and  a  half 
inches  ;  urine  two  or  three  quarts ;  gaining  strength,  though 
still  can  only  walk  a  short  distance.  Two  rather  loose  but 
otherwise  natural  stools.  Continue  one  solid  meal  with 
one  glass  of  beer,  and  the  rest  of  his  diet  skim  milk,  as 
before,  also  the  same  medicines.  The  same  system  was 
continued  until  the  6th  of  March,  when  the  girth  was  thirty- 
four  and  a  half  inches,  though  fluctuation  still  perceptible. 
He  can  walk  three  miles,  and  lie  fiat  and  sleep  in  any 
position ;  no  remains  of  anasarca  anywhere.  Weight  10 
stone  10  pounds.  Is  getting  tired  of  the  skim  milk,  so  to 
have  two  solid  meals  a  day,  and  three  doses  of  Apocynum 
and  one  dose  of  Aurum  daily. 

On  the  13th  of  March  the  girth  was  thirty-three  inches, 
and  no  fluctuation  to  be  detected.  He  feels  in  all  respects 
quite  well,  and  was  ordered  common  diet  and  no  more 
medicine.  He  has  been  seen  several  times  since  and 
remains  quite  well. 

Remarks. — It  is  in  general  difficult  to  apportion  the  due 
share  of  benefit  to  difierent  therapeutic  expedients  which  we 
may  have  to  use  simultaneously  or  in  succession.  But  in 
this  case  it  would  appear  that  the  skim-milk  diet  can  hardly 
have  been  the  all-sufiicient  cause  of  the  removal  of  the 
dropsy,   for,  however  beneficial   it   may  have  been  as  an 


824  Triturations. 

auxiliary  in  improving  the  state  of  the  atomach  and  liver, 
there  was  no  diminution^  but^  on  the  contrary,  an  actual 
increase  of  the  ascites  during  the  four  weeks  that  the  diet 
consisted  solely  of  skim  milk.  The  diminution  of  the 
ascites  did  not  begin  till  a  daily  solid  meal  had  been  taken 
some  time  and  certain  medicines  given.  The  action  of  the 
Apocynum  here  may  be  fairly  claimed  as  homoeopathic, 
acting  directly  on  the  disordered  capillaries  and  lymphatics, 
and  not  indirectly  as  a  primary  diuretic,  for  the  dose,  viz. 
four  drops  of  the  tincture  per  diem,  was  too  small  for  a 
diuretic.  The  other  medicines  also  no  doubt  acted  parely 
bomoBopathically  on  the  pleuritic  effusion  and  on  the  dif- 
ferent states  of  the  liver,  which  were  successively  manifested. 
It  is  to  be  noticed  that  two  doses  of  Aurum  were  given 
daily  from  the  10th  of  January  till  the  6th  of  March, 
alternated  first  with  Chelidonium  and  then  with  Apocynum, 
but  although  the  hepatic  and  general  symptoms  improved, 
the  ascites  did  not  begin  to  yield  until  the  Apocynum  was 
given.  It  may  be  asked — ^Would  it  not  have  been  better  to 
give  the  Aurum  alone  and  stop  it  before  beginning  the 
Apocynum  ?  This  is  to  my  mind  doubtful,  for  the  Aurum 
is  a  slow  long-working  medicine  and  required  to  be  con- 
tinued a  long  time.  During  that  time,  whatever  it  did,  it 
certainly  did  not  interfere  with  the  action  of  the  Apocynum, 
for  what  case  could  have  done  better  ?  Rather  must  we 
say  by  its  action  it  supplemented  that  of  the  Apocynum, 
and  this  speaks  in  favour  of  the  alternation  of  medicines  as 
well  as  the  succession  of  them,  which  has  never  been 
disputed. 


TRITURATIONS. 

The  trituration  is  one  of  the  most  distinctive  features 
of  Homoeopathic  Pharmacy.  It  is  our  mode  of  presenting 
substances  insoluble  in  water  or  alcohol,  so  that  they  shall 
be  taken   up   by  the  economy.     It   is  carried   out,  as  we 


Triturations.  325 

all  know,  by  rubbing  Up  in  a  mortar  a  portion  of  the  drug 
employed  with  a  certain  number  of  parts  of  sugar  of  milk. 
After  this  process  has  been  continued  for  a  certain  time,  a 
similar  quantity  of  the  resulting  trituration  is  mixed  with 
a  corresponding  proportion  of  vehicle,  and  rubbed  up  for  a 
like  time.  These  steps  are  repeated  until  the  milk-sugar 
used  is  to  the  drug  as  999,999  to  1,  at  which  point 
solution  takes  the  place  of  trituration  for  preparing  the 
subsequent  attenuations. 

The  theory  of  such  a  proceeding  obviously  is  that  by 
prolonged  rubbing  up  there  is  secured  so  complete  an 
admixture  of  drug  with  vehicle,  that  (to  take  Hahnemann's 
proportions)  every  grain  of  the  first  trituration  shall  contain 
a  hundredth  of  a  grain  of  the  medicine,  every  grain  of  the 
second  a  ten-thousandth,  and  every  grain  of  the  third  a 
millionth.  It  is  assumed  that  the  various  substances  so 
treated  are  thus  divisible,  and  that  such  uniform  division  is 
effected  in  them  by  the  mechanical  means  employed.  The 
theory  further  hypothecates,  that  when  the  million-fold 
degree  of  attenuation  is  reached,  insolubles  have  become 
soluble,  and  can  be  so  uniformly  diffused  through  water  or 
alcohol  that  every  drop  of  the  fourth  attenuation  shall  con- 
tain a  hundred  millionth  of  a  grain  of  the  drug,  every 
drop  of  the  fifth  a  ten  thousand  millionth,  and  so  on  ad 
infinitum. 

These  are  large  assumptions ;  but  they  have  been  tacitly 
admitted  for  many  years  in  the  school  of  Hahnemann.  The 
solubility  of  insolubles  has  sometimes,  indeed,  found 
questioners ;  but  the  only  result  of  their  doubts  has  been 
to  lead  to  the  recommendation  that  the  potencies  above  the 
third  should  also  be  prepared  by  trituration.  They  have 
felt  no  uncertainty,  therefore,  as  to  progressive  comminution 
being  effected  by  this  process ;  and  the  only  measure 
adopted  for  better  securing  this  end  has  been  a  lessening  of 
Hahnemann's  proportion  of  vehicle^  so  as  to  give  a  more 
graduated  admixture.  We  refer,  of  course,  to  the  substi- 
tution of  a  decimal  for  a  centesimal  scale,  which  has  been 
pretty  generally  made  throughout  the  homoeopathic  world 
in  regard  to  preparing  triturations.     With  or  without   this 


826  Triturationt. 

modificatioD,  howeyer,  the  effect  of  trituration  has  alwajs 
been  assumed  to  be  equivalent  to  that  of  solution ;  and  we 
have  all  written  and  acted  accordingly.  Dr.  Joslin,  indeed,  in 
h\n  Principles  of  Homaopaihy,  pursues  an  ingenious  argument 
as  to  the  merits  of  the  process,  regarding  the  milk-sugar 
as  playing  a  double  part  in  conducting  the  force  of  the 
pestle  upon  the  drug-particles,  and  keeping  them  separate 
when  once  divided. 

To  such  assumptions  something  like  a  shock  mnst  have 
been  administered  by  the  paper  of  Dr.  Conrad  Wesselhcsft's 
which  we  extracted  from  the  New  England  Medical  Gazette 
of  June,  1878,  in  the  number  of  this  Journal  for  April, 
1879.  It  treated  of  Silica  only ;  but  of  it  the  following 
were  the  results  of  microscopical  observation. 

1st.  Pure  unground  Silica  was  found  with  a  power  of 
40  diameters  to  contain  a  number  of  very  small  as  well  as 
coarser  particles.  Nothing  minuter  than  the  former 
appeared  as  higher  powers — ^up  to  660 — were  employed ; 
and,  measured  with  the  micrometer,  they  had  a  length  and 
breadth  not  exceeding  tkm^I^  of  a  millimetre. 

2nd.  Triturated  ;Sf/t^a  presented  much  the  same  appear- 
ance. The  larger  particles  were  indeed  fewer,  but  the 
smaller  ones  were  not  reduced  in  size,  and  even  the  former 
result  was  less  perfectly  attained  the  more  the  sugar  of 
milk  employed.  It  was  only  when  the  flint  was  ground  by 
itself  that  nothing  greater  than  T§o^hs  of  a  millimetre 
appeared ;  and  still  there  was  nothing  less  than  x^th  in  the 
field  of  vision. 

It  is  quite  clear  that  if  these  observations  are  valid,  the 
whole  theory  of  trituration,  at  least  as  applied  to  Silica, 
falls  to  the  ground.  We  must  affirm,  with  Dr.  Wesselhoeft, 
that  **  its  particles  do  not  increase  in  number  a  hundredfold 
in  trituration  with  saccharum  lactis.  They  cannot  be  smaller 
in  the  second  or  third  trituration,  as  they  are  not  reduced 
in  the  first.''  The  question  first  arises — Are  similar  results 
obtained  when  other  insoluble  substances  are  examined  ? 
and  then.  Is  the  method  of  examination,  and  is  its  con- 
ductor, trustworthy  f 

To  the  earlier  of  these  two  inquiries  Dr.  Wesselhoeft  h  a 


Triiuralions,  327 

himself  devoted  his  attention ;  and  the  results  of  his 
inyestigations  are  to  be  found  in  the  report  presented  by 
him  to  the  American  Institute  of  Homoeopathy  in  1878^ 
and  printed  in  its  Transactions  for  that  year  (p.  135). 

He  begins  by  resuming  the  work  of  former  investigators 
in  the  same  field.  Segin,  in  ]  838,  examined  the  first  seven 
triturations  (he  does  not  say  whether  decimal  or  centesimal, 
of  Cuprum  metaUicum  under  a  power  of  75  diameters.  He 
found  the  particles  of  the  metal  uniformly  distributed 
throughout  the  sugar  of  milk  up  to  the  sixth  attenuation ; 
but  in  the  seventh  no  more  was  visible.*  Mayerhofer,  in 
1844,  published  f  the  results  of  far  more  extensive  observa- 
tions. He  examined  triturations  made  in  the  proportion  of 
2  to  98,  and  used  powers  of  120  diameters  for  them,  and 
from  200  to  800  for  dilutions  prepared  from  them.  He  found 
gold  and  silver  leaf,  and  tin  and  copper  foil,  to  yield  very 
imperfect  triturations.  The  particles  of  gold-leaf  become 
less  and  less  numerous  until,  in  the  fifth  dilution,  they 
have  quite  disappeared  ;  and,  when  last  seen,  the  smallest  yet 
measure  ^^th  of  a  line  {i.e.  73^th  of  an  inch)  in  diameter. 
Leaf  silver  behaves  much  in  the  same  way,  though  it  is 
rather  more  easily  taken  up.  Copper  foil  is  muah  more 
divisible  than  the  powder  obtained  by  rubbing  the  metal 
under  water,  recommended  by  Hahneman ;  but  its  tritura- 
tions are  full  of  the  coarse  particles  seen  in  those  of  silver 
and  gold.  Tin  foil  is  no  better.  All  these  metals  are  best 
prepared  in  the  form  of  precipitates  from  their  solution 
in  acids.  Here  they  already  exist  in  fine  division ;  and, 
when  triturated,  these  particles  are  seen  distributed  evenly 
through  the  sugar  of  milk.  They  appear  to  diminish  some- 
what in  size  as  the  process  goes  on — the  smallest  particles 
of  gold  in  the  third  trituration  measuring  T^th  of  a  line, 
and  in  the  fourth  y^th.  Precipitated  tin  admits  of  finer 
comminution  than  the  others,  and  its  smallest  particles 
measure  the  s^th  of  a  line.  Though  ever  growing  fewer 
and  fewer,  they  could  be  traced  as  far  as  the  fourteenth  dilu- 
tion ;  those  of  gold  and  platinum  to  the  tenth  and  eleventh  ; 

•  Hygea,  vii,  1. 

t  (Esterr.  Zeitschr.f&r  Horn,,  1844;  see  also  vol.  iii  of  this  Journal,  p.  14. 


828  TrUuratioHs. 

of  BiWer  and  copper  to  the  twelfth.  Of  the  other  metals 
examined^  sidc  behaved  aa  badly  as  gold-leaf ;  while  mer- 
cory,  iroD|  and  lead  seemed  to  become  oxidised^  but  could 
be  traced,  the  first  to  the  teutb^  the  second  to  the  eighth 
dilution.  Mayerhofer  does  not  think  that  a  true  solution, 
but  only  a  suspension,  of  the  metals  takes  place  when  the 
fluid  attenuations  are  employed. 

Of  Dr.  Wesselhoeft^s  own  investigations,  which  follow,  we 
will  first  speak  of  those  which  occupy  the  same  ground  as 
Mayerhofer's. 

1.  Leaf-gold  was  found,  as  the  latter  had  said,  very 
diffic^lt  to  triturate.  Only  after  searching  most  carefully 
many  samples  of  the  third  trituration,  it  was  at  length 
possible  to  discover  here  and  there  a  particle  of  gold, 
measuring  no  less  than  ^th  of  a  millimetre.*  On  the 
ground,  thereforci  of  the  positive  hindrance  to  comminution 
exerted  (according  to  his  former  experience)  by  a  large 
quantity  of  vehicle,  he  had  a  series  of  six  triturations 
prepared  in  the  proportion  of  1  to  4.  On  examining  these 
preparations,  all  presented  precisely  the  same  appearances, 
the  largest  particles  measuring  ^th  mm.,  the  smallest  ^th. 
It  will  be  seen  that  these  last  are  three  times  as  small  as 
the  minutest  particles  reached  by  Mayerhofer  in  the  2 — ^98 
proportion,  while  yet  they  were  obtained  at  the  first  step. 
Precisely  the  same  results  followed  the  examination  of 
precipitated  gold.  Mayerhofer  is  confirmed  in  his  estimate 
of  its  superior  capacity  for  division.  The  first  trituration 
exhibiting  innumerable  minute  particles  ranging  from  ^th 
to  nssth  mm.  in  size,  the  last  again  being  some  four  times 
minuter  than  the  smallest  measurement  of  the  older  observer. 
But  the  second  and  third  triturations  exhibited  precisely 
the  same  range  of  dimension  in  their  gold  particles,  which 
moreover  became  fewer  and  fewer,  so  that  while  in  the 
second  100 — 180  appeared  in  the  field  at  a  time,  in  the  third 
there  were  only  3—5.  Finally,  on  examining  the  pure 
precipitate    itself,   the   particles   were   foundi  of   identical 

*  As  a  zntUim^tre  u  about  -rt^tlif  of  an  inch,  -^ih  of  a  miUimetn  will  be 
abont  TATsth  of  an  inch. 


Triturations.  829 

measurement,  showing  that  the  trituration  had  not  reduced 
them  at  all. 

2.  Copper  was  examined  in  the  form  of  filings  and  of 
a  precipitate.  The  former  could  be  reduced  by  trituration 
to  such  a  degree  that  its  particles  measured  from  ^^th  to 
Y^th  mm.  The  latter  showed  the  same  dimensions  at 
once,  and  the  first  three  decimal  triturations  effected  no 
further  reduction. 

3.  Lead,  triturated  in  the  centesimal  proportions^  is 
not  reduced  below  ^th  mm.  at  the  outset,  and  such  particles 
simply  become  fewer  subsequently.  When^  however,  fifteen 
grains  of  lead  are  rubbed  up  with  five  of  sugar  of  milk,  it 
undergoes  very  fine  division,  its  minutest  portions  ranging 
from  3^th  to  s^th  mm.*  No  change  was  effected  by 
further  admixture  and  trituration  with  milk  sugar. 

4.  Metallic  mercury  could  not  be  satisfactorily 
examined,  owing  to  the  great  tendency  of  its  globules  to  run 
together ;  but  trituration  with  sugar  of  milk  did  not  seem 
to  reduce  it  much.  On  the  other  hand,  rubbing  up  by 
means  of  a  blunt  glass  rod  a  minute  globule  of  quicksilver 
with  a  large  drop  of  Canada  balsam  effected,  in  five  or  six 
minutes,  such  thorough  division  that  its  particles  were 
found  to  measure  from  j^th  mm.  to  ^th  or  less,  which  is 
the  utmost  minuteness  hitherto  reached. 

6.  Iron  (we  suppose  in  filings)  was  found  by  Dr.  Wessel- 
hodft  to  behave  much  like  leaf-gold.  It  did  not  appear  to 
him  to  be  oxidised. 

Of  Mayerhofer^s  other  metals,  platinum,  silver,  tin  and 
sine  do  not  appear  to  have  been  examined.  On  the  other 
side,  charcoal  and  flint  have  undergone  the  process  for  the 
first  time.  Of  the  results  as  regards  Silica  we  have  already 
spoken.  Carbo  vegetabilis  agreed  with  the  other  substances 
selected  in  showing  no  diminution  in  size  of  particles  after 
the  first  trituration  had  been  performed,  the  smallest  here 
being  7999^^^  m™* »  I>ut  the  notable  fact  appeared  that  when 

•  It  is  printed  TT^n^th ;  but  Dr.  Wesselhoeft  speaks  frirther  on  of  i^j^j^tb, 
attained  with  mercniy,  as  being  "  more  minate  than  the  lead  particles;"  and 
in  his  subsequent  communication  (of  which  I  shall  speak  presently)  gives  the 
figures  as  above. 


830  Triturations. 

pure  charcoal  was  triturated  by  itself  for  three  quarters  of 
an  hour^  it  was  found  under  the  microscope  reduced  to  por- 
tions many  of  which  reached  the  minuteness  of  T7'5oth  to  s^th 
of  a  millimetre,  i.e.  smaller  by  nearly  one  half  than  those 
seen  in  the  trituration  with  saccharum  lactis. 

Dr.  Wesselhoeft's  conclusion  accordingly  is^  that  tritura- 
tion with  sugar  of  milk  does  not  reduce  the  particles  of  hard 
substances  beyond  a  certain  not  very  distant  pointy  and  thai 
it  does  not  reduce  them  at  all  if  they  are  very  minute  in 
their  original  state.  He  entirely  rejects,  as  may  be  sup- 
posedy  the  solubility  of  such  substances  at  the  furthest 
degree  of  comminution  they  have  been  proved  to  attain. 
He  considers,  moreover,  that  the  third  trituration  is  the 
practical  limit  to  which  they  can  be  carried  by  the  process, 
and  that  at  any  rate  "  their  presence  in  the  dilutions  above 
the  fifth  is  entirely  accidental/^  What,  then,  was  it  that 
Mayerhofer  saw  in  the  twelfth  and  fourteenth  attenuations? 
It  was,  he  thinks,  *'  certain  glistening  impurities  "  belong* 
ing  to  the  sugar  of  milk,  which  can  now  be  distinguished 
from  the  true  metallic  particles  by  being  transparent,  and 
by  remaining  undissolved  if  a  drop  of  nitric  acid  is  added, 
which  causes  the  latter  to  disappear.  This  argument  must 
be  borne  in  mind,  as  it  bears  upon  Dr.  Buchmann's  obser- 
vations now  to  be  examined. 

It  may  well  be  supposed  that  Dr.  Wesselhoeft's  experi- 
ments, when  published,  made  no  little  stir  in  homoeopathic 
circles.  Many  outcries  were  raised  against  the  conclusions 
drawn  by  him  from  them ;  but  few  attempted  to  repeat  his 
observations.  Of  those  who  did  so,  Haupt,  in  Oermany,* 
and  Drs.  Descheref  and  Edwards  Smith,:^  in  America,  came 
to  much  the  same  conclusions, — the  first  and  third  that,  by 
means  of  the  ordinary  method  of  trituration,  ^th  to  ^th 
mm.  is  about  the  limit  of  comminution  ;  the  second,  that 
after  the  second  decimal  trituration  the  particles  became 
fewer  but  not  smaller.  Drs.  Buchmann,  of  Alvensleben^ 
and  S.  A.  Jones,  of  Michigan  University,  report  somewhat 

•  Allff.  Horn.  Zeitung,  vol.  98,  Nos.  19  and  20. 
t  North  Atner.  Joum.  of  Horn.,  May»  1879,  p.  485. 
X  Trantactiont  of  dmer.  IntUtutefor  1879. 


Triiuration8.  831 

different  experiences^  and  we  will  inquire  at  length  into  what 
they  have  to  say. 

Dr.  Suchmann  has  gone  very  thoroughly  into  the  sub- 
ject, and  gives  us  his  results  in  the  ninety-ninth  volume  of 
the  AUgemeine  Horn.  Zeitunt/,  from  which  they  have  been 
translated  in  the  North  American  Journal  of  Homoeopathy 
for  May  in  the  present  year.  He  has  examined  Aurum, 
Carbo  vegetabilis,  Cuprum,  Plumbum,  Mercurius^  Ferrum, 
and  Silica ;  so  that  we  can  put  his  work  side  by  side  with 
that  of  Dr.  Wesselhceft,  and  compare  the  two.  We  defer 
for  the  present  his  criticisms  upon  the  mode  of  proceeding 
adopted  by  his  predecessor^  wishing  first  to  ascertain  how 
far  his  actual  results  differ  from  or  accord  with  those  of  the 
American  observer.  As  the  latter  has  himself  commented 
on  Dr.  Buchmanu's  views^  and  re-stated  his  own  with  some 
modification,  in  the  New  England  Medical  Gazette  for  the 
present  year^  we  will  combine  his  remarks  there  given  in 
our  present  survey. 

1.  As  regards  Aurum  foliaium,  the  two  microscopists 
differ  little  about  what  is  visible  with  low  powers;  when 
higher  powers^  however  (up  to  1200)/  are  used.  Dr. 
Suchmann  finds  the  spaces  described  by  Dr.  Wesselhoefc  as 
empty  full  of  minute  particles  measuring  (in  the  3x  tritura- 
tion) from  T^oth  to  3^as^^  ™™*  These  are^  probably^  the 
*^  glistening  impurities  "  mentioned  by  the  American  physi- 
cian,  and  ascribed  by  him  to  the  sugar  of  milk.  He  argues 
that  they  cannot  be  metallic  particles  on  account  of  their 
transparency^  but  Dr.  Suchmann  strongly  maintains  the 
opposite  position.  ''  It  was  only  necessary/'  he  says, ''  that 
he  should  have  turned  the  microscope  screw  a  little  to  trans- 
form them  forthwith  into  opaque  points.^'  '*  If  the  mirror 
be  turned  quite  slowly,  those  luminous  transparent  granules 
will  be  seen  gradually  to  take  on  the  lustre  of  gold, 
until,  finally,  when  the  transmitted  light  is  completely 
shut  off,  they  appear  on  the  dark  background  as  pearls, 
with  the  most  beautiful  lustre  of  gold,  while  the  occa- 
sional particles  of  sugar  of  milk  retain  their  white, 
glassy  glitter.^'  Moreover,  a  precipitate  of  gold  examined 
by  him  consisted  entirely  of  such  granules,  aud  similar  par- 


882  TrituraiioM. 

tides  only  were  found  in  the  gray  atain  left  on  paper  upon 
which  a  gold  coin  had  been  rubbed. 

Dr.  Buchmann  does  not  appear  to  have  tried  the  acid 
test  advised  bv  Dr.  Wesselhoeffc,  but  relies  on  the  above 
considerations,  which  the  latter  has  not  attempted  to  meet. 
Dr.  Buchmann,  moreover,  seeks  to  account  for  these  minute 
particles  by  supposing  them  to  be,  as  it  were,  rubbed-off 
corners  of  the  larger  fragments,  which  last  certainly  become 
more  rouuded  and  then  less  distinctly  outlined  as  trituration 
proceeds.  Of  this  he  aptly  says  in  illustration,  ''What 
quantities  of  the  finest  sand  have  been  rubbed  of  from  quartz 
rocks,  which  we  now  find  comminuted  to  rounded  pebbles!'' 
He  thinks  that  they  are  actually  soluble,  and  adduces  their 
lively  molecular  motion  both  in  water  and  in  glycerine  as 
evidence  thereof.  He  also  found  in  making  (by  three 
hours'  rubbing)  a  first  centesimal  trituration  of  Aurumpra^ 
cipitatum,  that  most  of  the  particles  had  become  perceptibly 
reduced  in  size,  so  that  their  average  size  was  only  ^^th 
mm.,  while  that  of  the  untriturated  ones  was  y^th. 

Dr.  Wesselhcsft  has  repeated  this  last  experiment,  but  with 
negative  results.  On  the  other  hand,  in  his  later  remarks 
he  admits  (1)  that  triturations  made  by  machines,  and  upon 
the  decimal  scale,  give  much  better  results  than  his  hand- 
made centesimals ;  (2)  that  even  the  latter  show  particles  up  to 
the  sixth  degree,  *'  after  long  and  patient  searching ;"  and 
(3)  that  the  utmost  minuteness  attainable  by  leaf-gold  in 
the  tfirst  centesimal  trituration  is  not  ^th  mm.,  as  pre- 
viously stated  by  him,  but  s^Qo^h-  '*  Such  particles,''  he 
adds,  "  are  less  frequent  in  the  first  than  in  the  third  tritu- 
ration^" showing  that  some  reduction  is  effected  by  the  pro- 
cess, ''  and  more  numerous  in  decimal  than  in  centesimal 
triturations.'' 

2.  In  respect  of  Cuprum,  the  two  observers  are  more 
agreed, — Dr.  Buchmann  saying  that "  Wesselhoeft  is  perfectly 
correct  in  asserting  that  by  triturating  copper-filings  with 
milk  sugar,  smaller  particles  than  are  found  in  the  precipi- 
tate cannot  be  obtained,"  though  he  thinks  that  the  Ameri- 
can has  not  recognised  such  smallest  particles  owing  to  his 
rejection  of  such  as  seems  transparent.    Dr.  Wesselhoeft  so 


Triturations.  333 

far  accedes  to  this  that  he  now  admits  minuteness  of  yg^o^h 
mm.y  instead  of  xigo^h,  to  be  obtained  in  the  first  trituration. 
Otherwise,  he  holds  his  ground  as  to  the  present  metal. 
Dr.  Buchmann  states  that ''  grains  of  copper  measuring  from 
3^„th  to  7550^1^  mm.,  which  have  sharply-defined  outlines  in 
the  precipitate,  lose  this  appearance  in  the  trituration  ;  and, 
therefore,  that  invisible  atoms  must  have  been  rubbed  off  J* 

3.  Dr.  Buchmann  found  particles  of  Plumbum  metallicum 
in  the  2x  trituration  of  the  size  Dr.  Wesselhoeft  could  only 
reach  by  using  three  parts  of  the  metal  to  one  of  milk 
sugar.  The  latter  now  recognises  the  existence  of  these  in 
the  centesimal  triturations.  He  cannot  agree,  however, 
that  prolonged  trituration  still  further  diminishes  their  size. 

4.  As  regards  quicksilver.  Dr.  Buchmann  cannot  allow 
that  none  but  coarse  particles  can  be  obtained  by  triturating 
with  milk  sugar.  He  admits  that  it  is  not  comminuted  by 
attrition,  but  by  subdivision,  yet  states  the  extent  of 
smallness  reached  in  the  8x  as  less  than  ^(^th  mm.  Dr. 
Wesselshaft  hereupon  re-examined  his  first  centesimal,  and 
found,  indeed,  in  the  midst  of  the  comparatively  large 
globules  a  few  of  the  smallest,  measuring  from  ^th  to  g^th 
mm.  Further  attenuation  and  prolonged  trituration  took 
him  no  further. 

5.  About  iron  there  is  no  difference  of  opinion  worth 
noting. 

6.  As  to  charcoal,  too.  Dr.  Buchmann  concurs  in  finding 
triturations  of  the  pure  substance  effect  as  complete  a  com- 
minution as  can  be  obtained  when  sugar  of  milk  is  used. 
Dr.  Wesselhaft,  as  we  have  seen,  says  "  more  complete,  *'  but 
^^6  T^^b  ^  mio'^^  ^^'  which  he  observed  only  in  the 
former  case  has  been  found  by  Haupt  in  the  first  three 
decimal  triturations.  Dr.  Buchmann  found  them  in  the 
Ix,  and  says  that  in  the  2x  they  were  at  least  ten  times 
more  numerous.  In  the  third  centesimal  there  were  very 
few  to  be  seen. 

7.  Last,  Dr.  Buchmann  examined  Silica,  He  found, 
like  Dr.  Wesselhoeft,  that  the  untriturated  substance  already 
contained  particles  as  small  as  j^o^h  mm.,  and  they  do 
not  seem   to  have  been  any  smaller  in  the  Ix   trituration 


834  Trituration. 

submitted  to  his  microscope.  He  considers,  however,  that 
he  has  made  a  fresh  discovery  as  to  the  solubility  of  this 
miueral.  On  adding  a  small  drop  of  alcohol  to  the 
aqueous  solution  of  Silica  placed  between  two  slides,  a 
rapid  clearing  up  the  field  of  vision  took  place.  Moreover,  a 
mixture  of  a  decigramme  of  the  pure  substance  with  one 
hundred  drops  each  of  alcohol  and  water  became  perfectly 
clear  on  filtering,  and  showed  nothing  on  microscopical  in- 
spection, whereas,  on  evaporation,  it  left  an  opaque  spot  on 
the  glass,  displaying  the  same  appearances  as  those  of  the 
Silica  in  its  original  state.*  Hence,  he  thinks,  Hahne- 
mann's directions  to  dissolve  the  third  trituration  in  equal 
parts  of  alcohol  and  water  were  fully  warranted.  He  made 
a  similar  experiment,  and  obtained  similar  results,  with 
precipitated  copper  and  comminuted  charcoal ;  and  in  the 
former  case,  as  also  with  Ftrrum  tnetallicum,  found  the 
filtered  solution  to  undergo  no  change  in  colour  when 
treated  with  caustic  ammonia  or  tincture  of  uut-galls. 

Dr.  Wesselhoeft,  in  reply,  maintains  that  everything  which 
can  be  seen  in  Silica  with  the  highest  powers  can  be 
resolved  into  distinct  particles,  not  more  than  from  ^th  to 
:i,'^th  mm.  in  diameter.  He  objects  to  the  inference  drawn 
from  the  effect  of  adding  a  drop  of  alcohol  to  the  solution 
between  slides,  on  the  ground  that  an  additional  drop  of 
water  produces  the  same  effect.  He  has  repeated  Dr. 
Buchmann's  experiments  to  solution,  with  very  different 
results, — the  triturations  still  remaining  milky  after  filtering, 
and  displaying  distinctly  the  siliceous  particles  under  the 
microscope.  The  apparent  recrystallization  only  proves,  he 
argues,  that  particles  of  extreme  fineness  pass  through  the 
texture  of  filtering  paper ;  or  what  is  deposited  may  be  the 

*  That  flolation  cannot  be  inferred  from  these  data  appears  firom  the  facta 
about  Faraday's  "  amethystine  flnid."  This  is  gold  dissolved  in  aqna  regis, 
atid  reduced  therefrom  with  an  etherial  solution  of  phosphorus.  There  results 
n  fluid  in  which  gold  is  present,  in  the  proportion  of  1  part  of  the  metal  to 
700,000  parts  of  liquid.  In  this  the  highest  power  of  the  microscope  fails  to 
find  any  particles  of  gold :  but  if  it  be  illuminated  by  a  cone  of  condensed 
sunlight  the  goldeu  gleam  in  the  path  of  light  shows  that  the  gold  is  present 
in  suspension,  not  in  solution ;  and  a  film  of  it  is  left  after  evaporation. 


Triturations,  335 

impurities  which  are  found  after  the  evaporation  of  distilled 
water  or  the  finest  obtainable  alcohol. 

Dr.  Wesselhoeft,  in  this  latest  contribution  to  this  subject, 
relates  experiments  made  by  him  with  fflass.  This,  on  being 
triturated  by  itself  for  four  minutes,  became  a  fine  powder^ 
which  the  microscope  showed  to  consist  of  innumerable  par- 
ticles measuring  from  j^^th  to  ^^^th  mm. ;  and  no  addition  of 
water  or  more  prolonged  trituration  caused  any  alteration 
in  these  appearances. 

He  concludes  with  a  few  general  remarks.  His  object 
was  to  test  the  results  of  the  ordinary  Hahuemannian 
mode  of  trituration ;  and  he  feels  that  a  step  has  been 
gained  in  its  being  convicted  of  inefiSciency.  But  he  points 
out  that  even  the  machine-made  decimals  do  not  reduce  the 
visible  particles  below  ^-Q^th  mm.^  or  show  them  beyond  (at 
the  utmost)  the  12x  (Hahnemann's  6th).  This  is  as  it 
should  be,  were  the  utmost  limit  of  comminution  attained  at 
the  first  trituration,  as  he  maintains  that  it  is.  A  grain  by 
weightof  quicksilver  would  contain  182,250,000,000  particles 
of  the  size  of  ^^ooth  mm. ;  but  it  is  easy  to  calculate  that, 
growing  a  hundred  times  fewer  at  each  stage  of  centesimal 
attenuation,  the  sixth  would  have  but  eighteen  to  the  grain. 
Charcoal  is  lighter,  and  would  contain  392,000,000,000 
particles  of  ^oQih  mm.  in  a  grain ;  but  the  same  remorseless 
process  would  reduce  these  at  the  sixth  degree  to  thirty-nine. 
He  further  argues  that  soco^h  mm.  is  still  on  the  wrong  side 
of  solubility,  as  matter  therein  is  far  from  being  in  a  liquid 
or  gaseous  state.  That  it  is  the  limit  of  subdivision  by 
grinding  in  a  mortar,  he  substantiates  by  pointing  out  that 
that  of  microscopic  vision  lies  far  beyond ;  so  that  if 
particles  ranging  from  so^th  to  ^oU^^  ^Q^*  ^^^  produced, 
they  ought  to  be  visible.  With  a  magnifying  power  of 
1100  diameters  they  could  be,  he  says,  "  distinguished  as 
easily  as  we  can  distinguish  small  shot  from  cannon-balls.^' 
Rejecting  Dr.  Buch mannas  transparent  particles  from  the 
category,  he  maintains  that  we  have  no  evidence  of  the 
existence  of  any  smaller  than  those  mentioned. 

So  much  for  the  controversy  as  between  Wesselhosft  and 
Buchmann.     Another  combatant  in  the  field  is,  as  we  have 


336  Triturations. 

said.  Dr.  Samael  Jones.  In  the  rarions  papers  lie  has 
written  on  this  subject*  he  has  collected  a  number  of  very 
interesting  facts  as  to  the  difisibility  and  yisibility  of  gold; 
but  none  of  these  carry  us  beyond  the  sixth  or  (at  the 
utmost)  the  seventh  centesimal  trituration.  They  do  not 
touch,  moreover,  the  practical  question  raised  by  Wessel- 
hoefty  which  was  the  behaviour  of  the  metal  under  the 
homoeopathic  triturations.  He  &irly  suggests,  however, 
that  the  optical  qualities  of  particles  are  changed  at  a 
certain  degree  of  division,  adopting  Dr.  Edwards  Smith's 
statement  that  extreme  tenuity  involves  such  a  change. 
Another  objection  he  makes  to  Dr.  Wesselboeffs  conclusions 
seems  to  me  hardly  warranted  by  the  facts.  Dr.  Smith 
found  that  a  slide  of  plain  glass  will  sometimes  glitter  with 
a  delusive  appearance  of  gold,  and  pointed  this  out  to  Dr. 
Jones.  The  latter  says  that  ever  since  he  has  guarded 
himself  against  mistakes  by  **  using  the  nitro-hydrochloric 
acid  test/'  By  this  we  suppose  he  means  testing  the 
glittering  points  with  this  acid,  to  see  if  they  disappear 
under  it.  But  it  does  not  follow  that  he  should  write,  ''  as 
no  illuminator  is  safe  without  the  nitro-hydrochloric  acid 
test,  the  value  of  Prof.  Wesselhoeft's  observations  may  be 
easily  determined/'  Its  non-use  might  suggest  his  having 
seen  gold  where  it  was  not,  but  it  could  not  prevent  his 
seeing  it  where  it  wa3 ;  and  his  failure  to  do  this  is  the 
point  urged  against  him. 

With  his  usual  wit.  Dr.  Jones  makes  a  good  point  of  the 
connection  between  Dr.  Wesselhoeft's  microscopic  exami- 
nations and  his  re-proving  of  Carbo  vegetabiks.  One  of 
the  symptoms  of  the  latter  is,  ''  He  became  short-sighted 
after  using  the  eyes  some  time.'' 

Dr.  Edwards  Smith,  who  is  a  practical  microscopist,  at 
first t  severely  criticised  Dr.  Wesselhoeft^s  examinations. 
His  remarks,  however,  were  based  on  an  incorrect  report  of  the 
latter,  as  the  author  showed ;  X  and,  since  their  appearance 

*  Hahn,  Monthly,  April,  Jane,  1879 ;  Amer,  Ohwrver,  Aug.,  Oct.,  Not., 
1879,  Feb.,  1880;  North  Amer.  Joum.  of  Bom,,  Feb.,  1880;  Trams,  of  At 
Itut,,  1879. 

t  Hahn,  Monthly,  May,  1879.  -^  J  Ibid,,  June,  187^ 


Triturations.  337 

ia  the  Transactions  of  the  Institute^  he  has  not  said  a 
word  against  them^  unless  anything  of  the  kind  is  contained 
in  his  report  to  that  body  at  its  meeting  in  1879^  of  which 
year  the  Transactions  are  not  yet  published.  In  a  paper 
in  the  American  Observer  for  February  of  the  present  year, 
he  questions  the  visibility  of  minutely  divided  gold,  as 
stated  by  the  authorities  cited  by  Dr.  Jones^  and  so  far 
seems  on  the  side  of  those  who  believe  in  the  possibly  in- 
visible presence  of  the  metal.  At  this  year's  meeting  of 
the  Institute^  moreover,  he  is  cited  *  as  saying,  *'  I  do  not 
believe  that  the  microscope  will  enable  us  to  discern  the 
ultimate  divisibility  of  matter/'  His  conclusions  from 
recent  examinations  of  triturated  gold  are  given  as  follows : 

'^  1st.  A  certain  so-called  trituration^  sold  for  Aurum  3x, 
contained  no  gold  at  all.  2nd.  Mr.  Witte's  triturations  of 
Aurum  foliatum  have  been  demonstrated  to  be  almost  equal 
in  fineness  of  particles  to  the  average  triturations  from  the 
precipitate.  3rd.  Four-hour  decimal  triturations  are  not 
very  far  superior  to  the  two-hour.  4th.  Triturations  of 
Aurum  met.  up  to  the  6x  from  various  makers  vary  con- 
siderably, no  two  being  identical  in  the  fineness  of  the 
contained  particles.  5th.  The. popular  idea  that  particles 
of  gold  are  ten  times  smaller  in  the  2nd  than  in  the  1st, 
and  ten  times  smaller  in  the  3rd  than  in  the  2nd,  is  very 
far  from  being  correct.  6th.  In  all  the  triturations  of 
gold  from  the  1st  to  the  6th  decimal  examined  by  me^ 
fully  33  per  cent,  of  the  metal  escapes  subdivision  by  the 
pestle,  i.e.  does  not  become  subdivided  to  anything  like  the 
extent  previously  accepted.'' 

He  concludes  by  recommending^  as  a  new  method,  the 
trituration  of  gold  recovered  from  Faraday's  '^amethys* 
tine  fluid."  By  this,  the  third  and  sixth  potencies  can  be 
made  to  yield  particles  from  93^th  to  n35o6^^  ^^  ^^  inch, 
equal  to  ^^th  to  ^^s^jth  of  a  millimetre* 

We  have  now  laid  before  our  readers  the  facts  relative  to 
trituratioui  and  to  the  divisibility  and  solubility  of  hard 
substances^   which  have  lately  been  brought  to  light.     It 

•  Sahn.  Monthly,  July,  1880. 
VOL,  ZXXVIII^  NO.  CLIV. OCTOBER,  1880  Y 


338  Triturations. 

remains  for  us  to  make  some  remarks  of  our  own  on  the 
whole  subject. 

1.  It  is  dear  that  trituration,  to  approach  an j  where 
near  its  ideal,  must  be  conducted  upon  a  better  method 
than  that  laid  down  by  Hahnemann,  and  with  a  rigid 
scrutiny  of  its  results  as  it  proceeds.  With  this  view  the 
instructions  of  our  own  Pharmacopma  may  be  cited  aa  of 
much  value.  It  directs  not  only  that  the  decimal  scale 
shall  be  followed  instead  of  the  centesimal,  but  that  the 
first  step  of  this  shall  be  the  rubbing  up  o£  the 
medicinal  substance  with  equal  porta  of  sugar  of  milk; 
and  it  adds — ''  as  the  reducing  of  the  medicines  to  the  finest 
possible  powder  is  a  most  essential  point  in  this  method  of 
preparation,  and  as  it  is  very  difficult  to  effect  this 
after  a  large  proportion  of  sugar  of  milk  has  been  added, 
a  small  portion  of  the  trituration  should  be  carefully 
examined  under  the  microscope  at  this  stage,  and  if  the 
particles  are  found  to  be  very  unequal  in  size,  the  trituration 
should  be  continued  until  the  reduction  of  the  particles  to 
a  uniform  degree  of  fineness  is  complete/'  The  remaining 
nine  parts  of  saccharum  lactis  are  then  gradually  added  and 
incorporated,  the  whole  process  lasting  an  hour.  The 
subsequent  attenuations  are  effected  in  two  stages,  taking 
forty  minutes  in  all.  Triturations  thus  prepared  bid  fair 
to  be  all  that  can  be  expected  from  them. 

2.  This  "  all,''  however,  is  not  so  much  as  their  theory 
requires,  or  as  we  have  hitherto  supposed  it  to  be.  The 
concurrence  of  all  observers  shows  (a)  that  a  large  propor<> 
tion — ^about  one  third-*M>f  the  drug  undergoes  nothing  but 
coarse  comminution;  (b)  that  much  of  the  finest  sub* 
division  is  already  reached  in  the  first  step  of  the  process ; 
and  (c)  that  at  the  succeeding  stages  there  is  a  progressive 
diminution  in  the  number  of  particles  present.  We  cannot, 
therefore,  say  with  any  precision  that  a  grain  of  the  third 
centesimal  trituration  represents  a  millionth  of  a  grain 
of  the  original  substance.  All  we  can  affirm  is  that 
it  contains  an  indefinite  number  of  more  or  less  minute 
particles  thereof ;  and  those  hardly  smaller  while  certainly 
fewer  than  would  be  furnished  by  a  similar  proportion  of 


Triturations.  839 

the  second  potency.  It  begins  to  look  as  if  Hahnemann 
was  wisest  in  his  earliest  practice  with  triturations,  in  which 
the  first  was  used  for  provings  and  the  second  for  medicinal 
purposes.  We  hardly  seem  to  gain  anything  by  going 
beyond  this  point. 

3.  Whatever  trituration  may  do,  however,  it  is  important 
that  it  should  be  given  the  best  possible  chance  of  efficiency, 
and  that  to  this  end  it  should  be  supplied  with  the  most 
suitable  materials.  It  has  again  been  abundantly  shown 
that  precipitates  are  far  superior  to  foil  or  filings  as  the 
form  in  which  metals  shall  be  used.  Our  Pharmacopoeia 
continues  to  direct  the  employment  of  the  latter :  we  hope 
that  in  its  forthcoming  edition  the  former  will  be  given,  at 
any  rate  as  an  alternative. 

4.  The  question  of  the  solubility  of  insolubles  can  hardly 
be  said  to  have  been  decided  by  these  investigations. 
They  certainly  do  not  make  anything  in  favour  of  substi- 
tuting trituration  for  dilution  after  the  third,  as  was  once 
recommended;  for  they  show  that  on  this  plan  few 
particles  of  the  drug  would  survive  at  the  sixth.  If  we 
must  raise  the  drug  farther,  it  must  be  by  means  of  a 
liquid  medium  -,  and  here  again  our  Pharmacopoeia  seems  to 
speak  most  wisely.  "  At  this  point  " — the  third — "  ex- 
perience has  shown  that  even  the  most  insoluble  substances 
have  become  soluble  both  in  water  and  alcohol ;  or,  if  not 
actually  soluble,  they  are  reduced  to  such  minute  particles 
that  tJiey  are  capable  of  permanent  suspension  through  the 
fluid,  so  that  it  retains  their  medicinal  virtues,  and  answers 
all  the  purposes  of  a  perfect  solution/'  The  ^'  amethystine 
fluid,''  of  which  mention  has  more  than  once  been  made, 
illustrates  this  suggestion,  and  Dr.  Wesselhoeft  found 
a  similar  result  when  he  diffused  through  water  his  finely 
powdered  glass. 

5.  So  far,  all  is  clear  enough.  But  what  are  we  to  say 
to  Hahnemann's  later  practice,  and  that  of  so  many  in  his 
school,  where  liquid  attenuations  (generally  in  the  form  of 
globules  saturated  with  them),  prepared  from  these  suspen- 
sions, and  carried  up  to  potencies  from  the  12th  to  the 
200tb,  are   freely   employed  and  highly  esteemed?     Dr. 


340  Triturations. 

Wetaelhceft  would  reject  all  such  experieace,  and  explain 
otherwise  the  cures  thus  wronght.  We  must  say  that  we 
think  so  serious  a  change  of  base  hardly  warranted  by  the 
facts  now  brought  to  light.  Dr.  Buchmann's  attrition- 
particles^  transparent  specks  and  immeasurable  points  of 
metallic  lustre^  dubious  as  they  might  be  by  themselves, 
acquire  a  good  deal  of  solidity  when  amalgamated  with  the 
clinical  results  obtained  from  the  higher  attenuations.  We 
feel  inclined  to  take  the  benefit  of  the  doubt  about  them^ 
and  use  them  to  substantiate  the  apparent  testimony  of 
practice.  Dr.  Wesselhoeft  compares  the  appearance  of 
triturated  leaf-gold,  when  examined  under  the  microscope, 
to  that  of  the  starry  sky.  May  there  not  be  nebulae  here 
also— some  indeed  resolvable  into  stars  under  higher  powers, 
but  some  remaining  nebulae  under  the  utmost  range  of  our 
glasses  ?  May  not  still  finer  star-dust  fill  the  vacant  intervals, 
and  become  diffused  through  almost  an  infinity  of  space  ? 
Did  not  Tyndall  tell  us  that  the  whole  mass  of  particles 
which  give  the  blue  to  the  sky  could  be  packed  together  in 
a  lady's  toilet  box  f 

It  is,  of  course,  quite  another  question  .whether  such 
semi-ethereal  matter  is  capable — still  more,  is  best  capable — 
of  inducing  the  medicinal  effects  of  the  substance  of  which  it 
is  composed.  This,  however,  clinical  experience  alone  can 
decide.  The  therapeutical,  like  the  physiological,  test  is — 
when  properly  applied — conclusive  per  se.  It  needs  not 
the  aid  of  the  physical  evidence,  for  which  it  is  confessedly 
the  substitute,  to  show  that  active  matter  is  present ;  and 
from  it  only  we  can  learn  how  active.  Its  fallacies  are 
acknowledged  by  all ;  but  the  recognition  of  fallacies  in  a 
test  does  not  necessitate  its  rejection. 


L 


841 


REVIEWS. 


Diseases  of  Infants  and  Children,  with  their  Homceopathic 
Treatment.  Edited  by  T.  C.  Duncan,  M.D.,  assisted 
by  several  Physicians  and  Surgeons.  Vol.  II.  Chicago  : 
Duncan  Brothers. 

We  noticed  in  our  Journal  for  July,  1878,  and  April, 
1879,  the  first  three  "  parts  ^'  of  this  work,  and  the  three 
remaining  ones  are  now  to  hand  in  the  shape  of  a  single 
bound  volume.  It  is  marked  by  the  same  industry  of 
compilation,  and  the  same  literary  defects  and  lack  of 
personal  practical  observation,  which  we  previously  noted. 
From  these  faults,  we  cannot  place  Dr.  Duncan's  work 
among  the  classics  of  our  school ;  but  it  is  an  undoubtedly 
useful  compilation  of  what  Vogel  and  others  have  written  on 
the  pathology,  and  Hartmann  and  others  on  the  homoeopathic 
therapeutics,  of  infantile  diseases.  Dr.  F.  H.  Foster  has 
contributed  a  chapter  on  the  affections  of  the  eye  and  ear 
incident  to  childhood,  of  which  we  can  speak  with  all  com- 
mendation. 


Surgical  Diseases  and  their  Homceopathic  Therapeutics.  By 
J.  C.  Gilchrist,  M.D.  Third  edition ;  revised ;  re- 
written.    Chicago :  Duncan  Brothers. 

The  previous  editions  of  this  work  have  not  reached  us ; 
but  we  gather  from  the  preface  to  the  first,  here  reprinted, 
that  it  was  but  an  outline  of  the  subject  which  he  has  now 
filled  in  from  further  experience  and  study.  Dr.  Gilchrist's 
aim  is  to  tell  us  what  can  be  done,  and  how,  in  the  maladies 
commonly  known  as  "  surgical,''  by  drug-medication  on  the 
principles  of  homoeopathy.  '^All  mention  of  surgical 
operations,  or  accidents  that  can  only  demand  instrumental 


842  Reviews. 

treatment,  or  malformfttions  that  are  manifestly  beyond  the 
reach  of  medicine^  have  been  omitted."  The  slipshod 
English  of  this  sentence  too  often  characterises  onr  author's 
style,  and  his  Latin  is  even  worse — ^as  the  "  per  Fiam 
naturalis  '*  of  p.  363  may  testify.  His  matter,  however, 
is  far  better  than  his  manner.  He  confines  himself  mostly 
to  a  few  well-tried  medicines  for  each  morbid  state,  and 
gives  their  indications  briefly  and  distinctly.  His  own 
experience  has  supplied  his  pages  with  some  welcome 
observations  and  corroborations,  of  which  we  may  instance 
the  value  of  Laehesis  in  traumatic,  and  of  Secale  in  senile 
gangrene  (p.  91) ;  of  Iris,  in  tincture  or  substance,  as  an 
abortive  application  to  whitlows  (p.  98) ;  of  Cuprum 
aceiicum  6  in  commencing  tetanus  after  an  operation 
(p.  192) ;  of  Gallic  acid  in  aneurism  (p.  229)  ;  of  Pintle 
sylvestris  and  Brucea  antidysenierica  in  talipes  valgus  and 
varus  respectively;  of  Calcarea  and  Silica  in  ganglions; 
and  of  Erigeron  by  inhalation  of  the  tincture  in  epistaxis. 
He  supports  Dr.  Helmuth  as  to  the  efficacy  of  Allium  Cepa 
in  traumatic  nouritis  (p.  171) ;  but  follows  him  into  error 
as  to  the  disease  stated  by  Boileau  to  have  been  cured  so 
largely  by  Hydrocotyle^  which  was  not  lupus  but  elephantiasis 
(p.  319).  He  is  rather  r&sh,  too,  in  saying  that  Dr.  Cooper 
reports  "  a  number  of  cases  '^  of  cure  of  cancer  of  the 
tongue  by  Muriatic  acid;  only  one  or  two  of  Dr.  Cooper's 
cases  treated  with  the  acid  belonged  to  this  dire  disease. 

Dr.  Oilchrist  is  an  ardent  '^  Hahnemannian.''  For  Arsenic 
cum  to  have  been  alternated  with  Apis  in  a  case  of  ovarian 
tumour  makes  the  case  *'  of  no  value,'^  though  it  recovered 
(p.  156) ;  and  he  lays  it  down  that  the  owner  of  a  hypo- 
dermic syringe  should  forfeit  his  claims  to  consideration  as 
a  homoBopathist  (p.  168)  !  In  spite  of  these  narrownesses^ 
the  book  is  a  good  one,  and  may  often  repay  consultation. 


Transaction  of  tfie  American  Institute  of  Homeopathy ,  1877 

and  1878. 

This  association  seems  to  have  wakened,  under  its  new 


American  Institute  of  Hommopathy.  343 

Secretary  (Dr.  Bargher)^  oat  of  the  apathy  in  respect  of  its 
publications  in  which  it  has  long  slumbered.  The  Transact 
tions  for  1877  and  1878  have  at  last  reached  us ;  and  we 
are  promised  those  of  1879  and  1880^  with  the  sadly- 
delayed  papers  of  the  World's  Convention  of  1876,  before 
the  end  of  the  present  year.  May  the  promise  be  fulfilled  ! 
The  volumes  before  us  contain  a  good  deal  of  valuable 
wheats  though  mixed  with  no  inconsiderable  proportion  of 
chaff  in  the  shape  of  mere  compilation  from  authors.  In 
the  former  category  stand  the  re-proving  of  Carbo  vegetabilis 
by  Pr.  Conrad  Wesselhoeft,  which  adorns  the  Transactions 
for  1877  and  the  microscopic  examinations  of  our  tritura- 
tions from  the  pen  of  the  same  writer  in  1878.  Of  the  last 
we  have  spoken  elsewhere  in  our  present  number,  but  the 
former  needs  some  notice  here.  Dr.  Wesselhoeft,  being 
entrasted  with  the  re-proving  of  Carbo  vegetabilis,  as  the 
work  of  the  Bureau  of  Materia  Medica  for  the  year, 
thought  it  well^  before  giving  the  triturations  to  his  experi- 
menters, to  distribute  a  quantity  of  pure  sugar  of  milk 
among  them,  leaving  them  under  the  impression  that  it 
contained  the  medicinal  substance  they  were  to  test.  The 
result  was  a  goodly  array  of  919  symptoms,  obtained  by 
sixteen  persons,  eleven  of  whom  were  women  imd  five  men. 
The  object  of  such  a  preliminary  step  was  to  find  what 
symptoms  were  peculiar  to  the  provers,  so  that,  when  the 
drug  itself  was  taken  by  them,  it  would  be  possible  to 
distinguish  between  symptoms  which  were  its  real  effects 
and  those  which  were  not.  Only  six  persons,  however,went  on 
to  the  further  experiment ;  and  the  results  obtained  by  these 
''  corresponded  so  closely  with  previous  non-pathogenetic 
symptoms  that  but  few  real  ones  remained  to  be  recorded.'' 
Six  persons,  moreover,  proved  the  first  three  triturations  on 
themselves,  and  others  without  any  result  whatever.  By 
the  nineteen  provers  in  whom  symptoms  did  appear,  325 
only  were  furnished ;  and  of  these  135  had  already  appeared 
in  them  without  any  medicine  at  all,  so  that  190  only 
remain,  i.e.  an  average  of  ten  to  each.  The  bearing  of 
these  facts  upon  Hahnemann's  provings  of  this  drug  and 
its  congeners  is  as  obvious  as  it  is  important;  and  Dr. 


341  Reviews. 

Wetselhoeft  merits  our  best  thanks  for  his  contribution  to 
the  subject. 

The  Report  of  the  Bureau  of  Materia  Medica  for  1878, 
besides  the  yaluable  microscopic  researches  by  the  same 
physician  to  which  we  have  ahready  referred,  comprises  three 
papers  of  interest  by  Drs.  Sherman,  Hale,  and  Owens 
respectively.  The  first  suggests  and  supports  the  theory 
that  "  the  specific  effects  of  the  insoluble  substances  depend 
in  a  great  measure  upon  their  insolubility/'  The  second 
discusses  *^  idiosyncrasy  in  relation  to  medicines,''  and 
raises  the  question  whether  those  who  are  insusceptible  to  a 
drug  in  health  will  not  also  fail  to  get  good  from  it  in 
sickness.  The  third  records  a  proving  o£  the  Nitrate  of 
Sanguinarinef  which  seems  a  potent  irritant  of  the  upper 
portion  of  the  respiratory  mucous  membrane,  and  a  valuable 
remedy  in  its  disorders. 

In  the  Transactions  for  1878,  Dr.  Walter  G.  Cowl 
gives  the  statistics  of  the  Ward's  Island  Homoeopathic 
Hospital  of  New  York,  as  compared  with  those  of  the 
neighbouring  ^'Charity  Hospital,"  which  are  largely  in 
favour  of  the  former.  To  both  volumes  Dr.  Ludlam 
contributes  extensive  observations  on  the  temperature  in  the 
puerperal  state,  which  would  be  a  mine  of  wealth  for  all 
practical  obstetricians.  Dr.  Woodyatt,  of  Chicago,  whose 
premature  decease  is  a  sad  loss  to  homoeopathic  ophthal- 
mology and  otiatrics,  contributes  a  valuable  paper  on  auditory 
nerve  vertigo,  for  which  in  his  hands  Petroleum  seems  to 
have  proved  the  chief  medicine. 

transactions  of  the  Homteopathic  Medical  Society  of  the 
State  of  Pennsy!va7iia.     Vol.  II,  1874—1878. 

This  second  volume  of  Pennsylvania  Transactions  contains 
(as  will  be  perceived)  the  work  done  at  five  annual  sessions. 
The  procedings  and  papers  are  mostly  of  local  interest ;  and 
the  proving  of  the  Arseniate  of  Soda,  which  would  other- 
wise have  made  the  volume  indispensable  to  all  students  of 
Materia  Medica,  has  already  appeared  as  an  appendix  to  tbe 
ffahnemanniau  Monthly. 


345 


The  Guiding  Symptoms  of  our  Materia  Medica.  By  C. 
Hering,  M.D.  Vol.  II,  Arnica — Bromium,  Phila- 
delphia :  J.  M.  Stoddart  and  Co. 

In  our  July  number  of  last  year  we  noticed  the  first 
volume  of  this  undertaking,  and  endeavoured  to  speak  kindly 
of  work  with  which  we  confess  to  having  little  sympathy, 
for  the  sake  of  its  venerable  author.  He  has  now,  as  our 
obituary  relates,  been  taken  to  his  rest ;  and  nothing  we 
can  say  has  power  to  give  him  pain  or  pleasure.  Even  had 
he  been  living,  however,  we  could  but  have  echoed  the 
judgment  we  passed  upon  his  first  volume.  It  is  a  vast 
olla  podrida  of  fact  and  fancy,  of  wheat  and  chafi^,  with  an 
obvious  preference  on  the  part  of  the  compiler  for  the 
second  member  of  each  pair.  Thus  Langhammer — the  least 
trustworthy  of  Hahnemann's  provers — is  singled  out  for 
special  commendation.  Arsenicum  is  said  to  cause  dis- 
appointment more  frequently  than  any  other  drug,  the 
cause  being  that  its  symptoms  from  poisonings  are  more 
numerous  than  those  from  provings  with  the  higher  dilu- 
tions ;  and  its  similarity  to  Asiatic  cholera  is  declared  '^  too 
great !  '*  All  "  symptoms,  provings,  poisonings,  and  cures  *' 
made  with  Atropine  are  to  be  regarded  as  *'  very  uncertain ;  " 
whereas  the  "  proving "  of  Asclepias  tuberosa  by  Savery, 
who  took  two  drops  of  the  tincture,  and  then  recorded  all 
his  symptoms  for  forty  days  thereafter,  is  given  at  full 
length,  though  very  few  of  his  observations  have  either 
been  *'  confirmed ''  by  others  or  "  verified  "  by  cures. 

Nevertheless,  we  must  repeat  our  expression  of  opinion 
that  this  work  is  of  much  practical  value,*  and  we  are 
pleased  to  hear  that  it  has  been  left  by  its  author  in  a 
complete  state,  only  needing  to  be  seen  through  the  press. 
The  historical  introductions  to  the  medicines  continue  to 
win  our  appreciation,  and  they  sometimes  contain  pharma- 
ceutical remarks  of  worth,  as  when  reasons  are  given  for 
using  the  root  only  of  Arnica  and  the  precipitate  of  Aurum. 

*  A  very  fair  presentation  of  its  merits  is  made  in  the  July  number  of 
The  Organon  for  this  year. 


846  Reviews, 

Materia  Mediea  and  Therapeutics^  arranged  upon  a  physio- 
logical and  pathological  basis.  By  Charlks  J.  Hbmpel, 
M.D.  Third  edition,  revised  by  the  author,  and  greatly 
enlarged  by  the  addition  of  many  new  and  valnable 
remedies,  personal  observations,  and  numerous  clinical 
contributions  from  public  and  private  sources,  by  H.  R, 
Abndt,  M.D,  Vol.  I.  Chicago  :  W.  H.  Chatterton. 
London :  Homoeopathic  Publishing  Company. 

This  is  another  posthumous  work,  Dr.  Hempel  having 
preceded  Dr.  Hering  into  "  the  land  of  the  great  departed/' 
We  can  but  acknowledge  at  the  present  time  the  receipt  of 
its  first  volume ;  for,  until  the  work  is  complete,  we  cannot 
tell  how  far  the  strictures  we  had  to  make  (fifteen  years 
ago)  upon  its  second  edition  have  now  been  rendered  un- 
necessary. This,  however,  we  may  say,  that  the  work  has 
evidently  lost  nothing  of  that  which  has  hitherto  given  it 
its  distinctive  value,  while  the  co-operation  of  Dr.  Arndt 
has  supplied  much  that  was  previously  deficient. 


A  Manual  of  Pharmacodynamics.  Fourth  edition,  revised 
and  enlarged ;  being  the  Course  of  Materia  Mediea  and 
Therapeutics  delivered  at  the  London  School  of  Homoso-* 
pathy,  1877—80.  By  Richard  Hughes,  L.R.C.P.  Ed, 
London  :  Leath  and  Ross. 

Our  only  notice  of  this  book  can  be  an  extract  from  its 
preface.  After  citing  what  he  said  in  introducing  his  third 
edition,  the  author  writes  : 

''In  1877  the  London  School  of  Homoeopathy  was  founded, 
and  I  was  appointed  to  fill  the  Chair  of  Materia  Mediea  and  The- 
rapeutics therein.  My  manual  naturally  became  the  text-book 
of  my  course,  and  the  groundwork  of  the  lectures  I  delivered. 
Such  fresh  matter  as  from  time  to  time  I  have  brought  before 
my  claB8>  and  such  improvements  in  presentation  as  have  occurred 
to  me  while  going  on,  I  have  incorporated  into  the  substance  of 
the  book  which  is  now  offered  to  the  profession  in  its  fourth 
edition. 

'I  have  described  this  as  '  revised  and  augmented.'    It  is  not, 


it 


Manual  of  Pharmacodynamics ^  by  Dr,  R.  Hughes.  847 

as  was  the  third  edition, '  mainly  re-written ;'  the  framework  on 
which  that  was  constructed  will  be  found  here  substantiallj  un- 
altered. But  it  has  been  filled  in  with  a  liberal  hand,  so  as  to  make 
the  volume  more  than  one  fourth  larger  than  its  predecessor,  and 
— I  hope — proportionately  more  satisfying  to  the  student.  There 
is  hardly  an  article  which  has  not  received  some  fresh  touch ;  and 
those  on  most  of  the  polychrests,  and  on  Cfhamomilla,  GeUemium^ 
Iris,  Flumhumy  and  others  have  been  much  enlarged.  Supple- 
mentary lectures  on  some  minor  and  recently-introduced  medi- 
cines are  appended ;  while  several  of  those  which  occupied  such 
rank  in  the  former  edition  find  place  in  the  main  series,  in 
which  also  will  be  found  new  sections  on  the  JPicric  and  Salicylic 
acids,  on  Chlorine  and  its  derivatives,  and  on  (Enanthe  crocata. 

"  Following  upon  the  introductory  lecture  will  be  found  six 
new  ones.  The  two  on  the  sources  of  the  HomoBopathic  Materia 
Medica  contain  the  substance  of  the  little  book  I  have  published 
under  that  title.  Those  on  the  general  principles  of  drug-action 
bear  the  same  relation  to  the  lectures  I  delivered  at  the  London 
Homoeopathic  Hospital  in  1877,  and  which  appeared  in  the  earlier 
numbers  of  the  Monthly  Homoeopathic  Review  of  that  year.  That 
entitled  'Homoeopathy — what  it  is  *  is  a  similar  reproduction  of 
the  paper  on  '  The  two  Homoeopathies,'  which  I  had  the  honour 
of  reading  at  the  British  Homoeopathic  Congress  held  at  Liver- 
pool in  1877  ;  and  that  on  *  Homoeopathic  Posology '  has  already 
appeared  in  the  British  Journal  of  Homoeopathy  for  July,  1878. 
By  including  these  materials  in  my  present  volume,  I  have  made 
it  contain  all  work  I  have  hitherto  been  able  to  do  in  the  field  to 
which  it  belongs ;  and  I  hope  that  it  may  continue  to  be  useful 
to  the  class  which  I  am  no  longer  able  to  conduct  in  person." 


Manuel  de  Th6rapeutique  selon  la  mSthode  de  Hahnemann. 
Par  BiCHABD  Hughes,  L.R.C.P.Ed.  Traduit  de 
TAnglais  sur  la  seconde  Edition  et  annot^  par  le  Dr, 
Gnerin-Meneville.'     Paris  :  J.  Bv  Bailliere  et  fils. 

Of  this  work  also  we  can  only  note  the  appearance. 

Handbuch  der  Homoopathischen  Arzneiwirkungslehre.     Von 
Dr.  Med.  Carl  Heinigke.     Leipzig :  Schwabe,  1880. 
Pathogenetic   Outlines  of  Homoeopathic   Drugs.      By   Dr. 


348  Reviews. 

MsD.  Carl  Heinigke.     Translated  by  Ekil  Tietze^ 
M.D.     New  York  :  Boericke  and  Tafel,  1880. 

Dr.  Heinioke  in  his  preface  gives  as  the  raison  d'etre  of 
his  work  that  the  manuals  of  Noack  and  Trinks  and  of 
Jahr,  requiring  such  large  repertories^  are  necessarily  expen- 
sivCj  and  have  not  obtained  the  anticipated  sale  among  the 
public.  If  by  *^  public  ^'  he  means  medical  public^  we  think 
his  assertion  is  scarcely  borne  out  by  f acts^  as  every  medical 
man  we  have  met  with  possesses  one  or  other  of  these  bulky 
manuals,  and  many  have  both.  But  if  he  means  the  non- 
medical public^  we  think  it  very  probable  that  but  few  lay 
adherents  of  homoeopathy  would  invest  their  money  in  these 
large  and  expensive  works,  which  would  not  possess  half 
the  value  to  them  that  the  ordinary  domestic  manuals  do. 
If  Dr.  Heinigke  imagines  that  because  he  has  boiled  the 
whole  materia  medica  down  into  an  octavo  volume  of  600 
pages  he  will  thereby  secure  for  his  work  a  sale  among  the 
public  denied  to  the  other  handbooks  mentioned,  we  fear  he 
will  be  disappointed,  for  his  matter  is  scarcely  arranged  in 
the  way  that  would  prove  attractive  to  the  non-medical 
persons  who  buy  up  the  domestic  homoeopathies  in  such 
numbers. 

Dr.  Heinigke's  plan  in  the  work  is  to  give  a  condensation 
or  summary  of  the  pathogeneses  of  the  various  drugs, 
arranged,  not  according  to  the  ordinary  Hahnemannic  schema, 
but  in  what  he  calls  an  ''  anatomico-physiological  schema  " 
of  his  own.  This  is  preceded  by  a  few  lines  mentioning  the 
active  principles  of  the  drug,  its  preparation,  its  duration  of 
action,  and  its  antidotes.  Then,  under  the  head  of  *^  gene- 
ralities," he  gives  s  short  account  of  the  presumed  general 
action  of  the  drug,  how  it  affects  the  nervous  system  aud 
circulation,  what  are  its  predominant  characteristic  con- 
ditions of  aggravation  and  amelioration  of  symptodns,  the 
general  character  of  the  mental  and  emotional  symptoms  it 
evokes,  aud  so  forth.  Under  this  heading  there  are  usually 
separate  paragraphs  referring  to  organs  or  structures  more 
especially  affected  by  the  drug.  The  next  heading  is 
"nervous  system,^^  subdivided  into  *' brain  aud  cerebral 
nerves,"  '^organs  of  sight,'*  '^organs  of  hearing,"  '^organs 


PatJiogenetic  Action  of  Homoeopathic  Drugs.        349 


if 


of  smell/'  "  spinal  nerves/'  Next  *'  organs  of  circulation^ 
then  "  organs  of  respiration,"  then  "  organs  of  digestion, 
subdivided  into  "buccal  cavity/'  *^ stomach/'  "intestinal 
canal."  Then  "  urinary  organs,  "  male  genitals,"  and 
"female  genitals.'*  The  whole  concludes  with  a  paragraph 
on  "employment  among  the  sick,"  or,  as  we  should  say, 
"  therapeutic  uses." 

We  are  at  a  loss  to  discover  on  what  principle  Dr. 
Heinigke  has  constructed  his  summaries  of  the  actions  of  the 
drug.  They  are  partly  taken  from  the  pathogenetic  records 
and  are  partly  derived  from  clinical  experience,  but  there  is 
no  indication  by  sign  or  type  from  which  of  these  sources  they 
are  taken.  That  no  sound  criticism  has  been  exercised  with 
respect  to  the  admission  or  rejection  of  pathogenetic  sym- 
ptoms is  evident  from  the  very  first  medicine  treated  of,  "-4co- 
m/e,"  where  Storck's  extremely  impure  symptom,  *'  copious 
viscid,  yellowish  leucorrhoea,"  is  reproduced  in  the  trans- 
muted form  of  "  catarrh  of  the  mucous  membrane  [of  the 
female  genitals],  with  discharge  of  yellowish  secretion." 

We  confess  ourselves  unable  to  see  the  use  of  such  works 
as  this  of  Dr.  Heinigke's,  and  though  Germany  has  hitherto 
been  exempt  from  them  they  are  numerous  enough  in 
America.  It  does  not  give  us  a  fair  or  anything  like  an 
adequate  account  of  the  pathogenetic  action  of  the  drugs.  In 
the  process  of  boiling  down  all  the  fine  traits  and  charac- 
teristics of  the  symptoms,  whereby  the  choice  of  the  practi- 
tioner is  so  often  determined,  are  lost.  The  symptoms  of 
many  important  organs  and  structures  are  altogether 
omitted,  owing  to  the  exigencies  of  the  "  anatomico-phy- 
siological  schema/'  There  is  no  distinction  between  effects 
of  the  drug  ascertained  by  provings  or  poisonings  and  the 
surmises  deduced  from  clinical  use.  Dr.  Heinigke's  work 
neither  gives  us  an  accurate  idea  of  the  physiological  aflSni- 
ties  of  the  drugs^  nor  does  it  afford  us  the  proper  data  for 
.  treating  our  patients  symptomatologically ;  it  is  neither 
fish  nor  flesh  nor  good  red-herring.  The  boiling-down 
process  has  produced,  not  a  concentrated  extract,  but  a  caput 
mortuum» 

The  work  is  accompanied  by  a  so-called  Repertory,  but 


S50  Our  Foreign  CotUemporariei. 

8Dch  a  repertory  as  we  are  not  accustomed  to.  It  is  not  a 
systematic  arrangement  of  symptoms^  but  merely  a  clinical 
index,  after  the  manner  of  the  Clinical  Remarks  forming 
Sect.  I  of  the  chapters  in  Jahr^s  Manual, 

Why  Dr.  Tietze  should  have  thought  it  worth  while  to 
translate  this  work,  and  why  he  should  have  been  in  such 
hot  haste  to  do  it  that  he  had  not  patience  to  wait  for  the 
appearance  of  the  Repertory,  nor  yet  to  get  some  one  to 
smooth  down  the  asperities  of  his  very  Teutonic  English, 
are  mysteries  beyond  our  power  to  soke. 

The  Nature  and  Treatment  of  Syphilis,  and  the  other  so^ 
called  '' Contagious  Diseases"  By  Charles  Robert 
Drysdalk,  M.D.y  &c.  4th  Edition.  London :  Bail- 
liere,  Tyndall,  and  Cox.     1880. 

In  vol.  xxxi^  p.  537,  we  gave  an  elaborate  review  of  the 
first  edition  of  this  work.  Dr.  Drysdale  was  then  a  decided 
anti-mercurialist.  In  that  review  we  expressed  the  hope 
that  Dr.  Drysdale  would  himself  see  ''  how  weak  and  insuf- 
ficient his  evidence  and  arguments  are  "  against  the  specific 
properties  of  Mercury  in  syphilis,  and  that  he  would  ere  long 
*'  return  to  the  very  small  doses  o{  Mercury  in  true  syphilis/' 

In  the  present  edition  Dr.  Drysdale  has  abandoned  his 
uncompromising  anti-mercurial  attitude,  and  for  the  last 
three  years  he  has  employed  Mercury  in  the  dose  of  one 
sixth  of  a  grain  of  the  iodide  twice  a  day  with  satisfactory 
results.     Tertiary  syphilis  he  treats  with  Iodide  of  Potassium. 

Dr.  Drysdale's  work  is  not  commendable  for  its  thera- 
peutics of  syphilis,  but  we  must  accord  to  it  great  praise  as 
a  complete  summary  of  all  the  views  of  former  and  recent 
times  respecting  the  history,  pathology,  and  treatment  of 
syphilis.  It  is  amazing  what  a  quantity  of  information  he 
has  contrived  to  impart  in  such  a  small  space. 

OUR   FOREIGN    CONTEMPORARIES. 

(  Continmdfrom  page  285.) 

TJktil  within  the  last  three  months  I  would  have  agreed 
exactly  with  J.  W.  M.  of  the  Pebnuuy  1st  number^  where  he  says, 


America.  351 

'^  If  there  is  any  more  unsatisfactory  disease  of  children  to  treat 
than  enuresis,  with  its  train  of  wet  beds,  &c.,  I  do  not  know  it." 
But  I  must  now  differ  from  him.  widely,  as  from  my  experience 
in  the  last  three  months  with  JSJquisetum  hyemale  in  ,this  disease 
I  am  led  to  believe  that  in  this  remedy  we  have  an  almost 
unfailing  cure.  In  looking  over  my  day  book  I  find  I  have  had 
seventeen  cases  under  treatment  during  the  last  twelve  months ; 
of  the  seventeen,  fourteen  I  had  treated  previous  to  the  first  of 
December,  and  was  unsuccessful  with  the  exception  of  five  cases ; 
two  of  these  I  cured  with  GeUemium  and  the  other  three  with 
Benzoic  aeid,  but  every  one  of  the  other  cases  stopped  treatment, 
having  lost  hopes  of  ever  being  cured,  or  went  to  other  doctors. 
It  is  not  necessary  for  me  to  say  that  I  was  as  completely  dis- 
gusted as  my  patients.  I  will  say,  however,  that  several  of  these 
cases  were  relieved  for  a  short  time  under  the  above-named 
reiAedies,  with  the  addition  of  Apis^  Canth.,  Cannabis^  and  a  few 
others,  but  they  were  soon  as  bad  as  ever.  About  the  last  of 
November  I  received  Sherman's  Bulletin  of  New  Remedies  and 
there  found  a  short  description  of  Equisetum,  with  the  statement 
that  many  almost  incredible  cures  of  bed  wetting  in  children  had 
been  reported  as  the  effects  of  this  remedy  suggested  in  the 
treatment  of  this  disease  in  Hale's  Therapeutics  of  New  BemedieSy 
BO  I  determined  to  try  an  experiment  with  this  remedy  on  the 
very  next  case  that  came  under  my  treatment.  About  the  first 
of  December  I  had  another  case.  Mrs.  H—  came  to  my  office 
saying  that  her  little  boy,  four  years  old,  had  never  failed  to  wet 
the  bed  a  single  night  for  two  years,  that  there  was  hardly  a 
night  but  what  she  took  him  up  and  always  took  him  out  just 
before  going  to  bed,  thinking  it  might  help  him.  She  had  punished 
him  for  it,  and  worse  than  that,  had  been  to  several  allopathic 
doctors,  but  all  of  no  avail.  I  told  her  that  she  had  come  to  a 
poor  saviour,  but  if  she  would  consent  that  I  would  try  a  new 
remedy  that  was  highly  recommended  and  was  perfectly  harm-^ 
less,  &c.,  and  further  if  I  did  not  cure  the  boy  I  would  not 
charge  her  anything.  She  consented,  and  I  gave  her  a  two- 
drachm  vial  of  tincture  Equisetum  with  directions  to  give  six 
drops  each  night  at  bedtime,  telling  her  not  to  allow  him  to  drink 
much  in  the  latter  part  of  the  day  and  especially  nothing  warm» 
to  take  him  out  just  before  going  to  bed,  and  report  to  me  in  a 
week.  She  did  so,  and  to  my  surprise  said  that  the  boy  had  had 
no  trouble  whaterer,  and  that  he  had  slept  better  and  was  feeling 


352  Our  Foreign  Contemporaries. 

better  than  he  has  for  two  years.  I  told  her  to  continue  same 
treatment  another  week,  and  then  I  dismissed  the  hoj  cured  and 
he  still  renu&ins  well.  She  told  me  that  she  would  have  no  other 
but  a  homoeopathic  doctor  if  she  had  to  send  a  hundred  miles, 
and  that  she  would  send  me  some  other  cases  she  knew  of. 
And  in  less  than  a  week  she  sent  me  a  case. 

A  girl  several  years  of  age,  that  had  been  troubled  with  incon- 
tinence of  urine  for  nearly  four  years,  ever  since  she  had  the 
diphtheria*  I  put  her  on  the  same  remedy  and  dose,  and  in  two 
weeks  rei)orted  cured,  sound,  and  well.  While  treating  this 
case  Mrs.  H —  brought  me  another,  a  girl  five  years  of  age,  that 
had  been  troubled  for  nearly  two  years,  which  I  treated  in  the 
same  way,  with  the  same  happy  result  as  with  the  other  two.  So 
confident  was  I  that  I  had  found  a  specific  that  I  could  not  wait 
for  new  cases,  but  spoke  to  several  of  the  parents  of  children  I 
had  treated  unsuccessfully  during  the  year,  telling  them  that  I 
had  found  a  sure  cure,  and  if  I  did  not  cure  them  in  two  weeks 
that  I  would  not  charge  them  a  cent.  So  during  January  two 
of  them  came  back  to  me,  both  of  which  I  cured  with  the  same 
treatment.  I  have  another  child  taking  the  medicine  at  present, 
but  have  not  heard  from  him  as  yet.  Some  may  doubt  these 
statements,  but  I  will  furnish  the  names  and  addresses  of  the 
parents  of  each  case  for  reference  if  any  one  wishes  them.  We 
cannot  say  of  these  cases  that  they  just  happened  to  get  well, 
for  they  were  all  chronic  and  otherwise  obstinate  cases.  The 
remedy  acted  alike  in  all  of  them.  I  intend  to  make  a  thorough 
proving  of  the  remedy  and  will  report  again.  I  think  that 
Benzoic  acid  is  the  next  best  remedy,  but  I  failed  with  it  in 
several  cases.  I  may  not  have  prepared  it  right.  I  dissolved  the 
crystals  in  strong  alcohol ;  a  drachm  of  alcohol  dissolves  about 
thirty  grains.  I,  with  ''Medicus,'*  of  February  15th  number, 
would  like  to  hear  from  "  J.  W.  M.'*  as  to  how  he  prepares  his 
drops,  and  suggest  to  '^Medicus*'  if  he  fails  with  Benzoic  acid 
to  try  Uquitetum.  I  would  also  like  to  hear  from  G-.  E.  Mitchell 
again.  I  see  that  he  reports  a  bad  case  cured  with  Equieefum 
in  the  January  15th  number. — M.  L.  Sesd. 

May  10. — In  a  report  of  a  meeting  of  the  New  York 
Central  Homceopathic  Medical  Society  we  find  the  following 
useful  item : 

"  Dr.  Wells  said  that,  some  twenty-five  years  ago,  he  and 


America.  353 

his  student^  Dr.  F.  Bigelow>  made  a  proving  of  Apis,  Both 
had  the  same  symptom  developed — a  feeling  as  if  they 
could  not  breathe  again.  In  a  case  of  hydrothorax  with 
orthopnoea  there  was  the  same  suffocative  sensation  as  in 
the  Apis  proving.  The  urinary  symptoms  corresponded 
with  Apis.  This  remedy  was  given.  The  patient  could 
soon  breathe  more  easily^  and  in  two  or  three  weeks  a 
complete  cure  was  made.  In  two  cases  of  epidemic  cere- 
bro-spinal  meningitis^  he  observed  the  same  feeling  of  suffo- 
cation ;  Apis  relieved  in  half  an  hour  and  soon  cured/^ 

We  are  pleased  to  hear  that  in  Sacramento^  California^ 
the  County  Hospital^  City  and  County  Dispensary^  and  the 
jails  have  a  homoeopathist  as  their  physician  and  superin- 
tendent j  and  that^  a  similar  appointment  having  been 
made  to  the  City  Board  of  Healthy  and  the  remaining  (allo- 
pathic) members  resigning^  homosopathists  were  appointed 
to  fill  all  the  vacant  places. 

''  E.  E.  W.''  reports  a  case  of  great  nervous  cardiac  dis- 
turbance^ in  which  Arnica  3,  given  upon  the  presence  of 
the  symptom^  *'  hot  head  and  cold  body/'  brought  about 
rapid  relief  and  cure. 

July  15. — In  this  number  is  contained  some  interesting 
information  regarding  the  history  and  literature  of  homoeo- 
pathy in  Spain. 

Aug.  15. — Dr.  Hoyne  contributes  here  a  useful  collection 
of  observations  as  to  the  curative  action  of  Sarsaparilla. 
Among  them  we  note  the  following : 

''Dr.  W.  H.  Holcombe  says: — During  the  very  hot 
summer  months  a  great  many  children  and  some  grown 
persons  present  themselves  with  cutaneous  affections — ^their 
name  is  legion.  Last  spring  I  gave  to  all  such  cases  small 
doses  of  Sarsa.,  8rd  trit.^  three  doses  per  day^  and  never 
before  have  I  practised  among  skin  diseases  with  such  satis- 
faction and  such  triumph.'^ 

Sept.  1. — We  have  here  some  provings  of  the  Nitrate  of 
Sanguinarina,  an  alkaloid  of  Sanguinaria,  with  clinical  veri- 
fications. It  seems  to  possess  the  broncho-pulmonary  action 
of  the  mother-plant  in  a  heightened  degree. 

Oct.  1. — Dr.  Hale  states  that  Carroll  Dunham  wrote  to 

VOL.  XXXVIII^  NO.  CLIV.-«-OCTQB£B|  1880.  « 


S64  Our  foreign  Caniemporaries. 

him,  thanking  him  for  introducing  Ceanothus  into  his 
'*  New  Remedies/'  because  it  had  enabled  him  to  cure  two 
Tery  bad  cases  of  enlarged  spleen  with  it.  Dr.  Kershaw 
relates  a  ease  of  cerebro«spinal  meningitis^  where  the  teeth 
were  so  firmly  set  that  it  was  impossible  to  give  medicine 
by  the  mouth,  but  where  Veratrum  viride  ^,  two  drops 
injected /^^rec^tim  erery  half  hour^  proved  remedial. 

Nov.  1. — ^Dr.  W.  H.  Hunt  speaks  warmly  of  Camphor  in 
after-pains.  He  drops  a  few  minims  (3 — 5)  on  a  lump  of 
sugar,  and  dissolves  this  in  a  tumbler  half  full  of  water, 
giving  teaspoonful  doses  every  half  hour  till  easy.  ''It 
seldom  requires  more  than  four  or  five  doses  to  ensure  com- 
plete relief.'' 

Si.  Louis  CUmeal  Review.  Jan. — Dec.,  1879. — ^This 
journal  visits  us  but  irregularly.  Our  last  notice  brought 
it  down  to  November,  1878,  and  since  that  time  the  num- 
bers for  December,  1878,  February,  March,  May,  July, 
August  and  November,  1879,  have  failed  to  reach  us.  We 
shall  be  glad  to  have  their  vacant  places  supplied,  and  may 
perhaps  find  more  in  them  to  note  or  extract  than  we  do  in 
the  five  numbers  before  us.  From  these  we  can  only  men- 
tion two  cases  in  which  Secale,  taken  in  largish  doses  to 
produce  abortion  when  pregnancy  did  not  exist,  caused 
gradually  increasing  uterine  hemorrhage,  with  disorganisa- 
tion of  the  right  ovary  in  one  (found  po$t  mortem),  and 
hypogastric  tenderness  on  pressure  with  dull  pain  in  the 
other.  These  are  in  the  issue  of  Sept. — October.  In  the 
same  number  we  are  rather  amused  to  see  the  review  of 
Dr.  Bumetfs  ''  Gold,''  which  appeared  in  the  Homoeopathic 
World,  appropriated  bodily,  without  acknowledgment,  as  if 
it  were  a  production  of  the  editorial  mind  of  the  Clinical 
Review.  We  must  also  note  a  proving  of  Arctium  lappa  in 
the  December  number. 

American  Homcecpath.  Jan»— -Nov.,  1879. — This  is  one 
of  the  twins  brought  forth  by  the  ''American  Homoeo- 
pathist "  when  departing  this  life.  The  publishers  of  the 
parent  journal  continue  to  cherish  this  offspring,  but  have 
transferred  it  to  New  York,  with  Drs.  Charles  Blumenthal 
and  Arthur  Hills  as  its  editors.     Our  series  of  it  for  1879 


America.  855 

lacks  the  numbers  for  June,  July^  August  and  December^ 
and  we  shall  be  glad  to  have  them  supplied. 

January. — Dr.  Hale  records  a  case  of  cardiac  disturbance 
alternating  with  aphonia^  in  which,  after  the  failure  of 
other  remedies,  Oxalic  acid  6  proved  curative.  Dr.  H.  N. 
Guernsey  records  a  case  in  which  stenotic  dysmenorrhoea 
was  associated  with  severe  pain  in  the  right  shoulder  and 
arm,  and  sick  headache.  Lycopodium,  in  rare  doses  of  a 
high  potency,  removed  the  whole  troublCj  including  the 
symptoms  of  stenosis. 

The  following  case  is  worth  extracting : 

OeUemium  in  Infantile  Paralysis. 
ByW.  M.  Haestjs,  M.D.,  Ellsworth,  Me. 
Case  2. — ^Willie  H — ,  aged  eleven  months,  when  perspiring,  was 
carried  into  a  cold  room,  and  shortlv  after  was  taken  with  severe 
chill,  and  immediately  went  into  convulsions,  which  lasted  about 
six  hours.  After  coming  out  of  the  convulsions,  found  that  the 
whole  left  side  of  the  body  was  completely  paralysed,  face  being 
drawn  round,  and  complete  loss  of  motion  and  sensation  in  whole 
left  half  of  body.  No  more  convulsions,  but  the  arm  and  leg  of 
affected  side  commenced  to  shrink  in  size  and  temperature  to  lower 
in  spite  of  treatment.  Used  Sulphur,  Oaust.y  Laehesis,  Bhus  tox^ 
and  applied  friction  and  electricity.  Continued  this  treatment 
several  weeks  without  the  least  benefit,  the  affected  limbs  becoming 
more  shrivelled  and  colder,  and  fingers  and  toes  being  tightly 
clenched.  Child  being  drowsy  at  times^  alternating  with  very 
nervous  excitable  spells,  which  were  followed  by  a  profuse  flow  of 
clear  urine,  led  me  to  prescribe  Oelsem.  30,  which,  with  continued 
friction  of  the  paralysed  parts,  caused  a  marked  improvement  in  a 
week,  and  entirely  cured  the  paralysis  in  less  than  a  month. 

October.— «Dr.  H.  C.  Allen  supplies  several  more  cases 
illustrating  the  value  of  that  *'  key-note ''  for  Colchicum — 
'^  He  has  appetite  for  several  things^  but  as  soon  as  he  sees 
them,  or  still  more,  smells  them,  he  shudders  from  nausea> 
and  is  unable  to  eat  anything."  Dr.  W.  Wright  finds 
Allium  Cepa  3  specific  for  that  kind  of  fluent  coryza  which 
is  apt  to  end  in  a  severe  and  deep-seated  cough. 

November. — Dr.  Curtis^  of  Chattanooga^  records  a  case 


856  Owr  Foreign  Contemporaries. 

of  poisoning  by  the  bite  of  the  snake  known  as  the  "  cop- 
perhead/' and  being  at  that  time  in  the  midst  of  the  recent 
yellow  fever  epidemic  in  the  South,  was  struck  with  the 
resemblance  of  his  patient's  symptoms  to  those'of  the  disease. 

The  Medical  Counselor.  Aprils  October^  November, 
Decemberi  1879. — This  is  the  other  twin ;  but  though  con- 
temporaneous in  appearance  with  its  brother,  the  numbers 
mentioned  above  are  all  that  have  found  their  way  to  us. 
Dr.  Mills,  the  former  editor  of  the  Homaopaihist,  fulfils 
this  function  for  the  Counselor. 

April. — Dr.  Woodyatt  relates  several  cases  of  corneal 
opacity,  in  which  very  great  improvement  in  vision  followed 
the  use  of  Calearea  carbonica  30.  Dr.  Holcombe  commu- 
nicates an  instance  of  epileptiform  hysteria  cured  by  Taran- 
tula 200 ;  and  Dr.  Woodward  one  of  pneumonia  where  a 
remedy  rarely  used  in  our  practice,  Kati  nitricum,  was 
given  (Ix  trit.).  The  indication  for  it,  in  his  eyes,  was  the 
great  dyspnoea,  so  disproportionate  to  the  small  amount  of 
lung  tissue  involved. 

October. — Dr.  H.  C.  Allen  has  found  great  benefit  from 
Arum  triphyUum  in  hay-fever.  Dr.  Arndt  presents  a  series 
of  throat  cases  which,  as  he  truly  says,  ''  seem  to  show  that 
in  ulcerated  sore  throats  Mercurius  cyanatus  acts  far  more 
promptly  when  the  ulcer  is  large  and  well-defined,  and 
when  there  is  little  glandular  enlargement,  while  the  binio- 
dide  surpasses  the  former  in  usefulness  when  the  glandular 
enlargement  is  a  prominent  feature  of  the  case,  and  the 
appearance  of  the  throat  itself  is  less  angry.'' 

November. — Dr.  Pearson,  who  passes  as  an  undeviating 
follower  of  Hahnemann,  tells  us  that  he  has  never  in  his 
life  cured  but  one  case  of  intermittent  fever  with  China. 
How  different  from  his  master,  who  says  of  endemic  inter- 
mittent fever,  attacking  a  person  on  his  first  arrival  in  the 
district,  *'  One  or  two  small  doses  of  a  highly-potentised 
solution  of  Cinchona  bark  will,  conjointly  with  a  well-regu- 
lated mode  of  living,  speedily  free  him  from  the  disease." 
If  such  result  do  not  follow  the  patient  must  be  treated  with 
antipsoric  remedies ;  there  is  latent  disease  in  him,  which 
is  only  accidentally  (so  to  speak)  taking  an  aguish  form. 


Miscellaneous.  357 

December. — Dr.  Hawley,  who  is  very  sensitive  to  Rhtts, 
relates  how  a  rheumatism  of  his,  which  had  involved  his 
left  ankle  for  two  months^  disappeared  in  a  few  hours  after 
handling  (through  silk  gloves)  two  sticks  of  the  Rhm  vene^ 
nata. 

Homoeopathic  News. — We  mentioned  this  little  journal  in 
our  number  for  last  October,  as  then  reaching  us  for  the 
first  time.  It  has  since  arrived  pretty  regularly,  and  con- 
tinues fairly  to  discharge  its  useful  oflSce  of  summarising 
the  contents  of  the  other  homoeopathic  journals. 


MISCELLANEOUS. 


An  Irish  Medical  Bull. 

Miss  Edgwobth,  we  believe,  wrote  an  elaborate  essay  on 
'  Irish  Bulls,'  which,  by  a  bull  equivalent  to  any  bred  in  Ireland, 
was  included  by  a  French  author  in  a  list  of  works  upon  cattle 
breeding.  Not  having  seen  the  essay  in  question,  we  are  unable  to 
say  if  the  authoress  alludes  to  the  Irish  bull  medical,  but  had  she 
lived  to  the  present  day  she  would  have  rejoiced  to  meet  with  such 
a  fine  specimen  of  it  as  that  which  has  just  been  engendered  by  the 
Boyal  College  of  Surgeons  in  Ireland,  and  triumphantly  trotted  out 
by  the  unconscious  Editor  of  the  Medical  Press  and  Circular. 
The  Irish  are,  as  a  rule,  quick-witted  and  brimming  full  of  fun,  but 
with  all  that  they  are,  it  must  be  confessed,  greatly  addicted  to 
making  bulls.  Now,  a  bull  is  something  grotesquely  stupid,  said  or 
done,  the  absurd  stupidity  of  which  is  patent  to  every  one  but  the 
sayer  and  doer;  and  it  is  seldom  possible  to  Convince  the  bull 
maker  that  he  has  said  or  done  something  flagrantly  silly.  The 
manufacture  of  bulls  in  Ireland  is  not  confined  to  individuals,  a 
grave  and  learned  corporation  can  make  them  equally  well. 

Shortly  after  the  passing  of  the  Medical  Act  of  1859,  which 
expressly  prohibits  all  licensing  bodies  from  imposing  any  obliga- 
tion on  candidates  for  their  diploma  to  adopt,  or  refrain  from 
adopting,  the  practice  of  any  particular  theory  of  medicine  or  sur- 


358  Miscellaneous. 

gerjf  the  Boyal  College  of  Stirgeons  in  Ireland  issaed  a  decree 
expresslj  prohibiting  its  feUows  and  licentiates  firom  practising 
homoDopathj.  We  pointed  out  at  the  time  the  exquisite  illegality 
and  impotence  of  this  decree,  which  has  never  been  acted  on  and 
has  not  had  the  slightest  effect  upon  the  relations  of  practitioners 
who  reject  or  accept  the  doctrines  of  Hahnemann.  We  beg 
pardon,  we  know  of  one  solitary  instance  in  which  it  did  inflaence 
the  conduct  of  a  practitioner.  One  of  our  colleagues  had  a  patient 
who  wished  to  try  the  effects  of  mesmerism  on  his  malady.  Ooi 
colleague,  willing  to  humour  him,  requested  the  late  Dr.  Eiliotson, 
who  was  at  that  time  the  great  authority  on  mesmerism,  to  meet 
him  in  consultation.  Dr.  Elliotson  refused,  alleging  his  inability 
to  do  so  in  consequence  of  the  decree  of  the  Boyal  Coll^;e  of  Sur- 
geons in  Ireland  against  the  practice  of  homoeopathy.  The  humour 
of  his  refusal  on  this  ground  was  intensified  by  the  fact  that  the 
said  decree  coupled  mesmerism  along  with  homceopathy  in  its 
denunciations. 

Hie  absurdity  of  the  Irish  Colly's  ukase  against  homoeopathy 
was  aggravated  by  the  fact  that  it  is  a  college  of  surgeons.  Now, 
colleges  of  surgeons  are  generally  supposed  to  interest  themselves 
in  surgery,  and  to  supply  the  world  with  pure  surgeons.  ^'  A  pure 
surgeon,"  old  Dr.  Mackintosh,  of  Edinburgh,  used  to  assert,  "  is  a 
person  who  prides  himself  on  his  knowledge  of  cutting  and  his 
ignorance  of  everything  else."  Whether  this  is  the  exact  truth  or 
not  we  are  unable  to  decide,  but  at  all  events  our  colleges  of 
surgeons  have  hitherto  never  felt  it  incumbent  on  them  to  attend 
much  to  therapeutics,  and  the  chief  of  them,  the  Soyal  College  of 
Surgeons  of  England,  has  steadily  refused,  in  spite  of  much  urging, 
to  express  any  opinion  with  regard  to  the  therapeutic  doctrines  of 
the  day.  But  the  Boyal  College  of  Surgeons  in  Ireland  seems  to 
entertain  a  different  view  of  its  functions,  and,  having  gone  out  of 
its  way  to  give  us  its  opinion  on  therapeutics,  it  may,  perhaps,  if 
success  should  attend  this  innovation  on  the  practice  of  colleges  of 
surgeons,  by-and-bye  favour  us  with  its  views  on  religion,  social 
science,  political  economy,  poetry,  Shakspeare,  and  the  musical 
glasses,  on  which  subjects  its  ideas  are  sure  to  be  quite  as  valuable 
as  those  it  has  expressed  on  therapeutics. 

The  ordinance  or  decree  of  1861  has,  we  are  informed  by  the 
Editor  of  the  Medical  Tress  and  Circular,  "  remained  in  full  force 
for  nearly  twenty  years,"  and  effected  a  wonderful  amount  of  good, 
not,  indeed,  visible  to  the  naked  eye,  but  probably  discoverable  bj 


An  Irish  Medical  Bull.  859 

means  of  an  oxj-hydrogen  microscope  of  40,000  horse-power.  It 
is  curious  that  though  the  ordinance  is  still  in  full  force,  and  has 
done  all  that  was  anticipated  from  it,  it  should  now  be  thought 
necessary  to  issue  another  decree  like,  but  still  different  from,  the 
decree  of  1861.  This  stamps  it  indelibly  with  the  characteristics 
of  an  Irish  bull.  It  is  in  '*  full  force,"  but  yet,  it  seems,  it  has  not 
the  slightest  effect  in  restraining  the  practices  it  professes  to  pro- 
hibit. It  resembles  "  bulls ''  of  another  sort,  namely.  Papal  bulls. 
It  denounces  from  an  infallible  elevation  doctrines  it  dislikes,  but 
while  still  remaining  in ''  full  force  "  requires  to  be  supplemented  by 
other  bulls,  differently  worded,  perhaps,  but  condemnatory  of  the 
same  heresy.  As  the  prototypal  Papal  bulls  are  distinguished  by 
the  first  word  or  two  of  the  language  in  which  they  are  couched,  as 
"  Unigenitus,"  "  Pater  Omnipotens,"  "  Spiritus  Sanctus,"  Ac.,  so 
the  bull  of  the  Irish  College  of  1861  will,  perhaps,  be  known  here- 
after by  the  title  of  "  No  Fellow,"  whilst  that  of  1880  will  bear 
the  designation  ''  That  the  ordinance." 

It  is  curious,  and  in  this  respect  savouring  more  of  the  Irish 
than  the  Papal  bull,  that  the  first  thing  the  Council  of  the  Boyal 
College  of  Surgeons  did  at  its  meeting  on  the  23rd  of  May,  1880, 
was  to  rescind  its  ordinance  of  1861,  an  ordinance  which,  we  are 
told  by  the  Editor  of  the  Medical  Fress  and  Circular,  is  still  in 
"  full  force,"  and  had  proved  so  perfectly  successful ;  so  successful, 
indeed,  that  no  member  of  the  College  seems  to  have  paid  the 
slightest  attention  to  it,  and  disobedience  to  it  was  quietly  ignored  by 
its  authors.  This,  indeed,  was  decidedly  the  best  course  to  pursue, 
for  had  the  Council  attempted  to  enforce  obedience  to  their  decree, 
so  utterly  illegal  was  it,  that  they  would  have  soon  found  them- 
selves in  disagreeable  conflict  with  the  law  of  the  land.  So,  like 
Don  Quixote,  with  his  helmet  all  patched  together  with  paper  and 
paste,  the  Council  of  the  Eoyal  College  of  Surgeons  in  Ireland 
resolved  to  take  it  for  granted  that  its  decree  was  sound  and  effica- 
cious, but  took  precious  good  care  not  to  subject  it  to  the  only  test 
whereby  its  soundness  could  be  ascertained.  Did  the  members  of 
the  Council  of  the  Eoyal  College  of  Surgeons  in  Ireland  know 
when  they  passed  their  ordinance  of  1861  that  they  were  commit- 
ting an  illegality,  or,  at  all  events,  that  they  would  have  subjected 
themselves  to  sundry  pains  and  penalties  had  they  attempted  to 
make  a  practical  application  of  it  ?  We  have  a  shrewd  suspicion 
that  they  knew  all  the  time  that  they  were  committing  an  illegal 
act,  and  probably  this  knowledge  added  a  zest  to  their  proceedings. 


360  Miseelldneoui. 

for  we  are  told  by  Irish  writers,  who  profess  to  know  their  coontrj- 
men,  that  the  opportunity  of  breaking  a  law  with  impunity  is  irre- 
sistible to  an  Irishman,  and  that  he  will  even  put  himself  to  con. 
•iderable  ineonyenienoe  to  do  so.    But  at  all  events,  as  we  learn 
from  the  Medical  Frea  and  Circular,  the  Council  were  made 
aware  of  the  illegality  of  their  ordinance  of  1861  by  the  represen- 
tatiTe  of  the  College  in  the  General  Medical  Council,  so  that  they 
must  have  congratulated  themselves  on  never  having  attempted  to 
act  upon  it,  and  as  their  original  intention  was  to  reaffirm  in  1880 
their  illegal  ordinance  of  1861,  they  found  themselves  precluded 
from  doing  so  after  its  illegality  was  formally  pointed  out  to  them. 
But  now  we  come  to  consider  the  reasons  for  the  reaffirmation 
in  1880  of  the  ordinance  of  1861,  which,  our  editorial  informant 
tells  us,  was  still  in  **  full  force.*'     We,  on  this  side  of  St.  George's 
Channel,  are,  of  course,  unable  to  see  how  an  ordinance  could  be  in 
"  full  force  for  nearly  twenty  years,"  which,  during  all  that  time,  was 
never  acted  on,  and  which,  being  illegal,  could  not  be  acted  on. 
This  msy  be  all  clear  to  the  Hibernian  intellect  of  the  Editor  of  the 
Medical  Press  and  Circular,  but  to  us  it  bears  the  impress  of  the 
"bull"  character  of  the  whole  proceedings.      The  only  reason 
assigned  by  the  Editor  of  the  Medical  Press  and  Circular  for  the 
proposed  reaffirmation  of  the  ordinance  of  1861  is  conveyed  in  the 
following  mysterious  words: — "Recently  the  subject"  (to  wit,  the 
open  association  of  Irish  surgeons  with  homoeopaths)  "  was  revived, 
and  became  the  focus  for  much  controversy  "  (a  "  focus  for  contro- 
versy "  is  a  novel  and  ingenious  figure  of  speech),  *'  and,  in  view  of 
a  particular  case  in  point "  (it  would  be  interesting  to  know  the 
particulars  of  this  particular  case,  but  no  information  is  vouchsafed 
to  us  thereanent),  ''was  brought   under  the  notice  of  the  Irish 
College  of  Surgeons  at  its  annual  general  meeting  on  the  last 
Monday  in  May."     We  should  have  thought  that  **  the  particular 
case  in  point "  would  have  afforded  an  excellent  opportunity  for 
putting  the  ordinance  of  1861  in  execution,  but  no  such  idea  seems 
to  have  occurred  to  the  sages  of  the  College.     Their  law  having 
been  broken  they  do  not  enforce  the  penalties  incurred  by  its 
breach,  but  they  propose  to  adopt  the  mild  and  imbecile  measure  of 
re-enacting  the  law  which,  we  are  told,  was  still  in  "  full  force." 
And  this  they  would  have  done  had  not  their  representative  in  the 
General  Medical  Council  informed  them  that  their  law  was  illegal, 
and  therefore  had  no  force  at  all.     Such  being  the  case,  the  next 
idea  that  occurred  to  the  College  was  to  frame  another  ordinance 


An  Irish  Medical  Bull.  861 

prohibiting  the  association  of  their  members  with  homoBopaths  in 
such  a  way  that  it  should  not  contravene  the  laws  of  the  land. 
This  task  was  performed — as  they  imagine — by  the  Council  at 
their  meeting  on  the  23rd  of  June,  and  at  the  same  time  they  took 
the  opportunity  of  rescinding  the  illegal  ordinance  of  1861,  which 
had  been  in  '*  full  force  for  nearly  twenty  years."  This  new  and 
wonderful  work  of  art  runs  as  follows : 

'^  That  the  ordinance  of  Council  of  the  22nd  of  August,  1861, 
be  and  it  is  hereby  rescinded,  and  instead  thereof  it  be  now  moved, 
that  it  be  an  ordinance  of  the  Council  that  no  Fellow  or  Licentiate 
of  the  College  shall  seek  for  business  through  the  medium  of 
advertisements,  or  any  other  disreputable  method,  or  shall  consult 
with,  advise,  direct,  or  assist,  or  have  any  professional  communica- 
tion with  any  person  who  professes  to  cure  disease  by  the  deception 
called  homcBopathy,  or  by  the  practice  called  mesmerism,  or  by 
any  other  form  of  quackery,  or  who  follows  any  system  of  practice 
considered  derogatory  or  dishonourable  to  physicians  and  surgeons. 
And  be  it  further  resolved  that,  in  the  opinion  of  this  Council,  it  is 
inconsistent  with  professional  propriety  and  derogatory  to  the 
reputation,  honour,  and  dignity  of  the  College  to  engage  in  the 
practice  of  homceopathy  or  mesmerism,  or  any  of  the  forms  of 
quackery  as  hereinbefore  set  forth." 

This  last  clause  seems  to  be  a  rhetorical  flourish,  put  in  to  round 
off  the  otherwise  slipshod  English  in  an  elegant  manner,  for  it  is 
obvious  to  the  most  careless  reader  that  no  "  forms  of  quackery  '* 
whatever  are  "  hereinbefore  set  forth." 

The  only  cause  for  all  this  hubbub  and  flutter  in  the  bosom  of 
the  Boyal  College  of  Surgeons  in  Ireland  is  apparently  the 
''particular  case  in  point "  above  alluded  to,  for  we  are  assured  by 
the  Editor  of  the  Medical  Frees  and  Circular  that  the  profession 
in  Ireland  have  nothing  to  fear  from  homceopathy,  *'  homoeopathy 
being  hopelessly  at  a  discount,  and  having  made  no  progress  at  all 
during  the  present  generation."  This  being  so,  and  we  have  the 
word  of  the  Editor  of  the  Medical  Press  and  Circular  for  it — who 
ought  to  know — we  are  all  the  more  anxious  to  know  what  this 
''particular  case  in  point"  was  that  produced  such  a  violent 
agitation  in  the  tranquil  precincts  of  the  Eoyal  College  of  Surgeons 
in  Ireland.  "Homoeopathy  being  hopelessly  at  a  discount"  in 
Ireland,  it  might  surely  have  been  suffered  to  slide  unnoticed  into 
bankruptcy  and  extinction.  It  was  hardly  worthy  of  the  "  reputa- 
tion, honour,  and  dignity  "  of  the  Eoyal  College  of  Surgeons  in 
Ireland  to  imiti^te  the  lon^-eared  animal  in  ^sop's  fable  and  make 


S62  Miicellaneous. 

such  a  gigantic  eflEorfc  to  administer  a  final  kick  to  the  poor  dying 
lion.  The  '^particalar  case  in  point*'  must  have  been  reij  par* 
ticular  indeed  to  rooae  the  ire  of  the  Hojal  Collie,  and  we 
tnitt  that  the  Editor  of  the  Medical  Prets  and  Circular^  who 
hai  hitherto  been  so  veiy  oommnnicative  with  respect  to  the  action 
of  the  College,  will  give  us  fuU  details  respecting  this  "  particular 
case." 

The  new  ordinance  of  the  College  finds  in  the  Editor  of  the 
Medical  Freee  and  Cireular  such  a  warm  eulogist,  and  he  expresses 
himself  so  **  gratified  and  even  proud  "  at  the  proceedings  of  the 
College,  that  we  feel  more  than  half  inclined  to  believe  him  to  be 
the  chief  promoter  of  those  proceedings,  if  not  the  actual  author  of 
the  new  ordinance,  just  as  Dugald  Dalgettj  guessed  his  visitor  in 
prison  to  be  the  Maocallum  More  himself,  as  no  one  else  could  pos- 
saj  so  much  good  of  that  chieftain. 

The  Editor  of  the  Medical  Press  and  Circular  makes  believe  to 
think  that  the  homoeopathic  body  are  awfully  enraged  at  the 
proceedings  of  the  Boyal  College  of  Surgeons  in  Ireland  and  their 
worthy  Council,  but  we  hasten  to  assure  him  that  this  is  a  complete 
misapprehension  on  his  part.  The  only  feeling  thathomoeopathists 
have  in  the  matter  is  one  of  amazed  amusement  at  the  sight  of  a 
Boyal  CoUege  of  Surgeons  perpetrating  such  an  enormous  bull, 
and  being  so  ludicrously  unconscious  of  the  pitiful  figure  they  cut 
before  the  world,  prating  about  their  honour,  dignity,  and  reputa- 
tion, while  disgracing  themselves  by  an  impotent  attempt  to  suppress 
liberty  of  opinion  on  a  subject  of  which  they  have  no  knowledge  and 
which  does  not  in  the  least  concern  them  as  a  College  of  Surgeons. 
Our  enjoyment  of  the  ridiculous  freaks  of  the  College  is  intensified 
by  the  enthusiastic  encomiums  bestowed  on  them  by  the  Editor  of 
the  Medical  Press  and  Circular,  and  our  earnest  desire  and  hope  is 
that  this  Boyal  College  and  this  able  editor  may  soon  favour  us 
with  another  equally  amusing  performance,  to  diversify  the  dull 
monotony  of  medical  practice,  and  enliven  the  more  serious  pursuits 
of  scientific  research ;  for  homoeopathy,  as  has  been  over  and 
over  again  proved,  theoretically  and  practically,  is  scientific  medicine 
based  on  rational  principles  and  constant  in  its  practice,  whilst  the 
method  or  methods  the  Editor  of  the  Medical  Press  and  Circular 
specially  patronises  are  unscientific,  irrational,  based  on  no  prin- 
ciple whatever,  and  changing  as  frequently  and  as  capriciously  as 
the  fashions  in  ladies*  dress. 

The  Boyal  College  of  Surgeons  in  Ireland  seem  to  have  no  doubt 


An  Irish  Medical  Bull.  363 

thai  their  new  ordiaance  is  perfectly  legal,  and  does  not  contravene 
any  of  the  sections  of  the  Medical  Act.  As  we  are  of  an  exactly 
contrary  opinion,  and  think  that  the  new  ordinance  is  as  utterly 
opposed  to  the  letter  and  spirit  of  the  Medical  Act,  as  the  earlier 
ordinance  of  the  College  confessedly  is,  we  resolved  to  give  the 
College  an  immediate  opportunity  of  acting  on  their  new  ordinance 
if  they  dared.  For  this  purpose  one  of  us  addressed  to  the  Council 
of  the  College  the  following  letter : 

'^  To  the  President  and  Council  of  the  Royal  College  of  Surgeons  in 

Ireland* 

**  I  observe  in  the  Medical  Press  and  Circular  of  the 
30th  of  June,  that  at  a  meeting  of  the  Council  of  the  Eoyal 
College  of  Surgeons  in  Ireland,  when  all  the  Council  were  present 
save  one,  a  resolution,  or  motion,  or  ordinance,  was  unanimously 
adopted,  of  which  the  following  is  a  portion — apparently  the  principal 
portion  to  judge  from  the  comments  of  the  Editor  of  the  Medical 
Press  and  Circular, 

" '  That  it  be  an  ordinance  of  the  Council  that  no  Fellow  or 
Licentiate  of  the  College  shall  .  .  .  consult  with,  advise,  direct, 
or  assist,  or  have  any  professional  communication  with,  any  person 
who  professes  to  cure  disease  by  the  deception  called  homoeopathy. 
.  .  .  .  And  be  it  furthermore  resolved  that,  in  the  opinion  of 
this  Council,  it  is  inconsistent  with  professional  propriety  and 
derogatory  to  the  reputation,  honour,  and  dignity  of  the  CoUege,  to 
engage  in  the  practice  of  homceopathy.' 

'^  Now,  though  you  do  not  mention  what  steps  you  intend  to 
take  against  fellows  and  licentiates  who  may  infringe  this 
ordinance,  no  doubt  you  have  resolved  to  visit  disobedience  to  your 
ordinance  by  some  pains  and  penalties,  for  it  is  impossible  to  suppose 
that  the  Council  of  the  Boyal  College  of  Surgeons  in  Ireland 
would  issue  such  a  stringent  and  solemn  ordinance  as  a  mere  brutum 
fulmen.  Being  desirous  to  assist  the  Council  in  its  laudable 
endeavour  to  suppress  a  practice  which  the  Council  in  its  wisdom 
has  declared  to  be  a  '  deception,'  and  '  inconsistent  with  profes- 
sional propriety  and  derogatory  to  the  reputation,  honoiu:,  and 
dignity  of  the  College,'  I  beg  to  draw  the  attention  of  the  Council 
to  the  fact  that  your  ordinance  is  habitually  disregarded  and 
disobeyed  by  the  following  licentiates  of  your  College,  viz.  William 
Bell,  E.  Tuthill  Massy,  H.  W.  Robinson,  John  Roche,  C.  C.  Tuckey, 
and  C.  G-.  Watson,  who  are  in  the  habit  of  consulting  with,  advising, 
directing,  assisting,  and  having  professional  communication  with, 
persons  who  profess  to  cure  diseases  by  homoeopathy,  which  you 
are  pleased  to  term  a  '  deception,'  though  that  is  a  slight  mistake 
on  your  part,  as  there  is  no  deception  nor  any  concealment  whatever 
in  the  practice  of  homoeopathy,  the  principles  of  which  must  be 
well  known  to  you,  or  if  not  may  be  easily  learned  from  scores  of 


864  Miicellaneaus. 

treatifet  published  upon  it ;  and  furthennore  the  aforesaid  lioentiates 
are  themeelves  engaged  in  the  practice  of  homoBopathj,  which  in 
your  opinion — vtileat  quantum — *  is  inconsistent  with  professional 
propriety  and  derogatory  to  the  reputation,  honour,  and  dignity  of 
your  College ' — and  worst  of  all,  their  names  are  openly  paraded 
m  the  HomoBopaihie  JHreetory^  published  by  Thompson  and  Capper, 
price  one  shilling. 

"It  is  grievous  to  think  that  the  ordinance  of  a  similar 
purport  you  enacted  so  long  ago  as  1861  has  hitherto  remained  a 
dead  letter,  and  that,  as  far  as  I  know,  no  action  has  been  taken 
by  you  to  enforce  obedience  to  it.  The  reason  for  this  may  be 
that  you  found  that  your  ordinance  of  1861  was  contrary  to  the 
■pint  and  letter  of  Sections  XXIII  and  XXVIII  of  the  Medical 
Act  of  1859,  or  perhaps  because  you  were  not  made  acquainted  with 
the  fact  that  certain  of  your  licentiates — among  them  the  genUe- 
men  whose  names  I  have  given  above^were  haoitually  disobeying 
your  ordinance.  However  that  may  be,  you  have  now,  as  you 
suppose,  so  worded  your  recent  ordinance  that  it  does  not  con- 
travene the  above  sections  of  the  Medical  Act,  and  as  you,  of 
course,  have  no  wish  to  pose  before  the  world  in  the  undignified 
and  ridiculous  attitude  of  promulgating  ordinances  that  are  never 
acted  on,  by  calling  your  attention  to  the  above  disobeyers  of  your 
ordinance  I  afford  you  an  excellent  opportunity  for  displaying 
your  zeal  in  the  noble  cause  of  the  suppression  of  liberty  of  opinion 
in  therapeutics,  and  I  assure  you  that  it  will  afford  to  myself  and 
my  colleagues, '  who  profess  to  cure  disease  by  homoeopathy,'  the 
greatest  pleasure  to  see  you  attempt  to  enforce  your  ordinance,  in 
which,  of  course,  you  reckon  on  being  warmly  seconded  by  public 
opinion. 

"  In  the  above  ordinance  you  likewise  denounce  those  *  who  follow 
any  system  of  practice  considered  derogatory  or  dishonourable  to 
physicians  and  surgeons.'  As  this  is  rather  vague  and  indefinite, 
perhaps  at  your  next  meeting  you  would  be  so  obliging  as  to  draw 
up  a  list  of  the  '  systems  of  practice  *  that  are  '  considered  deroga- 
tory  or  dishonourable  to  physicians  and  surgeons,'  and  at  the 
same  time  be  a  little  more  precise  in  intimating  by  whom  they  are 
considered  derogatory  and  dishonourable  to  physicians  and  surgeons, 
for  to  a  person  endowed  with  only  common,  and  not  coll^^iate, 
sense  it  would  seem  that  the  sentence  as  it  at  present  stands  has  a 
vagueness  and  indefiniteness  about  it  unworthy  of  a  learned  council. 
In  the  ordinance  of  18G1  the  parallel  words  were  '  any  system  or 
practice  considered  derogatory  or  dishonourable  hy  physicians  and 
surgeons,'  but  that  was  evidently  nonsense,  for  a  'system  or 
practice' — like  homceopathy  for  example — that  was  pursued  by 
many  physicians  and  surgeons  was  evidently  not '  considered  dero- 
gatory or  dishonourable  by  physicians  and  surgeons.' 

"  I  would  draw  your  attention  to  the  circumstance  that  as 
Section  XXYIII  of  the  Medical  Act  disallows  the  removal  of  the 
name  of  any  practitioner  from  the  Begister  on  account  of  his  having 


An  Irish  Medical  Bull  365 

*  adopted  the  practice  of  any  theory  of  medicine/  any  action  you 
might  take  against  any  of  your  fellows  or  licentiates  for  disobe- 
dience to  your  ordinance  would  have  no  effect  on  their  legal  status^ 
and  I  would  point  out  to  you  that  as  Section  XXIII  of  the  same 
Medical  Act  threatens  with  a  very  serious  punishment — ^no  less 
than  deprivation  of  its  power  of  granting  qualifications — any  body 
entitled  to  grant  qualifications,  should  it  attempt  Ho  impose  on 
candidates  for  examination  an  obligation  to  adopt  or  refrain  from 
adopting  the  practice  of  any  particular  theory  of  medicine/  that 
would  imply  a  fortiori  that  the  Medical  Act  is  in  spirit  opposed 
to  such  attempts  after  examination. 

**  Finally,  I  would  submit  to  your  consideration  if  a  college  of 
Burgeons  does  not  cut  a  most  ridiculous,  not  to  say  contemptible, 
figure  by  issuing  edicts  or  ukases  against  the  practice  of  a  particular 
system  of  therapeutics  to  which  it  is  unable  to  give  any  practical 
effect,  and  if  it  will  not  appear  to  an  impartial  public  that  by 
applying  such  an  epithet  as  '  deception,'  and  ranking  as  ^  quackery  ' 
a  method  of  treatment  which  is  followed  by  hundreds  of  properly 
qualified  fellows  and  licentiates  of  colleges  and  graduates  of  univer- 
sities in  this  country,  and  which  has  been  defended  in  numerous 
published   works,   and  is  practised  both  privately  and  in    hos- 
pitals   with    results    which    will    compare  favourably  with  any 
obtained  by  any  other  system  of  practice,  the  Boyd  College  of 
Surgeons  in  Ireland  does  not  thereby  display  a  wish  to  combat  by 
the  unworthy  weapons  of  insult  and  calumny  a  mode  of  practice  it 
is  unable  to  combat  by  the  fair  weapons  of  scientific  controversy. 

"Perhaps  the  Council  of  the  Boyal  College  of  Surgeons  in 
Ireland  will  condescend  to  explain   on  what  grounds  it  calls  a 
'  deception  *  a  system  of  practice  pursued  by  many  highly  respect- 
able and  intelligent  members  of  its  own  and  other  colleges  and 
graduates  of  universities,  and  respecting  which  treatises  in  abun- 
dance are  published,  and  periodicals,  monthly  and  quarterly,  edited 
by  gentlemen  having  the  highest  professional  qualifications,  and 
devoted  to  the  propagation  and  development  of  the  system,  are 
regularly  issued.     Perhaps,  too,  it  will  at  the  same  time  offer  some 
proof  that  the  practice  of  a  method  of  treatment  founded  on  the 
following  principles: — I.    Testing  on  the  healthy  the  effects  of 
drags;  2.   Administering  these  drugs  in  natural  morbid  states 
resembling  those  morbid  conditions  they  produce  in  the  healthy ; 
8.  Giving  but  one  medicine  at  a  time ;  4.  Giving  the  remedy  in  a 
dose  not  strong  enough  to  produce  its  physiological,  while  suffi- 
ciently strong  to  produce  its  therapeutical,  effects — '  is  inconsistent 
with   professional    propriety   and    derogatory  to  the  reputation, 
honour,  and  dignity  of  the  College.'     Unless  the  Council  of  the 
Eoyal  College  of  Surgeons  in  Ireland  should  offer  some  evidence  or 
proof  in  support  of  its  allegations,  it  is  greatly  to  be  feared  that 
the  outside  world  may  think   that  a  learned   college  in  calling 
certain  licentiates  of  its  own  and  other  colleges  and  graduates  of 
universities  bad  names  is  resorting  to  a  line  of  argument  more 


866  Miscellaneous. 

eoDgenul  to  the  illitqnte  Hall  of  Billingsgate  Market  than  con- 
ibtent  with  the  'reputation,  honour,  and  dignity*  of  a  leanied 
college.  That  the  '  reputation,  honour,  and  dignity '  of  the  Eojal 
College  of  Surgeons  in  Ireland  should  suffer  from  sudi  a  trifling 
cause  as  its  omission  to  assign  a  reason  for  denouncing  and  calling 
hy  opprohrious  epithets  a  system  of  medicine  that  is  practised  by 
hundreds  of  qualified  gentlemen,  and  has  been  so  practised  in  this 
country  for  upwards  of  half  a  century,  would  be  a  matter  of  infinite 
regret  to 

'*  Your  obedient  servant, 

"  (Name  of  no  importance). 
"  17th  July,  1880. 

''  Poii  seriptum. — As  no  doubt  the  Council  of  the  Royal  College 
of  Sureeons  in  Ireland  are  desirous  of  the  utmost  publicity  for  their 
spirited  effort  to  suppress  liberty  of  opinion  in  medical  matters 
I  will  do  my  best  to  forward  their  supposed  views.  I  hare 
accordingly  called  the  attention  of  the  General  Council  of  Medical 
Education  and  Registration  to  the  recent  ordinance  of  the  Council 
of  the  Royal  College  of  Surgeons  in  Ireland,  and  I  have  no  doubt 
the  General  Council  will  give  the  particular  Council  of  the  College 
their  wannest  approval.  I  shall  likewise  use  my  humble  endeavours 
to  spread  the  knowledge  of  the  recent  ordinance  among  both  the 
profession  and  the  public." 

To  this  the  writer  received  the  following  reply : 

"  RoTiL  CoLLBOB  01  STmexovs  nr  IxHiurD, 
"  DuBLiK ;  August  10th,  1880. 

"  Sib, 

'*  I  beg  leave  to  inform  you  that  your  communication  to  the 
President  and  Council  of  this  College  has  been  laid  before  them  in 
due  course  by  me  at  their  first  general  meeting  since  its  receipt. 

"  I  have  the  honour  to  be, 
"Sir, 

**  Your  obedient  servant, 

''J.  Stak^tus  HiraHXfi. 

"  Secretary  ofCounciV* 

The  letter  to  the  General  Council  alluded  to  in  the  letter  to  the 
Council  of  the  Royal  College  of  Sui^eons  in  Ireland  is  subjoined. 

"  To  the  President  of  the  General  Council  of  Medical  Education 

and  Registration. 

"Sis, 

"  The  Council  of  the  Royal  College  of  Surgeons  in  Ireland, 
as  we  learn  from  a  report  in  the  Medical  Press  and  Circular  of 
June  80th,  at  a  meeting  of  the  Council  held  on  the  23rd  of  June 
passed  the  following  resolutions : 

"  '  That  it  be  an  ordinance  of  the  Council  that  no  fellow  or  licen- 


An  Irish  Medical  Butt.  367 

tiate  of  the  College  shall  Mek  for  business  through  the  medium  of 
advertisements  or  any 'other  disreputable  method,  or  shall  consult 
with,  advise,  direct,  or  assist,  or  have  any  professional  communico' 
Hon  with,  any  person  who  professes  to  cure  disease  hy  the  deception 
called  homoeopathy,  or  by  the  practice  called  mesmerism,  or  by  any 
other  form  of  quackery,  or  who  follows  any  system  of  practice 
considered  derogatory  and  dishonourable  to  physicians  and  sur- 
geons. 

" '  And  be  it  furthermore  resolved  that,  in  the  opinion  of  this 
Council,  it  is  inconsistent  with  professional  propriety  and  deroga- 
tory to  the  reputation,  honour,  and  dignity  of  the  Oollege  to  engage 
in  the  practice  of  homoeopathy,  or  mesmerism,  or  any  of  the  forms 
of  quackery  as  hereinbefore  set  forth.' 

''  I  humbly  submit  that  the  words  underlined  in  the  above 
ordinance  are  a  distinct  contravention  of  the  spirit,  and.  also  of  the 
letter,  of  Sections  XXIII  and  XXVIII  of  the  Medical  Act,  for 
though  the  College  does  not  here  directly  '  attempt  to  impose  upon 
a  candidate  offering  himself  for  examination  an  obligation  to  adopt, 
or  refrain  from  adopting,  the  practice  of  any  particular  theory  of 
medicine.'  it  does  so  indirectly ;  for,  in  requiring  its  fellows  and 
licentiates  to  promise  to  obey  its  ordinances,  and  this  ordinance 
prohibiting  its  fellows  and  licentiates  from  having  any  professional 
communication  with  any  person  practising  homoeopathy,  it  thereby 
imposes  on  its  fellows  and  licentiates  an  obligation  not  to  practise 
homoeopathy,  which  is  equivalent  to  imposing  on  a  candidate  for 
examination  an  obligation  not  to  practise  homoeopathy,  for  a  candi- 
date for  the  diploma  of  the  college  who  was  convinced  of  the  tr«th 
of  homoeopathy  must  be  debarred  from  offering  himself  for  exami- 
nation if  he  has  to  promise  to  have  no  professional  communication 
with  those  practitioners  who  entertain  similar  therapeutic  views 
before  he  can  obtain  the  licence  of  the  College. 

"  I  would  further  submit  that  it  is  a  contravention  of  the  spirit 
of  the  Medical  Act  for  the  Council  of  the  EoyaJ  College  of  Surgeons 
in  Ireland  to  apply  opprobrious  and  insulting  epithets,  such  [as 
^  deception '  and  '  quackery,'  to  a  '  particular  theory  of  medicine,' 
which  the  Medical  Act  says  (Section  XXIII)  no  candidate  for 
examination  is  to  be  required  to  refrain  from  adopting,  and  further 
(Section  XXYIII),  for  adopting  which  the  name  of  no  person  shall 
be  erased  from  the  Eegister. 

« I  hereby  appeal  to  the  General  Council  of  Medical  Education 
and  Eegistration  to  cause  the  Council  of  the  Boyal  College  of 
Surgeons  in  Ireland  to  desist  from  infringing  the  above  sections  of 
the  Medical  Act  and  from  insulting  and  outraging  those  fellows 
and  licentiates  of  its  own  and  other  colleges,  and  those  graduates 
of  the  universities,  who  have  adopted  the  practice  of  a  particular 
theory  of  medicine  which  has  not  yet  received  the  approval  of  the 
majority  of  the  members  of  the  Council  of  the  Boyal  College  of 
Surgeons  in  Ireland,  but  which  the  Medical  Act  declares  shall  not 
be  a  disqualification  for  admission  to  examination  by  any  licensing 


868  itiicelUmeoui. 

bod  J,  or  for  being  enrolled  on  the  Register  of  tbe  (renersl  Goonoil 
of  Medical  Edacation  and  Registration. 

"lam, 
"Sir, 
"  Your  obedient  servant, 

''  (Name  of  no  oonseqaenoe). 
•*  18th  JqIj,  1880." 

No  answer  has  as  yet  been  received  to  this  appeal  to  the  Creneral 
Council,  nor  is  it  likely  that  it  will  meet  with  any  greater  suooees 
than  a  similar  appeal  addressed  by  one  of  us  to  the  General  Council 
on  the  subject  of  an  anti-homceopathic  declaration  required  by  tbe 
Eling's  and  Queen's  College  of  Physicians  in  Ireland  to  be  made  by 
candidates  for  its  licence,  just  then  come  to  light.  The  excuse  made 
by  the  General  Council  on  that  occasion  for  taking  no  action  in  the 
matter,  viz.  that  the  declaration  was  old  and  obsolete,  will  not  avail 
tbe  General  Council  now,  as  tbe  ordinance  of  the  Collie  of  Sur- 
geons is  brand  new^  and  apparently  meant  to  be  acted  on. 

The  utter  inadequacy  of  tbe  alleged  reason  for  the  late  monstrous 
commotion  among  the  members  of  the  Royal  Collie  of  Surgeons 
in  Ireland  on  the  subject  of  homoeopathy  gives  us  reason  to  credit 
the  authenticity  of  the  following  report  of  the  proceedings  of  the 
College,  for  which  we  are  indebted  to  Sir  Boyle  Roche's  c^ebrated 
little  bird,  which  possessed  tbe  faculty  of  being  in  two  places  at  tbe 
same  time.  We  have  here  a  plausible  explanation  of  the  mystery, 
which  tbe  editorial  champion  of  the  College  fails  to  give  us. 

Bojfal  College  of  Surgeon*  in  Ireland.    Annual  General  Meeting^ 

ZIH  May,  1880. 

The  Chair  was  taken  by  the  President,  the  venerable  Mr.  Dennis 
O'Plaherty,  at  2  o'clock  precisely. 

The  President  was  commencing  to  speak,  when  he  was  inter- 
rupted by  Surgeon  Finnikin,  of  Belfast,  who  inquired  if  it  was  not 
the  proper  thing  to  begin  the  proceedings  by  prayer. 

The  President. — That  has  not  hitherto  been  the  custom,  but  if 
the  honourable  member  would  favour  the  company  he  was  sure  they 
would  be  delighted. 

Surgeon  0*Donoghue  objected  that  Surgeon  Finnikin,  being  a 
Presbyterian,  bis  prayer  would  not  be  acceptable  to  the  majority  of 
the  members,  who  professed  allegiance  to  his  Holiness  the  Pope. 
If  the  President  would  allow  him,  as  there  was  no  priest  present,  he 
would  read  an  appropriate  prayer  in  Latin  from  the  breviary  he 
always  carried  in  his  pocket. 

Surgeon  Murphy  protested  against  any  Popish  dog-Latin  being 
used  at  their  meeting.     As  the  College  had  been  founded  whilst 


An  Irish  Medical  Bull.  869 

the  Anglican  was  the  Established  Church  of  Ireland,  he  thought 
the  only  prayers  that  could  be  used  in  that  assembly  were  those 
contained  in  the  Book  of  Common  Prayer.  He  would  accordingly, 
with  the  President's  leave,  proceed  to  read  the  Collect  of  the  day. 

Surgeon  O'Badiah  said,  as  one  of  the  ancient  Jewish  race  who 
had  not  forsaken  the  religion  of  his  fathers,  he  could  not  consent  to 
any  Christian  prayer,  but  if  they  would  kindly  listen  he  would 
read  to  them  the  CXIXth  Psalm  in  the  original  Hebrew,  which 
seemed  to  him  most  appropriate  for  opening  such  a  meeting  as  this. 

Suigeon  O'Badlaw,  as  a  thorough  believer  in  agnosticism,  for 
which  he  was  ready  to  undergo  martyrdom,  utterly  and  from  his 
soul  (if  he  had  one)  repudiated  any  religious  ceremony  whatever, 
whereby  the  solemnity  of  their  proceedings  would  be  destroyed  and 
their  ancient  hall  would  be  desecrated.  Now  if  gentlemen  would 
listen  to  a  chapter  from  the  Fruits  of  Phil —  (Oh !  oh!  order!  order !) 

The  President. — Gentlemen,  I  perceive  it  is  hopeless  to  expect 
anything  like  unanimity  on  this  subject,  and  with  my  best  thanks  to 
those  gentlemen  who  have  so  kindly  offered  to  open  the  meeting  by  a 
prayer — or  its  equivalent  in  their  creed  (looking  at  the  last  speaker), 
I  think,  as  the  chief  business  before  us  is  of  rather  an  opposite 
character,  it  would  be  more  appropriate  if  I  read  from  the  chair 
either  the  Commination  of  the  Book  of  Common  Prayer,  or  the 
Curse  of  Ernulphus,  provided  Surgeon  O'Badlaw  does  not  object. 

Surgeon  O'Badlaw  said  he  could  not  of  course  conscientiously 
swear,  but  he  had  no  objection  to  curse,  and  he  thought  the 
stronger  the  language  the  curse  was  pronounced  in  the  more  it 
would  please  himself  and  colleagues,  as  no  words  of  reprobation 
could  be  too  strong  for  the  odious  practices  they  were  that  day 
about  to  consider.  He  would  therefore  move  that  the  President 
should  read  aloud  the  Curse  of  Ernulphus. 

This  was  seconded  by  Surgeon  Kelly,  who  though  himself  a 
Protestant,  thought  that,  whilst  he  and  his  feUow-believers 
would  object  with  all  their  might  to  borrow  a  prayer  from  the 
Bomish  Church,  they  might,  without  doing  violence  to  their  con- 
sciences, borrow  a  curse  for  the  occasion. 

The  motion  was  agreed  to  nem,  con»,  and  the  President  read  the 
curse,  first  in  the  original  Latin,  then  in  English,  and  finally  in 
Irish,  so  that  its  beauties  might  be  appreciated  by  all. 

The  President  then  said : — Fellows  and  licentiates  of  the  Irish 
College  of  Surgeons !  Cead  miUe  fealthe !  It  is  with  mingled 
feelings  of  pleasure  and  pain  that  I  look  around  me  and  see  this  vast 
assembly  of  those  who  derive  their  honourable  title  from  this  noble 
College.  It  is  no  common  cause  that  has  led  you  to  hurry  up  from 
all  p^s  of  old  Ireland,  at  the  imminent  risk  of  letting  thousands 
of  patients  die  for  lack  of  your  skilful  services,  or,  what  is  worse,  of 
allowing  them  to  find  out  that  they  can  recover  without  your  aid. 
(Hear,  hear).  The  pleasure  your  presence  gives  me  is  more  than 
neutralised  by  the  cause  that  brings  you  here  to-day.  The  cause, 
the  melancholy  cause,  is,  as  you  are  aware,  the  notorious  fact  that 

VOL.  XXXVIII,  NO.  CLIV. — OCTOBER,  1880.  AA 


370  Miscellaneous. 

Fome  of  those  who  hold  the  diploma  of  this  illustrious  College 
liave  so  far  fori^otten  wh»it  is  due  to  tl»e  honour  and  diguity  of 
their  noble  profession,  and  what  is  due  to  the  reputation  of  their  a/fiia 
mater,  as  to  pretend  or  profess  to  cure  diseases  by  the  monstrous 
deception  called  homoeopathy.  I  care  not  to  inquire  what  amount 
of  scientiRc  truth  there  may  be  in  the  therapeutic  rule  of  homceo- 
pathy.  I  stop  not  to  ascertain  if  medicines  prescribed  according  to 
that  rule  cure  diseases  more  quickly  and  certainly  than  do  medicines 
given  on  our  own  time-honoured  and  traditional  principles.  Such 
inquiries  are  altogether  foreign  to  our  subject.  I  take  mj  stand 
on  the  ordinance  passed  by  the  Coll^^  nineteen  years  ago,  which 
expressly  forbids  its  members  to  **  profess  or  pretend  to  cure  diseases 
by  the  deception  called  homceopathy."  This  ordinance  has  been 
deliberately  disobeyed  by  these  degenerate  members,  and  I  ask 
you,  gentlemen,  to  surest  some  means  of  putting  a  stop  to  such 
practices  by  these  unworthy  members  of  our  College.  But  besides 
these  rebellious  members  who  practise  this  tabooed  system  in 
defiance  of  the  ordinance  of  our  College,  there  are  other  members 
who,  without  professing  to  practise  homoeopathy,  lend  their 
surgical  aid,  and  actually  perform  operations  on  the  patients  of 
physicians  and  practitioners  who  openly  practise  homoeopathy,  in 
direct  contravention  of  the  same  ordinance  which  expressly  forbids 
any  fellow  or  licentiate  of  the  College  to  "  consult  with,  meet^ 
advise,  direct,  or  assist,  any  person  engaged  in  such  deception  or 
practice."  We  are  met  here  to-day,  gentlemen,  to  devise  some 
means  for  putting  a  stop  to  this  scandal,  and  purging  our  CoUege 
of  these  offences  against  the  honour  and  digputy  of  the  profession. 
(Cheers). 

Surgeon  McGillicuddy  said  it  was  evident  the  ordinance  passed 
in  1861  was  not  severe  enough,  so  he  would  propose  to  add  to  the 
prohibition  about  meeting,  assisting,  and  so  forth,  the  words  '*  or 
directly  or  indirectly  have  any  professional  communication  with 
such  person.*'  That  would,  he  thought,  cover  every  sort  of  profes- 
sional meeting  with  those  disreputable  homoeopaths — even  at  a 
funeral.     (Hear,  hear.) 

Surgeon  Wyseman  thought  that  the  passiug  of  ordinances  against 
those  members  who  chose  to  practise  a  system  of  therapeutics  dif- 
ferent to  what  the  majority  practised  was  an  anachronism,  and 
unworthy  of  a  scientific  body  such  as  they  professed  to  be.  Medi- 
cine was  not  a  religion,  and  its  adherents  were  not  bound  by  a 
creed,  or  thirty-nine  articles,  or  Westminster  Confession  of  Faith, 
so  he  felt  he  must  vote  against  any  proposal  for  excommunicating 
members  who  thought  differently  on  therapeutic  matters  from 
the  majority.  As  he  was  an  old  President  of  the  College,  he  was, 
if  they  would  forgive  him  the  pun,  in  favour  of  precedents  for  every- 
thing they  did,  and  he  would  ask  if  there  was  any  precedent  for  a 
college  of  surgeons  to  bind  their  members  to  practise  always  accord- 
ing to  one  system,  and  never  on  any  account  to  resort  to  any  other  ? 

Surgeon  Bannagher. — Is  it  precedents  the  honourable  member 
wants  ?    There  is  a  precedent  that  exactly  suits  this  case.     I  hold 


I 


An  Irish  Medical  BvlL  371 

in  my  hand  the  form  of  oath  administered  by  an  eminent  French 
Faculty  of  Medicine  to  candidates  for  their  diploma,  and  with  the 
leave  of  our  present  President  I  will  read  this  former  precedent.  It 
13  given  in  the  form  of  question  and  answer  between  the  president 
of  the  college  or  faculty  and  the  candidate  for  the  licence  to  practise, 
and  runs  as  follows.  It  is  in  Latin,  but  that  is  a  language  we  are 
all  familiar  with,  so  I  shall  not  translate  it. 

Presses, — Jnras  gardare  statutt, 

Per  f acaltatem  prsescripta. 

Cum  sensn  et  jngcamento  ? 
Baehelierus, — Jnro. 

iVeMe«.— Essere  in  omnibus, 

Consultationibus, 

Ancienl  aviso, 

Aut  bono. 

Ant  mauvaiso  ? 
BacheUerus, — Juro. 

Prtfw#.— De  non  jamais  te  servire, 

Da  remediis  aucunis, 

Qaam  de  cenx  seulement  docttt  facnltatis, 

Maladns  d{it-il  crevare 

Et  mori  de  suo  malo  ? 
Bachelierus. — Jnro. 

There,  sir,  if  that  is  not  a  precedent  of  the  most  elegant  sort,  I 
hope  I  may  never  more  touch  potheen.     (Sensation.) 

Surgeon  Wyseman  granted  that  the  obhgation  enforced  on  candi- 
dates never  to  alter — not  even  to  improve — their  practice  was  stringent 
enough  in  the  oath  just  quoted,  but  the  college  or  faculty  by  which 
it  was  imposed  was,  as  he  understood,  one  of  medicine.  He  wanted 
to  know  if  there  was  a  precedent  for  a  college  of  surgeons  having 
imposed  any  such  oath,  or  promulgated  any  such  edict  as  the  one 
passed  by  their  own  College  in  1861. 

Surgeon  Brady  objected  entirely  to  the  search  for  precedents. 
Was  not  Ireland  the  first  flower  of  the  ocean,  the  first  gem  of  the 
earth,  and  was  it  becoming  in  them  to  look  for  precedents? 
Should  they  not  set  the  precedent  for  other  colleges  to  follow  ? 
(Loud  cheers.) 

Surgeon  Wyseman  allowed  that  the  argument  of  the  last  speaker 
was  unanswerable.  But  he  would  take  the  liberty  to  inquire  what 
where  the  grounds  on  which  the  College  had  pronounced  homoeo- 
pathy to  be  a  "  deception."  They  all  knew  the  principles  on  which 
homceopathy  was  founded,  and  the  partisans  of  the  system,  so  far 
firom  making  any  concealment  about  it,  had  published  lots  of 
treatises  addressed  to  the  public  and  the  profession  explaining  it  in 
the  clearest  and  most  concise  manner.  Under  these  circumstances 
he  did  not  see  how  it  could  fairly  and  justly  be  termed  a  "  decep- 
tion.*' 

Surgeon  Brady  rose  to  order.  He  conceived  that  his  friend 
Surgeon  Wyseman  was  completely  out  of  order  in  disputing  the 
dictum  of  the  College  that  homoeopathy  was  a  deception.  He 
submitted  that  it  was  not  for  them  to  criticise  the  solemn  judgment 
of  the  College.    If  the  College  had  pronounced  homoeopathy  to  be 


872  MiiceUaneaug, 

a  deceptioD,  a  deception  it  was  and  must  be,  and  its  partisans  base 
deoeiTers. 

The  President  ruled  that  Snigeon  Wjseman  was  out  of  order  in 
impugning  the  verdict  of  the  College,  and  as  it  had  pronounced 
homcBopathy  to  be  a  deception  they  must  bow  to  the  decision  of  the 
College. 

Surgeon  Wyseman  would  withdraw  his  opposition,  as  he  peroetTcd 
the  sense— or  nonsense — of  the  meeting  was  against  him.  (Groans.) 
He  would  only,  before  sitting  down,  make  one  other  remark.  The 
Piretident  in  hu  opening  address  had  spoken  about  our  time-honoured 
and  traditional  principles,  and  he  had  also  denounced  the  principles 
of  homcsopathy.  Now  they  all  knew  what  the  principles  of  homceo- 
pathy  were,  but  he  should  like  very  much  to  know,  and  he  thought 
the  College  was  bound  to  inform  an  expectant  world,  what  were 
the  time-honoured  and  traditional  principles  on  which  they  prac- 
tised medicine  ? 

The  President  replied  that  he  was  astonished  to  hear  Surgeon 
Wyseman  ask  such  a  question.  He  ought  to  know  that  the  great 
principle  of  orthodox  medicine  was  to  oppose  all  attempts  to 
introduce  a  principle  into  therapeutics.  This  the  homoeopaths 
had  pretendea  to  do,  and  they  professed  to  be  guided  by  a  prin- 
ciple in  the  selection  of  their  remedies.  Such  conduct  the  expo- 
nents of  rational  medicine  held  to  be  most  unprincipled,  and  hence 
deserving  of  reprobation. 

Surgeon  O'Trigger  asked  the  President  how  many  fellows  or 
licentiates  of  the  College  were  actually  engaged  in  the  practice  of 
the  deception  called  homoDopathy  ? 

The  President  believed  the  number  to  be  about  half  a  dozen. 

Surgeon  0*Trigger  said  if  that  was  all,  the  easiest  way  of  settling 
the  matter  would  be  to  act  according  to  the  principles  of  his  illus- 
trious ancestor,  Sir  Lucius,  and  for  half  a  dozen  of  them  to  call  out 
and  shoot  these  unworthy  members.     (Hear,  hear.) 

The  President,  while  doing  full  justice  to  the  courage  of  his 
valiant  friend,  begged  to  remind  him  that  the  days  of  duelling  were 
past. 

Surgeon  O'Trigger. — ^More*s  the  pity. 

The  President. — Possibly.  But  the  destruction  of  the  enemy 
being  impossible  in  the  way  proposed  by  his  distinguished  firiend, 
they  must  have  recourse  to  less  sanguinary  measures  for  getting  rid 
of  their  heretical  members. 

Surgeon  O'Grady  said  why  could  they  not  just  re-enact  the 
ordinance  of  1861,  intimating  at  the  same  time  that  it  would  be 
acted  on  this  time,  and  members  disobeying  would  be  expelled. 
He  would  ask  why  all  these  years  the  ordinance  had  never  been 
enforced  P 

Surgeon  Wyseman. — I  will  tell  the  honourable  member  why  the 
ordinaDce  of  1861  has  not  been  acted  on.  It]  is  in  fact  illegal. 
(Sensation.)  It  is  directly  contrary  to  certain  ^clauses  of  the 
Medical  Act  that  became  law  in  1859,  and  was  passed  in  defiance 
of  this  Act,  and  to  show  the  contempt  the  College  felt  for  it  and 


An  Irish  Medical  Bull  373 

its  authors,  bat  if  the  College  had  attempted  to  act  upon  its 
ordinance  it  would  have  run  the  risk  of  being  punished  by  losing 
its  right  to  make  legally  qualified  surgeons. 

Surgeon  O^Grady  did  not  think  that  was  any  reason  at  all  for 
not  enforcing  the  ordinance.  Let  them  boldly  do  it,  and  dare  an 
alien  Government  to  persecute  them.  He  thought  it  would  enlist 
the  sympathy  of  all  true  lovers  of  liberty  on  their  side  if  a  tyrannical 
Government  were  to  make  martyrs  of  them. 

Surgeon  Wyseman  doubted  if  their  legal  punishment  for  an 
illegal  attempt  to  suppress  liberty  of  opinion  among  their  members 
wovld  meet  with  the  sympathy  of  the  lovers  of  liberty  —unless  it 
were  those  lovers  of  liberty  who  claimed  the  liberty  to  '*  wallop 
their  own  nigger." 

Several  members  having  expressed  an  opinion  that  it  would  be 
injudicious  to  move  further  in  the  matter, 

Surgeon  O'Connell  rose  and  said: — Gentlemen,  I  had  no  in- 
tention to  speak,  but  I  cannot  remain  silent  when  I  see  the 
meeting  giving  signs  of  a  disposition  to  drop  the  matter  entirely,  at 
the  instigation  of  Surgeon  Wyseman,  who  I  should  be  sorry  to 
insinuate  is  a  hired  agent  of  a  base  and  bloody  Government,  whose 
constant  aim  it  is  to  oppress  and  tyrannize  over  this  beautiful  and 
imfortunate  country.  No,  gentlemen,  there  have  been  traitors 
among  Irishmen,  but  I  cannot  believe  that  so  base,  so  mean  a 
traitor  could  be  found  in  our  midst.  No,  gentlemen,  Surgeon 
Wyseman  is  no  traitor,  but  he  exhibits  a  timidity — I  will  not  say 
cowardice — unworthy  of  an  Irishman,  and  has  apparently  even 
infected  some  of  our  colleagues  with  his  own  pusillanimity.  What 
is  it  we  are  met  together  to-day  to  protest  against?  Homoeo- 
pathy! What  is  homoeopathy?  A  system  of  therapeutics. 
What  has  a  college  of  surgeons  to  do  with  a  system  of  thera- 
peutics ?  Nothing — that  is  a  subject  for  a  college  of  physicians. 
Ah,  then,  you  will  say,  let  us  say  nothing  about  it.  If  that  was 
all  then  I  would  myself  be  of  that  opinion,  and  say  we  have  made 
a  mistake,  let  us  retire  with  dignity.  But  is  that  all  ?  Far  from 
it.  Who  was  the  inventor  of  homoeopathy  ?  Samuel  Hahne- 
mann. And  who  was  Samuel  Hahnemann  P  A  Saxon !  (Sensa- 
tion.) Yes,  gentlemen,  a  Saxon  of  the  Saxons.  Born  at  Meissen 
in  the  very  heart  of  Saxony.  (Groans.)  Need  I  say  more,  gentle- 
men? Is  the  black  fact  that  the  author  of  homoeopathy  is  a 
Saxon  not  reason  enough  why  an  Irish  college,  whether  of  sur- 
geons, or  physicians,  or  theologians,  or  mathematicians,  or  engi- 
neers, or  cheesemonffcrs,  should  denounce  him  and  all  his 
works  P  (Hear,  hear!)  The  system  of  therapeutics  has  nothing 
at  all  to  do  with  our  opposition.  It  is  the  man  who  is  the 
author  of  the  system,  a  thoroughbred  of  the  detested  race  that 
we  strike  at  when  we  denounce  homceopathy.  (Hear,  hear.)  Of 
course  we  cannot  proclaim  this  to  the  world,  as  we  are  bound  by 
chains  to  a  race  of  Saxons  on  the  other  side  of  the  Channel,  so  we 
must  allege  another  reason  for  our  opposition.  It  is  certainly  an 
unusual  thing  for  a  college  of  surgeons  to  be  so  particular  about 


374  Miscellaneous. 

ft  sjsiem  of  therapeutics,  and  may  to  outsiders  appear  ridiculous. 
But,  gentlemen,  we  know  what  we  mean.  The  system,  or  practice, 
or  deception,  or  whatever  you  choose  to  call  it,  is  only  a  blind — an 
excuse.  All  the  time  it  is  the  Saxon  we  attack,  it  is  the  Saxon 
we  denounce,  it  is  the  hated  Saxon  we  condemn  under  pretence  of 
attacking,  and  denouncing,  aud  condemning  his  ndiculous  system, 
for  which  no  member,  I  venture  to  say,  cares  twopence.  So, 
gentlemen,  always  remember  when  you  are  pretending  to  as^il 
homoeopathy  it  is  the  perfidious  Saxon  you  are  reall}'  aimii^  at. 
The  ordinance  of  1861  is  perhaps  contrary  to  Act  of  Parliament, 
but  my  illustrious  relative,  Daniel  O'Connell  (tremendous  applause, 
the  whole  meeting  rising  to  their  feet,  and  waving  their  hats  and 
handkerchiefs,  the  clamour  only  being  allayed  by  the  ingenious  device 
of  the  President  proposing  they  should  drink  a  glass  of  potheen  all 
round  to  the  memory  of  Daniel  0*Connell  ^'  in  solemn  silence  "),  the 
great  liberator  of  Ireland  from  Saxon  thraldom  (great  cheering), 
taught  us  how  to  drive  a  coach  and  six  through  any  Act  of  Parlia- 
ment whatever.  Now,  gentlemen,  I  will  show  you  how  to  evade 
the  Act  of  Parliament  while  retaining  the  ordinance,  by  reminding 
you  of  the  story  of  old  Biddy  Malone.  One  day  Biddy  on  her 
rambles  met  Lord  and  Lady  Castleblamey  out  walking  arm  in  arm. 
'*  Good  maruing,  me  Lard,  and  God  save  ye,  me  Lady,*'  sa3'S  Biddy 
with  a  low  curtsey,  "  sure  I  dramed  last  noight  that  yer  Lardship 
guv  me  a  pound  o*  snuff,  and  yer  Ladyship  a  pound  o*  tay." 
**  Ah  !  but  Biddy,  you  know,"  says  my  Lord,  *'  that  dreams  always 
go  by  contraries."  ''  Faith  an'  that  is  so,  me  Lard,  so  its  yer 
Lardship  '11  be  after  givin'  me  the  tay,  and  her  Ladyship  the 
snuff."  Now,  gentlemen,  all  we've  to  do  is  to  imitate  Biddy  and 
reverse  the  order  and  slightly  alter  the  wording  of  the  denunciations 
in  the  ordinance.  The  original  ordinance  first  forbade  fellows  and 
licentiates  to  pretend  to  cure  diseases  by  the  deception  called 
homcBopathy,  and  then  it  ordered  that  no  fellow  or  licentiate  should 
consult  with,  meet,  advise,  direct,  or  assist,  any  one  engaged  in  such 
deception  or  practice.  Now,  I  propose,  first,  to  forbid  any  fellow  or 
licentiate  to  **  consult  with,  advise,  direct,  or  assist,  or  (as  Surgeon 
Mr.  Gillicuddy  suggests)  have  any  professional  communication  with 
any  person  who  professes  to  cure  disease  by  the  deception  caUed 
homoeopathy,'*  and  then  to  denounce  the  practice  of  homoeopathy 
as  **  inconsistent  with  professional  propriety,  aud  derogatory  to  the 
reputation,  honour,  and  dignity  of  the  College."  In  this  way  the 
letter  of  the  Act  of  Parliament  will  not  be  contravened,  though  its 
spirit  will,  but  that's  just  what  we  want,  and  in  this  way  we  show 
our  detestation  of  the  *'  base,  bloody,  and  brutal  Saxon."  (Thunders 
of  applause.) 

Surgeon  Wyseman  said,  in  his  opinion  it  was  ''derogatory  to  the 
reputation,  honour,  and  dignity  of  the  College"  to  seek  to  evade 
an  Act  of  Parliament  in  the  manner  proposed,  and  that  the  course 
the  College  was  counselled  to  pursue,  if  not  a  ''deception,"  was,  at 
all  events,  a  mode  of  proceeding  that  would  be  "  considered  dero- 
gatory and  dishonourable  "  by  all  gentlemen,  and,  he  suspected,  by 


American  Institute  of  Homoeopathy,  375 

all  "  physicians  and  surgeons  "  too,  except,  perhaps,  those  belong- 
ing to  the  Irish  College.     (Uproar.) 

Surgeon  O'Trigger  rose  to  order.  The  last  speaker  had  grossly 
insulted  the  College  and  every  member  of  it,  so  he  proposed  that, 
as  the  President  had  ruled  it  would  not  do  to  call  him  out,  they 
should  put  him  out. 

Which  was  done,  and  the  ordinance,  as  modified  by  Surgeon 
O'Connell,  was  passed  unanimously,  amid  the  most  exuberant 
demonstrations  of  enthusiasm. 


American  Institute  of  Homoeopathy, 

This  Association  held  its  thirty-second  Annual  Session  in  June 
last,  at  Milwaukee,  and  seems  to  have  had  an  enjoyable  meeting. 
Full  accounts  of  it  are  given  in  the  Hahnemannian  Monthly ^  for 
July,  and  the  HomoBopathic  Times,  for  July  and  August.  Our 
contributor,  Dr.  Berridge  (who  was  present),  has  requested  us 
to  publish  the  following,  which  grew  out  of  a  somewhat  emphatic 
repudiation  of  an  attempt  on  his  part  to  lecture  the  Institute  on 
its  neglect  of  true  homoeopathy. 

The  Inteeitational  Hahnemaknian  Association. 

At  an  adjourned  meeting  of  friends  of  Hahnemann  Homoeo- 
pathy, the  following  resolutions  were  adopted  : 

**  Whereas,  We  believe  tho  Organon  of  the  Healing  Art  as  pro- 
mulgated by  Samuel  Hahnemann  to  be  the  only  reliable  guide  in 
therapeutics,  and 

"  Whereas,  This  clearly  teaches  that  Homoeopathy  consists  in 
the  law  of  similars,  the  single  remedy,  the  minimum  dose  of  the 
dynamised  drug,  and  these  not  singly  but  collectively  ;  and 

"Whereas,  Numbers  of  professed  Homoeopathists  not  only 
violate  these  tenets,  but  largely  repudiate  them ;  and 

*^  Whereas,  An  effort  has  been  made  on  the  part  of  such 
physicians  to  unite  the  Homoeopathic  with  the  Allopathic  school ; 
therefore 

"Eesolved,  That  the  time  has  fully  come  when  legitimate 
Hahnemannian  Homoeopathists  should  publicly  disavow  all  such 
ionovations ; 

'^  Eesolved,  That  the  mixing  or  [alternating  of  two  or  more 
medicines  is  regarded  as  non-homoeopathic ; 

^'  Besolved,  That  in  non-surgical  cases  we  disapprove  of  medi- 
cated topical  applications  and  mechanical  appliances  as  being  also 
non-homoeopathic ; 


376  Miscellaneous, 

''  Besolyed,  That  '  as  the  best  doae  of  medidne  is  erer  the 
■malleBt/  we  cannot  recogniae  as  being  Homoeopathic  such  treat- 
ment as  suppresses  symptoms  by  the  toxic  action  of  the  drag; 

*'  Besolvedy  That  we  have  no  sympathy  in  common  with  those 
physicians  who  would  engraft  on  to  HomoBopathy  the  erode  ideas 
and  doses  of  Allopathy  and  Eclecticism,  and  we  do  not  hold  our- 
selres  responsible  for  their  '  fatal  errors,'  and  fiulures  in  theory 
and  practice ; 

'*  Sesolyed,  That  as  some  self-styled  Homodopathists  haye  taken 
occasion  to  traduce  Hahnemann  as  a  '  fanatic,' '  dishonesty*  and  a 
'  visionary,'  and  his  teaching  as  *  not  being  the  standard  of 
Homoeopathy  of  to-day,'  that  we  regard  all  such  as  being  recreant 
to  the  best  interests  of  Homoeopathy  ; 

"  Besolved,  That  for  the  purpose  of  promoting  these  senti- 
ments, and  for  our  own  mutual  improyement,  we  organise  our- 
selves into  an  International  Hahnemannian  Association,  and 
adopt  a  constitution  and  bye-laws." 

A  society  was  organised  by  the  adoption  of  a  constitution  and 
bye-laws,  and  electing  the  following  o£Bcers: — P.  P.  Wells, 
Brooklyn,  president ;  T.  F.  Pomeroy,  Detroit,  yice-president ;  J. 
P.  Mills,  Chicago,  secretary  and  treasurer ;  E.  W.  Berridge, 
London,  England,  corresponding  secretary.  Bureaus:  Ad. 
Lippe,  Materia  Medica;  C.  Pearson,  Clinical  Medicine;  E.  A. 
Ballard,  Therapeutic  Surgery;  T.  P.  Pomeroy,  Obstetrics  and 
Diseases  of  Women  and  Children. 

NoueleBS  Crockery, 

A  PATENT  has  been  taken  out  by  Mr.  Vernon,  of  Newton- 
Stewart,  for  rendering  crockery  absolutely  noiseless.  It  is  applied 
to  cups  and  saucers,  plates,  basins,  ewers,  jugs,  and,  in  short, 
all  domestic  articles  of  china  and  stoneware,  and  consists  in  the 
insertion  of  a  vulcanised  india-rubber  ring  in  the  bottom  of  the 
article.  This  invention  is  likely  to  be  of  especial  use  in  the 
sick-room,  where  the  clatter  of  crockery  is  often  very  disagreeable 
to  a  patient.  There  is  another  advantage  attending  the  inven- 
tion, and  that  is  that  a  vessel  fitted  with  it  will  not  slip  about. 
Thus,  a  cup  will  bear  to  be  inclined  in  the  saucer  at  a  very  con- 
siderable angle  without  sliding.  Services  of  porcelain  and  stone- 
ware fitted  with  these  rings  are  well  adapted  for  an  unsteady 
table,  such  as  we  find  in  sea-going  ships,  and  we  believe  they 


International  College  of  Hygiene.  877 

have  already  been  supplied  to  yaehte  and  several  lines  of  ocean 
steamers. 


Pathogenetic  JReeord. 
Wb  beg  to  call  attention  to  the  completion  of  the  first  volume 
of  this  work  which  has  been  published  with  varpng  regularity, 
as  an  appendix  to  the  Journal.  The  labour  bestowed  on  it  by 
its  industrious  author  Dr.  Berridge,  has  been  enormous,  and  the 
result  is  a  cyclopaedia  of  the  morbid  symptoms  and  artificial  dis- 
eases developed  by  the  medicines  named  in  the  volume  which  will 
be  of  vast  importance  to  the  Materia  Medica.  The  whole  homoso- 
pathic  world  is  deeply  indebted  to  Dr.  Berridge  for  his  labour 
of  love  in  their  service,  and  we  are  glad  to  know  that  his  work 
is  highly  appreciated  by  our  colleagues  on  the  other  side  of  the 
Atlantic.  The  further  publication  of  Dr.  Berridge's  work,  of 
which,  of  course,  this  first  volume  is  only  the  commencement, 
must  be  postponed  for  a  while  as  it  is  our  intention  to  devote 
the  appendix  for  some  time  to  come  to  a  critical  commeptary  by 
Dr.  Hughes  on  Allen's  Encyclopedia,  We  trust  by  and  by  to 
resume  the  publication  of  Dr.  Berridge's  Pathogenetic  Becord,  if 

he  will  allow  us  to  do  so. 

»  —  '  ^~^~~"  II 

Dr.  Dudgeon^s  Pocket  Sphygmograph. 
As,  contrary  to  expectation,  the  whole  stock  in  hand  was 
almost  immediately  sold,  gentlemen  who  have  ordered  the  instru- 
ment will  have  to  wait  a  week  or  two  until  another  supply  can 
be  manufactured.  This  is  being  done  with  all  due  rapidity,  but 
as  great  care  is  required  to  make  the  various  adjustments,  some 
little  time  will  elapse  before  the  instruments  are  ready  for 
delivery.  Mr.  Ganter  will  then  forward  them  to  those  who  have 
applied  to  him  for  them,  in  the  order  of  their  application. 


International  College  of  Hygiene, 
The  Congress  was  held  this  year  at  Turin.  Our  colleague, 
Dr.  M.  Both,  read  there  papers  on  the  following  subjects : — 
1.  On  Obligatory  Inspection  of  Schools.  2.  On  the  Ladies' 
Sanitary  Association  of  London  and  its  Work.  3.  On  the 
Introduction  of  the  Elements  of  Hygiene  and  Physical  Educa- 
tion into  all  Primary  and  Secondary  Schools.  4.  On  the  Means 
of  Preventing  Blindness.  5.  The  Anti-hygienic  Conditions  in 
which  the  Workmen  in  Scotch  Ship-building  Yards  are  placed. 


378 


OBITUARY. 


CONSTANTINE  HEfim&. 

Sings  the  death  of  Hahnemann  no  one  has  occupied  such  a 
prominent  place  in  the  homoeopathic  world  as  the  illnstriouB  man 
whose  death  we  no^^  deplete.    A  man  of  thoroughlj  onginaL 
genius,  he  would  haye  made  a  figure  in  anj  sphere  in  whi<£  he 
elected  to  move.    It  was  fortunate  for  homceopathj  that  he  earlj 
become  a  devoted  adherent,  for  his  career  has  been  one  long  suc- 
cession of  brilliant  and  important  services,  to  tha  method  of  Hah- 
nemann.    Bom  at  a  small  town  in  Sazonj,  on  the  first  day  of 
the  closing  jear  of  the  eighteenth  century,  he  had  just  completed 
his  fourscore  years  when  he  died  in  the  very  height  of  his  never- 
ceasing  activity,  never  having  known  what  it  was  to  take  rest 
from  his 'self-imposed  labours.    His  first  appearance  in  homceo- 
pathic  literature,  as  far  as  we  can  ascertain,  is  a  communication 
addressed  to  the  Archiv  in  1827,  in  which  he  gives  an  account 
of  his  sea-sickness  during  his  voyage  to  Surinam,  and  mentions 
the  remedies  that  cured  him,  namely,  Coceulw  for  the  actual 
sickness,  and  Staphisagria  for  a  spongy  state  of  the  gums  that 
remained  or  occurred  after  the  cessation  of  the  sickness.     In  this 
article  he  also  describes  some  of  the  diseases  he  met  vnth  among 
the  inhabitants,  Europeans  and  natives,  and  the  remedies  he 
had  found  useful.     A.mong  others,  a  case  of  tetanus  in  a  black, 
which  was  cured,  to  the  great  astonishment  of  the  people,  by 
Anguttura,    He  mentions  that  he  was  about  to  take  a  journey 
into  the  interior  under  the  guidance  of  an  Indian,  to  a  lake  never 
yet  visited  by  white  men,  where  wonderful  animals  and  plants 
abounded.     On  his  return  he  would  devote  himself  to  the  study 
of  yaws,  elephantiasis,  leprosy,  or  boassio,  which  is  considered 
incurable.     Later,  he  mentions  that  he  remained  for  fourteen 
days  in  the  region  set  apart  for  persons  afflicted  with  this  dis- 
ease, which  is  much  dreaded,  and  all  the  subjects  of  it  are  kept 
confined  on  a  particular  plantation,  and  not  allowed  to  leave  it 
for  fear  of  spreading  the  disease  by  infection. 

As  his  career  commenced  in  this  industrious  and  active  manner 
BO  it  went  on.  He  left  Surinam  in  1833,  and  came  to  Phila- 
delphia, where  he  settled  down  in  practice  after  a  short  sojourn 
in  AUentown  to  assist  in  the  establishment  of  a  homodopathie 
academy.  During  the  whole  course  of  his  long  medical  life,  he 
was  incessantly  oceupied  in  adding  new  medicines  to  the  homoeo- 
pathic materia  medica,  proving  them  on  himself  and  others,  and 
publishing  the  results  of  his  labours  from  time  to  time.    In 


Obituary — Conslantine  Hering.  379 

the  number  of  medicines  lie  made  available  for  homcBopathic 
treatment  by  provings  more  or  less  complete,  he  is  second  to 
Hahnemann  alone — some  of  whose  medicines  he  assisted  to 
prove,  notably,  Arsenic ^  JPhospharvs,  Phosphoric  acid  and  Silica, 
Lac/tcsis,  Apis,  Oxalic  add,  Glonoin,  are  some  of  the  most  valu- 
able of  Dr.  Hering's  additions  to  the  materia  medica.  Besides 
provings,  Dr.  Hering  was  a  diligent  maker  of  manuals  designed 
to  assist  the  practitioner.  He  published  Choss^s  Comparative 
Materia  Medica;  commenced  a  gigantic  work  called  Analytical 
Therapeutics  which,  however,  never  got  beyond  the  first  volume ; 
gave  us  a  few  years  ago  his  Condensed  Materia  Medica,  which  has 
reached  a  second  edition,  and,  at  the  time  of  his  decease,  was 
busy  with  the  proof  sheets  of  the  third  volume  of  his  Guidina 
Symptoms. 

But  his  literary  activity  was  not  limited  to  these  serious  works. 
He  was  a  great  master  of  sarcasm  and  had  an  abundance  of 
Attic  salt  to  spare.  This  he  bestowed  chiefly  on  his  German 
friends,  and  he  published  in  German  some  excessively  witty  and 
sarcastic  pamphlets  with  the  title  of  Neue  Hauhecheln  under  the 
pseudonym  of  "  Dr.  Wisent.''  These  pamphlets  are  brimming 
over  with  wit  and  wisdom ;  he  even  ushers  in  a  list  of  Errata 
in  the  following  humorous  manner. 

"  0  modesty !  O  thou  lovely  human  virtue,  who  art  only  to  be 
found  in  rags,  and  then  only  until  they  become  paper ;  when 
books  are  formed  thereof,  then  indeed,  there  is  no  more  thought 
of  thee !  O  let  thy  violet  perfume  spread  over  this  last  page, 
which  probably  will  not  appear  quite  free  from  faults.  The 
author  cannot  allege  as  his  excuse  for  these  his  remoteness  from 
the  printing  place,  nor  yet  lay  the  slightest  blame  on  his  com- 
positor, he  therefore  takes  upon  himself  alone  the  whole  blame, 
and  would  beg  his  courteous  readers,  especially  those  who  are 
afflicted  with  defective  education,  not  to  read  the  book  a  second 
time  without  carefully  making  the  following  corrections." 

In  a  short  intercourse  with  the  illustrious  departed  some 
thirty-four  years  since,  we  had  an  opportunity  of  enjoying  and 
admiring  a  mixture  of  learning,  simplicity,  earnestness,  and 
"  paukiness,"  such  as  combined  to  make  one  of  the  most  re- 
markable men  it  has  been  our  fortune  to  meet.  Since  then  we 
have  occasionally  had  letters  from  him,  and  we  shall  feel  his  loss 
as  that  of  an  old  and  valued  iriend. 

This  is  not  the  place  in  which  to  examine  critically  the  work 
done  for  homceopathy  by  Dr.  Hering.  His  influence  has  been 
immense,  and  if  we  have  found  it  necessary  sometimes  to  differ 
from  his  views  in  minor  points,  we  have  always  felt  that  Hering 
was  the  worthiest  representative  of  homoeopathy  since  Hahne- 
mann's death. 

At  the  British  HomcDopathic  Congress  held  last  month  at 
Leeds,  a  resolution  expressive  of  the  regret  of  the  congress  and 
their  sympathy  with  his  widow  was  passed  with  unanimity. 


380 


BOOKS   RECEIVED, 

"  SeraUikw  '*  of  a  Suraeon.      By  W.  T.  HEunrrH,    M.D. 
Chicago.    1879. 

Sp^uU  Indieatiofu  for  twenty-fioe  BeutetUet  in  IntermUietU 
Fmt,    Bj  T.  p.  Wilbok,  M.D.    PhflAdelpbi»,     1880. 

The  EffoeU  rf  TrUunOion.     By  C.    WssBiLHon,   M-D. 
Boston. 

Skin  DiteoiOi  ireaied  HomoBopatkieallff,    Bj   WASHnroTOJr 
Eppfl.    Second  edition.    London. 

EHudoi  Oeraei  ubro  HomtBopaihia  pole  medico  homasopaiha 
AuousTO  CssABio  d'Abrxit. 

Eneyelepadie  dei  Impfent  und  ieiner  Folgen.  Am  dem  JSn^lie- 
eken.    Hannover:  Eahn.    1880. 

8iei  Hwning  at  Home.    Bj  S.  F.  A.  Caitlfixld.     London : 
Basaar  Office. 

Oaetein;   iU  Sprinfi  and  Climate.    By  G-iraTATTrs  Pssll, 
M.D.    Fourth  edition.    Vienna.    1880. 

The  Homaopathie  TherapeuticM  of  Intermittent  Fever.    By 
H.  C.  Allik,  M.D.    Detroit    1880. 

Badieal  Meehaniet  of  Animal  Locomotion,     By  W.  P.  WAnr- 
WBIGHT.    ^'ew  York.    1880. 

jReviita  Portugueza  de  Therapeutiea  Homaopathicapeloc  medicoe 
homoeopathoi  Dr.  P.  Joubbet  e  A.  C.  d'Abbeu. 

Arehivoi  de  Mcdicina  Homeopatica. 

The  American  Journal  of  Microscopy  and  Popular  Science, 
New  York.    Vol.  V.    No.  7. 

II  Dinamioo,  Qiomale  mcdico^omiopatico.    Napoli. 

The  SomcBopathic  Espoiitor,  January,  1880. 

The  Medical  Oouneelhr, 

The  Homoeopathic  yewe. 

St.  Louie  Clinical  Becord. 

The  American  Homoeopath. 

Revue  Homoeopathique  Beige. 

The  Monthly  Momceopathic  Review. 

The  Hahnemannian  Monthly. 

The  American  Homoeopathic  Observer. 

The  United  States  Medical  Investigator, 

The  North  American  Journal  of  Homoeopathy. 

The  New  England  Medical  Chzette. 

El  Oriterio  Medico. 

L'Art  Midical. 

Bulletin  de  la  Sociiti  Mid,  Horn,  de  France. 

Allgemdne  homoopathische  Zeiiung 

The  Homoeopathic  World, 

The  Homoeopathic  Times. 

V  Homoeopathic  Militante. 

The  Organon, 

The  Medical  Herald. 

The  Medical  Becord. 


INDEX  TO  VOL.  XXXVIII. 


Accommodation  of  yision,  myopia  from  a 

blow,  illuitrating'  Dudobon's  theory 

of,  60 
Aeetie  add  in  nasal  polypi,  78 
Aconite,  indications  for,  in  heart  disease, 

158 
Action  of  drugs,  Fkbdault  on  the,  97 
After-pains,  eamph.  in,  354 
Aggravations,  what  they)  are,  101;  ^, 

various  kinds  of,  103 ;  — ,  general, 

103 ;  — ,  partial,  103  ;  — ,  relation, 

104  ;  — ,  accessory,  104 
Albuminuria,  Mr.  Emoall  on,  286 
Alcock's  porous  plasters,  Dr.  Ku  on, 

292 
Allantiasis,  23 
JUen*  Eneyclcprndia,  1 
AlUum  eepa  in  fluent  coryza,  355 
Alternation  with  the  antidote,  Hkkino 

on,  57 
American  Institute  of  Homoeopathy 
Amylmtrite  in  angina  pectoris,  Hbkino 

on,  55 
Antimony,  poisoning  by,  30 
Apis,  in  suffocative  sensation,  353 
Apocynum  in  convulsions  of  pregnancy, 

280 
Argyria,29 
Amiea  in  cardiac  dlsturbanee*  853 ;  — ,  in 

sore  nipples,  262;—,  eruption,  cause 

of,  298 
Anenie  in  gall*stones,  40 ;  — ,  in  heart 

affections,  161 
Anenic  and  its  compounds.  Dr.  Bkr< 

niDOK  on,  385 
Arum  trgthyllum  in  hay-fever,  356 
Ascites  and  anasarca,  by  Dr.  Drysdale^ 

321 
Jielepiat  syriaea  in  Bright's  disease, 

280 

Bee-sting,  symptoms  caused  by  a,  258 
Berberis  aquifoHtan,  by  Dr.  Wintbb- 

BUBN,  84 


Bbbbidgb,  Dr.,  on    artenie   and    its 

compounds,  App,,  385 
Bitmuth  poisoning,  31 
Black,  Dr.,  on  homoeopathic   educa- 
tional requirements,  177 
Blakb,  E.,  on  glycogenic  property  of 

uranium,  90 ;  — ,  on  zymotics,  130 
Blaoklbt,  Dr.  C.  H,,Hay'fever,  by,  255 
Blind,    Society    for    improvement    of 

Physique  of,  89 
BojANUH,  Hommepathy  m  Ruma,  by, 

305 
Bollb's  cotton-wool  bandage  in  wounds, 

41 
Borax  in  membranous  dysmenorrhcea, 

262;  — ,  uterine  symptoms  caused  by, 

281 
Boiton  Unhertity  Year-Book,  256 
BotuUsmus,  23 
Breath,  temperature  of,  Dudobok  on, 

294 
Brioht'b  disease,  MCJQi.syr.  in,  280 ;  — i 

phoi.  in,  86 
Bromine  in  diphtheria,  163 
Bbunton  on  pharmacology  and  thera* 

peutics,  by  Dr.  J.  Clabkb,  216 
Bryonia  in  pain  in  stomach  after  diph* 

theria,  259 
Buchmann's  investigations  of  tritura« 

tions,  331 
Btffo  in  uterine  fibroid,  265 
Bull,  Irish  medical,  357 
BuBNBTT,  Dr.,  curability  of  cataratt  by 

medicines,  166 
BuTLBB,    Textbook   of  Eteetro-thera' 

peuttee  by,  50 

Caetiu  in  heart  affections,  159 
Coiium,  proving  of,  58 
Ci{fein  in  heart  affections,  160 
Calcarea  in  heart  affections,  162 ;  — ,  in 

corneal  opacity,  356 
Calcarea  phoephorica  in  fractures,  55 
Cak*  auiph,  in  empyema,  280 


382 


tndex. 


1 


Ctm^Aor  in  after-ptins,  354 

CantkcrU  in  tricemintl  neuralgia,  261 

C^bo    Ttg^tabiiiM,    WBiscLBotrr,    re- 
proving of,  343 

Catartct,  curability  by  medicines  of,;  Dr. 
BuaKBTT,  166 

Ceanothwt  in  enlarged  spleen,  354 

Cerebro-spinal  meningitti,  ver,  rir,  in, 
354 

Charcoal,  trituration  of,  333 

Cheese,  poisonous,  24 

CkemiMtry,  Mtdieai,  WnaLsa'a,  174 

Childbed,  pnlse  in,  281 

Ckma  in  uterine  hemorrhage,  266 ;  — , 
in  gall'Stones,  280 

Ckhniform  in  gall-stones,  175 

Ckromimm  poisoning,  31 

Cimicifti{fa  in  myalgia  of  diaphngai,263 ; 
— ,  in  epilepsy,  277 

CLAmBB,  Dr.,  in  Baunton's  Phtanma* 
eologf  and  Tkerapeuiie»,  216 

CUmique,  The,  a  new  American  homoeo- 
pathic periodical,  174 

Coiekiemm,  keynote  symptoms  of,  355 

CoUc,  lead,  26 

Constipation,  tU.  in,  285 

CooKi  on  licenMd  foeticide,  255 

Copper  poisoning.  28;  — ,  triturations  of, 
332 

Corneal  opacity,  eak,  earb,  in,  356 

Coryza,  cj/.  ctp.  in,  355 

OiMsa  solvent  of  diphtheritic  mem- 
branes, 461 

Cyphir  Repertary,  Female  genitals  part, 
54 

Dakb,  Dr.,  The  Regeneration  of  the 
Materia  Medica,  hy,  12 

Derelopment,  the  new,  181 

Diaphragm,  myalgia  of,  eitnieif,  in,  263 

Diffitalii  in  heart  affections,  161 

Diphtheria,  pain  in  stomach  after,  bry. 
in,  259;  — ,  kiUi  bieh,  in,  261 ;  ^, 
hepar  in,  36 ;  — ,  mere,  cyan,  in,  37  ; 
— ,  brom,  in,  163 

Drury,  Dr.,  on  the  Britieh  Homao- 
pathic  Pharmaeopteia,  176 

Drybdalb,  Dr.,  on  ascites  and  anasarca, 
321 J  — ,  on  pyrexin,  140 

Drybdalb,  Dr.  C,  Nature  and  Treat- 
ment ef  Syphilie,  by,  350 

DuDOBON  on  the  temperature  of  the 
breath,  294 ;  — ,  on  a  new  sphygmo- 
graph,  299 

Duncan,  Dieeaeei  of  It^fante  and  Chil- 
dren, by, 341 

Dvsmenorrlices,  membranous,  bortue  in^ 
262 


Dysmenorrhma,  stenotic,  lye.  in,  35S 

EoBBRT  on  uterine  and    vagisal  dis- 
charges, 48 

Eleetro-tkerapeuiiee,  Butler's,  50 

Empyema,  eale.  eulplL  in,  280 

Encephalopathia  satumina,  28 

Eneyckpeidia,  Allbn's,  1 

Enoall  on  albuminuria,  286 

Enuresis  noctuma,  equieet.  in,  351 

Epilepsy,  dmieifa^fa  in,  277 

Egmeetum  kyemale  in  Doctumal  enuresis, 
357 

Faulknbr's  HenuBOpathie  Phy$ieian*t 

VitUinff  List,  54 
Foeticide,  licensed,  by  Cookb,  255 
Fox's  photographic  illustrations  of  skin 

diseases,  171 
Frbdault  on  the  action  of  drugs,  97 
Frostbite,  todsB  bicarb,  in,  259 

Gall-stones,  areenie  in,  40;  — ,  solution 
of,  175;  — ,  Dr.  Kbr  on,  232;  — , 
china  in,  280 

GeUemium  in  infantile  paralysis,  335 

GenoTCf  a  water,  299 

Gilchrist,  Surgical  Dieeaeet  and  their 
Homoeopathic  7Vea/mai^,by,34l 

Gold,  tritr nations  of,  331 

Glanderine  in  oza>na,  262 

Guiding  symptoms,  Hbrino's,  345 

Haemorrhage  between  retina  and  choroid, 

lach.  and  geli.  in,  262 
Haemorrhage,  uterine,  china  in,  266 
Hahnbmann'b  theory  of  aggravations, 

false.  Ill 
Hahnemann,  a  letter  of,  64 
Halb,  £.  W.,  on  diseases  of  women,  49 ; 

— ,  materia  medics,  172 
Hay-fever,  by  Dr.  C.  H.  Blacklet.  255 ; 

— ,  arum  tri.  in,  356 
Hatward,  Dr.,  on  intestinal  obstruc- 
tion, 193 
Heart,  affections  of  the,  remedies  for, 

158;  — ,  «con,  in,  158;  — ^  cactus  in, 

159;   '-,caffeiH  in,  160;    — ,  digit. 

in,  161 ;  — ,  are.  in,  161;  — ,phoM,  in, 

162;  —,  co/c.  in,  162 
Heiniokb's  PathogeneticOutlines,inxi^'^ 

lated  by  Tibtzb,  254,  347 
Hblmuth*s  System  qf  Surgery,  45 
Hem  pel,  D.  C.  J.,  death  of,  93 
Hem  pel's  Materia  Medica  and  Thera* 

peutics,  346 
H bring,  Dr.  Constantine,  death  of,  378 
11ering*8   Condensed  Materia  Medico, 

57 ;  — ,  Guiding  Symptoms,  345 


Index. 


383 


HirscheVa  Zeitschrifif  discontinuance 
of,  83 

HuGHBs,  Dr.,  Phamtaeodynamies,  346 

HuNTRR,  Hahnemann's  percursor  in 
explanation  of  cure,  100 

Hydrophobic  symptoms  caused  by  a  bee- 
sting,  258 

Hygiene,  prize  for  an  essay  on,  279  ;  — , 
International  Congress  of,  377 

Insanity,  treatment  of,  by  Dr.  Talcott, 
270 

International  Homoeopathic  ConTention, 
301 

Intussusception,  Bbistows  on,  210 

Irish  College  of  Surgeons  and  homoeo- 
pathy, 357 

Irish  medical  bull,  357 

Iron,  poisoning  by  salts  of,  31 

Italian  Council  of  Education  on  homoeo- 
pathy, 248 

Italy,  history  of  homoeopathy  in,  248 

Jenichbn's  high  potencies,  the  mys- 
tery rcYealed  of,  66 

Jbssen,  Materia  Medica^  by,  173 ;  — ,  on 
hereditary  syphilis,  43 

Johnson,  J.  D.,  Guide  to  Homceopathic 
Practice,  53 

Jousset'b,  Clinical  Medicine,  Lun- 
lam's  translation  of,  46;  — ,  on 
homoeopathic  educational  require- 
ments, 177 

Jones,  S.  A.,  Grounds  of  a  Hommpath't 
Faith,  by,  52 


KaU  hich,  in  diphtheria,  261 
Kali.  nit.  in  pneumonia,  356 
Kir,  D.,  on  gall-stones,   232; 
Alcock's  porous  plasters,  292 


— ,  on 


Lachesis  and  lycopodium,  differential 
indications  of,  in  throat  disease,  266 

Lead  colic,  26 ;  — ,  paralysis,  27 ;  -*, 
poisoning  by,  24 

Lilienthal's  Homceopathic  Therapeu- 
tics, 51 

Lilium  tigrinum,  action  on  the  eye  of,  79 

Liver,  chronic  enlargement  of,  nit.  ac,  in, 
283 

Lochia,  suppressed,  parii  in,  258 

Ludlam's  translation  of  Joussbt's 
Clinical  Medidnct  46 

Lycopodium  in  stenotic  dysmenorrhoea, 
355 

Manganese,  poisoning  byj  3 1 


Materia  Medica,  Dr.  Dake,  on  the  rege- 
neration of  ^the,  12  :  — ,  Hempel's, 
346 ;  — ,  Jessbn'm,  173  ;  — ,  con- 
densed, Herino's,  31 ;  — ,  Hale's, 
172 

Melancholia,  remedies  for,  275 ;  — ,  nat. 
mur.  in,  279 

Mbngozzi's  Memoria,  247 

Mental  and  Nervous  Diseases,  by  Dr. 
Talcott,  270 

Mercurial  poisoning,  29 

Mere,  cyan,  in  ulcerated  sore  throat, 
356 

MEYHOPrER  on  Affections  of  the  Heart, 
158 

Morphia  in  vomiting,  261 

Myopia  from  a  blow.  Dudgeon  on,  60 

Nasal  polypi  cured  by  injecting  acetic 

acid,  7S 
Nat.  mur.  in  melancholia,  279 
Neuralgia,  trigeminal,  canth.  in,  261 
Nitric  acid  in  chronic  enlargement  of 

the  liver,  283 
Noiseless  crockery,  376 
Nunez,  Dr.,  death  of,  91 

Obstruction,  intestinal.  Dr.  Hatward 

on,  193 
Oxalic  acid  in  cardiac  disturbance  with 

aphonia,  356 
Oz8ena,^ton<fmn«in,  262 

Palladium,  proving  of,  by  Dr.  Hbrimo, 

55 
Paralysis,  infantile,  yels,  in,  355 ;  — ,  lead, 

29 
Paris  Congress,  transactions  of,  155 
Paris  quadrifolia  in  suppressed  lochia, 

258 
Pathogenetic  Record,  The,  377 
Pharmacodynamics,  Dr.  Hughes',  346 
Pharmaccpceia,   British    Homceopathic, 

Dr.  Drurt  on,  176 
Phosphorus  in  Bright's  disease,  36 ;  — , 

in  heart  affections,  162 
Plumbum,  triturations  of,  333 
Pneumonia,  kali  nit.  in,  356 
Poisons,  effects  of,  23 
Portraits  of  British  faomoeopathists,  175 
Posology,  homoeopathic.  Carter  on,  164 
Provings  of  milk-sugar,  342 
Pulsatilla  causing  version  of  foetus,  259 
Pyrexin,  Dr.  Drysdalb  on,  140 
Pyrogen,  effects  of,  141 ;  — ^,  the  remedy 

for  typhous  pyrexia,  146  ;  — ,  indica-> 

tions  for,  150 ;   — ,  preparations  of, 

152 


884 


Index. 


Bh—mttitii  eored  by  bAiidliDg  rkut, 

357  ;  _^  rAaw  in,  281 
Mkm  in  rixmnatitm,  281 
Rnsna*  homoeopathy  in,  305 

SaUq^Uc  octtf  in  rbeamatiim,  Sick  on, 

35 
SAMonnno,  on  tulpk,  in  chronic  nicer  of 

Smtfummrm*f  miirMtt  rf,  proTing  of,  353 
Sanaagt  poiaomng ,  23 
Scbeoth's  thint-cnre  in  ulcert,  42 
SsAALB'a  new  form  of  nenrons  disease, 

56 
Sfcnlr,  pathogenetic  effects  of,  354 
Secondary  effects  of  drugs,  105 
Secret  retealed,  the,  66 
SqMtn,  nature  of,  140 
SMULnsAM,  Dr.,  on  Siammen»ff,  168 
Siok'b  homcsopathic  treatment,  32 
SiUe*  ]}a  constipation,  285 ;  •»,  tritura- 
tions of,  333 
Sihfr  poisoning,  28 
SiLTBnLOcn'a    MedioMi   FraetitUmen* 

Vuitm^  Hit,  54 
Skin  diseases.  Fox's  photographic  illus- 
trations, of  171 
Sphygmograph,  Dudobon's,  299, 377 
Spleen,  enlarged,  CHtmothiu  in,  354 
Simnmsring,  Dr.  Shuldham  on,  168 
StUpkMT  in  ulcer  of  leg,  59 ;  — ,  thera- 
peutic uses  of,  260 
5bry«ry,  UnLiitrrH's,  45 
S^kilia  JnesKN  on,  43 ;  — -,  C.  Dnrs- 
DALU  on,  350 

Talcott    on    Mental    and      Nervoui 

dueoieM,  270 
TarantuU  in  epileptiform  hysteria,  356 ; 

— ,  Dr.  Smith's  symptoms  ef,261 ;  — , 

cM^cNstt,  pathogenetic  and  therapeutic 

effects  of,  266 


TkaUimm  potsonlng,  31 

Thomas,  Cues t^  InUgtmal  Oielmefum 
by,  202 

TiBTzn's  translation  of  HsiNiGKB'a 
Handbook,  254,  347 

Tltfi  poisoning,  31 

Tnnsactions  of  American  Institate  of 
Homoeopathy,  342;  — ,  of  Homoeo- 
pathic Society  of  Pennsyhrania, 

Triturations,  324  ;  —  WBSSU.HOsrr'n 
experiments  on,  326;  — ,  of  goidf 
328 ;  — ,  of  etjjpper,  321 ;  —of  lead, 
329 ',  — ,  of  trofl,  329 ;  — ,  Buchanak 
on,  331 

Typhus,  Sice's  treatment  of,  33 

Ulcer,  eu^h.  in,  Sakdbbbg  on,  59 
Uranium,  Blake  on  glycogenic  property 

of,  90 
Uterine  fibroid,  bufo  in,  265 
Uterine  and  vaginal  discharges,  Eggbbt 

on,  48 

Vsccinstion  and  smallpox,  Dcdgkov  on, 
62 

Veraium  vir.  in  cerebro-spinal  menin- 
gitis, 353 

Version  of  foetus  caused  by  pult^  259 

Viiumum  prunif.  in  threatened  mis- 
carriage, 261 

Vomiting,  morphia  in,  261 

WBaSBLHOBFT's  J»f>eitiffatums  of  Tritn- 
ratiam,  326 ;    — ,  proving  of  car6. 
my.,  343 
Whbklbr's  Medical  Chemietry,  176 
Women,  Halb  on  diseases  of.  49 
WooDTAiT    on    the    action  of   Wimn 
ti§rimtm  oo  the  eye,  79 

Zinc  poisoning,  28 

Zymotiest  by  Dr.  £.  Blakb,  130 


PBDTTBD  BT  J.   E.  ADLABD,  BABTHOLOMEW  CLOSE.