Skip to main content

Full text of "The British journal of homoeopathy"

See other formats 


Google 


This  is  a  digital  copy  of  a  book  that  was  preserved  for  generations  on  Hbrary  shelves  before  it  was  carefully  scanned  by  Google  as  part  of  a  project 

to  make  the  world's  books  discoverable  online. 

It  has  survived  long  enough  for  the  copyright  to  expire  and  the  book  to  enter  the  public  domain.  A  public  domain  book  is  one  that  was  never  subject 

to  copyright  or  whose  legal  copyright  term  has  expired.  Whether  a  book  is  in  the  public  domain  may  vary  country  to  country.  Public  domain  books 

are  our  gateways  to  the  past,  representing  a  wealth  of  history,  culture  and  knowledge  that's  often  difficult  to  discover. 

Marks,  notations  and  other  maiginalia  present  in  the  original  volume  will  appear  in  this  file  -  a  reminder  of  this  book's  long  journey  from  the 

publisher  to  a  library  and  finally  to  you. 

Usage  guidelines 

Google  is  proud  to  partner  with  libraries  to  digitize  public  domain  materials  and  make  them  widely  accessible.  Public  domain  books  belong  to  the 
public  and  we  are  merely  their  custodians.  Nevertheless,  this  work  is  expensive,  so  in  order  to  keep  providing  this  resource,  we  liave  taken  steps  to 
prevent  abuse  by  commercial  parties,  including  placing  technical  restrictions  on  automated  querying. 
We  also  ask  that  you: 

+  Make  non-commercial  use  of  the  files  We  designed  Google  Book  Search  for  use  by  individuals,  and  we  request  that  you  use  these  files  for 
personal,  non-commercial  purposes. 

+  Refrain  fivm  automated  querying  Do  not  send  automated  queries  of  any  sort  to  Google's  system:  If  you  are  conducting  research  on  machine 
translation,  optical  character  recognition  or  other  areas  where  access  to  a  large  amount  of  text  is  helpful,  please  contact  us.  We  encourage  the 
use  of  public  domain  materials  for  these  purposes  and  may  be  able  to  help. 

+  Maintain  attributionTht  GoogXt  "watermark"  you  see  on  each  file  is  essential  for  informing  people  about  this  project  and  helping  them  find 
additional  materials  through  Google  Book  Search.  Please  do  not  remove  it. 

+  Keep  it  legal  Whatever  your  use,  remember  that  you  are  responsible  for  ensuring  that  what  you  are  doing  is  legal.  Do  not  assume  that  just 
because  we  believe  a  book  is  in  the  public  domain  for  users  in  the  United  States,  that  the  work  is  also  in  the  public  domain  for  users  in  other 
countries.  Whether  a  book  is  still  in  copyright  varies  from  country  to  country,  and  we  can't  offer  guidance  on  whether  any  specific  use  of 
any  specific  book  is  allowed.  Please  do  not  assume  that  a  book's  appearance  in  Google  Book  Search  means  it  can  be  used  in  any  manner 
anywhere  in  the  world.  Copyright  infringement  liabili^  can  be  quite  severe. 

About  Google  Book  Search 

Google's  mission  is  to  organize  the  world's  information  and  to  make  it  universally  accessible  and  useful.   Google  Book  Search  helps  readers 
discover  the  world's  books  while  helping  authors  and  publishers  reach  new  audiences.  You  can  search  through  the  full  text  of  this  book  on  the  web 

at|http  :  //books  .  google  .  com/| 


t 


r. 


BOSTON  MEDICAL  LIBRARY        ^1  o 

IN  THE 

■hancis  a.  countway 

UBRARY  OMIEDICINI 

BEITISH   JOFENAL 
HOMCEOPATHT. 

EDITED  BT 
J.  J.  DRYSDALE,  M.D.,  and  R.  E.  DUDGEON,  M.D. 


VOL.   XX. 


LONDON: 

H.  TURNER  &  CO^  77,  FLEET  STREET,  E.G.  j 

AND  lOfl,  MEW  BOND  8TBEET,  W. 

GROOMBRIDGE  &   SONS,   5,   PATERNOSTER   ROW. 

EDINBURGH:  J.  C.  POTTAGE,  99,  PRINCESS  STREET; 

NEW  YORK:  W.  RADDE,  300,  BROADWAY. 


PBIXTED  BT  W.   DAVY   AND  SON,  aiLBERT  STREET,   OXFOBP  BTREIT. 


COITTENTS  OP  No.  LXXIX. 

PAOS 

nURASITB  CANADENSIS  IN  GAKGEB,  BY  BB.  BATES. 1 

THE  THE&AFEUnCS  OF  PHTHISIS  FUU[ONAIiIS»  BY  MB.  POPE  18 

BZFBRIMEZrrAI.  KBSEABCHES  ON  DBOSEBA,  BY  DB.  E.  CUBIB  SO 

OS  CHSIJIX)NII7M  MAJVS  IN  FACIAL  NEUBALGIA,  BY  BB.  FIBHAT   47 

ON  FCBBOUS  TUMOUBS  OF  THE  X7TEBUS,  BY  BB.  KIBB A2 

ON  THE  PATHOOENBSY  OF  ACONITE,  BY  MB.  NANKIYEUU 6S 

CASES    OF    POISONINa  BY  BELLADONNA,   WITH   C0MMENTABIE8,   BY 

DB.  K.  HUGHES  70 

REVIEWS. 

AHSWXSS  TO  SIB  B.  BBOBDS,  BY  BBS.  BBVBY,  MABSTON  ANB  SHABF» 

AND  MESSBS.  MOOBE  ANB  SMITH 87 

DB.  INMAN*S  FOUNBATION  FOB  A   NEW   THEOBY  ANB  PBACTICB  OF 

MEDICINE  00 

BBS.  FETEBS'  ANB  SNELLINGP8  SCIENCE  ANB  ABT  OF  MEDICINE 116 

DB.  BUSHNAN'S  BEMABKS  ON  THE  NABBOW  LIMITS  OF  SO-GALLED 
BAnONAL  MEDICINE 126 

MISCELLANEOUS. 

Medkal  AjuhJs  of  s  Y«w,  131.— HypoRBBtivpia,  140.— The  Oampoeitioa  of  tbe  Sum,  IM.— 
BAdemadier  on  OheHdoninm  iiuijiu»  IfiS.— Wisdom  ia  High  Places,  198.— A  Ghronio 
Opponent,  ISl.— Br.  Cotton  on  Steel  in  Phtbins,  164.— Nitrate  of  Uraninm  in  Biabetoe, 
166. — ^An  Allopatliic  aooount  of  the  Homoeopefhic  Congresci,  171.— Homawipathy  in  Bfain, 
172.— Efiects  of  Upaa,  Tasghinia,  Digitalis  and  HoUobore,  172.— Poiaoning  by  Strychnine, 
173.— Aneoic  Inhalation  in  Bronchitis,  174.— The  Prince  Oonaort  and  his  Treatment,  174. 

OanxABT :  Dr.  Atldn,  of  Hull,  17S. 

Books  Bccutxd,  176. 


CONTENTS  OP  No.  LXXX. 

POISONING  BY  BELLADONNA,  WITH  GOMMSMTABIES,  BY  DB.  HUOHES    177 

EFFECTS    OF    ABSENIGAL    PAFEB-HANOINQS    ON    THE    HEALTH,     BY 

DB.  DUDGEON 100 

PHABMACOLOGICAL  STUDIES,  BY  DB.  BOTH 206 

LABYNOEAL  CATABBHS,  BY  DB.  KLEINEBT 248 

INFINITESIMAL  DOSES  AND  SPEOCEAL  ANALYSIS,  BY  DB.  OZANAM  267 

PELVIC  CELLULITIS,  BY  DB.  MACLIMONT  288 

REVIEW. 
DB.  BOBEBTS  ON  HOMCEOPATHY  IN  MANCHE8TBB  802 

MISCEbLAKEOUS. 

A  Tew  Words  about  Shoes,  800.— Exasperating  a  Disease,  818.— The  Letter  of  the  Law,  814.— 
The  Care  of  Popliteal  Aneurism  by  Flexion,  816.— A  Good  New  Year,  818.— On  the 
Origin  of  Organised  Beings,  323.— Modem  Spirit-Baising,  884.— ContagiousneBB  of 
Fhthias,  888.— A  Bebulce  to  the  Bigots,  843.— Therapeutics  advanced  AoddentaUy,  844.— 
Physiological  Operation  of  Atropin,  846.— Aconite  Antidoted  by  Nuz  vomioa,  340.— Com- 
pesmtlve  TrealOMnt  of  Diaxrhcea,  351.— EiSDots  of  Snake  Bites,  352. 

Books  Bscsiysd,  852. 


CONTENTS  "OF  No.  LXXXIi 

PAttB 

MB.  KANKIVELL  ON  THE  PATHOOEKESY  OF  AGOXTTE  SSS 

PR0FES80B  HOPPE  ON  THE  CAPILLARY  VESSELS a09 

MR.  OELSTON  ON  THE  ALTERNATION  OP  MEDICINES 899 

DR.  OERSON  ON  PROflOPALGIA , 401 

MEDICAL  TERRORISM,  BY  DR.  BAYES   r 430 

DR8.  MADDEN  AND  HUGHES  ON  HYDROCYANIC  ACID  ".  441 

DR.  OALLAVARDIN  ON  PHOSPHORIC  PARALYSIS  460 

DR.  LIEDBEGK  ON  BELLADONNA  AS  A  X7TERINB  REMEDY 483 

REVIEWa 

NEW  AX7BTRIAN  HOM(EOPATHIC  JOURNAL 490 

RUEGKERT'S  HOM(£OPATHIC  CLINICAL  EXPERIENCE 491 

MIISCELLANEOUS. 

Saooeoaflil  Xnocnlation  of  SyphDitio  Blood,  498.— Chlorate  of  Potash  in  Phthisis,  500.— Case 
of  Flat«ilen.t  Anthina,  60S.— Professor  CMrmak's  Laryngoscope,  SOS.^Dr.  WtUlams  on 
Cod  liver  Oil,  SOS.— Action  of  Phosphorus  on  the  liTer,  506.^Poisoning  by  Lead,  507.— 
How  tiiese  Allopaths  love  one  another,  509.— Almost  persuaded  to  be  an  Honunopathist, 
ftlO.— A  New  Hnmostatic,  511.— A  Nut  for  the  Medical  Coundl  to  Crack,  511.— Dr. 
'Williams  on  Simplicity  in  Therapoutics,  51S.— New  Homceopathio  Periodical,  513.— Two 
ways  of  telling  a  Story,  513.— Iodine  in  Gastralgia,  515.— Fnous  Veaiculosus  in  Obodty, 
515.— On  the  Remedial  Action  of  Compressed  Air,  517.— On  Veratram  Vbide  in  Disease, 
5S1.— SyphiliMtion,  527. 

Books  Rxcxitbd,  528. 


CONTENTS  OP  No.  LXXXII. 

DR.  LUDLAM  ON  PHYSIOLOGICAL  DIETETIOS  589 

DR.  McGUiCHRIOT  ON  PSYCHOLOGICAL  PHYSIOLOGY 547 

DR.  HIRSGH  ON  A  CASE  OF  OVARIAN  DROPSY 588 

PROFESSOR  HOPPE  ON  HOlMOPATHY  006 

DR.  LIEDBECK  ON  EXTERNAL  REMEDIES,  fta 616 

DR.  GODING  ON  THE  LAW  OF  SIMILARS  622 

SIX  MONTHS  OF  BRITISH  ALLOPATHY 635 

REVIEWS. 

MR.  YELDHAM'S  VENEREAL  DISEASES 644 

DR.  BURKE  RYAN'S  INFANTICIDE 651 

MISGELLANEOUa 

Report  on  Suspended  Animation,  662.— Rennet  Wine,  674.— The  Medical  (Hreular  on 
Modem  Therapeutios,  677.— Ai^hbishop  Ttf^tely  on  Medical  Trades'  Unions,  680.— 
Signatera  or  Fish-Poison  Disease,  681.— Angina  Pectoris  caused  by  Smoking,  685.— 
Petrolettm,  687.— IntemaHonal  Ezbitaition,  688.— Love's  Labour  Lost,  688.— The  Missing 
Link,  690.— Human  Remains  of  Remote  Antiquity,  091. 

OBITUARY. 
Dr.  B.  J.  Joelin,  691.- Dr.  J.  P.  Tesaor,  692.— Dr.  F.  R.  Homer,  69S.—Dr.  a  Haabold,  694. 

Books  Rbcsivsd,  604. 


/.      CXZ\.      ^^'      J^^^''^      tL.f^J,, 


THE 

BRITISH    JOURNAL 

OP 

HOMOEOPATHY. 


HYDRASTIS  CANADENSIS  IN  CANCER. 

By  Dr.  Bayes,  of  Cambridge. 

In  the  British  Journal  of  Homoeopathy  for  January,  1861, 
I  published  a  few  remarks  embodying  my  experience  of  the 
effects  of  Hydrastis  in  cancer.  I  then  stated  that  the  success 
of  the  remedy  had  been  variable  in  my  hands,  but  that  it  had 
been  sufficient  to  lead  me  to  form  an  opposite  conclusion  to 
that  expressed  by  Dr.  Hastings  in  the  April,  1860,  number  of 
the  Journal,  in  which  he  said,  **  in  no  single  instance  has  it 
effected  a  cure,  nor  even  appeared  to  check  the  disease." 

I  also  stated  that  I  had^  found  the  Hydrastis  exercise  a 
marked  influence  in  relieving  the  pain  of  cancer,  while,  at  the 
same  time,  it  had  improved  the  general  health  of  the  patient. 
I  further  mentioned  that  very  sudden  prostration  of  strength 
had  accompanied  the  continued  use  of  the  remedy  beyond  a 
certain  point. 

Subsequent  and  extended  experience  confirms  me  in  the 
correctness  of  the  views  I  then  expressed  as  to  the  value  of  the 
Hydrastis  in  cancer.  Its  varied  success  shows  that  this  remedy 
is  not  to  be  looked  on  as  the  specific  for  cancer ;  although  it  is 
equally  clear  that,  in  certain  cases,  its  use  is  strongly  indicated, 
and  that  it  is  a  very  valuable  addition  to  our  means  of  treating 
this  most  distressing  class  of  disease. 

VOL.   XX.,    NO.    LXXTX. — JANUARY    1862.  A 


2  Hydrastis  Canadensis  in  Cancer, 

Dr.  Bradshaw,  in  his  ''  Few  Remarks  on  Hydrastis,**  in  the 
Octoher,  186 1«  numher,  has  added  to  our  knowledge  of  the 
action  of  this  medicine,  in  the  relation  of  Jive  cases  of  cancerous 
disease.  In  case  No.  1,  the  patient  suffered  from  "unmistake- 
able  carcinoma "  of  the  left  breast.  He  "  gave  her  a  pilule  of 
Hydrastis  1,  four  times  a  day/'  with  benefit  to  her  general 
health,  and  he  speaks  of  the  remedy  as  "  evidently  exerting  an 
absorbing  counteracting  influence  over  the  scirrhous  tumour." 

In  Case  2,  the  patient  suffered  from  scirrhous  tumour  of  the 
left  breast,  and  was  also  treated  by  Hydrastis  1,  a  pilule  four 
times  a  day,  and  afterwards  with  drop  doses  of  the  mother  tinc- 
ture, and  subsequently  globule  doses  (dilution  not  named),  and 
**  her  disease  seems  stationary." 

The  third  Case  (numbered  5),  was  that  of  a  woman  with 
cancerous  ulceration  of  the  os  and  cervix  uteri.  Hydrastis  was 
given  every  four  hours  (no  dilution  named),  and  a  weak  injec- 
tion (no  strength  or  mode  of  preparation  named).  There  was 
some  mitigation  for  a  few  weeks,  but  ultimately  the  patieut  died. 

The  fourth  Case  (numbered  6),  was  also  one  of  cancerous 
ulceration  of  os  and  cervix  uteri.  The  Hydrastis  was  used 
for  two  months,  without  benefit  (the  dose  and  means  of  local 
application  are  not  mentioned). 

The  fifth  case  (numbered  7),  was  also  one  of  cancerous 
disease  of  os  and  cervix  uteri.  Hydrastis  has  been  given  for 
six  months  (in  what  doses  or  manner,  are  not  stated).  "  She 
lingers  on,  suffering  less,  and  the  disease  seems  arrested." 

These  oases  of  Dr.  Bradshaw's  appear  to  me  fully  to  bear 
out  my  formerly  expressed  opinion.  Three  out  of  the  five 
cases  have  derived  benefit  from  the  use  of  the  Hydrastis,  which 
appears  to  have  done  all  that  medicine  could  do  for  them.  The 
other  two  cases  were  hopeless  cases  firom  the  first ;  the  disease 
had  probably  progressed  too  far  to  admit  of  arrest.  Still,  I 
confess  it  would  have  been  more  satisfactory  had  Dr.  Bradshaw 
entered  fully  into  the  particulars  of  his  treatment. 

In  Case  No.  2,  we  have  an  interesting  confirmation  of  my 
own  experience  as  to  the  rapid  prostration  which  often  follows 
the  administration  of  too  large  a  dose  of  Hydrastis.  The 
tnedicifie  made  the  patient  feel  so  wretcJiedly  ill  that  she 


By  Dr.  Bayes.  3 

feared  ii  would  kill  her;  **\he  heart  was  beating  irregularly 
and  tumnltnonsly,  and  she  looked  nervoas  and  ill."  This  train 
of  symptoms  I  have  met  with  in  several  cases  where  the  mother 
tincture  was  given. 

Jadging  from  my  own  experience,  I  should  say  that  Dr. 
Bradshaw  administered  the  medicine  in  too  frequent  doses  and 
in  too  low  dilutions.  The  plan  I  have  found  most  beneficial, 
has  been  to  begin  with  the  80th  dilution,  giving  three  globules 
every  night,  for  a  fortnight ;  then  a  pilule  of  the  12th  dilution 
twice  a  day,  for  another  fortnight,  followed  by  the  6th,  the  drd, 
and  finally,  half-drop  doses  of  the  mother  tincture,  in  the  same 
way,  giving  a  fortnight  to  each  dilution.  Then  I  have  gone 
np  the  scale  again.  I  have  also  found  Dr.  Pattison's  suggestion 
a  good  one,  to  avoid  rubbing  the  tumour ;  but  instead,  to  apply 
a  lotion  over  the  parts  by  means  of  moistened  linen  rags.  I 
have  also  found  another  of  his  suggestions  of  great  service, 
that  of  using  a  cold  infusion  of  the  Hydrastis  as  an  application 
to  ulcerated  surfaces. 

I  have  made  the  cold  infusion  of  the  strength  of  3  ii«  of  the 
powdered  Hydrastis  to  half  a  pint  of  water.  Allow  it  to  stand 
four  days,  then  strain  and  keep  in  a  cool  place. 

I  am  indebted  to  Dr.  Pattison  for  these  suggestions,  which  I 
have  found  of  great  practical  service.  I  repeat  them  for  the 
acceptance  of  Dr.  Bradshaw,  or  of  other  medical  men  who  may 
incline  to  test  the  Hydrastis  in  cancer. 

I  would  also  suggest  to  Dr.  Bradshaw  that,  when  writing  on 
a  subject  of  scientific  enquiry,  it  is  better  to  confine  one's 
observations  to  a  calm  discussion  of  the  points  on  which  a 
difference  of  opinion  exists.  There  is  something  peculiarly 
ungraceful  in  the  manner  in  which  he  alludes  to  Dr.  Wilkinson's 
letter  and  to  my  own  paper  on  Hydrastis  (which  appeared  in 
the  British  Journal  for  January,  1861),  as  **  testimonials  on 
a  par  with  those  given  to  that  wretched  puff,  Dr.  De  Jongh's 
Cod  Liver  Oil."  The  Hydrastis  is  no  patent  medicine,  nor  has 
any  one,  that  I  am  aware  of,  any  interest  in  its  use,  beyond  that 
of  bringing  under  notice  a  remedy  which  appears  to  exert  a 
beneficent  influence  over  a  most  painful  disease.  The  short 
paper  alluded  to  was  reprinted  from  your  pages  by  Dr.  Pattison, 

A  2 


4  Hydrastis  Canadensis  in  Cancer, 

without  any  reference  to  me,  and  without  any  acknowledgement 
whence  he  extracted  it ;  and  this  had  heen  made  a  suhject  of 
remark  by  me  in  a  short  paper  which  I  sent  to  the  August 
number  of  the  Homoeopathic  Review,  There  was,  therefore, 
no  excuse  whatever  for  Dr.  Bradshaw's  strange  attack. 

I  will  now  proceed  to  relate,  at  more  length,  the  further 
experience  I  have  had  of  the  action  of  Hydrastis  in  cases  of 
cancer. 

With  respect  to  the  cases  mentioned  in  my  first  paper — 
.  The  case  of  cancer  of  the  left  breast,  in  a  young  unmarried 
woman,  has  entirely  disappeared  under  the  use  of  Hydrastis, 
prescribed  in  the  manner  indicated  above.  She  first  consulted 
me  on  March  19th,  1860.  The  tumour  was  as  large  as  a  small 
hen's  egg ;  the  nipple  retracted  and  the  skin  puckered.  She  had 
been  for  two  years  under  allopathic  care,  and  was  strongly 
advised  to  submit  to  an  operation.  The  tumour  soon  ceased 
to  be  painful,  and  had  totally  disappeared  on  February  20th  of 
the  present  year.  I  have  seen  her  within  the  last  few  weeks, 
and  she  remains  perfectly  well. 

The  case  of  open  cancer,  of  the  left  breast,  I  have  not  seen 
nor  heard  of  since  I  wrote  my  first  paper. 

At  our  Dispensary  we  have  had  the  following  cases : — 

Gase  I. 

Mrs.  F.,  aged  41,  married. — Inflamed  and  indurated  breast. 
Admitted  Feb.  10,  1860.     Arnica  8,  a  pilule  twice  a  day. 

Feb.  17. — Inflammation  has  subsided;  the  induration  proves 
to  be  scirrhus.  Hydrast.  Can.  3,  gtt.  iv. ;  Sacch.  lact.  gr.  xx.; 
to  be  dissolved  in  half  a  pint  of  water.  Take  a  table-spoonful 
twice  a  day. 

24th. — No  pain ;  no  change.  Mercur.  iod.  6,  a  pilule  twice  aday. 

March  2nd. — ^No  pain ;  no  change.  Continue  a  pilule  every 
night. 

March  16th. — Continue  medicine. 

April  5th. — Continue  medicine. 

20th  — ^No  change.  Hydrastis  Can.  (p  tinct.  gtt.  xii. ;  Aq. 
dist.  ^  ii.     A  teaspoonful  every  night. 

May  4th. — Some  improvement.     Repeat  medicine. 


by  Dr.  Bayes,  5 

28th. — Some  slight  iDflammation.  Arnioa  12,  a  pilale  twice 
a  day,  for  two  days ;  then  resume  Hydrast.  Oan. 

Jane  11th. — The  tumour  has  rapidly  disappeared;  there  is 
still  some  slight  pain.  Bepeat  Arnica;  a  pilule  every  morning; 
Conium  30,  gl.  iii.;  Sacch.  lact.  gr.  i.;  Ft.  pulv.,  mitte  chart,  iii. 
One  every  third  night. 

July  4th. — ^The  breast  remains  quite  well;  some  slight  indi- 
gestion.    Nux  6,  a  pilule  p.  r.  n. 

Case  II. 

Mrs.  A,  aged  42,  married.  Admitted  May  4th,  1860. — 
Ovarian  tumour  of  the  right  side,  with  severe  pain,  especially 
in  walking.  She  has  had  a  cancer  excised  from  right  breast. 
Hydrast.  Can.  30,  gl.  iii.;  Sacch.  lact.  gr.  i.;  Ft.  pulv., mitte ii. 
To  be  taken  every  third  night.  Aeon.  1-A,  gtt.  viii.;  Sacch. 
lact  gr.  xziv. ;  dissolve  in  half  a  pint  of  water.  Take  a  table- 
spoonful  twice  a  day. 

1 1th. — The  acuteness  of  the  pain  is  greatly  lessened;  the 
pain  now  is  most  severe  at  night.  Bhus  tox.  3,  gtt.  vi. ;  Sacch. 
lact.  gr.  XX. ;  dissolve  in  half  a  pint  of  water.  Take  a  table- 
spoonfiil  twice  a  day. 

21st. — ^Better.    Bepeat  medicine. 

26th. — Pajn  almost  gone;  tumour  still  remains,  and  is 
weighty.  Hydrast.  tine.  3,  gtt.  xvi. ;  Aq.  dist.  3  iv.  A  tea*- 
spoonful  three  times  a  day. 

June  4th. — Still  better.     Continue  Hydrastis. 

13th. — ^Much  the  same;  seems  at  a  standstill.  lod.  3,  gtt.  vi.; 
Sacch.  lact.  gr.  xx. ;  dissolve  in  half  a  pint  of  water.  Take  a 
table-spoonful  twice  a  day. 

26th, — ^Better.  Bepeat  Pulv. ;  Mercur.  sol.  6,  a  pilule  every 
night. 

July  4th. — Still  better.  Bepeat  Pulv. ;  Mercur.  iod.  1,  gr.  ii. 
every  third  night. 

July  9th. — Almost  well.  Bepeat  medicine.  Discharged  cured. 

Case  III. 

Mrs.  L.,  aged  46.— Admitted  July  2nd,  1860.  Cancer  of 
right  breast,  hard,  nodulated,  very  painful  at  times ;  skin  had  a 


6  Hydrastis  Canadensis  in  Cancer, 

bluish  appearance  over  the  tumour;  skin  was  puckered,  and 
adherent  over  a  portion  of  the  surface  the  size  of  a  shilling ; 
tumour  not  adherent  to  the  ribs. 

Of  this  case  I  have  lost  tlie  early  notes,  but  on  December  24th 
she  was  better;  the  tumour  had  decreased  in  size,  and  was 
scarcely  ever  painful.  The  Hydrastis  had  exerted  a  manifest 
influence  in  relieving  the  pain  and  reducing  the  tumour.  Inter- 
currently,  many  medicines  were  required  to  meet  indigestion  and 
other  constitutional  ailments — Arsenicum,  Gonium,  Spongia, 
China,  Nux,  &c.,  with  recurrence  to  Hydrastis  3,  6,  12,  and 
occasionally  the  mother  tincture.  She  still  visits  the  Dispen- 
sary, but  is  so  much  better,  that  it  is  with  difficulty  that  we  can 
keep  sight  of  her.  The  tumour  has  greatly  decreased,  but  has 
still  a  bluish  appearance,  and  is  yet  adherent  to  the  skin. 

Cask  IV. 

Mrs.  R.,  widow,  aged  77. — Admitted  August  24, 1860,  under 
Mr.  Freeman.  Cancer  of  right  breast.  The  tumour  is  unat- 
tached to  either  skin  or  ribs.  There  is  a  small  hard  movable 
tumour,  also,  just  above  the  clavicle.  She  has  occasionally  severe 
pains.  This  patient  has  continued  the  use  of  the  Hydrastis, 
internally  and  externally,  to  the  present  date  (October,  1861). 
The  tumours  have  not  increased,  and  are  less  painful,  and  the 
patient  is  in  excellent  health.  The  Hydrastis  has  been  given 
from  dOth  dil.  to  the  Mother  Tincture ;  and  a  lotion  of  Tinct. 
Hydrast.  (p  gtt.  x. ;  Aq.  dist.  J  xvi.,  has  been  applied  twice  a  day. 

Case  V. 

Mrs.  B.,  aged  25,  was  admitted  September  12th,  1860.  The 
cervical  glands  of  the  left  side  of  the  neck  are  enlarged,  appa- 
rently three,  and  have  a  stony,  hard  feeling.  A  tumour  of 
similar  character  was  excised  at  the  Allopathic  Hospital,  some 
years  since,  and  a  deep  scar  remains.  Some  months  after  the 
operation,  these  glands  enlarged,  and  are  now  very  painful.  Calc. 
carb.  80,  gl.  iii. ;  Sacch.  lact.  gr.  i.,  every  third  night;  Calc. 
carb.  6,  a  pilule  on  every  night  on  which  no  powder  was  taken. 

Oct.  3rd. — Better.  Calc.  carb.  12,  a  pilule  every  second 
night. 


by  Dr.  Bayes,  7 

24th. — ^The  hardness  remaiDs;  there  is  occasional  shooting 
pain.     Hydrastis  Can.  8«  a  pilule  every  night. 

Nov.  5th. — ^Much  better;  the  swelling  decidedly  less.  Oon- 
tinae  medicine. 

23rd. — ^Better;  suffers  from  indigestion.  Bepeat  pil. 
Hydrast. ;  Nuz.  vom.  6>  a  pilule  twice  a  day. 

Deo.  7th. — Greatly  better.     Bepeat  pil.  Hydrast. 

26th. — Bemedns  better ;  no  pain.    Bepeat  pilule. 

Feb.  idtb. — Still  better^  and  feels  so  well,  that  as  she  lives 
16  miles  from  Cambridge,  she  has  asked  to  be  allowed  to  stay 
away,  unless  there  is  any  return  of  pain  or  increase  of  tumour. 
Tinct  Hydrast  <P  3  ii. ;  two  drops  in  a  little  water  twice  a  day 
when  in  pain. 

Case  VI. 

Mrs.  D.,  aged  55. — ^Admitted  December  10,  1860.  Tumour 
on  the  dorsum  of  the  foot;  occasionally  painful;  has  had  it 
two  years ;  it  is  stony  hard,  the  size  of  a  walnut,  and  nodu- 
lated. Had  been  recommended  at  the  Hospital  to  have  it 
excised.  Ordered  Hydrast.  Can.  8,  a  pilule  twice  a  day ;  Tinct. 
Hydrast.  Can.  <P  3  i* ;  Aq.  dist.  J  ijs.  to  be  rubbed  in  every 
night  These  means  were  continued  till  May  6th,  when  the 
tumour  was  almost  removed,  not  being  larger  than  a  pea.  She 
has  not  returned  since. 

Case  VIL 

Mrs.  A.,  aged  45. — ^Admitted  December  10,  1860,  under 
Mr.  Freeman.  Scirrhus  of  the  breast.  Hydrastis  lotion  ordered, 
and  ArscD.  6 ;  a  pilule  twice  a  day.  This  patient  was  suffering 
also  from  phthisis,  and  Bryonia,  Phosphorus  and  other  medi- 
cinces  were  prescribed.  The  Hydrastis  lotion  always  removes 
the  pain  in  the  scirrhous  breast  This  patient  is  still  under 
treatment 

Case  VIH. 

Mrs.  G.,  aged  50. — Admitted  April  28th,  1860,  as  a  home 
patient,  under  Mr.  Theobald,  who  was  at  that  time  Surgeon  to 
the  Dispensary.  This  patient  was  too  ill  to  leave  her 
hoase,  and  was  for  some  time  coniSned  to  what  she  and  her 


8  Hydrastis  Canadensis  in  Cancer, 

friends  believed  to  be  her  death-bed,  with  a  large  open  cancer 
of  the  left;  breast.  Under  the  use  of  Hydrastis  she  continued 
to  improve,  till,  on  March  5th,  1860,  she  was  so  far  recovered 
as  to  be  able  to  go  out  daily  and  to  do  her  house  work.  She  still 
remains  under  treatment,  and  Mr.  Freeman,  our  present  surgeon, 
under  whose  care  she  is,  tells  me  that  the  cancerous  ulceration 
has  considerably  diminished;  that  it  secretes  a  far  healthier 
pus,  and  that  her  general  health  has  greatly  improved.  In  her 
case,  Hydrastis  has  been  discontinued  at  times,  from  its  pro- 
ducing the  depressing  effect  on  the  heart's  action  alluded  to 
before. 

Case  IX. 

Mrs.  J.,  aged  37. — Admitted  July  21st,  1860,  under  Mr. 
Freeman,  who  has  kindly  furnished  me  with  his  notes  of  the  case. 
"  Mrs.  J.,  laundress  help ;  health  good.  Has  stony  hard  tumour 
in  left  breast,  unattached  to  skin,  perfectly  moveable,  the  size  of 
a  large  filbert,  surface  somewhat  nodulated ;  suffers  from  lanci- 
nating pains.  Had  first  Hydrastis  12,  a  pilule  twice  a  day ; 
afterwards  Hydras t.  tinct.  <p  a  third  of  a  drop  three  times  a  day ; 
she  had,  intercurrently,  a  few  doses  of  Nux  vom.  for  dyspeptic 
symptoms.  The  tumour  became  painless,  and  gradually  lessened 
till  a  portion,  like  a  vein  filled  with  coagulum,  the  size  of  a 
crow  quill,  and  a  third  of  an  inch  long,  remained.  I  wished 
her  to  continue  the  treatment,  but  she  thought  herself  well,  and 
remained  away.  I  saw  her  in  May,  1861,  and  she  then  was 
quite  well,  neither  pain  nor  induration  remaining." 

The  following  oases  have  occurred  in  my  private  practice : — 

Case  X. 

Mrs.  S.,  aged  48,  a  lady  of  fair  complexion  and  fair  hair, 
consulted  me  on  December  7th,  1860,  for  cancer  of  right  breast. 
The  tumour  was  stony  hard,  firmly  adherent  to  the  subjacent 
tissues  and  to  the  skin ;  the  nipple  was  retracted,  and  a  little 
yellowish  watery  fluid  occasionally  exuded.  This  patient  was 
treated  with  the  Hydrastis,  commencing  with  the  80th,  and 
running  down  to  the  mother  tincture.  On  one  occasion,  by 
mistake,  she  took  five  drop  doses  of  the  mother  tincture,  and 
these  produced  extreme  prostration,  with  palpitation,  &c.     The 


by  Dr,  Bayes.  9 

disease  remained  statioiiary  for  some  months,  then  slowly  pro- 
gressed. I  saw  her  last  in  May,  1861.  The  Hydrastis  had  a 
marked  influence  in  relieving  her  pain ;  indeed,  she  scarcely 
suffered  at  all  from  it  while  taking  Hydrastis,  and  the  tumour 
had  scarcely  increased,  though  the  whole  of  the  mamma  became 
absorbed.  I  regret  to  say  that  the  patient  was  afterwards  seized 
with  pleurodynia  and  neuralgia  of  the  whole  side,  for  which  she 
consulted  her  local  surgeon,  and  after  a  month's  blistering,  &o., 

died. 

Cask  XI. 

Miss  O.,  aged  88,  consulted  me  on  February  26th,  1861. 
She  had  two  extremely  hard  knotty  tumours  in  the  right  breast, 
about  the  size  of  eggs,  and  one  in  the  left,  rather  smaller ;  they 
gave  a  feeling  of  metallic  hardness  to  the  touch ;  the  axillary 
glands,  on  both  sides,  were  also  enlarged  and  painful,  and  hard 
strings  appeared  to  lead  from  each  breast  to  the  glands  in  the 
axillo.  This  patient  had  been  for  some  long  time  under  allopathic 
care.  She  suffered  great  pain  at  times,  and  her  general  health 
was  much  broken  down ;  she  was  highly  nervous,  her  tongue 
loaded,  her  whole  health  disordered,  and  she  looked  dark,  and 
almost  dusky.  Ordered  Hydrastis,  in  increasing  doses,  and 
Hydrastis  lotion. 

I  saw  her  again  in  March,  when  her  general  health  was 
greatly  improved ;  the  pains  had  almost  entirely  subsided,  and 
the  tumours  were  less. 

In  April  there  was  a  still  further  improvement. 

On  May  4th  she  came,  considering  herself  quite  well,  but  the 
tumours  in  the  right  breast  are  still  the  size  of  a  walnut,  and 
that  in  the  left  breast  is  but  little  diminished ;  the  mammas  have 
enlarged,  and  she  is  very  much  stouter.  She  is  still  under 
treatment,  and  improving  steadily. 

Case  XII. 

Mrs.  H.,  aged  48,  is  the  mother  of  several  children.  I  had 
attended  her  for  some  months,  for  constitutional  ailments, 
before  she  drew  my  attention  to  a  fixed,  burning  pain  in  the 
left  inguinal  region,  accompanied  with  shooting,  darting  pains 
up  the  vagina,  from  which  she  has,  at  times,  suffered  during 


10  Hydrastis  Catiadensis  in  Cancer , 

tbe  past  five  or  six  years.  On  examination,  I  found  the  os 
uteri  greatly  enlarged,  and  presenting  a  stony,  hard  sensation 
to  the  touch ;  it  felt  like  a  hard,  stony  ring.  I  gave  Hydrastis 
6,  and  subsequently  12^  and  used  an  injection,  made  with  3  ii. 
of  the  mother  tincture  to  ^  viii.  of  water.  The  lotion  gave  great 
pain,  and  was  discontinued.  The  Hydrastis  produced  no  effect. 
Arsen.  iod.  8,  was  substituted,  with  a  very  rapid  change  for  the 
better  in  all  the  symptoms ;  and  when  I  examined  the  parts  in 
about  ten  weeks  after  my  first  examination,  I  was  struck  by  the 
very  great  improvement  in  the  condition  of  the  os  uteri ;  it  was 
softer,  and  had  regained  its  natural  shape,  though  still  greatly 
enlarged.  This  patient  is  improving;  but  I  am  about  to 
try  the  cold  infusion  of  Hydrastis,  as  an  injection,  as  she  still 
sufiers  much  pain. 

Cabb  XIII. 

Miss  W.,  aged  bQ, — In  July,  1860,  I  was  sent  for  to  see  this 
lady,  who  resided  about  thirty  miles  from  Cambridge.  She  had 
been  ill  for  many  years,  had  been  examined  by  many  allopaths, 
and  recently  by  a  London  surgeon  of  eminence,  who  pro- 
nounced her  case  to  be  one  of  uterine  tumour.  On  examina- 
tion, I  found  it  to  be  cancerous  ulceration  of  the  womb,  which 
had  already  destroyed  the  tissues  so  far,  that  an  opening  between 
the  vagina  and  rectum,  of  more  than  an  inch  in  diameter,  existed, 
and  the  feces  ran  through  the  vagina.  Though  feeling  that 
nothing  could  save  her  life,  I  ordered  Hydrastis,  with  a  hope 
that  it  might  alleviate  the  pain.  I  regret  to  say  that  it  had  no 
influence  whatever  over  the  disease.  The  management  of  this 
case  was,  of  course,  left  in  the  hands  of  the  local  practitioner, 
an  allopath,  and  she  existed  in  a  state  of  great  misery,  alleviated 
only  by  opiates  and  sedatives,  for  many  months. 

Cask  XIV. 

Miss  J.,  a  lady  of  42,  has  enlargement  and  induration  of 
the  body  of  the  womb ;  has  had  it  for  many  years.  I  fear  it 
is  scirrhus.  Pains  often  very  severe,  shooting  into  the  vagina, 
and  often  extending  over  the  whole  left  side.  She  has  been 
under  treatment  nearly  twenty  years,  at  first  under  allopathic, 
and  more  recently  under  homoeopathic.     The  Hydrastis  given 


by  Dr.  Bayes.  1 1 

internally  has  afforded  no  relief.    I  am  about  to  try  the  effect 
of  the  cold  infusion  as  an  injection. 

Case  XV. 

Miss  L.,  a  lady  of  about  60  years  of  age,  consulted  me  on 
November  6th,  1 860.  Hers  was  a  case  of  fungus  heomatodes 
of  the  right  thigh.  She  told  me  that  for  some  years  she  had 
suffered  from  the  accession  of  tumours  on  this  thigh.  The 
first  came  just  above  the  knee.  She  had  been  operated  upon 
by  a  London  surgeon  seven  times,  and  he  had  removed  nine 
tumours.  When  the  present  tumour  appeared  she  consulted 
him  again,  and  he  refused  to  operate  any  further.  She  was  a 
very  stout  woman,  and  her  thigh  bore  the  evidences  of  the 
severity  of  the  operations  in  the  large  and  deep  cicatrices  which 
remained.  She  had  consulted  Dr.  Pattison,  who  also  told  her 
that  her  case  was  hopeless,  and  sent  her  home.  There  was  a 
large  and  rapidly  forming  fuugoid  mass,  from  which  dead  por- 
tions frequently  detached  themselves.  The  fungus  was  as  large 
as  a  fist.  Also,  in  the  upper  and  inner  part  of  the  thigh,  there 
was  a  large  tumour  threatening  to  break.  The  stench  from  the 
fungus  was  overpoweriog.  The  Hydrastis  appeared  to  exert  no 
kind  of  power  whatever  in  this  case.  The  patient  gradually 
became  worse,  and  sank  on  the  29th  of  January  of  the  present 
year,  not  quite  three  months  after  I  first  saw  her.  She  appeared 
to  die  typhoid,  poisoned  by  the  cancerous  matter  entering  the 
circulation. 

In  relating  the  above  fifteen  cases,  in  addition  to  the  three 
mentioned  in  my  former  paper,  I  havd  adhered,  as  strictly  as 
possible,  to  the  discussion  of  the  merits  of  Hydrastis  in  cancer. 
Where  the  Hydrastis  has  failed,  other  remedies  have  been 
resorted  to.  It  is  only  just  that  I  should  point  out  that  in  my 
earlier  cases  I  had  been  in  the  habit  of  ordering  gentle  frictions 
of  the  Hydrastis  lotion  over  the  tumours,  but  Dr.  Pattison 
informs  us  that  his  experience  leads  him  to  avoid  all  friction. 
I  had  also  been  in  the  habit  of  keeping  the  parts  warm  by 
surrounding  them  with  cotton  wool.  Dr.  Pattison  recommends 
that  they  should  be  kept  cool.  In  my  future  oases  I  intend  to 
adhere  more  closely  to  the  general  directions  given  by  him  in 
his  little  work.    I  can  but  regret  the  unprofessiooal  style  of 


12  Hydrastis  Canadensis  in  Cancer, 

this  work,  and  that  Dr.  Pattison  does  not  enter  more  fully  into 
a  detail  of  the  applianoes  and  outward  applications  which  he 
uses. 

From  the  tabular  statement  which  I  subjoin,  it  appears  that 
Hydrastis  has,  under  my  hands,  proved  very  successful  in 
Bcirrhus  and  cancer  of  the  breast ;  that  it  has  failed,  or  been  of 
but  little  service  in  cancer  of  the  womb.  The  case  of  fungus 
hffimatodes  was  too  far  advanced  to  be  able  to  deduce  much 
firom  it ;  but  the  alleviation  of  pain  which  has  followed  the  use 
of  Hydrastis  in  other  forms  of  cancer  did  not  occur  in  this 
case. 

Age,    Bex,       Diaease,  JPosition,  Mesult, 

Case  1  . .  41  Female   Scirrhus Breast Cared. 

„    2  . .  42        „        Tumour Ovary,  right  ....  Relieved. 

„    8  . .  46        „        Cancer Right  breast  ....  Much  improved. 

„    4  ..  77        If        Cancer Right  breast  ....Arrested. 

„    6  . .  25        „        Scirrhus Cervical  glands  . .  Much  improved. 

},    6  . .  55        „        Hard     nodulated  Dorsum  of  foot  . .  Almost  cured. 

tumour    

„    7  . .  45        „        Schirrus Breast Pain  relieved. 

„    8  . .  50  about       Ulcerated  cancer  Left  breast Greatlj  improved. 

„    9  ..  37        „        Cancer Left  breast Cured. 

„  10  . .  48        „        Cancer Right  breast  . . .  .Pain  relieved. 

„  11  ..  88        „        Tumours  (cancer- Both  breasts  ....  Much  improved. 

ous?)  

„  12  ..  48        „        Scirrhus Os  uteri No  effect 

„  18  ..  56        „        Cancer,  ulcerated  Os  uteri,  vagina,  No  effect. 

and  rectum .... 

„  14  ..  42        ,,        Bcirrhus Uterus No  effect 

„  15  ..  60        „        Fungus     hssma-  Right  thigh    ....No  effect 

todes    

*  „  16  . .  22        „        Cancel^ Left  breast Cured. 

*  „  17  . .  50        „        Ulcerated  cancer  Left  breast Believed. 

*  „  18abt50  Male       Ulcerated  cancer  Lip  Arrested  and  im- 

proved. 

Add  to  this  statement  Dr.  Bradshaw's  cases. 

Age,    Sex,       Dieease.  Ftigition,  SesuU, 

40  Female   Carcinoma Left  breast Relieved. 

„        Bcirrhus Left  breast Arrested. 

„        Ulcerated  cancer  Os  &  cervix  uteri  Blight    temporary 

relief. 
Ulcerated  cancer  Os  &  cervix  uteri  No  relief. 
Ulcerated  cancer  Os  &  cervix  uteri  Arrested. 


Case  1 

..  40 

»» 

2 

..  58 

t) 

5 

..  40 

»i 

6 

..  60 

If 

7 

..  87 

•  These  three  cases  are  those  detailed  in  my  first  paper,  published  in  the 
Brit.  Journal  of  Homosopathy^  January,  1861. 


I 


On  Phthisis  Pubnonalis,  18 

We  have  here  the  records  of  23  cases,  and  they  certainly  go 
to  prove  that  Hydrastis  does  exert  a  curative  as  well  as  an  alle- 
viative  power  over  cancerous  and  scirrhous  disease. 

A  REVIEW  OF  THE  THEEAPEUTICS  OF 
PHTHISIS  PULMONALIS. 

By   Alfred   C.    Pope,   M.R.C.S.,   Eng. 
Surgeon  to  the  York  Honi(Bopathic  Dispensary. 

Phthisis  Pulmonalis  has,  of  late  years,  obtained  a  large  share 
of  attention  from  cultivators  of  medical  science.  To  regard 
it  as  under  all  circumstances  an  incurable  malady,  one  in 
which  the  physician  can  supply  but  partial  and  temporary 
relief,  is  no  longer  deemed  justifiable.  Post  mortem  evidence 
has  proved^  that  tubercular  cavities  at  the  apices  of  the 
lungs  have  been  healed.  The  histories  of  these  cases  have 
shown  that  years  before  death  symptoms  of  phthisical  disease 
had  existed,  that  on  some  change  taking  place  in  the  residence, 
occupation  or  habits  of  the  subjects  of  them,  they  had  passed 
off,  health  had  been  restored,  and  life  prolonged  to  an  average, 
and,  in  some  instances,  even  more  than  average  duration.  Dr. 
Hughes  Bennett  gives  interesting  details  of  one  case  in  the 
Edin.  Monthly  Medical  Journal  for  March  1850. 

The  observations  made  in  the  post  mortem  theatre  of  the 
Saltpetridre  Hospital  in  Paris,  by  Messrs.  Bog6e  and  Boudet, 
tend  to  confirm  the  view  that  phthisis  pulmonalis,  even  in  its 
advanced  stages^  has  been  cured.  "  Laennec,  Andral,  Cruveil- 
hier,  Kingston,  Pressat,  Bog6e,  Boudet,  and  others,  have  pub- 
lished cases  where  all  the  functional  symptoms  and  physical 
signs  of  the  disease,  even  in  its  most  advanced  stage^  were 
present,  and  yet,  where  the  individual  survived  many  years, 
ultimately  died  of  some  other  disorder ;  and,on  dissection,  cica- 
trices and  concretions  were  found  in  the  lungs." — Bennett, 
Princ.  and  Pract.  of  Med,  p.  717.  Two  pages  further  on  the 
same  author  observes, — "Although  the  curability  of  phthisis 
pulmonalis,  even  in  its  most  advanced  stage,  can  now  no  longer 
be  denied,  it  has  been  argued,  that  this  has  been  entirely  owing 
to  the  operations  of  nature,  and  that  the  physician  can  lay  little 


li  On  Phthisis  Pulmonalis, 

claim  to  the  result.  Andral,  ^ho  early  admitted  the  occasional 
cicatrization  of  caverns,  states  this  in  the  following  words : — 

" '  No  fact,'  he  says,  '  demonstrates  that  phthisis  has  heen 
ever  cured,  for  it  is  not  art  which  operates  in  the  cicatrization 
of  caverns ;  it  can  at  most  only  favour  this  hy  not  opposing  the 
operations  of  nature.  For  ages  remedies  have  heen  sought 
either  to  combat  the  disposition  to  tubercles,  or  to  destroy  them 
when  formed,  and  thus  innumerable  specifics  have  been  em- 
ployed and  abandoned  in  turn,  and  chosen  from  every  class  of 
medicaments.'  " 

Dr.  Bennett,  however,  thinks  differently,  and  believes  that 
the  physician  can  and  does  assist  materially  in  the  cure  of  this 
disease.  To  a  much  greater  extent  than  might  be  imagined  is 
this  true,  even  of  an  allopathic  physician.  The  mortality  in 
phthisis  has  been  great,  has  been,  indeed,  little  less  than  the 
whole  number  of  oases  hitherto  observed.  But,  when  we  con- 
sider the  treatment  to  which  they  have  been  subjected,  and 
when  we  reflect  that,  it  is  to  death  by  exhaustion  that  this  disease 
tends,  we  shall  find  a  difficulty  in  ascertaining  how  far  the  fatal 
terminations  that  have  occurred  are  attributable  to  the  very 
measures  taken  to  avert  them.  It  is,  indeed,  perfectly  possible 
that  under  more  favourable  auspices^  involving  less  physio  and 
more  food,  less  interference  with,  and  more  scope  for  the  undis- 
turbed display  of  nature's  own  rallying  powers,  many  might 
have  recovered  who  were  cut  off  early  in  life.  But  now  Drs. 
Bennett,  Cotton,  Tumbull,  Hogg,  and  other  allopathic  writers 
on  phthisis,  assure  us  that  the  true  character  of  the  disease 
being  better  known,  more  reliable  plans  of  treatment  are  fol- 
lowed out,  and  a  considerable  proportion  of  those  attacked  are 
permanently  relieved^  and  enabled,  without  adopting  any  ex- 
traordinary precautions,  to  pass  through  the  usual  term  of  years 
allotted  to  man  upon  this  earth.  Homoeopathic  practitioners 
who  have  given  their  experience  of  phthisis  to  the  world  are 
not  numerous.  Dr.  Epps  writes  regarding  its  cure  in  the  most 
sanguine  strain :— he  says,  "The  alleged  incurability  of  phthisis 
is  the  declaration  of  an  error.  It  is  the  creation  of  an  impos- 
sibility out  of  a  difficulty." — Consumption,  its  Nature  and 
Treatment,  hy  John  Epps,  M,D,  p.  J 11.  At  p.  116,  he  writes, 
"  Homoeopathy  opens  up  the  legitimately  founded  hope  of  the 


by  Mr.  Alfred  0.  Pope.  15 

care  of  phthisis;  legitimately  founded,  first,  because  homoeopathy 
presents  a  law,  by  which  the  action  of  medicines  on  the  diseased 
body  is  regulated ;  a  law  which  makes  it  certain  that,  if  a  medi- 
cine can  be  found  which  has  the  power  of  producing  symptoms 
similar  to  those  present  in  the  disease,  it  will  cure  the  disease 
so  medicinally  homcsopathized ;  second,  because  homoeopathy 
presents,  by  the  vicarious  sufferings  of  Hahnemann  and  his 
followers,  a  knowledge  of  the  pure  effects  of  medicine:  and 
third,  because  the  law  being  true,  and  the  knowledge  of  medi- 
cines being  sufficiently  extended  as  to  embrace  medicines  which 
produce  pathogenetic  effects,  which  cover,  i.  e.  homceopathize, 
the  special  phenomena  present  in  every  special  case  of  Phthisis, 
the  use  of  such  medicines  must  be  curative." 

The  records  Dr.  Epps  has  published  of  his  success  in  the 
treatment  of  phthisis  are  not  calculated  to  give  one  much  con- 
fidence in  his  diagnostic  caution.  A  few  symptoms  which  might 
have  arisen  from  chronic,  or  even  catarrhal  bronchitis  are 
detailed,  attributed  to  phthisis  pulmonalis,  and  their  cure  pro- 
nounced. With  a  single  exception,  the  nature  of  the  case  is 
diagnosed  without  any  aid  having  been  sought  from  auscultation 
and  percussion.  Such  a  mode  of  illustrating  the  results  of  a 
plan  of  treatment,  however  much  it  may  attract  the  attention, 
secure  the  admiration  and  excite  the  hopes  of  persons  ignorant 
of  pathology,  can  have  but  little  weight  with  any  who  have  had 
the  advantage  of  a  medical  education,  or  been  accustomed  to 
more  exact  methods  of  investigating  disease.  And,  further, 
this  loose  and  careless  style  of  reporting  cases,  especially  of  so 
formidable  a  disease  as  phthisis,  supplies  our  opponents  with 
an  excuse,  on  the  ex  una  disce  omnes  principle,  for  withholding 
from  homoeopathic  contributors  to  medical  science  that  con- 
fidence to  which,  as  a  rule,  they  are  so  justly  entitied. 

Dr.  Wyld,  in  his  work  on  Diseases  of  the  Heart  and  LungSy 
p.  289,  very  cautiously  remarks,  "  that  it  remains  yet  to  be  in- 
vestigated what  proportion  of  cases  would  recover  under  homoeo- 
pathic treatment,  aided  by  the  best  system  of  hygiene." 

From  the  foregoing  quotations  it  may  be  concluded,  Ist,  that 
phthisis  pulmonalis  has  been  recovered  from  after  having  been 
considerably  developed  without  any  medicinal  treatment  what- 
ever.    2nd.  That  a  similar  result  has  followed  the  directions 


10  On  Phthisis  Pulmonalis^ 

medicinal  and  hygienic  of  allopathic  physicians.     3rdly.    That 
by  homoeopathic  medication  a  cure  has  been  obtained.     What^ 
then,  are  the  measures  that  have  been  adopted  to  secure   this 
very  desirable  result  ?     Their  investigation  constitutes  our  pre- 
sent purpose. 

Phthisis  Pulmonalis  may  be  defined  as  a  depraved  constitu- 
tional state  tending  to  the  deposition  of  tubercle  in  the  air  cells 
of  the  lungs.  The  positive  appearance  of  tubercle  in  the  lun^ 
is  ushered  in  by  a  period  of  ill  health,  frequently  well  marked 
and  capable  of  being  easily  recognized.  The  constitutional 
cachexia  manifests  itself  before  its  most  dreaded  consequences 
have  become  apparent.  Louis  goes  so  far  as  to  say  that ''  tuber- 
culization commences  from  six  months  to  two  years  before  its 
announcement  by  cough  or  any  obvious  pectoral  symptoms." 

The  chief  features  of  this  stage  are,  1st.  A  gradual  loss  of 
weight.  2nd.  Slowly  decreasing  bodily  vigour.  3rd.  Irritabiltiy 
of  the  mucous  surfaces.  Dr.  Hogg  {Practical  Observations  on 
the  Prevention  of  Consumption^  p.  42)  thus  summarises  the 
symptoms  these  conditions  excite : — "  Emaciation,  susceptibility 
to  bronchial  catarrh,  mental  lassitude,  failing  of  bodily  strength, 
shortness  of  breath,  weakness  of  sight,  falling  off  of  hair^  fre- 
quent perspirations,  occasional  palpitations,  an  unsatisfactory 
state  of  the  digestive  organs  and  alimentary  canal,  are  the  har- 
bingers of  evil." 

Dr.  Cotton  describes  the  same  state  in  the  following  words  : — 

*'  From  some  cause,  for  which  no  good  reason  can  be  assigned, 
there  is  a  slow  but  marked  diminution  of  bodily  vigour,  com- 
pelling the  individual  to  abandon  many  of  his  accustomed 
pursuits;  the  spirits,  nevertheless  are  good;  and  not  only  is 
the  idea  of  consumption  never  entertained,  but  any  allusion  to 
it  is  at  once  ridiculed.  So  general,  indeed,  is  this  hopeful  con- 
dition^ this  almost  instinctive  blindness  to  the  real  cause  of 
distress,  that  in  its  absence,  however  suspicious  certain  sym- 
ptoms appear,  these  may,  with  much  probability  of  accuracy,  be 
pronounced  unconnected  with  phthisis.  The  complexion  is 
usually  either  pallid  or  sallow ;  the  expression  is  that  of  care, 
united  with  animation ;  the  features  are  somewhat  sharpened ; 
the  movements  of  the  body  are  hurried  and  anxious ;  the  mental 
condition  is  irritable  and  capricious,  whilst  every  act  betrays  an 


by  Mr,  Alfred  C.  Pope.  1 1 

eflbrt,  sometimes  instinotivey  and  at  others  involantary,  to  con* 
oeal  the  presence  of  disease.  The  appetite  is  uncertain^  and 
there  are  frequent  indications  of  imperfect  digestion,  as  well  as  a 
tendency  to  passive  diarrhcea.  The  palse  varies  in  different 
cases,  bat  is  generally  small,  and  easily  excited.  The  sleep  is 
restless,  nnrefreshing,  and  occasionally  attended  by  perspira- 
tions. Loss  of  weight  is  of  invariable  occurrence ;  sometimes 
the  decrease  is  so  rapid  that  it  will  attract  the  attention  of 
friends;  at  other  times,  it  requires  the  periodical  use  of  the 
weighing  machine  to  detect  it :  the  latter,  perhaps,  is  the  most 
usual,  but  I  have  met  with  examples  of  such  rapid  emaciation, 
that  several  pounds  have  been  lost  within  a  few  days.  *  *  4^ 
There  is  considerable  variety  in  the  association  of  its  different 
Symptoms ;  some  may  be  altogether  absent,  and  many  are  also 
tnet  with  in  other  diseases ;  yet,  when  a  number  of  them  are 
found  together,  and  the  patient's  antecedents,  his  occupations 
and  habits  of  life,  or  any  other  circumstances,  seem  to  be 
conducive  to  phthisis,  there  can,  I  think,  be  little  reason  for 
doubting  their  consumptive  nature." 

The  difficulty  of  accurately  assigning  these  symptoms  to  their 
light  source,  is  enhanced  by  our  inability  to  derive  any  informa- 
tion from  auscultation.  As  yet  tubercle  has  not  been  deposited 
in  the  lungs ;  their  structure  is  so  far  unaltered.  The  existence 
of  them,  however,  without  any  apparent  reason,  in  a  person  pre- 
disposed to  the  development  of  tubercle,  either  hereditarily  or 
as  a  consequence  of  an  unhealthy  mode  of  life,  calls  for  our 
gravest  attention,  and  demands  the  frill  adoption  of  all  those 
precautionary  measures  that  experience  has  shown  to  be  best 
adapted  to  stay  the  course  of  the  disease  whose  full  development 
they  precede.  Certain  it  is  that  a  period  of  illness  so  charac- 
terised, does,  in  many  cases,  usher  in  the  exposition  of  tubercle ; 
and  during  this  stage  it  is  that  remedial  measures,  whether 
hygienic  or  medicinal,  are  most  likely  to  prove  beneficial. 

As  emaciation  progresses  and  strength  declines,  cough  makes 
its  appearance ;  with  increased  breathlessness  hemoptysis 
occurs ;  pains  in  the  chest;  nocturnal  perspirations ;  dyspeptic 
symptoms  become  more  troublesome ;  percussion  denotes  con- 
solidation of  some  portion  of  the  lung,  in  the  vast  majority 

VOL.   XX.,   NO,   LXXIX. — JANUARY,    186^.  .,        B 


18  Of  I  Phthisu  Pulmonalis, 

of  cases  at  the  apex;  auscultation  teUs  qs  that  at  this  part 
air  is  bat  feebly  and  with  difficulty  permeatiDg  its  structure. 
Daring  the  second  stage,  the  stethoscope  gives  evidence  of  the 
softening  of  the  tubercular  masses ;  daring  the  third  and  last, 
the  presence  of  a  cavity  is,  by  the  same  means,  rendered  mani- 
fest. The  general  symptoms  are  those  of  the  first  stage,  only 
in  much  greater  intensity.  The  cough  becomes  attended  witli 
expectoration,  various  alike  in  quality  and  degree.  As  disease 
advances  the  pulse  rises,  emaciation  becomes  extreme,  and  all 
the  symptoms  point  to  a  rapidly  fatal  termination. 

The  rationale  of  the  destructive  process  which  constitutes 
phthisis  pulmonalis  has  been  variously  explained.  That  the 
development  of  tubercles  is  one  of  the  consequences,  rather 
than  the  cause  of  the  disease,  is  evident  from  the  existence 
of  a  tolerably  well  marked  morbid  state  prior  to  the  mani* 
festation  of  their  deposition.  Begarding  the  primary  nature  of 
phthisis.  Dr.  Cotton  observes,  that  it  is  a  *'  peculiar  and  obscure 
condition  of  the  whole  system,  in  which,  instead  of  the  healthy 
nutritive  material  required  for  the  growth  and  reparation  of  the 
body,  there  is  produced  in  the  blood  a  morbid  substance,  which 
sooner  or  later  appears  as  tubercle,  or  tuberculous  matter  in  the 
pulmonary  structures.  This  state  of  system  is  precisely  identical 
with  that  known  by  every  one  as  struma  or  scrofula.  ♦  ♦  * 
In  consumption,  as  in  many  other  maladies,  we  are  permitted 
to  recognize  the  disease  only  in  its  efiects.  *  *  *  *  It  is 
evident  there  must  be  something  which  constitutes  the  malady ; 
but  it  would  be  vain  to  search  after  it ; — it  has  no  individuality ; 
— ^it  is  a  process  which,  like  many  others,  is  so  subtle  and  far 
removed,  even  from  our  conceptions,  that  it  seems  destined  to 
remain  for  ever  beyond  our  reach ;  we  are  allowed  to  do  nothing 
more  than  study  its  laws,  and,  in  some  measure,  control  its 
actions."  pp.  2  and  d.  Op.  cit.  Dr.  Epps  defines  phthisis  to 
be  a  disease  depending  upon  a  cachexia  differing  in  different 
cases,  each  case  of  phthisis  having  a  "  special  cachexia"  of  its 
own.  Dr.  Hogg  describes  it  as  depending  on  "  constitutional 
debility,  on  a  want  of  power  in  the  system,  on  an  impaired  state 
of  the  digestive  organs^ — in  a  word,  **  on  a  strumous  diathesis." 
Op.  cit.  p.  8. 

Dr.  Bennett  regards  tubercular  deposit  as  the  consequence  of 


by  Mr.  Alfred  C.  Pope,  19 

mal-natrition  arising  from  imperfeot  assimilation.      A  very 

similar  view  is  that  adopted  by  Dr.  Tnmbull.    In  answer  to 

the  question, — ^What  is  this  constitutional  state  which  causes 

the  formation  of  these  tubercular  bodies  ? — he  says, — "  I  believe 

that  it  is  a  state  of  imperfect  nutrition :  a  condition  in  which  the 

digestive  organs  are  unable  to  manufacture  from  the  food  a 

perfect  kind  of  blood,  capable  of  nourishing  every  part,  without 

allowing  some  imperfectly  formed  particles  to  escape  at  the 

same  time."     {An  Inquiry  how  far  Consumption  is  curable.) 

And,  in  another  place,  he  remarks,  "  I  am  strongly  disposed  to 

think  that  deficient  ozydation,  that  completing  part  of  the  pro* 

cess  of  digestion  which  takes  place  in  the  lungs,  is  one  of  the 

great  causes  of  tubercular  formations.     *     *     *    There  is 

much  reason  to  believe  that  imperfect  digestion,  combined  with 

deficient  oxydation,*  or  a  want  of  uniformity  in  the  action  of  the 

oxygen  on  the  blood,  and  through  this  fluid  in  the  whole  system 

is  the  main  cause."     The  Progress  in  the  Improvement  in  the 

Treatment  of  Consumption^  dc.,  by  James  Turnbull,  M.D.^  &o. 

London:  Churchill,  1863.     p.  38. 

The  opinion  expressed  by  Dr.  Cotton  is  that  which  seems 
most  in  accordance  with  the  present  state  of  our  knowledge ; 
viz.  that  phthisis  depends  upon  a  morbid  condition  of  the  whole 
system  of  whose  pathological  nature  we  know  little,  if  anything. 

*  This  18  most  remarkable,  and  affords  an  instance,  in  a  general  way,  of 
the  hopelessness  of  improvement  in  therapentics  from  Allopathic  sources. 
The  theories  of  the  state  of  the  system  that  precedes  the  deposition  of 
tabeicles  are  as  nomerous  as  they  are  in  general  baseless  and  even  fantastic. 
Bat  among  all  that  yaxiety,  there  is  one  state,  and  one  only  we  may  almost 
say,  of  which  there  is  something  certain  known,  and  this  purely  by  the 
observation  of  a  large  number  of  cases —viz.,  it  has  been  established  by 
Bokitansky  that  cyanosis,  pregnancy,  tumours  of  the  abdomen,  distortion  of 
the  spine  even  in  consequence  of  scrofulous  disease  of  the  bones,  asthma,  and 
several  other  morbid  states,  are  incompatible  with  tuberculous  deposition; 
and  the  only  one  thing  in  common  with  those  various  diseases  is  the  circum- 
stance of  increased  venosity,  or  imperfect  oxydation  of  the  blood  I  That  Dr. 
TumbuU  should  have  chosen  this  one  out  of  the  innumerable  hypotheses 
open  to  him  is  unaccountable ;  but  what  are  we  to  expect  firom  any  method 
of  treatment  based  on  such  an  error  ?  Fortunately,  nature  is  not  misled  by 
false  theories,  and  the  remedies,  if  good,  will  act  well  in  spite  of  them ;  and 
pure  air  may  do  good  though  it  may  contain  no  more  oxygen,  and  impure  air 
bad  though  it  contains  not  a  particle  less. — [Em.J 

B   2 


20  On  Phthisis  Pulmonalis, 

Mal-nntrition  of  the  tissues  is,  undoubtedly,  one  of  its  earliest 
features,  as  it  is  one  of  its  most  fatal  characteristics ;  but  in 
order  to  the  development  of  tubercle,  the  imperfect  digestion 
producing  it  must  occur  while  the  constitution  is  under  the 
influence  of  a  cachexia  peculiar  in  its  nature,  tending  under 
certain  circumstances  to  the  production  of  tubercle.  Dyspepsia, 
however  severe  and  intractable,  does  not  necessarily  culminate 
in  phthisis. 

Though  at  present  unable  to  trace  back  to  its  origin,  or  to 
describe  the  exact  nature  of  the  tubercular  cachexia,  we  have 
ample  evidence  from  the  investigations  made  to  solve  this  still 
hidden  problem,  that  its  chief  consequences  are,  Ist.  An  exces- 
sive waste  of  tissue :  and  2nd.  a  feeble  condition  of  the  assimi- 
lating organs  seriously  impairing  the  function  of  nutrition.  To 
check  this  waste  of  tissue,  to  relieve  its  local  and  general 
consequences,  to  improve  the  tone  of  the  digestive  organs  and 
to  select  for  the  support  of  the  system  such  kinds  of  food  as 
may  be  adapted  to  their  powers,  constitute  the  leading  patho- 
logical indications  for  the  treatment  of  phthisis.  The  measures 
which  have  been  adopted  to  fulfil  these  requirements  may  be 
conveniently  divided  into  three  classes: — Ist.  The  Hygienic. 
2nd.  The  Dietetic,     drd.  The  Medicinal. 

The  Hygienic.  The  natural  stimulant  of  the  lungs  to 
healthy  action  is  pure  air.  To  obtain  this  daily  is  essential. 
During  the  period  prior  to  the  actual  presence  of  tubercle,  the 
patient  should  be  exposed  to  as  bracing  an  atmosphere  as  he 
can  bear.  "  Exercise  in  the  open  air  not  only  promotes  the 
digestive,  but  all  the  functions  of  the  economy,  and  especially 
those  of  secretion;  and  its  value  in  the  treatment  has  been 
made  strikingly  apparent  by  some  facts,  in  the  recent  Beport  of 
the  Hospital  for  Consumption,  which  prove  that  this  disease  is 
much  more  prevalent  among  those  who  follow  sedentary  and 
in-door  occupations,  than  among  those  employed  in  out-door 
pursuits." — Tumbull,  op.  cit.  p.  67. 

The  hills  of  Malvern  or  Ilkley  are  infinitely  better  adapted 
to  this  the  outset  of  the  disease,  much  more  likely  to  tone  the 
constitution  against  its  further  advance,  than  the  warm,  moist, 
and  relaxing  atmosphere  of  the  southern  coast.  Dr.  Epps  has 
long  been  in  the  habit  of  recommending  a  village  called  War- 


by  Mr.  Alfred  C.  Pope.  21 

Kngbam,  sitnated  amoDg  the  Smrey  Hills,  about  16  milee  from 
London.  He  describes  it  as  '' pardcnlarly  adapted  to  con- 
sumptive patients."  He  farther  remarks, — "  The  study  of  the 
Ordnance  map  will  exhibit  the  striking  peculiarities  of  this 
Tillage  both  in  connexion  with  the  surrounding  country,  and  in 
relation  to  its  own  locality.  Besides  this  peculiarity  of  position, 
Warlingham  is  remarkable  for  the  fact  that  there  is  no  water 
except  at  a  depth  of  200  feet  and  more,  and  the  water  used 
is  rain  water.  A  walk,  or  a  ride  or  drive  at  Warlingham,  ex- 
posed  to  the  sun  on  the  south-west  and  protected  on  the  east  by 
a  high  hedge  and  copses,  affords  the  means  of  exercise  to  the 
consumptive  even  on  a  cold  sunless  day." — Op.  cit.  p.  218.  The 
locality  appears  from  the  description  given  of  it  by  Dr.  Epps,  as 
well  as  from  a  report  I  have  received  from  a  patient  who  went 
there  at  his  desire,  to  be  eminently  bracing  and  exhilarating 
and  deserving  of  mention,  with  similar  localities,  as  desirable 
for  invalids  during  the  period  of  delicacy  which  ush«8  in 
consumption. 

Emigration  to  the  Gape  of  Good  Hope  or  to  New  Zealand 
for  a  lengthened  period  will,  when  phthisis  appears  imminent, 
not  unfrequendy  re-establish  health  both  thoroughly  and  per- 
manently. The  climate  in  both  regions  has  proved  eminently 
advantageous  to  phthisioally  disposed  patients.  Where  such  a 
banishment  cannot  be  submitted  to,  a  prolonged  voyage  has 
often  been  found  sufficient  to  enable  the  patient  to  struggle  suc- 
cessfully against  the  inroads  of  the  tubercular  diathesis. 

During  the  first  stage  of  actual  pulmonary  disease,  great  cau- 
tion is  requisite  in  exposing  a  patient  to  a  strong  bracing  air. 
Pure  air  in  abundance  and  sufficient  exercise  are  as  desirable  as 
ever,  and  such  a  locality  should  in  consequence  be  selected  as  will 
admit  of  these  being  obtained.  Many  places  in  our  own  country 
during  the  summer  and  autumn  months  will  supply  this  de- 
sideratum. But  during  the  chilling  frosts  of  winter,  and  the 
bleak  winds  of  spring,  with  the  constant  variations  both  in  the 
temperature  and  density  of  the  air,  absence  in  a  warmer  and  less 
variable  climate  becomes  requisite.  Dr.  Cotton  in  his  analysis 
of  the  climates  in  countries  and  places  commonly  resorted  to  by 
phthisical  invalids,  points  out  grievous  disadvantages  in  all. 
Still,  Dr.  Cotton's  criticisms  refer  rather  to  the  climate  during 


^2  On  PhihUiB  Pulmonaiis, 

the  whole  year  than  to  that  which  is  experienced  daring  portions 
of  it.  As  already  remarked,  the  winter  and  spring  are  the 
periods  to  be  avoided  in  Great  Britain.  Dr.  Mac  Limont,  in  a 
paper  published  in  the  last  volume  of  this  Journal,  records  his 
personal  observations  on  the  climates  of  several  countries,  and 
their  special  adaptation  to  the  several  stages  of  phthisis.  After 
reviewing  the  relative  advantages  and  disadvantages  of  Nice, 
Mentone,  Cannes,  and  Hydres, — ^places  which  may  all  be  "  said 
to  possess  a  climate  bright,  dry,  yet  mild,  highly  stimulating,  of 
considerable  uniformity,  and  free  from  pernicious  winds,  at  least 
during  the  months  of  November,  December,  January,  February, 
and  part  of  March," — ^he  remarks, — 

''Nice,  then,  upon  the  whole,  o£Pers  the  greatest  advantages 
to  invalids  of  any  of  the  places  upon  this  coast;  its  extent 
admits  of  a  variety  of  conditions  of  atmosphere,  which  do  not 
exist  at  the  smaller  places : — for  instance,  those  with  whom  a 
sea  air  agrees,  may  place  themselves  advantageously  on  the 
Promenade  des  Anglais  and  neighbouring  localities;  whereas 
patients  who  are  more  advanced  in  disease,  and  therefore  re- 
quiring a  less  stimulating,  more  sedative,  and  somewhat  moister 
air,  will  find  the  climate  of  St.  Etienne  or  the  Cimiez  better 
adapted  to  their  condition."  The  very  unfavourable  charac- 
teristics of  this  climate,  upon  which  Drs.  Meryon  and  Pollock 
have  laid  so  much  stress,  consist  chiefly  in  the  unhealthy  nature 
of  the  winds  which  blow  at  certain  seasons,  but  onfy  at  certain 
seasons.  These,  during  the  winter  months,  are  absent,  and  so 
render  Nice  a  residence  climatically  well  adapted  for  the  first 
stage  of  phthisis.  At  the  latter  end  of  February,  or  during  the 
first  week  of  March,  a  removal  to  Pau  is  perhaps  more  suitable 
than  to  any  other  place ;  as,  during  the  spring,  the  climate  is 
"  mild,  sunny,  and  remarkably  free  from  the  disturbing  influ- 
ence of  winds." — Dr.  Mac  Limont.     Op.  cit. 

While  the  changes  of  climate  from  England  to  Nice,  and 
from  Nice  to  Pau  are  beneficial  by  reason  of  the  facilities  afforded 
for  out-door  exercise,  good  also  is  derived  from  the  tonic  ex- 
citement of  change  of  scene  and  travelling, — than  which.  Dr. 
Tumbull  remarks,  he  "  knows  of  no  tonic  so  certainly  useful." 
The  mental  depression  which  may  arise  from  leaving  home  and 
friends,  the  inconveniences  involved  in  residing  in  a  foreign 


iy  Mr,  Alfred  C.  Pope,  28 

land  are  in  no  inconsiderable  degree  compensated  for  by  the 
novelty  and  variety  of  the  circumstances  and  scenery  with  which 
the  invalid  is  brought  in  contact  At  the  same  time,  the  mind 
is  diverted  from  that  constant  dwelling  upon  the  ailments  of 
the  body  which  is  so  peculiarly  prejudicial  to  recovery. 

The  first  stage  passed,  softening  of  the  tubercular  deposits 
having  commenced,  the  chances  of  recovery  having  been  now 
materially  diminished,  a  dry  and  bracing  air  having  become  too 
irritating  to  be  borne  with  impunity  by  the  morbidly  susceptible 
air  passages,  a  question  arises  whether  it  is  advisable  to  deprive 
a  patient  of  the  comforts  and  conveniences  of  home,  the  society 
of  relatives  and  friends,  and  the  associations  which  have  grown 
np  around  him,  for  the  very  doubtful  chance  of  any  good  being 
fiecnred  from  the  milder  air  of  a  distant  climate,  and  from  the 
excitement,  involving  fatigue,  incident  to  foreign  travel.  The 
voice  of  the  profession  at  the  present  day  is  nearly  unanimous 
in  replying  in  the  negative ;  and  there  are  few  medical  men  who 
will  not  endorse  the  opinion  of  Dr.  Cotton,  "  that  after  tuber- 
cular softening  has  commenced,  and  for  still  stronger  reasons 
after  cavities  have  formed,  the  patient  should  not  leave  his 
native  shores."  In  many  instances,  during  this  and  the  final 
stages,  by  a  little  careful  management,  patients  will  be  enabled 
to  live  as  long,  and  be  as  amenable  to  the  resources  of  art, 
when  remaining  in  their  own  homes,  as  they  would  be  were 
they  removed  to  the  milder  climates  of  the  Southern  coast. 
When,  however,  the  residence  of  a  patient  is  situated  in  an 
unusually  exposed,  bleak  or  damp  part  of  the  country,  or  in 
the  midst  of  a  densely  populated  town,  where  the  air  is  loaded 
with  organic  impurities,  such  a  removal  is  inevitable.  In  these 
oases  the  Isle  of  Wight,  during  the  last  three  months  of  the 
year,  and  Torquay,  Sidmouth,  or  Penzance,  during  the  spring, 
will  be  found  to  aflbrd  the  most  frequent  opportunities  for  in- 
haling a  pure,  soft,  and  healthy  atmosphere. 

While  it  is  thus  desirable  and  necessary  to  secure  for  the 
phthisical  patient  a  residence  in  a  climate  where  the  air  is  mild, 
warm,  and  free  from  moisture,  it  is  no  less  essential  that  perfect 
ventilation  should  exist  in  the  apartments  occupied  by  him.  In 
the  bed  and  sitting  rooms,  which  should  be  lofty  and  spacious. 


24  On  PfUhiftis  Pulmonalis, 

opportunitieB  for  the  free  ingress  of  pure,  and  egress  of  tainted, 
air  shoald  be  snpplied. 

The  dress  of  the  invalid  also  requires  attention.  It  should 
be  warm  and  lightly  fitting,  so  that  the  chest  may  be  in  no  way 
hindered  from  having  free  motion.  Flannel  worn  next  the 
skin  has  the  doable  advantage  of  being  a  bad  conductor  of 
heat>  and  by  its  rough  friction -producing  surface  of  develop- 
ing the  action  of  the  highly  important  organ  it  invests. 
Cleanliness  of  the  whole  body  is  equally  needed  both  for 
the  removal  of  disease  and  the  maintenance  of  health.  The 
power  of  reaction  in  the  tubercular  diathesis  is  generally 
feeble^  and  therefore,  though  sponging  of  the  chest  with  cold 
water  may  be  useful  before  any  pulmonary  lesion  has  actually 
taken  place,  great  caution  will  be  necessary  in  the  employment 
of  this  powerful  though  apparently  simple  agent — cold  water. 
The  use  of  tepid  water  is  less  open  to  objection,  and  followed 
by  careful  rubbing  with  a  warm  coarse  towel  or  flesh  brush, 
tends  to  strengthen  the  chest  and  promote  a  healthy  action  in 
the  skin. 

As  phthisis  is  pre-eminently  a  disease  where  loss  of  strength 
and  flesh  advances  rapidly,  and  where,  at  the  same  time,  the 
powers  of  assimilation  are  depressed,  the  diet  to  be  advised 
becomes  a  matter  of  primary  importance  for  our  consideration. 
The  chief  aim  in  framing  a  diet  table  for  the  phthisical  invalid, 
in  all  stages  of  the  disease,  is  the  selection  of  such  aliments,  as 
while  highly  nutritious,  are,  at  the  same  time,  easily  digestible. 
The  capacity  of  the  patient  for  taking  such  nutriment  as  may 
be  necessary  will  materially  depend  upon  his  opportunities  and 
ability  for  exercise  in  the  open  air.  Dr.  Bennett  very  justly 
lays  great  stress  upon  this  point.  Dr.  Stewart,  of  Erskine, 
some  thirty  or  forty  years  ago,  advocated  a  purely  dietetic 
treatment  for  phthisis.  Beefsteaks  and  porter  were  his  remedies; 
but  they  were  conjoined  with  horse  exercise  in  a  hilly  district. 
When  a  highly  animalized  diet  can  be  borne,  it  is  undoubtedly 
that  best  adapted  for  the  increase  and  maintenance  of  strength. 
Milk  has  from  time  immemorial  been  regarded  as  a  curative 
agent.  It  should  be  taken  freely ;  and  when,  as  in  some  cases, 
it  is  found  to  disagree,  boiling  will  generally  render  it  digestible^ 


*y  Mr.  Alfred  C,  Pope.  25 

Cocoa,  arrowroot  rice,  sago,  tapioca  and  similar  foods  will  be 
found  aseful.    Dr.  Epps  thinks  he  has  seen  advantage  from  a 
fish   diet.    The  propriety  of  the  use  of  stimulants  is  much 
debated.     Dr.  Cotton  says  that  "  wine  or  beer  should  be  in- 
doded  in  the  dietary."    In  every  stage  of  the  disease  he  insists 
cm  the  importance  of  their  use.    Dr.  Epps  (op  cit.  p.  287),  in 
his  emphatic  style,  remarks :  "  Wine  is  poison  in  this  disease ; 
so  is  beer ;  so  is  ale  (pale  ale,  in  reference  to  the  sick,  is  deep- 
dyed  delusion).    All  stimulating  liquors  are  to  be  avoided." 
On  this  point,  Dr.  TumbuU  {op  cit.  p.  56)  observes :  ^'  Wine 
and  fermented  liquors  will  rarely  form  any  part  of  a  curative 
plan  of  tzestment,  but  they  constitute  a  great  solace  to  the 
palMOt  in  the  advanced  stage."    If  milk,  eggs,  cocoa,  and  meat 
can  be  taken  in  fair  quantity,  stimulants  are  needless  and  un- 
desirable.   But  cases  are  continually  met  with,  where,  without 
some  slight  fillip  in  the  shape  of  a  little  sherry,  claret,  or  beer, 
food  could  not  be  taken;  while,  with  the  assistance  of  this 
stimulant,  not  only  is  an  appetite  for  it  excited,  but  its  digestion 
is  ensured.    To  withhold  the  plainly  demanded  stimulant  under 
such  circumstances  would  be  to  do  serious  mischief.    To  regard 
it  as  necessary  in  all  cases  is  erroneous. 

Individual  cases  require  as  careful  study  with  reference  to 
food  as  they  do  with  regard  to  medicine.  Indeed,  the  influence 
of  the  latter  will  have  much  to  do  with  the  selection  of  the 
former ;  inasmuch  as  upon  the  corrective  effects  of  medicine 
will,  in  no  small  degree,  depend  the  power  of  the  patient  to 
appropriate  dietetic  agents.  The  importance  of  regularity  in 
the  periods  for  taking  meals  cannot  be  too  strongly  enforced. 
Best  also  after  food  is  desirable,  that  the  digestive  process  may 
have  every  opportunity  for  advancing  unimpeded.  This  com- 
pleted, exercise,  where  possible,  should  be  sought. 

Of  all  the  measures  proposed  for  the  cure  of  this  terrible 
disease,  none  have  been  accorded  so  unanimous  a  sanction  from 
men  of  all  shades  of  opinion  in  matters  therapeutic,  as  the 
inhalation  of  a  pure,  warm,  dry  air,  a  constant  and  free  indoor 
ventilation,  and  a  highly  nutritious  dietary.  Attention  to  these 
points  alone  have,  in  some  instances,  we  may  reasonably  con- 
clude, su£Bced  to  remove  the  tubercular  pre-disposition,  if  not, 
indeed,  to  heal  tubercular  cavities.    That  a  judicious  medicinal 


26  On  PkihisU  Pulmonalis, 

treatment  will  materially  assist  and  hasten  the  curative  prooeMr 
is  incontestable;  bnt  it  is  equally  certain  that  drugs  alone, 
whether  homoeopathicallyy  allopathically  or  anti-pathically  pre- 
scribed, will  not  be  equal  to  the  task  we  desire  to  accomplish. 

The  medicinal  treatment  of  phthisis  may  be  described  as 
haying  a  twofold  object  in  view.  First,  to  promote  the  absorp- 
tion of  tubercle,  or  the  healing  of  cavities ;  and  secondly,  to 
remove  those  intercurrent,  inflammatory,  and  congestive  attadrs 
to  which  phthisical  patients  are  so  prone. 

Among  allopathic  physicians  the  first  end  is  endeavoured 
to  be  attained  chiefly  by  counter-irritants,  tonics,  and  cod's 
liver  oil. 

Dr.  Bennett,  relying  almost  exclusively  on  the  employment 
of  cod  oil,  animal  diet,  gentle  exercise  and  change  of  scene, 
prescribes  but  little  medicine.  He  advises  counter-irritation 
over  the  site  of  tubercular  deposit :  "  A  seton  or  issue,  a  suc- 
cession of  blisters,  tartar  emetic  ointment,  and  croton  oil  are  all 
beneficial."  "  Cough  mixtures"  and  "anodynes"  he  repudiates 
entirely,  as  rendering  the  stomach  intolerant  of  food.  As  a 
gastric  tonic,  he  advises  Tr.  Ammon.  Arom.  ten  drops  in  an 
infusion  of  Gentian  or  Galumba.  The  vomiting  which  occa- 
sionally occurs  in  phthisis  he  meets  with  Naptha,  Gardamoms 
and  Camphor  mixture.  Diarrhcea  is  opposed  by  the  ''mildest" 
astringents,  or  Antacids,  as  Carbonate  of  potash.  In  hismoptysis 
he  uses  the  probang  and  solution  of  Nitrate  of  Silver  to  the 
larynx,  believing  that  in  many  cases  the  bleeding  proceeds 
from  follicular  disease  of  the  pharynx  or  larynx.  In  attacks  of 
pleurisy,  pneumonia,  or  bronchitis,  the  treatment  on  which  Dr. 
Bennett  depends  *'  consists  of  at  first  the  internal  administra- 
tion of  the  neutral  salts,  especially  of  tartar  emetic  in  small 
doses,  combined  with  diuretics  in  order  to  favour  crisis  by  the 
urine.     Subsequently  quinine  is  undoubtedly  advantageous." 

Dr.  Tumbull,  of  Liverpool,  relies  on  cod  oil  as  a  neutraliser 
of  the  tubercular  cachexia,  the  syrup  of  the  Iodide  of  Iron  as  a 
tonic,  inunction  of  the  Iodide  of  Mercury  or  Iodide  of  Lead,  and 
the  administration  of  Liquor  Potass®  with  Iodide  of  Potassium, 
and  decoction  of  Sarsaparilla  to  excite  absorption  of  the  tuber* 
cular  deposit  In  a  later  essay  on  the  treatment  of  phthisis, 
already  alluded  to,  he  advises  the  use  of  Tar  water  as  a  tonic. 


hy  Mr,  Alfred  C.  Pope.  27 

^e  tells  us  that  it  relieves  the  nausea  and  vomiting  sometimes 
occasioned  by  the  oil,  and  at  the  same  time  checks,  in  some 
degree,  profuse  expectoration  and  night  perspirations.  Creasote 
has  similar  properties,  and  is,  we  are  informed,  a  useful  remedy, 
when  combined  with  metallic  astringents,  in  diarrhoea.  In 
reference  to  the  tincture  and  extract  of  the  seeds  of  the 
(Enanthe  phellandrium,  he  says :  ''  I  have  found  them  of 
great  service  in  relieving  the  cough  and  other  pectoral  symp- 
toms in  almost  every  case  of  consumption  in  which  I  have 
tried  them." 

Dr.  Hogg  strongly  insists  on  the  value  of  counter-irritants 
producing  purulent  sores,  and  the  administration  internally  of 
"  grateful  aromatic  tonics."  He  is  in  the  habit  of  applying  a 
compound  Burgundy  pitch  plaister  (6  by  4),  on  which  has  been 
sprinkled  three  or  four  grains  of  Tartrate  of  Antimony.  This  is 
to  be  kept  on  for  two  or  three  days,  according  to  the  patient  s 
powers  of  endurance,  and  the  sore  dressed  with  wet  lint,  a  mild 
ointment,  or  a  bread  and  milk  poultice.  The  application  is 
repeated  in  a  fortnight  or  three  weeks,  the  quantity  of  antimony 
being  diminished.  In  the  interval  Gentian  and  Calumba  are  to 
be  taken,  acidulated  with  dilute  sulphuric  acid.  Iron  also,  both 
as  a  prophylactic  and  tonic,  is  highly  lauded  by  Dr.  Hogg ;  and 
the  use  of  cod  oil,  and  that  derived  from  the  vegetable  kingdom, 
is  recommended,  but  not  so  strongly  as  by  Drs.  Bennett,  Turn- 
bull,  and  Cotton.  The  plan  of  treatment  advised  by  Dr.  Cotton 
is  very  similar  to  that  of  the  authors  I  have  already  quoted. 
As  a  counter  irritant  he  prefers  tincture  of  iodine,  and  expresses 
a  hope  that  it  may  be  found  to  be  a  "  specific."  The  syrup  of 
the  iodide  of  iron  and  the  citrate  of  iron  and  quinine  are  his 
favourite  tonics.  He  does  not,  like  Dr.  Bennett,  totally  abjure 
topical  blood-letting  and  depressing  remedies  in  intercurrent 
acute  attacks,  but,  on  the  contrary,  reccmimends  their  "cautious" 
adoption.  Dr.  Cotton  has  endeavoured,  by  an  appeal  to  the 
ex  usu  in  morbis  mode  of  experiment,  to  determine  what  medi- 
cine is  best  adapted  to  cure  phthisis.  He  has  tried  Chloride  of 
Sodium,  Iodide  of  Iron,  Hydriodate  of  Potash,  Liquor  Potass®, 
and  Phosphorus;  the  results  he  has  published  have  already 
appeared  in  the  pages  of  this  Journal,    So  far  they  have  been 


28  On  Phthisis  Pulmonalis, 

barren  of  instruction  for  oar  fbture  guidance.    That  any  infor- 
mation should  be  expected  by  this  method  of  searching  out  the 
special  adaptation  of  a  given  drug  to  the  cure  of  any  disease, 
it  is  essential,  first,  that  it  be  exhibited  without  admixture  with 
any  other  medicinal  substance ;  and  secondly,  that  the  points  of 
difference  between  those  cases  in  which  the  remedy  experimented 
with  has  been  of  apparent  service,  and  those  in  which  its  in- 
fluence has  been  entirely  or  partially  negative  should  be  clearly 
and  fully  stated.     The  reports  of  Dr.  Cotton  supply  neither  of 
these  requirements;  his  medicines  are  mixed  with  compound 
tincture  of  lavender,   tincture  of  cinnamom   and  other  sub- 
stances ;  while  his  summaries  of  results  are  as  bald,  as  void  of 
detail,  as  they  can  possibly  be.     For  example,  in  his  remarks 
on  the  action  of  Phosphorus,  we  are  told  that,  "  of  the  four 
greatly  improved  cases,  one  (in  the  first  stage  of  the  disease) 
quite  regained  his  health ;  and  the  other  three  (two  of  whom 
were  in  the  first,  and  one  in  the  third  stage)  left  the  hospital 
materially  improved   in  every  respect,  their  coughs  being  di- 
minished, and  their  general  health  being  greatly  restored." — 
Medical  Times  and  Gazette,  July  6,  1861.     What  we  want 
to  learn  from  Dr.  Cotton  is,  what  were  the  symptoms  which 
marked  these  cases,  and  what  were  those  which  characterised 
the  five  who  were   only  slightly  improved,  and  the  sixteen 
who  made  no  progress  at  all  or  became  worse  ?     How  shall 
we    recognise    such    cases    again  ?      Until    these    particulars 
are  supplied,  and  these  comparisons  drawn,  Dr.  Cotton  s  ex- 
periments cannot  be  said  to  have  had  any  useful  or  practical 
result.     Some  excellent  remarks  on  the  mode  of  investigation 
pursued  by  Dr.  Cotton  will  be  found  at  the  8  72nd  page  of  the 
number  of  this  Journal  for  July  1859. 

Specifics  almost  innumerable  have  been  vaunted  as  certainly 
curative  of  phthisis.  Testing  them  in  well-marked,  unmis- 
takeable  forms  of  the  disease  has  hitherto  done  little  but  serve 
to  prove  their  uselessness.  The  last  effort  in  this  direction  is 
that  of  Dr.  Churchill,  of  Paris,  who,  on  theoretical  grounds, 
was  led  to  the  conviction  that  in  the  hypophosphites  of  soda 
and  lime  he  had  discovered  agents  that  would  prove  "  not  only 
as  sure  a  remedy  in  consumption  as  quinine  is  in  intermittent 


hy  Mr.  Alfred  C.  Pope.  29 

fe?er,  but  also  as  effectual  a  preservative  as  vacciDation  in 
small-pox."  Drs.  Cotton  and  Qaain,  at  the  Brompton  Hospital^ 
have  prescribed  these  remedies  without  any  other  than  the  most 
purely  negative  results.  Testimony  is,  however,  conflicting  as 
to  iheii  merits.  Dr.  Dickson,  of  Jersey,  writing  in  the  Medical 
Cireular  for  March  14,  I860,  states  that  he  has  seen,  both  in 
Dr.  Charchill's  practice  and  his  own,  the  most  decided  evidence 
of  the  value  of  these  salts  in  the  treatment  of  phthisis. 

An  anonymous  writer,  B.  C.  H.,  quoted  in  Brailhwaitee 
Beiraspeci,  vol.  xli.  p.  96,  conclades  a  resume  of  his  observa- 
tions on  the  action  of  the  hypophosphites  in  these  words :  "  My 
experience  does  not  enable  me  to  say  that  they  cure  phthisis, 
but  that  they  retard  its  progress,  particularly  that  of  so/tenin^, 
I  am  quite  convinced ;  and  that  they  are  a  useful  auxiliary  in 
the  treatment  of  phthisis,  whatever  other  power  they  possess, 
has  been  estabjished  to  my  satisfaction." 

A  few  week's  since,  my  friend  Dr.  Bamsbotham  saw  with  me 
a  young  lady  in  whom  the  early  symptoms  of  phthisis  were 
well  marked.  In  consultation  he  advised  the  use  of  grain  doses 
of  the  first  trituration  of  Phosphate  of  soda  three  times  a-day; 
remarking,  at  the  same  time,  that  he  thought  he  had  seen  un- 
questionable benefit  accrue  from  its  use.  An  acute  attack  of 
pleurisy  setting  in  a  few  days  after  the  medicine  was  commenced, 
and  necessitating  a  resort  to  Bryonia,  renders  me  unable  to 
draw,  firom  this  instance,  any  conclusion  as  to  its  efficacy. 

At  present,  the  evidence  we  have  of  the  value  of  these  pre- 
parations of  soda  and  lime  is  too  contradictory  to  enable  us  to 
speak  positively  regarding  it.  In  the  absence  of  any  observa- 
tion in  corpore  sano,  and  with  but  a  limited  amount  of  experi- 
ments in  corpore  vili,  and  these  of  a  very  unsatisfactory 
character,  we  can  say  no  more  than  that  it  is  possible  a  series 
of  well-conducted  proving^  might  lead  us  to  a  knowledge  of 
some  particular  phase  of  phthisis  in  which  we  might  rationally 
expect  to  derive  benefit  from  their  use. 

From  the  brief  resum^  now  given  of  the  most  recent  plans 
of  treatment  recommended  by  allopathic  physicians,  we  may 
fairly  conclude  that  upon  pure  air,  in  an  appropriate  climate,  a 
nutritious  and  somewhat  stimulating  dietary,  upon  counter- 


30  On  Phthisis  Pulmonafis, 

irritation,  tonics  and  cod  s  liver  oil,  do  our  brethren  who  refase 
acknowledgment  of  the  value  of  the  homoeopathic  law  depend 
for  the  cure  of  phthisis.      Of  the  value  of  counter-irritation, 
without  tonics  and  cod  oil,  we  have  no  information ;  of  the 
curative  capabilities  of  tonics  merely  we  have  no  means  of 
judging ;  while  cod  oil  alone  has  equally  seldom  been  relied 
upon.     But  independently  of  the  relative  importance  of  these 
medicinal  agencies  in  promoting  the  cure  of  phthisis,  special 
objections  exist  with  regard  to  the  blisters  and  similar  applica* 
tions,  and  to  the  so-called  tonic  mixtures.     The  action  which  it 
is  desirable  to  excite  in  the  tubercular  lung  is  a  healthy  one, 
and  not  such  as  that  which  approaches  closely  to  a  state  of 
local  inflammation,  with  general  febrile  excitement.     The  latter 
it  is  that  ensues  on  the  severe  and  repeated  counter-irritation 
which  constitutes  the  leading  feature  of  the  teaching  we  have 
reviewed.     And  further,  the  maintenance  and  increase  of  the 
strength  of  a  phthisical  patient  is  of  primary  importance ;  but 
under  the  irritation  and  exhaustion  consequent  on  the  general 
excitement  and  enfeebling  discharges  of  blisters,    antimonial 
and  croton  oil  ointments,  &g.,  it  is  impossible  that  the  physical 
energies  of  a  patient   can  either  be  sustained  or  improved. 
Gentian,  Cardamom,  Ammonia  and  other  drugs,  prescribed  to 
increase  the  tone  of  the  digestive  organs  or  the  vigour  of  thd 
general  health,  like  all  other  anti-pathically  acting  remedies, 
involve  a  stage  of  reaction,  and  so  unless  other  influences  of  a 
more  highly  sanative  nature  are  at  work,  tend  rather  to  increase 
debility  than  to  efiect  its  removal.     Their  mode  of  action  is 
primarily  stimulating,  and  secondarily  exhausting,  rather  than 
simply  and  solely  corrective.     To  expectorants,  anodynes  and 
aperients  we  object,  because  they  disorder  the  functions  of  the 
stomach  and  bowels  beyond  what  the  weakness  of  the  patient 
will  allow  him  bear  with  impunity,  and  because  as  a  result  of 
so  doing,  the  power  of  digestion — ^upon  which  so  much  depends 
in  the  successful  treatment  of  phthisis — is  impured.    With 
regard  to  the  allopathic  treatment  of  intercurrent  acute  inflam- 
mations, we  may  remark  that  in  its  certainly  depressing  character 
is  to  be  found  its  completest  condemnation.     Though  the  anti- 
phlogistic system  advised  to  be  pursued  in  these  cases  is  defined 


by  Mr,  Alfred  C.  Pope.  31 

"  mild/'  it  mast  be  borne  in  mind  that  a  very  slight  loss  of 
blood,  whether  by  the  leech  bite,  vesication,  or  purgatives — ^for 
in  each  case  blood  is,  to  a  certain  extent,  withdrawn  from  the 
system — is  far  more  exhansting  to  the  phthisical  invalid  than  a 
much  lai^r  withdrawal  of  the  vital  fluid  from  a  person  suddenly 
attacked  with  a  sthenic  inflammation,  in  the  midst  of  robust 
health,  would  be. 

But  one  most  important,  the  most  important  remedial  agent 

employed  by  our  allopathic  brethren,  has  hitherto  only  been 

referred  to  by  name.     I  have  omitted  any  further  allusion  to 

Cod's  liver  oil  until  now,  because  its  value  has  been  recognised, 

with  but  one  or  two  exceptions,  as  widely  by  homoBopathists  as 

by  those  who  differ  from  them  in  therapeutics.    As  homoBO- 

palhists,  we  deprecate  the  use  of  vesicants,  tonics,  expectorants, 

anodynes,  and  astringents,  as  these  definitions  are  ordinarily 

understood — ^first,  because  they  act  injuriously,  depressingly  on 

the  constitution ;  and  secondly,  because  were  these  results  but 

temporary,  instead  of  being,  as  they  but  too  often  are,  perma* 

nent,  the  risk  of  inducing  them  is  unnecessary ;  the  law  of 

nmilia  and  our  ei9laor2Xe  provings  enabling  us  to  accomplish 

the  ends  designed  by  these  classes  of  remedies  more  directly 

and  without  hazarding  any  impairment  of  the  vital  forces. 

With  regard  to  God's  liver  oil  our  position  is  different ;  to  use 

the  words  of  Dr.  Cotton,  it  has  ''  the  singular  quality  of  com* 

bining  the  properties  both  of  jfood  a,ni  physic  "    As  homoeo- 

pathists,  all  we  have  to  ask  ourselves  is,  first,  is  the  food 

supplied  in  the  oil  appropriate  and  digestible ;  and  secondly,  is 

the/?Ay^  it  contains  homoeopathic  to  the  tubercular  diathesis 

and  its  wasting  consequences.    These  two  questions  may,  I 

think,  be  distinctly  answered  in  the  affirmative. 

Oleaginous  substances  have,  in  all  ages,  been  employed  in 
the  treatment  of  consumption,  and  the  one  we  are  now  con- 
sidering has  long  enjoyed  a  high  reputation.  At  various  times 
other  oils,  vegetable  as  well  as  animal,  have  been  experimented 
upon,  but  while  some  degree  of  advantage  has  been  generally 
observed  to  follow  all,  none  have  appeared  to  be  so  beneficial  as 
those  derived  from  fish,  and  especially  so  that  from  the  cod  fish. 
It  is  in,  perhaps,  the  majority  of  cases  easily  digested,  certainly 
it  ia  so  after  a  little  perseverance  in  its  use.     When  this  is  the 


82  On  Phthinu  Pulmonalis, 

case,  its  nutritive  properties  are  of  the  greatest  importance  in* 
supporting  the  patient,  in  increasing  his  strength,  and  adding  to 
his  weight.  When,  as  occasionally  happens,  the  stomach  revolts 
at  it,  I  have  found  Pulsatilla^  and  others  have,  I  believe,  found 
Greasote,  so  to  correct  the  weakness  of  this  organ,  as  to  admit 
of  its  being  taken  with  every  advantage.  It  enables  us  to 
supply  nutriment  in  a  more  decided,  more  concentrated,  and 
more  adequate  manner  than  any  other  means  at  our  disposal. 

Various  theories  have  been  broached  as  to  its  mode  of  action 
on  the  system.    Dr.  Bennett  regards  it  as  an  analeptic  remedy^ 
as  a  simple  nutrient  that  is.     Dr.  G.  J.  B.  Williams  holds  the 
same  view,  but  in  addition  he  thinks  that  it  acts  by  checking' 
the  process  of  oxydation,  which  he  considers  to  be  the  agency 
by  which  exudations  become  converted  into  unhealthy  pus. 
Dr.  Tumbull  attributes  its  value  to  its  chemical  composidon 
"  furnishing  fuel  for  the  support  of  the  important  function  of 
respiration  and  the  maintenance  of  animal  heat."    And  again, 
be  remarks :  '*  God  liver  oil  appears  to  improve  the  quality  of 
the  blood  by  increasing  the  red  corpuscles  which  are  supposed 
to  convey  the  oxygen  from  the  lungs  to  the  tissues  of  the  body ; 
by  its  attraction  for  oxygen,  it  would  appear  to  increase  the 
energy  of  the  respiratory   function,   furnishing  hydro-carbo- 
naceous fuel  well  suited  for  this  purpose,  and  thus,  as  well  as 
by  suppressing  the  purulent  secretions,  it  would  seem  to  promote 
a  more  uniform  action  of  the  oxygen  on  the  blood  and  system." 
The  Progress  of  Improvement  in  the  Treatment  qfConsump* 
tion,  &c,  p.  88.     Dr.  Gotten  considers  all  explanations  hitherto 
advanced  as  unsatisfactory,  and  appears  to  think  that  it  hm 
some  special,   though  unknown,   action  upon  the  tubercultr 
diathesis. 

All  allopathic  writers  agree  in  one  point,  namely,  that  the 
Iodine  which  is  present  in  the  oil  has  nothing  whatever  to  do 
with  its  utility ;  an  opinion  grounded  solely  on  the  infinitesimal 
amount  of  this  substance  contained  in  it.  In  its  chemical  com* 
position  as  a  nutrient^  or  as  affording  material  for  respiration, 
alone  do  they  seek  for  an  interpretation  of  its  curative  properties. 
But  were  this  all  that  is  requisite  to  produce  the  very  important 
results  that  have  followed  its  use,  other  oils,  whether  animal  or 
vegetable^  ought  to  be  equally  serviceable.     But  they  »*<»  unt 


hy  Mr.  Alfred  C.  Pope,  33 

80 ;  and  it  is  only  tbose  which,  like  it,  contain  Iodine,  that  can 
at  all  compete  with  it  in  the  treatment  of  phthisis.  Is  then 
Iodine  at  all  homoeopathic  to  phthisis  ?  Undoubtedly  it  is  so. 
Moreover,  the  physiological  effects  of  the  oil  have  been  shown 
to  be  almost  exactly  similar — so  far  as  respiration  and  nutrition 
are  concerned — to  those  of  Iodine,  as  detailed  in  the  provings 
we  possess  of  that  drug.  Dr.  Madden,  in  one  of  the  best  essays 
on  God  oil  that  has  appeared,  has  shown  this  to  be  the  case.  * 

Cod's  liver  oil  thus  presents  us  with  food,  in  the  shape  of  oil, 
of  a  highly  nutritious  easily  assimilable  character,  and,  at  the 
same  time,  with  a  medicine  homoeopathic  to  the  tubercular 
diathesis.  From  the  fact  that  other  oils  effect  a  certain  amount 
of  good  in  phthisical  cases,  we  gather  that  a  portion  of  the 
benefit  which  accrues  from  God  oil  is  derived  from  its  oil  simply; 
while  from  the  fact  that  oils  which  are  inferior  to  it  in  the  treat- 
ment of  this  disease  differ  irom  it  only  in  the  absence  of  Iodine ; 
and  from  the  further  fact,  that  the  symptoms  it  will  produce  are 
like  those  of  Iodine,  and  yet  again,  are  like  those  of  pulmonary 
tnberculosis,  we  conclude,  that  it  is  both  to  its  oleaginous 
character,  and  to  the  presence  of  a  remedy  homoeopathic  to 
tnberculosis,  that  its  remedial  power  in  phthisis  must  be 
ascribed. 

But  experience  has  shown,  that,  while  this  medicated  aliment 
has  proved  more  useful  in  promoting  the  cure  of  phthisis  than 
any  remedy  that  has  been  tried,  a  large  number  of  cases  yet 
remain  in  which  it  has  failed  in  effecting  any  good  results. 
This  arises,  doubtless,  in  not  a  few  instances  from  the  short 
trial  allowed  to  it,  and  from  many  other  circumstances  tending 
to  prevent  the  full  display  of  its  remedial  powers.  Still  cases 
occur  in  which,  with  every  opportunity,  it  does  no  good.  Careful 
analyses  of  the  history  and  symptoms  of  patients  benefited  by 
the  oil  and  of  those  who,  after  fairly  testing  it,  have  not  suc- 
ceeded in  gaining  any  good  from  it,  or  at  any  rate,  any  more 
good  than  they  would  have  done  from  other  oleaginous  sub- 
stances, would  constitute  a  valuable  addition  to  the  literature  of 
phthisis. 

*  BritiBh  Journal  of  Homoeopathy,  YoL  vi.  p.  433. 

VOL.  XX,  NO.  LXXIX. — JANUARY,  186^.  O 


84  On  Phthisis  Pulmonalis, 

When  Cod  liver  oil  is  indicated,  a  steady  persistence  in  its 
use  is  necessary.  Dr.  Tnmbull  speaks  of  cases  in  which  it  was 
continued  with  benefit  for  several  years,  and  seldom  omitted 
during  this  period  without  obvious  retrogression  on  the  part  of 
the  patient.  He  considers,  however,  that  it  ought  to  be  with- 
held during  an  attack  of  acute  inflammation ;  while  Dr.  Cotton, 
on  the  other  hand,  thinks  that  inflammatory  action  forms  no 
barrier  to  its  prescription. 

In  further  considering  the  medicinal  treatment  of  phthisis,  I 
shall  endeavour,  first,  to  point  out  the  remedies  best  adapted 
to  cope  with  the  tubercular  cachexia,  and  then  to  draw  atten- 
tion to  such  as  are  most  appropriate  in  the  various  complications 
that  ordinarily  arise,  from  time  to  time,  in  the  progress  of  a  case 
of  phthisis. 

The  tubercular  cachexia  manifests  itself  variously  in  difierent 
persons.  Practically,  however,  nearly  all  cases  will  be  found  to 
be  comprehended  in  the  three  following  classes ;  in  the  first  of 
which.  Iodine  or  Cod  liver  oil,  in  the  preliminary  and  first  stages, 
appears  the  most  homoeopathic  remedy ;  in  the  second  class, 
Calcarea ;  and  in  the  third  class,  Iron.  I  will,  therefore,  en- 
deavour briefly  to  point  out  the  leading  features,  and  to  suggest 
the  medicines  which  have  been  found  to  be  best  adapted  to 
several  stages  of  each. 

1.  The  patient  is  thin,  loses  flesh  rapidly ;  the  complexion  is 
pale,  the  cheek  frequently  surmounted  by  a  pink  flush ;  the  lips 
exsanguine ;  the  appetite  very  deficient ;  the  power  of  digestion 
feeble ;  the  bowels  easily  deranged ;  a  sense  of  languor  and 
weariness  is  felt  after  slight  exertion  ;  respiration  is  short  and 
hurried ;  when  tubercular  deposition  has  taken  place  in  the  lung, 
the  cough  speedily  becomes  troublesome,  and  the  physical  signs 
of  disease  rapidly  defined.  The  history  of  cases  of  this  kind 
generally  show  a  hereditary  predisposition  to  tubercular  disease. 
It  is  to  such  cases  that  Iodine  is  most  homoeopathic  both  before 
and  after  the  presence  of  tubercle  can  actually  be  detected.  In 
no  form  can  this  medicine  be  prescribed  so  advantageously 
as  in  that  in  which  it  occurs  in  Cod's  liver  oil.  To  this  oil  alone 
may  these  cases  best  be  trusted  so  far  as  constitutional  medicinal 
treatment  is  concerned.    The  amount  required  must  be  adapted 


bp  Mr.  Alfred  C.  Pope,  85 

to  individual  oases,  but  a  dessert  spoonful  of  the  pure,  clear, 
pale-coloured  variety,  taken  twice  a-day,  will  usually  accomplish 
all  that  can  be  obtained  from  it. 

To  the  second  stage  of  such  oases  the  oil  is  still  advantageous, 
but  now  Phosphorus  or  Bromine  will  generally  be  indicated. 
Some  homcBopathic  physicians  have  found  the  former  remedy 
to  be  best  adapted  to  disease  on  the  left  side  of  the  chest,  while 
the  latter  is  more  efficient  when  the  right  lung  is  affected. 

In  the  third  stage  Cod  liver  oil  may  still  be  given  with  confi- 
dence; and,  at  the  same  time,  unless  some  other  medicine 
appears  to  be  specially  indicated,  China,  given  in  the  pure 
tincture,  is  the  remedy  most  frequently  useful.  Dr.  Eidd  and 
Bfr.  Yeldham,  during  a  discussion  on  phthisis,  reported  in  the 
Transactions  of  the  British  HomcRopathic  Society  (No.  8), 
spoke  most  highly  of  the  results  which  they  had  seen  follow 
its  use  in  the  advanced  stages  of  phthisis. 

2.  In  some  cases  the  disease  advances  more  slowly  than  in 
those  just  described.  Emaciation  is  less  marked;  the  com- 
plexion of  the  patient  is  pale  and  heavy  looking ;  his  cheeks 
pnfiy ;  the  muscular  tissue  flaccid ;  the  areolar  tissue  distended 
with  serum ;  his  appetite  is  capricious  rather  than,  as  in  the 
cases  first  mentioned,  deficient;  nutrition  is  perverted  rather 
than  positively  checked  ;  the  bowels  are  inclined  to  consti- 
pation rather  than  to  diarrhoea,  but  are  often  extremely 
irregular.  Cough  is  slight,  but  decided ;  difficulty  of  breathing 
is  often  well  marked,  especially  on  going  upstairs  or  walking 
rather  more  rapidly  than  is  usual;  it  is  also  very  generally 
attended  with  palpitation. 

To  these  cases  experience  tells  us  that  the  oil  is  not  so  well 
adapted,  and  that  to  them,  as  a  rule,  one  of  the  salts  of  lime  is 
most  homoeopathic.  Phthisis,  exhibiting  itself  in  the  manner 
I  have  just  attempted  to  depict,  may  often  be  traced  back  to 
early  childhood.  In  such  children  growth  before  puberty  is 
slow.  The  development  of  the  frame  seems  to  be  prevented  by 
some  depressing  constitutional  power.  The  complexion  is  pasty^ 
the  muscles  soft  and  flabby.  The  bones  are  inclined  to  curve. 
The  circulation  is  languid.  Strength  is  but  feeble,  and  all  the 
usaal  physical  energy  of  early  life  is  absent.    Here,  likewise, 

c  » 


36  On  Phthisis  Pulmonalis, 

Galoarea  carbonica  is  en  invaluable  remedy.  The  tubercular 
cachexia  in  these  cases  is  met  both  in  its  early  phases  and  in 
its  later  stages  by  one  and  the  same  medicine.  In  cases  that 
have  thus  originated,  but  which  have  advanced  to  the  second 
stage,  Lycopodium  or  Nitric  acid  will  generally  be  found  more 
useful  than  Calcarea.  In  the  third,  Hepar  s.,  Arsenicum,  and 
Sulphur  appear  most  frequently  homceopathic. 

III. — There  yet  remains  a  third  class  of  cases  in  which 
phthisis  is  manifested  in  a  manner  essentially  different  from  either 
of  those  we  have  now  considered.  The  patient  is  usually  be* 
tween  20  and  80  years  of  age ;  his  family  history  is  free  from 
any  hereditary  taint  of  tubercle ;  he  is  of  a  sanguine  tempera- 
ment, of  a  florid  complexion,  with  an  active  circulation,  and  an 
easily  excited  nervous  system.  Disease  has  in  him  originated 
in  causes  productive  of  malnutrition,  and  of  frequent  inflam* 
matory  attacks  upon  the  pulmonary  organs. 

Epistaxis,  hemoptysis,  headache,  congestions  in  various 
parts,  are  easily  excited ;  hectic  fever  runs  high ;  and  the  loss 
of  strength  is  very  rapid.  In  these  cases  Iron  will  be  found  our 
most  serviceable  remedy.  Dr.  Glotar  Miiller  has  very  clearly 
pointed  out  its  homoeopathicity  to  this  phase  of  phthisis  in  a 
most  admirable  paper,  a  translation  of  which  appears  in  the  18th 
volume  of  this  Journal,  Dr.  Miiller  uses,  and  on  very  sub- 
stantial grounds  advises  the  use  of  the  Chloride,  or  rather  the 
Perchloride  of  the  metal,  in  doses  of  from  one  to  three  drops  of 
the  Jst  to  the  6th  decimal  dilution.  The  second  stage  of  these 
cases  is  best  met  by  Phosphorus  or  Bromine.  The  frequent 
attacks  of  congestion  and  inflammation  which  mark  their  course, 
often  render  Aconite,  Bryonia,  and  Belladonna  necessary.  In 
the  third,  Dr.  Glotar  Mtiller  again  recommends  Iron ;  China  is 
also  frequently  useful. 

In  that  very  rapid,  and  generally  fatal,  form  of  phthisis 
described  as  acute  pulmonary  tuberculosis,  or  tubercular  pneu- 
monia, the  symptoms  generally  correspond  to  Phosphorus, 
Iodine,  or  Hepar  s.  more  closely  than  to  any  others.  In  a  case 
of  a  very  well  marked  type,  and  apparently  hopeless  character, 
occurring  in  a  young  girl  of  a  highly  strumous  constitution, 
which  I  saw  a  few  years  since  in  Manchester  with  Dr.  Galloway, 


by  Mr.  Alfred  C.  Pofe.  37 

Araenicam  and  Calcarea  given  alternately  produced  a  most 
rapid  and  unexpected  chauge^  resulting  in  complete  recovery. 
The  author  of  a  paper  in  the  Monthly  HomoBopathic  Review 
for  November  last,  regards  Bromine  as  a  valuable  remedy  in 
acute  tuberculosis. 

But  while  the  cure  of  phthisis  is  most  satisfactorily  promoted 
by  medicines  corresponding  to  the  tubercular  cachexia,  the 
course  of  the  disease  is  so  marked  by  intercurrent  acute  inflam- 
matory disorders  of  the  chest  and  bowels,  by  the  occasional 
prominence  of  dyspepsia,  or  of  some  individual  symptom^ 
especially  of  the  cough  or  exhausting  nocturnal  perspiration, 
that  we  are  from  time  to  time  compelled  to  interrupt  what  may 
be  termed  our  constitutional  plan  of  treatment  in  order  to  meet 
indications  of  special  urgency. 

Nothing,  for  example,  is  more  serious  both  from  its  fre- 
quency and  exhausting  consequences,  than  haemoptysis.  When 
a  patient  has  been  placed  early  under  homoeopathic  treatment, 
this  symptom  is  less  often  present  than  when  allopathic  medica- 
tion has  been  depended  upon.  Ordinarily  it  is  met  with  in  from 
60  to  70  per  cent,  of  cases  attacked.  When  profuse,  and  the 
blood  of  a  bright  arterial  colour,  Aconite,  alternated  with  Arnica, 
are  the  medicines  most  commonly  prescribed.  I  have  found 
more  prompt  and  marked  results  follow  the  use  of  the  Acetate 
of  Iron  than  any  other  medicine,  giving  drop,  or  two  drop  doses 
of  the  solution,  repeated  every  twenty  minutes;  or  less  fre- 
quently, in  proportion  to  the  severity  of  the  attack.  This  pre- 
paration is  an  uncertain  one^  and  subject  to  rapid  chemical 
decomposition  on  exposure  to  the  air  and  on  being  united  with 
water.  I  should  therefore  be  disposed  to  substitute  for  it  the 
Perchloride,  as  being  more  manageable,  and  probably  equally 
efficacious,  all  the  Salts  of  Iron  appearing  to  be  very  similar 
in  their  mode  of  action.  Ipecacuanha  is  a  medicine  frequently 
prescribed  to  stay  hemoptysis.  Dr.  Eidd  speaks  of  turpentine 
in  doses  of  five  or  six  drops  every  six  hours,  as  a  most  efficient 
remedy.  Mr.  Yeldham  places  great  reliance  upon  China.  In 
hsemorrhage  that  is  active.  Aconite^  Arnica,  and  Iron,  are  our 
principal  remedies ;  in  that  which  is  passive,  China  and  Turpen* 
tine.     The  most  absolute  rest  and  silence,  with  cold  applications 


88.  On  Phthisis  Pulmonalis. 

to  the  ohest,  are  essential.  Ice,  frequently  sacked  by  the  patient, 
is  also  advantageous. 

The  Coughs  which  forms  so  distressing  a  feature  of  phthieisL 
occasionally  calls  for  especial  attention.  It  is  often  modified, 
and  even  entirely  abated  by  the  general  treatment ;  bat,  occa- 
sionally, its  severity  renders  a  special  medicine  necessary.  When 
arising  from  the  tubercular  irritation,  and  independent  of  any 
congestion  or  inflammation,  Ipecacuanha  and  Drosera;  Stan- 
num;  Sambucus, and  Senega;  Hyoscyamue,  Conium,  and  Hepar- 
Sulphuris  will  be  found  useful  palliatives.  Ipec'  and  Dros.« 
when  the  cough  is  spasmodic  in  character  with  a  free  amount 
of  mucous  expectoration ;  Stannum,  when  connected  with  the 
existence  of  a  vomica :  Samb.  and  Senega,  when  the  expectora- 
tion is  profuse  and  the  respiration  oppressed ;  Hyos.,  Con.  and 
Hep.  s.  in  the  troublesome  exacerbations  of  cough  which  occur 
so  frequently  at  night. 

Pleurisy  constitutes  one  of  the  most  formidable  intercurrent 
inflammations  that  happen  in  phthisis.  Bryonia,  Hepar  Sul- 
phuris,  and  Lycopodium,  are  the  most  clearly  indicated  remedies. 
Bryonia  I  recently  gave  in  the  Srd  and  first  dilutions  in  a  very 
severe  case  without  any  good  result,  but  drop  doses  of  the 
mother  tincture  were  followed  by  the  most  speedy  relief. 
Hepar  s.,  after  the  active  symptoms  are  abated,  is  most  useful ; 
apparently  promoting  the  more  complete  absorption  of  the 
exudation.  Lycopodium  is  an  excellent  medicine  when  the 
symptoms  are  not  severe ;  bat  in  very  acute  cases  it  has,  in  my 
hands  at  least,  been  but  of  little  service. 

Pneumonia^  whether  occurring  around  the  site  of  the  tu- 
bercular deposit  or  at  the  base  of  the  lungs,  is  of  serious  import ; 
but  of  less  so  than  pleurisy.  Aconite  and  Phosphorus,  when 
the  disease  is  in  the  upper  part  of  the  chest  and  active,  control  it 
more  completely  than  any  other  medicines ;  while,  when  in  the 
lower  lobes  and  of  an  asthenic  type,  Tartar  emetic  is  our  most 
effectual  remedy. 

Bronchitis  requires  chiefly  Aconite,  Ipecacuanha,  and  Tartar 
emetic. 

Dyspepsia  is  frequently  a  troublesome  symptom.  Pulsatilla 
and  Nux  v.  are  the  remedies  most  usually  serviceable.     When 


Experimental  Researches,  ^e.  89 

Baaflea  and  vomiting  are  prominent  symptoms^  Ipecao.,  Ereasote^ 
and  Petroleum  are  indicated.  When  arising  from  putreiactiye 
fermentation  in  the  stomach,  the  alternation  of  Garbo  t.  with 
Nuz  y.  is  very  generally  curative.  Daring  an  attack  of  Dys* 
pepeia,  it  is  ahnost  always  necessary  to  suspend  the  use  of  the 
Cod-liver  oil. 

Diarrhcea  constitutes  one  of  the  most  serious  and  un- 
manageable complications  of  phthisis  in  its  last  stage.  Ghina 
and  Phosphoric  acid  I  have  found  to  be  most  generally  suc- 
cessful in  controlling  it.  Mercury  in  both  its  soluble  and 
corrosive  forms  is  frequently  useful. 

The  Perspiratiofis  which  generally  follow  the  dry  hectic 
evening  fever,  reuderiug  the  patient's  rest  so  little  refreshing  to 
him,  are  very  frequently  checked  by  the  constitutional  remedies 
already  alluded  to.  When,  however,  they  are  not  so,  and  are 
80  profuse  and  exhausting  as  to  require  especial  consideration. 
Nitric  or  Phosphoric  acid,  or  Mercurius  will  be  needed.  My 
frigid.  Dr.  Dunn,  tells  me  that  Crotalus  horridus  is  more 
powerfol  in  meeting  this  very  important  symptom  than  any 
medicine  he  has  tried. 

The  Sleeplesstiess  which  is  occasionally  found  independently 
of  the  cough,  and  appears  to  arise  from  that  irritability  of  ner- 
vous system  which  marks  some  cases  of  phthisis,  especially 
those  vrhich  require  Iron,  is  relieved  by  Aconite  or  Coffea,  and 
in  some  instances  by  Silicea.  In  these  patients  exercise  in  the 
open  air  constitutes  the  best  calmative  of  the  excited  brain. 


EXPERIMENTAL   REMARKS   ON   THE    PHYSIOLO- 
GICAL AND  THERAPEUTICAL  PROPERTIES 

OF  THE  DROSERAS. 

By    Dr.    Eugene    Oueie. 

m 

{Bead  he/ore  the  Academy  of  Sciences  of  France,  2nd  Sept,,  1861.*) 

Some  years  ago,  when  engaged  in  studying  Yicat's  Treatise  on 
the  Poisonous  Plants  of  Switzerland,  my  attention  was  arrested 

*  From  the  JBtdieHn  de  la  SocUU  M^dioale  Bmceopaihique  de  Farie^  Nor., 

leei. 


40  Experimefital  Researches,  dc,^ 

at  the  article  '*  Drosera/'  by  a  passage  which  struck  me  as  being 
very  remarkable  in  connection  with  certain  medical  doctrines. 
This  plant,  in  fact,  was  said  to  be  indicated  as  a  remedy  in 
phthisis  by  some  old  authors ;  and  yet,  according  to  others,  it 
was  said  to  be  capable  of  developing  some  morbid  symptoms  in 
the  respiratory  organs. 

I  shall  quote  the  passage  to  which  I  allude.  The  author  is 
speaking  of  the  Droseras  rotundifolia  and  longifolia. 

"Both  these  plants  are  acrid  and  corrosive;  they  cause 
ulceration  of  the  skin  and  injure  the  teeth.  Triturated  with 
salt,  they  may  be  used  as  vesicatories.  Notwithstanding  that, 
the  sundew  is  sold  in  the  shops  as  a  useful  remedy  in  cougbs, 
asthma,  ulceration  of  the  lungs,  &c.  Still,  it  is  certainly 
poisonous  for  sheep ;  it  afifects  their  liver  and  lungs,  and  causes 
a  cough  that  makes  them  waste  away  slowly." 

This  twofold  action,  physiological  and  therapeutical,  the  two 
terms  of  which  may  at  first  appear  contradictory,  reminded  mo 
of  the  theory  of  the  homoeopathicity  of  remedies;  I  accord- 
ingly referred  to  the  Materia  Medica  of  Hahnemann,  where 
I  found  the  following  note : — 

"  Borrichius  asserts  that  this  plant  (the  Drosera)  causes  a 
very  violent  cough  among  sheep.  Several  medical  men  of 
former  times  employed  it  in  some  coughs  of  a  bad  description  ; 
and  in  phthisis  with  purulent  expectoration  they  found  it 
beneficial,  and  thus  inferred  its  homoeopathic  efficacy  in  these 
diseases.  But  modem  physicians,  reasoning  according  to  their 
antipathic  theories,  have  denounced  its  employment,  on  the 
ground  of  its  pretended  acridity." 

As  Hahnemann  does  not  mention  the  names  of  the  authors 
he  alludes  to,  in  order  to  obtain  information  on  this  point,  I 
applied  to  Professor  Kirschleger,  of  Strasburg,  who  kindly  sent 
me  the  following  note : — 

"  In  the  sixteenth  century,  Dodoens  was  the  first  author  who 
described  and  figured  the  drosera  rotundifolia  under  the  name 
of  rorella  prima  major ;  and  the  drosera  intermedia  under 
that  of  rorella  secunda  minor.  Tabemsemontanus  (1588) 
copies  Dodoens,  and  gives  pretty  accurate  representations  of 
the  two  species  mentioned  by  the  Belgian  author.   He  attempts 


by  Dr.  Eugetie  Curie,  41 

to  determine  their  medical  value.  He  declares  that  the  rorellas 
have  an  acrid  and  burning  taste^  and  that  they  are  hot  and  dry 
in  the  fourth  degree. 

Daring  the  heats  of  summer,  the  rorellas  never  lose  their  hu- 
mid plumpness ;  and  on  this  account  some  herhalists,  partizans 
of  the  doctrine  of  signatures,  have  imagined  that  the  rorella 
should  be  given  in  pulmonary  phthisis^  a  disease  in  which  the 
jntuita  persists  in  spite  of  the  heat  or /ever. 

"  Dodoens,  who  was  a  good  Oalenist,  thinks  that  the  Drosera 
is  much  too  dry  and  too  acrid,  or  too  hot  to  be  of  service  in 
phthisis :  and  he  therefore  rejects  it  ^s  a  useful  remedy  in  this 
disease.  Linnaeus  {FL  Suecica)  says  that  its  acrid  juice  is  con- 
sidered a  good  remedy  for  warts  and  corns.  Haller  {PL  de  la 
Suisse)  alleges  that  Drosera  causes  excoriations  and  ulcers  of 
the  skin.  But  long  before  these  great  masters,  a  German 
botanist,  of  the  name  of  Siegesbeck,  in  an  inaugural  dissertation 
defended  at  Wittemberg,  in  1716  {Diss.de  rorella),  i&  much 
more  explicit  on  the  subject  of  the  plant.  He  found  that  the 
taste  of  the  leaves  is  acrid  ;  that  the  fruit  and  the  flowers  are 
bitter.  The  expressed  juice  curdles  warm  milk.  The  plant  is 
injurious  to  sheep,  particularly  by  exciting  a  cough  which  is 
often  fatal.  Another  author,  Heerman  {Diss,  de  rore  solis, 
Erfurt,  1716),  is  referred  to  by  Siegesbeck.  Those  two  physi- 
cians tried  the  sundew  in  phthisis ;  they  allege  that  it  allays 
asthma,  removes  hoarseness  {raucedinem),  and  restores  the  lost 
strength.  Siegesbeck  prescribed  a  decoction  of  the  fresh  plant 
in  loose  cough,  in  catarrhal  bronchitis ;  he  also  prepared  a  tinc- 
ture with  spirits  of  wine,  which  was  of  great  use  in  catarrhal 
fevers  (influenza),  and  in  the  epidemic  hooping-coughs  that 
were  so  generally  prevalent  in  1712;  even  in  the  first  stage  of 
these  afiections,  when  the  cough  is  still  dry,  the  Drosera  is  of 
great  service.  The  pharmacopceia  of  Wurtemberg  had  ad- 
mitted a  syrupus  rorella  (compositus)  and  an  elixir  pectorale 
Wedelii,  of  which  Drosera  was  an  ingredient.  In  the  second 
half  of  the  eighteenth  century  Drosera  fell  into  neglect ;  several 
physicians,  in  fact,  abuse  it." 

Thus  it  is  well  attested  by  tradition  that  this  plant  has  been 
employed  in  phthisis,  and  yet  it  seems  equally  certain  that  it 
exercises  a  hurtful  action  on  the  lungs. 


4d  Experimental  Researches,  dtc,, 

Henoe  it  oconrred  to  us  that  it  would  be  interesting  to  deter- 
mine, with  all  the  precision  attainable  by  modem  science,  what 
was  the  precise  physiological  action  of  this  plant,  and  then  to 
ascertain  if  its  alleged  therapeutic  action  were  real,  and  in  how 
far  it  was  connected  with  the  theory  known  by  the  name  of  the 
substitutive  homoeopathic  method,  or  the  law  of  similars. 

Though  I  cannot  bring  forward  very  numerous  experiments, 
the  results  I  have  obtained  are  so  conclusive,  that  I  think  it 
wrong  to  withhold  them  any  longer,  but  I  believe  it  only  right 
to  direct  to  them,  as  speedily  as  possible,  the  attention  of  new 
observers,  of  whom  I  hope  there  will  be  no  deficiency;  for 
supposing  the  facts  I  adduce  to  be  confirmed,  their  theoretical 
and  practical  value  is  indisputable.  Thus  I  have  convinced 
myself  that  the  prolonged  use  of  this  plant  developes  tubercles 
in  animals  to  which  it  is  administered ;  and  secondly,  its  power 
to  cure  tuberculization  has  never  failed  with  me,  when  I  have 
been  able  to  administer  it  in  the  first  stage  of  the  disease. 

My  physiological  experiments  are  three  in  number.  I  have 
already  mentioned  that  I  hav^been  unable  to  add  to  their 
number,  partly  on  account  of  the  difficulty  of  obtaining  this 
very  small  plant,  partly  on  account  of  the  long  time  these 
experiments  require. 

It  will  be  easily  understood  that  a  much  longer  time  is 
required  to  produce  lesions  of  the  nutrition  and  the  intimate 
structure  of  the  tissues,  than  to  excite  functional  symptoms 
depending  on  the  nervous  system.  Thus  it  is  that  we  see 
naturally  developed  with  rapidity  diseases  like  cholera,  tetanus, 
&;c.,  and  that  we  can  almost  instantaneously  produce  similar 
artificial  diseases  by  means  of  veratrum,  strychnine,  and  other 
poisons.  Tuberculization,  on  the  other  hand,  is  the  work  of 
time ;  and  we  might  almost  have  foreseen  what  occurs  in  reality, 
which  is,  that  a  drug  capable  of  producing  by  its  action  on  the 
organism  the  formation  of  tubercles^  will  not  succeed  in  doing 
so  until  after  the  lapse  of  a  considerable  period. 

I  chose  for  the  subject  of  my  experiments  the  cat,  as  that  is, 
of  all  our  domestic  animals,  the  one  least  liable  to  exhibit 
spontaneous  tubercular  lesions.  Indeed,  it  is  not  certain  that 
tubercles  have  ever  been  found  in  them,  for  I  am  informed  by 
competent    authorities,  that   in  this  class  of  animals  lobular 


by  Dr,  Eugene  Curie,  43 

pneomonia  has  been  mistaken  for  phthisis.  Thas  the  results 
should  be  all  the  more  conclusiye^  and  the  quality  of  the 
subjects  experimented  on  Ynll  in  some  measure  make  up  for 
their  small  quantity. 

Of  the  three  cats,  I  killed  (by  means  of  ether),  the  first  at 
the  end  of  six  weeks,  after  having  made  him  swallow  every  day 
15  centigrammes  of  Drosera,  triturated  with  sugar  of  milk. 

I  killed  the  second  after  one  year  of  treatment ;  he  took  at 
first  a  drop,  and  the  dose  was  gradually  increased  till  it  amounted 
to  1600  drops  per  day  of  the  spirituous  tincture,  evaporated  in 
the  air  or  in  the  bain-marie,  and  latterly  in  vacuo. 

The  third  is  still  alive,  and  has  been  under  the  drug  for  six 
months.  As  he  presents  the  same  symptoms  as  the  two  others, 
there  is  every  probability  that  the  same  lesions  will  be  found 
pottt  mortem. 

As  regards  functional  symptoms,  all  the  three  had  diarrhoaa 
at  the  commencement,  and  a  very  marked  weakness  of  the  voice 
was  observed  after  six  weeks  of  treatment 

It  is  remarkable  that  in  the  two  animals  I  dissected,  there 
was  no  perceptible  lesion  in  the  trachea,  and  yet  in  all  three  the 
voice  was  altered.  They  could  certainly  utter  sounds,  but  they 
could  not  be  heard ;  whereas,  at  the  commencement  of  the 
experiment,  their  cries  caused  great  annoyance  to  my  neigh- 
bours. 

The  first  cat,  killed  after  six  weeks,  on  being  opened,  showed 
beneath  the  pleura  some  almost  gelatinous  deposits,  surrounded 
by  an  anomalous  redness ;  on  the  whole,  there  was  but  little  to 
be  seen,  and  the  characters  detectable  by  the  naked  eye  were 
not  sufficient  to  prove  the  existence  of  tubercle,  had  not  the 
microscope  removed  all  doubt  about  the  matter.  I  shall  not 
here  describe  the  characters  revealed  by  its  employment,  but 
I  may  refer  to  the  authority  of  Dr.  Gratiolet,  head  of  the 
anatomical  department  of  the  Museum,  who  kindly  verified  my 
examinations,  and  satisfied  himself  that  these  deposits  were  of 
tubercular  nature. 

Besides  the  pulmonary  lesion,  I  found  in  this  cat  a  very  con* 
siderable  enlargement  of  the  mesenteric  glands. 

The  second  animal,  killed  after  one  year  of  treatment,  showed 


44  Experimental  Researches,  de  , 

much  more  characteristic  lesions  in  the  lungs^  though  they 
were  not  of  great  extent.  These  lesions  consisted  of  small 
white  granules,  the  size  of  a  pin's  head,  situated  beneath  the 
pleura,  and  surrounded  by  a  very  red  injection  of  the  neigh- 
bouring tissue,  to  the  extent  of  several  milUmetres ;  an  injection 
that  penetrated  into  the  pulmonary  tissue,  but  was  unaccom* 
panied  by  induration. 

I  only  found  these  granulations  under  the  pulmonary  pleura. 
If  there  were  others  in  the  middle  of  the  pulmonary  paren- 
chyma, they  completely  escaped  my  observation. 

These  gray  granulations  were  moderately  hard ;  they  could 
be  crushed  on  the  glass,  and  showed  under  the  microscope  the 
following  characters :  irregular  corpuscules,  granular  internally 
and  externally;  the  external  granulations  brilliant  and  some* 
what  characteristic.  Most  of  the  corpuscules  were  Viooo  of  a 
millimetre  in  diameter,  almost  unafiPected  by  acetic  acid. 

I  shall  not  describe  certain  accessory  elements  which  were 
met  with  at  the  same  time,  because  I  do  not  wish  at  this  time 
to  treat  of  the  formation  of  tubercular  coi-puscules.  I  shall 
therefore  content  myself  with  pointing  out  the  above  chief 
histological  element,  which  constituted  the  principal  mass  of 
the  granulation,  and  left  no  room  for  doubt  as  to  its  significa- 
tion, any  more  than  did  the  characters  visible  to  the  naked  eye. 

Besides  this  pulmonary  lesion,  I  may  mention  the  enormous 
development  of  the  sub-maxillary  glands,  the  hypertrophy  of 
the  glands  of  Peyer,  and  of  the  shut  vesicles  of  the  large 
intestine,  containing  an  opaque  fluid,  that  showed  under  the 
microscope  glandular  corpuscules. 

In  conclusion,  I  may  allude  particularly  to  the  development 
of  the  acini  in  the  spleen.  They  were  so  much  developed  that 
they  could  be  seen  through  the  exterior  covering;  and  the 
spleen,  when  cut  into,  seemed  to  be  formed  entirely  of  them. 
They  were  decidedly  larger  than  a  large  pin's  head,  and  con- 
tained in  the  interior  a  mass  of  glandular  corpuscules. 

But,  unlike  what  I  had  observed  in  the  first  cat,  the  mesen- 
teric glands  were  not  appreciably  enlarged. 

To  resume,  Drosera  causes  the  production  of  tubercular 
elements  in   the   lungs,  and   acts  at  the  same  time  on  the 


by  Dr,  Eugefie  Curie,  45 

lymphatic  Bystem  in  general,  thus  presenting  the  analogy 
recognized  in  all  ages  between  the  tabercular  affection  and  the 
lymphatic,  not  to  say  scrofulous,  temperament.  I  may  remark 
that  the  hypertrophy  of  the  lymphatic  organs  was  a  hyper- 
trophy of  the  proper  elements  of  the  organs^  and  was  unaccom- 
panied by  any  plastic  deposit. 

I  admit  that  two  experiments  are  but  very  few  to  draw  con- 
clusions from.  The  chapter  of  coincidences  may  always  be 
alleged  against  them.  Still,  on  reflecting  that  the  experiments 
were  made  on  cats,  that  these  animals  are  seldom  or  never 
tubercular,  it  would  require  the  admission  of  a  most  ex- 
traordinary coincidence  to  explain  my  selection  of  two  tuber- 
cular cats ;  moreover,  the  third  having  presented,  at  the  same 
period  as  the  two  first,  the  same  symptoms  of  weakness  of  the 
voice,  it  is  probable  that  it  was  affected  in  the  same  manner  as 
they  were;  to  these  experiments  may  be  added  the  tradition 
which  is  both  scientific  and  popular ;  for  I  made  inquiries  of 
some  provincial  colleagues,  and  Dr.  Dilhon  of  Beziers,  who 
kindly  questioned  the  country  folk,  tells  me  that  the  fact  of  the 
deleterious  action  of  Drosera  on  the  cattle  was  well  known  to 
the  hill  shepherds. 

Beflecting  on  all  these  circumstances  and  collating  all  these 
considerations,  I  think  there  are  strong  grounds  for  presuming 
that  future  experiments  will  confirm  those  already  made. 

I  pass  over  the  consequences  that  may  be  deduced  in 
reference  to  physiology  and  general  pathology,  and  I  come  to 
the  second  point  I  am  desirous  of  elucidating. 

Drosera>  I  have  said,  when  used  in  tubercular  affections 
before  the  disease  has  gone  too  far,  cures  it. 

This  treatment  has  been  so  rarely  unsuccessful  in  my  hands, 
in  the  first  stages  of  the  disease,  that  I  am  inclined  to  refer 
the  few  cases  where  it  has  not  succeeded  to  an  error  of  diagnosis, 
or  to  a  want  of  perseverance  on  the  patient's  part. 

The  dose  in  which  I  employ  Drosera  is  four  to  twenty  drops 
of  the  tincture  in  the  twenty-four  hours.  A  weaker  dose  is  in- 
sufficient in  the  majority  of  cases. 

The  auscultatory  signs  in  the  various  cases  where  the  treat- 
ment was  successful  were  the  following :  dulness  more  or  less 


46  Experimental  Researches^  dc. 

ezteDsive,  weakness  of  the  respiratory  murmur,  roughness  of 
inspiration  or  expiration,  respiration  in  several  impulses,  pro- 
longed expiration,  souffie  behind  the  scapula. 

The  functional  signs  were :  cough  generally  dry,  oppression, 
spitting  of  blood,  thoracic  pains,  night-sweats,  emaciation. 

I  enumerate  all  the  signs  in  no  particular  order,  because  ft 
profound  discussion  of  the  different  cases  would  extend  this 
essay  to  an  undue  length.  I  shall  only  observe  that,  under  the 
influence  of  Drosera,  I  have  seen  all  these  symptoms  diminish 
and  even  entirely  disappear,  provided  the  general  state  of  the 
patient  is  still  good. 

The  presence  of  a  pretty  large  cavity  even  would  not  be  a 
reason  for  despairing,  provided  the  general  state  was  still 
favourable. 

This  is  an  indispensable  proviso,  for  in  all  cases  in  which  the 
fever  was  of  a  continued  character,  when  the  food  was  not  duly 
assimilated,  which  is  ordinarily  the  case  with  phthisical  patients, 
not  only  with  those  who  have  a  cavity,  but  often  also  with  some 
patients  where  the  stethoscopic  signs  are  not  very  marked — ^in 
such  cases  I  have  always  found  the  treatment  fail ;  still  it  gene- 
rally caused  relief  for  the  first  week,  and  what  is  somewhat 
remarkable,  the  patients  seemed  to  die  more  quietly. 

I  only  once  gave  the  remedy  in  larger  doses,  and  that  without 
good  result ;  hence  I  know  not  what  to  expect  from  the  use  of 
larger  quantities  of  the  drug ;  but  as  I  have  never  seen  a  failure 
from  doses  of  twenty  drops  when  the  general  state  was  favour- 
able, I  am  inclined  to  believe  that  if  we  could  enlarge  the  limit 
of  curable  cases  by  giving  larger  doses,  it  would  not  be  to  any 
very  great  extent. 

Such  are  the  results  which  I  offer  to  the  consideration  of  the 
scientific  and  medical  public.  I  hope  that  my  colleagues,  con- 
sidering the  importance  of  the  question,  will  not  be  deterred 
from  its  impartial  consideration  by  the  kind  of  disfavour  with 
which  all  that  relates  to  homoeopathy  is  still  regarded  by  some 
minds.  If  they  decide  in  verifying  on  their  patients  the  curative 
efforts  I  have  reported,  and  to  institute  trials  on  several  patients 
in  not  too  far  advanced  stages  of  tubercular  disease,  I  am  con- 
vinced that  a  fortnight's  trial  will  generally  suffice  to  encourage 


Chelidonium  Majus  in  Neuralgia.  47 

them  to  persevere ;  so  rapidly  do  certain  symptoms^  suob  as  the 
cough  and  pains  in  the  chest,  often  disappear. 

I  may  sam  np  the  resalt  of  my  trials  as  follows  : — 1st.  Dro- 
sera  given  to  cats  for  a  considerable  time  produced  tubercles  in 
these  animals ;  2nd.  Given  to  tabercular  cases  in  the  dose  of 
foor  to  twenty  drops  of  tbe  tincture,  it  cured  the  disease  in  its 
first  stages^  thus  confirming  in  this  particular  disease  the  truth 
of  the  therapeutic  law  of  similars. 


ON  THE  USE  OP  CHELIDONIUM  MAJUS 

IN  NEURALGIA  OF  THE  EYEBROW  AND  TEMPLE, 

ESPECIALLY  ON  THE  RIGHT  SIDE, 

Bt  Db.  Francbsco  Ferinat,  Madrid. 

{From  ihe  BuOeHn  de  la  Society  Mediodle.) 

Chelidonium  majus  is  a  perennial  plant  with  a  sharp^  bitter^ 
and  burning  taste,  yielding,  when  pressed,  a  yellow  corrosive, 
milky  juice ;  it  grows  in  hedges  and  waste  places  among  stones 
and  rubbish. 

Formerly  this  plant  had  so  great  a  reputation,  that  there 
were  scarcely  any  diseases  for  tbe  treatment  of  which  it  was 
not  extolled.  It  was  said  to  be  aperient,  evacuant,  cordial, 
detersive,  and  an  excellent  remedy  against  the  plague.  It  was 
recommended  in  dropsies,  congestions  of  the  liver  and  spleen, 
jaundice,  intermittent  fevers,  scurvy,  scrofula,  chlorosis,  pul- 
monary catarrh,  chronic  affections  of  the  chest  inducing  marasr 
mus,  rheumatism,  tinia  capitis  and  spots  on  the  face.  It  was 
equally  valued  in  the  treatment  of  diseases  of  the  eyes.  Dios- 
oorides  alleges  that  in  bis  time  it  was  believed  that  the  swallows 
made  use  of  the  juice  of  this  plant  for  restoring  sight  to  their 
young  when  they  had  become  blind.  Aristotle  repeats,  but 
Celsus  disputes,  this  statement. 

How  extraordinary  that  this  plant,  formerly  so  celebrated, 
hAS  in  our  day  fallen  into  such  oblivion,  that  it  is  only  used  to 
cauterise  corns  and  warts.  HomoBOpathy  will  repair  this  un- 
just neglect,  and  replace  it  in  the  position  it  deserves.    Unfor- 


48  Chelidonium  Majus  in  Neuralgia, 

tunately,  its  pathogenesis  is  far  from  being  complete,  but 
homoeopathy  has  verified  its  good  effects  in  different  morbid 
states  more  or  less  analogoas  to  those  in  which  it  was  formerly 
administered,  and  especially  in  diseases  of  the  eyes.  I  often 
prescribe  this  medicine,  and  have  proved  its  efficacy  in  those 
affections,  especially  in  acute  inflammations,  where  the  eyes  are 
swollen,  injected,  with  a  sensation  of  burning  as  if  from  the 
presence  of  a  foreign  body— when  there  is  excessive  photo- 
phobia, lachrymation,  abundant  sebaceous  secretion,  agglutina- 
tion of  the  eyelids  in  the  morning,  shiverings  from  time  to 
time,  pain  which  generally  extends  not  only  to  the  forehead, 
but  sometimes  over  all  the  head ;  this  pain,  beginning  to  be  felt 
towards  two  or  three  p.m.,  is  at  its  height  about  eight  or  nine, 
and  prevents  sleep  or  even  lying  down  till  nearly  daybreak.  It 
is  not  of  these  affections  I  intend  to  treat  at  present,  but  of 
neuralgia  of  the  temple  and  eyebrow,  chiefly  of  the  right  side ; 
I  say  the  right  side,  for,  according  to  Boenninghausen,  the 
action  of  Chelidonium  is  more  strongly  manifested  on  the  right 
than  on  the  left ;  although  I  have  cured  neuralgia  of  the  left 
eyebrow  and  temple  with  this  medicine,  as  will  be  seen  by  the 
fourth  case.  I  wish  to  show  the  efficacy  of  Chelidonium  majus 
in  these  neuralgias,  sometimes  so  refractory  and  so  subject  to 
relapse.  I  am  convinced  there  is  no  medicine  more  useful  when 
we  find  present  the  characteristic  symptoms  which  I  shall  point 
out  in  the  five  following  cases. 

Case  I. — A  young  man,  aged  80,  tall,  sanguine,  of  a  lively 
and  irritable  temper,  with  fair  whitish  grey  hair,  grey  eyes,  and 
affected  with  herpes.  Every  morning,  on  wakings  he  felt  some 
shivering,  followed  by  a  pulsative  pain  in  the  right  eyebrow 
and  temple.  This  pain,  slight  at  first,  increased  so  as  to  drive 
him  almost  to  distraction ;  it  extended  to  the  forehead,  and 
especially  to  the  eye  on  the  same  side.  The  patient  complained 
of  a  bruised  sensation  in  the  eye  from  the  front  to  the  back. 
The  eye  became  red,  watery,  and  very  sensitive  to  light; 
pressure  with  the  hand  relieved  the  pain  for  a  little ;  while 
light,  exposure  to  the  air,  and  especially  moving  and  holding 
down   the  head*  produced  a  considerable  aggravation.     The 


by  Dr.  Francesco  Ferinai.  4d 

attack  nsnally  tenninated  about  two  or  three  p.m.,  at  times  with 
aotir  perspiration,  and  only  left  a  certain  sensibility  of  the  eye 
to  light.  On  considering  that  the  attacks  returned  periodically 
in  the  morning  on  waking,  that  the  right  side  was  alone  affected, 
that  the  patient  was  of  a  sanguine  temperament  and  of  a  lively 
and  irritable  temper,  addicted  to  alcoholic  drinks,  and  that  the 
pain  was  increased  by  moving  and  holding  down  the  head,  I 
selected  Nox  vomica,  and  gave  it  in  the  1  dth  dilution ;  it  stopped 
the  fits  for  some  time,  but  they  soon  returned.  The  observa- 
tions  which  Dr.  Teste  has  published  in  his  Treatise  on  the 
Systematic  arrangement  of  the  Homoeopathic  Materia  Medica, 
on  Chelidonium  majus  came  to  my  mind,  and  I  remembered 
that  in  two  cases  he  mentions  a  neuralgic  affection  of  the  right 
eyebrow  and  temple.  Without  any  other  indication,  I  prescribed 
this  medicine  in  the  2nd  dilution,  a  spoonful  to  be  taken  every 
two  honrs.  The  result  was  so  favourable,  that  the  attacks  dis* 
appeared  after  the  second  day  of  treatment.  It  is  to  be  re- 
marked that  this  neuralgia,  which  had  been  going  on  for  more 
than  twelve  years,  returned  every  two  or  three  months  with  in- 
creased intensity,  in  spite  of  allopathic  treatment.  In  the  space 
of  two  years  after  Chelidonium  majus  had  been  given,  they  re^ 
turned  only  twice ;  but  the  symptoms,  although  the  same,  were 
much  less  intense,  thus  proving  the  efficacy  of  the  medicine. 

Case  2. — ^A  young  man,  aged  26,  lymphatic,  sanguine,  stout 
and  tall,  with  black  eyes  and  hair,  gentle  disposition,  but 
affected  with  herpes,  brother  of  the  last  patient.  The  pain, 
preceded  by  some  shivering,  commenced  about  1 1  a.m.  in  the 
right  eyebrow,  and  increased  in  severity  till  noon.  It  then  be- 
came insupportable,  and  extended  to  the  forehead  and  the  eye 
on  the  same  side ;  the  eye  was  red,  burning,  protuberant  as  if 
coming  out  of  the  socket,  and  watery ;  the  attack  ended  about 
three  p.m.,  sometimes  accompanied  by  a  slight  perspiration. 
Quinine  and  Veratrine  ointment,  prescribed  by  an  old  school 
practitioner,  far  from  relieving  these  terrible  paroxysms,  only 
aggravated  them.  At  length  the  patient,  in  spite  of  a  prejudice 
he  bad  against  homceopathy,  which  he  looked  upon  as  doing 
nothing,  decided  to  consult  me.    I  prescribed  Chelidonium  in 

VOL.  XX.,   NO.  LXXIX. — MNUAJIY,  1862.  D 


50  CMidonium  Majus  in  Neuralgia^ 

the  same  manner  as  in  the  previoos  oaae.  The  attack  which 
followed  was  so  slight,  that,  to  his  great  surprise,  he  could  go 
out  in  the  street,  and  since  then  (more  than  a  year  ago)  it  has 
not  returned,  whereas  before  such  attacks  frequently  occntred. 

Case  8. — ^A  woman,  aged  64,  little,  lymphatic,  with  fair 
skin,  grey  eyes,  and  fickle  character.  Every  day,  about  9  a-m** 
she  felt  in  the  right  eyebrow  and  temple  a  pulsative  pain,  which 
gradually  increased  until  it  became  intolerable ;  it  extended  to 
the  forehead,  and  became  tearing  round  the  orbit  The  eye 
was  injected,  burning,  watery,  and  excessively  sensitive  to  the 
light;  the  eyelids  were  contracted.  Pressure  with  the  hand 
relieved  for  a  little;  whereas  light,  movement,  and  free  air 
aggravated  the  pain.  The  patient  had  yawnings  and  shiverings 
during  the  paroxysm.  Chelidonium  removed  the  attack  on  the 
second  day  of  its  administration ;  it  returned  six  months  after- 
wards, but  with  less  intensity,  and  yielded  to  the  same  medicine ; 
there  has  been  no  return  for  a  year  and  a  half. 

Case  4. — ^A  little  girl  aged  10,  fair,  pale,  with  blue  eyes  and 
amiable  character.  Every  day,  about  three  p.m.,  she  was 
obliged  to  lie  down  on  account  of  a  pain  in  the  left  eyebrow 
and  temple,  accompanied  by  yawning  and  shivering.  This 
pain,  as  described  by  the  child,  was  pulsative ;  it  increased 
gradually,  causing  her  to  utter  sharp  cries.  The  little  patient 
complained  of  su£fering  in  the  left  side  of  the  head ;  her  eye 
was  injected,  watery,  and  very  sensitive  to  light  It  is  probable 
that  pressure  with  the  hand  relieved  it  a  little,  for  it  was  im- 
possible to  make  her  take  it  away  from  her  forehead.  About 
four  or  five  p.m.  a  slight  perspiration  came  on,  and  the  attack 
disappeared  so  completely,  that  the  child  returned  to  her  usual 
games.  Chelidonium,  8rd  dilution,  cured  this  neuralgia  after 
being  given  two  days. 

Case  5. — A  woman  aged  84,  ordinary  height,  thin,  bilious, 
dark  and  irritable.  When  getting  out  of  bed  in  the  morning, 
she  felt  some  uneasiness  in  the  right  eyebrow  and  temple,  ac- 
companied by  yawning  and  shivering.    This  uneasiness  soon 


by  Dr.  Francesco  Ferinat.  61 

changed  into  a  shooting  pain  which  extended  to  the  forehead 
and  eye  of  the  same  side.  The  eye  became  red,  watery,  and 
sensitiYe  to  light.  Pressure  relieved  the  pain  a  little;  while 
air,  moYoment  of  the  head,  and  particularly  stooping,  increased 
it  considerably;  taking  food  also  aggravated  the  pain.  The 
pain,  after  arriving  at  its  maximum  of  intensity,  diminished  by 
degrees,  and  terminated  about  4  p.m,  sometimes  by  a  little 
perspiitttion.  The  attack  did  not  return  after  the  second  day 
of  the  administration  of  Chelidoninm. 
From  these  cases  I  conclude-— 

I.  That  Chelidonium  majus  is  useful  in  all  ages,  sexes,  and 
temperaments. 

II.  That  it  may  be  used  at  all  hours  of  the  day. 

III.  That  it  is  a  most  useful  medicine  for  removing  neuralgic 
p«08  of  the  eyebrow  and  temple,  especially  of  the  right  side, 
but  also  sometimes  of  the  left. 

IV.  That  it  may  be  administered  in  repeated  doses,  for 
example  every  two  hours,  and  in  the  interval  between  the 
attacks. 

V.  That  in  order  to  be  successful,  the  pain  must  be  generally 
pnkative  and  burning,  or  less  frequently  lancinating  and  tearing. 

VI.  That  the  attacks  be  periodic  preceded  in  general  by 
yawning  and  shivering,  occasionally  continuing  during  the 
paroxysm,  and  terminating  most  frequentiy  by  perspiration 
sometimes  sOur. 

VII.  That  the  pain  always  begins  in  the  eyebrow  and  temple, 
extending  chiefly,  in  proportidn  as  it  becomes  more  intense  to 
the  forehead,  the  orbit  and  the  eye  of  the  same  side ;  the  eye 
becomes  injected,  at  times  prominent  and  very  sensitive  to 
light 

Vm.  Finally,  that  pressure  with  the  hand  relieves  the  pain 
slightly ;  while  light,  fresh  air,  movements  of  the  head,  especially 
stooping,  aggravate  it. 


2  D 


52  Oh  Fibrous  Tumour  of  the  Uterus, 

ON  FIBROUS  TUMOURS  OF  THE  UTERUS- 

By  Dr.  Joseph  Eidd. 

Of  all  the  organio  diseases  of  the  womb«  that  most  frequently 
met  with  is  fibrous  tumour.  It  most  frequently  occurs  in  un- 
married women  who  have  experienced  difficulty  and  pain  at  the 
monthly  period,  especially  if  the  menstrual  secretion  has  been 
insufficient,  or  too  profuse.  In  married  women  it  is  most  often 
met  with  in  those  who  have  not  borne  children,  or,  in  whom 
the  process  of  child-bearing  has  been  arrested,  during  the  period 
of  activity  of  the  reproductive  organs. 

I  have  known  it  caused  also  by  the  use  of  cold  sitz  baths 
employed  to  check  the  profuse  loss  at  the  menstrual  periods. 
This  profuse  loss  is  natural  to  many  constitutions,  and  should 
not  be  checked  as  long  as  the  health  continues  good. 

Whatever  lessens,  or  arrests  the  monthly  period,  before  the 
Tsscular  fulness  of  the  ovaries  and  womb  has  relieved  itself  to 
the  natural  extent,  predisposes*  to  the  deposition  of  fibrine  in 
the  tissues  of  the  womb  or  ovaries. 

Fibrous  tumour  is  sometimes  solitary,  but  more  often  a  series 
of  tumours  is  found  to  exist.  They  grow  generaUy  from  the 
substance  of  the  uterine  walls,  and  may  be  divided  into  those 
which  grow  outwards  into  the  abdomen,  or  pelvis,  and  into 
those  which  project  internally,  distending  the  uterine  cavity* 
The  latter  are  much  more  dangerous;  keeping  the  uterus 
distended  are  more  liable  to  cause  haemorrhage.  At  times 
they  fall  lower  and  lower,  so  as  to  dilate  the  os  uteri,  and 
escape  into  the  vagina,  when  their  removal  by  ligature  becomes 
feasible. 

When  the  tumour  grows  from  the  posterior  surface  of  the 
uterus,  it  sometimes  projects  into  the  space  between  the  uterus 
and  rectum,  and  there  causes  much  discomfort,  weight,  and 
pain  about  the  sacrum,  aggravated  by  walking  or  standing. 

•  It  is  extremely  important  not  to  mterfere  with  the  monthly  period,  even 
thoagh  profiue,  onleiw  signs  of  podtiTe  ezhaiistion  show  themselTes.  No 
medicine  should  be  given  during  the  monthly  period,  unless  some 
distinct  reason  calls  finr  it.    Cold  baths  should  be  discontinued  also. 


by  Dr.  Joseph  Kidd.  68 

'  The  stractare  of  fibrous  tumoar  of  the  uterus,  illustrates  its 
oiigiii  and  cause;  a  section  generally  shows  a  dense  greyish 
stmctare,  intersected  by  fibrous  bands,  in  a  concentric  or 
laminated  arrangement,  as  if  the  growth  had  occurred  in  pro- 
gressive layers,  probably  deposited  after  each  monthly  period 
firom  the  fibrine  of  the  blood  retained  in  the  uterine  vessels. 

The  utmost  variety  in  size  is  to  be  met  with ;  at  times,  so 
small  as  not  to  be  recognized  during  life,  except  by  the  obstinate 
recurrence  of  hemorrhage,  and  at  others,  so  large  as  to  fill  up 
the  greater  part  of  the  abdomen.     < 

Generally,  the  tumour  is  but  moderately  hard ;  occasionally. 
it  is  so  hard  as  to  deserve  the  name  of  "  stony."  Such  cases 
require  great  caution  in  giving  an  opinion ;  as,  although  most, 
even  of  the  hardest,  are  non-malignant,  yet  a  few  are  examples 
of  true  scirrhus  and  invariably  end  in  death,  generally  by  ex- 
haustion from  hemorrhage,  or  by  dropsy. 

The  symptoms  most  frequently  caused  by  fibrous  tumour, 
are  dull,  aching  pain  in  the  sacral  and  hypogastric  regions, 
inability  for  exertion,  dysuria,  constipation  or  diarrhoea,  and 
hemorrhage;  the  latter  I  have  found  in  a  great  number  of 
oases  to  be  the  most  dangerous  and  intractable  symptom.  In- 
deed, the  obstinate  persistence  of  monorrhagia  first  excites  the 
experienced  practitioner's  attention  and  leads  to  its  detection. 
The  tumour  seems  to  attract  blood  to  the  uterus  and  ovaries,  as 
the  ovum  in  pregnancy.  As  a  foreign  body,  also,  it  keeps  the 
blood-vessels  open,  in  the  same  way  as  the  retained  placenta 
keeps  up  hemorrhage,  till  its  expulsion  allows  the  uterus  to 
contract. 

In  many  cases,  I  have  known  even  very  large  tumours  to 
cause  little  or  no  inconvenience ;  so  much  so,  that  but  for  the 
enlargement,  the  patient  would  feel  very  little  the  matter  with 
her. 

The  occurrence  of  pregnancy  is  a  most  dangerous  complica- 
tion, as  the  tumour  causes  a  tendency  to  miscarriage,  with 
flooding  in  the  early  months.  If  the  pregnancy  goes  on  to  the 
full  time,  the  foBtal  head  may  be  obstructed  in  its  passage 
through  the  pelvis,  so  as  to  require  the  cesarean  section* 
If  this  danger  is  escaped,  and  the  child  safely  expelled,  the 


54  On  Fibroui  Tumour  of  the  Uterus, 

tamour  also  prevents  the  proper  uterine  oontraciion^  thus  keep- 
ing  up  hesmorrhage.  After  the  delivery,  there  is  still  a  liability 
of  the  fibrous  tumour  to  break  down,  and  cause  pyemia,  or 
peritonitis. 

In  the  diagnosis  of  fibrous  tumour,  care  is  requisite  to  avoid 
confounding  it  with  enlargement  of  the  ovaries.  Examination 
per  rectum,  as  well  as  per  vaginam,  will  enable  us  to  avoid  this. 
If  the  tumour  grows  firom  the  side  of  the  uterus,  or  if  it  is  em- 
bedded in  its  substance,  the  lifting  up  of  the  tumour  by  the 
finger  carries  the  womb  with  it ;  if  ovarian  not  so. 

In  ovarian  enlargement,  the  womb  is  generally  drawn  qp; 
more  often  it  is  pushed  down  by  fibrous  tumour  of  the  uterus. 
The  latter  is  more  elastic  and  generally  rounder  than  ovarian 
tumour. 

From  flexures  of  the  womb  the  diagnosis  may  be  made  by 
the  uterine  sound.  The  os  uteri  is  large  and  open  in  flexures 
of  the  womb,  but  generally  small  and  dosed  in  fibrous  tumours ; 
when  the  latter,  however,  is  pedunculated,  and  grows  into  the 
uterine  cavity,  the  os  becomes  open  and  enlarged. 

Cancer  uteri  is  the  disease  most  ^able  to  be  mistaken  for 
fibrous  tumour ;  but  the  gaping  orifice,  indurated  lips,  and  the^ 
immovability  of  the  body  of  the  uterus  in  cancer,  as  well  as  the 
continuously  offensive,  or  bloody  discharg^t  afford  a  most 
marked  distinction. 

Cancer  of  the  colon  may  be  distinguished  firom  fibrous  tu- 
mour of  the  uterus  by  the  malignant  expression  of  the  counte- 
nance, and  by  the  existence  of  bloody,  or  purulent  dianhcea,  ox 
of  obstruction  of  the  bowels.* 

The  condition  of  the  breasts,  the  freedom  from  bsmorrhAge, 
and  the  history  of  the  case,  will  easily  present  the  early  stage, 
of  pregnancy  from  bein^  iQistaken  for  fibrous  tumour. 

The  prognosis  of  fibrous  tumour  of  the  womb  should  be  cau- 


*  In  ft  case  of  obstroction  of  tho  bowels,  sent  to  me  bj  Dc  Osanne  of 
Guernsey,  I  passed  the  oolon  tube  up  aboat  12  or  13  inches  into  the  sigmoid 
fleznre,  threw  up  aboat  a  qnart  of  tepid  water  to  clear  away  the  obstraction, 
and,  ftom  the  microscopic  examination  of  the  discharge  adhering  to  the  end 
of  the  tube,  I  diagnosed  cancer  of  the  colon,  which  the  result  in  a  few  months 
verified. 


by  Dr.  Joseph  Kidd.  55 

tions  but  encouraging.  The  disease  is  likely  to  be  tedions — 
still  often  curable.  Even  if  curable,  it  is  a  great  comfort  to  the 
patient  to  receive  the  assurance  that  the  disease  is  not  malig- 
nant, nor  likely  to  degenerate  into  cancer;  that  at  the  worst  it 
only  causes  discomfort,  and  keeps  up  a  liability  to  hsBmorrhage, 
bat  is  no4  destructive  to  Ufe.  Also,  that  when  the  menstrual 
periods  oeaae,  the  tumour  may  probably  disappear,  and  all  its 
dangerous  results  cease, 

The  homoeopathic  treatment  of  fibrous  tumour  illustrates  the 
necessity  we  have  to  treat  disease  not  symptomatically,  but 
rationally.  No  medicine  is  known  to  cause  the  production  of 
fibrous  tumour,  and  although  medicines,  such  as  Sabina,  Secale;, 
and  Ferrum  muriaticum,  are  homosopathic  to  the  symptoms 
caused  by  the  tumour,  yet  their  use  is  only  palliative,  and  in  no 
way  curative  to  the  disease.  In  many  cases,  this  palliative 
treatment  is  all  that  can  be  obtained ;  still  it  is  our  duty,  in 
every  case  of  obstinately  recurring  hsemorrhage,  carefully  to  search 
for  the  local  cause^  and  if  fibrous  tumour  is  found,  to  apply 
our  treatment,  if  possible,  curatively,  and  not  to  rest  satisfied 
merely  with  palliating  the  symptoms,  and  leaving  the  caus6 
untouched. 

From  the  pathogenetic  effects  of  mercury,  it  seems  to  be  the 
nearest  homoeopathic  specific  for  the  disease.  The  primary 
patbogenetac  effect  of  mercury  is  to  cause  an  increase  in  the 
quantity  of  fibrine  in  the  blood ;  also,  an  increased  activity  in 
the  fibrous  structure  and  in  the  fibrous  organs,  such  as  the 
womb.  It  also  sets  up  an  increased  tendency  to  htemorrhage, 
and  to  muco-purulent  discharge,  from  the  membrane  lining  the 
uterine  cavity.  In  practice  I  have  found  it  the  most  useful 
medicine  in  the  treatment  of  this  disease ;  even  when  it  does 
not  cure,  it  afibrds  much  relief  to  the  worst  symptom  (the  he- 
morrhage), and  arrests  the  progress  of  disease  in  some  cases. 

Merc.  cor.  is,  I  think,  the  best  preparation  to  use,  especially 
when  profuse  muco-purulent  excoriating  leucorrhoea  exists.  To 
produce  any  decided  impression  on  the  disease,  it  should  be 
given  for  many  months.  The  dose  I  udually  employ  is  from 
1  to  d  drops  of  the  2nd  decl.  diln.  in  half  a  wine-glass  of  cold 
water,  two  or  three  times  a  day.    From  this  I  have  never,  in 


66  Oh  FihrduB  Tumour  of  the  Uterus, 

any  case^  found  the  least  injorioas  effect.  The  general  health 
nsaally  improves  very  much  under  its  use,  the  assimilation  of 
food  is  more  perfect,  and  the  formation  of  unhealthy  products 
seems  to  be  arrested,  and  the  tendency  to  hemorrhage  lessens. 

Merc,  biniod.  is  more  suitable  in  cases  characterized  by  a 
stony  hardness  of  the  tumour  without  much  leucorrhcea. 
•  This  disease  is  one  that  requires  prompt  and  judicious  treat* 
ment,  both  medicinal,  hygienic,  and  dietetic.  In  many  cases 
the  loss  of  blood  is  so  excessive  as  to  undermine  the  constitu- 
tion, unless  the  heemorrhagic  tendency  is  arrested  and  the 
system  well  supported  by  nourishment  and  by  stimulantB.  The 
best  medicines  to  check  the  hsemorrhage  are,  Sabina^  Secale, 
and  Ferrum  Muriaticum. 

Sabina,  when  the  discharge  is  bright,  accompanied  with 
pains  and  tenderness  in  the  ovarian  or  uterine  regions.  I  gene- 
rally use  the  Snd  dec.  dil.  of  the  essential  oil,  in  doses  of  from 
1  to  8  drops,  in  a  little  iced  water,  every  one,  two,  or  three 
hours,  according  to  the  severity  and  urgency  of  the  flooding. 

When  the  discharge  is  dark,  clotted,  or  thick,  with  uterine  or 
bearing-down  pains,  Secale  is  indicated.  It  should  be  given 
freely  and  frequently,  say  about  5  drops  of  the  mother  tincture, 
every  one  or  two  hours,  till  the  hasmorrhage  is  lessened  or 
arrested. 

Ferrum  muriaticum  I  have  found  most  useful  when  passive 
haemorrhage  exists,  with  little  or  no  pain,  but  with  total  pros- 
tration of  muscular  power ;  also  when  irritation  of  the  bladder 
accompanies  the  flooding.  If  the  tendency  to  flooding  exists 
at  the  monthly  period,  it  is  essential  to  enjoin  perfect  rest, 
outside  the  bed,  or  on  the  sofa,  for  at  least  four  or  five  days. 
After  the  period  has  ceased,  exercise  should  be  taken,  at  first 
most  cautiously,  so  as  to  avoid  provoking  a  recurrence  of  the 
flooding.  Abundance  of  nourishment  should  be  given,  esper 
cially  cold  beef  tea,  cold  meat,  &c.  The  free  use  of  claret  or 
port  wine  is  often  necessary ;  as,  without  wine,  the  bleeding 
will  not  be  easily  arrested  in  relaxed  or  lymphatic  constitutions. 

If  the  heemorrhflge  is  severe,  there  is  no  remedy  so  effective 
in  stopping  it  as  plugging  the  vagina  with  tow,  taking  care  to 
leave  a  piece  of  tape  attached  to  the  tow,  so  as  to  enable  the 


by  Dr.  Joieph  Kidd.  57 

medioal  attendant  to  remove  it  without  diffionlty,  in  two  or 
three  day8»  lest  the  blood  should  putrify. 

If  mechanical  obstruction  of  the  bowels  occurs  from  the 
pressure  of  the  tumour,  a  daily  enema  of  warm  water  into  the 
lower  bowel  is  advisable.  One  case  under  my  care  had  been 
for  five  or  six  years  under  allopathic  treatment,  and  took  (at 
the  advice  of  her  medical  attendant),  a  daily  purgative  for 
several  years«  On  discontinuing  this,  she  was  agreeably  sur- 
prised to  find  that  the  bowels  acted  with  the  most  perfect  regu- 
larity, every  day,  without  any  assistance. 

The  "  bittern  "  of  Eieuznach  has  acquired  a  widely  celebrated 
reputation  in  the  treatment  of  this  disease.  My  experience  of 
it  is  not  very  encouraging,  especially  as  regards  its  use  by 
external  application  and  in  artificial  sitz  baths.  The  latter 
seem  to  do  more  harm  than  good,  by  attracting  too  much 
blood  to  the  pelvic  organs.  The  external  application  (by  wet 
linen  and  oilsilk),  causes  very  great  excoriation,  and  does  not 
seem  to  produce  much  absorbent  eflPect. 

At  Kreuznach  this  '^  mutter  lye  "  is  added  in  various  propor- 
tions to  the  salt  water  baths,  and  when  the  patient  is  not  pros- 
trated by  the  resolvent  influence  of  the  bromine,  it,  in  some 
cases,  produces  a  sensible  diminution  in  the  size  of  the  tumour. 
When  I  was  at  Kreuznach  (in  1859),  Dr.  Frieger  told  me  that 
at  the  fiill  strength  of  the  baths,  the  addition  of  **  mutter  lye  " 
gives  about  eight  ounces  of  bromine  to  each  bath.  This  con- 
veys an  idea  of  extraordinary  power  in  promoting  absorption. 
Dr.  Prieger  also  assured  me  that  some  cases  of  fibrous  tumour 
were  perfectly  cured  there,  and  many  most  sensibly  became 
softer  in  consistence,  and  diminished  in  size. 

It  deserves  to  be  known  that  this  celebrated  '' bittern''  of 
Kreuznach  is  not  a  whit  superior  to,  nor  different  from,  the 
"mother  lye"  of  the  Salt  Springs  of  Cheshire,  where  the  very 
same  *Mye"  (after  all  the  salt  has  crystallized  out  of  the  brine), 
is  let  go  to  waste.  If  an  establishment  were  set  up  near  these 
springs  in  England,  much  better  results  might  be  obtained  than 
at  Kreuznach,  where  the  poor  diet  and  the  close  oppressive  heat 
of  the  place  disagree  with  many  of  the  English  visitors. 

The  ordinary  salt  water  from  the  springs  is  of  little  or  no 
efficacy  in  the  treatment  of  fibrous  tumours.    It  is  only  the 


58  On  Fibrotu  Tumour  of  the  Uterus, 

nnorystallizabie  reeidoe  (after  the  chloride  of  sodiam  has  beeif 
deposited),  which  contains  the  bromides  in  any  qnantity.  The 
diluting  of  this  with  soft  water  might  have  a  better  eflPect  than 
with  salt  water,  as  the  latter  probably  impedes  the  absorption  of 
the  bromides. 

I  append  four  cases  illnstrative  of  this  disease : — 

Case  I. 

J.  L.,  aged  40,  unmarried,  of  a  dark  complexion,  bilions 
temperament,  suffered  for  many  months  from  increasing  diffi- 
culty in  passing  water,  till  total  obstruction  came  on  in  July, 
J  654.  All  other  means  failing  to  afford  relief,  I  passed  the 
catheter,  which  drew  off  about  a  quart  of  urine.  This  reten* 
tion  of  urine  occurred  again  and  again. 

Investigating  the  cause  of  this  obstruction,  I  found  a  large 
tumour  extending  from  the  hypogastrium  to  the  left  iliac  region, 
and  downwards  into  the  pelvis.  The  tumour  was  very  hard, 
irregular  in  shape,  about  the  length  and  breadth  of  an  adult 
band ;  pressure  externally  on  the  tumour,  caused  uneasiness  in 
the  region  of  the  bladder. 

Her  general  health  was  tolerably  good ;  the  monthly  periods 
rather  scanty  and  painful ;  for  many  years  she  had  suffered  frt>m 
severe  attacks  of  spasms  in  the  iliac  region,  probably  connected 
with  this  tumour. 

.  I  prescribed  Merc,  cor.,  2nd  dec.  dil.,  three  drops  three  times 
n  day,  rest  on  the  sofa,  and  a  light,  simple  diet.  This  treat- 
ment she  continued  for  about  four  months;  gradually  the 
tumour  became  smaller  and  smaller,  and  finally  so  far  disap- 
peared as  to  leave  but  a  scarcely  perceptible  thickening  where 
the  tumour  existed.  For  seven  years  she  has  had  no  percep- 
tible return  of  the  tumour,  nor  any  necessity  for  resorting  to 
the  use  of  the  catheter. 

This  is  an  interesting  case  of  fibrous  tumour,  altogether  ex- 
tertutl  to  the  uterine  cavity ,  therefore  unattended  with  haemorr- 
hage ;  growing  from  the  anterior,  superior  wall  of  the  uterus, 
it  gradually  encroached  upon  the  neck  of  the  bladder,  till  total 
obstruction  resulted.  The  effect  of  the  Merc.  cor.  was  most 
satisfactory  and  permanent. 


hy  Lr,  Jo9€pJ$  Kidd,  69 

Case  II. 

Mn.  ,  aged  44,  lymphatic,  saQgoiae  temperament,  20 

yean  manied,  no  children,  having  noticed  an  enlargement  in 
the  lower  part  of  the  abdomen,  she  sent  for  me  in  May,  1855. 
On  examination  I  found  a  large,  nearly  round,  solid  tamonr, 
the  size  of  a  young  child's  head,  growing  from  the  superior 
fandos  of  the  utems.  It  extended  to  within  about  an  inch  of 
the  umbilicus.  There  was  little  or  no  pain  on  pressure,  and 
not  much  inconvenience,  except  from  the  increased  loss  at  the 
monthly  period,  whicb  amounted  at  times  to  flooding. 

Tracing  back  the  history  of  the  case,  I  found  that  the 
monthly  periods  had  been  perfectly  regular,  but  rather  scanty^ 
for  two  or  three  years  past,  till  October,  1854,  when  one  period 
passed  without  any  appearance,  and  the  same  in  October,  1855 ; 
about  this  time  also,  one  breast  became  enlarged.  For  nearly 
a  year  she  experienced  a  gradual  fdlness  and  hardness  in  the 
abdomen,  and  for  some  months  past  the  catamenial  loss  had 
become  excessive.  The  os  uteri  was  found  very  small,  the 
oerrix  undeveloped,  the  body  enlarged  and  distended. 

I  prescribed  Merc,  cor.,  2nd  dec.  dil.,  two  drops  in  a  wine* 
glass  of  cold  water,  three  times  a  day,  also  rest  on  a  sofa,  eepe* 
cially  at  the  monthly  period,  the  free  use  of  fresh  vegetables  and 
ripe  fruity  as  well  as  a  fall  proportion  of  fresh  meat.  After  three 
months'  use  of  this  treatment,  the  enlargement  of  the  breast 
was  quite  cured,  but  the  tumour  apparently  not  much  lessened. 

The  external  use  of  Kreuznach  Bittern  was  then  prescribed 
as  a  compress,  with  oil-silk  over  the  abdomen.  After  many 
months  use  of  it,  not  making  any  decided  progress,  I  advised 
ker  to  go  to  Ereuznach,  where  for  two  months  she  used  the 
baths,  with  an  admixture  of  "  mutter  lye,"  under  the  skilftil 
superintendence  of  Pr.  Frieger. 

On  her  return  I  found  the  tumour  rather  smaller  and  softer, 
but  not  any  decided  change,  her  general  condition  being,  on 
tke  whole,  improved,  and  no  symptom  present  except  the  me- 
Qorrhagia.  She  still  remains  under  my  oecasional  observation* 
The  tumour  certainly  does  not  increase — ^rather  the  oppoMt^-* 
the  tendency  to  menorrhagia  has  gradually  lessened,  and  her 
general  health  has  become  re-established. 


60  On  FibrouM  Tumour  of  the  Vierus, 

In  this  case,  the  tumonr  was  evidently  embedded  in  and  con' 
tinuous  with  the  fibrons  strnctnre  of  the  nteras.  From  its 
situation,  it  kept  the  fundus  of  the  womb  distended,  and  thus 
kept  up  the  tendency  to  heBmorrhage.  Being  of  an  active 
disposition,  she  took  a  great  deal  of  open  air  exercise,  in  the 
intervals  of  the  menstrual  periods,  with  great  benefit  to  her 
general  health. 

Case  III. 

Miss  ,  aged  88,  nervous  lymphatic  temperament,  for 

many  years  had  suffered  from  profuse  loss  at  the  monthly 
period,  of  which,  however,  she  took  little  notice,  till,  on  a  visit 
to  the  sea-side  in  October,  1858,  a  severe  flooding  came  on 
(after  a  ride  on  horseback).  This  continued  for  a  fortnight, 
and  she  recovered  very  slowly  from  it. 

In  November  she  came  up  to  London  to  consult  me.  On 
examination  I  found  a  tumour,  about  the  size  of  a  hen  s  egg, 
growing  from  the  posterior  wall  of  the  uterus,  and  pressing  into 
the  space  between  the  uterus  and  rectum.  The  os  uteri  was 
small,  the  cervix  and  body  natural.  She  complained  of  much 
debility,  languor,  nervous  excitability,  and  inability  to  walk. 

I  prescribed  China  0  with  much  benefit  to  her  general  health. 
After  this  was  tolerably  well  re-established,  Merc.  cor.  was 
given  for  a  month,  without  any  benefit;  afterwards  Kali  bromid. 
1st  dec.,  and  the  external  use  of  Ereuznach  bittern.  Aftier 
some  months  I  found  every  attempt  to  prescribe  curative  treat- 
ment only  disturbed  the  nervous  system,  without  any  real 
benefit.  I  then  discontinued  specific  treatment,  and  resumed 
that  for  her  general  health — viz.,  China  (p  during  the  intervals 
of  the  periods,  for  some  months,  subsequently  Ferri  sulph.,  1st 
dec.  dil.,  for  two  or  three  months,  perfect  rest  all  through  the 
menstrual  period,  and,  during  the  intervals,  open  carriage  exer- 
cise daily,  a  light,  unstimulating  diet,  a  glass  or  two  of  claret 
at  dinner.  Her  general  health  became  very  much  improved, 
and  the  loss  at  the  monthly  period  lessened,  but  the  tumour 
remains  unchanged. 

A  singular  circumstance  in  the  treatment  of  this  case  is^  that 
the  tumour  requires  lifting  up  once  in  six  or  eight  weeks; 


by  Dr.  Joseph  Kidd.  61 

gradaaUy  the  tumour  fidls  lower  and  lower  into  the  pehis^  so 
as  to  cause  increasing  inability  to  walk^  until  it  is  again  lifted 
up  above  the  brim  of  the  pelvis^  by  the  finger  introduced  into 
the  rectum. 

Case  IV. 

Mrs. ,  aged  44,  sanguine  temperament,  has  suffered  for 

about  eight  years  from  an  enormous  fibrous  tumour  filling  the 
abdomen ;  in  size,  it  is  equal  to  the  full  period  of  pregnancy. 
For  five  years  she  used  the  baths  at  Ereuznach  every  year, 
without  any  positive  decrease  in  the  tumour. 

In  1860,  she  went  from  Ereuznach  to  Heidelberg,  to  consult 
the  celebrated  Ghelius.  After  three  weeks'  residence  there,  a 
severe  form  of  intermittent  fever  came  on,  which  no  treatment 
was  able  to  arrest.  With  great  difiSculty  she  returned  to 
England,  and  spent  all  the  winter  in  London,  under  the  care  of 
an  able  allopathic  physician.  After  six  months'  trial  of  many 
medicines  (including  Quinine  in  every  form),  without  any  relief 
to  the  ague,  she  dispensed  with  his  services,  and  sent  for  me  in 
April,  1861.  I  found  her  prostrate  and  emaciated;  every  other 
day  a  chill  came  on,  followed  by  profuse,  long-continued  per-* 
spiration,  and  sleeplessness  (every  other  night).  I  prescribed 
Arsenicum  2nd  dec.  dil.,  one  drop  four  times  a  day.  Soon  after 
commencing  this  medicine  a  decided  improvement  set  in,  and 
the  intermittent  fever,  that  had  resisted  most  skilful  allopathic 
treatment  for  eight  months,  was  perfectly  cured  by  the  Arsenicum 
in  a  fortnight  Her  general  health  also  became  re-established, 
without,  however,  any  diminution  in  the  tumour. 

This  case  is  introduced  here  to  illustrate  the  admirable  effect 
of  "arsenicum,"  and  to  show  how  questionable  is  the  truly 
curative  influence  of  Ereuznach  baths  in  a  severe  case  of  fibrous 
tumour.  A  full  course  of  the  baths  every  year,  for  five  years 
(with  the  occasional  use  of  the  Bittern  in  the  intervals),  had 
no  perceptible  effect  in  lessening  the  size  of  the  tumour,  although 
she  consoled  herself  with  the  belief  that  it  was  kept  in  check, 
and  prevented  from  increasing,  by  the  annual  resort  to  the 
baths  of  Ereuznach. 


02  The  Pathogenwf  of  Aconite^ 

ON  THE  PATH0GENE8Y  OF  ACONITE  :    WITH 
CUNICAL  OBSERVATIONS. 

By  J.  H.  Nankivbll,  M.R.G.S.^  Penzance. 

(Contjimed  fhm  YoL  xik.,  page  658.) 

Scalp. — (''  Tingling  in  the  left  side  of  the  scalp ;  sensation  as 
if  pulled  by  the  hair  ;  bloated  appearance  of  the  face  and 
forehead;  single  spots  on  the  scalp  which  are  sensidve  to 
contact  and  cold  air ;  stitches  under  the  scalp ;  sensation  over 
the  scalp  as  if  the  hair  were  standing  on  end  here  and  there, 
the  scalp  being  very  sensitive.*^ 

The  first  sentence  points  out  excitement  in  the  cutaneous 
nerves,  such  as  may  arise  from  a  variety  of  causes ;  it  may  be 
unimportant  as  when  caused  by  exposure  to  cold,  or  it  may  be 
the  first  link  in  a  chain  of  symptoms  occasioned  by  lesion  in 
the  nervous  centres.  Every  variation  from  the  healthy  state  of 
the  organism  is  worthy  of  the  attentive  consideration  of  the 
physician,  more  especially  when  the  morbid  symptom  is  in 
immediate  relation  with  the  brain  itself. 

The  expression  ''  bloated  appearance  of  the  face  and  fore- 
head  "  suggests  to  the  mind  the  observations  made  by  Malpighi, 
Leuwenhnck,  F.  Dubois,  CI.  Bernard,  and  M.  Sucquet  on  the 
so-called  derivative  circulation  of  the  blood,  in  other  words,  of 
the  important  part  played  by  the  vessels  which  maintain  a  direct 
communication  in  certain  parts  of  the  body  between  the  arteries 
and  the  veins,  and  this  being  independent  of  the  capillary  circu- 
lation. Especially  are  such  vessels  found  on  the  skin  of  the  lips, 
nose,  eyelids,  forehead,  scalp,  &c.  These  vessels  increase  in 
volume  with  advancing  years,  and  their  especial  function  is  to 
take  off,  to  receive  and  return  to  the  heart,  any  extraordinary 
supply  of  blood  which  from  any  cause  may  have  been  sent  to 
an  important  organ  of  the  body,  and  which,  if  all  passed 
through  the  capillary  vessels,  might  involve  the  organ  in 
serious  disease.  Thus,  during  violent  exercise,  the  important 
viscera  of  the  body  do  not  participate  in  the  tumultuous  excited 
state  of  the  circulation  as  manifested  on  the  surface  of  the  body. 


bg  Mr.  J.  H.  Nankivell.  63 

Vat  are  enabled  to  carry  on  their  fiinctiona  in  the  aame  manner 
as  when  the  body  is  at  rest,  or  during  sleep.  It  is  highly  pro* 
bable»  from  the  proving  we  refer  to,  that  Aconite  would  be  most 
especially  indicated  in  apoplectic  conditions  or  congestions  of 
the  brain  or  its  membranes  when  the  "  bloated  appearance  "  of 
the  countenance  is  present  But,  for  example,  the  extent  to 
which  this  injection  of  the  face  and  scalp  may  exist,  especially 
in  elderly  persons,  is  almost  startling  to  witness.  I  have  seen 
a  man,  aged  70,  weeding  in  his  garden,  whose  bald  head  had 
changed  from  its  ordinary  sallow  tint  to  a  deep  plum  colour, — 
so  intense  was  the  engorgement  of  the  superficial  vessels,  he 
assured  me>  that  he  did  not  feel  any  degree  of  headache  or  in- 
oonvenience. 

M.  Suoquet  states  that  in  old  men  who  have  drunk  intem- 
perately  it  is  found  that  the  direct  arterioso-venons  trunks 
about  the  head  and  face  are  multiplied  and  developed.  This  is 
a  kind  of  conversative  effort  of  nature  against  the  lethal  effects 
of  alkohol ;  indeed  it  is  worthy  of  remark,  how  rarely  excessive 
drinking  produces  organic  changes  in  the  brain.  We  have 
known  several  instances  in  which  men  have  drunk  to  such 
excess  as  to  bring  on  repeated  attacks  of  delerium  cum  tremore, 
and  even  insanity,  and  notwithstanding  make  a  good  recovery, 
to  sink  after  several  years  from  organic  disease  of  liver,  stomachy 
or  kidneys. 

The  other  scalp  symptoms  in  the  text  appear  to  be  such  as 
might  commonly  arise  in  rheumatic  affections. 

Eyes. — ("  Staring  look ;  distortion  of  the  eyes  about  mid- 
night ;  protrusion  of  the  eyes.") 

These  expressions  remind  one  of  a  peculiar  and  complicated 
affection  which  the  French  call  la  cachexie  exophthalmique, 
and  which  has  been  so  frequently  found  associated  with  goitre 
and  disease  of  the  heart.  Dr.  Dufresne  says :  "  Qui  n'a  dans 
sa  dient^e  vu  de  ces.  personnes,  s^ches,  maigres,  au  teint 
blafard  et  jaun&tre,  les  yeux  saillants,  avec  un  goitre,  des 
hallemfflis  de  ooeur,  des  fremissements  continuels  des  gros  vaiss*. 
eaux."  A  case  of  this  kind  came  under  my  observation  a  few 
months*  since ;  it  was  distinctly  marked  with  this  triple  form  of 
disease,  and  in  addition  there  was  occasional  hnmoptysis  and 


64  The  Paihogenesy  of  AcofUUt 

a  kind  of  paralysis  agitans  of  tlie  hands.  The  patient,  more* 
over,  was  subject  to  extreme  mental  depression.  Aconite  did 
not  appear  to  be  indicated  by  the  "  totality  of  the  symptoms," 
but  the  patient  mended  under  the  influence  of  Puis.,  Ignatia  and 
Arsenic.  There  was  no  evidence  of  pulmonary  tubercle, — the 
hemoptysis  ceased,  the  strength  improved.  The  organic 
changes  in  the  thyroid  gland  and  in  the  heart  remained  as 
they  were.  It  seems  that  the  lesson  to  be  derived  from  our 
text  is,  that  in  the  early  stages  of  heart  disease,  or  of  goitre. 
Aconite  is  especially  indicated,  if  there  is  the  slightest  tendency 
to  protrusion  of  the  eyes.  Certain  it  is  that  this  interesting 
triad  of  diseases  would  amply  repay  a  searching  investiga- 
tion. Who  will  interpret  for  us  the  sequence  and  consequence 
of  the  morbid  conditions  ?  Is  the  projection  of  the  eyes  the 
direct  result  of  chronic  aortitis  ?  Has  the  goitre  anything  to 
do  with  it  by  retarding  the  return  of  blood  from  the  head  ? 

Is  there  not  in  most  cases  of  serious  disease  of  the  heart, 
even  when  goitre  is  not  present,  a  projection  and  staring  ex* 
pression  of  the  eyes  ?  Again  in  chlorosis  and  ansmia,  so 
intimately  associated  with  or  related  to  this  disease,  what  an 
interesting  enquiry  is  involved  in  the  fact  of  the  prolonged  and 
exalted  state  of  the  heart's  action.  Is  it  not  probable  that  this 
violent  palpitation  with  aortic  murmurs,  which  for  a  consider* 
able  period  may  be  the  mere  mimicry  of  heart  disease,  I  say 
is  it  not  probable  that  in  many  instances  it  goes  on  to  actual 
organic  disease  ?  I  once  saw  an  extraordinary  protrusion  of 
the  eyes  brought  on  in  a  woman  aged  70  by  an  attack  of  rheu- 
matism of  the  orbits.  The  disease  subsided,  but  the  eyes  never 
recovered  their  natural  expression  ;  the  stare  that  remained  was 
most  unpleasant ;  it  appeared  to  be  produced  by  an  effusion  of 
serum  or  lymph  in  the  sub-conjunctival  tissue — at  all  events 
the  conjunctiva  soon  after  had  a  puffed  baggy  look. 

{'^ ^ Sparkling  eyes:  pressure  in  the  eyes,  especially  wheth 
turning  them  and  looking  down  ;  or  accompanied  with  heat 
and  burning  in  the  eyes,  especially  in  the  left  eye  and  over  the 
eyebrows") 

The  first  sentence  mav  indicate  cerebral  erethism ;  the  others 
seem  to  bespeak  vascular  engorgements  of  the  orbits  or  of  the 


hy  Mr,  J,  H.  NankivelL  G5 

eyes,  the  pain  of  the  eyes  daring  motion  being  possibly  of  a 
rbenmadc  type,  or  rather  pointing  thereto. 

("  *  GreaLphotophobia.     The  pupils  are  much  dilated!*) 

I  have  transposed  the  two  last  sentences  that  they  may  fall 
into  a  more  natural  ordd^  and  sequence.  In  the  onset  of  in- 
flammation of  brain^  intolerance  of  light  (and  of  noise)  is  a 
prominent  symptom,  and  it  is  then  that  Aconite  is  especially 
indicated ;  in  the  succeeding  stage,  when  effusion  is  threatened* 
dilatation  of  the  pupils  loudly  demands  Bel. ;  indeed  from  the 
outset  of  the  disease  it  may  perhaps  be  wise  and  well  to  use 
Bel.  in  alternation  with  Aeon,  and  possibly  in  the  form  of  drop 
doses  of  the  mother  tincture. 

C  Black  spots  and  mist  before  the  eyes ;  sometimes  accom- 
panied with  vertigo.     Photomania.     Obscuration  of  sight.") 

Such  morbid  phenomena  may  exist  either  with  or  without 
fever ;  in  both  forms  Aconite  may  benefit.  A  case  has  recently 
come  under  my  treatment  in  which  the  patient,  a  woman  aged 
58,  is  the  subject  of  the  most  intolerable  noises  in  the  head, 
flashes  of  light  before  the  eyes,  frequent  retching  and  even 
vomiting,  and  yet  is  there  no  fever ;  but  quite  the  contrary,  a 
Tery  cool  state  of  the  skin,  small  weak  pulse,  menstruation  has 
ceased  for  several  months.  Can  any  pathologist  divine  what  is 
the  state  of  the  brain  in  such  a  case  as  this  ?  The  whole  sen- 
tence quoted  seems  also  to  point  to  amaurotic  diseases. 

("  Ophthalmia  accompanied  with  blear-eyedness  ;  it  is  so 
painful  that  he  would  rather  die  than  live;  sometimes  accom- 
panied with  pressure,  beat  and  burning  in  the  eyes,  especially 
when  moving  the  balls,  and  occasional  sensation  as  if  the  eyes 
were  swollen.") 

The  first  question  which  arises  from  a  consideration  of  this 
paragraph  is — Can  Aconite  produce  such  distress  in  the  eyes 
that  the  patient  would  rather  die  than  live  ?  Be  this  as  it  may, 
every  Homoeopath  has  seen  cases  of  ophthalmia  in  which  the 
patient's  life  had  been  a  burden  unto  them  until  they  had  been 
treated  by  Aconite;  and  seeing,  over  and  over  again,  the 
primary  effects  of  this  drug  in  the  different  forms  of  chronic 
lippitudo,  he  cannot  but  wish  that  in  the  onset  of  the  disease 
our  noble  remedies  had  been  used,  so  that  the  miserable  effects 

VOL.   XX,   NO.   LXXIX. — JANUARY,    1862.  £ 


66  The  Pathogefie$y  of  Acontie, 

of  chronic  ophtbalmia  on  the  cornea  and  on  the  eyelids  might 
have  been  altogether  prevented.  It  is  scarcely  necessary  to  say 
that  in  such  diseases  Aconite  is  not  the  only  remedy  which  may 
be  required.  It  will  be  almost  always  necessary  to  follow  it  up 
with  such  medicines  as  the  constitution  of  the  patient  may  seem 
to  require,  or  a  relapse  will  be  almost  sure  to  follow. 

LiPPnuDo,  &c. — About  three  months  since,  a  poor  woman 
came  to  the  Penzance  Dispensary  a  miserable  sufferer  from 
chronic  ophthalmia.     She  had  for  years  undergone  a  variety  of 
treatment,   but  was  constantly  getting  relapses,  as  she   ob- 
served, from  every  slight  cold.     The  edges  of  the  lids  were  red 
and  thickened,  the  interior  of  the  lids  much  injected,  the  con- 
junctiva of  the  globes  congested  and  relaxed,  the  come®  of 
both  eyes  starred  with  old  opacities,  four  or  five  in  each.     Sbe 
took  Aconite  and  Bel.  alternately,  and  at  the  end  of  a  week 
returned  in  a  state  of  comparative  ease  and  comfort ;  the  in- 
flammation of  the  eyes,  intolerance  of  light,  &c.  having  under- 
gone great  mitigation  after  another  week,  she  was  discharged 
relieved,    and   has   not   since   returned.     Again,    a   domestic 
servant,  who  had  lived  in  London,  and  had  been  there  in  some 
eye  hospital  for  chronic  lippitudo,  came  under  treatment  six 
weeks  since.     This  case  was  much  like  the  former,  except  that 
there  had  been  no  opacities  of  the  cornesB.     The  same  treat- 
ment, with  the  addition  of  a  weak  solution  of  Bel.  as  a  lotion 
to  the  lids,  had  a  very  satisfactory  effect.     These  plain  cases 
are  not  mentioned  as  being  at  all  out  of  the  ordinary  character, 
but  as  simply  corroboration  of  the  Aconite  healing. 

C  *  Acute  ophthalmia^  especially  congestive,  rheumatic,  and 
arthritic,  previous  to  administering  Bel,  or  Sulph.     Swelling 
of  the  inflamed  eyes.     Injected  state  of  the  vessels  of  the  in- 
flamed  conjunctiva  and  sclerotica") 

This  clinical  group  merely  recites  what  has  been  proved  over 
and  over  again  by  every  member  of  our  medical  school,  and 
the  unmistakable  facts  are  so  notorious,  that  it  would  be  a 
waste  of  time  to  make  any  comment  on  the  text. 

("  ♦  Ophthalmia  arising  from  a  foreign  body  having  petie- 
trated  into  the  ball  of  the  eye,  with  redness  of  the  whites,  a 
stinging  pain  with  pressure  in  every  part  of  the  eye;  photo- 


hy  Mr.  /.  H.  NankivelL  67 

phobia  and  lachrymation,  Drytiess  and  heaviness  of  the 
upper  eyelidsy  with  pressure  as  from  drowsiness.  Painfully 
iefuive  red  hard  swelliny  of  the  lids,  especially  early  in  the 
ntominy.") 

The  reference  to  traumatic  ophthalmia  in  these  passages  recalls 
to  my  mind  a  case  which  I  attended  in  my  allopathic  days, 
and  some  particulars  of  which  I  here  give. 

About  six  years  since,  a  boy  aged  9  shot  an  arrow  into  the 
air  and  watched  its  descent  Unhappily  the  point  struck  him 
in  the  eye,  wounding  the  corneee  and  probably  perforating  the 
anterior  chamber  of  the  eye.  Being  afiraid  to  confess  the  truth, 
he  concealed  the  nature  of  the  accident  from  his  parents  for 
three  days,  who  thought  that  there  was  only  a  little  catarrhal 
affection  of  the  organ.  By  this  time  inflammation  had  come 
on  to  a  frightful  extent.  I  saw  the  boy  and  attended  him  in 
consultation  with  two  other  surgeons.  Our  '*  sheet  anchor" 
was  leeches.  Atropine,  and  Calomel,  which  was  given  repeatedly, 
but  without  inducing  ptyalism  or  any  mitigation  of  the  symp- 
toms. The  termination  of  the  case  was  in  disorganization, 
atrophy,  and  collapse  of  the  entire  globe.  The  loss  of  the  first 
four  days  after  the  accident  rendered  the  case  almost  hopeless 
from  the  first,  but  the  question  has  often  since  then  occurred  to 
my  mind — Would  the  event  have  been  the  same  if  Aconite, 
Arnica,  and  Belladonna  had  been  used  ? 

"  The  dryness  of  upper  lids,"  in  the  second  sentence,  would 
seem  to  arise  from  a  diminished  secretion  from  the  lachrymal 
gland.  We  have  also  added  the  expression  "  pressure  as  from 
drowsiness"  Are  not  these  states  very  much  like  what  we 
find  to  be  the  natural  state  when  there  is  sleep  or  a  tendency  to 
it?  It  is  probable  that  at  night  the  secretion  of  tears  from  the 
lachrymal  gland  is  considerably  diminished,  as  they  are  not 
required  for  the  purpose  of  moistening  the  conjunctiva ;  and  it 
would  seem  that  the  secretion  of  the  meibomian  glands  is  at 
the  same  time  increased  to  compensate  for  or  rather  to  take 
the  place  of  the  tears,  and  to  lubricate  the  edges  of  the  eyelids. 

("  ♦  Pressure  in  the  upper  eyelids  from  without  inwards, 
and  sensation  as  if  the  whole  of  the  eyeball  were  pushed  into 
the  orbit,  the  eye  feeling  painful  as  if  contused.     Prickling 

2  E 


68  The  Pathogenesy  of  Aconite, 

and  smarting  of  the  eyelids  as  when  a  cold  is  setting  in. 
Soreness  and  itching  of  the  eyelids,") 

These  afford  satisfactory  evidences  that  Aconite  will  produce 
symptoms  like  those  of  catarrhal  ophthalmy,  the  swelling  of 
the  conjunctiva  causing  a  sensation  of  pressure  inwards,  and 
accompanied  with  prickling  and  soreness  which  in  natural 
disease  so  frequently  leads  patients  to  suppose  that  sand  or 
some  other  foreign  body  has  got  into  the  eye. 

("  Yellowness  of  the  sclerotica.") 

This  isolated  symptom  has,  of  course,  relation  to  hepatic, 
gastric,  or  duodenal  affections.  It  has  been  noticed  that  a 
bilious  tinge  in  jaundice  is  commonly  first  noticed  in  the  eye, 
and  lingers  there  long  after  it  has  ceased  to  be  apparent  in  the 
skin. 

Jaundice  of  Conjunctiva. — It  may  be  a  mere  sallowness  of 
the  conjunctiva,  or  it  may  be  the  first  symptom  of  severe  jaundice. 
If  the  latter  be  of  an  inflammatory  type,  the  administration  of 
Aconite  would  of  course  be  indicated.  I  have  treated  a  case  in 
which  at  the  commencement  there  was  much  fever,  almost  of  a 
typhoid  nature,  dry  brown  tongue,  thirst,  accelerated  pulse,  &c. 
Here  Aconite  was  first  given,  and  up  to  a  certain  point  it  did 
good;  the  febrile  symptoms  abated,  and  the  tongue  became 
moist,  but  much  coated  in  the  centre.  Mercurius  was  then 
given,  but  the  evacuations  did  not  lose  their  slaty  appearance, 
nor  did  the  saffron  tint  of  the  urine  diminish.  Taraxacum 
was  then  tried,  and  with  charming  effect.  As  the  constipation 
in  this  instance  was  at  first  very  obstinate,  I  did  not  hesitate  on 
two  occasions  to  give  three  grains  of  Blue  Pill ;  and  I  hold  that 
the  administration  of  Blue  Pill  or  Grey  Powder  is  perfectly  com- 
patible with  homoeopathic  orthodoxy.  They  both  derive  their 
potency  from  trituration,  and  the  question  of  dose  is  still  sub 
judice.  Very  recently  a  rickety  child,  aged  2,  has  been  brought 
under  treatment  with  marked  jaundice ;  it  took  mere.  8,  and 
at  the  end  of  a  week  was  convalescent. 

It  is  very  interesting  to  notice  the  epidemic  character  of 
jaundice.  A  few  years  since  I  had  to  treat  a  boy  aged  11.  He 
took  grey  powder,  and  recovered.  He  had  scarcely  got  well, 
when  his  brother,  aged  0,  had  a  similar  attack,  which  ran  the 


hy  Mr.  J.  H.  NankivelL  «fiF 

same  course.  A  few  months  after  I  had  to  treat  four  children 
in  one  family,  who  were  all  ill  of  janndice  at  the  same  time. 
They  took  nothing  bat  Mer.  sol.  8,  and  speedily  recovered. 
Natures  cures  for  the  most  part,  no  doubt,  and  yet  we  may, 
from  past  experience,  well  believe  that  these  patients  would  not 
have  so  quickly  recovered  had  they  not  taken  Mercurius. 

("  The  eye  has  lost  all  expression.  The  eye  squints  upwards. 
Complete  blindness.  The  eye  has  become  dazzled.  She  sees 
as  through  a  gauze.") 

These  sentences  vividly  paint  the  terrible  effects  of  inflamma- 
tion of  the  brain,  especially  as  witnessed  in  children  and  young 
persons.  It  seems  almost  incredible  that  the  provings  should 
have  been  carried  to  such  an  extent  as  we  have  represented. 
It  would  have  been  most  interesting  and  instructive  to  have  had 
a  history  of  the  recovery  from  the  conditions  mentioned,  and  to 
have  known,  for  instance,  how  long  the  pathogenetic  state  of 
*'  total  blindness "  continued ;  and  farther,  to  have  learned 
whether  antidotes  were  given  and  with  what  effect. 

("After  a  venesection  she  feels  as  if  she  had  been  trans- 
ported from  a  dark  into  a  light  room/') 

It  is  difficult  to  understand  under  what  circumstances  this 
bleeding  was  performed,  and  with  what  object.  Are  we  to  sup- 
pose that  the  prover  was  under  the  full  and  blinding  influence 
of  Aconite  at  the  time  when  the  vein  was  opened  ?  And  does 
the  passage  convey  this  lesson,  that  when  the  function  of  the 
retina  has  been  so  far  interrupted  by  Aconite  as  to  produce 
darkness,that  vascular  depletion  will  be  one  of  the  best  anti- 
dotes ?  and,  as  a  corollary,  may  we  conclude  that  in  some  forms 
of  amaurosis,  congestive  or  otherwise,  the  most  successful 
treatment  would  be  by  blood-letting  ?     I  trow  not. 

("  Warm  and  undulating  feeling  in  the  eyes,  and  sensation  as 
if  it  were  too  dark  to  read  in  a  light  room.  He  sees  sparks 
and  mist.  He  sees  flashes  and  scintillations.  Upon  going 
into  the  street  at  twilight,  the  light  of  the  lamps  appeared  tre* 
mulous,  and  he  saw  luminous  vibrations  before  his  eyes;  he 
found  it  difficult  to  observe  the  countenances  of  those  whom  he 
met ;  be  became  anxious  and  giddy.") 

The  undulations  so  called,  are  more  frequently  moving  zig- 


70  Poisofiing  hy  Belladonna ^ 

aags  when  the  effect  of  disordered  fdnction  of  the  retina,  from 
natural  (non-medicinal)  causes,  the  seeming  motions  of  the 
sharp  angles  heing  from  the  centre  towards  the  circumference  of 
the  eye  like  a  mimicry  of  forked  lightning,  and  are  generally 
accompanied  by  indistinct  vision,  not  alone  from  the  confusion 
of  the  objects  by  the  interlacing  of  the  luminous  zig-zag  lines, 
but  also  from  a  degree  of  dimness  of  the  sight  which  accom- 
panies this  state  of  things.  I  have  met  with  several  instances 
which  have  appeared  to  be  the  effect  of  indigestion,  and  a  few 
which  have  been  brought  on  by  leaning  the  head  forwards. 
The  whole  group  of  symptoms  affords  us  broad  outlines  of  dis- 
ease having  origin  in  the  great  nervous  centres,  or  of  that  por- 
tion of  it  in  immediate  connection  with  the  optic  nerves.  Such 
states  often  exist  in  a  most  exaggerated  form,  without  fever  or 
delirium ;  the  patient  may  be  haunted  by  a  variety  of  hideous 
apparitions,  but  may  all  the  time  be  quite  aware  that  the  phan- 
toms are  illusory.  Where  there  is  true  inflmmation  of  brain,  there 
is  almost  invariably,  in  the  first  instance,  an  exaltation  of  one 
or  more  of  the  senses.  The  hearing  is  more  acute,  the  sight 
and  smell  more  keen,  and  what  is  remarkable,  an  exquisite 
sensibility  exists  in  perhaps  one  only  of  the  extremities,  or  a 
part  of  it.  In  these  states  Aconite  is  our  great  and  most  reliable 
remedy,  but  afterwards,  when  the  senses  have  become  dulled,  or 
obscured,  it  will  be  of  no  avail. 


CASES  OF  POISONING  BY  BELLADONNA, 

With  Commentaries. 

By  Richard  Hughes,  M,R.C.S.,  L.R.C.P.  Ed.  {Exam,) 

The  following  paper  does  not  profess  to  comprise  all  the  cases 
of  poisoning  by  Belladonna  and  its  alkaloid  which  medical 
literature  can  furnish  ;  it  is  rather  a  collation  of  such  cases  as, 
being  well  authenticated  in  all  their  details,  should  form  a  series 
of  typical  pictures  of  the  more  important  physiological  actions 
of  the  drug.  The  commentaries  I  have  afi&xed  to  each  case  are 
intended  to  point  out  its  salient  features,  to  enquire  into  their 


by  Dr.  Richard  HughcB.  71 

physiological  rationale,  and  to  seek  the  indications  afforded 
by  them  for  therapeutical  uses. 

Case  I. 

The  first  case  I  shall  cite  is  one  of  poisoning  by  Atropine, 
recorded  by  Mr.  Holthonse,  surgeon  to  the  Westminster  Hos- 
pital, in  the  Medical  Times  and  Gazette  of  Dec.  17,  1859: — 

*'  At  nine  o'clock  on  Sunday  morning,  the  17th  of  July  last, 
my  second  child,  a  hearty  little  boy,  3  years  and  8  months  old, 
was  brought  to  my  bedroom  by  the  nurse,  who  said  she  did  not 
know  what  was  the  matter  with  him,  but  he  seemed  very  giddy, 
and  could  not  stand  (1).  Her  account  was  that,  hearing  what 
she  supposed  to  be  quarrelling  between  him  and  his  brother, 
who  were  alone  together  in  the  breakfast-room  awaiting  our 
assembling  at  breakfast,  she  took  him  into  the  kitchen,  and  on 
setting  him  on  his  feet  he  fell  down.  She  lifted  him  up,  and 
told  him  to  run  along,  but  he  again  fell,  and  appeared  to  have 
no  power  of  standing  (1).  On  observing  this,  she  immediately 
brought  him  up  to  me. 

**  His  face  was  at  this  time  flushed  and  mottled  with  white  (2), 
his  eyes  brilliant  (3),  and  his  manner  and  appearance  alto- 
gether very  strange  and  excited,  while  the  expression  of  his  coun- 
tenance was  quite  maniacal.  He  was  evidently  unconscious,  and 
very  irritable,  striking  his  mother  when  she  took  him  from  the 
nurse.  On  placing  him  on  the  bed  he  immediately  began  to 
pick  at  the  bed  clothes,  and  to  grasp  at  imaginary  objects  (4)." 
(It  was  now  ascertained  that  he  had  swallowed  a  solution  con- 
taining nearly  half  a  grain  of  Atropine.)  '*  The  cause  of  the 
symptoms  was  but  too  apparent.  I  rushed  with  the  child  to 
the  window,  and  the  fully  dilated  pupils  (3)  at  once  confirmed 
my  suspicion.  Dr.  Fincham  was  now  sent  for,  but  long  before 
his  arrival,  and  in  about  five  minutes  after  the  discovery,  I 
administered  20  grains  of  Sulphate  of  zinc,  and  on  the  arrival 
of  the  doctor  some  mustard  and  water  was  also  given ;  but 
three  quarters  of  an  hour  elapsed  from  the  giving  the  Sulphate 
of  zinc  before  vomiting  took  place.  The  quantity  of  fluid  ex*- 
polled  did  not  exceed  that  given  with  the  zinc,  which  was 


7S  Poi'softutp  by  Belladonna, 

gected  by  one  effort;  and  no  subsequent  retching  could  be 
produced  by  mustard  and  water  (5). 

"  As  no  more  vomiting  could  be  excited,  and  it  seemed  pro- 
bable that  all  the  poison  which  was  not  absorbed  had  been 
ejected^  stimulants  were  had  recourse  to,  viz.,  brandy  and  water. 
Ether,  and  Ammonia,  one  or  other  of  which  was  given  every 
quarter  of  an  hour;  there  was,  however,  great  di£Bculty  in 
getting  the  child  to  swallow,  each  attempt  to  do  so  producing 
paroxysms  of  suffocation,  which  appeared  to  threaten  his  ex- 
istence (6) ;  a  great  deal  of  what  was  put  into  the  mouth  was 
thus  wasted.  During  the  whole  of  this  time  till  one  o'clock 
p.m.,  the  child  was  insensible  (4),  the  pupils  were  widely  dilated 
and  immovable,  the  eyes  open,  and  the  lids  not  winking  on 
passing  the  finger  in  front  of  them  (3) ;  there  was  occasional 
jactitation  (7),  the  skin  was  pungently  hot  and  dry,  and  covered 
with  a  rash  closely  resembling  that  of  scarlatina,  which  the 
child  was  frequently  scratching  (2) ;  the  pulse  was  170,  and 
somewhat  feeble  (8). 

**  From  1  to  2  p.m. — Brandy  and  milk  was  given  from  time 
to  time ;  an  enema  of  Turpentine  and  Castor  oil  in  gruel  was 
also  administered,  and  brought  away  a  small  quantity  of  f®ces. 
He  vomited  once  during  this  period,  and  was  evidently  becom- 
ing more  conscious;  he  made  efforts  to  speak,  and  said,  'Papa;' 
his  face  was  less  red,  and  the  expression  more  natural. 

"From  2  to  5  p.m. — The  symptoms  during  this  period  exactly 
resembled  those  of  delirium  tremens.  There  was  incessant 
rambling,  great  restlessness,  a  grasping  at  imaginary  objects, 
and  occasional  screaming  from  fright  (4).  The  character  of 
the  delirium  varied;  sometimes  the  child  saw  objects  which 
frightened  him,  and  the  utmost  terror  was  depicted  on  his  coun- 
tenance, and  he  clung  to  his  nurse's  neck,  or  threw  himself 
violently  in  different  directions,  as  if  to  escape  them  (3).  This 
kind  of  delirium  prevailed  chiefly  at  the  commencement  of  this 
peiiod ;  towards  the  latter  half,  the  delusions  were  of  a  more 
pleasurable  kind — his  talking  was  more  intelligible — he  men- 
tioned the  names  of  his  brothers,  his  nurse,  and  '  mamma,'  and 
grasped  at  his  toys,  as  his  whistle,  which  he  blew,  in  imagina- 


by  Dr.  Richard  Hughes.  73 

CioD,  and  he  drew  imaginary  sketches  with  his  pencil^  and  was 
very  basy  two  or  three  times  in  patting  into  his  mouth  and 
eating  imaginary  carrants,  &c. 

*'  A  mixtnre  of  egg  and  brandy,  with  milk  and  sugar,  was 
given  him  at  short  intervals,  and  just  before  five  he  was  sick  for 
the  third  time.  After  this  he  fell  into  a  quiet  sleep,  and  so 
remained  antil  6  p.m.  ;  his  pulse  having  fallen  to  144 ;  his  skin 
being  still  hot,  hut  not  so  red. 

**From  6  to  7  p.m. — Oreat  restlessness  and  returning  con- 
scionsness  characterized  this  period ;  he  recognized  me  by  my 
voice,  kissed  me,  and  jumped  out  of  bed,  and  said  he  wanted  to 
ride  on  my  shoulders — an  amusement  he  was  occasionally 
indulged  in.  The  skin  was  less  hot  and  red,  and  there  was 
very  little  delirium.  He  refused  to  take  any  kind  of  food  or 
drink  ((>). 

"  From  7  to  8  p.m.— There  was  less  restlessness,  and  when 
quiet  he  sucked  his  thumb  (a  habit  he  always  indulged  in  when 
well)  ;  be  sneezed  and  rubbed  his  nose  frequently ;  conscious- 
ness increasing,  but  intermittent.  He  recognised  my  watch, 
put  it  to  his  ear,  and  remarked,  '  It  s  ticking ; '  but  on  giving  it 
to  him  again  a  minute  afterwards,  it  was  not  recognised,  and  he 
put  it  in  his  mouth. 

"  From  8  to  10  p.m. — There  was  more  restlessness  than  for 
the  last  hour  or  two,  and  a  constant  motion  of  the  hands  to  the 
mouth,  as  if  eating  something.  Taking  advantoge  of  this 
action,  a  small  piece  of  bread  and  butter  was  put  into  his  hand, 
which  he  ate  greedily;  but  there  was  a  difficulty  in  getting  him 
to  drink.  He  talked  frequently  about  persons  and  things  which 
he  fancied  were  before  him  (3).  At  a  quarter  to  10  his  bowels 
were  moved ;  he  also  passed  water  for  the  first  time  (9).  A 
powder  containing  two  grains  of  Calomel  and  five  of  Jalap  was 
now  given  him. 

"From  10  to  12  p.m.,  he  lay  on  the  bed  tolerably  quiet;  he 
winks  a  little  when  the  candle  is  put  close  to  his  face,  but  he 
sees  nothing  else ;  he  has  just  said,  '  I  can't  see  mamma.'  At 
a  quarter  past  11  he  took,  with  some  difficulty  (6),  a  saline 
mixture,  ordered  by  Dr.  Fincham,  after  which  his  bowels  acted 
to  a  greater  extent  than  before,  and  he  also  passed  water  again. 


74  PoUomng  hy  Belladofina, 

When  his  mother  lay  down  on  the  bed  beside  him,  he  raised 
himself,  voluntarily,  and  kissed  her  twice.  At  midnight  he 
took  a  little  milk  and  brandy,  and  fell  into  a  quiet  sleep. 

"  July  18th,  from  1 2  to  2  a.m. — He  slept  quietly  till  a  quarter 
past  one,  when  he  awoke,  and  before  he  could  be  raised  in  the 
bed,  had  a  violent  and  somewhat  copious  motion  of  a  watery 
character.  After  this  he  took  a  small  quantity  of  milk,  and  a 
teaspoonful  of  brandy,  with  some  resistance  (6) ;  put  his  thumb 
in  his  mouth  and  again  went  sleep. 

"  From  2  to  4  a.m. — He  slept  very  quietly  till  4,  when  his 
bowels  were  again  moved  slightly,  and  he  made  water  also. 
Though  his  pupils  are  as  much  dilated  as  ever,  he  can  now  dis* 
tinguish  objects,  for  he  told  his  mother  that  he  could  see  her 
(d);  and  he  also  took  a  cup  of  milk  from  her  hand,  and  a  little 
bread  and  butter. 

"  From  4  to  8  a.m. — He  slept  peacefully  the  whole  of  this 
time,  lying  on  his  back,  with  his  eyes  and  lips  a  little  apart, 
and  awoke  well.  He  remarked  that  he  could  '  see  gan- mamma' 
over  the  chimney  (a  photograph  of  his  grandmother),  and  he 
ate,  with  evident  relish,  a  basinful  of  bread  and  milk.  As  the 
morning  advanced  he  said,  more  than  once,  that  he  wanted  to 
have  his  cloches  on,  and  before  he  was  dressed  he  was  running 
about  the  room  in  his  night-gown,  playing  with  his  toys.  His 
difficulty  in  seeing  small  objects  which  were  near  him,  was  now 
the  most  prominent  feature  remaining  of  his  illness ;  and  his 
attempts  to  make  out  the  letters  of  a  newspaper  which  happened 
to  be  in  the  room,  putting  the  paper  first  in  one  position  and 
then  in  another,  and  eventually  throwing  it  from  him  in  disgust, 
were  highly  amusing.  The  dilatation  of  the  pupils  gave  his 
face  a  singular  expression,  and  they  did  not  recover  their 
normal  size  and  movements  for  nearly  a  week  (3)." 

Upon  this  interesting  and  well-reported  case  I  will  make  the 
following  remarks.  The  figures  within  brackets  refer  to  those 
inserted  in  the  narrative : — 

(1).  The  loss  of  standing  and  walking  power  observed  in  this 
and  other  cases  of  Belladonna  poisoning,  does  not  appear  to  be 
a  true  paralysis;  it  rather  seems  to  depend  upon  a  derangement 
of  the  co-ordinating  function,  which  most  physiologists  assign 


hy  Dr.  Richard  Hughes.  75 

to  the  cerebellum.  This  will  be  seen  in  subsequent  cases.  The 
intoxication  of  Alcohol  presents  similar  phenomena. 

(:2).  Heat,  dryness,  end  redness  of  the  skin  alone  might  be 
doe  to  a  simple  paralysis  of  its  yaso-motor  nerves.  But  the 
scarlatinoid  eruption  which  appeared  shews  that  these  pheno- 
mena must  rather  be  ascribed  to  a  specific  irritation  of  this 
tissue.  The  value  of  Belladonna  in  erythema,  erysipelas, 
scarlatina,  and  other  inflammations  of  the  skin,  is  well  known. 

(3).  Belladonna  exerts  a  most  striking  influence  upon  the 
optical  apparatus,  from  its  intra-cranial  centre  to  the  conjunc- 
tiva externally.  Marked  dilatation  of  the  pupil  is  an  invariable 
feature  of  its  poisonous  influence,  as  of  that  of  Hyoscyamus  and 
Stramonium  (hence  called  "Mydriatics").  I  believe  this  to 
depend  upon  an  excitation  of  the  dilator  fibres  of  the  iris^ 
through  the  medium  of  the  branch  of  the  sympathetic  which 
supplies  them.  That  Belladonna  is  an  excitant  of  the  sym- 
pathethic  has  been  proved  by  Mr.  Wharton  Jones,  who  found 
that  under  its  local  influence  the  arteries  become  contracted, 
while  under  that  of  Opium  they  are  dilated.  And  the  following 
statement  of  M.  Vulpian  seems  to  me  conclusive  on  the  point. 
He  is  speaking  of  poisoning  by  Woorara.  "  The  sympathetic 
nerve,"  he  says,  ''  sometimes  continues  responsive  to  galvanism 
more  than  two  hours  after  artificial  respiration  has  been  prac- 
tised ;  but  after  it  is  paralysed.  Atropine  no  longer  determines 
the  least  dilatation  of  the  pupil.  As  long  as  galvanization  of 
the  cervical  plexus  occasions  dilatation,  however  slight,  of  the 
pupil,  so  long  Belladonna  also  will  determine  it." — {Mem.  de  la 
Soc,  de  Biologie.  Transl.  in  Brit,  Jour,  of  Horn,,  vol.  xviii. 
p.  348).  Next,  we  have  in  this  case  impairment  of  vision 
amounting  to  entire  amaurosis.  That  this  arises  Arom  a  direct 
aneesthetic  influence  upon  the  retina  appears  from  the  similar 
affection  which  obtains  in  the  ophthalmic  branch  of  the  fifth. 
This  is  shewn  by  the  absence  of  winking  when  the  finger  was 
passed  in  front  of  the  eyes.  For  as  reflex  winking  may  be  ex- 
cited through  the  medium  of  both  the  fifth  and  the  optic  nerves, 
it  follows  that  when  it  is  entirely  absent  both  these  must  be 
paralysed.  The  amaurosis  is  not,  as  some  have  supposed^ 
dependent  upon  the  dilatation  of  the  pupil,  for  the  two  pheno- 


76  Poisoning  by  Belladonna, 

m 

mena  are  not  always  co- existent.  In  the  present  case,  the 
blindness  had  gone  while  the  pupil  was  still  dilated.  Upon  the 
persistence  of  the  latter  symptom,  however,  would  seem  to 
depend  the  presbyopia  noticed  at  the  termination  of  the  case. 
Dr.  Wright  (Medical  Times  and  Gazette,  Sept.  17,  1859) 
considers  that  presbyopia  is  always  due  to  dilatation,  and 
myopia  to  contraction  of  the  pupil.  Lastly,  we  have  the  visual 
hallucinations,  so  interesting  when,  as  here,  combined  with 
total  blindness  to  all  actual  objects.  These  would  probably 
depend  on  an  affection  of  the  intra- cranial  centres  of  vision, 
the  tubercula  quadrigemina,  which  thus  share  in  the  excitement 
of  function  manifested  by  the  whole  encephalic  mass. 

(4).  This  excitement  and  perversion  of  function  is  nowhere 
more  strongly  manifested  than  in  the  cerebral  hemispheres 
themselves.  Mr.  Holthouse  himself  compares  these  symptoms 
to  mania  and  delirium  tremens.  Of  the  latter  disease  it  is  the 
active  form  which  is  simulated  by  Belladonna. — that  which  Mr. 
Solly  distinguishes  as  "  delirium  ebriosorum,''  or  "  mania  a 
potu,"  which  is  the  direct  consequence  of  debauches,  rather 
than  the  result  of  a  sudden  cutting  off  of  the  stimulant;  and 
which  requires  (in  allopathic  hands)  leeches  and  tartar-emetic^ 
rather  than  opium  and  brandy.  The  hallucinations  of  vision, 
and  the  disorder  of  co-ordinating  function,  complete  the  picture. 

(5).  The  local  action  of  Belladonna  on  the  motor  and 
sensory  nerves  is  both  paralyzing  and  anaesthetic.  This  is  well 
seen  in  the  difficult  emesis  which  results  from  its  introduction 
into  the  stomach. 

(6).  As  the  throat  was  not  examined  in  this  case,  we  cannot 
ascertain  whether  the  difficulty  of  swallowing,  especially  of 
liquids,  depended  upon  the  specific  irritation  which  Belladonna 
exerts  upon  this  part,  or  upon  its  influence  on  the  medulla 
oblongata.  The  paroxysms  of  suffocation  which  accompanied 
the  early  attempt  at  swallowing  point  rather  to  the  latter  view, 
and,  combined  with  delirium,  point  strongly  to  its  use  in  hydro- 
phobia. 

(7).  The  ''jactitation"  here  mentioned  gives  only  a  hint  of 
the  chorea-producing  power  of  Belladonna  which  will  subse« 
quently  appear. 


ly  Dr.  Richard  Hughes.  77 

(8)  A  quick  but  feeble  poise  is  by  far  tbe  most  common 
aigii  of  the  effect  of  Belladonna  upon  the  circulation. 

(9).  No  urine  was  passed  from  9  a.m.  to  9-45  p.m.,  a  period 
of  nearly  13  hours.  As  there  is  no  mention  of  its  being  in 
excessive  quantity,  we  should  be  disposed  to  see  here  supression 
ratber  than  retention.  There  is  no  evidence  as  to  the  cause  of 
the  suppression,  whether  paralysis,  congestion,  or  vaso-motor 
irritation. 

Case  II. 
The  following  case  is  reported  by  Dr.  H.  M.  Gray,  of  New 
York,  and  will  be  found  in  the  North  American  Journal  of 
Homoeopathy^  vol.  i.  p.  509. 

"  The  subject  of  the  poisoning  was  a  child  between  two  and 
three  years  of  age,  and  the  amount  swallowed  from  eight  to 
twelve  grains  of  the  extract.  The  following  symptoms  pre- 
sented themselves  upon  seeing  the  case  some  thirty  or  fifty 
minutes  after  the  drug  had  been  taken  into  the  stomach. 

''  The  expression  of  the  countenance  was  that  of  a  pereon  in 
terror,  pupils  widely  dilated  and  immovable,  the  tunica  con- 
junctiva highly  injected,  and  the  whole  eye  prominent  and 
pretematurally  brilliant  (1).  The  face,  upper  extremities,  and 
trunk  of  the  body  exhibited  a  diffuse  scarlet  efflorescence, 
studded  with  innumerable  papillae,  very  closely  resembling  the 
rash  of  scarlatina ;  the  eruption  terminated  abruptly  at  the 
wrists  and  flexure  of  the  thighs,  the  rest  of  the  body  retaining 
the  natural  colour.  Skin  hot  and  dry  (2),  and  pulse  much  in- 
creased in  force  and  frequency  (3). 

"  The  patient's  manner  was  apoplectic  (4),  respiration  anxiousi 
and  attended  with  the  brazen,  stridulous  sound  of  croup  (5). 
A  constant  but  unsuccessful  attempt  at  deglutition  was  ob- 
servable, and  at  every  renewal  of  the  attempt  the  muscles  of  the 
thorax  and  pharynx  would  be  thrown  into  violent  spasmodic 
action  (6).  Severe  engorgement  of  the  venous  trunks  was  also 
present.  This  state  of  partial  coma  was  alternated  by  paroxysms 
of  uncontrollable  tendency  to  motion  and  rapid  automatic 
movement,  attended  with  convulsive  laughter  (7).  No  well- 
marked  convulsions  made  their  appearance,  although^  during 
the  brief  periods  of  sleep  into  which  the  patient  would  fall> 


78  Poitoning  by  Belladonna, 

a  slight  subsultaa  of  the  muscles  of  the  face  and  extremities 
was  noticed  (7). 

**  The  treatment  was  that  ordinarily  pursued  in  similar  cases. 
The  lower  extremities  were  immersed  in  a  mustard  bath,  while 
water  and  pounded  ice  were  applied  to  the  head.     An  active 
emetic  was  immediately  administered,  whose  operation  was  in- 
duced by  the  application  of  local  stimulants  to  the  epigastric 
region,  and  the  free  use  of  warm  diluents.    The  matter  vomited 
contained  several  portions  of  the  drug  in  a  partially  dissolved 
state.     As  soon  as  free  emesis  had  been  procured,  a  strong' 
decoction  of  coffee  was  ordered,  to  combat  the  soporific  effect 
of  the  poison,  alternated  with  diluted  Aqua  ammoniae,  for  the 
purpose  of  decomposing  any  of  the  Belladonna  that  might  still 
remain  in  the  stomach.     The  diuretic  effect  of  the  drug  now 
began  to  be  experienced,  the  patient  evacuating  an  enormous 
quantity  of  limpid  urine  (8).     The  alarming  symptoms  passed 
off  in  about  three  hours  from  the  commencement  of  the  treat- 
ment, and  the  child  soon  recovered,  with  the  exception  of  a 
moderate   diarrhoea,   and  a  slight  enlargement  of  the  pupil. 
The  eruption  had  entirely  faded." 

In  this  case  we  have  again  (2)  the  hot  and  dry  skin,  with 
scarlatinoid  eruption,  and  the  irritation  of  the  cerebellum  (7) 
and  medulla  oblongata  (6).  But  there  are  certain  additional 
phenomena  which  we  must  consider  in  their  order. 

(1).  Tn  the  eye,  besides  the  dilated  pupil  and  prominent  eye- 
ball, we  have  "  the  tunica  conjunctiva  highly  injected."  This 
must  depend  upon  a  specific  irritation  of  this  membrane, 
for  the  blood-vessels  of  the  eye  in  general  must  be  in  a  state  of 
contraction  through  the  excitation  of  the  sympathetic.  Accord- 
ingly, in  a  later  case,  we  shall  see  the  conjunctival  irritation 
running  on  to  true  inflammation  (Case  4). 

(8).  The  pulse  is  here  increased  in  force  as  well  as  in  fre- 
quency. This  variability  shows  the  state  of  the  pulse  to  be  of 
little  value  as  an  indication  for  the  choice  of  BeUadonna. 

(4).  In  the  cerebrum,  the  symptoms  of  hyperaemia  predomi- 
nate over  those  of  functional  excitement.  The  condition  of 
the  patient  is  compared  to  apoplexy,  instead  of  (as  in  Case  I) 
mania  and  delirium  tremens.    Belladonna  is  thus  an  irritant, 


by  Dr,  Richard  Hughes.  79 

not  merely  an  excitant,  to  the  cerebrum,  and  should  be  as 
useful  in  its  hypersemic  affections  as  in  its  functional  derauge- 
ments. 

(5).  The  difficult  and  stridulous  respiration  would  seem  to 
depend  on  a  narrowing  of  the  glottis  from  irritation  of  the 
medulla  oblongata.  The  parallel  symptoms  observed  in  the 
pharyns  (6)  confirm  this  supposition.  Belladonna  would  hence 
be  indicated  as  a  remedy  in  laryngismus  stridulus. 

(8).  In  this  case  Belladonna  acts  as  a  diuretic,  while  in  Case  1 
the  urine  was  almost  suppressed.  Belladonna  is  thus  neither  an 
ezcitor  nor  a  depressor  simply  of  the  functions  of  the  kidney, 
but  an  irritant  of  the  urinary  mucous  membrane.  A  small 
dose  will,  as  in  the  present  case,  increase  the  secretion ;  while  a 
larger  one  will  diminish  it,  or  even  set  up  (as  Gbristison  notes) 
hiematuna  and  strangury.    The  same  is  the  case  with  Arsenic. 

Case  UI. 

This  case  is  derived  from  the  same  source  as  the  last.  Dr. 
Gray  writes: — 

"  I  will  relate  another  case,  concerning  which  I  can  speak 
somewhat  experimentally,  it  having  occurred  in  my  own  person. 
It  is  of  interest  only  inasmuch  as  I  was  able  to  note  accurately 
my  own  sensations  during  the  operation  of  the  narcotic.  This 
is  an  interesting  point  in  the  investigation  of  cases  of  poisoning, 
and  one  about  which  little  can  be  known,  as  patients  are  gene- 
rally too  much  occupied  with  their  fears  or  actual  sufferings,  to 
be  able  to  impart  much  knowledge  of  their  sensations.  Although 
pretty  thoroughly  narcotized,  I  watched  with  some  curiosity  and 
care  the  phenomena  induced  by  Belladonna.  I  had  taken  an 
unwarrantably  large  dose  of  the  article  in  question,  to  quiet  the 
pain  of  a  severe  neuralgic  tooth-ache ;  not  finding  any  relief,  I 
repeated  it  in  the  course  of  ten  or  fifteen  minutes,  swallowing 
in  all  some  eight  or  ten  grains.  About  an  hour  after  the  last 
dose  had  been  taken,  the  medicine  began  to  induce  its  specific 
symptoms  in  the  following  order.  First,  vertigo,  increasing  to 
such  an  extent  as  to  render  it  impossible  to  walk  without  stag* 
goring.  The  dizziness,  which  was  at  first  transient,  soon  became 
continued  and  very  severe.    Now  came  on  the  affection  of  the 


80  Poisoning  by  Belladonna, 

eyesight,  every  object  growing  dim,  as  thoagh  a  cloQd   were 
between  the  eye  and  it.     Sometimes  objects  appeared  doable, 
and  with  an  undulating  motion  passed  before  the  eye.     I  ob- 
served that  by  a  strong  effort  of  the  will,  a  concentration  of  the 
nervous  power,  this  paralysis  of  the  retina  might  for  a  moment 
be  combated,  but  only  to  return  with  greater  severity  when  the 
mental  effort  had  been  succeeded  by  its  corresponding  relaxation. 
The  appearances  of  the  eye  were  much  the  same  as  those  men* 
tioned  in  the  former  case — viz  ,  pupil  immovably  dilated  ;  eye 
prominent,  dry,  and  exceedingly  brilliant.     The  conjnnctivai 
vessels  were  fully  injected.     There  was  total  absence  of  lach- 
rymation,  and  motion  was  attended  with  a  sense  of  dryness 
and  stiffness.     The  face  was  red  and  turgid,  and  the  tempera- 
ture and  colour  of  the  surface  considerably  augmented.     Pulse 
full,  and  about  120  to  ISO.  The  feeling  in  the  head  was  that  of 
violent  congestion,  a  full,  tense,  throbbing  state  of  the  cerebral 
vessels,  identically  the  same  sensation  as  would  be  produced  by 
a  ligature  thrown  round  the  neck,  and  impeding  the  return  of 
the  venous  circulation.     The  peculiar  state  of  the  throat  next 
excited  attention.     The  tongue,  mouth,  and  fauces  were  devoid 
of  moisture,  as  if  they  had  been  composed  of  burnt  shoe*Ieather. 
The  secretions  of  the  glands  of  the  mouth,  and  the  saliva,  were 
entirely   suspended.     A  draught   of  water,   instead   of  giving 
relief,  seemed  only  to  increase  the  unctuous,  clammy  state  of 
the  mucous  membrane.     About  the  bag  of  the  pharynx  this 
sensation  was  most  distressing.     It  induced  a  constant  attempt 
at  deglutition,  and  finally  excited  suffocation,  spasms  of  the 
fauces  and  glottis,  renewed  at  every  attempt  to  swallow.    A 
little  saliva,  white,  and  round  like  a  ball  of  cotton,  would  now 
and  then  be  evacuated. 

'^  The  slight  delirium  that  followed  the  action  of  the  narcotic 
was  of  a  strange,  yet  not  unpleasant  kind.  I  wished  to  be  in 
constant  motion,  and  it  certainly  afforded  me  an  infinite  deal  of 
satisfaction  to  be  able  to  walk  up  and  down.  The  intellectual 
operations  at  times  were  very  vivid.  Thoughts  came  and  went, 
and  ludicrous  and  fantastic  spectacles  were  always  uppermost  in 
my  mind.  I  was  conscious  that  my  language  and  gesticulations 
were  extravagant,  yet  I  had  neither  power  nor  will  to  do  other- 


hy  Dr.  Richard  Hughes,  ^l 

wise  than  I  did ;  and^  notwithstandiug  my  bodily  malaise,  my 
mind  was  in  a  state  of  delightfal  exhilaration. 

"The  treatment  was  very  simple;  cold  doache  to  the  head, 
and  an  emetic  soon  destroyed  the  dominion  of  the  poisoD. 

''In  this  case,  as  in  the  other,  I  found  some  difficulty  in  pro- 
voking the  operation  of  an  emetic,  owing  to  the  insensible  con- 
dition of  the  stomach.  After  vomiting,  the  disposition  to  sleep 
became  very  nrgent.  Strong  coffee,  however,  counteracted  this 
tendency. 

"  One  other  fact  relative  to  the  effects  of  Belladonna  is  worthy 
of  note — viz.,  its  tremendous  diuretic  power.  I  have  observed 
that  it  does  not  seem  to  reach  the  kidneys  until  it  has  been 
some  time  in  the  stomach,  and  has  exerted  its  specific  influence 
npon  the  brain.  But  its  power  over  the  secretion  of  urine  seems 
io  be  very  great.  I  am  confident  I  passed  in  the  course  of  an 
hour  three  pints  of  urine,  accompanied  with  a  slight  strangury 
at  the  neck  of  the  bladder." 

Case  IV. 

The  following  case  is  reported  by  Dr.  Burton,  in  the  Medical 
Gazette  of  June  15,  1848:— 

''A  porter  of  the  Ophthalmic  Hospital  in  Moorfields  took 
half  an  ounce  of  liquor  Belladonna  in  mistake  for  the  fluid 
extract  of  Sarsaparilla.  He  did  not  immediately  discover  his 
error,  but  in  five  minutes  or  thereabouts  after  it  had  been  com- 
mitted, he  was  rendered  sensible  of  his  mistake  by  the  unex- 
pected occurrence  of  a  sensation  of  heat  and  dryness  in  the 
throat,  succeeded  very  soon  by  vertigo  and  slight  aching  pains 
in  the  limbs,  but  no  headache.  Upon  the  appearance  of  these 
symptoms,  he  immediately  ran  across  the  street,  a  distance  of 
about  100  yards,  to  the  residence  of  his  usual  medical  adviser, 
Mr.  Edwin,  for  assistance,  and  was  by  that  gentleman  directed 
to  return  to  the  Hospital  and  drink  warm  water  until  the 
stomach-pump  could  be  got  ready.  The  man  did  as  he  was 
told,  and  vomited  on  his  return,  before  the  pump  was  applied  • 
but  whilst  in  the  act  of  drinking  he  became  powerless,  and  in 
less  than  a  quarter  of  an  hour  after  the  accident,  delirious  and 
insensible.     He  struggled  violently  in  his  unconscious  state, 

VOL.   XX,   NO.   LXXIX. — JANUARY,    1862.  F 


83  Poi9aning  by  Belladonna, 

and  the  combined  strength  of  several  men  was  required  to  hold 
him  steady  daring  the  operation  of  pumping  oat  the  contents 
of  the  stomach.  A  large  proportion  of  the  poison  was  ejected 
by  vomiting,  and  an  additional  quantity  drawn  oat  by  the 
stomach-pump  ;  bat,  notwithstanding  the  short  interval  which 
had  elapsed  between  the  acts  of  swallowing  and  removing  the 
poison,  for  the  most  part,  from  the  stomach,  a  sufficient  quan- 
tity had  been  absorbed  into  the  circulating  system  to  affect  the 
brain,  and  cause  delirium,  insensibility,  and  convulsions. 

''The  stage  of  delirious  excitement  was  brief;  and  whilst  in 
a  comatose  state,  the  patient  was  sent,  by  the  directions  o(  Mr. 
Macmurdo,  to  St.  Thomas'  Hospital,  where  he  was  placed  under 
my  superintendence,  about  ten  o'clock,  and  immediately  visited 
by  the  resident  medical  officer,  Mr.  Whitfield.  When  the  patient 
was  first  seen  by  me,  at  half- past  ten  o'clock,  he  was  totally 
unconscious  of  surroanding  objects;  he  was  lying  supine,  and 
all  his  limbs  were  equally  powerless.  There  was  no  hemiplegia; 
his  face  was  full  and  flushed;  the  head  and  general  surface 
warm;  the  pupils  widely  dilated;  scarce  any  iris  could  be  dis- 
tinguished, and  the  retina  was  quite  insensible  to  the  stimulus 
of  strong  daylight.     The  palpebrsB  of  the  left  eye  were  pufiy, 
and  redder  than  those  parts  on  the  right  side ;  and  the  upper 
left  lid  was  prolapsed,  as  in  ptosis  (I).     The  breathing  was 
stertorous,  and  the  respiratory  sounds,  hastily  examined  over 
the  anterior  parts  of  the  chest,  were  modified  by  rales.     The 
action  of  the  heart  was  feeble,  and  the  pulsations  of  the  radial 
artery  were  116  in  the  minute,  regular,  and  weak.    The  tongue 
could  not  be  seen.    The  abdomen  was  rather  contracted,  and 
no  distension  indicating  an  accumulation  of  urine  existed.   The 
sensibility  of  the  pharynx  was  so  much  impaired,  and  degluti- 
tion so  imperfectly  performed,  that,  on  introducing  a  warm 
infusion  of  coffee  into  the  patient's  mouth,  the  liquid  collected 
about  the  larynx,  and  his  features  became  alarmingly  turgid  in 
consequence  of  impeded  respiration. 

"Under  the  influence  of  treatment,  an  amendment,  indicated 
by  a  diminution  of  heat  and  fulness  of  face,  and  by  returning 
consciousness,  took  place  in  the  course  of  a  few  hours  after  the 
patient's  admission ;  and  about  three  o'clock  in  the  afternoon 


by  Dr.  Richard  Hughei.  83 

he  made  so  attempt  to  articulate  the  monosyllables  'yes'  and 
'no/  when  roused  by  questions*  The  amendment,  however,  was 
only  temporary;  for,  in  the  evening,  vioTent  delirium  succeeded 
the  stupor,  and  recurred  a  second  time.  The  patient  continued 
very  unmanageable  during  the  night,  and  could  only  be  restrained 
irith  safety  to  himself  and  the  neighbouring  patients  by  means 
of  a  strait  waistcoat  This  state  of  excitement  was  pro- 
tracted nntil  about  three  o'clock  next  morning,  when  he  again 
became  calm,  and  a  decided  abatement  of  all  the  urgent  symp- 
toms was  noticed  at  eight  o'clock. 

"At  one  o'clock  in  the  afternoon,  he  had  regained  the  power 
of  speech  and  deglutition ;  and  although  a  peculiar,  wild  ex- 
pression of  countenance  remained,  with  confusion  of  ideas,  he 
was  sensible  enough  to  thank  his  medical  attendants  for  the  aid 
they  had  aflTorded  him.  The  tongue  could  now  be  protruded ; 
the  pulse  had  subsided  from  11 6  to  68,  and  did  not  subse* 
qnently  undergo  any  material  variation.  The  sight  of  the  right 
eye  had  become  rather  clearer,  but  that  of  the  left  eye  more  im- 
paired ;  the  upper  lid  more  tumefied  and  prolapsed ;  the  con<* 
junctiva  more  vascular,  and  raised  above  the  margin  of  the 
transparent  cornea,  which,  in  a  few  days,  became  opaque ;  and 
a  small  quantity  of  a  puriform  fluid  had  accumulated  in  the 
anterior  chamber  of  the  eye.  The  sight  of  the  left  eye  was 
perfectly  natural  previous  to  the  accident ;  and  as  no  mechanical 
injury  had  been  since  done  to  it,  its  inflammatory  state  may  be 
fairly  attributed  to  the  virulence  of  the  Belladonna  (1). 

"  All  anxiety  for  the  immediate  safety  of  the  patient  ceased 
within  thirty  hours  after  his  admission ;  but  the  abnormal  con- 
dition of  the  nervous  system  prevailed  several  days :  and  not- 
withstanding he  conversed  rationally  on  the  second  day  of  the 
accident,  he  had  no  recollection  of  the  events  which  occurred  in 
St.  Thomas's  Hospital  until  near  sixty  hours  from  the  com- 
mencement of  his  first  delirium,  or  the  third  dav  of  the  accident. 

"  Upon  recovering  perfect  consciousness,  a  remarkable 
numbness,  extending  over  all  parts  of  the  trunk  and  ex- 
tremities, attracted  attention,  and  persisted  for  several  days. 
No  pain  could  be  excited  whilst  this  condition  continued,  by 
forcibly  pinching  the  skin  of  the  forehead  or  of  other  parts ; 

F  2 


84  Poisoning  hy  Belladonna, 

and  although  an  unosual  sensation  was  perceived  by  the  patient 
at  the  moment,  he  could  not,  with  his  eyes  averted  from  tbd 
operation,  point  out  the  precise  spot  subjected  to  compression  ; 
anaesthesia  with  consciousness  co-existed,  resembling  the  state 
often  recognised  during  recovery  from  the  effects  of  chloro- 
form (2). 

''  The  specific  sensibility  of  the  right  retina  was  not  entirely 
restored  until  after  common  sensation  had  returned  to  the 
general  surface ;  and  the  sight  of  the  inflamed  eye  continued 
dim,  from  the  events  of  the  secondary  affection,  until  a  later 
period ;  but  both  pupils  were  equally  contracted  and  small 
when  the  patient  quitted  the  hospital. 

"The  mental  delusions  during  the  delirium  were  for  the 
most  part,  though  not  altogether,  of  an  agreeable  kind ;  and 
the  prevalent  fancy  in  the  patient's  mind  was,  that  he  had  be* 
come  suddenly  rich,  and  possessed  of  a  splendid  mansion." 

(1).  The  tissue-irritant  power  of  BeUadonna  upon  the  con- 
junctiva is  here  plainly  marked,  and  points  to  its  use  in 
catarrhal  and  scroAilous  ophthalmia. 

(2).  It  is  rare  that  the  anssthetic  effects  of  the  drug  are 
seen  save  in  the  eye  and  in  those  parts  as  the  pharynx  and 
stomach-— which  it  reaches  locally.  This  case  forms  an  ex- 
ception. 

Case  V. 

This  and  the  three  following  cases  are  of  boys  who  pilfered 
and  ate  some  extract  of  Belladonna  from  Covent  Garden  Market. 
They  are  recorded  by  the  house-surgeons  of  the  hospitals  to 
which  they  were  taken  in  the  Lancet  of  December  drd,  1859. 

"  George  J.,  aged  ten  years,  was  admitted  on  the  evening  of 
the  2drd  of  November,  with  symptoms  of  poisoning  from 
swallowing  a  mixture  of  the  extract  of  Belladonna  with  water. 
He  was  quite  delirious,  the  delirium  being  of  a  mild  vagarious 
or  fantastic  character.  He  could  neither  hear  (1)  nor  speak 
plainly,  and  laboured  under  hallucinations,  but  was  otherwise 
unconscious.  The  pupils  were  widely  dilated,  and  the  eyes  had 
a  staring  look.  At  first  he  complained  of  pain  in  his  throat 
and  of  his  imperfect  sight,  objects  appearing  white  to  him.  His 


by  Dr.  Richard  Hughes.  85 

pulae  was  yery  feeble,  and  almost  countless.  There  was  no  dis- 
colouration or  redness  of  the  skin.  The  urine  was  scanty  for 
the  first  24  hours."    A  good  recovery  took  place. 

(1).  The  deafaess  here  will  probably  depend  on  the  same 
cause  as  the  amaurosis.    It  is  a  comparatively  rare  symptom. 

Case  VI. 

"  Charles  G.,  aged  ten  years,  was  admitted  about  three  hours 
before  the  previous  patient,  having  taken  about  a  teaspoonful 
of  the  undiluted  extract  of  Belladonna  shortly  before.  The 
symptoms  were  similar  to  those  in  Case  Y,  with  the  addition  of 
a  flushed  face  and  more  active  delirium ;  the  grasping  at  ima- 
ginary objects,  and  picking  of  the  clothes  being  also  much 
more  marked.  There  was  no  cutaneous  eruption.  He  passed 
no  urine,  and  the  bladder  was  evacuated  by  the  catheter,  the 
quantity  being  scanty  (I)  and  strongly  ammoniacal:  The  pulse 
was  very  feeble  and  quick.  Two  leeches  were  applied  to  each 
temple,  a  blister  to  the  nape  of  the  neck,  sinapisms  to  the  feet, 
cold  to  the  head,  and  a  purgative  and  diuretic  mixture.  On 
the  next  day  he  was  very  pale ;  both  pupils  dilated,  but  the 
right  very  much  more  so  than  the  left ;  vision  is  not  present  in 
the  left  eye,  the  lid  of  which  is  drooping,  inflamed,  and  very 
painful  when  touched  (2)."    He  recovered  slowly. 

(1).  In  this,  as  in  the  former  case,  the  absence  of  micturition 
is  seen  to  depend  upon  suppression  rather  than  retention  of 
urine.    See  remarks  on  Case  1,  note  (9),  and  Case  II,  note  (8). 

(2).  The  eye  symptoms  here  are  interesting.  We  have  con- 
junctival irritation  (as  in  Case  lY),  and  there  is  a  marked 
idifference  in  the  amount  of  dilatation  present  in  the  two  pupils. 
The  latter  fact  shows  that  the  sympathetic  excitation  of  Bella- 
donna, which  causes  dilatation  of  the  pupil,  is  a  localized  efliect, 
and  not  symptomatic  of  the  cerebral  disturbance.  The  state  of 
the  pupil,  therefore,  in  cerebral  afiections,  is  no  necessary  element 
in  the  indications  for  or  against  the  use  of  this  drug. 

Case  YII. 

"  A  boy  aged  nine,  and  another  ten  years  of  age,  were  treated 
as  out-patients.    Both  were  more  or  less  unconscious,   with 


86  Poisoning  bi/  Belladonna, 

slight  delirium,  dilated  pupils,  pain  in  the  stomach,  and  absence 
of  any  skin  eruption  or  dysphagia.  Both  recovered  speedily. 
In  one  of  these  hoys  one  pupil  was  much  more  dilated  than  the 
other,  as  in  Case  VI.*' 

Case  VIII. 

"  J.  D.,  a  child  seven  years  of  age,  was  admitted  on  Novem- 
ber 23rd,  at  half-past  eleven  p.m.,  with  symptoms  of  poisoning 
by  Belladonna.     On  admission  he  was  wildly  delirious,  bat  qoite 
fantastic,  almost  hysterical,  laughing  and  crying,  and  not  at  all 
conscious.     His  pupils  were  widely  dilated ;  no  cutaneous  erup- 
tion or  discolouration,  nor  dysphagia ;  no  tendency  to  stupor ; 
no  difficulty  in  micturition  then,  or  during  the  night.     He  eri- 
dently  saw  visions,  as  in  delirium  tremens,  for  he  was  constantly 
grasping  and  picking  at  imaginary  objects.     He  was  quite  blind, 
and  stared  yacaDtly."    He  rapidly  recovered  under  the  use  of 
Liquor  potass®,  which  Dr.  Garrod  has  shown  to  be  destructive 
of  the  activity  of  Belladonna,  Hyoscyamus,  and  Stamonium. 
{British  MedicalJournal,  Dec.  12,  1857,  Aug.  14,  1858.) 

Case  IX. 

The  following  case  is  extracted  from  Orfila,  by  Dr.  Hempel 
{Mat.  Med,  p.  326.) 

"  A  child  of  four  years  of  age,  of  feeble  constitution,  but 
otherwise  well,  ate  at  eleven  oclock  a  quantity  of  the  berries  of 
Belladonna.  The  following  symptoms  soon  set  in :  want  of 
appetite,  nausea,  vomiting,  symptoms  of  intoxication  and  slight 
delirium,  inextinguishable  thirst ;  afterwards,  tumefaction  and 
redness  of  the  face  and  lips  (1),  raising  of  the  eyelids,  dilata- 
tion of  the  pupils,  insensibility  of  the  eyes  to  light,  convulsive 
closing  of  the  jaws  and  contraction  of  the  muscles  of  the  face 
and  extremities,  very  feeble  pulse  and  irregular  respiration* 
Next  day :  increase  of  convulsive  movements  (2),  with  redness  of 
the  face  and  profuse  perspiration;  the  pupils  remained  dilated; 
there  was  great  rigidity  down  the  spine ;  tumefaction  of  the 
abdomen,  which  was  very  tender  to  the  touch  (1) ;  constipation 
and  weak  pulse.  On  the  third  day  these  symptoms  continued, 
but  in  a  less  degree ;  the  child  complained  of  great  pain  in  his 


ReviewB.  87 

tiBeth.  Next  day  all  the  symptoms  had  disappeared.  An  emetio 
was  giyen,  followed  by  vinegar  and  honey." 

(1 ).  Erysipelas  is  here  plainly  marked  in  the  facial  symptoms ; 
the  yalne  of  Belladonna  in  this  disease  is  well  known.  I  have 
eonpled  the  abdominal  symptoms  with  this,  because  they  look 
exceedingly  like  that  erysipelatous  peritonitis  which  forms  the 
local  basis  of  nine-tenths  of  the  cases  of  so-called  *'  puerperal 
fever."    Belladonna  is  a  tried  remedy  in  such  oases. 

(2).  The  convulsive  symptoms  in  this  case  are  clearly  de- 
scribed. They  are  probably,  as  in  the  other  instances^  choreic 
rather  than  tetanic. 

{To  he  continued.) 


REVIEWS. 


1.  nomcRopathy  and  its  Opponents;  being  a  Reply  to  Sir 
Benjamin  Brodie,  Bart,,  and  others.  By  Wm.  V.  Drdry, 
M.D.,  M.R.I.A.,  &c.     London:  Leath,  1861. 

2.  A  Practical  Reply  to  Sir  B.  Brodie  s  Letter  on  Homoeo- 
pathy, with  cases,  showing  the  efficacy  of  Homoeopathic 

Treatment  in  the  Diseases  of  Animals.    By  James  Moore, 
V.S.,  M.B.C.V.S.,  &c.     London:  Epps,  1861. 

3.  Has  Sir  Benjamin  Brodie  Spoken  the  Truth  about  Homoeo- 
pathy and  its  Practitioners}  By  J.  Harmar  Smith, 
M.R.C.S..  L.S.A.,  &c.     Loudon:  Tresidder,  1861. 

4.  Homoeopathy  atid  Sir  Benjamin  Brodie,  dc.  By  0.  H. 
Marston,  M.D.,  L.R.O.P.,  Ed.,  M.R.C.S.,  Eng.  Bath: 
Capper,  1861. 

5.  A  Letter  to  Sir  Benjamin  C,  Brodie,  Bart.,  P.R.S.,  in 
reply  to  his  Letter  in  "  Erasers  Magazine"  for  September, 
1861.  By  Wm.  Sharp,  M.D.,  F.E.S.  London:  Turner, 
1861. 

Sir  Benjamin   Brodie's  letter  in  Fraser,  which  he  wrote 
"  without  any  great  labour,"  has  called  forth,  as  might  have 


88  Reviews, 

been  anticipated,  a  shower  of  replies,  which  it  will   cost  hifn  a 
considerable  amount  of  labour  to  read,  should  he  condescend 
to  undertake  the  task,  which  is  doubtful.     But  that  is  of  very 
little  importance ;  for  none  of  the  answer-writers,  we  conceive, 
has  the  hardihood  to  imagine  that  he  will  convert  Sir  Benjamin 
to  homoeopathy,  or  make  him  retract  one  of  the  offensive  accu- 
sations against  its  practitioners,  with  which  his  letter  abounds. 
If  these  answers  circulate  freely,  as  they  are  pretty  certain  to 
do  among  those  who  have  read  the  attack  that  elicited  them ; 
and  if  they  serve  to  disabuse  any  minds  of  the  unfavourable 
impressions  respecting  homoeopathy  Sir  Benjamin's  letter  was 
meant  to  produce,  then  will  these  answers  have  performed  the 
utmost  that  could  be  expected  from  them,  and  homoeopathy  will 
be  amply  avenged  on  its  formidable  assailant.     And   yet   we 
should  imagine,  from  all  we  have  heard  and  noticed  since  the 
publication  of  Sir  BeDJamiu's  condemnatory  epistle,  that  its 
effect  has  been  precisely  the  opposite  of  what  he  intended ;  for, 
on  all  sides,  we  hear  the  exclamation,  "  Is  that  all  the  great 
allopathic    champion    can   say   against    homoeopathy   and    in 
favour  of  the  old  practice  ?"     We  doubt  whether  any  believer 
in  homoeopathy  has  had  his  faith  staggered  for  a  moment  by 
the  letter  in  Eraser — whether  even  any  one  hesitating  about 
employing  homoeopathy  has  been  deterred  by  it;  and  we  know, 
as  a  fact,  that  several  persons  not  previously  favourable  to 
homoeopathy,  have  been  led  to  consult  a  homoeopathic  practi- 
tioner in  consequence  of  Sir  Benjamin's  masterly  exposure  of 
the  system.     We  can  easily  understand  this;  for  Sir  Benja- 
min's admissions  are  most  condemnatory  of   the  old  system, 
and  all  his  allegations  respecting  homoeopathy  and  its  practi- 
tioners, such  as  his  account  of  the  mode  of  preparing  dilutions, 
and  his  insinuation  that  homoeopathic  practitioners  are  unquali- 
fied empirics,  are  known  by  every  educated  person  to  be  untrue. 
The  enquiring  patient,  finding  that  its  chosen  champion  admits 
the  badness  of  the  old  system,  and  seeing  that  he  can  say 
nothing  against  the  new  system  but  what  is  palpably  false,  natu- 
rally thinks  that  the  new  system  must  be  the  better  of  the  two. 
Such  being  the  effect  of  Sir  Benjamin's  letter,  we  should  not 


Answers  to  Sir  B.  Brodie.  89 

bare  cared,  ttnd  'homceopathy  would  not  have  suffered,  had  no 
reply  been  vonohsafed  to  it.  It  is  its  own  best  antidote.  Still 
its  publication  presented  a  favourable  opportunity  for  popularly 
re-8tating  the  homGeopathic  doctrine,  and  illustrating  it  by  new 
facts  and  arguments ;  and  it  was  not  likely  such  an  opportunity 
would  be  missed  by  those  among  us  who  possess  the  time  and 
think  they  have  the  talent  for  such  a  task. 

At  the  head  of  this  article  are  the  titles  of  five  of  these 
replies,  enumerated  in  the  order  of  their  publication,  or,  at  least, 
of  their  reception  by  us. 

1.  The  first  on  the  list,  by  Dr.  Drdry,  is  not  a  very  brilliant 
affair.  It  is  written  in  a  rather  slipshod  style,  quite  unworthy 
of  the  author,  who  might  have  profitably  spent  a  few  hours  in 
polishing  his  sentences  and  correcting  his  style  before  going  to 
press.  As  a  rule,  we  think  the  publication  of  cases  from  one's 
private  practice  objectionable  in  a  popular  pamphlet.  Statistics 
furnished  from  a  reliable  source,  particularly  those  of  public 
hospitals,  are  what  are  best  adapted  to  the  popular  comprehen- 
sion. But  if  cases  are  so  published,  they  should  be  clear  and 
striking,  and  such  as  any  non-medical  person  may  understand. 
Dr.  Drury  gives  three  cases  from  his  private  practice.  The 
first  is  one  of  croup,  but  doubtful  if  real  membranous  croup, 
notwithstanding  the  statement  that  ''  in  the  third  and  fourth 
day  there  was  some  vomiting,  and  a  great  many  shreds  of  mem- 
brane came  up."  The  next  is  called  "  rheumatic  iritis,"  but, 
for  aught  that  appears,  it  might  be  a  simple  case  of  catarrhal 
or  catarrho-scTofiilous  ophthalmia.  At  all  events,  ''  great  into- 
lerance of  light,  injected  state  of  the  vessels  of  the  eye,  and 
feeling  of  sand,"  are  not  the  characteristic  symptoms  of  *'  rheu- 
matic iritis ;"  nor  is  the  remedy,  phosphorus,  one  of  those  indi- 
cated by  its  pathogenesis  for  this  disease,  though  it  is  decidedly 
80  for  catarrhal  ophthalmia;  and  the  homoeopathic  clinical 
records  recount  no  instance,  as  far  as  we  know,  of  fhosphorus 
being  useful  in  any  rheumatic  affection  of  the  eye.  The  last 
case  is  called  '*  illness  of  a  horse,"  which  seems  to  have  been  a 
simple  catarrh,  the  cure  of  which,  by  anythmg  or  nothing,  is 
no  way  remarkable.  On  the  whole,  we  cannot  congratulate 
Dr.  Drury  on  the  success  of  his  reply  to  Sir  Benjamin. 


90  R€view9. 

2.  Mr.  Moore's  pamphlet  is  what  its  title  implies,  "  a  prac- 
tical reply "  to  Sir  B.  Brodie.    Mr.  Moore's  patients  do  not 
consist  of  "  individuals  who  have  plenty  of  money,  combined 
with  a  great  lack  of  employment/'  who  "  contrive  to  imagine 
diseases  for  themselves."  On  the  contrary,  Mr.  Moore's  clientele 
are  in  the  habit  of ''  getting  more  kicks  than  halfpence/'  and 
we  are  not  aware  that  they  have  ever  been  accused  of  imagining 
diseases  or  malingering.     The  horses,  cattle,  and  dogs,  among 
whom  Mr.  Moore  practises,  are  not  afflicted  with  complaints' 
that  are  "really  no  complaints  at  all."     Grease,  quittor,  spring- 
hock,  cough,  sprains,  inflammation  of  bowels,  purpura  haemoir- 
hagica,  pneumonia,  bronchitis,  eczema,  glanders,  spavin,  farcy, 
tetanns,  plenro-pneumonia,  ozaena,  diarrhcea,  are  very  tangible 
realities;  and,  when  they  do  not  kill,  often  lead  the  horse  to 
the  knacker's  yard,  and  the  cow  to  the  slaughter-house,  which 
is  about  the  least  profitable  use  that  these  valuable  animals  can 
be  put  to.     When  a  horse  is  ill,  there  can  be  no  doubt  on  the 
subject;  and  when  it  gets  well,  after  the  administration  of  a 
remedy,  there  can  be  no  reason  to  suppose  that  the  influence  of 
its  imagination  contributed  to  the  result.    Individual  cases  of 
horse  and  cattle  cures,  therefore,  are  not  subject  to  the  same 
objections  that  might  apply  to  individual  cases  of  human  cures, 
where  we  must  always  allow  a  considerable  margin  for  the 
influence  of  the  imagination,  both  in  causing  the  symptoms 
and  the  curative  result,  not  to  mention  the  occasional  perturbing 
elements  of  wilful  or  involuntary  deception.     The  cases  given 
by  Mr.  Moore  are  admirably  calculated  to  show  the  real  power 
of  homoeopathic  remedies  over  the  diseases  of  the  brute  crea* 
tion,  and  are  well  calculated  to  put  a  stop  to  the  twaddle  about 
the  influence  of  the  imagination,  to  which  many  of  our  oppo- 
nents are  in  the  habit  of  ascribing  all  our  successes.     The  re- 
mainder of  Mr.  Moore's  pamphlet  has  a  certain  rough-and- 
ready  horsey  smack  about  it,  by  no  means  inappropriate  in  a 
veterinary  work. 

8.  Mr.  Smith's  pamphlet  is  the  substance  of  a  lecture  deli- 
vered at  the  Beaumont  Institution,  last  October,  and  seems  to 
be  a  compilation  from  the  exceUent  reply  to  Sir  Benjamin  in  the 
October  number  of  the  Monthly  Horn,  Review^  from  Dr.  Drury's 


Answers  to  Sir  B.  Brodie,  91 

pamphlet  and  from  Dr.  Sharp's  Investigation,  with  a  good 
many  discursive  remarks^  more  or  less  amusing,  the  whole  in* 
teresting  and  appropriate  for  the  miscellaneous  audience  of  a 
literary  institntion,  sach  as  these  literary  institutions  are,  but 
scarcely  deserving  the  immortal  honours  of  print.  His  state- 
ment  of  the  case  of  empiricism,  at  page  15,  is  well  put,  though 
not  as  he  seems  to  think,  original — viz.,  that  in  the  use  of 
specific  remedies  it  is  the  allopathist  who  is  the  empiric,  while 
the  homceopathist  is  truly  rational. 

4.  Dr.  Mabston's  pamphlet  touches  all  the  points  alluded  to 
hy  Sir  Benjamin  Brodie,  and  refutes  all  his  charges  fairly 
enough,  though  without  much  originality.  Its  style  is,  how- 
ever, most  lachrymose.  He  "unfeignedly  regrets"  this,  "deeply 
grieves  over"  that,  and  ''could  fairly  weep"  at  something  else, 
80  that  when  the  reader  gets  to  the  end  of  the  pamphlet,  he  is 
left  with  the  impression  that  the  defence  of  homoBopathy  is  one 
of  the  most  dismal  occupations  a  man  can  engage  in.  In  an 
appendix,  Dr.  Marston  gives  a  number  of  cases  from  his  private 
practice,  several  of  which  are  recorded  in  the  most  objectionable 
style. 

5.  The  last  work  on  the  list,  and  the  last  published  reply  to 
Sir  Benjamin,  is  Dr.  Sharp's  Letter.  We  are  sorry  to  be  obliged 
to  confess  that  the  perusal  of  this  Letter  has  filled  us  with  the 
most  painful  disappointment.  From  Dr.  Sharp  s  well-earned 
reputation  as  a  popular  exponent  of  the  homoeopathic  system, 
we  fully  expected  that  his  reply  to  Sir  Benjamin,  so  long  an- 
nounced, would  contain  a  masterly  defence  of  the  points  assailed 
by  the  allopathic  champion,  written  in  a  broad,  catholic  spirit. 
We  are,  therefore,  surprised  and  disappointed  to  find  that  Dr. 
Sharp  has  narrowed  the  controversy  to  a  mere  personal  afiair 
betwixt  himself  and  Sir  Benjamin. 

When  a  handsome  and  rich  young  man  on  the  look-out  for  a 
wife  passes  two  or  three  weeks  in  a  country  house  in  company 
with  several  charming  young  ladies,  and  does  not  make  an  offer 
to  any  of  them,  it  is  pretty  plain  he  does  not  want  to  marry  any 
of  them,  and  this  is  quite  well  understood,  but  no  one  dreams  of 
taking  offence  at  it.  But  if  one  of  them,  or  some  officious 
mother  or  aunt  for  her,  ask  him  if  he  wont  take  her,  she  is  laid 


92  Reviews. 

open  to  a  mortifying  personal  refusal.    In  like  manner  many  of 
US  have  introduced  to  our  allopathic  brethren  the  charms  of  the 
young  and  beautiful  Homoeopathia.    Among  the  rest  comes  Sir 
B.  Brodie  to  look,  but  he  does  not  admire ;  on  the  contrary,  he 
turns  back  with  renewed  ardour  to  the  battered,  wrinkled,  and 
raddled  old  dame,  Allopathy.     We  regret,  of  course,  his  bad 
taste,  but  we  don't  see  there  is  any  personal  offence,  and  we  let 
him  and  his  generation  pass  on  in  tbe  hope  of  meeting  men  of 
better  taste  in  future.    Not  so  our  friend  Dr.  Sharp,  who  re- 
turns to  the  charge  as  a  personal  question,  and  thereby,  we  fear, 
incurs  the  mortification  of  getting  snubbed. 

Dr.  Sharp  has  thus  put  himself  into  a  most  unfortunate  posi- 
tion, and  if  his  present  work  does  not  equal  his  former  ones,,  it  is 
only  that  is  impossible  in  such  a  position  to  make  a  satisfactory 
book. 

Twenty  years  ago  Sir  B.  Brodie  wrote  an  article  which  vir- 
tually said,  '*  I  have  studied  homoeopathy  in  Hahnemann  and 
Curie,  and  I  find  it  a  delusion  in  which  there  is  some  good, 
but  that  is  all  negative,  and  much  bad  owing  to  that  negatire 
character,  and  its  professors  are  impostors  and  charlatans." 
Then  comes  Dr.  Sharp  who  studies  homoeopathy  and  is  con- 
verted, and  writes  a  book  saying  to  Sir  B.  Brodie,  ''You  know 
me  as  a  friend  and  fellow  surgeon  and  F.B.S.  and  no  impostor 
or  charlatan,  therefore  you  will  surely  listen  to  the  real  truth 
about  homoeopathy."    Again  comes  forward  Sir  B.  Brodie,  who 
now  says,  ''  I  have  studied  homoeopathy  in  Hahnemann,  Curie, 
and  Sharp,  and  I  find  it  is  a  delusion,"  and  so  on  da  capo^ 
exactly  in  the  same  style  as  before. 

Dr.  Sharp  is  thus  put  in  a  most  mortifying  and  thoroughly 
false  position,  so  much  so  that  we  do  not  see  how  he  could 
manage  to  appear  altogether  at  his  ease  under  the  rebuff. 
In  fact,  this  is  shown  by  the  constrained  courtesy  in  which 
he  always  alludes  to  Sir  Benjamin  personally,  much  more 
so  than  in  his  original  book,  where  he  speaks  sharply 
enough.  In  writing  a  reply,  what  can  Dr.  Sharp  in  effect  say  ? 
He  can  merely  recapitulate  what  was  said  before.  That,  in 
reality,  was  quite  sufficient;  there  is  pot  an  argument,  statement, 
or  insinuation  that  was  not  already  fully  met  in  Dr.  Sharp  s 


Answers  to  Sir  B.  Brodie,  93 

book  as  well  as  in  fifty  other  homoeopathic  publications  before 
his.  So  that  is  virtually  what  Dr.  Sharp  does ;  and^  indeed, 
to  save  recapitulation,  he  merely  refers  to  the  parts  of  the  book 
seriatim,  with  a  few  additional  remarks  that  add  nothing  to  the 
conviQcing  power  of  the  former.  We  are  tempted  to  say  cui 
hoHo  f  There  is  not  one  person  who  read  the  former  work  and 
was  not  convinced  by  it,  who  would  be  by  this  reply ;  and  does 
any  one  suppose  that  Sir  B.  Brodie,  if  he  reads  this  reply,  will 
be  inflaenced  one  way  or  another  ?  None,  we  apprehend.  He 
has  Moses  and  the  prophets,  and  if  he  heard  not  them,  is  he 
likely  to  listen  to  a  revetiant  like  this  ? 

For  the  large  class  who  take  an  interest  in  homoeopathy,  as 
patients,  no  doubt  this  and  the  other  replies  to  Sir  Benjamin 
are  necessary,  especially  since  the  Magazine  that  published  Sir 
Benjamin  8  letter  refused  space  for  any  reply,  and  therefore  the 
whole  thing  will,  no  doubt,  turn  to  our  advantage,  in  as  much 
as  all  controversies  help  to  advance  the  truth. 

The  art  of  popular  writing  on  matters  of  science  we  take 
to  be  as  much  of  teaching  as  can  be  apprehended  by 
readers  of  ordinary  non-technical  education,  combined  with 
arguing  on  just  as  much  technical  information  as  is  given  in 
the  work  itself.  To  attain  this  art  is  difficult,  apparently  very 
much  so,  judging  from  the  scarcity  of  good  popular  works  on 
science.  Dr.  Sharp  is  one  who  has  been  happy  in  this,  and  has 
benefited  homceopathy  to  a  very  great  degree  in  spreading  a 
knowledge  of  it  among  the  public  and  dissipating  their  preju- 
dices, and  his  tracts  have  even,  we  believe,  attracted  the  notice 
of  some  medical  men,  and  induced  them  to  study  further  and 
experiment  on  homoeopathy. 

So  far  as  refers  to  Dr.  Sharp's  popular  exposition  of  the  trite 
doctrines  of  homoeopathy  we  have  no  need  to  say  anything,  ex- 
cept a  repetition  of  the  unqualified  praise  formerly  given.  But 
when  in  a  popular  exposition  are  included  any  points  claiming 
peculiarity  or  novelty,  or  even  of  a  controversial  character,  and 
also  any  new  practical  addition,  then  the  work  claims,  and  in 
this  case  actually  challenges  the  criticisms  of  his  medical  brethren 
of  the  same  school.  And  here,  again,  Dr.  Sharp  has  put  him- 
self in  an  unfortunate  position  both  for  himself  and  us.     Be- 


94  Reviet€$, 

oaase,  cot  only  must  we  criticise  honestly,  bat  if  we  do  not  agpred 
with  him  we  are  compelled  to  protest  against  his  self-constituted 
championship. 

The  Materia  Medica  is  the  very  core  and  essence  of  practi- 
cal homoeopathy;  and  all  practical  advance  in  homoeopathy 
means  little  more  than  the  development  and  completion 
of  it.  On  this  subject  we  find  the  following,  which  is  partly 
addressed  to  the  public  as  an  example  of  the  superiority  of 
the  Homoeopathic  Materia  Medica  and  Therapeutics,  over  the 
Allopathic,  and  partly  to  us  as  ^  new  and  great  improvement 
on  the  existing  Homoeopathic  Materia  Medica. 

"  I  shall  introduce  a  few  pages  from  the  '  Materia  Medica  *  I  have 
been  for  some  time  engaged  upon,  and  give  two  remedies  as  ex* 
amples  of  my  method,  and  in  illustration  of  the  manner  in  which  the 
doctrines  I  have  been  attempting  to  explain  may  be  applied  in  prac- 
tice. One  of  these  drugs  shall  be  an  old  one  revived,  the  other  a 
new  one,  which  will,  in  this  manner,  make  its  entrance  into  the 
materia  medica,  and  be  presented  ibr  the  first  time  before  the  medical 
profession,  though,  doubtless,  should  it  be  adopted  by  your  party, 
some  other  name  than  mine  will  be  attached  to  it  as  its  discoverer. 

"  The  opportunity,  for  which  I  am  thus  indebted  to  you,  also  enables 
me  to  convey  to  my  own  party,  through  this  small  specimen,  some 
notion  of  the  plan  upon  which  I  am  working ;  and  they  can  express 
to  me,  in  any  way  that  they  think  proper,  their  opinion  as  to  the 
utility  of  such  an  undertaking,  and  whether  they  are  disposed  to 
encourage  me  to  persevere  with  it  or  not 

"  *  GOLD — AS  A   POISON. 

"  *  Professor  Christison,  quoting  from  Orfila,  writes  thus  of  gold : — 
'  Its  poisonous  properties  are  powerful,  and  closely  allied  to  those  of 
the  chlorides  of  tin  and  nitrate  of  silver.  In  the  state  of  chloride  it 
occasions  death  in  three  or  four  minutes  when  injected  into  the  veins 
even  in  very  minute  doses ;  and  the  lungs  are  found  after  death  so 
turgid  as  to  sink  in  water.  But  if  it  be  swallowed  corrosion  takes 
place,  the  salt  is  so  rapidly  decomposed  that  none  is  taken  up  by  the 
absorbents,  and  death  ensues  simply  from  the  local  injury.'  '  Even 
doses  so  small  as  the  tenth  of  a  grain  have  been  known  to  produce 
an  unpleasant  degree  of  irritation  in  the  stomach.*  (Majendie.) 
'  In  the  state  of  fulminating  gold  this  metal  has  given  rise  to  alarming 


Afiswers  to  Sir  B.  Brodie,  96 

poiooiung  in  former  tunes,  when  it  waa  used  medicinally/  '  It  ex. 
cites  griping,  diarrhoea,  Tomiting,  conyulsions,  fainting,  salivation; 
and  sometimes  has  proved  fatal.'  (Plenck.)  'Hoffman  likewise 
repeatedly  saw  it  prove  fatal,  and  the  most  remarkable  symptoms 
were  Tomiting,  great  anziety,  and  fainting.  In  one  of  his  cases  the 
dose  (which  caused  death)  was  only  six  grains.' 

^  *  Metallic  gold  was  pulverized  or  triturated  by  the  Arabians. 
SeTeral  modem  physicians  have  experimented  with  it,  thus  reduced 
to  minute  subdivision,  upon  themselves,  taking,  in  divided  doses,  one 
or  two  grains.  The  result  of  these  experiments  shows  that  gold  acts 
upon — 

"*  1.  The  mind  and  the  hrain;  producing  in  the  former  great 
melancholy  and  depression  of  spirits,  in  the  latter  congestion. 

^  *  2.  The  chesty  causing  dyspnoea,  expectoration  of  viscid  phlegm, 
palpitation  of  the  heart,  congestion  of  the  lungs. 

** '  3.  The  digesiwe  organs ;  fetid  odour  from  the  mouth,  putrid 
taste,  salivation,  nausea,  flatulence,  vomiting,  first  constipation,  after* 
wards  diarrhoea,  with  burning  in  the  rectum. 

"  *  4.  The  hmes^  generally,  particularly  the  nasal,  palatine,  and 
facial  bones ;  giving  rise  to  inflammation  and  caries. 

**  *  It  is  thus  seen  that  gold  has  a  penetrating  or  deep-seated  action ; 
commencing  in  the  brain,  and  affecting  very  specially  the  mind, 
passing  through  the  chest  and  abdomen,  and,  finally,  concentrating 
its  energies  on  the  bones  in  general,  but  particularly  on  those  of 
the  &ce. 


«C  ( 


OOLD — KB  A   BEHBDT. 


^  *  Gold  was  much  used  as  a  remedy  some  centuries  ago.  It  was 
thought  to  promote  the  production  of  animal  heat,  to  strengthen  the 
Jieart,  to  restore  the  blood,  to  expel  noxious  humours,  and  particularly 
to  exhilarate  depressed  spirits.  For  some  time  gold  has  been  aban- 
doned  as  a  medicinal  drug,  it  is  now  beginning  to  be  employed  again. 

*'  <  I  have  prescribed  triturated  gold  with  success  in  the  following, 
among  other,  cases : 

**^\.  A  case  of  extreme  melancholy  and  despondency,  arising  from 
a  Chancery  suit ;  the  patient  was  in  a  most  distressing  state ;  after 
Tarious  other  remedies  had  failed,  I  prescribed  the  first  trituration 
(one  hundredth  of  a  grain);  he  wrote  after  this,  *I  felt  better  at 
once.' 

'* '  2.  A  case  of  ozena,  of  long  standing,  in  which  the  constitution 


00  Reviews, 

was  greatly  deranged,  and  the  osseous  system  affected ;  this  boy 
permanently  cored. 

*"  3.  A  child  in  a  hopeless  state  of  disease,  one  of  the  features  of 
which  was  severe  ophthalmia,  with  ulcers  on  the  cornea  in  both  eyee, 
which  had  resisted  the  prolonged  and  varied  use  of  many  excellent 
remedies ;  the  poor  child  was  emaciated  and  exhausted  with  suffering 
and  fretfulness;  and  the  mother  was  almost  as  bad  from  nursing', 
anxiety,  and  want  of  rest.  The  quantity  taken  was  a  minute  frac- 
tion of  a  grain,  in  divided  doses.  The  little  patient  was  restored,  bj 
God's  blessing,  to  perfect  health. 

** '  4.  A  case  of  exostosis  of  the  tibia,  just  below  the  knee  in  a  boy  ; 
the  first  trituration  was  given  with  benefit;  I  believe  a  cure  was 
effected,  but,  as  is  often  the  case  when  that  happens,  the  patient*8 
friends  did  not  think  it  worth  while  to  communicate  this  intelligence 
directly  to  me. 

*' '  Gold  is  an  antidote  to  mercury,  relieving  the  neuralgic  paias 
and  other  mischievous  effects  of  that  metal,  especially  when  the 
bones  have  been  injured  by  it ;  and  vice  versd^  mercury  is  an  antidote 
to  gold. 

*'  *  The  organs  selected  by  gold  upon  which  to  produce  its  effects 
are  distinct,  and  its  action  profound ;  and,  whether  it  be  given  in 
health  or  in  disease,  as  a  poison  or  as  a  remedy,  the  organs  upon 
which  it  acts  are,  in  both  cases,  the  same.' '' 

The  above,  containing  an  arrangement  of  an  old  naedicine 
gives  us  the  opportunity  of  guessing  at  Dr.  Sharp's  method.  He 
describes  gold  as  an  old  remedy  revived,  though  we  do  not  know 
exactly  the  sense  in  which  he  uses  these  words.  However  that 
may  be,  gold  was  first  brought  into  practice  in  modern  times  by 
Hahnemann  about  40  years  ago,  and  has  been  in  daily  use  by 
homoeopathists  ever  since,  and  has  also  been  adopted  into  allo- 
pathy, as  usual  without  acknowledgment  of  Hahnemann's 
claims.  Out  of  the  physiological  and  clinical  materials  above 
named,  and  without  any  addition  to  what  is  contained  in  all 
ordinary  homodopathic  manuals,  Dr.  Sharp  gives  us  the  above 
arrangement  of  the  action  of  gold  But  we  are  at  a  loss  to  find 
the  exact  sense  in  which  it  is  intended  to  be  given  and  judged. 
If  it  is  to  be  taken  as  a  short  summary  of  the  chief  sphere  of 
action  of  gold,  to  be  added  to  the  more  complete  physiological 


Answers  io  Sir  B  Brodie.  .97 

and  therapeadc  arraDgements  of  that  medicine,  then  we  should 
say  it  was  correct  and  good  in  its  matter  and  form,  though  not 
in  that  respect  original,  as  similar  summaries  are  given  hy  others, 
Boch  as  those  in  the  later  parts  of  Noack  and  Trink  s  Manual* 
Besides,  we  can  hardly  suppose  an  independent  hook  would  be 
publisbed  composed  of  mere  appendices  to  other  works  already 
existing.     Nevertheless,  if  it  is  so,  the  homoeopathic  profession 
wil]  welcome  it  as  good  and  useful.    Next  it  may  be  intended 
as  a  short  epitome  or  pocket  book  of  the  Materia  Medica,  where 
the  most  prominent  and  trustworthy  effects  are  selected.     In 
this  sense  it  would  also  be  acceptable,  though  we  have  already 
several  very  good  works  of  the  kind,  and  we  had  certainly  ex- 
pected something  of  a  different  kind  from  Dr.  Sharp*    In  the 
third  place,  it  is  to  aspire  to  a  higher  place  and  fulfil  the  desires 
expressed  in  the  passage  at  p.  56.     "  There  is  nothing  so  much 
wanted  in  medicine  as  a  Materia  Medica  which  shall:  contain  a 
true  picture  of  the  sphere  of  action  of  each  drug.     This  picture 
must  not  be  like  Hahnemann's,  made  up  of  dismembered  and 
detached  fragments,  and  crowded  with  insignificant,  and  often, 
perhaps,  imaginary  sensations  and  other  trivial  matters,  which 
mingle  with  and  hide  the  meaning  of  the  real  and  important 
symptoms;  but  a  steadily  drawn  and  well  defined  exhibition  of 
all  that  is  characteristic  and  specific  in  the  effects  which  each 
drug  in  its  various  forms  and  doses  is  capable  of  producing. 
For  some  time  I  have  been  attempting  this,  but  it  is  work  of 
extreme  difficulty  and  labour."     Our  wants  are  here  well  ex- 
pressed ;  would  that  the  author  may  succeed  as  well  as  an  artist 
as  a  critic !     Are  we  to  conclude  that  the  above  short  summary 
contains  all  that  is  really  trustworthy  in  the  physiological  symp- 
toms of  gold  contained  in  our  Materia  Medica?    or,  at  any 
rate,  that  this  summary  being  deduced  from  those  of  them  that 
are  trustworthy  as  the  only  practically  useful  result  of  them, 
the  symptoms  may  be  thrown  aside  as  henceforth  of  no  value. 
In  short,  that  the  omission  of  nearly  the  whole  of  the  Materia 
Medica  is  not  negative,  caused  by  selecting  a  few  of  the  best, 
leaving  the  rest  to  stand  on  their  own  merits  in  other  books, 
but  positive,  the  latter  having  been  weighed  and  found  wanting. 
Of  course,  if  such  really  be  the  case,  the  knowledge  of  it,  though 

VOL.   XX,    NO.   LXXIX. — JANUARY,    1802  O 


98  Reviews, 

disappointing,  cannot  be  otherwise  than  nsefol,  in  faot  eaaeDtial. 
Bat  we  must  first  be  convinced  that  Dr.  Sharp  has  really  ascer- 
tained it.     In  the  first  place,  has  he  sifted  the  literature  of  gold 
in  the  Greek,  Latin,  and  Arabian  authors  in  the  same  way  as 
Hahnemann,  and  if  he  differs,  does  he  expect  we  should  prefer 
his  decision  to  Hahnemann's,  and  especially  in  a  bald  negative 
form  like  that  ?     If  so,  he  mistakes  his  position  most  lamen- 
tably.   Again,  as  to  the  redundancy  of  symptoms  in  Hahne- 
mann's proTings ;  no  doubt  many  are  trivial  and  many  narrated 
with  superfluous  minuteness.     On  this  subject,  however,  there  is 
not  so  much  to  be  said  as  is  thought ;  for  such  criticisms  as  can 
be  made  with  scissors  and  pen,  with  the  mere  guide  of  common 
sense,  is  easily  done  by  us  all ;  and  when  that  is  done,  the  dif- 
ficulty will  remain  just  as  great  as  before ;  for  the  number  of 
symptoms  necessary  to  express  the  real  character  of  any  drag 
is,  and  for  ever  must  remain,  very  large,  just  as  we  cannot 
expect  to  obtain  a  full  knowledge  of  a  plant  by  looking  merely 
at  the  seed,  but  must  have  the  whole  stem,  leaves,  flower,  and 
fruit.     The  fact  is,  we  had  better  all  make  up  our  minds  at 
onoe  that  the  idea  of  discovering  some  plan  which  will  do  away 
with  the  trouble  and  difficulty  of  those  enormous  masses  of 
symptoms  is  nothing  but  a  chimera  like  the  perpetual  motion^* 
a  vain  dream  of  the  indolent  and  incapable.     Doubtless  from 
time  to  time  we  shall  get  good  compilations  and  manuals  cor- 
responding to  the  progress  of  the  Materia  Medica.    But  that 
progress  must  in  future  be  an  afiair  of  monographs,  just  as 
pathology  is  gradually  advancing  by  the  better  understanding 
of  individual  diseases.     If,  therefore.  Dr.  Sharp  gives  us  one 
thoroughly  proved  medicine,  he  will  add  more  to  homceopathy 
than  by  a  whole  volume  in  the  style  of  this  arrangement  of  gold. 
Or  again,  are  we  to  suppose  the  omitted  symptoms  are  found  to 
have  been  false  ?     This  is,  we  know,  the  real  defect  in  our 
Materia  Medica.     It  is  not  that  the  symptoms  are  trivial  or 
redundant  that  constitutes  the  greatest  dfficulty,  but  that  many 
are  not  true.     Now  there  is  only  one  way  to  test  this,  viz., 
careful  reproving.     Has  Dr.  Sharp  done  this  for  gold  ?    If  so, 
then  let  him  give  us  the  details  of  his  provings  that  we  may  be 
satisfied,  or  even  tell  us  that  he  has  done  so :  till  then,  we 


Answers  to  Sir  B.  Brodie,  99 

iBgret  to  say,  his  opimon  is  without  any  valae.  Oddiy  enongh, 
Br.  Sharp  seems  to  put  no  great  faith  in  it  himself;  for  in  the 
cures  be  gives  by  gold,  which  are  merely  a  few  specimens  of  the 
eommonest  in  our  hand-books,  he  gives  one  in  which  a  pro- 
minest  feature  was  ophthalmia  with  ulcers  on  the  cornea.  Now, 
in  bis  physiological  part,  there  is  no  mention  of  its  action  on 
the  eyes  at  all.  Therefore  this  is  not  a  homoeopathic  cure  at 
all,  but  merely  a  blind  empirical  hit,  or  he  must  admit  the 
validity  of  the  Hahnemannic  eye  symptoms  of  gold  which  are 
omitted.  So  this  plan  sinks  down  to  nothing  but  a  bald  seleo- 
tion  of  some  of  the  actions  of  gold  given  in  this  form  for  short- 
iie88»  which  precludes  any  but  the  vaguest  hints  as  to  its  action, 
and  renders  all  differential  diagnosis  impracticable. 

The  last  supposition  we  can  form  of  this  Materia  Medica  is 
that  it  may  be  an  attempt  to  give  the  pathognomonic  symptoms 
of  the  drug  only.  This,  if  possible,  would  certainly  be  the 
greatest  boon  to  the  practitioner,  and  it  has,  to  a  certain  extent, 
been  done  by  Hahnemann,  in  giving  adypsia  as  the  cardinal 
indication  for  Pulsatilla.  What  we  mean  is  this.  Supposing 
it  could  be  said  of  Ipecacuanha  that  nausea  is  the  cardinal 
symptom,  and  unless  that  is  present,  however  else  it  might 
oonespond,  it  would  not  be  the  right  medicine;  and  if  the 
same  could  be  said  of  dilated  pupil  for  Belladonna,  these 
would  be  most  valuable  facts;  and  a  volume,  going  through  the 
Materia  Medica  in  that  way,  would  be  invaluable,  though  by 
no  means  superseding  the  full  provings.  Wo  have  no  reason 
to  believe  in  the  possibility  of  such  a  discovery  as  a  general 
character  of  medicines.  But,  however  this  may  be,  the  above 
specimen  of  Materia  Medica  does  not  give  us  any  hope  that 
Dr.  Sharp  is  the  man  to  give  us  that  boon. 

So  much  for  the  re-arrangement  of  an  old  medicine;  and  if 
this  form  is  defective  for  that,  what  must  it  be  for  introducing 
a  new  one  ? 

*'  The  following  substance  has  never,  to  my  knowledge,  been  used 
in  medicine  before.  I  have  proved  it  upon  myself  some  years  ago, 
and  have  prescribed  it  in  a  considerable  number  of  cases,  and  gene- 
rally with  the  greatest  satisfaction.  I  have  been  anxious  to  introduce 
it  to  my  professional  brethren,  but  have  hitherto  kept  it  back,  partly 
that  I  might  attain  a  more  settled  confidence  in  it  myself,  and  partly 

G  2 


1 00  Reviews. 

because  I  intended  it  to  appear  in  its  place  in  my  own  '  Materia 
Medica.'  But  as  that  undertaking  is  not  yet  completed,  for,  as  may 
be  supposed,  it  is  one  of  great  extent  and  labour ;  as  life  is  uncer- 
tain ;  and  as  this  opportunity  seems  to  be  a  fitting  one,  I  have  much 
pleasure  In  presenting  it  in  this  place,  under  your  auspices.  Sir 
Benjamin,  for  to  you  it  is  indebted  for  this  happy  opportunity  of 
revealing  its  admirable  utUity.  I  give  it,  not  only  as  a  specific  itself, 
but  as  an  illustration  and  proof  of  the  value  of  experiments  upon 
the  healthy,  as  a  method  of  discovering  specifics  in  any  number,  and 
for  any  complaint ;  the  limits  to  these  discoveries  being  the  very  few 
physicians  who  are  willing  to  try  to  make  them,  and  the  limited  zeal, 
industry,  and  talent  of  mankind. 

"  '  TITANIUM — AS   A   POISON. 

'''Titanium  was  discovered  by  Gregor  in  1791,  but  we  are  in- 
debted to  Wollaston's  experiments,  in  1822,  for  a  better  acquaint- 
ance with  it.  This  rare  metal  is  obtained  chiefiy  from  the  bottom  of 
the  large  smelting  furnaces  in  iron  works.  Several  years  ago,  when 
one  of  these  furnaces  at  the  Low  Moor  Iron  Works,  in  Yorkshire, 
which  had  been  burning  without  intermission  for  many  years,  was 
blown  out  for  the  purpose  of  undergoing  repairs,  through  the  kind- 
ness of  Mr.  Wickham,  I  obtained  a  considerable  lump  of  titanium.* 
The  metal  was  in  beautiful  cubic  crystals,  of  a  deep-red  copper 
colour,  and  very  brilliant  metallic  lustre.  I  had  some  of  these 
crystals  triturated  by  the  late  Mr.  Turner,  of  Manchester,  and 
experimented  with  this  trituration  upon  himself,  f  The  proportion 
was  one  grain  to  ninety-nine  of  sugar  of  milk.  I  am  not  aware  of 
any  other  proving. 

'' '  From  these  experiments  I  am  assured  that  titanium  has  a 
powerful  action  upon  the  human  body.  After  taking  the  prepara- 
tion I  have  described,  in  doses  of  two  grains,  once  a  day  for  a  week,^ 
I  became  greatly  disordered,  and  felt  and  looked  wretchedly  ill. 
On  a  careful  consideration  of  my  indisposition,  I  am  justified  in 
summing  up  the  action  of  the  drug  as  being  upon — 

"'1.  The  stomach;  bringing  on  nausea,  loss  of  appetite,  and 
feeling  of  discomfort. 

"  '  2.  The  brain  and  nerves;  giddiness,  imperfect  vision,  the  pecu-. 
liarity  being  that  h€Uf  an  object  only  could  be  seen  at  once,  desire  to 
keep  the  eyelids  closed. 

*  We  believe  that  the  most  recent  analyses  have  shewn  this  to  be  a  cyanide 
of  titanium,  and  not  the  pore  metal  as  was  formerly  supposed. — [Eds.] 
t  This  is  obscure,  is  "  himself"  perhaps  a  misprint  for  *'  myself?" — [Eds.] 


Afiswers  to  Sir  B,  Brodie,  101 

^  ^  3.  The  bhod;  a  perceptible  derangement  of  the  whole  system, 
which  could  not,  without  danger,  haye  been  carried  further.* 


*<•  TITANIUM — AB  A  BBMEDT. 


*1  have  found  titanium  a  most  valuable  remedy  for  certain 

cases,  for  which  no  good  remedy  was  known  before.     They  are 

cases  of  degeneration  of  the  blood.     A  time  will  come  when,  with 

a  more   refined  chemistry,  our  knowledge  of  the  constitution  of  the 

OTculating  fluid  which  is  the  life  of  man's  body,  and  the  changes  it 

undergoes  in  disease,  will  be  better  understood  than  they  are  at 

present.     We  can  now  speak  of  the  morbid  conditions  of  the  blood 

only  in  a  crude  and  general  manner.     We  know  that  the  blood  is 

altered  from  its  healthy  state  in  typhus,  in  chlorosis,  ia  jaundice,  in 

cholera,  in  inflammatory  fever,  and  in  some  other  diseases,  and  we 

can  describe,  in  an  imperfect  manner,  some  of  these  changes,  but 

there  remains  an  inexhaustible  field  of  research  in  this  department 

of  physiology  and  pathology.     The  morbid  condition  of  the  blood, 

which  may  be  called  the  titanium  condition,  will  be  understood  with 

some  degree  of  accuracy  by  a  careful  study  of  the  following  case, 

which  was  the  first  in  which  it  was  given  as  a  remedy. 

*^M.  Blood  disease, — Mr.  C.  F — ,  a  middle-aged  and  formerly 
stout  and  healthy  man,  seven  years  ago  had  an  attack  of  typhus 
fever,  recovered  imperfectly,  and  has  not  been  thoroughly  well 
since ;  during  the  last  five  years  has  gradually  but  steadily  become 
worse.  He  vomits  a  great  deal,  but  not  food ;  the  matter  rejected 
is  a  sour,  watery  phlegm ;  he  has  diarrhcea,  the  stools  consisting  of 
yellow,  frothy,  slimy  matter ;  the  secretion  of  the  kidneys  is  high 
coloured  and  thick  (in  some  other  cases  it  has  been  albuminous);  he 
spits  blood,  and  sometimes  has  hcemorrhage  from  the  bowels ;  he 
has  pain  in  the  region  of  the  liver  and  kidneys,  and  also  in  the 
lower  bowels,  with  much  cramp ;  the  eyes  slightly  jaundiced ;  there 
has  been  great  loss  of  strength  and  fiesh,  and  two  stones  (twenty- 
eight  pounds)  in  weight.  The  tongue  is  not  much  furred,  and  the 
pulse  is  80.  This  gentleman  tells  me  he  has  had  a  great  deal  of 
medical  advice,  but  as  yet  has  derived  no  benefit  either  from  medi- 
cines or  from  careful  diet,  or  from  change  of  air,  having  during  the 
five  years  paid  two  or  three,  long  visits  at  the  sea-side  and  also  one 
on  the  Webh  mountains.  This  account  I  received  on  the  28th  of 
April,  1858.  I  prescribed  half  a  grain  of  the  first  trituration  (one 
grain  in  a  hundred)  three  times  a  day  for  a  week,  being  moved  to 


J  02  Review. 

thifl  by  the  vivid  recollection  his  narrative  produced  in  my  Aiind  or 
the  condition  I  was  myself  falling  into  while  proving  titaniom.  A.t 
the  end  of  the  week  he  wrote  to  me  that  h^  was  *'  altogether  & 
different  man;"  and,  without  any  repetition  of  the  remedy,  and 
without  the  use  of  any  other  means,  in  a  very  short  Ume,  he  regained 
perfect  health.  He  continued  well  a  year ;  in  the  spring  of  1859  he 
made  himself  ill  by  hunting  too  much,  and  some  of  the  former  S3rmp- 
toms  showed  themselves  again,  but  they  were  immediately  removed 
by  the  same  remedy ;  he  has  continued  generally  well  since.'  ** 

In  the  above,  more  than  half  the  space  is  occnpied  with  pre* 
liminary  remarks,  and  from  these  we  learn  that  only  one,  or^ 
if  there  is  no  misprint  in  the  passage  above,  at  most  two  indivi- 
duals  were  experimented  on,  viz.,  himself  and  Mr.  Turner.  From 
this  meagre  proving  we  have  three  short  sentences  as  the  whole 
physiological  action  of  the  drug,  and  in  them  there  is  only  (Hie 
peculiar  symptom — viz.,  bemiopia,  which  is  not  taken  into  ae- 
count  at  all  in  the  subsequent  therapeutic  trial.    Our  readers  axv 
already  familiar  with  the  provings  of  Hahnemann  and  the  many 
admirable  treatises  on  the  subject  by  Helbig,  Hartlaub,  Rau,  te., 
and  the  provings  of  new  medicines  by  Hahnemann's  immediate 
followers,  and  by  our  American  brethren,  and  the  re-provings 
of  several  medicines,  wherein,  as  in  Watzke's  Colocynth,  the  sub- 
ject is  profoundly  examined.     It  would,  therefore,  be  an  insult 
to  them  were  we  to  go  through  the  reasons  that  show  the  utter 
inefficiency  of  the  above  for  displaying  the  physiological  action  of 
a  drug.  We  may  merely  notice  the  paragraph  in  which  Dr.  Sharp 
states  the  blood  is  acted  on,  as  that  is  the  ostensible  reason  for 
using  it  as  a  remedy.  How  does  he  know  Titanium  acts  on  the 
blood  ?     And  if  so,  in  what  way  ?     How  does  its  action  on  ihe 
blood,  supposing  it  to  have  any,  diflfer  from  that  of  Arnica, 
Iron,  Natr.  mur.,  Crocus,  Pulsatilla,  Sulph.  acid,  and,  in  fact, 
every  other  profound  and  long- working  drug?    And  again, 
what  reason  has  he  to  suppose  Mr.  C.  F.  laboured  under  a 
blood  disease  any  more  than  any  other  patient  with  any  chronie 
disease  involving  depraved  nutrition  ?     And  if  so,  what  ground 
is  there  for  supposing  it  resembled  the  Titanium  blood  disease 
any  more  than  that  of  common  salt  or  any  of  the  hundred 
other  medicines  that  produce  changes  in  the  blood  ?     In  short. 


Ati9wer8  to  Sir  B,  Brodie,  103 

in  what  way  was  it  a  homoeopathio  cure  at  all  ?  None^  that 
we  can  see;  and  the  cure  was  DOthing  but  pure  hap-hazard,  and 
the  repetition  of  the  medicine  in  like  cases  will  be  pure  empiri- 
cisin,  bearing  no  more  resemblance  to  rational,  specific  treatment, 
sach  as  homceopathy  is,  than  Dr.  Simpson's  chance  hits  with 
Nickel  and  Cerinm.  We  are  therefore  compelled,  with  great 
regret,  in  defence  of  onr  common  cause,  to  repudiate  entirely 
the  aboye  remarks  on  Titanium,  as  bearing  no  resemblance  to 
a  homceopathic  proving,  except  as  a  mere  parody  of  one.  This 
is  painful,  but  we  haye  a  duty  to  perform;  and  Dr.  Sharp 
haying  the  ear  of  the  public,  it  is  the  more  necessary  to  speak 
decidedly,  as  allowing  such  an  imperfect  representation  of  the 
matter  to  go  unchallenged,  will  do  infinitely  more  harm  than  all 
the  letters  of  Sir  6.  Brodie.  Dr.  Sharp,  at  page  89,  seems  anxi* 
ens  that  the  allopathic  party  should  not  claim  priority  in  the  use 
of  Titanium.  We  are  not  careful  as  to  that;  for,  as  above  said> 
the  field  is  open  yet,  and  we  cannot  admit  that  any  homoeopathio 
title  to  it  has  been  made  out  So  far,  Dr.  Sharp  and  Dr. 
Simpson  are  quite  on  a  par  in  their  trying  new  metals. 

Dr.  Sharp  is  most  anxious  to  disclaim  all  indebtedness  to 
Hahnemann,  and  he  therefore  seldom  mentions  his  name  without 
some  disparaging  remark.  Thus  he  takes  good  care  to  tell  us 
"I  haye  noticed  every  feature  of  Hahnemann's  exposition 
of  his  system,  and  there  is  not  one  which  I  admire,  or  can 
adopt  in  the  terms  in  which  they  are  propounded  by  him.  As 
expressed  in  his  writings,  they  all,  without  exception,  excite  in 
my  mind  a  strong  repugnance."  And  again,  "  I  may  be  sup- 
posed to  be  a  disciple  of  Hahnemann,  and  be  held  responsible 
for  his  follies.  I  altogether  disclaim  such  responsibility  and 
relationship."  From  this  we  infer  that  if  Hahnemann  had  not 
existed.  Dr.  Sharp  would  have  discovered  homoaopathy  all  by 
himself.  Possibly,  but  as  it  so  happened  that  Hahnemann 
preceded  Dr.  Sharp  in  the  discovery,  we  do  not  see  how  Dr. 
Sharp  can  altogether  repudiate  the  relationship  of  his  disciple. 
However,  as  he  goes  on,  Dr.  Sharp  endeavours  more  and  more 
to  discredit  Hahnemann,  and  make  him  an  object  of  contempt. 
We  doubt  if  any  professed  opponent  of  homoeopathy  ever  gave 
such  an  unfair  and  depreciatory  account  of  Hahnemann's  intro- 


104  Reviews, 

ductioD  of  his  diacoyery  to  the  notice  of  the  profesaion  as  is  to 
be  found  at  page  33  of  Dr.  Sharp  s  letter.  According  to  this 
account,  all  the  blame  of  the  acrimonious  controversy  that 
arose  originated  with  Hahnemann.  It  was  his  "irritable  mind** 
that  chafed  at  the  delay  of  his  brethren  to  adopt  his  yiews :  his 
impatience  and  self-esteem  ''  led  him  to  press  his  reform  with 
unwise  eagerness ;  and  the  two  together  tempted  him  to  use 
words  of  disparagement  towards  his  fellow-practitioners,  which 
they  did  not  deserve,  and  which  he  was  not  justified  in  using." 
Hdmemann,  according  to  Dr.  Sharp,  "should  have  been  more 
modest  and  more  patient." 

How  utterly  unjust  this  account  of  Hahnemann's  introdac- 
tion  of  homoeopathy  is,  every  one  at  all  conversant  with  bia 
life  and  writings  knows.  It  was  not  till  very  late  in  life  that 
Hahnemann  turned  round  upon  the  enemies  who  had  been 
baiting  him  for  many  long  years,  and  gave  them  back  some  of 
the  bitter  words  with  which  they  had  pelted  him.  No  one,  who 
will  look  through  his  Lesser  WHiingSy  but  must  wonder  at  the 
moderation,  modesty,  and  afibctionate  earnestness  that  pervades 
all  his  writings,  down,  at  all  events,  to  the  year  1816.     And 

vet  it  should  be  remembered,  that  ever  since  1799  he  had  been 

It  ' 

an  object  of  the  most  relentless  persecution  by  those  whom  he 
sought  to  instruct ;  a  persecution  to  which  there  could  be  no 
parallel  now-a-days,  for  he  was  literally  hunted  from  town  to 
town,  his  practice  destroyed,  and  himself  subjected  to  the  most 
vexatious  legal  prosecutions,  carried  on  with  a  vindictiveness 
and  constancy  that  would  have  worn  out  the  temper  and  broken 
the  spirit  of  a  less  noble  nature.  The  very  bitterest  things  he 
wrote  in  his  declining  years  are  but  good-humoured  banter 
compared  with  the  vile  calumnies,  and  mendacious  accusations 
of  his  opponents. 

What  Dr.  Sharp's  object  can  be  in  thus  misrepresenting  the 
great  and  good  old  man,  we  are  at  a  loss  to  conceive,  unless  it 
be  to  induce  others  to  believe  that  he  is  noways  indebted  to 
Hahnemann  for  the  method  of  practice  he  pursues,  and  that  he 
has  invented  something  infinitely  superior  to  anything  Hahne- 
mann promulgated.  That  something  like  this  is  the  case  is 
pretty  clear,  from  several  passages.     Thus,  at  page  88,  he  says. 


Answers  to  Sir  B.  Brodie.  105 

"ihe  new  tfeatmeDt,  as  taught  by  me,  is  a  doctrine  of  specifics/' 
The  Materia  Medica  of  HahnemaDn,  which  we  have  always 
hitherto  regarded  as  the  finest  monument  of  patient  industry, 
directed  by  genius^  that  the  history  of  medicine  gives  ns  any 
record  of,  is,  it  appears,  shortly  to  be  superseded  by  something 
infinitely  better,  and  this  is  his  own  Materia  Medica,  the  pre- 
tensioiis  of  which  we  have  already  considered. 

Bat  a  reconstruction  of  the  Materia  Medica  is  not  the  only 
achievement  in  regard  to  homoeopathy  Dr.  Sharp  plumes  him- 
self on ;  be  claims,  also,  to  have  discovered  a  posological  law. 
"I  have/*  he  says  (page  144),  "for  the  first  time,  suggested  a 
law  for  the  selection  of  the  dose."  If  by  this  Dr.  Sharp  meana 
that  he  is  the  first  that  has  suggested  such  a  law,  we  can  only 
say  that  he  is  mistaken ;  many  homoeopathic  writers  before  him 
have  suggested  laws  for  the  dose,  as  any  one  familiar  with 
homoeopathic  literature  must  know.  Among  these  we  need 
only  recal  the  names  of  Ran,  Stapf,  Watzke,  Trinks,  Attomyr, 
Hering  (whose  rule  for  the  dose  has  lately  been  revived  by  Dr. 
Hale,  of  America,  and  Dr.  Madden),  Black,  Eoch,  Stens, 
Mure,  Cruxent,  and  Scott. 

Dr.  Sharp  thus  formulizes  his  law  for  the  selection  of  the 
dose  (page  110): — 

"  Different  doses  of  the  same  drug,  given  in  health,  select 
different  organs  on  which  to  act  injuriously. 

"  Corresponding,  but  smaller,  doses  of  the  same  drug  are  to 
be  given  as  remedies  in  the  diseases  of  the  organs  which  they 
select." 

This  differs  Uttle  from  the  rule  laid  down  by  Hering  (N, 
Arch.  I.  8,  161),  only  the  latter  expressed  his  rule  in  different, 
and,  we  think,  more  correct  terms.  He  said,  in  effect,  "Different 
doses  of  the  same  drug,  given  in  health,  cause  different  symp- 
toms. Corresponding,  but  smaller,  doses  of  the  same  drug  are 
to  be  given  as  remedies,  according  to  the  symptoms  they 
produce." 

Not  only  is  this  rule  not  new,  but  we  have  before  expressed 
our  opinion  about  it,  and  it  has  been,  at  different  times,  enter- 
tained and  abandoned  on  the  same  grounds  by  many.  These 
are,  that  granting  it  has  a  qualified  value,  yet  it  can  have  no 


106  Reviews. 

practical  existence  till  we  have  first  ascertained  what  are 
large  and  what  small  hofnceopatbic  doses,  for  fractions  serve 
equally  for  big  and  little  doses,  jnst  as  the  big  hole  in  the 
bam  door  serves  for  the  hen  and  the  chicken.  Some,  for 
example,  call  30  small  and  6  large,  while  others  call  6  small 
and  1  large.  In  that  case.  No.  6  would  be  small  to  one  set  and 
large  to  the  other.  Besides,  the  role  is,  unfortunately,  by  no 
means  true  universally,  even  in  the  sense  intended.  To  give 
an  example^  we  know  that  corrosive  sublimate  never  excites 
dysentery,  except  in  large  poisonous  doses ;  while,  on  the  other 
hand,  it  is  so  completely  homceopathic  to  that  disease,  that  it 
cures  even  in  high  dilutions. 

But  we  altogether  deny  the  correctness  of  Dr.  Sharp's  pie- 
miss — viz.,  that  different  doses  of  the  same  drug  select  different 
organs;  in  fact,  to  assert  that  would  he  to  deny  the  spedfidty 
of  medicinal  action,  or  make  this  specificity  vary  with  every 
dose.  We  all  admit  the  twofold  action  of  many  drugs,  which,  in 
large  doses,  may  excite  purely  irritant,  mechanical,  or  chemical 
action  in  the  prim»  viee;  but  our  doctrine  of  specifics  is  founded 
on  the  belief  that  where  these  drugs  are  given  in  doses  small 
enough  to  avoid  such  irritant,  mechanical,  or  chemical  action, 
they  act  specifically  on  certain  organs,  the  varying  symptoms 
caused  by  various  doses  depending  on  the  different  degree 
such  organs  are  acted  on  by  these  doses.  Even  were  Dr.  Sharp's 
idea  as  true  as  we  believe  it  to  be  the  reverse,  we  do  not  see 
how  we  could  avail  ourselves  of  the  rule  in  practice,  without 
an  almost  entire  reconstruction  of  the  Materia  Medica,  for,  with 
respect  to  most  of  our  drugs,  we  know  nothing  about  the  doses 
in  which  they  were  proved.  And  we  may  observe,  incidentally, 
that  the  reconstruction  needed  would  have  to  be  very  different 
from  the  specimen  Materia  Medica  given  by  Dr.  Sharp. 

One  other  matter  in  Dr.  Sharp's  Letter  we  shall  allude  to. 
The  following  is  the  mode  in  which  he  thinks  it  becoming  to 
address  an  allopathic  colleague  who  may  be  disposed  to  meet 
him  in  attendance  on  a  patient.  '*  I  am  always  frank ;  I  say  to 
my  medical  brother  when  he  arrives, '  I  am  glad  to  see  you ;  J 
hope  we  shall  agree  in  our  diagnosis  and  views  as  to  the  general 
management  of  the  case ;  and,  with  regard  to  the  drugs  which 


Inmans  New  Theory,  dtc.  107 

may  be  required,  I  shall  explain  to  yon  what  I  wish  to  prescribe; 

yon  will  then  have  an  excellent  opportunity  of  witnessing  and 

watching  the  results  of  homoeopathic  treatment,  without  the 

respoDsibility  of  a  first  trial  made  by  yourself.     I  have  nothing 

to  conceal,  and  you  have  only  to  act  honourably,  of  course 

WMihing  no  attempt  to  undermine  the  confidence  of  the  patient 

or  his  friends  during  my  absence.'"    We  cannot  understand 

what  manner  of  men  Dr.  Sharp  is  in  the  habit  of  meeting,  who 

would  stand  language  similar  to  what  we  have  italicized  in  this 

speech ;  but  we  are  happy  to  think  that  we  are  not  acquainted 

with  any  medical  man  so  far  sunk  in  allopathy  as  to  submit  for 

one  moment  to  the  insinuation  it  conveys.    We  should  like  to 

possess  a  photograph  of  the  expression  on  the  countenance  of 

any  gentleman  of  spirit  and  honour  when  thus  addressed  by 

Dr.  Sharp. 

We  have  felt  it  our  duty  to  animadvert  severely  upon  Dr. 
Sharp  s  Letter,  all  the  more  that  Dr.  Sharp  is  regarded  by  many 
as  an  authority  in  homoeopathy.  It  is  of  the  utmost  moment, 
therefore,  that  we  should  protest  energetically  against  the  errors, 
mis-statements,  and  blemishes  contained  in  what  is  put  forth  as 
a  vindication  of  homoeopathy  by  its  champion  against  the 
attacks  of  the  head  of  the  opposite  school. 

Though  none  of  the  pamphlets  in  reply  to  Sir  Benjamin 
Brodie  are  altogether  such  as  we  could  have  wished,  still  we 
have  no  hesitation  in  saying  that  Dr.  Sharp's  is  the  very  worst 
of  the  whole.  For  while  the  others  are  deficient  in  vigour,  they 
are  perfectly  innocuous,  whereas.  Dr.  Sharp's  is  positively  a 
pernicious  misrepresentation  of  Hahnemann  and  homoeopathy, 
calculated  to  give  a  totally  erroneous  impression  of  what  our 
system  is,  and  more  fitted  to  inspire  the  reader  with  contempt 
than  respect  for  the  therapeutic  system  it  professes  to  defend. 

Foundation  for  a  New  Theory  atid  Practice  of  Medicine. 

By    Thomas    Inman,    M.D.,    London.     John    Churchill, 

1861. 
Sir  John  Forbes'  memorable  article,  ''Homoeopathy,  Allo- 
pathy, and  Young  Physic,"  undoubtedly  marks  an  epoch  in  the 
history  of  medicine  in  Great  Britain.    Since  the  time  of  its 


108  Seviews. 

publication  the  old  dogmatic  doctrines  and  the  accredited  ortho- 
dox practices  have  fallen  rapidly  into  disrepute,  both  ¥rith  the 
profession  and  among  the  general  pablic,  and  their  nltimate 
dissolation  promises  to  be  more  speedy  and  more  thorough  than 
could  have  been  anticipated.  No  unprejudiced  person  can  doabt 
that  this  overturn  is  attributable  to  the  discussions  which  have 
arisen  out  of  the  subject  of  homoeopathy.     Not  indeed   that 
that  system  has  been  making  such  rapid  strides  in  gaining 
converts  to  its  positive  tenets ;  but  it  has  shown  that  diseases 
are  more  certainly  and  more  speedily  cured  without  the  violent 
and  perturbative  measures  hitherto  in  vogue,  and  hence  that 
these  are  not  necessary.     The  means  employed  by  homoeo- 
pathists  being  regarded  by  others  of  the  profession  as  altogether 
nugatory,  the  results  of  that  practice  can  only  be  referred  by 
them  to  the  recuperative  powers  inherent  in  the  organism.  This 
has  led  to  a  decreasing  faith  in  the  powers  of  the  medical  art 
and  an  increasing  faith  in  the  restorative  powers  of  nature. 
The  results   of  direct   experiments  in   treating  severe  acute 
diseases  by  simple  nursing,  and  abstaining  entirely  from  active 
interference  by   drugs  or  depletion,  have  tended  greatly  to 
strengthen  this  growing  faith  and  confirm  the  distrust.     Now 
the  great  authorities  when  appealed  to,  as  witness  Sir  B.  Brodie's 
recent   letter,   speak   coolly,  as  if  they   all   along  knew   the 
expectant  method  to  be  the  best  and  wisest  in  practice,  and 
this  we  know  is  always  the  last  stage  of  a  discussion.     Even 
the  ordinary  practitioner  begins  to  discredit  his  ancient  weapons, 
and  the  peculiar  virtue  of  the  metropolitan  physician,  which 
leads  the  public  to  esteem  him  more  than  his  provincial  brethren, 
is  the  well  known  repugnance  of  the  former  to  active  treatment 
The  lancet  and  the  mercurial  are  fast  falling  into  disuse,  and 
with  the  other  heroic  arms  of  former  times,  will  soon  be  hung 
up  for  monuments.     Medical  scepticism  is  openly  taught  from 
our  chairs  of  clinical  medicine,  and  from  the  seat  whence  Dr. 
Henderson  was  deposed  for  his  revolutionary  tendencies.  Dr. 
Bennett  now  utters  such  sentiments  as  these : — *'  At  this  time 
medicine  is  undergoing  a  great  revolution,  and  to  you,  gentle* 
men,  to  the  rising  generation,  do  we  look  as  to  the  agents  who 
will  accomplish  it.     Amidst  the  wreck  of  ancient  systems  and 


InmauB  New  Theory^  dtc,  109 

tbe  approaching  downfall  of  empirical  practice,  yon  will,  I  trust, 
adhere  to  that  plan  of  medical  education  which  is  hased  on 
anatomy  and  physiology.  Everything  promises  that  before 
long  a  law  of  true  harmony  will  he  formed  out  of  the  discordant 
materials  which  surround  us;  and  if  we^  your  predecessors, 
have  failed,  to  youy  I  trust,  will  belong  the  honour  of  building 
up  a  system  of  medicine,  which,  irom  its  consistency,  simplicity, 
and  truth,  may,  at  the  same  time,  attract  the  confidence  of  the 
public,  and  command  the  respect  of  the  scientific  world." 

Nothing  could  show  more  forcibly  how  utterly  untenable  the 
old  fabric  has  become,  than  to  see  the  best  men  forsaking  it 
and  preferring  to  wander  in  the  desert  of  negation  till  they  have 
discoYered  a  new  foundation  for  their  faith.  Dr.  Bennett,  in  the 
passage  above  quoted,  points  to  anatomy  and  physiology  as 
most  likely  to  afford  such  a  foundation.  Dr.  Forbes  expected 
it  to  lie  in  the  study  of  the  natural  history  of  diseases,  and 
recommended  his  disciples  to  watch  the  progress  and  termina- 
tion of  their  patients'  sufferings  without  disturbing  their  obser- 
vations by  any  direct  medical  interference.  Whether  it  has 
been  found  impossible  to  exact  the  requisite  amount  of  self- 
denial  from  suffering  humanity,  or  whether  the  natural  instincts 
of  benevolence  revolted  at  this  *  philosophic  contemplation  of 
disease  and  death,'  we  know  not ;  but  already  we  are  presented 
by  Dr.  Inman  with  the  '^  Foundation  for  a  New  Theory  and 
Practice  gf  Medicine." 

Dr.  Inman  is  of  the  old  school  of  deductive  philosophers.  His 
views  are  the  production  of  an  original  and  clear  mind,  influ- 
enced by  the  myriad  observations  of  a  lifetime  of  experience 
rather  than  the  results  of  analysis  and  inductive  reasoning.  He 
uses  mainly  an  instrument  greatly  gone  out  of  fashion  among  us 
for  many  years — ^namely,  the  discerning  eye  of  the  cultivated 
intellect,  and  he  submits  to  its  scrutiny  an  equally  neglected 
object — namely,  the  living  body  viewed  as  a  concrete  whole. 
For  the  last  quarter  of  a  century  we  have  ceased  to  hear  the 
old  controversies  among  men  who  strove  to  grapple  with  the 
subject  of  the  entire  living  organism  in  health  and  disease; 
and  we  must  say,  that  to  witness  again  some  of  the  ancient 
sympathetic  gprasp  and  deductive  acuteness  is  refreshing. 


no  Reviews, 

Dr.  Intnan  clears  the  ground  by  insistiDg  upon  an  axiomatic 
truth  or  truism,  that  "  to  cure  disease  we  must  endeavour  to 
restore  the  patient  to  health  ;*'  or,  "  that  endeavours  must  be 
made  to  cure  disease  by  restoring  health ;  and  not  to  restore 
health  by  curing  disease."    Truism  as  this  appears  at  first  sight 
to  be,  it][will  bear  much  thinking  over ;  andjthe  practical  differ- 
ence between  the   two  modes  of  procedure  we  know    to   be 
immense.    There  is  no  doubt  that  the  converse  of  this  is  the 
rule  generally  adopted  in  practice  hitherto,  and  "  Died  Cured  " 
has  been  the  not  unfrequent  *'  result."   Dr.  Inman's  rule  necessi- 
tates the  watchful  observance  of  the  state  of  the  general  powers  of 
life,  which  all  practical  men  know  affords  much  more  importJaot 
indications  than  those  deduced  from  the  state  of  the  local  lesion. 
The  prevalent  metaphorical  language  of  the  schoolSi  which 
speaks  of  medicines  as  "  weapons,"  and  ''  powerful  remedies  " 
as  those  whose  onslaught  upon  disease  is  as  energetic  as  that  of 
disease  upon  the  body,  has  led  to  the  mistaken  idea  common 
alike  to  the  mass  of  the  profession  and  to  the  public,  that 
disease  is  an  entity  which  must  be  driven  out  of  the  suffering 
body.     This  great  error  is  the  parent  of  the  crude  and  destmo- 
tive  practices  which  have  brought  the  art  of  medicine  into  dis- 
repute, and  the  recognition  of  the  converse  principle  would  of 
itself  be  a  great  gain  in  the  right  direction.     When  medicines 
are  regarded  as  adjuvants,  not  as  independent  powers,  a  much 
higher  estimate  of  their  value  and  capabilities  will  be  /ormed. 

Dr.  Inman  is  a  vitalist.  He  maintains  the  existence  of  a 
vital  force  momentarily  causing,  directing,  and  sustaining  the 
phenomena  of  organization  and  function.  Indeed,  this  view  is 
necessary  to  his  theory  that  all  disease  depends  on  deterioration^ 
and  all  disordered  function  originates  in  debility  of  the  causal 
vital  force.  He  evidently  regards  the  force  of  life  as  apre- 
Ming  unity ^  liable  to  be  exhausted  in  the  general  or  enfeebled 
in  some  particular  direction,  and  thus  occasioning  the  pheno- 
mena of  general  and  local  disease.  This,  we  believe,  is  the 
mistaken  premiss  which  leads  to  the  erroneous  deductions  which 
we  will  by  and  bye  point  out.  Dr.  Inman  maintains  his  doc* 
trine  of  the  concrete  existence  of  a  vital  force  in  opposition  to 
the  view  most  in  fashion  among  physiologists  at  the  present 


Ifimans  New  Theory^  Ac.  1 1 1 

day,  which  regards  life  as  the  dynamical  condition  of  the 
organianiy  as  the  sum  total  of  all  the  activities  of  all  the  forces 
at  work,  and  which  holds  that  there  is  no  such  thing  as  a  vital 
force  independent  of  and  governing  the  sam  of  the  material 
conditions  present  in  the  organism.  In  the  region  of  physics 
we  certainly  find  it  convenient  and  more  like  the  tnith  to  con- 
cdve  and  speak  of  "  force "  as  something  not  identical  with 
"  matt^."  Some  prefer  to  call  it  the  "  dynamical  condition/' 
and  others  speak  of  it  as  the  various  "attributes  of  matter;*' 
bat  when  the  quantity  of  matter  is  fixed,  and  the  increments  of 
dynamical  condition  vary,  it  is,  to  say  the  least  of  it,  a  much 
more  apprehensible  idea  to  conceive  these  increments  of  power 
as  due  to  the  presence  of  a  varied  quantity  of  anoth^  concrete 
something  which  we  call  force.  We  are  certainly  in  the  habit 
of  catting  the  knot  in  our  physical  investigations,  and  using  the 
term  force  as  applied  to  momentum,  heat,  light,  magnetism, 
and  electricity,  and  with  great  practical  advantage  and  no  disad- 
vantage that  we  know  of.  But  if  a  student  of  physios  should 
attempt  to  resuscitate  the  Platonic  notion  of  a  concrete  univer* 
sal  inorganic  force,  even  with  the  knowledge  afforded  by  recent 
observations,  that  all  the  physical  forces  are  correlated  and 
mutaally  interchangeable,  we  would  condemn  the  idea  as  alto- 
gether hypothetica],  unnecessary,  and  confusing.  The  same  rule, 
it  appears  to  us,  should  apply  to  our  conceptions  and  language 
in  discussing  the  dynamical  phenomena  of  organic  life.  Organic 
affinities  and  cell  growth,  muscular  irritability,  neurility,  sensa- 
tion, perception,  and  will,  may  equally  be  regarded  as  correla- 
tives of  the  physical  forces.  The  forces  which  actuate,  as.  well 
as  the  matter  which  constitutes,  the  living  organism,  are  deriv^ 
ah  extra.  Force,  no  more  than  matter,  can  be  self-created. 
Our  food  contains  the  forces  which  uphold  its  constitution  as 
proper  aliment.  May  not  heat  which,  in  water  at  212^  changes 
into  repulsive  force,  in  the  human  body  at  96^  change  into 
some  different  expression  of  force  ?  May  not  motion  equally 
be  modified  under  the  peculiar  conditions  of  organic  matter, 
and  be  changed  into  iritability,  neurility,  or  will  ?  Dght  may 
become  sensation,  perception,  or  intelligence.  Of  these  changes 
we  as  yet  know  nothing.    But  these  organic  expressions  of 


112  Reviews. 

force  must  be  studied,  each  in  its  speciality  as  they  actually 
present  themselves.  Any  attempt  to  lump  tliem  all  into  one, 
as  the  various  phenomena  of  one  fundamental,  vital,  or  organic 
principle,  is  as  reprehensible  as  the  Platonic  idea  of  an  essential 
physical  fbrce  which  in  physics  we  repudiate. 

The  value  of  this  distinction  will  be  appreciated  when  \re 
come  to  examine  the  rationale  of  Dr.  Inman's  treatment   of 
disease.     Admitting  his  hypothesis  that  disease  depends  upon 
the  deterioration  or  debility  of  organic  force  in  some  particular 
direction,  we  must,  on  the  above  grounds,  demur  to  his  propo- 
sition that  any  general  stimulant  of  the  vital  powers  will  answer 
the  purpose  of  sustaining  the  particular  dynamic  condition 
which  is  at  fault.     When,  in  dealing  with  the  inorganic  forces, 
we  want  to  evoke  some  particular  form  of  force,  say  heat,  we 
must  use  the  means  which  experience  demonstrates  as  capable 
of  exciting  that  particular  force.     When  we  want  to  produce 
light,  magnetism,  or  electricity,  we  must  adopt  the  measures 
suited  to  the  peculiar  case.    A  mechanic  who  wants  the  repul- 
sive force  of  water  at  21 2°  must  employ  the  particular  forms  of 
matter  under  the  particular  conditions  which  experience  has 
demonstrated  as  those  which  will  lead  to  the  evolution  of  heat. 
To  employ  any  force-producing  combinations  of  matter  which 
should  be  most  at  hand,  will  not  suit  his  purpose,  unless  the 
educed  force  be  the  one  he  wants  in  the  particular  case.     So  to 
stimulate  or  increase  any  particular  organic  force,  we  must 
apply  an  agent  which  experiment  on  the  healthy  body  has  shown 
to  possess  the  property  of  exciting  the  particular  force  in  ques- 
tion.    This  idea  of  the  adequateness  of  general  stimulants 
constituted  the  fundamental  mistake  of  the  Brunonian  system, 
and  it  reappears  in  all  its  fulness  in  that  of  Dr.  Inman. 

Here  the  copiousness  of  the  resources  of  the  homoeopathic 
system  presents  itself  in  wonderful  contrast  to  the  meagreness 
of  the  other  two.  As  is  well  shown  by  Dr.  Fletcher  in  his 
Elements  of  Pathology,  Hahnemann's  experiments  with  drugs 
on  the  healthy  body  supply  us  with  a  special  stimulant  for 
each  special,  organic,  or  functional  derangement.  Hahnemann's 
theoretic  notion  of  the  modus  operandi  of  his  medicines  was 
perhaps  wrong ;  but  his  practical  rules  were  the  very  ideal  of 


Innians  New  Theory ^  dec,  113 

viiat  the  reqairements  of  the  medical  art  demand.  It  remains 
fi>r  his  followers  to  place  his  system  on  its  true  theoretic  basis. 
that  it  may  '*  command  the  respect  of  the  scientific  world  and 
attract  the  confidence  of  the  public ;"  and  in  doing  so  their  art 
will  acquire  that  clearness  and  precision  which  a  true  science 
always  reflects  upon  its  corresponding  art. 

Grateful  for  the  instruction  which  we  have  received  from  a 
perasal  of  Dr.  Inman  s  book,  we  would  respectfully  invite  him 
to  study  farther  Dr.  Fletcher,  who,  it  appears  to  us,  has  gone 
over  the  same  ground  which  he  has  travelled,  and  beyond  that 
has  cleared  a  path  on  which  he  may  proceed  much  further  with 
great  satisfaction  and  advantage. 

We  are  glad  to  find  that  Dr.  Inman,  while  he  entertains  the 
highest  estimate  of  the  recuperative  powers  of  the  diseased 
organism,  repudiates  the  notion  of  a  vis  medicatrix  naturse.  The 
conservative  and  the  reparative  powers  he  holds  to  be  identical 
with  the  normal  organising  forces  of  life.  He  thus  discards  the 
doctrine  of  eliminations,  and  draws  a  very  clear  distinction 
between  that  word  and  emanation,  or  evolution,  which  be  con- 
siders the  proper  term  for  the  phenomenon.  The  latter  implies 
the  simple  fact  of  a  poison,  or  miasm,  passing  off  by  the 
ordinary  process  of  excretion  of  effete  materials,  and  involves 
DO  theory.  The  former  implies  not  only  that  a  poison  is  pass* 
ing  off  from  the  body,  but  that  it  is  doing  so  in  consequence  of 
a  definite  process,  vhich  is  set  up  by  some  vis  medicatrix,  with 
the  distinct  intention  of  diminishing  the  quantity  remaining 
behind.  By  a  most  extraordinary  misconception  of  the  subject, 
for  which  we  are  at  a  loss  to  account,  Dr.  Inman  stigmatises 
the  homoeopathic  method  of  treatment  as  one  based  on  the 
doctrine  of  elimination.  Where  can  Dr.  Inman  have  got  the 
idea  that  bomoeopathists  use  "  diaphoretics  in  rheumatism, 
aperients  in  cholera  and  diarrhcea,  and  rubefacients  in  measles 
and  irregular  gout?"  After  ably  discussing  and  discarding  the 
elimination  theory,  he  "  concludes  that  the  homoeopathic  treat- 
ment of  the  diseases  of  a  poison  origin,  is  radically  wrong  both 
in  principle  and  detail ;  he  believes  that  acute  rheumatism  is 
not  to  be  alleviated  by  increasing  the  perspiration,  nor  gout  in 
one  foot  to  be  improved  by  inflaming  a  second  toe ;  diabetes 

VOL.   XX.,    NO.    LXXTX. — JANUARY    1862.  H 


114  Reviews, 

insipidus  is  not  to  be  cured  by  diuretics,  diarrhoea  or  dysentery 
by  purgatives,  nor  vomiting  by  emetics ;  nor,  if  urea  produces 
irritation  of  the  bowels  and  purging,  does  he  consider  it  ought 
to  be  encouraged  by  the  use  of  aperients ! "     Can  Dr.  Inman 
ever  have  given  the  doctrines  of  homoeopathy  the  smallest  study 
or  even  looked  into  any  of  the  works  on  the  subject?     We 
really  do  not  believe  that  he  has.  At  one  time  it  is  the  "  vulne- 
rary powder"  of  medicine ;  again  he  sees  in  it  only  a  sly  placebo 
to  assist  the  hope  and  faith  of  the  patient  while  nature  works 
the  cure;  or,  again,  it  is  condemned  as  the  very  embodiment  of 
the  pernicious  practice  of  elimination  !     In   the  concluding 
summary  at  the  end  of  the  book  we  find  the  following  catego- 
rical objections  to  the  homoeopathic  system  : — 

1st.  Because  it  ignores  the  principle  of  life  as  the  chief  power 
in  the  body. 

2nd.  Because  it  attributes  powers  to  substances  and  to  quan- 
tities which  are  absolutely  inert. 

drd.  Because  it  excludes  "systematically"  from  its  arsenals 
agents  of  known  power  in  restoring  power  to  the  constitution. 

4th.  Because  it  attributes  to  an  irrational  cause  effects  which 
must  be  attributed  to  a  rational  one. 

In  giving  a  categorical  answer  to  these  objections,  we  must 
repeat  that  we  are  astounded  to  find  a  gentleman  of  Dr.  Inman's 
integrity  discussing  the  demerits  of  a  system  of  which  he  can 
never  have  seen  the  fundamental  literature.  Had  he  once 
opened  the  pages  of  Hahnemann's  Organon,  he  could  never 
have  failed  to  apprehend  the  import  of  such  a  passage  as  this : 
(§  ix.)  ''  In  the  healthy  condition  of  man,  the  spiritual  vital 
force,  the  dynamis  that  animates  the  material  body  (organism) 
rules  with  unbounded  sway,  and  retains  all  the  parts  of  the 
organism  in  admirable,  harmonious  vital  operation."  Or,  again, 
(§  X.)  the  "  material  organism,  without  the  vital  force,  is 
capable  of  no  sensation,  no  function,  no  self-preservation;  it 
derives  all  sensation  and  performs  all  the  functions  of  life  solely 
by  means  of  the  immaterial  being  (vital  force)  which  animates 
the  material  organism  in  health  and  disease. "  Again  and  again, 
do  we  find  such  sentences  as  these  (§  xii.)  "  It  is  the  morbidly 
affected  vital  force  alone  that  produces  disease,"  (§  xi.)  "  When 


Inmans  New  Theory,  <tc.  115 

m  person  tells  ill,  it  is  only  this  spiritual,  self-  acting  (autotnatic), 
vital  force,  everywhere  present  in  the  organism,  that  is  primarily 
deranged  by  the  dynamic  influence  upon  it  of  a  morbific  agent 
inimical  to  life."  Indeed^  so  preposterous  to  us,  as  the  disciples 
of  Hahnemann,  seems  the  assertion  that  he  ignored  the  prin- 
ciple of  life  as  the  chief  power  in  the  body,  that  we  can  only 
answer  by  directing  Dr.  Inman  to  his  book. 

With  regard  to  the  second  objection,  we  must  protest  against 
the  petitio  principii  on  which  it  rests.  We  quote  Dr.  Inman  s 
words  (p.  484).  "  Where  specifics  are  employed,  there  is  no 
general  role  by  which  the  amount  of  the  dose  can  be  regulated. 
Each  stands  on  its  own  merits,  and  careful  empiricism  alone 
can  teach  the  requisite  quantity;"  and  (p.  345),  "they  should 
rarely,  if  ever,  be  used  in  doses  sufficient  to  make  a  sound  man 
ill."  Sorely,  holding  these  views,  it  would  be  more  becoming  of 
Dr.  Inman  to  abstain  from  passing  an  a  priori  judgment  on  the 
action  of  the  infinitessimal  doses. 

With  regard  to  the  third  objection,  we  are  not  informed  as  to 
the  names  of  the  powerful  agents  systematically  rejected  by 
homceopathy.  If  Dr.  Inman  means  God- liver  oil  and  Glyce- 
rine, of  which  he  entertains  so  exalted  an  opinion,  we  can,  we 
think,  take  it  upon  ourselves  to  say  that  homosopathists  have 
no  objection  to  the  use  of  any  dietetic  or  hygienic  adjuvants  to 
their  treatment 

We  are  not  very  sure  that  we  comprehend  the  fourth  objec- 
tion. Does  Dr.  Inman  mean  that  it  is  irrational  to  consider 
the  restoration  to  health,  consequent  on  the  exhibition  of  a 
homoeopathic  medicine,  as  the  efiect  of  the  action  of  the  medi- 
cine, because,  in  his  estimation,  the  only  rational  cause  of 
restored  health  is  the  reparative  vital  force  ?  We  fear  we  must 
give  this  enigma  up,  as  Dr.  Inman  does  not  otherwise  appear 
to  ns  BO  alarmingly  egotistical  as  this  interpretation  of  it  would 
imply. 

In  his  preface,  Dr.  Inman  repels  the  aspersion  that  he  has 
any  sympathy  with  the  doctrines  of  Hahnemann ;  we  consci- 
entiously believe  him,  since  he  does  not  seem  to  have  the  most 
remote  notion  of  what  they  really  are.  But  this  we  can  tell 
him,  and  all  who  are  of  bis  way  of  thinking,  and  who  may  be 

H  2 


116  Reviews. 


similarly  uninformed  in  this  respect,  that  the  sooner  they  devote 
some  attention  to  them,  the  sooner  they  will  find  the  true 
"  Foundation  of  the  Theory  and  Art  of  Medicine." 


The  Science  and  Art,  or  the  Principles  and  Practice  of 
Medicine.  Vol.  I.,  Parts  I  to  4,  hy  Dr.  Peters  ;  Part  5,  by 
Drs.  Peters  and  Snellino.     Badde,  New  York. 

It  has  all  along  been  felt  that  the  progress  of  homceopatby 
was  retarded  not  only  by  the  incompleteness  of  the  resources 
at  our  command  as  homoeopathists,  but  also  from  the  difficulty 
of  access  to  these  resources.  Not  long  ago  almost  no  one 
could  attempt  homoeopathy  who  was  not  familiar  with  the 
German  language,  and  then  as  that  was  gradually  remedied  by 
translations,  these  resources  were  so  scattered,  that  the  want  of 
a  standard  collective  manual  of  practice  became  seriously  felt. 
In  supplying  both  these  wants  our  American  brethren  have  been 
foremost,  and  lay  all  English  speaking  lands  under  a  debt  of 
gratitude  to  them.  The  present  work  we  are  glad  to  bring  to 
the  notice  of  our  readers  as  one  calculated  to  supply  the  want 
of  a  compendium  of  homceopathic  practice  so  much  felt  by  the 
busy  practitioner.  The  subject  of  homoeopathic  therapeutics 
systematized  is  a  very  large  one,  and  much  may  be  said  on  it, 
but  it  is  obvious  that  this  ultimate  aim  will  be  attained,  if  we 
can  by  any  plan  place  before  the  readers  a  collection  of  all  that 
is  known  on  the  subject.  The  rest  becomes  a  mere  matter  of 
arrangement.  The  best  may  not  be  found  at  first,  but  if  any 
of  the  plans  generally  understood  and  followed  in  the  ordinary 
works  on  practice  of  physic  is  taken,  and  the  homoeopathic 
experience  up  to  the  day  arranged  according  to  it,  the  main 
purpose  will  be  served.  This  is  in  the  main  what  is  done  in 
the  work  before  us.  We  have  first  an  interesting  summary  of 
the  history  of  medicine,  concluding  with  the  life  and  times  of 
Hahnemann.  This  last,  and  that  of  John  Brown,  are  naturally 
most  interesting,  and  rendered  more  so  by  the  manner  in  which 
Dr.  Peters  continually  keeps  us  in  mind  of  the  relation  they 
bore  to  each  other,  and  to  the  other  notable  men  both  in  and 
out  of  medicine  in  this  epoch,  at  each  stage  of  their  life.     We 


Peters  9  Science  and  Art.  117 

may  express  our  regret  here  that  the  anther  does  not  appear  to 
have  read  Fletcher  b  Physiology  or  Pathology ,  in  spite  of  the 
numerous  opportunities  we  have  taken  to  press  these  works  on 
the  attention  of  horaceopathists^  otherwise  he  would  not  have 
missed^  as  he  has  done,  the  point  of  the  intimate  connection 
between  the  two  great  discoverers.  In  fact,  the  whole  theory 
of  Hahnemann  may  be  termed  nothing  hut  the  corollary  of 
that  of  John  Brown.  For  while  the  Brunonian  doctrine  of  the 
cure  of  indirect  debility  by  stimulants  is  unimpeachable  in  the 
main,  yet  it  fails  in  particular  instances  from  disregard  of  the 
special  character  of  the  stimulus  in  both  causing  and  curing 
the  particular  disease.  Here  Hahnemann  steps  in  and  supplies 
the  "  missing  link,"  and  it  now  becomes  clear  not  only  how  a 
stimulus  can  cure  an  inflammation  that  it  could  cause,  but  also 
why  it  is  that  it  is  not  any  stimulus  but  only  one  of  a  special 
character  that  will  do  so;  and  it  is  not  difficult  to  see  also 
that  the  character  must  be  very  similar  to  that  of  the  stimulus 
which  in  other  circumstances  would  produce  the  inflammation. 
Hence  follows  the  proving  of  medicines  on  the  healthy  body  as 
the  basis  of  our  Materia  Medica. 

The  historical  department  occupies  Fart  I  and  about  a  third 
of  Part  2.  Then  the  author  enters  more  specially  on  the  task 
before  him.  The  plan  now  followed  is,  as  above  said,  pretty 
much  the  ingrafting  of  homceopathic  experience  on  a  selection 
of  the  best  results  of  modem  medicine.  For  instance,  the  1st 
section  treats  of  ''  Medicine  as  a  Science  and  as  an  Art ;  its 
objects  and  extent,"  taken  mainly  from  Aiikens  Handbook  on 
that  subject,  a  work  with  which  we  are  unacquainted,  but  which 
seems  to  be  valuable ;  at  any  rate,  this  section  is  good,  and 
forms  a  good  foundation  to  work  on.  The  2nd  section  is  on 
''  Morbid  Anatomy  and  Pathological  Histology,  and  the  means 
and  instruments  by  which  the  nature  of  diseases  are  [is]  investi- 
gated." This  shows  a  wide  and  well-grounded  acquaintance 
with  the  subject  down  to  the  most  modern  times,  and  begins  to 
touch  on  the  place  occupied,  or  rather  to  be  ultimately  occupied, 
by  homoeopathy  in  general  medicine.  Likewise,  the  true  posi- 
tion of  the  above  departments  of  science  in  practical  medicine 
is  well  set  forth.     At  page  1 33  we  read  : — 


118  Reviews, 

**  We  are  not  to  suppose  that,  because  the  stethoscope  euablea  um 
to  detect  a  mitral  murmur  or  a  crepitation  in  a  lung,  we  are  justified 
at  once  in  adopting  one,  and  only  one,  method  of  treatment  It  is 
this  exclusive  use  of  instruments  to  the  disregard  of  general  symp- 
toms and  the  signs  of  disease,  derived  from  close  observation  and 
knowledge  of  the  living  functions,  which  leads  to  the  repudiation  of 
the  use  of  such  instruments  by  the  sagacious  and  experienced  phy- 
sician, who  sees  the  numerous  errors  committed  by  his  younger 
brethren  trusting  too  exclusively  to  these  instruments  in  the  diag- 
nosis of  disease.  Like  the  stethoscope,  the  microscope  has  been 
unjustly  and  unnecessarily  burdened  with  labour,  and  has  been 
equally  unjustly  blamed  when  it  has  failed  to  elucidate  the  nature  of 
a  morbid  state.  *  *  *  It  is  only  from  the  combined  and  appropricUe  use 
[of  the  various  means  of  physical  diagnosis],  with  the  general  signs 
and  symptoms,  that  our  knowledge  of  the  nature  of  diseases  will  be 
advanced." 

Section  8,  "  A  Review  of  the  late  Reforms  in  Pathology 
and  Therapeutics."  In  this  chapter  a  therapeutic  system  like 
homoBopatby  is,  as  we  naturally  expect,  called  upon  to  vindicate 
Us  true  position  in  medicine.  From  the  antecedents  of  our 
author  Dr.  Peters,  it  receives,  as  we  would  expect,  a  high  and 
dominant  position  in  therapeutics,  but  not  an  exclusive  one. 
Here  we  may  be  permitted  to  make  a  few  remarks.  How  far 
can  we  say  that  any  one  of  our  body  is  able  to  define  what  will 
be  the  ultimate  place  of  homoeopathy  in  the  art  of  medicine  ? 
Is  not  a  certain  amount  of  zeal  and  enthusiasm  needful  for  the 
very  existence  and  early  development  of  a  new  doctrine,  and 
how  far  is  the  idea  of  exclusiveness  and  partizanship  necessary 
to  maintain  that  zeal  ?  Doubtless,  in  the  long  run,  the  practice 
of  medicine,  improved  and  purified  by  homoeopathy,  will  have 
to  be  carried  on  by  the  ordinary  run  of  medical  practitioners 
who  have  neither  zeal  nor  enthusiasm  for  the  particular  doc- 
trine, and  such  men  will  certainly  not  advance  the  art  of 
medicine  through  that  doctrine.  Thus  the  tendency  is  to  be- 
come stationary  on  the  cessation  of  opposition  and  persecution 
of  any  new  truth.  Is  the  time  then  come  for  the  high  and 
abstract  treatment  of  the  part  homoeopathy  is  to  play  ultimately 
in  general  medicine  ?     Hardly  as  yet,  we  think,  in  regard  to 


Peters  8  Science  and  Art,  119 

its    own  development ;    but  the    propriety  of  discussing    the 
sabject  in  an  eclectic  spirit  in  a  practical  work  depends  wholly 
on  the  man.     Dr.  Peters  has  now  for  many  years  given  evidence 
of  love  of  and  faith  in  the  homoeopathic  doctrine  by  his  immense 
and  untiring  labour  in  the  materia  medica  and  other  practical, 
as  well  as  theoretical,  departments.     From  him,  therefore,  we 
can  receive  instruction  in  disquisitions  in  an  eclectic  spirit  with- 
out fear  of  degeneration  into  a  cold  and  lifeless  indifference 
In  an  unknown  man  it  would  be  far  otherwise :  from  him  it 
vrould  be  taken  as  the  impertinent  conceit  of  a  new  fledged 
half  convert  affecting  to  patronize  Hahnemann,  by  allowing  his 
method  a  certain  amount  of  truth  in  some  cases.     The  fact  is, 
strictly  speaking,  we  are  all  eclectics,   and  we  differ  only  in 
degree.     Therefore,  it  is  impossible  to  judge  in  this  matter  with 
any  approach  to  correctness  without  knowing  a  man's  practice 
almost  to  minute  detail,  for  the  same  profession  of  faith  will  of 
course  cover  a  very  wide  difference  of  practice.     Since  the 
subject  of  auxiliaries  was  discussed  some  years  ago,  we  have 
not  been  able  to  And  one  practitioner,  however  loud  his  pro- 
fession of  pure  Hahnemannism  was,  who  did  not  occasionally 
use  other  than  homoeopathic  means  of  cure,  such  as  common 
sense  dictates  in  certain  instances.     To  be  sure  these  are  few 
and  exceptional.    But  when  one  is  writing  a  systematic  treatise 
on  general  medicine^  those  few  exceptional  oases   loom  very 
large,  while  there  is  no  proof  that  the  author  makes  them  a  bit 
less  exceptional  in  his  practice  than  the  so-called  purist  who 
ignores  them  in  his  professions.    So  we  think,  without  alarming 
the  faith  of  the  most  timid,  or  raising  the  ill-omened  cry  of 
heresy,  we  may  follow  Dr.  Peters  in  the  free  discussion  of  the 
subject.     It  is  so  far  pleasant  to  see  that  modern  physiology 
and  pathology,    whatever  they  may  do  for  homoeopathy,  at 
least  entirely  explode  allopathy  as  a  creed ;  and  it  is  remarkable 
that  the  earliest  converts  to  homoeopathy  in  the  old  medical 
schools  were  professors  of  physiology  and  pathology.  In  fact, 
of  the  medley  that  passes  current  as  the  ordinary  practice  of 
medicine,  the  greater  part  of  what  stands  the  test  is  nothing 
but  unconscious  homoeopathy. 

In  Dr.  Peters  8  critical  remarks  on  the  application  of  similia 


120  Reviews. 

similibus,  we  observe,  id  tbe  first  place,  tbnt  tbey  are  all  witliiii 
tbe  field  of  tbe  specifio  action  of  mediciDes*     Tbis  is  already  a 
great  step  as  applied  to  allopathy  as  well  as  bomoeopatby,  and 
involves,  as  a  part  of  general  scientific  medicine,  tbe  proving  of 
medicines  on  tbe  bealtby,  and  tbe  use  of  one  medicine  at  a  time, 
little  as  tbe  mass  of  allopatbs  are  prepared  for  tbat  as  an  estct- 
blidbed  trutb.    Tben,  baving  admitted  tbe  specific  properties  of 
all  drugs,  and  supposing  tbem  proved,  and  tbeir  effects  written 
down  correctly,  bow  are  we  to  use  tbem  ?   Tbat  is  tbe  question  ! 
At  p.  1 55,  we  read  : — 

'*  As  we  may  bave  tbree  or  more  remedies  acting  equally  speci- 
fically upon  a  certain  locality,  and  yet  acting,  tbe  one  similarly,  the 
other  differently,  and  the  third  oppositely  to  the  action  of  a  given 
disease  of  that  locality,  so  we  may  have  three  varieties  of  specific 
treatment — Ist.  The  specific  antipathic  or  specific  antagonistic  treat- 
ment, %.  e,y  the  exhibition  of  such  medicines  or  remedies  as  act  by 
preference  upon  the  locality  of  the  disease,  and  quite  or  nearly  oppo- 
sitely  to  the  action  of  the  disease.     2nd.  Specific  allopathic^  i.e., 
specific  alternative  treatment,  consisting  in  the  use  of  such  remedies 
as  act  by  preference  upon  the  seat  of  the  disease  to  be  cured,  and 
specifically  different  from,  •'.  «.,  neither   exactly  opposite,  nor  yet 
identical  or  similar  to  the  action  of  the  disease.     And  3rd.  Specific 
homceopathic  treatment,  characterized  by  the  use  of  such  medicines 
as  act  by  preference  upon  the  seat  of  the  disease,  and  similar  to,  yet 
somewhat  different  from  the  action  of  the  disease." 

As  an  example  of  specific  antipathic  treatment,  be  cites  tbe 
use  of  Secale  in  atony  of  tbe  uterus,  whereby  life  may  be  saved 
in  tardy  labours  and  uterine  beemorrbages.  "  Hence,*'  sa^^s  Dr. 
P.,  '*  I  agree  with  Rau  tbat  '  antipathic  treatment  should  not 
be  rejected  generally,  as  has  been  done  by  some  vehement 
advocates  of  tbe  homoeopathic  system ;  peaceful,  impartial,  and 
experienced  physicians  will  keep  aloof  from  tbat  blind  zeal 
which  denies  tbat  happy  results  bave  been,  and  will  be  again 
obtained  by  antagonistic  or  antipathic  treatment.' "  Precisely 
so,  we  quite  agree  with  both  in  the  above,  but  tbis  is  nothing 
more  than  what  has  already  been  discussed  by  Britisb  bomoeo- 
patbists  in  tbe  controversy  about  auxiliaries.  It  differs  in  no 
way  from  tbe  use  of  an  occasional  purgative  or  narcotic,  to 


Peters  8  Science  and  Art,  121 

meet  temporary  states  to  which  the  homoeopathic  action  of 
medicines  is  not  applicable.  We  are  obliged  to  use  the  primary 
antipathic  action  of  the  drug,  careless  of  the  subsequent  action, 
because  the  state  to  be  acted  on  is  not  idiopathic,  nor  the  object 
of  ultimate  cure;  we  only  require  to  tide  over  a  temporary  emer- 
gency. But  if  it  were  a  question  of  the  cure  of  chronic  atony 
of  the  uterus,  or  large  intestines,  or  the  capillaries  of  the  brain 
inducing  watchfulness,  we  should  most  certainly  fall  back  upon 
the  proper  homoeopathic  remedies.  As  physicians  who  are 
masters  of  their  art,  we  must  be  so  far  eclectic  as  to  give  our 
patients  the  benefit  of  those  means  wlien  necessary ;  but  we 
require  to  keep  a  strict  watch  on  ourselves  to  avoid  the  tempta- 
tion of  using  them,  to  escape  the  trouble  of  finding  the  homceo- 
pathio  remedy. 

As  regards  the  specific  homoeopathic  treatment,  we  need  not 
dwell  on  that.  But  it  is  in  discussing  the  "  specific  allopathic 
or  specific  alterative"  treatment  that  we  must  enter  more  closely 
into  the  theory  of  the  whole  matter. 

**  This  method,"  says  Dr.  P.,  p.  161,  "  is  oftentimes  more  diffi- 
cult of  application  than  the  antipathic,  for,  though  it  may  suffice  at 
times  merely  to  select  a  remedy  which  acts  specifically  on  the  locality 
of  the  disease,  and  specifically  different  from  the  action  of  the  disease, 
yet  at  other  times,  disease  is  such  a  strange  compound,  or  hybrid 
of  injurious  processes  and  salutary  re-actions,  that  we  are  forced  to 
select  a  remedy,  which  not  only  acts  specifically  upon  the  seat  of  the 
disease,  but  specifically  difierent  from  the  injurious,  and  specifically 
similar  to  the  salutary  tendencies,  or  termination  of  the  disease.  *  * 
The  true  ciurative  indication  (in  pneumonia  for  instance)  is  to  select 
a  remedy  which  acts  differently  from  the  first  or  progressive  stage, 
and  similarly  to  the  second  or  retrograding  and  curative  process. 
As  the  inflammation  is  eminently  plastic,  fibrinous,  and  adhesive  in 
its  nature,  we  should,  according  to  the  specific  alterative  method, 
avoid  medicines  like  the  Nitrate  of  silver,  which  excite  adhesive 
inflammation ;  and  may  select  Tartar  emetic,  which  causes  purulent 
or  supp««tiv;  inflammation,  or  Hydriodate  ;f  potash,  which  excites 
mucous  inflammation,  or  Cantharides,  which  excite  serous  inflamma- 
tion ;  for  nature  cures  pneumonia,  by  substituting  a  serous,  mucous, 
or  purulent  inflammation  in  the  place  of  the  original  plastic  and 


122  BevUwM. 

fibrinous  one.     Finally,  when  the  inflammation  has  subsided  and  « 
mere  blennorrhoea  remains,  the  expectorant  blennorrhceagognes — such 
as  Phosphor.,  Senega,  Sambucus,  &c. — ^which  are  powerless  in   tlie 
first  stage  may  complete  the  cure.  ***  Again,  there  are  numerous 
Yarieties  of  inflammation,  viz.,  the  plastic,   adhedve,  or  so-called 
fibrinous,  the  ulcerative,  the  purulent  or  suppurative,  the  mucous, 
serous,  rheumatic,  erysipelatous,  &c.     Now,  if  ulcerative  inflamma- 
tion were  committing  its  ravages,  this  mode  would  render  it  proper 
and  advisable  to  give  remedies  which  excite  adhesive  inflammation  ; 
if  suppurative  inflammation  were  progp^essing,  we  would  be  required 
to  give  remedies  which  excite   mucous  inflanmiation,  and  this  has 
been  done  successfully.'* 

Here  we  have  an  example  of  the  way  one  beoomes  lost  in 
the  labyrinths  of  therapeutics  when  once  the  clue  of  Ariadne, 
given  us  by  Hahnemann,  is  let  go.     Nearly  all  the  propositions 
here  brought  forward  are  already  familiar  to  homceopathists,  as 
di£Bculties  in  the  proper  application  of  the  homceopathic  law, 
the  degree  of  homoeopathicity  that  will  6u£Sce  for  cures,  and  so 
forth,  but  hitherto  we  have  not  recognised  them  as  a  positive 
method,  nor  admitted  the  existence  of  a  positive  specific  allo- 
pathic or  alterative  method  at  all.     On  the  contrary,  allopathy 
ia  and,  we  think,  ought  to  be  looked  on  as  a  mere  collective 
title  of  all  the  various  modes  of  treatment  not  homoeopathic, 
and  has  no  pretensions  to  a  place  among  the  definite  curative 
modes  of  specifics.     Some  pages  before,  Dr.  P.,  in  treating  of 
this  explanation  of  homoeopathic  action,  says,  that  the  very 
definition    aimilia   aimilibus   implies    some    differences    from 
the  disease,  in  as  much  as  it  must  not  be  identical.     Then 
comes  the  question — How  much  difference  ?    Can  we  not  extend 
the  difference  half  way,  or  further  towards  the  opposite,  or  indeed 
the  whole  way,  so  that  in  reality,  while  the  specific  acts  indeed 
upon  the  part,  may  it  not,  while  curing,  act  antipathically  ? 
And  he  is  very  much  inclined  to  answer  in  the  affirmative.     In 
arguing  the  question,  he  brings  in  Hahnemann's  illustration  of 
the  frozen  limb  being  restored  by  snow,  and  observes  quite 
correctly,  that  the  action  of  the  snow  in  this  case  is  not  by 
applying  cold,  but  simply  a  less  degree  of  heat,  and  is  therefore 
antipathic.      This  illustration  we  have  always  felt  to  be  an 


Peters  8  Scietice  and  Art,  123 

unhappy  one,  and  one  that  gives  rise  to  mnch  misconception. 
Bat  we  do  not  see  how  the  question  can  be  made  clear,  unless 
we  have  some  theory  of  the  real  nature  of  homoeopathic  cures. 
This  appears  to  us  to  be  met  by  none  but  the  adaptation  of  the 
Bninouian  theory  by  Dr.  Fletcher,  already  often  alluded  to  by  us. 
The  explanation  is  this,  viz.,  that  the  primary  action  of  stimuli, 
and  therefore  of  all  specifics,  as  well  as  of  other  positive  agents, 
is  in  reality  twofold ;  and  in  all  organic  diseases,  such  as  inflam- 
mation and  its  congeners,  fevers,  increased  secretion,  &c. — con* 
sists  in,  first,  a  stage  of  excitement,  with  constriction  of  the 
capillary  vessels,  followed  by  indirect  debility  with  dilatation  of 
the  capillaries^  and  increased  secretion  according  to  its  kind. 
When  the  homoeopathic  cure  takes  place,  the  disease  is  in  the 
stage  of  indirect  debility,  and  the  medicine  exerts  upon  it  its 
action,  viz.,  that  of  a  stimulus,  and  thus  the  cure  takes  place  by 
antipathic  action.  But  this  must  not  be  confounded  at  all 
with  that  action  in  the  sense  of  the  allopathists,  for  it  does 
not  refer  with  them  to  this  view  of  the  ultimate  nature  of  the 
action  of  medicine,  but  to  its  broad  meaning  as  primary  and 
secondary  on  the  healthy  body.  It  is  precisely  these  that  Dr. 
Peters  does  confound,  and  hence  his  difficulty.  The  broad 
meaning  of  a  purgative  is  that  it  increases  the  evacuation  in 
its  first  action,  followed  by  a  diminution  afterwards ;  and  if 
used  to  check  increased  evacuations,  that  is  a  homoeopathic  use 
in  its  plain  meaning,  as  regards  the  primary  physiological  action 
of  the  drug,  whether  the  mechanism  of  increased  secretion  be  a 
double  process  or  not.  We  thus  dispose  of  any  argument  from 
difference  as  tending  towards  a  antipathic  theory  of  the  action 
of  specifics,  and  we  reduce  the  question  to  its  old  limits,  viz., 
that  the  more  the  action  of  the  drug  resembles  that  of  the  dis- 
ease-producing cause,  the  more  completely  curative  it  is.  We 
thus  also  bring  all  other  specific  actions  on  the  affected  part  to  an 
inclined  place  of  degrees  of  homoeopathicity,  less  and  less  cura- 
tive till  we  get  to  the  opposite,  or  really  antipathic.  Now,  we  are 
not  disposed  to  admit  the  possibility  of  any  specific  allopathic 
cure  at  all.  In  fact,  we  positively  deny  it ;  and  if  we  do  admit 
the  use  of  antipathic  remedies  for  exceptional  employment  in 
our  practice,  it  is  certainly  not  for  the  specific  cure  of  idio* 


124  Reviews, 

pathic  affections  of  the  part  acted  on,  but  for  different  purposes 
entirely.     By  pursuing  the  argument  we  shall  perceive  that  the 
ingenious  theory  of  the  action  of  alteratives  as  allopathic  in  a 
positive  sense  has  no  real  foundation,  and  alteratives,  in  so  far 
as  they  are  specifically  curative,  are  nothing  more  than  homoeo- 
pathic remedies  in  different  degrees  of  homoeopathicity.     For 
instance,  if  we  are  to  cure  a  plastic  inflammation  of  the  Inn^  by 
exciting  a  suppurative,  mucous,  or  serous  one,  will  Dr.  P.  tell 
us  which  we  are  to  choose  ?  and  will  he  also  have  the  kindness 
to  tell  us  how  we  are  to  bring  about  such  inflammation,  without 
giving  the  enormous  doses  that  are  necessary  to  effect  that  pro- 
cess ;  likewise,  how  are  we  to  get  over  the  uncertainty  of  their 
doing  so,  that  attends  the  action  of  specifics  on  the  healthy  bodj, 
for  we  know  that  it  is  only  in  a  comparatively  small  per-centage 
of  provers  that  the  specific  effects  are  manifested ;  therefore,  will 
he  also  assert  that  in  disease  the  susceptibility  to  the  action  of 
an   allopathic  specific   is  exalted  in  the  same  way  as  for   a 
homoeopathic  one  ?     Then,  supposing  all  these  difficulties  got 
over,  will  he  tell  us  on  what  ground  he  supposes  that  the  super- 
vention of  an  erysipelatous  inflammation  in  any  part  will  cure  a 
plastic  one,  and  will  not  simply  aggravate  it  and  hinder  the 
cure  ?     We  know  of  no  ground,  and  if  the  fact  be  true,  it  is 
still  to  be  demonstrated,  for  we  are  inclined  to  think  the  pre- 
sumption is  the  other  way,  and  we  have  examples  of  dissimilar 
diseases  merely  suspending,  or  even  complicating  each  other, 
and  by  no  means  removing  each  other.     That,  in  fact,  when 
the  latter  effect  takes  place  at  all,  it  is  only  when  they  approach 
to  the  required  degree  of  homceopathicity.     In  fine,  the  real 
fact  of  the  matter  we  apprehend  is  simply  this,  that  the  degree 
of  homceopathicity  that  suffices  for  cure  is  not  accurately  fixed, 
and  as  we  recede  from   complete   homcBopathicity,  a  certain 
margin  is  left  within  which  specifics  given  in  more  massive 
doses   may   still    have   curative    effects.      This   margin  may, 
no   doubt,  contain  the  specifickers  and  Bademacherians  and 
Trousseauist    substitutivists.      But    beyond   that    we    protest 
against   allowing  any  such   method    as   an   allopathic  altera- 
tive one  any  positive  existence  at  all.      We  think  it  is  im- 
perative on  us  to  keep  fast  hold   on  the  great  discovery  of 


Peters  8  Sciet^e  and  Art.  125 

Hahnemann,  viz.,  the  positive  homoeopatbic  law  of  specifics, 
and  beware  of  letting  that  down  and  diluting  and  refining  it 
away  by  giving  it  only  a  place  as  one  of  a  sliding  scale  of 
specific  actions,  all  on  pretty  much  the  same  footing.     No  !  if 
we  are  compelled,  as  a  matter  of  fact,  to  admit  that  there  are 
other  actions  of  medicine  which  we  must  on  exceptional  occa- 
sions make  use  of,  such  as  the  antipathic  or  revulsive,  let  us 
say  so  plainly,  and  not  attempt  to  shade  them  off  into  the  ho- 
mceopatbic.    And  finally,  if  there  are  any  curative  actions  within 
the  limits  of  the  specific  action  of  drugs  on  the  affected  part 
that  we  cannot  as  yet  distinctly  bring  within  the  bomceopathio 
principle,  let  us  acknowledge  the  fact  as  an  empirical  and  as  yet 
unexplained  one,  and  not  prematurely  erect  it  into  a  principle 
to  be  placed  more  or  less  on  a  par  with  a  well  ascertained  one 
of  paramount  importance,  such  as  the  bomceopatbic.     Just  as 
in  chemical   analysis   of  organic   substances,    a  considerable 
per-centage  appears  as  ''  extractive,"  a  provisional  term  which 
the  progress  of  science  will  often  show  to  have  covered  various 
definite  principles  till  then  undiscovered. 

At  page  ]  69  Dr.  Peters  enters,  we  may  say,  on  the  special 
business  of  the  book  by  taking  a  standard  semiotic  list ;  in 
this  case,  Bennett's  examination  of  the  patient,  which  he  there 
comments  on  paragraph  by  paragraph,  giving  the  homoeopathic 
analogies  of  the  symptoms  therein  mentioned,  both  in  their 
physiological  and  clinical  aspects.  This  is  a  very  good  plan, 
and  a  very  useful  chapter  on  it  gives  the  practitioner  at  once  a 
knowledge  of  the  salient  points  of  the  action  of  our  medicines, 
and  gives  a  ready  resource  in  our  minds  for  the  most  prominent 
and  common  symptoms  that  occur  in  disease.  But  it  illustrates 
the  difficulties  of  making  a  homoeopathic  practice  of  physic,  for 
the  author  must  perpetually  descend  into  details  so  completely 
as  to  unite  the  whole  book  in  this  chapter,  or  run  the  risk  of 
inculcating  a  purely  symptomatic  treatment  such  as  the  allo- 
pathic generally  is.  This  is  well  illustrated  by  the  remarks  on 
Yeratrum  viride,  whose  action  in  controlling  the  quickness  of 
the  pulse  has  lately  become  known,  and  is  extensively  used  by 
allopaths  for  that  purpose  in  inflammations.  Dr.  P.  properly 
eautions  the  homoeopathic  practitioner  against  trusting  to  it 


126  Revi'eus, 

without  considenDg  "  it  may  not  be  the  true  specific  remedy 
against  true  plastic  inflammation,  but  merely  against  vascular 
irritation,  congestion  and  activity/'  On  the  whole  this  is  an 
excellent  chapter.  At  section  6  he  enters  on  the  special  treat- 
ment of  disease,  and  commences  with  choosing  a  system  of 
classification.  He  adopts  Dr.  Farr's,  which  is  likely  to  become 
general  and  international. 

Our  limits  prevent  us  continuing  our  remarks  on  this  interest- 
ing work  at  present,  but  we  hope  to  recur  to  it  on  a  future 
occasion. 


Remarks  ofi  the  Narrow  LimiU  of  so-called  Rational  Medi- 
cine.   By  J.  Stevenson  Bushnan,  M.D.,  &c.  &c.    London  : 
Churchill.     1861. 
Dr.  Boshnan  is  known  to  homoeopathists  as  the  writer  of  an 
elaborate  work  adverse  to  the  homoeopathic  system,  which,  un- 
like the  generality  of  our  opponents,  he  took  the  trouble  to 
study  in  the  writings  of  Hahnemann  and  some  of  his  disciples.^ 
We   gave  him  credit  for  his  studies  while   objecting  to  the 
mode  he  adopted  of  criticising  the  homoeopathic  system,  which 
he  condemned  because  he  found  certain  weak  points  in  Hahne- 
mann's writings  that  could  not  stand  the  test  of  a  severe  logic. 
We  noticed  with  approbation  that  Dr.  Bushnan  with  a  certain 
degree  of  candour  admitted  the  homoeopathic  principle  to  a 
certain  extent,  and  we  expressed  our  opinion  that  his  real  esti- 
mate of  our  system  was  more  favourable  than  appeared  in  his 
work.    Whether  we  were  right  in  this  supposition  or  not  we  have 
no  means  of  knowing,  but  since  his  great  work  against  homoeo- 
pathy, Dr.  Bushnan  does  not  certainly  seem  to  have  gained  any 
increased  respect  for  old-school  physic,  if  we  may  judge  by  the 
pamphlet  before  us. 

''  The  narrow  limits  of  so-called  Rational  Medicine."  Oh  ! 
Dr.  T.  E.  Chambers,  what  do  you  think  of  such  a  title  ?  In 
your  True  Art  of  Healing ,  which  we  reviewed  in  our  15th  vol., 
you  arrogated  for  the  ordinary  pilling,  potioning,  blistering,  and 
bleeding  method  the  title  of  '*  Rational  Medicine,"  and  here  is 
a  great  authority  of  your  own  school  actually  discoursing  about 

*  Tide  vol.  z.  p.  455  Review  of  Bu$hnan^8  Homctcpathy  and  the  Sonueopaiht, 


Bushnan  on  Raiional  Medicine,  127 

the  ''  aarrow  limits  '*  of  that  Rational  Medicine  of  which  yon  are 
a  champion.  And  more  than  all,  he  applies  to  Bational  Medi- 
cine the  contemptuous  expletive,  "  so-called/'  (or  soi-diaant* 
as  you  would  say)  as  though  he  somewhat  doubted  if  it  deserved 
the  appellation.  Bat  we  must  leave  the  doctors  to  fight  it  out 
l>etween  them  as  to  the  limits  and  the  rationality  of  the  medi- 
cine they  profess.  Let  us  see  what  Dr.  Bushnan  says  upon  the 
aubject 

Premising  that  by  '^  medicine/'  he  means  the  "  cure  of  disease/' 
lie  asks,  *'  from  which  of  the  numerous  branches  of  knowledge 
subservient  to  medicine  are  we  to  draw  the  rules  or  principles 
and  means  or  remedial  agents  by  which  the  cure  is  to  be  set  on 
foot  ?  "  Nor  is  this  altogether  an  impertinent  question ;  for  at 
▼arious  times  the  cultivators  of  different  auxiliary  sciences^  such 
as  physiology,  pathology,  and  chemistry,  have  tried  to  persuade 
us  that  in  their  province  we  are  to  seek  the  rules  and  principles 
to  guide  us  to  the  cure  of  disease.  But,  as  Dr.  Bushnan  justly 
observes,  it  is  firom  the  science  of  therapeutics  that  we  derive  our 
principles  and  our  remedial  means.  "  The  certainty  of  curing 
a  disease/'  he  says,  "  after  that  disease  has  been  ascertained,  is 
in  proportion  as  it  depends  upon  some  acknowledged  rule  or 
principle  in  die  science  of  therapeutics/'  But,  he  further  asserts, 
^'  there  are  no  principles  concerned  in  any  part  of  the  treatment 
of  disease  having  anything  at  all  approaching  the  certainty  of 
the  principles  in  physics.  The  so-called  principles  of  medicine, 
have,  at  the  utmost,  the  force  of  moral  certainty." 

"  It  may,"  he  writes,  **  be  urged  on  behalf  of  the  claim  of  medi- 
cine to  be  essentially  rational,  or  a  true  science,  that  hardly 
anything  can  have  more  of  the  character  of  a  principle  than  the 
effect  of  certain  substances  to  cause  vomiting,  certain  other  sub- 
stances to  cause  purging,  certain  other  substances  to  cause  sweat- 
ing, and  so  forth.  It  is  not  to  be  denied  that  the  known  effect  of 
such  substances  to  act  with  much  certainty  in  these  several  res- 
pective modes,  constitutes  a  most  important  series  of  principles. 
Bui  these  principles  are  but  remotely  concerned  in  the  great 
object  of  medicine,  which  is  not  merely  to  cause  vomiting,  or 
purging,  or  sweating,  but  to  cure  disease.  For  it  unfortunately 
*  See  Beriew  of  Dr.  Chambers's  Trm  AH,  vol.  xy.  p.  492. 


128  Reviews. 

happens  that  when  such  more  immediate  principles  are  laid 
down  as  that  emetics  cure  such  and  such  diseases,  purgatives 
such  and  such  other  diseases,  and  sudorifics  various  addi- 
tional diseases,  the  rule  or  principle  is  found  to  go  but  a  very 
short  way,  and,  under  every  variety  of  circumstances y  to  prove 
an  entire  failure.*' 

He  then  says  that  specifics  may  seem  to  belong  to  Rational 
Medicine;  but  admitting  this  to  be  the  case,  no  great  addition 
is  thereby  made  to  its  extent.  ''  In  so  far  as  such  an  order  of 
remedies  can  exist,  it  cannot  be  established  on  any  general 
principles  supplied  by  physiology  or  pathology."  But,  at  the 
same  time,  he  allows  that  they  may  with  equal  justice  be  held 
to  belong  to  empirical  medicine.  It  is  only  "by  courtesy" 
that  a  specific  can  be  regarded  as  belonging  to  rational  medi- 
cine. But  some  of  the  old  specifics  are  taken  from  empirical 
and  transferred  to  rational  medicine  in  this  way :  Bark,  for  ex- 
ample, possesses  the  property  of  curing  diseases  exhibiting  an 
intermittent  type;  hence  it  is  to  be  placed  along  with  arsenic, 
sulphate  of  bebeerine,  and  some  others  in  the  new  order  of  anti- 
periodica — and  thus  it  comes  to  belong  to  rational  medicine. 
That  is  to  say,  bark  given  to  cure  ague  because  it  had  been 
known  to  cure  ague  before,  is  empirical  medicine,  but  bark  given 
to  cure  ague  in  virtue  of  its  antiperiodic  character,  is  rational 
medicine.  Then  may  rational  medicine  fairly  claim  for  a  par- 
tisan, Moli^re's  distinguished  "  Bachelierus,"  who,  when  asked, 
*'  quare  opium  facit  dormire  ?'*  replied,  *'  quia  est  in  eo  virtus 
dormitiva."  So,  likewise,  rational  medicine,  if  asked  why  bark 
cures  an  intermittent  disease,  would,  teste  Dr.  Bushnan,  rationally 
reply  "  quia  est  in  eo  virtus  antiperiodica."  And  this  is  rational 
medicine !  We  are  glad  to  learn  from  Dr.  Bushnan  that  it  is 
so,  for  we  could  never  have  discovered  the  rationality  of  it  by 
our  own  unaided  powers.  We  should  have  rather  thought  that 
to  transfer  bark  from  the  class  of  empirical  specifics  to  this  new 
order  of  antiperiodics  was  to  change  merely  its  name  without 
making  it  a  fiit  more  of  a  rational  remedy ;  that  is,  a  remedy 
prescribed  according  to  a  distinct  and  acknowledged  therapeutic 
principle  or  law.  Does  not  Dr.  Bushnan  perceive  that  the 
question  to  be  solved  with  regard  to  remedies  in  order  to  bring 


Bushnan  on  Rational  Medicine,  129 

tbem  under  rational  medicine  is,  what  quality  in  the  drug  itself 
ia  there  to  guide  us  to  its  successful  administration  in  disease  ? 
If  this  question  be  answered,  these  remedies  at  once  fall  into 
the  domain  of  rational  medicine,  but  to  say  of  a  medicine  that 
it  cures,  for  example,  a  periodic  disease  because  it  possesses  an 
antiperiodic  power,  is  an  empirical  formula  of  the  very  crudest 
description.  Nor  is  Br.  Bushnan's  instance  of  rational  medi- 
cine in  respect  to  mercury  curing  syphilis,  a  bit  more  successful* 
'when  he  suggests  that  it  may  be  because  it  "  has  the  property 
of  destroying  the  poison  by  which  the  disease  is  generated  and 
maintained ; "  for  he  cannot  bring  forward  the  shadow  of  a 
proof  that  it  acts  in  this  way,  and  even  if  he  could  prove  this  to 
be  the  case^  the  administration  of  mercury  in  syphilis  would  not 
be  the  less  empirical,  and  the  reply  to  the  question,  **  why  does 
it  cure  syphilis  ?  "  would  only  be  "  quia  est  in  eo  virtus  antisy- 
philitica." 

'*  The  narrow  limits  of  rational  medicine"  indeed !  why  Dr. 
Bushnan  shows  conclusively  by  his  own  reasoning  that  there  is 
no  such  thing  as  rational  medicine  in  the  school  to  which  he 
belongs ;  for  he  limits  its  rationality  to  the  specifics  it  contains, 
and  it  is  evident  from  what  we  have  just  stated,  that  its  speci- 
fics are  prescribed  purely  empirically. 

In  order  to  enlarge  the  field  of  rational  medicine,  Dr.  Bush- 
nan looks  to  the  increase  of  the  number  of  specifics.  **  It  is 
not  impossible,"  he  says,  '^  that  further  exact  investigation  by 
minute  experience  of  the  properties  of  such  agents  may  re- 
establish an  order  of  specifics  on  a  far  larger  scale  than  that 
which  has  just  been  overthrown."  No  doubt — ^but  the  mode  of 
conducting  the  investigation  proposed  by  Dr.  Bushnan,  viz., 
**  exclusively  under  the  guidance  of  experience  at  the  bed-side 
of  the  patient,"  has  been  tried  in  vain  for  8000  years,  with  the 
only  result  of  discovering  3  or  4  substances  which  were  long 
held  to  be  specifics,  but  whose  claim  to  that  character  has  been 
strongly  contested  of  late  years. 

As  this  method,  to  wit :  clinical  experience,  patronised  and 
recommended  by  Dr.  Bushnan,  has  been  so  long  pursued  with 
such  miserable  negative  results,  as  Dr.  Bushnan  himself  shows, 
might  it  not  just  be  advisable  to  try  another  method,  that 

VOL.  XX.,  NO.  LXXIX. — ^JANUARY  1862.  I 


180  Reviews, 

namely,  reoommended  by  Haller,  and  parsned  so  BnooeBsfully  by 
Hahnemann,  the  proving  of  drags  on  the  healthy  body,  just  to 
see  if  possibly  a  better  result  could  not  be  obtained  in  the  way 
of  the  discovery  of  specifics?  A  worse  certainly  could  not 
occur ;  and  we  can  safely  promise  Dr.  Bushnan  that  if  he  will 
but  pursue  the  physiological  method  of  Hahnemann  his  pains 
will  be  rewarded  by  the  immeasurable  extension  of  the  domain 
of  Bational  Medicine.  We  would  strongly  advise  him  to  peruse 
attentively  Hahnemann's  essay,  entitled  "  Examination  of  the 
Soureen  of  the  common  Materia  Medica  "  (^Lesser  Writings^ 
p.  748)  where  he  will  find  a  true  estimate  of  the  nature  of  the 
source  he  relies  on  for  obtaining  specifics,  viz.,  clinical  ex- 
perience. With  a  masterly  and  irresistible  logic  that  has  never 
been  surpassed,  Hahnemann  shows  that  this  source  is  nothing 
but  crade  empiricism,  and  that  though  it  has  been  in  vogue 
from  the  earliest  days  of  medicine^  it  has  never  yet  given  us  a 
single  reliable  specific.  A  careful  study  of  this  and  of  some 
others  of  Hahnemann's  earlier  essays  would,  we  are  sure,  dis- 
abuse Dr.  Bushnan  entirely  of  the  idea  that  by  his  method 
rational  medicine  can  be  advanced  a  step,  and  would  show  him 
that  the  only  scientific  method  for  discovering  specifics  and  thus 
advancing  rational  medicine  in  the  way  pointed  out  by  Bacon, 
Sydenham,  and  himself,  is  Hahnemann's  plan  of  physiological 
experimentation  with  drags  on  the  healthy  individual. 

We  cannot  conclude  without  quoting  Dr.  Bushnan's  descrip- 
tion of  some  heroes  of  his  own  school,  who,  we  imagine,  are 
not  fully  aware  of  the  "  narrow  limits  of  Bational  Medicine." 
**  There  are  some  men  too  blind  to  see  the  mischief  they-pro- 
duce.  Their  coarse  perception  of  diseases  confounds  all  nice 
distinctions.  They  have  one  remedy  for  every  one  of  their  so- 
called  diseases.  It  never  fails  in  their  hands,  for  they  are  as 
blind  to  the  cause  of  death  as  to  the  nice  distinctions  of  diseases. 
They  blunder  on,  content  if  their  remedy,  whatever  it  be,  pro- 
duces a  sensible  efiect ; — purges,  if  it  be  purgative ;  affects  the 
amount  of  urine  if  it  be  a  diuretic — ^but  are  never  able  to  see  if 
what  they  are  doing  conduces  to  the  safety  of  the  patient  He 
must  go  through  their  ordeal.  If  he  be  strong,  he  survives — if 
he  be  weak,  the  grave  tells  no  tales." 


Medical  Ammls  of  a  Year.  131 


MISCELLANEOUS. 


Tmr  Nbw  Sydenham  Sooibty's  Yeas-Book  ov  Mxdicike 

AND  THB  AliLIED   SOJENCES   FOB    1861. 

HiBTOBT  has  been  described  to  be  *' an  old  Almanack,"  and  medical 
histoiy  equally  deserves  this  definition.  Here  we  have  the  Medical 
mjdhnanaek  for  1860  ;  let  us  see  if  we  can  extract  from  it  any  useful 
or  instmctiye  facts.  While  skimming  over  its  pages  we  shall  look 
oat  for  any  little  facts  or  opinions  that  may  be  interesting  to  the 
liomoeopathisty  and,  ^  when  found,  make  a  note  of  them." 

Making  BeUeve  to  give  Phyeie. 

The  first  part  of  the  work  is  a  '*  Eeport  on  the  Institutes  of 
Medicine,  by  Dr.  G.  Harley,"     Page  69. — "  Bodington  believes 
that  the  possibility  of  giving  large  doses  of  Opium  in  cases  of  de- 
lirium tremens  not  only  with  impunity,  but  even  with  advantage, 
arises  from  the  circumstance  that  alcohol  has,  to  a  certain  extent, 
the  power  of  controlling  the  physiological  effects  of  Opium.     Hence 
it  18  that,  when  the  system  is,  so  to  speak,  saturated  with  alcohol, 
Opuan  becomes  comparatively  innocuous."   He  considers  the  modem 
salts  the  most  dangerous  form  in  which  Opium  can  be  given.   '*  The 
native  Opium  contains  constituent  ingredients  of  a  contrary  character, 
which  are  counteractive  of  each  other.      Laudanum^  holding  all 
these  in  solution,  is  the  safest  form,  inasmuch  as  the  alcohol,  the 
oolvent,  in  some  measure  acts  as  an  antidote."     It  does  not  appear 
manifest  why  it  should  be  advisable  or  necessary  to  give  an  antidote 
along  with  our  remedy ;  for  apparently  the  remedial  effects  would  be 
annihilated  by  such  a  proceeding.   Perhaps  the  perfection  of  allopathic 
treatment  consists  in  giving  nominally  powerful  drugs,  which  shall 
actually  produce  no  effect,  and  if  so,  then  we  can  see  the  wisdom  of  Dr. 
Bodington's  remarks.     In  fact,  such  has  been  the  plan  unconsciously 
adopted  by  the  allopaths  with  regard  to  some  other  violent  medicines, 
for  Dr.  Garrod,  in  1857,  proved  that  the  properties  of  ffgoscgamus. 
Stramonium^   and   Belladonna^  were   completely  destroyed  by  the 
admixture  of  potash,  and  the  favourite  mode  of  administering  these 
drugs  was  precisely  mixed  with  the  alkali,  so  that  all  along  the 
allopaths  had  been  prescribing  under  the  names  of  these  substances 

I  2 


132  Miscellaneous. 

perfectly  inert  medicineB.  Howeyer,  we  don*t  believe  Dr. 
ton's  statement,  that  the  various  ingredients  in  Opium  are  counter- 
active of  each  other,  nor  that  the  alcohol  in  TVnc/.  cpii,  is  antidotal. 
We  believe  this  however,  that  the  salts  of  Opiums  given  singly, 
have  a  very  different  action  from  Opium  unmutilated,  and  we  believe 
a  great  mistake  is  committed,  and  many  accidents  occasioned  by  the 
administration  of  these  salts  instead  of  Opium^  in  cases  where  perhaps 
the  latter  would  have  been  useful. 

Rationale  of  Action  of  Belladonna  and  Opium. 

Page  60. — Dr.  Richard  Hughes  (surely  the  editor  does  not  know 
that  he  is  a  homoeopath)  has  some  interesting  remarks  on  the  caose 
of  the  effects  produced  by  Belladonnaj  especially  the  dryness  of 
throat  and  dysphagia,  which  he  believes  to  depend  on  its  depressing 
influence  on  the  pneumogastric  nerve.  In  proof  of  his  assertion,  he 
says,  that  hooping-cough,  asthma  and  obstinate  vomiting,  spasmodic 
affections  depending  on  irritation  of  the  pneumogastric,  are  controlled 
by  Belladonna  ;  also,  that  Valentin  found  contraction  of  the  trachea 
and  bronchial  tubes  foUow  galvanization  of  the  pneumogastric — ^while 
on  the  other  hand,  these  tubes  were  found  lax,  and  refused  to  con- 
tract under  the  strongest  stimuli,  in  animals  poisoned  by  Bell,  and 
Stram.  In  another  paper  he  inquires  why  Opium  contracts  and 
Belladonna  dilates  the  pupil ;  and  he  comes  to  the  conclusion  that 
Opium  contracts  the  pupil  by  depressing  the  sympathetic  nerve,  and 
that  Bell,  dilates  the  pupil  by  exciting  the  sympathetic  nerve. 

Appreciation  of  Pathological  Anatomy, 

Page  63. — J.  Bernard  thinks  that  '*  morbid  anatomy  cannot  be 
considered  as  the  key  to  all  the  phenomena  of  disease,' for  it  explains 
nothing  beyond  the  mere  mechanical  causes  of  death."  It  is  refresh- 
ing to  meet  with  this  bit  of  common  sense,  after  all  the  nonsense 
that  has  been  talked  about  the  superlative  value  of  pathological 
anatomy — that  it  alone  could  teach  us  how  to  know,  and  how  to  cure 
disease ;  an  enthusiastic  morbid  anatomist  even  going  so  far  as  to 
say,  that  the  main  object  of  the  physician  should  be  to  "  verify  his 
diagnosis  " — which  means,  cut  up  his  patient  on  the  dissecting-table. 

Useless  Information. 

Page  64. — The  observations  of  Eulenburg  and  Ehrenhaus  on  the 
action  of  Digitalis  on  the  extirpated  heart,  need  not  detain  us ;  we 


Medical  Annals  of  a  Year.  138 

are  more  interested  in  its  action  on  the  heart  while  that  organ  bUII 
remains  in  the  hody.  Nor  are  Dr.  Harvey's  learned  reflections  on 
the  mode  of  death  produced  by  Aconiie  of  much  interest ;  we  would 
rather  hear  about  its  power  to  prolong  life. 

Muscular  Poisons. 

Page  65. — CL  Bernard  has  some  interesting  observations  on  poisons 
that  act  on  the  muscular  tissue,  directly  abolishing  its  contractility. 
In  this  dase  are  DigitaUs^  Verairum,  Upas  antiar^  and  two  other 
substances  known  by  the  Indian  names  of  Carrowal  and  Woo. 

Doctors  Differ. 

Page  17. — MM.  Martin  Magron  and  Buisson  have  come  to  the 
conclusion  that  Woorara  and  Strychnine  act  upon  the  sensitive 
nerves  in  precisely  the  same  manner,  consequently  that  the  one 
cannot  antidote  the  other.  On  the  other  hand,  M.  Yella  relates 
several  experiments,  showing  that  Woorara  neutralizes  the  effect  of 
a  poisonous  dose  of  Strychnine^  whose  true  physiological  antidote  he 
therefore  considers  it  to  be.  Who  shall  decide  when  doctors 
disagree? 

Action  ofSantonine^  Pathogenetic  and  Therapeutic. 

Page  71. — A.  de  Martini  corroborates  the  fact,  long  known  to 
homoeopathists  with  regard  to  its  source  Cina^  that  santonine,  taken 
internally,  causes  the  majority  of  persons  to  see  every  thing  tinged 
green — some,  however,  he  says,  have  the  field  of  vision  blue,  and  a 
smaller  number  see  things  straw-yellow.  He  gives  the  following 
cases  where  it  did  good.  A  woman,  aged  70,  who  saw  things  very 
indistinctly  with  the  left  eye,  got  4 — 8  grs.  of  Santonine  daily, 
and  her  vision  was  thereby  much  improved,  though  the  medicine 
made  every  thing  appear  yellow.  A  case  of  amaurosis  was  bene- 
fited; and  another,  who  had  lost  the  right  eye,  and  saw  almost 
nothing  with  the  left,  after  10  grs.  for  a  week,  was  able  to  read 
words  written  in  large  characters  on  the  wall.  Gu^pin  administered 
JSantomtie  to  upwards  of  seventy  patients,  and  found  that  (1)  as  a 
general  rule,  the  urine  becomes  coloured  soon  after  the  derangement 
of  vision  has  passed  away.  (2)  In  some  patients  the  urine  continues 
coloured  even  after  the  derangement  of  vision  has  passed  away.  (3) 
In  those  patient  affected  with  atrophy  of  the  arteries  of  the  retina, 
as  well  as  in  those  suffering  from  subacute  choroiditis,  with  absorption 


134  MiscellaneouM. 

of  pigment,  the  yellow  coloration  of  vision  is  not  observed.     (4)  Tn 
certain  of  the  latter  cases,  objects,  on  the  contrary,  appear  whitisfa. 

(5)  In  almost  all  the  cases  of  cured  acute  choroiditis,  with  the 
exudation  more  or  less  coloured,  Sanionine  improved  the  vision. 

(6)  In  these  cases  it  generally  caused  headache.  (7)  In  patients 
who  have  formerly  suffered  from  iritis,  simple  or  with  choroiditis 
and  exudation,  Santonine  is  usually  beneficial ;  the  powers  of  vision 
increase,  without,  however,  the  exudation  diminishing.  (8)  In 
some  cases  it  causes  slight  inclination  to  vomit  J[9)  In  certain 
diseases  of  the  eye  (not  mentioned)  it  is  hurtful. 

Video  meliora  prohoque,  detertora  tequor. 

Page  140. — Dr.  Croskery  contrasts  the  treatment  of  an  epidemic 
of  yellow  fever  which  he  witnessed,  as  carried  out  at  the  convict 
establishment,  and  in  the  Naval  Hospital  in  the  West  Indies.  At 
the  former  the  mortality  was  twenty  per  cent.,  at  the  latter  only 
three.  The  treatment  in  the  former  consisted  in  a  warm  bath, 
emetic,  purgative  dose  of  Calomel,  followed  by  Calomel,  gr.  ij.,  Opii 
2  gr.  2  dis  horis,  till  slight  salivation  occurred.  Stimulants  are  given 
when  the  strength  begins  to  fail.  At  the  Naval  Hospital  no  Calomel 
or  Opium  are  given,  but  an  ordinary  diaphoretic  and  diuretic  mixture 
with  Chlorate  of  potash.  And  in  the  face  of  these  results.  Dr. 
Croskery  recommends  for  yellow  fever  a  treatment  in  which  Calomel 
and  Opium  play  a  conspicuous  part,  and  from  which  Chlorate  of 
potash  is  absent.  Possibly,  he  considers  20  per  cent,  a  more  legiti- 
mate  mortality  in  yellow  fever  than  3  per  cent,  or  perhaps  his 
practice  lay  chiefly  among  the  convicts,  among  whom  the  larger  per 
centage  of  mortality  was  desirable,  on  patriotic  and  economical 
grounds.  No  doubt,  for  the  Naval  Hospital,  Dr.  Croskery  would 
recommend,  on  similar  grounds,  the  treatment  that  caused  the 
smaller  mortality. 

Advoaicy  of  Bloodshed  hy  an  American, 

Page  142. — Dr.  Lawson,  from  the  other  side  of  the  Atlantic, 
inveighs  against  the  abandonment  of  blood-letting  in  pneumonia  by 
so  many  physicians  on  this  side.  He  asserts  that  bleeding  and 
Antimony  are  much  more  successful  than  the  expectant  system; 
but  as  the  statistics  are  all  against  this  view,  he  says,  that  the 
statistics  of  pneumonia  are  utterly  worthless  and  unreliable.  This 
sweeping  condemnation  of  the  statistics  of  his  own  school  by  an 


Medical  Annals  of  a  Year.  186 

aSopftthic  auUiorityy  may  reconcile  us  to  the  similar  condemnation  of 
the  statistics  of  our  school  hy  our  opponents.  It  is  a  good  specimen 
of  the  style  of  argument  adopted  by  a  medical  man  when  the  factn 
are  inconveniently  opposed  to  his  theories. 

Oretue  and  Cow-pox  Identical, 

Jenner*8  opinion,  if  we  remember  right,  was  that  cow»pox  had  its 
origin  in  the  disease  called  grease  to  which  horses  are  liable*  Dr. 
Fontan  (p.  146}  relates,  that  some  mares  being  affected  with  grease, 
the  matter  from  the  pustules  was  inoculated  on  the  teat  of  a  cow, 
where  it  produced  several  fine  pustules.  From  these  about  thir^ 
infiuits  were  vaccinated,  and  in  all  the  result  was  satisfactoiy. 

WhU  M  one  MatCe  Poison  is  another  MarCs  Meat. 

Page  146. — Ricord  states,  that  Pot,  iod,  not  only  causes  the  rapid 
disappearance  of  the  symptoms  for  which  it  is  prescribed,  but  also 
greatly  improves  the  general  health.  The  globules  of  the  blood  are 
increased,  the  strength  restored,  and  the  weight  augmented. 

^  Valuable  Remetfy/or  an  Espeotant  Practitioner. 

Page  147. — Dr.  Sigmund,  after  a  careful  trial  of  the  best  Sarsa- 
parilla,  has  come  to  the  conclusion  that  it  does  not  exercise  the 
alightest  perceptible  influence  on  the  course  and  termination  of 
syphilitic  disease.     What  saya  old  Dr.  Jacob  Townsend  i 

Syphilisation. 

Page  148. — ^Lindwurm  thinks  it  may  be  applicable  to  cases  in 
which  Merc,  and  Iod,  are  not  tolerated,  or  fail  to  cure*  But  he 
believes  that  the  same  results  may  be  obtained  by  exutories  of  any 
kind.  Hebra  says,  that  under  syphilisation  the  general  health 
improves,  and  all  the  subjective  and  objective  phenomena  of  syphilis 
gradually  disappear  during  the  continued  inoculation.  He  thinks, 
however,  that  the  disease  is  more  rapidly  cured  by  mercurials. 

Mercurial  Disease. 

Page  148. — Keller  thinks  it  can  no  longer  he  doubted  that  the 
so-called  syphilitic  ulcers  in  the  extremities,  which  are  /characterized 
by  their  ^grouping  and  renal  form,  by  their  serpigenous  advance  ai 
their  convex  border,  and  their  healing  and  skinning  over  at  their 
concave  border,  are  the  result  of  mercurial  cachexia ;  and  the  same 


136  Miscellaneous. 

is  true  of  the  BO-called  angina  sjpbiliUcay  with  serpigenous  ulcers  on 
the  palate,  throat,  or  root  of  the  tongue,  giving  rise  to  the  aphonia, 
80  often  descrihed  as  a  characteristic  of  syphilis.  Pot  iod,  cures 
such  hy  eliminating  the  Mere,  out  of  the  system. 

Perchloride  of  Iron  in  Diphtheria. 

Page  161. — Auhrun  cured  thirty-five  out  of  thirty-nine  diphtheric 
patients  with  Perchloride  of  trow,  3  ij,  of  a  weak  solution,  every  five 
minutes  during  the  day,  and  every  fifteen  during  the  night,  with  as 
much  cold  milk  (the  sole  food)  after  each  dose.  Crighton  (p.  141) 
had  an  equal  success  with  the  TV.  mur./erri^  four  to  eight  drops 
every  two  or  three  hours,  along  with  the  local  application  of  a  mixture 
of  TV.  /er,  mur.  and  Acid  mur,  dil.  Out  of  forty-five  cases  he  lost 
only  nine. 

Vaccination  for  SyphHis, 

Page  151.— Practised  with  success  hy  Kreyser.  He  made  from 
fifteen  to  twenty  punctures  in  the  thighs  and  arms,  and  repeated  the 
inoculations  when  the  pustules  had  dried  up. 

Aconite  in  Tetantts. 

Page  160. — Sedgewick  cured,  with  Acon.^  tetanus  in  a  man,  aged 
30.  The  symptoms  were  very  severe.  The  treatment  was  com- 
menced on  the  twelfth  day  after  the  accident  and  the  third  of  the 
disease,  and  continued  twenty-seven  days.  Page.  267. — ^A  case  was 
similarly  treated  and  cured  by  Morgan,  after  Strychnine  had  failed. 

Oymnastios  in  Chorea. 

Page  108. — Recommended  by  Bond.  They  will  enable  the 
patient  to  get  rid  of  his  diseased  consciousness  (whatever  that  may 
be),  to  break  the  incessant  chain  of  nervous  impulse  transmitted 
through  the  cerebro-spinal  axis,  and  to  restore  to  the  enfeebled  will 
its  healthy  control  over  all  the  other  nervous  functions. 

Pathogenetic  Effect  of  Lathyrtu  Sativus. 

Page  105.— In  a  very  swampy  district  on  the  right  bank  of  the 
Jumna  numerous  cases  of  lameness  occurred.  The  patients  averred 
they  had  all  become  paralytic  during  the  rains,  in  most  cases 
suddenly  so,  and,  in  many,  during  the  night.  There  was  no  pun  or 
splenic  enlargement.  The  cause  was  believed  to  be  the  use  as  food 
of  the  above  plant. 


Medical  Annals  of  a  Year.  187 

Belladonna  in  Brachial  Neuralgia. 

Page  166. — LuBsana,  of  Milan,  describes  several  kinds  of  ibis 
neoralgia,  for  tbe  cure  of  which  he  relies  chiefly  on  BeU.^  used  locally 
by  inanction,  endennically  or  cutaneously,  and  also  internally. 

A  Sensible  Man. 

Beau,  of  the  Charity,  discountenances  Y.  S.  because  he  reg^ards 
inflammation  as  especially  frequent  in  weakly  persons,  because  it 
injures  the  blood  by  diminishing  its  globules  and  increasing  its 
fibrine,  and  because  the  results  of  statistics  show  that  it  is  injurious. 
The  last  reason  would  suffice  for  most  persons  of  common  sense, 
liutwe  suspect  that  ail  combined  will  not  convince  his  colleague. 
Dr.  Bouillaudy  of^the  impropriety  of  bleeding  coup  sur  coup. 

Accurate  Statistics. 

Page  211. — Our  old  enemy,  Dr.  W.  T.  Oairdner,  gives  a  paper 
on  pneumonia,  in  which  he  says  that  he  has  had  eleven  fatal  cases 
out  of  **  from  sixty  to  one  hundred  cases  of  pneumonia,  or  disease 
verging  upon  it."  We  cannot  fail  to  admire  the  extreme  value  of  the 
figures  here  given  by  the  implacable  critic  of  homceopathic  statistics, 
and  yet  we  should  be  sadly  puzzled  ^to  make  out  the  per-centage 
of  mortality  in  Dr.  G.'s  cases  of  pneumonia  from  such  data. 

Discredit  of  the  last  New  Specific  for  Phthisis. 

Fags  211. — Dr.  R.  Quain  gave  a  fuU  trial  to  Churchill's  hypo- 
phosphites  of  lime  and  soda.  Of  twenty-two  cases  subjected  to  the 
treatment,  sixteen  derived  no  benefit  whatever,  in  three  the  benefit 
was  slight  and  temporary,  in  two  there  was  marked  but  temporary  im- 
provement, in  one  only  was  the  improvement  satisfactory  and  per- 
manent. Dr.  Q.  ascribes  the  benefit  to  the  rest,  diet,  and  good 
nursing  of  the  hospital. 

Diagnostic  Sign  of  Tubercle. 

Page  218. — Dutchen  thinks  the  red  line  on  the  gums,  when  pre- 
sent, an  in^EiUible  sign  of  tubercle.  It  was  present  in  forty-eight  out 
of  fifty-eight  cases  presenting  the  phthisical  signs. 

Medicated  Milk. 

Page  232. — ^Labourdette  gave,  with  impunity,  to  his  cows  and 
goats  20  grammes  of  Pot.  iod.,  3  grammes  of  Calomel,  1  gramme  of 


188  Miscellaneous. 

Hjdr.  bichLy  5 — 10  grammes  of  Liq.  pot  arsenical,  daily,  in  order  to 
impregnate  their  milk  with  these  substances,  which  was  then  given 
to  patients  requiring  these  drugs. 

A  Hint 

Page  256. — Hebra  says  that  all  the  forms  of  eczema  may  be 
artificially  produced  by  inunction  with  Crohn  oil. 

IntesHnal  Worms. 

Page  281. — Kuchenmeister  administered  to  a  criminal,  measljr 
pork  on  November  24,  1859,  and  January  18,  1860,  and  made  the 
autopsy  March  81.    Almost  50  per  cent,  of  the  cysticerci  were 
found  in  the  condition  of  tape-worms.     No  cysticerci  in  the  muscles. 
Page  260. — Devaine  has  satisfied  himself  that  the  ova  of  trico* 
cephalus  dispar  and  ascaris   lumbricoides   are  not  hatched  in  the 
intestines,  but  are  expelled  as  they  are  laid.     He  succeeded  in 
obtaining  their  development  by  placing  them  in  water,  which  was 
changed  every  day.     The  process  did  not  begin  for  six  months,  and 
the  embryo  was  not  found  till  nearly  nine  had  elapsed. 

Opium  in  Acute  Mania, 

Page  412. — Recommended  by  Legrand  du  SauUe,  in  from  half  a 
gprain  to  six  grains  daily.  The  patient's  excitement  increases  ia 
most  cases  during  the  use  of  the  remedy ;  if  calmness  is  produced, 
it  is  an  unfavourable  sign.  He  thus  cured  seven  out  of  ten  cases  of 
acute  mania,  and  three  out  of  twenty  cases  of  chronic  mania  of  more 
than  a  year's  standing. 

An  Auxiliary  to  the  Pledge. 

Page  213. — Smirnoff  administers  to  habitual  drunkards  a  glass  of 
strong  infusion  of  Asarum  europeum  and  of  Valerian  three  or  four 
times  a  day.  The  Asar,  improves  the  appetite,  and  counteracts,  the 
invincible  longing  for  alcohol. 

Rather  Fishy, 

Page  414. — Dr.  Awenarius,  of  St  Petersburgh,  used  Propylamine 
in  250  cases  of  rheumatism,  and  in  every  case  the  pain  and  fever 
disappeared  the  day  after  its  administration.  The  dose  was  20 
drops,  2  dis  horis.  Propylamine  is  prepared  by  distillation  from 
herring  brine. 


Medical  Annals  of  a  Year,  139 

.Digikdis  in  Ddirium  Tremens, 

Page  414. — Jones  gives  Jss*  of  TV.  digii,^  and  a  second  dose  of 
Jss.  in  four  hovirs,  and  in  a  few  cases  a  third  of  5  ji*  Out  of  seyenty 
cases  Digit,  failed  in  three  only  to  produce  sleep.  In  sixty-seven 
it  was  the  only  medicine  used  ;  of  these  sixty-six  recovered.  The 
hSal  case  had  a  tumour  in  the  brain. 

Iodine  m  Vesical  Catarrh. 

Page  414. — Meinhard  relates  three  cases  which  resisted  all  other 
treatment,  hut  were  cured  by  2  gr.  doses  of  Pot,  iod. 

Effects  of  Phosphoms. 

Page  489. — Lusinsky  relates  a  case  where  death  took  place  on 
the  sixth  day.  There  were,  at  first,  vomiting  and  purging ;  latterly 
icterus,  deep  somnolence,  rapid,  weak  pulse. 

Arsenic-drinking. 

Page  445. — Church  says  that,  in  the  village  of  Whitbeck,  Cum- 
berland, a  natural  water,  containing  nearly  a  grain  of  metallic  arsenic 
in  a  gallon,  is  used  habitually  by  the  inhabitants  with  beneficial 
results,  their  general  healthiness  and  longevity  being  remarkable. 

Arsenical  poisoning. 

Page  446. — ^Many  cases  are  related  of  poisoning  by  paper- 
hangings,  and  Chevalier  gives  instances  of  poisoning  by  arsenical 
compounds  contained  in  cotton  prints,  bracelets,  head-dresses,  linings 
of  caps,  articles  of  food,  such  as  cakes  and  sweetmeats,  coloured  with 
arsenic,  or  packed  in  arsenical  papers ;  preserved  and  potted  meats, 
French  plums,  figs,  and  other  fruits,  similarly  packed;  also  by 
arsenic  contained  in  playthings,  wafers,  postage  stamps,  &c.  One 
case  is  given  by  Biggs,  of  poisoning  caused  by  a  green  paper  lamp, 
shade. 

Antidote  to  Strychnine. 

Page  454. — ^Kurzak  has  found  Tannin  to  be  an  antidote  to 
Strychnine  poisoning.  To  be  effectual  it  must  be  given  in  the  pro. 
portion  of  twenty  or  twenty-five  to  one.  Where  pure  Tannin  is  not 
at  hand,  the  following  substances,  which  contain  Tannin  may  be 
substituted — ^Turkey  galls,  tea,  coffee,  oak-bark,  the  barks  of  horse- 
chestnut  or  willow,  the  green  shells  of  walnuts  and  acorns. 


140  Miscellaneous. 


hy  jteoniU, 

Page  465. — Brown  writes,  that  about  a  pound  of  Aconite  root 
was  added  to  a  gallon  of  pickles  in  mistake  for  horseradish.  Four 
persons  who  partook  of  these  pickles  were  attacked  within  an  hour 
with  pricking  sensations,  opbthotonos,  trismus,  partial  loss  of  sight 
imperceptible  pulse,  and  coldness  of  surface.  Problem  for  an 
allopath :  Compare  the  production  of  tetanic  symptoms  in  poison- 
ing by  Aconite  with  the  cures  of  tetanus  above  quoted,  by  the 
same  drug,  and  then  tell  the  therapeutic  law  of  the  matter. 

Protective  Power  of  Vaccination. 
Page  496. — Berg  gives  the  smallpox  statistics  of  Sweden  from 
1748  to  1859.  Vaccination  appears  to  have  first  become  general  in 
1805.  After  this  period  the  annual  mortality  of  smallpox  only 
exceeded  1000  in  five  years,  viz.— 1825  (1243),  1833  (1145),  1838 
(1805),  1839  (1954),  1850  (1007).  These  were  all  years  m  which 
smallpox  prevailed  epidemically.  Comparing  these  with  epidemic 
years  previous  to  1805,  we  find  in  1752  a  mortality  of  10,912  ; 
in  1784,  12,455;  in  1765,  17,375;  1800,  12,058.  According 
to  the  author,  no  observations  have  been  made  in  Sweden  &vour- 
ing  the  idea  that  scrofula,  eruptive  fevers,  or  other  diseases  had 
increased  or  become  more  malignant,  since  the  introduction  of 
vaccination. 

ffypennetropia^  a  Disease  of  Defective  Power  o/ Accommodation  of 

the  Eye. 

The  memoirs  of  Donders  on  the  anomalies  of  Uie  accommodation 
power  of  the  eye  have  recentiy  attracted  considerable  attention. 
We  observe  that  the  New  Sydenham  Society  is  about  to  publish 
the  original  papers  of  that  eminent  oculist,  which  will,  we  doubt  not, 
be  a  great  addition  to  our  ophthalmological  literature.  In  the  mean- 
time we  have  much  pleasure  in  extracting,  from  some  excellent 
articles  by  Mr.  J.  S.  Wells,  in  recent  numbers  of  the  Medical  Times 
and  Gazette^  the  views  of  Donders  on  a  hitherto,  we  imagine,  unde- 
scribed  form  of  defective  accommodation  power,  viz. : 

Hypebvetbofia. 

*'  We  have  now  to  turn  our  attention  to  an  affection  which  was  but 
littie  noticed,  certainly  not  properly  understood,  until  the  last  few 
years.     Von  Graefe  was  the  first  to  describe  it  accurately  and  scien- 


Hypermeiropia.  141 

tifically,'*  and  since  then  Donders'  elaborate  researches  have  shown 
liow  common  this  affection  is,  and  how  very  frequently  that  peculiar 
weakness  of  sight,  which  has  received  so  many  various  names,  and 
whose  nature  was  so  little  understood,  viz.,  asthenopia,  is  due  to  it 
The  affection  I  speak  of  was  first  called  Hyperpresbyopia,  but  it  was 
80OD  found  that  it  may,  and  generally  does,  exist  without  any  pres- 
byopia at  all,  and  that  therefore  this  name  was  most  inapplicable.  It 
was  then  termed  hyperopia ;  this  term  is  better,  but  Bonders  now 
proposes  to  call  it  hypermetropia,  which  is  undoubtedly  the  best 
name  for  it^  and  should,  therefore,  be  generally  adopted. 

**  By  hypermetropia  is  meant  that  peculiar  condition  of  the  eye  in 
which  the  refractive  power  of  the  eye  is  too  low,  or  the  optic  axis 
(the  antero-posterior  axis)  too  short,  we  may,  however,  also  have 
both  these  causes  coexisting.  We  may  often  almost  diagnose  the 
hypermetropic  eye  by  its  peculiar  shape  ;  it  appears  flatter  and 
smaller  than  the  normal  eye,  it  does  not  fill  out  the  aperture  of  the 
lids,  there  is  a  greater  or  less  space  (like  a  little  pouch)  between  the 
eyeball  and  the  canthus,  more  particularly  the  outer  canthus. 

^  The  effect  of  the  too  short  optic  axis,  or  the  too  low  refracting 
power  of  the  eye,  is  that  the  focal  point  of  the  dioptric  system  lies 
behind  the  retina,  so  that  in  a  state  of  rest  even  parallel  rays  are  not 
focussed  upon  the  retina,  but  behind  it,  and  only  convergent  rays  are 
united  upon  the  retina. 

**  The  normal  (emmetropic)  eye  unites  parallel  rays  upon  the  retina 
without  almost  any  (if  any)  effort  of  accommodation,  but  it  also  pos* 
Besses  the  power  of  accommodating  itself  without  difficulty  or  annoy- 
ance  for  divergent  rays,  coming  from  objects  6" — 8"  from  the  eye, 
for  a  short  time  it  can  even  unite  rays  upon  the  retina  which  come 
from  Z*' — 4"  distance.  The  focal  point  of  the  dioptric  system  lies 
in  the  normal  eye  exactly  upon  the  retina. 

**•  In  the  myopic  eye,  it  will  be  remembered,  the  state  of  refraction 
is  too  great,  or  the  optic  axis  too  long,  so  that  when  the  eye  is  in  a 
state  of  rest,  the  focus  of  the  dioptric  system  lies  in  front  of  the 
retina,  and  parallel  rays  (emanating  from  objects  at  an  infinite  dis- 
tance)  are  brought  to  a  focus  before  the  retina,  and  only  more  or  less 
divergent  rays  are  united  upon  the  latter. 

^  Now,  in  hypermetropia  we  have  just  the  reverse  of  this.  The 
refractive  power  of  the  eye  is  so  low,  or  its  optic  axis  so  short,  that 
when  the  eye  is  in  a  state  of  rest,  parallel  rays  are  not  united  upon 

*  Graefe's  **  Arohiv  fur  Ophthalmologie,"  ii.  1. 179. 


142  Mi8cellaneou8, 

the  retma,  bat  behind  it,  and  only  coAvei^nt  ttiys  tfre  focofted  upon 
the  latter.     We  give  the  slightly  divergenty  almost  parallel  rays 
emanating  from  distant  objects,  a  convergent  direction  by  means  of 
a  oonyex  glass,  and  the  reader  will  now  see  how  it  is  that  a  hyper- 
metropic eye  requires  convex  glasses  for  seeing  distant  objects.   T^he 
patient  may  require  perhaps  even  a  stronger  pair  for  near  objects. 
The  consequence  of  this  low  refractive  power  of  the  eye  is,  that 
whereas  the  normal  eye  unites  parallel  rays  upon  its  retina  without 
any  accommodative  effort,  the  hypermetropic  eye  has  already,   in 
order  to  do  so,  to  exert  its  accommodation  more  or  less  considerably, 
according  to  the  amount  of  hypermetropia.     This  exerticMi  increases, 
of  coarse,  in  direct  ratio  with  the  proximi^  of  the  object     If  the 
degree  of  hypermetropia  is  moderate,  and  the  power  of  accommoda- 
tion good,  no  particular  annoyance  is  perhaps  experienced,  even  in 
reading  or  writing.     If,  however,  the  hypermetropia  is  absolute,  the 
patient  will  not  be  able  to  see  well  at  any  point 

'*  We  must  not  be  surprised  at  the  fact,  that  persons  suffering  from 
hypermetropia  are  often  not  aware  that  they  see  worse  at  a  distance 
than  other  people.  On  the  one  hand,  but  few  people  have  to  look 
for  any  length  of  time  at  distant  objects,  and  on  the  other  hand  the 
aspirations  of  some  are  so  modest,  that  they  fancy  they  enjoy  capital 
sight  if  they  can  distinguish  between  a  church  and  a  house  across  a 
street  It  is  different,  however,  with  near  objects ;  a  person  soon 
finds  out  if  he  cannot  read  or  write  for  a  continuance  without  di£S- 
cttlty  and  annoyance. 

**•  We  sometimes  meet  with  normal  eyes  which  not  only  see  per- 
fectly near  at  hand  and  at  a  distance,  but  are  capable  of  relaxing 
their  power  of  accommodation  to  such  an  extent,  that  they  can  unite 
convergent  rays  upon  the  retina,  being  able  to  see  at  a  distance  with 
slightly  convex  glasses.  Their  eye  is  then  hypermetropic.  Bonders 
calls  ^VAfacuUaHve  hypermetropia. 

*'  Let  us  now  consider  how  we  are  to  examine  a  person  as  to  hyper- 
metropia. After  I  have  explained  this,  we  can  more  easily  pass  on 
to  the  consideration  of  other  questions  connected  with  this  affection. 

*'  The  patient  complains  that,  after  he  has  been  reading  or  writing 
for  a  short  time,  the  letters  become  ill-defined,  and  appear  to  run 
into  each  other.  At  a  distance,  however,  he  says  he  can  see 
perfectly. 

^  His  eye  appears  smaller  and  flatter  than  a  normal  eye  ;  it  does 
not  fill  out  the  palpebral  aperture  properiy ;  there  is  a  little  space 


Hjfpermetropia.  1 43 

between  ffae  onter  canthuB  and  the  eyeball.  Upon  turning  the  eye 
Teiy  much  inwards,  the  poeterior  portion  of  the  eyeball  is  seen  to  be 
flatter  and  less  rounded  than  it  should  be. 

*^  We  tell  the  patient  to  read  No.  20  of  Jager's  test-types,  placed 
at  a  distance  of  eighteen  to  twenty  feet,  so  that  the  rays,  as  they 
impinge  upon  the  eye  in  an  almost  parallel  direction,  may  be  oon- 
■idered  as'  coming  from  an  infinite  distance.  He  can  read  No.  20 
Tery  well  without  any  glass,  and  even  No.  19  somewhat  indistinctly. 
Now  a  normal  eye  should,  at  this  distance,  be  able  not  only  to  read 
No.  19  fluently,  but  even  No.  18,  and  words  of  No.  16,  We  now 
place  a  weak  convex  glass  of  86  or  40  inches  focus  before  his  eyes ; 
tills  improves  vision  somewhat ;  we  try  a  stronger  glass,  and  find  at 
last  that  convex  20  improves  most  of  all ;  with  it  he  can  read  No.  1 8. 
The  letters  appearing  clearer  and  well  defined---conTex  16  is  not  so 
good — ^No.  20  is  therefore  the  strongest  convex  glass  with  which  he 
can  see  well  at  a  distance ;  and  this,  according  to  Donders,  gives  us 
the  degree  of  hypermetropia,  which  is  consequently  sas  —  ly^o-  ^c^ch 
eye  should  be  tried  separately,  as  the  degree  of  hypermetropia  may 
Taiy.  We  now  let  the  patient  read  very  small  print  with  convex  20, 
and  find  that  he  can  read  No.  1  of  JMger  clearly  and  distinctly  as 
dose  as  7"  from  the  eye ;  his  range  of  accommodation  is  therefore 
good. 

**  If  we,  however,  prescribed  convex  20  for  the  patient,  and  told 
him  that  these  spectacles  would  permanently  free  him  from  all  annoy- 
ance in  reading,  writing,  etc.,  and  that  he  would  not,  after  a  time, 
have  to  change  them  for  a  stronger  pair,  we  might  commit  a  grave 
error,  and  subject  ourselves  to  the  vexation  of  having  him  return  to 
i»  in  the  course  of  a  few  weeks  with  the  complaint  that  the  glasses 
we  chose  for  him  did  not  suit :  that  although  they  enabled  him  to 
read  or  work  for  a  longer  time  than  before,  he  could  not  go  on  for 
any  length  of  time  without  bemg  doubled  by  symptoms  of  asthe- 
nopia. 

*'  Now,  into  what  error  should  we  have  fallen  here  ?  Simply  into 
that  of  having  given  him  spectacles  which  were  too  weak,  which  did 
not  neutralize  his  hypermetropia. 

*'  The  fact  is  that  the  patient  has  been  so  accustomed  to  exert  his 
accommodation  even  when  regarding  distant  objects  (in  doing  which 
the  normal  eye  has  hardly  to  accommodate  at  all),  that  this  exertion 
of  the  acconmiodation  has  become  so  habitual,  that  he  cannot  relax 
it  completely,  even  when  there  is  no  occasion  for  it^  when  the  mal- 


144  Miscellaneous. 

conttmction  of  his  eye  is  compeoflated  for  by  the  use  of  a  convex 
lens.  With  convex  20  he  did  not,  therefore,  accommodate  for  his 
natural  far  point,  but  for  a  nearer  point,  as  he  could  not  relax  his 
accommodation  sufficiently.  We  have,  therefore,  arriTcd  at  too  low 
an  estimate  of  the  degree  of  his  hypermetropia.  In  order  to  find 
out  its  real  amount  we  must  paralyse  the  power  of  accommodation 
by  the  instillation  of  a  strong  solution  of  atropine.  Donders  has 
found  that  in  order  completely  to  paralyse  the  muscle  of  acconomo- 
dation*  a  solution  of  4  grains  of  strop,  sulph.  to  1  ounce  of  water 
is  necessary,  and  that  it  takes  about  two  to  three  hours  to  act 
thoroughly.  A  weaker  solution  of  1  gndn  to  2000  parts  of  water 
suffices  to  dilate  the  pupil  widely,  but  only  partially  paralyses  the 
ciliary  muscle. 

*'  After  the  instillation  of  a  strong  solution  of  atropine,  we,  after 
the  lapse  of  a  couple  of  hours,  again  examine  our  patient.     We  now 
find  that  he  cannot  read  No.  20  (at  20  feet  distance)  at  all  without 
glasses.     A  normal  eye  would  be  able  to  do  so,  would,   indeed, 
according  to  Donders,  become  but  very  slightly  hypermetropic  after 
atropine,  requiring,  perhaps,  only  convex  glasses  of  80  or  60  inches 
focus  to  see  more  distinctly  at  a  distance.     In  our  patient,  however, 
the   difference  in   the  degree  of  hypermetropia,   before   and  after 
atropine,  is  great.     Whereas,  he  could  before  its  application  see  dis- 
tinctly at  a  dbtance  with  convex  20,  he  now  requires  convex  8.  And 
we  now  see,  from  the  difference  of  the  strength  of  the  glasses  re- 
quired before  and  after  atropine,  to  what  extent  be  still  exerted  his 
accommodation  in  looking  at  distant  objects,  before  we  had  para]y8e4 
his  power  of  accommodation  by  atropine.     Donders,  however,  points 
out  the  fact  that  only  in  young  persons,  with  a  good  range  of  ac- 
commodation, is  the  difference  in  the  degree  of  hypermetropia  before 
and  after  atropine  so  great.     In  more  advanced  age,  and  in  young 
persons  with  a  smaller  range  of  accommodation,  the  difference  is 
much  less.     We  should  only  put  the  atropine  into  one  eye  at  a  time, 
else  we  render  the  patient  incapable  of  working  for  several  days. 
After  the  effect  of  the  atropine  has  gone  off  completely  (which  some- 
times takes  six  or  seven  days)  we  apply  it  to  the  other  eye.     This 
precaution  is  the  more  necessary  in  the  case  of  poor  hospital  patients, 
to  whom  the  loss  of  a  few  days'  work  is  of  great  consequence. 

'*  Hypermetropia  is  very  frequently  latent.     If  its  degree  is  but 

*  This  miiBcle  has  received  various  names,  viz.  tensor  choroidesB,  oiliaiy 
muscle,  and  Brucke's  mosde. 


Hypermetropia.  146 

Blight,  it  is  often  perfectly  latent  till  the  age  of  twenty-five  or  thirty, 
when  Bymptoms  of  asthenopia  hegin  to  show  themselves,  if  the 
patient  is  obliged  to  work  for  any  length  of  time  at  near  objects. 
Our  suspicion  is  aroused  by  these  symptoms,  and  on  placing  a  convex 
g^ass  before  his  eyes,  we  find  that  he  can  distinguish  distant  objects 
bn  better  than  without  it.  If  the  glasses  be  only  momentarily  held 
before  the  eyes,  the  existence  of  hypermetropia  may  escape  us, 
for  the  patient  has  been  so  accustomed  to  exercise  his  power  of 
accommodation,  even  for  distant  objects  (in  regarding  which  the 
narmal  eye  scarcely  accommodates  at  all)  that  he  cannot  at  once 
relax  his  accommodation.  But  if  he  continues  to  look  through 
the  glasses  for  a  few  minutes,  he  gradually  finds  that  the  distant 
objects  become  more  and  more  distinct,  and  clearly  defined.  In 
order  to  make  sure  to  what  degree  the  hypermetropia  exists,  and  to 
what  extent  the  person  is  obliged  to  exercise  his  accommodation  in 
looking  at  distant  objects,  we  must  paralyse  his  power  of  accom* 
modation  by  the  instillation  of  a  strong  solution  of  atropine. 

**'  The  hypermetropia  may  be  so  great  that  it  is  never  latent,  even 
in  childhood  it  makes  itself  felt,  and  vision  of  distant  objects  is  im- 
proved by  convex  glasses.  In  these  cases  it  is  always  accompanied 
by  a  diminution  in  the  range  of  accommodation,  and  on  this  account, 
even  at  an  early  age,  two  pairs  of  spectacles  will  often  be  necessary, 
a  stronger  pair  of  convex  glasses  for  reading,  writing,  etc. ;  a  weaker 
pair  for  distant  objects. 

*^  It  is  a  curious  fact  that  when  the  hypermetropia  is  considerable, 
the  patient  can  often  read  better  when  the  print  is  only  a  short  dis- 
tance from  the  eye,  than  when  it  is  10" — 12"  off.  Von  Graefe 
thinks  this  is  due  partly  to  the  diminution  in  the  size  of  the  pupil 
which  takes  place  on  looking  at  small  objects,  for  the  area  of  the 
pupil  being  smaller,  some  of  the  peripheral  rays  are  cut  off,  and  there 
is  consequently  a  diminution  in  the  circles  of  dispersion  on  the  retina. 
He  has  also  shown  that  on  approximating  an  object  to  the  eye,  the 
circles  of  dispersion  on  the  retina  in  a  hypermetropic  eye,  increase 
comparatively  less  in  size  than  the  size  of  the  retinal  images.  In 
consequence  of  this,  there  is  more  chance  of  interspaces  between  the 
letters  when  the  print  is  held  at  a  distance  of  5" — 6"  than  at  10'  — 
12".  At  the  latter  distance,  there  would  not  be  so  much  difference 
between  the  size  of  the  retinal  images  and  the  circles  of  dispersion, 
so  that  the  letters  would  appear  more  confused  and  indistinct.  But 
besides  these  reasons,  Douders  thinks  that  the  greater  amount  of 

VOL.   XX.,   NO.    LXXIX, — JANUARY,    18C2.  K 


1 4  6  MwellaneouB. 

convergence,  and  consequent  increase  in  the  action  of  the  power  of 
accommodation,  has  some  influence  in  enabling  the  patient  to  see 
better  at  a  distance  of  5'' — 6". 

^'  When  speaking  of  presbyopia,  we  mentioned  that  according  to 
Bonders,  the  near  point  begins  to  recede  from  the  eye  at  about  ten 
years  of  age,  and  that  this  recession  continues  uninterruptedly  to 
advanced  age.  He  has  found  that  the  far  point  remains  stationary 
till  about  the  age  of  forty  or  forty-five,  then  it  gradually  recedes  £rom^ 
the  eye ;  at  fifty-five  or  sixty  this  is  distinctly  evident  in  the  originally 
normal  eye,  the  eye  has  become  hypermetropic,  and  a  convex  glass 
is  necessary  for  distinct  vision  of  distant  objects.  But  this  differs 
much  in  different  individuals.  At  seventy  or  eighty  years  of  age  the 
hypermetropia  often ^y 24*  Donders  considers  that  this  recession 
of  the  far  point — this  diminution  of  refraction — is  due  to  changes  in 
the  structure  of  the  lens,  which  becomes  firmer  and  more  consistent, 
and  its  surface  somewhat  flatter  with  advancing  years, 

^  We  have  seen  that  the  near  point  also  recedes  from  the  eye,  that 
at  the  age  of  45  it  was  about  9" — 10"  from  the  eye,  and  we  followed 
Donders  in  considering  presbyopia  to  commence  when  the  near  point 
was  removed  further  than  8"  from  the  eye.  A  hypermetropic  eye 
may,  therefore,  at  a  certain  age,  become  presbyopic ;  or  again,  an 
originally  normal  eye  may  become  presbyopic  at  the  age  of  forty-flve, 
and  hypermetropic  at  fifty  or  sixty,  so  that  we  may  have  presbyopia 
and  hypermetropia  co-existing  in  the  same  eye.  If,  with  the  glasses 
which  neutralise  this  hypermetropia,  a  hypermetropic  patient  cannot 
read  very  small  print  nearer  than  \2" — 14''  from  the  eye,  he  is  also 
presbyopic.  Let  us  suppose  that  convex  16  is  the  glass  which  neu- 
tralises his  hypermetropia,  which  enables  him  to  see  distant  objects 
distinctly  without  any  effort  of  accommodation;  on  telling  him  to 
read  No.  1  of  Jager  with  this  glass  we  find  that  the  nearest  point  at 
which  he  can  do  so  with  ease  is  12".  The  amount  of  presbyopia 
therefore =^/ 34;  and  as  convex  16  is  the  glass  which  neutralises  his 
hypermetropia,  the  latter=:^/ig,  and  he  will  require  convex  16  for 
objects  lying  between  12"  and  infinity,  and  a  stronger  glass  to  bring 
his  near  point  nearer  than  12".  This  is  easily  found  by  the  equa- 
tion Y/  ssay^^-i- YjgssQYj.  But  convex  10  would,  on  account  of  the 
infiuence  of  the  convergence  of  the  optic  axes,  be  found  somewhat 
too  strong.  Hence  convex  12  would  most  probably  be  the  fitting 
glass. 

'*  The  range  of  accommodation  of  a  hypermetropic  eye  is  easily 


Hypermetropia.  147 

found.  We  must  first  change  it  into  a  normal  eye  by  fiimiahiog  it 
with  that  convex  glass  which  will  enable  it  to  see  distant  objects 
distiiicUy  without  almost  any  exercise  of  the  accommodation ;  and 
th^i,  still  wearing  this  glass,  find  the  nearest  point  at  which  it  can 
read  No.  1  distinctly  and  easily.  If  the  patient  requires  for  distant 
vision  convex  20  befcws  the  instillation  of  atropine,  and  conyex  10 
after  it,  we  should  try  his  nearest  point  with  a  glass  between  the 
tw(^*<-No.  16  for  instance  (*),  for  No.  10  would  be  too  strong.  He 
has  been  so  accustomed  to  strain  his  accommodation  that  he  cannot 
all  at  onoe  really  command  his  near  point  with  conyex  1 0. 

**  Let  us  now  suppose  that  with  convex  16,  his  near  point  (p)  lies 
at  T' ;  his  far  point  (r)  has  been  found  to  be  at  an  infinite  distance 
(ao);  for  he  can  see  distant  objects  well  with  convex  16  without 
much  effort,  altliougb  convex  20  is  best  This  range  of  accommoda^ 
tioD  (A)  is  to  be  found  by  the  formula,  A^sYp — y^.  Now  p=7", 
r=:  Q»,  hence  Abb^/^ — ^^/«  ss  V7.    His  range  of  accommodation sc^/^. 

**  When  we  have  gradually  accustomed  the  eye  to  the  use  of 
stronger  and  stnmger  ^bsses  for  distant  vision,  and  have  finally  gone 
over  to  the  use  of  the  glass  which  completely  neutralises  the  hyper- 
metropia  (which  is  convex  10  in  our  supposed  case),  we  may  try  the 
nnge  of  aocommodadon  again  with  this  glass. 

**  I  am  well  aware  that  this  plan  of  finding  the  range  of  aecommo- 
dation  is  not  mathematically  exact.  But  it  is  by  far  the  simplest 
and  quickest  proceeding,  and  sufficiently  accurate  for  all  practical 
pniposes.  And  as  my  object  in  these  papers  is  to  make  the  subject 
of  which  I  am  treating  as  simple  and  practical  as  possible,  I  have 
purposely  abstained  from  entering  into  ekborate  formube,  and  some- 
what intricate  questions  and  experiments. 

^  Let  us  now  conmder  the  method  of  suiting  hypermetropic  patients 
with  spectacles. 

"  We  must  first  discover  the  amount  of  the  hypermetropia  before 
atropine,  by  letting  the  patient  read  No.  19  or  20  of  JSger  at  a 
distance  of  20  feet.  Let  us  suppose  that  convex  20  is  the  strongest 
glass  with  which  he  can  read  No.  19  fiuently  and  distinctly.  His 
hypermetropia  before  atropine  therefore  «  i/j^.  We  then  try  the 
nearest  point  at  which  he  can  read  No.  1  comfortably  ;  this  is  found 
to  be  7".     He  is,  therefore,  not  presbyopic.     In  order  to  find  out 

*  I  need  not  point  out  the  necessity  of  waiting  until  the  effect  of  the  atro- 
jrfne  is  thoroughly  gone  off,  which  may  take  five  or  six  days,  before  testing 
the  range  of  aooommodstion. 

K  2 


cc 


148  Miscellaneous. 

to  what  extent  he  has  strained  his  accommdation  in  reading  No.  19 
through  convex  20,  and  to  know  what  glass  will  completely 
neutralise  the  hypermetropia,  we  paralyse  his  power  of  accommoda- 
tion— his  ciliary  muscle — hy  the  instillation  of  a  strong  solution  of 
atropine  (gr.  iv.  to  the  ounce  of  water).  After  this  has  acted  for  a 
couple  of  hours  we  examine  the  patient  again.  He  cannot  now  read 
No.  20  without  a  glass,  or  even  with  convex  20;  but  now  requires 
convex  10  for  reading  No.  19  fluently.  The  real  amount  of  hjrper- 
metropia  therefore  s=  i/|q.  He  has,  however,  been  so  accustomed  to 
strain  his  powers  of  accommodation  that  he  could  not  relax  it  com- 
pletely, even  when  there  was  no  occasion  for  accommodating  at  all, 
when  we  corrected  the  malconstruction  of  the  eye  by  means  of  a 
convex-glass. 

What  spectacles  are  we  to  give  him  ? 

If  we  were  to  prescribe  convex  10  they  would  be  found  too  strong 
for  distant  objects,  or  even  for  reading.  He  could  not  all  at  once 
relax  his  accommodation,  so  as  to  be  able  to  use  the  glasses,  which 
really  neutralise  his  hypermetropia,  and  which  must  ultimately  be 
used  if  we  wish  to  free  him  permanently  from  the  annoyances  of  his 
affection.  We  must,  therefore,  gradually  accustom  his  eyes  to 
stronger  and  stronger  glasses,  until  convex  10  be  reached.  Let  us 
begin  with  convex  18  or  20.  He  is  to  wear  them  both  for  reading, 
writing  and  distant  objects.  Never,  indeed,  laying  these  spectacles 
aside  when  he  is  using  his  eyes.  In  the  course  of  a  few  weeks  we 
give  him  convex  16,  then  14,  12,  and,  at  last,  after  the  lapse  of  a 
few  months,  he  can  wear  No.  10  for  reading  and  for  distance. 

*'  When  the  degree  of  hypermetropia  is  great,  or  when  presbyopia 
co-exists,  two  sets  of  spectacles  will  be  required,  a  strong  pair  for 
reading,  writing,  etc.,  a  weaker  pair  for  distant  objects." 

The  following  is  a  resume  of  what  has  been  said  on  the  subject  of 
hypermetropia : — 

•*  In  this  affection  the  refractory  power  of  the  eye  is  too  low,  or  its 
antero-posterior  axis  too  short,  so  that  when  the  eye  is  in  a  state  of 
rest,  parallel  rays,  emanating  from  distant  objects,  are  not  focused 
upon  the  retina,  but  behind  it,  only  converging  rays  being  united 
upon  it.  But  the  latter  do  not  exist  in  Nature,  and  the  eye  must  either 
exert  its  accommodation  to  render  parallel  rays  sufficiently  convergent 
to  be  brought  to  a  focus  upon  the  retina,  or  we  must,  by  means  of 
the  proper  convex  glass  give  them  a  sufficiently  convergent  direction. 
In  the  latter  case  we  neutralise  the  hypermetropia,  and  transform  the 


Hypermetrojna.  149 

hypennetropic  into  a  nonna]  eye,  which  unites  parallel  rays  upon  the 
retina  without  almost  any  exertion  of  its  accommodation  apparatus. 

**  The  presence  of  hypermetropia  is  thus  tested.  If  a  person  can 
see  distant  ohjects  through  a  convex-glass,  he  is  hypermetropic. 
The  hest  object  is  Jager's  test-type.  The  strongest  glass  with 
which  the  patient  can  read  at  a  distance  of  20'  gives  us  the  degree 
of  hypermetropia  he/ore  the  action  of  atropine.  If  this  glass  be 
conyex  24,  his  hypermetropia  ^  — ^1/24.  The  power  of  accommoda- 
tion is  then  to  be  paralysed  by  a  strong  solution  of  atropine  (four 
gprains  to  one  ounce  of  water);  after  this  has  acted  for  from  two  to  three 
hours,  the  degree  of  hypermetropia  is  to  be  again  tested.  In  young 
persons  with  a  good  range  of  accommodation,  the  difference  in  the 
convex  glass  required  before  and  after  atropine  is  often  very  con- 
siderable.  In  the  normal  eye  the  far.point  begins  to  recede  from  the 
eye  about  the  age  of  55  or  60,  the  eye  becomes  hypermetropic,  at 
80  the  h3rpermetropia  may  according  to  Bonders,  s=  1/24. 

**  Range  of  AccommodatUm, — We  change  the  hypermetropic  eye 
into  a  normal  one  by  means  of  the  suitable  convex  glass,  and  then 
find  the  nearest  point  at  which  No.  1  of  Jager  can  be  read  with  this 
glass.     If  the  near  point  lies  at  T\  A  :=  Y^. 

'*  It  has  already  been  pointed  out  that  presbyopia  may  co-exist  with 
hypermetropia. 

**  Spectacles. — A  person  suffering  from  hypermetropia  must  be  gra- 
dually accustomed  to  wear  those  glasses  which  neutralised  his  hyper- 
metropia after  the  accommodation  was  paralysed  by  atropine.  At 
first  weaker  glasses  will  be  required,  but  the  strength  should  be 
gradually  increased  until  he  has  arrived  at  the  glass  which  really 
neutralises  his  hypermetropia.  These  spectacles  should  be  worn 
both  for  near  and  distant  objects,  should,  indeed,  be  always  worn 
when  the  eyes  are  used.  If  the  hypermetropia  is  great,  or  if  a  pres- 
byopia co-exists,  two  pairs  of  spectacles  will  be  required,  a  strong 
pair  for  reading,  etc.,  a  weaker  for  distance. 

*'  Hypermetropia  is  a  very  frequent  cause  of  Asthenopia^  and  also  of 
Convergent  Strabismus,  The  asthenopia  is  produced  by  the  over- 
straining of  the  accommodation  apparatus  in  reading,  writing,  etc., 
without  the  proper  spectacles.  We  have  seen  that  the  hyperme- 
tropic eye  has  already  to  exert  its  power  of  accommodation,  more  or 
less,  for  distant  objects,  in  viewing  which  the  normal  eye  hardly  uses 
its  accommodation  at  all.  How  much  greater  must  this  exertion  be 
when  the  hypermetropic  eye  looks  for  any  length  of  time  at  near 


150  Misceilaneous. 

objects,  the  rays  from  which  are  Btrongly  dtyergent  The  eye  cannot 
keep  up  this  great  strain  of  its  powers  of  accommodation  for  any 
kngth  of  time,  and  hence  symptoms  of  astenopia  soon  arise. 

'*  Hypermetropia  often  eatues  Conceryent  8irabismu9.-AB  the  power 
of  accommodation  increases  when  the  convergence  of  the  optic  axeH 
is  augmented,  a  person  suffering  from  hypermetropia  often  squints 
inwards  involuntarily,  in  order  to  see  more  distinctly.  This  squint 
soon  becomes  permanent,  if  the  hypermetropia  is  not  treated,  and  a 
strasbismus  operation  will  then  be  required." 

—  — —  ■— — ■ —  -  -  -  -  ■  — 

The  Composition  of  the  Sun  and  Chemical  Analysis  hy  the  Spectrum, 

The  gorillas,  and  M.  Du  Chaillu*s  adventures,  have  formed  the 
leading  topics  of  the  scientific  gossip  of  the  season.  But  they  have 
not  been  without  a  rival ;  for  the  curiosity  of  the  thinking  part  of 
society  has  been  almost  as  much  excited  by  accounts  of  new  dis- 
coveries of  the  composition  of  the  sun,  as  by  those  of  the  discovery 
of  the  nearest  relations  of  the  human  race  in  Central  Africa*  The 
interest  excited  by  the  discussion  on  the  physical  composition  of  the 
sun,  at  the  meeting  of  the  British  Association  at  Oxford,  last  year, 
has  been  so  kept  up  by  the  brilliant  account  which  Faraday  gave  at 
the  Royal  Institution,  of  the  results  of  the  observation  of  the  total 
eclipse  in  Spain,  as  well  as  by  Professor  Roscoe*s  Lecture  on 
M&rch  12,  on  Bunsen  and  Kirchhoff*s  researches;  and  by  Pkofeesor 
Tyndall's,  on  June  7,  that  we  are  tempted  to  give  our  readers  each 
an  account  of  the  matter  as  our  limits  allow. 

The  sun  is  an  enormous  mass,  or  nucleus^  of  matter,  heated  to  an 
inconceivable  degree,  and  luminous  in  proportion;  and  it  is  sur* 
rounded  with  an  atmosphere  of  flame.  This,  under  the  influence  of 
the  rotation  of  the  sun  on  its  axis,  is  subject  to  variations  of  tem- 
perature, and  to  currents  passing  from  the  equator  to  the  poles  and 
back  again,  like  those  in  the  atmosphere  of  the  earth ;  and  not  less 
to  tropical  storms  and  whirlwinds  of  flame.  Most  remarkably  do 
the  photographs  of  the  late  total  eclipse  show  this  flaming  atmos- 
phere as  it  appeared  at  the  edges  of  the  darkened  disc,  as  well  aa 
the  existence  of  certain  huge  outlying  masses  of  flame,  which  hoter 
over  it,  apparently  detached  like  clouds. 

The  light  of  the  sun,  as  is  well  known,  can  be  separated  by  the 
prism  into  seven  rays  of  colours,  known  as  prismatic^  and  these 
present  a  number  (nearly  GOO)  of  dark  lines  parallel  to  each  other, 


Chemical  AnalysU  bp  the  Spectrum.  151 

which,  from  the  name  of  their  discoverer,  are  called  Fraunhofer's 
lines.  These  lines  are  constant,  or  fixed,  and  always  occupy  the 
same  place  in  the  spectrum ;  and  they  are  accurately  catalogued  and 
numbered. 

Having  set  forth  these  facts  about  the  sun,  let  us  turn  to  some  few 
elementary  doctrines,  very  clearly  stated  by  Professor  Tyndall,  and 
showing  the  exact  harmony  which  exists  between  light  and  sound, 
and  the  similarity  of  the  condition  which  generates  either  sensation. 
Heat  and  light  are  propagated  by  means  of  an  ether  which  fills 
space,  and  whose  existence  is  proved  by  its  retarding  the  speed  of 
comets.  They  consist  in  certain  movements  or  vibrations  of  the 
atoms  of  bodies.  When  these  vibrations  are  communicated  to  the 
surrounding  ether,  they  are  said  to  radiate.  When  they  are  com* 
municated  to  and  arrested  by  any  other  body,  they  are  said  to  be 
ahiorhed.  Some  gases — oxygen,  for  example — do  not  give  ofiT  heat 
by  radiation ;  others,  as  defiant  gas,  do  so  largely.  The  same  gases 
which  radiate  also  absorb  it,  and  i>ice  verad.  This  was  shown  very 
beautifully  by  experiments,  in  which  a  current  of  oxygen  passing 
over  a  heated  copper  ball  did  not  affect  a  thermo-electric  pile,  while 
a  current  of  heated  defiant  gas  did  so ;  and  by  a  counter  experi- 
ment, showing  that  a  sheet  of  oxygen  gas  does  not  arrest  the  heat 
radiating  from  a  heated  surface,  but  allows  it  to  pass  through,  while 
a  sheet  of  defiant  gas  arrests,  absorbs,  and  cuts  off  the  heat,  and 
does  not  allow  it  to  pass  through.  The  difference  in  the  relation  of 
these  gases  to  heat  was  stated  to  depend  probably  on  mechanical 
principles.  The  atoms  of  simple  bodies,  being  probably  simple 
spheres  of  extreme  tenuity,  allow  the  vibrations  of  the  ether  to  pass 
over  them ;  while  the  atoms  of  compound  bodies,  being  complex, 
arrest  them  mechanically,  and  are  capable  of  communicating  them 
by  radiation.  The  more  complex  the  gas,  the  greater  does  its  power 
of  radiation  and  absorption  of  heat  become. 

As  sound  consists  in  the  coarser  vibrations  which  affect  the  audi- 
tcny  nerve,  so  light  consists  in  other  subtler  vibrations  which  are 
taken  cognizance  of  by  the  optic  nerve.  The  intensity  or  loudness 
of.  sounds  depends  on  the  extent  of  the  vibrations  or  on  the  magni- 
tude of  the  wave,  and  the  pitch  on  the  number  of  vibrations  per 
second.  Just  so,  it  seems  certain  that  there  is  a  numerical  ratio 
between  the  breadth  of  the  vibrations  of  the  luminiferous  ether, 
which  constitute  colours.  But  any  vibrating  body — the  pendulum  of 
a  common  clock,  for  example — is  able  to  be  set  vibrating  by  any 


1 52  Miscellaneous. 

other  body  vibrating  in  equal  measure.  So  a  string  in  a  piano  will 
often  resound  to  a  similarly  sounding  string.  So  also  any  luminous 
particles  absorb  the  vibrations  of  any  similarly  luminous  particles 
'which  impinge  upon  them. 

The  vapour  of  every  metal,  heated  to  incandescence  (as  when  a 
solution  of  soda  in  alcohol  is  burned),  yields  light  of  a  peculiar 
colour,  having  definite  refractive  powers,  and  when  passed  through 
the  prism,  appearing  in  the  form  of  one  or  many  bright,  luminous 
bands,  at  a  particular  part  of  the  spectrum.  The  commonest  example 
is  sodium,  the  incandescent  vapour  of  which,  in  any  combination, 
yields  a  homogeneous  yellow  light,  which,  passing  through  the  prism, 
appears  as  a  yellow  band  in  a  definite  place.     Every  other  metal 
produces  its  own  band  or  series  of  bands  in  a  definite  part  of  the 
spectrum,  and  no  two  metals  agree  ui  the  colour,  the  number,  or  the 
place  of  these  bands. 

Now  for  the  practical  results  of  these  purely  scientific  details. 
First,  by  these  means — that  is,  by  observing  the  exact  place,  num- 
ber, and  colour  of  the  luminous  bands  produced  when  any  metallic 
substance  is  so  heated  as  to  rise  in  vapour  and  to  shine  as  flame  does 
— a  new  instrument  of  chemical  analysis  is  placed  in  the  hands  of 
the  philosopher.     It  is  in  its  infancy  yet,  but  it  is  very  possible  that 
we  may  see  it  used  for  the  determination  of  the  presence  of  metals. 
Any  one  who  has  seen  the  instrument  exhibited  by  Mr.  Ladd,  will 
not  doubt  this.     Any  number  of  metals  may  be  mixed,  and  yet  their 
flame  will  give  all  the  bright  bands  produced  by  each  separately. 
Result  the  second  is,  that  at  least  two  new  metals  have  been  dis^ 
covered.     For  the  residue  afler  evaporating  certain  mineral  waters, 
produced  by  its  flame  two  bright  blue  lines,  not  referrible  to  any 
known  metal ;  and  the  substance,  submitted  to  analysis,  yielded  a 
new  metal,  which  from  its  coloured  flame  has  been  called  ciBsium, 
Another  new  metal  has  been  found,  which,  from  its  red  lines  has 
been  called  rubidium.     It  has  been  discovered,  further,  that  many 
metals,  once  thought  rare,  are  really  very  widely  diflused,  though  in 
extremely  minute  quantities.     Lithium  is  an  example.     Professor 
RoBCoe  tells  us  that  it  is  found  in  most  rocks;  in  sea,  river,  and 
Thames  water ;  in  the  ashes  of  tobacco  and  most  plants ;  in  milk, 
human  blood,  and  flesh.     The  third  result  is  the  demonstration 
afforded  of  the  chemical  composition  of  that  atmosphere  of  flames 
that  envelopes  the  sun.     White  light  produces  a  spectrum  of  seven 
colours.    The  flame  of  any  given  metal  produces  one  or  more  bright 


Chelidortium  Majus.  153 

cdoured  bands  only,  and  not  an  entire  spectrum.  When  an  intense 
white  light  is  passed  through  the  light  of  a  metallic  flame,  a  dark 
line  is  seen,  in  the  exact  situation  of  each  coloured  band.  When, 
for  instance,  a  soda  flame  is  placed  before  the  electric  light,  a  dark 
band  is  seen  in  the  yellow  part  of  the  spectrum  where  a  bright  yellow 
band  would  have  been  if  the  soda  flame  had  been  there  singly.  The 
fact  being  that  the  yellow  rays  of  the  white  light  are  absorbed  by 
the  isochronously  yibrating  particles  of  the  soda  flame.  Now  the 
sun  has  a  nucleus,  yielding  an  intense  white  light,  like  the  electric 
lamp;  and  it  has  a  less  intensely  luminous  atmosphere  of  flame 
aroond  it ;  and  its  spectrum  contains  dark  lines ;  a^d  these  dark 
lines  coincide  in  place  and  number  with  the  dark  lines  produced 
when  certain  incandescent  metallic  vapours  are  put  before  the  elec- 
tric light, — therefore  the  flaming  atmosphere  of  the  sun  contains 
these  metals.  Iron,  sodium,  magnesium,  and  nickel  exist  there 
largely,  whilst  it  seems  that  silver,  copper,  zinc,  aluminium,  cobalt, 
lead,  and  antimony,  are  probably  absent.  In  addition  to  the  know- 
ledge thus  certainly  obtained,  a  very  probable  hypothesis  may  be 
formed  of  the  nature  of  the  spots  in  the  sun.  From  the  immense 
magnetic  disturbances  with  which  they  are  associated,  they  are  pro- 
bably masses  of  iron,  in  a  cool  and  non-candescent  state,  precipitated 
during  the  fluctuations  of  temperature  which  accompany  the  torna- 
does that  occur  in  the  tropical  regions  of  the  sun's  atmosphere. — 
Medical  Times  and  Gazette^  June  22nd,  1861. 

Rademacher  on  Chelidonium  Mc^us. 

In  a  former  part  of  this  number  we  have  inserted  an  article  on  the 
use  of  Chelidonium  in  some  neuralgic  affections.  It  is,  no  doubt, 
true,  as  the  author  asserts,  that  the  employment  of  this  drug  in  old- 
school  medicine  is  almost  nil;  but  it  is  not  so  in  the  system  of 
revived  Paracelsism,  introduced  by  Rademacher.  On  the  contrary, 
CTuHdanium  is  a  very  conspicuous  curative  agent  in  Rademacher's 
treatment,  and  we  think  we  shall  interest  our  readers  by  giving  them 
the  substance  of  that  very  original  writer's  remarks  on  its  use. 

The  preparation  of  CJieUdoniumy  preferred  by  Rademacher,  is  a 
tincture,  prepared  in  the  same  way  as  Hahnemann's  tinctures.  In 
the  peculiar  phraseology  of  Rademacher,  Chelidonium  is  a  hepatic 
remedy  acting  on  the  internal  structure  of  the  liver.  But  we  shall 
give  his  own  account  of  his  first  employment  of  the  drug  and  of  the 


]  61  MifceUaneouB. 

diseaBe  in  which  he  found  it  most  servioeable.  Our  readers  will,  we 
•re  sure,  find  pleasure  in  perusing  the  gr<^phic  description  of  the  dis- 
ease, which  reminds  us  of  Hippocrates  more  than  any  other  medical 
author  :— 

**  I  must  first,*'  he  says,  *'  to  my  shame^  confess  that  up  to  the 
year  1827, 1  felt  nothing  but  contempt  for  Chelidonium  as  a  hepatic 
remedy,  for  which  it  had  in  former  times  been  renowned,  and  I  be- 
lieved I  had  found  a  substitute  for  it  of  a  more  efficacious  character. 
The  reason  why  I  despisd  it  was  because  in  my  youth  I  had  often 
seen  it  employed  in  Jaundice,  but  without  ever  seeing  the  jaundice 
removed  by  it.  Moreover,  in  the  first  third  of  my  medical  career, 
jaundice  was  a  disease  rarely  met  with,  and  the  cases  that  occurred 
were  so  slight  that  a  dose  or  two  of  Calomel,  or  the  moderate 
stimulus  of  a  purgative,  sufficed  to  cure  them.  Subsequently,  acci- 
dent rather  than  the  teaching  of  others  directed  my  attention  to  the 
action  of  Nux  vomica  ;  and  afterwards,  when  during  a  prevalence  of 
gastric  affection,  I  had  a  great  deal  to  do  with  cases  of  jaundice  that 
came  to  me,  many  from  distant  parts,  I  had  very  frequent  opportunity 
to  strengthen  my  prepossessions  against  Chelidonium^  by  seeing  the 
ineffectual  employment  by  other  doctors  of  prescriptions  in  which 
Calomel,  Exiractum  chelidonii^  and  Aloes  were  constant  ingre- 
dients. At  length,  in  the  year  1827,  I  was  punished  for  my  want 
of  faith  in  the  experience  of  the  old  masters,  by  much  toil  and 
trouble. 

"  Late  in  the  summer  of  the  year  alluded  to,  a  curious  kind  of 
fever  commenced  to  show  itself,  which,  after  careful  examination, 
during  which  I  had  to  play  longer  than  I  liked  the  part  of  a  hesi- 
tating and  cautious  experimenter,  I  discovered  to  be  a  primary 
affection  of  the  internal  structure  of  the  liver.  Now,  as  medical 
works  treat  more  of  affections  of  the  convex  and  concave  surface  of 
the  liver  than  of  its  internal  structure,  my  readers  may  think  it  odd 
that  I  should  pronounce  this  to  be  an  affection  of  the  interior  of  the 
liver ;  they  might  justly  think  that  such  subtle  distinctions  of  morbid 
states  came  very  ill  from  one  who,  like  myself,  pretended  to  be  a 
pure  experimental  doctor. 

'*  True  it  is,  that  if  I  were  compelled  to  enumerate  the  signs  that 
distinguish  all  cases  of  this  hepatic  affection  from  all  other  hepatic 
affections,  I  should  be  much  embarrassed.  Nature  has  drawn  no 
very  sharply  defined  limits  betwixt  the  different  morbid  states  of  an 
organ.     The  internal  liver-affection  in  its  extreme  character,  in  its 


ChelidoniuM  Majus.  155 

most  p^ect  form,  Cftn  be  very  well  distingaisbed  both  by  tbe  senseB 
And  the  reason  from  the  other  morbid  conditions  of  the  liver.  It  is 
only  when,  by  inappreciable  shades,  it  approaches  to  other  morbid 
ixmditione  that  its  distinctive  signs  become  always  more  indistinct, 
and  at  last  vanish  altogether.  The  perfect  form  of  the  internal 
hepatic  disease  is  distinguished  by  white,  quite  colourless  ftsces,  as 
in  jaundice,  and  by  the  complete  absence  of  all  the  other  symptoms 
of  jaundice.  The  skin  is  and  continues  white,  has  not  even  a  dirty 
appearance,  and  the  urine  is  merely  straw-coloured,  as  in  healthy 
persons.  This  internal  liver  affection  in  such  a  perfect  form  is 
rather  rare ;  still  some  writers  have  described  it.  I  have  seen  five 
cases  of  it  in  my  lifo»  But  had  it  never  been  alluded  to  by  medical 
authors,  had  I  only  seen  A  single  case  of  it,  still  this  one  case  would 
have  sufficed  to  establish  the  reality  of  such  a  morbid  condition  as 
much  as  if  I  had  seen  a  hundred,  or  more,  and  considering  the 
incontrovertible  truth  that  nature  produces  innumerable  degrees  of 
one  and  the  same  morbid  state,  we  should  have  been  forced  to  take 
for  granted  innumerable  degrees  of  such  a  disease. 

**•  It  is  not  necessary  that  a  physician  should  possess  any  great 
^qperience  in  order  to  know  that  the  disease  of  the  liver,  which  in 
its  most  perfect  form  results  in  jaundice,  has  innumerable  degrees, 
some  of  which  would  not  be  called  jaundice  either  by  medical  or 
non-medical  persons.  The  very  slightest  degree  of  this  morbid 
Mate,  however,  is  accompanied  by  a  golden  colour  of  urine,  and  the 
skin,  especially  that  of  the  face,  has  a  more  or  less  dirty  appearance* 
Now,  as,  in  the  cases  above  alluded  to,  the  white  fffices  incontro- 
vertibly  proved  that  the  bile  ceased  to  be  poured  into  the  intestinal 
canal,  so  the  absence  of  the  slightest  symptoms  of  jaundice  proved 
just  as  incontrovertibly  that  here  not  only  was  no  bile  poured  into  tbe 
duodenum,  but  that  the  unknown  organ  whereby  the  bile  is  formed 
from  the  blood  was  itself  diseased ;  that,  in  fact,  there  was  no  bile 
present,  therefore  none  absorbed,  deposited  in^  the  skin,  or  evacu- 
ated by  the  urine.  So  when  I  talk  of  an  affection  of  the  interior  of 
the  liver,  the  reader  will  be  so  good  as  only  to  regard  this  as  a 
figurative  expression,  for  I  am  free  to  confess  that  I  know  no  more 
than  any  of  my  colleagues,  in  what  particular  part  of  the  liver  the 
actual  bOe-making  organ  is  placed. 

**  Now  to  the  fevers.  They  commenced  with  alternate  rigor  and 
heat,  and  this  state  continued  a  long  time— often  two  or  three  days. 
The  headache  was  moderate,  and  went  off  in  the  first  days  of  its  own 


156  Miscellaneous, 

accord ;  instead  of  it  there  always  occurred  a  sensation  of  ^ddinesa 
or  staggering,  to  which  those  around  them  gave  the  name  of  madness 
or  light-headedness.  This  sensation,  however,  as  is  well  known 
oilen  precedes  ordinary  hilious  fevers  and  brain  fevers.  I  remember 
only  two  patients  who  had  violent  intolerable  headache,  such  as 
occurs  in  brain  fever.  The  pulse  was  moderately  quick,  just  as  it 
is  in  ordinary  innocuous  fevers ;  in  very  few  cases  was  it  irregular. 
The  thirst  varied  in  different  cases,  but  was  on  the  whole  moderate ; 
the  tongue  not  furred,  hardly  showing  in  the  centre  a  slight  white 
coating.  No  pain  or  tension  in  the  precordial  region.  In  very  rare 
cases  a  slight  pain  in  the  hepatic  region  could  be  detected.  Chest 
affections  were  rare,  and  were  only  present  in  those  cases  where 
there  was  slight  hepatic  pain.  Some  patients  were  observed  to  sigh 
involuntarily.  Bitter,  sour,  or  foul  taste,  eructations,  nausea,  &c., 
were  not  present;  and  when,  as  very  rarely  happened,  a  patient 
complained  of  bitter  taste,  this  symptom  was  removed  in  24  hours, 
by  means  of  Natron^  without  its  removal  having  the  slightest  modi- 
fying influence  on  the  disease.  The  urine  varied — in  some  it  was 
yellowish  and  somewhat  turbid,  without  being  actually  opaque ;  in 
others  it  was  clear,  and  of  a  bright  golden  colour,  just  as  it  is  in 
slight  affections  of  the  biliary  ducts ;  in  others,  again,  it  was  pale 
straw-coloured,  as  in  healthy  persons.  In  many  cases,  when  they 
entered  on  convalescence,  the  urine  became  dark  yellow,  as  in 
decided  affections  of  the  biliary  passages.  However  the  urine  might 
vary,  it  was  never  deficient  in  uric  acid. 

*'  The  muscular  powers  were  little  weakened  even  in  advanced 
stages  of  the  fever,  and,  with  the  exception  of  two  patients,  who 
could  not  raise  themselves  up  in  bed,  most  of  them  could  not  only  do 
this  without  assistance,  but  with  the  aid  of  another's  hand  could 
get  out  of  bed ;  indeed  there  were  many  who  could  do  this  without 
any  help. 

"  The  skin  was  neither  dry  nor  moist ;  in  some  there  was  an 
occasional  outbreaking  of  perspiration,  which,  however,  did  no  good« 
The  complexion  in  some  was  quite  unchanged ;  in  others,  it  was 
dirty,  as  it  is  in  some  slight  affections  of  the  bUiary  ducts. 

**  The  febrile  paroxysms  were  irregular ;  they  showed  themselves 
in  the  patient's  restlessness,  and  in  the  increased  fulness  of  the 
pulse.  The  remissions  were  not  marked  by  diminished  quickness, 
but  by  diminished  fulness  of  the  pulse. 

**  It  is  quite  impossible  to  describe  perfectly  the  course  of  the 


CAelidofiium  Ma  jus,  157 

disease  on  account  of  its  irregularity ;  it  might  last  from  three  to 
twelve  weeks.  Most  of  the  symptoms  might  occur  either  early 
or  late ;  in  short,  there  was  something  so  changeable  in  its 
course,  that  the  best  thing  I  can  do  is  to  mention  the  symptoms  that 
attended  it  one  by  one,  noticing  whether  they  occurred  frequently 
or  seldom,  early  or  late.     These  symptoms  were  the  following : — 

**  Subsultus  tendinum  was  frequent,  and  often  occurred  during 
the  first  five  days. 

**  I>T3mess  of  the  tongue  was  frequent,  but  did  n6t  last ;  to-day 
tbe  tongue  might  be  dry,  to-morrow  moist,  and  the  day  following 
again  dry,  and  so  on.  This  symptom  might  occur  in  the  first  six 
days.  I  neyer  saw  the  tongue  constantly  dry,  and  covered  with  a 
thick  dirty  coating. 

*^  Raving  was  very  seldom  constant ;  it  occurred  in  the  first 
eight  days — ^indeed,  in  one  young  lady  I  observed  the  very  first  day  a 
mental  excitement  bordering  on  mania.  But  the  delirium  was  seldom 
continued.  I  could  obseiTC  no  regularity  in  its  coming  and  going. 
In  some  few  it  was  continued.  In  two  cases  it  was  attended  by  a 
constant  desire  to  leave  the  bed;  in  many  there  was  no  delirium 
at  all.  In  one  female  patient  I  observed,  what  is  rare  in  acute 
diseases,  not  exactly  raving,  but  great  perplexity  about  religious 
subjects.  This  woman  had  never  before  troubled  herself  about  re- 
ligious difficulties,  nor  did  she  after  her  recovery. 

*'  Diarrhoea  was  very  frequent — indeed,  so  frequent  that  its 
absence  must  be  looked  on  as  an  exception  to  the  rule.  It  came 
on  early ;  the  disease  often  commenced  with  it ;  in  some,  though 
rare  cases,  it  was  a  premonitory  symptom  of  the  disease ;  in  most,  it 
continued  until  the  patient's  recovery.  The  feeces  were  generally 
bright  yellow,  like  babies*  motions;  in  some  however  they  were  of  the 
normal  brown  colour.  I  do  not  remember  any  case  where  they  were 
grey  or  white.  The  most  extraordinary  symptom  in  this  fever  was 
the  involuntary  discharge  of  the  fseces,  which  did  not  certainly  occur 
in  all  those  who  had  diarrhcea,  but  in  very  many  of  them ;  nor  was 
it  a  constant  phenomenon  among  the  latter,  but  it  varied,  so  that  one 
day  they  dirtied  the  bed,  the  next  day  remained  clean,  and  so  on ; 
and  yet  no  kind  of  regular  periodicity  could  be  detected  in  the  alter- 
nate appearance  and  disappearance  of  this  troublesome  symptom.  I 
should  not  forget  to  mention,  that  the  diarrhoea  was  quite  unaccom- 
panied by  pain ;  the  usual  feeling  in  the  abdomen  before  a  stool, 
that  every  healthy  person  has,  never  preceded  the  evacuations. 


158  Miscellaneous. 

^  DrownneM  occurred  in  some  patientB  earlier,  in  tome,  later ;  but 
was  variable,  like  the  delirium. 

**  Chest  affections  were  rare ;  cough  rare,  both  in  the  coarse  of 
the  disease  and  daring  the  oouYalescence. 

^  Pains  in  the  abdomen  occurred  in  manj*  patients  (but  by  no 
means  in  aU}  in  the  later  periods  of  the  disease,  and  were  sometinMs 
so  yiolent  as  to  make  the  physician  anxious  about  the  patient's  re- 
covery. I  remember  a  case  where  two  old  doctors  in  consultation 
took  these  violent  abdominal  pains  for  inflammation  of  the  bowels, 
and  treated  them  accordingly.  I  know  not  if  the  post  mortem  exa- 
mination confirmed  their  views.  These  abdominal  pains,  however, 
are  not  characteristic  of  the  fever  1  am  describing ;  for  thou^  I 
have  not  met  with  them  in  ordinary  bilious  fevers,  I  have  offen 
enough  seen  them  occur  in  the  later  periods  of  other  abdominal 
fevers.'* 

Rademacher  then  proceeds  to  enumerate  the  various  remedies  he 
tried  unsuccessfully  in  this  fever,  and  relates  how  he  was  led  at  last 
to  the  selection  of  Chelidonium.  The  administration  of  this  drug,  he 
considers,  shortened  the  duration  of  the  disease  to  one-third  of  its 
natural  course.  Thus  it  cured  it  in  fVom  14  to  18  days;  whereas, 
when  left  to  nature,  it  required  40,  60,  80  days,  or  even  more, 
for  its  cure.  The  doses  he  gave  were  1  drachm  of  the  tincture 
mixed  with  8  oz.  of  water — a  spoonful  every  hour  when  there  was 
no  diarrhoea.  If,  on  the  contrary,  diarrhoea  was  present,  the  strength 
of  the  medicine  was  diminished,  a  scruple  only  being  mixed  with 
the  8  oz.  of  water. 


Wisdom  in  High  Places, 

Our  readers  have,  doubtless,  not  forgotten  the  declaration  required 
by  the  "  King  and  Queen's  College  of  Physicians  "  from  each  licen- 
tiate, which  we  published  in  our  last  number.*  I'hey  will  remember 
that  the  document  in  question  commences  thus  : — 

*'  I  engage  not  to  practise  any  system  or  method  (so-called)  for  the 
cure  or  alleviation  of  disease,  of  which  the  college  has  disapproved;" 
and  then  it  goes  on  to  state  the  pains  and  penalties  that  are  to  follow 
sny  violation  of  this  solemn  declaration — such  as  censure,  pecuniary 
fine,  expulsion,  and  surrendering  of  the  diploma. 


•  Vol.  xix.,  p.  575. 


Wisdom  in  High  Places.  150 

As  the  declaration  named  not  the  particular  sjrstems  or  methods 

of  treatment  that  had  incurred  the  displeasure  of  the  College,  and 

the  practice  of  which,  hy  any  of  its  licentiates,  was  to  he  yisited  hy 

such  heavy  penalties,  the  very  vagueness  and  mystery  therehy  added 

to  its  denunciations  and  threats  were  calculated  to  impress  with  awe 

the  subscrihing  licentiate.     Possibly,  candidates  for  the  licence  of 

the  College  might  also  be  altogether  repelled  from  the  attempt  to 

obtain  it,  by  a  doubt  as  to  whether  they  might  not  perhaps  one  day 

uncimscioualy  practise  one  of  the  proscribed  systems  or  methods, 

and  thereby  forfeit  the  honours  they  had  obtained  by  a  severe  esami- 

nation  and  considerable  pecuniary  expenditure.    Indeed,  we  can  fancy 

the  vague  denunciation  of  the  College  creating  such  terror  among  con- 

templating  licentiates  as  to  deter  them  altogether  from  the  attempt, 

and  driving  them  into  the  bosom  of  some  other  Alma  Mater,  to  the 

great  loss  of  the  College  which  insisted  on  the  dreaded  declaration. 

What  in  the  name  of  all  that  is  scientific,  we  exclaimed,  can  be 
the  systems  and  methods  of  treatment  disapproved  of  by  this  College  ? 
We  ransacked  back  numbers  of  the  medical  journals  to  find  some 
answer  to  this  question,  but  in  vain.  Has  the  council  of  the  College, 
in  secret  midnight  conclave  assembled,  formally  denounced  by  name 
those  systems  and  methods  it  vaguely  alludes  to  in  this  declaration  ? 
We  could  obtain  no  answer  to  our  query  in  the  past  archives  of  medi« 
cal  intelligence.  How  to  clear  up  the  mystery  ?  Evidently  nobody 
could  give  us  such  authentic  information  as  the  College  itself.  To 
the  College  therefore  let  us  write,  and  respectfully  demand  what  are 
those  methods  and  systems  of  treatment  that  it  has  disapproved 
of.  Will  Mokanna  remove  his  veil  at  our  request,  and  disclose  his 
hidden  features  ?  That  we  can  only  ascertain  by  trying.  So,  em- 
bracing the  opportunity  ofifered  us  by  the  enquiries  of  a  young  friend 
desirous  of  obtidning  the  licence  of  a  College  of  Physicians,  we  wrote 
on  his  behalf  to  the  Registrar  of  the  College,  requesting  that  he 
would  kindly  inform  us  what  were  the  particular  ^*  systems  and 
methods  for  the  cure  and  alleviation  of  disease "  that  had  incurred 
the  disapprobation  of  the  College,  and  moreover,  if  it  was  compulsory 
on  licentiates  to  subscribe  the  declaration  which  imposed  all  those 
pains  and  penalties  on  him  who  should  practise  any  of  the  disap- 
proved systems  and  methods.  Our  missive  was  dated  the  14th  Oct., 
and  by  return  of  post  we  received  the  following  answer  from  the 
Registrar: — 


IGO  Miscellaneauii, 

''  King  and  Queen's  College  of  Physicians  in  Ireland, 

«  Dublin,  15th  October,  1861. 
"  Sir, 

*'  In  reply  to  your  queries,  I  have  to  state  that  the  College 

has  not  disapproved  of  any   system.      Ganditate  have  to  take  the 

delcleration  before  being  admitted. 

**  I  am,  sbr, 

"  Your  fai, 

*•  LOMBE  AtTHILL." 

We  give  the  registrar's  answer  as  it  stands,  with  all  its  pecu- 
liarities of  orthography,  judging  from  which  we  might  perhaps 
conclude  that  the  hall  porter  of  the  College  combines  the  ofBce  of 
registrar  with  his  less  literary  avocation,  or  else,  that  like  his  coun- 
tryman  of  the  story,  the  registrar  had  such  a  bad  pen,  that  it  would 
not  spell  properly. 

The  veiled  prophet  removes  his  mask,  and  behind  it  we  discover — 
nothing  at  all !     The  systems  and  methods  of  treatment  disapproved 
of  by  the  College,   and  prohibited  to  its  licentiates  under  fearful 
penalties,  have  no  existence  !     The  College  tries  to  scare  its  licen- 
tiates with  bogie  ;  but  behind  the  sheet  there  is  nothing.     It  makes 
a  new  decalogue,  in  which  it  threatens  condign  punishment  to  those 
who  practise  what  it  disapproves,  and  all  the  time  it  disapproves  of 
nothing ;  and  yet  it  insists  on  candidates  subscribing  a  declaration — 
or  ddcleraHoriy  as  the   registrar  writes  it — which   binds  them    to 
abstain  from — nothing! 

Is  the  whole  thing  a  hoax  or  a  bull  ?  Considering  which  side  of 
the  Channel  it  was  concocted  in,  we  should  be  disposed  to  consider 
it  the  latter,  were  it  not  that  it  is  too  stupid  even  for  an  Irish  bull. 
We  are  rather  of  opinion  that  the  College  was  in  such  hot  haste  to 
assert  its  purity  in  the  face  of  the  medical  profession  that  it  com- 
mitted the  slight  mistake  of  putting  the  cart  before  the  horse — we 
mean,  exacting  a  promise  from  its  licentiates  to  abstain  from  hete- 
rodox systems  before  it  had  made  up  its  mind  as  to  what  these 
heterodox  systems  were. 

We  may  imagine  a  dialogue,  something  like  the  following,  occur- 
ring between  the  president  and  a  candidate  for  the  licence  of  the 
College. 

President — ''  The  examiners  unanimously  agree  that  you've  passed 
a  creditable  examination,  so  Til  just  throuble  ye  to  put  yer  hand  to 
this  bit  o'  writin',  bindin'  ye  not  to  practise  any  of  the  systems  or 


A  Chronic  Opponent.  161 

methods  for  the  care  or  alleyiation  of  disease  the  College  has  dis- 
^proved  of." 

Candidate — ^'^  Permit  me  to  ask  what  systems  the  College  has 
disapproved  of?" 

President  — **  Faith,  and  ye  may  ask,  my  hoy ;  but  it  will  be 
hard  to  answer  ye,  for  the  divil  a  system  has  the  College  disapproved 
of,  at  all,  at  alL" 

Candidate — **  Then  I  cannot  see  the  use  of  signing  a  declaration 
of  this  character." 

President — "  Och,  and  do  ye  mane  to  doubt  the  wisdom  of  the 
College,  ye  spalpeen?  Sign  away,  or  sorra  a  diploma  will  ye 
get  from  the  College.  By  the  shilelah  of  ^sculapius,  is  it  the  use 
of  signin'  ye  want  to  know  ?  then  let  me  tell  ye,  that  the  use  ye'll 
find  to  be  this — sign  and  we  admit  ye,  refuse  to  sign  and  ye'll  find 
*  No  admission '  chalked  up  for  ye  on  the  College  door." 

The  candidate,  convinced  by  this  irresistible  logic,  signs  the 
unmeaning  declaration  and  pockets  his  diploma,  deeply  impressed 
with  the  sagacity  of  the  College  authorities. 


A  Chronic  Opponent. 

In  former  days  we  enjoyed  the  acquaintance  of  a  young  gentle- 
man, of  prepossessing  appearance,  but  not  overburdened  with 
worldly  wealth  or  intellectual  endowments.  He  became  smitten 
with  the  charms  of  a  young  lady  who  lived  with  her  parents,  whose 
only  child  she  was.  One  fine  morning  this  young  lady  received  a 
letter  from  her  innamorato,  couched  in  the  following  terms  : — 


My  dear  Miss 


c« 


The  admiration  I  have  long  entertained  for  you  has, 
on  further  acquaintance,  ripened  into  a  warmer  sentiment.  When 
I  now  confess  that  I  love  you,  I  believe  that  you  will  not  feel  alto- 
gether surprised ;  and  I  hope  I  do  not  deceive  myself  in  supposing 
that  my  passion  is  reciprocated  by  you.  My  future  fate  is  now  at 
your  disposal.  I  trust  you  will  not  refuse  to  make  me  the  happiest 
of  men,  by  accepting  my  hand  and  fortune,  and  I  sincerely  hope  that 
my  honourable  proposals  will  meet  with  the  sanction  of  your  parents 
or  guardians  (as  the  ceise  may  be).  Should  it  be  my  enviable  lot  to 
be  united  in  matrimony  with  one  I  so  ardently  love,  it  shall  be  the 
study  of  my  whole  life  to  promote  your  felicity,  and  my  earnest 

VOL.  XX.,  NO.  LXXIX — JANUARY,  1862.  L 


1 62  Misceilatieous. 

endeavours  shall  ever  be  directed  to  render  myself  agreeable  and 
useful  to  your  brothers  and  sisters  (if  any)  ; "  and  so  on  through 
four  pages  of  highly  glazed,  delicately  tinted,  and  strongly  perfumed 
note  paper,  such  as  was  fitting  for  the  momentous  occasion. 

When  we  look  through  any  of  the  pamphlets  that  have  been 
written  against  homcBopathy  any  time  these  ten  years  back,  we  are 
irresistibly  reminded  of  our  sapient  young  friend,  who  copied  his 
epistle  from  the  Complete  Letter  Writer,  There  must,  we  are  con- 
fident, exist  somewhere  a  Complete  AniuhomcBopathic  Pamphlel 
Writer^  from  which  all  these  controversialists  conscientiously  copy 
all  their  arguments  and  statements,  totally  irrespective  of  what  has 
been  written  on  the  opposite  side,  and  of  the  real  facts  of  the  case* 
We  are  certain  to  meet  with  stereotyped  phrases  like  the  follow- 
ing : — '*  The  careful  trials  of  homceopathy  by  the  distinguished 
Andral " ;  "  the  masterly  exposure  of  the  system  by  Professor  Simp- 
son" ;  ^  the  refutation  of  their  mendacious  statistics  by  Dr.  Ronth  " ; 
**the  triumphant  reply  of  Dr.  Gairdner"  ;  and  we  may  usually  ex- 
pect to  read  in  one  page  about  the  greedy  little  boy  who  swallowed 
a  whole  easeful  of  globules,  bottles  and  corks  included,  and  was 
not  a  bit  the  worse  ;  and  on  the  next  page,  the  tragical  fate  of  the 
Duke  of  Somcthing-or-other,  who  fell  dead  on  the  spot  after  taking 
a  single  globule.  The  anti-homceopathic  pamphleteers  do  not  know, 
or  do  not  care  to  know  that  the  trials  of  Andral  have  been  shown  to 
be  illusory ;  that  Professor  Simpson  only  exposed  himself,  not 
homoeopathy ;  that  Dr.  Routh  unconsciously  furnished  the  most 
telling  proofs  in  favour  of  the  system  he  attacked ;  and  that  Dr. 
Gairdner  drew  entirely  on  his  imagination  for  his  facts.  The  greedy 
boy's  swallow  was  nothing  compared  to  that  of  these  pamphleteering 
gobemouches ;  and  the  illustrious  duke,  whose  tragical  end  excited 
the  sympathy  of  their  readers,  was  alive  and  well  when  last  heard  of. 
But  what  of  that  ?  The  above  phrases  and  allegations  stood  ready 
for  them,  and  they  must  needs  oopy  them  literally,  just  as  our 
amorous  friend  transcribed  from  his  Letter-toptter  that  genei'ous  ofiTer 
of  his  hand  and  fortune,  though  he  had  not  a  rap ;  and  that  modest 
wish  for  the  sanction  of  the  *'  parents  or  guardians  {m  the  ease 
^'^y  ^^)  " ;  ^^^  ^^^^t  affecting  devotion  *'  to  the  brothers  and  sisters  (tf 
a7iy)y^  though  he  must  have  known  that  there  were  no  guardians  or 
brothers  and  sisters  in  the  case.  The  pamphleteers  must  know  by 
this  time  that  all  the  old  allegations  against  homoeopathy  have  been 


A  Chrofkic  OjyponetU,  168 

proved  to  be  unfounded ;  but  still  they  must  reproduce  them,  as 
their  pamphlets  would  look  incomplete  without  them,  and  they  have 
not  the  wit  to  invent  new  ones  in  their  place. 

Our  old  enemy.  Dr.  Edwin  Lee,  has  just  published  another 
pamphlet  against  homoeopathy,*  which,  of  course,  contains  all  the 
old  mis-statements  respecting  it,  that  have  almost  become  venerable 
from  their  age,  and  ought  by  this  time  to  be  almost  true,  if  frequent 
repetition  can  ever  change  a  falsehood  into  truth,  as  many  people 
seem  to  think. 

How  is  it  that  Dr.  Edwin  Lee  has  constituted  himself,  as  it  were, 
the  champion  of  the  anti-homoeopathists,  so  that  when  any  event 
occurs  to  make  homoeopathy  talked  about,  we  are  as  sure  of  a 
pamphlet  from  him  as  we  are  of  a  sermon  by  Mr.  Spurgeon  on  every 
event  that  interests  the  nation  or  the  metropoliB.  And  how  is  it 
that  all  those  who  write  against  homoeopathy  must  needs  mis- 
represent it  while  they  attack  it  ? 

Sir  Emerson  Tennent,  in  his  new  work  on  Ceylon,  says  the 
Cingalese  have  a  tradition  that  the  leopard  when  hard  up  for  food, 
digs  up  lumps  of  the  white  porcelain  clay,  or  kaolin,  lays  them 
down  beside  him,  and  then  gazes  steadily  on  the  sun  for  a  short 
tune,  so  that  when  he  again  looks  at  the  lumps  of  clay,  they  no 
longer  appear  white,  but  blood-red,  like  bits  of  flesh,  whereupon  he 
devours  them  with  eager  relish.  Have,  perchance,  our  opponents, 
like  the  Ceylon  leopard,  been  so  dazzled  by  gazing  at  the  brilliant 
sun  of  allopathy,  or,  mayhap,  by  the  glittering  corruscations  of 
the  flashing  Lancet — at  once  the  emblem  and  the  organ  of  their 
crafl — ^that  the  pure  white  and  innocent  homoeopathy  appears  to 
their  distempered  mental  vision  as  a  sort  of  monstrous  Raw-head-and- 
bloody-bones,  which  they  must  incontinently  attack  and  "chaw  up?*' 

Besides  attacking  homoeopathy  in  general.  Dr.  Lee,  into^whose 
hands  the  recent  pamphlets  of  Drs.  Drury  and  Sharp  have  fallen, 
attempts  a  feeble  critique  of  these  not  very  successful  productions, 
and  manages  to  maunder  along  through  some  sixty  pages  of  print  in 
a  dreary  fashion,  spinning  out  the  little  he  has  to  say  by  means  of 
copious  quotations  from  like-minded  writers.  On  the  whole,  we 
don't  think  Dr.  Lee  has  improved  in  controversial  writing  since  his 
flrst  onslaught  upon  us  some  twenty  odd  years  since. 

*  Remarks  on  Homcoopathy,  being  a  rejoinder  to  some  Replies  elicited  by 
Sir  B.  Brodie'0  letter  in  Fraser's  Magazine,  by  Edwin  Lee,  M.D.  London: 
Churchill,  1861. 

l2 


1G4  Miscellaneous. 

Dr.  Richard  P.  Cotton  on  the  Action  of  Steel  in  Phthisis. 

The  following  observationB  upon  the  action  of  steel  were  made  upon 
twenty .fi?e  in-patients  of  the  Consumption  Hospital.  As  in  all  my 
preceding  experiments,  I  studiously  avoided  any  selection  of  cases, 
and  excluded  only  those  in  which  the  disease  was  obviously  too  far 
advanced  to  render  any  kind  of  treatment  available,  and  those  in 
which  there  existed  some  complication  which  would  tend  to  negative 
the  result. 

Of  the  twenty-five  patients  ten  were  males  and  fifteen  females. 
Six  were  in  the  first,  six  in  the  second,  and  thirteen  in  the  third 
stage  of  the  disease.  Ten  were  under  the  age  of  twenty,  and  the 
rest  were  between  twenty  and  forty  years  of  age. 

I  selected  the  old  vinum  ferri  as  being  the  most  simple  of  the 
many  forms  of  iron,  as  well  as  one  which  is  seldom  objected  to,  and 
is  rarely  found  to  disagree.  At  the  commencement  I  prescribed  two 
drachms  twice  a  day,  each  dose  being  gradually  increased  to  half  an 
ounce,  and,  in  some  few  instances,  to  an  ounce.  The  treatment  was 
continued  for  periods  varying,  according  to  the  different  cases,  from 
four  to  thirteen  weeks.  In  two  or  three  of  the  female  patients,  the 
steel  seemed  to  cause  slight  headache,  which,  however,  generally 
disappeared  when  the  dose  was  lessened  or  temporarily  discontinued. 
During  its  use  the  patients'  appetites  were  usually  very  good,  and 
there  was  not  the  slightest  indication  of  increased  liability  either  to 
hnmoptysis  or  any  other  active  symptom  of  the  disease. 

Of  the  twenty.fi ve  patients,  thirteen  greatly  improved;  three 
slightly  improved;  and  nine  derived  no  benefit;  of  these,  three  died 
in  the  hospital. 

In  thirteen  of  the  cases  cod-liver  oil  was  occasionally  but  not 
regularly  taken  in  conjunction  with  the  steel ;  but  in  the  remainder, 
no  other  medicine  was  administered  except  some  simple  linctus  for 
the  cough.  Fourteen  patients  increased  in  weight — some  of  them 
very  considerably  ;  eight  lost  weight ;  and  three  remained  unchanged 
in  weight.  Nine  of  the  fourteen  cases  in  which  the  weight  increased 
were  of  those  who  had  taken  cod-liver  oil.  One  of  these  patients, 
in  the  second  stage  of  the  disease,  illustrated  the  remarkable  but  not 
very  rare  phenomenon,  of  increasing  in  weight,  whilst  both  the  local 
and  many  of  the  general  symptoms  of  consumption  were  steadily 
advancing. 

Of  the  thirteen  patients  greatly  improved,  several  left  the  hospital 


Cotton  on  Steel  in  Phthisis.  165 

with  their  general  health  restored,  and  their  active  B3anptom8  dissi- 
pated. Four  were  especially  remarkable  for  the  improvement  they 
exhibited,  being  able,  in  spite  of  the  unmistakable  existence  of  pul- 
monary cavities,  to  resume  their  several  occupations  on  leaving  the 
hospital. 

Seven  of  the  thirteen  improved  cases  were  under  the  age  of 
twenty — a  large  proportion,  if  we  consider  the  respective  ages  of  the 
patients. 

Perhaps  I  may  here  remark,  that  although  I  had  not  hitherto 
compared  and  tabulated  the  cases  I  have  treated  with  steel-wine,  I 
have  long  been  in  the  habit  of  prescribing  this  medicine,  in  conjunc- 
tion with  cod-liver  oil,  to  phthisical  and  strumous  patients,  especially 
to  children  and  young  persons,  and  have  always  placed  great  faith  in 
its  efficacy.  I  have,  indeed,  always  considered  it  amongst  the  most 
useful  remedies  in  this  class  of  diseases ;  and  in  this  homage  to  tlie 
rtntim  ferri  very  many  of  my  medical  brethren  will  doubtless  join. 
That  the  remedy  fairly  deserves  to  be  thus  estimated,  is,  I  think, 
sufficiently  shown  by  the  experiments  I  have  detailed. 

After  I  shall  have  recorded  similar  observations  upon  a  few  other 
substances  which  are  now  undergoing  probation  in  my  hospital 
wards,  I  hope  to  give  a  general  summary  of  their  comparative 
results.  And,  although  I  am  quite  willing  to  admit  that  any  con- 
clusion at  which  I  may  arrive  in  the  course  of  these  experiments 
must  necessarily  be  imperfect,  and  at  most  but  an  approximation  to 
truth — considering  that,  in  order  to  reach  the  actual  truth,  many 
insuperable  difficulties  present  themselves,  such  as  a  want  of  uni- 
formity in  the  cases,  circumstances,  and  stages  of  the  various 
patients,  as  well  as  in  the  season  of  the  year,  the  diet,  and  a  multi- 
tude of  other  circumstances — it  will,  I  think,  be  nevertheless  conceded, 
that  the  trial  to  which  I  have  subjected  the  different  remedies  is  not 
altogether  unproductive,  and  that  on  the  present  occasion  steel-wine 
comes  before  us  very  favourably  as  a  medical  agent  in  the  treatment 
of  phthisis.  In  order,  however^  to  assimilate  this  paper  with  those 
which  have  preceded  it,  I  would  record  the  following  conclusions: — 

1.  Steel- wine  is  a  very  useful  auxiliary  in  the  treatment  of  a  con- 
siderable number  of  consumptive  patients. 

2.  It  seldom  disagrees,  but  tends  rather  to  increase  the  appetite 
and  improve  digestion. 

3.  It  is  especially  valuable  in  the  cases  of  children  and  young 
persons. — Medical  Times  and  Gazette, 


1 66  Miscellaneous, 

Nitrate  of  Uranium  in  Diabetes.     By  Edwin  M.  Hale,  M.D.,  of 

JonesYille,  Mich.* 

The  attention  of  the  homoeopathic  profession  was  first  attracted  to 
this  new  remedy  hy  a  communication  from  F.  S.  Bradford,  M.D., 
and  is  to  he  found  in  Vol.  viii.,  page  502  of  the  North  American 
Journal  of  Homceopathy, 

For  the  henefit  of  those  who  may  not  haye  hack  volumes  of  the 
Journal,  and  as  the  article  referred  to  is  a  hrief  one,  I  take  the 
liberty  of  republishing  it.  The  results  of  my  own  experience  satisfy 
me  that  this  remedy  will  prove  one  of  the  most  valuable  in  the  treat- 
ment of  the  different  forms  of  diabetes  and  diuresis,  of  all  the  medi- 
cines used  for  those  maladies. 

The  following  is  the  communication  of  Dr.  Bradford  : 

**  It  is  not  the  object  of  this  paper  to  discuss  the  treatment  of 
diabetes  farther  than  to  propose  a  new  remedy,  to  the  trial  of  which 
I  was  led  by  a  statement  contained  in  the  January  number  of  the 
British  and  Foreign  Medical  Chirurgical  Review  for  1857.  In 
review  111,  page  34,  it  is  stated  that  the  gradual  poisoning  of  dogs 
with  small  doses  of  the  Nitrate  of  Uranium  invariably  caused  the 
urine  of  the  animals  thus  poisoned  to  become  sugary.  It  occurred 
to  me  that  this  Nitrate  of  Uranium  might  prove  a  valuable  homceo- 
pathic  remedy  in  the  treatment  of  diabetes  in  the  human  subject. 
Accordingly  I  had  it  prepared  in  trituration,  from  the  first  to  the 
third  ;  and,  although  I  have  had  as  yet  but  few  opportunities  of  ad- 
ministering it  in  cases  of  diabetes-mellitus,  I  feel  warranted,  from 
its  satisfactory  effect  in  those  few  cases,  in  recommending  those  who 
have  patients  suffering  from  this  disease,  to  make  a  trial  of  this 
remedy.  Doses  of  two  or  three  grains  of  the  third  trituration,  ad* 
ministered  morning  and  night,  will  in  a  short  time  reduce  the  quantity 
of  urine  passed  to  nearly  a  normal  standard,  and  after  a  continued 
use  the  proportion  of  sugar  is  materially  lessened.  I  have  also  em- 
ployed  it  with  the  greatest  success  in  cases  of  acute  and  chronic 
diuresis  in  children  and  grown  people.  It  is  peculiarly  successful 
where  the  urine,  from  time  to  time,  assumes  an  acrid,  irritating 
nature.  From  the  experience  which  I  have  thus  far  had  with  the 
Nitrate  of  Uranium,  I  am  fully  persuaded  that  it  merits  a  careful 
and  scientific  proving,  and  any  contribution  toward  such  a  proving, 
by  those  who  feel  inclined  to  test  the  remedy,  will,  without  doubt,  be 
gratefully  welcomed  by  the  profession." 

*  From  the  North  American  Journal  of  Bamaopathi/j  No.  zzxviii. 


Nitrate  of  Uranium  in  Diabetes,  167 

Dr.  Bradford  is  deserving  of  credit  for  thus  seizing  upon  the 
pathogenetic  fact  developed  by  Uranium  poisoning,  and  testing  and 
proving  the  value  of  the  homceopathic  law,  by  submitting  it  to  the 
ordeal  of  clinical  experiment.  It  is  thus  that  an  acute  mind  may 
seize  upon  a  single  symptom  of  a  new  and  unproven  remedy,  and 
from  it  deduce  valuable  therapeutic  results. 

The  Nitrate  of  Uranium,  employed  in  the  following  cases,  was 
procured  through  Halsey  and  E^g,  of  the  Chicago  pharmacy,  and 
was  prepared,  as  they  informed  me,  by  a  talented  and  scientific 
German  chemist. 

Case  1. — The  patient  was  an  old  gentleman,  aged  about  sixty- 
five.  I  had  treated  him  occasionally  for  three  years  for  a  form  of 
diabetes,  which  I  had  every  reason  to  believe  was  a  real  case  of  gly- 
cosuria, although,  owing  to  a  want  of  the  necessary  facilities  for  a 
correct  examination  of  the  urine,  I  could  not  say  positively  whether 
sugar  appeared  habitually  in  the  discharges.  (Let  me  here  add  that 
it  is  ^utterly  impossible  for  a  country  practitioner — by  this  term  I 
mean  a  physician  in  our  towns  and  villages — to  get  the  time  to  make 
those  analyses  of  morbid  discharges,  so  necessary  to  a  perfectly 
correct  diagnosis  of  disease.  Such  examinations  would  necessarily 
involve  him  in  an  expense  for  the  procurement  of  apparatus,  which 
could  not  well  be  borne.  In  these  cases  of  diabetes  which  I  shall 
report,  although  I  may  have  been  satisfied  from  my  own  tests  of  the 
correctness  of  my  diagnosis,  my  tests  might  not  come  up  to  the 
standard  of  those  required  by  modem  analytical  chemistry.) 

The  patient  was  of  corpulent  habit,  not  addicted  to  the  use  of 
ardent  spirits,  and  a  temperate  eater.  The  disease  has  been  alter- 
nately relieved  and  aggravated  during  the  six  years  of  its  existence. 
Under  my  treatment  he  had  been  relieved  at  times  by  Cantharides, 
Cannabis,  Tereb.,  Merc-sol.,  Phos.-ac,  and  Arsenicum*  His  symp- 
toms, at  the  time  of  the  trial  of  the  Nitrate  of  Uranium,  were  much 
the  same  as  during  the  last  few  years,  only  much  aggravated  in  every 
respect,  and  were  as  follows :  Constantly  increasing  debility  and  ema- 
ciation ;  a  dropsical  condition  of  the  legs ;  great  pain  and  weariness 
in  the  lower  extremities,  accompanied  by  a  distressing  sensation  of 
crawling  or  formication  under  the  skin,  as  of  thousands  of  worms. 
(This  sensation  I  have  often  noticed  as  preceding  or  accompanying 
the  access  of  dropsy  of  the  legs  or  abdomen.)  Clammy  state  of  the 
mouth  and  tongue  ;  the  tongue  coated  with  white  fur  ;  at  the  same 
time  a  sensation  of  dryness  of  the  mouth  and  fauces,  with  excessive 


1  OS  Miscellaneous. 

and  uncontrollable  thirst.     Appetite  variable — at  times  wanting,  at 
times  excessive.     Dyspeptic  symptoms  promment;  such  as  sour  erac- 
tations,  burning  and  cramps  in  the  stomach,   and  sensations  of  ex-> 
treme  faintness   at  the  pit  of  the  stomach.     Bowels  constipated, 
fsces  pale,  odorless,  and  dry.     Almost  constant  desire  to  urinate, 
and  Toids  large  quantities  at  every  emission  ;  he  states  that  he  has 
voided  as  high  as  sixteen  pints  in  one  day  and  night.     If  he  tries  to 
retain  the  urine,  severe  pain  in  the  bladder  comes  on.     The  urine  is 
acrid  and  excoriating,  has  a  sweetish  odor,  and  he  says  a  sweetish 
taste.     His  perspiration  and  breath  have  the  same  sickly  sweet  odor. 
Skin  dry  and  harsh  most  of  the  time,  although  he  perspires  when 
sleeping  or  on  unusual  exercise.     Pulse  small  and  90. 

He  was  given  Merc-sol.,  2,  and  Ars..alb.,  3,  each  thrice  a  day* 
These  remedies  had  alleviated  similar  symptoms  a  few  months  before, 
but  did  not  seem  at  this  time  to  be  of  any  benefit,  except  to  diminish 
somewhat  the  extreme  thirst. 

After  waiting  one  day,  during  which  he  had  no  medicine,  he  was 
given  powders  of  Nitrate  of  Uranium,  1st  dec,  one  grain  each,  to  be 
taken  three  times  a  day.  The  effect  of  the  remedy  was  prompt  and 
decisive.  The  first  night  he  had  only  to  get  up  twelve  times  instead 
of  twenty,  as  usual,  and  the  urine  was  much  less  in  quantitfr.  The 
next  day  the  urgency  to  void  urine  was  diminished,  and  the  next 
night  he  had  to  urinate  but  six  times.  Under  its  continued  use  all 
the  symptoms  became  much  ameliorated,  until  he  informed  me  that 
the  amount  of  urine  voided  was  not  much  above  normal,  and  his 
strength  and  health  were  much  improved.  He  took  the  remedy 
about  three  weeks,  decreasing  the  dose  at  the  rate  of  one  powder  a 
day,  during  the  time,  so  that  the  last  week  he  took  only  one  daily. 
Under  the  use  of  Phos.  ac  and  Helonin,  2,  his  health  improved  for 
several  months,  when  he  had  another  attack  of  a  similar  nature, 
which,  however,  gave  way  under  the  use  of  the  same  remedy  for  a 
week.  Since  that  time  he  has  had  occasional  attacks  more  or  less 
severe,  which  are  always  relieved  by  the  Uranium.  At  his  advanced 
age,  it  is  to  be  doubted  whether  a  cure  can  be  effected,  but  the 
marked  beneficial  effects  of  this  remedy  demonstrate  its  great  utility 
as  a  palliative  agent  in  such  cases.  I  have  tried  very  many  medi- 
cines in  similar  cases  but  have  never  met  with  one  which  manifested 
such  happy  effects. 

Case  2. — Was  a  son  of  the  above,  a  strong  and  apparenUy  healthy 
man  of  above  forty.     He  first  noticed  a  frequent  and  profuse  urina- 


Nitrate  of  Uranium  in  Diabetes.  169 

tioQ  about  six  months  previously.  This  trouble  gradually  increased; 
about  three  months  ago  he  began  to  be  troubled  with  nocturnal  urg- 
ing to  urinate,  obliging  him  to  get  up  several  times  after  retiring. 
His  present  symptoms  are : — A  growing  debility  ;  a  good  deal  of 
weakness  in  the  lower  extremities  and  back  ;  considerable  pain  in  the 
region  of  the  kidneys ;  after  a  day's  work  the  legs  ache  so  that  he 
cannot  get  to  sleep  till  after  midnight.  Mouth  dry,  saliva  tenacious, 
tongue  coated  white,  good  appetite,  but  his  food  causes  much  dis- 
tress in  the  stomach.  A  constant  sensation  of  faintness  in  the  region 
of  the  stomach,  even  after  a  full  meal ;  bowels  constipated ;  urine 
profuse,  frequent,  and  accompanied  by  burning  and  scalding ;  milky 
at  times,  at  other  times  of  a  straw  colour,  and  fcBtid ;  thinks  he  voids 
nearly  ten  pints  in  twenty-four  hours.  He  is  dispirited,  discouraged ; 
has  lost  his  usual  liking  for  labour,  and  is  inclined  to  be  morose. 

For  a  week  he  took  Canth.,  3,  and  Merc-sol.,  3,  with  no  parti- 
cular benefit,  except  to  somewhat  lessen  the  ardor  urinas,  I  then 
put  ten  grains  of  Nitrate  of  Uranium  in  half  an  ounce  of  distilled 
water,  and  ordered  him  to  take  ten  drops  four  times  a  day. 

The  second  night  after  commencing  the  remedy  he  was  obliged 
to  get  up  to  urinate  but  once,  and  during  the  day  the  urine  was 
much  less  in  quantity.  Improvement  progressed  steadily  for  a  week, 
at  which  time  the  secretion  had  become  nearly  normal,  and  his 
general  health  was  much  improved.  For  the  debility  and  some 
genital  weakness  I  gave  Phos.  ac,  i,  six  drops  three  times  a  day, 
and  six  pellets  of  Nux,  3,  at  night,  and  continued  the  Uranium  twice 
a  day.  At  the  expiration  of  three  weeks  he  reported  himself  well, 
as  well  as  he  had  been  for  many  years. 

Next  to  the  Nitrate  of  Uranium,  Phosphoric  acid  is  the  most 
important  remedy  in  cases  of  diabetes.  Not  so  much  because  of  any 
specific  relation  which  it  bears  to  the  essential  nature  and  causes  of 
the  malady,  but  for  its  renovating  and  recuperative  powers,  in  re- 
storing nervous  energy  to  the  enfeebled  organism.  It  is  eminently 
the  remedy,  when,  from  loss  of  fluids,  the  solids  of  the  body  become 
wasted  and  nervous  prostration  supervenes.  In  such  cases  it  must 
however  be  ^ven  in  appreciable  doses,  because,  firsts  It  is  given  for 
conditions  which  simulate  its  secondary  effects ;  and  second^  Because 
it  is  not  so  much  for  its  dynamic,  as  its  nutritive  powers,  in  restoring 
the  lost  Phosphorus,  which  has  escaped  from  the  system. 

Case  3. — A  somewhat  intemperate  man,  about  forty-five  years  of 
age,  a  cooper  by  trade,  had  been  afflicted  with  symptoms  of  diabetes 


170  Miscellaneous. 

for  seyeral  months.  He  complained  of  increaBing  debility ;  sweats 
easily  and  during  sleep ;  constant  pain  in  the  lumbar  region,  soreness 
in  the  region  of  the  kidneys ;  severe  aching,  drawing  weary  pains 
in  the  legs  in  the  after  part  of  the  day ;  they  are  so  weak  and  heavy 
that  he  can  hardly  walk  in  the  evening.  (This  distressing  aching 
and  weakness  of  the  lower  limbs  seems  to  be  decidedly  pathogno- 
monic of  diabetes.  It  has  been  present  in  every  case  which  has 
come  under  my  observation.)  Urination  profuse,  and  sometimes 
painful ;  frequent,  every  hour  or  two ;  sometimes  pale,  often  milky, 
with  strong  ammoniacal  odor.  His  sleep  was  broken  by  the  frequent 
calls  to  urinate.  He  states  that  he  is  almost  completely  impotent^ 
and  that  the  sexual  power,  which  was  strong  before  the  diabetic 
symptoms  appeared,  is  constantly  decreasing.  A  cold  perspiration 
collects  on  the  penis  and  scrotum,  both  of  which  are  relaxed  and 
cold.  He  feels  feverish  in  the  afternoon,  has  great  thirst,  canine 
hunger  from  a  gnawing  and  faintness  in  the  stomach,  abdomen  feels 
bloated;  and  he  is  constipated.  Some  of  the  symptoms  were 
relieved  by  the  use  of  Cannabis,  Caladium,  and  Merc,  sol.,  but  the 
diabetes  and  other  most  prominent  symptoms  remained  the  same. 
He  was  then  put  upon  Nitrate  of  Uranium,  second  decimal  tritura- 
tion, three  times  a  day.  Improvement  commenced  immediately  and 
continued  until  the  urine  became  nearly  normal  in  quantity  and  the 
symptoms  in  general  were  much  ameliorated.  One  dose  of  the 
remedy,  every  evening,  was  ordered,  and  he  was  given  Phos.  ac., 
Ist  dec.  dil.,  ten  drops  in  every  six  hours.  Under  its  use  the  general 
and  local  debility  was  in  time  removed. 

Case  4. — A  delicate  nervous  female,  subject  to  attacks  of  neural- 
gia and  hysteria,  was  much  troubled  with  sudden  attacks  of  diuresis^ 
accompanied  by  much  prostration,  followed  in  a  day  or  two  by  an 
opposite  state  marked  by  some  fever,  much  thirst,  dryness  of  the 
mouth,  headache,  and  acantyj  high-coloured  urine.  This  was  un- 
doubtedly a  case  of  diahetes-itrnpidus  (might  it  not  be  called  nervous 
diabetes?),  I  had  treated  her  with  Digitalis,  Pulsatilla,  Gelseminum, 
Ignatia,  and  Belladonna,  all  of  which  are  homceopathically  indicated, 
but  failed  to  afford  more  than  palliative  relief;  they  did  not  prevent 
the  reactive  symptoms  from  appearing.  This  patient  called  me  in 
one  day,  and  wished  a  prescription  for  one  of  her  attacks,  which  she 
knew  was  about  to  set  in,  from  certain  premonitory  symptoms. 
Being  desirous  of  testing  the  Nitrate  of  Uranium  in  cases  differing 
from  true  diabetes,  I  gave  her  six  powders  of  the  second,  one  to  be 


Homoeopathic  Congress.  171 

taken  CTeiy  four  hours.     The  diuresis  ^as  much  less  than  was  anti- 
cipated, and  was  not  followed  by  the  usual  feverish  reaction. 

By  this  it  would  seem  that  the  remedy  was  homoeopathic  not  only 
to  glycosuria,  but  to  other  forms  of  diabetes.  It  may  prove  useful 
in  the  azoturia  of  Willis,  characterized  by  an  excess  of  urea^  although 
Colchicum,  Yerat.  virid..  Digitalis,  and  perhaps  Gelseminum  are 
more  homoeopathic.  In  the  anureous  diuresis  or  auazoturia  of  Willis, 
it  will  undoubtedly  prove  valuable.  Case  2  may  have  been  of  that 
variety.  In  aUtuminous  diuresis  it  may  prove  of  some  benefit,  in 
connection  with  Canth.,  Digit.,  or  Merc.  cor.  It  may  prove  useful 
in  chylO'Serous  urine — a  curious  and  rare  affection,  of  which  I  have 
seen  one  case,  and  cured  it  with  Phosphoric  acid,  1,  in  a  few  weeks, 
after  a  useless  allopathic  treatment  of  months. 

An  AUopathic  Account  of  the  Homoeopathic  Congress, 

On  the  10th  instant  the  annual  Congress  of  the  Central  Union  of 
German  homoeopaths,  which  was  founded  as  far  back  as  1829,  on 
the  occasion  of  Hahnemann's  Doctor's  Jubilee,  took  place  here. 
The  proceedings  of  this  year's  congress  were  not  of  a  very  remark- 
able kind.  The  chair  was  taken  by  Dr.  Miiller,  who  gave  a  sketch 
of  the  doings  of  previous  homoeopathic  congresses ;  after  which  Dr. 
Meyer  gave  a  report  on  the  Homoeopathic  Clinique  of  this  city,  in 
which  941  patients  have  been  treated  during  the  last  year,  amongst 
whom  were  742  cured,  115  improved,  and  7  deaths.  Since  the 
existence  of  this  clinique,  altogether  26,168  patients  have  been 
treated  in  it,  according  to  homoeopathic  principles.  Niirnberg  has 
been  chosen  by  acclamation  as  the  seat  of  next  year's  congress,  and 
Dr.  Grauvogel  has  been  entrusted  with  the  management  of  it.  Fame 
is  silent  on  Drs.  Meyer  and  Miiller,  who  played  so  important  a  part 
in  the  proceedings  of  the  congress  just  come  to  an  end ;  but  Dr. 
Grauvogel  has  made  himself  remarkable  by  a  pamphlet  lately  pub- 
lished by  him  under  the  title.  The  Homceopathic  Law  of  Similarity  : 
an  Open  Letter  to  Baron  von  Liehig.  In  this  very  amusing  little 
book  the  author,  who  was  not  called  Grauvogel  (Grey-bird)  for 
nothing,  displays  the  mite  of  wisdom  conferred  on  him  by  his  god- 
mother Minerva.  He  leads  Baron  von  Liebig,  as  well  as  Professor 
Virchow,  with  the  most  perfect  sang  froid  ad  alsurdum,  and  per- 
emptorily challenges  these  gentlemen  to  refute  his  arguments,  if  they 
can !     No  doubt  homoeopathy  will  again  come  victorious  out  of  this 


1 72  Miscellaneous, 

(one-sided)  fight,  since  Baron  von  Liebig,  as  well  as  Professor  Vir- 
chow,  are  of  opinion  that  it  would  be  dangerous  and  foolhardy  to 
enter  the  lists  against  the  irresistible  Grauvogel  who  may,  therefore, 
justly  claim  the  champion's  belt.  Palmam  qui  meruit  ferat. — 
Medical  Times  and  Gazette,  Sept.  28,  1861. 


HomwopcUhy  in  Spain, 

H.R.H.  the  Infanta  Dona  Maria  de  la  Concepcion  sank  under 
her  severe  illness  on  the  2l8t  October,  at  a  quarter  to  three  p.m. 
In  the  latter  stage  of  her  malady,  when  the  cerebral  structures  had 
already  undergone  serious  alterations  in  the  course  of  the  disease, 
which,  according  to  the  opinion  of  the  Court  physicians,  scarcely 
allowed  any  hope  from  the  resources  of  art,  her  Majesty,  inspired  by 
maternal  affection,  decided  on  calling  in  the  aid  of  the  homcBOpathic 
system,  and  consigned  the  treatment  of  the  august  chUd  to  the  care 
of  Dr.  Joaquin  de  Hysem.  On  undertaking  the  case.  Dr.  Hysem 
had  a  consultation  with  Dr.  Jos^  Nunez,  Dr.  Andres  Merino,  Dr. 
Juan  de  Lartega,  and  Dr.  Bernardo  Sacristan.  They  all  agreed  in 
considering  the  state  of  the  princess  to  be  very  serious,  and,  indeed, 
almost  beyond  the  reach  of  art.  Dr.  Hysem,  assisted  by  Dr.  Rivas, 
was  most  assiduous  in  his  attention  on  the  august  patient ;  but  all 
the  distinguished  talent,  the  skill,  and  experience  of  our  respectable 
countryman  were  destined  to  fail,  in  consequence  of  the  intrinsic 
gravity  of  the  disease,  its  advanced  stage,  and  the  consequent  ex- 
haustion of  the  strength  of  the  vital  reaction  during  so  many  months 
of  suffering. 

We  deplore  sincerely  the  misfortune  that  has  befallen  the  royal 
family,  and  all  the  more  because  we  have  the  firm  conviction  that 
homceopathy  possesses  gentle  and  effectual  means  for  modifying, 
when  employed  early  enough,  the  morbid  diatheses  of  children 
before  they  have  effected  profound  changes  in  the  organs  essential  to 
life.— ^/  Oriterio  Medico,  Oct.  25,  1861. 

Effects  of  Upas,  Tanghinia,  Digitalis,  and  Hellebore, 

A  series  of  experiments  made  upon  frogs,  with  the  poisons  (upas 
antiar,  tanghinia  venenifera,  digitalis,  and  green  hellebore)  either 
administered  by  the  mouth  or  inserted  under  the  skin  in  various 
parts,  give  the  following  results,  which  were  constantly  the  same: 


PoisoniMg  by  Strychnia.  173 

The  heart's  action  was  arrested,  although  the  nervous  irritability  and 
voluntary  muscular  power  of  the  animal  persisted  for  a  considerable 
time.     The  average  duration  of  the  heart's  action  after  the  exhibition 
of  the  poison  was,  in  the  case  of  the  upas,  tanghinia,  and  hellebore, 
ten  minutes;   and  in  that  of  digitaline,  from  ten  to  twenty.     The 
action  of  the  ventricle  in  the  frog  was  invariably  found  to  be  arrested 
in  systole ;  it  was  strongly  contracted,  pale,  and  quite  empty,  whilst 
the  auricle  was  distended  and  gorged  with  blood.     The  contractions 
of  the  heart  were  sometimes  accelerated  at  the  commencement  of  the 
experiment,  at  other  times  they  were  less  frequent  from  the  begin- 
ning.    The  paralysis,  or  rather  arrest  of  motion,  in  the  case  of  the 
Tentricle,  is  shewn  after  a  certain  period  in  the  diminution  of  the 
pulsations ;  that  of  the  auricle  is  gradual  and  almost  imperceptible, 
its  contractions  outiiving  those  of  the  ventricle  by  some  minutes. 
MM.  Dybrowski  and  Pelikan  have  proved  by  experiment  that  these 
poisons  exercise  their  deleterious  influence  upon  the  heart  inde- 
pendently of  the  cerebro-spinal  system,  and  that  in  those  animals  in 
which  the  medulla  oblongata  and  pneumo-gastric  nerves  had  been 
previously  destroyed  or  divided,  the  toxical  effects  of  these  agents 
were  equally  manifest — {Lancet.) 

Poisoning  hy  Strychnia, 
(From  the  Lancet) 

I  was  sent  for  on  the  22nd  of  January  last,  at  half-past  one  p.m., 
by  Mr.  Yarrow,  to  see  a  person,  and  on  my  arrival  I  found  a  woman, 
aged  twenty-eight,  in  the  following  state :  lying  on  her  back  on  the 
floor,  quite  sensible;  arms  and  legs  stretched  out  to  their  fullest 
extent;  hands  clenched;  toes  flexed;  legs  close  together;  body  in 
a  state  of  opisthotonos.  Countenance  livid  and  anxious;  eyes 
starting  from  their  sockets  and  fixed,  pupils  widely  dilated,  con- 
junctiva highly  injected ,  teeth  firmly  clenched.  Breathing  irregular, 
and  at  times  almost  ceasing ;  skin  hot,  bathed  in  perspiration,  and 
steaming;  pulse  rapid  and  scarcely  perceptible.  The  spasms 
relaxed  at  times,  but  did  not  entirely  cease  for  one  minute ;  and  on 
the  slightest  touch  of  the  body  or  legs,  or  on  attempting  to  give  her 
anything  to  drink,  she  immmediately  would  cry  out,  "  my  legs !  my 
legs!  hold  me!  hold  me!"  and  then  utter  a  shriek.  The  head 
would  then  become  drawn  back,  arms  and  legs  extended,  hands 
clenched,  and  the  body  in  a  state  of  opisthotonos;  face  and  head 


1 74  Miscellaneous, 

a  deep  purple;  foaming  at  the  mouth;  teeth  clenched;  eyes  pro- 
truding and  fixed;  heart  palpitating  Tiolently;  and  the  breathing- 
irregular,  and  as  if  drawn  through  a  reed.  No  action  of  the  bowels 
or  bladder  took  place. 


Arsenic  inhalation  in  Bronchitis. 

M.  Trousseau  frequently  orders  the  inhalation  of  the  fumes  of 
arsenious  acid,  in  chronic  bronchitis,  by  means  of  cigarettes,  each 
charged  with  one-fifth  of  a  grain  of  arsenic,  and  three  or  four  of 
them  being  used  during  the  day,  the  smoke  being  inspired  as 
deeply  as  possible.  The  plan  seems  to  be  followed  by  mnch 
temporary  relief. 

The  Prince  Consort  and  his  Treatment, 

Thb  disease  that  carried  off  the  illustrious  Consort  of  Her  Majesfty 
is  yariously  stated  to  have  been  gastric  ferer  and  typhoid  feyer; 
probably  it  was  g^tric  fever  with  a  typhoid  type.  We  know  nothing 
of  the  treatment  pursued  by  his  medical  attendants,  but  as  he  was 
latterly  attended  by  four  simultaneously,  we  may  suppose  that  the 
actual  treatment  adopted  was  a  compromise  among  the  four  favourite 
methods  of  the  doctors ;  for  in  the  treatment  of  this,  as  of  most 
acute  and  chronic  diseases,  by  allopaths,  we  may  safely  say,  quot 
capita,  tot  sententia.  Under  this  heavy  infliction  of  medical  advice, 
the  Royal  patient  had  hardly  a  chance  of  recovery ;  for  it  is  scarcely 
to  be  supposed  that  an  intelligent  or  intelligible  plan  of  treatment 
would  be  pursued  under  the  direction  of  so  many,  and  perhaps 
such  opposite  opinions.  The  Lancet  and  the  Medical  Times  each 
furnish  us  with  articles  to  prove  that  Prince  Albert  was  just  the 
most  unfavourable  subject  for  a  fever  of  the  sort,  and  that  no  surprise 
need  be  felt  at  his  sinking  under  it ;  but  that  it  would  have  been 
astonishing  if  he  had  recovered.  We  confess  we  are  dull  enough 
not  to  perceive  how  a  man  in  the  prime  of  life,  of  vigorous  and 
athletic  frame,  a  moderate  liver,  and  with  every  thing  conducive  to 
health  around  him,  should  be  just  the  most  unlikely  person  to  recover 
from  typhoid  fever,  from  which  so  many  persons,  much  less  favour- 
ably situated,  recover  readily ;  but  we  suppose  it  would  never  do  for 
the  Lancet  or  Medical  Times  to  utter  a  suspicion  that  the  treatment 
of  four  eminent  English  doctors  was  not  the  very  best  that  could 


Obituary.  175 

ponibly  be  deviBed.  We  remember  when  Count  Cavour  died  of  a 
similar  disease,  these  same  journals  set  up  a  howl  at  the  practice 
pursued  in  bis  case,  and  plainly  insinuated  that  be  had  fallen  a  victim 
to  the  erroneous  treatment  of  his  doctors  ;  and  that  if  he  had  only 
bad  the  advantage  of  being  attended  by  some  sensible,  English 
doctor,  be  would  certainly  (^'in  all  human  probability,"  we  think  the 
conventional  phrase  is),  have  recovered.  It  was  little  to  be  expected 
that  such  an  early  opportunity  would  have  been  offered  to  the  public 
of  comparing  the  results  of  rational  English  practice  with  those  of 
irrational  Italjan  practice.  We  doubt  not  the  Lancei  would  have 
lustily  shouted  "  Murder ! "  had  Prince  Albert's  death  occurred  under 
homcBopathic  treatment;  but  we  can  hardly  imagine  homoeopathy 
installed  in  the  palace — and  we  cannot  imagine  the  Prince's  death 
occurring  under  its  mild  and  efficacious  medication. 

OBITUARY. 


Db.   AtKIN    op   HtTLL. 

It  is  with  the  most  unfeigned  sorrow  that  we  have  to  record  the 
death  of  our  esteemed  fellow-editor  in  this  journal,  Dr.  George  Atkin, 
which  occurred  at  Hull  on  the  13th  of  December  last,  after  a  tedious 
and  painful  illness.  The  disease  of  which  he  died  was  a  large 
carbuncle  on  the  back  of  the  neck,  which  seemed  to  be  going  on 
fiivourably  towards  recovery,  but  violent  haemorrhage  set  in  and 
proved  too  much  for  a  constitution  already  enfeebled  by  gout  and 
diabetes,  and  he  died  calmly  and  tranquilly  on  the  fifteenth  day  after 
the  first  appearance  of  the  carbuncle. 

Dr.  Atkin  was  the  son  of  a  presbyterian  minister  of  Northumber- 
land, and  before  embracing  homoeopathy  and  settling  down  at 
Hull  as  a  practitioner,  had  pursued  a  useful  career  in  Edinburgh 
as  a  medical  tutor.  For  this  occupation  he  was  weU  qualified  by  his 
scientific  acquirements  and  his  thorough  acquaintance  with  aU  the 
departments  of  medicine.  On  Dr.  Russell's  retirement  from  the 
editorship,  we  were  fortunate  in  being  able  to  secure  his  valuable 
services  for  the  Journal,  and  our  columns  have  been  frequently 
enriched  by  editorial  articles  and  translations  from  his  pen.  Indeed, 
one  of  the  translations  in  this  very  number  is  by  him,  and  he  had 
not  time  to  look  over  the  proof  sheet  ere  he  was  hurried  away 
from  his  earthly  career  at  the  early  age  of  forty-six. 


176  Books  received. 

Dr.  Atkin*8  loss  will  be  felt  not  by  ub  aloue  but  by  all  his  nu- 
merous friends  and  by  the  homoeopathists  of  Britain  generally.  His 
wise,  calm,  and  judicious  advice  on  many  important  occasions  has 
been  of  infinite  service  in  allaying  the  irritations  and  disputes  that 
will  sometimes  arise  among  professional  brethren.  He  was  a 
universal  favourite,  and  his  genial  wit,  his  perfect  good-humour,  his 
singular  modesty,  and  his  sage  advice,  will  long  be  remembered  and 
missed  by  those  who  were  so  happy  as  to  enjoy  his  friendship.  To 
ourselves  his  death  is  a  heavy  blow,  the  full  extent  of  which  we  are 
hardly  yet  able  to  realise  when  the  ink  is  scarcely  dry  on  the  last 
communication  we  received  from  him. 

Although  the  exigencies  of  a  large  practice  and  bodily  infirmity 
prevented  Dr.  Atkin  from  devoting  as  much  time  to  literary  pur- 
suits as  would  have  been  desirable  in  one  of  such  superior  intellec- 
tual  qualifications,  still  he  has  left  behind  him  no  inconsiderable 
records  of  his  talents  and  diligence.  Besides  numerous  papers  iu 
this  Journal,  he  gave  us  the  Homceopathic  Directory,  and  assisted 
in  the  authorship  of  the  New  Repertory, 

He  has  left  a  widow  and  six  children  to  deplore  his  premature 
decease. 

BOOKS   RECEIVED. 


Homeopathy  and  its  Opponents ;  a  Reply  to  Sir  JB.  Brodie,  by  Dr. 
Druby.    London,  Leath,  1861. 

A  Practical  Reply  to  Sir  B,  Brodie^  by  J.  Moorb,  V.S.  London, 
Eppe,  1801. 

Has  Sir  B,  Brodie  spoken  the  Truth  about  Homoeopathy  t  by  J.  H. 
Smith,  M.R.C.  S.     London,  Tresidder,  1861. 

Homoeopathy  and  Sir  B,  Brodie^  by  C.  H.  MARsroir,  M.D.  Bath, 
Capper,  1861. 

A  Letter  to  Sir  B.  C.  Brodie,  by  W.  Sharp,  M.D.  London^  Turner, 
1861. 

HulTs  Jahr,  edited  by  Dr.  Snblling.  Repertory.  New  York,  Radde, 
1862. 

United  States  Journal  of  Homoeopathy. 

North  American  Journal  of  Homoeopathy. 

Art  Midieal, 

Bidletin  de  la  SocUtS  Midicale  Homoeopathique. 

Monthly  Homoeopathic  Review. 

El  Criterio  Medico. 

Remarks  on  Homoeopathy,  by  Edwin  Lse,  M.D.  London,  Churchill, 
1861. 

Remarks  on  the  Narrow  Limits  of  Rational  Medicine,  by  J.  9.  Bush- 
nan,  M.D.    London,  Churchill,  1861. 


Printed  by  W.  Davt  &  Son,  8,  Qilbert-etreet,  Oxford-street,  W. 


THE 

BRITISH    JOURNAL 

OF 

HOMOEOPATHY. 


CASES  OF  POISONING  BY  BELLADONNA,  WITH 

COMMENTARIES. 

By  EiCHARD  Hdgheb,  M.R.C.S.,  L.B.C.P.— Ed.  (Exam). 

{Continued  from  page  87.) 

Case  X. 

My  tenth  case  is  quoted  from  the  Lancet  (date  not  given)  in 
the  North  American  Jourtial  of'Homoaopathyy  vol.  i.,  p.  876, 
It  is  reported  by  a  Mr.  Edwards. 

'^Miss  G.,  aged  34,  unmarried,  of  slight  figure,  fair  complexion, 
and  nervous  temperament,  has  been  an  invalid  for  many  years ;  is 
the  subject  of  lateral  curvature  of  the  dorsal  vertebrae,  for  which  she 
has  on  several  occasions  undergone  a  good  deal  of  professional  treat- 
ment. Such  are  the  physical  characteristics  of  the  individual  I  was 
called  to  see  under  the  foUowing  circumstances : — 

'*  January  8th,  at  8  o'clock  ▲.!£.,  I  received  a  verbal  message  from 
her  sbter — accompanied  with  an  ounce-and-a-half  phial,  labelled 
^Embrocation  of  Belladonna,' — to  the  effect  that  Miss  G.  had  just 
swallowed  the  contents  of  the  bottle,  instead  of  an  aperient  that  she 
intended  to  take.  Having  an  emetic  draught  close  at  hand,  in  my 
dressing-room,  I  sent  it  down,  requesting  that  it  might  be  adminis.* 
tered  immediately,  and  that  I  would  call  upon  her  as  soon  as  I  could. 
In  about  half  an  hour  I  arrived  at  the  house,  and  found  my  patient 
stretched  upon  a  couch,  and  presenting  the  foUowing  appearances: — 
Head  bent  forward  upon  the  chest,  speechless,  eyes  closed,  breathing 

VOL.  XX.,  NO.  LXXX, — APRIL  1862.  M 


178  Poisoning  by  Belladonna, 

heavy  and  stertorous,  pupils  widely  dilated ;  hands  and  feet  cold  ; 
pulse  scarcely  perceptible,  jaws  firmly  fixed  (1).  At  this  time  there 
was  not  the  least  convulsive  action,  but  a  constant  disposition  to  raise 
the  hands  to  the  face.  Notwithstanding  she  had  taken  the  emetic^ 
together '  with  copious  draughts  of  mustard  and  water,  no  vomitings 
had  taken  place.  I  lost  no  time  in  directing  my  servant  to  procure 
the  stomach-pump,  and  also  the  assistance  of  my  friend.  Dr.  Topham. 
In  the  mean  time  I  roused  the  patient  by  having  her  raised  up  and 
shaken,  upon  which  she  appeared  conscious  when  spoken  to,  but  had 
lost  all  power  of  answering  any  question  addressed  to  her  (2).  Her 
teeth  being  closed,  we  had  great  difiSculty  in  getting  any  liquid  into 
her  mouth,  nor  was  she  capable  of  swallowing  it  when  we  did  (2). 
By  compressing  her  nostrils  and  forcing  her  to  breathe  through  her 
mouth,  the  teeth  became  sufiiciently  separated  to  enable  me  to  intro- 
duce a  long  feather  into  the  back  of  the  fauces ;  this  soon  produced 
copious  vomiting  of  a  large  quantity  of  a  green>coloured  fluid, 
strongly  impregnated  with  camphor.  This  operation  was  repeated 
two  or  three  times,  each  one  producing  more  or  less  vomiting  of 
similar  matter.  Hot  water  was  applied  to  her  feet,  friction  to  her 
hands,  and  sal-volatile  to  her  nose.  The  same  uncontrollable  dispo- 
sition to  heavy  comatose  sleep  still  existed.  At  ten  o*clock  Dr. 
Topham  arrived  with  the  stomach-pump,  which  we  immediately  pro- 
ceeded to  use ;  but  from  the  rigid  closure  of  the  jaws,  we  had  great 
difficulty  in  separating  them  sufficiently  to  adjust  the  gag,  and  pass 
the  CBsophagus  tube  into  the  stomach.  After  some  trouble  this  was 
effected,  and  about  a  pint  and  a  half  of  warm  water  was  injected, 
and  then  carefully  withdrawn ;  it  was  of  a  greenish  hue,  and  strongly 
impregnated  with  camphor.  We  continued  to  wash  out  the  stomach 
with  warm  water  and  slight  quantities  of  aromatic  spirit  of  ammonia, 
until  the  fluid  withdrawn  was  quite  colourless  and  devoid  of  the 
smell  of  camphor.  We  then  threw  into  the  stomach  a  breakfast-cup 
full  of  strong  coffee,  to  which  had  been  added  three  tea-spoonsful  of 
aromatic  spirit  of  ammonia,  and  withdrew  the  tube.  The  pulse  had 
risen  considerably,  and  the  countenance  had  assumed  a  more  natural 
appearance ;  a  mustard  poultice  was  applied  to  the  epigastrium ;  she 
was  put  into  a  warm  bed,  with  hot  flannels  to  her  feet,  and  allowed 
to  doze. 

**  The  following  facts  were  elicited  from  her  sister : — She  says  that 
at  half.past  seven  A.ic.,  she  was  aroused  by  a  loud  knocking  at  her 
bed^room  door,  on  opening  which,  she  saw  Miss  O.  in  her  dressing. 


by  Dr.  Richard  Hughes.  179 

gown,  presenting  an  appearance  of  great  alarm  and  anxiety.  She 
informed  her  what  had  happened,  and  that  the  medical  man  who 
prescribed  the  embrocation  had  cautioned  her  to  be  careful,  as  the 
Bmallest  quantity  swallowed  would  be  fatal.  At  this  time  she  only 
complained  of  *  a  sensation  of  madness  in  her  brain.'  She  was  able 
to  speak  and  swaUow  perfectly  well  until  a  few  minutes  before  my 
airiyal,  when  she  appeared  to  lose  the  power  of  executing  both  these 
acts  quite  suddenly,  and  fell  into  the  comatose  condition  in  which 
I  found  her  (2). 

^'  Twelve  o'clock.  There  seemed  to  be  a  gradual  improvement  in 
her  breathing,  circulation,  and  general  appearance ;  there  was  a  slight 
twitching  of  the  muscles  of  the  right  side  of  the  face ;  not  able  to 
swallow ;  but  we  fancied  she,  in  answer  to  a  question  put  to  her, 
said  *  Yes.'  Five  p.m.  Symptoms  remained  much  the  same  as  in 
last  report ;  no  evacuation  from  bladder  or  bowels ;  pupils  widely 
dilated  and  immoveable;  has  slept  a  good  deal;  skin  warm,  pulse  112, 
feeble ;  still  unable  to  speak  or  swallow.  Nine  p.m.  Countenance 
more  naturaL  There  was  constant  nictitation  (qy.  ?  'jactitation')  and 
picking  at  the  sheets ;  if  touched  by  any  person,  she  jumped  as  if  in 
great  alarm.  This  I  observed  to  occur  whenever  her  hair  was  re* 
moved  from  her  face,  or  when  I  felt  her  pulse.  When  thoroughly 
roused  she  answered  in  monosyllables,  and  apparentiy  attempted  to 
form  connected  expressions,  but  they  were  unintelligible ;  pupils  still 
greatly  dilated,  nor  did  they  contract  when  a  lighted  candle  was 
placed  before  the  eyes ;  pulse  120 ;  no  action  from  bladder  or  bowels. 
On  asking  her  if  her  throat  was  sore,  she  replied, '  Dry ;'  on  asking 
her  if  she  could  suck  an  orange,  she  replied,  *  Yes.'  I  therefore  had 
some  orange-juice  squeezed  into  a  glass,  and  by  means  of  a  teaspoon, 
got  her  to  swallow  perhaps  half  an-ounce;  but  this  was  accomplished 
with  great  difficulty.  Ordered  an  injection  of  a  pint  of  gruel  with 
half-an-ounce  of  oil  of  turpentine  and  an  ounce  of  castor  oil  to  be 
administered  directiy,  and,  when  able  to  swallow,  the  following  mix- 
ture : — Spirit  of  nitric  ether,  three  drachms ;  compound  tincture  of 
cardamoms,  two  drachms ;  camphor  mixture,  five  ounces  and  a  half; 
mix.     To  take  an  ounce  every  three  hours. 

■  '*  January  9th,  eleven  a.m.  Has  passed  a  restiess  night,  sleep  being 
much  disturbed  by  frightful  dreams ;  complains  of  intense  pain  in 
the  head  (3),  and  says  that  it  feels  enormously  large,  as  also  does 
her  throat ;  is  much  annoyed  by  a  constant  sensation  of  trembling  in 
all  the  muscles  of  the  body ;  bowels  were  moved  after  the  injection, 

M  2 


180  Poisoning  by  Belladonna, 

and  some  lirine  passed  at  the  same  time,  none  since ;  great  intoler- 
ance of  light  and  noise  (8) ;  tongue  rather  dark,  but  moist ;  skin 
natural ;  complains  of  thirst ;  pulse  88 ;  pupils  as  dilated  as  ever. 
She  says  she  can  see  me  distinctly  for  a  moment  only,  and  then  my 
face  becomes  horribly  distorted.  The  power  of  speech  seemed  to 
return  about  twelve  or  one  o'clock,  at  which  time  she  was  very  deli- 
rious, and  would  persist  that  there  were  very  horrid  monsters  all 
over  the  room  staring  at  her.  Ordered  eight  leeches  to  the  temples ; 
effervescent  mixture  every  three  hours ;  and  two  grains  of  calomel, 
with  seven  of  extract  of  colocynth,  to  be  taken  directly.  She  says 
she  remembers  my  coming  to  her  yesterday  morning,  but  was  uncon- 
Bcious  of  everything  afterwards  until  the  evening. 

"January  10th.  Better;  head  much  relieved  by  the  leeches; 
passed  a  restless  night,  her  sleep,  she  says,  being  disturbed  by 
'  miserable  phantoms  ;*  bowels  have  been  relieved  two  or  three  times, 
and  urine  has  been  excreted  copiously  (4) ;  skin  moist ;  pulse  1 00 ; 
slight  thirst;  pupUs  still  unaffected  by  light;  complains  of  the 
trembling  of  her  muscles,  but  has  lost  the  sensation  of  her  head  and 
throat  being  enlarged.  Continue  effervescing  mixture,  and  take 
some  beef  tea. 

"January  11th.  Improved  in  every  respect;  pupils  not  so  widely 
dilated,  are  now  slightly  affected  by  light.  To  sit  up  on  the  sofa, 
take  nourishing  diet,  and  tonic  medicine. 

*'  From  the  above  date  gradual  amendment  took  place,  and  the 
power  of  vision  slowly  returned.  It  was,  however,  some  days  before 
she  was  able  to  walk,  even  with  the  assistance  of  a  person  on  each 
side  of  her ;  this  inability  to  walk  did  not  arise  from  weakness,  but 
she  appeared  to  have  lost  all  power  of  controUing  the  action  of  her 
legs  (5). 

"  Remarks, — This  case  is  interesting,  inasmuch  as  we  possess  but 
few  opportunities  of  witnessing  and  recording  the  symptoms  arising 
from  the  exhibition  of  poisonous  doses  of  Belladonna.  The  quantity 
taken,  as  I  aflewards  ascertained  from  the  medical  man  who  pre- 
scribed the  embrocation,  was  one  drachm  of  extract  of  Belladonna 
in  an  ounce-and-a-half  of  soap  liniment.  Coma  preceded  any  con- 
vulsive action  by  some  hours,  save  the  twitching  of  the  facial  muscles. 
The  pneumogastric  nerves  were  early  influenced  by  the  poison,  as 
evidenced  by  the  difficulty  of  articulation  (2)  and  deglutition.  Orfila 
found  that  Belladonna  given  to  dogs  frequently  produced  weakness 
of  the  posterior  limbs.     This  effect  was  most  palpable  in  the  case 


by  Dr.  Richard  Hughei.  181 

before  ub,  my  patient  being  unable  to  control  the  actions  of  her  legs 
for  some  days  after  all  the  other  symptoms  had  quite  subsided." 

On  this  case  I  will  make  the  following  remarks : — 

(1).  The  trismus  is  a  rare  symptom.  It  probably  depends 
on  the  irritation  of  the  medulla  oblongata,  propagating  itself 
along  the  motor  branch  of  the  fifth. 

(2).  From  irritation  of  the  medulla,  too,  proceeds  the  impair- 
ment of  deglutition  and  articulation  noticed  in  the  case.  Mr. 
Edwards  is  wrong  in  attributing  both  these  to  an  affection  of 
the  pneumogastric  nerve :  it  is  the  hypoglossal  upon  whose  in- 
tegrity depends  the  right  performance  of  the  act  of  articulation. 
But  both  these  nerves  originate  in  the  medulla  oblongata. 

(3).  The  symptoms  of  the  second  day  (January  9th)  are 
clearly  those  of  inflammatory  irritation  of  the  cerebrum.  The 
beneficial  effect  of  the  leeches  is  noticeable  in  this  respect. 

(4).  The  primary  suppression  and  secondary  copious  flow  of 
urine  confirms  the  view  of  the  action  of  fielladonna  on  the 
urinary  organs  stated  in  the  Notes  to  Case  II. 

(5).  Still  more  striking  is  the  support  afforded  by  this  case 
to  the  theory  of  the  Belladonna-paralysis  enunciated  in  the 
Notes  to  Case  I.  The  reporter  himself  observes  that  it  is  not 
tme  motor  paralysis,  but  a  want  of  due  controlling  power.  It 
is  almost  confined  to  the  lower  limbs. 

Case  XI. 

Dr.  Teschenmacher  relates  the  following  narrative  of  six 
persons  poisoned  by  Belladonna.  His  account  is  translated 
from  Casper  8  Wochetiachrift,  No.  81,  1843,  in  the  British 
Journal  of  Homoeopathy ^  vol.  vi.,  p.  430. 

**  A  mother,  with  her  four  children  and  a  maid-servant,  ate  one 
evening  of  the  ripe  berries  of  this  plant :  the  mother  and  maid  had 
each  eaten  about  six  bunches.  In  the  course  of  a  few  hours  the 
symptoms  of  poisoning  manifested  themselves  in  all  of  them:  these 
were  nausea,  double  vision,  sense  of  constriction  at  the  throat  (1), 
giddiness,  and  sleepiness.  On  the  following  day,  fifteen  hours  after 
the  poison  had  been  taken.  Dr.  T.  saw  the  patients.  The  operation 
of  the  poison  displayed  itself  in  four  degrees.  The  first  and  slightest 


182  Poisoning  hy  Belladonna, 

was  in  the  mud-serrant,  who  produced  vomiting  in  herself  by  drinking* 
warm  water  and  tickling  her  throat.  She  complained  only  of  headache 
and  weariness.  The  pupils  were  enlarged,  the  face  red,  and  the 
pulse  somewhat  quickened.  The  second  degree  was  observed  in 
two  of  the  girls,  one  of  whom  was  four,  and  the  other  eight  years 
old.  It  displayed  itself  in  a  tottering  gait,  incoherent  talk,  protruding* 
eyes,  dilated  pupils,  staring  look,  very  quick  pulse,  and  increased 
temperature  of  the  skin.  The  third  degree  was  exhibited  by  the 
mother.  She  fell  into  a  delirious  state  in  the  morning,  attempted  to 
bite  and  strike  her  attendants,  broke  into  fits  of  laughter,  and  gnashed 
her  teeth.  The  head  was  hot,  the  face  red,  the  look  wild  and  fierce, 
the  tongue  dry,  the  abdomen  swollen,  the  pulse  small  and  frequent. 
The  fourth  degree  showed  itself  in  the  two  boys,  the  one  of  whom 
was  two-and-ahalf,  and  the  other  six  years  old.  They  lay  in  a  sopo- 
rose condition,  with  violent  convulsions  of  the  extremities:  the  head 
was  very  hot,  the  face  red,  the  eyes  protruding.  They  were  also 
affected  with  a  croupy  cough  (1).  The  cases  were  all  treated  with 
emetics,  purgatives,  and  stimulants;  and  the  patients  recovered  in 
the  course  of  twenty-four  hours." 

(1).  See  Note  (5)  on  Case  11. 

Case  XII. 

A  series  of  ten  cases  of  poisoning  by  Belladonna  berries  are 
recorded  by  Mr.  Seaton,  of  Leeds,  in  the  Medical  Times  and 
Oazette,  of  December  3rd,  1859.  They  are  extracted  at  length 
in  the  British  Journal  of  Homoeopathy  for  January,  1860. 
Their  main  interest  lies  in  the  great  success  attendant  upon  the 
use  of  Opium  as  an  antidote  to  the  efifects  of  the  Belladonna — 
a  practice  suggested  by  Mr.  Benjamin  Bell,  of  Edinburgh 
{Edinburgh  Medical  Journal^  July  J  868),  on  the  ground  of 
their  antagonistic  effects  on  the  iris — Opium  causing  contrac- 
tion, and  Belladonna  dilatation  of  the  pupil.  The  cases  are  all 
so  much  alike,  that  I  shall  content  myself  with  quoting  the 
account  of  the  first  of  the  series,  and  Mr.  Seaton  s  remarks 
upon  the  whole. 

''J.  W.,  aged  23.  On  September  12th,  1858,  at  a  quarter-past 
seven  p.m.,  took  ten  berries;  at  eight  p.m.  complained  of  dryness  of 
the  throat,  and  great  difficulty  in  swallowing,  followed  by  indistinct- 


by  Dr.  Richard  Hughes.  183 

ness  of  vision,  and  pain  in  the  head  and  eyeballs,  which  felt  as  if 
starting  from  their  sockets.  These  symptoms  were  followed  by 
delirium,  characterized  by  intense  wakefulness  and  vivacity,  and  a 
vrant  of  coherency  in  his  ideas  and  speech.  At  half-past  ten  he  took 
an  emetic,  which  induced  free  vomiting,  notwithstanding  which  the 
symptoms  persisted.  At  two  a.m.  on  the  Idth,  he  was  ordered  a 
dose  of  castor  oil,  and  Tinct.  Opii.  gtt.  vij.,  every  four  hours.  At  five 
^M.  slept  for  a  short  time,  but  on  awaking  was  still  delirious ;  took 
the  medicine  every  two  hours  up  till  two  p.m.,  when  he  fell  asleep, 
and  awoke  two  hours  afterwards  quite  collected.  The  indistinctness 
of  vision  in  this,  as  in  the  other  cases,  continued  several  days.  The 
pupils  which,  before  sleep,  were  widely  dilated,  on  sleep  being 
obtained,  became  contracted  to  the  ordinary  size." 

Mr.  Seaton*8  remarks  are  as  follows : — 

**The  first  symptom  appears  to  have  been  dryness  of  the  mouth 
and  throat;  next,  indistinctness  of  vision  and  dilated  pupil;  and 
afterwards,  in  the  more  severe  cases,  delirium  supervened.  The 
indistinctness  of  vision  was  the  most  persistent  symptom ;  in  all  the 
cases  it  existed  in  a  greater  or  less  degree  for  several  days,  and  in 
one  (a  boy)  the  vision  continues  defective  up  to  the  present  time. 
The  delirium  was  of  a  busy,  restless,  vivid  character,  but  generally 
rather  pleasing  than  otherwise.  The  patients  appeared  to  think  that 
they  were  pursuing  their  ordinary  occupations;  one  boy  appeared 
eager  in  fiying  a  kite ;  another  pulled  tables  and  chairs  about,  thinking 
he  was  working  in  a  coal-pit ;  and  a  woman  appeared  to  be  remark- 
ably busy  with  her  ordinary  household  duties.  All  their  movements 
were  of  a  quick,  excited  character,  strikingly  resembling  delirium 
tremens.  There  was  no  very  marked  vascular  excitement ;  the  skin 
was,  in  most  of  the  cases,  moderately  cool,  and  the  pulse  rapid,  but 
without  power." 

Case  XIII. 

The  following  case  is  recorded  by  Dr.  William  Jenner,  in  the 
Medical  Times  and  Gazette  for  November  22,  1856.  The 
symptoms  being  produced  by  the  external  application  of  the 
drug,  exhibit  indubitably  its  specific  action : — 

^Mr.  T.,  having  suffered  for  some  time  from  pain  in  the  back, 
palpitation,  and  dyspeptic  symptoms,  consulted,  on  October  4th,  a 


184  PatBoning  hy  Belladonna, 

physician,  who  prescribed  mtro-muriatic  add,  and  a  belladonna  plas* 
ter,  nine  inches  by  six,  for  the  back.  The  plaster  produced  a  crop 
of  pustules,  though  the  patient  was  not  aware  of  it. 

''At  ten  A.M.,  October  14th,  he  removed  the   old   plaster,  and 
applied  on  the  same  part,  now  the  seat  of  the  pustules  and  of  a  few 
minute  ulcers,  a  new  one  of  like  size.     At  this  time  he  felt  particu- 
larly welL  Soon  after  ten  he  left  home.   Between  eleven  and  twelve, 
while  in  the  city,  he  noticed  that  his  tongue  and  throat  were  ex- 
tremely dry,  and  that  his  tongue  was  covered  with  a  white,  clammy 
fur,  which  he  could  pull  off  in  strings.     The  sense  of  dryness  and 
discomfort  of  the  mouth  and  throat  were  most  distressing,  and  such 
as  to  impede  articulation.     At  the  same  time  he  was  afiected  with 
extreme  desire  to  micturate,  though  he  could  pass  only  a  few  drops  of 
perfectly  colourless  urine.    From  this  time,  till  he  lost  consciousness, 
his  desire  to  pass  urine  was  constant;  wherever  he  could  retire  he  did 
so,  but  succeeded  in  expelling  from  the  bladder,  with  considerable 
effort,  only  a  few  drops  of  colourless  fluid.     The  sense  of  dryness 
of  the  throat  and  tongue  continued  to  increase,  and  he  soon  began 
to  feel  a  little  confused  in  his  head,  so  that  he  was  fearful  people 
would  think  he  had  been  drinking.     He  transacted  all  his  business 
correctly,  though  at  his  office,  where  he  was  between  two  and  three 
o'clock,  it  was  observed  that  there  was  something  strange  in  his 
manner  and  speech.    Here  he  drank  some  water,  which  seemed  even 
to  increase  his  sense  of  dryness  of  the  tongue.     He  drove  himself 
home,  which  he  reached  about  three  o'clock.    His  mind  by  this  time 
was  a  good  deal  confused ;  and,  feeling  himself  unable  to  pay  his 
men,  he  placed  the  money  he  had  just  drawn  from  the  bank  in  safety 
in  his  own  room.     Soon  after  he  had,  five  or  six  times  in  quick  suc- 
cession, convulsive  catchings  of  the  extremities,  face,  and  trunk — 
such,  he  says,  as  animals  have  when  bitten  by  venomous  serpents.* 
Then  his  mind  began  to  ramble,  and  his  ordinary  medical  attendant, 
Mr.  Knaggs,  of  Kentish  Town,  was  sent  for.     When  Mr.  Knaggs 
arrived,  Mr.  T.  was  very  delirious,  but  still  recognized  him. 

"  I  saw  the  patient  about  six  p.m.,  at  Mr.  Knaggs'  request.  We 
found  Mr.  T.  much  worse  than  when  Mr.  Knaggs  had  left  him.  He 
was  standing  by  the  bedside,  supported  by  two  men ;  he  seemed  to 
exercise  very  little  control  over  the  lower  extremities,  and  to  have 
very  little  power  in  them.  It  was  clear  that  he  must  have  fallen  to 
the  ground  had  he  been  left  without  support.     He  leaned  a  little  to 

*  Mr.  T.  18  employed  in  the  Zoological  Gardens. 


by  Dr.  Richard  Hughes.  185 

the  right,  as  though  the  right  fdde  were  weaker  than  the  left;  but 
those  about  him  told  us  that  shortly  before  he  had  inclined  to  the 
left  side.  He  was  led,  at  my  request,  to  the  opposite  side  of  the 
room ;  both  leg^  dragged,  but  neither  one  more  than  the  other.  He 
was  restless  in  the  extreme,  and  would  not  lie  down  for  an  instant; 
his  hands  were  in  constant  motion ;  he  seemed  as  if  he  were  busy 
moving  some  light  objects.  Occasionally,  he  raised  his  feet  alter- 
nately some  distance  from  the  ground,  as  one  does  in  ascending 
stairs.  He  moved  his  mouth  incessantly,  evidently  with  the  idea 
that  he  was  talking ;  but  the  sounds  that  he  uttered  were  inarticulate, 
and  altogether  unintelligible.  He  paid  no  attention  to  those  about 
him ;  in  fact,  seemed  unconscious  of  their  presence,  only  now  and 
then,  when  addressed  in  a  loud  voice,  he  stared  at  the  speaker  for 
an  instant,  like  one  suddenly  aroused  from  a  sound  sleep.  Once  he 
laughed,  when  bid  to  put  out  his  tongue,  and  in  the  most  rapid 
manner  protruded  it,  and  then  as  quickly  withdrew  it.  There  was  a 
little  deviation  of  the  face  to  the  left,  though  not  more  than  is  natural 
to  many  adults,  and  is,  I  think,  proper  to  Mr.  T.  The  pupils  were 
very  large ;  when  a  candle  approached  them  they  acted  equally,  but 
imperfectly  and  sluggishly.  The  head  was  warm,  but  not  warmer 
than  the  surface  generally ;  the  face  was  a  little  flushed.  There 
was  no  throbbing  of  the  vessels  of  the  neck  or  head.  The  pulse 
was  between  80  and  90,  and  regular.  The  heart's  action  was  toler- 
ably strong ;  the  left  ventricle  was  hypertrophied,  and  a  loud,  double 
endocardial  murmur  was  heard  at  the  base. 

''The  history  of  the  symptoms  before  Mr.  Knaggs  saw  the  patient 
was  only  obtained  from  him  after  his  perfect  recovery,  and  so  some 
doubt  was  at  first  entertained  as  to  the  nature  of  the  case.  Still,  as 
the  symptoms  agreed  with  no  disease  of  the  brain  or  meninges  with 
which  I  was  acquainted,  while  the  majority  were  such  as  occur  in 
poisoning  by  Belladonna,  we  thought  it  highly  probable  that  they 
were  due  to  absorption  of  Belladonna  by  the  skin.  The  plaster  was 
accordingly  removed  at  once,  and  the  surface  greased  and  washed, 
and  clean  linen  put  on,  some  of  the  Belladonna  having  passed  on  to 
the  shirt.  A  blister  was  applied  to  the  back  of  the  neck,  and  an 
aperient,  with  five  grains  of  Sesquicarbonate  of  Ammonia,  directed 
to  be  given  every  two  hours.  The  first  dose  of  the  Ammonia  pro- 
duced such  decided  improvement,  that  Mr.  Knaggs  gave  a  second 
dose  in  half-an-hour ;  this  was  followed  almost  instantly  by  perfect 
consciousness . 


186  Poitonmg  by  Belladonna, 

''The  next  mormng  Mr.  T.  was  able  to  arrange  his  accounts, 
though  he  had  not  slept  for  an  instant.  He  had  no  sleep  the  following 
night,  and  his  memory  for  two  or  three  days  was  very  defective.  He 
does  not  remember  anything  that  passed  between  Mr.  Knaggs'  first 
yiut  (and  even  of  that  he  has  only  a  dim  recollection)  and  his  return 
to  consciousness,  about  half-past  ten  or  eleven  p.m.  He  is  now  quite 
well,  with  the  exception  of  slight  dimness  of  vision,  and  dilatation  of 
the  pupils,  and  a  consciousness  of  a  little  impairment  of  memory. 
There  does  not  seem  to  have  been  any  eruption  of  the  skin,  excepting 
the  pustules,  nor  any  itching  on  the  surface." 

Case  XIV. 

Seven  cases  of  poisoning  by  Belladonna  came  under  Dr. 
Pereira's  notice  at  the  London  Hospital.  In  the  later  editions 
of  his  Materia  Medica,  he  sams  up  the  symptoms  observed  by 
him  in  the  following  words : — 

"  1st.  Dryness  of  the  fauces,  causing  excessive  difficulty  of  swal- 
lowing and  alteration  of  the  voice. 

"  2nd.  Scarlet  eruption  on  the  arms  and  legs. 

"  3rd.  Dilatation  of  the  pupil,  with  presbyopia. 

"  4th.  Delirium  and  phantasms.  The  delirium  was  of  the  cheerful 
or  wild  sort,  amounting,  in  some  cases,  to  actual  frenzy.  In  some  of 
the  patients  it  subsided  into  a  sort  of  sleep,  attended  with  pleasant 
dreams,  which  provoked  laughter.  The  delirium  was  attended  with 
phantasms,  and,  in  this  respect,  resembled  that  caused  by  alcohol; 
but  the  mind  did  not  run  on  cats,  rats,  and  mice,  as  in  the  case  of 
drunkards.  Sometimes  the  phantasms  appeared  to  be  in  the  air, 
and  various  attempts  were  made  to  catch  them  or  chase  them  with 
the  hands ;  at  other  times  they  were  supposed  to  be  on  the  bed.  One 
patient  (a  woman)  fancied  the  sheets  were  covered  with  cucumbers. 

"  dth.  Convulsions,  paralysis,  sopor,  or  coma.  In  most  of  the 
cases,  the  power  of  the  will  over  the  muscles  was  so  far  disordered, 
that  the  muscular  movements  were  somewhat  irregular,  causing  a 
kind  of  staggering  or  jerkings;  but  actual  convulsions  were  not 
general.  There  was  sopor,  which  terminated  in  coma,  with  a  weak- 
ened or  paralytic  condition  of  the  muscles.** 

The  chorea-like  character  of  the  disordered  muscular  move- 
ments of  Belladonna  is  plainly  described  in  the  fifth  paragraph. 


bp  Dr.  Richard  Hughes.  187 

Case  XV. 

Dr.  Taylor,  in  his  work  on  Poisons,  records  the  following 
case,  which  occurred  in  Gay's  Hospital,  in  August  1846: — 

**A  boy»  aged  14,  ate,  soon  after  breakfast,  about  thirty  of  the 
berries,  which  he  had  bought  in  the  street  In  about  three  hours  it 
appeared  to  him  as  if  his  face  had  become  swollen,  his  throat  became 
hot  and  dry,  vision  impaired,  objects  appeared  double,  and  they 
seemed  to  revolve  and  run  backwards.  His  hands  and  face  were 
flushed,  and  his  eyelids  tumid ;  there  were  occasional  flashes  of  light 
before  his  eyes.  He  tried  to  eat,  but  could  not  swallow  on  account 
of  the  state  of  his  throat.  In  endeavouring  to  walk  home,  he  stum- 
bled and  staggered ;  and  he  felt  giddy  whenever  he  attempted  to 
raise  his  head.  His  parents  thought  him  intoxicated ;  he  was  inco« 
herent,  frequently  counted  his  money,  and  did  not  know  the  silver 
from  the  copper  coin.  His  eyes  had  a  fixed,  brilliant,  and  dazzling 
gaze;  he  could  neither  hear  nor  speak  plainly,  and  there  was  great 
thirst :  he  caught  at  imaginary  objects  in  the  air,  and  seemed  to  have 
lost  all  knowledge  of  distance.  His  fingers  were  in  constant  motion : 
there  was  headache,  but  neither  vomiting  nor  purging.  He  did  not 
reach  the  hospital  until  nine  hours  had  elapsed  ;  and  the  symptoms 
were  then  much  the  same  as  those  above  described.  He  attempted 
to  get  out  of  bed  with  a  reeling,  drunken  motion ;  his  speech  was 
thick  and  indistinct  The  pupils  were  so  strongly  dilated,  that  there 
was  merely  a  ring  of  iris,  and  the  eyes  were  quite  insensible  to  light 
The  eyelids  did  not  close  when  the  hand  was  passed  suddenly  before 
them.  He  had  evidently  lost  the  power  of  vision,  although  he  stared 
fixedly  at  objects  as  if  he  saw  them.  The  nerves  of  common  sensa- 
tion were  unaflected.  When  placed  on  his  legs  he  could  not  stand. 
The  pulse  was  90,  feeble,  and  compressible ;  his  mouth  was  in  con- 
stant motion,  as  if  he  were  eating  something.  His  bladder  was  full 
of  urine  on  admission.  He  continued  in  this  state  for  two  days, 
being  occasionally  conscious ;  when,  by  a  free  evacuation  of  the 
bowels,  some  small  seeds  were  passed.  These  were  examined  and 
identified  as  the  seeds  of  Belladonna.  The  boy  gradually  recovered, 
and  left  the  hospital  on  the  sixth  day  after  his  admission.  The 
progress  of  recovery  was  indicated  by  the  state  of  the  pupils, 
which  had  then  only  acquired  their  natural  size  and  power  of  con- 
ti-action." 


188  Poisoning  by  BelladontM, 

Case  XVI. 

The  following  case  appears  among  the  proceediDgs  of  the 
Meeting  of  the  Provincial  Medical  and  Surgical  Association, 
held  at  Bath,  in  1848.     The  reporter  is  a  Mr.  Jackson: — 

*'T.  G.,  aged  75,  a  man  of  spare  habit,  had  a  box  of  extract  of 
Belladouia,  containing  five  drachms,  given  him  with  a  view  to  its 
being  spread  as  a  plaster  for  his  chest.     The  poor  old  man  mistook 
the  verbal  directions,  and  took  a  portion  of  the  extract.     The  dose 
taken  was  represented,  by  a  female  who  was  present  at  the  time,  as 
80  small  as  not  to  exceed  four  or  five  grains.  Whether  this  person  was 
mistaken  as  to  the  quantity  taken  is  uncertain.     This  occurred  at 
about  six  in  the  evening.     In  a  short  time  the  symptoms  became 
manifest,  and  at  seven  he  had  lost  the  power  of  articulation,  and 
presented  the  general  appearance  of  a  person  seized   with  slight 
paralysis.     He  was  quite  unable  to  stand  or  walk,  and   his  limha 
were  in  a  state  of  tremor  and  agitation.     He  became  cold,  and 
nearly  approaching  a  state  of  insensibility;  the  eyes  had   a  wild, 
vacant  appearance;  the  respiration  was  laborious,  and  occasionally 
stertorous ;  and  he  moved  the  body  almost  incessantly  backward  and 
foward,  as  if  his  inward  sufiering  (not  otherwise  expressed)  was  very 
great.     At  ten  o'clock  the  temperature  of  the  body  had  increased, 
face  swollen,  mouth  and  throat  extremely  dry,  and  insensibility  more 
complete.     Castor  oil  had  been  g^ven,  but  was  rejected.    One  of  the 
attendants  stated  that  nausea  prevailed  at  various  times.     No  active 
delirium  was  manifested,  but  from  the  general  appearance  of  the  eye 
and  features,  no  doubt  that  peculiar  derangement  existed,  subdued 
partially  by  the  pressure  on  the  cerebral  organ,  so  as  more  nearly  to 
approach  the  character  of  apoplexy.     At  six  the  following  morning 
he  appeared  considerably  exhausted,  but  had  still  sufficient  power  to 
take  some  wine  and  water,  and  for  the  first  time  indistinctly  uttered  a 
few  words.     His  mouth  and  fauces  at  this  time  (to  use  the  words  of 
an  attendant)  were  as  dry  as  a  chip.     His  face  was  so  much  swollen 
and  red,  as  quite  to  chance  his  usual  appearance.     His  daughter 
remarked  that  the  wrinkles  of  old  age  had  disappeared,  and  he 
appeared  much  fatter  than  usual.     Between  nine  and  ten  in  the 
morning  he  appeared  quite  exhausted,  and  he  died  at  eleven,  being 
seventeen  hours  after  taking  the  extract. 

**  The  post-mortem  examination  showed  the  presence  of  great  con- 


iy  Dr.  Richard  HugJies,  189 

^estion  of  the  brain,  particularly  at  the  base,  and  of  the  medulla 
oblongata,  together  with  considerable  (serous?)  effusion*  .  There  was 
also  congestion  of  the  lungs,  and  dark  discolouration  of  a  portion  of 
the  great  curvature  of  the  stomach. 

''The  points  of  interest  Mr.  Jackson  considered  to  be — the  rapid 
accession  of  the  symptoms,  particularly  those  affecting  the  voice ; 
their  resemblance,  in  some  respects,  to  the  early  progress  of  conges- 
tive ferer ;  and  the  fact  that  the  chief  action  of  the  Belladonna  was 
on  the  medulla  oblongata." 

Case  XVII. 

I  do  not  propose  to  report  at  length  any  more  cases  of  Bella* 
donna  poisoning,  but  shall  conclude  the  series  with  some 
isolated  notes  selected  from  various  sources,  with  a  view  to 
illustrate  some  of  its  physiological  effects. 

The  dryness  of  the  throat  is  an  almost  constant  symptom  in 
the  cases  of  poisoning  recorded.  In  two  instances  it  is  said 
to  have  been  hot  as  well  as  dry,  but  no  visual  examination 
seems  to  have  been  made  to  ascertain  the  physical  condition  of 
the  parts.  From  other  sources,  then,  some  account  of  this  must 
be  given.  In  a  case  of  poisoning  by  Atropine,  recorded  in  the 
North  American  Journal  of  HomoBopathi/,  vol.  i.  p.  116,  it  is 
stated  that  the  patient  complained  next  day  of  '*  sore  throat." 
In  another  case,  in  vol.  iv.  of  the  same  Journal,  p.  122,  it  is 
said  "  he  felt  great  soreness  in  the  throat,  which  looked  very 
red  about  the  tonsils  and  palate.  The  soreness  extended  to  the 
ears."  And  in  Dr.  Black's  paper  on  Belladonna  in  Scarlet 
Fever,  in  the  1st  volume  of  the  British  Journal  of  HomoBo- 
pathy^  a  case  of  poisoning  is  mentioned  as  reported  by  Mr. 
Wade,  in  the  London  Medical  and  Physical  Journal,  April 
1827,  where,  from  the  external  application  of  Belladonna,  "  the 
mucous  membrane  from  the  posterior  third  of  the  palate,  as  far 
down  as  could  be  seen,  was  of  a  deep  crimson  colour,  and  the 
tonsils  were  much  enlarged." 

Again,  Ghristison  speaks  of  "redness  of  the  throat"  in  one 
case,  and  of  "  aphthous  inflammation"  of  this  part  in  two  others. 

I  think  that  from  these  facts  it  is  evident,  that  the  dry  mouth 
and  throat  of  Belladonna  does  not  result  from  an  aneemic  con- 


190  Poisoning  by  Belladonna^ 

ditioQ  of  these  parts,  whether  from  pneamogasiric  depression 
or  sympathetic  excitation  ;  but  is  the  arrest  of  secretion  which 
accompanies  congestion  and  inflammation,  and  that  consequently 
Belladonna  is  tissue-irritant  to  this  portion  of  the  alimentary 
mucous  membrane.  Its  therapeutic  value  in  the  various  forms 
of  angina  is  well  known. 

Case  XVIII- 

The  symptoms  produced  by  Belladonna  in  the  urinary  organs 
are  very  constant  and  characteristic.  They  usually  consist  of 
frequent  urging  to  micturate,  with  either  a  very  great  diminution 
(when  large  doses  have  been  taken)  of  the  urinary  secretion,  or 
more  rarely  (under  the  influence  of  comparatively  small  doses) 
a  considerable  increase  in  the  same.  Sometimes  the  latter 
symptom  follows  upon  the  former,  as  in  Case  X.  That  these 
phenomena,  like  those  of  the  throat,  depend  upon  a  specific 
irritation  of  the  urinary  mucous  membrane,  appears  when  we 
investigate  the  ultimate  effects  of  the  dnig  in  this  sphere. 
Christison  quotes  one  from  Wibmer,  in  which  the  patient ''  had 
violent  strangury  towards  the  close,"  and  another  from  M. 
Jolly,  where  there  was  "  violent  strangury  with  suppression 
of  urine  and  bloody  micturition."  Belladonna  is  much  used  by 
the  old  school  in  irritable  bladder,  and  is  considered  little  short 
of  a  specific  in  enuresis. 

Case  XIX. 

The  power  of  Belladonna  to  cause  active  determination  of 
blood  to  the  head  is  well  seen  in  Cases  II,  III,  X,  XI,  XYI. 
The  following  case,  quoted  by  Dr.  Taylor  {Op,  cit.)  from  a 
German  periodical,  exhibits  this  symptom  in  its  fullest  degree : 

^  A  man,  aged  84,  ate  about  fifty  berries  to  reKeve  his  thirst.  He 
immediately  perceived  a  burning  sensation  in  the  throat  and  feeling 
of  stupefaction.  He  staggered  home  and  went  to  bed.  In  the 
evening  he  was  seized  with  such  violent  delirium  that  it  required 
three  men  to  confine  him.  His  face  was  li^id ;  his  eyes  injected 
and  protruding ;  the  pupils  strongly  dilated ;  the  carotid  arteries  pul- 
sating most  violently ;  a  full,  hard,  and  frequent  pulse,  and  loss  of 
power  to  swallow.     He  was  bled,  and  in  about  half-an-hour  was 


by  Dr.  Richard  Hashes,  191 

able  to  Bwallow  aa  emetic,  which  brought  away  a  violet-blue  or 
purple  liquid.  Purgative  medicines  and  enemata  were  employed,' 
and  he  recovered  hie  consciousness  in  about  twelve  hours." 

In  the  majority  of  cases  where  a  post-mortem  examination 
has  been  obtained,  a  highly  hypereBmic  state  of  the  encephalic 
mass  has  been  observed. 

Here,  too,  the  hypothesis  of  a  specific  irritation  of  this 
portion  of  the  nervous  centres  supplies  the  best  explanation  of 
the  phenomena.  The  delirium  is  the  primary  effect  of  this 
irritation,  and  the  determination  of  blood  the  subsequent 
result  of  its  continued  influence. 

Case  XX. 

A  great  many  experiments  have  been  made  by  Lusanna  to 
ascertain  the  physiological  action  of  Atropine.  A  summary  of 
his  observations  appears  in  the  Allgetneine  Honioopathische 
Zeitung^  vol.  Iv.,  of  which  the  following  is  a  translation  by 
Dr.  Hoffendahl,  of  Boston,  communicated  to  the  North  Ame- 
rican Journal  of  Homoeopathy,  vol.  vii. 

**  The  physiological  effects  of  Atropine,  when  taken  continuouBly 
and  in  increasing  doses,  are  as  follows  : — 

**1.  Dilatation  and  ImmobUiiy  of  the  Pupil, — The  dilatation  is 
most  marked  at  the  beginning  (fourteen  to  twenty  minutes  alter 
swallowing  a  dose  of  y^  or  Y30  of  a  grain)  and  at  the  end  of  the 
experiment  At  the  height  of  the  intoxication  the  pupil  is  quite 
immoveable,  and  has  nearly  its  normal  diameter.  The  return  of  a 
slight  motion  of  the  iris  is  the  first  sign  that  the  effects  of  the 
remedy  are  diminishing.  Dilatation  of  the  pupils  often  continues 
for  eight  days  after  the  cessation  of  the  other  symptoms. 

2.  Disturbance  of  the  Sight. — Objects  appear  as  if  enveloped  in  a 
fog.  As  the  dose  is  increased,  the  obscurity  increases  even  to  perfect 
blindness.  On  omitting  the  remedy,  these  symptoms  diminish  with 
great  rapidity,  and  disappear  entirely  in  one  or  two  days. 

8.  Somnolence  and  Confusion  of  Ideas, — ^First  merely  sluggishness 
of  the  mind,  then  dizziness  and  a  condition  resembling  commencing 
intoxication.     Headache  occurred  in  but  one  case. 

4,  Hallucinations  of  the  Sense  of  Hearing. — Not  frequent,  con- 
sisting of  various  sounds,  roaring,  &c. 


192  Poisoning  btf  Belladofma, 

5.  HattucifuUions  of  the  Sight. — ^While  the  obscurity  of  objects  is 
increasiDg,  various  phantoms  are  observed,  gigantic  forms,  and  some- 
times laughable,  sometimes  terrifying  appearances ;  also  quick  rota- 
tion and  duplication  of  objects. 

6.  AntBitheiia — Cessation  of  pains,  especially  of  spasmodic  neu- 
ralgis  ;  diminished  sensibility  for  painful  physical  impressions.  The 
sense  of  touch  alone  appears  to  be  but  litUe  affected. 

7.  Dryn$99  of  the  mouth  and  fauces  always  occurs  in  a  few  days. 
At  first  it  is  only  a  subjective  symptom,  but  later  it  can  be  observed 
objectively,  depending  upon  a  diminution  of  the  salivary  secretion, 
but  never  connected  with  gastro-enteric  irritation,  a  symptom  which 
was  never  observed. 

8.  Loss  of  appetite  ;  present  in  all  cases,  changing  to  great  voracity 
at  the  end  of  the  experiment.  There  is  no  thirst,  notwithstanding 
the  dryness  of  the  fauces. 

9.  DifficuUy  of  utterance ;  present  at  the  height  of  the  intoxi- 
cation. 

10.  DeUriutn^  often  followed  by,  or  alternating  with,  stupor.  Al- 
ways occurs  after  larger  doses  (}/iq  to  i/^)  of  a  grain),  is  generally  of 
a  petulant,  cheerful  character,  and  disappears  slowly. 

11.  Dysphagia  is  never  absent  if  the  use  of  the  drug  is  per- 
severed in,  and  keeps  pace  with  the  dryness  of  the  fsiuces. 

12.  Itedness  of  the  skin  was  only  observed  in  one  person,  having  a 
delicate  white  skin.  The  redness  appeared  so  constantiy  in  this  case, 
from  half-an-hour  to  an  hour  after  each  dose,  that  it  was  undoubtedly 
caused  by  the  medicine. 

13.  Torpor  and  Paralytic  Trembling, — ^The  limbs,  especially  the 
lower  ones,  gradually  became  weak,  and  the  gait  unsteady ;  finally, 
the  subject  was  obliged  to  He  down.  Slight  convulsive  trembling  of 
some  of  the  muscles  may  be  observed,  but  never  spasm,  painful  re- 
traction or  spasmodic  rigidity.  With  the  loss  of  consciousness,  the 
motions  become  entirely  automatic.  When  the  medicine  has  been 
given  in  gradually  increasing  doses,  there  is  subsultus;  when  a  single 
large  dose  has  been  given,  convulsions  occur. 

14.  Paralysis  of  the  Sphincters  of  the  Bladder  and  Rectum, — This 
is  the  highest  step,  beyond  which  it  is  not  safe  to  push  the  physio- 
logical experiment.  In  two  patients,  who  took  the  dose  of  one  and 
one-half  gprains,  there  were  involuntary  fecal  discharges.  Another 
patient  took  a  still  larger  dose,  followed  by  incontinence  of  urine  and 
involuntary  discharges." 


by  Dr.  Richard  Hughes,  193 

This  last  mentioned  effect  of  the  drug — ^paralysis  of  the 

BphinctezB — ^is  very  interesting,  for  we  have  Belladonna  highly 

recommended  in  the  involuntary  defalcation  and  micturition  of 

children.     (See  New  Sydetihatn  Society  s  Year  Book  for  1860, 

page  400.) 

Case  XXI. 

In  Case  I,  note  (8),  I  have  argued  that  the  mydriatic  power  of 
Belladonna  and  its  congeners  Hyoscyamus  and  Stramonium, 
depends  upon  an  excitation  by  them  of  the  sympathetic  supply 
of  the  iris.  I  may  here  mention  that  this  view  is  also  main- 
tained by  Mr.  Wharton  Jones  {Principles  and  Practice  of 
Ophthalmic  Medicine  and  Surgery)^  Mr.  B.  Bell  (Edinburgh 
Medical  Journal,  July  1858),  Prof.  Allen  Thomson  {Glasgow 
Medical  Journal,  January  1857),  and  Dr.  Harley  (Medical 
Times  and  Gazette,  January  81,  1857).  Mr.  Wharton  Jones 
supplies  from  comparative  anatomy  a  most  powerful  argument 
in  its  favour.  ''  In  birds,"  he  says,  "  the  iris,  which  contains 
no  radiating  fibres,  and  receives  no  branches  from  the  sympa- 
thetic, is  not  influenced  by  Belladonna."  He  refers  also  to  the 
power  which  he  has  found  Belladonna  to  possess  of  contracting 
the  arteries  when  locally  applied,  as  an  analogous  action  to  its 
dilating  the  pupil ;  since  the  arteries  also  are  supplied  by  the 
sympathetic.  Opium,  which  causes  contraction  of  the  pupil, 
dilates  the  arteries — ^in  each  case  probably  by  paralysing  the 
sympathetic  Further  arguments  in  support  of  this  view  will 
be  found  in  a  paper  of  my  own  in  the  London  Medical  Review 
of  August  1860. 

Case  XXII. 

Dr.  Cbristison,  in  the  third  edition  of  his  work  on  Poisons, 
relates  the  following  case  of  compound  poisoning  by  Opium 
and  Belladonna : — 

^  A  lady,  who  used  a  compound  infusion  of  Opium  and  Bella- 
donna as  a  wash  for  an  eruption  in  the  vulva,  took  it  into  h^r  head 
one  day  to  use  the  wash  as  an  injection ;  and  actually  received  three 
successive  injections,  containing  each  the  active  matter  of  a  scruple 
of  Opium  and  half  an  ounce  of  Belladonna  leaves.     Fortunately, 

VOL.   XX.,    NO.    LXXX. — APRIL,    1862.  N 


194  PoUoning  by  BeUadonna, 

none  of  the  three  was  retained  above  a  few  minutes,  except  the  last, 
which  was  not  discharged  for  ten  minutes.  In  less  than  an  hour  she 
was  found  in  bed  in  a  deep  sleep,  but  the  true  cause  was  not  sus- 
pected till  three  hours  later.  She  was  then  completely  insensible 
and  motionless,  with  the  face  pale,  the  pupils  excessively  dilated  and 
not  contractile,  the  pulse  frequent  and  small,  and  the  breathing 
hurried.  After  the  use  of  purgative  injections,  blood-letting,  leeches 
to  the  head,  and  sinapisms  to  the  legs,  she  began  in  five  hours  to 
show  some  signs  of  returning  consciousness,  which  improved  after  a 
fit  of  vomiting.  When  thoroughly  aroused,  the  vision  continued 
dim,  with  the  pupils  excessively  dilated,  and  the  ideas  somewhat 
confused.  For  three  days  after  the  pulse  continued  frequent,  and 
the  pupils  somewhat  dilated.  Here  the  Opium  seems  to  have  pre- 
vented the  delirium  induced  by  Belladonna  in  the  early  stage ;  while, 
on  the  other  hand,  the  Belladonna  prevented  the  usual  effect  of  Opium 
on  the  pupils,  and  actuaUy  produced  the  opposite  action." 

I  have  quoted  this  case  in  illustration  of  a  remark  I  pre- 
vioasly  made,  that  the  state  of  the  pupils  induced  by  Belladonna 
is  not  dependent  upon  or  connected  with  its  cerebral  derange- 
ment. Were  this  the  case,  the  pupils  should  be  contracted 
during  the  delirium,  which  corresponds  to  the  first  stage  of 
cerebral  inflammation,  and  dilated  only  in  the  subsequent 
sopor.  The  present  case  shows  us  the  cerebral  symptoms  of 
Belladonna  entirely  obliterated,  so  to  speak,  by  the  inferior  in- 
fluence of  the  Opium ;  while  the  dilatation  of  the  pupil  is  as 
marked  as  ever,  and  this  in  spite  of  the  tendency  of  Opium  to 
cause  its  contraction.  We  are,  therefore,  justified  in  concluding 
that  the  dilated  pupil  is  a  localized  efiect  of  Belladonna,  and 
forms  no  necessary  indication  or  counter-indication  as  to  its 
use  in  cerebral  affections. 

I  will  now  conclude  this  paper  by  summing  up  the  inferences 
which  may  be  drawn  from  the  above  facts  as  to  the  essential 
physiological  action  of  Belladonna.  In  so  doing,  I  shall  be 
giving  in  brief  the  results  of  a  study  of  the  drug  undertaken 
by  Dr.  Madden  and  myself  on  the  basis  (mainly)  of  the  materials 
here  collected. 

Belladonna^  then,  in  the  language  of  the  old  school  tozico- 
logists  is  a  "  narcotico-irritant"    By  "narcotic"  (better  "neu- 


by  Dr.  Richard  Hughes,  196 

rotio")  they  mean  a  sabstanoe  which  exerts  a  specific  influence 
upon  the  nervoos  system ;  by  "  irritant,"  one  which  is  capable 
of  oansing  inflammation  in  various  tissues  and  organs.  Under 
these  two  heads  I  shall  range  the  physiological  action  of  the  drug. 

I. — Neurotic. 

This  action  of  the  drug  varies  according  as  it  is  exerted  upon 
the  sensory,  the  motor,  or  the  sympathetic  division  of  the 
nervous  system. 

1.  Sensory, — Belladonna  is  an  anesthetic — a  depressor  of 
the  sensory  nerves.  This  influence  is  invariably  seen  when  the 
drag  is  applied  to  the  external  surface — local  ansDSthesia  being 
always  the  result.  When  swallowed  in  large  quantity,  it  is 
exerted  upon  the  stomach,  as  shown  by  the  insensibility  of  that 
organ  to  emetics.  It  almost  invariably  extends  to  the  eye,  pro- 
dneing  impaired  vision  going  on  to  amaurosis,  and  insensibility 
to  the  stimuli  which  ordinarily  give  rise  to  winking.  It  is  some- 
times seen  in  the  ear,  in  the  form  of  deafness  (Case  V).  Very 
rarely  it  a&cts  the  nerves  of  common  sensation,  giving  rise  to 
general  anesthesia  (Case  IV). 

The  only  homoeopathic  application  of  Belladonna  which  would 
result  from  the  above  hc\A  would  be  its  use  in  functional  amaurosis 
and  nervous  deafness.  As  an  antipathic  palliative,  its  anesthetic 
power  may  be  made  use  of  as  a  local  application  to  painful  parts* 
Given  intemaliy  for  this  purpose,  it  may  palliate  the  photophobia 
which  accompanies  many  affections  of  the  eye,  but  can  hardly  be 
depended  upon  to  relieve  pun  in  general.  This  is  the  experience  of 
physicians  of  the  old  school,  as  Pereira  testifies. 

2.  Motor. — Here,  too.  Belladonna  acts  as  a  depressor — a 
paralyser.  As  in  the  sensory  sphere,  this  influence  is  rather 
local  than  general.  The  difficult  emesis  which  so  often  obtains 
is  probably  partly  due  to  its  paralysing  effect  on  the  stomach ; 
and  Lusanna  has  told  us  how  it  relaxes  the  sphincters.  But 
general  paralysis  is  rarely  seen,  for  the  loss  of  the  power  of 
stonding  and  walking  is  probably  to  be  referred  to  a  different 
cause.     (See  Case  I.  note  1,  and  Case  X.  note  6.) 

The  use  of  Belladonna  in  involuntary  micturition  and  defecation  is 
strictly  homoeopathic.    In  the  former  affecticm — enuresis — so  com- 

2  N 


196  Poisoning  by  Belladonna, 

mon  in  young  children,  it  rarely  fails  when  given  in  the  lower 
dilutions,  from  the  3rd  decimal  downwards.  AntipathicaUy,  it  may 
he  used  as  a  local  application  to  spasmodic  strictures  ;  as.  in  rigidity 
of  the  OS  uteri  during  lahour  or  difficult  menstruation,  spasmodic 
stricture  of  the  urethra  with  retention  of  urine,  chordee,  &c. 

8.  Sympathetic, — To  the  sympathetic  or  ganglionic  nerves 
Belladonna  is  an  excitant.  This  inflaence,  however,  appears 
never  to  be  exerted  except  by  a^ocal  application  of  the  drug — 
save  in  the  eye,  where  the  dilated  pupil,  and  open,  staring, 
brilliant  eyeball  are  precisely  the  effects  of  excitation  of  the 
cervical  sympathetic,  from  which  the  eye  is  supplied. 

We  can  hardly  use  this  power  of  Belladonna  except  physiologically 
or  antipathically.  To  the  eye  we  apply  it  to  dilate  the  pupil,  for 
ophthalmoscopic  purposes,  or  to  prevent  adhesions  in  iritis.  With 
regard  to  the  latter  use,  however.  Dr.  Madden  states  that  he  has 
treated  numerous  cases  of  iritis  with  homoeopathic  remedies,  espe- 
cially Clematis,  without  using  mydriatics,  and  has  never  had  reason 
to  regret  their  neglect.  The  power  of  Belladonna  to  contract  the 
arteries,  through  the  medium  of  the  vaso-motor  nerves,  renders  it  a 
valuable  adjunct  in  the  treatment  of  many  inflammations.  It  is,  of 
course,  most  useful  when  the  inflamed  part  can  be  reached  by  it 
locally.  Thus  in  the  inflammation  of  the  mamma,  known  (from  its 
usual  termination  under  ordinary  treatment)  as  *'  milk-abscess,"  the 
local  application  of  Belladonna,  if  made  in  time,  will  almost  in- 
variably cause  speedy  resolution.*  In  gastritis.  Belladonna  will 
greatly  aid  the  specific  irritant  of  the  part — as  Arsenic,  or  may  itself 
efiect  a  cure.  It  should  not  be  applied  (in  substance)  to  an  inflamed 
part  to  which  it  is  specifically  irritant,  or  aggravation  will  ensue.  I 
have  known  it  greatly  increase  the  pain,  &c.  of  a  boil. 

II. — ^Irritant. 

The  tissue-irritant  power  of  Belladonna  is  exerted  upon  the 
encephalic  mass,  certain  portions  of  the  mucous  membranes, 
and  the  skin. 

1.  Eneepluilic  Mass, — This  must  be  considered  under  the 
heads  of  its  various  divisions. 

*  See  8  case  related  by  myself  in  BrtxUhwaiU^s  Betrotpeti,^  vol.  zlii.  p.  395. 


by  Dr,  Richard  Hughes.  197 

'  a.  Cerebrum.  The  first  effect  of  Belladonna  upon  the' cere- 
brum is  to  excite^  and  at  the  same  time  pervert,  its  function. 
Thus  we  have  delirium,  insomnia,  mania.  If  the  influence  be 
severe  or  prolonged,  active  determination  of  blood  takes  place, 
and  we  have  symptoms  of  congestion,  inflammation,  and 
effoaion. 

The  value  of  Belladonna  is  so  well  known  in  all  active  perversions 
of  function,  and  all  hypersemic  conditions  of  the  cerebrum,  that  I 
need  adduce  no  evidence  of  it  here. 

b.  Cerebellum,  The  disturbing  influence  of  Belladonna 
upon  the  cerebellum  appears  in  the  loss  of  co-ordinating  and 
balancing  power  observed  in  the  muscular  system  generally, 
and  especially  in  the  muscles  of  the  lower  limbs. 

It  is  a  plausible  theory  of  some  French  physicians  that  chorea  has 
its  seat  in  the  cerebellum.*  If  this  be  true,  the  power  of  Bella- 
donna to  cause  and  cure  this  disease  may  be  ranged  under  the 
present  category.  There  is  little  recorded  homoeopathic  experience 
in  this  disease,  but  many  allopathic  physicians  testify  to  the  control 
exercised  over  it  by  Belladonna.  Dr.  Fuller  administered  it  to 
twelve  choreic  children  in  St.  George's  Hospital :  "  in  seven  cases  • 
its  action  appeared  to  be  decidedly  curative,  but  in  two  cases  it 
failed  to  exercise  the  slightest  control  over  the  spasms ;  and  in  the 
other  three  cases  it  is  doubtful  whether  the  improvement  ought  to  be 
ascribed  to  its  action." 

e.  Medulla  Oblongata.  The  excited  and  perverted  function 
of  this  centre  is  seen  in  the  abnormal  phenomena  of  the  parts 
supplied  by  the  nerves  which  originate  in  it.  The  spasms  of 
the  larynx  and  pharynx,  the  difficult  articulation  and  deglutition, 
and  the  spasmodic  cough  (Case  XI.),  belong  to  this  category. 

An  excited  state  of  the  medulla  oblongata  may  give  rise  to  many 
diseases.  If  its  influence  fall  on  the  blood-vessds  of  the  brain,  we 
have  epilepsy,  f    In  this  disease  Belladonna  is,  after  Hydrocyanic 

•  See  Watson,  Practice  ofPhysie  (4th  ed.),  vol.  i.  p.  672. 
t  See  my  Paper  on  the  Nerroos  System,  BriHah  Jowmal  of  HomaopcOhy^ 
October  1861,  p.  663. 


198  On  the  Action  of  Belladonna, 

acid,  incomparably  our  bestre  medy.     Dr.  Russell  has  recorded 
some  valuable  cases  illustrative  of  this  in  the  15th  volume  of  the 
British  Journal  of  HomaopcUhy^  and  it  is  Dr.  Brown-Sequard*B 
leading  remedy  at  the  Hospital  for  the  Paralysed  and  Epileptic.      If 
the  laryngeal  and  pharyngeal  nerves  be  mostly  affected,  we  have 
laryngismus,  pertussis,  or  hydrophobia  (so  far  as  the  latter  affection 
is  confined  to  the   throat  symptoms).     In  laryngismus  stridulus 
(Millar's  asthma)  we  have  no  records  of  the  use  of  Belladonna;  and 
Aconite  is  so  successful  in  this  disorder  as  rarely  to  g^ve  us  the 
trouble  of  seeking  a  new  remedy.     In  pertussis  Belladonna  is   a 
favourite  remedy  in  both  old  and  new  schools.*    In  alternation  with 
Drosera,  it  is  probably  the   best  remedy  in  the   second  stage    of 
this  disease.     And  if  hydrophobia  ever  has  been  cured,  the  credit  is 
due  to  Belladonna.     Dr.  Watson  tells  us  that  Mr.  Touatt  considered 
it  the  best  prophylactic  against  this  frightful  affection  {Practice  of 
Physic,  4th  ed.  vol.  i.  p.  629)  ;  and  it  is  stated  that  in  China  Stra- 
monium is  considered  a  sovereign  remedy  for  it     By  its  influence 
on  the  hypoglossal,  or  motor  nerve  of  the  tongue.  Belladonna  may 
prove  useful  in  some  cases  of  stammering.     Lastly,  if  the  excited 
state  of  the  medulla  falls  most  severely  on  the  pulmonary  branches 
of  the  vagus,  we  may  have  spasmodic  asthma — ^an  affection  for  which 
Stramonium  is  the  favourite  remedy  of  the  old  school.     Of  course, 
if  Belladonna  is  to  prove  curative  in  any  of  these  diseases,  irritation 
of  the  medulla  oblongata  must  be  their  central  cause. 

d.  Corpora  Quadri^emitia.  Upon  irritation  of  these  organs 
— the  centres  of  vision — depend  the  visual  hallaoinations  so 
common  in  Belladonna  poisoning,  even  where  the  retina  is 
paralysed  to  all  actual  objects. 

The  curative  action  of  Belladonna  with  regard  to  visual  hallucina- 
tions is  most  frequently  called  into  play  when  these  arise  as  a  part  of 
delirium  ebriosorum.  But  it  should  be  thought  of  in  any  subjective 
derangement  of  vision — chromatopsia,  diplopia,  &c. — apparently  of 
intra-cranial  origin. 

*  I  have  just  had  a  case  in  which  an  epileptic  paroxysm  oocorred  in  the 
coarse  of  a  severe  attack  of  hooping-cough.  Belladonna,  in  drop  doses  of  the 
Ist  dilation,  was  immediately  resorted  to ;  under  the  use  of  which  the  cough 
rapidly  sahsided,  and  without  any  return  of  the  paroxysm.  The  patient  was 
a  child  of  ten  months  old. 


by  Dr.  Richard  Htighes.  199 

We  have  no  knowledge  of  the  symptoms  resulting  from  irri- 
tation of  the  corpora  striata,  opdo  tbalami,  or  other  unmentioned 
portions  of  the  encephalic  mass. 

2.  Mucous  Membranes. — ^The  mucous  membranes  on  which 
the  specific  irritation  of  Belladonna  falls  are  those  of  the  eye, 
the  throat,  and  the  urinary  passages. 

a.  Conjunctiva.  In  poisoning  by  Belladonna  this  membrane 
18  generally  injected,  and  in  two  cases  we  have  seen  it  actually 
inflamed  (Gases  IV.  YI.) 

Belladonna  is  rarely  called  for  in  catarrhal  ophthalmia,  but  is  a 
useful  adjunct  in  the  treatment  of  the  strumous  form. 

b.  Throat.  In  the  effects  of  Belladonna  upon  the  throat  we 
have  dryness,  heat,  soreness,  and  redness.  This  is  the  direct 
order  of  the  frequency  of  the  occurrence  of  these  symptoms. 
Ghiistison  mentions  (as  we  have  seen)  two  cases  in  which  the 
iiritation  went  on  to  aphthous  inflammation. 

The  value  of  Belladonna  in  the  various  anginse  is  well  established. 
Its  irritant  influence  on  the  throat  forms,  moreover,  an  important 
element  in  its  homoeopathicity  to  scarlatina  and  erysipelas. 

c.  Urinary.  In  this  tract  the  influence  of  Belladonna  causes 
frequent,  painful,  and  scanty  micturition,  sometimes  going  on  to 
strangury  and  hematuria.  Occasionally  the  urine  is  much 
increased  in  quantity,  sometimes  after  previous  diminution. 

Belladonna  is  of  much  value  in  irritable  states  of  the  urinary 
apparatus,  short  of  actual  inflammation.  When  this  occurs,  it  is 
superseded  in  value  by  Cantharis,  Terebinthina,  &c. 

8.  Skin. — ^The  irritant  influence  of  Belladonna  is  seen  in 
simple  redness,  redness  with  swelling  (usually  in  the  face),  or 
scarlatinoid  eruption. 

The  curative  power  of  Belladonna  in  inflammatory  affections  of 
the  skin  is  very  marked.  In  erythema  it  easily  effects  a  cure.  In 
simple,  non-vesicular  erysipelas,  its  use  b  one  of  the  most  triumphant 
things  in  homoeopathy.  Mr.  Liston's  testimony  to  its  efficacy  in  this 
disease  is  well  known.     Carbuncle,  furuncle,  and  whitlow — which 


200  Arsenical  Paper  Hangings,  ^c. 

are  all  of  an  erysipelatous  natures-demand  the  use  of  Belladonna, 
either  as  a  sole  or  helping  remedy ;  and  it  is  probably  the  relation 
of  Belladonna  to  the  erysipelatous  poison  which  renders  it  so  useful 
in  puerperal  fever,  which  in  nine  cases  out  of  ten  is  erysipelas, 
having  its  local  manifestation  in  the  peritoneum.  Belladonna  covers 
all  the  essential  symptoms  of  ordinary  scarlatina — the  rash,  the 
angina,  and  the  delirium — and  is  thus  deservedly  our  leading 
remedy  in  this  affection.  The  fever  and  the  renal  inflammation 
alone  are  heyond  its  border,  and  where  prominent  symptoms  require 
the  aid  of  other  remedies. 

A  word  on  the  prophylactic  power  of  Belladonna  in  this  disease. 
It  has  been  too  much  regarded  as  an  isolated  phenomenon  ;  whereas 
I  believe  the  truth  to  be,  that  all  true  homoeopathic  specifics  are 
prophylactic  as  well  as  curative.     Acting  upon  the  same  tissues  and 
organs  as  the  disease  they  combat,  they  can  prevent  by  pre-occupy- 
ing  the  ground,  as  well  as  cure  by  driving  out  the  intruder.     Thus 
Quinine  is  prophylactic,  as  well  as  curative,  of  ague.  Cuprum  of 
cholera.  Mercury  of  constitutional  83rphilis.     But  it  b  obvious  that 
only  with  a  few  diseases  can  any  medicinal  prophylaxis  be  properly 
carried  out ;  and  as  yet  we  have  but  few  drugs  like  the  above-men- 
tioned which  completely  cover  the  symptoms  of  the  dreaded  aflection. 
A  scientific  Pathogenesy  must  make  much  progress,  and  the  mind  of 
the  public  must  be  greatly  enlightened,  before  we  can  hope  tor  any 
systematic  practice  of  medicinal  prophylaxis ;  but  I  believe  that  when 
this  is  reached,  we  shall  have  to  thank  the  law  of  similars,  and  the 
man  who  established  it,  for  the  very  possibility  of  its  attainment. 

The  antidotes  in  cases  of  Belladonna  poisoning  are  the 
mineral  alkalies — Ammonia,  Potash,  Soda:  and  Opiom.  Its 
most  nearly  allied  medicines  are  Hyoscyamus  and  Stramoniam. 
These  three  are  considered  by  some  chemists  to  possess — ^liko 
Nux  Vomica  and  Ignatia — a  common  active  principle. 

EFFECTS    OF  ARSENICAL   PAPER-HANGINGS    ON 

THE  HEALTH. 

By  R.  E.  Dudgeon,  M.D. 

From  time  to  time  extracts  have  been  given  in  this  Joomal 
from  other  publications  bearing  upon  the  injurious  effects  of 
arsenical  paper-hangings  on  the  health  of  those  living  in  rooms 


by  B.  E.  Dudgeon,  M,D.  20 1 

adorned  with  them.  In  the  present  paper  I  propose  to  give  an 
account  of  the  cases  that  have  fallen  under  my  own  observation, 
vrhere  I  believe  I  can  trace  the  morbid  symptoms  entirely,  or 
almost  entirely,  to  this  cause. 

1.  Though  I  had  frequently  read  in  the  medical  journals  of 
tbe  injurious  effects  of  arsenical  paper-hangings,  it  was  not  till 
the  beginning  of  last  year  that  I  observed  in  my  own  practice 
any  cases  where  I  could  distinctly  trace  their  poisonous  action. 
At  that  time  I  was  extremely  puzzled  by  the  prevalence  of 
disease  among  all  the  members  of  a  family  who,  up  to  that 
Ume,  had  been  comparatively  healthy.     The  family  consisted  of 
a  lady  and  gentleman  and  their  three  children — one  grown  up, 
tbe  other  two  a  girl  and  a  boy  of  the  respective  ages  of  1 5  and 
]  2.     The  father,  aged  about  55,  had  a  severe  attack  of  rheu- 
matism, and  on  his  recovery  from  that,  a  difficulty  of  making 
water,  neither  of  which  affections  do  I  at  all  attribute  to  the 
poisonous  influence  of  arsenic.     His  wife,  aged  about  38,  was 
affected  with  langour,  inability  to  go  about  her  usual  occupa- 
tions, total  loss  of  appetite,  frequent  sickness  and  headaches. 
The  eldest  daughter,  her  step-child,  aged  about  40,  was  much 
more  seriously  ill.     She  had  violent  attacks  of  cough   with 
copious  expectoration,  a  peculiar  neuralgic  pain  in  the  left  arm 
that  took  her  suddenly  after  meals,  shortness  of  breathy  loss  of 
appetite,  frequent  diarrhoea,  extreme  debility  and  constant  ex- 
hausting menorrhagia  at  the  catamenial  period.     The  other  two 
children  were  subject  to  unaccountable  attacks  of  pain  in  the 
abdomen,    sickness  and  debility.     Another  member  of   the 
family,  who  resided  generally  at  Brighton,  was  always  affected 
with  sickness  and  abdominal  pains  when  she  stayed  a  day  or 
two  at  her  father  s  house  in  London.     Those  of  the  family  who 
resided  in  London  got  immediately  much  better  when  they 
went  for  a  day  or  two  into  the  country.    Visiting  at  the  house 
one  day,  I  observed  that  the  room  I  was  shown  into  had  a 
bright-green  arsenical  paper,  and  on  enquiry  I  found  that  every 
room  in  the  house  was  likewise  hung  with  arsenical  paper.     I 
learned  also,  on  further  investigation,  that  the  ill-health  of  the 
family  was  coincident  in  time  with  the  hanging  of   these 
brilliant  papers   in  their  rooms.     I  had  no  difficulty  in  per^ 


202  Arsenical  Paper  Hangings,  dtc. 

Buading  the  head  of  the  house  to  have  the  papers  lemoTed 
immediately,  and  replaced  by  less  gaudy,  but  more  innocent 
hangings.     The  change  was  followed  by  an  almost  immediate 
cessation  of  the  gastric  and  abdominal  symptoms  of  all   the 
family.    The  case  of  monorrhagia  did  not  derive  such  palpable 
benefit;  for  though  the  gastric  symptoms  were  removed,   the 
menorrhagia  recurred  as  violently  as  ever,  and  was  attended  by 
an  oedematous  state  of  the  eyelids  often  closing  up  the  eyes 
completely  for  a  day  or  two.     I  cannot  say  that  the  menor- 
rhagia was  caused  by  the  poisonous  paper-hangings,  for  she  had 
been  subject  to  it  for  years,  but  it  seemed  that  since  she  had 
been  exposed  to  their  influence,  the  menorrhagia  had  certainly 
increased  in  intensity,  and  was  attended  by  the  OBdematoos 
symptoms,  which  was  not  formerly  the  case.     I  imagine  that 
the  blood   had  been   considerably   aflfected  by   the  arsenical 
poisoning,  and  had  lost  much  of  its  proportion  of  fibrine  and 
red  particles ;  for  the  discbarge  was  very  much  paler  than  it  was 
formerly,  and  the  osdema,  as  well  as  the  paleness  of  complexion, 
showed  a  preponderance  of  its  watery  constituents. 

2.  A  young  lady  of  19,  who  lived  in  an  apartment  hung  with 
a  bright  Schweinfurt  green  paper,  had  several  very  severe  gastrio 
attacks,  one  of  which  almost  amounted  to  gastric  fever.  They 
were  marked  by  violent  burning  pains  in  the  bowels,  increased 
to  sharp  pain  on  pressure,  tongue  thickly  furred,  anorexia,  great 
thirst.  The  worst  attack  lasted  a  week.  She  changed  her 
residence,  but  oddly  enough  again  took  up  her  abode  in  an 
arsenical  room.  She  here  became  affected  with  a  peculiar  skin 
disease.  The  skin  of  her  neck,  bosom,  and  shoulders  was 
covered  with  a  rough,  cracked-looking,  dirty  brownish-red 
eruption,  which  burned  and  itched.  She  frequently  took  cold 
in  her  head,  during  which  the  itching  and  burning  of  the  rash 
were  always  very  much  increased.  After  residing  some  months 
in  this  room,  she  again  removed  and  went  to  the  country,  where 
she  speedily  improved.  This  eruption,  as  well  as  the  gastric 
attacks,  I  am  disposed  to  attribute  to  the  influence  of  the  ar- 
senical poisoning. 

3.  A  boy  of  eight  years  of  age  was  brought  to  me  suffering 
from  loss  of  appetite,  frequent  vomiting,  pain  in  the  stomach. 


by  M,  E.  Dudgeon,  M.D.  208 

and  a  reddish  brown  rough  eruption  in  patches  over  his  chest 
anteriorly.  He  had  only  had  these  symptoms  since  being  at  a 
boarding-school  for  three  months,  previous  to  which  he  was 
perfectly  well  and  strong.  On  enquiry  about  the  bed-room  he 
slept  in,  I  found  it  was  hung  with. the  bright  arsenical  paper* 
I  should  observe  that  his  brother,  who  slept  in  the  same  room 
with  him  at  school,  was  not  affected  in  the  same  way.  On 
leaving  school  and  going  home  he  rapidly  recovered ;  and  I 
may  remark,  though  the  observation  may  be  unimportant, 
that  some  of  the  members  of  the  family  at  home  had  hooping- 
cough,  which  was  immediately  taken  by  the  boy  who  had  not 
had  the  arsenical  symptoms,  but  not  by  him  who  had  suffered 
that  way. 

4.  A  lady,  aged  about  85,  who  had  long  been  under  my  care 
for  some  pectoral  symptoms  that  gave  some  uneasiness,  as  there 
were  distinct  signs  of  tubercles  in  the  apex  of  the  right  lung, 
had  been  rather  fatigued  by  attendance  on  an  invalid  relative, 
during  the  course  of  which  she  became  affected  with  slight 
hsemorrhage  from  the  bowels  when  they  were  moved,  from 
which  she  had  frequently  suffered  before.  When  in  this  state 
she  went  to  reside  with  a  relative  at  Walton,  where  her  bed- 
room was  hung  with  an  arsenical  paper.  Here  she  became  ex- 
tremely ill ;  the  haemorrhage  from  the  bowels  increased  to  an 
extent  she  had  never  before  known  it ;  she  became  weak,  anaemic, 
lost  her  appetite,  and  was  affected  with  diarrhoea  and  violent  pains 
in  the  bowels,  of  a  burning  character  chiefly,  much  aggravated 
by  pressure.  A  rough  itching  eruption  similar  to  that  of  the  last 
case  appeared  upon  her  chest  and  abdomen,  and  she  had  fre- 
quent attacks  of  nausea  and  vomiting.  On  going  down  to  see 
her  in  the  country,  I  thought  I  detected  the  cause  of  the  in- 
disposition in  the  paper  of  her  bed-room,  and  though  neither 
she  nor  her  friends  were  willing  to  allow  that  the  paper  could 
do  any  harm,  I  insisted  on  a  removal.  She  came  up  to  town, 
and  all  the  dangerous  symptoms  rapidly  subsided.  The  heemor- 
rhage  ceased,  the  eruption  went  off,  the  appetite  returned,  and 
the  anaemic  condition  is  gradually  giving  way  to  her  normal  rosy 
complexion.  In  this  case  the  hcemorrhage  was  not  caused  origi- 
nally by  the  arsenical  poisoning,  but  it  was  undoubtedly  very  much 


204  Arsmical  Paper  Hangings^  dc, 

increased  thereby,  and  attended  by  diarrhoea,  pains  in  the  bowels, 
and  gastric  derangement  which  had  never  formerly  accompanied 
it.  The  patient  when  I  visited  her  was  in  such  a  condition  of 
debility  and  exhaustion,  that  I  believe  she  would  not  have  lived 
much  longer  subjected  to  the  same  influences.  I  may  mention 
that  the  hemorrhage  from  the  bowels  in  this  case  seemed  to  be 
rapidly  checked  by  hammamelU  even  before  the  patient  could  be 
removed. 

5.  A  lady  aged  28,  who  had  recently  come  to  reside  in  town, 
consulted  me  two  months  ago  for  very  violent  pain  soon  after 
every  meal  in  tbe   epigastrium,  with  nausea  and  indifferent 
appetite.     The  skin  on  her  waist  and  bosom,  as  high  up  as  her 
throat,  was  beset  with  a  dry,  brownish  red  eruption,  in  irregular 
patches,  which  itched  a  good  deal.    She  had  frequent  and  violent 
attacks  of  sneezing,  which  woke  her  up  at  night,  and  were  at- 
tended by  copious  watery  discharge  from  the  nose.  She  had  been 
suffering  from  these  symptoms  for  many  months,  and  on  enquiry 
I  found  that  her  bed-room  in  the  house  she  formerly  resided  in 
had  an  arsenical  paper.     The  gastric  symptoms  rapidly  subsided 
in  her  new  habitation,  but  the  eruption  is  still  under  treatment. 
Her  husband  was  also  affected  with  gastric  symptoms  similar  in 
character  to  those  of  his  wife,  but  he  had  no  eruption. 

6.  A  few  weeks  since  I  was  consulted  by  a  woman,  aged  41, 
nurse  in  a  family  at  Kingston- on-Thames.  She  told  me  that 
soon  after  coming  to  live  with  the  family  where  she  was  now, 
about  two- and- a- half  years  since,  she  became  affected  vri th 
attacks  of  ague,  which  have  continued  ever  since.  The  fits  of 
ague  were  generally  of  the  quotidian  type,  but  sometimes  they 
became  tertian,  and  she  has  never  been  a  week  without  one.  All 
that  time  she  had  been  subject  to  almost  constant  burning  in 
the  epigastrium,  frequent  attacks  of  faintness  often  nearly 
amounting  to  syncope.  Diarrhoea,  pain  in  the  bowels,  sickness 
and  vomiting  were  often  present.  Before  coming  to  Kingston 
she  had  some  spots  of  lepra  on  her  arms  ;  since  then  the  erup- 
tion has  very  much  increased,  and  has  extended  to  her  face.' 
The  room  she  has  slept  in  all  this  time  is  papered  with  an 
arsenical  paper.  She  has  left  this  room  now  for  four  days,  but 
is  still  very  faint  and  occasionally  sick,  and  has  not  yet  lost  her 


hy  R.  E.  Dudgeon,  M.D.  205 

A^e  fits.  She  never  resided  in  an  aguish  district,  nor  knew 
what  agne  was  before  sleeping  in  this  room,  and  Kingston-on- 
Thames  is  not  supposed  to  be  an  aguish  place.  A  child  belong- 
ing to  the  family  has  occasionally  slept  in  the  room  with  her, 
but  each  time  it  did  so  it  was  affected  with  sickness,  violent 
Tomiting  and  fainting. 

7.  One  more  case  came  under  my  observation  during  the 
latter  part  of  last  year.     It  was  that  of  a  lady,  aged  42,  who  for 
eighteen  months  had  been  subject  to  diarrhoea.     I  am  unable  at 
this  moment  to  say  if  during  all  that  time  she  had  lived  in 
the  same  house.     The  diarrhoea  occurred  every  morning,  and 
the  bowels  were  opened  from  five  to  seven  times  during  the 
forenoon.     It  seldom  troubled  her  in   the   afternoon.     The 
motions  were  loose  and  slimy,  preceded  by  griping  and  fol- 
lowed by  straining.     I  treated  her  for  nearly  three  months 
without  material  benefit ;  on  the  contrary,  she  continued  to  get 
rather  worse,  weaker,  and  more  emaciated ;  and  about  the  end 
of  October  a  very  violent  cough,  with  diarrhoea  and  pain  in  the 
chesty  and  mucous  expectoration,  came  on.     She  became  so  ill, 
indeed,  that  she  was  no  longer  able  to  come  to  see  me,  and  at 
the  beginning  of  December  I  paid  her  a  visit,  and  found  her  in- 
habiting rooms  hung  with  the   gaudiest  arsenical  paper.     I 
advised  an  immediate  removal,  which  was  speedily  followed  by 
complete  recovery  from  the  diarrhoea  and  cough.     During  her 
residence  in  the  arsenical  rooms  she  had  a  bad  whitlow,  which 
T  should  scarcely  think  worth  mentioning,  had  not  the  same 
affection  occurred  to  another  patient  who  sat  most  of  the  day 
in  a  similar  arsenical  room. 

These  are  all  the  cases  I  can  at  present  recal  to  my  memory 
where  the  symptoms  have  appeared  to  be  caused  or  aggravated 
by  a  residence  in  rooms  coated  with  this  poisonous  pigment.  I 
have  attributed  the  effects  produced  to  the  arsenic  in  the  colour- 
ing matter,  because  though  the  pigment  is  a  compound  of 
arsenic  and  copper,  the  symptoms  more  nearly  resemble  those 
of  the  former  substance. 

If  I  am  right  in  attributing  the  above  effects  to  the  influence 
of  the  arsenic  in  the  paper  on  the  walls*  as  arsenical  papers  are 
now  so  frequently  used  in  the  interiors  of  houses,  it  is  obvious 


200  Arsetneal  Paper  Hanffingg,  ^c. 

that  we  should  make  particular  inquiries  in  all  suspioioua  cases 
as  to  the  character  of  the  paper-hangings  in  the  rooms  they 
inhabit.     We  may   often  be    vainly   treating — perhaps    with 
arsenic  itself,   as  has  happened  to  myself  more  than  once — 
maladies  that  owe  their  origin  entirely  to  the  poisonous  action 
of  that  substance.    All  the  resources  of  the  medical  art  could 
avail  but  little  for  a  patient  who  is  daily  and  hourly  respiring 
an  atmosphere  laden  with  minute  particles  of  this  subtle  and 
lethal  poison,  and  it  should  be  our  duty  to  insist  on  the  instant 
removal  of  such  papers  from  any  dwelling  or  sleeping  room  as 
soon  as  we  become  aware  of  them.    This  we  should  do  irre- 
spective of  the  unwillingness  of  the  patient  or  his  friends  to 
attribute  his  symptoms  to  the  action  of  the  poisonous  pigment. 
Patients  are  often  extremely  obstinate  on  this  subject.     They 
like  the  colour  of  the  paper,  and  are  unwilling  to  put  them- 
selves to  the  expense  and  inconvenience  of  re-papering  their 
room,  so  they  will  allege  all  sorts  of  reasons  for  refusing  to 
comply  with  our  advice.     The  paper  was  there  a  long  time 
before  the  symptoms  appeared,  or  other  members  of  the  family 
equally  exposed  to  its  influence  remain  unaffected-*-and  so 
forth.    But  if  we  are  satisfied  that  the  paper  is  the  cause,  we 
should  either  insist  on  its  removal,  or  on  the  removal  of  the 
patient  from  its  baneful  effects,  otherwise  our  remedial  efforts 
will  be  all  in  vain. 

It  will  be  observed  that  the  symptoms  in  the  above  cases 
varied  considerably,  but  all  were  truly  characteristic  symptoms 
of  arsenical  poisoning.  In  some  it  was  the  gastric  and  in- 
testinal mucous  membrane  that  was  most  affected;  in  others 
the  respiratory  organs  suffered  most;  in  several  the  skin  was 
attacked ;  and  the  case  numbered  6  was  a  most  perfect  specimen 
of  ague,  which,  as  far  as  I  could  trace,  had  no  other  cause  than 
the  arsenical  room. 

The  pernicious  employment  of  this  dangerous  arsenical 
pigment  is  not  confined  to  paper-hangings.  Recent  coroners 
inquests  show  us  that  it  exerts  its  deadly  influence  on  the  poor 
women  employed  in  artificial  flower-making,  and  if  in  several 
cases  it  has  unmistakeably  occasioned  death,  it  cannot  be 
doubted  that  in  many  others  it  has  been  the  cause  of  painful 


Pharmacological  Studies.  207 

and  dangerous  diseases  among  these  poor  women.  There  can  he 
no  doubt  also,  that  the  girls  employed  in  making  ap  the  bright 
green  dresses,  worn  so  frequently  by  ladies  last  season,  must 
have  been  much  injured  by  their  occupation ;  and  perhaps  the 
dancers  in  the  ball  room  have  to  blame  these  same  verdant 
dresses^  worn  by  themselves  or  their  companions,  for  some  of 
their  ailments,  which  probably  they  have  attributed  to  quite 
other  causes. 

It  is  well  known  that  the  workmen  employed  by  the  paper- 
hanging  makers  in  the  manufacture  of  these  arsenical  papers 
are  frequently  seized  with  violent  symptoms  indicative  of 
arsenical  poisoning,  and  we  have  been  told  by  men  employed 
to  put  up  and  take  down  these  papers  that  they  have  felt  ill  for 
many  days  after  such  work. 

It  seems  very  doubtful  if  the  government  will  interfere  to 
pnt  a  stop  to  this  wholesale  poisoning  of  the  people.  The 
imbecile  way  in  which  they  maunder  about  suppressing  any 
practice  of  adulteration,  unless  it  may  ioterfere  with  the 
revenue — as  in  the  case  of  the  innocuous  adulteration  of  coffee 
with  chicory — make  us  despair  of  seeing  any  vigorous  and 
effectual  action  in  the  case  of  arsenical  poisons  employed  as 
paper-hangings  or  as  articles  of  dress.  So  at  present  the 
matter  rests  chiefly  with  ourselves,  and  we  should  endeavour  to 
let  it  be  known,  far  and  near,  that  the  employment  of  these 
bright  green  gaudy  pigments  is  fraught  with  danger,  and 
should  be  at  once  discontinued,  if  serious  consequence  would 
be  prevented. 

PHARMACOLOGICAL  STUDIES, 

By  Dr.  Both,  Paris. 

Symptoms  produced  hy  Arsenical  Poisoning,  referred  to  in 

vol.  xix.,  p.  628. 

The  sources  whence  the  symptoms  are  taken  are  the 
following.  The  numbers  after  each  symptom  refer  to  the 
cases  of  poisoning  enumerated  in  this  list  by  corresponding 
numbers:— 


308  Pharmacological  Studies, 

1.  James,  Souflard^s  death.  In  the  Transactions  of  the  Acad;  de 
M^d.,  March  1839.— 2.  Rummel,  Horn.  Ztg.,  32,  232. — 3.  Idem, 
ihid.,  233. — 4.  Idem,   ihid.,  234. — 5.  Jacquemin,  Arch.  g^n.    de 
M^d.,  1,  1,  148.— 6.  Orfila,  ibid.,  49,  4,  602.— 7.  Heifelder,  Hei- 
delb.  med.  Ann.,  4,  2,  256. — 8.  Friedrich,  Hufel.  Jour.,  5,  171. — 
9.    Puchelt,   Heidelb.   med.   Ann.,   4,   2,   256. — 10.    Hohnbaimi, 
Henke's   Zeitsch.,   2,   4,   306.— 11.  Schlegel,   ibid.,    1,   29. — 12. 
Kaiser,  ibid.,  13,  2,  266.— 13.  Schreyer,  ibid.,  24,  3,  78.-14. 
Kortum,  ibid.,  26,  3,  165.— 15.  Stachow,  ibid.,  26,  3, 165. — 16. 
Rothhamel,  ibid.,  Erganzhft.,  29,  78.— 17.  Klose,  ibid.,  43,  1,  41. 
— 18.  Spengler,  ibid.,  55,  2,  450. — 19.  Sonderland,  Harless,  2,  2, 
175._20.    Canetta,   Henke's   Erganzhft,   32,   98.  — 21.    Amatus 
Lusitanus,  Obs.  et  cur.  med.  centur.  II.  obs.  65. — 22.  Minich,  Kurtz, 
Hom.  Ztg.,  33,  14.-23.  Schapper,  ibid.,  33,  13.— 24.  Van  den 
Dale,  Manuel  de  Toxicol,  de  Frank,  p.  28. — 25.  Tonnellier,  Jour, 
de  m^d.  chir.  et  pharm.,  4, 15. — 26.  Kraft,  Preuss.  Yereinsztg,  10, 
190.— 27.  Opler,  ibid.,  66.-28.  Schenlen,  Casp.  Wchnschr,  1844, 
872.-29.  Borges,  Rust's  Mag.,  5,  1,  64.-30.  Koch,  ibid.,  50,  1, 
111. — 31.  Hausbiitner,  Frank's  Mag.,   1,  361.-32.  Idem,  ibid., 
862. — 38.    KeUermann,  (Est.  Jhrb.,  30,  3,  423. — 34.  Homung, 
Frank's  Mag.,  1,  685. — 35.  Brenner,  ibid.,  1,  686. — 36.  Neumann, 
Horn's  Arch.,  21,  3,  483.-37.  Bodenmiiller,  Frank's  Mag.,  2,  39. 
— 38.  McLeod,  Edin.  Med.  Jour.,  15,  4,  553.-39.  Ward,  ibid., 
83,  1,  61.-40.  Gairdner,  ibid.,  32,  2,  306. — 41.  Watson,  ibid.,  32, 
2,  3G6.— 42.  Dymock,  ibid.,  59,  2,  350. — 43.  Franque,  Nassauer 
Jhrb.,  2,  4, 1. — 44.  Renter,  ibid.,  2,  4,  97. — 45.  Marcus,  Epheme- 
riden  d  Heilk,  1,  3,  64.-46.  Ebers,  Hufel  Jour.,  37,  10, 17.— 47. 
ZiJUner,  Eichhom  Bair.  Corresp.,  2,  680. — 48.  Buchholz,  Beitr.  z. 
ger.  Arznk.,  4,  154. — 49.  Beauchesne,  Renault  Nouv.  Ezper.,  86. 
—60.  Wolf,  Act.  Nat.  Cur.  V.  obs.  29.— 51.  Majault,  Samml. 
auserl.  Abh.  VII.,  279.-52.  Leroy,  ibid.— 63.  P.  Forestus,  Obs. 
et.  Cur.  lib.  30,  Obs.  6. —  54.  Quelmalz,  Commerc.  Normberg., 
1731,  h.  28,  II.— 55.  Preussius,  Act.  Pat.  Cur.  et.  III.,  et.  IV., 
Obs.  15. — 56.  Criiger,  Miscl.  Cur.  dec.  II.,  ann.  4,  Obs.  12. — 57. 
H.  Kapp's  Jahrb.  d.  Stastsarzneik.  II.,  181. — 58.  Hammer,  Com- 
merc. Litt.  Nov.  1738,  212.—  59.  Heimreich,  Act.  Nat.  Cur.,  vol.  ii., 
Obs.  10.— 60.  Pyl,  Aufs.  v.  Beob.,  8,  73. — 61.   Dehenne,  Anc. 
Jour,  de  m^d.,  10,  4,  330.-62.  GuUbert,  ibid.,  4,  6,  353.-63. 
Odier,  ibid.,  49,  3,  333.-64.  Barrier,  ibid.,  1846,  712.-65.  Orfila, 
Toxicol.  6,  ed.  1,  112. — 66.  Anonym.  Jour,  de  Chim.  M^d.,  1846, 


by  Dr.  Roth.  209 

712, — 67.  Forget,  Gaz.  d.  H6p.  16  F^br.  1850.— 68.  Wcpfer, 
Hist,  Cic.  aq.,  346.-69.  De  Haen,  Rat.  Med.  IX.,  cap.  VI.,  249. 
— 70.  ThomsoQ,  Med.  Gss.,  4,  41. — 71.  Falconer,  Mem.  of  Lond. 
Med.  Soc.,  2,  224.-72.  Pinel,  Nosogr.  1807,  2,  226.-73.  Missa, 
Orfila  Tox.,  6,  edit  1,  390.— 74.  Gerard,  ibid.,;891.— 75.  Devergie, 
Jour.  Univ.  des  Scien.  M^d.,  6,  333. — 76.  Leuret,  Rec.  period,  de 
Gaultier  de  Claubry,  94,  1,  31.— 77.  Fielitz,  Baldinger's  Neuea 
Mag.,  8,  437.-78.  Hafter,  Frank's  Mag.,  3,  438.-79.  Algui^, 
Rec.  de  M^d.  Milit,  5,  162.-80.  Flechner,  Wien.  Verhandl.,  2, 
237.-81.  Hubs  Buech,  Frank's  Mag.,  4, 445.-82.  Nissen,  Pfaff's 
Nord.  Arch.,  1,  2,  326.-83.  Pfaff,  ibid.,  1, 1,  45.-84.  Bruckner, 
Allg.  Horn.  Ztg.,  57,  91. — 85.  Ooqueret,  Orfila  Tox.,  5  edit,  1, 

403.-86.  Edwards,  ibid.,  408.— 87.  Skillmaud,  ibid.,  409.-88. 

Augouard,  ibid.,  413.-89.  Schafer,  Hufel.  Jour.,  42,  6,  65.— 90. 

Hasemann,  Reil's  Jour.  f.  Pharmacod.,  2,  2,  164. — 91.  Alberti, 

Juriap.  Med.  torn.  II.,  p.  517. — 92.  Montanus,  ConsO.  Med.,  367. 

— ^93.    G.  W.  Wedel,  Dissert,  de  Arsenico,  1719,  p.   10.-94. 

Murray,  Edin.  Med.  and  Cbir.  Jour.,  XVIII.,  p.  167. — 95.  Jeeske, 

Kurtz,  Yierteljahrschr.  v.  Mulier,  8,  468. 

Consciousness. — 1. — Retained.  The  intellectual  faculties 
not  in  the  least  disturbed.  1.  Mental  faculties  undisturbed, 
bat  the  senses  morbidly  delicate.  84.  Consciousness  unim- 
paired.    28.    Full  presence  of  mind.    48,  88. 

5. — Consciousness  perfect  till  death.  12,  48.  She  retained 
h  er  intellect,  clear  consciousness,  and  an  imperturbable  calm- 
ness. 43.  Intellect  dear ;  answers  tardy.  67.  Comprehen- 
sion and  speech  distinct  and  calm,  but  often  interrupted  by 
vomiting.  40.  He  gives  very  short  answers  to  the  questions 
pnt  to  him.     5. 

10. — Lost.  He  seemed  not  to  be  clearly  aware  of  his  condi- 
tion. 15.  Loss  of  consciousness.  88, '84,  86,  90.  Uncon- 
sciousness for  some  hours.  76.  Loss  of  consciousness  and 
convulsions.     76.    Loss  of  recollection.     15,  83. 

15. — ^They  lay  without  recollection  or  sensation.  64.  After 
vomiting,  unconsciousness  for  several  days.  After  vomiting 
and  diairhcea,  a  state  of  stupor,  out  of  which  it  was  difficult 
to  rouse  her.     75.    Lethargic  state,  out  of  which  ^he  often 

VOL.   XX.,   NO.   LXXX. — APKIL    1862.  O 


210  Pharmacohgieal  Studies, 

awoke,  but  only  for  a  short  time.   43.    Lethargy,  with  the  eyea 
fixed.    85. 

20. — Lethargy  and  abiding  sleepiness.  85.  Apoplectic  state, 
di£Bcult  breathing,  with  convulsions  over  the  whole  body.  88. 
Comatose  stupefaction.  64.  Stupefaction  and  somnolence.  15. 
Delirium.— Delirium.  5,  25,  28,  64,  65,  81,  82,  85. 
25.— Slight  delirium  at  night.  67.  He  is  said  to  have  talked 
at  random  sometimes  in  the  night.  44.  Very  strong  delirium, 
especially  at  night,  accompanied  with  great  restlessness.  85. 
Strong  delirium,  with  loss  of  consciousness.  88.  Violent 
delirium  for  the  last  three  or  four  days.     15. 

80. — He  slips  down  in  bed,  can  hardly  move  his  limbs,  and  is 
difficult  to  rouse  out  of  his  lethargy,  which  is  combined  with 
delirium.  47.  Delirium :  he  gets  up  to  go  to  his  daughter, 
whom  he  must  have  known  to  be  absent,  and  could  not  without 
trouble  be  restored  to  calmness,  but  speaks  rationally.  16. 
Violent  ravings,  off  and  on.  8.  He  raved  often  in  the  course 
of  the  disease.  15.  Savings  and  **  carphology,"  catching  with 
his  fingers  under  the  quilt.     15. 

85. — ^Wanderings,  in  which  he  made  motions  with  his  hands, 
as  if  measuring  with  a  yard,  as  then  bis  delirium  turned  most 
upon  his  employment.  1 5.  Embarrassment  of  the  thoughts. 
10.  His  reason  left  him  firom  time  to  time.  62.  Illasions  of 
the  senses,  alternating  with  half-stupified  sleep. 

Fear. — ^Anxiety  of  mind.     19. 

40. — ^His  movonents  were  trembling,  and,  with  his  fixed  stare, 
betray  fear  and  anxiety.  45.  He  looked  about  him  in  fear  and 
trembling,  whether  any  one  was  watching  him,  and  begged  the 
door  might  be  shut.     45.    Excited  and  anxious.     28. 

Murderous  Fropensitv. — Whenever  he  shaves  any  one,  an 
almost  incessant  inclination  comes  over  him  to  cut  the  man's 
throat  after  lathering  him.     45. 

Folly. — Fits  of  folly  and  sadness.     68. 

45. — Sadness. — 12,  68. 

Despair. — She  is  desponding  about  her  condition.    25. 

Anger«— Her  state  of  mind  had  altered  greatly  since  the 
poisoning   (four  months  ago);  her  natural  cheerfulness  was 


hy  Dr.  Roth.  211 

quite  scared  away;  she  dreaded  solitude  and  death.  The  most. 
trifling  motive  was  sufficient  to  put  her  into  a  fnriotis  passion^ 
wbich  was  especially  the  case  if  one  spoke  of  her  perfect  re- 
oovery,  which  she  looked  npon  as  utterly  impossible.  At 
times,  also,  she  was  seized  with  indescribable  sadness.  Her 
original  cheerfulness  did  not  return  tiU  a  whole  year  had 


Giddiness  (Vertioo). — Giddiness.  15,  18,  27,  28.  Stag- 
gering.   83,  91. 

50. — Great  giddiness,  so  that  she  had  to  support  herself.  4. 
Bo  giddy  that  he  could  not  hold  his  head  up.  28.  Giddiness 
and  stupidity  in  the  head.  77.  Giddiness,  with  temporary 
loss  of  sight.  84.  Giddiness,  with  calm  expression  of  counte- 
nance.    44. 

55.  Giddiness  on  standing  up.  18.  Giddiness  and  trem- 
bling.    18.    Giddiness  and  strong  twitchings.     70. 

Pains  of  the  Head  in  general. — Great  confusion  of  the 
head  (Kopfeingenommenheit).  18,87.  Severe  headache.  2, 
11,  15,  18,  23,  27,^4,  54,  76,  81,  87. 

60. — Headache  and  vertigo.  12,  18.  Fains  in  the  head  and 
vertigo  for  several  days.  93.  Pains  in  the  head  and  confu- 
sion. 10.  Complains  of  severe  pains  in  the  head,  with  burning 
and  pain  in  the  neck.  88.  The  child  grasped  at  its  head  and 
neck.     15. 

65. — ^Pains  in  the  head  at  indefinite  times,  mostly  at  night. 
33.  Pains  in  the  head,  continuing  eight  days.  85.  Pains  in 
the  head  and  stomach.  26.  Severe  pains  in  the  head,  with 
fever,  and  sensitiveness  in  the  region  of  her  stomach.    85. 

Heaviness  of  the  Head. — ^Heaviness  of  the  head,  without 
pain.    85. 

70. — ^Heaviness  and  gloominess  in  the  head.  48.  Heaviness 
of  the  head.  64^  75,  85.  Heaviness  and  pressure  in  the 
head.     33. 

Frontal  Bbgion. — Gold  sweat  on  the  forehead.     10,  82. 

Temporal  Beoion. — Troublesome  pains  in  the  temporal 
region.     33. 

75. — ^Vertical  Begion.— Pain  in  the  region  of  the  crown. 
33.    A  pain  in  the  crown  of  the  head,  which  was  sometimes^ 

0  2 


S12  Pharmacological  Studies, 

pressively  stannicg,  sometimes  severely  throbbing,  sometimes 
burning;  which  yields  to  gentle  nibbing.  4.  The  burning 
pain  in  the  crown  of  the  head  has  (after  ten  days),  not  yet  quite 
disappeared,  and  she  complains,  when  touched  on  the  part,  of 
pain  like  a  wound  in  th^  scalp. 

Occipital  Bboion. — Head  painful,  especially  in  the  occi- 
put   d. 

Integuments  op  the  Head. — ^Tumefaction  of  the  whole 
head,  even  of  the  veins  and  eyes.     54. 

80. — ^A  scurfy  eruption  on  the  occiput  (Achores).    8. 

Hair.— Falling  off  of  the  hair.  2,  4,  24,  23.  The  hair, 
which  had  fallen  off,  grew  again,  but  was  hard,  brittle,  and 
grey.  These,  however,  fell  off  soon  again  of  themselves,  and 
gave  place  to  healthy  brown  hair,  which  gradually  attained  the 
same  thickness  and  length  as  before.     4. 

Eyelids. — Swelling.  Swollen  eyes.  15.  Great  swelling 
of  the  eyelids,  which  are  closed  thereby.     11. 

85. — CEdematous  swelling  of  the  left  eyelid,     18. 

Colour. — The  eyelids  swollen  and  reddeijjed.  61.  Eyelids 
and  lips  blue.  J  8.  Blue  rings  around  the  eyes.  12,29. 
Blue  rings  around  the  heavy  eyes.     12. 

90. — Edges  op  the  Eyelids. — ^The  edge  of  the  eyelids  highly 
reddened.    85. 

Conjunctiva.— The  eyes  red.  61.  The  eyes  very  red.  85. 
The  conjunctiva  somewhat  reddened.  18.  Eyes  injected.  85, 
65,  86. 

95.  Eyes  injected  as  at  the  beginning  of  eruptive  fever.  85. 
Injection  of  the  conjunctiva.  84.  Conjunctiva  inflamed.  12. 
Conjunctivitis  palpebralis.     66.     The  eyes  not  reddened.     28. 

100. — No  trace  of  inflammation  of  the  eyes.     12. 

Sclerotica.— The  whites  of  the  eyes  reddened.    20.    The 

whites  of  the  eyes  yellow.     79.    Yellowness  and  rigidity  of 

the  eyes,  with  complete  obscuration  of  sight.     54.     On  the 

albuginea  and  the  edges  of  the  reddened  cheek  a  slight  tinge  of 

jaundice.     44. 

105.— Iris.— Symptoms  of  iritis.  84.  Conjunctiva  little  in- 
jected, but  about  the  cornea  the  ciliary  vessels  so  enlarged  that 
they  almost  resemble  the  vascular  ring  in  iritis  acuta.    42. 


by  Dr.  Roth.  218 

Pupils. — Fapils  enlarged.  12,  42,  76,  90,  Papils  only  a 
little  dilated.     12.     Pupils  eontraoted.     1,  90. 

110. — ^Muscles  of  the  Eyeball. — ^From  time  to  time  ihe 
eyes  are  tamed  upwards,  and  squint,  but  only  transiently.  1. 
Eyes  projecting  and  rigid.  12,  62.  Eyes  projecting  and  quite 
led.     80. 

Sight. — She  seemed  sensitive  to  light,  and  often  kept  her 
eyes  shut.     88.    Weakness  of  the  eyes.     88. 

115. — ^Variation  of  the  sight  79.  Sight  indistinct.  15. 
Darkening  and  flickering  before  the  eyes.  12.  During  the 
nausea  he  sees  yellow  before  his  eyes.  91.  Darkness  before 
the  eyes.     15. 

120. — ^He  opens  his  eyes  and  complains  that  they  have  lost 
the  power  of  seeing.  25.  She  completely  lost  the  power  of 
seeing.     48,  54. 

Expression  of  the  Etes. — A  yivacious,  piercing  look.  SB* 
A  wild  look.  51,  62,  79.  An  anxious  look,  but  not  wild  and 
disturbed.  28.  Eyes  very  sharp,  betraying  no  great  pain,  but 
yet  decided  uneasiness.  40.  Eyes  fixed.  81.  Eyes  heavy. 
12,  64.  The  eye  heavy,  without  brilliancy,  and  generally 
closed.     48. 

Secretion  of  Tears.*— Tears,  which  corroded  the  eyelids.  62. 

180. — ^The  eyes,  as  if  bathed  in  tears,  stood  far  out  of  the 
head.     62.     The  eyes  tearfal,  half  opened,  and  reddened.     25. 

Ears. — Humming  in  the  ears.  7,  12.  Humming  in  the 
left  ear.     88.     No  humming  in*  the  ears.     1. 

]  35. — ^NosE. — ^Burning  pain  in  the  nose,  eyes,  and  mouth.  61. 
Severe  bleeding  at  the  nose  after  taking  wine.  28.  Bleeding 
at  the  nose  during  vomiting.    4. 

Muscles  of  the  Jaw.— Jaws  firmly  closed.  88,  64.  Tris- 
mus, with  convulsions  over  the  whole  body.     88. 

140. — She  swallowed  the  drink  presented  to  her  with  a  convul- 
sive motion  of  the  jaws,  almost  sufficient  to  shiver  the  glass.  88. 

Complexion. — Pale.  Paleness  of  the  face.  8,  5,  12,  27, 
85,  51,  68.  Face  pale  and  dingy.  88.  She  looked  very  pale, 
and  felt  much  enfeebled.  48.  The  face  pale ;  disturbed  ex- 
pression.    9,  12,  67. 

145. — Blue, — Face  blueish  grey.   48.    Face  somewhat  livid. 


jil4  Pharmacological  Biudies, 

26.    Face  lead-colonr.    15,  58.    TeUow. — Complexion  grejisli 
yellow.    2.    Complexion  yellowish.     15, 44. 

150.  Face  of  a  yellowish  tinge  about  the  al®  nasi,  and  led- 
dened.  79.  iZ^^f.— Face  ied«  15,  27,  88,  86.  Face  and 
tongue  red«  76.  Buddy  and  distorted  countenance.  43. 
Face  red  and  inflamed.     64. 

155. — ^Face  and  eyes  injected.  65.  Face  irregularly  red,  and 
covered  with  perspiration.     25. 

Expression  of  the  Face. — Miserable  look.  2.  linea- 
ments much  altered.  12,  48,  47.  Face  deadly  pale,  linea- 
ments quite  changed.     12,  91. 

160. — Countenance  sunken.  4,  78.  Nose  sharp.  48,50. 
Face  sunken,  pale,  and  covered  with  cold  sweat.  68.  "Hip- 
pocratic  countenance."  48,  77.  Face  pale,  with  an  expression 
of  extreme  pain.     5. 

165.  Signs  of  inexpresssible  anguish  and  perplexity,  with  an 
expression  of  some  deep  suffering.  16.  Face  expressing  the 
greatest  anguish;  first  red,  then  white.  18.  Expression  of 
real  anguish  of  soul.  27.  Countenance  betraying  terrible 
expression  of  fear.    42.    Face  stupid.    47. 

Pebspiration  on  the  Face. — Face  covered  with  perspira- 
tion.   25,  80. 

170. — ^Temperature  of  the  Face. — ^Face  covered  with  cold 
sweat,  26,  48,  QZ.  Face  cold,  nose  and  lips  blue.  25.  Heat 
of  the  face,  with  quick  pulse.  40.  Face  and  hands  cold,  and 
covered  with  cold  sweat.     26. 

Muscles  of  the  Face. — Muscles  of  the  face  get  from  time 
to  time  into  convulsions.     62. 

175. — ^Faoe  horribly  distorted  by  cramps  and  pain.  9.  Face 
pale,  cadaverous,  convulsively  drawn.     9. 

Tumefaction  and  Eruptions  on  the  Face. — ^Face  at  times 
puffed  up.  88.  Face  red  and  puffy,  12,  67.  Swelled  face. 
10,  11,  15,  88,  42,  64. 

]  80. — CEdema  of  the  face.  2.  Swelling  of  the  face  and  legs. 
15.  Pale  grey  swollen  face.  15.  Cachectic  ^welling  of  the 
face.  54.  On  the  left  side  of  the  face,  corresponding  with  the 
parotid,  an  inflamed  patch  on  the  skin,  red,  solid,  firm,  painful, 
looking  yellow  on  pressure  with  the  finger.     18. 


hy  Dr.  Both.  216 

185. — On  tike  Ted  inflamed  patch  of  skin,  nnmerons  vesioles 
filled  widi  yellow  fluid,  whioli  extend  redness  and  inflammation 
around  the  nose  and  mouth.  18.  Eruption  on  the  face, 
eoTered  with  blisters.  18.  The  eruption  is  drying — scabs  fall 
off  here  and  there,  and  on  the  concha  of  the  left  ear  new  vesicles 
are  forming.  1 8.  The  eruption  on  the  face  dried  to  a  crust : 
nose  and  eyelids  desquamating.  18.  Erysipelatous  redness 
and  swelling  of  the  face  and  fauces.     55. 

190. — ^Face  covered  with  pustules.     61. 

I^iPS. — Lips  blueish.  12.  Lips  and  tongue  blueish.  48. 
Lips  sprinkled  with  little  black  spots.  62.  White  powdered 
lips.     36. 

195. — ^An  eruption  on  the  lips  resembling  Herpes  labialis.  2. 
He  cannot  speak,  being  unable  to  close  his  lips :  the  under  lip 
is  scorched,  hanging  outwards,  everted,  and  very  painful.  1. 
Lips  convulsively  distorted,  as  in  the  '^Sisus  Sardonicus."  64. 
Frequent  smiling.     38. 

Gums. — ^A  purplish  red  line  on  the  ^um.     84. 

200. — ^Teeth.— Toothache.     88. 

CAVitY  or  THE  Mouth. — Burning  in  the  mouth  and  throat. 
10.  Mouth,  throat,  and  oesophagus  begin  to  burn  severely.  34. 
Burning  in  the  mouth,  along  the  gullet,  and  in  the  sorobicu- 
lus  cordis.  89.  Cavity  of  the  mouth  and  the  fauces  inflamed 
and  red,  which  lasted  three  days.     60. 

205. — Dryness  of  the  mouth.  20,  37,  76.  He  fancies  he  has 
sand  in  his  mouth.  44.  Aphthee  in  the  mouth,  at  first  white, 
afterwards  black.  68.  Painful  vesicles  in  the  mouth  and  on 
the  tongue.    2.    Numerous  aphthee  all  over  the  mouth.     75. 

210. — ^Tongue. — Burning.  Severe  burning  on  the  tongue, 
the  palate,  and  throat.  1 5.  Severe  burning  on  the  tongue, 
in  the  throat,  and  stomach.  77.  Very  troublesome  burning 
and  biting  of  the  tongue  and  throat.  54.  Moist. — ^The  tongue 
moist.    28.     Tongue  cold  and  moist.     67. 

215. — Tongue  moist,  white  in  the  middle.  76.  Dry, — The 
tongue  dry.  51,53,62.  Tongue  dry,  loaded  in  the  hinder 
portion.  15.  Tongue  dry,  with  a  brown  fur.  15.  Tongue 
and  inner  cavity  of  the  mouth  dry,  and  as  if  inflamed.     29. 

220. — ^Tongue  dry  and  white.  40.  Swollen. — ^Tongue  swollen. 


2 1 6  Pharmacological  Studies, 

15.   Tongae  swollen  and  greyish.    1.   Loaded.-^Tongae  much 
loaded.     8,  89,  44.     Tongue  loaded  and  whitish.     9,  87,  91. 

225. — A  slimy  coat  on  the  tongae.  75.  Tongae  thickly 
coated.  81.  Tongae  coated  and  whitish  yellow.  1.  Tongae 
covered  with  yellowish  far  on  the  hase,  red  at  the  tip  and  edges. 
79.  Tongue  with  the  papillsB  very  prominent,  bright  red  at  the 
tip.     8. 

280. — Tongae  clean.  88.  Upper  surface  of  the  tongae  white; 
not  coated,  but  thickened.  19.  Aphthm. — ^Blisters  on  the 
tongue,  on  the  edges  of  the  tongue,  five  superficial  ulcers  of  the 
size  of  a  pea.  18.  Movement. — ^Weakness  and  pain  of  the 
tongue.     87. 

285. — Taste. — Disagreeable  taste.  28.  He  is  complaining 
of  an  abominable  taste  in  the  mouth  and  throat  1.  Biting, 
repulsive  taste.  60.  Disgusting  astringent  taste  in  the  mouth. 
18.     Bitter  taste  in  the  mouth.     54. 

240. — Saliva. — ^Frequent  spitting.  64.  Continual  spitting 
of  saliva  and  phlegm.     1.     Bloody  saliva.     61. 

Throat  and  (Esophagus. — Pain  in  throat  and  mouth.  86. 
Pain  in  throat  and  stomach.     87. 

245.^-Pain  in  gullet  and  belly.  18.  Feel  of  heat  and  dis- 
tress in. the  gullet.  40.  Heat  and  burning  in  the  throat.  88, 
75.  Burning  in  the  throat.  10,  29.  Burning  in  the  gullet. 
15,  18. 

250. — A  burning  sensation  from  the  acrobiculua  cordis  up  the 
gullet,  as  far  as  the  pharynx,  where  it  is  most  severe,  produces 
a  distinct  scraping,  and  prevents  swallowing.  18.  Severe 
burning,  commencing  at  once  in  the  gullet.  57.  Violent 
burning  in  the  gullet  down  to  the  stomach.  38.  Sensation  of 
slight  burning  in  the  oesophagus.  80.  Burning  sensation 
along  the  cesophagus.     88,  76. 

255. — Violent  burning  like  fire  in  the  throat  and  chest.  44. 
Burning  in  the  throat  and  gastric  region.  16.  Violent  burning 
in  the  gullet  and  stomach.  47.  Uvula  somewhat  swollen  and 
reddened.     18.     Throat  swollen  and  red.     87. 

260. — Fauces  much  reddened.  18.  Sore  throat,  with  inflam- 
mation and  swelling  inside  and  out,  about  the  root  of  the 
tongue.     88.     Erosion  of  the  throat,  suppurating  deeply.     18. 


by  Dr.  Roth.  217 

Superficial  excoriation  of  the  faaces.  18.  Sensation  of  sore- 
ness  in  the  oesophagus.    85. 

265. — ^Bemarkable  contraction  of  the  throat  and  chest.  55. 
Occasional  convulsive  cramps  in  the  throat.  38.  The  throat 
contracted.  61,  91.  Cramp  in  the  gullet.  16.  Dryness  and 
constriction  of  the  throat.     23. 

270. — Swallowing  very  difficult.  25,  9 1 .  Difficult  swallowing 
and  pain  in  the  throat.  60.  She  could  neither  speak  nor 
swallow.  38.  Swallowing  very  difficult  and  painful.  ^\. 
Dysphagia.     38,  75. 

275. — Difficulty  of  swallowing,  owing  to  ulcers  in  the  throat. 
1 8.  Unable  to  swallow  or  speak,  and  always  pointing  to  the 
throat.     38. 

Hunger. — ^Want  of  appetite,  2,  3,  11,  15,  IQ,  18,  23,  33, 
37,  58,  60.  Want  of  appetite,  with  a  sense  of  pressure  on  the 
gastric  region.     1 6.     Loss  of  appetite  for  eight  days.     33. 

280. — Nauseating  all  food.  1 8,  9 1 .  Slight  disgust,  without 
any  pain  whatever.     39.     Morbid  increase  of  appetite.     84. 

Thirst. — ^Thirst  not  very  remarkable.  44.  She  will  not 
drink.     25. 

285.— Thirst.  23,  68,  76.  Increased  thirst.  2,  3,  7, 12, 15, 
18,  27,  33,  35,  38,  39,  40,  43,  75,  80,  91.  Burning  thirst 
17,  29,  51.  Burning  thirst,  without  any  particular  longing  to 
satisfy  it.     88.     Violent  tormenting  thirst.     18. 

290.— Unquenchable  thirst.  16,  20,  28,  32,  37,  48,  62,  81, 
84,  86.  The  thirst  becomes  unquenchable  in  the  evening.  43. 
Burning  unquenchable  thirst.  64.  Thirst  so  violent  that  in 
one  day  and  a  half  he  drank  ofif  eleven  pitchers  of  water.  44, 
Choking  thirst,  for  which  she  drank  very  cold  spring  water,  in 
large  quantities.     53. 

295. — ^Frequent  and  violent  longing  for  cold  water.  1 2.  Very 
thirsty,  with  griping  of  the  whole  abdomen.  53.  Eager  drinking 
of  what  is  offered  when  the  pain  is  allayed.  12.  Thirst,  with 
anguish.     15.     Thirst  and  continued  fever  heat.     55. 

300. — The  vomiting  ceases ;  he  only  cries  perpetually,  **  I  am 
thirsty."  1.  He  longs  for  refreshing  fruit,  and  sucks  slices  of 
lemon  with  great  eagerness.     1. 

Eructation. — Frequent  eructation.  37.  Violent  eructa- 
tion.    38.    Eructation  and  nausea.     28. 


218  PJkarmacoloffieal  Siadiet, 

805. — Eroctation,  with  smgiiltiu.    47.    Acidity  of  the  sto- 
mach.   Sd. 

.    Nausea. — ^Elts  of  nausea.     12,  23,  38,  34,  91.    Nausea, 
with  constant  proTocation  to  voniit.     60. 

YoMXTUJUTiON — Batching. — Inclination  to  Tomit^  without 
vomiting.     18,  84,  88. 

8 1 0. — ^Yery  hard  straining  to  vomit.  8,  25.  Continual  retch  - 
ing  without  actual  vomiting.  23,  57.  Violent  retching.  10. 
27,  86.  Frequent  ineffectual  retching.  12,  29,  79.  Ineffao* 
tual  retching,  continued  almost  without  intermission.     10. 

8 1 5. — ^Periodic  vomiting ;  or,  rather  retching.  1 5.  Constant 
vomiturition,  with  rare  vomiting,  but  firequent  retching,  which 
seems  to  be  aggravated  periodically  with  oppression.    15. 

VoMiTiNO. — ^Vomiting.  11,  36,  41,  56.  Fits  of  nausea, 
then  vomiting.  12,  28,  54.  Nausea  and  severe  vomiting.  11, 
83,  64. 

320. — Great  nausea,  with  repeated  and  very  fatiguing  vomit- 
ing, without  any  relief.  12.  Vomiting,  not  copious,  combined 
with  remarkable  straining.  18.  Frequent  and  violent  vomiting, 
constantly  followed  by  great  fatigue  and  languor.  12.  Vomiting 
eighteen  to  twenty  times  in  succession,  and  becoming  so  feeble 
after  it,  that  she  could  not  speak,  but  to  complain  of  her  bowels. 
15.    Constrictive  nausea,  followed  by  vomiting.    82. 

325.— Very  violent  vomiting.  10, 16,  25,  26,  29, 34, 48,  58, 
76.  Frequent  vomiting,  with  straining.  12^  63.  Vomiting 
at  short  intervals,  till  the  second  day.  33.  Bepeated  vomiting  for 
forty-eight  hours.  6.  Botching  and  violent  vomiting.  26,34,53. 

330. — Vomiting  continuing  amidst  painful  retching,  and  re- 
peated at  latest  every  ten  minutes.  47.  Amidst  fearful  retching 
and  cramp-like  contraction  of  the  stomach,  he  was  obliged  to 
throw  up  six  times.  9.  Prolonged  hard  vomiting,  with  a  sen- 
sation as  if  one  was  tearing  out  his  stomach  and  intestines  with 
pincers.  27.  Constant  vomiting,  with  frightful  cries  of  pain. 
59.     Vomiting,  with  the  return  of  his  senses.     64. 

385. — Hard  vomiting  and  violent  bleeding  at  the  nose.     4. 
After  each  draught  the  vomiting  is  renewed,  with  violent  pains 
in  the  abdomen  and  gullet.  18.  Vomiting  always  after  drinking. . 
20.    Taking  brandy  relieves  the  inclination  to  vomit.    33.    He 
vomits  readily,  even  after  slight  meals.     33. 


hy  Dr.  Roth.  %\9 

840. — ^The  voiniting  is  relieved  by  water.  88.  Betohing  and 
Tomiting  as  soon  as  he  had  taken  a  few  spoonfok  of  soup*  87* 
Vomiting  resnits  by  jerks,  without  much  straining.  2.  Most 
▼iolent  Tomidng^  with  frightful  pains  in  the  abdomen  and  legs. 
16.^  Incessant  vomiting  amidst  hard  retching,  griping  of  the 
abdomen,  and  other  pains.     9. 

845. — ^Almost  nnintermitting  vomiting  for  forty-eight  hours, 
along  with  firightful  burning  in  the  abdomen,  and  unappeasable 
thirst.     4 

QaALiTY  OF  THE  Mattee  THROWN  UP. — Vomiting  of  all  the 
ingesta.  15.  Vomiting,  first  of  the  food  taken,  then  nothing 
but  clear  water.  8.  Vomiting  of  the  food  and  of  white 
mocus.  20.  Vomiting  of  the  food,  mixed  with  a  viscous 
matter.     25. 

850. — ^Violent  vomiting,  not  only  of  the  food  last  taken,  but 
also  of  a  fluid.  88.  He  at  several  times,  and  with  great 
violence,  threw  up  at  first  remnants  of  food,  and  then  the  water 
he  had  taken,  with  great  alleviation.  88.  Nausea,  sometimes 
proceeding  to  vomiting  of  food,  mucus,  and  a  fluid  partly  acid 
and  partly  bitter.  80.  Incessant  vomiting  of  the  milk  he  had 
taken,  and  roaring  with  pain  like  a  wild  beast.  1.  At  first  he 
threw  up  food,  then  mucus  and  green  bile.    2. 

855. — Violent  ejection  of  mucous,  bilious,  and  frothy  masses. 
18.  Botching  and  repeated  violent  vomiting  of  mucus  and 
bile.  28,  91.  The  ejectamenta  said  to  have  tasted  bitter,  like 
sharp  bile,  and  to  have  looked  green.  44.  Vomiting,  espe- 
cially of  yellow  fluid  and  mucus.  40.  She  vomited  much, 
including  green  bile.     53. 

860. — ^Vomiting  of  much  green  bile  during  the  first  hour.  8. 
Much  green  bile  thrown  up.  2.  Vomiting  of  abundant  pale  yellow 
fluid.  48.  Vomiting  of  a  bitter,  greenish-yellow  fluid.  28. 
Copious  vomiting  of  bilious  matter.  28.  Vomiting,  at  first  of 
whitish,  frothy  fluid,  afterwards  of  saburra,  mized  with  sharp 
bile.  54.  Frequent  vomiting  of  much  mucus,  saliva,  and  a 
considerable  portion  of  the  poison.  89.  Betohing,  with  fireqnent 
vomiting  of  white  mucus.  80.  Frequent  vomiting  of  a  brownish 
matter,  with  extraordinary  straining  and  debility.  12.  Frequent 
vomiting  of  a  dark,  brownish  matter.     12. 


220  Pharmacological  Studies, 

370. — ^Vomiting  of  food,  with  a  reddish-brown  fluid.  JO. 
Vomiting  of  brown  and  green  substances.  SB.  Vomiting  two 
or  three  times  of  viscid  mucus  and  a  brown  mass.  43.  The 
ejectamenta  colourless  or  pale  yellow,  mixed  with  a  little  firothy 
saliva,  or  some  streaks  of  blood.  25.  Vomiting  of  the  water 
he  had  drunk,  at  last  with  yellowish  mucus^  once  only,  streaked 
with  some  blood.    40. 

876. — ^Vomiting  of  mucus  mixed  with  blood.  S6*  Violent 
vomiting,  with  little  intermission,  for  a  day  and  a-half,  some- 
times mixed  with  blood,  accompanied  by  cutting  in  the  stomach. 
81.  Vomiting  of  mucus  and  blood.  61.  Vomiting  of  blood. 
38,  49.  Vomiting  of  actual  blood.  8.  Vomiting  of  substances 
that  excited  contraction  of  the  throat.     75. 

881. — SxoBiACH.  —  Disagreeable  Sensations.  Unpleasant 
feeling  in  the  stomach.  19.  Disagreeable  feeling  in  the 
stomach.  88.  Disagreeable,  yet  not  very  painfal  feelings  in 
the  scrobiculus  cordis,  accompanied  by  a  peculiar  anguish  of 
mind.  ]2«  Anguish  in  the  gastric  region.  15.  Great  op- 
pression in  the  precordial  region.     27. 

886. — Pains  of  an  undefined  nature. — Pains  in  the  gastric 
region.  12,17,18,84,61,83.  Cardialgia.  64.  Very  violent  pain 
in  the  epigastrium.     76,  87.     Neither  pain  nor  sensitiveness  in 
the  epigastrium.     40.     Only  slight  pain  in  the  gastric  region. 
48.     He  feels  pain  nowhere  but  in  the  stomach.     1.     Violent 
pains  in  the  stomach,  and  nausea.     12.     He  seemed  to  be  in 
violent  pain,  wailed,  groaned,  cried  out,  pressing   his   hand 
against  the  gastric  region,  but  gave  no  verbal  indication  of  the 
seat  of  the  pain ;  as  in  general,  nothing  could  be  got  out  of 
him.    10.    He  scratched  the  skin  of  the  epigastrium  constantly 
with  his  nails.     1. 

895. — Pains  in  the  precordium,  and  vomiting.  53.  Tor* 
menting  pains  in  the  gastric  region,  with  vomiting.  88. 
Stomach  and  oesophagus  painful.  61.  Pains  in  the  gastric 
region  and  abdomen.  85,  58.  Violent  pain  in  the  stomach 
and  abdomen.  8,  26.  Pains  in  the  stomach  and  intestines. 
80.  The  child  complained  of  great  pain  in  the  stomach  and 
abdomen.  18.  Violent  pains  in  the  epigastrium  and  umbilical 
region.     76.     The  stomach  pains  relieved  by  sweet  milk.    83. 


hy  Dr.  Both.  221 

Burning. — ^Burning  sensatioii  in  the  sorobicalas  cordis.    12. 

405. — ^Burning  in  the  stomach.  18»  84,  86.  Sensation  in 
the  stomachy  as  if  it  would  bum  up^  1.  Violent  burning  pains 
in  the  stomach.  53,  88.  Frightful  burning  pains  in  the  stomach* 
25.  Glowing  heat,  with  great  anguish  in  the  gastric  region, 
and  tormenting  retching.     16. 

410. — ^Burning  sensation  in  the  scrobiculas  cordis,  with  pains 
in  the  abdomen^  and  nausea.  12.  Severe  burning  pain  in  the 
stomach  and  bowels.  33.  Bemitting  burning  pains  in  the 
stomach,  with  remarkable  anxiety.  12.  Burning,  gnawing, 
and  griping  in  the  region  of  the  stomach  and  bowels.  55. 
Pressure, — Pressure  on  the  scrobiculus  cordis,  and  a  hot  feeling 
within.     12. 

415. — Pinching. — ^At  times,  traces  of  pinching  and  pains  in 
the  scrobiculus  cordis.  Tearing. — Tearing  pains  in  the  stomach 
and  bowels.'  29.  Tearing  in  the  stomach  and  abdomen.  17. 
Cutting. — Gutting  sensation  in  the  scrobiculus  cordis.  60. 
Cutting,  cramp-like  pains  in  the  stomach,  abdomen,  and 
chest     4. 

420. — Drawing. — Painful  drawing  in -the  stomach,  with  slight 
cold  shivering.  79,  420.  Coniractioti. — ^Painful  contraction 
in  the  epigastrium.  73.  Sensation  of  contraction  in  the  gas- 
tric region.  27.  Severe  constrictive  sensation  in  the  gastric 
region*  26.  Violent  constriction  of  the  stomach  and  gullet, 
with  painful  burning.     34. 

425. — ^Violent  cramp  in  the  stomach  and  abdomen.  84,  85. 
Frightfully  violent  cramps  and  pains,  especially  in  the  gastric 
region.  9.  Sense  of  Laceration. — ^Extremely  painful  sensa- 
tion in  the  stomach,  as  if  it  were  powerfully  stretched  in  its 
whole  circuit,  and  would  certainly  be  torn  to  pieces.  57- 
Stomach  Pains  from  External  Pressure. — Slight  pain  on 
touching  the  gastric  region.  8,  19,  88.  He  complained  little 
of  pain,  yet  the  gastric  region  was  sensitive  to  external  pres- 
sure. *  2. 

430. — Slight  sensitiveness  in  the  gastric  region^  removed  by 
firm  pressure.  Pain  on  touching  the  region  of  the  stomach 
and  bladder.  10.  Slight  pressure  on  the  epigastrium  seemed 
to  cause  uneasiness.    42.    Pressure  on  the  stomach  painful. 


823  Pharmacologieal  Studies, 

1,5,  18,  88,  89,  88,  86-  The  gastric  region  very  sensitive,  and 
ako  very  violent  pains  in  the  intestinal  canal.     25. 

485. — Oastrio  and  umbilical  region  sensitive.  89.  Stomach 
extraordinarily  sensitive.  87,  49.  Painfiil  pricking  heat  in 
the  stomach,  not  aggravated  by  pressure  on  the  epigastrium. 
40.  Puffi$ig  up  of  the  Oasiric  Region. — Stomach  somewhat 
puffed  up,  and  warmer  to  the  feel  than  the  rest  of  the  body. 
12.  Stomach  much  puffed  up,  rather  hard,  vrith  violent  pain 
near  the  abdomen.     12. 

440. — ^Violent  pains  in  the  stomach  and  abdomen,  which  were 
not  remarkably  puffed  up.     12. 

DiOBSTiON. — Indigestion.  83.  Di£Bk)ulty  of  digesting  the 
smallest  quantity  of  food.    4. 

Pains  ofthb  Abdomen  without  Evacuation. — Undefined 
Pain.  Pain  of  the  bowels.  10,  41.  Violent  pain  in  the 
bowels.     8,  16,  26,  27,  28,  29,  80,  81,  49,  56,  64,  67. 

445. — Intolerable  pains  in  the  abdomen.     82.     Such  violent 
pain  in  the  bowels,  that  in  returning  home  he  had  to  support 
himself  against  the  houses  to  keep  from  falling.     9.     Fain  in 
the  bowels  and  intolerable  anguish.     18.     Fains  in  the  bowels, 
accompanied  with  an^ety,  and  so  violent  that  he  first  clung  to 
the  bystanders,  then  thrust  them  from  him,  often  sprang  on  the 
bed,  seated  himself  on  the  night-chair,  or  ran  about  the  room. 
15.    Intolerable  pain  of  the  bowels,  with  continuing  increasing 
anguish  and  cries  for  help.     16. 

450. — ^Violent  pain  in  the  bowels,  causing  outcry.  37.  Fre- 
quent, but  not  lasting  pain  in  the  bowels.    43. 

Chip€9, — ^Frequent  gripes.  83.  Colic. — Colicky  fits.  18. 
Violent  colic  fi^m  time  to  time.     52. 

455. — ^Violent  colic  pains  in  the  night.  68.  Burning. — 
Warm  sensation  in  the  abdomen.  27.  Violent  burning  in  Ae 
whole  traeius  intesHnorum.  47.  Burning  pain  in  the  bowels* 
14.    Burning  heat  in  the  intestines.     64. 

460. — Severe  burning  in  the  abdomen,  neck,  and  breast  15. 
Burning  pain  in  the  intestines.  62,  91.  The  pains,  which  a£ 
first  had  their  seat  in  the  stomach  alone,  proceeded  downwards 
to  the  intestines ;  he  pressed  the  navel  with  his  right  hand,  and 
cried  that  his  intestines  were  burning.     1 .    Tearing. — ^Violent 


by  Dr.  Both.  323 

tearing  in  the  bowels,  lasting  half-an-honr.  44.  Tearing  in 
tbe  bowels.     91. 

465. — Cutting, — Gutting  in  tbe  abdomen.  23, 9 1 .  Frequent 
cntting  in  the  abdomen.  1.  Cries  from  pain,  as  if  the  epigas- 
trium were  quite  cut  off  from  the  hypogastrium.  91.  Pain9 
in  the  abdomen,  as  if  the  intestines  would  be  cut  through  with 
swords,  compelling  him  to  cry  out.  15.  Cutting  burning 
pains  in  the  bowels.     18. 

470. — ^The  burning  of  the  intestines  soon  subsided,  and  there 
remained  no  trace  but  cutting  in  the  abdomen  appearing  at  long 
intervals.     1. 

MsTBORisM. — ^Abdomen  distended.  24,  84,  86.  Abdomen 
distended,  with  violent  cramps  in  the  intestines.  54.  Abdomen 
distended.     11.    Tension  of  the  abdomen.     47,  67,  72,  76. 

475.— Diarrhoea,  preceded  by  a  sensation  as  if  he  were  going 
to  burst.  91.  Hard,  swollen,  distended  abdomen.  60.  Tume- 
&cdon  of  the  abdomen  and  the  regio  orbitalis,  1 5.  Abdomen 
much  distended  and  painftil.  62.  Belly,  especially  the  gastric 
region,  somewhat,  but  not  remarkably,  distended.     12. 

480. — Hardness  and  sweUing  of  the  abdomen,  which  did  not 
disappear  after  the  bowels  were  opened.  60.  The  abdomen 
was  soft  and  not  distended.  1.  The  abdomen  hardly  at  all 
distended.  28.  Abdomen  sofb  and  sunken.  19.  Abdomen 
not  distended,  neither  stretched  by  cramps,  not  painful  from 
toiiidi  or  pressure.    44. 

485. — Severe  rattling  in  the  abdomen.     3. 

Abdominal  Muscles  Stbetched. — ^The  abdominal  parietes 
seem  drawn  in  against  the  spinal  column.  78.  Belly  drawn  in, 
more  solid,  resembling  to  the  feel  the  condition  of  painter's 
colic,  little  sensitive  to  pressure.  9.  The  abdominal  muscles 
contracted,  and  almost  touching  the  spinal  column ;  the  recti 
stretched  like  cords.     1. 

490. — Pains  in  the  Bellt  from  External  Pressure. — . 
Abdomen  sensitive  to  the  touch.  9.  Abdomen  painful  to  the 
touch.  79*  Abdominal  pain,  aggravated  by  touch.  15.  Violent 
pain  on  touching  the  abdomen,  and  especially  tbe  scrobioulus 
cordis.  48.  Painfulness  and  distension  of  the  abdomen,  so 
that  he  cannot  bear  the  bed-clothes.    81. 


224  Pharmaeoloffical  SiudieSy 

495.  Pain  in  the  abdomen,  especially  the  Bcrobicolus  cordis, 
ivhich  increased  on  pressare.  28.  At  first  the  gastric  region, 
afterwards  that  of  the  liver  and  hypogastrium,  painful  to  the 
touch.  8.  The  abdomen  is  not  sensitive  to  pressure;  it  is 
only  when  one  approaches  the  gastric  region  that  sensitiveness 
is  manifested.  I.  The  belly  not  painfiil  to  the  touch,  and 
normal.    43,  00. 

Pains  of  the  Abdomen,  with  Evacuation. —  With  Vomit- 
ing. Discomfort  in  the  abdomen,  followed  hy  colic  and  very 
frequent  vomiting.     75. 

600.  Cutting  of  the  abdomen  and  vomiting.     28.     Violent 
cutting  of  the  abdomen  and  vomiting.     1 3.     Violent  tearing  in 
the  abdomen,  with  nausea  and  vomiting.  44.     With  Diarrhcsa. 
— ^Diarrhcea  and  pain  of  the  abdomen.  15,  43.   Pains  in  the  ab- 
domen, with  copious  stool,  followed  by  diarrhoeic  evacuation.  43. 

505.  Violent  pains  in  the  bowels,  with  unceasing  diarrhoea. 
77.  Diarrhoea  and  pain  in  the  bowels,  during  which  he  grasped 
his  friend  with  both  hands,  complained  of  the  abdomen,  and 
drew  his  legs  high  up.  15.  Ailer  sUght  pinching  in  the  lower 
bowels,  three  or  four  yellowish,  watery  stools,  with  thirst.  43.. 
Colic,  with  copious  stools.  75.  Tearing  in  the  abdomen  and 
diarrhoea.     60. 

510. — He  had  already  been  more  than  one  hundred  times  at 
stool,  and  could  no  longer  help  himself  alone,  through  debility, 
but  the  diarrhoea  continued  still,  with  greater  anguish  and  cut- 
ting in  the  intestines.     77. 

Pains  in  the  Bowels  Localized. — In  the  Umbilical 
Itegiofi,  Violent  pains  from  touching  about  the  navel,  compel- 
ling him  to  bend  forwards,  and  aggravated  by  the  attempt  to 
straighten  himself  or  to  lie  on  bis  back.  63.  Hypochondria. — 
The  hypochondria  tense  and  shaken  by  convulsions.  64.  Pain 
in  the  region  of  the  liver.  79.  Dull  pain,  with  a  sensation  of 
tension  and  weight  in  the  right  epigastric  and  hypogastric 
regions.     79. 

515. — Hypogaetrium, — Pain  deep  down  in  the  abdomen.  15. 
Cutting  and  tearing  sensations  seated  deep  in  the  hypogastrium. 
60.    Violent  cutting  in  the  hypogastric  region.     47. 

VoMiriNO  AND  DuBRHCEA. — ^Vomiting  and  diarrhoea.    7, 


bjf  Dr.  Roth.  235 

10,  14,  15,  20,  83,  84,  95.  He  vomited  and  became  violently 
relaxed.     51. 

520. — ^Violent  vomiUng  and  purging  often  repeated.  43. 
Liong  continaed  vomiting  and  purging.  67.  Vomiting,  espe* 
cially  at  night,  which  abated  by  morning,  when  a  diarrhoea  set  in. 
15.  Vomiting  and  purging  all  night  long.  87«  Violent  vomiting 
and  purging  for  four  days.     17. 

525. — ^Vomiting,  followed  by  violent  diarrhoea.  15.  Vomiting 
and  diarrhoea  of  such  violence  that  the  evacuations  could  not 
be  counted ;  at  the  same  time  great  anguish  in  the  precordia. 
50.  He  vomited  in  the  two  first  days  and  the  night  about 
seventy  times ;  this  did  not  cease  till  the  eighth  day,  and  he  had 
frequent  stools,  especially  in  the  early  part  of  the  time.  89. 
Stools  and  vomiting  to  an  enormous  degree.  55.  Vomiting 
and  painful  diarrhoea.  75.  Vomiting  and  diarrhoea,  with  violent 
pain  in  the  bowels.     48. 

530. — Continued  diarrhoea,  combined  with  incessant  vomiting, 
and  followed  by  great  pain  in  the  stomach  and  abdomen.  50. 
Amidst  tormenting  retching,  violent  vomiting  of  a  great  quan- 
tity of  greenish  fluid,  and  two  stools,  containing  the  food  taken 
on  the  previous  day,  nearly  undigested.  47.  Vomiting,  then 
colic,  and  repeated  stools.  67.  Violent  vomiting  and  frequent 
loss  of  consciousness,  only  lasting  for^  few  moments,  imme- 
diately followed  by  shivering,  pain  m  the  bowels,  and  inter- 
rupted stools.  75.  Violent  pains,  including  the  whole  of  the 
abdomen,  with  long-Continued  vomiting  and  purging.  48. 

585. — Bepeated  vomiting  of  the  food  taken,  and  immedi* 
ately  after  it  repeated  purging,  with  alleviation.  88.  Vomit- 
ing and  purging,  with  intolerable  odour.  24.  Frequent  dark- 
coloured  fetid  stools,  and  at  the  same  time  vomiting  of  a  clear, 
slimy,  inodorous  fluid.  48.  Vomiting  and  stool  bloody.  84. 
Violent  vomiting  of  bloody  and  evacuation  of  dark  blood  per 
anum,  during  which,  latterly,  a  violent  burning  pain  was  felt. 
The  hiemorrhage  so  copious,  that  not  a  drop  of  blood  seemed 
to  be  left  in  the  body«    4. 

540. — ^Evacuations  upward  and  downward  of  a  great  quantity 
of  blood  mixed  with  bilious  matter,  with  visible  alleviation.  79. 
Vomiting  and  stool  of  greenish  serum.  4.  He  had  all  through 

i  VOL.   XX.,  NO.   LXXX. — ^APBIl.   1862.  P 


t 


226  Pharmacologieal  Studies, 

the  day  several  Btools  and  firequent  vomiting  of  yellowish  flaid, 
5.  LoDg-continaed  violent  vomiting,  with  diarrhoea,  ejecting 
slimy,  greenish  matter.  29.  Several  dark,  bilious  evacuations, 
mixed  with  mnous,  and  long-continaed  inclination  to  stool.  39. 

545. — ^Dark,  slimy  evacuation,  with  long-continued  vomiting, 
about  seven  times  a  day.  44.  The  incessant  vomiting,  the 
diarrhoea,  the  cramp  in  the  calves  of  the  legs,  and  the  livid 
countenance,  and  especially  the  liquid  evacuations,  exhibiting 
no  trace  of  blood,  led  us  to  consider  the  disease  as  a  form  of 
sporadic  cholera.  28.  Vomiting  alternately  with  diarrhoea, 
followed  by  lasting  constipation.     15. 

Constipation. — Stool.    81.    No  stool.     87,  40. 

550.— Stool  retarded.  47.  Constipation.  8,  9,  18,  23,  44, 
60,72,85,86.  Obstinately  constipated.  15,79.  Obstinate 
constipation  for  two  years.  84.  Diarrhoea  alternately  with 
constipation.     15. 

555. — At  first  diarrhoea ;  at  last  constipation  ;  no  vomiting. 
15.     Green  stools :  at  first  thick ;  then  lax.     2. 

DiABRHOBA. — Inclination  to  diarrhoea.  ^^,  Diarrhoea.  54, 
57,  60.    Purging.     41. 

560.  Severe  watery  diarrhoea.  15.  Fluid  stools.  67.  Fre- 
quent evacuations  of  thin  fluid.  26.  Inodorous  bilious  evacu- 
ations recurring  every  five  or  ten  minutes.  43.  Lax  stools 
without  smell,  as  if  in  consequence  of  indigestion.     75. 

565. — Evacuations  of  mere  blood  and  water.  20.  Violent 
diarrhoea,  three  to  four  stools  per  hour ;  fetid  black  stools,  i^* 
Anal  hemorrhage.  88.  Dysenteric  diarrhoea.  84.  Dysen- 
tery.    56. 

570. — Severe  flux,  with  evident  alleviation.  8.  Diarrhoea 
and  low  spirits;  soon  after,  delirium.  15.  Diarrhoea  with 
straining.    23. 

Excrements. — Stools  serous,  not  frequent.  80.  Frequent 
evacuations  of  slimy,  greasy  masses.     27. 

575. — Green  stool.  88.  Black  matters  and  worms  passed 
by  stool.  17.  Frequent  black  stools.  15.  The  stools  con- 
tained bloody  mucus.  5.  Stools  at  first  blackish  and  hard; 
afterwards  covered  with  bilious  slime.    3. 

580. — Evacuations  consisting  of  a  white,  viscid,  slimy  mass, 


hy  Dr.  Roth.  227 

fbrming  lumpy  masses  of  the  size  of  a  fist.  18.  Evacuation  of 
Ae  lining  of  the  prims  viee  with  the  stool.  24.  Tolerably 
noimal  looking  evaonations  were  covered  with  a  mass  which 
seemed  to  be  composed  of  jelly  and  bile*  L  Two  normal 
Btoob.  25.     Stool  normal.  18. 

585. — ^Involuntary  Evacuations. — Involuntary  discharge 
of  a  great  quantity  of  sharp  burning  (scalding)  water.  62.  Semi- 
fluid matter  escaping  involuntary/i^r  aiit^m  just  as  if  one  had 
suddenly  opened  the  pipe  of  a  vessel  containing  fluid.  The 
evacuations  are  very  copious;  at  first  white,  then  yellowish, 
and  seem  to  originate  from  the  fluids  drank  by  the  patient.  1. 
In  the  later  stages,  just  before  deaths  the  stools  escape  involun- 
tarily in  a  lying  posture.  1.  During  full  consciousness  she 
passed  feces  and  urine  involantarily  without  being  at  all  aware 
of  it  4.    Involuntary  discharge  of  faeces  and  urine.  1 0. 

590. — Tenesmus.— Ineffectual  straining  at  stool.  84.  Te- 
nesmus. 18.  Continual  tenesmus.  85.  Urging  to  stool  and 
urine.  18.  Betendon  of  stool  and  urine  with  a  feeling  of 
necessity  within.  91. 

595. — ^Tenesmus  and  strangury.  87. 

Excretion  of  Urine. — Urine  in  moderate  quantity.  48. 
Urine  copious  and  dark  brown.  19.  Frequent  passing  of 
urine.    61,  94.    Urine  oftener  than  usual.    81. 

600. — ^Urine  scanty.  18,  87.  Urine  scanty,  passing  with 
difficulty.  75.  Urine  not  passing  at  all.  43.  Urine  sap- 
pressed.  62.  He  neither  passes  urine  voluntarily  nor  in- 
voluntarily. 1. 

605. — Spasmodic  difficulty  in  passing  urine.  18.  Frequent 
urgency  to  pass  urine,  which  sometimes  passes  not  at  all,  some- 
times only  with  pain.  18.  Urgency  to  pass  urine  which  he 
cannot  satisfy ;  for  the  bladder  is  empty,  and  by  the  catheter 
only  a  few  spoonfuls  of  clear  urine  are  passed.  I.  Discharge 
of  urine  with  much  sediment.  8.    Urine  passed  with  pain.  28. 

610. — ^Urine  passed  with  burning.  10,  61. 

Penis. — Swelling  and  intolerable  burning  of  the  penis.  61. 
Penis,  bladder,  and  kidneys  give  him  fearful  pain.     61. 

Menstruation. — ^Menstruation  not  disturbed.  88.  Men- 
struation, which  should  have  commenced,  ceased.    4. 

p  2 


928  Pharmaeological  SiudieSj 

6 1 5. — ^MenstraatioQ  flome  days  longer  and  rather  more  oopions. 
18.  After  the  monthly  ooarses  there  occurred  regularly  ihe 
discharge  of  a  yellowish,  fetid,  watery  fluid  for  some  days.  Also 
there  passed  frequently  from  the  rectum  blood,  purulent  mucus, 
accompanied  with  burning  pain  in  that  part. 

Voice.  Phonatio. — Hoarseness.  88.  Weak  voice.  28. 
Low  Yoice*    27. 

620. — ^The  voice  almost  gone.  25.  Voice  hollow,  speech 
unintelligible.  1.  Voice  trembling.  62.  Cries  out  from 
time  to  time.  25.  Frequent  crying  out  for  pain.  I,  15.  He 
spent  the  night  in  groaning  and  cries.     18. 

625. — Cough. — Frequent  cough.  2.  Cough,  oppression  of 
the  chest,  and  painful  pricking  in  the  chest.  19.  Heavy 
catarrh  extending  to  both  lungs.  18.  Left  sided  catarrh,  and 
the  chest  overloaded  with  mucus.     18. 

680. — He  never  coughs.  1. 

Pains  IN  THE  Chest. — ^The  chest  aches.  11.  Tormenting 
pain  in  the  chest  and  throat,  with  a  sensation  of  contraction  in 
both.  88.  A  pricking,  tearing,  stretching,  pressing,  burning 
pain  in  the  chest.    4.    No  pains  in  the  chest.     1. 

635. — Respiration. — Oppression  in  the  chest.  83.  Chest 
oppressed.  12.  Violent  oppression  of  the  chest  in  the  even- 
ing.  48.  Oppression  of  the  chest  and  a  feeling  of  anxiety. 
12,  15,  18.  Great  pressure  on  the  chest;  he  felt  as  if  be  must 
burst  asunder.     28. 

640. — ^Respiration  much  oppressed.  48,  61.  Oppression  and 
pain  of  the  chest.  11.  Oppression  of  the  chest.  18.  As 
soon  as  he  walked  a  little,  he  immediately  felt  oppression  at  the 
chest.  52.  Extraordinary  oppression  of  the  chest,  with  gouty 
pains  of  the  head  and  limbs.     54. 

645. — Great  dyspnoea,  with  pain  in  the  right  side  of  the  chest 
and  shoulder.  79.  He  breathes  with  difficulty.  12,  81,  87, 
72.  Breathing  hard,  and  interrupted  by  frequent  sighs.  62, 
87.  Short  breath.  18.  Short  breathing,  with  violent  pains 
in  the  chest,  throat,  and  abdomen.     11. 

650.— Respiration  short,  accelerated.  1,  25.  Respiration 
short,  irregular.  48.  Respiration  accelerated.  65,  88. 
Breathing  slow.    25.     Difficult  respiration.     76. 


hy  Dr.  Roth.  229 

655. — ^Bespiratory  movement  and  action  of  the  heart,  weak 
and  qoick.  42.  Want  of  breath  increasing  constantly,  1. 
He  is  on  the  point  of  choking,  and  protrudes  bis  tongue.  93. 
He  cries  out  "  I  am  choking,"  whilst  he  rolls  about  in  bed, 
throws  the  clothes  off  to  a  distance,  opens  bis  mouth  wide,  as  if 
tryiug  to  breathe,  and  remains  several  seconds  in  this  state 
motionless.  1.  Shortness  of  breath  continually  aggravated^ 
and  ending  in  Asphyxia.     1. 

660. — ^Respiration  normal.  85.  Bespiration  not  disturbed* 
44.    Inspiration  normal,  sometimes  sighing.    48. 

HiGCOUOH. — ^Hiccough,  25,  68,  64,  91.  Hiccough  in  the 
nighu     18. 

665. — ^Back. — ^DuU  pain  in  the  back,  with  painful  flitting 
drawing  on  the  outside  of  the  extremities.  81.  Pain  in  the 
region  of  the  two  last  dorsal  vertebrsB.     47. 

Loins.  Complaining  of  a  straining  and  tearing  sensation  and 
pressure  on  both  loins,  especially  under  the  left  ribs,  where  it 
is  also  very  sensitive  to  the  touch.     18. 

Should£R. — Intolerable  pain  in  the  left  shoulder.     76. 

Upper  Arm. — Bheumatism  (?)  of  the  muscles  of  the  right 
scapula,  shoulder  aud  hutnerusy  so  that  for  four  nights  he  did 
not  get  into  bed ;  whilst  an  erect  posture,  walking  or  sitting 
seemed  to  alleviate  the  pains.  Having  recovered  after  a  long 
time,  he  was  (exactly  that  day  twelve  months)  again  attacked 
by  the  pains,  without  any  exciting  cause,  and  they  continued 
eight  days.     The  like  recurred  for  two  years.     22. 

670. — ^Elbows. — Pains  in  the  elbows  and  fingers.  15.. 

Hands. — ^The  hands  icy  cold.  48.  Trembling  of  the  hands. 
88.  Eruption  on  the  hands,  thumbs,  and  forehead.  61.  Para- 
lysis of  the  hand ;  it  begins  with  heaviness,  but  not  combined 
with  wasting.     71. 

675. — The  hands  have  never  regained  their  former  fulness 
and  stiength,  and  the  ball  of  the  thumb  has  disappeared  almost 
entirely  (ten  years  after).  4.  Hands  and  lower  half  of  the  two 
forearms  dark  and  livid,  as  in  the  malignant  kind  of  cholera. 

42. 
Fingers.— Sensation  fails  in  the  tips  of  the  fingers.  4.  Sen- 


2S0  Pharmacoloffieal  Studies, 

saUon  blunted  from  the  fingers,  where  it  is  very  feeble,  np  to  the 
wrist,  bat  above  that  it  is  normal.  81.  Loss  of  sensation  in 
the  fingers,  as  if  everything  stagnated  there.     15. 

680.'-^Still,  after  years,  numbness  of  the  fingers.  15.    In  the 
wrist  there  was  extremely  small  muscular  power.    The  finders 
could  neither  grasp  nor  hold  smaller  objects ;  those  of  greater 
circumference,  as  the  crutches,  they  could,  in  some  measure  at 
least;  although  all  feeling,  even  in. case  of  injury,  failed  the  tips 
of  the  fingers.     23.     Muscular  power  weakened,  so  that  he  can 
only  grasp  an  object,  but  not  hold  it  fast     81.    He  could  not 
move  his  fingers.     23.     The  extensors  of  the  fingers  more  in- 
active than  the  flexors,  so  that  the  fingers  were  always  somewhat 
bent.    23. 

685. — The  flexion  of  the  fingers  is  possible,  but  the  extension 
not.  65.  The  hand  can  be  extended,  but  the  fingers  do  not 
obey  their  extensors.  85.  The  contraction  of  the  fingers 
turned  into  such  a  paralysis  that  she  could  neither  lie  down  nor 
get  up  by  herself,  nor  grasp  anything  with  the  hand.     54. 

Upper  Extremities  in  General. — ^Painful  swelling  of  the 
right  hand  and  arm.  61.  Hands  and  arms  lost  their  moving 
power.     69. 

690. — Lov7ER  Leg. — From  the  knees  to  the  ancle  remarkable 
weight  and  fatigue.  83.  Fatigue  and  weight  in  the  legs.  12. 
15.  Convulsive  contraction  of  the  legs;  they  bend  under  the 
thigh.  74.  From  time  to  time  he  lies  on  his  back,  touching 
his  buttocks  with  his  heels,  the  knees  being  raised  high  and  far 
apart.  Suddenly  he  turns  himself  round  and  adopts  another 
posture.  1.  Twitchings  in  the  legs,  with  painful  drawing 
coming  from  the  back.  81. 

695. — Cramps  of  the  legs.  40.  The  cramps  in  the  legs  ex- 
tend upwards.  40.  Quiet  and  sleepiness  amidst  extension  of 
quite  painless  cramps  from  the  legs  to  the  abdomen.  40. 
Very  violent  pains  in  the  legs,  especially  in  the  joints.  52. 
Violent  pain  in  the  left  leg,  which  disturbs  sleep.     67. 

700. — The  left  leg  and  the  foot  cold,  with  blue  spots  up  to  the 
knee,  and  very  sensitive  to  pressure.  67.  Complains  of  great 
weariness,  heaviness,  and  cold  in  the  legs.     12. 


hy  Dr.  Both.  281 

Oalves  of  the  Legb.— Oramps  in  the  oalves  of  the  legs. 
27.     Cramp-like  contractions  in  the  calves  of  the  legs.    28. 
Fkst. — Weakness  of  the  feet.    83. 

705. — ^Weakness  of  the  feet  lasting  for  three  weeks.  88. 
Weakness  of  the  feet  when  nsing  mnoh  exertion.  88.  (Edema 
of  the  feet  and  weakness.  15.  Swelling  of  the  feet,  which  for  a 
long  time  afterwards  remained  weak  and  heavy.  15.  (£de* 
matons  feet  (after  six  weeks).     16. 

710. — ^Very  serious  oedema  of  the  feet,  which  remained  for 
many  weeks.  19.  Unbearable  itching  of  the  foot  and  leg.  69. 
Cramp  of  the  foot.  69.  Numbness  going  to  sleep,  and  cold- 
ness of  the  feet  up  to  a  handbreath  above  the  ankle.  18.  If  he 
turns  himself  upon  the  left  side  of  the  body,  he  can  easily  move 
his  whole  right  leg  either  inwards  or  outwards ;  the  foot  then 
remains  turned  inwards ;  that  is,  the  toes  remain  directed  to- 
wards the  left  leg.  But  in  the  left  leg  these  movements  are 
impossible,  and  die  voluntary  extending  of  the  foot  is  on  both 
Bides  impossible.    85.  - 

715. — Paralysis  of  the  foot.  59.  In  walking  he  dragged  his 
feet  loose  after  him  ;  when  lying  down  they  lie  flat  and  lifeless. 
28.  Complete  paralysis  of  the  feet.  69.  Fain  in  the  feet, 
which  diminish  from  year  to  year,  but  still  after  ten  years  have 
not  quite  disappeared ;  and  these  pains  show  themselves  par- 
ticularly at  the  commencement  of  the  menses.  4.  Burning 
of  the  foot  and  leg  half  way  to  the  knee.     67. 

720. — ^Heels. — Ulcers  on  both  heels  discharging  ichorous 
matter.     68. 

Soles. — The  callosity  of  the  heels  wore  oflT.     69. 
Toes. — ^Toes  cold  and  pale.    67.    Dead  feet  from  the  toes 
to  the  knees.    81.    The  extensors  as  well  as  flexors  of  the  toes 
paralysed.     85. 

725. — ^The  toes  always  bent,  and  can  only  be  extended  by  the 
patient's  own  power  very  little^  and  with  great  effort ;  but  very 
easily  by  the  hand.  Through  this  weakness  of  the  toes,  her 
gait  is  heavy  and  clumsy.  4.  Weakness  of  the  toes;  the 
walking  is  performed  on  the  entire  sole  of  the  foot,  so  that  her 
gait  is  clumsy.  4.  On  the  toes,  especially  the  two  little  ones,  a 
very  hard,  homy  skin  grew  gradually,  with  burning  pain. 


28d  Pharmaeoloffieal  SiudieM, 

^bich  rendered  walking  very  distressing.     4.     The  hard  homy 
skia  on  the  toes  very  troublesome  and  baming,     4. 

Lower  Extrebotieb  in  General. — Pain  at  times  along  the 
nervus  omralis  as  far  as  the  heels  or  toes.     23* 

780.— The  lower  extremities  with  some  oedematous  swelling. 
87.  Painful  cramps  in  the  lower  extremities  47.  Cramps  of 
all  the  mnscles  of  the  lower  extremities,  but  especially  of  the 
plantaris  of  the  right  foot,  84.  Violent  twitching  of  the 
lower  limbs  for  a  week  together.  95.  Lower  extremities 
paralysed.     64,  92. 

785.— Paralysis  of  the  lower  half  of  the  body  for  near  six 
months.  64.  Weakness  in  the  muscular  system,  especially  in 
the  lower  extremities,  so  that  the  gait  was  unsteady  and  stum- 
bling. 81.  Paralysis  of  the  lower  extremities;  when  he  had 
apparently  quite  recovered,  a  new  paralysis  showed  itself  exactly 
two  years  after  the  first  attack ;  in  this  instance,  however, 
attacking  not  only  the  lower,  but  also  the  upper  extremities, 
and  caused  anxiety  for  his  intellects.  He  is  now  recovered. 
46.     The  lower  limbs  much  wasted  in  substance.     52. 

Upper  and  Lower  Extremities. — Cold  extremities*  /O, 
89,  86,  88. 

740. — Cold  of  the  hands,  feet,  and  face,  with  tearing  and 
cutting  in  the  abdomen.  9J.  Cold  of  the  extremities  and 
collapse.  40.  Extremities  quite  cold  and  pulseless.  4J2. 
Extremities  and  face  cool  in  the  afternoon,  cold  about  five 
o'clock.  43.     Cold  in  the  extremities,  nose  and  ears.  67. 

745. — Extremities  cold  and  afiected  with  violent  convulsions. 
56.  Prostration  of  the  limbs.  76,  80.  Relaxation  of  t/ie 
limbs.  44,  80.  Prostration  and  debility  in  the  limbs.  18. 
Great  debility  in  the  limbs.     28. 

760. — Debility  in  the  limbs  and  falling  away.  15.  Debility 
and  sense  of  weakness  in  all  limbs.  11.  Weight  in  the  limbs. 
60.  Weight  in  the  arms  and  legs.  12.  Trembling  of  the  ex- 
tremities.    9,  18,  59. 

755. — Violent  trembling  of  the  limbs.  26.  Trembling  and 
very  violent  movements  of  the  limbs.  75.  Trembling  and 
pricking  sensibility  in  hands  and  feet.  15.  Towards  evening, 
but  not  in  the  day,  a  crawling  sensation  in  the  fingers  and  toes. 


by  Dr.  Roth.  283 

81.     Prequent  sleep  and  insensibility  of  the  right  arm  and 
foot.     83. 

760. — ^Insensibility  and  a  sense  of  going  to  sleep  in  the  upper 
and  lower  extremities,  which  lasted  through  the  whole  illness,  and 
hindered  her  from  holding  objects  fast  15.  Sense  of  namb- 
ness  in  hands  and  feet,  with  frightful  pains  day  and  night, 
which  for  three  months  scared  away  all  sleep  from  her.  4. 
Insensibility  in  hands  and  feet,  89.  Very  complete  insensi- 
hility  of  hands  and  feet.  75.  Diminished  sensibility ;  at  first 
in  the  tips  of  the  fingers,  from  which  it  afterwards  extended  to 
the  hands  and  arms,  and  then  to  the  toes,  and  at  last  to  the  feet 
and  legs.     81. 

765. — ^Extremities  as  if  paralysed.  1 8.  Immobility  of  fingers 
and  toes.  85.  He  can  no  longer  move  his  limbs  voluntarily. 
78.  The  moving  power  and  strength  of  limbs  diminished,  so 
that  the  patient  could  only  with  difficulty  hold  anything  fast, 
and  his  gait  became  unsteady  and  stumbling.  81.  Partial 
paralysis  of  arms  and  legs,  which,  however,  does  not  depend  on 
a  palsied  condition  of  the  motor  nerves,  but  on  anaesthesia  of 
the  nerves  of  the  skin ;  for  although  the  palms  of  the  hands 
were  very  sensitive  to  the  touch,  he  did  not  know  whether  he 
was  holding  anything  or  not ;  also  he  could  not  walk  without 
help,  as  the  soles  of  his  feet  were  like  wooden  ones,  and  did  not 
feel  the  ground.    95. 

770. — ^Auffisthesia  and  paralysis  of  the  hands  and  feet  com- 
pletely established,  and  equally  exhibited  in  extension  and 
flexion.  23.  Almost  entire  immobility  of  the  limbs,  especially 
on  the  left  side.  The  power  of  feeling  was  merely  diminished, 
not  lost  85.  He  lost  the  use  of  his  hands  and  feet,  and  at 
the  same  time  set  in  violent  neuralgic  pains  in  the  extremities, 
which  lasted  nearly  two-and-a-half  years,  and  did  not  yield  even 
to  the  strongest  doses  of  morphia.  The  paralysis  lasted  about 
three  years.  84.  The  paralysis  of  the  extremities  affected  not 
only  the  motor,  but  also  the  sentient  nerves,  notwithstanding 
which  the  parts  were  highly  sensitive  to  cold.  84.  Neuralgic 
pains  in  arms  and  legs.     95. 

775. — Neuralgic  pains  in  the  forearm  and  in  the  legs  from  the 
hips  downwards ;  they  seem  not  to  follow  the  main  branches  of 


284  PAarmaeolo^ical  Siudiea, 

the  nervefly  increased  gradaallj  to  their  mxaxmnm,  gradaaUy 
decreased  again,  and  were  of  a  lancinating  character.     Oold  air 
or  water  aggravated  them  at  once.    They  were  worst  between 
half-past  nine  p.m.  and  eight  a.m.    84.     Fearful  pains  day  and 
nighty  generally  burning  as  when  one  holds  a  bamt  part  again  to 
the  fire,  at  times  also  pricking  and  then  tearing  like  gout,  where- 
upon sometimes  an  extraordinarily  sudden  twitching  and  pluck- 
ing sets  in.    Generally  the  limbs  specially  affected  were  in  a  con- 
tinual state  of  twitching.    4.     The  burning,  pricking,  tearing 
pains,  especially  in  the  extremities,  affected  the  patient  so  much 
the  more  severely  in  proportion  as  the  bodily  energy  diminished 
and  the  sensibility  was  exalted.  4.    Oouty  and  lancinating  pains 
of  the  limbs,  with  immobility  and  OBdematons  swelling  of  the 
feet.    54.     Pricking  pains  like  needles  in  the  hands  and  feet. 
85. 

780. — ^Muscles  of  the  extremities  sensitive*  83.  Flitting 
pains  in  the  limbs.  72.  Wandering  pains  of  the  limbs.  74. 
Contraction  of  the  extremities.  72.  The  contractions  in  the 
fingers  and  toes  disappeared  after  a  very  severe  loss  o(  blood  by 
vomit  and  stool ;  as  they  were  straitened,  they  remained  in  that 
posture,  but  seemed  as  if  dead.  After  a  warm  bath,  life  re- 
turned into  the  hands  and  feet,  but  the  fingers  and  toes  again 
got  bent  crooked.    4. 

785. — Strong  contractions  of  all  the  limbs,  so  that  she  could 
neither  move  these  nor  stand  on  her  feet.     The  power  of  moving 
returned  afterwards,  but  she  could  not  walk  steadily.    58.    The 
flexor  muscles  of  the  upper  and  lower  extremities  are  con- 
tracted.    76.     Contraction  of  the  upper  and  lower  extremities. 
88.     The  toes  and  fingers  were  in  perpetual  flexion ;  if  they 
were  straitened  by  external  force,  they  got  back  to  the  bent 
posture  when  that  force  was  removed.    4.    Distortion  of  the 
limbs.  25. 

790. — ^From  time  to  time  he  extended  his  extremities  and  re- 
mained a  few  moments  in  this  state  of  relaxation,  when  the 
vomiting  returned  with  renewed  violence.  1 .  Gait  tottering 
and  stumbling ;  on  attempting  to  stand  he  falls,  unless  prop- 
ped up.  He  can  with  difiiculty  even  hold  himself  in  a  sitting 
posture ;  yet  the  extremities  can  be  moved  or  pushed,  though 


By  Dr.  Both.  285 

not  witbont  effort,  in  all  directions.    81.    He  oan  no  longer 
sit  Qp«  8tand»  or  walk,  bnt  can  make  every  movement  when 
lying  down.    28.    Arms  and  legs  perfectly  strong  and  move- 
able ;  hands  and  feet,  on  the  contrary,  extremely  emaciated,  so 
that  without  actual  organic  change  the  condyles  of  the  bones 
stick  out  in  unseemly  fashion ;  and  with  regard  to  power  of 
motioxi  or  sensation,  they  are  so  paralysed,  that  nothing  can  be 
grasped  firmly,   the  feet  did  not  admit  of  being  raised,  in 
stepping  the  whole  sole  is  set  on  the  ground,  and  in  walking 
they   had  to  be  dragged  after  as  dead  weights.     28.    Hands 
and  feet  as  if  mummified,  so  that  the  skin  hangs  in  many  folds 
about  the  unsightly  projecting  bones  which  were  not  otherwise 
swollen.     28. 

705. — Joints. — Pains  in  the  joints.  SB.  Burning  pains  in 
the  joints.  54.  Weakness  in  the  joints  of  the  hands  and  feet ; 
they  are  stiff  and  often  painful.     64. 

Nails. — Fingers  and  toes  emaciated;  the  nails  very  hard^ 
brittle,  and  talon-like.  25.  Loss  of  the  finger  and  toe-noils.  24. 
800. — The  nails  change  their  colour  almost  every  month.  At 
first  as  red  as  fire,  then  black  as  if  from  extravasated  blood ; 
after  which  they  gave  place  to  new  nails,  which  were  very  thin 
and  transparent.     4. 

Skin. — Pricking  over  the  whole  skin.  61.  Purple  spots  on 
the  chest  and  nape  of  the  neck.  38.  Large  red  spots  all  over 
the  skin.     36.     He  was  red  and  moist  all  over.     68. 

805. — ^No  ecchymosis  nor  petechiee.  1.  His  whole  skin  be- 
came blue.  1 .  His  veins,  especially  those  of  the  throat,  much 
enlarged,  from  which  the  skin  acquired  a  blue  appearance.  1. 
One  can  compare  his  appearance  to  nothing  better  than  to  that 
of  a  cholera  patient  in  the  cold  stage.  1.  Swelling  of  the 
whole  body.     1^4. 

810. — Swelling  of  head,  belly,  and  feet  11.  The  whole 
body  covered  with  spots  like  measles.  70.  Miliary  rash  all 
over  the  body,  except  the  limbs.  Numerous  little  white 
vesicles  covered  the  skin,  which  between  the  vesicles  seepied 
inflamed.  4.  Miliary  eruption  on  the  skin,  especially  in  the 
region  of  the  abdomen.     10.    Breaking  out  of  an  immense 


286  Pharmacoloffieal  Studies, 

crop  of  white  miliary  vesicles,  conflaent  and  filled  with  very 
sharp  flaid,  covering  nearly  the  whole  sarface  of  the  body.  64. 

815. — ^The  miliary  eruption  lasted  eight  to  ten  days,  ending 
in  desquamation.     54.    A  violent  miliary   eruption   over  the 
whole   body;    this   was  repeated   several    times    in    fourteen 
days,  and  at  last  ended  in  bran-like  scales.     62.     On  the  fore- 
head, around  the  eyes,  on  the  cheek-bone,  the  shoulders,  the 
upper  part  of  the  arm,  and  the  chest  an  eruption  of  white 
pustules  in  great  numbers,  which  in  regard  to  their  form  and 
course  resembled  small-pox.     These  were  partly  isolated,  partly 
confluent,  very  easily  broken,  turned  into  thick  crusts,  and  left 
very  visible  scars  after  them.     85.     Bash   like  that  which  ia 
brought  out  by  nettles,  and  little  vesicles  as  in  an  eruption  of 
miliary.     60.    Troublesome  itching,  and  an  eruption  of  little 
pustules  like  scabies,  soon  desquamating.     64. 

820. — ^Desquamation  on  a  great  part  of  the  body,  especially 
on  the  forearms,  with  a  return  of  tetters  (which  had  been 
shortly  before  cured)  on  the  chin,  lasting  five  or  six  days.  76. 
The  skin  comes  olf  from  the  head  to  the  feet.  24.  Epidermis 
comes  ofP  everywhere  excepting  the  head.  69.  The  sinapisms 
caused  pain  without  redness,  and  brought  neither  warmth  nor 
swelling  on  the  parts.     1. 

Sleep. — Sleepiness.  2,  18,  40.  Constant  strong  tendency 
to  sleep.  12.  The  child  had  a  strong  tendency  to  sleep,  bom 
which  it  could  only  be  kept  with  difficulty.  12.  Inclined  to 
sleep  at  half-past  nine  in  the  morning,  with  disturbed  languid 
eyes.  89.  Remarkable  tendency  to  sleep,  often  disturbed  by 
pain.  12.  She  became  sleepy,  without  being  able  to  sleep  or 
rest.     48. 

• 

830. — Gentle  sleep  after  vomiting.  8.  Slept  badly.  48. 
Quiet  sleep.  26,  27.  Sleeplessness.  18,  19,  23,  60,  76. 
Bestless  sleep.     12,  15,  37. 

885. — She  was  awakened  out  of  sleep  by  vomiting.  %^' 
The  little  patient  slept  very  well  when  not  awcdcened  by  vomit- 
ing, 2.  Sleepless  all  night,  throwing  up  everything  she  took. 
53.  During  sleep  complains  of  headache;  first  in  the  fore- 
head, then  in  the  occiput  2.  No  sleep,  but  tendency  to 
slumber.    47. 


by  Dr.  Roth.  287 

840. — Slumber,  with  slight  dielirinm.  47.  Sleep  at  night, 
altematiDg  with  delirium  and  various  illusions.  15.  Distress- 
ing dreams  and  nightmare.  Even  in  the  day  the  dreams  float 
before  his  mind  and  distract  him.    84. 

Coldness. — SkiQ  cool,  and  coldness  of  the  skin  for  many 
months.     4. 

845. — Coldness  over  the  whole  body.  10, 11, 12,  15,  40,  48. 
As  cold  as  a  corpse.  24.  Skin  icy  cold,  and  the  face  fright- 
fbUy  pale.  1.  Skin  icy  cold,  covered  with  cold  sweat,  espe- 
cially on  the  forehead  and  temples.  1.  Coldness  of  the  face, 
hands,  and  forearms.    25. 

850. — Chattering  of  the  teeth,  frightful  distortion  of  the  mus- 
cles of  the  face,  with  cries  that  he  can  no  longer  hold  out  against 
the  cold,  which  made  him  shiver  as  if  he  had  the  ague.  The 
room  had  a  fire  in  it,  and  the  temperature  was  not  cold.  1. 
The  coldness  of  the  body  could  not  be  diminished  by  the  appli- 
cation of  external  warmth.  Complete  failure  of  reaction.  1. 
The  whole  body,  especially  hands  and  feet,  cold  and  dry.  48. 
Shivering.     88.     Gold  shivering.     82. 

855. — ^Violent  chill  and  shivering.  79.  Sudden  attack  of 
general  shivering.  40.  No  horripilation.  1.  Shivering.  48. 
Complains  of  chill,  without  feeling  particularly  cold.     12. 

860.— Violent  chill.  12.  Violent  shivering  chiU.  18.  Chill, 
till  the  teeth  chatter,  with  forehead  glowing  hot.     16. 

Heat. — ^Temperature  of  the  skin  raised.  28,  88, 40.  Skin 
very  hot.     64. 

865. — Oreat  heat  of  the  skin.  65.  Skin  hot  and  dry.  18. 
Bemarkably  dry  heat,  preceded  by  chill.  12.  Heat.  23,  88. 
Oreat  heat.  68.  Burning  heat  and  thirst.  78.  Complains 
of  general  heat.  88.  Burning  heat  over  the  whole  body,  the 
skin  feeling  cool.  89.  Sensation  as  if  he  would  bum  inwardly. 
81.    Equable  temperature  all  over  the  body.     44. 

875. — ^Temperature  of  the  skin  normal.  85.  Skin  normally 
warm,  without  dryness.    85. 

FssspiBATiON. — ^Moist  skin,  with  cold  extremities.    2.    Per- 
spiration.   87.    Perspiration,  with  increased  diuresis.     18. 
880. — ^Frequent  perspiration.  81.    Very  profuse  perspiration. 


S88  Phamuicoloffical  Studies, 

8,  27.    ProfuBe  perspiration.    88.     Very  violent  perspiration 
for  several  days.    85.     Cold  sweat.      16,  39. 

886. — Covered  with  cold  sweat.  3 1 .  Gentle  cold  sweat  12. 
Skin  covered  with  cold,  not  very  profuse,  perspiration.  J  2. 
Profuse  cold  sweat  84.  Cold,  thick  perspiration  on  the 
skin.     42. 

890. — ^Tlie  whole  body  covered  with  cold  sweat.  77.  Cold 
sweat  on  the  whole  body,  disappearing  after  a  quarter  of  an 
hour,  and  then  (after  being  well  all  day  long),  returning  towards 
evening  and  departing  just  as  quickly.  6S.  Cold  sweat,  alter- 
nating with  cold  dryness.  12.  Fetid  sweat  all  over  the  body. 
62.     Skin  very  dry.     18. 

895. — Skin,  tongue,  and  throat  dry.  72. 

Fever. — ^Irregular  fever  movements.  54.  At  first  gentle 
fever  movements,  becoming  masked  afterwards.  80.  Strong 
fever.     2,  8,  15.    Fever  and  restlessness.     15. 

900. — ^Fever,  with  stiffness  and  very  violent  pains  in  the  swol- 
len legs  and  feet,  which  also  continued  till  the  fever  was  subdued 
on  the  eighth  day.     23.     Severe  chill,  lasting  for  an  hour,  fol- 
lowed by  great  heat,  the  pulse  irregular,  at  times  stopping, 
violent  thirst,  severe  headache,  and  such  decided  contraction  of 
hands  and  feet,  that  she  could  not  extend  them   at  all.     54. 
Aggravation  of  the  heat  in  the  afternoon,  thirst,  with  cold  sweat, 
and  contraction  of  the  limbs.     54.     Attacks  of  fever.    25. 
Every  evening  an  attack  of  fever.     75. 

905. — Regular  tertian  ague.  76.   At  first  sight  one  supposes 
it  a  case  of  typhoid  fever.    Incessant  sleepiness,  stupefaction, 
stupid  look,  ringing  in  the  ears,  no  pains,  redness  of  the  cheeks, 
slight  ophthalmia,  lying  on  the  back,  paralysis  of  the  limbs  and 
the  trunk,  great  emaciation,  perspiring  skin,  strong  pulsation  ot 
the  hearty  with  normal  sound.    Lungs  free.    Pulse,  95  to  100. 
Tongue  clean,  not  dry.    Abdomen  not  sensitive  to  the  toacA, 
but  drawn  in  and  hollow.  Gurgling  in  the  bowels,  no  diarrhoea, 
and  involuntary  urine.     85. 

Movements  of  the  Heart. — ^Palpitation.  15,  51.  Com- 
plaints of  strong  palpitation.  43.  Palpitation  setting  in  from 
time  to  time.    9. 


hg  Dr.  Roth.  289 

910. — ^Talpitation  and  anxiety.  18.  Violent  palpitation,  pulse 
quick,  fall,  excited.  12.  Heart's  action  and  pulse  accelerated. 
37.  Strong  beating  of  the  heart,  with  small,  irregular  pulse. 
16.  Beating  of  the  heart  violent,  quick,  excited,  v?ith  small, 
quick,  almost  imperceptible  pulse.     12. 

915. — ^Violent  beating  of  the  heart,  with  complete  loss  of 
poise.  12.  Very  violent  and  even  painful  beating  of  the  heart. 
6.  Beating  of  the  heart  distinct,  yet  often  excited.  12.  Beating 
of  the  heart  strong  and  hard.  39.  The  heart  acts  very  violently; 
one  hears  a  strong  blowing  sound,  whilst  the  pulse  is  very  full 
— 110  beats  per  minute.     85. 

920. — ^The  sounds  of  the  heart,  but  especially  the ''choc," 
tolerably  strong,  with  the  small  pulse  not  in  unison.  9.  One 
oould  scarcely  any  longer  notice  the  movements  of  the  heart. 
12.  Increasing  weakness  of  the  heart-beating  and  pulse.  -  89. 
Constantly  increasing  diminution  of  the  pulse  and  heart-beat. 
12.     Beating  of  the  heart  quite  gone.     1. 

925. — ^He  complains  of  no  heart-pain,  has  no  palpitation,  and 
no  syncope.     1.     Action  of  the  heart  natural.     89. 

Babial  Pulse. — ^Accelerated  pulse.  5,  58,  54,  65.  Pulse 
quick  and  weak.  52.  Pulse  frequent  and  small.  2,  15,  19, 
28,  48,  51,  61,  67. 

930. — Pulse  frequent,  small,  but  regular.  12.  Excited 
pulse.  9.  Pulse  restless  and  small,  yet  elevated  after  repeated 
vomiting.  48.  Exalted  pulse.  27.  Pulse  hard  and  frequent. 
79. 

085. — ^Pulse  rather  hard  and  slow.  85.  Pulse  depressed, 
hard,  and  quick.  82.  Pulse  hardish,  irregularly  accelerated. 
84.     Pulse  strong.     18,  65.     Pulse  full  and  frequent.     67. 

940. — ^Pulse  full,  not  rapid.  18.  Pulse  full  and  strong.  64. 
Pulse  small  and  nneven.  76.  Pulse  small,  contracted,  stop- 
ping (intermittent).  78.  Pulse  contracted,  frequent,  irregu- 
lar.    68. 

945. — Convulsive,  small,  rapid  pulse.  48.  Pulse  convulsive, 
rapid,  irregular,  weak.  62.  Pulse  small^  uneven,  irregular, 
very  frequent.  25.  Pulse  intermittent.  47.  Pulse  irregu- 
lar.    75. 

950.— Pulse  regular,  not  small,  frequent.  28.    Pulse  varying 


240  Pharw^aeologieal  8iudie»,  dc. 

between  70  end  140,  email  end  irregnler.    40.    Polae  75  to  8. 
18.    PiJee  90,  week.    38.    Pnlee  feverish,  90  at  moet.     44. 

955. — ^Polee  90,  eoft,  and  ^  first  weak.  89.  False  104,  full. 
88.  Pulse  112,  tolerably  hard.  40.  Pulse  115,  bat  sofL  39. 
Poke  120,  hard,  but  feeble,  compressed.     89. 

960. — ^Pnlse  140,  irregular.  87.  Poise  small,  depreesed.  27. 
Pulse  miserable.  47.  Puke  hardly  perceptible.  48.  False 
small,  firequent,  hardly  perceptible.  9,  10.  Pulse  trembling^, 
scarcely  perceptible*  77,  90.  Pube  neariy  imperceptible, 
small,  contracted,  irrq[ular.  1.  Pulse  and  breathing  hardly 
perceptible.     64. 

965. — ^Pulse  no  more  to  be  found.  12.  It  is  impossible  to 
feel  eren  the  smaUest  trembling  of  the  radial  pulse.  1.  Pulse 
early  in  the  morning  quiet;  about  9  to  10  a.m.  rather  excited  ; 
about  noon  small,  hardish,  frequent;  from  five  o'clock  till 
death,  after  midnight,  imperceptible.     48. 

Physical  Bestlessness. — Great  anguish.  12,  29,  60. 
Undeecribable  anguish.  4,  18,  26,  57.  Very  great  anguish  of 
the  precordia.    28,  54,  55. 

970. — ^His  anguish  and  restlessness  are  indescribably  great. 
"Kill  me,"  said  he,  ''or  mitigate  my  pains!"  1.  Anguish 
with  outbreak  of  cold  sweat  68.  Great  restlessness.  10,  25, 
27,  87,  89,  81,  86.    After  midnight  a  little  restless.     89. 

975. — Very  restless,  with  weak  and  rapid  poise,  sunken  eyes, 
and  cold  extremities.  89.  Very  restless,  unable  to  lie  still  one 
minute.  48.  He  threw  himself  here  and  there  constantly.  17. 
Bestless  movement  more  than  twenty  minutes.  42.  Bestless- 
ness, tossing  from  side  to  side.     15. 

980. — ^He  tossed  here  and  there  on  the  bed  restlessly.  28* 
Tossing  about  in  bed.  44.  He  lay  first  on  the  right  side,  then 
on  the  left,  and  changes  posture  with  incredible  celerity.  1. 
Bestlessness  and  angubb,  so  that,  by  tarD8,he  left  the  bed  and 
threw  himself  on  the  floor.  15.  He  starts  up  in  paroxysms 
and  becomes  very  restless.     1 5. 

985. — Occasionally  he  finds  her  shrinking,  twisting,  and  toss- 
ing in  bed,  making  incessant  efforts  to  alleviate  her  misery  by 
change  of  posture ;  generally  moaning  wretchedly,  at  times 
eructating,  and  crying  at  short  intervals,  "  I  am  deadly  sick." 


hy  Dr.  Roth,  241 

42.  Great  restlessness.  She  tossed  herself  about  in  bed^  and 
in  her  anguish  and  distress  clang  fast  to  a  bystander.  15.  He 
could  not  stay  out  of  bed,  became  very  restless  in  increasing 
pain,  doubled  himself  and  turned  about  in  bed^  full  of  anguish 
and  distress.  12.  BesUessness,  crying  out  and  twisting  of  the 
body.  12.  Incessant  restlessness  and  contraction  of  the 
body.     5. 

990. — Postures  of  the  Patients. — ^The  body. bent.  5. 
He  lies  in  bed  bent  double.  81.  He  lies  leaning  over  a  trunk, 
propped  on  both  sides,  deadly  pale,  and  retching  violently.  81. 
She  lies  doubled  up  in  bed,  moans  and  groans.  48.  She  lay 
almost  always  on  her  back,  and  only  during  frightful  awaken- 
ings sought  to  adopt  a  new  posture.     42. 

995. — Bed-sores  on  the  back ;  great  restlessness  and  inability 
to  lie  on  the  side.     79. 

General  Weakness. — Bela^ation.  88.  Belaxation  and 
physical  apathy.  12.  Amazing  depression  and  a  state  of  dis- 
comfort.    75.     Great  debility.     2,18,47. 

1000. — ^He  was  very  feeble  and  debilitated.  82.  Great  de- 
bility ;  he  had  to  go  home  and  lie  down.  47.  Debility,  so 
that  he  cannot  quit  his  bed.  15,  98.  He  remained  a  long  time 
very  feeble.  15.  Deadly  weakness;  face  of  cadaverous  pale- 
ness.    9. 

1005. — Quite  powerless.  15,  81,  88,  58,  77.  Great  weakness. 
12,  26,  29.  Very  great  weakness.  28,  88,  88,  41,  67.  Lasting 
weakness  and  relaxation.  88.  General  weakness  of  the  body, 
especially  the  feet.     88. 

1010. — She  was  so  weak  that  she  had  to  be  carried  into  her 
room.  6.  Extraordinary  prostration.  EJaeeling  on  the  floor 
of  her  chamber,  with  her  head  supported  on  her  brother's  arm ; 
she  eould  not  hold  herself  up.  25.  Great  weakness ;  her  walk 
was  that  of  a  person  very  drunk.  6.  So  weak  from  vomiting 
that  he  cannot  walk  alone.  91.  After  standing  up  he  fell 
down  on  the  floor.     15. 

1015. — He  stepped  out  of  bed,  fell  down,  and  wounded  the 
occiput  5.  He  can  hardly  walk.  5.  Great  debility  and 
bodily  weakness,  especially  after  the  vomiting,  which  set  in  at 

VOL.   XX.,   NO.   LXXX. — APRIL    1862  Q 


2i2  Pharmacological  Sttsdies^ 

times*    2.    A  feeling  of  leaden  weight.     47.     He  seems  very 
little  exhausted.     8. 

1020, — Involuntary  Muscihjir  Movements.  —  General 
tremor.  82.  Tremor  of  the  whole  body  in  the  morning.  18. 
Trembling  all  over  the  body.  19.  Trembling  and  shaking,  with 
perspiration  on  the  face.     91.    He  trembled  greatly.     20. 

1025. — Trembling  and  formication  all  over  the  body.  81. 
Twitching  in  the  tendons.  51.  Starting  of  the  tendons.  91. 
Some  sadden  and  involuntary  mascular  contractions.  75. 
Tonic  cramps  all  over  the  body.  12. 

1080. — Frightful  cramps,  stiff,  and  with  the  body  drawn  back. 
25.  Tetanic  cramps,  in  which  the  body  is  bent  back,  ibe  chest 
raised  high  up,  making  him  utter  a  doleful  cry.  14.  Convul- 
sions. 56,  68.  Slight  convulsions,  lasting  some  minutes,  on 
which  violent  vomiting  was  renewed.     25. 

1035. — Convulsive  cramps,  which  moved  painfully  the  trunk, 
the  head,  and  the  limbs  (but  without  the  loss  of  reason),  with 
sighs  and  groans.     54.    Violent  convulsions  after  profuse  per- 
spiration, then  sleep.     76.     Attacks  of  cramp,    which  set  in 
from  time  to  time,  though  always,  as  it  seems,  after  some  exter- 
nal excitement,  especially  vexation,  or  other  violent  emotion. 
They  gave  about  one  hour's  notice  of  their  commencement,  by 
drawing  in  the  limbs,  with  inclination  to  lie  down,  but  without 
going  to  sleep.    At  the  actual  commencement,  she  either  expe- 
rienced a  sudden  jerk  through  the  whole  body,  or  else  an  icy 
chill  ran  like  lightning  from  the  head  down  the  back.     At  the 
same  moment  she  lost  her  consciousness,  stretched  and  twisted 
herself,  and  then  drew  her  limbs,  especially  her  arms,  together. 
Meanwhile,  also,  were  manifested  convulsive  drawings  of  the 
muscles  of  the  face  and  convulsion  of  the  cheeks,  from  which  it 
has  occurred  that  the  under  lip,  or  even  the  tongue,  was  injured, 
and  made  to  bleed  by  the  teeth  closing  fast.     Oflener,  however, 
the  convulsion  raged  in  the  abdomen,  which  is  very  quickly 
raised  and  sunk  again  during  the  fit,  with  gurgling  in  the 
bowels.    After  some  remission,  the  attack  returned  generally 
once  more,  before  she  regained  her  senses.     The  whole  fit 
lasts  ten  minutes  at  the  most;  on  the  return  to  conscious- 


On  Laryngeal  Catarrhal  dtc.  243 

ness  she  asks  for  water,  which,  however,  renews  the  convulsions. 
4.  Cramps,  which  appear  to  begin  in  the  abdomen.  63.  In 
his  last  moments  he  had  neither  convulsion  nor  any  brain 
symptoms.     1 . 

1040.— Violent  convulsive  movements  before  death.  15. 
General  Sensations. — Increased  sensibility,  so  that  even 
the  gentle  opening  and  shutting  of  the  door  of  the  room,  or  an 
unexpected  touching  of  the  bed  clothes,  made  the  patient 
shrink ;  and  an  unforeseen  shutting  of  the  house-door  drew 
tears  and  caused  pain.  4.  Great  sensitiveness.  90.  Sensi- 
tiveness to  so  high  a  degree  that  a  mere  breath  caused  cramp 
and  convulsions.  49.  Sensitive  to  cold.  40.  General  pains. 
43.  He  felt  himself  corpulent.  44.  Insensibility  to  external 
stimuli.     38. 

Fainting. — ^Paroxysms  of  fainting.  15,  53.  Fainting.  2S, 
60,  64.  Fainting,  during  which  she  grew  cold  all  over.  16. 
Fainting  fits  coming  on  interrupted  the  anguish  of  the  heart 
and  lulled  the  piercing  cries  of  pain.     8. 

Nourishment. — Emaciation.  33.  He  wastes  away  gradually. 
21.  She  became  amazingly  thin.  49.  The  healthy,  well-fed, 
feminine  person  had  altered  in  eight  weeks  into  a  feeble  skele- 
ton, barely  covered  with  skin,  and  the  fresh,  red,  and  white 
complexion  into  a  pale  bluish  grey.  The  integuments  of  the 
abdomen  were  olive  green,  the  back  as  if  ecchymosed,  mouth 
and  nose  covered  with  scabs,  the  hair  nearly  gone.  After  a  year 
the  muscular  system  was  flabby  compared  with  what  it  was 
previously.  4.  Belaxation  of  the  muscles.  2,  3.  Nutrition  of 
the  body  not  essentially  impaired. 

ON  LAEYNGEAL  CATAEBHS  AND  THEIR  REFLEX 

PHENOMENA. 

By  Dr.   Klsinebt.^ 

It  is  a  phenomenon  of  perpetual  recurrence,  nay,  almost  a 
stereotyped  custom  of  modem  times,  which  cannot  but  be  fami- 
liar to  physicians  of  larger  towns,  that  persons  who  live  by  the 

*  From  the  Vierttiljakndnft,  ix.,  3,  p«ge  178. 

Q  2 


244  On  Laryngeal  Catarrhs^  de., 

professional  exercise  of  their  respiratory  organs   (as  actors/ 
singers,  prompters,  performers  on  wind  instruments,  preachers, 
teachers,  Sec,),  almost  without  exception,  place  themselves  in 
the  hands  of  homoeopaths  rather  than  practitioners  in  any  other 
section  of  the  faculty,  even  to  the  neglect  and  rejection  of  treat- 
ment which  is  often  at  their  service,  gratuitously,  from  other 
quarters.    This  predilection  and  petichant  is  owing  to  the  testi- 
mony of  those  who  had  to  pay  dear  for  their  experience.     For 
though  these  organs,  considered  from  a  sanitary  point  of  view, 
are,  in  themselves,  the  most  important,  a  priori,  of  the  whole 
body,  whilst,  in  the  cases  above  adduced,  they  fall  into  the  scale 
with  double  weight,  as  sources  of  a  livelihood,  on  the  other 
hand,  the  treatment  in  many  cases  has  been,  and  still  is,  either 
owing  to  scientific  apathy,  or  through  the  urgency  and  suffering 
of  the  impatient  and  anxious  invah'ds,  or  lastly,  through  fear 
of  poor  remuneration,  so  trifling,  careless,  indolent,  and  super- 
ficial, that  the  proportion  of  sickness  and  mortality  among  these 
classes  never  need  cause  astonishment. 

It  is,  for  instance,  an  acknowledged  fact,  that  singers  of 
either  sex,  during  the  last  twenty  years,  have  not  remained  in 
undisturbed  possession  of  their  voice,  i.  e,,  their  "capital/*  for 
more  than  five  years  on  the  average.  And  for  this  sad  result 
they  are  indebted,  for  the  most  part,  to  their  doctors,  with  here- 
ditary antediluvian  charlataneries,  and  for  the  other  and  lesser 
part  (a  field  to  which  we  shall  return  by  and  bye),  to  frivolous, 
narrow-minded  singing  masters,  and  to  extravagant  composers. 
At  no  distant  period  by  any  means,  nay,  sometimes,  even  still 
is  practised  the  method  (routine)  of  combating  catarrhal  in* 
flammations  of  the  larynx  and  bronchia,  with  fomentations^ 
gargles  of  expectorant  infusions,  Sal  ammoniac.  Nitre,  Ems 
and  salt  spring  waters  of  Upper  Silesia,  Seltzer  water — not 
forgetting  Lapis  infernalis  and  Morphine — and  then,  when 
hoarseness  or  soreness  supervened,  recourse  was  had  to  the 
so-called  "infallible  tincture  of  Pimpernel "  internally,  whilst 
externally  cataplasms  (of  temperature  according  to  the  clique 
of  the  doctor),  and,  if  the  malady  progressed.  Sinapisms, 
Auteurieth's  pock-producing  ointment  or  Croton  oil  were  ap- 
plied.   Pathological  anatomy  (results  of  post-mortem  examina- 


by  Dr.  Kleitiert  S45 

tions)  must,  ere  this,  bave  shown  how  infinitely  destnictive,  in 
most  cases,  was  the  efiPeot-of  these,  and  especially  of  the  last 
named  procedare;  seeing  that,  instead  of  cure,  irritation,  en- 
lai^ement  and  degeneration  of  the  glandule  concatenates  sur- 
rounding the  sheath  of  the  par  vagum,  jugular  vein  and  carotid 
artery,  and,  consequently,  fresh  asthmatic  and  suffocating 
symptoms  used  to  supervene.  Homoeopathy,  proscribed  as  a 
heresy^  which,  twenty  years  earlier,  accomplished  cures,  radical 
cnres,  and  without  torture,  could  not  penetrate,  in  spite  of 
common  sense  and  ocular  demonstration. 

Since,  in  the  exploration  {pharyngoacopy,  dc),  of  the 
oigan  of  voice,  a  technical  medical  appliance,  or  instrument, 
can  never  ensure  a  complete  survey  of  the  parts,  whilst  those 
mechanical  aids  and  facilities  warranted  to  us  by  reflectors, 
such  as  Lahrsens  mouth-mirror,  by  the  spatula,  by  the 
finger,*  including  palatometer,  plessimeter,  and  stethoscope,  can 
only  sufiBce  partially,  so,  on  the  other  hand,  an  exhaustive 
examination  of  symptoms  is  (and  ever  remains)  strictly  accord- 
ing to  the  doctrines  of  the  patriarch  Hahnemann,  as  a  means 
of  complete  deliverance,  and  must,  as  such,  form  the  basis  of 
enquiry.  Strictly  abiding  by  Hahnemann's  doctrines,  and 
intimately  acquainted  with  his  inexhaustible  materia  medica, 
I  say  most  deliberately,  because  it  has,  assuredly,  by  this  time, 
struck  every  attentive  physician,  that  the  modern  physiological 
school  has  impudently  profited  by  the  apparently  prolix,  but 
comprehensive  genius  of  this  high  priest  of  science,  who,  long 
before  Laennec  and  his  disciples,  invented,  with  linguistic 
acumen,  names  for  the  sounds  and  sensations  of  the  several 
organs,  especially  the  lungs,  bronchia,  and  larynx,  and  made  a 
present  of  them  to  the  symptom  codex  and  to  science.  For 
the  Nihilist  cannot  out  of  the  Zenta  Vesta  of  the  old  school, 
name  any  work,  either  original  or  compiled,  which  renders 
the  normal  and  morbid  sounds  of  the  respiratory  organs  with 
such  decisive  expression,  and  in  such  rich  variety,  as  Hahne- 

*  One  succeeds  best,  after  all,  by  making  the  patient  pnsb  his  tongue  down 
with  his  own  finger,  and  pronounce  "a"  with  his  month  opened  to  the  utmost, 
and  for  a  deep  inspection,  bringing  on  retching  by  tickling  the  palate. 


246  On  Laryngeal  Caiarrhs,  de,^ 

mann  (blowing,  crepitating,  whistling,  snorting,  buzzing,  P^P* 
ing,   hissing,    parring,   crackling,   snufiBing,  snoring,  rattling, 
wheezing), — ^a  selection  of  symptoms  noticed  by  one  organ   of 
sense  only — and  just  as  little  will  he  be  able  to  give  parallel 
quotations  out  of  the  old  and  new  school  in  this  kaleidoscopic 
exuberance,  listened  to  by  contact  with  the  senses  of  the  pa- 
tient, and  presented  to  contact  with  the  senses  of  the  pby- 
sician.     That  the  Nemesis  of  necessity  and  of  common  sense 
will  come,  is  as  certain  as  that  the  due  recognition  of  Hahne- 
mann's genius,  on  the  part  of  the  Nihilists,  has  been  refused 
heretofore,  and  will  be  refused  hereafter. 

The  stethoscope,  the  ophthalmoscope,  pathological  and  micro- 
scopic anatomy  and  chemistry,  have  their  valuable  sphere,  their 
exhaustible  limits,  they  are  all  meagre,  shallow,  fallacious;  for 
one  will  still  think  of  the  cure,  and  from  the  cure  pass  on  to 
the  medicine;  from  the  medicine  to  the  symptom,  from  the 
symptom  to  Hahnemann.* 

There  is  a  real  necessity  connected  with  the  repetition  of 
examination  which  must  not  remain  unnoticed  here.  Even 
without  any  complication  of  the  laryngeal  malady  with  hypo- 
chondriasis or  hysteria,  patients  so  affected  have  usually  a  pen- 
sive disposition,  that  leads  them  to  imagine  they  have  the 
symptoms  they  are  asked  about.     On  this  account,  one  should 

*  Intentional  or  nnintentional  poisonings  and  piOTings  (i.  e.,  more  cautions, 
conscientious,  and  scientific  than  many  of  the  existing  provings),  wiU  giro 
an  explanation.  For  instance :  "  Ammaniae.  A  glittering  appearance  before 
the  eyes  as  of  molten  metal.'*  In  this  case,  inflammation  of  the  deeper 
seated  parts,  the  choroidea,  &c.,  is  present,  with  which  amaurosis  citen 
commences.  Traces  of  the  change  must  be  perceptible  in  the  provers  by  the 
aid  of  the  opthalmoscope.  Muriatic  Acid. — Perpendicular  hemiopia ;  thus 
partial  paralysis  of  the  optic  nerve,  perhaps  exudation — extravasation  of 
blood  on  the  choroidea.  So  also  Alumina  and  other  substances  cause  vision 
of  yellow,  perhaps  perceptible  on  the  corpus  vitrei  and  the  aqueous  humour ; 
a^purely  icteric  symptom,  which  will  manifest  itself  decisively  on  isolated 
parts  of  the  body.  Symptoms  such  as  under  jSeco/e— **  seeing  trebUf"  ought 
to  be  consigned  to  the  old  lumber-room ;  for  here  it  is  easy  to  perceive  that 
the  prover  had  cicatrices  from  former  ulcers  and  injuries  of  the  cornea, 
leading  to  accidental  phenomena,  which  millions  of  other  provers  never 
can  and  never  will  have. 


by  Dr.  Kleinert.  247 

beware  of  receiving  confidently  phenomena  which  do  not  be- 
long to  the  normal  course  of  the  disease^  and  which  had  been 
denied  on  previous  occasions;  these  are,  for  the  most  part^ 
merely  transient  reflex  actions. 

As  soon  as  the  examination  depending  on  the  information  the 
patient  can  give  is  over,  we  proceed  to  ocular  inspection.  Many 
will  find  the  contrary  order  of  succession  more  suitable,  because 
it  saves  time  and  questions.  The  fact,  however,  is  not  so.  In 
most  diseases  of  the  organ  of  voice,  it  ensures  very  little  assist- 
ance, for  this  reason — that  all  the  organs  accessible  to  the  sight 
stand,  with  regard  to  the  importance  of  the  disease  in  the  second 
class,  quite  irrespective  of  the  fact  that,  by  inspection  in  the 
first  instance,  a  decided  and  certain  judgment  upon  the  size, 
structare,  and  colour  (as  to  their  morbid  proportions),  cannot 
be  formed,  because  we  did  not  know  them  in  their  healthy 
condition.  A  relaxed  or  unequal  state  of  the  velum  petidulum 
faiati,  elongated  uvula,  projecting  tonsils,  the  lymphatic  glands 
looking  like  a  string  of  coral  beads,  a  gorged  venous  plexus  on 
the  posterior  walls  of  the  pharynx,  may,  at  first  sight,  be  taken 
by  the  physician  for  the  real  material  cause  of  the  malady,  and 
are  often  mere  lusus  natura,  with  which  the  patient  under  ob- 
servation has  Uved  for  years  at  ease  and  in  health.  The  diseased 
epiglottis,  and  the  red  spots  on  its  side,  may  be  seen  in  many  pa- 
tients, but  only  now  and  then,  if  they  press  the  tongue  down  or 
protrude  it  by  violent  yawning.  In  the  so-called  "  cedema  of  the 
glottis"  we  find  a  strange  swelling,  a  kind  of  pad  around  the 
upper  opening  of  the  larynx;  the  membranous  fold  between 
the  thyroid  and  arytenoid  cartilages  is  far  thicker  and  firmer 
than  usual ;  the  touch  is  excessively  painful.  In  acute  laryn- 
gytis,  pressure  between  the  thyroid  and  cricoid  cartilages^  or 
even  between  the  cricoid  cartilage  and  the  hyoid  bone,  causes 
pretty  severe  pain,  which  provokes  marked  cough.  In  trachei- 
tis, pressure  on  the  sides  of  the  trachea  also  produces  pretty 
severe  pain. 

Plessimetbt. — If  the  air  passages  alone  are  inflamed  and 
no  important  material  disease,  either  primary  or  secondary,  of 
the  lungs  or  neighbouring  parts  be  present,  then  the  plessimeter 
produces  no  abnormal  phenomena.    These  negative  results  are 


248  On  Laryngeal  Catarrhs,  dtc, 

well  worthy  of  obserration,  and  greatly  facilitate  the  diagnosis 
of  inflammation  of  the  air  passages.  If  we  find  no  plessimetiic 
indications  of  pneumonia,  plenrisy,  or  pulmonary  phthisis,  we 
must  then  infer  a  simple  affection  of  the  bronchial  tubes. 

Auscultation. — The  stethoscope  indicates  no  inflammation 
of  the  air  passages,  but  only  the  presence  of  secreted  products, 
thickening  of  the  parietes  of  the  air-tubes. 

It  was  observed  at  the  outset  that  dramatic  and  singing 
masters,  as  well  as  composers,  who  are  bigoted  to  their  own 
fancies,  lay  the  foundation  for  diseases  of  the  respiratory  organs. 
Permit  us  here  to  take  a  cursory  glance  at  their  practices,  and 
those  of  the  artists  themselves.     "  Time  is  short,  art  is  long/' 
said  Ooethe.     And  when  he  said  this  he  was  not  only  thinking 
of  the  student  of  philosophy  or  science,  but  also  of  the  artist 
with  his  excellencies   and  defects.     Industry,   ambition,  and 
self-denial  on  the  one  hand ;  frivolity  and  excitement  on  the 
other.  And  here  three  kinds  of  causation  come  especially  undw 
consideration. 

1.  The  rhythm  of  respiration  in  the  artist's  life  is  quite  dif* 
ferent ;  there  is  entire  deviation  from  that  of  ordinary  life,  inas- 
much as  the  physiologically  normal  rule  of  human  breathing,  viz., 
three  short  and  eighteen  long  breaths  per  minute,  is  quite  out  of 
the  question.  Long  sustaining  of  the  tone,  with  swells  and  dying 
away,  in  singing  and  playing  wind  instruments — the  delivery 
of  long  extended  paragraphs  of  poetry  or  prose,  which  do  not 
permit  taking  breath — compulsory  artificial  heaving  of  the  chest 
during  the  exhibition  of  dumb  excited  action — the  avoiding 
of  speaking  when  drawing  in  the  breath — the  drying  up  of  the 
mucous  membrane — all  these  induce  more  or  less  turgescence 
of  these  noble  organs,  and  with  it,  a  considerable  febrile  con- 
dition. 

2.  The  body  in  general,  but  especially  the  thoracic  organs^ 
form  the  material  instrumental  sounding-board  of  the  impinging 
volumes  of  tone.  H.  Lauvergne,  that  talented  French  physi- 
cian, whose  extensive  practice  and  examination  of  the  most 
diverse  hospitals  in  all  parts  of  the  world  enabled  him  to  collect 
a  mass  of  information  respecting  life  and  death,  which  he  has 
recorded  in  his  excellent  work,  *'The  Last  Hours  and  Death  in 


ijf  Dr.  Kleineri.  249 

•U  classes  of  Human  Society,"  dwells  with  specnal  emphasis  on 
this  circamstance  in  the  chapter  which  treats  of  artists.  The 
fireqaent  appearance  of  mental  affections,  especially  melancholy 
and  of  phthisis  among  them  he  derives  from  hence ;  he  alleges 
amongst  wind  instruments,  the  key  bugle  is  the  most  pemi- 
ciuas,  although  one  is  inclined  very  naturally  to  attribute  the 
worst  effects  to  other  instruments  which,  resting  immediately 
on  the  teeth,  conduce  still  more  to  the  propagation  of  vibra- 
tions ;  and  he  ranks  next  to  this  a  stringed  instrument,  from 
which  one  might  think  this  was  least  of  all  to  be  expected,  the 
violoncello. 

8.  The  body,  especially  the  thoracic  organs  and. the  cerebel- 
lum, form  a  species  of  psychological  sounding-board.  Music 
speaks  to  us  with  the  love  of  a  mother,  when  our  own  mother 
fails ;  for  it  comes  from  the  heart  and  penetrates  into  the  heart; 
it  has  power  to  ennoble  the  rudest,  to  raise  up  the  most  heart- 
broken. How  much  more  powerfully,  enduringly,  and  even, 
under  certain  conditions,  more  wearingly  and  destructively,  will 
it  have  power  to  act  on  those  who  hope  to  extend  their  material 
and  psychological  welfare  by  the  range  of  their  voice,  and 
often  obtain  calamity  instead.  Let  us  now  consider  the  arro- 
gant, one  might  almost  say  rude  pretensions  and  inventions 
of  the  singing  masters  and  of  fashion,  in  opposition  to  these 
subtile  works  of  nature.  Let  us  take  Mozart  and  Cimarosa, 
thus  about  the  date  of  the  rational  composition  of  operas, 
1792-98,  and  of  their  works,  for  instance,  the  Zauberfl5te 
and  Matrimonio  Segreto ;  let  us  at  the  same  time  remember 
that  these  demanded  the  widest  range  of  voice,  with  the  most 
fabulous  dexterity,  in  uttering  the  words;  and  then  let  us  draw 
a  parallel  with  our  time,  in  which  the  concert  pitch  has,  in 
consequence  of  a  different  construction  of  the  wind  instruments, 
(oboe,  clarionet,  horn),  been  raised  by  nearly  a  whole  note,  and 
we  shall  find  that  our  composers  demand  the  same  compass  to 
the  same  amount  of  words,  but  that,  furthermore,  they  exact 
from  every  voice  greater  strain  of  vocal  power  in  relation  to  the 
volume  of  tone  produced  by  more  massive  instrumentation, 
the  same  in  relation  to  the  longer  duration  of  their  pieces  and 
greater  variety  of  expression. 


S50  On  Laryngeal  Catarrhs,  dtc. 

And  the  sins  of  the  singing  masters  ?      They  are  legion. 
We  must  first  mention  their  utter  ignoraoce  of  the  anatomy  and 
physiology  of  the  respiratory  organs,  which  we  before  intimated. 
And,  though  it  is  not  to  be  demanded  of  them   that,  like  the 
instructors  of  deaf  mutes,  with  the  upper  half  of   the  body 
stripped,  they  should  teach  their  pupils  to  produce  correct  tones 
and  to  take  breath,  yet  surely  the  limits  oT  possibility  in  train- 
ing the  voice  should,  by  observation  of  the  person,  be  ascer- 
tained by  them  during  the  first  hours  of  instruction.     Then 
would  vanish   the  folly   of  wisliing,   in   the    case    of    fleshy 
tongues  and   narrow  velum   pendulum  (grand    hindrances  to 
volubility  of  tone)  to  extort  rapidity  of  exeoution,  though  there 
may,  perhaps,  be  otherwise,  most  excellent  voices  ;  the  disorders 
of  stomach  and  diaphragm  induced  by  eternal  hammering  and 
practising  di£Bcult  and  often  even  impossible  solfeggios  would 
disappear ;  and  the  hysterical  sufierings  of  the  liver  and  spleen^ 
which  also  belong  to  this  category,  being  produced  by  too  long 
retraction  of  the  said  parts,  and  of  the  abdominal  muscles  in 
general,   along  with  the  spasmus  glottidis,  with    cough   and 
hoarseness,  brought  on  by  reflex  action  into  the  larynx*     That 
very  incorrect  notion  of  calling  by  the  name  of  "chest- tones," 
those  deep  notes  produced  by  strong  depression  of  the  lower 
jaw  and  larynx,  and  "  throat-tones,"  those  in  which  daily  speech 
is  carried  on,  would  be  exploded ;  and  the  comical  production 
and   cultivation  of  the   "falsetto,"   which  may  be    extraordi- 
narily screwed  up  till  about  thirty  years  (and  then,   one  may 
almost  say,  lasts  for  ever),  would  become  better  regulated,  and 
therefore  in  every  way  more  available.   Let  us,  moreover,  reflect 
that  the  great  body  of  singing  masters  are  recruited  from  com- 
pletely invalided  performers,  who,  along  with  their  voice,  have 
lost  the  main  point,  the  power  of  showing  how  to  sing ;  added 
to  this  that  they  are  destitute  of  a  sound  study  of  the  theory 
of  music,  and  that  the  chaste  enthusiasm  of  a  Garcia,  a  Bour- 
doigner,  a  Newa,  a  Panseron,  a  Oentilhuomo,  a  Bank,  is  of  no 
use  to  them,  as  they  educated  and  still  educate  but  a  limited 
class  of  singers  (tenor  and  soprano,  bass  and  treble),  and  these 
again  only  as  long  as  a  healthy  body  is  united  with  a  youthful, 
fresh,  or  unworn  out  voice,  and  all  this  without  immediate  or 


by  Dr.  Kleinert.  261 

perhaps  any  necessity  for  gaining  a  livelihood  by  the  Yoice— 
this  is  a  small  portion  of  the  catalogue  of  their  sins. 

G.  H.,  24  years  old,  a  choleric  excitable  Hungarian,  who, 
with  her  Juno-like  figure  and  extremely  powerful  contralto  Toice, 
at  first  sight  gave  the  impression  of  a  Virago,  suffered  when  I 
first  knew  her  from  fits  of  laughing  and  crying,  which  recurred 
four  to  six  times  a  week,  lasting  from  half-an-hour  to  one  hour, 
and  were  brought  on  through  vexatious  influences,  or  else  through 
brooding  over  the  condition  of  her  affairs,  which  was  at  the 
time  one  of  extreme  depression.     The  first  severe  grievances 
which  she  had  to  endure  in  her  professional  life,  combined  with 
alarm,  danger,  and  want  of  sustenance  (a  combination  of  mis- 
fortanes  which  overtook  her  shortly  after  getting  over  a  typhus 
fever  daring  the  siege  of  Ofen),  had  been  the  exciting  cause, 
whilst  previous  to  that  nature  and  no  anxiety  for  the  future  had 
sufficed  to  cure  all  her  little  ailments.     The  narration  of  these 
ordinary  minutice  in  female  professional  life,  and  that  in  the 
case  of  a  person  otherwise  in  perfect  health,  might  be  consi- 
dered as  rather  superfluous,  and  hardly  worthy  of  notice  in 
the  compass  of  this  history  of  disease,     £ut   though  one  fa- 
miliar with  theatrical  life  might  take  no  notice  of  this  stereo- 
typed category   of  the  hysterics  in  actresses  and  dancers,  it 
would  neither  be  right  nor  advisable  to  venture  to  do  so  in 
the  case  of  female  singers  ;  because  a  spasmus  glottidis,  begin- 
ning with  scarce  perceptible  convulsions  and  contractions,  or 
even   a  laryngitis  spasmodica,  at  the  very  first   catarrhal  or 
moral  afibction,  may  so  easily  trouble  patients  of  this  class, 
at  first  imperceptibly,  but  afterwards  in  a  marked  degree.    A 
combination  with  the  last-mentioned  malady   was  at  all  times 
manifest  in  this  case,  and,  though  not  actually  dominant,  could 
be  detected  by  her  wheezing  breathing  and  by  pressure  on  the 
larynx.     This,  however,  yielded,  even  during  the  continuance 
of  the  moral  influences,  to  a  few  doses  of  Hyoscyamus.  During 
fourteen  months  I  constantly  found  her,  both  in  private  circles 
and  on  the  stage,  in  the  calmest  and  happiest  mood,  but  was 
sorry  to  observe  an  evident  breaking  down  and  woody  sound 
of  her  upper  notes  in  singing ;  yet,  on  account  of  her  excita- 


262  On  Laryngeal  Catarrhs,  dtc. 

bility    imd  vanity,  I  notioed  it  only  in  the  way  of  a  hint    At 
the  end  of  the  fourteen  months  (Feb.  II,    1856)  she  sent  for 
me  on  aocoant  of  a  hoarseness  of  long  standing,   which  had 
been  treated  allopathically    without    benefit.     As    I    already 
knew  that  since  our  first  interview,  she  had  availed  herself  of 
the  instruction    of    an  invalid  singer    as   talentless  as  con- 
ceited, and  had  given  herself  up  to  his  fatiguing  method  in 
characters  and  pieces  far  beyond  the  range  of  her  voice,  I  soon 
suspected  that  the  catarrh  would  have  found  an  ample  harvest- 
field  in  the  exhausted  muscular  parts,  the  excited  nerves  and 
relaxed  mucous  membranes  of  the  larynx,  and  (since  the  short- 
ness of  the  attack  here,  as  in  tuberculosis,  cannot  be  taken  into 
consideration)    already   amounted   to  a  tolerably    established 
affection.     Unhappily,  however,  I  had  to  deal  not  merely  with 
this,  but  also  with  that  gastric  affection  which,  during  severe 
straining  and  retention  of  the  breath  in  singing  and  playing, 
results  from  the  fact  that  the  diaphragm  [stomach]  and  ab- 
dominal muscles  are  forced  into  the  deepest  depression,  and  to 
a  long  continuance  in  this  unnatural  position;  an  affection 
which  manifests  itself  through  gastric  derangements,  and  mostly 
also  draws  into  the  strongest  sympathy  the  branches  of  the  par 
vagum  that  supply  the  larynx.     To  all  this  were  added  stili  the 
previous  fits  of  crying,  along  with  the  clearest  traces  of  laryngitis, 
brought  on  by  the  unfortunate  coincidence  that   the  grand 
rehearsal   of  an  extremely  trying  piece  of  execution  studied 
and  expected  for  more  than  twelve  months,  fell  out  precisely 
at  the  same  time  when  she  felt  indisposed  not  only  from  the 
incipient  hoarseness,  but  also  from  the  monthly  infirmity,  and 
thus  she  bad  got  only  shrugs  of  the  shoulders  and  sneering 
consolations  in  place  of  a  brilliant  reception  !    Fever  had  set  in 
with  violence,  especially  in  the  evening,  whilst  her  nights  were 
marked  by  restless  dreams  and  exhausting  perspirations. 

At  once  a  priori  was  my  mind  made  up  as  to  the  employment 
of  a  remedy  whose  actual  specific  effect  in  such  complications 
had  already  often  surprised  me,  viz.  Cuprum.  Staudigl,  who 
is,  alas,  now  so  unfortunate,  had  to  add  to  his  manifold  excel- 
lences the  fact  that  he  was  not  only  a  devoted  friend  of  homooo- 


by  Dr.  Kleineri.  258 

pathy,  but  also  tolerably  coDversant  with  the  system.  Daring 
his  repeated  residence  at  Leipsic  daring  Easter,  he  drew  my 
attention  to  this  medicine ;  and,  as  its  successful  employment 
was  known  to  me  for  many  years  previous,  especially  in  cases 
of  hooping-cough,  where  the  stomach  itself,  on  slight  pressure^ 
exhibited  the  most  painful  reaction  on  its  own  periphery,  the 
GBsophagus  and  larynx^  I  refused  not  to  take  a  lesson  and  a 
benefit  even  at  the  hands  of  a  layman  ! 

Eight  drops  of  Cuprum  6  in  |  ii.  of  water,  a  teaspoonful  every 
three  hours,  in  this  case  also  assuaged  the  gastric  sufferings^ 
which  had  been  allopathically  combated  in  vain  by  warm  cata- 
plasms and  Hoffman's  anodyne  liquid,  entirely  in  twenty  hours* 
The  larynx,  too,  showed  itself  less  sensitive  to  pressure,  the 
rough  hoarse  cough  was  repeated  at  longer  intervals ;  yet  the 
bosky  voice,  the  suspicious  signs  of  laryngitis  spasmodica,  the 
febrile  reaction,  and  the  fits  of  crying  were  little,  if  at  all,  re- 
lieved. Next  I  gave  Brom.  2,  eight  drops  to  ^  ii.  of  water, 
every  three  hours,  and  ordered  in  the  evening  hours  a  few  doses 
of  Aconite  to  be  interspersed  in  alternation.  I  allowed  her 
returning  appetite  to  be  cautiously  satisfied  with  thin  beef-tea 
for  breakfast,  chicken  for  dinner,  and  for  supper  ale  posset,  in 
which  the  milk  preponderated,  without  any  regard  to  the  still 
existing  feverishness.  Above  all  I  interdicted  visits,  i,  e.  such 
as  might  remind  her  of  her  situation  and  the  previous  events ; 
recommended  cheerful  reading,  and  smuggled  away  the  key  of 
the  piano^  whereby  at  least  in  that  quarter  any  experiment  on 
the  correct  rendering  of  the  tone  was  prevented.  The  next 
morning  gave  indication  of  essential  improvement.  The  fever 
was  found  considerably  on  the  decrease ;  the  cough  inconsider- 
able and  loosening  easily ;  the  breathing  firee  and  without 
any  wheezing  accompaniment.  The  night  perspiration  did 
not  come  on  till  morning,  and  was  even  then  very  trifling. 
Certainly,  late  in  the  evening  of  the  previous  day,  fits  of 
crying  had  again  occurred,  yet  their  duration  was  soon  cut 
short  by  judicious  conversation,  and  the  violent  sobbing 
was  hardly  remarked.  Her  speech  was  sonorous;  and  the 
voice  which  she,  in  spite  of  all  prohibition,  tried  cautiously  to 
give  out,  was,  according  to  her  account^  clear  in  the  middle 


S54  On  Laryngtal  Catarrhs^  <tc,^ 

tones,    bat  a  sensation  as  if  the    larynx   was    still  swollen 
and  enlarged  had   soon  made   her   leave  off  the  experiment. 
Haying  every  reason  to  be  perfectly  contented  with  the  pro- 
gress of  recovery,  I  persevered  exactly  with  the  treatment  and 
remedies  adopted  daily  up  to  this  time,  and  the  next  day  at 
noon  I  had  the  pleasure  of  hearing  the  patient  complain  merely 
of  slight  tickling  in   the  larynx,  with   a  cough  on  drawing 
breath  sharply  with  the  mouth  wide  open  ;  and  of  slight  chilly 
shivering  and  very  rare  occurrence  of  the  crying  fits.     In  order 
to  remove  these  few  remains,  I  gave  Conium  1 5,  two  drops  at 
once;  ordered  one  dose  of  Aconite  to  follow  in  the  evening, 
and  on  the  next  day  one  repetition  of  the  same  medicine  morn- 
ing and  evening.     On  the  10th  of  February  this  lady,  who  had 
been  incapable  of  singing  for  more  than  five  weeks,  was  able  to 
resume  her  activity  on  the  stage. 

In  a  case  very  similar  to  the  preceding  one,  where  the  painful 
irritability  extended  from  the  false  ribs  over  the  liver  and 
stomach,  Yerbascum  and  Ambra  rendered  an  essential  service 
before  t  had  become  better  acquainted  with  Cuprum.  From 
Garduus  marianus,  whose  eminent  powers  in  sufferings  ot  this 
kind  Dr.  FroU,  of  Oastein,  during  his  residence  in  Leipsic, 
could  not  sufficiently  praise,  I  am  sorry  to  say  I  have  seen  no 
beneficial  results. 

S.  B.,  a  concert  singer  from  Prague,  engaged  for  a  course 
of  concerts  in  the  Gewandhaus  at  Leipsic,  had  on  Tuesday, 
November  17,  overheated  herself  at  a  soiree  by  singing,  talking, 
and  dancing;  and,  either  in  returning  or  at  her  hotel,  where  she, 
by  an  oversight,  went  into  a  room  which  had  not  been  aired, 
caught  cold.     On  the  morning  of  the  18th  I  was  earnestly  re- 
quested by  Professor  Moscheles  (to  whom  she  had  been  recom- 
mended, and  who  by  his  invitation  had  unintentionally  been, 
more  or  less,  the  cause  of  her  illness)  to  visit  her  as  speedily  as 
possible,  and  to  employ  all  practicable  means  of  restoration,  or 
at  least  amendment;  inasmuch  as  a  rehearsal  for  a  morning 
performance  had  been  announced  for  eleven  o'clock  that  day, 
and  the  procuring  of  another  singer  not  only  lay  out  of  the  reach 
of  possibility,  but  also  might  be  prejudicial  to  the  professiooBl 
renown  of  a  lady  as  yet  but  little  established  in  the  muffloal 


hy  Dr.  Kleinert.  255 

world.    I  found  this  singerr  who  had  some  little  fever,  and  was 
at  tbe  moment  saffering  from  impeded  utterance  and  cough, 
basy  at  an  employment  which  is  pernicious  to  the  unaccus- 
tomed, as  such,  but  to  invalids  doubly  so,  on  account  of  the 
heat  and  the  moist  disagreeable  atmosphere — ^viz.,  ironing  her 
concert  dresses,  an  object  which,  when  the  party  is  exposed  to 
the  critical  eyes  of  so  many  of  her  own  sex,  even  if  not  dis- 
posed to   vanity,   cannot  be  so  easily  dispensed  with.     The 
gentle  rebukes  which  I  at  once  administered  on  the  subject, 
and  the  fears  which  I  expressed  as  to  her  capability  on  the 
morrow,  she  parried  by  saying  that  she  had  done  all  this  from  a 
kind  of  vegetative  instinct,  and  from  external  stimulus;  inas- 
much as  she  had,  during  a  sleepless  night  (caused  by  the  attack 
of  catarrh  during  menstruation),  clearly  seen  the  impossibility, 
or  at  least  the  risk,  of  her  performance.     After  I  had  removed 
her  fears  in  regard  to  the  danger  to  her  voice,  by  explaining 
that  it  was  QOt  so  much  the  secretion,  which  was  but  a  natural 
function,  as  the  congestion  of  blood  to  the  organs  destined  for 
relief  at  that  period,  which  rendered  it  most  unsuitable  for  a 
violent  strain  of  the  larynx,  but  still  not  absolutely  prejudicial, 
I  asked  her  for  a  history  of  her  sufferings.     Her  voice  was, 
as  above  noticed,  husky ;  the  singing  tones  absolutely  refusing 
to  play  their  part  in  the  higher  notes ;  in  the  middle  ones  soon 
breaking  down  when  slightly  forced,  or  interrupted  by  phlegm. 
Mucous  membrane  of  the  nose  not  irritated,  but  dry  ;  cough,  of 
itself,  slight,  and  with  no  expectoration  ;  but  the  thought  of  it 
and  the  trial  of  a  longer  breath  brings  on  uneasiness  in  the 
larynx  with  tickling  and  then  slight  efforts  at  coughing.     The 
uvula  and  velum  pendulum  palati  (known  to  the  patient  in 
their  normal   condition),   of  rather  brighter  red,   and  more 
relaxed  than    usual;    tonsils   and   posterior    parietes   of   the 
pharynx  normal,  exhibiting  only  mucous  follicles ;  auscultation 
found   the   larynx   and  bronchia  free   from   defect;    head   a 
little   stupified  in  the  morning,  with  now  and  then  a  stitch 
that  was  fugitive    and    easily    endured    (probably   from   the 
ironing) ;  the  skin  towards  morning  covered  with  perspiration, 
which,  though  she  stayed  in  bed  for  it,  caused  no  alleviation  ; 
the  chilly  shivering  of  the  night  infrequent,  and  recurring  in  a 


259  On  Laryngeal  Catarrhs,  Ac, 

degree  hardly  perceptible  to  others ;  pulse  accelerated,  pretty 
fall;  respiratioo  rather  more  hurried,  and  the  chest  heaving 
with  frequent  sighs;  feelings,  as  before  noticed,  depressed; 
otherwise  everything  normal.  Without  paying  any  further 
regard  to  the  menstruation,  I  ordered  the  administration,  at 
half-past  nine,  of  Causticum  9,  two  drops,  and  at  eleven  allowed 
the  patient  to  go,  well  wrapped  up,  to  the  jehearsal,  with  a 
positive  order,  however,  that  she  should  merely  mark  the  music. 
After  the  rehearsal  I  ordered  her  to  take  light  but  nourishing 
food,  and  then  to  lie  down.  She  had  lain  down  at  half-past 
one;  at  three  I  interrupted  this  pretty  sound  sleep,  repeated 
the  Causticum,  stipulated  for  rest,  strict  silence,  and  a  repetition 
of  the  medicine  about  six  p.m. 

About  seven  p.m.,  as  I  immediately  observed  from  her  speech 
an  evident  abatement  of  the  catarrhal  irritation,  although  the 
fever  presented  some  little  exacerbation,  and  the  skin  only  a 
little  moistened,  I  set  aside  the  first  medicine,  and  ordered 
Aconite  6,  two  drops  at  eight  and  again  at  ten,  whose  well- 
known  sudorific  effects  I  ordered  to  be  reinforced  by  hot  milk 
and  water,  half  and  half. 

The  night,  uninterrupted  by  disturbing  thoughts  or  dreams, 
passed  off  with  slight  perspiration.     By  the  account  of  the 
nurse,  who  kept  up  the  fire  and  a  gradual  current  of  steam 
firom  boiling  water,  the  fits  of  coughing  came   on   seldoffl> 
and  without  further  disturbing  the  patient.     The  speech  was 
clear,  the  head  free,  the  position  and  colour  of  the  velum  pen- 
dulum had  returned  to  their  normal  condition.     Notwithstand- 
ing these  favourable  results,  I  ordered  her  to  stay  in  bed  the 
forenoon,   and  to   avoid  experiments  on  the  capability  and 
fluency  of  her  voice.     To  promote  the  clearing  of  the  tone, 
I  advised  her  to  take  two  drops  of  Selenium  6  at  nine  A.H* 
and  at  three  p.m. 

In  the  evening  she  sang  to  the  astonishment  of  the  orches- 
tra, knew  how  to  separate  well  the  fictitious  and  real  hoarseness, 
and  had  already  prepared  herself  for  supernumerary  work,  with 
a  voice  as  clear  as  a  bell;  at  first  trembling  slightly  frosi 
anxiety^  but  afterwards  strong  and  pure. 

Dr.  G.  L.,  a  schoolmaster,  in  his  60th  year,  of  robust  hot 


by  Dr.  Kleitiert.  257 

not  oyer-deyeloped  bodily  frame,  who  neither  smoked  nor  took 
snuff,  married  twice,  and  each  time  to  a  bazom  lively  wife  (the 
last  still  living),  after  having  for  more  than  twenty  years  per- 
formed the  arduous  duties  of  his  calling  without  any  phonetic 
impediment,  was  in  the  autumn,  |856,  suddenly  seized  with 
hoarseness  after  an  insignificant  cold.  Be  it  remarked,  at  the 
ontset,  that  neither  auscultation  nor  percussion,  either  at  the 
commencement  or  in  the  subsequent  course  of  this  extremely 
obstinate  case,  indicated  any  changes  calculated  to  awaken 
actual  anxiety,  and  that  the  patient,  being  blindly  devoted  to 
homoeopathy,  persevered  in  the  most  exemplary  attention  to 
all  prescriptions  during  the  space  of  twelve  months.  The 
hoarseness  disappeared  aft.er  the  exhibition  pro  re  natd  of 
Hepar  aulph.,  Drosera,  Puis.,  Acid,  nitr.,  Bryon.,  Phosph. 
The  hoarseness  had  been  combined  with  scarcely  a  per* 
ceptible  inclination  to  cough,  but  always  with  a  sore  sensa- 
tion in  the  throat,  and  the  symptom  described  by  the  patient 
as  follows :  "  I  feel  that  I  am  talking,  and  that  I  have  a  larynx, 
without  feeling  actual  pain  there.'*  It  returned  constantly 
during  east  wind ;  and  besides,  whenever  the  patient  was  ex- 
posed^ after  long  and  animated  speaking,  to  gusts  of  wind^ 
showers  of  rain,  or  wet  feet.  It  continued  generally  for  four 
to  six  days,  setting  in  oftener  in  winter  and  spring;  whilst 
in  summer  when  he  used  to  go  through  a  milk-cure,  and  enjoyed 
perfect  rest  for  four  weeks,  he  had  but  three  or  four  transient 
attacks.  It  also  deserves  notice,  that  when  once  the  bronchia 
were  drawn  into  sympathetic  action,  which  only  happened  twice, 
the  consciousness  of  possessing  a  morbidly  irritated  larynx 
ceased  for  a  short  time ;  but  that,  nevertheless,  we  could  not 
expect  a  crisis,  or  rather  a  lysis,  from  an  increase  of  loose  and 
coloured  expectoration,  because  that  extremely  trifling  sputum 
that  was  removed  from  the  glottis  by  hawking  (generally  in  the 
morning  or  in  the  day  when  the  voice  was  weak  even  to  ex- 
tinction) remained  always  the  same  The  expectoration  always 
remained  in  its  usual  quantity  and  quality  (saliva  with  little  lumps 
of  the  size  of  groats,  viscous,  and  exhibiting,  as  it  were,  fibres 
like  wool) ;  streaks  of  blood  did  not  appear  even  with  the  greatest 
increase  of  the  disease  or  the  most  violent  exercise.    Still,  be  it 

VOL.   XX.,   NO.   LXXX. — APRIL,    1862.  B 


858  On  Laryngeal  Catarrhs,  dbc.^ 

obsorved,  that  Lach.  never  did  good,   bat   Phos.  effected  the 
most  rapid  and  solid  curative  results. 

In  autumn,  October  11,1 867,  after  having  for  nine  weeks 
had  to  congratulate  himself  on  unimpeded  speech  and  a  com- 
plete removal  of  the  tickh'i)g  irritation,   he   once  more  had  to 
claim  medical  assistance.   Unhappily,  a  few  days  before  a  change 
had  taken  place  in  the  whole  physical  and  mental  condition  of 
the  patient,  through  an  extremely  severe  mortification,  which 
immediately  affected  his  professional  career-  and  his  pecuniary 
means ;  and  had  fastened  on  a  body,  in  itself  qaite  strong  and 
full-blooded,  the  most  marked  nervous  weakness  and  excita- 
bility, associated  with  fear  of  death  and  other  hypochondriac 
and  melancholic  symptoms.     The  form  of  disease  present  at  this 
time  was  as  follows: — Attitude  of  the  body  drooping;  com- 
plexion  pale;  eyes  restless,   easily   excited   to    weeping,   and 
unable  to  fix  on  the  person  speaking  to  him  ;  hands  trembb'ng, 
their  skin  perspiring  and  clammy;  occasional  headache  and 
rushing  in  the  ears ;  appetite  small  and  satisfied  mecbaDioally ; 
thirst  small,  generally  in  the  evening,  and  then  only  to  supply 
moisture  to  the  larynx ;  stool  hard ;  night  restless  from  dis- 
turbance of  thought,  unrefreshing,  and  towards  morning,  an 
offensive  perspiration;   urine  scanty,  clear  as  water;   speech 
trembling,  querulous,  husky,  cleared  by  voluntary  (often   in- 
voluntary) scraping  and  dry  fits  of  coughing ;  phlegm  sweet- 
ish ;  the  larynx  had  a  feel  as  if  swollen  and  enlarged ;  the 
thorax  oppressed  with  a  sensation  as  if  something  hindered  the 
exit  of  the  breath  in  coughing  and  speaking ;  the  tickling  and 
scraping  early  in  the  morning  on  rising,  and  most  severe  when 
lying  on  the  left  side. 

Although  under  the  existing  symptoms  Ipec,  China,  Pals., 
Dros.  and  Stannum  were  most  strongly  indicated ;  still  I  gave 
Ignatia  12  in  order  as  soon  and  as  energetically  as  possible  to 
obviate  the  depression  of  his  spirits,  without,  however,  neglect- 
ing the  malady  of  the  larynx.  The  exceedingly  favourable 
operation  of  this  medicine  declared  itself  from  day  to  day  so 
strikingly  that,  even  by  the  lith  of  October,  after  repeated 
accurate  examination  of  the  patient,  and  after  previous  consul- 
tation with  the  family   (who  by  the  most  careful  observation 


Ig  Dr.  Kleitiert.  259 

had  had  opportunity  to  notice  the  most  striking  amendment  as 
to  spirits  and  way  of  speaking)  ^  we  could  proceed  again  to  the 
remedy  which  had  been  to  him  a  true  panacea — viz.  Phos.  J  2. 
The  result  exhibited  at  tbe  end  of  a  week,  after  three  doses  per 
day,  justified  my  confidence  as  well  as  my  choice.  From  Oct. 
21  he  took,  with  a  carefully  selected  strengthening  diet,  a  dose 
of  China  30  every  evening,  not  so  much  with  regard  to  the 
state  of  his  organs  of  speech,  which  were  restored  to  their  normal 
condition  (t.  e.  still  slightly  irritable,  yet  quite  available  for  his 
vocation),  as  to  act  alteratively  on  his  enfeebled  general  con- 
dition ;  and  on  the  1st  of  November  we  had  the  pleasure  and 
satisfaction,  after  he  had  passed  several  days  of  nine  hours 
energetic  teaching  in  the  school  (which  he  had  not  given  up 
even  on  the  anxious  days  of  October  11  and  12),  of  hearing 
him  complain  no  more  of  fatigue,  still  less  of  huskiness. 
The  winter,  which,  especially  at  Leipsic,  is  so  pernicious  on 
account  of  prevailing  east  winds,  passed  without  any  more 
serious  effect  on  him,  and  nothiug  but  the  urgent  recommenda- 
tion of  Dr.  Haubold  could  induce  the  patient  to  give  himself 
a  longer  respite  than  the  usual  Midsummer  four  weeks  holi- 
days for  a  tour  of  recreatiou.  Although  two  years  ago  he 
celebrated  the  semi- Jubilee  of  his  professional  career,  he  de- 
clared this  prolonged  absence  to  be  a  flagrant  sin  against  the 
duties  of  his  vocation. 

In  two  cases  where  the  circumstances  were  somewhat  similar 
to  the  above  case,  but  where  the  patients  were  hysterical  females^ 
I  saw  in  Haubold's  practice  as  surprisingly  favourable  re* 
suits  produced  by  the  administration  of  Platina,  as  in  the 
above  case,  by  Ignatia.  One  cannot  be  cautious  enough  in 
giving  Eupion  in  stronger  doses,  and  such,  as  to  this  particu- 
lar medicine,  I  should  reckon  even  the  12th  potency.  In  two 
cases  of  phthisis  laryugea,  where  alteration  of  the  voice  took 
place  without  complete  hoarseness,  I  saw  the  hoarseness  com- 
mence after  Eupion  9,  and  persist  to  the  end  of  the  patient's 
life. 

C.  H.,  84  years  old,  a  wealthy  master  tinman,  of  exuberant 
health  from  infancy,  and  notwithstanding  a  wild  bachelor  life, 
never  affected  with  any  venereal  disorder,  was,  in  November  1 857, 

R  2 


260  On  Laryngeal  Catarrhs,  dc, 

attacked  with  hoarseness,  which  neither  at  first,  nor  during  the 
whole  course  of  the  illness,  was  attended  by  alterations  in  the 
fauces  or  hronchia.  He  could  call  to  mind  no  actual  cause, 
and  only  suspected  that  it  set  in  from  an  incautious  inspiration 
of  the  prevalent  east  wind  to  which  he  had  been  exposed  hy 
standing  a  long  time  in  the  street,  after  working  at  the  blow- 
pipe in  his  hot  workshop  more  than  two  hours.  The  chemicals 
connected  with  this  process  were  not  to  blame. 

After  he  had  for  more  than  seven  weeks  of  allopathic  treat- 
ment, gone  through  the  whole  course,  even  to  the  blowing  m 
of  Lunar  caustic,  he  turned  to  homoeopathy ;  and  on  Decem- 
ber 11,  because  the  larynx  felt  swollen,  with  short  fits  of  cough- 
ing, and  the  tickling  which  prevailed  in  the  morning  turned 
into  scraping  in  the  evening,  he  got  Laurocerasus  9.  The 
short  triumph  which  this  medicine  gave,  so  far  that  the  patient 
could  speak  clearly  on  the  morning  of  December  13,  disap- 
peared again  by  noon,  and  the  same  treatment  was  repeated 
on  the  14th  and  15th. 

With  the  general  orders  not  to  stand  still  nor  to  talk  in  the 
street,  on  account  of  the  prevalent  east  wind,  to  v^ear  a  shawl 
constantly  over  the  mouth  in  the  open  air,  to  go  home  in  good 
time,  and  not  to  smoke  at  all,  he  took  Selenium  6.  Results  on 
the  16th  and  17th,  no  favourable  change. 

From  the  18th  to  the  21st  he  kept  in  doors,  and  took  two 
drops  of  Mang.  acet.  6,  every  four  hours.  Besides,  poultices 
of  pretty  hot  oatmeal  porridge  were  put  over  the  larynx  every 
two  hours. 

The  highly  satisfactory  state  observed  on  the  morning  of  the 
22nd  changed  after  he  went  out  at  noon,  the  evil  returning  to 
its  previous  extent.  In  the  evening,  during  long  and  animated 
conversation,  his  speech  was  clearer  (the  contrary  from  formerly)* 
occasional,  not  inordinate  hawking,  brought  up  paste-like  phlegm, 
which,  when  on  the  handkerchief,  after  the  surrounding  saliva 
soaked  into  the  linen,  showed  a  dingy  bit  of  jelly,  of  the  size 
of  a  small  shot. 

For  this  he  took  on  the  23rd  and  24th  two  grains  per  day  of 
Stannum  8.  The  results  were  no  more  lasting  than  before, 
inasmuch  as  the  inspiration  of  the  east  wind  brought  on  aU  the 


hy  Dr.  Kleinert.  261 

previous  sufferings  afresh,  however  well  he  might  have  been  in 
the  morning.  As  the  patient,  who  had  treated  the  whole  illness 
with  a  certain  amount  of  levity,  could  not  be  persuaded  to  carry 
out  the  treatment  through  the  Christmas  holidays,  I  refrained 
firom  exhibiting  any  medicine,  as  I  was  informed  and  knew 
that  be  had  already,  even  on  common  working  days,  often  broken 
his  parole  as  to  the  prescribed  diet. 

On  the  28th  he  came  to  me  hoarser  than  ever,  but  also  more 
anxious.  All  his  relatives  and  friends,  and  amongst  them  an  allo- 
pathic doctor,  who  happened  to  be  present,  had  put  him  into 
an  infernal  stew,  pictured  to  him  the  prospect  of  consumption 
with  the  richest  rhetorical  embellishments,  and,  above  all  things, 
had  made  the  immediate  acquisition  of  a  respirator  a  positive 
duty. 

Under  existing  circumstances,  I  considered  it  my  duty  to 
conceal  my  own  chagrin  behind  an  assumed  levity  on  my  part. 
First  of  all,  I  prohibited  the  respirator,  whilst  I  called  his 
attention — as  he  plumed  himself  on  his  chemical  knowledge 
— to  the  ozone  formation  that  went  on  behind  its  wires,  and 
told  him  this  thick  and  warm  kind  of  atmosphere,  like  that 
common  in  cow  houses,  might  be  of  use  in  tuberculosis, 
but  was  evidently  dangerous  with  his  apoplectic  habit  of  body, 
his  tendency  to  embonpoint,  and  his  shortness  of  breath.  Here- 
upon I  stipulated  for  three  days  confinement  to  his  room, 
attaching  thereto  strong  promises  of  amendment,  and  ordered 
during  this  period  four  grains  of  Merc,  solub.  8,  every  morning 
and  a  four-grain  lozenge  of  Saccharum  lactis,  impregnated  with 
two  drops  of  Acid,  nitr.,  every  evening.  This  rapid  succession 
of  an  antidote  will  make  some  homceopathists  shake  their  heads 
And  scold.  Bepeated  observations,  however,  which  I  made 
with  these  very  medicines,  in  a  case  where,  notwithstanding  the 
assurances  and  protestations  of  the  patient,  I  believed  I  ascer- 
tained a  syphilitic  condition  not  yet  in  the  pronounced  form 
of  "secondary  symptoms,"  taught  me  the  value  of  this 
method. 

And  so  it  happened  in  this  case.  On  the  2nd  of  January,  I 
had  the  pleasure  of  hearing  his  voice  sound  once  more  in  its 
original,  somewhat  thick  (fett),  but  clear  fashion.     All  other 


262  On  Laryngeal  Catarrhs,  dtc, 

morbid  symptoms  had  given  place  to  the  previous  normal  con- 
dition of  health.  He  had  permission,  notwithstanding  pretty 
rough  weather  and  east  wind,  to  go  out. 

On  the  morning  of  January  3  he  informed  me,  with  a  coua- 
tenance  beaming  with  joy,  that  he  had  the  evening  before  Iain 
down  free  from  all  traces  of  his  former  illness,  and  had,  a  short 
time  before,  got  out  of  bed  equally  so.  Under  these  circum- 
stances, I  prescribed  a  repetition  of  the  aforesaid  medicines 
every  second  day,  and  on  the  10th  released  him  from  treatment, 
perfectly  cured. 

Opponents  of  homoeopathy,  especially  some  well-known  adhe- 
rents of  the  new  physiological  school,  allege  that  the  excessively 
strict  diet  is  the  real  agent  in  homoeopathy.  They  take  great 
pleasure  (hard  and  painful  as  it  must  be  to  them)  in  enumerating 
the  advantages  which  our  system  apparently  enjoys  from  the  fact 
that  it  is  chiefly  the  wealthy  and^intelligent  classes  of  society  who 
avail  themselves  of  it;  and  they  know  how  to  expand,  after  the 
fashion  of  goldbeaters,  the  benefits  that  are  all  included  in 
the  simple  word  "nursing"  (Ffiege),  to  such  a  degree  that 
our  remedies,  always  spoken  of  as  infinitesimal  nothings, 
completely  vanish  from  the  view.  Cases,  then,  which  exhibit 
the  value  of  that  curative  principle  which  is  never — at  least 
never  candidly — interpreted  by  our  adversaries,  "similia  simili- 
bus;"  cases  which,  besides  this,  clearly  prove  that  for  the  resto- 
ration of  the  disturbed  equilibrium  of  the  human  body,  there 
is  as  little  need  of  ounces  and  pounds  as  for  that  of  a  well- 
adjusted  balance;  cases,  in  short,  which  weaken  the  above- 
named  main  lever  of  the  opponents,  can  never  be  sufficiently 
published.  May,  then,  the  following  cases  taken  from  the  re- 
ports of  the  Leipsic  Dispensary,  cases  where  not  only  these 
auxiliary  means,  "diet  and  nursing"  were,  necessarily,  most 
particularly  wanting,  but  where  also,  the  steady  continuance 
of  positive  material  causes  stood  in  the  way  as  a  grand  hin- 
drance to  the  cure — may  these,  I  say,  contribute  to  combat 
these  prejudices. 

Franz  Sattler,  aged  87,  carpenter  and  crier  at  the  Mechanical 
Theatre  of  Floutiaux  fibres,  from  Paris.  [Mens  List,  No.  627.] 

The  muscular,  plethoric   patient   presented   himself  during 


ly  Dr.  Kleinert.  263 

the  Autumn  Fair,  October  25,  1854,  to  bespeak  our  assistance 
for  cough  and  a  hoarseness,  ^hich  nearly  amounted  to  aphonia. 
According  to  bis  description,  he  had  previously^  yet  never  so 
Yiolently  as  now,  had  several  attacks  of  hoarseness^  particularly 
when  he  had  tried  to  neutralize  the  fatigue  and  discomfort 
of  his  employment  in  wet^  stormy  weather^  by  the  use  of 
spirituous  liquors  (as  was  the  case  this  time).  On  close 
examinaUon  of  the  mouth  and  pharynx,  nothing  striking  was 
disGOYcred.  The  pricking,  burning  pain  over  the  whole 
larynx  was  aggravated  by  pressure  on  the  ligamentum  crico- 
thyroideum,  and  by  attempting  to  swallow.  The  dry  cough, 
during  which  neither  the  thorax  nor  diaphragm  suffered, 
sounded  metallic  and  whistling.  That  the  chordes  yoccdes  took 
an  active  part  in  the  inflammation  was  betokened  by  a  peculiar 
whistling  on  inspiration.  Percussion  and  auscultation  exhi- 
bited no  striking  phenomena,  further  than  that  at  the  part- 
ing of  the  bronchia  a  very  slight  rale  could  be  noticed.  Fever 
slight.  Pulse  rather  accelerated,  strong,  but  neither  hard  nor 
tense. 

He  took  Carb.  veg.  6,  five  drops  every  four  hours.  As  for 
the  customary  regulations  respecting  diet  and  nursing,  he  spoke 
out  candidly  that  he  coald  not  observe  them,  as  his  extremely 
limited  means  of  subsistence  neither  permitted  him  to  neglect 
his  business,  nor  allowed  him,  as  a  stranger  in  the  town,  any 
domestic  comforts.  To  the  objection  that  he  would  thereby 
be  prolonging  and  aggravating  his  sufferings,  he  replied  by  a 
sorrowful  shrug  of  the  shoulders,  and  promised  to  avoid,  as 
far  as  possible,  loud  speaking,  drinking,  and  letting  off  fire- 
works, and  Bengal  fire.  From  private  inquiries  we  learnt  that 
he  had,  notwithstanding  these  promises,  been  at  work  in  all 
these  occupations,  and  moreover,  in  continued  bad  weather. 

October  28th,  he  made  his  appearance,  without  fever,  with 
slighter  cough,  somewhat  clearer,  more  articulate  speech,  and 
calmer  mien.  After  some  gentle  reproaches,  against  which  he 
protested  on  the  ground  that  he  was  already  three-parts  cured, 
he  once  more  got  the  same  medicine  to  take  three  times  a  day. 
On  November  2nd  he  could  be  entered  on  the  list  as  cured, 
for  his  voice  was  clear  and  the  cough  removed. 


264  On  Laryngeal  Catarrhs,  tfc, 

Johanna  Brandt,  84  years  old,  hawking  pedlar.     [Womens' 
list,  No.  14.] 

With  this  name  presented  herself,  on  January  4,  1854,  a  per- 
sonage well  known  in  the  town,  given  to  excess  of  every 
kind,  and,  in  fact,  an  old  acquaintance  of  our  Dispensary, 
hecanse  she  (1),  after  residing  for  a  year  and  a  half  in  America, 
was  not  at  once  willing  again  to  attend  the  allopathic  Hos- 
pital, which  she  knew  to  her  heart's  content;  and  (2),  because 
in  New  York,  as  well  as  in  Leipsic,  she  had  got  to  hear  much 
that  was  fayourable  about  homcsopathy. 

The  patient  was  affected  with  the  most  marked  emphysema, 
partly  in  consequence  of  her  irregular,  fatiguing  trade,  partly 
through  hard  drinking,  lastly,  in  all  probability  from   cica- 
trized constriction  of  the  larynx.     She  complained  in  a  voice 
thoroughly  hoarse  (and  now  and  then  interrupted  by  single, 
crowing  tones,  or  fits  of  coughing),  of  a  constantly  increasing 
hoarseness  of  her  already  husky  and  cracked  voice,  in   conse- 
quence of  uncommonly  stormy  weather.     To  this  was  joined  a 
cough,  especially  in  the  morning,  very  noisy,  and  attended  with 
retching,  and  a  viscid  sputum,  hard  to  be  detached;    sharp 
pricking  and  burning  in  the  larynx,  amounting,  especially  in 
the  evening,  to  intolerable  pain,  but  which,  even  in  the  day 
time,  never  quite  abated,  during  the  shouting  ahd  chaffering 
necessary  to  her  trade ;  moreover,  a  sensation  of  throttling  in 
the  larynx,  and  chilly  shivering.     As  the  posterior  and  deeper 
parts  of  the  pharynx  bore  the  most  infallible  marks  of  former 
infection,  and  she  herself  made  no  secret  of  it,  she  got  (with 
special  'reference  to  the  mercury  which  had  most  certainly  been 
employed  unsparingly),  the  second  decimal  trituration  of  Hepar 
sulph.,  two  grains  every  four  hours.     She  promised,  as  all  the 
patients  do,  as  a  rule,  to  attend  to  diet  and  regimen ;  but  for  all 
that  was  observed   that  same  evening,  and  likewise  on  the 
second  and  third,  actively  employed  in  her  rough  business,  and 
that  too,  in  the  roughest  weather. 

On  the  7th  of  January  she  was  received,  on  her  re- appear- 
ance, with  pretty  strong  animadversions.  When,  however,  we 
heard  her  grounds  of  exculpation,  founded  on  real  poverty, 
when  we  learnt  that  she  never  came  home  before  eleven,  and 


by  Dr.  Kieineri.  265 

then  wet  through,  and  that,  daring  the  New  Year's  fair,  she 

had  no  other  dwelling-place  than  a  cold,  draughty  ground  floor, 

no  other  hed  than  straw,  which  she  left  as  early  as  four  a.m., 

just  as  tired  as  she  lay  down ;  when  she  recounted  all  this  in  a 

clearer  voice,  more  free  from  cough,  and  thanked  us  for  our 

valuable  services,  which  had  enabled  her  to  breathe  more  freely 

at  night,  and  removed  the  shivering,   then  we,  moved  by  a 

mingled  feeling  of  sorrow  and  joy,  refrained  from  any  further 

admonitions.    Though  her  condition  was  much  improved,  yet 

it  was  far  from  being  entirely  cured;    on  the  contrary,  she 

had    of  late   expectorated  little  blood-streaked    particles    of 

phlegm,   by  coughing  in  the  morning;   and  in  the   evening 

had  again  to  complain  of  repeated  failure  of  voice.     She  now 

took  five  drops  of  Nitric  acid  three  times  a  day.     After  three 

days  she  presented  herself  again,  and  asked  for  her  discharge 

as  perfectly  cured,  and  able  to  work,  but  at  the  same  time  also, 

for  permission  to  claim  our  kindness  and  skill  again  in  the 

summer,  when  she  should  be  able  to  take  more  care  of  herself, 

and  that  without  sacrifice  of  business,  and  could  consequently 

hope  for  a  surer  relief  from  her  difficulty  of  breathing  and  her 

husky  voice. 

Ferdinand  J&nich,  38  years  old,  a  discharged  soldier  and 
letter  carrier.     [Mens*  List,  No.  53 J.] 

The  patient,  who,  furnished  with  uniform  and  letter  bag, 
begged  for  admission  before  his  turn,  because  his  business 
admitted  of  no  loss  of  time,  had  been  compelled  to  inordi- 
nate efibrts,  hurry,  and  neglect  of  his  health,  in  consequence 
of  the  illness  of  a  colleague.  Having  been  wet  through  and 
through,  by  two  showers  on  the  selfsame  day,  this  otherwise 
hearty  man  had  observed,  late  that  evening,  a  roughness  in 
the  throat  and  chest,  constriction  in  the  pharynx,  and  a  dull 
pressure  affecting  the  eustachian  tubes  on  each  side,  to  which 
had  been  added  a  swollen  sensation  in  the  nose  and  the  first 
traces  of  hoarseness*  A  foot  bath  and  sudorific  medicines  had 
indeed  brought  some  alleviation  the  next  morning,  but,  unhap- 
pily, this  had  not  been  permanent.  His  sufferings,  notwith- 
standing the  varied  employment  of  expectorant,  sudorific,  and 
epispastic  medicines,  had  so  increased,  that  on  August  I4thj 


266  On  Laryngeal  Catarrhs^  dbc. 

1854,  he  was  obliged  to  demand  oar  aid.     What  appeared  from 
examination  of  the  cayity  of  the  pharynx,  and  from   palpa* 
tion,   was  as   follows  : — Reddened    uvula   and    velum  pendu- 
lum, tonsils  a  good  deal  enlarged,  yet  no  difficalty  of  swallow- 
ing.    All  these  parts  were  proportionately  dry  and  streaked. 
Pricking,  burning  pain  over  the  whole  larynx,  increased  by 
pressure  on  the  crico-thyroid  ligament  and  by  trying  to  swal- 
low. Early  in  the  morning  his  food  regurgitated  partly  through 
the  nose,  partly  through  the  mouth,  a  proof  that  the  glottis  and 
epiglottis  had   also   shared  in  the  inflammation.     The  voice 
altered  and  whistling.     Cough  purely  laryngeal,  with  a  little 
gelatinous  phlegm  thrown  up  with  difficulty.     Fever  of  syno- 
chal  character.     The  patient,  who  at  once  gave  notice  that  to 
give  up  his  employment  at  that  moment  was  absolutely  impos- 
Bible,  had  Merc.  sol.  2,  in   eight  powders,  one   to  be  taken 
every  four  hours,  besides  Aeon.  6,  five  drops  of  which  were  to 
be  taken  before  going  to  sleep.    In  addition,  a  warm  moist  oat- 
meal poultice  was  ordered  during  the  first  hours  of  the  oight,  or 
if  it  could  be  done,  he  was  to  lay  a  hot  slice  of  bacon,  three 
inches  long  and  two  wide,  on  the  larynx. 

August  1 7th  he  again  showed  himself,  to  announce  a  striking 
alleviation  of  his  sufierings.     Undoubtedly  the  pharynx,  in  all 
parts  accessible  to  the  sight  by  the  aid  of  pressure  with  the 
spatula,  showed  itself  relieved  from  inflammation,  the  larynx 
free  from  pain  during  swallowing,  pressure,  and  displacement; 
but  neither  the  patient  nor  we  could  be  satisfied  with  the  tone 
of  the  voice,  which  still  continued  rough  and  impeded  by  accu- 
mulations of  phlegm,  which,  however,  were  easily  loosened, 
especially  in  the  intervals  of  rest,  after  violent  exertion  from 
running  up  stairs,  talking  and  laughing.     The  fever  was  en- 
tirely removed.     Argentum  and  Mangan.  acet.  were  indicated 
to  remove  these  remaining  symptoms.    We  selected  the  latter, 
because  it  was  manifest  to  the  patient  himself  that  the  sharp, 
changeable  weather  of  the  past  days,  caused  alternate  aggrava- 
tion and  amendment  in  the   patient's   symptoms,  and  Man- 
ganum  has  this  amongst  its  symptoms.     On  the  21st  he  could 
be  described  completely  cured. 
.  Observation. — Of  the  remedy  mentioned  by  Elb  in  No.  liii.  6, 


Analysis  of  Lights  dc.  267 

of  the  AUg,  Horn,  Zeiiung,  Hemiania,  for  the  laryngeal  disor- 
ders of  Ynni  instrament  players,  and  Erysimum  vulgare  for 
hoarseness  in  singers,  there  are  no  fresh  notices.  No  more  are 
there  of  the  Tr.  of  Lactuca  virosa,  which  Altschul  mentions  as 
prescribed  by  Carus  in  his  Handbook,  under  '*  hoarseness." 

NoTB  — The  scale  of  dilution  is  not  mentioned  by  Dr.  Kleinert, 
but  we  presume  it  was  the  decimal,  as  that  is  most  common  in 
Leipsic. — [Eds.] 

INFINITESIMAL  DOSES  AND  BUNSENS 

DISCOVERY.* 

By  Dr.  Ch.  Ozanam. 

I. 

The  scientific  world  is  at  this  moment  occupied  with  a  great 
discovery.  Germany  is  its  birth-place;  and  France  has  suffered 
herself  to  be  distanced  in  a  noble  race.  This  discovery  might 
justly  be  entitled  the  language  of  light ;  its  scientific  name  is 
Optochemistry  or  spectral  analysis.  We  shall  attempt  to  give  an 
account  of  it,  by  analysing  the  translation  which  M.  Bodolphe 
Radan  has  given  of  it  in  Quesnevilles  Moniteur  Scientifique 
(August  and  September),  and  M.  Grandeau  in  the  Annates  de 
Chimie  et  de  Physique  (August,  1861). 

Two  savans  of  Heidelberg,  Bunsen  the  chemist,  the  inventor 
of  the  charcoal  pile,  and  Kirchoff,  professor  of  natural 
philosophy,  are  the  authors  of  this  new  discovery.  But,  as  is 
the  case  with  many  discoveries,  they  found  the  soil  already 
prepared  by  their  predecessors.  A  short  sketch  will  shew  the 
part  played  by  each,  and  will  render  the  subject  more  intel- 
ligible. Every  one  knows  that,  when  a  ray  of  the  sun  is  re- 
ceived on  a  prism  in  a  dark  room,  the  light  expands  like  a 
fan,  and  forms  a  rainbow  with  seven  colours,  which  goes  by  the 
name  of  the  solar  spectrum.  Now,  if  you  notice  the  solar 
spectrum  attentively,  you  will  see  it  scored  by  a  multitude  of 
lines,  some  dark,  others  bright,  always  situated  at  the  same 
spots.     These  are  "  Frauenhofer  s  lines,"  named  after  the  sci« 

*  From  VAri  Medical,  January,  1S62,  page  60. 


268  On  InftniteBimal  Doses, 

entifio  optician  of  Manioh,  who  discovered  them.  He  studied 
them  carefully,  and  distinguished  the  eight  principal  groups 
hy  the  eight  jQrst  letters  of  the  alphabet,  for  the  conyenience  of 
indicating  them.  At  first  he  made  out  600,  hat  afterwards 
Brewster  was  able  to  count  2000,  having  sharpened,  they  say, 
his  vision  hy  ammoniacal  gas,  which  dissolves  the  mucus 
spread  over  the  surface  of  the  eye. 

But  the  sun  is  not  singular  in  giving  an  iridescent  spectrum : 
every  light,  every  star,  is  also  able  to  give  one.     Now,  whilst 
the  moon,  luminous  clouds,  and  the  planets,  which  like  mirrors 
reflect  the  sun  s  light  to  us,  give  the  same  spectral  lines  as 
that  brilliant  luminary,  each  fixed  star  affects  a  characteristic 
mode  of  arrangement  in  the  disposition  of  its  h'nes.     The  dark 
line  D  is  wanting  in  the  yellow  of  the  spectrum  of  Sirius;  the 
star  Pollux  has  only  very  feeble  ones.     Each   of  these  lights 
then  differs  from  that  of  the  sun  ;  and  this  difference,  as  we  shall 
soon  see,  evidences  in  the  constitution  of  those  worlds  a  distinct 
elementary  composition  in  each  star.     Brewster  soon  foond 
that  artificial  flames  emit  rays  of  determinate  colours.     Talbot, 
in  1826  and  1834,  satisfied  himself  that  light  emanating  from 
a  solid  or  liquid  body  (molten  metal  for  instance)   gives  a 
complete  spectrum ;  whikt  gases  in  a  state  of  incandescence, 
or  volatilized  metals,  give  one  whose  colors  are  traversed  by 
dark  lines,  which  may  serve  as  analytical  indices.     In  18S6 
Wheatstone  studied  the  spectrum  of  the  electric  light ;  Yander- 
Willigen  made  a  drawing  of  it.    Flucker  did  as  much  tor  the 
electric  tubes  of  Oeissler,  extolled  at  the  present  day  by  M* 
Fonssagrives,  as  a  means  of  illustrating  the  deep  cavities  of  our 
economy. 

The  Scotch  physician  Swan  explained  the  habitual  appear- 
ance of  the  yellow  line,  by  the  almost  constant  presence  of 
chloride  of  sodium  in  our  atmosphere.  Angstrom  and  Stockes 
in  1855  came  nearer  to  the  truth,  establishing  themselves  on 
that  principle  of  Euler,  that  '*  if  a  body  absorbs  the  series  of 
vibrations  which  it  can  execute  itself,  it  follows  that  the  same 
body,  heated  till  it  becomes  luminous,  ought  to  emit  the  same 
rays  which  it  absorbs  at  the  ordinary  temperature." 

Professor  •  Thompson  ascertained  after  Stockes  and  Milldf> 


and  their  Analysis  of  Light.  209 

the  presence  of  Tapoar  of  soda  in  tbe  sun's  atmosphere.    For 
bemg  dark  for  the  yellow  ray  D,  that  vapour  prevents  their 
penetrating  the  sun's   atmosphere,  and  causes  a  dark  line  in 
their   place.     Lastly,  the  Ahb6  Moigno,  in  his  Bepertory  of 
Modem  Optics,  had  already  hinted  the  possibility  of  a  general 
method  of  spectral  analysis.     See  what  he  wrote  in  1850, 
"  With  a  little  experience  we  shall  succeed  in  making,  by  the 
ohservation  of  the  lines,  an  analysis,  if  not  quantitative  at  least 
qoalitative,  of  the  most  complex  combinations  of  very  dissi- 
milar metals/'— Tom.  iii.  p.  1224. 

Science  had  got  to  this  point  in  the  question,  when  Bunsen 
and  Elirchoff  announced  in  December,  1859,  tx>  the  Academy 
of  Science,  at  Berlin,  that,  in  studying  the  spectra  of  artificial 
flames,  they  had  arrived  at  the  explanation  of  Frauenhofer's 
lines,  and  at  some  conclusions  respecting  the  constitution  of  the 
son  and  of  the  stars.  The  following  are  the  general  facts  on 
which  they  are  based : 

1.  Every  metallic  substance  in  the  volatilized  state,  in  a 
luminous  source,  colors  in  a  definite  manner  one  .or  more  of 
Frauenhofer's  lines. 

2.  Those  colored  flames  which  have  a  very  marked  emissive 
power  for  certain  particular  rays,  act  upon  those  same  rays 
when  coming  firom  other  sources  in  the  way  of  elective  absorp- 
tion, so  as  to  produce  blanks  or  dark  lines  in  the  place  of  those 
luminous  or  colored  rays,  which  ought  to  exist  in  the  spectrum ; 
thus,  for  example,  the  brilliant  red  line  produced  by  the 
chloruret  of  lithium  in  the  spectrum  of  a  gas  flame,  changes 
into  a  dark  line  when  that  flame  is  traversed  by  the  direct  rays 
of  the  sun.  The  continued  spectrum  of  Drummond's  light 
(lime,  incandescent  in  the  flame  of  oxy-hydrogen  gas),  presents 
the  dark  line  D,  when  its  rays  are  traversed  by  the  flame  of 
salted  alcohol. 

As  for  the  electric  light,  that  double  line  appears  also  in 
black  under  special  circumstances,  which  are  perfectly  ascer- 
tained since  1850,  by  M.  Foucault ;  it  is  when  the  vivid  light  of 
the  charcoal  points  is  mingled  with  the  feebler  light  of  the 
voltaic  circle. 


270  On  Iftfinitesimal  Doses, 

ir. 

Let  us  apply,  with  Kirchoff,  to  the  study  of  the  constitution 
of  the  sun,  this  relation  which  exists  between  the  absorbing 
power  and  the  emissive  power,  which  bodies  possess  for  light. 

The  sun  emits  from  his  incandescent  nucleus  luminous  rajs 
whose  spectrum  would  be  entire  and  without  dark  lines  if  it 
were  not  obliged  to  traverse  the  vapoury   atmosphere  which 
surrounds  that  luminary.    This  atmosphere,  according  to  the 
nature  of  its  compound  elements,  absorbs  one*  or  another  of  the 
luminous  rays,  to  replace  them  by  nothing  but  a  blank  or  a 
dark  line;    and  those  dark  lines  are  found  precisely  in  the 
situation  of  the   brilliant   ones  which  those   same   vaporised 
elements  would  oflFer  in  their  turn,  if  one  analysed  their  proper 
light  and  their  complete  spectrum  by  the  aid  of  a  prism.    Each, 
therefore,  of  Frauenhofer  s  dark  lines  indicates  the  existence,  in 
the  sun's  atmosphere,  of  all  the  substances,  whose  spectra  pre- 
sent a  luminous  line  in  the  corresponding  place. 

It  follows  from  hence  that,  whilst  in  ordinary  experiments,  we 
charge  directly  a  flame  of  the  metallic  substance  which  we  wish 
to  examine,  and  whilst  it  is  the  direct  observation  of  the  ray 
that  characterizes  the  nature  of  that  body,  we  must,  in  order  to 
ascertain  the  constitution  of  the  stars,  proceed  with  those  in  the 
inverse  direction,  and  learn  which  are  the  black  and  absent 
lines,  to  deduce  from  them  the  nature  of  the  substances  which 
have  absorbed  them  ;  that  is  to  say,  to  deduce  the  presence  of 
the  solar  metals. 

This  problem  seemed  at  first  difficult  to  solve,  but  on  com' 
paring  the  negative  image  of  the  solar  spectrum  with  the 
positive  images  of  the  artificial  metallic  spectra,  it  is  easy  to 
ascertain  the  lines  which  should  be  ascribed  to  such  and  such 
a  substance.  Thus  the  solar  atmosphere  must  contain  the 
vapours  oisoda  sni  potash,  because  we  find,  in  the  solar  spec- 
trum, the  lines  D  of  sodium,  and  A  and  B  of  potassium, 
as  black  ones,  which  indicate  that  the  yellow  and  red  rays  of 
the  substances  in  question  have  been  intercepted  at  their 
outset  from  the  incandescent  nucleus,  by  the  compound 
atmosphere. 


and  their  Analysis  of  Light.  271 

Kirchoff  has,  moreover,  established  the  presence  of  iron  in 
the  sun,  a  substance  remarkable  for  the  great  number  of  its 
lines  (70  between  D  and  B)  of  magnesium  (3  lines  in  the  group 
B),  of  chromium  and  oi  nickel.  On  the  contrary,  copper,  mer- 
cury^ zinc,  cobalt,  antimony  and  lithium  do  not  exist  there, 
nor  the  precious  metals  gold  and  silver.  Lastly,  we  find  there 
no  trace  of  silicium  and  aluminium,  those  two  elements  of 
quartz  and  clay,  so  widely  distributed  over  our  globe. 

It  may  be  objected  that  these  spectral  variations  are  due  to 
the  radiation  of  space,  or  to  the  terrestrial  atmosphere ;    but 
this  cannot  be,  for  in  that  case  they  would  be  the  same  for  the 
stars,  which,  as  we  have  seen  above,  is  not  the  case,  for  the 
line  D  of  sodium  does  not  exist  in  the  star  Pollux  nor  Sirius. 
Bat  there  do  exist  certain  lines  which  Gladstone  designates  by 
the  name  atmospheric  lines.    These  appear  especially  at  sunset, 
in  cold  and  dry  weather ;  they  are  wanting,  on  the  contrary, 
when  the  sun  is  high  and  the  weather  hot  and  dry.     Azote  by 
itself  seems  to  produce  almost  all  the  luminous  rays  of  atmos- 
pheric air:    its  spectrum  so  well  studied  by  M.  Morren,  of 
Marseilles,  presents  a  wonderful  appearance.     More  serious  ob- 
jections have  been  raised  by  the  astronomers ;  the  majority  of 
them,  especially  M.  Faye,  regarding  the  existence  of  the  sun's 
atmosphere  as  merely  hypothetical.   '*  The  aspect  of  the  aureola 
during  total  eclipses  of  the  sun,  varying  from  one  place  to 
another,  at  short  intervals,  entangled  with  rays  that  are  straight, 
curved,  brilliant  or  dark,  in  the  form  of  a  lyre^  an  ostensoir  or 
a  plume  of  feathers  extending  here  and  there  to   distances 
double,  treble,  and  even  six  times  greater  than  the  ray  of  the 
sun,  by  no    means    suggests    the   idea  of   an    atmospheric 
envelope/'    However,  a  recent  opportunity  of  verification  must 
have  presented  itself.     On  December  8 1st  of  this  year  there 
was  an  eclipse  of  the  sun,  of  which  we  do  not  as  yet  know  the 
result.      If  the  spectrum    of  the  areola  which  is  produced 
around  the  moon  presents  an   inversion   of  the  solar    spec- 
trum, i.e.,  if  Frauenhofer  s  lines  are  replaced  by  coloured  lines, 
shining   here   and  there  on  a  darker  ground,   the   existence 
of  a  solar  atmosphere  ought  to  be  completely  demonstrated. 


273  On  Ififiniiesimal  DoMes, 

In  case  it  should  be  otherwise,  it  will  be  necessary  to  abandon 
that  hypothesis,  and  seek  elsewhere    (perhaps  in  the  extreme 
thickness  of  the  laminous  strata  of  the  photosphere  reacting  on 
each  other)  the  cause  of  certain  luminous  rays  being  absorbed.* 
For  his  experiments  Kirchoff  made  use  of  Steinheil's  appa- 
ratus.    This  is  a  small  triangular  camera  obscara,  in  the  centre 
of  which  is  a  prism  of  flint  glass,  or  of  hollow  glass  filled  with 
bisulphuret  of  carbon,  a  substance  of  high   refracting  power  ; 
at  the  three  sides  of  the  camera  are  three  lenses,  one  furnished 
with  a  collimator,  having  a  linear  slit,  directs  on  the  prism  the 
light  which  has  to  be  analysed;  the  other   almost   opposite, 
magnifying  four  diameters,  is  destined  for  the  eye  of  the  ob* 
server;  the  third,  placed  sideways  and  illuminated  separately, 
is  destined  for  the  micrometer  which  serves    to   measure  the 
specific  lines.    The  metallic  spectrum  is  procured  with  Bunsen's 
hydrogen  gas  lamp,  or  "  illuminating  lamp." 

When  little  light  is  given,  all  the  secondary  lines  disappear, 
whilst  the  principal  one  is  detached  on  a  black  ground.  Bat, 
to  analyse  the  metals,  we  have  to  employ  the  electric  light 
furnished  by  BumkorfTs  apparatus  of  induction. 

It  is  then  necessary  to  have  two  spectra  at  once,  that  the  eye 
may  easily  apprehend  their  differences,  and  to  contrive  that 
they  should  be  placed  side  by  side,  separated  by  a  slight  band 
of  shade,  so  that  it  is  easy  to  see  whether  the  coincident  or 
variable  lines  are  found  in  the  two  images. 

Kirchoff  has  found  that  the  rarest  metals,  as  erbium  and 
terbium,  are  recognised  without  difficulty;  and,  what  is  re^ 
markable,  that  the  lines  characteristic  of  each  radical  element 
are  always  identical,  whatever  be  the  chemical  combination  of 
the  metal,  and  whatever  be  the  flame  by  which  it  is  heated* 
This,  no  doubt,  is  owing  to  the  fact  that  all  the  salts  under 
examination  are  decomposed  at  that  high  temperature,  and 
reduced  to  the  state  of  a  vapour  purely  metallic:  but  the 
intensity  of  the  lines  increases  with  the  temperature  of  tbe 
luminous  source. 

•  JJIntlUut^  Journal  Umoenddei  ScteneeSf  p.  375, 1861., 


afid  their  Analysis  by  Light,  273 

in. 

We  will  now  mention  the  curious  researches  of  these  two 
Savans,  regarding  the  principal  alkaline'  metals. 

Tbe  reaction  of  sodium  under  the  test  of  the  spectrum  is 
more  .perceptible  than  that  of  any  of  the  others.  The  following 
is  the  proof  of  this :  in  a  room  of  sixty  cubic  metres,  a  mixture 
of  sugar  of  milk,  and  three  milligrammes  of  chlorate  of  soda 
was  bamt  at  the  opposite  extremity  to  that  where  the  flame 
was  furnishing  the  spectrum :  the  vapours  spread  through  the 
air,  and  at  tbe  end  of  a  few  minutes  there  appeared  the  yellow 
line  of  sodium,  whicb  remained  ten  minutes  and  then  disap- 
peared.  Now,  according  to  the  contents  of  the  room  and  the 
weight  of  the  salt  employed,  analysis  indicates  that  in  that  case 
the  eye  could  easily  detect  the  spectral  reaction  of  a  three- 
millionth  (Vsxno^  of  A  milligramme  of  soda.  Thus  we  have 
obtained  unexpected  results.  In  studying  the  atmospheric 
spectrum,  we  ascertain,  for  instance,  that  more  than  ^/^^  of  the 
earth's  surface  are  traversed  by  currents  of  chloride  of  sodium, 
whose  impalpable  powder  impregnates  the  air  that  passes  over 
the  ocean.  Without  doubt  this  salt  is  destined  to  furnish  to 
infinitely  small  creatures  conditions  adequate  to  their  preserva- 
tion. "  Perhaps  also,"  as  Kirchoff  remarks,  "  the  dissemination 
of  this  antiseptic  substance  is  our  preventive  of  epidemics.  It 
would  at  least  be  curious  to  observe  whether  variation  in  the 
brilliancy  of  the  line  N  A  does  not  bear  some  relation  to  the 
different  phases  of  an  epidemic ;  or  again,  whether  contagious 
miasms  may  not  be  revealed  by  means  of  perturbations  induced 
in  the  lines  of  the  atmospheric  specti'um." 

Lithium  is  indicated  by  two  lines ;  one  yellow  L  I  0,  the 
other  red  L  I,  and  less  perceptible  than  that  of  sodium.  Its 
reaction,  however,  cnn  render  perfectly  visible  less  than  the  nine 
millionth  (^/i/mfioo)  of  a  milligramme.  M.  Bunsen  has  arrived 
at  the  important  conclusion,  that  lithium  is  one  of  the  sub- 
stances most  widely  diffused  over  the  globe,  though  always  in 
an  ''  infinitesimal  dose."  It  has  been  discovered  in  sea- water, 
in  the  ashes  of  sea  plants,  in  the  orthoses  and  granites  of  the 
Odenwald,  in  tobacco  ashes,  the  leayes  and  twigs  of  vines,  in 
the  grapes  and  wheat  of  the  valley  of  the  Bhine.     The  milk  of 

VOL.   XX.,   NO.   LXXX. — APRIL,  1862,  8 


274  Oh  InfiniteHmal  Doses^ 

animals  fed  on  those  crops,  human  blood  and  moscalar  tissne 
redaced  to  ashes,  also  exhibit  traces  of  it,  as  Dr.  Folwarczny 
has  shewn.  A  great  number  of  mineral  springs,  Diirckheim, 
Kreuznach,  Ems,  Plombieres,  Wildbad  contain  it  equally. 

When  ordinary  analysis  is  incapable  of  discovering  the 
presence  of  this  metal  in  a  quart  (litre)  of  mineral  water,  one 
drop  suffices  to  detect  it  with  certainty  by  the  optochemical 
process. 

Potassium  betrays  itself  by  a  continued  spectrum,  of  great 
length,  with  two  specific  lines :  one  E  A  and  red,  in  place  of  A  of 
Frauenhofer ;  the  other,  E  «  0»  also  corresponding  with  a  black 
line  in  the  solar  spectrum.    A  third  line,  on  the  blue  band  B, 
only  appeared  with  a  vivid  light.    The  presence  of  Viooo  of  a 
milligramme  was  recognised  without  difficulty.     The  ashes  of  a 
cigar,  placed  in  the  flame  of  the  lamp,  easily  showed  the  yellow 
line  of  sodium,  and  the  two  red  lines  of  potassium  and  of 
lithium.    The  spectrum  of  strontium,  more  complicated  than 
the  others,  is  characterized  by  the  absence  of  the  green  zones. 
It  presents  eight  lines ;  six  red,  one  orange,  one  blue.     The 
presence  of  strontium  in  sea  water  has  been   determined   by 
analysing  the  precipitate  which  incrusts  the  steam  boilers.    By 
exploding  seventy-seven  milligrammes  of  chloruret  of  strontiam 
in  a  room  containing  77,000  grammes  of  air,  it  has  been  pos- 
sible to  establish  the  presence  of  Vioo/m  of  a  milligramme  o( 
strontium  in  that  atmosphere. 

The  spectrum  of  calcium  is  distinguished  by  a  very  brilliant 
line  0  A  0  in  the  green ;  another  not  less  vivid,  G  A  «  in  the 
orange;  and  one  very  difficult  to  observe  in  the  blue.  As  in 
the  case  of  strontium,  the  Vioo/kn)  of  a  milligramme  was  again  well 
made  out.  The  spectrum  of  barium  is  very  long,  and  presents 
three  specific  lines  B  A  « ,  S  and  y.  The  presence  of  ^/vm  of  a 
milligramme  was  ascertained. 

IV. 

But  the  optical  analysis  is  not  content  with  disclosing  the 
presence  of  certain  bodies  disseminated  in  quantities  almost  im- 
ponderable. It  has  arrived  at  results  still  more  valuable,  by 
leading  to  the  discovery  of  elements  unknown  up  to  the  present 


and  their  Analysis  by  Light.  S75 

day.     It  ia  thus  that  M.  Bunson  has  effected  the  isolation  of 
two  new  alkaline  metals^  both  more  powerful  ih^si  potassium^^ 
Tiz.,  rubidium  and  cesium  ;  and  M.  Crookes  has  foand  a  third 
substance — thallium.    This  is  the  way  they  made  the  discovery. 
Bansen  bad  submitted  to  his  lamp  (Bumkorff's  electric  induc- 
tion lamp)  the  sediment  of  the  saltspring  of  Dtirckheim^  and 
found  two  new  blue  lines  near  the  line  Sr  i  of  Strontium.    He 
disoovered  also,  in  deposits  of  the  analysis  of  the  lepidolite  of 
Saxony,  two  red  lines  of  great  brilliancy,  between  Sr  i  aud  Ea  0. 
He  inferred  from  this  the  presence  of  two  new  substances ;  and> 
to  insure  himself  of  it,  he  had  80  tons  or  86,400  kilogrammes 
of  the  waters  of  DUrckheim  evaporated ;  and  he  analysed  1 50  kilo- 
grammes of  lepidolite  from  Rozna,  near  Eradisco,  in  Moravia. 
Afker  having  eliminated  all  the  known  substances,  there  actually 
remained  some  grammes  of  two  new  ones.    He  named  the  first 
cstsium,  and  the  other  rubidium,  after  the  colours  which  they 
communicate  to  the  spectrum  {casius  sky  blue;  rubidius  red). 
As  to  thallium,  discovered  by  M.  Crookes,  it  is  characterized  by 
a  single  line  of  green  on  a  black  ground  between  Ba  X  and  Ba  ij. 
This  new  metalloid,  of  the  sulphur  class,  has  been  found  in  a 
seleniferous  deposit  at  Tilkerode,  in  the  Hartz  mountains ;  but 
it  is  met  with  in  much  greater  abundance  in  the  native  sulphur 
of  the  isles  of  Lipari,  and  in  certain  pyrites  from  Spain.     The 
two  first  exist  in  such  small  quantities  that  the  80  tons  of 
mineral  water  yielded  but  6  grammes  of  casium,  and  the  160 
grammes  of  lepidolite  about  0*80  centigrammes  of  oxyde  of 
rubidium.    To  these  three  new  simple  substances,  of  which  we 
have  spoken  as  due  to  the  spectral  analysis,  we  must  add  a 
fourth — dianium,  discovered  in  March,  1860,  by  the  celebrated 
chemist.  Van  Eobell,  who  extracted  it  from  the  tantalites  of 
Tammela,   from   eux6nite  and  eeschynite.     Its  existence  is, 
however,  questioned  by  M.  Bose.    It  rests  with  Bunsen  to  give 
it  a  definite  existence  or  death,  by  subjecting  it  to  his  beautiful 
method  of  analysis. 

V. 

Such  is  the  risum^  of  the  first  operations  due  to  the  new 
method — Optochemical  analysis,  and  of  the  grand  and  unex- 

8  2 


276  On  Ififiniteaimal  Doses » 

pected  oonsequence  to  which  it  is  leading  us.  It  is  easy  to 
foresee  that  henceforward  the  natural  sciences  must  undergo 
this  novel  test.  Geology  will  hence  find  a  certain  analysis  of 
the  various  soils,  and  mineralogy  a  singularly  neat  and  precise 
method  of  determining  rocks.  Astronomy  sees  opening  hefore 
her  a  field  as  illimitable  as  the  number  of  the  stars  which  she 
will  have  to  study,  and  will  henceforth  teach  men  of  what 
elements  Ood  has  made  the  worlds. 

"  What  signify  then,"  as  M.  Foucault  says,  "  the  thirty  millions 
of  leagues  which  separate  us  from  the  Sun  ?  Each  substance, 
reduced  to  vapor,  vibrates,  like  a  harp  string  with  a  sound  pe- 
culiar to  itself,  emitting  its  rays  into  space  like  luminous  notes 
of  unutterable  tone,  and  capable  of  traversing  the  greatest  dis- 
tances. The  prism  expands  his  innumerable  rays  in  the  spec- 
trum ;  they  are  there,  so  to  speak,  numbered  in  order ;  and  if 
they  contain  signs  characteristic  of  substances  known  amongst 
our  elements,  the  inference  is  inevitable;  those  substances 
necessarily  belong  to  the  Sun." 

VI. 

But  medicine  will  equally  have  to  claim  her  share  of  im- 
provement and  progress  towards  perfection. 

The  study  of  poisoning  cases  and  of  forensic  medicine  will 
find  in  Optochemistry  a  sure  method  of  ascertaining  the  nature 
of  the  poisons. 

Hydrology  will  be  obliged  to  repeat  all  her  analyses  to  detect 
the  presence  of  lithium,  rubidium,  casium,  and  thallium  ;  and, 
as  an  instance,  we  will  give  the  two  following  analyses  of 
Diirckheim  water,  by  Bunsen  himself,  in  which  each  sub- 
stance is  investigated  to  the  Vioo  of  a  milligramme : — 

Saline  Mineral  Water  of  Mother  liquor  from  the  same  Salt- 

DUrckheim,  of  1000  parts.  springs,  of  1000  parts. 

Bicarbonate  of  lime  0*28350 

of  magnesia  0*01460 

of  protox.  of  iron        0*00840 

of  protox.  of  magnesia  traces 

Chloruret  of  lime  .  .         3.03100       296-90 

of  magnesium     .         0*39870      41*34 


and  timr  Analysis  by  Light. 


277 


Gbloruret  of  stroDtiam 
Sulphate  of  stroDtian 
Bromaret  of  potassium 
Cblomret  of  potassium 
■  of  sodium 

of  lithium 

■  of  rubidium 

of  cssium 

Alaxnina   . 

Silica 

Azote 

Free  carbonic  acid 

Sulphuric  acid^  traces 


0-100810 
0-01960 
0.02220 
009660 

12-71000 
0-30910 
0-00021 
000017 
000020 
0-00040 
0-00460 
1-64300 


800 

0-20 

2-17 

1618 

20-98 

1109 

004 

0-03 


Total 


Total 


In  Germany  tbe  presence  oi  rubidium,  strontium,  and  lithium 
has  heen  just  discovered  this  year  in  the  iodo-bromurate  waters 
of  Hall  (Upper  Austria)  ;  the  two  latter  metals  have  been  found 
also  in  the  mineral  waters  of  Gastein  (Salzbburg)  [^Cosmos,  xix. 
p.  316,  1861].     In  France,  a  young  and  clever  chemist,  M. 
Grandeau,  treading  in  the  steps  of  the  scientific  professors  of 
Heidelberg,  has  just  announced  the  discovery  of  five  new  sub- 
stances in  the  mineral  water  of  Bourbonne-les  Bains — viz., 
lithine,  strontian,  boraeic  acid,  c€esium,  and  rubidium  {Revue 
dHydrologie,  4th  year).     These  last  bodies  are  even  in  con- 
siderable quantity ;  for  nearly  2  grammes  of  them  have  been 
extracted  from  10  quarts  (litres)  of  mineral  water  (LInstitut, 
1861,  p.  380).     He  has  also  found  indications  of  them  in  the 
water  of  Vichy ;  but  no  trace  in  the  water  of  the  Dead  Sea, 
though  so  rich  in  alkaline  chlorurets. 

VIL 

Lastly,  homoeopathy  is  about  to  be  enriched  by  a  new  means 
of  very  important  verification  for  her  infinitesimal  medication. 
It  is  a  fact  that  she  has  too  often  been  reproached  with  inability 
to  submit  her  remedies  to  the  control  of  analysis,  in  order  to 
assure  herself  of  their  presence,  and  of  their  correct  prepara- 
tion. Henceforward  that  verification  will  be  easy,  at  least  for 
the  lower  attenuations.  We  can,  in  fact,  by  the  spectral  analysis, 


278  On  Ifi/tniiesifnal  Doses, 

detect  the  millionth  of  a  milligratDme,  i.e.  a  qnantity  equivalent 
to  the  4th  dilution.  I  am  well  aware  that  several  homoeopatbio 
physicians,  Rummel,  Colombier,  and  Mayrhofer  (Rapou  Hist, 
de  la  Doctr.  honuBop.,  t.  ii.  p.  422-5)  have  professed  to  ascer- 
tain the  presence  of  medicines  up  to  the  10th  and  80th  dilation 
by  means  of  the  solar  microscope ;  bat  their  assertions,  being; 
too  meagre  in  details,  have  always  left  some  doubts  on  my  mind. 

Nevertheless,  certain  privileged  substances,  with  highly  colored 
reaction,  have  been  followed  very  far;  and,  as  an  impartial 
example  of  the  ancient  method,  I  ought  to  quote  the  following;, 
due  not  at  all  to  a  homoeopath,  but  to  Dr.  Thomson,  in  speak- 
ing of  the  divisibility  of  substances.  (David  Low,  An  enquiry 
into  the  nature  of  the  simple  bodies  of  chemistry.)  **  He  dis- 
solved 1  grain  of  nitrate  of  lead  in  500,000  gr.  of  water,  and 
then  passed  through  it  a  current  of  sulphuretted  hydrogen, 
which  perceptibly  tinged  the  whole  liquid  mass  with  black  (by 
forming  sulphuret  of  lead). 

Now  1  gr.  of  water  is  equal  to  one  drop ;  and  that  drop,  ex- 
tended, can  cover  a  surface  of  1  inch  square.  With  an  ordinary 
microscope  one  can  distinguish  the  millionth  part  of  a  sq.  inch. 

The  water  then  could  be  divided  into  500,000,000,000 
parts.  The  lead  contained  in  the  nitrate  weighs  0'87  gr«; 
the  sulphur  O'ld  gr.  An  atom  of  lead  can  only  weigh  the 
6,000,000,000,000th  (6  billionth)  part  of  a  gr.;  whilst  the 
sulphur  combined  with  it  ought  not  to  weigh  more  than  the 
three  billionth  part  of  a  grain,  or  VaoooooiMxxMiooL 

So  that,  in  this  case,  the  eye  perceives  a  quantity  equivalent 
to  the  7th  and  8th  dilutions. 

I  will  complete  this  calculation  (by  this  time  rather  an  old 
story)  by  the  data  which  the  science  of  our  day  can  add  to  it.  I 
have  seen,  in  the  workshop  of  Froment,  our  celebrated  manu- 
facturer and  natural  philosopher,  the  millimetre  divided  into 
1000  parts,  perfectly  appreciable  by  the  microscope.  Now,  one 
drop  of  water  can  cover  3  sq.  centimetres  (hardly  more  than  an 
inch),  and  thus  represents  30,000  parts  in  length ;  which,  raised 
to  the  2nd  power  (or  **  squared")  to  represent  the  area,  give  no 
longer  one  million,  but  900,000,000  (or  900  million)  of  parts 
visible  to  the  naked  eye  in  3  square  centimetres.     The  whole  of 


and  ilieir  Analysis  by  Light.  279 

the  water  then  could  be  divided  into  45,000,000,000,000,000  parts 
(45>000  billions),  and  the  sulphur  represents  Vs/m/m/m/noAX),  or 
one  three  thousand  billionth  of  a  grain,  u  e*  the  9th  dilution ; 
the  1st  being  expressed  by  1  gr.  of  the  substanoe. 

Thus  we  may  affirm  that  the  9th  dilution,  if  it  is  properly 
made,  contains  still  (or  at  least  may  contain)  the  material  sub- 
stance, and  not  merely  the  medicinal  power  separated  from  its 
sahetratum  and  communicated  to  a  neutral  vehicle.    But  this 
extreme  point  of  penetration  into  the  infinitely  small  is  only 
perceptible  to  our  senses  in  rare  cases  of  marked  and  persistent 
reaction ;  and  even  if  those  means  indicate  to  us  the  undoubted 
presence  of  a  substance,  they  do  not  necessarily  determine  its 
nature.  Most  frequently  we  only  obtain  white  or  colorless  preci- 
pitates ;  the  smallest  traces  of  foreign  substances  suffice  to  mo- 
dify the  coloring,  and  to  prevent  the  recognition  of  the  substance. 
On  the  contrary,  in  the  spectral  analysis,  the  colored  lines 
are  not  at  all  altered  by  the  addition  of  new  bodies.     The 
spectra  are  superimposed,  and  succeed  each  other  regularly; 
the  position  of  the  rays  in  the  spectrum  implies  a  fundamental 
chemical  property,  the  nature  of  which  is  as  immoveable  as  the 
atomic  weight     In  proportion  as  one  is  exhausted  and  effiiced, 
the  next  makes  its  appearance,  to  be  developed  in  its  turn,  ac- 
cording to  the  order  of  its  calorific  capacity  and  volatilizability; 
and  one  can  at  once  study  the  nature  of  the  substances,  their 
number,  and  their  reciprocal  relation. 

But,  in  medicines,  it  is  not  sufficient  to  advance  a  fact ;  we 
must  also  prove  it.  I  therefore  wished  to  assure  myself,  inde- 
pendently, of  the  results  which  the  new  method  of  analysis 
could  give  us ;  and,  getting  myself  initiated  into  the  secrets  by 
Sumkorff  and  M.  Grandeau,  I  have  already  been  able  to  verify 
several  products  belonging  to  our  materia  medica.  I  should 
have  wished  to  experiment  first  upon  the  chloruret  of  sodium, 
for  of  all  the  substances  it  is  the  most  sensible  to  analysis ; 
but  it  is  so  disseminated  in  the  atmosphere  (and  especially  in  the 
confined  air  of  a  laboratory  like  that  of  the  normal  school), 
that  the  line  D  was  permanently  present,  and  rendered  the 
necessary  comparison  impossible. 

I  have  attempted  to  verify  the  presence  of  the  medicine  in  the 
following  preparations : — 


280  On  hifinii€$imal  Doses, 

Chlorate  of  potash,  2nd  and  3rd  trituration. 

2nd  dilation. 

Ghloruret  of  potassium,  2nd  and  drd  trituration. 

■  2nd  and  8rd  dilution. 

Chloruret  of  lithium  2nd  trituration. 

2nd  dilution. 

.^__ 3rd  dilution. 

'  4th  dilution. 

I  recognised  no  trace  of  the  active  substance  in  the  two  first 
One  only,  a  pinch  of  the  2nd  trit.  of  chlorate  of  potash,  seemed 
to  give  indications  of  the  specific  line,  but  not  suflBciently 
apparent  to  leave  the  least  certainty.  But  the  chloruret  of 
lithium  furnished  me  with  admirable  results. 

An  infinitely  smnll  fragment  of  a  drop,  collected  on  a  platioa 
wire  as  fine  as  a  hair,  bent  into  a  loop  at  the  end,  was  exposed 
to  the  flame.  This  fragment  of  a  drop,  appreciable  by  very 
delicate  scales,  was  found  to  weigh  half  a  milligramme.  It  was, 
therefore,  the  10,000th  part  of  the  entire  dilution.  Now,  not 
only  with  so  minute  a  quantity  did  the  specific  line  of  lithium 
appear  in  the  2nd  dilution,  but  it  was  also  perfectly  visible  in 
the  3rd  dilution,  and  easily  verifiable  by  any  one. 

The  4th  dilution  at  first  offered  but  very  doubtful  indication  ; 
but,  on  concentrating  it  to  one  half,  the  red  line  re-appeared. 
If  we  consider  the  trifling  quantity  of  matter  under  examination, 
we  shall  be  aware  that  it  is  so  infinitesimal  as  to  pa8s,j9^r  saltumy 
over  the  interval  between  2  dilutions,  and  that  in  reality  we  ap- 
preciate in  that  fragment  of  the  3rd  the  precise  quantity  which 
ought  to  enter  into  the  5th,  since  the  5th  contains  the  10,000th 
part  of  the  3rd.  We  might  then,  with  a  8rd  dilution  properly 
made  and  easily  verifiable,  compose  the  5th  directly,  with  a  cer- 
tainty of  introducing  into  it  the  substance  in  a  still  palpable 
and  evident  form. 

Finally,  here  are  the  results  set  down  in  figures  : — 

The  1st  dilution  contains    .  .  0'05        centigrammes. 

2nd  0-0005  „ 

8rd  0-000005 

\  million  of  the  3rd  contains        .         .  00000000005  „ 

\ 4  th  concentrated  to  0.000000000025      „ 


and  i/ieir  Analysis  hy  Light.  281 

Our  astODishment  beoomes  still  greater  if  we  reflect  on  the  uature 
of  the  chloruret  of  lithium.  This  salt  contains  bat  a  10th  part 
of  lithium ;  so  that  the  very  Ist  dilution,  instead  of  containing 
1  grain  of  the  substance,  which  thus  reveals  its  presence,  con- 
tains in  reality  only  5  milUgrammes ;  also  the  reaction  of  5  centi- 
grammes of  lithium  (1st  dilution)  has  been  perfectly  visible  up 
to  the  4th  dilution,  and  might  have  served  to  form  the  6th 
directly,  by  the  procedure  above  pointed  out. 

Along  with  this  analysis,  which  opened  to  us  so  fruitful  a 
pad),  we  sought  in  vain  for  the  presence  of  lithine  in  the  2nd 
trituration  of  the  chloruret  of  lithium  ;  whether  because  this 
mode  of  preparation  is  less  favourable  to  the  analysis  than  dilu- 
tion (which  I  believe),  or  because  the  triturations  actually  furnish 
a  less  regular  and  less  constant  composition. 

After  all,  the  negative  conclusions  do  not  at  all  invalidate  the 
astonishing  result  which  we  have  obtained,  and  which  has  given 
ns,  by  means  of  our  numbered  dilutions,  an  approximation  fifty 
times  more  infinitesimal  on  the  divisibility  of  the  lithine,  than 
that  which  Bunsen  obtained  by  charging  the  air  of  a  room  with 
metallic  vapours.  So  I  purpose  following  up  this  work  with 
the  greatest  care,  and  extending  it  to  all  the  metallic  substances. 
I  shall  seek  for  the  causes  of  error  as  well  as  the  means  of  ren- 
dering the  analysis  more  perfect,  and  shall  strive  to  establish  for 
each  substance  the  maximum  of  divisibility  which  still  permits 
us  to  ascertain  its  presence. 

I  can  now  bring  forward  a  fact  for  the  consolation  of  those 
who  believe  in  the  two  easy  alteration  of  the  homoeopathic 
remedies.  Each  of  the  dilutions  which  we  examined  was  acidu- 
lated with  a  drop  of  hydrochloric  acid,  in  order  to  facilitate  the 
experiment ;  and  for  all  that,  the  lithine  appeared  with  all  the 
regularity  of  its  proper  nature.  That  infinitesimal  quantity  was 
not  in  any  respect  influenced  by  the  presence  of  an  acid  in 
a  dose  proportionably  so  colossal ! 

The  new  method  therefore  instituted  by  the  two  German 
savans  inaugurates  for  our  art,  as  well  as  for  all  the  sciences,  a 
real  advancement.  It  will  soon  become  general,  applicable  to 
all  the  elementary  bodies,  and  we  shall  be  able  to  repeat,  after 
M.  Dumas,  "  that  the  physical  sciences  have  not  made  a  happier 
effort  since  the  days  of  Lavoisier." 


282  Ou  Infiniietimal  Doses, 

This  revolation  in  the  method  of  analysis,  by  giving  an  import- 
anoe  hitherto  nnknown  to  infinitely  small  qaantities,  will  per- 
haps exercise  a  salutary  influence  on  many  prejudiced  minds; 
it  will  dispose  them  to  receive  with  less  repugnance  and  indig- 
nation the  therapeutic  doctrine  of  the  action  of  infinitesimal 
doses.    By  that  discovery*  in  fact,  Hahnemann  forestalled,  and, 
so  to  speak,  predicted  that  of  Bunsen ;  he  raised  medicine  to 
the  level  of  other  sciences,  by  creating  for  it  a  method  analo- 
gous to  that  of  the  infinitesimal  calculus  ("limiting  ratios")  in 
mathematics,  the  atomic  and  molecular  doctrine  in  chemistry, 
the  theory  of  the  ether  in  natural  philosophy,  the  cellular  theory 
and  microscopic  studies  in  normal  and  pathological  anatomy.  Nor 
did  this  Novum  Organum  remain,  in  his  mind,  in  a  state  purely 
speculative ;  for  he  used  to  cure  the  sick  with  doses  of  which 
the  most  profound  science  is  now  scarcely  beginning,  half  a 
century  after  that  genius,  to  recognize  the  presence  and  to 
suspect  the  value. 

Early  in  January,  M.  Bumkorff  having  had  the  kindness 
to  place  at  my  disposal  an  apparatus  by  Steinheil  (above  de- 
scribed), I  was  able  to  resume  my  experiments  at  home,  with 
more  care,  working  in  total  darkness,  and  fencing  myself  round 
with  the  greatest  precautions;  and  I  arrived  at  results  still 
more  complete. 

The  chloruret  of  lithium  was  then  recognized  in  a  drop  ot 
the  4th  dilution,  which  gives  us  0.000,000,005,  i.  e.,  the  com- 
position of  the  full  5th  dilution. 

The  lithium^  properly  so  called,  was  recognized  in  a  drop  of  the 
5th  dilution,  t. «.,  in  the  equivalent  of  the  6tb,  0.000,000,000,00^, 
or  5  billionths  of  a  milligramme.  This  preparation  had  been 
made,  not  approximately,  but  by  weight  and  measure.  But 
I  was  particularly  anxious  to  experiment  upon  soda.  It  was 
necessary,  for  that  purpose,  to  obtain  a  spectrum  perfectly  pure* 
in  which  the  line  of  soda  did  not  already  exist  naturally.  I 
effected  this  by  working  in  a  very  pure  atmosphere,  and  by 
lighting  the  apparatus  with  the  lower  portion  of  a  long  flame 
of  alcohol :  that  part  of  the  flame  being  bluish,  and  of  small 
luminosity,  is  especially  favourable  to  the  operation. 

By  these  means  I  obtained  a  spectrum  nearly  dark,  cogniza- 
ble, with  difficulty,  by  a  faint  light  on  the  side  of  the  greeDi 


and  their  Analysis  by  Light.  283 

and  free  from  any  line  of  soda.  I  then  tried  the  several  dilu- 
tions, and  obtained  certain  signs  of  the  presence  of  the  soda 
not  only  in  the  4th  and  5th  dilations  of  chloruret  of  sodium,  but 
eren  in  one  single  drop  of  the  6th.  That  drop,  appreciable 
by  a  very  delicate  balance,  weighed  8  centigrammes.  Conse- 
quently, the  substance  appreciated  was  equivalent,  in  figures  to 
0.000,000,000,000,03,  or  three  hundred  billionths  of  a  milli- 
gramme, I.  e.,  a  quantity  even  less  than  that  which  ought  to 
form  the  7th  dilution. 

Here  seemed  to  be  the  last  appreciable  degree  of  the  sub- 
division :  drops  less  bulky,  which  weighed  but  1  centigramme, 
tbongh  tried  over  and  over  again,  did  not  give  any  clear  and 
decisive  result.  Let  us  observe  here,  that  chloruret  of  sodium 
contains  Vs  of  sodium  and  %  of  chlorine.  But,  as  one  can 
always  skip  over  one  dilution,  and  with  half  a  milligramme  of 
the  6th  (of  which  we  are  sure),  form  an  8th  dilution  directly, 
it  follows  that,  for  the  eight  first  dilutions,  we  can  be  rationally 
and  physically  certain  of  the  presence  of  the  medicinal  sub- 
stance in  its  vehicle.  The  third  trituration  of  sea  salt  is  not 
so  easy  to  recognize ;  we  are  obliged  to  make  a  thick  paste  of 
it  with  very  pure  hydrochloric  acid,  to  carbonize  the  magma 
with  a  lamp,  then  to  moisten  this  carbon  afresh  with  hydro* 
chloric  acid,  and  then  bum  the  whole  in  the  flame  employed  for 
the  analysis. 

After  all,  these  difiiculties  in  the  experimentation  in  no  degree 
invalidate  the  astonishing  result  which  we  have  obtained,  and 
which  has  given  us  an  approximation  90  times  more  infinitesi- 
mal on  the  divisibility  of  chloruret  of  lithium,  and  10,000  times 
more  so  for  chloruret  of  sodium,  by  means  of  our  numbered 
dilutions,  than  that  which  Bunsen  obtained  by  charging  the  air 
of  a  room  with  metallic  vapour. 

It  is  but  right  to  say  that  that  distinguished  savant  was 
not  proposing,  as  we  were,  to  seek  the  furthest  point  to 
which  matter  is  still  cognizable  by  analysis;  he  was  satisfied 
with  demonstrating  the  power  and  infinite  delicacy  of  his 
method. 


284  On  Injiniiesimal  Doae^^ 

VIII. 

Analysis  of  Gaseods  and  Volatile  Sobstancks. — Whilst 
we  can  easily  analyze  the  earthy  metals,  by  volatilizing  them  in 
the  flame  of  gas ;  whilst  we  sacceed  in  stadying  the  spectra  of 
fixed  metallic  substances  by  means  of  eleotrio  volatilization, 
the  examination  of  gaseous  matters,  or  such  as  are  too  readily 
volatile,  as  ammonia,  chlorine,  bromine,  iodine,  sulphuretted 
hydrogen  and  nitric  acid,  &o.,  require  different  apparatus  and 
other  precautions.  We  have,  in  these  cases,  to  enclose  the 
substance  in  "  Geissler  s  tubes,"  of  which  we  have  already  said 
a  word,  and  on  which  we  shall  here  expatiate  farther. 

Geissler's  tubes  are  capillary  tubes  from  80  to  50  centimetres 
long,  provided  at  certain  distances  with  a  dilatation  or  halb,  of 
larger  diameter.     These  tubes  are  dried  with  the  greatest  care, 
and  then  as  perfect  a  vacuum  as  possible  is  made  in  them,  by 
filUng  them  with  boiled  mercury ;  lastly,  the  mercury  is  expelled 
by  introducing  the  substance  (a  vapour  or  a  gas),  which  we 
wish  to  examine.    A  partial  vacuum  is  then  restored  in  tbe 
tube,  and  the  gas  previously  introduced  is  exhausted,  not  en- 
tirely, but  so  as  to  leave  only  a  quantity  almost  inappreciable, 
forming  a  vacuum  within  from  4  to  2,  or  1  millimetre.     The 
tubes  are  hermetically  sealed,  and  they  are  ready  for  experi- 
menting. 

The  following  is,  according  to  Plucker,  what  is  observed  in 
the  analysis.  (Cosmos,  t.  xiii.,  p.  807,  1858.)  On  passing 
the  electric  discharge  through  the  capillary  tubes  (Geisslersj, 
filled  with  highly  rarefied  vapours  or  gas,  and  on  observing  tbe 
light  of  it  through  a  prism  furnished  with  a  magnifying  leos« 
we  obtain  spectra  widely  expanded,  and  scored  with  streaks  or 
lines  either  brilliant  or  dark,  more  or  less  narrow,  more  or  less 
dilated. 

The  gas  enclosed  in  these  tubes  is  so  rarefied  that,  in  general, 
it  would  be  impossible  to  prove  its  presence  either  by  the  aid  of 
the  most  delicate  balance  or  by  that  of  chemical  tests ;  never- 
theless, the  spectra  are  magnificent,  and  perfectly  characterize 
the  gas  which  has  produced  each  of  them.  We  can,  by  exami- 
ning the  bright  or  dark  lines,  not  only  recognize  the  gas  con- 
tained in  the  tubes,  but,  in  the  case  of  a  compound  gas,  we  can 


and  their  Analysis  hy  Light,  285 

be  assured  that  decomposition  has  taken  place  before  oar  eyes, 
and  that  certain  component  elements  have  disappeared  in  con- 
sequence of  their  combination  with  the  electrodes. 

The  spectrum  of  hydrogen  manifests  itself  by  a  dazzling  red 
line,  a  blue,  and  a  violet. 

That  of  nitrogen  is  known  by  fifteen  dark  grey  lines,  very  fine, 
of  exactly  equal  breadth,  which  appear  in  the  red,  below  the 
red  of  hydrogen,  and  reach  as  far  as  the  orange  and  yellow. 

Ammoniacal  gas,  after  being  decomposed  by  the  electric 
corrent,  presents  a  spectrum  in  which  one  at  once  perceives  a 
coalition,  a  super-position  of  the  spectra  of  the  simple  gases 
which  have  separated — viz.,  hydrogen  and  nitrogen. 

Chlorifte,  Bromine,  and  Iodine  offer  very  beautiful  spectra, 
the  great  similarity  of  which  are  a  fresh  proof  of  the  intimate 
relation  which  subsists  between  those  three  bodies  so  closely 
connected  in  chemical  classification. 

For  these  three  last  bodies  a  combination  is  formed  immedi- 
ately with  the  negative  electrode  of  platina. 

Along  with  the  last  traces  of  ponderable  matter,  the  electric 
current  ceases  also. 

Substances  composed  of  two  simple  gases  are  instantly  de- 
composed. We  obtain  thus  the  super-position  of  the  spectra 
of  the  two  simple  gases ;  spectra  which  it  is  impossible  to  obtain 
with  the  compound  gas  itself.  Thus  it  is  with  the  vapour  of 
water,  ammoniacal  gas,  the  protoxyde  and  the  oxyde  of  nitro- 
gen, and  nitrous  acid. 

Sulphurous  acid,  carbonic  acid,  the  oxyde  of  carbon,  all  being 
composed  of  a  simple  solid,  with  oxygen,  are  only  decomposed 
into  their  ultimate  elements  gradually.* 

The  analyses  of  Plucker  preceded  those  of  Bunsen  and 
Eirchoff;  and  it  is  surprising  that  those  savans  have  not  noticed 
the  labours  of  their  illustrious  brother  at  Bonn.  These  analyses 
were  not  confined  to  simple  substances,  for  we  may  see,  as  we 
have  already  noticed,  certain  substances  enclosed  in  the  tubes 
decomposed  under  our  own  eyes  by  electric  action ;  and  also, 

•  Plucker,  at  a  Meeting  on  Angnst  4,  of  the  Society  of  Natural  Sciences 
and  Medicine  of  the  Lower  Rhine  Department,  On  the  electric  discharge  in 
spaces  containing  highly  rarefied  gases. 


880  On  Infinitesinuil  Doses, 

under  certain  circamatancesy  recompoaed.     It  is  thus  that  the 
magnificent  spectrum  of  sulphuric  acid  is  transformed  gradually, 
like  the  'MissoWing  views,"  in  the  spectrum  of  sulphoroos  acid; 
then,  after  a  sufficiently  long  interruption  of  the  current,  it 
returns  to  its  original  appearance,  hecause  the  sulphurous  acid 
gas  is  replaced  by  the  vapours  of  sulphorio  aoid.     It  is  just 
the  same  with  the  spectrum  of  $eleniaied  hydrogen;  under  the 
influence  of  the  electric  current,  the  gas  is  decomposed,  the 
selenium  is  deposited  on  the  sides  of  the  glass,  and  we  see  the 
spectrum  of  the  hydrogen  alone.    After  interrupting  for  a  few 
moments  the  electric  current,  recomposition  takes  places  and  we 
again  find  the  spectrum  of  seleniated  hydrogen.  (Cosmos,  1862, 
and  xiz.,  p.  807.) 

If  we  wish  now  to  examine  the  different  homodopathio  prepa* 
rations  of  these  substances,  we  must,  as  far  as  possible,  employ 
triturations,  or  dilutions  by  glycerine:  the  medicinal  vapours, 
ammonia,  iodine,  or  bromine,  will  separate  themselves  under 
the  influence  of  the  vacuum  or  electricity,  and  we  can  examine 
them  alone,  without  being  hindered  by  another  spectrum. 

But,  when  obliged  to  use  aqueous  or  alcoholic  dilutions,  we 
ought  first  to  study  the  spectrum  of  these  substances — the 
spectrum  of  the  oxygen,  hydrogen,  and  carbon,  which  compose 
water  and  alcohol;  then  we  shall  recognize,  by  the  super- 
added lines,  the  presence  of  the  medicinal  substance  whose  spec- 
trum is  super-imposed  on  that  of  the  vehicle. 

This  difficult  study  demands  great  attention  and  much 
practice. 

Analysis  by  Coloured  Flames. — ^There  is  still  another 
method,  quite  old  and  more  simple  than  that  of  Bunsen,  although 
less  perfect  and  generally  applicable,  for  it  can  only  be  appli^ 
to  a  small  number  of  substances.  We  will,  however,  point  it 
out,  because  it  is  within  the  reach  of  everybody,  and  its  real 
value  is  not  nearly  appreciated. 

This  is  the  analysis  by  coloured  flames  and  heat  Certain 
substances  colour,  directly ^  the  luminous  centre  where  they  are 
volatilized. 

Soda  gives  a  yellow  flame;  the  compounds  of  baryta  a 
greenish  yellow ;  lithium  a  purplish ;  strontian  a  jet  of  orange- 


and  their  Analysis  hy  Light.  287 

red  and  bine ;  the  salts  of  lime  orange-red  (exoept  the  borate 
and  phosphate). 

The  salts  of  potash,  of  ammonia,  and  of  proto-chlornret  of 
mercury,  colonr  the  flame  with  violet ;  the  compounds  of  arsenic 
and  of  antimony  with  livid  blue;  those  of  tellariam  with 
greenish  blue;  those  of  selenium  and  of  lead  with  azure;  the 
chlomret  of  copper  blue,  bordered  with  purple ;  the  bromuret 
of  copper  blue,  bordered. with  green;  all  other  salts  of  copper 
emerald  green.  The  salts  of  barytes  and  boracio  acid,  yellowish 
green.  The  borates  and  phosphates  also  yellowish  green,  when 
heated  along  with  concentrated  sulphuric  acid. 

The  compounds  of  molybdenum  also  give  a  greenish  flame ; 
the  tellurians  and  osmic  acid  bluish  green. 

Now,  by  the  aid  of  this  simple  flame,  we  obtain  astonishing 
resnlts. 

For  this  purpose,  we  employ  the  pale  bluish  flame  of  gas,  of 
alcohol,  or  oxide  of  carbon.  We  fill  a  slender  platina  wire, 
ending  in  a  ring,  with  a  drop  of  the  substance  to  be  analysed ; 
or,  if  it  be  a  trituration,  we  make  a  paste  of  it  with  very  pure 
hydrochloric  acid.  Then  we  put  the  platina  wire,  not  in  the 
centre,  but  on  the  bluish  edge  of  the  flame.  As  soon  as  the 
liquid  (or  paste)  is  volatilised,  we  see  the  specific  colour  appear, 
but  only  for  an  instant. 

In  order  to  succeed,  we  sometimes  have  to  bum,  at  first,  the 
powder  that  we  are  examining,  then  to  moisten  it  afresh  with 
hydrochloric  acid,  and  heat  it  over  again. 

By  these  means,  simple  as  they  are,  I  have  been  able  to 
recognize  the  sulphate  of  copper  in  I  grain  of  the  drd  tritura- 
tion, and  in  1  centigramme  of  the  3rd  dilution,  which  is  equiva- 
lent to  0'000,001  (or  one  thousandth  of  a  milligramme). 

lithine,  in  I  drop  of  the  drd  dilution,  and  in  5  centigrammes 
of  the  8rd  trituration. 

Soda,  in  1  milligramme  of  the  5th  dilution,  t .  ^.,  in  a  quan- 
tity equivalent  to  the  7th  dilution,  concentrated  to  one  half, 
which  is  expressed  by  0*000,000,000,000,1  (or  10  billionths  of 
a  milligramme). 

For  certain  substances  more  volatile  and  odoriferous,  the 
flame  is  not  necessary;  it  is  enough  to  heat  the  platina  wire 


288  On  Pelvic  Cellttliiis, 

and  to  lay  it  on  a  small  quantity  of  the  trituration  which  we 
wish  to  examine.  The  substance  is  thus  volatilized,  and  we 
recognize  it  well  by  its  odour.  We  perfectly  discern  this  in 
1  or  2  centigrammes  of  the  3rd  trituration  of  ammonium  carbo- 
nicum,  a  preparation  which  I  had  previously  considered  not 
trustworthy,  because  of  the  easy  volatilization  of  that  substance. 
That  which  I  examined  had  been  prepared  three  years  before, 
and  came  from  Gatellan  s  excellent  establishment. 

Musk  was  recognized  by  its  perfume,  on  applying  the  platina 
wire  to  an  atom  of  the  third  trituration,  whicb^  in  the  ordinary 
state,  is  inodorous. 

These  facts  suffice  to  show  us  not  only  that  the  triturations 
are  trustworthy  preparations,  but  also  that  they  tend  to  fix 
volatile  aubstances  atid  odoriferous  emanations  in  tTie  sub- 
stance  of  the  inert  body  which  serves  as  their  vehicle. 

We  should  obtain  a  much  greater  number  of  reactions  by 
experimenting  sometimes  with  the  flame  of  the  blowpipe  alone, 
sometimes  with  the  aid  of  a  solvent  or  flux,  hydrochloric  or 
sulphuric  acid,  bisulphate  of  potash,  nitrate  of  cobalt,  borax 
or  the  double  phosphate  of  soda  and  ammonia,  &c. 

All  are  in  a  capacity  to  repeat  these  simple  experiments;  but 
these  will  not  supersede  the  necessity  of  having  recourse  to  t/ze 
method  generalized  by  Bunsen,  which  alone  can  distinguish 
between  bodies  that  have  similar  reactions  (as,  for  example, 
boracic  acid  and  copper,  lithine  and  strontian),  so  as  to  give 
absolute  certainty. 


ON  PELVIC  CELLUUTIS. 

By  B.  MacLimont,  M.D.,  M.B.C.S.,  &  L.M,, 
Physician  to  the  Bath  Homaopathio  Hospital. 

It  is  somewhat  remarkable  that  so  very  frequent  and  formidable 
an  affection  as  inflammation  of  the  cellular  tissue  of  the  female 
pelvis  should,  to  so  great  an  extent,  have  been  almost  com- 
pletely overlooked  by  authors  on  diseases  of  women. 

It  cannot  be  that  this  is  a  new  disease,  or  one  becoming  more 
frequent  in  all  classes  of  society.     Why  is  it,  then,  that  it  is 


ty  Dr.  MacLimont.  289 

only  within  the  last  few  years  that  any  detailed  and  satisfactory 
information  has  appeared  of  so  distressing,  and  often  fatal  a 
disease^  and  one,  too,  of  almost  daily  occurrence? 

The  reason  is,  that  up  to  a  comparatively  recent  date,  ac- 
conchearB,  both  English  and  foreign,  were  wont  to  regard  the 
Tery  striking  group  of  symptoms  constituting  pelvic  cellulitis 
as  so  many  indications  of  metritis,  peritonitis,  phlegmasia 
dolens,  &c.,  whilst  those  not  very  unfrequent  cases  occur- 
ring'in  the  non-puerperal,  or  eyen  single  state,  were  too  gene* 
rally  referred  to  cystitis,  fibrous  tumour  of  the  uterus,  abscess 
of  the  rectum,  hip-joint  disease,  mesenteric  tuberculosis,  ulcera- 
tion of  the  oerviz,  &c. 

In  the  hope,  therefore,  of  being  able  to  throw  some  little 
additional  light  oq  this  obscure  and  very  serious  affection,  I  am 
ii^daoed  to  embody  in  this  paper  some  of  the  more  important 
details  of  nine  well-marked  cases,  which  have  come  within  my 
own  observation  during^  the  last  ten  years ;  and  I  beg  that  my 
homo^pathic  brethren  in  particular,  whether  practising  mid- 
wifery or  not,  will  give  this  subject  their  very  serious  attention, 
for  I  feel  assured  that  sooner  or  later  in  the  course  of  their 
career,  they  will  be  called  upon  to  treat  some  alarming  and 
obscure  cases  of  ill  health,  solely  depending  upon  the  existence 
of  acute  or  chronic  abdominal  cellulitis. 

In  treating  of  cellulitis,  it  may  be  well  to  clear  away  any 
mistiness  that  may  exist  in  the  reader's  nund  as  to  what  I  mean 
by  the  term ;  but  to  the  right  understanding  of  it,  as  well  as 
recognition  of  it,  we  ought  to  have  some  general  idea  of  the 
anatomy  of  the  pelvic  fascia.  It  is  impossible,  however,  within 
the  prescribed  limits  of  a  paper  in  this  Journal,  to  enter  at  all 
minutely  into  such  a  subject,  nor  is  it  necessary  for  our  pur- 
pose that  we  should  do  so,  if  we  simply  bear  in  mind  the  posi- 
tions which  the  uterus  and  ovaries,  the  bladder  and  the  rectum, 
relatively  bear  to  one  another. 

By  pelvic  cellulitis,  then,  I  mQBXL  phlegmonous  ififlammation 
of  the  cellular  tissue  within  the  folds  of  the  peritoneum  or 
broad  ligaments  of  the  uterus,  and  not  that  form  of  disease 
known  to  surgeons  as  psoas  abscess,  in  which  the  inflammation 
is  limited  to  the  tissue  connected  with  the  psoas  and  iliacua 

VOL.    XX.,   NO.   LXXX. — APBIL    1862.  T 


290  On  Peltfic 

mufloles;  nor  yet  to  those  ooUectionsof  matter  in  the  yicmitj  of 
the  rectam,  which  are  so  common  an  accompaniment  of  pnl* 
monary  taberonlosis.  Neither  is  this  affectioo  to  be  coofiranded 
with  abscess  of  the  uterus  or  oyaries ;  or  with  fibrous  or  can- 
cerous softening  of  these  organs ;  nor  yet  with  displacements, 
or  fibrous  deposits  on  the  posterior  wall  of  the  uterus;  or, 
lastly,  with  scybala  in  the  rectum. 

Bat  it  is,  perhaps,  even  more  frequently  in  the  acute  and 
recent  form  of  this  disease,  and  as  occurring  in  the  puerperal 
state,  that  pelvic  cellulitis  is  liable  to  be  byerlooked  or  con- 
founded with  other  forms  of  abdominal  infiammation;  and  as  it 
is  chiefly  in  this  early  stage  that  much  benefit  may  be  derived 
from  remedies,  I  shall  endeavour  so  to  point  oot  the  symptoms 
as  to  make  it  easy  for  any  careful  and  competent  practitioner  to 
recognise  this  formidable  malady,  should  he  at  any  time  have 
to  encounter  it  in  the  course  of  his  practice. 

Though  I  do  not  consider  that  cellulitis  is  by  any  means 
limited  to  the  puerperal  stete,  there  can  be  no  doubt,  that  in  the 
majority  of  instances,  it  is  more  or  less  connected  with  the 
parturient  process,  though  we  shall  see,  by  and  by,  that  in  all 
the  cases  under  observation,  there  had  existed  previously  a 
degree  of  well-marked  uterine  disturbance,  evidenced  by  amen* 
horrhoea,  dysmenorrhcea,  menorrhagia,  ulceration  of  the  labia 
or  cervix  uteri,  tendency  to  abortion,  &c. 

What,  then,  is  the  history  of  a  case  of  pelvic   oellufitis? 
The  woman,  in  all  probability,  has  had  an  easy  labour;  all  has 
gone  well  with  perhaps  the  exception  of  a  placenta  somewhat 
unusually  adherent,  and  which  a  time-pressed  or  officious  medical 
attendant  may  have  seen  fit  forcibly  to  detach ;  or,  the  secun- 
ines  having  been  naturally  expelled,  convalescence  may  have  pro- 
ceeded uninterruptedly  for  some  days,  or  it  may  be  some  weeks, 
when,  through  exposure  to  cold,  or  some  imprudence  in  diet^ 
such  as  partaking  of  a  draught  of  cold  water,  or  from  sitting 
up  too  soon,  inattention  to  the  state  of  the  bowels,  or  other 
indiscretion,  the  patient  is  seized  with  a  more  or  less  de- 
cided rigor,  followed  by  flushing  and  perspiration.     The  rigors 
often  recur  at  regular  intervals,  and  as  they  are  usually  followed 
by  hot  skin  and  perspiration,  they  must  not  be  confounded  with 


jy  Dr.  MacLimont.  S9i 

pttrozysms  of  qnotidiaD  agae.    Early  in  its  ooune,  oellolitis 
may  alqo  be  mistaken  for  an  nndue  continuance  and  aggrttva- 
tion  of  the  after  pains,  but  tbe  diagnosis  will  be  assisted  by 
remembering  that  cellalitis  does  not  9et  in  before  the  sixth  or 
seventh  day  after  confinement,  and  is  attended  with  shiverings, 
sncceeded  by  deep-seated  throbbing  pain  in  the  riffkt  or  left 
iHaefo99a;  the  lochia  are  either  checked  or  wholly  suppressed, 
the  flow  of  milk  is  arrested,  the  breasts  becoming  flaccid ;  the 
pulse  rises  to  110,  or  even  120,  though  it  may  retain  its  soft 
and  elastic  feel,  which  is  not  the  case  in  peritonitis;  the  tongue 
18  coated  with  a  whitish  fur;  there  is  a  degree  of  nausea,  and 
even  vomiting,  seldom  excessive;  the  bowels  are  usuaUy  consti- 
pated, and,  as  a  diagnostic  sign  most  important  of  all,  there  is 
very  generally,  even  in  this  early  stage  of  the  disease,  a  more 
or  less  marked  degree  of  dyntria;  as  also  a  fieeUng  of  bearing 
down;  a  peculiar  facial  aspect,  indicative  of  anxiety;   frontal 
headache  and  other  symptoms  of  constitutional  disturbance. 

One  very  striking  symptom  of  cellulitis,  puerperal  or  other- 
wise, is  a  certain  painful  sensation  in  one  or  both  legs,  not  con- 
fined to  one  or  two  spots,  as  the  course  of  the  femoral  vessels, 
or  the  popliteal  space,  as  in  phlegmasia  dolens,  but  an  undefined 
feeling  of  soreness,  and  a  grei^t  disinclination  on  the  part  of  the 
patient  to  extend  the  limb.  Usually  but  one  leg  is  affected, 
and  this  the  one  corresponding  with  the  inflamed  lateral  liga- 
ment, right  or  left,  as  the  case  may  be,  and  the  affiacted  limb  is 
either  flexed  on  the  abdomen,  the  patient  lying  on  her  side,  or 
it  is  drawn  up,  the  dorsal  decubitus  being  observed  as  in  peri- 
tonitis* 

In  cellulitis  occurring  in  the  puerperal  state,  the  peritoneum 
may  become  sympathetically  and  secondarily  affected,  so  that 
we  may  sometimes  meet  with  a  certain  amount  of  tenderness  on 
pressure,  and  even  of  tympanitis,  but  both  in  a  less  degree  than 
in  pure  peritonitis.  The  diagnosis  is  further  assisted  by  our 
frequently  being  able  to  detect  a  fulness,  sometimes  even 
amounting  to  a  considerable  swelling,  in  the  groin.  This  is 
generally  very  hard,  and  highly  painful  to  the  touch. 

On  examining  per  vaginam,  this  canal  will  often  be  found 
hard,  hot,  and  inelastic ;  the  uterus  may  be  found  high  up,  low 

T  2 


292  On  Pelvic  Cellulitis, 

down,  or  pnahed  to  one  side,  according  to  the  sitaation  and  size 
of  the  tumour^  which  can  generally  be  felt  on  one  sid^  of  the 
uterus,  and  in  the  direction  of  the  right  or  left  aacro-iliac 
synchondrosis.    It  may  he  thrown  forward  on  the  bladder,  or 
bound  down  by  adhesive  inflammation  to  that  viscus,  or  it  may 
incline  towards  the  rectum,  producing  in  the  former  case^  pain- 
ful and  constant  micturition,  and  in  the  latter,  distressing 
tenesmus  and  congestion  of  the  hcemorrhoidal  vessels.  The  pain 
occasioned  by  the  limbs  being  put  on  the  stretch  is  probably 
caused  by  pressure  being  thus  made  by  the  tumour  on  some  of 
the  distributions  of  the  lumbar  or  sacral  plexus  of  nerves,  and 
the  want  of  circulation  and  feeling  of  coldness  so  often  com- 
plained of,  may  arise  from  the  arrest  or  disturbance  thereof, 
from  the  same  cause. 

Puerperal  cellulitis  is,  for  the  most  part,  a  highly  acute  affec- 
tion, and  as  it  hut  too  seldom  terminates  in  resolution,  the 
prognosis  must  depend  upon  the  extent  of  the  suppuration  and 
the  strength  of  the  patient  s  constitution  to  bear  up  against  it. 
When  the  inflammation  from  the  first  runs  high,  with  a  small  and 
rapid  pulse  of  110  to  120,  feverish  hot  skin,  furred  dry  tongue, 
total  suppression  of  the  lochia  and  milk,  frequent  rigors,  vomiting, 
delirium,  singultus,  &c.,  little  hope  of  recovery  can  be  entertained ; 
and  should  the  patient's  strength  carry  her  through  the  inflam- 
matory stage  of  the  disease,  there  is  always  a  danger  of  her 
sinking  under  the  hectic  from  which  she  must  necessarily  suffer 
even  when  the  pus  has  found  for  itself  an  outlet  through  one 
or  other  of  the  natural  channels,  such  as  the  vagina  or  rectum. 
I  have  met  with  one  or  two  instances  in  which  the  matter  failed 
to  find  for  itself  an  outlet,  and  appeared  to  have  been  absorbed. 
Such  cases  are  always  tedious  in  their  course,  and  attended  with 
great  constitutional  disturbance. 

Puerperal  cellulitis  may  also  give  rise  to  general  peritonitis, 
and  so  destroy  life,  or,  the  pus  finding  its  way  to  the  surface, 
the  patient  may  sink  under  the  wearing  effects  of  chronic 
abscess. 

Not  unfrequently,  however,  the  patient  survives  the  acute 
stage  of  the  disease,  and  at  a  period  varying  from  three  to  six, 
or  eight  weeks,  rises  from  the  "  lit  de  misere,"  but  not,  alas,  in 


by  Dr.  MacLimont.  298 

a  conditibD  to  resume  her  ordinary  porBuits  or  avocatioDa* 
Should  the  nature  or  the  existence  of  the  disease  have  been 
OTerlooked  in  the  first  instance,  as,  unfortunately,  is  too  often 
the  case,  then  the  patient  is  told  that  her  symptoms  arise  solely 
from  weakness,  and  she  is  exhorted  to  "make  an  effort"  and  to 
'*  throw  it  off/'  the  belief  of  many  patients  and  their  injudicious 
though  well-meaning  friends  being,  that  a  return  to  daily  duties 
or  to  daily  toil  is  an  infallible  cure  for  almost  every  bodily 
weakness.    But  this  can  only  aggravate  tenfold  the  mischief 
that  aLready  exists;  and  what  might  otherwise  have  been  con- 
ducted to  a  safe  and  speedy  termination,  thus  lapses  into  a 
weary  and  painfiil  case  of  chronic  cellulitis. 

But  should  the  patient,  by  reason  of  a  good  degree  of 
constitutional   strength    and  vigour,   have   survived  the   ex- 
hausting, wearing  effect  of  an  acute  attack  of  this  disease,  or, 
as  I  have  already  said,  should  it  have  been  overlooked  or  neg- 
lected in  its  forming  stage,  it  will  not  be  long  before  she  finds 
herself  compelled  to  have  recourse  to  the  help  of  her  medical 
adviser,  and  her  symptoms  will  now  be  as  follows : — ^Very  con- 
siderable weight  and  bearing  down  in  the  hypogastric  region ; 
urgent  desire  to  urinate^  the  patient  often  complaining  of  a 
feeling  of  olstructiofi  to  the  free  fiow  of  urine,  though  on  the 
catheter  being  passed,  the  bladder  will  be  found  contracted  and 
empty;  the  urethra,   in  such  cases  is  often  much  elongated 
and  very  tortuous,  owing  to  its  being  considerably  displaced  by 
the  change  of  structure  in  its  immediate  vicinity.*     The  urine, 
too,  frequently  contains  a  considerable  amount  of  vesical  mucus, 
is  of  an  alkaline  reaction,  and  low  specific  gravity;  though 
occasionally  I  have  met  with  the  very  reverse  conditions.    The 
patient  usuaUy  complains  of  painful  and  difficult  defeecation, 
and  on  this  account  it  is  always  incumbent  on  the  medical 
attendant  to  see  that  the  rectum  in  particular  is  never  allowed 
to  accumulate  any  considerable  amount  of  faeces;  otherwise 
these,  hardened  as  they  usually  are  by  reason  of  the  torpid  con- 
dition of  the  bowels  which  very  commonly  follows  in  the  wake 
of  this  disease,  press  upon  the  enlarged  and  highly  sensitive 

*  In  all  0nch  cases  it  is  safer  and  easier  to  ose  the  gam  catheter,  rather 
than  the  usiial  metallic  instnunent 


$9d  On  Petvie  Cellulitis, 

tumour,  and  thus  not  only  aggravate  the  disease,  bnt  cause 
great  distress  to  the  patient  It  sometimes  happens,  faowerer, 
that  instead  of  constipation,  we  have  a  relaxed  oondition  of  the 
bowels  to  combat,  the  cause  of  this  being  the  irritation  set  up 
in  the  rectum  by  the  pressure  of  the  tumour  upon  it. 

In  addition  to  these  symptoms  the  patient  will  be  found  to 
complain  of  occasional  rigors,  followed  by  flushings  and  night 
perspirations ;  loss  of  strength  and  flesh ;  parched  mouth ;  the 
tongue  red,  dry,  or  furred ;  the  lips  cracked  ;  i^petite  perhaps 
unnaturally  good,  amounting  even  to  craving ;  pulse  90,  small, 
and  weak ;  and  the  skin  moist.     The  body  also  will  generally 
be  bent  forwards  (the  patient  observing  a  stooping  attitude)-, 
and  any  attempt  to  straighten  it  is  attended  with  a  considerable 
increase  of  pain.    There  is  also  very  generally  a  feeling  of  un- 
easiness, and  sometimes  even  of  positive  pain,  in  the  right  or 
left  groin — as  the  right  or  left  lateral  ligament  may  happen  te 
be  affected — and  on  this  account  the  patient  sits  or  lies  a  good 
deal,  and  generally  with  the  affected  limb  drawn  up  so  as  to 
relax  the  abdominal  muscles. 

Should  the  medical  attendant,  on  eliciting  the  above  iu&r- 
mation  from  his  patient,  be  led  to  suspect  the  existence  of 
pelvic  cellulitis,  and  to  press  upon  her  the  absolute  necessity 
of  a  vaginal  examination,  and  this  being  acceded  to,  and  he 
further  possessed  of  that  indispensable  requisite  to  a  right 
diagnosis  in  all  female  diseases — the  tactus  eruditus,  he  will 
probably  discover  something  like  the  following  state  of  things* 

On  the  finger  being  passed  into  the  vagina,  it  will  be 
remarked  that  the  passage  is  both  hotter  and  harder  than 
natural.  The  uterus  will  be  found  either  low  down  (prolapsed) 
or  high  up,  pashed  to  one  side,  anteverted,  or  retroverted,  ac- 
cording to  the  site  and  size  of  the  pelvic  tumour.  This  can 
generally  be  felt  as  occupying  the  region  of  the  right  or  left 
lateral  ligament,  and  if  the  index  finger  of  the  right  hand  be 
carried  forward  by  the  eide  and  in  front  of  the  uterus — the 
bladder  having  previously  been  emptied-^-and  the  left  hand 
placed  on  the  hypogastrium,  the  examiner  will  not  be  able  to 
bring  the  fingers  of  the  two  hands  at  all  near  each  other;  whilst 
the  effort  to  do  so  will  occasion  a  degree  of  pressure  on  the 


ijf  Dr.  MacLimonL  295 

Aickened  and  inflamed  lateral  ligament  exceedingly  painful  to 
the  patient. 

Most  commonly,  a  bard  tamour,  not  veil  defined  in  its  out* 
Hney  and  Tarying  in  size  from  a  pigeon  s  egg  to  an  orange^  will 
be  felt  between  tbe  fingers,  or  thrust  aside  into  the  right  or  left 
iliac  fossa ;  or  the  tumour  may  be  displaced  backwards,  and  lie 
quite  in  the  hollow  of  the  sacrum,  when  it  may  easily  be  mis- 
taken for  a  fibrous  tumour  in  the  posterior  wall  of  the  uterus, 
or  a  retroflexion  of  that  organ. 

Cellulitis  is  not  always  limited  to  the  broad  ligaments,  for  it 
may  oocnr  in  the  cellular  tissue  between  the  uterus  and  bladder, 
or — as  is  more  frequently  the  case — in  tbe  recto-vaginal  septum 
or  sulcus.  It  is  therefore  necessary  to  examine  the  patient  per 
rectum,  and  this  is  best  done  by  introducing  the  index  finger 
of  the  iefl  hand  into  the  bowel — the  corresponding  finger  of  the 
ri^hi  hand  being  in  the  vagina — when  a  very  thorough  explora- 
tion of  the  whole  pelvis  can  be  made,  and  a  satisfactory  conclu- 
sion arrived  at.  But  it  will  require  some  diagnostic  skill  on  the 
part  of  the  examiner,  especially  in  certain  obscure  and  di£Scult 
cases,  to  avoid  mistaking  a  fibrous  deposit  or  tumour  of  the 
womb,  as  well  as  a  displacement  of  this  organ,  for  a  pelvic 
tumour.  The  introduction  of  the  uterine  sound  will  always 
settle  this  point,  for  in  fibrous  tumour  the  sound  will  pass  into 
the  enlarged  cavity  of  the  uterus  some  three  to  six  inches ; 
whilst  in  retroflexion  or  anteflexion  the  introduction  of  the 
instrument  will  rectify  the  displacement,  and  so  clear  up  the 
difficulty.  The  diagnosis  in  the  case  of  ovarian  cysts,  especially 
the  unilocular  form  of  the  disease,  is  also  attended  with  some 
difficulty;  but  the  position  the  ovary  occupies  in  the  pelvis, 
the  absence  of  rigors,  dysuria,  painful  or  difficult  defeecation, 
pain  in  the  limb,  the  absence  of  fluctuation  in  making  an  ex- 
ternal examination,  and  the  history  of  the  case,  will  generally 
suffice  to  settle  the  point.  From  general  puerperal  peritonitis 
the  differences  are  also  sufficiently  well  marked,  for  in  cellulitis 
the  tenderness  on  pressure  is  confined  to  the  region  of  the 
right  or  left  lateral  ligament,  or  to  the  groin,  and  is  not  general 
as  in  peritonitis.  Neither  is  there  any  considerable  amount  of 
tympanitis  in  pelvic  cellulitis,  unless,  indeed, — as  sometimes 


396  On  Pelvic  CelluUtU, 

Bappens  in  pnerperal  cases — ^ihe  poritoneam  beoomes  i] 
bat  even  then  the  peritoneal  symptoms  are  always  someirhat 
masked  and  kept  in  abeyance.  The  palse,  too,  in  cellulitis  is 
neither  so  hard,  so  small,  nor  so  frequent  as  in  peritonitis ;  the 
vomiting,  if  present  at  all,  is  not  urgent,  nor  does  the  disease 
run  BO  rapid  a  course  as  child-bed  fever,  which,  moreover, 
usually  sets  in  a  day  or  two  earlier  after  confinement  than 
puerperal  cellulitis. 

Uterine  phlebitis  may  be  distinguished  from  cellulitis  by  the 
pain  and  tenderness  in  the  former  being  confined  to  the  region 
of  the  uterus,  and  in  the  legs,  to  the  sheath  of  the  femoral 
veins  and  the  popliteal  space.  The  appearance  of  the  limb  or 
limbs  in  phlegmasia  dolens  is  also  characteristic,  being  swollen, 
white,  tense,  and  shining,  as  also  exquisitely  painful,  whereas 
there  is  little  or  no  alteration  in  the  appearance  of  the  leg  in 
cellulitis,  and  the  pain  is  more  generally  referred  to  the  groin 
and  hypogastrinm  than  to  the  limb  itself. 

The  lochial  and  breast  secretions  are  more  completely  ar- 
rested in  uterine  phlebitis  than  in  the  afiection  under  notice  ; 
whilst  the  presence  of  dysuria,  painful  defecation,  and  bearing 
down  will  also  assist  us  in  forming  a  correct  diagnosis ;  but  in 
every  case  of  doubt  or  difficulty  we  should  at  once  have  re- 
course to  a  vaginal  examination,  as  that  alone  can  decide  the 
point. 

Having  detected  the  existence  of  a  tumour  either  within  the 
folds  of  the  broad  ligaments,  or  in  the  loose  cellular  tissue  in 
the  vicinity  of  the  uteras,  we  should  endeavour  to  ascertain  its 
exact  position,  relations,  size,  &c.,  and  also  whether  we  can 
detect  fluctuation  in  it.  In  its  early  stage,  cellulitis  is  marked 
by  very  acute  inflammation,  lymph  is  rapidly  and  extensively 
efiused  and  infiltrated  into  neighbouring  organs,  so  that  in- 
stead  of  a  rounded  and  regular  tumour,  we  shall  oflten  find  an 
irregular,  hard,  immobile  impacted  mass,  binding  the  uterus 
and  bladder,  or  uterus  and  rectum  together. 

Suppuration  being  by  far  the  most  usual  termination  of  pelvic 
cellulitis,  the  practitioner  will  be  anxious  to  ascertain  whether 
the  pus  should  already  have  made  an  outlet  for  itself,  and  this 
is  not  only  a  point  most  important  to  establish,  but  one  often 


by  Dr.  MacLimoni.  207 

^ery  difficult  to  asoertain,  for,  in  a  great  many  instances,  it 
either  escapes  by  the  rectum  or  the  vagina,  and  this  without 
attracting  the  patient  s  notice.    Such  is  very  generally  the  case 
when  the  abscess  discharges  itself  into  the  vagina ;  for,  if  in  the 
puerperal  state  the  patient  or  her  nurse  mistakes  the  flow  of  pus 
for  a  return  or  iucrease  of  the  lochial  secretion,  whilst  if  the 
patient  be  in  the  non-puerperal  state,  the  discharge  is  attributed 
simply  to  an  increase  of  the  leucorrhoea,  which  is  almost  always 
an  intercurrent  afifection.    When  the  abscess  communicates  with 
the  rectum,  the  patient  is  mach  more  generally  cognizant  of  the 
fact,  stating,  that  after  an  unusual  degree  of  straining  at  stool,  a 
gush  of  fluid  takes  place,  which,  on  inspection,  turns  out  to  be  pus 
mixed  with  blood  ;  hot  however  the  evacuation  may  take  place, 
it  is  invariably  followed  by  a  marked  abatement  of  all  the  symp- 
toms, and  the  patient  from  this  time  begins  to  recover ;  I  say 
begins  to  recover,  for  the  convalescence  is  usually  very  gradual, 
and  the  woman  may  have  many  relapses.    On  making  a  vaginal 
examination  now,  a  marked  diminution  in  the  size  of  the  tumour 
will  be  perceived,  but  it  will  often  retain  its  hard,  doughy  feel 
for  months  afterwards. 

In  all  the  cases  I  have  examined,  I  have  never  yet  been  able 
to  detect  the  point  at  which  the  pus  escaped  into  either  of  the 
two  natural  outlets.  It  is  probably  exceedingly  minute  and 
valvular  in  form.  I  have  occasionally  thought  that  I  could  feel 
a  slight  indentation — a  thickened  ring  of  mucous  membrane,  as 
it  were,  but  neither  the  eye  nor  the  probe  verified  this.  Happy 
is  it  for  the  patient  when  the  abscess  opens  into  either  the  vagina 
or  the  rectum,  but  unfortunately  this  is  not  always  the  case.  I 
remember  one  instance  in  which  the  pus  made  its  way  to  the 
abdominal  parietes,  and  pointed  in  the  neighbourhood  of  the 
anterior  superior  spinous  process  of  the  ilium ;  this  case  oc- 
curred in  St.  Bartholomew's  Hospital,  and  recovered.  In  another 
case  which  came  under  my  notice  at  the  London  Hospital  for 
Diseases  of  Women,  when  I  was  house  surgeon  to  that  Institu- 
tion, the  abscess  communicated  with  the  bladder,  and  gave  rise 
to  a  very  severe  and  protracted  attack  of  cystitis ;  this  patient 
also  recovered.  In  another  case,  which  occurred  in  the  practice 
of  a  friend,  the  pelvic  tumour  suddenly  collapsed,  and  its  subsi- 


S98  On  Pelvic  OelluUUs, 

denoe  coincided  with  as  sadden  an  attack  of  peritonitis;  and  fronk 
this  we  ooneladed,  with  reason  I  think,  that  the  abscess  had 
opened  and  discharged  itself  into  the  peritoneal  saa     Xfaia 
patient  all  hut  died — the  attack  being  one  of  great  severity,  l>ot 
eventually  she  got  well.    It  is  said  that  such  an  accident  as  I 
have  described  is  always  fatal,  but  this  case — ^if  we  were  correct 
in  our  diagnosis,  and  there  seems  no  good  reason  to  doubt  it—^ 
disproves  the  correctness  of  such  an  assertion.    My  own  belief 
is,  that  a  small  quantity  of  pus  may  escape  into  the  abdominal 
cavity  and  be  absorbed,  whilst  there  can  be  no  doubt  that  in 
the  injection  of  ovarian  tumours,  with  a  view  to  their  oblitera- 
tion, a  small  quantity  of  iodine  or  other  irritant  has  often  es- 
caped into  the  sac,  and  the  patient  recovered.    In  tapping* 
ovarian  cysts  also,  and  likewise  in  the  operation  of  ovariotomy, 
I  have  myself  frequently  witnessed  the  escape  of  some  of  the 
contents  of  the  cyst,  blood,  &c.  into  the  cavity,  and  no  bad 
result  follow.    It  is  therefore  not  improbable  that  the  escape  of 
a  small  quantity  of  pus  into  the  peritoneal  sac  may  only  give 
rise  to  a  manageable  attack  of  peritonitis,  not  necessarily  fataL 

The  abscess  may  also  communicate  with  a  fallopian  tube  when 
the  pus  may  get  into  the  uterus;  or  it  may  pass  along  the  round 
ligaments  and  point  in  the  labia  externa.  But  such  instances 
are  rarely  met  with,  the  usual  course  being  that  in  which  the 
abscess  opens  into  the  vagina  or  rectum,  and  into  the  latter 
more  commonly  than  the  former. 

The  insidious  nature  of  this  disease,  and  the  marked  tendency 
to  relapse,  should  lead  the  practitioner  to  give  a  very  guarded 
prognosis  in  most  cases ;  for  he  will  do  well  to  remember,  that 
•however  satisfactorily  a  case  may  seem  to  be  progressing,  the 
abscess  may  at  any  time  re-form^  when  a  return  of  all  the  old 
and  unfavourable  symptoms  may  be  expected. 

Although  cellulitis  occurs  more  frequently  in  the  married 
than  the  single  state,  yet  it  would  appear  in  both  to  be  con- 
nected with  and  preceded  by  a  considerable  degree  of  uterine 
disturbance,  which  perhaps  is  more  to  be  regarded  as  its  remote 
cause  than  the  various  accidents  usually  assigned  as  causes  by 
patients  themselves.  I  do  not,  however,  mean  to  assert  that 
cellulitis  may  not  sometimes  have  for  its  sole  cause  one  or  other 


bff  Dr.  MncLimqni.  899 

of  soch  accidents,  as  exposure  to  cold  in  diild-bed,  sitting  up. 
too  soon,  partaking  of  cold  drinks,  neglect  of  the  bowels,  &e. 
Indeed  in  one  of  die  cases  under  notice  the  attack  was  clearly 
due  to  an  injudicious  and  unskilful  remoTal  of  an  adh^ent 
placenta ;  in  another  to  the  use  of  the  forceps,  and  I  remember 
ft  case  in  which  a  severe  attack  was  brought  on  by  a  persistent 
attempt  to  introduce  the  uterine  sound  and  the  intra-uterine 
stem.  Certain  operations  on  the  uterus,  such  as  dilatation  of  the 
canal  of  the  cervix,  slitting  up  of  the  same ;  attempted  catheter- 
ism  of  the  fallopian  tubes ;  the  application  of  potassa  fusa  to 
indurated  or  hypertrophied  labia  uteri,  &c.  may  also  give  rise 
to  an  attack  of  cellulitis,  but  in  most  of  the  cases  which  as  yet 
have  come  under  my  observation  there  previously  existed  a 
more  or  less  marked  degree  of  derangement  of  the  uterine 
functions.  For  instance,  in  all  the  cases  under  notice  there  was 
obsUnate  and  profuse  leucorrhoea  from  the  very  commencement 
of  menstruation.  Abortion  occurred  more  than  once  in  six  out 
of  the  eight  cases  in  married  women.  Dysmenorrfaoea  and 
monorrhagia  were  prominent  symptoms  in  two  of  the  cases, 
whilst  the  ninth,  which  occurred  in  a  single  woman,  was  pre- 
ceded by  a  severe  form  of  ulceration  of  the  os  and  cervix  uteri. 
The  exeiling  cause  of  the  cellulitis  in  this  case  was  a  severe 
qprain  of  the  back  in  lifting  a  heavy  weight.  This  was  followed 
by  rigors,  flushings,  severe  pain  in  the  pelvic  region,  &c. ;  and 
in  the  course  of  about  six  weeks,  on  straining  one  day  when  at 
stool,  she  passed  about  two  tablespoonfuls  of  pure  pus,  after 
which  she  experienced  great  relief;  the  pus,  however,  continued 
to  discharge  per  rectum  for  about  eighteen  months,  and  her  con- 
valescence was  very  protracted. 

The  treatment  of  pelvic  cellulitis  is  a  very  wide  subject,  and 
one  upon  which  I  can  only  here  throw  out  a  few  general  hints. 
To  be  salutary  it  must  be  energetic,  for  it  cannot  be  too  forcibly 
impressed  upon  the  mind  of  the  practitioner  that  he  has  to  treat 
a  highly  acute  affection,  and  one  in  which  he  ought,  by  every 
means  within  his  reach,  to  endeavour  to  bring  about  speedy 
resolution,  and  so  prevent  the  formation  of  matter.  I  say  speedy 
resolution,  because  I  have  found  that  unless  the  inflammatory 
action  is  soon  arrested — viz.  within  twenty-four  hours  irpm  th^ 


800  On  Pelpie  CelluUtiMy 

occurrence  of  the  first  rigor,  there  exists  but  slender  hopes  of 
preventing  the  formation  of  an  abscess,  and  of  saving  the  patient 
from  a  long  and  wearing  illness  under  which  she  not  very  un- 
frequently  sinks. 

On  the  very  first  occurrence  of  rigors.  Aconite  or  Veratram 
viride  ought  to  be  administered  ;  but  to  be  of  use^  these  medi- 
cines must  be  given  in  low  potencies  and  at  short  intervals.      I 
consider  it  worse  than  useless  to  give  highly  attenuated  medicines 
in  a  disease  in  which  irreparable  mischief  may  be  eflfected  in  a 
few  hours.     We  must,  therefore,  give  the  medicine  indicated  in 
a  sufficiently  low  potency  and  in  such  a  dose  as  to  bring  the 
system  under  its  influence  within  a  few  fMurs^  otherwise  the 
patient  will  have  but  little  reason  to  thank  us  for  our  interfer- 
ence, or  we  to  congratulate  ourselves  upon  our  success.   Aconite 
1st  decimal,  or  even  (in  very  urgent  and  severe  cases)  the  pure 
tincture  itself,  ought  to  be  given  every  hour  until  the  rigors 
abate  ;  or  this  medicine  may  be  given  in  alternation  with  Bella- 
donna ;  but  valuable  as  these  drugs  undoubtedly  are  in  most 
inflammatory  diseases,  they  will  still  occasionally  disappoint  us. 
I  therefore  hail  with  pleasure  the  advent  of  so  powerful  and 
valuable  an  antiphlogistic  as  Yeratrum  viride,  especially  as  it 
has  been  proved  to  exercise  a  most  decidedly  beneficial  control 
over  all  pelvic  inflammations,  &c.    According  to  Dr.  Hale  of 
America,  this  drug  is  homoeopathic  to  a  great  many  forms  of 
uterine  disease,  such  as  amenorrhoea,  sudden  suppression  of  the 
menses,  and  particularly  to  suppression  of  the  lochia  and  milk 
accompanied  by  fever,  nausea,  vomiting,  and  headache.    It  will 
therefore   readily  occur  to  the  minds  of  most  homoeopathic 
physicians  that  it  is  strikingly  indicated  in  the  first  stage  of 
pelvic  cellulitis,  and  although  I  have  not  yet  put  this  to  the 
proof,  I  should  not  hesitate  to  do  so  if  opportunity  ofiered,  and 
with  a  pretty  confident  expectation  of  success. 

I  wish  to  impress  upon  my  professional  brethren  the  great 
importance  of  attending  to  the  state  of  the  bowels  in  this 
disease,  for  a  collection  of  hardened  faeces  can  never  fail  to 
aggravate  the  afiection  where  it  exists,  and  even  in  some  cases 
of  great  neglect  I  can  believe  that  it  would  even  occasion  an 
attack.    The  rectum  in  particular  must  bo  kept  constantly 


by  Dr.  MacLimont.  801 

empty ;  to  effect  this  there  is  no  better  means  than  the  daily 
nse  of  copioas  warm  gruel  or  warm  water  lavements.  Nax 
and  opium  may  be  tried  in  order  to  overcome  the  accompanying 
constipation,  but  they  will  not,  in  some  cases  at  least,  suffice  to 
produce  a  sufficiently  soluble  motion ;  and  Podophyllin,  or 
even  a  small  dose  of  castor  oil^  should  be  had  recourse  to.  The 
vagina  should  also  be  carefully  syringed  out  with  warm  flax-seed 
tea  at  least  twice  in  the  twenty-four  hours,  and  the  hypogastrium 
should  be  covered  with  a  hot  bran  or  linseed  meal  poultice, 
which  ought  to  be  renewed  from  time  to  time. 

If,  notwithstanding  the  use  of  all  these  means,  pus  should 
form  (which  will  be  known  by  the  rigors  partially  subsiding, 
and  followed  by  a  deep-seated  painful  throbbing  in  one  or  other 
iliac  region,  by  the  pulse  becoming  small,  and  by  symptoms  of 
collapse  setting  in),  we  must  then  have  recourse  to  Mercurius, 
and  also  to  Arsenicum,  Pulsatilla,  China,  &c. ;  and  the  patient 
must  be  well  supported  with  strong  beef  tea,  animal  jellies,  and 
particularly  with  brandy.  If  there  be  any  one  diseased  con- 
dition more  than  another  which  calls  for  the  free  exhibition  of 
the  hydro-carbons^  it  is  that  in  which  the  pyogenic  process 
exists  in  all  intensity,  and  having  given  rise  to  blood  poisoning, 
is  threatening  life  at  its  very  fountain.  That  form  of  sustenance, 
therefore,  which  can  be  most  readily  assimilated,  and  that  can 
pass  into  the  circulation  simply  by  endosmosis  without  under- 
going the  tardy  and  exhaustive  process  of  digestion,  is  the  one 
most  clearly  indicated  in  such  a  case  as  this ;  but  to  be  of  use, 
the  brandy  must  be  given  freely ^  though  in  regulating  the 
quantity  much  of  course  must  depend  upon  the  age,  constitu- 
tion, and  temperament  of  the  patient ;  but  it  should  be  borne 
in  mind  that  there  is  far  miore  danger  of  giving  too  little  than 
too  much. 

Before  concluding  this  subject,  we  have  yet  to  consider  the 
expediency  of  making  an  artificial  outlet  for  the  pus  in  those 
cases  in  which  we  can  detect  fluctuation,  but  where  the  walls  of 
the  abscess  are  too  thick  to  allow  nature  to  relieve  herself.  In 
making  an  opening  into  the  abscess,  we  must  be  guided  by 
many  circumstances  which  will  readily  occur  to  the  mind  of  any 
intelligent  practitioner ;  in  particular  he  must  take  great  care 


SOS  Reviews. 

not  to  mjore  adjacent  organs  or  arteries,  and  in  no  case  even  to 
dream  of  performing  the  operation  nnless  floetoation  can  be  dis- 
tinotly  felt,  and  the  pus  be  near  the  sor&ce.  Snch  precantions 
being  obeenred,  I  feel  eore  then  an  artificial  opening  may,  in 
certain  caaes,  be  had  recourse  to  with  manifold  advantage  to  the 
patient ;  indeed  I  can  conceive  of  instances  in  which  it  might 
even  save  life. 


REVIEWS. 


1.  Homoeopathy,  as  Practised  in  Manchester  Contrasted 
with  its  Alleged  Principles,  By  William  Roberts,  B.A., 
M.D.,  &c.    Manchester:  1862.    David  Eelly. 

2.  Hotnmopathy.  A  Review  of  Dr.  Roberts'  Attack  on  the 
Homoeopathic  Practitioners  of  Manchester.  By  Thomas 
Bayner,  M.D.,  &c.    Manchester:  1862. 

8.  Homoeopathy  as  Practised  in  Manchester  in  Harmony 
with   its  Alleged  Principles.     A  Reply   to   Dr.   Roberts 
Pamphlet.     By  John  Drummond,  M.B.C.S.Liv   &c.    H. 
Tomer,  Manchester  and  London. 

We  have  here  another  of  those  periodical  attacks  open  homceo- 
pathy  with  which  we  are  favoured  by  our  intimate  enemies,  the 
allopaths,  every  now  and  then,  to  revive  their  declining  hopes 
that  the  detested  heresy  is  "going  down"  at  last    In  language 
and  style  it  is  certainly  an  improvement  upon  "Homceopathy 
Unmasked,"  and  it  contains  none  of  the  ridiculous  nonsense 
about  the  heretical  theological  tendencies  of  our  system,  which 
Dr.  Simpson  talked.    It  is,  however,  not  the  less  imbued  with 
malus  animus,  and  we  must  add,  mala  fides,  and  cannot  be 
credited  with  the  high  motives  and  aim  to  which  the  author 
lays  claim.    Any  evil  it  might  do  to  the  canse  of  truth  is  likely 
to  be  averted  by  the  speedy  appearance  of  the  above  two  excel- 
lent replies,  which  expose  the  misrepresentations  completely; 
and  it  is  certain  that  the  ultimate  effect  of  this  controversy  will 
be  to  gain  us  new  adherents,  as  has  hitherto  been  the  case, 


Soberti  on  HomcBopathfi  in  Manchester.  808 

« 

without  ocoeption  in  all  previous  ooiitPOYersiee.  The  first  thing 
we  have  to  notice  in  Dr.  Boberts's  hook  is,  that  it  is  an  appeal 
to  the  non-medical  public.    On  this  Dr.  Bayner  remarks: — 

••'W^e  may,  at  this  point,  notice  an  objection  our  author  urg^s 
•gainst  the  literature  of  homoeopathy,  which  is  its  adaptation  to  the 
general  or  un-Bcientific  reader.     *  Homoeopathy,'  he  says, '  claims  to 
be  a  science,  yet  its  adyocates,  dissatisfied  with  its  reception  by  scien- 
tific men,  have  turned  to  the  public  for  support.     Now  this  is  a  bus. 
plcious  proceeding  in  a  department  of  knowledge  which,  if  a  science 
at  all,  is  simply  a  branch  of  pure  natural  science  and  natural  history.' 
He  then  goes  on  to  show  that '  medicine  is,  for  inherent  reasons,  one 
of  the  most  intricate  of  the  natural  sciences,  requiring  a  knowledge 
of  physiology,  of  which  the  basis  is  organic  chemistry  and  micro- 
Bcopic  anatomy.'     And,  *  that  to  appreciate  and  pronounce  on  facts 
relating  to  the  cure  of  diseases,  requires  an  extensive  personal  expe- 
rience of  the  natural  history  and  course  of  diseases,  and  a  practical 
knowledge  of  morbid  anatomy.'    He  then  reiterates  his  former  state- 
ment, that  'it  is  a  suspicious  proceeding  on  the  part  of  homoeopa- 
thiats  to  appeal  to  the  general  public  on  questions  which,  manifestly, 
can  only  be  decided  in  the  Court  of  Science.     But  it  has  been  the 
course  of  medical  empirics  in  all  ages,  and  the  fashion  is  not  dead  in 
our  days.'    (p.  53.)     Clearly  not ;  or  Dr.  Eoberts  would  not  have 
relinquished  '  for  months,  congenial  pursuits,'  for  the  sake  of  appeal- 
ing to  the  public  to  decide  on  this  vexed  scientific  question.     How 
insidiously  the  malaria  has  stolen  upon  him,  and  benumbed  his  sense 
of  propriety,  so  that  he  has  not  only  appealed  to  the  public,  but  in 
order  to  bring  down  hb  appeal  to  the  meanest  capacity,  has  copied, 
translated,  and  published  (ynfac  9imile\  the  prescriptions  of  other 
medical  men — a  course  of  conduct,  in  all  time,  held  to  be  most 
unprofessional.'' 

Dr.  Boberts's  own  account  of  the  main  object  of  his  book  is 
as  follows: — 

**  Before  proceeding  to  my  task,  however,  I  have  an  observation  to 
make.  Although  mit/ta  stmtUhus  curaniur  is  the  fundamental  doc- 
trine of  homoeopathy,  and  is,  indeed,  embalmed  in  its  very  name,  it 
is  not,  for  all  that,  its  most  prominent  feature  to  the  perception  of 
mortals.  The  law  of  nMia,  as  the  reader  will  find  demonstrated 
in  the  second  chapter,  is  little  more  than  a  snblime  abstraction,  inciu- 


804  .        Reviews. 

pable  of  any  but  the  most  imperfect  and  limited  translatioii  into 
practice.  The  doctrine  of  infinitesimal  doeea,  on  the  contrary,  is  one 
of  mathematical  plainness ;  and  it  is  capable  of  easy  and  unerring 
application  to  practice.  It  might  have  been  foretold  from  the  begin- 
ning that,  in  consequence  of  this  inherent  difference,  the  abstract 
principle  would  abide  in  cloudland ;  while  the  tangible  rule  would 
give  body,  complexion,  and  outward  dress  to  the  new  ftdth,  and, 
before  long,  attract  to  itself  the  exclusiye  devotion  of  its  yotaries. 
And  so  it  happened.  The  tiny  phial  of  tincture,  with  its  drop  dose; 
the  fairy,  tasteless  globule,  the  sugar  of  milk  powder,  the  cup  of 
pure  water — these  were  palpable  enough  to  the  patient  and  to  his 
wondering  friends ;  but  whether  the  treatment  was  in  unison  or  not 
with  the  law  of  nrnt/ta,  how  could  they  tell?  This  law  could  never 
be  to  them  more  than  a  form  of  words  altogether,  and,  of  necessity, 
beyond  their  appreciation.  Whatever  came  in  the  litde  phial,  or  in 
the  shape  of  a  globule,  or  as  insipid  sugar  of  milk  powder,  thai 
was  homoeopathy  to  them.  It  vrill  now  be  understood  why  infini- 
tesimal doses  take  the  precedence  in  these  pages."     (p.  ix.) 

We  certainly  do  understand  it  very  well.  But  we  are  amazed 
that  he  should  confess  it  with  such  a  cynical  frankness.  He 
knows  perfectly  well  that  the  dose  is  merely  incidental  to 
homosopathy,  but  that  it  has  attracted  the  almost  exclosiye  at- 
tention of  a  public  incapable  of  fully  comprehending  the  ques- 
tion as  a  whole.  With  the  object  of  proving  a  number  of  his 
medical  brethren  to  be  cheats  and  impostors,  he  addresses  him- 
self to  that  public  on  the  only  point  palpable  to  them,  with  the 
hope,  if  he  can  show  something  inconsistent  in  that,  with  their 
preconceived  (though  erroneous),  notions,  he  may  easily  throw 
dust  in  their  eyes  as  to  the  more  theoretical  and  recondite  parts 
of  the  question.  The  plan  is  simple.  1st.  He  asserts  the  in- 
finitesimal dose  is  essential  to  homoeopathy.  2nd.  He  decrees 
that  the  third  dilution,  or  the  millionth  of  a  grain,  is  the 
strongest  dose  that  can  be  called  infinitesimal  (all  above  that 
being,  we  presume,  allopathic),  drd.  Therefore,  when  any 
larger  dose  is  given,  the  practitioner  has  no  belief  in  homoeo- 
pathy ;  and  when  the  medicine  is  one  also  in  ordinary  use,  it  is, 
he  roundly  asserts,  allopathic  in  action  as  well  as  in  dose, 
while  the  latter  is  disguised  so  as  to  take  in  the  homoeopathic 


Boberis  on  Homceopathy  in  Manchester,  805 

pablio — that  homoBopatby  is,  in  fact,  the  ''mock  practice  of  a 

mock  scieDce."   Dr.  Boberts  tells  us  he  feels  it  a  pablio  duty  to 

expose  all  this,  and  is  anxious  that  the  charitable  subscribers 

to   the  Homoeopathic  Dispensary  should  be  aware  that  their 

money  is  spent  on  old-fashioned  drugs  in  old-fashioned  doses. 

Why  does  he  not  say  at  once  he  is  anxious  that  the  other  class 

of  patients  should  be  aware  that  the  new  puffing  shop  over  the 

way  sells  nothing  but  the  old  wares  under  new  names,  and  the 

said  patients  had  better  come  back  to  the  old  shop?     The  way 

be  sets  about  his  task  is  this :  he  gathers  all  the  homceopathic 

prescriptions  he  can  get,  and  prints  some  in^a^  simile^  with  an 

explanation  of  their  meaning.     By  this  means  he  proves  or 

discovers,  as  he  imagines  (what  nobody  dreamt  was  hidden), 

that  we  often  give  much  larger  doses  than  the  millionth  of  a 

grain !     Of  course  the  gist  of  his  case  is,  that  this  should  be 

inconsistent  with  the  principles  of  homoeopathy.    On  this  point 

we  quote  Dr.  Bayner: — 

''A  quotatiou  from  Hahnemann  heads  the  chapter  on  the  dose,  to 
the  effect  that  a  medidne,  though  it  may  be  homceopathically  suited 
to  the  cure  of  disease,  does  harm  in  every  dose  that  is  too  large— 
the  more  harm  the  larger  the  dose ;  and  by  the  magnitude  of  the 
dose,  it  does  more  harm  the  greater  its  homoeopathicity.  This  is  so 
self-evident  a  proposition,  that  even  the  author  of  the  pamphlet 
cannot  demur  to  it,  especially  when  he  remembers  his  cases  of  teta- 
nus. But  the  question  comes — what  dose  is  too  large  ?  In  many 
cases,  the  dose  is  too  large  if  it  produce  aggravation  or  develop  its 
own  physiological  effects  in  the  patient;  and  yet  there  are  cases  in 
which  even  this  may  be  done  to  some  slight  extent,  not  only  without 
harm,  but  with  benefit:  probably  syphilis  is  such  a  case.  As  a 
rule,  however,  we  hold  that  dose  to  be  small  enough  which  produces 
in  the  patient  no  other  effect  than  the  relief  of  the  ailment  under 
which  he  labours ;  or,  in  other  words,  which  acts  as  an  alterative  is 
said  to  do.  If,  then,  an  infinitesimal  dose  answers  this  end,  it  is  not 
too  small ;  if  a  massive  dose  does  this,  and  no  more,  it  is  not  too 
large.  This  allows  plenty  of  range,  surely,  and  is,  we  believe,  the 
view  taken  of  the  dose  by  many  practitioners  of  homoeopathy,  as 
weU  in  Manchester  as  elsewhere." 

Tliis  we  accept  as  a  clear  and  correct  view  of  the  matter;  and 

VOL.   XX.,   NO.   LXXX. — APRIL    1862.  U 


806  Beview, 

if  80,  what  becomes  of  Dr.  Roberts's  whole  charge  of  incon- 
sistency ?  The  foundation  being  gone,  the  whole  edifice  tumbles 
in  pieces. 

But  we  will  meet  him  on  even  a  lower  ground.  No  doubt« 
though  not  essential,  the  small  dose  is  a  great  incidental  advan- 
tage of  homceopathy;  in  that,  as  a  rule,  the  drugs  have 
neither  smell  nor  taste,  and  are  of  small  bulk  and  small  cost. 
Let  us  go  into  detail,  and  we  shall  be  able  to  claim  that  still 
for  homoeopathy,  even  with  those  instances  given  by  Dr.  Roberts* 
though  no  doubt  they  do  not  give  the  fairest  average  of  homoeo- 
pathic prescriptions. 

Out  of  the  classified  list  of  doses  at  page  22,  seven  were 
stated  to  be  in  pure  tinctures.  From  this  the  reader  is  supposed 
to  infer  that  the  dose  was  allopathic,  or  something  like  it.  But 
when  we  turn  to  \hefac  simile  of  one  of  these  prescriptions,  at 
page  1 0,  we  find  that  a  powder  moistened  with  the  said  tincture 
(the  quantity  not  stated,  but  Dr.  Roberts  says  the  custom  is  to 
use  6  drops ;  a  chemist,  in  Liverpool,  says  his  custom  is  to  put 
2  drops  when  the  quantity  is  not  stated),  say  6  drops,  is  to  be 
dissolved  in  12  spoonfuls  of  water,  and  one  given  for  a  dose. 
The  dose  in  this  case  is,  in  reality,  only  half  a  drop.  The 
medicines  so  mentioned  in  that  prescription  are  tincture  of  Can* 
tharides  and  tincture  of  Bark.  The  dose  of  those  two  medi- 
cines, in  allopathic  practice,  according  to  Neligan,  is  10  to  40 
drops,  and  60  to  180  drops  respectively;  and  yet  the  ignorant, 
non-medical  persons  whom  he  is  addressing  are  informed  by 
Dr.  Roberts  that  the  above  are  allopathic  prescriptions !  By 
analyzing  the  remaining  prescriptions,  which  are  all  in  more 
minute  doses,  with  the  exception  of  one  class,  we  find  that  in 
14  the  dose  is  from  Vio  to  Vjo  or  ^/^  of  a  drop.  In  19  it  was 
firom  Vioo  to  Viooo,  ^^^  in  14  from  Viooo  to  *  billionth.  The 
excepted  class  is  those  given  really  in  the  ordinary  dose  of  allo- 
paths. Of  this  class  he  states  there  were  18.  We  have  no 
means  of  checking  the  truth  of  this,  but  we  can  state  positively 
that  does  not  form  anything  like  an  average  per  centage  of  such 
prescriptions  used  by  homoeopathic  practitioners.  Some  of  the 
instances  given  are  of  medicines  common  to  both  schools,  and 
which  are  really  homoeopathic,  though  used  empirically  by  the 


Sober  is  on  Homoeopathy  in  Manchester.  807 

allopaths.  Of  course,  of  these,  we  may  push  the  dose  to  any 
extent  experience  leads.  Others,  again,  are  openly  and  avowedly 
used  by  us  for  allopathic  or  antipathic  purposes,  and  of  course 
require  the  ordinary  dose.  On  this  point,  we  quote,  as  a  com- 
plete explanation,  from  Drummond,  page  17: — 

**  Although  Hahnemann  contended  for  the  universality  of  the  law 
of  similars,  we  do  not  wish  to  do  this,  because  we  believe  it  to  be  a 
general^  and  not  a  universal  therapeutical  law.     As  an  example  of 
my  meaning,  we  will  take  a  case  in  which  the  patient  is  suffering 
from  undigested  and  fermenting  food.     Here  we  have  the  palpable 
cause  of  the  suffering — viz.,  the  undigested  food,  as  well  as  the 
functional  or  structural  changes,  which  are  probably  the  vital  causes 
of  the  food  remaining  undigested.     Now  the  medical  man  may  use 
his  discretion  whether  the  proper  and  best  mode  for  him  to  proceed 
is  to  empty  the  stomach  of  its  contents  and  thus  remove  the  cause  of 
complaint,  or  whether  he  should  treat  the  purely  vital  disorder  which 
has  impaired  the  vigour  of  the  digestive  system.     If  he  adopts  the 
first  course,  he  will  rid  .the  patient  of  pain  for  a  time,  and  he  will  do 
so  quickly,  but  probably  this  relief  will  only  continue  until  he  par- 
takes of  his  next  meal.     He  therefore  follows  up  his  palliative  treat- 
ment by  other  means  of  a  specific  nature.     Now,  if  the  homoeopath 
treated  the  case  after  this  common-sense  fashion,  he  might  be  said  to 
have  administered  an  emetic  for  the  cure  of  indigestion,  although  in 
reality  he  only  gave  it  to  get  rid  of  some  offending  and  undigested 
food,  and  really  cured  his  patient  afterwards  by  the  use  of  such 
remedies  as  nux  vomica,  Pulsatilla,  etc.     Or  again,  in  a  case  of  con- 
stipation, we  have  to  deal  with  the  lessened  vigour  of  the  intestines, 
which  is  the  cause  of  their  acting  inefficiently,  and  with  the  accumu- 
lation within  them,  which  might  proceed  to  obstruction  if  allowed  to 
go  on  unchecked.     A  homcBopath  may  therefore  use  castor  oil,  croton 
oil,  compound  colocynth  pill,  or  any  other  purgative,  in  the  first  in- 
stance, as  a  means  to  remove  the  obstruction ;  but  for  the  cure  of  the 
causes  of  the  obstruction — the  vital  deficiency  which  has  led  to  im- 
paired action — he  will  use  appropriate  specific  remedies,  as  nux 
vomica,  alum,  opium,  or  lead." 

Before  leaving  the  subject  of  the  dose,  as  the  question  raised 
by  Dr.  Roberts  really  possess  an  interest,  we  have  taken  steps 
to  ascertain  what  is  the  actual  average  of  doses  used  at  least  in 

D  2 


808 


Review. 


the  north  of  England.    The  dose  is  entirely  a  matter  to  be  de- 
termined by  experience,  and  since  homoeopathists  have  refused  to 
be  bound  by  any  dogmatic  teaching  on  this  point  by  Hahnemann 
or  any  one  else,  the  question  may  be  looked  on  as  in  a  state  of 
transition.     On  enquiry  in  Liverpool,  which  was  most  conve- 
nient, we  have  been  kindly  furnished  by  the  principal  homoeo- 
pathic chemist  with  a  list  of  the  doses  ordered  in  the  hundred 
prescriptions  preceding  the  day  on  which  the  information  was 
sought.    The  result  is  as  follows : — Of  doses  of  one  drop  and 
upwards  of  the  pure  tincture  there  were  ten  examples.     Of 
these  one  drop  was  usual,  and  the  highest  quantity  three  drops, 
viz.  of  Chelidonium,  which  is  a  weak  medicine  like  Taraxacum. 
Of  doses  under  a  drop  or  grain,  and  above  i/ioth,  there  were 
also  ten  examples.    Between  and  Yioth  and  Yioth  there  were  nine 
examples.  Between  Visoth  and  Viooth  there  were  fifteen  examples. 
Between  the  Yiooth  and  the  billionth  there  were  fifty-six  ex- 
amples, viz. : — 

Of  the  100th  ....        9  examples. 


1000th 
10,000th      . 
millionth 
100  millionth 
billionth 


8 
11 
15 

5 
13 


56 


On  enquiry  at  the  Liverpool  Homoeopathic  Dispensary  we  find 
a  somewhat  similar  scale,  but  the  majority  of  prescripUons 
were  between  the  Yioth  and  the  millionth. 

With  respect  to  the  cost  of  drugs  for  the  Liverpool  Homoeo- 
pathic Dispensary,  we  find  that,  by  the  report  for  January  1862, 
there  were  dispensed  during  last  year  34,069  prescriptions,  at 
the  total  cost  of  drugs  of  34/.,  exclusive  of  cod  liver  oil,  giving 
an  average  of  about  ^d.  for  each  prescription. 

These  data  we  think  triumphantly  vindicate  for  the  actual 
practice  of  homoeopathy  as  close  a  correspondence  between  the 
ideal  of  homoeopathy  and  its  working  out  in  reality  as  we  can 
ever  expect  in  the  working  out  of  any  theory.  While  we  have 
never  attempted  to  conceal  that  in  certain  exceptional  instances 


A  Few  Words  about  Shoes.  809 

allopathic  prescriptions  are  avowedly  used,  and  while  in  other 
cases  from  the  strong  taste  or  smell  or  colonr  of  certain  other- 
wise weak  medicine  perceptible  doses  mast  be  given,  yet  we 
maintain  that  on  the  average  our  system  possesses  in  practice  the 
merits  of  the  tastelessness^  small  bulk  and  cheapness  of  drugs 
we  have  always  claimed  for  it.     On  the  whole,  therefore,  we 
may   conclude  that  the  Manchester  doctor  has  discovered  a 
mares  nest,  and  we  wish  him  and  his  jubilant  colleagues  joy  of 
It.     No  doubt  his  friends  of  the  Medical  Ethical  Society  (who 
turned  out  Dr.  Boberton  because  he  acted  as  no  man  of  com- 
mon humanity  or  gentlemanly  feeling  could  have  done  otherwise 
than  act)  will  vote  their  thanks  to  him  and  sympathize  with  his 
indignation  against  the  "  mock  practitioners  of  a  mock  science/' 
But  they  cannot  but  feel  that  we  are  quite  aware  that  all  this  is 
mere  affectation  put  on  to  conceal  their  anger  and  vexation  at 
finding  we  are  not  the  noodles  they  would  fain  have  the  public 
believe  we  are,  and  are   not  sectarians  hide-bound  by  narrow 
dogmas,  but  able  and  willing  to  practise  medicine  as  masters  of 
all  the  resources  of  our  art.     In  short,  the  sting  of  the  whole 
thing  lies  in  this,  that  we  are  the  phtsicians  and  they  are  only 
Allopaths. 

MISCELLANEOUS. 


A  Few  Words  about  Shoes. 

SiKCS  the  day  when  the  classical  shoemaker,  elated  by  his  success- 
ful criticism  on  the  statuary's  representation  of  a  sandal,  ventiu*ed 
OD  further  faalt-finding  and  was  snubbed  back  to  his  business,  with 
the  recommendation  to  stick  to  his  last,  his  representatives  in  all 
succeeding  ages  have  amply  revenged  the  insult  offered  to  their 
predecessor,  by  playing  all  sorts  of  fantastic  tricks  with  the  last  to 
which  they  were  relegated.  The  torture  they  have  inflicted  on 
humanity,  in  their  cruel  efforts  to  twist  and  distort  the  human  foot, 
from  the  shape  nature  fashioned  it  to  their  own  fanciful  and  unnatu- 
ral ideal,  is  something  appalling  to  contemplate.  In  defiance  of 
nature  and  of  their  original  snubber,  the  statuary,  they  have  inces- 
santly endeavoured  to  alter  the  shape  of  the  foot  into  a  pointed  men- 


dIO  Miscellaneous. 

BtroBity,  ill  adapted  for  walking,  but  ingeniously  contrived  for    the 
development  of  various  painful  maladies,  which  would  be  totally 
unknown  were  natural  principles,  and  not  shoemaker's  fashious,  to 
regulate  the  shape  of  the  shoe.     Bunions,  corns,  deformed  nails, 
perhaps  even  gout  itself,  are  some  of  the  common  torments  shoe- 
makers have  inflicted  on  our  unhappy  race ;  while  flat  feet,  caries  of 
the  bones,  lameness,  are  often  the  result  of  the  baleful  art.     And 
mankind  have  suffered  in  silence,  scarcely  daring  to  murmur  at  their 
torturers.     We  have  been  content,  with  every  pair  of  new  boots,  to 
walk  about  in  agony  for  days  or  weeks,  until  our  foot  could  work 
the  leather  from  the  shoemaker's  fancy  shape  into  some  approxima- 
tion to  the  natural  form ;  and  then  we  have  been  chagrined  to  observe 
that  our  boot  has  been  so  worked  "  out  of  shape,"  t.  e.,  out  of  the 
shoemaker's  shape  into  something  resembling  the  natural  shape. 
But,  in  the  end,  the  shoemaker  triumphed ;  for  each  successive  pair 
of  new  boots,  by  repeating  the  process  of  distortion,  irremediably 
altered,  more  and  more,  the  original  shape  of  the  foot,  until  at  length 
we  discovered,  to  our  mortification,  that  our  foot  was  permanently 
disfigured,  and  would  bear  no  comparison  with  the  foot  of  the  classi- 
cal statue.     For  ages  we  have  conceded  to  the  shoemaker  unlimited 
control  over  the  shape  of  that  last  he  was  counselled  to  stick  to;  and 
the  consequence  has  been  that  he  has  done  with  our  feet  just  what 
he  pleased ;  and  now  the  well-shod  foot  no  more  resembles  the  foot 
nature   intended  us  to  have,  than   Caliban  resembles  the  Apollo 
Belvidere. 

But  the  despotism  of  the  shoemaker  is,  we  hope,  coming  to  an 
end.  In  this  nineteenth  century,  when  nothing  is  acquiesced  in 
because  it  is  conventional — ^when  the  spirit  of  scepticism  attacks  all 
time-honoured  traditions  and  unceremoniously  explodes  the  most 
venerable  fallacies — when  everyone  pokes  his  nose  into  eveiyone 
else's  business — and  reforms  in  one  profession  are  usually  the  work 
of  members  of  another — in  this  century,  we  repeat,  it  could  hardly 
be  expected  that  the  shoemaker's  traditional  notions  as  to  the  proper 
form  of  the  human  foot  would  remain  unquestioned.  Accordingly, 
we  have  before  us  two  treatises  on  the  proper  shape  of  the  shoe, 
published  within  the  last  two  years,  one  by  Dr.  H.  Meyer,  Professor 
of  Anatomy,  Zurich,*  the  other  by  a  practical — but,  we  presume, 

*  Why  the  Shoe  Pinches ;  a  ConiribuHon  to  Applied  Anatomy.  By  Hermann 
Moyer,  M.D.,  &c.;  translated  by  J.  S.  Craig,  L.RC.P.E.  Edinburgh,  1860. 


A  Few  Words  About  Shoes.  8 1 1 

lieretical — shoemaker,  Mr.  Dowie,  of  ChariDg  Cross.*  The  work  of 
Professor  Meyer  is  chiefly  upon  the  proper  form  to  he  given  to  the 
sole  of  the  shoe  or  hoot.  He  points  out  that,  in  the  natural  shape 
of  the  foot,  a  straight  Hne  drawn  through  the  centre  of  the  great 
toe,  if  prolonged  to  the  heel,  would  pass  through  its  centre ;  and  he 
asserts,  quite  correctly,  that  the  sole  of  the  shoe,  in  order  to  fit  the 
normal  foot,  should  be  so  constructed  as  to  allow  the  great  toe  to 
have  its  normal  position  in  the  shoe.  In  the  sole  of  the  shoe,  as 
usually  constructed,  a  straight  line  drawn  through  the  position  occu- 
pied by  the  centre  of  the  great  toe,  falls  to  the  inside  of  the  heel, 
and  the  shoe  constructed  on  a  sole  of  this  shape  will  have  a  tendency 
to  push  the  great  toe  towards  the  centre  of  the  foot,  which,  as  is 
well  known,  it  actually  does.  But  if  the  great  toe  be  pushed  towards 
the  centre  of  the  foot,  its  metatarsal  joint  wUl  be  injured,  the  liga- 
m^its  strained,  the  joint  itself  partially  dislocated.  The  consequence 
is  an  unsightly  projection  which  is  exposed  to  pressure,  bruises,  and 
other  injuries,  whereby  bunions  are  the  usual  result;  and  in  the  case 
of  a  gouty  subject,  as  the  gout  usually  fastens  on  a  part  that  has 
been  injured,  the  common  seat  of  the  gouty  attack  is  in  this  poor, 
partially  dislocated  and  systematically  injured,  great  toe.  In  soles 
of  shoes  constructed  on  the  principles  laid  down  by  Professor  Meyer, 
when  the  shoes  are  placed  side  by  side,  with  the  heels  in  contact, 
the  inner  margins  of  the  front  part  will  be  found  to  lie  close  together, 
just  as  the  normal  feet,  when  placed  close  together,  will  be  found  to 
be  in  contact  all  along  their  inner  borders,  from  the  heels  to  the  end 
of  the  great  toes.  Shoes  constructed  on  this  principle  will  preserve 
the  natural  shape  of  tlie  foot,  and  ^ve  the  pedestrian  the  full  power 
of  his  toes  in  walking,  which  he  cannot  have  in  shoes  constructed  in 
the  ordinary  fashion,  where  the  great  toe  is  forcibly  thrust  into  the 
middle  of  the  foot,  probably  oyerlapping  some  of  the  other  toes, 
which,  in  their  turn,  are  squeezed  out  of  all  shape  and  proportion  by 
the  similar  inclination  given  to  the  outside  of  the  sole. 

For  feet  already  distorted  and  mis-shapen  by  the  sinister  skill  of  the 
shoemaker.  Professor  Meyer  insists  on  constructing  his  ideally  perfect 
shoe.  That  is  to  say,  the  sole  is  to  be  cut  exactly  as  if  the  great 
toe  were  in  its  proper  position.  By  this  means,  he  asserts,  the  toe 
will  be  brought  to  resume  its  normal  position,  and  the  deformed  foot 
will  be  regenerated.     Whether  this  assertion  is  borne  out  by  facts 

♦  The  Fool  and  its  Covering.    By  James  Dowie.    London,  1861 . 


312  Miscellaneous. 

or  no,  we  are  not  in  a  position  to  decide ;  but  certainly  Profeseor 
Meyer's  plan  reminds  us  of  the  philosophic  tailors  of  Laputa,  who 
measured  their  customers  on  strictly  mathematical  principles,  with 
quadrants,  sextants,  dumpy  levellers,  and  the  like  scientific  instru- 
ments ;  and,  if  we  remember  right,  the  clothes  never  fitted  properly. 
Dr.  Meyer  evidently  dislikes  the  plan  adopted  by  some  shoemakers, 
of  taking  an  outline  of  the  foot.  '*  Most  shoemakers,"  he  says,  *'  use 
such  drawings  in  order  to  find  out  how  they  will  be  able,  most  con- 
veniently, to  squeeze  the  foot  into  the  smallest  possible  compass." 
'^  For  healthy  feet,"  he  adds,  *'  a  drawing  is  superfluous ;  it  is  suffi- 
cient to  have  the  length  and  breadth,  and  a  knowledge  of  the  struc- 
ture of  the  healthy  foot." 

Mr.  Dowie*s  little  book  contains  a  translation  of  Professor  Cam- 
per's treatise  ''On  the  Best  Form  of  Shoe."  If  the  principles 
inculcated  by  Camper  had  been  acted  on  by  shoemakers  in  general 
since  his  day,  the  world  would  have  been  spared  a  great  deal  of 
torture.  He  pointed  out  the  mischief  of  the  ordinary  construction 
of  the  sole,  its  effect  in  distorting  the  great  toe  and  causing  corns 
and  bunions;  and  though  he  did  not  lay  down  an  exact  rule  for  the 
construction  of  the  sole,  as  Professor  Meyer  has  done,  he  insisted 
strongly  on  giving  it  sufficient  breadth,  and  one  of  the  figures  he 
gives  represents  pretty  accurately  the  shape  of  a  sole  adapted  to  a 
normal  foot. 

Mr.  Dowie,  in  his  part  of  the  work,  recognises  the  principle  of 
making  the  sole  of  the  shoe  correspond  to  the  shape  of  the  foot,  but 
he  does  not  go  to  the  same  length  in  this  respect  as  Professor  Meyer. 
He  exposes  the  ill  effects  of  the  ordinary  wedge-shaped  toe  of  boots 
and  shoes,  to  which  he  attributes  the  deformity  of  the  great  toe  and 
its  dislocation  into  the  middle  of  the  foot.  The  remedy  for  this  he 
proposes  is  to  make  plenty  of  room  in  the  shoe  for  the  toes,  by 
increasing  the  upper-leather  at  the  toe  of  the  shoe.  But  Mr.  Dowie's 
great  claim  to  be  considered  a  reformer,  consists  in  his  introduction 
of  a  piece  of  ''elasticated  leather"  into  the  middle  of  the  sole  of  the 
boot  or  shoe.  By  this  simple  and  ingenious  contrivance,  he  gives  to 
a  thick-soled  boot  or  shoe  all  the  flexibility  of  a  slipper,  and  the 
foot,  in  walking,  retains  all  its  natural  springiness.  None  but  those 
who  have  tried  them  can  form  a  notion  of  the  comfort  and  pleasure 
it  is  to  walk  in  thick-soled  boots  constructed  on  Mr.  Dowie's  princi- 
ple, after  having  been  accustomed  to  wear  the  ordinary  stiff-soled 
shoes.     Another  innovation  of  Mr.  Dowie's  is  in  the  heel  of  his 


Exasperating  a  Disease.  813 

shoe,  which  is  very  wide,  and  scarcely  thicker  than  the  rest  of  the 
sole. 

AVe  feel  assured  that  at  length  the  true  principles  of  constructing 
the  coTering  of  the  foot  have  heen  discovered.  With  the  sole 
shaped  according  to  the  principle  laid  down  hy  Professor  Meyer, 
with  a  waist  of  elasticated  leather,  as  in  Mr.  Dowie's  patent,  with  a 
broad,  low  heel,  and  a  soft,  wide,  hut  well-fitting  upper-leather,  the 
pedestrian  will  he  ahle  to  walk  with  all  the  native  springiness  of  his 
foot,  bunions  and  corns  will  he  impossible,  and  lame  feet,  from 
chafing  or  pressure,  will  be  unknown. 

Scientific  principles  in  the  construction  of  boots  and  shoes  must 
ultimately  obtain  universally.  Already  we  see  in  many  shoe  shops 
a  notice  to  the  effect  that  boots  and  shoes  are  made  on  the  "  natural 
method,"  with  a  reference  to  Meyer's  book. 

When  this  is  the  case,  we  poor  creatures,  who  have  so  long  been 
tortured  by  our  shoemakers,  shall  have  the  satisfaction  to  find  that 
henceforth  our  shoes  will  be  made  to  fit  our  feet,  not  our  feet  made 
to  fit  our  shoes. 

Exonerating  a  Disease, 

The  special  correspondent  of  the  Times,  in  his  letter  from  the 
Dismiited  States,  that  appeared  on  the  17th  of  January,  writes: — 
**  General  M'CleUan  is  slowly  recovering  from  an  attack  of  fever  of 
a  mild  typhoid  type,  which  has  been  treated  homceopathically,  and 
was,  probably,  much  exasperated  in  consequence."  The  issue  of 
the  General's  malady,  as  all  the  world  knows,  was  perfect  restoration 
to  health  and  strength.  Cavour,  the  Prince  Consort,  the  King  of 
Portugal  and  his  brother,  and  several  other  great  personages,  whose 
names  we  cannot  at  present  recal,  were  lately  attacked  by  typhoid 
fever,  said  to  be  of  a  mild  type,  and  they  did  not  recover.  But  then 
their  diseases  were  not  exasperated  by  the  treatment — at  least,  no 
special  correspondent  hinted  at  such  an  occurrence.  Decidedly, 
then,  the  best  mode  of  treating  typhoid  fever  is  to  exasperate  it  by 
homoeopathic  treatment.  Apparently,  the  disease,  when  so  exas- 
perated, leaves  the  patient  in  a  huff.  It  is  not  used  to  be  so  treated, 
and  won't  stand  it;  so  it  abandons  the  patient  to  his  fate,  and  he 
recovers.  Reader,  should  you  or  your  friends  be  attacked  by  typhoid 
fever,  hasten  to  adopt  the  exasperating  mode  of  treatment,  i.  e,,  the 
homoeopathic,  if  you  wish  to  recover  with  M'Clellan,  and  not*  die 
with  Cavour  and  the  others. 


814  Miscellaneoui. 

The  Letter  of  the  Law. 

Our  oontemporaiy,  the  Monthly  Homosopathie  Review,  whose 
classic  erudition  we  have  often  admired  and  envied,  comes  do^vn 
upon  us  rather  severely  in  its  February  number,  on  account  of  the 
motto  that  surrounds  the  woodcut  of  Hahnemann's  head,  on    our 
cover.     Following  the  fashion  set  many  years  since  by  writers  on 
homceopathy,  we  had  the  homoeopathic  formula  inscribed,  '^similia 
similibus  curantur."  This  seems  to  give  great  offence  to  our  classical 
contemporary,  compelling  him  to  allude  to  us  in  the  following  vigor- 
ous style:    "The  very  law  of  homoeopathy  has  been  subjected  to 
vicious  and  false  interpretations  by  substituting  one  letter,  one  vowel, 
for  another,  a  for  e.    Hahnemann  was  a  good,  though,  in  the  critical 
sense,  not  a  profound  scholar.     The  old  hero  knew  very  well  the 
value  of  the  words  he  employed.     He  was  incapable  of  the  ridicu- 
lous solecism,  of  the  ignorance,  which  is  perpetuated  on  the  title-page 
of  the  British  Journal  of  Homceopatht/.     His  expression  for  this  law 
of  drug-healing  was,  and  is,  similia  similibus  curentur,  not  curantur. 
His  best  beloved  English  friend,  and  his  reverent  pupil,  the  late 
Rev.  T.  R.  Everest,  told  us  how  much  Hahnemann  was  annoyed  at 
the  employment  of  the  word  curantur.     In  the  medical  sense  the 
Latin  verb  euro  means  to  take  charge  of,  to  treat,  to  doctor,     Hah- 
nemann was  too  much  of  a  philosopher  to  arrogate  the  cure,  he  pro- 
posed the  treatment,      'Let  likes  he  treated  by  likes;*  that  is  the 
formula  or  expression  he  adopted  for  the  law  of  drug-healing.     In 
that  formula  he  expresses  one  of  Nature's  laws  of  healing — that  is, 
a  law  of  Qod ;  the  expression  foisted  on  him  is  an  impertinence. 
Let  this  formula  be  adopted — 

filHILIA   SIMILIBrS  CUBEKTUB. 

The  editors  of  the  British  Journal  of  Homceopathy  should  turn  the 
a  into  an  «." 

Overlooking  the  strength  of  this  language,  which  we  ascribe  to 
the  zeal  of  the  scholar  on  the  occasion  of  a  fancied  outrage  on  his 
classical  sensibilities,  we  will  argue  the  point  with  him,  without  dis- 
playing the  slightest  irritation. 

^^  Similia  similibus  curentur,**  as  Hahnemann  and  our  contempo- 
rary have  it,  means,  as  we  all  know,  and  as  our  contemporary  informs 
us,  ^^Let  likes  be  treated  by  likes,"  ^* Similia  similibus  curantur"  as 
many  put  it,  and  as  we,  in  happy  ignorance  of  the  storm  that  was  to 
burst  over  us  twenty  years  later,  inscribed  on  our  cover  when  we 


The  Letter  of  the  Law.  8 1 5 

published  oar  first  number,  means,  as  we  all  likewise  know,  ^'  Likee 

ure  treated hy  likes"  The  former  our  classical  contemporary  regards 

as  *'a  thing  of  beauty  and  a  joy  for  ever;"  the  latter  as  a  *' ridiculous 

solecism,"  an  *' ignorance,"  an  "impertinence,"  and  we  know  not 

^what  else  besides.     Now,  to  our  own  confusion,  we  confess  that, 

possibly  owing  to  defective  classical  learning,  we  cannot  see  very 

much  difference  between  the  two  formulas.     Supposiirg  some  re- 

nowned  professor  were  to  say  to  his  listening  pupils,  "  pneumonia  is 

treated  by  bleeding,"  his  audience  would  thereby  understand  him  to 

express  a  rule  for  the  treatment  quite  as  well  as  if  he  said,  "  let 

pneumonia  be  treated  by  bleeding."     It  would  come  to  precisely  the 

same  thing  whether  he  said  *^pneutnonia  veneeectione  curaiury*  or 

**pneumonia  venesecitone  curetur." 

But  we  are  not  alone  in  our  supposed  offence  against  the  proprie- 
ties.     We  have  sinned  in  company  with  a  very  numerous  array  of 
physicians,  both  here  and  abroad.     Writers  who  can  justly  pretend 
to  much  more  classical  purity  than  ourselves,  have  sanctioned,  by 
their  example,  the  odious  fault  for  which  our  contemporary  is  so 
severe  upon  us.     The  Monthly  HomcBopathic  Review  will  surely 
allow  the  classical  lore  of  our  friend.  Dr.  Chapman,  and  yet  he,  who 
should  know  as  well  as  any  one  in  these  islands  what  is  correct,  in 
his  Plea  of  a  Convert^  published  in  our  second  volume,  unhesitatingly 
employs  the  word  curantur.     With  such  an  eminent  example  before 
us,  we  need  not  be  careful  to  defend  our  own  reading  of  the  formula. 
Our  contemporary  inveighs  against  curantur  apparently  because 
the  formula,  if  so  written,  might  be  translated  by  those  who  did  not 
know  Latin  very  well,  likes  are  cured  by  likes.  We  are  not  anxious  to 
contend  against  the  assertion  of  our  classical  friend,  that  euro  may 
occanonally  mean  to  cure  or  to  healy  though  the  best  Latin  dictionaries 
say  so;  but  we  boldly  assert  that  the  formula  would  not  have  been  a 
bit  worse  if  it  had  actually  nm  thus — similia  similtbus  sanantur^  likes 
are  cured  hy  likes.  And  we  do  not  hesitate  to  say,  our  contemporary 
to  the  contrary  notwithstanding,  that  it  would  thus  have  better  ex- 
pressed what  Hahnemann  meant  to  convey.     ''Hahnemann,"  says 
the  Monthly  Review^  **  was  too  much  of  a  philosopher  to  arrogate 
the  cure,  he  proposed  the  treatment."     Now,  it  so  happens,  that  in 
the  only  place,  we  believe,  where  Hahnemann  gives  the  formula  in  full 
^-viz.,  in  the  introduction  to  the   Oryanon,  he  calls  it  '*  the  only 
natural  law  of  cure''  {Heilgesetz\  and  so  far  was  he  from  being 
chary  about  ''arrogating  the  cure,"  that  he  invariably  talks  about  his 


316  MUcellaneauM. 

law  of  eure^  bia  method  as  being  the  only  euroHve  one,  and  so  forth, 
while  to  other  methods  he  will  not  allow  the  possibility  of  curing, 
but  he  will  only  allow  them  to  be  modes  of  treatment  {Curmethoden). 
That  others  have  understood  Hahnemann  to  express  a  law  of  cure 
by  his  formula  is  evident  from  the  English  paraphrase  so  commonly 
adopted,  *'  likes  cure  likes ;"  and  one  of  the  finest  essays  Uiat  ever 
was  written  by  a  homceopathist.  Dr.  Scott's  Prize  Eseay^  published 
in  our  sixth  volume,  hinges  upon  the  idea  of  the  formula  being*  a 
law  of  cure.     But  we  need  not  go  further  than  this  very  article  in 
our  contemporary  for  corroborative  testimony;  he  there  says:  '^That 
is  the  formula  he  adopted  for  the  law  of  drug-healing.     In  that 
formula  he  expresses  one  of  Nature's  laws  of  healing." 


The  Cure  of  Popliteal  Aneurism  hy  Flexion, 

The  treatment  of  aneurism  has  increased  in  simplicity  pari  passu 
with  the  progress  of  physiological  and  pathological  science.  In  some 
isolated  cases  before  John  Hunter's  day,  the  femoral  artery  was 
ligatured ;  but  the  cure  was  thus  attempted  rather  by  circumstances 
peculiar  to  individual  cases,  than  from  any  fixed  principles  of  action. 
Starvation,  on  Valsalva's  plan,  compresses  applied  directly  to  the 
tumour,  and  somewhat  later,  after  the  researches  of  Winslow  and 
Haller  had  shown  the  possibility  of  the  circulation  being  maintained 
by  anastomosis,  the  aneurism  was  laid  open  and  the  vessel  tied  at 
each  end.  Towards  the  close  of  the  seventeenth  century,  it  was 
sought  to  effect  a  cure  by  compresses  applied  in  various  relations  to 
the  tumour,  and  the  vessels  connected  with  it.  A  vaiying  amount 
of  success  attended  these  experiments,  when  the  operation,  known 
as  the  Hunterian,  took  the  place  of  all  other  methods  of  treatment. 

In  1787,  after  having  demonstrated  the  pathology  of  the  disease, 
having  shown  that  the  arterial  coats  were  diseased  to  some  distance 
from  the  tumour,  the  power  of  continuing  the  circulation  below  a 
ligature  by  means  of  anastomosis  having  also  been  fully  established, 
John  Hunter  proposed,  and  carried  into  effect,  the  ligature  of  the  femo- 
ral  artery,  at  some  distance  on  the  cardiac  side  of  the  popliteal  space. 
The  principle  on  which  this  mode  of  treatment  is  founded  is  that 
which  has  formed  the  basis  of  almost  all  the  surgical  management  in 
popliteal  and  other  aneurisms  since  the  time  of  its  introduction  till 
within  a  comparatively  brief  period.  During  the  last  few  years,  and 
almost  entirely  through  the  Dublin  School  of  Surgery,  compression 


Cure  of  Popliteal  Aneurtsm  by  Flexion,  817 

has  again  been  resorted  to  in  popliteal  aneurism,  and  with  much 
more  success  than  formerly,  because  applied  on  greatly  more  scien- 
tific principles.     But  even  this  comparatively  simple  and  bloodless 
mode  of  procedure  bids  fair  to  be  superseded  in  many  cases  by  a  plan 
of  treatment  lately  suggested  by  Mr.  Ernest  Hart,  one  of  the  surgeons 
attached  to  the  Great  Northern  Hospital.     Two  years  and  a  half 
ago,  Mr.  Hart  read  a  paper  at  the  Koyal  Medical  and  Chirurgical 
Society,  in  which  he  proposed  to  retard  the  current  of  blood  in  the 
vessels  of  the  limb  by  flexion  of  the  leg  upon  the  thigh,  giving,  at 
the  same  time,  the  details  of  two  cases  in  which  his  method  had 
proved  successful.     At  a  meeting  of  this  society,  on  the  28th  of  last 
January,  Mr.  Hart  again  brought  forward  this  subject,  and  reported 
seven  more  cases  of  cure  by  flexion.     In  three  of  these  compression 
was  at  the  same  time  applied  to  a  limited  extent     In  one,  under  the 
care  of  Mr.  Spence,  of  Edinburgh,  the  femoral  had  been  tied  on  a 
previous  occasion,  but,  after  a  few  months,  the   aneurism  again 
formed.     Compression  was  then  tried,  but  with  no  good  results.     In 
May  1859,  flexion  was  resorted  to,  and  the  cure  has  been  permanent. 
In  another,  compression  had  been  unsuccessfully  tried  by  Mr.  Collins, 
of  Dublin,  while  Mr.  Hart's  method,  in  the  same  hands,  was  fol- 
lowed by  a  complete  cure. 

The  great  importance  which  must  ever  be  attached  to  a  plan  of 
treatment  so  simple  and  efficacious  of  a  disease  so  serious,  and  in 
which  previous  modes  of  operation  have  been  attended  with  so  many 
casualties,  induces  us  to  give  a  few  of  the  details  mentioned  by  Mr. 
Hart  in  his  paper  read  to  the  society. 

Mr.  Hart  lays  down  as  a  principle,  that  *'the  object  in  healing 
aneurism  is  not  to  cut  off  the  supply  of  blood,  or  altogether  at  once 
arrest  the  circulation  in  it,  but  to  cause  such  a  retardation  in  it  as 
would  lead  to  the  gradual  deposit  of  fibrinous  laminse  in  the  interior, 
and  so  effect  its  gradual  consolidation.  The  former  method  is  un- 
certain and  dangerous ;  the  latter  safe  and  permanent  in  its  results." 
To  attain  this  partial  arrest,  of  the  circulation  in  the  limb,  a  flannel 
bandage  is  rolled  around  the  leg  from  the  foot  upwards,  stopping 
below  the  tumour,  so  as  not  to  compress  it  in  any  way.  The  leg  is 
then  bent  on  the  thigh,  and  retained  in  its  flexed  position,  by  means 
of  three  pieces  of  bandage  attached  to  the  ancle  and  along  the  leg. 
Confinement  to  bed  is  unnecessary,  the  patient  can  move  about  the 
room  with  a  crutch.  After  a  few  hours  the  limb  will  require  to  be 
released  from  its. restrained  position;  but,  after  an  interval  of  a  night, 


8 1 8  MiseeUaneaus. 

it  is  again  bound  up  and  retained  bo  for  several  days.  Absolute 
necessity  for  the  retention  of  the  flexed  position  will  probably  be 
gone  in  a  week,  but,  as  a  measure  of  precaution,  it  is  desirable  that 
it  be  kept  up  for  some  days  longer.  To  relieve  the  stiffness  and 
aching  of  the  knee-joint,  which  results  from  its  forced  position,  Mr. 
Hart  uses  a  liniment  of  chloroform  and  oil.  It  is  more  than  proba- 
ble that  arnica,  in  place  of  the  chloroform,  would  be  more  efficacious. 
The  flexion  should  be  employed  with  care,  and  graduated. 

During  the  discussion  which  followed  the  reading  of  this  paper, 
Mr.  Solly,  Mr.  W.  Adams,  Mr.  Fergusson,  and  other  dbtmguished 
surgeons,  spoke  in  high  terms  of  commendation  of  Mr.  Hart's 
proposal. 

A  Good  New  Tear. 

On  New  Year's  Day,  or  thereabouts,  we  were  surprised,  and ' 
rather  amused,  by  the  intrusion  of  an  illustrious  stranger.  A  copy 
of  the  Medical  Times  and  Oaxetle^  duly  addressed,  lay  upon  our 
heterodox  breakfast  table.  We  had  seldom  consulted  such  an  oracle 
voluntarily,  except — as  one  occasionally  inspects  an  abnormal  speci- 
men of  something  human — ^in  an  idle  and  weary  hour,  in  search  of 
an  attack,  weak  and  wicked,  on  Homoeopathy ;  for  we  are  given  to 
understand  from  time  to  time,  by  certain  good-natured  Allopathic 
brethren  of  ours,  that  *'  we  had  caught  it  again  and  no  nustake — 
there  was  another  elasher  on  HomcBopathy  in  that  week's  Medical 
Times  and  Oazetter 

Strange,  thought  we,  till  turning  to  the  leading  article,  entitled 
"  1862,"  the  riddle  was  solved  instanter.  «« As  this  First  Number," 
says  the  generous  Editor,  "  of  a  new  Volume,  will  be  distributed  to 
every  member  of  the  medical  profession  in  the  United  Kingdom,  so 
no  Editor  can  address  a  circle  of  readers  more  weighty,  from  their 
social  position  and  their  education,  and  from  t^e  degree  to  which  the 
welfare  of  the  whole  community  hangs  upon  the  due  discharge  of  their 
functions." 

Now  this  is  not  perhaps  very  elegant  English ;  the  style  is  not 
happy ;  there  may  even  be  some  question  as  to  whose  functaoiiB  it  is 
whereof  mention  is  made  in  the  last  part  of  the  sentence ;  but  the 
printed  words  thus  set  up  to  our  eager  gace  manage  nevertheless  to 
convey,  that  a  great  number  of  No.  601  of  the  Vol  1  for  186d^  of  the 
Medical  Timce  and  OomUc^  have  been  giveti  away  dirt  cheap  (and 


I 

I 


A  Good  New  Year,  819 

we  note  that  the  paper  is  not  a  bad  article  apart  from  the  type  which 

covers  it),  and  without  respect  of  party.     What  less  could  we  do, 

having  gone  so  far — ^what  less  than  wade  through  the  leading  article  i 

To  be  sure  we  did  not  forget  the  while,  that  this  is  a  terrible  fellow, 

or  was  very  lately — this  Editor  of  the  Medical  Times  and  Gazette  ; 

a  huge  slayer  of  the  heretics ;  the  tomahawker,  the  latest  tomahawk  er 

In  chief  of  homceopathy  in  especial ;  the  slashingest  of  slashers ;  and 

we  therefore  approached  his  leading  article,  bom  of  a  New  Year 

whereon  he  had  risen,  doubtless  like  a  giant  refreshed,  to  out-Herod 

his  own  Heroding — we  approached  it  with  due  suspiration.     Here 

we  shall  find,  thought  we,  bone,  muscle,  and  nerve  ;  for  is  not  this 

the  New  Year's  Day  delivery,  or  deliverance,  of  the  famous  bruiser 

who  has  been  knocking  homoeopathy  out  of  time  for  the  last  year  or 

two ;  are  not  we  face  to  face  with  the  Sayers  of  the  'legitimate  "  ring  ? 

However  general  the  theme,  here  at  least  we  shall  have  choice  English, 

pithy  sentences,  happy  or  heavy  hits,  graphic  touches — in  a  word,  '*a 

sbfihing  article."  Down,  then,  Weme! — our  shaggy  old  Scotch  terrier 

that  will  share  our  attention  at  meal  times-— down !  we  say,  till  we 

devour  '  the  Slasher.' 

^  Our  purpose  is  to  show,  as  in  a  mirror,  the  daily  life  and  working 
of  the  whole  profession  in  all  its  relations."  Ha !  what  can  he  mean 
by  that  ?  Why  the  daily  life  and  working,  and  why  of  the  whole 
profession  ?  and  to  show  it  in  a  mirror  too,  and  in  aXL  its  relations  ? 
What  sort  of  mirror  is  alluded  to  here  ?  Surely  it  must  be  a  magic 
mirror,  since  it  b  the  profession  and  all  its  relations  (poor  relations 
of  course  included)  which  it  shall  show  up.  WeU,  this  is  to  be  done 
honourabkfy  look  you  : — *'  We  uphold  that  high  principle  of  honour 
by  which  the  proceedings  of  professional  men  towards  each  other 
should  be  guided,  and  we  support  their  privileges  [whose? — the 
privileges  of  the  proceedings  of  professional  men,  or  the  privileges 
of  the  professional  men  themselves?]  from  all  attacks,  whether  in  the 
shape  of  crude  legislation,  or  of  official  jealousy." 

Well  promised,  if  not  very  well  expressed  !  It  does  occur  or  recur 
to  us,  indeed,  that  the  proceedings  of  certain  persons  towards  some 
of  their  professional  brethren  have  not  been  very  —  but  never 
mind.  Heaven,  or  the  slashing  Editor  of  the  Medical  Times  and 
Gazette^  preserve  us  from  **  crude  legislation!" — to  which,  if  all 
accounts  are  correct,  we  were  very  near  being  subjected  when  the 
last  Medical  Beform  Act  was  at  length  passed^and  may  all  good 
angels  avert  from  us  the  attentions  of  <*  official  jealousy !"    It  is 


S*ZO  Miscellaneous. 

kind  of  the  Slasher  to  reassure  us  on  such  points,  and  we  certainly 
ought  to  feel  grateful,  if  not  prosperous,  for  the  assurance  that  he  is 
always  in  trainmg  to  •'  support  our  privileges.*'  True,  the  question 
obtrudes — what  are  our  privileges  ?  as  to  which  he  is  not  very  ex- 
plicit. All  of  us  are  not  privileged,  like  the  Slasher  and  his  clique, 
to  be  Fellows  of  Royal  Colleges  of  Physicians,  Physicians  Extraor- 
dinary to  Courts  or  richly  endowed  public  hospitals,  or  to  exhibit 
ourselves  as  filling  professorial  chairs  in  the  universities.     And  even 

when  it  comes  to  a  consultation But  perhaps  it's  good  for  us, 

and  we  ought  to  bear  it  quietly ;  and  so  we  were  mostly  inclined  to 
do,  till  we  read  this  fraternal  article,  in  which  the  Slasher  really  doth 
protest  too  much,  and  acteth  the  cruel  doctorial  part  of  offering 
tonics,  as  it  were,  to  starving  men. 

He  engages  to  **  supply  the  earliest  and  fullest  medical  news  and 
notices  of  such  of  the  occurrences  in  the  world  at  large  [the  big- 
bellied  world]  as  have  any  bearing  [however  chUdish]]  on  medicine.'' 

The  English  language  being  more  or  less  flexible,  this  might  have 
been  differently  worded  thus : — *  General  topics  that  can  anyhow  be 
spliced  on  to  medical  palavers  always  on  hand,  and  duly  snppUed 
when  short  of  the  genuine  article.  N.B.  Homceopathy  dissected 
once  a  quarter.' 

The  next  paragraph  of  our  famous  leader  commences  with  this 
little  bit  of  modesty,  of  which  we  make  a  respectful  present  to  the 
Lancet : — **  As  an  earnest  of  the  future  we  may  refer  to  the  past. 
The  volumes  of  1861  contained  a  far  greater  quantity  o£  matter 
(apart  from  advertisements)  than  any  Journal  which  can  aspire  to  be 
a  rival."  It's  no  great  matter  perhaps — ^but  this  is  not  luminous, 
though  it  is  self-satisfied  writing ;  and  surely  there  is  some  mistake 
about  the  parenthesis,  which  should  have  run  thus — **  Matter  (splenic, 
malignant,  and  unlaudable)." 

But  what  have  we  here  ? — ^what  next !  *^  In  style  and  power,  the 
editorial  articles  would  stand  their  ground  with  those  of  any  literary 
Journal  in  the  English  language."  Would  they  so,  sirs,  would  they 
so  ?  Dear,  dear  I  it's  sad  to  think  we  and  others  were  so  blind  to  the 
rich  literary  treats  and  treasures  that  passed  our  doors  every  week 
— **  sixpence  unstamped,  sevenpence  stamped,"  and  to  be  ^*  conve* 
niently  ordered  of  any  bookseller  or  newsman,  unstamped  at  26fl. 
per  annum." 

Style  and  power — stand  ground — literary  Journal — English  lan- 
guage.    It  takes  one's  breath  away.     What  have  we  not  missed 


A  Good  New  Tear.  821 

during  the  past  year  of  grace  that  was  graced  by  bo  much  editorial 
*^  power  and  style ! "  Let  us  be  thankful  meanwhile  for  the  specimen 
before  ns,  wherein  a  greater  than  Dickens  or  Thackeray,  Bulwer  or 
Macaulay,  goes  on  to  say ;  proving  his  thesis,  as  it  were,  ye  ob- 
serre : — **^  In  whatever  branch  of  practical  medicine  the  greatest 
progress  is  making,  he  [the  reader]  was  rapidly  put  in  possession  of 
the  improvements  gained.  Whenever  the  profession  was  assailed 
by  danger  within  or  without,  the  best  policy  to  be  pursued  was 
pointed  out."  Taking  the  ** power  and  style"  of  this  for  granted-— 
if  it  wem't  for  very  shame  we  would  own  that  we  don't  see  it — at 
his  succeeding  paragraph,  or  round,  the  Slasher  walks  up  to  one  of 
his  antagonists — that  big  fellow  styled  Quackery — ^and  just  brains 
him  on  the  spot : — 

**  Quackery  (in  the  future)  shall  be  systematically  counteracted.'' 
It  is  the  **  style"  on  which  he  prides  himself,  the  grace  which  is  dear 
to  him,  which  prevents  the  Slasher  from  expressing  himself  more 
artistically,  and  saying  that  Quackery  shall  be  scientifically  coun- 
tered, which  is  doubtless  what  he  means  to  convey  to  **  the  know- 
ing ones." 

Bat  he  is  a  candid  as  well  as  a  determined  fellow,  and  he  hastens 
to  acknowledge  that  *'  quackery  may  be  of  two  sorts."  We  cordially 
agree  to  this  semi-proposition.  It  may  be  of  more  sorts  than  two, 
we  suspect,  whenever  the  Editor  of  the  Medical  Timee  and  Oaxette 
pleases  to  withdraw  the  restrictions  he  puts  on  its  development.  At 
present,  however,  there  are  only  two  sorts,  since  he  decrees  it  so. 
Let  us  see  how  nicely  he  defines  them : — 

**  Sometimes  the  quack  pretends  to  obtain  results  from  means 
absurd  in  themselves — such  as  mesmeric  passes,  or  homceopathic 
globules.  More  frequently  he  selects  some  agent  which  may  have 
its  value  in  its  proper  place,  but  the  use  of  which  is  absurdly  erected 
into  an  ezclunve  system,  and  patients  with  the  most  opposite  maladies 
subjected  to  the  indiscriminate  use  of  it.  Such  are  the  exclusive  apos* 
ties  of  the  cold-water  cure  or  the  Turkish  baths ;  such  are  the  rubbers, 
bandagers,  botanists,  galvanists,  and  movement  doctors.  Such  per- 
sons bring  useful  remedies  into  discredit,  as  the  Harpies  of  old  be- 
fouled what  they  did  not  devour.  Besides  these  are  some  legitimate 
members  of  the  profession  who  resort  to  tmworthy  modes  of  obtain- 
ing notoriety,  by  advertisements  of  books,  testimonials,  and  other 
kinds  of  puffery." 

VOL.  XX.,   NO.   LXXX.— APRIL,    1862.  X 


Sd2  Miscellaneous. 

Here  ye  observe,  sirs,  bow  interestiiig  and  refined  the  distinctioa 
k,  not  only  between  the  two  kinds  of  qoackeiy,  but  also  between 
qoackeiy  and  that  other  improper  **  legitimate  **  thing  which  adopts 
**  unworthy  modes*'  of  making  itself  notorioafl.     Brown,  yon  ob- 
serve, who  treats  disease  homoeopathically^no  matter  what  his  ac- 
quirements and  qualifications  generally— is  a  quack  of  the  first  order; 
and  Jones,  who  patronises  hydropathy,  is  a  quack  <^  the  second ;  and 
no  mistake  at  all  about  it*  Because  why  ?    They  *^  pretend  to  obtain 
results  from  means  absurd  in  themselves."     The  Slasher's  logic  is 
irresistible.    The  means  being  absurd,  of  coarse  those  who  employ 
the  said  absurd  means  are  quacks.     This  may  be  called  *  the  ready 
method '  of  dealing  with  your  Brown  and  your  Jcmes,  and  be  hanged 
to  them  for  a  brace  of  hopeless  and  helpless  heretics  1     But  with 
*'  legitimate"  Robinson,  who  merely  resorts  to  unworthy  modes  of 
gulling  the  public,  the  case  is  quite  different     The  means  he  em* 
ploys,  d'ye  see,  are  not  necessarily  **  absurd  in  themselves ; "  at  least 
it  need  not  be  taken  for  granted  out  of  hand  that  they  are  so  (and 
Robinson,  being  a  knowing  hand,  finds  them  answer  A£s  purpose,  be 
sure) ;  and  therefore  Bobinson  is  no  quack.     Naughty,  Bobinson 
clearly  is ;  there  is  no  den3ring  that ;  but  then  Robinson  is  **  legiti- 
mate," and  blood  being  proverbially  thicker  than  water,  why  Robin- 
son  is  to  be  admonished  and  corrected  as  an  erring  child,  not 
denounced  as  a  quack. 

*'  But  feeling  how  imperfect  is  the  protection  which  the  best  Legis- 
lature can  afford  against  ignorance,  prejudice,  and  fraud,  we  give  our 
readers  such  help  as  only  a  Journal  can  give  towards  placing  them 
in  a  position  to  receive  more  abundantly  the  homage  which  the  best 
part  of  society  pays  to  their  general  shrewdness  and  intelligence, 
their  skill  in  their  own  profession,  and  their  general  integrity  and 
benevolence." 

Having  rebuked  and  corrected  his  erring  ^  legitimate"  children, 
our  Editor  thus  offers  to  place  **  our  readers"  in  a  first-rate  position. 
They,  doubtless,  have  been  accustomed  to  receive  in  times  past  some 
share  of  some  sort  of  "  homage,"  whatever  that  may  mean,  since  they 
are  to  receive  it  "more  abundantly"  in  future,  and  "  from  the  best 
part  of  society"  too,  through  the  agency  of  the  Medical  Tim$s  and 
OazeUe,  We  wish  them  joy  of  it;  we  wish  they  may  get  it 
**  genuine"  through  such  an  agency.  If  they  have  no  **  protection 
against  ignorance,  prejudice,  and  fraud"  other  thim  this  vulgar 


Origin  of  Organized  Beings.  323 

Slasher  can  afford  Uiem,  and  if  their  ^*  intelligence*'  and  ''  benevO' 
fence''  are  to  be  measured  by  his  standard,  we  don't  envy  them  the 
Jdnd  of  homage  they  are  most  likely  to  receive  from  *'  the  best  part 
of  society." 


On  the  Origin  of  Organized  Beinge. 

When  the  Caliph  Omar  burnt  the  books  in  the  library  of  Alex- 
andria, he  is  said  to  have  assigned  as  his  reason  for  this  act,  "  If  the 
books  agree  with  the  Koran  they  are  superfluous,  if  they  disagree 
they  are  pernicious."  The  sentiments  of  this  worthy  Saracen  seem 
to  prerail  in  a  modified  manner  among  some  theologians  of  our  own 
time.  The  literature  of  a  whole  nation  cannot,  it  is  true,  now-a-day s  be 
used  up  in  heating  our  Turldsh  baths,  but  many  books  are  denounced 
and  anathematized  by  certain  influential  men  if  they  do  not  altogether 
agree  with  the  Bible,  or  at  least  if  they  contain  aught  opposed  to  their 
own  interpretation  of  it.  This  is  especially  the  case  with  works  bear- 
ing  on  natural  history,  and  particularly  on  the  formation  of  the  earth  and 
the  production  of  organized  beings,  it  being  contended  that  the 
Mosaic  record  is  a  literal  and  exact  account  of  those  matters. 

In  all  ages  theologians  have  been  the  greatest  opponents  of  scien- 
tific progress,  and  at  one  period  they  were  able  effectually  to  stop  the 
advance  of  science,  but  now  science  has  grown  too  powerful  for  them, 
and  in  its  steady  march  onwards  gives  its  theological  opponents  many 
an  ugly  fall.  As  science  advances  and  carries  all  intelligent  minds 
along  with  it,  the  theologians,  not  to  be  left  behind,  pick  themselves 
up,  and  in  order  to  curry  favour  with  their  rival  and  retain  their  posi- 
tion with  the  educated  classes,  confess  their  previous  interpretation  of 
scripture  to  have  been  wrong,  and  profess  to  find  that  far  from  con- 
tradicting, the  Bible  actually  anticipates  the  modem  discoveries  of 
science.  The  motion  of  the  earth,  the  pretensions  of  geologists,  the 
enormous  antiquity  of  the  world,  have  been  successively  found  by 
theologians  to  be  opposed  to  and  consonant  with  biblical  teachings, 
and  now  the  doctrine  of  the  mutability  of  species  is  as  vehemently 
opposed  by  them  as  any  of  these  other  views ;  but  if  its  advocates 
should  succeed  in  proving  its  rationality,  we  shall  doubtless  find  their 
present  theological  opponents  eager  to  declare  its  perfect  consonance 
with  the  Mosaic  cosmogony. 

The  history  of  all  these  controversies  should  teach  us  that  all 
matters  of  science  should  be  examined  and  discussed  without  any 

X  2 


824  Miscellaneous. 

reference  to  their  sapposed  theological  bearings,  for  we  may  rest 
assured  of  this,  that  when  the  scientific  matter  is  settled  one  way  or 
another  by  the  men  of  science,  the  theologians  will  not  be  long  before 
they  discover  its  perfect  accord  with  the  scriptural  narrative.  We 
confess  to  a  strong  repugnance  to  the  style  of  controversy  that  seeks 
to  annihilate  an  opponent  by  a  reference  to  the  Book  of  Genesis,  and 
although  we  can  tolerate  it  in  a  theologian  pure  and  simple,  we  hare 
no  patience  with  the  man  of  science  who  resorts  to  such  a  weapon. 
If  the  opinions  belong  to  the  domain  of  science,  let  them  be  argued 
within  that  domain ;  if  they  are  untenable,  let  them  be  refuted  on 
scientific  g^unds ;  if  they  are  sound,  it  will  be  the  theologian's 
business  to  reconcile  the  scriptural  record  with  the  revelations  of 
science,  but  in  no  case  has  the  scientific  man  any  call  to  be  biassed  by 
the  prevailing  theological  tenets,  or  the  received  interpretation  of  the 
Mosaic  record. 

The  common  belief  of  naturalists,  with  a  few  noteworthy  excep- 
tions, has  hitherto  been,  that  all  species  of  plants  and  animals  are 
immutable  productions,  and  have  been  separately  created.  As  a 
corollary  to  this  belief,  in  order  to  account  for  the  very  difiTerent 
organized  beings  that  geology  has  shown  existed  at  different  periods 
of  the  world's  growth,  naturalists  have  supposed  that  the  earth  has 
been  visited  at  different  periods  by  tremendous  cataclysms,  that  have 
destroyed  all  existing  living  creatures  and  plants,  and  after  each 
such  cataclysm  a  new  creation  of  organized  beings  has  taken  place, 
each  successive  creation  being  of  a  higher  type  of  beings  than  the 
previous  one.  This  view  has  been  very  eloquently  supported  by 
many  writers,  from  Buckland  down  to  Hugh  Miller,  and  we  have 
read  a  great  deal  of  fine  writing  descriptive  of  the  aforesaid  tre- 
mendous cataclysms  and  successive  creative  fiats.  There  have, 
however,  been  geologists  of  high  standing  who  have  opposed  the 
cataclysm  theory,  and  have  contended  that  the  ordinary  forces  in 
constant  action  on  the  earth  are  sufficient  to  account  for  all  the 
geological  phenomena  the  surface  of  the  earth  displays.  And  there 
have  likewise  been  naturalists  of  distinction  who  could  not  be  per- 
suaded of  the  beauty  of  these  successive  acts  of  creation,  but  who 
have  vigorously  maintained  that  the  present  inhabitants  of  the  earth 
might  be  the  direct  descendants  of  previous  and  simpler  organic 
forms. 

It  could  hardly  fail  that  these  latter  theorists  should  be  vigorously 
opposed  by  the  partisans  of  the  Mosaic  cosmogony,  by  whom  they 


■ 


Origin  of  Organized  Beings,  825 

accordingly  accused  of  infidelity  and  all  its  attendant  enormities. 
But  they  may  console  themselves — the  theologians  were  just  as 
bitter  at  first  against  the  holders  of  the  cataclysm  and  successive 
creation  theory,  with  whom,  however,  they  eventually  joined ;  and  at 
that  stage  they  are  at  present,  constituting  themselves  the  defenders 
of  views  which  a  few  years  since  they  denounced  as  opposed  to  the 
Bible  and  to  common  sense.  A  little  patience — and  if  the  new  theory 
ehall  recommend  itself  to  the  scientific  world,  we  shall  find  the  theo- 
logians its  warmest  partisans,  protesting  that  it  is  the  only  view  of 
cosmogony  that  agrees  perfectly  with  the  Mosaic  record. 

Those  naturalists  who  dispense  with  cataclysms  and  successive 
creations  hold  that  the  present  species  of  plants  and  animals  are 
not  persistent  and  immutable  forms,  but  have  been  developed  out  of 
some  antecedent  different  forms,  and  are  capable  of  generating  forms 
different  to  their  own. 

By  genera]  consent  the  distinguished  French  naturalist  Lamarck 
was  the  first  who  entertained  this  view  and  defended  it  in  a  scientific 
manner.  Since  his  time  the  views  promulgated  by  him  have  been 
more  or  less  heartily  adopted  by  several  naturalists  of  eminence  ;  and 
facts  corroborative  of  these  views  have  been  accumulated  by  intelli- 
gent observers,  until  at  length  the  evidence  has  attained  quite  a  re- 
spectable quantity. 

The  latest  and  most  illustrious  defender  of  the  mutability  of 
species  is  Mr.  Charles  Darwin,  whose  work  On  the  Origin  of  Species 
has  excited  a  vast  amount  of  interest,  made  many  converts  to  the 
development  theory,  and  raised  up  a  host  of  opponents. 

It  has  never,  we  believe,  occurred  to  the  most  determined  partisan 
of  the  immutability  of  species  to  contend  that  species  are  absolutely 
invariable,  that  each  individual  of  a  species  is  in  fact  an  exact  repro- 
duction of  the  other.  On  the  contrary,  it  is  a  common  subject  of 
remark  that  no  two  individuals  of  the  same  species  are  exactly  alike ; 
and  when  the  differences  are  more  than  usually  striking,  and  are 
propagated  by  inheritance,  the  inheritors  of  this  considerable  differ- 
ence constitute  what  is  termed  a  yariety.  Now  in  every  class  of  the 
animal  and  vegetable  kingdom  there  exist  a  multitude  of  groups  re- 
specting which  naturalists  are  not  agreed  whether  they  should  be 
caUed  varieties  or  distinct  species.  Accordingly,  in  successive  works 
on  natural  history,  what  are  at  our  time  declared  to  be  species,  are  at 
another  held  to  be  varieties  only ;  and  on  the  other  hand,  the  varieties 
of  yesterday  are  distinct  species  of  to-day.     This  hesitation  and  un- 


826  Miscellaneou$. 

certainty  on  the  part  of  careful  observers  shows  an  acknowledged 
degree  of  yariability  within  the  species,  and  might  give  rise  to  the 
suspicion  that  species  are  not  quite  so  immutable  as  has  been  repre- 
sented.   Community  of  descent  and  fertility  of  the  yarious  individuals 
among  one  another  are  generally  implied  in  reference  to  varieties^ 
whilst  non-community  of  descent  and  sterility  in  the  first  or  second 
degree  are  supposed  to  distinguish  species.     But  it  is  often  as  diffi- 
cult to  prove  community  of  descent  in  the  one  case  as  the  reverse  in 
the  other  case ;  and  some  varieties  are  sterile  among  one  another, 
whereas  some  acknowledged  species  are  undoubtedly  fertile.     Thus 
the  blue  and  red  pimpernel,  and  the  cowslip  and  primrose,  which 
most  botanists  regard  as  varieties,  are  said  to  be  infertile  when 
crossed;   whereas  many  of  the  different  species  of  pelargonium, 
fuchsia,  and  calceolaria,  some  of  them  differing  widely  firom  one 
another,  are  said  to  be  quite  fertile  when  crossed.     Indeed  certain 
species  of  lobelia  and  hippeastrum  are  actually  far  more  easily  fer- 
tilised by  the    pollen  of   different    species    than  by  their    own 
pollen.* 

Hence  sterility  can  no  more  be  taken  as  a  test  of  diversity  of 
descent  than  fertUity  of  community,  if  these  qualities  are  to  be  ac- 
cepted as  the  distinguishing  signs  of  species  and  variety.  If  we  hold 
that  the  different  species  of  a  genus  have  all  a  common  descent  from 
some  anterior  type,  we  may  easily  account  for  the  general  sterility  of 
the  species  when  crossed,  by  supposing  that  usually  the  differences 
that  distinguish  the  species  from  one  another  are  very  marked  in  the 
reproductive  system. 

Man,  by  carefully  selecting  the  peculiarities  which  constantly 
present  themselves  in  a  species  of  plant  or  animal,  can  create 
varieties  of  the  most  striking  appearance,  varieties  probably  which 
differ  more  among  one  another  than  many  undoubted  different 
species.  Witness  the  varieties  he  has  created  among  horses,  cattle, 
sheep,  dogs,  pigeons,  &c.  What  differences  do  not  the  dray-horse, 
the  thoroughbred  racer,  and  the  Shetland  pony  present  Look  at 
the  greyhound,  the  bulldog,  and  the  poodle;  who  would  imagine 
they  were  derived  from  the  same  stock  ?  See  the  pouter  and  the 
fan-tail,  and  compare  them  with  their  common  ancestor  the  rock- 
pigeon  1 

If  man  by  intelligent  selection  can  in  a  comparatively  short  period 
of  time  develope  such  amazing  differences  out  of  one  original  species, 

*  Darwin,  op.  cit.,  272. 


Origin  of  Organized  Beings.  827 

ire  may  Barely  admit  diat  during  an  almost  infinite  number  of  eons 
of  years  the  Tarious  species  of  a  genus  may  have  been  developed 
from  one  original  form  by  a  power  that  is  continually  going  on,  viz., 
what  Darwin  calls  **  natural  selection."  And  if  species  from  a  com- 
mon  genus^  why  not  genera  from  a  family,  families  from  a  class,  and 
8o  on,  until  we  ultimately  arrive  at  a  common  progenitor  for  all  the 
tribes  of  oi^anized  beings  ?  Darwin  makes  out  a  strong  case  in 
favour  of  the  mutability  of  species,  and  he  hesitates  not  to  follow  his 
theory  to  its  logical  conclusion,  and  to  claim  a  strong  antecedent 
probability  for  the  descent  of  all  organized  beinjg^s  from  one  common 


.  It  is  accident,  circumstances,  and  the  struggle  for  existence  that 
cause,  according  to  Darwin,  the  different  varieties,  species  and  genera 
of  plants  and  animals  we  observe  upon  the  face  of  the  globe.  By 
accident  is  meant  monstrous  growths  and  variations  in  various  organs, 
which,  if  they  give  the  plant  or  animal  any  advantage  over  its  rivals, 
are  propagated  and  become  a  permanent  type  of  the  future  de« 
soendantB.  In  like  manner  a  change  of  circumstances  will  often 
produce  a  change  in  some  of  the  parts  of  a  plant  or  animal  which 
may  also  become  a  permanent  type,  and  thus  cause  a  variety  or  a 
new  species.  The  struggle  for  existence  that  is  always  g^ing  on 
among  all  organized  beings  will  secure  for  that  creature  that  has  any 
peculiarity  giving  it  an  advantage  over  its  neighbours,  preserva- 
tion, and  cause  the  extinction  of  its  congeners,  destitute  of  this  lucky 
pecuHarity.  That  such  a  struggle  for  existence  actually  takes  place, 
and  is  continually  going  on,  is  evident  from  calculations  that  have 
been  made,  showing  that  any  single  species  of  plants  or  animals,  if 
allowed  to  propagate  themselves  unrestrictedly,  would  soon  occupy 
every  part  of  the  earth's  surfoce,  some  from  their  great  rate  of  in- 
crease in  an  incredibly  short  space  of  time.  Hence  it  is  that  the 
individuals  of  a  species  or  variety  that  have  a  peculiarity  in  their 
organization  that  makes  them  more  fitted  to  retain  their  place,  will 
survive  and  propagate  their  peculiarity,  while  the  less  favoiured  indi. 
viduals  will  succumb  and  become  extinguished.  We  may  illustrate 
this  by  an  imaginary  example.  Suppose  in  an  island  there  was  a 
race  of  bees  which  could  obtain  an  abundance  of  honey  from  a  plen-> 
tiful  supply  of  flowers,  with  easily  accessible  nectaries.  The  bees, 
supposing  they  had  no  enemies,  would  multiply  to  an  extent  only 
limited  by  the  supply  of  flowers.     Again,  suppose  some  plant,  with 


828  Miscellaneous. 

a  long  narrow  calyx,  like  the  red  clorer,  were  to  be  conveyed  to  tibe 
island  and  gradually  to  supplant  all  the  other  plants.  In  that  case 
only  those  individuab  among  the  bees  that  had  a  longer  proboscis 
than  the  average  would  be  able  to  obtain  the  honey  from  the  clover 
flowers.  The  bees  with  the  shorter  proboscis  would  become  extinct^ 
and  long  trunked  bees  would  alone  be  propagated.  This  is  what 
Darwin  calls  "  natural  selection.**  It  is  this  natural  selection  acting 
through  myriads  of  ages  that  has  produced  all  the  numerous  varieties 
in  animal  and  vegetable  life  we  now  behold. 

It  certainly  would  require  a  length  of  time  almost  inconceivable. 
But  the  revelations  of  geology  have  prepared  us  to  admit  almost  any 
required  length  of  time  for  effecting  these  changes  and  developments, 
so  that  on  this  point  there  is  no  difficulty.  The  chief  difficulty  is, 
undoubtedly,  the  acceptance  of  the  occurrence  of  these  develop- 
ments. 

Opponents  point  to  the  Egyptian  monuments  8,000  years  old, 
where  we  find  accurate  delineations  of  the  animals  that  to  this  day 
inhabit  Egypt.  If  no  change,  they  say,  has  occured  in  these  3,000 
years,  it  is  highly  improbable  that  such  supposed  changes  have  ever 
occurred.  But  the  advocates  of  the  theory  contend  that  3,000  years 
is  but  an  infinitesimal  portion  of  the  time  tiiat  has  actually  been 
taken  up  in  effecting  these  changes. 

If  Darwin's  theory  be  true,  the  number  of  intermediate  varieties 
and  transitional  links  must  have  been  enormous,  from  the  earliest 
organized  germs  to  the  existing  species  of  plants  and  ftnimq^i^. 
Where  have  all  these  gone  to?  Does  geology  reveal  any  such  finely, 
graduated  organic  chain }  Assuredly  it  does  not,  and  this  would 
seem,  at  first  sight,  a  serious  objection  to  the  theory.  But  Darwin 
answers  this  objection  by  showing  the  great  imperfection  of  the 
geological  record.  It  would  take  too  much  space  to  recapitulate  his 
observations  on  this  subject  ,*  in  fact,  in  this  paper  we  have  necessa. 
rily  confined  ourselves  to  the  barest  statement  of  the  Darwinian 
theory,  and  we  must  refer  the  reader  for  facts  and  arguments  to 
Darwin's  book,  which  cannot  fail  to  afford  delight  to  everyone  inter, 
ested  in  natural  history. 

The  views  of  Darwin  and  others  relative  to  the  mutability  of 
species  have  received  a  curious  confirmation  from  the  labours  of  one 
of  our  distinguished  German  colleagues.  Dr.  Rentsch,  of  Wismar, 
who  has  recentiy  published  a  work  embodying  the  results  of  liis  re-« 


Origin  of  Organized  Beings.  829 

Searches  and  discoveries  relative  to  the  gammarus  omatus  and  its 
parasites.'*    In  this  work  the  author  traces  the  development  of  the 
iwrent  animal,  of  its  several  parts,  and  of  its  parasites,  in  the  most 
careful  and  laborious  manner.   He  shows  the  production  of  the  para- 
sites  with  which  it  is  infested  from  their  primitive  cells,  their  trans- 
formations, and  how  apparently  one  kind  of  animal  becomes,  under 
c^ertiun  circumstances,  a  totally  different  animal  or  even  a  vegetable, 
bow  an  apparently  independent  organized  being  is  changed  into  a 
jiortion  of  the  tissue  of  the  animal  with  which  it  is  connected.     He 
imagines  he  has  discovered  the  law  of  the  production  or  formation 
of  organized  beings,  but  we  shall  let  him  speak  for  himself,  and  give 
an  extract  from  his  preface. 

**  Attention  has  often  been  directed  to  the  relationship  of  similarity 
in  which  the  forms  of  the  visible  world  stand  to  one  another,  but,  as  far 
as  I  know,  this  relationship  has  never  been  traced  back  to  a  single  and 
dominant  law  of  nature.  As  a  partizan  of  the  homceopathic  method 
of  treatment,  I  felt  it  to  be  my  duty  to  investigate  the  law  of  simi- 
larity— which  has  shown  such  briUiant  results  in  the  department  of 
medicine — in  other  regions  of  organic  life,  and,  indeed,  throughout 
all  nature,  and  I  was  at  last  convinced,  by  my  microscopical  investi- 
gations, that  all  forms  and  motions  of  matter  are  caused  by  one  law, 
to  wit,  the  law  of  spirals.  But  if  all  forms  and  motions  obey  the 
law  of  spirals,  ihey  must  stand  in  a  relationship  of  similarity  to 
one  another,  and  by  the  co-operation  of  all,  only  similar  can  proceed 
from  similar ;  if  form  and  motion  can  be  comprehended  in  one  idea, 
in  one  law,  this  law  must  be  the  only  one,  the  dominant  one.  Hence 
the  name  (homoiogenesis)  I  have  given  to  these  contributions. 

''In  nature  there  is  neither  an  absolute  something  nor  an  absolute 
nothing.  We  know  neither  the  beginning  nor  the  end  of  things ; 
in  our  comprehension,  there  is  only  the  idea  of  infinity,  and  that  is 
also  the  idea  of  the  spiral.  Life,  motion,  form,  ebbing  and  flowing 
in  this  direction  {spira^  spiro^  epirihUj  respiraiio\  constitutes  the 
history  of  the  infinite ;  to  investigate  its  course  is  the  pragmatic 
object  of  the  physiologist ;  but,  for  scientific  proof,  it  is  requisite  to 
seize  hold  of  one  link  of  this  infinite  chain,  on  which  to  hang  our 
conclusions.  The  starting  point  of  our  investigation  is,  therefore, 
always  an  arbitrary  one,  violently  detached  from  infinity. 

*  JSiomoiogenesU,  BeUrdge  zur  Natur-  und  BeHhmde.  Erstea  Heft,  Qhm^ 
marua  omatus  wnd  seine  Schmarottser,  Von  Dr.  S.  Bentsch.  Wismar: 
Hmstorff,  1860. 


S30  Miscellaneoua. 

**1tl  the  actual  phenomenal  worid,  there  is  no  such  thing  as  an 
oppoaite,  only  a  relationship  of  greater  or  less  similarity,  or  of  polarity, 
whereby,  not  mutual  annihilation,  but  something  more  or  less  similar, 
is  produced.  Again,  there  is  no  such  thing  as  absolute  identity;  the 
similar  implies  the  different.  The  latter  stand  in  the  relationship 
of  similarity  to  one  another,  and  proceeds  from  that  relationship. 
When  we  speak  in  the  abstract  sense  of  something  identical,  in 
order,  0.  ^.,  to  describe  types  of  formation,  which  propagate  and 
maintain  themselves  by  parental  generation,  this  parental  propagation 
is  actually  only  rendered  arable  by  there  being  the  relationship  of 
greatest  similarity  between  the  male  and  female  individual,  or  in  the  eel* 
lular  construction  of  the  organbm  whence  both  have  a  oonmion  origin, 
but  the  parents  are  always  somewhat  different  from  their  poeteri^. 

"Who,  in  the  present  state  of  physiological  science,  can  maintain 
that  this  so-called  identical  reproduction  has  been  the  only  one  from 
all  eternity?  The  history  of  extinct  and  existing  creations  shows 
that  only  one  of  two  things  was  possible,  either  that  the  forms  of 
life,  newly  appearing  at  eveiy  period  of  creation,  were  like  a  deus  est 
macAuid,  placed  all  perfect  on  the  earth,  or  else  that  they  were 
gradually  developed  from  types  and  germs  of  a  different  generation, 
and  formed  new  and  different  individuals  and  genera.  The  latter 
process  is  not  only  conceivable,  it  is  supported  by  analogy  and  by 
the  knowledge  we  have  obtained  relative  to  the  extinct  races  that 
have  inhabited  the  earth ;  whereas,  for  the  former  view,  the  credu- 
lous mind  finds  no  support  except  in  the  Mosaic  cosmogony. 

"  Now,  though  the  organic  forces  met  with  in  the  present  state  of 
the  earth,  as  weU  as  those  that  existed  in  former  periods  of  creation, 
are  generally  maintained  and  increased  by  identical  or  parental  gene- 
ration, it  by  no  means  follows  that  their  vital  forms,  which  are 
repeated  in  certain  distinct  types,  did  not  originally  arise  in  a  non- 
identical  way,  or  from  germs  and  parents  of  a  different  kind  and 
orig^ 

*' Because  the  investigations  of  modem  physiologists  have  shown 
the  parental  generation  and  propagation  in  the  case  of  most  of  the 
types  of  organic  life,  non-identical  generation  has  been  rejected,  and 
physiologists  too  hastily  asserted  that  no  such  thing  has  ever  hap- 
pened, only  they  omitted  to  fill  up  the  gaps  in  the  cosmogenesis. 

"If  we  follow  the  development  of  tissues  and  cells  within  the 
organism  that  has  originated  by  parental  generation,  and  that  propa- 
gates itself  by  sexual  intercourse,  it  cannot  be  denied  that  the  various 


Origin  of  Organized  Beings.  881 

cellSy  tissues,  &c.,  which  belong  to  the  organism,  are  subjected  among 

themselyes  to  a  constant  change  of  matter,  and  are  incessantly  re* 

produced  anew  from  the  most  diverse  alimentary  substances,  which 

are    taken  up  and  assimilated  in  order  to  maintain  the  organism. 

-Can  tliis  be  likewise  termed  a  parental  generation,  or  is  it  not  rather 

a  non-identical,  a  parentless  generation  ?     The  parental  generation 

.can  only  be  maintained  by  means  of  this  non-identical  cell-produc- 

lion.   Are  we  really  so  blinded  by  beholding  the  one  form  of  parental 

generation  and  origin,  as  to  overlook  the  higher,  more  universal,  the 

all-preserving  process  of  heterogeneous  cell-production  ?     Has  the 

apparent  spontaneous  production  of  many  infusoria  been  fully  proved 

to  be  owing  to  identical  generation  ? 

**  I  do  not  believe  it ;  on  the  contrary,  I  am  convinced  that  the 

parentless  generation  of  many  infusoria  occurs  still;  that  although  it 

occurs  in  a  narrow  sphere,  it  has  always  been  a  necessary  link  in  the 

great  chain  of  terrestrial  life,  and  in  former  times,  under  other  cos^ 

mical  and  telluric  conditions,  it  played,  as  a  creative  power,  a  much 

more  important  part,  but  at  present  it  lies  almost  dormant,  because 

the  end  of  maintaining  and  propagating  life  can  be  attained  in  one 

single  mode,  a  mode  dependent  on  the  former.     Perhaps  at  some 

future  creative  period  of  the  earth,  when  something  still  higher  is  to 

be  produced,  this  principle  of  spontaneous  generation  may  yet  re« 

assert  its  valae,"  &c. 

Whatever  we  may  think  of  Dr.  Rentsch*s  notions  respecting  spon- 
taneous or  parentless  generation,  we  cannot  fail  to  admire  the  wonder- 
ful industry  displayed  by  him  in  carrying  out  his  microscopical  inves- 
tigations, and  the  masterly  manner  in  which  he  has  contrived  to 
transfer  to  the  lithographic  stone  the  revelations  of  his  lens. 

He  has  followed,  with  the  microscope,  the  development  of  every 
tissue  and  organ  of  the  gammarui  omahtSy  and  if  the  results  he  has 
arrived  at  are  really  the  processes  that  take  place  in  nature,  then  we 
shall  have  to  dispossess  ourselves  entirely  of  our  previous  ideas  of 
the  fixity  or  stability  of  organized  forms.  Almost  every  page  of  the 
book  records  the  transformation  of  one  creature  into  another.  Thus 
he  has  observed  and  depicted  the  transformation  of  the  gregartna 
gammari  into  enterobrguM  hdbosua  and  into  distamum  gammari.  He 
shows  how  xooihamntutn  parasiia  is  produced  from  other  animals, 
and  he  describes  the  transformation  of  some  morutds,  vihriones  and 
bacteria^  into  vegetable  forms.  In  short,  he  records  so  many  trans- 
formations and  metamorphoses  of  various  animals  into  one  another. 


882  Miscelianeous. 

that  we  rise  from  a  perusal  of  his  book  with  very  confused  notions 
as  to  which  is  the  real  original  animal,  and  which  the  transformed 
one.  In  those  microscopical  regions  which  Dr.  Rentsch  has  devoted 
his  time  and  attention  to,  we  think  it  must  be  a  wise  child  indeed 
that  knows  its  own  father — if,  indeed,  he  happens  to  have  any  father 
at  all,  which,  in  many  cases,  seems  doubtful — ^for  besides  that  Dr. 
Rent8ch*s  protegSs  are  generated  indifferently  by  sexual  intercourse, 
budding,  and  splitting  or  dividing,  some  of  them  seem  to  be  capable 
of  forming  themselves  out  of  anything  that  happens  to  be  handy. 

Until  Dr.  Rentsch's  statements  are  corroborated  by  the  observa- 
tions of  others,  we  may  be  permitted  to  accept  some  of  them  pro- 
visionally and  under  protest.  Some  of  the  extraordinary  transforma- 
tions he  records,  we  may  be  allowed  to  set  down  to  possible  imper- 
fect observation,  and  others  that  seem  to  admit  of  no  doubt,  may 
probably  be  of  the  character  we  observe  in  the  insect  world,  where  a 
grub  becomes  a  pupa,  and  ultimately  an  imago,  all  very  different 
forms  of  one  and  the  same  animal. 

However  this  may  be,  we  must  confess  that  Dr.  Rentsch  has 
opened  up  a  very  interesting  field  of  inquiry,  and  though,  from  want 
of  technical  knowledge,  we  are  not  qualified  to  criticize  his  labours^ 
we  feel  assured  that  he  has  carried  them  out  with  a  talent,  and  zeal, 
abd  desire  for  the  truth,  that  must  command  the  admiration  of  all 
interested  in  the  more  recondite  speculations  respecting  the  origin  of 
life. 

The  speculations  of  Darwin  have  met  with  comparatively  little 
attention  from  German  naturalists,  so  it  is  singular  to  find  his  views 
so  strikingly  borne  out  and  upheld  by  an  independent  labourer  in  a 
remote  part  of  Germany.  If  Dr.  Rentsch*s  observations  are  correct 
respecting  the  common  occurrence  of  transformation  and  metamor- 
phosis among  the  simpler  forms  of  organized  beings,  there  will  be 
less  difficulty  in  accepting  the  theories  of  Darwin  respecting  the 
gradual  transformations  that  he  alleges  to  occur  among  the  higher 
species  of  animals  and  vegetables. 

Some  of  the  facts  adduced  by  Darwin  in  support  of  his  views  are 
very  curious  and  almost  inexplicable,  except  on  the  supposition  of 
the  common  origin  of  the  various  species  of  a  genus  from  a  common 
ancestor.  Thus,  with  regard  to  the  genus  equus^  which  includes  so 
many  different  species,  he  states  that  the  ass  has  frequently  stripes 
on  its  shoulders  and  legs.  The  koulan  of  Pallas  has  sometimes  a 
double  shoulder  stripe.    The  hemionus  sometimes  shows  in  its  youth 


Origin  of  Organized  Beings.  883 

traces  of  stripes  on  its  shoulders  and  legs.     The  quagga,  though 

striped  like  a  zehra  on  the  hody,  is  without  bars  on  the  legs,  and  yet 

Dr.  Gray  has  figured  one  specimen  with  stripes  in  its  hocks.     With 

regard  to  the  horse,  the  most  various  breeds  and  colours  sometimes 

show  the  spinal  stripe ;  tranverse  bars  are  often  seen  on  the  legs  of 

duns,  and  sometimes  of  chesnuts.   In  the  Katty  war  breed  of  horses, 

stripes  are  so  usual,  that  one  without  stripes  is  not  considered  purely 

bred.     The  stripes  are  on  the  spine,  legs,  shoulders,  and  side  of  the 

-face.    They  are  plainest  in  the  foal.    In  short,  stripes  are  occasionally 

met  with  in  all  breeds  of  horses  from  Britain  to  Eastern  China,  and 

iioixi  Norway  to  the  Malay  Archipelago.     In  the  mules  produced  by 

crossing  the  various  species,  there  is  a  great  tendency  to  the  occur-* 

rence  of  these  stripes,  though  both  parents  may  have  been  quite 

destitute  of  them.    What  is  the  inference  from  these  facts  ?    Darwin 

says:  "I  venture  confidently  to  look  back  thousands  on  thousands  of 

generations,  and  I  see  an  animal  striped  like  a  zebra,  but  perhaps 

otherwise  very  differently  constructed,  the  conmion  parent  of  our 

domestic  horse,  whether  or  not  it  be  descended  from  one  or  more 

wild  stocks,  of  the  ass,  the  hemionus,  quagga,  and  zebra."     The 

probability  of  this  inference  will  be  more  apparent  when  we  are 

aware  of  thif  fact,  that  animals  which  have  been  bred  into  various 

distinct  varieties  that  will  go  on  almost  interminably  reproducing  the 

pure  variety  or  race  when  kept  separate,  will,  if  the  races  be  crossed, 

show  a  tendency  to  reproduce  in  the  offspring  of  the  cross  some  of 

the  characters  of  the  common  progenitor.     Thus,  if  two  distinct  and 

differentiy  coloured  breeds  of  pigeons  be  crossed,  their  offspring 

often  exhibits  the  slaty-blue  colour  and  the  black  bars  on  the  i^rings, 

characteristic  of  the  original  rock-pigeon,  from  which  all  the  breeda 

of  pigeons  are  supposed  to  be  descended. 

Again,  the  young  of  species  very  dissimilar,  when  mature,  often 
resemble  one  another  in  some  characteristics  that  seem  to  point  to  i^ 
common  origin.  Thus  the  thrush  tribe,  which  differ  so  widely  in 
maturity,  all  display,  when  young,  spotted  feathers,  indicating  a 
common  descent  from  some  spotted  ancestor*  The  cat  tribe  are 
usually  striped  or  spotted  in  lines,  and  these  spots  or  stripes  can  be 
plainly  discovered  in  the  whelp  of  the  uniformly  coloured  puma  and 
lion. 

But  we  think  the  strongest  ground  for  the  belief  in  the  common 
origin  of  all  animals  is  what  we  may  term  the  unity  of  creation,  the 
existence,  namely,  of  a  single  type  of  construction  for  all  animals. 


834  MineellaneouM. 

Though  this  unity  cannot  be  so  well  seen  in  the  ampler  fonn  of 
animal  life,  we  feel  assured  it  exists  even  among  them ;  but  it  is 
obvious  enough  among  the  higher  orders  of  animals,  which  are 
evidently  all  constructed  on  a  common  principle,  their  diversities  being 
caused  by  their  several  organs  being  relatively  to  one  another  more 
or  less  developed,  or  more  or  less  rudimentary. 

How  about  our  noble  selves  ?  many  will  ask.     It  is  certainly  most 
flattering  to  our  self-esteem  to  imagine  a  common  progenitor  placed 
perfect  on  the  earth  some  6,000  years  since,  but  without  supposing 
a  series  of  miraculous  transformations  in  his  descendants,  we  cannot 
satisfactorily  account  for  the  presence  on  the  earth  of  so  many  utterly 
different  and  distinct  races  of  men.  We  need  not  doubt  the  common 
origin  of  all  mankind,  but  we  can  hardly  imagine  that  all  the  vane* 
ties  have  been  produced  from  an  ancestral  pair  within  the  period 
assigned,  more  especially  as  we  find,  from  the  pictorial  monuments 
of  Egypt,  that  are  at  least  3,000  years  old,  that  the  races  were  just 
as  distinct  then  as  they  are  at  this  day.     The  tendency  of  recent 
investigations,  philological,  ethnological  and  geological,  is  to  fix  the 
first  appearance  of  man  on  the  earth  at  a  much  more  remote  period 
than  is  assigned  to  him  in  the  common  chronology.     In  fiict,  there 
seems  little  doubt  that  man  was  a  contemporary  of  many  of  the 
ftnimiilg  that  are  only  known  to  us  as  extinct  fossils.     But,  however 
that  may  be,  it  is  impossible  for  us,  in  the  present  state  of  science, 
to  do  more  than  form  a  conjecture  as  to  the  duration  of  any  of  the 
so-called  periods  of  geology,  and  our  conjecture  may  be,  after  all, 
very  wide  of  the  mark.    All  that  geology  can  teach  us  is  that  the 
age  of  the  earth  must  be  something  enormous,  and  without  exactly 
saying  with  Mr.  Jenkinson  that  *'the  world  is  in  its  dotage,"  we 
may  subscribe  to  his  dictum  that  **the  cosmogony  or  creation  of  the 
world  has  puzzled  philosophers  of  all  ages,"  and  will  probably  puzzle 
a  few  more  before  the  matter  is  finally  settled. 

Modem  tS^rit^Ratsmg, 

Olsndower.  I  can  eall  spirits  firom  the  vasty  deep. 
Hottpur.      Why  so  can  I  $  or  so  can  any  man : 

But  will  they  oome  when  yon  do  call  for  them  ? 
Olendonoer,  Why,  I  can  teach  yon,  oousin,  to  cominand  the  devil. 
ffatspur.      And  I  can  teaoh  thee,  coz,  to  shame  the  devil. — 

By  telling  tmtb ;  tell  troth,  and  shame  the  deviL 

{King  Henry  IV.  Pt.  1.) 

An  enthusiastic  friend — a  determined  believer  in  the  wonders  of 


Modem  Spirit' Raising.  885 

modern  necromancy,  persuaded  us  lately  to  have  a  seande  with  the 
latest  and  most  maryellous  of  mediums.  We  were  not  very  anxious 
to  test  his  powers,  but  our  friend  appealed  to  us  as  professed  en- 
qairers  into  truth  to  witness  the  new  phenomena,  which  he  asserted 
revealed  a  great  and  mysterious  power  in  nature  with  which  it  was 
imperatively  necessary  every  cultivator  of  science  should  become  ac- 
quainted. So  to  avoid  being  accused  of  bigotry  and  prejudice,  and 
to  gratify  a  sort  of  languid  curiosity,  we  made  an  appointment  with 
Mr.  Foster,  the  hero  about  whom  the  Times  has  lately  written,  half- 
belieTing,  half-doubting  the  truth  of  his  pretensions. 

At  the  appointed  hour  we  assembled  in  Mr.  Foster*s  room  in 
Bryanstone  Street.  Our  party  consisted  of  our  enthusiastic  fnend,  a 
lady,  an  old  friend  of  ours,  more  inclined  to  doubt  than  to  believe, 
and  the  present  writer.  In  the  room  besides  Mr.  Foster  there  sat  a 
gentleman,  a  friend  of  his,  who  did  not  appear  to  take  any  part  in  the 
proceeding^. 

The  magician  himself  is  a  stout  florid  young  man,  with  a  more 
than  French  exuberance  of  grimace  and  gesticulation.  During  the 
sSance  he  talked  a  great  deal,  and  was  perpetually  saying  he  saw 
spirits  here  and  there  and  everywhere,  now  behind  some  one's  chair, 
and  now  at  a'distant  comer  of  the  room.  Of  course  one  could  hardly 
help  turning  one's  head  in  the  directions  indicated,  and  probably  he 
took  the  best  advantage  of  our  eyes  being  removed  from  himself. 
On  the  table,  a  round  not  very  steady  one,  at  which  we  sat,  lay 
a  card,  on  which  was  printed  the  alphabet,  the  Arabic  numerals,  and 
the  information  that  one  rap  meant  ^'no,"  two  raps  **  doubtful,"  and 
three  raps  *'  yes."  On  sitting  down  Mr.  Foster's  first  remark  was 
that  he  had  just  come  in  from  a  walk,  and  had  gathered  a  great  deal 
of  electricity,  which  he  said  was  eminently  favourable  for  the  appear- 
ance of  the  spirits,  who  he  gave  us  to  understand  were  intimately 
connected  with  electricity.  He  asked  us  if  we  had  any  names  of 
dead  people  in  sealed  envelopes,  and  we  mustered  altogether  about 
eight  or  nine.  Observing  that  those  of  this  writer  were  numbered^ 
he  volunteered  the  surprising  intelligence  that  the  spirits  told  him  we 
had  a  corresponding  list  in  our  pocket,  which  he  desired  us  to  pro- 
duce. We  drew  the  list  from  our  pocket  to  show  that  he  was 
correct,  but  at  the  same  time  took  good  care  he  should  not  see  the 
names  on  it,  which  indeed  were  only  in  initial.  He  next  took  up 
one  of  the  envelopes  belonging  to  the  lady  of  our  party,  and  after 
receiving  an  affirmative  response  from  the  spirit  representing  it,  in 


A86  MUeellaneous. 

reply  to  his  enquiry  if  it  were  present,  he  set  the  spirit  to  spell  out 
its  name  hy  means  of  the  printed  alphabet ;  the  lady  touching  the 
letters  successiyely,  and  the  spirit  indicating  what  it  believed  to  be  the 
letters  composing  its  name  by  three  taps  under  the  table  whenever 
the  pencil  pointed  to  these  letters.  After  many  failures,  the  lady 
always  good-naturedly  telling  the  blundering  spirit  when  it  was 
wrong,  the  letters  A,  L,  £  were  at  length  fixed  on,  when  Mr.  Foster 
said :  *'  I  see  the  spirit  standing  behind  the  lady,"  and  presently  after- 
wards: *'  It  will  write  its  name  on  this  piece  of  paper."  He  had 
been  fiddling  with  some  half  sheets  of  paper  and  a  pencil,  one  of 
which  he  now  presented  to  this  writer,  folded  up  with  the  pencil 
lying  in  the  fold,  and  desired  us  to  hold  it  below  the  table.  This 
we  did,  keeping  fast  hold  of  the  pencil  so  that  we  are  sure  it  never 
moved.  After  two  or  three  seconds  he  asked  us  to  produce  the 
paper,  whereon  we  found  written  the  name  *'  Alexander."  Our 
belief  is  that  Mr.  Foster  himself  wrote  this  name  on  the  paper  and 
folded  it  up  when  we  were  looking  for  the  ghost,  at  any  rate  we  can 
certify  that  the  pencil  was  never  moved  when  we  held  it  below  the 
table.  He  made  a  shrewd  guess  that  this  Alexander  was  a  near 
relative  of  the  lady's,  and  presently  produced  another  piece  of  paper 
vrith  the  surname  (the  same  as  the  lady's)  written  ba^wards  upon 
it,  in  the  way  that  most  persons  can  write  with  their  left  hand.  This 
and  another  good  guess  about  the  place  of  the  party's  death — the 
not  very  unlikely  locality  of  London — were  almost  the  last  of  his 
apparent  successes  during  the  siance.  We  cannot  think  much  of  his 
guessing  this  writers's  name  out  of  a  list  of  half-a-dozen  names  he 
asked  us  to  write — as  he  might  easily  have  heard  our  name — which 
is  an  uncommon  one.  The  remainder  of  the  sSance  was  a  wearisome 
repetition  of  blunders.  The  spirit  representing  a  name  in  an  envelope 
commencing  with  C,  tried  several  letters  in  vain,  and  at  last  fixed 
decidedly  on  J.  Mr.  Foster  enquired  if  one  of  our  envelopes  did  not 
contain  a  name  of  which  this  was  the  initial  letter,  and  on  our  reply* 
ing  *'  yes,"  and  showing  him  which  envelope,  he  took  it  up,  asked  if 
that  spirit  was  present,  received  three  raps  in  reply,  and  the  spirit 
spelt  out  its  name  "  JOHN ;"  which  was  wrong,  the  name  being 
**  Jane,"  which  it  got  after  a  few  more  failures.  At  Mr.  Foster's 
suggestion,  we  enquired  if  this  spirit  knew  the  name  of  its  father,  to 
which  an  affirmative  answer  waff  given.  However,  a  spirit  that  was 
so  undecided  about  its  own  name,  could  not  be  expected  to  know  its 
father's  name  better,  so  it  made  three  unsuccessftd  guesses — Thomas, 


Modern  Sjnril'Raisintjf.  337 

'William,  and  Patrick — whereas  the  real  name  was  Peter.  It  was 
quite  as  ignorant  of  the  place  of  its  death,  guessing  Aberdeen,  Elgin, 
Liverpool,  and  Leith  before  it  got  the  right  place  —Edinburgh,  which 
^we  think  was  the  only  remaining  name  on  the  list.  We  should 
mention  that  the  spirits,  finding  themselves,  we  presume,  so  unsuc- 
cessful with  the  alphabet,  much  preferred  to  make  their  guesses  from 
among  half-a-dozen  names  written  by  their  interrogator  on  a  piece 
of  paper.  This  method  obviously  gave  a  much  better  chance  to  a 
shrewd  guesser  than  the  alphabet  plan. 

We  were  favoured  with  a  sight  of  spirit-writing  on  Mr.  Foster*s 
arm.  After  repeated  unsuccessful  attempts,  a  spirit  at  length  spelt 
out  on  the  alphabet  the  commencement  of  its  name  H,  E,  which  the 
lady,  who  was  the  interrogator,  said  was  correct.  Thereupon  Mr. 
Foster  said :  **  Stop  !  he  is  going  to  write  his  name  on  my  a**^."  He 
thereupon  twisted  about  his  arms,  rolled  his  eyes  hideously,  and  made 
sundry  contortions  of  his  body  as  though  he  were  suffering  dreadful 
agony.  At  length  he  became  calm,  laid  his  left  arm  on  the  table, 
pushed  up  the  sleeve  of  his  coat,  and  displayed  to  our  admiring  gaze 
the  name  ''Henry"  written  in  large  sprawling  letters  of  a  red  hue. 
As  it  happened,  however,  the  spirit  had  again  made  a  mistake,  and 
Mr.  Foster  had  undergone  his  agony  in  vain  ;  for  the  real  name  of 
the  lady's  departed  friend  was  ''  Herbert,"  and  not  "  Henry."  Mis- 
takes will  occasionally  happen  among  the  best  regulated  spirits,  we 
suppose,  but  here  the  mistakes  were  the  rule  and  the  correct  guesses 
the  exception,  and  even  these  exceptions  not  very  wonderful.  The  dis- 
comfited magician,  whose  vivacity  and  boisterousness  at  the  com. 
mencement  of  the  sitting  were  conspicuous,  began  to  show  signs  of 
impatience,  especially  when  his  last  astounding  trick  turned  out  such 
a  miserable  failure  ;  and  he  endeavoured  to  get  rid  of  his  incredulous 
visitors  by  alleging  that  time  was  up,  that  we  had  come  to  the  end 
of  our  stipulated  hour,  though  we  had  scarcely  been  more  than  half- 
an-hour  with  him.  We  therefore  walked  away  firmly  convinced  that 
this  modem  spirit-raiser  was  but  a  very  second-rate  conjurer,  and  our 
only  satisfaction  for  our  loss  of  time  and  money  was  that  we  had  not 
for  one  moment  been  imposed  on  by  his  pretensions. 

With  regard  to  the  production  of  the  writing  on  the  arm,  about 
which  so  much  has  been  said,  that  is  a  simple  enough  trick.  If  we 
take  a  blunt-pointed  instrument,  as  a  tooth-pick,  a  watch-key,  the 
stone  of  a  ring,  &c.,  and  write  the  name  with  a  moderate  degree  of 
pressure  on  the  skin  of  .the  arm,  for  two  minutes  or  thereabouts  nothing 

VOL.    XX.,   NO.    LXXX. — APRIL,    1862.  Y 


S38  Mttcellaneous. 

10  Tisible,  but  at  the  end  of  that  time  the  letten  begin  to  appear  of 
a  bright  pink  colour,  more  or  less  raised  according  to  the  degree  of 
pressure  exercised.  The  letters  continue  Tirible  for  from  five  to  thirty 
minutes,  according  to  the  fbroe  used,  after  which  they  giaduaU^  die 
away,  and  leave  the  arm  clear  for  another  spirit-writing.  We  haTe 
repeated  this  experiment  half-a-dozen  times,  and  in  a  coat  with  a 
moderately  wide  sleeve  we  can  easily  write  the  name  on  the  arm 
without  drawing  up  the  sleeve.  We  may  observe  that,  as  fiur  as  we 
can  ascertain,  the  names  always  appear  on  Mr.  Foster's  left  arm — 
obviously  the  most  convenient  one  for  writing  on ;  and  in  tiie  writing 
we  witnessed,  which  exacUy  resembled,  in  colour  that  we  executed  on 
our  own  arm,  the  initial  letter  H  conmienced  with  a  very  peculiar 
flourish  precisely  similar  to  what  we  noticed  on  some  specimens  of 
Mr.  Foster's  writing  on  paper. 

Qmtagumsfieis  ofPhthisU  Pulmonalis^  hyDr,  R,  Rogenan^  Manchester. 

Continued  from  vol.  xix.,  page  171. 

Some  few  months  ago  I  directed  your  attention  to  a  series  of  cases 
illustrating  the  contagiousness  of  phthisis  under  certain  circum- 
stances ;  those  cases  were  carefully  selected  and  investigated  as  to 
family  history  and  present  occupation,  avoiding  as  much  as  possible 
to  detail  any  case  where  there  was  suspicion  of  a  hereditarily  contami- 
nated system.  Many  pathologists  are  of  opinion  that  the  true  tuber- 
cular morbific  agent  cannot  be  acquired  from  any  other  source,  unless 
transmission  from  one  generation  to  another,  and  presenting  itself  in 
different  families,  by  intermarriage,  &c. ;  there  can  be  no  doubt 
whatever,  but  that  intermarriage,  more  especially  among  relatives, 
tends  to  reflect  backwards  not  only  the  prevailing  features  and  dispo. 
sitions  common  to  such,  but  also  has  a  debilitating  effect  upon  the 
whole  vital  powers,  rendering  them  more  effeminate,  and  less  able  to 
stand  against  the  change  of  season  and  climate,  as  well  as  predisposiDg 
them  to  the  same  morbid  affections,  common  to  their  (bodily  similar) 
representatives  of  the  past — the  same  eye  has  the  same  lusts — and 
the  same  heart  becomes  elevated  or  depressed  by  similar  impressions 
—and  the  same  body  has  the  same  predisposition  for  the  same  mor- 
bid affections.  But  independent  of  family  similarity,  there  are  maoy 
instances  presented  to  us  where  we  are  enabled  to  assign  some  irre- 
gularity in  diet,  clothing,  (injudicious  change  of  clothing),  or  exposure 
to  cold,  sleeping  in  damp  beds,  hastening  from  the  ball-room,  or  over- 


Contagiousness  of  Phthisis.  389 

citmded  evening  party  to  the  cold  air ;  neglect  of  or  repeated  attacks 
of  catarrhs,  mechanical  injuries  of  the  thorax,  or  too  eudden  disap- 
pearance of  certain  exanthemata.  Causes  such  as  these  operate  most 
powerfully  over  even  the  most  muscularly  formed  and  healthy  indi* 
vidnal,  although  the  invasion  is  so  sbw  and  insiduou^— eo  temporary 
and  seemingly  unimportant  as  not  to  attract  attention,  until  the  con- 
stitution becomes  undermined,  or  one  of  the  vital  organs  becomes 
affected. 

We  must  not  look  upon  disease  of  whatever  form  with  the  eye  of 
tradition,  not  like  the  masonic  sign  orally  received  and  communicated 
from  age  to  age,  preserving  all  its  primitive  grandeur,  and  original 
power;  but  varying  with  each  succeediog  generation^  changing 
type  and  character  with  accidental  circumstances,  and  becoming 
acted  upon  by  every  influence  which  interferes  with,  or  acts  upon  our 
social,  political,  or  domestic  circles;  or  that  because  in  syphilis, 
however  virulent  in  character  or  form,  however  unpleasant  or  dis- 
agreeable the  exhalations,  cannot  produce  in  the  healthy  a  similar 
disease  without  contact  of  surface  to  surface,  or  affected  part  to 
healthy.  The  question  becomes  quite  different  with  regard  to 
phthisis. 

We  have  a  reservoir  for  the  deposition  of  the  destructive  material ; 
we  have  the  function  of  a  most  vital  organ  becoming  impaired ;  we 
have  cutaneous  and  intestinal  sympathy,  with  excess  of  action,  and 
as  suppuration  advances  of  the  lung,  or  molecular  disintegration  of 
the  morbid  products,  with  a  certain  amount  of  surrounding  vitality, 
together  with  direct  communication  through  trachea  with  surround- 
ing atmosphere,  sleeping  chamber  contaminated,  the  amount  of  venti- 
lation insufficient,  and  inhalation  of  such  highly  charged,  heated  air, 
must  undoubtedly  possess  injurious  effects  over  the  health,  constitu^ 
tion,  and  vital  powers  of  any  one  coined  for  some  length  of  time  to 
such  an  apartment,  aided  by  sleeping  in  the  same  room,  and  in  the 
same  bed. 

Dr.  Wyld  mentions  in  his  *'  Heart  and  Lung  Disease,"  that  he  is 
not  aware  of  nurses  who  are  in  attendance  upon  such  patients  in 
hospitals,  &c.,  suffering  more  frequently  than  others  from  phthisis. 
How  far  from  the  bed  of  the  sufferer,  or  what  time  is  necessary  for 
its  development  is  a  matter  of  imposttbility  to  decide-<-at  least  until 
further  researches  have  been  made.  We  may  look  through  a  key- 
hole into  a  chamber  where  there  lies  a  case  of  scarlet  fever,  and  next 
day  suffer  from  premonitory  symptoms,  be  confined  to  bed,  and  in  a 

Y  2 


340  MiHcellaneoui. 

fortnight  be  seen  walking  in  perfect  health  on  the  streets.  Months- 
are  necessary  in  many  instances  for  the  development  of  physical 
signs  in  the  other ;  besides,  nurses  generally  live  well,  are  of  advanced 
years,  often  unmarried,  pay  g^eat  attention  to  cleanliness,  and  are 
only  occasionally  to  be  found  at  the  very  bedside  of  the  patient. 

I  will  only  give  a  few  more  examples,  in  as  concise  a  manner  as 
possible,  omitting  physical  signs  and  unnecessary  particulars,  unless 
practically  interesting  or  important,  and  conclude  with  experience  of 
some  of  the  remedies  useful  to  the  disease. 

J.  H.,  Stockport,  set.  37.     Fair  complexion ;    well  formed  mus- 
cular system ;   osseous  system  proportionate ;    excitable ;    frequent 
flushing  with  exercise ;  hair  fine ;  prominent  brow ;  large  nose  and 
mouth,  with  alae  well  developed ;  resembled  father  in  body.     Had 
been  in  general  good  health,  until  some  months  ago  a  brother  came 
home  from  Ireland  in  the  last  stage  of  phthisis ;  and  there  being  two 
sisters,  on  whom  all  depended  for  support,  it  was  agreed  that  the 
two  brothers  should  sleep  together,  in  order  that  the  healthy  one 
should  attend  to  the  wants  of  the  invalid,  and  at  the  same  time 
prevent  their  wearied  sisters  from  being  disturbed.     The  brother, 
who  had  been  in  Ireland  for  upwards  of  three  years,  contracted  the 
disease  from  sleeping  in  the   same   bed   with  the  governor  of  a 
lodging-house,  who  died  some  months  before  his  return  to  England, 
of  consumption.     How  far  this  is  true,  we  are  unable  to  say ;  but  so 
very  few  diseases  resemble  consumption,  and  those  symptoms  so 
much  depended  upon  as  indicating  the  disease  in  question  are  of 
such  a  nature,  among  the  poor  and  improperly  fed,  that  even  the 
evidence  of  one  in  a  better  or  higher  sphere  of  life  may  be  partly 
relied  upon.     The  brother  who  contracted  the  disease  in  Ireland 
died,  after  a  long  and  tedious  illness.     The  other,  having  been 
obliged  to  go  to  bed  some  two  weeks  after,  the  cough  became  more 
severe ;    breathing  more   oppressed ;    emaciation  more  and   more 
apparent ;   sputa  more  fcetid  and  profuse ;  nocturnal  perspirations 
and  general  nervous  and  vascular  prostration  increased,  until  the 
vital  powers  surrendered. 

There  were  certain  external  or  physiognomic  appearances  favour- 
able for  the  development  of  tubercular  disease,  especially  the  steady 
and  fixed  look  of  amazement  or  wonder ;  the  coolness  of  expression 
which  often  masks  the  irritable,  although  more  common  in  the  lym- 
phatic ;  the  expanded  nostrils,  and  general  form  of  body ;  together 
with  the  pulmonary  and  cutaneous  exhalations. 


Contagiousness  of  Phthisis.  34 1 

The  next  case  is  very  interesting  as  well  as  exceptional.     A 
gentleman  of  good  circumstances  and  position  in  life,  of  a  moderately 
temperate  habit — was   frequently,  however,   from   his   professional 
calling,  obliged  to  partake  of  spirits — lived  some  few  miles  out  of 
town,  and  by  a  walk  every  morning  and   evening  enjoyed   good 
health,  and  a  voracious  appetite.     After  due  consideration  of  the 
many  circumstances  connected  with  his  histoiy,  such  as  father  and 
two  sisters  having  died  from  phthisis,  and  niece  at  that  time  suffering 
from  hydrocephalus,  with  glandular   enlargement,   &c.,  &c.,  as  he 
himself  was  in  the  most  perfect  and  sound  health,  to  all  appear- 
ance, being  free  from  cough,  and  not  at  all  disposed   to  catarrhs, 
even  under  trying  and   unfavourable  circumstances,  he  determined 
upon    marriage,    having  been  engaged   for   some  years.     His  in« 
tended  was  of  healthy  parentage,  and  herself  of  a  robust  consti- 
tution, cheerful  nature,  and  kindly  disposition.     Three  months  after 
the  wedding  the  wife  began  to  become  oppressed  in  breathing,  after 
which  succeeded  a  hard,  dry  cough,  sometimes  so  intense,  especially 
in  a  morning,  that  on  several   occasions  blood   was   mixed   with 
sputa.     This  state  continued  some  five  or  six  weeks,  when  the  sputa 
became  more  frequent ;  at  the  same  time  the  dyspncea  abated,  from 
the  expectoration  being  more  readily  expelled,  and  the  necessary 
mechanical  impetus  to  the  pulmonary  circulation   being  partially 
diminished.  The  violent  efforts  of  coughing  produce  in  many  instances 
the  congestion  so  frequent  in  phthisical  cases,  whether  mechanically 
or  by  destroying  the  tone  of  the  abundant  vascular  system  ramifying 
throughout  the  pulmonary  tissue,  and  so  affording  more  easy  access 
to  deposition  and  development.     She  gradually,  however,  took  to 
bed,  from  which  she  never  rose;  became  weaker  and  weaker;  throat 
became   ulcerated ;    heemoptysis   frequent   and  profuse ;    dyspnoea 
increased ;   quietude  succeeded  restless  nights ;    the  voice  became 
more  and  more  tremulous,  ultimately  indistinct;  and  death  closed 
the  scene.     Ever  since  her  decease,  he  has  been  complaining  of  a 
slight  cough,  and  pain  in  right  lung  and  shoulder ;    his  appetite 
requires  more  inviting,  and  his  spirits  are  very  much  depressed ; 
physical  examination  reveals  nothing  but  a  present  healthy  state  of 
the  lungs.     The  effects  of  the  mental  depression  by  the  loss  of  his 
wife,  the  constant  and  hourly  pondering  over  every  suspicious  symp- 
tom that  may  present  itself,  and  his  natural  or  hereditary  predisposi- 
tion, may  in  some  few  months  prevent  him  from  pursuing  his  usual 
occupation.      How  his  wife   became   affected,  I  am  at  a  loss  to 


S42  Misceilaneoui. 

diBCOver.  Prior  to  her  illnesB  she  had  no  cough;  Bhe  had  no 
chOdren,  and  was  regular  at  her  monthly  period  until  she  became 
affected  with  hemoptysis. 

It  is  unnecessary,  howeyer,  to  remark  further,  or  to  give  more 
examples  so  striking  and  confirmatoiy;  but  we  will  now  take  a  rapid 
sketch  of  the  disease,   and  mention  some  of  the  most  important 
remedies.   Where  there  is  a  predisposition  to  the  disease,  the  patient 
experiences  more  or  less  a  difficulty  in  respiration,  after  excitement 
or  yk>lent  exercise,  even  before  cough  or  pain  attract  attention  ;  the 
cough  at  first  seems  to  affect  the  head,  and,  from  its  being  dry  and 
hard,  very  much  distresses  the  chest,  producing  great  exhaustion. 
A  hot  hand  during  digestion,  and  a  flushed  face  appearing  after  each 
meal— of  a  very  temporary  duration,  however — are  frequently  found 
in  this  the  first  or  incipient  stage,  and  gradually  becoming  more  and 
more  persistent  as  the  digestive  powers  fail ;  the  oppression  of  the 
chest  increases ;  throat  and  mouth  become  dry  and  hot,  sometimes 
painful;  slimy  expectoration  in  morning;   cough  increases  during 
the  night,  abates  during  day ;  appetite  may  still  remain  good ;  the 
voice  may  now  become  rough  or  hoarse,  although  more  commonly  so 
in  the  advanced  stages  ;  emaciation  ;  pube  becomes  accelerated,  with 
slight  fever  at  noon  and  evening;  and  during  this  febrile  disturbance 
the  second  stage  usually  makes  its  appearance  ;  skin  becomes  more 
dry  and  hot;  pulse  more  accelerated;   and  now,  in  the  morning, 
when  he  ought  to  rise  from  bed,  he  only  begins  to  get  sleepy,  and 
desirous  of  rest ;  perspiration  occurs  ;  pains  in  chest,  with  vomiting 
in  some  cases  after  severe  coughing;  expectoration  tough  and  semi- 
transparent,  becoming  gradually  green  or  yellow ;  fever  more  per- 
manent ;   flushings  more  regular  and  lasting  (like  the  side  of  an 
apple  exposed  for  some  time  to  the  sun's  rays),  more  circumscribed 
than  vaiying  towards  side ;  perspiration  increases ;    expectoration 
assumes  a  gpreyish  colour,  with  a  foetid  smell,  tasting  pungent,  and 
occasionally  mixed  with  blood ;  bones  of  face  show  their  form ;  eyes 
sink;  teeth  seem  to  become  more  prominent;   urine  scanty,  with 
sediment ;  thirst  during  fever ;  debilitating  diarrhoea  sets  in ;  vital 
powers  become  diminished ;  the  pulse  softer,  and  very  much  accele- 
rated ;  voice  low,  soft  or  harsh ;  tongue  becomes  fissured ;  papilla 
prominent ;  feet  begin  to  swell ;  patient  gradually  sinks,  in  many 
cases  with  full  consciousness. 

Every  town  or  country  village  has  its  own  remedies  for  con- 
sumption ;  every  practitioner,  in  fact,  relies  upon  fixed  agents,  to 


A  Rebuke  to  Uhe  Bigots.  843 

meet  certain  stages  and  symptoms;  but  of  all  homoeopathic  remedies, 
I  have  found  the  following  to  be  the  most  efficacious : — Droseray 
NiL  aeid.j  Calc.  pAotph.  and  KaH  carb.  The  two  former  most 
efficaciouB  in  the  male ;  the  two  latter  in  the  female. 

Drosera  in  the  incipient  stage — ^pulmonary  congestion^  or  develop- 
ment of  crude  tubercle — preferable  to  Bell.,  with  a  hard,  dry, 
harking  or  ringing  cough,  with  or  withoutexpectoration. 

JVti^.  acid,  where  there  exists  a  predisposition  or  suspicion  of  the 
deyelopment  of  tubercle,  as  well  as  in  the  advanced  stage,  with 
purulent  expectoration,  diarrhoea^  or  nocturnal  perspirations. 

Caic.  phos,  in  the  excitable;  cough  hard  and  dry,  or  expectoration 
of  a  saltish  or  sweetish  taste,  and  a  yellow  or  purulent  consistence, 
especially  in  stonemasons,  sculptors,  &c.,  &c. 

£ali  carb.^  females  advanced  in  years,  who  have  had  large  fami- 
lies ;  harsh  cough,  with  yellow  expectoration ;  in  both  incipient  and 
advanced  stages. 

There  are  certain  intermediary  remedies,  such  as  Aeon.,  which 
must  be  given  when  the  case  demands  it;  cod-liver  oil;  the  Turkish 
bath,  prior  to  purulent  expectoration,  is  of  very  great  service ;  living 
plants  in  bed-room,  and  a  generous  diet,  have  been  in  my  hands 
successful,  where  treatment  or  remedial  agents  were  at  all  of  any 
value. 


A  Itebuke  to  the  Bigots. 

Until  a  perfect  science  of  life  has  been  elaborated  by  physiologists, 
there  can  be  nothing  more  than  an  enlightened  empiricism  in  medi- 
cine. The  physician  is  an  enlightened  empiric ;  and  it  is  only  thus 
that  he  b  distinguished  firom  the  quack.  Accordingly,  as  we  glance 
back  at  the  early  periods  in  the  history  of  medicine,  we  see  this 
mark  of  distinction  becoming  fainter  and  fainter ;  and  as  we  look  at 
the  various  quarrels  of  the  faculty  with  heterodox  systems,  such  as 
homoeopathy  or  hydropathy,  we  know  that  they  are  really  disputes 
as  to  matters  of  doctrine^  and  should  be  conducted  as  such.  The 
tone  adopted  by  the  faculty  towards  such  systems  is  unworthy  and 
unwarrantable.  To  designate  these  systems  as  quackeries  is  pre- 
posterous. They  may  be  one-sided ;  they  may  be  absurd ;  but  is 
orthodox  medicine  in  any  condition  to  warrant  unhesitating  allegiance 
to  its  doctrines?  The  homoeopath  and  the  hydropath  have  their 
theories  of  the  laws  of  healthy  and  diseased  action,  and  of  the  effect 


344  Miacellafieouft. 

of  their  remedial  methods  ;  these  theories  may  be  absurd ;  let  it  l>e 
granted  that  they  are  so ;   they  have  the  same  legitimacy  as  tlie 
theories  of  the  faculty  which  may  be  also  absurd,  and  which  many 
believe  to  be  so.    Let  all  serious  doctrines  receive  earnest  discussioD, 
and  let  the  practice  of  flinging  '*  atheist'*  and  '^  quack"  at  any  man 
who  ventures  to  think  differently  from  the  **  gowned  doctors"  be  left, 
to  those  who  have  bad  temper  and  worse  logic.     If  it  is  unjust  to 
stigmatise  the  physician  because  he  is  ignorant  and  incompetent,  the 
existing  state  of  knowledge  leaving  him  no  other  alternative — if  we 
respect  him  and  reward  him  because  he  does  his  best  and  acts 
according  to  the  lights  given  him — not  less  unjust  is  it  to  stigmatiae 
the  homoeopath  or  hydropath  because  he  also  is  ignorant  and  in- 
competent.   The  real  question  in  each  case  is.  Has  he  any  conviction 
guiding  him  ?  is  his  practice  founded  upon  real  study  ?  or  does  he 
know  that  he  is  an  imposter? — BktckwootTs  Magazine^  Feb.,  1862. 


Therapeutics  Advanced  Accidentalty. 

The  following  case,  reported  in  the  Lancet  £ot  January  18th,  1862* 
p.  68,  illustrates  one  of  the  modes  in  which  allopathic  therapeuUcs 
are  advanced,  one  of  the  indirect  ways  in  which  real^  because  hanugo- 
pathic,  remedies  are  discovered.  It  shows,  further,  the  value  which 
must  ever  be  attached  to  the  Hahnemannic  canon,  that  for  a  homceo- 
pathic  cure  to  be  effected,  the  dose  employed  must  be  smaller  than 
that  ordinarily  resorted  to,  to  obtain  so-called  tonic  or  eliminative 
actions. 

"  Some  months  back  we  watched,  with  considerable  interest,  a  case 
of  acute  renal  anasarca,  which  became  complicated  with  psoriasis 
and  lichen,  for  which  this  solution  of  Arsenic  was  employed,  and 
with  extremely  beneficial  effects  upon  the  quantity  of  albumen  in 
the  urine. 

"The  patient  was  a  female,  aged  19  years,  who  was  admitted" 
(into  St.  Bartholomew's  Hospital,  under  the  care  of  Dr.  Frederick 
Farr),  "with  acute  renal  anasarca,  of  two  weeks'  duration,  posses- 
sing all  the  usual  characteristics  of  that  affection,  with  the  urine  not 
only  highly  albuminous,  but  very  smoky.  For  this  condition  she 
was  ordered  suitable  treatment.  About  a  month  after  her  admission, 
an  eruption  of  psoriasis  appeared,  associated  with  lichen,  on  the 
arms  and  hands,  for  which  she  was  ordered  five  minims  (afterwards 


Therapeutics  Advanced  Accidentally,  345 

increased  to  seven)  of  Fowler's  solution,  in  peppermint  water,  three 
times  »  daj.  This  was  found  to  be  of  service,  not  only  in  dispelling 
the  cutaneous  eruption,  but  also  in  diminishing  the  quantity  of  albu- 
men to  such  an  extent,  that  it  had  almost  wholly  disappeared  from 
the  urine.  In  two  months  the  eruption  had  much  diminished,  and 
Was  quite  cured  by  the  tenth  week ;  although  the  albumen  had  all 
but  g^ne,  it  re-appeared,  in  very  smaU  quantity,  whilst  taking  the 
Arsenic.  Besides  other  treatment,  she  had  alkaline  baths  and  creo- 
sote ointment.  She  left  the  hospital  at  the  end  of  the  twenty-fifbh 
week,  being  much  stouter,  and  altogether  looking  a  great  deal  better. 
The  arsenic  had  evidently  acted  as  a  powerful  tonic,  and  exercised  a 
very  decided  influence  on  the  albuminuria." 

Though  the  foregoing  case  is  very  indifferently  reported,  it  shows 
that  arsenic  evidently  tended  to  relieve  the  renal  congestion,  which 
previous  "  suitable  treatment "  had  failed  to  ameliorate.  We  gather 
incidentally,  rather  than  from  any  direct  information,  that  after  the 
albumen  **  had  almost  wholly  disappeared  from  the  urine,"  the  use 
of  Fowler*s  solution  was  suspended ;  and  that  on  a  recurrence  to  it 
subsequently,  the  physiological  action  of  the  drug  made  itself  felt, 
and  albumen  '*  re-appeared  in  very  small  quantity  whilst  taking  the 
arsenic." 

Of  the  homoeopathicity  of  arsenic  to  albuminuria  we  have  abun- 
dant evidence,  as  we  have  also  of  the  similarity  of  the  general  symp- 
toms of  arsenical  poisoning  to  those  of  Bright's  disease.  At  p^  124 
of  the  14th  volume  of  the  Edinburgh  Monthly  Joiamal  of  Medical 
Science^  is  a  very  carefully  reported  case,  in  which  recovery  followed 
after  a  large  dose — two  drachms — of  arsenious  acid  had  been  swal. 
lowed,  in  mistake  for  carbonate  of  magnesia.  Dr.  Douglas  Maclagau 
here  found  the  urine  to  be  highly  albuminous  on  several  occasions. 
The  full  details  of  this  case  form  a  proving  of  arsenic  well  worthy  of 
study. 

Allopathic  practitioners  have  now  obtained  a  knowledge  of  three 
forms  of  disease  to  which  arsenic  is  homceopathic — viz.,  to  eczema, 
to  cholera,  and  to  Bright*s  disease.  The  clues  to  the  use  of  arsenic 
in  the  two  first  were  doubtless  derived  directly,  though  without  ac- 
knowledgment, from  Hahnemann's  writings;  the  discovery  in  the 
present  instance  is  probably  due  to  one  of  those  happy  accidents  to 
which  allopaths  have  at  all  times  been  so  much  indebted  for  their 
best  remedies.     They  have  yet  to  learn  that  to  derive  unmitigated 


846  Miscellaneous, 

good  firom  a  homcBopAthically  prescribed  drug,  it  must  be  given  in 
smaller  quantities  than  it  is  their  custom  to  order,  otherwise  tempo* 
rarj  aggravations — such,  for  example,  as  that  noticed  in  Dr.  Farr*8 
case — ^must  inevitably  occur. 

We  trust  that  others  of  our  well-proved  medicines  will  be  **  dis* 
covered^*  by  our  allopathic  brethren ;  feeling  confident,  that  as  theae 
therapeutic  advances  become  multiplied,  their  true  source  cannot  Hail 
of  being  admitted,  and  the  vast  debt  of  gratitude  under  which  the 
profession  lies  to  Hahnemann  being  candidly  acknowledged. 


ContrSmiions  on  the  Physiological  Operation  of  AiropUt, 

From  Dr.  Michzk. 

[As  we  do  not  possess,  as  far  as  we  know,  any  notable  provings  of 
Atropin,  excepting  the  short  ones  by  Lusanna  {AUg.  Horn,  Z.^ 
Bd.  55),  and  by  Eidherr  (Ihid.,  Bd.  60),  the  following  physiological 
effects  of  Atropin,  observed  by  Dr.  Michen,  a  weU-known  allopathic 
enquirer,  must  be  worth  communicating,  though,  being  derived  from 
patients  affected  with  chronic  ailments,  and  taken  in  a  summary, 
generalizing  way,  they  do  not  present  nearly  the  same  interest  and 
utility  for  homcBopathic  practice  as  the  individualizing  provings  of 
our  school,  which  report  the  most  minute  details. — ^Ed.  qf  AUg. 
Horn,  Zeitung^  from  which  this  is  taken,  Vol.  Ixiv.,  Feb.  1862.] 

Since  1853,  says  Michen,  I  have  had  occasion  to  employ  Atropin, 
or  its  most  important  salts,  in  the  treatment  of  forty-two  persons  of 
different  age  and  sex.  Almost  all  these  individuals  had  been,  for  a 
longer  or  shorter  time,  affected  with  epilepsy,  which  was  either 
simple  or  complicated  with  aberration  of  mind.  The  Atropin,  which 
was  almost  always  employed  inwardly,  I  gave  in  doses  from  ^/^  a  milli- 
gramme (Vioo  ^^  ^  ?"^)  to  1  centigramme  (}/^  of  a  grain),  in 
twenty-four  hours.  These  last  strong  doses  were  only  tried  a  few 
times,  with  certain  individuals. 

The  following  are  the  most  important  primary  or  physiological 
phenomena  which  1  observed : — 

All  the  subjects  of  experiment,  without  exception,  complained,  on 
the  second  or  third  day  after  taking  the  Atropin  (even  in  the  smallest 
doses,  e.  y.,  Vw  ^  ^/loo  ^^  &  ST'^'^)*  ^^  unpleasant  dryness  of  the 
mouth,  lips,  tongue,  palate,  and  throat 

This  dryness,  which  was  seldom  accompanied  by  actual  thirst,  and 


Effects  of  Atropin.  84 7 

mstantly  disappeared  on  moistening  the  month  with  a  gulp  of  liquid^ 
seemed  to  be  brought  on  sometimes  by  simple  diminution  of  the 
secretion  in  the  mucous  lining  of  the  mouth,  palate,  and  throat ; 
sometimes  by  diminished  action  of  the  saUvary  glands.  Soon  after 
^  above-named  symptoms,  there  was  manifested  a  more  or  less 
considerable  enlargement  of  the  pupil,  with  tendency  to  immobility 
of  the  iris,  even  when  only  2  milligrammes  Q/^  of  a  grain)  had  been 
given*  This  mydriasis  was  accompanied  by  no  very  remarkable  injury 
to  the  sight,  as  the  patients  were  not  prevented  from  reading  pretty 
small  print 

As  I  gradually  raised  the  dose  to  4  to  5  milligrammes,  twenty- 
duree  of  the  subjects  of  experiment  complained  of  difficulty  in  swal- 
lowing either  liquid  or  solid  substances,  but  especially  of  the  small 
quantity  of  saliva  which  they  had  in  their  mouth ;  frequently,  they 
eoald  onfy  effect  deglutition  after  making  several  strains  with  the 
muscles  of  the  neck  and  throat.  Yet  the  dysphagia  did  not  proceed 
from  a  spasmodic  contraction  of  these  muscles,  as  in  hysterical  or 
epileptic  attacks.  They  seemed  rather  to  be  the  consequence  of  a 
partially  paralysed  condition ;  for  none  of  the  patients  experienced 
the  sensation  of  a  ligature  on  the  gullet,  as  hysterical  and  many 
epileptic  persons  complain  at  the  beginning  of  their  attack ;  and,  on 
passing  the  hand  over  their  throat,  one  did  not  perceive  the  projec- 
tion and  shooting  which  is  observed  when  the  muscles  of  this  region 
are  spasmodically  contracted. 

After  the  dose  of  6  milligrammes,  I  found  in  nineteen  cases  a 
fieiilure  of  voice,  which,  in  one  individual,  amounted  to  complete 
iqphonia. 

At  the  same  time,  there  appeared  in  thirteen  a  slowness  and  hesi- 
tation in  the  articulation  of  certain  words.  The  hindrance  to  utter* 
ance  seemed  to  lie  not  merely  in  the  muscles  of  the  lips — as  is  the 
case,  for  instance,  in  paralysis  of  the  facial  nerves — where  the  pro- 
nunciation of  vowels  demanding  the  co-operation  of  the  lips,  such  as 
o,  and  of  the  labial  consonants,  such  as  h  and  j9,  is  impeded.  In 
our  cases,  the  impediment  seemed  to  lie  quite  as  much  in  the  muscles 
of  the  tongue,  as  I  often  observed  a  slight  quivering  of  the  tongue. 
Besides,  I  have,  in  this  impeded  utterance,  found  a  great  resemblance 
to  that  difficulty  of  pronouncing  certain  words  which  characterizes 
the  so-called  progressive  paralysis  of  the  insane.  {Paralysie  pro^ 
greeewe  dee  aliinie). 

After  the  dose  of  7  milligrammes^  all  the  subjects  of  experiment 


348  MiscellaneouB. 

complained  of  dimness  of  sight ;  and  I  found  the  papils  then  regu- 
larly in  a  state  of  great  dilatation.  They  saw  all  objects  as  if  in- 
voWed  in  a  mist,  and  could  no  longer  distinguish  their  contour 
properly;  could  barely  read  very  large  print,  could  not  thread  a 
needle,  &c.  Lastly,  twelve  persons  presented  diplopia  or  slight 
strabismus,  and  six  complained  of  difficulty  in  moving  the  eyeball. 

Afler  a  dose  of  8  milligrammes,  nine  out  of  sixteen  of  the  subjects 
complained  that  they  could  no  longer  so  well  command  their  oi^gans 
of  locomotion.     They  felt  at  intervals,  in  spite  of  strong  efforts  of  the 
will,  a  staggering  in  walking,  like  that  of  a  drunken  man,  only  not  in 
so  marked  a  degree.     They  could  no  long^  keep  themselves  so 
steady  on  their  legs,  nor  make  use  so  rapidly  and  easily  of  their 
hands  to  button  their  clothes.     In  a  word,  they  exhibited  in   the 
movement  of  the  upper  and  lower  extremities  a  certain  heaviness 
and  helplessness,  which  was  very  like  the  heaviness  and  helplessness 
of  movement  which  one  observes  in  the  first  stages  of  the  progressive 
paralysis  of  the  insane.     The  resemblance  between  the  symptoms 
which  characterize  this  last  disorder,  and  the  hindrance  to  move- 
ment produced  by  Belladonna,  is  often  so  great  that,  in  the  com- 
mencement, it  is  very  difficult  to  draw  the  line. 

Eight  out  of  twelve  subjects  of  experiment,  with  whom  I  proceeded 
to  a  dose  of  9  milligrammes,  complained  of  difficulty  in  passing  urine. 
Besides,  the  sensibility  of  the  skin  was  remarkably  diminished ;  when 
tliey  were  tickled  with  feathers  on  the  alse  nasi  and  in  the  nostrils, 
or  the  commissure  of  the  lips,  they  hardly  seemed  to  feel  it.  If  they 
were  pricked  suddenly,  and  without  being  made  aware  of  it,  on  the 
skin  of  the  neck,  the  trunk  and  the  extremities  with  needles,  the  pain 
which  they  felt  was  much  slighter  than  in  the  normal  condition. 

Lastly,  in  six  cases  of  individuals  who  had  been  epileptic  for  a  long 
time,  with  whom  the  dose  of  Atropin  amounted  to  one-fiAh  of  a  grain, 
there  appeared,  besides  the  above-named  symptoms,  a  moral  and 
physical  apathy ;  the  intellect  was  beclouded  in  a  way  which  had  a 
resemblance  to  the  stupor  in  typhus.  These  persons  seemed  to 
understand  with  great  difficulty  the  questions  put  to  them;  they 
answered  very  carelessly  and  slowly.  Notwithstanding,  their  ideas, 
though  they  were  communicated  but  slowly,  and  with  an  effort, 
were  still  connected  and  not  very  obscure ;  only  in  a  single  case 
there  was  exhibited  a  noisy  delirium,  accompanied  with  hallucination. 
It  is  important  to  add  this  remark,  that  all  these  physiological 
effects,  though  some  of  them  were  of  a  somewhat  alarming  nature, 


Poisoning  ly  Aconite,  349 

never  had  dangerous  results;  and  that  moreover,  soon  after  the 
administration  of  the  Atropin  had  ceased — disappeared ;  and  in  fact, 
either  spontaneously  or  else  after  taking  tea  or  coffee  ;  excepting  the 
dilatation  of  the  pupils  and  the  dryness  of  the  tliroat,  which  often 
continued  still  for  six  to  ten  days  after  we  had  discontinued  the 
Atropin. 

From  these  ohservations  the  following  general  conclusions  present 
themselves : — 

1.  The  Atropin  and  its  salts  act  especially  on  the  cerehro.spinal 
nervous  system. 

2.  They  depress  successively,  hut  not  synchronously,  the  functions 
of  the  different  parts  of  this  system. 

3.  They  affect  the  motor  nervous  system  hefore  the  sensitive ;  and 
the  organs  which  minister  to  the  intellectual  and  moral  faculties  are 
those  which  are  last  attacked. 

4.  The  effect  of  Atropin  on  the  motor  nervous  system  is  exhibited 
in  convulsions,  which,  like  those  in  epileptic  fits,  almost  always 
begin  in  the  muscles  of  the  neck  and  face.  The  paralysis,  however, 
constantly  begins  in.  the  iris,  and  passes  on  successively  to  the 
muscles  which  minister  to  deglutition,  vocalization,  pronunciation, 
and  the  movement  of  the  eyeball. — Gazette  des  Hdpitaux^  1861, 
141,  etc. 

Ciue  of  Poisoning  hy  Aconite — Successful  Use  of  Nux  Vomica  as  an 

Antidote, 

Dr.  Hanson,  of  Hartford,  Conn.,  reports  the  following : — 
'*On  April  19th,  1861,  I  was  called  to  see  a  coloured  boy,  five 
years  of  age,  a  son  of  Mr.  Lewis,  Pine-street,  this  city,  who  had 
taken,  as  I  subsequently  learned,  a  preparation  of  the  tincture  of 
Aconite  and  simple  syrup,  a  mixture  I  had  some  time  previously 
prescribed  for  a  member  of  the  family.  He  was  seen  with  the 
bottle,  *  tasting'  it ;  how  much  had  really  been  taken  could  not  be 
definitely  ascertained,  but,  from  his  condition,  it  was  manifest  he  had 
swallowed  a  destructive  dose.  The  first  intimation  that  anything 
was  wrong  was  given  about  an  hour  and  a  half  before  I  saw  him, 
when  he  complained  of  his  throat,  walked  unsteadily,  and  articulated 
with  difficulty.  I  found  him  comatose,  the  eyes  half  closed,  ex- 
pressionless, the  pupils  insensible  to  light,  though  not  much  dilated. 
The  pulse  was  feeble  and  irregular,  respiration  requiring  artificial  aid 


850  MucellaneouB, 

to  Bupport  it,  and  the  muscles  and  ligaments  so  mach  relaxed,  that 
he  oould  neither  stand  up  nor  sit  unless  supported.  His  re^iratkm 
finally  degenerated  to  a  gasp,  occurring  five  or  six  times  the  miniitey 
then  he  would  convulsively  straighten  out  in  the  lap  of  his  atteadanl-^ 
throw  his  head  and  shoulders  hack,  and  his  hands  over  his  head,  as 
if,  mechanically,  to  get  a  longer  and  fuller  inspiration,  then  relax 
into  the  same  state  as  before. 

*'  No  time  was  lost  in  getting  his  feet  into  hot  water,  sinapiBms  on 
the  soles  of  the  feet,  calves,  and  over  the  abdomen  and  chesU  I 
failed  in  my  attempts  to  get  an  emetic  dose  of  mustard  into  the 
stomadi,  from  its  bulk  and  difficult  deglutition.  Ipecac,  and  Anti- 
mony being  the  least  bulky  of  anything  at  hand,  I  forced  down  a 
double  dose ;  soon  after  I  irritated  the  fauces  with  a  feather.  Fifteen 
minutes  passing,  and  no  signs  of  vomiting  having  iqppeared,  I  re* 
peated  the  dose,  and  irritated  the  throat  as  before.  No  retching 
occurred  from  this  at  the  expiration  of  half  a&  hour  from  the  first 
dose,  the  respiration  grew  more  difficult,  and  the  pulse  became  im- 
perceptible at  the  wrist.  He  was  sinking,  evidently,  and  the  emetics 
were  aiding  the  poison  instead  of  the  patient,  as  the  muscular  fibres 
of  the  stomach  were  rendered  insensible  to  expulsive  stimuli  by  the 
depressing  influence  of  the  poison,  and  the  difficult  respiraUon  and 
deglutition  were  referable  to  the  operation  of  the  same  cause  upon 
the  diaphragm  and  pharynx.  The  case  now  appeared-  desperate, 
unless  these  tissues  could  be  excited,  and  Nux  vomica  was  manifestly 
capable  of  producing  this  effect,  as  its  full  therapeutic  action  was  the 
exact  opposite  of  that  now  dominant  from  the  poison.  Impressed 
with  this  idea,  I  gave  him  three  drops  of  the  tincture  of  Nux  vomica ; 
I  then  placed  my  finger  upon  the  wrist  and  awaited  the  result.  My 
pleasure  can  be  well  imagined  when,  in  a  few  minutes,  I  felt  the 
heart's  impulse  returning  with  accelerated  vigour  as  the  tincture 
became  more  and  more  absorbed,  and  the  respirations  were  corres- 
pondingly improved  in  steadiness  and  depth.  At  the  end  of  twmitj 
minutes  I  repeated  the  dose,  soon  after  CiclQing  the  fauces  with  Hie 
feather.  Retching  was  soon  induced,  and  vigorous  emesis  followed. 
After  this  operation,  young  ebony  opened  his  eyes,  and  after  satisfy- 
ing himself  that  matters  were  progressing  circumspectly,  he  coolly 
lay  back  in  the  lap  of  his  attendant,  with  a  quiet  and  steady  respira- 
tion and  palse.  I  remained  half  an  hour  longer,  when  I  considered 
him  safe,  and  left  him,  with  directions  to  take  three  drops  once  itt 
three  hours  during  the  night,  albwing  him  to  sleep  during  the  inter- 


Comparative  Treatment  of  Diarrhoea,  ^1 

▼alB  if  the  breatiiiiig  continued  regular.  The  next  day  I  found  him 
ntting  in  a  chair,  and  apparently  fuUy  recovered,  having  rested  well 
daring  the  night,  and  taken  light  noiurishment  during  the  day.  I  left 
him  two  drop  doses  of  the  tincture  for  meal  times  during  three  days, 
to  ensure  perfect  tone  of  the  muscles. 

Ab  a  corollary  to  this,  I  think  it  may  be  said  that  Nuz  vomica  is 
a  complete  antidote  to  Aconite,  and,  conversely,  that  Aconite  is 
equally  an  antidote  to  Nuz  vomica.  No  doubt  the  Nuz  vomica 
would  have  been  equally  as  prompt  in  this  case  when  I  first  saw  it 
as  when  I  gave  it.  Nor  is  it  unworthy  of  thought  that  the  antidotal 
powers  of  Nuz  vomica  may  extend  with  equal  force  to  the  whole 
£unily  of  acro-narcotic  and  narcotic  poisons.  There  can  be  no  doubt 
that  Aconite,  Belladonna,  Digitalis,  Conium,  Hyoscyamus,  Stramo- 
nium, as  well  as  Opium,  Tobacco,  and  Prussic  acid,  act  directly 
upon  the  nerves  and  muscles  of  organic  life  through  the  brain,  para- 
lysing them  more  or  less  completely  as  their  toxic  powers  are  devel- 
oped, and  that  the  stimulus  excited  by  Nuz  vomica  upon  the  spinal 
cord,  and  reflezed  through  the  sympathetic  ganglia,  could  not  be 
ezpected  to  do  less  than  revive  and  maintain  these  suspended 
functions  more  or  less  perfectly,  until  the  brain  recovers  from  the 
effects  of  the  poison. — Boston  Med.  Jour.^  and  American  Medical 
Monthly. 


Comparative  Treatment  of  Diarrkcea, 

From  a  letter  of  Mr.  K.  Macdonald,  L.R.C.8.  Edin.,  to  the 
Lancet^  on  the  treatment  of  the  autumnal  forms  of  diarrhoea  and 
dysentery,  by  nitric  acid  and  opium,  we  extract  the  following 
remarks : 

^'  I  conducted  my  experiments  in  such  a  manner  as  to  test  not  only 
the  real  virtues  that  nitric  acid  and  opium  possess  in  the  treatment 
of  the  above  diseases,  but  also  their  relative  value  when  compared 
with  other  remedies.  Four  suitable  cases  were  selected  to  commence 
with.  One  was  restricted  to  a  farinaceous  diet,  vrith  brandy; 
another  had  in  addition  chalk  mixture  and  aromatic  confection ;  to 
a  third  acetate  of  lead  and  opium  were  administered ;  and  nitric  acid 
and  opium  to  the  fourth.  All  terminated  successfully ;  those  who 
received  the  stronger  remedies  recovered  soonest,  but  the  nitric  acid 
was  not  so  efficacious  as  the  acetate  of  lead.  I  next  selected  three 
cases,  and  administered  sulphuric,  nitric,  and  muriatic  acids  respec- 


352  Books  received. 

Uvely,  in  combination  with  opium.  The  effect  was  manifest;  the 
nitric  acid  proved  more  efficacious  than  the  others.  I  have,  moreover, 
given  it  a  trial  in  several  other  insUnces,  and  with  marked  success, 
but  it  does  not  appear  to  possess  the  active  properties  of  sugar  of 
lead  and  tannin." 


Effects  of  Snake  Bites, 

The  Hon.  W.  Bland  in  a  paper  on  the  bites  of  the  venomous 
serpents  of  Australia,  in  the  Australian  Medical  Journal,  relates  that 
the  principal  symptoms   are:    great   prostration    of  strength,   and 
almost  irresisUble  somnolency.     Ptosis  of  the   right   upper  eyelid 
occurred  in  one  case  from  the  bite  of  the  gold-coloured  or  yellow 
snake ;  and  in  another  case,  from  the  bite  of  the  same  species  of 
snake,  a  feeling  of  intense  insupportable  oppression  in  the  left  side  of 
the  chest,  particularly  in  the  cardiac  region;  this  occurred  about 
seven  or  eight  hours  from  the  time  of  the  bite,  nearly  the  whole  of 
which  time  the  patient  had  been  under  active  treatment. 


BOOKS   RECEIVED. 


Homoiogenesis,    Beitrdge  zttr  Nature  und  Heilkunde.     Erstes  Heft. 
Von  Dr.  S.  Rbntsoh.    Wismar,  1860. 

The  Old  and  New  Systems  of  Medicine  Contrasted.    Part  III.    By 
J.  W.  Hatwabd.    London^  Turner,  1862. 

Third  Annital  Report  of  the  Leamington  Homcecpathic  Dispensary' 

Report  of  the  Liverpool  Homoeopathic  Dispensary,  1862. 

Report  of  the  Penzance  Homaopathic  Dispensary ,  1861. 

The  Foot  and  ite  Covering,  by  Jambs  Dowib.    London,  1862. 

A  Review  of  Dr.  RoherU^  Attack  on  the  Hommopathic  Practitumert 
of  Manchester,  by  T.  Raynbr,  M.D.    Manchester,  1862. 

Homoeopathy,  as  Practised  in  Manchester,  in  Harmony  with  its 
Alleged  Principles,  by  J.  Dbukmond,  M.R.C.S.    London,  1862. 

Guernsey's  Homoeopathic  Practice,  by  Dr.  Thomas.    Third  Englifih 
Edition.    London,  Turner,  1862. 

ITie  Monthly  Homcsopaihic  Review. 

El  Criterio  Medico. 

DArt  Midical. 

Bulletin  de  la  Sociiti  MSdicale  Hommopathique  de  Frarice. 


Fzinted  by  W.  Dayt  ft  Son,  8,  Qilbert^^treet.  Oxford-street,  W. 


THE 

BRITISH   JOURNAL 


OF 


HOMCEOPATHY. 


ON  THE  PATHOGENESY  OF  ACONITE :   WITH 
CLINICAL  OBSERVATIONS. 

By  J.  H.  Nanktvell^  M.B.C.S.,  Penzance. 

(Oonthmed  from  page  70.) 

Ears. — {*'  Tearing  in  the  ears^  or  tickling  (as  of  a  little  worm 
in  the  right  esi),  aching  pain  behind  the  le/i  ear." — Oesi.  Zeit* 
schrifL    "  Sensation  as  if  the  mastoid  process  were  swollen.") 

It  is  remarkable,  that  of  severe  diseases  connected  with  the 
ear  I  have  only  seen  two  instances,  and  that  these  were  both  on 
the  le/i  side.  In  the  first,  the  patient,  a  yonng  man,  had  been 
the  subject  of  otorrhcea;  after  a  time  he  complained  of  pain  in 
the  mastoid  process,  became  feverish,  and  vomited  whatever  he 
took  into  the  stomach.  An  unqualified  surgeon  was  sent  for, 
who  treated  the  man  for  biliousness ;  he  became  worse,  and  I 
was  requested  to  see  him.  The  patient  was  quite  conscious, 
and  pointed  to  the  seat  of  pain ;  although  no  fluctuation  could 
be  felt,  the  parts  behind  the  ear  had  a  suspicious  look,  as  if 
there  was  pus  under  the  periosteum  of  the  mastoid  process.  A 
lancet  was  passed  down  to  the  diseased  part,  and  a  small  quan- 
tity of  pus  escaped.  The  vomiting  soon  ceased,  and  after  a  few 
weeks  the  parts  cicatrised. 

The  second  case  was  of  a  man  who  had  a  fistulous  canal 

VOL.  ZX,^  NO.  LJLXXl. — ^JULT  1862.  Z 


854  The  Pathogenesy  of  Acotnte, 

leading  down  to  diseased  mastoid  cells.  He  stated  that  a 
medical  man  was  one  day  syringing  bis  ears,  and  that  the  fluid 
was  suddenly  and  violently  forced  into  the  ear,  where  it  seemed 
to  lodge,  producing  a  strange  feeling  of  numbness  and  tingling; 
and  that  from  that  time  he  dated  his  sufferiDgs.  I  proposed  to 
lay  open  the  sinus  and  examine  the  diseased  bone,  with  a  view 
to  its  removal ;  hut  to  this  he  would  not  consent.  A  few 
months  afterwards  he  became  comatose,  and  died,  the  disease 
having  doubtless  extended  to  the  brain.  This  case  teaches  the 
necessity  for  caution  in  injecting  the  ear,  otherwise,  should  the 
drum  of  the  ear  be  perforated,  the  injection  may  find  its  way 
into  the  mastoid  cells,  through  the  canal  situated  in  the  posterior 
wall  of  the  tympanum. 

("  Burning  in  the  left  ear  (whilst  eating).  Tingling  and 
*  roaring  in  the  eare.  The  ears  feel  stopped  up,  with  sensation 
as  if  the  vibrations  of  the  air  were  prevented  from  impinging 
upon  the  tympanum.") 

The  successful  treatment  of  diseases  of  the  auditory  apparatus 
requires  the  most  careful  discrimination  of  the  causes  which 
have  originated  those  affections,  and  even  then  we  are  often 
bafiSed  in  our  attempts  to  give  relief.     Moreover,  when  we 
succeed  in  our  efforts,  it  not  unfirequently  happens  that  there  is 
a  marked  liability  to  a  relapse.     In  the  autumn  of  last  year,  a 
person  was  in  a  railway  carriage,  and,  being  next  the  window, 
the  right  ear  was  exposed  to  a  draught  of  air.    The  next  day 
there  was  a  confused  noise  in  the  ear,  and  considerable  deaf- 
ness ;  the  ear  felt  stopped,  and  there  was  a  pulsative  sensation 
in  it.    I  gave  drop  doses  of  mother  tincture  of  Aconite,  and  the 
symptoms  quickly  subsided. 

Again,  in  January  of  the  present  year,  a  young  girl,  who  for 
several  years  had  been  deaf  on  the  left  side,  began  to  experience 
a  number  of  unpleasant  sensations  in  the  right  ear,  which  had 
up  to  this  time  been  in  a  healthy  state.  There  was  constant 
beating  and  throbbing,  but  not  much  pain,  the  pulsations  only 
giving  rise  to  a  sound  as  of  the  roaring  of  the  sea.  As  it  was 
evident  that  there  was  marked  disturbance  in  the  vascular 
system  of  the  organ,  I  gave  Aconite.  The  relief  of  the  pulsa* 
tions,  and  the  improvement  in  the  hearing  consequent  thereon, 


by  Mr.  J,  H,  NankivelL  856 

followed  very  quickly ;  but  every  few  days  there  would  be  a 
return  of  the  disorder.  Being  thus  baffled,  I  thought  it  desirable 
to  syringe  the  ear  with  a  weak  dilution  of  Calendula,  and  found 
that  the  fluid  passed  into  the  throat;  the  membrane  of  the 
tympanum  was  evidently  destroyed  by  ulceration,  to  some 
extent.  Finally,  after  giving  a  few  remedies  calculated  to 
prevent  the  further  extension  of  the  disease,  the  treatment  was 
discontinued.  It  is  hardly  necessary  to  state,  in  these  plain 
comments,  how  important  it  is,  in  all  cases  of  deafness,  to 
ascertain  in  the  first  instance  whether  they  are  caused  by  the 
accumulation  of  wax.  Two  cases  have  come  under  my  notice 
during  the  past  year,  of  great  deafness  from  this  cause,  and  this 
only.  In  the  one  case,  of  a  man  aged  40, 1  removed  with  a 
small  ear-scoop,  masses  of  dark  wax  which  completely  occupied 
the  meatus,  and  had  prevented  the  air  from  acting  on  the  drum. 
The  function  of  the  organ  was  completely  restored.  In  the 
other  case,  which  is  still  under  treatment,  the  patient  had  been 
in  the  habit  of  wearing  wool  in  his  ears;  this  material  had 
become  entangled  in  the  wax,  and  by  degrees  had  insinuated 
itself  deep  into  the  meatus  auditorius.  I  thus  had  to  take  away 
pellets  of  wax  matted  with  wool.  When  I  saw  the  patient  the 
first  time,  he  could  not  hear  the  ticking  of  a  watch ;  on  my 
second  visit  he  heard  his  watch  very  plainly,  and  no  doubt  will 
be  much  benefited. 

Again,  a  woman,  aged  47,  came  to  our  dispensary  in 
November  last,  complaining  of  deafness  in  the  right  ear.  On 
examination,  I  found  that  the  whole  organ,  externally  and 
internally,  was  a£Eected  with  what  might  be  termed  chronic 
erysipelas.  The  meatus  was  much  contracted  by  the  tumid 
state  of  the  skin,  and  there  was  a  constant  desquamation  going 
on,  portions  of  the  cuticle  being  easily  peeled  ofif,  when  laid 
hold  of  with  a  small  pair  of  forceps.  Having  cleansed  the  ear- 
passage,  and  given  Aeon.,  Bell,  and  Ars.  in  succession,  the 
disease  was  removed  and  the  hearing  restored. 

About  the  same  time  I  was  requested  to  see  a  lady  who  had 
been  getting  deaf  very  gradually  for  some  years.  The  case  was 
very  similar  to  the  last  mentioned,  except  that  the  disease  had 
not  been  arrested,  and  consequently  the  meatus  had  been- 

z  2 


856  The  Pathogenesy  of  Aconite, 

redaced  to  a  mere  chink.    I  endeavourecl  to  overcome  tbe  con- 
traction  by  a  dilator,  but  with  very  little  saccess. 

In  several  instances  of  what  may  be  called  Ainctional  deaf* 
ness,  or  more  properly,  of  deafness  in  which  it  was  impossible 
to  ascertain  the  exact  cause,  and  where  the  treatment  was 
necessarily  tentative  and  quasi  empirical,  I  have  utterly  failed 
to  afford  any  relief.  One  instance  of  cure  by  Aconite  it  may 
be  well  to  record,  although  it  was  not  a  severe  case.  A 
gentleman  complained  of  deafness  of  the  rig^hi  ear,  which  con- 
tinued daily  from  the  time  he  awoke  of  a  morning  until  ten  or 
eleven  in  the  forenoon ;  it  was  like  the  sensation  of  stopped 
ears  felt  after  bathing,  and  the  patient  attributed  it  to  the  fact 
of  his  always  sleeping  on  the  right  side.  Be  this  as  it  may,  it 
was  relieved  by  Aconite,  and  has  not  returned. 

(*'Tbe  hearing  is  excessively  sensitive;  every  noise  is  in- 
tolerable.") 

It  is  scarcely  necessary  to  remark  that  this  exalted  sensibility 
of  the  organ  of  hearing  is  analogous  to,  and  often  in  relation 
with,  the  exalted  state  of  the  functions  of  the  other  senses, 
and  that  it  is  very  generally  indicative  of  the  first  stage  of 
hyperffimia,  or  inflammation  of  the  cerebral  ganglions.     The 
innumerable  sounds  which  are  simulated  in  the  ear  itself,  when 
the  organ  alone  is  diseased,  form  a  remarkable  fact;  almost  eveiy 
kind  of  sound  has  been  heard  in  this  morbid  state ;  but  it  is 
only  necessary  to  allude  to  them  here.     These  perverted  states 
of  the  auditory  functions  are  by  no  means  necessarily  connected 
with  mental  disorders  or  delusions  of  any  kind.     On  the  other 
hand,  the  illusions  of  the  senses  of  sight,  smell,  taste  and  touch 
more  comtnonly  have  their  origin  in  a  disordered  state  of  the 
nervous  centres. 

Nose. — ("  Stupiiying  pressure  over  the  root  of  the  nose.") 

That  this  is  an  Aconite  symptom  of  some  importance,  I  have 
had  a  gratifying  proof  during  the  present  month  (February)' 
I  was  summoned  to  a  patient,  a  girl  of  12  years  of  age,  and  the 
messenger,  who  was  a  highly  intelligent  person,  and  deeply 
interested,  not  only  in  the  welfare  of  the  patient,  but  in  the 
success  of  homoeopathy,  gave  me  the  following  recital  of  the 
symptoms : — The  child  had  at  first  symptoms  of  common  cold, 


by  Mr.  J.  H.  NankiveU.  857 

with  headache;  she  was  feverish  and  shivering;  pain  in  the 
back ;  could  not  sleep ;  had  felt  as  if  she  should  vomit ;  had 
talked  when  dozing;  the  tongue  is  white  and  foul;  there  is 
scarcely  any  appetite ;  bowels  constipated ;  is  very  thirsty,  and 
asks  for  water ;  has  ground  her  teeth  ;  the  head  gravitates 
backwards  and  forwards^  as  if  it  were  very  heavy ;  there  is 
much  intolerance  of  light;  there  is  a  sefisation  as  if  the  brain 
would  protrude  through  the  forehead,  and  the  pain  shoots  to 
the  root  of  the  nose.  These  symptoms  were  of  so  grave  a 
nalore  that  I  gave  Aeon,  and  Bel.  in  alternation,  the  dose  being 
one  drop  of  the  pure  tincture.  After  a  dose  of  each  of  these, 
then  Aeon,  and  Bel.  in  alternation,  3rd  decimal  dilution.  In 
this  manner  the  alarming  condition  of  this  patient  was  soon 
relieved,  and  after  about  a  week  she  was  convalescent.  She 
derived  great  comfort  from  the  application  to  the  head  of  cloths 
wrung  out  of  hot  water. 

There  is  another  disease  in  which  this  kind  of  pain  might  be 
complained  of,  viz.,  in  chronic  disease  of  the  frontal  sinuses. 
The  most  severe  case  of  this  kind  which  I  ever  treated  was 
accompanied  with  an  acrid,  foetid  discharge  from  the  nostrils. 
The  patient  was  a  bootmaker,  and  being  obliged  in  his  trade  to 
stoop  the  head  forward^  he  suffered  intensely.  It  is  now  many 
years  since,  and  he  was  treated  allopathically,  but  with  indifferent 
success. 

("  *  Bleeding  from  the  nose,  especially  in  plethoric  persons.") 
This  kind  of  hemorrhage  may  take  place  from  a  variety  of 
causes,  as  from  simple  uncomplicated  congestion  of  the  mucous 
membrane  of  the  organ,  or  from  any  cause  giving  rise  to  vascular 
excitement  of  the  brain  or  its  membranes,  or  when  there  is  any 
obstacle  to  the  free  return  of  blood  from  the  head.  If  it  occurs 
in  plethoric  persons,  it  is  most  probably  salutary,  when  to  a 
moderate  extent;  and  whereas  many  persons  are  liable  to 
bleeding  at  the  nose  during  a  long  life,  it  becomes  a  question 
bow  far  we  may,  in  some  cases  of  threatened  apoplexy,  act 
according  to  the  dictates  of  common  sense  as  well  as  of  medical 
science,  by  imitating  the  operations  of  nature,  and  relieving  the 
overloaded  vessels  by  the  application  of  a  few  leeches.  It  would 
be  a  mere  waste  of  time  to  endorse  the  doctrine  contained  in 


358  The  Pailiogefiesy  of  Aconite, 

our  text,  that  Aconite  is  most  valuable  in  the  epistaxis  of 
plethoric  persoM.  It  is  probable  tbat^  as  a  general  role, 
women  bear  the  loss  of  blood  better  than  men.  An  eztensive 
experience  in  midwifery  practice  has  convinced  me  that  the 
female  sex  is  wonderfully  tolerant  of  the  loss  of  blood ;  they 
quickly  recover  health  and  strength  after  very  exhausting 
hemorrhage.  The  Sangrado  practice  is  nearly  extinct  in  every 
school  of  medicine  {laus  Deo) ;  but  I  frankly  confess  that  I 
still  have  a  leaning  to  the  application  of  leeches^  in  a  few 
exceptional  cases  of  disease  in  "  plethoric  persons." 

("  The  sense  of  smell  is  very  sensitive ;  disagreeable  odours 
affect  him  a  good  deal.") 

Such  symptoms  are  given,  in  most  of  our  standard  works  on 
medicine,  as  indicative  of  approaching  apoplexy ;  they  may  also 
be  manifest  at  the  commencement  of  other  diseases  of  the  brain. 
They  belong  to  the  same  category  as  a  very  acute  state  of 
hearing,  &c.,  &c.,  and  distinctly  point  to  Aconite  as  the  most 
reliable  remedy. 

(*' Violent  sneezing,  with  pain  in  the  abdomen  or  in  the 
region  of  the  left  ribs;  coryza;  headache;  humming  in  the 
ears,  and  colic") 

The  connection  of  the  first  group  of  symptoms  is  evident ; 
violent  sneezing  is  at  times  an  apoplectic  symptom,  and  when 
caused  by  catarrh,  might  give  rise  to  serioas  disease  in  the 
brain,  to  persons  in  advanced  age,  or  with  a  marked  tendency 
to  cerebral  congestions ;  it  is  indeed  wonderful  that  the  violent 
and  continued  succussions  in  protracted  sneezing  should  so 
seldom  produce  mischief  in  the  brain.     In  an  incipient  case  of 
real  inflammatory  or  congestive  disease  of  the  nervous  oenUes, 
the  ''  pain  in  the  abdomen  or  in  the  region  of  the  left  ribs"  may 
be  a  consensuous  symptom,  a  nerve-pain  such  as,  under  similar 
causes,  might  be  felt  in  any  part  of  the  body :  in  a  child 
affected  with  acute  hydrocephalus,  one  of  the  first  symptoms 
complained  of  was  intense  pain  in  the  right  thigh.    In  the 
second  group  of  symptoms  above  quoted,  the  three  first  aj^ear 
to  be  en  rapport  with  each  other  and  with  our  medicine ;  the 
last- mentioned — viz.,  colic — seems  to  be  accidental,  and  would 
probably  not  often  occur  in  practice,  in  the  relation  in  which  it 
here  stands. 


hy  Mr,  J.  H.  NankivelL  859 

(O.  Z.  "  Fnrancle  at  the  tip  of  the  nose;  the  nose  is  entirely 
dry ;  a  clear  liquid  is  discharged  from  the  nose.") 

The  first  symptom  cannot  have  occurred  with  sufScient 
fineqnency  to  entitle  it  to  a  place  in  our  pathogenesy ;  the  second 
and  third  symptoms  are  merely  different  stages  of  coryza,  and 
when  accompanied  with  fever,  would  doubtless  be  notably 
relieyed  by  our  drug. 

Facs. — "  Bluish  face,  with  black  lips.  (During  the  febrile 
paroxysms)  the  face  is  bloated,  red,  hot;  or  else  it  is  alternately 
red  and  pale.  Bedness  of  one  cheek  and  simultaneous  paleness 
of  the  other ;  or  e/^e  redness  of  both  cheeks  at  the  same  time. 
Upon  raising  the  head,  the  face,  which  is  usually  red,  turns  pale 
as  death." 

If  all  our  pathogenesy  were  so  photographic  as  the  passage 
just  quoted,  it  would  be  in  truth  a  more  attractive  study  than  it 
is  at  present.  In  reading  it,  one  is  carried  in  imagination  back 
to  many  a  bedside,  where  he  has  day  after  day  watched  and 
observed  parallel  states.  The  first  symptom  appears  to  point 
out  severe  disease  of  the  pulmonary  organs,  the  venous  colour 
in  the  cheeks  being  intensified  in  the  lips.  In  some  forms  of 
asthma,  in  which  the  dyspnoea  was  intense  and  the  cyanosis 
severe  and  extreme.  Aconite  alternated  with  Belladonna  has  in 
my  hands  done  good  service.  The  other  sentences  give  a  graphic 
picture  of  the  varying  conditions  of  the  countenance  in  fever. 
The  alternation  of  redness  and  paleness  marks  perhaps  the 
commencement  of  prostration  of  the  vital  powers ;  every  excite- 
ment of  the  neryous  system,  from  whatever  cause,  trifling  or 
otherwise,  will,  under  these  conditions,  give  rise  to  a  phe- 
Bomenon  allied  to  that  of  blushing.  Usually,  when  one  cheek 
is  pale  and  the  other  red,  it  is  when  the  patient  lies  on  the  side ; 
the  want  of  vital  tone  in  the  vessels  occasioning  the  pallor  in 
the  one  case  and  the  congestion  in  the  other.  When  both 
cheeks  are  red,  the  decubitus  would  probably  be  on  the  back, 
and  the  stage  of  fever  not  so  advanced  as  to  give  rise  to  the 
contrasted  appearances  we  have  attempted  to  explain.  The  last 
symptom  quoted — viz.,  the  face  turning  as  pale  as  death — 
marks  great  exhaustion  or  debility,  and  is  closely  allied  to 
faintness.    It  would  be  a  bold  assertion  that,  in  such  a  con- 


S60  The  Paihagene9g  of  Aconite, 

janotare  as  ihiB,  Aoonite  woald  not  be  borne  irell ;  bat  there 
can  be  no  qaeadon  that  onr  drog  is  more  osefol  in  the  earlj 
stages  of  fisrer  than  at  any  snbseqaent  period. 

This  change  of  position^  giving  rise  to  syncope,  recalls  to  my 
mind  a  case  of  consumption  in  a  yonng  lady  of  15.  I  had 
▼isited  her  one  morning,  and  foond  her  weak  and  much  ex- 
hansted,  but  not  apparently  near  death ;  there  was  cough  and 
expeeioraiion,  and  consequently  no  accumulation  of  mucus  in 
the  lungs,  so  as  to  produce  that  slow  suffocation  and  apncea 
which  we  usually  find  when  patients  in  this  sad  disease  are 
moribund.  I  had  left  the  house,  and  proceeded  about  a  quarter 
of  a  mile,  when  a  messenger  came  hastily  after  me,  to  say  that 
I  must  return  immediately.  On  reaching  the  house,  I  found 
that  the  patient  was  dead ;  and  on  charging  the  nurse  with 
having  lifted  her  up  in  bed,  she  acknowledged  that  she  had  done 
so,  and  that  the  patient  had  suddenly  fallen  back  and  expired. 
As  I  had  cautioned  the  nurse  on  this  subject,  it  was  the  more 
vexatious  to  find  one's  orders  disregarded.  In  all  cases  of 
exhaustion  the  same  caution  should  be  given. 

("  *  Sweat  upon  the  forehead,  upon  the  upper  lip,  and  upon 
the  cheek  upon  which  one  is  lying.") 

This  is  a  truthftil  description  of  the  bead-like  sweat  that 
every  physician  has  noticed,  in  many  forms  of  disease  accom- 
panied with  fever.  I  think  that  it  is  most  frequently  found  in 
connection  with  obstruction  in  the  pulmonary  organs,  and  con- 
sequently with  an  increased  action  of  the  muscles  of  the  al» 
nasi,  and  indeed  of  the  other  assistant  respiratory  muscles.  As 
a  general  rule,  this  excessive  perspiratory  action  of  the  skin  is  a 
vicarious  act  for  the  relief  of  internal  organs;  the  excessive 
sweat  18  one  of  nature's  efforts,  and  is  of  a  critical  nature. 

{"  Contortion  of  the  facial  muscles.") 

The  gentle  tvritching  of  a  few  muscular  fibres  in  the  faces  of 
healthy  infants,  when  they  are  asleep,  is  called  by  nurses  in  this 
county  "  Vester  fits."  I  do  not  know  the  origin  of  the  expres- 
sion, but  have  heard  it  frequently.  I  have  at  present  a  patient 
who  is  the  subject  of  epilepsy ;  the  fits  always  come  on  about 
four  o'clock  in  the  morning,  but  almost  every  day  he  gets 
*'  contortion  of  the  facial  muscles ;"  most  commonly  it  is  the 


by  Mr.  J,  H.  Nankivell.  861 

right  side  of  the  month  which  is  aflTeoted,  and  the  sensation  is 
acsoompanied  with  a  slight  degree  of  distnrhance  of  the  mental 
fimctions  (petti  mal):  he  calls  these  lesser  attacks  "  sqnitches." 
He  has  heen  mnch   benefited  by  Opium,  Belladonna,  and 
Cupmm;  that  is  to  say,  the  fits  return  less  frequently  than 
heretofore.     I  have  not  given  him  Aconite,  but  think  it  worthy 
of  trial.    In  fevers  with  brain  disease,  this  contortion  of  the 
facial  muscles  is  a  most  grave  and  terrible  symptom ;   and 
more  especially  so  when  the  muscles  of  the  eyes  cause  a  jerking 
or  catching  motion  of  those  organs.    We  all  know  and  believe 
that  one  great  reason  why  our  atomic  doses  act  so  well  in  acute 
disease,  is  because  the  affected  organs  are  in  a  state  of  exalted 
and  exquisite  sensibility,  and  are  thus  in  a  state  highly  sus- 
ceptible of  medicinal  impressions;   now,  although  this  is  the 
case  in  disease  in  general,  it  becomes  a  question  whether,  when 
the  very /ons  et  origo  of  sensibility  is  diseased,  we  ought  not  to 
consider  how  far  its  susceptibility  to  the  action  of  remedies  does 
not  become  very  quickly  blunted  ; — ^briefly,  whether  in  brain 
disease  we  ought  not  to  administer  more  palpable  doses  than  in 
other  cases. 

C'  Tingling  pain  in  the  cheeks,  and  sensation  as  if  they  were 
swollen.  Ulcerative  pain  in  the  region  of  the  malar  bones. 
Semilateral  prosopalgia,  with  swelling  of  the  lower  jaw.  Fain  in 
the  articulation  of  the  jaw  when  chewing.  Burning,  tingling 
and  lancinating  jerks  in  the  lower  jaw.  Penetrating  pain  in  the 
lower  jaw,  as  if  it  would  drop.") 

I  have  purposely  omitted  from  this  group  the  sentence  **  *  The 
lips  are  black  and  dry,"  because  it  is  evidently  out  of  place ; 
and  I  would  here  remark,  that  if  ever  our  Materia  Medica  is 
re-edited,  there  would  be  infinite  gain  by  bringing  the  symptoms 
more  into  relation  one  with  another.  The  sentence  I  have 
extracted  would  be  more  at  home,  perhaps,  after  that  of 
*'  Bluish  face,  with  black  lips,"  or,  at  all  events,  amongst  the 
fever  symptoms :  it  is  not  in  connection  with  the  rheumatic  or 
neuralgic  pictures.  With  respect  to  the  other  passages,  they 
seem  to  point,  for  the  most  part,  to  rheumatic  affections  of  the 
face.  The  last  two  sentences  would  seem  to  refer  to  neuralgia 
with  a  rheumatic  complication,  or,  indeed,  such  sufferings  might 


362  The  Pathogefiesy  of  Aconite, 

arise  from  a  centric  course ;  but  the  diagnosis  wonld  not  be 
difficult 

(O.  Z,  "  Expression  of  terror  and  imbecility  in  the  coun- 
tefiance.  Hippocratic  countenance.  Alteration  of  the  features  ; 
twitchings  of  the  facial  muscles.") 

Aconite  is  unquestionably  a  most  valuable  medicine  in  cases 
of  fright.  In  this  neighbourhood  I  have  to  treat  many  cases 
of  extreme  and  alarming  nervous  depression  produced  by  shock; 
and  as,  unhappily,  the  patients  have  a  notion  that  bleeding  is 
the  best  remedy  for  their  su£ferings,  they  often  prescribe  this 
depletion  for  themselves,  and  are  indulged  in  this  delusion 
before  they  come  to  me,  to  the  great  and  serious  injury  of  their 
constitutions.  The  inhabitants  of  the  villages  hereabout  are 
exclusively  occupied  in  the  fisheries,  and  it  frequently  happens 
that  information  of  the  drowning  or  sudden  and  violent  death 
of  friends  or  relations  is  brought  home  and  communicated, 
without  any  caution  to  lessen  the  severity  of  the  shock.  Fami- 
liarity with  these  sad  events  does  not  have  the  effect  of  rendering 
the  people  in  the  slightest  degree  callous ;  on  the  contrary,  it 
would  appear  that  their  nervous  systems  have  become,  by  here- 
ditary descent,  highly  impressible,  and  that  there  is  an  extreme 
susceptibility  and  proneness  to  be  deeply  and  permanently 
affected  by  bereavements.  It  is  almost  incredible  how  many  of 
the  patients  applying  at  the  Penzance  Homoeopathic  Dispensary 
trace  or  attribute  their  sufferings  and  diseases  to  grief  and 
fright  Although  our  standard  writers  on  mental  diseases  have 
protested  against  depletory  means,  as  tending  to  fix  and  confirm 
a  tendency  to  melancholia  or  dementia,  it  is  perfectly  astounding 
that  in  these  days  men  can  be  found  who  will  bleed  a  patient  in 
order  to  cure  a  fright;  and  yet  such  things  are  done  to  an 
extent  that  is  truly  lamentable. 

C  Blisters  upon  the  forehead,  as  from  heat.  The  face  feels 
cold  to  him,  but  warm  to  others.  The  left  cheek  feels  to  him 
as  if  swollen  and  hot,  whereas  it  is  cool  to  the  touch.  Hot 
face,  with  coldness  of  the  hands  and  feet  Glowing  heat  of  the 
face.  Redness  and  heat  of  both  cheeks,  with  sensation  as  if 
the  face  had  grown  larger.") 

These  sentences  appear  to  form  a  natural  group ;  the  first  is 


by  Mr.  J.  H.  Nankivell.  d69 

XiiKE  the  effects  of  erysipelas  of  the  head.     One  cannot  douht 
for  a  moment  how  admirably  Aconite  would  comport  itself  in 
Buch  a  case.    Unfortunately  for  my  clinical  remarks,  I  am  not 
able  to  give  many  results  of  homoeopathic  practice,  in  con- 
sequence of  my  haying  been  so  short  a  time  acquainted  with  its 
wonder- workings;   I  therefore  feel  compelled  to  eke  out  my 
paper  by  referring  to  my  experience  of  the  treatment  of  disease 
"when  I  was  an  allopath.    Many  observations  which  I  insert  are 
therefore  not  apropos  to  Aconite,  except  by  implication. 

I  cannot  refrain  at  this  point  from  relating  very  briefly  two 
cases  of  erysipelas  of  face  and  head,  which  a  few  years  since 
oame  under  my  observation.  The  first  was  in  a  man  of  40. 
He  was  extremely  ill,  the  face  so  bloated  and  altered  that  he 
was  but  little  like  himself;  he  was  delirious,  and  it  was  evident 
that  the  membranes  of  the  brain  were  beginning  to  participate 
in  the  disease  which  had  for  days  been  raging  external  to  the 
skull.  He  took  Mercury  in  the  form  of  calomel,  and  afterwards 
of  grey  powder,  and  the  scalp  and  forehead  were  every  day 
$cari/ied,  very  freely  and  very  superjicially,  after  which  the 
parts  were  fomented  with  hot  water.  The  amount  of  blood  lost 
altogether  could  not  have  been  more  than  two  ounces.  The 
relief  appeared  to  be  very  great,  and  I  always  thought  the 
scarification  was  the  principal  means  of  his  recovery.  Probably 
mild  local  depletion  is  absolutely  necessary  in  allopathic 
practice  for  diseases  of  an  inflammatory  nature. 

Again,  I  was  called  in  consultation  to  see  a  married  woman^ 
aged  85.  She  had  erysipelas  of  the  head  and  face,  and  was 
delirious.  I  was  much  shocked  to  find  that  blisters  had  been 
applied  to  the  scalp  and  brow :  it  was  a  sad  sight  She  died 
the  next  day. 

The  two  next  sentences  point  out  instances  of  perverted 
sensations.  It  is  scarcely  necessary  to  remark  how  frequently 
such  sensations  are  noticed,  especially  at  the  onset  of  febrile 
attacks.  The  difference  in  temperature  at  the  extremities  is  also 
common  enough,  when  the  balance  and  harmony  of  the  circula- 
tion is  lost  in  consequence  of  the  want  of  healthy  innervation. 

0'  Pressing  and  drawing  about  the  chin  ;  sticking  and  draw-* 
ing  in  the  left  upper  and  lower  jaw.    The  lower  jaw  is  involun- 


864  The  Pathogenetn  of  Aconite^ 

tarily  pressed  against  the  upper.    StifiBaess  of  the  jaws.     Lock- 
jaw.  ) 

These  seDtences  remind  me  of  a  case  of  rheumatio  lock-jaw 
(if  it  might  be  so  called),  which  I  saw  many  years  since.  The 
lady  who  was  the  subject  of  it  was  very  susc^eptible  of  cold,  and 
had  many  attacks  of  this  severe  rheumatism  of  the  face.  The 
attack  generally  lasted  a  week,  during  which  time  **  the  lower 
jaw  was  involuntarily  pressed  against  the  upper,"  and  that  with 
much  pain ;  there  was  complete  inability  to  take  any  solid  food, 
and  the  jaws  were  as  rigidly  closed  as  in  a  case  of  true  tetanus 
— nothing  but  a  little  fluid  could  be  got  into  the  mouth. 

It  is  worthy  of  observation  how  rarely  we  meet  with  cases  of 
spontaneous,  or  what  might  more  correctly  be  called  rheumatic 
tetanus.    I  have  seen  one  case  allied  to  this  tetanoid  affection. 
The  patient  was  a  poor  man,  who  had  to  work  in  a  wet  bog ; 
he  was  a  pale,  sickly-looking  fellow,  and  during  the  winter 
months  had  suffered  much  from  cold  and  damp.     At  last  he 
began  to  complain  of  pain  in  his  limbs,  and  by-and-bye  he  was 
attacked  with  universal  cramp,  of  the  most  intense  kind  I  ever 
witnessed.    His  agonies  were  so  great,  that  I  was  under  the 
necessity  of  administering  chloroform  to  him.     This,  and  this 
only,  appeared  to  give  any  prompt  relief.    I  do  not  recollect 
much  about  the  medical  treatment,  but  it  consisted  of  aperients 
and  diaphoretics. 

Teeth. — (''  Sensation  as  if  the  teeth  were  loose,  with  burning 
and  tingling  in  the  jaws  and  in  the  tongue ;  stinging  in  the 
teeth  ;  pressure  in  the  upper  teeth.") 

These  symptoms  point  to  an  inflammatory  origin,  and  are 
unquestionably  to  be  removed  by  Aconite.  A  case  recently 
came  under  my  treatment,  presenting  characters  very  similar  to 
the  above,  accompanied  with  throbbing.  I  gave  Aconite  in  the 
pure  tincture,  1  drop  every  8  hours,  applying  at  the  same  time 
an  Aconite  lotion  to  the  cheek.  The  pain  quickly  subsided, 
leaving  a  sensation  of  numbness,  which  soon  disappeared  after 
the  medicine  had  been  discontinued. 

("Toothache  (especially  when  occasioned  by  a  cold)  in  a 
raw  wind,  accompanied  with  a  throbbing  pain  in  the  whole  of  one 
^ide  of  the  face ;  intense  redness  of  the  cheek ;  congestiott  of 


ly  Mr.  J.  H.  NankivelL  865 

blood  to  the  head ;  burning  heat  in  the  face,  and  great  rest- 
lessness.") 

T7e  have  here  presented  hyperemia  of  the  yessels  sup- 
plying   the    teeth,   associated    with    erysipelatoas    inflamma- 
tion of  the  cheek,  and  a  good  deal  of  feverish  disturbance. 
Aconite  would  be  the  leading  remedy  in  such  a  case ;  but  the 
congestion  of  blood  to  the  head  might  also  demand  Belladonna, 
in  order  to  insure  perfect  relief. 

(*'  Bheumatic  toothache  and  faceache,  especially  in  sensitive 
persons,  subject  to  rushes  of  blood,  the  pain  is  excited  or  aggra- 
vated by  wine,  or  similar  stimulating  drinks ;  or  when  it  is 
brought  on  by  excited  feelings,  particularly  by  chagrin.") 

Bheumatic  toothaches  are  generally  marked  by  a  tendency  to 
come  on,  or,  at  all  events,  to  be  aggravated  at  night,  and  are 
usually  from  their  origin  associated  with  faceache.  The  increase 
of  suffering  after  taking  wine,  or  by  any  kind  of  mental  agita- 
tion of  a  depressing  character,  should  be  borne  in  mind  as  an 
Aconite  indication. 

Q*  Congestive  toothache  (and  faceache),  especially  in  young 
people  (particularly  in  lively,  young  girls),  who  lead  a  seden- 
tary life,  with  abdominal  venous  congestion." — O.  Z,  ''  The 
teeth  are  sensitive  to  the  air ;  the  teeth  are  set  on  edge.") 

It  is  almost  unnecessary  to  remark  how  much  young  persons 
of  highly  nervous  temperaments  and  exalted  sensibilities  are 
subject  to  congestive  and  neuralgic  toothache ;  although  it  may 
be  observed  that  the  manifold  symptoms  of  dyspepsia  which 
accompany  abdominal  congestion,  are  perhaps  more  frequently 
associated  with  that  bite  noir  of  medicine,  viz.  Pleurodynia. 
Before  I  dismiss  this  subject,  which  is  one  that  does  not  much 
fall  under  the  notice  of  the  surgeon,  I  cannot  forbear  making  a 
few  remarks  on  dentistry  in  general.  Doubtless,  in  London 
and  other  large  and  important  towns,  the  dentists  are,  as  a  rule, 
gentlemen  well  acquainted  with  their  profession,  and  fully  com- 
petent to  be  the  conservators  of  the  teeth  of  their  patients.  But 
I  have  had  many  proofs  of  the  injurious  effects  of  stopping  teeth 
with  the  amalgam  which  is  so  convenient  for  the  purpose.  In  what 
manner  this  amalgam  acts  on  the  teeth  I  know  not;  but  certain 
it  is,  that  after  a  time,  the  teeth  become  gradually  pervaded  by 


366  The  Pathogenety  of  Aconite, 

a  dark  stain,  and  the  actual  decay  of  the  teeth  is  much  aocele* 
rated.  I  give  my  judgment  in  this  not  unimportant  subjeot 
with  submission  to  the  higher  authorities,  and  it  is  as  follows: — 
That  if  a  tooth  is  in  a  fit  state  to  be  plugged  or  stopped,  the 
greatest  care  should  be  taken  to  remove  first  all  carious  matter, 
and  then  pure  gold  only  should  be  used;  and  secondly  (judging 
from  experience),  that  as  soon  as  a  carious  spot  appears  on 
any  part  of  a  tooth,  the  most  common-sense  treatment  is  to 
remove  it  by  filing.  I  remember  an  instance  in  which  the 
posterior  edge  of  an  inferior  molar  was  rapidly  breaking  down 
with  disease ;  the  part  was  attacked  with  files  for  about  half  an 
hour  (the  operation  was  intensely  disagreeable,  so  is  the  idea 
or  recollection  at  the  present  moment),  fourteen  years  have 
passed  by  since  then.  The  integrity  of  the  tooth  is  remarkable, 
although  the  patient  has  arrived  at  the  age  of  58.  Once  more. 
The  destruction  of  teeth  by  the  administration  of  calomel  and 
blue  pill  entails  such  fearful  consequences  on  the  digestive 
organs,  that  it  ought  to  be  put  down  by  act  of  Parliament,  or 
by  some  other  efficient  means.  In  the  report  of  the  Penzance 
Homoeopathic  Dispensary  for  the  year  1861  will  be  found  no 
less  than  six  cases  of  mercurial  poisoning,  with  utter  destruc* 
tion  of  the  teeth  ! 

Mouth.— ("  ♦  Sensation  of  dryness,  or  actual  dryness  of  the 
mouth  and  tongue ;  sometimes  accompanied  with  heat  ascend- 
ing from  the  chest  to  the  head.") 

These  states  point  out  that  a  sensation  of  dryness  may  exist 
without,  or  may  precede  actual  dryness.  It  would  seem  that  in 
the  first  condition  there  is  an  interruption  of  the  function,  or 
at  least  an  impaired  state  of  the  function  of  the  nerves  of  the 
tongue ;  and  in  the  second,  a  morbid  change  in  the  vessels  and 
glands  of  the  organ.  The  primary  condition  often  precedes  the 
secondary  by  a  short  space  of  time. 

("  Tingling,  smarting,  stinging  and  burning  of  the  dorsum 
of  the  tongue") 

Of  course,  such  sensations  as  these  are  often  felt  in  the 
course  of  many  diseases,  in  which  the  whole  system  is  im- 
plicated.    I  have  never  had  to  treat  more  than  one  case  of 


by  Mr.  J,  H,  Nankiiell.  367 

*w1iat  might  be  called  pnre  glossitis.    In  this  case  Aconite  acted 
cliarniingly,  and  the  child  soon  recovered. 

(**  Paralysis  of  the  tongne,  which  lasts  only  a  short  while. 
Trembling,  stammering  speech.") 

A  well  marked  case  of  this  kind  came  under  my  observation 
during  the  last  year.  A  gentleman,  aged  50,  had  to  make  a 
long  journey  in  very  cold  weather,  and  the  business  in  which 
he  was  engaged  was  of  a  most  disagreeable  character,  so  that 
during  the  day  he  was  subject  to  extreme  annoyance  and  morti- 
fication, and  this,  with  the  effect  of  the  inclement  weather  and 
a  prolonged  fast,  produced  such  a  depressing  effect  that  the 
next  day  he  found  himself  unable  to  speak  distinctly.  There 
was  no  headache,  nor  any  confusion  of  mind,  but  a  necessity  to 
speak  slowly  and  with  extreme  deliberation.  He  felt  much 
alarmed  from  an  impression  that  his  state  would  be  noticed  by 
his  friends.  I  at  once  gave  him  Aconite,  8rd  dil.,  every  two 
hours,  and  all  the  distressing  symptoms  quickly  passed  away. 
I  well  remember  when  attending  the  lectures  of  the  late  Dr. 
Marshall  Hall,  that  he  called  our  attention  to  the  fact  that, 
under  the  influence  of  emotion,  many  paralysed  persons  were 
able  to  utter  words  and  sentences  with  great  distinctuess,  and 
he  said  that  he  thought  there  was  a  part  of  the  brain  that  was 
especially  affected  by  the  emotions.  Be  this  as  it  may,  I  know 
an  instance  in  which  a  gentleman,  aged  about  70,  is  able,  under 
the  stimulus  of  business,  to  express  himself  very  pertinently, 
but  immediately  after  business  hours,  when  he  retires  to  his 
own  fireside,  and  attempts  to  keep  up  a  conversation  with  his 
t>wn  family,  his  nervous  system  appears  to  suffer  a  kind  of 
collapse,  and  he  is  ever  and  anon  calling  things  by  wrong 
names. 

C  Soreness  of  the  orifices  of  the  salivary  ducts,  as  if  cor- 
roded ;  ptyalism  with  stitches  in  the  tongue.") 

It  has  been  remarked  that  a  kind  of  ptyalism  (not  mer^ 
curial)  exists,  in  which  there  is  what  may  be  called  an  idiopathic 
excitement  of  the  salivary  and  mucous  glands.  The  parotid, 
subiQaxilliary  and  sublingual  glands  may,  from  their  nervous 
connections,  be  associated  in  these  conditions.  In  waterbrash 
there  is  a  sudden,  gush  of  fluids  from  these  glands,  aecompahied 


868  The  PaihogeMBy  of  Aconite, 

with  a  peculiar  sensation  diflScult  to  describe ;  it  is  a  sort  of 
qualm  or  pang,  and  arises  in  most  cases  from  sympathy  of  those 
glands,  with  a  disordered  state  of  the  stomach.     I  remember 
one  instance  of  ptyalism  that  might  well  be  called  recurrent 
A  youth  had  bathed  in  the  sea,  and  remained  therein  for  about 
an  hour,  he  took  cold  and  had  a  severe  attack  of  congestion  of 
the  kidneys,  with  much  fever.    He  was,  unhappily  for  him, 
treated  by  a  gentleman  who  was  a  great  believer  in  mercurials. 
He  became  deeply  salivated,  and  made  a  slow  recovery.     Some 
months  after  this  he  had  a  return  of  the  renal  disease  and 
discharged,  as  on  the  first  occasion,  a  quantity  of  urine  much 
loaded  with  blood ;  at  the  same  time  his  breath  had  the  charac- 
teristic mercurial  fcetor,  and  there  can  be  no  doubt  that  the 
mineral  was  at  this  time  in  his  system.    It  is  scarcely  necessary 
to   add,  that  according  to  the  best  observations,  Hepar  ot 
Mercurius    are  the  most   efPectual    remedies   for   this  quasi 
poisoning  of  the  system,  and  that  Aconite  would  be  the  right 
remedy  for  inflammatory  catarrh  of  the  salivary  glandi^  accom- 
panied with  the  symptoms  mentioned  in  the  text. 

O.  Z. — C'  The  lips  are  burning  and  feel  swollen  ;  burning 
extending  from  the  lips  down  to  die  oesophagus.  Burning  of 
the  tongue;  it  feels  swollen^  with  sensation  as  if  a  currefU 
of  cold  air  were  moving  over  it.  Burning  of  the  tip  of  the 
tongue ;  the  tongue  feels  like  leather ;  vesicles  on  the  tongue 
which  bum  a  good  deal.") 

Case. — During  the  last  year,  an  infant,  aged  8  months,  was 
brought  to  our  dispensary,  presenting  most  of  the  above  symp- 
toms. The  condition  of  the  child  was  truly  pitiable.  It  was 
unable  to  suck  from  the  swollen  state  of  the  tongue,  and  was 
thus  threatened  with  actual  starvation.  The  tongue  was  pro- 
truded from  the  mouth,  studded  with  vesicles,  and,  as  it 
appeared,  thrilling  with  pain.  The  child  cried  and  wailed 
piteously.    Aconite  relieved  it  very  beautifully. 

("  Numbness  in  the  inner  part  of  the  mouth ;  numbness  of 
the  tongue ;  coldness  of  the  tongue ;  spasmodic  sensation  in 
the  region  of  the  root  of  the  tongue ;  inability  to  speak.") 

These  expressions  would  appear  to  indicate  partial  paralyeis/ 
or  interrupted  function  of  the  nerves  supplying  the  tongue; 


Capillary  Vessels,  869 

conditions  of  disease  which  might  exist  during  the  progress  of 
feyers  or  brain  disease.  The  last  sentence^  viz.>  "  Inability  to 
speak/'  recalls  to  my  mind  two  cases  of  fever,  in  which  this 
was  a  prominent  feature ;  albeit  Aconite  had  nothing  to  do  with 
the  recovery ;  but  as  a  certain  degree  of  interest  attaches  to 
them,  I  cannot  refrain  from  recording  them  in  these  my  clinical 
observations.  An  intelligent  Uttle  girl,  aged  7,  was  attacked 
with  fever  and  congestion  of  brain.  She  went  on  from  bad  to 
worse,  and  her  life  was  despaired  of.  As  she  had  all  the  symp^- 
toms  of  effusion  in  the  brain,  I,  as  a  last  resort,  gave  her 
Hydriodate  of  Potash,  but  with  faint  hopes  of  benefit.  To  the 
surprise  of  everybody,  the  child  rallied ;  but  to  the  horror  of 
her  parents,  there  was  every  reason  to  fear  that  if  she  recovered 
she  would  be  an  idiot.  She  did  not  speak  or  seem  to  care  about 
anything,  or  notice  anything  for  nearly  three  months.  At  last 
a  favourite  doll  was  placed  by  her  side ;  this  she  took  up  and 
amused  herself  with  it.  By-and-bye,  she  attempted  to  speak, 
and  in  doing  this,  her  efforts  were  much  the  same  as  those  of 
a  child  when  first  learning  to  talk.  She  made  a  perfect  recovery 
after  having  been  literally  twice  an  infant. 

Again,  a  little  boy  had  fever,  which  nearly  extinguished  him. 
The  only  symptom  of  lesion  of  the  brain  which  he  had  was 
paralysis  of  the  tongue.  Throughout  his  illness  he  had  an 
intelligent  expression  of  the  countenance.  He  did  not  speak 
for  six  weeks.  Oarbonate  of  Ammonia,  mutton  chops,  and 
wine  rendered  him  good  service.  He  made  a  satisfactory 
recovery ;  but  for  more  than  twelve  months  his  utterances  were 
slow  and  labouring. 

CAPILLABY  VESSELS. 

How  DO  THS  Capillary  Vessels  behave  in  the  Process 

OF  Cure  ? 

By  Prof.  Dr.  J.  Hoppe,  Basle.* 

I  HAVE  repeatedly  asserted  that,  in  our  curative  treatment,  the 
capillary  vascular  system  should  be  taken  into  account  decidedly 

*  From  Hirschel'8  Neue  ZeUechrifty  band  yii.  p.  8. 
VOL.   XX.,   NO.   LXXXI. — JULY,    l862.  2  A 


870  Capillary  Vessels, 

aboTO  all  the  other  tissues,  and  that»  for  by  far  the  most  part, 
the  physician  effects  cures  of  the  vessels  only — ue,f  he  produoes 
favourable  changes  and  subdues  disease,  by  acting  on  the 
vascular  system,  and  in  fiict  mainly  by  direct  influence  on  the 
vessels  of  the  part  affected.  If  this  be  a  true  verdict,  and 
surely  it  is  beyond  all  doubt  true  and  correct,  then  must  the 
study  of  the  vessels  and  of  vascular  action  be  one  of  the  most 
weighty  problems  for  the  physician.  For  this  reason  I  have 
already,  in  every  shape  and  way,  cited  the  agency  of  the  vascular 
system  in  relation  to  the  therapeutic  process  and  the  actual 
cure;  and,  in  the  foUowing  treatise,  offer  one  more  contri- 
bution to  the  same  cause.  I  shall  discuss  the  part  which  the 
capillary  vessels  play  at  the  moment  when  the  cure  of  an  affec- 
tion depending  on  abnormal  vascular  activity  commences,  and 
is  completed ;  for,  decidedly,  we  must  endeavour  to  obtain  as 
clear  a  knowledge  as  possible  of  this  act.  I  must  also  premise 
some  general  remarks. 

The  capillaries  have  the  power  of  springing  open ;  and  then 
they  swell  and  occasion  a  local  byperaemia,  or  superabundance 
of  blood.  Moreover,  they  have  the  power  of  contracting,  and 
produce,  by  excessive  contraction,  deficiency  of  blood,  or 
auflemia  of  the  part  affected.  On  the  swelling  of  the  vessels, 
there  instantly  occurs  an  abatement  of  muscular  power  in  the 
region  of  the  swelling;  and  on  their  contraction,  a  propor- 
tionate increase  of  muscular  action.  But  if  a  vessel,  or  branch 
of  a  vessel,  a  little  twig,  a  twigling  not  visible  to  the  naked 
eye,  or  in  short  if,  as  frequently  happens,  a  mere  point  in  the 
course  of  a  vessel^  abates  in  its  muscular  action,  and  just  in 
consequence  of  this  abatement  the  vessel  is  so  quickly  widened^ 
distended,  and  swollen  by  the  rapidly  flowing  and  crowding  in, 
that  it  looks  not  so  much  as  if  it  were  merely  forced  open  by 
the  blood,  but  far  more  assumes  the  appearance  of  having 
entirely  sprung  open  of  itself,  yet  this  vessel  is,  notwithstanding 
such  abatement  of  muscular  action,  by  no  means  ''  paralysed," 
as,  unfortunately,  it  has  hitherto  been  the  fashion  to  assert  in 
every  case  of  a  distended  vessel. 

For  the  said  twig  which  has  now,  so  to  speak,  sprung  open, 
can  the  next  moment  fly  to  again ;  and  I  use  this  last  expression. 


*y  Dr.  J.  Hoppe,  871 

because  it  is  derived  from  actaal  observation,  and  because  these 
^expressions  clearly  set  forth  the  mode  of  action,  or  the  behaviour 
of  the  capillaries.  Also,  the  annular  muscles  of  the  vessels 
Tvhich  have  just  now  abated  in  ieictivity,  and  become  swollen 
from  the  excessive  entrance  of  blood  into  their  calibre  can  at 
once,  or  after  a  few  seconds  or  minutes,  contract  upon  ihe  fuller 
and  wider  stream  of  blood,  by  means  of  their  recovered  activity, 
and  they  can  develope  even  upon  that  wider  stream  the  same 
degree  of  activity  which  they  previously  exerted  ii^  the  tranquil 
state,  and  with  their  normal  dimensions.  It  cannot  therefore 
be  said  that  a  distended  vessel  is  a  paralysed  one.  And  if  a 
vessel  actually  can,  with  such  rapidity  and  as  if  by  a  spring, 
alternate  its  state  of  distention  and  contraction,  how  is  it  in 
this  case  possible  to  call  it's  distension  a  paralysis  ?  In  blush- 
ing, the  vessels  swell  from  a  momentary  abatement  of  muscular 
action,whil8t  in  pallor  of  shame  they  contract  and  drive  out  the 
contained  blood ;  but  blushing  and  pallor  can  notoriously  alter^ 
nate  in  the  space  of  a  few  seconds ;  and  how  can  any  one 
call  blushing  a  paralytic  condition  ?  In  cases  of  hypereamia 
too,  there  can  be  no  talk  whatever,  at  least  in  general,  of 
'*  paralysis."  On  the  contrary,  it  is  tnie  that  in  this  cessation 
of  muscular  activity,  during  which  the  vessel  becomes  distended 
with  blood  or  hypersBmic,  there  lies  a  mystery  as  yet  utterly 
nnrevealed— 'a  process  not  hitherto  designated,  a  phenomenon 
not  yet  comprehended.  And  further,  it  is  a  fact,  that  the 
muscles  of  a  vessel  do  suffer  an  enfeeblement  in  their  dis- 
tended state ;  and  that  also  they  can  be  paralysed,  only  no 
one  will  easily  divine  whether  the  muscles  of  a  distended 
vessel  have  actually  already  suffered  enfeeblement,  nor  will 
he  be  able  to  distinguish  whether  a  paralytic  condition  exist 
in  a  distended  vessel,  inasmuch  as,  in  the  former  case,  evidently 
collateral  symptoms  do  not  pronounce  clearly  on  the  question, 
and  in  the  latter  case,  the  somewhat  gross  lesion  of  the  tissue 
does  not  give  evidence  as  loudly  as  one  would  wish.  For  in  an 
instance  where  we  have  ascribed  enfeeblement  or  paralysis  t6 
the  muscle  of  a  vessel,  it  may  happen,  and  that  most  suddenly, 
that  the  muscle  reviving  resumes  its  contractility,  and  the 
byperffimic  enfeeblement  and  paralysis  disappears  before  otir 

2  a2 


373  CapiUary  Vessels^ 

eyes.  The  homcBopatluc  cures  also  are  an  evidence  against  tbe 
paralysis  theories  which  have  been  invented  in  various  forms 
since  1840. 

Let  us,  however,  for  the  present  set  aside  this  chapter  of  the 
debility  and  paralysis  of  the  said  muscles.  I  will  endeavour  to 
investigate  in  a  separate  treatise  the  manner  in  which  the  cure 
of  an  enfeebled  or  paralysed  vessel  proceeds. 

So  let  us  consider  the  phenomenon  of  a  vessel  springing 
open  and  remaining  abnormally  dilated  as  non-paralytic;  let 
us  also  look  upon  the  numerous  cases  of  hyperemia  which  daily 
occupy  us  as  no  kind  of  paralysis  whatever;  let  us  also  not 
speak  here  of  a  condition  of  feebleness  which  occurs  rather  in 
the  way  of  supplement  to  the  dilatation. 

This  springing  open,  the  flying  open,  and  the  permanent 
dilatation  of  the  vessel  is  a  singular  phenomenon ;  and  if  we 
say  that  during  the  opening  of  the  vessels  their  muscles  have 
abated  in  power,  and  that  no  active  dilatation  takes  place, 
we  undoubtedly  assert  something  correct  and  weighty,  but  then 
we  merely  paraphrase  the  facts  thereby,  and  do  not  state  their 
origin.  What  may  be  the  cause  of  this  enigmatical  pheno- 
menon, upon  which,  up  to  this  hour,  every  judgment  has 
turned  out  wrong  ? 

**  The  circle  is  completed — the  circle  is  interrupted,"  we  may 
perhaps  venture  to  say ;  so  it  must  surely  be — it  must  be  a 
galvanic  phenomenon,  and  the  apparatus  must  be  complete  in 
each  cell  of  the  muscles  of  the  vascular  system,  and  furthermore, 
must  stand  in  connection  with  the  nervous  centre  of  that  system. 
If  the  circle  be  completed,  then  the  muscles  of  the  vascular  system, 
in  proportion  to  their  closing,  increase  their  activity  ;  and  if  the 
circle  be  interrupted,  then  their  activity  abates  proportionably, 
and  the  vessel  becomes  distended  with  blood.  I  have  endea- 
voured to  illustrate  this  extraordinary  action  of  the  muscles  in 
question  by  a  diagram. 

Suppose  tbe  atoms  in  the  efficient,  ue.,  the  nervous  sub- 
stance of  these  muscles,  to  lie,  when  in  their  normal  condition, 
in  this  figure  :::::::::  then  suppose  a  stimulus  acts  upon 
them,  in  consequence  of  which  the  vessel  swells,  they  will 
perhaps  place  themselves  aslant  in  the  following  figure  '.'.'.*.'. 


hy  Dr,  J.  Hoppe.  373 

and  tbeD  the  atoms  are  displaced,  and  their  normal  activity  will 
no  longer  exert  itself,  however  capable  the  muscle  may  pre* 
vionsly  have  been  of  doing  so. 

Whether  we  assame  such  a  displacement  of  the  atoms,  or 
assume  that  the  atoms  take  a  greater  or  less  distance,  viz., 
during  distension  stand  forther  apart,  and  during  contraction 
touch  each  other  more  intimately,  or  if  we  assume  that  the 
electric  tension  of  the  atoms  oscillates,  rising  and  falling  in 
various  degrees — if  I  say  we  suppose  such  anomalies  in  the 
efficient  corpuscles  of  the  muscular  substance,  we  may,  I  should 
think,  render  somewhat  more  conceivable  to  ourselves  the 
phenomenon  of  dilatation  and  contraction  of  the  vessels,  and 
their  alternation  between  these  two  conditions. 

If,  then,  a  vessel  be  dilated,  it  ought  to  contract  again,  and 
if  it  be  contracted,  it  ought  to  dilate  again  to  its  normal 
condition,  and  the  vessel  does  this,  at  least,  often  enough ;  but 
how  does  this  go  on  ?  What  is  the  latens  processus  in  the 
phenomenon  ?     To  ascertain  this  process  is  very  important. 

First  of  all,  I  must  admit  that  it  profits  nothing,  or  that  it  is 
only  a  blind  help,  if  we  contract  the  dilated  vessel  by  pressure, 
by  astringents,  by  withdrawing  its  contents,  &c.,  or  if  we  would 
dilate  it  by  increased  supply,  augmented  attraction,  or  forcible 
injection  of  blood.  Such  a  procedure  does  not  help  us,  or  does 
so  only  accidentally,  and  the  employment  of  such  a  procedure 
implies  ignorance  of  the  process  by  wbich  the  vessels  give  up 
their  existing  condition,  and  pass  into  another.  If  a  distended 
vessel  is  refractory,  one  can  actually  tie,  press,  tear,  and  stimu- 
late it ;  and  for  all  that  it  does  not  do  the  thing  required,  but 
remains  in  an  abnormal  condition. 

If,  on  the  contrary,  it  is  (so  to  speak)  willing,  thus  when  the 
displaced  or  strained  atoms  of  its  efficient  substance  are  easily 
restored  to  their  former  condition,  then  frequently  any  trifling 
impulse  suffices  to  accomplish  the  wonder,  so  that  the  vessel 
becomes  normal  under  its  influence.  Conjunctivitis  is  treated 
with  Lead  Wash,  with  Zinc  or  Blue  Vitriol,  with  Lunar 
Caustic,  &c.,  and  under  this  treatment  the  distended  vessel  may 
actually  become  normal  and  the  inflammation  may  disappear, 
and  that  rapidly ;  then  it  is  said  that  they  have  contracted  the 


874  Capillary  Ve$sel9, 

vessels,  and  the  remedies  seem  proved ;  the  phyBioian  rejoiees, 
and  the  people  praise  him ;  but  yet  there  is  nothing  in  it  all. 
For  it  was  the  vessels,  or  rather  the  atoms  of  th<»r  efficieiit 
substance,   that  were  willing ;    it    was  the    displacement    of 
abnormal  tension   of  these  last  that  was  inconsiderable^  or 
favourable,  and  any  constraining  cause,  or  any  fresh  stimulus 
sufficed  to  make  them  recover  their  normal  condition,  and  that 
voluntarily.    The  cure  thus  succeeded  quite  blindly,  and  the 
physician  had  effected  it,  not  by  his  astringents,  not  by  the 
vessel*contracting  power  of  his  remedies.     Surely  one  must  not 
suppose  that  we  can  contract  a  distended  vessel,  and  thereby 
render  it  normal!     The  contraction  does  not  occur  until  a 
favourable  change  has  already  taken  place  in  the  distended 
vessel,  and  to  this  favourable  change  succeeds  the  self-contrac- 
tion of  the  distended  vessel  as  a  second  act,  and  as  a  necessary 
manifestation  of  the  condition  again  rendered  normal. 

If  one  thinks,  after  this,  that  he  has  effected  a  eontraction 
by  his  remedy,  he  makes  a  gross  blunder.  To  be  sure  we  can, 
by  main  force,  contract  every  thing ;  but  for  all  that  we  can  not 
contract  the  vessel  precisely  to  its  normal  circumference,  still 
less  can  we  thereby  restore  to  it  its  normal  activity.  Nay, 
truly,  it  is  the  dilated  vessel  that  must,  of  itself,  return  to  its 
normal  state  and  function.  It  must  make  itself  normal,  and  no 
one  can  gain  this  point  ad  libitum,  whether  by  the  blind, 
fortunate  success  of  an  impulse,  or  through  a  sly  and  orafty 
observation  of  the  laws  under  which  the  vessel  exists.  The 
morbidly  active  vessel  must  spring  again  into  its  normal 
State ;  it  must  spring  back.  It  has  sprang  out  of  its  quiescent 
state  into  one  of  dilatation,  or  of  contraction,  and  it  must 
spring  back  again.  This  springing  is  the  correct  expression—* 
the  process  is,  as  one  can  even  see,  a  downright  spring,  and 
in  this  regard  I  remember  (to  give  an  example)  the  phe*< 
nomenon  of  vascular  changes  in  the  vessels  of  a  rabbit's  ear. 
Undoubtedly,  too,  the  change  of  condition  in  a  vessel  may 
follow  very  slowly,  nevertheless  this  slow  change  consists  of 
several  very  small  springing  (t.^.^  sudden)  movements  added 
together ;  for  where  electric  currents  are  at  work,  and  where, 
moreover,  a  special  apparatus  is  chasing  the  blood  onward  with 


by  Dr.  /.  Happe,  d7d 

almost  stormy  speed,  there  are  no  lingering  movenients,  and 
therefore  it  would  be  very  wrong  to  ascribe  only  a  slow  rnove^ 
ment  to  the  mnscles  of  the  vessels.  Besides,  I  remember 
gonorrhoea  and  the  numerous  varieties  of  injections  employed 
in  snch  oases,  now  to  contract  the  vessels,  formerly  to  produce 
an  alterative  action.  The  latter  was  a  much  more  confused, 
but  nevertheless,  actually  a  more  correct  view.  For  as  to  the 
contraction.  Oh  !  that  will  not  do.  But  all  the  injected  drugs 
merely  give  an  impulse  to  the  stimulated  vessels,  so  that  they 
spring  back  if  they  can,  ue.y  if  in  consequence  of  such  artificial 
stimulus  they  are  able  to  do  so. 

One  cannot  band  fide  contract  any  vessel  in  the  body ;  but 
one  can,  by  the  supposed  contractive  drug,  merely  give  it  a 
stimulus,  so  that  it  contracts  itself  or  springs  out  of  its  dilata- 
tion into  a  narrow  calibre ;  and  even  the  physical  contraction 
itself  has  its  limits.  The  abnormally  secreting  mucous  lining 
of  the  urethra  can  be  forcibly  made  to  shrink  up;  but  all 
remains  as  it  was,  only  in  smaller  compass,  unless  the  vessels, 
partly  in  consequence  of  the  constrictive  stimulus,  spring  back 
of  themselves  to  their  normal  state.  A  vessel  can  be  made  to 
shrink  up  under  the  actual  cautery ;  but  then  it  is  destroyed. 
Every  distended  vessel  then  which  is  to  recover  its  normal 
dimensions,  must  return  to  it  by  means  of  its  own  agency,  nay, 
we  may  say,  by  means  of  its  own  will ;  and  all  that  can  be 
applied  to  it  for  this  purpose  can  merely  give  it  an  impulse  to 
that  action. 

Accordingly,  if  the  contraction  of  a  dilated  vessel  succeed 
through  any  adventitious  impulse  whatever — this  nevertheless 
proves  nothing;  that  is  after  all  merely  a  fact  accomplished 
blindly.  Unfortunately  much  has  to  be  done  before  this  trifling 
fact  will  be  at  all  explained. 

Again,  one  can  not  dilate  a  contracted  vessel  by  the  influence 
which  we  exert  upon  it,  unless,  under  this  influence,  it  springs 
open  of  itself;  and  as  we  cannot  dilate  the  contracted,  so 
neither  can  we  contract  the  dilated  vessel  by  our  forcible 
efiPorts,  and  according  to  our  absolute  will. 

And  suppose  we  could  actually,  by  our  remedy,  reduce  a 
vessel  from  the  dilated  to  the  contracted  state,  it  must  surely 


876  Capillary  Ves$el$, 

be  impossible  by  the  Bame  remedy  to  bring  it  oat  of  contraction 
into  a  state  of  greater  dilatation ;  for  we  frequently  employ  the 
selfsame  remedy  for  the  doable  purpose  of  both  dilating  and 
contracting  the  yessels !  By  China  we  dilate  the  contracted, 
and  by  China  we  also  (as  we  are  in  the  habit  of  saying)  con- 
tract the  dilated  vessels ;  with  Ferrum  we  act  curatively  upon 
contracted,  as  well  as  upon  dilated  vessels;  with  Arsenic  we 
treat  the  dilated  vessels  of  an  inflammation,  and  also  the  con- 
tracted vessels  of  an  emaciated  body,  and  that  too,  ceteris 
paribus,  with  equally  good  result ;  with  Ipecacuanha  we  stop 
hemorrhages,  i.e,,  cause  dilated  bleeding  vessels  to  contract 
themselves,  and  we  can  also  with  Ipec.  cause  the  vessels  to 
distend  to  such  a  degree  that  they  pour  out  blood,  &c.  It  is, 
therefore,  the  vessels'  own  proper  act,  when  they  recover  their 
state  of  dilatation  or  contraction,  and  thereby  become  normal 
again  ;  and  so  it  was  their  own  proper  act  when  they  sprang 
out  of  their  quiescent  state  into  that  of  dilatation  or  contrac- 
tion. It  is  merely  a  rightly  directed  stimulus  that  gives  them 
the  impulse  to  effect  this  act ;  one  stimulus  causes  it,  another 
removes  it.  This  second  stimulus,  which  is  said  to  impart  to 
the  already  stimulated  vessel  another  impulse,  another  irrita- 
tion, whereby  it  springs  back  to  its  normal  condition — this 
second  stimulus,  however,  must  not  only  be  rightly  aimed,  but  it 
must  also  be  rightly  measured,  and  of  proper  quality ;  it  must, 
according  Hahnemann's  doctrine,  be  a  ** simile**  I  do  not, 
however,  speak  of  that  here.  I  will  merely  sketch  the  manner 
in  which  the  vessels  act,  when  they  relinquish  an  abnormal 
condition  in  which  they  are  found.  I  must  however,  in  the 
meantime,  insert  a  few  words  in  regard  to  the  specific,  or 
"  simile  J*  A  gross  impulse — thus  any  violent  stimulus  super- 
added to  the  already  stimulated  vessel  must,  undoubtedly,  give 
to  many  a  vessel  a  definite  inducement  to  alter  its  condition, 
and  this  alteration  may  be  a  fortunale  one,  of  course,  merely 
by  accident,  as  must  needs  be  the  case  with  an  impulse  that  is 
given  at  random,  and  withal  on  a  large  scale.  Also,  in  the 
case  of  a  vessel  easily  influenced,  almost  any  influence  may 
occasion  it  to  spring  into  its  normal  condition.  This  is  why  it 
is  so  difficult  to  assert,  upon  the  completion  of  a  cure,  that 


by  Dr.  J.  Hoppe.  377 

&  given  remedy  has  acted  specifically.  A  cold,  for  instance, 
may,  under  certain  circumstances,  disappear,  and  that  easily, 
speedily^  and  positively  after  the  most  dissimilar  modes  of 
treatment ;  and  yet  one  cannot,  on  this  account,  ascribe  to  the 
curative  means  any  special  relation  to  the  vascular  condition 
vhich  it  removed,  and  therefore  cannot,  after  all,  call  it  a 
*'  specific."  Leeches,  cupping,  venesection,  purging,  vomiting, 
cold  and  heat,  pressure,  rubbing,  muscular  movements,  Sio. — all 
these  operations  may  produce  all  sorts  of  effects,  and  yet 
nothing  whatever  of  a  specific  character  may  result  for  the 
scientific  apprehension  of  the  process  of  cure.  Fire,  on  the 
right  spot,  must  often,  and  in  various  ways,  effect  much  good, 
and  electricity  must  have  its  results  also ;  but  yet,  even  their 
curative  action  proves  mere  generalities,  nothing  specific,  for 
the  study  of  the  inherent  morbid  activity  of  the  vessel.  But  it 
is  just  this  condition  that  is  the  object  of  tberapeutic  study,  the 
hinge  on  which  every  thing  turns,  and  the  right  comprehension 
of  this  condition  in  therapeutics  is  the  problem  of  scientific 
medicine. 

The  mere  cell  theory  does  not  suffice  at  the  point  where 
there  is  an  enigma  in  the  action  of  the  ultimate  particles. 

As  many  an  abnormal  vessel  has  to  accommodate  itself  to 
the  gross,  and  to  the  casual  and  the  ad  libitum  impulses,  and 
under  their  influence  springs,  as  if  voluntarily,  into  its  normal 
condition,  so  also  it  accommodates  itself  to  many  refined 
impulses,  without  any  necessity  for  their  having,  for  that 
purpose,  any  specific  significance.  Aconite  in  a  state  of  dilu- 
tion may  advantageously  affect  many  a  vessel,  so  that  it  springs 
back  from  the  dilated  condition  to  its  normal  state  of  con- 
traction, and  yet  the  Aconite  need  not  for  this  purpose  have 
any  special  relation  to  the  existing  abnormal  vascular  condition 
— a  merely  general  suitability  may  allow  even  a  homoeopathic 
remedy  to  become  useful.  Phosphorus  diluted  may  remove  an 
inflammation  of  the  lungs,  because  it  is  a  powerful  medicine, 
because,  when  diluted,  it  enters  with  sufficient  subtlety,  and 
because  the  vessels  have,  in  a  manner,  a  certain  willingness, 
and  thus,  Phosphorus  in  a  diluted  form  may  bring  about  the 
desired  effect,  and  yet  it  is  not  therefore  the  specific.     Secale 


378  Capillary  Vesiels, 

Cornatma  when  dilated  may»  under  the  sanie  circamstances, 
effect  a  cure  in  the  uterus,  and  yet,  in  like  manner,  is  not,  for 
all  that,  the  right  medicine.  Diluted  Arnica  may,  in  case  of 
wounds,  vertigo,  bomorrhage,  &o.,  remove  all  symptoms,  and 
yet  even  the  Arnica  is  not  therefore  of  necessity  the  spedfie, 
just  because  the  case  was  an  easy  one,  owing  to  the  willingness 
of  the  vessels. 

The  mere  weakening  of  the  medicine  by  its  dilution,  opens  to 
it  a  wide  sphere  of  operations;  nevertheless,  the  great  capability 
acquired  thereby  ought  not  to  mislead  us  into  a  decision  upon 
its  specific  efficiency.  As  we  are  at  present  unable  to  say 
wherein  specific  power  consists,  so  it  is  also  as  yet  necessarily 
difficult  to  distinguish  whether,  in  any  case  whatever,  a  medi- 
cine has  effected  a  cure  through  its  elective  and  exclusive 
relation  (and  thus  its  **  specific "  relation)  to  the  anomalous 
condition  of  the  morbid  activity  of  the  muscles  of  the  vessels, 
or  whether  it  is  iodebted  for  the  appearance  of  this  fact  to 
nothing  more  than  its  general  stimulative  action,  and  to  the  favour 
of  circumstances.  Further,  the  more  the  proving  of  medicines 
speaks  to  the  point,  the  more  we  are  able  to  ascribe  the  specifio 
importance  to  the  curative  action  of  the  remedies,  and  this  is 
hitherto  the  solitary  resting  place,  though  still  unsettled. 

After  this  episode  on  specifics,  I  will  proceed  to  describe  the 
part  played  by  the  vessels  when  they  relinquish  a  state  of 
abnormal  activity,  and  when,  consequently,  a  morbid  condition 
disappears  before  our  eyes,  and  actually  very  often  dissolves 
away  (as  it  were)  into  nothing.  One  must  start  from  this  point 
— *that  the  vessels,  uuder  the  influence  of  a  stimulus,  open  and 
close  themselves  by  their  own  act,  and  thus  they  more  or  less 
co-operate ;  from  this  truth,  I  say,  one  must  start,  in  order  to 
comprehend  their  changes  daring  the  commencement  and 
departure  of  diseases,  and  must  refrain  from  the  force  with 
which  we  have  long  enough  been  trying  to  master  them,  after 
the  manner  of  parts  or  organs  entirely  passive.  The  result 
obtained  by  such  force  is  only  to  be  considered  as  the  effect  of 
accident,  and  it  is  not  the  physical  power  of  the  force  directed 
towards  the  distended  or  contracted  vessel  that  produces  the 
result,  but  it  is  the  stimulus  that  comes  into  operation  in  this 


hy  Dr.  J.  Hoppe.  379 

force,  and  that  corresponds  to  the  physical  power  of  the  atoms 
in  the  active  substance  of  the  vessels. 

It  is  an  inner  dynamism,  but  of  such  a  kind  as  no  longer  to 
permit  the  previous  gross,  crude,  and  superficially  physicial 
comprehension  of  the  subject,  or  at  least  no  longer  allow  any 
decisive  significance  to  attach  to  this  last.  Where  we  exert  a 
pressure,  it  is  not  the  pressure,  but  the  stimulus  that  is  effec- 
tive; where  we  use  an  astringent,  the  astringent  is  only  the 
medium  of  a  stimulus;  if  we  apply  a  stoppage,  we  in  like 
manner  effect,  directly  or  indirectly,  a  stimulation  of  the  active 
substance  composing  the  muscular  coat  of  the  vessels,  and  so 
forth ;  and  whatever  it  be,  physical,  chemical,  or  functional, 
that  is  set  in  motion  by  dint  of  curative  agency  upon  the 
morbidly  active  vessels,  it  is  only  the  stimulus  acting  on  those 
last  that  is  effectual. 

Under  the  influence  of  a  stimulus  a  vessel  springs  iuto  an 
abnormal  calibre,  and  under  the  iufluence  of  another  stimulus 
it  must  spring  back  to  its  normal  state ;  if  it  was  contracted, 
it  must  spring  open — if  distended^  it  must  spring  together  to  the 
respective  average  amount.  These  alterations  the  vessel  can 
assume  even  of  itself,  when  the  atoms  of  its  active  substance,  which 
had  got  into  a  morbid  state,  have  sufficiently  recovered  themselves 
under  the  influence  of  the  nutritive  metamorphosis.  If  this 
does  not  happen,  or  is  too  tardy,  assistance  must  be  given  by  a 
fresh  stimulus.  Now,  assuredly,  there  lies  something  daring  in 
this  idea  of  conducting  a  fresh  stimulus  to  the  vessels  already 
excited  by  a  previous  one,  in  order  that,  under  this  new 
impulse,  its  displaced  or  abnormally  stretched  fibres  may 
recover  their  normal  position.  This  is  something  daring,  and 
it  is  so  much  the  more  so  in  proportion  as  it  is  deficient 
in  method  and  management. 

It  is,  we  say  plainly,  if  it  be  not  consciously  executed 
according  to  natural  laws,  a  piece  of  artifice ;  and  because  it 
was  mere  artifice  that  was  practised,  people  spoke  of  the  **  art " 
of  medicine;  and  it  is  merely  because  the  morbidly  active 
vessel,  or  the  atoms  of  their  active  substance,  often  have  a 
certain  willingness,  or  have  given  way  in  favourable  circum- 


880  Capillary  Vessels, 

stances,  that  tbis  "  artifioe "  could  appear  a  trifling  and  safe 
one,  and  medicine  an  easier  thing  than  it  really  is,  and  for  this 
reason  the  profession  of  medicine  is  often  practised  with  levity. 
Against  this  unfortunate  prepossession,  with  its  terrible  conse- 
quences, there  is  no  defence  but  the  study  of  the  process  of 
cure.  In  proportion  as  we  comprehend  this,  another  view  must 
gain  ground ;  and  along  with  the  respect  paid  to  the  attempts 
at  curing  must  professional  earnestness  increase. 

In  reference  to  our  subject  of  cures  by  the  capillaries,  we 
must  thus  try  to  determine  how  the  abnormally  active  vessels 
behave  when  they  come  in  contact  with  a  curative  substance, 
and  this  behaviour  we  must  follow  up  even  to  the  finest  and 
most  subtle  peculiarities.  This  I  will  endeavour  to  illustrate 
by  some  examples. 

Suppose  a  case  of  choroifditis.  Now,  it  may  be  that  ori- 
ginally merely  a  single  twig  of  a  vessel  became  abnormally 
stimulated  ;  but  secondarily,  the  vessels  in  the  whole  extent  of 
the  choroid  membrane  are  swollen,  just  as  in  panaritium  also, 
the  disorder  sets  out  from  a  single  spot ;  though,  secondarily, 
the  finger  and  hand  become  extensively  hypersemic  and  swollen. 
Suppose  Belladonna  be  administered  for  the  hypereemic  vessels 
of  the  choroid  ;  then  this  medicine  imparts  a  new  stimulus  to 
these  already  stimulated  vessels.  But  if  this  new  stimulus  be 
too  strong,  then  those  vessels  of  the  choroid  will  not,  as  we  wish, 
spring  into  a  narrower  calibre ;  but  they  will  either  swell  still 
more,  or  else  they  will  perhaps  contract  a  little ;  but  while  a 
state  of  abnormal  width  still  continues,  they  will  only  so  much 
the  more  tightly  contract  upon  their  contents,  and  by  driving 
them  on  more  forcibly,  increase  the  injection.  It  is  thus 
possible  that  Bell.,  suitable  as  it  may  be  in  itself,  may  produce 
aggravation  of  the  ailment,  and  a  new  irritation  even  of  long 
duration  may  be  communicated  to  the  vessels.  Moreover,  it 
will  not  unfrequently  (especially  if  our  observation  of  the 
medical  eflect  of  the  remedy  be  so  careless)  be  difficult  to  recog- 
nize this  induced  aggravation.  Suppose  dimness  and  darkness 
constantly  before  the  eyes,  before  and  after,  a  trifling  increase 
of  the  darkness  is  not  noticed ;  little  stars,  flashes,  or  colours  . 


by  Dr,  J.  Hoppe,  381 

show  themselves  perhaps,  but  so  small  and  so  feeble  are  they, 
that    the  listless  patient    does    not    observe    the  fact ;    and 
perhaps  the  eyeball  becomes  somewhat  fuller,  but  so  slightly 
that    the  finger  finds    no   difference   between   yesterday   and 
to-day.     The  Bell,  is  given  up,  because  presumed  to  be  unsuit- 
able ;  but  no  one  observes  that  it  has  done  harm.     Never- 
theless, it  might  have  been  a  suitable  remedy  here ;  but,  from 
exercising  too  powerful  an  influence,  it  missed  its  aim.   As  it  is 
the  quality  of  the  medicine,  so  also  it  is  the  quantity,  by  whose 
help  one  studies  the  behaviour  of  the  vessels  during  the  process 
of  cure ;  and  the  variation  of  dose  will  especially  be  the  coad- 
jutor, to  the  beginner  at  least,  enabling  him  to  penetrate  most 
easily  into  the  depth  of  the  matter.     Suppose  one  has  hitherto 
taken  a  merely  superficial  notice  of  the  behaviour  of  the  vessels 
during  the  process  of  cure,   he  must  in  fact   acknowledge, 
with  wonder,  that  a  host  of  physicians  are  adherents  to  the 
doctiine  of  the  small  doses.    There  are  also  in  reality  infinitely 
small  and  fine  parts  in  which  the  activity  of  the  capillary 
muscles  is  contained,  and  there  are  infinitely  refined  changes 
which  constitute  the  abnormal  condition  of  these  muscles ;  it 
will  therefore  be  necessary,  if  we  will  act  according  to  the  right 
rules  of  art,  to  work  with  extreme  subtlety,  and  the  more  so, 
the  less  we  are  able  to  hit  the  mark,  a  priori,  with  certainty. 

Moreover,  the  preparatory  school  for  these  capillary  studies 
in  man,  during  the  curative  action  of  medicine,  is  formed  out 
of  the  studies  resulting  from  the  application  of  the  medicines  to 
the  denuded  capillaries  of  the  lower  animals,  either  mutilated 
or  living. 

Again,  suppose  a  case  of  prolapsus  uteri.  Here  Secale 
Comutum  will  effect  something.  Here,  the  vessels  of  the  uterus 
and  the  vagina  are  affected,  not  certainly  both  in  the  same 
degree,  nor  in  a  similar  way ;  and  the  respective  vessels  in  each 
have  also  a  very  different  nature.  Now,  suppose  Secale  be 
given  in  rather  too  strong  a  dose,  then  this  medicine  may 
perhaps  influence  beneficially  the  vessels  of  the  prolapsed 
vagina ;  and  whilst  they  spring  into  their  normal  calibre,  it  is 
possible  that,  during  the  remission  or  disappearance  of  their 
distension,  the  consequences  of  the  latter,  viz.,  the  abnormal 


882  Capillary  Vessels, 

fulness  and  weight  of  the  Tagina  (and  therefore  the  prolapsus) 
may  amend,  or  cease  altogether  ;  on  the  other  hand,  the 
Secale  in  the  dose  employedi  may  also  at  the  same  time 
increase  the  aiknent  of  the  ateras,  so  that,  for  instance,  partial 
swellings  in  the  parietes  of  the  uterus  may  come  forward  more 
evidently  after  it,  or  (as  one,  perhaps  with  less  experience,  or 
merely  from  a  different  interpretation,  would  say)  they  may 
originate  as  a  conaequetice  of  the  medicine.  Here,  sure 
enough  then,  the  vessels  sprang  under  the  Secale  treatment 
into  a  more  normal  condition,  and  thereupon  contracted  to  a 
normal,  or,  at  any  rate,  to  a  better  calibre.  If  one  has 
recognized  the  fact  that,  wherever  animal  activities  exists 
nothing  essential,  nothing  fundamental  is  to  be  accomplished 
by  gross  physical  influences,  and  that  the  living  tissues  do  not 
allow  themselves  to  be  driven  into  their  normal  condition,  but 
require  to  be  led  back  to  it  almost  by  cunning ;  one  shall  pro* 
ceed  much  more  rationally  and  discreetly  than  when  short  of  this 
apprehension ;  and  so  much  the  more  discreetly,  if  one  further 
considers  that  the  vessels  of  each  part  of  the  body,  and  of  each 
organ,  have  a  distinct  and  specific  endowment  and  natural 
gift,  and  that,  consequently,  the  stimulus  which  acts  on  them 
beneficially  on  any  given  spot,  is  not  permitted  to  excite  the 
neighbouring  vessels,  and  the  vessels  of  distant  parts  of  the 
body,  to  a  prejudicial  activity.  Neither  allopaths  nor  homoeo- 
paths have  learnt  that  the  vessels  spring  out  of  their  abnormal 
calibre  to  the  normal,  and  out  of  the  abnormal  distension  of 
their  parietes  to  their  proper  distension — ^in  other  words,  recover 
themselves,  and,  in  fact,  by  their  own  proper  power ;  of  them* 
selves  in  spontaneous  cure,  and  in  consequence  of  an  impulse, 
in  cures  brought  about  designedly.  But  whilst  the  allopaths, 
by  their  depletive,  tonic,  and  astringent  treatment  sought  to  con- 
tract the  vessels,  or  by  various  grossly  physical  operations,  to 
enlarge  them  when  contracted,  and  thereby  upheld  the  type  of 
cure  vi  et  armis  as  the  paragon ;  the  homceopaths  have  folfowed 
out,  in  its  general  outlines,  the  marvel  of  the  specific,  or,  as 
may  also  be  said,  the  spontaneous  cure  ,*  and  they  have^  by 
their  cures,  at  least  permitted  or  caused  the  facts  of  the  process 
of  cure,  as  here  sketched  out,  to  come  to  light.    And  there  lies 


by  Dr.  J,  Hoppe.  •  888 

in  the  homceopatfaio  cures  a  deeper  meaning — there  lies  in 
them  the  entire  model  of  the  therapeutics  of  tissues,  and  what 
has  still  more  significance,  of  the  atomic  principle  of  cure. 

The  profession  may,  some  time  or  other,  learn  to  cure  hotter 
than  the  homoeopaths  do  up  to  the  present  time ;  hut  as  for 
the  question,  how  the  curative  operation  of  the  medicines  arises, 
and  how,  by  the  impulse  which  the  medicines  give  to  the 
tissues,  to  allow  the  proper  action  of  the  latter,  with  the  least 
possible  disturbance,  to  succeed  in  the  happy  solution  of  a 
morbid  state — ^this  in  fact  cannot,  in  essentials,  be  answered 
in  any  other  way  than  the  Homceopaths  have  done  it. 

How,  for  instance,  did  the  cure  come  about  in  the  following 
case? 

A  lady,  aged  72,  who  had  sufiered  a  whole  twelyemonth  from 
intercostal  neuralgia  of  the  right  side,  gradually  began  to 
experience  tightness  of  the  chest,  hardly  perceptible  during  rest, 
but  on  moving,  walking,  or  climbing,  severe ;  and  at  last  so 
severe  that  she  could  only  walk  a  little  way^  and  slowly,  and 
could  no  longer  get  on  at  all  on  a  somewhat  rising  street.  All 
treatment  continued  inefiectual,  and  the  sympathy  bestowed  on 
the  patient  was  great  and  general. 

So  Chamom.  12  was  givAi  to  her  (one  drop  only),  and  in 
half  an  hour  she  walked  somewhat  more  easily ;  on  the  next 
day,  there  was  a  loud  psan  sung  that  the  lady's  shortness  of 
breath  had  disappeared !  The  removal  of  this  complaint  was 
indeed  a  striking  fact ;  and  it  has  continued  permanent  for  a 
whole  year.  Well  now,  what  had  happened  here?  Here 
were  the  vessels  of  the  heart,  and  probably  also  of  the  lungs, 
already  involved  in  an  abnormal  distension,  and  this  distension 
was  increasing,  and  was  aggravated  in  a  distressing  way  by 
movement.  To  these  vessels  then  the  Chamom.  gave  an 
impulse,  in  consequence  of  which  they  sprang  back  to  their 
normal  calibre,  lost  thereby  their  abnormally  swollen  state,  and 
thereupon  oould  endure  the  action  of  walking  undisturbed.  It 
was  a  cure  similar  to  that  which  often  enough  is  effected  on  the 
maxillary  vessels  in  toothache,  also  by  Ghamomilla.  Why 
Ghamomilla  must  have  been  the  remedy  here,  that  question 
does  not  at  all  concern  us  here  (although  that  lady  also  perspired 


884  Capillary  Vessels, 

habitaally  od  the  head  very  much,  and  amongst  the  hair  not  a 
little).  But  that  the  Cham,  here  did  good  in  the  way  specified* 
we  cannot,  it  is  tnie,  see  with  oar  eyes ;  on  the  other  hand^  it 
follows  step  by  step  from  the  facts — nay,  it  follows  from  all 
facts,  that  there  is  no  essential  difference  between  the  behaviour 
of  the  yessels  in  this  care  and  the  oscillation  of  the  vessels  in 
the  ears  of  rabbits.  The  Ghamom.  re-established  the  normal 
direction  between  the  atoms  of  the  active  substance  in  the 
capillary  muscles,  and  in  consequence  the  vessels  returned  to 
their  normal  condition.  The  Cham*  did  not  contract  them,  but 
only  restored  the  functions,  whereupon  they  contracted  them- 
selves. When  the  above  discussed  process  in  curing  vascular 
affections  is  understood,  and  the  behaviour  of  the  vessels  during 
tliat  process  investigated  in  all  its  individualities  and  peculiar- 
ities, then  only  can  we  have  pretensions  to  disclose  the  essential 
nature  of  a  ''  specific." 

Again,  suppose  an  ansmic  condition,  with  emaciation  (and 
let  the  case  be  one  where  the  system  is  attacked  by  no  inflam- 
matory ailment  at  the  same  time,  which  would  have  required  to 
be  removed  by  the  resilience  of  the  vessels  existing  in  a  state 
of  distension  and  injection  at  the  focus  of  the  inflammation), 
then  the  vessels  are  involved  i&  a  state  of  abnormal  con- 
traction and  have  need  of  an  impulse,  under  which  they  experi- 
ence, as  it  were,  an  electric  shock,  in  consequence  of  which 
the  atoms  of  their  active  substance  get  into  a  more  normal 
condition,  at  the  same  time  their  action  also  becomes  more 
normal,  abates  from  its  undue  amount,  and  the  calibre  of  each 
vessel  again  becomes  dilatable  for  the  blood  that  rushes  into 
it.  China,  Ferrum,  and  many  other  remedies  might  here  have 
given  the  favourable  impulse ;  but  it  is  not  every  medicine  that 
suits  in  all  cases. 

All  medicines  which  give  the  vessel  an  impulse  tending  to 
distension,  can  also  give  them  an  impulse  in  order  to  remove 
their  possibly  present  distension,  and  to  contract  themselves; 
and  there  are  no  medicines  that  can  limit  them  exclusively  to 
the  accomplishment  of  a  distension  or  a  contraction.  Electricity 
can  solve  both  problems  in  the  vessels,  and  in  like  manner  every 
remedy.     The  very  acids  which,  even  in  small  doses,  have  such 


hy  Dr.  J.  Hoppe.  885 

a  dominant  inflaence  over  tbe  capillary  muscles  that  these 
contract  themselves ;  even  the  very  acids  can  induce  a  disten- 
sion of  the  vessels,  and  that  instantly,  at  the  first  touch. 

It  always  depends  on  the  existing  state  of  the  vessel  whether 
it  will  answer  in  one  way  or  the  other,  and  one  cannot 
oomniand  this,  nnless  the  force  employed  succeeds  by  accident ; 
but  then  still  the  question  is,  whether  this  forcible  success  is 
truly  and  permanently  beneficial.  On  the  other  hand,  there 
are  medicines  which,  as  a  rule,  determine  distension  of  the 
vessels,  and  others  which,  as  a  rule,  determine  their  contrac- 
tion— and  those  which  determine  distension  are  the  most 
numerous.  We  may  also  say,  that  all  weaker  medicines  and 
influences  are  apt  to  distend  the  vessels,  and  all  stronger  ones 
to  induce  their  contraction,  unless  some  existing  abnormity  of 
the  vessels  exerts  a  directly  counteracting  agency,  as  is  actually 
the  case  in  disease.  It  is  also  true  that  all  substances  and 
influences  whatever  that  act  at  all  on  the  vessels,  distend  those 
vessels,  and  that  all  those  same  substances  and  influences  can 
also  make  the  vessels  contract  themselves. 

But  as  all  stimuli  can  cause  vascular  distension,  and  do  so  in 
their  primary  action — thus,  at  the  instant  when  they  come  in 
contact  with  the  vessels;  and  farther,  as  in  hypersemia  and 
inflammation  the  vessels  are  dilated  ;  and  lastly,  as  every  thing 
that  causes  the  vessels  to  distend  can  also  prove  beneficial,  by 
communicating  an  impulse,  as  a  remedy  for  existing  distension 
of  the  vessels,  thus  similia  similibus  is  confirmed,  although  in 
this  argument  it  can  only  pass  as  a  very  general  expression  for 
vascular  therapeutics. 

If  we  take  cofiee  for  breakfast,  we  acquire  for  the  forenoon  a 
greater  capability  of  endurance,  and  we  feel  ouraelves  till  mid^ 
day,  and  perhaps  all  day  long,  better,  warmer,  and  stronger 
than  if  we  had  drunk  no  cofiee.  Now,  independently  of  any 
other  effect  of  cofiee  on  the  tissues,  how  do  the  capillaries 
behave  during  this  action  of  cofiee  ?  Coffee  pre-eminently 
induces  distension  of  these  vessels,  especially  when  combined 
with  warmth,  and  taken,  furthermore,  with  blood-making 
substances,  it  imparts,  as  it  circulates  with  the  blood  over  the 
body,  an  impulse  to  the  vessels  provided  with  muscular  fibres, 

VOL.   XX.,   HO.   LXXXI.— JULY,  1862.  2  B 


886  CapillaYif  VeueU. 

in  oonseqoenoe  of  which  the  atoms  of  their  active  sabstanoe 
experience  a  kind  of  electric  shock,  with  lelazation  or  displace- 
ment, whereby  the  muscles  for  a  moment  become  less  ener- 
getic, and  consequently  more  yielding  to  the  pressnra  of  blood, 
and  hence,  suffer  still  further  distension.    As  a  result  of  these 
changes,  the  Ycssels  become  hypemmio,  and  there  arises  all 
over  the  body  a  distended  condition  of  the  vessels,  not  so  tran- 
sitory as  when  one  incorporates  water  with  them  by  drinking*, 
but  in  very  different  degrees  much  more  lastingly.    During  this 
increased  and  prolooged  distension  of  the  vessels,  the  blood 
stayd  longer  in  the  tissues,  and  can  thus  serve  much  better  and 
more  effectually  for  feeding  them,  and  also,  by  means  of  a  more 
lively  maintenance  of  the  nutritive  process,  for  producing  the 
needful  warmth.     In  consequence  of  this  we  feel  better,  and 
that  for  a  longer  time  than  if  we  had  not  taken  so  distensive  a 
beverage  for  breakfast.     Also,  because  the  blood  stays  longer 
in  the  tissues  during  the  act  of  liutrition,  it  cannot  during  that 
time  be  much  filtered  through  the  secreting  organs,  and  hence, 
it  was  found  that  coffee  diminishes  the  secretions;  it  was  accord* 
ingly  said  that  coffee  retarded  the  nutrition,  whereas  it  rather 
prolongs,  and  in  every  xeB^eQi  pro$notes  it.    But  then,  if  coffea 
is  given  for  excitement  of  the  cerebral  vessels,  this  medicine 
can,  in  suitable  circumstances,  and  in  the  right  dose,  produce 
an  entirely  opposite  effect,  for  here  it  meets  with  vessels  already 
distended ;  and,  in  consequence  of  the  impulse  which  it  gives 
those  vesselfii,  they  are  enabled,  by  their  own  proper  power  and 
act,  to  spring  back  to  their  normal  calibre. 

It  is  an  old  joke  to  say  that  the  meals  of  a  HomoBopath 
ought  to  be  as  small  as  his  doses.  But  had  people  at  all 
considered  that  the  exhausted  material  must  be  restored  to  the 
body— had  they  at  all  imagined  the  activity  of  the  capillaries — 
had  they  taken  any  notice  of  the  fact  that  HomoBopathy  is 
eminently  a  process  of  cure  by  means  of  the  powers  of  the 
tissues  themselves,  they  would  not  have  perpetrated  such  a 
witticism.  If  the  vessels  merely  have  to  spring  back  to  their 
normal  condition,  then  small  doses  are  not  to  be  despised,  if 
it  is  meant  that  medicine  should  be  a  profession  canned 
out  with  precision  and  with  success.    But  if  it  is  intended 


by  Dr;  J.  Hoppe.  387 

to  Yaing  the  normal  yessels  into  an  artificially  abnormal  dis- 
tension by  means  of  Dourishing  the  body,  then  we  must  give 
large  doses  of  the  snbstancea  calculated  to  stimulate  and  to 
ieed,  and  the  result  will  vary  directly  as  the  quantity  of  the 
dose,  so  far  as  this  last  does  not  by  its  magnitude  cause  some 
injury,  which  in  that  case  again  defeats  the  result.  Contrac- 
tion of  the  vessels  requires  larger  doses,  in  order  that  they  may 
distend ;  distensions  require  much  smaller  doses,  in  order  that 
the  vessels  may  contract. 

This  also  must  be  kept  in  mind,  that  no  force  ought  to  be 
applied  to  the  vessels  during  the  process  of  curing.  This  can 
have  a  favourable  result  only  by  mere  accident,  and  often  barely 
for  a  moment  Moreover,  that  the  vessels  put  themselves  into  an 
abnormal  condition,  and  restore  themselves  to  a  normal  con- 
dition, and  that,  to  this  end,  they  require  nothing  but  an 
exciting  impulse.  A  congenital  or  acquired  infirmity  in  the 
atoms  of  the  active  substance,  and  a  feebleness  in  the  structure 
of  the  parietes  of  the  vessels,  may  push  the  above  mentioned 
process  of  the  vessel  to  an  excessively  morbid  condition.  In 
like  manner,  a  tendency  to  decomposition  in  the  blood,  and  a 
tendency  to  over-development  in  the  cells  may  greatly  complicate 
the  morbid  activity  of  the  vessels. 

Sometimes  the  vessels  spring  back  easily,  sometimes  with 
difficulty;  sometimes  quickly,  sometimes  dowly;  sometimes 
perfectly,  sometimes  imperfectly,  or  only  with  the  appearance 
of  perfection ;  sometimes  at  one  bound,  sometimes  by  starts,  &c., 
and  herein  there  are  modifications  and  variations.  Now,  it  should 
be  borne  in  mind  that  the  vessels  change  their  condition  merely  by 
their  own  act,  and  that  this  motive  phenomenon,  like  every  eleo- 
trieal  phenomenon,  makes  its  appearance  with  a  certain  sudden- 
ness, however  small  be  the  change  of  movement  in  each  instance. 
But  as  the  behaviour  of  the  vessels  is  known  in  general,  now 
it  further  remains  for  us  to  study  this  behaviour  in  particular, 
thoroughly  and  exhaustively,  and  also  to  observe  how,  with 
what  peculiarities,  and  in  what  special  ways  the  vessels  efiect 
this  act  of  change ;  t.  ^.,  we  must  seek  to  investigate  the  moda- 
lity of  this  act,  and  this  must  be  done  whether  we  be 
homcsopaths  or  allopaths,  and  whether  we  deal  with  the  vessels 

2b  2 


388  Capillary  Vessels, 

in  this  or  in  that  way.  Thus,  if  you  have  a  mind,  in  a  case  of 
inflammation,  to  render  the  vessels  normal  by  depletion,  f -  ^-f 
if  yoo  have  a  mind,  by  diminishing  their  contents,  to  com- 
municate tQ  them  an  impulse  towards  alteration  of  their  state, 
yon  must  at  the  same  time  take  notice,  how  strongly,  bow^ 
rapidly,  how  permanently,  ice.,  they  spring  back,  just  as  mach 
as  you  would,  in  case  you  wished  to  provoke  this  spring  by 
Aconite,  Bryonia,  Ac 

The  study  is  the  same  for  both  ;  but  in  the  allopathic  dealing 
with  the  capillaries,  or  at  least  the  dealing  by  means  of  gross 
attacks  and  gross  doses,  the  fruitlessness  of  this  study  will  soon 
disgust  the  physician. 

The  disease  and  the  individuality,  in  short,  the  condition 
arising  from  abnormal  vascular  activity,  the  medicine,  and  the 
dose — these  three  things  come  essentially  under  consideration 
in  this  study. 

The  remedy  may,  both  in  degree  and  manner,  act  excessively 
on  the  morbidly  active  vessel,  and  it  may  thereby  pri- 
marily aggravate  the  existing  condition— a  phenomenon  not 
uncommon,  and  easy  to  be  noticed  in  the  detached  leg  of  a 
frog.  Thus,  Aconite  may  primarily  increase  an  inflammatory 
fever,  a  headache,  a  pulmonary  affection ;  Bellad.  may  primarily 
aggravate  an  irritation  of  the  brain  ;  Bryonia,  a  rheumatism — 
and  after  this  aggravation  the  medicines  may  at  last  cnre  the 
said  disorders.  In  such  cases  the  process  is  as  follows : — The 
distended  vessel  in  the  immediate  seat  of  disease,  after  too 
rough  a  qualitative  or  quantitative  handling,  gets  at  first  into  a 
still  more  distended  state  (just  as,  in  other  cases,  the  morbidly 
contracted  vessel,  in  consequence  of  too  rough  handling,  gets 
at  first  into  a  still  more  contracted  state),  and  it  is  only  subse- 
quently, after  the  first  impression*  has  lost  its  power,  that  the 
opposite,  i.e.,  the  desired  action  is  established.  But  this 
desired  effect  may,  after  some  time,  disappear  again,  and  the 
disorder  then  turns  to  either  the  same,  or  a  somewhat  altered 
or  mitigated  form,  whereupon  it  again  disappears  to  make  way 
for  permanent  amendment  Yet  such  an  alteration  may  set 
in  three  or  four  times,  and  one  may  consider  such  recru- 
descences as  pertaining  to  this  category  in  proportion  as  they 


hy  Dr.  J,  Hoppe.  389 

are  repeated  more  feebly.     Now,  this  is  the  "  vascalar  oscilla- 
tion/' which  is  the  property  of  all  vessels,  and  consists  in  this, 
that  a  vessel  incited  by  a  stimulus  repeatedly  oscillates  between 
distension  and  contraction,  before  it  has  assumed  a  .permanent 
condition  of  its  activity ;  and  if  any  one  should  think  of  shortly 
sending  a  new  remedy,  or  a  fresh  dose  after  a  medicine  which 
had,  during  the  process  of  cure,  provoked  such  an  oscillation, 
excessive  mischief  might  be  done,  and  the  induced  action  sadly 
distarbed*  although,  even  here,  blind  chance  may  occasionally 
be  favourable  to  a  foolhardy  meddling  interference. 

Thus,  the  resilience  of  the  morbidly  active  vessels  depends 
Tery  much  upon  the  quality  and  quantity  of  the  impulse  which 
is  communicated  to  them.  I  need  not,  however,  inform  the 
homoeopaths  on  this  point.  By  their  unfrequent  repetition  of  the 
medicines,  and  by  their  small  doses,  they  have  already  long  since 
hit  upon  that  which  I  have  found  in  other  ways  ;  they  have,  by 
observation  true  to  nature,  and  by  quietly  listening  to  her 
voice,  found  a  something  pregnant  with  results,  which  even 
already  one  cannot  choose  but  designate  as  *'  capillary  thera- 
peutics." All  medicinal  remedies  are  capillary  remedies ;  nine- 
tenths  of  all  disorders  are  capillary  affections,  and  if  then  a 
physician,  whilst  either  exclusively,  or,  at  least,  in  a  very  pre- 
dominant degree,  he  has  to  do  with  capillary  afifections  and  their 
remedies,  attentively  watches  the  diseases  and  the  operations  of 
medicines  with  unprejudiced  mind,  it  must  be  strange  indeed 
if  he  should  not  collect  facts  which  are  also  discovered  by  other 
means,  and  which  one  must  regard  as  pertaining  to  the  physio- 
logy and  therapeutics  of  capillary  action. 

In  the  behaviour  of  the  muscular-walled  vessels  during 
disease  and  cure,  there  certainly  lies  no  inexhaustible  variety, 
and  it  rather  seems  to  me  that  this  behaviour  may  be  reduced 
to  no  very  numerous  modifications,  nor  do  I  think  that  it  is,  in 
its  diversities  and  peculiarities,  so  unfathomable.  On  the  other 
hand,  there  lies  in  this  behaviour  a  something  so  singularly  and 
strangely  striking,  that  physicians  are  inclined  to  turn  away 
from  the  subject,  and  that  is  the  provoking  circumstance  in  the 
matter.  Accustomed  to  ancient  conceptions,  the  physician  is 
not  inclined,  as  it  were,  to  watch  the  atoms  at  work,  and  to 


390  Capillary  Veiseh^ 

observe  life  in  its  very  inner  movement,  and  he  is  so  much  tlie 
more  hindered^  as  he  will  not  let  go  the  idea  of  being  able  to 
act  through  general  physical  views  directed  to  the  grosser  parts. 
Meanwhile,  nothing  else  remains,  bat  to  go  to  the  innermost 
core  of  the  question,  and  to  collect  the  phenomena,  however 
strangely  they  present  themselves,  in  order  to  work  them  up 
into  a  physiology  of  the  capillary  vessels. 

As  man's  mind  appears  so  unfathomable,  and  yet  is  not  at 
all,  so  is  it  also  with  the  muscles  of  the  capillaries,  and  I  often 
compare  in  my  own  mind  the  morbidly  active  vessel,  which  I 
am  treating  with  medicines,  to  a  man!  Both  have  their 
peculiarities,  which  one  has  to  study  quietly,  and  which  do  not 
lie  on  the  surface. 

One  throws,  for  instance,  often  by  accident,  a  thought  into  a 
man's  mind,  and  there  it  sticks,  and  works  after  weeks  pass  by, 
and  the  thought  breeds  and  works  on  the  brain  fibres,  which  it 
has  excited,  and  at  last  the  thought  is  become  a  fact  In  like 
manner  often  is  the  action  on  the  capillaries.  A  medicine  is 
given,  perhaps  only  one  dose,  and  the  medicine  comes  in 
contact  with  the  morbidly  acting  vessel.  Nothing,  however, 
betrays  this  immediately  or  else  the  patient  feels  it,  but  says 
nothing.  Days  go  by  and  then  an  alteration  will  seem 
probable  to  the  patient  and  again  days  elapse,  and  gradu- 
ally out  of  the  totality  of  symptoms  traces  of  amendment  shine 
forth  more  and  more.  This  appearance  increases  irom  week  to 
week,  and  at  lost  the  amendment  has  become  an  unmistakeable 
fact,  and  the  doubtful  mind  must  acknowledge  that  the  medicine 
in  one  dose,  or  in  small  doses,  has  commenced  and  perfected 
the  cure.  People  speak  then  of  the  after  effects  of  the  medicine, 
and  of  letting  it  exhaust  its  action.  It  seems  plain  enough 
that  these  are  obscure  expressions.  However,  it  is  correct  that 
many  a  morbidly  acting  vessel  does  not  bear  much  of  the  curative 
impulse,  and,  at  best,  passes  over  gradually  into  its  normal 
condition,  after  it  has,  by  a  slight  stimulus,  learnt  to  make  the 
first  step  in  that  direction,  and  to  this  point  I  feel  bound  in 
this  treatise  still  to  call  attention.  For  it  is  true  that  the 
mojbidly  acting  vessels  often  enough,  and  in  a  surprising  way, 
spring  back  suddenly,  and  at  one  bound  remain  as  innocently 


by  Dr.  J,  Hoppe,  891 

if  they  had  never  done  anything  improper,  or  had  never 
known  how  to  do  each  a  thing.     But  these  striking  cares^ 
altfaoagh  they  should  be  to  us  as  brilliant  models  never  to  be 
forgotten,  ought  not,  however,  to  dazzle  us,  so  that  we  should 
doubt  the  possibility  of  every  other  modus  operandi  in  the 
behaviour  of  the  vessels  during  their  resilience.     Who  can  even 
say  that  the  vessels  ought  invariably  to  spring  back  so  very 
Buddenly  ?  and  who  can  obstinately  expect  invariably  to  induce 
this  by  the  choice  and  the  dose  of  the  medicine  ?      tt  is 
possible  that  many  afFections  of  the  capillaries  exist  in  nature^ 
which  ca''.  only  be  brought  to  a  happy  termination  by  a  suc- 
cession of  these  resiliences. 

The  humour  and  temper  of  the  vessels,  if  such  an  expression 
is  permitted — the  peculiarities  in  the  return  of  the  vessels  to 
health,  which  have  been  but  generally  indicated,  in  short,  their 
proper  action — this  it  is  that  must  be  studied  in  order  that  treat- 
ment may  be  as  successful  as  possible.  For  even  this  is  not 
sufficient^  that  one  should  gain  a  subtle  hold  of  the  morbidly 
active  vessel  by  a  power  of  medicine  diminished  to  the  utmost — 
subtle,  that  is,  in  accordance  with  the  minutely  fine,  and  certainly 
often  very  trifling  alterations  in  the  active  muscular  substance  of 
the  vessels  themselves ;  but  even  the  impulse  itself  requires  to 
be  given  in  proportionable  unfrequency,  because  it  is  always  the 
proper,  and  in  many  regards,  the  free  action  of  the  vessels  that 
must  effect  their  return  to  the  normal  condition. 

To  draw  attention  to  this  "  proper  action"  of  the  vessels 
during  cure,  and  to  advocate  the  idea  of  letting  this  proper 
action  predominate  in  medical  treatment  is  the  object  of  this 
treatise.  I  have  pointed  out,  in  general,  how  the  capillaries 
behave  during  cure ;  but  the  varieties  and  peculiarities  in  this 
behaviour  must  still  be  investigated  in  particular.  This  will 
be  done  if,  after  the  student  has  made  himself  expert  by 
experimenting  on  dissected  vessels  proper  to  the  subject,  he 
transfers  the  various  processes  of  amendment,  which  he 
observes  in  vascular  affections,  to  the  vessels  themselves,  and 
thence,  led  by  the  experimentally  investigated  action  of  the 
remedy  on  the  capillaries,  and  by  the  provings  of  that  same 
remedy  he  construes  the  behaviour  of  the  vessel  during  curative 


392  AHernation  of  Medicities, 

notion,  and  at  the  same  time  investigates  the  pecQliarides  of 
this  behavioar,  not  only  with  reference  to  the  quality  of  the 
medicine,  but  also  to  the  quantity  and  frequency  of  the  dose. 

What  I  have  said  in  this  treatise  is  new  ;  yet,  to  the  homoeo- 
paths, the  rules  of  cure,  and  the  grosser  facts  of  the  prooees  of 
cure  which  I  haye  touched  upon,  are  not  new.  In  conse- 
quence of  a  wonderful  observation  of  the  effects  of  medicine 
and  of  curative  action,  they  have  already  attended  so  much  to 
the  diseased  human  body  when  under  cure,  that  future  ohservers 
will  find  it  difficult  to  discover  anything  new  here.  On  the 
other  hand,  they  have  missed  the  direction  which  they  oug^bt 
to  give  to  their  observations  and  experience,  and  so  they  missed 
the  objective  and  real  ground,  the  material  and  clear  basis. 

It  is  therefore  the  capillaries,  it  is  the  activity  residing  in 
the  muscles  of  the  capillaries,  and  it  is  in  that  "  behaviour  of 
the  capillaries  "  which  has  been  here  investigated  in  its  many 
peculiarities  in  the  transition  from  one  state  of  their  calibre  to 
another  by  their  own  proper  activity,  to  which  the  homoeopaths 
will  have  to  direct  their  observations  in  their  treatment  of 
vascular  cases,  and  as  vascular  affections  and  vascular  treatment 
are  the  most  frequent  of  any,  it  is  to  them  they  will  have  to 
direct  their  attention  in  a  great  majority  of  cases,  with  the  aid 
of  the  physiological  investigation  of  the  process  of  cure. 

But,  in  conclusion,  I  recal  once  more  the  capillary  oscilla- 
tion in  the  rabbit's  ear,  which  will  ever  be,  for  every  one  who 
wishes  to  follow  up  studies  of  this  kind,  the  first  rough  sketch 
of  a  phenomenon  which  extends  in  unmeasurable  importance 
over  the  whole  body. 

THE  ALTERNATION  OF  MEDICINES. 
By  J.  Gelston,  L.F.  Ph.  G. 

(Read  before  the  liyeipool  Homoeopathic  Medical  Society). 

HoMOSOPATHY,  by  its  practice  and  pretensions,  would  seem  to 
have  reflched  its  ultima  thule,  or  the  ne  plus  ultra  limits  of 
medical  lore.  Science,  with  the  faculty  would  appear  to  have 
arrived  at  a  common  par,  or  dead  level.    The  flights  of  ambi- 


hy  Mr.  J,  Gelston.  893 

lion  are  chiefly  confined  to  pamphleteering,  or  catering  for  the 
public  in  the  form  of  '*  Domestic"  treatises,  which  as  faithfully 
resemble  one  another  as  a  family  of  turnips,  and  are  now  as 
nauseatingly  plentiful  as  potatoes  were  in  Ireland,  hefore  the 
rebellion  between  these  esculents  and  the  elements.    The  merits 
of  these  productions  for  the  most  part  consist  in  facile  rechauff^B 
rendered  from  Jahr,  Possart,  Bonninghausen,  Hering,  and  that 
elite  confraternity.     I  by  no  means  wish  to  disparage  the  ser- 
vices conferred  on  the  community  by  the  labours  of  disinterested 
'writers,  but  the  profusion  of  these  works  tends  to  excite  some 
degree  of  scepticism  as  to  their  assumed  philanthropy.     With 
regard,  however,  to  these  at  least,  if  not  to  the  wholesale  con- 
demnation of  the  more  legitimate  offspring  of  the  press,  I  am 
strongly  inclined  to  coincide  with  the  conclusion  of  Dr.  Both : — 
"  Even  as  it  is  my  most  firm  conviction,  that  one  day  the  truth 
and  absolute  value  of  similia  aimilibus  will  attain  a  general 
recognition;  even   so  am  I  as  fully  persuaded,  that  all  our 
hitherto  published  works,  the  whole  list  of  our  provings,  all  our 
cases  of  diseases,  with  very  few  exceptions,  will  pass  to  oYAi- 
v\oji:'— {Horn,  Vierteljahrschrift,  Elft,  Jahrg.  Dritt.  Heft  ^ 
1860).     The  following  sentence  of  this  logical  thinker  is  highly 
suggestive,  and  will  be  I  hope  thoroughly  appreciated — "As 
the  bases  essential  to  proper  researches  are  as  yet  wanting 
to  us,  as  many  of  our  dictators  have  never  yet  entertained  a 
misgiving,  such  as  a  single  proper  experiment  would  excite,  so 
each  one  concludes,  looking  through  the  spectacles  of  precon- 
ceived notions,  observations  to  have  been  truly  discoveries  pro- 
ceeding from  experiments." — (76). 

In  Hue's  Travels  in  Tartary.  we  learn — "  The  pharmacopceia 
of  the  Lamas,  who  are  at  the  same  time  apothecaries,  consists 
exclusively  of  pulverized  vegetables,  administered  either  as  in- 
fusions, or  rolled  into  pills.  If  the  little  magazine  of  vegetable 
medicine  be  exhausted,  the  Lama  doctor  is  not  at  fault.  He 
writes  the  name  of  the  remedies  upon  morsels  of  paper  and  rolls 
them  between  his  fingers,  having  previously  moistened  them 
with  his  saliva;  and  the  patient  takes  the  paper  pellets  with  the 
same  faith  as  he  swallows  the  veritable  drugs.  According  to 
the  Tartars,  it  is  precisely  the  same  whether  you  swallow  the' 


804  Aliemaiiofh  of  Medicines^ 

drag  or  its  written  appellation."     I  would  strongly  commeDd 
ibis  last  sentence   to  the  experimental   enquirer.     Negative 
evidence  is  a  great  desideratum.     If,  instead  of  the  medicinal 
alternation  so  much  in  Togue,  the  mere  ideal  (in  Sugar  of  milk 
form)  were  presented  to  the  patient,  and  comparisons  thereby 
instituted,  some  useful  conclusions  might  be  deduced.     Data 
might  also  be  furnished,  by  the  same  means,  of  the  comparative 
excellence  of  those  representatives  of  physic,  the  high  dilutions, 
and  the  pure  ideal.    The  result  would  determine  whether  the 
dictum  of  opponents  be  just,  that  things  which  are  equal  to  the 
same  are  equal  to  one  another. 

So  much  by  way  of  exordium.  I  now  proceed  to  the  subject 
in  hand.  The  propriety  of  alternating  medicines  has  excited 
considerable  controversy.  In  Dudgeon  s  excellent  Lectures  an 
Homoiopathyy  opinions  pro  and  eon.  are  copiously  set  forth. 
Only  a  few  of  these  require  our  present  attention;  I  shall 
therefore  merely  refer  to  those  which  seem  to  me  more  pertinent 
to  this  enquiry,  or  more  appropriate  for  quotation.  Hahnemann, 
whose  notions  were  so  variable  on  all  points,  begins  to  lose  in 
respect  of  authority,  by  reason  of  his  notable  inconsistencies. 
In  the  first  edition  of  the  Organon  he  considers  the  practice 
expedient;  in  later  editions  he  discountenances  it,  for  the  reason 
that  the  number  of  proved  medicines  suffice  for  all  contingencies, 
and  also  on  the  ground  that  we  cannot  tell  what  alterations  the 
first  remedy  shall  have  effected.  In  some  diseases — those  of 
acute  and  fixed  character — from  experience  of  its  advantage,  he 
advised  the  alternation  of  two  or  more  remedies.  Thus,  in  a 
peculiar  kind  of  typhus,  he  recommended  the  alternation  of 
Rhus  and  Bryonia;  in  an  epidemic  of  purpura  miliaria,  the 
alternation  of  Aconite  and  Coffee.  For  the  prophylaxis  of 
cholera,  he  advises  the  alternation  of  Cuprum  and  Yeratram,  a 
proceeding  which  Hering  condemns,  as  those  remedies,  he  says, 
will  be  unable  in  the  very  least  to  afford  that  protection  against 
what  they  possess  in  common. 

Of  the  famous  author  of  Don  Quixote^  a  satire  which  ex- 
tinguished the  extravagant  passion  for  knight-errantry,  it  is  re- 
lated by  his  biographer,  that  in  his  old  age  he  betook  himself  to 
writing  romances  every  whit  as  absurd  as  the  most  absurd  of 


by  Mr.  J.  Gehion,  895 

tbiDse  which  he  says  turned  the  brain  of  his  own  hidalgo.  A 
like  declension  would  appear  to  have  befallen  the  latter  days  of 
the  hero  of  homoeopathy.  Among  the  6rst  attacks  of  Hahne- 
mann on  the  practices  of  the  old  school,  were  denunciations 
against  its  complex  prescriptions ;  and  almost  his  first  entreaty 
to  his  colleagues  was  to  give  but  one  medicine  at  a  time.  Lux, 
the  inventor  of  the  isopathio  system,  asserts  that  Hahnemann, 
in  a  letter  addressed  to  him,  sanctioned  the  proposition  of 
mixing  medicines,  and  that  Hahnemann's  views  concerning  this 
subject  would  have  been  published  in  the  Inst  edition  of  the 
Organon.  if  the  physicians  to  whom  the  publication  of  this 
edition  was  confided  in  Germany  had  not  taken  upon  them  to 
suppress  them.  Tbe  medicines  intended  for  mixtures  were 
probably  those  which  Lux  himself  proposes,  viz.,  those  which 
are  deemed  proper  for  alternation. 

Hering  commends  the  administration  of  the  remedy  in  alter- 
nation with  its  antidote;  a  proceeding  which,  to  my  humble 
conception,  appears  illogically  un philosophical. 

Hering  holds,  it  is  true,  indeed,  that  there  are  no  such  things 
as  antidotes,  that  completely  do  away  with  the  action  of  a 
medicine;  the  stronger  medicine  always  continues  to  act 
through  the  weaker.  Whatever  that  precisely  means,  I  am 
somewhat  at  a  loss  to  determine ;  perhaps  he  fancies  that  medi- 
cinal potencies  enjoy  the  happy  faculty  of  transmigration.  The 
argument  naturally  leads  towards  the  fioM-impropriety  of  ad- 
mixtures. Taken  in  connection  with  his  other  idea,  that  any 
disease  may  be  cured  with  any  remedy,  entitles  him,  I  think,  to 
rank  with  the  philosophic  Lamas  of  Tartary. 

"  Dr.  Trinks  says  that  the  practice  of  alternating  two  medi- 
cines is  adopted  nominally  in  those  cases  in  which,  among  the 
list  of  proved  medicines,  the  most  appropriate  one  cannot  be 
discovered.  But  he  quietly  hints  that  this  may  not  be  always 
the  true  reason  for  the  practice,  but  that  it  may  sometimes  be 
owing  to  a  subjective  want  of  thorough  acquaintance  with  the 
Materia  Medica.  It  is,  he  says,  strictly  speaking,  contrary  to 
the  principle  of  homoeopathy,  which  allows  of  the  employment 
of  but  one  remedy  at  a  time ;  and  another  remedy  ought  not  to 
be  given  until  the  action  of  the  first  is  carefully  noted,  for  it 


490  Alternation  of  Medicines, 

may  effeot  such  a  change  in  the  morhid  picture  as  to  cause   tbe 
second  medicine   to  be   no   longer  indicated.     Homoeopathy 
demands  the  greatest  individualization,  and  the  greatest  care- 
fulness  in  the  selection  of  the  remedy,  and  cannot  sanction  such 
a  procedure,  the  less  so  as  the  supply  of  well-proved  medicines 
is  now  so  great  as  to  render  it  almost  an  impossibility  that  vre 
should  fail  to  discover,  amid  the  recorded  pathogenetic  symp- 
toms, the  counterpart  of  the  disease  we  have  to  treat.     As   a 
makeshift  in  certain  cases,  the  practice  may  be  allowed ;  for 
two  remedies  given  in  alternation  do  often  mutually  support 
each  other's  action.   Bat  these  cases  are  at  the  best  exceptional. 
There  is  no  doubt  that  it  tends  to  obscure  our  knowledge  of 
the  action  of  medicines.**     {Lectures  on  Horn.) 

Herr  von  Bonninghausen,  in  his  views  on  the  selection  of 
the  remedy,  observes  that  most  likely  all  homoeopathists,  on 
first  commencing  the  study  of  the  system,  felt  as  he  did,  that 
the  pathogenesis  of  almost  every  medicine  contained  the  ele- 
ments of  every  disease  under  the  sun ; — a  fact  which  may  have 
originated  the  universal-efficiency  doctrine  of  Dr.  Hering  here- 
tofore referred  to. 

Dr.  Dudgeon  is  variously  inclined  on  the  subject.  In  chronic 
diseases,  he  holds  it  to  be  a  practice  rather  to  be  reprehended 
and  avoided ;  in  acute  disorders,  on  the  contrary,  he  considers 
it  judicious  to  moderate  the  fever  by  a  few  doses  of  an  anti- 
pyretic. In  many  acute  diseases,  he  says,  our  medicines  are 
employed  rather  for  the  sake  of  moderating  the  violence  of  the 
different  stages,  than  with  the  hope  of  cutting  short  the  entire 
malady.  This  is  very  much  after  the  style  of  the  "  general 
principles"  practice  of  the  old  school;  but  the  advantage  of 
resources  is  on  the  side  of  the  latter,  as,  besides  antipyretics, 
they  luxuriate  in  diuretics  and  peristaltics,  besides  other  "ics" 
and  "  ogues.'*  This  routine,  moreover,  is  an  evident  abnegation 
of  the  claims  of  homoeopathy  to  be  considered  in  the  light  of 
what  Hahnemann  had  primarily  intended  to  designate  his 
system — specific  medicine. 

Hempel,  whose  rationale  of  the  similia  similihus  principle  is 
not  a  little  enthusiastically  fantastic,  says  on  the  subject  of 
alternations : — "  In  chronic  diseases  we  generally  confine  our- 


by  Mr,  J,  Gehton.  897 

aelves  to  one  remedy  at  a  time.  The  method  of  alternating 
two  medicines  at  regular  Intervals  is  generally  resorted  to  in 
acute  cases  only.  It  should  be  remarked,  however,  that  in 
many  cases  this  method  of  alternation  is  an  expedient  shift 
rather  than  a  usage  necessitated  or  justified  by  principle.*' 

Antidotes  in  physiological  relation  are  obviously  comparative. 
The  purgative  action  of  a  drachm  of  Jalap  would  exhibit  no 
appreciable  contravention  by  the  addition  of  a  drop  of  Lau- 
danum ;  on  the  other  hand,  the  peristaltic  influence  of  10 
grains  of  the  former  would  be  partially  or  totally  controlled  by 
a  grain  of  the  latter.  In  like  manner,  in  infinitesimal  doses, 
antidotes  must  bear  a  positive  relation.  The  very  doctrine  of 
homoeopathy  is  subservient  to  this  principle.  The  physician,  in 
bis  zeal  to  cover  the  totality  of  the  disease-symptoms,  selects  a 
medicine  whose  pathogenetic  action  possesses  the  nearest  coun- 
terpart to  those  of  the  complaint.  The  process  is  evidently 
antidotal;  to  deny  which  is  tantamount  to  assert  that  the 
timilia  similibus  is  false.  I  hold  it,  indeed,  to  be  the  fact,  that 
if  the  actions  of  two  medicines  be  characteristically  and  in- 
timately allied,  they  do  not  antidote  each  other,  but  that  they 
exaggerate  the  total  operation.  And  I  am  likewise  firmly  per- 
suaded that  if  a  very  precise  analogy — that  which  is  regarded  as 
so  very  desirable — obtain  between  the  medicine  and  the  disease, 
an  aggravation  or  amelioration  will  follow,  according  to  the 
stage  or  character  of  the  disease.  We  know  for  certain  that 
medicines  whose  action  is  very  similar,  when  exhibited  in 
quantities  sufficient  to  evoke  appreciable  pathological  e£Pects, 
exalt  each  other  s  influence.  It  is  contrary  to  reason  to  assume 
— though  indeed  it  is  maintained — that  infinitesimal  doses  of 
such  medicines  act  upon  an  opposite  principle,  and  antagonise 
or  antidote  each  other.  If  the  fact  apply  to  medicinal  relations 
among  each  other,  the  same  congruity  of  relationship  must 
obtain  between  natural  diseases  and  remedial  agents.  This 
relationship  will  be  beneficial  or  the  reverse,  as  I  have  observed, 
according  to  condition.  A  person  having  dined  heartily  off 
roast  beef,  with  cucumbers  and  cauliflower,  is  taken,  perhaps, 
some  hours  thereafter,  with  diarrhoea  and  colic.  Would  Bryonia 
and  Colocynth  relieve  him  ?    I  apprehend  not,  from  the  nature 


498  AUemation  of  Medicines, 

of  the  cause  and  that  of  the  remedies  heing  too  nearly  allied. 
Pneamonia,  in  the  congestive  stage,  may  be  arrested  in  farther 
progress  by  Aconite,  not  by  virtue  of  immediate  similarity  of  its 
operation,  bat  by  one  precisely  the  reverse.  If  the  complaint, 
however,  has  proceeded  beyond  this  stage,  this  remedy,  accord- 
ing to  experience,  and  conformable  to  this  theory,  is  not  suitable. 
But,  supposing  the  remedy  selected  be  one  which  in  its  patho- 
genesy  bears  a  very  close  analogy  to  the  whole  course  of  pnea* 
monia,  such  as  Antimony  or  Phosphorus,  would  the  disease,  in 
its  primary  stage,  be  cat  short  thereby  ?  I  maintain  that  an 
aggravation  would  ensue,  in  the  ratio  of  the  proportion  of  the 
pathogenetic  element;  the  least  untoward  result  would  be  a 
mere  acceleration  of  the  disease  process.  When  disorganization 
has  already  taken  place,  to  auiH  the  eliminatory  progress,  by 
conformity  of  means,  will  expedite  the  cure.  The  study  of 
medicines  in  antidotal  relations,  is  calculated  to  throw  the  most 
important  light  upon  the  efficiency  of  remedies  in  the  absolute 
cure  of  diseases.  An  attentive  survey  of  what  Bering  designates 
the  **  genus  epidemicus,"  in  the  vraiwmblable  pictures  presented 
by  the  remedial  pathogenetics,  may  afford  a  shadowy  prospect-^ 
a  prophecy  **  of  the  main  chance  of  things  as  yet  not  oome  to 
light."  The  prevalent  scarlatina,  succeeded  by  diphtheria, 
hooping-cough,  and  measles,  may,  through  the  outlines  of  their 
remedial  co-relatives,  possibly  betoken  an  accession  of  fever, 
dysentery,  and  small-pox. 

All  this,  however,  on  the  mode  of  action  of  the  remedy,  is  a 
digression  from  the  subject, — to  return  to  which,  I  find  I  have 
omitted,  in  their  proper  place,  the  proposition  of  Dr.  Richard 
Hughes,  in  the  British  Journal  of  HonuBopathy,  He  recom- 
mends the  administration,  in  alternation,  of  medicines  which 
have  relation  to  each  other  and  to  the  diseased  structure,  the 
one  in  the  quality  of  a  tissue  irritant,  and  the  other  by  the 
faculty  of  cerebro- spinal  excitant.  In  a  succeeding  paper,  how- 
ever, on  the  action  of  Belladonna,  these  two  operatives  appear 
to  dispute  one  another's  pedigree,  and  although  considerable 
ingenuity  is  displayed  in  determining  their  claims,  we  must 
await  the  adjudication  of  their  definite  pretensions.  Dr.  Hale, 
of  America,  propounded  previously  a  similar  theory,  with  a 


by  Mr.  J,  Gekton.  399 

■ 
somewbat  different  explanation.     Two  appropriate  medicines 

are  advised  in  alternation,  one  in  an  appreciable  and  tbe  other 

in  an  infinitesimal  dose;   the  weaker  one  allies  itself  to  tbe 

disease,  as  it  were,  which  together  go  to  the  wall,  while  the 

stronger  one  succours  the  reaction,  and  the  disease  is  put  hora 

de  combat. 

It  is,  as  I  said,  by  endeavouring  to  cover  the  totality  of  the 
symptoms,  that  a  disposition  to  employ  more  than  a  single 
remedy  prevails.     By  confusing  the  sympathetic  symptoms,  it 
may  be,  with  the  more  important,  or  by  affording  these  and 
their  trivialities  too  great  a  prominency  in  the  analysis,  a  per- 
plexity is  likely  to  be  engendered  in  this  mind  of  the  prescriber, 
not  lessened  by  the  consideration  of  the  emulous  claims  of  half- 
a-dozen  polychrests.   Thus  :  say  a  patient  presents,  with  frontal 
headache,  furred  tongue,  and  costive  bowels ;  he  is  also  some- 
what chilly  and  flatulent,  and  if  questioned  narrowly,  admits  of 
dreams  and  tenderness  of  his  corns.     For  the  headache,  &c., 
Bell,  suggests;   for  the  chilliness.   Aeon,  pretends;   for  the 
tongue  and  bowels,  Bryon.  or  Nux  put  in  their  claims ;  while 
tbe  toes'  tenderness,  in  relation  with  the  flatulence,  avouch  the 
merits  of  Ant.  crud.  or  Lycopod.     The  prescriber,  no  donbt,  is 
in  somewhat  of  a  quandary :  '*  How  happy  could  he  be  with 
either,  were  t'other  dear  charmer  away."     He  selects,  perhaps,  as 
most  important  to  be  looked  after,  the  stomach,  and  decides  on 
Aeon,  and  Bry.  (a  very  common  couple) ;  be  disregards,  or  has 
forgotten,  that  these  two  are  set  down  as  antidotes.   The  patient 
probably  returns  to  say  he  is  much  the  same ;  recourse  is  then 
had  to  Nux  and  Bry.  (Bry.  is  a  favourite,  and  merits  further 
consideration).    The  partners,  according  to  Jahr,  are  incom- 
patible ;  but  the  patient  has  the  benefit  of  the  dubiety  of  Jahr's 
authority ;    he  may   not  peradventure    have    experienced    it. 
Thereupon  Ant.  crud.,  Merc,  Puis.,  Lycop.,  are  arrayed  in  pairs, 
and  if  the  patient  does  not  return,  it  is  presumed  that  he  is 
cured,  but  whether  by  the  result  of  time  and  regimen,  or  the 
influence  of  physic,  it  would  be  difficult  to  determine. 

But  it  may  be  said  that  the  medicines,  not  being  administered 
at  one  time,  or  together,  no  antagonism  or  antidotalism  can 
prevail ;  that  the  first  medicine  is  given  against  a  particular  set 


400  Alterfiaiion  of  Medicines^ 

of  symptoms,  while  the  second  brings  up  a  reserve  force  to 
parsue  the  remainder.     Assuming  that  the  first  was  effectual, 
and  the  general  symptoms  have  abated,  then  comes  the  second, 
and,  by  its  rdle  as  an  antidote,  liberates  the  symptoms  in  present 
submission,  and  the  original  disturbance  is  re-inaugurated  :  or 
the  second  lays  claim  to  the  honours,  which  the  first  in  its  torn 
is  bound  to  disparage.     It  may  be  argued  that  the  balance 
having  been  obtained  by  the  agency  of  the  first,  the  race  being 
run  and  the  battle  over,  the  second  is  nowhere ;  which  would 
doubtless  be  plausible  were  the  disorder  so  complaisant,  but  as 
the  complaint  generally  endures  beyond  the  term  of  the  dose, 
the  virtue  of  antagonism  holds  sway,  and  the  disease  proceeds 
on  its  course,  the  head,  stomach  or  toes  taking  the  lead,  accord- 
ing to  the  capacities  of  the  rider  in  these  particular  localities  : 
or  we  have  first  the   disease  to  which  two   remedies  are  in 
homoeopathic  rapport.     The  first  medicine,  if  it  do  its  duty, 
antidotes  the  disease ;  then  comes  forward  the  second,  to  anti- 
dote the  antidote.  A  sort  of  triangular  duel  is  hereby  established, 
such  as  they  sometimes  have  in  America;   the  doctor  thinks 
himself  scientific,  and  the  patient  is  happy  by  being  allowed  to 
recover. 

The  whole  matter,  in  fine,  is  encumbered  with  distractions. 
It  would  be  well,  as  a  rule,  if  the  practice  were  generally  dis- 
countenanced, or  if  applied  at  all,  it  should  be  with  agents 
which  bear  a  thoroughly  general  alliance,  although  the  character 
of  each  may  display  particular  diversities  of  symptomatic  appe- 
tencies. It  has  been  alleged  that  a  disease  attended  with  high 
sympathetic  fever  is  best  treated  when  the  latter  has  been  con- 
trolled by  the  antipyretic  Aconite;  but  I  think  it  is  obvious, 
that  if  a  proper  medicine  were  first  selected  for  the  disease,  this 
being  sufficiently  controlled  thereby,  the  attendant  symptomatic 
fever  would  necessarily  succumb.  Dr.  Dudgeon  says,  however, 
that  we  are  not  bound  to  vindicate  the  remedy,  but  to  cure  the 
patient  A  similar  argument  was  probably  maintained  by  the 
College  of  Physicians  at  the  time  of  the  introduction  of  Jesuits' 
bark.  If  the  knowledge  of  specifics  is  to  be  advanced,  it  is 
certainly  not  in  the  direction  of  the  present  routine  so  much  in 
vogue  among  homoeopathists.    Allopathy  slowly  emerges  firom 


On  the  Tl^erapetitics  of  Prosopalgia*  401 

the  obloqny  of  its  complexity  of  prescription ;  therapeotics  begin 
to  excite  the  attention  which  the  merits  of  the  sabjeot  demand 
The  reformed  school  would  do  well  to  look  to  its  laurels^  that 
it  lag  not  behind  in  the  race  of  progress  which  its  opposition 
tended  so  materially  to  arouse. 


CONTBIBUTIONS  TO  THE  THERAPEUTICS  OF 

PROSOPALGIA. 

By  Dr.  Gdstavds  Gerson,  of  Dresden.* 

We  propose  to  make  this,  like  former  works,  a  contribution  to 
special  therapeutics.  The  chief  criterion  of  the  efficiency  of 
special  therapeutics  in  the  sense  and  the  spirit  of  homoeopathy, 
consists,  we  believe,  in  the  indication  of  the  characteristics  of 
each  remedy,  in  its  specific  relation  to  each  form  of  disease. 
By  many  it  is  alleged  that  homoeopathy  has  no  need  of  special 
therapeutics,  and  that  the  mere  admission  of  persistent,  well 
defined  forms  of  disease,  is  not  allowable  in  our  system  of  medi- 
cine, seeing  that  the  sole  actual  characteristic  indications  of  the 
several  remedies  is  only  to  be  found  in  tlie  symptoms  of  the 
physiological  provings  of  medicines,  guided  thereto  by  the  law 
of  similars.  But  how  unsuitable  this  view  is  for  every  case,  is 
demonstrated  even  by  tliose  practitioners  among  us  who,  under 
the  name  of  pure  Hahnemannists,  profess  to  be  guided  by 
symptomatology  alone  in  the  treatment  of  their  patients  and  the 
choice  of  their  remedies.  For  even  these  gentlemen  have  not 
disdained  to  recommend  certain  medicines  in  certain  forms  of 
disease,  such  as  croup,  scarlatina,  small-pox,  &c.,  and  they 
have  thus  proved  that,  for  the  very  strictest  Hahnemannist, 
special  therapeutics  are  a  necessity.  We  willingly  allow  that 
special  therapeutics  must  chiefly  be  derived  from  the  results  of 
our  medicinal  provings;  still  there  must  not  be  a  mere  verbal 
correspondence  of  the  medicinal  and  morbid  symptoms,  but  we 
must  be  guided  by  the  spirit  revealed  in  them,  in  a  word,  by  the 
whole  character  of  the  medicine.  It  is  in  this  sense  that  we 
wish  the  following  observations  to  be  judged. 

•  From  the  AOg.  Horn.  Ztg.,  bd.  64,  p.  1. 
VOL.    XX.,   NO.   LXXXI. — ^JULY,    1862.  2  C 


403  •  On  the  Therapeutics  of  Prosopalgia, 

That  the  paroxyems  of  pain,  scientifically  called  nearalgia, 
that  occur  in  certain  nerves,  with  certain  sensations,  at  certain 
times,  from  certain   external  influences,  under  peculiar  con- 
stitutional  conditions,  physiological  and  pathological,   under 
epidemic  influences,  &c.,  do  actually  exist  as  independent,  well 
defined  forms  of  disease,  will  be  admitted  by  every  experienced 
practitioner.     At  the  same  time,  every  practitioner  will  allow  that 
neuralgias  form  most  especially  an  object  of  medical  art,  Boeing 
that  left  to  nature  they  are  sometimes  incurable,  and  generally 
only  cured  after  a  very  long  continuance.     The  pathology  of 
the  neuralgias,  in  the  sense  of  modern  exact  science,  is  still  very 
obscure,  and  all  that  is  known  on  the  subject  the  author  must 
take  for  granted  is  known  to  his  readers,  and  therefore  need 
not  be  repeated  here.     But  so  much  the  more  important  do  we 
deem  it  to  make  a  careful  enumeration  of  all  the  circumstances 
pertaining  to  the  observance  and  the  phenomena  attending  the 
occurrence  of  the  neuralgias,  for  purposes  of  comparison  with  the 
characteristics  of  the  corresponding  specific  remedies. 

In  the  therapeutic  treatment  of  the  neuralgias,  homoeopathy, 
in  spite  of  many  undeniable  deficiencies,  has  obtained  great 
triumphs.  A  complete  monographic  treatise  upon  the  thera- 
peutics of  neuralgias,  according  to  the  homoeopathic  principle, 
would  be  highly  desirable,  and  tend  to  advance  our  system. 

The  author,  whose  practice  happens  to  be  chiefly  among  the 
upper  classes  of  society,  among  whom  neuralgic  afiections  are 
particularly  rife,  has  enjoyed  great  opportunities  of  studying  the 
characteristic  peculiarities  of  the  appropriate  remedies.  But,  in 
order  not  to  overstep  the  limits  of  a  journal  article,  we  shall 
confine  ourselves  in  this  essay  to  the  enumeration  of  what  we 
have  learned  by  clinical  experience,  concerning  the  specific 
efficacy  of  some  medicines  in  the  treatment  of  nervous  faceache, 
or  neuralgia  facialis,  in  the  widest  sense  of  the  term.  The 
choice  of  the  remedy  in  the  treatment  of  faceache  is  often  very 
difficult,  and  only  manifold  comparative  experiments  can  enable 
us  to  attain  to  certainty  in  the  selection  of  the  right  remedy  for 
a  given  case.  We  do  not  pretend  that  we  have  investigated  the 
medicines  we  shall  allude  to  in  all  their  curative  relations  to 
neuralgia  facialis,  still  less  do  we  presume  to  assert  that  we  have 


Jy  Dr.  Gusiavus  Gerson.  403 

experimented  "with  all  remedies  winch  are  capable  of  acting  as 
specifics  in  faceache.  But,  we  can  confidently  state^  that  our 
observations  are  not  compiled  out  of  the  Materia  Medica,  but 
that  they  are  the  result  of  pure  clinical  experience.  Thus, 
scanty  though  the  contribution  is,  it  is  truly  drawn  from  nature. 

We  may  commence  by  a  few  general  maxims: — 

Prosopalgia  seldom  occurs  as  a  primary  and  idiopathic 
affection,  still  we  have  repeatedly  observed  it  as  an  independent 
disease  in  otherwise  normally  healthy  subjects. 

Prosopalgia  most  frequently  occurs  in  dyscrasic  subjects,  or 
as  an  accompaniment  and  symptom  of  an  acute  morbid  process, 
bat  in  most  cases  it  appeals  to  the  intervention  of  the  practi- 
tioner as  an  independent  form  of  disease,  whatever  relation  it 
may  maintain  to  the  chronic  or  acute  morbid  process. 

The  dyscrasias  of  which  prosopalgia  is  frequently  the  ex- 
pression, are,  as  far  as  we  can  judge,  particularly  the  chlorotic, 
the  herpetic,  the  arthritic,  the  sycotic  (gonorrhoea),  and  the 
eancerous.  The  more  acute  morbid  processes  it  is  connected 
with  are  chiefly  typhus,  measles,  influenza,  and  ague. 

Most  frequently  true  prosopalgia  presents  an  intermittent 
character,  with  intervals  ranging  from  hours  to  months,  and 
more  or  less  regular;  but,  also,  not  unfrequently  as  a  con- 
tinuous disease,  with  remissions  and  exacerbations. 

Intermittent  forms  may  change  to  continued,  and  vice  versa. 

The  more  recent  the  individual  case,  the  more  favourable  the 
prognosis.  In  general,  the  prognosis  of  the  non-intermittent 
form  is  more  favourable  than  that  of  the  intermittent^  but  there 
are  exceptions  to  this  rule. 

In  like  manner  the  prognosis  is  more  favourable  for  those 
forms  that  proceed  from,  and  are  connected  with,  acute  morbid 
processes,  but  only  provided  they  decline  with  such  afiections. 
As  seqael®  of  these  diseases,  prosopalgia  is  often  very  stubborn 
and  malignant 

When  cancerous  or  sycotic  dyscrasia  is  the  radical  ailment^ 
the  prognosis  is  most  unfavourable.  The  prosopalgia  of  chlo- 
rotics  is  also  often  very  obstinate ;  but,  at  the  same  time,  we^ 
should  state,  that  prosopalgia,  like  any  other  neuralgia,  may  be 
itself  the  cause  of  the  greatest  degree  of  anamia  and  cachexia. 

2c2 


404  On  tfte  Therapeutics  0/  Prosopalgia, 

The  form  in  which  prosopalgia  appears  is  variable. 

Prosolpagia  has  a  great  tendency  to  relapse,  and  the  liability 
of  the  affected  nervous  branches  remains  for  a  long  time. 

Anything  that  acts  in  a  lowering  manner  on  the  body  or  mind 
will  predispose  to  prosopalgia;  hence  all  losses  of  fiaids,  want 
of  nutriment,  excessive  bodily  and  mental  work,  sitting  up  late 
at  night,  attending  on  the  sick,  care,  sorrow,  fear,  &c. 

Although  no  age  is  exempt  from  prosopalgia,  still  it  is  least 
frequent  in  childhood  and  old  age. 

Much  the  greatest  number  of  cases  of  prosopalgia  occur  in 
the  female  sex. 

It  is  not  rare  that  a  case  of  prosopalgia  is  cured  by  a  single 
remedy ;  but,  in  consequence  of  the  variability  of  its  form,  as 
above  mentioned,  it  often  requires  the  employment  of  several 
remedies. 

Under  the  term  prosopalgia,  we  understand  not  merely  the 
affcQtions  of  the  facial  nerve,  but  those  of  all  the  branches  of 
the  fifth  pair  distributed  over  the  face,  from  the  forehead  to  the 
chin. 

As  to  the  duration  of  the  disease,  various  periods  are  required 
in  order  to  cure  prosopalgia,  so  that  we  are  not  in  a  position  to 
give  a  mean  duration;  but  we  have  sometimes  succeeded  in 
curing  perfectly,  in  a  very  short  time,  cases  that  have  lasted 
years,  and  been  unsuccessfully  treated ;  and,  on  the  other  hand, 
we  have  completely  failed  to  cure  some  cases. 

As  regards  the  doses  and  repetition  of  the  medicines  in  the 
treatment  of  prosopalgia,  we  have  constantly  stuck  to  the  dilu- 
tions from  1  to  6,  and  in  acute  and  violent  cases  have  repeated 
the  doses  frequently,  in  chronic  cases  with  few  symptoms  more 
rarely. 

In  the  following  pages,  the  author  has  followed  the  alpha* 
betical  arrangement  so  generally  employed  by  homoeopathists, 
but  should  any  one  think  this  contribution  worthy  of  a  more 
extended  working  out,  we  would  beg  him  to  make  a  more  scien- 
tific arrangement  of  the  materials. 

In  conclusion  we  should  state,  that  in  the  choice  of  the 
remedies  we  have  had  less  regard  to  the  several  symptoms  than 
to  the  essential  nature  of  the  medicines,  and  we  set  great  value 


by  Dr.  Gusiavus  Gerson,  405 

on  the  indications  deduced  from  this  source,  and  consider  them 
the  surest  and  most  excellent  guides  for  treatment. 

Arsenicum. — Powerful  as  is  the  action  of  this  remedy  in  the 
most  varied  forms  of  neuralgia,  we  have  but  seldom  seen  certain 
results  from  its  employment  in  prosopalgia.  The  reason  of  this 
is  that  arsenic  has  no  great  specific  affinity  for  the  fifth  pair  of 
perves.  Hence,  in  individual  cases  of  faceache,  I  have  drawn 
the  indications  for  arsetnc  chiefly  from  the  general  pharmaco* 
dynamic  character  of  the  drug,  and  from  its  well-ascertained 
Bpeoific  relation  to  certain  morbid  processes,  and  in  the  absence 
of  positive  grounds  in  the  pathogenetic  symptoms,  I  had  to 
infer  its  applicability  from  analogy. 

I  found  arsenic  of  use  when  the  facial  pains  were  chiefly  in 
the  facial  and  frontal  nerves,  of  a  violent  gnawing,  drawing, 
tearing  character,  and  when  at  their  worst,  of  a  burtnng  kind. 
The  desperate  restlessness  and  anxiety  accompanying  the 
pains  so  peculiar  to  arsenic  must  also  be  present,  along  with 
tonic  spasms  of  the  facial  muscles,  and  hence  distortions  of  the 
face  during  and  after  the  paroxysms.  The  attacks  came  on  with 
chilliness,  that  increased  to  actual  rigor.  The  exhaustion  after 
the  attacks  was  extreme  and  long-continued.  The  patients  had 
a  cachectic,  puffy  appearance,  were  much  emaciated,  and  had 
suffered  from  intermittent  or  typhus  fever,  or  they  showed  the 
marks  of  herpetic  or  cancerous  dyscrasia.  The  paroxysms 
occurred  by  night  as  well  as  in  the  forenoon.  In  such  cases, 
when  I  administered  arsenic,  the  prolonged  use  of  the  remedy 
might  be  necessary,  but  the  cure  was  permanent. 

SfiLLADONNA. — It  is  wcU  kuown  what  an  injurious  misappli- 
cation the  allopaths  k^ve  long  made  of  belladofina  in  the 
treatment  of  facial  neuralgia,  and  if  ever  the  accusation  of 
inedicinal  poisoning  can  with  justice  be  made  against  the  allo- 
paths, this  is  especially  the  case  with  regard  to  their  insane 
misuse  of  belladonna  in  the  treatment  of  neuralgias,  and  par* 
ticularly  of  prosopalgia.  It  is  in  such  cases  that  the  importance 
.and  necessity  of  an  accurate  knowledge  of  the  characteristics  of 
inedicines,  of  specifics,  and  hence  the  great  advantage  of  the 
homoeopathic  method,  are  obvious. 

The  symptoms  that  guided  the  author  in  his  choice  of  bella- 


406  On  the  Therapeutics  of  Prosopalgia, 

donna  in  facial  neuralgia  were  the  following : — As  regards  tbe 
kind  of  pains,  it  is  not  any  very  well  defined  kind  that    can 
guide  ns  to  the  choice  of  belladontia,  as  the  pains  it  is  soitable 
for  are  of  a  variable  character,  sometimes  drawing,  tearing, 
shooting,  sometimes  huming  to  such  a  degree  that  it  feels  as  if 
the  skin  of  the  face  were  denuded  by  a  blister,  sometimes  deeply 
boring,  and  sometimes  as  if  the  bones  of  the  face  would  split* 
In  most  cases  the  pains  are  relieved  by  pressure  of  the  strong'est 
kind,  but  in  others  the  slightest  touch  increases  them.     In  most 
cases,  cold  air  blowing  on  the  part,  or  even  the  application  of 
ice-cold  compresses  relieves  the  pain,  whilst  in  other  cases  warm 
applications,   or  even  hot  poultices,   are  most  grateful.    As 
regards  the  period  of  the  day,  the  forenoon  and  the  night  are 
tbe  times  when  the  belladonna  facial  pains  are  usually  at  their 
worst,  but  they  may  occur  at  all  periods  of  the  day ;  and,  indeed, 
the  prosopalgias  for  which  belladonna  is  especially  suitable  are 
often  distinguished  by  having  no  complete  intermissions,  and  in 
resembling  inflammatory  a£fections.    Thus  there  is  generally  an 
increase  of  objective  and  subjective  heat,  redness  of  the  face, 
and  strong  beating  of  the  arteries  accompanying  the  nerve.  The 
pains  generally  extend  to  a  great  distance,  though  the  seat  of 
the  disease  may  be  found  to  be  in  certain  nervous  branches,  and» 
as  far  as  my  experience  goes,  it  is  chiefly  in  the  large  branch 
of  the  facial  nerve  that  proceeds  from  the  inner  border  of  the 
ear  into  the  face.     The  salivary  glands,  the  mucous  membrane 
of  the  fauces,  and  especially  of  the  hard  palate  are  oflen  sympa- 
thetically irritated.    In  many  cases  I  found  the  upper  dorsal 
vertebra  very  painful ;  but  this  spinal  irritation  appeared  to  me 
to  be  generally  of  a  secondary  character.     It  is,  of  courae,  to  be 
expected  that,  in  very  sensitive  subjects,  as  in  the  case  of  all 
violent  prosopalgias,  as  also  in  the  prosopalgia  of  belladosma, 
spasmodic  affections  will  occur,  but  too  much  attention  should 
not  be  bestowed  on  these  in  our  selection  of  the  remedy. 

Although  the  prosopalgias  for  which  belladonna  is  suited 
generally  occur  in  full-blooded  subjects  disposed  to  congestions, 
yet  I  have  sometimes  cured  facial  neuralgia  in  individuals  defi- 
cient in  blood,  with  this  remedy.  In  persons  disposed  to 
erysipelas,  and  hence  during  and  after  scarlatina,  belladonna 


ly  Dr^  Gusiavus  Qerson.  407 

fias  often  proved  of  use  in  prosopalgia.     Occasionally  I  have 
found  it  useful  when  the  patient  had  ague. 

The  most  striking  cure  of  a  facial  neuralgia,  that  had  already 
lasted  several  years,  affecting  principally  the  infraorbital  nerves, 
worse  at  night,  and  on  the  application  of  external  warmth,  and  by 
its  duration  sympathetically  affecting  the  nervous  centres,  espe- 
cially the  spinal  chord,  I  lately  effected  by  means  of  the  prolonged 
use  of  belladonna.  The  patient  complained  of  a  sensation  of  great 
swelling  of  the  bone  of  the  jaw,  of  boring,  and  at  the  same  time 
bursting  pains  there,  without  any  particular  redness  of  the  face. 
The  patient  was  never  free  from  pain.  No  predisposing  or 
maintaining  cause  could  be  discovered  in  the  constitution  of  the 
robust  young  lady,  nor  in  any  ascertained  external  influences. 
Myjnvestigations,  at  last,  led  me  to  the  discovery  of  an  inflam- 
matory irritation  at  that  part  of  the  jaw  where  the  wisdom  tooth 
was  about  to  come  through.  My  medical  studies  had  already 
made  me  acquainted  with  the  fact,  that  the  process  of  develop- 
ment of  these  teeth  often  goes  on  for  years,  and  sympathetically 
excites  and  keeps  up  the  most  complicated  morbid  symptoms. 
I  chose  belladonna  for  the  chronic  inflammation  of  the 
alveolar  socket,  and  although  the  wisdom  tooth  has  not  yet 
come  through,  the  lady  has  lost  her  faceache  these  four 
months. 

Bryonia. — In  but  few  cases  of  tri^e  prosopalgia  have  I  em- 
ployed and  seen  good  results  from  this  remedy.  Shooting  and 
aching  paios  in  the  zygoma,  with  circumscribed  redness  and 
increased  heat  perceptible  to  the  touch  in  gouty  individuals  and 
wine  drinkers.  The  pains  were  permanent,  but  were  increased 
by  the  action  of  the  wind^  and  by  alcoholic  drinks.  This  is  the 
brief  resume  of  my  personal  experience  of  the  efiScacy  of 
bryonia  in  prosopalgia. 

Galcarea  Carbonica. — ^This  powerful  remedy,  which  is  a 
valuable  specific  against  neuralgias  in  general,  as  for  example, 
certain  forms  of  cephalalgia,  sciatica,  &c.,  I  have  found  to  be  an 
excellent  remedy  in  some  few  cases  of  faceache.  To  the  choice 
of  this  remedy  I  was  not  led  by  the  pathogenetic  local  symptoms 
alone.  The  cases  treated  and  cured  by  me  with  calcarea  were 
two  married  women,  n  girl,  and  a  man.     All  bad  a  cachectic 


408  On  tfie  Therapeutics  of  Prosopalgia,  | 

Appearance^  and  were  deficient  in  bIood»  in  conseqaence   of  ) 

material  losses.     The  adults  had  been  scrofulous  at  one  time  of  j 

their  lives,  the  girl  was  still  so.     The  married  women    bad  \ 

carried  on  the  nursing  of  their  children  a  long  way  beyond  tbeir 
strength,  and  both  had  long  suffered  from  galactorrhcna  after 
weaning.     The  man  had  long  had  seminal  discharges,  and  had 
overstrained  his  mental  faculties.     The  girl  had  suffered  mach 
from  scrofulous  blennorrhoeas  of  various  mucous  membranes, 
and  still  suffered  from  these,  especially  from  ozena.    All  were 
inordinately  irritable,  of  melancholic  temperament  and  equable 
temper,  very  sensitive  to  the  open  air.     The  facial  pains  were 
seated   in  the  infraorbital  region,   and  also   at  the   point   of 
entrance  of  the  facial  nerve.     They  were  dull  drawing,  as  if  in 
the  substance  of  the  nerves,  like  anxiety  in  the  nerves,  only 
slightly  burning  at  the  worst  of  the  attack,  when  a  circumscribed 
redness,  hot  to  the  touch,  showed  itself  on  the  cheek.     In  all 
there  was  slight  irritation  of  the  upper  dorsal  vertebra.     The 
exacerbations  occurred  always  in  the  latter  hours  of  the  forenoon, 
these  were  ushered  in  by  chilliness.     Nocturnal  exacerbations 
were  rare,  but  there  were  intervals  quite  free  from  pain,  and, 
therefore,  these  cases  belonged  to  the  neuralgias  with  an  inter- 
mittent character.     The  remedy  showed  its  curative  influence 
after  a  few  doses,  but  it  required  to  be  continued  for  some  weeks 
in  order  to  produce  a  perfect  cure.    Doses  from  the  3rd  to  the 
6th  dilution. 

These  calcarea  prosopalgias  had  all  been  exposed  to  the  iron 
shots  of  ihe  allopaths,  but  none  had  hit  the  mark. 

China  and  Chininum  Sulphuricum. — While  preparing  to 
put  in  order  my  comparatively  scanty  clinical  experience  respect 
ing  the  therapeutic  efScacy  of  Chvia  and  its  alkaloid  in  facial 
neuralgia,  the  spirit  of  the  therapeutics  of  the  prevailing  school 
rises  up  before  my  mind's  eye,  recalling  all  the  emotions  that  a 
retrospect  of  the  therapeutic  extravagancies  of  the  physicians  of 
our  times  must  awake  in  us. 

To  what  category  of  spirits  this  ill-omened  one  belongs 
I  leave  to  the  determination  of  more  knowing  ones  than  I  am. 
But  it  is  certainly  a  frivolous,  feckless,  and  thoughtless  creature, 
one  of  the  empty  wind  bags  of  our  time.     Certainly  no  one  has 


by  Dr,  Gustavus  Gerson.  409 

the  right  to  demand  the  deposition  of  Cinchona  Bark  and  the 
enthronement  of  Quinine,  on  the  ground  of  any  comparative 
physiological  and  clinical  experiments.  Messieurs  the  pro- 
fessors by  this  act  of  caprice  have  merely  made  a  confession  of 
the  intellectual  ineptitude  of  the  therapeutic  authorities  of  the 
dominant  school.  At  all  events,  it  matters  little  to  the  super- 
ficialneas  and  thoughtlessness  with  which  therapeutic  indications 
are  now-a-days  laid  down,  whether  the  question  is  concerning 
the  total  action  of  a  medicinal  substance  or  the  partial  action  of 
a  portion  of  it  The  proper  study  of  medicinal  actions  is,  at 
all  events,  quite  neglected,  and  the  cardinal  categories  of  medi- 
cinal actions  which  are  only  dubiously  acknowledged,  are 
decried  by  the  professors.  Is  it  not  enough  to  pronounce, 
regarding  Quinine,  that  it  removes  the  intermittent  character  of 
diseases,  that  it  fortifies  the  blood  and  the  nerves,  and  above 
all,  that  it  acts  as  an  astringent  on  the  tissues  ?  Tes,  astrin- 
gent, that  is  the  most  peculiar  and  most  important'  action  of 
Cinchona  and  its  alcaloid,  that  is  the  sublimest  expression  and 
highest  epithet  for  a  grand  medicine,  and  that  from  a  medical 
school  that  looks  down  with  pride  and  contempt  on  the  achiev- 
ments  of  former  ages,  that  minutely  investigates  all  the  anato- 
mical and  chemical  alterations  of  the  diseased  organism — on 
the  dead  subject  But  medicinal  actions  assuredly  regard  the 
life,  the  organic  life.  This  organic  life,  which  is  sophistically 
regarded  as  a  mere  mechanical  contrivance,  according  to  the 
axiom  ear  morle  vita,  must,  when  it  goes  wrong,  be  mechani- 
cally corrected,  and  hence  it  is  quite  enough  that  Cinchona 
should  be  a  substance  with  astringent  properties.  Does  not 
this  spirit  of  the  dominant  therapeutics  remind  one  of  those 
sinister  demons  of  the  middle  ages,  which  weighed  like  an 
incubus  on  all  attempts  at  free  investigation  in  science  ?  And 
is  it  not  the  capricious  arrangement  of  medicines  in  such  cate- 
gories that  gave  rise  to  the  accumulation  of  the  trashy  load  of 
surrogates  which  are  now-a-days  contemptuously  rejected  ? 

We  know  well  enough  that  the  therapeutic  axioms  laid  down 
by  the  principal  clinical  authorities  of  the  eighteenth  century 
are  not  reliable ;  but,  at  all  events,  it  should  be  mentioned  to 
their  honour  that  they  first  studied,  in  a  rational  and  diligent 


410  On  the  T/ierapeuttes  of  Prosopafyia, 

manner,  the  effects  of  Cinchona,  and  that  their  indications  for 
the  use  of  this  remedy  exhibit  the  subtlest  observation  and  the 
aoatest  ratiocination.  They,  worthy  high  priests  of  -ffiscnlapius, 
lived  and  wrought  in  fall  consciousness  of  the  chief  aim  of  the 
physician,  which  should  be — the  cure  of  diseases.  No  doubts 
in  conformity  with  the  prejudices  of  the  times,  they  generally 
administered  Cinchona  in  complex  mixtures,  but  still  they  re- 
garded the  medicine  as  a  unity,  and  as  such  they  were  tfao* 
roughly  well  acquainted  with  it  in  their  own  fashion.  But  they 
did  not  know,  as  the  clinical  heroes  of  to  day  do,  that  a  consti- 
tuent part  of  it,  its  alcaloid  Quinine,  is  well  adapted  for  adminis- 
tration in  natty  little  powders,  in  a  form  in  which  a  concession 
is  made  to  that  desire  for  the  smallest  doses  of  medicine  which 
homoeopathy  has  excited  among  the  public;  yes,  in  a  form 
which  allows  the  practitioner,  when  his  patient  expresses  a  desire 
for  homoBopathic  treatment,  to  whisper  in  his  ear,  that  the 
powder  really  contains  only  a  homoeopathic  dose  I 

What  a  difference  there  is  between  the  method  pursued  by 
the  homoeopathist  in  ascertaining  the  indications  for  Cinchona 
and  that  of  the  therapeutic  authorities  of  the  dominant  school ! 
How  constantly  and  perseveringly  must  we  study  and  pore  ov6r 
the  list  of  Cinchona  symptoms,  which  still  seem  to  us  so  imper- 
fect and  defective,  in  order  to  draw  from  it  new  treasures,  new 
acquisitions  for  our  therapeutics!     Must  we  not  appear  like 
fools,  deluded  by  some  trickish  sprite  of  the  mountains,  who 
see  precious  metals  sparkling  where  the  unprejudiced  masters  of 
modem  physic  seek  and  find  nothing  more  than  the  tanner 
extracts  from  his  bark  ?     Truly  it  requires  a  manly,  noble  de- 
votion to  his  calling,  and  an  enduring  enthusiasm  for  the  truth, 
to  persevere  and  not  to  weary  in  a  work  such  as  the  homceo- 
pathist's  is.     Happy  we,  if  we  succeed  in  finding  an  immediate 
reward  in  the  results  of  our  labour,  and  if  we  continue  to 
progress  in  the  light  of  truth.     For  the  judgment  of  history, 
that  weighs  and  pronounces  its  verdict  respecting  merit  and 
truth,  is  not  seated  ex  permafience,  nor  do  all  events  come 
under  its  ken.     But  the  great  statistical   experiment  in  the 
number  of  deaths  remains  pretty  much  the  same  whether  Cin- 
chona be  given  to  patients  according  to  its  homoeopathic  indi- 


ly  Dr.  Oustavus  Oenofu  411 

cations,  or,  unthinkingly,  as  a  tonio  and  astringent  remedy  in 
the  form  of  its  alcaloid  !  And  we  live  in  the  days  when  statis- 
tics are  all  powerful,  and  the  truth  is  least  perceived  when  the 
strength  of  therapeutic  knowledge  lies  in  negation.  I  must 
apologise  for  this  polemical  digression,  which  seems  rather  un- 
called for.  But  how  is  it  possible  to  prevent  an  explosion  when 
opportunity,  acting  as  accident^  throws  a  spark  upon  the  over 
abundant  combustibles  ? 

The  pathogenetic  local  afifections  of  China  are  not  very  well 
marked ;  hence,  for  very  intense  idiopathic  prosopalgias,  this 
medicine  can  scarcely  pretend  to  be  a  specificum  similitmum* 
It  is  mostly  constitutional  affections,  profound  alterations  of  the 
blood,  diseases  of  nutrition,  for  which  China  is  the  remedy* 
Hence  the  local  affections,  and,  therefore,  also  the  neuralgias, 
those  caused  by  China  as  well  as  those  for  which  it  is  thera- 
peutically indicated,  are  only  such  as  can  be  properly  said  to  be 
dependent  on  a  constitutional  affection.  It  must,  moreover,  be 
candidly  confessed,  that  Hahnemann's  proving  of  China  does 
not  consist  entirely  of  the  results  of  pure  physiological  experi- 
mentation, but  it  contains  a  large  admixture  of  citations  from 
the  works  of  those  authors  whose  labours  I  have  above  thank- 
fully acknowledged.  The  more  such  anomalies  exist  in  our 
codex  of  symptoms,  the  more  difficult  does  it  become  to  ascer- 
tain the  strictly  homoeopathic  indications  for  the  several  medi- 
cines, and  the  more  frequently  are  we  compelled  to  form  our 
conclusions/?^  inductionem  et  analogiam.  Thus  much  I  have 
found  to  be  the  result  of  my  studies,  that  the  fundamental 
character  of  the  China  disease  is  one  of  irritable  debility,  and  as 
the  neuralgias  usually  have  this  for  their  source,  it  follows  that 
China  must  be  the  appropriate  remedy  for  characteristic  cases 
of  prosopalgia. 

I  have  found  China  serviceable  in  the  faceaches  of  chlorotio, 
anaemic,  leucophlegmatic,  scrofulous  subjects,  and  sometimes 
also  in  those  of  arthritic  patients.  It  was  generally  indicated  by 
the  existing  constitutional  affection,  by  aneemia,  hydreemia, 
scrofula.  When  I  found  China-prosopalgia,  the  existence  of 
habitual  disposition  to  neuralgias  could  generally  be  discovered. 


41  d  On  the  Therapeutics  of  Prosopalgia, 

Hence,  I  cannot  claim  for  the  cases  of  prosopalgia  I  have  cored 
by  China  anything  bat  a  symptomatic  character. 

My  China-prosopalgias  had  generally  their  seat  in  the  smaller 
and  middle-sized  nervous  twigs,  in   branches   of  the   nasal, 
frontal,  and  maxillary  nerves,  they  often  changed  about  from 
one  branch  to  another.     The  characteristic  form  of  the  pains 
vrere  dull,  aching,  drawing,  jerking,  cutting,  usually  leaving 
behind  great  numbness.     The  pains  had  certainly  more  vio- 
lent paroxysms,  especially  after  dinner,  and  in  the  first  hour 
of  the  night,  but  they  did  not  show  well  defined  intermissions, 
as  is  the  case  with  some  other  medicines.     The  extraordinary 
agitation  which  accompanied  the  local  and  proportionately  cir- 
cumscribed affection,  compelled  the  patient  to  a  frequent  change 
of  position,  in  the  night  to  covering  himself  all  over  with  the 
bed-clothes,  and  then  suddenly  throwing  them  all  off  again. 
In  one  and  the  same  attack,  heat  and  cold  would  cause  short 
remissions — pressure  made  no  alteration :  frequent  jerking  and 
twitching  of  single  muscular  fibres,  visible  pulsation  of  small 
arteries,  rapid  variation  of  the  complexion,  and  partial  variability 
of  the  temperature,  perceptible  to  the  touch.     When  the  pain 
occurred  near  the  eye,  flow  of  tears — when  near  the  maxillary 
nerves,  flow  of  saliva  and  thirst.     The  fits  lingered  on  for  many 
hours,  the  pain  varying  all  the  time  in  severity.  A  characteristic 
feature  of  the  pain  seemed  to  me  that  it  did  not  radiate,  as  is 
the  case  in  many  other  forms  of  prosopalgia.     The  subsequent 
exhaustion  was  very  great,  the  patients  being  generally  of  low 
vital  powers.     The  mental  disposition  during  the  fits  was  des- 
ponding, whining,  but,  in  general,  cross,  irritable,  pusillanimous. 
I  was  particularly  struck  with  the  number  of  cases  in  chlorotio 
and  scrofulous  girls,  about  the  age  of  puberty,  and  in  young 
onanists,  whose  complete  cure  was  effected  by  China.     The 
cases  I  have  mentioned  as  occurring  in  arthritic  subjects  were 
only  two  in  number,  and  they  were  suffering  from  atonic  gout 
and  dropsy.     I  should  also  mention  some  cures  in  patients 
affected  with  mercurial  cachexia,  and  I  may  state,  that  I  have 
found  China,  as  a  rule,  one  of  the  best  antidotes  to  mercurial 
poisoning. 


by  Dr.  Ousiavus  6ei*son.  413 

As  regards  chininum  auiphuricum,  I  must  confess  that  I  have 
made  but  very  few  applications  of  this  remedy  according  to 
homoeopathic  indications  in  the  treatment  of  prosopalgia,  and 
hence  I  am  unable  to  point  out  its  therapeutic  characteristics 
for  this  disease ;  but  in  those  cases  where  I  have  made  an  em- 
pirical use  of  quinine,  in  some  violent  cases  of  faceache,  I  have 
generally  failed  to  attain  my  object,  and,  to  my  confusion,  have 
sometimes  only  effected  a  severe  aggravation  of  the  pains. 

Although  it  is  not  in  the  alphabetical  order,  still  I  think  this 
is  an  appropriate  place  to  say  what  I  have  to  say  about  iron. 
Unfortunately,  the  provings  of  the  remedy  are  so  imperfect  and 
scanty  that  they  do  not  allow  us  to  draw  any  positive  indications 
from  them  for  prosopalgias.  When  I  have  given  this  remedy, 
experimentally,  in  a  homceopathic  dose,  on  mere  general  prin- 
ciples, in  ancemia  and  scrofulous  faceaches,  I  have  never  been 
able  to  do  any  good.  But,  I  must  not  omit  to  mention  that,  in 
my  youth,  at  the  dispensary,  and  also  at  the  commencement  of 
my  private  practice,  I  observed  very  marked  curative  results 
from  the  employment  of  minute  doses  of /errum  carbonicum  in 
some  cases  of  prosopalgia,  in  women  who  had  become  aneemic 
from  galactorrhoea. 

CoccrLUS. — This  remedy  is  one  of  the  real  jewels  of  our 
medicinal  treasury,  it  is  a  brilliant  of  the  purest  water,  trans- 
parent, clear.  Its  study  causes  intense  inward  satisfaction,  and 
allows  us  to  feel  quite  at  home  within  a  limited  vital  circle ; 
hence,  also,  the  indications  for  this  remedy  may  be  discovered 
with  great  certainty. 

I  have  found  cocctUus  indicated,  and  administered  it  in  but 
few  cases  of  prosopalgia ;  but  these  cases  were  highly  developed, 
idiopathic,  and  generally  deeply  seated  forms,  that  had  lasted  for 
years.  They  occurred  in  ladies  of  the  upper  ranks,  of  ages 
varying  from  80  to  40  years.  The  patients  besides  suffering 
from  abdominal  plethora,  had  extreme  irritability  of  the  nervous 
system,  especially  of  the  spinal  chord ;  they  had  been  more  or 
less  mistreated  with  mineral  waters  and  thermal  baths;  they 
suffered  much  from  a  collection  of  wind  in  the  epigastrium,  from 
acidity,  obstinate  constipation,  and  diarrhoea,  from  menstrual 
colic,  and  bland,  thick  leucorrhoea.    Some  of  them  had  formerly 


414  On  the  T/ierapeuiics  of  Prosapalffia, 

suffered  much  from  nearalgia  of  the  soiatic  or  brachial  nerve ; 
in  all  there  was  spinal  irritation,  with  nocturnal  boring  pains. 
Of  choleric  temperament,  the  patients,  through  their  long  con- 
tinued sufferings  had  been  brought  into  a  state  of  desperation, 
constantly  changing,  and  that  quickly,  from  pusillanimity  and 
despondency  to  outrageous  gaiety.  They  bad  not  lost  much  in 
flesh,  but  their  complexion  was  pale,  their  expression  was  some- 
what distraughtj  and  in  one  patient  a  permanent  distortion  was 
perceptible. 

The  attacks  proper  regularly  came  on  in  my  patients  in  the 
afternoon,  and  in  one  case  only  did  a  second  paroxysm  occur 
about  midnight.      Some  hours  before  the  occurrence  of  the 
paroxysm,  the  disposition  became  irritable,  there  was  prostration, 
yawning,  chilliness,  coldness  of  feet ;  then  followed  a  violent 
jerk  in  the  affected  nerve,  in  my  cases  in  the  pes  anserinus 
or  the  temporal.     Boring,  stitching,  crushing,  lancinating  pains 
in  the  jaws,  drawing,  jerking,  in  the  sympathetically  affected 
nerves ;  these  radiations  extended  very  &r,  as  far  as  the  finger 
points.    In  one  case,  chilly  feeling  through  the  teeth,  and  fine 
drawing  in  the  borders  of  the  teeth,  trembling  throughout  the 
body,  spasms  in  the  throat,  diuresis,  cold,  perceptible  to  the 
touch  in  the  distorted  face ;  loud  cries  of  despair,  and  irritation, 
alternated  with  the  characteristic  cocculus  stupefaction  of  the 
brain.     The  attacks  lasted  from  four  to  six  hours,  and  even 
after  the  cessation  of  the  prosopalgia  the  cerebral  stupefaetion 
with  delirium  lasted  till  late  at  night.     In  the  period  of  remis^ 
sion,  during  the  day,  the  facial  nerves  were  quite  free  from  pain, 
but  the  sympathetic  affections  in  other  nerves,  as,  for  instance, 
the  paralysed  feeling  in  the  arm  of  the  same  side,  and  the 
drawing  in  the  dental  nerves  continued.     In  the  case  I  have  here 
described  I  soon  came  to  discover  the  indications  for  cocculua, 
and,  therefore,  I  rapidly  hit  the  mark,  and  when  slight  relapses 
subsequently  showed  themselves,  they  yielded  readily  to  a  few 
additional  doses. 

In  my  descriptions,  I  have  purposely  avoided  making  an 
artistic  arrangement  of  my  observations,  and  I  have  preferred 
giving  my  impreE»ions  just  as  they  occurred  to  me.    The  en- 


by  Dr.  Gusiavus  Gerson.  415 

lightened  reader  will  know  how  to  constrnct  the  characteristic 
picture  oat  of  the  raw  material. 

CoLocYNTHis. — I  havc  repeatedly  proved  the  efficacy  of  this 
remedy  in  a  peculiar  form  of  neuralgia  of  the  small  branches  of 
the  infraorbital  nerves,  which  I  have  found  quite  characteristi- 
cally in  several  plethoric,  choleric,  irritable  men,  from  40  to  50 
years  of  age ;  these  patients  were  disposed  to  hasmorrhoidal  and 
gouty  affections,  and  to  congestions  towards  the  head :  the  most 
firequent  cause  was  vexation,  but  sometimes  also  too  close  appli- 
cation to  business ;  but  once  produced,  this  neuralgia  was  apt 
to  recur  many  days  successively^  at  the  same  hour  in  the 
forenoon* 

After  feeling  of  heat  in  the  face  and  forehead,  there  occurred, 
in  a  small  circumscribed  spot,  below  the  lower  eyelid,  an  ex- 
tremely tiresome,  aching,  pinching  pain,  which  produced 
twitching  in  the  lower  lid,  dazzling  before  the  eyes,  and  diplopia. 
The  fits  often  lasted  several  hours,  aud  left  behind  dull  frontal 
headache ;  colocynih  prevented  the  recurrence,  and  cut  short 
the  attacks  very  quickly. 

Ignatia  amara. — Our  Ignatia!  ours,  wholly  and  solely! 
Set  aside,  turned  out  of  the  allopath's  pharmacopoeia  and  thera- 
peutics, by  the  paternal  decree  of  the  great  dons  of  modern 
pharmacology,  whose  profound  schooMearning  warns  them 
against  the  medicinal  use  of  ignatia,  because  this  substance 
shows  a  larger  proportion  of  brucine  in  its  composition  than 
nnx  vomica,  whence  it  must  follow  that  ignatia  must  be  a  much 
more  powerful  poison  than  nux  vomica,  and  as  it  is  a  well  known 
maxim  among  all  children's  friends,  that  children  should  not  play 
with  fire,  edged  tools,  or  poisons,  so  it  is  right  and  consistent  to 
proscribe  ignatia;  for  those  who  cannot  refrain  from  playing  with 
brucine  have  a  less  dangerous  poison  in  nux  vomica.  Such  is  the 
sublime  reasoning  of  the  pharmacologists.  We  can  fairly  cer- 
tify of  them  that  the  friends  of  children  could  not  teach  any- 
thing more  childish !  So,  once  more,  and  with  increased  em- 
phasis, I  designate  i^ia/ia  our  ignatia.  For  truly  this  medicine 
is  a  sign  and  symbol  of  homoeopathy ;  the  history  of  ignatia  is 
a  miniature  picture  of  the  history  of  homoeopathy  itself.  All 
the  advantages  and  virtues,  all  the  victories  and  conquests  of 


416  On  the  Therapeutics  of  Prosopalgia^ 

honKBopathy  ore  unmistakeably  recognisable  in  sharp  concen* 
trated  characteristic  lines  in  the  history  of  igtiatia^  sQch  as 
homoeopathic  clinical  experience  exhibits  it;  bat,  at  the  same 
time,  all  the  errors,  faults,  defects,  and  deformities  !  We  know 
no  other  proved  medicinal  substance,  whose  indications  are 
shown  with  greater  pregnancy  and  plasticity,  none  with  which 
more  positive  real  cures  have  been  effected;  but  no  other 
homoeopathic  remedy  has  been  so  abused  by  the  faith  of  lay 
practitioners  of  homoeopathy,  no  other  has  been  so  much  pun- 
ished for  the  hysterical  petulance  of  homoeopathic  practitioners 
as  ignatia  !  Breathes  there  a  hysterical  girl,  or  hlas€  swell, 
who  has  not  learned  from  some  medical  friend  that,  for  the 
disagreeable  effects  of  every  kind  of  mental  emotion,  they  have 
only  to  swallow,  in  full  faith,  a  globule  of  the  dOth  dilution  of 
ignatia^  or,  still  better,  daintily  to  sniff  up  their  delicate  nose, 
the  wondrous  aroma  that  is  inexhaustibly  given  off  by  the 
mysterious  globule  lying  perdu  at  the  bottom  of  a  vial.  All 
that,  in  the  course  of  time,  has  occurred  to  reduce  homoeopathic 
practice  to  a  mere  dead,  weakly  inanity,  to  a  mere  routine  prac- 
tice, to  a  system  of  verbal  correspondences,  may  be  clearly  and 
legibly  read  in  the  history  of  ignatia. 

These  circumstances,  however,  will  never  diminish  either  the 
real  importance  of  ignatia  as  a  remedy,  or  the  merits  of  its 
incomparable  proving ;  on  the  contrary,  it  is  an  infallible  sign 
of  its  great,  true,  and  admirable  character,  that  fools  and  shal- 
low pates  give  themselves  such  pains  to  disguise  and  misre- 
present it. 

We  are  not  in  the  habit  of  judging  of  medicinal  effects  by 
weight  and  measure,  and  when  I  am  asked  i)y  those  colleagues 
who  practise  homoeopathy  in  the  meantime,  because  it  pays 
pretty  well,  but  who,  in  their  hearts,  and  also  in  their  dubious 
behaviour,  are  attached  to  so-called  progressive  science,  when  I 
am  asked  by  such  as  these  ''  if  the  cases  of  prosopalgia  which  I 
have  treated  and  cured  by  homoeopathy  belonged  to  the  idio- 
pathic intense  sort,  depending  on  a  distinct  affection  of  the 
nerves  ?  "  I  certainly  could  not  reply  decidedly  in  the  affir- 
mative. 

The  cases  of  prosopalgia  I  have  cured  with  ignatia,  by  no 


ftjf  Dr.  Ousiavus  Gerson.  417 

nkeans  Few  in  nomber,  were  generally  of  Bymptomatio  character. 
Bat  among  them  were  some  cases  which  occurred  in  regular 
paroxysms  and  shewed  an  idiopathic  persistency.  Though 
most  of  my  cases  were  in  women  of  the  upper  ranks,  delicate, 
aofl-fibredy  anasmic,  nervous,  of  melancholy  or  melancholic- 
«angnineous  temperament,  yet  some  were  persons  full" blooded, 
or  with  an  abnormal  condition  of  the  blood,  such  as  gouty  and 
faeemorrhoidal  subjects.  Excessive  sensitiveness,  hypereesthesia 
of  the  nerves,  marked  impressionability  and  variability  of  the 
disposition  were  shown  by  most  of  the  patients,  and  all  had 
more  or  less  suffered  from  those  trials  and  shocks  to  the  heart 
and  mind  with  which  Providence  afflicts  poor  mortals,  or  which 
they  ftimish  for  themselves. 

Moreover,  the  greater  number  showed,  more  or  less,  well- 
marked  spinal  irritation,  the  origin  of  which  could  be  traced  to 
positive  or  relative  excessive  solicitation  of  the  sexual  functions, 
in  the  most  extended  sense  of  the  term,  or  as  in  the  case  of 
some  musical  virtuosi,  to  inordinate  mechanical  irritation  of  the 
spinal  nerves,  combined  with  the  debilitating  action  of  going 
too  much  to  evening  parties.  Ouriously  enough  I  have  re* 
peatedly  removed,  by  i^tiatia,  prosopalgias  that  were  undoubt<r 
edly  owing  to  the  presence  of  ascarides.  It  was  extremely 
interesting  to  me  to  observe  that  the  ignatia  prosopalgias  often 
alternated  with  neuralgias  and  hyperesthesias  of  other  parts,, 
some  examples  of  which  will  be  given  below. 

In  the  pure  arthritic  form,  ignatia  was  given  in  two  cases. 
I  repeatedly  observed  the  ignatia  prosopalgia  in  the  course  of 
typhus  and  miliary  fevers,  and,  if  I  remember  right,  also  in 
some  rouis  during  the  prolonged  course  of  gonorrhoea. 

As  before  said,  t  have  cured,  with  ignatia^  but  few  cases  of 
what  I  believed  to  be  deeply  rooted  idiopathic  prosopalgia ;  they 
were  generally  intermittent  affections  in  the  course  of  other 
diseases  of  a  temporary  and  vicarious  character,  and  particularly 
regularly  recurring  cases,  dependent  on  certain  well  known 
influences ;  but,  wherever  I  found  ignatia  indicated,  according 
to  the  criteria  I  have  given,  its  employment  was  followed  by 
evident  curative  action,  in  the  symptomatic  forms  rapid,  in  the 
idiopathic  gradual.    The  sage  dictum  of  modem  wisdom,  that 

VOL.   XX.,   NO.   LXXXI. — JULY,    1862.  2  D 


416  On  the  Therapeutics  of  Prosopalgia, 

the  symptomatio  forms  would  have  ceased  spontaneously,  can- 
not detract  an  iota  from  the  value  of  my  observations,  for  my 
patients,  who  had  long  been  used  to  the  attacks,  thankfully 
acknowledged  and  lauded  the  curative  power  of  the  remedy,  and 
I  flatter  myself  that  I  possess  some  little  ability  and  impartiality 
in  the  observation  and  estimation  of  positive  medicinal  efifects. 
Moreover,  it  so  happened,  that  frequently  the  existing    and 
maintaining  causes,  as,  for  instance,  prolonged  nursing,  pollu- 
tions, musical  excesses,  &c.,  could  not  be  removed,  whereas  the 
prosopalgias  were  permanently  cured  by  ignatia.  Most  of  the 
cases,  too,  were  by  no  means  of  an  ephemeral  character,   and 
this  remark  brings  me  to  the  subject  of  the  duration  of  these 
igtiatia  prosopalgias.     Seldom  had  my  cases  lasted  for  weeks, 
but  yet  the  tendency  to  the  attacks  was  often  of  many  years' 
duration.    Thus,  some  were  women  who  always  suffered  from 
faceache  during  their  pregnancy,  or  the  paroxysms  had   the 
peculiarity  of  occurring  for  a  series  of  successive  days,  in  a 
regular  or  irregular  manner,  completely  unaffected  by  the  action 
of  all  sorts  of  palliatives ;  some  of  the  cases  occurred  regularly, 
owing  to  some  known  cause,  but  needed  two  to  five  days  for 
their  subsidence. 

The  ignatia  prosopalgia  often  comes  on  suddenly,  without 
any  warning,  or  it  is  preceded  by  slight  premonitory  symptoms, 
such  as  bruised  feeling,  tension,  twitching  in  the  face. 

The  duration  of  a  paroxysm  is  very  various,  sometimes  the 
only  cessation  during  a  whole  day  consists  in  a  few  hours  passed 
in  uneasy  sleep.  Sometimes  the  attack  commences  on  first 
waking  in  the  morning,  and  is  ended  often  firom  four  to  eight 
hours,  or  sometimes  it  begins  about  noon,  only  terminating  late 
in  the  evening,  or  its  occurrence  is  confinecf  to  the  night :  be- 
sides the  frequently  long  intermissions  in  the  periodical  cases, 
the  remissions  in  other  cases  vary  very  much. 

The  exciting  causes  of  these  prosopalgias  were  chiefly  mental 
emotions,  but  they  were  sometimes  excesses  in  mental  work,  in 
musical  performances,  in  venere,  and  in  baccho.  Suppressed 
perspiration,  blennorrhcea,  and  hemorrhoidal  fluxes,  were  fre- 
quently the  remote  cause  of  facial  neuralgia. 

The  seat  of  igmttia  prosopalgia  is,  as  far  as  I  can  make  out, 


by  Dr.  Guslavus  Gerson,  419 

generally  in  the  smaller  twigs  of  the  facial  nerves,  seldom  in  the 
larger  branches ;  generally  it  is  single  small  branches  of  the 
infraorbital,  supraorbital,  nasal,  and  labial  nerves  that  are  at- 
tacked, and  that  in  very  well  marked  limits,  seldom  extending 
into  any  other  region,  and  having  no  tendency  to  radiation. 
The  attacks  by  day  are  preceded  by  uneasy  sleep,  wakening 
with  a  bruised  feeling,  pandiculations  and  ill-humour. 

The  kind  of  pains : — boring,  dart-like  shoots,  giving  quite  a 
diock,  dull,  drawing,  twisting,  formication.  Seldom  do  the 
ptaiks  attain  such  a  height  as  to  cause  the  patient  to  toss  about 
in  despair,  as  happens  in  some  other  prosopalgias;  on  the  con- 
trary, the  pains  are  borne  in  dull  resignation,  and  the  patient 
lies  quietly. 

Concomitant  circumstances : — partial  convulsions  of  the 
facial  muscles,  trismus,  the  branches  of  the  maxillary  nerve 
were  particularly  affected,  paleness,  and  coolness  of  the  face, 
laohrymation  and  photophobia,  spasms  in  the  cheek,  yawning, 
shuddering,  diuresis,  urinary  tenesmus,  pulse  quickened,  small, 
cutaneous  temperature  cool ;  quiet  weeping,  pusillanimity.  Pa- 
tients of  a  heroic  character  were  able  even  to  go  about  their 
business,  or  their  pleasure,  during  the  pains. 

In  referetice  to  the  above-mentioned  alternation  of  the  proso- 
palgia with  other  affections,  I  may  briefly  relate  some  examples. 

A  plethoric  lady,  who,  when  85  years  of  age,  had  already 
borne  and  nursed  1 1  children,  suffered  occasionally,  and  espe- 
cially some  days  before  the  catamenial  .period,  from  enormous 
diuresis,  which  was  diagnosed  by  some  Parisian  doctors  to  be 
hydrometra,  but  Scanzoni  more  correctly  pronounced  it  to  be 
hyperffithesia  of  the  kidneys.  At  first,  under  my  treatment,  as 
Boon  as  the  enormous  diuresis  was  rapidly  removed  by  Pulsatilla, 
the  following  day  a  regular  attack  of  prosopalgia  came  on,  which 
yielded  readily  to  igfiatia.  Now  the  patient  has  been  free  from 
both  affections  for  eight  months. 

Another  very  delicate  lady,  who,  like  many  of  her  country- 
women, had  had  children  in  rapid  succession,  and  had  nursed 
them  for  a  full  year,  suffered  from  extreme  lancinating  uterine 
pains  (a  small  indurated  spot  was  observable  in  the  neck  of  the 
displaced  uterus)  which,  as  soon  aa  they  were  removed  by  ar- 

2  D  2 


420  Medical  Terrorism, 

senio,  regularly  changed  into  a  prosopalgia,  which  in  its  tam 
readily  yielded  to  ignaiia. 

A  person,  affected  with  hemorrhoids,  40  years  old,  who  bad 
a  fissure,  had  freqaent  attacks  of  proctalgia.  Every  time  this 
was  removed  by  nitric  acid,  prosopalgia  occurred,  and  iffnatia 
never  failed  to  cure  it  rapidly. 

Platina. — This  remedy,  which  has  much  in  the  character  of 
its  action  analogous  to  Ignatia,  differs  from  the  latter  in  this 
unhappy  way,  that  its  proving  is  much  more  imperfect ;  and,  to 
my  knowledge,  the  best  qualities  of  this  remedy  knovm  to  the 
practitioner  are  not  indicated  in  the  Materia  Medica.     Thos,  I 
have  seen  the  most  brilliant  cures  effected  by  plalina  in  two 
most  violent  cases  of  prosopalgia.    The  cases  occurred  in  child- 
less married  women,   who   suffered  habitually   from  profuse 
menstruation,  uterine  spasms,  headache,  palpitation  of  the  heart, 
variable  humour  and  megrims.    They  were  not  ancemic.     The 
paroxysms  which  occurred  in  the  forenoon  attacked  the  pes 
anserinus ;  the  pains  were  pinching,  boring,  burning ;  the  facial 
muscles  were  horribly  distorted;  trismus  was  present;  the  face 
was  hot,  dark  red  ;  there  was  great  lachrymation  and  ptyalism, 
convulsions  of  the  upper  extremities,  and  of  the  pectoral  muscles; 
loud  crying,  insane  tossing  about  and  striking  out  on  all  sides 
of  them.     In  the  several  paroxysms  there  were  but  short  remis* 
sions,  during  which  the   patient  sat  wrapped  up  in  herself: 
duration  of  the  paroxysms  from  six  to  ten  hours,    Platina 
cured  permanently. 

("To  be  continued  J. 


MEDICAL    TERRORISM. 
By  William  Bates,  M.D. 

"  ThiB  trtdes-nnion  peneeatioa  is  yery  contemptible,  and  can  lead  to  no 
good."— jDtitteryrom  a  London  BotpikU  Surgeon  qfeminmee. 

The  public  are  greatly  and  immediately  interested  in  checking 
all  attempts  at  undue  interference  with  the  mutual  relations 
between  employer  and  employed.    If  a  man  chooses  to  refuse 


by  William  Bayes,  M.D.  421 

to  work,  except  under  certain  conditions,  die  freedom  of  the 
subject  upholds  him  in  his  right  to  refuse ;  but,  if  he  advances 
the  further  claim  to  the  right  to  compel  others  to  refuse  who 
have  not  the  same  objection  as  himself,  then  he  is  committing 
an  unlawful  act,  and  is  using  his  own  liberty  as  an  occasion  to 
tyrannise  over  others.  The  present  claims  of  the  British  Medi- 
cal  Association  to  dictate  to  the  profession  what  it  may,  and 
what  it  may  not  do,  is  an  illustration  of  how  greatly  liberty  may 
be  thus  prostituted  to  the  worst  forms  of  tyranny. 

This  Association,  in  the  year  1851,  met  at  Brighton,  and 
framed  a  series  of  resolutions  against  homcsopathy,  order* 
ing  the  expulsion  from  the  Association  of  homoeopaths,  of 
physicians  and  surgeons  partially  practising  homoeopathy,  and 
of  physicians  and  surgeons  who  met  either  of  the  above  classes 
in  consultation.  Though  illiberal,  the  Society  had  an  undoubted 
right  to  frame  these,  or  any  other  rules  which  should  meet  the 
wishes  of  the  majority  of  the  members  present ;  but,  after  some 
years,  finding  that  homoeopathy  still  continued  to  rise  and  spread, 
in  spite  of  the  "  rules  "  against  it,  the  British  Medical  Associa- 
tion lay  claim  to  the  further  right  of  forbidding  others,  not 
members  of  their  Society,  from  meeting  with  physicians  and 
surgeons  practising  homoeopathy ;  holding  up  to  them  iti  ter- 
rorem  the  active  hostility  of  the  whole  Association,  if  they  dared 
to  set  its  veto  at  defiance.  This  active  hostility  took  the  prac- 
tical form  of  threatening  to  withdraw  consultation  practice  from 
the  recalcitranst,  and  of  opposing  their  election  to  any  post  of 
honour  or  trust. 

In  1858,  this  new  policy  was  brought  to  bear  against  Mr. 
Fergusson,  who  was  forced  to  yield  to  this  tyrannous  trades- 
unionism,  and,  in  1862,  it  has  been  similarly  brought  to  bear 
against  Mr.  Adams.  The  following  is  a  relation  of  the  facts 
which  led  to  the  latter  attack. 

A  few  weeks  since,  I  desired  to  obtain  a  first-rate  surgical 
opinion  upon  a  case  under  my  care.  The  leading  local  sur- 
geons had,  on  former  occasions,  refused  to  meet  me,  I,  therefore, 
did  not  again  seek  their  aid,  but  wrote  to  my  friend,  Mr. 
William  Adams  (of  the  Orthopaedic  and  Great  Northern  Hos- 
pitals), who  very  promptly  and  kindly  responded  to  my  call. 


48S  Medical  Terromm, 

There  was  no  medical  question  inyolved  in  the  oonsaltatioa,  the 
point  under  discussion  being  one  of  a  purely  surgical  nature. 

Some  weeks  after  this  consultation,  Mr.  Adams  reoeived  4 
letter  from  Mr.  Helm,  a  young  surgeon  of  this  town,  and  atill 
an  under-graduate  of  the  university.  To  this  letter,  Mr.  Adiuna 
replied,  it  led  also  to  others,  and,  finally,  Mr.  Helm  published 
the  whole  correspondence  in  the  British  Medical  Journal,  of 
May  24  th.  In  tbe  same  number  of  the  Journal^  there  appeared 
a  leading  article,  in  the  usual  style  of  inveterate  and  undying 
hostility  to  homoeopathy,  blading  Mr.  Adams  severely,  because 
he  would  not  consent  to  join  the  surgeons  of  this  town  in  re- 
fusing to  meet  me. 

With  these  few  remarks,  I  will  lay  before  you  the  correspon- 
dence and  leading  article  referred  to,  as  weU  as  some  other 
papers  bearing  on  the  subject  under  discussion. 

MsniCAL   COKSULTATIOHS  WITH  HOXOBOPATHS. 

[The  following  correBpondence  has  been  forwarded  to  us  for 
publication ; — ] 

1. — Letter  from  Q,  F.  Helm^  Esq. 

2,  King's  Parade,  Cambridge,  May  3rd,  1862. 

Deab  Sir, — I  wish  to  call  your  attention  to  the  following  report 
just  now  current  amongst  some  members  of  our  profession  in  Cam- 
bridge.    The  report  is  as  follows : — 

A  homceopathic  practitioner  here,  being  in  difficulties  during  the 
treatment  of  a  surgical  case,  was  compelled,  a  few  weeks  since,  in 
consequence  of  the  repeated  refusals  of  the  surgeons  in  this  town  to 
give  any  countenance  to  the  homoeopathic  imposition,  to  seek  the 
assistance  of  a  London  surgeon ;  and,  according  to  the  words  of  a 
near  relative  of  the  patient,  '  Mr.  Adams,  the  great  chib  foot  man, 
came  and  gave  his  advice.' 

I  conclude,  from  your  connection  with  the  Orthopiedic  Hospital, 
and  from  your  numerous  writings  on  dub-foot,  that  this,  statement 
applies  to  yourself.  I  shall,  however,  be  very  glad  to  receive  from 
you  a  denial  of  this  report ;  for,  until  some  contradiction  of  it  is  put 
forth,  I  fear  we  must  attribute  to  you  a  support  of  hommopatbs, 
which  tbe  Cambridge  surgeons  refuse  to  give ;  particularly  as.  this  is 


hy  miliam  Bayes,  M.D.  42$ 

1  the  first  occasion  on  which  a  Mr.  Adams  is  repoirted  to  have  come 
tio  the  assistance  of  the  homoBopaths  here. 

I  am,  dear  sir,  iaithfullj  yours, 

W.  Adams,  Esq.  Geobge  F.  Hblm. 

2. — Letter  from  WiHiam  Adams,  Esq. 

5,  Henrietta  St.,  Cavendish  Sq.,  W.,  May  6, 1862. 

Deab  Sib, — On  the  6th  of  April,  I  went  down  to  Camhridge,  at 
the  request  of  Dr.  Bayes,  to  see  a  patient  who  was  then  under  his 
care,  and  supposed  to  require  a  surgical  operation.  It  was  not  for 
the  purpose  of  any  consultation  to  decide  upon  the  treatment  to  he 
adopted;  hut  if  I  considered  an  operation  necessary,  the  patient 
would  at  once  he  placed  under  my  care,  and  for  this  purpose  removed 
to  town.  I  found  that  it  was  not  necessary  to  perform  any  operation 
at  the  present  time ;  and,  therefore,  left  the  patient  without  expres- 
nng  any  opinion  as  to  the  medical  treatment  adopted  in  this  case, 
ahout  which  I  was  not  asked.  There  was  not  the  least  necessity  for 
any  consultation;  neither  was  any  consultation  held.  The  sole 
question  which  Dr.  Bayes  wished  me  to  determine  was,  whether  at 
that  time  the  performance  of  an  operation  would  afford  relief  to  his 
patient ;  and  if  so,  whether  I  would  take  the  case  under  my  care  for 
this  purpose. 

In  reference  to  the  general  question  of  consultations  with  homoeo- 
pathic practitioners,  I  may  state  that  I  hold  it  utterly  impossihle  that 
any  such  consultations  can  he  held ;  as  our  practice  can  never  he 
based  upon  the  same  principles,  and  there  can  be  nothing  in  common 
between  us ;  hut,  in  my  opinion,  to  have  a  case  placed  wholly  and 
entirely  under  yonr  care  by  a  homoeopathic  practitioner,  is  a  very 
different  thing  to  meeting  him  in  consultation,  to  determine  the 
treatment  to  be  adopted ;  and  in  such  cases,  the  patients  readily  sub- 
mit to  take  the  ordinary  medicines  and  doses  of  our  recognised 
practice  whilst  under  surgical  treatment ;  though,  perhaps,  afterwards 
they  may  return  to  their  homoeopathic  ideas.  I  may  very  safely  say 
that  neither  in  London  nor  elsewhere  have  I  ever  held  a  consultation, 
ox  treated  a  case  in  conjunction  with  any  homoeopathic  practitioner. 

With  regard  to  Dr.  Bayes,  who,  I  believe,  is  now  considered  to  be 
a  homoeopathic  practitioner,  I  may  add  that  I  have  been  intimately 
acquainted  with  him  as  a  personal  friend  for  about  fifbeen  years,  and 
with  his  wife's  family  for  a  much  longer  period.     I  knew  him  first 


424  Medical  Terrorism, 

when  he  was  an  allopathic  practitioner,  ki  good  general  practioe,  in 
the  neighbourhood  of  London,  and  afterwards  at  firighUuiy  ^vrhere  ho 
practised  as  a  physidan,  and  was  attached  for  some  years  to  the 
Brighton  Dispensary.  His  health  obliged  him  to  trarel;  and,  I  be- 
lieye,  after  his  return  fix>m  the  continent,  his  views  in  medicine  had  a 
homoeopathic  tendency,  and  he  afterwards  settied  in  Cambridge, 
where  I  have  occasionally  yisited  him  as  a  friend ;  and,  on  the  occa- 
sion aDuded  to,  Mrs.  Adams  accompanied  me  on  a  yisit  to  Mrs.  Bajes 
for  a  few  days. 

Of  course,  a  change  of  medical  opinions  ought  not  to  be  allowed  to 
interfere  with  priyate  and  family  friendship ;  and  Dr.  Bayes  wrould 
have  too  much  good  sense  and  gentlemanly  feeling  to  place  any  friend 
in  a  false  position  with  regard  to  consultations. 

Very  faithfully  yours, 

O.  F.  Hehn,  Esq.  Wm.  Abaics. 

Z.— Letter  from  G.  F.  Helm,  Esq. 

2,  King's  Parade,  Cambridge,  May  9th,  1862. 

Deaji  Sib, — I  must  thank  you  for  your  very  candid  letter  of  May 
5th ;  but  as  I  am  in  danger  of  misunderstanding  some  of  its  contents, 
I  shall  be  much  obliged  to  you  if  you  will  inform  me  whether  you 
examined  the  patient  referred  to  in  our  letter  in  company ^with  Dr. 
Bayes ;  i.e.,  was  Dr.  Bayes  in  the  room  at  the  time  that  the  surgical 
examination  was  made  ? 

An  answer  to  this  question  will  enable  me  to  understand  your  ex- 
planation more  thoroughly. 

I  am,  dear  sir,  faithfully  yours, 
G.  F.  Helm,  Esq.  Geobge  F.  Helv. 

Z.-— Letter  from  Wm.  Adams,  Esq. 

5,  Henrietta  St.,  Cavendish  Sq.,  W.,  May  12,  1862. 
DzAB  Sib, — I    should  have  replied   to  your  note   earlier,   but 
was  absent  from  town,  and  returned  from  St.  Leonards  only  this 
morning. 

With  regard  to  the  question,  whether  Dr.  Bayes  was  in  the  room 
at  the  time  I  made  the  surgical  examination  of  the  patient  at  Cam- 
bridge, I  have  no  hesitation  in  saying  that  he  was  in  the  room  at  the 


by  William  Bayes,  M.D.  425 

time.  Although,  la  deference  to  extreme  opinionB  on  this  point,  it 
might  have  heen  as  well  to  have  avoided  his  presence  on  the  occa- 
non,  to  which  my  friend.  Dr.  Bayes,  would  very  readily  have  con- 
sented ;  yet,  conscientiously,  I  could  not  feel  that  any  ohjection  ought 
to  he  taken  to  it,  as  the  object  was  merely  to  hand  the  case  wholly 
and  entirely  over  to  my  care,  if  I  thought  an  operation  would  be  of 
any  service  to  the  patient.  The  medical  treatment  of  the  case  was 
never  touched  upon ;  neither  do  I  know  what  medicines  had  been 
given. 

The  distinction  between  receiving  a  patient  from  a  homoeopath- 
all  homoeopathic  attendance  and  treatment  ceasing  from  that  moment 
— ^and  continuing  to  attend  a  patient  conjointly  with  a  homoeopath,  is 
so  broad,  and  the  circumstances  so  dissimilar,  that  they  cannot  be 
confounded  when  any  spirit  of  justice  prevails. 

I  do  not  believe  that  any  surgeon  in  London  would  refuse  to  re- 
ceive a  patient  from  a  homoeopath,  either  sent  by  letter,  or  by 
personal  introduction;  nor  do  I  believe,  whatever  may  have  been 
done  in  past  times,  that  any  surgeon  of  repute  would  attend  a  patient 
conjointly  with  a  homoeopathic  practitioner;  indeed,  I  have  never 
been  asked  to  attend  a  patient  conjointly  with  a  homoeopath ;  but,  as 
I  remarked  in  my  former  letter,  when  surgery  becomes  necessary, 
the  patients  readily  give  up  homoeopathy,  and  submit  to  our  ordinary 
allopathic  treatment,  and  afterwards  return  to  homoeopathy. 

Very  truly  yours, 

G.  F.  Helm,  Esq.  Wm.  Adams. 

5. — Letter  Jrom  Oeorge  F,  Helm,  Esq. 

d.  King's  Parade,  Cambridge,  May  15th,  1862. 
DsAJt  Sir, — The  distinctions  which  you  try  to  draw  in  your  two 
letters  now  before  me,  between  holding  consultations  with  homoeopaths, 
and  examining  patients  in  the  presence  of  such  persons,  are  so  ex- 
tremely minute  as  to  be  quite  unintelligible  to  my  mind ;  for,  if  afler 
going  into  the  country  at  the  request  of  a  homoeopath,  the  surgeon  is 
introduced  to  the  patient's  room  by  him,  and  examines  the  patient  in 
hie  presence^  then  I  consider,  and  I  think  the  majority  of  the  profes- 
sion will  concur  with  me,  that  a  consultation  has  been  held  ;  and  this 
undoubtedly  is  the  impression  which  such  an  interview  leaves  in  the 
mind  of  the  patient  and  his  friends.  I  cannot,  therefore,  consider 
your  explanations  as  in  any  way  contradicting  the  reports  to  which  I 


426  Medical  Terrariim, 

have  drawn  your  attention:  you  have  done  what  the  Cambridge 
Biu^geona  hare,  from  a  senae  of  professional  honour,  repeatedly  refuaed 
to  do ;  and,  therefore,  I  cannot  but  attribute  to  you  a  support  of 
hooMBopathy  whkh  they  reAise  to  gire. 

I  have  not  discussed  your  letters  in  detail,  as  it  19  my  wish,  with 
your  permission,  to  bring  them  to  the  notice  of  the  professioii  at 
large,  through  the  medium  of  the  British  Medical  Journal^  wliera 
your  conduct  in  this  matter  will  be  discussed,  and  verdicts  given—* 
possibly  of  approval — but  most  likely  in  accordance  with  the  Toiy 
strong  opinions  which  I  entertain  on  the  subject. 

I  am,  dear  sir,  faithfully  yours, 

Oeobge  F.  Helic. 

6. — Letter  from  Wm,  AdanUy  Esq^ 

5,  HenrietU  St.,  Cavendish  Sq.,  W.,  May  16,  1862. 

DsAB  SiB, — Although  my  letters  were  not  written  with  any  view 
to  their  publication,  and  matters  of  a  private  nature  were  alluded  to, 
still  essentially  they  contain  my  own  opinions  and  conviction  in  rela- 
tion to  the  matter  discussed,  and  you  are  quite  at  liberty  to  publish 
them. 

The  distinction  which  I  draw  between  attending  patients  con- 
jointly with  homoeopaths,  and  receiving  patients  for  surgical  treat- 
ment from  homoeopaths^-homoeopathy  ceasing  from  that  time — ^must, 
I  feel  assured,  be  recognised  and  acted  upon  in  practice  by  all 
consulting  surgeons. 

Very  faithfully  yours, 

G.  F.  Helm,  Esq.  Wm.  Adaks. 


On  reading  over  the  above  correspondence,  one  can  bat  con- 
fess to  some  degree  of  astonishment,  at  the  coolly  dictatorial 
manner,  in  which  a  young,  untried  man,  still  "  in  statu  pupil- 
lari"  intrudes  his  budding  ethical  idea  upon  one  who  has 
already  won  high  professional  position,  and  a  name  and  reputa- 
tion as  an  accomplished  pathologist,  a  skilful  and  inventive 
operator,  and  an  excellent  teacher  of  his  art  in  a  metropolitan 
medical  school.  Looked  at  from  this  point  of  view,  letters  1> 
3,  and  5  bear  the  aspect  of  an  impertinence^  and  I  am  sot 


By  William  Bayes,  M.D.  407 

smprised  to  hear  that  they  are  regarded  in  this  light,  by  the 
Teal  heads  of  the  profession,  the  Hospital  Sargeona  of  London. 

Bot  not  80  do  they  appear  to  the  Editor  of  the  '*  British 
Medical  Journal/'  With  the  true  Milesian  spirit,  he  grasps  the 
hand  of  the  boy  that  raises  the  shout  for  the  fight,  and  rushes 
down  to  the  battle  with  these  words  : — 

British  Medical  Journal^  Saturday ^  May  24M,  1862. 

**  MEDICAL  CONSTJLTATIOKS  WITH  HOMOEOPATHS. 

*'  We  much  regret  to  find  that  we  have  again  to  call  the  attention 
of  our  readers  to  the  subject  of  medical  consultations  with  homoeo- 
paths. At  another  page  will  be  found  a  correspondence  on  this 
topic,  which  has  been  forwarded  to  us  for  publication,  between 
Mr.  Adams  of  tjie  Orthopsedic  Hospital  and  Mr.  Helm  of  Cam- 
bridge. 

**  There  lives,  it  appears,  at  Cambridge  a  homceopath,  with 
whom,  most  properly,  the  medical  gentlemen  of  that  town  refuse  to 
hold  any  kind  of  professional  intercourse.  The  homoeopath,  there- 
fore, has  to  cast  abroad  for  assistance  when  he  requires  it ;  and,  in 
the  present  case,  looking  to  the  metropolis,  invites  Mr.  Adams  tq 
his  assistance.  Mr.  Adams  accepts  the  invitation,  which  comprises 
simply  the  demand  that  Mr.  Adams  is  solely  to  examine  the  patient, 
and  to  decide  whether  or  not  an  operation  is  requisite ;  if  the  opera- 
tion be  requisite,  then  the  patient  is  to  be  delivered  over  into  thQ 
entire  charge  of  Mr.  Adams.  Mr.  Adams  and  the  homoBop;ath 
eventually  do  meet ;  and  the  decision  arrived  at  by  the  two,  or  by 
Mr.  Adams  alone,  is,  that  no  operation  is  required.  Mr.  Adams 
therefore  retires,  and  the  homoeopath  is  left  in  undoubted  possession 
— we  may  say,  complete  master  of  the  situation. 

^  Now  this  conference,  Mr.  Adams  says,  is  not  a  consultation  vrith  Si 
homoeopath.  We  entirely  differ  in  opinion  from  Mr.  Adams  in  this  ; 
and  we  are  certain  that  the  profession  does  likewise.  Indeed,  after  the 
clear  and  unmistakable  position  which  the  profession  has,  we  may 
say,  unanimously  assumed  on  this  subject,  we  are  surprised  to  find 
that  any  medical  man  could  have  doubts  as  to  the  right  line  of  con- 
duct which  he  should  pursue  in  such  a  case.  It  is  as  clear  to  us  as 
plain  sense  can  make  it,  that  the  practice  assumed  and  defended  by 
Mr.  Adams  is  a  direct  encouragement  of  the  deception  of  homoeo- 
pathy ;  and  we  are  satisfied  that  a  due  reconsideratbn  of  the  point 


428  Medical  Terrorism, 

will  force  upon  Mr.  Adams  himself  that  the  line  of  conduct  which  he 
has  chalked  out  is  in  a  false  direction. 

**  The  question  to  be  answered  is  plainly  this  :  Does  or  does  not 
the  meeting  with  a  homceopath,  under  the  conditions  described  by 
Mr.  Adams  (and  it  is  mere  trifling  with  common  sense  to  say  that 
such  a  meeting  is  not  a  consultation),  encourage  homoeopathy  and 
its  practitioners  ?  To  this  question  there  can  be  but  one  answer  :  It 
does  encourage  the  thing,  and  the  men  who  practise  it.  This  is 
what  you  thereby  do,  you  publicly  in  the  face  of  the  public — silently 
and  tacitly  admit  that  homoeopathic  treatment  is  what  a  patient  may 
innocently  submit  to.  It  is  vain  to  say  that  no  question  of  homoeo- 
pathy comes  up  at  the  conference  ;  your  silence  is  eloquent  in  its 
favour.  If  homoeopathy  be  a  quackery,  you  tacitly  foster  the 
quackery;  you  enter  no  protest  against  the  treatment  which 
the  patient  had  undergone  before  you  visited  him ;  you  enter 
no  protest  against  the  treatment  which  the  patient  may  un- 
dergo  when  you  leave  him.  You  quietly  look  on,  and,  though 
urgent  medical  aid  may  be  required  for  the  patient*s  cure, 
though  accidents  may  arise  in  the  progress  of  his  complaint  which 
may  demand  medical  treatment — nay,  knowing  that  contingencies 
may  spring  out  of  his  sick  condition  in  which  the  patient's  very  life 
may  be  positively  sacrificed  if  medical  treatment  be  not,  and  if 
homoeopathic  folly  be,  adopted — ^you  remain  silent.  It  is  no  con- 
cern of  yours,  you  say,  if  the  man  is  silly  enough  to  subject  himself 
to  such  a  treatment ;  let  him  pay  the  penalty  of  his  folly. 

**  It  is  useless  to  pretend  the  contrary.  Meetings  of  this  kind  with 
homoeopaths,  are,  in  the  eyes  of  the  patient,  whatever  they  may  be 
in  the  eyes  of  the  surgeon,  a  distinct  recognition  both  of  homoeo- 
pathy  and  of  the  homoeopath.  We  would  go  further ;  and  we  will 
assert  that  the  surgeon  is,  under  such  circumstances,  responsible  for 
any  injury  which  may  thereafter  happen  to  the  patient  through  want 
of  proper  medical  treatment.  In  fact,  is  it  not  as  clear  as  the  day 
that  the  patient  suffering  under  such  injury  may  afterwards,  with 
perfect  justice,  turn  round  on  the  surgeon  and  accuse  him  of  having 
silently  looked  on,  and  never  warned  him  against  the  possible  contin- 
gency. What  would  the  surgeon  answer  when  thus  accused  by  the 
patient  ?  *  You  never  told  me  that  my  life  might  be  sacrificed ;  you 
never  said  that  you  knew  homoeopathy  to  be  a  deceit  and  snare.  It 
is  true  I  never  asked  you  the  question ;  but  what  right  had  you,  with 
^our  better  knowledge  to  witness  tacitly  my  blind  delusion,  to  give 


By  William  Bayes,  M.D.  429 

me  no  word  of  warning.  Nay,  am  I  to  believe  that  you  would  have 
come  at  the  call  of  the  homoeopath,  when  other  surgeons  had  refused 
to  do  8o,  if  yon  really  believed  the  thing  was  an  injury  to  me ;  that 
you  would  have  left  me  in  his  hands  practising  injuriously  upon  my 
body,' 

**  These  are  to  our  view,  the  unanswerable  objections  which  must 
be  taken  to  Mr.  Adams'  position  in  this  matter.  A  medical  man 
has  no  right,  under  any  circumstances  whatever,  to  attend  the 
call  of  a  homoeopath,  or  knowingly  to  meet  him  at  the  bedside  of 
the  sick. 

^  But  we  may  go  a  step  further  in  the  special  case  of  Mr.  Adams, 
and  say  that,  by  his  proceeding,  he  has  distinctly  recognised  the 
claims  of  homoeopathy  to  be  ranked  on  the  same  footing  with  medi- 
cine. This  was  the  compact  with  the  Cambridge  homoeopath  :  If 
an  operation,  which  we  presume  Mr.  Adams  was  to  perform,  were  pro- 
per, the  patient  was  to  be  placed  under  Mr.  Adams's  care ;  if  the  opera- 
tion were  not  proper  or  not  required,  the  patient  was  to  continue  under 
the  homoeopathic  treatment.  We  cannot  see  how  Mr.  Adams  can  say 
that  this  agreement  does  not  distinctly  mean  that — ^but  for  the  acci- 
dent of  an  operation — homoeopathic  treatment  was  quite  as  good 
for  the  patient  as  ordinary  medical  treatment ;  or  how,  under  such 
circumstances,  any  other  inference  could  be  drawn  than  that  the 
merits  of  homoeopathy  and  of  legitimate  medicine  are  equal,  and  that 
these  two  forms  of  treating  disease  may  be  substituted  one  for  the. 
other  according  to  the  judgment  of  the  practitioner  or  the  fancy  of 
the  patient. 

**The  surgeons  of  Cambridge,  iu  the  course  they  have  taken, 
have  a  right  to  the  support  of  the  profession.  They  have  acted 
an  honourable  part — they  have  refused  to  do  what  Mr.  Adams  has 
done.'*  * 

In  this  leading  article  there  are  four  points  to  which  I  would 
direct  the  attention  of  the  profession. 

Firstly — ^Tbe  assumption  that  the  practice  of  homoeopathy,  by 
a  legally  qualified  medical  man,  is  so  grave  an  oiOfenoe,  that  it 
necessarily  casts  him  out  from  the  pale  of  the  profession. 

Secondly — The  assertion  that  a  man,  so  practising,  is  a 
"  homoeopath"  i.e.,  a  "  medical  sectarian,"  with  whom"  most 
properly"  the  orthodox  "refuse  to  hold  professional  inter- 
course." 


480  Medical  Terrorism, 

Thirdly — ^The  assertioQ  that  Mf.  Adams,  in  meeting  m^,  cotn- 
tnitted  a  professional  fault,  and  that  "  a  medical  man  has  no 
rights  under  any  circumstances  whatever,  to  attetid  this  call 
of  a  homoeopath,  or  knowingly  to  meet  him  at  the  bedside 
of  the  sick," 

Fourthly — ^The  assumption  of  the  power  to  dictate  to  Mr- 
Adams  what  his  course  shall  be — being  a  direct  interference 
with  the  right  of  private  judgment. 

To  these  four  assertions  I  answer,  firstly — That  the  law  dis- 
tinctly provides  for  the  freedom  of  medical  opinion,  and  pro- 
tects the  developments  of  science  from  the  cramping  effects 
of  penal  bye-laws,  or  other  prohibitive  enactments,  on  the  part 
of  the  Colleges  or  Universities.  I  therefore  say  that  to  exercise 
the  liberty  which  the  law  expressly  provides  for  me  (see  clause 
28  of  the  New  Medical  Act)  cannot  be  an  oflEenee  against  my 
profession. 

Seoondly-^I  deny  that  a  man  who  adopts  bomoeopathio 
praotioci  necessarily  becomes  a  homoeopath,  i.e.,  a  medical  sec- 
iarian.  He  still  remains  a  physician  or  a  surgeon,  and  ought 
no  more  to  be  called  a  homoeopath,  than  a  man  who  adopts  the 
late  Br.  Todd  s  principles  ought  to  be  called  a  *'  stimulator." 

Thirdly — I  hold  that  Mr.  Adams  could  not  have  refused  to 
meet  me,  without  at  the  same  time  behaving  with  want  of  pro- 
fessional courtesy.  Mr.  Adams  met  me  as  a  surgeon,  in  a 
surgical  case.  Difference  of  medical  views  offered  no  bar  to  our 
meeting  in  this  case,  since  no  medical  question  was  involved. 
To  have  refused  to  meet  me  would  have  been  a  violation  of 
professional  etiquette  and  a  breach  of  Christian  charity.  In 
speaking  on  this  point,  a  distinguished  London  surgeon  wrote 
thus  to  me — "  they  have  no  right  to  complain  if  we  meet 
either  for  the  purpose  of  diagnosis  or  to  determine  any  sur- 
gical point"  To  this  I  think  all  the  better  class  of  our  oppo- 
nents would  agree.  But  I  would  go  a  step  further  and  say  that 
the  holding  of  opposite  opinions  on  medical  science.  Offers  no 
barrier  .to  a  consultation.  It  might  enhance  the  difficulty  of 
coming  to  an  agreement,  but  the  declining  a  case  should  come 
after  such  a  cotisultation  and  only  when  agreement  was  proved 
impossible.    Indeed,  in  the  present  day,  the  chief  use  of  a 


By  William  Baye$,  M,D.  431 

oonsoltation  is  to  determine  some  difficult  point  of  diagnosis,  lind 
in  this»  as  it  involves  pathological  and  physiological  dicussion 
only,  the  physicians  of  hoth  schools  could  meet  in  accord. 

The  refusal  to  meet^  in  these  cases,  can  only  proceed  from  the 
spirit  of  '*  trades-union  persecution  :*  from  an  attempt  to  put 
down  those  who  practise  homceopathy  by  making  their  path 
difficult,  and  by  holding  over  the  public  the  threat  that  they 
must  expect  no  further  assistance  in  a  difficult  case,  if  they  call 
in  a  physician  who  practises  homoeopathy. 

But  persecution  never  yet  trod  out  the  flame  of  truth.  Listen 
to  the  words  of  the  Editor  of  the  "  London  Medical  Review," 
an  allopathic  journalist.  He  says,  in  a  letter  published  in  this 
very  number  of  the  "  British  Journal"  (May  24),  "It  is  idle  for 
UB  to  contend  that  homoeopathy  is  a  subject  we  all  ought  to 
ignore,  right  or  wrong,  it  has  somehow  or  other  got  a  hold  on 
the  public  mind  which  it  is  vain  to  dispute,  as  it  is  con- 
stantly obtruded  upon  us  in  practice  in  a  way  that  is  sin- 
gularly unpleasant.  I  venture  to  say,  there  is  scarcely  a  medical 
man  in  the  kingdom  who  has  not  felt  the  influence  of  this 
'  delusion'  on  his  professional  income ;  and  it,  therefore,  behoves 
us  all  to  look  at  this  question  in  some  way  different,  to  that  in 
which  it  has  hitherto  been  regarded;  for  I  fear  that  the  'delu- 
sion' is  rather  increasing  than  otherwise. 

"  Now,  sir,  what  has  been  the  conduct  of  the  medical  press 
on  the  question  for  years  past  ?  Has  it  not  been  one  continued 
tirade  of  illiberal  persecution  f — and  what  has  been  the  re- 
sult? Why,  as  ever  happens  in  all  persecutions,  the  persecuted 
excite  the  greatest  amount  of  attention  and  sympathy." 

It  is  cheering  to  hear  the  "notes  of  nobler  song"  from  the 
hitherto  discordant  ranks  of  our  literary  opponents. 

Fourthly — It  scarcely  is  needful  to  do  more  than  to  point  out 
that,  whatever  may  be  the  feelings  of  the  editor  of  the  "British 
Medical  Journal,"  or  those  of  the  Cambridge  doctors,  they  clearly 
have  no  right  to  dictate  to  Mr.  Adams  what  is  his  line  of  duty 
This  is  "  trades'uniotiism"  in  its  worst  phase.  The  individual 
surgeons  have  an  undoubted  right  to  cast  down  their  scalpels 
before  the  idol  of  their  prejudice,  but  they  have  no  right  to  in- 
sist on  Mr.  Adorns  joining  in  an  idolatry  he  detests. 


488  Medical  TerroriMm, 

I  forwarded  the  following  letter  embodying  these  ideas  to  the 
editor,  which  he  published  in  the  "Journal  "for  May  81  St.: — 

KEDICAL   C0V8ULTATI0N8  WITH   H0H(E0FATH8. 

Letter  Jrom  WtUtam  Bayee^  M,D, 

Sib,-- I  appeal  to  your  sense  of  justice  to  insert  these  few  lines  In. 
reply  to  an  attack  upon  my  professional  reputation  which  appeared  in 
your  '*  Journal*'  of  May  24th. 

I  have  also  some  further  claim  upon  your  space,  as  an  old  member 
of  the  British  Medical  Association ;  from  which  I  withdrew  in 
consequence  of  the  policy  adopted  by  the  Association  towards 
those  members  of  the  profession  who  adopted  the  practice  of  homceo- 
pathy. 

It  is  not  to  discuss  this  policy  that  I  now  address  you ;  but  to 
draw  your  attention  to  a  very  important  error  in  Mr.  Helm's  note  ; 
Tiz.,  his  having  characterised  me  as  a  honuBoptUh. 

We  all  remember  the  result  of  the  discussion  before  a  certain 
learned  society,  as  to  why  a  glass  of  water  toUh  afieh  m  t^  weighed 
less  than  a  glass  of  water  containing  no  fish ;  and  how,  after  yeiy 
numerous  and  long  arguments  had  been  heard  on  both  sides,  it  was 
at  last  determined  to  weigh  both  glasses,  and  ascertain  if  the  asser- 
tion were  true. 

Now,  Mr.  Helm  might  have  spared  himself  much  trouble  had  he 
first  ascertamed  whether  I  was  a  homceopath. 

In  a  reply  I  wrote  to  Mr.  Braithwaite's  Temperate  JSxammatton 
of  HonuBopathy  (^Two  sides  to  a  Questton)^  I  distinctly  state  that  *'  I 
object  to  the  title  of  homceopath ;  its  assumption  savours  of  sectarian- 
ism." I  am  content  with  the  title  of  physician  and  surgeon.  I  am 
an  extra-licentiate  of  the  London  College  of  Physicians  and  a  mem- 
ber of  the  College  of  Surgeons  of  England ;  and  by  virtue  of  these 
diplomas,  I  am  bound  to  practise  my  profession  conscientiously,  and 
to  prescribe,  in  every  case  which  comes  under  my  care,  to  the  best  of 
my  judgment^  unswayed  by  prejudice,  and  undeterred  by  threats  and 
intimidation. 

It  may  offend  you,  and  some  other  members  of  the  British  Medical 
Association,  that  I  have  examined  into  and  adopted  homoeopathj 
into  my  practice ;  but  my  duty  clearly  binds  me  to  use  my  own  judg- 
ment and  not  yours.     I  do  not  say  this  offensively. 

It  may  also  be  an  offence  to  certain  homoeopaths  that  I  have  occa- 
sional resort  to  allopathic  means ;  but  I  am  not  deterred  by  this  from 


By  William  JBdyes;  MJ).  438 

giviiig  an  opiate  or  an  aperient ;  nor  from  using  an  enemil  or  Apply- 
ing a  mustard  plaster ;  nor  from  using  galvanism  or  cold  water  com- 
presses ;  if  my  judgment  tells  me  that  any  one  of  these  is  best  for 
my  patient. 

This  is  the  course  I  conceive  it  to  be  my  duty  to  pursue  in  prac- 
tice.  If  I  have  erred  in  judgment,  I  have  at  least  the  satisfaction 
of  feeling  that  I  have  kept  those  solemn  engagements  into  which  I 
entered  when  I  became  a  licentiate  of  the  College  of  Physicians,  and 
a  member  of  the  College  of  Surgeons.  I  have  striven  to  maintain  a 
strict  eclecticism,  to  discard  sectarian  views  and  prejudices,  and  to 
hold  myself  ever  open  to  conviction.  I  therefore  hold  that  no  man 
has  more  right  to  call  me  a  homceopath,  than  he  would  have  to  call 
me  an  allopath,  a  hydropath,  or  a  galvanist.  If  I  have  used  any 
unprofessional  license  in  thus  exercising  my  judgment  in  the  choice 
of  the  remedies  I  have  employed,  I  am  ready  to  answer  for  it  when 
summoned  to  do  so  by  the  abovenamed  Colleges.  I  have  acted,  and 
shall  continue  to  act,  openly ;  and  hold  myself  ready,  at  any  time, 
to.  defend  my  conduct  before  my  professional  brethren. 

Holding  these  views,  I  altogether  deny  the  right  of  the  physicians 
and  surgeons  of  this  town  to  refuse  to  consult  with  me.  You  say, 
^  The  surgeons  of  Cambridge,  in  the  course  they  have  taken,  have  a 
right  to  the  support  of  the  profession." 

To  this  I  answer,  they  have  behaved  towards  me  in  an  unprofes- 
sional manner,  in  refusing  to  meet  me ;  and  in  an  un-English  manner, 
in  condeming  me  unheard. 

'  The  late  Dr.  Bright  to  my  personal  knowledge,  prescribed 
Kuspini's  s(yptic  in  a  case  of  hsematemesis.  Was  he  a  quack  be- 
cause be  prescribed  a  (]^uack  remedy  ? ,  Nearly  all  the  physicians  and 
surgeons  in  England  prescribe  James's  powder,  an  empirical  re- 
medy.    Does  this  make  them  all  empirics  ? 

Many  physicians  and  surgeons  in  London  and  elsewhere  prescribe 
aconite  in  inflammations  and  fevers,  arnica  in  wounds  and  bruises, 
belladonna  in  scarlet  fever,  and  as  a  prophylactic  against  scarlet 
fever.  Does  this  make  them  homcQopaths  ?  Nay,  I  am  told  that 
those  Tery  men  who  refuse  to  'meet  me  because  I  prescribe  homoe- 
opathically,  do  so  themselves  without  reproach.  I  heard  of  a  case  of 
purulent  ophthalmia,  under  one  of  the  surgeons,  having  been  cured 
by  the  application  of  gonorrhceal  matter  to  the  eye ;  and  that  another 
of  the  surgeons  had  used  the  third  dilution  of  belladonna  in  another 
case  with  good  effect. 

V0T„    XX.,  NO.   LXXXI. — JuLT,    1862.  2    B 


484  Medical  Terrari$m, 

'  What  then  oonBtitutet  a  homaopath  ?  If  the  use  of  two  or  three 
homoeopathic  remedies  does  not  make  a  man  a  homcBopaU^  how 
tnwnj  are  required  to  produce  that  result  ?  Will  the  use  of  fifty  do 
it  ?  or  one  hundred  ?  or  three  hundred  ?  Or,  perhaps,  the  transmn-* 
tation  of  a  physician  into  a  homoeopath  does  not  result  from  the  use 
of  a  numher  of  homoeopathic  remedies;  hut  comes  from  his  confeas- 
mg  to  their  use.  To  use  aconite,  anuca,  and  helladonna,  may  be 
lawful  and  right ;  hut  to  acknowledge  that  they  are  used  homoeopftthi* 
caUy  may  he  a  deadly  sin.  The  medicines  may  he  used ;  hut  their 
effect  must  not  he  ascribed  to  their  homoeopathicity.  Our  greatest 
poet  says : 

'*  The  rose  by  any  other  name  would  smell  as  sweet;" 

but  in  matters  of  science  it  is  usually  considered  most  oonducdve  to 
advancement  to  call  all  things  by  their  right  names.  I  see  no  justice 
in  holding  a  man  up  to  professional  reprobation  because  he  accepts 
the  theory  of ''similars"  as  an  explanation  for  certain  facts  which 
cannot  otherwise  be  accounted  for. 

In  my-  opinion,  no  man  desenres  the  title  of  homoeopath  unless  he 
confines  himself  solely  to  homoeopathy  in  his  practice.  Such  a  man 
ceases  to  be  a  physician,  in  the  wide  sense  of  the  term.  On  this 
point,  I  have  always  spoken  as  strongly  as  you  would  do ;  but  the 
use  of  homoeopathic  treatment,  so  far  as  judgment  and  experience 
prove  it  to  be  advantageous  to  a  patient,  does  not  appear  to  me 
to  constitute  a  man  a  homoeopath,  nor  to  give  the  members  of 
the  profession  any  right  to  stigmatise  the  physician  so  usmg  it» 
nor  to  withdraw  themselves  from  consultation  with  him. 

Finally,  let  me  assure  Mr.  Helm  and  the  other  members  of  my 
profession,  that  I  shall  not  look  on  it  as  an  unfriendly  act  if  he  or 
they  cite  me  before  any  legally  constituted  court-medical,  such  as 
before  the  College  of  Physicians  or  the  College  of  Surgeons.  I  will 
offer  every  facility  to  a  full  inquiry,  and  will  accept  their  decision  on 
the  matters  in  dispute ;  but  I  must  protest  against  the  un-English 
and  unprofessional  proceedings  by  which  the  members  of  this  tovra 
have  sought  to  blacken  my  reputation. 

I  am,  etc., 

WiLLiAH  Bates. 

Cambridge,  Iday  25tb,  1862. 


By  William  Bayes,  M.D.  486 

To  this '  letter  the  Editoc  vonchsafed  a  reply  in  a  leading 
article  in  the  same  number^  as  under  :— 

Leadmy  Article^  extracted Jrom  the  British  Medical  Journal^ 

May  ZXet^ 

"WHAT  IS  ▲  HOHCEOPATH? 

«  We  have  more  than  once  been  forced  to  argue  with  members  of 
the  profession  as  to  what  does  and  what  does  not  constitute  a  pro- 
fessional consultation  with  homcBopaths ;  though,  at  the  same  time, 
we  have  always  felt  that  if  men  would  only  listen  to  common  sense 
as  their  guide,  instead  of  to  their  private  interests,  there  never  would 
have  been  any  need  for  such  an  argument. 

**It  appears  that  there  are  individuals  possessing  the  title  of 
Doctors,  who  practise  homceopathy,  and  yet  do  not  know  what  a 
homoeopath  is.  At  another  page  will  be  found  a  letter  from  Dr. 
Bayes,  the  gentleman  alluded  to  (in  a  correspondence  published  in 
last  week's  '  Journal')  as  the  homoeopath  with  whom  Mr.  Adams, 
of  the  Orthopaedic  Hospital,  had  held  medical  consultation.  Dr. 
Bayes,  though  he  practises  homoeopathy,  declares  that  he  is  not  a 
homoeopath.     He  feels  insulted  at  the  insinuation. 

**  We  would  call  attention  to  his  epistle,  because  it  shows  (If  any- 
thing more  were  wanted  as  a  proof)  so  clearly  the  deceptive  cha- 
Tacter,  in  the  face  of  the  public,  of  the  thing  which  goes  by  the 
name  of  homoeopathy.  Dr.  Roberts  of  Manchester,  as  our  readers 
may  remember,  lately  proved  to  demonstration  that  men  under  the 
guise  and  name  of  homoeopaths  are  practising  medicine  after  the 
manner  of  medical  men  ;  using  the  same  therapeutical  agents,  giving 
the  same  doses  of  drugs,  and  putting  their  patients  under  similar 
conditions  to  those  usually  prescribed  by  medical  men.  This  they 
do,  and  boast  themselves  to  be  homoeopaths;  and  so  induce  the 
public  to  set  down  the  good  results  of  their  practice  to  the  credit  of 
homoeopathy. 

Are  we,  then,  unjust  when  we  say  that  the  practice  of  homoeopathy 
is,  in  great  part,  dishonest  as  well  as  delusive?  And  ought  we 
not,  with  such  considerations — such  flagrant  proofs  of  dishonesty  in 
its  practice  before  us — to  be  especially  careful  to  eschew  all  profes- 
sional tampering  with  homoeopathy  ?  That  there  are  men  amongst 
the  homoeopaths,  who  honestly  believe  the  Hahnemannic  theory,  and 
honourably  practise  what  they  believe,  we  doubt  not  for  a  moment. 

S  E  2 


436  Medical  Terrorism^ 

And  all  we  can  fairly  do 'with  such  men  is  to  pity  their  simlplicity  Oand 
avoid  their  professional  acquaintance.  But,  as  we  have  already  said, 
and  know  right  well,  at  this  present  moment  the  great  body  of  the 
homoeopaths  are  acting  and  sailing  along  under  false  colours.  They 
pretend  to  one  thing,  and  practise  another;  and  doubly  practise  upon 
the  credulity  of  the  public,  acting  as  medical  men  under  the  title  oF 
homoeopaths ;  practising  medicine,  and  telling  their  patients  that  it 
is  homoeopathicaUy  they  are  being  treated. 

**  With  regard  to  Dr.  Bayes,  we  will  readily  admit  what  hie 
claims — that  he  is  acting,  in  all  he  does  in  this  matter,  according  to 
the  peremptory  dictates  of  his  reason,  his  knowledge,  and  his  con- 
science.    But  then  we  are  driven  to  the  conclusion  that  men  who 
honestly  believe  in  the  doctrine  of  *  similars'  possess  a  logic  of  their 
own.   There  is  no  arguing  with  them  according  to  the  ordinary  sense 
of  mankind.     What,  for  instance,  are  we  to  do  with  Dr.  Bayes,  as 
he  writes  himself  down  ?    He  practises  homceopathy,  but  is  indignant 
at  being  called  a  homceopath.     He  says  that,  by  acting  as  he  does, 
he  keeps  the  solenm  engagements  he  entered  into  with  the  Colleges 
to  which  he  belongs  ;  quite  ignoring  the  fact  that  if  he  had  told  the 
Colleges,  when  he  entered  into  those  engagements,  what  his  con- 
science now  suggests  to  him  as  the  right  line  of  practice,  the  Colleges 
would  have  entered  into  no  engagements  with  him.     He  is  bold  also 
in  now  offering  to  defend  himself  before  Colleges  which  have  no  powe^r 
over  him.     He  is  blind  to  the  fact  that  the  men  of  Cambridge  have 
just  as  much  right — are  just  as  much  bound  in  conscience — to  refuse 
to  meet  him,  as  he  is  to  practise  homoeopathy.     He  argues  that  Dr. 
Bright,  in  using   Ruspini^s  styptic,  was  as  much  of  a  quack  as  the 
man  who  practises  homoeopathy !     He   thinks   the  cases  similar ! 
Does  the  fact,  he  asks,  of  many  physicians  and  surgeons  prescribing 
aconite  and  belladonna  make  them  homoeopaths  ?  A  demi-homceopath, 
he  asserts,  may  be,  but  an  entire  homoeopath  ceases  to  be  a  physician. 
He  fully  goes  with  us  in  denunciation  of  the  homoeopath /H«r«  et  simple. 
What  will  the  homoeopathic  fraternity  say  to  this  new  confession  of 
modified  homoeopathic  credulity  ?     As  a  specimen  of  aberration  of 
logic,  and  particularly  as  a  proof  of  the  position  which  homoeopathy 
is  now  made  to  assume — ^its  shifting  shuffling  character — we  have 
called  attention  to  this  letter.'^ 

This  article  appeared  to  me  to  demand  an  answer,  especially 
as  the  Editor  entirely  "  begged  the  question  "  as  to  the  legaliiif 


By  William  Bayes,  M.D.  487 

of  the  liberty  we  claim  oh  matters  medicaL  I  thetefore  sent 
him  the  following  letter : — 

'*  To  the  Editor  of  the  British  Medical  Journal. 

'*  OONSITLTATIONS  WITH   HOM0BOPAIHI8TS. 

-  *^SiB, — I  have  to  thank  yon  for  your  courtesy  in  inserting  the 
letter  which  I  forwarded  to  you  last  week. 

*  **  I  shall  esteem  it  an  equal  favour,  if  you  will  grant  me  a  little 
space  in  your  valuable  pages,  to  notice  a  few  points  in  your  leading 
article  upon  that  letter ;  presuming  that  it  is  as  much  your  desire  as 
mine  to  elicit  truth,  and  not  to  darken  or  confuse  it. 

^In  controversial  writing  two  points  appear  to  me  to  be  per- 
manent Firstly^  to  give  your  opponent  credit  for  perfectly  good 
fSaith ;  and,  secondly ^  to  be  very  careful  that  all  the  /acta  should  be 
fully  and  accurately  stated. 

"  In  the  leading  article, '  What  is  a  Homceopath  ?'  you  speak  of 
my  consultation  with  Mr.  Adams,  as  a  *  medical  constdtatioh ;' 
whereas  it  was  purely  surgical^  and  one  in  which  no  point  of  difference 
as  to  medical  treatment  could  arise. 

«*  I  must  further  ask  your  forbearance  if  I  make  a  few  remarks 
on  the  latter  part  of  the  same  article,  in  which  you  say  that^  / 
ignore  the  fact  that,  if  I  had  told  the  Colleges^  when  I  entered  into 
my  engagements  toith  them,  what  my  conscience  now  suggests  as  the 
right  line  of  practice^  the  Colleges  wotdd  have  entered  into  no  engage* 
ments  with  me, 

**  It  does  not  appear  quite  clear  whether  you  mean  that  the  Col* 
leges  would  have  rejected  me,  if  I  had  told  them  that  I  intended  to 
practise  homoeopathy ,  or  whether  you  intend  to  convey  that  they 
would  have  refected  me,«  if,  after  having  proved  to  them  that  I  was 
acquainted  with  the  therapeutics,  &c.,  of  the  day,  I  had  added  that  I 
ehould,  nevertheless,  adopt  new  remedies  from  time  to  time,  and 
^  prescribe,  in  every  case,  according  to  my  judgment,'  the  new  or  the 
old? 

**  If  your  article  is  to  bear  the  latter  interpretation,  and  had  the 
pledge  been  exacted  from  each  candidate  that  he  would  promise  to 
restrict  himself  to  the  practice  and  the  remedies  in  vogue,  or  even  to 
the  theories  in  vogue,  on  the  day  of  his  examination,  I  opine  that  but 
few  new  members  would  have  been  enrolled  at  either  College. 

''  But  if  you  meant  that  had  I  confessed  myself  a  homoeopath. 


488  Medical 

tbej  would  not  have  patsed  me — to  this  I  feel  bound  to  answer.  In 
justice  to  myself,  that  at  the  time  I  obtained  my  degrees,  I  was 
entirely  ignorant  of  homcBopathic  practice,  and  had  a  very  imperfect 
and  unjust  Tiew  of  homceopathic  principles.  Had  I,  at  that  time 
known  or  practised  either,  I  should  haye  deemed  it  right  to  avow 
such  knowledge  and  such  practice. 

**  As  to  the  consequences  of  such  an  avowal,  it  is  scarcely  profit- 
able to  discuss  what  might  have  bem^  in  the  presence  of  what  is. 

Still  I  beliere  the  College  of  Physicians  has  not  attempted  to  in* 
terfeie  with  the  medical  liberty  of  its  candidates^  or  its  members, 
since  the  days  when  it  imprisoned  Dr.  Groenvelt  for  administering 
cantharides — and  the  College  of  Surgeons  has  passed  men  who 
have  made  no  secret  of  their  belief  in  homoeopathic  medication. 

**  The  position  which  I  assumed  in  my  letter,  when  I  challenged 
my  opponents  to  cite  me  before  the  Colleges,  is  not  an  empty  boast, 
but  b  made  to  illustrate  the  proposition,  that,  if  I  have  hrokem  no 
Imo,  I  ought  to  9ufer  no  jnaiiihment. 

^In  adopting  homcBopathy  into  my  practice,  I  have  broken  no  clause 
in  the  Medical  Act^  nor  any  bye-law  of  the  CoUege  of  Physicians  or 
College  of  Surgeons, 

**The  23rd  Clause  of  the  new  Medical  Act,  makes  it  illegal  for 
any  College  *  to  impose  upon  any  candidate  an  obligation  to  adopt 
or  refrain  from  adopting  the  practice  of  any  particular  theory  of  medi- 
cine and  surgery' — but  it  does  not  take  away  their  *  power'  over 
me  if  I  have  committed  any  act  unworthy  of  my  professional  honour, 

**  Nor  do  I  object  to  meet,  openly,  any  charge  of  non-professional 
conduct  (if  my  opponents  can  charge  me  with  such),  either  before 
the  Colleges,  or  before  some  finirly  constituted  *  Court  Medical,* 
such  as  that  which  has  recently  tried  the  case  between  Dr.  A.  P.  Stewart 
and  Mr.  I.  B.  Brown.  ,    . 

^  All  that  I  ask  of  the  members  of  the  profession  is  that  they 
should  adhere  strictly  to  the  law.  Their  present  conduct  towards 
me  savours  more  of  the  un-English  law  of  Judge  Lynch  than  of  the 
well  ordered  adjustment  of  an  English  dispute. 

*^  English  law  considers  every  man  innocent  till  he  is  proved 
guilty.  My  opponents  have  condemned  me  unheard  and  without  one 
tittle  of  evidence  against  me. 

**  It  is  thus  that  I  answer  the  assertion,  *  that  the  men  of  Cam? 
bridge  have  just  as  much  right — are  just  as  much  bound  in  cour 


By  WaUam  Bayes^  MJ).  48ft 

adeoee-^-te  refiue  to  meet  him  (Dr;  Bayes)  as  he  has  to  practaatf 
homoeopathy/ 

**  I  am  acting  with  the  strictest  legality,  hoth  in  accordance  with  the 
Medicai  Act  and  with  the  hye-laws  of  the  €k>llege8  to  which  I 
belong,  while  the  profesdonal  men  of  Ciunhridge  Lyheh  me  because 
I  holdf  to  some  eltent,  views  offreaimeni  dijfwmg'fnm  their. awn. 

^  I  nnnt  add  that  I  should  not  have  brought  the  conduct  of  the 
physicians  and  surgeons  of  Cambridge  before  the  profession  at  large, 
had  they  not  gone  so  &r  beyond  all  bounds  of  moderation. ' 

**.Nbt  content  with  refusing  to  meet  me  in  consultation  themselves, 
I  have  yet  to  learn  on'  what  possible  principle  of  justice  they 
should  attempt'  to  deter  others  (who  have  not  the  same  objection  as 
themselves)  from  giving  me  the  benefit  of  theii:  advice.' 
.  <•  They  Lynch  me  for  doing  that  which  is  leyal^  and  they  threaten  to 
Lynch  any  one  who  wont  join  them  in  lA^nehing  me. 

*'  Show  me  that  I  break  any  law  or  bye-law  of  the  profession  or  of 
the  colleges,  and  I  wiU  submit,  without  raising  any  quibble,  to  the 
legal  punishment.  But  if  I  have  broken  no  laWy  I  protest  against 
being  illegally  punished. 

^*  I  am,  yours,  &c., 

**  William  Bates. 
^Ombridyey  June  1,  1862." 


This  letter  was  refused  insertion  by  the  Editor,  but  it  was 
noticed  in  the  subjoined  paragraph : — 

**  Db.  Bates. — We  really  cannot  see  that  justice  to  Dr.  Bayes 
demands  the  publication  of  his  second  letter  to  us.  With  the 
homoeopathic  logic  to  which  we  formerly  referred,  he  says :  *  Tou 
speak  of  my  consultation  with  Mr.  Adams  as  a  medical  oonsultalion^ 
whereas  it  was  purely  surgical*  Are  not  surgeons  medical  men  ?. 
Besides,  what  are  we  to  understand  as  to  the  fact  of  a  consultation  ? 
Mr.  Adams  says  there  was  no  consultation  at  all;  Dr.  Bayes  says 
there  was  a  consultation,  but  that  it  was  surgical.  These  two  gen- 
tlemen do  not  seem  to  be  helping  each  other  much  in  attempting  to 
define  distinctions  without  differences.  Dr.  Bayes  also  wishes  to 
know  what  we  meant  about  the  Colleges  entering  into  no  engage- 
ment with  him  under  certain  circumstances.  We  meant  simply  this : 
that,  if  he  had  stated  a  belief  in  homoeopathy  when  he  presented 


440  Medical  Terrorism. 

bimself  fbr  examination,  he  'would  have  been  '"rejected '— ^*.  «.,  not 
admitted  a  member  of  tbem.     Dr.  Bayes  states,  what  eTerybodjr 
knows^  that  be  breaks  no '  medical  Act,  nor  bye-law  of  Colleges,  'in 
practising  homoeopathy;  and  he  therefore  accuses  those  who  refuse 
to  meet  him  of  being  Lynchers.     He  would  like  to  be  tried  by  m 
College,  or  even  by  a  couple  of  referees.     *  They '  (the  Cambridge, 
doctors)  *  Lynch  me  for  doing  that  which  is  legal,  and  they  threaten 
to  Lynch  every  one  who  won*t  join  them  in  Lynching  me.'     We 
give  Dr.  Bayes  all  the  credit  he  can  ask  for  the  strictest  honesty  in 
this  matter  of  his  credulity ;  but  he  at  the  same  time  must  in  a  Hke 
manner  give  us  the  same  credit  for  strict  honesty  in  believing  that 
no  member  of  the  medical  profession  who  believes  homoeopathy  ta 
be  be  a  delusion,  can  honourably  and  honesdy  have  medical  inter^ 
course  with  homoeopaths.     We  therefore  praise  the  men  of  Cam- 
bridge for  their  resolute  demeanour  in  the  matter  of  homoeopathic, 
consultations." 

There  is  something  very  ludicrions  in  the  confusion  which 
exists  in  the  editorial  mind  of  the  British  Medical  Journalist. 
He  cannot  see  any  difference  between  a  "  surgical"  and  a 
''  medical"  consultation,  and'  asks,  in  the  piteous  helplessness 
of  inextricable  mental  confusion,  Are  not  surgeons  medical 
men  f  The  Editors  ideas  of  logic  appear  to  be  quite  on  a  par 
with  those  of  th^  celebrated  logician  who  proved  that  an  **  eel 
pie*'  was  a  ** pigeonJ* 

He  says  that  a  "  surgical  consultation**  is  a  ''medical  con- 
sultation," because  a  surgeon  is  sometimes  called,  in  common 
parlance,  a  '*  medical  man  !" 

Then  he  still  hugs  the  idea  that,  if  I  had  stated  my  belief  in 
homoeopathy  when  I  presented  myself  for  examination,  I 
should  have  been  rejected.  Yet  he  very  well  knows  that  I  knew 
nothing  about  homoeopathy  at  that  time,  and,  since  that  time, 
the  law  says  distinctly,  that  the  colleges  shall  "impose  no 
restrictions  as  to  any  particular  theory,"  on  candidates.  Does 
the  Editor  forget  that  the  reason  why  Guy  Faux  did  not  walk 
over  Westminster  Bridge,  was  simply  because  Westminster 
Bridge  was  not  built  till  after  Guy  Faux  was  dead. 

But,  seriously,  I  thank  the  Editor  for  this  admission :  "  Dr. 


A  Study  of  Hydrocianic'  Add^  441 

■  .  •  •  •  .  •       -  • 

Saye9  states  what  everybody  knouys^  that  he  breaks  no  medical 
act,  nor  bye- law  of  colleges,  in  pra^itisiny  honnBOfathy  !* 

On  this  I  am  oontent  to  take  my  stand,  and  to  ask  my  pro- 
fessional brethren  why,  if  I  have  broken  no  law  or  bye-law, 
they  treat  me  as  a  culprit  ?  They  stand  convicted  of  lawless- 
ness out  of  their  own  mouth. 

In  conclusion,  let  me  bring  to.the  remembrance  of  the  better 
of  my  adversaries,  the  words  of  a  great  man  when  unlawfully 
accused.  '^  For  if  I  be  an  offender,  or  have  compiitted  any- 
thing worthy  of  death,  I  refuse  not  to  die :  but  if  there  be  none 
of  these  things  whereof  these  accuse  me,  no  man  may  deliver 
me  unto  them.     I  appeal  unto  CcBsnr. ' 

:  I  too  appeal  unto  Cesar — ^to  that  public  opinion  which  has, 
in  the  present  day,  decided  ipany  and  weighty  points,  and 
which  has  rescued  many  oppressed  from  their  oppressors.  And 
I  have  every  confidence  that  their  decision  will  favour  the  cause 
of  liberty  and  of  science. 

It  rejoices  me  to  see,  as  a  sign  of  the  times,  that  the  Editors 
of  the  "London  Medical  Review"  and  of  the  "Medical 
Circular,"  openly .  express  their  disapprobation  of  the  course 
adopted  by  the  "  British  Medical  Journal,"  while,  in  the  pre- 
sent instance,  both  the  "Lancet"  and  "Medical  Times"  havei 
hitherto  stood  aloof  and  kept  ominous  silence. 

Cambridge,  June  10, 1862. 


A  STUDY  OF  HYDROCYANIC  ACID. 

By  Henry  R.  Madden,  M.D.,  and  Richard  Hughes, 
L.R.C.P.,  Ed.  (Exam.)  M.R.C.S. 

Introduction. — Hydrocyanic  Acid,  although  one  of  the  most 
powerful  and  frequently  used  of  poisons — although  its  main 
physiological  effects  are  of  a  purely  dynamic  character,  and 
tolerably  well  known,  at  least  phenomenally,  has,  nevertheless, 
been  very  rarely  used  in  homoBopathic  practice.  In  the  old 
school  even,  its  empirical  use  is  practically  restricted  to  the 
relief  of  pain  and  sickness  of  the  stomachy  and  of  spasmodic 


442  A  Study  of  Hydrocyanic  Acid^. 

afPeotions  of  the  organs  of  respiration.*  To  rescue  the  medl* 
oine  from  this  undeserved  neglect,  and  to  indicate  with  pre- 
cision its  sphere  of  usefulness,  is  the  object  of  the  foUowiiig* 
paper.  We  are  especially  urged  to  the  task  from  our  growing- 
couTiction,  that  in  Hydrocyanic  Acid  we  possess  the  true 
curative  agent  for  one  of  the  most  distressing  and  intractable, 
disorders  which  afiSict  humanity — ^we  mean  epilepsy. 

HiSTORT.— The  poisonous  energy  of  the  Bitter  Almond  and- 
of  the  Cherry  Laurel  had  been  long  familiarly  known ;  but  the 
principle  upon  which  this  property  of  theirs  depends  was  dis- 
covered in  1782  by  Scheele,  and  was  first  obtained  in  a  state 
of  purity  by  Oay  Lussac.  It  is  this  which  is  commonly  known 
as  Hydrocyanic  or  Frussic  Acid. 

Physical  and  Chemical  Characters.— The  pure  or  anhy- 
drous Frussic  Acid  is  composed  of  one  equivalent  of  hydrogen 
and  one  of  cyanogen  (H.  +  Cy.)>  hence  the  name  "  Hydro- 
cyanic." It  is  liquid,  limpid,  and  colourless.  "  It  has  an  acrid, 
pungent  taste,  and  a  very  peculiar  odour,  which,  when  di£Fused 
through  the  air,  has  a  distant  resemblance  to  that  of  Bitter 
Almonds ;  but  is  accompanied  with  an  impression  of  acridity 
on  the  nostrils  and  back  of  the  throat.  It  is  an  error,  however, 
to  suppose,  as  very  many  have  done,  that  the  odour  is  the  same 
as  that  of  the  Almond.  It  boils  at  80^^  and  freezes  at  5^ 
It  is  very  inflammable.  It  decomposes  spontaneously,  and 
becomes  brown  sometimes  in  an  hour,  and  commonly  within 
twelve  hours,  unless  it  is  kept  very  cold.  When  united  with 
water  it  forms  the  acid  discovered  by  Scheele,  and  now  kept  in 
the  chemists'  shops.  In  this  state  it  has  the  same  appearance, 
taste,  and  smell  as  the  pure  acid ;  but  it  is  less  volatile,  does 
not  bum,  and  may  be  preserved  long  without  change,  if 
excluded  from  the  light.  In  consequence  of  its  volatility, 
however,  it  becomes  weak,  unless  kept  with  great  care." 
(Ghristison). 

*  See  Christison's  Dispentalcry,  in  verb,  Pereira's  Materia  Mtdioa,  2iid  £d.| 
vol.  L  p.  442-3. 


by  Drs.  Madden  dt  Hughes,  448 

SouBCES,  Compounds,  &o. — Medicinal  Prud^'o  Acid  is 
oidinarily  obtained  from  the  Ferro-cyanide  of  Pptascdam,  by 
the  re-action  with  this  substance  of  Snlphuric  Acid^  It  is  also 
contained  in  many  vegetable  productions,  as  the  bitter  almond, 
the  cherry  laurel  (Laurocerasus),  the  leaves  of  the  Acacia,  the 
sweet  almond,  and  the  oommon  lilac;  the  kernels  of  the 
cbeiry,  peach,  nectarine,  damson,  mountain  ash,  and  apricot, 
with  the  leaves  of  the  corresponding  trees ;  the  seeds  of  apples 
and  pears ;  and  the  root  of  the  Jatropha  Manihot,  or  bitter 
Cassava,  of  the  West  Indies*  Of  theso,  the  bitter  almond  and 
the  cherry  laurel  are  of  most  importance.  In  the  bitter  almond 
the  acid  does  not  exist  ready  formed,  but  is  produced  by  the 
agency  of  water  on  the  pulp.  The  essential  oil  js  highly 
poisonous,  containing,  as  it  does,  about  12*76.  per  cent,  of 
anhydrous  Prussic  Acid.  The  distilled  waters  of  the  bitter 
almond  and  cherry  laurel  vary  much  in  strength,  their  qaantuni 
pf  acid  ranging  from  0*25  to  1  per  cent.  The  compounds  of  this 
acid  with  alkaline  bases  are  highly  poisonous ;  the  Cyanide  of 
Potassium  being  one  of  the  most  formidable  poisons  known. 
Its  compounds  with  metals  vary  much  in  character;  the 
cyanide  of  iron  (Prussian  blue)  being  altogether  inert,  the 
cyanide  of  Mercury  behaving  like  Mercury,  and  the  cyanide  of 
silver  like  Hydrocyanic  Acid. 

Physiological  Action. — ^We  shall  best  study  the  physio- 
logical action  of  Hydrocyanic  Acid  by  relating  some  of  the 
numerous  cases  of  poisoning  by  it  which  are  on  record,  adding 
such  commentaries  as  may  be  necessary  to  .elicit  the  meaning  of 
the  symptoms.  We  shall  then  give  some  account  of  the  prov- 
ings  which  have  been  made  with  this  drug  upon  the  healthy 

body. 

I. 

The  following  case  is  extracted  by  Dr.  Hempel  from  the 
Lancet  {Materia  Mediea^  p.  823).  We  have  been  unable  to 
ascertain  in  what  volume  or  number  of  that  journal  it  is  con- 
tained.   The  narrator  is  Dr.  Letheby  : — 

"  A  girl,  aged  22  years,  swallowed,  by  mistake,  a  dose  of 


444  ^  Study  of  Hydrocyanic  Aeid, 

PniBsio  Acid^  equivalent  to  a  little  less  than  a  grain  of  the 
pure  poison.  At  the  time  when  this  was  taken,  she  was  sitting 
in  a  chair;  but  she  instantly  jumped  up,  ran  for  a  short 
distance,  holding  up  her  arms,  and  gasping,  as  it  were,  for 
breath ;  she  then  fell,  became  insensible,  and  was  violently 
convulsed  ;  the  muscles  of  her  face  undergoing  great  distortioD, 
her  limbs  becoming  spasmodically  extended,  and  her  head 
drawn  down  upon  h6r  shoulders.  In  this  state  she  was  removed 
to  her  bed,  and  was  seen  directly  afterwards  by  Mr.  Watson,  who 
found  her  lying  on  her  back,  with  the  body  drawn  a  little  for* 
wards ;  the  limbs  fixed  and  extended  in  tetanic  spasm ;  the  whole 
face  swollen,  turgid,  and  almost  purple  from  congestion;  the  jaws 
clenched ;  the  mouth  covered  with  foam  ;  the  eyes  half  closed, 
but  prominent  and  glistening,  with  their  pupils  widely  dilated, 
and  quite  insensible  to  the  stimulus  of  light  She  was  breath^ 
ing  slowly  with  deep,  prolonged  inspirations,  and  uttering  a 
low,  moaning  noise.  The  pulse  at  her  wrist  could  not  be  felt, 
although  the  heart  still  continued  to  beat  with  a  feeble,  flutter* 
ing  effort 

''The  symptoms  so  closely  resembled  an  epileptic  fit,  that 
the  medical  gentlemen  who  were  called  in  supposed  at  first  that 
the  patient  was  labouring  under  such  an  attack;  but  soon 
discovering  that  she  was  suffering -under  the  action  of  Hydro- 
cyanic Acid,  they  instantly  adopted  means  for  her  recovery,  but 
without  the  least  avail,  for  the  breathing  became  slower  and 
slower ;  the  limbs  at  this  time  remaining  fixed  and  immovable, 
and  she  died  in  from  fifteen  to  twenty  minutes  after  the  adminis^ 
tration  of  the  poison. 

**  The  post  mortem  appearances  in  this  case  were  as  usual 
in  cases  of  poisoning  by  Hydrocyanic  Acid.  The  cerebral 
vessels,  both  upon  the  surface  and  in  the  substance  of  .the 
brain,  full  of  black,  fluid  blood ;  the  lungs  highly  congested, 
but  free  from  tubercle  or  other  disease ;  the  cavities  of  the 
heart  full  of  black,  uncoagulated  blood." 

Upon  this  narrative  we  would  make  the  following  remarks : — 

1.  llie  tetanic  character  of  the  convulsions  in  this  case  is 
very  well  marked;  and  this  type  of  spasm  almost  invariably 


bff  Dra.  Madden  d  Hughes.  445 

obtains  in  poisoniDg  by  this  drug.     We  are  thus  led  to  set  it 

down  as  an  excitant  of  the  motor  tract  of  the  spinal  cord.    The 

only  other  possible  source  of  the  tetanus  of  Hydrocyanic  Acid 

^rould  be  its  excitant  influence  on  the  medulla  oblongata ;  for  it 

Ims  been  ascertained  by  Professor  Weber,  that  if  the  medulla 

ohlongata  be  excited  by  galvanism,  general  tetanic  convulsions 

are  the  consequence,  which  resemble  those  observed  in  persons 

poisoned  by  strychnia.^     But  an  experiment  by  Wedemeyer 

shews  conclusively  the  independent  action  of  our  drug  upon  the 

spinal  cord.     He  divided  the  cord  between  the  last  dorsal  and 

the  first  lumbar  vertebrso,  so  that  the  hind  legs  were  completely 

paralysed  and  insensible  to  mechanical  irritants  ;  Hydrocyanic 

Acid  was  then  introduced  into  one  of  the  hind  legs ;  in  one 

minute,  symptoms  of  poisoning  commenced  ;  the  hind,  as  well 

as   the    fore-legs,  were  violently  convulsed,   and   in    twelve 

minutes  the  animal  was  dead.f 

2.  The  next  most  prominent  symptoms  are  those  of 
asphyxia.  The  face  was  '*  swollen,  turgid,  and  almost  purple 
from  congestion  ; "  and  after  death  the  head,  lungs,  and  heart 
were  found  gorged  with  dark  and  fluid  blood.  The  ''  gasping 
for  breath,"  with  which  the  symptoms  set  in,  and  the  laboured 
respiration  which  went  on  until  death,  points  to  the  cause  of 
this  asphyxia,  viz.,  to  an  impediment  in  the  way  of  the  entrance 
t)f  air  through  the  respiratory  passages.  This  spasmodic 
character  of  the  dyspnoea  of  Hydrocyanic  Acid  is  frequently 
noticed  by  writers  on  toxicology,  and  narrators  of  cases  of 
poisoning.  To  account  for  it,  we  have  only  to  extend  the 
excitement  produced  by  the  drug  in  the  spinal  cord  up  into  the 
medulla  oblongata,  which,  indeed,  is  nothing  but  the  intra* 
cranial  continuation  (as  its  name  implies)  of  the  medulla 
spinalis.  This  being  the  centre  of  the  pneumogastric  nerves, 
its  excitation  will  necessarily  give  rise  to  laryngismus,  trache- 
lismus,  and  bronchial  spasm  like  that  of  asthma. 

3.  Another  phenonmenon  observed  by  Professor  Weber, 
after  galvanism  of  the  medulla  oblongata,  was  stoppage  of  the 
action  of  the  heart.*     Claude  Bernard  has  demonstrated  that 

•  8ee  Althams  on  MedieaL  JSledricUi/,  p.  74. 
t  Hempel,  Op.  cU.,  p.  823. . 


446  A  Sttidy  of  Hydrocyanic  Acid, 

« 

this  inflaence  is  trasmitted  to  the  heart  through  the  pneniiK'^ 
gastric  nerves ;  and  Brown  Sequard  has%8hoiini  that  this,  and 
not  any  interference  with  a  "  noeud  vital,"  or  respiratory  cjentie, 
is  the  cause  of  the  sudden  death  which  follows  upon  the 
operation  of  "  pithing."  We  should  be  disposed  to  refer  to 
excitation  of  the  medulla  oblongata,  the  imperceptible  pulse 
and  feeble  fluttering  action  of  the  heart  noticed  in  this  case,  as 
well  as  the  exceedingly  sudden  death,  which  so  often  occurs  in 
poisoning  by  this  drug,  and  which  can  only  be  compared  to 
that  consequent  on  pithing. 

4.  The  last  phenomenon  which  we  have  to  consider  is  the 
sudden  loss  of  consciousness.     In  the  epileptic  paroxysm,  for 
which  this  case  was  at  first  mistaken  by  the  medical  attendants, 
this  s3rmptom  arises  from  a  contraction  of  the  cerebral  arteries ; 
the  excitement  of  the  medulla  oblongata  being  directed  upon 
these  through  the  medium  of  the  cervical  sympathetic,  with 
which  it  communicates.      We  have   already  ascertained   the 
presence  of  excitement  of  this  centre  in  the  case  before  us ;  and 
in  the  dilated  and  insensible  pupil,  with  prominent  and  glisten* 
ing  eyeball,  we  have  abandant  evidence  of  excitation  of  the 
cervical  sympathetic.      We  therefore  believe  ourselves  fully 
justified  in  setting  down  the  sudden  loss  of  consciousness  in 
this  case  to  contraction  of  the  cerebral  arteries  by  the  excitant 
influence  transmitted  firom  the  medulla  oblongata,  and  upper 
part  of  the  spinal  cord,  through  the  cervical  sympathetic. 

5.  Lastly,  we  think  that  every  reader  of  the  case  will  under* 
stand  the  mistake  of  the  medieal  attendants,  who  regarded  it  at 
first  as  a  severe  epileptic  paroxysm.  The  sudden  fdling  and 
loss  of  consciousness,  with  dilated  pupil ;  the  subsequent  laryn* 
gismus,  empurpled  face,  foam  at  the  mouth,  and  convulsions — 
together  form  a  perfect  picture  of  the  attack  of  this  firightful 
disease.  We  know  of  no  other  drug  capable  of  causing  so 
close  a  resemblance  to  the  epileptic  paroxysm,  except  occarion* 
ally  some  of  the  Umbeliiferae,  especially  the  OEnanthe  Grocata. 
The  only  point  of  difference  lies  in  the  character  of  the 
general  convulsions,  which  here  are  tonic,  but  in  epilepsy 
clonic.  But  this  is  accounted  for  by  the  independent  action  of 
Hydrocyanic  Acid   upon  the  spinal    cord,   which  it  excites 


by  Drs.  Afaddeti  dt  Haghea.  447 

similarly  to  strychnia.  The  convalsions  of  epilepsy  are  due 
either  to  the  circulation  of  non-arterialised  bloody  thus  resem- 
bling  those  of  poisoning  by  Carbonic  Acid,  or,  in  some  yet 
unexplained  manner,  are  the  direct  consequence  of  the  sudden 
cutting  off  of  the  supply  of  blood  to  the  brain* 

11. 

The  symptoms  of  poisoning  by  Hydrocyanic  Acid  are  so 
nniform,  and  the  above  case  is  so  typical  of  its  ordinary  effects, 
that  we  shall  content  ourselves  with  summaries  of  a  few  other 

« 

cases. 

1.  Professor  Christison  gives  the  following  summary  of  a 
case  of  involuntary  poisoning,  taken  from  the  Revue  Medicale, 
for  18259  vol.  L,  p.  265.  The  case  is  recorded  at  length  in 
Hempers  Materia  Medica,  p.  824. 

"Very  soon  after  swallowing  a  teaspoonful  of  the  diluted 
acid,  he  felt  a  confusion  in  the  head,  and  then  fell  down 
insensible  as  suddenly  as  if  struck  by  lightning.  There  was 
difficult  breathing ;  small  pulse,  scarcely  perceptible  at  the  left 
wrist ;  bloating  of  the  face  and  neck ;  dilated  and  insensible 
pupils;  and  lock-jaw.  Afterwards  he  had  several  fits  of 
tetanus ;  one  of  them  extremely  violent.  In  about  two  hours 
and  a  half  he  began  to  recover  his  intellect,  and  rapidly 
became  sensible." 

The  epileptiform  loss  of  consciousness,  the  tetanoid  convul- 
sions, and  the  spasmodic  dyspncea  of  Hydrocyanic  Acid  are 
well  marked  in  this  case. 

2.  Dr.  Taylor*  gives  the  following  account  of  the  poisoning 
of  seven  epileptic  patients  in  the  BicStre,  at  Paris,  by  an  over- 
dose of  this  drug : — 

"  The  symptoms,  as.they  are  described  by  Orfila  and  Devergie, 
were  as  follows : — Seven  minutes  after  the  poison  had  been 
swallowed,  all  the  patients  were  found  lying  on  their  beds  in  a 
state  of  insensibility ;  they  all  had  convulsions.    The  respira- 

*  On  Poisons^  1st  Ed.,  p.  654. 


44d  A  Study  of  Hydro'eyamc  Acid, 

tion  was  loud  and  hurried,  the  mooth  covered  with  froth,  the 
body  in  a  state  of  perspiration,  and  the  pulse  frequent.  To  this 
stage  of  general  excitement,  there  gradually  succeeded  a  mortal 
collapse,  which  terminated  in  death/' 

•  _ 

8.  The  followiug  case  is  recorded  in  the  Medical  Times 
and  Oazeite,  of  Jan.  9th  1858: — 

*'  The  deceased,  Agnes  Montgomery,  was  27  years  of  age, 
hn  active  woman  of  good  health,  and  never  subject  to  fits  or 
convulsions.  She  was  seen  by  her  sister  in  her  usual  health 
about  half- past  four  o'clock,  p.m.,  on  Sept.  13,  1857.  Soon 
after  five  o'clock,  in  consequence  of  hearing  a  moaning  noise, 
the  witness  entered  her  room,  and  found  her  sitting  in  a  dhair 
insensible,  with  her  head  leaning  on  a  table,  her  right  hand 
hanging  down,  and  her  left  hand  in  her  liip.  Her  eyes  were 
prominent,  fixed,  and  staring;  and  a  thick  'slavery  froth,* 
tinged  with  blood,  issued  from  her  mouth.  Her  face  was 
bluish-red,  and  swollen.  There  was  difficulty  of  breathing ; 
she  gave  heavy  sighs,  with  occasional  sobs,  got  worse,  and 
died.  A  medical  man  saw  deceased  at  about  balf*past  five.  His 
evidence  as  to  her  condition  confirmed  that  of  the  non-profes^ 
sional  witness.  The  eyes  were  staring  and  motionless,  and  the 
pupils  dilated.  She  breathed  slowly  and  with  difficulty,  and 
the  respirations  were  rather  deep  (heaving) ;  the  pulse  was 
between  70  and  80 ;  there  was  coldness  of  the  skin,  with  spas* 
modic  contraction  of  the  jaw.  She  had  bitten  her  tongue,  and 
this  had  occasioned  the  bloody  appearance  of  the  froth  which 
issued  from  her  mouth." 

« 

The  biting  of  the  tongue  in  this  case  is  interesting,  as 
frequently  occurring  in  the  epileptic  paroxysm.  Professor 
Van  der  Eolk  has  shown  it  to  depend  upon  a  special  intensity 
of  irritation  in  that  part  of  the  medulla  oblongata  from  which 
the  hypoglossal  nerve  takes  its  origin.  This  causes  the  tongue 
to  protrude,  at  the  same  time  that  the  jaw  is  forcibly  closed  by 
the  excitation  of  the  motor  division  of  the  fifth. 

4.  One  more  case  of  poisoning  by  this  drug  may  be 
recorded.    The  account  is  given  by  Dr.  Geoghegan,  in  the 


fty  Drf.  Madden  d  Hughes.  449. 

Dubiin  Medical  Journal,  Noy.>  1885.  We  take  the  snmmary 
firom  Pereira : — 

"  The  patient  was  a  gentleman,  aged  21.  He  bad  been  taking 
Hydrooyanie  Acid  for  a  gastrodynia,  and  gradually  increasing 
the  dose.  On  the  sixth  day,  be  swallowed  2  drms.  of  the  dilute 
Acid  of  the  Dublin  Pharmacopoeia  ( 1'  6  per  cent.) .  In  two  minutes 
after  taking  this  quantity,  he  experienced  a  sensation  of  extreme 
bitterness  in  the  mouth,  and  having  walked  a  few  paces,  was 
affected  with  great  confusion,  headache,  and  loud  ringing  in  the 
ears.  He  now  with  difficulty  retraced  his  steps ;  and  leaning 
forward  on  a  table,  became  insensible,  and  fell  backwards.  In 
tbis  state  he  remained  altogether  between  three  and  four 
minutes,  during  which  time  he  was  violently  convulsed.  His 
thighs  became  rigid,  and  were  drawn  up  on  the  abdomen  ;  and 
as  he  was  about  falling,  he  was  caught  and  placed  on  the 
ground.  The  upper  extremities  were  then  observed  to  be  also 
rigid ;  and  on  drawing  them  from  the  side,  they  forcibly  reverted 
to  their  former  position ;  the  eyes  were  shut,  the  teeth  clenched, 
and  the  muscles  of  the  face  violently  convulsed." 

Bapid  recovery  took  place  under  the  use  of  Ammonia. 

6.  Ghristison  gives  the  following  account  of  the  action  of 
the  poison  upon  animals  : — 

**  When  an  animal  is  poisoned  by  a  dose  not  quite  sufficient 
to  cause  death,  it  is  seized  in  one  or  two  minutes  with  giddi- 
ness, weakness,  and  salivation  ;  then  with  tetanic  convulsions ; 
and  at  last  with  gradually  increasing  insensibility.  After  lying 
in  this  state  for  some  time,  the  insensibility  goes  off  rapidly, 
and  is  succeeded  by  a  few  attacks  of  convulsions,  and  transient 
giddiness.  The  whole  duration  of  such  cases  of  poisoning  some- 
times does  not  exceed  half-an-hour ;  but  may  extend  to  a  whole 
day,  or  more.  When  the  dose  is  somewhat  larger,  the  animal 
perishes  either  in  tetanic  convulsions  or  comatose." 

6.  The  poisonous  effects  of  Cyanide  of  Potassium,  and  of 
the  Bitter  Almond,  depend  entirely  upon  their  Hydrocyanic 
Acid.  The  following  quotations  from  Dr.  Taylor's  Treatise  on 
Poisons  will  shew  this.  Of  the  first-named  substance,  he 
writes : — 

VOL.   XX.,   NO.    LXXXI. — JULY,    1862.  2  F 


450  A  Study  of  Hydrocyanic  Acid, 

*^  The  symptoms  produced  by  Cyanide  of  Fotasuum  aid 
similar  to  those  occasioned  by  Prassic  Acid — spasmodic  respi- 
ration ;  convulsions,  with  tetanic  stiffness  of  the  limbs  and 
trunk.  M.  Bonjean  found  that  animals  to  which  this  poison 
was  given,  invariably  had  oonvulaionsy  tetanic  spasms,  and 
abdominal  respiration." 

And  he  narrates  the  following  case  of  poisoning  by  the 
essential  Oil  of  Bitter  Almonds  : — 

"  A  woman  swallowed  about  seventeen  drops  of  the  oil,  and 
died  in  half-an*hour.  She  was  seen  by  Dr.  Bull  in  about 
fifteen  minutes.  Her  face  was  livid;  lips  separated;  teeth 
clenched  ;  froth  about  the  mouth  ;  eyes  half  shut  and  glassy  ; 
pupils  dilated  and  fixed ;  heavings  of  the  chest  at  intervals ; 
there  was  no  pulse;  and  the  action  of  the  heart  was  barely 
perceptible.  The  first  symptoms  observed  in  this  case  were 
strong  convulsions.  In  the  jposi  mortem  examination,  the 
system  was  found  gorged  with  venous  blood." 

III. 

Pereira  thus  sums  up  the  post  mortem  appearances  in  cases 
of  poisoning  by  this  acid  : — 

"  Olistening  and  staring  expression  of  the  eyes,  which,  how- 
ever, is  not  a  constant  phenomenon,  nor  peculiar  to  this  poison, 
since  it  has  been  observed  after  death  by  Carbonic  Acid,  from 
eholera,  and  during  the  epileptic  paroxysm  (Christison)." 

It  is  so  frequent,  however,  that  Dr.  Paris  considers  it  as  alone 
supplying  decisive  evidence  of  poisoning  by  Prussic  Acid.  It 
probably  depends  upon  the  excitation  of  the  cervical  sympa- 
thetic. 

"  The  venous  system  usually  gorged  with  blood,  while  the 
arteries  are  empty." 

This  results  from  tbe  usual  mode  of  death  in  poisoning  by 
this  drug)  viz.,  asphyxia. 

*'  The  blood  is,  in  many  cases,  fluid,  dark,  or  bluish-black,, 
and  viscid,  or  oily." 

Pereira  considers  that  Hydrocyanic  Acid  has  a  direct  haematic 
action,  and  the  evidence  seems  in  favour  of  this  view.     The 


by  Drs.  Madden  d  Hughes.  451 

oondition  of  the  blood-plasma  induced,  strikingly  resembles 
that  which  obtains  in  Asiatic  cholera. 

''  The  vessels  of  the  brain  and  spinal  marrow  are  freqaently 
gorged  with  blood,  and  the  cerebral  ventricles  sometimes  con- 
tain a  serous,  or  sanguineous  liquor ;  the  lungs  are,  in  some 
instanoesj  natural ;  in  others,  turgid  with  blood.  The  internal 
lining  of  the  stomach  is  sometimes  red." 

The  muscles  are  usually  fully  susceptible  to  galvanic  excita- 
tion ;  but  sometimes,  after  death  by  the  strong  acid,  are  insen- 
sible to  it — probably  from  exhaustion  of  excitability. 

IV. 

We  now  pass  from  the  more  intense  effects  of  Hydrocyanic 
Acid  to  the  symptoms  resulting  from  less  powerful  doses ;  and 
finally,  to  those  elicited  by  its  systematic  proving. 

The  following  extracts  are  taken  from  Dr.  Taylor  s  work  :— 

"1.  A  practitioner  was  shewing  to  some  friends  the  effects 
of  Scheele's  acid  on  an  animal,  when,  by  accident,  a  quantity  of 
the  poison  fell  upon  the  dress  of  a  lady  who  was  standing  before 
a  fire.  The  poison  was  rapidly  evaporated,  and  the  lady  was 
immediately  seized  with  dizziness,  stupor,  inability  to  stand, 
and  faintness.  The  pulse  became  feeble  and  irregular.  Brandy 
was  administered,  cold  affusion  employed,  and  the  patient  was 
exposed  to  a  free  current  of  air.  In  ten  minutes  the  pulse 
began  to  improve ;  and,  with  the  exception  of  tremor  in  the 
limbs,  the  unpleasant  symptoms  disappeared." 

''  2.  I  have  known  headache  and  dizziness  produced  by  the 
vapours  from  the  small  quantities  used  in  chemical  experi- 
ments." 

**  8.  In  a  case  in  which  a  person  poisoned  himself  with  two 
ounces  of  the  acid,  and  his  body  was  examined  twenty-eight 
hours  after  death,  the  vapour  of  Prussic  Acid,  which  escaped 
on  opening  the  stomach,  was  so  powerful  that  the  inspectors 
were  seized  with  dizziness,  and  obliged  to  quit  the  room 
hastily." 

4.  A  physician  took  by  mistake  a  small  quantity  of  a  solu- 
tion of  Cyanide  of  Potassium.  *'He  immediately  felt  severe 
pain  in  the  back  of  the  head ;  there  was  inability  to  stand ; 

2j% 


462  A  Study  of  Hydrocyanic  Acid, 

indistiDCt  vision ;  nausea ;  a  rushing  sound  in  the  ears ;  loss  of 
consciousness ;  and,  without  complaining  of  any  well-defined 
pain,  he  felt  that  he  had  lost  the  power  to  make  a  deep  inspira- 
tion. The  loss  of  sense  was  as  rapid  as  in  ordinary  syncope. 
When  an  eflTort  was  made  to  swallow  some  milk,  there  was  a 
strong  sense  of  choking,  followed  by  copious  vomiting.  For 
more  than  an  hour,  he  could  not  stand  upright.  Vertigo, 
weight  in  the  head,  and  constriction  in  the  throat,  continued  for 
many  hours." 

From  Dr  Hempel's  article  in  his  Materia  Medica  we  extract 
the  following : — 

"  5.  Ittner,  while  preparing  the  acid  and  inhaling  the 
vapours,  experienced  constriction  of  the  chest;  di£Bculty  of 
breathing ;  vertigo  ;  weariness  ;  shivering." 

"  6*  GouUon  says,  in  his  Recherches  sur  tAcide  Hydro- 
cyanigus,  that  he  swallowed  successively  20,  80,  40,  50,  00, 
80,  and  86  drops  of  Prussic  Acid  in  water.  The  taste  was 
intolerably  bitter.  The  first  doses  had  no  effect.  The  last- 
mentioned  doses  caused  the  following  symptoms — Increased 
secretion  of  saliva  for  two  or  three  minutes,  and  two  or  three 
attacks  of  nausea.  The  pulse  rose  from  57  to  77  or  78  beats ; 
in  an  hour  and  a  half,  it  bad  regained  its  normal  frequency. 
For  some  minutes  the  experimenter  complained  of  heaviness  of 
the  head,  and  of  some  headache,  which  seemed  to  be  localised 
beneath  the  hairy  scalp,  on  the  anterior  portion  of  the  head. 
For  upwards  of  six  hours  he  experienced  a  marked  anxiety  in 
the  region  of  the  heart,  alternated  with  a  slight  throbbing  pain 
in  the  same  region,  which  did  not  increase  by  pressure." 

"  7.  Sandras  reports  in  the  December  number  of  the  Gazette 
Medicate,  1829,  that  Hydrocyanic  Acid,  if  taken  in  small 
doses,  causes  formication ;  prickling ;  sleep,  or  else  sleepless- 
ness ;  frequently  headache ;  shivering.  Larger  doses  cause 
vertigo  ;  buzzing  in  the  ears  ;  a  sort  of  delirium ;  intoxication." 

8.  Pereira  writes,  "  If  the  ordinary  medicinal  dose  be 
cautiously  increased,  and  its  operation  carefully  watched,  the 
following  effects  are  usually  observed — a  bitter,  but  peculiar 
taste;  increased  secretion  of  saliva;  irritation  in  the  throat; 


.  by  Drs*  Maddeti  d  Hughes.  458 

-frequently  nausea ;  disordered  and  laborious  respiration  (some- 
times quick,  at  others,  slow  and  deep) ;  pain  in  the  head ; 
giddiness;  obscured  vision,  and  sleepiness.  The  vascular 
system  is,  in  some  cases,  not  obviously,  but  in  others,  much 
affected,  though  not  uniformly;  its  action  being  sometimes 
quickened,  at  others  reduced  in  frequency.  In  some  instances 
faintness  is  experienced.  Drs.  Macleod  and  Granville  have 
noticed  salivation  and  ulceration  of  the  mouth  during  its  medi- 
cinal use." 

9.  The  Cyanide  of  Potassium  is  used  in  the  process  of 
galvanic  gilding  and  silvering,  as  a  solvent  for  the  metals.  Dr. 
Taylor  writes,  "  The  symptoms  in  those  who  remain  for  a  long 
time  at  this  work  are — dull  headache,  accompanied  by  shooting 
pains  in  the  forehead ;  noises  in  the  ears  ;  vertigo  ;  dizziness ; 
and  other  effects  indicative  of  cerebral  congestion.  Then 
follow  difficult  respiration ;  pain  in  the  preecordium ;  sense  of 
suffocation ;  constriction  in  the  throat,  and  palpitation,  with 
alternate  fits  of  somnolency  and  wakefulness." 

10.  Sir  B.  Brodie  applied  one  drop  of  the  essential  oil  of 
bitter  almonds  to  his  tongue.  He  immediately  felt  a  remark- 
able and  unpleasant  sensation  at  the  epigastrium,  with  such 
weakness  in  the  limbs  and  loss  of  power  in  the  muscles,  that  he 
thought  he  should  have  fallen.  These  sensations  were  quite 
momentary. 

There  is  no  difficulty  in  understanding  the  majority  of  these 
symptoms  upon  the  principles  elicited  in  our  study  of  cases  of 
poisoning  by  this  drug.  They  are  the  same  morbid  conditions, 
but  in  a  minor  degree  of  intensity.  Thus,  the  dizziness  so 
constantly  noticed  is  just  the  first  stage  of  that  contraction  of 
the  cerebral  arteries,  which,  in  severer  cases,  goes  on  to  entire 
loss  of  consciousness. 

V. 

Hydrocyanic  Acid  is  not  among  the  medicines  proved  by 
Hahnemann.  Professor  J5rg,  however,  and  his  pupils,  have 
given  us  an  account  of  the  symptoms  produced  upon  themselves 
by  this  drug.  Not  having  access  to  their  original  record,  we 
must  content  ourselves  with  the  extracts  given  by  Dr.  Hempel, 
in  his  Materia  Medica. 


45i  A  Study  of  Hydrocyanic  Acid, 

The  following  gronp  of  symptoms  are  referable  to  the  head: — 

1.  One  proyer  experienced  ''  dnlness  in  the  frontal  region  ; 
cloadinesSy  like  intoxication  ;  dimness  of  sight" 

2.  Another  prover  felt  a  pressure  from  the  occiput  to  the 
forehead ;  transient  yertigo,  followed  by  violent  pressure  in  the 
occiput  and  forehead,  especially  in  the  right  side.  From  three 
drops  this  prover  experienced  stupefaction  and  vertigo  ;  wavering 
of  surrounding  objects ;  dimness  of  sight.  He  was  scarcely  able 
to  stand.  These  symptoms  were  followed  by  great  dulness  in 
the  forehead  and  occiput 

8.  Another  prover  has  recorded  the  following  symptoms — 
"  Pressure  extending  from  the  top  of  the  head  to  each  orbit, 
where  it  became  fixed,  and  from  the  top  of  the  head  to  the 
occiput,  followed  by  drowsiness  and  lassitude.  These  symp- 
toms were  caused  by  one  drop  of  the  acid.  Three  drops  caused 
a  sudden  paroxysm  of  vertigo ;  the  air  seemed  to  move  slowly 
around  the  prover ;  there  was  no  staggering ;  the  sensation  was 
attended  with  slight  pressure  from  the  occiput  to  the  left  side 
of  the  forehead.  During  this  attack  the  eyes  seemed  immov- 
able;  the  pupils  were  at  first  dilated,  afterwards  permanently 
contracted ;  the  pulse  varied — at  times  it  was  strong,  at  others, 
feeble.  The  attack,  which  the  prover  describes  as  a  sort  of 
intoxication,  lasted  ten  or  fifteen  minutes ;  it  was  followed  by  a 
scraping  sensation  in  the  throat;  dyspnoBS,  as  if  the  lungs 
could  not  expand ;  drowsiness ;  loss  of  strength." 

4.  Professor  J  org  himself  took  two  drops.  They  caused 
a  scraping  at  the  root  of  the  tongue,  and  in  the  throat ;  slight 
shiverings,  followed  by  dimness  of  sight,  and  a  weary  feeling  in 
the  brain.  For  some  days  the  prover  complained  of  aching 
pains,  now  in  one,  then  in  another  part  of  the  head  :  a  want  of 
clearness  of  perception  ;  irritable  temper ;  inability  to  perform 
mental  labour. 

The  alimefitafy  canal  was  affected  as  follows : — 

5.  All  the  provers  experienced  a  scraping  at  the  root  of 
the  tongue,  and  in  the  throat,  followed,  in  one  case,  by  a  sensa- 
tion of  foul  air  at  the  root  of  the  nose,  and  by  pricking. 

6.  Another  prover  experienced  a  sensation  as  of  a  lump  in 


by  Dra.  Madden  db  Hughes.  455 

tlie  stomach.  After  eating  some  bread  and  batter*  be  com- 
plained of  malaise,  heartburn,  vaterbrash,  followed  by  an 
increase  of  hanger ;  in  spite  of  which,  he  felt  an  aversion  to 
food.  Violent  hiccoagh  troubled  him  afterwards,  accompanied 
iRTith  a  disposition  to  heat  and  sweat. 

7.  One  prover,  who  took  two  drops  of  Ittner  s  Acid,  experi- 
enced a  scraping  in  the  larynx,  which  the  other  provers  Ukewise 
complained  of,  with  secretion  of  mucus ;  tightness  and  pain  in 
the  chest.  The  symptoms  in  the  throat  and  chest  suddenly 
disappeared,  and  were  succeeded  by  rumbling  in  the  bowels, 
followed  by  pain  in  the  right  kidney,  thence  shifting  to  the 
stomach,  and  spreading  all  over  the  bowels,  without  any  urging 
to  stool;  with  a  more  copious  discharge  of  cloudy  urine; 
general  malaise ;  cold  shiverings ;  occasional  return  of  pain  in 
the  head ;  drowsiness ;  weariness ;  diminished  frequency  of  the 
pulse. 

8.  In  the  urinary  organs  nothing  was  noticed,  but  an 
increased  flow  of  watery  urine  subsequent  to  the  cerebral  and 
respiratory  disturbances. 

In  the  respiratory  organs  we  have — 

9.  From  two  drops,  scraping  in  the  throat,  with  prickling 
and  tickling  in  the  larynx ;  hacking  cough,  as  if  from  little 
hairs  in  the  throat. 

10.  Constriction  across  the  chest ;  shooting  stitches  in  the 
region  of  the  fifth  and  sixth  ribs,  near  the  sternum ;  tightness 
of  the  chesty  with  stitches  when  taking  a  long  breath ;  pressure 
and  tightness  in  the  chest ;  aching  pain  in  both  sides  of  the 
chest,  changing  to  stitching ;  laboured  and  deep  breathing. 

And  the  cardiac  symptoms  elicited  were — 

11.  Palpitation,  with  flying  stitches  in  the  region  of  the 
heart ;  oppression  of  the  heart. 

These  symptoms  are  perfectly  intelligible  upon  the  doctrines 
already  laid  down  as  to  the  physiological  action  of  our  drug. 

Jahr  gives  a  schema  of  Laurocerasus,  for  which  he  refers  to 
the  Archiv.  The  symptoms  appear  to  be  mainly  derived  from 
records  of  poisoning,  and  add  nothing  to  what  we  have  collected 
in  the  above  extracts. 


456  A  8iudy  of  Hydrocjfafiic  Acid, 

Physiological  Summary  and  Therapeutical  Inferences. 

We  may  now  proceed  to  snm  up  the  physiological  action  of 
this  drag,  and  to  point  out  the  therapeutical  inferences 
deduqible  therefrom. 

The  specific  action  of  Hydrocyanic  Acid  is  confined  to  the 
nervous  system  (neurotic),  and  the  blood  (haematic).  Its 
irritant  action  is  slight  and  purely  local. 

Neurotic. 

1.  Sensory  Sphere' — ^Hydrocyanic  Acid  is  an  ancesthetic, 
though  this  effect  is  rarely  manifested,  save  locally.  M. 
Bobiquet  informed  Christison  that  once,  while  he  was  making 
some  experiments  on  the  tension  of  its  vapour,  his  fingers,  after 
being  sometime  exposed  to  it,  became  affected  with  numbness, 
which  lasted  several  days ;  and  the  formication  and  prickling 
spoken  of  by  Sandras,  resemble  the  first  stage  of  the  anaesthesia 
of  Aconite. 

Lotions  of  this  acid  have  been  employed  with  much  benefit  to 
allay  itching  in  certain  cutaneous  eruptions.  Dr.  Elliotson  says, 
that,  to  an  irritable  face,  it  is  very  soothing,  if  employed  before 
and  after  shaving. 

2.  Motor  Sp/tere. — Hydrocyanic  Acid  is  a  powerful  excitant 
to  the  whole  motor  tract  of  the  cranio-spinal  axis,  from  the 
medulla  oblongata  to  the  cauda  equina.  The  great  majority 
of  the  symptoms  produced  by  it  are  to  be  referred  to  this  action. 
We  shall  consider  them  as  they  appear  in  the  brain,  the  respi- 
ratory organs,  the  heart,  and  the  muscular  system  in  general. 

a.  There  is  no  evidence  that  Hydrocyanic  Acid  exerts  any 
direct  influence  on  the  cerebrum.  The  sudden  loss  of  con- 
sciousness with  which  its  poisonous  influence  sets  in  is,  as  we 
have  shown,  the  result  of  contraction  of  the  cerebral  arteries  by 
the  stimulus  conveyed  through  the  cervical  sympathetic  from 
the  excited  medulla  oblongata  and  upper  part  of  spinal  cord. 
The  dizziness,  with  or  without  headache,  which  smaller  doses 
occasion,  is  but  a  minor  degree  of  the  same  morbid  condition. 
Thus  Pereira  s  statement  is  correct,  that  '*  whatever  be  the  pre- 
cise pathological  condition  of  the  brain  in  poisoning  by  this 
drug;,  it  is    probably  identical  with   that  which   occurs   dur- 


hy  Drs.  Madden  atul  Huffhes.  457 

iog  an  epileptic  paroxysm,  and  with  that  produced  b^  loss  of 
blood."  The  resemblance  between  epilepsy  aod  poisoning  by 
Prnssic  Acid  has  been  noticed  by  most  writers  on  toxicology 
and  Materia  Medica.  Pereira's  fourth  class  of  cerebro-spinants 
are  "  epileptifacients,"  and  are  headed  by  Hydrocyanic  Acid, 
and  the  substances  containing  it.  Of  them  he  writes :  "  The 
Budden  loss  of  sensation  and  consciousness,  with  violent  con- 
vulsions, which  are  the  characteristic  efifects  of  this  order, 
constitute  also  the  essential  symptoms  of  an  epileptic  paroxysm." 
Christison  says :  "  Epilepsy  resembles  closely  the  symptoms 
caused  by  Frussic  Acid ; "  and  again,  ''  it  induces  coma  and 
convulsions,  especially  of  the  muscles  of  respiration,  constitut- 
ing phenomena  not  unlike  those  which  characterise  some  varie- 
ties of  the  epileptic  paroxysm,"  Dr.  Taylor  says,  of  epilepsy, 
'*  This  disease,  in  some  of  its  symptoms,  resembles  poisoning  by 
Prussic  Acid  alone." 

We  have  found  Hydrocyanic  Acid  curative  in  a  case  of  head- 
ache, with  dizziness.  Our  experience  with  it  in  the  treatment 
of  epilepsy,  we  purpose  to  bring  forward  in  the  next  number  of 
this  Journal,  We  will  only  say  that,  hitherto,  it  has  been 
'most  highly  encouraging,  and  has  already  led  us  to  rank  this 
drug  far  above  all  other  remedies  for  this  disease.  Several  cases 
of  cure  by  it  in  allopathic  hands  are  extracted  from  Frank's 
Magazine  by  Hempel. 

b.  The  tonic  spasm  excited  by  Hydrocyanic  Acid  is  no  where 
more  marked  than  in  the  organs  of  respiration.  This  also  is 
the  general  testimony  of  toxicologists.  Taylor  says :  "  The 
symptoms  produced  by  Cyanide  of  Potassium  are  similar  to 
those  occasioned  by  Prussic  Acid :  spasmodic  respiration^  &c."; 
and  Pereira  states  that,  after  poisonous  doses,  '*  the  respiration 
is  difficult  and  spasmodic,*'  and  that,  ''  in  most  cases,  the  im- 
mediate cause  of  death  is  obstruction  of  respiration." 

The  principal  morbid  conditions  of  the  respiratory  organs 
dependent  upon  spasm  of  muscular  fibre  are  laryngismus  stri- 
dulus, hooping-cough,  and  asthma.  It  is  in  this  class  of  affec- 
tions, next  to  those  of  the  stomach,  that  Hydrocyanic  Acid  has 
obtained  its  chief  reputation  among  the  practitioners  of  the  old 
school.    In  hooping-cough,  Dr.  West  states,  that  it  "sometimes 


458  A  Study  of  Hydrocyanic  Acid, 

exerts  an  almost  magical  influence,  diminishing  the  frequency 
and  severity  of  the  paroxysms  almost  immediately ;  while,  in 
other  oases,  it  seems  perfectly  inert."  He  gives  it  in  yery 
minute  doses.  In  spasmodic  and  "  nervous  "  coughs  in  general, 
and  in  asthma,  it  has  been  found  of  much  service.  We  shall 
record  several  cases  illustrative  of  its  value  in  this  class  of 
affections. 

c.  Through  the  medium  of  the  nervous  system,  and  espe- 
cially through  the  pneumogastric.  Hydrocyanic  Acid  exercises  a 
considerable  disturbing  influence  upon  the  action  of  the  heart* 
as  many  symptoms  testify. 

Through  the  same  medium,  it  may  regulate  the  cardiac  func- 
tions, when  morbidly  disturbed.  Dr.  Wood,  the  Fereira  of 
America,  writes :  "  In  palpitation,  and  other  irregularities  in  the 
function  of  the  organ,  of  no  very  energetic  character,  whether 
purely  nervous,  or  associated  with  organic  disease,  I  know  no 
medicine  better  calculated  to  alleviate  the  disturbance  of  the 
function,  and  aSbrd  ease  and  comfort  to  the  patient."  {Materia 
Medica,  voL  ii.  p.  181).  Dr.  Chapman  suggests  its  use  in 
angina  pectoris. 

d.  General  tetanic  spasm  is  one  of  the  most  characteristic 
efiects  of  poisoning  by  Prussic  Acid. 

Hydrocyanic  Acid  forms,  with  Aconite  and  Strychnine,  the 
triad  of  drugs  really  homoeopathic  to  tetanus.  Fereira  states, 
that  cases  of  this  disease  have  been  published,  in  which  the 
remedy  has  proved  beneficial.  But  it  is  also  homoBopathic  to 
tonic  spasm  in  general,  wherever  occurring.  Into  this  cate- 
gory fall  the  gastrodynia  and  enterodynia,  for  which  Fereira 
regards  it  as  a  true  specific.  He,  himself,  states  of  the  former 
affection,  that  "  pain,  of  a  spasmodic  character,  is  the  leading 
symptom ; "  and  calls  the  enterodynia  "  a  painful  affection  of 
the  bowels,  analogous  to  that  of  the  stomach."  Dr.  Elliotson 
mentions  the  following,  as  the  stomach  affections  relieved  by  it : 
"  first,  those  in  which  pain  at  the  stomach  was  the  leading  symp- 
tom ;  secondly,  those  in  which  the  gastrodynia  was  accompanied 
by  water-brash ;  thirdly,  when  the  excessive  irritability  of  the 
stomach  produces  vomiting;  and  fourthly,  those  disorders  of 
the  stomach  which,  in  some  of  their  symptoms,  resemble  affec- 


hy  Dr8»  Madden  and  Huffhes.  450 

tions  of  the  heart."  (^Numerous  cases  illustrative  of  the  effi- 
cacy of  the  Hydrocyanic  Acid  in  affections  of  the  stomach, 
1820). 

HiEMATIC. 

Hydrocyanic  Acid  induces,  as  we  have  seen,  a  condition  of  the 
blood  similar  to  that  which  obtains  in  Asiatic  cholera ;  it  is 
flaid,  dark,  or  bluish  black,  and  viscid  or  oily. 

We  cannot,  from  the  above  fact,  infer  the  homoBopathicity  of 
Pmssic  Acid  to  this  frightful  disease.  Dr.  Bussell,  in  his  work 
on  "  Epidemic  Cholera,"  relates  a  case,  in  which  the  acid  gave 
great  and  speedy  relief  to  an  intense  spasmodic  oppression  of 
the  chest,  which  came  on  in  a  cholera  patient.  Pereira  says : 
**  I  have  seen  Hydrocyanic  Acid  used  with  great  success  to  allay 
vomiting  and  purging  in  severe  forms  of  the  ordinary  English 
cholera,  after  opium  had  completely  failed.  In  Asiatic,  or  ma- 
lignant cholera,  it  has  occasionally  appeared  to  be  serviceable. 

Allied  Heme  dies. — Aconite^  Strychnine^  and  the  triad  of 
Umbellifers,  Mthusa  Cynapium,  Cicuta  Virosa,  and  (Etianthe 
Crocata,  especially  the  last. 

Pharmaceutical  Preparations. — The  dilute  Hydrocyanic 
Acid  of  the  London  pharmacopoeia  is  a  tolerably  certain  prepara- 
tion, and  contains  2  per  cent,  of  the  anhydrous  acid.  This, 
therefore,  diluted  with  equal  parts  of  alcohol,  will  form  our  first 
centesimal  potency ;  and  from  this  the  other  dilutions  may  be 
made.  The  Oil  of  Bitter  Almonds  may  occasionally  be  used  as 
a  form  for  the  administration  of  Hydrocyanic  Acid.  A  pure 
and  good  oil  should  contain  about  12^  per  cent,  of  the  anhy- 
drous Acid. 

Dose. — We  have  found  the  drd  decimal  the  most  useful 
potency  for  ordinary  purposes.  In  epilepsy,  however,  it  may 
be  necessary  to  use  the  1st  centesimal,  in  the  intervals  between 
the  paroxysms.* 

*  In  the  next  number  of  the  Journal,  we  propose  to  give  a  series  of  cases 
of  Epilepsy  and  other  diseases  treated  by  this  drug.  If  any  of  our  colleagues 
have  had  experience  with  it,  or  should  he  led  to  use  it  successfully  in  the 
direction  indicated  in  the  ahove  paper,  we  should  he  greatly  ohliged  if  they 
would  communicate  to  us  their  observations,  that  we  may  incorporate  them 
in  our  series. 


460  On  Phosphoric  Paralysis, 

ON  PHOSPHOBIO  PARALYSIS. 

By  Dr.  Gallavardin,  Lyons.* 

I  WISH,  in  this  memoir,  to  bring  prominently  forward  one  of 
the  many  elective  effects  of  Phosphorus ;  ▼12.,  that  which  it  pro- 
duces on  the  muscular  system — on  the  nerves  of  motion.  This 
elective  action  I  shall  demonstrate  by  experiments  on  the  human 
subject,  both  in  health  and  disease.  The  researches  which  I 
have  undertaken  for  the  purpose  have  led  me  to  discover,  in 
allopathic  literature — 

1 1  Cases  of  paralysis  cured  by  Phosphorus. 

8  Gases  of  paralysis  produced  by  Phosphorus, 
and,  in  homoeopathic  literature — 

1  Case  of  paralysis  cured  by  Phosphorus. 

A  great  number  of  paralytic  symptoms  produced  by  Phos- 
phorus. 

This  double  experimentation  once  more  confirms  the  truth  of 
the  homoeopathic  law  of  therapeutics  **  similia  similibus,"  by 
the  aid  of  arguments  borrowed  from  its  adversaries  as  well  as 
from  its  partisans. 

True  science  is  cosmopolitan,  so  she  ought  to  interrogate  all 
the  schools.  They  are  like  so  many  different  nationalities  in 
the  republic  of  letters ;  a  federal  republic,  if  there  ever  was  one ! 
This  thought  directed  and  fertilised  the  labours  of  Hahnemann, 
who,  to  establish  his  pathogenesis,  completed  and  controled  his 
own  experiments  by  those  of  his  predecessors.  Thus  Professor 
Imbart  Gourbeyre  was  able  to  say  with  perfect  truth,  "  Hahne- 
mann holding  forth  on  the  properties  of  the  medicines,  is 
tradition  itself." 

I  thought  I  could  not  do  better  than  follow  here  the  example 
of  the  German  reformer ;  and  henceforward  the  allopathic  phy- 
sicians will  be  obliged  to  act  so  too,  under  pain  of  repeating*  fit 
their  expense,  the  humorous  blunder  of  the  Academy  of  Medi- 
cine, which  (in  1855)  innocently  received,  from  a  sea-goinjf 
ship  captain,  the  common  red  pepper  Ccapsicum  annuumj  ^  ^ 
new  remedy  for  hemorrhoids,  whereas  it  is  in  daily  use  by  the 
homoeopathic  school  for  the  last  half  century !   As  for  those  allc- 

•  From  VAH  Medical^  April,  1S62. 


by  Dr,  Oallavardin,  461 

pathic  physiciaiiB  who  borrow  from  homcBopatby  ber  remedies 
and  their  indications,  I  advise  them  to  borrow  ber  doses  also ; 
or  else  they  will  expose  their  patients  to  aggravations  which  are 
always  useless,  or  even  to  accidents  which  prove  very  serious, 
sometimes  fatal,  of  which  it  would  be  easy  to  cite  more  than  one 
example. 

I  mean  to  present  first  the  1 1  cases  of  paralysis  cured  by 
Phosphorus ;  then  the  paralysis  and  paralytic  symptoms  pro- 
duced by  Phosphorus. 

I. 

Pabaxysis  Cured  bt  Phosphobus. 

1.  Paralysis  (qu.,  of  what  part?)  in  the  case  of  a  young  girl, 
having  lasted  two  years;  cured  by  Phos.  administered  internally.  At 
the  same  time,  this  medicine  induced  menstruation — Dr.  Franck, 
of  Langsberg.  Hufeland's  Journal  de  Medectne  Pratique^  July, 
1824,  p.  112. 

2.  Hemiplegia  of  the  right  side  in  a  young  girl,  in  consequence 
of  amenorrhoea.  It  was  of  several  years'  staoding,  and  was  cured  in 
a  week,  by  rubbing  with  phosphorated  liniment  (Targioci  Tozzetti, 
Journal  de  Litierature,  Sciences  et  Arte  ;  Pisa,  1809). 

3.  Paraplegia  in  a  Russian  officer,  29  years  old,  cured  in  six 
weeks  by  Phosphorus,  internally  and  externally  (Dr.  Gumprecht, 
The  London  Med.  Repository  ;  March,  1815). 

4.  Paralysis  of  both  arms  in  an  officer  of  the  Russian  militia,  in 
consequence  of  gout,  cured  by  Phosphorated  Ointment  (Loc,  cit.), 

5.  Paralysis  (qu.,  of  what  part  ?)  in  a  young  girl,  cured  by  the 
aid  of  frictions,  with  a  liniment  containing  but  1  gr.  of  Phosphorus. 
Previously,  8  grains  of  Phosphorus,  taken  in  three  days,  removed 
the  gastrodynia  and  hsematemesis,  without  affording  any  relief  to 
to  the  paralytic  affection.     {Bihliotheque  Medicale,  1813.  39,  269.) 

6.  Paralysis  of  the  lower  extremities,  and  of  the  sphincters  of  the 
anus  and  bladder  of  a  woman  at  Berlin,  in  consequence  of  apoplexy, 
cured  by  Phosphorus  administered  in  Sulphuric  Ether.  Some  time 
after,  this  patient  died  of  a  fit  of  apoplexy  {Bihliotheque  de  Thera- 
peutie^  Bayle,  vol.  3). 

7.  Paralysis  of  the  third  pair  of  cranial  nerves. 

8.  Paralysis  of  the  sixth  pair  of  cranial  nerves. 

I  quote,  verbatim,  the  article  from  the  Monitetir  des  Hopi- 


462  On  Phoapharie  Parafysis, 

taux  (1858,  p.  1022),  in  which  Dr.  Tavignot  relates  these  two 
notices  of  core. 

MUSCCTLAB  FaIUIiTBIS  OF  THE  £yE  TBBATSD  WITH  PhOSFHOBATED 

P&EPAEATI0K8. 

Several  cases  of  paralysis,  both  of  the  third  and  the  sixth  pair  of 
nenreSy  have  presented  themselves  to  us.  Some  of  them  are  still 
under  treatment.  The  method  which  I  employ  is  very  simple,  and 
generaUy  one  of  the  most  efficacious.  It  has,  moreover,  furnished 
me,  during  several  years,  with  successful  cases,  in  such  numbers  that 
I  have  no  idea  of  despising  its  use  in  a  hurty. 

This  treatment  consists  in  prescribing  Phosphorus  internally,  and 
also  externally,  by  friction  round  the  orbit  As  to  the  external 
application,  the  following  is  the  formula  for  the  liniment  to  be  used 
every  night,  making  use  of  a  piece  of  flannel,  which  is  afterwards 
unfolded,  and  bound  upon  the  forehead  for  the  whole  night  :— 

R.     Nut  Oil 100  grammes. 

Naphtha 25         „ 

Phosphorus 0*20  centigrammes. 

Internally,  I  make  use  of  pills  prepared  with  hog's  lard,  in 
which  Phosphorus  has  been  melted.  Each  piU  contuns  2  milli- 
grammes of  Phosphorus,  and  I  begin  with  one  per  day,  proceeding 
gradually  to  three.  Latterly  I  have,  nevertheless,  followed  the 
advice  of  my  scientific  friend.  Dr.  Ducour,  chief  chemist  of  Lari- 
boissiere,  and  have  substituted  the  following  emulsion : — 

R.    Oil  of  Sweet  Alm<«ds     .  •     •  •  10  grammes. 

Syrup  of  Gum 90         „ 

Gum 2        „ 

Phosphorus       0*10  centigrammes. 

The  bottle  is  always  to  be  shaken,  and  a  teaspoonful  of  the  emulsion 
given  to  the  patient,  then  two,  and  even  three. 

As  a  general  rule,  when  the  Phosphorus  thus  administered  is  the 
right  medicine,  it  cures  veiy  rapidly,  and  it  often  does  so.  I  cannot 
here  report  the  detailed  observations  which  will  find  their  place  in 
my  TrefilUe  on  the  Nervatu  Affections  of  the  Eye.  I  shall  merely 
say  that  two  new  facts  have  just  proved  to  me  still  more  the  effi- 
cacy of  this  treatment.  In  the  first  case,  the  patient  was  the  wife 
of  an  upholsterer,  who  had  been  directed  to  me  by  Dr.  Huv^e.    The 


by  Dr.  Gallavardin,  463 

jparafyns  of  the  third  pair  was  complete,  with  ptoeis,  external 
BtrabismuB,  mydriasis,  &c.  During  two  months,  electricity  had  been 
employed  by  a  brother  physician,  without  marked  result.  In  twenty. 
fire  days  this  lady  was  cured,  under  the  influence  of  the  phosphoric 
treatment. 

The  second  case  is  still  more  interesting,  in  another  point  of  view. 
A  wealthy  proprietor,  in  the  country,  came  to  Paris,  to  put  himself 
under  the  hands  of  a  specialist,  to  be  cured  of  seminal  discharges  of 
long  standing.  The  treatment  had  not  yet  commenced,  when  the 
patient  was  seized  with  paralysis  of  the  sixth  pair  of  nerves  of  the 
right  eye.  That  specialist  sent  me  his  patient,  whom  I  cured  in 
eight  or  ten  days  with  Phosphorus.  I  then  made  a  point  of  sending 
the  patient  back  to  his  first  physician,  to  follow  his  advice  for  the 
treatment  of  the  seminal  discharges ;  but  the  patient  avowed,  to  my 
great  surprise,  that,  under  the  influence  of  the  Phosphorus,  he  had 
been  completely  cured  of  the  latter  also. 

Here  is  a  fact,  evidently  worthy  of  fixing  the  attention  of  practi- 
tioners. For,  unless  we  have  to  do  in  this  case  with  a  simple 
coincidence.  Phosphorus  may  be  utilized  for  the  cure  of  an  afifection 
which  has  hitherto  remained  very  difficult  to  treat. 

If  M.  Tavignot  was  greatly  astonished  to  see  Phosphorus 
oare  Bpermatorrhcea,  sure  enough  the  homceopaths  will  not  be 
at  all  astonished ;  for  daily,  during  many  years  past,  they  em- 
ploy saccessfxilly  phos.  and  acid  phos.  in  the  treatment  of  sper- 
matorrhcea  and  abnormal  poUntions. 

9.  Paraplegia,  with  oedema  of  both  limbs,  after  typhoid  fever,  in 
the  case  of  an  aged  female  cured  by  Phosphorus. — Gauthier-Clau- 
bery  Journal  Giniral  de  Medecine^  1803,  xvi.  6. 

10.  Paraplegia  and  paralysis  of  the  sphincter  vesicae,  with 
oedema  of  both  limbs,  after  acute  disease,  in  an  infant,  cured  by 
Phosphorus. — Id. 

11.  Paralysis  of  the  right  leg,  with  oedema  of  the  limb,  after 
acute  disease,  cured  by  Phosphorus. — Id. 

12.  Paraplegia  cured  by  Phosphorus. 

In  homoeopathic  literature,  I  know  of  only  one  observation  of 
thei  curd  of  paralysis  by  phos.,  it  is  the  following,  which  I  ex- 
tract &om  a  German  journal. 

Mrs.  P.,  aged   36,  was,  soon   after  her  marriage,  seized  with 


•164  On  Phosphoric  Paralysis, 

paralysis  of  the  lower  extremities.     During  three   months  manj 
remedies  were  tried  without  result,  in  the  hospital  at  Gottingen. 
She  could  not  move  her  limbs  at  all,  which  were  of  low  temperature 
and  sensibility.     The  back  was  also  very  stiff;  and  at  a  certain  part 
of  the  sacrum  there  was  no  sensibility.     She  often  experienced  a 
tearing  and  formication  from  the  back  to  the  legs.     The  other  func- 
tions were  normal.     After  two  doses  of  Sulphur  12,  she  took  the 
Tincture  of  Phosphorus,  2nd  dilution,  10  drops  every  other  day. 
After  using  this  remedy  14  days,  she  could  already  walk  with  the 
aid  of  a  stick,  and  without  any  other  medicine  she  was  completely 
cured  of  her  malady.    (Dr.  Engelhard,  ^UgemeiM  Horn,  Zdhmg.) 
13.     Impotence,  spermatorrhcea,  abnormal  pollutions. 

May  we  not  consider  these  affections  as  produced  by  paralysis 
of  the  erector  muscles,  of  the  muscular  fibres,  the  seminal 
yesicles,  and  the  ejaculating  canal  ?  If  so,  it  is  enough — for 
homoeopaths — to  recal  the  classic  efficacy  oiphos,  and  acidphos. 
in  such  oases. 

II. 

PaBALTSIS  PB0DX7CED  BT  PhOSPH  OBITS. 

1.  Paralysis  of  the  Left  Arm, — Ch.  E.  Dieffenbach,  chemist,  at 
Biel,  wishing  to  make  experiments  on  Phosphorus,  took,  in  three 
days,  6  gprains  of  that  substance.  Strong  and  continued  vomituri- 
tion ;  eructations,  with  the  odour  of  garlic ;  spasmodic  contractions  ; 
paralysis  of  the  left  arm;  delirium.  Such  were  the  symptoms 
which  it  presented,  and  to  which  his  death  put  an  end.  Now- 
veUe  Bibliotheque  Medicate,  1829,  t.  ii.,  p.  398;  Merat  Sf  Delens, 
t  v.,  p.  281.) 

2.  Paraplegia;  convulsione ;  then  paralysis  of  the  erector 
muscles  :  progressive  general  paralysis,  produced  by  Phos. 

J.  Frank  has  borrowed  this  observation  from  the  Treatise  of 
Magnus  Huss,  of  Stockholm,  on  Chronic  Alcoholism,  and  has 
given  it  (p.  666)  in  his  Ma^azin  fur  physiologische  und  iltft' 
ische  Arzneimittellehre  und  Tozicologte,  ^ter  batid,  2les  heft, 
Leipzig,  1853.     I  translate  it  verbally. 

A  man,  aged  39,  who  led  an  ordinary  kind  of  life,  occupied  him- 
self for  three  years  in  the  preparation  of  phosphoric  matches.  He 
used  to  work  in  the  room  where  he  lived,  and  there  he  kept  the 


iy  Dr.  Oallavardin,  465 

materialfl  and  the  prodact  of  hia  trade.  He  had  suffered  no  iAcon- 
Tenienoe  from  it  until  a  year  ago  when  a  great  quantity  of  Phos.  and  of 
phosphorated  matches  took  fire,  after  a  violent  explosion.  At  the  time, 
whikt  trying  to  extinguish  it,  he  so  thoroughly  respired  the  vapour 
of  Phos.,  that  at  last  he  fainted  from  suffocation.  Immediately  after 
this,  he  experienced  a  sensation  of  weakness  in  the  back,  as  if  he 
were  ready  to  sink ;  then  weakness  in  the  extremities,  and  trembling 
at  every  effort;  creeping  under  the  skin,  and  a  sensation  as  if 
something  were  starting  beneath  the  epidermis.  At  first,  great 
sexual  excitement,  which  afterwards  diminished,  and  for  the  last 
six  months  gave  place  to  impotence ;  absolute  impossibility  of 
erection. 

Independent  of  that,  he  found  himself  well,  with  good  appetite ; 
regular  evacuations;  good  health;  normal  respiration.  Nothing 
indicated  any  affection  of  the  bndn.  On  his  admission  to  the 
hospital,  the  following  symptoms  were  remarked — his  two  legs 
were  so  weak  that  he  could  only  walk  a  few  steps,  and  even  that  he 
did  with  a  tottering  gait,  and  as  if  he  was  not  sure  of  himself;  if  he 
tried  to  stand  upright,  his  legs  trembled  and  his  knees  bent ;  his 
hands  and  arms  trembled  on  making  an  effort.  In  the  state  of 
repose,  the  muscles  started,  out  all  over  the  body  (musatiar  contract 
tions),  chiefly  in  the  extremities,  which  were  not  painful,  but  suffi- 
ciently sensitive  to  exhibit  the  convulsive  movements  under  the 
skin ;  and  the  muscles  contracted  from  time  to  time,  at  various 
points.  Sometimes  nothing  of  the  kind  was  visible,  and  yet  he 
cried  out  all  at  once,  as  if  a  part  of  his  body  had  been  suddenly 

m 

touched.  On  the  left  arm,  constantly  a  feeling  of  formication  under 
the  skin ;  normal  sensation  over  the  general  surface  of  the  body. 
The  spine  not  sensitive,  nor  painful,  but  so  weak  that  the  patient 
cannot  straighten  himself,  nor  remain  standing  when  once  straigh- 
tened. The  faculties,  both  intellectual  and  moral,  the  functions  of 
the  chest,  of  the  heart,  and  of  the  digestive  organs,  normal ;  but 
the  pronunciation  embarrassed  (paralysis  of  the  tongue).  The 
patient  tived  three  or  four  years  in  the  fuU  enjoyment  of  his  senses, 
whilst  the  paralysis  increased  and  extended  (progressive  paralysu) ; 
but  all  the  attempts  at  treatment  were  unavailing. 

8.  Parafytu  of  the  hands  produced  by  Phosphorus.  J.  Miffet, 
of  St  Etienne-sur-ChaUronne,  whom  his  wife  had  several  times 
tried  to  poison  with  Phosphorus  in  1861,  did  not  die,  but  his  hands 

VOL.  XX.,  NO,  LXXXI. — ^JULY  1862.  2  O 


466  On  PhoMphoric  Paralysis^ 

continued  paralysed.     {AnndUi  ^Hygtm$  et  de  Medecme  Le^cXt^  2d 
aeries,  1855,  t  iii.  p.  157.) 

A  work,  which  I  have  not  been  able  to  consult,  the  Journal 
de  Chimie  Medicate,  1854,  p.  830,  gives  the  history  of  a  hus- 
band poisoned  several  times  by  his  wife,  by  the  aid  of  Fhos- 
phorus ;  he  did  not  die,  but  he  continued  paralysed  (in  what 
part  ?).  I  have  not  been  able  to  ascertain  whether  this  is  the 
same  case  as  the  preceding. 

III. 

Paralytic  Symptoms  produced  by  Phosphorus. 

In  consulting  the  different  treatises  on  the  homceopathic 
Materia  Medico,  we  find,  in  the  pathogenesy  of  Phosphorus, 
the  fbllowing  phenomena,  which  may  be  considered  as  paralytic 
symptoms,  or,  at  least,  as  premonitory  symptoms  of  paralysis. 
Hahnemann  and  his  disciples  observed  them  in  experiment- 
ing on  themselves  with  Phosphorus  in  small  doses.  They 
would  probably  have  obtained  paralytic  symptoms  better  charac- 
terised, even  true  paralysis,  if  they  had  taken  the  pkoe.  in 
stronger  doses ;  but  then  they  would  have  run  a  risk  of  poison- 
ing themselves,  like  the  chemist,  Diffenbach.  One  might,  it  is 
true,  have  tried  that  substance  on  animals ;  but,  unhappily,  one 
could  not  always  draw  conclusions  respecting  man  from  them. 
In  fact,  the  maladies  are  different  in  one  and  the  other ;  and 
probably  it  would  be  the  same  with  the  symptoms  and  affections 
produced  by  a  given  medicine  on  the  healthy  organism,  so  that» 
in  order  to  learn  more  completely  ihe  paralysigefietic  properties 
otphos.,  we  are  obliged  to  confine  ourselves  to  studying,  in  that 
point  of  view,  the  accidental  poisonings  by  that  substance.  For 
this  study,  I  particularly  invite  the  physicians  who  have  occa- 
sion to  visit  the  manufactories  where  Phosphorus  is  prepared  or 
employed.  Meanwhile,  till  they  shall  have  published  their 
observations  on  the  subject,  I  enter  below  all  the  paralytic  symp- 
toms contained  in  the  pathogenesy  of  phos.  I  cite  them  with 
their  respective  ordinal  numbers,  with  excess  of  detail.  These 
symptoms  observed  and  reproduced  by  the  experimenters,  recal, 
even  to  an  extent  to  be  mistaken  for  them,  the  initial  pheno- 
mena of  paralysis  as  set  forth  by  the  approved  authors. 


Sy  Dr,  Gallavafdin.  467 

1420.  One  hand  is  sometimes  as  if  paralysed  for  some  hours. 

1436.  Numbness  and  insensibility  of  the  fingers  of  one  hand. 

1446.  Paralysis  of  the  fingers,  which  have  feeling,  but  which  he 
can  hardly  move. 

1672.  The  hands  and  feet  are  as  heavy  as  lead. 

1683.  Great  weakness  in  the  limbs  during  more  than  three 
weeks. 

1699.  After  sitting  down,  he  is  as  if  paralysed  for  some  minutes. 

1700.  He  is  as  if  paralysed,  and  ill  all  over. 

1702.     All  the  right  side  as  if  paralysed,  with  fits  of  nausea. 

1704.  In  the  morning  on  rising,  and  all  day,  he  is  as  if  paralysed 
in  body  and  mind. 

1705.  Paralysis  of  all  the  limbs,  in  bed,  which  ceases  on  rising. 
984.     Stool  scanty ;  and  for  all  that,  requiring  great  efforts. 

{ParalytU  of  the  defecator  muscles  f) 

935.     Great  efforts  to  pass  faeces,  which  are  not  hard. — (Id,) 
955.     Stool  half.liquid,  scanty,  and  not  passed  without  effort. 

{Id.)* 

Xnvoluntary  stool.  {Paralysis  of  the  intestinal  canal^  and  of  the 
sphincter  ani  f) 

Flow    of   mucus  from  the  anus,    which  remains  always  open. 

(/-*■)  t 

1026.  Violent  desire  to  pass  urine;  without  thirst;  the  urine 
escapes  involuntarily.     {Paralysis  of  the  sphincter  vesica  f) 

1029.  Wetting  the  bed  at  night.     {Id.) 

1030.  Involuntary  emission  of  urine.     {Id.) 

1034.  Not  having  at  once  attended  to  the  desire  of  urinating, 
he  passes  water  involuntarily.     {Id,) 

1080.  Incapacity  of  erection  at  the  end  of  about  seventeen  days. 
{Paralysis  of  the  erector  muscles  f) 

1087.     Absolute  impotence.     {Id,) 

1084.  Pollutions  without  concurrence  of  the  imagination,  at  the 
end  of  about  eight  days.  {Paralysis  of  the  muscular  fibres  of  the 
seminal  vesicles  and  the  efaculatory  canal  f) 

1082.     Pollution  shortly  after  coition.     {Id.) 

1084.  Pollution  at  night,  without  corresponding  dreams,  at  the 
end  of  eight  or  ten  days.     {Id,) 

1086.     Emission  of  prostatic  fluid  during  a  hard  stool.    {Id,)  * 

•  Hahnemann's  Chronic  Diseases,  v.  ilL,  p.  213-284. 
t  Manud  RimaopcMqvut,  Jahr. 

Sg2 


iG8  On  Pkoipkorie  ParafyMt 

Emimon  of  wtmtn  without  energy,  and  tb6  promptly  dmitig 
coition.    (Id.)  * 

Difficulty  of  opening  the  eyelids.  {Parafysii  of  the  levator 
muede  of  the  upper  eyelid^  and  a  precursory  symptom  of  paralysis  of 
the  third  pair  f) 

The  upper  tid  is  difficult  to  raise.     {Id,) 

Dilatation  of  the  pupil.     {Id.)  f 

IV. 
C0NVOL8IVE  Symptoms  pkoduced  by  Phosphorus. 

I  think  it  right  to  borrow  from  the  authors  above  cited,  the 
tremors  and  the  convulsive  symptoms  produced  by  Phosphorus; 
for  these  symptoms,  which  form  the  habitual  retinue  of  paraly- 
sis, equally  prove  the  elective  action  of  that  substance  on  the 
muscular  system. 

811.     Starting  of  the  eyelids,  which  is  often  repeated. 

312.     Great  contraction  of  the  pupils. 

317  I      Myopia  (Contraction  of  the  four  recti  muscles  of  the 
818)  eye?) 

441.  Convulsions  in  the  muscles  of  the  cheeks. 

442.  Convulsions  in  those  below  the  right  eye. 
809.     Convulsk>ns  of  the  face. 

451.    Stardngs  on  the  right-cheek  bone^  removed  by  friction. 
474.     Closing  the  jaws,  preventing  their  separation.     (Contxmc- 
tion  of  the  masseter  muscles  ?) 

718.  Frequent  hiccough  during  the  day,  even  before  eating. 
(Convulsion  of  the  diaphragm  ?) 

719.  Constlmt  hiccough.     {Id,) 

720.  Hiccough  after  dinner,  so  severe  as  to  cause  a  pressive 
and  smarting  pain  in  the  pit  of  the  stomach.     (Id.) 

982.  After  stool,  tenesmus. 

983.  Violent  tenesmus  some  time  after  stool. 

1000.  Conriderable  and  painftil  spasm  of  the  rectum  in  the 
morning  in  bed. 

1073.  Erection  in  the  evening,  without  concurrence  of  the 
imagination. 

*  Mamtd  HomcBopathiqtie,  Jdkr. 

I I  conld  not  lemember  the  name  of  the  antbor  from  whom  I  have  borrowed 
the  three  preceding  paralytic  symptoms. 


by  Dr.  Oaltavardin.  469 

1074.  Some  instances  of  erection  in  an  aged  man,  during  the 
first  seven  days,  then  from  the  29th  to  43rd. 

1075.  Erections,  day  and  night 

1076.  Frequent  erections  in  the  night  (the  fourth  day). 

1077.  Violent  erections  in  the  morning  (at  the  end  of  six  days). 
1279.     Flow  of  hlood  to   the  heart,  with  palpitations,   which 

become  yery  serere  after  a  meal. 

1271.  Palpitations  of  the  heart,  with  anxiety  in  the  eyening  and 
the  morning  on  awaking,  in  bed. 

1272.  Often  strong  palpitation  of  the  heart. 

1274.  Palpitations  in  the  morning  after  a  common  breakfbst. 

1275.  Palpitations;  two,  three,  or  six  beats  of  the  heart,  each 
stronger  than  the  last,  when  walking  or  sitting  after  a  meaL  Only 
one  or  two  at  night,  when  lying  on  the  left  side. 

1276.  Some  strong  beats  of  the  heart  on  the  least  movement, 
especially  of  the  lefl  arm,  or  on  straightening  himself  in  bed,  or 
stretching,  &c. 

1277.  Strong  beating  of  the  heart  on  awaking  in  the  morning, 
and  at  night  after  lying  down. 

1748.  At  night,  violent  palpitations. 

1348.  Convulsions  of  the  muscles  in  the  neck. 

1418.  Trembling  of  the  hands. 

1419.  Trembling  of  the  hands  in  the  morning. 

1438.  Starting  in  some  of  the  fingers. 

1439.  Starting  sometimes  in  the  right  thumb,  when  writing. 

1440.  The  fingers  bend  inwards  from  time  to  time,  as  if  by  the 
effect  of  cramp. 

1441.  Weakness  and  starting  in  one  finger  all  day. 

1442.  Violent  startings  in  the  little  finger  of  the  left  hand. 

1454.  Startings  in  the  muscles  of  the  buttocks. 

1455.  Visible  and  painful  convulsions  in  the  muscles  of  the 
buttocks  and  the  thigh,  on  one  side. 

1470.  Stiffness  of  the  right  leg,  even  during  repose. 

1471.  Tension  in  both  legs,  and  pressive  painful  stiffness  in  the 

left. 

1472.  Constriction,  in  the  form  of  cramp,  in  the  two  legs  and 

feet,  with  startings. 

1489.  Trembling  in  the  knees. 

1490.  Spasmodic  twitching  in  the  knee  when  walking. 
1495.     Twitching  from  the  left  knee  down  to  the  foot. 


470  On  PhonphoHc  Parafysis, 

1496.     T^tching  in  the  left  knee  in  the  erening,  and  after  eadii 
twitch  a  painftil  shock. 

1508.  Cramp  in  the  calf. 

1509.  Cramp  in  the  calf,  and  starting  of  the  leg  on  twitching  it, 
during  walking. 

1547.  Cramp  in  the  soles  of  the  feet. 

1548.  Continual  tendency  to  cramps  in  the  sole  of  the  foot  and 
the  great  toes. 

1550.  Shocks  (or  jerks  ?)  in  the  feet,  with  formicating  cramp  in 
the  soles  of  the  feet 

1551.  Instantaneous  jerks  in  the  feet 

1508.  Twitching  in  the  left  great  toe  when  sitting. 

1 646.  Trembling  in  the  morning,  with  twitching  in  the  limbs. 

1648.  Trembling  of  the  hands. 

1649.  Trembling  of  the  hands  so  that  he  cannot  write. 

1650.  Sensation  of  trembling  all  over. 

1651.  Trembling  of  the  thighs,  like  a  shivering  fit 

1 652.  Trembling  ♦  (Lobstein). 

I  borrow  from  various  authors  the  following  symptoms  which 
pho8,  has  produced  in  animals,  or  the  human  subject  in  health. 

"  His  muscular  powers  are  doubled."  (Alphonse  Leroy 
Bouttatz). 

•'  It  augments  muscular  irritability."     (Fr.  Pilger). 

"  It  destroys  muscular  irritability  in  frogs."  (Giulio  of 
Turin). 

"  It  produces  trembling  of  the  frame,  frightful  convulsions 
and  annihilation  of  the  vital  powers  "     {Ibid), 

"  In  the  greater  part  of  the  Phosphorus  poisonings,  we  see 
death  preceded  by  very  strong  convulsions,  sometimes  with  de- 
lirium in  man,  and  vertigo  in  animals.  (Hahnemann,  Chrofiic 
DiseaseB,  v.  iii.,  p.  213 — 284). 

Phosphorus  exercises  an  elective  influence  on  the  muscular 
system,  even  in  animals  belonging  to  most  dissimilar  classes, 
^.^.,  in  quadrupeds,  and  in  batrachians.  To  demonstrate  this,  I 
am  going  to  borrow  the  report  of  experiments  made  on  them, 
from  the  German  journal,  Schmidt's  JahrhUcher,  1861,  b.  cix., 
p.  172.     Professor  Mayer  has  experimented  with   Phosphorus 

*  Hahnemann^B  Chronic  DiHases,  ▼.  iii.,  p.  213-284. 


by  Dr.  Gallapardin.  471 

on  rabbits,  dogs,  oats,  rats,  and  frogs,  causing  tbem  to  absorb 
that  substance  by  the  stomach,  by  the  cellular  tissue,  or  by 
rounds.  Amongst  other  results,  he  has  obtained  those  which 
he  sums  up  in  the  following  manner :  Phosphorus  acts  specifi- 
cally on  the  nerves  of  voluntary  motion,  and  on  the  muscles 
themselves.  It  impedes,  diminishes,  and  at  last  entirely  destroys 
the  power  of  movement,  or  rather  it  destroys  the  irritability  of 
the  motor  nerves,  the  contractility  of  the  muscular  fibres,  and 
at  last  completely  paralyses  the  powers. 

Phosphorus  acts  equally  on  the  nerves  of  involuntary  motion, 
on  the  muscular  system  of  the  heart  and  chest.  It  retards  the 
pulsations,  disturbs  the  normal  rhythm  of  the  heart,  and  even 
completely  suspends  its  beating ;  so  that  this  viscus  becomes 
gorged  with  blood.  It  acts  on  the  respiration,  by  paralysing  the 
motor  nerves  of  the  thorax  and  diaphragm,  in  such  a  way  that 
the  lungs  too  are  distended  with  blood.*  In  consequence  of 
this  diminution,  of  this  weakness,  of  this  ultimate  abolition  of 
the  beating  of  the  heart  and  #f  the  respiratory  movements,  there 
results  such  a  lowering  of  temperature,  that  (the  physiological 
calorification  being  suspended)  the  animal  dies  benumbed,  in- 
sensible, and  stiffened,  as  in  death  by  frost. 

The  Phosphoric  and  Phosphorous  Acids  are  less  active  than 
Phosphorus ;  yet  they  are  like  it  in  weakening  and  paralysing 
the  motor  nerves,  and  the  movements  of  the  heart  and  chest. 

Paralytic  Symptoms  produced  by  Phosphoric  Acid. 

I  have  consulted  the  pathogenesy  of  Phosphoric  Acid,  which 
presents  a  certain  analogy  with  that  of  phosphorus.  That  is 
my  reason  for  extracting  from  it  the  following  symptoms. 

Hemiplegia,  f 

644.  Rheumatism  of  the  thighs,  which  hardly  allows  one  to 
drag  oneself  along,  especially  after  sleep. 

721.     Rheumatism  in  the  hips,  the  arms,  the  thighs,  and  the 

*  This  would  explain  and  confirm  the  homoeopathic  indication  of  Phos- 
phoms  in  pneumonia  generally,  and  especially  in  the  false  pneumonia  of 
typhoid  fever. 

t  HionuiBopathie  Manual,  Jahr. 


473  On  Phaspkoric  Paral^Ms, 

nape  of  the  neck,  with  tearing,  shooting  pains,  especially  on  going 
up  stairs,  and  beginning  to  walk. 

719.  Contusive  pain  in  the  hands  and  feet,  whidi  are  as  if 
paralysed. 

784.     Weakness,  physical  and  mentaL 

735.     He  thinks  he  totters  in  walking. 

737.  Weakness  and  dejection. 

738.  Extreme  feebleness  in  the  morning  on  rising,  with 
paleness. 

739.  Lassitude  all  over  the  body. 

147.     The  eyelids  are  heavy,  as  if  they  were  going  to  close. 

151.     Pressure  on  the  right  eyelid,  with  a  sensation  of  weight. 

190.  Dilatation  of  the  pupils  at  the  end  of  three  hours,  and 
lasting  six  hours. 

1 92.     Enormous  dilatation  of  the  right  pupil  (instantly). 

198.     Pupils  very  much  dilated  (in  8|  hours). 

403.     Stool  requiring  great  efforts,  though  it  is  not  hard. 

474.     During  coition,  the  erection  continues  without  emission. 

473.     Frequent  pollutions. 

472.  Discharge  of  semen  on  making  efforts  to  relieve  the 
bowels. 

427.  Abundant  discharge  of  watery  urine,  which  he  often  finds 
it  difficult  to  retain. 

Frequent  and  irresistible  desire  to  urinate. 

VII. 

COKYULSITE  STH^TOMS  PRODUCED  BY  PhOSPUOBIC  AcID. 

185.     Quivering  of  the  lower  eyelid,  towards  the  inner  angle. 

187.  Dilatation  at  first,  then  contraction  of  the  pupils  during 
sixteen  hours. 

188.  Closing  of  the  pupils  during  several  days. 

189.  Closing  of  the  pupils  without  alteration  of  the  sight 
194.    Myopia  in  conversing,  reading,  and  writing. 

196.  Increase  of  the  myopia. 

197.  At  more  than  six  paces,  all  objects  appear  sunrounded  by 
a  mist. 

413.     After  stool,  prolonged   tenesmus,  without    pain    in  the 
bowels. 
423.     Tenesmus  in  the  urethra  and  rectum. 


by  Dr.  OaUavardin,  478 

419.  Retraction  of  urine  for  the  first  seven  hours,  then  firequent 
urination,  hut  less  copious  than  usual,  with  huming  in  the  neck  of 
the  hladder. 

420.  Desire  to  urinate,  with  scanty  discharge. 
468.     Erection  without  any  cause. 

471.    Violent  erection  without  desire. 

508.  Painful  spasm  of  the  chest  and  diaphragm,  which  comes 
on  suddenly,  and  prevents  him  from  sitting  or  standing  upright. 

568.  Spasmodic  quivering  of  the  muscles  of  the  right  side  of  the 
neck  up  to  the  eye,  on  turning  the  head. 

570.  Painful  stiiBfness  of  the  muscles  on  the  left  side  of  the  neck, 
extending  to  the  head. 

582.  Muscular  twitching  in  the  arm,  which  is  stopped  hy 
movement 

609.     Cramp-like  pain  in  the  fingers  of  the  left  hand. 

627.  Spasm  in  the  hip-joint,  with  rheumatic  pain  in  the  whole 
thigh ;  insupportable  when  sitting. 

648.  Pulsative,  painful  quivering  from  the  middle  of  the  thigh 
down  to  the  knee. 

657.  Spasmodic  tearing  in  the  leg,  which,  in  the  day,  obliges 
him  to  get  up  ;  and  at  night,  to  change  the  place  of  the  limb  every 
instant. 

667.  Spasmodic  quivering  in  the  left  calf,  which  ceases  for  a 
time  on  rubbing. 

670.     Spasmodic  pains  in  the  feet  brought  on  by  movement. 

720.     His  limbs  are,  as  it  were,  smitten  with  contraction. 

722.     Muscular  quiverings  here  and  there,  especially  in  the  legs. 

Conclusion. 

If  we  analyse  the  observations  on  paralysis  in  the  various 

forms  above  quoted,  we  may  say,  in  the  way  of  recapitulation, 

that  we  have  seen  phosphorus  cure  16  cases  of  paralysis, 
to  wit : — 

1  Paralysis  of  the  third  pair  of  cranial  nerves. 

1         „  „  sixth  pair. 

1  „  ^,  sphincter  ani. 

2  „  „  sphincter  vesicie. 

1  Hemiplegia. 

2  Parslysis  of  both  arms. 


474  On  Phoitphoric  Parafysis, 

5  Paraplegic  oases. 

2  Paralysis  (the  precise  seat  not  indicated). 

1  Paralysis  of  the  right  leg. 
And,  on  the  other  hand,  we  haye  seen  Phosphorus  produce,  in 
the  healthy  human  subject,  six  cases  of  paralysis ;  viz. : — 

1  Paralysis  of  one  arm,  1  paraplegia. 

1  Paralysis  of  the  erector  muscles  (impotence  produced  by 
priapism). 

1  Partial  paralysis  of  the  tongue. 

1  Progressive  paralysis,  general,  with  preservation  of  the  in- 
tellectual faculties. 

1  Paralysis  of  the  hands. 
Besides  a  great  number  of  paralytic  symptoms,  which  would 
probably  have  become  complete  paralysis,  if  the  experimentors 
had  thrown  in  a  stronger  dose  of  Phosphorus. 

Now,  the  reader  will,  undoubtedly,  be  persuaded  that  phos. 
exercises  a  well  marked  elective  influence  on  the  muscular  sys- 
tem. All  the  above  cited  observations  must  have  shown  him, 
moreover,  that  this  medicine  has  caused,  and  probably  will 
cause,  in  the  sick,  paralysis,  similar  or  analogous  to  those 
which  it  produces  on  the  healthy. 

From  the  clinical  and  pathogenetic  experiments  hitherto 
known,  I  believe  one  may  conclude  that  Phosphorus,  when  it 
shallbe  otherwise  indicated  by  the  totality  of  symptoms,  accord- 
ing to  the  law  of  similitude,  it  may  be  employed  successfully  for : 

1.  Complete  or  partial  paralysis  of  the  third  pair;  meaning 
by  "  partial "  that  which  presents  one  only  of  the  following 
symptoms :  which,  when  united,  constitute  complete  paralysis. 

External  strabismus  (paralysis  of  the  right  internal  muscle). 

Dilitation  and  immobility  of  the  pupil. 

Falling  of  the  upper  eyelid. 

Abolition  of  the  rotatory  movement  of  the  eye. 

Diplopia  (as  soon  as  the  patient  leans  the  head  to  the  side 
opposite  to  the  paralysis). 

fb^  Paralysis  of  the  sixth  pair,  i.  e.,  internal  strabismus. 

Paralysis  of  the  right  internal  muscle ;  a  paralysis  so  rare, 
that  the  anatomist,  M.  Sappey,  has  found  but  two  cases  cited  in 
medical  literature ;  one  by  Yelloley,  the  other  by  M.  Jobert. 


by  Dr.  Gallavardin.  475 

We  have,  above,  Teprodnced  a  third  case,   observed  by  M. 
Tavignot. 

3.  Paralysis  of  the  tongue,  especially  when  it  seems  to  be  a 
premonitory  symptom  of  general  progressive  paralysis. 

4.  Paralysis  of  the  arms,  hands,  and  fingers. 
b.  ^,         „       sphincter  vesicffi. 

6.  „  „  sphincter  ani  (involuntary  stools  in  in- 
fiunts  and  old  people). 

7.  Hemiplegia. 

8.  Paraplegia. 

9.  Sexual  impotence,  spermatorrhoea,  and  abnormal  pollu- 
tions (paralysis  of  the  erector  muscles,  the  muscular  fibres  of 
the  vesiculiB  setninaies,  and  the  ejaculatory  canal)  especially 
when  there  has  been  previous  priapism-— venereal  excesses. 

10.  Progressive  general  paralysis. 

According  to  the  law  of  similitude,  or  analogy.  Phosphorus 
appears  to  me  to  be  also  indicated  for — 

Paralysis  with  oedema  of  the  parts  affected  (Gaultier  Glanbery 
has  cured  three  cases  of  this  kind). 

General  weakness  which,  proceeding  from  sexual  excesses, 
announces  premature  old  age,  or  an  approaching  lesion  of  the 
spino-cerebral  substance. 

Muscular  weakness  in  children  who  are  long  in  learning  to 
walk ;  especially  when  there  exists  along  with  it  habitual  diarr- 
hoea, and  respiratory  affections. 

Weakness,  consequent  upon  various  haemorrhages  (haemop- 
tysis, metrorrhagia,  &c.),  even  when  there  exists  the  delirium 
so  common  after  violent  bsemorrhage. 

Mentz,  founding  his  opinions  on  the  application  ofpAos,,  in 
continued  fever,  with  depression  and  absolute  debility,  says  it 
would  perhaps  be  desirable  to  try  this  medicine  in  paralysis  (see 
the  seventh  observation  of  his  dissertation,  in  the  collection  of 
Hollers  Theses,  U  vii.)  That  hypothesis  of  Mentz  seems  to  be, 
historically,  the  starting  point  of  the  employment  of  Phosphorus 
in  paralysis. 

Besides  the  authors  above  cited,  Phosphorus  has  been  also 
employed  for  paralysis  by  Sedillot,  Poilroux,  Gerdy,  Gardessus, 
Gruveilhier,  and,  it  would  seem,  for  paraplegia,  by  Brera,  whose 


476  On  Pkospharic  Paralysis, 

work  I  bave  not  been  able  to  consult:  Rifte$9iani 
pratiche  suU'uso  intemo  del  fofforo^  particolarmenie  nelV 
emipUffia^  Bwo.,  1798.  At  the  epoch  of  its  discovery.  Phos- 
phorus was  employed  often,  and  with  success,  for  very  difiereot 
diseases.  What  caused  it  to  be  almost  entirely  rejected  from 
ofiBcinal  medicaments  was  the  numerous  oases  of  death  caused 
by  its  administration  in  too  strong  doses ;  some  of  which  are 
reported  by  Weickard,  Zepler,  Brera,  Hufeland,  Louth,  Vorbo. 
On  this  ground  also  we  reject  equally  all  the  heroic  medicines, 
mercury,  arsenic,  &c ,  which  certain  practitioners  make  it  a 
point  of  honour,  in  the  eyes  of  their  patients,  never  to  employ ! 
To  those  practitioners,  Imbart-Oourbeyre  wishes,  with  good 
reason,  a  little  less  conscience,  and  a  great  deal  more  science. 

In  fact,  if  one  wishes  to  utilize  the  properties  of  a  medicine, 
and  to  avoid  its  inconveniences,  it  must  be  given  in  small  doses. 
When  we  have  a  mind  to  diminish  the  effect,  we  diminish  the 
dose:  this  is  logical.  Let  not,  therefore,  a  false  respect  for 
their  fellow  creatures  prevent  the  physician  from  employing  the 
most  attenuated  doses,  be  they  even  infinitesimal.  This  is  par- 
ticularly the  case  with  Phosphorus.  "  This  medicine,"  says 
Ldbenstein-Lobel  of  Jena,  *'  administered  in  the  small  quantity 
of  I  of  a  grain  (6  millegrams)  has  speedily  put  an  end  to  a 
lunatic."  Is  not  this  fact  eloquent  enough  to  justify  the  em- 
ployment of  the  infinitesimal  doses  ? 

Besides  the  experiments  with  this  substance,  on  healthy  ani- 
mals and  man,  might,  a  priori,  lead  us  to  foresee  the  advantage 
of  the  small  doses,  and  the  danger  of  the  strong  ones.  In  fact, 
if  we  administer  small  doses  of  Phosphorus,  the  muscular 
powers  are  doubled  (A.  Leroy,  Bouttatz),  the  muscular  irrita- 
bility is  increased  (Fr.  Pilger).  If  it  is  given  in  too  strong 
doses,  the  muscular  irritability  is  destroyed  (Oiulio  of  Turin), 
and  there  ensues  general  weakening,  convulsions^  paralysis,  even 
death  itself,  as  is  proved  by  the  history  of  poisonings  by  that 
substance. 

When,  therefore,  we  wish  to  attenuate  the  effects  of  Phos- 
phorus, we  have  simply  to  attenuate  the  dose.  To  attain  this 
end,  it  does  not  suffice  to  mix  it  with  correctives.  In  fact, 
where  the  oorrective  reacts  chemically  on  the  Phosphorus,  it 


jy  Dr,  Oallavardin.  477 

transforms  it  into  a  new  sabstance ;  and^  thenceforward^  it  is  no 
longer  Phosphoms  that  you  administer:  or,  perhaps  the  cor* 
rective  alters,  masks,  neutralises  the  effects  of  that  medicine.  In 
that  case,  it  is  as  well  not  to  give  any  Phosphorus  at  all ;  for 
one  cannot  say  to  the  corrective,  ''  You  shall  prevent  the  Phos- 
phorus from  producing  thU  effect,  and  you  shall  allow  it  to 
produce  that*'  Who,  then,  knows  the  science  of  antidotes  in 
order  to  arrive  at  such  results  ? 

The  physicians  who  administer  each  remedy  escorted  by 
correctives^  adjuvants,  directives,  &c.,  assimilate  a  medical  pre- 
scription precisely  to  a  parcel  of  letters  sent  to  the  stomach ;  a 
kind  of  postman,  charged  with  getting  this  new  kind  of  mes- 
sages to  their  respective  destinations.  Poor  stomach  !  Phos- 
phorus is  especially  indicated  when  the  progressive  paralysis 
exists  with  the  intellectual  faculties  preserved ;  when  it  has  had, 
as  a  precursory  phenomenon,  hypochondriasis ;  and,  as  an  excit- 
ing cause,  chagrins,  vexations,  morally  depressing  affections. 

Phosphoric  Acid  will  be  indicated  in  preference  for  progres- 
sive paralysis  with  alteration  of  the  intellectual  functions, 
consequently  for  the  general  paralysis  of  lunatics. 

A  German  homceopath  used  to  tell  me,  some  years  ago,  that 
his  colleagues  were  employing  efficaciously,  for  softening  of  the 
brain,  Phos.  in  low  dilutions,  for  two,  four,  six  weeks  without 
interruption. 

In  Germany,  as  in  France,  the  organic  school  have  invented 
the  disease,  lesion.  They  thus  consider,  as  a  disease,  the 
softening  of  the  brain,  which  is  a  symptomatic  affection  {locum 
cffectuni),  a  lesion  common  to  several  maladies,  such  as  gout, 
syphilis,  piles,  &c. 

An  over-excited  life,  the  abuse  of  intellectual  labour,  sexual 
excesses,  violent  or  long  continued  chagrins,  absorbing  or  pain* 
ful  pre-occupations,  may,  in  consequence  of  continued  cerebro- 
spinal tension  fubi  stimulus,  ibi  Jluxus),  it  is  true,  produce 
softening  of  the  nervous  centres,  a  lesion  so  common  in  our  day 
that  one  may  consider  it  in  a  manner  as  forming  an  integral 
part  of  XbQ  medical  constitution  of  the  nineteenth  century.  But 
the  various  causes  above-named  only  act  in  the  capacity  of 
objective  exciting  causes ;  they  rouse  the  individual  tempera- 
ment,  the  predisposing  subjective  cause,  and  indooe  a  settling 


478  On  Phosphoric  Paralysis, 

npon  it,  and  especially  on  the  cerebro- spinal  system,  one  or 
other  of  the  lesions  which  are  peculiar  to  it. 

We  admit  it  then,  the  softening  of  the  brain  is  not  as  it  is 
generally  called,  a  disease ;  it  is  merely  a  sympathetic  affectioa 
of  several  very  different  diseases.  I  might  make  exactly  the 
same  remarks  on  a  class  of  lesions  which,  in  our  days,  are  as 
common  amongst  women  as  the  cerebro-spinal  affections  are 
amongst  men.  I  mean  affections  of  the  uterus — affections 
which  are  symptomatic  to  chlorosis,  scrofula,  syphilis,  but 
which  are  diagnosed  and  treated,  unfortunately,  as  true  diseases. 

The  organic  school,  who,  for  half  a  ceutury,  have  had  so 
pernicious  an  influence  on  the  medical  body,  have  introduced 
disorder  into  the  medical  world,  by  confounding  a  part  with  the 
whole,  the  symptoms  and  lesions  with  the  diseases.  If  chaos 
actually  exists  in  scholastic  therapeutics,  it  is  no  less  manifest 
in  nosography ;  and  it  displays  itself  boldly  on  the  covers  of 
books,  under  the  titles.  Internal  Pathology,  External 
Pathology,  as  if  there  were  internal  and  external  diseases ! 

There  are  internal  and  external  symptoms,  lesions,  affections 
but  not  diseases :  seeing  that  disease  is  an  unnatural  state  of 
the  entire  man  ftotius  substantia) — a  symptom,  an  unnatural 
state  of  ihe  functions — a  lesion,  an  unnatural  state  of  the  parts. 
A  lesion,  accompanied  by  symptoms  constitutes  an  ajffectiofi.* 

I  take  the  liberty  of  recalling  to  my  readers  these  elements  of 
general  medicine  for  two  reasons :  first,  because  they  are  not 
always  found  in  ''classical"  books  so  called;  in  the  second 
place,  I  fear  that  the  clinical  and  pathogenetical  experiments 
reported  above  may  induce  some  physicians  to  employ,  after  the 
example  of  certain  German  homoeopaths.  Phosphorus  as  a  sort 
of  specific  for  softening  of  the  brain.  I  was  desirous,  before 
hand,  to  dissuade  my  professional  brethren  from  it.  With  this 
view,  I  have  endeavoured  to  shew  them  that  this  affection  pro- 
ceeds from  very  different  diseases,  presents  indications  not  less 
different — vindications  which  one  single  remedy  evidently  cannot 
satisfy.  In  advertising  a  medicine,  one  must  prevent  the  irra- 
tional use  of  it,  lest  failures,  repeated  too  oft;en,  should  cause  it 

*  These  simple  and  penpicnoiui  definitions  are  taken  firam  the  writings  and 
teachings  of  Dr.  J.  P.  Tessier.  See  his  Etudu  de  Mtdeane  Generale^  and  his 
nnmerons  articles  in  the  Art  MedicaL, 


iy  Dr^  Gallavardin.  479 

to  fall  speedily  into  discredit ;  also,  lest  Phosphorus  and  Phos- 
phoric Acid  should  be  employed  indiscriminately  for  paralysis, 
I  wish  to  show  here,  if  I  can,  the  special  indications  for 
one  and  the  other,  after  the  law  of  similitude.  With  this 
Tiew,  I  mean  to  exhibit,  in  a  synoptic  table,  the  difference  of 
their  sphere  of  action — of  their  elective  properties.  These  two 
remedies  having  different  features,  will  necessarily  present  a  very 
distinct  physiognomy:  henceforward,  there  will  be  no  longer 
even  a  pretext  for  confounding  them  in  their  therapeutic  appli* 
cation.  I  need  not  say  that  the  study  of  their  resective  patho^ 
genesy  will  give  a  much  more  complete  idea  of  each  than  the 
following  table  :— 

Phosphorus.  Phosphoric  Acid. 

Elective  actions  numerous,  and 
more  pronounced. 

Congestive  symptoms  more  fre- 
quent and  marked  ;  particularly  in 
the  head  and  chest. 

Cephalic,  thoracic,  and  dyspeptic 
symptoms  more  numerous  and 
characteristic. 

Hemorrhages,  by  all  the  pas- 
sages ;  by  wounds  and  cicatrices — 
by  the  anus — by  heemorrhoids,  and 
the  uterus;  epistaxis,  haematemesis, 
hemoptysis Epistaxis. 

OBdematous  puffing  of  the  feet, 
hands,  face^  eyelids,  particularly 
the  upper  lid    (Edematous  swellings  only 

Febrile    symptoms     (shivering,         of  the  lower  eyelid, 
heat,  perspiration)  more  frequent 
and  marked. 

Paralytic  symptoms  more  nu- 
merous, and  better  characterised. 

Greater  sensibility  to  moral 
causes,  especially  hypochondriasis ; 
preservation    of    the    intellectual 

faculties   Alteration  of  the  intellec- 
tual faculties. 


480  On  Phosphoric  Paralysts, 

Seeing  Phos.  produce  in  healthy  pereons,  on  the  one  hand, 
varions  paralyses  (amongst  others,  hemiplegia,  complete  or 
partial) ;  and  on  the  other  hand,  hflsmorrhages  taking  nearly 
every  possihie  direction,  I  am  led  to  infer  its  relative  e£Bcacy  for 
hemiplegia,  and  other  paralysis,  consequent  upon  cerehral 
hemorrhages.  My  inference,  moreover,  is  justified  hy  the 
sixth  clinical  observation,  which  reports  the  history  of  a  woman, 
in  whose  case  Pbos.  cured  paralysis  of  the  lower  limbs,  and 
of  the  sphincters  of  the  anus  and  bladder,  which  followed  an 
apoplectic  attack.  I  invite  my  professional  brethren  to  ad- 
minister, in  like  cases,  that  same  remedy  (perhaps  preferring 
the  low  dilutions)  when  it  shall  be  otherwise  indicated  by  the 
ensemble  of  symptoms.  For,  to  the  pathologic  concrete  state, 
one  must  always  oppose  a  medicinal  concrete  state  as  similar 
as  possible. 

Goindet  is  the  first  that  employed  Phos.  in  apoplexy.  He 
professes  to  have  seen  magic  effects  produced  by  it  in  the 
apoplectic  cases,  "  whenever  the  symptoms  were  due  to  a 
spasmodic  state,  perhaps  situated  elsewhere  than  in  the  brain, 
and  acting  there  only  by  sympathy." 

Goindet,  without  doubt,  means  by  this,  that  Phos.  is  effica- 
cious in  paralysis  consequent  on  apoplexy,  especially  where 
there  exist  in  the  paralysed  parts  twitching  and  muscular 
contractions.  That  particular  indication  is,  in  fact,  confirmed 
by  the  pathogenesy  of  this  medicine  such  as  we  have  quoted  it 
above. 

Phos.,  which  produces  in  a  healthy  person,  on  the  one  hand, 
urine,  with  whitish  sediment  (albumen  ?) ;  and  on  the  other 
hand,  oedema  of  the  upper  parts  of  the  body  (hands,  face, 
eyelids)  appears  to  me,  for  that  very  reason,  indicated  for 
albuminuric  paralysis.  It  might  also  be  employed  for  puer- 
peral paralyses,  whether  symptomatic  of  Bright's  disease  or  not, 
especially  when  they  have  been  preceded,  or  are  accompanied  by 
uterine  haemorrhage. 

According  to  the  law  of  similitude,  Phosphorus  is  also 
indicated  for  chlorotio  paralysis,  when  there  is  pufi^ess  of  the 
flesh,  and  particularly,  with  a  pale  yellowish  face,  puffed  espe- 
cially about  the  eyes. 


by  Dr.  Gallavardin.  '481 

.  In  conclasion,  I  have  a  lively  hope  that  this  brief  notice 
may  awaken  the  attention  of  physicians^  and  lead  them  to 
inqnire  whether  the  working  people  who  handle  Phos.  and 
Phos.  Acid  do  not  present  some  phenomena  peculiar  to  the 
muscular  system,  such  as  tremblings,  convulsions,  paralysis. 
If  it  be  so,  let  them  be  so  kind  as  to  publish  the  results  of 
their  observations,  and  then  one  may,  by  the  aid  of  these  fresh 
documents,  make  a  good  monograph  of  the  phosphoric 
paralyses. 

SUPPLEMENT. 

Elective  Action  of  Phosphorus  on  the  Nerves  of 

Sensation. 

We  have  seen  Phosphorus  act  in  a  peculiar  way  on  one  part 
of  the  cerebro' spinal  system.  Before  we  quit  that  region,  and 
by  way  of  finishing  this  notice,  I  feel  bound  to  point  out  further 
the  elective  action  of  the  same  remedy  on  another  part  of  the 
nervous  system,  viz. :  the  nerves  of  sensation.  For  this  pur- 
pose, it  sufi&ces  to  cite  the  testimony  of  the  following  authors: — 

Professor  Mayer,  after  having  experimented  on  various  ani- 
mals (quadrupeds  and  batrachians),  concludes  that  Phosphorus 
acts  specifically  on  the  nerves  of  sensation :  it  destroys  sensi- 
bility, by  destroying  from  the  periphery  to  the  brain,  the 
sensarium  being  in  a  small  degree  disturbed. 

Von  Bibra  and  Oeist  report,  amongst  others,  the  case  of  a 
girl  of  19,  who  was  attacked  with  necrosis,  after  working  for 
two  and  a  half  years  in  a  chemical  match  manufactory.  Besides 
the  local  accidents  of  the  necrosis,  the  patient  presented  a  com- 
plete absence  of  pain  and  of  sensibility  in  the  velum  palati. 
(Die  Krankheiten  der  Arbeiier  in  den  Phosphor-zUndholz- 
fabriken,  obs.  6,  p.  137.     Erlangen,  1847). 

The  Materia  Medica  Pura  of  Hahnemann  contains  a  cer- 
tain number  of  symptoms  observed  in  health,  which  equally 
prove  the  elective  action  of  Phosphorus  on  the  nerves  of  sensa- 
tion. To  avoid  too  frequent  repetition,  I  sum  up  the  symptoms 
as  follows : — 

Exaltation  of  the  general  sensibility. 

VOL.  XX  ,  NO.  LXXXI. — ^JULY,  1862.  2  H 


481  On  Pkoiphorie  Paralysis, 

Orer-exciteineiit  of  all  the  senses,  especisUy  the  hearing  and  the 
amell,  and  of  the  sexual  instinct^  as  occurs  sometimes  in  satjiiasis. 

Morbid  sensibility  ;  hallucinations ;  diminution  and  total  loss  of 
sight  (photophobia,  appearance  of  sparks  in  the  dark,  myopia, 
amblyopia,  amaurosis). 

Exaltation,  hallucinations,  and  total  loss  of  the  hearing ;  otalgia. 

Perversion,  diminution,  total  loss  of  taste. 

Exaltation  of  the  sense  of  smelling,  especially  for  bad  odours. 

Diminution  and  total  loss  of  the  sense  of  touch,  as  shown  by 
formication  and  numbness  in  the  limbs. 

Itching  OTer  the  whole  body,  or  only  on  some  spots. 

Itching  on  the  hairy  scalp. 

Pains  in  the  bones  of  the  jaw  and  face. 

Veiy  frequent  toothaches. 

Headache  over  almost  eveiy  part  of  the  cranium,  in  a  fixed  or 
erratic  form  of  the  remittent  or  intermittent  type,  quotidian  or 
tertiary. 

Pains  in  the  palate.     {See  Bibra  &  Geist.) 

Pains  in  different  parts  of  the  chest,  in  the  cardiac  region. 

Pains  in  the  stomach,  intestines,  anus,  hemorrhoids,  or  uterus. 

Pains  in  the  loins  and  sacrum. 

Pains,  with  a  sense  of  formication  or  numbness  in  the  muscular 
fibres,  which  we  have  above  shown  to  be  affected  with  twitchings, 
convulsions,  and  paralysis,  complete  or  incipient. 

Pains  in  the  limbs  and  joints. 

Phosphorus  provokes,  in  the  healthy  subject,  symptoms  both 
more  numerous  and  better  characterised  than  Phosphoric  Acid ; 
but  the  latter  produces  one  which  is  peculiar  to  itself  apparently, 
i.e.,  a  pain  on  the  periosteum  of  all  the  bones. 

All  the  symptoms  of  Phosphorus  and  of  Phosphoric  Acid, 
relative  to  the  sensorial  or  tactile  sensibility,  fully  justify  the 
established  employment  in  homoeopathy  of  those  two  medicines 
(when  they  are  otherwise  indicated  by  the  totality  of  morbid 
phenomena)  for  deafness. 

Photophobia,  amblyopia,  amaurosis. 

Impotence,  preceded  by  excess  of  sexual  excitement. 

Perversion,  or  loss  of  taste. 

Osteocopous,  rheumatic,  arthritic  pains. 

Neuralgia,  assuming  various  forms,  and  variously  seated. 


483 

A  FEW   OBSERVATIONS    ON   BELLADONNA   AS  A 
UTERINE  REMEDY,  WITH  OASES. 

By  Dr.  Liedbbck,  of  Stockholm. 

Thb  name,  Belladonna,  indicates  the  effects  produced  by  this 
drug ;  which,  in  large,  even  poisonous  doses,  produces  high- 
coloured  cheeks,  and  a  kind  of  amorous  expression,  with 
either  lively  or  languishing  expression  in  the  eyes  (erotic 
or  torpid  uterine  affection).  Just  as  the  periodically  recur- 
ring activity  of  the  uterine  system,  with  increased  or  de- 
creased transmutation  (mauserung)  we  find  also  something 
similar  in  the  phy$iological  action  of  Belladonna,  as  Bdcker 
has  proved  in  his  Beitrage  zar  Heilkunde,  11,  1849,  with  ex- 
periments, the  best  hitherto  known  to  exist.  As  nearly  related 
to  this  subject  belongs  the  observation  of  Bretonneau  and 
Trousseau  {Zeisehriftfiir  Erfahrungsheilku^Mle,  t.  iv.  p.  12, 
1848),  that  vomiting,  depending  on  the  gravid  state  of  the 
uterus,  has  speedily  been  cured  by  Belladonna,  externally  em- 
ployed. The  same  effect  has  been  obtained  by  its  internal  use, 
according  to  the  observation  of  homosopathic  physicians,  in  this 
respect,  the  first  and  most  original  I  know  of,  and  which  I 
acknowledge  in  the  same  manner  as  I  acknowledge  the  gr^at 
originator  of  the  homoeopathic  treatment  to  be  our  common 
master,  the  founder  of  homosopathy. 

Besides  the  group  of  symptoms,  in  women,  of  Belladonna, 
viz. :  painful  burning  of  the  genital  organs^  redness  and  swel- 
ling of  vulva,  increased  or  diminished  menstrual  discharge, 
accidents  of  abortion,  pressure,  as  if  everything  would  pass 
through  the  genitals,  with  expansion  of  the  abdomen ;  after  this 
pressure  the  abdomen  contracted  itself  with  a  secretion  of  white 
mucus  from  the  uterus  (see  Hahnemann,  Roth,  M.  L.  Noack, 
H.A.M.L.,  1)  proving  the  uterine  effects  of  this  remedy.  Still 
more  light  has  been  brought  to  bear  on  the  subject,  through  the 
experiments  of  the  American  homceopathists,  who  have  repro- 
duced and  again  confirmed  what  Noack  (H.A.M.L.,  227)  in 
1843,  had  shown  of  the  physiological  action  of  the  remedy :  the 
appearance  of  filling  of  milk  in  the  mammes,  in  non-pregnant 
women,  galactorrhoea,  &c.     I  have,  myself,  seen  in  practice  the 

2  H  2 


484  Observaiiotis  on  Belladonna, 

reappearance  of  milk  where  it  had  disappeared,  from  frictions 
with  the  fresh  juice  of  Belladonna. 

Furthermore,  a  homoeopathic  physician  has  declared  he  would 
no  longer  practise  midwifery  if  he  were  deprived  of  the  use  of 
Belladonna.  (Either  Schron,  or  perhaps  an  Austrian,  Dr. 
Mayerhofer,  I  cannot  rememher  at  present,  as  it  dates  as  long 
ago  as  the  time  when  the  Hygea  existed).  To  this  category  be- 
longs also  Mayerhofer  s  plaster  for  calming  the  after-pains  and 
spasms  after  turning.  Extract.  Belladonnas  gr.  x,  with  Butyrum 
or  Axungia  J  j.  (see  All^,  Repert.  d.  Medicin.  Jouralistik^ 
1841).  I  have,  however,  learnt,  in  a  practical  way,  a  more 
extensive  use  of  Belladonna,  as  a  uterine  medicine,  from  Allff. 
Homoeop,  Zextung,  vol.  61,  No*  22,  p.  176,  in  an  article  ex- 
tracted from  a  so-called  allopathic  journal,*  the  German  Clinic, 
(Gosohen  and  Dr.  Baur,  of  Tubingen). 

The  following  are  my  extracts  from  the  Allg,  Horn,  Zeiiung, 
1.  c. :    "  For    uterine  pains  from   deviation   of  the    normal 
position  of  the  uterus ;  cramp  and  pains  in  pelvic  organs, 
hysteria,  and  abnormalities  in  the  menstruation,  leucorrhosa, 
sterility,  constipation,  afid  cofisequent  uterine  affection,  has 
been  used  with  the  best  results,  Unguentum  Belladonnse,  Ph. 
Wurtemb.,  three  times  a  day,  one  tea-spoonful  rubbed  in,  and 
only  for  three  consecutive  days,   even  in  chronic  cases  with 
prolapsus  uteri,  hemorrhages,  painful  swelling,  pressure,  ten- 
sion ;  pressure  on  the  uterus,  bladder,  rectum,  sacrum,  even 
down  on  the  thighs,  profuse  mefistruation,  acute  paifis  in  the 
abdomen,  especially  boring  and  pressure,  difficult  and  pain- 
ful evacuation,   disturbed    digestion,  even    in   two   cases  of 
typhus." 

I   have,   myself,   observed  in  praxi  all  the   symptoms  in 
italics   more   often   cured   by    the   use   of   Belladonna    than 

*  I  say  purposely  the  "  so-called  "  allopathic,  because  I  have  never  found 
(unless  exceptionally)  any  acute  physiological  Belladonna  symptom  as  a  con- 
sequence  of  the  use  of  the  plaster,  unless  sleeplessness  and  generally  a  ces- 
sation  of  the  pains,  which  also  sometimes  happens  from  Belladonna  3  dec. 

I  have  not  yet  ohserred  any  allopathic  action  firom  the  unguentum  Bella- 
donnn,  when  used  on  the  skin,  hut  stronger  action  when  introduced  in  ano, 
i^hen  I  have  sometimes  ohserved  enlargement  of  the  pupils  the  following  day — 
though  this  only  exceptionally  in  one  or  two  cases,  Exctptionesfirmani  regtdam. 


by  Dr.  Liedbeck.  485 

by  any  other  remedy  known  to  me.  I  had  before,  in  similar 
cases;  led  by  the  symptomatology  of  the  remedy,  and  by  re- 
ported observations  of  other  homoBopathio  physicians,  used 
Belladonna  3-30  internally,  but  not  with  the  same  degree  of 
success. 

Now,  a  few  words  on  my  method  of  employing  the  Unguen- 
tum  Belladonn®.  I  have  searched  for  it  in  vain  in  an  old  edition 
of  Pharmacopceia  WUrtembergica,  It  is  well  known  that  this 
pharmacopoeia  is  one  of  the  most  complicated  that  exists; 
I  do  not  know  whether  the  latest  edition  is  improved  with  sim* 
plified  formulflB,  but  I  take  it  for  granted  as  quite  impossible 
that  it  can  be  worse  than  that  old  Pharmacopcsia  Wurtember- 
gictty  which  I  have  read,  with  its  theoretical  compositions, 
jusqu  a  crever,  I  suppose,  therefore,  that  the  new  pharma- 
copoeia, even  in  Wurtemberg,  has  not  quite  remained  without 
the  pale  of  the  influence,  even  though  unconsciously,  of  the 
simplicia  of  Hahnemann  and  homoeopathy,  somewhat  modi- 
fied perhaps  by  the  doctrines  of  Bademacher,  and  by  the  labours 
of  the  celebrated,  but  nevertheless  deposed,  Professor  Carl  Bapp, 
of  Tiibingen. 

In  taking  all  this  into  consideration,  I  have,  from  the  chemist 
here,  in  Stockholm,  prescribed  my  ointment  a  la  Banr,  to  the  ^ 
best  of  my  knowledge;  in  the  spirit  of  the  Ph.  Wurietnbergica, 
viz.: — 

B    Extract.  Belladonnae, 

cum  Fol.  pulv.  et  Bad.  pulv.  aa.  3  iss, 
Butyr.  rec  insal.,  3  iss.  a  ijes. 

Gonterendo  mortario  marmoreo  probe  depurato  f.  1.  a.  unguent, 
equabile. — Dr.  S.  Baur's  ointment — To  rub  one  teaspoonful, 
night  and  morning,  according  to  prescription.* 

•  During  the  winter,  when  the  batter  is  bard,  and  more  difficnlt  to  pre- 
pare in  the  mortar,  it  has  happened  occasionally  that  a  chemist  nsaally 
tmstworthy,  prepared  the  ointment  with  Olenm  Olivamm,  contrary  to  my 
ordination.  The  ointment  became  certainly  more  lubricating,  but  not  so 
powerful  (nay,  even  quite  inactiye  in  one  case)  as  when  prepared  with 


486  Observations  on  Belkuhnna, 

This  profloription  has  consisted  in  having  the  ointment 
nibbed  in  with  the  hand,  or  rather  both  the  hands  of  the 
patient,  on  the  abdomen,  and  below  the  navels  from  hip  to  hip, 
as  well  as  the  whole  of  the  ihigh^  on  as  large  a  surface  as 
possible,  till  the  ointment  has  quite  disappeared.  Besides,  I 
have  ordered  the  skin  to  be  well  oleansed  from  the  ointment 
before  each  renewal  of  its  application,  which  should  take  place 
morning  and  evening,  before  dressing  and  after  undressing^. 

I  give  here  a  few  extracts  from  my  case  book ;  it  would  be 
easy  to  give  many  more  were  I  not  afraid  to  fatigue  the  reader, 
especially  as  my  annotations,  entirely  from  private  praotioe,  are 
not  so  readily,  nor  so  exactly  made^  as  may  he  done  in  hospital 
practice. 

Miss  St Im,  aged  48,  with  light  complexion,  thin,  blonde 

hair,  and  blue  eyes,  rather  tall,  tolerably  well  preserved  for  her 
years,  sent  for  me  in  the  commencement  of  1861 ;  she  lived  in 
the  country,  about  two  miles  from  Stockholm.  It  was  almost 
impossible  for  her  to  be  out  of  bed,  as  no  sooner  was  she  in  an 
erect  position,  than  severe  pains  affected  her,  with  weight  and 
pressure  in  pelvis,  tenesmus,  and  straining  as  to  a  motion ;  she 
has  less  pain  in  a  lying  posture,  but  enough  to  keep  her  awake 
^  at  night :  strains  to  pass  water  and  to  go  to  stool  without  results. 
Fever — pulse  1 00,  irritable. 

It  was  not  till  I  positively  declared  that  I  neither  would  nor 
could  prescribe  for  her,  that  a  manual  examination  was  per- 
mitted. I  found,  then,  the  orificium  utori  situated  so  far  back- 
wards that  it  could  scarcely  be  reached  with  the  finger.  To  the 
feel  it  seemed  like  a  transversal  fold  on  the  uterus,  which  had  a 
globular  form — the  mucous  membrane  of  the  vulva  was  rather 
pale,  and  rather  hot,  whilst  the  hands  and  feet  felt  quite  cold. 

I  gave  Belladonna,  three  drops,  but  without  any  ameliora- 
tion, till  six  to  seven  o'clock  in  the  afternoon,  and  it  was  not 
till  the  Belladonna  Ointment  had  been  rubbed  in,  about  nine 

butter.  I  have  no  ezperienoe  as  to  whether  Aznngia  can  be  used  instead  of 
Bntyram,  bat  betieve  it  to  be  better  than  oil,  thongb  not  so  good  as  batter. 
I  leave  this  to  others'  experienoe.  Should  any  one  know  this  better,  I  shall 
be  qaite  ready  to  profit  by  the  lesson. 


by  Dr,  Liedb^ck.  487 

0  olook,  thai  the  patient  felt  easier,  and  had  a  tolerable  good 
night. 

The  improvement  continued,  so  that  the  patient  eoald  remain 
out  of  bed  after  three  days  were  over,  and  was  able  to  come  and 
see  me  in  town  before  the  week  was  ended.  She  said  she  could 
not  have  believed  in  so  sudden  relief  as  I  had  foretold  her. 

On  the  2drd  of  January,  she  eame  to  me  again.  She  felt 
feeble,  and  had  some  pain ;  but  in  no  way  to  compare  with  her 
sufferings  on  the  evening  of  my  first  visit.  I  found  the  palate 
pale,  like  a  sheet  of  paper ;  the  urine  was  alkaline.  This,  as 
well  as  other  circumstances,  decided  me  to  give  Ferrum  Car- 
bonicum  9  j.,  one  pinch,  morning,  noon,  and  night.  She  felt 
better  after  she  bad  this  medicine.  The  heat  was  much 
diminished,  and  the  urine  of  acid  reaction,  when  I  tested  it  on 
the  4th  February.  I  was  then  told  that  the  periods,  which  had 
commenced  at  her  i4th  year,  had  disappeared  since  1840.  I 
prescribed  again  the  Belladonna  Ointment,  which,  having  been 
repeatedly  applied^  completely  cured  the  old  maid,  who  is  now 
luckily  married  since  the  commencement  of  the  summer. 

Gasb  2. — ^An  unmarried  servant,  aged  30,  with  light  hair, 
blue  eyes,  and  oval  face,  and  rather  strongly  built,  suffered 
excruciating  pains  in  the  pelvic  region,  when  lying  on  her 
back.  She  had  great  difficulty  in  getting  rid  of  her  excreta. 
She  visited  me  on  the  11th  May,  1841,  and  I  found  her  suffer- 
ings depending  on  retroversio  uteri  to  such  a  degree,  that  the 
08  was  turned  against  the  symphisis  pubis ;  corpus  uteri  was 
pressed  against  the  anterior  aspect  of  rectum ;  os  uteri  was  not 
round,  but  oblong.  The  rugeo  abdominales;  and  other  signs^ 
made  me  ask  if  she  had  not  been  pregnant,  which  she 
acknowledged.  The  mucous  membrane  of  vulva  was  bright 
red  and  cHtoris  in  a  state  of  erection  (erectio  feminina) 
ttom  pain,  as  the  patient  expressed  herself—''  it  swells  when 

1  am  most  suffering ;  otherwise,  it  is  not  felt,  except  when 
passing  the  urine,  which  often  is  difficult."  I  prescribed  the 
triplicated  Belladonna  Ointment  to  be  rubbed  in,  morning  and 
evening,  one  teaspoonful,  as  above;  and  told  the  patient  to 
come  again  in  three  days,  when  I  hoped  to  find  her  free  from 
pains.     I  advised  her  besides  to  pass  the  urine  every  hour,  or 


488  ObservaitofM  on  Belladottna, 

at  least  every  other  hour,  and  to  see  that  the  bladder  was  well 
emptied.  Besides,  I  recommended  her  to  sit  at  the  exoneratio 
alvi  bent  forwards,  with  the  elbows  on  her  knees ;  and  to  walk 
like  a  soldier,  with  the  chest  out  and  the  stomach  in,  so  that 
she  might  get  the  lumbar  region  as  much  hollow  as  possible. 
This. is  to  facilitate  machauically  the  return  of  the  uterus  to 
its  normal  position.* 

After  having  used  the  ointment  for  three  days,  the  patient, 
as  agreed,  visited  me  again.  She  was  then  nearly  without  any 
pains ;  nay,  as  she  expressed  herself,  with  joy  and  satisfaction 
beaming  in  her  face — "  Quite  another  being  to  what  I  was  before." 
She  submitted,  notwithstanding,  to  a  new  examination,  and  I 
found  the  os  had  so  much  altered  its  position  that  it  was  in  a  quite 
normal  position.  She  came  again  on  the  1st  of  June,  perfectly 
well,  and  tendered  me,  of  her  own  accord,  as  a  fee,  the  fourth 
part  of  her  yearly  salary,  "  as  a  mark  of  her  great  debt  of 
gratitude." 

Case  3. — Anne  Christina  S ^g,  a  servant,  suffered  firom 

cutting  pains  in  the  stomach  ;  leucorrhcea,  in  some  degree ; 
difficult  and  hard  stools.  She  felt  better  in  a  lying  posture 
than  when  she  was  up.  When  I  first  saw  her,  on  the 
2drd  August,    186 J,   she   had    had    leeches   applied    by  an 

experienced  and  examined  midwife,  Mrs.  U g,  under  the 

use  of  the  speculum ;  accordingly,  either  on  the  vulva  or  os 
uteri.  She  became  rather  worse,  instead  of  better,  afterwards, 
and  felt,  in  standing,  a  pressing  weight  downwards.  In  the 
morning,  and  in  a  lying  posture,  as  well  as  during'her  periods, 
she  felt  somewhat  relieved. 

At  my  examination  I  found  the  os  only  one  inch  within  the 

*  It  is  possible  that,  besides  the  mechanical  manipalation  under  such  dr- 
Cttmstances,  a  kind  of  ideo-magnetism  from  the  hands  of  the  patient  occnrs, 
and  assists  to  help  it  to  improyement.  Super  soeptici  may  take  all  this 
into  account,  but,  for  my  part,  I  am,  with  Dr.  Baur,  satisfied  as  well  as  the 
patients,  of  the  good  effect  of  the  external  application  of  the  Belladonna  Oint- 
ment In  conclasion,  permit  me  an  anatomical  observation  in  this  caser  I  have 
never  so  clearly,  as  in  the  present  case,  observed  the  form  and  situation  of 
ditorii  eum  fremdo  suOy  in  accordance  with  what  Professor  Kobelt  in  Frey- 
burg  demonstrated  to  me  (1844),  on  his  injected  preparations,  and  which  he 
has  described  in  his  master-work,  Die  WoUustorgane,  &c. 


hy  Dr.  Liedbec/k.  489 

^vulva ;  08  tinoae  thin  as  the  end  of  a  finger,  with  the  os  tarned 

forward  ;  rectum  felt  full  of  scyhala. 

I  prescrihed  T^  Extract.  Belladonnes,  cum  Fol.  &  Bad., 
aa.  9  J8. ;  Butyr.  Bee.  Insal.,  ^  ijss.  f.  1.  a.  Qnguent.  »qua- 
bile ;  D.  S.,  to  rub  in  one  teaspoonful,  night  and  morning. 

On  the  28th  August,  when  she  came  again,  she  reported  that 
the  costiveness  was  cured,  and  the  pressure  and  bearing  down 
pains  were  diminished.  I  found  the  os  tine®  half-an-inch 
higher,  according  to  my  feel.  She  felt  increased  sensitiveness 
to  cold,  which  she  attributed  to  the  ointment,  which,  according 
to  Bockers  experiments,  depends  on  the  increased  transmu- 
tation of  tissues  from  the  efiects  of  Belladonna. 

The  general  improvement  was  apparent  in  the  patient's 
expression  of  countenance,  but  was  not  described  by  the  patient 
so  energetically  as  in  the  two  previous  cases,  or  as  I  had  found 
in  other  patients.  I  told  her,  accordingly,  to  introduce  in  ano 
of  the  ointment,  as  much  as  the  size  of  a  nut,  and  to  come 
again  in  three  days.  The  patient  having  experienced  no  im- 
provement from  this  application,  I  had  recourse  to  the  oint- 
ment, with  some  result,  though  not  to  my  entire  satisfaction. 
I  gave,  therefore,  on  the  9th  September,  Belladonna,  3,  glob.  j. 
morning  and  evening. 

12tli  Sept. — The  patient  feels  herself  much  better.  She 
continued  with  this  prescription  till  the  end  of  the  month,  when 
she  felt  quite  well,  though  I  could  not  find  any  alteration 
in  the  abnormal  position  of  the  uterus.  I  advised  her  to 
avoid  carrying  heavy  weights ;  to  walk  with  the  loins  drawn  in 
(hollow  back) ;  empty  the  bladder  every  two  or  three  hours 
whether  there  was  a  call  to  do  so  or  not.  Though  not  quite  cured, 
she  was,  at  least,  free  from  pain,  and  could  perform  her  duties 
as  a  servant. 


490 


REVIEWS 


Zeitschrift  des  Vereins  HotncBopathUcher  Aertze  Oesterreichs, 
Bedigirt  von  Dr.  M.  Eidherr.  Enter  Jahrgang,  Erster 
Band.  1  Heft.  Wien:  1862.  Druck  yon  Ludwig 
Mayer. 

Journal  of  the  Austrian  Society  of  HomoBopathic  Phystdans. 
Edited  by  Dr.  M.  Eidherr.  First  year,  first  yolame,  first 
number.    Vienna :  Ludwig  Mayer. 

We  have  never  hesitated  to  allow  to  our  Austrian  colleagaes 
the  first  rank  in  the  march  of  progress  of  homoeopathy,  both 
from  the  talent  and  zeal  of  the  individual  members  of  their 
body  there,  and  from  their  unrivalled  opportunities  of  hospital 
practice.     We  therefore  welcome  with  great  interest  the  appear- 
ance for  the  third  time,  after  the  two  interruptions,  of  a  perio- 
dical devoted  mainly  to  those  original  observations  in  practice 
and  Materia  Medica,  for  which  the  former  works  of  the  Vienna 
Society  were  distinguished.  The  plan  of  publication  of  the  present 
periodical  is  different  from  the  last,  and  resembles  tlie  first  in 
the  fact  that  the  numbers  are  not  to  come  out  at  fixed  periods, 
nor  of  fixed  size,  but  according  to  the  quantity  of  important 
matter  that  may  be  furnished.     This  plan  we  can  testify  has 
its  advantages,  and  might  be  adopted  by  we  dare  not  say  how 
many  periodicals,  without  detriment  to  the  readers. 

The  greater  part  of  this  present  number  is  occupied  with  the 
subject  of  the  comparative  utility  of  the  Srd,  7th,  and  15th  dilu- 
tions in  inflammation  of  the  lungs.  The  subject  is  examined  in 
the  most  complete  manner  that  has  hitherto  been  attained,  and  all 
possible  disturbing  causes  have  been  considered.  It  will  not  be 
concluded  till  next  number,  and  then  we  propose  to  go  into  the 
details.  In  the  meantime,  we  may  state  one  remarkable  result, 
viz.,  the  average  number  of  days'  illness  for  each  patient  was 
as  follows : — 

For  those  treated  with  the  Srd  dilution,  19*5  days;  7th 
dilution,  14'6  days;  15th  dilution,  ITS  days. 


Homoeopathic  Clinical  Experience.  491 

Klinische  Erfahrungen  in  der  HamoBopathie,  eine  vollstdn- 
dige  Sammlung^  dtc.  dc.  Yon  Th.  J.  BdeckebTi  Prakt 
Arzte  in  Herrohut.     4  vote.     Dessau,  1854-61. 

EomoBopathic  Clinical  Experience ;  a  Complete  Collection  of 
all  the  Cures  and  Practical  Observations  that  have  been 
Published  in  Germany  from  1822  to  1850.  By  Th.  J. 
RuECKEET,  M.D.,  Herrnbut.     4  yols.     Dessau  :  1854-61. 

The  completion  of  this  very  useful  cyclopeBdia  of  homoeopathic 
therapeutics  as  exemplified  in  clinical  experience,  deserves  to  be 
recorded  as  the  most  important  literary  achievement  that 
homoeopathy  has  to  show  for  many  years  past.  The  labour 
and  skill  exercised  by  Dr.  Bueckert  in  his  stupendous  task  no 
one  who  has  not  attempted  to  collect  and  abridge  the  recorded 
cases,  illustrating  some  group  of  diseases,  can  form  an  idea  of. 
What  some  of  us  have  endeavoured  to  do  for  a  particular  class 
of  diseases.  Dr.  Biieckert  has  effected  for  all  diseases.  He  has 
executed  his  task  in  so  complete  and  exhaustive  a  manner  as 
to  leave  nothing  to  be  desired.  If  some  maladies  are  but 
scantily  illustrated,  the  fault  is  not  Dr.  Biieckert's,  but  of  the 
deficient  literature  of  the  subject,  and  the  poverty  of  the  records 
of  our  literature. 

The  various  monographs  published  by  Dr.  Peters,  of  New 
York,  on  headaches,  diseases  of  the  eye,  female  derangements, 
&o.,  which  are  founded  on  the  corresponding  chapters  in  this 
work  of  BUokert's,  will  give  the  English  reader  some  notion  of 
the  vast  amount  of  research  and  labour  entailed  on  Dr.  Bueckert 
by  the  task  he  has  imposed  on  himself. 

The  work  consists  of  four  goodly  octavo  volumes,  containing 
eighteen  divisions,  corresponding  to  the  parts  and  functions  of 
the  body,  in  the  order  of  the  Hahnemannic  schema.  These 
eighteen  divisions  are  further  sub-divided  into  149  chapters, 
representing  diseases  and  groups  of  disease,  necessarily  rather 
arbitrarily  arranged.  The  chapters  are  thus  arranged  : — ^First  is 
given  the  name  of  the  disease,  or  group  of  diseases  treated 
of;  next,  a  list  of  the  literary  sources  referred  to;  then  the 
names  of  the  observers  and  authors  who  have  recorded  their 
remarks  on  the  disease ;  then  the  names  af  the  medicines  that 


492  Beviewi, 

haye  been  found  osefal  in  its  treatment ;  then  follow  in  alpha- 
betical order  the  medicines,  as  heads  of  sections^  and  nnder 
each,  1st,  the  general  observations  respecting  it.  2nd,  Brief 
abstracts  of  the  cases  cared  by  it.  3rd,  A  short  review  of  the 
observations  respecting  it  At  the  end  of  each  chapter  is  a 
general  resume  of  the  therapeutics  of  this  chapter. 

In  order  to  give  a  correct  idea  of  the  mode  in  which  Dr. 
Biieckert  has  executed  his  very  difficult  task,  we  shall  here 
transcribe  a  chapter  from  his  work.  We  select  one  of  the 
shortest  on  account  of  the  limits  imposed  on  us : — 

"Hundred  and  Twelfth  Ghafteb. 
"  Shingles — Zona. 

"  Literature.— AWg.  h.  Ztg.  1,  11,  13,  34,  51.  Arch.,  12, 
3.     Corr.  Bit.    Ereuss.,  Yehsem.  1. 

"Observers. — Bute,  Croserio,  Gaspary,  Hendricks, Ereussler, 
Kretschmar,  Lingen,  Lobethal,  Muhlenbein,  Beisig,  Trinks, 
Wolf. 

"Remedies. — Arsen.,  Oraph.,Merc.,Mezer.y  Puls.^Bhus,  Silic. 

"  1.  Arsenicum. 
"  A. — General  Observations, 

In  a  case  of  zona  in  a  woman  of  very  scrofulous  constitution, 
Arsen.  15,  one  drop,  gave  rapid  relief,  and  removed  the  burning 
that  was  especially  troublesome  at  night  in  24  hours. — Allg.  h. 
Ztg.  1,  89.— Trinks. 

"2.  Graphites. 

"  A. — Oetieral  Observatiotis, 

"  a.  When  Graph,  is  of  use,  we  shall  generally  find  that  there 
have  been  for  some  time  previously  derangement  in  the  internal 
organ  whose  disturbance  occasions  the  disease. — Kreuss.,  233. 

"  B. — Special  Case. 

"A  boy,  aged  15 — zona  for  14  days — had  been  hitherto 
treated  with  rose  ointment,  which  had  caused  abscesses. 

"  Symptoms. — ^Large  vesicles  on  an  inflamed  ground,  that 
occupied  a  space  6"  long,  from  the  navel  towards  the  spine ; 


HomcBopathic  Clinical  Experience.  498 

the  vesicles  were  all  scratched  open.      He  cries  bitterly  on 
account  of  tbe  burning  pain. 

*•  Prescription, — Arsen.  30,  one  drop,  had  no  effect.  The 
third  day,  Graph.  f30,  whereby  the  burning  was  diminished  by 
next  day ;  and  after  two  more  doses,  the  disease  was  cured  by 
the  following  day. — AUg.  h.  Ztg.  1,  71. — Eretschmar. 

"Vehsem.,  ibid,  11,  291.,  does  not  consider  the  above  case 
a  cure,  but  merely  a  recovery.  The  complete  cure  of  the  boy 
was  only  effected  in  three  weeks,  but  the  zona  had  been 
destroyed  by  external  remedies,  still  Graph,  removed  the 
burning  in  three  days. 

"  3.  Mercurius. 

A. — General  Observatiotis. 

**  a.  Trinks  gave  to  a  man  affected  with  zona,  Merc.  3,  and 
was  informed  that  the  disease  disappeared  much  sooner  than  on 
other  occasions,  when  allopathic  treatment  had  been  employed. 
— Allg.  h.  Ztg.,  1-89. 

**  b.  Wolf  stated  that  he  had  cured  several  cases  of  zona  in 
nine  days,  by  means  of  Merc. — Allg.  h.  Ztg.,  11,  293. 
Yehsem. 

"  c.  Merc,  is  the  only  remedy  which  will  rapidly  remove  the 
burning  pains,  and  which  shows  a  specific  power  in  zoster. — 
Allg.  h.  Ztg.,  13,  261.     Lobethal. 

"  B. — Special  Cases. 

"  2.  Shingles  with  gastric  derangement  was  cured  in  two 
days,  by  means  of  Merc.  300,  in  solution,  a  teaspoonful  every 
three  hours. — Allg.  h.  Ztg.  34,  336.  Croserio.  From  the 
Jour,  de  la  Mid,  Horn.,  tom.  17.     1840. 

**  3.  A  boy,  aged  12,  had  a  red  spot  in  the  small  of  the  back, 
with  shooting  pains.  In  a  few  days  a  number  of  similar  spots 
occurred  and  extended  nearly  quite  round  the  body  towards  the 
navel.  The  shingly  eruption  was  about  three  fingers'  breadth, 
exuded  a  watery  fluid  when  scratched,  and  occasionally  burned 
like  fire.    Merc.  30  cured  in  a  few  days. — Corr.  Bl.  7,  94. 

*'  C. — Resume, 

"  Four  different  practitioners  employed  Merc,  in  zona,  in  a 


404  Reviews, 

to  c,  however,  they  give  no  special  indicatioos  for  its  use.     In 
No.  8  the  baming  came  on  periodically. 

"  Mezereum. 

"  A. — General  Ohiervatiotis, 

**  In  a  case  of  zona  which  bad  been  cared  by  others,  there 
remained  great  coldness  of  the  whole  body,  with  burning  pain 
in  the  spot  where  the  emption  had  been.  Both  were  cured 
rapidly  and  completely  by  Mezer. — Allg.  h.  Ztg.  51,  63. 
Hendricks. 

"  5.  Pulsatilla. 

"  B. — Special  Cases, 

"  4.  A  man,  aged  40,  frequently  ill,  and  subject  to  scrofulous 
ulcers  and  glandular  swellings,  became  affected  with  zona. 
Cham.,  Rhus.,  Bell.,  did  no  good.  Puis,  cured  in  two  days, 
and  the  disease  did  not  return.  The  following  are  the  indica- 
tions  leading  to  the  selection  of  Puis. : — 

"  1 .  The  gastric  fever  and  deranged  digestion  are  precisely 
similar  to  those  of  Puis. 

"  2.  Puis,  has  the  property  of  causing  symptoms  on  one 
side  of  the  body  (Oomp.  Mat.  Med.,  Pur.  2,  note).  This 
was  also  the  case  in  the  zona.  The  eruption  extended  from  the 
spine  on  the  left  side  towards  the  navel  a  hand's  breadth  wide. 

"  3.  The  shingly  inflammation  caused  sore  pain  and  burning 
on  the  affected  part.  Worst  at  night  until  midnight.  The 
pains  of  Puis,  are  also  worst  at  the  same  period. 

"  4.  Several  of  the  symptoms  of  Puis,  point  to  local  inflam- 
mation, with  swelling  of  the  skin,  itching  and  burning  of  the 
affected  parts ;  and 

"  6.  The  moral  state  of  the  patient  corresponded  to  that  of 
Puis.  He  was  cross,  fault-finding,  lachrymose,  irritable; 
whereas,  naturally,  he  was  mild  and  good-natured. 

"5.  Since  the  above,  I  have  treated  a  second  case  of 
shingles.  It  appeared  in  the  form  of  a  military  rash,  extending 
from  the  back  on  the  right  shoulder  towards  the  navel  (about 
three  fingers'  breadth  wide),  in  a  scrofulous  child,  li  years  old. 
The  inflammation  had  already  existed  three  days.  The  child 
cried  incessantly,  and  scratched  the  inflamed  part  quite  sore 


HomcBopaihic  Clinical  Experience.  405 

'wberever  it  could  reach  it.  It  could  not  sleep ;  bad  uo  appe- 
tite; thickly  furred  tongue^  and  greenish- watery  diarrhoea. 
I  gave  immediately  Pulsat.^  and  the  amendment  soon  set  in. 
In  three  days  the  child  was  quite  well. — Allg.  h.  Ztg.^  1,  159. 
Oaspary. 

"Vehsemyer  {ibid,  11,  291). — Saw  no  good  effects  from 

Polsat.,  and  hence  he  doubts  its  power. 

"  Gaspary's  experience  of  the  efficacy  of  Pulsat.  stands  alone, 

but  it  cannot  be  rejected  because  in  other  cases  Pulsatilla  did 

no  good,  particularly  as  they  are  not  fully  described.     Further 

trials  in  appropriate  cases  can  alone  decide. 

"  6.  Bhus  Toxicodendron. 

"  B. — Special  Cases. 

*'  6.  Three  cases  of  zoster  abdominalis  in  persons  of  various 
ages,  were  on  the  left  side  of  the  abdomen,  and  extended  from 
the  linea  alba,  beneath  the  navel,  to  the  spinous  processes  of 
the  vertebrse.  The  spherical  vesicles  were  arranged  in  rhom- 
boidal  groups,  and  formed  a  band  two  or  three  inches  broad, 
at  right  angles  with  the  spinal  column.  The  exanthema 
appeared  first  at  one  end  of  the  belt,  sometimes  at  the  spine 
end  and  sometimes  at  the  abdominal  end  ;  it  then  leaped  to  the 
other  end,  and  the  interval  was  filled  up  by  the  groups  of 
vesicles  spreading  from  both  ends  to  the  centre,  and  this  was  the 
course  the  disease  followed  when  it  went  off.  A  zoster  pectoralis 
exhibited  the  same  phenomena,  but  it  occurred  on  the  right 
side.  Bhus.  alleviated  the  course  of  the  disease  considerably  ; 
it  especially  removed  the  intolerable  burning  and  itching. — 
Gorr.  Bit.,  3,  44.     Lingen. 

"  7.  A  girl  was  affected  with  shingles;  small  pustules  appeared 
on  a  red  ground.  At  first  they  were  discrete,  but  afterwards 
several  united  and  became  confluent,  secreting  a  purulent- 
looking  fluid,  and  extending  half  round  the  body.  One  dose  of 
Bhus.  30  cured  within  nine  days.  For  three  evenings  only  did 
pain  occur ;  on  the  fourth  the  little  patient  was  free  from  pain, 
and  the  restlessness  and  ordinary  pains  which  are  wont  to  accom- 
pany this  disease  only  lasted  three  days.  After  that  complete 
relief  occurred. — Arch.,  12,  3,  127. — Mtlhlenbein. 

''  8.  A  girl,  22  years  old,  had  been  treated  allopathically  for 


496  Reviewi. 

eight  days.     Tartar  Emetic  and  Aurum  Mar.  had  been  given 
without  relief. 

**  Symptoms, — Violent  pain  with  marked  gastric  symptoms. 
The  raah,  with  its  characteristic  vesicles,  extended  from  the 
ensiform  cartilage  round  the  right  side  to  the  spine,  forming  a 
complete  semi -circle,  which,  at  the  last  named  point,  was 
beset  with  a  group  of  small  recently  formed  vesicles,  indicating 
a  fresh  eruption. 

"  Prescription. — Rhus.  100,  a  dose  every  two  hours.  After 
twenty-four  hours  the  pain  was  gone,  and  the  vesicles  began  to 
wither  up,  and  no  new  eruption  appeared.  The  remedy  was 
continued,  and  in  the  course  of  eight  days  the  cure  was  com- 
plete.— ^Vehsemeyer,  1,  2,  168. — ^Reisig. 

"  0.  A  girl,  aged  8,  suffered  from  shingles,  extending  from 
the  middle  of  the  chest,  round  the  left  side.  Febrile  heat, 
often  interrupted  by  rigors;  frontal  headache;  vomiting  of 
everything  that  she  takes  into  her  stomach,  even  water ;  bitter 
taste  (the  emitted  matter  is  as  bitter  as  gall) ;  yellow  furred 
tongue;  much  thirst;  constipation. 

"  Prescription. — Rhus.  8,  one  drop.  Until  the  following 
day,  marked  aggravation  of  the  febrile  symptoms,  but  no 
new  eruption.  In  the  next  twenty-four  hours  the  pain  went 
off  completely,  and  the  eruption  dried  up  into  scabs.  Cure 
complete  in  a  few  days. — Ibid.  159. 

"  C— Resume. 

"  Three  different  practitioners  evidently  shortened  the  dura- 
tion of  the  disease  by  giving  Rhus ;  the  restlessness  and  tor- 
menting pains,  and  also  the  fever  soon  went  off.  In  No.  9 
gastric  symptoms  were  well  marked. 

''  The  doses  were,  Rhus  8,  in  drops,  80,  and  100. 

"  7.    SlLICEA. 

"  A.'^Oefieral  Observations, 

"  The  cases  of  shingles  given  in  No.  6  remind  me  of  the 
only  three  cases  I  have  met  with  which  were  rapidly  cured  by 
Silic.  30.— Corr.  Bit,  6,  81.— Bute. 

''  A  general  review  of  these  few  observations  would  be  super* 
fluous.     The  chapter  is,  on  the  whole,  very  meagre. 


BbmcBopathic  Clinical  Experience.  497 

"Among  the  few  remedies,  Rhus  is  distinguished  for    its 
efficacy.     The  particular  indications  for  Merc,  and  Silic.  are 
awanting. 

"  In  the  violent  burning  Arsen.  was  of  use,  and  so  was 
Caust,  according  to  GouUon  {see  Chap.  113).  When  the 
digestive  organs  are  much  aflfected,  Kretschmar  administers 
Graphites." 

This  chapter  is  by  no  means  a  favourable  specimen  of  Dr. 
Riieckerts  work;  but  we  have  selected  it  on  account  of  its 
shortness,  as  it  would  have  been  impossible,  with  the  available 
space  at  our  command,  to  have  transferred  one  of  his  longer 
and  more  complete  chapters  to  our  pages.  This  chapter, 
imperfect  as  it  is,  will  give  the  reader  a  fair  notion  of  the 
plan  of  the  work,  and  he  will*  readily  imagine  how  valuably 
such  a  work  must  be  to  the  practitioner,  containing,  as  it  does, 
a  summary  of  every  case  and  every  opinion  as  to  the  thera- 
peutic value  of  our  medicines,  that  have  appeared  in  German 
homceopathic  literature. 

A  supplementary  volume  by  Dr.  Oehme,  of  Concord,  is  being 
published,  which  brings  the  record  up  to  the  year  1860.  The 
whole  work  will  constitute  a  valuable  cyclopeodia  of  homoeo* 
pathic  therapeutics ;  not  a  mere  transcription  of  cases,  like  the 
Clinique  MomoBopathique  of  Dr.  Beauvais  {alias  Both),  but  a 
complete  digest  and  analysis  of  all  the  valuable  therapeutic 
observations  that  have  been  published  in  Germany  since  1822. 

We  should  very  much  like  to  see  a  good  English  translation 
of  the  whole  work,  with  the  addition  of  the  cases  and  observa- 
tions  that  have  been  published  ia  England,  America;  and 
France ;  but  we  fear  that  none  of  our  countrymen  have  the 
pluck  to  undertake  such  a  task,  and  from  America,  in  its 
present  unsettled  state,  we  can  hardly  look  for  any  such  peaceful 
occupation  as  translating  a  medical  work.  There  are  several  of 
our  American  colleagues  well  qualified  to  execute  this  task,  but 
as  long  as  the  whole  population  of  the  States  are  so  entirely 
absorbed  in  the  exciting  operation  of  killing  and  ruining  one 
another,  we  can  hsirdly  expect  our  transatlantic  colleagues  to 
aettle  down  to  the  tame  and  unexciting  pursuits  of  literature. 

VOL.  XX.,   NO.  LXXXI. — JULY,  1862.  2  I 


498  Mincellaneaus, 


MISCELLANEOUS. 


Successful  Inoculation  of  SyphiUtic  Blood. 

We  lately  referred  to  some  experiments  recently  performed  at 
Florence:  the  inoculation  of  healthy  persons  with  the  blood  of 
■jrphilitic  patients.  The  results  of  these  experiments  have  been 
just  published  in  a  pamphlet  by  Professor  Pellizari,  of  the  Clinique 
of  Venereal  Diseases  at  Florence.  The  experiments  were  performed 
with  the  utmost  care ;  and  every  precaution  taken  to  exclude  all 
sources  of  error  in  the  results.  The  residts  of  the  experiments 
appear,  on  the  face  of  them,  to  be  of  very  great  importance;  and 
we,  therefore,  hasten  to  lay  a  summary  of  them  at  once  before  our 
readers. 

On  January  23rd,  1860,  two  young  doctors  were  inoculated  with 
the  blood  of  a  63rphilitic  patient.  No  abnormal. results  followed. 
On  February  6th,  1862,  (in  presence  of  all  the  students),  Drs. 
Bargioni,  Rosi,  and  Passagli,  who  were  perfectly  free  from  all 
syphilitic  affection,  were  subjected  to  the  inoculation.  Blood  was 
taken  from  the  cephalic  vein  of  a  female  suffering  from  well 
marked  secondary  syphilitic  disease ;  the  bandage,  lancet,  and  cup 
used  being  all  new.  Charpie  was  soaked  in  the  blood,  whilst 
flowing,  and  then .  applied  to  the  upper  and  outer  part  of  the  left 
arm  of  Dr.  Bargioni,  the  part  having  been  previously  denuded  of 
epidermis  and  incised  with  three  cuts.  The  same  operation  was 
performed  on  Rosi  and  Passagli ;  but  in  the  case  of  Rosi,  the  blood 
was  already  cold  when  applied;  and  in  the  case  of  Passagli,  it  was 
coagulated.  In  the  first  twenty-four  hours  no  change  appeared. 
On  March  3rd,  Dr.  Bargioni  perceived  in  the  centre  of  the  in- 
oculated surface,  whereon  the  blood  was  laid,  a  slight  elevation 
and  a  little  itching.  Professor  Pellizari  examined  the  papule,  and 
covered  it  with  dry  charpie  and  diachylon;  and  examined  it  also 
^ery  day.  At  the  end  of  eight  days  the  papule  was  of  the  size  of 
a  twenty  centime-piece.  On  the  11th,  it  was  covered  with  a  slight 
crust,  and  had  a  sOvery  colour.  On  the  13th  and  13th,  the  crust 
was  thicker,  very  adherent,  and  split  in  the  centre.     On  the  14th» 


Successful  Inoculation  of  Syphilitic  Blood.  499 

X'wto  glands  as  large  as  nuts,  moveable  and  indolent,  appeared  in 

tike  axilla ;  the  papule  was  still  indolent,  but  its  sensibility  slightly 

increased.     On  the  22nd   the   crust  fell  off,  and  a  funnel-shaped 

cliancre  presented  itself,  with   elastic  and   resistent   borders.     On 

tlie  26th,   the  chancre   was   increased  in   size,  and  its  induration 

greater.     On  the  12th  April,  there  appeared  on  the  surface  of  the 

lx)dy,  but  chiefly  on  the  sides  of  the  thorax  and  in  the  hypochondriac 

regions,  spots  of  irregular  form,  and  of  a  rose  colour,  but  giving  no 

kind  of  inconvenience  to  the  patient.     The  glandular  swellings  in  the 

neck  were  well  marked.     The  erythema  spread,  and  became  more 

confluent,  so  as  to  leave  no  doubt  whatever  as  to  its  specific  nature. 

It  lasted  eight  days,  and  pursued  a  regular  course.   On  the  20th,  the 

cervical  glands  had  increased  in  size  and  hardness.     The  chancre 

maintained  its  specific  state,  and  showed  no  tendency  to  cicatrization. 

On  the  22nd,  the  colour  of  the  erythema  became  decidedly  coppery. 

Lenticular  papules  were  mixed  with  the  erythema ;  the  edges  of  the 

chancre  were  sanguinolent.     Mercurial  treatment  was  now  begun. 

From   these   experiments  it  follows:    that  the   blood  of  a  person 

affected  with  secondary  syphilis  and  in  its  acute  staye,  inoculated  on 

fve  persons  free  from  every  hind  of  anterior  syphilitic  disease^  com- 

mumcated  syphilis  to  one  of  the  five. 

The  following  is  the  resumi  given  of  the  experiments : — 

1.  Three  or  four  days  after  the  inoculation,  all  traces  of  it  dis- 
.appeared,  with  the  exception  of  a  red  colour  at  the  point  of  denuded 
epidermis. 

2.  Twenty  days  elapsed  before  Dr.  Bargioni  perceived  the  papule 
at  the  inoculated  point. 

3.  This  tardy  appearance  of  the  papule  cannot  be  explained  by 
inexperience  or  negligence,  as  Dr.  Bargioni  was  perfectly  well  ac- 
quainted with  the  characters  of  the  primitive  form,  such  as  it  appeared 
in  the  case  related  by  Waller. 

4.  The  papule  at  first  retained  a  dry  character.  It  did  not  become 
moist  and  ulcerated  until  the  ninth  day. 

5.  The  swellings  of  the  axillary  glands  preceded  the  ulceration  of 
the  papule. 

6.  The  primitive  phenomenon,  which  produced  the  syphilis  with 
which  Dr.  Bargioni  is  now  affected,  possessed  the  characters  and  fol. 
lowed  the  course  of  those  phenomena  which  are  the  result  of  the 
inoculation  of  constitutional  syphilis. 

7.  Sixty-five  days  intervened  between  the  inoculation   and   the 

2  I  2 


500  Miscellaneous, 

manifeBtation  of  general  symptoms ;  forty-three  days  between  th^ 
appearance  of  the  papule  and  the  erythema ;  and  twenty-two  days 
between  the  inoculation  and  the  appearance  of  the  papule. 

It  is  thus  demonstrated  that,  in  a  person  who  has  never  been 
affected  with  syphilis,  we  can,  by  means  of  the  inoculation  of  blood 
taken  from  a  syphilitic  person  at  the  acute  period  of  the  secondary 
affection,  produce  at  the  inoculated  point  a  papule,  which  ulcer- 
ated, and  was  accompanied  and  followed  by  all  the  phenomena  proper 
to  an  infecting  chancre. 

The  sceptical  may  satisfy  their  doubts,  it  would  appear,  by  the 
exercise  of  their  own  eyes ;  for  Dr.  Bargioni  only  on  the  22Dd'  of 
last  month  commenced  a  mercurial  treatment  of  the  disease  inoca- 
lated  upon  him ;  and  is  no  doubt  still  suffering  from  the  signs  of  the 
disease. — British  Medical  Journal. 


On  the  Action  of  Chlorate  of  Potash  upon  Phthisis, 
Bt  Richabd  Payne  Cottok,  M.D., 

Having  already  considered  the  thrapeutical  action  of  chloride  of 
sodium,  iodide  of  potassium,  iodide  of  iron,  hydrochloric  acid, 
liquor  potasss,  phosphorus,  and  vinum  ferri,  respectively,  upon 
twenty.five  hospital  cases  of  uncomplicated  chronic  phthisis,  I  pro- 
ceed to  add  that  of  chlorate  of  potassa  upon  a  similar  number  of 
hospital  patients. 

The  generally-acknowledged  tonic,  antiseptic,  and  upholding  in- 
fluences of  the  chlorate  of  potassa  have  caused  this  agent  to  be 
rather  extensively  tried  in  consumptive  cases.  The  results,  however, 
have  been  very  variously  stated ;  but,  in  a  recent  number  of  the 
"  Dublin  Quarterly  Medical  Journal,"  a  physician  of  Belfast  has  un- 
hesitatingly brought  it  forward  as  a  specific  for  pulmonary  tubercu- 
losis, at  least  in  the  first  and  second  stages  of  the  disease. 

Of  the  twenty-five  cases  for  which  I  prescribed  it,  fifteen  were 
males  and  ten  females.  Eight  were  in  the  first  stage,  eight  in 
the  second,  and  nine  in  the  third  stage  of  phthisis.  They  varied  in 
age  :  one  had  reached  fifty  ;  but  the  rest  were  from  twenty  to  thirty 
years.  Notes  were  regularly  taken  by  Mr.  Harrington,  resident 
clinical  assistant. 

Of  the  entire  number,  five  improved  considerably,  four  improved  a 
little,  and  sixteen  seemed  to  derive  no  advantage.    Of  the  latternum- 


On  Chlorate  of  Potash  in  Phthisis.  501 

ber,  four,  at  least,  may  be  said  to  haye  been  more  or  less  benefited 
when  the  chlorate  was  exchanged  for  some  other  tonic. 

The  period  during  which  it  was  administered  varied  in  different 
cases.  In  this,  as  in  the  preceding  experiments,  my  habit  has  been 
to  continue  the  same  treatment  for  at  least  three  weeks.  If,  at  the 
expiration  of  that  time,  very  little  or  no  progress  has  been  made,  I 
have  tried  something  else ;  but  whenever  there  has  been  encourage- 
ment to  proceed,  I  have  done  so.  My  notes  record  the  chlorate  of 
potassa  was  taken  in  five  cases,  for  periods  varying  from  six  to  ten 
weeks ;  the  average  being  four  weeks.  The  dose  was  ten  or  twelve 
grains  three  times  a  day. 

In  twelve  cases  cod-liver  oil  was  occasionally,  but  not  quite  regu- 
larly, taken  at  the  same  time.  It  would,  of  course,  have  been  more 
satisfactory  had  the  chlorate  in  every  instance  been  administered 
alone ;  but  many  patients  on  entering  the  hospital  are  already  so 
practically  acquainted  with  the  good  effects  of  the  oil,  that  it  would 
be  cruel  to  deprive  them  of  its  use,  whilst  in  such  cases  the  attempt 
to  do  so  would  in  all  probability  only  prove  abortive,  for  I  have  many 
times  discovered  that  patients  for  whom  I  have  not  prescribed  cod- 
liver  oil  have  very  significantly  testified  to  its  usefulness  by  taking  it 
clandestinely.  In  analysing  those  cases  in  which  the  oil  had  been 
taken,  I  find  that  six  belong  to  the  list  of  nine  more  or  less  improved 
patients. 

Nine  increased  in  weight  whilst  taking  the  chlorate,  seven  lost 
weight,  and  nine  underwent  no  change.  Of  the  nine  who  gained  in 
weight,  six  belong  to  the  number  who  had  also  taken,  more  or  less, 
the  cod-liver  oil. 

Of  the  improved  cases,  three  were  very  decided,  the  patients 
having  expressed  themselves  as  feeling  better  than  they  had  done  for 
many  months ;  two  of  these,  however,  belong  to  the  class  who  had 
taken  the  oil.  It  was  generally  observed  that  those  patients  in  whom 
there  was  any  perceptible  improvement  were  of  broken  down  and 
cachectic  constitution ;  indeed,  just  in  that  condition  in  which,  with- 
out regard  to  their  being  phthisical,  the  chlorate  of  potassa  might  very 
hopefully  have  been  prescribed. 

The  preceding  facts,  taken  in  connexion  with  the  very  potent  in- 
fluences of  improved  sanitary  and  dietetic  arrangements  to  which  all 
the  patients  were  subjected  on  entering  the  hospital,  would  seem  to 
justifj  the  following  conclusions : — 


d02  Miscellaneous, 

1.  That  chlorate  ef  potassa  has  no  ipeei/h  action  upon  con- 
sumption. 

2.  That  its  usefulness,  even  as  an  auxiliary  in  the  general  treat- 
ment  of  phthisis,  is  very  questionable,  and  is  probably  limited  to  that 
cachectic  class  of  cases  in  which  it  and  allied  remedies  are  so  often 
serviceable. 


Case  of  Flatulent  Asthma, 
By  Dr.  6.  Hibschsl,  Dresden. 

The  hours  of  luck  in  a  physician's  life  are  numbered.  They  are 
those  when  one  can  say  with  certainty  that  he  has  effected  an  art- 
cure  in  the  true  sense  of  the  word.  Such  happiness  was  my  position, 
a  short  time  ago. 

Madame  von  D.,  at  Z ,  to  whom  I  was  called  in  by  her  sister, 

because  I  had  succeeded  in  alleviating  her  own  sufferings  and  re- 
spiting her  life,  after  she  had  been  long  under  allopathic  treat- 
ment, (her  complaint  was  well-marked  Scirrhus  pylori)^  consulted 
me  on  September  12th  this  year  (1860).  The  lady,  aged  45,  had  a 
pale  complexion  with  a  yellowish  tinge,  was  rather  thin,  and 
until  the  complaint  mentioned  below,  had  otherwise  been  always 
quite  well.  After  a  violent  mental  emotion,  she  had,  two-and-a-half 
years  ago,  had  a  severe  attack  of  asthma.  This  was  afterwards  very 
often  repeated  ;  after  constipation,  (to  which  she  was  very  liable,) 
after  getting  her  feet  cold,  after  vexation  and  other  excitements; 
so  that  she  was  never  long  free  from  it.  Upon  more  exact  inqtiiry, 
the  attack  appeared  to  consist  in  this,  that  the  stomach  swelled  out, 
whereupon  a  pressure  set  in  upon  the  soft  parts  of  the  back,  which 
seized  her,  like  a  vice,  mid- way  between  the  shoulder-blades,  so  that 
the  breathing  was  gasping  and  hesitating.  When  at  the  worst,  the 
patient  was  obliged  to  lie  down,  and  even  to  kneel  on  the  ground 
for  anguish.  By  eructation,  which  followed  with  a  loud  noise,  the 
attack  was  alleviated  ;  but  it  was  only  after  flatus  or  stool  that  it  dis- 
appeared  entirely.  The  duration  of  the  attack  was  variable  up  to  half 
an  hour :  its  return  not  limited  to  any  part  of  the  day.  By  objective 
examination  was  found  slight  enlargement  of  the  liver  without  altera- 
tion of  its  texture.     The  prominent  left  lobe  was  evidently  pressing 


Professor  Czermak's  Laryngoscope.  603 

.upon  the  stomach,  which  was  enlarged  and  sounded  tympuiitic.    No 
81^  whatever  of  icterus,   gastric  catarrh,  spinal  irritation,  or  any 
affection  of  the  heart  or  kidneys.     I  thought  myself  authorised  to 
deduce  the  constipation   from  deficient  discharge  of  bile  into  the 
intestinal  canal,  and  an  abnormal  retention  of  the  excessively  deve- 
loped  gas,  and  from  a  failure   of  the  peristaltic   motion,  and   the 
passive  enlargement  of  the  stomach,  whilst  this  (the  wind)  pressed 
upwards  and  mounted  into  the  oesophagus,  the  pressive  sensation  of 
a  vice  was  produced  between  the  8houlders,]and  not  from  any  kind  of 
spinal  origin,  as  neither  painful  sensations  in  the  vertebrs,  nor  any 
other  nervous  symptoms  were  present ;  and  the  sensation  confined 
itself  to  the  soft  parts.     The  difficulty  of  breathing,  which,  moreover, 
disappeared  afler  eructation  and  flatus,  doubtless  depended  on  the 
distension  of  the  stomach  and  the  compression  of  the  diaphragm ; 
to   which   also   the   pressu  e  in  the    back  contributed    its    share. 
These  considerations,  but  especially  the  objective  symptoms,  decided 
me  upon  prescribing  Lycopodium  3rd  trit.  (1*10)  3ij.  to    3j*  of 
saccharum  lactis^  every  second  day  as  much  as  would  lie  on  the 
point  of  a  knife. 

The  patient  let  us  hear  nothing  of  her  again ;  until  a  few  weeks 
ago,  her  son  paid  us  a  visit,  commissioned  by  her  to  inform  me  that, 
after  taking  the  above  powder,  a  single  very  slight  attack  had  suc- 
ceeded ;  and  that  the  patient  felt  perfectly  well  for  two  months  past. 
She  could  well  value  this,  after  two-and-a-half  years  of  suffering ; 
and  her  confidence  in  homceopathy  was  decidedly  won  from  that 
time  forward.  I  quite  share  the  enthusiasm  of  the  highly  respected 
GouUon  for  Lycopodium  in  gastric  disorders,  but  have  never  been 
obliged  to  make  use  of  the  30th  potency.  fHirschd^a  ZeitschriftJ, 


Professor  CzermaVs  Laryngoscope. 

Having  recently  had  the  advantage  of  witnessing  a  demonstration 
of  the  employment  and  uses  of  his  laryngoscope,  by  Professor 
Czermak,  we  were  thereby  reminded  that  we  have  hitherto  omitted 
to  notice  this  novelty  in  our  pages,  and  we  now  hasten  to  repair  this 
omission. 

We  shall  not  attempt  to  settle  the  question  as  to  whether  the  honor 
of  priority  in  the  employment  or  invention  of  this  instrument  belongs 
to  Garcia,  Turk,  or  Czermak  himself.    Indeed,  from  a  quotation  made 


504  Miscellaneous, 

by  Czermak  in  his  work,*  from  the  "  Practical  Surgery"  of  Mr.  LiBton, 
it  would  seem  that  to  our  chirurgical  countryman  the  profession  is 
indebted  for  the  first  employment  of  a  laryngeal  speculum  for  the 
purpose  of  diagnosis.  But  we  are  more  concerned  with  the  instru- 
ment and  its  revelations  than  with  the  rival  claims  of  the  angry 
disputants. 

Csermak's  instrument,  as  every  one  knows,  consists  of  a  flat  mirror 
of  glass,  speculum  metal,  or  steel,  of  a  square  shape  with  the  angles 
rounded  off,  attached  at  an  obtuse  angle  to  a  long  stalk.  This  mirror 
is  introduced  into  the  patient's  mouth  and  made  to  lie  on  the  soft 
palate,  so  that  the  reflection  of  the  glottis  is  conveyed  to  the  observer*s 
eye  who  stands  immediately  in  front  of  the  patient.  The  necessary 
illumination  of  the  glottis  is  made  by  means  of  a  gas,  camphine,  or 
oil  lamp,  the  rays  from  which  are  thrown  upon  the  mirror  in  the 
mouth  by  means  of  the  concave  mirror.  This  mirror  has  a  hole  ia 
its  centre,  as  in  the  ophthalmoscope,  through  which  the  eye  of  the 
operator  looks.  As  doubUess  all  our  readers  are  familiar  with  the 
apparatus,  we  need  not  here  enter  into  any  more  particular  descrip- 
tion of  it.  With  the  simple  addition  of  a  small  flat  mirror  any  one 
may  inspect  his  own  glottis  and  larynx  just  as  well  as  those  of  another 
person. 

The  lafjmgoscope  in  the  hands,  or  rather  in  the  mouth  of  Professor 
Czermak — for  by  constant  practice  he  has  acquired  a  dexterity  in 
exhibiting  its  powers  possessed  by  few — enables  us  to  see  not  only 
the  epiglottis,  rima  glottidis,  vocal  cords,  ar}'tenoid  cartilages,  and 
cavity  of  the  larynx,  but  even  the  interior  of  the  trachea  itself  as  far 
as  its  bifurcation.  All  this  we  saw  in  Professor  Czermak's  throat ; 
because  he  is  able  to  introduce  into  his  mouth  and  keep  in  apposi- 
tion -with  the  soft  palate  a  mirror  of  the  largest  size,  and  the  confor- 
mation of  his  throat  is  such  that  neither  tongue  nor  epiglottis  comes 
in  the  way  of  the  image  of  the  other  parts.  But  this  facility  of 
exposure  of  the  hidden  parts  of  the  throat  is  not  possessed  by  all 
persons.  We  saw  Signor  Garcia,  the  eminent  singing-master,  who 
has  long  carried  on  a  series  of  investigations  with  a  laryngoscope  of 
his  own  construction,  and  who  already,  in  1855,  published  an  article 
on  the  subject  in  the  ''  Philosophical  Magazine  ;*'  we  saw  him,  we 
repeat,  attempt  to  show  his  larynx  in  the  manner  of  Professor  Czermak, 
but  the  attempt  was  a  comparative  failure,  in  consequence  of  the  in- 
terference of  the  epiglottis. 

*  "  On  the  Laryngoscope."    New  Sydenham  Society,  1861. 


Action  of  Cod-Liver  Oil.  606 

All  medical  obeerTers  are  aware  how  difficult  it  is  to  obtain  a 
ght  even  of  the  fauces  of  many  individuals.  When  we  desire  to  do 
8o  we  find  the  tongue  in  the  way,  and  on  attempting  to  depress  it 
^vrith  a  spatula,  or  handle  of  a  spoon,  retching  immediately  ensues 
and  we  are  foiled.  In  such  persons  it  would  be  hopeless  to  think  of 
using  the  laryngoscope.  And  generally  when  an  irritable  condition 
of  the  soft  palate  and  fauces  exists,  the  instrument  would  be  inappli- 
cable, unless  by  practice  or  the  employment  of  some  anssthetic,*  we 
cau  succeed  in  dulling  the  sensibility  of  these  parts. 

However,  besides  such  cases  there  are  many  in  whom  no  difficulty 
would  be  experienced  in  obtaining  a  perfect  view  of  the  glottis  by 
means  of  the  laryngoscope,  and  when  this  can  be  done,  we  can 
readily  imagine  that  the  instrument  must  be  of  great  use  in  assisting 
us  to  diagnose  affections  of  these  parts.  Indeed,  during  his  stay  in 
London,  Professor  Czerraak  has  frequently  demonstrated  the  existence 
of  unsuspected  disease  in  the  glottis,  and  his  work  which  lies  before 
us  is  full  of  remarkable  phenomena  revealed  by  his  instrument. 

We,  therefore,  must  express  our  cordial  thanks  to  Professor 
Czermak  for  the  valuable  aid  to  diagnosis  his  industry  and  zeal  have 
placed  in  our  hands,  and  we  believe  that  it  will  prove  of  immense 
value  in  many  cases,  though  its  employment  is  necessarily  limited 
by  the  capability  of  the  patient  to  display  his  fauces,  and  by  the 
sensitiveness  of  the  parts  with  which  the  instrument  comes  in 
contact. 

Professor  Czermak  has  employed  a  modification  of  his  instrument 
for  the  purpose  of  exploring  the  posterior  nares,  but  any  objections 
that  may  be  made  to  the  use  of  the  instrument  for  exploring  the 
larynx,  apply  with  ten-fold  force  to  his  adaptation  of  it  to  rhinoscopy, 
to  do  which  effectually  the  soft  palate  must  be  drawn  forward^  by 
means  of  a  ring-shaped  spatula,  an  operation  which  we  conceive  would 
not  be  tolerated  by  one  out  of  a  hundred  persons. 

Dr,  /.  (7.  B.  WilHams  on  the  Action  of  Cod-Liver  OH. 

It  is  in  my  opinion  a  mistaken  view  to  regard  cod-liver  oil  as  a 
material  which  only  plays  the  part  in  the  body  of  a  simple  nutrient. 
Twenty  years  of  experience,  various  in  kind  and  extensive  in  its 
range,  have  convinced  me  that  it  has  other  and  directly  therapeutic 

*  Bromide  of  potassium  is  said  to  produce  insensibility  of  the  pharyngeal 
region. 


506  Miscellaneous, 

powers.  Over  and  over  agun  I  have  seen  not  only  an  improfrement 
in  the  system  generally  under  its  use,  but  a  diminution  in  the  amount 
of  tubercular  deposit.  I  entertain  the  conyiction  that  it  promotes  the 
dispersion,  absorption,  and  removal  of  tubercle.  This  is  a  quesUon 
too  long  to  discuss  here  ;  but  it  may  be  observed  that  the  cod- liver 
oil  has  a  power  of  pervading  tlie  system  more  thoroughly  than  any 
other  oil.  It  is  highly  assimilable,  and  peculiarly  well  tolerated  by 
the  stomach.  It  makes  a  particularly  perfect  emulsion.  An  indica- 
tion of  one  of  its  remarkable  properties  is,  the  preference  which  it  has 
had  over  other  oils  for  the  purpos  *  of  currying  leather  owing  to  the 
penetrative  power  which  it  possesses.  Its  divisibility  promotes 
absorption,  and  the  oil  being  taken  into  the  blood  pervades  the 
system ;  and  we  have,  as  it  were,  a  liquid  oleaginous  bath  operating 
on  the  tuberculous  matter.  A  large  proportion  of  the  tuberculous 
deposit  is  made  up  of  fatty  matters — there  is  a  good  deal  of  solid 
fat  in  its  composition  ;  and  he  oil  may  help,  I  think,  to  soften  and 
dissolve  the  tnargaraiet  wh  ch  enter  into  the  constitution  of  tubercle. 
I  will  not,  however,  dwell  upon  this ;  and  after  all  it  may  be  purely 
speculative. — Lumleian  Lectures^  1862. — "  Lancet^^  April  19,  1862. 


The  Action  of  Pho$phor%u  on  the  Liver, 

Dr.  Lewin  has  recently  directed  the  attention  of  the  medical  pix>- 
fession  to  the  curious  fact  that  there  is  an  evident  connexion  between 
poisoning  by  phosphorus  and  fatty  degeneration  of  the  liver.  He 
was  led  to  this  discovery  by  finding  in  the  published  reports  of  cases 
of  poisoning  by  phosphorus,  in  which  autopsies  had  been  made, 
statements  regarding  an  alteration  of  the  liver.  He  then  experi- 
mented upon  dogs  and  rabbits,  and  found  that  we  may,  by  adminis- 
tering small  doses  of  phosphorus  which  do  not  immediately  kill, 
cause  fatty  degeneration  of  the  liver,  with  destruction  of  the  acini, 
that  is  a  condition  closely  analogous  to  that  which  is  found  to  exist 
in  cases  of  acute  atrophy  of  the  liver.  He  also  discovered  that  poi- 
soning by  phosphorus  produced  a  peculiar  affection  of  the  kidneys 
and  rendered  the  urine  albuminous  as  long  as  life  continued. 

These  physiological  experiments  were  soon  afterwards  shown  to 
be  perfectly  correct  by  a  case  of  poisoning  by  phosphorus  which 
occurred  in  the  clinique  of  Professor  Frerichs,  in  the  Charit^  Hos- 
pital.    A  servant  girl  committed  suicide  by  eating  the  tops  of  a 


PoiBoning  by  Lead.  507 

Hiousand  lucifers ;  when  brought  into  the  Hospital  she  siii!bred  from 
icterus  and  enlargement  of  the  liver ;  the  urine  contained  bUiphilin 
and  albumen.  8he  died  shortly  afterwards  without  having  had  much 
pain,  and  no  symptoms  of  a  disturbance  of  the  nerrous  system  having 
been  observable.  The  post-mortem  examination,  which  was  per- 
formed with  the  greatest  care,  showed  that  the  blood  was  in  a  state 
of  dissolution,  it  had  the  colour  of  cherry  juice,  was  very  thin,  and 
no  coagula,  and  scarcely  any  globules  were  found  in  it  The  skin 
and  mucous  membranes  were  sufiused  with  blood,  the  liver  was 
greatly  enlarged,  and  its  edges  blunt.  On  being  examined  by  the 
microscope,  the  acini  appeared  to  be  filled  with  fat  to  bursting. — Me- 
dical Times  and  Gazette,  May  3,  1862,/?.  463. 


Pohoning  hy  Lead, 

A  hair-dresser,  passionately  addicted  to  the  use  of  the  spirituous 
bitter  called  €tbsinthe,  after  being  turned  out  of  several  situations,  as 
a  last  means  of  earning  a  livelihood,  sought  refuge  in  a  white-lead 
factory.  He  was  admitted  into  this  establishment  on  the  24th  of 
August,  1861,  and  nineteen  days  afler  was  compelled  to  leave  on 
account  of  severe  symptoms  of  saturnine  poisoning.  He  was  received 
into  the  hospital  of  La  Charit^,  where  the  eccentricity  of  his  temper 
and  some  incoherence  in  his  mind  attracted  attention.  On  the  4th 
of  January,  1862,  however,  he  resumed  his  labour  in  the  factory,  and 
a  month  afterwards,  he  applied  for  admission  at  the  Hotel-Dieu, 
where  he  was  admitted  on  the  5th  of  February,  and  the  second  night 
after  his  entrance  into  the  wards,  he  had  no  less  than  six  convulsive 
attacks,  the  last  of  which  proved  fatal. 

Was  the  case  to  be  considered  one  of  epilepsy,  or  one  of  saturnine 
eclampsy?  The  urine  contained  no  trace  of  albumen,  and  Mr. 
Trousseau  might  have  rejected  the  idea  of  eclamptic  fits,  had  he  not 
been  aware  that  albuminous  urine,  a  sign  of  much  importance  to  the 
diagnosis  in  the  instance  of  children  or  gravid  women,  is  never  found 
in  subjects  labouring  under  lead-poisoning.  Epilepsy,  moreover,  is 
seldom  fatal ;  eclampsia  frequently  causes  death,  and  this  man  perished 
in  convulsions.  From  these  reasons,  the  Professor  concluded  that 
the  patient  died  from  the  effects  of  convulsions  consequent  on  satur- 
nine intoxication. 

Instances  of  the  kind  are  not  very  uncommon.  Tanquerel  des 
Planches  relates  seven  cases  in  point,  and  in  some,  the  subjects  had 


508  Miscelianeous. 

been  but  a  short  Ume  exposed  to  the  noxious  emanations.  Mr. 
Trousseau's  patient  had  altogether  worked  but  seven  weeks  in  the 
lead  factory.  It  should,  however,  be  observed,  that  some  individuals 
become  affected  after  comparatively  trifling  exposure,  and  present,  at 
the  same  time,  a  remarkable  degree  of  resistance  to  equally  powerful 
mgesta.  We  have  seen  in  Mr.  Trousseau's  ward  a  man  affected  with 
polyuria  who  drank  in  the  course  of  an  hour,  twenty  bottles  of 
wine  without  inconvenience,  and  who  manifested  symptoms  of 
poisoning  after  taking  one-sixth  of  a  grain  of  extract  of  belladonna. 
The  present  case  is  illustrative  of  this  apparent  contradiction. 
This  habitual  drunkard,  inured  to  the  absorption  of  enormous  quan- 
tities of  spirits,  was  killed  by  saturnine  emanations  in  the  course  ol 
seven  weeks. 

In  Mr.  Trousseau's  opinion  all  the  symptoms  induced  by  lead- 
poisoning  are  the  result  of  the  action  of  the  deleterious  principle 
on  the  nervous  centres.  Poisons,  whatever  their  nature,  display 
a  singular  elective  affinity  for  certain  organs.  Each  toxic  agent 
would  appear  to  have  a  specific  direction  which  it  assumes  in  pre- 
ference to  any  other.  Thus  lead  seems  to  act  more  particularly  on 
the  cerebro-spinal  axis. 

Messrs.  Devergie,  Guibourt,  and  Barth  have  already  chemically 
demonstrated  the  presence  of  lead  in  the  brain  and  spinal  cord  of 
subjects  who  perish  under  the  influence  of  saturnine  poisoning,  lir. 
Chatin,  in  the  present  instance,  again  ascertained  the  same  fact 
Requested  by  Mr.  Trousseau  to  institute  an  inquiry  into  this  point, 
this  able  chemist  examined  equal  portions  (half  a  pound  in  weight) 
of  the  brain,  liver,  and  spinal  cord,  and  found  in  the  latter  one* 
twentieth  part  of  a  grain  of  sulphuret  of  lead,  somewhat  less  in 
the  brain,  and  one-fifth  of  a  grain  in  the  liver.  It  is,  therefore 
beyond  all  doubt,  that  a  notable  amount  of  lead  can  be  conveyed 
to  the  nervous  centres  and  gives  rise  to  very  serious  neurotic  symp- 
toms, even  when  the  impregnation  has  taken  place  at  no  very  distant 
date. 

A  case  of  the  same  description  recently  occurred  in  Professor 
Piorry's  wards,  at  La  Charit^,  and  chemical  research  yielded  similar 
results. 

A  patient  havmg  died  from  cerebral  symptoms  induced  by  satur- 
nine poisoning,  Mr.  Piorry  requested  Mr.  Fordos,  the  able  chemist 
attached  to  the  hospital,  to  examine  the  brain,  and  the  presence  of 
lead  was  ascertained  in  that  viscus. 


How  these  Allopaths  Love  otie  another!  509 

Mr.  Fordos,  it  would  appear,  has  twice  before  verified  the  same 
fact,  which  has  suggested  to  Mr.  Piorry  the  idea  of  exhibiting,  in 
cases  of  nervous  disturbances  induced  by  lead,  essence  of  turpentine 
in  inhalations,  in  frictions,  or  internally,  in  order  to  act  through  the 
medium  of  the  circulating  system  on  the  lead  contained  in  the 
iriscera.  Future  experience  only  can  decide  on  the  value  of  this  theo- 
retical view. — MeduxU  Circular^  May  7,  1862. 


How  these  Allopaths  love  one  another  !    Dr,  T,  K,  Chambers  on  Dr. 

Hastings^  last  remedy  for  Phthisis, 

A  few  words  as  to  special  specifics  for  consumption.  Some 
years  ago.  Dr.  John  Hastings  announced  that  '*  napththa"  was  an 
infallible  cure  for  this  disease.  Well,  people  tried  it,  and  soon 
knew  that  it  was  only  applicable  at  all  in  cases  where  alcohol  was 
beneficial,  and  even  to  those  patients  they  found  the  purer  and 
wholesomer  forms  of  alcohol  in  daily  use  were  both  more  useful 
and  more  acceptable.  All  the  advantages  of  the  remedy  had  been 
in  the  possession  of  the  public  in  a  pleasanter  form  years  ago. 
Determined  at  last  to  try  a  virgin  substance — integros  accedere 
fonies  atque  haurire — ^the  same  gentleman  has  lately  announced 
that  serpent's  dung  (!)  now  succeeds  to  the  throne  on  which 
naphtha  reigned  of  old.  Our  rude  forefathers  in  art  administered 
many  curious  things :  the  ashes  of  toads,  the  urine  of  boars,  live 
spiders,  are  in  their  lengthy  pharmacopceias.  Their  notion  was,  I 
believe,  to  drive  out  the  devil  by  disgusting  him.  But  I  do  not 
think  they  ever  hit  upon  the  bright  thought  of  using  the  very 
dung  of  the  accursed  type  of  evil,  that,  as  he  '^  went  out,"  he  might 
say — 

"  That  eagle's  fate  and  mine  are  one, 
Who  in  the  shaft  that  made  him  die 
Beheld  a  feather  of  his  own, 
Wherewith  he  wont  to  soar  so  high.'' 

I  really  believe  the  idea  is  original. 

Good  coprologists  tell  us  that  the  excreta  of  snakes  consist 
mainly  of  lithate  of  ammonia — a  harmless  though  unattractive  sub- 
stance, and  which  most  persons  familiar  with  physiology  would  con- 
clude to  be  inert.  I  remained  satisfied  with  that  belief  till  I  heard 
Dr.  Hastings,  when  arraigned  before  a  public  court  of  justice  for 
avaricious    malpraxis  in  knowingly    administering   inert  remedies. 


010  Miscellaneous, 

swear  positively  that  he  believed  this  substance  to  be  a  powerfal 
physiological  agent.  The  powerful  physiological  agent  was  made 
by  dissolving  (t.  e.^  destroying)  sixteen  grains  of  boa  constrictor^ff 
ejecta  in  a  gallon  of  water  by  the  addition  of  bromine.  A  Bible  oath 
is  a  staggerer,  and  after  that  I  could  not  feel  justified  in  asserting^ 
fteces  to  be  useless  till  I  had  tried.  I  procured,  therefore,  a  sample 
from  the  Sec  etary  of  the  Zoological  Society,  and  caused  to  be  pre- 
pared a  quantity  of  the  *^  solution,"  under  the  name  of  "  mistura 
pythonis."  You  have  seen  me  order  it  a  good  many  times  since  in 
cases  where,  no  drugs  being  required,  I  felt  myself  justified  in  so 
doing.  But  instead  of  half  an  ounce,  which  was  stated  to  be  so 
active,  I  have  given  two  ounces  three  times  a  day.  You  have  seen 
that  its  effects  are  exactly  the  same  as  those  of  so  mudi  pump-water. 
— i?rtVwA  Medical  JournaL 


Almost  persuaded  to  be  a  Homaopathist. 

Among  other  anUphlogistics  to  reduce  inflammatory  fever,  I  would 
say  a  few  words  on  tteonite^  calomel,  purgatives  generally,  and 
blood-letting.  Aconite,  I  have  observed,  like  opium,  has  a  vexy 
powerful  influence  upon  children,  and  it  is  to  a  certain  extent 
cumulative.  If  anything  could  make  me  a  homceopath,  it  would  be 
this  action  of  aconite.  Two  drops  of  aconite,  I  mean  the  tincture  of 
the  root,  are  fully  equivalent  to  twenty  drops  of  laudanum.  Now 
you  are  aware  how  readily  opium  poisons  infants.  Several  cases  are 
on  record.  Ramisch,  of  Prague,  nearly  killed  an  infant  four  months 
old,  by  one  grain  of  Dover's  powder ;  fo  ir  ^  rs.  of  the  same  medicine 
killed  a  child  four  and  a  half  years  old  in  seven  hours.  Kelso  met  a 
case  where  a  child  nine  months  old  was  killed  by  four  drops  of 
laudanum.  A  child  six  days  old  was  killed  by  half  a  minim  of 
laudanum,  and  so  on.  Aconite  would,  upon  the  scale  above  given,  kill 
in  minute  doses ;  y^go  of  a  drop  of  aconite  would  kill  a  babe  two  days 
old.  Perhaps,  however,  this  is  an  exaggeration,  but  there  can  be  no 
doubt  of  its  specifically  powerful  action  on  infants.  Aconite,  more- 
over, possesses  another  peculiarity.  In  particular  idiosyncracies  it 
acts  with  extraordinary  vigour.  One  drop  sometimes  produces 
poisonous  effects  even  in  adults.  It  should,  therefore  be  given  with 
great  caution  to  adults.  The  specific  action  of  this  drug  upon  infants 
is  upon  the  pulse,  and  this  is  the  test  of  its  beneficial  or  opposite  influ- 
ence.    I  usually  dissolve  five  drops  of  the  strong  tincture  of  the  root 


A  Nul/or  the  Medical  Gawicil  to  Crack.  511 

(FlemmingB)  in  12  ozs.  of  water,  and  give  5  ss*  every  two  hours  till 
tlie  fever  subsides.  This  amounts  to  about  two  minims  of  laudanum 
if  the  scale  above  given  (two  m.  aeon,  to  20  of  laudanum)  be  correct. 
At  any  rate,  in  practice  I  have  found  this  quantity,  which  is  nearly 
one-fifth  of  a  drop,  has  sufficed  to  bring  down  the  pulse  by  the 
second  or  third  dose.  With  very  young  infiemts  half  this  quantity 
will  suffice. — {From  a  Lecture  hy  Dr,  Routh,  author  of  "  The 
FaSaeies  of  Homcsopathi/y*  m  the  **  Medical  Oirctdar"  May  14, 
1862.) 

A  New  HtBmostatic, 

An  addition  to  the  list  of  efficient  hesmostatics  must  always  be 
acceptable  to  surgeons.  A  plant  called  Pengawar  Jamba  {Palea 
Tibotii)  has  been  lately  brought  over  from  Java,  and  is  said  to  be 
possessed  of  extraordinary  hemostatic  power.  It  is  a  kind  of  fern, 
yielding  a  mass  of  delicate  filaments  so  light  and  flexible  as  to  be 
capable  of  floating  a  long  time  in  the  air.  Their  colour  varies  firom 
a  brownish  gold  hue  to  a  greyish  black.  Six  grains  of  these  fila- 
toients  form  a  sufficient  quantity  to  stop  the  bleeding  of  an  artery,  a 
twelfth  of  an  inch  in  diameter.  This  substance  displays  excessive 
avidity  for  water,  exhales,  when  heated,  an  empyreumatic  perfume, 
and,  if  it  be  burnt,  explodes.  The  rapidity  with  which  the  filaments 
absorb  the  aqueous  parts  of  the  blood,  induces  the  immediate  coagu- 
lation of  this  fluid,  and  the  fibres  form,  moreover,  an  impenetrable 
pledget,  which  efficiently  closes  the  wounds  to  which  they  are 
applied.  The  promptness  with  which  Jamba  checks  haemorrhage  will 
doubtless  make  it  highly  valuable  in  cancerous  and  scorbutic  ulcers. 
— OaUynafWe  Messenger. 


jl  Nut  for  the  Medical  Council  to  C^ack. 

We  take  the  following  from  the  minutes  of  the  Medical  Council  of 
May  16, 1862:— 

Read  the  following  letter  from  Richard  Hughes,  Esq,,  M.R.C.S., 
England,  and  L.R.C.P.,  Edinburgh  : — 

<*  10,  Clarence  Square,  Brighton,  Sept  2lBt,  1861. 
"  Sib — ^I  am  desirous  of  calling  your  attention  to  the  declaration 
recently  adopted  by  the  College  of  Physicians  in  Ireland  as  requisite 


512  Miscellatuout. 

to  be  taken  by  all  candidates  for  its  licence.     It  is  thas  reported  in 
the  '  Lancet'  of  August  10th,  1861 : — *  I  engage  not  to  practiae 
any  system  or  method  (so  called)  for  the  cure  or  alleviation  of  dis- 
ease, of  which  the  College  has  disapproved.     And  I  solemnly  and 
sincerely  declare,  tliat  should  I  violate  any  of  the  conditions  specified 
in  this  declaration  so  long  as  I  shall  be  either  a  Licentiate  or  Fellow 
of  the  College,  I  thereby  render  myself  liable  and  shall  submit  to 
censure  of  the  College,  pecuniary  fine  (not  exceeding  £20)  or  ex- 
pulsion^  or  surrendering  of  the  diploma,  whichever  the  President  and 
Fellows  of  the  College,  or  the  majority  of  them,  shall  think  proper 
to  inflict.'     This  resolution  makes  the  first  granting  and  subsequent 
tenure  of  the  diploma  of  this  College  dependent  on  an  avoidance  of 
all  systems  of  medicine  disapproved  of  by  the  College,  by  which,  of 
course,  homoeopathy  is  mainly  intended.     Now  such  a  course  of 
conduct  is  in  direct  contravention  of  clause  23  of  the  Medical  Act. 
It  is  well  known  that  clause  23  was  introduced  into  the  Medical 
Act  expressly  to  prevent  any  one  being  hindered  in  obtaining  or 
deprived  of  his  diploma  on  the  ground  of  his  belief  in  homoeopathj. 
The  King  and  Queen's  College  of  Physicians  in  Ireland,  therefcve, 
in  requiring  this  declaration  to  be  taken  by  all  candidates  for  its 
license,  has  offended  against  both  the  letter  and  spirit  of  the  Medical 
Act     And  1  call  upon  you,  sir,  as  President  of  the  Medical  Council, 
to  report  this  proceeding  to  the  Privy  Council,  that  the  proper  mea. 
Bures  may  be  taken  for  checking  or  punishing  this  breach  of  the 
law. 

« I  am.  Sir, 

''RlCHABD   HVOHSS. 

"  (Registered  under  the  Medical  Act.) 
**  To  the  President  of  the  Medical  Council." 

"  Dr.  A.  Smith,  the  representative  of  the  King  and  Queen's  College 
of  Physicians  in  Ireland,  explained  that  the  declaration  complained  of 
was  of  very  old  date;  that  the  College  has  never  expressed  any 
opinion  on  any  theory  of  medicine,  and  that,  therefore,  it  never  did 
impose  any  restraint  on  the  practice  of  medicine  by  any  candidate ; 
and  moreover,  that  the  declaration  referred  to  does  not  exist  in  the 
present  code  of  bye  laws. 

*' Moved  by  Dr.  Corrigan,  seconded  by  Sir  C.  Hastings,  and 
agreed  to, — *  That  the  Council  decline  to  take  any  steps  in  the  above 
matter.'  '* 


Two  Ways  of  telling  a  Story.  518 

Dr.  /.  C.  B.  WtUtafM^  on  SimpUcUy  m  Therapeutics, 

The  deduction  of  results  from  the  administration  of  compound 
Ibrmuke,  and  under  ordinary  circumstances,  is  open  to  so  many 
BooTces  of  fallacy  as  to  be  practically  of  little  yalue  ;  and  such  ex- 
periments are  useless  unless  we  take  the  therapeutic  element  in  its 
strictest  isolation  and  direct  it  simply  and  anatomically  to  the  special 
organ  or  tissue  to  which  the  experiment  relates.  •  •  #  # 
When  I  look  back  twenty  years,  and  see  the  great  improvements 
which  have  been  made  in  our  art,  I  am  sanguine  of  much  further 
progress  in  the  next  period.  The  best  prospect  for  that  advance  lies 
in  the  study  of  the  separate  elements  of  disease  in  relation  to  each 
organ  and  tissue,  and  the  bringing  to  bear  upon  them  simple  thenu 
peutical  elements  for  their  cure. — Lumleian  Lectures^  1862, — 
♦*  Lancet;'  April  9. 

New  Homceopathw  Periodical. 

The  medical  officers  connected  with  the  Manchester  and  Salford 
Homoeopathic  Dispensaiy  have  started  a  monthly  homoeopathic  Jour- 
nal. The  second  number  lies  before  us.  Its  contents  are  very 
interesting  and  well  written,  and  we  doubt  not  that  this  youngest 
member  of  the  family  of  homoeopathic  periodicals  is  destined  to  do 
much  good,  and  to  spread  a  knowledge  of  the  truth  among  a  class  of 
readers  to  whom  it  is  unlikely  the  hitherto  existing  journals  oould 
penetrate.  We  heartily  welcome  the  Homcsopathic  Observer,  and 
wish  it  a  long  and  prosperous  career. 


Two  ways  of  tdUng  a  Story. 

The  following  appeared  in  the  Medical  Circular  of  May  14, 
1862  :— 

TaB&IKO  ▲   HOMCBOPATHIO   ESTABLISHMENT. 

A  Correspondent  writes : — **  It  will  give  our  readers  some  idea 
how  homoeopathy  is  respected  in  York,  when  we  inform  then^ 
that  on  the  night  of  Monday,  the  21st  ult.  (as  the  police  report 
words  it),  '  some  evil-disposed  person,  or  persons,  did  wilfully  daub 
and  deface  with  yas  tar  the  gold  lettering  over  the  homoeopathic  dis- 
pensary situate  in  Little  Blake  street!'  which,  let  us  add,  b  an 
obscure  establishment  conducted  by  Mr.  Cope,  surgeon,  who  on  the 
morning  after  this  lamentable  disjiyurement  and  nocturnal  outraye^ 

yoL.  XX.,  wo.  Lxxxi. — JuLT,  1862.  2  x 


514  Miscellaneous. 

repaired  to  the  police  oflBce  in  that  city  to  obtain  redress,  but  with- 
out avail.  The  police  authorities  knew  nothing  about  it,  and  even  re- 
fused to  move  in  the  matter,  which  they  treated  as  9LpracHcal/oke" 

To  this,  the  editor  of  our  hebdomadal  contemporary  adds :  "  This 
tarring  is  an  inconvenient  precedent.  Supposing  it  should  be  carried 
to  the  extent  of  tarring  the  homoeopath  himself !  Such  a  practical  joke 
has  been  perpetrated,  though  now  fallen  into  disuse ;  we  should  be 
sorry  to  hear  of  its  being  revived  in  York  on  the  person  of  Mr.  Cope.** 

This  answer  appeared  the  following  week : — 

To  the  Editor  of  the  Medical  Circular. 

8iB, — Four  young  scapegraces  having  disfigured  the  sign-board  of 
the  Homoeopathic  Dispensary  in  this  city,  your  correspondent  here 
argpies  therefrom,  that  Homoeopathy  is  not  so  respected  in  Tork  as 
those  who  believe  in  it  consider  it  deserves  to  be.  Permit  me  to  give 
you  one  or  two  facts  relating  to  this  **  nocturnal  outrage^^  that  you 
and  your  readers  may  see  how  far  they  tend  to  support  the  theory 
your  correspondent  has  so  hastily  deduced  from  the  **  lamentaMe  dis- 
figurement^* over  which  he  rejoices.  The  police,  who  I  have  eveiy 
reason  to  believe  sifted  the  matter  as  far  as  they  were  able,  informed 
me  that  they  had  evidence  of  the  affair  having  been  arranged  at  a 
brothel  in  Barker's  Hill,  one  of  the  lowest  neighbourhoods  in  the 
city.  Of  the  four  persons  implicated  three  are  known,  though  the 
evidence  against  them  b  insufficient  to  sustain  a  prosecution,  the 
fourth  is  probably  your  correspondent.  With  regard  to  the  police 
report,  from  which  your  correspondent  professes  to  quote — it  does 
not — never  did — exist;  none  was  issued.  The  gist  of  the  whole 
affair  is  this, — that  a  foolish  outrage,  concocted  in  a  brothel,  by  four 
dirty  lads,  is  evidence  that  Homoeopathy  is  not  respected  in  Tork ! 
Surely,  Sir,  I  may  congratulate  myself  on  my  opponents  being  sadly 
pressed  for  means  to  show  that  the  position  of  Homoeopathy  here  is 
what  tiiey  would  have  it  to  be  ! 

As  well  might  the  fact  of  the  knocker  having  been  wrenched  off 
the  door  of  the  Mansion  House  three  times  since  last  October  be 
regarded  as  evidence  that  Mr.  Alderman  Leeman  and  his  successor, 
the  present  Lord  Mayor,  were  not  respected  by  their  citizens ! 
Both  occurrences  exhibit  a  thoroughly  inefficient  state  of  the  City 
police,  and  the  existence  of  a  few  persons  envious  of  distinction  as 
local  nuisandes. 

I  cannot,  however,  conclude  without  mentioning  that  the  damage 


Remedy  for  Obesity.  5 15 

done  in  mischieyous  malice  has  been  repaired  at  the  instance  of  its 
perpetrators,  the  tradesman  employed  having  first  of  all  been 
silenced  in  the  usual  way  regarding  the  names  of  his  employers. 

I  hope  that  in  future  your  correspondent  will  avoid  contact  with 
pitch — excepting,  perhaps,  in  the  shape  of  pills  and  plasters ! 

Trusting  to  your  well-known  and  highly-appreciated  sense  of  justice 
to  procure  the  insertion  of  this  letter, 

I  am,  &c., 

A.  C.  P.  ; 

Dupensaty^  LitUe  Blake  Street^  May  8, 1862. 

We  cannot  congratulate  the  Editor  of  the  Medical  Circular  on  his 
taste  in  countenancing  the  silly  dirty  joke  so  justly  commented  on  by 
the  aggrieved  party,  Mr.  Cope. 

Efficacy  of  Iodine  for  the  Cure  of  Gastralyia. 

A  fresh  instance  of  neurotic  symptoms  relieved  by  small  doses  of 

iodine,  induces  us  to  publish  the  formula  of  a  solution,  the  utility  of 

which  is  pointed  out  by  Dr.  Massart,  of  Napoleon  Vendue,  in  a  paper 

forwarded  to  the  Medical  Society  of  Antwerp.     The  following  are 

its  components : — 

R.     Tinct.  iodini,  gr.  xv. ; 

Potass,  iodid.,  gr.  j. ; 
Aq.  distill.,  5j. 
Six  drops  of  this  mixture  should  be  exhibited  thrice  daily  in  a  little 
sugar  and  water.     Mr.  Massart  highly  recommends  it  in  the  sympa- 
thetic sickness  of  pregnancy,  in  gastralgia,  dyspepsia,  and  oesopha- 
geal neuralgia. — Medical  Circular^  May  21,  1863. 


Efficacy  of  Fucus  Vesiculosus  (Quercus  Marina)  for  the  Cure  of 

Obesity. 

Fucus  vesiculosus,  sometimes  termed  quercus  marina^  and  Mp-ware^ 
is  a  cryptogamic  sea-weed,  which  was  formerly  employed  by  the  Romans 
for  the  cure  of  gout.  Mr.  Duchesne  Duparc  has  recently  published 
an  interesting  monograph  on  this  plant,*  in  which  he  informs  us 
that  GaubiuB,  Annel,  and  Baster,  to  whom,  on  Dr.  Pereira's  autho- 
rity, we  may  add  the  name  of  Dr.  Russell,  employed  it  with 
supposed  advantage  as  a  deobstruent  in  scrofula,  goitre,  and  glandular 
enlargements.     The  discovery  of  the  medicinal  virtues  of  iodine  had 

*  A  Pamphlet,  8vo,    J.  B.  Bulfiere  and  8<m. 

2  K  2 


6 1 6  Miscellaneous. 

caused  it  to  be  forgotten,  but  accident  again  recommends  it  to  the 
attention  of  the  therapeutist,  and  thanks  to  Mr.  Duchesne  Duparc, 
it  is  in  a  fair  way  to  recoTer  a  portion,  at  least,  of  its  former 
celebrity. 

**  Some  years  ago,"  says  that  practitioner,  **Jucus  vesictdosus  was 
mentioned  to  me  as  a  useful  remedy  for  inveterate  psoriasis ;  I  gave 
it  a  trial  which  did  not  yield  the  promised  results,  but  the  failure  was 
compensated  by  the  discovery  of  other  remarkable  effects.  In  all  the 
persons  to  whom  the  drug  was  exhibited,  a  more  or  less  considerable 
loss  of  flesh  was  observed.  This  phenomenon  invariably  occurred, 
occasionally  in  a  short  time,  but  always  without  discomfort  or  dis- 
turbance of  the  digestive  functions,  the  only  appreciable  symptom 
being  an  increase  of  the  urinary  secretion." 

Since  this  period  (1857),  several  patients  affected  with  excessive 
obesity  having  derived  considerable  benefit  from  the  use  of  the 
remedy,  Mr.  Duchesne  Duparc  continued  to  prescribe  it,  not  as  a  spe- 
cific for  diseases  of  the  skin,  but  as  a  new  stimulant  of  the  absorbents 
of  fatty  matter,  and  as  a  deobstruent,  calculated  to  arrest  the  pro- 
gress of  premature  encumbrance  of  flesh.  The  author  adduces  in 
his  pamphlet  several  new  cases  confirmative  of  the  first  results  ob- 
served, and  enters  into  an  interesting  disquisition  on  the  subject  of 
the  nature  and  treatment  of  obesity.  We  must  confine  ourselves  to 
a  brief  description  of  the  characters  and  mode  of  exhibition  of  Jiicut 
vesiculosus. 

Kelp-ware  is  one  of  the  numerous  genera  of  the  tribe  Fucoidea 
to  which  rural  economy,  arts,  manufactures  and  medicine  are  further 
indebted  for  many  useful  contributions.  It  abounds  on  the  shores 
of  the  Atlantic  and  Mediterranean,  and  is  attached  by  a  fan- 
shaped  pedicle  to  the  rocks,  rising  to  a  height  of  13  or  15  inches, 
in  a  coriaceous  dichotomous  frond,  supplied  with  air-vessels  and  re- 
cepUcles  filled  with  mucus.  Its  substance  is  thickish,  flexible,  and 
tough ;  glossy  green  when  fresh,  dark  brown  when  dry ;  its  odour  is 
strong,  and  its  taste  nauseous. 

Fucus  vesictdosus  may  be  pulverised,  and  an  extract  is  prepared 
which  is  more  active  than  the  powder.  Mr.  Duchesne  Duparc  pre^ 
scribes  the  extract  in  three-grain  pills,  15  or  20  of  which  should  be 
taken  in  the  course  of  the  day.  A  decoction  which  can  be  exhibited 
between  or  at  the  meals,  may  also  be  made  with  half  an  ounce  of 
desiccated  fucus  (the  stem  and  smaller  branches  being  removed),  for 
two  pints  of  water. — Medical  Circular^  June  11,  1862. 


Comprei^Hiid  Air  Bath.  517 

On  compressed  Air  as  a  I%erapetUic  AgerU  in  certain  states  of 

Disease.* 

For  a  series  of  years  there  have  existed  some  special  institutions 
(to  my  knowledge  at  Lyons,  Nice,  and  Montpellier),  in  which,  under 
the  particular  direction  and  careful  conduct  of  a  physician,  patients, 
particularly  of  the  pulmonary  and  laryngeal  class,  remain  for  a  cer- 
tain space  of  time  in  bells  with  compressed  air.  In  some  individual 
cases,  very  favourable  results  are  said  to  have  been  obtained.  At 
any  rate,  the  fact  is  too  important  to  deserve  to  be  utterly  ignored. 
Several  publications  on  the  subject  of  these  air  baths  have  already 
appeared;  namely,  by  Dr.  J.  Milliett  {De  Vair  comprimS  au  point 
de  vue  phystohgique,  Lyon,  18;56),  and  by  Dr.  Pravaz.  An  ex- 
tract from  the  latter  work,  made  by  Dr.  Proel,  will  be  best  calculated 
to  inform  the  reader  of  the  *^  Vierteljahrschrift,"  summarily,  respect- 
this  new  curative  agent.f    (Dr.  Muller,  Editor.) 

1.  The  pressure  of  the  air  exerts  a  mechanical  influence  on  the 
development  of  the  lungs,  and  hence,  also,  on  the  expansion  of  the 
chest ;  up  to  a  certain  degree,  in  condensed  air,  the  inspiration  gains 
a  longer  protraction. 

d.  The  chemical  phenomena  of  respiration  are  also  modified  by 
the  degree  of  atmospheric  density.  The  endosmose  of  the  oxygen 
increases  with  the  pressure.     (According  to  Biot  and  Hervier.) 

3.  Atmospheric  pressure  is  one  of  the  agents  which  promote  the 
venous  circulation.  Hence,  an  increase  of  density  must  favour  the 
return  of  the  blood  to  the  right  cavities  of  the  heart ;  and,  on  the 
contrary,  rariflcation  of  the  air  must  caiyse  congestion  to  the  capillary 
net-work. 

4.  The  physiological  phenomena  which  are  observed  in  the  ascent 
of  high  mountains,  or  under  the  diving  bell,  agree  perfectly  with 
the  above  position.  In  fact,  in  the  rarified  air  of  the  higher 
regions,  the  respiration  becomes  short  and  gasping ;  the  muscular 
movements  proceed  with  difficulty ;  the  arterial  circulation  is  acce- 
lerated, whilst  the  venous  is  retarded;  hence  come  the  various 
hsemorrhages,  and  the  stasis  of  blood  in  the  portal  system,  which 
betrays  itself  by  colic,  nausea,  and  tendency  to  vomit.      In  the 

*  From  the  Homldopathische  ViertdjahrBehrifl, 

f  In  ToL  xiv.,  p.  124,  we  gave  an  accoimt  of  this  mode  pf  treating  disease, 
which  was  then  a  novelty,  bat  is  not  so  now,  as  it  has  been  introduced  into 
some  of  oar  large  hydropathic  establishments,  particalarly  Dr.  M^Leod's,  of 
Ben-Rhydding. 


518  Misceilatieous, 

condensed  air  of  the  diving  bell,  on  the  oontraqr,  the  respiration  be- 
comes  easier,  and  more  prolong^.  The  muscular  movements  show 
more  energy ;  the  functions  of  digestion  and  secretion  proceed  with 
more  celerity ;  the  rythm  of  the  pulse  remains  stationary,  or  even 
becomes  slower, 

5.  The  curative  results  which  may  be  deduced  from  the  physiolo- 
gical phenomena  observed  in  condensed  air  were  not  observed  and 
made  available  till  these  latter  times,  when  the  scientific  society  at 
Haarlem  (1783)  directed  the  attention  of  physicians  to  this  circum- 
stance, which  is  closely  connected  with  the  contemporaneous  dis- 
covery  of  pneumatic  chemistry. 

6.  One  of  the  first  applications  of  the  (condensed)  atmospheric 
bath  to  the  treatment  of  invalids  had  for  its  subject  pulmonaiy 
phthisis,  when  it  had  not  yet  passed  the  second  stage  ;  but  it  is  still 
more  to  be  prescribed  as  a  powerful  modifier  of  the  constitution,  and 
as  a  prophylactic. 

7.  The  curative  and  preservative  efi*ect  of  compressed  air  upon  the 
tuberculous  diathesis  is  apparent  from  the  fact  that  the  components 
of  its  total  action  on  the  organism  are  opposed,  every  one  of  them, 
to  the  causative  influence  of  that  diathesis.  Thus  tlie  air  bath,  by 
retarding  the  arterial  circulation  and  accelerating  the  venous,  leads 
to  the  resolution  of  the  abdominal  exudations  which  are  so  fre- 
quently connected  with  the  development  of  phthisis.  And,  inasmuch 
as  it  makes  the  respiration  more  extensive,  it  promotes  the  combus- 
tion and  excretion  of  the  detritus  of  the  organs,  whose  weakness  is 
one  of  the  principal  causes  of  the  deposition  of  the  tuberculous  matter. 

8.  The  air  bath  may  also  be  employed,  with  good  result,  in  Pott*s 
disease,  and  in  local  gout  (gout  with  exudation).  In  the  first,  it 
facilitates  the  interstitial  absorption  of  the  tuberculous  matter,  and 
furthers  the  secretion  of  the  osseous  element  which  has  to  repair  the 
loss  of  substance  that  goes  to  waste  by  the  erosion  of  the  bodies  of 
the  vertebree.  In  the  second  case,  it  diminishes  (besides  its  general 
restorative  effect)  the  various  exudations  in  the  veins  of  the  joints ; 
and  thus  diminishes  the  periodic  symptoms  produced  by  the 
exudations. 

9.  Since  the  primary  symptomatology,  and  perhaps  cetiology  of 
rhachitis  is  founded  upon  the  two  following  fundamental  evils  : — 

a.  Retarded  development  of  the  organs  of  respiration. 

b.  Infarctus  of  the  liver  and  the  chylopoietic  structures.  Hence 
the  compressed  air  bath  is  rationally  indicated  in  the  treatment  of 


Compressed  Air  Bath,  519 

this  disease,  since  it  enlarges  the  field  of  respiration,  and  pro- 
motes the  venous  circulation  of  the  abdomen.  And  experience  con- 
firmed this  indication  in  the  rhachitis  of  the  earliest  childhood. 

10.  The  foundation  of  lateral  deviations  of  the  spine  is  laid  in 
insufficient  nourishment,  which  last  does  not  supply  the  earthy  por- 
tion to  the  bones  (by  which  they  maintain  firmness)  and  the  fibrinous 
matter  to  the  muscles,  which  is  their  principal  component  part. 
The  bones,  reduced  almost  to  a  gelatinous  mass,  attain  an  abnormal 
growth,  whilst  they  lose  their  consistence.  The  muscles,  on  the 
contrary,  are  kept  back  in  their  development.  Through  these  cir- 
cumstances combined,  the  spinal  column,  whilst  it  lengthens,  is 
forced  to  curve  itself  in  alternately  various  directions,  and  to  rotate 
on  its  axis  in  compliance  with  the  resistance  offered  to  it  by  the 
relative  shortness  of  the  oblique  spinal  muscles.  Therefore  the  atten- 
tion must  be  directed  to  the  nourishment  of  the  various  main  phases 
of  growth,  in  order  to  prevent  the  deformities,  or  to  correct  them, 
if  they  are  still  recent.  Now  the  condensed  air  favours  digestion 
and  improves  the  heematosis,  by  increasing  the  absorption  of  oxygen, 
and  extending  the  respiratory  surfaces. 

11.  A  relative  deficiency  of  the  number  of  blood  globules  is  often 
united  with  chlorosis,  if  it  is  not  the  entire  cause  of  it.  Ferrum  and 
Manganese  are  not  always  borne  in  this  condition.  The  air  bath 
acta  innocently,  and  at  once  restoratively  and  directly  on  the 
economy. 

12.  From  observations  borrowed  from  the  diving  bell,  one  might 
already  have  inferred  the  curative  action  of  compressed  air  in  deaf- 
ness arising  from  disease  of  the  tympanum,  and  stoppage  of  the 
eustachian  tubes.  But  it  also  serves  for  a  congested  state  of  the 
vessels  of  the  labyrinth,  inasmuch  as  it  attenuates  the  blood  in  the 
Tenous  sinuses  at  the  base  of  the  cranium.     (Legorge.) 

18.  By  the  same  mechanical  power,  it  subdues  certain  hyper- 
smise  of  the  brain  and  spinal  chord,  which  are  capable  of  giving  rise 
to  epileptic  diseases,  to  muscular  shortenings,  and  weakness  of  the 
lower  extremities. 

14.  Other  forms  of  neurosis,  which  seem  to  depend  on  an  affec 
tion  of  the  pneumogastric  in  its  various  ramifications,  as  spasmodic 
asthma,  some  kinds  of  aphonia,  painful  palpitation  of  the  heart,  and 
gastralgia,  yield  to  compressed  air.  One  may  conjecture  that  an 
energetic  circulation  of  the  blood  in  the  branches  of  the  vena  porta^ 
or  of  the  azygos,  in  this  case,  drives  towards   the  intestines   the 


520  Mi9cellatieou9. 

congestion  which  caused  the  disturbance  in  the  functions  of  that 

nenre. 

15.  As  oxygen  is  the   main  agent  in  those  chemical  changes 

which  prepare  for  elimination  the  detritus  of  the  organs  and  other 

foreign  substances   introduced    into    the    animal  economy,    eyeiy 

increase  of  the  endosmose  of  oxygen  into  the  blood  must  accelerate 

the  resolution  of  miasmatic  diseases,  as  well  as  the  metasyncrisis,  in 

those  which  appear  to  be  produced  by  defectiye  assimilation.     The 

curative  effects  of  compressed  air  in  influenia»  intermittent  fever, 

whooping  cough  and  rheumatism,  confirm  the  above  presumptions. 

Dr.  Pravaz  employs  the  following  arithmetic  formula,  modelled  on 

that  of  Dr.  Person  :^ 

A  =hV 
^    » — A  as  Increase  of  volume  in  the  lungs. 

because  h         H ^  ~  height  of  the  mercury  in  the  tabe, 

V  +  A  after  a  fbcoed  inspiration. 

according  to  Marriott's  law. 

.  I        1^1  y  y  =  Tolome  of  air  which  the  tabes  re- 

sn ri  ceive  at  the  beginning  of  the  experiment, 

^   —  ^  and  under  a  different  pressure. 

A  :  A  =  h^  V       h^  V  h  =  height  of  the  column  of  merooiy  in 

H — ^h  *  H^  h^  the  barometer. 

A^hi  V 


A   HI  — hi       hWH  — h)       , 

ISTV^  =  h(Hi-- h)  '  ^' ^  ^=  *^^H --'^)  ^  (H' -^')- 
H  — h 

Dr.  Person  writes,  in  his  elementary  Treatise  on  Natural  PkHo^ 
eophy,  1836 : — 

**  If  we  part  the  wings  (flaps)  of  a  pair  of  bellows  from  each  other, 
we  diminish  the  elastic  force  of  the  air  inside,  and  the  external  air 
rushes  in  by  its  superior  power,  partly  through  the  little  pipe,  partly 
through  the  valve  which  is  compelled  to  open.  The  mechanism  of 
inspiration  is  incidentally  the  same,  at  least  so  far  as  concerns  the 
valve  that  is  destined  to  prevent  the  entrance  of  warm  air  into  the 
bellows." 

"  But  this  simile  is  not  quite  correct,"  says  Dr.  P.  further.  *'  Ac- 
cording  to  Dexy*s  experiments,  at  an  ordinary  inspiration,  0*650 
litres  of  air  enter  the  chest ;  but  by  a  deep  inspiration  one  can  draw 
in  1^  to  2  litres.  From  5  to  6  lib*es  is  taken  to  be  the  average 
Capacity  of  the  chest :  hence  it  appears  that  one  can,  by  a  strong 
inspiration,  raise  the  elastic  force  of  the  air  contained  in  the  lungs 


On  the  Veratrum  Viride  in  Disease.  52 1 

nearly  two-thirds,  and  thereby  raise  the  mercury  in  the  tube  about 
8  or  9  inches,  whilst,  in  reality,  as  the  breathing  is  performed  by 
the  chest,  the  elastic  force  hardly  reaches  2  inches.  The  reason 
of  this  is  that  we  are  far  from  being  able  to  attain  an  expansion 
of  1^  to  2  litres  during  the  non-entrance  of  air :  in  order  to  expand 
the  chest  up  to  that  point,  the  elastic  force  of  the  penetrating  air 
must  help  to  overcome  the  resistance  of  the  external  air.  In  fact 
one  ascertains  by  a  belt  that  the  chest  expands  very  little  if  one 
tries  to  make  an  inspiration  without  letting  the  air  rush  in." 

Whilst  I  was  repeating  this  experiment  pointed  out  by  Dr.  Person 
on  air  compressed  in  various  degrees,  I  found  that,  from  the  ordinaxy 
pressure  of  0*76  metres,  the  mercury  rose  progressively  in  the  tube 
with  the  increase  of  condensation  up  to  a  certain  degree,  which  was 
Variable,  just  according  to  the  individual  subjects  of  experiment. 
Above  this  degree,  the  column  came  to  its  pormal  level  again,  or 
even  sank  below  it.  The  results  presented  thereby  may  be  shown 
by  the  above  Algebraic  analysis,  and  expressed  in  words  as 
follows : — 

1 .  The  expansion  of  the  forced  inspiration  or  the  development  of  the 
lungs  increases  with  the  atmospheric  pressure  up  to  a  definite  point, 
which  is  generally  limited  by  the  strength  of  the  individual. 

2.  The  atmospheric  pressure  ceases  to  favour  the  expansion  of 
the  organs  of  respiration  as  soon  as  it  reaches  the  point  where  it 
overpasses  the  ever  increasing  difference  that  exists  between  the 
effort  of  the  inspiratory  muscles  and  the  elasticity  of  the  thoracic 
parieties. 


On  the  Veratrum  Viride  in  Disease, 

[The  following  summary  of  the  action  of  this  medicine  as  used  by 
allopaths,  is  contained  in  the  Monatsblatt  to  the  Alfy.  Horn,  Zeitung^ 
voL  Ixiv.,  p.  26.] 

**  The  Veratrum  Viride,  or  HeUehorus  Americanus,  a  drug  in 
great  favour  with  the  American  physicians,  is  as  yet  very  little 
known  amongst  us.  Pereira  mentions  it  in  a  note,  but  confounds 
its  action  with  that  of  the  Veratrum  Albttm.  The  first  mention  of 
this  plant  as  a  medicine  occurs  in  1817,  in  Bigehw's  American 
Botany,  where  Dr.  Ware's  experience  of  it  is  communicated,  and  the 
peculiarity  pointed  out  that  it  does  not,  like  other  emetics,  run  off 
as  a  purgative  when  it  fails  to  cause  vomiting.     A  further  mention 


522  Misceiianeous. 

of  it  is  made  in  1885  by  Dr.  Osgood,  who  speaks  of  the  narcotic,  as 
well  as  of  the  heart-depressing  action  of  this  medicine,  which  he 
used  in  tincture  of  the  fresh  root  In  1852,  Dr.  Norwood  pub- 
lished his  experience  of  Veratrum  yiride,  and  his  statements  differ 
from  Dr.  Osgood*s,  in  that  he  denies  the  narcotic  properties  of  the 
drug,  since  it  by  no  means  benumbs  like  opium,  but,  acting  as  a 
nervine,  it  lowers  the  morbidly  increased  irritability,  and  removes 
neuralgias  and  convulsions,  and  brings  about  amelioration  in  cholera 
and  epilepsy.  Norwood  saw,  also,  under  its  use,  the  pulse  sink 
down  to  35  without  the  production  of  nausea  or  vomiting.  He  em- 
ployed it  in  a  tinoture  made  from  8  oz.  of  the  fresh  dried  root, 
macerated  16  days  in  a  pint  of  Sp.  vini. :  the  dose  was  4  to  6  drops, 
and  this  was  increased  till  falling  of  the  pulse  or  nausea  began  to 
appear.  Dr.  Wood  recommended  this  tincture  in  all  inflammatory 
diseases  except  those  of  the  prima  ous,  and  especially  in  pneumonia 
and  acute  rheumatism.  In  March,  1858,  the  Medical  Society  of 
Massachusetts  formed  a  committee  for  the  trial  of  the  medicinal  pro- 
perties of  the  veratr.  virid. ;  and  first  took  especial  care  to  secure  a 
good  preparation  for  distribution  among  the  members.  The  fresh 
roots  were  cleaned  carefully,  then  dried  with  a  stream  of  hot  air, 
broken  in  pieces  and  ground  in  a  coffee  mill.  From  20  lbs.  of  this 
coarse  powder  10  gallons  of  spirituous  tincture  were  prepared.  The 
first  report  of  the  committee  was  furnished  in  December,  1858.  It 
was  founded  on  the  experiments  of  10  phydcians  on  34  patients, 
children  and  adults,  and  confirms  the  calming  effect  of  the  medicine 
on  the  arterial  system  remarkably ;  and  also  the  fact  that  it  differs 
from  Veratrum  album  in  seldom  or  never  causing  vomiting  or 
purging.  A  second  report  was  published  in  October,  1861,  con- 
taining detaUed  experiments  of  SO  physicians.  The  majority — in 
fact  all  with  two  exceptions-^verified  its  predominant  action  on  the 
heart  und  its  high  value  as  a  remedy  in  diseases  characterised  by 
Tascular  excitement.  They  recommended  the  tincture  of  the  Vera- 
trum viride,  more  especially  in  the  following  diseases  : — 1st,  pneu- 
monia, without  any  other  medicine  ;  it  mitigates  the  dyspncea,  helps 
the  expectoration,  and  brings  about  rapid  cure  both  in  chUdren  and 
adults;  2nd,  pleuritis;  3rd,  peritonitis;  4th,  palpitation  of  the 
heart;  5th,  hypertrophy  of  the  heart;  6th,  acute  rheumatism, 
against  which  it  is  the  most  effective  remedy ;  7th,  all  inflammatory 
diseases  in  general,  including  those  which  follow  surgical  operations ; 
8th,  acute  mania.     Besides  the  above,  the  following  have  more 


On  the  Veratrum  Virtde  in  Disease.  529 

reoeatly  testified  to  the  power  of  the  Veratr.  Tiride.  Dr.  Toland,  of 
San  Francisco,  remarks  :  **  The  increased  vascular  excitement  which 
accompanies  hsemoptysis,  is  more  rapidly  quelled  by  this  medicine 
than  by  any  other.  The  acute  rheumatism  (common  in  its  worst 
form  in  California)  is  more  successfully  treated  by  Veratrum  Yiride 
than  all  other  remedies  hitherto  tried.  Independently  of  the  mo- 
derating of  the  heart's  action,  the  pains  are  mitigated  ;  the  secretion 
of  urine  is  excited,  and  the  metastases  to  the  heart,  which  are  so 
common  after  venesection,  are  prevented.  To  the  surgeon  this 
remedy  is  indispensable,  as  in  traumatic  fever  it  can  lower  the  pulse 
to  its  normal  standard.  Dr.  Backer,  of  Alabama,  names  it  one  of 
the  most  active  remedies  against  convulsions  of  children,  puerperal 
convulsions  and  chorea.  Dr.  Barker,  Professor  of  Midwifery  in 
New  York,  speaks  thus  of  it:  **  We  have,  in  the  Materia  Medica,  a 
medicine  much  praised  in  recent  times,  which  depresses  arterial 
action  without  injuring  the  vital  powers.  For  more  than  twelve 
years  I  have  used  it  in  puerperal  fever,  and  in  no  other  disease  have 
I  found  the  beneficial  action  so  striking.  This  remedy,  however, 
requires  caution  in  its  use,  and  the  patient  cannot  be  left  out  of  sight 
if  we  mean  to  push  the  medicine  to  its  full  influence.  It  is  true  I 
have  never  had  an  unfortunate  case  with  it,  but  I  have  observed  very 
alarming,  though  transitory  depression  produced  by  it."  The  usual 
way  of  using  the  tinctura  Veratri  viridis  is,  to  begin  with  8  drops, 
and  repeat  the  dose  every  3  hours,  increasing  the  dose  by  1  drop  at 
^ch  repetition  till  the  pulse  falls,  or  nausea  or  vomiting  come  on ; 
then  the  dose  is  gradually  diminished  so  as  to  keep  the  pulse  in  its 
k>wered  state." 

In  connection  with  the  above  we  may  quote  from  the  same  journal 
a  notice  of  the  experiments  of  Dr.  Cammerer,  of  Stuttgart,  with 
Verairine.  "  In  acute  rheumatism  he  gave  up  to  1  grain  in  10  hours 
in  doses  of  Y^o  fS^^  evexy  hour.  The  immediate  effect  was  violent 
vomiting  and  purging,  with  a  sense  of  excessive  prostration ;  of  this 
I  nwle  the  patients  and  attendants  aware  beforehand,  in  order  to 
encourage  them  to  go  through  with  the  treatment,  for  the  good  effects 
would  soon  be  manifest.  The  pulse  sinks  to  70 — 80,  and  in  the 
same  proportion  the  heat  of  the  skin  £Edls,  and  if  the  skin  was  dry 
before,  it  now  becomes  soft  and  moist.  At  the  same  time  also  the 
pains  abate,  and  the  patient  feels,  though  very  tired,  very  comfort- 
able. With  this  one  grain  the  administration  of  the  medicine  is 
finished.    In  a  few  isolated  cases  only  the  pulse  and  heat  of  skin  rose 


521  Miscellaneous. 

again  a  little  in  a  few  days,  but  never  got  to  their  former 
height.  I  had  two  cases  of  severe  acute  rheumatism  in  strong, 
hitherto  healthy  young  men,  in  whom,  on  administration  of  the 
remedy  as  above,  the  disease  was  cut  short,  and  convalescence 
began.  Warm  baths  and  good  diet  did  the  rest,  and  both  were  dis- 
missed cured  in  the  third  week.  In  other  cases,  it  is  true,  the 
disease  became  more  protracted,  but  in  a  degree  of  severity  much 
more  bearable  for  the  patient,  or,  at  any  rate,  much  milder  than 
usual.  There  was  always  this  advantage  gained,  that  the  rapid 
pulse  and  high  temperature  proper  to  acute  rheumatism,  and 
which  consumes  the  strength  of  the  patient,  remained  permanently 
lowered ;  and  in  by  far  the  majority  the  pains  were  permanently 
mitigated  and  their  duration  shortened.  I  administered  the  medicine 
at  first  only  in  quite  uncomplicated  cases,  but  afterwards  also  in 
complications,  and  in  valvular  imperfections  of  the  heart  produced 
by  former  attacks  of  this  disease,  without  any  ill  effects,  and  with  the 
same  success.  Whether  by  this  method  the  affections  of  the  heart, 
otherwise  so  frequent,  will  be  rendered  seldomer,  must  be  left  for 
experience  to  determine.  The  more  acute  the  case  and  the  stronger 
the  patient,  the  more  favourable  appears  to  be  the  action  of  the 
medicine.  Diseases  of  the  intestinal  canal  are  naturally  a  decided 
contra- indication.*' 

[Upon  this  we  think  it  well  to  make  some  remarks  more  at  length. 
The  first  thing  that  suggests  itself  is  the  similarity  of  this  to  the 
reported  effects  of  the  Veratrum  viride  in  the  hands  of  our  American 
homoeopathic  colleagues,  and  also  of  the  American  allopaths,  who  seem 
to  be  using  it  largely.  Dr.  Peters  is  strong  in  his  recommendation 
of  Verairum  viride  as  fulfilling  the  symptomatic  indications  of 
lowering  the  pulse  and  calming  excited  action  of  the  heart.  Dr. 
Hale  goes  even  farther,  and  considers  it  infinitely  superior  to  any 
remedy  we  possess  for  fevers  and  inflammations  ;  and  that  aco.,  bry., 
gelsem.,  tar.,  and  rhus.  cannot  compare  with  it  for  certainty  of  action. 
All  fevers,  pneumonia,  pleuritis,  peritonitis,  scarlatina — ^in  short, 
wherever  there  is  a  hot  skin,  quick,  hard  full  pulse,  with  any  great 
local  pain,  congestion  or  inflammation — there  is  the  sphere  of  its 
action,  and  we  may  rely  implicitly  upon  it  to  bring  down  the  pulse 
in  a  few  hours  from  120  or  140  to  80  or  60  in  the  minute,  while 
the  heat  of  skin,  fever,  thirst  and  pain,  will  proportionably 
diminish.  These  are  wonderful  statements,  but  unfortunately  we 
are  not  told  what  becomes  of  the  local  inflammation  in  the  meantime^ 


On  the  Veratrum  Viride  in  Disease.  626 

and  the  unwelcome  reminiscence  forces  itself  on  us  that  we  haye 
been  told  this  same  thing  of  blood-letting;  and  no  doubt  it  did 
happen  so  at  first,  but  we  all  know  that  the  ultimate  effect  on  the 
whole  course  of  the  disease  was  anything  but  favourable,  for  the 
still  existing  and  uncured  inflammation  very  soon  set  up  the  consti- 
tutional fever  again,  rendering  the  palliative  equally  necessary,  but, 
alas !  the  patient  not  equally  able  to  undergo  it.  Whether  this  Yet2^ 
trum  treatment  will  share  the  same  fate  as  blood-letting,  we  cannot 
tell,  but  in  the  meantime  it  bears  a  most  suspicious  resemblance  to 
the  above  allopathic  use  of  Yeratrine,  and  that  again  to  the  so 
lately  vaunted  cure  of  all  fevers  by  the  ten  grain  doses  of  quinine, 
which  has  already  gone  almost  into  the  limbo  of  oblivion. 

The  veratrine  treatment,  we  may  remember,  was  Vioth  of  a  grain 
every  hour  till  1  grain  had  been  taken.  Now  one  grain  of  veratrine 
corresponds  to  5  j  of  the  fresh  root  of  the  Veratrum  album — a  dose 
which,  given  at  once,  would  be  dangerous,  if  not  fatal.  Of  the 
Veratrum  viride.  Dr.  Hale  is  very  particular  that  we  get  the  real 
concentrated  tincture  that  will  render  water  turbid.  Of  this  3  drops 
are  ordered  every  2  hours :  and  we  are  recommended  to  stop  with  the 
patient  and  suspend  the  medicine  upon  the  pulse  flagging.  The 
allopaths  push  it,  8  or  10  drops  often  producing  vomiting.  After 
all  the  above,  we  need  hardly  be  surprised  when  we  find  Dr.  Hale 
saying,  *'  I  will  add  that  I  have  used  the  3rd  and  6th  dilutions  in 
fevers  and  inflammations,  but  without  any  effect,  and,  therefore,  am 
free  to  confess  that.  I  think  it  antipathic  to  those  affections." 

Now,  when  we  calmly  reflect  on  these  statements,  the  conclusioa 
is  forced  upon  us  that,  in  reality,  the  observers  have  been  led  away 
with  the  sanguine  hope  that  some  wonderful  new  plan  has  been  dis- 
covered, while,  in  reality,  the  only  discovery  is  that  of  an  extension 
to  one  or  more  new  medicines  of  powers  and  modes  of  application 
that  are  already  known  of  old  medicines.  For  example,  it  is  new 
that  we  have  such  a  lowering  power  over  the  pulse  in  Veratrum  viride 
and  in  Veratrine.  But  is  it  anything  new  to  be  told  that  we  have 
medicines  whose  direct  action  is  to  lower  the  pulse  ?  Did  no  one 
ever  hear  of  Digitalis  before  ?  And  has  not  its  power  of  controlling 
the  pulse  excited  hopes  over  and  over  again  of  getting  a  royal  road 
to  the  cure  of  acute  diseases  by  just  giving  a  medicine  that  could 
counteract  the  cardinal  symptoms  ?  And  have  not  all  those  hopes 
been  disappointed  ?  Also,  in  what  way  does  this  differ  from  thct 
tartar  emetic  treatment  of  pneumonia?     Contrast  these  all  with  the 


026  Misceilatieous. 

f^niArkable  fmll  of  the  ptilse  obfleired,  on  a  large  scale,  by  Tessier, 
in  the  treatment  of  pneumonia  by  Bryonia  in  the  6th  dilation,  and 
we  there  see  the  difference  between  a  real  cure  and  a  forced,  Tiolent 
disturbance  of  nature  by  the  primary  action  of  drugs.  In  the  one 
case,  the  remedy  being  homoeopathic  and  specific  to  this  local  inflam- 
mation and  whole  morbid  state,  the  whole  symptoms  improve  simul- 
taneously, and  the  fall  of  the  pulse  is  steady  and  permanent,  while 
in  the  other  the  pulse  is  beat  down  by  rapid  and  dangerous  doses 
that  required  to  be  watched  for  fear  of  poisoning ;  and  it  is  stated 
by  Drs.  White  and  Ford  that,  **  in  order  to  keep  the  pulse  15  beats 
below  its  normal  standard,  repeated  doses,  half  as  large,  or  nearly  as 
large,  were  given  every  second  or  third  hour,  suspended  when  the 
pulse  was  low,  and  promptly  resumed  agun  when  it  rose."  They 
remarked  "  that  it  was  very  easy  to  control  the  pulse  when  once 
reduced,  but  diflicult  to  reduce  it  a  second  or  third  time,  when,  by 
neglect,  it  had  risen  beyond  one  hundred  beats  a  minute."  This  is 
a  very  suspicious  remark,  and  shows  simply  that  the  plan  failed  in 
cases ;  in  how  many,  is  not  stated,  nor  is  any  account  of  the 
local  inflammation  given,  nor  indeed  any  statistics  or  any  reliable 
data  for  judging  of  this  method  at  all.  There  is,  we  fear,  every 
reason  to  suppose  that  it  is  nothing  more  than  another  example  of 
the  ordinary  allopathic  treatment,  whereby  some  accessory  troublesome 
symptom  is  stifled  for  the  moment,  while  the  original  disease  is  left 
to  nature. 

While,  therefore,  we  think  we  should  pause  before  being  led  away 
into  the  old  folse  path  of  mere  allopathic  treatment  by  the  brilliant 
qualities  of  a  new  and  powerful  medicine,  we  must  not  neglect  its 
real  value  as  a  homosopathic  medicine.  As  such  the  Yeratrnm 
viride  has  been  found,  according  to  Dr.  Hale,  in  homoeopathic  dilu- 
tions, good  in  nausea  and  vomiting  with  prostration,  vertigo  with 
weak  pulse,  fainting,  bilious  vomiting,  nervous  headache,  with  dim 
vinon  and  dilated  pupils,  somnolency  of  debility, 

We  have  seen  it  of  marked  benefit  in  a  case  of  dropsy,  with 
disease  of  the  heart,  in  which  the  patient  suffered  immensely  frmn 
the  palpitation  and  dyspnoea.  On  giving  drop  doses  of  the  1st 
decimal  dilution,  the  action  of  the  heart  was  calmed,  and  the  legs 
poured  out  the  serum  of  oedematous  swelling  with  great  relief.  In  a 
case  of  rheumatic  fever  with  bUious  cong^estion,  and  with  pericardial 
rubbing  sound,  we  found  it  also  useful  in  the  same  dose.] — Eds. 


Syphilization.  627 

SypMUzatum. 
1.  Facts,  byPBOPEssoB  Hebba. 

Between  November,  1858,  and  January,  1860,  twenty-four 
paUents  (primary  sypbilis,  3,  secondary,  19  ;  four  of  which  had  been 
previously  treated  with  mercury;  serpiginous  lupus,  2)  have  been 
inoculated  with  matter  taken  from  a  soft  chancre.  In  all  cases  the 
operation  was  repeated  every  two  or  three  days,  as  long  as  any 
reaction  (appearance  of  pustules)  followed.  No  treatment  of  the 
wounds  beyond  the  application  of  an  oiled  cloth.  All  morbid 
symptoms  usually  disappeared  within  from  three  to  six  weeks,  after 
a  varjring  number  of  inoculations :  some  reaching  immunity  with 
seven,  others  not  with  six  hundred.  An  increase  of  weight  was 
noticed  in  all  those  inoculated,  except  two. 

Mercurial  inunctions  have  no  influence  on  the  course  of  syphilid 
sation.  Where  the  patients  are  inoculated  until  immunity  is  reached, 
a  relapse  need  not  be  feared. 

While  the  experiments  are  continued,  the  fact  has  been  already 
established  that  patients  suffering  from  primary  or  secondary  syphilis 
are  perfectly  well  during  continued  inoculation  from  chancres,  im- 
prove in  appearance,  increase  in  weight,  and  lose  graduaUy  all 
symptoms  of  the  disease.  The  latter  happens  in  the  same  manner 
as  under  the  mercurial  or  iodine  treatment,  but  more  slowly. 

The  most  rapid  and  certain  cure  of  a  syphilis  is  obtained  by 
treating  it  with  mercurials. — '  Zeitchr.  d.  Oesellsch.  d.  Aerzte  zu 
Wien.' 

'2.  Faitcies,  by  Db.  F.  E.  Fiebee. 

In  a  therapeutical  view,  syphilisation  can  only  be  compared  to 
the  isopathic  treatment  of  cholera,  with  the  potential  evacuation  of 
cholera-patients,  of  variola  with  potential  small-pox  matter,  &c. 

The  augmented  quantity  of  venereal  poison,  introduced  into  the 
organism,  does  certainly  not  increase  the  latter's  energy  and  power 
of  resistance,  but  diminishes  them,  like  all  other  poisons. 

The  reported  success  is  evidently  more  due  to  nature  than  to  the 
infliction  of  seventy  or  a  hundred  fresh  ulcers.  Relapses  seem  to 
be  frequent. 

A  mercurial  treatment  gives  so  satisfactory  results  that  it  needs 
no  substitute  in  a  dangerous  innovation.  Syphilisation  may  be 
tried,  but  only  in  desperate  cases,  where  the  rational  methods  prove 
of  no  avail. 


528  Books  Received. 

Prophylactically,  vaccination  might  be  compared  with  syphiUsa- 
tion.  But  the  cow-pox  prevents  Bmall-pox — ^the  leseer  evil  the 
greater,  and  to  a  certain  degree  only,  while  it  i»  claimed  for  syphi- 
lisation  that  a  disease  cures  itself,  if  implanted  over  again  in  the 
same  organism,  and  protects  the  organism  against  a  renewed  in- 
fluence of  itself.  The  inoculation  of  variola-matter  has  never  beea 
thought  of  as  a  cure  for  variola. 

Another  analogy  would  be  the  capability  to  swallow  large  doses 
of  opium  without  direct  injury.  Here,  however,  no  immunity 
against  the  effects  of  the  poison  is  claimed.  Several  ounces  may 
result  in  death,  where  several  drams  are  taken  with  impunity. 

That  syphilisation  carries  the  patient  rapidly  through  all  stages 
of  the  disease  to  a  point  where  the  danger  of  further  infection  ceases, 
is  an  unproved  hypothesis.  Pyemia  may  follow ;  pain,  fever,  im- 
paired nutrition  certainly  do,  and  it  is  probably  of  some  importance 
to  the  paUent,  whether  to  have  one  scar  in  some  part  easily  covered, 
or  to  have  hundreds  over  the  chest  and  extremities. 

Notwithstanding  all  these  objections,  judicious  trials  with  syphi- 
lisation are  justifiable,  until  its  value  is  fully  established. — *  Zeitschr. 
d.  Gesellsch.  d.  Aerzte  zu  Wien.* 


BOOKS    RECEIVED. 

HomiBopathy  Explained.   By  Richard  Epps,  ALR.C.S.E.   London. 
Epps. 

Mamial  of  Homctopatlde  Theory  and  Praeiiee.  By  Arthub  Lutzb, 
M.D.    Translated  by  C.  J.  Hbmpxl,  M.D.    New  York,  Badde,  1862. 

The  North  American  Journal  of  Homoeopathy. 

El  CriUrio  MedUso. 

BuHetm  de  la  SoeiStS  M6dicale  HomcBcpathique  de  France. 

The  HomcBopathic  Observer. 

Medical  Testimony  m  regard  to  the  proper  Mechanical  Treaiment  of 
Joint  Diseases.    By  Dr.H.  G.  Davis.    New  York. 

On  the  Therapeutic  Action  of  Atomic  Doses.    By  Arthur  Db  Noh 
Walkbr,  M.R,C.S.    Eog. 


Printed  by  W.  Datt  ft  Bow,  8,  GUbert-«treet,  Ozford-itz«et,  W. 


THE 

BRITISH   JOURNAL 


OP 


HOMOEOPATHY- 


PHYSIOLOGICAL  DIETETICS: 

SOME    PRACTICAL  DISTINCTIONS    BETWEEN 

FOOD  AND  MEDICINES. 

Bead  be/ore  the  lUifwis  Homceopathie  Medical  Asaociaiion, 
May  22nd,  1862,  by  R.  Ludlam,  M.D.,  Professor  of 
Physiology,  Pathology  and  Clinical  Medicine  in  Hahne- 
tnann  Medical  College,  Chicago.  (U.S.) 

As  they  are  related  to  the  human  organism,  all  known  sub- 
stances may  be  divided  into  two  classes,  viz.,  nutrients  and 
non-nutrients.  With  the  one  class  the  relation  is  the  more 
intimate  because  of  modelling  processes  which  are  constantly 
going  on  within  that  organism,  since  it  supplies  organizable 
elements  for  the  preservation  of  forms.  The  members  of  the 
other  general  group  are  non-assimilable,  excepting  as  they  add 
to  or  modify  the  animal  and  organic  forces  of  the  economy. 
Nutrients,  if  rightly  appropriated,  are  to  be  regarded  as  material 
ft<?na,/U^  contributions  toward  strpctural  growth  and  develop- 
ment. The  non-nutrients  are  merely  the  vehicles  for  those 
immaterial  and  imponderable  agencies  which,  as  they  are  ap- 
plied, have  a  toxical  or  curative  influence  over  the  life-actions. 

The  distinction  we  have  made  is  an  important  one.  The 
line  separating  food  and  medicine  has  not  been  drawn  with 
sufficient  clearness.  Nutrients  have  a  definite  line  of  action, 
and  so  also  have  the  non-nutrients.     Introduced  into  the 

VOL.  XX.,  NO.  LXXXII.— OCTOBEB  1862.  2  L 


530  Physiological  Dietetics, 

human  organism,  each  has  its  sphere  of  duty,  and,  as  a  rule, 
they  are  not  convertible, — certainly  not  within  the  body.  Each 
particle  of  the  aliment  which  is  to  be  vivified  and  organized 
is  labelled,  so  to  speak,  like  one's  car-ticket,  *'  not  transferable." 
It  does  not  minister  directly  to  the  increase  of  the  organic 
forces,  but  is  itself  operated  upon  by  them.  Neither  a  man's 
physical,  moral,  nor  yet  his  intellectual  strength,  are  to  be 
measured  by  his  size  merely,  but  by  the  available  power  resident 
in  his  body,  whether  it  be  lean  or  portly.  Thomson's  "little 
round,  fat,  oily  man  of  God  "  for  a  minister,  is  not  always  the 
most  efficient  member  of  the  cloth,  nor  would  the  obese 
Lambert  rival  the  wiry  Winship  as  an  athlete. 

The  vigorous  exercise  of  a  gymnast  developes  his  muscles 
and  his  appetite  at  the  same  time.  The  former  result  comes  of 
a  more  active  and  thorough  operation  of  the  nutritive  and 
assimilative  forces ;  the  latter  from  the  increased  physiological 
detritus  of  tissue,  demanding  an  increased  supply  of  material 
for  purposes  of  repair.  It  is  thus  that  the  formative  forces  of 
the  organism  act  and  react  with  those  which  are  dynamical  and 
more  demonstrative. 

This,  therefore,  is  the  physiological  distinction  between  food 
and  medicine  which  the  practical  physician  will  always  observe, 
id  est,  that  nutrients  are  assimilated  into,  and  concern  more 
intimately,  ihe forms  which  characterize  the  living  structures; 
while  each  of  the  non-nutrients  supplies  a  variety  oi  force  to 
the  organism,  which,  varying  in  degree  and  quality,  as  well  as 
in  the  time  and  method  of  its  application,  may  be  either  toxical 
or  remedial.  In  a  literal  sense  there  are  no  nutrient  remedies. 
One  might  feed  a  patient  for  an  indefinite  period  upon  the 
attenuations,  but  the  principal  result  would  be  to  attenuate 
him!  On  the  contrary,  there  is  nothing  of  healing  virtue />^ 
se,  in  the  best  chosen  aliment.  A  rigid  diet  is  sometimes,  not 
very  frequently  perhaps,  a  wholesome  expedient,  and  indirectly 
efficacious  because  it  rids  the  organism  of  a  source  of  increased 
embarassment,  thus  giving  it  an  opportunity  to  react  against 
the  perturbing  influences  which  have  been  brought  to  bear  upon 
it.  It  may  sometimes  be  serviceable  also  in  permitting  remedies 
to  regulate  more  directly  the  play  of  the  operative  forces  which 


hy  Br,  Ludlam.  581 

have  been  disordered.  Bat  it  does  not  relate  to,  or  afifect  in  a 
primary  way,  the  therapeatic  processes  by  which  health  is 
restored.  At  the  same  time,  medicines  are  not  to  be  regarded 
as  sovereign  for  the  relief  of  the  earlier  and  the  more  remote 
consequences  of  diseased  action. 

The  idea  finds  utterance  in  the  fact  that  it  is  absurd  for  one 
claiming  a  familiarity  with  the  laws  of  the  human  organism,  of 
a  rational  physiology,  to  be  attached  to  either  agency  as  an 
exclusive  means  of  cure.  We  might  with  as  much  propriety 
ignore  the  claims  of  the  cerebro-spinal  system  to  our  recognition 
and  study,  upon  the  ground  that  because  there  is  a  ganglionic 
or  organic  system  of  nerves,  we  do  not  therefore  need  to 
familiarize  ourselves  with  another,  as  to  exalt  a  pure  expectancy 
upon  the  one  hand,  or  any  method  of  drugging  whatever  upon 
the  other,  to  the  rank  of  a  specific'  and  universal  method  of 
cure.  Such  one-sided  opinions  have  always  been  the  bane  of 
medical  science. 

Take,  as  an  example,  the  two  schools  of  physiologists,  the 
chemists  and  the  vitalists.  Because  zoo-chemistry  is  competent 
to  explain  the  more  crude  and  tangible  conditions  of  life- 
action,  the  chemists  insist  that  it  must  be  capable  of  unravelling 
the  subtler  details  of  function  belonging  to  the  inner  existence. 
With  this  class,  all  is  a  species  of  refined  chemistry.  But  the 
vitalists  are  more  transcendental,  and  refer  the  phenomena  of 
functional  activity  in  our  bodies  to  the  play  of  those  intangible 
forces  which  are  more  ethereal  and  evanescent.  With  this 
school  of  philosophers  the  most  varied  processes  are  believed  to 
result  from  the  same  moving  power  or  spirit,  the  animus  of  the 
organism.  They  will  strain  a  point  to  demonstrate,  if  it  were 
possible,  that  the  soul  is  the  source  of  animal  heat !  and  make 
themselves  to  appear  equally  ridiculous  in  ignoring  the  fact  that 
organic  chemistry  can  afford  any  plausible  explanation  what- 
ever of  the  phenomena  of  human  physiology.  The  truth  lies 
between  the  two.  Both  are  wrong,  because  both  are  too  ex* 
elusive.  "  Not  a  step  can  the  physiologist  advance  without  the 
assistance  of  the  chemist ;  but  he  must  employ  chemistry  as  a 
means  of  exploration,  not  of  deduction — as  a  pillar,  not  a 
pinnacle — an  instrument,  not  an  aim.'*  (Lewes.) 

2  L 


582  Physiological  Dieielics, 

Precisely  80  is  it  with  those  phydcians  who  insist  that  our 
attenuations  are  the  only  desiderata  for  the  sick  chamher ;  and 
with  such  also  as  having  become  sceptical  of  therapeutics,  have 
determined  to  place  their  reliance  alone  upon  diet,  hygiene  and 
the  like.  Both  are  out  of  the  way,  and  only  travel  farther  and 
farther  from  the  goal  the  more  radical  they  become. 

It  is  with  a  view  to  illustrate  the  harmony  of  operation  in 
these  two  sciences  made  practical,  to  show  that  they  are  by  no 
means  incompatible,  that  we  have  been  induced  to  offer  the 
present  paper.  In  what  follows  we  propose  to  discuss  the  sub- 
ject of  nutrients  in  their  physiological  and  pathological,  rather 
than  in  their  chemical  relations  to  the  organism.  At  some 
future  time  we  may  set  forth  our  peculiar  views  concerning  the 
therapeutical  spheres  and  modus  operandi  of  the  non-nutrients. 

Nutrients. 

Permit  us  to  recommend  a  somewhat  original  and  more 
available  classification  of  these  substances  than  has  hitherto 
been  proposed.     Nutrients  are  either  direct  or  indirect. 

1.  Direct  Nutrients. — This  class  includes  all  the  albumi- 
noid or  proteioaceous  bodies,  whether  derived  from  vegetables 
or  animals.  They  are  the  organic  substances  proper;  the 
nitrogenized,  or  histogenetic  elements,  as  they  are  sometimes 
called.  Chemistry  has  discovered  in  them  the  four  essential 
elements — carbon,  oxygen,  hydrogen  and  nitrogen,  with  a 
trace  of  sulphur  and  phosphorus;  but  because  they  are  of 
organic  origin,  and  adapted  to  the  ever-varying  necessities  of 
the  human  body,  in  nourishing  the  blood  and  bone,  the  brain 
and  muscle,  and  the  remaining  tissues,  the  most  careful  analysis 
has  failed  to  detect  in  them  a  uniform  chemical  composition. 
In  this  respect  they  differ  from  all  other  nutrients.  As  found 
in  the  textures  of  the  body,  they  have  undergone  a  change 
which  has  fitted  them  to  become  an  integral  part  thereof.  The 
albumen  of  the  liquor  sanguhiis  is  not  identical  with  that  which 
has  been  organized  into  neurine,  any  more  than  the  crassamen- 
tum  of  the  blood-current  is  composed  of  bofha  fide  muscular 
fibre.  In  each  example  of  their  organization,  these  elements, 
albumen,  fibrin  and  casein,  indicate  a  progressive  metamor* 


hy  Dr.  Ludlam.  538 

phosis  which  initiates  them  into  the  more  intimate  anatomy  of 
the  bodily  structures.  Each  of  these  principles,  therefore, 
exists  in  the  body  under  two  separate  forms^  the  soluble  and 
the  insoluble,  the  organizable  and  the  organized.  And  there  is 
no  retrograde  metamorphosis,  which  shall  restore  them  to  their 
original  state,  as  found  in  the  blood-plasma  before  the  process 
of  construction  had  commenced.  The  only  means  of  outlet  for 
this  class  of  elements  from  the  system  is  their  physiological 
waste  or  moulting,  and  final  discharge  through  the  various 
excretions ;  unless  indeed,  we  include  the  pathological  processes 
resulting  in  suppuration,  ulceration  and  mortification. 

The  functional  use,  if  so  we  may  term  it,  of  the  albuminoid 
substances  is  simply  to  minister  under  proper  conditions  to  the 
textural  repairs  of  the  organism.  They  represent  the  bricks 
and  mortar,  the  plastic  material,  from  which  the  more  impor- 
tant parts  of  the  building  are  to  be  constructed.  But  we  must 
not  forget  that,  while  intimately  related  to  resulting  .forms,  they 
are  not  endowed  with  an  innate  power  of  organization.  Like 
true  building  materials,  they  must  be  moulded  and  operated 
upon  by  other  and  specific  forces,  or  nutrition  will  prove  a 
failure;  a  fact  which  has  its  illustration  in  the  fibrillation 
of  the  blood-clot,  as  well  as  in  pseudo-membranous  formations, 
where  the  resulting  product  is  an  abortion  of  structure.  The 
component  cells  of  each  particular  tissue  contain  and  impress 
the  modelling  forces  which  pertain  to  special  histogeny,  and  are 
the  constructors  of  each  particular  textural  compartment  in  it* 
The  cell  wall,  or  periplast,  is  albuminous,  and,  with  its  con- 
tained fluid,  nuclei  and  nucleoli,  represents  an  organ  which  is 
set  apart  to  the  double  function  of  structural  repair  and  repro* 
duction.  From  an  available  plasma,  and  in  conformity  to  a 
specific  type  and  form,  it  is  to  re-construct,  re-model  and  re« 
produce  all  the  myriad  details  of  microscopical  anatomy. 

The  nutrition  of  the  various  tissues  may  be  in  excess  or 
deficiency.  In  a  case  of  tabes  mesenterica  in  a  child,  for 
example,  the  more  prominent  symptom  is  a  decided  atrophy, 
marasmus  or  wasting  away  of  the  flesh.  The  little  patient  may 
eat  inordinately,  but  still  be  remains  a  mere  skeleton.  The 
most  nourishing  aliment  appears  to  be  dissolved  somewhere  in 


534  Phytiological  Dietetics, 

the  coune  of  the  digestive  tract,  but  it  fails  to  minister  to  the 
repair  of  the  nitrogenized  tissues.  And  why  is  this  ?  Simply 
because  its  absorption  into  the  lacteals,  or  into  the  portal 
system,  or  its  more  intimate  assimilation  into  the  structures,  or 
both,  is  disordered.  If  the  mesenteric  glands  fail  to  establish 
those  changes  in  the  albuminous  and  other  peptones  brought 
to  them  which  indicate  a  step  forward  in  the  organizing  pro- 
cesses peculiar  to  this  department  of  nutrition,  the  histogenetic 
function  18  necessarily  disordered.  Or,  if  the  little  capillary 
rills  continue  to  irrigate  the  tissues  as  in  health,  bringing  the 
most  appropriate  food  for  the  supply  of  their  morphological 
and  organic  necessities,  and  still  they  remain  impoverished  and 
emaciate,  we  infer  that  the  more  intimate  function  of  assimila- 
tion, and  not  that  of  absorption  merely,  is  at  fault.  The 
aliment  is  the  proper  one.  It  has  been  digested,  absorbed  and 
emptied  into  the  circulation,  carried  to  the  hungry  tissues,  the 
actual  seat  of  the  appetite,  and  yet  their  repair  is  not  effected. 
The  marasmus  is  due  to  the  fact  that  the  elements  of  growth 
are  not  rightly  appropriated.  The  drain  is  a  serious  one,  for  it 
may  sap  and  undermine  the  life-processes,  so  that;  by  and  bye, 
the  textures  shall  come  to  resemble  the  worm-eaten  timbers  of 
an  old  and  ricketty  edifice. 

In  the  hypertrophy  of  an  organ  the  formative  forces  are 
too  active,  cell-growth  and  development  have  reached  their 
maximum.  The  nutritive  resources  are  spent  in  a  profligate 
manner  upon  the  mechanism  itself,  it  may  be  at  the  expense  of 
its  healthy  function.  Progressive  assimilation  h§s  gone  on 
uninterruptedly,  but  prodigally.  The  plastic  material  furnished 
has  been  greedily  appropriated,  and  those  little  tissue-builders, 
the  cells,  have  been  as  busy  as  bees,  that  nothing  which  they 
could  work  into  the  structures  should  be  left  out 

Here,  then,  are  the  two  extremes  of  histogenetic  function, 
neither  of  which  is  to  be  remedied  by  nutrients  alone,  but  first 
and  foremost  by  a  means  which  shall  be  .competent  to  regulate 
the  formative  forces  of  the  economy,  and  subsequently,  by 
supplying  an  aliment  which  shall  be  acted  upon  and  assimilated 
by  them. 

Direct  nutrients,  therefore,  include  nil  that  class  of  proximate 


by  Dr,  Ludlam.  535 

principles  which  supplies  the  nitrogenized  elements  of  the  food. 

They  are  the  material  from  which  the  living  tissues,  and  in 

chief  part,  the  liquor  sanguinis  and  other  organizable  fluids  are 

formed.     Without  their  presence  the  tissue-repairs  which  are 

so  significant  of  healthy  life-action  could  not  be  perpetuated. 

They  rebuild  the  solids,  renewing  the  growth  and  development 

of  organic  forms  and  compounds  through  the  agency  of  specific 

modelling  forces  which  are  resident,  not  in  themselves,  Cut  in 

the  tissue-germs,  or  cells,  to  which  they  are  brought  by  the  aid 

of  absorption  and  of  the  circulation. 

2.  Indirect  Nutrients. — This  variety  of  nutrients  may  be 
divided  into  three  classes,  viz. : 

a.  Those  whose  chemical  identity  is  preserved  in  the 
organism. 

b.  Those  which,  in  the  body,  undergo  some  chemical 
transformation,  and 

c.  Those  which  act  by  preventing  an  excessive  tissue 
metamorphosis. 

a.  The  first  of  these  orders  includes  water,  the  chlorides  of 
potassium  and  sodium,  and  the  alkaline  phosphates  and  car- 
bonates of  calcium,  sodium,  potassium  and  magnesium.  They 
may  be  either  of  organic  or  of  inorganic  origin,  but  are  them- 
selves of  an  inorganic  nature.  They  have  a  definite  chemical 
composition,  which,  upon  the  most  accurate  analysis,  is  found 
to  be  the  same,  whether  in  the  body  or  out  of  it. 

In  the  synthesis  of  the  animal  tissues  we  discover  them  to  be 
of  service  in  one  of  two  ways — either  oatalytically  or  mechani- 
cally. The  former  method  of  their  union  and  use  has  an 
illustration  in  the  presence  of  sulphur  and  phosphorus  in  the 
nitrogenized  tissues  ;  the  latter,  in  the  arrangement  and  deposit 
of  compounds  of  lime  in  the  bones,  and  of  the  carbonate  of 
potassa  in  the  muscles.  Their  assimilation  is  only  approxima* 
tive,  and,  with  the  exception  of  the  sulphur  and  phosphorus 
already  spoken  of,  they  are  not  discovered  in  excess  in  any  of 
the  more  highly  vitalized  tissues.  We  find  them,  however,  in 
the  osseous,  the  cartilaginous  and  the  ligamentous  structures. 
Circulating  in  the  blood-current,  they  represent  the  more  crude 


ft36  Phyiioloffieal  DieUites, 

material,  or  stock-in-trade  of  the  organiflm.  The  tissues 
belonging  to  a  higher  grade  of  organization  are  only  indirectly 
related  to  them.  Thus,  for  example^  all  the  animal  tissues  of 
whatever  variety  are  hygroscopic,  and  firom  its  liberal  supply 
by  osmosis,  water  therefore  becomes  in  some  sort  a  proximate 
principle,  necessary  to  their  formation.  It  constitutes  by  weight 
about  ninety  per  cent  of  the  entire  body. 

The  chloride  of  potassium  abounds  in  the  blood-cell,  and  the 
same  salt  of  sodium  in  the  blood-serum.  Inde^,  these  two 
compounds  have  been  discovered  in  all  the  tissues  and  fluids  of 
the  body,  excepting  only  the  enamel  of  the  teeth,  and  really 
fulfil  such  important  subordinate  functions  in  the  economy, 
that,  like  the  hydro-carbon  furnished  by  the  great  sugar  re- 
finery, the  liver,  their  production  must  be  placed  beyond  a  per- 
adventure,  so  that  mere  caiprice  of  appetite  or  diet  shall  not 
occasion  disorder.  The  chloride  of  sodiom  is  of  as  incalculable 
service  in  holding  in  solution  the  albumen,  as  ammonia  is  in 
preventing  the  coagulation  of  the  fibrin  of  the  blood-current. 
It  supplies  a  chemical  condition  of  absorption  and  of  exudation, 
whereby  the  functions  of  secretion  and  of  excretion  may  be 
properly  performed.  It  ministers  to  the  election  or  separation 
of  those  elements  which  are  to  be  vitalized  from  such  as  are 
innutritions  and  worthless. 

The  salts  of  lime,  which  contribute  to  the  firmness  and 
solidity  of  the  skeleton,  are  deposited  mechanically  in  the 
osseous  cells  of  the  bony  fabric.  Ghossat  produced  artificial 
rickets  in  certain  inferior  animals  by  restricting  them  to  food 
which  contained  little  or  no  phosphate  of  lime,  ^he  form  of 
fragilitas  ossium  common  to  old  people,  in  whom  the  neck  of 
the  femur  is  so  often  and  so  easily  fractured  within  the  capsular 
ligament,  is  due  to  an  abnormal  excess  of  the  earthy  salts  over 
the  animal  constitaents  of  this  bone. 

Without  specifying  those  farther  physiological  details  con- 
cerning this  department  of  zoo-chemistry,  already  familiar  to 
my  hearers,  permit  me  to  direct  your  attention  to  a  significant 
fact  pertaining  to  this  class  of  "  principles  "  which  appears  to 
have  been  almost  entirely  overlooked  by  medical  writers.  I 
allude  to  their  dual  character  and  capacity  as  indirect  nutrients 


by  Dr.  Ludlam.  587 

and  as  remedies,  when  prepared  and  introduced  into  the  or- 
C^nism  nnder  different  forms  and  conditions. 

In  crnde  sabstance,  the  chloride  of  sodium  taken  with  our 
food  is  a  proximate  principle  capable  of  becoming  a  part  of  the 
typical  solids  and  fluids  of  the  body ;  but  dynamized,  or  tri* 
turated,  and  administered  in  the  form  of  natrum  muriaticum,  it 
is  found  to  have  a  curative  sphere  which  is  altogether  foreign  to 
it  as  a  simple  condiment.  Excepting  water  only,  the  same  is 
true  of  every  other  member  of  this  class  of  indirect  nutrients. 
And  so  also  of  other  substances  not  enumerated  in  the  fore* 
going  catalogue,  as  carbon,  iron  and  silica.  Whether  they  will 
prove  nutrient  or  remedial  will  depend  entirely  upon  the  form 
in  which  they  are  introduced  into  the  organism. 

It  is  just  here  that  we  shall  discover  the  line  which  separates 
food  from  medicines.  This  is  a  great  desideratum  among 
medical  men,  as  is  proven  by  the  frequent  attempts  and  failures 
to  fix  upon  its  precise  location.  Upon  this  subject  Dr.  Chambers, 
in  his  word  on  Digestion  and  its  Derangements,  says :  "  When 
instinctively  or  rationally  they  are  taken  by  a  body  in  health, 
with  the  intention  of  keeping  up  that  health,  they  are  foods  ; 
when  administered  to  a  sickly  body,  that  is  one  whose  physiolo* 
gical  actions  are  inconvenient  to  the  individual,  with  the  inten- 
tion of  restoring  health,  they  are  medicines.  Whether  an 
article  is  food  or  medicine  depends  entirely  on  the  intention, 
and  on  nothing  else." 

In  this  extract  nothing  is  said  of  the  dynamization  of  these 
principles,  but  we  are  expressly  informed  that  the  will  of  the 
giver  is  to  determine  whether  they  shall  act  as  food  or  as 
medicines !  There  is  no  recognition  of  the  fact  that  this  is  the 
more  prominent  class  of  substances  which  do  not  undergo  some 
manifest  chemical  or  vital  change  when  introduced  into  the 
living  organism,  and  that  of  necessity  they  must  be  more  re- 
liable as  remedial  agents  than  either  the  bistogenetic  or  the 
calorifacient  principles  contained  in  the  food. 

Dumas  determined  long  ago,  and  more  modem  chemists 
endorse  the  view,  that  the  manifestation  of  peculiar  properties 
by  different  bodies  depends  not  on  the  nature  of  the  atoms,  but 
on  the  mode  of  their  arrangement.    Here  then  is  the  key  to 


588  Physiological  Dietetics^ 

the  almost  marvelloas  virtaea  of  dynamized  matter.  By  a 
simple  mechanical  means  which  so  modifies  the  atomic  ar- 
rangement of  particles  in  the  carbonate  of  lime,  for  example, 
that  substance  is  changed  from  a  crude  nutrient  to  a  remedy, 
the  calcarea  carbonica,  which  possesses  a  wide  range  of  action 
and  a  most  wonderful  efficacy.  As  common  chalk  it  may  be 
eaten  in  considerable  amount  without  causing  any  manifest 
derangement  of  system.  If  not  assimilated  by  the  nutritive 
forces  into  one  or  another  of  the  less  vitalized  textures^  it  finds 
its  way  out  of  the  body  through  the  emunctories.  But  change 
the  molecular  arrangement  of  its  particles  by  mechanical  sub- 
division, as  the  mercury  is  changed  in  the  blue  mass,  or  the  fat 
globules  of  the  food  are  changed  into  globulets,  or  even  into 
Gullivers  molecular  base,  by  intestinal  succussion,  and  new 
properties  are  eliminated  which  indicate  a  range  of  curative 
action.  And,  strangely  enough,  when  so  prepared,  we  find 
there  is  such  a  complete  alteration  in  its  properties  that  the 
calcarea  carbonica,  once  a  nutrient  and  ordained  like  all  its 
class  to  be  fashioned  and  moulded,  operated  upon  by  the 
modelling  force  of  the  cell,  by  this  new  arrangement  of  its 
atoms  has  acquired  an  entirely  new  relation  to  bistogenetic 
processes.  Now  it  may  modify  these  same  forces  when  they 
are  disordered.  It  has  become  possessed  of  a  therapeutical 
relation  to  nutrition.  Administered  in  the  tabes  mesenterica, 
it  well-nigh  deserves  the  title  of  "  specific,"  because  of  its  pe- 
culiarly pleasant  and  satisfactory  action  in  aid  of  the  progressive 
assimilation  of  the  plasmtf.  It  ministers  to  tissue-repairs,  not 
by  supplying  material  for  the  growth  of  the  atrophied  struo* 
tures,  but  by  modifying,  qualifying  and  perhaps  regulating  the 
operative  forces  which  are  in  charge  of  this  department  of 
organised  life.  Just  as  by  transmission  through  the  cow  the 
small-pox  virus  becomes  a  preventive  of  that  loathsome 
disease  in  the  human  species,  so  by  a  voluntary  means,  and 
not  a  mere  intention  only,  are  we  enabled  to  transform  this 
class  of  nutrients  into  remedies. 

Nor  is  this  principle  of  duality  of  action,  as  nutrients  or  as 
remedies,  peculiar  to  the  calcarea  carbonica  and  its  congeners. 
Berzelius  taught  that  there  are  few  elements  whose  properties 


by  Dr.  Zudlam.  539 

are  not  Completely  altered  when  the  conditions  which  they  have 
assamed  are  changed. 

h:  The  second  division  of  this  class  includes  those  principles 
'which,  although  they  are  exclusively  of  organic  origin,  are 
nevertheless  hut   slightly  organizable.     These   are   the  non- 
nitrogenized  suhstances :  starch,  the  various  sugars  and  fats  or 
oils.     They  have  a  definite  chemical  composition,  and  consist 
of  the  three  essential  elements — carbon,  hydrogen  and  oxygen. 
TVIien  hydrogen  and  oxygen  exist  in  equal  proportions  in  any 
one  of  these  proximate  principles,  we  have  a  carbo-hydrate,  as 
starch  and  sugar ;  otherwise  the  chemical  union  of  these  gases 
with  the  carbon  produces  the  hydro-carbons,  as  the  various  fats 
or  oils.    For  this  reason  the  one  class  is  inflammable  while  the 
other  is  not.     Both  are  believed  to  contribute  indirectly  to  the 
activity  of  the  nutritive  processes  by  ministering  to  one  of  its 
essential  conditions — the  maintenance  of  a  proper  animal  tem- 
perature. 

The  idea  thus  formulated  by  Dr.  Thompson,  the  founder  of 
a  once  famous  medical  sect,  that  "heat  is  life  and  cold  is 
death,"  is,  with  certain  qualifications,  a  better  physiological 
than  a  therapeutical  maxim.  A  temperature  in  the  body  of  98^ 
to  102^  F.,  is  found  to  be  a  necessary  requisite  of  the  life- 
actions.  Not  only  are  the  more  tangible  and  familiar  functions 
of  digestion,  respiration,  and  the  circulation  directly  interested 
in  calorification,  but  absorption  also,  and  the  more  intimate 
nutrition  of  the  tissues  by  osmosis  through  their  myriad  little 
periplasts,  not  to  speak  of  innervation,  animal  and  organic,  or 
of  those  intellectual  functions  which  personate  the  presiding 
genius  of  the  whole. 

Heat  represents  one  of  those  chemical  conditions  which  con- 
stitute a  point  of  departure  and  return  in  the  arc  or  circle  of 
organization.  It  certainly  supplies  a  chief  source  of  the  me- 
chanical, or  dynamical  phenomena  of  life.  If  excessive,  it 
implies  danger  from  a  too  rapid  detritus  of  tissue,  and  a  too 
prodigal  play  of  the  operative  forces  of  the  economy.  If  defi- 
cient, for  any  considerable  time,  that  the  organic  resources 
are  at  a  low  ebb,  and  life-functions  and  phenomena  imperilled 
thereby. 


I 


^^^  Phytioloffical  DieteticB,  I 

Not  that  all  pathological  states  depend  for  a  primary  cause 
upon  a  disorder  of  calorification^  evidenced  by  what  is  familiarly 
termed  a  fever,  or  its  opposite;  but  that,  as  fever  has  been 
defined  to  consist  in  a  general  perturbation  of  function,  so  we 
find  that  this  particular  function  never  fails  to  be  implicated  in 
the  disordered  action. 

The  oxidation  of  this  class  of  Proximate  Principles,  as  intro- 
duced along  with  the  food,  is  regarded  as  an  important  source 
of  animal  heat,  and  is  believed  to  supply  a  very  important  con- 
dition of  its  development.  When  subjected  to  the  influence  of 
the  digestive  process,  each  of  the  aforesaid  elements  undergoes 
an  early  and  decided  change  in  chemical  character.  Each  loses 
its  identity :  the  starch,  by  the  action  of  the  salivary  and  pan- 
creatic fluids  upon  it,  is  converted  into  a  species  of  sugar ;  the 
sugar  into  lactic  acid,  thus  furnishing  to  the  blood  a  solvent 
for  the  phosphate  of  lime,  and  the  acid  which,  with  the  alkaline 
bases,  is  to  form  the  lactates;  and  the  fats  or  oils,  by  oxidation, 
into  so  many  equivalents  of  caloric,  or,  by  mechanical  deposi- 
tion into  the  tissues,  into  adipocere.  They  minister  indirectly 
to  the  morphological  interests  by  regulating  one  of  the  more 
vital  conditions  of  assimilation,  viz.,  the  maintenance  of  that 
degree  of  temperature  which  facilitates  the  absorption  and  ready 
appropriation  of  a  proper  aliment.  Their  use  is  none  the  less 
important  because  it  is  a  subordinate  one;  none  the  less 
nutritious  for  furnishing  fuel-food,  and  not  direct  tissue  material 
capable  of  being  transmuted  into  honajide  flesh  and  blood. 

But  more  modem  physiologists  insist  that  Liebig's  doctrine, 
concerning  the  non-nitrogenized  constituents  of  the  blood,  that 
"  they  take  no  direct  share  by  their  elements  in  the  formation 
of  organs,  and  have  no  vital  properties,"  is  not  tenable.  Fats 
and  salts  are  necessary,  say  they,  to  the  formation  of  a  cell, 
and  if  of  a  single  cell,  then  of  fibres  also.  They  thus  claim 
that  these  elements  are  not  the  mere  accessories  of  organization, 
but  essential  requisites,  each  and  all  of  them,  to  the  formation 
of  a  healthy  plasma, — the  concentrated  solution  of  all  the 
bodily  tissues,  and  that  they  are  tissue-makers  as  well  as  heat- 
producers. 

Such  a  view  authorizep  the  classification  of  the  members  of 


by  Dr.  Ludlam.  54 1 

this  group,  and  especially  of  the  oily  suhsiances,  among  the 
proximate  principles  of  organic  life.  And  the  theory  finds  a 
confirmation  in  the  manner  in  which  the  cod's  liver  oil,  and 
other  fatty  nutrients  are  disposed  of  in  the  body.  Prescribed 
for  the  relief  of  the  emaciation  of  phthisical  patients,  or  for  the 
fattening  up  of  those  who  suffer  an  atrophy  of  tissue  from  other 
causes,  and  in  other  diseases,  as  the  Germans  give  the  dog's  fat 
in  marasmus,  they  will  sometimes  increase  the  weight  and 
plumpness  of  the  individual  in  a  very  considerable  degree.  No 
one,  however,  claims  for  them  the  possession  of  any  proper 
remedial  virtues,  but  simply  that  they  furnish  the  materials 
requisite  to  the  more  normal  development  of  some  of  the 
bodily  textures. 

c.  Thirdly,  we  have  those  substances  which  nourish  indi- 
rectly by  preventing  an  excessive  tissue  metamorphosis.  The 
more  prominent  members  of  this  class  are  alcohol,  tea  and 
coiFee,  It  is  but  recently  that  the  true  physiological  sphere  of 
action  of  these  substances  begins  to  be  understood.  First  they 
were  classed  as  siimulants,  and  viewed  in  the  light  of  remedial 
agents,  possessed  of  curative  virtues,  as  opium  and  other  nar- 
cotics. More  recently  they  are  spoken  of  as  calori/acients, — 
supporters  of  combustion.  The  oxidizable  properties  of  alcohol 
within  the  body  were  supposed  to  be  the  same  in  kind  and 
degree  with  its  inflammable  properties  in  the  chemist's  labora- 
tory. If  spirit  would  bum  readily  and  almost  spontaneously, 
in  the  test-lamp,  why  should  it  not  lighten  up  the  darkened 
avenues  of  the  blood-tide  ? 

Furthermore,  certain  phenomena  signifying  an  increased 
animal  temperature  are  known  to  be  manifested  directly  after 
its  administration,  and  since,  according  to  the  Leibigian  doc- 
trine, such  a  result  could  only  arise  from  combustion,  the  case 
seemed  a  plain  one,  that  alcohol  was  a  carbonaceous  substance 
especially  useful  in  aid  of  the  function  of  calorification. 

What  was  true  in  explanation  of  the  modus  operandi  of 
alcohol  in  the  body,  was  believed  also  to  afford  the  true  key  to 
the  effects  of  tea  and  coffee  upon  the  system.  No  one  could 
properly  claim  for  these  substances  that  they  ministered  directly 
to  tissue  repairs.    Each  was  thought  to  be  a  more  or  less 


542  Physiological  Dieielics, 

prompt  and  decided  member  of  the  calorifacient  class,  which  by 
combustion  was  decomposed  within  the  body,  and  found  exit 
therefrom  at  the  pulmonary  mucous  membrane,  in  the  form  of 
carbonic  acid  gas  and  watery  vapor.  Berzelius  and  MtLller 
deny  that  alcohol  ever  finds  its  way  as  such  into  the  urine. 

But,  in  its  turn,  this  view  also  is  exploded  by  the  researches 
of  more  recent  and  satisfactory  explorers.  Alcohol  and  its 
congeners  are  found  to  differ  from  all  the  proper  alimentary  sub- 
stances with  which  we  are  acquainted.  There  is  not  one  among 
the  real  alimentary  "principles**  which  we  have  enumerated 
that  escapes  the  system  unchanged,  excepting  these.  We  are 
of  course  speaking  of  a  healthy  state  of  the  organism.  Albu- 
men may,  indeed,  filter  away  through  the  tubular  septa  of  the 
kidneys  in  albuminuria ;  and  sugar  through  more  than  a  single 
emunctory  surface  in  diabetes,  but,  nevertheless,  the  rule  holds 
good  that  alcohol  is  the  only  substance  not  of  inorganic 
origin,  which  is  expelled  unchanged  from  the  system  by  means 
of  the  excretory  processes. 

Drs.  Ogston  and  Percy  have  demonstrated  beyond  a  doubt 
that  alcohol  is  neither  assimilated  nor  consumed  in  the  body. 
They  discovered  it  under  its  identical  form,  and  possessed  of  its 
identical  chemical  properties,  in  the  substance  especially  of  the 
brain  and  liver, — upon  which  it  fastens  by  a  powerful  "  elective 
affinity,*'  and  by  which  tissues  it  had  to  be  separated  from  the 
blood ;  and  also  that  after  it  is  taken,  the  various  emunctories 
are  continually  engaged  in  its  eUmination.  This  elimination 
was  found  to  be  a  progressive  one,  and  to  be  carried  on  more 
or  less  actively  through  the  three  great  excretory  surfaces ;  the 
pulmonary  mucous  membrane,  the  cutaneous  septum,  and  the 
kidneys,  and  to  continue  for  a  greater  or  less  duration  of  time, 
a  period  which  is  in  exact  ratio  with  the  quantity  of  alcohol 
which  has  been  administered.  Indeed  it  is  a  matter  of  every- 
day observation,  that  alcohol  in  any  of  its  combinations,  and 
all  of  the  anesthetics,  are  more  or  less  powerfully  diuretic. 

Still  later  experimenters,  among  whom  the  more  prominent 
are  Drs,  Bocker,  of  Germany,  and  Hammond  of  the  U.  States, 
have  shown  the  members  of  this  class  to  be  possessed  of  a 
peculiar  power  as  **  arresters  of  metamorphosis."    This  more 


hy  Dr.  Ludlam.  543 

recent  view  looks  toward  a  physiological  explanation  of  their 
sphere  of  action.  If  we  remember  that  waste  and  repair  is  the 
law  of  life  in  the  tissues ;  that  the  grade  of  each  of  the  animal 
structures  is  marked  by  its  yascularity ;  this  vascularity  being 
an  index  to  the  activity  of  its  physiological  metamorphosis,  the 
importance  of  determining  whether  or  not  this  order  of  indirect 
nutrients  are  of  service  in  the  regulation  and  control  of  such 
important  processes,  is  at  once  apparent.  More  than  this,  if 
the  opinions  of  Drs.  Bocker  and  Hammond  are  well  grounded — 
as  their  published  experiments  would  seem  to  prove — alcohol, 
tea,  coffee,  and  the  like,  are  to  be  classed  among  the  foods,  and 
not  among  the  medicines.  Hammond  proved  that  where  food 
was  sufficient,  alcohol  was  injurious;  but  that,  where  it  was 
deficient,  or  of  an  improper  quality,  it  might  arrest  or  retard 
the  too  rapid  waste  of  tissue  material.  A  labouring  man  who 
exceeds  the  strength  of  his  rations  in  his  outlay  of  physical 
force,  flies  to  one  or  another  of  these  substances,  thinking  them 
capable  of  supplying  any  deficiency  in  proper  alimentary 
materials.  He  knows  them  capable  of  aiding  him  in  his  ex- 
tremity, and  resorts  to  them  without  fear  of  ultimate  con- 
sequences. But  the  result  in  patching  out  his  available  force 
18  not  because  of  their  being  stimulantSy  in  the  old  sense  of  that 
term ;  not  because  they  are  calorifacient,  and  minister  to  his 
muscular  power  through  a  proper  regulation  of  the  bodily  tem- 
perature; but  for  the  simple  reason  that  they  turn  the  key 
upon  the  destructive  assimilation  of  the  tissues,  and  thus 
economize  the  nutritive  resources.  They  do  not  supply  a  direct 
nutriment,  for  as  we  have  seen,  they  are  eliminated  as  speedily 
as  possible,  unchanged  from  the  organism ;  are  not  heat-making; 
but  so  regulate  the  drain  through  the  various  emunctories  as 
indirectly  to  make  an  ounce  of  food  go  farther  than  otherwise  it 
would.  Moleschott  calls  alcohol  "  the  savings'  bank  of  the 
tissues."  It  is  certainly  as  proper  to  rank  it  as  food,  as  any 
substance  which  is  not  histogenetic,  as  for  example,  starch  and 
sugar. 

We  need  not  enlarge  upon  the  theme  of  eloquent  physiolo- 
gists, that,  not  only  every  species  of  bodily  exercise,  but  every 
thought,  and  every  effort,  or  emotion  of  the  mind,  involves  an 


514  PhyBiological  Dieietica, 

expense  to  the  textnral  economy,  which  must  be  met.  Alcohol, 
tea,  co£Pee  and  tobacco,  have  each  and  ail  a  calmative  influence, 
which  depends  upon  the  facility  with  which  they  arrest,  or  more 
properly  speaking,  retard  structural  metamorphosis,  and  so 
husband  the  nutritive  resources  of  the  organism.  Alcohol 
finds  its  way  most  rapidly  into  all  the  tissues,  and  the  same  is 
proved  to  be  true  of  coffee  when  given  as  an  antidote  to  most 
of  the  narcotic  poisons.  This  very  diffusibility  adds  to  thdr 
seductive  charm.  It  makes  them  the  more  dangerous  in  the 
bands  of  the  weak-minded  and  irresolute.  Our  men  of  business, 
whose  mental  friction  is  rasping  away  their  tissues  too  rapidly, 
and  threatening  a  worse  bankruptcy  than  that  which  they  hope 
to  avert  through  very  excess  of  toil ;  and  thousands  of  others, 
to  the  seamstress  who  has  grown  intemperate  upon  tea  and 
toast  as  her  sole  aliment,  are  driven  to  the  use  of  this  class  of 
substances  as  the  most  available  temporary  nutrients  at  com- 
mand.  And  in  this  we  have  the  key  to  their  physiological 
action,  the  only  simple  and  yet  satisfactory  method  of  explana- 
tion for  their  good  effects  in  conditions  of  the  system  in  which 
there  exists  a  want  of  balance  between  waste  and  repair,  where, 
BO  to  speak,  the  leakages  are  endangering  the  good  ship,  and 
the  indication  is  most  manifest.  There  fnay  be  conditions  of  the 
system  in  which  they  shall  act  both  in  a  nutritive  and  curative 
manner,  in  which  a  little  of  alcohol  or  of  tea  or  coffee,  appro- 
priately administered,  might  serve  to  save  life;  and  where 
stronger  food  on  the  one  hand,  or  medicine  alone  upon  the 
other,  or  both  these,  might  fail  of  any  good  result. 

The  following  practical  hints  and  inferences  are  deducible 
from  the  foregoing  views  upon  this  subject  :-^ 

1st.  We  should  study  the  subject  of  dietetics  from  a  physio- 
logical^  as  well  as  from  a  chemical,  stand-point. 

It  is  a  chief  fault  of  Liebig's  classification  of  food,  and  all 
modifications  of  it,  that  it  is  exclusively  chemical.  His  tables 
begin  and  end  in  the  laboratory,  as  if  life'  processes  and  pecu- 
liarities did  not  transcend  chemical  analysis.  It  is  true  that  we 
must  not  ignore  the  claims  of  the  latter,  for  it  is  an  eld  maxim, 
that  **  the  man  who  holds  the  ladder  at  the  bottom  is  frequently 
of  more  service  than  he  who  is  stationed  at  the  top  of  it."    It 


by  Dr.  Ludlam.  545 

18  simply  impossible  to  keep  life  within  the  orgauism^  unless  the 
conditions  of  its  stay  are  made  certain.  But»  in  its  broadest 
sense,  nutrition  does  not  concern  alone  the  mere  statics  of 
structure.  It  is  intimately  connected  with,  and  responsible  for, 
the  proper  play  and  performance  of  the  hodily  functions.  If, 
therefore,  we  would  study  the  relations  of  a  proper  aliment  to 
the  human  organism,  we  must  lay  a  rational  physiology,  as  well 
as  chemistry,  under  contribution,  toward  that  end. 

The  worthlessness  of  exclusively  chemical  diet-tahles,  de- 
signed for  particular  diseases,  is  shown  in  the  medical  history 
of  the  diabetes  mellitus,  the  more  modern  and  successful  phy- 
sicians having  discarded  them  in  toto. 

2nd.  It  is  not  desirable  to  be  super-scientific,  or  rather,  too 
exacting  of  nature,  insisting  that  she  shall  accept  and  appro- 
priate what  we  proffer  as  aliment,  and  be  satisfied  therewith. 

The  best  general  criterion  for  the  food  is  the  appetite,  pro- 
viding always  that  it  be  not  too  depraved  and  morbid.  The 
Btomach  is  the  indicator  for  the  system,  and  it  does  not  cry 
alone  for  the  supply  of  its  own  needs.  One  and  singular  of  all 
the  miniature  members  of  the  cell-republio  send  up  their  peti- 
tions through  it  The  appetite  is  really  in  the  several  tissues 
themselves.  The  organism  is  a  cell-republic,  the  stomach  its 
central  bureau  of  original  supplies,  the  blood  its  treasury.  An 
independent  existence — state  sovereignty,  if  you  please — ^would 
not  be  tolerated  in  our  natures,  any  more  than  in  our  nation ! 
If  it  were  carried  too  far,  sloughing  and  death  would  be  the 
inevitable  result. 

The  simple  lack  of  a  little  vegetable  acid  in  the  human 
system  once  kept  the  whole  of  the  ships,  the  hospitals  on  shore, 
and  dead-houses  everywhere,  full  of  the  victims  of  a  disease 
which  is  now  known  only  to  the  history  of  medicine — the 
scurvy.  When  my  patients  crave  acids,  I  allow  them,  but  in  a 
form  not  to  be  harmful.  Indigestible  cucumbers,  walnuts, 
cabbage,  etc.,  are  always  unwholesome,  and  should  be  forbidden, 
especially  since  it  is  possible  to  introduce  the  desired  acid  in 
some  other  way.  Oranges,  affording  a  mild  strength  of  citric 
acid,  are  often  grateful,  and  salutary  also.  I  am  much  in  the 
habit  of  prescribing  them  in  biliary  and  anginose  disorders,  and 

VOL.   XXI.,   NO.   LXXXH. — OCTOBER    1862.  2   M 


546  Physiological  Dietetics. 

have  cured  cases  of  aphthn,  and  of  stomatitis  materna  with  them 
aloDe.  The  most  aggravated  case  of  pyrosis  which  ever  fell 
under  my  observation  was  cured  by  eating  tart  apples,  and 
every  member  has  heard  of  diarrhoeas  and  dysenteries  being 
cured  by  buttermilk,  cider,  lemonade,  etc.,  etc. 

Mrs.  K was  dying  in   the   early  convalescence   firom 

typhoid  fever.  The  crisis  had  passed  a  few  days  previously,  and 
I  found  her  sinking  rapidly  from  a  mere  lack  of  vitality,  of 
available  strength  with  which  to  rally.  She  had  had  a  morbid 
desire  for  raw  oysters  and  vinegar-— something  which  she  never 
ate  while  in  health — ^but  these  had  'been  denied  her.  I  per- 
mitted them,  and  prescribed  nothing  else,  excepting  a  gradual 
change  to  a  more  nourishing  diet,  and  she  recovered  rapidly. 

J.  M.  W.,  Esq.,  had  been  forbidden  to  eat  baked  apples,  on 
account  of  a  recent  attack  of  autumnal  dysentery.  He  was  ex- 
tremely emaciated,  scarcely  able  to  crawl  around  the  house,  and 
had  desired  the  above  food  for  a  fortnight.  At  the  end  of  this 
period  he  despatched  the  family,  save  a  young  daughter,  by 
subterfuge  to  church  on  Sunday,  got  hold  and  ate  freely  from  a 
plate  of  apples,  and  convalesced  very  rapidly  without  any  ill 
results. 

Such  cases  are  familiar  in  every  one's  experience,  but  do  we 
learn  the  practical  lesson  taught  by  them  ?  One  s  obliquity  of 
vision  should  not  lead  him  astray.  We  must  sail  the  ship  to, 
or  alongside  of  nature,  and  we  shall  not  go  very  far  in  the 
wrong.  We  might  with  as  much  propriety  deny  our  patients 
sleep,  as  deny  them  food.  A  patient's  eyes  may  be  "  larger 
than  his  stomach,"  but  the  true  physician  has  the  tact  to  dis- 
cern the  disparity.  It  is  useless  to  speculate  upon  the  value  of 
this  or  that  regimen,  or  of  this  or  that  chemical  rationale. 
We  must  bring  the  abstract  and  the  actual  together,  and  then 
we  shall  discover  that,  in  the  matter  of  dietetics,  as  well  as  of 
distinguishing  between  food  and  medicines,  homcBopathy  and 
common  sense  are  not  so  incompatible  after  all.  We  should 
carry  out  the  principles  of  the  golden  rule,  and  not  set  reason 
and  revelation  at  defiance  by  our  too  rigid  diet  tables  for  health 
or  disease. 

3rd.  Medicines  deal  primarily  with  forces  and  secondly  with 


Psychological  Physiology,  547 

forms ;  food  primarily  with  forms  and  secondly  with  forces : 
only  remember  this  one,  well-defined  line  of  separation,  and 
you  need  never  confound  their  spheres  of  action,  or  fail  of  the 
best  and  most  appropriate  results  in  their  employment. 


PSYCHOLOGICAL  PHYSIOLOGY. 
By  Dr.  MacGilchrist. 

Perhaps  no  class  of  intellectnal  men  has  received  greater 
homage  than  the  metaphysicians,  and  perhaps  none  has  less 
merited  the  commendation  bestowed  so  freely  and  so  generally. 
The  world,  in  the  past  at  least,  has  taken  the  metaphysicians 
on  their  own  showing  and  at  their  own  value,  as  it  has  often 
done  the  respectably  pretentions,  and  has  dignified  with  the 
name  of  subtle  analysis  that  which  is  simply  unintelligibility, 
and  called  profound  what  is  weak,  vain  and  preposterous.  An 
inability  to  distinguish  between  words  and  ideas  has  always  been 
at  onoe  the  vice  and  the  salvation  of  metaphysics.  This  in- 
ability on  the  part  of  the  greater  number  of  mankind  has 
indeed  been  the  salvation  of  metaphysics,  which  could  never 
otherwise  have  attained  the  reputation  of  a  science  of  ideas^ 
since  it  is,  in  truth,  little  better  than  a  science  of  words.  It 
now  begins  to  be  very  generally  suspected  by  the  world  of 
letters,  that  this  subtle  but  yet  noisy  dog  has  had  his  day ;  and 
there  are  symptoms  very  plainly  discernible  of  a  general  ten- 
dency to  abandon  the  barren  field  of  metaphysics,  in  favor 
of  another  branch  of  philosophy,  which  till  very  lately  has  been 
a  twin  of  the  mist,  but  which  promises,  even  in  Germany,  the 
home  of  speculation  by  excellence,  to  supersede  this  hag-ridden 
philosophy  called  the  metaphysical.    We  allade  to  psychology. 

As  distinguished  from  metaphysics,  which  is  the  science  of 
ahsiraci  speculaiion,  psychology,  as  most  people  know,  is 
definable  as  *'  the  science  of  the  human  mind."  To  those  who, 
in  these  practical  and  earnest  days,  are  not  mis-spending  their 
time  in  vain  efforts  to  square  a  circle,  but  rather  devoting 
themselves  to  the  true,  t.^.,  the  physical  sciences,  the  use  of 
the  word  science  in  the  psychological  no  less  than  in  the  meta- 
physical connection,  must  seem  somewhat  out  of  place ;  and  it 

2  M  2 


548  Psychological  Physiology^ 

most  be  owned  that  to  talk  of  a  science  of  Bpecnlatibn,  es- 
pecially, involves  a  contradiction  in  terms.  As  regards,  psy- 
chology, however,  there  seems  ground  for  hope  that,  specnlative 
as  it  has  hitherto  been,  this  phase  of  philosophy  has  more  to 
recommend  it  than  mere  interest  in  dialectics.  It  is  a  good 
sign  of  her  that  she  has  quarrelled  with  her  so-called  sister 
science — she  of  the  pure  speculation,  metaphysics — and  a  still 
better  sign,  that  she  shews  a  leaning  towards  that  side  of  the 
problem  she  professes  to  solve  which  was  wont  to  be  sneered  at, 
and  is  still  sneered  at  by  the  metaphysicians,  as  the  material 
side :  in  a  word,  that  she  wooes  the  advances  of  physiology. 

It  is  the  object  of  this  paper  to  shew- part,  at  least,  of  what 
has  been  doing  of  late,  both  by  the  professed  psychologists  and 
by  the  physiologists,  in  a  common  direction  towards  the  in- 
auguration, if  not  the  consolidation,  of  an  alliance  between  the 
philosophy  of  mind  and  the  first  of  the  organic  sciences — ^phy- 
siology.  In  doing  this,  we  have  properly  to  concern  ourselves 
only  with  psychology  on  the  one  hand,  in  certain  of  its  aspects, 
and  with  physiology  on  the  other;  but  inasmuch  as  speculative 
science  proper,  or  metaphysics,  denounces  as  vain  all  attempts 
at  reconciliation  of  mental  and  physical  manifestations,  of  the 
kind  at  least  we  are  about  to  pass  under  review,  we  may  glance 
first  at  the  present  position  and  past  history  of  this  purely 
speculative  philosophy  which  essays  to  stop  the  way.  Here, 
however,  we  shall  court  brevity  to  the  utmost 

We  may  just  begin  by  quoting  from  a  recent  and  a  student 
or  standard  work  on  metaphysics,  an  utterance  which  suflBciently 
indicates  the  pretensions  in  which  that  so-called  science  still 
revels,  and  the  unblushing  effrontery  with  which  it  seeks  to 
make  a  virtue  of  parading  its  own  nakedness,  whilst  ignoring 
every  other  phase  of  philosophy: — ^''It  will  be  observed  that 
this  system  (metaphysical)  is  antagonistic,  not  only  to  natural 
thinking,  but,  moreover,  to  many  a  point  of  psychological 
doctrine.  Psychology,  or  '  the  science  of  the  human  mind,* 
instead  of  attempting  to  correct,  does  all  in  her  power  to 
ratify  the  inadvertent  deliverances  of  ordinary  thought,  to 
prove  them  to  be  right.  Hence  psychology  must,  of  necessity, 
come  in  for  a  share  of  the  castigation  which  is  directed  upon 


hy  Dr.  MacGilchritt,  549 

common  and  natural  opinion.  It  woald  be  well  if  this  could  be 
BTuided;  but  it  cannot.  Philosophy  (metaphysical)  must 
either  for^o  her  existence,  or  carry  on  her  operations  corrective 
of  ordinary  thinking,  and  subversive  of  psychological  science. 

To  prevent^  then,  any  mistake  as  to  the  object^  or 

fmrposej  or  business  of  philosophy  [metaphysical  always,  ob- 
serve], let  it  be  again  distinctly  announced  that  the  object  of 
philosophy  is  the  correction  of  the  inadvertencies  of  ordinary 
thinking;  and  as  these  inadvertencies  are  generally  confirmed, 
and  never  corrected,  by  psychology,  it  is  further  the  business  of 
philosophy  to  refute  psychology.  This  is  what  philosophy  (or 
metaphysics)  has  to  do.  But  this  is  only  the  negative  part  of 
philosophy.  In  rectifying  the  inadvertencies  of  popular  thought, 
and  in  subverting  their  abetment  by  psychology,  philosophy 
most  of  course  substitute  something  in  their  place.  Yes ;  and 
that  something  is  truth — so  that  the  object,  the  business,  the 
design,  the  purpose  of  philosophy,  fully  stated,  is  this,  which 
may  be  laid  down  as  the  definition  of  metaphysics :  '  Meta- 
physics is  the  substitution  of  true  ideas — that  is,  of  necessary 
truths  of  reason — in  the  place  of  the  oversights  of  popular 
opinion  and  the  errors  of  psychological  science.'  That  seems  a 
plain  enough  statement,  and  it  may  serve  as  an  answer  to  a 
question  by  which  many  people  have  professed  themselves 
puzzled, — what  are  metaphysics?  ....  This  definition  may 
serve  to  let  people  know  precisely  what  philosophy  or  meta- 
physics proposes, — what  the  instigating  motives  of  speculative 
inquiry  are ;  and  it  may  also  serve  to  clear  people's  heads  of  the 
confusing  notion  that  metaphysics  is,  in  some  way  or  other, 
vaguely  convertible  with  what  is  called  '  the  science  of  the 
human  mind,'  and  has  got  for  its  object — ^nobody  knows  what— 
some  hopeless  inquiry  about  'faculties,'  and  all  that  sort  of 
rubbish.  This  must  all  come  down,  when  philosophy,  which  has 
hitherto  been  going  about  like  an  operative  out  of  employment, 
seeking  work  and  finding  none,  is  put  in  a  fair  way  of  obtaining 
a  livelihood  by  having  discovered  her  proper  vocation,  and  got 
something  definite  to  do."* 

*  Institutes  of  Metaphysic,  by  Professor  Ferrier.  2nd  edition,  Introduction, 


550  Puycholoffical  Physiology^ 

After  a  staid  perasal  of  this  modest  utteranoe,  wberein  its 
expounder  ignores  OTory  other  phase  of  philosophy,  and  assames 
for  his  so-called  science  a  monopoly  of  the  "  something"  termed 
emphatically  *'  truth/'  it  need  not  surprise  us  that,  metaphysics 
being  avowedly  "  antagonistic  to  natural  thinking,"  a  great  many 
otherwise  intelligent  people  should  still  go  about  aakiDg  what 
the  dickens  they  (the  metaphysics)  are  all  about;  or  that 
natural  thinking  should  still  prefer  to  Professor  Ferrier's  de- 
finition an  older,  a  wittier,  and  we  much  fear  a  truer  one, 
which  endorses  metaphysics  as  I'art  de  segarer  avee  methode. 
Notwithstanding  the  vast  libraries  that  have  been  filled  with 
works  on  metaphysical  philosophy,  many  of  them  ingenious 
and  subtle  to  the  verge  of  phantasy,  there  is  only  one  question 
of  all  their  elaborate  speculations — there  is  but  one  deserving 
the  serious  attention  of  mankind.  It  is  the  question  as  to  the 
origin  of  our  ideas.  Most  metaphysicians  have  given  this 
question  the  go-by,  asBuming  —  what  it  is  indeed  almost 
necessary  to  their  speculations  to  assume — the  still  unproved, 
and,  as  many  think,  the  unprovable  doctrine  of  innate  ideas ; 
and  very  few  have  had  the  candour  or  the  courage  to  acknow- 
ledge the  fundamental  importance  to  speculative  philosophy  of 
this  question,  which  is  still  at  issue,  although  the  tendencies  of 
physical  science  are  certainly  opposed  to  this  metaphysical 
notion  of  innate  ideas  which  has  been  such  a  god-send  to  the 
philosophic  system -mongers.  It  is  not  strange,  indeed,  that 
the  schools  of  abstract  philosophy  should  have  assumed  this 
question  for  the  most  part,  since  how  else  could  they  have  lived 
on  flourishingly  through  the  centuries  of  interminable  talk  ?  And 
when  the  question  has  been  fairly  analysed  as  the  foundation  of 
a  philosophy  of  consciousness,  the  intuitive  philosophers  have 
generally  resented  it  as  on  affront  to  them  and  their  craft.  No 
modern  thinker,  for  example,  has  been  more  maligned,  and 
robbed  of  what  philosophic  originality  he  had  the  courage  to 
utter  forth,  than  John  Locke.  Locke  had  the  misfortune  (in 
view  of  his  reputation  as  a  thinker)  to  have  meddled  with  posi- 
tive science  before  he  became  a  mental  philosopher :  he  was  a 
physician,  and  practised  our  arduous  profession,  for  some  years 
at  least,  at  Oxford.     What  sort  of  reproach  this  was  to  him 


hy  Dr,  MacGihhrist.  551 

iLinong  the  metaphysioiaas  whom  he  shouldered,  is  to  be 
measured  by  the  difference,  in  a  really  scientific  point  of  view^ 
between  his  times  and  ours.  Then  positive  science  was  at  a 
discount,  and  no  attainments  were  held  admirable  or  valuable 
which  were  not  either  classical  or  metaphysical.  Locke,  ac- 
cordingly, was  written  down  by  his  contemporaries,  and  his 
doctrine  has  been  mis-stated  by  the  metaphysicians  generally. 
He  has  been  called  a  mere  popularizer  of  Hobbes,  and  charged 
with  reducing  all  knowledge  to  sensation,  because  he  held,  as 
Aristotle  enunciated  more  than  2,000  years  before,  that  "  no- 
thing enters  the  mind  of  man  but  through  the  medium  of  his 
senses." 

But  though  he  raised  no  new  question  in  inquiring  anew  into 
the  origin  of  our  ideas,  Locke  was  certainly  the  first  modem 
thinker  who  showed  conclusively  that  the  fabric  of  scholastic 
philosophy  was  based  on  an  assumption,  that  assumption  being 
the  received  doctrine  of  innate  ideas,  and  who  logically  insisted 
on  the  necessity  of  trying  that  question  first,  before,  thac  is  to 
say,  the  airy  systems  of  the  intuitive  philosophers  could  come 
into  court  or  deserve  a  thought.  This  was  his  crime,  for  which 
your  pure  speculators  can  never  forgive  him.  But  in  further 
deciding  against  the  doctrine  of  innate  ideas,  Locke  did  not 
hold,  as  they  have  represented,  with  Hobbes — whose  dictum 
was,  nihil  est  in  intellectu  quod  non  prius  fuerit  in  sensu — 
that  sensation  is  the  only  source  of  our  knowledge ;  but  only 
that  sensation  is  the  primary  or  immediate,  there  being  another, 
a  secondary  or  mediate  source,  viz.,  reflection.  Popularly 
stated,  Locke's  doQtrine  is,  that  the  mind  does  always  found  its 
ideas  on  some  sensible  object,  either  immediately  or  via  sensa- 
tion— as  a  man,  a  tree,  &c., — or  mediately,  via  reflection,  and 
in  the  last  analysis  of  its  own  workings — as  when  it  forms  the 
ideas  it  has  of  virtue,  vice,  futurity,  and  the  like.  And  the 
general  inference  of  this  doctrine  is,  that  those  so-called  ideas, 
no  less  than  the  words  in  which  they  may  be  clothed,  which  are 
not  referrible,  either  mediately  or  immediately,  to  sensible 
objects,  are  devoid  of  sense  and  meaning.  It  is  manifest  that 
tested  by  such  a  doctrine  as  this — assuming  it  to  be  founded  in 
fact — metaphysics,  as  a  whole,  are  little  better  than  a  curious 


552  Psychological  Phynologyy 

pile  of  Q8eld88  speculatioiis — ^ideas  without  a  foandalioo,  and 
words  devoid  of  meaniDg. 

Thas  much  of  Locke,  who  of  all  the  metaphTsiciaos  of 
fnodern  times  stands  out  foremost  in  the  influence  his  system 
has  exerted,  and  despite  the  carpings  of  his  critics  is  yet  destined 
to  exert,  on  philosophy.  By  sapping  the  assumption  on  which 
the  great  mass  of  metaphysical  speculadons  are  based,  be  in  a 
manner  overthrew  metaphysics,  and  erected  in  its  place  a 
psychology,  and  paved  the  way  for  that  reconoiliatioD  which, 
as  we  shall  shew,  is  now  in  course  of  being  eflFected  between 
the  phenomena  called  mental  and  those  termed  functional  or 
organic.  More  clearly  stated  in  some  parts,  or  rather  we  should 
say,  expressed  in  more  modem  language,  aud  certain  of  its 
weaker  points  eliminated  (such  as  some  of  his  notions  on  ab- 
stract ideas,  and  on  the  subject  of  impulse),  Locke's  views 
present  a  near  approach  to  that  "  common  sense  **  philosophy 
which  the  Scotch  school  of  metaphysicians  would  fain  have 
arrogated  to  themselves.* 

Passing  over  the  several  metaphysical  thinkers  who,  between 

*  In  an  article  in  JiacmtUan'a  Magaasme  for  July  of  this  year,  entitled 
*'  The  Beal  World  of  Berkeley,''  Professor  Eraser,  of  Edinbnrgli,  classes 
Locke  with  *' Berkeley  and  the  philosophers"  (meaning,  we  take  it,  the 
idealistic  metaphysidans),  on  the  groond,  apparentiy,  that  **  Locke  took  for 
granted  that  what  we  are  consdons  of  in  sense  is  not  at  all  the  real  thing, 
and  that  we  could  be  conscious  in  sense  of  an  idea  or  resemblance  only  of  tiie 
real  thing,  which  itself  exists  behind  its  merely  ideal  representation  in  the 
consciousness." 

Now,  although  Locke's  principles  certainly  inTolred  the'  suhjeetivity  of  aU 
our  knowledge,  the  disting^hing  characteristic  of  his  philosc^by  of  ideas  is, 
tiiat  all  our  knowledge  is  referrible  to  experience.  Hence  he  took  for  granted 
—he  held  and  could  not  bat  hold— that  there  was  an  objectiye  as  well  as  a 
subjective  fact  in  the  consciousness.  This  is  what  separates  him  by  a  great 
gulf  from  Berkeley  and  the  idealistic  philosophers,  who  held  that  the  sob- 
jective  &ct  is  the  whole.  Their  condusionB,  accordingly,  are  not  merely 
different  but  exactiy  opposite.  For  Berkeley  shewed  (as  he  belieyed)  that  we 
have  no  experience  of  an  external  world  apart  from  perception,  therefore — the 
conclusion  is  inevitable — matter  is  a  figment;  a  conclusion  It  ftirly  pusded 
the  other  philosophers  to  overthrow,  till  Hume  gave  it  the  reducUo  ad  alh- 
surdum,  by  showing,  in  bis  turn,  not  only  that  matter  is  a  figment,  but 
proving  incontrovertibly  that,  by  the  same  token,  mind  is  a  figment  too. 
'  Bach  are  the  triumphant  results,  how  important  to  humanity  I  at- which  the 
idealistic  philosophers— in  whose  company  Professor  Fraser  incontinentiy 


iy  Dr.  MacOilchrist,  658 

Locke  and  Eant,  have  given  their  names  to  systems*  more  or 
less  famous  and  more  or  less  evanescent,  we  come  to  the  great 
German  philosopher,  on  whom  we  must  expend  a  few  brief 
sentences,  as  he  is  the  most  noticeable,  in  his  later  era,  in 
relation  to  the  fundamental  question  which  Locke  so  pitilessly 
thrust  in  the  teeth  of  hungry  speculation. 

It  might  be  almost  sufficient  to  say,  that  during  the  century 
which  separated  these  two  philosophers,  no  progress  was  made — 
none  whatever — towards  proving  the  assumption  on  which 
metaphysics  rested;  and  that  metaphysics  still  does  virtually 
rest  on  the  selfsame  assumption.  But  as  the  ground  has  been 
slightly  shifted,  we  must  advance  proof  of  the  last  part  of  this 
assertion  at  least. 

The  pretensions  set  up,  by  certain  of  his  verbose  disciples, 
for  Kant  and  his  philosophy  are  great :  these  enthusiasts  speak 
of  the  man  as  having  "  the  highest  and  strongest  claims  to  the 
gratitude  of  mankind;"  but  for  what  does  not  very  clearly 
appear,  since  they  have  freely  accused  one  another  of  a  remark- 
able incapacity  to  fathom  or  comprehend  his  system,  and  an 
obscure  oracle  has  surely  not  the  very  highest  claims  on  the 
gratitude  of  the  perplexed  inquirer.  Kant  called  his  system 
crilieal;  and  if  we  allow  that  he  analysed  the  operations  of 
the  mind  ingeniously,  and  deduced  from  them  certain  principles 
of  certitude,  which,  however,  he  himself  admitted  could  not  be 
applied  to  things  beyond  what  he  held  to  be  the  mind — were  in 
fact  limited  to  its  ideas — we  give  him  his  due,  and  probably 
allow  all  that  he  claimed  for  himself  as  a  psychologistf  But 
it  is  on  another  head  that  his  followers  are  chiefly  jubilant. 
They  imagine,  many  or  most  of  them,  that  he  has  laid  the 
ghost  of  Locke,  and  settled  that  little  matter  about  the  origin 
of  our  ideas  conclusively. 

finds  Locke — Rach  the  edifying  conclusions  to  which  those  ingenious  gen- 
tlemen come  at  last  I 

**  The  chief  of  these,  after  Leibnitz,  are  Berkeley  and  Hnme,  and  their 
reactionary  counter-parts,  the  heads  of  the  Scotch,  or  **  common  sense " 
school  of  philosophy,  as  it  was  self-styled. 

t  Although  he  compared  himself  as  a  philosophical  reformer  to  Gopemious ! 


554  Pnychological  fhytiology^ 

Stripped  of  its  surroundings,  the  doctrine  of  Kant  here  is 
plain  enough.  He  adopts  innate  ideas,  but  not  in  all  their 
nakedness,  nor  without  advancing  something  in  plausible  illus- 
tration or  proof.  By  a  change  of  language,  by  substituting 
especially  the  term  necessary  truth  for  innate  idea,  he  seeks  to 
wrap  the  latter  in  fresh  coverings,  as  't  were ;  and  his  followers 
have  hugged  the  delusion  that  these  may  not  be  readily  torn 
off,  which,  however,  we  believe  they  have  been  most  effectually. 

The  vital  part  of  his  system,  then,  is  that  which  claims  for 
the  ideas  of  primary  intuition  necessary  truth,  and  thus  makes 
knowledge,  so  far,  independent  of  experience.  Whence  Kants 
so-called  law,  which  his  followers  have  compared  to  an  axiom 
of  Euclid,  and  regarded  as  the  crucial  test  by  which  all 
mental  operations  must  be  tried : — '*  What  truth  soever  is 
necessary  and  of  universal  extent  is  derived  to  the  mind  from 
its  own  operatiofis,  and  does  not  rest  on  observation  and  ex- 
ferience;  as  conversely  what  truth  or  perception  soever  is 
present  to  the  mind,  with  a  consciousness  not  of  its  necessity 
but  of  its  contingency,  is  ascribable  not  to  the  agency  of  the 
mind  itself,  but  derives  its  origin  from  observation  and  ex- 
perience." It  will  bo  seen  that  the  first  part  of  this  proposition, 
which  we  have  italicised,  contains  the  point  in  dispute^  the 
thing  to  be  proved.  Kant  attempted  to  prove  it,  as  we  venture 
to  think,  by  a  kind  of  reasoning  which  is  circular.  Without 
staying  to  show  this  specially — he  advanced,  that  the  mind 
forms  synthetic  no  less  than  analytic  judgments,  and  that  one 
class  of  its  synthetic  judgments  is  based  on  a  priori  ideas. 
This  is  just  another  way  of  saying  that  there  are  certain 
**  necessary  truths,"  or  inherent,  or  primitive,  or  "  innate  *' 
ideas,  which  are,  of  course,  independent  of  experience.  Well, 
the  truths  or  axioms  of  geometry,  the  relations  of  number  and 
mathematics,  are  pointed  to  as  one  class  of  these  necessary 
truths  or  "synthetic  judgments  a  priori;"  and  what  he 
termed  "  truths  of  generalization  " — such  axiomatic  dicta,  for  in- 
stance, as  *'  every  cause  must  have  an  effect" — as  the  other  class. 

Now,  taking  the  latter  first,  this  class  of  so-called  a  priori 
ideas  has  over  and  pver  again,  and  from  different  points  of  view, 


by  Dr,  MacGikhrist.  565 

been  shewn  to  be  resolTable  nebula.  The  word  effect  implies 
as  a  correlative  the  word  caase ;  but  the  thing  we  see  before  us 
does  not  imply  the  existence  of  some  other  thing  which  caused 
it:  and  our  judgment  that  it  must  have  had  an  antecedent 
cause  is  therefore  purely  synthetic  and  beyond  the  region  of 
experience.  So  say  the  Eantists.  But  when  we  ask  them.  If 
every  existence  must  have  had  a  cause,  how  can  the  mind 
arrive  (by  the  road  of  causation)  at  a  Jlrst  cause  ? — they  can 
give  no  intelligible  reply ;  and  the  attempt  to  arrive,  by  this 
road,  at  proof  of  the  necessary  existence  of  Deity  has  in  the 
hands  of  certain  of  Kant's  followers  tended,  it  may  well  be,  to 
suggest  atheism  where  it  had  no  previous  place  in  the  mind. 
In  fact,  the  necessary  truth  of  causation  is  not  inherent  in  the 
mind.  There  is  indeed  a  necessity  of  belief  in  causation ;  but 
why  ?  Simply  because  this  belief  is  founded  in  experience ;  it 
is  nothing  more  than  our  experience  generalized ;  and  as  has 
been  well  said,  and  amply  demonstrated — though  to  enter  into 
special  proof  of  it  would  lead  us  too  long  a  dance  here—"  to 
assume  that  any  such  universal  idea  is  independent  of  ex- 
perience, is  to  forget  that  what  experience  may  not  guarantee 
it  may  suggest ;  and  the  boasted  universality  and  necessity  of 
our  ideas  is  nothing  more  nor  less  than  the  suggestions  of  the 
understanding,  operating  in  obedience  to  a  law  of  human 
nature,  and  generalizing  from  particulars,  converting  them  into 
universals." 

But  neither  do  the  relations  of  number  and  the  truths  of 
geometry  respond  to  Kant's  synthetic  judgments  a  priori^ 
Three  and  two  make  five  ;  we  cannot  conceive  it  to  be  other- 
wise; therefore  this  is  a  necessary  truth.  It  is  so,  but  not  an 
d^  priori  truth,  not  an  innate  conviction,  since  we  have  been 
taught  the  relations  of  number,  which  prove  to  us  objectively 
as  well  as  subjectively  that  such  is  the  fact.*     As  little  as  the 

*  Thoagh  from  its  simplicity  (says  Lewes)  the  caloalation  of  three  added 
to  two  is  with  a  gprown  man  an  instantaneoas  act,  yet  if  yon  ask  him  suddenly 
liow  many  are  twice  365,  he  cannot  answer  till  he  has  reckoned.  He  may 
dedare  *Mt  is  a  necessary  truth  that  865  added  to  865  make  730,  and  we 
should  not  dispute  the  necessity  of  the  truth,  but  presimie  that  he  himself 
would  not  dispute  that  he  had  arrived  at  it  through  experience,  viz.,  through 


058  Psychological  Physiology, 

neoeesary  truths  of  number,  are  the  neceasary  truths  of  geo- 
metry d  priori.  **  The  points,  lines,  circles  and  squares/'  says 
John  Stuart  Mill,  System  of  Logic,  Vol.  I.,  "  which  any  one 
has  in  his  mind,  are  simple  copies  of  the  points,  lines,  circles 
and  squares  he  has  known  in  his  experience.  Our  idea  of  a 
point  I  apprehend  to  be  our  idea  of  the  smallest  portion  of 
space  we  can  see.  We  cannot  conceive  a  line  without  breadUi ; 
we  can  form  no  mental  picture  of  such  a  line :  all  the  lines  we 
have  in  our  minds  are  lines  possessing  breadth."  Thus,  as 
some  of  the  acutest  thinkers  of  modem  times  are  constrained 
to  admit,  the  most  abstract  science — geometry,  which  may  be 
held  to  be  the  parent  of  all  speculation — ^is  not  a  priori,  and 
not  one  of  its  axioms  can  be  shown  to  embody  a  necessary 
truth  which  is  out  and  out  independent  of  experience.  If  so, 
the  last  stronghold  of  metaphysical  philosophy  is  demonstrably 
untenable,  and  Kant  and  his  refiners,*  like  all  their  predecessors, 
haye  proved  unequal  to  the  task  of  confuting  Locke. 

Thus — though  perhaps  we  owe  the  reader  an  apology  for 
having  detained  him  so  long,  if  detained  him  we  have,  over  this 
first  part  of  our  paper — thus,  by  pinning  it  down  to  its  first 
principle  of  inquiry,  by  arresting  metaphysics,  as  Locke  did,  at 
the  threshold  of  the  one  question  which  must  first  be  answered, 
and  which  has  never  yet  been,  and  we  iuQline  to  think  will 


his  knowledge  of  the  relationB  of  nnmben,  a  knowledge  which  he  rememben 
to  hare  lahorionaly  acquired  when  a  hoy  at  school." 

*  It  is  onrioiiSi  though  veiy  ftr  from  instroctiTe,  to  observe  how  eiiticaU j 
some  of  the  lesser  fry  among  the  mental  specolatois  have  dealt  with  tho 
system  of  the  gpreat  German— each  according  to  his  own  pet  idea  or  crotchet. 
Professor  Fernery  of  St.  Andrew's,  has  written  an  ingeniously  useless  book 
[InstiJMn  of  Mekifhyti^  already  noticed],  whereof  the  pet  idea  or  crotchet  is, 
that  **  the  Jaw  cf  eowhradiotion,"  and  not  Kant's  law,  is  the  one  test  essential 
for  the  verification  of  all  mental  operations.  In  his  eagerness  to  crown  liis 
own  system,  this  modest  philosopher  gives  the  master  the  lie  direct.  "  The 
fact  is  (says  he),  that  all  propositions  expressing  necessary  or  ft  priori  truths — 
[monstrously  assuming  that  necessary  truths  are  necessarily  ft  priori} — are 
analytic  or  resolvent."  According  to  Fenrier  there  are  no  synthetic  judg- 
ments ft  priori,  Kant  is  all  in  the  wrong,  and  the  hero  of  "  oontradictian," 
Ferrier,  your  only  Simon  Pure  among  the  intuitive  philosophers.  In  a  note  to 
a  former  paper  (on  the  Correlations  of  Science,  FhUoeqphy  and  Medicine)  we 
noticed  another  of  this  hero's  Kant  contradictions. 


by  Dr,  MacGilchrist,  667 

nerer  be  answered  (metaphysioally),  we  have  compressed  into 
tlie  foregoing  few  pages  a  century,  or  for  the  matter  of  that 
two  centuries,  of  ingenious  babblement.  For  we  yenture  to 
assert  with  Locke  and  the  many  thinkers,  his  disciples,  who 
liave  seen  nothing  since  in  metaphysics  beyond  this  question, 
\mt  windy  contentions  about  nothing  and  the  pompous  pursuit 
of  shadows,  that  until  the  doctrine  of  innate  ideas  shall  have 
been  established,  not  speculatively,  approximately,  or  problema- 
tically, but  demonstrably — ^so  that  the  proof  of  it  shall  ne- 
cessarily rest  on  a  higher  plane  than  does  any  axiom  of  geometry 
or  necessary  truth  of  arithmetic — ^not  till  then  shall  the  so-called 
science  of  metaphysics  rivet  the  serious  attention  of  mankind* 
It  shall  continue  to  hide  itself  in  universities  and  among  priggish 
pedants — ^languishingly,  as  it  confesses  in  these  latter  days — 
eventually  to  die  the  death  of  the  charlatan  in  the  dim  and 
dusty  obscurity  of  its  remote  attic. 

If  there  be  any  measure  of  truth  in  such  representations, 
which  are  those  of  some  of  the  first  thinkers  (a  minority  among 
''  the  philosophers "  certainly)  of  this  and  other  ages,  then  it 
seems  clear  that  metaphysics  are  not  merely  useless  as  a  whole, 
but  antagonistic  to  positive  or  physical  science — a  something 
to  be  swept  out  of  the  way  as  obstructive  to  the  onward  march 
of  knowledge. 

Is  it  so  with  psychology  also  ?  is  it,  too,  the  pursuit  of 
shadows  and  obstructive  in  its  tendency  ?  From  the  fact  that 
(academically  speaking  at  least)  metaphysics  and  psychology 
merge  into  each  other,  and  are  in  a  great  measure  inseparable,* 
we  may  conclude  that  if  the  pursuit  of  the  one  be  vain,  that  of 
the  other  is  likely  to  be  so  too.  And,  accordingly,  in  times 
past  it  has  been  so ;  hitherto  psychology  seems  to  have  had  for 
its  object  (to  requote  the  redoubtable  Ferrier)  "  some  hopeless 
inquiry  about '  faculties,'  and  all  that  sort  of  rubbish."  It  does 
not  follow,  however,  that  it  must  always  be  so.  As  already 
hinted,  it  is  a  good  sign  of  psychology  that,  in  one  or  more 

*  Hence  the  absnrdity  of  Profesisor  Fenrier's  daim  for  metaphysics— that  it 
does,  or  can,  ignore  psychology.  Why,  great  part,  indeed  the  greatest  part, 
of  all  the  specnlative  systems,  including  those,  of  Locke  and  Kant,  has  heen 
pejrchological. 


058  PsychologiciU  Phy^iology^ 

qnartera,  she  bas  quarrelled  with  metaphysics,  and  expressed  a 
determination  to  set  up  for  herself.  How  and  where«  chiefly, 
■he  has  done  this,  we  must  now  briefly  indicate. 

After  Elant  oame  Fichte — let  not  the  indulgent  reader  take 
unnecessary  alarm  and  turn  from  us  in  despair :  'pon  honour, 
we  are  not  going  into  Fichte  metaphysically.  But  Fichte — 
the  great  Jobann  Gottlieb  Fichte — ^had  a  son,  who  still  lives, 
we  suppose,  though  he  must  necessarily  be  an  old  man  now, 
and  this  son  has  done  somethiug,  or  said  it,  that  would  have 
made  his  anxious  parent  stare.  In  his  old  age  he  has  published 
a  little  book,  wliioh  he  calls  a  "  confession/'  and  wherein  he 
virtually  acknowledges  the  vanity  of  some  of  his  own  (for, 
earlier,  he  wrote  several  big  and  elaborate  philosophical  treatises, 
including  a  Critical  History  of  Ethical  Philosophy,  none  of 
which,  so  far  as  we  know,  have  been  yet  done  into  English) 
and  his  eminent  father's  speculations,  as  well  as  that  of  the 
method  of  the  schools ;  and,  in  a  word,  gives  up  metaphysics  as 
effete,  proposing  to  substitute  a  psychology  which,  instead  of 
ignoring,  shall  distinctly  recognise  positive  science.  This  little 
work  has  been  translated  by  Morell,  from  whose  preface  we 
give  the  following  extracts  as  explanatory  of  the  scope  and 
spirit  of  the  '*  Philonophische  confession" 

"The  philosophic  tendencies  (of  Fichte  the  younger  — 
Immanuel  Hermann)  are  contained  in  a  series  of  works  on 
speculative  theology,  ethics  and  psychology,  which  have  ap- 
peared at  pretty  regular  intervals  since  1847.  I  need  only  say, 
at  present,  that  in  these  works  he  has  completely  broken  with 
the  abstract  d  priori  tendencies  which  for  a  long  time  had 
ruled  the  mind  of  his  country ;  and  that  he  has  shown  the 
nonentity  of  all  science  which  is  not  based  upcm  facts  that 
appeal  directly  to  human  experience  ....  In  the  works  of 
Fichte  we  have  embodied  well  nigh  the  whole  course  of  Oerman 
speculation^  from  its  first  rise  and  dissemination  to  its  present 
results.  We  see  a  mind  nursed  up  from  infancy  in  the  atmos- 
phere of  abstract  investigations,  passing  through  all  the  logical 
processes  which  the  acutest  analysts  and  system-makers  could 
supply,  emerging  at  last  into  the  world  of  experience,  as  that 
alone  on  which  the  lever  of  science  can  be  placed  so  as  to 


by  Dr,  MacOilchrist,  559 

produce  any  abiding  effect  Metaphysics  we  see  (through  his 
experience)  must  return  after  all  to  the  form  of  psychology ; 
and  psychology  must  link  itself  to  the  rest  of  the  natural  sci* 
ences.  Borrowing  from  them  all  the  light  they  can  supply,  it 
may  at  last  avail  to  carry  us  a  little  further  into  the  secret 

workings  of  human  nature  and  the  human  soul Fichte 

is  the  uncompromising  opponent  of  mere  materialism.  But 
instead  of  building  his  spiritualistic  views  in  the  air,  or  founding 
them  on  abstractions,  he  insists  on  the  most  rigid  scientific 
procedure." 

Perhaps  this  is  claiming  too  much  for  Fichte,  in  any  view  of 
his  psychology:  from  the  physiological  or  scientific  point  of 
view,  it  clearly  is ;  but  such  is  not  quite  his  translator  s  point 
of  view ;  Mr.  Morell,  unfortunately,  though  much  in  advance 
of  most,  being  like  most  professed  philosophers  guiltless  of 
regular  scientific  training.  As  a  thinker  he  has  himself  some 
claim  to  originality;  and  he  makes  the  claim  in  the  very 
preface  from  which  we  have  just  quoted,  when  he  says: — 
**  psychological  efforts  in  this  country  have  almost  all  proceeded 
on  one  of  two  principles.  First,  there  is  the  old  dunlistic 
principle,  which  regards  the  soul  and  the  body  as  two  distinct 
essences,  each  having  its  own  peculiar  attributes  formed  and  de- 
veloped by  wholly  different  agencies,  and  adapted  to  each  other 
for  a  time  by  some  intelligent  power  distinct  from  and  superior 
to  both.  This  has  been  the  ordinary  view  of  the  Scottish 
school  of  mental  philosophy,  and  may  be  regarded  also  as 
having  been  for  some  time  past  the  most  current  popular 
notion  on  the  subject  in  our  own  country  generally.  The  very 
unsatisfactory  nature  of  this  theory  has  long  become  apparent 
to  investigators,  particularly  to  those  who  have  regarded  mental 
phenomena  mainly  from  a  physiological  point  of  view.  The 
close  connection  between  the  mind  and  the  body,  and  their 
mutual  actions  and  reactions  on  each  other,  all  point  by  the 
most  indisputable  proofs  to  a  far  more  intimate  and  essential 
unity  than  the  above  theory  supposes.  Accordingly,  an  op- 
posite tendency  has  for  some  time  past  set  in  strongly  amongst 
the  less  metaphysical  class  of  mental  analysts,  the  tendency, 
viz.,  to  regard  all  mental  phenomena  as  strictly  dependent  upon 


660  Psychological  Physiology, 

physical  conditions,  and  to  set  aside  the  questioDj  as  to  the 
separate  essence  of  the  mind»  as  an  enqniry  wholly  futile  and 

transcendental I  have  already  shown  in  a  former 

work,*  that  we  are  by  no  means  shut  up  to  the  alternative  which 
these  two  systems  present ;  that  we  may  hold  the  separate  ex- 
istence of  the  mind  and  the  body,  and  yet  regard  the  former  as 
perfectly  pervading  the  latter,  nay  as  being  the  formative  prin- 
ciple by  which  it  is  constructed  and  adapted  to  our  nature 
and  use" 

The  italics  in  the  last  part  of  this  quotation  are  our  own. 
They  point  attention  to  the  fact  which,  inter  alia,  it  is  the 
design  of  this  paper  to  illustrate,  that  without  the  correction  to 
his  ideas  which  the  regular  study  of  the  physical  sciences  is 
calculated  to  supply,  the  student  of  mental  science  is  unfitted, 
by  the  bias  of  his  own  ideas,  to  settle,  even  approximately,  the 
very  problems  he  deems  he  holds  in  special  trust;  as  conversely 
— though  it  may  be  to  a  lesser  extent — the  man  of  special 
science,  who  is  a  physiologist  or  a  chemist,  an  anatomist  or  a 
pathologist,  and  nothing  more,  is  ill-fitted,  by  the  cultureless 
state  of  his  mind,  or  the  absorbing  nature  of  his  too  material 
pursuits,  to  assist  much  the  great  movement  whereby  physical 
science,  as  a  whole,  shall  be  raised  to  the  higher  platform  of  a 
deductive  philosophy.  The  problems  to  be  solved  involye  not 
merely  the  phenomena  of  mind  on  the  one  hand,  and  those  of 
organization  on  the  other:  this  is  but  the  question  as  it  is 
bandied  about  between  the  philosophers  and  the  men  of  special 
science — the  question  begged  on  both  sides.  The  problems  to 
be  solved  involve  a  consistent  explanation,  a  solution,  a  recon- 
ciliation of  these  phenomena,  and  nothing  less.  The  problems 
to  be  solved  are  at  once  abstract  and  concrete,  analytic  and 
synthetic;  they  are  psychical,  physiological,  ethnological  and 
social :  they  concern  man  in  all  his  relations  to  life,  and  in  all 
his  dependencies;  and  it  is  neither  the  authoritative  phy- 
siologist nor  the  famous  philosopher  who  can  solve  them. 
The  party  of  progress  among  the  psychologists,  as  represented 
by  Mr.  Morell,  for  example,  the  emancipated  thinkers,  as  they 

•  VideUBElment8ofF^jfchohgy,i?uU\AeAhiie53, 


by  Dr.  MacGilcArisL  561 

consider  themselves,  who  see  at  length  that  physical  science  is 
a  great  fact  not  to  be  ignored  in  any  fature  estimate  of  man's 
double  organization.*  Mr.  Morell  tells  us  that  we  are  to 
regard  the  mind  as  ''  the  formative  principle  hy  which  the  body 
is  constmcted."  But  the  physiologist  knows  that  there  is  a 
germinal  vesicle,  and  he  has  traced  the  process,  more  or  less 
minutely  and  satisfactorily,  by  which  the  primordial  cell  of  a 
rabbit  or  a  human  being,  which  at  first  presents  no  difference 
from  that  of  the  humblest  plant,  expands  itself,  multiplies  itself, 
transforms  itself,  till  ii  makes  a  man.  He  has  watched  the 
contenta  of  this  primordial  cell  divided  into  two  halves ;  then, 
seen  these  each  divide  into  two  by  a  similar  process  of  dicho- 
tomy ;  and  each  of  these  again  divide  into  two ;  until  the  pri- 
mordial cell  is  filled  with  minute  cells.  Then  he  has  noticed  a 
new  process  commence,  by  which  the  granules  or  minute  cells 
are  integrated  so  as  to  form  the  germinal  membrane,  out  of 
which  the  various  tissues  and  organs  are  successively  developed 
by  the  formation  of  the  more  special  tissue  out  of  the  more 
general,  all  in  a  fixed  and  invariable  order.  And  he  has  ascer- 
tained, finally,  that  this  evolution  does  not  cease  at  birth,  but 
continues  till  the  organism  attains  its  complete  development — 
I.  e.y  till  the  reproductive  organs  by  means  of  which  it  is  to 
transmit  its  life  to  its  successor  have  attained,  at  puberty,  their 
functional  perfection — ^and  the  primordial  cell  has  become  a 
finished  man.  The  physiologist  knows  this,  and  knows  it  dif- 
ferently from  his  friend  the  liberal  psychologist,  who  has  learnt 
something  about  development,  just  as  he  has  leamt  something 
about  sewage  or  ventilation.  The  primordial  cell,  that  might, 
for  all  the  tensest  scrutiny  can  determine,  have  developed 
equally  into  a  mushroom,  a  rabbit,  or  a  Shakspeare,  has  a 
very  different  meaning  for  the  two  inquirers;  and  when  the 

*  This  doMe  organisation  (mind  and  body  as  Beparatet  or  separaUe  en. 
titiea)  18  constantly  assomed  by  the  psychologists ;  thongh  Mr.  J.  8.  liill, 
probably  the  most  adyanced,  ».e.,  the  most  scientific,  of  English  "philoso. 
phers  "  remarks :  **  It  must  by  no  means  be  forgotten  that  the  laws  of  mind 
may  be  derivatiye  laws  resulting  from  the  laws  of  animal  life,  and  their 
troth,  therefore^  may  nltimately  depend  on  physical  conditions."— /%8<00i  of 
JLogic,  Vol.  IL,  p.  426. 

VOL.   XXI.,  NO.   LXXXII. — OCTOBER    1862.  2  N 


562  Psychological  Phjftiohgy^ 

physiologist,  perobance,  asks  the  philosopher  how  he  oonoeiTeB 
of  the  mind,  which  afterwards  gradually  illames  the  wondrous 
organism,  during  the  eariy  stages  of  this  evolation — ^whether  as 
latent  in  the  primordial  cell,  or  saperadded  invisibly  at  the 
period  of  the  formation  of  the  germinal  membrane,  or  at  birtb, 
or  when  ? — his  psychological  friend  probably  turns  from  him, 
with  a  kind  of  contemptuous  pity,  as  a  "  mere  materialist ; " 
whilst,  on  his  part,  the  man  of  science  fails  to  stifle  a  sentiment 
of  contempt  which  he  entertains  for  the  "  dreamer."  Yet, 
probably  this  physiologist  is  no  mere  materialist,  nor  this 
psychologist  a  mere  dreamer:  they  misunderstand  each  other 
hopelessly,  simply  because  they  entertain  a  totally  different 
appreciation  of  the  same  facts. 

Such,  we  apprehend,  are  the  present  relations  of  philosophy 
and  positive  science,  as  subsisting  between  the  more  advanced 
thinkers  on  either  hand.  Ordinary  men  of  science  refuse,  gene- 
rally, to  look  full  in  the  face  or  follow  to  their  legitimate  con- 
clusions facts  that  militate  against  the  settled  opinions  of  their 
time,  whether  these  be  metaphysical,  theological,  or  social; 
each,  in  the  department  he  has  chosen,  sticks  to  it  like  a 
cobbler  to  his  last.  Your  mere  philosophers,  again,  turn  their 
backs  on  science  as  something  vulgar  and  debasing,  and  live 
and  die  in  their  metaphysical  prejudices;  though,  by  the  way, 
it  does  not  follow  that  they  believe  in  them  to  the  last,  if  it  be 
true — as  Mr.  Lewes  has  specially  insisted  on,  in  that  admirable 
compendium  the  Biographical  History  of  Philosophy — that 
metaphysical  philosophy  tends  ultimately  and  inevitably  to 
universal  scepticism,  like  the  pig  that  has  got  adrift,  cutting 
her  own  throat  in  her  desperate  efforts  to  keep  swimming. 

Mr.  Morell  represents,  as  we  observed,  a  party  of  advanced 
or  liberal  psychologists  in  thia  country,  whose  views  we  have 
somewhere  seen  termed  "  eclectic : "  in  his  work  already  alluded 
to  {Element^  of  Psychology)  he  advocates  a  so-called  com- 
promise on  that  fundamental  question  of  all  philosophy  about 
which  we  have  spoken  at  some  length — the  origin  of  our  ideas. 
It  is  to  this  effect :  that  "  we  are  not  obliged  to  adopt  either 
the  theory  of  innate  ideas,  or  the  purely  experience  hypothesis, 
but  that  we  may  regard  the  mind  as  endowed  with  primordial 


hy  Dr.  MacOilchrisi.  563 

instincts,  whiob  develop  into  faculties  by  the  regular  process 
of  growth  in  connection  with  the  outer  world." 

This  may  be  termed  the  key*note  of  the  so-called  "  eclectic  " 
psychology.  It  is  a  lame  attempt  to  solve  a  difficulty  by  as- 
suming, under  the  gloss  of  new  language,  the  matter  in  dispute. 
It  betrays  also  the  same  confusion,  as  to  the  bodily  side  of  the 
problem,  that  we  commented  on  further  back.  What  are  those 
"primordial  instincts"  which,  like  material  primordial  cells, 
are  said  to  "  develop  ? "  They  are  not  material,  yet  they  de- 
velop ;  but  out  of  what  contenia,  or  how,  they  so  develop,  is 
not,  and  of  course  cannot  be,  shewn.  Then,  unless  they  stand 
for  '*  innate  ideas,"  we  may  affirm  that  they  stand  for  nothing 
at  all,  being  two  words  without  definite  meaning.*  In  short, 
there  is  no  alternative :  we  are  obliged  to  adopt  the  one  or 
other  in  accounting  for  the  source  of  our  ideas-^the  hypothesis 
of  innate  ideas,  or  the  theory  of  esjpefience. 

To  return  to  Fichte :  as  might  be  expected,  he  holds  tens* 
oioualy  to  innate  ideas,  and  even  transcends  the  ordinary  con- 
ception of  them : — "  The  human  soul  (as  we  have  expressed  it) 
has  not  only  elements  prior  to  experience  in  its  consciousness, 
but  it  is  itself  an  a  priori  being,  furnished  with  definite  impulses 
and  instincts,  and  goes  through  a  series  of  very  effective,  though 
unconscious,  processes  of  thought  before  it  comes  to  the  power 
of  conscious  thinking."  Here  are  the  "  primordial  instincts  " 
under  psychological  development.  Here,  and  on  other  fanda-* 
mental  questions,  Fichte,  except  that  he  is  of  a  newer  school, 
is  in  consistency  with  the  spirit  of  the  philosophy  in  which  he 
was  reared.  In  one  sense  it  is  curious,  that  he  should  profess, 
elsewhere,  to  see  so  clearly  the  necessity  of  reconciling  phi- 
losophy to  science,  and  still  continue  to  endorse  speculations  of 
the  most  abstract  and  transcendental  kind.  He  is  the  first,  or 
one  of  the  first,  among  the  professed  philosophers  of  Germany 
who  has  specially  insisted,   as  part  of  his  sys^m,  on  the 

*  If  the  word  "  instiiicts "  here  ahoold  bear  the  meaning  of  inttmOt  as 
generally  contradJBtingiiished  by  the  philosophers  (as  we  believe,  however, 
on  insofficient  grounds)  from  rea9onj  then,  perhaps,  we  might  apply  the  doc- 
trine not  inaptly  to  certain  fishes,  insects,  birds  and  brutes;  bat  not  to  man's 
mental  constitution. 

2n  2 


564,  Psychological  Physiology, 

necessity  of  taking  into  account  and  solving  what  have 
termed  the  abnormal  phenomena  of  the  human  mind ;  as  the 
more  remarkable  phases  of  dreaming,  but  especially  somnam- 
bulism^  hallucination,  presentiments,  hypnotism,  clairvoyance, 
ghost-seeing,  and  the  alleged  phenomena  of  what  is  called 
"mediumship"  In  the  present  state  of  philosophy  (transi- 
tional ? )  he  is  a  bold  man,  either  of  science  or  letters,  who 
proposes  to  himself  the  harmonious  solution  of  these  vexed 
abnormalities ;  as  will  be  noticed  at  the  end  of  this  paper,  they 
present  a  kind  of  frontier  ground  admirably  fitted  for  the 
meeting,  in  consultation  as  it  were,  of  the  professed  psychologist 
and  the  physiologist.  Fichte  gets  sadly  into  the  bogs  of 
spiritualistic  speculation  here ;  yet  his  chapter  on  ^'  Primitive 
Consciousness  atul  Self-consciousness"  in  which  chiefly  he 
discusses  these  slippery  phenomena,  is  not  merely  readable, 
connected,  and  ingenious,  but  also  very  suggestive.  With 
Fichte  8  psychology,  as  sucb,  we  have  no  further  concern.  The 
theological  element  enters  largely  into  it,  involving  him  in 
supematuralism  to  an  extent  scarcely  compatible  with  the  pre- 
tensions of  "  eclecticism,"  or  the  appeal  he  makes  to  physical 
science :  but  that  he  does  make  the  appeal,  is  the  important 
lact  for  us  of  his  work.*  There  is  an  appendix,  the  second 
part  of  which  we  may  quote  nearly  entire,  as  both  conveying  a 
very  good  epitome  of  "  nerve-physiology,"  after  Wagner,  and 
showing  to  what  extent  the  appeal  to  science  is  beginning  to  be 
tolerated  in  some  psychological  regions. 

**  The  Elementary  Organisation  of  the  Nervous 
System,  and  its  Belation  to  Psychology. — I  have  already 
remarked,  that  the  greatest  stress  ought  to  be  laid  upon  the 
question,  as  to  whether  anatomical  results  are  in  accordance 
with  the  views  I  have  propounded,  and  able  indirectly  to  confirm 
them.  According  to  my  views,  it  must  be  maintained  that 
the  structure  of  the  fiervous  system  presents  us  with  a  perfect 
reflex  of  psychical  relations,  and  that  cofisequetUly  there  must 
be  various  mental  processes  corresponding  teith  the  different 

*  We  should  liave  noted  it  sooner,  Cc/nJbnkvl^ffM  to  Mental  Ththscphy.  By 
Immanuel  Herman  Fiohto.  Translated  and  edited  by  J.  D.  Morell,  A.M. 
London,  I860. 


hy  Dr.  MacOilchrist.  505 

/unetioti9  which  we  find  to  exist  in  connection  with  nervous 
activity — -processes  which  psychology  ought  to  discover,  and 
whichy  wheti  discovered,  we  should  see  to  he  in  perfect  cor- 
relation with  physiology  and  anatomy.  I  must  here  fully 
subscribe  to  tike  expression  of  Fortlage,  that  the  external 
functions  of  the  nervous  system  are  really  mind  become  visible.* 
*'  On  this  account  the  conclusion  cannot  seem  strange  that 
in  these  psychical  relations  we  may  find  the  key  to  that  most 
dark  and  enigmatical  question,— I  mean  the  anatomical  structure 
of  the  nerre-matter.  At  present  it  would  he  doubtless  premature 
to  attempt  any  such  parallel,  for  it  is  only  quite  recently  that 
psychology  has  begun,  on  the  one  side,  to  investigate  the  more 
inward  processes  of  consciousness,  having  been  contented  so 
long  with  a  mere  enumeration  of  faculties — [Professor  Ferrier's 
"  hopeless  enquiry  about  ^  faculties,'  and  all  that  sort  of  rub- 
bish"] ; — while,  on  the  other  hand,  both  physiology  and 
anatomy,  by  their  own  confession,  are  as  yet  far  enough 
H  removed  from  drawing  any  definite  conclusions  from  their 
researches  into  the  structure  of  the  nervous  system.  Whatever 
I  have  to  communicate  respecting  the  parallel,  I  must  present 
rather  as  a  preliminary  attempt,  which  may  be  hereafter  made 
good,  than  as  giving  any  fixed  and  ascertained  conclusions 
regarding  it.  The  relation,  however,  which  Wagner  has  so 
acutely  pointed  out  between  the  primitive  nerves  and  the  nerve 
centres,  is  too  striking  not  to  lead  us  to  attempt  a  psychological 
interpretation,  which  bears  very  closely  upon  the  distinction 
between  the  individual  elements  of  sensation  and  the  elaboration 
of  them  into  perceptions  and  notions.  This  distinction  is  now 
thoroughly  well  grounded,  and  goes  far  to  reveal  the  mystery 
of  the  whole  development  of  our  consciousness.  Whether  it 
can  be  shown,  however,  to  have  its  reflex  in  the  structure  of 

*  We  liave  italicised  the  above  passage,  as  perhaps  the  most  important 
dednction  of  psychological  physiology.  V^e  shall  presently  notice  shortly 
a  work  written  ostensibly  from  the  physiobgioal  point  of  view — Professor 
Laycock's  **  Mind  and  Brainy"  pnblished  about  the  same  time  as  this  English 
version  of  Fichte's  "  Confession  " — ^in  which  we  find  the  same  generalisation 
adyanced  scientifically,  and  with  the  assumption  of  originality.  To  us  it 
seems  dear,  however,  that  these  ideas  were  first  eliminated  phllosophicaUy, 
and  that  they  did  not  originate  in  this  country. 


d66  Psychological  Physiology ^ 

the  nerves,  is  at  present  only  conjectoral.  I  shall  endeavour 
to  give  a  brief  sketch  of  what  is  already  aaoertained  in  the 
region  of  nerve- physiology,  and  what  Wagner  has  himself  been 
able  to  add  to  it 

*'  In  the  brain  and  spinal  marrow  these  oonducting  nerves — 
[the  centripetal  and  oentrifogal,  which  he  has  first  described]— 
are  connected  with  the  other  kind  of  nerve-snbstance, — ^the 
cellular  or  grey  matter.  External  impulses  come  to  perception 
only  when  they  are  brought,  by  means  of  the  oonducting  nerves, 
into  contact  with  the  cellular  matter.  This  fact  would  be  of 
extraordinary  importance,  in  relation  to  the  parallel  between 
physiology  and  psychology,  if  it  could  only  be  raised  from  an 
hypothesis  to  the  rank  of  a  physiological  axiom.  There  are 
strong  grounds  in  its  favour,  and  it  would  be  interesting  to 
show  the  results  that  would  flow  from  it 

'*  The  primitive  nerves,  as  we  remarked,  never  anastomose 
into  each  other;  they  shew,  in  this  way,  a  natural  adaptation 
to  propagate  each  single  operation,  as  elements  of  sensation 
and  volition,  isolated  and  unmixed.  But  in  the  ganglionic 
cells  they  appear  to  come  into  mutual  action  and  reaction,  so 
that  it  is  here,  firsts  that  the  various  simple  operations  are 
combined:  i.e.,  either  the  single  elements  of  sensation  are 
fused  into  a  conscious  act  of  perception,  or  a  single  act  of  will 
is  distributed  over  the  several  organs,  which  must  co-operate 
in  order  that  it  may  be  carried  out  into  a  practical  execution. 
Several  conclusions  may  be  drawn  from  this:  first,  that  the 
well-defined  distinction  between  sensible  and  motor  nerves 
must  be  extefwled  to  the  gangUonie  cells,*  We  should  have 
to  distinguish  such  cells,  therefore,  as  those  which  snbsorve 
sensational  and  those  which  subserve  volitional  processes. 
Secondly,  that  every  ganglionic  cell,  according  to  the  number 
and  importance  of  the  primitive  nerves  which  meet  in  it,  is  in 
a  greater  or  less  degree  a  centralisifig  organ,  that  very  thing, 
in /act,  which  psychology  has  hitherto  only  looked  for  in  the 
soul  itself. \    Still  we  must  only  regard  these  relative  centres  of 

*  This  is,  in  effect,  a  separate  ennnciation  of  ^  reflex  action  of  the 
cerebrum,  for  which  Dr.  Laycock  fairly  claims  credit  in  this  oonntrj.  The 
italics  are  ours. 

t  The  italics  arc  ours. 


hy  Dr.  MacGilchrisL  567 

conscionsDess  as  the  elemefita  out  of  which  and  witMn  which 
the  soqI  comhines  its  more  extended  processes  of  consciousness. 
Lastly,  it  follows  that  these  ganglionic  cells,  heing  at  the  same 
time  relative  centres  of  consciousness,  must  be  connected  with 
each  other  by  means  of  the  intermediate  nerve-fibre.  We  can 
here  hardly  overlook  the  still  further  consequence,  that  there 
is  a  third  series  of  primitive  nerves ;  that  besides  the  sensible 
and  motor,  there  is  also  another  species  of  nerves,  which  is 
adapted  to  combine  the  higher  states  of  consciousness  together. 
"  Let  us  consider,  then,  what  it  is,  in  these  principles  of 
Wagner,  which  tends  to  support  the  hypothesis  we  have  brought 
forward.  The  following  facts  are  in  the  highest  degree  eigni* 
ficant :  *  From  all  the  ganglionic  cells  there  are  offsets,  which 
unite  them  with  the  primitive  nerves,  or  with  other  cellular 
formations.  Most  of  the  ganglia  shew  ja  great  many  of  such 
offsets.  Whether  there  are  any  which  only  have  one  bond 
of  connection,  is  doubtful ;  it  seems  that  there  are  none  wholly 
isolated.  Again,  the  cells  transmit  impulses  from  one  kind 
of  nerve-bundle  to  another,  that  is,  from  the  nerves  of  sensation 
to  those  of  motion,  and  vice  versa :  in  this  way  reflex  actions 
are  originated.  Other  cells  transmit  the  operation  of  the  nerves 
to  the  gland-substance,  in  order  to  produce  secretions  from  the 
blood.  The  secretion  of  tears  and  saliva  (as  the  consequence 
of  external  objects)  is  explicable  on  the  same  principle.  Large 
masses  of  small  cells  (as  in  the  case  of  the  corpora  quadrigemena 
and  the  optic  thalami)  are  necessary  in  order  to  call  forth  the 
sensations  of  light  and  colour ;  so  that  these  may  produce  such 
sensations  even  without  the  co-operation  of  the  eyes  and  the 
optic  nerves,  as  is  often  the  case  in  congestion  of  the  brain. 
Similar  masses  are  found  in  connection  with  the  nerves  of 
hearing  and  smelling.'  From  these  facts  it  follows  incontestibly, 
that  the  operation  of  the  ganglionic  cells,  so  far  as  the  lower 
region  of  feeling  is  concerned,  is  independent  and  central; 
while  the  activity  of  the  primitive  nerves  and  commissures  is 
elementary  and  subordinate.  A  similar  relation  appears  to  exist 
in  reference  to  the  organs  of  the  higher  intelligence :  '  Millions 
of  small  connected  cells  (Wagner  says),  in  layers  of  various 
thickness,  line  the  outside  of  the  hemispheres.     Millions  of 


568  PisyehohgicijU  PAyiiology, 

fine  fibres  spring  out  of  them,  and  fonn  the  white  snbstanoe 
of  the  brain.  These  fibres  condact  all  the  impulses  of  the 
senses  to  the  cells  round  the  surface,  and  carry  away  the 
impulses  of  the  will  firom  those  cells  to  the  periphery.'  Wagner, 
therefore,  calls  these  cells  psychical  cells,  and  remarks  that 
if  we  can  speak  of  the  seat  of  a  soul  ai  all  in  a  physiological 
sense,  these  cells  must  be  it,  as  they  are  the  last  point  of 
connection  between  the  anatomical  nerve-elements  and  the 
consciousness.  At  least  it  can  be  shewn  that,  in  the  creatum 
qfperceptione  and  other  purely  mental  processes^  those  celh 
round  the  surface  are  in  action  *  Whether  they  are  so  lo  /A^ 
very  last  pointy  we  cannot  say,  for  there  is  still  one  objection 
remaining,  viz.,  that  in  the  unknown  basis  of  the  brain  there 
may  yet  lie  some  single  organ  of  great  importance  to  which  the 
cells  at  the  surface  are,  attendants.  Wagner,  however,  cites  the 
following  facts  to  the  contrary :  1st.  Wherever  these  cells  are 
largely  distributed,  mental  disturbances  in  propordon  always 
take  place.  All  pathological  experiences  confirm  this,  particu- 
larly insanity.  2nd.  That  it  is  only  when  disturbances  do  take 
place  in  these  cells,  either  directly,  as  in  inflammation,  brain 
fever,  &c.,  or  indirectly,  as  in  lesion  or  pressure,  that  mental 
disturbances  can  uniformly  be  detected,  drd.  That  no  nuMre 
certain  cause  of  mental  affection  is  known,  as,  e.g.,  where  any 
other  parts  of  the  brain  are  injured,  without  the  sympathy  of 
the  cellular  substance  referred  to  being  awakened  by  it. 
4th.  Well-known  observations  on  animals,  in  which  the  upper 
part  of  the  brain  has  been  cut  away  in  slices,  confirm  all  this. 
Wagner  has  convinced  himself,  by  observation,  that  the  greater 
or  less  degree  of  idiotcy  [in  the  human  subject  ?]  or  insensibility 
in  animals,  depends  on  the  extent  to  which  the  cellular  surface 
has  been  removed  [or  congenitally  injured  ?].  From  all  which, 
his  own  and  Huschkes  observations,  he  has  deduced  the 
following  principle :  The  increase  of  the  convolutions,  and  their 
more  vigorous  folding,  consist  simply  in  the  increase  of  the 
cells  which  are  embedded  in  the  grey  matter.  The  region  of 
the  forehead,  and  the  sides  and  upper  portions  of  the  cerebrum, 
shew  more  numerous  convolutions  in  the  case  of  men  of  high 

*  The  italics  are  ours. 


hy  Dr.  MacGikhrist.  569 

intelligence.  Finally,  the  brain  is  a  highly  complex  organ; 
it  consists  of  numerous  prominent  apparatuses  and  conducting 
'wireSy  like  the  network  of  telegraphs,  whose  millions  of  stations 
stand  in  connection  with  each  other,  and  whjch  all  have  their 
central  office  in  the  consciousness.  It  is  quite  clear  that  the 
most  recent  anatomical  investigations  can  shew  no  one  Mingle 
point^ivL  which  all  the  impressions  converge,  and  from  which 
the  impulses  take  their  start.  To  whatever  extent  the  atomistic 
philosophy  [materialistic  ?]  requires  this,  it  fails  at  present  of 
support  on  physiological  grounds. 

''  We  may  remark  as  a  corollary,  that  the  doctrine  of  the 
perfect  simplicity  of  the  soul  cannot  be  affirmed  on  anatomical 
grounds.  The  opposite  view,  on  the  other  hand,  gains  strength, 
viz.,  that  the  soul  is  a  real  existence,  involving  a  space-relation, 
like  all  other  realities ;  and  that  the  fac(  of  an  invisible  pneu- 
matical  body,  which  has  been  a  stone  of  stumbling  to  the 
empirics  of  our  day,  is  rendered  in  the  highest  degree  probable 
from  the  plain  intimation  of  palpable  physiological  facts." 

So  mach  for  Fichte,*  and  his  very  suggestive  appeal  to 
physiology  in  favour  of  his  somewhat  inconsistent  and  contra- 
dictory views.  We  deem  them  so,  as  appealing  to,  rather  than 
admitting  the  guidance  of,  physiology.    Exception  must  be 

*  Perhaps  the  most  characteristic  part  of  his  psychology  is  the  doctrine  of 
iiM  precontdous,  as  distinguished  from  the  conscious^  or  ordinary  life  of  the 
soul,  involying  the  view  already  alluded  to,  which  regards  the  soul  as  "  the 
formatiTe  principle"  of  the  body.  How  this  doctrine  is  sought  to  he  established, 
^fuoft  scientifically,  we  may  just  sketch,  as  a  good  example  of  the  mixed  forms 
of  reasoning  sanctioned  hy  this  school :  It  being  assumed  hypothetically  that 
this  preconsdous  life  of  the  soul  (to  which  are  referred  all  the  insHncHve  aetiona 
and  all  the  involurUary  workings  of  the  intelligence)  is  both  capable  of 
exhlMting  phenomena  which  altogether  transcend  its  ordinary  and  oonscioos 
powers,  and  of  operating  in  this  way  without  organic  eondUiontt  the  appeal  to 
science  in  favour  of  the  doctrine  is  made  in  this  wise :  Sir  W.  HamUton  many 
years  ago  pointed  out  the  fact,  that  there  is  a  process  of  latent  thought  always 
going  on  more  or  less  energetically  in  the  soul ;  and  certain  physiologists 
have  referred  such  phenomena  to  what  they  have  termed  unoontcimta  cere-^ 
braUofi;  whilst  Dr.  Laycock  has  brought  them  under  the  general  category 
of  reflex  actions,  &c.— hence,  it  is  argued,  "  we  may  regard  the  whole  theory 
of  the  preconscions  life  of  the  soul  as  having  a  large  basis  both  of  fact  and 
authority  to  rest  upon."  But  what  becomes  of  preconscions  life  of  the  soul 
if  it  be  referrible  to  reflex  nervous  action  ? 


570  Psychological  Physiology^ 

taken,  for  example,  to  the  conclnsion  set  forth,  and  no  leas  to 
the  ground  on  which  oatenaibly  it  is  set  forth,  in  the  concluding 
paragraph.     It  may  not  be  consequential  to  deny  that  the  sool 
may  be  a  real  ^istence;   but  as  to  its  involving  a  ''space- 
relation,"  compatibly  with  the  notion   of  its  assuming  ''an 
invisible  pnenmatical  body,"  this  is  evidently  a  mere  hypothesis, 
not^  as  yet,  rendered '  probable  from  palpable  physiological  facts/ 
There  are  various  other  points  on  which,  like  his  translator 
Morell,  and  the  new  school  of  psychologists  generally,  Fichte» 
while  appealing  to,  overrides  the  practical  and  scientifio  side 
of  the  questions  he  discusses.     The  facts  of  hereditary  trans- 
mission,  and   other   materifd   elements  in   the  formation    of 
individual  character,  are  unworthy  the  consideration  of  this 
class  of  philosophers.     It  is  ''the  plastic  power  of  the  soul 
which  operates  with  an  individualising  force  upon  the  body« 
and  the  more  powerful  the  soul,  i.e.,  the  more  decidedly  it  comes 
forth  as  mind^  the  more  peculiar   and   characteristic   is   the 
organism  in  physiognomy  and  expression/'    (See  the  Chapter 
on   the  Essential   Nature  of  the  Human  SouL)    Despite, 
however,  such  incongruities,  and  irreconcilable  in  some  important 
respects  as  even  this  phase  of  mental  philosophy  seems  with  the 
teachings  or  tendencies  of  positive  science  in  these  days,  still 
we  cannot  but  regard  it  as  being,  by  virtue  of  the  very  appeal  it 
does,  however  obliquely,  make  to  science,  far  in  advance  of  the 
speculative  Metaphysics  which  professes  to  treat  it  with  contempt 
There  are  two  modem  English  writers  on  psychology  who 
have  made  the  appeal  to  science  in  a  more  systematic  and 
direct  manner,  and  to  whose  works,  without  being  able,  or 
thinking  it  necessary  to  notice  them  here,  we  would  refer  the 
reader — Mr.  Alexander  Bain  and  Mr.  Herbert  Spencer.    Both 
these  writers  have  been   styled  materialistic  by  the  purely 
speculative  philosophers,*  inasmuch  as  they  view  mental  phe- 
nomena not  wholly  from  the  abstract  side,  but  regard  them  in 
their  necessary  and  essential  dependence  on  physical  conditions. 
The  same  charge  can  scarcely  in  fairness  be  brought  against 
Fichte,  whose  unique  utterance  we  have  chosen  as  perhaps  more 
suggestive  in  several  respects  than  any  English  one  on  the 
same  side. 


hy  Dr.  MaeGilchriat.  571 

It  seems  time  now  to  approach  the  subject  from  the  other, 
the  physiological  or  scientific  side;  to  ask  what  the  men  of 
science  generally,  the  physiologists  especially,  have  done  towards 
reconciling  the  phenomena  called  mental  or  psychological  with 
those  considered  nervons,  functional,  or  organic.  Various 
scattered  and  fragmentary  contributions  have  been  made  of  late 
years  to  this  side  of  the  desiderated  connection,  by  physicians 
or  surgeons,  as  Sir  H.  Holland,  Sir  B.  Brodie,  &c. ;  but  of 
attempts  to  develop  a  system,  of  systematic  endeavours  to 
enclose  the  whole  ground,  we  know  of  none,  till  the  appearance 
of  Dr.  Laycock's  elaborate  work  in  I860.* 

Opinions  may  differ — though  we  have  met  with  no  great 
differences  as  yet — as  to  the  value  of  this  work  in  certain 
directions ;  but  few  readers  of  it,  we  should  think,  will  dispute 
that  it  is  written  on  a  very  bad  plan,  if  plan  that  can  be  called 
which  embraces  under  a  great  variety  of  headings  a  mass  of 
disjointed  observations,  or  what  to  the  unguided  reader  must 
seem  such.  And  this  blemish  is  not  a  little  aggravated  by  the 
inordinate  repetition  of  technical  terms,  and  the  use  of  new 
words,  in  which  the  author  has  revelled  seemingly,  rather  than 
moderately  indulged.  The  last  is  a  kind  -of  fault  which  in 
another  might  be  set  down  to  a  weakness,  but  in  our  author  s 
ease  is  due,  probably,  to  over- refinement :  it  is  not  the  less 
a  repulsive  feature,  however,  in  a  book  which  professes  to  address 
not  exclusively  either  the  philosopher  or  the  physician,  but  the 
student  also.  Again,  there  is  no  proper  distinction,  as  we 
should  expect  from  its  title  and  professed  purpose,  between  that 
part  of  the  work  which  treats  more  specially  of  mental  phe- 
nomena in  their  relations  to  scientific  and  physiological  data, 
and  that  which,  conversely,  adapts  or  correlates  the  facts  or 
inferences  of  science  to  the  doctrines  of  philosophy.  We  miss 
something  distinctive,  which  ought  to  stamp  the  whole  as  the 
utterance  of  the  philosopher  who  is  besides,  and  specially,  the 

*  Mind  and  Brain:  or  ihe  Correlations  of  Comeiousness  and  Orffomtation: 
with  their  applicaUons  to  Fhilo8<^hy^  Zoology,  Physiology,  Mental  Pathology,  and 
the  Practice  of  Medicine.  By  Thomas  Laycock,  M.D.,  F.R.S.E.,  &c.,  &o.. 
Professor  of  the  Phictice  of  Medicine,  and  Lecturer  on  Medical  Psychology  in 
the  University  of  Edinburgh.    Ed.  and  Load.,  I860. 


572  P»ychological  PhyMlogy^ 

physiologist  and  the  medical  psychologist;  and  if  we  except 
the  last  third  of  the  second  Tolame  perhaps,  and  the  several 
allusions  to  Dr.  Laycock's  scattered  papers,  there  is  nothing 
distinctive  in  the  work  to  stamp  it  as  one  which  might  not  have 
emanated  from  a  clever  and  laborious  student  of  the  mixed 
sciences — from  a  Bain,  a  Morell,  or  a  O.  H.  Lewes,  instead 
of  the  Professor  of  the  Practice  of  Medicine  in  the  University 
of  Edinburgh.  Its  doctrine^  no  doubt,  is  ingeniously  oom- 
prehensive ;  but  it  is  proportionately  obscure.  The  style  is  at 
once  stilted  and  involved,  and  the  matter  tautological  in  the 
extreme.  Considerable  part — we  had  almost  said  the  greater 
part — of  these  two  closely  printed  volumes  consbts  of  the  same 
ideas,  for  the  most  part  psychological  and  transcendental, 
presented  and  represented  in  different  connections  and  under 
varying  conditions,  generally  without  any  really  new  result; 
yet  so  metamorphosed,  or  tacked  on  to  other  topics,  that  the 
general  reader  fails  even  to  recognise  them  as  the  old  friends 
with  the  new  faces  that  the  author  doubtless  intends  them  to 
appear.  As  we  learn  from  an  index  at  the  beginning,  some 
275  authorities,  or  thereby,  are  referred  to,  some  of  them  many 
times  over,  and  both  volumes  teem  with  quotations,  which  are 
sometimes  introduced  without  very  decided  point,  not  assisting 
the  reader,  therefore,  to  the  inferences  presumedly  deducible ;  and 
on  many  points,  chiefly  of  metaphysico-psychological  dispute, 
we  have  not  been  able  to  gather,  from  the  large  use  the  author 
makes  of  such  varied  authority,  to  what  views  he  himself  leans» 
or  whether  he  means  purposely  to  leave  his  readers  to  balance 
these  authorities,  and  draw  what  conclusions  seem  to  them  the 
best  supported.  For  the  most  part.  Dr.  Lay  cock  speaks 
indistinctly,  except  in  the  appendix  to  the  whole,  where,  very 
properly  and  fairly,  as  between  himself  and  Dr.  Carpenter,  he 
vindicates  his  claims  as  the  "  Discoverer"  (perhaps  it  were  more 
gracious  to  say,  the  first  distinct  enunciator)  of  "the  law  of 
unconscious  cerebration," — a  most  important  physiological 
principle,  to  the  psychological  bearings  of  which  we  have  at 
least  alluded  in  a  foregoing  part  of  this  paper.  Dr.  Laycock's 
work  is  in  many  respects  a  remarkable  one ;  bat  it  is  of  extremely 
detached  interest,  and  has,  to  us  we  confess,  all  the  appearance 


»y  Dr.  MacGikhrist,  573 

of  having  been  compiled  hurriedly  from  a  mass  of  miscellaneons 
notes — of  great  value  in  themselves,  as  notes — which  the 
accomplished  author  has  been  collecting  probably  for  many 
years,  and  of  which  we  cannot  but  think  he  might  have  made 
a  better  use.  In  its  present  shape  the  book  is  unreadable  as 
a  whole.  We  have  seen  several  notices  of  it^  but  none  that 
attempts  to  grapple  with  it  analytically ;  nor  shall  we  now  fhce 
the  Herculean  task  of  putting  into  common  coherence  this 
remarkable  omnium  gatherum  of  metaphysics  and  all  the  oIoqUb. 

We  fancy  it  will  be  the  general  opinion  of  his  admirers,  that 
Dr.  Layoock  has  been  happier  in  his  shorter  and  more  synthetic 
published  utterances.  We  have  perused  with  dififerent  feelings 
than  those  we  have  been  expressing,  several  of  the  separate 
papers  (in  the  British  atid  Foreign  Medico-Chirurgical 
Review  chiefly)  to  which  he  makes  general  reference ;  and  there 
is  now  before  us  a  comprehensive  and  comprehensible  essay, 
in  the  shape  of  an  "Introductory  Address,"*  which  appeared 
about  a  year  after  the  publication  of  the  work  in  question,  in 
which  he  gives  some  account  of  his  book  and  a  summary  of  his 
views,  so  far,  on  psychological  physiology,  or  ''medical  psycho- 
logy." From  this  deliverance  we  may  appropriately  quote 
certain  connected  passages.  And  first,  let  us  hear  Dr.  Laycock 
on  his  own  book : 

**  The  text  book  (as  he  now  calls  Mind  and  Brain)  ia 
necessarily  encyclopsdic  in  its  character,  to  meet  the  present 
aspects  of  mental  science.  [This  is  scarcely  consistent,  however, 
with  the  pretensions  advanced  for  it  elsewhere,  or  with  the 
character  it  bears  on  the  face  of  it.]  It  first  develops  an 
appropriate  method;  for  without  this  neither  progress  nor  a 
nseful  arrangement  of  what  is  known  is  possible.  It  then 
summarizes  the  results  of  experience,  whether  attained  by 
common  sense  or  metaphysical  inquiries,  with  a  view  to  the 
elimination  of  principles.  Proceeding  from  these  as  a  starting 
point,  it  teaches  the  fundamental  correlations  of  the  physical, 

*  The  SdenHJic  Place  and  Prindjplei  of  Medical  Ptychdlcffy:  an  InLrodudory 
Addreu.  By  T.  Laycock,  M.D.,  &e.,  &c.  Keprinted  from  the  JEdinburgh 
Medical  Journal,  Jime,  1861. 


574  Psychological  Phgniologg, 

Tita],  and  mental  ibroes  and  laws,  onder  the  two  heads  of 
teleology  and  biology.  These  subjects  occupy  the  first 
Tolome." 

Which  Tolome,  we  may  jast  remark,  is  the  more  unreadable 
of  the  two,  being  wanting,  so  far  as  we  can  find,  in  that  **  usefiil 
arrangement  '*  on  which  the  author  congratulates  himself. 

**  In  the  second  Tolume  (he  continues),  the  principles  and  laws 
thus  eYolved  are  applied  to  the  development  of  a  scientific  psycho- 
logy in  the  first  place,  and  then  of 'a  mental  physiology  and 
organology.  In  this  part  of  the  work  [which  is,  we  consider, 
the  best  part  of  it  decidedly]  all  the  more  recent  disooTeries  in 
natural  history  and  zoology,  in  comparative  anatomy,  in  the 
development,  structure,  and  physiology  of  the  nervous  system, 
and  in  mental  physiology  and  pathology,  find  their  appropriate 
place.  By  this  plan  the  study  of  the  connection  of  the  body 
and  mind  is  placed  on  the  broadest  scientific  basis,  and  the  work 
is  made  to  constitute  a  systematic  summary  of  our  present 
knowledge  of  life  and  organisation  and  thought  in  their  reci- 
procal relations." 

As  we  hinted,  the  encyclopedic  character  given  to  it  is 
perhaps  a  little  inconsistent  with  such  a  "  systematic  summary  " 
as  is  here  claimed  for  the  work ;  but  such  has  been  the 
author's  grand  aim,  and  this  programme  may  perhaps  assist 
the  casual  reader  of  Mind  and  Brain,  As  to  his  general 
views,  take  the  following  connected  passages  from  the  body  of 
the  same  paper. 

*'  Physiological  psychology  is  only  of  recent  origin,  and  has 
arisen  concurrently  with  the  advances  made  in  neurology.  It 
has  been  cultivated  in  two  modes,  viz.,  as  a  department  of  the 
science  of  life  [physiology],  and  as  a  system  of  philosophy. 
Of  late  years,  eminent  physicians  and  surgeons  (as  Sir  H. 
Holland,  &c.)  have  cultivated  psychology  from  a  physiological 
starting  point.  These,  however,  have  not  developed  a  system, 
but  have  rather  leaned  to  speculative  psychology  [meta- 
physics] as  the  basis  of  their  researches.  The  school  of 
phrenological  psychology  is  also  of  this  class,  but  it  claims  to 
be  systematic.     Under   Gall  and   Spurzheim  it  sprung  like 


by  Dr.  MacOilchrist.  bib 

other  sciences  of  life,  out  of  medicine ;  and  if  it  had  remained 
in  connecticHi  with  medicine  it  might  have  attained  as  high  a 
position  as  any  of  them.  But  unfortunately  for  its  progress,  it 
was  too  quickly  severed  from  the  medical  sciences  and  consti- 
tuted into  a  distinct  and  popular  art,  as  cranioscopy.  The 
practice  of  it  then  fell  into  the  hands  of  persons  either,  for  the 
most  part,  devoid  of  physiological  training,  or  else  who  had  a 
stronger  hias  towards  philosophy  than  biology.  In  this  way 
it  became  wholly  unscientific,  or  took  an  ethical  and  philo- 
sophical development,  and  its  progress  consequently,  as  one  .of 
the  biological  sciences,  was  checked.  It  is  for  this  reason  that 
phrenology  has  hardly  made  any  progress  as  a  science  since 
the  days  of  its  founders ;  and  not  to  advance  is  to  recede.  .  .  . 

"  Looking  -at  the  position  of  psychology  proper,  it  is  clear 
that  medical  psychology  must  take  an  independent  place 
between  biology  on  the  one  hand,  and  metaphysics  on  the 
other.  It  cannot  ignore  the  vast  labours  of  the  metaphysi- 
cians ;  it  must  of  necessity  take  in  all  that  biology  has  accom- 
plished. Hence  its  method  must  be  eclectic,  to  the  end  that 
every  solid  result  of  every  kind  of  enquiry  may  be  made  avail- 
able to  its  scientific  and  practical  development.  It  must 
virtually  be  a  science  of  mind  developed  as  a  science  of  life.  Or, 
briefly,  medical  psychology  must  be  cultivated  independently 
as  a  positive  and  practical  science,  and  not  as  a  mere  offset 
from  speculative,  metaphysical^  or  philosophical  systems  of 
psychology 

"  Medical  psychology  affirms  the  fundamental  principle  of 
physiology,  that  no  change  whatever  arises  in  the  consciousness 
without  a  corresponding  change,  or  series  of  changes,  of  some 
kind  in  the  organism.  .  .  .  In  this  particular  medical  psychology 
differs  wholly  from  speculative  psychology  (which  expressly  ex- 
cludes this  inquiry),*  and  follows  therein  its  own  independent 
course ;  for  it  teaches  that,  devoid  of  this  knowledge,  we  can 
never  attain  to  a  science  of  consciousness  at  all — that  is,  to  a 

*  From  a  foregoing  part  of  our  paper,  it  wiU  be  seen  that  this  does  not 
fairly  apply  to  the  phase  even  presumedly  specnlatiTe  psychology  has 
assumed  in  the  hands  of  certain  of  its  later  expounders. 


576  PMychological  Phytwlogy^ 

knowledge  of  the  order  of  vital  events,  in  yirtae  of  which  those 
changes  in  the  consciousness  known  as  pleasure,  pain,  desire, 
aversion,  perception,  thought,  impulse,  passion,  will,  and  the  ^ke, 
arise,  are  intensified,  are  disordered,  or  cease.  Neither,  devoid 
of  this  fundamental  basis,  can  we  have  any  sufficient  theory  of 
neuralgia  or  melancholia,  of  delirium,  or  of  insanity,  or  of  the 
influence  of  climate,  diet,  regimen,  and  drugs  on  the  mental 
powers;  nor  can  we  establish  otherwise  a  scientific  basis  for 
mental  hygiene  and  mental  training,  or  education.  In  short, 
without  a  knowledge  of  the  mutual  relations  of  vital  and 
mental  changes,  no  practical  mental  science  is  possible,  and 
therefore  no  true  medical  psychology. 

"  While  we  affirm  as  a  fundamental  principle,  that  changes 
in  the  organisation  coincide  with  mental  changes,  we  are  not 
materialistic ;  on  the  contrary,  we  postulate  Force  as  the  first  of 
these  changes.  It  is  not  matter,  but  the  forces  of  matter  as  mani- 
fested in  living  things,  upon  which  these  changes  immediately 
depend.  This  general  principle  only  affirms  a  recognised 
general  law  of  creation.  Ceaseless  change  within  the  limits  of 
its  laws  is  the  order  of  creation.  When  the  changes  cease 
which  constitute  the  phenomena  of  life,  it  is  death.  But  still 
this  is  only  a  change  in  the  mode  of  being ;  and  if  medical 
psychology  do  not  follow  the  inquiry  further,  it  is  because  it 
recognises  the  impossibility  of  any  scientific  inquiry  being 
instituted  in  that  direction.  The  order  of  phenomena  beyond 
the  grave  is  matter  of  faith,  and  not  of  science  or  observation. 

"  The  unity  of  the  phenomena  of  life  and  consciousness  in 
man  implies  a  unity  of  forces  and  laws.  Hence  the  laws  of  the 
mental  and  vital  forces  should  correlate  each  other.  Now  the 
highest  development  of  consciousness  is  the  reason,  or  a  know* 
ing  direction  of  all  the  powers'to  the  attainment  of  desired  or 
desireable  ends ;  consequently,  the  laws  of  reason  itself  must 
be  correlative  with  the  laws  of  life  and  organisation.  But  the 
converse  of  this  proposition  is  also  true,  so  that  the  prin- 
ciples of  biology  must  correlate  the  principles  of  mental 
science." 

Now,  all  this  is  very  intelligible,  and  in  the  main  commands 


ly  Dr.  MacGilchrist.  677 

tlie  assent  of^  probably,  most  physiologists  who  have  directed 
their  attention  to  the  subject.  In  the  last  paragraph  we  have 
the  special  point  of  departure  of  this  psychologico-biological 
inquiry  clearly  stated ;  it  is  the  text,  as  it  were,  of  Dr.  Lay* 
cock's  systematic  work.  That  the  laws  of  reason  itself  must  be 
correlative  with  the  laws  of  life,  there  is  no  dispute,  let  us 
assume,  on  the  physiological  side ;  and  it  is  also  admitted  in 
the  general,  that  the  principles  of  biology  ouffhi  to  correlate 
the  principles  of  mental  science.  But  now  comes  the  problem, 
how,  in  the  present  conflicting  state  of  science,  philosophy,  and 
medicine,  this  can  be  shown.  The  approaches  made  on  the 
philosophical  side  have  been  inadequate  to  show  it.  Is  it 
possible,  then,  systematically  to  show  it  from  the  biological 
side  ? — I.  e.,  taking  the  facts  and  inferences  of  all  that  pertains 
to  the  science  of  life  along  with  us  in  our  use  of  the  psycho- 
logical phenomena.  This  is  the  special  question  which  Dr, 
Laycock  has  attempted  to  answer  in  the  affirmative ;  and  we 
have  to  ask — Has  the  system  developed  in  his  work  proved 
equal  to  that  conclusion  ?  And  the  answer  is  very  decidedly 
in  the  negative.  The  system  he  has  developed  fails,  very  much 
because  it  is  a  system.  The  problems  to  be  solved  are  not  ripe 
for  such  a  system,  so  to  speak.  The  question  at  present  is 
rather,  how  far  the  principles  of  physiology  can  be  ascertained 
to  correlate  the  principles  of  mental  science ;  and  so  far  as  the 
''  principles  "  of  both,  or  of  either,  are  unsettled  or  unfinished, 
just  so  far  is  a  complete  and  systematic  exposition  of  the  cor« 
relations  of  consciousness  and  organization,  such  as  Dr.  Lay- 
cock  has  eliminated,  premature.  And  if  this  be  true,  it  may 
partly  account  for  what  we  have  already  commented  on,  and 
which  is  perhaps  not  wholly  due  to  the  authors  involved  and 
tautological  style — the  unreadatleness  as  a  whole  of  his  ambi- 
tious book.  "  I  think  I  shall  be  able  to  prove  to  you  (he  says^ 
in  his  paper  we  have  been  quoting  quoad  his  greater  work)  how 
simple  are  the  general  laws  common  to  the  two  classes  of 
phenomena  (those  of  the  vital,  and  those  of  the  mental  forces 
and  manifestations),  and  how  capable  they  are  of  application  to 
an  infinite  variety  of  changes  in  both  health  and  disease,  and 

VOL.   XXI.,   NO.   LXXXII. — OCTOBER,  1862.  2  O 


578  Psychohffical  Physiology, 

whether  of  the  body  or  the  mind.    But  to  attain  this  clear  view 
we  must  take  a  wide  sweep  of  the  horizon  of  life." 

Now,  it  is  just  this  mnst  give  us  pause — the  **  wide  sweep/' 
the  application  to  an  infinite  variety  of  changes.  So  long  as  we 
confine  our  survey  to  a  few  general  laws,  it  can  be  shown,  proved, 
or  rendered  morally  certain,  that  they  are  common  to  the  two 
classes  of  phenomena;  and  for  our  individual  part  we  don't 
much  doubt  what  Dr.  Laycock  believes,  viz.,  that  all  the 
phenomena  of  consciousness  and  organization  are  correlated. 
What  we  deny  is,  that  it  is  at  present  possible  to  trace  these 
correlations  throughout,  or  beyond  the  generals ;  and  what  we 
very  much  doubt  is,  whether  such  a  demonstration  as  Dr.  Lay- 
cock  has  attempted  in  Mind  and  Brain  can  much  assist  as 
beyond  these  generals.  It  is  when  he  gets  within  them  that  be 
strands  often  on  the  very  shoals  he  keeps  buoying,  so  to  speak : 
without  seeming  to  be  aware  of  it— of  course,  he  does  not  think 
so — ^Dr.  Laycock  gets  positively  metaphysical  in  those  particular 
''  correlations "  of  his.  He  rides  them  to  death  in  pursuit  of 
this  system — a  system  that  shall  unravel  the  chain  that  runs 
from  the  extreme  end  of  consciousness  to  the  limits  of  organiza- 
tion. These  arbitrary,  undemonstrated,  and,  as  we  hold,  still 
undemonstrable,  particular  "  correlations,"  he  dignifies  with  the 
appellation  of  "  laws."  He  confounds  analogy  with  correlation 
too. 

In  view  of  some  snch  paper  as  the  present,  in  which  Dr. 
Laycock's  work  demanded  notice  as  being  the  only  systematic 
one  from  the  biological  side  of  the  inquiry,  we  had  marked  a 
number  of  passages  in  consecutive  illustration ;  but,  on  reflec- 
tion, abandon  the  idea  of  quoting  them  now,  as  it  seems  scarcely 
either  fair  or  satisfactory,  without  undertaking  a  systematic 
review,  to  depart  from  the  "general  notice"  tone  of  these 
remarks.  Loath,  however,  to  leave  it  without  tendering  a 
sample  of  so  remarkable  a  treatise,  we  cite  a  passage  which  is 
to  be  found  at  p.  61-2  of  the  second  volume,  near  the  beginning 
of  the  chapter  headed  "  Fundametital  Correlations  of  the  Laws 
of  Growth  and  Development  of  the  Laws  of  Thought" : — 

"418.    The  development  of  the  organic  basis  of  the  vital 


by  Dr,  MacOilchrisi.  579 

powers,  and  the  evolation  of  the  sabstrata  of  the  knowing 
facnities,  both  follow  the  same  law.  First  we  see  the  simplest 
evolation  of  the  combined  action  to  unity  of  the  various  funda-' 
mental  processes  whereby  life  is  maintained  in  an  organism  of 
the  simplest  form,  as  a  zooid  or  polype.  Then,  as  we  ascend 
the  sbale,  and  differentiation  of  tissue  takes  place,  there  is  a 
correlative  manifestation  of  the  fundamental  or  teleiotic  *  ideas, 
and  instincts  of  plants  or  animals  appear,  with  their  appropriate 
instruments  and  vital  substratum.  As  we  ascend  still  higher 
in  animal  life,  the  instincts  gradually  lose  their  unknow- 
ing  character,  and  the  mental  faculties  emerge,  with  their 
appropriate  organic  basis  in  the  encephalon,  and  their  appro- 
priate vital  mechanism  or  instruments.  Finally,  with  ^the 
highest  evolution  of  the  biotic  [biological]  ideas  we  find  man  in 
his  highest  development,  evincing  in  arts  and  science  the  results 
of  the  operation  of  mental  powers,  which  in  the  lowest  animals 
are  purely  instinctive,  in  the  lowest  organisms  simply  vital 
processes.  The  derivative  teleiotic  ideas  have  become  completed 
as  noetic  [intellectual]  ideas  or  cognitions.  The  intellect  is 
supreme. 

[From  this  mark  what  follows.] 

"414.  Hence  it  follows,  that,  while  every  fundamental 
intuition,  as  the  correlative  of  a  teleiotic  idea,  is  the  neotic 
basis  of  a  corresponding  mental  faculty  so-called,  or  group  of 
faculties,  it  is  also  the  evolutional  cause  of  a  corresponding 
encephalic  tissue,  or  group  of  tissues — i.  e.,  of  their  vital 
substratum — together  with  the  corresponding  mechanism  of 
external  relations  constructed  to  be  in  affinity  with  external 
phenomena,  viz.,  the  organs  of  the  senses.  And  as  these 
various  machinery  are  developed  and  worked  in  accordance 
with  the  law  of  evolution  of  casual  ideas  (155  sqq.),  and  all 
their  vital  processes  are  dependent  thereon,  however  contingent 
and  variable  they  may  be,  the  fundamental  intuitions  become 
evolved  into  experience,  the  formularised  results  of  which  con- 
stitute a  corresponding  science  and  art,  or  group  of  them. 
This  doctrine,  therefore,  of  correlative  biotic  [physiological] 

*  A  new  word,  as  he  elsewhere  tells  ns,  "  from  rtkttoc  (derivative  of  nXog) 
tummus,  peffedus," 

2o2 


580  Psychological  PhgMlogy, 

and  neotio  [inteUeotnal]  evolation,  is  the  baas,  on  the  one 
hand,  of  a  science  of  Mental  Oboanographt^  and  on  tiie 
other  hand,  of  a  science  of  Induction.  Without  the  mental 
causes  operating  as  biotic  ideas^  there  can  be  no  development 
of  a  proper  9ub$iraium ;  without  the  correlative  substratum, 
there  can  be  no  manifestation  of  mental  power,  and  no  cogni- 
tions, whether  primary  or  deriyative." 

This  passage,  the  latter  paragraph  of  it  especially,  which 
presumedly  contains  the  gist  of  what  the  author  would  be  at, 
is  a  very  characteristic  one.  Numbers  of  passages  very  much 
like  it  occur  throughout  the  work — like  it  in  their  general  style, 
and  like  it  in  the  style  of  their  ratiocination.  It  will  be  seen 
that  a  certain  vital  substratum,  which  the  author  makes  much 
of  throughout,  acts  here  the  part  of  a  fundamental  principle. 
Great  confusion  of  idea  attends  the  use  frequently  made  of  it ; 
and  this  is,  indeed,  inevitable,  seeing  that  this  same  ''  vital 
substratum  "  has  usually  been  taken  by  the  metaphysicians  as 
an  immaterial  substance,  or  the  mind  itself.  Dr.  Laycock  may, 
indeed,  say  that  his  substratum  is  not  the  same  as  that  of  the 
metaphysicians.  In  fact  he  does  say  so,  in  the  first  chapter  of 
this  second  volume ;  but  his  exposition  of  the  matter  amounts 
to  the  institution  of  a  distinction  without  establishing  a  differ- 
ence.* To  him  the  substratum  on  which  he  founds  may 
convey  a  substantial  idea,  but  the  case  must  obviously  be 

*  He  says,  p.  8,  ^'  In  all  metapbyricial  discassions,  therefore,  the  idea  of 
a  9ulfitratum  of  consdoas  states  is  ever  present ;  and  do  what  we  will,  we 
most  call  it  substance  of  some  kind— immaterial,  spiritoal,  material.  [A  mani- 
fest contradiction  in  terms.]  NcTertheless,  although  we  term  it  substance 
and  material,  yet  if  inorganic  be  but  an  assemblage  of  forces,  a  forUorif  we 
must  predicate  the  same  of  the  matter  of  the  brain,  so  highly  organised  as  it 
is,  and  so  conolusiyely  the  seat  of  mind.  But  even  as  an  integration  of 
forces  we  stiU  must  speak  of  it  as  a  substance,  in  so  ikr  as  its  forces  are  in 
relation  to  our  states  of  consciousness ;  for  substance  or  matter  is  fundament- 
ally nothing  more  than  that  which  is  the  seat  of  motion  to  ends,  of  which 
mind  is  the  source  and  cause.  Hence,  as  a  scientific  question,  the  inquiry 
whether  mind  is  material  or  immaterial,  is  valueless.  With  this  understand- 
ing of  the  term,  let  us  now  examine  the  vital  substratum,  &c.  This  examina- 
tion will  enable  us  to  adopt  a  method,''  &c — Then  foUows,  under  the  head 
still  of  **  the  tubstratum  of  eonsdent  mind^"  a  dissertation  shedding  no  ftother 
light  on  this  distinction  without  a  difference. 


hy  Dr.  MacGilchruL  581 

various  or  opposite  with  his  readers,  just  as  it  strikes  them ; 
and  in  any  view  of  it»  this  is  a  very  flimsy  fdndamental  prin- 
ciple on  which  to  rest  any  part  whateyer  of  a  designedly  snh- 
stantial  system,  such  as  our  author  professes  to  have  evolved. 

Again,  it  will  be  seen  that  here  we  are  referred  to  a  previous 
exposition  (at  paragraph  155,  et  seq.,  in  the  first  volume)  of  a 
law  of  evohitum  of  carnal  ideas,  on  "which  part  of  the  argu- 
ment, or  "  doctrine,"  as  the  author  says,  turns.  But  when  we 
recur  to  what  is  said  in  that  part  of  the  work,  under  the  not 
very  concise  head  of  "  Modes  of  Derivative  Evolution  of  Ide<u 
considered  as  Causes,"  we  find  it  too  indefinite  and  hypothe- 
tical to  deserve  in  any  degree  to  rank  as  a  demonstration  of  a 
law  of  casual  ideas.  The  word  law,  which  should  be  always 
appropriately  and  precisely  applied — which  scientifically  should 
be  held  in  a  certain  sort  of  sacredness — is  here,  as  frequently  else- 
where, abused  by  Dr.  Laycock ;  great  part  of  whose  involved 
language,  like  that  of  the  above  paragraph,  when  evolved, 
proves  to  be  essentially  speculative  or  metaphysical. 

But  though,  as  a  systematic  exposition,  this  work  is  too 
evidently  a  failure,  we  cannot  dismiss  it  without  expressing  the 
sense  we  have  of  its  authors  varied  information  and  general 
accomplishments.  Elsewhere,  perhaps,  Dr.  Laycock  has  been 
happier;  but  as  an  encyolopedic  book,  this  is  well  worthy  a 
place  on  the  shelves  of  every  physician's  library.  The  general 
medical  reader  into  whose  hands  it  may  fall  we  would  advise  to 
peruse  it  from  the  end  towards  the  beginning,  taking  Part  VI. 
(''Principles  of  Mental  Organography"),  which  closes  the 
second  volume,  first,  and  so  on  backwards  till  the  first  volume 
is  reached,  when,  probably,  he  may  feel,  with  us,  that  he  has 
had  enough  of  Mind  and  Brain. 

We  have  now  reviewed  the  subject  in  its  general  relations, 
and  the  result  seems  to  show,  contrary  perhaps  to  common 
expectation  and  belief,  that,  as  yet,  the  advanced  philosophers 
have  done  more  towards  reconciling  the  long  confiicting  pheno- 
mena of  mind  and  organization  than  the  anatomists  and  phy- 
siologists; that  psychological  physiology  is  indebted  for  its 
present  hopeful  position  more  to  a  Ficbte,  a  Mill,  or  a  Spencer, 


683  Psj/ckoloffical  Phytioldg}/, 

than  to  a  Holland,  a  Layoock,  or  a  Carpenter.*  That  this 
will  be  rerersed  in  the  fdtnre,  however,  seems  oertain.  The 
gulf  to  be  bridged  has  already  lost  much  of  its  breadth  on 
the  philosophical  side,  and  if  the  work  is  more  difficult 
and  therefore  proceeds  slower  from  the  scientifio  shore,  it  will 
prove  more  solid.  Mental  philosophy  is  old,  vital  science  is 
young.  The  doctrines  founded  on  the  assumed  independent 
essence  and  abstract  relations  of  the  human  mind,  have  grown 
into  creeds  which,  in  the  eyes  of  their  disciples,  have  some- 
thing awfully  sacred  about  them  ;  whilst  the  teachings  and 
tendencies  of  cerebral  and  comparative  physiology  want  as  yet, 
that  unity  and  universality  of  aim — or  cannot  give  adequate 
expression  to  a  creed — which  would  go  far  to  recommend  them 
in  quarters  where  they  are  still  regarded  as  crude,  vulgar,  and 
materialistic.  But  science,  through  its  destined  practical  repre- 
sentative, biology — the  science  of  life  is  the  advancing,  whilst 
mental  science,  or  metaphysical  philosophy,  its  representative, 
is  the  retiring  power  in  modem  education  and  civilization. 

This  fact  is  not  necessarily  inconsistent  with  the  relations 
assigned  above  to  the  two  sides  of  psychological  physiology. 
All  feudalisms  must  lay  down  their  barbaric  pomps,  and  submit 
to  be  merged  in  the  law  and  order  of  practical  governments. 
Philosophy  is  now  unwillingly  abrogating  the  kind  of  feudal 
reign  she  has  maintained  over  letters  during  the  many  centuries 
that  have  intervened  betwixt  Thales,  the  father  of  Greek  specu- 
lation, and  Elant,  the  last  of  the  great  philosophical  system- 
mongers.  It  may  be  sad  for  tbe  romancers  and  dreamers,  but 
it  is  true;  and  here  and  there  a  dreamer — as  Fiohte,  the 
younger,  kc, — throws  oiF  the  old  illusions,  and  rising  up  listens 
to  the  questioning  of  the  iron  reasoner  Science,  till  recognising 
in  him  no  longer  an   enemy,  but  a  younger  and  healthier 

*  The  latter  is  to  be  regarded,  however,  as  one  of  those  famous  oompQera  who 
do  little  directly  for  the  adrancement  of  science;  about  whom  ihere  is 
nothing  original ;  who  are .  alwa3r8  '*  reoonciling ''  the  facts  of  science  with 
the  dominant  theological  or  social  orthodoxy  of  the  day ;  and  who  are  given, 
undesignedly  perhaps,  to  the  sin  of  literary  piracy.  Dr.  Laycook  has  fairly 
established  such  a  charge  against  Dr.  Carpenter.-~6ec  the  Appendix  to  Mvid 
and  Brain, 


hy  Dr.  MacGilcArisi.  583 

brother,  he  takes  him  by  the  hand.  Soon  this  young  Science 
wiil  be  a  man,  and  then  it  will  be  his  turn  to  snpport  the 
tottering  frame  of  aged  Philosophy.  But  as  yet  the  age  is  more 
or  less  transitional. 

Auguste  Comte  has  laboured  to  show  this  systematically. 
In  this  country,  his  views  have  not  met  with  the  attention  or 
acceptance  they  generally  deserve  perhaps;  but  it  is  now  begin- 
ning to  be  recognised  that  he  was  at  least  in  advance  of  his 
time,  and  that,  in  Comte,  France  has  stepped  before  both  Ger- 
many and  England.  His  elaborate  work,  the  Cour$  de  Philo* 
9ophie  Positive,  is  well  known  by  more  than  one  English 
translation,  that  of  the  indefatigable  G.  H.  Lewes  being  the 
most  concise;  and  there  are  not  a  few  among  the  advanced 
thinkers  of  the  three  countries  (England,  France,  and  Ger- 
many) who  regard  this  work  as  the  greatest  of  our  century. 
Comte  not  only  claims  to  have  discovered  the  great  law  of 
mental  evolution;  he^has  applied  it  historically,  and,  as  his 
disciples  believe,  conclusively.  The  scope  of  his  positive 
philosophy  is  too  wide  of  our  subject,  but  as  bearing  upon  part 
of  it,  and  what  has  been  said  in  the  last  paragraph,  we  may 
state,  in  the  words  of  Lewes,  this  law  of  mental  evolution, 
which  is  also,  according  to  Comte's  exposition  of  it,  the  law  of 
historical  progression : — 

''Every  branch  of  knowledge  passes  successively  through 
three  stages : — 1st,  The  supernatural  or  fictitious ;  2nd,  The 
metaphysical,  or  abstract;  3rd,  The  positive,  or  scientific. 
The  first  is  the  necessary  point  of  departure  taken  by  human 
intelligence;  the  second  is  merely  a  stage  of  transition  from 
the  supernatural  to  the  positive ;  and  the  third  is  the  fixed  and 
definite  condition  in  which  knowledge  is  alone  capable  of  pro- 
gressive development. 

"  In  the  supernatural  stage,  the  mind  seeks  after  causes ; 
aspires  to  know  the  essettces  of  things,  and  their  modes  of 
operation*  It  regards  all  effects  as  the  productions  of  super- 
natural agents,  whose  intervention  is  the  cause  of  all  apparent 
anomalies  and  irregularities.  Nature  is  animated  by  super- 
natural beings.  Every  unusual  phenomenon  is  the  sign  of  the 
pleasure  or  displeasure  of  some  being  adored  and  propitiated 


584  Psychological  Physiology, 

as  a  god.  The  lowest  condition  of  this  stage  is  that  of  the 
savages,  vis.,  Fetiohism.  The  highest  condition  is  where  one 
being  is  sahstituted  for  many  as  the  personal  cause  of  the 
phenomena.  —  In  the  metaphysical  stage,  which  is  only  a 
modification  of  the  former,  bat  which  is  important  as  a  tran- 
sitional stage,  the  sapematnral  agents  give  way  to  abstract 
forces  (personified  abstractions),  supposed  to  inhere  in  the 
▼arions  substances,  and  capable  themselves  of  engendering 
phenomena.  The  highest  condition  of  this  stage  is  when  all 
these  forces  are  brought  under  one  general  force  named  Nature. — 
In  the  positive  stage,  the  mind,  convinced  of  the  futility  of  all 
inquiry  into  causes  and  essences,  applies  itself  to  the  observa- 
tion and  classification  of  laws  which  regulate  eflects,  i.e.,  the 
invariable  relations  of  succession  and  similitude  which  all 
things  bear  to  each  other.  The  highest  condition  of  this  stage 
would  be,  to  be  able  to  present  all  phenomena  as  the  various 
particulars  of  one  general  view."  « 

Do  we  not  feel  as  if  here,  Comte's  other  views  apart,  we  had 
touched  the  great  problem  of  our  century  ?  Is  it  not  indeed 
to  this  that  the  various  labours  of  science  are  insensibly 
tending  ? — to  be  able  to  present  all  phetwmena  as  the  various 
particulars  of  one  view. 

Meanwhile,  the  more  special  problem  of  psychological^phy- 
siology  tends  towards  the  solution  it  demands.  It  may  well 
be  questioned  whether,  in  the  phase  through  which  science  gene- 
rally is  now  passing,  it  is  longer  possible  to  study  the  pheno- 
mena of  mind  and  those  of  organization  apart;  and,  accordingly, 
the  conviction  that  they  must  be  taken  together  as  particulars 
of  one  general  view,  begins  to  penetrate  from  both  sides :  the 
psychologist  and  the  physiologist  are  approaching  each  other 
apace. 

The  difficulties,  on  the  biological  side  especially,  are  still 
confessedly  great,  and  it  remains  a  question,  by  what  mode  of 
presenting  the  facts  and  phenomena  at  his  disposal  the  philo- 
sophical physiologist  may  best  smooth  the  way.  We  humbly 
conceive  that  the  most  natural  and  simple  plan  is  likely  to 
prove  the  best.  He  should  approach  the  subject  from  the 
scientific  side,  rather  than — ^like  Dr.  Laycock  and  other&r-from 


hy  Dr.  MacGilchrut.  685 

the  old  metaphyBico-psyohoIogical  side.  By  way  of  introduo* 
tion,  what  is  wanted  is,  not  long  dissertations  **  towards  the 
development  of  an  appropriate  philosophical  method,  with  a 
view  to  the  elimination  of  principles/'  bnt  only,  meanwhile,  a 
concise  and  comprehensive  exposition  of  the  extant  correlations 
of  science,  philosophy,  and  biological  medicine,  weeded  alike  of 
the  verbatim  deliverances  of  the  philosophical  system-mongers, 
and  the  scientific  crotchets  of  the  medical  psychologists.* 
Then  should  follow  a  clear  statement  of  the  most  general  and 
important  principles  upon  which  this  science  of  psychological 
physiology  may  claim  to  found ;  and  the  illustration  of  these, 
with  the  amplification  of  the  results  thence  deducible,  would 
complete  the  simple  plan  of  the  concise  book  which  is  yet  to  be 
written  towards  reconciling  generally  the  psychological  and 
physiological  phenomena  from  the  scientific  side. 

As  to  what  these  principles  are  which  should  in  this  way 
receive  due  illustratioiu  this  is  not  the  place  to  inquire  further ; 
but  there  is  one  of  such  importance  in  itself,  and  capable 
through  its  illustrations  of  such  practical  conclusions,  that  it 
may  be  noticed.  It  has  reference  to  the  doctrine.  Dr.  Laycock 
deserves  so  much  credit  for  having  first  eliminated  distinctly, 
of  the  reflex  function  of  the  cerebrum.  While  every  other  part 
of  the  nervous  system  has  been  credited  with  the  phenomena  of 
reflex  action,  the  brain  proper  alone — the  cerebrum  specially, 
as  the  organ  known  to  be  intimately  concerned  in  the  formation 
of  ideas — the  cerebrum  continued  to  be  viewed,  till  just  the 
other  day  we  may  say,  as  something  apart,  which  it  was  difficult 
or  impossible  to  understand,  whose  special  function  it  was 
perhaps  presumptuous  to  elucidate.  Most  probably,  the  efforts 
of  Qall  and  Spurzheim  to  expound  its  functions  speciaUy  and 
systematically,  tended  to  discourage  further  exploration  in  this 
ticklish  frontier  ground  which  touches  literally  both  the  mental 
and  the  corporeal  ego.  Otherwise  it  seems  strange,  now  that 
it  is  acknowledged,  physiologists  were  so  long  of  coming  to  the 
simple  and  natural  conclusion  that  this  cerebrum,  this  organ  of 

*  Among  the  latter,  e.g,t  the  extreme  views  on  insanity,  of  which  Dr. 
Forbes  Winslow  is  presently  the  representative,  and  of  which  Dr.  Laycock 
also  seems  enamoured. 


586  P^jfchological  Ph^ology. 

mind,  is  no  exception  to  the  rest  of  the  nerrous  system,  of 
which  it  is  the  consummation,  in  the  main  oharacteiistic  of  a 
developed  nervoas  system — reflex  action.  What  must  flow  from 
this  natural  admission  (taken  in  connection  with  the  duality 
of  the  cerebrum,  and  the  semi-independence  of  each  of  its 
hemispheres),  invoWes  conclusions  more  important  perhaps 
than  most  people  are  aware,  or  at  first  view  may  appear.  One 
of  these  is,  that  the  encephalic  ganglia  may  be  placed  tempo* 
rarily,  partially,  or  wholly,  in  the  condition  of  the  "true  spinal" 
or  reflex  system,  to  the  suspension  of  the  action  of  volition 
and  consciousness ;  as  conversely,  ideas  may  produce  motions 
independently  of  volition,  through  the  cerebrum  exciting  the 
spinal  cord  independently  of  the  other  centres.  Now  if  this  be 
true,  it  goes  at  once  to  unravel  nearly  all  the  mystery  of  those 
so-called  ''  abnormal  phenomena "  of  the  mind  which  have 
given  occasion  for  so  much  ingenious  psychological  specula- 
tion— trance,  coma,  somnambulism,  dreaming,  ghost-seeing, 
&c.  Its  applications  in  other  directions  and  relations  are 
probably  not  less  significant  Their  elucidation  would  effec- 
tually dispose,  inter  aiia,  of  the  metapbysico-psychological 
view  which  represents  the  soul  as  "  the  formative  principle  "  of 
the  body,  and  explain,  on  scientific  instead  of  speculative  prin* 
ciples,  the  doctrine  of  the  preconscioue  as  distinguished  from 
the  conscious  or  ordinary  ''  life  of  the  soul,"  which  is  a  con- 
spicuous part  of  some  modem  psychological  systems.  To  some 
extent  this  has  been  pointed  out  already,  but  only  casually  and 
incidentally.  When  more  comprehensively  applied,  the  pheno- 
mena of  the  reflex  function  of  the  cerebrum — ^involving  those 
of  what  has  been  termed  ''  unconscious  cerebration" — will  tend 
to  approximate  mind  and  brain,  to  a  degree  perhaps  not  yet 
generally  suspected. 

Finally,  as  the  correlative  view  of  such  organic  phenomena, 
there  is  the  luminous  principle  which  comes  to  us  rather  from 
the  psychological  side,  already  alluded  to  as  perhaps  the  most 
important  deduction  of  psychological  physiology,  and  which 
finds  its  consummation  in  the  dictum  adopted  by  Fichte,  that 
the  external  functions  of  the  nervous  system  are  really  mitid 
become  visible.    A  conclusion  to  be  further  arrived  at  by  a 


by  Dr.  MacGilcArist.  687 

correlation  of  the  mental  processes  with  the  different  fdnctionsy 
showing  their  correspondence^  and  demonstrating  that  the 
strncture  and  plan  of  the  nervous  system  offer  a  perfect  reflex 
of  mental  relations.  The  great  significance  of  such  a  demon- 
stration has  been  fully  recognised  by  Dr.  Laycock,  whose 
exposition  of  the  Correlations  of  Consciousness  and  Organisa- 
Hon  (or  Mind  and  Brain)  is  an  undoubtedly  ingenioas  attempt 
chiefly  in  this  direction ;  although,  being  a  chaotic  work  before 
its  time,  it  wholly  fails. 

Considering  the  results  already  obtained,  viz.,  1st,  The 
partial  explosion  of  metaphysics,  for  which  some  of  the  philo- 
sophers even  are  losing  reverence,  as  incompetent  to  deal  with 
any  of  the  questions  which  are  now  appealing  to  science ;  2ndly, 
The  advances  the  new  psychologists  are  making  towards  phy- 
siological interpretations  of  mental  phenomena ;  and  Hrdly, 
The  gleams  of  new  light  which  are  appearing  on  the  biological 
horizon — it  seems  more  than  probable  that  the  day  is  not  far 
distant  when  the  extant  doctrine  of  thought  as  an  entity  super- 
added to  the  organ  of  thought  will  be  abandoned  on  all  sides, 
and  this  sublimer  faith  reign  in  its  stead  :  That  matter  organised 
to  the  utmost,  organisation  developed  to  the  human  highest, 
becomes  self-conscious.  A  sublimer  faith  than  the  old  super- 
natural or  metaphysical  one ;  because  the  latter  was,  and  ever 
must  remain,  essentially  speculative,  and  therefore  chaotic. 
Once  realised  and  applied  psychologically,  the  biological  idea 
of  the  self'consciousness  0/ matter  loses  its  supposed  grossness, 
and  becomes  indeed  sublime.  The  old  but  ever  renewed  war 
between  materialism  and  immaterialism  must  cease,  when  it  is 
generally  seen  that  it  is  only  a  childish  dispute  about  words, 
and  that  the  attributes  of  Sensative  Matter  are  nothing  less, 
though  they  may  signify  much  more,  than  the  pneumatical 
entities  with  which  the  metaphysical  philosophers  have  endowed 
what  they  call  Mind. 


588 


PERFECT  CURE  OF  AN  EXTENSIVE  OVARIAN 

CYST, 

WITH  BOMB  BEMARKS  ON  THE  EXCEPTIONAL  EXHIBITION  OF 
LABOEB  DOSES  OF  MEDICINE,  AND  ON  THE  EFFECTS  OF 
MINERAL  WATEB. 

By  Dr.  Hibsch,  Prague.* 

Madame  Miethsam,  milliner,  50  years  old,  married,  but  with- 
out children,  sent  for  me  in  Aagust,  1857,  to  pay  her  a  visit. 
I  found  a  leuoo-phlegmatio  individual  in  bed,  more  sitting  than 
lying,  as  the  horizontal  posture  brought  on  violent  tightness  of 
the  chest,  shortness  of  breath,  and  even  vertigo.  After  I  had 
carefully  examined  the  chest  and  contained  organs,  by  per- 
cussion and  auscultation,  and  found  them  perfectly  normal,  I 
proceeded  to  the  examination  of  the  abdomen,  a  mere  glance  at 
which  at  once  surprised  me  most  painfully,  by  its  very  evident 
distention.  The  surface  was  pale,  somewhat  shining,  tightly 
distended.  In  the  region  of  the  umbilicus  stood  a  cylindrical 
swelling,  thicker  than  one's  thumb,  an  inch  high,  which  how- 
ever, by  slight  compression,  admitted  of  diminution  ;  whilst  its 
gaseous  contents  were  forced  back  into  the  abdominal  cavity. 
On  relaxing  the  pressure,  the  tumor  returned  to  its  former  size. 
The  abdomen,  tightly  stretched,  excessively  distended,  and 
quite  smooth  to  the  touch,  gave  unmistakeable  evidence  of 
fluctuation,  yet  it  could  be  plainly  discovered,  by  percussion, 
that  the  collection  was  enclosed  in  a  cyst,  since  the  sound  was 
much  clearer  on  each  side,  in  the  depth  of  the  lumbar  region. 
And  what  further  led,  especially  to  a  perfect  certainty  in  the 
diagnosis,  was  the  inquiry  into  the  previous  history,  from 
which  it  appeared  that  the  patient  had,  nine  years  before,  been 
attacked  by  severe  oophoritis  of  the  left  side,  during  which  a 
rigorous  energetic  allopathic  course,  with  repeated  local  and 
general  bleeding,  as  well  as  continued  applications  of  cata- 
plasms sufficed  indeed  to  relieve  the  pain,  but  left  behind  a 

*  From  Meyer's  AUgemeine  Bbm^opathUche  ZeUunff^  May,  17, 1862. 


Cure  of  Ovarian  Cyst.  589 

persistent  tamor,  gradually  extending  more  and  more  towards 
the  centre,  and  at  last  even  towards  the  right  side. 

Tarious  remedies  haying  been  tried  by  varioas  physicians 
daring  the  following  year,  at  least  to  check  the  progress  of  the 
malady,  but  alas !  without  success ;  the  patient  had  recourse 
to  a  clinical  professor  of  this  place,  who,  according  to  his  thera- 
peutic principles,  exerted  himself  to  an  unlimited  extent,  but 
"with  infinitely  small  success ;  nay,  on  the  contrary,  by  a  steady 
continuance  (with  some  variations)  of  solvent,  drastic,  and 
diuretic  medicines,  hindered  the  digestive  functions,  and  thereby 
the  nutritive  process,  and  reduced  the  general  powers  of  the 
patient  to  such  a  degree,  that  the  following  complication  of 
symptoms  were  manifested  besides  the  original  local  affection : 

Along  with  a  total  loss  of  appetite,  the  tongue  was  coated 
with  yellow,  and  at  the  same  time  had  a  tendency  to  dryness. 
Even  after  taking  water,  or  clear  meat  broth,  frequent  eructa- 
tion ensued.  No  stool  took  place  any  longer  without  previous 
purgatives ;  pulse  small,  somewhat  accelerated ;  the  muscles, 
which  a  year  before  had  been  tolerably  strong  and  firm,  were 
now  flabby  and  shrunk.  The  patient  felt  so  feeble  that  she 
conld  with  difficulty  keep  on  her  legs  for  a  few  minutes. 
Besides  this^  for  some  days  an  excessively  tormenting  (mostly 
dry)  cough  had  set  in,  which,  especially  at  night,  was  accom- 
panied by  regular  fits  of  suffocation.  At  the  same  time,  the 
urine  was  scanty  and  brownish,  and  when  analysed  exhibited 
no  considerable  amount  of  albumen. 

The  symptoms  now  sketched,  as  well  as  a  regard  to  the 
circumstance  that  the  patient  had  become  so  evidently  enfeebled 
by  the  continued  exhibition  of  solvent  and  purgative  medicines, 
determined  at  once  the  prescription  of  chitia»  which  I  ordered 
to  be  taken  in  the  Bth  dilution  three  times  a  day,  a  small 
portion  of  a  drop  in  a  powder  of  saccharum  lactis.  By 
the  continued  use  of  this  medicine  for  eight  days  a  change 
decidedly  advantageous  commenced  in  the  digestive  system, 
which  manifested  itself  by  a  cleaner  tongue,  by  an  actively 
awakened  desire  for  food,  by  a  more  normal  digestion  and 
gradually  even  by  spontaneous  action  of  the  bowels.  The 
pulse,  in  regard  to  frequency,  had  quite  returned  to  its  normal 


590  Cure  of  Ovarian  Cyst, 

state.     The  patient  felt  herself  strooger,  was  able  to  paas 
several  hours  out  of-  bed,  sitting  in  an  easy  chair;  slept  some- 
what longer  at  night ;  her  temper  was  more  serene.     Still  the 
coagh  kept  steadily  up  to  the  same  point,  mostly  dry,  straining, 
as  if  a  tough,  thick  phlegm  were  settled  in  the  trachea,  which 
was  only  now  and  then  and  Tery  sparingly  coughed  up,  and 
had  an  extraordinary  salt  taste.     These  fits  of  coughing  were 
generally  accompanied  by  severe  pressure  on  the  chest,  and 
uncommon  shortness  of  breath,  and  even  after  the  fits  of  congh* 
ing  were  quite  over,  a  still  longer  time  elapsed  before  this  kind 
of  asthmatic  suffering  subsides.      In  accordance  with   these 
symptoms  I  resolved  on  the  exhibition  of  cannabis  saiiva,  and 
so  much  the  more,  as  this  medicine  seemed  to  me  to  be  espe- 
cially indicated  because  of  its  relation  to  abdominal  cysts.     The 
patient  took,  three  times  a  day,   10  to  15  globules  moist- 
ened with  the  3rd  dilution,  and  in  a  few  days  the  beneficial 
influence  of  this  medicine  was  unmistakeable.     The  fits  of 
coughing  occurred  seldomer,  with  less  violence,  and  the  diffi- 
culty of  breathing  was  considerably  diminished.     By  continaed 
use,  without  interruption,  of  cannabis,  the  cough  and  difficulty 
of  breathing  had  entirely  given  way  within  the  next  eight  days; 
and  also  in  regard  of  the  urinary  secretion,  an  alteration  was 
so  far  observable  that  it  appeared  clearer  and  purer,  still  its 
quality  remained  much  the  same  as  before.     I  continued  the 
use  of  this  medicine,  but  prescribed  it  in  the  1st  dilution,  and 
made  the  patient  take  one  drop  in  a  teaspoonful  of  water  every 
four  hours.     Although  the  measurement  of  the  abdominal 
circumference  taken  after  a  period  of  fourteen  days  showed  no 
perceptible  diminution,  yet  on  the  other  hand,  it  appeared  that 
now  the  horizontal  posture  could  be  better  tolerated  in  bed,  the 
patient  could  turn  from  side  to  side,  and  step  out  of  bed  without 
help.     The  quantity  of  urine  had  increased  about  6  oz.  in 
twenty-four  hours,  on  the  average ;  yet  the  stools  took  place 
seldom   and  scantily,  on  which  account  I   prescribed  a  few 
doses  of  Sulphur  12,  at  intervals  of  two  days,  whereupon  a 
greater  activity  in  this  abdominal  function  was  manifested,  and 
again  I  continued  the  use  of  cannabis  as  before,  when,  after  an 
interval  of  fourteen  days,  the  measurement  of  the  abdomen  for 


hy  Dr.  Hirsch,  591 

the  first  time  gave  a  favourable  result^  inasmuch  as  it  had 
diminished  somewhat  more  than  two  inches.    The  nearly  hori- 
zontal posture  in  bed  was  now  established  without  inconveni- 
ence;  the  quantity  of  urine  was  increased,  on  the  average, 
about  6  or  8  oz.  per  day.     Full  of  the  best  hopes  that  I  should 
by  the  persevering  use  of  cannabis  attain  increasingly  favour- 
able results  in  the  local  affection,  I  found  myself  somewhat 
disappointed  after  the  next  measurement,  taken  after  a  further 
interval  of  fourteen  days,  as  I  observed  not  the  slightest  pro- 
gress in  the  expected  decrease  of  the  abdominal  circumference, 
although  the  quantity  of  urine  exhibited  no  diminution.     Still 
my  confidence  in  this  remedy  never  wavered.     I  had  recourse 
to  the  mother  tincture ;  but  even  this  failed  in  its  duty,  which 
served  me  as  a  sure  sign  that  the  system  was  no  longer  suscep- 
tible to  this  medicine,  which   had  now  been   exhibited  for 
several  weeks;   a  phenomenon  which  many  practitioners  will 
have  already  observed  as  well  as  myself.     Now  my  choice  fell 
on  Iodine,  and  as  manifold  experience  had  taught  me  that  this 
medicine,  especially  in   chronic  cases  suited  for  its  action, 
developes  its  efficacy  far  more  certainly  in  the  form  of  mineral 
waters  impregnated  with  iodine,  so  I  resolved  on  prescribing 
Iodine  water  of  Hall,  upon  which  I  shall  come  to  speak  more 
particularly  elsewhere  in  the  course  of  this  paper.    I  ordered 
the  patient  to  take  three  tablespoonfuls  of  this  iodized  spa  every 
morning  fasting;  and  thus,  according  to  the  newest  chemical 
analysis,  she  was  taking  about  the  forty-eighth  of  a  grain  of 
iodine  at  each  dose.     After  eight  days  of  this  treatment  visible 
changes  plainly  appeared,  consisting  chiefly  in  this,  that  a 
much  livelier  activity  was  to  be  observed  as  well  in  the  kidneys 
as  in  the  outer  skin.    In  the  same  proportion  as  the  secretion 
of  urine  increased  constantly  and  considerably,  so  the  skin, 
previously  rather  cold  and  inert,  was  now  almost  constantly  in 
a  gentle  perspiration,   which,  especially  during  sleep,  often 
proceeded  even  to  a  complete  sweat,  and  in  this  same  propor- 
tion the  abdomen,  which  a  short  time  before  had  been  so 
tightly  stretched  and  extended  to  such  remarkable  dimensions, 
gradually  began  to  grow  slacker,  and  to  assume  a  more  doughy 
consistency. 


592  Cure  of  Ovarian  Cy9t. 

After  fourteen  days  txeatment  vith  tbe  Iodized  water  tbe 
measurement  showed  a  surprising  dimination  of  the  abdominal 
drcamference.  In  order  to  keep  the  system  sensitive  to  the 
further  beneficial  operation  of  the  Iodized  spring,  I  allowed  an 
interval  of  several  days  in  the  exhibition  of  it,  and  as  soon  as  I 
remarked  that  the  secretion  of  nrine  began  to  become  again 
somewhat  more  scanty,  the  use  of  the  Iodized  water  was 
resumed,  and  at  once  an  important  increase  of  urine  was 
remarked,  and  at  the  same  time  a  visible  diminution  in  the 
distension  of  tbe  abdomen,  which  was  constantly  growing  flatter. 
As  the  patient  was  otherwise  quite  well,  I  continued  the  use  of 
the  Hall  water  during  a  period  of  four  weeks  (with  a  single 
interruption  of  five  days),  by  which  the  absorption  of  the 
encystic  fluid  was  almost  completed.  Next,  I  ordered  the 
patient,  laying  aside  the  use  of  all  medicine,  to  live  in  the 
country,  in  a  healthy  woody  region,  for  several  months.  By 
frequent  exercise  in  the  open  air,  by  regular,  light,  nourishing 
food,  she  gained  so  much  in  strength  and  freshness,  that  after 
three  months  she  returned  to  town  in  the  exuberance  of  full 
health. 

From  a  careful  examination  of  the  abdomen  (now  quite 
reduced  to  its  normal  dimensions  and  perfectly  soft),  it  was 
ascertained  that  the  contents  of  the  cyst  were  completely 
absorbed ;  and  as  the  surest  proof  of  a  fundamental  and 
perfect  cure  might  be  accepted  the  fact,  that  four  years  have 
passed  since,  without  the  slightest  trace  of  relapse  having 
shown  itself. 

This  case  of  perfect  cure  of  an  extensive  ovarian  cyst  claims 
considerable  interest  for  its  own  sake,  yet  this  will  be  the  more 
heightened  if  we  take  into  account  that  this  brilliant  curative 
result  was  brought  about  solely  by  the  operation  of  medicine 
acting  specifically.  It  can  not  be  disputed  that  coftnabts 
developed  a  strikingly  specific  efficacy  for  the  complication  of 
symptoms  that  were  present,  yet  is  it  undeniable  that  the  greater 
part  of  the  most  essential  benefit  was  attained  by  the  use,  for 
many  weeks,  of  the  Hall  Iodized  water ;  but  whether  it  was 
exclusively  the  iodine  contained  in  this  spa  to  which  we  ought 
in  preference  to  ascribe  this  cure,  I  might  so  much  the  more 


fty  Dr.  Hinch.  598 

doabt,  in  «8  mnoh  as,  during  many  attempts  to  cure  hyper- 
trophy of  the  thyroid  glands  by  higher  or  lower  dilations  of 
Iodine,  I  was  not  able  to  attain  any  important  results,  but  sinoe 
I  haT6  almost  solely  used  the  Hall  water  in  such  cases, 
and  that  in  the  doses  above  indicated,  I  cannot  with  sufficient 
emphasis  extol  the  excellent  effects  of  this  mineral  spring  in 
such  oases.  It  is  surely  the  very  peculiar  chemical  composi- 
tion of  this  well,  proceeding  from  the  great  laboratory  of 
nature,  which  presents  us  there  with  a  very  peculiar  medicine. 
If  we  oast  a  glance  at  the  chemical  analysis  of  this  powerful 
medicinal  spring,  we  find  as  the  principal  constituents  chloride 
of  sodium^  calcarea,  magnesia,  iodine,  and  bromine.  It  is 
remarkable  that  the  whole  of  these  compound  medicines  stand  in 
striking  relation  to  the  lymphatic  system  in  general,  and  to 
several  of  its  glandular  structures  in  particular,  with  regard  to 
their  various  indications  of  abnormal  activity  or  inactivity. 
We  cannot,  however,  along  with  this,  accept  as  a  fact  that 
it  is'  this  or  that  one  of  its  constituents  in  particular  to  which  we 
have  to  ascribe  the  result  of  the  treatment,  but  it  is  the  peculiar 
mixture  of  certain  chemical  substances  which  nature  herself 
accomplishes,  forming  a  wondrous  whole,  endowed  with  won- 
drous medicinal  power,  whereby  various  morbid  conditions  still 
to  be  more  precisely  ascertained  by  careful  physiological  prov- 
ing, are  effectually  counteracted.  The  fact  that  we  perceive  in 
these  mineral  waters  a  combination  of  medicinal  substances 
which  exhibit  a  striking  affinity  in  their  physiological  operation, 
might  well  direct  us  approximately  to  an  indication  of  their 
specific  sphere  of  action ;  still,  even  if  we  comprise  the  general 
expression  of  the  effects  of  the  medicines  represented  in  these 
springy,  we  get  but  a  sort  of  general  picture  of  their  specific 
relations  to  the  system.  And  in  this  generalism  the  claims, 
which  we  are  accustomed  to  advance  now-a-days  for  our 
doctrine  of  therapeutics,  are  not  satisfactorily  met. 

So  much  is  certain,  that  the  predominant  constituents  of  the 
Hall  water  agree,  as  to  their  effects  upon  the  lymphatic  system, 
in  one  point,  viz.,  that  by  exciting  a  livelier  activity  in  the 
absorbents,  they  are  enabled  to  produce  absorption  of  the  lym- 
phatic products  abnormally  deposited  in  individual  structures 

VOL.   XX.,  NO.   LXXXII. — OCTOBER,    1862.  2  P 


594  Cure  of  Ovarian  Cyst, 

as  on  the  other  hand,  oolleotively,  in  their  physiological 
relation  to  the  outer  dermoid  system  and  the  kidneys,  they 
exhibit  so  far  a  visible  resemblanoe,  that  they  are  able  to 
determine  these  organs  to  increased  vital  action,  and  to 
more  active  secretions.  Whether,  however,  this  exhibition  of 
action,  by  their  united  powers  ('^  viribus  unitis"),  is  merely 
an  increase,  or  whether  this  spring  has  the  power,  by  its 
peculiar  combination  of  materials,  to  effect  a  quantitively 
modifying  effect  on  the  organism — to  determine  this  ought,  in 
my  opinion,  to  be  no  difiBcult  problem,  and  I  would  with  the 
fullest  confidence  declare  myself  for  the  latter  theory.  We  find* 
however,  very  similar  constituents,  only  in  different  quantative 
proportions,  in  the  Adelheid  spring  at  Oberheilbrunn,  and 
repeatedly  I  had  occasion  to  convince  myself  that  its  mode  of 
acting  differs  essentially  from  that  of  the  Hall  water.  It 
must  be  highly  probable,  since  the  proportions  of  Iodine  in  the 
two  spas  are  tolerably  equal,  that  the  considerably  greater 
amount  of  Chloride  of  Sodium  at  Hall  causes  this  difference 
in  the  medicinal  effects,  and  especially  makes  the  cbaracteiistic 
Iodine  symptoms  somewhat  less  marked ;  for  it  is  a  striking 
phenomenon,  that  by  the  continued  use  of  the  Adelheid  spa, 
the  shrinking  and  disappearance  of  the  mammary  glands  in 
women  so  often  occurs  as  a  predominant  Iodine  symptom ;  whilst 
I  never  observed  this  phenomenon  during  the  moderate  use.  of 
the  Hall  water.  From  the  fact  that  we  view,  and  must  view 
each  mineral  spring  severally  in  its  peculiar  composition  as  a 
distinct  medicine,  the  reproach  with  which  the  allopathic 
school  assail  the  homceopaths,  namely,  that  "  we  also  oftea 
have  recourse  to  these  so  complex  mineral  waters,"  will  be 
perceived  to  have  no  soundness,  and  to  be  null  and  void* 
It  is  certainly  much  to  be  regretted  that,  up  to  this  time,  we 
have  before  us  no  really  thorough  and  extensive  provings  (or  at 
least  very  scanty  ones)  of  the  individual  mineral  springs,  and 
that,  consequently,  we  are  for  the  most  part  obliged  to  draw 
our  indications  for  the  several  springs  chiefly  from  the  cures 
already  effected  (ex  usu  in  morbis),  as  well  as,  approximately, 
from  the  collection  of  the  ascertained  physiological  effects  of 
the  main  constituents  of  each  spa.    Yet  will  we  indulge  the 


by  Dr.  Hirsch.  595 

pleasing  hope  that  even  those  desiderata,  towards  which 
much  is  already  contribtited  by  many,  will  in  time  be  sup- 
plied. Further,  as  to  what  concerns  the  dose  in  which  the 
medicines  are  presented  during  the  employment  of  the  mineral 
water;  this,  even  with  a  very  moderate  use  of  the  wells, 
still  is,  strictly  speaking,  not  quite  (of  the  dimensions  called) 
"  homceopathic,"  yet  must  we,  even  in  this  respect,  appeal  to 
experience,  the  only  true  criterion,  and  as  this  teaches  us  that, 
in  the  cases  which,  £rom  the  peculiar  course  of  disease,  are 
specially  suited  to  this  or  that  spa,  the  moderate  use  of  the 
waters  has  approved  itself  as  beneficial  in  manifold  disorders, 
without  doing  harm  in  other  respects,  so  it  would  be  in  the 
highest  degree  superfluous  on  our  part  to  bring  forward 
apologies  of  any  other  kind,  of  which,  however,  without  being 
obliged  to  seek  for  them,  we  should  find  no  lack  whatever. 
Suppose,  for  instance,  we  consider  one  of  the  widest  spread 
species  of  disease,  viz.,  abdominal  plethora,  with  its  various 
concomitant  symptoms,  which  every  year  furnishes  so  con- 
siderable a  contingent  to  the  watering  places,  and  especially 
to  Carlsbad,  Marienbad,  Eissingen,  &o.  Who  are  for  the 
most  part  the  su£Ferers  from  this  ailment?  Epicures — 
people  who,  living  in  excess,  and  long  accustomed  to  ma- 
terial good  living,  know  how  to  tickle  their  palate  with 
dainties  of  various  kinds,  in  order  to  procure  the  admission  of 
too  large  a  proportion  of  food,  and  by  these  means  to  introduce 
into  their  body  more  nutritive  matter  than  it  can  bear  without 
inevitably  suffering  a  disturbance  of  its  functions,  or,  to  speak 
briefly  and  in  homely  terms,  good  folks  who  have  over-fed 
themselves.  Then  comes  the  legion  of  worshippers  of  Gam* 
brinus  and  Bacchus,  who,  through  the  immoderate  use  of 
spirituous  liquors,  lay  the  foundation  of  excessive  venosity  of 
the  blood.  Lastly,  appear  those  poor  fellows  who,  confined  by 
their  vocation  to  a  sedentary  life,  and  often  at  the  same  time 
by  intense  mental  occupation,  give  sufficient  cause  for  venous 
accumulation  and  stases  in  the  abdomen.  In  all  these  indivi- 
duals, with  their  abdominal  plethoras,  produced  either  by 
eating,  drinking,  sitting  or  studying,  the  homoeopathic  physi- 
cian, with  best  intention  and  his  best  choice  of  medicines, 

2p» 


596  Cure  of  Ovarian  Cfst^ 

cannot  attain  the  desired  effect  of  cure,  at  leasts  onless  he  is  in 
a  position  to  remove  the  exciting  causes  for  a  long  time ;  and 
for  the  attainment  of  this  object,  the  most  suitable  means  is  a 
residence  of  several  weeks  ht  a  watering  place.  When  once 
the  patient  gets  there,  he  must  necessarily  conform  to  the 
dietetic  prescriptions  of  his  physician.  Tom  away  from  his 
ordinary  surroundings,  his  mode  of  life  will  be  a  totally 
different  one — a  mode  fiar  more  conformable  to  nature,  a  mode 
considerably  conducive  to  the  cure  or  aUeviation  of  the  com- 
plaint. Under  such  circumstances,  which  of  themselves  are 
enough  to  bring  all  the  organic  functions  into  a  better  track,  a 
very  important  aid  is  rendered  to  the  operation  of  every  medi- 
cine that  is  otherwise  suitable  to  the  morbid  condition.  But  to 
bring  about  this  metamorphosis  of  the  dietetic  and  other  con- 
ditions of  life  without  sending  the  patient  to  a  watering  place  is, 
for  the  most  part,  quite  beyond  the  reach  of  possibility. 

In  the  above  lines  I  ventured  to  remark  that  the  dose 
of  medicine  which  we  employ  in  the  use  of  the  mineral 
waters,  even  ever  so  moderately,  is  still,  after  all,  not  strictly 
^'homoBopathic;"  a  circumstance  to  which  the  adversaries 
of  homoBopathy  refer  very  significantly.  Tet  I  do  not 
properly  comprehend  with  what  reason,  on  the  part  of  the 
allopaths,  so  much  stress  is  laid  upon  the  dose  of  a  specific 
remedy,  which  in  our  eyes  only  appears  somewhat  large, 
as  we  still  often  stumble  upon  expressions  in  which  these 
very  adversaries  express  their  wonder  at  the  uncommonly 
powerful  effects  of  doses  comparatively  so  small,  as  are  pre- 
sent in  the  mineral  waters.  Thus,  we  find  in  Dr.  Oettinger's 
pamphlet,  "  The  Adelheid's  Well  at  Heilbrunn,"  the  following 
very  naive  remark,  after  he  had  spoken  with  astonishment  of 
the  powerful  effects  of  the  minute  constituents  of  spas  in  gene- 
ral : — **  It  is  ascertained  of  chalybeate  water,  that  one  pint,  which 
contains  at  the  most  one-third  to  half  a  grain  of  Oarbonate  of 
Iron,  if  taken  daily  and  for  a  long  time,  acts  with  more  curative 
power  than  a  scruple  of  this  preparation  taken  in  a  solid  form. 
The  case  is  very  similar  with  Adelheid  s  Well.  This,  if  taken 
to  the  amount  of  one  pint  per  day  (equal  to  quarter  of  a 
grain  of  Iodine,  and  one-third  of  a  grain  of  Bromine)  acts 


by  Dr,  Hirsch.  697 

more  as  an  absorbent  tban  grains  of  these  metalloids,  or 
somples  and  drachms  of  the  very  same  salts  of  iodine 
and  hramine.  To  what  then  is  this  to  be  ascribed,  this  so 
mighty  power  of  such  minute  doses  of  medicine  con- 
tained in  the  mineral  waters  ?  Wherein  does  the  secret  lie 
that  these  decimal  parts  in  proportion  to  the  large  doses 
taken  in  a  substantial  form  operate  more  forcibly,  and  present 
more  satisfSactory  curative  results  ?  Probably  we  ought  by 
these  observations  to  attain  the  conviction  that  the  blood 
requires  hardly  more  than  the  decimal  part  of  a  grain  of 
medicine  in  order  to  produce  essential  changes  in  the  circulat- 
ing-fluid,  and  thereby  in  the  whole  organism,  and  that,  there- 
fore, it  is  not  the  quantity  of  medicine  swallowed,  but  only  the 
decimal  portion  of  it  transfused  into  the  blood  that  determines 
the  physiological  effects,  and  therapeutic  results." 

We  perceive  from  the  above  quoted  expressions  of  an  allo- 
pathic physician,  that  they  are  gradually  beginning  to  have  a 
notion,  that  even  with  small  doses  of  medicines  great  effects 
can  be  attained,  although  the  opinion  that  they  develope  their 
efficacy  through  transfusion  in  the  mass  of  blood  cannot  be 
thoroughly  acknowledged  as  correct  in  all  cases.  I  say  "  not 
in  all  cases,"  for  that  there  are  cases  where  the  cure  is  accom- 
plished, not  before  the  medicine  has  arrived  at  the  circulating 
fluid,  seems  to  me  liable  to  no  doubt.  And,  in  &ct,  there  are 
nndisputed  groups  of  disease  whose  proper  essence  consists  in 
this,  that  the  blood  is  more  or  less  deficient  in  this  or  that 
constituent ;  and  as  soon  as  that  desideratum  is  supplied,  the 
force  of  disease  gradually  abates,  and  the  several  organic  func- 
tions return  to  their  normal  condition.  Thus  we  find,  for 
instance,  in  many  cases  of  chlorosis,  that  the  quantity  of  blood 
globules  (always  in  direct  proportion  with  the  presence  of  a 
greater  or  a  less  share  of  iron  in  the  blood)  is  frequently 
diminished  two-thirds.  If  the  patient  gets  iron,  the  volume  of 
blood  globules  gradually  increases,  and  also  the  symptoms  of 
chlorosis  gradually  disappear.  It  is  in  these  cases  especially 
where,  in  my  opinion,  it  becomes  the  duty  of  even  the  homoeo- 
pathic physician  to  incorporate  Iron  into  the  system  in  larger 


698  Cure  of  Ovarian  Cytt, 

qaantity,  ODtil  the  blood  has  attained  its  oonnal  proportioii  of 
Iron,  and,  therewith,  also  its  normal  quantity  of  blood  globules. 
According  to  my  experience,  the  form  of  disease  which  demands 
for  the  purposes  of  cure  these  larger  quantities  of  iron^  makes 
itself  known  by  the  following  symptoms: — Complexion  pale, 
waxlike,  often  somewhat  pu£fed;  remarkable  ansmia  of  the 
mucous  membranes,  distinctly  shown  by  striking  paleness  of  the 
lips,  the  gums,  the  cavity  of  the  mouth,  and  pharynx,  and  the 
conjunctiva ;  feeling  of  faintnees  and  nnking^  especially  in  the 
lower  extremities,  and  also,  consequently,  peculiar  laziness  and 
indisposition  to  occupation;  great  weariness  and  sleepiness, 
even  in  the  morning;  frequent  headache,  like  a  pressure  on 
the  crown ;  pressive  stomachache ;  shortness  of  breath ;  pal- 
pitation of  the  heart  from  exercise,  especially  on  going  up 
stairs;  a  kind  of  purr  in  the  arteries,  as  well  as  the  noted 
*'  nun  sound"  in  the  interval  jugular  on  the  right  side,  clearly 
observable  on  application  of  the  stethescope.  The  menstrual 
discharge  (which  is,  in  general,  of  short  duration,  and  passes 
off  with  labor-like  pains)  is  pale,  watery ;  very  poor  in  blood 
globules ;  abundant  in  mucous  and  epithelial  follicles. 

Several  years  ago  a  young  lady  of  18,  affected  in  a  high 
degree  with  the  above  group  of  symptoms,  came  to  me  from 
Zwickau,  in  Saxony,  accompanied  by  her  mother,  who  ex- 
pressed a  wish,  in  accordance  with  her  physician  at  Zwickau, 
to  try  electricity  a  few  times  on  her  daughter,  previous  to 
undertaking  the  earnestly  prescribed  journey  to  Franzensbad, 
with  the  idea  of  rendering  the  patient  the  more  susceptible  of 
the  influence  of  chalybeate  water.  The  benefit  to  be  expected 
from  this  proceeding  could  not  be  made  quite  clear  to  me,  and 
I  hesitated  to  comply  with  this  wish  so  much  the  more,  as  the 
patient  had,  especially  of  late,  very  frequently  suffered  from 
nervous  headache*  As,  moreover,  the  journey  to  this  spa  was 
commenced  about  a  month  too  soon,  viz.,  in  the  beginning  of 
May,  and  the  patient,  from  the  unfavourable  condition  of  weather, 
had  had  no  reason  to  expect  any  good  results  from  the  mineral 
water  treatment,  and  as  besides  she  was  glad  to  spend  some  time 
with  her  relatives  at  Prague,  whom  I  attended  medically,  I  made 


by  Dr.  Hirseh.  699 

tbe  proposal  (as  independently  of  this  my  aid  was  required  for 
violent  intercurrent  sufferings  during  the  period  preceding  the 
intended  journey  to  F.)  to  make  an  attempt  meanwhile  to 
combat  as  effectuaUy  as  possible  this  ailment  of  one  and  a  half 
years*  standing,  in  order,  at  least,  to  try  and  obtain  some  im- 
provement. 

Although  the  patient  had,  during  the  time  when  she  was 
under  treatment  at  Zwickau,  taken  a  considerable  quantity  of 
Steel  pills  and  powders,  combined  with  aromatic  substances, 
with  the  sole  result  of  producing  frequent  and  violent  fits 
of  megrim,  I  nevertheless  determined  at  once,  supported  by 
repeated  experience,  to  exhibit  iron  again,  only  in  another 
form  much  better  suited  to  the  organism.  Beginning  with 
Tery  small  doses,  I  increased  them  very  gradually,  so  that 
the  patient,  within  the  three  weeks  of  my  medical  attendance, 
took  nearly  an  ounce  of  carbonate  of  iron,  and  by  that 
means,  with  the  co-operation  of  frequent  walks  in  the  open  air 
and  exercise,  had  gained  so  much,  that  at  the  expiration  of 
that  period  she  was  able  to  go  back  to  Zwickau,  for  there 
could  not  possibly  be  any  more  talk  about  a  journey  to 
Franzensbad,  with  the  blooming  face  and  perfectly  healthy 
condition  of  the  lady,  who  had  so  lately  been  such  a  suf« 
ferer.  With  the  observance  of  a  mode  of  life  expressly  pre- 
scribed, it  was  clear  in  the  sequel  that  her  ailment  was  radically 
cured. 

The  fact,  that  there  are  cases  where  even  the  homoeo- 
pathic physician  finds  indications  for  exhibiting  a  medicine 
in  unusually  large  doses,  is  so  important  that  it  must  be 
desirable  to  submit  this  practice  to  a  thorough  examination* 
In  the  first  years  of  my  homcsopathic  practice,  during  the 
treatment  of  similar  cases  of  chlorosis,  I  steadily  set  up  the 
principle  that,  with  a  careful  selection  of  the  medicine  exactly 
corresponding  to  the  group  of  symptoms,  in  **  homoeopathic" 
doses,  at  the  same  time  suitably  regulating  the  diet  and  other 
conditions  of  life,  even  the  defective  condition  of  the  blood 
most  be  gradually  altered,  and  brought  back  to  tbe  normal 
condition,  by  inducing  a  more  natural  action  in  the  organs 


600  Cure  of  Ovarian  Cyst, 

appropriated  to  the  elaboratioD  of  the  ciroalating  fluid.  Yet 
I  mast  candidly  admit  that,  aettiog  oat  on  this  principle,  and 
grounding  my  medical  practice  thereon,  I  unfortunately  found 
myself  Tery  often  disappointed  in  my  expectations.  There 
would  pass  weeks  and  months,  whilst  the  improvement  went  on 
so  slowly  and  imperceptibly,  that  even  the  patience  of  the  most 
patient,  the  confidence  of  the  most  confident,  amongst  the 
Bofferers  in  qaeetion  had  to  stand  too  hard  a  probation,  ao  that 
they  often  found  themselves  obliged  to  have  recoarae  to  allo- 
pathic treatment ;  whereas,  with  larger  doses  of  a  preparation 
of  iron,  or  the  ose  of  a  strong  chalybeate  spa,  I  saw  evident 
and  permanent  results  broaght  about  No  wonder  that  such 
experiences  stirred  me  up  to  deeper  inquiries,  and  the  resalt 
was  the  firm  conviction,  obtained  many  years  ago  by  various 
experiments,  that  those  cases  of  chlorosis  whose  cause  is  to  be 
found  solely  in  a  deficiency  of  iron  in  the  blood,  can  only  be 
cared  in  the  surest  and  speediest  way,  by  the  introduction  of 
larger  doses  of  a  suitable  preparation  of  iron  into  the  system,  in 
order  to  repair  the  deficiency  of  that  element  in  the  circulating 
medicine. 

I  speak  advisedly  of  larger  doses  of  *'  a  suiiabie  preparation 
of  iron,'*  inasmuch  as,  after  many  and  various  experiments,  I 
hold  it  to  be  by  no  means  unimportant,  which  preparation  of 
iron  be  employed  with  a  view  to  cure,  as  we  clearly  see  from 
the  above  cited  case,  where,  after  the  utterly  fruitless  employ- 
ment of  Steel  pills  and  Steel  powders,  a  different  preparation 
of  Iron  produced  the  desired  effect  It  has  been  my  good 
fortune,  in  some  instances,  to  bring  about  the  happiest  results  by 
the  exhibition  of  carbonate  of  iron,  beginning  with  doses  of  one- 
tenth  of  a  grain  and  gradually  advancing  to  half  a  grain,  three 
times  a  day,  and  that  within  a  few  weeks.  Ypt  for  several  years 
past,  I  employ  with  considerably  greater  certainty  a  different 
compound  of  Iron,  which  contains  the  main  ingredients  of  the 
Franzensbad  water,  is  just  as  easily  assimilated  as  that  water,  is 
quite  compatible  with  moderate  bodily  exercise,  and  offers 
the  remarkable  advantage  of  rendering  a  journey  to  the  spa 
superfluous  in  the  cases  just  indicated,  and  also  shows  itself 


b^  Dr.  Hirsch.  601 

by  far  more  e£Bcacioiis  than  the  use  of  the  ohalybeate  water 
sent  from  the  spa. 

Salts  of  Soda  and  Iron  compose,  as  is  well  known,  the  most 
active  ingredients  in  the  Franzensbad  springs,  which  take  a 
tolerably  high  rank  amongst  chalybeate  waters,  and  a  very 
dose  imitation  of  this,  though  with  a  larger  proportion  of  Iron, 
is  this  preparation  (the  one  best  of  all  suited  to  the  or- 
ganism) of  equal  parts  of  Carbonate  of  Soda  and  Sulphate  of 
Iron,  which  salts,  after  their  introduction  into  the  digestiye 
system,  so  far  undergo  a  change  that,  in  consequence  of  their 
chemical  affinities,  they  become  respectively  Carbonate  of  Iron 
and  Sulphate  of  Soda.  Besides  it  appears,  from  the  following 
experiment,  that  Sulphate  of  Soda  exercises  a  very  important 
influence  on  the  formation  and  more  active  development  of 
blood  globules.  If  fluid  blood  be  filtered,  the  blood  globules 
pass  right  through  the  filter-paper ;  but  if  the  blood  be  mixed 
with  Sulphate  of  Soda,  the  globules  stay  behind  on  the  paper 
(Dumas). 

Many  will  perhaps  regard  these  views  as  too  material — ^wUl 
not  choose  to  consider  the  digestive  apparatus  as  a  '^  filter," 
and  yet  such  it  is;  for  it  is  experience,  and  always  expe- 
rienoe  that  serves  the  physician  as  a  leading  star.  The  highest 
principle,  the  proper  stronghold  of  the  homoeopathic  system 
is  always  incontestably  Dynamism;  to  it  we  must  concede, 
with  the  fullest  right,  the  largest  sphere  of  action  in  the 
curative  process  of  most  diseases  of  the  human  frame;  yet, 
we  cannot  altogether  ignore  Materialism,  and  not  one  of  us 
does  so,  though  not  always  conscious  of  the  fact.  When« 
in  this  or  that  case  of  disease,  we  prescribe  an  an\pal  or  a 
vegetable  diet,  containing  more  or  less  nitrogen,  does  this 
mean  anything  else  than  that  we  intend  to  induce  this  or 
that  metamorphosis  in  the  primary  material  of  the  blood  ?  The 
fibrine,  the  albumen  contained  in  the  food,  is  changed  into  the 
very  similar  material  of  the  blood ;  and  as  to  the  inorganic 
materials  contained  in  the  food,  these,  too,  for  the  most  part, 
are  found  again  in  the  blood.  When,  moreover,  our  respected 
coUeaguCj  Gerson  (in  this  volume,  No.  6),  informs  us  that 


602  Cure  of  Ovarian  Cyst, 

he  has  had  the  opportcmity  of  obserring  decided  cnrative 
results  from  the  employment  of  gross  doses  oiferrum  earboni- 
cum  for  prosopalgia  in  some  cases  of  women,  who  had  become 
aniemic  from  galactorrhoea,  it  mnst  be  allowed,  with  more  than 
approzimative  certainty,  that  the  abnomality  lying  at  the  root  of 
this  neuralgia  most  haye  consisted  in  a  too  scanty  proportion 
of  Iron  in  the  blood. 

Meritorious  in  the  highest  degree  is,  indispntably,  the 
scientific  contribation  of  my  honoured  colleague.  Forges,  of 
Carlsbad,  who,  in  his  brochure  on  the  **  Specific  Opwation 
and  Phymdogical  Analysis  of  the  Carlsbad  nuneral  springs," 
proceeding  from  the  homcDOpathic  stand-pointy  o£fors  as  much 
that  is  very  interesting  and  worth  knowing.  Without  going 
oyer  his  proring-experiments  with  a  tiresome  partieularity 
(which  in  all  cases  is  only  individual),  these  experiments  bear 
the  character  of  a  rational  picture  of  the  symptoms,  which 
keeps  more  to  essentials,  and  by  that  very  means  acquaints 
us  the  more  clearly  with  the  principal  effects  of  the  medi- 
cine, and  thus  attains  a  higher  degree  of  practical  utility. 

His  view  that  each  mineral  water  forms  of  itself  a  peculiar 
exclusive  whole,  a  peculiar,  though  variously  compounded, 
medicinal  substance,  is  entirely  to  be  approved  of,  and  yet  I 
shall  take  the  liberty  to  add  a  few  further  remarks  arising 
entirely  out  of  my  own  individual  view  and  comprehension. 
The  thermal  symptoms  of  our  colleague's  proving  present  the 
result  on  the  organism  of  a  peculiar  combination  of  different 
alkaline  and  earthy  salts  transfused  into  the  system,  whose  Imses 
consist  of  a  marked  preponderance  of  soda,  potash,  lime,  and  mag- 
nesia. The  soda  appears  prominently  in  combination  with  Sul- 
phuric Acid ;  but  also  with  Carbonic,  Muriatic,  and  Phosphoric 
Acids,  which  last  also  produce  various  salts  with  the  other  bases, 
and,  taken  altogether,  supply  the  main  constituents  of  the  Carls- 
bad Spa.  It  is  these  very  bases  and  acids  above  named  which 
collectively,  though  in  different  proportions,  are  found  in 
normally  constituted  blood,  and  thus  Dr.  P.  has,  strictly 
speaking,  undertaken  his  proving  experiments  with  an  excess 
of  this  combination  of  salts,  which  is  not  utterly  strange  to 


bjf  Dr.  Hirsch.  603 

the  human  organism.  Now  modem  physiology  has  demon- 
strated that  the  alkaline  salts  in  particalar  play  a  part  entirely 
essential  in  the  animal  economy,  inasmuch  as  they  are 
absolutely  necessary  to  the  solution  and  dilution  of  the  pro- 
tein compounds,  esp^ally  albumen,  which  mainly  supplies 
nutrient  matter  to  the  system.  Just  as  pathological  physiology 
recognises  in  hypezinosis  an  abnormal  increase  of  fibrine,  and 
in  hypinosis  an  abnormal  diminution  of  it,  so  she  discovers 
anomalies  of  the  circulating  fluid  with  excess  of  its  most 
nutritive  constituent,  the  albumen,  and  on  the  other  hand,  a 
striking  diminution  is  often  recognised.  Whilst  in  these  lines, 
in  conformity  to  my  special  object,  I  intend  to  direct  a  special 
view  to  the  morbid  excess  of  albumen  in  the  blood ;  I  consider 
it  needful  to  point  out  that,  when  the  normal  proportion  of  albu- 
men is  in  the  circulating  fluid,  the  albumen  is  combined  with 
soda,  and  as  albuminate  of  soda  kept  in  a  state  of  solution. 

Chemistry  certainly  demonstrates  the  occurrence  of  certain 
anomalies  in  the  blood,  whereby  its  contents  suffer  a  greater  or 
less  loss,  either  of  salts  in  general,  or  of  some  particular  salts. 
Thus,  for  instance,  according  to  Garrod  s  chemical  experiments, 
the  deficiency  of  potash  in  the  blood  is  said  to  be  the  main 
cause  of  scurvy,  and  this  form  of  disease  is  said  to  be  brought* 
on  by  the  use  of  food  that  is  deficient  in  potash,  as,  on  the 
other  band,  the  articles  of  diet  curative  in  this  disease  shew 
themselves  abundant  in  potash. 

Independently  of  the  fact  that  even  an  absolute  diminution 
of  the  salts  in  general  often  occurs,  we  find,  in  cases  of  the 
above-mentioned  overcharging  of  the  blood  with  albumen  a 
relatively  too  small  quantity  of  salts,  whereby  unquestionably 
there  is  caused  an  anomalous  condensation  of  the  blood. 
In  recent  blood,  as  well  in  the  liquor  sanguinis  as  in  the 
serum,  the  albumen  appears  every  where  combined  with 
soda,  by  which,  in  fact,  it  is  held  in  solution.  Now,  suppose 
there  should  occur  such  a  disturbance  of  the  proportion 
between  the  substance  to  be  dissolved  and  its  solvent,  that  the 
former  appears  relatively  or  positively  predominant;  that  is. 


604  Cure  of  Ovarian  Cy$tf 

tiie  albumen  of  the  blood  exhibits  itself  in  too  great  qnantity  to 
be  dissolved  by  the  salts  which  are  present  in  a  normal  state  of 
eolation ;  then  by  the  inspissation  of  the  blood  thus  indaoed 
most  its  oircnlation  be  sraioosly  impeded,  especially  in  the 
capillary  vessels,  and  thereby  also  would  arise  a  tendency  to  stag- 
nation, particularly  in  the  portal  circulation,  where  (as  physiologj 
shows),  even  in  a  perfectly  normal  condition,  the  movement  of 
the  blood  is  somewhat  slower.  The  conditions  under  which  the 
increased  formation  of  albumen  takes  place  are  the  same  aa 
those  where  a  general  increase  of  the  volume  of  blood  is  pro- 
duced, and  as  albumen  is  so  clearly  indicated  by  physiology  to 
be  the  main  material  of  nutrition,  this  may  be  couffldered  as 
plethora  properly  so  called.  An  animal  diet,  too  copious  and 
ezcesrively  nitrogenous,  which  of  itself  furnishes  in  consider- 
able quantity  ready  material  for  the  formation  of  albumen,  by 
its  easy  digestibility  (containing  in  essentials  the  same  com- 
bination of  elements  as  the  blood,  and  being  therefore  easily 
converted  into  it)  produces  a  palpable  injury,  inasmuch  as,  in 
my  view,  it  offers  too  little  difficulty  to  the  digestive  powers — 
too  little  stimulus  to  occasionally  increased  exertion.  And  it 
is  just  this  monotony  of  the  organic  action  in  the  laboratory  of 
the  blood  formation,  by  which  the  nervous  energy  is  involved,  to 
a  more  relaxed  and  enfeebled,  than  brought  to  a  more  powerful 
development  Now,  suppose  there  be  added  to  this  a  want  of 
the  aid  of  bodily  exercise,  and  thereby  also  of  the  supply  and 
consumption  of  oxygen,  that  so  important,  so  stimidating 
element,  which,  as  it  were,  ofifors  to  the  nervous  system  wine 
in  a  gaseous  form ;  or  suppose  overstraining  of  the  intellect 
comes  into  play,  or  the  harass  of  the  various  states  of  mind 
which  exhaust  the  higher  nervous  life,  whereby  too  great  in- 
roads are  made  on  the  stimulating  nervous  principle  of  animal 
life,  whilst  the  vital  and  biochemical  processes  of  the  animal 
economy  are  injured,  and  the  assimilation  is  considerably 
retarded,  then  every  one  must  clearly  see  that  the  consequent 
retardation  of  the  collective  functions  of  the  abdomen  may  lead 
to  inspissation  of  the  fluids,  with  its  various  sad  results. 


by  Dr,  Hirach.  605 

I  refrain  from  giving  an  enumeration  of  the  symptoms  whioh^ 
nnder  snoh  circnmstances,  are  wont  to  supervene  with  more 
than  a  hundred-fold  variations,  and  which  the  suffering  visitors 
of  Carlsbad  detail  to  their  physician ;  and  I  merely  remark 
that  pendants  to  this  set  of  symptoms  (wiUi  some  shades  of 
difference  which  make  them  more  suited  to  that  watering 
place)  are  met  with  not  less  numerously  at  Marienbad,  as  both 
places  exhibit  a  manifest  resemblance  in  the  predominant 
constituents  of  their  mineral  waters. 

As,  on  the  one  hand,  I  think  I  may  again  give  expression  to 
my  convictions,  that  the  (often  not  inconsiderable)  saline 
contents  of  the  mineral  springs  should  be  considered  as  an 
agent  that  chemically  influences  the  anomalous  condition  of 
the  blood ;  so,  on  the  other  hand,  I  will  by  no  means  deny 
that  it  is  in  the  variety  and  strange  peculiarity  of  the  saline 
compounds,  as  well  as  in  the  temperature  of  their  aqueous 
solution  that  the  specific  and  proper  character  of  each  spa  is  to 
be  sought ;  I  should  add,  however,  the  remark  that  the  quan- 
titattpe,  or  (in  consequence  of  its  superior  powers  of  action) 
the  qualitative  predominance  of  one  or  the  other  medicine 
must  serve  as  the  criterion.  And  thus  we  find,  in  the  results 
of  Porges'  provingB  of  the  Carlsbad  springs,  where  the  sulphate 
of  soda  appears  predominant,  an  evident  similarity  in  the  groups 
of  symptoms  to  those  recorded  in  the  Annals  of  Hartlaub 
and  Trinks,  as  results  of  the  proving  of  that  medicine. 

[The  mineral  water  above  spoken  of  is  that  of  Hall,  near 
Linz,  in  Austria,  and  its  composition  is  as  follows,  in  16  oz.  :— 

Grains. 

Chloride  of  Sodium        1120412 

„         Potassium    00499 

„         Ammonium 0*0880 

„          Calcium        2-9380 

Chloride  of  Magnesium 2*6220 

Iodide  of  Sodium    00607 

„         Magnesium     0'2849 

Bromide  of  Magnesium 0*5176 


606  Cure  of  Ovarian  Cyt, 


Gmms. 

Phosphate  of  Lime 

*••• 

00261 

Carbonate  of  I  Jme 

•••• 

0*4808 

„            Magnesia  .... 

•*•• 

0-2419 

ff                       JJvGI     ••••         .••. 

.■«• 

0-0876 

Silicic  Acid     

••.• 

0-0780]— Jffrf. 

WHAT    IS    HOMOEOPATHY? 
By  Professob  Hoppe,  Basle.* 

(TransUted  by  J.  H.  Nxxkiyell,  Penzance.) 

When  we  say  that  homoeopathy  is  a  system  of  therapeutics, 
according  to  the  principle  of  similars^  we  utter  a  truth  m^st 
certainly ;  nevertheless  this  explanation  is  incomplete,  inasmuch 
as  it  fails  to  specify  the  treatment  in  an  ohjective  manner. 

Besides  this  explanation  has  the  effect  of  repelling  every  one 
who  is  not  a  homoeopath,  and  who  does  not  sufficiently  recog- 
nize the  fact,  that  many  non-homoeopathic  practitioners  do  at 
times,  either  hy  accident  or  with  semi-consciousness,  treat  disease 
homoBopathically  ;*  and  that  at  other  times,  their  practice  is 
carried  out  in  the  same  sphere  of  the  animal  tissues  as  that  of 
the  homoeopath :  consequently,  this  explanation  does  not  have 
the  effect  of  bridging  over  the  chasm  which  still  separates 
homoeopathy  and  allopathy. 

Moreover  this  explanation  is  not  sufficiently  intelligible  to 
the  uninitiated,  nor  is  it  very  easily  comprehended  at  all. 

In  fine  we  may  be  allowed  to  add  that  the  law  of  similars  has 
been  by  no  means  thoroughly  investigated,  and  the  facts  on 
which  it  is  founded  have  not  been  so  completely  enqnired  into, 
that  the  formula  (similia  similibus  curetitur)  can  be  regarded 
as  an  unobjectionable  or  happy  explanation  of  the  principle  of 
homoeopathy. 

The  chief  fault  I  have  to  find  with  the  explanation  is,  that 
it  does  not  define  the  anatomical  object  of  the  treatmeot, 
whereby  alone  a  thorough  understanding  of  the  subject  can  be 

*  From  the  AUg.  Ram.  Zeitung,  Bd.  64 


What  is  HomoBopalhy  f  607 

attained.  A  clear  appreheDsion  of  the  sabject  is  indispensably 
necessary,  both  for  those  unacquainted  with,  and  for  the  adhe- 
rents o^  homoeopathy. 

There  have  always  been  some  general  expressions  by  which  it 
was  usual  at  different  periods  to  indicate  the  character  of  the 
prevalent  medical  art>  and  these  expressions  still  remain 
amongst  us.  Amongst  these  I  may  for  example  mention  the 
following:  "Hippocratic  Medicine;"  ''The  Empirical  and 
Methodic  Schools;"  "The  Schools  of  the  Solidists  aud 
Humoralists/'  &c.  These  and  all  such  expressions  are  for 
ever  passed  away.  Besides  it  is  evident  that  such  ideas  which 
express  only  a  part  of  the  whole  thing,  are  not  very  satisfactory. 

There  are  in  modem  times  two  expressions  which  have  a 
degree  of  stability  in  them,  viz.,  "  tissue-therapeutics "  and 
"cell-therapeutics;  the  latter  not  yet  positively  enunciated, 
but  rather  hoped  for.  It  must  be  conceded  to  me  on  the 
ground  of  my  investigations  and  experiments  that  I  have  laid 
the  fiist  foundation  stone  of  tissue-therapeutics,  still  I  cannot 
approve  altogether  of  the  expression  "  tissue-therapeutics,"  for 
the  tissues  form  the  di£Eerent  parts  of  the  body,  and  therefore 
the  term  tissue-therapeutics  expresses  little  else  than  the  thera- 
peutics of  the  body  in  general,  and  serves  no  useful  purpose. 
Nevertheless  it  cannot  be  denied  that,  with  the  expression 
"  tissue  therapeutics,"  something  is  gained  for  a  right  compre- 
hension  of  the  whole  subject,  for  the  expression  "  tissue " 
throws  a  physiological  and  pathological  light  upon  the  body  in 
general,  and  it  may  serve  to  recall  to  our  mind  the  whole 
compass  of  histology  with  the  peculiarities  of  each  tissue ;  and 
further  it  reminds  us  that  we  should  investigate  and  treat  each 
tissue  and  its  affections  according  to  their  several  natures. 

Therefore  the  expression  "  tissue-therapeutics  "  is  in  certain 
respects  an  advance.  But  all  is  not  tissue  which  falls  within 
the  domain  of  treatment^  and  moreover  the  expression  is  too 
general  or  indefinite.  The  term  "  solids-therapeutics  "  formerly 
meant  something  similar,  and  yet  it  has  fallen  into  disuse ;  of 
the  expression  "  cell- therapeutics  "  we  can  say  the  same.  The 
cells  form  the  tissues,  the  tissues  form  the  body ;  and  therefore 


608  WAai  i$  HomcBopaihy  f 

"  cell-therapeutioB "  is  also  *' body-therapeatics/'  Bat  this 
expression  goes  farther  than  **  tissue-therapeutics;  it  leads  as 
to  the  primary  structares  of  the  body,  and  prompts  as  to  make 
a  keener  and  deeper  insight  into  the  phenomena  of  oar  or- 
ganism ;  so  that  in  this  expression  there  is  again  an  advance, 
not  essentially  of  a  therapeutic  kind,  but  of  a  pathological 
character.  For  the  term  ''  cell-therapedtics  "  aids  us  but  little 
in  the  actual  business  and  peculiarities  of  medical  treatment^ 
whilst  it  fascinates  us  by  implying  a  knowledge  which  do^  not 
yet  exist ;  it  deludes  us  a  little — indeed,  I  may  say,  a  great 
deal. 

It  is  only  as  opposed  to  the  therapeutics  of  the  solidists  and 
humoralists,  and  to  other  exploded  terms,  that  "  tissue  thera- 
peutics "  and  "  cell-therapeutios "  have  a  meaning ;  but  even 
as  those  older  terms  have  no  longer  any  value,  so  both  these 
more  modem  expressions  are  losing  their  importance. 

The  terms  " homoBopathy "  and  "allopathy"  originated  in 
medical  polemics,  and  have  become  the  mere  nick-names 
of  parties.  But  these  words  imply  something  so  violently 
severed  from  the  whole  medical  art,  that  it  is  difficult  to 
perceive  their  exact  relation  to  the  latter.  They  both  rest 
on  an  anatomical  basis,  but  they  do  not  indicate  with  clearness 
and  distinctness  the  anatomical  object  on  which  they  operate, 
and  as  they  do  not  embrace  the  whole  field  of  medical  treat- 
ment, so  do  they  leave  us  in  a  state  of  uncertainty  as  to  the 
extent  of  their  several  spheres,  and  the  limits  of  their  operation 
— consequently  they  are  to  a  certain  extent  unsatis&ctory. 
One  is  not  in  a  position  to  express  an  opinion  on  the 
boundary  line  between  homoeopathy  and  the  grosser  mechanical 
and  chemical  modes  of  treatment,  until  one  is  able  to  give  a 
clear  and  explicit  answer  to  the  question  "  What  is  homoeo- 
pathy ?  "  Hence  I  agree  with  Dr.  Von  Grauvogl  that  the  word 
homoeopathy  is  not  applicable  as  indicating  the  character  of  a 
complete  system  of  medical  treatment,  but  the  expression  is 
indispensable  in  order  to  characterize  a  more  limited  sphere  of 
medical  action. 

Meanwhile,  the  question  presses  on  us   '*  What  is  homoeo- 


by  Prof.  Hoppe.  609 

patby  ?  "  or  in  other  words,  what  is  the  treatment  that  must  be 
pronounced  homoeopathic,  or  at  least  mainly  homoeopathic  ? 

In  order  to  answer  this  question,  I  am  obliged  first  of  all  to 
draw  out  a  schema  in  which  will  be  arranged  every  kind  of 
medical  practice,  to  whatever  school  it  may  belong. 

The  schema  is  as  follows : 

Class  I .  Includes  medical  treatments  directed  to  the  functions* 
of  the  active  tissues,  or  in  short  to  the  animal  functions.  All 
these  functional  treatments  may  be  comprehended  in  two  ordere. 

Ist  order. — The  calming  treatment  of  the  animal  functions. 

2nd  order. — The  exciting  treatment  of  the  animal  functions. 

Willingly  do  I  admit  that  both  expressions  "  calming  "  and 
'^  exciting"  should  be  replaced  by  more  apt  expressions,  how- 
ever this  is  not  possible  at  present,  and  we  must  provisionally 
be  contented  with  these  general  ideas.  Now  each  of  these 
orders  divides  itself  into  as  many  species  as  there  are  active 
tissues,  and  accordingly  we  may  for  the  present  indicate  at 
least  the  following  species,  e,  g. 

Calming  and  exciting  treatment  of — 

1,  The  nerves  of  blood-vessels ;  2,  of  the  other  motor  nerves ; 
8,  of  the  nerves  of  sensation ;  4,  of  the  mental  actions ;  5,  of 
the  cells. 

This  schema  is  to  be  perfected  in  accordance  with  the  in- 
vestigation of  the  tissues,  and  of  the  action  of  medicines  on 
those  tissues. 

Class  2.  Includes  also  further  medical  treatments  directed 
to  the  material  of  the  perfect  tissues,  and  to  those  material 
conditions  existing  on  the  same  or  within  the  same ;  and  these 
material  treatments  may  be  divided  into  the  following  five  orders. 

1st  order. — Composition-altering  treatment. 

2nd  order. — Material-restoring  treatment 

drd  order. — Protecting  (prophylactic  ?)  treatment. 

4  th  order. — Treatment  for  the  restoration  of  suitable  form 
and  position. 

*  TJMghnti  here  and  ibroaghoat  the  essay  translated  '*  function/'  is,  we 
are  aware,  not  exactly  expressed  by  this  rendering.  **  Vital  action  "  would 
perhaps  best  convey  the  author's  meaning,  bat  the  word  we  have  adopted  ia 
more  convenient,  and  perhaps  sufficiently  literal. 

YOL.   XX.|   NO.   LXXXIL— OCTOBER,    1862.  2  Q 


610  What  is  Homasopathy  f 

5th  order. — Abstracting  treatment 

It  is  clear  that  the  three  last  orders  also  comprehend  the 
whole  operative  action.  By  these  material  treatments  we  try 
to  restore  the  form,  composition  and  normal  relative  cq[>aci- 
ties  without  intentionally  selecting  the  fdnction  of  the  tissue 
itself  for  our  attack.  So  far,  however,  as  this  happens  con- 
temporaneously, we  perform  at  the  same  time  functional  cures, 
and  we  must  then  endeavour  to  distinguish  accurately  what 
belongs  to  these  functional  cures,  and  what  to  the  mechanioal 
or  chemical  attacks  on  form,  composition  and  relative  capacities. 
Besides  it  is  difiBcult  to  find  for  the  second  order  of  medical 
treatment  an  appropriate  general  expression,  for  our  functional 
cures  also  depend  upon  material  interference  in  the  mechanism 
or  chemistry  of  the  active  tissues,  hut  still  the  alteration  of 
function  is  always  the  object  we  endeavour  to  effect ;  whilst  in 
the  material  treatments  the  alteration  of  the  composition,  or  of 
the  form,  or  of  relative  capacity,  is  our  chief  aim,  with  which  the 
thereby  disordered  function  returns  of  itself  to  the  normal  state. 

It  is  therefore  very  probable  that  both  orders  of  medical 
treatment  will  be  occasionally  still  further  subdivided  or 
reunited,  when  we  shall  be  able  to  direct  functional  treatment 
to  be  conducted  so  as  to  make  the  material  fundamental  con- 
dition, on  which  an  abnormal  action  depends,  the  ostensible 
object  of  attack;  and  thus  for  instance,  as  regards  common 
salt,  we  need  not  say  that  we  calm  or  excite  action,  but  that  we 
merely  withdraw  from  the  abnormally  acting  structure  a  certain 
quantity  of  water,  of  which  it  has  too  much,  in  order  to  allow 
the  structure  to  return  to  its  normal  condition. 

Every  classification  will  contain,  both  now  and  for  a  long 
time  to  come,  much  that  is  artificial ;  but  the  fundamental  idea 
of  the  classification,  however  completely  it  may  be  worked  out, 
will  remain  essentially  the  same. 

In  the  above  schema  every  mode  of  medical  treatment  of 
each  party  may  be  included,  and  no  one  can  treat  disease  by 
any  mode  not  included  under  the  headings  of  these  schemes : 
and  further  whatever  of  good  and  true  a  medical  system  may 
have,  must  find  its  natural  and  rightful  place  in  this  schema^ 
when  fully  developed. 

There  will  be  no  harm  in  designating  fundamental  methods 


by  Prof.  Hoppe^  61 1 

the  general  modes  of  treatment  and  manners  of  operation  which 
I  have  laid  down  in  this  schema,  for  the  first  time,  according  to 
a  fixed  plan,  and  founded  upon  the  tissues  of  the  body  instead 
of  the  former  planless,  unmethodical,  desultory  fundamental 
methods,  rubrics  and  categories.  These  difierent  modes  of 
treatment  form  the  framework  on  which  the  material  of  a 
universal  therapy  unfolds  itself,  and  surely  homoeopaths  will 
not  object  to  see  all  medical  treatments  comprehended  under 
general  modes  of  treatment,  provided  the  various  ascertained 
facts  and  laws  obtain  their  full  value  in  the  special  carrying  out 
of  each. 

There  are  treatments  of  the  animal  functions  of  the  tissues 
and  treatments  of  the  material  conditions  existing  in  the  tissues, 
or  in  short  there  are  functional  modes  of  treatment,  and  there 
are  organic  modes  of  treatment. 

Now,  as  all  which  a  physician  can  do,  in  a  medical  point  of 
view,  is  referrible  to  one  or  the  other  of  the  general  modes  of 
treatment  described,  the  question  arises  under  which  head  we 
are  to  class  Hahnemann's  medical  treatment?  Certain  it  is 
that  some  of  Hahnemann's  treatment  is  according  to  the 
second  class  of  medical  treatments.  But  most  of  his  cures, 
and  the  most  notable  of  them,  those  by  which  he  became  so 
eminent,  and  which  led  him  to  establish  his  doctrine,  and  to 
create  homoeopathy,  were  cures  under  the  first  class  of  the 
schema  we  have  set  forth,  they  were  cures  of  the  functions,  and 
by  means  of  the  functions,  of  the  active  working  tissues ;  they 
were,  in  fact,  functional  cures. 

But  yet  there  have  always  been  physicians  who  have  many 
times  effected  functional  cures  without  being  aware  of  it,  and 
every  one  who  has  at  any  time  administered  medicines,  though 
he  may  have  occasionally  employed  a  treatment  productive  of 
alteration  in  the  composition  or  nutrition  of  the  organism,  still 
he  makes,  for  all  that,  in  a  predominant  degree,  those  mysteri- 
ous cures,  the  material  changes  accompanying  which  are  still 
unknown,  which  are  effected  by  influencing  the  morbidly 
deranged  functions  of  the  actively  working  tissues. 

Whoever  administers  China,  Opium,  Mercury,  Iodine, 
Arsenic,  Potash,  Soda,  Sabina,  &c.,  does,  undoubtedly,  perform 

2  Q  2 


6 1 2  What  is  Homceopathy  f 

in  his  practice  functional  cnres,  and,  in  fact,  functional  cares 
chiefly  by  directly  influencing  the  morbidly  acting  tissues.  But 
further,  he  who  effects  (hydropathic)  cold  water  cures ;  he  who 
applies  electricity,  he  who  practises  the  gymnastic  art,  he  who 
treats  mental  affections  by  means  of  mental  influences,  &c.» 
each  of  these  effects  functional  cures— that  is  to  say,  cures 
through  the  functions  of  the  active  tissue. 

Hahnemann's  cures  were  therefore  functional  cures  by  aid  of 
medicines.  But  in  contrast  with  those  who  employ  medicines 
according  to  vague  tradition,  or  merely  according  to  hypothe- 
tical explanations  of  their  effects,  Hahnemann's  cures  were 
medicinal  functional  cures,  accomplished  according  to  the 
principle  of  the  operation  of  similars. 

Hahnemann's  therapeutical  treatment  is  then  homceopathy, 
and  homoeopathy  is  also  the  curing  of  diseases  by  means  of 
directly  influencing  the  morbid  tissue  functions  by  medicines 
given  in  accordance  with  the  law  of  similars — in  other  words, 
the  homoeopathic  treatment  means  functional  treatment  with 
similarly  acting  medicines. 

And  inasmuch  as  the  law  of  similars  is  alone  accurate, 
binding,  and  regular,  but  every  kind  of  vague  treatment  is  of 
no  value,  so  we  may  assert  briefly  that  homoeopathic  treatment 
means  performing  functional  cures  according  to  nature's  laws, 
or,  simply,  functional  cures. 

A  law  of  similars  can  moreover  only  be  for  the  animal 
functions,  for  the  functionally  acting  tissues;  and  when  we 
therefore  speak  of  cures  according  co  the  law  of  similars,  we 
can  imderstand  nothing  else  but  cures  effected  in  and  by  means 
of  the  animal  functions. 

In  all  professions  there  is,  in  fine,  an  empirical  and  a 
rational  mode  of  action  ;  and  to  perform,  or  rather  to  imitate, 
functional  cures,  without  any  further  and  deeper  investigation, 
and  to  do  this  by  means  of  small  doses  must  be  considered  hom- 
oeopathy, and  is  indeed  part  and  parcel  of  it. 

I  have  remarked  above  that  there  are  as  many  kinds  of 
functional  treatments  as  there  are  of  tissues  possessing  active 
functions.  We  address  our  treatment  to  the  functions  of  the 
cells ;  but  in  the  meanwhile  our  knowledge  is  sadly  limited  on 


by  Prof.  Hoppe.  618 

this  subjecty  and  willing  as  I  am  to  allow  that  Galoarea  and 
Silicea  may  be  cell  medicines,  still  both  may  be  merely  com- 
pensatory medicines  for  the  chemical  requirements  of  the  cells, 
and  Oalcarea,  at  least,  can  also  operate  on  the  blood  vessels  and 
thus  e£Pect  a  vascular  cure,  where  we  imagined  that  we  had 
before  us  a  cure  through  the  cell  functions. 

We  make,  e.^.,  functional  cures  by  acting  medicinally  on 
the  brain,  and  yet  the  medicines  which  act  on  the  brain  pells 
can  also  act  on  the  vessels  of  the  brain,  and  in  these  produce  a 
mere  vascular  cure,  where  we  only  contemplated  effecting  a 
cerebral  cell  cure,  for  we  are  unable  sufficiently  to  isolate  the 
action  of  the  medicines  on  the  cerebral  cells,  and  wa  have 
moreover  very  few  remedies  that  act  exclusively  on  the  brain 
cells. 

In  the  same  manner  we  can  e£fect  a  functional  treatment  by 
acting  on  the  nerves  of  motion  and  of  sensation ;  but  the 
medicines  which  act  on  these  nerves,  act  also  on  the  nerves  of 
the  blood  vessels,  and  thus  on  the  vessels  themselves. 

Certain  as  it  may  be,  that  by  means  of  medicinal  remedies 
we  treat  the  functions  of  all  function-performing  tissues,  equally 
certain  is  it  that  Hahnemann's  treatment,  that  the  treatment  of 
homceopathists,  and  that  the  functional  treatment  of  all  practi- 
tioners is  chiefly  performed  on  the  functions  of  the  vessels. 

Indeed,  it  is  chiefly  vascular  cures  that  are  effected  by  prac- 
titioners, and  the  homoeopathic  cures  are  therefore  not  merely 
functional  cures,  but  they  are  in  a  much  greater  proportion 
cures  of  the  vascular  function,  and  they  are  this  so  much  the 
more  than  the  cures  effected  by  other  physicians,  just  because 
the  small  doses  are  capable  of  influencing  exclusively  the  func* 
tional  activity  of  the  blood  vessels. 

"  Functional  treatment"  and  '*  dynamic  treatment"  are  more- 
over two  very  different  things,  for  here  there  is  not  any  ques- 
tion about  the  point  that  cures  are  effected  by  means  of  such 
material  medicinal  actions  as  we  are  still  unable  to  discover, 
and  hence  call  them  dynamic  ;  but  the  question  is  simply  this, 
that  these  cures  are  effected  by  influencing  the  animal  functions, 
and  more  especially  the  actual  diseased  animal  function. 

Finally,  albeit  homoeopathy  occupies  itself  in  a  more  espe- 


«  U  VThai  is  HofncBopaiky  f 

cia]  manlier  with  medioinal  treatment  only,  still  all  other 
irritants  (mechanical,  thermal,  or  electrical)  can  also,  according 
to  the  law  of  "  similars/'  he  allied  to  functional  treatments. 

It  is  impossible  that  the  conception  of  homooopathy  can  be 
floating  about  in  idealism,  and  merely  rest  on  a  law.  It  must, 
on  the  contrary,  be  fitted  with  and  built  upon  an  anatomical 
basis.  Now  the  animal  functions,  the  functions  of  the  active 
acting  tissues  are  that  basis.  We  must  also  consider  that  in 
the  entire  structure  of  homoaopatbio  doctrine,  there  lie  two 
distinct  and  entirely  separate  acquisitions : — 

1st     Tissue- therapeutics,  with  the  law  of  **  similars." 

2nd.     The  doctrine  of  the  efficacy  of  minute  doses. 

When  a  physician  gives  small  doses,  he  undoubtedly  profits  by 
an  important  discovery  of  Hahnemann's,  but  still  he  does  not  on 
that  account  necessarily  practise  homoeopathically.  Further,  when 
a  physician  practises  a  compensatory  treatment  with  Caloarea 
or  Silicea,  in  small  doses,  he  then  practises  a  modem  physio- 
logical system  by  means  of  one  of  Hahnemann's  discoveries ; 
but  even  though,  thereby,  he  practises  in  accordance  with  a 
law  of  nature  more  correctly  than  physicians  in  general,  yet  is 
this  not  homoeopathy. 

Homoeopathy,  as  an  eminently  anatomical  and  physiological 
doctrine  of  therapeutics,  refers  solely  to  the  treatment  of  the 
uctive  tissues,  and  all  that  Hahnemann  has  discovered  besides 
for  medical  practice,  must  not  be  confounded  with  his  tissue- 
therapeutics,  professedly  based  on  a  rule  of  treatment. 

This  was  certainly  Hahnemann's  greatest  merit,  that  he  over- 
turned the  depleting,  decomposing,  dissolvent,  absorbent,  and 
other  unmethodical  fundamental  systems,  and  raised  to  a 
universal  system  what  we  must  now  designate  the  treatment  of 
the  animal  functions,  and  made  it  a  study  highly  deserving  of 
attention,  though  perhaps,  in  some  respects,  too  one-sided ;  and 
it  would  have  been  long  enough,  ere  functional  treatments,  even 
though  the  anatomical  rationale  was  unknown,  would  have 
carried  the  day  in  practice.  Through  the  whole  history  of  medi- 
cine, a  suspicion  certainly  existed  that  a  direct  attack  should  be 
made  upon  the  diseased  parts  themselves ;  and  in  point  of  fact, 
Hahnemann  appeared  as  a  Messiah  of  physic,  and  laid  before 


by  Prof,  Hoppe,  616 

the  world  the  direct  treatment,  the  tissue  treatment,  the  fane* 
tional  treatment,  thoroughly  elaborated,  and  ready  for  imi- 
tation. 

This  is  therefore  his  greatest  merit ;  and  although  the  dis- 
covery of  the  effect  of  small  doses  is  but  little  inferior  to  it  in 
importance,  yet  the  system  of  treatment  that  constitutes  a 
method,  or  we  may  say  of  it  in  contrast  with  the  traditional  treat- 
ment, a  school,  cannot  rest  upon  small  doses,  but  must  take  its 
stand  on  the  therapeutic  object,  on  the  tissues  to  be  cured,  so 
that  consequently  the  functional  treatment,  or  the  direct  treat- 
ment of  the  active  acting  tissues,  forms  that  which  is  essential 
and  charactmstio  in  the  Hahnemannic  therapeutic  system. 

Let  us  take  drugs  and  perform  experiments  with  them. 
Now,  there  are  nerve-fibres,  muscles,  vessels,  branches  of  sen- 
ditive  nerves,  cells,  in  which  the  drugs  furnish  us  with  symptoms 
which  we  had  not  expected,  symptoms  which  depend  no  doubt 
apon  material  changes  in  the  atoms  of  the  active  substance  of 
the  tissues,  but  which  we  are  unable  to  designate  otherwise 
than  as  phenomena  of  vital  action.  Now,  notwithstanding  these 
functional  manifestations  elicited  by  experiments  with  medi- 
cines ;  notwithstanding  the  fact  that  in  the  whole  of  creation, 
there  does  not  seem  to  be  anything  which  does  not  act  on  the 
activity  of  the  blood  vessels  ;  notwithstanding  the  changes  whiqh 
we  can  produce  on  the  blood  vessels  by  medicines,  or  antidotes, 
or  by  repeated  doses  on  the  same  vessels ;  notwithstanding  the 
visible  revolution  by  which  a  dilated  vessel  springs  into  contrac- 
tion, and  the  contracted  vessel  into  dilatation  in  our  experiments 
on  the  operating  table  ;  notwithstanding  the  sudden  disappear- 
ance of  hyperemias  during  the  rapid  motion  of  the  animal ; 
notwithstanding  the  unsatisfactory  character  of  all  explanations 
hitherto  given  of  the  curative  operation  effected  on  the  animal 
functions ;  notwithstanding  the  complete  resemblances  of  spon- 
taneous recovery  to  processes  observed  during  experiment — not- 
withstanding all  these  facts,  we  are  always  looking  about  for  phy- 
sical, chemical,  electrical,  atomic  facts,  rubrics,  and  ideas ;  but  still 
we  cannot  refuse  to  admit  the  importance  and  the  correctness 
of  the  modest  expressions,  "  functional  operations  "  and  "  func- 
tional treatment." 


616  Om  Exiemal  Remedie§,  de., 

Afi,  however^  every  pbjmoian  doee  not  excltudyely  praotise 
functional  treatment*  as  also  impartiality  requires  as  to  be 
masters  of  the  whole  sphere  of  general  medical  treatment^  and 
as  science  must  ever  tend  towards  nniversality,  so  will  it  be 
impossible  for  the  idea  of  functional  treatment  to  remain  the 
essential  of  a  doctrine. 

Cells  and  tissues  are  given,  functional  treatment  is  pro- 
vided, operating  on  the  active  acting  tissues  is  self-evident* 
and  a  school  which  seeks  to  attain  universality*  must  hence- 
forth carry  on  its  front  a  more  general  all-embracing  idea.  The 
principle  of  similars  cannot  serve  as  such  an  idea,  and  hence* 
Herr  von  Grauvogl  is  justified  in  the  expression  proposed  by 
him — "  Therapeutics  according  to  natures  laws*' 

The  expression*  ''According  to  natures  laws*"  will  also 
certainly  eventually  disappear*  when  the  laws  of  nature  bave 
been  discovered  and  become  familiar*  and  nothing  will  remain 
but  the  word  "  therapeutics" — nothing  but  one  single  thera- 
peutics fur  all  physicians*  and  then  will  homoeopathy  have 
risen  up  in*  or  obtained  undisputed  sway  over  the  whole  of 
therapeutics. 

However,  in  order  that  I  may  express  myself  dearly*  the 
expression  "  homoeopathy "  must  remain  until  the  functional 
treatment  is  more  thoroughly  decyphered  in  regard  to  the 
material  changes  produced  by  it*  and  till  then  this  expression 
will  be  indispensable*  inasmuch  as  we  practise  functional  treat- 
ment according  to  the  law  of  "  similars."  Therefore,  as  long 
and  as  far  as  the  '*  law  of  similars "  obtains  in  "  functional 
treatments,"  so  long  and  so  far  must  these  treatments  be 
designated  "  homoeopathic." 

ON  EXTEBNAL  REMEDIES,  AND  ON  SLIGHT 
DEFORMITY  OF  THE  CHEST  AS  A  CAUSE  OF 
DISEASE. 

By  Dr.  Liedbeck,  of  Stockholm. 

My  ideas  about  external  applications  of  remedies  have  already 
been  published  in  sundry  periodicals.  I  have  lately*  in  a  case 
of  tubercular  dyscrasia,   in   which  Iodide  of  Iron  produced 


by  Dr.  Liedbeck.  617 

beomoptysis,  seen  a  complete  cure  by  Frotiod.  feni  gr.  j,  Aq. 
J  188  externally  applied,  ,one  teaspoonful  nigbt  and  morning. 
Every  body  bad  considered  tbe  patient  as  beyond  recovery. 
However,  at  present,  sbe  is  well,  bas  lost  tbe  night  perspira- 
tions and  expectoration,  and  recovered  a  healtby  colour  on  ber 
cbeeks.  Sbe  is  moreover  quite  erect,  instead  of  being  as 
previously,  ronnd-sbouldered  and  stooping. 

In  children  with  abdominal  atrophy  often  complicated  with 
obstinate  diarrhoea,  and  where  allopathic  physicians  had  pro- 
nounced that  everything  would  be  of  no  avail,  and  where  the 
little  patients  were  lying  with  immoveable  glassy  eyes,  I  have 
often  seen  immediate  relief  follow  the  application  of  a  cataplasm 
of  brandy  on  tbe  abdomen;  and  in  cases  complicated  with 
diarrbcea,  I  have  cured  it  with  thirty  drops  of  the  wine  of 
Tokay,  a  popular  remedy  in  Hungary  not  to  be  despised.  The 
late  Professor  Wahlenberg  was  of  opinion  that  its  effect  in  such 
cases  depends  on  the  presence  of  some  calcareous  elements  in 
the  wine. 

In  the  case  of  Mr.  Aspegren,  a  79  years  old  colour-ser- 
geant, who  suffered  from  hypertropbia  excentrica  cordis,  I  have 
seen,  for  a  short  time  at  least,  a  more  decided  relief  follow  from 
Digitalin  gtt.  j  than  from  Digitalis  3,  as  well  as  B.  Digitalis, 
dispensed  from  one  of  the  allopathic  chemists*:  afterwards 
Digitalis  3  had  a  better  effect.  The  patient  suffering  afterwards 
from  dysphagia  was  cured  by  Bell.  gr.  j,  Aq.  dest.  J  js,  one  tea- 
spoonful  every  other  hour  (a  la  Popper). 

It  would  be  interesting  for  me  to  know  if  any  of  my  col- 
leagues in  England  have  already  made  observations  relative  to 
an  affection  of  the  heart,  about  which  I  am  going  to  speak,  and 
for  which  our  medical  gymnastics  is  the  true  specific,  in  accord- 
ance with  the  nature  of  the  affection,  and  our  idea  of  healing 
effects  in  general.  In  perusing  some  anatomical  author  (the 
name  has  escaped  my  memory  for  the  moment)  my  attention 
was  drawn  to  the  fact  that,  besides  the  well-known  conditions 
of  the  pelvis  in  woman  being  wider  than  that  in  man,  tbe  chest 
of  man  being  in  every  dimension  larger  than  in  woman,  whilst 
his  pelvis  on  the  other  hand  is  narrower  but  higher  than  in  tbe 
female  sex ;   we  find,  on  comparing  the  angles  of  the  arcus 


618  On  External  Remedies^  <tc., 

pnbis  and  the  angles  fonned  by  the  cartilages  of  the  false  ribs 
of  the  right  hypochondriam  with  the  left,  another  characteristic 
difference,  viz.,  the  angles  of  the  arcus  pubis  in  woman  larger 
than  90^  but  in  man  acute,  whilst  the  hypochondriacal  angle 
in  man  is  larger  than  90^,  but  in  woman  smaller,  or  at  the 
utmost  amounting  to  90^.  These  conditions  pre-suppose  every 
thing  in  normal  development  as  regards  the  lower  part  of  the 
thorax.  When  the  hypochondriacal  angle,  as  appears  from 
uildemeath  the  integuments,  on  the  contrary,  is  less  than  90^ 
the  thorax  in  both  sexes  has  not  its  normal  form  and  develop- 
ment. It  is  evident  that  in  women,  from  the  fashion  of  dis- 
torting the  ^gure  by  the  use  of  stays,  especially  when  tight 
laced,  the  hypocondriacal  angle  becomes  more  acute  through 
the  depression  of  the  ribs  and  their  cartilages,  by  which  the  free 
action  of  the  lungs  becomes  impaired,  causing  palpitation, 
oppression  of  the  chest,  involuntary  sighing,  &c.  The  me- 
chanical effects  of  the  pressure  of  the  corset  become  still  more 
important  from  what  I  have  observed  in  posi  mortem  exami- 
nations,* as  regards  the  liver,  which  frequently  is  forced  to 
abnormal  growth,  in  so  far  as,  contrary  to  its  normal  form,  the 
lateral  diameter  is  diminished  whilst  the  antero-posterior  dia- 
meter becomes  larger :  nay,  the  liver  is  even  pressed  downwards 
below  the  edge  of  the  ribs,  in  order  to  find  place  where  place  is 
to  be  foumd,  which  is  afforded  by  the  yielding  and  relaxed  abdo- 
minal muscles.  It  is  even  possible  that  the  dress  of  the  woman 
is  the  cause  that  the  sternal  angle  at  the  pit  of  the  stomach  is 
only  acute,  or,  at  the  most,  a  right  angle,  never  obtuse,  except 
in  cases  of  considerable  emphysema,  which  obliges  her  to  leave 
off  both  the  corset  and  all  tight  fitting  dresses  around  the  lower 
part  of  the  thorax. 

In  man,  using  generally  a  looser  dress,  the  precordial  region 
is  generally  normal  with  the  angle  of  the  cartilages  larger  than 
90^.  But  I  have  even  seen  men  where  this  angle  has  presented 
an  acute  opening.  In  such  oases  we  find  often  tubercular 
deposits  in  the  lungs,  or  a  secondary  affection  of  the  heart, 
depending  on  the  pressure  of  the  ribs  on  the  heart,  which  thus 
being  irritated,  an  increased  action  (palpitation)  is  set  up, 
causing  hypertrophy,  or   even    under  certain  complications, 


hif  Dr,  Liedbeck.  619 

atrophy.  The  former  is  the  case  with  those  who  do  not  suffer 
from  tubercular  disease,  the  latter  is  the  case  in  phthisis  pulmo- 
nalis  and  has  been  proved  hj posi  mortem  examinations.  Occa- 
sionally this  abnormal  form  of  the  thorax  is  also  accompanied 
by  secondary  bronchitis.  With  every  exertion  follows  great 
excitement,  anxiety,  &c.,  which  increases  the  palpitation  of  the 
heart,  often  causing  even  fits  of  syncope. 

I  have  observed  lately  a  still  more  curious  case  in  which  the 
hypochondrium  of  the  left  side  was  depressed  in  an  acute  angle 
against  the  right  one.  The  patient  had  been  treated  allopathi- 
cally  with  Sal-ammoniac,  Digitalis,  &c.,  of  course  with  no 
result.  Professor  Branting  was  of  opinion  that  this  depression 
was  caused  by  a  paralytic  state  of  the  intercostal  muscles. 
How  far  I  am  of  the  same  opinion  the  copy  of  my  certificate, 
without  any  bias  for  ancient  or  modem  modes  of  treatment, 
will  shew.  The  result  of  the  gymnastic  treatment  which  was  at 
first  carried  out  in  the  country  by  Mr.  Therein,  M.A.,  under 
the  superintendence  of  Professor  Branting,  will  be  seen  here- 
after. Dr.  Jentsen,  the  patients  former  physician,  had  de- 
clared that  neither  gymnastics  nor  homoeopathy  could  do  any 
thing  in  this  case,  declariug  at  the  same  time  that  he  could  do 
no  more  himself.  With  all  this  Dr.  Ereysig  s  old  expression  is 
quite  to  the  point,  "  Heart  disease  is  a  very  sad  disease." 

The  cause  of  this  paralysis  intercostalis  is  probably  the  fol- 
lowing :  the  in  other  respects  powerful  young  man  had  whilst 
living  in  the  country  been  perfectly  well,  amusing  himself  with 
shooting,  swimming  and  other  sports.  At  once,  on  going  to 
the  University  of  XTpsala,  he  is  confined  to  a  small  room  where 
he  lies  continually  on  his  left  side,  keeping  a  heavy  book  in  the 
left  hand.  After  some  months  constant  reading  he  commences 
to  feel  unwell,  and  after  an  unsuccessful  examination  the  pre- 
sent symptoms  became  manifested,  and  though  he,  during  the 
following  session,  passed  his  examination,  the  injury  was  already 
done.  At  present  he  has  a  kind  of  fits;  he  gets  livid,  the 
extremities  become  cold,  he  feels  as  if  he  should  die,  he  looks 
quite  bewildered  and  loses  his  speech,  the  respiration  is  very 
much  oppressed,  and  at  the  same  time  there  is  congestio  cerebri, 
the  head  feeling  heavy  and  confused.     It  had  been  surmised 


620  .    On  External  Remedies,  dc, 

that  this  oonld  be  cored  by  some  sedative  pills  and  foot-baths  ; 
and  to  keep  the  bowels  open  Bhubarb*  Cream  of  Tartar, 
Salts  were  not  omitted,  besides  cuppings,  &c.  The  pulse  is 
feeble,  large ;  when  the  fits  occur  it  is  said  to  be  intermittent. 
He  felt  some  relief  from  my  advice  to  use  an  enema  of  cold 
water  when  the  bowels  are  confined,  without  any  medicine. 
My  certificate  was  as  follows  : — 

"  That  Mr.  John  Alfred  Erling,  whom  I  visited  last  week  in 
the  Rectory  of  Huddinge,  is  suffering  from  disease  of  the  heart, 
principally  caused  or  accompanied  by  paralysis  intercostalis 
sinistra,  and  thence  is  unfit  to  enter  into  active  service,  unless 
by  the  use  of  appropriated  medical  gymnastics  for  some  months, 
and  probably  as  an  adjuvant,  some  hydropathic  treatment,  his 
affection  becomes  alleviated  and  gradually  conquered, 'which 
according  to  my  opinion,  never  can  be  obtained  by  any  kind  of 
pharmaceutical  remedies.  This  I  hereby  testify  as  my  opinion, 
which  I  corroborate  with  my  oath  as  physician  ;  so  God  help 
me  here  and  hereafter. — Stockholm,  15th  of  July,  1658. 

"  P,  J.  LlEDBECK." 

This  decided  opinion  of  mine  had  been  confirmed  through 
repeated  observations  of  the  effects  of  a  rational  medical-gym* 
nastic  treatment  in  similar  cases,  amongst  which  I  only  mention 
the  following :  Mr.  Oranberg,  commander  of  a  merchant  ship, 
was  always  well  whilst  on  sea,  but  no  sooner  did  he  put  his 
foot  on  land  than  he  became  more  or  less  suffering.  On  ex* 
amining  him  a  few  years  ago  I  found  the  hypochondriacal 
angle  acute,  the  beat  of  the  heart  strongly  vibrating  against  the 
left  side  of  the  thorax.  He  had  used  divers  allopathic  medi* 
cines  without  the  slightest  benefit.  I  did  not  prescribe  any 
homoeopathic  medicines  for  him,  but  sent  him  to  Professor 
Branting,  who  perfectly  cured  him.  The  following  year,  how- 
ever, no  sooner  had  he  come  on  shore  again  than  he  felt  his 
former  symptoms;  furred  tongue,  dry  skin,  precordial  op* 
presaion  and  anxiety,  general  sinking  feelings  along  with  strong 
pulsation  of  the  heart  against  the  thorax,  disproportionate  to 
the  feebleness  of  the  pulse.  Persuaded  by  his  former  physician 
he  went  this  time  to  Dr.  Satherberg  s  gymnasium,  and  became 


by  Dr.  Liedbeck,  621 

well,  probably  by  the  application  of  the  same  movements  as 
taught  and  employed  by  Branting.  The  patient  praised  highly 
the  gymDastic  treatment,  thanking  me,  in  the  following  words, 
for  my  advice :  "  Had  you  not  advised  me  to  use  medical  gym- 
nastics, I  should  probably  have  died,  or  at  least  I  would  have 
become  a  constant  martyr  to  the  abominable  drugs  from  the 
chemists'  shops/' 

The  result  of  the  movement-cure  in  Mr.  Erling's  case  has 
entirely  justified  my  opinion.  The  treatment  having  been  con- 
tinued in  the  country  for  a  couple  of  months,  the  patient  could 
be  removed  to  Stockholm,  and  for  the  sake  of  convenience  the 
treatment  was  thenceforth  administered  by  Mr.  Brouhu,  di- 
rector of  the  gymnasium  in  the  southern  suburb  of  Stockholm. 
Though  improved  and  living  quite  close  at  hand,  he  was  obliged 
to  rest  sixteen  times  in  the  street  before  he  arrived,  quite  out  of 
breath,  and  livid  in  the  face.  His  treatment  commenced  the 
2nd  November,  1858,  till  the  end  of  May,  1859,  thus  lasting 
for  six  months.  In  March  the  patient  found  himself  so  much 
improved  that  he,  contrary  to  the  advice  of  Professor  Branting, 
resumed  his  official  duty  as  a  notary.  Though  occupied  only 
one  hour  daily  his  symptoms  became,  however,  so  much  worse, 
that  he  was  obliged  to  discontinue,  and  to  procure  a  new  cer- 
tificate for  leave  of  absence. 

I  am  aware  that  the  physician  to  whom  he  applied  for  a  certi- 
ficate, as  well  as  others,  considered  his  sufiering  to  be  primarily 
hypertrophy  of  the  heart,  and  that  the  alteration  in  the  form  of 
the  thorax  was  only  secondary ;  but  nevertheless  my  opinion  is 
decided  that  the  hypertrophy,  if  there  ever  existed  one,  was 
caused  by  the  paralytic  state  of  the  intercostal  muscles  of  the 
left  side,  in  consequence  of  which  the  heart  not  having  sufficient 
room  became  oppressed,  and  the  beat  agaiust  the  thorax  ap- 
parently larger  than  if  both  sides  of  the  thorax  had  been  sym- 
metrical. I  think  it  was  Claude  Bernard  who,  by  pressure  with 
the  finger  outside  the  thorax  on  the  left  side  where  the  beat  of 
the  heart  (ictus  pulsus  cordis)  is  felt,  produced  in  the  rabbit 
first  syncope,  and  after  continued  pressure  on  the  same  spot, 
the  death  of  the  animal. 

Mr.  Erling  had  exposed  himself  to  a  somewhat  similar  in- 


622  The  Law  of  Similars, 

flueDce;  by  remaining  month  after  month  lying  constantly 
with  the  book  in  his  left  hand,  with  the  elbow  and  arm  closely 
pressed  to  the  side,  whilst  making  annotations  with  pencil  with 
his  right  hand,  as  before-mentioned.  To  retnm  to  Mr.  Erling  s 
recovery.  In  the  months  of  Jane,  July  and  August,  he  passed 
through  a  febris  lenta  nervosa.  The  gymnastic  treatment  was 
afterwards  resumed  in  the  month  of  October,  and  in  the 
coarse  of  a  month  he  was  quite  well  and  able  to  resume  his 
duties. 

In  the  meantime  I  had  taken  the  opportunity  of  examining 
his  thorax  and  found  its  form  much  more  normal,  although  as 
no  mensuration  had  been  made,  the  perfect  synmietry  was  not 
fully  ascertained. 


THE  LAW  OF  SIMILARS,  IS  IT  UBIQUITOUS  ? 

By  Francis  Coding,  M.D. 

To  us  who  recognise  the  law  of  similars  as  an  established  prin- 
ciple regulating  the  practice  of  medicine,  it  seems  strange  that 
there  should  exist  any  doubt  of  the  universality  of  its  applica- 
tion to  the  treatment  of  disease.  And  yet  there  is  distrust! 
Why  and  wherefore  ? 

We  speak  of  a  homoeopathic  law  of  cure — and  truly  so  ;  but 
is  it  one  altogether  excluded  from  disturbance  of  action  when 
subjected  to  opposing  conditions  ?  What  is  law  ?  The  most 
comprehensive  definition  of  "  law,"  as  understood  by  the  best 
authorities,  is — that  whether  in  reference  to  the  universe  of 
matter  or  mind,  law  is  simply  a  rule  of  action,  or  some  definite 
mode  in  which  force  or  motion  proceed  toward  the  accomplish- 
ment of  an  end.  As  such  it  operates  within  certain  prescribed 
limits  or  conditions  ;  and  so  long  as  this  is  the  case,  it  may  be 
said  to  act  in  a  fixed  and  determinate  method.  Law  then,  in 
itself  is  neither  force  nor  motion,  but  the  rule  of  action  which 
these  powers  in  their  operation  are  made  to  observe.  Now,  we 
may  safely  hazard  the  opinion  that  there  are  no  laws  operating 
in  nature  which  are  not  to  some  degree,  either  directly  or  in- 
directly, liable  to  the  influence  of  disturbing  causes,  which  for 


by  Francis  Godin^,  M.D.  628 

a  moment  may  interfere  with,  or  impede,  the  otherwise  orderly 
and  unbroken  series  of  their  operations.  We  say  for  a  moment 
in  a  limited  sense,  becaase  it  is  easy  to  see,  that  if  there  could 
be  any  force  or  motion  uithout  a  regulating  method  or  law  of 
action,  their  operation  would  necessarily  be  chaotic,  and  would 
tend  to  the  subversion  of  all  order  and  arrangement  in  nature. 
Impediments  then  to  a  rule  or  law  of  action  are  not  absolute  or 
final ;  they  are  only  occasional  and  exceptional — not  necessarily 
destructive  of  the  end  proposed.  The  tendency  of  the  magnet, 
for  instance,  to  point  north  and  south  is  called  the  law  of 
polarity,  and  we  know  that  it  has  disturbing  causes  influencing 
its  operation ;  yet  how  essential  is  it  to  the  mariner !  The  law 
of  polarity,  notwithstanding  these  irregularities,  still  holds  good, 
and  by  a  compensating  process  becomes  serviceable  to  the  safe 
navigation  of  his  vessel.  Does  this,  or  does  it  not,  illustrate 
the  law  of  similars  ?  Take  another  familiar  illustration.  The 
mechanism  of  a  watch  is  set  in  motion — a  fall  or  an  accidental 
blow  often  stops  the  action  which,  by  a  law  of  mechanics  to 
"  take  note  of  time,"  should  be  uninterrupted ;  a  similar  slight 
concussion  sets  the  watch  a  going  again.  Is  the  law  of  me- 
chanics here  obstructed,  less  universal,  less  adapted  in  its  appli- 
cation to  the  construction  of  time*pieces  ?  It  may  be  objected, 
that  in  this  particular  case,  the  end  cannot  be  said  to  be  accom- 
plished, since  the  time  by  the  stopping  of  the  watch  is  not 
correct.  True ;  but  then  it  is  only  one  watch — that  individual 
watch,  that  is  temporarily  affected,  while  the  law  of  mechanics 
still  holds,  and  will  always  hold,  good  even  for  the  same  watch, 
and  a  thousand  others  besides. 

Indeed,  we  scarcely  know  any  laws  which  operate  in  nature, 
such  as  gravitation,  chemical  affinity,  attraction,  &c.,  that  are 
not,  philosophically  speaking,  in  some  way  or  other,  subject  to 
occasional  variations  or  disturbance — ^however,  practically  speak- 
ing, it  is  admissible  to  describe  and  view  them  as  "  fixed  and 
determinate."  Look  to  the  perturbating  forces  of  the  Planetary 
bodies,  causing  those  deviations  firom  their  regular  elliptic  revo- 
lutions round  the  Sun — to  determine  the  effects  of  which  is  the 
great  problem  of  Astronomy  !  Are  not  these  disturbances  com- 
.pensated  in  the  long  run  of  their  periodical  courses,  and  hence 


624  The  Law  of  Similars, 

is  not  the  stability  of  the  Planetary  system  a  proof  that  it  con 
tains  within  itself  no  element  of  destmotion,  bat  that  the  cease- 
less joumeyings  of  the  orbs  which  compose  it  are  calcalated  to 
go  on  for  ever  ? 

If  these  things  be  true,  is  onr  law  of  similars  an  exception — 
exempt  from  disturbances  which,  of  some  kind  or  other,  affect 
other  laws  ?  Surely  there  is  nothing  absolutely  perfect  Per- 
fection belongs  not  to  this  sphere — is  merely  relative,  and  the 
old  adage,  "  no  rule  without  an  exception,"  is  just.  If  all  and 
everything  were  perfect,  what  becomes  of  the  law  of  pro- 
gression ? 

I  have  been  led  into  the  above  train  of  thought  by  a  fre« 
quently  recurring  question  asked  by  many  a  doubting,  nervous, 
and  anxious  patient.  Even  professional  confr^es  are  not  free 
from  an  implied  misgiving  on  this  head.  As  far  as  I  can  learn, 
it  has  its  origin  in  a  somewhat  dogmatical  assumption  that 
homoeopathy  (in  which  term  is  included  the  therapeutic  law  of 
cure)  is  in  some  places  so  influenced  by  climatic  and  atmo- 
spheric conditions,  as  to  be  inefficacious  in  the  treatment  of 
disease  in  those  particular  localities.  Deluded  by  this  broad 
and  gratuitous  assertion — a  weak  invention  of  the  enemy — there 
are  people  who  repeat  this  calumny  under  the  full  persuasion 
that  homcBopathy  is  not  reliable  as  a  means  of  cure,  and  thus 
give  extension  to  a  disparaging  rumour  against  the  system ; 
received,  no  doubt,  on  the  ipse  dixit  of  an  opponent  of  the 
system,  who  fathers  the  thought  and  propagates  it»  without 
having  troubled  himself  to  satisfy  his  mind  whether  or  not  it  be 
a  wrong  conclusion  ;  the  question  is  not  unusually,  by  an  in- 
valid coming  from  a  spot  alleged  to  be  obnoxious  to  homoeo- 
pathy, put  thus, — "  Will  your  remedies  act  in  such  a  place  ?  I 
would  like  to  take  them  back  when  I  go  home  again,  but  I  am 
led  to  believe  they  will  be  of  no  use  there."  Nor  is  there  at 
times  a  lack  of  assigned  reasons  for  this  presumed  failure  of 
the  system — evincing  plainly  enough  that  doubt  and  distrust  do 
exist.  It  is  to  be  observed,  that  on  the  part  of  the  patient  the 
doubt  confines  itself  to  our  medicines,  probably  because,  ignorant 
of  our  literature,  he  knows  little  or  nothing  of  the  law  regulating 
the  administration  of  our  remedies.    We  oan>  therefore^  all  things 


by  Fraficis  Ooding,  M,D.  C25 

ooDsidered,  make  allowancee  for  his  inoredality  at  oar  small 
doses ;  but  why  a  colleagae  should  entertain  misgivings  of  the 
universality  of  the  law,  is  hard  to  discern^  unless  indeed,  like 
the  patient,  he  is  haunted  by  ghostly  apprehensions  regarding 
the  e£Scacy  of  our  remedies.  To  him  I  would  say,  in  the  words 
of  Polonius, — ''  Take  eaoh  man  s  oensure,.but  reserve  thy  judg- 
ment." 

'Taking,  then,  a  broad  view  of  the  subject  as  involving  points 
of  practice  of  both  the  old  and  the  new  systems  of  medicine,  and 
reasoning,  as  far  as  we  can  command  them,  from  facts  to  prin- 
ciples, let  us  duly  weigh  the  matter,  premising  my  own  belief  to 
be — that  the  law  of  similars,  as  a  general  principle  of  thera- 
peutics, is  the  same  everywhere,  however  modified  it  may  happen 
to  be  by  occasional  conditiof^.  As  in  physics,  the  character 
and  tendency  of  the  moving  principle  should  be  first  understood 
and  established,  before  we  can  attend  to  the  impediments  of 
friction  and  the  resistance  of  the  air ;  so  in  medicine,  it  follows 
that  a  law  of  cure  must  be  first  discovered  and  recognised  ere  it 
be  sought  to  ascertain  how  and  in  what  way  it  is  liable  to  be 
affected*  And  that  such  a  law — the  law  of  similars,  in  spite  of 
all  impediments,  does  exist  and  produce  immensely  important 
results,  every  one  the  least  acquainted  with  our  literature  and 
the  logic  of  facts  must  perceive,  who  contemplates  the  present 
condition  of  medicine  as  compared  with  what  it  was  before  the 
old  school  became  a  questionable  teacher  of  the  art  of  healing, 
and  Hahnemann  the  discoverer  and  the  pioneer  of  an  improved 
system. 

But  has  the  sweeping  allegation  to  which  I  have  alluded 
against  homoeopathy  as  containing  a  law  of  cure  (which  has 
been  proved  to  exist  by  the  fairest  induction,  independently  of 
therapeutic  agents  and  the  modes  of  exhibiting  them),  been  sub- 
stantiated by  any  well  authenticated  statements,  or  upon  any 
rational  grounds  of  inquiry  ?  I  think  not.  Until,  then,  su£Ei- 
oient  evidence  be  aidduced  confirmatory  of  such  a  change,  the 
bare  assertion  must  stand  not  only  not  proven,  but  directly  at 
variance  with  certain  well  known  facts  and  observations.  Let 
US  advert  to  these  and  to  such  other  data  as  I  possess.  Homoeo- 
pathy has  obtained  not  only  a  firm  footing,  but  is  at  the  present- 

VOL.   XX.,   NO.   LXXXn. — OCTOBER    1862.  2   R 


eS6  The  La^  a 


day,  mora  or  l68d»  praoiisad  eyerywhere-— on  the  oontine&t  of 
America,  from  Oaiiada  to  the  Brazils,  and  in  this  extensiTe 
area  is  foond  oomprised  avery  Tariety  of  climate.  Gold  and  heat 
in  their  extremes,  hnmid  and  dry  atmospheres,  sea  and  land 
hreezes,  differenoes  in  races,  habits  and  onstoms,  these  exist  to 
exercise  their  influences  on  the  human  organism;  and  yet, 
throughout  this  vast  tract  of  country,  no  complaint  from  our 
oolleagufls  has  reached  our  ears  that  the  grand  principle  of  cure 
—the  law  of  similars  is  so  ftur  in  default  as  to  be  inert — that 
in  certain  localities  it  is  nugatory  and  of  no  avail.  I  promi- 
nently refer  to  America  as  presenting  the  widest  range  of 
physical  circumstances,  especially  for  obtaining  cumulatiye  evi- 
dence,/t^  and  eon.  the  stability  of  the  homcnopathic  law ;  and 
I  repeat  that  I  am  notaware  of  any  rumour  to  land  us  in  the 
region  of  doubt  and  uncertainty  in  regard  to  the  law  itself. 
Difficulties  might  be  experienced,  and  stubbornness  of  oases  to 
succumb  to  treatment  alluded  to,  but  no  hint  is  given  that  the 
law  is  inoperative.  To  India,  Europe  and  other  climes  a  like 
appeal  might  be  made  with  similar,  negative  response.  But 
there  is  something  beyond  this  mere  tacit  recognition  of  hommo- 
pathy  as  a  mode  of  cure.  Besides  statistical  evidence  deduced 
from  the  comparative  results  of  the  practice  of  the  old  and  new 
school  showing  a  preponderance  in  ftvour  of  the  latter,  one 
cannot  fail  to  perceive  a  growing  tendency  on  the  part  of  the  old 
system  to  appropriate  our  remedies  and  to  laud  their  effects  in 
oases  precisely  similar  to  those  in  which  our  law  requires  that 
we  should  administer  the  same  remedies.  And  to  those  who  do 
not  merely  look  at  the  surface  of  things,^  this  internal  evidence 
ought  to  have  great  weight-Hhe  truth  of  ihe  law  thus  mani- 
festing itself,  in  spite  either  of  the  actual  want  of  a  knowledge 
of  it,  or  the  affectation  to  disregard  and  ignore  its  existence. 

I  have  already  intimated  my  belief — ^not  from  any  direct  or 
searching  investigation,  for  that  is  still  needed,  but  chiefly  upon 
the  grounds  of  analogy — that  the  law  of  cure  may  become  in- 
fluenced by  occasional  causes  operating  detrimentally.  Such 
opposing  conditions  have  their  source  in  certain  powers  or  in- 
fluences of  universal  nature,  by  which  man,  as  a  component  part 
thereof,  must  be  more  or  less  affected  according  as  th^  are  mani- 


ip  Francis  Qodinff,  M.D.  627 

fested  by  and  in  him.  In  general,  eaferis  paribus,  they  act  in- 
sensibly on  his  constitution;  bnt  there  are  times  and  places 
when  and  where  we  are  made  more  sensible  of  their  inflaenoe, 
when  they  preponderate  in  the  scale  over  ordinary  and  more 
healthy  conditions,  and  so  come  to  exert  injuriously  their  action 
in  a  more  concentrated  and  intensified  form.  These  physical 
influences  long  experienced  observation  enables  us  to  describe 
under  the  general  term  of  exciting  and  remote  causes,  when 
they  are  spoken  of  and  applied  to  disease  or  abnormal  states  of 
the  human  body.  Some  are  solar  products — ^heat  and  cold, 
humidity  and  dryness,  rareness  and  density  of  the  atmosphere, 
as  ascertained  by  the  barometer  and  thermometer ;  winds  and 
their  direction ;  atmospheric  electricity ;  degrees  of  latitude ; 
miasms;  lunar  phases.  Allied  to  the  above  are  sudden  and 
ftequent  changes  of  temperature,  besides  several  other  climatic 
circumstances  determining  the  genius  loci  ;  such  as  the  nature 
of  the  soil,  marshy  or  dry ;  luxuriant  or  scanty  vegetation ; 
stagnant  or  running  water.  As  not  irrelevant  to  the  subject,  I 
include  in  this  category  of  causes,  moral  and  social  influences ; 
such  as  the  way  of  living  and  occupation — ^the  motory  or  seden* 
tary  life,  and  all  causes  of  anxiety,  as  famine,  depressed  trade« 
fidlnre  of  crops,  and  the  calamities  of  war,  hurricane,  and  earth- 
quake ;  all  of  which  contribute  their  quota  of  influence  to  affect 
man  as  a  being  subject  to  the  vicissitudes  of  mortality. 

A  little  reflection,  therefore,  leads  us  to  recognise  a  close 
relation  existing  between  the  rule  of  action — our  law  of  cure— * 
and  the  vital  action  of  the  human  organism ;  upon,  and  with 
which,  the  former  operates,  and  is  in  correspondence.  And  the 
inference  seems  to  me  unavoidable,  that  whatever  exerts  its 
action  on  man's  frame,  be  it  physical  or  be  it  moral,  must  have 
a  tendency  to  affect,  more  or  less  favourably  or  injuriously,  the 
operation  of  the  law  of  cure — ^favourably  when  they  (the  in- 
fluences) are  auxiliary  to  medical  treatment*«-injuriously  when 
ibey  retard  or  seem  to  oppose  remedial  measures.  Thus  in 
consumption,  I  have  found  that  a  dry  air — a  north-easterly 
wind  prevailing,  for  instance^— generally  operates  disadvantage- 
onsly  upon  the  pati^it,  while  a  humid  atmosphere  seems  to 
have  a  more  benign  influence.    Dr.  Blest,  of  Nice,  whose  ex- 

2fi2 


628  The  Law  of  Similars. 

perience  is  entitled  to  respect,  deplores,  as  an  egregious  and 
fatal  mistake,  tbe  sending  confirmed  consumptive  cases  to  that 
city.  The  dry  atmosphere  of  the  place,  instead  of  benefiting 
such  patients,  most  assuredly  hastens  their  end.  In  corrobo- 
ration of  this  opinion,  I  would  mention  that  in  Demerara,  vith 
a  humid  atmosphere,  consumption  is  very  rate — scarcely  known ; 
while  in  other  parts  of  the  West  Indies,  with  dry  air  and  ex- 
posure to  N;E.  trade  winds,  the  disease  is  very  common* 

Shall  we  then  deny  that  our  law  of  cure  is  aflTected  by  certain 
opposing  conditions  ?  Certainly  not  I  admit  it  to  a  certain 
extent ;  but  if  this  be  used  as  an  argument  against  its  applica- 
tion to  the  treatment  of  disease,  what  shall  be  said  of  the  *'  law 
of  contraries,"  the  ''  derivative"  or  "  revulsive"  methods,  or  of 
any  other  mode  of  action  such  as  the  old  school  adopts  ?  Is  it 
not  notorious  that  they  fail  too — that  they  have  signally  failed, 
one  after  another,  to  such  an  extent  as  to  bring  the  whole 
system  of  old  school  therapeutics  into  unenviable  disrepute  ? — 
and  not  only  so,  but  that  these  short-comings  have  been  the 
font  et  origo  of  those  extemporaneous  quacks  and  quackeries 
which  disgrace  medicine  ?  Does  immunity,  then,  fix>m  opposing 
conditions,  climatic,  atmospheric  and  other  influences,  entirely 
and  universally  attend  the  old  school  system,  or  even  more  so 
than  it-does  ours  ?  I  opine  not.  Are  they  so  perfect  of  them- 
selves, that  they  bid  defiance  to  epidemic  diseases  ?  The  records 
of  cholera  and  yellow  fever  do  not  so  interpret  for  them  as  to 
fiivour  and  encourage  such  a  notion. 

I  proceed  to  trace  to  its  source  the  suppositious  charge 
against  homoeopathy.  As  just  admitted,  there  may  be  some 
grounds  for  it,  however  erroneous  the  conclusion  arrived  at; 
and  the  way  I  have  attempted  so  far  to  dispose  of  the  plea 
against  our  law  of  similars — ^namely,  the  imperfection  of  all 
laws  in  general,  I  think  lays  open  a  very  interesting  tract,  not 
of  fanciful,  but  of  most  legitimate  and  sober-minded  inquiry, 
how  far  our  law  of  cure  is  implicated  by  this  imperfection,  how 
it  may  be  compensated,  and  how  it  now  stands  in  comparison 
with  the  methods  pursued  by  the  old  school — an  inquiry  leading 
to  important  information,  and  which  I  trust  my  colleagues, 
better  placed  than  myself  for  obtaining  results,  will  pursue. 


By  Francis  Goding,  M.D.  629 

Irrespective,  then,  of  any  animus  provoking  hostility  against 
homoBopathy,  I  imagine  that  the  prejudices  and  evil  report  of 
the  uninformed  are  founded  on  the  difficulty  experienced  in 
combating  endemic  disorders  whose  essential  character  is  well 
marked  periodicity.  I  mean  those  intermittent  fevers  which  are 
variously  termed  according  to  their  habit — colony  fever,  marsh 
fever,  chill  and  fever,  ague  and  fever,  &c.  Circumstances 
warrant  the  belief  that,  like  typhoid  fevers,  they  vary  in  cha* 
racter  with  the  locality — in  other  words,  that  each  place  has  its 
own  kind  and  degree  of  fever.  However,  differing  in  mildness 
or  severity,  some  being  more  easy  of  control  than  others,  they 
are  everywhere  regarded  with  dread ;  and  it  must  be  confessed 
that  the  treatment  of  these  fevers,  from  the  general  obstinacy 
they  exhibit,  is  comparatively  our  weakest  point.  I  have  almost 
always  found  that  our  school,  wherever  intermittents  prevail,  do 
not  hesitate  to  acknowledge  this,  and  unite  in  saying  that 
''  they  are  for  the  most  part  a  troublesome  class  of  disorders  to 
deal  with — that  they  sometimes  baffle  them  as  much  as  they  do 
baffle  their  allopathic  brethren — that  to  all  appearances  the 
latter  frequently  do  as  well,  or  even  better,  with  them — that  as 
to  the  results  there  is  not  much  to  choose  on  the  part  of  the 
sufferers  from  these  attacks  between  the  modus  operandi  of 
either  scbooL"  In  short,  I  conclude  that  their  treatment,  in 
spite  of  the  ''  sovereign"  remedy  Quinine,  is,  in  some  respects, 
a  terrible  opprobrium  to  both  schools.  Not  that  the  difficulty 
arises  from  the  inability  of  our  school  to  cure  them,  even  in  their 
worst  forms — the  journals  of  our  American  brethren  teem  with 
such  cases  of  cure — but  from  their  not  yielding  so  quickly  in 
our  hands  as  the  aborted  cases  of  the  allopaths  do.  "  You  may 
be  slow  and  sure,"  said  a  patient  from  Demerara  to  me  when 
under  a  paroxysm  of  an  untamed  fever,  ''  and  your  practice  less 
liable  to  produce  after  evils,  but  you  don't  hit  off  the  fever  as 
our  doctors  sometimes  do  down  with  us."  And  so  it  is  that  this 
difficulty  of  **  hitting  off,"  even  with  its  liability  to  dangerous  or 
unpleasant  sequel®,  is  the  very  head  and  front  of  the  offence, 
giving  rise  to  all  the  whispers  of  distrust  and  reproach  of 
homcBopathy.  Men  will  try  to  avoid  present  suffering,  even  at 
the  risk  of  its  suppression  being  attended  with  evil  consequences. 


6S0  The  Law  of  StmUars, 

It,  then,  my  ooDJeotare  be  joet  in  adribatiDg  the  ▼srioa  inn- 
endoes  against  the  system  to  the  difficulties  encoantered  in 
treating  endemic  fe^era,  is  there  anything  fiirtfaer  to  be  adduced 
in  its  behalf,  or  in  extenuation  of  its  assumed  inefficiency  ?  Is 
our  loyalty  to  a  noble  cause  to  be  damped  by  the  allegation  of 
its  unreliableness  as  a  means  of  cure,  and  is  so  giaye  a  charge 
to  be  silently  endured  without  a  thorough  sifting  of  the  whole 
matter  in  question  ?  In  the  absence  of  any  direct  investigation 
of  its  merits,  let  us  regard  the  case  as  it  at  present  stands. 

An  accomplished  physician  of  the  old  school,  in  replying  to 
my  inquiries,  for  it  is  not  a  new  subject  of  anxious  considera- 
tion, assured  me,  as  regards  the  treatment  of  the  endemio  inter- 
mittents  of  America,  that  any  defined  plan  of  medioation  was 
hx  from  being  universally  successful;  and  in  evidence  of  this,  he 
gave  me  to  understand,  that  in  the  vicinity  of  Philadelphia  he  rarely 
if  ever  gave  Quinine-— that  neither  did  he,  or  his  colleagues, 
rely  upon  it  as  an  efficient  remedy  in  the  fevers  of  that  locality; 
and  that  they  found  Arsenic  a  better  medicine.  How  are  we  to 
interpret  this  explanation,  except  as  a  failure  of  a  vaunted 
qiecifio,  and  consequently,  up  to  the  time  of  its  having  been 
tried  and  relinquished,  that  the  school  of  which  my  friend  was 
a  membtf ,  had  in  his  person  suffered  repulse  frt>m  the  fevers 
of  the  Delaware  and  the  SdiuylkilL 

Of  the  West  India  colonies,  many  are  well  known  to  nourish 
endemic  fevers,  more  or  less,  of  an  intractable  kind.  It  is  fix)m 
these  quarters,  so  far  as  I  can  glean,  that  the  sendmenta 
adverse  to  homoeopathy  emanate.  But  with  the  exception  of 
Barbados,  no  other  British  colony,  I  speak  under  correction, 
rejoices  in  a  homoeopathic  physician,  although,  judging  from 
my  oorredpoudenoe^  there  are  few  places  where  homoBopathy  is 
not  resorted  to  by  amateurs.  Here  then,  without  any  intended 
disparagement  of  the  non-professionals  in  their  efforts  to  do 
good,  it  is  easy  to  see  sources  of  distrust,  for  no  one  unac* 
quainted  with  the  character  of  these  endemics  can  possibly  form 
any  just  idea  of  their  violence,  or  sufficiently  appredate  the 
«taot,  the  nice  discrimination  in  giving  medicines,  and  the  self* 
reliance  and  patience  which  are  demanded  in  treating  them 
skilfully.    If,  theu,  th^  suffin^ers  diemselves,  or  their  friendly 


ly  Francis  Goding,  M.D.  681 

attendants,  get  alanned  at  the  severity  of  tbe  fever»  and  call  in 
professianal  aid»  and  thus  give  occasion  to  invidions  rmnarks^ 
it  need  not  excite  our  surprise  that  inferences  iqurious  to 
homoBopathy  should  occur.  The  negation  therefore  of  the 
affioacy  of  homoeopathy  under  such  circumstances,  is  simply 
an  ahsnrdity,  and  the  reasoning  indulged  in  a  sophism* 

The  island  of  Barbados  being  free  from  those  aggravated 
forms  of  fever  engendered  elsewhere,  there  is  no  fair  oppor- 
tunity offering  itself  there  to  test  the  law  of  cure,  and  the 
efficiency  of  our  remedies,  by  a  comparison  of  the  results  of  the 
two  schools;  but  scores  of  patients  come  up  yearly  from 
various  colonies  with  a  view  to  the  restoration  of  their  health. 
Of  these,  I  have  had  many  falling  to  my  share  for  treatment — 
as  many  as  ten  or  twelve  at  one  period — suffering,  some  from 
unabated  fever,  others  from  the  cachexia,  and  other  sequelao  of 
the  disease.  Those  cases  with  recurring  paroxysms,  varying 
in  regard  to  time,  violence,  and  duration,  yielded  to  homoso- 
pathic  treatment;  some  much  more  readily  than  others.  A 
few  oases  proved  exceedingly  obstinate,  which  I  attributed  to 
the  hold  the  miasm  had  upon  the  constitation,  and  affecting 
internal  organs,  and  thus  keeping  up  and  creating  additional 
causes  to  influence  and  sustain  the  duration  of  the  fevej^ 
which  in  these  cases,  in  spite  of  the  large  doses  of  Quinine  and 
other  medicines  previously  exhibited,  had  not  succumbed  to 
allopathic  treatment — a  ftirther  and  very  significant  testimony 
that  allopathy  no  more  than  homoeopathy  is  infalUble.  Of  the 
colonies  most  notorious  for  aggravated  forms  of  endemic  fevers, 
particularly  the  intermittent,  Demerara,  Berbice,  Tobago,  and 
St  Lucia^  send  up  the  most  patients  to  Barbados ;  and  if  there 
is  a  circumstance  that  speaks  to  the  imperfection  of  medicine 
as  an  art,  it  is  unmistakingly  displayed  in  these  sufferers  from 
natural  and  drug  diseases.  Their  cachetic,  aneemic,  and  jaun- 
diced looks — the  enlarged  liver  and  qpleen — the  swollen 
features,  loose  teeth,  and  Mercurial  foator,  and  other  sequelffi  of 
an  untamed  and  would-not-be-cured  fever,  and  of  drugging,  give 
evident  intimation  "  that  something  is  rotten  in  the  state  of 
Penmark." 

As  far  as  I  glean  from  patients  who  from  time  to  time  have 


6811  The  Law  of  Similars, 

oome  under  my  care.  Calomel  and  Quinine  are  the  remedies 
chiefly  relied  upon  in  the  treatment  of  intermittent  fever.  With 
these*  and  under  the  allopathic  system,  I  am  informed  that 
three  results  are  attained — Firstly,  The  aborting,  or  sup- 
pression of  the  fever  by  large  doses ;  secondly.  When  this  fails 
to  happen,  a  return  of  the  paroxysms  at  certain  periods  of  time, 
and  the  disease  prolonged  to  an  indefinite  period,  varying  in 
point  of  duration  finom  days  to  weeks,  or  even  months,  until 
recovery  is  accomplished ;  and  lastly.  Such  persistence  of  the 
malady,  with  superinduced  and  dangerous  symptoms — obsCruo- 
don  and  engorgement  of  the  abdominal  viscera,  dropsy  and 
nervous  disorders,  for  instance — ^as  to  necessitate  the  removal 
of  the  patient  to  some  other  locality  or  climate.  What  the 
proportions  of  cures  is  to  the  uncured  does  not  transpire ;  but 
some  peculiarities  attendant  on  the  fever  of  Demerara  remain 
to  be  mentioned,  and  are  worthy  of  consideration  in  a  question 
like  the  present,  which  would  court  investigation  into  the 
nature  of  many  circumstances  connected  with  a  true  analysis 
of  both  modes  of  treatment  Thus  there  is  the  prevailing 
opinion  among  Demerara  people  that  their  fevers  are  influ- 
enced by  the  spring  and  neap  tides,  and  that  with  susceptible 
fever  patients  the  fever  does  not  entirely  cease,  but  disappears 
only  to  return  at  the  spring  tide,  although  at  such  return  dif« 
ferently  affecting  in  degree  different  persons — the  recurrence  in 
in  some  amounting  to  a  mere  malaise,  while  in  others  it  is  more 
sensibly  and  acuteTy  felt.  Again,  I  was  informed  by  a  clergy- 
man from  that  colony,  that  persons  in  whom  fever  attacks  are 
wont  to  be  aborted  or  suppressed,  not  unfrequendy  die  of 
apoplexy,  or  of  brain  affecdons,  accompanied  with  convulidons, 
and  become  subject  to  determinadons  of  blood  to  the  head. 
In  corroboradon  of  this  latter  circumstance  I  narrate  a  case 
which  subsequendy  occurrred  in  my  own  praodoe,  and  forcibly 
recalled  the  clergyman's  observadons.  A  strong  healthy 
planter  from  Barbados  was  travelling  in  Demerara,  on  business 
which  he  had  been  commissioned  to  look  after;  en  route  up  the 
Essequibo  river,  he  was  suddenly  seized  with  a  severe  chill  and 
fever,  in  the  house  of  a  friend.  The  physician  who  saw  him 
administered  a  dose  or  doses  of  medicines,  which  he  believed 


by  Francis  Ooding,  M.D,  638 

were  Quinine  and  Calomel,  and  which  so  far  suppressed  the 
fever  as  to  enable  him  to  resume  his  journey  on  the  following 
day.  He  felt  the  shock  he  had  experienced,  but  there  was  no 
return  of  the  attack  during  the  remainder  of  his  sojourn  in 
Demerara — some  eight  or  ten  days ;  but  no  sooner  had  he  got  to 
his  home  in  Barbados,  than  a  violent  attack,  similar  to  the  one  in 
Demerara,  occurred,  accompanied  with  torturing  pains  in  the 
head.  When  called  to  him,  I  found  that  he  laboured  under  a 
severe  form  of  tertian  ague,  accompanied  with  bilious  vomiting 
and  congestion  of  the  head  during  the  paroxysms.  In  the 
state  of  afyrexia  there  was  great  prostration,  with  a  dull 
benumbing  sensation  of  the  brain,  with  tendency  to  stupor, 
which  pain  increased  in  violence  when  the  paroxysm  of  fever 
returned,  until  he  became  delirious  and  almost  frantic.  Several 
severe  paroxysms  ensued,  and  were  only  moderated  and  finally 
subdued  by  frequent  doses  of  Bryonia  and  Belladonna.  The 
tertian  still  following  up,  without  the  urgent  head  symptoms, 
yielded  at  length  to  Arsenic,  followed  by  decimal  triturations  of 
Quinine,  cautiously  given.  The  attack  left  him  very  weak,  but 
sea- air  and  relaxation  firom  his  vocation  as  a  planter,  soon 
restored  him  to  his  former  health,  without  any  sequel®.  In 
this  case,  the  germ  of  the  disease  arrested  at  first  in  its  growth, 
seems  to  have  remained  for  a  while  latent  in  the  constitution  of 
my  patient,  and  then  to  have  burst  forth  again  in  a  very  aggra- 
vated form,  in  which  I  professed  to  discover  a  metastatic  action 
to  the  bndn  produced  by  the  aborting  plan  of  treatment.  There 
likewise  came  to  my  knowledge  another  case,  in  which  convul- 
sions, terminating  in  death,  occurred,  after  fever  had  been 
treated  with  large  doses  of  Quinine ;  it  was  that  of  a  young 
married  lady,  of  delicate  constitution,  who  visited  Barbados  for 
change  of  climate.  A  few  days  after  her  arrival  a  quotidian 
seized  her,  when  having  given  such  remedies  as  I  thought 
necessary  in  her  case  without  any  sensible  result,  I  administered 
Quinine  every  hour  during  the  apyrexia — six  grains  of  Quinine 
in  all,  intimately  triturated  with  twenty  grains  of  Sugar  of  Milk, 
and  divided  into  twelve  powders.  The  usual  paroxysm  did  not 
return,  and  shortly  after  she  went  home  in  her  usual  state  of 
health.    A  few  months  subsequently,  I  learnt  that  my  patient 


684  The  Law  of  Similars. 

had  been  again  a  safferer  from  fever,  in  order  to  check  whioh, 
large  doses  of  Quinine  were  given,  and  that  very  elkartij 
after  convulaions  without  any  assignable  reason  had  snddenly 
ensued,  and  oarried  her  off.  Am  I  right  in  my  supposition  of 
attributing  the  brain  affections  in  the  above  cases  to  the 
anppression  of  the  fever ;  and  furthermore,  that  by  our  system 
of  treatment,  all  such  and  similar  sequels  are  avoided  ? 

Oonneoted  with  the  present  inquiry  comes  an  important 
question — Whether  as  comparatively  an  infant  school  we  ore 
in  the  position  to  supply  every  requirement  of  the  law  of  cure 
with  remedial  agents  specifically  suited  to  the  treatment  of 
endemics  so  variable  as  these  are  in  their  nature  ?  No  longer 
than  in  the  beginning  of  the  present  year  a  fatal  form  of  dyseutory 
developed  itself  in  Port  of  Spain,  Trinidad.  Few  escaped 
death  who  were  attacked,  and  several  valued  lives  fell  victims 
to  its  malignancy.  Besides,  as  in  ordinary  dysentery,  constant 
urgency  to  go  to  stool,  tenesmus,  violent  abdominal  pains»  and 
bloody  and  mucous  discharges,  it  was  characterised  by  profuse 
flows  of  fresh  blood;  great  prostration  and  rapid  slnldng. 
The  treatment  by  the  allopathic  school  was  very  unsuccessfiiL 
While  wondering  if  the  disease  would  appear  elsewhere  and  show 
itself  in  Barbados,  a  case  fell  into  my  hands.  It  was  a  young 
man  in  search  of  employment  in  Demerara.  He  left  Port  of  Spain 
well,  when  just  before  reaching  Barbados,  in  the  mail  steamer, 
he  was  seized  with  the  disease.  On  his  landing  I  was  sent  for. 
With  him  the  flow  of  blood  was  not  at  any  time  very  jHrofuse,  or 
serious;  but  the  mixed  blood  and  mucous  discharge  were  inces- 
sant. Merc.  Cor.  alone,  and  afterwards,  that  and  Golocynth  alter- 
nately, except  some  mitigation  of  abdominal  pains  and  tenes- 
mus, made  no  impression  on  the  disease ;  aod  when  weakness 
manifested  itself,  they  were  changed  for  Arsenicum  and  Mux. 
It  still  persisted.  A  dose  of  Sulphur  was  administered,  followed 
by  a  few  doses  of  Colchioum ;  then  Gantharis,  the  secretion  of 
the  urine  having  become  almost  suppressed.  Some  mitigation 
of  the  symptoms  now  took  place.  But  there' was  no  decided 
improvement  which  warranted  the  belief  that  the  patient  was 
out  of  danger,  as  some  typhoid  symptoms  had  manifested  them- 
selves. I  decided  to  give  Petroleum,  and  to  this  medicine  a 
gradual  and  slow  amendment  succeeded,  whioh  ultimately  ended 


Sis  Months  of  Brttinh  Allopathy.  685 

in  a  tardy  recovery.  Here  certain  medicines  fidled  which  my 
experience  had  tanght  me  hitherto  to  rely  npon  inyariably  in 
eases  of  dysentery.  But  why  in  this  form  of  colitis  did  they  fail  7 
Ooald  it  hare  been  due  to  some  idiosyncrasy  of  the  patient  ?  Or« 
as  I  believe,  were  there  elements  in  the  endemic  constitution  of 
the  disease  itself,  which  these  remedies  hardly  covered,  or  of 
which  they  were  not  the  true  analogues  ?  The  reader  will  see 
in  this  an  obstacle  to  the  law  of  similars— one  which  only  time 
will  remedy.  He  will  see  why  it  is  that  Quinine  will  not  cure 
every  intermittent — ^how  it  is  that  not  Arsenic,  nor  Oedron,  nor 
Oimex,  nor  Eupatorium,  nor  Gancilagua,  are  specifics,  except 
so  far  as  in  their  relations  they  are  the  true  repreeentativee  of 
the  endemic  itself. 

As  an  apologist  on  behalf  of  the  principle  of  ubiquity  whieh 
attaches  to  the  law  of  similars,  I  have  merely  thrown  together 
my  own  views  of  the  matter.  Believing  that  the  subject 
demands  a  further  and  more  searching  investigation,  as  opening 
np  a  field  for  scrutiny  into  the  relations  which  therapeutic 
agents  have  to  diseases  in  general,  and  to  endemic  disorders  in 
particular-^thus  leading  to  fresh  discoveries  of  remedies  more 
nearly  allied  to  them  severally — and  as  involving  the  vexed 
question  of  auxiliaries  and  potency  of  the  dose,  I  look  forward 
with  the  hope  of  its  being  taken  up  in  all  its  bearings  upon 
these  topics,  and  upon  the  comparative  merits  of  the  treatment 
of  intermittents  by  both  schools  of  medicine,  concerning  which 
discordant  opinions  at  present  exist. 


SIX  MONTHS  OF  BBITISH  ALLOPATHY. 
Braithwaites  Restrospect  of  Medicine.    Jan. — June,  1862. 

Bbaithwaite's  Betrospect  is  too  well  known  and  valued  to 
need  any  general  criticism.  We  take  it  only  as  the  text-book 
for  a  resum6  and  criticism  of  the  allopathic  literature  of  the  last 
half-year. 

1.  The  first  paper  is  by  Dr.  William  Budd  of  Clifton.  It 
examines  carefully  the  common  notion  that  typhoid  or  intestinal 
fever  is  usually  originated  by  miasmatic  causes.    The  condu- 


686  Six  MoiUks  of  Bntuh  Allopathy. 

8ion8  to  whiob  the  author  oomes  are,  that  this  fever  is  as  efisen- 
tially  specific  and  contagious  as  typhus  or  small-pox :  that  the 
doctrine  of  spontaneous  generation  is  as  untrue  in  reference  to 
such  specific  diseases  as  it  is  in  regard  to  the  reproduction  of 
living  beings ;  that  the  contagion  of  typhoid  fever  is  usually  con* 
veyed  by  the  discharges  from  the  diseased  intestine,  as  that  of 
diphtheria  by  the  false  membrane  of  the  diseased  throat;  and  that 
the  best  mode  of  prophylaxis  consists  in  the  addition  of  disin- 
fectant fluids  to  the  evacuations  as  soon  as  they  are  passed. 

This  paper  of  Dr*  Budd's  is  but  a  sequel  to  numerous  writings 
on  the  subject  which  he  hss  published  in  the  Lancet  since  1856. 
His  views  have  been  lately  adopted  by  Mr.  Simon,  the  health- 
officer  of  the  metropolis :  as  Braithwaite's  second  paper  gives 
us  to  see.  The  facts  and  arguments  he  adduces  are  very  for- 
cible ;  and  at  least  warrant  the  adoption  of  his  prophylactic 
measure.  This  is  simply  to  place  two  ounces  of  caustic  solution 
of  Chloride  of  zinc  in  the  night-stool  on  each  occasion  before  it 
is  used  by  the  fever-patient. 

8.  Dr.  Gull  contributes  a  paper  upon  Typhus  Fever,  which 
is  chiefly  interesting  from  the  fact  that,  his  treatment  being 
purely  expectant,  we  are  able  to  study  the  natural  history  of  the 
disease.  He  likens  its  course  to  an  inverted  curve,  the  patients 
becoming  gradually  worse  up  to  a  certain  point,  and  then  either 
dying  or  as  gradually  improving.  The  turning-point  is  usually 
reached  on  the  fifteenth  day  of  the  illness.  It  would  be  in- 
teresting to  show,  from  statistical  data,  how  far  this  natural 
duration  of  the  disease  can  be  shortened  by  homoeopathic  treat- 
ment 

5.  Dr.  Chambers  is  giving  a  series  of  Clinical  Lectures  on 
what  he  calls  the  "  Restorative  "  mode  of  treatment,  as  distin- 
guished alike  from  the  allopatliic  and  the  homoeopathic.  It 
may  easily  be  conceived  that  his  remedies  are  almost  entirely 
dietetic  or  chemical.  Thus,  in  the  present  article  (on  Continued 
Fever)  he  lays  it  down  that  we  must  restore  the  nitrogenized 
matter  which  the  fever  is  wasting,  and  supply  acid  to  neutralize 
the  super- alkalinity  of  the  blood,  which  Dr.  Bichardson  has 
proved  to  exist  in  this  disease.  The  food  must  be  liquid : — 
beef  tea,  milk  and  lime-water,  eggs  beaten  up  in  milk,  &c.,  and 


Six  Months  of  British  Alhpathy.  687 

administered  in  small  doses  frequently' repeated.  Stimulants 
are  rarely  required.  The  acid  he  recommends  is  the  Muriatic. 
He  states,  that  under  this  treatment  he  has  only  lost  one  case 
of  low  fever  in  four  years,  and  this  one  from  perforating  ulcer 
of  the  intestines.  His  treatment  is  undoubtedly  a  great  im- 
provement upon  that  ordinarily  in  vogue  among  allopathic 
practitioners,  and  there  is  even  reason  to  believe  that  there  is  a 
something  of  a  specific  character  about  it.  For  Muriatic  acid 
is  of  no  little  service  in  typhoid  conditions  of  the  system,  ad* 
ministered  in  the  homoeopathic  dilutions. 

8.  The  last  paper  on  Continued  Fever  is  by  Dr.  George 
Johnson.  He  calls  attention  to  the  not  unfrequent  occurrence 
of  renal  congestion  and  inflammation,  with  albuminuria,  during 
the  progress  of  typhus  and  typhoid  fevers.  This  may  some- 
times be  the  cause  of  the  drowsiness  and  other  cerebral  symp- 
toms which  occur.  He  considered  the  complication  very  serious. 
To  us,  it  affords  another  strong  indication  for  the  use  of  Arsenic 
in  these  fevers,  by  which  the  renal  affection  may  be  best  averted 
and  cured. 

6,  7.  In  the  sixth  paper  Dr.  Oameron,  Deputy  Inspec- 
tor General,  tells  us  that  nearly  all  tropical  diseases  .pre- 
sent a  periodic  type,  and  that  "  Quinine  is  the  master-key  to 
their  treatment."  The  author  of  the  ''  Fallacies  of  the  Faculty  " 
will  crow  over  this  statement ;  but  we  should  be  strongly  dis- 
posed to  set  it  down  as  but  another  of  those  fallacies  themselves. 
A  companion  paper  shews  the  value  of  that  component  of  Opium 
called  "  Narcotine  "  as  an  anti-periodic,  which  is  considerable. 

10.  Dr.  Marsden,  of  the  Cancer  Hospital,  gives  four  cases 
of  the  treatment  of  cancer  by  the  local  application  of  Arsenic. 
He  states  that  he  has  not  seen  a  single  instance  of  the  disease 
returning  in  any  of  the  cases  thus  treated. 

18.  Dr.  McWilliam  gives  the  first  account  of  the  sarracenia 
purpurea,  or  pitcher  plant,  considered  by  the  North  American 
Indians  a  specific  for  small-pox.  Its  action,  as  described,  quite 
resembles  that  of  our  remedies,  and  it  would  probably  repay 
some  physiological  experimentation. 

14.  Another  of  Dr.  Chambers*  interesting  Clinical  Lectures 
follows,  the  subject  being  anemia.    Under  the  usual  treatment 


688  8i»  Monih9  of  BrMtk  Alhpatk^. 

by  Iron,  Aloes,  and  nonrishisg  diet,  be  caloalatee  that  the 
patient  under  notice  had  manafEustnred  twenty  ounces  of  led 
blood-oorpnscles  in  a  month.  He  insists  <m  the  neoessity  of 
gradually  rising  to  a  full  diet,  and  not  forcing  the  repugnant 
appetite  of  the  patient  ''  It  is  obvious/'  he  says, ''  that  if  I  had 
ordered  ever  so  many  '  ordinary  diets,'  a  patient  to  whom  the 
▼cry  sight  of  food  was  an  abomination,  would  have  gained  no- 
thing by  it — she  would  simply  have  gone  without  I  directed 
therefore,  no  meals  at  all,  and  no  solid  food,  but  a  cup  of  milk, 
with  some  lime  water  in  it,  to  be  given  as  medicine  every  two 
hours,  and  a  pint  of  beef-tea  in  small,  divided  doses  during  the 
day.  After  two  days  she  managed  an  egg  also  daily,  and  aftev 
twelve  days  of  gradaal  additions  of  this  sort,  you  will  find  her 
on  full  allowance  of  mutton-chop,  porter,  beef-tea,  and  milk." 
We  are  inclined  to  think  that  Homoeopathy  has  yet  much  to 
learn  as  to  the  treatment  of  an«mia. 

15,  16.  Aniline  is  an  artificial  alkaloid,  a  constituent  of 
indigo,  and  of  the  Oleum  Animale  of  Dippel, — ^both  known  as 
nervine  remedies.  Dr.  TambuU  was  thus  induced  to  try  the 
Sulphate  of  Aniline  in  some  obstinate  cases  of  chorea,  which 
had  defied  the  usual  remedies ;  and  he  gives  six  cases  strikingly 
illustrative  of  its  value.  The  nature  of  its  curative  operation 
soon  emerges  when  we  read  his  remarks  on  its  physiological 
action.  **  In  all  the  animals  experimented  upon,  violent  clonic 
and  tonic  spitsms  ensued  after  the  application  of  the  aniline, 
and  continued  almost  uninterruptedly  till  death."  The  curadve 
action  of  aniline  in  chorea,  then,  is  but  a  fresh  illustration  of 
the  law  "  similia  similibus  ourantur."  In  the  following  paper. 
Dr.  Fraser  contributes  five  cases  of  chorea,  in  which  the  Sol- 
phate  of  aniline  fiiiled  in  producing  any  improvement  His 
reason  for  employing  it  comes  strangely  firom  an  allopath. 
''  The  theory  for  the  employment  of  aniline  in  cases  of  chorea 
may  be  founded  on  this  physiological  &ct,  determined  by  expe^ 
riments  now  being  condacted  by  Dr.  Letheby  in  the  Laboratory 
of  the  London  Hosintal  Medical  College,  that  upon  Ae  adnu** 
nistration  of  aniline  to  dogs,  rabbits,  &c.,  the  functions  of  the 
brain  proper  are  anested,  while  those  of  the  spinal  marrow  are 
highly  exalted;  as  demonstrated  by  the  extaordinary  clonic 


Six  MontA$  of  British  Ailopaik^.  689 

spasms  at  the  time  when  the  animal  is  entirely  deprived  of  ordi- 
nary sensation  and  voluntary  mnsoular  actioo :  for  example^  a 
dog  under  the  influence  of  3  j  of  aniline  will  remain  for  three 
or  four  hours  comatose,  while  the  limbs  are  in  a  state  of  con- 
stant motion,  as  if  in  the  act  of  running.  Hence  it  might  be 
inferred  that  the  abnormal  muscular  movements  in  chorea  may, 
by  the  action  of  the  aniline,  be  averted,  and  give  place  to  the 
normal  voluntary  movements." 

17*  Dr.  O'Connors  cases  of  severe  and  long-lasting  neu« 
ralgia,  cured  in  a  short  time  by  the  Valerianate  of  ammonia, 
are  well  worth  reading.  He  gives  it  in  the  solution  prepared 
by  Bastick,  and  his  smallest  dose  is  equivalent  to  twenty  grains 
of  the  salt 

]  8.  Dr.  Wilks  recommends  the  Bromide  and  Iodide  of  potas- 
sium in  epilepsy.  The  former  is  supposed  to  be  an  ovarian 
sedative ;  and  the  power  of  the  latter  over  syphilis  and  lead- 
poisoning  is  well  known.  In  epilepsy  arising  from  such  causes 
benefit  may  fairly  be  expected  from  these  drugs.  Cases  are 
given  illustrative  of  their  action. 

19.  In  the  next  paper,  a  case  of  epilepsy  is  recorded  in  which 
Arsenic  was  exhibited  with  effects  so  "  sudden  and  remarkable,'^* 
that  the  reporter  is  at  a  loss  to  account  for  the  happy  result  of 
his  empirical  prescription.  A  reference  to  Chrisdson  on  poisons 
would  shew  him  that  the  power  of  Arsenic  to  core  epilepsy  is 
dependent  upon  its  tendency  to  cause  it. 

22.  In  a  paper  on  "Regurgitant  Aortic  Disease  of  the 
Heart,"  Dr.  Hyde  Salter  speaks  in  the  highest  terms  of  the 
value  of  Elaterium  as  a  palliative  in  cardiac  dropsy.  Given  in 
moderate  doses,  and  accompanied  by  stimulants,  it  need  cause 
no  dangerous  exhaustion ;  and  "  the  results  attained  are  among 
some  of  the  most  striking — I  may  say  the  most  startling^-* 
triumphs  of  therapeutics.  Floods  of  water  are  draughted  away 
from  the  bowels,  the  dropsy  vanishes^  the  breathing  becomes 
unembarrassed,  and  the  patient  is  restored,  for  a  time  to  a  oon« 
dition  of  very  tolerable  comfort" 

28.  The  following  sentences  from  Dr.  C.  J.  B.  Williams' 
Lecture  on  Pneumonia  are  of  interest  to  us.  ''  There  are  certain 
poisons  which,  if  introduced  into  the  blood,  produce  pneumonia. 


040  Biz  Months  of  BriiUh  Allopathy. 

The  bite  of  a  rattlesnake  has  this  consequence ;  the  injection  of 
Phosphorus  into  the  veins;  the  slow  absorption  of  Arsenic 
through  a  wound." 

84.  Mr.  Bryant,  in  this  article,  tells  us  how  easily  and  surely 
aphtha  and  ulcers  of  the  tongue  may  he  cured  by  the  Chlorate 
of  Potash. 

87.  The  same  drug,  in  conjunction  with  Ouiaoum,  is  highly 
lauded  by  Dr.  John  West  Walker  as  curative  of  diphtheria. 
He,  however,  attributes  the  efiBoaey  of  the  compound  to  the 
Ouiacum,  which  he  considers  a  ''  specific"  for  all  kinds  of  sore- 
throat.  This  Chlorate  of  potash  is  a  very  interesting  drug,  and 
deeerves  extensive  physiological  investigation.  Its  provings 
show  it  to  be  homoeopathic  to  the  aflfections  of  the  mouth  in 
which  it  is  found  of  so  much  value. 

SS,  144.  These  two  articles  display  in  a  forcible  manner  the 
gross  empiricism  and  unscientific  confusion  of  old  school  treat- 
ment in  Uie  instance  of  diarrhoea.  This  symptom,  so  varying 
in  its  import,  is  set  down  as  a  substantive  disease,  of  uniform 
character,  requiring  uniform  treatment.  Dr.  Andrew  Clark 
tries  **  Sulphuric  acid  in  contrast  with  chalk.  Opium,  Nitrate  of 
silver.  Copper,  Bismuth,  Lead,  Pemitrate  of  iron,  and  others, 
singly  and  in  combination;"  and  comes  to  the  conclusion  that 
the  first  named  drug  is  a  more  rapidly  efficient  agent  than  any 
of  them  in  the  cure  of  diarrhoea.  Seeing  that  it  is  thoroughly 
homoeopathic  to  some  forms  of  the  disease,  we  might  rejoice  at 
his  conclusion ;  but  our  satisfaction  will  be  dashed  when  we 
read  the  form  in  which  he  gives  it*  This  is  as  foOows :  ''  J^ 
Acid,  sulph.  Arom.  |  zx ;  Tinct  camph.  oomp.  9  i ;  ^theris 
chlorioi  ^t;  spirit  menthce  pip.  9ss;  Syrupi  rhceados  9j; 
Decoct.  Hfematoxyli  ad  Z  i."  There  are  just  eleven  ingredi- 
ents in  this  highly  scientific  prescription,  of  which  some — as 
Opium,  Logwood,  Camphor,  the  aromatics— are  themselvee 
reported  diarrhoeic  remedies.  And  yet  because  this  draught — 
repeated  every  4,  6,  or  6  hours  according  to  the  urgency  of  the 
case — ^has  succeeded  in  curing  74  per  cent,  of  cases  of  diairhoea 
within  forty-eight  hours.  Sulphuric  acid  is  concluded  to  be  the 
remedy,  par  excellence,  for  this  disorder.  We,  who  know  the 
power  of  veratrum,  to  say  nothing  of  our  other  numerous  re- 


Sir  Months  of  British  Allopathy.  G4 1 

medies  for  diarrboea^  have  no  cause  to  envy  our  brethren  in 
point  of  science  or  success. 

45.  The  amusing  accidental  cure  of  albuminuria  by  Arsenic, 
contained  in  the  45th  article,  has  already  been  extracted  and 
commented  upon  in  this  Journal.  The  difference  between  the 
effects  of  the  "  suitable  treatment"  on  which  the  patient  was  put 
on  first  entering  the  hospital,  and  that  of  the  Arsenic  afterwards 
exhibited,  affords  an  admirable  specimen  of  the  contrast  between 
allopathic  and  specific  medication. 

47.  Dr.  Favy  records  some  experiments  to  prove  that  the 
presence  of  an  excess  of  acid  in  the  system  occasions  the  pro- 
duction of  saccharine  urine.  It  is  curious  that  the  acid  he  used 
in  his  experiments  was  the  Phosphoric.  It  yet  remains  to  be 
seen  whether  we  have  here  a  chemical  or  a  dynamic  effect  of  the 
aoid:  if  the  latter,  the  great  efficacy  of  Phosphoric  acid  in 
diabetes  is  explained. 

74.  The  Articles  from  51  to  100  are  upon  Surgical  matters, 
and  many  are  extremely  interesting.  We  would  call  especial 
attention  to  Mr.  Hilton's  cases  illustrative  of  the  value  of  rest  in. 
the  treatment  of  diseased  joints.  The  article  whose  number 
stands  above  (No.  74)  is  upon  hemorrhoids;  and  must  convey 
to  every  humane  mind  a  strong  feeling  of  the  barbarity  of  the 
measures  practised  for  the  cure  of  this  affection.  The  knife, 
the  ligature,  and  the  application  of  strong  Nitric  aoid  appear  to 
constitute  in  almost  all  cases  the  anti-heemorrhoidal  weapons  of 
the  old  school.  The  homoeopathic  physician  knows  further  that 
this  treatment  is  as  unnecessary  as  it  is  cruel, — the  affection 
being  nearly  always  within  at  least  the  palliative  reach  of  drugs. 
Nux  and  sulphur,  hammamelis  and  aloes,  are  his  substitutes  for 
the  knife,  the  ligature,  and  the  caustic,  and  humanity  must  de- 
clare the  contrast  in  his  favour. 

86.  This  brief  article  contains  a  useful  hint  We  give  it 
entire.  *'  How  to  relieve  pain  in  a  diseased  bladder.  The 
presence  of  urine,  and  more  particularly  of  calculi  or  concretions 
at  the  has  fond  of  a  diseased  bladder,  sometimes  produces  vio* 
lent  pains  in  the  bladder,  and  renders  all  movement  painful. 
In  such  oases  if  the  patient  be  placed  on  an  inclined  p1ane» 

VOL.   XX.,  NO.  ULXXU.— OCTOBEB   1862.  2   8 


642  But  MoHiks  of  Briti$h  Alhpaihy. 

wbioh^  by  raisiiig  the  lower  part  of  the  pel^ifl,  throws  the  con* 
tents  of  the  bladder  towards  the  upper  and  posterior  part  of  the 
cavity  (which  is  mnoh  less  sensitive),  relief  is  almost  immediately 
prodaoed,  even  though  other  means  have  been  tried  in  vain." 

94.  The  Biniodide  of  mercury  is  a  very  interesting  substance. 
It  appears  capable  of  acting  like  either  of  its  component  ele- 
ments. In  syphilis  and  diphtheria  its  curative  power  undoubt- 
edly resembles  that  of  Mercury :  and  in  the  present  article  we 
learn  that  it  is  no  less  powerftilly  curative  in  goitre  than 
Iodine.  It  is  used  in  the  form  of  a  strong  ointment,  locally 
applied. 

105,  106*  We  still  receive  testimonies  to  the  occasional  value 
of  Dr.  Simpson's  newly  discovered  remedy  for  the  sickness  of 
pregnancy,  the  Oxalate  of  cerium.  It  would  be  well  to  prove 
this  substance,  which  would  probably  be  found  to  be  a  specific 
emetic.  Still  more  extensive  testimony,  however,  is  home  to 
the  efBcacy  of  Pepsine  in  this  complaint.  It  is  given  in  ten- 
grain  doses,  and  probably  acts  dietetically  rather  than  dynami- 
cally. 

108.  Dr.  Simpson  also  instructs  us  upon  a  subject  of  which 
he  is  unquestionably  the  grand  master — chloroformization. 
He  has  adopted  a  new  method  of  administering  die  drug,  of 
which  he  speaks  in  high  terms  as  effecting  a  more  rapid  anaes- 
thesia, and  causing  much  saving  in  point  of  quantity.  He  lays 
one  single  layer  of  a  towel  or  handkerchief  over  the  patient  s 
nose  and  mouth,  taking  care  not  to  cover  the  eyes,  and  on  this 
single  fold  the  Chloroform  is  poured,  drop  by  drop,  until  com- 
plete anostbesia  is  induced.  He  states  that  **  The  first  patient 
to  whom  he  had  administered  it  in  this  manner  had  been  chlo- 
roformed several  times  previously,  and  had  never  gone  to 
sleep  till  an  ounce  and  a  half  or  two  ounces  of  the  fluid  had  been 
employed ;  but  when  administered  drop  by  drop  on  a  single 
layer  of  a  thin  towel,  one  drachm  had  sufficed  to  induce  the 
most  profound  sleep.  "  One  precaution,"  he  states, ''  must  be 
attended  to  in  employing  Chloroform  in  this  manner,  viz.,  care 
should  be  taken  to  anoint  the  lips  and  nose  of  the  patient  be- 
forehand with  oil  or  ointment,  to  prevent  the  skin  from  being 


Six  Months  of  Briiuh  Allopathy.  643 

injared  by  the  oontaot  of  the  fluid  that  resulted  from  the  close 
application  of  the  wetted  towel  to  the  patient's  face.'* 

127.  If  the  barbarity  of  the  old  school  treatment  of  hsemor- 
rhoids  has  roused  indignant  comment,  what  shall  we  say  when 
we  come  to  the  treatment  of  uterine  ulcers.  The  worst  horrors 
of  Middle  Age  Surgery  are  outdone  by  the  modem  uterine  oaa- 
terizers.  The  article  here  referred  to  will  exhibit  this  fact  as 
well  as  any.  Five  varieties  of  the  uterine  ulcer  are  named  : 
the  indolent,  the  inflamed,  the  fungous,  the  senile,  and  the 
diphtheritic ;  and  the  treatment  is  summarized  as  follows :  For 
the  indolent  ulcer, ''  the  caustic  pencil  for  a  few  times ;  after- 
wards, several  applications  of  solution  of  Nitrate  of  silver  in 
strongest  Nitric  acid."  For  the  inflamed  ulcer^  "occasional 
leeching;  warm  hip-baths;  emollient  injections*  Then  Acid 
nitrate  of  mercury  several  times,  succeeded  by  the  solid  lunar 
caustic,  Fotassa  fusa  or  cum  calce."  For  the  fungous  ulcer, 
"  at  first  the  caustic  pencil ;  subsequently.  Nitric  acid,  solution 
of  Nitrate  of  silver,  or  Acid  nitrate  of  mercury ;  electric  or 
actual  cautery."  For  the  senile  ulcer,  "  Fotassa  fusa,  or  strong 
Nitric  acid,  with  Nitrate  of  silver,  once  or  twice,  at  long  inter- 
-vals.  Then  solid  Sulphate  of  copper  in  a  pencil."  For  the 
diphtheritic  ulcer, ''  at  first,  electric  cautery,  Fotassa  cum  calce, 
or  Acid  nitrate  of  mercury,  two  or  three  times,  at  long  intervals. 
Subsequently,  stimulant  applications — ^tincture  of  Iodine  or 
Sulphate  of  copper."  Surely  if  homoeopathy  can  do  nothing 
else  than  rescue  womankind  from  the  tender  mercies  of  such 
surgeons  as  this,  it  has  deserved  well  of  humanity. 

We  have  now  extracted  from  Braithwaite's  Six  Months' 
Compendium  of  Allopathic  Progress  such  matter  as  will  interest 
us  as  homoeopaths,  and  such  practical  hints  as  we  can  avail 
ourselves  of  consistently  with  our  principles.  For  more  ex* 
tended  information  we  refer  our  readers  to  the  volume  itself. 


2  s  2 


644  Reviews. 


REVIEWS. 


Homoeopathy  in  Venereal  DiseoMes.    By  Stephen  Yeldhak, 
M.B.O.S.,  &iO.    London :  Turner.     1862. 

A  treatise  on  a  class  of  diseases*  by  a  practical  man*  who  has 
drawn  his  conclusions  from  a  large  experience*  and  who  baa 
sufficient  intelligence  to  constitute  him  a  good  and  impartial 
observer,  is  a  rarity  in  our  homoeopathic  literature.  While  our 
editorial  book-shelves  groan  under  the  weight  of  manuals  of 
homoeopathic  practice,  domestic  and  others,  wherein  the  treat- 
ment of  all  the  diseases  of  all  the  organs  of  the  body  is 
dogmatically  laid  down,  the  rarest  phenomenon  that  meets  our 
critical  eye,  is  a  good  monograph  of  a  given  class  of  diseases 
by  a  practitioner  of  enlarged  experience  and  tolerable  observing 
powers.  It  seems  strange  that  it  is  so  much  easier  to  write  the 
manual  treating  of  all  diseases,  than  the  monograph  of  one 
class  of  diseases,  but  it  is  evident  that  such  is  the  tact,  fot 
many  a  practitioner  of  two  or  three  years'  experience  in  homcBO- 
pathy  will  publish  the  former,  whilst  the  latter  seems  to  require 
a  longer  apprenticeship  to  medical  practice.  The  reason  seems 
to  be,  that  in  case  of  the  manual,  the  author  contents  himself 
with  copying  from  predecessors  in  the  same  line,  occasionally 
doing  a  little  bit  of  original  symptomatic  comparison — ^usually 
worthless — while  no  one  would  venture  to  do  a  monograph 
without  some  extensive  experience  of  his  own  in  the  class  of 
diseases  treated  of. 

Mr.  Teldham  is  one  of  our  homoeopathic  writers,  whose 
works  have  generally  the  stamp  of  practical  experience  about 
them.  The  present  work  is  unmistakeably  the  production  of  a 
practical  man.  It  is  short  and  pithy.  There  is  not  much  of 
the  bookmaker's  craft  about  it.  The  diseases  are  briefly  de- 
scribed; the  directions  for  treatment  are  succinct  and  summary. 
There  is  no  desire  on  the  author's  part  to  show  how  well  he  is 
up  in  our  Materia  Medics,  or  how  diligently  he  has  read  the 


Yeldham  on  Venereal  Diseases.  645 

Sympiomen-Codex,  by  giving  a  long  list  of  remedies  for  each 
form  of  disease,  which,  for  the  most  part,  serves  but  to  show 
that  the  author  knows  little  practically  ahoat  the  matter.  On 
the  contrary,  Mr.  Yeldham  recommends  very  few  remedies  for 
each  disease ;  but  he  is  careful  to  give  very  distinct  indications 
for  the  use  of  those  he  advises  to  be  given.  If  anything, 
perhaps,  Mr.  Yeldham's  Materia  Medica  is  rather  scanty,  and 
probably  some  of  the  diseases  he  treats  of  would  require  some- 
thing more  than  the  two  or  three  specifics  he  recommends. 
Bat  we  would,  we  confess,  rather  have  this  poverty  of  the 
practical  man  than  the  embarrassing  riches  of  the  mere  manual- 
maker  ;  the  former  shows,  at  least,  that  the  author  has  cured 
cases  with  the  remedies  he  vaunts,  the  latter  rather  indicates 
that  the  author  knows  his  diseases  and  remedies  from  books 
only.  Mr.  Yeldham  seems  to  be  aware  that  exception  might 
be  taken  to  the  meagreness  of  his  pharmacopoeia,  as  by  way  of 
conforming  to  the  prejudices  of  those  who  desire  a  more  exten- 
sive array  of  medicaments  he  generally  throws  in,  in  a  con- 
temptuous sort  of  by-the-way  manner,  a  list  of  the  names  of 
other  remedies  that  *'  may  also,  under  particular  circumstances, 
be  employed  with  advantage." 

Gonorrhcea,  a  disease  often  treated — ^but  seldom  cured — with 
oontempt,  is  the  first  affection  of  importance  Mr.  Yeldham 
mentions.  His  treatment  is  a  combination  of  internal  remedies 
and  injections.  For  the  earlier  stages  he  advises  aeon.,  mere, 
cor.,  and  canth. ;  for  the  later  stages,  cann.  and  thuj.  He 
has,  he  says,  seldom  found  it  necessary  to  travel  beyond  these 
remedies.  The  injections  he  employs  are  a  weak  solution  of 
the  Acetate  of  Lead ;  half  a  drachm  of  the  lig.  plumb,  to  an 
ounce  of  distilled  water,  and  an  infusion  of  hydrastis  in  the 
proportion  of  an  ounce  of  the  drug  to  a  pint  of  water.  The 
periods  when  the  injections  are  to  be  used,  are  in  the  first 
twenty-four  or  forty-eight  hours  of  the  disease,  when  there  is 
merely  slight  itching  and  some  mucous  discharge,  before  the 
acute  or  inflammatory  symptoms  have  developed  themselves  • 
and  in  the  later  periods  of  the  disease,  after  the  inflammatory 
symptoms  have  subsided,  and  when  the  disease  is  sensibly  on 
the  wane. 


646  ReviewM. 

InjeotionB  in  gonorrhcea  have  been  objected  by  many  houMBO- 
pathio  writers^  as  contrary  to  the  fandamental  principle  of 
homoeopathy,  bat  practical  men  who  have  doting  the  year  many 
oases  of  gonorrhcea  to  treat,  know  that  injections  often  afford 
mnch  assistance  in  the  removal  of  the  disease,  and,  if  corefiilly 
employed,  are  never  injarious.     Mr.  Yeldham  contends  for 
the  homoeopathicity  of  those  he  nses;   bat  in  that  view  we 
cannot  join  him.     Oonorrhcoa  is,  in  many  cases,  snch  a  parely 
local  disease,  that  the  mere  application  of  an  astringent  to  the 
secreting  sarfaoe  saffices  to  remove  it    Bot  in  most  oases  the 
astringent  injection  is  only  an  adjunct  to  the  specific  treatment* 
and  is  no  more  homceopathic  to  the  disease  than  the  sospen- 
sory  bandage  is  to  the  swelled  testicle,  or  the  elastic  stocking 
to  the  varicose  leg.     It  is  absnrd  to  object  to  the  employment 
of  a  remedy  that  practice  has  proved  nsefol,  becaase  it  may  not 
be  capable  of  being  brought  under  the  category  of  homoso- 
pathic  agents.    We  are  physicians,  boand  to  do  the  best  for  onr 
patients,  before  we  are  homceopathists,  and  we  are  not  justified 
in  prolonging  the  malady  of  a  patient  one  day  in  order  to  carry* 
out  our  notions  of  parity  of  practice,  provided  we  can  diminish 
by  an  equal  period  our  patient's  disease,  without  injury  to 
himself,  by  departing  from  this  fanciful  standard  of  parity. 
Our  own  experience  fully  bears  out  Mr.  Yeldham,  when  he 
alleges  that  gonorrhoea  may  be  materially  shortened  by  injec- 
tion, and  we  shoald  not  feel  justified  in  refdsing  them  to  any 
patient  for  whom  we  believed  them  indicated.    Many  cases  of 
gonorrhoea  may  certainly  be  cared  by  cann,^  canih.,  mere,^  or 
pelroseL,  without  local  treatment ;  but  many  others  resist  these 
and  other  internal  medicines,  and  will  only  yield  to  injections. 
Besides  the  injections  to  which  Mr.  Teldbam  refers,  we  have 
found  benefit  firom  weak  solutions  of  nitrate  of  siker,  of  sui- 
phate  of  zinc^  of  chloride  of  zinc,  and  even  of  green  and  black 
tea. 

Mr.  Yeldham  asserts  that  cannabis  to  be  of  any  use  in 
gonorrhoea,  must  be  given  in  palpable  doses.  He  prescribes  5, 
10,  or  15  drops  of  the  tincture  three  or  four  times  a  day.  Onr 
own  experience  bears  out  Mr.  Yeldham's  views,  and  we  have 


Teldkam  an  Venereal  Dieemes*  647 

long  since  ceased  to  prescribe  eannabie  in  any  bot  material 
doses. 

A  very  obstinate  fonn  of  gonorrhoBa  is  omitted  in  Mr.  Teld- 
ham's  work.  It  is  that  which  originates  without  any  specific 
venereal  infection,  where  the  patient  has  had  no  intercourse 
except  with  his  rirtnous  wife.  Some  authorities  suppose  it  to 
be  owing  to  intercourse  being  carried  on  during  the  menstrual 
flux,  but  our  own  observations  and  inquiries  incline  us  to 
believe  that  some  women  become  temporarily  capable  of  com* 
municating  a  virulent  blennorrhagia  to  their  husbands,  in  con- 
sequence of  a  morbid  alteration  of  their  usual  mucous  secretions 
caused  by  some  depressing  mental  emotion.  How  fiar  this  view 
is  correct,  it  would  require  a  large  amount  of  experience  to 
show ;  but  however  it  may  be,  certain  it  is  that  this  accident 
which  occasionally  happens  in  the  best  regulated  m6nage,  is 
generally  of  a  very  obstinate  character,  and  resists  the  usual 
internal  remedies  most  provokingly,  only  yielding  to  injections 
and  general  hygienic  measures. 

Another,  but  less  obstinate  form  of  gonorrhoea,  we  have 
occasionally  seen  occur  after  the  introduction  of  a  bougie  for 
the  dilatation  of  a  stricture.  This  form  is  best  cured  by 
Gantharis  and  warm  bathing. 

Mr.  Teldham's  observations  on  gleet  are  of  an  equally  prac- 
tical  character.  The  remedies  he  recommends  are  cant  A.,  mere. 
(in  the  form  of  cinnabar)  nux  vom.,  pule  ,  and  eulph.  In  debi- 
litated constitutions  he  gives  tinct.  ferri  aesquichlarid,  in  10 
drop  doses,  three  times  a  day.  Injections,  he  contends,  are 
most  necessary  in  gleets. 

A  form  of  gleet  he  omits  to  allude  to,  is  that  often  observed 
in  gouty  subjects.  This  kind,  we  believe,  is  not  to  be  cured  by 
injections,  at  least  we  have  never  ventured  to  prescribe  them, 
but  we  have  generally  removed  them  in  a  reasonable  time  by 
the  internal  administration  of  nitric  acid. 

Among  the  complications  of  gonorrhoea,  orchitis  is  one  of 
the  most  important*  Mr.  Teldham  says  aeon,  and  puU* 
rarely  fail  to  afford  speedy  relief,  and  he  has  seldom  found  it 
necessary  to  resort  to  any  other  remedies.    We  cannot  say  that 


«4e  BeiieW8. 

our  experience  sltogether  beaia  out  that  of  Mr.  Yeldham,  and 
we  should  be  disposed  to  attribute  a  higher  remedial  efficacy  to 
cUmaiii  and  arnica  in  orchitis  than  to  the  medicines  ho 
prefers.  In  one  chronic  case  of  sweUed  testicle  of  very  long 
standing,  we  obtained  the  best  results  from  spon^ia  ;  but  in 
Ibis  case  the  disease  was  not  originally  induced  by  gonorrhcea. 

We  are  less  pleased  with  the  chapter  on  stricture^  in  Mr. 
Yeldham's  work«  than  with  that  on  gonorrhcea.  Stricture, 
whether  under  homoeopathic  or  allopathic  treatment,  assisted  by 
the  mechanical  means  common  to  both  schools,  is  often  an 
incurable  complaint.  Though  temporary  relief  is  generally 
obtained  by  the  use  of  bougies,  the  tendency  of  the  disease  is 
too  often  to  relapse.  But  it  does  not  appear  from  Mr.  Yeld- 
ham's observations  to  be  at  all  difficult  of  cure.  There  is 
altogether  too  much  of  the  vefii-vidi-vici  sort  of  style  in  what 
our  author  says  about  it  to  please  us.  **  I  have  had  under 
care,"  he  says,  "  cases  of  this  disease  which  had  existed  for 
years,  notwithstanding  the  regular  use  of  the  bougie,  which, 
with  the  use  of  that  instrument  for  a  few  times,  when  at  the 
same  time  appropriate  homcDopathic  medicines  were  given,  have 
got  completely  and  permanently  well."  This  may  be  so,  and 
if  it  be,  we  can  only  say  that  Mr.  Yeldham  has  been  more 
fortunate  than  most  of  his  surgical  brethren ;  but  still  even  he 
must  have  met  with  cases  that  did  not  yield  in  this  miraculous 
manner  to  his  remedies,  and  we  think  it  would  have  been  but 
right  to  mention  that  some  strictures,  do  what  you  will  for 
them,  dilate  them  so  that  they  will  allow  the  largest  sized 
bougie  to  pass  easily,  will  relapse  again  and  again,  to  the 
despair  of  the  patient  and  the  confusion  of  the  surgeon. 

Mr.  Yeldham  gives  a  series  of  ctises,  twenty  in  number, 
illustrative  of  his  treatment  of  gonorrbcna  with  its  compli- 
cations, including  orchitis,  gleet,  and  stricture.  These  cases 
^re  well  though  briefly  written,  and  the  results  are  such  as  we 
should  be  happy  to  attain  in  evei7  case  of  the  sort ;  bnt»  alas  ! 
we  fear  that  Mr.  Yeldham's  cases,  like  those  of  most  writers, 
ore  the  cream  of  those  he  has  treated,  and  probably  he  could 
have  furnished,  as  we  all  could  furnish,  some  cases  that  did  not 
yield  so  rapidly  to  his  skill.    But  we  suppose  we  must  be 


Veldham  on  Venereal  Diseases.  649 

content  to  regard  them,  and  similar  oases,  as  we  do  specimens 
in  a  museum,  not  as  common  things  to  be  met  with  every  day, 
but  as  model  samples  of  their  kind.  We  are  particularly 
struck  by  the  excellent  effects  the  author  met  in  some  of 
these  cases  from  the  injection  of  an  infusion  of  Hydrastis  in 
gonorrhoea  and  gleet.  He  makes  this  infusion  with  one  ounce 
of  the  root  to  half  a  pint  of  water. 

In  the  treatment  of  primary  syphilis  Mr.  Teldham's 
favourite  remedy  is  the  mere,  sol.,  and  the  dose  he  gives  is  two 
or  three  grains  of  the  Ist  or  2nd  decimal  trituration  three  times 
a  day.  He  justly  condemns  the  large  doses  of  Mercury  given 
by  the  allopathic  school,  and  bis  own  doses  are  equally  far 
removed  from  the  infinitesimals  of  the  ultra-Hahnemannists. 
We  confess  to  a  partiality  for  the  more  material  preparations  of 
Mercury  in  this  disease,  and  indeed  have  rarely  seen  any  cura- 
tive effect  on  the  primary  chancre  from  the  administration  of 
the  higher  dilutions.  '  The  material  character  of  the  syphilitic 
virus  seems  almost  to  demand  a  material  administration  of  the 
medicinal  antidote. 

The  observations  and  practice  of  Hahnemann  in  respect  to 
syphilis,  in  the  earlier  period  of  his  career,  have  scarcely  met 
with  so  much  attention  as  they  deserve.  Though  in  the  last 
edition  of  the  Materia  Medica  Pura,  he  recommends  Mercury 
to  be  given  for  syphilis,  as  for  every  disease  in  which  it  was 
indicated,  in  the  dose  of  a  single  globule  of  the  80th  dilution, 
yet  we  know  that  up  to  1816,  at  all  events,  bis  practice  in 
syphilis  was  very  different.  In  that  year  he  published  an  essay* 
in  which  he  tells  us,  that  for  the  deeply  rooted  syphilis,  the 
soluble  Mercury  must  be  given  to  such  an  extent  as  to  deve- 
lope  some  of  its  peculiar  physiological  symptoms.  What  these 
symptoms  are  he  does  not  say,  he  only  gives  a  list  of  what  they 
are  not;  but  we  beUeve  we  are  justified  in  assuming  that  they 
are  the  same  as  those  he  described  in  his  first  work, ''  On 
Venereal  Diseases,"  f  to  which  we  must  refer  the  reader.  In 
that  same  work,]:  published,  be  it  remembered,  in  1789,  he 
states  that  the  quantity  of  soluble  Mercury  required  to  deve- 
lope  these  symptoms  sometimes  did  not  exceed  one  grain, 

« Lmer  WrUingi,  p.  726.       flh.,p,  77.  \Ih.,  p.  IM. 


650  Reviewi. 

whilst  at  other  times  m  mach  as  sixty  gndns  were  oeoeessry. 
Thoagh  we  do  not  now  think  that  Hahnemann  was  right  in 
alleging  that  sixty  grains  of  Meronry  are  requisite  to  care  syphi- 
lis, still  we  most  admit  that  different  cases  require  different 
quantities ;  and  hence  we  cannot  agree  with  him  in  his  later 
opinion,  that  one  glohule  of  the  80th  dilution  suffices  for  erery 
case.  The  practice  of  our  best  practitioners,  among  whom  we 
do  not  hesitate  to  reckon  Mr.  Teldham,  more  nearly  assimilates 
to  the  earlier  than  the  later  practice  of  Hahnemann,  and  will, 
we  think,  he  found  more  successful  than  the  latter,  or  even 
than  the  transcendental  treatment  of  the  new-light  or  high- 
dilution  homoBopathisto  represented  by  Wolf,  Bdnninghausen, 
and  others. 

Nitric  acid  is  another  remedy  Mr.  Yeldham  considers  indis- 
pensable in  the  treatment  of  syphilis.  He  says  it  cannot  be 
considered  to  be  a  substitute  for  Mercury  as  many  of  the 
allopaths  contend,  but  it  is  applicable  to  quite  a  different  form 
of  the  disease.  Whilst  Mercury  is  useful  in  hard  chancres. 
Nitric  Acid  is  to  be  given  in  soft  chancres  in  persons  of  debili- 
tated constitution,  whether  the  result  of  scrofula,  of  the  preyious 
abuse  of  Mercury,  or  of  a  former  venereal  taint  The  two 
remedies,  given  alternately,  will  often  be  found  more  efficacious 
than  either  singly.  The  doses  of  Nitric  Acid  he  gives  are  five 
to  ten  drops  of  the  2nd  decimal  dilution. 

Not  having  the  fear  of  the  purists  before  his  eyes,  he  advises 
certain  local  appUcations  to  the  chancre.  His  favourite  is  a 
weak  lotion  of  Calendula,  and  when  that  cannot  conveniently 
be  obtained,  the  common  black  wash ;  but  Calendula  is  to  be 
preferred.  Lunar  Caustic,  too,  is,  he  says,  sometimes  useful 
for  stimulating -sluggish  ulcers. 

We  have  not  space  to  give  an  account  of  what  Mr.  Teldham 
says  regarding  the  treatment  of  secondary  and  tertiary  syphilis, 
but  we  may  only  observe,  that  his  observations  seem  very  just 
and  his  treatment  is  decided,  and  if  we  may  judge  by  the  oases 
he  gives,  highly  successful. 

We  observe  that  Mr.  Teldham  does  not  treat  of  sycosis  as  a 
distinct  form  of  venereal  disease  different  firom  syphilis,  as 
Hahnemann  believed,  but  he  includes  warte  among  the  symp- 


Infanticide.  651 

toms  of  syphiKs  proper.  Whether  this  is  correct  theoretioally 
we  shall  not  take  upon  us  to  decide,  hat  practically  there  seems 
to  be  little  use  in  separating  the  two,  as  warts  seldom  occur  with- 
out the  simultaneous  or  antecedent  occurrence  of  syphilitic 
symptoms. 

In  the  treatment  of  syphilitic  iritis  Mr.  Teldham  practises 
the  dropping  in  of  a  solution  of  atropine,  and  this,  in  many 
cases,  is  of  most  absolute  necessity  if  we  wish  to  preserve  the 
integrity  of  the  pupil ;  but  it  is  a  precaution  which  is  too  gene- 
rally neglected  by  homoeopathic  practitioners. 

In  conclusion,  we  would  express  our  hearty  thanks  to  Mr. 
Yeldham  for  his  valuable  little  work,  which,  though  small,  con- 
tains a  vast  deal  of  sound  practical  instruction,  and  it  is  a  book 
which  might  with  profit  be  consulted  by  all  young,  and  many 
old  practitioners  of  homodopathy. 


Infanticide:  its  Law,  Prevalence,  Prevention  and  History. 
By  WiLLUM  Burke  Byan,  M.D.  (Lond.)>  F.B.G.S.^  &c. 
London:  Churchill,  1862. 

It  was  lately  stated  in  the  public  papers  that  1,104  coroner's 
inquests  were  held  on  the  bodies  of  children  under  two  years 
of  age  in  London,  or  rather  in  the  metropolitan  districts, 
during  the  past  year,  and  the  statistics  of  several  years  shew 
that  this  is  the  average  number  of  such  inquests.  The  Lancet 
gives  us  the  following  analysis  of  the  verdicts  in  these  cases. 

Verdicts  : 

Wilful  murder 66 

Manslaughter 5 

Found  dead 141 

Su£Ebcation:  how  caused  unknown         .        .        •        .181 

„  accidental 147 

From  neglect,  want,  cold,  or  exposure  and  natural  disease    614 

Total 1104 

How  many  of  those  under  the  five  last  heads  might  have 
justly  been  ranked  under  the  first,  it  is  of  course  impossible  to 


652  Reviews. 

say,  bat  the  general  belief  ot  coroners  and  others  is  that  at  least 
one  half  of  snob  oases  have  been  aotaally  murdered,  and  that  as 
many  more  obildren,  on  whom  no  inqaests  are  held,  meet  their 
death  by  foal  means.  We  may  therefore,  without  exaggeration, 
assume  that  on  an  ayerage  about  1000  cases  of  infanticide  occur 
annually  in  our  metropolis. 

A  nation  educated  firom  youth  upward  to  regard  Herod's 
massacre  of  the  innocents  as  one  of  the  most  horrible  of  crimes, 
oould  not  be  expected  to  view  with  indifference  the  dreadful 
slaughter  of  infants  going  on  in  its  midst — ^but  yet  it  is  surprising 
how  little  horror  is  excited  among  us  by  the  daily  occurrence 
of  infanticides.  Juries  seldom  return  verdicts  of  ''wilful 
murder"  against  the  unhappy  perpetrators  of  the  crime,  and 
when  they  do,  and  the  sentence  of  death  is  pronounced,  it  is 
never  carried  into  effect,  as  it  is  always  felt  that  great  allowance 
must  be  made  for  the  miserable  mother  who  is  usually  the 
criminal. 

Moreover,  the  law  on  the  subject  of  infanticide  is,  that  no 
murder  has  been  committed  unless  the  child  was  fully  bom,  and 
as  it  is  in  most  cases  impossible  to  ascertain  whether  death 
ensued  on  the  passage  of  the  infant  from  the  mother  or  after- 
wards, as  the  delivery  usuaUy  takes  place  in  secret,  juries  will 
always  give  the  prisoner  the  benefit  of  the  doubt  and  acquit  her 
of  the  greater  crime,  merely  finding  her  guilty  of  the  lesser 
offence  of  concealment  of  birth. 

The  remedy  for  the  awful  destruction  of  infant  life  that  has 
been  repeatedly  proposed,  viz.,  the  establishment  of  foundling 
hospitals  in  su£Bcient  numbers,  is  too  generally  believed  to  be 
provocative  of  inchastity  to  be  likely  to  be  adopted,  for  it  is  a 
remarkable  peculiarity  of  the  English  people  that  they  would 
rather  suffer  the  scandal  of  a  great  amount  of  secret  crime, 
than  have  their  moral  sense  outraged  by  seeming  to  encourage 
a  more  venial  immorality  by  the  public  avowal  of  its  existence. 
Another  illustration  of  this  peculiarity  is  our  mode  of  treating 
the  "  social  evil."  While  we  will  not  suffer  the  public  recog- 
nition of  prostitution  by  putting  it  under  legal  control,  we  make 
strenuous  private  efforts  to  diminish  the  evil  by  Magdalen 
Asylums  and  Midnight  Meetings,  the  effect  of  which  is  merely 


Infanticide.  658 

to  remove  a  few  of  the  existing  courtezans^  and  thereby  make 
room  for  the  immediate  admission  of  new  candidates,  without 
producing  the  slightest  effect  on  the  actual  numbers  of  the 
body. 

Evidently  an  increased  severity  of  punishment  for  infanticide 
will  not  diminish  the  evil,  for  at  the  present  moment  the  legal 
punishment  is  as  severe  as  it  can  be,  the  crime  being  murder  and 
the  penalty  death.  The  only  effect  of  this  severity  is  that  juries 
will  not  convict  of  the  capital  offence  when  they  can  possibly 
avoid  it.  Were  the  penalty  for  the  crime  less,  and  were  the 
absurdity  of  requiring  proof  of  the  child  being  fuUy  bom  abro- 
gated, convictions  might  be  oftener  obtained.  But  we  doubt  very 
much  if  even  an  increased  certainty  of  punishment  would  deter 
from  the  commission  of  the  crime  in  the  majority  of  cases.  On 
the  poor  sensitive  shrinking  girl,  who  dreads  exposure,  the  risk 
of  the  possible  legal  punishment  for  the  concealment  of  her 
shame  is  as  nothing  compared  to  the  fear  of  her  shame  being 
known  to  those  about  her.  When  to  this  fear  is  added  the 
suppressed  agony  of  parturition,  who  can  tell  what  desperate 
resolves  are  capable  of  being  carried  into  execution  by  the 
unhappy  girl.  The  stifling  of  her  half  born  babe  will  seem  but 
a  trifle  to  her  who  has  through  long  hours  stifled  her  own 
groans  and  shrieks.  The  torture  she  has  silently  suffered 
would  have  been  suffered  in  vain,  were  the  infant  to  betray  its 
presence  by  a  cry,  so  the  wretched  mother  clutches  at  the  throat 
of  the  infant  for  whom  she  has  never  felt  in  anticipation  the 
joys  of  maternity,  but  whom  she  has  always  regarded  with 
horror  and  apprehension  as  the  possible  cause  of  her  disgrace. 

That  this  is  the  history  of  many  a  child-murder  is  corrobo- 
rated by  the  following  words  from  M.  Schoetzer's  oflicial  report 
to  the  Belgian  Council  of  State:  "I  discovered,"  he  says, 
"  that  the  crime  of  infanticide  was  not  committed  on  children 
who  had  lived  a  few  days ;  that  as  soon  as  any  woman  had 
experienced  the  pleasures  of  being  a  mother,  she  no  longer 
thought  of  attempting  the  life  of  her  child ;  that  this  barbarous 
act  was  committed  only  during  the  first  moments  of  the  woman's 
embarrassment,  and  while  she  was  still  struggling  between  the 
feeling  of  shame  and  natural  affection ;  and  lastly,  that  the  life 


Mi  lUvieufi. 

of  the  child  was  safe  whenever  the  mother  was  sure  that  the 
fact  of  her  having  been  delivered  was  known  to  a  second  or 
third  person."* 

While  infanticides  at  the  moment  of  birth  are  generally  of 
the  kind  just  described,  there  is  yet  a  large  number  of  child- 
murders  that  are  less  excusable.  Infants  are  made  away  with 
by  their  unnatural  mothers  because  they  are  troublesome  to 
rear,  because  they  cost  more  than  the  mother  can  afford,  or  be- 
cause their  death  is  a  source  of  gain  to  avaricious  parents  who 
have  insured  their  lives  in  one  or  more  burial  clubs.  In  these 
cases,  however,  the  crime  is  not  committed  at  the  moment  of 
birth,  and  is  consequently  of  a  much  more  revolting  and  inex- 
cusable character  than  the  first  described  class  of  infanticides. 
In  these  cases  the  crime  usually  betrays  a  great  amount  of 
depravity,  selfishness  or  avarice  being  the  chief  motive  to  its 
commission ;  whereas  in  the  first  mentioned  cases,  the  motive 
is  usually  a  sense  o&  shame,  a  desire  to  keep  up  the  appearance 
of  respectability,  feelings  laudable  enough  in  themselves,  but 
which  we  here  see  are  capable,  like  many  other  good  qualities 
when  carried  to  an  extreme  length,  of  prompting  to  evil  and 
unnatural  deeds.  Greater  certainty  of  punishment  following 
detection  of  the  crime  would  not  exercise  any  influence  over  the 
infanticides  of  the  shame-stricken  erring  girl,  for  it  is  the 
exposure  of  her  secret,  not  the  punishment  of  her  crime  that 
she  dreads,  and  the  motive  for  secrecy  would  remain  as  power- 
ful as  ever.  Greater  certainty  of  punishment  might,  and  we 
think  would  diminish  considerably  those  more  revolting  infan- 
ticides caused  by  avarice  and  laziness;  buf  still  there  are 
hundreds  of  ways  of  getting  rid  of  children,  without  actually 
resorting  to  what  the  law  would  recognise  as  murder — such  as 
neglect,  insufficient  food,  improper  medicine,  and  harsh  treat- 
ment, which  no  legislation  could  altogether  prevent.  Something 
might  be  done  by  way  of  neutralizing  the  sinister  incentives  to 
child-murder  afforded  by  the  burial  clubs.  If,  for  instance, 
these  clubs  were  not  allowed  to  give  money  on  the  death  of  the 
insured  child,  but  to  provide  a  certain  class  of  burial,  as  their 
name  implies,  the  great  inducement  to  make  away  with  the 

•  Quoted  viB.dF.  Med.  Smf.    April,  1842. 


Infanticide,  655 

dbild  would  be  done  away  with.  It  is  well  known  that  parents 
will  insure  one  child  in  several  clubs,  and  a  child  so  insured 
has  but  small  chance  of  fair  play. 

With  regard  to  the  sad  cases  of  infanticide  caused  by  dread 
of  exposure,  no  increased  severity  will,  as  we  have  already  said, 
avail  to  prevent  them.  Something  must  be  done  to  diminish 
the  infamy  and  disgrace  with  which  a  prudish  society  visits  the 
unfortunate  girl  who  has  been  guilty  of  the  sin  of  yielding  to 
the  solicitations  of  illicit  passion. 

It  is  all  fustian  to  declaim  against  the  hard-heartedness  of 
society  towards  an  erring  sister,  and  to  advise  a  less  harsh 
treatment  of  one  who  is  perhaps  more  sinned  against  than 
sinning.  The  fact  is,  that  society  in  these  matters  is  under  the 
despotism  of  the  prudes  and  hypocrites,  and  such  is  their 
power  that  none  dare  show  kindness  or  sympathy  for  the  girl 
that  has  gone  astray,  unless  she  wail  out  her  sorrows  in  har- 
monious notes,  under  the  Italian  title  of  Traviata,  It  is  then, 
but  a  waste  of  time  to  appeal  to  the  kindly  and  humane  feelings 
of  society.  Society  is  not  influenced  by  any  such  feelings,  nor 
yet  by  justice,  in  the  punishment  it  metes  out  to  its  offenders. 
The  man,  generally  the  greater  culprit  of  the  two,  scarcely  loses 
anything  of  its  consideration ;  the  woman  loses  everything  she 
holds  dear — good  name,  position,  intercourse  with  her  fellows. 
Society  places  the  girl  who  has  once  loved,  not  wisely^  but  too 
well,  on  the  same  level  with  her  who  deliberately  embraces 
prostitution  as  a  profession.  It  is  sad  that  it  should  be  so,  but 
so  it  is,  and  we  cannot  help  it. 

Far  different  must  be  the  appeal  made  to  society  in  order  to 
induce  it  to  check  the  firightful  evil  of  infanticide.  Here  is  an 
ever  increasing  catalogue  of  infanticide — can  we  remain  indifferent 
to  it  ?  If  not,  what  is  the  remedy  ?  Evidently  the  largest 
number  of  infanticides  is  caused,  1st,  by  the  difficulty  a  girl 
who  has  become  pregnant  has  of  being  delivered  without  great 
scandal  among  all  her  acquaintances ;  and  2nd,  By  the  difiB- 
culty  of  disposing  of  the  child. 

A  girl,  we  shall  suppose  in  the  rank  of  life  of  our  domestic 
servants,  finds  herself  pregnant.  By  means  of  a  firm  will,  and 
aided  by  the  present  preposterous  style  of  female  dress,  she 


G56  Reviews, 

is  able  to  go  to  the  faU  time  without  perhaps  exciting  the 
suspicioDS  of  her  employers  or  fellow-servants ;  bat  there  is  no' 
place  where  she  can  be  confined,  without  exposing  her  weakness 
to  a  large  number  of  persons  who  have  no  hesitation  in  ruining 
her  character  and  prospects  by  telling  every  one  of  her  misfor- 
tune. Her  means  will  perhaps  not  admit  of  her  engaging 
private  lodgings,  and  the  services  of  a  nurse  and  doctor,  and 
she  knows  that  such  a  mode  of  delivery  ensures  no  exemption 
from  exposure.  She  may  claim  the  asylum  of  the  workhouse 
during  her  trial,  but  the  obstacles  thrown  in  the  way  of  every 
one  who  seeks  admission  to  those  institutions,  the  supercilious 
insolence  of  the  master,  and  the  searching  inquiries  of  the 
guardiaos  would  of  themselves  deter  any  sensitive  girl  from 
undergoing  the  ordeal  of  an  admission  to  a  workhouse;  and  more- 
over, the  reputation  of  workhouse  treatment  is  of  itself  sufficient 
to  deter  every  self-respecting  woman  from  entering  one  if  she  can 
possibly  avoid  doing  so.  One  or  two  of  the  London  lying-in 
charities  admit  unmarried  women,  but  the  number  of  beds  in 
these  establishments  is  so  small,  and  the  difficulties  of  admission 
so  great,  that  but  an  infinitesimal  proportion  of  cases  of  the  kind 
we  are  speaking  of  can  be  accommodated ;  and  even  here  there 
is  no  guarantee  against  publicity  and  exposure.  The  poor  girl 
is  thus  induced  to  conceal  her  delivery,  as  she  has  hitherto 
concealed  her  pregnancy ;  and  in  the  lonely  attic  she  resolutely 
suppresses  the  rising  scream  of  agony,  and  unassisted  she 
passes  through  the  dreadful  ordeal,  and  endeavours  to  efiace  all 
traces  of  her  su£fering  and  her  crime  at  a  period  when  her 
more  fortunate  sisters,  who  need  not  to  exercise  concealment, 
are  ministered  to  by  nurses  and  friends,  and  gently  compelled 
to  refrain  from  all  exertion  and  movement.  The  sufferings 
endured,  the  resolution  exercised,  the  presence  of  mind  dis- 
played would,  in  different  circumstances,  be  highly  praise- 
worthy ;  but  alas !  all  these  great  qualities  are  here  employed 
to  break  the  law  which  renders  concealment  of  birth  criminal, 
and,  ah  woe !  that  same  will  which  has  stifled  her  own  moans, 
has  likewise  prevented  the  new-bom  babe  from  betraying  its 
wretched  mother  by  a  cry. 
If  we  would  prevent  such  tragedies,  the  frequency  of  which 


Infanticide.  657 

is  a  national  disgrace,  we  must  provide  a  sufficient  number  of 
lying-in  hospitals,  as  different  as  possible  from  our  workhouses, 
where  poor  girls — and  why  not  rich  ones  too  ? — may  receive 
that  help  so  needful  to  them  during  their  trial,  without  running 
the  risk  of  exposure  and  publicity.  It  is  objected  to  lying-in 
hospitals  of  the  character  described,  that  they  would  increase 
immorality ;  but  supposing  they  did  so  (which,  however,  the 
fiicts  show  they  do  not),  the  choice  would  then  lie  between  a 
little  immorality  and  a  great  deal  of  crime ;  for  by  refusing  to 
assist  forlorn  and  forsaken  girls  in  their  extremity,  we  force 
them  to  commit  unnatural  crimes.  The  dread  of  shame,  and 
the  desire  to  preserve  one  a  respectability,  are  commendable, 
but  as  things  are  at  present,  we  force  upon  poor  girls  the 
fearful  alternative  of  social  degradation  or  child-murder. 

We  shall  be  told  that  the  girl  who  has  so  far  forgotten  her- 
self as  to  yield  to  the  solicitations  of  an  illicit  love,  must  and 
should  stand  the  consequences,  which  are  the  just  indignation 
of  outraged  society.  But  stop  a  little  !-ris  the  indignation  then 
ao  just  ?  The  more  active  culprit,  the  man,  escapes  all  this 
indignation  and  its  consequences,  while  the  more  passive 
sinner,  the  woman,  receives  it  entire,  and  her  one  fault  is 
visited  with  the  greatest  and  the  most  disproportioned  punish- 
ment society  can  inflict 

In  France,  in  Germany,  in  Italy,  and  in  other  countries  for 
aught  we  know,  there  are  lying-in  hospitals  to  which  pregnant 
women  are  readily  admitted,  and  no  questions  asked,  so  that 
they  may  preserve  their  incognita  if  they  choose.  We  have  no 
time  to  go  into  details  concerning  the  management  of  these 
lying-in  hospitals,  all  that  we  at  present  wish  to  direct  attention 
to  is  the  necessity  for  these  establishments,  if  we  wish  to 
prevent  the  infanticides  that  now  disgrace  us. 

As  essential  as  lying-in  hospitals  are  foundling  hospitals, 
conducted  on  a  liberal  scale,  and  easily  accessible  to  all.  With- 
out resorting  to  the  extreme  measure  of  having  tours  attached 
to  these  foundling  hospitals,  into  which  any  one  can  put  a  child 
with  the  certainty  of  its  being  well  taken  care  of,  the  admissions 
to  these  hospitals  should  be  so  easy  as  not  to  deter  the 
shrinking,  shame- faced  mother  from  having  recourse  to  them. 

VOL.   XX.,    NO.   LXXXII, — OCTOBER,    1802.  2  T 


668 

Id  fact,  we  would  confer  the  right  to  each  admission,  where  it 
could  be  shown  that  the  mother  was  not  in  a  position  to  take 
proper  care  of  her  infant. 

Poor  girls  earning  a  scanty  subsistence  by  their  daily  toil, 
aod  domestic  servants,  are  evidently  not  able  to  pursue  their 
avocations  and  take  charge  of  a  child  at  the  same  time.  What 
they  usually  do  is  to  place  the  child  out  to  nurse,  at  a  cost 
of  three  or  four  shillings  a  week,  to  which  the  father  may 
or  may  not  contribute,  as  the  case  may  be— -often  he  cannot  be 
made  to  assist — especially  since  the  new  legislation,  which 
requires  corroborative  evidence  of  the  paternity,  has  come  into 
force.  If,  then,  the  whole  burden  of  the  infant's  support  is 
thrown  on  the  mother,  it  is  evident  that,  in  many  oases,  she 
cannot  afford  to  pay  for  its  support.  The  inducement  to  make 
away  with  a  child  in  such  cases  is  strong  and  often  irresistible, 
and  an  infant  perishes  for  want  of  an  asylum  in  which  to  place 
\L  Again,  the  wife  of  a  daily  labourer  dies  in  child-bed,  the 
father  must  be  out  all  day  to  earn  his  livelihood — what  is  to 
become  of  his  infant?  More  children  are  bom  to  a  poor 
couple  than  they  can  support  In  these  and  similar  cases,  the 
inducement  to  infanticide,  if  not  by  violence,  at  all  events  by 
neglect,  withholding  proper  nourishment,  administering  im- 
proper food  or  physic,  is  great,  and  will  not  be  resisted  in  many 
oases.    Foundling  hospitals  would  save  the  destined  victims. 

Foundling  hospitals  should  be  in  connection  with  the  Lying- 
in  hospitals  spoken  of.  At  present,  if  a  girl  is  delivered  of  an 
illegitimate  child  in  the  workhouse,  as  soon  as  ever  she  is  able 
to  stir,  she  is  thrust  forth  from  the  inhospitable  building  with 
her  child  in  her  arms.  The  poor  girl  has  perhaps  no  money ; 
she  could  earn  a  livelihood  by  her  needle  or  by  going  into  ser- 
vice if  she  had  not  the  child ;  she  must  starve — both  must 
starve,  if  she  keeps  it ;  she  wanders  about  forlorn,  irresolute — 
the  canal,  the  sewer,  or  the  river  offer  a  ready  means  of  getting 
rid  of  her  burden ;  half  maddened  with  hunger,  desolation,  and 
despair,  she  casts  the  helpless  infant  from  her,  and  perhaps 
quiets  her  conscience  with  the  reflection  that  her  little  babe  is 
better  in  heaven — whither,  the  superstition  that  stands  to  her  in 
the  stead  of  religion  leads  her  to  believe,  it  will  immediately  pass 


Infanticide,  659 

— than  growing  up  in  misery  and  vice.  Tlie  foundling  hospital 
in  connection  with  the  lying-in  hospital  would  prevent  this  un- 
natural crime. 

The  objection  so  often  urged  against  foundling  hospitals,  that 
they  would  be  productive  of  immorality  and  increase  the  number 
of  illegitimate  births,  is  not  justified  by  statistics.  Thus  it  is 
shown  by  Gerando,  that  while  France,  Naples  and  Austria, 
which  have  foundling  hospitals,  have  a  proportion  of  ille- 
gitimate to  legitimate  births  of  71,  46,  and  42  per  1000  re- 
spectively, the  following  is  the  proportion  among  States  that 
have  no  hospitals : — Prussia,  69 ;  England  and  Wales,  55  ; 
Wales  alone,  88 ;  Saxony,  121 ;  and  Hesse,  149  per  1000  births ; 
while  puritan,  Sabbatarian,  and  whiskey-drinking  Scotland, 
without  the  aid  of  foundling  hospitals,  shows  in  its  different 
connties  a  proportion  of  illegitimate  births  from  61  as  the 
lowest  up  to  157,  162,  171,  and  175  per  1000  births ! 

It  is  not  for  the  writer  to  enter  into  details  as  to  how  these 
foundling  and  lying-in  hospitals  are  to  be  constituted  and  con- 
ducted. The  corresponding  institutions  of  Paris,  Vienna,  and 
Borne  ^might  be  studied  with  advantage  and  profit  by  those 
whose  business  it  would  be  to  establish  them. 

And  whose  business  should  it  be  to  furnish  us  with  lying-in 
and  foundling  hospitals  ?  *  We  think  that  the  genius  of  our 
institutions  would  render  it  necessary  that  tbey  should  be  under 
the  control  of  the  Boards  of  Guardians  of  the  Poor,  and  subject 
to  the  general  direction  and  surveillance  of  the  Central  Poor  Law 
Board  ;  but  an  Act  of  Parliament  would  be  required  to  initiate 
them.  Some  active  and  influential  member  of  Parliament,  on 
the  outlook  for  an  interesting  hobby  to  ride  in  the  house, 
might  profitably  take  up  this  subject  of  infanticide  and  its 
remedy,  and  thereby  do  a  world  of  good  to  humanity,  besides 
ensuring  his  own  immortal  fame. 

*  It  may  be  olgected  tliat  there  is  already  a  Foundling  Hospital  in  London. 
There  is  an  institation  bearing  that  name  no  donbt,  but  though  it  spends  a 
Tast  annual  income,  it  is  so  hampered  by  absurd  regulations,  that  it  is  not 
of  the  slightest  use  to  those  who  most  need  a  Foundling  Hospital,  and  it  has 
not  the  slightest  atom  of  influence  in  preventing  the  crime  of  infanticide. 
The  purpose  of  its  benevolent  founder,  Captain  Coram,  is  utterly  frustrated 
by  tha  mode  in  which  it  is  now  oonducted.  ■ 

2  T  2 


660  Reviews. 

The  length  to  which  oar  remarks  have  extended  forbid  us 
to  say  much  about  Dr.  Byan's  book.  And,  indeed,  there 
is  not  much  to  be  fiaid  about  it.  It  is  written  in  a  style  we 
abhor.  There  is  no  method  or  order  in  it  A  large  portion  of 
it  is  borrowed  from  an  article  that  appeared  in  the  British  and 
Foreign  Medical  Review  for  1842,  and  the  chief  statistics  of  the 
book  are  those  of  that  ancient  essay.  The  author  repeats  the 
same  facts  over  and  over  again  in  wearisome  iteration.  The 
remedies  proposed  for  infanticide,  with  the  exception  of  the  es- 
tablishment of  foundling  hopitals,  are  absurd  and  cruel,  and 
would  be  totally  inoperative. 

One  passage  only  redeems  his  book  from  the  charge  of 
absolute  dulness,  and  that  is  an  attack  upon  homoeopathy,  at 
page  169.  Apropos  of  the  temptations  to  medical  men  to  pro- 
duce abortion,  he  thus  pours  forth  his  withering  denunciation 
of  homoeopathy. 

"  Quackery  in  all  times  has  existed^  and  has  flourished,  as  in 
England,  where  the  people  are  willing  dupes.  But  in  all  cases 
has  the  profession  kept  aloof,  and  even  warned  the  deluded 
people  of  the  risk  they  ran ;  and,  indeed,  great  has  been  the 
risk  up  to  this  last,  and  most  impudent,  and  untenable  impos- 
ture— the  homoeopathic  delusion.  Had  that  delusion  anything 
in  it,  the  lie  would  be  given  to  all  previous  history,  and  to  all 
previous  efforts  of  the  human  mind.  The  laboure  of  ages  must 
go  for  nothing ;  and  the  experience  handed  down  from  genera- 
tion to  generation,  to  be  improved  upon  as  time  goes  on,  is 
utterly  worthless.  All  philosophical  theories  of  progress  must 
be  thrown  to  the  winds;  and  Bacon,  with  the  inductive  sciences, 
must  be  ignored  as  worse  than  useless  ;  for  they  only  lure  us  to 
the  loss  of  time  which  might  be  better  employed.  For  is  not 
here  Hahnemann  and  his  disciples,  who  have  absolutely  sprung 
to  perfection,  without  trouble  and  without  study,  in  an  art  that 
has  taken  century  after  century  of  hard  working,  high-minded 
and  honourable  men,  in  an  endeavour  to  bring — and  unsuccess- 
fully to  bring,  up  to  the  present — to  something  like  perfection. 
But  there  is  no  danger  for  the  divine  art  of  healing ;  and  this 
last  quackery,  which  promised  to  be  so  gigantic  an  error,  has 
already  collapsed.     Having  nothing  of  vitality  in  it — ^being 


Infanticide.  661 

Bimply  the  'baseless  fabric  of  a  yision' — its  impending  destruo- 
tion  will  leave  no  wreck  behind.  Belying  their  professions  by 
their  acts,  the  disciples  of  this  new  creed — ^if  creed  it  can  be 
called — have  long  been  known,  in  cases  of  real  disease  and 
where  great  danger  threatened,  to  pitch  their  globules  to  the 
winds,  and  to  fly  to  those  good  '  allopathic'  remedies  which 
stood  the  test  of  time,"  and  so  forth,  in  a  continuous  stream  of 
execrable  grammar  and  wretched  twaddle. 

The  reader  will  be  pleased  to  hear  that  the  profession  has 
always  kept  aloof  from  quackery,  and  especially  from  that  most 
impudent  and  untenable  imposture,  homoeopathy.  Without 
being  obliged  to  consider  homoeopathy  an  imposture,  he  may 
hitherto  have  been  under  the  delusion  that  its  practitioners  were 
recruited  from  the  ranks  of  the  profession.  The  pleasure  of  the 
reader  will  be  enhanced  when  he  learns  that  if  there  is  anything 
in  homoeopathy,  all  previous  history  and  all  previous  efforts  of 
the  human  mind  are  merely  lies.  Perhaps  he  was  not  formerly 
aware  that  the  authenticity  of  Heroditus,  Tacitus,  Gibbon,  Hume 
and  Macaulay  depended  on  the  nullity  of  homoeopathy,  so  that 
the  announcement  of  this  great  fact  will  come  upon  him  with 
all  the  charm  of  a  surprise.  Perhaps  he  was  under  the  delusion 
that  the  labours  of  Aristotle,  Newton,  Locke,  Leibnitz  and  Kant 
were  independent  of  the  truth  or  falsity  of  homoeopathy  ;  he  is 
undeceived  by  Dr.  Byan.  Bacon  and  the  inductive  sciences 
must  be  ignored  as  worse  than  useless,  if  an  infinitesimal  dose 
of  aconite  cures  an  inflammation,  and  yet  Bacon  was  no  friend 
to  the  traditional  physic  of  his  time,  which  he  abused  as  unphi- 
losophical  and  defective,  pointing  out  that  the  only  way  in  which 
medicine  could  advance  towards  anything  like  certainty  was  by 
searching  for  specifics,*  which  is  in  fact  the  main  object  of 
homoeopathy. 

The  reader  will  not  fail  to  observe  that  *'  Hahnemann  and 
his  disciples"  are  not  honoured  with  a  plural  verb,  and  that 
"  they  absolutely  sprung  to  perfection  without  trouble  and 
study."  We  were  not  aware  that  we  had  ''  absolutely  sprung 
to  perfection,"  as  Dr.  Byan  eloquently  expresses  it,  but  of 
course  we  are  glad  to  hear  it  from  such  a  disinterested  witness ; 
*  AdYancement  of  Learning,  Book  iy.  chap.  8. 


G62  Mi$ceUa$9€otis, 

still  we  do  not  imagine  this  testimony  to  our  perfection  will 
make  us  relax  our  endeavours  to  improve  the  pracdoe  of  our 
art  just  as  though  we  had  not  qnite  attained  to  absolute  perfec- 
tion.    Some  little  trouble  and  study  it  certainly  cost  Hahnemann 
to  bring  his  system  up  to  the  present  point,  otherwise  we  should 
scarcely  have  the  testimony  of  his  high-minded  opponents,  such 
as  Hufeland  and  Sir  J.  Forbes,  that  he  was  a  man  of  great 
learning  and  indefatigable  industry ;  but  we  suppose  Dn  Ryan 
speaks  comparatively,  and  means  that  the  trouble  and  study  re- 
quired by  Hahnemann  in  order  to  bring  his  system  to  perfection 
were  as  nothing  compared  with  what  Dr.  Byan  has  gone  through 
in  order  to  attain  to  the  grammatical  perfection  he  displays  in 
this  work.    Apparently  the  system  practised  by  Hahnemann 
and  his  disciples  has  not  fared  so  well  as  its  practitioners,  for 
while  they  "  have  absolutely  sprung  to  perfection,"  their  system 
"  has  already  collapsed,"  and  has  been  found  to  be  butthe  "baselesa 
fabric  of  a  vision,"  that  leaves  ''  no  wreck  behind."    We  do  not 
exactly  see  how  the  practitioners  can  have  attained  to  absolute 
perfection  amid  the  collapse  of  their  practice,  but  it  is  none  of 
our  business  to  discover  sense  in  Dr.  Byan  s  mannderings.    In 
fact,  we  have  already  dwelt  too  long  on  this  paltry  exhibition  of 
venomous  spite  against  the  homoeopathic  system  and  its  prac* 
titioners,  the  former  much  above  the  comprehension  of  a  man 
of  Dr.  Byan*s  mental  calibre,  the  latter  not  the  least  injured  by 
this  miserable  explosion  of  silly  abuse. 

MISCELLANEOUS. 


Report  of  the  Comnuitee  appointed  hy  the  Royal  Medieal  and  CkL 
rurgical  Society ^  to  investigate  the  euhfeet  of  Suspended  Animation. 

The  inquiry  was  conducted, — 

By  means  of  experiments  upon  living  animals ; 
By  means  of  experiments  upon  the  dead  human  body. 
In  investigating  anew  the  subjest  of  apnoea  by  means  of  ezperii- 
ments  on  the  lower  animals,  it  seemed  expedient  to  observe,  in  the 
first  place,  the  principal  phenomena  of  apncea  in  its  least  compli- 
cated form — namely,  when  produced  by  simply  depriving  the  animal 
of  air. 


Report  ofi  Suspended  Animation,  668 

The  jHrincipal  facts  to  which  attention  was  directed  daring  the 
progress  of  the  apnoea  thus  induced  were — 

The  duration  of  the  respiratory  moyements ; 

The  duration  of  the  heart's  action. 

The  duration  <^  the  heart's  action  was  observed — 

(a)  In  rehition  to  the  duration  of  the  respiratory  moyements. 

(5)  In  relation  to  the  time  after  the  stoppage  of  the  breathing. 

From  the  experiments  performed  it  appeared  that  in  the  dog  the 
average  duration  of  the  respiratory  movements  after  the  animal  has 
been  deprived  of  air  is  4  min.  5  sec,  the  extremes  being  3  min. 
30  sec.  and  4  min.  40  sec.  The  average  duration  of  the  heart's 
action  is  7  min.  11  sec,  the  extremes  being  6  min.  40  sec  and 
7  min.  45  sec. 

From  these  experiments  it  appears  that  on  an  average  the  heart's 
action  continues  for  3  min.  15  sec  after  the  animal  has  ceased 
to  make  respiratory  efforts,  the  extremes  being  2  min.  and  4  min. 
respectively. 

Rabbits,  on  an  average,  ceased  to  make  respiratory  efforts  in 

3  min.  25  sec.  Their  heart's  action  stopped  in  7  min.  10  sec ; 
consequently,  the  interval  between  the  last  respiratory  effort  and  the 
cessation  of  the  heart's  action  was  3  min.  45  sec. 

The  next  question  investigated  was — ^the  period  after  the  simple 
deprivation  of  air  at  which  recovery  is  possible,  under  natural  cir- 
cumstances, without  the  aid  of  any  artificial  means  of  resuscitation. 

The  experiments  performed  led  to  the  conclusion  that  a  dog  may 
be  deprived  of  air  during  3  min.  50  sec,  and  afterwards  recover 
without  the  application  of  artificial  means ;  that  a  dog  is  not  likely 
to  recover,  if  left  to  itself,  after  having  been  deprived  of  air  during 

4  min.  10  sec. 

The  force  of  the  inspiratory  efforts  during  apnoea  was  observed 
in  the  experiments  to  be  so  great  that  it  was  determined  to  measure 
them.  They  were  found  to  be  capable,  in  the  dog,  of  raising  a 
column  of  mercury  four  inches.  It  appeared,  moreover,  that  their 
force  increases  up  to  a  certain  period. 

In  other  experiments,  Plaster-of-Paris,  and  even  Mercury,  were 
thus  dtawn  upwards  into  the  minute  bronchial  tubes. 

It  is  easy  to  understand,  therefore,  how  foreign  bodies  may  be 
drawn  into  the  lungs  in  cases  of  drowning,  and  tthe  importance  of 
this  &ct  in  the  consideration  of  the  pathology  and  treatment  of 
apncea. 


664  Miscellafieous. 

The  Committee  next  passed  on  to  the  subject  of  drowning. 

The  first  question  inyestigsted  wis — For  whit  period  can  an 
animal  be  submerged,  and  yet  recoTer  without  tbe  aid  of  artificial 
means? 

It  was  found  as  the  result  of  numerous  experiments  on  dogs  that 
in  striking  contrast  to  the  preTious  ones,  li^  minutes  immersion  in 
water  suffices  to  destroy  life. 

Other  experiments  satisfactorily  showed  that  the  difiEbreoce  of 
time  between  simple  apnosa  and  that  by  drowning  is  not  due  to  sub- 
mersion, or  to  depression  of  temperature,  or  to  struggling,  but  that 
it  IB  connected  with  the  fact,  that  in  the  one  case  a  free  passage  of 
air  out  of  the  lungs,  and  of  water  into  them,  is  permitted ;  in  the 
other,  the  exit  of  ur  and  the  entrance  of  water  are  prevented. 

There  can  be  no  doubt,  firom  other  considerations  put  forward, 
that  although  both  these  circumstances  are  concerned  in  producing 
tbe  difference  observed,  yet  that  it  is  mainly  due  to  the  entrance  of 
water,  and  the  effects  thereby  produced. 

The  treatment  of  apncea  was  next  considered. 

For  conclusions  respecting  artificial  respiration,  the  Committee 
refer  to  the  second  portion  of  the  Report 

Many  other  methods  of  resuscitation  which  haye  been  recom- 
mended were  employed,  including  actual  cautery,  venesection,  cold 
splash,  alternate  application  of  hot  and  cold  water,  galyanism, 
puncture  of  the  diaphragm. 

Although  some  of  the  above  means  were  occasionaUy  of  manifest 
advantage,  no  one  was  of  such  unequivocal  efficacy  in  a  sufficient 
number  of  cases  as  to  warrant  the  Committee  in  specially  recom- 
mending its  adoption. 

The  experiments  upon  the  dead  subject  were  made  with  a  view 
to  determine  tbe  value  of  the  various  methods  which  have  been 
employed  for  alternately  compressing  and  expanding  the  cavity  of 
the  chest  in  such  a  manner  as  to  imitate  the  natural  movements  of 
the  thoracic  walls  in  breathing.  The'  following  methods  have  been 
investigated :— * 

1.  Pressure  exerted  by  the  hands  on  the  anterior  wall  of  the 
thorax,  the  body  being  in  the  prone  posture.  Such  pressfire  has 
for  its  object,  to  expel  a  portion  of  the  air  contained  in  the  chest  • 
on  relaxing  the  pressure,  the  chest  expands  and  air  enters. 

2.  The  postural,  or  so-called  ^  ready  "  method,  described  by  Dr. 
Marshal   Hall,^  which  consists  essentially   in  **  turning  the   body 


Report  ofi  Suspended  Animation^  665 

gently  on  the  side  and  a  little  beyond,  and  then  briakly  on  the  face 
altenxately ;"  and  in  making  pressure  along  the  back  of  the  chest 
each  time  the  body  is  brought  into  the  prone  position. 

8.  The  method  of  Dr.  Silvester,  in  which  the  action  of  the  pec- 
toral and  other  muscles  passing  from  the  shoulders  to  the  parietes 
of  the  chest  in  deep  inspiration  is  imitated.  An  inspiratory  effort 
is  produced  by  extending  the  arms  upwards  by  the  sides  of  the 
head ;  on  restoring  them  to  thdr  original  position  by  the  side  of 
the  body,  the  expanded  walls  are  allowed  to  resume  their  previous 
state  and  expiration  takes  place,  the  quantity  of  air  expelled  being 
in  proportion  to  that  which  had  been  previously  inspired. 

It  being  necessary  to  measure  the  flow  of  air  in  and  out  of  the 
respiratory  cavity  under  conditions  of  pressure  closely  resembling 
those  which  exist  in  natural  respiration,  no  means  of  measurement 
could  be  used,  which,  in  its  working  would  offer  any  appreciable 
resistance  to  the  passage  of  air.  With  this  consideration  in  view, 
an  instrument  designed  by  Dr.  Sanderson  was  employed.  (The 
instrument  was  exhibited  to  the  Society.) 

Gekbiul  Rbsttlts. 

1.  As  regards  the  volume  of  air  which  can  be  expelled  from  the 
thorax  by  compression  of  its  walls,  and  inspired  by  the  elastic  expan- 
sion, consequent  on  relaxation  of  the  pressure,  it  was  found— 

(a)  That  pressure  by  both  hands  on  the  lower  third  of  the 
sternum  in  the  adult  male  subject  usually  displaced  from  8  to  10 
inches  of  air. 

The  pressure  actually  exerted  amounted  to  about  80  lbs.  It  was, 
therefore,  not  greater  than  might  be  safely  applied  to  the  living  sub- 
ject. The  volume  of  air  expelled  varied  from  8  cubic  inches  to 
15  cubic  inches. 

(6)  That  pressure  made  in  the  same  manner  on  the  upper  part 
of  the  sternum  usuaUy  displaced  2  or  8  cubic  inches  less  than  pres- 
sure on  the  lower  part. 

(e)  That  pressure  exerted  by  one  hand  on  the  upper  part,  by  the 
other  on  the  lower  part  of  the  sternum,  produced  about  the  same 
resultii  as  were  observed  in  a. 

In  this  case  the  whole  amount  of  pressure  did  not  exceed  that 
exerted  in  a. 

{d)  That  the  pressure  of  a  weight  laid  on  the  lower  third  of  the 
sternum  produced  similar  results  according  to  its  amount. 


666  MiiceUaneous. 

{$)  Tbtt  lateral  preamire  exerted  on  the  ribi  or  ooatal  cartilag»of 
both  aides  nmultaneoasly,  waa,  in  no  inatance,  more  effectual. 

(/)  That  compreaeion  bj  a  broad  bandage  encircling  the  chest 
the  enda  of  which  were  crossed  over  the  'atemaniy  and  drawn  in 
oppoaite  direcliona  bj  two  persona,  produced  no  greater  efieet  than 
pleasure  with  the  hands  on  the  sternum  or  aidea. 

2.  Aa  regards  the  whole  amount  of  exchange  of  air  produced 
by  the  method  of  Dr.  Marahall  Hall,  **  to  imitate  respiration,"  it 
Taried  much  according  as  the  subject  was  favourable,  or  the  con- 
trary ;  sometimes  not  exceeding  a  few  cubic  inches,  but  never  ex- 
ceeding 15  cubic  inchea. 

3.  Aa  regards  Dr.  Silvester's  method,  it  was  found  that,  on  ex- 
tending the  anna  upwarda,  a  volume  of  air  was  inspired  into  the 
chest,  which  varied  in  different  aubjects  from  9  to  44  cubic  inches, 
and  it  waa  observed  that  the  reaults  obtained  in  succeasfiil  experi- 
ments on  the  same  body  were  remarkably  uniform,  in  which  respecti 
aa  well  aa  in  their  amount,  they  contrasted  with  thooe  obtained  by 
the  method  of  Dr.  M.  Hall.  On  restoring  the  arma  to  the  aide,  the 
quantity  of  air  expelled  was  generally  nearly  equal  to  that  previously 
inspired.     Occasionally  less. 

In  the  treatment  of  apncea  generally,  the  Committee  off^  the 
Ibllowing  suggestions : — 

That  all  obstrucUon  to  the  passage  of  air  to  and  fran  the  lungs 
be  at  once,  so  far  aa  is  practicable,  removed ;  that  the  mouth  and 
nostrils,  for  example,  be  cleansed  from  all  foreign  matters  or  adher- 
ing mucus. 

That  in  the  abaence  of  natural  respiration,  artificial  respiration 
by  Dr.  Silvester's  plan  be  forthwith  employed  in  the  following 
manner :— The  body  being  laid  on  its  back  (either  on  a  flat  surface, 
or,  better,  on  a  plane  inclined  a  little  from  the  feet  upwards,)  a  finn 
ouehion  or  some  similar  support  should  be  placed  under  the  shoulders, 
the  head  being  kept  on  a  line  with  the  trunk.  The  tongue  ahould 
be  drawn  forward  so  as  to  project  a  little  from  the  side  of  the 
mouth.  Then  the  arms  should  be  drawn  upwards  until  they  nearly 
meet  above  the  head  (the  operator  grasping  them  just  above  the 
elbows),  and  then  at  once  lowered  and  replaced  at  the  side.  This 
ahould  be  immediately  followed  by  moderate  pressure  with  both 
hands  upon  the  lower  part  of  the  sternum.  This  process  is  to  be 
repeated  twelve  or  fourteen  times  in  the  minute. 

That  if  no  natural  respiratory  efforts  supervene  a  dash  of  hot 


Report  OH  Suspetuied  Ahimaiion,,  667 

water  (120  deg.  Fahr.)  or  cold  water  be  employed,  for  the  purpoae 
of  exciting  respiratory  efforts. 

That  the  temperature  of  the  body  be  maintained  by  friction^  warm 
blankets,  the  warm  bath,  &c. 

In  the  case  of  drowning,  in  addition  to  the  foregoing  snggesttons, 
the  following  plan  may  be  in  the  first  instance  practised: — ^Place 
the  body  with  the  face  downwards,  and  hanging  a  little  over  the 
edge  of  a  table,  shutter,  or  board,  raised  to  an  angle  of  about  thirty 
degrees,  so  that  the  head  may  be  lower  than  the  feet  Open  the 
mouth  and  draw  the  tongue  forward.  Keep  the  body  in  this  posture 
for  a  few  seconds,  or  a  little  longer  if  fluid  escapes.  The  escape  of 
fluid  may  be  assisted  by  pressing  once  or  twice  upon  the  back. 

(Signed)       C.  J.  B.  Wiixiaks,  Chairman. 

W.  S.  KiBKSS. 

George  Haslet. 

J.  B.  SAin>EB80N. 

C.  E.  Bbowk-Sequabd. 

H.  Hyde-Saltbb. 

£.  H.  SiEYEKiKO,  ex  officio, 

Wm.  S.  Satobt,  Hon.  Secretary. 

On  the  motion  of  Dr.  Edward  Smith,  the  resolution  of  the  Crooncil 
appointing  the  Committee  was  read. 

Dr.  C.  J.  B.  Williams  said,  the  Committee,  haying  to  consider 
the  subject  of  ^  Suspended  Animation,"  directed  their  enquiries  to 
that  kind  of  interference  with  life  which  results  from  stoppage  of 
the  breath  in  suflbcation,  strangulation,  and  drowning.  The  flrst 
series  of  experiments  was  to  investigate  the  result  of  simple  apnoea, 
or  stoppage  of  the  breatlr;  and  for  this  purpose  the  trachea  of 
animals  was  opened,  and  a  tube  inserted  so  as  to  command  the 
supply  of  aur ;  and  this  tube  being  furnished  with  a  stop«cock  could 
be  closed,  and  the  results  noted,  especially  these : — After  the  closure 
of  the  tube,  1,  how  long  respiratory  efforts  continue ;  2,  how  long 
the  heart's  action  continues ;  3,  how  long  the  heart  beats  after  the 
breathing  efforts  cease.  The  experiments  show  a  considerable  variety 
of  result;  but,  as  a  general  average,  it  may  be  stated  that  in  doga 
efforts  at  breathing  continued  a  few  seconds  more  than  four  minutes 
after  the  closure  of  the  tube ;  and  the  heart's  action  three  minutes 
and  a  quarter  longer.  The  duration  and  force  of  these  respiratory 
efforts  in  an  animal  deprived  of  air,  were  not  more  remarkable  than 


668  MUcellaneoui. 

impcMrtant,  u  indicating  the  period  within  which  an  animal  deprited 
of  air  could  recover ;  and  this  was  found  to  be  almost,  but  not  quite, 
as  long  as  the  duration  of  these  efforts — that  is  to  say,  a  dog  de- 
prived of  air  four  minutes  only,  would  recover ;  but  if  the  exclusion 
of  air  lasted  ten  seconds  longer,  he  did  not  recover.  The  extra- 
ordinary force  of  these  strugg^  for  breath  was  shown  by  plunging 
the  end  of  the  tube  into  mercury,  when  it  was  found  that  the  inspira- 
tory effort  sometimes  raised  a  column  of  four  inches  of  mercury,  and, 
if  the  tube  was  shorter,  would  draw  the  quicksilver  in  considerable 
quantities  into  the  bronchial  tubes  and  air-cells  of  the  lungs.  The 
next  subject  of  investigation  was  suspended  animation  firom  drowning ; 
and  here  the  experimenters  soon  found  a  remarkable  dii!arence  in 
the  greater  rapidity  of  the  death,  and  the  shorter  time  during  which 
life  is  recoverable.  An  animal  simply  deprived  of  air  for  four 
minutes  may  recover;  but  one  immersed  in  water  for  one  minute 
and  a  half  is  irrecoverably  dead.  Recovery  took  place  in  several 
cases  where  the  immersion  lasted  one  minute  and  fifteen  seconds ; 
but  fifteen  seconds  more  made  all  the  difference.  The  experi- 
menters proceeded  to  search  into  the  cause  of  this  peculiarly  des- 
tructive operation  of  drowning,  as  compared  with  simple  privation 
of  air ;  and  very  soon  they  were  enabled  to  trace  it  to  the  action  of 
the  water  itself,  forcibly  drawn  into  the  lungs  by  the  respiratory 
struggles  of  the  animal.  Two  dogs  were  plunged  into  water,  one 
having  its  trachea  closed  by  a  stop-cock  at  the  moment  of  immer- 
sion.  The  dog  with  the  trachea  firee  was  taken  out  in  two  minutes, 
irrecoverably  dead.  The  other,  with  the  trachea  closed,  was  taken 
out  at  the  end  of  four  minutes;  the  trachea  was  opened,  and  in 
the  course  i>f  a  few  seconds  the  animal  began  to  gasp,  and  socm 
recovered.  Another  mode  of  diminiBhing  the  inspiratoiy  struggleB 
of  the  animal  was  by  stupifying  it  with  chloroform  before  immer- 
sion in  water,  and  it  was  actually  found  that  recovery  took  place 
after  two  minutes  and  fifteen  seconds'  immersion.  On  this  point  he 
(Dr.  Williams)  adverted  to  a  popular  opinicm,  that  it  is  more  diffi- 
cult  to  drown  a  drunken  man  than  one  who  is  sober,  as  having 
some  foundation  on  this  fact,  thai  insensibility  of  any  kind  retards 
the  fcital  influence  of  drowning,  by  diminishing  those  violent 
struggles  for  breath  which,  by  forcing  water  into  the  lungs,  soon 
put  the  case  beyond  recovery.  But  nothing  so  fully  pointed  out 
the  extent  and  nature  of  the  fatal  influence  of  water  in  the  lungs 
as  the  appearance  of  these  organs  in  drowned  animals  as  compared 


Report  on  Suspended  Animation,  600 

with  those  killed  by  simple  apnoea.  In  the  latter,  the  air-passages 
remained  free  from  all  secretion  or  effusion,  and  the  lungs  them- 
selves were  light  and  buoyant,  and  contained  remarkably  little 
blood.  Now  this  is  contrary  to  what  is  generally  described  as  the 
state  of  the  lungs  in  asphyxia;  and  probably  in  ordinary  cases, 
where  death  is  not  sudden,  but  prolonged,  more  or  less  engorge- 
ment may  take  place.  But  here  there  was  no  engorgement  or 
obstruction,  and  it  was  not  wonderful  that  animals  would  recoTcr 
more  readily.  But  with  drowned  animals,  not  only  were  all  the  air- 
passages  choked  with  frothy  fluid,  and  that  fluid  generally  more  or 
less  bloody,  but  the  whole  lungs  were  always  highly  engorged  with 
blood,  so  that  they  were  heavy,  dark-coloured,  pitted  on  pressure, 
and  on  being  cut  exuded  an  abundance  of  blood-tinged  fluid  with 
many  air-bubbles  in  it  On  this  subject  he  would  make  two 
remarks  on  his  own  responsibility,  apart  from  his  office  in  the 
Committee.  One  was — How  opposed  these  observations  and  con- 
clusions are  to  those  many  years  ago  propounded  by  Goodwyn  in 
his  treatise  on  suspended  Animation,  whose  opinions  have  generally 
been  adopted  to  the  present  time.  Goodwyn  concluded  from  his 
observations,  that  water  never  to  a  hurtful  extent  enters  the  lungs 
of  the  drowned,  and  he  deprecated  the  popular  practice  of  hanging 
up  a  drowned  person  by  the  heeb  to  let  the  water  run  out  He 
(Dr.  Williams)  was  by  no  means  sure  that,  as  Dr.  Goodwyn  was 
certainly  wrong  in  his  pathology,  some  modification  of  the  popular 
practice  may  not  be  beneficial.  The  other  remark  related  to  the 
mode  in  which  the  water  which  got  into  the  lungs  of  the  drowned 
proved  so  rapidly  and  extensively  injurious.  No  doubt  much  was 
due  to  its  mechanical  pressure  on  the  tubes  and  ceUs,  forming  an 
imper\ious  barrier  to  the  readmission  of  air;  but  this  would  not 
account  for  the  extraordinary  increase  of  blood  in  the  lung,  and  its 
transudation  into  the  air-tubes.  He  believed  the  injurious  infiuence 
of  water  to  be  due  to  its  chemical  power  of  acting  by  endosmosis 
on  the  blood  within  the  capillaries  of  the  lungs,  swelling  up  and 
bursting  the  blood-corpuscles,  and  causing  their  rapid  accumulation 
in  the  organ,  and  their  extravasation  into  the  bronchial  tubes.  This 
was  a  subject  for  further  experimental  investigation,  and  he  thought 
it  one  of  great  importance,  as  bearing  on  the  action  of  water  as  a 
noxious  or  a  therapeutic  agent.  He  would  not  detail  the  various 
means  of  resuscitation  which  were  tried  by  the  Committee,  but  the 
results  of  the  trials  were  not  such  as  to  induce  the  Committee  to 


670 


recommeiid  them  strongly  for  general  adoption.  Vartons  instmetive 
experimentt  were  made  on  different  modes  of  performing  artificial 
reapiration,  and  the  moat  concluaiTe  of  these  had  reference  to  the 
so-called  ''readj  methods"  of  Dr.  Marshall  Hall  and  Dr.  Silvester. 
One  of  their  Committee  (Dr.  Sanderson)  contrived  the  apparatus  on 
the  table  for  measuring  the  air  which  could  be  forced  out  of  it  into 
the  lungs  of  a  dead  body  by  these  methods  of  artificial  respiration; 
and  the  general  result  was,  that  by  Dr.  Hall's  method  the  quantity 
of  air  moved  in  and  out  of  the  lungs  rarely  reached  nine  cubic  inches, 
and  never  exceeded  fifteen ;  whereas  by  Dr.  Silvester's  plan  an  inter- 
change of  forty  cubic  inches  was  effected ;  and  when  this  method 
was  further  improved  by  alternating  the  drawing  up  of  the  arms 
with  depressing  them,  and  with  pressure  on  the  lower  part  of  the 
sternum,  the  expelled  air  was  as  much  as  fifty  cubic  inches.  So 
for,  then,  as  these  experiments  go,  they  show  a  great  superiority  of 
Dr.  Silvester's  over  Dr.  Marshall  Hall's  ''  ready  method." 

Dr.  Edwabd  Smith  adverted  to  the  importance  of  the  quantity 
of  bloody  water  found  in  the  lungs  of  the  dogs  drowned,  and  ex- 
plained that  the  water  would  be  introduced  firom  the  bronchi  into 
the  blood-vessels  by  endosmosis,  and  these  would  cause  the  swell- 
ing and  bursting  of  the  blood-corpuscles  after  the  circulation  had 
been  greatly  retarded  or  arrested,  and  would  also  cause  rupture  of 
the  capillaries,  or  the  attenuated  blood  would  pass  through  the 
vralls  by  exosmosis,  and  thus  appear  in  the  bronchi.  He  did  not 
think  that  the  experiments  upon  the  action  of  chloroform  in  defer- 
ring the  fatal  issue  were  conclusive,  since  they  were  too  few,  and 
the  increased  duration  of  life  veiy  small,  and  it  had  not  been  shown 
that  a  narcotised  animal  might  not  have  greater  tolerance  of  apncea 
independent  of  ^e  idea  which  the  Committee  had — the  diminu- 
tion of  muscular  effort.  The  matter  of  greatest  interest  in  the 
Report  was  the  comparison  of  the  Marshall  Hall  and  Silvester 
methods,  and  he  (Dr.  Smith)  thought  that  both  might  be  equally 
advantageous  in  the  cases  in  question.  The  experiments  have 
shown  that,  with  the  lungs  full,  there  was  greater  change  of  air 
with  the  Silvester  method.  The  Marshall  Hall  method  started  from 
the  point  of  expiration,  but  living  persons  could  by  their  efibrt 
expire  forty  cubic  inches  below  that  point,  and  if,  by  external 
pressure  on  the  inanimate,  one-half  of  that  quantity  could  be  dis- 
placed, it  would  probably  suffice  for  the  purpose  in  hand.  The 
Silvester  method,  by  enlarging  the  cavity  of  the  chest  above  the 


Report  on  Suspended  Animation,  67  i 

line  of  ezpimtion,  mast  cause  greater  diBplacement  of  air;  but  it 
had  been  shown  by  the  Report,  that  in  a  case  of  phthisis,  where  the 
lung  capacity  was  greatly  reduced,  the  effect  of  the  two  methods 
was  precisely  the  same.  Such  would  also  probably  be  the  case 
with  drowned  persons,  in  whom  the  lungs  were  full  of  water,  which 
offered  a  great  obstacle  to  the  introduction  of  air ;  and  in  this  con- 
dition the  Committee  had  not  made  any  experiments.  It  was  in 
reference  to  the  practical  object  in  the  appointment  of  the  Committee 
that  the  Report  failed^  The  Committee  had  not  proved  that  any 
one  of  their  inquiries  was  applicable  to  the  drowned  human  eubject. 
The  time  during  which  a  man  could  be  immersed  in  water  and 
recover  could  not  be  proved  by  experiments  on  dAgs,  and  the  Com* 
mittee  themselves  had  shown  that  all  their  plans  for  the  restoration 
of  drowned  dogs  had  failed.  The  Committee  had,  in  one  part  of  the 
Report,  disclaimed  any  intention  to  say  how  far  the  Silvester  method 
was  fitted  for  the  restoration  of  the  drowned ;  and  yet  in  their  recom- 
mendations they  advise  the  use  of  this  method  almost  exclusively, 
without  having  in  any  experiment  tried  it,  under  these  conditions. 
The  recommendation  to  place  the  body  prone,  and  allow  fluid  to  run 
out  of  the  mouth,  was  an  old  recommendation ;  but  they  had  inferred, 
and  not  proved,  its  value,  and  that  only  from  experiments  on  drowned 
dogs  which  they  could  not  resuscitate.  The  experiments  on  dogs 
had  shown  that  neither  cold  nor  hot  water  alone  had  any  value  as 
restorative  agents,  but  that  the  alternation  of  the  two  was  some- 
what  useful;  but  this  alternation  had  not  been  recommended  for 
man.  Hence  he  (Dr.  Smith)  regarded  this  Report  as  but  the  com- 
mencement of  the  inquiry,  a  labour  which  had  elicited  important 
facts  fitted  to  be  employed  in  further  researches;  but  as  to  the 
great  object  had  in  view  in  the  appointment  of  the  Committee — the 
scientific  determination  of  the  best  method  for  restoring  drowned 
men — he  thought  that  it  had  altogether  failed. 

Dr.  Websteb.  said  that  he  thought  the  Silvester  method  was  the 
best,  and  that  the  recommendation  was  very  important  He  was 
sorry  to  hear  that  the  lives  of  so  many  dogs  had  been  sacrificed  in 
the  experiments.  He  hoped  that  in  future,  if  possible,  experiments 
on  living  animals  would  be  avoided. 

Dr.  Mabcst  agreed  with  Dr.  £dward  Smith,  inasmuch  as,  from 
the  method  of  investigation  adopted  by  the  Committee,  he  felt 
assured  of  the  correctness  of  their  results.  He  was,  however,  sorry 
that  so  little  consideration  had  been  given  to   the  instrumental 


67S  MUceUaneaui. 


means  of  performing  artiflcia]  respintioa,  which  he  believed  to  be 
of  the  greatest  importance  in  a  practical  point  of  view  becaoae, 
in  his  opinion,  a  much  larger  quantity  of  ur  was  required  to  inflate 
the  lungs  in  suspended  animation  than  the  SilTCster  or  the  Marshall 
Hall  method  could  possibly  effect.  It  was  to  be  borne  in  mind  that 
in  cases  of  asphyxia  or  of  poisoning  by  chloroform,  poisonous  gas 
accumulated  in  the  blood;  and  the  object  of  artifidal  respiration 
was  to  remoTe  this  poison  and  ezdte  the  action  of  the  heart.  He 
(Dr.  Marcet)  contended  that  in  order  to  obtain  a  sufllcient  amount 
of  diflbnon  to  allow  of  poisonous  gases  to  escape  from  the  blood  at 
the  lungs,  it  was  necessary  that  these  organs  should  be  inflat^^  with 
as  much,  or  nearly  as  much  air  as  they  could  contain,  and  this  no 
ready  method  was  capable  of  doing,  as  the  volume  of  air  required 
would  be  finom  150  to  200  cubic  inches.  He  believed  that  the 
instruments  for  performing  artificial  respiration  should  not  be  set 
aside  on  the  ground  that  they  cannot  be  had  and  applied  quick 
enough  when  wanted,  and  proposed  that  surgeons  and  hospitals 
should  provide  themselves  with  some  i^paratus  of  acknowledged 
efficiency  for  inflating  the  lungs.  In  hospitals  there  would  be  no 
difllculty  in  carrying  out  this  plan,  so  as  to  have  in  readiness  a  means 
of  restoring  animation  in  cases  of  accidents  with  chloroform.  Dr. 
Marcet  then  alluded  to  the  instrument  he  had  exhibited  to  the 
Society  on  the  11th  February  last  He  said  he  had  obtained  most 
satisfoctory  results  when  using  it  to  restore  animation  in  cases  of 
dogs  poisoned  with  chloroform,  and  that  in  these  experiments  he  had 
been  able  to  avoid  performing  tracheotomy  for  the  purpose  of  insert- 
ing a  canula  into  the  trachea,  which  greatly  added  to  the  interest  of 
the  resnlto.  He  had  no  doubt  that  this  very  simple  instrument 
would  prove  most  available  in  cases  of  suspended  animation  in  the 
human  individual,  and  concluded  by  observing  that  the  instrument 
used  by  the  Committee  in  their  inquiries  was  one  he  had  invented 
and  described  in  1854;  it  was  not  nearly  so  practical  as  that 
exhibited  lately  to  the  Society. 

Mr.  Ckaxlxs  Hvhtxb  said,  that  as  he  was  one  of  those  gentle- 
men who  six  years  ago  conducted  the  experimente  upon  the 
dead  body  for  Dr.  Marshall  Hall,  upon  which  experimente  the 
<« Ready  Method"  was  established,  he  felt  called  upon  for  a  few 
words  in  ite  defence.  He  regretted  that  the  Committee  thought  fit 
to  condemn  it,  and  observed,  that  if  the  MarshiJl  Hall  method  alter 
all  was  a  failure,  the  long  series  of  experimente  carefully  made  by 


Report  oh  Suspended  Animation,  673 

him  (Mr.  Hunter)  with  others  must  go  for  nothing ;  and  yet  the 
original  experiments  were  much  more  numerous  than  those  made  hy 
this  Committee,  and  perfectly  conclusiye  in  their  general  results  to 
those  who  made  and  saw  them.  They  were,  moreover,  hacked  hy 
astonishing  evidence  in  its  favour  from  medical  men  in  all  parts  of 
the  kingdom — testifying  to  its  success  in  actual  cases  of  drowning. 
In  reply  to  Dr.  Harley,  he  said  the  Silvester  plan  was  tried  a  few 
times,  hut  without  success  equal  to  that  obtained  by  the  '*  Ready 
Method."  He  would  correct  the  idea  that  only  ten  cubic  inches 
were  obtained  in  the  experiments — it  was  much  more,  and,  in 
favourable  cases,  varied  between  twenty-five  and  thirty -five  cubic 
inches,  and  sometimes  forty  inches.  LIr.  Hunter  was  glad  to  find 
his  own  experience  on  the  lungs  of  drowned  animals,  as  described 
by  him  in  the  Lancet^  were  corroborated  by  the  Committee  ;  he  was 
also  glad  to  hear  that  they  did  recommend  the  pronation  of  the  body 
as  the  first  measure  in  cases  of  drowning — it  was  the  essential  part 
of  the  Marshall  Hall  treatment.  The  special  advantages  of  the 
pronation  are  that  fluids  escape  from  the  mouth,  throat,  and  lungs, 
and  the  tongue  dropping  forward  leaves  the  glottis  free  during 
inspiration.  He  was  sorry,  then,  to  find  that  the  Committee  recom- 
mend the  Silvester  plan.  He  could  imagine  no  plan  so  rational  as 
the  Marshall  Hall  method  for  a  case  of  drowning.  The  experiments 
of  the  Committee  prove  that  water  is  drawn  forcibly  into  the  lungs  in 
drowning,  and  that  that  water  hastens  death  ;  how  necessary,  there- 
fore, a  method  of  recovery  that  will  get  rid  of  the  water !  The 
Committee  objected  to  the  Marshall  Hall  method  that  the  expiratory 
act  precedes  the  inspiratory.  Mr.  Hunter  considered  it  a  physio- 
logical advantage,  as  by  first  inducing  expiration  much  of  the  fluid 
is  got  rid  of  that  has  entered  the  lungs,  as  well  as  the  bad  ur,  which 
it  is  as  important  to  get  rid  of  as  to  introduce  good  air.  He  observed 
that  frequently  in  his  experiments  artificial  respiration  could  not  be 
effected  in  the  supine  position,  but  could  by  pronolateral  movements. 
He  considered  that  in  drowning  cases  pronation  of  the  body  should 
be  continued  some  length  of  time,  as  fluid  can  be  expelled  from  the 
lungs  of  a  drowned  individual  for  half  an  hour  by  the  Marshall  Hall 
method.  He  inquired  if  the  Committee  meant  to  recommend  the 
continuous  warm  bath  or  not,  as  they  had  recorded  no  experiments 
in  the  Report.  His  own  observations,  he  considered,  proved  it  to 
be  a  most  prejudicial  measure,  impeding  respiratory  action,  and 
excluding  the  prone  and  postural  movements. 

VOL.  XX.,  NO.  LXXXII. — OCTOBER,  1862.  2  U 


674  Miicellaneous. 

Mr.  Acton  was  sorry  to  hear  that  the  opposition  to  the  Report 
was  more  to  its  details  than  to  the  Report  itself.  He  thought  that 
the  members  of  the  Society  should  consider  that  the  Committee 
had  come  forward  for  the  first  time,  and  that,  as  in  the  Academy  of 
Medicine  at  Paris,  they  ought  to  be  received  with  laudation.  Mem- 
bers of  the  Society  should  not  come  forward,  each  with  his  own 
particular  Yiews,  to  attack  the  Report ;  and,  instead  of  dwelling  on 
its  shortcomings,  they  ought  to  receive  the  labour  of  the  Committee 
thankfully. 

Dr.  KiDD  considered  that  artificial  respiration  would  be  valuable 
in  restoring  persons  from  the  effects  of  an  overdose  of  chloroform. 
He  had  seen  cases  in  which  pressure  on  the  chest  seemed  to  restore 
life. 

Dr.  C.  J.  B.  Williams  said  that  the  experiments  detailed  in  the 
Report  had  been  made  with  great  care,  and  the  methods  of  Dr. 
Marshall  Hall  and  Dr.  Silvester  had  been  fully  compared.  He 
thought  that  the  Committee  had  done  wisely  in  not  recommending 
instruments,  but  what  they  considered  to  be  the  readiest  plan  under 
all  circumstances. — Medical  Circular^  July  16,  1862. 


Rennnet  Wine. 
By  Geobqb  Ellis,  M.B.,  F.R.C.S.L 

That  a  supply  of  good  gastric  juice  to  the  stomach,  after  its 
reception  of  food,  is  indispensable  for  healthy  gastric  digestion,  is  a 
truth  that  needs  but  little  comment  Defect  in  quality  of  this  fluid 
may  be  considered  one  of  the  most  frequent  starting  points,  often 
overlooked  as  such,  of  many  diseases  which  surely,  though  it  may 
be  slowly,  undermine  the  constitution  and  shorten  life.  Few  of  us 
are  entirely  exempt  from  some  of  the  immediate  consequences  of 
unhealthiness  in  this  secretion.  Acid  eructations,  gastralgia,  thirst, 
foul  tongue,  vertigo,  headache,  and  nausea,  are,  under  the  name  of 
dyspepsia,  among  the  commonest  affections  treated  by  medical  men 
in  themselves  and  others  ;  and  the  consciousness  of  the  want  of  some 
substitute  or  corrective,  better  than  any  of  our  present  Pharma. 
copceia  can  offer,  has  led  to  the  very  extensive  trial  of  a  costly  pre- 
paration, still  prescribed  pretty  largely,  under  the  supposition  that 
it  contains  the  active  principle  of  the  gastric  juice.  Of  this  prepara- 
tion, called  pepsine,  I  can  only  say  that,  having  tried  it  more  than 


Refinet  Wine.  679 

bttce,  I  have  failed  to  detect  its  utility.  It  will  not  coagulate  milk, 
and  as  to  any  digestive  action  on  the  food,  I  suspect  there  are  few 
practitioners  who,  though  continuing  to  prescrihe  it,  do  not  feel 
inclined,  from  their  own  experience,  to  question  its  efficacy. 

About  two  years  since,  failing  to  obtain  benefit  from  this  new 
remedy,  I  had  recourse  to  the  direct  preparation  of  a  solution  of 
gastric  juice  from  the  calf's  stomach ;  and  I  have  found  the  result 
so  gratifjring,  its  effect  in  gastric  derangements  so  satisfactory  and 
remarkable,  both  in  my  own  hands  and  in  those  of  several  medical 
friends  to  whom  I  reconmiended  it,  that  I  wish  to  communicate  to 
the  profession,  more  extensively,  the  following  mode  of  preparation 
which,  after  many  trials,  appears  to  me  to  be  the  simplest  and  most 
convenient  for  general  prescribing  purposes.  Take  the  stomach,  or 
rennet  bag,  as  it  is  called,  of  a  calf  fresh  from  the  butcher ;  cut  off 
about  three  inches  of  the  upper  or  cardiac  extremity,  which  portion, 
as  it  contains  fewer  glandular  follicles,  may  be  thrown  away ;  slit  up 
the  stomach  longitudinally ;  wipe  it  gently  with  a  dry  napkin,  taking 
care  to  remove  as  little  of  the  clean  mucus  as  possible  ;  then  cut  it 
into  small  pieces  (the  smaller  the  better),  and  put  all  into  a  common 
wine  bottle ;  fill  up  the  bottle  with  good  sherry,  and  let  it  remain 
corked  for  three  weeks.     At  the  end  of  this  time  it  is  fit  for  use. 

Dose. — One  teaspoonfiil  in  a  wineglassful  of  water  immediately 
after  meals. 

Test  of  Quality, — One  teaspoonful  will  solidify,  to  the  consistency 
of  blanc  mange,  in  from  one  or  two  minutes,  a  cup  of  milk  (about 
eight  ounces)  at  the  temperature  of  100  deg.  Fahr. 

In  this  action  on  the  casein  of  the  milk,  it  may  be  said  that  the 
wine  itself  might  have  some  effect  This,  however,  cannot  be  the 
case,  as  wine  will  not  solidify  milk,  and  it  will  only  curdle  it  at  a 
much  higher  temperature  and  in  lai^er  proportion. 

This  preparation,  which  I  propose  to  call  '*  rennet  wine,'*  has 
many  advantages  over  the  watery  infusion  of  rennet  which  is  oh** 
tained  from  the  dried  and  salted  calf's  stomach  (used  largely  in 
cheese-making).  The  objections  to  the  latter  are,  that  it  is  much 
more  troublesome  to  prepare,  and  becomes  very  soon  spoiled  in 
warm  weather,  when  it  begins  to  react  on  the  animal  matter  con- 
tained in  it.  Rennet  wine,  on  the  contrary,  is  so  easily  made, 
requiring  no  drying  or  salting  of  the  stomach,  is  so  inexpensive,  and 
can  be  so  easily  prescribed  in  private  and  hospital  practice,  that  I 
have  little  doubt  if  known  and  tried  it  would  l^ecome  a  very  highly 

2  u  2 


676  Miscellaneous. 

valued  remedial  article  in  the  hands  of  the  profession,  and  would 
take  a  permanent  place  on  the  shelves  of  the  apothecary. 

I  recommend  the  employment  of  good  sherry,  because  this  wine 
has  sufficient  body  to  keep  the  infusion  sound  for  any  length  of  time, 
and  is  not  so  strong  in  alcohol  as  to  interfere  with  its  power  of 
taking  up  the  active  principle  of  the  rennet. 

To  the  physiologist  it  is  unnecessary  to  say  that  it  should  be  given 
after  or  during,  and  not  before  meals.  A  single  dose  given  daily 
after  dinner  will  be  found  quite  sufficient  to  act  speedily  and  effec- 
tively, without  other  treatment,  in  the  common  run  of  cases  of  func- 
tional disorder  of  the  stomach.  It  is  not,  perhaps,  easy  to  explain 
the  operation  of  this  small  quantity  when  we  consider  the  large 
supply  of  the  gastric  secretion  required  for  the  thorough  digestion 
of  an  ordinary  meal.  The  action  is  probably  due  to  those  indirect 
chemical  changes  called  catalytic  transformations,  which  some 
organic  substances,  by  their  mere  presence  and  contact  induce  in 
each  other  and  in  other  proximate  principles.  Thus  the  conversion 
of  a  small  portion  of  food  in  the  stomach  into  healthy  albuminose 
by  this  small  quantity  of  sound  gastric  juice  may  induce  the  same 
healthy  action  throughout  the  stomach's  contents  during  the  entire 
process  of  stomach  digestion.  It  is  at  least  equally  difficult  to  ex- 
plain the  action  and  rapid  extension  of  ferments  generally  in  their 
appropriate  solutions.  I  have  often  been  forcibly  struck  by  the 
magical  effect  of  this  small  dose  in  removing  offensive  odour  from 
the  breath  of  young  persons — a  distressing  symptom  sometimes 
aggravated  rather  than  relieved  by  purgative  medicine ;  and  I  may 
also  mention  that  in  one  of  these  cases  cod-liver  oil  was  easily 
tolerated  afterwards  though  never  before. 

It  would  be  a  mistake,  however,  to  suppose  that  oil  is  at  all  acted 
on  by  the  gastric  juice.  The  oil  globules  of  coagulated  milk  are 
seen  under  the  microscope,  unchanged,  though  imbedded  in  the 
solidified  casein,  the  digestion  of  oil  being  entirely  intestinal.  But 
intestinal  digestion  itself  must  surely  be  influenced  essentially  by 
the  healthy  preparatory  action  of  the  stomach  secretion  on  the 
albuminous  compounds  presented  to  it,  and  thus  the  digestion  of 
oils  and  fatty  matters,  though  not  commenced  in  the  stomach,  will 
be  indirectly  facilitated  by  their  being  mingled  with  the  products 
of  the  healthy  gastric  operation,  when  submitted  subsequently  to  the 
action  of  the  pancreas  and  liver.  • 

It  is  unnecessary,  however,  at  present,  to  theorize  further  on  the 


The  Medical  Circular.  677 

subject.  My  object  is  to  bring  to  the  notice  of  the  profesaion,  and 
have  subjected  to  the  test  of  larger  experience,  a  preparation  which 
in  my  very  limited  sphere  I  have  found  extremely  serviceable  ;  and 
as  I  believe  there  is  no  class  in  society  more  liable  to  suffer  from 
gastric  disturbance,  oflen  long-continued,  with  wasting  and  debility, 
than  members  of  our  own  profession,  through  worsy  of  mind  and 
body,  with  irregular  hours  for  meals  and  sleep,  I  would  earnestly 
suggest  their,  at  least  experimental,  adoption  of  this  remedy,  at  once 
so  simple,  so  little  costly,  and  which  is  no  trifling  recommendation,  so 
perfectly  innocuous. — Dublin  Medical  Press. 

The  Medical  Circular  on  Modem  Therapeutics. 

There  is  a  general  notion  that  we  modems  infinitely  surpass  our 
ancestors  in  the  arts  of  life;  and  Medical  men  in  particular  are 
prone  to  congratulate  themselves  upon  the  great  advances  which  the 
practice  of  medicine  has  made  during  this  nineteenth  century.  In 
illustratfon  of  the  barbarous  ignorance  of  our  predecessors,  some 
erudite  archsologist  will  occasionally  reproduce  for  the  satisfaction 
of  the  curious,  a  prescription  written  by  Dr.  Caius,  or  Revirius,  or 
perhaps,  even  his  own  great  grandfather,  who  pottered  away  his 
time  and  industry  among  his  simples  and  mineral  oxides  in  some 
remote  country  village  a  hundred  years  ago. 

We  have  all  of  us  seen  such  prescriptions,  including  some  dozen 
or  twenty  different  articles,  which  have  been  dried  and  boiled  and 
squeezed  and  macerated,  and  in  numberless  other  ways  subjected 
to  thaumaturgical  processes  by  which  their  marvellous  virtues  have 
been  extracted,  so  as  to  be  made  operative  on  the  peccant  humours 
of  the  animal  frame.*  We  laugh  and  think  ourselves  much  more 
sensible  men  than  our  grandfathers.  We  prescribe,  now-a-days,  in 
a  far  simpler  manner.  Three  or  four  drugs  in  one  prescription 
are  quite  sufficient  to  satisfy  our  ingenuity  and  cure  our  patients. 
Pathology  is  better  understood,  chemistry  has  revealed  to  us  its  many 
wonders,  the  correlations  of  forces  is  a  new  discovery.  Though 
we  despise  homoeopathy  from  the  bottom  of  our  soul,  we  still  believe 
in  occult  influences,  and  look  forward  with  hope  to  the  grand 
climacteric  of  Medical  science,  when  the  laws  of  the  conservation 
or  conversion  of  forces  being  well  understood,  we  shall  be  able  to 
replace  loss  of  heat  in  aged  persons  with  a  suitable  dose  of  electricity, 
and  re-excite  motion  in  a  clot  of  blood  by  the  aid  of  a  rarefied  sunbeapi. 


678 


MUeeUaneou$. 


In  our  progrefls  to  Uub  bappy  state  of  therapeutical  perfection,  wd 
content  ourselves  with  prescriptions  of  a  very  simple  character.  We 
abide  strictly  by  the  adjuvants,  corrigents,  and  dirigents  of  Dr.  Paris, 
and  are  satisfied  with  the  results.  Let  us  ask  if  there  may  not  be 
a  little  delusion  in  the  matter?  Are  our  prescriptions  really  so 
simple  as  they  appear  ?  Have  we  any  right  to  laugh  in  such  a  self- 
satisfied  way  at  the  elaborate  combinations  of  our  forefathers  ? 

Here  is  a  prescription  :^ 


R  Tinct  cinchon.  co. 
Sp.  ammon.  arom. 
Aq.  Anethi 
ft.  haust. 


3j. 

58S. 

ad  §i68. 


Few  modem  prescriptions  are  simpler  than  the  foregoing;  it 
contains  but  three  pharmacopoeial  preparations,  is  reasonable  in  its 
design,  and  would  in  all  probability  prove  efficacious.  Does  the 
reader  know  how  many  simple  articles  contribute  to  form  this  very 
simple  prescription?  Does  he  know  further  the  actual  quantities 
of  the  separate  articles  entering  into  it  ?  If  he  do  not,  we  will  try 
to  enlighten  him — begging,  however,  beforehand,  that  we  may  be 
excused  from  solving  the  difficult  arithmetical  problem  of  the  quan- 
tities.   We  do  not  profess  such  a  mastership  of  the  subject. 

An  old  pharmaceutist — say  the  venerable  Huxham — would  have 
written  the  prescription  in  this  ridiculous  manner 

Be  Rad.  cinchon.  (Flav.) 
Cort.  aurant  . 
Rad.  serpentar. 
Croci  stigmat. 
Cocci    . 
Sp.  vin.  reot. 


Aq.  destill. 
Macera  &c.,  &c.,  et  cola  &c 


Ec  Amm.  hydrochlorat 

Potas.  carb.    . 

Cort.  cinnam. 

Caryophill.     . 

Cort.  limon.   . 

Sp.  vin.  rect. 

Aq.  destill.     . 
Misce  et  destill.,  &c.     Deinde. 

R  Sera.  Anethi  .....         q.s, 

Aq q.s 

M.  et  destill.  Denique  misce  omnia  pro  haustu. 


Deinde. 


q.s. 
q.s. 
q.s. 
q.s. 
q.s. 
q.s. 
q.s. 


q.s. 
q.s. 
q.s. 
q.s. 
q.s. 
q.s. 
q.s. 


The  Medical  Circular,  679 

The  last  part  of  the  prescription  might  have  been  varied  by 
ordering  the  oil  of  dill  and  a  little  powdered  flint. 

'This  is  the  anatomy  of  the  corpus  of  our  simple  prescription.  We 
see  that  it  is  just  as  elaborate  and  minute  as  the  most  pedantic  old 
pharmacologist  could  desire.  Here  are  combined  in  one  prescription, 
cinchona,  serpentary,  orange-peel,  lemon-peel,  saffron,  cochineal, 
cinnamon,  cloves,  dill-seed,  hydrochlorate  of  ammonia,  carbonate  of 
potass,  spirits  of  wine,  and  water.  It  would  be  very  easy  to  write 
a  prescription,  not  over  long,  that  should  contain  twice  as  many 
simple  ingredients  ;  in  fact,  the  wholesale  druggists  now  do  the 
work  which  was  formerly  done  by  the  apothecary  himself  in  his 
laboratory. 

We  have  ^ven  the  details  of  these  magistral  preparations,  not 
with  any  intention  of  dissuading  our  readers  from  employing  them, 
because  in  the  present  state  of  therapeutics  they  are  almost  indis- 
pensable; but  to  show  that  our  present  habits  of  prescribing,  as 
sanctioned  by  the  highest  authority,  originate  rather  in  a  reliance 
upon  the  experience  of  others  than  in  a  personal  observation  of  the 
action  of  individual  drugs.  We  have  been  nuilured  in  an  artificial 
system.  We  are  the  slaves  of  the  manufacturing  druggists,  and  our 
science  is  subordinated  to  a  trade.  Can  we  not  alter  this  practice 
and  adopt  a  greater  simplicity  in  prescribing?  After  Dr.  Parkes 
and  Dr.  Bennett  have  proved  to  us  that  pneumonia  may  be  success- 
fully treated  by  the  mildest  means,  have  we  not  a  solid  argument  for 
recommending  a  closer  attention  to  the  action  of  separate  drugs? 
Is  it  not  very  probable  that  three-fourths  of  the  ingredients  in  the 
prescription  we  have  just  given  are  either  superfluous  or  of  no  real 
use  ?  There  is  no  drug  in  more  constant  employment  than  ammonia; 
yet  to  this  hour  its  operation  in  the  animal  economy  is  only  vaguely 
apprehended.  It  is  thought  to  be  "  good  for  the  stomach,"  to  relieve 
spasms,  or  revive  from  syncope;  but  apart  from  its  properties  as 
a  *' nervine,"  what  is  generally  known  of  its  action?  How  does 
it  afiect  the  blood  ?  Is  it  a  cure  for  scarlet  fever,  and  for  certain 
cutaneous  diseases  as  stated  by  some  authors  ? 

It  is  unnecessary  to  dilate  upon  this  subject  It  has  frequently 
occupied  our  attention  in  these  columns,  and  the  general  tendency 
of  our  arguments  must  be  well  understood.  We  desire  to  know  the 
specific  qualities  of  drugs,  and  these  can  never  be  ascertained  with 
precision  whilst  one  drug  is  given  in  combination  with  a  dozen  others 
either  resembling  or  diflering  from  it  in  action.     For  this  reason  we 


680  Miscellaneous. 

hope  that  the  Committee  of  Therapeutics  appointed  by  the  British 
Medical  Aseociation  will  receive  the  assistance  of  our  readers,  so  that 
an  ample  body  of  evidence  may  be  collected  for  future  guidance. 
Afed.  CVrc,  leading  article.  Sept  3,  1862. 

[Decidedly  the  editor  is  in  a  hopeful  way,  and  we  would  earnestly 
recommend  him  to  pursue  the  subject  further,  and  to  read  Hahne- 
mann's Essay  entitled,  **  Are  the  obstacles  to  Certainty  and  Simplicity 
in  Practical  Medicine  insurmountable  ?  "  Lesser  Writings^  p.  359. — 
Ed.] 


Archlnshop  JfTiately  on  Medical  Trades*  Unions. 

The  Archbishop  of  Dublin  has  written  the  subjoined  reply  to  a 
letter  from  a  London  physician,  enquiring  whether  His  Grace  was 
aware  that  the  College  of  Surgeons  in  Dublin  had  passed  the  follow- 
ing *•  ordinances,"  viz. — "  That  no  Fellow  or  Licentiate  of  the  Royal 
College  shall  pretend  or  profess  to  cure  diseases  by  the  deception 
called  Homoeopathy,  or  the  practice  called  Mesmerism,  or  by  any 
other  form  of  quackery.'*  *•  It  is  also  hereby  ordained  that  no  Fellow 
or  Licentiate  of  the  College  shall  consult  with,  meet,  advise,  direct  or 
assist  any  person  engaged  in  such  deceptions  or  practices,  or  in  any 
system  or  practice  considered  derogatory  or  dishonourable  by  phy- 
sicians  or  surgeons." 

"^  Dublin,  13M  June,  1862. 

"Mt  deab  Sib, — I  was  well  aware  of  the  detestable  act  of 
tyranny  you  refer  to.  I  believe  some  persons  were  overawed  into 
taking  part  in  it  against  their  own  judgment.  I  have  always  pro- 
tested  against  such  conduct  in  all  departments  of  life.  You  may 
see  somethmg  to  the  purpose  in  my  little  penny  tract  on  *'  Trades' 
Unions"  (to  be  had  at  Parker's).  In  fact,  the  present  is  one  of  the 
Trades'  Unions.  A  man  has  a  right  to  refuse  to  work  except  for 
such  wages,  or  under  such  conditions,  as  he  himself  chooses  to  pre- 
scribe, but  he  has  no  right  to  compel  othera  to  concur  with  him.  If 
there  is  any  mode  of  medical  treatment  which  he  disapproves  of,  or 
any  system  of  education  which  he  thinks  objectionable,  he  will  be 
likely  to  keep  clear  of  it  of  his  own  accord,  without  any  need  of  com- 
pulsion or  pledges.  Those  again  who  may  think  differently  ought 
not  to  be  coerced  or  bullied.  Some  persons  seem  to  have  a  notion 
that  there  b  some  connection  between  persecution  and  religion,  but 
the  truth  is,  it  belongs  to  human  nature.     In  all  departments  of  life 


Siguatera  ;  or  Fish-Poison  Disease,'  681 

you  may  meet  with  narrow-minded  bigotry,  and  uncharitable  party 
spirit.  Long  before  the  outbreak  of  the  Reformation  the  Nominalists 
and  the  Realists  of  the  logical  School  persecuted  each  other  unmer- 
cifully, so  have  Royalists  and  Republicans  done  in  many  countries ; 
and  in  our  own  country  the  Trades'  Unions  persecute  any  one  who 
does  not  submit  to  their  regulations.  In  Ireland,  if  any  one  takes  a 
farm  in  contravention  of  the  rules  of  the  agrarian  conspirators,  he  is 
waylaid  and  murdered ;  and  if  he  embraces  the  Protestant  faith,  his 
neighbours  all  conspire  to  have  no  dealings  with  him.  The  truth  is, 
the  majority  of  mankind  have  no  real  love  of  liberty,  except  that  they 
are  glad  to  have  it  themselves,  and  to  keep  it  all  to  themselves ;  but 
they  have  neither  spirit  enough  to  stand  up  firmly  for  their  own 
rights,  nor  sufficient  sense  of  justice  to  respect  the  rights  of  others. 
They  will  submit  to  the  domineering  of  a  majority  of  their  own 
party,  and  will  join  with  them  in  domineering  over  others.  In  the 
midst  of  the  disgust  and  shame  which  one  must  feel  at  such  pro- 
ceedings as  you  have  alluded  to,  it  is  some  consolation  to  the  advo- 
cates of  the  systems  denounced  to  see  that  there  is  something  of  a 
testimony  borne  to  them  by  their  adversaries,  who  dare  not  trust  the 
cause  to  the  decision  of  reason  and  experience,  but  resort  to  such 
expedients  as  might  as  easily  be  employed  for  a  bad  cause  as  a 
good  one. 

(Signed)  «  R.  Dttblin." 


Siguatera,  or  Ftsh-Poison  Disease. 

In  our  last  impression  we  described  those  fishes  which,  in  warm 
climates,  produce  symptoms  of  poisoning  when  consumed  as  food. 
We  named  of  these  six  varieties,  viz.,  the  perches,  the  guniards,  the 
flounders,  the  spares,  the  gobies,  the  sardines,  and  the  globe  fishes, 
including  two  forms — the  Diodon  and  the  Tetrodon. 

Confining  our  attention  exclusively  to  these  poisonous  fishes,  we 
found  that  they  are  most  common  in  the  following  localities — at  all 
events,  that  they  have  been  discovered  in  these  localities  more 
frequently  than  elsewhere :  in  the  Caribbean  Sea,  ofi*  Brazil,  New 
Caledonis^,  the  Seychelles,  the  Chinese  Sea,  the  Malabar  coast,  and 
other  parts  of  India.* 

We  proceed,  on  the  present  occasion,  to  describe  the  way  in  which 
the  poisonous  efiects  of  these  fishes  are  developed,  so  that  those 


682  Miscellaneous. 

who  are  interested  on  the  subject  may  recognise  those  signs  which, 
in  a  tropical  climate,  when  fish  is  forming  an  article  of  diet,  would 
indicate  that  a  poison  derived  from  such  food  was  doing  its  dangerous, 
it  may  be  its  fatal,  work.  Such  information  may  serve  three  pur- 
poses. It  may  be  useful  to  some  merely  as  matter  of  general 
knowledge ;  to  others,  who  are  going  to  tropical  climates,  or  have 
friends  going  thither,  it  may  afford  some  practical  hints  and  suggest 
new  inquiries ;  while,  should  it  attract  the  attention  of  any  of  the 
authorities  of  the  Navy,  it  may  be  a  means  of  inducing  them  to  order 
a  scientific  inquiry  into  the  whole  subject. 

The  first  remark  which  has  to  be  made  on  the  present  question 
is  this  :  that  fishes,  like  reptiles,  found  in  temperate  regions,  are  not 
often  venomous.  Certainly  some  reptiles  and  some  fishes  in  tem- 
perate climates  have  the  power  of  producing  deleterious  effects,  but 
such. effects  are  rarely  fatal.  In  tropical  climates, on  the  other  hand, 
a  vast  number,  both  of  reptiles  and  fishes,  are  naturally  venomous ; 
and  further,  when  they  do  produce  poisonous  effects,  these  are 
exceedingly  dangerous  in  character. 

Secondly,  it  should  be  remarked,  that  in  poisonous  fishes  the 
digestive  organs,  the  spawn  and  the  liver,  are  invariably  most 
dangerous ;  and  that  there  are  many  fishes  that  may  be  eaten  with 
the  greatest  safety  when  those  parts  are  avoided.  Another  fact 
worthy  of  notice  is  the  age  of  the  fishes  :  some  are  dangerous  when 
they  have  arrived  at  maturity.  The  Lethrinus  mambo^  for  example, 
can  be  safely  eaten  when  very  young,  but  afterwards  is  exceedingly 
dangerous.  Some  naturalists  attribute  the  poisonous  qualities  to  the 
food  found  in  the  seas  frequented  by  certain  classes  of  these  fishes. 
This  is  true  under  some  circumstances,  as  in  the  case  of  the  Meletta 
venenosa,  which  at  certain  seasons  of  the  year  feeds  upon  a  green 
nomad  which  covers  the  sea  in  large  quantities.  Wherever  this 
green  nomad  is  seen  the  Meletta  is  poisonous,  but  wherever  it  has 
not  appeared  the  same  fishes  are  eaten  with  the  greatest  safety. 
MM.  Fonssagrives  and  Mericourt  agree  with  M.  de  Rochas  in  his 
opinion  respecting  the  spawn,  and  with  him  consider  it  as  the  most 
poisonous  part.  If  such  be  the  case  it  could  soon  be  determined  by 
ascertaining  whether  the  injurious  properties  of  the  fishes  are  per- 
manent, whether  in  the  same  species  adults  only  are  poisonous  in 
their  effects,  and  whether  there  is  poison  in  those  fishes  only  which 
contain  spawn.  To  decide  these  questions,  comparative  experi- 
ments might  be  made  with  the  male  and  female  fishes  of  the  same 


Siguatera ;.  or  Fish-Poison  Disease.  683 

species  inhabiting  the  same  streams  or  waters.  If  it  were  found 
that  the  latter  only  were  injurious  the  difficulty  would  be  satisfac- 
torily solved. 

The  Spanish  colonists  gave  the  name  of  Siguatera  to  that  union 
of  symptoms  which  results  from  the  eating  of  poisonous  fishes 
indigenous  to  hot  countries.  The  symptoms  which  arise  are  of  two 
kinds.  Severe  attacks  of  indigestion  or  gastro-enteritic  poisoning  ; 
or  an  icy  coldness  and  depression,  accompanied  with  great  nervous 
disturbance.  The  symptoms  are  the  same,  whether  severe  enough 
to  cause  death,  or  only  to  excite  inconvenience  or  temporary  derange, 
ment ;  they  differ  only  in  intensity.  Gastro-enteritic  Siguatera 
has  all  the  appearance  of  a  severe  attack  of  indigestion,  viz.,  nausea, 
vomiting — ^first  of  the  food,  then  of  mucus — coldness,  depression  of 
the  pulse,  cramp,  and  diarrhcea.  The  nervous  types  of  symptoms, 
-viz.,  convulsion  and  paralysis,  which  characterise  the  process  of 
poisoning  by  fishes,  are  not  to  be  found  in  any  case  of  metallic 
poisoning.  They  seem  to  arise  from  a  combination  of  accidents,  as 
if  they  had  been  produced  by  different  vegetable  poisons  of  narcotic 
and  acrid  character.  When  the  Siguatera  assumes  a  gastro-enteritie 
form,  the  sufferer  is,  in  general,  quickly  restored  to  health,  while  the 
nervous  symptoms  leave  behind  them  the  most  serious  traces  of 
debility  and  irregularity.  These  have  been  known  to  continue  for 
eight  or  nine  days. 

There  is,  usually,  no  difficulty  in  distinguishing  the  Siguatera  of 
hot  countries,  the  symptoms  being  well  defined.  The  only  difficulty 
that  could  arise  would  be  in  the  similitude  of  the  minor  symptoms 
of  the  gastro-enteritic  form  and  those  arising  from  poisoning  by 
copper  or  arsenic,  and  in  the  analogies  of  the  nervous  or  convulsive 
form  with  the  effects  of  vegetable  poisons. 

As  illustrating  the  way  in  which  the  members  of  crews  of  vessels 
are  poisoned  by  the  eating  of  poisonous  fishes  the  following  facts 
fron)  the  Linnaan  Transactions  for  November,  1860,  are  valuable. 
The  history  of  the  circumstances  was  communicated  by  Mr.  H. 
Jameson,  of  Her  Majesty's  ship  '*  Winchester,'*  to  Sir  William 
Burnett.  The  accident  occurred  on  board  the  Dutch  ship  *'  Postil- 
4ion,"  lying  in  Simon's  Bay,  Cape  of  Good  Hope.  The  "  Win- 
chester "  being  near,  Mr.  Jameson  was  called  to  render  his  services 
to  the  sufferers.  On  arrival  he  found  that  the  boatswain's  mate  and 
purser's  steward  had  been  suddenly  taken  ill  after  eating  a  part  of  a 
well-known  deleterious  fish,  common  in  Simon's  Bay,  and  called  the 


684  Miscellaneous. 

toad  or  bUdder-fish-^the  Diodon.  They  had  been  warned  that  the 
fish  was  poisonous,  but  were  resolved  to  try  the  experiment,  the 
boatswain  declaring  that  the  liver  was  not  poisonous,  but  a  great 
delicacy.  They  had  partaken  of  dinner  at  twelve  o'clock,  imme- 
diately  afterwards  they  partook  of  the  fish,  and  scarcely  ten  minutes 
had  elapsed  when  the  boatswain  became  so  ill  that  he  was  unable  to 
raise  himself  without  the  greatest  difficulty  ;  his  face  was  somewhat 
flushed ;  his  eyes  glistened,  the  pupils  were  rather  contracted ;  his 
mouth  was  open  ;  the  lips  were  tumid  and  somewhat  blue,  the  fore- 
head covered  with  perspiration,  the  pulse  weak,  quick,  and  inter- 
mittent The  patient  was  extremely  uneasy  and  in  great  distress, 
but  still  conscious ;  he  complained  of  pain  from  constriction  of  the 
throat,  and  appeared  inclined  to  vomit  It  was  with  difficulty  he 
could  swallow  a  powder  with  some  warm  water.  His  state  quickly 
assumed  a  paralytic  form ;  his  eyes  became  fixed  in  one  direction  ; 
his  breathing  was  difficult  and  accompanied  with  a  dilatation  of  the 
nostrils ;  his  face  was  pale  and  covered  with  cold  perspiration,  his 
lips  livid ;  his  consciousness  and  pulse  failed,  and  in  scarcely  seven- 
teen minutes  after  partaking  of  the  fish  he  was  dead.  The  symptoms 
exhibited  by  the  purser's  steward  were  of  a  similar  kind.  He  also 
died  within  twenty  minutes  of  the  time  after  he  had  partaken  of  the 
fish. 

The  quantity  consumed  between  the  two  men  "Was  only  the  liver 
of  one  fish ;  the  liver  might  have  weighed  about  four  drachms.  The 
entire  fish  measured  only  from  six  to  eight  inches  in  length. 

Other  examples  similar  to  the  above  have  been  recorded  by 
Prceger ;  in  all  death  was  rapid,  but  we  do  not  stop  to  chronicle 
these,  as  the  effects  were  the  same  as  in  the  instances  above  dted. 

It  is  worthy  of  note  that  some  of  the  poisonous  fishes  we  have 
named  are  as  hurtful  to  inferior  animals  as  they  are  to  man. 
Several  illustrations  of  this  fact  have  been  collected.  Dr.  CoUas, 
chief  of  the  marine  department  of  health  at  Pondicherry,  had  occa^ 
•sion  to  inquire  into  the  poisonous  nature  of  the  goby,  as  he  had 
been  informed  by  the  director  of  police  there,  that  several  accidents 
had  occurred  in  a  native  mussulman's  family  of  three  persons,  who  had 
partaken  of  a  dish  made  of  some  small  fishes  called  in  Talmic  Calou- 
oulouvi.  The  head  of  the  family  also  told  Dr.  CoUas  that  three 
fowls  had  died  soon  after  eating  some  of  the  same  dish.  A  native 
doctor  or  **  meatris "  repeated  this  experiment  of  feeding  fowls  on 
the  fish  and  with  the  same  result. 


Angina  Pectoris  caused  by  Smoking.  68d 

At  eight  o*clock  in  the  moraing  Dr.  Collas  gave  to  one  chicken 
three  heads,  and  to  another  four  heads  of  these  fishes ;  at  half-past 
nine  the  symptoms  hegan,  at  eleven  o'clock  they  increased,  between 
one  and  two  the  poisoned  animals  died,  with  convulsions,  in  a  state 
of  extreme  prostration.  In  a  second  experiment,  the  bodies  of  these 
same  fishes  were  used  from  which  the  heads  had  been  taken  off. 
The  animals  suffered  from  the  same  symptoms,  but  less  severely,  and 
were  quite  well  the  next  morning. 

The  livers  of  ten  gobies  were  administered  to  one  chicken  and 
killed  it  in  two  hours.  The  intestines  of  ten  of  these  fishes,  sepa- 
rated from  the  livers,  produced  the  same  results.  The  entire  fishes, 
deprived  of  their  livers  and  intestines,  caused  death  in  four  hours  and 
a  half,  in  other  experiments. 

Three  experiments  made  upon  dogs,  to  which  these  fishes  were 
given  after  being  fried,  caused  them  to  be  seriously  ill,  and  deranged 
their  digestion  ;  they  very  soon  recovered. 

We  have  now  adduced  sufficient  evidence  to  indicate  the  import* 
ance  of  further  inquiry  on  the  subject  of  poisonous  fishes.  Much 
remains  as  yet  to  be  discovered.  First,  we  require  to  have  a  more 
correct  classification  of  poisonous  fishes :  secondly,  we  want  more 
information  as  to  the  times  when  they  are  poisonous :  thirdly,  as  to 
the  nature  of  the  poison  :  and  fourthly,  as  to  the  treatment  when  the 
poison  has  taken  effect  The  discovery  of  these  facts  depends 
greatly  for  its  success  upon  the  medical  officers  employed  in  the 
various  naval  stations,  and  who  have  such  ample  means  of  observation. 
The  study  has  not  yet  become  one  of  the  necessary  attributes  of  a 
naval  medical  officer's  education,  and  until  it  has,  the  only  way  of 
supplying  the  deficiency  is  to  preserve  all  those  fishes  supposed  to  be 
poisonous,  as  they  are  to  be  found  in  any  sea  or  fishing-ground  in 
which  they  may  be  detained,  either  in  spirit  or  glycerine.  At  the 
same  time  it  is  necessary  carefully  to  note,  in  the  fresh  state,  all 
those  peculiarities  which  the  preserving  liquid  might  possibly  destroy. 
Photography  might  be  made  to  lend  its  aid,  so  that  the  forms  of 
these  poisonous  fishes  could  be  made  familiar  to  every  eye. — Social 
Science  Beview,  July  19,  1862. 


Angina  Pectoris  caused  hy  Smoking, 

We  recorded  in  the  first  paper  of  our  present  number  our  im- 
pressions on  the  subject  of  Mr.  Beau's  paper  relative  to  the  influence 


686  Miscellaneous. 

of  tobacco-smoke  on  the  production  of  ai^ina  pectoris.     The  follow- 
ing are  the  facts  on  which  the  author  grounds  his  opinion  : — 

1.  A  gentleman,  aged  about  sixty,  in  the  habit  of  smoking  to 
excess,  frequently  suffered  at  night,  for  a  month,  from  palpitation  of 
the  heart,  oppression,  and  pain  in  the  shoulders.  He  discontinued 
smoking,  and  the  attacks  entirely  ceased,  the  digestive  functions  be- 
coming at  the  same  time  more  regular.  After  three  months  he 
resumed  his  old  habits,  and  again  experienced  the  same  symptoms. 
At  last  he  completely  eschewed  tobacco,  and  no  further  return  of  the 
attacks  has  since  taken  place. 

2.  A  physician,  aged  fifty,  who,  although  presenting  the  outward 
signs  of  health,  was  troubled  with  dyspepsia,  and  constant  debility, 
indulged  in  the  use  of  cigarettes  whenever  the  opportunity  offered. 
For  some  time  he  complained  of  palpitations,  accompanied  by  op- 
pression and  a  sense  of  tightness  about  the  chest,  recurring  in 
paroxysms  at  various  hours  of  the  day  or  night.  He  gave  up  smok- 
ing, and  the  attacks  ceased.  One  day  he  found  himself  in  the  same 
room  with  several  smokers,  and,  although  he  did  not  yield  to  temp. 
tation,  he  inhaled  the  fumes  of  tobacco,  and  on  the  following  night 
the  former  symptoms  returned. 

3.  A  physician,  aged  thirty-five,  who  practises  in  the  country, 
incessantly  smoked  cigarettes  in  the  intervals  of  his  profesdontl 
visits.  For  a  long  time  his  appetite  had  declined,  and  he  conse- 
quently  took  very  little  food.  One  morning,  while  fasting,  and 
smoking  a  cigarette  on  his  way  to  one  of  his  patients,  he  was  sud- 
denly ceased  with  precordial  anxiety  and  tightness  across  the  upper 
part  of  the  chest  He  was  unable  to  speak  or  walk ;  his  pulse  be- 
came imperceptible,  and  his  hands  cold.^  These  symptoms  lasted  half. 
an-hour.  He  came  to  Paris,  and,  by  Mr.  Beau's  advice,  relinquished 
the  habit  of  smoking,  promising  to  write  if  a  paroxysm  of  the  same 
nature  as  the  first  again  reappeared.  Mr.  Beau  has  not  heard  from 
him  since. 

4.  A  young  Spaniard,  aged  thirty,  in  the  constant  habit  of 
smoking  cigarettes,  suffered  much  from  dyspepsia  and  impaired 
digestion.  One  evening,  while  indulging  in  his  customary  relaxa- 
tion, he  suddenly  experienced  violent  constriction  of  the  chest,  and 
for  ten  minutes  his  pulse  was  imperceptible.  Alarmed  at  this  oc 
currence,  he  greatly  diminished  his  daily  consumption  of  tobacco,  and 
the  symptoms  of  angina  have  not  since  returned. 

5.  A  physician,  who  has  been  compelled  to  discontinue  the  pnu> 


Petroleum.  687 

tice  of  smoking  on  account  of  disturbance  of  the  gastric  functions, 
also  experienced,  when  he  was  in  the  habit  of  using  tobacco,  noc- 
turnal attacks  of  tightness  of  the  throat,  with  palpitation  and  neu- 
ralgic pains  in  the  neck.  He  now  enjoys  perfect  freedom  from  these 
symptoms. 

6.  A  merchant,  who  for  fifteen  or  twenty  years  had  sufiered  from 
dyspepsia  consequent  on  immoderate  smoking  of  cigaretteSy  suffers, 
chiefly  at  night,  from  paroxysms  of  precordial  oppression,  with  pal- 
pitation and  pain  between  the  shoulders.  The  features  are  drawn, 
and  the  pulse  small  and  irregular.  This  gentleman  now  smokes 
more  than  ever. 

7.  A  healthy  and  vigorous  old  man,  aged  seventy-five,  seeks  con- 
solation in  smoking  from  mental  distress.  On  a  Saturday  an  attack 
of  angina  supervenes,  of  half-an-hour's  duration  ;  a  second  fit  recurs 
next  day,  and  he  is  found  dead  in  his  bed  on  the  Monday  morning. 

8.  A  foreign  diplomatic  agent,  an  inveterate  smoker,  who,  despite 
appearances,  was  of  weak  constitution,  was  seized  one  evening,  on 
his  return  home,  with  angina  pectoris,  characterised  by  dyspncea, 
smallness  of  the  pulse,  coldness  of  the  extremities,  and  lividity 
of  the  integuments.  He  went  to  sleep  at  eleven  o'clock,  awoke  next 
morning  at  his  customary  hour,  and  transacted  business  as  usual. 
At  five  o'clock,  while  smoking  a  cigar  in  his  arm-chair,  he  suddenly 
expired.  A  fatty  condition  of  the  heart  was  the  only  alteration  de- 
tected at  the  post-mortem  examination. — Med,  Circ,  Aug.  27,  1862. 


Petroleum. 

Our  contemporary,  the  Monthly  HomoBopafhtc  Review^  may  be 
right  in  its  assertion  that  the  Barbados  tar  is  the  best  petroleum^  but 
the  petroleum  of  Hahnemann  was  assuredly  not  Barbados  tar,  and 
therefore  we  hold  that  it  is  a  mistake  to  attempt  to  substitute  the  one 
for  the  other.  The  petroleum  of  Hahnemann  is  the  mineral  oil,  a  very 
volatile,  yellowish,  limpid  fluid,  a  drop  of  which  on  a  piece  of  white 
paper  rapidly  evaporates,  leaving  no  residue.  The  Barbados  or 
mineral  tar,  on  the  other  hand,  is  a  thick,  viscid  substance,  of  a  dark 
colour,  containing  a  large  portion  of  bitumen,  and  is  improperly 
termed  petroleum,  without  the  qualifying  adjective  nigrum.  Our 
contemporary  is  in  error  in  stating  that  Hahnemann  was  unac- 
quunted  with  the  mineral  or  Barbados  tar,  for  in  his  Apotheker 


.  1 


688  Jfisceliafieoui. 

Lexicon^  Hahnemann  giTea  a  full  account  of  all  the  different  mineral 
oils  and  tan,  mentioning  the  localities  where  the  different  sorts  are 
obtained,  and  detailing  the  processes  for  ascertaining  their  parity. 


International  ExMtntion, 

We  are  pleased  to  observe  that  a  prize  medal  has  been  awarded 
to  our  energetic  and  zealous  colleague.  Dr.  Roth,  ''  for  models  and 
efforts  in  behalf  of  physical  education."  We  congratulate  Dr.  Rodi 
on  this  gratifying  public  recognition  of  his  services  to  the  cause  of 
physical  education,  and  we  are  sure  that  the  honour  awarded  him 
will  be  but  an  incentive  to  him  to  pursue  still  further  the  subject  to 
which  he  is  so  earnestly  devoted,  and  for  which  he  has  already 
effected  so  much. 


Lovers  Labour  Lost. 

In  some  recent  numbers  of  the  Monthly  Honusopathic  Review^ 
Mr.  Wilson  has  been  directing  attention  to  the  imperfections  of 
I  Hempel's  translation  of  Hahnemann's  Chronic  Diseases,     It  appears 

y  that  Hetnpel  has  omitted  a  good  many  of  the  symptoms  that  occur 

in  Hahnemann,  which  was  very  wrong  of  him,  for  as  a  faithful 
translator  he  was  bound  to  give  a  literal  rendering  of  the  original. 
Mr.  Wilson  therefore  deserves  the  thanks  of  HempeFs  readers  for 
pointing  out  the  untrustworthiness  of  the  translation.  Mr.  Wilson 
takes  Sarsaparilla  as  a  specimen  of  HempeFs  faulty  rendering,  231 
of  the  original  symptoms  having  been  omitted  by  Hempel.  These 
omitted  symptoms  !Mr.  Wilson  supplies,  and  suggests  that  those 
who  have  Hempel's  translation  should  restore  them  to  their  proper 
place  in  the  work,  so  that  they  may  be  able  to  study  the  entire 
sphere  of  action  of  sarsaparilla.  To  this  proposal  we  altogether 
demur.  On  examining  these  231  omitted  symptoms  of  sars^a- 
rilla,  we  find  that  no  less  than  205  of  them  are  symptoms  con- 
tributed by  the  anonymous  prover,  indicated  by  the  letters  *'  Ng." 
Now  those  who  have  devoted  most  attention  to  a  critical  ezamina^ 
tion  of  Hahnemann's  Materia  Medico^  assure  us  that  the  symptoms 
furnished  by  *'Ng."  are  altogether  untrustworthy.  That  this 
verdict  is  true  our  own  less  profound  examination  and  comparison 
have  satisfied  us,  and  we  are  the  more  disposed  to  this  unfavourable 


Loves  Labour  Lost.  689 

c^inion  from  Che  stigbting  manner  in  which  HTahnemann  himsdf 
speaks  of  *'  Ng./'  while  making  use  of  his  provings.  Thus  in  a 
note  to  Alumina  {Chr,  Kr.  II.  35)  Hahnemann  says:  **Dr8. 
Hartkub  and  Txinks  indicate  by  these  two  letters  only  (which  is 
'  actually  leaving  anonymous)  a  man  who  furnished  the  greater  number 
of  the  symptoms  of  medicinal  provings  for  their  AnnciU^  which  are 
often  recorded  in  very  careless,  prolix  and  ambiguous  expressions, 
I  was  only  able  to  extract  what  seemed  useful  from  them,  and  that 
only  on  the  understanding  that  he  conducted  his  observations  like  an 
honest  discreet  qian/'  &c.,  &c.  Again  in  a  note  to  Magnesia  car» 
hontca  {Chr.  Kr,  lY,  134)  Hahnemann  .gives  another  hit  at  this 
prover.  **  The  symptoms,"  he  says,  "  to  which  the  letters  '  Htb.  and 
Tr.'  are  attached  are  from  the  Pure  Materia  Medica  of  Drs.  Hartlaub 
and  Trinks ;  the  name  of  the  original  prover  is  not  given ;  but  they 
bear  the  stamp  of  having  their  origin  in  the  ever-ready  symptom- 
manufiictory  of  *  Ng.'  "  From  these  expressions  it  b  evident  Hah- 
nemann had  but  a  poor  opinion  of  this  most  fertile  prover.  A  glance 
at  the  provings  of  the  Chronic  Diseases  will  show  us  how  largely 
they  are  indebted  to  this  industrious  unknown,  for  we  find  that  out 
of  the  forty-seven  medicines  contained  in  that  work,  no  less  than 
twenty  were  proved  by  this  anonymous  hero.  Surely  such  a  martyr 
to  science,  who,  if  we  are  to  believe  him,  must  have  suffered  the 
tonnentB  of  the  damned  in  proving  these  twenty  medicines-^for  in 
ahnost  every  case  he  is  the  lai^gest  contributor  of  symptoms  to 
the  medicines  he  professed  to  prove — surely  his  name  should  have 
been  revealed  in  order  that  the  homoeopathic  world  might  have  done 
•him  honour.  Can  it  be  that  he  has  declined  to  reveal  himself 
because  he  was  conscious  of  being  what  our  transatlantic  friends 
^would  call  a  '* bogus"  prover?  However  this  may  be,  we  cannot 
-help  feeling  very  distrustful  about  his  recorded  symptoms,  and  we 
xmly  wish  that  they  were  every  one  eliminated  from  our  Materia 
.Medica,  for  we  are  convinced  that  they  do  not  add  to  its  utility,  and 
we  are  very  imich  inclined  to  think  that  the  assumed  initiak  *'Ng  " 
should  be  read  *'  No  go."  Hempel  has  in  a  rough  and  imperfect 
manner  attempted  to  winnow -some  of  this  chaff  out  of  our  Materia 
Medica;  we  are  only  sorry  he  has  not  performed  his  task  more 
.thoroughly.  We  cannot  therefore  see  the  use  of  restoring  all  this 
rubbish.  We  think  it  would  be  more  worth  Mr.  Wilson's  time  and 
trouble  if  he  were  to  institute  a  critical  examination  of  the  medicines 

VOL  XX.,  NO.  LXXXII. — OCTOBER,  1862.  2  X 


690  Miscellaneous. 

in  the  Chr<mie  Dissasss^  as  Dn.  Roth  aad  Frank  liaTe  done  witb 
some  of  them,  and  perhaps  he  might  find  that  **^  Ng."  is  not  the  only 
prober  whose  symptoms  might  with  advantage  he  omitted,  but*that 
Langhammer,  who  rivals  "  Ng.*'  in  the  number  of  provings  he  pro- 
fessed to  make,  is  not  a  bit  more  to  be  depended  on.  While  Mr. 
Wilson  is  about  his  task  of  correcting  Hempel*s  translation,  we 
would  advise  him  that  dbersehenkd  and  unierscksnkd  mean  thigh  and 
Ug^  and  not  tfpp^r  thigh  and  lower  thigh  as  he  translates  them. 


The  Missing  Link. 

The  announcement  made  to  the  geologists  of  Germany,  about 
three  months  ago,  by  Hermann  Yon  Meyer,  that  he  had  obtained 
fiom  the  lithographic  slate  of  Solenhofen,  in  Bavaria,  a  fossil  im- 
pression of  a  feather  on  the  upper  and  under  surfaces  of  a  split 
slab,  and  that  this  feather  was  undistinguishable  in  its  appearance 
from  that  of  existing  birds,  attracted  but  little  attention  beyond 
palaontological  circles.  We  had  already  evidences  of  birds  fit>m 
the  greensand ;  and  the  discovery  of  birds  in  the  Solenhofen  oolite 
would  merely  lead  us  to  connect  the  osseous  remains  still  more 
closely  with  the  evidences  of  avian  footprints  discovered  by 
Hitchcock  in  the  Triassic  sandstones.  Von  Meyer's  feather,  which 
he  termed  Archceopteryx^  is,  however,  completely  eclipsed  in  interest 
by  the  intelligence  made  public  by  the  Rev.  A.  Wagner,  of  Munich, 
that  in  the  collection  of  M.  Haberlein,  of  Pappenheim,  exists  the 
skeleton  of  an  animal  undoubtedly  of  reptilian  organisation,  as  in- 
dicated by  the  vertebral  column  and  the  form  of  the  pelvis,  and 
offering  most  analogy  to  the  genus  Ramj^^orhynckus  or  long-tailed 
Pterodactglus,  It  approaches  the  class  birds  by  its  tiifid  meta- 
tarsals, and  by  having  developed,  from  a  fiat  bone  near  the  ulna  and 
radius^  and  supposed  to  be  a  carpal,  a  radiate  fan  of  feathers, 
similar  to  those  of  birds.  At  the  apical  extremity  of  the  tail  is 
another  radiant  fan,  also  of  feathers.  The  rest  of  the  animal  appears 
to  have  been  destitute  of  plumage.  Unfortunately  the  head  is 
wanting.  This  anomalous  form  is  referred  by  Wagner  to  the  order 
Pterosawria^  and  has  been  generically  distingubhed  by  the  term 
OriphosauruSf  from  ypc^,  an  enigma. 


Obituary,  691 


Human  Bemaina  ofBemote  ArUiquiiy, 

At  the  meeting  of  the  Ethnological  Society,  held  on  the  let  inst., 
Mr.  Mackie  described  the  human  remains  found  at  Markham,  in  the 
Valley  of  the  Trent.  The  skull  possesses  very  peculiar  character, 
istics,  and  belongs  to  an  extinct  and  pre-historic  race  of  mep.  Its 
most  remarkable  feature  is  the  unusual  direction  of  the  foramen 
magnum.  The  direction  of  this  plane,  indicating  an  approach, 
though  in  a  very  moderate  degree,  to  the  head  of  the  gorilla  and  the 
chimpanzee,  leads  to  the  inference  that  the  individual  to  whom  it 
belonged  was  possibly  not  completely  erect  in  his  carriage.  The 
other  human  bones  discovered,  including  those  found  at  the  Heathery 
Bum  Cave,  belonging  to  the  same  pre-historic  race  of  men. 


OBITUARY. 


Amebic  A,  France,  England  and  Germany  have  each  to  deplore  the 
recent  loss  of  a  distinguished  follower  of  Hahnemann..  Joslin, 
Tessier,  Homer  and  Haubold  have  been  removed  from  their 
several  spheres  of  usefulness.  All  four  have  exercised,  in  different 
ways,  no  small  amount  of  influence  on  the  destinies  and  progress  of 
Homceopathy. 

JosLiir. 

Dr.  Benjamin  F.  Joslin  was  bom  in  the  year  that  homoeopathy 
was  first  promulgated,  1796.  His  tastes  early  inclined  him  to 
scientific  pursuits,  and  before  he  became  a  homosopathist  be  occu- 
pied a  prominent  position  in  the  medical  world  of  New  York,  where 
he  filled  the  chair  of  Mathematics  and  Natural  Philosophy  in  the 
Uniyersity  from  1838  to  1844.  At  first  deeply  prejudiced  against 
homoeopathy,  be  yet  thought  it  right  to  investigate  the  system  before 
pronouncing  against  it.  His  investigations,  carried  on  with  the 
honesty  and  love  of  truth  that  was  natural  to  him,  resulted  in  his 
conversion  to  the  doctrines  of  Hahnemann.  From  1842  his  practice 
became  homoeopathic,  and  all  conversant  with  homoeopathic  litera- 
ture know  how  much  it  is  indebted  to  his  labours.  Nor  was  he  a 
mere  writer.     He  enriched  the  Materia  Medica  by  some  piovings 

2x2 


092  Obituary. 

which  are  highly  valuahle.  We  refer  to  those  of  rhu8  reulieam  and 
rwnsm  eri$pu9.  After  a  long  life  of  HBefulneee  he  died,  after  a  week's 
illness,  on  the  81st  of  December,  1861.  The  caase  of  his  death  was 
rupture  of  the  aorta  which  was  extensively  ossified. 

Tessiejl 

The  influence  that  Jean-Paul  Tessier  exercised  oyer  homoeopathy 
in  France  is  scarcely  calculable  as  yet.     He  was  one  of  the  most 
distinguished  Frenchmen  who  have  adopted  the  practice  of  Hahne- 
mann.    One  of  that  ^lite  class  from  whom  hospital  physicians  and 
surgeons  are  selected  by  concours,  he  had  already  attained  the  post 
of  physician  to  the  Hopital  Ste.  Marguerite,  a  kind  of  offshoot  or 
chapel-of-ease  to  the  Hotel-Dieu,  when  his  investigations  led  him  to 
adopt  the  homoeopathic  practice.     In  the  course  of  time  he  was 
transferred,  not  without  violent  opposition  from  his  allopathic  col- 
leagues to  the  Beaujon,  and  latterly  to  the   Enfants  Malades.     A 
vacancy  occuning  at  the  Hotel  Dieu,  he  ought  to  have  succeeded  to 
the  post,  but  a  miserable  and  underhand  intrigue  taking  advantage 
of  his  absence  frx>m  Paris  at  the  sick-bed  of  his  father,  succeeded  in 
superseding  him  and  placing  a  junior  over  his  head,  in  the  post  that 
was  his  right  and  his  ambition.     There  is  little  doubt  that  the 
annoyance  caused  by  this  injustice  acted  unfavourably  on  his  health, 
which  was  at  the  time  not  very  good,  and  though  he  bore  up  against 
it  with  manly  courage,  and  continued  to  practise  almost  to  the  last 
day  of  his  life,  still  he  did  not  long  survive  the  disappointment.     He 
died,  surrounded  by  his  friends  and  pupils,  on  the  1 6th  of  May  last, 
in  the  52nd  year  of  his  age.     Tessiet*s  principal  writings  are  well 
known.     His  work  on  Pneumonia  and  Cholera  is  in  the  hands  of 
most  homoBopathists,  and  is  a  very  remarkable  production,  distin- 
guished by  patient  observation  and  logical  reasoning.     He  was  the 
founder  and  chief  contributor  to  the  Art  Af^dSuM/,  a  journal  second  to 
none  in  the  medical  world  for  learning,  wit  and  sound  practical  re- 
marks.    An  ardent  Catholic,  Tessier's  aim  was  to  oppose  what  he 
termed  the  materialism  of  the  dominant  Parisian  school,  and  in  the 
words  of  one  of  his  disciples,  **He  laboured  to  reconcile  medi- 
cine with  the  teachings  of  the  Christian  religion,*'  (meaning  of  course 
the  Catholic  Church).     A  short  extract  from  one  of  his  papers  will 
give  some  notion  of  the  task  he  proposed  to  himself  and  the  principles 
he  professed :    "  As  Catholics,  we  cannot  and  will  not  accept  any 
philosophy  that  is  not  in  conformity  with  our  faith.     It  would  be  too 


Dr.  Tessier,  698 

inconsequential  to  have  on  the  subject  of  capital  questions  like 
those  concerning  the  nature  of  man  and  the  origin  of  diseases, 
two   contradictory  solutions,   one   in  our  character   of  Christians, 

the  other  in  our  character  of  physicians In  metaphysical 

philosophy,  the  rationalists  have  as  their  avowed  chiefs  Bacon  and 
Descartes ;  we  have  no  other  law  than  that  of  the  truth  as  defined 
and  sanctioned  by  the  Church:  her  science  is  our  science,  her  phi- 
losophy is  our  philosophy.  Consequently  it  is  from  her  doctrines 
that  we  draw  our  principles ;  but  it  is  not  sufficient  to  content  our- 
selves with  such  a  general  idea ;  in  Christian  philosophy  we  must 

choose  a  master The  choice  is  determined  for  us  by  the 

Catholic  savants,  who  almost  unanimously  regard  St.  Thomas  as  the 

master  of  science St.  Thomas  the   disciple  of  Albertus 

Magnus,  was  his  rival  in  natural  science,  and  surpassed  him  in 
metaphysioal  and  theological  science." 

We  are  unable  to  say  if  Tessier  and  his  followers  have  succeeded 
in  their  endeavour  to  catholicise  medicine,  nor  can  we  tell  how  far 
the  discoveries  of  Hahnemann  are  conformable  to  the  teachings  of 
the  angelic  doctor.  But  our  opinion — if  that  is  of  any  value — has 
always  been  that  the  more  religion  and  science  are  kept  asunder, 
each  on  its  own  line  of  rails,  the  less  chance  will  there  be  of  a  dis- 
astrous collision  of  the  two.  The  prejudices  of  theological  zeal 
brought  to  bear  upon  scientific  facts  and  theories,  have  a  decided 
tendency  to  distort  these  facts  and  theories.  Science  has  hitherto 
flourished  best  when  working  out  its  development  independently. 
Its  progress  has  always  been  greatest  when  untrammelled  by  tradi- 
tion and  authority,  and  we  fear  that  its  growth  would  only  be 
stunted  by  the  attempt  to  bring  it  into  subjection  to  a  theological 
system  based  on  tradition  and  upheld  by  authority.  Opposed  as  we 
are  to  the  attempt  of  Tessier  to  subject  medicine  to  the  teachings  of 
the  Catholic  Church,  we  still  cannot  help  regarding  Tessier*s  pre- 
mature decease  as  a  great  loss  to  our  cause,  for  independently  of  his 
theological  views  Tessier  laboured  earnestly  and  successfully  to 
advance  our  system  of  therapeutics  on  the  practical  as  well  as  on  the 
theoretical  side,  and  his  position  as  physician  to  a  Parisian  hospital 
gave  homoeopathy  a  status  in  Paris  it  would  not  otherwise  have 
enjoyed. 

HORKEB. 

Without  being  a  man  of  genius,  Dr.  Homer,  by  his  conversion  to 
homoeopathy,  created  a  greater  sensation  amongst  the  public  than 


694  Books  Received. 


mlmott  anj  other  medical  man  in  Engluid  has  done  by  hia  adoption  of 
Hahnemann's  doctrines.  In  Hull,  ^e  town  where  he  practised,  he 
long  occupied  a  conspicuous  position,  both  as  a  medical  and  a  public 
man,  having  been  at  one  time  a  member  of  the  Town  CounciL 
He  was  President  of  the  British  Medical  Association  the  year  before 
that  illustrious  body  distinguished  itself  by  passing  its  anti-homceo- 
pathic  resolutions  at  Brighton.  When,  therefore,  he  avowed  his 
conversion  to  the  homoeopathic  faith,  he  excited  a  great  deal  of 
attention  among  the  general  public,  and  the  pamphlet  he  wrote 
detailing  his  Eeasans/or  Adopting  the  Rationed  System  of  Medicine 
went  rapidly  through  a  large  number  of  editions ;  and  as  it  was  well 
written  and  contained  a  number  of  very  striking  cases,  it  served  to 
arouse  a  great  spirit  of  enquiry  among  the  patient  part  of  the  com- 
munity, and  caused  many  converts.  His  death  took  place  at  Hull 
on  the  6th  of  June  last     His  age  was  fifty-nine. 

Hactbold. 

Dr.  Carl  Haubold  was  like  Dr.  Joslin  bom  in  1 796.  He  was  one 
of  Hahnemann's  earliest  and  most  zealous  disciples,  and  possessed 
more  influence  over  the  master  than  almost  any  of  his  followers.  In 
Leipzic  he  enjoyed  a  large  practice,  and  he  is  said  to  have  been  a 
most  successful  practitioner.  Though  he  wrote  little,  he  was  held 
in  high  esteem  by  all  his  colleagues  in  Leipzic.  Though  a  thorough 
master  of  the  Materia  Medica,  and  a  most  skilful  physician  in  every 
respect,  he  was  never  dogmatical  nor  overbearing  towards  hb  junior 
brethren,  and  he  always  gave  his  opinion  with  a  modesty  and  de- 
ference for  the  opinion  of  others,  that  won  for  him  the  affection  of 
all,  and  made  him  a  great  favourite  at  consultations.  He  died  at 
Ems,  whither  he  had  gone  to  try  the  effect  of  the  waters  on  a 
disease  of  the  throat,  on  the  8th  of  June  last. 


BOOKS    RECEIVED. 

•  VArt  Midical 

BuUetin  de  la  SocUtS  MSdicale  Homceopathique  de  France. 

The  Monthly  Homoeopathic  Review. 

The  Homoeopathic  Observer, 

The  North  American  Journal  of  Hommopathy, 

El  Criteria  Medico. 

Addreu  on  the  Life  and  Character  of  the  late  Benjamin  F.  JoeBny 
M.D.    By  B.  F.  Bowbrs.    New  York:  Smith,  1862. 

The  Medical  Record  of  Australia.    Vol.  11.,  No.  7. 

Notes  on  Spa.    By  Thos.  Cutlbr,  M.D.     Brussels,  1862. 

Transactions  of  the  Illinois  Homaopathic  Medical  Association.    New 
York,  1802. 


INDEX  TO  VOL.  XX. 


Aeonkej  Mr.  Natikivell  on,  62,  853; 
— ^  in  diseases  of  the  scalp,  62 ;  — , 
in  diseases  of  the  eye,  63;  — ,  in 
lippitado,  66 ;  •--,  in  Janndice  of  con- 
Jonctiya,  68;   — i  in  tetanus,  136; 
— ,  poisoning  by,  140 ;  — ,  antidoted 
by  nux  vamieat  349 ;  — ,  in  diseases 
of  ear,  868 ;  — ^  in  diseases  of  nose, 
856 ;  — ,  in  diseases  of  face,  859 ;  — , 
in  diseases  of  teeth,  864;    — ,  in 
diseases  of  mouth,  866 ;  — ,  Dr.  Bonth 
on,  610 
Albert,  Prince,  his  treatment,  174 
Albuminuria,  arsenic  in,  844,  641 
Alcohol  as  a  food,  541 
Allopathy,  six  months  of  British,  635 
Almost   persuaded   to   be  a  homoBO- 

pathist,  510 
Alternation  of  medicines,  Mr.  (Jelston 

on,  392 
Annmia,  dietetic  treatment  of,  637 
Aneurism,  popliteal,  cured  by  flexion, 

816 
Angina  pectoris  caused  by  smoking,  685 
AnUine  in  chorea,  638 
Animation,  suspended,  report  on,  662 
Aphih»,  Mfraie  ofpoia$s  in,  640 
ArsemCj  drinking,  189;  — ,  poisoning 
'  by,  189 ;  — ,  inhalation  of,  in  bron- 
chitis, 174 ;  — ,  in  albuminuria,  844, 
641 ;  — ,  in  epilepsy,  689 ;  — ,  symp- 
toms of  poisoning  by,  207 
Arsenical  paper-hangings,  Dr.  Dudgeon 

on  the  effects  of,  200 
Asanm  for  drunkards,  188 
Asthma,  flatulent,  Dr.  Hirschel  on,  502 
Atkin,  Dr.,  death  of,  175 
Atropin,  physiological  action  of,  846 
Austrian  Homoeopathic  Journal,  490 


Barbados,  exemption  fVom  ferer  of,  681 ; 

— ,  tar,  687 
Bayes,  Dr.,  on  hydrasHt  in  cancer,  1 ; 

— ,  on  medical  terrorism,  420 
Belladonna,  Dr.  Hughes  on  poisoning 

by,  70 ;  — ,  cases  of  pdsoning  by,  71, 

77,  79,  81,  84,  85,  86;  — ,  and  optum, 

Dr.  Hughes  on  rationale  of  action  of, 

1 32 ;  ^,  in  bronchial  neuralgia,  137 ; 

— ,  summary  of  physiological  action 

of,  194 ;  — ,  as  a  uterine  remedy.  Dr. 

Liedbeck  on,  488 
Bigots,  rebuke  to  the,  843 
Bladder,  the  inclined  plane  in  pain  of 

the,  641 
Bloodshed  advocated  by  an  American 

physician,  134 
Bodington   on   the   neutralisation  of 

opium  by  alcohol,  1 3 1 
Bradshaw,  Mr.,  on  hydratHs  in  cancer,  2 
Braithwaite's  Retrospect,  635 
British  allopathy,  six  months  ci,  635 
Brodie,  Sir  B.,  answers  to,  87 
Bronchitis,  inhalation  of  cnrsenic  in,  174 
Budd,  Dr.,  on  typhoid,  685 
Bushnan,  Dr.,  on  the  narrow  limits  of 

rational  medicine,  126 


Cancer,  Dr.  Bayes  on  hydraetis  in,  1 ; 
— ,  of  breast,  cases  of,  4, 5, 6,  7,  8,  9 ; 
— ,  of  neck,  6;  — ,  of  foot,  7;  — , 
of  womb,  9;  — ,  of  thigh,  11;  — , 
tabular  view  of  cases  of,  treated  by 
hydrasiia,  12 ;  — ,  arsenic  in,  637 

Capillary  vessels,  their  behaviour  in 
the  process  of  cure,  Hoppe  on,  869 

Cardiac  dropsy,  daterium  in,  639 

Cellulitis,  pelvic,  Dr.  McLimont  on,  288 


606 


INDEX. 


Cerimm^  cooalaU  cf^  in  noknefs  of  preg- 
lumcy,  642 

duunben,  Dr.,  on  the  excret*  of  makes 
in  phthiBis,  509;  — ,  on  continaed 
fever,  636;  — ,  on  anamU,  637 

CktUdommm  in  neuralgia.  Dr.  Finnat 
on,  47;  — ,  Rademacher  on,  163 

ChioraJte  of  potaa  in  aphtlue  and  diph- 
theria, 640 

CUorofbrmt  Dr.  flimpaon's  new  mode  of 
administering,  642 

Choiea,  gymnaatios  in»  136;  — ,  amUm 
in,  638 

QMwer  ail,  Dr.  Williams  on,  505 

Compressed  air  bath»  517 

Comte's  Positiye  Philosophy,  583 

Consultations  with  allopaths,  Dr.  Bajes 
on,  421 ;  — ,  British  Medical  Jooraal 
on,  422,  427 

CoDtagionaness  of  phthisis,  Dr.  Roger- 
son  on,  338 

Continued  ferer,  mtariaUe  add  in,  637  • 
~,  oomplications  of,  637 

Cow-pox  «nd  grease  identical,  135 

Croton  otZ,  exanthematogenio  efiEecta  of, 
138 

Curie,  Dr.,  on  the  tuberde^sausmg 
effects  of  dro§era,  39 

Ckermak's  huryngosoope,  503 


Darwin  on  the  origin  of  species,  325 
Deformity  of  the  chest,  Dr.  liedbeck 

on,  617 
Diabetes,  Dr. Hale  on  urasMim  in,  166; 

— ,  caused  hy*pk<mphorie  oewl,  641 
Diarrhoea,  nitric  add  and  cpium  in, 

351 ;  — ,  tulphurie  add  in,  640 
Dietetics,  physiologioal,  Dr.  Ludlam 

on,  529 
Z>i0iUiUt,  in  delirium  tremens,  189 ;  ~, 

effects  of,  172 
Diphtheria,  pereUaride  of  iron  in,  136 . 

~,  ehhraiB  qfpoUiuB  in,  640 
Doctors  differ,  133 
DroHTo,  Dr.  Curie  on,  39;  — ,  Vicat 

on,  40;   — ,    Kirsohleger   on,    40; 

Dodoens  on,  41 ;   »,  physiological 


experiments  with,  42;  — ^,  production 

of  tubercles  by,  43 
Drummond,  Mr.,  on  hmnooc^iatfay  In 

Manchester,  202 
Drunkards,  cure  for,  138 
Drury's,  Dr.,  reply  to  8tr  B.  Brodie,  89 
Dublin,    Archbishop   of,   on   medical 

trades*  unions,  680 
Dudgeon,  Dr.,  on  the  effects  of  arsenical 

paper  hangings,  200 


EUOerium  in  eaidiao  dropsy,  639 
Epilepsy,  hromide  and  iodide  of  potoM- 

num  in,  639 ;  — ^  anemic  in,  639 
ExaspM«ting  a  disease,  313 
External  resaedies,  Dr.  Liedbeck  oo, 

616 

Ferrier  on  metaphysics,  548 

Fichte,  philosophical  confession  of,  558 ; 
— ,  nerve  physiology  of,  564 

Firmat  on  ehdidoniumf  47 

Fish -poison  disease,  681 

Flexion,  cure  of  aneurism  by,  316 

Food  and  medicine,  distinction  between. 
Dr.  Ludlam  on,  529 

Fdster  the  spirit-rajser,  334 

Foundation  of  a  new  theory  and  prac- 
tice of  medicine.  Dr.  Inman  on,  107 

Foundling  hospitals,  need  of,  657  ;  — , 
not  productive  of  immorality,  659; 
— ,  the  London,  inutility  of,  659 

Fucui  ve$iculofU8  in  obesity,  515 

Gallavardin,  Dr.,  on  phosphoric  para- 
lysis, 460 
Qelston,  Mr.,  on  altemation  of  medi- 
cines, 392 
Qerson,  Dr.,  on  prosopalgia,  401 
Goding,  Dr.,  on  Uie  law  of  sinulacs,  622 
Goitre,  hiniodide  qf  mercury  in,  642 
Odd,  Dr.  Sharp's  reconstruction  o[,  94 
Gonorrhoea,  homooopathic  treatment  of, 

645 
Grease  and  cow-pox,  identity  oi^  135 
Gull,  Dr.,  on  typhus,  636 
G3rmnA8tic8  in  chorea,  136 


INDEX. 


697 


Hsmorthoidi,  barbaions  treatment  of, 

641 
Hsmostatio,  a  new,  511 
Hale,  Dr.,  on  uremium  in  diabetes,  166 
Hall,  Dr.  Marshall,  ready  method  of 

restoring  animation,  666 
ffaU'Water  in  orarian  disease,  591 ;  — , 

analysis  of,  606 
HeUebare,  effects  of,  172 
Haabold,  Dr.,  death  of,  694 
HempePs  mistranslations,  688 
Hirsch,  Dr.,  core  of  oyarian  cyst  by,  588 
Hirschel,  Dr ,  on  flatulent  asthma,  502 
HomcBOpathic  Congress  described  by 

an  allopath,  171 
Homoepathie  Observer,  the,  513 
Homoeopathy,  in  Spain,  172;    ^,  in 
Manchester,   Roberts,   Rayner   and 
Dmmmond  on,  302 ;  — ,  by  Professor 
Hoppe,  606 ;  — ,  Dr.  Ryan  on,  669 
Hoppe,  Professor,  on  the  behaviour  of 
the  capillary  vessels  in  the  process 
of  cure,  869 ;  — ,  on  homoeopathy, 
606 
Homer,  Dr.,  death  of,  693 
Hughes,  Dr.,  on  poisoning  by  heOa- 
donna,  70, 177 ;  — ,  rationale  of  action 
of  opium  and  helladonnaj  132 ;  — ,  on 
hydroeyanic  add,  441 ;  — ,  and  the 
Medical  Council,  511 
Human  remains,  ancient,  691 
JBydrtutis  in  cancer.  Dr.  Bayes  on,  1 ; 

— ,  in  gonorrhoea,  649 
Hydrocyanic  add^  Drs.  Madden  and 
Hughes  on,  441 ;  — ,  history  of,  442 ; 
— ,  physical  and  chemical  characters 
of,  442 ;  — ,  sources,  compounds  of, 
443 ;  — ,  physiological  action  of,  443 ; 
— ,  physiological  summary  and  the- 
rapeutic inferences,  456 ;  — ,  neurotic 
action  of,  456 ;  — ,  hnmatio  action 
of,  459;   — ,  allied  remedies,  459; 
— ,  pharmaceutical  preparations  of, 
459 ;  — ,  dose  of,  459 
Hypermetropia,  Dr.  Wells  on,  140 

Illegitimate  births  in  different  coun- 
tries, 659 


Infanticide,  Dr.  Ryan  on,  651 
Infinitesimal  doses  and  their  analysis 

by  light,  by  Dr.  Ozanam,  267 
Inman,  Dr.,  foundation  for  a  new  theory 

and  practice  of  medicine  by,  107 
International  Exhibition,  688 
Iodide  of  potassium,  Ricord  on,  135 
Iodine  in  vesical  catarrh,  139 ;  — ,  in 

gastndgia,  515;  — ,  mineral  water 

of  HaU,  598 

Johnson,  Dr.,  on  continued  fever,  637 
Joslin,  Dr.,  death  of,  691 

Kant's  philosophy,  553 

Kidd,  Dr.,  on  fibrous  tumours  of  the 
uterus,  52 

King  and  Queen's  College  of  Phy- 
sicians, stultifying  conduct  of,  158; 
— ,  medical  council  on,  511 

Kleinert  on  Laryngeal  Catarrhs,  243. 

Krenznach- water  in  fibrous  tumours  of 
the  uterus,  57 

Laryngeal  catarrhs,  Kleinert  on,  248 ; 
— ,  plessimetry  in,  247;  — ,  auscul- 
tation in,  248 ;  — ,  causes  of,  248 ; 
— ,  liability  of  singers  to,  248 ;  — , 
cases  of,  251,  254,  256,  259,  262 
264,265 

Laryngoscope,  Czermak's,  503 

LaJthyrus  saHvus,  pathogenetic  effects 
of,  136 

Laycock,  Dr.,  on  the  mind  and  brain, 
571 ;  — ,  on  medical  psychology,  573 

Law  of  similars,  Dr.  Coding  on,  622 

Lead,  poisoning  by,  507 

Lee  on  homoeopathy,  161 

Letter  of  the  law,  314 

Lewes  on  innate  ideas,  555 

Liedbeck,  Dr.,  on  belladonna  as  a  ute- 
rine  remedy,  483;  — ,  on  external 
remedies,  &c.,  615 

Link,  the  missing,  690 

Liver,  action  of  phosphorus  on,  506 

Locke  on  innate  ideas,  551 

Love's  labour  lost,  688 

Loves  of  the  allopaths,  509 


698 


INDEX. 


Lodhm,  Dr.,pli7riologieal  diotetiotligr, 

Lying-ill  baqpitali,  need  of,  667 

McCleUan'f  typhoid  foTer,  3t8 
McGilchrist,  Dr.,oiip0yohological  phy- 
siology, 647 
McLimoat,  Dr.,  on  pelTic  oellnlitiB,  288 
MAdden,  Dr.,  on  kjfdroeyanic  add,  441 
Making  helioTo  to  gire  phytic,  181 
Manchester,  homoeopathy  in,  208 
Maxaton,  Dr.,  reply  to  Sir  B.  Biodieby, 

91 
Materia  nedica,  Dr.  Sharp's  proposed 

reoonstraction  of  the,  94 
Medical  terrorism.  Dr.  Bayes  on,  420 
Medical   trades'   anions,   Archbishop 

Whalely  on,  680 
Medicated  milk,  187 
Mereorial  disease,  Keller  on,  186 
Metaphysics,   inutility  of,   647;    — , 

opposed  to  science,  848 
MiU  on  intohkms,  666 
Mineral  waters,  defence  of  the  nse  of, 

695 
Missing  link,  the,  690 
Moore's  practical  reply  to  Sir  B.  Bro- 

die,  90 
Morell,  on  psychology,  659 ;   — ,  pri- 
mordial instincts  of,  568 
Mascnlar  poisons,  Gande  Bernard  on, 
138 

NankiTcll,  Mr.,  on  ooomU^  62,  868 
Neuralgia,  ehdidaniym  in,  48 ;  — ,  txtU- 

rianaU  of  ammonia  in,  689 
New  year,  a  good,  818 
Nutrients,  direct,  582 ;  — ,  indirect,  686 
Hwf  vomica  antidotal  to  aoouUe,  849 

Ohenty^fiumtvesicuioiUMia  516 
Obituary:  Atkln,  175 ;  — ,  Joelin,  691 ; 

— ,  Teasier,  692;  — ,  Homer,  698; 

--,  Haubold,  694 
Cpium,  neutralised  by  aleokol,  181 ;  — , 

belladontuij  Dr.  Hughes  on,  182 ;  — , 

in  acute  mania,  188 
Orchitis,  homoeopathic  treatment  of,  647 


Ori^  of  organised  befngs,  828 

Ovarian  cyst,  cnre  d,  688 

Oxanam,  Dr.,  on  speetrsl  analyns,  267 


Paralysis,  cured  by  pkotphorwt^  461 ; 
— ^  caused  by  pkotphomM,  464 

Pathological   anatomy,    Claude   Ber- 
nard's appreciatiou  of,  182 

Pattison  on  hydraitU  in  cancer,  8 

Peters  and  SnelUng's  science  and  ait 
of  medicine,  116 

iWo20iim,687 

I%)tphorie  ood,  paralytic  symptoms 
caused  by,  471 ;  — ,  convulsiTe  symp- 
toms caused  by,  472;  — ^  diabetes 
caused  by,  641 

Phosphoric  paralysis,  Dr.  GaUaTudin 
on,  460 

Fho9phortt9,  effects  of,  189;  ',  para- 
lytic symptoms  caused  by,  466;  — ^ 
oonTulsiTe  qrmptoms  caused  by,  468 ; 
— ,  elective  action  on  nerves  of  sen- 
sation  of,  481 ;  — ,  action  on  liver  of, 
606 

Phthisis,  Mr.  Pope  on  the  then^ntics 
of,  18;  — ,  curability  ol^  18;  — ,  An- 
dral  on,  14;  ^,  Epps  on^  14;  ->, 
W>ld  on,  16;  — ,  symptoms  of  first 
stage  of,  16;  — ,  Cotton  on,  16;  — , 
nature  of,  18;  — ,  Tumbull  on,  19; 
— ,  treatment  oC,  20;  — ,  hygienic 
treatment  of,  20;  — ,  McLimonton 
proper  climate  for,  22 ;  — ,  dress  in, 
24;  — ,dietin,24;  ~, medidnes in, 
26;  — ,  Bennett's  treatment  o(  26; 
— ,  TuznbuU's  treatment  of^  26;  — ^ 
Hogg's  treatment  o(  27;  —,  Cot- 
ton's treatment  of,  27 ;  — -,  Churchill's 
kffpopkotphUei  in,  28;  — ,  eod  Uaer 
oU  in,  81;  — ,  homoeopathic  treat- 
ment of,  84;  — ,  Qnain  on  the  hj/po- 
phoipkUes  in,  187;  — ,  Cotton  on 
flee!  in,  164;  ^,  Cotton  on  dUorale  of 
potass  in,  600 ;  — ,  Chambers  on  the 
excreta  of  snakes  in,  609 ;  — ,  Ro- 
gerson  on  the  contagiousness  of, 
888 


INDEX* 


699 


Physiologioal  Dietetics,  Dr.  Lndlam 
on,  529 

Pneumonia,  Lawson  on  blood-letting 
in,  t34;  — ,  Gkdrdner's  accnrate  sta- 
tisticfl  of,  137 ;  — ,  comparative 
qnicknesa  of  cure  under  different 
dilutions,  490;  — ,  medicines  that 
produce,  639 

Pope,  Mr,  on  the  therapeutics  of 
Phthisis,  13 

Propylamine  in  rheumatism,  138 

Prosopalgia,  Dr.  Gerson  on,  401 ;  <— , 
ixrsenic  in,  405;  -~,  heUadonna  in, 
405 ;  — ,  hryoma  in,  407 ;  — ,  cailoa- 
tea  in,  407 ;  — ,  china  in,  408 ;  — , 
eocculvt  in,  418;  — ,  eUoeyidk  in, 
415;  — ,  ignatia  in  416;  — ,  platina 
in,  420 

Psychological  physiology,  Dr.  McGil- 
Christ  on,  547 

Quackery   defined    by   the    Medical 

Times,  321 
Quininej  inefScacy  of,  in  some  agues, 

630 ;  — ,  dangerous  effects  of,  633 

Bational  medicine,  Bushnan  on  the 
narrow  limits  of,  126 

Rayner,  Mr.,  on  homoeopathy  in  Man- 
chester, 302 

Bemote  antiquity,  human  remains  of, 
691 

Bennet  wine,  674 

Rentsch,  Dr.,  on  mutability  of  species, 
328 

ISihemnBiMm,  propylamine  in,  138 

Roberts,  Dr.,  on  homoeopathy  in  Man- 
chester, 302 

Rogerson,  Mr.,  on  the  contagiousness 
of  phthisis,  338 

Roth,  Dr.,  prize  medal  awarded  to,  688 

Roth,  symptoms  of  arsenical  poisoning, 
207 

Riickert's  homcsopathio  clinical  expe- 
rience, 491 

Ryan  on  infanticide,  651 ;  — ,  on  ho- 
moeopathy, 660 


8cnUoninet  Mart{ni  on  the  action  of,  133 
Sofrraoema  in  small-poz,  637 
Sarsaparilla,  Sigmund  on,  135 
Science  and  art  of  medicine,  Peters  and 

Snelling  on,  116 
Sharp,  Dr.,  letter  to  Sir  B.  Brodie  from, 

91 
Shoes,  a  few  w0tds  about,  309 
Siguatera,  681    < 
Silvester's  readl^  method  of  restoring 

animation,  66p 
Similia  similib^  curantur  orcurentur, 

314 
Simplicity  in  therapeutics,  Dr.  Wil- 
liams on,  513 
Singing-masters,  sins  of,  250 
Small-pox,  Bomraeenia  in,  637 
Smith,  Mr.,  answer  to  Sir  B.  Brodie 

by,  90 
Smoking,  angina  pectoris  caused  by, 

685 
Snake-bites,  effects  of,  352 
Snelling  and  Peters'  science  and  art 

of  medicine,  116 
Spain,  homoeopathy  in,  172 
Spectral  analysis,  150;  — ,  Dr.  Ozanam 

on,  267 
Spiral,  law  of  the,  in  relation  to  origin 

of  organized  bemgs,  829 
Spirit-raising,  modem,  334 
Story,  two  ways  of  telling  a,  513 
Stricture,  treatment  of,  648 
Sirtfchnine  and  tooorara  compared,  133; 

•— ,  ta/nmn^  the  antidote  of,  139 ;  — , 

poisoning  by,  173 
Sulphwric  acid  in  diarrhoea,  640 
Suspended  animation,  report  on,  662 
Sydenham  Society's  yearbook  of  medi- 
cine, 131 
Syphilis,  Kreyser  on  vaccination  in, 

136 ;  — ,  Hahnemann's  treatment  of, 

649 
Syphilitic  blood,  inoculation  of  498 
Syphilization,  Idndwurm  on,  135 ; , 

facts  and  fancies  regarding,  527 

Tanghinia^  effects  of,  172 
Tapeworms,  development  of,  138 


700 


INOBX. 


Tufing  4  lionHgopatTite  difpeiittr]r,51S 
Tessier,  Dr.,  death  of,  ^2 
Tetaniu  cured  bj  aetmite,  136 
Therapentios   adT)moed   acddentally, 

844 
Theimpeutics,  the  Medical  €Srcitlar  on 

modenif  677 
TUamum,  Dr.  Siarp's  accoant  of,  100 
Taberde,  diagnoatic  aign  of,  187 
Typhoid,  caaae  of,  636 
Typhoa,  natural  hiatory  of,  686 

C>oi,  effecta  of,  172 

Uranimm  in  diabetea,  Dr.  Hale  on,  166 

Ufleleea  information,  182 

Utema,  Dr.  Kidd  on  fibrooa  tomoara  of, 

62 ;  — ,  oaaea  of  fibroaa  tnmonrB  of, 

68,  69,  60,  61 ;  — ,  barbarona  treat- 
ment of  uloeri  of,  648 

Taocination,  in  ayphilia,  Krejaer  on, 
186;  — t  proCectiTe  power  o£^  140 


Valerianate  of  ammonia  in  aeunlga, 

639 
Venereal  diaeaaea,  Mr.   Yeldfaaan  on, 

644 
Veneaection,  Beau's  disapprorai  of,  13? 
Veratmrn  vtricis,  therapeutic  effecta  d, 

521 
Video  melioria,  proboqae,  deterioim  ae- 

qnor,  134 

WhateJy,     Archbiahop,    on     nttA^mi 

tradea'  uniona,  680 
Williama,  Dr.,  on  cod  Uver  aS,  506; 

— ,  on  aimplicity  in  therapeatica,  613 
Wilaon  on  Hempel*a  miatranalataoos, 

688 
Wifldom  in  high  placea,  168 
Woorara  and  eirychnme  compated,  133 

Teldham,  Mr.,  on  renereal  diaeaaea, 

644 
Yellow-fever,  Dr.  Crockery  on,  184 


END   OF  VOL.   XX. 


PrinUd  by  W.  Davy  ft  8ok,  8,  GUbert-itnet,  Oxfoid-Btreet,  W. 


HI